Bangladesh Journal of Child Health The official organ of the Bangladesh Paediatric Association. Full text articles available. en-US (Professor Dr. Md. Al-Amin Mridha) (Md Fahmid Uddin Khondoker) Mon, 17 Dec 2018 16:19:34 +0000 OJS 60 Cystic Fibrosis: A Deadly Disease and the Vast Majority are Unaware of It <p>Abstract not available</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :105-107</p> Probir Kumar Sarkar, ARM Luthful Kabir ##submission.copyrightStatement## Sat, 15 Dec 2018 05:23:07 +0000 Assessment of Proteinuria in Nephrotic Syndrome in Children by Using Spot Urinary Protein/Creatinine Ratio <p><strong>Background: </strong>Quantification of proteinuria is usually predicted upon 24-hour urine collection. Multiple factors influence urine collection and the rate of protein and creatinine excretion. A spot urine protein-creatinine (P-C) ratio has been shown over the years to be a reliable alternative to the 24-hour collection for detection and follow up of proteinuria. The objective of the study was to evaluate the accuracy of urine protein creatinine ratio (UP/UC) in a spot sample for quantitative measurement of proteinuria in comparison with 24 hours urinary protein excretion in children of nephrotic syndrome having normal Glomerular Filtration Rate (GFR).</p> <p><strong>Methodology</strong>: This was a prospective study conducted in the department of paediatrics, Sir Salimullah Medical College &amp; Mitford Hospital Dhaka over a period of six months from January 2003. Fifty cases of Nephrotic syndrome were included who were on initial attack and relapse cases noted down into the proforma with respect to history, examination and investigation. All the patients were advised regarding 24 hours urine collection. They were asked to give a 24 hours urine sample starting at 9.00 am for total protein excretion rate. A spot urine sample was obtained and urine protein/creatinine ratio was calculated. The data was analyzed by linear regression and by calculating the correlation coefficient between urinary protein/ creatinine ratio and 24-hour urinary protein.</p> <p><strong>Results: </strong>Sample size was fifty. Urine total protein in a timed 24-hour sample of nephrotic syndrome patients was in the range of 300-3150mg/m<sup>2</sup>/hour with the mean value of 1725 mg/m<sup>2</sup>/hour. While as U(Pr/Cr) ratio ranged from 3.1-27.5 with the mean value of 15.2. A significant correlation was found between timed 24-hour urinary protein and UP/UC ratio (r=0.622, p=&lt;.001.)</p> <p><strong>Conclusions: </strong>Spot urine protein-creatinine ratio is highly reliable and rapid test for quantification of proteinuria in children with nephrotic syndrome.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :108-111</p> Delowar Hossain, - Zahiruddin, Monimul Hoque ##submission.copyrightStatement## Sat, 15 Dec 2018 05:33:05 +0000 Neonatal Pneumonia in NICU of a Tertiary Care Center <p><strong>Background</strong>: Pneumonia is one of the causes of neonatal infection and responsible for significant morbidity and mortality, especially in developing countries. The study was aimed to reveal frequency and outcome of pneumonia among hospitalized sick newborn of neonatal intensive care unit.</p> <p><strong>Methodology</strong>: This observational study was carried out in the NICU of Bangabandhu Sheikh Mujib Medical University (BSMMU) on 94 neonates with the diagnosis of pneumonia admitted from July 2012 to June 2014. All studied neonates were subjected to history taking, clinical examination, routine investigations, chest radiography and blood culture and sensitivity.</p> <p><strong>Results</strong>: Incidence of neonatal pneumonia was 43% among admitted neonates with respiratory distress. Mean birth weight and gestational age were 2392±854 and 33±3.9 weeks respectively. Of enrolled infants with pneumonia, 38 (40.4%) were early onset, 24 (25%) were hospital acquired pneumonia and community acquired pneumonia was documented in 14 (14.8 %) and the rest 18 (19%) were ventilator associated pneumonia. Blood culture was positive in 18 (19%) of cases with neonatal pneumonia; most common pathogen isolated was acinetobacter. Mean duration of hospital stay was 19±8 days. Most of the neonatal pneumonia were cured 72 (76%) with therapy, whereas 17 (18%) died during their hospital course.</p> <p><strong>Conclusion</strong>: Overall incidence among admitted sick neonates was 8.4% which constituted 34% of distressed neonate.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :112-117</p> MA Mannan, Nazmun Nahar, Firoz Ahmed, Ismat Jahan, Taskina Mosleh, Kamrul Ahsan Khan, Sanjoy Kumer Dey, Mohammod Shahidullah ##submission.copyrightStatement## Sat, 15 Dec 2018 13:38:11 +0000 Retinal Changes in Severe Malaria in Bangladeshi Children <p><strong>Background: </strong>In malaria endemic areas diagnosis of severe malaria by microscopy and immunodiagnostic test is confounded by asymptomatic peripheral blood parasitemia. In such settings, retinal changes by ophthalmoscopy showed some diagnostic utility. Contribution of ophthalmoscopy in diagnosis of severe malaria in children is not well studied in Bangladesh. The aim of this study was to describe the retinal findings in children of cerebral and non-cerebral severe malaria by direct and indirect ophthalmoscope and relate their outcome and to determine the course of changes in the fundus.</p> <p><strong>Methodology: </strong>In this prospective observational study 130 consecutive children aged between 6 months to 12 years admitted with confirmed severe Plasmodium falciparum malaria in pediatrics ward of Chittagong Medical College Hospital, Chittagong, Bangladesh were assessed by both direct and indirect ophthalmoscopy during the period of April 2008 to March 2009.</p> <p><strong>Results: </strong>Out of 130 patients 80 children had cerebral malaria and of these 49 (61.2%) had some degree of retinopathy; 24 (48%) of 50 with non cerebral severe malaria had retinopathy. Predominant retinal changes were Retinal hemorrhage and Macular whitening each in 53 (40.77%) patients, followed by peripheral whitening, Vessels changes and papilloedema in 50 (38.46%), 40 (30.77%) and 14 (10.78%) patients respectively. With indirect ophthalmoscope as reference, direct ophthalmoscopy had a high sensitivity to detect macular whitening, and papilloedema but was less sensitive to detect peripheral whitening and vessel changes. Patients with retinopathy had more chance to had unfavorable outcome (Death) in comparison to the patients who had not {Odds ratio:1.09 (95% CI:1.017-1.167)}. Most of these retinal changes were transient and resolved gradually as clinical condition improved.</p> <p><strong>Conclusion:</strong>Features compatible with malarial retinopathy were commonly found in our children with severe malaria. Ophthalmoscopy is an important clinical tool to aid in diagnosis and prognosis in children. However, indirect ophthalmoscopy provides better information than direct ophthalmoscopy.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :118-124</p> Abul Kalam Azad, Sanat Kumar Barua, Farid Uddin Ahmed, Parvez Iqbal Sharif, Nasir Uddin Mahmud ##submission.copyrightStatement## Sun, 16 Dec 2018 04:20:38 +0000 Recurrent and Persistent Pneumonia in Dhaka Shishu (Children) Hospital: Clinical Profile and Etiology <p><strong>Background: </strong>Recurrent and persistent pneumonia have become a challenge for the physicians. The aim of this study was to evaluate the clinical profile and determine the underlying causes of recurrent and persistent pneumonia among the children admitted in Dhaka Shishu (Children) Hospital.</p> <p><strong>Methods: </strong>In this study, retrospective analysis of medical records of the children was done, who met the criteria of recurrent pneumonia and persistent pneumonia. Analyzed Patients were admitted in Dhaka Shishu (Children) Hospital from January 2016 to Decembe 2016.</p> <p><strong>Results: </strong>A total of 30 patients were analyzed during the study period. Twenty-four patients presented with recurrent pneumonia (80%) and six patients presented with persistent pneumonia (20%) during the study a period. After analysis of clinical profile, identified causes were pulmonary TB (23.3%), congenital heart disease (13.3%), cystic fibrosis (16.6%), aspiration syndrome (13.3%), bronchial asthma (10%), immune deficiency disorders (10%), bronchiectasis (6.6%), congenital lung agenesis (3.3%), unknown cause (3.3%).</p> <p><strong>Conclusion: </strong>The most frequent underlying cause for recurrent and/or persistent pneumonia was pulmonary TB followed by congenital heart disease and cystic fibrosis among the patients admitted in Dhaka Shishu (Children) Hospital.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :125-129</p> Nazia Hossain, Kamruzzaman Kamrul, Akhand Tanzih Sultana, Md Shakibur Rahman, Md Ruhul Amin ##submission.copyrightStatement## Mon, 17 Dec 2018 09:54:27 +0000 Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis <p><strong>Background: </strong>Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay.</p> <p><strong>Methodology: </strong>A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay.</p> <p><strong>Results: </strong>Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p&gt;0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p&lt;0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p&lt;0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects.</p> <p><strong>Conclusion: </strong>Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :130-137</p> Khandaker Tarequl Islam, Abid Hossan Mollah, Abdul Matin, Mahmuda Begum ##submission.copyrightStatement## Mon, 17 Dec 2018 10:48:00 +0000 Progressive Myoclonic Epilepsy: Review Article with A Case Report of Lafora Disease <p>Progressive myoclonic epilepsy (PME) is an autosomal recessive, apparently a rare complex epilepsy syndrome. Among different types of PME, lafora body disease is more quickly progressive usually fatal within 2<sup>nd</sup> and 3<sup>rd</sup> decade. They are characterized by childhood or adolescent onset difficult to control multiple type seizures including myoclonous, generalized tonic clonic, absences, psychomotor regression with ataxia, dementia, dysarthria, visual hallucinations, and other general features. Early suspicion is important that leads to the rational diagnostic workout. The electro-clinical criteria would help a lot to exclude the benign epilepsy syndrome such as juvenile myoclonic epilepsy (JME) and suspect PME at the early stage of the complex epilepsy syndrome. Diagnosis is further clarified and confirmed by finding lafora body in skin and genetic study. Genetic mutation found in more than 87% cases in EPM2A gene or the EPM2B also known as NHLRC1 gene and are inherited in an autosomal recessive manner. EMP2A gene is located on chromosome 6q24. They are reported from Mediterranean basin, central Asia, India, Pakistan, northern Africa and Middle East where consanguineous marriage is common. We report a diagnosed case for the first time in Bangladesh. With the detail clinical history, rational use of the available investigation tools and clinical suspicion, diagnosis of the disorder at its early stage is possible. The rapid progress in genetic therapy would be a great hope in near future.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :138-147</p> Selina Husna Banu, Mashaya Zaman Koli ##submission.copyrightStatement## Mon, 17 Dec 2018 15:17:35 +0000 Dyslipidemia in Childhood Obesity: A Review <p>Childhood obesity has become epidemic in developed as well as developing countries. Apart from genetic factors, changes of lifestyle like consumption of excess calorie rich food, lack of physical activity and increased screen time are major contributing factors for childhood obesity. Many co-morbid conditions like cardiovascular, metabolic, neurological, hepatic, pulmonary, orthopedic, and renal disorders are associated with childhood obesity. It has both immediate medical complications as well as long term health consequences in later life. The most hazardous consequences like the cardiovascular disorder occur due to early athrosclerotic process which is accelerated due to dyslipidemia. As a result dyslipidemia is an important etiologic factor for development of cardiovascular disease (CVD), which is a leading cause of death in adulthood throughout the world. As abnormal vascular changes begins in childhood, and as dyslipidemia is an significant risk factor for CVD, screening and treatment of dyslipidemia in obese children and adolescents are an important health issue to prevent development metabolic syndrome and its consequences.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :148-154</p> Shahana A Rahman, Monira Hossain, Suraiya Begum ##submission.copyrightStatement## Mon, 17 Dec 2018 15:23:43 +0000 Mediastinal Cystic Teratoma with Right Sided Extra Renal Wilms’ Tumor - A Rare Case Report <p>A teratoma of the mediastinum is an uncommon germ cell tumor. Five percent of germ cell tumors are extragonadally located and men are affected more than women .Most mediastinal teratoma produce no symptoms, but we are presenting a case which was present with respiratory distress in early childhood. Classical wilm’s tumor usually found within the kidney but rarely it can occur in extra renal situations. Combination of these two is not reported until today we have searched extensively. We are presenting a 26 month old boy with mediastinal cystic teratoma with right sided extra renal wilms’ tumor which may be the first reported case. Combined effort of various concern departments ensures the diagnosis and management of such a rare case.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :155-158</p> AKMA Morshed, S Islam, K Alam ##submission.copyrightStatement## Mon, 17 Dec 2018 15:27:20 +0000 Caudal Regression Syndrome: A Rare Case Report <p>Caudal regression syndrome is a rare disorder characterized by abnormal development of structures in the caudal region of the embryo like lower lumbar and sacral vertebrae, urogenital and lower gastrointestinal system occur in early gestation. It’s a sporadic disorder. Maternal diabetes, genetic predisposition and vascular hypo perfusion have been shown to be associated with its pathogenesis. Here we report a newborn of diabetic mother diagnosed as caudal regression syndrome type II. Treatment for this patient is multidisciplinary. So, after giving necessary supportive treatment we discharged the patient with proper advice of his further management to improve the prognosis.</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :159-161</p> Lazina Sharmin, Shaheen Akter, Md Ismail Hossain, Abu Saleh Musa ##submission.copyrightStatement## Mon, 17 Dec 2018 00:00:00 +0000 Farber’s Disease: A Case Report <p>Abstract not available</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :162-165</p> Shoheli Akhter, Abdullah Amaan, Muhammad Rezaul Karim, Shahana A Rahman ##submission.copyrightStatement## Mon, 17 Dec 2018 16:00:43 +0000 Abstract from Current Literature Vol.42(3) <p>Abstract not available</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :166</p> - Editor ##submission.copyrightStatement## Mon, 17 Dec 2018 16:03:25 +0000 Notes and News Vol.42(3) <p>Abstract not available</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :167</p> - Editor ##submission.copyrightStatement## Mon, 17 Dec 2018 00:00:00 +0000 Corrigendum Vol.42(3) <p>Abstract not available</p> <p>Bangladesh J Child Health 2018; VOL 42 (3) :168</p> - Editor ##submission.copyrightStatement## Mon, 17 Dec 2018 16:10:55 +0000