DEPARTMENT OF PAEDIATRICS MEDICINE UNIT- I

King Edward Medical University houses the country’s premier Pediatrics Department. It was established in a small room in Outpatient Department of Mayo Hospital Lahore in 1948 by late Prof. S.M.K. Wasti who later assumed charge as its first professor in 1953. In 1956, the department of Pediatrics was shifted to new premises, which was constructed by donation by Rai Bahadur Amarnath given in 1946. The department was expanded to a new block in 1982 with increased bed strength to 110. The Children’s Medical Specialty Block became operational in 2010 and housed Pediatric emergency, Neonatal and Pediatric ICU and other pediatric sub-specialties. A second unit was created in 2004.

Our goal is to impart standard child health services by

• Producing medical graduates, post-graduates and pediatrician by virtue of quality education & training;
• Contemporary research in the field of pediatrics; and
• Evidence-based preventive and curative services.

OUR VALUES

To achieve our objectives, we, at the department of Pediatrics Unit-I, are committed to work on these core values:

Quality, Innovation, Team work, Service, Integrity and Compassion.

POST-GRADUATE PROGRAMS

FCPS, Pediatric Medicine

MD – Pediatric Medicine

FCPS – Neonatal Pediatrics

FCPS – Pediatric Infectious Diseases

Diploma in Child Health

UNDER-GRADUATE PROGRAMS

MBBS – Pediatrics

Pediatric Nursing

EDUCATIONAL ACTIVITIES (2017)

• Ongoing series of CME workshops on Helping Baby Breathing Initiative
• Foreign Faculty Lecture on Pediatric Infection Control (Prof. Mobeen Rathore)
• Foreign Faculty Lecture on Neonatal Hypothermia (Prof. Irfan Ul Haq Cheema)
• Foreign Faculty Workshop on use of Bubble CPAP in Neonates (Dr. Musaddaq Inayat)
• Pediatric Lung Ultrasound workshop (Collaboration with AKU, Karachi)
• TOACS for FCPS, MCPS, IMM, Pediatrics
• Thalassemia Day with the children of Thalassemia
• Diabetes Day & awareness program
• Training on Clinical Management of Dengue Fever
• Review seminar on Thalassemia Chelation Guidelines
• Workshop on Basics of Mechanical Ventilation
• Workshop on Pediatric Oncological Emergencies
• Faculty & Residents’ participation in National & International Pediatric Conferences & Symposia.

RESEARCH (PAST FIVE YEARS)

PUBLICATIONS

• Characteristics of Dengue Hemorrhagic Fever in Children in 2011 & 2013 Outbreaks A Comparison (Pak Pediatr J 2018; 42(2))
• Spectrum of Joint deformities in children with Juvenile Idiopathic Arthritis (J Coll Physicians Surg Pak 2018; 28(6):470-73).
• Basics of Mechanical Ventilation-A review (Pak Pediatr J 2018; 42(1): 3-15).
• Loss-of-function mutations in ADCY3 cause monogenic severe obesity (Nature Genetics 2018; 50:175-9)
• Role of melatonin in management of hypoxic ischemic encephalopathy in newborns: A randomized control trial (J Pak Med Assoc 2018; accepted for publication)
• Latent tuberculosis infection (LTBI) in children less than 12 years of age in a tertiary care centre, Lahore, Pakistan (Pak Pediatr J 2017; 41(4): 208-11)
• OptiCard: An inexpensive and portable method of bedside direct fundoscopy (J Coll Physicians Surg Pak 2017;27:719-21.
• Frequency of benign blood disorders in children. A bone marrow based analysis at a tertiary care hospital (Pak J Med Health Sci 2017; 11(3): 898-901)
• Spectrum of Pancytopenia in Children Based upon Bone Marrow Study (Pak J Med Health Sci 2017; 11(2):661-3)
• Hematological Diagnosis in Children: Results of a 10 year Bone Marrow Examination (Pak J Med Health Sci 2017; 11(2): 664-6)
• Immune memory and anamnestic immune response in children, 1-10 years after primary hepatitis B vaccination (J Ayub Med Coll Abbottabad 2016; 28(4):715-7)
• Knowledge and perception of hand hygiene among house officers in a tertiary health care centre in Punjab, Pakistan (Ann King Edward Med University 2016; 22(3):185-90)
• The validity of hematologic markers for diagnosis of neonatal sepsis (Ann King Edward Med Uni 2015;21(4):240-6)
• Genetic variants in LEP, LEPR, and MC4R explain 30% of severe obesity in children from a consanguineous population (Obesity 2015; 23: 16871695)
• Chikungunya fever among children presenting with nonspecific febrile illness during an epidemic of dengue fever in Lahore, Pakistan (Merit Research
• Journal of Medicine & Medical Sciences 2015; 3(3):69-73)
• Effect of formulated Gluten free flour on the nutritional status of celiac patients (J Nutr Ecol Food Res 2014;2(1): 54-63)
• Vaccine-induced anti-HBsAb level in 1-5 years-old malnourished children (Infect Dis J 2014; 23(1): 654-6)
• Experience of Malaria in children; A field hospital study (East Mediterr Health J 2013; 19(7):613-6)

PROJECTS COMPLETED

1. Effect of intermittent Kangroo Mother care in improving vital physiological parameters of preterm newborn
2. Etiology of Congenital Hypothyroidism
3. Iatrogenic or Medical Error; Make not two sorrows of one
4. Comparison of salbutamol delivered by a metered dose inhaler with spacer versus nebulizer in asthmatic children presenting in Pediatric emergency section
5. Comparison of effectiveness of nebulization with 3% hypertonic saline vs. 0.9% saline among the children presenting in emergency with moderate to severe acute bronchiolitis
6. Comparison of mean duration of Rota Virus diarrhea after administration of zinc sulphate versus control
7. Frequency of neonates on exclusive breast feeding and comparison of the growth in terms of gain in length and weight of breast fed compared to formula fed infants
8. Etiology of Congenital Hypothyroidism, target height calculation in Lahore: Are we doing it right, Ovarian and Uterus volume from birth to puberty: A local norm leptin deficiency in severe obese children.
9. Mean duration of Rota Virus diarrhea in children after admission of first dose of nitazoxanide
10. Comparison of Growth Parameters of Preterm Neonates with and without Zinc Supplementation
11. Comparison of oral versus intramuscular cobalamin for treatment of nutritional megaloblastic anemia
12. Comparison of safety of desferrioxamine with oral chelating agent deferasirox in Beta thalassemia major patients.
13. Frequency of complete EPI vaccination in patients coming to tertiary care OPD
14. Diagnostic Accuracy of modified TAL’s score in assessment of Hypoxemia in infants with Acute Bronchitis
15. Role of 4% Chlorhexidine in reducing the incidence of omphalitis and neonatal mortality when used on the umbilical cord of the newborn
16. Specificity and sensitivity of USG in diagnosis of pneumonia in children
17. Comparison of emollient therapy vs standard care in preterm and low birth weight neonates presenting in a tertiary care hospita
18. Role of home make CPAP in management of respiratory distress in neonates
19. Mean Time to Return to Normal Stool with Probiotic Lactobacillus GG versus Placebo during management of children presenting with Acute Watery Diarrhea
20. Accuracy of the CRIB II for the prognosis of severely ill preterm neonates
21. Frequency of UTI in children presenting with fever without fever under 5 years age
22. Risk factors associated with morbidity in pattern of Acute Bacterial Meningitis
23. Role of probiotics in prevention of neonatal necrotizing enterocolitis (NEC) in premature infants
24. Dexamethasone in the treatment of neonatal meningitis: a randomized controlled trial
25. Comparison of efficacy of daily versus intermittent iron therapy in children with iron deficiency anemia
26. Mean duration of Rota virus diarrhea in children after admission of first dose of Nitazoxanide

ONGOING PROJECTS

1. WHO surveillance projects for sepsis, bacterial meningitis, pneumonia and rotavirus
2. Pakistan Rotavirus Network (PARVAN): Post- vaccination impact of Rotavirus in collaboration with Aga Khan University Karachi, WHO & Bill Melinda Gates Foundation
3. Retinopathy of prematurity- in collaboration with College of Ophthalmology & Allied vision sciences (COAVS)
4. Tolerability of dispersible zinc tablets in children with acute diarrhea
5. Lactose-free formula vs Lactase enzyme in post-diarrheal lactose intolerance
6. Quality of life among Pediatric patients suffering from Acute Lymphoblastic Leukemia
7. Validity of PIM 2 score as an outcome predictor in PICU
8. Comparison of serum bilirubin measurements by venous capillary and transcutaneous methods in neonates
9. Comparison of outcome of hypoxic ischemic encephalopathic newborn with and without erythropoietin therapy
10. Comparison of the efficacy of levetiracetam with phenytoin for the management of children with status epilepticus
11. Comparison of efficacy of nebulized with intravenous magnesium sulphate in children with acute asthma
12. Association of vitamin D supplementation with outcome of critically ill children
13. Factors associated with Cerebral Edema among children with Diabetic Ketoacidosis
14. ECG pattern in Anti-tissue Transglutaminase Antibodies positive Celiac Disease; can we use as a diagnostic Tool.
15. Assessment of quality of life in 8 to 12 years old children with beta thalassemia major
16. Comparison of continuous and intermittent phototherapy in exaggerated physiological hyperbilirubinenemia in newborn more than 34 weeks gestational age
17. Oxygen saturation index and severity of hypoxemic respiratory failure in children
18. Association of mortality with hyperglycemia in critically ill children presenting in intensive care unit
19. Association of Rota virus immunization with frequency of acute diarrheal hospitalization in infants
20. Frequency of anaemia in children with community acquired pneumonia presenting in tertiary care hospital of Punjab
21. Comparison of outcome of oral and intravenous antibiotics for management of children with pneumonia
22. The measurement and making of stretched penile length (spl) chart of punjabi newborn
23. Study on microbial colonization of intravascular catheters inserted in neonates admitted in NICU
24. Comparison of efficacy of nebulised epinephrine versus salbutamol in acute bronchiolitis
25. Comparison of insulin glargine mixed with regular insulin versus the standard neutral protamine hagedorn (NPH) and regular insulin in the treatment of type I diabetes mellitus
26. Diagnostic accuracy of bacterial meningitis score in confirmed cases of acute pneumococcal meningitis in children 2 months-12 years
27. CSF lactate as a diagnostic biomarker of bacterial meningitis in children Correlation of Mean Platelet Volume and severity of acute gastroenteritis
28. Frequency of Giardiasis in acute diarrhea in children
29. Outcome comparison of rice based ORS vs hypo-osmolar ORS in acute watery diarrhea
30. Diagnostic accuracy of leukocyte esterase in confirmed cases of urinary tract infection in children
31. Diagnostic accuracy of absolute leukocyte count in infants younger than 90 days of age with fever without focus
32. Diagnostic accuracy of lung ultrasound in diagnosis of pneumonia in children
33. Comparative accuracy of serum bilirubin measurement in neonates by venous capillary and transcutaneous methods in neonates
34. Comparison of duration of hospitalization with continuous and intermittent pulse oximetry in patients presenting with acute bronchiolitis
35. Comparative efficacy of apple juice and hypo-osmolar ORS in acute watery diarrhea with no dehydration
36. Diagnostic accuracy of urinary dipstick for detection of bacterial meningitis
37. Diagnostic accuracy of modified Centor score in confirmed cases of group A streptococcal acute pharyngitis in children of age 3-12 years
38. Comparison of risk factors for Methicillin Resistant Staphylococcus aureus (MRSA) colonization in healthy newborns, born to mothers with and without MRSA colonization
39. Diagnostic accuracy of pulse oximetry for prediction of spo2 in children with pneumonia taking arterial blood gases as gold standard
40. Frequency of anemia in children with pneumonia
41. Pulse oximetry in bronchiolitis continuous vs intermittent
42. Comparison of bubble CPAP and control (nasal oxygen cannula) in reduction of respiratory distress in neonates
43. Association of Iron Deficiency Anemia with Febrile Seizures in children Less than 5 years of age
44. Prevalence and risk factors of neonatal candidemia
45. Comparison between single dose oral dexamethasone versus oral prednisolone therapy in acute pediatric asthma
46. Efficacy of 0.9% saline versus 0.45% saline in 5% dextrose water as a maintenance fluid therapy in children with acute central nervous system infections
47. CMV sero-positivity in multi-transfused children
48. Low maternal measles immunity; A risk factor for measles in infants under 9 months of age
49. bCPAP vs oxygen therapy in neonatal respiratory distress

The Pediatric Specialty Block has five floors. The Ground floor of the department houses the Pediatric Emergency, Radiology, Pharmacy, Follow up Clinics including Asthma Clinic and Vaccination Clinics. The 1st floor of the block houses the Neonatology Unit, Diarrhea Unit and Isolation Section. On the 2nd floor there are General Medical Section, Pediatric Nephrology and Hemodialysis section. The 3rd floor has PICU, NICU, HDU, Endocrinology & Pulmonology sections. The 4th floor has been dedicated to Pediatric specialties (Pediatric Hematology/Oncology, Pediatric Infectious Diseases, Pediatric Cardiology, Pediatric Neurology and EMG and EEG rooms). The 5th floor houses the offices, audiovisual room, class room, conference room, computer lab, library, PCR Laboratory and Research Office. The Neonatal Section of Lady Willingdon Hospital is also attached to Pediatrics Unit-1. Pediatric Pathology & Pediatric Radiology is under the supervision of Chairman Department of Pediatrics, as is Preventive Pediatric Services. Pediatric Radiology provides routine X-Rays, ultrasound and Color Doppler ultrasound and portable Radiography services in critical areas like PICU and NICU. Affiliated hospitals with Pediatrics Unit-I include Govt. Mian Munshi Hospital, Lahore and Govt. Said Mitha Hospital, Lahore.

DEPARTMENT STATISTICS 2017

• Pediatric Unit-I Admissions 14112
• Pediatric Out Patient Department Visits 69675
• Follow up clinic visits 5112
• Laboratory tests 833568
• Radiology tests 51465

DAILY MORNING CONFERENCE

• 8:00-8:30 AM           Daily Morbidity/Mortality statistics
• 8:30-9:15 AM            PG / HO Teaching:
• Monday                      Seminar
• Tuesday                      Short Case Discussion
• Wednesday                Consultant Lecture/Guest Speaker
• Thursday                    Long Case Discussion
• Friday                         Radiology/TOACS
• Saturday                     Journal Club/Weekly statistics

• Ward Rounds in sections by consultants / SR as per monthly roster
• Duty for Affiliated Hospitals & LWH Nursery as per monthly roster

NRP-KEMU (IN COLLABORATION WITH KEMCAANA & APPNA PEDS) NRP TRAINING HANDS ON WORKSHOP

WORKSHOP: BASIC PEDIATRIC PROCEDURAL SKILLS

WORKSHOP: CHILDHOOD VACCINATION BENEFITS & FUTURE DIRECTIONS