Background : Dengue is a mosquito-borne (Ades Agepti) infection which in recent years has become a major public health problem. It is now endemic in more than 100 countries in Africa, America, Eastern Mediterranean, South-East Asia and Western Pacific areas. According to WHO currently approximately 50 million cases of dengue fever occur every year.
Background: Parapneumonic effusion/complicated pleural effusion/empyema thoracis in children causes significant morbidity. Standard treatment of pleural effusion includes tube drainage and antibiotics. But the tube drainage often fails. Intrapleural Streptokinase has been used in empyema thoracis as well as complicated pleural effusion with good success rate. Though its efficacy is documented in Western literatures and textbooks, there are no clinical trials in children has been reported from Bangladesh.
Objectives: We evaluated the efficacy of intra-pleural Streptokinase in the management of Parapneumonic effusion / complicated pleural effusion/ empyema thoracis even in advanced stages.
Patients and Methods: A total of 3 patients with parapneumonic effusion requiring intercostal tube drainage, aged 4 year 6 month to twelve years were included in the study who were admitted in Pediatric respiratory medicine unit in Dhaka Shishu (Children) Hospital. Intercostal chest tube drain was given in all patients and inj: Streptokinase (10,000 units/kg/dose) was instilled into the pleural cavity and kept the Streptokinase for 4 hour in pleural cavity. Response was assessed by clinical outcome, after unclamping and serial chest ultrasounds and subsequent chest radiography.
Results: Streptokinase enhanced drainage of pleural fluid and complete resolution of effusion in all the 3 patients.
Conclusions: Intrapleural Streptokinase is the preferred treatment for treating pediatric empyema/parapneumonic effusion/complicated pleural effusion even in advanced stages and can avoid surgery.
Bangladesh J Child Health 2020; VOL 44 (2) :104-108
Background
To delineate the clinico-epidemiological characteristics of pediatric coronavirus disease-2019 (COVID-19) patients was the objective of the study.
Method:
This observational study included 290 pediatric patients with a definite diagnosis of COVID-19 admitted to Dhaka Shishu Hospital, Bangladesh, from April 2021 to October 2021. Clinical and epidemiological characteristics were analyzed based on demographic data, medical history, laboratory tests, and outcome information. Data analysis was performed with SPSS 26. Ethical measures were taken in compliance with the current declaration of Helsinki, and final analysis was performed using SPSS 26.
Result
Of all, 42 (14.5%) were neonates (< 28 days), 88 (30.3%) were infants (28 days to < 1 year) and 160 (55.2%) were children (1–17 years). The median age of the children was 18 (0.3–204) months, 58.3% were male, 62% had malnutrition, and presented with various clinical presentations. The main symptoms were fever (5.7%) and breathlessness (20%). Approximately 22% of children were asymptomatic, and 57% had at least one comorbidity. Fever and abdominal pain were predominant presenting symptoms in children compared with neonates and infants (p < .01 for both), while cough and breathlessness were more frequent in infants (p < .01 for both). The infants suffered significantly from neutropenia and lymphocytosis than neonates and children (p < .001 for both). The discharge and death rates were 77.8% with 6.9%. Overall case fatality was higher among neonates than others.
Conclusion
Compared to other pediatric groups, neonatal case fatality was higher, and COVID-19 in neonates, infants, and children has similar epidemiological and clinical manifestations. The findings from this study might help to guide the development of measures to prevent and treat this ongoing global pandemic of these particular age groups.
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