Background: Acute Lower Respiratory Tract Infections (ALRI), particularly Pneumonia and Bronchiolitis, are important causes of death in childhood in Bangladesh. The cardiovascular and respiratory systems function as a single unit and alteration in cardiorespiratory interactions, can cause significant changes in cardiac function. The objective of this study was to find out any electrical and functional changes, myocardial injury, frequency of heart failure and the outcomes in these patients with ALRIs. Methodology: It was a prospective observational study carried out at DMCH from January to June 2012 on 35 consecutive children admitted with ALRI, which were further diagnosed as pneumonia or bronchiolitis using operational definitions. Heart failure cases were identified and all the cases were then evaluated for any cardiovascular changes. Results: Most of the patients were male. ECG changes occurred in the form of tachycardia. Abnormal echocardiographic findings were noted in the form of pulmonary hypertension, left ventricular systolic (LV) dysfunction and tricuspid regurgitation. 82.9% had raised CK-MB and was significantly higher in patients with tachycardia and having abnormal echocardiographic changes. Nine patients developed heart failure, 3 of them had pulmonary hypertension along with LV systolic dysfunction and one of pulmonary hypertension and LV systolic dysfunction each. CK-MB was raised significantly in all the patients with heart failure. Conclusion: Raised CK-MB, tachycardia out of proportion on ECG and pulmonary hypertension with left ventricular systolic dysfunction were common findings in patients with ALRI. Bangladesh J Child Health 2019; VOL 43 (1) :27-34

A prospective, observational study was conducted in the Department of Obstetrics & Gynaecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2008 and January 2009 to compare position and attachment of the babies during breastfeeding before and after counselling the mothers. Our study samples include 100 healthy mothers and 100 term healthy babies. Initially, all the mothers and babies were observed for their position and attachment during breastfeeding within 24 hours of the delivery and documented in a standard data sheet. Then the mothers were shown the wall chart of nursing mothers and breastfeeding manual and taught practically by the investigators. Mothers were requested to come after 15 days for follow-up visit so that they become physically fit by that time and improve their skills. At follow-up visit, documentation of the position and attachment during breastfeeding was done in the data sheet. Comparison of each of the components of positioning and attachment was done with first observation (i.e., within 24 hours of the birth of the baby) and follow-up observation (i.e., after 15 days). The mean age of the mothers was 29.40±4.71 years. In all components of the position and attachment of the babies, the difference between before and after counselling the mothers was statistically significant (P<0.05). Similarly, in all signs of effective sucking, the difference was also statistically significant between before and after counselling (P<0.05) except for the sign of oxytocin reflex noticed by the mother (P>0.05). CBMJ 2022 July: vol. 11 no. 02 P: 102-107

Diagnosis of congenital heart disease (CHD) which is a structural abnormality of the heart or intra thoracic great vessels in the earliest possible time is very important. Identifying the various modes of presentation, early referral and appropriate intervention can save lives and reduce risk of complications. The objectives of this study were to determine the clinical profile, complication and immediate outcome of children with congenital heart disease in first year of life. This cross-sectional observational study was conducted from October 2011 to March 2012 among 50 children from zero to one year of age who was diagnosed as CHD by echocardiography admitted in Department of Paediatrics of ShaheedSuhrawardy Medical College, Dhaka and Department of Paediatric Cardiology of National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. Among 50 infants acyanotic CHD was detected in 70% and cyanotic in 30% infants. Major structural defects were venticularseptal defect 34%, patent ductusarteriosus 30%, tetralogy of fallot’s 14%, transposition of great arteries 12%, atrial septal defect 6%. Presenting features were cough 82%, dyspnea 80%, poor weight gain 70%, feeding difficulty 68% and fever 58%. Frequently observed complications were failure to thrive, pulmonary hypertension and heart failure. Among the outcome of CHD 8% cases closed spontaneously, case fatality rate was 8% and the rest were advised accordingly for surgery, intervention and medical management among which 14% had device closure within the study period. High index of suspicion, early diagnosis, close monitoring and timely intervention can reduce complication of CHD. Bangladesh Med J. 2020 Sept; 49(3) : 17-21

Background: Rheumatic fever (RF) and rheumatic heart disease (RHD) are the leading causes of early cardiovascular morbidity and mortality especially in developing world. Recently more emphasis is given on the role of echocardiography for diagnosis of these diseases. Objective: Recent and reliable data and studies on RF and RHD are very limited in Bangladesh. Therefore, this study was done to diagnose rheumatic fever and rheumatic heart disease among clinically suspected patients. Methods: This cross-sectional study was conducted from February to June 2021 in National Center for Control of Rheumatic Fever and Heart Disease, Dhaka. A total of 250 patients irrespective of age and sex with complaints of joint pain and clinically suspected of RF and RHD were enrolled. Laboratory investigations including CBC with ESR, ASO titer, CRP, ECG and echocardiography were done. Results: Among the suspected patients, acute rheumatic fever without carditis was diagnosed in 10 (4%) patients and 15 (6%) had rheumatic heart disease with recurrent RF and carditis. Rheumatic fever with carditis were diagnosed in 63 (25.2%) patients; among whom 19 (7.6%) had clinical carditis and 44 (17.6%) were diagnosed as subclinical carditis. Acute rheumatic fever was diagnosed only within 5-20 years of age patient and 60% patients of RHD were found in 21-30 age groups. About half (49.20%) of the patients of rheumatic fever with carditis were between 11 to 15 years of age. Several abnormalities of heart valves were detected by Echocardiography; 78.2% of the patients of RF and RHD had mitral regurgitation and all the mitral stenosis cases were detected in patients with RHD. Combination of mitral regurgitation with aortic regurgitation and mitral regurgitation with mitral stenosis was also present. Conclusion: The findings of the study indicate that RF and RHD are not negligible in our country. Though the result does not indicate the prevalence or incidence; however, it highlights the need of systematic large-scale study with inclusion of echocardiography to find the prevalence of rheumatic fever and rheumatic heart disease in Bangladesh. Bangladesh Medical Res Counc Bull 2022; 48: 83-89

Background: Antimicrobial resistance is a global health problem and the number of organisms developing resistance to commonly used antibiotics is increasing. Objective: The study was aimed to find out the pattern of common organism isolated from wound swabs and pus with their antibiogram. Methods: This observational study was conducted from September 2018 to January 2019 in a tertiary care hospital in Dhaka, Bangladesh. Culture and sensitivity tests were done for wound swabs and pus samples. Data regarding information of the patients, isolated organisms and culture and sensitivity reports were collected from the records of the department of microbiology. Results: Out of 1709 samples, 72.0% yielded growth of organisms of which 86.4% were gram negative and 13.6% were gram positive bacteria. Pseudomonas spp was the most commonly (43.8%) isolated organism from both wound swab and pus samples followed by Escherichia coli (16.6%), Staphylococcus aureus (11.8%), Klebsiella spp (9.8%). Among gram negative bacteria, 14.9% were ESBL producing organisms and Klebsiella spp were the most commonly isolated ESBL producers. Most of the bacteria showed high resistance to commonly used antibiotics. Gram negative bacteria were mostly resistant to amoxicillin followed by fluoroquinolones, co-trimoxazole, and cephalosporins whereas colistin, carbapenems and piperacillin/tazobactum were the most effective drugs against them. Majority of gram positive bacteria were resistant to fluoroquinolones and co-trimoxazole but 100% Staphylococcus aureus were sensitive to vancomycin, followed by linezolid (98.0%) and teicoplanin (86.0%) and 32.0% of them were Methicillin resistant (MRSA). Conclusion: The susceptibility pattern shows that some common antibiotics, especially antibiotics of oral form have very limited usefulness in treatment of infections and also highlight the need for regular reporting and antibiogram guided antibiotic prescription. Bangladesh Med Res Counc Bull 2021; 47(2): 181-187