We are reporting a case of a 10 year old boy admitted in Dhaka Shishu (Children) hospital with the complaints of -swelling of both side of inguinal region for 2 months, tenderness of the same area for 1 month and low grade fever for 2 months. With the history and physical examination of the patients our differential diagnosis was Tuberculosis/Lymphoma/Cat scratch disease (CSD). He had only a history of contact with a kitten for 1 week 3 months back but no history of cat scratch or bite. Lymph node biopsy revealed that it was a case of Cat scratch disease. Introduction Cat scratch disease (CSD) also known as "Cat scratch fever" or "Subacute regional lymphadenitis" 1 is a usually benign infectious disease caused by the intracellular bacterium Bartonella henselae. It is most commonly found in children following a scratch or bite of a cat by about one to two weeks. It was first discovered in 1889 by Henri Parinaud.2 It oc curs worldwide with no racial or sex predilection.Kittens are more likely to carry the bacteria in their blood, and may therefore be more likely to transmit the disease than are adult cats. However, the results of experimental studies showed that fleas serve as a vector for transmission of B. henselae among cats. 3Although this disorder is strongly associated with cats, other animals have also been implicated. Reports also be found of transmission by dogs, rabbits, and monkeys. A few anecdotal cases have also been described involving transmission by porcupine quills and fish bones. Transmission occurs by scratching, biting or possibly even licking. Kittens seem to be particularly common as vectors. Case HistoryA 10 year old previously healthy boy from a slam area admitted in Dhaka Shishu (Children) hospital with the complaints of -swelling of both side of inguinal region for 2 m onths, tenderness of the same area for 1 month and low grade fever for 2 months.Two months back he first noticed bilateral swelling of his both ingunal region and initialy it was hard and nontender. He also complaints of low grade intermittent fever for the same duration. Ultimately the size of swelling increased and its consistency changed to soft and it became tender as an abcess for the last 1 month. He did not get any treatment for these problems. The boy was fully immunized and BCG m a rk was present. There was no history of contact with TB patient, gradual weight loss, night sweating; no abdominal pain and abdominal fullness.He did not notice similar swelling anywhere of his body and recalled a history of contact with a kitten 3 months back. At that time he was circumcized and cofined to home for 7 days and used to play with a kitten on his bed. But there is no history of cat scratch or bite on his lower limbs. After that, he never went to any contact with any cat or kitten. On physical examinationThe boy was cachetic (anthropometric measurements were-hight-120 cm, weight-17 kg, OFC-48 cm) and febrile. He was mildly pale and vital signs were within normal limit. Abdomen was soft and nontender without organomeg...

Background & objective : Chicken pox or varicella is a disease of both tropical and temperate zones bearing a complex-relationship with climatic variables, like temperature, rainfall and relative humidity, wind velocity and so on. As no study has, by far, been conducted to relate its occurrence with these climatic variables in Bangladesh, this study was intended to explore the effect of weather conditions on the incidence of varicella in Dhaka city of Bangladesh. Methods: The present cross-sectional study obtained data of 172 varicella cases from the records of the daily register of Out-patient Department of Dhaka Shisu Hospital, Dhaka between January 2018 to December 2019. According to the study protocol a child was diagnosed as having varicella or chicken pox who had a history of short febrile illness accompanied by a pruritic vesicular eruption (on the face and trunk)) of the skin and mucous membranes which ultimate weeps out and crusts. Total number of cases treated monthly at Out-patient Department (OPD) during the period was also recorded. Climatic data were provided by Bangladesh Meteorological Department, which among others, included monthly average temperature, relative humidity (RH) and amount of rainfall or precipitation. While the outcome variable was monthly number of varicella cases, the predictive variables were average temperature, humidity and rainfall during the study period. Result: Over 70% of children were 1-10 years old with median age of the children being 5.5 years (range: < 1 month -14 years). Boys were a bit higher (54%) than the girls (46%). A seasonal pattern of chicken pox was seen with clustering of cases between mid-February to mid-April (spring season) with two peaks – one in February and another in April, when monthly average temperature, total rainfall and humidity all were at their optimum. The peak incidences of chicken pox cases during the spring both in 2018 and 2019 as correlated with climatic data of the same period, it is seen that the prevailing weather then was optimum-average temperature was 23°C, average precipitation was 20-25% of the total annual precipitation and relative humidity was around 65%. Conclusion: The study concluded that majority of the varicella cases occur under ten years of age and boys are a little more susceptible to have the infection than the girls. A seasonal pattern of chicken pox is clearly seen with clustering of cases between mid-February to mid-April (spring season) with two peaks when monthly average temperature, total rainfall and humidity all are optimally favorable for the multiplication of varicella zoster virus. Ibrahim Card Med J 2020; 10 (1&2): 11-17

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IntroductionSkin comprises about 15% of the total body weight 1 . Infants have a higher surface area-to-volume ratio in comparison to older children & adults. There are important structural and physiological differences between skin of adult and that of infant, the function of skin remaining essentially the same at all phases of life, including: barrier, photo-protection, thermoregulation, immune surveillance, vitamin synthesis, prevention of insensible fluid loss, and sensory perception. 2 Infant skin is found to have higher water content and is able to absorb more water and lose excess water faster than adult skin. Micro structural difference relates to thinner stratum corneum and papillary dermis in infant skin. 3 There is greatly increased mortality of premature infants due to microbial invasion with impaired barrier function. 4 The stratum corneum of infant is 10-15micron thick. Pattern of Dermatologic Disorders in Infants

Background & Objective: Hand, foot and mouth disease (HFMD) is a contagious disease of children, occurs primarily under five years of age, characterized by a history of brief febrile illness and a typical skin rash over hands and feet with or without sores in mouth, caused usually by Coxsackievirus A16 viruses. It is mainly the disease of tropical and subtropical countries and bears a complex-relation with meteorological variables, like temperature, rainfall and relative humidity, although no study has yet been done in Bangladesh to explain the complex relationship of the disease with these variables. This study sought to describe the occurrence of HFMD and its association with meteorological factors in Dhaka city. Methods: The present cross-sectional study collected data of 231 HFMD cases from the records of the daily register of Out-patient Department of Dhaka Shisu Hospital, Dhaka between January 2018 to December 2019. According to the study protocol a child was identified as having HFMD who had a history of brief febrile illness accompanied by a typical skin rash with or without mouth ulcers. Total number of cases treated monthly at OPD during the period were also recorded. Meteorological data were provided by Bangladesh Meteorological Department, which among others, included monthly average temperature, relative humidity and amount of rainfall. While the outcome variable was monthly number of HFMD cases, the predictive variables were average temperature, humidity and rainfall during the study period. Result: Majority (85.3%) children in the present study was < 5 years old. A male preponderance was observed in the series (60%) with male to ratio being 3:2. A clustering of HFMD cases was observed to occur between June to October when monthly average temperature, total rainfall and humidity all were at their maximum compared to those found between November to April. The clustering of cases was more intense in the year 2019 than that in the year 2018. During the period average monthly temperature was 29.20C, average rainfall was 62.6% (238 mm) of the total annual precipitation and mean relative humidity was 79%. The proportion of HFMD cases out of total cases treated during the period was 2.2% in 2018 and was 4.1% in 2019, which in the dry season (November to April) was 0.4% and 0.5% in 2018 and 2019 respectively. Conclusion: The study concluded that majority of the HFMD cases occur under five years of age and boys are more likely to have the infection than the girls. A seasonality of HFMD occurrence is observed with a higher number of cases occurring in the monsoon season and fewer cases in the dry season. Clustering of HFMD cases occur between May to October when monthly average temperature, total rainfall and humidity all are at peak compared to those in November to April of the year. Ibrahim Card Med J 2021; 11 (1): 14-20