Background: Organ donation is the process of retrieving healthy organs and tissues from a living or deceased person for transplantation into another individual in need. It plays a vital role in saving lives and improving the quality of life for patients suffering from organ failure such as kidney, liver or heart. Methods: This descriptive cross-sectional study was conducted from 21st to 31st October 2024 among final-year students of Anwar Khan Modern Medical College (AKMMC), Green Life Medical College (GLMC), and Northern International Medical College (NIMC). The knowledge, attitude, and practice (KAP) of the students regarding organ donation were assessed using 10 questions on knowledge, 10 on attitude, and 6 on practice, assigning a score of 1 for each correct response and 0 for each incorrect response. Purposive sampling technique was used for data collection and the final sample size was 261. The data were analysed via SPSS (version 25.0) p < 0.05 was considered statistically significant. Results: The study population included 61.3% females and 38.7% males with a mean±SD age of 24.5±1.5 years. AKMMC represented almost half of the participants (48.3%), while GLMC and NIMC accounted for 31.4% and 20.3% of the participants, respectively. The majority of the participants (88.9%) were from urban areas, while only 11.1% were from rural areas. Association between gender and participants’ knowledge regarding organ donation was significant (p = 0.02), while their attitude towards and practice regarding organ donation was not significant (p> 0.05). Females were more knowledgeable than male. Association between medical college and participants’ knowledge, attitude, and practice regarding organ donation was not significant (p > 0.05). Association between residence and participants’ knowledge and practice regarding organ donation was significant (p = 0.01), while their attitude towards organ donation was not significant (p > 0.05) Conclusion : The results of our study revealed that the majority of the participants had a satisfactory level of knowledge, showed a positive attitude, but had poor practice regarding organ donation. The majority first heard about organ donation from the internet and were aware that kidney, liver, heart, lung, cornea and bone can be donated. As most of the participants lacked knowledge about ‘The Human Organ Transplantation Act’ of Bangladesh, awareness programs and activities should be arranged to discuss its details. Northern International Medical College Journal Vol. 16 No. 1-2 July 2024-January 2025, Page 706-711
Background: Metabolic acidosis is a frequent biochemical abnormality in critically ill neonates, often contributing to poor clinical outcomes. The corrected anion gap (cAG) serves as a valuable marker for unmeasured anions and acid-base disturbances, yet its role in predicting mortality and mechanical ventilation requirement in neonates remains underexplored. This study aimed to assess the prognostic significance of cAG in critically ill neonates with metabolic acidosis. Methods: This prospective observational study was conducted at Bangladesh Shishu Hospital & Institute (BSH&I) from July 2021 to June 2023, including 115 critically ill neonates with metabolic acidosis admitted to the NICU. Clinical and biochemical data were collected, including pH, bicarbonate, sodium, anion gap (AG), corrected anion gap (cAG), and base excess. Neonates were categorized into survivors (n=64) and non-survivors (n=51). Statistical analyses, including Pearson’s correlation, Student’s t-test, chi-square test, and logistic regression, were performed using SPSS version 22.0, with p < 0.05 considered statistically significant. Results: The mean cAG was significantly higher in non-survivors (31.53 mEq/L) compared to survivors (18.60 mEq/L) (p = 0.001). Severe metabolic acidosis (lower pH and bicarbonate, higher AG and cAG) was strongly associated with increased mortality. Mechanical ventilation was required in 90.6% of non-survivors, reinforcing its role as a predictor of poor outcomes. A strong negative correlation was observed between cAG and mechanical ventilation requirement (r= -0.607, p = 0.001). Additionally, a weak but statistically significant negative correlation between cAG and NICU length of stay (r = -0.213, p = 0.023) suggested that higher cAG values were associated with shorter LOS due to increased mortality. Conclusion: cAG is a strong predictor of mortality and mechanical ventilation requirement in critically ill neonates with metabolic acidosis. The severity of metabolic acidosis, as indicated by lower pH, bicarbonate levels, and elevated AG and cAG, was significantly associated with poor outcomes. Routine monitoring of cAG in NICU settings could serve as a valuable tool for early risk stratification and clinical decision-making. Northern International Medical College Journal Vol. 16 No. 1-2 July 2024-January 2025, Page 728-733
Background: Neonatal sepsis remains a leading cause of morbidity and mortality worldwide, with the burden disproportionately high in low- and middle-income countries. Nonspecific clinical signs, overlapping presentations with other neonatal conditions, and limited microbiological facilities complicate timely diagnosis and management. In Bangladesh, where neonatal mortality remains substantial, context-specific evidence is needed to refine empirical treatment and preventive strategies. Objective: This study aimed to evaluate the clinical and bacteriological profile, maternal and neonatal risk factors, and immediate outcomes of neonates with suspected sepsis admitted to a Neonatal Intensive Care Unit (NICU)of a tertiary care hospital in Dhaka. Methods: We conducted a prospective observational study at the NICU of Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, between January 2024 and June 2024. A total of 40 neonates with one or more sepsis risk factors and/or clinical features suggestive of infection were enrolled. At the time of admission demographic, clinical, laboratory, and maternal variables were recorded and blood culture and septic screen also performed. Statistical analysis was done by using SPSS version 26. Data were summarized as frequencies and percentages for categorical variables, and continuous variables as means with standard deviations or medians with ranges, depending on distribution. Results: Among the total 40 neonates, 67.5% were male, 50% had low birth weight, and 45% were preterm. Maternal risk factors included gestational diabetes (40%), urinary tract infection (30%), and premature rupture of membranes (20%). Poor activity (95%) and desaturation (85%) were the most common presenting features. Blood culture positivity was 20%, with Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA) each accounting for 37.5% of isolates. C-reactive protein was elevated in 50% of cases. The survival rate was 95%, with an average ICU stay of 11 days; 5% of neonates died. Conclusions: Neonatal sepsis was strongly associated with prematurity, low birth weight, maternal UTI, and PROM. Blood culture yield was low, but Klebsiella and MRSA predominated among isolates. Northern International Medical College Journal Vol. 16 No. 1-2 July 2024-January 2025, Page 734-739
Background: Neonatal morbidity and mortality remain major public health challenges in Bangladesh, particularly among critically ill neonates requiring intensive care. Identifying the clinical profile and outcomes of neonates admitted to tertiary care facilities is essential for improving neonatal survival and guiding preventive strategies. Methods: This cross-sectional study was conducted in the Department of Neonatal Medicine, Bangladesh Shishu Hospital and Institute, Dhaka, from 1st January 2023 to 30th June 2023. A total of 382 neonates were admitted to the Neonatal Intensive Care Unit (NICU) during this period were included. Data on demographic characteristics, morbidity patterns and outcomes were collected and analyzed using SPSS version 25. Results: Among 382 neonates admitted to the Neonatal Intensive Care Unit (NICU), males predominated (63.6%). Most were term infants (81.7%) and delivered by normal vaginal delivery (57.6%). Birth asphyxia (41.9%) was the leading cause of morbidity, followed by preterm low birth weight (18.3%) and neonatal sepsis (13.1%). The overall mortality rate was 41.4%, with birth asphyxia (54.4%) being the primary cause of death. Most admissions occurred within 24–72 hours of life (55.2%). Conclusion: Birth asphyxia, neonatal sepsis and prematurity were identified as the major causes of neonatal morbidity and mortality in this tertiary care setting. Northern International Medical College Journal Vol. 16 No. 1-2 July 2024-January 2025, Page 740-744
Background: Guillain-Barre Syndrome (GBS) is a leading cause of acute flaccid paralysis in children. Clinical presentation and the nature of treatment significantly influence short-term outcomes. This study aims to assess the association between the clinical profile and short-term outcomes in paediatric GBS. Objective: The objective of this study was to evaluate the association between various clinical presentations, with shortterm outcomes in paediatric Guillain-Barre Syndrome (GBS) Methods: This retrospective observational study included paediatric GBS patients (ages 6 months to 16 years) admitted to a tertiary care hospital in Bangladesh from January 2023 to December 2024. Data were collected on clinical features, electrophysiological subtype, and treatment modality. Short-term outcomes were assessed by using the Hughes GBS Disability Score during discharge and 3 months after discharge. Statistical analysis was done to find out the association between presentation, treatment, and outcomes. Results: Among 45 children the most common clinical features were ascending lower limb weakness (100%), paraesthesia (89%), cranial nerve involvement (13.3%), and respiratory failure (24.4%). 31% were ambulatory. Electrophysiological subtypes included axonal type (84.4%) and demyelinating (15.6%). IVIG was administered to 42.2% of patients in ward and in ICU, while 31% required ICU care. The disease was progressive in 38%. Good outcomes (Hughes 0-3) were found in 47% at discharge and 62.2% after 3 months. Poor outcomes at discharge were significantly associated with progressive disease (OR =1.5, 95% CI: 0.7-3.2, p=0.01) and respiratory failure (OR=1.2, 95% CI: 0.64-2.4, p=0.02). After 3-month follow-up, several factors were found to be significant. The factors were progressive disease (OR = 6.72, 95% CI: 1.75–25.76, p = 0.005), Respiratory failure (OR = 7.4, 95% CI: 1.6–34.2, p = 0.01), respiratory tract infection as a preceding illness (OR = 3.5, 95% CI: 1.0–12.6, p=0.04) and Need for IVIG (OR=4.58 (95% CI: 1.26–16.63, p = 0.02). Conclusion: The presence of progressive disease, respiratory failure, a history of preceding respiratory infection, and those who required intravenous immunoglobulin (IVIG) therapy were found to be significant indicators of poor outcome. Early identification and aggressive management of these risk factors are crucial for improving paediatric GBS outcomes. Northern International Medical College Journal Vol. 16 No. 1-2 July 2024-January 2025, Page 721-727
