Poisoning after eating puffer fish containing highly lethal tetrodotoxin (TTX) is widespread in Asia. In 2008, naïve inland populations in Bangladesh were exposed to cheap puffer fish sold on markets. In three outbreaks, 141 patients with history of puffer fish consumption were hospitalized. Symptoms of poisoning included perioral paraesthesia, tingling over the entire body, nausea and vomiting, dizziness, headache, abdominal pain and muscular paralysis of the limbs. Seventeen patients (12%) died from rapidly developing respiratory arrest. Blood and urine samples from 38 patients were analyzed using a TTX-specific enzyme-linked immunoassay (ELISA). Medium to high TTX levels were detected (1.7-13.7 ng/ml) in the blood of 27 patients. TTX was below detection level (< 1.6 ng/ml) in 11 blood samples but the toxin was detected in urine. Ten patients had blood levels above 9 ng/ml and developed paralysis; seven of these died. The remaining patients recovered with supportive treatment. High concentrations of TTX and its analogues 4-epiTTX and 4,9-anhydroTTX were also found in cooked puffer fish by post-column liquid chromatography-fluorescence detection. To prevent future instances of puffer fish poisoning of this magnitude, measures should be implemented to increase awareness, to control markets and to establish toxicological testing. To improve the management of this and other poisoning in Bangladesh, facilities for life-saving assisted ventilation and related training of healthcare personnel are urgently needed at all levels of the health system.
The study was carried out in Medicine and Pediatrics Department of Rajshahi Medical College Hospital, and Natore Sadar Hospital, both are located in the northern territory of Bangladesh. Period of study ranged from admission of patients till discharge.
This was a prospective study conducted in a cohort of live normal full term singleton newborns delivered in Rajshahi Medical College Hospital with the objective to explore their early neonatal health as well as the role of low birth weight on it. A total 770 live normal newborns were Included in this study. For data collection APGAR Score Estimating Checklist and one protested structured questionnaire were used. Simple descriptive as well as analytical techniques including Chi-square t test were done.The results of this study suggested that low weight (LBW) babies were more prone to develop early neonatal morbidity and mortality than normal birth weight (NBW) babies. LBW infants needed more resuscitation and responded less to resuscitative effort than the infants of NBW. Birth asphyxia was the commonest cause of early neonatal morbidity and mortality.
Pneumonia was the leading common cause of death in young children in Bangladesh. 351 patients of Pneumonia below five years of age were selected as per WHO guidelines. Out of 351 patients, one patient died due to very severe pneumonia that had history of low birth weight and malnutrition. The following factors were taken into consideration such as age, sex, low birth weight, feeding pattern, malnutrition, housing, paternal education, ventilation of living room and smoking habits of parents. It was found that below 2 months of age, severe pneumonia showed 50% and there was male preponderance in all age group and also 41.6% of male children had recurrent attack of pneumonia. Low birth weight and lack of breast feeding patient had suffered more frequently of Pneumonia. In this study, it was statistically proved that malnutrition (p=.00028), inadequate paternal education (p=.00007), bad ventilated living room (p=.00037) and also smoking habits of parents (p=.04054) had significant important risk factors of recurrent attack of Pneumonia in children.
This was a prospective study conducted in a cohort of live normal full term singleton new-borns delivered in Rajshahi Medical College Hospital with the objective to explore their early neonatal health and as well as the role of low birth weight on it. A total 770 live normal new-borns were included in this study. For data collection APGAR Score Estimating Checklist and one pretested structured questionnaire were used. Simple descriptive as well as analytical techniques including Chi-square and t test were done.The results of this study suggested that low birth weight (LBW) babies were more prone to develop early neonatal morbidity and mortality than normal birth weight (NBW) babies. LBW infants needed more resuscitation and responded less to resuscitative effort than the infants of NBW. Birth asphyxia was the commonest cause of early neonatal morbidity and mortality.
Wilson’s disease (hepatolenticuler degeneration), an inborn error of copper metabolism, is an autosomal recessive disorder characterized by degenerative changes in brain, liver disease and Kayser Fleisher (KF) rings in the cornea. It is due to a defect of p-type ATPase which is probably required for normal excretion of copper through bile. Hepatic manifestation of the disease is common at early age and neurological manifestation is common at an older age. We are reporting Wilson disease with neurological manifestation in a 10 year old boy.
TAJ 2010; 23(1): 87-90
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