Difference in Clinical Patterns between COVID-19 Affected Children and Adults

Coronavirus has created a major global health problem since December 2019. People of all age groups were affected by this virus though children showed milder clinical characteristics and initially less number of children was affected by this virus. It is very important to know the difference in clinical patterns between COVID-19 affected children and adults. This cross-sectional prospective study was carried out in Kurmitola General Hospital, Dhaka from April to September 2020 to compare the clinical pattern and laboratory findings between COVID-19 positive children and adults. Total 150 COVID-19 positive patients were enrolled in this study, among them 100 patients were adults (>18 year) mean±SD age (49.9±14.33) and 50 patients were children (Day 1-18 year) mean±SD age (8.7±4.79). The adult group had 66 males and 34 females and the pediatric group had 27 males and 23 females. No significant sex difference was seen between the two groups (0.153). Most of the children were affected by family contact and they showed a mild type of illness but adult patients had contact from different sources. Fever and cough were the main symptoms of both groups but fever was more common in adults (81%) than children (36%), p-value (0.001). In children no severe or critical cases were found. But asymptomatic cases were 8%, mild cases (68%) and moderate cases (24%) in children. In adults no asymptomatic patients were found. Moderate cases were 72%, severe 14% and critical 5% (p value 0.001). Leucopenia, Lymphopenia and raised CRP and increased ferritin were found more in adults than children. Chest X-ray showed 42% of children had pneumonia and 83% adults had pneumonia. There was significant difference between the two groups (p value 0.0001). This study concludes that corona virus affects children like adults but their presentation is not so severe and children show mild clinical symptoms in comparison with adults.

Detection of Cervical Cancer through Visual Inspection of Cervix with Acetic Acid (VIA) and Colposcopy at Mymensingh Medical College Hospital

Cervical cancer is the second most common cause of cancer related morbidity and mortality in women with 50% mortality rate. It is preventable if cervical cellular changes are detected and managed at early stage. This was a retrospective study conducted at VIA center of outpatient department and Colposcopy clinic at in-patient department of Mymensingh Medical College Hospital, Bangladesh covering a period from September 2013 to November 2014. Objective of this study was detection of cervical cancer and precancerous condition amongst patients reported to VIA center and Colposcopy clinic. In primary screening at VIA Center, total respondents were 3604, their mean age was 35.9 and highest were in the age group 31 to 40 years. At VIA center, 110(3.05%) were found positive and highest were between 31 to 40 years. In Colposcopy Clinic, out of 700 patients, 51.7% were CIN 1, 4.9% CIN 2, 1.4% CIN 3, invasive carcinoma was 0.3% and unsatisfactory or inconclusive were 34.3%. Most of the respondents were housewives and majority had poor monthly income. Amongst respondents, 72.1% were from rural area and Colposcopic findings revealed in 62.5% abnormal cervical changes, 46.5% were from rural area. Mean age at marriage or age at first coitus was found 16.25 years and 92.7% were in 11 to 20 years. Maximum abnormal cervical findings including CIN were between the ages ranged from 11 to 20 years of marriage age. In patients having 1 - 5 number of child having abnormal (58%) cervical changes, 48% were CIN 1. Histopathology reports found 19.6% CIN 1 (Total CIN 20.7%), cervical carcinoma 1.3%, inflammatory 7.0% and 0.42% cases were reported normal. Amongst 438 histopathology advised cases, 230 respondent's reports with patients were not available. VIA followed by Colposcopy has been a feasible, easy and reliable tools for screening cervical cancer in Bangladesh.