Search

Background: Thalassemias are the most common inheritable blood disorders requiring regular blood transfusions and iron chelating therapy. Non-adherence to iron chelation therapy increases complications and is a problem in treating thalassemia. To assess the reasons of non-adherence to iron chelating drug in treating thalassemia. Materials and methods: This descriptive cross-sectional study was carried out in the thalassemia ward of Chattogram Maa Shishu-O-General Hospital, Chattogram from July, 2013 to June, 2014. 70 thalassemia patients aged 2-18 years previously treated with iron chelating drugs were included. Parents were interviewed according to a formulated questionnaire based on discontinuation of iron chelating drugs and its reasons. Data were analyzed by both manually and by SPSS-18. Results: About 48.6% patients needed blood transfusion >10 units/year and 62.9% patients were prescribed with iron chelating drugs. Near about half patients (47.7%) did not continued iron chelating therapy till full prescribed period. Deferiprone (31.8%) and combination of deferipronc & desferrioxamine (31.8%) was the most commonly prescribed drug. Deferiprone is the drug to which most of the patients (70%) were adherent and a good number of patients (65%) discontinued desferrioxamine. Financial problem (100%) was the only reason for discontinuation of oral chelator. In case of parenteral chelator, besides finanacial problem (38.5%), time consuming natures (38.5%), need of hospital admission (23%) are the other causes for non-adherence to iron chelation therapy. Conclusion: Financial problem is the main cause of non-adherence to iron chelation therapy. Iron chelating drugs should be available at low cost. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 45-49

Background: Thalassemias are the most common heritable blood disorders that represents a major public concern. Poor awareness and lack of knowledge lead to increase number of carrier that is a silent reservoir of the disease. To observe the knowledge and awareness level of parents of thalassemic children about the disease. Materials and methods: This descriptive cross-sectional study was conducted in the Thalassemia ward of Chattogram Maa Shishu-O-General Hospital, Chattogram from July 2013 to June, 2014. Parents of 70 thalassemia patients aged 2-18 years interviewed with a formulated questionnaire based on knowledge status and awareness level of parents towards thalassemia. Data were analyzed by both manually and by SPSS-18. Results: Majority of patients were from rural background (54.3%). Only 8.6% parents were consanguineous parents and majority of them completed only secondary education. 44.3% resolved it as inherited disorder. 52.9% resolved thalassemia cannot be cured. Only 24.3% regarded bone marrow transplantation as a measure of cure. More than half (55.7%) did not know how to prevent thalassemia. Only 37.1% knew about prenatal diagnosis. Carrier status of both father and mother were unknown in majority of patients (80%) and screening of sibs was not done at all in a significant number of patients (51.5%). Only 34.3% wanted to do prenatal diagnosis after conception and 65.7% parents were ready to accept therapeutic abortion if fetus would be diagnosed as thalassemia by prenatal diagnosis. Conclusion: Knowledge level and awareness of parents of thalassemic child regarding the disease is unsatisfactory. To reduce disease burden an awareness program regarding the disease and its prevention covering premarital screening, acceptance of prenatal diagnosis and therapeutic abortion is essential. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 12-15

Klippel-Feil Syndrome (KFS) is a complex syndrome comprises of classical clinicaltriad of short neck, limitation of head and neck movements and low posteriorhairline. This syndrome is resulting from failure of the normal segmentation ofcervical vertebra.In this present case in addition to classical clinical triad we have found short stature,scoliosis at cervico- dorsal junction and sprengel deformity of the shoulder. Wedidn’t find any association of hearing impairment, congenital heart disease andrenal abnormalities. There was no any neurological deficit and normal schoolperformance.Patient with KFS usually have good prognosis if cardiopulmonary, genitourinary,auditory problems are identified and treated early. Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 78-81

Background: Thalassemia is the most common hemoglobin disorder in the worldincluding Bangladesh. Population migration and intermarriage between differentethnic groups have had a major impact on disease epidemiology. To observe theprevalence and specturm of thalassemia as well as demographic and social factorsof thalassemia patients. Materials and methods: This descriptive cross-sectional study was conducted in theThalassemia Care Center of Chattogram Maa Shishu-O-General Hospital,Chattogram from July, 2013 to June, 2014. Parents of 70 thalassemia patients aged2-18 years interviewed with a formulated questionnaire based on social anddemographic characteristics. Data were analyzed by both manually and by SPSS-18. Results: Mean age of patients was 6 years (± 3.66). Near about half of patients(40%) were diagnosed at the age less than 5 years. Mean age of diagnosis was 1.6years (± 1.53 SD). Majority of patients belonged to lower middle class (42.9%) withmale predominance (62.9%). A good number of patients (22.8%) were not engagedin any educational activity. Mean annual income of family was 262000 taka/year ±245477.35 (USD 3324.87 ± 3115.19). Mother contributed to annual income in only4.7% families. The percentage of Hb E/b thalassemia was the highest (54.4%)followed by b thalassemia major (37.1%) and Hb E disease (4.3%). Malepredominance was found in every type of thalassemia. Half of the thalassemiamajor patients were diagnosed during infancy and majority (60.53%) of Hb E/bthalassemia patients were diagnosed at the age less than 5 year. Conclusion: A nation-wide screening program should be carried out to address thecarrier status of population at risk. There may be further analysis regarding clinicaldiversity of thalassemia. Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 33-37

Background : Valproic Acid (VPA) is an effective anticonvulsant widely used for the treatment of epilepsy in children, but there are pitfalls in VPA therapy, especially in case of various endocrine organs like thyroid. So the aim of this study was to evaluate the thyroid dysfunction in terms of subclinical hypothyroidism during Valproic Acid (VPA) therapy in children with epilepsy. Methods: The study was conducted in the Department of Paediatrics, and Shishu Bikas Kendra, Chittagong Medical College Hospital (CMCH) over one year duration on 50 newly diagnosed idiopathic epileptic children who were decided to start Valproate at the dose of 20mg/kg/day. At the same time similar number (n=50) of age and sex matched children visited the paediatric OPD for other health events(e.g. acute upper respiratory infection, Influenza like illness and Acute watery diarrhoea) other than epilepsy were included in the study as control group. Thyroid function status like serum levels of Thyroid-Stimulating Hormone (TSH) Free Triiodothyronine (FT3) and Free Thyroxin (FT4) were evaluated at baseline and after six months. Moreover, serum VPA level was also measured in children receiving valproate at follow up visit. Anti thyroid peroxidise antibody (Anti TPO ab) was checked at follow up visit in those having TSH level beyond normal reference range. After collecting all data it was analyzed by SPSS-19. Results: In the current study, cases consisted of 30(60%) male and 20(40%) female children. Male to female ratio was 1.5:1. Gender and age were matched in cases and control group (p>0.05). Most of the population in the cases were from rural areas 29(58%) and most of them 40(80%) belonged to middle class family. The mean±SD of TSH level significantly increased after six months in comparison with base line values (1.76±0.57μIU/ml vs. 2.70±1.50μIU/ml, p

Background: Autism Spectrum Disorders (ASD) is becoming global problem as it is being diagnosed very frequently amongst the non communicable diseases. Lack of socialization, communication skill and behavioural abnormality are the main problem belongs to the disease. Cornerstone of the management is based on early intervention program directed to improve the communication and socialization skill. In Bangladesh different early intervention strategies are implicated adopting from evidence based practices in the developed countries. To determine the effect of early intervention program on the improvement of socialization and communication skills of children with ASD who attended an early intervention programme at the Institute of Autism and Child Development, Chattagram Maa Shishu -O-General Hospital.Methods: This is a quasi experimental study carried out at Institute of Autism and Child Development, Chattagram Maa Shishu-O-General Hospital from January 2015 to December 2015. Children with ASD (Autism Spectrum Disorder) aged 1-5 years enrolled as study subjects which is fifty in number. Screening of ASD was carried out by psychological tools like M—Chat (1-3yrs) & ASD assessment scale (> 3yrs). Diagnosis was confirmed by ADOS-G (Autism Diagnosis Observation Schedule- Generic). Internvention was provided on a 1:1 basis which was adopted from various evidence based practices including the ‘More Than Words’. Intervention were given for three subsequent session in one month interval. Level of communications were measured after intervention and compared with pre intevvention level.Results: Significant improvements has been observed in overall level of communication and activities of daily living which included eye contact, attention, joint attention, turn taking, toilet training.Conclusion: A well planned early intervention programme for children with ASD can speed up the social communication development in such a way that gives rise to a hope of mainstreaming these children in future.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 9-13

Background: The majority of children with Cerebral Palsy have feeding difficulties. It has a great impact on growth and development in children with cerebral palsy. Feeding difficulties may leads to chronic respiratory disease, malnutrition and reduce quality of life of both children and caregiver. Feeding difficulties cause stressful meal time for caregivers and fear of food for children. In well resource country many hi-tech equipments for the management of feeding difficulties are available but which is not available in low resource country like Bangladesh. Though some of low tech approaches have started a little but the effectiveness or outcomes of these technologies are not evaluated. This study is aimed to evaluate the effect of feeding training on feeding difficulties in children with cerebral palsy.Methods: This is a quasi experimental study. Twenty children with cerebral palsy aged 2 – 9 years having feeding difficulties enrolled as study subjects. Initially degree of feeding difficulties were assessed by evaluating body posture and frequency of aspiration during feeding which is scored according to the response of the child. After giving feeding training to the mother feeding difficulties were reevaluated. Mean score of feeding difficulties before and after intervention were compared by paired 't' test. Results were analyzed by SPSS.Results: Among the study subject 14(70%) were male and 6(30%) were female. Most of them were found to have hemiplegic CP 7(35%). The mean score in terms of positioning and frequency of aspiration were significantly changed after intervention (14.15 vs. 15.85 p =

Background: The predominant form of malnutrition is commonly called proteincalorie malnutrition. Protein Energy Malnutrition (PEM) is still a major health problem in children of developing countries including Bangladesh. The causes of malnutrition are multifactorial including nutritional factors, socioeconomic factors, health status of the mothers and repeated infections in children.Objective: To explore the information regarding the breast feeding practices of children suffering from Protein-Energy Malnutrition.Methods: This case control study was conducted in Chittagong Medical College Hospital from November 2006 to April 2007. A total of 65 controls and 65 cases were selected consecutively for the purpose of the study. Their mothers were interviewed with help of structured questionnaire containing all the variables of interest to attain the study objectives. The test statistics used to analyze the data were descriptive statistics and Chi-square (c2) or Fisher’s Exact Probability Test.Results: A significantly higher frequency of cases (67.7%) were given pre-lacteal feed, predominantly honey and sugar-water compared to control group (41.5%) (p = 0.008). Nearly 100% of controls were given colostrums compared to 75% of the cases. About one-third (31.3%) of the cases was exclusively breast-fed in comparison to 58.5% of the control group (p = 0.003). Over onequarter (27.7%) of the control were breast-fed upto 6 months of age, as opposed to only 1.5% cases (p < 0.001). Duration of predominant breast feeding for more than 6 months of age was also significantly higher in control group than that in case group (p = 0.001). Breast milk substitutes demonstrate their significant presence in cases (38.5%) than that in controls (9%) (p = 0.003).Conclusion: The study showed that rejection of colostrums, practice of prelacteal feeding, delayed initiation of breast feeding, early cessation of exclusive breast feeding and use of formula milk all were significantly higher in the malnourished group of children than those in their normal counterpart.Chatt Maa Shi Hosp Med Coll J; Vol.14 (2); Jul 2015; Page 43-47

Background: Cerebral Palsy (CP) is a diagnostic term used to describe a group of permanent disorders of movement & posture causing activity limitation that are attributed to non progressive disturbances in the developing fetal or infant brain. The motor disorders are often accompanied by disturbances of sensation, perception, cognition, communication and behavior as well as by epilepsy, secondary musculoskeletal problem and feeding difficulties. Aims: To see the development of a child with cerebral palsy after comprehensive feeding & seating intervention. To recommend measure for reducing neurodevelopmental problems. To improve mother- child interaction. Methods: This hospital based prospective cross sectional observational study was done in Child Development Center (CDC) of the Department of Pediatrics, Chattagram Maa Shishu-O-Genaeral Hospital (CMSOGH), Chittagong from July 2013 to December 2013. Children with Cerebral palsy aged 1-15 years included in this study. Results: Most of the patients (60%) before intervention were having only liquid food. After intervention most of the patients were having either a combination of semi-solid and solid food (48%) or only semi-solid food (42%). After intervention 80% of patients were sitting during feeds which was only 12% before intervention. After intervention feeding time is reduced to 15 to 30 minutes which was 30 min to one hour. Most of the patients (90%) never ate by themselves before intervention, only 4% were selffed. After intervention 56% were self feeding for some part of the meal & 24% were self feeding at every meal. Conclusion: Feeding problems in children with cerebral palsy are common. Simple home based measure, like feeding and seating intervention, should be carried out under the guidance of Child Development Center run by developmental therapist with assistance from pediatricians & child psychologists in order to improve the development of the child with cerebral palsy as well as the quality of life.DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22872 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 11-14