Congenital syphilis is caused by Treponema Pallidum. The fetus can acquire it transplacentally during maternal spirochetemia, or contact with genital lesion during the intrapartum period. The prevention and treatment of congenital syphilis are very much cost-effective, but if it remains undiagnosed and untreated, can result in a deadly outcome. It can affect multiple organs and systems. In this present case, skeletal systems were predominantly involved. The clinical presentation was the failure to gain weight, painful mobilization of the right arm, and swelling of the proximal and distal end of this arm. Erythematous, maculopapular scaly skin eruption was also noticed in the scalp and scrotum. Radiological examination showed metaphyseal irregularity, and periosteal reaction at the right humerus, radius, and ulna. Nontreponemal antibody test (VDRL) and a treponemal antibody test (TPHA) both were reactive. Early congenital syphilis may have a subtle clinical presentation or may remain asymptomatic. Therefore physicians should aware of the clinical presentation of congenital syphilis; at the same time, detailed clinical history can play an important role to suspect congenital syphilis. Promotion of pregnant women for antenatal care and screening for syphilis in the first trimester are the keys to eliminating congenital syphilis. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 73-77

Background: Thalassemia is one of the most common chronic and genetic hematological disorder. This chronic disease challenges the individual at the physical, emotional, cognitive level and disrupts the quality of life because of persistent anemia and hypoxia. The aim of study is to assess the cognitive status in thalassemia. Material and methods: This is a cross-sectional observational type of study that was performed in Autism and Child Development Center of Chattagram Maa Shishu–O–General Hospital. Children aged 6 to 16 years with thalassemia of different catagories were enrolled as study subjects. Study period was six months. Cognitive status of this study subject was assessed by WICS-IV equipment. Results: Among the 50 study subjects, Hb E b thalassemia was the most common type of thalassemia 39(78%). 2(4%) patient took oral chelating agent, 18 (36%) were under injectable, 20(40%) were found taking both oral and injectable and 10(20%) were observed not under any iron chelation therapy. Regular iron chelation therapy was found in 22(44%) cases.10(20%) cases had normal intelligence,19(38%) cases had mild mental retardation and 21 (42%) had moderate mental retardation. Among the 10 patients who do not use any chelation therapy,8(80%) patients had moderate retardation and 2(20%) had mild mental retardation. On the other hand, among the 40 patients who were having iron chelation therapy, 10(25%) patients showed normal level of intelligence, 17(42.5%) had mild mental retardation and 13(32.5%) had moderate mental retardation. In different score of WISC-IV, it was found that working memory and processing speed were poorer than verbal comprehension and perceptual reasoning in different type of thalassemia. This study also showed poor cognition is more prominent in thalassemia major and Hb E beta thalassemia. Conclusion: Cognitive status of the study subjects who take regular iron chelation therapy is much better than those who do not take iron chelation therapy. Hence, iron chelation therapy is proved to have better cognitive outcome for thalassemia patients with iron overload. Chatt Maa Shi Hosp Med Coll J; Vol.22 (1); January 2023; Page 57-61

Tuberculoma is one of the manifestations of Central Nervous System (CNS) tuberculosis (TB). A tuberculoma is a tuberculous focus, which enlarges with in brain tissue, firm, avascular, spherical masses, with size varying between 2 cm to 10 cm in diameter and the compressed surrounding tissue shows edema and gliosis. Tuberculoma resuls from aggregation of caseous tubercle that usually manifest clinically as brain tumour. Tuberculomas account for upto 40% of brain tumours in some areas of the world. In adults tuberculomas are most often supratentorial, but in children they are often infratentorial, located at the base of the brain near the cerebellum. Lesions are most often singular but may be multiple. The most common symptoms are headache, fever & convulsion & also may give rise to signs of raised intracranial pressure or a hemiplegia, or cranial nerve palsy if in the brain stem. Here described a case of 4 years old female child who presented with the complants of high grade fever for 10 days duration followed by right sided weakness for 4 months. She had 6,sup>th and 7th cranial nerve palsy with exaggerated reflex on right side. Her tuberculin test was positive but Cerebro Spinal Fluid (CSF) study was normal & Magnetic Resonance Imaging (MRI) of brain showed rim enhancing lesion. Early recognition and timely treatment of CNS TB is critical if the considerable mortality and morbidity associated with the condition is to be prevented. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22892 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 74-76