Infantile Hypertrophic Pyloric Stenosis - Experiences of 77 Cases.

Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants which needs surgical treatment. The aim of this study was to review the management of IHPS in our hospital to compare with other developed centers. This is a prospective analytical study carried out in the Department of Pediatric Surgery, Faridpur Medical College Hospital and Dr. Zahed Children Hospital at Faridpur, during the period of May 2002 to October 2010. Total 77 patients were treated by Ramstedt's pyloromyotomy after proper diagnosis and resuscitation. The male to female ratio was 10:1. Most of the patients presented to us within 40 days of age (90%).Younger one was 15 days and elder one was 69 days. In all cases diagnosis were done on clinical basis. The diagnosis is confirmed by barium meal x-ray in 71 cases and sonogram in 15 cases. Serum electrolytes were not estimated in all patients. There was moderate to severe dehydration in more than 60% cases. 71 cases were operated under general anesthesia and 06 cases were operated with local anesthesia. There was one postoperative death on 4th post-operative day. Oral feeding started after 8 to 10 hours postoperatively in all cases. Mucosal perforation occurred in 1 case and that was recognized and treated conservatively without any ill effect. Superficial wound infection encountered in 3 cases. Early diagnosis, preoperative correction of dehydration and electrolyte imbalance and experiences of surgeons play important role for management of IHPS.

Role of nutrition in common dental diseases in rural Bangladesh.

A cross-sectional study was performed to evaluate whether dietary intake and nutrition contribute to the aetiology of common dental diseases in rural Bangladesh. Study subjects were selected following multi-staged stratified random sampling procedure. A total of 300 people of both sexes were included in the study with age ranging from 12-40 years. Data were collected for demographic and socio-economic condition, oral hygiene and related knowledge, dietary consumption, history and clinical findings. The study subjects were categorized as adequate nutrient and undernutrient by dichotomy based on their needed intake and the quality of diet consumed. The results showed that only 19% of the subjects had fulfilled their required intake and the rest were undernutrient. The results also showed that about 93% of the subjects were disease positive. The results between dietary intake and prevalence of diseases were statistically significant (p<0.05). From the findings of the study, it was concluded that low income, poor dietary intake, poor oral and general health may be jointly associated with higher prevalence of dental diseases in the rural community.

Exclusive breastfeeding and nutritional status in Bangladesh.

OBJECTIVE: The purposes of the study were to assess exclusive breastfeeding practice and examine the factors effect on nutritional status of children from 0 to 24 months age. METHOD: Data from a national survey entitled "Surveillance on Breastfeeding and Weaning Situation and Child and Maternal Health in Bangladesh" were used to investigate the exclusive breastfeeding practice and to examine the factors having influence on child nutrition. Information was collected from mothers of 2781 children between 0 and 24 months of age. RESULTS: It was that 16% of women still exclusively breastfed their children for less than 6 months. Of the children 38.1% were stunted and 38% were under weight for their age. Overall, 46% of children were suffering from diseases. Bivariate analysis showed that maternal education and family income were important correlates of exclusive breastfeeding (Chi-square p<0.001). Exclusively breastfed children were nutritionally better off (p<0.001). Logistic regression analysis showed that the children of illiterate women were nutritionally more vulnerable than children of women who had secondary and higher education (OR=1.69, 95% CI=1.33-2.15). The children of older age women were less likely to be stunted than children of younger age women (OR=0.78, 95% CI=0.64-0.96). CONCLUSION: Despite efforts of different government agencies and NGOs, exclusive breastfeeding rate was still low in Bangladesh. Traditional cultural barriers still exist. In order to remove the harmful cultural beliefs and to spread the messages of the benefit of exclusive breastfeeding for survival and nutritional status of the children more behaviour change communication should be made to promote, protect and support breastfeeding.

Stroke: seasonal variation and association with hypertension.

A prospective study was contemplated with 155 patients of acute stroke in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from March 1996 to February 1997. The objective of the study was to find out seasonal variation of stroke occurrence. An attempt was also made to find out the association of hypertension with ischaemic and haemorrhagic stroke during summer and winter. The numberofsubjects duringsummer and winterwere 121 and 34, respectively. In summer, out of 121 subjects, 87(71.9%) were ischaemic stroke and 34(28.1%) haemorrhagic stroke, of which 32 were intracerebral haemorrhage (ICH) and 2 subarachnoid haemorrhage (SAH). There were 18 (52.9%) ischaemic stroke and 16(47.06%) haemorrhagic stroke (all ICH) among total 34 subjects during winter. The frequency of ischaemic stroke during summer was significantly greater than that during winter (p<0.05). The frequency of haemorrhagic stroke during winter was significantly greater than that during summer (p<0.05). Temperature was positively correlated to ischaemic stroke (p<0.01) and negatively correlated to haemorrhagic stroke (p<0.1). Hypertension was significantly more associated with haemorrhagic stroke than with ischaemic stroke irrespective of season (p<0.05).

Prednisolone in Duchenne muscular dystrophy.

This Study was carried out in the department of Neuromedicine, Bangabandbu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. A total of 19 Duchenne muscular dystrophy (DMD) patients were recruited for randomized controlled study to see the effect of prednisolone in the natural course of the disease process. Prednisolone was given in 10 patients (study group) in a dose of 0.75 mg/kg for six months. Vitamin was given in 8 patients (control group) for the same duration. One patient was dropped from the study. Patients were assessed for average muscle strength, timed function test and functional grades (pelvic and pectoral). It was found that at the end of the study, almost all the parameters were improved significantly in the prednisolone treated group (P < 0.05).