Search

Background: Short stature can cause psychosocial problems both in parents and children. It can be a normal variant or secondary to an underlying pathological condition. It is necessary to evaluate cause of short stature and thus to decide whether further management needed. This study aimed to determine the causes of short stature in children and adolescents. Methods: This cross-sectional study was done at the paediatric endocrine out patient department, BIRDEM General Hospital 2, Dhaka from January to December 2019. A total 175 patient with short stature who fulfilled the inclusion criteria were recruited. Detailed history, physical examinations including anthropometric measurements and relevant investigations were recorded. Results: The mean age of the children was 9 ± 4 years, with female preponderance (female: male 1.27:1). Majority of the children had normal variation of growth (29%). Systemic illness and non-endocrine causes were found in 27.4%, endocrine cause in 26.85%, 13.7 % cases had dysmorphic features and idiopathic short stature was found in 2.85% cases. Familial short stature (FSS) was the most common cause (20.57%) followed by hypothyroidism (13.14%), familial short stature co-existing with nutritional problem (8.6%), growth hormone deficiency (7.4%), Turner syndrome (6.28%). Other causes that contributed for short stature in our study included constitutional delay of growth and puberty (CDGP) (2.85%), FSS coexisting with CDGP (5.7%) and systemic diseases and chromosomal abnormalities. Conclusions: The majority of short stature in children had normal variations of growth. Potentially treatable causes such as hypothyroidism, growth hormone deficiency, nutritional problem, Turner syndrome etc. accounted for a considerable percentage of short stature in our study. BIRDEM Med J 2022; 12(2): 117-123

Background: Junior doctors form the majority of the workforce in patient care. Their job is perilous, highly critical, tedious and exhausting and it is imperative that they stay motivated while at work. Improving the morale of physicians has the potential to increase efficiency, ensure patient safety and improve patient outcomes. We aimed to identify the existing status and explore the factors affecting junior doctors’ morale, their sense of feeling supported and their levels of autonomy in 2 large teaching hospitals in Bangladesh. Methods: This cross-sectional observational study was done across 2 large tertiary hospitals- Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders(BIRDEM) General Hospital and Dhaka Shishu Hospital, over 4 months period from September- December 2020. The study was carried out on 120 junior doctors by an online questionnaire, distributed through emails and Facebook messenger, asking junior doctors to rate their morale, sense of feeling supported and autonomy and rank the top factors that positively affected them. Results: Data were finally collected from 117 junior doctors after 3 incomplete data were discarded. Most of the junior doctors felt ‘neither good nor bad’ in the domains of existing ‘morale’ (44.4%), ‘feeling supported’ (46.5%) and ‘autonomy’ (48.7%). Additionally, ‘good’ morale was seen in 39.3%, while around 34% rated their support system as ‘good’ and around 24% reported a ‘good’ autonomy. The most important factor positively affecting morale was recognition and reward for good performance (70.1%), factor influencing support was an easy access to senior clinicians (70.4%) and that defining autonomy was constant senior supervision of the everyday work (61.1%). Conclusion: The study aims to identify the existing level of morale, support and autonomy of the junior doctors at their workplace and explore the factors positively affecting them. It is concluded from this study that the junior doctors rated their existing morale, support and autonomy as ‘average’. According to the opinions of the doctors, this study also concludes that, to improve their morale, there is a need to recognize and reward their good work and provide positive feedback. Doctors identified an easy access to senior clinicians with a problem was the primary factor influencing support. Finally, junior doctors wanted constant senior supervision of their everyday work in the wards to improve output. BIRDEM Med J 2022; 12(1): 30-35

DiGeorge syndrome is caused by a micro-deletion of chromosome 22q11.2 that disrupts development of the third and fourth pharyngeal pouches during early embryogenesis. Other structures forming at the same period are also frequently affected. So, the phenotypic spectrum shows a wide variability. In this case report, we describe a 1-month and 24-day old male child who presented with history of recurrent afebrile seizure and noisy breathing since early neonatal period. He had history of repeated chest infections. On examination, patient had stridor, facial dysmorphism, pectus excavatum and clinical features of pneumonia. Investigations revealed hypocalcaemia, hypoparathyroidism, consolidation on X-ray chest and cellular immunodeficiency. Echocardiography findings were normal. Fluorescent in situ hybridization (FISH) was performed which confirmed the diagnosis 22q11.2 deletion. Birdem Med J 2021; 11(2): 128-132

Background: Dengue is a major health problem affecting Bangladesh. The number of cases have increased over the last few years with a large number of population being children. However data regarding dengue among children is limited. The objectives of this study were to see the clinical and laboratory profile of dengue fever (DF) in children and their outcome. Methods: This cross - sectional study was carried out in the department of Paediatrics, BIRDEM General Hospital 2 from June 2018 to August 2019. Three hundred and ten confirmed dengue cases were enrolled in the study. Their clinical profile and laboratory findings including haemoglobin (Hb%), haematocrit (Hct), total count of white blood cells (TC), differential count of white blood cells ( DC), platelet count (PC), serum alanine aminotransferase ( S. ALT), serum aspartate aminotransaminase (S. AST), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT) were documented. Comparison was made between the clinical and laboratory profile with severity of dengue. Results: One hundred and ninety eight (63.9%) had dengue fever, 58(18.7%) had dengue haemorrhagic fever (DHF I, II) and 54 ( 17.4 %) had dengue shock syndrome ( DHF III and IV). All the patients had fever, vomiting was present in 40%, ascites and skin rash in 21 %, pleural effusion 20%, abdominal pain 14% and 12.2% came with shock.Thrombocytopenia, raised hct, raised liver enzymes and abnormal coagulation profile were more common in dengue haemorrhagic fever when compared to patients with dengue fever. Conclusion: Gastrointestinal features like vomiting, ascites ,abdonminal pain were common presentations. Thrombocytopenia, raised hct, raised liver enzymes, abnormal coagulation profile were more common in dengue haemorrhagic fever. Birdem Med J 2020; 10(3): 200-203