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Papers by abdul baki

Journal of Bangladesh College of Physicians and Surgeons, Jul 5, 2022

Niemann Pick disease is a rare lysosomal storage disease of infancy which occurs due to accumulat... more Niemann Pick disease is a rare lysosomal storage disease of infancy which occurs due to accumulation of sphingomyelin in various tissues of the body. This leads to characteristic features of failure to thrive, marked organomegaly and neurodegenerative regression. The disease is uncommon in South East Asia and here we present this case as it is rarely found in Bangladesh.

BIRDEM Medical Journal, Aug 23, 2020

Background: Dengue is a major health problem affecting Bangladesh. The number of cases have incre... more Background: Dengue is a major health problem affecting Bangladesh. The number of cases have increased over the last few years with a large number of population being children. However data regarding dengue among children is limited. The objectives of this study were to see the clinical and laboratory profile of dengue fever (DF) in children and their outcome. Methods: This cross-sectional study was carried out in the department of Paediatrics, BIRDEM General Hospital 2 from June 2018 to August 2019. Three hundred and ten confirmed dengue cases were enrolled in the study. Their clinical profile and laboratory findings including haemoglobin (Hb%), haematocrit (Hct), total count of white blood cells (TC), differential count of white blood cells (DC), platelet count (PC), serum alanine aminotransferase (S. ALT), serum aspartate aminotransaminase (S. AST), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT) were documented. Comparison was made between the clinical and laboratory profile with severity of dengue. Results: One hundred and ninety eight (63.9%) had dengue fever, 58(18.7%) had dengue haemorrhagic fever (DHF I, II) and 54 (17.4 %) had dengue shock syndrome (DHF III and IV). All the patients had fever, vomiting was present in 40%, ascites and skin rash in 21 %, pleural effusion 20%, abdominal pain 14% and 12.2% came with shock.Thrombocytopenia, raised hct, raised liver enzymes and abnormal coagulation profile were more common in dengue haemorrhagic fever when compared to patients with dengue fever. Conclusion: Gastrointestinal features like vomiting, ascites ,abdonminal pain were common presentations. Thrombocytopenia, raised hct, raised liver enzymes, abnormal coagulation profile were more common in dengue haemorrhagic fever.

IMC Journal of Medical Science

Tramadol has become a popular analgesic in last few years. Number of studies has reported tramado... more Tramadol has become a popular analgesic in last few years. Number of studies has reported tramadol poisoning in children. Here, we report a case of tramadol poisoning in a one and half month old infant who presented with repeated seizures and apnea following accidental administration of tramadol suppository. IMC J Med Sci. 2023; 17(1): 010. DOI: https://doi.org/10.55010/imcjms.17.010 *Correspondence: Israt Zahan Ima, Department of Pediatrics, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), 1/A Ibrahim Sarani, Segunbagicha, Dhaka, Bangladesh. Email: imaisratzahan@gmail.com

Prevalence of obesity among affluent school children in Dhaka

Mymensingh medical journal : MMJ, 2010

A cross sectional study was conducted in September 2006 in one of the private schools in Dhaka, B... more A cross sectional study was conducted in September 2006 in one of the private schools in Dhaka, Bangladesh to see the prevalence of obesity among affluent school children and adolescents. Informed consent was taken from school authority to take anthropometric measurement of all school children. Standing height was measured with a stadiometer and weight with a bathroom scale. Waist and hip circumference were measured with a measuring tape. The body mass index (BMI) was calculated using weight in kilogram/(height in meter)2 formula. Obesity was defined as BMI≥95th percentile for age and sex, over weight as BMI≥85th percentile for age and sex, normal weight as BMI between 5th and 84th percentile and underweight as BMI <5th percentile. Official centers for disease control (CDC) growth chart for boys and girls age 2-20 years was used. Children and adolescents were divided into group 1(3-5 years), Group 2(6-9years), group 3(10-13 years) and group 4(14-18 years). There were a total of 4...

Ibrahim Medical College Journal, 2010

Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characte... more Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characteristics and outcomes related to neonatal jaundice in Bangladesh has not been studied so far. This study addressed the outcomes, characteristics and risks of the jaundiced newborn admitted into hospital. The babies who had significant jaundice and required phototherapy and /or exchange transfusion were investigated. A detailed history of delivery with gestational age was noted and clinical examination of the admitted newborn was done. Birth weight was recorded. The investigations included complete blood count, ABO and Rh compatibility, serum bilirubin, glucose 6 phosphate dehydrogenase (G6PD), thyroid stimulating hormone (TSH) and ultrasonography (USG) of brain. The newborns were closely monitored for the prognosis. The requirement of individualized phototherapy and exchange transfusion were also noted. Finally, the outcomes were recorded. Overall, 60 (m v. f = 58.3 v. 41.7%) newborns wer...

BIRDEM Medical Journal, 2017

Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head a... more Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head and genitourinary region are the common locations of rhabdomyosarcoma. Here, we report a 7-month-old child who presented with a protruding mass per vaginally. Abdominal examination revealed a 6 cm x 6 cm hard, irregular, non-tender mass at pelvic region. Ultrasound of abdomen showed large heterogenous pelvic mass of uterine origin. Magnetic resonance imaging of whole abdomen revealed an intrapelvic teratoma (9.5 x 7.4 x 10 cm3) with left sided hydronephrotic change as the mass was pressing the rectum and bladder. The child underwent a total hysterectomy. Histopathology result was suggestive of rahbdomyosarcoma of uterus.Birdem Med J 2017; 7(3): 242-244

BIRDEM Medical Journal, 2016

Background: A large number of neonates in intensive care unit require mechanical ventilation due ... more Background: A large number of neonates in intensive care unit require mechanical ventilation due to various disease conditions. There has been a dramatic fall in neonatal mortality in developed countries with the advent of mechanical ventilation and the concept of neonatal intensive care. But still fatality rate is very high in developing countries. So, this study or was done to identify the immediate hospital outcome of the neonates who required mechanical ventilation. Methods: This study was done in Special Care Baby Unit, BIRDEM General Hospital from July 2009 to June 2010. All neonates requiring mechanical ventilation during the study period were prospectively enrolled in this study. During the time of mechanical ventilation neonates were followed up to observe any complication till discharge or death. Results: Total 37 neonates were enrolled in the study. Among them 27 (73%) were preterm and 30 (81%) were low birth weight. Respiratory distress syndrome was the most common reason for ventilation accounting for 17 (45.9%) cases. The other indications were perinatal asphyxia (9, 24.3%), congenital pneumonia (5, 13.5%), septicemia (5, 13.5%) and meconium aspiration syndrome (1, 2.7%). The most common complication during the period of ventilation was septicemia (14, 37.8%). Other complication included pneumothorax (6, 16.2%), acute renal failure (5, 13.3%), pneumonia (5, 13.3%), pulmonary hemorrhage (3, 8.1%), intraventricular hemorrhage (2, 5.4%) and heart failure (2, 5.4%). The fatality rate was 38% and most of the infant died of perinatal asphyxia (5, 35.7%), septicemia (4, 28.5%), respiratory distress syndrome (3, 21.5%) and congenital pneumonia (2, 14.3%). Conclusion: Respiratory distress syndrome was the most common reason for mechanical ventilation followed by perinatal asphyxia and septicemia. Most common complication during mechanical ventilation was septicemia which was also a common cause of death. Another important cause of death was perinatal asphyxia.

Pediatric Oncall

Background: Both auditory brainstem response audiometry (ABR) and otoacoustic emission (OAE) are ... more Background: Both auditory brainstem response audiometry (ABR) and otoacoustic emission (OAE) are two widely used tests for a neonatal hearing screening. The OAE is easier to perform, faster, and cost-effective. However, ABR is precise with few false-positive results. We intended to know the sensitivity and specificity of OAE compared to ABR. Methods: This cross-sectional study was conducted on 282 neonates in a neonatal intensive care unit (NICU) at Dhaka. All the neonates had one or more risk factors for hearing impairment (as defined by The Joint Committee of Infant Hearing). All the study subjects were screened by an expert team with a proper environment and machine (GSI AUDIOscreener, Denmark). Initial DPOAE was done within 30 days of age and then ABR, at three months. The results were expressed as "Pass" (probably no hearing impairment) or "Refer" (further evaluation is needed). Results: Among the 282 neonates, 44(15.6%) neonates were referred at the initial screening. However, at ABR it was found that 27 (9.5%) had a hearing impairment. Among these 27, twenty-four were also referred at DPOAE (true positive). But 3 were not detected by DPOAE (false-negative). Other 20 neonates who were referred at DPOAE, were normal at ABR (false-positive). So it was estimated that the sensitivity of DPOAE for identifying hearing loss was 88.9% and the specificity was 92.2%. Conclusion: The DPOAE is a good screening test for neonatal hearing screening with high sensitivity and specificity.

Bangladesh Journal of Child Health

Introduction: Dyslipidemia increases the frequency and severity of micro and macrovascular compli... more Introduction: Dyslipidemia increases the frequency and severity of micro and macrovascular complications of type 1 diabetes (T1D). Materials & Methods: This cross-sectional study was aimed to evaluate the frequency of dyslipidaemia and its association with other risk factors in children and adolescents with type 1 diabetes. A total of 397 Type 1 diabetes (T1DM) patients aged 10-18 years who attended, Paediatric diabetes clinic in BIRDEM over one year period were included in this study. Results: The overall frequency of dyslipidaemia was 63.5% and median duration of diabetes was 3.0[2.0- 5.0 years]. The High LDL was most cmmmon dyslipidaemia (81%) in our study population. FBS was significantly higher 12.8[10.0-15.5] vs 10.8[7.7- 12.6] (p<0.0001)) and higher median HbA1c 9.9 [8.5-11.9] vs 9.0[7.9-10.5] (p<0.0001)) was found in dyslipidaemic patients. Median systolic blood pressure was higher (110 vs100) in dyslipidaemic patients ( p =.042). Conclusion: The frequency of dyslipide...

Community Based Medical Journal, 2014

Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in d... more Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries. Epidemiology and surveillance of neonatal sepsis helps in implementation of rational empirical antibiotic strategy. A cross-sectional prospective study was conducted in the special care baby unit under department of Paediatrics and Neonatology, BIRDEM General Hospital during the period of November 2008 to September 2009 to determine the pattern of bacterial agents causing neonatal sepsis and their susceptibility pattern to various antimicrobial agents. Blood cultures were performed on admitted newborn babies (0-28 days) to rule out sepsis. Antimicrobial susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Out of 720 screened blood cultures, 64 (8.9%) reported as positive and the gram positive and gram negative bacteria accounted for 6 (9.4%) and 5...

BIRDEM Medical Journal, 2020

Background: Congenital hypothyroidism is one of the most common preventable causes of mental reta... more Background: Congenital hypothyroidism is one of the most common preventable causes of mental retardation. Early diagnosis and initiation of treatment is fundamental for optimal neuro-developmental outcome in children with congenital hypothyroidism. Thyroid hormones play crucial role in early neuro-development especially in the first 2-3 years of life. If left untreated or delayed initiation of treatment in congenital hypothyroidism results in neurological and psychological deficits. Aim of this study was to assess neuro-developmental status of children with congenital hypothyroidism who were on treatment (levo-thyroxine) started at different ages. Methods: This cross-sectional study was done at paediatric endocrine outpatient department (OPD) and child development centre (CDC), BIRDEM General Hospital. Children with congenital hypothyroidism presenting at different ages who were followed up at pediatric endocrine OPD between January 2014 and January 2015 were included in the study.T...

BIRDEM Medical Journal, 2014

Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, parti... more Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries and it is caused by Gram positive bacteria, Gram negative bacteria and fungi. Thrombocytopenia has been used as an early but nonspecific marker for sepsis. About 75% of culture positive neonates have thrombocytopenia. The severity and duration of thrombocytopenia varies in different types of organism. So, the objectives of this study were to examine platelet counts and platelet indices in neonates with culture proven sepsis and to determine if there was an organism specific platelet response.Methods: This cross- sectional prospective study was carried out in the special care baby unit (SCABU) under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka from November 2008 to September 2009.Results: Total 120 newborn babies with culture positive sepsis were included in this study. Gram positive bacteria was found in 06 (5%), Gram negative ...

BIRDEM Medical Journal, 2020

Background: Dengue is a major health problem affecting Bangladesh. The number of cases have incre... more Background: Dengue is a major health problem affecting Bangladesh. The number of cases have increased over the last few years with a large number of population being children. However data regarding dengue among children is limited. The objectives of this study were to see the clinical and laboratory profile of dengue fever (DF) in children and their outcome. Methods: This cross - sectional study was carried out in the department of Paediatrics, BIRDEM General Hospital 2 from June 2018 to August 2019. Three hundred and ten confirmed dengue cases were enrolled in the study. Their clinical profile and laboratory findings including haemoglobin (Hb%), haematocrit (Hct), total count of white blood cells (TC), differential count of white blood cells ( DC), platelet count (PC), serum alanine aminotransferase ( S. ALT), serum aspartate aminotransaminase (S. AST), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT) were documented. Compar...

BIRDEM Medical Journal, 2020

Background: Fetal iron stores are affected by maternal diabetes and it is lower at birth in infan... more Background: Fetal iron stores are affected by maternal diabetes and it is lower at birth in infants of diabetic mothers (IDMs). Risks for developing iron deficiency and neurocognitive impairment are reported in IDMs. This study was done to assess serum ferritin and red cell indices in IDMs and to compare the values with infants born to mothers without diabetes mellitus. Methods: This cross-sectional study was carried out at BIRDEM General Hospital from March to October, 2018. Total 102 full term neonates were included in this study. Among them 70 neonates were IDMs and 32 were infants born to mother without diabetes mellitus. Serum ferritin and red cell indices like hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW) were measured within 48 hours of birth. Comparison of red cell indices and serum ferritin level were done between IDMs and infant...

BIRDEM Medical Journal, 2017

Background: Intraventricular hemorrhage (IVH) is common among preterm infants as many of them sur... more Background: Intraventricular hemorrhage (IVH) is common among preterm infants as many of them survive with the advancements in neonatal care. Severe IVH may lead to significant morbidity and mortality. The objective of our study is to find out the significant clinical signs of IVH in preterm neonate for early detection by ultrasonography. Methods: This prospective observational study was done in special care baby unit (SCABU), Bangladesh Institute of Research & rehabilitation of Diabetic, Endocrine & metabolic Disorder (BIRDEM) for a period of one year. Eighty five preterm neonates were included in this study. Clinical features of IVH like-convulsion, lethargy, irritability, bulged fontanelle, recurrent apnea, sudden onset of respiratory distress, sudden pallor and bradycardia were observed. Cranial ultrasound studies were done within 7 days of life in all cases to identify IVH. Result: Mean gestational age of these neonates was 31.31(±2.2) weeks & mean birth weight was 1413.42 (±330.55) gm. Among 85 preterm neonates 21(24.7%) developed IVH, confirmed by ultrasonography of brain. Clinical features like convulsion, bulged fontanel, repeated apnea & sudden pallor were significantly present in IVH group. Conclusion: Intraventricular Hemorrhage constitutes an important cause of morbidity and mortality in neonate. This study showed that clinical features like convulsion, bulged fontanel and sudden pallor had a significant relationship with intraventricular hemorrhage which will help for its early detection.

BIRDEM Medical Journal, 2017

Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head a... more Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head and genitourinary region are the common locations of rhabdomyosarcoma. Here, we report a 7-month-old child who presented with a protruding mass per vaginally. Abdominal examination revealed a 6 cm x 6 cm hard, irregular, non-tender mass at pelvic region. Ultrasound of abdomen showed large heterogenous pelvic mass of uterine origin. Magnetic resonance imaging of whole abdomen revealed an intrapelvic teratoma (9.5 x 7.4 x 10 cm3) with left sided hydronephrotic change as the mass was pressing the rectum and bladder. The child underwent a total hysterectomy. Histopathology result was suggestive of rahbdomyosarcoma of uterus.Birdem Med J 2017; 7(3): 242-244

BIRDEM Medical Journal, 2016

Background: A large number of neonates in intensive care unit require mechanical ventilation due ... more Background: A large number of neonates in intensive care unit require mechanical ventilation due to various disease conditions. There has been a dramatic fall in neonatal mortality in developed countries with the advent of mechanical ventilation and the concept of neonatal intensive care. But still fatality rate is very high in developing countries. So, this study or was done to identify the immediate hospital outcome of the neonates who required mechanical ventilation. Methods: This study was done in Special Care Baby Unit, BIRDEM General Hospital from July 2009 to June 2010. All neonates requiring mechanical ventilation during the study period were prospectively enrolled in this study. During the time of mechanical ventilation neonates were followed up to observe any complication till discharge or death. Results: Total 37 neonates were enrolled in the study. Among them 27 (73%) were preterm and 30 (81%) were low birth weight. Respiratory distress syndrome was the most common reason for ventilation accounting for 17 (45.9%) cases. The other indications were perinatal asphyxia (9, 24.3%), congenital pneumonia (5, 13.5%), septicemia (5, 13.5%) and meconium aspiration syndrome (1, 2.7%). The most common complication during the period of ventilation was septicemia (14, 37.8%). Other complication included pneumothorax (6, 16.2%), acute renal failure (5, 13.3%), pneumonia (5, 13.3%), pulmonary hemorrhage (3, 8.1%), intraventricular hemorrhage (2, 5.4%) and heart failure (2, 5.4%). The fatality rate was 38% and most of the infant died of perinatal asphyxia (5, 35.7%), septicemia (4, 28.5%), respiratory distress syndrome (3, 21.5%) and congenital pneumonia (2, 14.3%). Conclusion: Respiratory distress syndrome was the most common reason for mechanical ventilation followed by perinatal asphyxia and septicemia. Most common complication during mechanical ventilation was septicemia which was also a common cause of death. Another important cause of death was perinatal asphyxia.

Kawasaki Disease - A Rare Presentation in a Bangladeshi Infant - A Case Report

BIRDEM Medical Journal, 2012

A three month old exclusively breast fed, immunized, male baby having presented with high continu... more A three month old exclusively breast fed, immunized, male baby having presented with high continued fever for 5 days. There was no clue to any infection. It was treated as viral fever. As soon as Kawasaki Disease was suspected, on about 12th day of fever, appropriate treatment was started. The baby developed multiple coronary artery aneurysms, large pericardial effusion and a rare complication, right brachial artery thrombosis resulting in pulselessness and subsequently dry gangrene of right hand and forearm. Effusion was tapped. The baby died following amputation of the limb - probably of a major adverse cardiac event. Early diagnosis and appropriate treatment according to guidelines on time are essential for saving life of children with Kawasaki disease. Lack of awareness about the disease is a problem in our country. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12392 Birdem Med J 2011; 1(1): 43-45

Kawasaki Disease - A Rare Presentation in a Bangladeshi Infant - A Case Report

BIRDEM Medical Journal, 2012

A three month old exclusively breast fed, immunized, male baby having presented with high continu... more A three month old exclusively breast fed, immunized, male baby having presented with high continued fever for 5 days. There was no clue to any infection. It was treated as viral fever. As soon as Kawasaki Disease was suspected, on about 12th day of fever, appropriate treatment was started. The baby developed multiple coronary artery aneurysms, large pericardial effusion and a rare complication, right brachial artery thrombosis resulting in pulselessness and subsequently dry gangrene of right hand and forearm. Effusion was tapped. The baby died following amputation of the limb - probably of a major adverse cardiac event. Early diagnosis and appropriate treatment according to guidelines on time are essential for saving life of children with Kawasaki disease. Lack of awareness about the disease is a problem in our country. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12392 Birdem Med J 2011; 1(1): 43-45

Medicine Today, 2014

Neonatal sepsis is a major cause of mortality and morbidity in newborn, particularly in developin... more Neonatal sepsis is a major cause of mortality and morbidity in newborn, particularly in developing countries. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. The organisms responsible for early onset and late onset sepsis are different. The objective of the study was undertaken to determine the pattern of bacterial isolates responsible for early and late onset neonatal sepsis based on the presence of one or more clinical signs, and its outcome. A cross- sectional prospective study was carried out in the special care baby unit (SCABU) from November 2008 to September 2009 under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka, Bangladesh. Organisms were isolated from 8.9% of collected blood samples. The male female ratio of culture proven sepsis was 1.7:1. Most of the culture proven septic neonates(71.88%) were preterm & 65.63% had low birth weight. The most frequent clinical presentations of patients with culture-...

Journal of Bangladesh College of Physicians and Surgeons, Jul 5, 2022

Niemann Pick disease is a rare lysosomal storage disease of infancy which occurs due to accumulat... more Niemann Pick disease is a rare lysosomal storage disease of infancy which occurs due to accumulation of sphingomyelin in various tissues of the body. This leads to characteristic features of failure to thrive, marked organomegaly and neurodegenerative regression. The disease is uncommon in South East Asia and here we present this case as it is rarely found in Bangladesh.

BIRDEM Medical Journal, Aug 23, 2020

Background: Dengue is a major health problem affecting Bangladesh. The number of cases have incre... more Background: Dengue is a major health problem affecting Bangladesh. The number of cases have increased over the last few years with a large number of population being children. However data regarding dengue among children is limited. The objectives of this study were to see the clinical and laboratory profile of dengue fever (DF) in children and their outcome. Methods: This cross-sectional study was carried out in the department of Paediatrics, BIRDEM General Hospital 2 from June 2018 to August 2019. Three hundred and ten confirmed dengue cases were enrolled in the study. Their clinical profile and laboratory findings including haemoglobin (Hb%), haematocrit (Hct), total count of white blood cells (TC), differential count of white blood cells (DC), platelet count (PC), serum alanine aminotransferase (S. ALT), serum aspartate aminotransaminase (S. AST), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT) were documented. Comparison was made between the clinical and laboratory profile with severity of dengue. Results: One hundred and ninety eight (63.9%) had dengue fever, 58(18.7%) had dengue haemorrhagic fever (DHF I, II) and 54 (17.4 %) had dengue shock syndrome (DHF III and IV). All the patients had fever, vomiting was present in 40%, ascites and skin rash in 21 %, pleural effusion 20%, abdominal pain 14% and 12.2% came with shock.Thrombocytopenia, raised hct, raised liver enzymes and abnormal coagulation profile were more common in dengue haemorrhagic fever when compared to patients with dengue fever. Conclusion: Gastrointestinal features like vomiting, ascites ,abdonminal pain were common presentations. Thrombocytopenia, raised hct, raised liver enzymes, abnormal coagulation profile were more common in dengue haemorrhagic fever.

IMC Journal of Medical Science

Tramadol has become a popular analgesic in last few years. Number of studies has reported tramado... more Tramadol has become a popular analgesic in last few years. Number of studies has reported tramadol poisoning in children. Here, we report a case of tramadol poisoning in a one and half month old infant who presented with repeated seizures and apnea following accidental administration of tramadol suppository. IMC J Med Sci. 2023; 17(1): 010. DOI: https://doi.org/10.55010/imcjms.17.010 *Correspondence: Israt Zahan Ima, Department of Pediatrics, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), 1/A Ibrahim Sarani, Segunbagicha, Dhaka, Bangladesh. Email: imaisratzahan@gmail.com

Prevalence of obesity among affluent school children in Dhaka

Mymensingh medical journal : MMJ, 2010

A cross sectional study was conducted in September 2006 in one of the private schools in Dhaka, B... more A cross sectional study was conducted in September 2006 in one of the private schools in Dhaka, Bangladesh to see the prevalence of obesity among affluent school children and adolescents. Informed consent was taken from school authority to take anthropometric measurement of all school children. Standing height was measured with a stadiometer and weight with a bathroom scale. Waist and hip circumference were measured with a measuring tape. The body mass index (BMI) was calculated using weight in kilogram/(height in meter)2 formula. Obesity was defined as BMI≥95th percentile for age and sex, over weight as BMI≥85th percentile for age and sex, normal weight as BMI between 5th and 84th percentile and underweight as BMI <5th percentile. Official centers for disease control (CDC) growth chart for boys and girls age 2-20 years was used. Children and adolescents were divided into group 1(3-5 years), Group 2(6-9years), group 3(10-13 years) and group 4(14-18 years). There were a total of 4...

Ibrahim Medical College Journal, 2010

Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characte... more Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characteristics and outcomes related to neonatal jaundice in Bangladesh has not been studied so far. This study addressed the outcomes, characteristics and risks of the jaundiced newborn admitted into hospital. The babies who had significant jaundice and required phototherapy and /or exchange transfusion were investigated. A detailed history of delivery with gestational age was noted and clinical examination of the admitted newborn was done. Birth weight was recorded. The investigations included complete blood count, ABO and Rh compatibility, serum bilirubin, glucose 6 phosphate dehydrogenase (G6PD), thyroid stimulating hormone (TSH) and ultrasonography (USG) of brain. The newborns were closely monitored for the prognosis. The requirement of individualized phototherapy and exchange transfusion were also noted. Finally, the outcomes were recorded. Overall, 60 (m v. f = 58.3 v. 41.7%) newborns wer...

BIRDEM Medical Journal, 2017

Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head a... more Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head and genitourinary region are the common locations of rhabdomyosarcoma. Here, we report a 7-month-old child who presented with a protruding mass per vaginally. Abdominal examination revealed a 6 cm x 6 cm hard, irregular, non-tender mass at pelvic region. Ultrasound of abdomen showed large heterogenous pelvic mass of uterine origin. Magnetic resonance imaging of whole abdomen revealed an intrapelvic teratoma (9.5 x 7.4 x 10 cm3) with left sided hydronephrotic change as the mass was pressing the rectum and bladder. The child underwent a total hysterectomy. Histopathology result was suggestive of rahbdomyosarcoma of uterus.Birdem Med J 2017; 7(3): 242-244

BIRDEM Medical Journal, 2016

Background: A large number of neonates in intensive care unit require mechanical ventilation due ... more Background: A large number of neonates in intensive care unit require mechanical ventilation due to various disease conditions. There has been a dramatic fall in neonatal mortality in developed countries with the advent of mechanical ventilation and the concept of neonatal intensive care. But still fatality rate is very high in developing countries. So, this study or was done to identify the immediate hospital outcome of the neonates who required mechanical ventilation. Methods: This study was done in Special Care Baby Unit, BIRDEM General Hospital from July 2009 to June 2010. All neonates requiring mechanical ventilation during the study period were prospectively enrolled in this study. During the time of mechanical ventilation neonates were followed up to observe any complication till discharge or death. Results: Total 37 neonates were enrolled in the study. Among them 27 (73%) were preterm and 30 (81%) were low birth weight. Respiratory distress syndrome was the most common reason for ventilation accounting for 17 (45.9%) cases. The other indications were perinatal asphyxia (9, 24.3%), congenital pneumonia (5, 13.5%), septicemia (5, 13.5%) and meconium aspiration syndrome (1, 2.7%). The most common complication during the period of ventilation was septicemia (14, 37.8%). Other complication included pneumothorax (6, 16.2%), acute renal failure (5, 13.3%), pneumonia (5, 13.3%), pulmonary hemorrhage (3, 8.1%), intraventricular hemorrhage (2, 5.4%) and heart failure (2, 5.4%). The fatality rate was 38% and most of the infant died of perinatal asphyxia (5, 35.7%), septicemia (4, 28.5%), respiratory distress syndrome (3, 21.5%) and congenital pneumonia (2, 14.3%). Conclusion: Respiratory distress syndrome was the most common reason for mechanical ventilation followed by perinatal asphyxia and septicemia. Most common complication during mechanical ventilation was septicemia which was also a common cause of death. Another important cause of death was perinatal asphyxia.

Pediatric Oncall

Background: Both auditory brainstem response audiometry (ABR) and otoacoustic emission (OAE) are ... more Background: Both auditory brainstem response audiometry (ABR) and otoacoustic emission (OAE) are two widely used tests for a neonatal hearing screening. The OAE is easier to perform, faster, and cost-effective. However, ABR is precise with few false-positive results. We intended to know the sensitivity and specificity of OAE compared to ABR. Methods: This cross-sectional study was conducted on 282 neonates in a neonatal intensive care unit (NICU) at Dhaka. All the neonates had one or more risk factors for hearing impairment (as defined by The Joint Committee of Infant Hearing). All the study subjects were screened by an expert team with a proper environment and machine (GSI AUDIOscreener, Denmark). Initial DPOAE was done within 30 days of age and then ABR, at three months. The results were expressed as "Pass" (probably no hearing impairment) or "Refer" (further evaluation is needed). Results: Among the 282 neonates, 44(15.6%) neonates were referred at the initial screening. However, at ABR it was found that 27 (9.5%) had a hearing impairment. Among these 27, twenty-four were also referred at DPOAE (true positive). But 3 were not detected by DPOAE (false-negative). Other 20 neonates who were referred at DPOAE, were normal at ABR (false-positive). So it was estimated that the sensitivity of DPOAE for identifying hearing loss was 88.9% and the specificity was 92.2%. Conclusion: The DPOAE is a good screening test for neonatal hearing screening with high sensitivity and specificity.

Bangladesh Journal of Child Health

Introduction: Dyslipidemia increases the frequency and severity of micro and macrovascular compli... more Introduction: Dyslipidemia increases the frequency and severity of micro and macrovascular complications of type 1 diabetes (T1D). Materials & Methods: This cross-sectional study was aimed to evaluate the frequency of dyslipidaemia and its association with other risk factors in children and adolescents with type 1 diabetes. A total of 397 Type 1 diabetes (T1DM) patients aged 10-18 years who attended, Paediatric diabetes clinic in BIRDEM over one year period were included in this study. Results: The overall frequency of dyslipidaemia was 63.5% and median duration of diabetes was 3.0[2.0- 5.0 years]. The High LDL was most cmmmon dyslipidaemia (81%) in our study population. FBS was significantly higher 12.8[10.0-15.5] vs 10.8[7.7- 12.6] (p<0.0001)) and higher median HbA1c 9.9 [8.5-11.9] vs 9.0[7.9-10.5] (p<0.0001)) was found in dyslipidaemic patients. Median systolic blood pressure was higher (110 vs100) in dyslipidaemic patients ( p =.042). Conclusion: The frequency of dyslipide...

Community Based Medical Journal, 2014

Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in d... more Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries. Epidemiology and surveillance of neonatal sepsis helps in implementation of rational empirical antibiotic strategy. A cross-sectional prospective study was conducted in the special care baby unit under department of Paediatrics and Neonatology, BIRDEM General Hospital during the period of November 2008 to September 2009 to determine the pattern of bacterial agents causing neonatal sepsis and their susceptibility pattern to various antimicrobial agents. Blood cultures were performed on admitted newborn babies (0-28 days) to rule out sepsis. Antimicrobial susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Out of 720 screened blood cultures, 64 (8.9%) reported as positive and the gram positive and gram negative bacteria accounted for 6 (9.4%) and 5...

BIRDEM Medical Journal, 2020

Background: Congenital hypothyroidism is one of the most common preventable causes of mental reta... more Background: Congenital hypothyroidism is one of the most common preventable causes of mental retardation. Early diagnosis and initiation of treatment is fundamental for optimal neuro-developmental outcome in children with congenital hypothyroidism. Thyroid hormones play crucial role in early neuro-development especially in the first 2-3 years of life. If left untreated or delayed initiation of treatment in congenital hypothyroidism results in neurological and psychological deficits. Aim of this study was to assess neuro-developmental status of children with congenital hypothyroidism who were on treatment (levo-thyroxine) started at different ages. Methods: This cross-sectional study was done at paediatric endocrine outpatient department (OPD) and child development centre (CDC), BIRDEM General Hospital. Children with congenital hypothyroidism presenting at different ages who were followed up at pediatric endocrine OPD between January 2014 and January 2015 were included in the study.T...

BIRDEM Medical Journal, 2014

Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, parti... more Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries and it is caused by Gram positive bacteria, Gram negative bacteria and fungi. Thrombocytopenia has been used as an early but nonspecific marker for sepsis. About 75% of culture positive neonates have thrombocytopenia. The severity and duration of thrombocytopenia varies in different types of organism. So, the objectives of this study were to examine platelet counts and platelet indices in neonates with culture proven sepsis and to determine if there was an organism specific platelet response.Methods: This cross- sectional prospective study was carried out in the special care baby unit (SCABU) under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka from November 2008 to September 2009.Results: Total 120 newborn babies with culture positive sepsis were included in this study. Gram positive bacteria was found in 06 (5%), Gram negative ...

BIRDEM Medical Journal, 2020

Background: Dengue is a major health problem affecting Bangladesh. The number of cases have incre... more Background: Dengue is a major health problem affecting Bangladesh. The number of cases have increased over the last few years with a large number of population being children. However data regarding dengue among children is limited. The objectives of this study were to see the clinical and laboratory profile of dengue fever (DF) in children and their outcome. Methods: This cross - sectional study was carried out in the department of Paediatrics, BIRDEM General Hospital 2 from June 2018 to August 2019. Three hundred and ten confirmed dengue cases were enrolled in the study. Their clinical profile and laboratory findings including haemoglobin (Hb%), haematocrit (Hct), total count of white blood cells (TC), differential count of white blood cells ( DC), platelet count (PC), serum alanine aminotransferase ( S. ALT), serum aspartate aminotransaminase (S. AST), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT) were documented. Compar...

BIRDEM Medical Journal, 2020

Background: Fetal iron stores are affected by maternal diabetes and it is lower at birth in infan... more Background: Fetal iron stores are affected by maternal diabetes and it is lower at birth in infants of diabetic mothers (IDMs). Risks for developing iron deficiency and neurocognitive impairment are reported in IDMs. This study was done to assess serum ferritin and red cell indices in IDMs and to compare the values with infants born to mothers without diabetes mellitus. Methods: This cross-sectional study was carried out at BIRDEM General Hospital from March to October, 2018. Total 102 full term neonates were included in this study. Among them 70 neonates were IDMs and 32 were infants born to mother without diabetes mellitus. Serum ferritin and red cell indices like hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW) were measured within 48 hours of birth. Comparison of red cell indices and serum ferritin level were done between IDMs and infant...

BIRDEM Medical Journal, 2017

Background: Intraventricular hemorrhage (IVH) is common among preterm infants as many of them sur... more Background: Intraventricular hemorrhage (IVH) is common among preterm infants as many of them survive with the advancements in neonatal care. Severe IVH may lead to significant morbidity and mortality. The objective of our study is to find out the significant clinical signs of IVH in preterm neonate for early detection by ultrasonography. Methods: This prospective observational study was done in special care baby unit (SCABU), Bangladesh Institute of Research & rehabilitation of Diabetic, Endocrine & metabolic Disorder (BIRDEM) for a period of one year. Eighty five preterm neonates were included in this study. Clinical features of IVH like-convulsion, lethargy, irritability, bulged fontanelle, recurrent apnea, sudden onset of respiratory distress, sudden pallor and bradycardia were observed. Cranial ultrasound studies were done within 7 days of life in all cases to identify IVH. Result: Mean gestational age of these neonates was 31.31(±2.2) weeks & mean birth weight was 1413.42 (±330.55) gm. Among 85 preterm neonates 21(24.7%) developed IVH, confirmed by ultrasonography of brain. Clinical features like convulsion, bulged fontanel, repeated apnea & sudden pallor were significantly present in IVH group. Conclusion: Intraventricular Hemorrhage constitutes an important cause of morbidity and mortality in neonate. This study showed that clinical features like convulsion, bulged fontanel and sudden pallor had a significant relationship with intraventricular hemorrhage which will help for its early detection.

BIRDEM Medical Journal, 2017

Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head a... more Rhabdomyosarcoma is the soft tissue tumor derived from embryonic primary mesenchyme. Neck, head and genitourinary region are the common locations of rhabdomyosarcoma. Here, we report a 7-month-old child who presented with a protruding mass per vaginally. Abdominal examination revealed a 6 cm x 6 cm hard, irregular, non-tender mass at pelvic region. Ultrasound of abdomen showed large heterogenous pelvic mass of uterine origin. Magnetic resonance imaging of whole abdomen revealed an intrapelvic teratoma (9.5 x 7.4 x 10 cm3) with left sided hydronephrotic change as the mass was pressing the rectum and bladder. The child underwent a total hysterectomy. Histopathology result was suggestive of rahbdomyosarcoma of uterus.Birdem Med J 2017; 7(3): 242-244

BIRDEM Medical Journal, 2016

Background: A large number of neonates in intensive care unit require mechanical ventilation due ... more Background: A large number of neonates in intensive care unit require mechanical ventilation due to various disease conditions. There has been a dramatic fall in neonatal mortality in developed countries with the advent of mechanical ventilation and the concept of neonatal intensive care. But still fatality rate is very high in developing countries. So, this study or was done to identify the immediate hospital outcome of the neonates who required mechanical ventilation. Methods: This study was done in Special Care Baby Unit, BIRDEM General Hospital from July 2009 to June 2010. All neonates requiring mechanical ventilation during the study period were prospectively enrolled in this study. During the time of mechanical ventilation neonates were followed up to observe any complication till discharge or death. Results: Total 37 neonates were enrolled in the study. Among them 27 (73%) were preterm and 30 (81%) were low birth weight. Respiratory distress syndrome was the most common reason for ventilation accounting for 17 (45.9%) cases. The other indications were perinatal asphyxia (9, 24.3%), congenital pneumonia (5, 13.5%), septicemia (5, 13.5%) and meconium aspiration syndrome (1, 2.7%). The most common complication during the period of ventilation was septicemia (14, 37.8%). Other complication included pneumothorax (6, 16.2%), acute renal failure (5, 13.3%), pneumonia (5, 13.3%), pulmonary hemorrhage (3, 8.1%), intraventricular hemorrhage (2, 5.4%) and heart failure (2, 5.4%). The fatality rate was 38% and most of the infant died of perinatal asphyxia (5, 35.7%), septicemia (4, 28.5%), respiratory distress syndrome (3, 21.5%) and congenital pneumonia (2, 14.3%). Conclusion: Respiratory distress syndrome was the most common reason for mechanical ventilation followed by perinatal asphyxia and septicemia. Most common complication during mechanical ventilation was septicemia which was also a common cause of death. Another important cause of death was perinatal asphyxia.

Kawasaki Disease - A Rare Presentation in a Bangladeshi Infant - A Case Report

BIRDEM Medical Journal, 2012

A three month old exclusively breast fed, immunized, male baby having presented with high continu... more A three month old exclusively breast fed, immunized, male baby having presented with high continued fever for 5 days. There was no clue to any infection. It was treated as viral fever. As soon as Kawasaki Disease was suspected, on about 12th day of fever, appropriate treatment was started. The baby developed multiple coronary artery aneurysms, large pericardial effusion and a rare complication, right brachial artery thrombosis resulting in pulselessness and subsequently dry gangrene of right hand and forearm. Effusion was tapped. The baby died following amputation of the limb - probably of a major adverse cardiac event. Early diagnosis and appropriate treatment according to guidelines on time are essential for saving life of children with Kawasaki disease. Lack of awareness about the disease is a problem in our country. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12392 Birdem Med J 2011; 1(1): 43-45

Kawasaki Disease - A Rare Presentation in a Bangladeshi Infant - A Case Report

BIRDEM Medical Journal, 2012

A three month old exclusively breast fed, immunized, male baby having presented with high continu... more A three month old exclusively breast fed, immunized, male baby having presented with high continued fever for 5 days. There was no clue to any infection. It was treated as viral fever. As soon as Kawasaki Disease was suspected, on about 12th day of fever, appropriate treatment was started. The baby developed multiple coronary artery aneurysms, large pericardial effusion and a rare complication, right brachial artery thrombosis resulting in pulselessness and subsequently dry gangrene of right hand and forearm. Effusion was tapped. The baby died following amputation of the limb - probably of a major adverse cardiac event. Early diagnosis and appropriate treatment according to guidelines on time are essential for saving life of children with Kawasaki disease. Lack of awareness about the disease is a problem in our country. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12392 Birdem Med J 2011; 1(1): 43-45

Medicine Today, 2014

Neonatal sepsis is a major cause of mortality and morbidity in newborn, particularly in developin... more Neonatal sepsis is a major cause of mortality and morbidity in newborn, particularly in developing countries. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. The organisms responsible for early onset and late onset sepsis are different. The objective of the study was undertaken to determine the pattern of bacterial isolates responsible for early and late onset neonatal sepsis based on the presence of one or more clinical signs, and its outcome. A cross- sectional prospective study was carried out in the special care baby unit (SCABU) from November 2008 to September 2009 under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka, Bangladesh. Organisms were isolated from 8.9% of collected blood samples. The male female ratio of culture proven sepsis was 1.7:1. Most of the culture proven septic neonates(71.88%) were preterm & 65.63% had low birth weight. The most frequent clinical presentations of patients with culture-...