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Abstract: Introduction: Macrophage activation syndrome (MAS) secondary to visceral leishmaniasis is a rare clinical entity. We report the case of a 4-year-old boy with no prior medical history, who had presented with fever and pallor for three weeks. Clinical examination revealed a temperature of 39°C, hepatomegaly, and splenomegaly. Laboratory tests showed bicytopenia, hypertriglyceridemia, and elevated lactate dehydrogenase (LDH). Bone marrow examination revealed Leishman bodies and hemophagocytic images. The patient was hospitalized and received treatment. The clinical and biological course was favorable. Conclusion: Visceral leishmaniasis associated with hemophagocytic syndrome is severe and may be life-threatening. Physicians should consider this diagnosis in children presenting with fever and splenomegaly. Urgent complementary investigations are needed to confirm this association and initiate appropriate treatment.

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Background: The optimal rate of feeding advancement in preterm LBW infants remains uncertain, especially in low-resource settings. This study aimed to compare feeding intolerance and nutritional outcomes between rapid and gradual feeding protocols. Aim of the Study: The aim of the study was to compare feeding intolerance and nutritional outcomes in preterm low birth weight neonates receiving rapid versus gradual advanced feeding protocols. Methods: This randomized controlled trial at the Department of Neonatology, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka, from July 2022 to June 2024, included 88 low birth weight preterm neonates. Neonates were randomized to receive either rapid or gradual feeding advancement. Primary outcomes included feed intolerance, sepsis, NEC, hospital stay, and mortality. Data were analyzed using SPSS with a significance level of p < 0.05. Results: The study compared two feeding protocols in preterm low birth weight neonates. There were no significant differences in gestational age or birth weight between the groups. Feed intolerance was more common in group A (29.5%) than in group B (15.9%), but not significantly (p = 0.127). Group A reached full feeds faster (7.0 vs. 8.5 days, p = 0.004) and required less parenteral nutrition (5.0 vs. 7.5 days, p = 0.001). Group B had a longer hospital stay (10.0 vs. 7.0 days, p = 0.002), but no difference in weight at discharge (p = 0.740). Conclusion: Rapid enteral feeding in low-birth-weight preterm neonates improves nutritional outcomes without increasing feed intolerance.

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The present review is designed to integrate recent developments in the diagnosis and treatment of heart failure (HF), a worldwide medical challenge associated with substantial morbidity and mortality. A systematic search of the literature published from 2015 up to October 2024 was performed using PubMed, Scopus and Web of Science. The search used the keywords “heart failure diagnosis,” “heart failure management,” and “novel therapies.” The studies were included when relevant, methodologically robust and of importance. Important findings of the review are diagnostic novelties as the natriuretic peptide testing and the advanced imaging, as well as therapeutic novelties as the SGLT2 inhibitors and the personalized medicine. Non-pharmacological interventions, including cardiac rehabilitation and device therapies, have also contributed to improvement in outcome. Yet, inequities in quality of care and heterogeneous guideline uptake remain. This review highlights the importance of integrated care paradigms and ongoing research in precision medicine to manage the multifaceted pathophysiology of HF. This review integrates the evidence to offer clinicians and researchers a complete resource for practice and future studies.

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Background: Sweet syndrome or acute febrile neutrophilic dermatosis is a recurrent and rare skin disease caused by the release of cytokines, with diverse possible etiologic causes mainly being associated with infections, malignancy and drugs, with a reported incidence of 0.08 pediatric cases Historically, the Von den Driesch diagnostic criteria has been used to diagnose sweet syndrome. Case Presentation: We report a 6 month-old African female infant who presented with features of sweet syndrome. This case illustrates the typical presentation, diagnosis, and treatment outcome of this highly misdiagnosed condition. Conclusion: Due to the limited resources and knowledge about this under-reported disease in resource –constrained settings, the characteristic manifestation of sweet syndrome can be easily missed and thus requires a high index of suspicion for earlier diagnosis and management.

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Median nerve neuropathy, which is characterized by pain, reduced muscular strength, and restricted nerve movement, is increasingly associated with long-term computer use. This study investigated in symptomatic computer users the effect of muscle strengthening exercises alone vs a combination of strengthening exercises and median nerve manipulation in 30 symptomatic computer users. Before conducting the four-week experiment, volunteers in Group A were split into two groups and had been selected out of 90 individuals to receive conservative treatment (muscle strengthening exercises) whilst Group B received both muscle strengthening and Butler's median nerve mobilization procedure. Pain and muscle strength were assessed using Visual Analog Scale (VAS) and Medical Research Council (MRC) grading respectively. Both groups separately showed significant improvement (p < 0.001) though Group B had a relatively more reduction in discomfort and gain in muscle strength than Group A and recommends that in computer users, a synergy of neural mobilization with usual strengthening exercises is more effective in moderating median nerve neuropathy signs. They recommend larger scale studies with objective evaluations in the future.

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Abstract: Introduction: Adolescent girls are at risk of anemia. Anemia is a condition where hemoglobin levels in the blood are below normal. Based on data from the Kupang City Health Office as of March 2023, 38% (371) of 965 junior high school girls screened had anemia. One of the factors that influence the occurrence of anemia is physical activity. Aims: Analyzing the relationship between physical activity and the incidence of anemia among junior high school girls in Kupang City. Methods: The analytic observational study with cross-sectional design. The research instrument used was the IPAQ-Short Form questionnaire to measure physical activity and blood sampling using EasyTouch GcHb to measure hemoglobin levels. The sampling technique used was probability sampling technique, namely proportionate stratified random sampling and got 100 respondents. Data analysis used was univariate and bivariate analysis using the Chi-Square test. Results: Based on physical activity, out of 100 respondents, 20% were in the heavy category, 44% in the moderate category, and 36% in the light category. Based on the incidence of anemia, out of 100 respondents, 33% were anemic and 67% were not anemic. The results of bivariate analysis of the relationship between physical activity and the incidence of anemia showed a p value = 0.684 (p>0.05). Conclusion: There was no significant relationship between physical activity and the incidence of anemia among junior high school girls in Kupang City.

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Background: Septic arthritis is a potentially debilitating condition in young infants, and the optimal duration of antimicrobial therapy to prevent complications remains a clinical dilemma. This study compared long-term outcomes of short and long courses of parenteral antimicrobial s and identified predictors of unfavorable outcomes in infants with septic arthritis. Methods: This randomized controlled trial was conducted at the Department of Paediatrics, Dhaka Shishu Hospital, Bangladesh, from July 2021 to June 2023. Sixty-nine infants aged 0–2 months with septic arthritis were randomized into two groups: Group A received long-term parenteral antimicrobial treatment (14 days) and Group B received short-term antimicrobial treatment (7 days). Data were collected using purposive sampling. Patients were followed up at 3, 6, and 12 months. Variables included clinical improvement, radiological recovery, haematological parameters, and complications. Statistical analysis used SPSS v26, with significance at p < 0.05. Results: Group A included 35 participants and Group B 34 participants. Follow-up attrition occurred in both groups. At 3 months, 83.9% of Group A and 78.6% of Group B showed clinical improvement (p=0.602). Radiological recovery at 6 months was similar between groups (89.7% vs. 92.3%, p=0.999). After 12 months, 85.2% of Group A and 80.0% of Group B had favorable outcomes (p=0.722). Predictors of unfavorable outcomes included delayed treatment initiation and polyarticular involvement. Conclusion: Short- and long-term antimicrobial therapies showed comparable outcomes in infants with septic arthritis. The duration of antimicrobial therapy did not significantly affect long-term complications, suggesting that a shorter course may be sufficient in most cases.