Background : Seizure is common neurological disorder in children. It is one of the common causes of referral of child to hospital and often requires emergency intervention. Rectal diazepam is the established first line drug for this purpose, but seizure recurrence and respiratory depression are the two major side effects. Midazolam is a water-soluble benzodiazepine with anticonvulsive activity at physiologic PH, which facilitates its effects on brain tissue. Midazolam is also easy to use, and no adverse events were reported in relation to the route of administration. Objectives : To compare the efficacy and safety of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in children. Methodology : This prospective randomized study was conducted in the Department of pediatrics, Sir Salimullah Medical College (SSMC) and Mitford Hospital, from March 2018 to December 2018.Fifty (50) patients aged 3 months to12 months who were convulsing and experiencing prolonged seizure (lasted >5 minutes) were included. Patients was randomly assigned to one of the two treatment arms: rectal diazepam and buccal midazolam. Primary and secondary outcome was compared between 2 treatment arms. Primary outcome was: 1. cessation of visible seizure activity within 10 minutes. 2. without recurrence of seizure in the subsequent hour. Secondary outcome included: 1. proportion with cessation of convulsion and exact time needed for cessation of convulsion within 10 minutes2. proportion of seizure recurrence in the sub sequent hours and within 24 hours after initial control and exact time of recurrence within the respective period. Also the safety and adverse effects were also compared. Results : The two groups did not differ significantly in sex, age, type of seizures, temperature, and baseline RBS, respiratory rate and blood pressure. Comparing the 2-treatment group, 13 (52%) patient experienced treatment failure who received rectal diazepam compared with 7 (28%) who received buccal midazolam (P>0 .05). For initial cessation of seizures, 18 (72%) seizures terminated within 10 minutes in the diazepam group compared with 19 (76%) in the midazolam and mean time to cessation of the seizure was 4.02±1.03 minutes and 4.4 ± 1.09 minutes respectively (p>0.05). Among the 18 children in whom seizure was initially controlled within 10 minutes by rectal diazepam, 6 (33.33%) of them experienced a seizure recurrence in the subsequent hour compared with 1 (5.26%) of 19 children in the buccal midazolam group (P<0 .05). children who experienced a seizure recurrence within 1 hour after initial control, the mean time torecurrence was 20.0±5.0 vs 25±0.0 minutes in diazepam group and midazolam group respectively (P =0.478). Seizure recurrence after initial control during the 24 hours after treatment was 5 (41.36%)vs 6 (33.33%).The mean time to recurrence within 24 hours was114.00±39.11.53 vs 320.83±173.10 minutes which was highly significant (P<0 .05) Conclusion : Buccal midazolam was as safe as and more effective with an improved efficacy over 1 hour (P<0 Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 493-498

Introduction: Among adolescent girls, iron deficiency is not uncommon due to various factors. During this period, iron deficiency anemia can greatly impact various factors of daily life, and additional iron supplementation might be needed. Aim of the Study: The aim of the study was to observe the benefits and side effects of iron folate tablet supplementation in adolescent women garments workers. Methods: This cross-sectional observational and descriptive study was conducted with the female adolescent garment workers of one garment factory located in the Narayangonj district. The data collection for the study was done in a very short period of time, from the 1st week of April to the 2nd week of July 2002, which led to a small sample size of 188 adolescent female workers. Result: Among the participants, 98.40% were Muslim, over half the participants were unmarried, 46.28% had been illiterate, and 51.06% had education up to class 1-3, Among the 81 married cases, 45.68% had husbands who received education from class 1-5, 48.94% had 2- 5 family member, 46.81% had 6-9 family members, and 4.26% had 10-12 family members. The financial characteristics of the participants revealed that 35.11% had 1500-3000 monthly income, 58.51% of the participants had 3-5 earning members, and 40.96% had only 1-2 earning member’s Per capita income was between 286-600 for 34.57% of participants, between 601-1000 for 53.19% participants. It was observed that in 3rd week, 43.62% had good health, 28.72% had increased work performance, and 13.83% had been free from sickness. By 4th week, 38.83% had good health, 25.00% had increased work performance and 10.11% had been free from sickness, which was true for the following weeks as well. In terms of side effects, anorexia, constipation, black stool, and vomiting were observed, with the highest frequency in 4th week of iron supplementation. Conclusion: The study observed that socio-demographic factors had no effect on the acceptance or reluctance ...

Background:Wilson disease (WD) is an autosomal recessive disorder of copper metabolism with diverse clinical manifestations. Zinc (Zn) has been used for treatment of WD. Recent studies showed low serum zinc level in patients suffering from WD than the normal. Objective: This cross sectional observational study has been designed to compare the serum Zinc level in children suffering from different presentation of WD before started treatment. Methods: This work was carried out at the department of Pediatric Gastroenterology and nutrition, BSMMU, Dhaka between July’ 2018 to June2019. Total 27 children diagnosed as WD disease, aged between three to eighteen years were included in this study. The patients of WD were divided into four groups according to their presentation as acute hepatitis, decompensated liver disease, acute liver failure and Wilson disease with neurological manifestation. Informed written consent were obtained from all patients for participation in this study. Along with other physical findings and laboratory investigations 3 ml of venous blood were collected for estimation of serum Zinc level. After estimation of serum Zinc level results were analyzed statistically. The difference in serum zinc levels were compared between the groups. Results: Serum Zinc level was founded low in all Wilson disease patients (43.8 ±19.7 [13-83] µg /dl) compared to normal value (64-124µgm. /dl). Among the patients, Serum Zinc level was significantly lower in those who presented as CLD (18 cases, 38.4±17.4µg/dl) and acute liver failure (4 cases, 33.1±3.7µg/dl) compared to those presented as acute hepatitis (4cases, 71.8±4.3 µg/dl) and p value was 0.001 and <0.001 respectively. Mean serum Zinc level was low in 4 patients suffering from acute liver failure (33.1±3.7µg/dl) but was not significant compared to those (23) who presented as Wilson disease non-ALF (45.7±20.8 µg/dl) (P= 0.013) and as Wilson disease CLD (38.4±17.4µg/dl) (p=.25). Conclusion: Serum Zinc level was lowered in patients of Wilson disease. Serum level of zinc was significantly low in patients presented as CLD and acute liver failure in comparison to patients with acute hepatitis. J Bangladesh Coll Phys Surg 2023; 41: 126-131

Background: Thalassemia is the most common heterogeneous group of genetic disorders in which the production of normal hemoglobin (Hb) is partly or completely suppressed because of defective synthesis of one or more globin chains that vary widely in severity from asymptomatic forms to severe or even fatal entities. Aim of this study is to compare of various lipid levels in patients with b-thalassemia major with that of normal individuals. Methods: In this cross sectional study, 30 children (case) previously diagnosed as beta thalassemia major were evaluated for serum lipid levels who were admitted at the Department of Pediatrics in DMCH & Thalassemia center of Dhaka Shishu Hospital from January 2012 to December 2012. The control group included 30 ages & sex matched healthy participants. Serum lipids profiles (total cholesterol, triglycerides, LDL­ cholesterol, and HDL cholesterol) as well as hemoglobin, MCV, MCH & MCHC were compared between the two groups. P value < 0.05 was considered statistically significant. Serum total cholesterol (TC), Triglycerides (TG) and HDL cholesterol concentrations were measured by using Photoelectric Colorimeter (ERMA INC, model no AE-30F, made in Japan) in clinical biochemistry department of Dhaka Medical College. Results: Hematological tests showed the mean haemoglobin level in thalassemia group was 7.23 gm/dl with standard deviation of 1.23 whereas in control group the mean haemoglobin level was 10.37 gm/dl with standard deviation of 1.22. There was significant differences between two groups (p=.001). Mean MCV, MCH and MCHC in thaiassemic group were significantly lower [69.83 fl (SD 8.34), 23.10 pgm (SD 3.57) and 28.03% (SD-2.58)] than those in their control counterpart [8323 fl (SD 4.97), 29.23 pgm (SD 2.43) and 31.20% (SD-1.83)] respectively (p = 0.001 in all parameters). Beta thalassemia major patients had significantly lower high-density lipoprotein (HDL) and low-density lipoprotein (LDL) compare with controls (p<0.001). ......