1
|
Low JM, Afroze S, Al Mamun MA, Afroze S, Tisha S, Hossain MA, Mannan MA, Dey SK, Amin Z, Shahidullah M. Short term Outcomes of COVID-19 Vaccines Among Lactating Mother and Child Dyads in Bangladesh: A Multi-centre, Cross-sectional Study. Matern Child Health J 2024; 28:1080-1085. [PMID: 38252330 DOI: 10.1007/s10995-023-03881-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION The aims of the study are to: (1) determine the short-term reactogenicity of WHO-approved COVID-19 vaccines (i.e., Pfizer-BioNTech, Moderna, Sinovac, Oxford-AstraZeneca, Johnson and Johnson, Covaxin) amongst lactating women and their children, and 2) evaluate lactation-related outcomes following the same vaccines in Bangladesh. METHODS This was a multi-centre, self-reported, cross-sectional study of lactating woman-child dyads in Bangladesh. Demographics, past medical history, breastfeeding history and clinical outcomes of lactating woman-child dyads at least 7 days after the last dose of vaccine were determined through a structured questionnaire. RESULTS There were 750 participants from four centres. The mean age of lactating women and children surveyed were 27.6 (SD ± 4.6) years and 10.3 (SD ± 6.7) months, respectively. Majority (81.2%; 608 of 750) received 2 doses of COVID-19 vaccinations while lactating. Almost all (99.9%; 749 of 750) vaccinated lactating women surveyed reported no change in human milk supply. More than half of the participants (56.9%; 373 of 656) reported no symptoms after both doses of COVID-19 vaccines. There were no serious adverse events such as anaphylaxis or hospital admission. Majority of the lactating women (98.9%; 742 of 750) reported that the children whom they breastfed had no symptoms such as fever or cough. DISCUSSION This large study of lactating woman-child dyads in Bangladesh, who received a diverse range of WHO-approved COVID-19 vaccines, showed no serious short-term adverse effects.
Collapse
Affiliation(s)
- Jia Ming Low
- Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Singapore, National University of Singapore, Singapore, Singapore
| | - Sharmin Afroze
- Department of Neonatology, Dr. M R Khan Shishu Hospital and Institute of Child Health, Mirpur, Dhaka, Bangladesh
| | - Mohammod Abdullah Al Mamun
- Department of Paediatric Cardiology, Bangladesh Shishu (Children) Hospital and Institute, Sher- E-Bangla Nagar, Dhaka, Bangladesh
| | - Sadia Afroze
- The Second Urban Primary Health Care Project (UPHCSDP-II), DSCC, PA-2, BAPSA, Dhaka, Bangladesh
| | | | - Md Arif Hossain
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | - Md Abdul Mannan
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | - Sanjoy Kumer Dey
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | - Zubair Amin
- Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore.
- Department of Paediatrics, Yong Loo Lin School of Singapore, National University of Singapore, Singapore, Singapore.
| | - Mohammod Shahidullah
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| |
Collapse
|
2
|
Banik G, Halim MA, Md. Abdullah AS, Oishee I, Boyce C, Dey SK, Mannan MA, Moni SC, Shabuj MKH, Jahan I, Chowdhury RM, Afroze S, Wall S, Shahidullah M. Vayu bubble continuous positive airway pressure is a promising solution with favorable treatment outcomes for respiratory distress syndrome in newborns: a qualitative study in Bangladesh. Front Pediatr 2024; 12:1359406. [PMID: 38742241 PMCID: PMC11089189 DOI: 10.3389/fped.2024.1359406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background According to Bangladesh Demographic and Health Survey (2022), neonatal mortality, comprising 67% of under-5 deaths in Bangladesh, is significantly attributed to prematurity and low birth weight (LBW), accounting for 32% of neonatal deaths. Respiratory distress syndrome (RDS) is a prevalent concern among preterm and LBW infants, leading to substantial mortality. The World Health Organization (WHO) recommends bubble continuous positive airway pressure (bCPAP) therapy, but the affordability and accessibility of conventional bCPAP devices for a large number of patients become major hurdles in Bangladesh due to high costs and resource intensiveness. The Vayu bCPAP, a simple and portable alternative, offers a constant flow of oxygen-enriched, filtered, humidified, and pressurized air. Our study, conducted in five health facilities, explores the useability, acceptability, and perceived treatment outcome of Vayu bCPAP in the local context of Bangladesh. Methods A qualitative approach was employed in special care newborn units (SCANUs) of selected facilities from January to March 2023. Purposive sampling identified nine key informants, 40 in-depth interviews with service providers, and 10 focus group discussions. Data collection and analysis utilized a thematic framework approach led by trained anthropologists and medical officers. Results Service providers acknowledged Vayu bCPAP as a lightweight, easily movable, and cost-effective device requiring minimal training. Despite challenges such as consumable shortages and maintenance issues, providers perceived the device as user-friendly, operable with oxygen cylinders, and beneficial during referral transportation. Treatment outcomes indicated effective RDS management, reduced hospital stays, and decreased referrals. Though challenges existed, healthcare providers and facility managers expressed enthusiasm for Vayu bCPAP due to its potential to simplify advanced neonatal care delivery. Conclusions The Vayu bCPAP device demonstrated useability, acceptability, and favorable treatment outcomes in the care of neonates with RDS. However, sustained quality service necessitates continuous monitoring, mentoring and retention of knowledge and skills. Despite challenges, the enthusiasm among healthcare providers underscores the potential of Vayu bCPAP to save lives and simplify neonatal care delivery. Development of Standard Operating procedure on Vayu bCPAP is required for systematic implementation. Further research is needed to determine how the utilization of Vayu bCPAP devices enhances accessibility to efficient bCPAP therapy for neonates experiencing RDS.
Collapse
Affiliation(s)
- Goutom Banik
- Health and Nutrition Sector, Save the Children Bangladesh, Dhaka, Bangladesh
| | - M. A. Halim
- Centre for Injury Prevention and Research, Dhaka, Bangladesh
| | | | - Irtifa Oishee
- Health and Nutrition Sector, Save the Children Bangladesh, Dhaka, Bangladesh
| | - Carolyn Boyce
- Save the Children Federation, Inc., Fairfield, CT, United States
| | - Sanjoy Kumer Dey
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Md Abdul Mannan
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sadeka Choudhury Moni
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Ismat Jahan
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Rumpa Mani Chowdhury
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sharmin Afroze
- Department of Neonatology, Dr. M R Khan Shishu Hospital & Institute of Child Health, Dhaka, Bangladesh
| | - Steve Wall
- Save the Children Federation, Inc., Fairfield, CT, United States
| | - Mohammod Shahidullah
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| |
Collapse
|
3
|
Chakma D, Prince MMB, Islam MH, Tanvir EM, Nabi MM, Reybroeck W, Sasanya JJ, Islam MJ, Islam MN, Talukder MSU, Shaha CK, Mannan MA, Saifullah ASM. Screening for antimicrobial residues in poultry eggs in Bangladesh using Charm II radio-receptor assay technique following validation. Food Addit Contam Part B Surveill 2023; 16:288-300. [PMID: 37381071 DOI: 10.1080/19393210.2023.2225157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
The aim of the study was to screen for the presence of antimicrobial residues in poultry eggs from Bangladesh using the Charm II radio-receptor assay in the absence of expensive confirmatory instrumentation. This was based on cut-off values as set in the validation guidelines according to Commission Decision 2002/657/EC and Commission Implementing Regulation (EU) 2021/808. Fortified eggs spiked with fixed concentrations of doxycycline, erythromycin A, sulphamethazine, and benzylpenicillin were used to determine the cut-off values and detection capabilities (CCβ). Other validation parameters included were applicability, ruggedness, and robustness. A total of 201 egg mix samples from native organic chicken, duck, and commercial farm-raised laying hens (both brown and white eggs) were tested and after analysis 13%, 10%, and 4.5% of the egg mix samples showed positive signals for sulphonamides, macrolides/lincosamides, and tetracyclines, respectively. Presence of multiple drug residues were also suspected in 11 out of 201 egg mix samples.
Collapse
Affiliation(s)
- Darmin Chakma
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - Md Maruf Billah Prince
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - Md Hedayetul Islam
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - E M Tanvir
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - Md Mahamodun Nabi
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - Wim Reybroeck
- Flanders Research Institute for Agriculture, Fisheries and Food (ILVO), Technology and Food Science Unit (T&V), Melle, Belgium
| | - James Jacob Sasanya
- International Atomic Energy Agency (IAEA), Vienna International Centre, Vienna, Austria
| | - M Jahurul Islam
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - Md Nazrul Islam
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - Md Shahabe Uddin Talukder
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - Chironjit Kumar Shaha
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - M A Mannan
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| | - A S M Saifullah
- Veterinary Drug Residue Analysis Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, Bangladesh
| |
Collapse
|
4
|
Akhtaruzzaman M, Islam MJ, Mannan MA, Sumon MA, Ebert M. Delivery of a VMAT technique with flattening filter (FF) and flattening filter free (FFF) mode for whole breast irradiation with five fractions (FAST-Forward trial). Med Dosim 2023; 48:211-215. [PMID: 37188547 DOI: 10.1016/j.meddos.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/11/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023]
Abstract
To investigate the feasibility of volumetric modulated arc therapy (VMAT) delivery for whole breast irradiation with a 5-fraction regimen according to the FAST-Forward trial. Recently, we treated 10 patients with carcinoma of the left breast after breast conserving surgery. The dose prescription to the PTV was 26 Gy in 5 fractions. Treatment plans were produced using a VMAT technique with the Eclipse treatment planning system for 6 MV flattening filter (FF) and FF free (FFF) beams. Dose volume histograms (DVHs) for the PTV and the organs at risk (OARs), the ipsilateral lung and heart, were compared with the dose constraints specified in the FAST-Forward trial (PTV, D95 > 95%, D5 < 105%, D2 < 107% and Dmax < 110%; ipsilateral lung, D15 < 8Gy; Heart, D30 < 1.5Gy and D5 < 7Gy). Furthermore, conformity index (CI), homogeneity index (HI) and dose to the heart, contralateral lung, contralateral breast, and left anterior descending artery (LAD), were also assessed. Mean ± SD D95(%), D5(%), D2(%), and Dmax (%) for PTV were 97.75 ± 1.12, 105.2 ± 0.82, 105.90 ± 0.89, 109.36 ± 1.00 (FF) and 96.46 ± 0.75, 103.97 ± 0.97, 104.70 ± 1.09, 108.58 ± 1.33 (FFF) respectively. The mean ± SD CI was 1.07 ± 0.05 (FF), 1.048 ± 0.06 (FFF) and HI was 0.11 ± 0.02 (FF), 0.10 ± 0.02 (FFF). Dose constraints for OARs were met for both treatment techniques. However, D15 (Gy) for ipsilateral lung was 3.0% lower with FFF beams. In contrast, D5 (Gy) for heart was 9.0% higher with FFF beams. The dose difference between FF and FFF beams for other OARs such as contralateral lung-D10 (Gy) contralateral breast-D5 (Gy) and LAD was up to 6.0%. Both FF and FFF methods met the acceptable criteria. However, the treatment plans with FFF mode were more conformal and provided greater target homogeneity.
Collapse
Affiliation(s)
| | | | - Md Abdul Mannan
- Labaid Cancer Hospital and Superspecialty Centre, Dhaka, Bangladesh
| | - Mostafa Aziz Sumon
- Labaid Cancer Hospital and Superspecialty Centre, Dhaka, Bangladesh; Kurmitola General Hospital, Dhaka, Bangladesh
| | - Martin Ebert
- The University of Western Australia, Perth, Australia; Sir Charles Gairdner Hospital, Perth, Australia
| |
Collapse
|
5
|
Saha S, Roy D, Jahan I, Hassan Shabuj MK, Choudhury S, Mannan MA, Shahidullah M, Dey SK. Frequency and outcome of thrombocytopenia in neonates who are at risk of developing thrombocytopenia - a prospective observational study. Bangabandhu Sheikh Mujib Medical Univ J 2023. [DOI: 10.3329/bsmmuj.v15i2.60866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Thrombocytopenia is the commonest hematological abnormality encountered in the neonatal intensive care unit (NICU). This prospective, observational study was conducted among 78 consecutive at-risk neonates admitted in NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from September 2016 to August 2017. Platelet count was measured in all at risk neonates at enrollment and less than 1,50,000/cmm was consiered as the cut off point for determining thrombocytopenia. Platelet count was measured every alternate day till discharge or normalisation of platelet count if the initial platelet count was low. If initial platelet count revealed normal, then the babies were followed up clinically if they develop any further risk condition for developing thrombocytopenia. During the period from enrollment to discharge, if any baby develops thrombocytopenia at any time then baby was defined as thrombocytopenic. Overall 39.7%patients found to be thrombocytopenic among 78 at-risk neonates. Pregnancy induced hypertension (PIH), neonatal sepsis and small for gestational age (SGA), intra uterine growth restriction(IUGR), prematurity, necrotizing enterocolitis (NEC) were significantly associated with thrombocytopenia. Sepsis and NEC were found to be independent risk factor for thrombocytopenia. Regarding outcome, length of hospital stay was significantly more in thrombocytopenic patients than non-thrombocytopenic patients. Death rate was also higher in thrombocytopenic patients in comparison to non-thrombocytopenic patients.
BSMMU J 2022; 15(2): 115-120
Collapse
|
6
|
Mhajabin S, Banik G, Islam MS, Islam MJ, Tahsina T, Ahmed FU, Islam MU, Mannan MA, Dey SK, Sharmin S, Mehran F, Khan M, Ahmed A, Al Sabir A, Sultana S, Ahsan Z, Rubayet S, George J, Karim A, Shahidullah M, El Arifeen S, Rahman AE. Newborn signal functions in Bangladesh: Identification through expert consultation and assessment of readiness among public health facilities. J Glob Health 2022. [PMCID: PMC9480864 DOI: 10.7189/jogh.12.04079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to identify a set of newborn signal functions (NSFs) that can categorize health facilities and assist policymakers and health managers in appropriately planning and adequately monitoring the progress and performance of health facilities delivering newborn health care in Bangladesh and similar low-income settings. Methods A modified Delphi method was used to identify a set of NSFs and a cross-sectional health facility assessment among the randomly selected facilities was conducted to test them in public health facilities in Bangladesh. In the modified Delphi approach, three main steps of listing, prioritizing, and testing were followed to identify the set of NSFs. Then, to finalize the set of NSFs and its variables, a total of five Delphi workshops and three rounds of Delphi surveys were conducted. Finally, 205 public health facilities located in 41 randomly selected districts were assessed for the availability and readiness of finalized NSFs using the updated tool of Bangladesh Health Facility Survey (BHFS) 2017. Results Twenty NSFs were identified and finalized, nine of which were categorized as primary NSFs, 13 as basic NSFs, 18 as comprehensive NSFs, and 20 as advanced NSFs. Almost all district hospitals (DHs), Upazila health complexes (UHCs,) and maternal and child welfare centres (MCWCs) performed the primary NSFs in the last three months. However, around one-third of the union health and family welfare centres (UH&FWCs) and very few community clinics (CCs) performed them during the same period. The basic, comprehensive, and advanced NSF readiness was inadequate and inappropriate across all types of facilities, including DHs and UHCs. Conclusions In the absence of internationally or nationally agreed-upon NSFs to measure a health facility's service availability and readiness for providing newborn care, this study becomes the first to identify and finalize a set of NSFs and to incorporate relevant variables in the health facility assessment tool which can be used to monitor the availability and readiness of a newborn care facility. The identified NSFs can also be adapted for the countries with similar contexts and can serve as a standard base to determine a global set of NSFs.
Collapse
Affiliation(s)
- Shema Mhajabin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Goutom Banik
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services, Government of Bangladesh Ministry of Health and Family Welfare, Bangladesh
| | - Md Jahurul Islam
- Directorate General of Health Services, Government of Bangladesh Ministry of Health and Family Welfare, Bangladesh
| | - Tazeen Tahsina
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Farid Uddin Ahmed
- Directorate General of Family Planning, Ministry of Health & Family Welfare, Bangladesh
| | - Mushair Ul Islam
- Directorate General of Health Services, Government of Bangladesh Ministry of Health and Family Welfare, Bangladesh
| | - Md Abdul Mannan
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | | | | | | | - Anisuddin Ahmed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Shahin Sultana
- National Institute of Population Research and Training, Dhaka, Bangladesh
| | | | | | | | | | | | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| |
Collapse
|
7
|
Akhter M, Shahidullah M, Mannan MA, Dey SK, Jahan I, Moni SC, Shabuj MK, Rahman T, Rumman M, Begum B. Clinical Risk Index for Babies II Score as a Predictor of Neonatal Death among Preterm Low Birth Weight Babies. Mymensingh Med J 2021; 30:601-608. [PMID: 34226444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Clinical risk index for babies II (CRIB II) score is simple, validated and widely used risk-adjustment instrument for predicting mortality among preterm low birth weight babies. To assess the efficacy of CRIB II score as a tool to predict the risk for neonatal death among the preterm and LBW babies admitted in NICU of BSMMU, a tertiary care hospital in Bangladesh. This prospective observational study was conducted in Department of Neonatology in BSMMU from September 2016 to August 2017. Inborn preterm neonates with gestational age ≤34 weeks admitted were enrolled in the study. CRIB-II score was calculated for each infant within 1 hour of birth from birth weight, gestational age, sex, admission temperature and base excess. The primary outcome measured in the study was neonatal death or survival up to 28 days. Total 112 patients were finally analyzed in this study. Mean CRIB II score was significantly higher in the non-survivor group compared to the survivor group (p-value <0.0001). Receiver operating characteristic (ROC) curve analysis for mortality prediction by CRIB II score, gestational age and birth weight showed AUC 0.87 (95% CI 0.76-0.97), 0.76 (95% CI 0.63-0.88) and 0.79 (95% CI 0.66-0.92) respectively. ROC curve analysis also revealed that the most suitable cut-off points for predicting mortality were 5 for CRIB II score, 32 weeks for gestational age and 1250 gram for birth weight. Using these most suitable cut-off points, CRIB II score had the highest sensitivity and specificity followed by birth weight and gestational age. In this study, CRIB II score was found to be an effective tool for predicting neonatal death among preterm LBW babies. It predicted outcome more accurately than birth weight or gestational age alone.
Collapse
Affiliation(s)
- M Akhter
- Dr Mohosina Akhter, Assistant Professor, Department of Neonatology, Mymensingh Medical College, Mymensingh, Bangladesh; E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Islam ARMT, Hasanuzzaman M, Shammi M, Salam R, Bodrud-Doza M, Rahman MM, Mannan MA, Huq S. Are meteorological factors enhancing COVID-19 transmission in Bangladesh? Novel findings from a compound Poisson generalized linear modeling approach. Environ Sci Pollut Res Int 2021; 28:11245-11258. [PMID: 33118070 PMCID: PMC7594949 DOI: 10.1007/s11356-020-11273-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/15/2020] [Indexed: 05/06/2023]
Abstract
Novel coronavirus (SARS-CoV-2) causing COVID-19 disease has arisen to be a pandemic. Since there is a close association between other viral infection cases by epidemics and environmental factors, this study intends to unveil meteorological effects on the outbreak of COVID-19 across eight divisions of Bangladesh from March to April 2020. A compound Poisson generalized linear modeling (CPGLM), along with a Monte-Carlo method and random forest (RF) model, was employed to explore how meteorological factors affecting the COVID-19 transmission in Bangladesh. Results showed that subtropical climate (mean temperature about 26.6 °C, mean relative humidity (MRH) 64%, and rainfall approximately 3 mm) enhanced COVD-19 onset. The CPGLM model revealed that every 1 mm increase in rainfall elevated by 30.99% (95% CI 77.18%, - 15.20%) COVID-19 cases, while an increase of 1 °C of diurnal temperature (TDN) declined the confirmed cases by - 14.2% (95% CI 9.73%, - 38.13%) on the lag 1 and lag 2, respectively. In addition, NRH and MRH had the highest increase (17.98% (95% CI 22.5%, 13.42%) and 19.92% (95% CI: 25.71%, 14.13%)) of COVID-19 cased in lag 4. The results of the RF model indicated that TDN and AH (absolute humidity) influence the COVID-19 cases most. In the Dhaka division, MRH is the most vital meteorological factor that affects COVID-19 deaths. This study indicates the humidity and rainfall are crucial factors affecting the COVID-19 case, which is contrary to many previous studies in other countries. These outcomes can have policy formulation for the suppression of the COVID-19 outbreak in Bangladesh.
Collapse
Affiliation(s)
| | - Md Hasanuzzaman
- Department of Disaster Management, Begum Rokeya University, Rangpur, 5400, Bangladesh
| | - Mashura Shammi
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Roquia Salam
- Department of Disaster Management, Begum Rokeya University, Rangpur, 5400, Bangladesh
| | | | - Md Mostafizur Rahman
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, 1342, Bangladesh.
| | - Md Abdul Mannan
- Bangladesh Meteorological Department, Meteorological Complex Agargaon, Dhaka, 1207, Bangladesh
| | - Saleemul Huq
- ICCCAD, Independent University Bangladesh, Dhaka, Bangladesh
| |
Collapse
|
9
|
Rahman AE, Banik G, Mhajabin S, Tahsina T, Islam MJ, Uddin Ahmed F, Islam MU, Mannan MA, Dey SK, Sharmin S, Mehran F, Khan M, Ahmed A, Al Sabir A, Sultana S, Ahsan Z, Rubayet S, George J, Karim A, Shahidullah M, Arifeen SE. Newborn signal functions in Bangladesh: identification through expert consultation and assessment of readiness among public health facilities-study protocol using Delphi technique. BMJ Open 2020; 10:e037418. [PMID: 32873672 PMCID: PMC7467517 DOI: 10.1136/bmjopen-2020-037418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION There is a set of globally accepted and nationally adapted signal functions for categorising health facilities for maternal services. Newborn resuscitation is the only newborn intervention which is included in the WHO recommended list of emergency obstetric care signal functions. This is not enough to comprehensively assess the readiness of a health facility for providing newborn services. In order to address the major causes of newborn death, the Government of Bangladesh has prioritised a set of newborn interventions for national scale-up, the majority of which are facility-based. Effective delivery of these interventions depends on a core set of functions (skills and services). However, there is no standardised and approved set of newborn signal functions (NSFs) based on which the service availability and readiness of a health facility can be assessed for providing newborn services. Thus, this study will be the first of its kind to identify such NSFs. These NSFs can categorise health facilities and assist policymakers and health managers to appropriately plan and adequately monitor the progress and performance of health facilities delivering newborn healthcare. METHODS AND ANALYSIS We will adopt the Delphi technique of consensus building for identification of NSFs and 1-2 indicator for each function while employing expert consultation from relevant experts in Bangladesh. Based on the identified NSFs and signal function indicators, the existing health facility assessment (HFA) tools will be updated, and an HFA survey will be conducted to assess service availability and readiness of public health facilities in relation to the new NSFs. Descriptive statistics (proportion) with a 95% CI will be used to report the level of service availability and readiness of public facilities regarding NSFs. ETHICS AND DISSEMINATION Ethical approval was obtained from Research Review and Ethical Review Committee of icddr, b (PR-17089). Results will be disseminated through meetings, seminars, conference presentations and international peer-review journal articles.
Collapse
Affiliation(s)
- Ahmed Ehsanur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Goutom Banik
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shema Mhajabin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tazeen Tahsina
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Jahurul Islam
- Directorate General of Health Services, Government of Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Farid Uddin Ahmed
- Director General of Family planning, Government of Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Mushair Ul Islam
- Directorate General of Health Services, Government of Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | | | | | | | | | - Anisuddin Ahmed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | | | | | - Joby George
- Save the Children Bangladesh, Dhaka, Bangladesh
| | | | | | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| |
Collapse
|
10
|
Ahmed F, Dey SK, Shahidullah M, Mannan MA, Raj AY, Sharmin S. Early Versus Delayed Enteral Feeding for Achieving Full Feeding in Preterm Growth-Restricted Infants: A Randomized Clinical Trial. Mymensingh Med J 2020; 29:638-645. [PMID: 32844806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Optimal enteral nutrition is essential for growth restricted preterm infants because if nutrition remains suboptimal during early days of life, physical and neuro-developmental outcome might be in danger. However, chronic hypoxia during antenatal period makes them susceptible for feeding intolerance and necrotising enterocolitis during post natal period. So this randomized clinical trial was conducted in the department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2018 to June 2019; to evaluate the effect of early versus delayed enteral feeding on preterm growth-restricted infants. During the study period, out of 127 infants with small for gestational age, 50 babies were enrolled and randomly assigned to either early feeding group (n=25) or late feeding group (n=25). Clinical characteristics at trial entry were well balanced between groups. Newborn enrolled in early feeding group reached full feed significantly faster than late feeding group (p=0.001; Hazard ratio 1.24). Early feeding group regained birth weight faster; experienced lesser incidence of neonatal sepsis, experienced less number of feed intolerance, had shorter mean duration of hospital stay and achieved higher weight on post natal age 16th days. All values were statistically significant. Early enteral feeding found to be safe and beneficial in reducing the time to reach full enteral feeding and better weight gain in growth restricted preterm infants.
Collapse
Affiliation(s)
- F Ahmed
- Dr Farzana Ahmed, Associate Professor & Head, Department of Paediatrics, Marks Medical College Hospital, Dhaka, Bangladesh; E-mail:
| | | | | | | | | | | |
Collapse
|
11
|
Ahmed N, Kurita N, Chowdhury MAM, Gao J, Hassan SMQ, Mannan MA, Mallik MAK, Choudhury SA, Bhuiyan MAQ, Karim MM. Atmospheric factors controlling stable isotope variations in modern precipitation of the tropical region of Bangladesh. Isotopes Environ Health Stud 2020; 56:220-237. [PMID: 32482086 DOI: 10.1080/10256016.2020.1770245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
The study investigates the factors that control the isotopic composition of tropical precipitation in Bangladesh. Daily and monthly rainfall samples were collected from three stations from 2013 to 2015: (1) northern and moderately high altitude: Sylhet, (2) middle part of the country (close to Tropic of Cancer): Savar, and (3) southern coastal region: Barisal. To escape from the post-evaporation effect, proper care was adopted. This is supported by the fact that the local meteoric water lines (LMWLs) derived for the daily precipitations of all stations mostly follow the global meteoric water line (GMWL). The results exhibit a clear seasonal and spatial variation in both δ 18O and δ 2H of precipitation. 18O is more depleted in samples collected during rainy (monsoon) seasons, while 18O enrichment is associated to winter and summer (pre-monsoon) seasons. During rainy season, intra-seasonal variability of δ18O rainfall is clearly seen and remarkable depletion of 18O is observed during the period of intense convective activity over the Bay of Bengal. This feature indicates that isotope variability in Bangladesh is controlled by large-scale convective activity rather than local rainfall amount.
Collapse
Affiliation(s)
- Nasir Ahmed
- Isotope Hydrology Division, Institute of Nuclear Science and Technology, Bangladesh Atomic Energy Commission, Savar, Bangladesh
| | - Naoyuki Kurita
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Japan
| | | | - Jing Gao
- Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - S M Quamrul Hassan
- Bangladesh Meteorological Department, Storm Warning Centre, Agargaon, Bangladesh
| | - Md Abdul Mannan
- Bangladesh Meteorological Department, Storm Warning Centre, Agargaon, Bangladesh
| | - Md Abul Kalam Mallik
- Bangladesh Meteorological Department, Storm Warning Centre, Agargaon, Bangladesh
| | | | - Md Abdul Quaiyum Bhuiyan
- Isotope Hydrology Division, Institute of Nuclear Science and Technology, Bangladesh Atomic Energy Commission, Savar, Bangladesh
| | - Md Masud Karim
- Isotope Hydrology Division, Institute of Nuclear Science and Technology, Bangladesh Atomic Energy Commission, Savar, Bangladesh
| |
Collapse
|
12
|
Dey SK, Islam S, Jahan I, Shabuj KH, Begum S, Chisti MJ, Mannan MA, Shahidullah M, Chowdhury S. Association of Hyperbilirubinemia Requiring Phototherapy or Exchange Transfusion with Hearing Impairment among Admitted Term and Late Preterm Newborn in a NICU. Mymensingh Med J 2020; 29:405-413. [PMID: 32506097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Hearing impairment is one of the deleterious ramifications of neonatal hyperbilirubinemia, but its impact during the newborn period has not been well studied in Bangladesh. This prospective observational study was conducted during January 2016 to December 2017 in the Department of Neonatology and Otolaryngology-Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh to identify the relationship between hyperbilirubinemia requiring phototherapy or exchange transfusion with hearing impairment in term and late preterm neonates. Admitted term and late preterm neonates with hyperbilirubinemia requiring either phototherapy or exchange transfusion were taken as hyperbilirubinemia group. Neonates without hyperbilirubinemia from postnatal ward were taken as control. All newborn were screened with Distortion Product Otoacoustic Emissions (DPOAE) prior to discharge from hospital. A second screen was done in referred newborn after one month of first screen. A diagnostic Auditory Brainstem Response (ABR) was performed in both the ears prior to 3 months of postnatal age if referred in both 1st and 2nd screen. Total 264 neonates included in this study; 132 in the hyperbilirubinemia and 132 in the control group. In the hyperbilirubinemia group 74(56.06%) were male and 58(43.94) were female. Mean gestational ages in the hyperbilirubinemia group and control group were 36.95±1.60 weeks and 37.01±1.67 weeks respectively. Newborn in the hyperbilirubinemia group, 4(3.03%) had hearing impairment and none had hearing impairment in the control group. Peak Total Serum Bilirubin (TSB) 23mg/dl was found as best cut off value with a sensitivity of 100% and specificity of 93% for the development hearing impairment. Hearing impairment was significantly more frequent among newborn with TSB level >23mg/dl when compared to those having TSB level ≤23mg/dl (20% vs. 0.9%, p=0.009; OR=29, 95% CI 2.79, 301). Hearing impairment was associated with newborns with hyperbilirubinemia requiring phototherapy or exchange transfusion. Peak TSB level >23mg/dl can be predictive for the development of hearing impairment.
Collapse
Affiliation(s)
- S K Dey
- Professor Dr Sanjoy Kumer Dey, Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Akther M, Moni SC, Jahan I, Shabuj KH, Dey SK, Mannan MA, Shahidullah M. Antenatal Bartter Syndrome: A Case Report. Mymensingh Med J 2020; 29:469-472. [PMID: 32506108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Bartter syndrome is an autosomal recessive disorder manifested by a defect in sodium-potassium-chloride transport in the thick ascending limb of Henle with different genetic origins and molecular pathophysiology. Bartter syndrome usually a common disease in children and in early infancy presented with persistent polyuria and associated with dehydration, electrolyte imbalance, and failure to thrive. Though prompt diagnosis and proper treatment of Bartter syndrome may improve the outcome, some children will progress to renal failure. We report a case of a 6 days-old male infant who was admitted in Neonatal Intensive Care Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh on 26 April 2018 for prematurity and low birth weight. On subsequent follow up he developed electrolyte imbalance and failure to thrive. Laboratory studies revealed hyponatremia, hypochloremic metabolic alkalosis with severe hypokalemia. When excessive chloride losses appear to be renal in origin and the patient has normal blood pressure and high levels of serum renin and aldosterone were considered as Bartter syndrome. Molecular genetic studies are indicated to identify the primary genetic defect.
Collapse
Affiliation(s)
- M Akther
- Dr Mahboba Akther, Resident Phase-B, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | | | | | | | | | | |
Collapse
|
14
|
Afroze S, Mannan MA, Dey SK, Moni SC, Shabuj MKH, Jahan I, Shahidullah M. Risk Factors and Complications of Newborns with Birth Defect: A Hospital based Case-Control Study. Bangladesh J Med Sci 2019. [DOI: 10.3329/bjms.v19i1.43886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Birth defect is one of the most important causes of neonatal mortality worldwide. In a developing country like Bangladesh many possible factors for birth defects are present which should be identified. This study was performed to determine those risk factors of birth defect and complications associated with it.
Materials and Methods: A hospital based matched case-control study was conducted from August 2015 to July 2016 in department of Neonatology along with Obstetrics and Gynecology at BSMMU. A total of 98 mother-infant pair (49 babies with birth defect as cases and 49 healthy babies without any birth defects as controls) was included in the study. For each case, a gestational age, sex and post-natal age matched control was taken. Data was collected by face to face interview. Univariate and multivariate conditional logistic regression models were computed to examine the effect of independent variables on outcome variable using SPSS 23.0. Variables with p-value <0.05 were considered statistically significant.
Results: The mean (± SD) birth weight for cases and controls were 2718.37 (±756.9) grams, and 2617.14 (±978.8) grams respectively. Cardiovascular system was the predominant system (21%) involved in birth defects. Maternal age between 20-29 years (AOR: 4.69; 95% CI 1.078, 20.448), less than four antenatal care visits (AOR: 10.07; 95% CI 2.816, 36.0), no multivitamin intake (AOR: 7.38; 95% CI 1.791, 30.365) and presence of maternal diabetes (AOR: 0.194; 95% CI 0.047, 0.799) were significantly associated with birth defects among newborns. Sepsis, asphyxia, hypoglycemia and dyselectrolytemia were the most prevalent problems among these babies. The need of intravenous fluid, thermal care, antibiotics and mechanical ventilation was also high among the cases.
Conclusion: Birth defect is an upcoming issue in current newborn health situation which need to be prioritized. Significant risk factors should be addressed timely for early diagnosis and proper management of these babies can help in reduction of mortality.
Bangladesh Journal of Medical Science Vol.19(1) 2020 p.133-140
Collapse
|
15
|
Jahan N, Mannan MA, Akter S, Afroz F, Farhana T, Nasrin M, Islam Z, Nazma N. Prematurity: A Major Cause of Early Neonatal Mortality in Ad-din Medical College Hospital. Bangladesh J Med Sci 2019. [DOI: 10.3329/bjms.v18i3.41634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: Early neonatal mortality within the fi rst 24 hours contributes substantially to overall neonatal mortality rates. Reliable cause- specific mortality data are limited; thus the estimated proportion of prematurity-related deaths nationally remains questionable. The objective was to determine the presumed causes of neonatal death within the fi rst 24 hours in Ad-din Medical College Hospital.
Methods: This is a retrospective study initiated in January of 2016 to December 2016, conducted in the delivery room and adjacent neonatal area at Ad-din Medical College Hospital. Research assistants were trained to observe and record events related to labor, neonatal resuscitation, and 24-hour postnatal course. Perinatal asphyxia (PNA) was defined as failure to initiate spontaneous respirations and/or 5-minute Apgar score <7, prematurity as gestational age <37 weeks, and low birth weight (LBW) as birth weight (BW) < 2500gm. Data were analyzed with using the SPSS version (Chi-Square test).
Results: Over 1 year, 14316 neonates were born and evaluated. Of these, 1867 were admitted to the neonatal area. Twenty seven neonates died secondary to Prematurity (55.56%), PNA (37.03%) and Meconium aspiration syndrome (7.41%).
Conclusions: Most cases of early neonatal mortality were related to Prematurity and its related complications and Perinatal asphyxia are additional important considerations. Reducing Perinatal mortality requires a multifaceted approach with attention to issues related to potential complications of Prematurity and its related complications and PNA.
Bangladesh Journal of Medical Science Vol.18(3) 2019 p.593-597
Collapse
|
16
|
Mannan MA, Dey S, Karim SMR, Iqbal S, Yasmin S, Ferdous N. Neonatal arterial blood gases & immediate outcome following perinatal asphyxia. Bangladesh J Med Sci 2019. [DOI: 10.3329/bjms.v18i2.40692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Perinatal asphyxia (PNA) remains a significant cause of death and disability despite the important advances in perinatal care in the past decades. Early neonatal mortality within the first 24 hours contributes substantially to overall neonatal mortality rates. Estimates of the incidence of perinatal asphyxia vary, in resource-rich countries is about 1/1000 live births and in resource-poor countries is probably much more common, an incidence of 5–10/1000 live births and represents the second most common cause of neonatal death (24%) after preterm birth related complications (35%). About one quarter of all neonatal deaths globally are caused by PNA & an equal number of serious neurological consequences ranging from cerebral palsy & mental retardation to epilepsy.
Objective: To determine how well neonatal arterial blood pH and base deficit predict immediate outcome (survival to discharge) following perinatal asphyxia.
Methods: This was a prospective study conducted in the delivery room and adjacent neonatal area (NICU) of Ad-din Medical College Hospital (AMCH), over 6 months from 1st June and 30th November, 2017. Research assistants were trained to observe and record events related to labor and neonatal resuscitation. Patient information was obtained which included patient characteristics (gender, birth weight & gestational age) and APGAR scores at and beyond 5 minutes. Within one hour of delivery all admitted neonates were subjected to an arterial blood gas (ABG) analysis by GEM Premier 3000 blood gas analyzer and pH and base deficit were noted. All the neonates were classified according to GA, BW and Gender. After proper cleaning the collected data were analyzed thoroughly. Descriptive analyses were performed; differences in outcome by GA, BW, Gender, APGAR scores and ABG (pH and base deficit) status were determined using analysis of variance. Analyses were performed using the Statistical Package for Social Sciences (SPSS) version (Chi-Square test).
Results: A total 50 neonates were studied in this period of which 72% survived & 28 % expired. Death was mostly observed in neonate who had very high level of base deficit (> 20mmol/L) & very low pH (pH <7.0) in 1st hour postnatal ABG. Survival rate was higher, 94.7% in >35 - <37 weeks GA group in comparison of >37 weeks (58%) of GA (p = 0.0050). The neonates with birth weight (BW ) >2000 - <2500 gm were observed 77.78% survival and 68.75% in neonates with BW >2500gm (p = 0.494). In this study most of the neonates were male (70%) & recovery rate was relatively better among baby boys (74.3%) than baby girls (66.67%) (p = 0.582). High APGAR score neonates had better rate of recovery than poor APGAR score neonates. The neonates with APGAR score 4-6 beyond 5 minutes were observed 88.33% survival & the neonates with APGAR score 0-3 beyond 5minutes were 55% survival (p= 0.028). High pH value neonates in 1st hour ABG were found higher rate of survival in comparison to low pH value neonates. It was 83.33% in pH 7.10- <7.20 neonates, 72.73% in pH 7.0- <7.10 neonates and 33.33% in pH <7.0 neonates respectively (p=0.0136). The neonates with high level of base deficit in 1st hour ABG showed lower rate of survival than low level of base deficit neonates. It was 12.5% in base deficit > 20mmol/L neonates, 33.33% in base deficit > 15 - 20mmol/L neonates & 87.18% in base deficit > 12 -15mmol/L neonates respectively (p=0.00003).
Conclusion: From this study it is concluded that initial pH and base deficit of 1st hour ABG of neonates along with APGAR score at or beyond 5 minutes is a good predictor of risk & immediate outcome following perinatal asphyxia. A good percentage of neonates recover due to early diagnosis, meticulous nursing care and timely intervention.
Bangladesh Journal of Medical Science Vol.18(2) 2019 p.238-243
Collapse
|
17
|
Moniruzzaman M, Mannan MA, Hossen Khan MF, Abir AB, Afroze M. The leaves of Crataeva nurvala Buch-Ham. modulate locomotor and anxiety behaviors possibly through GABAergic system. BMC Complement Altern Med 2018; 18:283. [PMID: 30340574 PMCID: PMC6194725 DOI: 10.1186/s12906-018-2338-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/26/2018] [Indexed: 02/08/2023]
Abstract
Background Crataeva nurvala Buch-Hum is an indigenous herb, extensively used in traditional medicines of the South Asian countries to treat inflammation, rheumatic fever, gastric irritation, and constipation. Despite this wide range of uses, very little information is known regarding its effects on the central nervous system (CNS). Therefore, this study evaluated the neuropharmacological properties of methanolic extract of Crataeva nurvala leaves (MECN) using a number of behavioral models in animals. This study also identified potentially active phytochemicals in MECN. Methods Following MECN administration (at 50, 100 and 200 mg/kg; b.w.) the animals (male Swiss albino mice) were employed in hole-cross test (HCT), open field test (OFT), and rota-rod test (RRT) to evaluate sedative properties, where anxiolytic activities were investigated using elevated plus maze (EPM), light dark box (LDB), and marble burying test (MBT). The involvement of GABAergic system was evaluated using thiopental sodium (TS)-induced sleeping time determination test. Moreover, colorimetric phytochemical tests as well as GC/MS-MS were also conducted to define the phytochemical constituents of MECN. Results MECN possesses sedative properties indicated through the dose-dependent inhibition of locomotor activities of the animals in HCT and OFT and motor coordination in RRT. MECN also exhibited prominent anxiolytic properties through decreased burying behavior in MBT, increased time spent and transitions in open arm of EPM, and increased time spent in light compartment of LDB. In addition, the treatments potentiated TS-mediated hypnosis indicating a possible participation of GABAergic system in the observed sedative and anxiolytic activities. Phytochemical screening of MECN revealed 48 different compounds in it. We reviewed and conceive that the sedative and anxiolytic effects could be due to the presence of neuroactive compounds such as phytol, D-allose, and α-Tocopherol in MECN. Conclusion The present study showed that MECN possesses sedative and anxiolytic potential which could be beneficial in treatment of anxiety and insomnia associated with different psychological disorders.
Collapse
|
18
|
Das JC, Hossain MA, Shahidullah M, Mannan MA. Off-Label Medication in Children: Responsibilities of Pediatrician and Neonatologist. Mymensingh Med J 2018; 27:912-916. [PMID: 30487515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Use of drug in pediatrics and neonatology should be rational. There are clinical situations when the use of unlicensed medicines or use of medicines outside the terms of license (i.e., 'off-label') may be judged by prescriber in the best interest of the patient. Off-label prescribing is clinically appropriate when the benefits outweigh the potential risks. Such practice is particularly common in pediatrics and neonatology where development of age-appropriate formulations is difficult. Before going to prescribe a drug on off-label basis, the clinician should be satisfied that an alternative medicine would not meet the patient's needs. The clinician should be satisfied that there is sufficient evidence base safety and efficacy on off-label drug use. Communication with legal guardian with sufficient information about proposed treatment is needed. The clinician has a responsibility to monitor the off-label use of drug. He should submit a report on suspected adverse drug reactions if he observes to the authorized body.
Collapse
Affiliation(s)
- J C Das
- Professor Jagadish C Das, Professor, Department of Neonatology, Chittagong Medical College, Chittagong, Bangladesh; E-mail:
| | | | | | | |
Collapse
|
19
|
Md Pervez AF, Badal MFA, Nabi SMN, Shabuj MKH, Dey SK, Mannan MA, Shahidullah M. Randomized Controlled Trial between Levetiracetam and Phenobarbital in the Treatment of Neonatal Seizure due to Perinatal Asphyxia. ACTA ACUST UNITED AC 2018. [DOI: 10.3329/bjch.v42i2.37761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Seizure occurs more frequently in neonatal period and incidence of seizure is 50%-68% in perinatal asphyxia. At present phenobarbital is the drug of choice for treating neonatal seizure, which has some adverse effects on neurodevelopment status. Levetiracetam is a novel antiepileptic agent well-tolerated and effective in focal, generalized and neonatal seizure as well and lacks the adverse effects like phenobarbital. The present study was undertaken to compare the safety and efficacy of levetiracetam to phenobarbital in the treatment of neonatal seizure due to perinatal asphyxia.Methodology: This interventional study (Randomized Controlled Trial) was conducted in Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital, Dhaka, Bangladesh from 1st January’ 2014 to 30th June’ 2015. Intravenous levetiracetam injection, 50 mg/kg loading followed by 10 mg/kg 8 hourly maintenance was used and phenobarbital intravenous 20-40 mg/kg loading and 2.5 mg/kg/dose 12 hourly maintenance was given as per institutional protocol.Results: Sixty-nine term asphyxiated neonates (intention to treat population) provided analyzable data. Seizure control was found significantly higher (p = 0.011) higher in levetiracetam group in comparison to phenobarbital group (71% vs 40%). Need for more than one drug was significantly lower in levetiracetan group (p=0.011). Adverse effects were found significantly (p=0.001) lower in levetiracetam group (9% vs 43%). No serious adverse effect was observed in any group and most common adverse effect was somnolence in both group followed by irritability. Restlessness, sedation and shallow breathing were found only in phenobarbital group.Conclusion: Levetiracetam is more effective and safe in comparison to phenobarbital in the treatment of neonatal seizure due to perinatal asphyxia.Bangladesh J Child Health 2018; VOL 42 (2) :67-72
Collapse
|
20
|
Mia S, Uddin ME, Kader MA, Ahsan A, Mannan MA, Hossain MM, Solaiman ZM. Pyrolysis and co-composting of municipal organic waste in Bangladesh: A quantitative estimate of recyclable nutrients, greenhouse gas emissions, and economic benefits. Waste Manag 2018; 75:503-513. [PMID: 29439929 DOI: 10.1016/j.wasman.2018.01.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 01/27/2018] [Accepted: 01/27/2018] [Indexed: 06/08/2023]
Abstract
Waste causes environmental pollution and greenhouse gas (GHG) emissions when it is not managed sustainably. In Bangladesh, municipal organic waste (MOW) is partially collected and landfilled. Thus, it causes deterioration of the environment urging a recycle-oriented waste management system. In this study, we propose a waste management system through pyrolysis of selective MOW for biochar production and composting of the remainder with biochar as an additive. We estimated the carbon (C), nitrogen (N), phosphorus (P) and potassium (K) recycling potentials in the new techniques of waste management. Waste generation of a city was calculated using population density and per capita waste generation rate (PWGR). Two indicators of economic development, i.e., gross domestic product (GDP) and per capita gross national income (GNI) were used to adopt PWGR with a projected contribution of 5-20% to waste generation. The projected PWGR was then validated with a survey. The waste generation from urban areas of Bangladesh in 2016 was estimated between 15,507 and 15,888 t day-1 with a large share (∼75%) of organic waste. Adoption of the proposed system could produce 3936 t day-1 biochar blended compost with an annual return of US $210 million in 2016 while it could reduce GHG emission substantially (-503 CO2 e t-1 municipal waste). Moreover, the proposed system would able to recover ∼46%, 54%, 54% and 61% of total C, N, P and K content in the initial waste, respectively. We also provide a projection of waste generation and nutrient recycling potentials for the year 2035. The proposed method could be a self-sustaining policy option for waste management as it would generate ∼US$51 from each tonne of waste. Moreover, a significant amount of nutrients can be recycled to agriculture while contributing to the reduction in environmental pollution and GHG emission.
Collapse
Affiliation(s)
- Shamim Mia
- Centre for Carbon, Water and Food, The University of Sydney, Camden, Australia; Department of Agronomy, Patuakhali Science and Technology University, Bangladesh.
| | - Md Ektear Uddin
- Department of Agricultural Extension and Rural Development, Patuakhali Science and Technology University, Bangladesh
| | - Md Abdul Kader
- Department of Soil Science, Bangladesh Agricultural University, Bangladesh; School of Veterinary and Life Sciences, Murdoch University, WA, Australia; School of Agriculture and Food Technology, University of South Pacific, Samoa
| | - Amimul Ahsan
- Department of Civil Engineering, Uttara University, Dhaka 1230, Bangladesh; Department of Civil and Construction Engineering, Swinburne University of Technology, Melbourne, Australia
| | - M A Mannan
- Department of Agronomy, Bangabhandhu Sheikh Mujibur Rahman Agricultural University, Bangladesh
| | | | - Zakaria M Solaiman
- School of Agriculture and Environment, University of Western Australia, Perth, Australia
| |
Collapse
|
21
|
Mannan MA, Hossain MA, Nasim J, Sabina Y, Navila F, Subir D. Immediate Outcome of Preterm Neonates with Respiratory Distress Syndrome Required Mechanical Ventilation. Mymensingh Med J 2018; 27:130-135. [PMID: 29459604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Since its inception, the neonatal mechanical ventilator has been considered an essential tool for managing preterm neonates with Respiratory Distress Syndrome (RDS) and is still regarded as an integral component in the neonatal respiratory care continuum. Mechanical ventilation of newborn has been practiced for several years with several advances made in the way. This clinical intervention study was done to analyze immediate outcome of preterm neonates with RDS required mechanical ventilation and conducted on preterm neonates with RDS required mechanical ventilation from July 2014 to June 2015. Total of 31 preterm neonates with RDS were mechanically ventilated during the study period, of which 77.42% (N=24) survived. The survival rate was highest among 30- <34 weeks (100%) gestational age (GA) group and lowest in 27- <30 weeks (56%) GA, (p=0.0036). The neonates with Birth Weight (BW) 1500gm -1800gm were higher rate of recovery which was 100% and gradually declined in 1000-1499gm (93.75%) and 800-999gm (33.33%) BW groups (p=0.00083). In this study most of the neonates were male (61.29%) but recovery rate was relatively better among baby girls (83.33%) than baby boys (73.68%) (p=0.53). RDS with surfactant therapy was better outcome than non surfactant group & survival of neonates who got surfactant were 93.33% & non surfactant neonates were 62.50%, (p=0.040). Majority (71.43%) of RDS with surfactant therapy recovered earlier <7 days than non surfactant therapy neonates (30.00%) and most of non surfactant neonates (70.00%) required prolonged ventilator support >7days (p=0.045). During the period of ventilation a total 17(54.84%) neonates developed different complications, of which ventilator associated pneumonia was (16.13%), sepsis (16.13%), pneumothorax (9.68%), pulmonary hemorrhage (6.45%) and intraventricular hemorrhage (6.45%) and among them 10 neonates recovered. No complications encountered in 14(45.16%) neonates, all of them survived, (p=0.0064). All (N=31) preterm neonates were candidate for surfactant therapy but only 15 neonates got surfactant therapy, remaining (N=16) did not get for their financial issue. As mechanical ventilation with surfactant therapy reduces the neonatal mortality; hence, facilities for neonatal ventilation and cost effective surfactant therapy should be included in the regional and central hospitals providing intensive care for neonates.
Collapse
Affiliation(s)
- M A Mannan
- Dr Md Abdul Mannan, Associate Professor of Neonatology, Department of Neonatology, Ad-din Medical College Hospital (AMCH), Dhaka, Bangladesh
| | | | | | | | | | | |
Collapse
|
22
|
Khan KA, Alam J, Nahar N, Dey SK, Mannan MA, Shahidullah M. Predicting Neonatal Hyperbilirubinemia Using First Day Serum Bilirubin Level in Late Preterm and Term Healthy Newborn. Mymensingh Med J 2017; 26:854-862. [PMID: 29208875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hyperbilirubinemia is a common problem during the neonatal period and is the most common reason for readmission after early hospital discharge of the healthy near term and term infants. This early discharge policy along with limited follow-up facilities in developing countries and inadequate communication between physicians and parents necessitates a prognostic test to predict hyperbilirubinemia in these newborns; for early and effective management and prevention of potential complication before it occurred. This observational analytical study was done to determine the predictability of day1 total serum bilirubin (TSB) level as a screening test and identify the best cutoff value which would predict neonates likely to develop significant hyperbilirubinemia. The study was carried out in the Department of Neonatology and Department of Gynecology and Obstetrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from 1st April 2013 to 31st March 2014. A TSB level of ≥17mg/dl after 72 hours was defined as significant hyperbilirubinemia. By purposive sampling method, 100 healthy late preterm and term neonates fulfilling the inclusion criteria were enrolled and 89 were finally analyzed. Among 89 neonates 14(15.74%) developed significant hyperbilirubinemia (Group II) and 75(84.26%) did not develop hyperbilirubinemia (Group I). Mean time of sample collection was similar in both groups. Mean TSB level on day1 was significantly higher in Group II (5.97±1.74mg/dl) than Group I (3.19±1.4mg/dl). By using ROC (Receiver Operating Characteristic) analysis, TSB level of 5.65mg/dl on day 1 has the best combination of sensitivity (86%) and specificity (91%) to predict neonates at risk of significant hyperbilirubinemia (AUC-0.880, p=0.001). At this cut-off PPV was 63% and NPV 97%. Total serum bilirubin level on first day of life predicts neonates at risk of subsequent significant hyperbilirubinemia and late preterm and term babies with TSB level of ≥5.65mg/dl on day 1 of life should be followed up strictly either in the hospital or in the outpatient department on day 5.
Collapse
Affiliation(s)
- K A Khan
- Dr Md Kamrul Ahsan Khan, Assistant Professor (Neonatology), Department of Pediatrics, Sheikh Sayera Khatun Medical College, Gopalgonj, Bangladesh
| | | | | | | | | | | |
Collapse
|
23
|
Dey SK, Afroze S, Jahan I, Mannan MA, Shahidullah M. Neonatal Hyperbilirubinemia associated with Minor Blood Group Incompatibility: Two Case Reports. ACTA ACUST UNITED AC 2017. [DOI: 10.3329/bjch.v41i1.33638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract not availableBangladesh J Child Health 2017; VOL 41 (1) :64-66
Collapse
|
24
|
Nahar N, Mannan MA, Dey AC, Ahmed F, Khan KA, Jahan I, Dey SK, Shahidullah M. Comparison of Serum Bilirubin with Transcutaneous Bilirubinometry in Late Preterm and Term Newborn. Mymensingh Med J 2017; 26:621-627. [PMID: 28919619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Neonatal jaundice or hyperbilirubinemia is a common occurrence in newborns. It can progress to develop kernicterus unless intervention is initiated. Severity and decision for management are usually based on serum bilirubin which needs blood sampling. Transcutaneous bilirubin measurement is a noninvasive technique and correlates closely with serum bilirubin. This Cross sectional study was done in the Department of Neonatology, Bangabandhu Sheikh Mujib Medical University from March 2013 to August 2014 to evaluate the transcutaneous bilirubin in comparison to serum bilirubin. Total 160 infants with ≥35 weeks were purposively included over a period of 16 months. Neonates with less than 35 weeks, previously exposed to phototherapy, serious illness which leads to impaired circulation, who have had exchange transfusion, having major congenital malformation were excluded. Transcutaneous bilirubin measurement was performed within 30 minutes of obtaining sample for total serum bilirubin measurements. Of the enrolled infants, mean birth weight was 2631±520 grams, postnatal age was 4.99±3.02 days ranging from 2 to 25 days and mean transcutaneous bilirubin and serum bilirubin value was 14.59±2.55 and 13.62±2.86mg/dl respectively. Mean difference of transcutaneous bilirubin and serum bilirubin was 0.97±1.01mg/dl. In the total enrolled infant, transcutaneous bilirubin and serum bilirubin values showed significant correlation (r = 0.93, r2 = 0.876, p<0.001) and this was not affected by sex, gestational age, postnatal age, and birth weight. The area under ROC curve for transcutaneous bilirubin was 87% (p value <0.001). If the cut off value of transcutaneous bilirubin was set at 15 mg/dl, then a sensitivity of 77%, specificity of 88% and accuracy of 82% were obtained. Use of transcutaneous bilirubin can reduce need for serum bilirubin in assaying neonatal jaundice; as it showed significantly high correlation with serum bilirubin. Predictive accuracy of transcutaneous bilirubin was found to be statistically significant in comparison to serum bilirubin.
Collapse
Affiliation(s)
- N Nahar
- Dr Nazmun Nahar, Resident, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Ahmed F, Mannan MA, Dey AC, Nahar N, Hasan Z, Jahan I, Dey SK, Shahidullah M. Randomized Controlled Trial of Slow Versus Rapid Enteral Feeding Advancements on the Clinical Outcomes in Very Low Birth Weight Neonates. Mymensingh Med J 2017; 26:318-326. [PMID: 28588168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Starting and advancement of feeding in very low birth weight (VLBW) infants are big challenges for the neonatal practitioners. Wide variations in volume of feed advancement have observed in earlier trials both in slow and rapid advancement groups. Volume advancement in slow advancement groups have ranged from 10ml/kg/day to 23ml/kg/day and in rapid advancement groups have ranged from 15ml/kg/day to 45ml/kg/day in earlier different studies. This randomized controlled trial was conducted in neonatal intensive care unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2013 to July 2014 to evaluate the effects of slow versus rapid rates of feeding advancements on the clinical outcomes in very low birth weight infants. A total 95 infants were enrolled into two strata according to their birth weight. Infants of each stratum were randomly allocated to either slow or rapid advancement group during initiation of feeding. After gut priming over five days, feeding was advanced daily 10ml/kg in slow and 15ml/kg in rapid advancement group for 1000 - <1250gm weighing infants. For 1250 - <1500gm weighing infants, feeding was advanced daily 15ml/kg in slow and 20ml/kg in rapid advancement group. The primary outcome variable was time taken to achieve full enteral feed. Total 82 infants completed the trial. Demographically both groups were same. Infants in the rapid feeding advancement group achieved full enteral feedings before the slow advancement group, had significantly fewer days of parenteral nutrition and regained birth weight earlier. There were no statistical differences in episodes of feed interruption, number of infants with apnea, feed intolerance or diagnosis of sepsis. Rapid enteral feeding advancements were well tolerated by very low birth weight infants.
Collapse
Affiliation(s)
- F Ahmed
- Dr Firoz Ahmed, Resident Physician, Department of Pediatrics, Sher-e-Bangla Medical College Hospital, Barisal, Bangladesh
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Jahan N, Haque ZSM, Mannan MA, Nasrin M, Afroz F, Parvez A, Rahman T, Islam M. Indication and short term outcome of Mechanical Ventilation in Neonates in a tertiary care hospital. Bangladesh J Med Sci 2017. [DOI: 10.3329/bjms.v16i1.31128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Mechanical ventilation of newborn has been practiced for several years with advances in many ways. As compared to the western world, neonatal ventilation in our country started in recent years.Subjects, Methods and Results: A retrospective chart review was conducted to analyze the common indications and outcome of neonates requiring mechanical ventilation in neonatal intensive care unit at Ad-Din Medical College Hospital from January 2012 to July 2013. Fifty eight neonates were ventilated over a period of 19 months of whom 39 (67.24%) survived. Respiratory distress syndrome was the commonest indication for ventilation (32.75%), followed by Perinatal asphyxia (18.96%), Pneumonia (13.79%), Neonatal Sepsis (13.79%), Meconium aspiration syndrome 6(10.16%) & Pneumothorax 6 (10.16%). Among the babies who survived, 35(89.74%) were managed solely with conventional ventilator and 4 babies required both conventional and High Frequency Oscillatory (HFOV) ventilation. Survival rate was higher where birth weight >2500gm (76.19%) and gestational age 34-37 weeks (88.88%). Survival rates was (69.23%) in <30 weeks and 60% in <1000 g. Prolong ventilator support was needed for Respiratory Distress Syndrome without surfactant (mean 254 hrs), Perinatal asphyxia (mean 187hrs) and Neonatal sepsis (mean 187hrs). Common complications were Pneumonia (12.06%), Pneumothorax (10.34%), sepsis (8.6%) & Pulmonary hemorrhage (3.4%). Survival rate was higher in babies requiring mechanical ventilation for respiratory distress syndrome (84.21%).Conclusion: Use of surfactant could decrease the duration of ventilation and mortality further in babies with respiratory distress syndrome.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.24-28
Collapse
|
27
|
Mannan MA, Pasha K, Nahar S, Begum K. Granulomatosis with Polyangiitis (Wegener Granulomatosis) with Unusual Presentation. Mymensingh Med J 2017; 26:205-207. [PMID: 28260778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We came across a 32 years old male admitted in our hospital with prolonged low-grade fever, haemoptysis, leg swelling, weight loss, purpuric rashes and malaena. He received anti-TB treatment at another hospital without any improvement. He was pale with bullous and purpuric lesions over legs and feet. He also had features of consolidation over both lung fields. His CRP was 312mg/L, Urine R/M/E showed 40-50 RBC/HPF, Chest X-ray showed features of bilateral consolidation, c-ANCA-10U/L (positive); Tracheal aspirate for AFB was found to be negative. We diagnosed the case as Granulomatosis with Polyangitis (WG) and started treatment with steroid and cyclophosphamide. But the patient could not be saved probably due to delay in starting management.
Collapse
Affiliation(s)
- M A Mannan
- Dr MA Mannan, Consultant, ICU, Dr Sirajul Islam Medical College & Hospital, Dhaka, Bangladesh
| | | | | | | |
Collapse
|
28
|
Dey SK, Sharker S, Jahan I, Moni SC, Shabuj KH, Chisti MJ, Mannan MA, Shahidullah M. Neonatal Transport - Experience of a Tertiary Care Hospital of Bangladesh. Mymensingh Med J 2017; 26:169-174. [PMID: 28260772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Safe transportation is mostly an unnoticed neonatal health issue in Bangladesh and no documentation is available regarding the existing practices. So this study was intended to document transport status of the referred newborn to a tertiary care hospital. This observational study included 150 out born neonates over 12 months period transported from various places to NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU) from May 2015 to April 2016. A structured data collection form was used to record information categorized into pre-transport, during transport and at admission. At admission detailed clinical assessment of the baby was done and recorded. Outcome was determined as discharge or death. Of 150 transported neonates, two-third were preterm 115(77%) & LBW 113(75%). Common indications for referral were prematurity and sepsis. Most of the patients were referred from private hospital 107(71%). Majority of newborns (86%) were referred from hospitals of Dhaka city while only 14% were referred from outside Dhaka. Referral notes were supplied in most of the cases 134(89%) but comprehensive information was obtainable only in 3 cases. Although main transport vehicle was ambulance 130(87%), medical personnel accompanied the sick baby only in 6(4%) of cases. The distance traveled was less than 10 kilometers (kms) in 95(63%) and more than 100 km in 10(7%) of enrolled neonates. Transport time was less than 1 hour in 72(48%), 1-6 hours in 66(44%) and more than 6 hours in 12(8%) of cases. Nearly two third of newborn were transported after office period, 107(72%). At admission 21(14%) babies had hypothermia, 8(7.62%) hypoglycemia, 16(11%), poor perfusion 28(19%), low saturation 27(18%). Hyperthermia & hyperglycemia were observed in 8(5%) & 7(5%) cases respectively. Of the total 150 babies referred, 17(11%) died. While comparing with discharged newborn, died newborn were more frequent sufferer of hypothermia (p value 0.007) and low saturation (p value 0.049) at admission. Premature, low birth weight and sick newborns are being transported despite lack of safe transport system.
Collapse
Affiliation(s)
- S K Dey
- Dr Sanjoy Kumer Dey, Associate Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Amin ML, Ahmed T, Mannan MA. Development of Floating-Mucoadhesive Microsphere for Site Specific Release of Metronidazole. Adv Pharm Bull 2016; 6:195-200. [PMID: 27478781 DOI: 10.15171/apb.2016.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 04/20/2016] [Accepted: 04/24/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to develop and evaluate metronidazole loaded floating-mucoadhesive microsphere for sustained drug release at the gastric mucosa. METHODS Alginate gastroretentive microspheres containing metronidazole were prepared by ionic gelation method using sodium bicarbonate as gas forming agent, guar gum as mucoadhesive polymer, and Eudragit L100 as drug release modifier. Carbopol was used for increasing the bead strength. The microspheres were characterized by scanning electron microscopy and evaluated by means of drug entrapment efficiency, in vitro buoyancy, and swelling studies. In vitro mucoadhesion and drug release studies were carried out in order to evaluate site specific sustained drug release. RESULTS All formulations showed 100% buoyancy in vitro for a prolonged period of time. Amount of guar gum influenced the properties of different formulations. The formulation containing drug and guar gum at a ratio of 1:0.5 showed the best results with 76.3% drug entrapment efficiency, 61.21% mucoadhesion, and sustained drug release. Carbopol was found to increase surface smoothness of the microspheres. CONCLUSION Metronidazole mucoadhesive-floating microspheres can be effectively used for sustained drug release to the gastric mucosa in treatment of upper GIT infection.
Collapse
Affiliation(s)
| | - Tajnin Ahmed
- Department of Pharmacy, Stamford University Bangladesh
| | | |
Collapse
|
30
|
Dey AC, Hossain MI, Afroze S, Dey SK, Mannan MA, Shahidullah M. A Survey on Current Practice of Management of Early Onset Neonatal Sepsis. Mymensingh Med J 2016; 25:243-247. [PMID: 27277355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
It was a survey type of cross sectional study where the participants were from different teaching/referral hospital across the country and was done to gather information regarding current practice of management of neonatal sepsis among paediatricians and neonatologists and was conducted on the spot during a national conference of Bangladesh Perinatal Society in December 2013. Specialists in neonatology, paediatrics, and some other disciplines working in different institutes across the country were requested to respond. Out of 150 physicians, 92 (61.33%) were neonatologists. Physicians suspected early onset neonatal sepsis (EONS) when there is history suggestive of prolonged rupture of membrane (74.77%), prolonged labour (9.33%), chorioamnionitis (7.33%) and maternal fever (2%). Clinical sepsis is found commonly (53.33%) which is later proved by laboratory evidences such as Hb%, TC, DC PBF (peripheral blood film), C-reactive protein, chest X-ray etc. Injection Ampicillin and Gentamycin are still the first choice of antibiotics (61.3%). Preferred route was intravenous (95.3%). Antibiotics were given for 7-10 days by most of the physicians (48.77%). However there is lack of uniformity among the participants in regard to taking decision about antibiotics, the choice of first line and the subsequent options of antibiotics. So, neonatal sepsis is the most important cause of neonatal mortality in the community. Therefore a standard protocolized approach for diagnosis and management of Early Onset Neonatal Sepsis may prove critical which is currently not in practice uniformly.
Collapse
Affiliation(s)
- A C Dey
- Dr Arjun Chandra Dey, Assistant Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail: acd_70@yahoo. Com
| | | | | | | | | | | |
Collapse
|
31
|
Dey AC, Hossain MI, Dey SK, Mannan MA, Shahidullah M. Neonatal Conjunctivitis Leading to Neonatal Sepsis--A Case Report. Mymensingh Med J 2016; 25:161-162. [PMID: 26931268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Neonatal conjunctivitis is the most common occular disease in neonates. Most infections are acquired during vaginal delivery. In spite most of these cases are benign; some of them may progress to systemic complications like loss of vision if left untreated. The authors present a case of a newborn who developed late onset neonatal sepsis from E. coli positive conjunctivitis. The baby was treated with Injection Meropenem and Injection Amikacin for 10 days. The course was uneventful, after that baby responded well and discharged home on 24th day.
Collapse
Affiliation(s)
- A C Dey
- Dr Arjun Chandra Dey, Assistant Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | | | | | | |
Collapse
|
32
|
Nahar N, Dey AC, Khan KA, Dey SK, Mannan MA, Shahidullah M. Salt Losing Variety of Congenital Adrenal Hyperplasia--A Case Report. Mymensingh Med J 2016; 25:179-181. [PMID: 26931272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Congenital adrenal hyperplasia is a genetic endocrinologic disorder. The severe classic form occurs in one in 15,000 births worldwide. Twenty-one-hydroxylase deficiency (21-OHD) is the most common cause in this autosomal recessive disease. It can cause virilization, ambiguous genitalia at birth and severe life threatening condition due to salt wasting. In this report we describe the clinical course of a male neonate presenting with lethargy, failure to thrive (FTT), genital pigmentation, electrolytes imbalance and high serum 17-hydroxy-progesterone (17-OHP) level and subsequently diagnosed as Congenital Adrenal Hyperplasia. After the initial crises management, the child was continued on replacement therapy. During the follow up, he was found to grow appropriately and achieving normal milestones for age.
Collapse
Affiliation(s)
- N Nahar
- Dr Nazmun Nahar, Resident, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | | | | | | | | |
Collapse
|
33
|
Mosleh T, Dey SK, Mannan MA. A Case of Organic Acidemia: Are Physicians Aware Enough? Euroasian J Hepatogastroenterol 2016; 6:89-90. [PMID: 29201734 PMCID: PMC5578568 DOI: 10.5005/jp-journals-10018-1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 12/20/2015] [Indexed: 11/23/2022] Open
Abstract
Diversity of clinical presentation of inborn errors of metabolism (IEM) gives a diagnostic challenge to the practicing physicians. In recent years there have been dramatic advances in the diagnosis and treatment of these fatal diseases, which shows improved prognosis of many of these conditions. The need for screening for IEM arises out of the fact that most cases take to irreversible effects as time progresses. Here, the main challenge is to recognize the early signs and symptoms that are also common to sick infants with other diseases. We describe a 32-day-old female infant who was finally diagnosed as a case of IEM (organic acidemia).The baby had a history of multiple neonatal intensive care unit admission. She died during her last hospital admission. The purpose of our case presentation is to provide clues to the true nature of the disease and to make physicians aware about the possibility of IEM. HOW TO CITE THIS ARTICLE Mosleh T, Dey SK, Mannan MA. A Case of Organic Acidemia: Are Physicians Aware Enough? Euroasian J Hepato-Gastroenterol 2016;6(1):89-90.
Collapse
Affiliation(s)
- Taskina Mosleh
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sanjoy Kumer Dey
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Md Abdul Mannan
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| |
Collapse
|
34
|
Abstract
Brinjal shoot and fruit borer infestation varied significantly in relation to plant age and season. The peak shoot infestation was 8.56% in the 10th week of transplanting. No infestation of BSFB was found up to 5 weeks of transplanting. The shoot infestation was initiated in the 6th week of transplanting which increased to a little higher level in the next week. Then it showed an exponential increase of shoot infestation up to 10th week after which it declined steadily. Flowering and fruit setting started in the 9th week of transplanting. Infestation of brinjal shoot and fruit borer (BSFB) shifted to fruits from shoots causing a steady declined in the trend of shoot infestation. Plant age had significant effect (r2=0.87) on fruit infestation. The fruit infestation reached the highest level (38.56%) in 14th week of transplanting. However, the level of infestation at different ages of the plant may vary depending on the location, temperature, variety etc. The shoots and fruits of brinjal plant were found to be infested by BSFB throughout the year, although the level of infestation varied. Maximum shoot and fruit infestation was found in the month of September.Bangladesh J. Agril. Res. 40(3): 399-407, September 2015
Collapse
|
35
|
Mannan MA, Jahan I, Rahman MZ, Hasan Z, Dey AC, Shahidullah M. Osteopenia of Prematurity: Are We at Risk? Mymensingh Med J 2015; 24:631-637. [PMID: 26329969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The continuous advances in intensive care have led to increased survival of premature infants. As a consequence, the problem of less imminent, slowly progressing disorders such as osteopenia of prematurity has been emerging. Osteopenia of prematurity (OOP) also called metabolic bone disease of prematurity (MBD) or rickets of prematurity is characterized by a reduction in bone mineral content usually manifest between 6th to 12th weeks of corrected gestational age. It occurs in up to 55% of infants born with weight <1000gm and 23% of infants weighing <1500gm. Clinical features of osteopenia of prematurity are mostly non-specific often appears as a late symptoms. Several biochemical markers have frequently been used as screening tools and diagnostic markers, but timing of measurements and the levels at which treatment should be initiated vary widely. Dual energy X-ray absorptiometry (DEXA) and Quantitative ultrasnogram are important diagnostic tool. Standard X-ray, a widely accepted but cannot detect osteopenia unless 20% loss of bone mineralization. The treatment of osteopenia includes provision of adequate mineral supplementation. Monitoring of serum and urinary markers are mandatory. The focus on prevention has largely centered on providing adequate intake of phosphorus and calcium but more research is needed. Till date there are neither enough data regarding clinical risk factors, valid biochemical markers which can detect premature babies at risk of osteopenia nor supplementation as well as appropriate timely management protocol is practicing in Bangladesh.
Collapse
Affiliation(s)
- M A Mannan
- Professor Md Abdul Mannan, Professor, Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | | | | | | | | |
Collapse
|
36
|
Haque SM, Jahan N, Mannan MA, Hasan M, Begum M, Rob S, Akhter M, Yasmin S, Hasnat SK. Identification of bacterial isolates in neonatal sepsis and their antimicrobial susceptibility. Mymensingh Med J 2014; 23:709-714. [PMID: 25481589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A cross-sectional descriptive study was conducted in the Neonatal Intensive Care Unit (NICU) of Ad-din Medical College Hospital during the period of January to December 2011 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 1000 screened blood cultures, 87(8.7%) reported as positive and the gram positive and gram negative bacteria accounted for 21(24.1%) and 66(75.9%) respectively. The most common gram positive organisms were Coagulase Negative Staphylococcus Aureus (CONS) (18.4%) and Staphylococcus Aureus (4.6%) and gram negative organisms were Acinetobacter (34.4%), Pseudomonas (21.8%) and Klebsiella spp. (6.9%). The susceptibilities were remarkably low to Ampicillin (20%) and Cefotaxim (29.6%) for both gram positive & gram negative isolates. Gram positive group had susceptibilities of 71.1% to Gentamicin, 85.7% to Imipenem & 100% to Amikacin & Vancomycin. Gram negative isolates showed higher sensitivities to Colistin (96.9%), Piperacillin-Tazobactum (78.7%), Imipenem (74.2%), Levofloxacillin (71.2%), respectively. Gram-negative bacteria showed high level of resistance to commonly used antibiotics (Ampicillin, Ceftazidim and Cefotaxim). Gentamicin, Amikacin, Imipenem and Levofloxacin were the most effective drugs compared to others. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care.
Collapse
Affiliation(s)
- S M Haque
- Professor Zabrul SM Haque, Professor & Director, Paediatrics and Neonatal ICU, Ad-din Medical College Hospital, Dhaka, Bangladesh; E-mail:
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Rahman ATMA, Gupta SK, Mannan MA, Nahar K. Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. Kathmandu Univ Med J (KUMJ) 2014; 10:53-9. [PMID: 23575054 DOI: 10.3126/kumj.v10i4.10996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Children with high-risk acute lymphoblastic leukemia (ALL) who have a slow response to initial chemotherapy (more than 25 percent blasts in the bone marrow on day 7) have a poor outcome despite intensive therapy. We conducted a randomized trial in which such patients were treated with either an augmented intensive regimen of post-induction chemotherapy or a standard regimen of intensive post-induction chemotherapy. OBJECTIVE To compare the effect of augmented therapy with standard intensive post induction therapy in children with high-risk ALL who entered remission after a slow response to initial therapy. METHODS Between January 2005 and December 2011, 311 children with newly diagnosed ALL who were either 1 to 9 years of age with white cell counts of at least 50,000 per cubic millimeter or 10 years of age or older, had a slow response to initial therapy, and entered remission at the end of induction chemotherapy were randomly assigned to receive standard therapy (156 children) or augmented therapy (155). Those with lymphomatous features were excluded. Event-free survival and overall survival were assessed from the end of induction treatment. RESULTS The outcome at five years was significantly better in the augmented-therapy group than in the standard-therapy group. The difference between treatments was most pronounced among patients one to nine years of age, all of whom had white-cell counts of at least 50,000 per cubic millimeter (P<0.001). Risk factors for an adverse event in the entire cohort included a white-cell count of 200,000 per cubic millimeter or higher (P=0.004). The toxic effects of augmented therapy were considerable but manageable. CONCLUSION Augmented post-induction chemotherapy results in an excellent outcome for most patients with high-risk ALL and a slow response to initial therapy.
Collapse
Affiliation(s)
- A T M A Rahman
- Department of Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh
| | | | | | | |
Collapse
|
38
|
Mannan MA, Choudhury SM, Dey AC, Dey SK, Naher BS, Shahidullah M. Newborn hearing screening: what are we missing? Bangladesh Med Res Counc Bull 2014; 40:1-5. [PMID: 26118164 DOI: 10.3329/bmrcb.v40i1.20319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objectives of the study were to demonstrate hearing status in newborns at first screening by Transient Evoked Otoacoustic Emissions and to find out the relationship between abnormal hearing screening and known risk factors. This study was conducted in the department of neonatology of Bangabandhu Sheikh Mujib Medical University in collaboration with department of otolaryngology and department of obstetrics and gynaecology. This prospective observational study included a cohort of 168 neonates from Neonatal Intensive Care Unit and neonatal Nursery (Minimal care unit). All were screened for hearing impairment using Transient Evoked Otoacoustic Emissions in out-patient department of otolaryngology by a trained audiologist before discharge from hospital. Risk factors analysed were according to the criteria of American Academy of Pediatrics. Of the total neonates screened, Refer rate was 32.7% irrespective of presence or absence of risk factors. Small for gestational age, in-utero infections, ototoxic medications, birth weight < 1500, sepsis/meningitis, hyperbilirubinemia were found to be significant risk factors (p < 0.0001). It can be recommended that hearing screening should be universally done for all newborns.
Collapse
|
39
|
Latif ZA, Pathan MF, Mannan MA, Siddiqui MNI, Ashrafuzzaman SM, Rahman MM, Sobhan MJ. Clinical experience with BIAsp 30: Results from the Bangladesh cohort of the global A1chieve study. Bangladesh Med Res Counc Bull 2013; 39:93-98. [PMID: 26118154 DOI: 10.3329/bmrcb.v39i3.20307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of A1chieve was to remedy the deficit of data on the efficacy and safety of insulin analogues in routine clinical care in less well-resourced developed countries. To present results from the Bangladesh cohort of the A1chieve study receiving BIAsp 30 ± oral anti diabetic drugs. A1chieve was a 6-month, observational study of 66,726 people with type 2 diabetes, started on insulin detemir, insulin aspart or biphasic insulin aspart (BIAsp 30) in 28 countries across four continents. A total of 1,093 subjects were recruited from 49 sites in Bangladesh and 580 subjects initiated on BIAsp 30 were studied. In the entire cohort, treatment with BIAsp 30 for 24 weeks significantly reduced mean HbA(1c) (2.8%, p < 0.001), fasting plasma glucose (4.0 mmol/L, p < 0.001) and post prandial plasma glucose (6.6 mmol/L, p < 0.001) levels from baseline. The rate of overall hypoglycaemic events in the entire cohort also reduced significantly at 24 weeks (1.86 to 0.02 events/person year, p < 0.0001). BIAsp 30 can be considered as a safe and effective option for initiating as well as intensifying insulin therapy for type 2 diabetes.
Collapse
Affiliation(s)
- Z A Latif
- Department of Endocrinology, BIRDEM Hospital, Dhaka.
| | | | | | | | | | | | | |
Collapse
|
40
|
Hossain MM, Mannan MA, Yeasmin F, Shaha CK, Rahman MH, Shahidullah M. Short-term outcome of magnesium sulfate infusion in perinatal asphyxia. Mymensingh Med J 2013; 22:727-735. [PMID: 24292304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This randomized, single blind, controlled, clinical trial was done to see the effect of magnesium sulfate infusion in perinatal asphyxia. This study was conducted in the Department of Neonatology, Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital from January, 2010 to October, 2010. Total 50 term neonates having postnatal age less than 12 hours with history of perinatal asphyxia and had history of hypoxic ischemic encephalopathy (moderate or severe) were included in this study. Patients were assigned randomly to receive either 3 doses of magnesium sulfate infusion at 250mg/kg per dose (0.5ml/kg per dose) 24 hours apart (experimental group) or 3 doses of normal saline infusion 24 hours apart (placebo-controlled group). Both groups also received supportive care according to the unit protocol for perinatal asphyxia. Baseline characteristics of 50 neonates had no differences in gestational age, birth weight, gender, mode and place of delivery, parity, ANC, liquor colour and hypoxic-ischemic encephalopathy (HIE) staging and mean age of intervention between the experimental and controlled groups. The mean serum magnesium at admission was 1.6±0.3mg/dl and 1.8±0.4mg/dl and after 48 hours was 3.9±0.6mg/dl and 1.9±0.2mg/dl in experimental group and in controlled group respectively. There was no significant difference or alteration in colour, heart rate, respiration, capillary filling time/blood pressure and oxygen saturation between the experimental and control groups. At discharge, 26% (5 of 19) of infants in the experimental group had neurological abnormalities, compared with 61% (11 of 18) of infants in the control group. At discharge experimental group were received more (78% vs. 44%) oral feedings by sucking compared with the controlled group. There is no significant difference in Electroencephalographic (EEG) abnormalities between groups. Good short-term outcomes at discharge were seen more (60% vs. 32%) in the experimental group, compared with the placebo-controlled group. The overall mortality rate in our study was 26%. Postnatal magnesium sulfate infusion is effective in improving short-term outcomes in neonate with perinatal asphyxia.
Collapse
Affiliation(s)
- M M Hossain
- Dr Md Monir Hossain, Assistant Professor, Department of Neonatology, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh
| | | | | | | | | | | |
Collapse
|
41
|
Abstract
DOI: http://dx.doi.org/10.3329/bjch.v36i2.13084 Bangladesh J Child Health 2012; Vol 36 (2): 82-89
Collapse
|
42
|
Mannan MA, Rahman MH, Ara I, Afroz H. Prevalence and Pregnancy Outcome of Gestational Diabetes Mellitus Among Bangladeshi Urban Pregnant Women. ACTA ACUST UNITED AC 2012. [DOI: 10.3329/jom.v13i2.12749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the prevalence of gestational diabetes mellitus (GDM) among the pregnant women of Dhaka city and to find out the consequences or effects of GDM on pregnancy outcome. Materials and methods: This was a descriptive type of cross sectional study followed by cohort type of study, conducted in different hospitals in Dhaka city. Initially 960 pregnant women of 24th to 28th weeks were selected purposively; plasma glucose was measured at fasting and two hours after taking 75g oral glucose load. Modified method of Carpenter and Coustan criteria was followed to diagnose GDM. For each GDM case diagnosed, one non-GDM pregnant women was taken as control after matching age and parity. Both groups were followed up to 4 wks after delivery to find out maternal and neonatal mortality and morbidities. Results: Out of 960 pregnant women 72 were GDM positive (7.5%).There was no maternal mortality but morbidities like hydramnions (p<0.001)), pre-eclampsia (p<0.001)), urinary tract infection (p<0.05), puerperial sepsis (p<0.05)) and surgical interventions (p<0.001) were more prevalent in GDM compared to non-GDM groups. The prevalence of antipartum haemorrhage, post partum haemorrhage, and eclampsia did not vary between the groups. There was one still birth, one perinatal mortality (due to respiratory distress syndrome) and one congenital anomaly observed in neonates of GDM mothers. More pre-term (p<0.01), post-term (p<0.01), low birth weight (p<0.001) and macrosomic (p<0.001) babies were found among the babies of GDM mothers than non-GDM mothers. More babies also suffered from neonatal jaundice (p<0.05) and respiratory distress syndrome (p<0.05) in GDM groups than non GDM groups. Conclusion: The prevalence of GDM in urban Bangladeshi population is about 7.5%. Maternal morbidities like hydramnios, pre-eclampsia, infections and operative interventions were observed more in GDM mothers. Pre-term, post-term and LBW babies alone with perinatal morbidities like respiratory distress syndrome, macrosomia and neonatal jaundice were more common in babies of GDM mothers. DOI: http://dx.doi.org/10.3329/jom.v13i2.12749 J Medicine 2012; 13 : 147-151
Collapse
|
43
|
Asaduzzaman AKM, Rafiquzzaman M, Aich ML, Mannan MA, Alam MR, Islam MT, Sarder MAR. Caldwel-Luc operation without intranasal antrostomy. Bangladesh J of Otorhinolaryngology 2012. [DOI: 10.3329/bjo.v18i2.12007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction: Sub-labial antrostomy also known as Caldwel-Luc operation is a well-accepted procedure to remove any diseased mass, organic tissue or non-organic foreign body from maxillary antrum. The proceedings of this operation are though complex but not complicated if done by an expert hand. In addition to sub-labial approach this procedure is followed by an intranasal antrostomy to facilitate future drainage and through which the antral pack is introduced and removed post-operatively.Methods: In our series of 30 patients, we performed the same procedure through sub-labial approach only. No intranasal antrostomy were done. Also we opened the antrum by a small hole made over antero-lateral wall of the antrum.Results: The adopted method decreased the post-operative morbidity and also reduced the period of healing. No patient developed any major complication like oro-antral fistula either on immediate or long term follow-up up to one year. Only one (3.33%) patient had a temporary obstruction in drainage of collection in antrum even after not performing the intranasal antrostomy.Conclusion: Thus we conclude that this modification of Caldwel-Luc operation only through sub-labial approach without performing intranasal antrostomy could be accepted as an innovative procedure for better outcome of the patients as well as its cost-effectiveness DOI: http://dx.doi.org/10.3329/bjo.v18i2.12007 Bangladesh J Otorhinolaryngol 2012; 18(2): 156-160
Collapse
|
44
|
Mannan MA, Jahan N, Dey SK, Uddin MF, Ahmed S. Maternal and foetal risk factor and complication with immediate outcome during hospital stay of very low birth weight babies. Mymensingh Med J 2012; 21:639-647. [PMID: 23134911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This prospective study was done to find out the maternal and foetal risk factors and complications during hospital stay. It was conducted in Special Care Neonatal Unit (SCANU), Department of Child Health, Bangabandhu Memorial Hospital (BBMH), University of Science and Technology Chittagong (USTC) from1st October 2001 to 30th March 2002 and cases were 35 very low birth weight (VLBW) newborns. Common complications of VLBW babies of this series were frequent apnea (40%), Septicemia (25.71%), Hypothermia (17.14%), NEC (14.28%), Convulsion (11.43%), Hyper-bilirubinaemia (8.57%), Anemia (5.71%), IVH (5.71%), RDS (2.86%), HDN (2.86%), CCF (2.86%), ARF (2.86%), either alone or in combination with other clinical conditions. Newborns 62.86% male, 37.14% female & their mortality rate were 40.91% & 38.46% respectively; Preterm 88.57% & their mortality (41.93%) were higher than term babies (25.00%); AGA 62.86%, SGA 37.14% & mortality rate of AGA babies (45.46%) were higher than of SGA (30.77%) babies. The mortality rate of VLBW infants of teen age (≤ 18 years) mothers (57.14%) & high (≥ 30 years) aged mothers (50.00%) were higher than average (19-26 yrs) maternal age mothers (33.33%). Mortality rate was higher among the babies of primi (41.67%) than multiparous (36.36%), poor socioeconomic group (53.33%) than middle class (30.00%) & mothers on irregular ANC (47.83%) than regular ANC (25.00%). It has been also noted the mortality rate of home delivered babies (50.00%) higher than institutional delivered (34.78%) babies; higher in LUCS babies (46.15%) than normal vaginal delivered babies (31.58%); higher in the babies who had antenatal maternal problem (48.15%) than no maternal problems babies (12.50%); higher in the babies who had fetal distress (50.00%) and twin (46.67%) than no foetal risk factors (28.57%) during intrauterine life; higher in the babies who had problems at admission (46.67%) than no problems (35.00%); and mortality higher in twin (46.67%) than singleton babies (35.00%). Maximum VLBW babies who died during hospital stay had multiple problems and mortality was varied from ?60-100%. The babies who had frequent apnea have been carried relative better outcome (mortality rate 35.72%). In this study out of total 35 studied baby 21(60.00%) survived and 14(40.00%) died. Frequent apnea, sepsis, hypothermia, NEC, convulsion, jaundice, anemia, IVH, and RDS are common complications in VLBW babies. Male sex, prematurity, primiparity, average (middle) socio-economic status, irregular ANC, preterm labor, toxemia of pregnancy, prolonged rupture of membrane, malnutrition, multiple gestations and foetal distress are risk factor for VLBW delivery. Clinical outcome depends on maturity, birth weight, centile for weight, maternal age, parity, maternal nutrition & socio-economic status, ANC, place & mode of delivery, maternal problems during antenatal & perinatal period, number of gestation, fetal condition, presentation at admission, postnatal problems, time of start of management & referral and level of care.
Collapse
Affiliation(s)
- M A Mannan
- Department of Neonatology, Ad-din Medical College Hospital, Dhaka, Bangladesh
| | | | | | | | | |
Collapse
|
45
|
Begum M, Jahan S, Tawfique M, Mannan MA. Out come of induction of remission in undernourished children with acute lymphoblastic leukaemia. Mymensingh Med J 2012; 21:691-695. [PMID: 23134919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Acute lymphoblastic leukaemia (ALL) is the most common childhood leukaemia. On the other hand under-nutrition is a common problem in our country. This prospective study was conducted to see the outcome of induction of remission in undernourished children with acute lymphoblastic leukaemia. This study was carried out in the department of Paediatric hematology and oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period from November 2002 to October 2004. A total of sixty (60) children who were diagnosed as acute lymphoblastic leukaemia in 1 to 15 years of age were included in this study. But the children with previous history of congenital disease and that of chemotherapy or steroid were excluded from this study. Patients were divided into two groups on the basis of Z score of weight for age. Thirty (30) children those with Z score- 2 or less were classified as undernourished and was labeled as Group A and another thirty (30) patient those Z score above-2 were classified as well nourished and was placed in Group B, After inclusion into the study, completion of induction of remission was monitored by physical examination and laboratory investigations. The result showed that mean age in Group A was 77.16 ± 7.07 months and that in Group B was 74.13 ± 5.09 months with male preponderance in both the groups. Mean body weight in Group A was 14.55 ± 0.76 Kg and that in Group B was 21.40 ± 1.05 kg (p<0.001). Children in Group A required 39.06 ± 0.72 days to complete induction but in Group B it required 31.63 ± 0.17 days (p<0.04). Hospital stay in Group A children was 52.10 ± 1.08 days and in Group B 42.37 ± 0.50 (p<0.002). The result suggested that under nutrition has an influence on the out come of induction of remission in undernourished children with acute lymphoblastic leukaemia. So appropriate measures are essential to improve nutritional status of children for successful management of ALL in children.
Collapse
Affiliation(s)
- M Begum
- Department of Paediatric Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka-1212, Bangladesh
| | | | | | | |
Collapse
|
46
|
Shah S, Rahman MA, Mannan MA. Nutritional parameters in children with cancer. Mymensingh Med J 2012; 21:522-528. [PMID: 22828554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The study was conducted in the Departments of Pediatric Haemato-Oncology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh from January 2007 to May 2009. Total 44 children (34 males and 10 females) aged between 10 months and 12 years with newly diagnosed malignancy. Nutritional status of 44 children with newly diagnosed malignancy was evaluated by anthropometric, hematological results and biochemical parameters before initiating therapy and response to therapy was assessed during follow up. Malnutrition was seen in 56.8% children by weight for age criteria (WFA <-2z). Low hemoglobin was found in 82% children, 25% had low total proteins (<5.7g/dL), 20.5% low serum albumin (<3.2g/dL), 27.3% low serum transferrin (<210mg/dL) and 16.3% low serum iron (<60μg/dL). Mean anthropometric and biochemical parameters were higher among the survivors compared to non-survivors. Significant difference between the well nourished and the malnourished group was detected in the achievement of remission/response (69.5% vs. 38.1%), delays in therapy (8.7% vs. 38.1%) and mortality (30.5% vs. 61.9%). Complications like febrile neutropenia and bleeding were more in the malnourished group. A statistically significant higher incidence of infection was seen in children with serum iron <60μg/dL than those with higher values of serum iron (42.8% vs. 8%).
Collapse
Affiliation(s)
- S Shah
- Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh
| | | | | |
Collapse
|
47
|
Khan TH, Shahidullah M, Mannan MA, Nahar N. Effect of recombinant human granulocyte colony stimulating factor (rhG-CSF) for the treatment of neonates in presumed sepsis with neutropenia. Mymensingh Med J 2012; 21:469-474. [PMID: 22828545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Bacterial sepsis continues to be an important cause of morbidity and mortality in neonates. In newborn with presumed sepsis, short-term treatment with rhG-CSF increased the neutrophil count and more importantly improved survival. The objective of the study was to evaluate the effect of rhG-CSF for the treatment of neonates in presumed sepsis with neutropenia. This interventional study was conducted in the Department of Neonatology, BSMMU, Dhaka during July 2009 to May 2010. Total 30 neonates of presumed sepsis with absolute neutrophil count ≤5000/cumm, age<28 days and birth weight 1000-2000g were included in the study. A subcutaneous injection of rhG-CSF (10μgm/kg/day) was administered to 15 neonates for 5 consecutive days (study group) and 15 neonates did not receive it (control group) in addition to standard antibiotic protocol for neonatal sepsis. Baseline characteristics of 30 neonates shows male/female ratio, weight on admission, gestational age were similar in both groups. Among 30 neonates of clinically presumed sepsis 7(23%) were culture proven. E. coli was the most common organism. After 24 hours of treatment mean ANC was increased more in study group (p<0.05) compared to control group. Mean ANC after 72 hours of treatment was increased significantly in study group than control group: 5940.00 versus 5706.00 (p=0.01). At the end of treatment, the mean ANC was higher than that of control (p=0.001). Twelve neonates in study group and ten neonates in control group survived to hospital discharge. The mortality rate in the study group 3/15(20%) and in control group 5/15(33%) were not significant. Duration of hospital stay was less in study group but not significant. The study concluded that before routine use of rhG-CSF in neonatal sepsis with neutropenia further large scale, multi-centre, randomized, placebo controlled trial are needed to validate the beneficial effect.
Collapse
Affiliation(s)
- T H Khan
- Department of Neonatology, Dhaka Medical College Hospital, Dhaka, Bangladesh.
| | | | | | | |
Collapse
|
48
|
Mannan MA, Shahidulla M, Salam F, Alam MS, Hossain MA, Hossain M. Postnatal development of renal function in preterm and term neonates. Mymensingh Med J 2012; 21:103-108. [PMID: 22314463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The study was done to determine the renal function in preterm and term newborn infants in the neonatology unit of the Department of Paediatrics and Labour Ward of the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of February 2002 to February 2003. Sixty physiologically stable newborn infants were enrolled in this study, 40 of those were preterm and 20 were term. The gestational ages of preterm and term babies were 35.6±4.7 and 39.10±1.41 weeks respectively. Mean weight of preterm babies was 1840±410 gm and term babies was 3150±340 gm respectively. Male to female ratio was1.6:1. The concentration of serum creatinine was high during the first week of life in both the term and preterm babies. The concentration decreased in both the groups during the subsequent 3 weeks. Although creatinine values were significantly high in preterm babies than the term babies at first week (p<0.001), the values reach to almost similar at 3rd week of life. A negative correlation was found between serum creatinine and gestational age (r=0.86, p<0.001). Creatinine clearance was found low at birth, the lowest values being observed in the most premature infants (p<0.0001) and was increased in the subsequent 3 weeks of the study period. Creatinine clearance showed a positive correlation to gestational age from the first week onwards (r=0.87, p<0.001). Fifteen percent preterm babies were hyponatraemic and in all term babies serum level of sodium was within normal limit. Fractional excretion of sodium was high in preterm neonate than the term neonate especially in early weeks of life (p<0.001). The value correlated negatively to gestational age (r=0.67, p<0.001). It was evident from the present study that the renal function is significantly lower in preterm neonates than term neonates. The study also indicates that the maturation of renal function occurs earlier in the term babies than the preterm babies.
Collapse
Affiliation(s)
- M A Mannan
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh
| | | | | | | | | | | |
Collapse
|
49
|
Rahman MH, Hoque MA, Mannan MA. 17β-hydroxysteroid dehydrogenase-3 deficiency in disorder of sex development. Mymensingh Med J 2012; 21:170-174. [PMID: 22314477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 29 years old patient, claimed to be a male, presented to us with pubertal gender swing from female to male. Since birth he was reared as a female child. His breasts, axillary hairs and pubic hairs developed at about 11-12 years of age. At that time he also observed the mental and physical changes towards a male. He began to feel sexual attraction towards females due to enlargement of his phallus and he preferred to behave as a male. The patient further noticed deepening of voice as well as appearance of facial hairs at about 15 years of age. He never experienced menstruation. His parents are first degree cousins. On examination, there was facial hairs in upper lip and chin (G3), breasts were in mature stage (B5), pubic hairs were darker, coarser and curlier and spreading sparsely (P3), and stretched dorsal phallic length was 6cm. In perineoscrotal area, there was hypospadias with blind vaginal pouch, partially fused, pigmented & ruggated bilateral labio-scrotal folds and soft palpable ellipsoid gonads measuring about 8 ml (each) in volume within labio-scrotal folds. Ultrasound examination revealed no uterus and karyotyping test found 46XY. Provisionally, he was diagnosed as a case of 46,XY Disorders of Sex Development (DSD). On further investigations, serum testosterone was low, serum LH and DHEA were raised and serum electrolytes were normal. From history, physical examination and investigations we diagnosed the case as 46,XY DSD due to 17β-hydroxysteroid dehydrogenase-3 deficiency.
Collapse
Affiliation(s)
- M H Rahman
- Department of Endocrinology, Dhaka Medical College & Hospital, Dhaka, Bangladesh
| | | | | |
Collapse
|
50
|
Naher BS, Mannan MA, Noor K, Shahiddullah M. Role of serum procalcitonin and C-reactive protein in the diagnosis of neonatal sepsis. ACTA ACUST UNITED AC 2011; 37:40-6. [PMID: 21877603 DOI: 10.3329/bmrcb.v37i2.8432] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This cross sectional observational study was done in the division of neonatology, department of pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) in the year 2007. The study population was 50 newborns in total who needed evaluation of sepsis on clinical suspicion. The main objective of this study was to assess serum procalcitonin (PCT) as a better diagnostic marker than C-Reactive Protein (CRP) in neonatal sepsis. The total study populations were classified into 4 groups like highly probable, probable, and possible and no sepsis group according to the clinical and blood parameters. PCT and CRP were assessed and compared by statistical analysis. For the estimation of PCT and CRP, venous blood was drawn and centrifuged and stored at - 20 degrees C in the refrigerator. Later on PCT was measured by rapid semi quantitative immunochromatographic test. Level of CRP was determined by semi quantitative method (latex). All data were analyzed by SPSS version 10 windows. For statistical analysis appropriate tests were done. In all observations sepsis was found to be more common in male newborns and in those who were delivered by caesarean section. In low birth weight and preterm newborns sepsis was more prevalent. Premature rupture of membrane (PROM) was found to be the commonest maternal clinical condition as a risk factor of sepsis. There was positive correlation between serum PCT and CRP and values of serum PCT as well as CRP differed significantly in the different categories of sepsis indicating relation to the severity of sepsis. PCT is a useful, sensitive and independent biomarker of neonatal sepsis. CRP measurement along with PCT measurement may increase the specificity. Though PCT measurement is comparatively expensive but an easy bed side promt convenient procedure for sick neonates in addition to CRP for rapid evaluation of neonatal sepsis rather than waiting for the report of blood culture.
Collapse
Affiliation(s)
- B S Naher
- Department of Neonatology, Sir Salumullah Medical College & Mitford Hospital, Dhaka
| | | | | | | |
Collapse
|