Chattagram Maa-O-Shishu Hospital Medical College

Developmental and epileptic encephalopathies (DEE) comprise a severe spectrum of early-onset epilepsy syndromes where epileptic activity aggressively drives progressive cognitive and neurological regression beyond the underlying pathology. This narrative review evaluates the expanding genetic architecture of DEE, explores modern diagnostic developments, and outlines the ongoing paradigm shift from conventional symptomatic management toward gene-targeted, precision therapeutic strategies. A comprehensive literature search was conducted across major databases for articles published between 2010 and 2026. Recent breakthroughs in next-generation sequencing have dramatically escalated diagnostic yields, allowing clinicians to identify pathogenic variants earlier and establish refined genotype-phenotype correlations. This molecular precision has opened doors for novel mechanism-based interventions, including antisense oligonucleotides, gene replacement platforms, and mutation-specific pharmacology. Concurrently, artificial intelligence-driven electroencephalography analytics and wearable multimodal monitoring networks are improving real-time seizure mapping and patient safety. However, widespread clinical implementation remains restricted by intense genetic heterogeneity, uncertain long-term safety records, and steep financial barriers. Ultimately, incorporating genomic diagnostics into standard practice is transforming the clinical trajectory of DEE. Future research must prioritize multi-center clinical trials to validate long-term therapeutic efficacy and optimize early-intervention windows during critical stages of neuroplasticity.

Background: Mesenteric cysts are intra-abdominal masses found in children, mainly caused by embryonic defects in the development of the lymphatic system. This study aims to evaluate the clinical findings, management strategies, and outcomes associated with mesenteric cysts at our institution. Materials and methods: This prospective observational study involved 27 pediatric patients who underwent surgery for mesenteric cysts at the Department of Pediatric Surgery of Chattagram Maa-O-Shishu Hospital Medical College between January 2019 and December 2024. We assessed clinical findings, radiological investigations, surgical procedures, histopathological evaluations, postoperative complications, and follow-up data. All data were collected prospectively. Results: The median age at diagnosis was 5.25 years, with a female-to-male ratio of 1.45:1. The most common clinical manifestations were abdominal pain (70.4%) followed by a palpable abdominal mass (55.5%) and vomiting (25.9%). The jejunal mesentery (55.5%) was the most common site of origin for mesenteric cysts, followed by the ileal mesentery (33.3%) and 11.2% originated from the sigmoid mesentery. The median size of the mesenteric cystic mass was 8.6 ± 4.4 cm. Complete and successful removal of the mesenteric cysts was achieved in all cases. Surgical management included enucleation (n =17) cyst excision combined with bowel resections and primary intestinal anastomosis (n =8) and laparoscopic resection of the cyst (n = 2). Early post-operative complications included only wound site infections in three (11.1%) patients. Histologically, simple cyst with mesenteric lymphangiomas was detected in 19 cases and mesotheliomas in 6 cases. None of the patients experienced a recurrence of their condition. Conclusions: The most common presenting symptom of a mesenteric cyst was abdominal pain. Jejunal mesentery was the commonest site. The relationships between the mesenteric cyst and adjacent organs largely influence the surgical approach. JCMCTA 2026 ; 37 (1) : 152-157

Background: Fetal biometry is used in modern obstetrics to precisely estimate gestational age, assess growth and detect anomalies. Nonetheless, different populations may not benefit from international growth charts, such as Hadlock's, which are widely used in Bangladesh. This study aimed to establish local reference ranges for fetal biometric parameters in the Chattogram population of Bangladesh and compare them with the World Health Organization (WHO) international standards. Materials and methods: A retrospective chart review of 2,017 ultrasound reports of singleton, non-anomalous pregnancies between 14 and 40 weeks of gestation. Percentile curves for Biparietal Diameter (BPD) Abdominal Circumference (AC) Femur Length (FL) and Estimated Fetal Weight (EFW) were generated and compared with the corresponding WHO International Fetal Growth Standards. Results: While the median BPD and AC were largely comparable to WHO standards, the local 97.5th percentiles were consistently lower in the later stages of pregnancy. FL measurements, in contrast, were consistently slightly larger than WHO standards. The most significant finding was a distinctive "Crossover" pattern in the EFW charts, with the local 2.5th percentile showing accelerated growth and the 97.5th percentile flattening in the third trimester. Additionally, a 1.35% prevalence of congenital anomalies was detected, with Anencephaly and Multiple anomalies being the most common, each representing 9.30% of the total detected anomalies. Conclusion: The findings suggest that a one-size-fits-all approach to fetal growth monitoring is inappropriate for this population. The development and adoption of local reference charts are crucial for improving prenatal care and ensuring better perinatal outcomes in Bangladesh, as international charts may lead to the misclassification of fetal growth abnormalities. JCMCTA 2026 ; 37 (1) : 17-24

Hemophagocytic lymphohistiocytosis (HLH) is a serious condition induced by Dengue virus which becomes fatal if not detected early and treated appropriately. So objectives of the present study are to observe the different patterns of presentations, clinical features and outcome of HLH induced by Dengue. In this observational study, 14 patients admitted and diagnosed HLH as per diagnostic criteria, were included after informed written consent. Study conducted in a period of six months from 01/07/2025 to 31/12/2025. All patients were followed up till discharge. After collection, all data were analyzed by Microsoft Excel 2010. Ethical clearance was taken from Ethical Review Board of the Medical College. Among 14 cases, male were more affected then the female (78.6% VS 21.4%) and majority were in between 20 to 50 years age groups. Clinical data showed, all 14 cases had fever for >7 days, joint pain 3(21.4%), headache 11(78.6%), skin rashes 10(71.4%), retro-orbital pain 2(14.3%), vomiting 11(78.6%),bleeding 10(71.4%), cough 4(28.6%), loose motion 9(64.3%), abdominal pain 7(50.0%), anorexia 2(14.3%), Melaena 2(14.3%), jaundice 4(28.6%) and spleenomegaly 9(64.3%). One(7.1%) case had history of Hypertension. Laboratory data showed different level of Bi or Pancytopenia, high ferritin, high TG, low fibrinogen, raised liver enzymes and low sodium. Dengue RT PCR and serology results showed 8(42.9%) cases were both IG M and Ig G dengue antibody positive, 6 cases were RT PCR positive, 2 cases were IgM and another 4 cases were IgG positive. Outcome of patients revealed, among all 14 cases12(85.8%) patients improved uneventfully and 2 were shifted to ICU where one improved and one died. Dengue is prevailing for long time and different complications are evolving and HLH is a relatively newer incident among the dengue patients. Infection by different serotypes at different time or multiple dengue serotype infection may be related with HLH and it might be a future subject to explore and to evaluate.

Introduction: Jaundice is the commonest presenting features of hepatitis and it is a common clinical condition in Bangladesh. As a country of the Asia Pacific region Bangladesh is considered to be a high risk country for developing hepatitis by different hepatotropic viruses. This study represents the patterns and types of viruses among the patients admitted in a tertiary care hospitals in Bangladesh who were presented with jaundice. Methods: Present cross sectional observational study done during a one year study period from July 2022 to June 2023 in a tertiary care hospital, Chattogram, Bangladesh among 114 patients. All patients who had clinical jaundice or having serum bilirubin > 2 mg/dl were recruited in the study. Clinical data were collected from all of them and viral serology were also done by ICT or ELISA. Informed written consent were taken from all patients and permission for the study were taken from ERB of the medical college. Results: Among 114 study subjects, male were 73(64%) and female were 41(36%) and male to female ratio was 1: 0.56. Among all, maximum were in the age range of <20 years and 21- 30 years which were 46(40.4%) and 44(38.6%) respectively. Regarding clinical features, 109(95.6%) had jaundice and 89(78.1%) had fever and 74(64.9%) had nausea and these were three dominant clinical features found. Viral serology study revealed frequency of HAV, HBV, HCV and HEV infection were 43(37.7%), 9(7.9%), 1(0.9%) and 26(22.8%) respectively. There were viral coinfections with (HAV+HEV), (HAV+HBV) and (HBV + HEV) and it were 8(7.0%), 4(3.5%) and 3(2.6%) respectively. Among all 20(17.5%) cases were tested negative for hepatotropic viruses. Again 6(5.3%) had Anti HBc Positivity and 2(1.8%) cases were found coinfected with HIV. Conclusions: In a year round, HAV and HEV are two common viral infection causing jaundice among the locality. HBV had a significant level of infection with low level HCV causing jaundice. Two HIV coinfection is an alarming condition found among the jaundice patients which need further exploration and risk factor evaluations. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Fund was obtained to conduct the study from Chattogram Maa O Shishu Hospital Medical College research fund ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: An ethical clearance to conduct the study was obtained from the ethical review board(ERB) of Chattogram Maa O Shishu Hospital Medical College(CMOSHMC). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors