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Background: Millions of people worldwide have been affected by the COVID-19 pandemic. Due to the prevalence of malnutrition, refusal of immunization during a pandemic, nutritional anemia, air pollution, poverty, poor parental education, inadequate access to high-quality acute healthcare, the clinical characteristics and outcomes of children in Bangladesh may vary from other countries. Information on clinical presentations, outcomes, the relationship between disease incidence and the prevalence of associated disease in Bangladeshi children affected by COVID-19 are scarce. Objective: In this study, our main goal was to evaluate the clinical profile of pediatric COVID-19 patients in child corona unit of Dhaka Medical College Hospital, Bangladesh. Method: This single center observational study was conducted in Child Corona Unit of Dhaka Medical College Hospital (DMCH). A total of 1020 COVID-19 positive pediatric patients were included in this study. Results: In our study, 89.1% of patients had fever, 80.8% had a cough, 23.1% had diarrhea, and 70.8% had myalgia. According to CXR reports, 2.1% patients had ground-glass opacity, 38% had local patchy shadowing, 31.8% patients had bilateral patchy shadowing and 27.9% patients had interstitial abnormalities. Correlation of disease severity between without co-morbidity and with co-morbidity is statistically significant (p=0.01). Conclusion: This research revealed a variable range of presentations. This sheds light on the cases of COVID-19 in the pediatric population. Children with COVID-19 normally present with or are asymptomatic with different symptoms; infants may have a high risk of serious illness. However, most cases were reported in children 11-15 years of age and fever, cough, nasal congestion and dyspnoea were typical symptoms. Serious cases were those with co-morbidity and in order to save them additional attention during home care and prompt hospitalization therapy are needed.

Objective: The present study was undertaken to assess liver function (using markers like SGPT, serum bilirubin, prothrombin time, serum albumin) in children suffering from Acute Lymphoblastic Leukemia. Materials & Methods: This study was carried out in the Department of Pediatric Hematology & Oncology, Dhaka Medical College Hospital, Dhaka, over a period 12 months from the day of approval of the protocol. All acute lymphoblastic leukaemia children admitted in Pediatric Hematology & Oncology Department in Dhaka Medical College Hospital and receiving chemotherapy of standard protocol for induction of remission were the study population. A total of outcome variable was hepatotoxicity resulting from chemotherapy given for induction of remission. Result: The mean age of the children was 4.4 years (range 2- 8 years). Males were a bit higher in the series with male to female ratio being 11:9. Liver function tests before therapy revealed that none of the children exhibited raised serum billirubin and only 2(4.5%) children had increased SGPT. However, 50% of the children had raised prothrombin and 43.2% had reduced serum . albumin. Liver function tests after therapy after induction of remission shows that 9(20.5%) children exhibited raised serum billirubin, the proportion of children with raised prothrombin remained almost same as before but the status of serum billirubin improved to some extent. However, proportion of children with raised SGPT was increased to 25%. Comparison of liver function in children after therapy during induction of remission with that before induction did not show any significant difference, except that the serum SGPT was significantly raised during induction of remission (p < 0.001). Conclusion: The study concluded that the current therapy for induction of remission of ALL cases does not produce any toxic effect on liver. Although, enzymes like SGPT take a sharp rise during induction of remission, it is transient and does produce any deleterious effect on liver. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 33-37

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Background: Platelet indices (plateletcrit, mean platelet volume, platelet distribution width and Platelet count) are potentially useful markers for the early diagnosis and outcome of many diseases. Platelet indices could serve as surrogate marker for remission in patients with ALL. Objective: To observe change of platelet indices in ALL during induction of remission. Material & Methods: This observational study was carried out with 52 newly diagnosed ALL patients ranging from 1.5 to 12 years admitted at DMCH, from January to December 2015. Platelet indices such as plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PLT) were monitored from admission to induction of remission phase of chemotherapy and were analyzed. Result: Mean PLT was found 93442.3±29966.4 cmm before treatment, 137442.3±27217.9 cmm in 1st week and 231653.8±42543.5 cmm in 4th week. Mean PCT was found 0.09±0.11% before treatment, 0.16±0.11% in 1st week and 0.25±0.18 % in 4th week. Both PLT & PCT was increased significantly during induction of remission after one and four weeks. Mean PDW was found 13.1±3.9 fl before treatment, 12.9±3.5 fl in 1st week and 12.0±3.1 fl in 4th week. MPV was found 10.6±2.1 fl before treatment, 11.0±1.4 fl in 1st week and 10.7±1.4 fl in 4th week. The change of MPV & PDW were not statistically significant when compared with that of before treatment. Conclusion: It can be concluded that among four important platelet indices, PLT and PCT were significantly associated with remission in ALL during induction of remission. Bangladesh J Child Health 2020; VOL 44 (1) :34-39

Hemophilia is the most common serious congenital coagulation factor deficiencies. The prevalence of hemophilia is estimated to be about 1:10,000 birth and that of the severe form of the disease to be about 6% per 1,00,000 population. The most pathetic part of this disease is that even medical personnel are sometimes not familiar with its diagnosis and management. There is obviously a need to establish facilities and treatment options that will help the patient with hemophilia to manage their life with ease. As this is a genetic disorder no complete cure is possible as of now. The only available treatment option is the infusion of factors and some adjuvant therapies depending upon the bleeding conditions .Hemophilia, if not properly managed, can lead to chronic disease and lifelong disabilities. The challenges and issues in infants/young children are different from those in older children and adults although episodes of bleeding still predominate as the diagnostic trigger. Currently, inhibitor development is a challenging complication of pediatric hemophilia and prophylaxis is emerging as the optimal preventive care strategy. In this section we will review some important aspects of hemophilia in children including early prophylaxis, current evidence relating to inhibitor development.

J Dhaka Medical College, Vol. 21, No. 2, October, 2012, Page 245-249 DOI: http://dx.doi.org/10.3329/jdmc.v21i2.15368

Abstract:Desmoplastic small round cell tumor (DSRCT) is a rare pathologic entity that most frequently affects the peritoneal cavity and presents in pediatric and adolescent boys. It often presents at an advanced stage and has a generally poor prognosis. Sometimes it may involve liver at diagnosis. We present an unusual case of DSRCT who was present with mass in lower abdomen, pain, hepatomegaly and mild ascites. This tumor is characterized by nests of small undifferentiated cells that show immunohistochemical evidence of epithelial, mesenchymal and neural differentiation. In our patient histologicaly tumor had the characteristic features of DSRCT and were composed of small round cells with hyperchromatic nuclei and scanty cytoplasm. With various difficulties in diagnosis we ultimately reached at diagnosis by open biopsy and immunohistochemistry. Now patient is on multidrug chemotherapy (modified p6 protocol). Diagnosis and management of a rare tumor needs high level of suspicion and in time intervention.