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Over the last few years, there is a rise in the use of button batteries(BB) in children’s toys and home appliances. Easy availability and small size of these batteries pose a significant risk of ingestion by small children which is exceedingly dangerous. After ingestion, the BB may lodge in the esophagus or enters easily into the stomach due to its variable sizes. If lodged in the esophagus, BB can cause injury due to their caustic and electric properties, as well as by direct pressure. In our case, the 16 months old boy had accidentally ingested a BB, removed approximately after 30 hours from the esophagus, had developed esophageal perforation followed by tracheaesophageal fistula, complications related to aspiration and finally expired due to bronchopneumonia with septicemia and respiratory failure. So, Prompt removal is mandatory to reduce devastating outcome if it is a button battery BANGLADESH J CHILD HEALTH 2021; VOL 45 (1) : 41-44

Background: Nebulized salbutamol is commonly used in treatment of asthma in children. The use of nebulized MgSO4 is one of the different treatment options available during acute exacerbation. Objective: To compare the efficacy of nebulized MgSO4 with nebulized salbutamol in the treatment of acute asthma in children. Materials and method: This randomized controlled study was conducted in Dhaka Medical College Hospital between January to December 2016. Children of 7-12 years with acute exacerbation of asthma were randomized into study group-A (MgSO4 group, n=30) and control group-B (Salbutamol group, n=30). Children of both groups were treated with serial nebulization thrice at 20 minute intervals by either 2.4 ml (4% MgSO4, 96 mg) or salbutamol (0.15 mg/kg minimum 2.5 mg) with 2.5 ml of isotonic normal saline. Results: The mean final PEFR were not different between the two groups (275.0±41.42 L/min in MgS04 group and 263±36.17 L/min in salbutamol group). The increase in PEF was statistically significant and comparable in both groups (by 35.1% in the MgS04 group and by 42.1% in the salbutamol group). Fischl score improvement was comparable and significant in both groups (4.31 to 0.43 in MgS04 group and 4.29 to 0.76 in salbutamol group). Statistically significant increase in oxygen saturation and reduction of heart rate was found in MgS04 group without any side effects. Nebulized MgSO4 was found having significant bronchodilator effect which is comparable to salbutamol. Conclusion: Nebulized MgS04 was found equally effective as nebulized salbutamol in the treatment of severe acute asthma in children. Bangladesh J Child Health 2020; VOL 44 (1) :24-29

Background: Acute bronchiolitis is an acute viral lower respiratory tract infection of infants and is the leading cause of hospitalization of infants below 2 years of age. Being a viral disease, there is no effective treatment of this problem other than supportive care. To provide this care, both 0.9% normal saline with salbutamol and 3% hypertonic saline has been found effective. This study was undertaken to assess the efficacy of 7% hypertonic saline on recovery from acute bronchiolitis. Methodology: This was a randomized controlled trial, carried out in the Department of Paediatrics, Dhaka Medical College Hospital (DMCH), Bangladesh between January 2015 to December 2015. A total of 90 children from 1 month to 2 years of age of either sex who were diagnosed and admitted as acute bronchiolitis were enrolled. After enrollment, they were randomly assigned to either 7% nebulized hypertonic saline (Group-I = 45) or to 0.9% nebulized normal saline with salbutamol (Group-II = 45). The efficacy was determined by assessing clinical severity score and length of hospital stay. Data were analyzed using computer software SPSS version 19. Result: In this study the two groups were almost similar with respect to their demographic and baseline clinical severity score. After intervention the clinical severity score of both treatment modalities were reduced (Group-I(HS) were 7.9, 6.8, 3.8, 1.4, 1.33 while in Group-II(NS+ Salbutamol) score were 8.6, 7.6, 4.9, 3.11, 2.12) but the reduction was significant more in children who received 7% nebulized hypertonic saline than those who received 0.9% nebulized normal saline with salbutamol. Majority 42(93.3%) of group-I(HS) children recovered at the end of 72 hours whereas 17(37.8%) of the children of group-II (NS+ Salbutamol) recovered from the disease during the same period. Length of hospital stay was shorter in hypertonic saline group compared to normal saline with salbutamol group (56.36±12.33 hours vs71.07±13.48 hours, p

Background: The present study was intended to make a comparison of acute kidney injury (AKI) diagnosed and classified by two diagnostic modalities such as paediatric Risk Injury Failure Loss of End Stage Renal Failure (pRIFLE ) criteria and acute kidney injury network (AKIN) staging .Methodology: A total 44 neonates (from 3 – 28 days) with AKI as case and other 26 neonates without AKI as control were also included in the study. Both were admitted in special care baby unit (SCABU) Dhaka Medical College Hospital.Results: The neonate of ≤7 days old comprised the main bulk. Majority of the neonates were of average birth weight. The diagnosis was based on estimated creatinine clearance (eCCL) criteria of pRIFLE showed that 40.9% neonates were at risk of AKI, 20.5% have had already injured. Higher proportions of neonates were classified as failure (38.6%).The diagnosis was based on Serum creatinine criteria of AKIN showed that about 64% of the neonates were at AKI-stage I, 22.7% at stage-II and 13.6% at stage-III. Higher proportions of neonates were classified as stageI.We found moderate agreement between pRIFLE criteria and AKIN staging, these two diagnostic modalities for diagnosis of AKI by kappa- statistics. Outcome of neonatal AKI predicted by pRIFLE criteria was significantly higher compared to AKIN staging (p < 0.001) in respect to SCABU stay, multiorgan failure, need for dialysis. Here 43% neonates with AKI were improved with normal renal function and 16% improved with impaired renal function. Increased frequency of death (34%) in this series was due to multiorgan involvement with acute kidney failure (AKF). Mortality was significantly higher (p=0.03) in failure group by pRIFLE criteria compared to AKIN stage III. So it is evident that pRIFLE criterions are highly sensitive to classify AKI, it is also superior to AKIN staging in predicting early diagnosis, need for intervention and immediate outcome.Conclusion: The study concluded that pRIFLE criteria and AKIN staging are useful in the diagnosis of AKI in neonates and pRIFLE criteria are fairly sensitive for better characterization of AKI.Bangladesh J Child Health 2017; VOL 41 (3) :147-154

Congenital pulmonary airway malformation (CPAM) is a very rare congenital cystic lung disease in children. Frequent respiratory tract infections (RTI) are major concerns in these patients. When a child having recurrent episodis of RTI, CPAM could be the underlying pathology. Surgical excision is recommended to make a definite diagnosis and exclude hidden malignancies and is also the treatment of choice. Here in, we report a 6 months old girl presenting with an acute respiratory infection for the first time. An routine USG of abdomen incidentally showed multiple cystic lessions in the left lower lung. CT scan of chest also revealed similar lessions in some area. After receiving treatment for pneumonia surgical excision was performed and she was doing well after surgeryBangladesh J Child Health 2017; VOL 41 (2) :129-134

not availableBangladesh J Child Health 2017; VOL 41 (1) :60-63

Melioidosis is a relatively uncommon but fatal infectious disease caused by the gram negative bacterium, Burkholderia pseudomallei which is usually found in the wet soil, mud and pooled surface water in tropic and subtropics. Documented reports of melioidosis from Bangladesh have been few and sporadic. All of the reported cases in Bangladesh were on adult. Melioidosis is commonly associated with underlying diseases like diabetes mellitus, renal diseases and immunodeficiency disorders. Early and correct diagnosis is important, as mortality in untreated melioidosis is high. Our patient, an eleven years old boy, a known case of diabetes mellitus, presented with fever for one month associated with right sided neck swelling, abdominal distension & pain for 10 days. He had an abscess on the right side of the neck and hepatosplenomegaly. Ultrasonography of abdomen showed multiple abscesses in the liver and spleen. Culture of pus drained from the neck abscess revealed growth of Burkholderia pseudomallei. After getting parenteral antibiotics and insulin, his abscesses gradually resolved and cured completely.Bangladesh J Child Health 2018; VOL 42 (1) :46-48

not availableBangladesh J Child Health 2015; VOL 39 (2) :99-101

not available DOI: http://dx.doi.org/10.3329/bjch.v38i3.22828 Bangladesh J Child Health 2014; VOL 38 (3) :164-168

not available DOI: http://dx.doi.org/10.3329/bjch.v38i2.21137 Bangladesh J Child Health 2014; VOL 38 (2) : 58-61

Background : Seizure is a common neurological disorder in neonatal age group. Primary metabolic derangement is one of the common reason behind this convulsion during this period. Among metabolic abnormalities, hypocalcaemia is most common followed by hypoglycemia and hypomagnesaemia. Objectives: The present study was carried out to assess calcium status in the serum of neonates with convulsion, where no obvious cause of convulsion was found. Methodology : This prospective case control study was conducted in the neonatal ward of Dhaka Medical College Hospital over one year from July 2003 to June 2004. A total of 50 neonates (1- 28 days) who had convulsion but no apparent reasons of convulsion had been found out, were enrolled as cases and 50 age, sex body weight matched neonates who had no history camalnia admitted cases of were enrolled as controls. After a quick clinical evaluation and control of convulsion and before giving any specific treatment serum calcium status was measured by colormetric determination (O- CRE-SOL Phahalein complex) method. Neonatal hypocalcemia is considered if serum calcium value less than1.75 mmol/L (7 mg/dl). Results: Among a total of fifty cases, 60% had hypocalcemia, and about 20% of controls also had low calcium level without any manifestation. The mean serum calcium level of cases and controls were 1.62 ± 0.29 and 2.07 ± 0.03 mmol/l respectively (p

not available DOI: http://dx.doi.org/10.3329/bjch.v38i2.21144 Bangladesh J Child Health 2014; VOL 38 (2) : 94-97

Background: Prevalence of Asthma in children is about 7% in Bangladesh but Spirometric value of children is not available. Objective: The study was conducted to find out the spirometric value of normal school going children and to compare the values with those of other countries. Methodology: Sprirometric evaluation of normal school going children was done by computerized spirometer (Ponygraphic of COSMED srl-ltaly) in a school of Dhaka city during the period of February 2002 to July 2002. Nine hundred twenty seven healthy children aged 6-15 years were selected for the study. Outcome variable were the forced vital capacity (FVC), forced expiratory volume in first second (FEV1), peak expiratory flow (PEF), the ratio of FEV1 to FVC and forced expiratory flow (FEF) between 25% & 75% of vital capacity (FEF 25% & 75% ). The pulmonary function data was separated by sex and categorized on the basis of height, weight, age and body surface area. The mean and standard deviation were calculated for every such variable. The results (FVC) of present study was compared with those of other countries (India, Nigeria, British and America). Results: The lung function variables showed a linear positive correlation with height, weight, age and body surface area (independent variables). Strong correlation was found between lung function values and independent variables. Height showed the maximum correlation in comparison with other variable. Forced vital capacity (FVC) and FEV1 showed a spurt after the height of 150 cm. Regression equations for lung function values were determined for boys and girls considering height as independent variable. Boys showed higher values for lung functions than those of girls. Lung function values of these studied children are nearly similar to Indian children and significantly lower than Nigerian, British (UK) and American (USA) peers. Conclusion: Spirometric values of our children are very much comparable with those of regional children (India) but values are lower than those of African (Nigeria), European (British) and American (USA) children. Recommendation: Further study should be done with larger sample size to have our own national data and to fill up the standard spirometric values for the children of our country. Key words: Spirometric standards; healthy children. DOI: 10.3329/bjch.v29i3.6187 Bangladesh J Child Health 2005; Vol 29 (3): 93-98

Background: Perinatal asphyxia is the most important preventable cause of cerebral injury in the neonatal period leading to very high neonatal mortality and morbidity in developing countries. Little can be done for a baby affected by severe perinatal asphyxia. So, prevention is unquestionably desired. Objective: To identify the maternal and fetal risk factors for the development of birth asphyxiated babies and to see the short term outcome of the affected babies. Methods: An analytical type of or observational study was done in the Special Care Baby Unit (SCBU) of Dhaka Medical College Hospital from October 2003 to March 2004. Identification of the risk factors was done by retrospective comparison of the cases and controls. Outcome was analyzed by cross sectional comparative study. One hundred consecutive cases of birth asphyxia, admitted in SCBU, were enrolled in the study. Another 30 neonates admitted during this period for other reasons (i.e., jaundice, septicemia, low birth weight) were taken as control. Necessary information were collected by detailed history taking, clinical examination and close follow up of the hospital course, using pre-designed questionnaire and recording form. Results: Male: female ratio 3:2 both in the cases and controls. Mean age on admission was 13.8 hours and 2.6 days for case and control respectively. Identified important maternal risk factors were primiparity (57% in cases vs. 33.3% in control), hypertension (16.6% vs. 3.3%), pre-eclamptic toxemia of pregnancy (24% vs. 13.3%), prolonged rupture of membrane (33.3% vs. 6.7%), prolonged labour (34% vs. 3.3%) and use of oxytocin during labour (16% vs. none). All these were statistically significant (p