Clostridium Difficile Associated Diarrhea in Children with Hematological Malignancy-Experience from a Pediatric Oncologic Centre, Bangladesh

Background: Clostridium difficile Associated Diarrhea (CDAD) is considered to be one of the commonest causes of nosocomial diarrhoea worldwide. Gastrointestinal infections in the form of diarrhoea are common in pediatric oncology patients in Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. The study was conducted to find out the frequency of Clostridium difficile infection (CDI) among diarrheal children with haematological malignancy. Materials and Methods: This prospective observational study was conducted from April 2012 to March 2013 at the Pediatric Hematology and Oncology Unit, BSMMU, Bangladesh. Total 58 diarrheal episodes occurred in 51 children with various types of haematological malignancies were included consecutively. Faecal samples of the children were sent to International Centre for Diarrheal Disease Research, Bangladesh (ICDDR, B) laboratory for detection of Clostridium difficile antigen (GDH) and toxins (A and/ or B) by Enzyme Immunoassay (EIA). Results: Among 58 diarrheal episodes 22.4% faecal samples were positive for GDH, but none of the faecal samples was positive for toxin A and or B. There were a significant association with leucopenia, severe neutropenia; usage of meropenem plus vancomycin, cefepime plus amikacin, imipenem, cytarabine and omeprazole with GDH positive diarrheal episodes. Conclusion: Positive GDH antigen with a negative result for toxin indicates C. difficile colonization. Among GDH positive episodes, a significantly higher proportion of children had leucopenia, severe neutropenia and usage of some drugs known as risk factors for C. difficile infection. To confirm the CDI advanced tests are needed

Spectrum of Hospital Acquired Acute Kidney Injury in Critically ill Children in a Tertiary Level Hospitall

Introduction: Although hospital acquired acute kidney injury (hAKI) is common and significantly increases the risk of hospital mortality, little is known about its frequency in developing countries where ICU facilities are limited. The purpose of this study was to investigate the frequency, cause, and outcome of hAKI in critically ill children in a tertiary level hospital.Materials and Methods: In this prospective cross-sectional study, a total 36 critically ill patients with hAKI were analyzed. hAKI was diagnosed according to the AKIN criteria. The clinical data of the patients admitted to the Pediatrics and Allied Departments in this hospital from November 2014 to October 2015 were collected.Results: A total of 3950 patients were admitted during the study period and 1103 (27.9%) were critically ill patients. Among the critically ill children, 36 (3.3%) were diagnosed with hAKI. Among different age groups, the highest incidence (5.05%) of hAKI was seen in children aged above 10 years. Sepsis was the major cause of hAKI accounting for 44.1% followed by antibiotics (27.1%), hypovolemia (13.6%), nephrotoxic agents (10.2%), and contrast agents (5.0%). Renal replacement therapy was required only in 8.3% of the cases.Conclusions: In comparison to other studies, this study showed a low incidence of hAKI where ICU facilities are limited. Among the hospital admitted critically ill patients, a significant number of patients may develop AKI mostly due to sepsis and use of antibiotics. Keywords: Hospital acquired AKI; Sepsis; Critically ill children; Incidenc

A 2-year-old male child with diffuse abdominal pain, mass in the abdomen and red currant jelly stool

This article has no abstract. The first 100 words appear below: A 2-year-old male child, the second issue of non-consanguineous parents, from average socio-economic status hailing from Dinajpur, Bangladesh was attended at Pediatric Surgery outpatient department with the complaints of vague diffuse abdominal pain in the lower right side of abdomen and around the umbilical region for last 3 days. His mother also reported the feeling of a solid mass in the abdomen during dressing of her child. Then, gradually his problems were increasing in nature with several times of nausea, vomiting, and the passage of blood mixed stool three times before his admission

Brief report on pediatric oncology in Bangladesh

Cancer in children is emerging as a significant threat to life as deaths from infections and malnutrition have begun to decrease due to concerted maternal and child health initiatives. Efforts are being made to create a comprehensive service for children with Cancer. The major challenges to be overcome are professional and public awareness, late diagnosis, perceptions of incurablity, treatment refusal and abandonment, toxic deaths and drug costs/inconsistent availability

Coagulopathy in pediatric acute promyelocytic leukemia in Bangladesh: A single-center, prospective study

Background: Acute promyelocytic leukemia (APL) is one of the most curable subtypes of acute myeloid leukemia in childhood. It usually presents with a characteristic coagulopathy. The aim of the study was to determine the extent and outcome of this coagulation disorder. Methods: This prospective observational study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, and included PML:RAR-α (Promyelocytic Leukemia-Retinoic Acid Receptor-α) positive APL cases. At presentation, all patients were assessed with coagulation parameters and followed up clinically and hematologically while treated with ATRA (all-trans-retinoic acid)-based chemotherapy. The presence of disseminated intravascular coagulation (DIC) was determined using the DIC scoring system of the International Society on Thrombosis and Hemostasis (ISTH). Results: Among 20 APL cases, the mean DIC score was 5.75 ± 0.6. DIC was detected in 90% (n = 18/20) of the patients. The incidence of fatal thrombo-hemorrhagic complications was 15% (n = 3/20). Though hemorrhagic complications are common, thrombosis may also occur in pediatric APL

Transient convection flow in super-imposed fluid and porous layers

This paper is aimed at investigating the effects of combined Marangoni and Rayleigh convections in a porous layer, underlain by a fluid layer. The two-dimensional transient numerical model represents a dual rectangular cavity system in which the porous cavity is located below the fluid cavity. Both cavities are saturated with hexane. The problem consists of studying the combined Marangoni and Rayleigh effects on the flow. The interaction between the Marangoni and the Rayleigh convection is investigated in detail. The porous cavity is heated at the bottom while the top liquid cavity has a free surface and is maintained at a room temperature. In addition, the role of the aspect ratio of the porous layer over the fluid layer in determining the convection pattern was studied. Results indicate that the Marangoni convection enhances the flow in the porous layer for high aspect ratio while the Rayleigh number suppresses the Marangoni convection at the free surface for a low aspect ratio. At a critical aspect ratio above 3, the Marangoni convection becomes dominant over the Rayleigh convection in the liquid layer. Copyright © 2000 Society of Automotive Engineers, Inc.SCOPUS: cp.jinfo:eu-repo/semantics/publishe