Suraiya Begum

Alternating Hemiplegia of Childhood: Report of Two Cases

Alternating hemiplegia of childhood (AHC) is a rare disorder which presents before 18 months of age characterized by repeated attacks of hemiplegia involving either side of the body, paroxysmal disturbances,developmental delay and learning disability. The cause of AHC remains largely unknown and treatment evidence is less available. AHC is unreported in Bangladeshi literature. We report two cases of AHC. Our first case is a 16-month-old girl who presented with hemiplegia in alternate side for four episodes. She also had abnormal body movement and irritability during awakening. Every episode subsided spontaneously after 2 to 5 days. All investigations were normal except iron deficiency anemia. She was treated with flunarizine. Our second case, a 7 year and 10 month-old boy presented with recurrent alternate hemiplegia since 3½ years of age with epilepsy. His attacks were precipitated in high temperature. His EEG was abnormal. He was treated with multiple antiepileptic drugs and flunarizine. These are first two cases reported from Bangladesh. AHC remains undiagnosed in many cases. So a detailed history and diagnostic evaluation is very important for early counseling and treatment. J Enam Med Col 2018; 8(1): 46-49

Death audit in the neonatal ICU of a tertiary care hospital in Bangladesh: a retrospective chart review

Abstract Background: Expectant reduction of neonatal mortality and formulation of preventive strategies can only be achieved by analysis of risk factors in a particular setting. This study aimed to document incidence of neonatal death and to analyze the risk factors associated with neonatal death. Methods: This retrospective study was carried out in department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) over a 12-month period from January to December 2015. The newborns that died within 28 d of life were defined as “Cases” and “Control” were the surviving newborn discharged to home as healthy. Two birth weight and gestational age matched controls were taken for each case. Maternal, obstetric, and newborn characteristics were analyzed between both the groups. Data analysis was performed using SPSS version 20.0 (SPSS Inc., Chicago, IL). A probability of < .05 was considered statistically significant. The strength of association was determined by calculating odds ratio and their 95% confidence intervals (CIs). Results: During the study period, the proportion of death was 9.6% (64/612). Both in Chi-square analysis and in logistic regression analysis, less than four antenatal visits (odds ratio (OR) 2.78; 95% CI: 1.23–6.28, p = .014) and sepsis (OR 2.37; 95% CI: 1.07–5.26, p = .034) were found to be independent risk factors for deaths, whereas LUCS found to be protective for deaths (OR 0.40; 95% CI: 0.19–0.83, p = .015). Conclusion: In conclusion, less than four antenatal visits and presence of sepsis were found to be independent risk factors whereas LUCS protective of newborn death.

Drug-resistant organism in early-onset and late-onset neonatal sepsis at tertiary care hospital

Context: Neonatal sepsis is one of the common reasons for admission to neonatal units in developing countries. Resistance to antibiotics is increasing in neonatal sepsis. Aims: To evaluate the antibiotic resistant pattern of pathogens associated with early-onset and late-onset neonatal sepsis. Settings and Design: This cross-sectional study was done at special care baby unit of a tertiary care hospital from January 2008 to June 2009. Subjects and Methods: All neonates with risk factors or clinical features of sepsis were enrolled and samples for blood cultures were taken. Neonates whose blood culture yielded growth of bacteria were included in this study. Standard data collection form was used to collect all demographic data, pathogen, and resistant to antibiotics. Statistical Analysis Used: Chi-square test and Fishers exact test were used for compare the variables. The value P< 0.05 was considered statistically significant. Statistical analysis was done using EpiInfo 7. Results: Sixty-five blood culture positive neonates were included in this study. Early-onset neonatal sepsis and late-onset neonatal sepsis were 35.4% and 54.6%, respectively, and 98.5% sepsis was caused by Gram-negative organism. Common organisms isolated were Klebsiella and Enterobacter. Organisms isolated were resistant to first- and second-line antibiotics and quinolone derivatives. In about 15% cases, bacteria showed resistance to third line of antibiotics used in neonatal sepsis. Conclusion: Gram-negative bacteria and in particular Klebsiella and Enterobacter species are the leading causes of early-onset and late-onset neonatal sepsis. All organisms were resistant to ampicillin, gentamicin, and third generation cephalosporin but resistant to imipenem and meropenem were low.