ABSTRACT
Abstract: One of the primary causes of mortality and morbidity in children are congenital heart disease (CHD); they have become a major burden on the global health. Babies with congenital heart disease are at a higher risk to be born with low birth weight. The purpose of the study is to investigate the relationship between the presence of CHD and low birth weight in the Sudanese children. This was an observational, cross-sectional study, conducted at Ahmed Gasim hospital, recruiting children with CHD from June to November 2018. The study included 139 study participants; 116(83.5%) mothers were between the ages of 20 to 40, only 85 (61.2%) mothers had regular antenatal care. 96 mothers (69%) were multiparous, 11 mothers (7.9%) reported an illness during pregnancy such as Diabetes and Hypertension. 90 children (64.7%) had been born with low birth weight while 49(35.3%) were born with normal weight. There was statistically a significant difference between the mean birth weight for the study group (2.35 kg) and the mean birth weight in Sudan (3.04 kg). Of the CHD lesions 20.9% were classified as cyanotic heart disease while the remained classified as a cyanotic heart disease. With regard to cyanotic status, a significant difference in the birth weight was not found. In Sudan, the percentage of low birth weight was found to be higher in children with CHD; larger birth weight deficits were found in Sudanese children than in other populations.

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Abstract: Aim: Benefits of new surgical technique for pterygium excision and access the postoperative pain and surgical time. Material and Methods: This study was conducted at Dr. RML Hospital, New Delhi. Complete history and eye examination was recorded. The diagnosis of pterygium was made on clinical judgment. All the pterygiums were examined with the help of slit lamp to check the vascularity, encroachment towards the cornea and congestion. The pterygium was surgically excised and autologous conjunctival graft was taken from the superiotemporal limbus, was utilized to cover the sclera after the pterygium excision. No suture or glue is used to fix the conjunctiva to cover the bare sclera. Follow up period was upto 6 months. Intraopertive and postoperative pain was measured according to the visual analogue scale (VAS). The surgical time was noted from the very first surgical incision till the eye lid speculum was removed. Results: In this study 30 patients were enrolled; out of which 15 patients were male and 15 patients were female, thus the male to female ration was 1:1. Graft was in position in 100% cases on 1st post operative day. No recurrence was found till 6 months follow up period. Conclusion: Cut and spread without suture or glue for attaching the conjunctival transplant tissue in pterygium surgery causes significant less postoperative pain and shortens the surgical tim.

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Abstract: Introduction: The need for prolonged mechanical ventilation for children with congenital heart disease after cardiac surgery has changed with the advances in surgical and perioperative care. Objectives: In the present study, we evaluated our six months experience with the fast-track protocol and investigated the preoperative predictors of successful outcome. Methods: Between July to December 2019, BSMMU, Dhaka, Bangladesh 60 consecutive patients undergoing cardiac surgery were preoperatively selected for post-operative admission in the postanaesthesia care unit (PACU) and were included in this study. These patients were then transferred to the ordinary ward on the same day of the operation. The primary end-point of the study was the success of the PACU protocol, defined as discharge to the ward on the same day, no further admission to the intensive care unit and no operative mortality. Logistic regression analysis was performed to detect the independent risk factors for failure of the PACU pathway. Results: 110 patients underwent cardiac surgical procedures in our institution. The majority of the patients were males (68.4%). The most important comorbidities were diabetes (16.7%), COPD (6.7%), previous cerebrovascular accident (CVA) (5%), peripheral vascular disease (10%), hypertension (45%), renal dysfunction (1.7%) and BMI >15 kg m−2 (8.3%). Using the multivariate logistic regression analysis, child age and left ventricular dysfunction were found to be independent risk factors for failure of the PACU protocol [odds ratio of 0.98/year (0.97–0.98) and 0.31 (0.14–0.70), respectively. Conclusions: Our fast-track management, called the PACU protocol, is efficient and safe for the postoperative management of selected patients undergoing cardiac surgery. Age and left ventricular dysfunction are significant preoperative predictors of failure of this protocol.

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Abstract: Background: Dorsolumbar trauma is the most common cause of paraparesis or paraplegia. Optimal goals of the management include establishment of a painless, balanced and stable spinal column with vertebral fusion. One of the general cause of Paraplegia is Dorsal-lumbar spine injury where damage to the dorsal- lumbar spinal cord that causes temporary or permanent changes in its function. Objective: The aim of our study is to evaluate Outcome of Surgical Management of Unstable Dorso-Lumbar Spine Injuries with Transpedicular Screws and Rods Fixation with Posterior Decompression. Method: This observational descriptive study was conducted at Rajshahi Medical College Hospital, Rajshahi, Bangladesh from January 2017 to January 2019 where 59 cases was observed and clinically Patients were graded using Frankel classification of neurological deficits pre-and postoperatively. Results: In this result injury where most of the patients face fall of height and D12 vertebra was fractured in 20 cases. Also Majority of the patients belonged to frankel grade A (71.18%). Conclusion: After much analysis we can conclude that this rapid surgical management is safe and helps in early.

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Abstract: Introduction: Behavioural and psychological problems are one of the common problems in children attending Pediatric outpatient department. Identification of behavioural and psychological problems is most important not only to prevent further progression of illness but also for proper growth and development of the child. Objective: Aim of this study is to determine the proportion of various behavioural and psychological problems in children of age 6 to 12 years. Material & methods: The study was conducted for a period of 3 months in 2018. Study was done on 500 children of 6-12 years attending Pediatric outpatient department Rajshahi Medical College Hospital and some Private Hospitals Rajshahi, Bangladesh. Children were screened using child behaviour check list (CBCL). Patients who were positive for behavioural problems in CBCL were assessed with DSM V criteria for any psychiatric illness. Results: In our study, we found that 7% children had behavioural and psychological problems. Enuresis was a very common problem in children between 6 to 12 years of age.11 children (2.2%) had enuresis. Another common psychological problem found in our study was PICA. 1.8% children had PICA. Conclusion: Identification of behavioural and psychological disorders is most important so that preventive and treatment strategies can be planned at the earliest to prevent psychiatric morbidity in later life.

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Abstract: Background: Ureteral stones account for 22% of all urinary tract stones with 68% of them being located in the distal ureter. Conservative management strategies such as observation or medical expulsive therapy (MET) using pharmacological agents to facilitate spontaneous passage of ureteral stones have gained popularity in the management of ureteral stones during the recent years. Objectives: To compare the efficacy of silodosin (8 mg) versus tamsulosin (0.4mg), both in terms of the stone expulsion rate and the time to stone expulsion. Patients and Methods: A prospective and randomized controlled study was conducted in the department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. Starting from October 2018, till September 2019; a total of 96 patients (M=56; F=40) who were between age group of 18–50 years, who had unilateral, non–impacted, uncomplicated middle or lower and loweror middle ureteral stones which were ≤ 1cm and ≤0.9cm were enrolled in a prospective study and they were randomized into two groups. Group 1 received tamsulosin (0.4mg)................

ABSTRACT
Abstract: Background: Malnutrition is widely recognized as a major health problem in children in developing country. Malnutrition is a serious public health problem that has been linked to increase the risk of morbidity and mortality. Many factors can cause malnutrition, most of which are related to poor diet, family size, family income repeated infections, particularly in the underprivileged populations. Objective: To observe the nutritional status of under five children of Co-operative slum in Dhaka city. Methodology: This is a descriptive cross sectional study and conducted among 250 under five children. They were randomly selected from Co-operative slum in Dhaka city, Bangladesh. It was carried out during March-2018 to June-2019. Anthropometric measurements were taken using standard methods. These were weight, height, MUAC, age ..........