A pattern of antibiotic drug resistance of Salmonella Typhi and Salmonella Paratyphi among children with enteric fever in a tertiary care hospital in Lahore, Pakistan.

AIM: To establish the pattern of antibiotic resistance and assess the frequency of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Salmonella Typhi and Salmonella Paratyphi among children with enteric fever. METHODS: This cross-sectional study was carried out in the Department of Pediatrics, Sharif Medical City Hospital, Lahore, from July 2020 to January 2021. The study involved patients aged between 0 to 15 years who attended our outpatient department or were admitted to the ward with the suspicion of typhoid fever. A convenience sample of patients with blood cultures positive for S. Typhi and S. Paratyphi was enrolled. RESULTS: Of the 105 participants, 70 (66.7%) were male. The mean age was 8.48±4.18 years, and the most affected age group was 6-10 years (n=46, 43.8%). Among the cultured organisms, 95 (90.5%) isolates were S. Typhi and 10 (9.5%) were S. Paratyphi A. Antibiotic resistance was highest against ampicillin (n=91, 86.7%), and all of the isolates were sensitive to imipenem and meropenem. Twenty-three (21.9%) cultured organisms were MDR and 54 (56.8%) were XDR. CONCLUSION: An alarming antibiotic drug resistance pattern was observed among children with enteric fever in Lahore. The lowest resistance was noted for azithromycin, meropenem, and imipenem. Our findings warrant the immediate implementation of tailored antibiotic stewardship and infection control strategies.

Assessment of upper to lower body segment ratio and arm span to height difference in school children of Lahore.

Objective: To assess upper-to-lower body segment ratio and arm span to height difference in children. METHODS: The descriptive, cross-sectional study was conducted in schools of the Raiwind area near Lahore, Pakistan, from November 2021 to May 2022, after approval from the ethics review committee of the Sharif Medical and Dental College, Lahore. The sample comprised children aged 3-14 years whose height fell between the 3rd and 97th centiles on the Centers for Disease Control and Prevention height-for-age chart. Data was analysed using SPSS 23. RESULTS: Of the 1,836 children, 906(49.3%) were boys with mean age 8.45±3.02 years, mean height 132.54±17.78cm and mean weight 32.0±13.72kg. Besides, there were 930(50.7%) girls with mean age 8.26±3.21 years, mean height 130.41±18.03cm and mean weight 31.09±13.88kg. The mean upper-to-lower body segment ratio in boys was 1.06±0.15 at age 3 years, 0.96±0.08 at age 7 and 0.94±0.08 at age 10. The mean upper-to-lower body segment ratio in girls was 1.08±0.08 at age 3 years, 0.98±0.07 at age 7, and 0.92±0.10 at age 10. The mean arm span to height difference in boys was -1.81±5.83 and in girls -4.09±5.77. Conclusion: Upper-to-lower body segment ratio and arm span to height difference may help paediatricians in the evaluation of disproportionate short stature.

Caudal Regression Syndrome - a rare congenital disorder: A case report.

Caudal regression syndrome is a rare anomaly that is characterised by impaired development of the lower half of the body. This includes absent or abnormal development of lumbar and sacrococcygeal segments. Other associations of this disease include abnormalities of genitourinary tract, gastrointestinal tract, and cardiopulmonary system. The exact aetiology is unknown and is believed to be multifactorial but maternal diabetes is significantly linked to this rare disorder. We report the case of a new-born baby boy with caudal regression syndrome, hyperbilirubinaemia and patent ductus arteriosus.

Sleep disturbances in children with autism spectrum disorder in Lahore, Pakistan; a cross-sectional study.

OBJECTIVE: To assess the frequency of insomnia and other sleep disturbances among children with autism spectrum disorder. METHODS: The descriptive cross-sectional study was conducted in Lahore, Pakistan, from May to August 2019, after approval from the ethics committee of Sharif Medical and Dental College, Lahore. It comprised children aged 6-12 years pre-diagnosed with autism spectrum disorder who were enrolled from 3 institutions and an out-patient department of a tertiary care hospital. Sleep disturbance scale for children was used for data-collection, and the parents were asked to fill it out. Data was analysed using SPSS 23. RESULTS: Of the 93 subjects, 71(76.3%) were boys and 22(23.7%) were girls, and 58(62.4%) were aged 6-8 years. Overall, 37(39.8%) children had at least one type of sleeping disorder; the most common being insomnia 24(25.8%), and the least common being sleep breathing disorders 4(4.3%). CONCLUSIONS: Nearly 40% children with autism spectrum disorder had sleep disorders, and insomnia was the most common.

Congenital Lobar Hyperinflation - A rare anomaly misdiagnosed as bronchiolitis: A case report.

Congenital Lobar Hyperinflation is an overinflation of one or more than one lobes of the lung and is caused by an abnormal development of broncho-pulmonary segment. We report a case of a 2-month-old female who presentedin outpatient department with complaints of fever, cough and difficulty in breathing. This case was seen in January, 2018. Congenital Lobar Hyperinflation was diagnosed on chest x-rays and Computed Tomography (CT ) scan. Immediate surgical excision (lobectomy) of the affected lobe was conducted.