Pediatric Outpatient Department Research Articles

Mesenchymal Hamartoma – A Case Report

We report a thirteen-month-old female with a history of abdominal distension for two months. She presented to the outpatient pediatric department with pallor, massive abdominal distension, and hepatomegaly. She was initially diagnosed with a liver abscess and admitted to the pediatric ward. Baseline labs, including liver aspirate culture and staining did not reveal any infectious etiology. The patient responded initially to empirical antibiotics, but abdominal distension continued to increase during admission. She was referred to gastroenterology where the investigations showed a solid-cystic liver mass. The patient underwent a surgery for mass excision, and a biopsy revealed mesenchymal hamartoma.

Parental Views on the Non-Operative Management of Simple Appendicitis in Children: Results of a Cross-Sectional Survey.

To determine parental attitudes for the non-operative management of simple appendicitis and determine willingness to participate in research evaluating different management options. Voluntary cross-sectional survey of parents/guardians presenting to paediatric outpatient department. Likert scale of 0-10 (strongly disagree-strongly agree) was utilised, analysis by individual question responses. Results are presented as medians [IQR], paired t test, the Mann-Whitney U test and Kruskal-Wallis test analysis as appropriate. A p value of < 0.05 is considered significant. Of 311 respondents, 81% (252/311) completed all the questions. The majority (73%, 220/303) believed that appendicitis needed an urgent operation, and 88% (264/299) believed that perforated appendicitis was a life-threatening condition. Fifty-two per cent (131/252) preferred operative management, and 48% (121/252) preferred antibiotic treatment. The most important factors influencing treatment choice were removal of pain (84%, 246/293), removal of infection (83%, 244/293) and minimising complications (54%, 162/293). Concerns regarding antibiotic treatment included the potential for recurrence (75%, 204/271), the risk of progression (63%, 170/271) and the potential of future surgery (53%, 145/271). The perceived beneficial factors of antibiotic treatment included avoiding surgery, 64% (173/269) and surgical complications 68% (184/269). When asked to consider whether they would participate in clinical research evaluating the two treatment options, parents were equally in favour (39%), against (26%) or unsure (35%). Our study demonstrates equipoise in the parental acceptance of antibiotics as a treatment simple appendicitis in children, or participation in research evaluating this topic. However, the important factors that may influence this decision have been identified to guide future conversations.

Drug utilisation pattern of antihistamines in upper respiratory tract infections in paediatric patients

Background: Upper respiratory tract infections (URTIs) are the most common infections in the paediatric population leading to health care consultations. Antihistamines are commonly prescribed medicines in children. Objectives: This study attempted to assess the current prescription patterns of antihistamines used in the treatment of URTIs. Methods: A descriptive cross-sectional study was conducted in the outpatient paediatric department of Kathmandu Medical College from January 2020 to April 2021. Ethical approval was taken from Institutional Review Committee of Kathmandu Medical College. A convenient sampling technique was used. The data were collected from the outpatient department prescription card into a suitably designed proforma. Drug use indicator developed by the World Health Organisation for Rational Use of Drugs was utilised. Data were analysed using SPSS v.20. Results: Data from prescriptions of 345 patients aged less than 14 years were collected from the paediatric outpatient department of KMCTH. The most common condition was common cold (132, 38.26%). Most commonly prescribed antihistamines were Fexofenadine (156, 45.21%). Average number of drugs per prescription was 2.31. The total number of drugs prescribed by generic name was 128 (16%). Antibiotics made its place in prescriptions 279 (34.96%) times. No parenteral medication was used and 140 (17.5 %) of all drugs prescribed were from the National List of Essential Medicines. Conclusion: Antihistamines, mostly second generation, were commonly prescribed in URTIs in paediatric patients. Majority of WHO indicators were within normal limits while some needed marked improvement. Different programmes can be implemented for improvement in prescribing patterns and promotion of rational drug use.

Study of Drug Prescribing Pattern in Pediatric Outpatient Department at a Tertiary Care Teaching Hospital

Background: Infants and children suffer from frequent but usually non serious illnesses and are more vulnerable to various adverse events related to drugs and poor understanding of instructions on prescription by the patient or caretakers were likely to cause medication error. The correct identification of an illness and its management with medications is a vital aspect of patient care, especially for paediatric population. So, prescribing pattern studies are very helpful in promoting the appropriate use of drugs in population. Objectives: It aims to obtain data on the current prescribing pattern in pediatric OPD at a tertiary care teaching hospital with ultimate goal to promote appropriate use of drugs. Methods: This study was conducted in 62 pediatric patients of either sex visiting Pediatric out-patient department over a period of three months at NMCH and RC, Raichur, Karnataka. Results: Prescription analysis showed that the average number of drugs per prescription was 3.32. Drugs were mostly prescribed by brand name (98.06%), Injections (4.83%) were least prescribed, drugs prescribed from Essential Drug List was 48.54%. Antibiotics were most prescribed class of drugs (33.9%). Conclusion: The study concludes that polypharmacy was slightly seen in prescriptions. Diagnosis of the patient was recorded for most of the prescriptions. There is need to conduct many such studies at regular interval as it is useful for auditing large number of prescriptions to find out early signals of the irrational drug use. Our study evaluated drug use pattern only from the outpatients hence prescription pattern may vary among inpatients.&#x0D; Keywords: Prescribing pattern, Infants, WHO core prescribing indicators, Polypharmacy, Generic name

Application of Quality Care Centered on Children in Outpatient Department of Pediatrics

Application of Quality Care Centered on Children in Outpatient Department of Pediatrics

Patient flow analysis in a children’s clinic

Patient flow analysis was used to assess the waiting time of patients referred to a large paediatric outpatient department, and also the lengths of the consultations of the paediatricians and interns. The average waiting times to see the paediatricians and interns were 77 minutes and 7.8 minutes, respectively. The average lengths of consultation for the paediatricians and interns were 3.4 minutes, and 7.7 minutes, respectively

Anemia among Adolescent Girls Attending the Pediatric Outpatient Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Adolescents are children aged 10-19 years. Nutrition influences the growth and development during infancy, childhood and adolescence. Adolescent girls are at higher risk of anemia and undernutrition. This research was aimed to find the prevalence of anemia among adolescent girls in a tertiary care hospital. A descriptive cross-sectional study was done in the adolescent girls attending the pediatric outpatient department of a tertiary care centre from October 2020 to May 2021. After the ethical clearance from the institutional review committee, 380 adolescent girls were taken using a convenient sampling technique. Anthropometric measurements, social demography and blood for hemoglobin estimation were taken and documented in predesigned proforma. Data were analyzed with Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was done, and frequency and proportion were calculated. Out of 380 adolescent girls, 230 (60.5%) at 95% Confidence Interval (55.56-65.41) were anemic with mean hemoglobin of 11.138±1.954 gm/dl. The mean age was 14.57±2.107 years. This study showed a higher prevalence of anemia than the national data. Proper education regarding personal and menstrual hygiene, weekly supplementation of iron in school, dietary habits and uplifting of economic status can prevent anemia in this population.

Association Between Caregivers' Family Management and Quality of Life in Children with Chronic Disease in Southern Thailand.

PurposeCaring for children with chronic diseases, caregivers have to manage their child’s daily life to prevent complications and improve their quality of life. This study investigated family management of children with chronic diseases, quality of life of children, and correlation between family management of caregivers and quality of life of children as perceived by the caregivers.Patients and MethodsThis cross-sectional study collected data from 200 pairs of caregivers and children with asthma, anemia, and thalassemia aged 5 to 12 years after receiving treatment and follow-up in the pediatric outpatient department of the tertiary hospital, June to November 2020. Research instruments comprised a Family Management Measure (FaMM) and the Pediatric Quality of Life Inventory (PedsQL 4.0). Data were analyzed using descriptive and Spearman rank correlation coefficient statistics.ResultsThe caregivers of children obtained a mean score on family management of 166.88 (S.D.= 11.32). The quality of life of children with chronic illness had a mean score of 66.59 (S.D.= 18.63). Correlation analysis revealed that easy family management of the caregivers had a positive correlation with the quality of life of children with chronic diseases. On the contrary, difficulty in family management negatively correlated with the quality of life of the children.ConclusionMost caregivers could have easy family management in caring for the children. In summary, easy family management will allow children with chronic illness to receive decent care from their caregivers, contributing to improved quality of life.

Exposure and use of digital media among under-five children

Background: The use of digital media, such as television, smart phones, tablets, iPod has become a significant part of children’s lives. Children's exposure to digital media is increasing, as are concerns about the impact that screen time has on children and families. The study evaluates the exposure and use of digital media among under five children.Methods: The study was conducted among mothers of under-five children attending Paediatric outpatient department of a hospital. The sample included 150 mothers of under-five children. A structured questionnaire was used to collect data on selected demographic variables. A modified rating scale was used to elicit data regarding the exposure and use of digital media among under-five children.Results: Around half of children were exposed to smartphones between 1-2 years of age. During infancy around forty percent of children were exposed to smart phones. More than half the mothers used mobile devices while doing household chores. A higher proportion of under five children had increased screen time and large proportion (65.3%) of under-five children had high levels of exposure to digital media.Conclusions: A significant number of under five children were using the digital media and screen time exposure exceeded than that of recommended limit.

Knowledge and practices of mothers of under-five children regarding Zinc supplementation in childhood diarrhea

Diarrhoea continues to plaque the developing worldresulting in morbidity of 1.7 billionand mortality of 5.25 lakhsin under- five childrenIn India diarrhea is 3 most common cause of death among under-five children with morbidity of 11.6 million and mortality of 1300 deaths and thus causing 8% of deaths per yearZinc has a major role in prevention of diarrhea. To assess the knowledge and practices of mothers of under-five children regarding zinc supplementation for prevention of childhood diarrhea, to find out the reasons for not supplementing Zinc during diarrhoeal episodes, to find out association between socio-demographic factors and awareness of zinc supplementation. : Hospital based cross sectional analytical study was conducted among 200 mothers of underfive children in outpatient department of Paediatrics of a tertiary care hospital. The data was entered in predesigned semistructured questionnaire. Data was analysed by EPI INFO 7 software. Only 18(9%) mothers were aware about use of Zn supplementation to the under-five children in childhood diarrhoea. Only 10 mothers administered zinc supplementation in childhood diarrhea. Unawareness regarding Zn supplement was common reason mentioned for not giving Zn supplementation. Association was found between religion, type of family and awareness of Zn supplementation. There is a need to increase awareness of mothers regarding zinc supplementation by conducting health education sessions.

A Comparative Evaluation on the effect of Zinc-Probiotic combination versus Zinc alone therapy in children (3month-5year) with acute watery diarrhea attending the outpatient clinic of Sub-District hospital, Uttarakhand

Background: Diarrhea is the major cause of morbidity and mortality among children worldwide.Various studies were done on the role of zinc therapy and probiotic therapy in reducing the durationand severity of acute watery diarrhea. This study aimed to compare the effect of Zinc –probioticcombination versus Zinc only therapy in acute watery diarrhea in pediatric patients. Material andMethods: This was an open, randomized control trial in the pediatric outpatient department of Sub-District Female Hospital, Haldwani (Uttarakhand), from June 2020 till August 2020 for three months.Total 104 children aged six months to 5 years with acute diarrhea who met the inclusion criteriawere enrolled and divided into 52 patients each. 1stGroup A (n=52) received Zinc-Probioticscombination therapy, and 2ndGroup B (n=52) received Zinc only. Measurement of disease severitywas based on the frequency of diarrhea (times/day) and duration of diarrhea (hours) after initialdrug consumption. The resolution was assessed in mean remission time (time required to form solidstool from watery stool).Result: Among the study population in group A, 62% were male, 38%were female, and in group B, 65% were male &amp; 35% were female. Male predominance was observedin both groups. The mean frequency of diarrhea before treatment in Group A was 7.46 ± 4.1times/day as compared to 6.69 ± 3.6 times/day in Group B. Mean duration of diarrhea in Group Awas 53.5 ± 30.5 hours as compared to 57.6 ± 34.3 hours in Group B. Conclusion: Combinationtherapy was more effective than Zinc only therapy in early remission and resolution of acute waterydiarrhea in children.

The effect of the humanistic care teaching model on nurse patient conflict and nurse turnover intention in a pediatric outpatient department: results of a randomized trial

BackgroundThis study was carried out based on the background that sharp nurse-patient conflicts in the pediatric outpatient department lead to a high turnover rate of nurses.MethodsA total of 68 nurses working in the pediatric outpatient department of Xiangyang No. 1 People’s Hospital were selected as the study subjects, and randomly divided into an experimental group (n=34) and a control group (n=34). Nurses in the control group received a traditional pediatric nursing teaching model, while those in the experimental group received a traditional pediatric nursing teaching model combined with the humanistic care teaching model. The effect of these two nursing teaching models on nurse-patient conflicts in the pediatric outpatient department and the turnover intention of nurses was then compared and analyzed.ResultsThere were no significant differences in personal information between the two groups (P>0.05). The strain capacity, operational capacity, nurse-patient communication skills, autonomous learning ability, and teamwork ability of the nurses in the experimental group after training were significantly higher than those in the control group (P<0.05). Both groups after training had significantly higher scores on a professional identity scale than before training, and nurses in the experimental group had significantly higher scores of professional identity than those in the control group (P<0.001). The turnover intention of the nurses in the experimental group were significantly lower than those in the control group (P<0.001). The problem solving ability of nurses in the experimental group was significantly better than that in the control group (P<0.001). Scores in the domains of waiting to see the doctor, the health knowledge education, the ward environment, and nursing quality of nurses in `the experimental group were significantly higher than those in the control group (P<0.001).ConclusionsThe humanistic care teaching model can significantly improve the professional identity and problem solving ability of nurses in facing different nurse-patient conflicts with significant effect and is worthy of application and popularization in clinical nursing teaching.Trial RegistrationChinese Clinical Trial Registry ChiCTR2100048751.

Impact evaluation of immunisation service integration to nutrition programmes and paediatric outpatient departments of primary healthcare centres in Rumbek East and Rumbek Centre counties of South Sudan

ObjectiveTo evaluate the impact of immunisation service integration to nutrition programmes and under 5-year-old paediatric outpatient departments of primary healthcare centres in Rumbek East and Rumbek Centre counties of South...

Assessment of plasma levels of IL-9 and IL-17 in patients with Immune thrombocytopenia

Background: Immune thrombocytopenia (ITP) is an autoimmune disorder associated with decreased platelet production and accelerated platelet destruction lead to thrombocytopenia and mucocutaneos bleeding. It is usually a benign, self-limiting disease in children. An impaired immune system may be associated with ITP. objectives: The aim of this study was to assess the level IL-17 among active patients in relation to control. Subjects and methods : This study was a case-control study. The study included 20 patients with acute ITP. The patients were recruited from Pediatric hematology outpatient clinics and departments, Benha University Hospitals. In addition, 20 healthy children of comparable age and sex were taken as controls. Informed consents were obtained. Results: There was no statistically significant difference between cases and control regarding HB and WBCs but value of platelets was significantly lower among cases than control. . IL -17 level was Significantly higher in ITP cases when compared to control groups . Conclusion: This study concluded that, IL-17 may contribute to the pathogenesis of ITP. It could be potential biomarker that diagnose and predict the clinical course of ITP.

Effect of Guideline Education on Knowledge and Performance of Mothers regarding Using of Cook Salt for Management of Infants with Granuloma Umbilical

Granuloma Umbilical from major problem in neonates and young infants. It is reported frequently by mothers as continuous leakage of secretion at umbilicus site following cord separation. Delayed management of granuloma, it remain oozing and causes persistent irritation for long period reach weeks. Several management modalities were performed for umbilical granuloma including; using cook salt, ligation of the granuloma, cauterization chemically with silver nitrate or copper sulphate, electro-cauterization, cryocauterization and excision surgical . Aim of the study: Evaluate mother knowledge and performance regarding using of cook salt for management of infants with granuloma umbilical. Subject and Methods: Research Design: A quasi-experimental research design was used Setting: The study was conducted at outpatient pediatric department of Tanta and Menoufia University Hospital. Tools: Two tools were used: Structure interview schedule was developed by the researcher included three parts: Tool I: Biosocial data of infants and their mother, mothers' knowledge and reported practice was evaluated by using observational check list about cook salt use for umbilical granuloma. Tool II: Guideline reported educational intervention for the mothers Results: Infants with granuloma showed complete resolution after course of cook salt treatment. Conclusion: Using of cook salt for management umbilical granuloma is costeffective, simple curative and safe mode of treatment which can be performed by mothers at home. Recommendation: Using of cook salt as a treatment modality should be more encouraged by the health staff.

Frequency of Anemia among Primary School Children Visiting the Paediatrics OPD of a Tertiary Care Hospital

Background: In young children, Anemia is a common public health issue which significantly contribute in childhood morbidity and mortality. Anemia is associated with growth retardation, impaired cognition, decreased physical activity and contributor as a high national infant mortality rate. Aim: To determine the frequency of anemia in school going children presenting to OPD of a tertiary care hospital. Methods: A Cross Sectional Study conducted at Paediatric outpatient department of Sharif Medical City Lahore from 15.02.2018 to 14.08.2018. About 150 primary school children presenting to the Paediatric outpatient department of Sharif medical city Lahore for minor acute ailments and fulfilling the inclusion criteria were approached and an informed consent was taken from their parents before enrolling in the study. Results: From 150 patients , it was observed that the minimum age was 5 years and maximum age was 11 years with mean and standard deviation of the age was 8.10 ± 1.89 years. The minimum hemoglobin level was found as 7.8 gm/dL and maximum hemoglobin level was 14 gm/dL with mean and standard deviation was 12.47±1.62 gm/dL. The minimum body mass index was found as 10 kg/m2 and maximum BMI was 20 kg/m2 with mean and standard deviation was 15.52 ± 2.91 kg/m2. Presence of anemia was found in 14% patients while anemia was not found in 86% children. Conclusion: Presence of anemia was found in 14% primary school children presenting to the outpatient department of a sharif medical city Lahore, tertiary care hospital. Effect modifiers showed significant association. Keywords: Anemia,Hemoglobin Level, Body Mass Index, Socioeconomic Status.

Prevalence of underweight and its risk factors among under-five children in a tertiary care hospital of Chitradurga

Children constitute a large and vulnerable group, as 50% of all deaths occur during the first 5 years of life. Children below five years of age are at-risk population due to their susceptibility to malnutrition. The nutritional status of pre-school children is a sensitive indicator, ignoring which puts the long term health and development of population at risk. The level of childhood malnutrition is exceptionally high in India (45-48%). Objective of this study was to assess the status of nutritional status of under 5 children and to identify the risk factors associated with it. Methodology of the prospective cross-sectional study included 250 under-five children attending paediatric outpatient department of two tertiary care hospitals in Chitradurga from June to November, 2020. Socio demographic measures were obtained from structured questionnaire and followed by anthropometric measurements. Grading was done as per Indian Academy of Paediatrics (IAP) classification. The prevalence of underweight among under five children was 55.6%. Around 7% of children were severely malnourished. Males (52.5%) were more malnourished than females (47.5%). The sociodemographic determinants birth weight and duration of exclusive breastfeeding had statistically significant association with malnutrition. The burden of underweight was very high and some important risk factors for underweight were determinants birth weight and duration of exclusive breastfeeding. Therefore, any interventions to prevent and solve the problem of under nutrition should focus on maternal health. Keywords Underweight, Risk factors, Under­Five children, Malnourishment, IAP classification 1

Trial design and protocol of randomized controlled trial comparing the efficacy of oral mefenamic acid, paracetamol and placebo for analgesic prophylaxis in childhood vaccination (MAP VaC trial)

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Needle related pain has been one of the most important concerns for parents of children receiving vaccination. Non-steroidal anti-inflammatory drugs (NSAIDs) like paracetamol and mefenamic acid have been commonly used as analgesics in pediatric population. However, prophylactic administration of these drugs for analgesia during vaccination has not been studied. The main objective of this study is to compare the efficacy of prophylactic paracetamol, mefenamic acid and placebo on needle pain associated with vaccination.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a three-arm parallel, triple blind, randomized controlled trial. Children aged 6 weeks to 7 years who need immunization as per national immunization schedule and reporting to pediatric outpatient department (OPD) at tertiary level hospital, AIIMS Mangalagiri, Andhra Pradesh, will be included. All participants will be randomly allotted to any of the three groups by computer based block randomization. Each participant will be given any one of the three drugs as per their allocation. Vaccination will be done as per national immunization schedule after 30 minutes of drug administration. Face, legs, activity, cry, consolability (FLACC) scoring will be done immediately after vaccine administration and repeated at 15 minutes and 30 minutes. All personnel involved in randomization, drug and vaccine administration, FLACC scoring and statistical analysis will be blinded along with parents and children enrolled in the study.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;If this intervention study shows evidence of a difference between drug and placebo signifying reduction in vaccine related pain with these drugs, this will have a huge impact on National Immunization programme by improving compliance, vaccine coverage and by reducing vaccine hesitancy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Trial registration:&lt;/strong&gt; Clinical trials registration number is CTRI/2021/01/030239.&lt;/p&gt;

The Scenario of Dengue-like Illness in Paediatric Population of Southern Bangladesh

Dengue is one of the most important mosquito-borne viral diseases affecting humans. Dengue infections can result in a broad spectrum of disease severity ranging from an influenza-like illness (DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). Although adults do experience shock, vascular leakage is generally more severe in young children, and in endemic areas, DSS is seen primarily in the pediatric population. The detailed clinical and laboratory profile is crucial for the diagnosis and the successful management of the patients. This study aims to observe the clinical features and laboratory results for the better understanding of patient management to reduce child death in case of dengue fever. A prospective cross-sectional study was conducted at the dengue ward of Khulna Medical College Hospital; 167 suspected dengue patients were enrolled in our research during the period from 7th August to 8th November 2019. Patients attending the emergency department and pediatric outpatient department with complaints of fever and features of dengue with positive NS1 antigen test and/or positive dengue specific antibody IgM or IgG or both were included in this study. Diagnosis of dengue was made on the basis of compatible clinical features and NS1 antigen positivity and/or detection of IgM and IgG antibodies. Patients were classified according to WHO 2012 protocol, and data was analyzed. One hundred sixty patients (95.8%) were diagnosed as having dengue illness, and the rest 7(4.2%) as fever other than dengue. Among the dengue illness, dengue fever (DF) 87(52.1%), DF with warning signs 51(30.5%), DHF 19(11.4%), and DSS 3(1.8%).The most common sign-symptoms of dengue was fever(100.0%),vomiting(52.1%),abdominal pain(38.3%), headache(23.4%),skin rash(13.25%), melena (7.8%), abdominal tenderness(28.7%),palpable liver (24.6%),and palpable spleen(3.0%). NS1 antigen was found positive in 88.6% cases, negative 3.0%, and NS1 antigen test not done 8.4% cases due to time constrain. Anti-dengue antibody IgM positive in 10(6.0%),IgG positive 7(4.2%),both IgM &amp; IgG positive 7(4.2%),both IgM &amp; IgG negative 57(34.1%) and antibody test not done in 86(51.5%) cases due to time constrain. Anti-dengue antibody not done in 86(51.5%) cases; among them most of the cases (98.8%) are found NS1 positive and 1.2% NS1 test negative(P&lt;0.001) in our study which is statistically significant.&#x0D; Observation of clinical and laboratory parameters is helpful for dengue classification and management to reduce child death.&#x0D; TAJ 2021; 34: No-1: 86-96

PRESCRIBING PATTERN OF DRUGS USED IN PAEDIATRIC PATIENTS IN OUTPATIENT DEPARTMENT OF A TERTIARY CARE INSTITUTION

Background: Paediatric prescription is a major concern in terms of public health since infections are the most frequent cause of childhood disease. The aim of this hospital-based observational prospective study was to assess the pattern of drug use in the paediatric outpatient department attached to government medical college, Amritsar. &#x0D; Methods: A prospective study of six months duration was carried out for the month of October 2020 to March 2021. A total number of 201 patients case sheets were utilized for our study from paediatric out-patients department of GNDH, Amritsar. The data collected was then analysed for various prescribing indicators as laid down by world health organisation (WHO) for analysis of drug use parameters.&#x0D; Results: The average number of drugs per encounter was 2.52. In present study antibiotic were 18% of total drugs prescribed. Antihistaminics prescribed were 25%. Syrup was the most prescribed dosage form. %age of drugs prescribed from essential drugs list was 60.3%. Polypharmacy was evident from the study.&#x0D; Conclusions: Drug prescribing in children is relatively high in GNDH, Amritsar. This study revealed deviation in prescribing pattern from WHO core prescribing indicators. Possible reasons are heavy patient load, lack of essential drug list, insufficient government supply of generic drugs and lack of regular prescription audits.&#x0D; Keywords: prescription pattern, observational study, Paediatric, WHO core prescribing indicators.