Development and Evaluation of Weaning Foods Using Locally Available Nutritious Fruits in Bangladesh

Bangladesh has one of the highest rates of malnutrition in the world although the country is endowed with agricultural produce that could be properly utilised to prepare adequate food for children. Considering this, three weaning foods were formulated using locally available cereals and nutritious fruits such as wheat, soya flour, jackfruit and mango. Methods: Standard procedures of Association of Official Analytical Chemists (AOAC) and American Public Health Association (APHA) were used to determine the chemical composition and microbiological analysis. Organoleptic qualities were analysed by twenty adult panelists of the Institute of Food Science and Technology, Bangladesh, using a 9-hedonic scale against a cereal based commercial brand as standard for proximate and sensory properties. Results: The moisture content of the developed weaning foods ranged from 2.78-3.59%, crude protein content 14.74-16.55%, fat 11.04-12.70%, ash 1.38-1.68%, crude fibre 1.04-1.52%, carbohydrate 65.83-71.09% and energy content from 445.80-465.48 kcal/100g of the foods. The formulated weaning foods A, B and C were significantly different (p<0.05) in moisture, protein, fat, carbohydrate and energy contents from the commercial brand, D. According to rat bioassay method, the prepared weaning foods C and B had the highest Protein Efficiency Ratio and Feed Efficiency Ratio than the commercial brand, D. Total bacterial counts were nil for all weaning foods. Sensory analysis revealed acceptability of all the weaning foods and preference for weaning food C that compared favorably with the standard in all the quality attributes. Conclusion: The formulated weaning foods are inexpensive and nutritious, and its ingredients are locally available. These foods have the potential for improving malnutrition problems facing children in Bangladesh.

Pott's disease in a young child.

A 16-month-old emaciated, immunized child presented with low-grade fever and progressive kyphosis with a right sided para-vertebral abscess for 9 months. During this period of illness the child had marked loss of appetite and progressive weight loss. There was history of contact with sputum smear positive father. A gibbus was present at thoraco-lumbar region with a cold abscess at the right side of the gibbus and signs of upper motor neuron lesion were found on lower limb examination. Diagnosis was supported by relevant investigations including MRI of dorsolumbar spine and treatment was started beforehand with anti-tubercular drugs. The paravertebral abscess was drained several times and antibiotics were used depending upon the results of microbiological study. At the same time the patient was advised to wear a modified chest brace for immobilization and the management for severe malnutrition was also started accordingly. There was significant clinical improvement observed within one month of starting treatment.

Diagnostic efficacy of Aldehyde test in late cases of Kala-azar.

This case control study was carried out in the Paediatric wards of Mymensingh Medical College Hospital for a period of one year from April 2002 to March 2003 to determine the sensitivity, specificity and predictive values of Aldehyde test in the diagnosis of Kala-azar. A total of seventy five febrile cases of Kala-azar from Paediatric wards were enrolled in the study and Seventy five controls having splenomegaly with or without fever were also included from the same source. Aldehyde test was done in both cases and controls. Diagnosis of Kala-azar was confirmed by demonstration of Leish-man-Don-o-van body (LD) in bone marrow or splenic aspirates. Out of 75 parasitologically proven cases of Kala-azar, AT was positive in 56 cases. The sensitivity irrespective of duration of illness was 74.6%. We found sensitivity of AT increases with the duration of illness where AT was sensitive in 34.7% cases having fever for less than 3 months, 90.90% with fever for 3 months to less than 6 months and 100% with fever for 6 months or more in duration. Specificity of AT was calculated as 96% with positive and negative predictive values of 94.9% and 79.1% respectively. So AT is a very sensitive and specific test with high positive and negative predictive values. Considering the cost, availability, simplicity, sensitivity, and specificity we would recommend the Aldehyde test as an important diagnostic tool for field diagnosis of Kala-azar especially after three months of febrile illness.

Clinical picture of craniopharyngioma in childhood.

This cross sectional and observational study was carried out among the admitted patients of the department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of 1st March 2004 to 31st March 2005. Among the all intracranial tumours, 2.5-04% are Craniopharyngiomas. Although there is a bi-modal age distribution-1st peak at 5-10 years and the 2nd peak at 55-65 years, the common patients are children (9% of childhood tumour). A typical child with Craniopharyngioma (CP) is short, obese and half blind and has a poor school record. The study has been undertaken to know in details, how child patients with Craniopharyngiomas in Bangladesh present their disease at the hospital. Earlier diagnosis and management may improve the quality of life and longivity. The average age of the patients was 13 years ranging from 07 to 17 years. The vast majority patients were admitted with visual problems as their presenting complaints. Among the patients 33% had total blindness of which 03 had primary optic atrophy and 1 has secondary optic atrophy. Among the remaining 08 patients, 75% were found to have field defect. All patients showed fundal changes ranging from early papilloedema to optic atrophy. We found major endocrinological deficiency in child patients with Craniopharyngioma in 17% cases. Raised Prolactin level may not be significant, because it could be due to stalk effect. Although 25% patients were of short stature, their hormonal profile was within normal range according to age and sex.