Perinatal risk factors were studied among 50 cases of neonatal septicemia and 200 matched normal neonates during one year period. The consanguinity among parents, birth order and sex of the baby did not increase the risk for developing septicemia. There was significant increase in the risk for septicemia when the duration of labour was more than 24 hours (P less than 0.01), time interval between rupture of membrane and delivery of baby was more than 12 hours (P less than 0.001), liquor was meconium stained or foul smelling (P less than 0.001) and delivery was operative (P less than 0.01). The neonatal factors identified with risk for septicemia were preterm delivery (P less than 0.01), low birth weight (P less than 0.01), birth asphyxia (P less than 0.001) assisted ventilation (P less than 0.001) and intravenous alimentation (P less than 0.02). Identification of high risk pregnancies and appropriate management can minimize many of the above risk factors which in turn will reduce the occurrence of neonatal sepsis.

Neonatal sepsis was studied among one hundred neonates (50 hospital born and 50 outborn babies) over one year period. The incidence of neonatal septicaemia was 15.5 per 1000 live births in the hospital. Among outborn babies it accounted for 6.1% of total pediatric admissions and 43.7% of sick neonates referred from outside. Low birth weight and prematurity were important predisposing factors in both the groups. Blood culture was positive among 32% of outborn and 34% of inborn babies. Coagulase-negative Staphylococcus, Klebsiella and Acinetobacter were the common causative organisms. All isolated organisms were sensitive to Gentamicin whereas 75% of them were resistant to Ampicillin. Mortality among outborn neonates (32%) was much higher in comparison to (10%) hospital born babies. Early identification of high risk antenatal cases and neonates and appropriate referral can bring down mortality and morbidity from neonatal sepsis.

Background: Throughout the world multi-drug resistant hospital acquired infections (HAI) are one of the leading causes of deaths and morbidity amongst hospitalized patients. Objective: The aim of study was to identify prevalence and variations of predominant microorganisms and their drug sensitivity and resistance pattern in a tertiary care public hospital, Dhaka, Bangladesh. Methodology: The study was conducted in Intensive Care Unit (ICU), High Dependency Unit (HDU), Post-operative ward and general wards of a tertiary care publicNeuro- hospital in Dhaka during 1st January, 2017 to 31st December, 2018. Patients admitted in any of the four units (ICU, HDU, Post-operative and general wards) of the hospital who were clinically suspected of having acquired any infection after 48 hours of admission to the ICUs were included. Depending on the clinical suspicion laboratory samples were collected from the patients. Samples were subjected to the testing and antibiotic sensitivity. Results: A total number of total 1672 samples from these patients yielded clinically relevant microorganisms. Of these samples, 273 were respiratory specimens were tracheal aspirate; 537 were urine; 377 were blood; 396 were cerebrospinal fluids; and 82 were other clinical samples. More than two-third samples were growth negative (71.4%) and only one-thirdsamples (28.6%) were growth positive. Maximum growth negative in blood samples and about half of samples of urine and tracheal aspirates were growth negative. About 80% were Gram-negative bacteria like Escherichia coli, Pseudomonas spp., Klebsiella whereas gram-positive organisms were about 20%. Most of the pathogens were Multi-drug resistance. Conclusion: Among HAIs Multidrug-resistant Gram-negative bacteria are the main challenge. Regular updating resistance of microbial are needed to develop antibiotic guideline to combat these infections and reduce morbidity and mortality. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 82-86

Background: Depressive illness is present among Parkinson’s disease (PD) patients. Objective: The purpose of the present study was to see the influencing factors of development of depressive illness among Parkinson’s disease patients. Methodology: This comparative cross-sectional study was carried out in the Department of Neurology and Department of Psychiatry at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2009 to June 2011 for a period of two (2) years. Parkinson’s disease patients who were attended at the movement disorder clinic and general OPD of Department of Neurology and in-patient department of Neurology at BSMMU, Dhaka were selected as study population. Patients with Parkinson’s plus syndrome, with dementia or other causes of parkinsonism like vascular or drug induced parkinsonism were excluded from this study. Data were collected by filling structured clinical questionnaire, then filling up of ‘structured clinical interview for DSM-IV Axis I disorders’ (SCID-CV) and self-reported ‘Depression scale` questionnaire. Parkinson disease was diagnosed by neurologist by the presence of two or more of the four cardinal criteria namely tremor, rigidity, bradykinesia and postural instability. Then patients were screened for depression by a psychiatrist of Department of Psychiatry at BSMMU, Dhaka. Result: A total of 100 Parkinson’s disease patients were interviewed and 80 patients ultimately participated in the study. The mean age of total Parkinson’s disease patients was 57.71±12.36 years ranging from 35 to 82 years with highest percentage (35%) had age group 65 years or above, 28.7% in 55 to 64 years, 22.5% in 45 to 54 years and lowest percentage (13.8%) in age group less than 45 years. Among 80 Parkinson’s disease patients, depression was present in 34 (42%) patients and was absent in 46 (58%) patients. Diabetes mellitus (p=0.125), hypertension (p=0.097), hypothyroidism (p=1.000), other illness (p=0.595), family history of PD (p=0.758) and levodopa use (p=0.661) were not significantly associated with the development of depressive illness in Parkinson’s disease. Conclusion: Diabetes mellitus (DM), hypertension (HTN), hypothyroidism, other illness, family history of PD and levodopa use do not significantly influence in the development of depressive illness among the Parkinson’s disease. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 106-110

Objectives. Optic nerve sheath fenestration (ONSF) is commonly used in idiopathic intracranial hypertension (IIH). Here we will present our experiences of ONSF in 26 patients with special attention to indications, surgical techniques and results Methods. The recorded data of patient management (with the result) who underwent ONSF were reviewed and studied retrospectively. Results. The total number of patients who underwent ONSF was 26. The male-female ratio was 1:12. Indications of ONSF were: 1. Idiopathic Intracranial Hypertension (IIH)-23 cases; 2. Cerebral Venous Sinus Thrombosis (CVST)-02 cases; 3. CNS Tuberculosis-01case. All patient underwent bilateral ONSF with post-operative continues lumbar CSF drain for 04 days. After fenestration gush of CSF came out with force in all-first operated eyes whereas 13-second operated eyes showed very little CSF flow after fenestration. Vision improved in different grades in all cases at discharge except in three cases. Preoperatively, visual acuity was either PL&PR or hand movement in 40 eyes where 04 eyes were preoperatively total blind (no PL&PR). Visual acuity improved in 48 eyes (92.3% eyes) where the patient can do his/her daily life activities including self-care. Improvement in IIH is 100% (23 cases i.e-46 eyes) whereas 01 case out of 02 cases in CVST. Though vision was improved dramatically fundal appearances changes very slowly and very less frequently returned to normal appearance. Conclusion. Due to the delicate and technically demanding nature of the surgery, safety is a major concern of the ONSF. Our experience showed ONSF is a technically safe operation with very good results where indicated.