A Comparative Study of Oral Ivermectin and Topical 5% Permethirn Cream in the Treatment of Scabies in Patient Suffering from Diabetes Mellitus.

Scabies is one of the commonest diseases among all age groups. Topical permethrin is a widely used treatment option for scabies. Ivermectin is a newer oral agent for the treatment of scabies. This study was done to compare the efficacy of permithrin and oral Ivermectin in the treatment of Scabies in patient suffering from Diabetes mellitus. This comparative clinical trial was carried out in the outpatient department of Dermatology & Venereology, Diabetic Association Medical College Hospital (DAMCH), Faridpur from January 2012 to December 2012. A total 60 cases were enrolled purposively and divided into 2 groups. Group I received 2 doses oral Ivermectin and group II treated with 5% permethirn cream. Patients were followed up at the 3rd and 4th week. Total 86.6% patients of Ivermectin group and 90% of permethrin group were cured. Though permethrin showed somewhat more effective, the difference was not statistically significant. The study found that both ivermectin and permethrin were similarly effective in the treatment of scabies in patients suffering from Diabetes Mellitus.

Nebulization by Isotonic Magnesium Sulphate Solution with Salbutamol Provide Early and Better Response as Compared to Conventional Approach (Salbutamol Plus Normal Saline) in Acute Exacerbation of Asthma in Children.

Asthma attacks are serious respiratory problem that can be lethal when not treated appropriately. Till today the main stay of therapy is short acting ß2-agonist. Unfortunately in acute asthma episodes this is not enough to relieve the bronchospasm and reduce dyspnea. The shortcoming of ß2-agonist therapy has resulted in the use of a variety of other treatment in the management of acute asthma. The use of magnesium sulphate is one of the recent treatment options. This study was done to compare the efficacy of nebulized salbutamol with magnesium sulphate versus salbutamol with normal saline in the treatment of acute exacerbation of asthma in children. This randomized controlled trial was carried out among 60 patients with acute exacerbation of bronchial asthma fulfilling the inclusion criteria, admitted in the department of Paediatrics, Mymensingh Medical College Hospital over a period of one year from January 2009 to December 2009. They were distributed randomly, 30 patients received nebulized salbutamol (0.15mg/kg; minimum dose 2.5mg) with 2.0 ml of isotonic magnesium sulphate solution and another 30 patients received the same dose of salbutamol with 2.0 ml of normal saline on 3 occasions at 20 minute intervals. With single dose of nebulization in the magnesium sulphate with salbutamol group, by 20 minute almost all 26 (86.7%) patients achieved at least 60% of predicted PEFR. Within 20 minute from control group none could achieve 60% of predicted PEFR. After second dose of nebulization control group started achieving 60% of predicted value. Regarding response criteria, with second dose of nebulization, at 40 minute 16 (53.3%) patient from magnesium sulphate with salbutamol group showed good response (PEFR>70% predicted). But within the first 40 minutes, none could show good response in control group. With 3rd dose of nebulization all from magnesium sulphate group showed good response but even at 60 minute, 5 (16.7%) patients in control group failed to be included as good responder. In conclusion, nebulization by isotonic magnesium sulphate solution with salbutamol provide early and better response as compared to conventional approach (salbutamol plus normal saline) in acute exacerbation of asthma in children.

Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age.

Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium. They have rarely been described as originating in early age. A case of left atrial myxoma successfully removed using cardiopulmonary bypass in a 8-year-old child is presented. Review of the literature emphasizes the rarity and clinically aggressive behavior of this tumor in this age group. The object of this case report is to present myxoma in children and to evaluate possible differences between young and adult patients.

Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age.

Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium. They have rarely been described as originating in early age. A case of left atrial myxoma successfully removed using cardiopulmonary bypass in a 8-year-old child is presented. Review of the literature emphasizes the rarity and clinically aggressive behavior of this tumor in this age group. The object of this case report is to present myxoma in children and to evaluate possible differences between young and adult patients.

Improved Preservation of Saphenous Venous Conduits by the Use of Papaverine mixed heparinized blood Solution during Harvesting.

Background: High-pressure distension during harvesting damages the saphenous vein (SV) and may contribute to subsequent coronary artery bypass graft (CABG) occlusion. Application of vasodilator agents to the SV during harvesting may reduce the need for high-pressure distension and improve graft quality. We tested the effects of a vasodilator solution containing the conventional agent papaverine (Pap) mixed with heparinized blood on the pressure necessary to overcome SV spasm and on the structure. Methods: 150 patients undergoing CABG were nonrandomly allocated to receive an application of either intraluminal papaverine (Pap) mixed with heparinized blood(Group-A), or intraluminal heparin mixed normal saline(group-B) to the SV for distension during harvesting. The peak pressures required to distend the vein were recorded. Samples of SV were taken for microscopical analysis just before we performed the anastomosis. Results: The results for mean peak pressures (mm Hg) were: Normal saline 131.77±20.6 (range 85 to199 mmHg); and Papaverine mixed blood solution, 56.4±2.1 (range 40 to 90 mmHg); P<0.001, (Pap mixed blood solution versus normal saline); The results of histological study for endothelial injury were: Normal saline, 52.5 %; Papaverine mixed blood solution , 20%; (P<.02, untreated versus Pap mixed blood solution). Conclusions: Intraluminal use of Papaverine mixed heparinized blood solution during vein harvesting requires low distension pressure and improves endothelial coverage compared with the use of heparin mixed normal saline.

Sex and socioeconomic differentials in child health in rural Bangladesh: findings from a baseline survey for evaluating Integrated Management of Childhood Illness.

This paper reports on a population-based sample survey of 2,289 children aged less than five years (under-five children) conducted in 2000 as a baseline for the Bangladesh component of the Multi-country Evaluation (MCE) of the Integrated Management of Childhood Illness strategy. Of interest were rates and differentials by sex and socioeconomic status for three aspects of child health in rural Bangladesh: morbidity and hospitalizations, including severity of illness; care-seeking for childhood illness; and home-care for illness. The survey was carried out among a population of about 380,000 in Matlab upazila (subdistrict). Generic MCE Household Survey tools were adapted, translated, and pretested. Trained interviewers conducted the survey in the study areas. In total, 2,289 under-five children were included in the survey. Results showed a very high prevalence of illness among Bangladeshi children, with over two-thirds reported to have had at least one illness during the two weeks preceding the survey. Most sick children in this population had multiple symptoms, suggesting that the use of the IMCI clinical guidelines will lead to improved quality of care. Contrary to expectations, there were no significant differences in the prevalence of illness either by sex or by socioeconomic status. About one-third of the children with a reported illness did not receive any care outside the home. Of those for whom outside care was sought, 42% were taken to a village doctor. Only 8% were taken to an appropriate provider, i.e. a health facility, a hospital, a doctor, a paramedic, or a community-based health worker. Poorer children than less-poor children were less likely to be taken to an appropriate healthcare provider. The findings indicated that children with severe illness in the least poor households were three times more likely to seek care from a trained provider than children in the poorest households. Any evidence of gender inequities in child healthcare, either in terms of prevalence of illness or care-seeking patterns, was not found. Care-seeking patterns were associated with the perceived severity of illness, the presence of danger signs, and the duration and number of symptoms. The results highlight the challenges that will need to be addressed as IMCI is implemented in health facilities and extended to address key family and community practices, including extremely low rates of use of the formal health sector for the management of sick children. Child health planners and researchers must find ways to address the apparent population preference for untrained and traditional providers which is determined by various factors, including the actual and perceived quality of care, and the differentials in care-seeking practices that discriminate against the poorest households.