Background Globally, it is estimated that 50 million children under five are wasted. National nut... more Background Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3 and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study explores use of energy dense, home fortified diet in achieving weight gain of malnourished children in Karachi. Methods A descriptive, retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, a...
As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiol... more As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiological and clinical features among pediatrics have been noticed across different countries. We describe the spectrum of COVID‐19 in pediatric patients treated in tertiary health care. We conducted a retrospective chart review of pediatric patients admitted to Indus Hospital & Health care network, Korangi campus, Karachi; from April 1st, 2020 to July 31st, 2020. A total of 141 COVID‐19 cases were reported, males were 81 (57%) and the median age was 8 (0.3–17) years. Moderate and severe infections were noted in 36(26%), and 17(12%) children respectively. Fever (50%) was the most common clinical feature. The SF ratio less than 264 was significantly associated with severe disease (p < .05). Lab investigations that differed significantly across disease severity groups included IL‐6 levels (p < .01) and Prothrombin time (p < .05). Majority of children were advised home isolation 89 (63%), 29 (20.5%) were admitted while mortality was observed in 10 (7%) children. No significant difference was observed between children with and without malignancy. Pre‐existing comorbidities are significantly associated with COVID‐19 infections among children. Reduced SF ratio, elevated Prothrombin time, and interleukin‐6 levels are associated with greater disease severity.
There is a scarcity of data summarizing the clinical picture, laboratory, and imaging findings an... more There is a scarcity of data summarizing the clinical picture, laboratory, and imaging findings and outcome in children with malignancy and coronavirus disease 2019 (COVID-19) infection. This study characterizes a detailed comparison of pediatric oncology patients with and without COVID infection. A retrospective study was conducted at The Indus Hospital, Karachi, from March 2020 to June 2020. Clinical presentation, laboratory and imaging findings, disease severity, and outcome were compared between cohorts. The mean age of children with and without COVID was 8.0±4.9 and 7.4±4.1 years, respectively. Hematologic malignancy comprised the largest number of patients, followed by solid tumors. Lymphocytosis and low neutrophil-lymphocyte ratio was observed in the COVID positive group. Cardiac dysfunction (1.4% vs. 0%), acute respiratory distress syndrome (8% vs. 0%) and lower peripheral capillary oxygen saturation/fraction of inspired oxygen ratio (473 vs. 486) found to be associated with severe disease in COVID positive group (P<0.05). Overall mortality in children with COVID was 6.8% versus 2.7% in children without COVID. Pediatric patients with malignancy have different clinical features and laboratory parameters as compared with children without malignancy. Acute respiratory distress syndrome, absolute lymphocytosis and low neutrophil-lymphocyte ratio is associated with severe disease in children with malignancy and COVID infection. In contrast to adults, biochemical markers and complete blood count parameters do not help recognize COVID infection in pediatric patients with malignancy.
Background: Globally, it is estimated that 50 million children under five are wasted. National nu... more Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections, and currently, WHO recommends community-based management of malnutrition with the provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using the home-fortified diet in Pakistan. This study evaluated the effectiveness of using the home-fortified diet in achieving recovered from malnutrition through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged six months –5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A predesigned data extraction form was used to record detailed information about demographic characteristics, feeding, ant...
Background: Globally, it is estimated that 50 million children under five are wasted. National nu... more Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study aims to evaluate effectiveness of using energy dense, home fortified diet in weight gain of malnourished children in Karachi, through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, ...
Background Enteric fever is a systemic infection caused by Salmonella enterica serovar Typhi and ... more Background Enteric fever is a systemic infection caused by Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi A, B, and C. There is an emergence of Typhoid fever caused by extensively drug-resistant Salmonella Typhi strain called XDR S.Typhi. This strain is resistant to recommended first-line antibiotics and cephalosporins. WHO estimated 5274 cases of XDR S.Typhi in Karachi from November 2016 to December 2019. This study aims to determine clinical course, complications and response to treatment of XDR S.Typhi among the pediatric population coming to Indus Hospital. Method We reviewed the records of children who had culture-proven XDR S.Typhi infection at Indus Hospital from July 2017 to December 2018. A pre-designed data abstraction form was used to record information about seasonality, demographic details, clinical features and course, treatment, complications and outcomes of the cases of XDR S.Typhi. Results The records of 680 children were reviewed. The m...
Background Globally, it is estimated that 50 million children under five are wasted. National nut... more Background Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3 and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study explores use of energy dense, home fortified diet in achieving weight gain of malnourished children in Karachi. Methods A descriptive, retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, a...
As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiol... more As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiological and clinical features among pediatrics have been noticed across different countries. We describe the spectrum of COVID‐19 in pediatric patients treated in tertiary health care. We conducted a retrospective chart review of pediatric patients admitted to Indus Hospital & Health care network, Korangi campus, Karachi; from April 1st, 2020 to July 31st, 2020. A total of 141 COVID‐19 cases were reported, males were 81 (57%) and the median age was 8 (0.3–17) years. Moderate and severe infections were noted in 36(26%), and 17(12%) children respectively. Fever (50%) was the most common clinical feature. The SF ratio less than 264 was significantly associated with severe disease (p < .05). Lab investigations that differed significantly across disease severity groups included IL‐6 levels (p < .01) and Prothrombin time (p < .05). Majority of children were advised home isolation 89 (63%), 29 (20.5%) were admitted while mortality was observed in 10 (7%) children. No significant difference was observed between children with and without malignancy. Pre‐existing comorbidities are significantly associated with COVID‐19 infections among children. Reduced SF ratio, elevated Prothrombin time, and interleukin‐6 levels are associated with greater disease severity.
There is a scarcity of data summarizing the clinical picture, laboratory, and imaging findings an... more There is a scarcity of data summarizing the clinical picture, laboratory, and imaging findings and outcome in children with malignancy and coronavirus disease 2019 (COVID-19) infection. This study characterizes a detailed comparison of pediatric oncology patients with and without COVID infection. A retrospective study was conducted at The Indus Hospital, Karachi, from March 2020 to June 2020. Clinical presentation, laboratory and imaging findings, disease severity, and outcome were compared between cohorts. The mean age of children with and without COVID was 8.0±4.9 and 7.4±4.1 years, respectively. Hematologic malignancy comprised the largest number of patients, followed by solid tumors. Lymphocytosis and low neutrophil-lymphocyte ratio was observed in the COVID positive group. Cardiac dysfunction (1.4% vs. 0%), acute respiratory distress syndrome (8% vs. 0%) and lower peripheral capillary oxygen saturation/fraction of inspired oxygen ratio (473 vs. 486) found to be associated with severe disease in COVID positive group (P<0.05). Overall mortality in children with COVID was 6.8% versus 2.7% in children without COVID. Pediatric patients with malignancy have different clinical features and laboratory parameters as compared with children without malignancy. Acute respiratory distress syndrome, absolute lymphocytosis and low neutrophil-lymphocyte ratio is associated with severe disease in children with malignancy and COVID infection. In contrast to adults, biochemical markers and complete blood count parameters do not help recognize COVID infection in pediatric patients with malignancy.
Background: Globally, it is estimated that 50 million children under five are wasted. National nu... more Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections, and currently, WHO recommends community-based management of malnutrition with the provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using the home-fortified diet in Pakistan. This study evaluated the effectiveness of using the home-fortified diet in achieving recovered from malnutrition through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged six months –5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A predesigned data extraction form was used to record detailed information about demographic characteristics, feeding, ant...
Background: Globally, it is estimated that 50 million children under five are wasted. National nu... more Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study aims to evaluate effectiveness of using energy dense, home fortified diet in weight gain of malnourished children in Karachi, through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, ...
Background Enteric fever is a systemic infection caused by Salmonella enterica serovar Typhi and ... more Background Enteric fever is a systemic infection caused by Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi A, B, and C. There is an emergence of Typhoid fever caused by extensively drug-resistant Salmonella Typhi strain called XDR S.Typhi. This strain is resistant to recommended first-line antibiotics and cephalosporins. WHO estimated 5274 cases of XDR S.Typhi in Karachi from November 2016 to December 2019. This study aims to determine clinical course, complications and response to treatment of XDR S.Typhi among the pediatric population coming to Indus Hospital. Method We reviewed the records of children who had culture-proven XDR S.Typhi infection at Indus Hospital from July 2017 to December 2018. A pre-designed data abstraction form was used to record information about seasonality, demographic details, clinical features and course, treatment, complications and outcomes of the cases of XDR S.Typhi. Results The records of 680 children were reviewed. The m...
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