Variceal bleeding results as a consequence of portal hypertension and it is a leading cause of morbidity and mortality of children with chronic liver disease (CLD). Upper gastrointestinal endoscopy is the only confirmatory tool for detecting esophageal varices but due to its invasive nature, high cost and lack of available facilities for pediatric endoscopy, alternative laboratory predictors are essential. In this study, we aimed at identifying laboratory predictors that may predict the presence of esophageal varices in children with CLD. This cross-sectional study was done at the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from July 2008 to June 2010. Fifty consecutive children with CLD, aged 3-15 years of both sexes, who had no history of active/recent variceal bleeding, taking beta blockers or surgery for esophageal varices were included in the study. All patients underwent history and physical examination. Venous blood of the patients was taken for laboratory analysis of serum bilirubin, serum alanine aminotransferase, serum albumin, platelet count and International Normalization Ratio (INR). Later, upper gastrointestinal endoscopy of the patients were done. Based on endoscopic findings children were divided into two groups. Group-I: CLD with esophageal varices included 29 children and Group-II: CLD without esophageal varices included 21 children. A univariate analysis was initially done on laboratory variables followed by a logistic regression analysis to identify the independent variables associated with presence of esophageal varices. Then performance of these independent variables were analyzed using upper gastrointestinal endoscopy as the gold standard test. Out of 50 patients 30 were male. Male-female ratio was 1.5:1. Fifty eight percent (29 out of 50) had esophageal varices. Amongst all the laboratory variables, thrombocytopenia (platelet count <150000/mm3) was an independent predictor of esophageal varices (p=0.018). Thrombocytopenia showed good sensitivity and specificity (82.7% and 80.9% respectively) to be used as a screening test for predicting esophageal varices in children with chronic liver disease. Thrombocytopenia can be used as an independent predictor for esophageal varices in children with chronic liver disease. Faridpur Med. Coll. J. 2021;16(1):3-7
Prematurity is one of the major causes of neonatal death in developing countries like Bangladesh. Appropriate protocol for nutritional support of the preterm infants is essential to achieve a postnatal growth rate similar to that of a normal fetus. Objective of the study was to assess the effects of the existing nutritional support protocol of Bangabandhu Sheikh Mujib Medical University (BSMMU) in the early postnatal growth velocity of the preterm infants.This quasi-experimental study was conducted in the Department of Neonatology, BSMMU, Bangladesh from January to December 2015. All admitted infants aged <48 hours and born <_32 weeks of gestational age were included in this study. Infants were provided with nutritional support as per the BSMMU feeding guideline. The subsequent growth of the children was followed up routinely to measure the growth velocity. Of the 38 infants of our study, the mean calorie intake was 66.71 Kcal/kg/day. Overall mean growth velocity of weight, length and occipitofrontal circumference (OFC) up to discharge were 8.97 g/kg/day, 0.85 cm/week, and 0.41 cm/week respectively. Very low birth weight (VLBW) infants got significantly more calories compared to low birth weight (LBW) infants (p = 0.009). Mean growth velocity in weight of LBW infants were 8.18 g/kg/day and VLBW were 9.95 g/kg/day (p = 0.233). At birth, only 2.6% of infants had weight <10th centile, but at discharge, it was 52.6%. Early postnatal nutritional supplementation was not adequate, and postnatal growth failure remains very high in the hospital admitted preterm infants. Faridpur Med. Coll. J. 2020;15(2): 79-84
Optimal growth and development of a child depends mostly on proper breastfeeding and complementary feeding practices. However, many children yet suffer from malnutrition and the recommended practices of complementary feeding have yet not been established among the majority of the population. In this observational study, we looked for the causes behind the improper complementary feeding practices among the mothers attending the outdoor and indoor units of the Department of Pediatrics, Faridpur Medical College Hospital, Faridpur, Bangladesh, from January 2018 to January 2019. A total of 447 mothers were interviewed regarding their complementary feeding practices and data were analyzed to find out the demographic and social influences. The majority of the respondents were between the age group of 21-25 years (54%). Thirty five percent were illiterate, 60% were from the rural area, 78% were housewives, 64% came from a nuclear family, and 87% had a monthly family income of 5000-20000. Most of the deliveries were conducted at home (58%) and the most common source of feeding related information was healthcare workers (66%). Only 41% of the mothers started complementary feeding at the age of 6 months. The most common complementary food was Suji, 60% of them lacked the knowledge of food preparation and 35% of them practice forceful feeding to the children. The promotion of proper complementary feeding needs to be ensured to achieve the children's catch-up growth and development. Faridpur Med. Coll. J. 2021;16(1):30-33
Efficient blood transfusion facility in the casualty wards is essential to minimize the morbidity and mortality of the injured patients. Proper knowledge of blood transfusion demand in a facility can help forecast future demands and facilitate the planning of existing resources allocation for best injury care. This cross-sectional study was conducted at the causality wards of Dhaka Medical College Hospital from July 2018 to December 2018. During this period, patients who attended the casualty wards and needed whole blood transfusion were selected as the study population. Relevant information regarding the required blood units, blood group, and blood collection source were recorded and analyzed. During our study period, 1619 units of whole blood were required by 896 patients. Most of the study population were from the age group of 31-40 years. Male group was the predominant at a 3.9:1 male-female ratio. Majority of the patients (55.13%) required only one unit of blood, and 28.57% of the patients required two units. O+ve blood group was the most demanded (34.65%) followed by B+ve, A+ve, AB+ve, O-ve, B-ve and A-ve (31.87%, 23.72%, 7.6%, 1.42%, 0.49% and 0.25%, respectively). The patients' relatives donated around 85% of blood, and the rest were from voluntary donors. The average daily and weekly requirement of whole blood for the causality departments of Dhaka Medical College Hospital was around 9 and 62 units respectively. Evidence-based expert guideline for the use of whole blood in the casualty management and social awareness for blood donation may save thousands of valuable lives. Faridpur Med. Coll. J. 2021;16(1):8-11
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