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Airway foreign body aspiration (FBA)is a frequent problem that affects young children, present with acute respiratory distress and cough followed by sudden chocking. Prompt identification and early treatment can save the child from a life-threatening emergency.Delayed diagnosis due to lack of history and clinical suspicion may lead to permanent lung damage, which may be a curse for a lifetime.We share an experience of a 4½-year-old boy who presented with suppurative lung disease was associated with neglected FBA. Early diagnosis and intervention canprevent,and ultimately reduce long-term morbidity and mortality, along with improving the better outcome regarding FBA. Bangladesh Journal of Medical Science Vol.20(1) 2021 p.208-211

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

Introduction: To determine the clinical types and etiological factors and to assess the biochemical abnormalities in neonates with seizure. Materials and Methods: This was a Cross-sectional, comparative hospital based study. Ninety neonates, age up to 28 days of both sexes were evaluated for clinical types, etiological factors and biochemical abnormalities with seizure and compared with those having no seizures. The variables were analyzed using student t- test. All the data was processed and analyzed by computer software SPSS version 15.0. Level of significance was considered as p value less than 0.05. Results: Most of the neonates having seizures (72%) within 3 days of life. The seizures were common in male babies (62%). 35% of the mother of baby with seizure gave history of prolonged labour. HIE was diagnosed 56.67% neonates with seizure whereas infection were found in 25% cases with seizure. Among the seizure subtypes, subtle seizures were 58% followed by clonic seizures 30%. Significant biochemical changes we found in 43.34% of neonates with seizures. Hypocalcemia (46%) was most common followed by hypoglycemia(38%). Conclusion: Hypoxic ischemic encephalopathy was the commonest cause of neonatal seizure followed by neonatal infections including meningitis and sepsis.. Biochemical abnormalities are more common in neonates with seizure than neonates free from seizure. Among the biochemical abnormalities hypocalcaemia and hypoglycemia occurs most commonly followed by hyponatraemia and hypomagnesaemia. Medicine Today 2020 Vol.32(1): 37-41

Background: Cerebral palsy is the most common chronic motor disability that begins in childhood with the predominant motor abnormality that is spasticity. Objective: The purpose of the present study was to compare the efficacy of oral baclofen and oral tizanidine in reducing spasticity in cerebral palsy patients. Methodology: This randomized controlled trial was conducted from January 2010 to December 2011 and it was carried out in the Out Patient Department (OPD) of Pediatrics at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh and Center for Neurodevelopment and Autism in Children (CNAC) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Results: A total number of 70 cerebral palsy children were recruited for this study of which 35 patients were in Tizanidine group and 35 patients were in baclofen group. Furthermore, 70 cerebral palsy children were taken as control who were treated with placebo. Tizanidine had superior efficacy in reducing tone in spastic cerebral palsy over baclofen measured by using Modified Ashworth scale in different time periods from AS score-3 to score-2 (p physician rating scale from AS score-3 to score-2 (crouch p Adverse effect was more in baclofen group. Conclusion: For reducing generalized spasticity with regards to muscle tone, joint angle and improvement in gait in cerebral palsy patients, tizanidine has superior efficacy and less adverse effects than baclofen.

Background & objective: Perinatal asphyxia affects all organs of the body and brain is the most affected organ. The study was undertaken to find out the status of serum magnesium and calcium level and their significant association among asphyxiated term newborns with moderate to severe HIE.Material & methods: The Cross sectional study was done in the Department of Neonatology, Dhaka Medical College Hospital during January 2012 to July 2012. A total of 102 asphyxiated term neonates were enrolled , who has H/O perinatal asphyxia and had Apgar score of 6 or

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

Background and objective: Neonatal sepsis is associated with increased mortality and morbidity of newborns. Moreover, inability to tolerate enteral feeding contributes to prolonged hospital stay and nosocomial sepsis. Probiotics confers health benefit to host by altering the gut environment. This study aimed at determining the efficacy of probiotics in reducing nosocomial sepsis and feeding intolerance in hospitalized low birth-weight infants.Methods: A quasi experimental clinical trial to compare between newborn infants getting probiotics along with breast milk (experimental group) with those getting breast milk only (non experimental group). Study was conducted from June to December 2013 with a total of 49 newborns, weighing 1000 to 2000gm.Results: In weight category 1000-1250 gm, 15.8% developed culture proven sepsis in probiotics/experimental group (n=9) and 10.5% in breast milk/non experimental group (n=10); p value was 0.655. Feeding intolerance was developed in 10.6% of the probiotics group and 31.5% of breast milk group, p value was not significant but the mortality was significantly lower among the probiotics group i.e., 5.3% in probiotics group Vs 42.1% in breast milk group (p 0.018). Between weight range of 1250-1500 gm, sepsis and feeding intolerance showed no significant differences (p value 0.305 & 0.305 respectively) but mortality differed significantly (0% probiotics group Vs 20% breast milk group; p 0.043). In weight range 1500-2000 gm, the result was not statistically significant for sepsis (p value 0.292), feeding intolerance (p value 0.292) and mortality (p value 0.292). Mortality was significantly lower in two weight categories (1000-1250 gm & 1250-1500 gm) and hence the overall result showed significant difference in the statistical analysis (p value 0.001).There were no differences either in nosocomial sepsis or feeding intolerance between the probiotics group and the breast milk group.Conclusion: Probiotics does not have any impact in reducing nosocomial infection and feeding intolerance but the use of probiotics seems to reduce mortality especially in the lower weight category.J Bangladesh Coll Phys Surg 2018; 36(2): 48-52

not availableJ Bangladesh Coll Phys Surg 2018; 36(2): 44-46

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

Background: The use of disposable diaper is gradually increasing for the infants in our country. However, the major hazard of diaper is diaper dermatitis. The magnitude of diaper related hazards is unknown in Bangladesh. This study was conducted to assess the frequency of hazards of wearing diaper among infants.Objectives: The study was conducted (i) to observe diaper related hazards among infants and (ii) to assess the factors affecting diaper related hazards.Materials and Methods: This observational study was conducted at department of Pediatrics of Dhaka Medical College Hospital & Bangabandhu Sheikh Mujib Medical University during May to September 2012. Fifty children aged 7 days to 12 months wearing disposable diaper for at least 7 days were enrolled in this study. A face to face interview was taken and finding were recorded on a preset questionnaire. The infants were also examined for presence of diaper rash. Obtained data were analyzed thoroughly by SPSS 21. Results: Among 50 children, 24(48%) male and 26(52%) female infants. Of them 13(26%) infants developed diaper rash in their diaper wearing time. The age distribution of the cases was 3(23.1%) below 01 months; 2(15.3%) 1-6 months and 8(61.6%) 7-12 months. Six (24%) male infant and 7(27%) female infant developed rash in their diaper wearing time. Diapers are mostly used by solvent families as diapers are not cost effective. The frequency 84.6%, increases with increased duration of using a single diaper at a time for more than 4 hours without change whereas those who changed diaper more frequently every 3-4 hours and 1-2 hours have diaper rash 15.4% and 0% respectively.Conclusion: From the result of the present study it can be concluded that the frequency of diaper rash is increased with increasing age of infants and use of diaper for long duration.J Bangladesh Coll Phys Surg 2017; 35(4): 170-173

Introduction: Kidney is the 2nd commonest affected organ as a consequence of asphyxia1. Most attention is given to prevent CNS damage and neurological sequel but hypoxic renal insult not only influences neonatal morbidity & mortality but may give rise to CKD. to assess the renal functional status of asphyxiated babies.Material & Methods: This cross sectional study was conducted in the Department of Neonatology & Department of Gynecology and Obstetrics, Dhaka Medical College Hospital during January 2012 to January 2013. A total of 150 inborn, term asphyxiated neonates with e” 2.5 kg who had history of delayed or no cry with Apgar score

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

Background: Acute Bronchiolitis and pneumonia pose significant morbidity and mortality of under five children. This outcome is further influenced by poor nutritional status of the affected child because of depressed immunity.Objective: We sought to evaluate nutritional status of children suffering from acute bronchiolitis and pneumonia in Bangladesh.Methods: This cross sectional study was conducted in the Department of Pediatrics of Dhaka Medical College Hospital and Dhaka Shishu Hospital from July, 2010 to June, 2011. A total of 50 patients of pneumonia aged 2-24 months and 50 patients of acute bronchiolitis of same age were enrolled in this study according to case definitions. After enrolment, the patients were thoroughly assessed with particular emphasis on the anthropometric measurements. Weight, length, MUAC and OFC were measured and recorded in a pretested semi structured questionnaire. For each group Z score of weight for age, weight for length, length for age, OFC and MUAC were calculated. Z score +2 to -1 was defined as normal, -1 to -2 z score as mild poor, -2 to -3 z score as moderate poor and 1.96 is equivalent to p value< 0.05). Results: Children with pneumonia more often had severe underweight (weight for age

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

Introduction: Acute bronchiolitis is a condition where patients are presenting with breathing difficulties, cough, poor feeding, and irritability. Treatment of bronchiolitis have many controversies. Most trials of bronchiolitis treatment suffer from 2 constraints: possible inclusion of patients with asthma and inconsistent outcome measures. The aim of the study was to determine the efficacy of prednisolone in recovery from acute bronchiolitis who have a family history of atopy. Material & Methods: This randomized double blind placebo controlled trial (RCT) was conducted in the department of pediatrics Dhaka Medical College Hospital (DMCH) from July 2008 to June 2010. Sixty (60) bronchiolitis patients having family history of atopy were included in his study. Prednisolone and placebo were packaged in identical envelops with separate code number given by the guide and the code number were recorded in a preformed questionnaire. The trial was so planned that neither the parents nor the investigator were aware of group allocation. The collected data were analyzed thoroughly by SPSS program version of 16.0 software. Informed written consent from parents or legal guardians was taken and ethical clearance was obtained from the ethical review committee of Dhaka Medical College to conduct the research works. Results: In our study, mean age of the patients of this series were 3.68 months (±1.29SD) and 3.52 month’s (±1.1SD) in prednisolone and placebo group respectively. Use of accessory muscle score was assessed twice at 8 am and 8 pm each day for three days. On first assessment at day 1 the score was similar in both the treatment groups (P>.05). More people in Prednisolone arm recovered within 3 days then the placebo group. The difference is statistically significant (P

Background : The cause of acute kidney injury (AKI) in neonate is multifactorial. The short-term outcome of AKI in newborns is highly dependent on the underlying etiology, the condition of other organs, and the facilities for renal replacement therapy.Objective : The aims of the present study were to find out the etiology and immediate outcome of AKI in neonate.Methodology : This observational study was done over a period of six months, at special care baby unit (SCABU) in Dhaka Medical College Hospital (DMCH). Neonates (aged 3-28 days) admitted in SCABU, who had AKI were the study population. Among them 44 neonates with AKI were included purposivly. AKI was diagnosed and classified by pediatric RIFLE (pRIFLE) staging criteria. Etiology of AKI was find out by dividing pre renal, renal and post renal cause of AKI. All neonates were treated conservatively and with intermittent peritoneal dialysis (IPD) as needed. Immediate hospital outcome was determined by improved with normal renal functions; improved with impaired renal functions and death.Result : The diagnosis based on estimated creatinine clearance (eCCL) criteria of pRIFLE showed that 43.2% neonates were at risk (R) stage, 22.7% were at injury (I) stage and 34.1% of neonates were at Failure (F) stage of AKI. Among 44 neonates 21 were male and 23 were female. Pre renal cause of AKI is predominant in this series. More than two-thirds (68.2%) of the neonates experienced perinatal asphyxia stage-II and III and 52.3% were exposed to meconium stained liquor during delivery. Septicemia with shock, history of aminoglycoside use were reported to be 59.1%, 52.3% respectively. Post renal cause was found in 16% neonates, like obstructive uropathy due to posterior urethral valve, exstrophy bladder and cloacal exstrophy. Neonate at Failure stage of AKI (n=15) had a significantly longer stay at SCABU (p < 0.001). Multiorgan failure was found to be significantly higher in failure group (p = 0.026). Majority of the failure group needed dialysis (p < 0.001). Most of the neonate at risk and injury stage was improved with normal renal functions. The resolution from AKI was almost similar among the groups (p = 0.885). The mortality was progressively higher from Risk to Failure Groups (p = 0.106). Overall 27% of the neonates diagnosed as AKI died from this illness, 57% improved with normal renal function and 16% improved with impaired renal function.Conclusion : The study concluded that perinatal asphyxia, septicemia with shock and use of aminoglycosides were the commonest cause of AKI in neonate. The mortality was higher in Failure group.Northern International Medical College Journal Vol.7(2) Jan 2016: 127-130

not availableJ Bangladesh Coll Phys Surg 2016; 34(2): 53-55

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

Not Available J Bangladesh Coll Phys Surg 2020; 38(3): 109

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

Objective : To determine the efficacy of oral prednisolone among children with acute bronchiolitis who have associated family history of atopy.Materials and Methods : This randomized double blind placebo controlled trial was carried out in Dhaka Medical College Hospital during July’08 to June’10. A total of sixty patients (1-24 months) of acute bronchiolitis who had family history of atopy (e.g. allergic rhinitis, allergic conjunctivitis, asthma, eczema) were enrolled. After enrollment, allocation of either prednisolone or placebo to the study subjects were done randomly by lottery method and the researcher remained blind about the allocation. Finally 30 cases received prednisoloneorally at a dose of 2mg/kg/day 8 hourly for 3 consecutive days and 30 cases received placebo (made of flour). In addition, both the groups got same supportive measures. During intervention, study subjects were monitored by Modified Respiratory Distress Assessment Instrument (MRDAI) score twice daily for consecutive 3 days. Duration of oxygen therapy as well as length of hospital stay was also determined. Data were analyzed using appropriate statistical tests and a p value of .05). Mean duration of oxygen therapy needed in Prednisolone group was significantly lesser than the placebo group (13.7 vs 24.1 hours; P

J Dhaka Medical College, Vol. 21, No. 2, October, 2012, Page 245-249 DOI: http://dx.doi.org/10.3329/jdmc.v21i2.15368

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

Delayed first passage of meconium and also prolongation of meconium passage creates great anxiety among parents. Some study showed that that first passage of meconium is delayed in preterm infants compared to term infants. The difference in duration of meconium passage in term and preterm infant has however never been assessed before. This cross sectional study was carried between July 2010 to December 2010 among 100 Newborn babies ranging from 28 to 42 weeks of gestation who were delivered in the Department of Obstetrics and Gynaecology or admitted in the Department of Neonatology of Dhaka Medical college Hospital were included in the study. Gestational age was determined from first day of last menstruation (when available) and also by using Expanded Ballard Scoring System. In case of any discrepancy of more than 2 weeks, the later was accepted. This study was carrying out to determine the time of first passage of meconium and duration of passage of meconium in term and preterm infants. Out of total 100 infants, 58 were male and 42 were female. The numbers of babies were 21, 28, 25 and 26 in group I, II, III and IV respectively. The mean age at which the babies passed first meconium were 23.5±3.5, 33.0±3.8, 25.7±4.2 and 17.3±4.6 hours in group I, II, III and IV respectively, which was4 days was 32.6±4.3 weeks and this observation was statistically significant (p

This cross-sectional study was carried out among 1000 children between 10 months to 5 years of age during November 2004 to February 2005 attended in the department of pediatrics, Dhaka Medical College Hospital (DMCH) with different childhood illness. Aim of study was to know the Immunization (EPI) coverage, dropout rate and factors influencing dropout. According to parent's statement, 82.5% of the children were fully, 16.1% were partially and 1.4% were non-immunized. Specific immunization coverage revealed that, 97.3% were immunized with BCG, 96.7% with DPT1/OPV1, 92.9% with DPT2/OPV2, 91% with DPT3/OPV3 & 84% with measles vaccine. Among the BCG vaccinated children 91.77% had BCG scar. Drop out of DPT1-DPT3 was 5.78% & DPT1- measles was 12.88%. The main reason found for non-immunization were lack of faith in programme (57.1%), lack of awareness (21.4%), and fear of side effects (21.4%), whereas lack of awareness (41.6%) and illness of child (32.9%) played role behind drop out. Drop out cases were found to be associated with female sex, parent's illiteracy, higher number of children in the family and father's occupation (p0.05). The study findings suggested that despite the effort taken by Government and NGOs to expand coverage, dropout rates are unacceptably high. To combat this challenge counseling and motivation on EPI, improvement of information system, health education and training of health workers are required. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13499 Faridpur Med. Coll. J. 2012;7(2): 59-62

Reducing Neonatal Mortality at Satkhira District Hospital by Quality Improvement Interventions

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

Background: Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to lack in laboratory-diagnostic facilities. Methods: Following the World Health Organization’s case-definition, we conducted a rapid-appraisal of HFMD among all of the 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and extremity rash. Data were collected between September and November 2017 using a preset syndromic approach and stringent differential diagnostic-protocols. Results: The mean age of children was 2.9±2.3 years. There was a significant difference among the age and sex of children (P=0.98), first sibling being more belonging to middle-income families (62%). Younger children ( Conclusions: Our findings highlight potential usefulness in diagnosing HFMD based on clinical parameters, although stringent differential diagnosis remains indispensable, which is particularly applicable for resource-constrained countries lacking appropriate virology/essential laboratories. Since no specific treatment or effective vaccination is available for HFMD, supportive therapy and preventive measures remain the primary methods to circumvent disease-transmission augmented by climate-related factors. Standardized virology laboratory warrants appropriate diagnosis and globally representative multivalent-vaccine deem essential towards preventing HFMD.

Background: Seizure is a common neurological disorder in neonatal age group!. Primary metabolic derangement is one of the important reason behind this convulsion during this period. Among primary metabolic derangement hypoglycemia, is most common followed by bypocalcaemia, hypomagnesaemia, low zinc status etc. As causes of many cases of convul­sion remain unknown in neonate. Objectives: To see the zinc status in the sera of neonate with convulsion. So that if needed early intervention can be taken up and thereby prevent complications. Method: A total of 50 neonates (1-28 days) who had convulsion with no apparent reasons of convulsion were enrolled as cases and 50 healthy age and sex matched neonates were enrolled as controls. After a quick clinical evaluation serum zinc status was estimated from venous blood by atomic absorption method in Chemistry Division, Atomic Energy Centre. Low zinc was considered if serum value was Results: Among a total of 50 cases 6% had low zinc value & 2% of controls also had low zinc level. The mean serwu zinc level of cases and controls were 1.57±0.95 and 2.37±1.06 mmol/1 respectively (pConclusion: From the study it is seen that low zinc value is an important cause of neonatal seizure due to primary metabolic abnormalities. So early recognition and treatment could save these babies from long term neurological sequelies.

Integration of infant- and child-feeding index (ICFI) addressing the multidimensional child-feeding practices into one age-specific summary index is gaining importance. This cross-sectional study was aimed at understanding the association between the ICFI and the nutritional status of 259 children, aged 6-23 months, who attended the paediatric outpatient department of the Dhaka Medical College Hospital in Bangladesh. The mean length-for-age z-score (LAZ) of children aged 12-23 months was significantly (p0.05) higher among those who were at the upper ICFI tercile compared to those who were at the middle or lower ICFI tercile (-2.01 and -3.20 respectively). A significant correlation was found between the ICFI and the LAZ (r = 0.24, p = 0.01 and r = 0.29, p = 0.01) in children aged 6-8-months and 12-23-months. Multivariable analysis, after adjusting for potential confounders, also found a significant association between the ICFI and the LAZ (beta = 0.13, p = 0.03). The predictive capability of the proposed ICFI on nutritional status of children, especially length-for-age, needs to be further evaluated prospectively among healthy children in the community.

This was an analysis of one hundred ten children with cerebral palsy (CP) attending at the Child DevelopmentNeurology Care Center of Dhaka Medical College Hospital during January 2002 to December 2003. These children were observed to study their clinical profile, etiological factors and associated problems. The mean age of these children was 2.9 +/- 2.9 years, mostly being males (n=79, 71.8%). Most of the families of these children belonged to poorer socioeconomic strata. Spastic diplegia constituted the predominant group (34.5 per cent), followed by spastic quadriplegia (25.5 per cent). Dyskinetic CP was present in 15.5 percent of the cases. Hypotonic CP constituted a significant proportion of cases. Delayed Motor Function was observed in all 110 cases, delayed speech was complained in 67.3% cases and impaired hearing was identified in 26.8% CP children. Mothers of 43.6% CP cases reported that they had prolonged labour during delivery and almost one third (29.1%) had suffered from pre-eclampsia or eclampsia. Majority (53.6%) of the CP cases were reported to have had perinatal asphyxia. Comprehensive assessment and early management of these problems are emphasized, which can minimize the extent of disabilities. By proper perinatal care, CP can be prevented.

Ulcerative colitis in children has not been reported previouslyin Bangladesh. This case report is of a 7 year old girl whopresented with frequent passage of slimy stool mixed with bloodfor 4 months. She also had fever, weight loss, abdominal painand urgency at defecation. Barium enema showed pancolitiswith multiple pseudopolyps and collar button appearance.Colonoscopy revealed a friable and granular mucosa withdiffuse ulceration and multiple pseudopolyps. There was bloodyexudate and the lumen was narrow. Histopathology findingsshowed necrosed tissue probably representing a base of ulcerand inflammatory cell infiltrate in the lamina propria. Thecrypt architecture was distorted with cryptitis and goblet celldepletion. There was no granuloma. She was diagnosed as acase of ulcerative colitis & treated with Sulfasalazine and oralcorticosteroid. Her response to treatment was very well andnow she is on regular follow up.DOI: 10.3329/jbcps.v28i2.5372J Bangladesh Coll Phys Surg 2010; 28: 117-120

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

DOI: 10.3329/jbcps.v27i1.4236 J Bangladesh Coll Phys Surg 2009; 27: 1-3