Background: Nephrotic syndrome (NS) is one of the most common renal diseases in children. It is a chronicchildhood disorder with a course of relapse and remission. Hyperlipidemia is a constant feature (95% cases)of minimal change nephrotic syndrome (MCNS) having serum cholesterol >250 mg/dl. Both increased synthesisand decreased clearance of lipoproteins may contribute to the hyperlipoproteinemia which frequently complicatesthe NS. Persistent hyperlipidemia can lead to relapse of NS which is a potential risk factor for progression ofglomerular injury. Persistent hyperlipidemia and frequent relapse of NS are further responsible forcardiovascular disease and progressive glomerular damage leading to renal failure. This study was done todetermine relationship between plasma lipids and relapse of idiopathic NS in children. Methods: This prospective study was carried out from July 2015 to June 2017 at the Department of Paediatricsin Sylhet MAG Osmani Medical College Hospital. Patients with the diagnosis of NS fulfilling the inclusioncriteria were included in this study purposively. A total of 50 children were included into this study. Theprimary end point was to determine plasma lipids level in children having idiopathic NS at acute phase, inremission and at 6 months after completion of treatment. The secondary end point was to evaluate the relationshipbetween persistent hyperlipidemia in remission phase and relapse of NS. Results: Among 50 children with clinical diagnosis of NS, 35 were first episode and 15 were in relapse cases.Among the first episode NS cases serum lipids level were decreased significantly during remission but HDLwas increased, whereas in relapse cases even during remission serum lipids level were significantly higher.After six months of follow up, out of 50 patients 28 patients had persistent remission and 22 patients hadrelapsed. The relationship between plasma lipids level and the incidence of relapse showed that acute lipidfraction levels were not risk factor in relapsing NS. Only the triglyceride level during remission was a riskfactor in relapsing NS (p<0.035) with OR 5.4 and 95% CI [1.06, 25.4]. Conclusion: Persistent hypertriglyceridemia and hypercholesterolemia in remission phase is a risk factor forrelapse of idiopathic NS in children. Birdem Med J 2020; 10(2): 97-102

Background: Growth assessment is an essential component of pediatric health surveillance because almost any problem within the physiologic, interpersonal and social domains can adversely affect growth. The most powerful tool in the growth assessment is the growth chart. Growth parameters of children are usually interpreted in relation to international standards like the National Center for Growth Statistics (NCHS) and Centers for Disease Control and Prevention (CDC) Growth Charts of 1977and 2000, respectively. In 2007 published a new set of growth charts believed to be applicable to children reared healthily in all parts of the globe. The aim of current study was determine the growth pattern of school children in Sylhet using the CDC standards and WHO standards. Methods: A Comparative cross-sectional study was done in the department of paediatrics, Sylhet MAG OsmaniMedical College Hospital from July, 2012 to Dec, 2012. Multi-stage random sampling technique was adopted for the survey. This study was carried out in selected primary schools in Sylhet Metropoliton City area. The participants were healthy school children, aged 6 to 11 years who was purposively selected. A total of 504 children were included into this study. The primary end point was to determine weight, height and body mass index (BMI) and the secondary end point was to compare the values using 2000 CDC standards and 2007 WHO standards. Results: The mean weights, height and BMI of the studied child were lower from CDC and WHO standards but closer with the WHO standards and wider from CDC. The weight Z-scores have got closer on the two reference charts for both male and female but differ at age 6 and 7 years. The median height Z-scores were almost closer to the median for male and female at all different ages on both CDC and WHO charts. The median BMI Z-scores for both sexes were below the reference values on both CDC and WHO charts. The prevalence of underweight and stunting were higher in both sexes when determined using the CDC standards compared to WHO standards. Conclusion:The WHO references would under diagnose under-nutrition and over-diagnose overweight/obesity in the population studied. However, this study results are closer to the WHO reference and wider from the CDC standards.

Background: Nutritional rickets has emerged as a public health problem in Bangladesh during the past two decades, with up to 8% of children being clinically affected in some areas. Insufficiency of vitamin D and dietary calcium is thought to be the underlying cause. Vitamin D administered with or without calcium is commonly regarded as the mainstay of treatment. Calcium alone or in combination with vitamin D has also been used in the treatment of nutritional rickets. So this study was done to assess the effects of vitamin D, calcium or combination of vitamin D and calcium for the treatment of nutritional rickets in Bangladeshi children. Methods: This open labeled randomized comparative study was done in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from July 1, 2010 to June 30, 2012 A total 48 rickets patient was enrolled in this study. After selection of cases patients were divided in to three groups by lottery method. Group A received single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock), Group B received calcium (750 mg per day) for 6 weeks and Group C received both calcium (750 mg per day) for 6 weeks and single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock). Response was evaluated by serum alkaline phosphatase level and using 10-point radiographic score developed by Thacher and colleagues at baseline, 6 weeks, and 12 weeks. Results: Mean age of the study participants was 35.83 months. Male to female ratio was 2:1. The radiographic score was significantly improved in first and second follow up (p<0.001) in all groups. But there was significant difference of improvement in Group C than Group A and Group B. In Group C, the percent reduction from base to first follow up was 80.05±7.04 and 90.65±3 in second follow up which showed quick improvement in combination therapy. Serum alkaline phosphatase also significantly reduced in all three groups. Conclusion: Combination use of vitamin D and calcium in the treatment of nutritional rickets is more effective than prescribing either vitamin D or calcium alone. Birdem Med J 2021; 11(1): 39-46

Aim: This study aims to access and evaluate canal transportation and canal centering ability of Protaper Gold (PTG), XP EndoShaper (XPS) and EdgeFile X7 using cone-beam computed tomography (CBCT). Materials and Methods: Sixty freshly extracted single-rooted premolars with mature apex and a canal curvature of 10°–20° were chosen and arbitrarily divided into three experimental groups (n = 20). After decoronation, the teeth measuring 16 mm were included in the study for standardization. According to the manufacturer's instructions, canals were shaped with PTG in Group 1, XPS in Group 2 and EdgeFile X7 in Group 3. For the evaluation of the root canal transportation at 2 mm, 4 mm, and 6 mm from the apex, canals were scanned before and after instrumentation using CBCT scanner. Independent t-tests and one-way ANOVA were used to analyze data and significance level was set at P < 0.05. Results: XPS showed significantly lower canal transportation than PTG system. Moreover, the centering ability of the XPS significantly higher than EdgeFile X7 and PTG at all root levels (P < 0.05). Conclusion: The XPS and EdgeFile X7 rotary file system showed the lowest transportation in both mesiodistal and buccolingual directions and also the highest centering ability. The PTG file showed the highest transportation and lowest centering ability.