Disease Pattern among Children attending Pediatric Outpatient Department in Community Based Medical College Hospital, Bangladesh

Disease pattern is based on socio-demographic characteristics, comprehensive health care services, and environmental variables like water supply, basic sanitation and housing, illness behavior like quick decision to arrive at health care facility, and treatment behavior like the modality of treatment they receive. The descriptive cross-sectional study was conducted during the period of January 2014 to December 2015. The study was carried out among 310 purposively selected children attended at Pediatric Outpatient department of Community Based Medical College Hospital, Bangladesh. Data were collected by face to face interview of the parents and clinical examination and anthropometric measurement of children using case record form. Mean age of the children was 4.11 years with a SD of 4.35 years, male-female ratio was 1.25:1 with predominance 201(64.84%) of under-five children. The common diseases were 121(39.03%) with Acute Respiratory Infections (ARI), while 43(13.87%) diarrheal diseases, 25(8.06%) each with bronchial asthma and helminthiasis. Other diseases 96(30.97%) include anemia 17(5.48%), urinary tract infection 15 (4.84%), peptic ulcer disease 9(2.90%), enteric fever, oral candidiasis, apthous ulcer of mouth, scabies and vulvovaginitis. Average number of children per family was 2.2 including 251(80.97%) children having sanitary latrine in the family, 297(95.81%) with safe drinking water facilities and 270(87.10%) were fully vaccinated under EPI. More than three fourth 76(24.52%) of the children were underweight, 114(36.77%) were from poor families and 136(43.87%) lived in Kancha house. With the improvement of safe water supply and use of sanitary latrine diseases like diarrhoeal disease and helminthiasis are showing a decreasing trend.

Vaginal rhinosporidiosis: a case report

The female genital tract is an extremely rare site for Rhinosporidiosis. Here we described a 13 year old girl who presented with a slow growing polypoid fleshy mass in the posterior vaginal wall near the orifice for 6 months with scanty bleeding from the mass. The girl was admitted to hospital with profuse watery vaginal discharge. Excision of the mass was followed by histopathological examination which confirmed the diagnosis Rhinosporidiosis.

Treatment of ampullary neuroendocrine tumor by endoscopic snare papillectomy

Patient: Female, 45

Final Diagnosis: Neuroendocrine tumor

Symptoms: Abdominal pain

Medication: —

Clinical Procedure: —

Specialty: Gastroenterology and Hepatology

Mass media exposure and its impact on family planning in Bangladesh

This paper analyses mass media exposure and its effect on family planning in Bangladesh using data from the Bangladesh Demographic and Health Survey (BDHS) 1993-94. The findings indicate that radio and television are two important mass media for disseminating family planning information in Bangladesh. However, access to them and exposure to family planning through them are still limited. Slightly more than 40% (42.1%) of respondents reported that they had heard family planning messages via radio, while 17.2% said television, 8.4% said poster and 5.4% said billboard. Respondent's place of residence, education, economic status, geographical region and number of living children appeared to be the most important variable determining mass media exposure to family planning. Multivariate analysis shows that both radio and TV exposure to family planning messages and ownership of a radio and TV have a significant effect on current use of family planning methods. These factors remain significant determinants of contraceptive use, even after controlling socioeconomic and demographic factors. The study reveals that both socioeconomic development policies and family planning programmes with a special emphasis on mass media, especially radio, may have a significant effect on contraceptive use in Bangladesh. The principal policy challenge is to design communications strategies that will reach the less privileged, rural and illiterate people who are by far the majority in Bangladesh.

The epidemiology of schistosomiasis in Egypt: Ismailia governorate

A multi-stage stratified sample of 12,515 individuals from 1,941 households in 42 villages in the Ismailia governorate of Egypt were surveyed for schistosomal infection. A subset of 2,390 subjects were surveyed for morbidity by physical and ultrasonographic examination. The prevalence of Schistosoma mansoni infection in rural Ismailia was 42.9% and the geometric mean egg count (GMEC) was 93.3 eggs/gram of stool, with considerable variability between communities. Prevalence and intensity peaked in the 20-30-year-old age group and was higher in males than in females. Prevalence and intensity of S. haematobium was very low: 1.8% and 3.5 ova/10 ml of urine GMEC, respectively. Canal water exposure risk factors for S. mansoni infection were males bathing (odds ratio [OR] = 2.2), females washing clothes (OR = 1.9), and children playing or swimming (OR = 2.3). Presence of in-house piped water supply and latrine lowered infection rates (P < 0.001 and P = 0.002, respectively). Histories of S. mansoni infection (OR = 1.6) or treatment (OR = 1.5) and blood in feces (OR = 3.5) were associated with infection. Hepatomegaly (16.0%) was more frequently detected than splenomegaly (3.6%) by physical examination, with both being more frequent in older age groups. Splenomegaly, but not hepatomegaly, was associated with presence of S. mansoni ova in stools (OR = 1.4) and the community burden of infection (P = 0.02). Ultrasonographically detected hepatomegaly, splenomegaly, and periportal fibrosis (PPF) were detected in 43.0%, 17.4%, and 39.7% of the subjects, respectively. The higher grades of PPF were rare. Ultrasonographically detected splenomegaly, not hepatomegaly, was associated with S. mansoni infection, community burden of infection, and PPF. Risk factors for PPF were the same as for S. mansoni infection. There was a marginal association of PPF with infection and none (P = 0.33) with the intensity of infection in individuals or in the community. We conclude that in rural Ismailia, S. haematobium infection is rare but the prevalence and intensity of infection with S. mansoni is high. The risk of infection is associated with environmentally detected factors and behaviors. Hepatosplenic morbidity attributable to S. mansoni infection is low, presumably because of the favorable effect of wide application of praziquantel therapy.

Hepatobiliary complications in chronic pancreatitis

Thirty nine patients undergoing surgery for chronic pancreatitis were investigated for evidence of hepatobiliary disease. In addition to pre-operative assessment by liver function tests, ultrasound, ERCP (in 33) and percutaneous transhepatic cholangiography (in five), all had peroperative liver biopsy. Common bile duct stenosis was diagnosed in 16 (62%) of the 26 patients with successful cholangiography. Features of extrahepatic biliary obstruction were found on biopsy in 11 patients, three of whom showed features of secondary sclerosing cholangitis. No patients had secondary biliary cirrhosis. Three had parenchymal liver disease (cirrhosis, resolving hepatitis and alcoholic hepatitis respectively) and two others had features suggestive of previous alcohol-induced injury. Five (83%) of the patients with clinical jaundice had biopsy features of extrahepatic biliary obstruction, as did eight (67%) with alkaline phosphatase above twice normal and seven (44%) with radiological common bile duct stenosis. Neither alkaline phosphatase rise, nor common bile duct stenosis alone or in combination, were a reliable indication of the need for biliary enteric bypass surgery. Pre-operative liver biopsy may be a valuable adjunct in the assessment of such patients.