There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO ‘Watch’ list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.

Introduction:In developing countries, thermal protection of the newborn is not properly addressed. Neonates presented to Neonatal intensive care unit (NICU) for admission with various problems are frequently found to be hypothermic. The objective of this study was to determine the incidence and associated risk factors for neonatal hypothermia on admission to NICU. Materials and Methods: This was a prospective observational study carried over a period of three years at Enam Medical College and Hospital (EMCH) among the newborns admitted to NICU. Hypothermia has been defined as axillary temperature <36.5 0 C (<97.7 0 F). Temperature was measured at admission. Data were collected regarding perinatal and socio economic factors. Bivariate and multivariate analysis has been done to see the association of risk factors. Result: A total of 2310 babies between 0 and 680 h of age (mean 43± 12 hours) were studied. Thirty four percent (785) of the neonates had hypothermia. Mean gestation was 34±3 weeks and 42.5% were inborn.

Introduction: Abdominal pain is a common complaint in children. In most cases it may be functional. Among all organic causes, an abdominal cyst of omental or mesenteric origin is an uncommon etiology. Case Presentation: A 7-year-old girl presented with a short history of abdominal pain for 1 month associated with gradual abdominal distention. Physical examination revealed a large oval palpable firm, non-tender mass extending almost the whole abdomen. Imaging studies were suggestive of an intra-abdominal cyst, and the diagnosis was confirmed after exploratory laparotomy. The patient was managed surgically by enucleation of the cyst. Conclusion: Omental cysts are a rare benign condition, but should be considered as a diagnostic hypothesis in children with abdominal pain with or without a mass. It is difficult to diagnose an omental/mesenteric cyst clinically. A proper imaging study can guide the diagnosis. After confirming the diagnosis, the main treatment would be surgical excision.

Background: Although neonatal tetanus (NT) has been declared eliminated from Bangladesh in June 2008, it is not uncommon in Infectious Disease

VLBW (p=.03; OR .93;, duration of oxygen inhalation (p=.001; OR 28; OR3.36;

DOI: 10.3329/bjch.v30i1.6180 Bangladesh J Child Health 2006; VOL 30 (1/2/3): 25-28

Infantile colic is a distressing condition in infants, pathogenesis of which is still not clear. Several treatment strategies have been attempted before, but only some of them proven successful. The aim of this paper is to review studies on treatment options for infantile colic. For this, a systematic literature review was done on studies regarding pathophysiology, medical and conventional interventions for infantile colic from 1954 to March 2011. Forty nine articles included in Cochrane database were reviewed. Fourteen studies on pathophysiology and risk factors, 7 studies on effect of infantlie colic on parents and family,19 studies on management, 5 studies on other related factors and 4 literature reviews were included for review. Pathophysiology has been described in various ways in different studies and yet not conclusive. Regarding studies on management, simethicone could not significantly control colic, dicyclomine hydrochloride had serious side effects and cimetropium bromide results were favourable, but milder side effects were noted. Some nutritional studies reported low-allergen maternal diets in breastfed infants but suitability of these methods are questionable in Bangladesh. Behavioural studies on the use of decreased stimulation and contingent music were favourable in some studies. Mixed herbal tea and probiotic like Lactobacillus reuteri studies showed encouraging results. There are some scientific evidences to support a low-allergen maternal diet in breastfed infants with infantile colic. Some encouraging results exist for mixed herbal tea, cimetropium bromide and probiotics

Background: Establishment and maintenance of breastfeeding in preterm low birth weight (PT LBW) neonates after discharge from hospital is challenging and may be affected by multiple factors. We designed this study to find out the association of these factors with breastfeeding in our population. Objectives: To observe the rate of exclusive breasrfeeding (EBF) among the PT LBW neonates at one month follow up and to identify the factors that are related with the maintenance of EBF. Materials and Methods: This observational study was conducted during the period from July 2009 to October 2011 in Enam Medical College Hospital (EMCH). Preterm infants ≤ 34 wks gestation, stayed in the NICU for >3 days and discharged home were eligible. Mothers were interviewed at one month follow-up after discharge. Infants who were given only breast milk up to 4 weeks were termed as “Exclusively breastfed (EBF)” and who were given formula milk in addition were labeled as “Nonexclusively breastfed (NEBF)”. Baseline information regarding maternal demography, delivery of the baby, feeding during discharge was taken from database of neonatal ward. Results: Among 89 infants, 37 (42%) were female and 52 (58%) were male, including 5 twins. Gestational age ranged from 29 to 34 weeks (mean 32±2), and birth weight ranged from 1100 to 2200 grams (mean 1763±20 g). At one month follow up visit 19% (17/89) were found to be NEBF and 81% were EBF. Factors significantly associated with EBF were shorter duration of hospital stay (p=0.001), method of feeding at discharge (p=0.001), mode of delivery (p=0.004), below average socio-economic status (p=0.03), maternal education (p=0.02), number of antenatal visits (p=0.02) and larger birth weight (p=0.038). Conclusion: A variety of factors may affect EBF in PT LBW babies. Extensive counseling of the mothers during antenatal visits, counseling of the family members regarding the advantages of exclusive breastfeeding is necessary. Support should be provided for the mothers both in the hospital and also outside the hospital for a long period