Soofia Khatoon

Setting research priorities to improve global newborn health and prevent stillbirths by 2025

Background In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs) in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013–2025. Methods We used adapted Child Health and Nutrition Research Initiative (CHNRI) methods for this prioritization exercise. We identified and approached the 200 most productive researchers and 400 program experts, and 132 of them submitted research questions online. These were collated into a set of 205 research questions, sent for scoring to the 600 identified experts, and were assessed and scored by 91 experts. Results Nine out of top ten identified priorities were in the domain of research on improving delivery of known interventions, with simplified neonatal resuscitation program and clinical algorithms and improved skills of community health workers leading the list. The top 10 priorities in the domain of development were led by ideas on improved Kangaroo Mother Care at community level, how to improve the accuracy of diagnosis by community health workers, and perinatal audits. The 10 leading priorities for discovery research focused on stable surfactant with novel modes of administration for preterm babies, ability to diagnose fetal distress and novel tocolytic agents to delay or stop preterm labour. Conclusion These findings will assist both donors and researchers in supporting and conducting research to close the knowledge gaps for reducing neonatal mortality, morbidity and long term impairment. WHO, SNL and other partners will work to generate interest among key national stakeholders, governments, NGOs, and research institutes in these priorities, while encouraging research funders to support them. We will track research funding, relevant requests for proposals and trial registers to monitor if the priorities identified by this exercise are being addressed.

Clinical Profile of Brain Tumour in Children

Background: This study was designed to evaluate the clinical profile and location of brain tumours in children so that brain tumour cases could be diagnosed and managed earlier. Materials and Methods: This cross sectional study was carried out from April 2011 to April 2012. A total 50 clinically suspected cases of brain tumour and supported by MRI were enrolled in this study. Results: Brain tumour of children was predominant in male where male to female ratio was almost 1.9:1. Supratentorial and Infratentorial brain tumour were found in 36% and 64% cases respectively in children. According to MRI findings in the supratentorial location, craniopharyngioma were commonest (50%) followed by cerebral astrocytoma (22.2%). In the infratentorial region, medulloblastoma was observed in (40.6%), followed by cerebellar astrocytoma (31.3%). Vertigo, weakness of limbs were found in 46.9% and 87.5% cases respectively in infratentorial group which were significantly (p<0.05) higher than supratentorial group. Growth failure and behavioral change were found in 16.7% and 22.2% cases respectively in supratentorial which were significantly (p<0.05) higher than infratentorial group. Papilloedema, reduced muscle power, increased muscle tone, exaggerated deep reflexes, clonus, gait disturbance and cerebellar signs were significantly (p<0.05) higher in infratentorial group. Conclusion: Craniopharyngioma and medulloblastoma were more common findings in MRI evaluation in the supratentorial and infratentorial location respectively. Growth failure and behavioral change were found higher in supratentorial than infratentorial group. Vertigo, weakness of limbs, papilloedema, reduced muscle power, increased muscle tone, exaggerated deep reflexes, clonus, gait disturbance and cerebellar signs were higher in infratentorial group. J Shaheed Suhrawardy Med Coll, June 2016, Vol.8(1); 8-12