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Rosai-Dorfman disease (RDD) is a type of sinus histiocytosis. It is a rare disease (1:200000), particularly in children and commonly presents with massive, painless and usually bilateral cervical lymphadenopathy along with fever and weight loss. Leukocytosis, elevated erythrocyte sedimentation rate and hypergammaglobulinemia are common. A definitive diagnosis can only be made by histological analysis of affected lymph nodes. Emperipolesis and a typical immunohistochemical pattern characterized by positivity for S-100 protein and CD68 antigen and negativity for CD1a antigen are diagnostic for RDD. Here we report a case of RDD occurring in a 10-month-old child with progressive cervical lymphadenopathy and persistent fever. Histopathological and immunohistochemistry studies of a lymph node biopsy established the diagnosis. A watchful follow-up resulted in the resolution of fever and lymphadenopathy. J Bangladesh Coll Phys Surg 2022; 40: 299-301

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

Introduction: Inadequate knowledge on nutritious foods and feeding practices are determinant of malnutrition rather than lack of food. Health professionals particularly nurses pass long contact time with the mothers, so positive attitude among them can be used in motivating mothers for infant and young child feeding. There is little data available in this regard, therefore evaluation of nurses’ knowledge, attitude and practice on complementary feeding is very important. This study was conducted among the female nurses in a tertiary level hospital of Bangladesh to find out the knowledge, attitude and practice of complementary feeding to their own under-2 children. Methods: The descriptive study was carried out at Dhaka Medical College Hospital between September 2014 and August 2015. Total 95 nurses having children from 6 months up to 2 years of age were enrolled as sample. Results: It showed that 63.1% of the nurses had good understanding on complementary feeding. But 46.3% of them did not know the duration correctly and 27.4% considered infant formula as the complementary food. Almost all had the positive attitude but 28.4% stated that distraction during feeding is needed. Among the respondents, 97% strongly agreed about the importance of complementary feeding but 67.4% of the nurses introduced complementary food before 6 months of age. Only 58.9% of them continued breast feeding up to 2 years. Conclusion: The study reflects that although most of the nurses have adequate knowledge and positive attitude towards complementary feeding but deviation was noted in timely Introduction of complementary food and use of feeding bottle. This indicates clear disparity between knowledge and practice of the female nurses. J Bangladesh Coll Phys Surg 2022; 40: 87-92

Backgrounds: Children are mostly the victims of pneumonia and bronchiolitis for which they are often hospitalized. Acute respiratory infection(ARI)results in 1.9 million deaths per year in developing countries(Taneja et. al 2009). It is important to know the recovery time of individual acute lower respiratory tract infection (ALRTIs) like pneumonia and bronchiolitis for better understanding the clinical feature and outcome. Knowing the length of stay (LOS) in case of ALRTI has not yet been worked out and studied well. Objective: To determine the recovery of different clinical features Length of hospital Stay and outcome of two common LRTIs viz pneumonia and bronchiolitis. Methods: A cross-sectional analytical study was done in department of pediatrics of Dhaka Medical College Hospital during the from October 2013 to September 2014. Cases were selected according to selection criteria. Pneumonia was diagnosed on the basis of fever, cough, breathing difficulty, and found chest indrawing, fast breathing, and bronchial breath sound or crackles on examination and consolidation or patchy opacity in chest X-ray and bronchiolitis on the basis of presence of runny nose followed by cough, breathing difficulty and wheeze on auscultation in a child below 2 yrs. Cases of pneumonia were treated with standard protocol of WHO and cases of bronchiolitis were treated with national guideline. The cases were followed up 12 hourly for 8 days using case collection sheet by monitoring 17 clinical features. Results : There were 54 cases of pneumonia and 54 cases of bronchiolitis. Baseline selected clinical-sociodemographic parameters of both the cases were similar in terms of sociodemographic status and some clinical features. The following clinical features were similar in both groups viz. cough(100% vs 100%) breathing difficulty (100%vs 100%), feeding difficulty (92.6%vs96.3%), chest indrawing(92.6%vs 96.3%).The dissimilar clinical features were fever (100%vs77.8%, p

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

Background: Bronchiolitis is an acute seditious lesion of the lower respiratory tract. Further, than 70 cases are caused by a respiratory syncytial virus (RSV); other less common pathogens include parainfluenza, influenza, rhinovirus, adenovirus, mortal metapneumovirus, mortal Boca contagion and mycoplasma pneumonae. The aim of the study was to evaluate the efficacy of nebulized hypertonic saline in children with acute bronchiolitis in the improvement of clinical features and decreasing length of hospital stay.Methods: The study was a randomized control trial carried out in the department of paediatrics, Dhaka medical college hospital (DMCH), Dhaka between January to December 2013. A total of 100 children from 1 month to 24 months of age irrespective of sex with clinical presentation of bronchiolitis admitted in the paediatric wards of DMCH were included in the study and were randomly assigned to either 4 ml 3% hypertonic saline nebulization (group I=50) or to 4 ml normal saline and 0.4 ml salbutamol respiratory solution nebulization (group II=50). The therapy was repeated 8 hours every day for 120 hours.Results: The clinical severity scores (CS) based on respiratory rate, wheezing, chest retraction and general conditions at baseline on the first day of treatment were 9.0±1.0 in group I and 9.3±1.8 in group II (not significant). The study demonstrated that clinical severity score improved by three days but the improvement was more significant in children who received nebulized hypertonic saline (1.7±1.2) compared to those who received nebulized normal saline and salbutamol (3.5±1.8). The cases of group I required a shorter duration of oxygen therapy compared to those of group II (15±6.0 hours versus 26.4±5.4 hours; p