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Socio-demographic Profile and Complications of Measles in Children: A Hospital Based Study 儿童麻疹的社会人口概况和并发症:一项基于医院的研究
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70591
F. Rahat, Afm Abiduzzaman, M. Khanam, A. Choudhury
Background: Measles is a self-limited viral disease. But it can cause serious complications in young children and still remains as an important cause of mortality and morbidity in under five children worldwide. Objectives: The aim of the study was to determine the complications of measles in hospitalized children and to observe the socio-demographic profile of them. Methods: A prospective observational study was conducted in Dr M R Khan Shishu Hospital and Institute of Child Health from March to December 2019. Children of 6 months to 10 years who came with signs and symptoms of measles according to the case definition criteria by WHO, like fever with maculopapular rash associated with cough, runny nose and conjunctivitis were included in the study. Their sociodemographic profile was recorded and different complications were noted. Results: A total of 86 children suffering from measles with different complications were admitted during the study period. They were from 6 months to 10 years. Among them 59% were below 1 year, 80% were below 4 years and 94% were less than 7 years. Thirty eight percent children were from lower and thirty percent from middle socioeconomic background. Pneumonia was the main complication found in 62(72%) cases followed by diarrhea 28(32%), oral ulcer 26(30%), croup 5(6%) and febrile seizure 4(4.6%). Most (79%) of the children, had normal nutritional status. Among 62 children aged 9 months to 10 years, only 16(26%) received 2 doses of measles vaccine, 14(23%) only the first dose and 32(52%) was not vaccinated at all. Vaccination rate was poor (27%) in low socio-economic condition. The mortality rate was 1(1.16%). Conclusion: About 60% of the children, suffering from measles, were less than one year of age. Fifty nine percent of them were not vaccinated. The children developed complications like pneumonia, diarrhea, oral ulcers etc. Vaccination status was poor in low socio-economic condition. So, awareness should be created about timely vaccination of measles. DS (Child) H J 2022; 38(2): 84-88
背景:麻疹是一种自限性病毒性疾病:麻疹是一种自限性病毒性疾病。但麻疹可导致幼儿出现严重并发症,至今仍是全球五岁以下儿童死亡和发病的重要原因之一。 研究目的本研究旨在确定住院儿童的麻疹并发症,并观察他们的社会人口学特征。 研究方法2019 年 3 月至 12 月,在 M R Khan Shishu 医院和儿童健康研究所开展了一项前瞻性观察研究。根据世界卫生组织的病例定义标准,6 个月至 10 岁的儿童出现麻疹症状和体征,如发热、斑丘疹伴咳嗽、流鼻涕和结膜炎,均被纳入研究范围。研究人员记录了他们的社会人口学特征,并记录了不同的并发症。 研究结果研究期间共收治了 86 名患有麻疹并伴有不同并发症的儿童。他们的年龄从 6 个月到 10 岁不等。其中 59% 的儿童不到 1 岁,80% 不到 4 岁,94% 不到 7 岁。38%的儿童来自较低的社会经济背景,30%来自中等社会经济背景。肺炎是 62 例(72%)患儿的主要并发症,其次是腹泻 28 例(32%)、口腔溃疡 26 例(30%)、咳嗽 5 例(6%)和发热惊厥 4 例(4.6%)。大多数儿童(79%)的营养状况正常。在 62 名 9 个月至 10 岁的儿童中,只有 16 人(26%)接种了两剂麻疹疫苗,14 人(23%)只接种了第一剂,32 人(52%)根本没有接种疫苗。在社会经济条件较差的地区,疫苗接种率较低(27%)。死亡率为 1(1.16%)。 结论约 60% 的麻疹患儿不到一岁。其中 59% 的儿童没有接种疫苗。这些儿童出现了肺炎、腹泻、口腔溃疡等并发症。在社会经济条件较差的地区,疫苗接种情况较差。因此,应树立及时接种麻疹疫苗的意识。 DS (Child) H J 2022; 38(2):84-88
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引用次数: 0
Students Qualified from Bangladesh Institute of Child Health (At present BSH&I) 孟加拉国儿童健康学院(现为 BSH&I)的合格学生
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70602
The Editor
Abstract not available DS (Child) H J 2022; 38(2): 115
摘要不详 DS (Child) H J 2022; 38(2):115
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引用次数: 0
Exchange Transfusion in Neonatal Hyperbilirubinemia: Experience of A Tertiary Care Hospital in Dhaka 新生儿高胆红素血症的交换性输血:达卡一家三级医院的经验
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70592
S. Rahman, S. Afroze, R. Parvin, Kazi Iman, Zinnatunnesa
Background: Hyperbilirubinaemia is a benign condition in newborn babies in some infants may become severe, progressing to kernicterus with substantial risk of neonatal mortality and long-term neurodevelopmental impairments. Among many treatment options exchange transfusion (ET) is the standard method for treatment of severe hyperbilirubinemia. Objectives: To investigate the frequency of primary risk factors for neonatal hyperbilirubinemia leading to ET, to evaluate the complications and immediate outcome of ET. Methods: This was an observational cross sectional study conducted in Dr. MR Khan Shishu Hospital and ICH, Dhaka. Frequency of primary risk factors for severe neonatal hyperbilirubinemia leading to ET, characteristics of babies undergoing ET, complications and immediate outcome of ET were analyzed among the neonates admitted between January 2017 to February 2021. Results: Among 61 neonates 49.18% were male and 50.82% were female, 65.57% of neonates were term and 34.43% pre term. The mean gestational age was 37.00 ± 1.50 weeks and mean birth weight was 2619±50gm. The leading causes of jaundice requiring ET were sepsis 31.17%, ABO incompatibility 24.59%, Rh incompatibility 14.75%, PT LBW with sepsis 14.75%, Infant of diabetic mother (IDM) 6.55%, PT LBW 6.55%, and neonatal sepsis with Down syndrome with congenital hypothyroidism 1.63%. Twenty (32.79%) neonates presented with signs of Kernicterus. Seven neonates (35%) presented with lethargy/poor feeding or hypotonic posture, 4(20%) patients had opisthotonus posture/hypertonia, and 9(45%) had convulsion. Nineteen (31.14%) neonates had complications related to ET. The most frequent complication was bradycardia (16.34%), then Catheter block (9.83%), apnaea (6.55%), cardiac arrest (6.55%), hypothermia (4.92%), NEC after ET (1.64%). Immediate outcome was good in 72.13% patients with smooth recovery, 14.75% had neurological deficit and 1.64% died. Among 20 neonates who presented with signs of Kernicterus 35% patients discharged with good recovery, 45% had neurological deficit. Conclusion: The common causes of exchange transfusion in neonatal jaundice were sepsis, ABO incompatibility, PT LBW, and infants of diabetic mothers. Overall outcome was good few developed neurological deficit. DS (Child) H J 2022; 38(2): 89-95
背景:高胆红素血症是新生儿的一种良性病症,但有些婴儿的病情可能会变得严重,发展成核黄疸,造成新生儿死亡和长期神经发育障碍的巨大风险。在众多治疗方法中,交换性输血(ET)是治疗严重高胆红素血症的标准方法。 研究目的调查导致 ET 的新生儿高胆红素血症主要危险因素的频率,评估 ET 的并发症和直接结果。 方法:这是一项观察性横断面研究:这是一项在达卡 MR Khan Shishu 医生医院和 ICH 进行的观察性横断面研究。研究分析了2017年1月至2021年2月期间收治的新生儿中,导致ET的严重新生儿高胆红素血症的主要风险因素的频率、接受ET的婴儿的特征、ET的并发症和直接结果。 结果61 名新生儿中,49.18% 为男性,50.82% 为女性,65.57% 为足月新生儿,34.43% 为足月前新生儿。平均胎龄为 37.00±1.50 周,平均出生体重为 2619±50 克。需要做 ET 的主要黄疸原因是败血症 31.17%、ABO 不相容 24.59%、Rh 不相容 14.75%、伴有败血症的 PT LBW 14.75%、糖尿病母亲婴儿(IDM)6.55%、PT LBW 6.55%,以及伴有先天性甲状腺功能低下的唐氏综合征的新生儿败血症 1.63%。有 20 名新生儿(32.79%)出现核黄疸症状。7名新生儿(35%)表现为嗜睡/喂养不良或低张力姿势,4名(20%)患者表现为瞳孔散大姿势/高张力,9名(45%)患者出现抽搐。19(31.14%)名新生儿出现了与 ET 相关的并发症。最常见的并发症是心动过缓(16.34%),然后是导管阻滞(9.83%)、呼吸暂停(6.55%)、心脏骤停(6.55%)、体温过低(4.92%)和 ET 后 NEC(1.64%)。72.13%的患者恢复良好,14.75%的患者出现神经功能缺损,1.64%的患者死亡。在 20 名出现核黄疸症状的新生儿中,35% 的患者出院后恢复良好,45% 的患者出现神经功能缺损。 结论导致新生儿黄疸的常见换血原因是败血症、ABO血型不相容、PT低体重儿和母亲患有糖尿病的婴儿。总体治疗效果良好,只有少数患儿出现神经功能缺损。 DS (Child) H J 2022; 38(2):89-95
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引用次数: 0
Institute News Vol 38(2) 研究所新闻》第 38(2)卷
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70600
The Editor
Abstract not available DS (Child) H J 2022; 38(2): 113
摘要不详 DS (Child) H J 2022; 38(2):113
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引用次数: 0
Rare Complication of Chicken Pox in Children - Acute Respiratory Distress Syndrome (ARDS): A Case Report 儿童水痘的罕见并发症--急性呼吸窘迫综合征(ARDS):病例报告
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70596
Farhana Yasmin, S. Afroz, T. Ferdous, Umme Tanjila, Sukriti Baroi
Abstract not available DS (Child) H J 2022; 38(2): 107-110
摘要不详 DS (Child) H J 2022; 38(2):107-110
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引用次数: 0
Presentation and Outcome of Children with Kawasaki Disease: Experience in A Tertiary Care Hospital in Bangladesh 川崎病儿童的表现和预后:孟加拉国一家三级医院的经验
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70586
F. Zabeen, M. Quamrul, T. Nazrin, Chowdhury Farheen, Abu Sayeed, Mohammad Iqbal, M. I. Hossain, Sabina Sultana, Nusrat Farooq
Background: Kawasaki disease (KD) is an acute difficult-to-diagnose febrile illness in children caused by self limiting vasculitis in medium and small sized arteries. Objetive: This study has been conducted to analyze its presenting symptoms, clinical course, laboratory findings, and therapeutic options in a tertiary hospital in Bangladesh to aid early diagnosis and optimum management. Methods: This is a retrospective study where the medical records of 31 children admitted and diagnosed with Kawasaki Disease (KD) in Evercare Hospital Dhaka between 2009 and 2020, were assessed. Through a structured form, the demographic information, clinical profile, laboratory results, and echocardiographic data were obtained from the hospital records and then entered into a Microsoft Excel sheet. Cleaned and verified data were transferred to SPSS program version 23 and analyzed to obtain descriptive statistics. Results: Out of total 31 patients with KD enrolled, 64.5% of the patients were between six months to five years of age with a median age of three years; 97% had an age below 6 months. Though 68% of patients met all the required criteria for KD, one-third (32%) were diagnosed as incomplete KD with fewer manifestations. Along with high fever in all cases, the most common clinical features were polymorphous rash (90%) and changes in extremities (90%) followed by changes in the lips and oral cavity (77.4%), cervical lymphadenopathy (68%) and conjunctival injection (61%). Common laboratory abnormalities found were anemia (90%), leukocytosis (65%), thrombocytosis especially in the second week (78%), high ESR (100%), and elevated CRP (84%). About 42% of patients had cardiac abnormalities at the onset. Seven children (63.6%) had coronary artery aneurysms (CAA) whereas 18% had coronary dilatations. In subsequent followups, coronary artery changes remained almost the same up to 6-8 weeks. After 3-6 months, 87.5 % of children recovered from cardiac abnormality. Conclusion: A high index of suspicion for KD and an active search for compatible findings in children with unexplained fever can help in early diagnosis. Timely initiation of IVIG treatment is needed to reduce the risk of cardiac complications. Young infants under six months of age need further careful early suspicion and evaluation because of their incomplete presentation and more vulnerability to developing cardiac complications. DS (Child) H J 2022; 38(2): 70-78
背景:川崎病(KD)是一种难以诊断的儿童急性发热性疾病,由中小动脉的自限性血管炎引起。 研究目的本研究旨在分析孟加拉一家三级医院的症状表现、临床过程、实验室检查结果和治疗方案,以帮助早期诊断和优化治疗。 研究方法这是一项回顾性研究,对达卡 Evercare 医院在 2009 年至 2020 年期间收治的 31 名川崎病(Kawasaki Disease,KD)患儿的病历进行了评估。研究人员通过结构化表格从医院病历中获取人口统计学信息、临床概况、实验室结果和超声心动图数据,然后将其输入 Microsoft Excel 表格。经过清理和验证的数据被转入 SPSS 程序 23 版,并通过分析获得描述性统计结果。 结果在31名KD患者中,64.5%的患者年龄在6个月至5岁之间,中位年龄为3岁;97%的患者年龄在6个月以下。虽然 68% 的患者符合 KD 的所有必要标准,但有三分之一(32%)的患者被诊断为表现较少的不完全 KD。除了所有病例都有高烧外,最常见的临床特征是多形性皮疹(90%)和四肢变化(90%),其次是口唇和口腔变化(77.4%)、颈淋巴结病(68%)和结膜注射(61%)。常见的实验室异常有贫血(90%)、白细胞增多(65%)、血小板增多(尤其是在第二周)(78%)、血沉增快(100%)和 CRP 升高(84%)。约 42% 的患者在发病时心脏出现异常。7名儿童(63.6%)有冠状动脉瘤(CAA),18%有冠状动脉扩张。在随后的随访中,冠状动脉的变化在 6-8 周内几乎保持不变。3-6 个月后,87.5% 的患儿恢复了心脏异常。 结论高度怀疑 KD 并积极寻找与不明原因发热患儿相匹配的检查结果有助于早期诊断。需要及时启动 IVIG 治疗,以降低心脏并发症的风险。6 个月以下的幼儿由于表现不完整,更容易出现心脏并发症,因此需要进一步仔细地早期怀疑和评估。 DS (Child) H J 2022; 38(2):70-78
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引用次数: 0
Newborn Screening, Where We Are 新生儿筛查,我们在哪里
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70585
Md Mahbubul Hoque
Abstract not available DS (Child) H J 2022; 38(2): 68-69
摘要不详 DS (Child) H J 2022; 38(2):68-69
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引用次数: 0
Role of Surgery in the Outcome Difference of Gastroschisis between High-income and Lowmiddle- income Countries: A Review 手术在高收入国家和中低收入国家之间胃畸形结果差异中的作用:综述
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70595
Samiul Hasan, Ashrarur Rahman
Gastroschisis is a major congenital abdominal wall defect where the abdominal viscera comes out through a gap right to the umbilicus. The management of gastroschisis requires prompt and aggressive medical and surgical intervention immediately after birth. However, there is a notable disparity in mortality rates between developed countries and LMICs. Despite various surgical technique adjustments, LMICs still suffer from a high mortality rate, with certain centers reporting a 100% mortality rate. This article seeks to examine the literature and evaluate the impact of surgical techniques on the outcome of gastroschisis. DS (Child) H J 2022; 38(2): 103-106
胃裂是一种严重的先天性腹壁缺损,腹腔内脏会从直达脐部的缝隙中流出。胃裂的治疗需要在婴儿出生后立即采取及时、积极的医疗和手术干预措施。然而,发达国家与低收入和中等收入国家之间的死亡率存在明显差异。尽管对手术技术进行了各种调整,但低收入国家的死亡率仍然很高,某些中心报告的死亡率高达 100%。本文旨在研究文献,评估手术技术对胃螺裂结局的影响。 DS (Child) H J 2022; 38(2):103-106
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引用次数: 0
Abstracts from current literature Vol 38(2) 最新文献摘要 第 38(2)卷
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70597
The Editor
Abstract not available DS (Child) H J 2022; 38(2): 111-112
摘要不详 DS (Child) H J 2022; 38(2):111-112
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引用次数: 0
Clinicoepidemiological Profile of Short Stature at A Tertiary Care Centre in Bangladesh 孟加拉国三级医疗中心矮小身材的临床流行病学概况
Pub Date : 2023-12-26 DOI: 10.3329/dshj.v38i2.70587
R. Biswas, Nahid Farzana, Sultana Nadira Rahman
Background: Short stature (SS) is a common pediatric problem, which can cause psychosocial disturbances both in parents and children. The goal of the evaluation of a child with SS is to identify the subset of children with pathologic causes so that appropriate timely intervention can be made. Objective: The aim of the study was to study the clinical, epidemiological, and etiological profile of SS at a tertiary hospital of Bangladesh. Methods: This was a cross-sectional study and was conducted in the department of pediatric endocrinology, over a period of 1 year (January 2021-December 2021). A total of 100 children aged 3-14 years, with height <-2SD below the mean height for age and sex were studied. Clinical history, examination, and laboratory evaluations were done to assess the cause of SS and the data were analyzed using appropriate statistical methods. Results: About 55% were female and 45% were male. The causes of SS were found to be familial SS (36%), constitutional growth delay of growth and puberty (12%), hypothyroidism (11%), growth hormone deficiency (8%), malnutrition (10%), chronic diseases (9%), genetic syndromes and skeletal problem (8%). Conclusion: The majority of short stature in children had normal variation of growth. Along with endocrine causes, chronic systemic illnesses and malnutrition still form a major bulk in the etiological profile of SS in Bangladesh. DS (Child) H J 2022; 38(2): 79-83
背景:身材矮小(SS)是一种常见的儿科问题,可对父母和儿童造成心理社会困扰。对患有矮小症的儿童进行评估的目的是确定哪些儿童属于病理性矮小症,以便及时采取适当的干预措施。研究目的本研究旨在研究孟加拉国一家三级医院的 SS 临床、流行病学和病因概况。研究方法这是一项横断面研究,在儿科内分泌科进行,为期一年(2021 年 1 月至 2021 年 12 月)。共有 100 名 3-14 岁儿童接受了研究,他们的身高均低于同年龄和性别平均身高的 2SD 值。通过临床病史、检查和实验室评估来评估 SS 的病因,并采用适当的统计方法对数据进行分析。研究结果约 55% 为女性,45% 为男性。SS的病因包括家族性SS(36%)、生长和青春期发育迟缓(12%)、甲状腺功能减退(11%)、生长激素缺乏(8%)、营养不良(10%)、慢性疾病(9%)、遗传综合征和骨骼问题(8%)。结论大多数身材矮小的儿童发育正常。除内分泌原因外,慢性系统性疾病和营养不良仍是孟加拉国矮小症的主要病因。DS (Child) H J 2022; 38(2):79-83
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引用次数: 0
期刊
Dhaka Shishu (Children) Hospital Journal
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