Background: Initiation of breast-feeding within 1hour after birth has been associated with reduced neonatal mortality. Baby Friendly Hospital Initiative has profound effects on appropriate practice of BF and thus helps to reduce infant mortality and morbidity. Objective: This study was conductedin the dept.Gynae & Obs and Dept of Paediatrics of Shaheed Suhrawardy Medical College Hospital,Dhaka, to observe the rates of exclusive breast feeding and child health status after cancelling from Baby Friendly Hospital Methodology: 100 term babies of normal birth weight irrespective of sex, born in Sh.SMCH by NVD or caesarian section were included. Data was collected from the mother with a pretested questionnaire at postnatal period, at 6th week, 14th week & 6th month of age. Result: The mean age of studiednewborn (100) was 20.02±19.54 hours. All the infants started breast feeding after birth and among them fifty six percent initiated with in 1 hour. Fifty five percent mothers were fed breast milk more than 8 times of her baby in last 24 hours. Difficulty in breast feeding was found in 36(36.0%) infants, which was resolved mostly (94%) by nurse. Exclusive breastfeeding was found in 100% of infants during discharge from hospital. In 1st and 2nd follow up 95(95.0%) and 89(89.0%) infants were exclusively breastfed. In 3rd follow up at last week of 6th month 78(78.0%) infants were exclusively breast fed. Five(5%) and six(6%) infants received supplementary food in 1st and 2nd follow up respectively. In last follow up the number were eleven (11%) and the total number was 22(22%).The causes of supplementation were crying of baby due to perceived insufficient breast milk and job of the mother in 1st& 2nd and 3rd visit respectively. Weight was significantly (p<0.05) higher in exclusive breast feeding group than the non EBF group and sickness were also more in non EBF group. Conclusion: Exclusive breast feeding was found in 78.0% of infants upto last week of 6 months. Crying of baby due to perception of insufficient breast milk and joining in outside job of the mother were the causes of introduction of formula milk in the 1st,2nd and 3rd visit respectively. Weight gain and sickness were significantly less in EBF group than in non EBF group. J Shaheed Suhrawardy Med Coll 2021; 13(2): 164-170

Background: Dengue fever is a serious public health problem with a wide range of clinical manifestations. In 2019, the clinical presentation of dengue infection was novel in relation to the conventional features of the previous years and also in degree of severity. So the study was done to see the varied clinical presentation, predictors of severity and outcome in pediatric population in 2019 endemic. Methods: It was a cross sectional, descriptive study conducted among 100 cases of serologically positive dengue patients from department of Paediatrics of Shaheed Suhrawardy Medical College Hospital, Dhaka from July to October, 2019.The data were collected by preformed semi-structured questionnaires and analyzed using SPSS version 16.0. Results: The mean age of the patients was 7.4 ± 3.4 years with equal male and female ratio. Children between 5-12 years were most (72%) commonly affected. Mean duration of fever was 4.5 ± 1.8 days and fever was present in 63% cases on presentation. Features of shock were present in 61% of patients who were designated as severe dengue. Most of the patients presented with abdominal pain (77%) followed by vomiting (70%), headache (35%), myalgia(32%) and retro-orbital pain(30%). Among the important clinical findings, tender hepatomegaly was present in 77% cases followed by ascites in 35% and pleural effusion in 4% cases. Melaena was found to be the most common form of bleeding manifestation. Risk factors for severe dengue were vomiting, abdominal pain, melaena, ascites and low platelet count. Majority of the patients (95%) were discharged, 4% were referred to ICU and only 1% died. Conclusion: Majority of admitted pediatric dengue patients presented with severe Dengue (Dengue Shock Syndrome). Presence of vomiting, abdominal pain, ascites and low platelet count were found to be significant in predicting severity of dengue. J Shaheed Suhrawardy Med Coll 2021; 13(1): 8-14

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

Background: The measurement of left ventricular diastolic dysfunction is important among the impaired glucose tolerance patients. Objectives: The purpose of the present study was to see the echocardiographic characteristics of left ventricular diastolic dysfunction among impaired glucose tolerance patients. Methodology: This cross sectional study was carried out in the Department of Cardiology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2005 to June 2007 for a period of two (02) years. Patients with impaired glucose tolerance (IGT) patients attending Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh and fulfilled selection criteria were included in this study as group A. The apparently healthy persons without cardiovascular disease were taken as group B. All the study subjects underwent 2D and M-mode echocardiography for chamber enlargement, ventricular hypertrophy and ventricular systolic function according to recommendation of American Society of Echocardiography. Result: 2D and M-mode echocardiographic characteristics were compared between groups. Among the parameters, LA size in the group A was 31.18±3.49 mm and in group B was 25.22±4.95 mm which was significantly higher (p<0.01) in the case group. LA size was also compared among left ventricular diastolic dysfunction (LVDD) present and absent group, which was (32.76±4.61 vs 28.79±4.11 mm, p<0.001) significantly higher in the LVDD present group. Conclusion: In conclusion there is a significant differences of echocardiographic characteristics of left ventricular diastolic dysfunction among impaired glucose tolerance patients. Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 38-42