As a Pediatrician, I Don’t Know the Second, Third, or Fourth Thing to Do: A Qualitative Study of Pediatric Residents’ Training and Experiences in Behavioral Health

Despite a mandated 1-month rotation in developmental-behavioral pediatrics (DBP), pediatric residents report inadequate training in behavioral health care. As a first step in much needed curriculum development in this area, this study sought to assess learner experiences regarding the management of behavioral health problems during residency. Four focus groups were conducted for residents in years 1-3 of training in 2 residency programs in a northeastern state. Transcripts were analyzed and coded by researchers through qualitative classical content analysis. The exploratory analysis revealed 9 key themes: time requirements, rapport building, resources and referrals for behavioral health, psychiatric medications, diagnosis vs. treatment, working with families, the importance of behavioral health, fears of working with a pediatric population, and training issues. These qualitative data further identify gaps in the behavioral health training of pediatric residents and may inform future innovations in training curricula

High Likelihood of Meningitis with Late Onset Septicemia in Newborn

Neonatal meningitis must be recognized and treated quickly  to prevent death or disability. Incidence of neonatal  meningitis with late onset sepsis is higher in developing  countries than those of resource-rich countries. In neonates  signs and symptoms of serious infections are often obscured  and clinical examination cannot distinguish among septic  babies with or without meningitis. Clinicians often differ  whether neonates undergo lumber puncture or not to  distinguish septic babies with or without meningitis.  Abnormal CSF findings are often used to detect neonatal  meningitis and determine the type and length of antibiotic  therapy with proven sepsis and meningitis cases. This study  was conducted to evaluate the bacterial meningitis among  the late onset sepsis in newborns and to identify the clinical  manifestations that can distinguish septicemia from  meningitis in neonates.  Total 1706 admitted patient in NICU of Bangabandhu  Sheikh Mujib Medical University from January 2007 to  December 2009 were evaluated retrospectively. Among the  133 (27.94%) cases of suspected late onset sepsis 47(35.33%)  were proven sepsis, 63(47.37%) were probable sepsis and  23(17.29%) cases were clinical sepsis based on clinical  features laboratory reports and blood cultures. Among the  proven sepsis 12(42.85%) cases were found to have definitive  bacterial meningitis and 16(57.15%) were probable bacterial  meningitis. Among the provable sepsis only 1(12.50%) cases  were found to have definite bacterial meningitis and 7  (87.50%) cases were probable bacterial meningitis. There  were no meningitis have found among the clinical sepsis.  Neonatal meningitis frequently occurred in late onset sepsis.  The most frequent presenting clinical features for meningitis  cases are more or less similar to those of septicemic cases.  The data of the study suggest that newborns with a positive  blood culture are significantly more likely to have meningitis  than those with a negative blood culture.   DOI: http://dx.doi.org/10.3329/jbcps.v30i1.11362   J Bangladesh Coll Phys Surg 2012; 30: 17-23  </jats:p

Role of Hydroxyurea in Psoriasis - A Review

Most of the patients of psoriasis have a chronic course withthe need for continuous control of disease activity. Patientswith moderate-to-severe disease generally requirephototherapy, photo-chamotherapy or systemic agents (e.g.cyclosporine, methotrexate, oral retinoids, fumaric acidesters) to control their disease adequately. In general thesetherapeutic modalities have proven to be highly effective inthe treatment of psoriasis. However, potentially serious toxicitycan limit their long term use. In this respect, hydroxyureacompares favourably with methotrexate which has a potentialfor producing irreversible hepatic damage and cyclosporineA with its potential for dose-related nephrotoxicity.Hydroxyurea, a hydroxylated molecule of urea is commonlyused to treat chronic myelogeneous leukemia andpolycythemia vera. Recent studies suggest it as an alternativeto methotrexate in moderate-to-severe psoriasis.   DOI: http://dx.doi.org/10.3329/jbcps.v29i4.11330   J Bangladesh Coll Phys Surg 2011; 29: 219-226</jats:p

Regeneration potential of seedling explants of chilli (Capsicum annuum)

A study was conducted with hypocotyl, cotyledon and shoot tip of chilli as explants for regeneration on MS medium supplemented with different concentrations and combinations of auxins and cytokinins.Regeneration potential was determined by two ways. One is regeneration of shoot via callus formation from hypocotyls and cotyledon explants; another was direct shoot regeneration from shoot tip explant. The highest callus was induced from hypocotyl in a combination of BAP (5.0 mgL-1) with NAA (0.1 mgL-1) and cotyledon in a combination of BAP (5.0 mgL-1) with IAA ((1.0 mgL-1). The callus induction as well as shoot initiation was higher in hypocotyls than cotyledon. Shoot tips regenerated into plantletsdirectly with sporadic small callus at the base. Shoot elongation was accelerated by using additional supplementation of GA3 and AgNO3. Regenerated shoots rooted best on the MS medium supplementedwith 0.1 mg L-1 NAA + 0.05 mg L-1 IBA

Anomalous Origin of Left Coronary Artery from Pulmonary Trunk in an Adult Patient –A Rare Occurrence

Anomalous origin of coronary arteries is a rare cause of cardiac disease. One of the very rare coronary anomalies is origin of left main coronary artery from pulmonary trunk. Most of these patients die in the first year of life and only 10-15% survive in adulthood. We are reporting a rare case of anomalous origin of left coronary artery from pulmonary artery who survives into sixth decade of life. Key words: Anomalous origin of coronary artery, Pulmonary artery, Left coronary artery DOI: http://dx.doi.org/10.3329/cardio.v1i1.8209 Cardiovasc. j. 2008; 1(1) : 117-121</jats:p

Impact of Risk Factors on the Size of Ruptured Intracranial Saccular Aneurysms

Background: Un-ruptured intracranial aneurysms (UIAs) are common and prevalence is about 2 to 8%. Several studies have shown that the decision to treat un-ruptured aneurysms should not be based on aneurysm size alone. A study suggest that treatment of UIAs smaller than 7 mm in hypertensive patients and smokers may be beneûcial.&#x0D; Aim and objective: The goal of this study is analysis of correlation of age, gender, location of the aneurysm, history of hypertension and cigarette smoking, previous history of SAH with the size of ruptured aneurysms.&#x0D; Materials and Methods: This hospital based observational cross-sectional study was conducted in the Department of Neurology &amp; Neurosurgery, Dhaka Medical College Hospital (DMCH), Dhaka. Total 44 patients with SAH were taken by inclusion &amp; exclusion criteria. The aneurysms size, site of location and aneurysm multiplicity was assessed by three-dimensional rotational digital subtraction angiography (DSA).&#x0D; Results:The mean age of the study population was 49.24 ±11.5. About half of the population were within 51-60 years. The male female ratio was 1:1.2. Out of 44 population, 93.2% were presented with headache, 90.9% with vomiting. In this study aneurysms mean size was 5.72±4.010 mm. 93.2% of aneurysms were below 10 mm, 75.0% were below 7 mm and 50.0% below 5 mm. Size of ruptured aneurysm is small in hypertensive population and is significant (p-value 0.037). Aneurysm size was significantly (p- value 0.013) smaller in case of smoker. Mean aneurysm size in hypertensive smoker population was significantly (p-value-0.004) smaller than hypertensive non-smoker. Population with one risk factor had mean aneurysm size was 8.32±6.84 mm, two risk factors had 5.26±1.86mm, three risk factors had 4.79±2.05 mm and more than three risk factors had 2.85±1.43.&#x0D; Conclusion: This study shows that more the risk factors, smaller the size of aneurysms. Therefore, history of hypertension, cigarette smoking, female sex, age and positive family history should be considered in the assessment of treatment of un-ruptured intracranial aneurysms.&#x0D; Bangladesh Journal of Neuroscience 2019; Vol. 35 (2): 86-94</jats:p