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Background: Breastfeeding along with appropriate complementary feeding has now been well recognised as one of the most effective interventions for child survival particularly to address morbidity and mortality related to three major problems. Over two thirds of these deaths are often associated with inappropriate feeding practices and occur during the first 2 years of life. Objective: To assess the Pattern in Infant and Young Child Feeding Attending in the Outpatient Department In tertiary care hospital, Dhaka, Bangladesh. Methods: This is a cross sectional study conducted at the outpatient department of Upazilla health complex, Gazaria, Munshiganj, Bangladesh from January 2018- December 2019. Total 328 infants with their mother attending Pediatric outpatient department were included in the study. Investigator herself interviewed the mother using a structured questionnaire. All responses were recorded by 24 hours recall method except for initiation of breast feeding and exclusive breast feeding in children 6 to 24 months of age which were elicited by historic recall. Results: A total of 328 infants (0 to 24 months) were included in this study who visited in Upazilla health complex, Gazaria, Munshiganj, Bangladesh during the study period. Demographic profiles of the infants showed Mean age of children in month was 6.85±6.15 months. Among the study children 58.23% were below 6 months of age and 41.77% were of 6 to 24 months age group. 54.57% were male and 45.43% were female. Among the mothers 79.26% were housewives and 20.74% were students or professionals. Mean age of mothers was 29.68 ±5.1 year. 42.9% mothers were diabetic. At the time of interview 59.82 % mothers had single child. 92% were delivered by caesarian section. Breastfeeding was initiated with in 1 hour of birth in 68.60% of the study children (0-23 months). Exclusive breastfeeding was found in 66.67% children under 6 months of age. At the time of interview 79.31% of children of 12 to 15 months age ......

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Background: The Integrated Nutrition House (RGT) Which Was Initiated By The Aceh Jaya Government Also Held A Gathering In One Place To Provide An Explanation Or Understanding of Stunting. Objective: To Determine The Success Rate of RGT In Preventing And Reducing Stunting In Alue Ambang Village, Aceh Jaya Regency. Methods: This Research Was Conducted In Aceh Jaya, While The Selection Of Research Sites Took Into Account That Aceh Jaya District Was Running An Integrated Nutrition Home Program To Reduce Stunting Rates. This Study Uses A Qualitative Method With A Descriptive Approach Which Will Produce Data in The Form Of Speech, Writing, And Observed Behavior. Result: The Integrated Nutrition Home Program (RGT) is A Highly Prioritized Program In The Context Of Realizing Public Health. Infants And Toddlers Will Be Weighed, Body Measurements, Supplementary Feeding (PMT), Especially Stunting. Posyandu Activities Must Be Carried Out Frequently in Order To Improve The Health Status of The Community. Infants And Toddlers Will Be Weighed, Body Measurements, Supplementary Feeding (PMT), Complete Immunization of Infants And Toddlers. Conclusion: In The Implementation Of The Integrated Nutrition Home, It is Relatively Better Than Before, The Community Can Understand About The Provision of Additional Food (PMT), Complete Immunization, The Importance of Posyandu, The First 1000 Days of Life.

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Cancer is a common disease and is growing in incidence and prevalence. It is expected to become the number one killer of humans in the coming decade. It is associated with considerable suffering, decreased survival, and huge economic costs. Death is usually due to metastasis. Major cancers include those of the lung, breast, colorectum, prostate, stomach, and liver. It results from a complex interaction involving genetic, environmental, and lifestyle factors. It is estimated that up to 95% of cancer events are attributable to lifestyle factors such as physical inactivity, cigarette smoking, poor diet, alcohol, and obesity. Smoking cigarettes is a major cause and may be responsible for 40% of all cancer cases in the US. Obesity is the next major modifiable lifestyle factor. The impact of improper diet and alcohol intake is estimated at being more than 5% followed by lack of physical activity. These factors are modifiable and can greatly help reduce the risk of common cancers, improve their management, and beneficially affect their prognosis. In addition, following healthy lifestyles will help mitigate the deleterious effects of many co-morbid chronic diseases that cancer patients have. This manuscript discusses the impact of these major lifestyles on cancer.

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Five lifestyles appear to play a major role in morbidity and mortality with major diseases. These include smoking, alcohol consumption, exercise, diet, and body weight. Li et al. using data from the Nurses’ Health Study and the Health Professionals Follow-up Study estimated that adherence to all five healthy lifestyles increases the lifespan at age 50 by 14 years in females and 12.2 years in males when compared with those with zero low-risk factors. Excess body weight with a BMI of >30 is classified as obesity. Obesity is recognized by the World Health Organization (WHO), along with several National and International medical and scientific societies as a disease. It has become a worldwide epidemic and has deleterious effects on most major health disorders, such as cardiovascular diseases, diabetes mellitus, and cancer. Obesity is also interlinked with other health lifestyles. This relationship is discussed in this manuscript.

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Introduction: The World Health Organization (WHO) broadly defines a burn as an injury caused by heat (hot objects, gases or flames), chemicals, electricity, and lightning, friction or radiation [1]. Annually, burns result in more than 7.1 million injuries, the loss of almost 18 million disability-adjusted life years (DALYs) and more than 250,000 deaths worldwide. Burn injuries are more common in developing countries like India due to various socio-cultural factors namely illiteracy, poor living and housing conditions, poverty, poor substandard electrical wiring and malpractices like dowry. There is lack of awareness and ignorance regarding burn injuries coupled with the difficulty in accessing health-care services. Methods: This was a three and a half years’ retrospective and prospective study and included all patients of burn injuries who were admitted in IGMC Shimla from 1st January 2014 to 30th June 2016 and patients who either reported to the Casualty OPD or were admitted in the wards of IGMC Shimla from 1st July 2016 to 30th June 2017. Percentage of Burn was calculated by using Lund and Browder chart. Inj. Tetanus toxoid and painkillers such as tramadol were given to all patients. Intravenous fluids were administrated according to parklands formula(3-4 ml/kg/TBSA, 1/2 in first 8 hours and rest in next 16 hours) to patients of burns >10% total burn surface area(TBSA) in children <12 years of age and >20% TBSA in adults. Intravenous or oral antibiotics were given depending on the severity of the burn. Patients with respiratory distress were given oxygen support. Result: In our study we found that maximum patient who underwent burn injury is <18 years and are male, married, unemployed. Most common type of burn is flame urns and second degree burns are most common one. There were 24 patients who expired during the course of hospitalization due to sepsis and 8 patients were referred to the higher center. There were 206 (86.19%) patients who recovered .............

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Situs inversus totalis is a rare anomaly and acute abdominal conditions in these patients poses a challenge in diagnosis as well as treatment. We report a case of acute appendicitis in a 27 year old male who came to emergency department of IGMC Shimla with pain in left iliac fossa. Patient was investigated evaluated and with help of radiological investigations diagnosed as situs inversus totalis with acute appendicitis. Patient operated on the same, appendectomy done and discharged on POD-2.

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Background: Chronic rhinosinusitis (CRS) significantly affects the quality of life of patient. Chronic rhinosinusitis (CRS) is common chronic condition and is treated with antibiotics, nasal irrigation and steroids. Patients who do not respond to medical therapy are subjected to functional endoscopic sinus surgery. Objective: To assess the clinical improvement after functional endoscopic sinus surgery among the patients of chronic rhinosinusitis (CRS) who failed medical management. Methods: A Prospective longitudinal study conducted in ENT department of Mission General Hospital, Nilphamary, Bangladesh. The study period was from March 2020 to May 2020. Patient with CRS who failed with medical management were subjected functional endoscopic sinus surgery (FESS). Pre –operative symptoms score and endoscopic score were assessed and compared with that of post- operative scores at the end of 6 weeks and 12 weeks. Results: Fifty-One patients who completed three months of follow up were included in the study. The mean preoperative VAS symptoms score was 5.7 and was 2.23 after FESS and difference was significant (P <0.01). There was significant improvement of the endoscopic score (ES) after FESS, the mean ES preoperatively was 4.038 and it improved to1.31 at 6 weeks and 0.75 in the 12 postoperative weeks. Post-operative adhesion was the most common complication and occurred in 15% of patients. Conclusions: FESS is a safe procedure. Patients with CRS who don’t respond to medical therapy should undergo this safe surgical procedure FESS with good outcome.

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Introduction: Iodinated contrast media are being used increasingly for therapeutic and diagnostic procedures intravenous and intraarterially. This has led to the increased incidence impairment of renal function after the administration of contrast media especially in high risk population. The concept of CIN was first described during the 1950s by Bartel et al. [1]. Treatment of Contrast induced Nephropathy is mainly supportive, consisting of careful fluid and electrolyte management, although dialysis may be required in some cases. The limitation in the available treatment options makes prevention and early diagnosis the cornerstone of management. Methods: All the patients above 18 yrs. of age are planned for CECT and willing to participate in the study are selected. Total of 200 patients are selected. After taking informed consent. Selected patients underwent CECT with intravenous contrast. Similar contrast media was used in all patients i.e., LOCM (Iohexol)/ Volume used was 1.5ml/Kg body weight. All routine blood parameters were sent including pre procedure BUN, serum creatinine. After CECT, patients were followed up with repeat blood sample for BUN, serum creatinine on day 3rd/ day 5th to assess any rise of Serum creatinine > 0.5mg/dl. Result: Total of 31 of 200 patients was diabetic. Of these 7 developed CIN. In our study, 32% of CIN+ positive patients had diabetes. Diabetes was significantly associated with incidence of CIN (P=0.004). Conclusion: Contrast induced nephropathy is more in patients with co morbidities and especially diabetes mellitus. As diabetes mellitus is already a leading cause of nephropathy, contrast in such patients make the picture even worse and lead to nephropathy in a larger portion of people.

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Managing end-stage renal failure poses a significant challenge for healthcare professionals, requiring a comprehensive approach to ensure the best outcomes for patients. The main therapeutic options include hemodialysis, peritoneal dialysis, and kidney transplantation, each with its own advantages and disadvantages. It is crucial to recognize that these methods are not mutually exclusive but rather complementary, and can be used sequentially or in combination according to individual needs. Hemodialysis involves using a machine to filter blood through an artificial kidney and remove waste and excess fluid from the body. This procedure is typically performed in a dialysis center several times a week and can be burdensome for patients due to the need for regular clinic visits. Peritoneal dialysis is another treatment option in which the peritoneum, a membrane inside the abdomen, is used as a semi-permeable membrane to filter blood. This method can be performed at home, offering more flexibility and comfort for patients. However, it requires increased patient commitment and may pose a higher risk of infections. Kidney transplantation is often considered the optimal treatment for end-stage renal failure, offering better quality of life and longer survival compared to dialysis. However, the limited number of donors and strict compatibility criteria make this option inaccessible for many patients. Therefore, it is essential for nephrology centers to offer these three therapeutic options to meet the varied needs of patients. By customizing treatment plans based on individual preferences and providing continuous support, we can improve the management of end-stage renal failure and outcomes for patients and their families. By adopting a collaborative approach, we can better address the growing demand for care for this population.

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Renal involvement in antisynthetase syndrome, although less frequent than other manifestations such as inflammatory myopathy or interstitial lung disease, is an important complication that can present as acute or chronic renal failure as well as significant proteinuria. The exact mechanisms are not fully understood, but various renal lesions have been described. Diagnosis relies on clinical evaluation, laboratory and imaging tests, as well as detection of autoantibodies, notably anti-Jo 1 antibodies. A multidisciplinary approach involving rheumatologists, nephrologists, and other specialists is necessary for comprehensive evaluation and rapid identification of renal complications. Early intervention and close monitoring are crucial to optimize clinical and renal outcomes in patients with this syndrome. As was the case with our 30-year-old patient managed for glomerular syndrome, with a history of early abortions. She presents with symptoms including muscle weakness, joint pain, Raynaud's phenomenon, cough, and general deterioration. Biological examinations show anemia, inflammation, liver and muscle involvement, as well as proteinuria and hematuria. Anti-Jo1 antibodies are positive, confirming autoimmune reactivity. Radiological examinations reveal pulmonary and muscle involvement, corroborating the clinical picture. Treatment with corticosteroids and immunosuppressants is initiated, leading to significant improvement in the patient's condition. Antisynthetase syndrome, although rare, can affect multiple organ systems, including the kidneys. Its diagnosis relies on multidisciplinary evaluation and detection of specific autoantibodies. Treatment aims to control inflammation and prevent complications. Long-term monitoring is necessary to maintain clinical and biological improvements.