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Abstract

Background: The advancements in intensive care in recent decades have enabled better survival of newborn. Knowledge of essential newborn care is important for the survival, growth, and development of a newborn. In spite of its essentiality, most health-care professionals do not know and follow the World Health Organization recommendation. Aim and objectives: The aim of this study was to assess the knowledge of nurses regarding essential newborn Care in Special Care Neonatal Units (SCANU). Materials and methods: This observational study was conducted among the nurses working in SCANU of Chattogram Medical College and Hospital, Chattogram Maa- O- Shishu Hospital and Bangabandu memorial hospital of University of Science and Technology, Chattogram (USTC) for 6 months. Purposive sampling technique were applied for selecting the sample. A structured data sheet was predesigned to collect data. Knowledge regarding Essential Newborn Care among the nurses graded as satisfactory or not satisfactory. Results: In this study it was observed that 69.0% nurses had completed diploma in nursing and midwife education, B. Sc in nursing 11.0%, diploma in nursing 7.0%. 56.0% nurses attended special courses/training in neonatology. 94.75% of the nurses had satisfactory knowledge regarding essential newborn care. 58.0% of nurses washed their hands with disinfectant solution before handling the baby, 99.0% mentioned that the baby must be breast feeding within 1st hour of delivery, 92.0% mentioned that baby must be fed 6 months of exclusive breast feed, 91.0% knew how to stabilize body temperature of low birth weight newborn. The knowledge regarding essential newborn care were almost similar with age, gender, religion, marital status, educational level, working place and attending special courses/training in neonatology. Conclusion: Most of the nurses working in SCANU of both Government and non-government hospitals of Chattogram have good knowledge regarding ENC. This knowledge appeared irrespective of their age, gender, religion, marital status, working place and special courses/training in neonatology. J Bangladesh Coll Phys Surg 2021; 39(3): 185-192

Background: Adverse Drug Reactions (ADRs) are global problem of major concern. Spontaneous reporting of ADRs is the cornerstone of pharmacovigilance. However, underreporting is a huge problem due to lack of reporting culture among healthcare professionals. Objectives: the purpose of the present study was to assess the knowledge, attitude and practice of physicians regarding reporting of ADRs, and pharmacovigilance as well as to identify the reasons for under-reporting with suggestion for improvement in the reporting system. Methodology: This cross sectional, observational study was conducted to assess the knowledge, attitudes and practices regarding adverse drug reaction reporting among physicians working in different level hospitals of Bangladesh. Data were collected from 308 physicians during the period of January to December 2012 using structured questionnaire. Result: Response rate was 97%. Majority of the respondent (95%) felt that ADR reporting is necessary and it is a professional obligation. Inadequate knowledge of reporting mechanism, unavailability of reporting form, complex reporting system, lack of time and inadequate expertise were the main reasons cited for underreporting. Majority of the respondents suggested regular training sessions, strengthening the drug administration department, government law, regular follow up and inclusion of ADR reporting exercise in undergraduate and post graduate curriculum may help to improve the situation. Conclusion:The deficiency of knowledge, attitude and practice of physician regarding ADR reporting need urgent attention on priority basis not only for the success of pharmacovigilance program but also for better clinical management of the patient in general. [J Shaheed Suhrawardy Med Coll, 2014;6(1):18-22]

Background: Nebulized salbutamol is commonly used in treatment of asthma in children. The use of nebulized MgSO4 is one of the different treatment options available during acute exacerbation. Objective: To compare the efficacy of nebulized MgSO4 with nebulized salbutamol in the treatment of acute asthma in children. Materials and method: This randomized controlled study was conducted in Dhaka Medical College Hospital between January to December 2016. Children of 7-12 years with acute exacerbation of asthma were randomized into study group-A (MgSO4 group, n=30) and control group-B (Salbutamol group, n=30). Children of both groups were treated with serial nebulization thrice at 20 minute intervals by either 2.4 ml (4% MgSO4, 96 mg) or salbutamol (0.15 mg/kg minimum 2.5 mg) with 2.5 ml of isotonic normal saline. Results: The mean final PEFR were not different between the two groups (275.0±41.42 L/min in MgS04 group and 263±36.17 L/min in salbutamol group). The increase in PEF was statistically significant and comparable in both groups (by 35.1% in the MgS04 group and by 42.1% in the salbutamol group). Fischl score improvement was comparable and significant in both groups (4.31 to 0.43 in MgS04 group and 4.29 to 0.76 in salbutamol group). Statistically significant increase in oxygen saturation and reduction of heart rate was found in MgS04 group without any side effects. Nebulized MgSO4 was found having significant bronchodilator effect which is comparable to salbutamol. Conclusion: Nebulized MgS04 was found equally effective as nebulized salbutamol in the treatment of severe acute asthma in children. Bangladesh J Child Health 2020; VOL 44 (1) :24-29

Prematurity and low birth weight contributes to 27.8% of neonatal deaths in rural areas of Bangladesh. Fluid, electrolyte and metabolic abnormalities are the commonest derangements encountered in preterm infants due to their renal immaturity and relatively immature skin. Premature infant are at increased risk of developing dehydration or overhydration4. Therefore, high index of suspicion, prompt recognition and thorough understanding of common electrolyte abnormalities are necessary to improve neonatal outcome. Appropriate fluid and electrolyte management is essential for better neonatal outcome. Objectives: To identify the serum electrolytes abnormalities in preterm low birth weight neonates. Methodology: It was a cross- sectional study and carried out in the Department of Neonatology, Dhaka Medical College Hospital, Dhaka between January 2017 to August 2017. Information was collected who gave consent and participated in the study willingly. The sample size was 50. Patients admitted in the above mentioned hospital and after meeting the inclusion and exclusion criteria a simple random sampling technique was applied for selecting the study subjects. Results: Fifty preterm LBW neonates fulfilling the inclusion criteria were studied during this study period. Abnormal electrolytes were documented in 20(40%) out of 50 preterm LBW neonates and electrolyte status was normal in 30(60.0%) cases. Of 20 neonates who had abnormal electrolytes, hyperkalemia was the predominant electrolyte abnormality found in 8(16.0%) neonates, hyponatremia was found in 7(14.0%), hypokalemia in 3(6.0%) and hypernatremia 2(4.0%). Conclusion: Electrolyte abnormalities are common in preterm LBW neonates. So, identification of electrolyte abnormalities and proper management of fluid and electrolytes and close monitoring are important. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 145-148

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Neonatal seizures are common in the first month of life and may impair neurodevelopmental outcome. Phenobarbitone (PB) currently represents the anti epileptic drug (AED) of choice, despite related to cognitive impairment in human subjects and limited efficacy. Intravenous levetiracetam is increasingly being used in the neonatal period to treat seizures. Presently, insufficient data about the efficacy and safety of intravenous levetriacetam in neonates, we have structured a randomized control trial with levetiracetam in the initial treatment of acute neonatal seizure. Objective: To find out the efficacy of levtiraracetam for controlling the convulsions in acute neonatal seizures compared to phenobarbitone. Methodology: The study was a randomized control trial. A total of 100 neonates from 0 day to 28 days of age irrespective of sex with clinical presentation of neonatal seizures admitted in the special care baby unit (SCABU) of Dhaka Medical College Hospital were included in the study and were randomly assigned to either levetiracetam or Phenobarbitone group after matching inclusion and exclusion criteria. The outcome variables were seizure control, times taken to be seizure free, and hospital stay. Outcome was evaluated through routine monitoring up to 48 hours and followed up to discharge or death. Result: The study groups were almost similar with respect to their demographic characteristics like age, sex and gestational age. According to maternal obstetric data i.e- antenatal care (ANC), modes of delivery in the both groups were statistically not significant. Seizures status was nonsignificant in both groups. The study demonstrated that controlling the seizure with levetiracetam & Phenobarbitone were 66.0% and 34.0% respectively. Length of the hospital stay was shorter in levetiracetam group. Eventually the phenobarbitone group required more than one drug to control seizures.. But immediate adverse effect was not significant in both groups. Conclusion: The study concluded that levetiracetum significantly control the convulsion in comparison to phenobarbitone as first line antiepileptic drug in the initial treatment of acute neonatal seizures. Both the modalities of treatment were found to have no adverse effect. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 182-189