Mirza Md Ziaul Islam

Evaluation of Chronic Cough in Children: A Prospective Study in a Tertiary Care Hospital

Background : Chronic cough is a common complaint in children which causes distress, and affects the quality of life of parents and children. While cough may be seen as a common condition of childhood without serious consequences, ignoring a cough that may be the sole presenting symptom of an underlying illness can lead to delayed diagnosis and progression to a chronic respiratory morbidity. Objective : To evaluate the specific diagnosis and prognosis of chronic cough in children. Methods : A prospective study was done on children with chronic cough (history of cough>8 weeks) referred to Dhaka Shishu (Children) Hospital, a tertiary hospital.Children aged 2 to 8 years with chronic cough referred by the general physicians, pediatricians and other peripheral hospitals were the study subjects. Exclusion criteria were children with immune-deficiency,congenital anomalies of lung,congenital heart disease, gastro-intestinal disorders (e.g. gastro-esophageal reflux, peptic ulcer disease), in born error of metabolism (e.g. cystic fibrosis) and other chronic conditions (e.g. gross neurodevelopmental delay). The evaluation of chronic cough was based on simple principles: careful history-taking concerning the characteristics of the cough, full clinical examination to look for any associated symptoms and relevant investigations done. Underlying diagnoses and outcomes were ascertained after follow-up for a period of six months and treatment was given as per the management protocol of the hospital. Results : The most common final diagnosis was allergic rhinitis (31%), followed by asthma (28.6%), rhinitis coexisting with asthma (23.8%), post viral cough (16.6). Cough resolved in 54.8%, partially improved in 40.5% and persisted in 4.7% of patients. Conclusion : Allergic rhinitis with or without co-existing asthma was the commonest cause of chronic cough in children referred to this hospital. Northern International Medical College Journal Vol.9(1) July 2017: 264-266

Community-Acquired Pneumonia in Children-An Update

Community-acquired pneumonia (CAP) is a potentially serious infection in children and often results in hospitalization.CAP symptoms are nonspecific in younger infants, but cough and tachypnea are usually present in older children. The diagnosis can be based on the history and physical examination results in children with fever plus respiratory signs and symptoms. Chest radiography and rapid viral testing may be helpful when the diagnosis is unclear. The most likely etiology depends on the age of the child. Viral and Streptococcus pneumonia infections are most common in preschoolaged children, whereas Mycoplasmapneumoniaeis common in older children.Most children can be managed empirically with oral antibiotics as outpatients without specific laboratory investigations.The decision to treat with antibiotics is challenging, especially with the increasing prevalence of viral and bacterial coinfections. Those with severe infections or with persistent or worsening symptoms need more intensive investigations and may need admission to hospital. The choice and dosage of antibiotics should be based on the age of the patient, severity of the pneumonia and knowledge of local antimicrobial resistance patterns. Bangladesh J Child Health 2018; VOL 42 (1) :38-42

Cystic Fibrosis - An Update

Cystic fibrosis (CF) is said to be the most common lethal inherited disease of the white population. It affects the exocrine glands of body, primarily of the gastrointestinal and respiratory system. CF is caused by one of a large numbers of mutations of the gene for a protein called the cystic fibrosis transmembrane conductance regulator (CFTR). This CFTR regulates chloride and sodium transport across epithelial membranes. The main complications involve in the lungs, with damage to the small and large airways by chronic and recurrent bacterial infections. Other major consequences include pancreatic malfunction, leading to malabsorption of nutrients and vitamins with consequent impaired growth and development and in older patient diabetes. Diagnosis is usually done by sweat test or identification of two CF-causing mutations in patients with characteristics symptoms. Treatment is supportive through aggressive multidisciplinary care. The prognosis of CF has improved due to earlier diagnosis through screening, better treatment and access to health care. Although CF is a rare disease in Bangladesh, but its possibility should be kept in mind in appropriate circumstances. Bangladesh J Child Health 2016; VOL 40 (3) :174-178

Nipah virus Infection: A fatal Emerging disease

Abstract not available Northern International Medical College Journal Vol.7(2) Jan 2016: 146-148