Introduction: Meconium staining amniotic fluid is associated with lots of adverseoutcome and has long been considered to be a bad predictor of fetal outcome.Objective: This prospective observational study was undertaken to find out immediatefetal outcome in meconium stained liquor.Materials and Methods: This study was conducted in Obstetrics and Gynecologydepartment of Dhaka National Medical Collage Hospital from July to December 2008.The pregnant women with yellow, brown and thinly stained amniotic fluid in labour withgestational age 37 completed weeks were enrolled in the study. Their babies weretaken as case and followed upto 7 days after delivery in National Medical CollageHospital and in Dhaka Shishu Hospital after admission when required. Babies bornwithout meconium stained liquor were taken as a control.Results: Total 80 cases were enrolled in the study as case and 80 cases wereenrolled as control. Mean gestational age was 39.3±1.5 weeks in cases and 38.5±1.3weeks in control. There was 13.8% pregnancy induced hypertension in case groupand 3.8% in control group. Pre-eclampsia were present 10% in case group and 1.1%in control group (p<0.05). Caesarean deliveries were high (75%) in cases and it wasmuch higher with thick meconium (75%) as compared to the thin meconium (25%,p<0.001). Apgar scores in first minute and fifth minute were also low in cases. Birthasphyxia was more in cases (20%). Meconium Aspiration syndrome (25%) andConvulsion (3.8%) were developed only in cases. Admission in neonatal ward wasmore (22.5%) in cases (p<0.05) as compared to control. Neonatal mortality was high(3.8%) in cases than control (1.3%).Conclusion: Meconium stained amniotic fluid were associated with higher rate ofcaesarian delivery, increased need for neonatal resuscitation, increased rate of birthasphyxia with hypoxic ischemic encephalopathy, meconium aspiration syndrome,hospital admission and mortality.Key words: Meconium stained liquor; foetal outcome.DOI: 10.3329/bjch.v33i2.5675Bangladesh Journal of Child Health 2009; Vol.33(2): 41-45

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Introduction: Acute kidney injury (AKI) is an important clinical problem in sick neonate. In most patients, AKI accompanies with a predisposing factor such as sepsis, asphyxia and surgery. The aims of this study were to determine the incidence, associated contributing factors and short term outcome of AKI in hospitalized newborn infants. Materials and Methods: This prospective cohort study was done in Dhaka Shishu Hospital from March 2011 to September 2011. This study included 300 sick neonates admitted during the study period. AKI was defined when serum creatinine level >1.5 mg/dl and BUN was >20 mg/dl on two separate occasions at 24 hours apart. Oliguria was defined as urine output <1ml/kg/ hr. Medical records of those patients were reviewed and data were analyzed using SPSS software.Results: Fourteen babies (4.66%) out of 300 sick neonates had AKI, of whom 64.2% were male and 35.7% female. The term and preterm neonates were 71% and 29% respectively. While a normal birth weight was observed in 57% cases, 35% had low birth weight and 7.14% had very low birth weight. Sepsis was the most common (71%) association of AKI, followed by perinatal asphyxia (52%). All patients had more than one predisposing factors. Frequency of oliguric kidney injury was 57% and non-oliguric was 43%. Mortality among the hospitalized neonate with AKI was 21%.Conclusion: This study showed that in a tertiary care hospital AKI is not uncommon (4.66%) in neonatal care unit. It is associated with some preventable conditions such as sepsis, perinatal asphyxia and shock. Outcome is poor in sick neonates with AKI (21% mortality) in comparison to sick neonates without AKI (10.3%).

Background: Congenital Rubella infection is a serious disabling problem for children resulting in Congenital Rubella Syndrome (CRS). The exact pattern of the CRS related cardiovascular malformation has not yet been well established in Bangladesh. The objective of this study was to observe the pattern of cardiovascular malformation in Congenital Rubella Syndrome. Methodology: This cross-sectional study was conducted in Dhaka Shishu (Children) Hospital and National Institute of Cardiovascular Diseases (NICVD). Total 40 suspected CRS cases were recruited from both indoor and outpatient departments of the two study hospitals. Serum samples were tested for rubella-specific IgM and IgG, visual and hearing assessment, chest radiography and colour doppler echocardiography were performed at appropriate specialized centres. Results: The mean (±SD) age of the study population (n=40) was 6.6 (±5.7) months (range: 0–24 months), 68% children were male and 32% were female. Congenital heart disease (CHD) was found in 78% children. Patent ductus arteriosus was the commonest (47.5%) structural defect followed by pulmonary stenosis (22%), atrial septal defect (17.5%) and ventricular septal defect (17%). The chest X-ray of CHD cases showed cardiomegaly in 71% cases and patchy opacity and/or consolidation in 65% cases. Regarding serological assessment of the 37 patients (3 patients rejected blood collection), 60% cases showed IgG positive and 28% cases revealed positive IgM. Conclusions: Various forms of cardiovascular malformation are present in CRS patients. Treatment modalities differ in each type of CHD and its early detection can reduce childhood mortality and morbidity. DOI: http://dx.doi.org/10.3329/bjch.v38i3.22822 Bangladesh J Child Health 2014; VOL 38 (3) :137-141

ImportanceThe number of deaths of children younger than 5 years has been steadily decreasing worldwide, from more than 17 million annual deaths in the 1970s to an estimated 5.3 million in 2019 (with 2.8 million deaths occurring in those aged 1-59 months [53% of all deaths in children aged &amp;lt;5 years]). More detailed characterization of childhood deaths could inform interventions to improve child survival.ObjectiveTo describe causes of postneonatal child deaths across 7 mortality surveillance sentinel sites in Africa and Asia.Design, Setting, and ParticipantsThe Child Health and Mortality Prevention Surveillance (CHAMPS) Network conducts childhood mortality surveillance in sub-Saharan Africa and South Asia using innovative postmortem minimally invasive tissue sampling (MITS). In this cross-sectional study, MITS was conducted in deceased children aged 1 to 59 months at 7 sites in sub-Saharan Africa and South Asia from December 3, 2016, to December 3, 2020. Data analysis was conducted between October and November 2021.Main Outcomes and MeasuresThe expert panel attributed underlying, intermediate, and immediate conditions in the chain of events leading to death, based on histopathologic analysis, microbiological diagnostics, clinical data, and verbal autopsies.ResultsIn this study, MITS was performed in 632 deceased children (mean [SD] age at death, 1.3 [0.3] years; 342 [54.1%] male). The 6 most common underlying causes of death were malnutrition (104 [16.5%]), HIV (75 [11.9%]), malaria (71 [11.2%]), congenital birth defects (64 [10.1%]), lower respiratory tract infections (LRTIs; 53 [8.4%]), and diarrheal diseases (46 [7.2%]). When considering immediate causes only, sepsis (191 [36.7%]) and LRTI (129 [24.8%]) were the 2 dominant causes. An infection was present in the causal chain in 549 of 632 deaths (86.9%); pathogens most frequently contributing to infectious deaths included Klebsiella pneumoniae (155 of 549 infectious deaths [28.2%]; 127 [81.9%] considered nosocomial), Plasmodium falciparum (122 of 549 [22.2%]), and Streptococcus pneumoniae (109 of 549 [19.9%]). Other organisms, such as cytomegalovirus (57 [10.4%]) and Acinetobacter baumannii (39 [7.1%]; 35 of 39 [89.7%] considered nosocomial), also played important roles. For the top underlying causes of death, the median number of conditions in the chain of events leading to death was 3 for malnutrition, 3 for HIV, 1 for malaria, 3 for congenital birth defects, and 1 for LRTI. Expert panels considered 494 of 632 deaths (78.2%) preventable and 26 of 632 deaths (4.1%) preventable under certain conditions.Conclusions and RelevanceIn this cross-sectional study investigating causes of child mortality in the CHAMPS Network, results indicate that, in these high-mortality settings, infectious diseases continue to cause most deaths in infants and children, often in conjunction with malnutrition. These results also highlight opportunities for action to prevent deaths and reveal common interaction of various causes in the path toward death.