Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in December 2019 and now has led to a global pandemic. The incidence is lower in neonates. A five days old newborn infant got admitted with history of reluctance to feeding and less movement. On admission, the newborn infant was found to be lethargic, icteric, tachypnoeic, afebrile with SPO2 of 90% throughout his hospital stay. Chest x-ray was normal but RT-PCR for COVID-19 was positive. His mother had symptoms of COVID-19 with positive RTPCR. The neonate was isolated and was treated with antibiotics along with supportive care, then improved gradually and was discharged on day 10 of his age. Suspicion about COVID-19 in newborn infants with prompt identification is essential to limit its transmission in the community. Bangladesh J Child Health 2020; VOL 44 (3) :170-173
Hyperpigmentation as primary symptom is rare in vitamin B12 deficiency. This adolescent non vegetarian girl presented with hyperpigmentation, anaemia, glossitis and weight loss. She was worked up to find out the cause of anemia and hyperpigmentation. Addison disease was a strong provisional diagnosis. Her cortisol level was normal and megaloblastic anemia due to vitamin B12 deficiency was found. All of her symptoms were dramatically improved by injectable cobalamin. As vitamin B12 deficiency is a treatable condition so it should be ruled out in patient presenting with hyperpigmentation. Early replacement therapy also prevents multisystem involvement like bone marrow failure and demyelinating neurological disease. J Bangladesh Coll Phys Surg 2021; 39(1): 62-67
In resource-constrained settings, mucopolysaccharidosis (MPS) is a rare hereditary metabolic illness that frequently remains undiagnosed. We present a scenario that illustrates the challenges in diagnosing and managing MPS because of test inaccessibility, and we propose potential approaches to minimize the hurdles. We recommend that physicians anticipate a rare genetic disease, such as MPS, based on the clinical history findings from routine radiological investigations. Additionally, stakeholders should perform risk stratification and implement screening tests as soon as possible to ensure that patients are effectively enrolled in treatment programs.
Aims: Aim of the study was to know the clinical presentations of biliary ascariasis. Materials and Methods: It was a cross-sectional observational study had been carried out on 50 patients over a period from January 2017 to December 2018 at the Department of Medicine, Sadar Hospital, Cox’s bazar. The clinical presentation, ultrasonographic findings, management and follow up of patients diagnosed to have biliary ascariasis were recorded in a pre-designed case record form and finally all the relevant data were processed and analyzed. Results: This study revealed that maximum patients of biliary ascariasis belonged to 31-40 yrs age group. Number of female patients was more (86%) in comparison to male patients (14%). Among female patients, 20.93% patients were pregnant. Most of the patients 92%came from rural areas. All patients in this study presented with upper abdominal pain. Other complaints were nausea, vomiting, fever and jaundice. Most of the patients (38%) had history of passage of worm with vomitus. Ultrasonographic profile of this study revealed that ascaris was most commonly entrapped in the common bile duct (80%). The percentage of complications was 38%. Acute acalculous cholecystitis was the commonest. The percentage of Cholangitis and acute pancreatitis was also significant. Conclusion: Bangladesh is an endemic zone for ascaris lumbricoides infestations. Ultrasonography is the investigation of choice for diagnosis and follow up of the patient of biliary ascariasis. Majority of the patient can be managed with conservative treatment and mechanical removal of worms by endoscopy. This study recommends that proper hygiene and regular deworming can prevent biliary ascariasis. J Dhaka Med Coll. 2021; 29(1): 87-93
Introduction Discharge against medical advice (DAMA) is an unexpected event for patients and healthcare personnel. The study aimed to assess the prevalence of DAMA in neonates along with characteristics of neonates who got DAMA and, causes and predictors of DAMA. Methods and findings This case-control study was carried out in Special Care Newborn Unit (SCANU) at Chittagong Medical College Hospital from July 2017 to December 2017. Clinical and demographic characteristics of neonates with DAMA were compared with that of discharged neonates. The causes of DAMA were identified by a semi-structured questionnaire. Predictors of DAMA were determined using a logistic regression model with a 95% confidence interval. A total of 6167 neonates were admitted and 1588 got DAMA. Most of the DAMA neonates were male (61.3%), term (74.7%), outborn (69.8%), delivered vaginally (65.7%), and had standard weight at admission (54.3%). A significant relationship (p < 0.001) was found between the variables of residence, place of delivery, mode of delivery, gestational age, weight at admission, and day and time of outcome with the type of discharge. False perceptions of wellbeing (28.7%), inadequate facilities for mothers (14.5%), and financial problems (14.1%) were the prevalent causes behind DAMA. Predictors of DAMA were preterm gestation (AOR 1.3, 95% CI 1.07–1.7, p = 0.013), vaginal delivery (AOR 1.56, 95% CI 1.31–1.86, p < 0.001), timing of outcome after office hours (AOR 477.15, 95% CI 236–964.6, p < 0.001), and weekends (AOR 2.55, 95% CI 2.06–3.17, p < 0.001). Neonates suffering from sepsis (AOR 1.4, 95% CI 1.1–1.7, p< 0.001), Respiratory Distress Syndrome (AOR 3.1, 95% CI 1.9–5.2, p< 0.001), prematurity without other complications (AOR 2.1, 95% CI 1.45–3.1, p < 0.001) or who were referred from north-western districts (AOR 1.48, 95% CI 1.13–1.95, p = 0.004) had higher odds for DAMA. Conclusions Identification of predictors and reasons behind DAMA may provide opportunities to improve the hospital environment and service related issues so that such vulnerable neonates can complete their treatment. We should ensure better communication with parents, provide provision for mothers’ corner, especially for outborn neonates, maintain a standard ratio of neonates and healthcare providers, and adopt specific DAMA policy by the hospital authority.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.