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Background: Measures of peripheral perfusion can be used to assess the hemodynamic status of critically ill patients. The peripheral Perfusion Index (PI) based on analysis of the pulse oximetry signal has been implemented in monitoring systems as an index of peripheral perfusion. The aim of this study was to evaluate clinical state of shock by PI in a Pediatric Intensive Care Unit (PICU) of a tertiary care hospital of Bangladesh. Materials and methods: This prospective observational study was carried out in the PICU of Chittagong Medical College Hospital. Children aged 1 month to 12 years who needed hemodynamic monitoring were included and categorized into five age groups. Demographic data, vital parameters and PI were recorded. Hemodynamic monitoring was started as early as possible within 24 hours of arrival in PICU, then 30 minutes after, then 8 hourly for a total 4 observations. Results: In total, 199 children were included with or without features of shock and 796 hemodynamic measurements were taken and analyzed. Mean/median PIs were significantly higher in patients without shock compared to patients with shock in all age groups except age group 10-12 years of age. Clinical shock can be reasonably detected when PI value was < 1.25 in children

Background: Guillain-Barre syndrome (GBS) is the leading cause of acute flaccid paralysis in children. This study was aimed to compare the clinical spectrum and shortterm outcome of children with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN) subtypes of GBS in children. Methods: The study was a prospective cohort study done in a tertiary neurology hospital for 3 years. Children under 18 years of age fulfilling the Brighton diagnostic criteria for GBS were enrolled in the study. Based on the nerve conduction study, patients were subclassified as AIDP, AMAN, AMSAN, and others. Finally, a comparison was done in children with AIDP and AMAN subtypes. Results: A total of 102 children have fulfilled the Brighton diagnostic criteria of GBS during that study period. Among them, 83 children were included in the final analysis as NCS findings suggestive of AIDP and AMAN were found in 29(28.43%) and 54(52.94%) of cases respectively. No patient died in this cohort and follow-up was done at 3 months after discharge. A comparison of clinical data between the two groups revealed similar clinical features in most of the cases. The mean age difference between the two groups was statistically significant and AIDP was found to be more frequent in the 1-5 years age group. There was a significant association between gastroenteritis and AMAN subtypes. On symptom analysis, pain and tingling sensation were found predominantly in AMAN subtypes. Children having AMAN variants developed respiratory distress more than AIDP. Assisted ventilation were needed in 14.45% of cases and the majority of them were from the AMAN group. The mean duration of hospital stay and the mean disability scores at three months after discharge were significantly higher in the AMAN group. Conclusions: AMAN was the commonest GBS subtypes in children. AIDP was more frequent in the younger age group. Children with AMAN appeared to have higher short-term morbidity and slower recovery than those with AIDP. Bang. J Neurosurgery 2022; 11(2): 94-100

Background: Drowning is an important cause of mortality among children in rural Bangladesh. This study was done to find out the sociodemographic characteristics of drowning affected children. Materials and methods : It is a descriptive study among the victim of drowning admitted in the Department of Pediatrics, Chittagong Medical College Hospital, Chattogram during the period of January 2014 to December 2014. One hundred victims were selected for the study. History and face to face interview were taken, the sociodemographic characteristics were analyzed statistically. Results: Of 100 patients in this study, age ranged from 6 month to 12 years, largest number (76%) of victims belonged to 1-4 years age group. Most of the drowning events occurred in rural area (82%). Almost all (87%) of rural drowning occurred in pond, 8% drowning occurred in bucket, all of which were urban. April to October (88%) were found to be high risk months for drowning. Almost all (96%) of the victims were found unable to swim and in 100% cases, there is no fencing present around pond. Most (82%) of the victim survived without morbidity, 6% died, 4% survived with morbidity. Conclusion: Children of 1-4 years old, rural children,children of poor socioeconomic background are vulnerable to drowning. Drowning mostly occurs during daylight, lack of supervision of child is strongly associated with drowning. Drowning has specific seasonal pattern. Busy mother with a large family, illiterate mother, lack of pond fencing or door fencing, and lack of swimming ability are also associated with drowning. IAHS Medical Journal Vol 5(1), June 2022; 38-44

Background: Only a few studies investigated the association of a positive blood culture with mortality in the pediatric population, the predictive significance of a positive blood culture in children admitted to the Pediatric Intensive Care Unit (PICU) remains uncertain. This study aimed at evaluating the characteristics and outcomes of negative blood culture compared to those of positive blood culture in children admitted to the PICU of Chittagong Medical College Hospital (CMCH). Materials and methods: A retrospective cohort study was conducted at the PICU of CMCH. All pediatric patients, from 1 month to 12 years of age, admitted between October 2021 and March 2022were included in the study. All blood culture samples sent from patients hospitalized in the PICU of CMCH between October 2021 and March 2022, were evaluated retrospectively. Information collected includes the demographic data, Primary diagnosis, and outcome of the patients. Results: Of the 214 patients, 29 (13.6%) had a positive blood culture whereas 185 (86.4%) had a negative bacterial blood culture. Pneumonia was extremely common, present in 65.5% and 34% of the patients, respectively in culture positive and negative patients, and tended to result in a positive culture (p

Background: Use of automated device with ultrasound guidance in renal biopsy has improved the adequacy and reduced the complication. Chittagong Medical College Hospital (CMCH) is a tertiary teaching hospital where Pediatric Nephrology Department started its journey on 11th December 2013. Since then renal biopsy is going on. Aim of the study is to see the rate of adequacy and complication of renal biopsy along the course of years. Materials and methods: This is a retrospective study carried on 100 consecutive ultrasonography guided percutaneous renal biopsy from lower pole of left native kidney performed by the pediatric nephrologist. All hospitalized children aged up to 12 years admitted since 2014 were included. Spring loaded automated biopsy needle was used in 88% cases and Trucut biopsy needle in 12% cases. Results: Most of the patients were aged between 1 to 10 years with male female ratio 0.9:1. Midazolam was used for sedation in all patients except one who needed general anesthesia. Light microscopy and Direct Immunofluorescence (DIF) report was made but no facility for electron microscopy. Gross hematuria was experienced in 5% cases and one case needed blood transfusion. There was one case with blood clot in urinary bladder causing dysuria but no urinary retention was observed. Post biopsy perinephric hematomas developed in 4 cases. Number of needle passes to obtain adequate biopsy material in native kidney was £3 in 78% cases. Adequate specimen was found in 95% cases. Conclusion: Percutaneous renal biopsy can be done adequately and safely in resource poor setup if pediatric nephrologist and radiologists are available. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 9-12

Introduction: Tuberculosis (TB) in children is increasingly becoming an important cause of global child morbidity and mortality. Objective: The objective of this study was to evaluate the clinical spectrum of TB in children under the age of 15 years and document any changes that occur over time. Materials & Methods: This observational study was conducted in the pediatric outpatient department (OPD) of 250 Bedded TB Hospital, Shyamoli, Dhaka, from October’2016 to January’2017. A total 71 children of both sex up to 15 years of age, who were diagnosed as having TB and attended the pediatric OPD of TB hospital during the four months study period were enrolled. The data was analyzed on the basis of patient’s age, gender, socioeconomic status, mode of presentation, BCG vaccination status, history of contact with smear positive TB patient, clinical findings, investigations and associated co-morbidities. Results: This study revealed that among the 71 cases of TB, (72%) had extra-pulmonary TB (EPTB) and (28%) had pulmonary TB (PTB), the commonest age group was 6 to 15 years with male preponderance (51%). Pulmonary TB was diagnosed mostly clinically (60%) followed by positive sputum smear result (20%), gastric aspirate for acid-fast bacilli AFB (5%) and sputum for Gene Xpert (5%). Distribution of extra-pulmonary TB (EPTB) according to the organ involvement was TB lymphadenitis (49%), osteoarticular TB (19.6%) and abdominal TB (5.9%). Cervical lymphadenopathy was the commonest presentation (76%) among the EPTB cases. Tuberculin skin test (TST) was positive in (69%) cases. Among the total cases (90%) children had TB alone whereas (10%) had other co-morbid disease along with TB. Conclusion: Extra-pulmonary TB (EPTB) was more prevalent among the childhood TB cases in a tertiary level set up where cervical TB lymphadenitis was the commonest.