Introduction Birth weight is described as the primary determinant of the chances of survival among newborns. Low birth weight (LBW) is considered to be a major public health issue, especially among developing countries where poor maternal nutritional status is identified as a cause of both long and short-term adverse consequences. In developing countries, the majority of the LBW infants are born at term but are affected by intrauterine growth restriction, which might have begun early in the pregnancy period. We conducted this study in order to determine the possible effects of the poor nutritional status of mothers on the birth weight of their newborns. However, in disparity to the previous literature, our study evaluated unpredictable results. Methods This is a cross-sectional study that was conducted at two tertiary care teaching hospitals from November 2020 to April 2021 in order to determine the possible effects of the poor nutritional status of mothers on the birth weight of their newborns. 156 women both primigravida and multigravida of ages between 15 and 50 years and those who delivered low birth weight (LBW) babies of either gender at term (37-40 weeks of gestation) were included. For all mothers who delivered LBW (<2500 g) at term, their mid-upper arm circumference (MUAC) was measured by inelastic tape. Mothers with MUAC less than 21 cm were considered malnourished. Results A total of 156 study participants were included in the study, with majority (n=112, %=71.8%) of them between the ages of 20 and 30 years. The mean age of all included participants was calculated to be 25.96 +/- 4.54 years (ranging from 18 to 38 years). Prevalence of maternal malnutrition was observed in 41 (26.3%) of the included women who delivered LBW babies, in contrast to high prevalence rates in previous literature. Conclusions In contrast to the previous literature, our study has shown that the nutritional status of mothers has no significant impact on the weight of neonates and the majority of neonates in our study were not severely low weight

Brain abscess is a serious infection of brain parenchyma in patients with cyanotic congenital heart disease (CCHD) and around 25–46 % of unrepaired CCHD patients develop brain abscess. Aim of this study was to determine the incidence, clinical features, microbiology and factors associated with early and short term outcome of cerebral abscess in CCHD. ology: This is a retrospective study, conducted at Pediatric cardiology department, National Institute of Cardiovascular Diseases (NICVD) Karachi. The data was collected from January 2019 to December 2021. All CCHD patients between 1 and 25 years of age were included. Data of patients with cerebral abscess was reviewed. Among the 544 pediatric patients hospitalized in the last two years, brain abscesses were identified in 51 (9.3 %). Polycythemia (31.4 %) was the most significant contributing factor, especially in patients aged above 10 years. The most frequently seen CCHD was tetralogy of fallot (TOF) 60.8 %. Majority of the patients (84.3 %) had a single abscess while 15.7 % had multiple abscesses. E coli (9.7 %) was the most common isolated pathogen. Immediate complication identified was cerebral edema in 22 (43.1 %). Four patients (7.8 %) died, 47 (92.2 %) patients completed treatment course. 45.1 % had complete recovery however, 17 (33.3 %) had neurological deficits, 8 (15.7 %) had seizures and 2 (3.9 %) patients had residual abscess. Prolonged hospitalization was observed in patients of age group <10 years. In patients with underlying CCHD,early referrals and intervention are key to mitigating the severe consequences of cerebral abscesses and can drastically improve patient outcomes.

Objective: To determine the distribution pattern and possible reasons of delayed diagnosis of congenital heart disease in adult population. Method: The analytical, cross-sectional study was conducted at the Department of Paediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi, from July to December 2021, and comprised patients of either gender aged 18 years and above with congenital heart disease confirmed by echocardiographic examination. Age, gender, weight, height, provincial affiliation, marital status, number of children, if any, duration of disease and New York Heart Association classification were noted on a predesigned proforma. Patterns of congenital heart disease types and reasons behind delayed diagnosis, if noted, were recorded. Data was analysed using SPSS 26. Results: Of the 129 patients, 68(52.7%) were males. The overall mean age was 25.8±9.8 years. Mean age at the time of diagnosis was 12.4±14.8 years. There were 91(70.5%) cases with delayed diagnosis. There was no significant gender difference with respect to delayed diagnosis (p>0.05). Delayed referral 39(42.9%), delayed consultation 22(24.2%), delayed diagnosis by the doctor 21(23.1%), and social factors 9(9.9%) were the most frequent reasons behind delayed diagnosis. Ventricular septal defect was the most frequently defect 38(29.5%), followed by tetralogy of fallot 32(24.8%). Right ventricular dysfunction was the most common complication of delayed diagnosis 35(27.1%). Conclusion: Delayed diagnosis of congenital heart disease was reported in over two-thirds of the cases, with ventricular septal defect being the most frequent type of defect, and delayed referral being the most common reason. Key Words: Congenital heart disease, Diagnosis, Echocardiography, Tetralogy of fallot, Ventricular septal defect.

Background: Breastfeeding is recognized as the optimal method for infant nutrition, yet bottle feeding remains prevalent due to various socio-economic and cultural factors. In Pakistan, understanding the dynamics between maternal demographics, infant feeding practices, and healthcare accessibility is essential for improving child health outcomes. Objective: This study aims to evaluate infant feeding practices, particularly the prevalence of bottle feeding, among mothers in a pediatric department in Pakistan, identifying the socio-demographic factors influencing these practices. Methods: A cross-sectional study was conducted from March 2023 to March 2024 at the Department of Pediatrics, SMBB Medical University, Children's Hospital, Larkana. We utilized non-probability purposive sampling to enroll 650 mothers. Data were collected through structured proformas focusing on demographics, feeding practices, and healthcare utilization. Statistical analysis was performed using SPSS version 25 to assess correlations between feeding methods and maternal characteristics. Results: Among the mothers surveyed, 86% reported using bottle feeding. The age distribution of infants showed 43% (0–5 months), 28% (6–11 months), and 29% (12–23 months). Educational status of mothers varied, with 38% having no formal education. Antenatal care was received by 44% of participants, while postnatal care was slightly higher at 45%. Breastfeeding counseling was received by only 41% of mothers, with 31% informed about the disadvantages of bottle feeding. Conclusion: The high rate of bottle feeding and the substantial gaps in antenatal and postnatal care highlight the need for targeted healthcare interventions to promote breastfeeding and enhance maternal and child health services. Improved counseling on feeding practices and better healthcare access are critical for addressing the health needs of this population.

Idiopathic ventricular tachycardia (VT) is a rare form of arrhythmia in neonates that can be life-threatening prompting its timely diagnosis and importance of treatment to avoid serious complications, that is; heart failure. We describe a neonate with an incessant idiopathic ventricular tachycardia presented with heart failure and severe left ventricular dysfunction. This infant presented with poor feeding, irritability, increase work of breathing, and heartbeat of 260/min. The electrocardiogram (ECG) showed wide complex tachycardia and the echocardiogram showed a structurally normal heart with dilated cardiomyopathy. The clinical signs and chest X-ray changes were consistent with cardiac failure but preserved peripheral perfusion. This presentation, the sustained VT and the global cardiac failure makes the treatment challenging; therefore, early diagnosis of incessant VT in neonate is important for better prognosis.

Congenital heart disease (CHD) remains the most common congenital anomaly worldwide and a leading cause of infant morbidity and mortality. Despite remarkable advances in prenatal diagnosis, surgical correction, and long-term cardiac care, prevention of CHD remains an unmet global health priority. The etiology of CHD is multifactorial, arising from complex interactions between genetic predisposition and environmental influences during critical stages of embryonic development. Consequently, increasing attention has focused on identifying potentially modifiable risk factors that may reduce the incidence of CHD and improve maternal-child health outcomes [1,2]. In this context, the study by Öncül et al. [3] provides important evidence regarding the potential contribution of maternal micronutrient status and parental environmental exposures to the development of CHD and associated extracardiac anomalies. The authors observed significantly lower maternal serum zinc and vitamin A concentrations, alongside higher homocysteine levels, among mothers of infants with CHD compared with mothers of healthy controls. Additionally, paternal smoking was significantly more prevalent in families of affected children. These findings are particularly compelling because each of these factors represents a potentially modifiable exposure. If validated through larger prospective investigations, such observations could inform targeted preconception and antenatal interventions aimed at reducing the burden of congenital cardiovascular disease. The relationship between maternal nutrition and fetal cardiovascular development has garnered substantial interest in recent years. Micronutrients are fundamental regulators of embryogenesis, influencing cellular proliferation, differentiation, oxidative homeostasis, and epigenetic programming. Zinc plays a critical role in DNA synthesis, gene expression, and cellular growth, while vitamin A and its active metabolites regulate developmental signaling pathways essential for cardiac morphogenesis, including neural crest cell migration and outflow tract formation [3]. Elevated homocysteine concentrations, frequently reflecting disturbances in one-carbon metabolism and folate-dependent pathways, have similarly been associated with adverse pregnancy outcomes and congenital malformations [4-6]. Although previous studies examining the association between micronutrient deficiencies and CHD risk have yielded inconsistent results, the findings reported by Öncül et al. add to a growing body of evidence suggesting that maternal nutritional status may influence fetal cardiac development and potentially contribute to congenital cardiac defects [3]. An important contribution of this study is its examination of extracardiac anomalies among infants with CHD. Approximately one-third of affected infants exhibited associated non-cardiac malformations, reinforcing the concept that CHD often reflects broader disturbances in embryonic development rather than isolated organ-specific defects [7,8]. The predominance of gastrointestinal and central nervous system abnormalities within this cohort is clinically relevant and underscores the importance of comprehensive multisystem evaluation in infants diagnosed with CHD. Early identification of associated anomalies facilitates coordinated multidisciplinary care, optimizes clinical outcomes, and may improve long-term developmental trajectories. The study also highlights the potential role of paternal smoking, an exposure that has historically received less attention than maternal risk factors in congenital disease research. Emerging evidence suggests that paternal tobacco exposure may influence reproductive and fetal outcomes through multiple pathways, including sperm DNA damage, oxidative stress, epigenetic alterations, and indirect environmental exposure during pregnancy [9,10]. The association identified in this study further supports the inclusion of prospective fathers in reproductive health counseling and smoking cessation initiatives. Such strategies may represent an underutilized avenue for reducing preventable congenital anomalies and improving overall pregnancy outcomes. Several limitations warrant careful consideration. The retrospective design limits the ability to establish causality and introduces susceptibility to recall and selection bias. Maternal micronutrient concentrations were measured postpartum rather than during the critical window of cardiac organogenesis, making it difficult to determine whether these measurements accurately reflected fetal exposure during early pregnancy. The relatively small sample size may have limited statistical power to detect associations across specific CHD subtypes. Moreover, the absence of genetic and genomic analyses precludes evaluation of potential gene–environment interactions that likely contribute substantially to CHD pathogenesis. These factors necessitate cautious interpretation of the findings and highlight important directions for future research. Despite these limitations, the study delivers a timely and important public health message. While genetic susceptibility remains a cornerstone of CHD pathogenesis, environmental and nutritional determinants may provide tangible opportunities for prevention. Optimizing maternal nutritional status before conception and throughout pregnancy, strengthening prenatal care programs, ensuring adequate micronutrient intake, and minimizing tobacco exposure are practical interventions with the potential to improve not only cardiovascular outcomes but also broader maternal and child health indicators. Looking forward, prospective longitudinal studies incorporating serial micronutrient assessments, comprehensive dietary evaluations, biomarker profiling, environmental exposure monitoring, and genomic analyses will be critical to elucidating causal mechanisms and identify high-risk populations. Such investigations may ultimately...