Dhaka Shishu (Children) Hospital Journal

Abstracts from current literature Vol 38(2)

2023-12-26T04:20:35+00:00

Abstract not available

DS (Child) H J 2022; 38(2): 111-112

Institute News Vol 38(2)

2023-12-26T04:36:52+00:00

Abstract not available

DS (Child) H J 2022; 38(2): 113

Postgraduate Courses and Training in Paediatrics in Bangladesh Shishu Hospital & Institute [Vol 38(2)]

2023-12-26T04:36:53+00:00

Abstract not available

DS (Child) H J 2022; 38(2): 114

Students Qualified from Bangladesh Institute of Child Health (At present BSH&I)

2023-12-26T04:36:54+00:00

Abstract not available

DS (Child) H J 2022; 38(2): 115

Presentation and Outcome of Children with Kawasaki Disease: Experience in A Tertiary Care Hospital in Bangladesh

2023-12-26T03:33:11+00:00

Background: Kawasaki disease (KD) is an acute difficult-to-diagnose febrile illness in children caused by self limiting vasculitis in medium and small sized arteries.

Objetive: This study has been conducted to analyze its presenting symptoms, clinical course, laboratory findings, and therapeutic options in a tertiary hospital in Bangladesh to aid early diagnosis and optimum management.

Methods: This is a retrospective study where the medical records of 31 children admitted and diagnosed with Kawasaki Disease (KD) in Evercare Hospital Dhaka between 2009 and 2020, were assessed. Through a structured form, the demographic information, clinical profile, laboratory results, and echocardiographic data were obtained from the hospital records and then entered into a Microsoft Excel sheet. Cleaned and verified data were transferred to SPSS program version 23 and analyzed to obtain descriptive statistics.

Results: Out of total 31 patients with KD enrolled, 64.5% of the patients were between six months to five years of age with a median age of three years; 97% had an age below 6 months. Though 68% of patients met all the required criteria for KD, one-third (32%) were diagnosed as incomplete KD with fewer manifestations. Along with high fever in all cases, the most common clinical features were polymorphous rash (90%) and changes in extremities (90%) followed by changes in the lips and oral cavity (77.4%), cervical lymphadenopathy (68%) and conjunctival injection (61%). Common laboratory abnormalities found were anemia (90%), leukocytosis (65%), thrombocytosis especially in the second week (78%), high ESR (100%), and elevated CRP (84%). About 42% of patients had cardiac abnormalities at the onset. Seven children (63.6%) had coronary artery aneurysms (CAA) whereas 18% had coronary dilatations. In subsequent followups, coronary artery changes remained almost the same up to 6-8 weeks. After 3-6 months, 87.5 % of children recovered from cardiac abnormality.

Conclusion: A high index of suspicion for KD and an active search for compatible findings in children with unexplained fever can help in early diagnosis. Timely initiation of IVIG treatment is needed to reduce the risk of cardiac complications. Young infants under six months of age need further careful early suspicion and evaluation because of their incomplete presentation and more vulnerability to developing cardiac complications.

DS (Child) H J 2022; 38(2): 70-78

Role of Surgery in the Outcome Difference of Gastroschisis between High-income and Lowmiddle- income Countries: A Review

2023-12-26T04:20:33+00:00

Gastroschisis is a major congenital abdominal wall defect where the abdominal viscera comes out through a gap right to the umbilicus. The management of gastroschisis requires prompt and aggressive medical and surgical intervention immediately after birth. However, there is a notable disparity in mortality rates between developed countries and LMICs. Despite various surgical technique adjustments, LMICs still suffer from a high mortality rate, with certain centers reporting a 100% mortality rate. This article seeks to examine the literature and evaluate the impact of surgical techniques on the outcome of gastroschisis.

DS (Child) H J 2022; 38(2): 103-106

Clinicoepidemiological Profile of Short Stature at A Tertiary Care Centre in Bangladesh

2023-12-26T03:33:13+00:00

Background: Short stature (SS) is a common pediatric problem, which can cause psychosocial disturbances both in parents and children. The goal of the evaluation of a child with SS is to identify the subset of children with pathologic causes so that appropriate timely intervention can be made.

Objective: The aim of the study was to study the clinical, epidemiological, and etiological profile of SS at a tertiary hospital of Bangladesh.

Methods: This was a cross-sectional study and was conducted in the department of pediatric endocrinology, over a period of 1 year (January 2021-December 2021). A total of 100 children aged 3-14 years, with height <-2SD below the mean height for age and sex were studied. Clinical history, examination, and laboratory evaluations were done to assess the cause of SS and the data were analyzed using appropriate statistical methods.

Results: About 55% were female and 45% were male. The causes of SS were found to be familial SS (36%), constitutional growth delay of growth and puberty (12%), hypothyroidism (11%), growth hormone deficiency (8%), malnutrition (10%), chronic diseases (9%), genetic syndromes and skeletal problem (8%).

Conclusion: The majority of short stature in children had normal variation of growth. Along with endocrine causes, chronic systemic illnesses and malnutrition still form a major bulk in the etiological profile of SS in Bangladesh.

DS (Child) H J 2022; 38(2): 79-83

Socio-demographic Profile and Complications of Measles in Children: A Hospital Based Study

2023-12-26T04:07:18+00:00

Background: Measles is a self-limited viral disease. But it can cause serious complications in young children and still remains as an important cause of mortality and morbidity in under five children worldwide.

Objectives: The aim of the study was to determine the complications of measles in hospitalized children and to observe the socio-demographic profile of them.

Methods: A prospective observational study was conducted in Dr M R Khan Shishu Hospital and Institute of Child Health from March to December 2019. Children of 6 months to 10 years who came with signs and symptoms of measles according to the case definition criteria by WHO, like fever with maculopapular rash associated with cough, runny nose and conjunctivitis were included in the study. Their sociodemographic profile was recorded and different complications were noted.

Results: A total of 86 children suffering from measles with different complications were admitted during the study period. They were from 6 months to 10 years. Among them 59% were below 1 year, 80% were below 4 years and 94% were less than 7 years. Thirty eight percent children were from lower and thirty percent from middle socioeconomic background. Pneumonia was the main complication found in 62(72%) cases followed by diarrhea 28(32%), oral ulcer 26(30%), croup 5(6%) and febrile seizure 4(4.6%). Most (79%) of the children, had normal nutritional status. Among 62 children aged 9 months to 10 years, only 16(26%) received 2 doses of measles vaccine, 14(23%) only the first dose and 32(52%) was not vaccinated at all. Vaccination rate was poor (27%) in low socio-economic condition. The mortality rate was 1(1.16%).

Conclusion: About 60% of the children, suffering from measles, were less than one year of age. Fifty nine percent of them were not vaccinated. The children developed complications like pneumonia, diarrhea, oral ulcers etc. Vaccination status was poor in low socio-economic condition. So, awareness should be created about timely vaccination of measles.

DS (Child) H J 2022; 38(2): 84-88

Exchange Transfusion in Neonatal Hyperbilirubinemia: Experience of A Tertiary Care Hospital in Dhaka

2023-12-26T04:07:19+00:00

Background: Hyperbilirubinaemia is a benign condition in newborn babies in some infants may become severe, progressing to kernicterus with substantial risk of neonatal mortality and long-term neurodevelopmental impairments. Among many treatment options exchange transfusion (ET) is the standard method for treatment of severe hyperbilirubinemia.

Objectives: To investigate the frequency of primary risk factors for neonatal hyperbilirubinemia leading to ET, to evaluate the complications and immediate outcome of ET.

Methods: This was an observational cross sectional study conducted in Dr. MR Khan Shishu Hospital and ICH, Dhaka. Frequency of primary risk factors for severe neonatal hyperbilirubinemia leading to ET, characteristics of babies undergoing ET, complications and immediate outcome of ET were analyzed among the neonates admitted between January 2017 to February 2021.

Results: Among 61 neonates 49.18% were male and 50.82% were female, 65.57% of neonates were term and 34.43% pre term. The mean gestational age was 37.00 ± 1.50 weeks and mean birth weight was 2619±50gm. The leading causes of jaundice requiring ET were sepsis 31.17%, ABO incompatibility 24.59%, Rh incompatibility 14.75%, PT LBW with sepsis 14.75%, Infant of diabetic mother (IDM) 6.55%, PT LBW 6.55%, and neonatal sepsis with Down syndrome with congenital hypothyroidism 1.63%. Twenty (32.79%) neonates presented with signs of Kernicterus. Seven neonates (35%) presented with lethargy/poor feeding or hypotonic posture, 4(20%) patients had opisthotonus posture/hypertonia, and 9(45%) had convulsion. Nineteen (31.14%) neonates had complications related to ET. The most frequent complication was bradycardia (16.34%), then Catheter block (9.83%), apnaea (6.55%), cardiac arrest (6.55%), hypothermia (4.92%), NEC after ET (1.64%). Immediate outcome was good in 72.13% patients with smooth recovery, 14.75% had neurological deficit and 1.64% died. Among 20 neonates who presented with signs of Kernicterus 35% patients discharged with good recovery, 45% had neurological deficit.

Conclusion: The common causes of exchange transfusion in neonatal jaundice were sepsis, ABO incompatibility, PT LBW, and infants of diabetic mothers. Overall outcome was good few developed neurological deficit.

DS (Child) H J 2022; 38(2): 89-95

Immunophenotypic Characterization of Childhood Acute Leukaemia in A Tertiary Care Center of Bangladesh

2023-12-26T04:07:21+00:00

Background: Leukemia is one of the most common tumors in children. Childhood acute leukaemia (AL) is a heterogenous disease. Immunophenotyping is an essential part of the modern diagnostic workup/for typing and subtyping and prognostic stratification of AL and thus for an appropriate treatment of these complex and heterogeneous diseases.

Objectives: Objective of this study was to find immunophenotypic charectarization of childhood acute leukemia in children of Bangladesh. There is very limited study done on this subject in our country. Methods: This is a retrospective observational study done in children with acute leukemia under 15 years of age, treated in two tertiary care centers for Paediatric Oncology [Combined Military Hospital Dhaka and Ahsania Mission Cancer Hospital, Mirpur, Dhaka]. Data were collected from hospital registry from 2014 to 2020 and then analyzed.

Results: Total study population were 82; among them male 55%, female 45% and M:F 1:0.82. Most common age group was <5 years age with 55% patients. Disease distribution showed 77% patients had ALL and 23% AML. Among ALL, subtype distribution showed B-cell type 90.5% T-cell type 9.5%. A good number of patients did Immuno-phenotyping analaysis before starting chemotherapy, 68 out of 82 acute leukemia patients (83%). In case of B-ALL highest expression of antigen was CD19 (90%) followed by CD10 (76%), HLADR (76%), CD22 (74%), CD79a (68%), TdT (56%) and CD34 (48%). co-expression of CD10/19was seen in 38% cases. Even in 13% cases, expression of myeloid marker CD13 (14%) and T cell marker CD5 (2%) were seen. In case of T-ALL there was 100% expression of CD3. Expression of other antigen CD4, CD5, CD7, CD45, TdT was 33.33% in each. Expression of CD10, CD1a, CD2 and TCRAb also found 33.33% in each. In case of AML highest expression was MPO (93.24%) followed by CD33 (86.58%), CD13 (79.92%), CD117 (73.26%), CD45 (66%), HLADR (46.62%) and CD64 (46.62%). There was 6.66% aberrant expression of B cell marker CD19 and and T-cell marker CD3 (6.66%), CD5 (6.66%) and CD7 (6.66%).

Conclusion: In this study we found in case of B-ALL there was maximum expression was CD19 (90%), 2% aberrant expression of T-ALL marker CD5 and 14% aberrant expression of myeloid marker CD13 were present. In case of T-ALL maximum expression was CD3 (100%). In case of AML there was maximum expression of MPO (93%) and CD33 (87%) along with aberrant expression of B cell marker CD19 (6.66%) and 6.66% of each T cell marker CD3, CD5 and CD7 were present.

DS (Child) H J 2022; 38(2): 96-102

Rare Complication of Chicken Pox in Children - Acute Respiratory Distress Syndrome (ARDS): A Case Report

2023-12-26T04:20:34+00:00

Abstract not available

DS (Child) H J 2022; 38(2): 107-110

Newborn Screening, Where We Are

2023-12-26T03:33:10+00:00

Abstract not available

DS (Child) H J 2022; 38(2): 68-69