Dengue fever is a self-limiting, systemic viral illness that has a wide range of clinical manifestations. Last year dengue was severe in children with much mortality. This study was aimed to see the clinical profile of dengue and to find out the risk factors for developing severity. This cross sectional study was conducted over four months (June-September, 2018) in Department of Pediatrics of United Hospital Limited. All admitted dengue cases were analyzed. The predictors of developing severity were assessed by comparing variables between classical and severe dengue fever groups. A total of 106 children with Dengue fever were admitted. Mean age was 5.8±3 years with male predominance (60%). Common presentations include fever (100%), flushed appearance (72%), rash (43%), vomiting (39%), abdominal pain (36%), shock (28%) and respiratory distress (23%). In risk factor analysis, overweight (OR: 8.275, CI: 1.378-49.706) and massive serositis (OR: 17.86, CI: 4.733-67.399) were found statistically significant predictors of severe dengue. The overall mortality was 3%. So, overweight children and those patients who develop massive serositis are at increased risk of having severe dengue. Early identification of these features can help physicians to manage these cases judiciously.
Background: Vitamin D deficiency is one of the most common micronutrient deficiency in children worldwide, even in Bangladesh. However, to date, the prevalence of vitamin D deficiency among children of different region of Bangladesh is less reported. Objective: This study was conducted to assess vitamin D status of urban and rural Bangladeshi children including the risk factors associated with vitamin D deficiency are also evaluated. Methods: A multi-centre (urban and rural based), cross sectional study was done from July 2016 to June 2017, using serum 25(OH) vitamin D3 as a marker of nutritional vitamin D status. Urban and rural children were taken from Paediatric Outpatient Department, United Hospital Limited. Dhaka and Medical Outpatient Department, Upazila Health Complex, Ghatail, Tangail respectively. Children of 1-10 years age attending OPD with mild undernutrition (<–1 SD z score) and/or clinical features suggestive of vitamin D deficiency were included in the study. Results: A total 150 children were studied with 102 (68.0%) urban and 48 (32.0%) rural children. Hypovitaminosis D (25-OHD <30ng/ml) was found in 75.0% of children. Hypovitaminosis D was found significantly more in urban children (81.0%) compared to rural (62.0%) children (OR=0.382, 95% CI: 0.177-0.822, p value <0.05). Inadequate exposure to sunlight was significantly associated with hypovitaminosis D compared to adequate sun exposure and it was about 2.5 times higher (OR=2.475, 95% CI: 1.139-5.380, p value <0.05). No significant associations of vitamin D deficiency were detected with skin color of children, covering clothes of mother, exclusive breast feeding, limb pain and anthropometric status. Children of higher educated mother (above Secondary School Certificate) (OR=0.412, 95% CI: 0.189-0.900) were more associated with vitamin D deficiency. Conclusion: Vitamin D deficiency (VDD) is prevalent among Bangladeshi children, urban children being more vulnerable to VDD. Adoption of a screening programme for children of all age group and implementation of preventive strategies for VDD through public health policies are strongly recommended. Bangladesh Med Res Counc Bull 2020; 46(2): 134-141
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