Paediatric blunt abdominal trauma with organ injury: a comprehensive analysis of cases at a tertiary hospital in Bangladesh

Background: Pediatric blunt abdominal trauma with organ injuries is a critical issue in Bangladesh, lacking sufficient research. This study focuses on managing such cases in a tertiary hospital. Objectives were to assess clinical characteristics, injury patterns, and outcomes of pediatric patients with blunt abdominal trauma and organ injuries. It aims to identify causes, associated injuries, and hospital stay durations.Methods: A prospective study of 142 pediatric patients aged 1-12 was conducted at Rajshahi medical college hospital study period January 2020 to December 2021. In addition, this study aimed to identify and grade solid organ injuries according to the American association for the surgery of trauma organ injury scale.Results: Prevalence of hepatic injuries (76.8%), solid organ injuries (90.1%), road traffic accidents (71.8%), falls from height (25.4%). Most received conservative treatment, had short hospital stays, and a 7% mortality rate. Gender had no significant impact on organ injuries (p>0.001). Among the causes, 84.5% had hepatic injuries, 15.5% had spleen injuries due to road traffic accidents, and 58.3% had injuries from falls from height, with a highly significant cause-organ injury relationship (p<0.001).Conclusions: pediatric blunt abdominal injuries in Bangladesh affect various organs, primarily in males and school-aged children, primarily due to road accidents. Timely surgical intervention and preventive measures are crucial for improved outcomes.

Oral health related disorder among children with behavioral problems

Background: The best mouth function, the absence of disease, and oral health are achieved by maintaining the highest self-esteem possible. When someone has good dental health, they can communicate and connect with people without getting sick, feeling uncomfortable, or feeling embarrassed. This study aimed to evaluate the Oral health-related disorder specifically to assess dental caries and gingivitis among children with behavioral problems. Methods: This study was a prospective cross-sectional investigation carried out at Kalachandpur Government Primary School and Jashim Uddin Institute, Dhaka. The study was carried out between October 2021 and December 2022 and included 650 pediatric patients who were aged between 6 to 15 years. Results: Most 290 (44.62%) children were aged 6-9 years, 250 (38.46%) were 10-12 years, and the rest 110 (16.92%) were 13-15 years old. Patients with 11-15 years had lower dental caries. 310 (48%) were female, and 340 (52%) were male. Dental caries is associated with elevated risk. Children in the elevated caries risk group had a significantly higher mean value of conduct problems and Hyperactivity/inattention based on the SDQ compared to those with low caries risk. No statistically significant differences were found between the low caries risk group and the elevated caries group for the other subscales. Conclusions: There were statistically more children in the study group who had a high risk of getting caries. Behavior problems were observed while externalizing children who had a high risk of getting caries. Children with externalizing behavior also have more conduct problems and hyperactivity compared to children with reduced caries risk.

Histopathological alterations in gills, liver, kidney and muscles of Ictalurus punctatus collected from pollutes areas of River / Alterações histopatológicas em brânquias, fígado, rim e músculos de Ictalurus punctatus coletados em áreas poluídas do rio

Abstract Untreated sewage and industrial wastes from Faisalabad city are disposed to River Chenab through Chakbandi Main Drain (CMD). The present project is planned to investigate the effects of this freshwater pollution on the body of fish Ictalurus punctatus. The specimens of this fish species were collected upstream and downstream of the entrance of CMD into River Chenab. Fish gills, liver, kidney and muscles from dorsolateral regions of fish were subjected to histopathology. Farmed fish and fish from upstream areas were used as control. Fish collected from polluted experimental sites showed significant damage in selected organs. Gill tissues showed an abnormality in the form of an uplifting of the primary epithelium, fusion, vacuolation, hypertrophy, and necrosis. While liver tissues subjected to hepatocytes degeneration, necrosis, mitochondrial granular hepatocyte, and sinusoids dilation. Kidney tissues indicated increased bowmen space and constricted glomerulus and degenerated nephrons. Edema, necrosis, and atrophy were observed in muscle tissues of fish from polluted areas. Fish from the upstream area showed fused gill lamellae, inflammatory cell infiltration, hypertrophy and vacuolation in hepatocytes. Kidney tissues indicated the presence of nuclear tubular cells, destructive renal tubules, hemorrhage, and necrosis at tubular epithelium. Intra myofibril spaces were also observed in muscles. Specimens of control fish indicated no variation in gills, liver, kidney, and muscles. The present study revealed a strong correlation between the degree of tissue damage and environmental contamination. Present findings also compel global warnings to protect our water bodies and fish to rescue the human population.

Resumo O esgoto não tratado e os resíduos industriais da cidade de Faisalabad, no Paquistão, são descartados no Rio Chenab através do dreno principal de Chakbandi (CMD). O presente projeto busca investigar os efeitos dessa poluição de água doce no corpo de peixes Ictalurus punctatus. Os espécimes deste peixe foram coletados a montante e a jusante da entrada do CMD no Rio Chenab. Brânquias, fígado, rim e músculos das regiões dorsolaterais dos peixes foram submetidos à histopatologia. Peixes de criação e peixes de áreas a montante foram utilizados como controle. Peixes coletados em locais experimentais poluídos mostraram danos significativos em órgãos selecionados. Os tecidos branquiais mostraram uma anormalidade na forma de elevação do epitélio primário, fusão, vacuolação, hipertrofia e necrose. Observou-se que os tecidos hepáticos estão sujeitos a degeneração de hepatócitos, necrose, hepatócitos mitocondriais granulares e dilatação de sinusoides. Os tecidos renais indicaram aumento do espaço dos arqueiros, glomérulos contraídos e néfrons degenerados. Edema, necrose e atrofia foram observados nos tecidos musculares de peixes de áreas poluídas. Peixes da área a montante apresentaram lamelas branquiais fundidas, infiltração de células inflamatórias, hipertrofia e vacuolização em hepatócitos. Os tecidos renais indicaram a presença de células tubulares nucleares, túbulos renais destrutivos, hemorragia e necrose no epitélio tubular. Os espaços intramiofibrilas também foram observados nos músculos. Amostras de peixes controle não indicaram variação em brânquias, fígado, rim e músculos. O presente estudo revelou uma forte correlação entre o grau de dano tecidual e a contaminação ambiental. As descobertas atuais também constituem avisos globais para proteger nossos corpos d'água e peixes para resguardar a população humana.

Role of JAK in the Induction of iNOS in Macrophages using Pharmacological Inhibitors

Inducible nitric oxide synthase (iNOS) is induced in different cell types by cytokines and lipopolysaccharide (LPS). Cytokine signal transduction is believed to be mediated primarily through the JAK/STAT pathway. We, therefore, examined the effects of JAKs (Janus Kinase) in the induction of iNOS in macrophages using pharmacological inhibitors by using cell culture, Griess assay, protein assay, and western blotting techniques and also to compare the responses of JAK1and JAK2 inhibitor at different concentrations. The result of this study concludes that JAK inhibitors, i.e., JAK 1 and AG-490 down-regulates multiple signaling pathways such as STAT1-activation, iNOS gene expression and NO production in LPS treated macrophages. JAK2 proved to be an active ingredient and has shown anti-inflammatory effects. Activated JAK2 regulates the phosphorylation of JAK through the activation of PI3K thus plays a pivotal role in LPS-induced iNOS expression.

Histopathological alterations in gills, liver, kidney and muscles of Ictalurus punctatus collected from pollutes areas of River

Abstract Untreated sewage and industrial wastes from Faisalabad city are disposed to River Chenab through Chakbandi Main Drain (CMD). The present project is planned to investigate the effects of this freshwater pollution on the body of fish Ictalurus punctatus. The specimens of this fish species were collected upstream and downstream of the entrance of CMD into River Chenab. Fish gills, liver, kidney and muscles from dorsolateral regions of fish were subjected to histopathology. Farmed fish and fish from upstream areas were used as control. Fish collected from polluted experimental sites showed significant damage in selected organs. Gill tissues showed an abnormality in the form of an uplifting of the primary epithelium, fusion, vacuolation, hypertrophy, and necrosis. While liver tissues subjected to hepatocytes degeneration, necrosis, mitochondrial granular hepatocyte, and sinusoids dilation. Kidney tissues indicated increased bowmen space and constricted glomerulus and degenerated nephrons. Edema, necrosis, and atrophy were observed in muscle tissues of fish from polluted areas. Fish from the upstream area showed fused gill lamellae, inflammatory cell infiltration, hypertrophy and vacuolation in hepatocytes. Kidney tissues indicated the presence of nuclear tubular cells, destructive renal tubules, hemorrhage, and necrosis at tubular epithelium. Intra myofibril spaces were also observed in muscles. Specimens of control fish indicated no variation in gills, liver, kidney, and muscles. The present study revealed a strong correlation between the degree of tissue damage and environmental contamination. Present findings also compel global warnings to protect our water bodies and fish to rescue the human population.

Resumo O esgoto não tratado e os resíduos industriais da cidade de Faisalabad, no Paquistão, são descartados no Rio Chenab através do dreno principal de Chakbandi (CMD). O presente projeto busca investigar os efeitos dessa poluição de água doce no corpo de peixes Ictalurus punctatus. Os espécimes deste peixe foram coletados a montante e a jusante da entrada do CMD no Rio Chenab. Brânquias, fígado, rim e músculos das regiões dorsolaterais dos peixes foram submetidos à histopatologia. Peixes de criação e peixes de áreas a montante foram utilizados como controle. Peixes coletados em locais experimentais poluídos mostraram danos significativos em órgãos selecionados. Os tecidos branquiais mostraram uma anormalidade na forma de elevação do epitélio primário, fusão, vacuolação, hipertrofia e necrose. Observou-se que os tecidos hepáticos estão sujeitos a degeneração de hepatócitos, necrose, hepatócitos mitocondriais granulares e dilatação de sinusoides. Os tecidos renais indicaram aumento do espaço dos arqueiros, glomérulos contraídos e néfrons degenerados. Edema, necrose e atrofia foram observados nos tecidos musculares de peixes de áreas poluídas. Peixes da área a montante apresentaram lamelas branquiais fundidas, infiltração de células inflamatórias, hipertrofia e vacuolização em hepatócitos. Os tecidos renais indicaram a presença de células tubulares nucleares, túbulos renais destrutivos, hemorragia e necrose no epitélio tubular. Os espaços intramiofibrilas também foram observados nos músculos. Amostras de peixes controle não indicaram variação em brânquias, fígado, rim e músculos. O presente estudo revelou uma forte correlação entre o grau de dano tecidual e a contaminação ambiental. As descobertas atuais também constituem avisos globais para proteger nossos corpos d'água e peixes para resguardar a população humana.

experience of burn injueies

To study the demographical data of burn patients. This study was carried out in department of Plastic Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from January 2002 to December 2003. Only admitted patients of either sex of age more than 12 years were included. Total 77 males and 65 females fulfilled the criteria. The mean age in males was 32.2 years and 24.4 years in females. Male to female ratio was 1: 1.18 respectively. Burns were common during winter season [42.2%] In 6% patients, suicidal burns were noted. 15% patients were homicidal cases. 79% patients had the burns accidentally. Stove burst [22%] was the major mechanism in females whereas in males, 18% had the direct flame injury. Kitchen [27%] was the commonest place in females. Housewives [35%] were most frequently affected. More married males [39%] were burnt as compared to 18% of the unmarried females. Inhalational injury was present in 23% patients. Males had average burns of 27.4% TBSA and females had 39.5% TBSA involvement. 18% of the deaths were among the males and 16% in females. Prevention is always the rule to be safe from burns but once it occurs, immediate and proper care should be given with aggressive treatment to minimize the post burn problems

Efficacy and safety of phlogenzym--a protease formulation, in sepsis in children.

BACKGROUND: Infections are a major cause of hospitalisation wherein the host mounts an inflammatory response against the infecting agent. Administration of proteolytic enzymes could regulate the host's immune system and help early recovery from sepsis. OBJECTIVE: To test the efficacy and safety of an oral enzyme formulation, Phlogenzym (Mucos Pharma GmbH, Geretsried, Germany; constituents of each enteric-coated tablet were bromelain 90 mg, trypsin 48 mg, rutin 100 mg) as adjuvant therapy in treatment of sepsis in children. SUBJECTS AND METHODS: Double-blind, randomised, controlled phase III study at a tertiary care centre wherein 60 eligible children aged one month to 12 years with sepsis were randomised to receive either phlogenzym (n=30; 17 boys) or placebo (n=30; 22 boys) tablets (1 tablet/10 kg body weight up to maximum six tablets a day in two or three divided doses for 14-21 days) along with appropriate antibiotics and supportive treatment. RESULTS: Median time taken for fever to subside was three days (range 1-12; 95% CI--1.14 to 7.14) in the phlogenzym group vs four days (range 1-18; 95% CI--3.52 to 11.52) in the placebo group (p < 0.05); haemodynamic support was needed for two days (range 1-3; 95% CI--0.84 to 3.16) in the phlogenzym group but three days (range 1-8; 95% CI--0.76 to 5.24) in the placebo group (p < 0.05). The modified Glasgow coma scale score normalized in three days (range 1-14; 95% CI--4.62 to 9.62) in the phlogenzym group vs 5.5 days (range 1-18; 95% CI--2.52 to 13.52) in the placebo group (p > 0.05). Oral feeds could be started in four days (range 1-15; 95% CI--1.74 to 9.74) in the phlogenzym group vs five days (range 1-11; 95% CI--1.26 to 11.26) in the placebo group (p > 0.05). Two patients died in the placebo group. CONCLUSION: Phlogenzym is effective as an adjuvant with antibiotics and supportive treatment for early improvement of pediatric patients with sepsis.