Poisoning after eating puffer fish containing highly lethal tetrodotoxin (TTX) is widespread in Asia. In 2008, naïve inland populations in Bangladesh were exposed to cheap puffer fish sold on markets. In three outbreaks, 141 patients with history of puffer fish consumption were hospitalized. Symptoms of poisoning included perioral paraesthesia, tingling over the entire body, nausea and vomiting, dizziness, headache, abdominal pain and muscular paralysis of the limbs. Seventeen patients (12%) died from rapidly developing respiratory arrest. Blood and urine samples from 38 patients were analyzed using a TTX-specific enzyme-linked immunoassay (ELISA). Medium to high TTX levels were detected (1.7-13.7 ng/ml) in the blood of 27 patients. TTX was below detection level (< 1.6 ng/ml) in 11 blood samples but the toxin was detected in urine. Ten patients had blood levels above 9 ng/ml and developed paralysis; seven of these died. The remaining patients recovered with supportive treatment. High concentrations of TTX and its analogues 4-epiTTX and 4,9-anhydroTTX were also found in cooked puffer fish by post-column liquid chromatography-fluorescence detection. To prevent future instances of puffer fish poisoning of this magnitude, measures should be implemented to increase awareness, to control markets and to establish toxicological testing. To improve the management of this and other poisoning in Bangladesh, facilities for life-saving assisted ventilation and related training of healthcare personnel are urgently needed at all levels of the health system.

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The study was carried out in Medicine and Pediatrics Department of Rajshahi Medical College Hospital, and Natore Sadar Hospital, both are located in the northern territory of Bangladesh. Period of study ranged from admission of patients till discharge.

This was a prospective study conducted in a cohort of live normal full term singleton newborns delivered in Rajshahi Medical College Hospital with the objective to explore their early neonatal health as well as the role of low birth weight on it. A total 770 live normal newborns were Included in this study. For data collection APGAR Score Estimating Checklist and one protested structured questionnaire were used. Simple descriptive as well as analytical techniques including Chi-square t test were done.The results of this study suggested that low weight (LBW) babies were more prone to develop early neonatal morbidity and mortality than normal birth weight (NBW) babies. LBW infants needed more resuscitation and responded less to resuscitative effort than the infants of NBW. Birth asphyxia was the commonest cause of early neonatal morbidity and mortality.