Factors associated with hydrocarbon ingestion in children

OBJECTIVE: To investigate the types of hydrocarbon ingested by children and identify factors associated with hydrocarbons ingestion. PATIENTS AND METHODS: It was a hospital based case control study in which medical records of sixty seven children with hydrocarbon ingestion, admitted through emergency department between January 2001 to December 2005 of Aga Khan Hospital were reviewed. Variables such as age, sex, types of hydrocarbons, amount ingested, socioeconomic status, family size, number of children, type of containers, trend of ingestion during hot weather, length of stay at hospital along with the outcomes were evaluated. RESULTS: Out of 67 patients, 53 (79%) were male and 14 (21%) were female. Majority of children 36 (54%) were between the ages 2-5 years. Kerosene oil 59 (88%) was the most commonly ingested hydrocarbons. Socioeconomically 48 (71%) children belonged to lower middle class. Children with large family size (\u3e or = 3 siblings/family) were more commonly affected. Hydrocarbon were mostly 41 (61%) stored in beverages and mineral water bottles. The accident occurred in 43 (65%) during summer, whereas 34 (56%) patients had presented with fever and cough. Consolidation of lungs was found in 38 (56%) cases. Majority 53 (79%) of the patients were discharged from the hospital within the first 24 hours of admission. Male, age \u3c 2 years, large family size, poor socioeconomic status, hot weather (afternoon and summer vacations), kerosene oil, unsafe containers were the major factors loading to hydrocarbon ingestion in this study. CONCLUSION: There is a need for strategic planning with parent awareness programs to reduce the hydrocarbon poisoning in our children

Unintentional, paediatric domestic injury in a semi rural area of Karachi.

OBJECTIVE: To identify the characteristics of unintentional domestic injury in children living in a semi-rural area of Karachi. METHODS: This retrospective descriptive study was carried out at a private hospital located at the northern outskirts of Karachi, Pakistan, from January 2005 to January 2007. We enrolled 271 out-patient children of either gender with a positive injury history. A questionnaire inquiring socio-demographic characteristics, timing of injury, monthly variation, injury pattern and factors was filled out. Descriptive analysis and Chi-square test were applied to find out the statistically significant differences. RESULTS: Among the 271 patients, the male-to-female ratio was 1.2:1. Fall from height 145 (54%) or at the same level 52 (19%) was the commonest form of domestic unintentional injury across all ages. Children younger than 2 years of age, 140 (52%), were more prone to injuries, with 49 (51%) having fallen from the lap. Cuts with sharp domestic utensils were noted in 19 (6%), while 15 (6%) had burns. Submersion in underwater tank was noted in 20 (7%) cases and poisoning in 7 (3%). Majority of the injured children were from the low socio-economic stratum and more injuries, 194 (72%), were reported during the summer months. CONCLUSION: Male children are more prone to suffer unintentional domestic injuries especially during summer vacations. Fall was the commonest pattern noted

Mothers’s education and working status; do they contribute to corrosive poisoning among paediatric patients of Karachi, Pakistan?

Objectives: To determine the causative factors behind corrosive poisoning in children like effect of working mothers, their educational status, financial background, family size and number of siblings. Methods: The multi-centre, prospective, case series of all paediatric patients presenting to the Emergency Department of the National Institute of Child Health and the Aga Khan University Hospital, Karachi from August 2008 to July 2009 is presented. It comprised all paediatric patients with a history of corrosive poisoning at the two hospitals. SPSS 20 was used for statistical analysis. Results: Out of 105 cases, 56(53%) related to the private-sector Aga Khan University Hospital, and 49(47%) to the public-sector National Institute of Child Health. Of the total, 82(78%) were in 1-5 age group; 61 (58%) were males; and 44(42%) were females. While 59 (56.2%) mothers were educated, only 21 (20%) were working. Of the 46 (43.8%) non-educated mothers, 20 (19%) were working. The type of poison was alkali in 81(77%) cases, acid in 23(22%). The corrosive varied from liquid in 80(76%) cases to powder/gel/semi-solid form in 25(24%) exposures. Besides, 65 (61.9%) families had 3 or more siblings, and the age of siblings was less than 10 in 60 (57.14%) cases, In 34 (32.38%) cases, the chemical were kept in the original container, while in 71 (67.61%) cases other commonly used and familiar containers were used to store these chemicals. Kitchen was the most common place with 51 (48.57%) cases. The time of incident was afternoon in 51(48.57%) cases. Majority cases (n=23; 21.9%) occurred in October. Conclusion: There are multiple contributory factors in corrosive exposure among children rather than the mother\u27s working status and her educational background

Attitudes towards child restrains and seat belts usage in the learned population of Karachi, Pakistan.

BACKGROUND: Motor vehicles crashes (MVCs) are the leading cause of injury relatedmorbidity and mortality in developed countries. Recent evidence proves that properly used child seat belts can dramatically reduce the risk of severe and life-threatening injury from MVCs. There are rarities of thought and inspiration regarding the use of child seat belts in our society and region, therefore we lack of data regarding factors and paucity of usage of child seat belts in motor vehicles.This study aimed to assess the knowledge and attitudes of child seat belt usage among the educated population in Karachi, Pakistan. METHODS: Altogether 304 employees were investigated. They were employees of Aga Khan University who were using their cars and having children younger than 10 years old. A cross sectional observational study was designed, and a 36-item questionnaire in English was used to collect data on participants\u27 demographic details, designation, educational level, economic status, validity of driving license, number of children and cars, availability of adult seat belts and child seat belts along with their functionality, awareness, knowledge and attitude toward its use, and reason of not using these devices. SPSS version 20 for Windows was used to analyze the data and the Chi-square test was used. RESULTS: Totally 290 participants were recruited with a response rate of 72% (212). Of 212 participants, 126 (59%) were male. 154 (72.6%) participants had valid driver licenses, and 154 (72.6%) had adult seat belts in their vehicles. Only 32 (15%) reported regular use of adult seat belts. Although 168 (79.2%) participants had some knowledge about child restrains (CRs), only 65 (22%) had CRs in their cars. Eighty-two (38.7%) participants got the knowledge about CRs and seat belts from media. Mothers were more concerned about the use of CRs than fathers. Only 14 (6.6%) parents were found to use both adult and child seat belts all the time. Of the 157 parents who did not us use CRs, 42 considered unnecessary, 35 lacked relevant knowledge. But 15 parents used CR against their children\u27s wills. CONCLUSIONS: The pattern of CR usage among the employees at Aga Khan University, Karachi is dictated by the unavailability of CR, followed by ignorance, inconvenience, and nonacceptance by their children. The important issue of CR has consistently been ignored over the years and it has never gained enough popularity in Pakistan

Multiple intracellular signal transduction pathways mediating inward current produced by the neuropeptide, achatin-I

博士論文 (Doctoral dissertation)doctoral thesi

Chediak-higashi syndrome

Chediak Higashi Syndrome is a rare inherited autosomal recessive disorder of immune system. Susceptibility to infection due to phagocyte dysfunction ranges from recurrent skin infection to over whelming fatal systemic infection. A five years old male child was admitted on 31st March 2006 with the complaints of pallor, fever & ear discharge for 6 month. He was treated by several medications but had temporary relief. The ear discharge was bilateral, foul smelling and of yellowish color. Past history was significant with episodes of abscess involving the different parts of body. Myeloid precursors shows giant, purple stained granules mainly in metamyelocytes, band cells and mature neutrophils