Background:Fasting (Sawm) during Ramadan, one of the five pillars of Islam is obligatory for all healthy adult and adolescent Muslims from the age of 12 years. Some children with diabetes, despite their exemption insist on fasting in Ramadan. We evaluated the safety of fasting among children with type 1 diabetes.Materials and Mathods:A prospective observational study was designed for diabetic children and adolescents who wish to fast during Ramadan 2012. Patients with their caregivers were given intensive education and instructions were provided by diabetic educators, dieticians and physicians on insulin adjustment, home blood glucose monitoring and dietary adjustments prior to Ramadan.Results:A total of 33 children and adolescents were included in this study. Of these, 16 were male and 17 were female. Majority (60.6%) of the patients could complete their fasting during the Ramadan. Patients were divided into two groups, those who completed fasting were considered as Group-I, whereas patients who broke the fast were in Group-ll. Blood glucose, hemoglobin A1c weight, and insulin dose before and after Ramadan in two groups showed no significant difference.Conclusion:Children older than 11 years of age with type 1 diabetes mellitus with conventional twice-a-day regimen can fast safely during Ramadan provided they have proper education and intensive follow-up during Ramadan.

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Abstract

Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characteristics and outcomes related to neonatal jaundice in Bangladesh has not been studied so far. This study addressed the outcomes, characteristics and risks of the jaundiced newborn admitted into hospital. The babies who had significant jaundice and required phototherapy and /or exchange transfusion were investigated. A detailed history of delivery with gestational age was noted and clinical examination of the admitted newborn was done. Birth weight was recorded. The investigations included complete blood count, ABO and Rh compatibility, serum bilirubin, glucose 6 phosphate dehydrogenase (G6PD), thyroid stimulating hormone (TSH) and ultrasonography (USG) of brain. The newborns were closely monitored for the prognosis. The requirement of individualized phototherapy and exchange transfusion were also noted. Finally, the outcomes were recorded. Overall, 60 (m v. f = 58.3 v. 41.7%) newborns were found who developed significant jaundice and were investigated. Of them, 35% had gestational age less than 32wks and only 32% had equal to or greater than 35wks. Regarding delivery, 83.3 % had the history of caesarean section. ABO-and Rh-incompatibilities were found in 13.3% and 3.3%, respectively. Septicemia was diagnosed among 26.7% though blood culture yielded growth only in 20%. Compared with the higher gestational age-group (≥ 35 wks) the lower group (<32 wks) showed significantly higher rate of septicemia (12.5 v. 68.8%, p<0.005). G6PD deficiency was found in only one (1.7%) case. Birth asphyxia was found as a concomitant factor in three patients. Exchange transfusion was done only in 2 (3.3%) babies. Among them one was preterm IDM with septicemia and other had G6PD deficiency. None of these babies developed kernicterus. Five (8.3%) babies died, all of them had septicemia and one baby also had intraventricular hemorrhage (IVH) with PDA. The study revealed that a substantial number of neonatal jaundice had the history of lower gestational age in Bangladeshi newborns; and the lower gestational age is significantly associated with septicemia and possibly with hyperbilirubinemia. More study is needed to establish the study findings.Ibrahim Med. Coll.

IntroductionCentral nervous system (CNS) tumors comprise 2% to 5% of all tumors. 80% involve the brain and 20% involve the spinal cord. Brain tumors cause approximately 2% of all cancer deaths. 60% to 80% of brains tumors are primary and rest 20% to 40% are metastatic. 1 Tumors of the CNS account for as many as 20% of all cancers of childhood and are second only to leukaemia as a cause of death from malignancy. In childhood 70% of primary brain tumors are infratenorial and involve cerebellum, midbrain, pons and medulla. 2 Benign tumors of the brain tend to grow slowly and some of them may be cured by surgery with or without radiation therapy. The malignant tumors grow more rapidly and are associated with a shorter survival. Some of those highly lethal tumors, such as medulloblastoma and ependymoblastoma have a tendency to disseminate throughout the CNS.There are increasing data documenting a genetic basis or at least a genetic association with some brain tumours. Total 50 patient age 2-60 years attending the oncology department with the diagnosis of primary brain tumor were included in this study. Clinical symptoms and sign in relation to brain tumor were recorded. X ray skull and CT scan reports of all cases were evaluated. To find out the histopathological pattern of the brain tumors all histopathological reports were also evaluated. Results: Most common symptoms of brain tumor were headache (76%), mental change (64%), vomiting (52%), visual defect (46%), difficulty in movement (42%) and convulsion (36%). Astrocytoma was found in 40% patients and 30% brain tumor was associated with hydrocephalus Conclusion:This study represent the brain tumor and gives some idea about the clinicopathological aspects of the disease in our country. It will help to do further studies to evaluate the clinical, epidemiological and pathological characteristics of brain tumor.[ BSMMU J 2010; 3(2): 68-71]

Objective: To determine the indication and complications of exchange transfusion (ET) performed for neonatal hyperbilirubinaemia. Methods: The medical records of infants < 28 days old who required exchange transfusion (ET) due to neonatal jaundice in Special Care Baby Unit (SCABU), BIRDEM hospital from January 2009 to April 2010 were retrospectively reviewed. Results: Exchange transfusion was performed in 30 neonates during the study period. Indications of exchange transfusion were ABO incompatibility (30.0%), Rh incompatibility (13.3%), septicaemia (6.6%) and in majority causes, were unidentified (50%). Most common complication were thrombocytopenia (33.3%) hyperkalaemia (20%), hypocalcaemia (16.7%) Conclusion: Indication of ET was unidentified in majority cases and among identified cases most common causes was ABO incompatibility. Adverse events were common after exchange transfusion.DOI: http://dx.doi.org/10.3329/bjch.v36i1.13029Bangladesh J Child Health 2012; Vol 36 (1): 16-19

Abstract:Objectives: The Prevalence and magnitude of childhood obesity are increasing dramatically. The study was undertaken to see the prevalence of metabolic syndrome among children and adolescents with obesity, attending the Paediatric Endocrine OPD, BIRDEM. Conclusions: The prevalence of metabolic syndrome is high among obese children and adolescents. Factors contributing towards obesity needs to be identified and strategies should be planned for prevention and management of this health problem. Methods

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