Search

Background: Tuberculosis is one of the most frequent and persistent global diseases causing millions of deaths every year. Pakistan lies at number 6 among the 22 most dominant countries, with multidrug resistance up to 15%. Isoniazid-resistant strains of Mycobacterium tuberculosis are gradually rising and seem to be more prevalent in developing countries. Mutations in the katG gene are considered to be responsible for the accusation of isoniazid resistance in M. tuberculosis. Objectives: The current study was designed to investigate the structural and functional associations of KatG gene mutations (S315R and S315T) and multidrug resistance in M. tuberculosis isolates from Karachi, Pakistan. Results: The present study revealed conformational changes in the structure of the KatG enzyme due to observed mutations, which led to induced alterations in isoniazid binding residues at the active site of the KatG enzyme. Furthermore, substantial changes were observed in interaction energy, ligand-receptor energy, electrostatic energy, salvation energy, and ligand-receptor conformational entropy. All these resultant modifications due to S315R and S315T mutations ultimately reduced the flexibility and stability of proteins at isoniazid-binding residues. Conclusions: This deviation in the consistency of protein texture eventually compromises the enzyme activity. It is well expected that the outcomes of the current study would provide a better understanding of the consequences of these mutations and provide a detailed insight into some previously unknown features.

Background: Despite proven cost effective intervention, there has been little change in neonatal mortality. In Bangladesh neonatal mortality accounts for two third of infants death. About 90% deliveries take place in home and majority of neonatal death are taking place within 7 days of birth. Information about reasons for delivering at home and newborn care practices will be useful to undertake simple intervention measures by policy makers. Aims and objective : To see the knowledge, perception and behaviour of mothers towards their normal and sick newborn. Methods: A cross sectional study was carried out in Dhaka Shishu Hospital from June to November, 2007. A semistructured, pretested questionnaire was used to interview mothers attending inpatient (IPD) and outpatient department (OPD) of hospital. Results: A total 198 mothers were interviewed. Home deliveries were 35.5% and Institutional were 64.5%. Among the Institutional deliveries 35% (44 out of 127) were planned and tried first at home, but when failed mothers were taken to hospital. Majority (86%) of home deliveries were conducted by Dai/relatives. Umbilical cord was cut with new/boiled blade in 85% of home deliveries and household knife was used in 4% cases. Birth place were not at all heated in all home deliveries. In 32 % of home deliveries babies were given bath within 1 hour of birth and it was 15% in case of hospital deliveries. Forty-eight percent babies of home deliveries were wrapped within 10 minutes. Prelacteal feed was given in 51% of home deliveries in comparison to 23% of institutional deliveries. The rate of initiation of breast feeding within one hour of birth was 52% in home and 35% in institutional deliveries. In all cases breast milk was given within 48 hours. Main reasons cited for delivering at home were preference (43%) and fear about hospital (39%). In case of educated (graduate) mothers 72% deliveries took place at hospital. Less feeding (56%), vomiting (42%), less movement (32%), fever (29%) and cough (27%) could be recognized by mothers as signs of sickness. Conclusion: Home deliveries and poor newborn care practices are commonly found in this study. Traditional birth attendants should be adequately trained as they are conducting majority of home deliveries. Female education is very important to reduce home delivery as it is seen that deliveries of educated mothers are taking place in hospital. High risk traditional newborn care practices like delayed wrapping, early bathing, use of oil in umbilical stump and prelacteal feeding need to be addressed. This study also found that knowledge to identify sickness in newborn is still poor. DOI: http://dx.doi.org/10.3329/bjch.v35i3.10497 Bangladesh J Child Health 2011; Vol 35 (3): 90-96

Clinical care of infants with very low birth weight (weighing

Reducing maternal and neonatal mortality remains a big challenge for a developing country like Bangladesh. Mothers’ knowledge in neonatal care plays an important role in bringing down the mortality as well as morbidity. This study was conducted in Dhaka Shishu Hospital during the period of December 2007 to February 2008 and was based on primary data collected on socioeconomic status, knowledge and practice of mothers of neonates attending the hospital. A total of 400 mothers were interviewed. More than fifty percent mothers had an appropriate knowledge on feeding neonates, hand washing before handling neonates, care of eye, care of umbilicus and they were practicing as well. Where as less than fifty percent mothers had appropriate knowledge on keeping neonates warm, cutting hair, bathing, vaccination, oil massage and their practice rate also commensurate well with their knowledge level. Majority of the mothers were in the age group of 21-25 years, having completed primary education or passed SSC exam. They were house wives living in an urban area, with a monthly family income of 3000-7000 taka. Statistically significant association was found between socio demographic variables and knowledge and practices on neonatal care of the mothers. Ibrahim Med. Coll. J. 2010; 4(1): 17-20 Key words: Socio-economic factors; knowledge and practices; neonatal care DOI: 10.3329/imcj.v4i1.5930

This study was conducted in Dhaka Shishu Hospital from December 2007 to February 2008 and was based on primary data on knowledge and practice of 400 mothers of neonates attending the hospital. More than 50% of the mothers had appropriate knowledge on feeding, hand washing, care of eye and umbilicus and they were practicing as well. Less than 50% of the mothers had an appropriate knowledge on raising neonates, shaving hair, bathing, vaccination, oil massaging and their practice rates also did commensurate with their knowledge level. It may be concluded that half of the interviewed mothers had an inadequate knowledge and adopted inappropriate practices in the care of their neonates. Strong steps should be taken to improve the level of knowledge and change attitudes for providing healthy practices of mothers in the care of their children. Ibrahim Med. Coll. J. 2009; 3(2): 59-62 DOI: 10.3329/imcj.v3i2.4218

Introduction: Meconium staining amniotic fluid is associated with lots of adverse outcome and has long been considered to be a bad predictor of fetal outcome. Objective: This prospective observational study was undertaken to find out immediate fetal outcome in meconium stained liquor. Materials and Methods: This study was conducted in Obstetrics and Gynecology department of Dhaka National Medical Collage Hospital from July to December 2008. The pregnant women with yellow, brown and thinly stained amniotic fluid in labour with gestational age 37 completed weeks were enrolled in the study. Their babies were taken as case and followed upto 7 days after delivery in National Medical Collage Hospital and in Dhaka Shishu Hospital after admission when required. Babies born without meconium stained liquor were taken as a control. Results: Total 80 cases were enrolled in the study as case and 80 cases were enrolled as control. Mean gestational age was 39.3±1.5 weeks in cases and 38.5±1.3 weeks in control. There was 13.8% pregnancy induced hypertension in case group and 3.8% in control group. Pre-eclampsia were present 10% in case group and 1.1% in control group (p