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.

Birth defects are one of the leading causes of neonatal mortality worldwide. Every year more than 8.14 million children are born with a serious birth defect. The risk factors predictive of birth defects in babies vary from country to country even from region to region. About 60% of the causes of birth defect in humans are still unknown. However, in about 25% cases, the causes seem to be “multifactorial”, indicating a complex interaction between genetic and environmental risk factors. Many studies have been conducted to determine the association of various risk factors with the incidence of birth defects. Most of them found significant association with maternal age, parity, consanguinity, poor nutrition, life style factors, low socioeconomic condition and many more. But still there is debate in certain issues like common type of birth defect, specific age of mother for having birth defect babies, role of drugs during pregnancy etc. With advancement of diagnostic tools, birth defects can be identified both prenatally and post- natally. This helps further in decision making and planning for both parents as well as physicians to provide accurate treatment in time. Major birth defect babies require intensive care and more hospitalization. Often multidisciplinary approach is essential for them. But till now birth defect cases are neglected in society. Increasing awareness about maternal care during pregnancy, educational programs on birth defect and the consequences of consanguineous marriages need to be highlighted to decrease the incidence of birth defect and their co-morbidities as well as mortality. Bangladesh J Child Health 2019; VOL 43 (1) :49-58

Background: Birth defect is one of the most important causes of neonatal mortality worldwide. In a developing country like Bangladesh many possible factors for birth defects are present which should be identified. This study was performed to determine those risk factors of birth defect and complications associated with it. Materials and Methods: A hospital based matched case-control study was conducted from August 2015 to July 2016 in department of Neonatology along with Obstetrics and Gynecology at BSMMU. A total of 98 mother-infant pair (49 babies with birth defect as cases and 49 healthy babies without any birth defects as controls) was included in the study. For each case, a gestational age, sex and post-natal age matched control was taken. Data was collected by face to face interview. Univariate and multivariate conditional logistic regression models were computed to examine the effect of independent variables on outcome variable using SPSS 23.0. Variables with p-value <0.05 were considered statistically significant. Results: The mean (± SD) birth weight for cases and controls were 2718.37 (±756.9) grams, and 2617.14 (±978.8) grams respectively. Cardiovascular system was the predominant system (21%) involved in birth defects. Maternal age between 20-29 years (AOR: 4.69; 95% CI 1.078, 20.448), less than four antenatal care visits (AOR: 10.07; 95% CI 2.816, 36.0), no multivitamin intake (AOR: 7.38; 95% CI 1.791, 30.365) and presence of maternal diabetes (AOR: 0.194; 95% CI 0.047, 0.799) were significantly associated with birth defects among newborns. Sepsis, asphyxia, hypoglycemia and dyselectrolytemia were the most prevalent problems among these babies. The need of intravenous fluid, thermal care, antibiotics and mechanical ventilation was also high among the cases. Conclusion: Birth defect is an upcoming issue in current newborn health situation which need to be prioritized. Significant risk factors should be addressed timely for early diagnosis and proper management of these babies can help in reduction of mortality. Bangladesh Journal of Medical Science Vol.19(1) 2020 p.133-140

Objective To describe the implementation, coverage and performance of the national kangaroo mother care programme in Bangladesh. Methods Kangaroo mother care services for clinically stable babies with birth weight under 2000 g were set up in government-run health-care facilities in rural and urban areas of Bangladesh. Each facility provided counselling on kangaroo mother care, ensured adequate nutrition, and followed up mothers and babies. We studied implementation of the programme from January 2016 to March 2020 using data from the national database. We tracked the number of eligible babies enrolled and their outcomes, mortality and post-discharge follow-up. Findings The numbers of kangaroo mother care facilities increased from 16 in 2016 to 108 in 2020. Over the 4-year period 64 426 babies weighing under 2000 g were born in these facilities,  6410 of whom received kangaroo mother care. The quarterly percentage of eligible babies receiving kangaroo mother care increased from 4.7% (37/792) during the first quarter to 21.7% (917/4226) during the last five quarters of the programme. Deaths of babies receiving kangaroo mother care showed a downward trend over the study period. The overall mortality was 1.2% (77/6410), with large quarterly fluctuations in mortality. Post-discharge follow-up was low and only 15–20% of babies received four follow-up visits. Conclusion Implementation of kangaroo mother care interventions is feasible in low-resource settings. Such care has the potential to reduce mortality among low-birth-weight and premature babies. Challenges include low coverage, expanding the programme to the community and strengthening the monitoring system.

In conclusion, less than four antenatal visits and presence of sepsis were found to be independent risk factors whereas LUCS protective of newborn death.