Background: An understanding of epidemiological trend in hospital admissions, including diseases and death pattern, is critical for health care planning, appropriate resource allocation & improving existing services facilities. Objectives: To evaluate the disease and death pattern of children admitted in the department of Child Health, Chittagong Medical College Hospital (CMCH), Chittagong. Materials and Methods: This was a retrospective study. The case records of all patients admitted in the department from Jan 1, 2008 to Dec 31, 2010 were analyzed. Result: Total 38,692 children were admitted during this study period; among them total 1897(4.9%) patient died. Infant and under five age groups constitute 45.2% and 75.9% respectively, total admission whereas deaths from the same groups were 43.7% & 79.3% respectively. Bronchopneumonia (22%), acute watery diarrhea (15%), hereditary hemolytic anemia (12%), and bronchiolitis (10%), topped the first four positions in each of the three years of admission. Septicemia and encephalitis, with a case fatality rate of 24% and 35% respectively, were found as top two causes of death. Highest case fatality rate was found in hepatic encephalopathy (54%). Other common causes of death include meningitis (19%), severe malaria (21%), leukemia (22%), severe malnutrition with complications (11%), and congenital heart diseases (12%) Conclusion: Comprehensive evaluation of admission and death related findings of this study will help to determine possible gaps in patient care and planning for more effective case-management strategies. DOI: http://dx.doi.org/10.3329/bjch.v36i2.13081 Bangladesh J Child Health 2012; VOL 36 (2) : 66-70

Background: In malaria endemic areas diagnosis of severe malaria by microscopy and immunodiagnostic test is confounded by asymptomatic peripheral blood parasitemia. In such settings, retinal changes by ophthalmoscopy showed some diagnostic utility. Contribution of ophthalmoscopy in diagnosis of severe malaria in children is not well studied in Bangladesh. The aim of this study was to describe the retinal findings in children of cerebral and non-cerebral severe malaria by direct and indirect ophthalmoscope and relate their outcome and to determine the course of changes in the fundus. Methodology: In this prospective observational study 130 consecutive children aged between 6 months to 12 years admitted with confirmed severe Plasmodium falciparum malaria in pediatrics ward of Chittagong Medical College Hospital, Chittagong, Bangladesh were assessed by both direct and indirect ophthalmoscopy during the period of April 2008 to March 2009. Results: Out of 130 patients 80 children had cerebral malaria and of these 49 (61.2%) had some degree of retinopathy; 24 (48%) of 50 with non cerebral severe malaria had retinopathy. Predominant retinal changes were Retinal hemorrhage and Macular whitening each in 53 (40.77%) patients, followed by peripheral whitening, Vessels changes and papilloedema in 50 (38.46%), 40 (30.77%) and 14 (10.78%) patients respectively. With indirect ophthalmoscope as reference, direct ophthalmoscopy had a high sensitivity to detect macular whitening, and papilloedema but was less sensitive to detect peripheral whitening and vessel changes. Patients with retinopathy had more chance to had unfavorable outcome (Death) in comparison to the patients who had not {Odds ratio:1.09 (95% CI:1.017-1.167)}. Most of these retinal changes were transient and resolved gradually as clinical condition improved. Conclusion:Features compatible with malarial retinopathy were commonly found in our children with severe malaria. Ophthalmoscopy is an important clinical tool to aid in diagnosis and prognosis in children. However, indirect ophthalmoscopy provides better information than direct ophthalmoscopy. Bangladesh J Child Health 2018; VOL 42 (3) :118-124

Hepatitis a Virus Is a Very Common Infection In The Pediatric Age Group, Especially in Developing Countries and Pleural Effusion Is One of It Rare Extra-Hepatic Complication. Here We Are Reporting a Case of Acute Hepatitis a Infection, Complicated With Pleural Effusion. JCMCTA 2016 ; 27 (1) : 72 - 74

Key words: Foreign body; collapse consolidation; bronchoscopyDOI: 10.3329/jcmcta.v21i2.7739 Journal of Chittagong Medical College Teachers' Association 2010: 21(2):47-49

Background: Pediatric Intensive Care Unit (PICU) has very important role in the management of critically ill children who require advanced airway, respiratory, and hemodynamic supports with the aim of achieving a better outcome. To describe the clinical spectrum and outcome patterns of diseases managed at PICU in Chittagong Medical College Hospital (CMCH) in order to provide data, which will assist in improving the management of diseases and the rational allocation of health resources. Materials and methods: It was a retrospective crosssectional study in which records of admissions of children from 29 days to 12 years of age were obtained from the PICU records. Results: A total of 851 patients were analyzed during the period of October 2015 to December 2016, of which 533 (62.6%) were males and 318 (37.3%) were females. The mean duration of hospital stay was 5.2 ±2.1 days (Range 0- 20 days). Among admission cases, Central Nervous System (CNS) was the most common system affected in our study 356 (41%) followed by respiratory system 263(31%) sepsis 89(10.45%) and cardiovascular diseases 55(%). We observed overall mortality rate 46.1%and Leave Against Medical Advice (LAMA) 4.11%. Highest mortality occurred in age group of 29 days to 1 year. Children with encephalitis and sepsis had higher mortality 25% and 21% respectively. Conclusion: The leading cause of admission was CNS infection followed by respiratory diseases and sepsis. The overall mortality rate in our PICU was high. A wellequipped intensive care unit with modern and innovative facilities along with the availability of fulltime trained pediatric intensivists made a significant impact on the outcome of critically ill children in our PICU. JCMCTA 2018 ; 29 (1) : 11-16