Bangladesh Journal of Child Health <p>The official organ of the Bangladesh Paediatric Association. Full text articles available.</p> Bangladesh Paediatric Association en-US Bangladesh Journal of Child Health 0257-3490 Cover and Content Page Vol. 46(3) <p>Abstract not available</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3)</p> Sanjoy Kumer Dey Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-16 2024-05-16 46 3 i i Notes & News Vol. 46(3) <p>Abstract not available</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 151</p> The Editor Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 151 151 10.3329/bjch.v46i3.72680 Abstract from Current Literatures Vol. 46(3) <p>Abstract not available</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 148-150 </p> The Editor Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 148 150 10.3329/bjch.v46i3.72679 Rational Use of Antibiotics in Childhood Pneumonia: A review <p>Inappropriate antibiotic treatment in childhood pneumonia may lead to greater expense, antibiotic resistance, toxic side effects, or even death. Important risk factors are infant and young children, low birth weight, nonexclusive breastfeeding, malnutrition, vitamin A deficiency, incomplete immunization and exposure to polluted air. Common organisms involved in pneumonia in neonatal periods are gram negative rods, group B streptococcus and staphylococcus. Beyond the neonatal period S. pneumoniae, H. influenzae, staphylococcus and mycoplasma are common. MRSA, gram negative rods and Legionella spp are commonly involved in nosocomial pneumonia. Rational use of antibiotic for bacterial pneumonia is based on probable organism, age, vaccination and clinical status of the child. Children who do not require hospitalization should have high doses of amoxicillin 90 mg/kg/day orally divided twice daily, alternatives include cefuroxime and amoxicillin/clavulanate. For schoolaged children when mycoplasma is suspected, azithromycin is generally preferred, alternatives clarithromycin can be given. Fully immunized against H. influenzae type b and S. pneumoniae children who are not severely ill should give ampicillin or penicillin G. For children who do not meet these criteria: ceftriaxone or cefotaxime should be given. If clinical features suggest staphylococcal pneumonia (pneumatocele or empyema), then include oxacillin or vancomycin. Vancomycin and meropenem are the initial treatment of choice for nosocomial pneumonia. Pneumonia in neonatal period should have ampicillin plus gentamicin or ceftazidime plus amikacin. Antibiotics should be continued until the patient has been afebrile for 72 hours, and the total duration should be 10 days. Selection of appropriate antibiotic in childhood pneumonia considering age of the child, risk factor, probable organism, immunization status and clinical severity are paramount important.</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 102-109</p> Md Al Amin Mridha Md Shakibur Rahman Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 102 109 10.3329/bjch.v46i3.72672 Frequency and outcome of sodium disturbances in children admitted with acute watery diarrhea in a tertiary hospital of Bangladesh <p><strong>Background: </strong>Acute watery diarrhea (AWD) is one of the common causes of hospital admissions in pediatric age group. Majority of children with dehydration suffer from different electrolyte abnormalities which needs to be identified and treated.</p> <p><strong>Objectives: </strong>To investigate the frequency and outcome of sodium disturbances in AWD among children admitted in a tertiary hospital in Bangladesh.</p> <p><strong>Method: </strong>In this prospective observational study, 121 children of 2 months to 5 years of age admitted in the Department of Pediatrics, Chittagong Medical College Hospital with AWD were included. Clinical features and sodium levels on admission were recorded. Patients were followed up during their hospital stay to record the outcomes. Children were grouped in hyponatremia (serum sodium &lt;135mmol/l), hypernatremia (serum sodium &gt;145mmol/l) and normonatremia (serum sodium 135–145mmol/l) and compared.</p> <p><strong>Results: </strong>Of the 121 children, 38.0% and 62.0% had moderate and severe dehydration, respectively. The majority (58.7%) had normal sodium levels. Sodium disturbances was found in 41.3% cases. There were 26.4% cases of hypernatremia and 14.9% cases of hyponatremia among them. Out of 18 hyponatremic patients, 77.8% had mild hyponatremia and the rest 22.2% had moderate hyponatremia. Among 32 hypernatremic children, 62.4% had mild, 18.8% had moderate and 18.8% had severe hypernatremia. The case fatality rate was 2.6% and all of them had hypernatremic dehydration at admission.</p> <p><strong>Conclusion: </strong>Sodium disturbances particularly hypernatremia is more frequent and is associated with high case fatality rate among children hospitalized with acute watery diarrhoea.</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 110-114</p> Ferdous Ara Nasir Uddin Mahmud Mohammed Maruf Ul Quader Muhammad Jabed Bin Amin Ahowdhury Golam Mohammad Tayeb Ali Tasnuva Sharmin Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 110 114 10.3329/bjch.v46i3.72673 Prenatal & Perinatal Risk Factors of Autism Spectrum Disorder <p><strong>Background: </strong>Autism spectrum disorder (ASD) is lifelong neurodevelopmental disorder characterized by impairments in social function, communication, and certain behaviors. The etiology of ASD is unclear &amp; it is believed to be multi-factorial, among those several prenatal &amp; perinatal factors are found to be significant. So, the necessity of this study is to detect the presence of known risk factors of ASD which in turn may help in the early diagnosis and intervention for better long-term outcomes.</p> <p><strong>Objective: </strong>To find out prenatal and perinatal risk factors of ASD<strong>.</strong></p> <p><strong>Method: </strong>A case control study was conducted with 112 cases of ASD and 201 controls of 2-6 years of age. The study was carried out in Center for Neurodevelopment and Autism in Children (CNAC), in the department of Paediatrics, Bangabandhu Sheikh Mujib Medical University and Autism Welfare Foundation (AWF). ASD was diagnosed by DSM-IV TR criteria. Mothers were interviewed and data were collected by semistructured questionnaires.</p> <p><strong>Results: </strong>Total 5 risk factors were identified as the risk factors of ASD. They were: advanced paternal age (OR=2.84) and maternal age (OR=1.87); male baby (OR=2.01); environmental stress during pregnancy (OR=1.61) and preterm delivery (OR=1.80).</p> <p><strong>Conclusions: </strong>It is concluded that advanced paternal age, maternal age, male baby, environmental stress during pregnancy and preterm delivery are associated with increased risk of ASD.</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 115-121</p> Mohsina Akter Lucky Khondoker Ehsanul Arefin Md Mizanur Rahman Md Elias Bhuiyan Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 115 121 10.3329/bjch.v46i3.72674 Congenital Heart Disease in a Tertiary Care NICU; Pattern, Risk Factors and Outcome <p><strong>Background: </strong>Identification of congenital heart disease (CHD) is increasing, may be due to advancement of diagnostic technology and availability of trained man power. Several studies have been conducted in Bangladesh to identify the prevalence and pattern of CHD but paucity of data regarding etiology and outcome.</p> <p><strong>Objective: </strong>The aim of this study is to identify the frequency and risk factors of so that preventive measures can be taken.</p> <p><strong>Methods</strong>: This retrospective case control study was conducted in the neonatal intensive care unit (NICU), BSMMU, Dhaka from January 2021 to June 2022. All admitted neonates in NICU with the diagnosis of CHD were considered as cases. Twice number of newborn having gestational age and birth weight matched neonates diagnosed other than CHD in NICU were considered as control. Data were extracted from the Medical records of patient files and computer electronic data records of “Newborn Birth Defect (NBBD) surveillance in Bangladesh.” The level of significance was set at 5% (P &lt;0.05).</p> <p><strong>Result: </strong>Total 914 patient were admitted during the study period among them 119 patient were CHD (frequency rate 13%). Mean birth weight and gestational age of CHD group were 2376±783.85g &amp; 35.80±3.26 weeks respectively. About 85.7% had acyanotic CHD, among them most prevalent were atrial septal defect (42%) then patent ductus arteriosus (11.8%). Cyanotic CHD were 17 (14.3%). Maternal DM significantly increase the risk of developing CHD, Odd’s ratio 1.971 (CI: 1.182 - 3.285). Death were more in CHD group (34.5%) than control group (20.4%), p values = 0.005.</p> <p><strong>Conclusion: </strong>Frequency (13%) of congenital heart disease was high. Maternal diabetes mellitus increases the risk of developing CHD of their baby. Death were more among babies with CHD.</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 122-129</p> Sanjoy Kumer Dey Md Arif Hossain Faria Yasmin Ismat Jahan Mohammad Kamrul Hassan Shabuj Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 122 129 10.3329/bjch.v46i3.72675 Reproducibility of Naked Eye Single Tube Red cell Osmotic Fragility Test (NESTROFT) as a screening test for the detection of b thalassemia and Hemoglobin E traits with the variation of reading time <p><strong>Background: </strong>Though 0.36% NaCl buffered solution has been used as an effective reagent for carrying out Naked Eye Single Tube Red cell Osmotic Fragility Test (NESTROFT) as a screening test for the detection of b thalassemia and Hemoglobin E traits, reading time for its interpretation is yet to be settled.</p> <p><strong>Methods: </strong>This cross -sectional analytic study was done at Department of Pediatric Hematology and Oncology, BSMMU from January 2006-June 2007. NESTROFT was performed in 3 separate tubes for each of the 100 subjects (with â thalassemia trait and HbE trait and normal hemoglobin) with 0.36% NaCl buffered solution and reading was taken at different time at 5-minute, 15-minuteand 30-minute. Results were recorded as positive and negative. Hb electrophoresis, Hemogram with RBC indices for each sample and iron profile of selected subjects were done.</p> <p><strong>Results: </strong>Among the 100 study subjects, 48 were carriers (18 were â thalassemia traits, 30 were Hb E traits). Age range was 1 to 52 yrs. Mean Hemoglobin concentration, MCV, MCH of both b thalassemia and Hb E carrier were significantly lower than normal subjects (p values &lt;. 001). At 5-minute observation, NESTROFT was positive in 17 out of 18 â thalassemia traits with a sensitivity of 94.4%, 24 out of 30 HbE traits gave positive result with a sensitivity of 80%. Among the 52 normal subjects 35 gave negative result with a specificity of 67%. Positive predictive value and negative predictive value for detection of b thalassemia traits and HbE traits were 50% &amp; 97% and 58% and 85%respectively. Result of NESTROFT interpreted at 15-minute and 30-minute did not show any change.</p> <p><strong>Conclusion: </strong>From this study it may be concluded that for interpretation of NESTROFT reading at 5-minute would be optimum.</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 130-137 </p> Md Anwarul Karim Chowdhury Yakub Jamal MA Mannan Mia Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 130 137 10.3329/bjch.v46i3.72676 Gallbladder Wall Thickening for Early Detection of Plasma Leakage Among Children with Dengue Fever Admitted in a Tertiary Care Hospital <p><strong>Background: </strong>Plasma leakage is defined as e”20% elevation of hematocrit from baseline or evidence of plasma leakages such as pleural effusion, ascites, or hypoalbuminemia. In the early phase, these signs of plasma leakage are usually difficult to ascertain by physical examination and laboratory tests.</p> <p><strong>Objective</strong>: This study aimed to investigate whether gallbladder wall thickening (GBWT) in the febrile phase of the disease can be used to detect the occurrence of plasma leakage in dengue patients.</p> <p><strong>Methods: </strong>A cross-sectional analytical study was conducted during a 4-month period in Dr. M R Khan Shishu Hospital and ICH from September 2021 to December 2021. Children from 6 months to 14 years who were admitted with acute onset of fever less than 3 days with NS1 positivity were included consecutively. Laboratory tests and abdominal Ultrasonography were also performed to confirm the occurrence of plasma leakage.</p> <p><strong>Result: </strong>Out of 114 patients, the majority were male (64%), in the 5-&lt;10-year age group(48.25%). Common presentations include fever (100%), flushed appearance (66.7%), abdominal pain (66.7%), vomiting (44.7%), bodyache (39.5%), During the febrile phase, 56patients were presented with GBWT, 49 of which showed plasma leakage during treatment. The sensitivity and specificity of GBWT during fever were 89% and 88%. PPV and NPV were 87% and 90% respectively. In risk factor analysis, Gallbladder wall thickening was found statistically significant (&lt;.009) predictor of plasma leakage in dengue.</p> <p><strong>Conclusion: </strong>Gallbladder wall thickening during the febrile phaseis a predictor of plasma leakage in Dengue.</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 138-143 </p> Morsheda Khanam Sultana Amena Ferdoucy Farhana Rahat Kazi Iman Riad Mohammad Moshaed Hossain Ahmed Murtaza Chowdhury Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 138 143 10.3329/bjch.v46i3.72677 A 7-year-boy with Recurrent Acute Disseminated Encephalomyelitis: A case report. <p>Acute Disseminated Encephalomyelitis (ADEM) is one form of inflammatory demyelinating disorder of central nervous system affecting the children following an idiopathic course of onset and usually monophasic. Recurrent ADEM is a rare entity and will arise a confusion about its diagnosis. There is no definite clinical criteria and treatment protocol for the management of ADEM. Here we report a case of recurrent ADEM where a 6 year old boy presented with recurrent episodes of low grade fever, difficulty in walking, altered sensorium and focal seizure. MRI of brain showed reappearance of demyelinating lesion on the previous site. The gap between first and second episode was six months. After the first attack of ADEM patient was completely recovered both clinically and neuroradiologically with immunotherapy. But after 7 months of disease free remission, patient again developed same features. So we diagnosed the baby as recurrent ADEM based on the consensus criteria of International Pediatric MS study group (IPMSSG).</p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 144-147 </p> Naznin Akter Sheikh Azimul Haque Rumana Islam Tania Saad Copyright (c) 20242 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 144 147 10.3329/bjch.v46i3.72678 Riddles of Lupus Anticoagulant in children <p>Abstract not available </p> <p>BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 100-101</p> Chowdhury Yakub Jamal Copyright (c) 2022 Bangladesh Journal of Child Health 2024-05-07 2024-05-07 46 3 100 101 10.3329/bjch.v46i3.72671