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Background: Total anomalous pulmonary venous return (TAPVR) is an uncommon congenital cardiovascular anomaly with poor natural prognosis without proper intervention. It has been detected more frequently in recent year due to the advent of echocardiography. The aim of this study is to evaluate the clinical manifestations, age at diagnosis and short term outcomes in TAPVR patients. Methods: From 1st January 2013 to 31st December 2013, a total of 34 cases with TAPVR were admitted in pediatric cardiac centre at Dhaka Shishu Hospital, Dhaka, Bangladesh. All of them were evaluated with 2-dimensional (2-D) and color Doppler echocardiography examination. CXR and ECG were also done. Patient's sex, age at diagnosis, types of TAPVR, clinical manifestations, radiological finding, ECG findings and outcomes were compiled and analyzed. Results: In 34 patients with TAPVR, 23 (67.6%) were male and 11 (32.4%) were female with male to female ratio of 2.09:1. Most of the patients were diagnosed between 0-6 months of age that is 13 (38.2%) cases were in 0-2 month's age group, 14 (41.2%) cases were in more than 2 month's to 6 month's age group. Tachypnea and cyanosis were more common symptoms. The types of TAPVR was supra-cardiac 18 (52.9%), cardiac 11 (32.4%), infra-cardiac 3 (8.8%) and mixed in 2 (5.9%) cases. Pulmonary hypertension was present in 31 (91.2%) of 34 cases. Among them, 20 (58.8%) patients had severe pulmonary hypertension. The most common associated intra-cardiac lesions of TAPVR patients were ASD 13 (38.2%) and PFO 13 (38.2%). ECG findings of TAPVR, 18 (52.9%) patient had right axis deviation (RAD), right ventricular hypertrophy (RVH) and 14 (41.2%) had right axis deviation (RAD), right ventricular hypertrophy (RVH), right atrial enlargement (RAE). X-ray findings of TAPVR patients, 32 (94.1%) patients had Cardiomegaly and increased pulmonary vascularity. Among admitted patient, 3 (8.8%) patients died due to pneumonia and intractable heart failure, 31 (91.2%) patients referred to advanced cardiac centre for operative treatment. Conclusions: Tachypnea and Cyanosis were an obvious clinical symptom of TAPVR. 2-D and color Doppler echocardiography can provide quick and accurate diagnostic information of TAPVR. Death rate is high in TAPVR patient in spite of adequate medical management. So, early detection and definitive surgical treatment of TAPVR is much needed.

To determine the effect of a massive single oral dose of vitamin A (200,000 IU) supplementation on diarrhoea and acute respiratory infection (ARI), a double-blind placebo controlled trial involving 174 children under six years of age (excluding infants) was carried out in a Calcutta slum community. Ninety-one children received vitamin A supplementation (experimental group) and 83 children received a placebo (control group). All the children were followed up for six months by active fortnightly surveillance for occurrence of diarrhoea or ARI and their duration. There was no statistically significant difference in the incidence of diarrhoeal episodes or ARI. However, there was a significant difference (p < 0.05) in the average duration of diarrhoea per episode (2.1 vs. 3 days) between the experimental and control groups. Possible beneficial effects of a single oral dose of vitamin A supplementation on the incidence of diarrhoea and ARI could not be demonstrated in the present study.

Background : Febrile convulsion (FC) is the most common type of seizure that occurs in children aged 4-60 months, which is benign and had a good prognosis.Objective : To evaluate the clinical profile and management of hospitalized children with Febrile convulsion.Methodology : This cross sectional study was done in Dhaka Shishu (children) Hospital during July 01, 2013 to June 30, 2014. Total 80 children aged between 4-72 months who were admitted in to Pediatric Medicine department with diagnosis of FC were purposively recruited in the study. Data were collected by a trained physician from history, clinical examination, laboratory findings, treatment and outcome using a structured questionnaire.Results : Among the study children 41(51.3%) were between 6 months to 12 months with a male to female ratio was1.5:1. Forty-nine (61.2%) children had simple seizures, and 16 (20%) of the patients had family history of febrile seizures. In 70 (87.5%) cases the duration of seizure was less than 15 minutes and 75% patients had less than one attack within 24 hours of onset of fever. Upper respiratory tract infection was the most common (31%) cause of fever followed by unclassified in 21 (26%) cases. Complete blood count revealed leukocytosis in 49% cases, CRP raised in 30% cases while CSF study and ultrasonography of brain was normal in 30 cases and 10 cases. We could not perform any investigation to isolate possible causative virus. More than 90% per cent received intravenous broad-spectrum antibiotics and prophylactic anticonvulsant drugs during early days of hospitalization.Conclusion : In this study, Upper respiratory Tract infection was found as common cause of febrile convulsion. Duration of seizure was less than 15 minutes and Leukocytosis, raised CRP was identified and nearly all patients received broad-spectrum antibiotics during hospital stay.Northern International Medical College Journal Vol.7(1) Jul 2015: 101-104

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