Dengue is a self-limiting acute mosquito born disease caused by Dengue virus. Dengue infections may be asymptomatic or can result in a wide spectrum of disease severity ranging from an influenza-like illness (Dengue fever) to the life-threatening Dengue hemorrhagic fever (DHF)/Dengue shock syndrome (DSS). We aimed to analyze the variation in clinical spectrum, outcome and possible risk factors for fatality among Dengue infected children. This was an observational study carried out over a period of one year involving 89 children up to 15 years of age. Upon clinical suspicion Dengue was confirmed by NS 1 antigen and/or Dengue antibody IgM, IgG. Positive Dengue cases were enrolled & interviewed and the information obtained related to the risk factors, clinical presentation, pattern of Dengue infection and outcome were documented in the pre-structured questionnaire. Among the 89 studied children the highest percentage (51.68%) was between 0-5 year and male female ratio was 1.2: 1. Mosquito net was not used by (74.15%) children and there was source of stagnant water in/near the house of (13.48%) children. Fever was present in (100%), rash in (48.31%), nausea/vomiting in (37.07%), headache in (12.35%), myalgia/arthralgia/backache (13.48%), retro orbital pain (1.12%) and abdominal pain in (23.59%) patient. Epistaxis was the commonest (70%) form of bleeding. CNS involvement was in the form of restlessness/irritability (19.10%), altered sensorium (2.24%) and convulsion. Pleural effusion was commoner than ascites; (25.84%) and (12.35%) respectively. Among the enrolled children Dengue fever was (74.15%), Dengue hemorrhagic fever (6.74%) and Dengue shock syndrome (19.10%). Two patients died out of 17 from Dengue shock syndrome which was (11.76%). World Health Organization (WHO) guideline based management should be applied in assessing and managing Dengue cases to reduce mortality rate. Public awareness should be widened to prevent Dengue.

The primary objective of this study was to determine the clinical improvement after oral magnesium (Mg 2+) supplementation in severely malnourished children. The specific objectives were to observe the changes in clinical signsymptoms between Mg 2+ supplemented and un-supplemented group and to see serum Mg 2+ level before and after oral Mg 2+ supplementation. This observational study was conducted in three tertiary level hospitals in Dhaka city involving 60 severely malnourished children of 6-59 months of age by non-probability purposive sampling from July'2016 to June'2018. Children were divided into two groups; Group I was given standard management for severe acute malnutrition according to the national guideline, Group II received similar treatment plus oral Mg 2+ supplementation. Improvement of the clinical profile and the serum Mg 2+ level was observed in children treated with Mg 2+ supplementation. The mean age of Group I children was 21.13±13.02 months and Group II was 22.52±12.13 months. Male female ratio was 1.2:1. Statistically significant improvement was observed in case of nausea/vomiting, appetite, generalized weakness and weight gain (p<0.01). Appearance, diarrhea, skin changes and edema also improved in Mg 2+ supplemented group but the results were not significant. Post-treatment serum Mg 2+ levels were significantly different in Group I and Group II i.e., 1.52±0.27mg/dL Vs 2.03±0.31mg/dL respectively (p<0.001). It was observed that oral Mg 2+ supplementation improved clinical outcome in severely malnourished children. Further large scale randomized control trial is needed to more precisely delineate the beneficial role of oral Mg 2+ supplementation in severely malnourished children.

The term Kangaroo mother care (KMC) is derived from the practical similarities to marsupial care giving -mother acts as an incubator as kangaroo and put low birth infant vertically in between the chest. It is an effective way to meet baby's needs for warmth, breastfeeding, protection from infection, stimulation, safety and love. Objective: The general objectives were to see the implementation challenges and outcome of intermittent KMC at a secondary level district hospital. The specific objectives were to observe the nature of family participation, practice pattern of intermittent KMC, length of hospital stay, effect on weight gain, mortality and problem experienced by the newborns and mothers/caregivers during KMC practice. Materials & Methods: This was an observational study for three months at 250 Bedded District Hospital, Moulvibazar, Bangladesh involving 50 preterm (gestational age <37 week) & low birth weight (<2000 g) newborns and their mothers/caregivers. Participants were included and KMC was initiated in stable newborns according to the national KMC guideline. Information related to the study objectives were obtained from examination and interview and the findings were recorded during the hospital stay and follow up visits in a pre-structured data collection sheet. Results: Among the studied newborns male female ratio was 1.5:1 and 32 (64%) were out born (delivered at home or any other hospitals). The mean postnatal age at the time of admission was 57.90 h, at the time of initiation of KMC was 115.38 h and at discharge was 227 h. So, there was mean delay of 66 h from admission to initiation of KMC and in 47(94%) newborns. Mostly, the delay was due to absence of mothers or eligible caregivers and unstable clinical condition of the newborns. The mean weight at admission and discharge was 1625.80 g and 1520.60 g respectively. Among the family members, mother practiced KMC in 45(90%) [n=50] followed by grandmother 28 (56%). KMC was practiced in 44 (88%) newborns in the evening shift followed by 43 (86%) & 27(54%) in the night & morning shifts respectively. The mean duration of KMC was 2.58 h in the night shift followed by 2.46 h & 2.46 h in the evening & morning shifts respectively. The mean hospital stay was 109.95 h. Total 32 studied newborns completed up to 3 rd follow up after discharge among which 5(15.62%) did not gain weight, 6(18.75%) gained weight at 1st follow up (7th day of age), 14(43.75%) at 2nd follow up (15 th day of age) & 7(21.87%) at 3 rd follow up (30th day of age). The total mortality was 6(12%). Most of the newborns and mothers/caregivers experienced no problem during KMC practice. Conclusion & recommendation: Family motivation and participation is a key to standard KMC practice. Constant supervision and follow up home visit involving community health personnel until the neonatal age is completed constitute the most important aspect for implementing KMC effectively and reducing the mortality.

Background: Chikungunya is a viral disease in humans caused by the bite of mosquitoes. Chikungunya and dengue fever are closely related as they share common symptoms and are often mistreated. Even though the symptoms are almost alike the excruciating arthritic pain is a typical manifestation of Chikungunya infection. The disease also has long term effect on musculoskeletal system causing crippling arthritis in most of the people. Objectives:The main objective of this study was to assess the level of awareness about Chikungunya among the parents of Chikungunya infected children in a tertiary level hospital. The specific objective was to assess knowledge and attitude of the parents about Chikungunya and to find the sociodemographic factors associated with the level of awareness.Method: This is a descriptive cross-sectional study conducted at Square Hospital Ltd., Dhaka in order to assess the level of awareness about Chikungunya among the parents of Chikungunya infected children. This survey included parents of 150 children diagnosed as Chikungunya. Nonprobability purposive sampling technique was applied. Face to face questioning method was used to collect data from the parents related to their sociodemographic and awareness related factors. Data was compiled in a pre-structured questionnaire and was analyzed in SPSS version 19.