HEENA RAIS | Ziauddin Medical University (original) (raw)

Papers by HEENA RAIS

The professional medical journal, Dec 10, 2018

To determine the knowledge and practice of parents of children with Asthma. Introduction: Asthma ... more To determine the knowledge and practice of parents of children with Asthma. Introduction: Asthma is a disease characterized by recurrent attacks of breathlessness and wheezing typically begins in early childhood with an earlier onset in males than females. Life time prevalence of asthma is 13.5% and current asthma prevalence of 9.3% among children <18 years. According to WHO 15 million disability adjusted life years (DALY) are lost annually due to Asthma. Prevalence of asthma in Pakistani children is 19%. Due to rapid industrialization and urbanization prevalence of Asthma has increased from 9 t0 20% during the last decade. This study was conducted to assess the extent of knowledge and practice which are associated with the control of Asthma. Methodology: It was descriptive cross sectional study conducted in ED, Pediatric unit CHK. Sampling was convenience and the study duration six months. One hundred and twenty parents of asthmatic children from 4-13 years of age were selected. Results: Average age of the children was 7.69±2.58 years (95% CI: 7.23 to 8.16) and average duration of illness was 3.08±2.0 years (95% CI: 2.69 to 3.45). Minimum duration was two years and maximum ten years. One hundred and four mothers (86.7%) and 16 fathers(13.3%) participated in the study. Over all asthma knowledge and practice of parents was adequate in 20(16.7%), inadequate in 46(39.3%) and average in 54(45%). Conclusions: Asthma knowledge especially about the management is inadequate and practices are also inappropriate in the urban population of Karachi.

The Professional Medical Journal

Objective: To assess the spectrum of measles during COVID-19 era among children. Study Design: Co... more Objective: To assess the spectrum of measles during COVID-19 era among children. Study Design: Cohort study. Setting: Department of Pediatric, Dr. Ziauddin University Hospital, Kemari Karachi. Period: February 2019 to February 2021. Material & Methods: Clinically diagnosed measles children of either gender aged between 3 months to 5 years admitted to our tertiary care center in the 2 years marked period of the study were analyzed. Measles was labeled as the presence of high grade fever (>104 0F) and maculopapular rash. Medical history was noted and clinical examination was performed in all children. Necessary laboratory investigations like complete blood count and chest X-rays (CXR) were evaluated. All patients were treated as per standard institutional protocols. Outcomes were noted in terms of successful discharge or expiry. Results: In a total of 88 children, 55 (62.5%) were male. The mean age was 1.61±1.12 years while 49 (55.7%) children were aged ≤ 1 year. Twenty four (27.3%...

Cureus

To compare the WHO cutoff of the mid-upper arm circumference (MUAC) with the weight for height z-... more To compare the WHO cutoff of the mid-upper arm circumference (MUAC) with the weight for height z-score (WHZ) in different age groups of children (6 months to 59 months of age) with acute malnutrition in Pakistan. Methodology A cross-sectional study was carried out in the pediatric unit of Ziauddin Medical University and Hospital on malnourished children from six to 59 months of age to compare two different indices of malnutrition, MUAC and WHZ. A total of 450 children with WHZ of <-2SD and <-3SD were included in the study after excluding children with failure to thrive due to chronic illness, congenital defects, and immune deficiencies/malabsorption. Results The study revealed a significant mean difference in weight, height, and MUAC among the participants (0.030, 0.053, and 0.02). The sensitivity of MUAC at <11.5 cm was highest in the 12-24-month age group with a decline at 24-48 months while specificity was highest at six to 12 months of age, which shows a mixed response. Conclusion The result revealed variation in the cutoff value of MUAC in different age groups; the best specificity of MUAC was found at six to 12 months of age and the best sensitivity at 12-24 months of age.

Pakistan Journal of Medicine and Dentistry, 2021

Background: Dengue is the commonest arboviral disease that is endemic in our country. Electrolyte... more Background: Dengue is the commonest arboviral disease that is endemic in our country. Electrolyte imbalance is commonly encountered in this disease. There had been only a few worldwide research studies investigating at all the metabolic parameters of dengue infection. Therefore, the study aimed to assess the electrolyte imbalance and its correlation with the severity of dengue fever in pediatrics. Methods: This cross-sectional study was carried out in the Pediatric Department of Ziauddin Hospital over 18 months. Diagnosed patients through detection of Dengue NS1 antigen or serology of dengue fever from 6 months to 18 years of age were enrolled and their history, hematological and electrolyte values (sodium, potassium, calcium, magnesium, and phosphate) were analyzed. Data was analyzed by SPSS and a Chi-squared test was used to compare the frequency of electrolyte disturbances between patients. A p-value <0.05 was considered statistically significant. Results: A higher incidence of dengue fever was observed in the younger age group (81)54 %. The majority of the patients showed mild hyponatremia 82(54.6%), mild hypokalemia 63(42%) and hypocalcemia 96(64 %). Hypophosphatemia 98(65.3 %) (p-value 0.045) was found more compared to hypomagnesemia 22(14.6%). Fever was observed in 100% of patients along with body aches 90(60%), drowsiness 31(20.7%) and abdominal pain 16(10.7%). We also found leucopenia 48(32%) and thrombocytopenia 127(84.6%), whereas hematocrit 30(20 %) was also raised. Conclusion: Majority of electrolytes (sodium, potassium, calcium and phosphate) were found decreased in dengue patients. However, hyponatremia (p=0.001) and hypophosphatemia (p=0.045) were significantly associated to the severity of dengue.

INTERNATIONAL JOURNAL OF ENDORSING HEALTH SCIENCE RESEARCH (IJEHSR), 2021

Background: The treatment of 21st Century XDR typhoid fever is potentially life-threatening and e... more Background: The treatment of 21st Century XDR typhoid fever is potentially life-threatening and endemic in Pakistan, presents a therapeutic challenge as currently there is no universal treatment strategy whether to use monotherapy with meropenum or a combination of meropenum and azithromycin. Our objective was to compare the efficacy of both therapies in complicated XDR typhoid fever in children, regarding defervescence, bacterial clearance time, resolution of complications, hospital stay, and relapse. Methodology: This open-label randomized comparative trial was conducted over 18 months at the Department of Pediatrics, Kemari, Clifton and North Campuses, Ziauddin University Hospital Karachi, Pakistan, in which children (aged 6 months to 18 years) with positive blood culture for XDR enteric fever, were recruited into 2 parallel treatment groups (meropenum) and (meropenum+azithromycin combined). Primary outcome viz clinical improvement (resolution of defervescence, complications, an...

Journal of Pharmaceutical Research International, 2021

Background: Community acquired pneumonia (CAP) is a common cause of childhood morbidity, attribut... more Background: Community acquired pneumonia (CAP) is a common cause of childhood morbidity, attributed to every 1 in 500 hospitalization of children under the age of 5 years. While science made therapeutic advancements to battle CAP, the pathogens too have acquired resistance to many drugs. In this fight for dominance, Ampicillin plus Gentamicin and 3rd Gen Cephalosporins are nowadays the cornerstone of treatment. However, their efficacy varies in different parts of the world owing to differing levels of drug resistance. Objective: To compare the effect of Ampicillin and Gentamicin vs. third generation cephalosporin in treatment of severe community acquired pneumonia. Methodology: This Randomized Controlled Trial was conducted at the Dept. of Pediatrics (Ziauddin University Hospital) upon a sample of 74 patients (in two equal groups) of either gender, aged 2 months to 5 years, presenting with CAP. After taking written informed consent, data was recorded onto a pre-structured questionna...

The Professional Medical Journal, 2018

Objective: To determine the knowledge and practice of parents of children withAsthma. Introductio... more Objective: To determine the knowledge and practice of parents of children withAsthma. Introduction: Asthma is a disease characterized by recurrent attacks of breathlessnessand wheezing typically begins in early childhood with an earlier onset in males than females. Lifetime prevalence of asthma is 13.5% and current asthma prevalence of 9.3% among children <18years. According to WHO 15 million disability adjusted life years (DALY) are lost annually due toAsthma. Prevalence of asthma in Pakistani children is 19%. Due to rapid industrialization andurbanization prevalence of Asthma has increased from 9 t0 20% during the last decade. Thisstudy was conducted to assess the extent of knowledge and practice which are associated withthe control of Asthma. Methodology: It was descriptive cross sectional study conducted in ED,Pediatric unit CHK. Sampling was convenience and the study duration six months. One hundredand twenty parents of asthmatic children from 4-13 years of age were selected...

PubMed, Jun 1, 2023

Chronic granulomatous disease (CGD) is a rare, primary immunodeficiency disorder that occurs due ... more Chronic granulomatous disease (CGD) is a rare, primary immunodeficiency disorder that occurs due to a defective NADPH (Nicotinamide Adenine Dinucleotide Phosphate) oxidase system. Due to the varying clinical presentation and symptom overlap with other conditions, CGD can often pose as a challenge for paediatricians. This case report describes the approach to diagnosis and management of an infant affected by CGD, with liver abscess.

Transfusion Clinique et Biologique

The Professional Medical Journal, Mar 10, 2020

… In developing countries, typhoid fever is mostly seen due to poor public health and low socioec... more … In developing countries, typhoid fever is mostly seen due to poor public health and low socioeconomic indices. Currently Pakistan is going through the largest outbreak of XDR typhoid fever which has resulted in increased morbidity and mortality especially in pediatric population. Objectives: To see the pattern of extended drug resistant typhoid fever in different areas of Karachi. Study Design: Cross sectional study. Setting: Department of pediatrics, Ziauddin Hospital (KDLB, NORTH, CLIFTON campus). Period: 6 months from October 2018 till March 2019. Material & Methods: All patients who presented with history of fever for 3 or more days with signs and symptoms of typhoid fever were recruited. For data collection a self-structured questionnaire was used. Age, gender, socioeconomic status, personal hygiene, water supply and sanitation were taken into account. Blood samples were sent for cultures. Salmonella isolates were tested for antibiotic susceptibility. Tested antimicrobials were ampicillin, TMP/SMX, cefixime, ceftriaxone, aztreonam, ciprofloxacin, azithromycin, meropenem. For data analysis SPSS version 22 was used. Results: Out of 415 patients, 235 had culture proven typhoid fever. Salmonella typhi was isolated in 94.4%of the patients and salmonella paratyphi was isolated in 5.57%. Of the 235, Males were 62% and females were 42.4%. Major determinants associated with acquiring salmonella infection were young age (74%), male sex (62%), middle and low socioeconomic status (83.8%), living in west district of Karachi (54.9%) and drinking line water (79.2%). Extended drug resistance was encountered in 69.5%. Most of the isolates were sensitive to meropenem and azithromycin (96.7 %, and 95.5% respectively). Ceftriaxone resistance was prevelant in all three districts of Karachi (p value <0.001), in different age groups 1-6yrs (98%), 7-12 yrs(91%), 13-18 yrs (100%) and in males(58%) predominantly. Conclusion: Karachi is facing an outbreak of XDR typhoid fever. Risk of acquiring extended drug resistant typhoid fever is increased in younger age group 1-6 yrs, males, west district of Karachi and poor socioeconomic status. Drinking unboiled water is identified as one of the major culprits. Actions should be taken at all health care levels to monitor the judicious use of antibiotics, and preventive strategies like safe water supply, improved sanitation along with typhoid vaccination are suggested to overcome this outbreak.