Context: Children with COVID-19 present with less severe disease and require fewer hospitalizations than adults. Our previous study on children with renal disease and COVID-19, which included predominantly children with nephrotic syndrome, found anemia in a significant number of participants. Aims: This study aimed at evaluating the risk factors of anemia in children with nephrotic syndrome presenting with COVID-19 and the influence of anemia on hospital outcome. Methods: This case–control study was conducted at five pediatric nephrology centers in two major cities of Bangladesh. Consecutive patients with nephrotic syndrome and positive polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 were included as cases, and subsequently, two cases of nephrotic syndrome with negative PCR were enrolled as controls. Participants who presented between April 2020 and December 2020 were included, and demographic data, clinical features, and laboratory parameters were retrieved from hospital records for analysis. Results: A total of 22 children with nephrotic syndrome were positive with COVID-19 and subsequently, 44 children were included as control. The median age was 6.4 years in the cases and 5.2 years among the control. Most children presented with the initial episode of nephrotic syndrome. The children in the case group had a significantly lower hemoglobin level than the controls, and anemia was associated with raised inflammatory markers. In multivariate analysis, female sex and impaired renal function was associated with lower hemoglobin, but anemia did not have effect on hospital outcome. Conclusions: Anemia in children can be multifactorial. Anemia in nephrotic syndrome associated with COVID-19 does not appear to influence length of hospital stay and outcome.

Background: Hemoglobin E disease are the most common structural haemoglobinopathies, reaching its highest frequency in South East Asia and also prevalent in Bangladesh. There are very few data for effective screening of HB E trait. The aim of the study was to analyze hematological profile and RBC indices as a marker of screening for Hb E trait. Methodology:A cross sectional observational study was conducted among 150 subjects at Dhaka Shishu (Children) Hospital from December 2008 to November 2009. On the basis of Hb electrophoresis, all subjects were divided into three groups. Group I comprised of 50 subjects with Hb E trait, group II comprised 51 subjects with ß thalassemia trait and Group III comprised of 49 normal subjects. Result of RBC indices and blood count were compared between Hb E trait and normal study population. Results:In group I the mean age was 29.53 years and the age range was 2-47 years. In group II the mean age was 30.31 years and the range was 1-55 years. In group III the mean age was 21.81 years and the range was 1-52 years. The present study revealed the mean±SD haemoglobin level (g/dl) in group I (E trait) and group III (normal subjects) were 11.76±1.91 and 10.77±1.4 respectively. Statistically no significant difference was found between these 2 groups (P>.05). The mean corpuscular volume (MCV) in mean±SD in group I and group III were 72.89±12.24 fl and 77.35±10.27 fl respectively. No statistical significance was found as P>0.05. The mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) in group I were 24.84±2.71pg & 32.97±2.27 g/dl and in group III were 28.28±2.71 pg & 32.97±2.38 g/dl respectively. There were no significant difference between group I and III regarding MCH and MCHC.The mean RBC count in E trait and normal subject group were 5.01±71 million/cmm and 4.61±0.65 million/cmm respectively. There was no significant difference was found P>0.05. Mean red cell distribution width (RDW) in group I and III were 14.32 ±2.34 and 14.83±1.28 without any statistical difference (P>0.05) Conclusion: In our study there were no diagnostic significance of Blood count and RBC Indices for detection of Hb E trait. More study should be conducted to find out reliable marker of screening for Hb E carrier.Key Words: Hb E Disease, Hb E Trait. ß Thalassemia trait ABSTRACT including South East Asia². The hereditary disorder of haemoglobin usually present as either a reduced rate of production of one or more of the globin chain (thalassaemia) nor those in which there is

Foreign body aspiration most commonly affects young children, with respiratory symptoms such as wheeze and cough after a choking episode. A careful history and clinical examination can identify those children that need additional investigation including bronchoscopy. However foreign body aspiration can mimic other conditions. The link between choking and subsequent symptoms may not be made by parents. We present a case with a delay in diagnosis, and discuss the appropriate management of suspected foreign body aspiration.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 47-49

ORIGINAL ARTICLEand dialyzers, combined with the cost of treatment, challenges in obtaining vascular access, and a need for specialized staff. Intermittent HD is also technology-dependent, and in our country, age-and size-appropriate blood lines, dialyzers, and catheters for infants and young children are also scarce. Furthermore, young children may not tolerate the volume shifts that occur during HD 7. The most readily available modality of RRT for young children with AKI in resource-limited countries is PD 8,9. The mortality rate in children with AKI is highly variable and considered to depend largely on the nature of the underlying disease process and early initiation of PD rather than on renal failure itself. Children with AKI caused by a renal-limited condition such as post-infectious glomerulonephritis reportedly have a very low mortality rate (<1%), IntroductionAcute kidney injury (AKI) is a common problem associated with increased mortality and health care costs. Renal replacement therapy (RRT) is the main option for management of AKI patients. Continuous RRT and intermittent hemodialysis (HD) are the modalities most commonly used in developed countries 1,2 . In the developing countries PD is frequently used because of its lower cost and minimal infrastructure requirements 3,4 . Recently, interest in using PD to manage patients with AKI has been increasing. It has been postulated that PD may be more physiologic and less inflammatory than HD in AKI because of the absence of contact between blood and synthetic membranes 5, On the other hand, the technique for PD is relatively simple 6 . In the developing countries or resource-poor settings, continuous RRT is limited because of a lack of ageappropriate vascular catheters, pediatric blood lines, Peritoneal Dialysis in Children with Acute Kidney Injury: Dhaka Shishu (Children) Hospital Experience. The choices for renal replacement therapy (RRT) in children with acute kidney injury (AKI) are limited in developing countries. Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute kidney injury (AKI) in children and hemodynamically unstable patients. Methods: This is a cross sectional descriptic type of observational study of children who underwent PD for AKI in 43 children (27 boys) in nephrology department of Dhaka Shishu (children) Hospital from January 2013 to December 2013. Result: The study included 43 children (62.8 % male). Mean age was 2 ± 1.07 years, with the youngest being 2 months, and the oldest, 14 years. Most common causes was septicaemia (25.6%) and hypovolumia (25.6%) followed by unknown etiology (16.2%), glomerulonephritis (11.6%), wasp sting (9.3%) and hemolytic uremic syndrome (7%). Overall mortality was 32.5%, most common in unknown etiology and high in male but not statistically significant (p=0.42). Conclusions: In the developing countries, PD can be successfully performed for the management of childhood AKI. Septicaemia and hypovolumia are the leading causes of AKI, however mortality higher in male and unknow...

Background: Hemoglobin E B thalassemia is the commonest thalassemia syndrome in Bangladesh. All tests for diagnosis of Hb E trait are expensive,time consuming and require sophisticated equipment. The need therefore, is a simple,low cost ,rapid and reliable test which can be used for mass screening of E trait. The present study was designed to see the validity of DCIP test as screening test for detection of E Trait. Methodology: A cross sectional observational study was conducted at Dhaka Shishu (Children) Hospital from December 2008 to November 2009. Total 150 subjects attending Dhaka Shishu Hospital Thalassemia centre were selected and evaluated for Hb estimation, RBC indices, Hb Electrophoresis and DCIP test. According to electrophoresis results patients were divided into 3 groups. Group I comprised of 50 subjects with Hb E trait, group II comprised 51 subjects with ß thalassemia trait and Group III comprised of 49 normal subjects. In all 3 groups DCIP test was done and in positive cases, precipitated haemoglobin was visualized by naked eye at the bottom of the test tube. Negative samples with normal electrophoresis and ß thalassemia trait were used to see the samples gave false positive result. Results: The test successfully detected 48 subjects among total 50 subjects of E trait. DCIP sensitivity, specificity, positive predictive value and negative predictive values were 96%,97%,94.12% and 97.97% respectively. Conclusion: DCIP has high sensitivity, specificity, positive and negative predictive value. So, it might be considered as a valid single screening test to detect E Trait in areas with limited laboratory facilities and economic resources. AKMMC J 2020; 11(2) : 113-119