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Risk Factors and Outcome of Neonatal Hyperbilirubinemia: A Case Control Study in a Tertiary Level Paediatric Hospital 某三级儿科医院新生儿高胆红素血症的危险因素和结局
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63218
S. Afroze, R. Parvin, K. Nahar, Razia Sultana, S. Rahman, Erfan Ahmed, S. F. Sonia, Azmeri Sultana, N. Ghosh, N. Begum, M. Mannan
Introduction: Neonatal jaundice is one of the most common morbidities observed during the neonatal period. Several risk factors are responsible for this condition. Objective: This study was aimed to determine the possible risk factors and immediate outcome for jaundice in newborns. Methods: This case control study was performed over a period of 18 months (March 2019 -August 2020) in the Special Care Newborn Unit (SCANU) of Dr. M R Khan Shishu Hospital & Institute of Child Health (ICH). Risk factors for jaundice were evaluated by comparing cases with jaundice and controls having no jaundice. Results: A total of 230 neonates with jaundice and 250 neonates having no jaundice were enrolled. Maternal age between 31-40 years, less than 4 antenatal visits, primi, presence of maternal diabetes, babies born via caesarian section, small for gestational age, prematurity and intra-uterine growth restriction were significantly associated with jaundice in neonates (p value < 0.05). Multi-variate analysis revealed, babies with mothers having <4 antenatal visits were found to have 13 times more risk of developing jaundice than their matched controls (p= 0.00, CI= 0.78-14.9). Mean duration of phototherapy was longer for babies having jaundice due to blood group incompatibilities (4.82 ± 1.94). Most of the patients (91%) were discharged to home. Conclusion: Less than four antenatal visit is a significant risk factor for neonates to develop significant jaundice requiring treatment. Babies with blood group incompatibilities tend to require longer duration of phototherapy wherever most of the babies discharged to home with good recovery. DS (Child) H J 2021; 37(2): 109-115
新生儿黄疸是新生儿期最常见的疾病之一。有几个风险因素导致了这种情况。目的:本研究旨在确定新生儿黄疸的可能危险因素和直接预后。方法:本病例对照研究于2019年3月至2020年8月在Dr. R Khan Shishu医院和儿童健康研究所(ICH)的特殊护理新生儿病房(SCANU)进行,为期18个月。通过比较黄疸患者和无黄疸的对照组来评估黄疸的危险因素。结果:共纳入230例黄疸新生儿和250例无黄疸新生儿。产妇年龄在31-40岁之间、产前检查少于4次、初产妇、产妇是否患有糖尿病、剖宫产、小于胎龄、早产和宫内生长受限与新生儿黄疸有显著相关性(p值< 0.05)。多变量分析显示,母亲产前检查次数<4次的婴儿患黄疸的风险是对照组的13倍(p= 0.00, CI= 0.78-14.9)。血型不合的黄疸患儿平均光疗时间更长(4.82±1.94)。大多数患者(91%)出院回家。结论:少于四次产前检查是新生儿发生严重黄疸需要治疗的重要危险因素。血型不合的婴儿往往需要更长时间的光疗,而大多数婴儿出院回家后恢复良好。DS(儿童)H J 2021;37 (2): 109 - 115
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引用次数: 0
Managing Dengue Syndrome in Children: Challenges for Paediatricians 管理儿童登革热综合征:儿科医生面临的挑战
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63158
M. Islam
Abstract not available DS (Child) H J 2021; 37(2): 85-86
摘要不可用DS (Child) [J] 2021;37 (2): 85 - 86
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引用次数: 0
Impact of COVID-19 on the Symptoms of Asthma in Children and Its Management COVID-19对儿童哮喘症状的影响及其管理
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63159
Md. jahangir Alam
Abstract not available DS (Child) H J 2021; 37(2): 87-92
摘要不可用DS (Child) [J] 2021;37 (2): 87 - 92
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引用次数: 0
Instructions for Authors Vol. 37(2) 作者说明书第37卷(2)
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63228
The Editor
Abstract not available DS (Child) H J 2021; 37(2): 149-150
摘要不可用DS (Child) [J] 2021;37 (2): 149 - 150
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引用次数: 0
Outcome of Dengue Patients Admitted in the PICU of Bangladesh Shishu Hospital & Institute 孟加拉石树医院及研究所重症监护病房收治登革热患者的预后分析
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63162
R. Akhter, Shubhra Paul, Fannana Ahmed
Background: Recent re-emergence of dengue patient among Bangladeshi children have created a huge burden in the morbidity and mortality of our children. Objectives: This study was designed to document the outcome of dengue patients, admitted in the ICU of Bangladesh Shishu Hospital & Institute (BSH&I). Methods: This retrospective observational study was performed among the children having dengue infection and who were admitted in the PICU of BSH&I from 1st June 2019 to 31st December 2019. All patients who were diagnosed as dengue fever by serological tests (NS1, Dengue IgG & IgM) and those who were admitted in the PICU were included in this study. Total one hundred and twenty-six patients were enrolled. Data were collected from hospital record of the Dengue patients. Results: Mean age of the Dengue patients were 5.91(±3.53) years. Most of the patients suffering from dengue fever were urban dwellers; among them 52.4% were female. Presenting symptoms during admission in the PICU were fever which was present in 119 patients (94.4%), followed by hypotension in 106 (84.1%) patients. Severe dengue (SD) was diagnosed in maximum number of cases (i.e., 62.7%), followed by Dengue fever with warning signs (DFWS) in (20.6%) and Expanded Dengue Syndrome (EDS) in 16.7%. Maximum cases received crystalloid (98.4%), about 51.6% patients received colloid. A good number of patients received blood transfusion (23%), plasma was received in (23%) and albumin was received in (33.3%) cases. Majority of the patients received Oxygen (80.2%); antibiotics were prescribed in 87.3% cases. Fifty-five percent patients received inotropes for the management of shock. The overall outcome revealed 75.4% patients were cured and discharged. Only 21.43% patients died in the PICU despite protocol-based management. Death due to severe dengue was 15(18.9%) out of 79, followed by death due to Dengue Hemorrhagic fever with warning signs which was 8 (30.7%) out of 26 and death in Expanded Dengue syndrome was 4(19.04%) out of 21. Conclusion: This retrospective study found that majority of the Dengue patients admitted in PICU has survived. However the death due to Dengue with warning signs was higher than death in severe Dengue cases. Delayed recognition of warning signs along with delayed referral to PICU may be responsible for such outcome. DS (Child) H J 2021; 37(2): 103-108
背景:最近孟加拉国儿童中再次出现登革热患者,给我国儿童的发病率和死亡率造成了巨大负担。目的:本研究旨在记录孟加拉国石树医院和研究所(BSH&I) ICU收治的登革热患者的预后。方法:对2019年6月1日至2019年12月31日在BSH&I PICU住院的登革热感染儿童进行回顾性观察研究。所有通过血清学检测(NS1、登革热IgG和IgM)诊断为登革热的患者以及PICU收治的患者均纳入本研究。共纳入126例患者。数据来自登革热患者的医院记录。结果:登革热患者平均年龄5.91(±3.53)岁。登革热患者以城市居民居多;其中女性占52.4%。入院时的主要症状为发热119例(94.4%),低血压106例(84.1%)。诊断为重症登革热(SD)的病例最多(62.7%),其次是有警告体征的登革热(DFWS)(20.6%)和扩展型登革热综合征(EDS)(16.7%)。晶体移植最多(98.4%),胶体移植约51.6%。大量患者接受输血(23%),接受血浆(23%),接受白蛋白(33.3%)。以吸氧为主(80.2%);87.3%的病例使用抗生素。55%的患者接受了肌力疗法来治疗休克。总体结果显示,75.4%的患者治愈出院。只有21.43%的患者在PICU中死亡,尽管有基于协议的管理。79人中重症登革热死亡15人(18.9%),其次是有警示迹象的登革出血热死亡8人(30.7%),扩展型登革综合征死亡21人(19.04%)。结论:本回顾性研究发现大多数入住PICU的登革热患者存活。然而,有警告迹象的登革热的死亡率高于严重登革热病例的死亡率。警告信号的延迟识别以及延迟转诊到PICU可能是造成这种结果的原因。DS(儿童)H J 2021;37 (2): 103 - 108
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引用次数: 0
Hepatitis A: Leading Cause of Paediatric Acute Liver Failure in Bangladesh 甲型肝炎:孟加拉国儿童急性肝衰竭的主要原因
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63160
R. Rashid, A. Karim, F. Islam, S. Mahmud, Sk Serjina Anwar
Background: Pediatric acute liver failure (PALF) is a multisystem disorder that gives rise to severe liver failure within days or weeks and occurs in children without pre-existing chronic liver disease. The etiology of PALF varies with age group and geographical area. Objectives: This study was aimed to evaluate the etiological factors of PALF in Bangladeshi children. Methods: This observational study was conducted at the Department of Paediatric Gastroenterology & Nutrition, Bangabandhu Sheikh Mujib Medical University, Bangladesh, from 2017 to 2020. Twenty-six PALF patients were included, purposively, excluding the acute-on chronic liver failure cases. Demographic data, vaccination history, and other information regarding etiology and complications were recorded. During hospital stay following investigations were performed: Serum bilirubin, liver enzymes, prothrombin time, serum albumin, serum creatinine and electrolytes. Fisher’s exact test determined the association between etiologies of PALF and past histories along with other descriptive statistics using the open-source PSPP software. Results: The average age of the 26 studied patients was 8.6±3.5 years, and 73.1% belonged to 5-12 years of age group. Half of the patients had a history of taking street food or unsafe water. Only six patients had a history of ingestion of herbal medicine. None of the patients had history of vaccination against Hepatitis A. The etiology of PALF patients varied. About 54% of the studied patients had HAV infection, in 23.1% etiology was not determined. About 71.4% of the study patients with HAV infection had a history of taking street food or unsafe water, and this association was statistically significant. Conclusion: This study found that hepatitis A virus infection is the leading cause of paediatric acute liver failure in Bangladesh. Timely preventive measures may help in lowering fatality from liver diseases in children in Bangladesh. DS (Child) H J 2021; 37(2): 93-97
背景:小儿急性肝衰竭(PALF)是一种多系统疾病,可在数天或数周内引起严重肝功能衰竭,发生在没有慢性肝病的儿童中。PALF的病因因年龄组和地理区域而异。目的:本研究旨在评估孟加拉国儿童PALF的病因。方法:本观察性研究于2017年至2020年在孟加拉国Bangabandhu Sheikh Mujib医科大学儿科胃肠病学与营养学系进行。有目的地纳入了26例PALF患者,排除了急性慢性肝衰竭病例。记录人口统计数据、疫苗接种史和其他有关病因和并发症的信息。住院期间进行以下调查:血清胆红素、肝酶、凝血酶原时间、血清白蛋白、血清肌酐和电解质。Fisher的精确测试确定了PALF病因与过去病史之间的联系,以及使用开源PSPP软件的其他描述性统计数据。结果:26例患者平均年龄8.6±3.5岁,5-12岁年龄组占73.1%。一半的患者有吃过街头食品或不安全的水的历史。只有6例患者有服用草药的历史。所有患者均无甲型肝炎疫苗接种史,其病因各不相同。约54%的患者有甲型肝炎感染,23.1%的患者病因不明。研究中约71.4%的HAV感染患者有街头食品或不安全饮用水的历史,这一关联具有统计学意义。结论:本研究发现甲型肝炎病毒感染是孟加拉国儿童急性肝衰竭的主要原因。及时的预防措施可能有助于降低孟加拉国儿童肝病的死亡率。DS(儿童)H J 2021;37 (2): 93 - 97
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引用次数: 0
Effect of Intrahepatic Cholestasis of Pregnancy (ICP) on Neonatal Outcome 妊娠肝内胆汁淤积(ICP)对新生儿结局的影响
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63222
N. Begum, Israt Jahan Chaudhury, N. Bari, S. Afroze
Intrahepatic cholestasis of pregnancy is a condition unique to pregnancy characterized by pruritus and elevated serum bile acids and/or aminotransferase levels. It usually manifests during second or third trimester of pregnancy and improves after delivery. But neonates are at increased risks of still birth, prematurity, respiratory distress syndrome and metabolic problems. Timely identification and appropriate intervention can reduce the adverse neonatal outcomes. DS (Child) H J 2021; 37(2): 135-139
妊娠期肝内胆汁淤积症是妊娠期特有的一种疾病,其特征是瘙痒和血清胆汁酸和/或转氨酶水平升高。它通常表现在怀孕的第二或第三个月,并在分娩后改善。但新生儿出现死产、早产、呼吸窘迫综合征和代谢问题的风险增加。及时识别和适当干预可减少新生儿不良结局。DS(儿童)H J 2021;37 (2): 135 - 139
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引用次数: 0
Students Qualified from Bangladesh Institute of Child Health (At present BSH&I) Vol. 37(2) 孟加拉国儿童健康研究所(目前为BSH&I)第37卷(2)合格学生
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63227
The Editor
Abstract not available DS (Child) H J 2021; 37(2): 147-148
摘要不可用DS (Child) [J] 2021;37 (2): 147 - 148
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引用次数: 0
Spectrum of Upper GI Endoscopy in Children: A Tertiary Centre Experience from Bangladesh 儿童上消化道内窥镜的光谱:来自孟加拉国的三级中心经验
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63220
S. Mahmud, Jahida Gulshan, Madhabi Baidya, R. Rashid, Farhana Tasneem, A. Hasan, T. Farhana, D. Begum, Nafis Fatema Asha, Syed Shafi Ahmed
Background: Upper gastrointestinal endoscopy is an essential, safe and sensitive investigation for diagnosing pediatric gastrointestinal diseases. In resource-limited countries like Bangladesh, the practice of pediatric endoscopy remains rudimentary, lacking in trained pediatric endoscopists and appropriate-sized endoscopes. There is limited study on paediatric upper GI endoscopy in our country. Objectives: The aim of the study was to find out the indications, common endoscopic findings and immediate post procedure complication of UGI endoscopy in children. Methods: This is a retrospective study; the records of all the patients whose age is less than 18 years and who underwent endoscopy in the last 6 years were studied. Results: Among the total of 384 children (age <18 years), the most common indications were recurrent abdominal pain in 133 (34.7%) patients followed by hematemesis±melena in 99 (25.8%), esophageal varices (follow up with eradication) in 67 (17.5%), recurrent vomiting in 31 (8.1%), foreign body, CLD screening, suspected celiac disease, isolated splenomegaly, corrosive injury, and weight loss. The most common abnormal findings were gastritis in 103 (26.9%) children followed by esophageal varices in 73 (19.2%), duodenitis in 26 (6.8%), foreign body, esophagitis, hiatus hernia, esophageal stricture, esophageal ulcer, gastric ulcer, duodenal ulcer etc. Minor adverse events occurred in 7.0% of children. Conclusion: The commonest indication for Pediatric UGI endoscopy was recurrent abdominal pain and the commonest endoscopic feature was gastritis. No significant post procedure complication was noted in the study. DS (Child) H J 2021; 37(2): 123-128
背景:上消化道内镜检查是诊断儿童胃肠道疾病的必要、安全、敏感的检查方法。在孟加拉国等资源有限的国家,儿童内窥镜检查仍然处于初级阶段,缺乏训练有素的儿科内窥镜医生和合适尺寸的内窥镜。我国对小儿上消化道内镜的研究有限。目的:本研究旨在探讨儿童UGI内镜的适应症、常见内镜表现及术后即刻并发症。方法:回顾性研究;研究年龄小于18岁且近6年内行内窥镜检查的所有患者的记录。结果:384例<18岁儿童中,最常见的指征为反复腹痛133例(34.7%),其次为呕血±黑黑99例(25.8%),食管静脉曲张(随访根除)67例(17.5%),反复呕吐31例(8.1%),异物、CLD筛查、怀疑腹腔疾病、孤立性脾大、腐蚀性损伤、体重减轻。最常见的异常表现为胃炎103例(26.9%),其次为食管静脉曲张73例(19.2%),十二指肠炎26例(6.8%),异物、食管炎、食管裂孔疝、食管狭窄、食管溃疡、胃溃疡、十二指肠溃疡等。7.0%的儿童发生轻微不良事件。结论:儿童UGI内镜检查最常见的指征是反复腹痛,最常见的内镜特征是胃炎。研究中未发现明显的术后并发症。DS(儿童)H J 2021;37 (2): 123 - 128
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引用次数: 0
Hypocalcemic Seizures in Infancy and its Relationship with Maternal Vitamin D Deficiency 婴儿低钙性癫痫发作及其与母体维生素D缺乏的关系
Pub Date : 2022-12-11 DOI: 10.3329/dshj.v37i2.63161
R. Biswas, Abm Kamrul Hasan
Background: Hypocalcemia accounts for a large number of seizures in infants presented at the emergency department of our hospital. Objective: To evaluate the role of Vitamin D deficiency as the etiology of hypocalcemic seizures in infancy and its relationship with maternal Vitamin D levels. Methods: Cross sectional hospital based study over a period of 35 months from July 2016 to June 2019. Total 60 infants with hypocalcemic seizures were enrolled into the study. Blood samples were taken for serum total calcium, inorganic phosphate, alkaline phosphatase, albumin, 25(OH)D and PTH from the child. Maternal serum 25(OH)D levels were measured as well. Results: The mean age of the studied infants was 3.6 (±1.2) months. All patients had low total calcium (mean 6.5 mg/dl) and most of them had low inorganic phosphate (mean 3.5 mg/dl), while all of them had raised alkaline phosphatase (mean 1093.50 IU/L) and PTH levels (mean104 pg/ml) at presentation. Forty percent of infants were severely deficient and 60% were deficient in vitamin D; none of them were vitamin D sufficient. Among their mothers, none were sufficient, 10% were insufficient, 45% were deficient, and 45% were severe deficient of vitamin D. Neonatal 25(OH)D showed strong negative correlation with their serum PTH levels and strong positive correlations with maternal serum 25(OH)D levels. Conclusion: All infants in our setting presented with hypocalcemic seizures were found due to Vitamin D deficiency and it was mostly related to maternal Vitamin D deficiency. DS (Child) H J 2021; 37(2): 98-102
背景:低钙血症是我院急诊科大量婴儿癫痫发作的原因。目的:探讨维生素D缺乏在婴儿期低钙性癫痫发病中的作用及其与母体维生素D水平的关系。方法:2016年7月至2019年6月,以横断面医院为基础,为期35个月。共有60名患有低钙癫痫发作的婴儿参加了这项研究。采集患儿血清总钙、无机磷酸盐、碱性磷酸酶、白蛋白、25(OH)D、甲状旁腺激素。同时测定母体血清25(OH)D水平。结果:研究婴儿的平均年龄为3.6(±1.2)个月。所有患者均有低总钙(平均6.5 mg/dl)和低无机磷酸盐(平均3.5 mg/dl),而所有患者在就诊时碱性磷酸酶(平均1093.50 IU/L)和甲状肾上腺素(平均104 pg/ml)水平升高。40%的婴儿严重缺乏维生素D, 60%缺乏维生素D;都没有足够的维生素D新生儿25(OH)D与新生儿血清PTH水平呈显著负相关,与母亲血清25(OH)D水平呈显著正相关,新生儿25(OH)D与母亲血清25(OH)D水平呈显著正相关。结论:本组患儿发生的低钙性癫痫均为维生素D缺乏所致,且多与母体维生素D缺乏有关。DS(儿童)H J 2021;37 (2): 98 - 102
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引用次数: 0
期刊
Dhaka Shishu (Children) Hospital Journal
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