Abstract

Background: Congenital Heart Disease (CHD) is the most common congenital problem in children. Early detection and proper management of congenital heart disease is very important to reduce mortality and morbidity. The purpose of this study was to find out the disease pattern of CHD among children in present situation in a center outside Dhaka. Methods: This study was conducted over a period from March 2016 to June 2017 prospectively and all patients with CHD was diagnosed by Color Doppler Echocardiography aging from 1st day of life to 12 years were included in the study. Results: Acyanotic CHD was most common among CHD. Atrial Septal Defect (ASD) was the commonest acyanotic congenital heart disease 100 (35.7 %) followed by Ventricular Septal Defect (VSD) 77 (27.5 %). Commonest cyanotic CHD was Tetralogy of Fallot (TOF) 9 (3.2 %). Only 25.36 % CHD were diagnosed during neonatal period whereas 54.64 % were diagnosed during the period of 29 days to completion of 12 months. Most of the patient (63.21%) were male. Conclusion: ASD was the commonest acyanotic CHD whereas TOF was the commonest cyanotic CHD. About 80% cases were diagnosed before 1 year of age. With the advancement of diagnostic facility and neonatal care, early detection of CHD is possible and treatment can be started at an earlier age.

Background: Urinary tract infection (UTI) is a common infection in nephrotic syndrome children having a propensity for long term renal damage. Organisms causing UTI in nephrotic syndrome are becoming resistant to common antimicrobial agents and increase the morbidity and mortality. Surveillance of local antibiotic sensitivity pattern is necessary for proper management of UTI in nephrotic children.Objective: To see the pattern of antimicrobials sensitivity of organisms causing UTI in Nephrotic syndrome children.Methods: This was a hospital based cross-sectional study conducted in the department of Paediatrics, Chittagong Medical College Hospital, Chittagong from January 2009 to December 2009. 52 nephrotic children aged 2-6 years with typical clinical features were included. A clean catch midstream urine sample were collected in aseptic procedure and sent for inoculation in culture media. In case of collection failure, urine was collected by sterile catheterization. Bacterial isolates were tested for microbial sensitivity. Data regarding etiological organisms and antibiogram were analyzed using appropriate statistical method.Results: UTI was found in 30.8% nephrotic children. E-coli was the commonest organism isolated in urine culture followed by klebsiella. All organisms isolated on culture were more or less resistant to commonly used antibiotics except to amikacin. E coli were resistant to most of antibiotics and resistance to cotrimoxazol is quite high for all isolates. Ciprofloxacin as oral and amikacin as parenteral are good for first line treatment of UTI in nephrotic syndrome.Conclusion: Resistance among organisms causing UTI in nephrotic syndrome is an emergent problem now a day. Routine urine culture should be advised since treatment failure is likely to occur with commonly used antibiotics. Risk factor for emergence of antibiotic resistance of these pathogens should be evaluated.Bangladesh J Child Health 2016; VOL 40 (3) :154-159

Background: The predominant form of malnutrition is commonly called proteincalorie malnutrition. Protein Energy Malnutrition (PEM) is still a major health problem in children of developing countries including Bangladesh. The causes of malnutrition are multifactorial including nutritional factors, socioeconomic factors, health status of the mothers and repeated infections in children. Objective: To explore the information regarding the breast feeding practices of children suffering from Protein-Energy Malnutrition. Methods: This case control study was conducted in Chittagong Medical College Hospital from November 2006 to April 2007. A total of 65 controls and 65 cases were selected consecutively for the purpose of the study. Their mothers were interviewed with help of structured questionnaire containing all the variables of interest to attain the study objectives. The test statistics used to analyze the data were descriptive statistics and Chi-square (χ 2 ) or Fisher's Exact Probability Test. Results: A significantly higher frequency of cases (67.7%) were given pre-lacteal feed, predominantly honey and sugar-water compared to control group (41.5%) (p = 0.008). Nearly 100% of controls were given colostrums compared to 75% of the cases. About one-third (31.3%) of the cases was exclusively breast-fed in comparison to 58.5% of the control group (p = 0.003). Over onequarter (27.7%) of the control were breast-fed upto 6 months of age, as opposed to only 1.5% cases (p < 0.001). Duration of predominant breast feeding for more than 6 months of age was also significantly higher in control group than that in case group (p = 0.001). Breast milk substitutes demonstrate their significant presence in cases (38.5%) than that in controls (9%) (p = 0.003). Conclusion: The study showed that rejection of colostrums, practice of prelacteal feeding, delayed initiation of breast feeding, early cessation of exclusive breast feeding and use of formula milk all were significantly higher in the malnourished group of children than those in their normal counterpart.