Adnan Mirza

Jailinmates may be at increased risk of contracting tuberculosis [TB]. We studied 386 detainees [mean age 17.7 years] in Karachi juvenile jail to determine the prevalence of TB and possible risk factors for contracting TB. We found a 3.9% prevalence of TB among the inmates, significantly higher than the estimated 1.1% prevalence in the general population of Pakistan. Positive family history of TB was a significant risk factor for TB. Poor adherence of previously diagnosed patients to anti-TB treatment was found. Our study highlights the vulnerability of inmates to TB owing to the presence of highly infectious cases, along with environmental conditions such as overcrowding and poor ventilation. This study strongly indicates the need for an effective treatment programme in the jails as well in the general community

Scientific literature suggests that pregnant women are at greater risk of acquiring a more severe form of COVID-19 exposing both mother and child to a higher risk of obstetric and neonatal complications. These include increased hospitalization rates, ICU admissions, or ventilatory support among pregnant women when compared to COVID-19 negative pregnant womenA case-control study was conducted at the Aga Khan University Hospital, Karachi, Pakistan with the objective of evaluating the clinical presentation of COVID-19 in pregnancy and its effect on maternal and neonatal outcomes. Data was retrospectively collected from April 2020 till January 2022 of obstetric patients with COVID-19 positive cases and were compared with COVID-19 negative cases from the same time. A total of 491 women were included in the study, 244 cases and 247 controls. The most common complication amongst cases was gestational diabetes mellitus (n = 59, 24%), followed by gestational hypertension (n = 16, 31.7%), pre...

Acute appendicitis is an infrequent condition in neonates, especially in term infants. With around 100 cases in the last century and no specific diagnostic tool, this case report is an addition to the existing literature that helps in our understanding of the disease. A preterm infant who had greenish aspirates and dilated bowel loops on abdominal x ray and was treated on the lines of necrotizing enterocolitis failed to improve. Baby had issues of abdominal distension whenever feeds were started hence exploratory laparotomy was done on the 45th day of life which showed appendicitis with adherent terminal ileum, caecum, and appendix. Two months after the surgery, the patient was unable to respond to antibiotic therapy for septic condition leading to death.

Background: Neonatal diabetes mellitus is a rare disorder characterized by refractory hyperglycaemia which is further divided into two types, transient (TNDM) and permanent neonatal diabetes (PNDM), which is associated with genetic aberrations at the human chromosome 6q24 accompanied with pancreatic structural abnormalities or b-cell dysfunction requiring insulin treatment. This case report analyzes a rare correlation between a case of permanent neonatal diabetes mellitus with Trisomy 21. Methods: An infant presented with intrauterine growth retardation and very low birth weight showing signs of persistent hyperglycaemia where genetic analysis suggested presence of permanent neonatal diabetes mellitus accompanied with Trisomy 21. Chest X-ray examination alongside an echocardiogram revealed significant pericardial tamponade. By the 6th week of life, pericardial effusion spontaneously resolved supported by normal follow-up echocardiograms without any treatment plan. The patient became...

Fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO syndrome) is a rare, genetic, congenital limb malformation characterized by unilateral or bilateral fibular aplasia, tibial campomelia, and lower limb oligosyndactyly involving the lateral rays. A newborn male born at term via a Caesarean Section presented with malformations consisting of tibial campomelia, unilateral fibular hypoplasia, and oligosyndactyly, a “FATCO variant” case. On radiographic examination, an anterolateral shortened and bowed right lower limb at the distal third of the tibia, a rudimentary right fibula and absence of three rays on right foot were revealed. “FATCO syndrome” although rare may be linked to involvement of different body systems with morbidity and mortality. Proper parent counseling is a key aspect of this syndrome. Timely diagnosis and management with a multidisciplinary approach is essential to avoid lifelong disability, which can be a hurdle in a developing country.

Citation: Adnan Mirza., et al. “A Case of Resolved Cerebral Venous Sinus Thrombosis after Prolong Ventilatory Support with No Neurological Deficit”. EC Clinical and Medical Case Reports 3.8 (2020): 01-04. *Corresponding Author: Adnan Mirza, Faculty of Paediatrics, Neonatal Intensive Neonatal Care Unit, The Aga Khan University Hospital, Karachi, Pakistan. Received: March 04, 2020; Published: July 04, 2020

Cutis marmorata telangiectatica congenita (CMTC) is a benign angiomatous condition usually seen at birth as dilation of superficial capillaries and veins. Its characteristic feature is red or purple reticulated anastomosed macules having localized or generalized asymmetrical appearance. These lesions may also be associated with ulceration or atrophy. It is a rare disease with unknown etiology. However, prognosis is generally good. Here, we are presenting a case of male term baby born at 40 week gestation with APGAR score 5/1 and 9/5 and no associated abnormalities. The management of such a case requires involvement of a pediatrician, dermatologist and psychologists.

Background Raine syndrome (RS) is a rare autosomal recessive disorder caused by biallelic loss-of-function mutations of FAM20C. The most common clinical features are microcephaly, exophthalmos, hypoplastic nose and severe midface hypoplasia, leading to choanal atresia. The radiological findings include generalized osteosclerosis and brain calcifications. RS is usually lethal during the neonatal period due to severe respiratory distress. However, there exists a non-lethal RS form, the phenotype of which is extremely heterogeneous. There is paucity of data about clinical course and life expectancy of these patients. Results This is the first description of follow-up features of non-lethal RS patients. Moreover, we present three unpublished cases. There are five Asian and two Arab patients. All were born to consanguineous parents. The most common neonatal comorbidity was respiratory distress secondary to choanal atresia. A variable degree of neurodevelopmental delay was seen in the maj...

Vinod K Hasija1, Adnan Mirza1*, Hinamumtaz Hashmi2, Manoj Kumar2, Saleem Sadqani3 and Sadaf Altaf4 1Faculty of Paediatrics and Neonatology, The Aga Khan University Hospital, Karachi Pakistan 2Instructor Paediatrics, The Aga Khan University Hospital, Karachi Pakistan 3Faculty of Paediatrics and Cardiology, The Aga Khan University Hospital, Karachi Pakistan 4Faculty of Paediatrics and Hematology, The Aga Khan University Hospital, Karachi Pakistan

Objective: Our study aimed to ascertain rates and most frequent causes of perinatal mortality in a major tertiary care private maternity and neonatal intensive care unit (NICU) setup in Saudi Arabia. We also conducted a comparative analysis with the perinatal mortality rates (PMRs) from public setup in Saudi Arabia as well as the most recent global and regional data. Study Design: This was a retrospective, analytic, and comparative study. Methodology: One-year data (from January 1, 2017, to December 31, 2017) were ascertained from the Electronic Patient Medical Records database (VIDA) as well as the annual reports of four tertiary care maternity units and NICUs of Sulaiman Al Habib Medical Group in Saudi Arabia. The data were analyzed using Excel. The outcomes were compared with the 2015 data published by the Global Burden of Disease study and 2015 data published by the Euro-Peristat Study. Results: The total number of deliveries during the study period was 14,339, whereas the total number of births was 14,593 (live births 14,543 + stillbirths 50). Perinatal deaths were 80 (50 stillbirths + 30 early neonatal mortality [ENM]). PMR was 5.48/1000 (stillbirth rate: 3.42/1000, ENM rate: 2.06/1000). Third-trimester perinatal deaths were 31 and third-trimester PMR 4.18/1000. Majority of perinatal deaths were either due to congenital anomalies and/or prematurity. The perinatal mortality outcomes were comparable with countries with a high sociodemographic index. Conclusions: The PMRs in Saudi Arabia's private setup is lower than the public setup. This may be reflective of differences in the sociodemographic and economic status of the population being served by public and private sectors as well as a difference in the level of care provided by each sector. A large prospective, multicenter study conducted over a period of 5–10 years to assess differential perinatal outcomes, their underlying factors, and the causes of high incidence of major and futile congenital fetal anomalies is warranted.