Change of Hemoglobin Level among Exclusively Breastfed Term and Preterm Babies up to Six Months of Age.

There is progressive increase of Hb levels is observed during course of intrauterine development of fetus but high concentrations found at birth. In preterm neonate normal Hb is characteristically deviated from term neonate. Breast milk is the only natural ideal food for both term and preterm babies from birth up to 6 months. Preterm milk was found to contain significantly higher concentrations nutrients particularly iron than term milk. Preterm human milk is more suitable for the premature infant than term human milk. As Hb concentration varies in term and preterm babies in different counties in different feeding practices. The purpose of this longitudinal descriptive study is to find out the pattern of changes in the Hb level among exclusively breastfed preterm and term infants during the first six months of life. This study was carried in the Neonatal Intensive Care Unit (NICU), Mymensingh Medical College Hospital (MMCH), Mymensingh from September 2016 to February 2018. One hundred fifty (150) neonates both term and preterm were included in this study and followed up to 6 months of age. After admission informed written consent was taken from parents, thorough history taking and clinical examination were done. Data were collected in a pre-designed case record form. All the babies of Group A provided 2mg/kg iron supplementation from 6 weeks for 2 months for universal recommendation. Hb level was measured of all exclusively breast feed babies at admission after birth then next follow-up at 6 weeks, 3 months and 6 months. All information regarding history, anthropometrics measurement, Hb level was recorded in structural questionnaire. Data analysis was done by SPSS version 20.0. Male were predominant in both groups. Most of the preterm (72.0%) and term babies (65.3%) were delivered by vaginal route. Mean Hb level was found significantly higher among preterm babies than term babies after birth were 16.55g/dl and 15.98g/dl respectively. Sharp fall of Hb concentration was observed after birth up to 6 weeks in both preterm and term babies but Hb level was found significantly lower in preterm in comparison to term babies (9.27gm/dl vs. 9.58gm/dl). In term babies, even after 6 weeks fall of Hb level continued to 3 months of age followed by gradual increase up to 6 months without iron supplementation. Hb level of in preterm babies gradually increased from 6 weeks up to 6 months with universal iron supplementation. Hb level fall sharply up to 6 weeks in both exclusively breastfed term and preterm babies but even after 6 weeks term babies experienced gradual fall of Hb levels up to 3 months. Hb level increases in exclusively breast-fed term babies without iron supplementation from 3 months of age. Hb level in exclusively breastfed preterm babies increase from 6 weeks onward might be effect of universal iron supplementation.

Neuro-developmental Outcome of High Risk Neonates in a Tertiary Level Hospital.

An observational longitudinal study was conducted in the Department of Neonatology and Child Developmental Center, Mymensingh Medical College Hospital (MMCH), Bangladesh during the period of September 2016 to February 2018 to find out the neuro-developmental outcome of high risk neonates at the age of 6 months. Five hundred seventy six (576) high risk neonate who were admitted in the neonatology department in Mymensingh Medical College Hospital were selected as study population by Purposive sampling technique. After admission written informed consent from parents or guardians obtained and Data was collected in a pre-designed case record form. At 6th months of age total 400 baby were came to Child Development Centre and their motor, cognition and behavior development were assessed by Bayley Scale of Infant Development and severity of cognitive, motor and behavior impairment were graded. All data were compiled, tabulated and then analyzed by computer software SPSS version 20.00. Mean age was 7.2±3.3 days. Among studied newborns 18.1% were preterm and 81.9% were term. Most of the newborn were male (63.0%). Developmental delay was found in 81.5% and neuro-developmental outcome was found normal in only 18.5% newborns. Significant delayed motor performance was found in 52% newborns where 17% had mild delay. Significantly delayed mental performance was found in 57.0% and 28.52% had mildly delayed mental performance. Non-optimal behavior was found in 57.0% newborns and14% had questionable behavior. Very low birth weight, preterm very low birth weight, home delivery, perinatal asphyxia and neonatal seizure were found to have significant relation with developmental delay. Most of the high risk neonates develop developmental delay.

Tacrolimus pharmacokinetics in Hispanic children after kidney transplantation.

Ethnic differences in drug pharmacokinetics are well recognized including that for tacrolimus (TAC) in adult subjects. However, similar knowledge among pediatric populations is missing. Our limited retrospective study compares steady-state pharmacokinetics of TAC in Hispanic versus non-Hispanic children. Serial blood samples were collected and whole blood concentrations of TAC were measured using radioimmunoassay. Compared with non-Hispanic children, Hispanic children had lower measures of drug exposure (maximum drug concentration [Cmax] and area under the drug concentration-time curve [AUC0-∞]), higher volume of distribution, and faster clearance. Interestingly, only in Hispanic children, significant correlations were found between body weight and clearance, age and volume of distribution, and Schwartz estimated glomerular filtration rate and half-life. In conclusion, our study suggests that ethnic differences exist between Hispanic and non-Hispanic children in TAC PK, and based on our preliminary findings, either a higher or more frequent TAC dosing may be required for effective immunosuppression therapy in Hispanic children.

Prevalence of soil transmitted helminthes infections among Bangladeshi males seeking job abroad.

This cross-sectional study was undertaken to identify the prevalence of soil transmitted helminthes infections and its relation to socio-demographic characteristics among Bangladeshi males seeking job abroad. The stool sample of each respondent coming for medical check up was collected by code number and examined under microscope to see the presence helminthic ova or larvae. Among 8140 respondents, 68.05% were from rural and 31.95% from urban area. As a whole, helminthic infection was found in 20.22% respondents. Off which rural and urban distribution were 27.58% and 5.22% respectively (p<0.001). Pattern of helminthes as per rural and urban basis were as follows: Ascaris lumbricoides in 12.45% & 2.61%, Trichuris trichurias in 2.61% & 2.50% samples respectively. As per age distribution was concerned, number of positive cases among rural population in all age groups was statistically higher (p<0.001) than that of urban population. Similarly, rate of combined infections among the rural population was also statistically higher (p<0.001). Higher positivity of helminthes was obtained in low-level educated respondents and in the farmers group. Since the study reflected a high proportion of helminthes infections in rural people, so it was recommended to launch regular deworming programme in rural community at national level. Health education activities on proper sanitary practice, safe disposal of excreta and taking safe food-drinks should be meaningful to eradicating helminthes infections. Further study is needed for monitoring the active status in the community.

Role of male factors in infertility and analysis of semen.

PIP: This study attempted to determine the male factors among infertile couples who attended consultation centers of obstetricians/gynecologists and endocrinologists in Dhaka, Bangladesh. Data were collected from 260 male partners of the infertile couples using a structured questionnaire. Semen specimens were collected from each respondent after a sexual abstinence of 3 days. Physical (quantity, density, morphology and motility), chemical (pH), microscopic (sperm counts and pus cells), and serological [Venereal Disease Research Laboratory (VDRL)] examinations were conducted for each specimen. Data were analyzed and interpreted using univariate and multivariate descriptive analyses. The mean standard deviation of age was 30.35 +or- 2.8 years and the majority (65.4%) was between the ages of 30 and 35 years. Duration of infertility following marriage was 6-10 years for most of the subjects (63.1%). The commonest (63.1%) method of semen specimen collection was masturbation. Volume of ejaculate varied between 2 and 3 ml in the majority of the subjects (81.2%). Microscopic examination showed that 166 (63.9%) of the subjects were normospermic, 54 (20.8%) were azospermic, and 20 (7.6%), 13 (5%), and 7 (2.5%), respectively, were severely, moderately, and mildly oligozoospermic. Only 8 (3.9%) showed necrospermia (dead spermatozoa). Only 34 (13%) subjects reported a past history of relevant illnesses. VDRL tests were negative in all the cases. A strong relationship of the presence of plenty pus cells was found with abnormal sperm motility (P 0.00001). Further study is recommended to assess the actual male infertility factors in the population.^ieng

Studies on the anaerobic (bacterial) vaginosis among the Bangladeshi women of reproductive age group.

Vaginal swab from 190 patients aged between 15 to 45 years with the complaint of excessive and foul smelling vaginal discharge and 50 healthy controls of comparable age were studied. Different diagnostic techniques used for the detection of G.vaginalis were compared. Antibiogram of isolated G.vaginalis was also performed to determine the drug sensitivity pattern. G. vaginalis were isolated from 74 patients (38.9%) and from 6 controls (12%). The rate of isolation of G. vaginalis in the vaginal swabs of patients is significantly higher (p < 0.001) as compared to controls. Vaginal flora in 91% of G. vaginalis positive patients were Gardnerella morphotype and clue cells were found in vaginal discharge in 85% of these cases. In contrast, vaginal flora of 92% control group were Lactobacilli morphotype N and no clue cell was detected. No pus cell was observed in the vaginal discharge of 66 (89.2%) of 74 patients infected with G. vaginalis. Amine test was positive in 81% G. vaginalis positive patients. The test was negative in all the control cases. Significance of these findings were discussed in detail.