We report a successful closure of large patent ductus arteriosus (PDA) in a low-birth weight preterm neonate using an ADO IIdevice for the first time in AFIC/NIHD Rawalpindi. A hemodynamically significant PDA in a preterm neonate carries anincreased risk of morbidity, including chronic lung disease, necrotizing enterocolitis and renal impairment. After the failure ofmedical therapy, successful, timely and safe transcatheter closure of PDA using appropriate equipment is a milestone inmanaging PDA in preterm neonates.
Abstract Pseudomonas aeruginosa is one of the most antibiotic-resistant and opportunistic pathogens in immunocompromised and debilitated patients. It is considered the cause of most severe skin infections and is frequently found in hospital burn units. Due to its high antibiotic resistance, eliminating P. aeruginosa from skin infections is quite challenging. Therefore, this study aims to assess the novel in vitro antibacterial activity of methylene blue using a 635-nm diode laser to determine the effective power and energy densities for inhibition of P. aeruginosa . The strain was treated with various concentrations of methylene blue and 635-nm diode laser at powers of 300 mW/cm 2 and 250 mW/cm 2 . The diode laser’s potency in the photo-destruction of methylene blue and its degradation through P. aeruginosa were also evaluated. Colony-forming unit (CFU)/ml, fluorescence spectroscopy, optical density, and confocal microscopy were used to measure the bacterial killing effect. As a result, the significant decrease of P. aeruginosa was 2.15-log 10 , 2.71-log 10 , and 3.48-log 10 at 60, 75, and 90 J/cm 2 after excitation of MB for 240, 300, and 360 s at a power of 250 mW/cm 2 , respectively. However, a maximum decrease in CFU was observed by 2.54-log 10 at 72 J/cm 2 and 4.32-log 10 at 90 and 108 J/cm 2 after 300 mW/cm 2 of irradiation. Fluorescence images confirmed the elimination of bacteria and showed a high degree of photo-destruction compared to treatment with methylene blue and light alone. In conclusion, MB-induced aPDT demonstrated high efficacy, which could be a potential approach against drug-resistant pathogenic bacteria. Key points • Combination of methylene blue with 635-nm diode laser for antibacterial activity. • Methylene blue photosensitizer is employed as an alternative to antibiotics. • aPDT showed promising antibacterial activity against Pseudomonas aeruginosa.
Objective: To determine the distribution of microorganisms causing urinary tract infections in children.Study design: Descriptive cross sectional study.Place and Duration of study: Study was conducted from October 2015 to April 2016 at Pediatric Department, Combined Military Hospital Multan.Patients and Methods: One hundred and fifty one Children between age groups >28 days to 12 years of both gender with UTI were included in the study. Urinary tract infection was diagnosed on the basis of a positive urine culture report. Among positive urine culture results, the frequency of different microorganisms was calculated. Data was analyzed using SPSS version 20. Descriptive statistics were used to calculate qualitative and quantitative variables. Qualitative variables like gender, microorganisms were measured as frequencies and percentages. A quantitative variable like age was measured as mean and standard deviation. Results: Age range in this study was from > 28days to 12 years with a mean age of 4.149 ± 2.92 years. 38 (25.2%),64 (42.4%),49 (32.5) patients were from age group 29 days to 1 year, >1 year to 5 years and >5 years to 12 years respectively. Out of 151, 58 (38.4%) patients were males and 93 (61.6%) females. E. coli was seen in 106 (70.2%) patients. Klebsiella was seen in 22 (14.6%) patients. Proteus was seen in 15 (9.9%).Conclusion: Frequency of microorganisms causing urinary tract in children in this study was not significantly different from that of other developing and developed countries.
Objective: To determine the spectrum of Grown up Congenital Heart (GUCH) at Armed Forces Institute of Cardiology/National Institute of Heart Dieases.
Study Design: Descriptive cross sectional study.
Place and Duration of Study: Paediatric Cardiac Surgery and Obstetric department of Armed Force Institute of Cardiology/National Institute of Heart Diease, Rawalpindi Pakistan, from 2011 to 2021.
Methodology: It was a descriptive cross sectional study conducted at Paediatric Cardiology, Paediatric Cardiac Surgery and Obstetric department of AFIC/NIHD. After taking informed consent, a total of 1344 patients fulfilling inclusion and exclusion criteria with non probability consecutive sampling were enrolled in study from 2011 to 2021. Diagnosis, transthoracic echocardiography findings, procedural details (cardiac catheterization/cardiac surgery/obstetrical intervention) and outcome of all patients were noted.
Results: Out of 1344 patients, 700 patients had cardiac catheterization. Among patients who underwent cardiac cath, 304(43%)were males and 396(56.6%) were females. 279(39%) diagnostic and 421(61%) cardiac interventional procedures were done.Most common procedure done was ASD device closure in 227(32%) patients. Complications were seen in 29(4%) patients and mortality in 3(0.4%) patients. There were a total of 188 patients who underwent congenital cardiac surgery. Out of patients who underwent congenital cardiac surgery procedures, 96(51%) were male and 92(49%) were female patients. Major complications were observed in 51(25%) patients and the mortality was 11(5%).There were total of 456 patients in obstetrics department. Out of 456 patients, 54(11%) were with congenital cardiac lesions .The most common defect was VSD 27(6%)patients and dilated cardiomyopathy (DCM) 27(6%) patients followed by ASD and TOF. The maternal and fetal mortality was12(2.7%) and 22(5.5%) respectively.
Conclusion:With immense advancement in diagnosis and management of congenital cardiac diseases, a significant number of patients remain undiagnosed and untreated till the time they present as GUCH. Most common presentation is ASD which is mostly manageable by transcatheter intervention, however late presentation carries a risk of complications like pulmonary hypertension.
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