BACKGROUND:Autism spectrum disorder (ASD) is a neurodevelopmental disorder believed to be strongly associated with epilepsy. The prevalence of epilepsy among children with ASD ranges widely, and an increased prevalence is observed in low-resource countries. Besides, individuals with ASD have an increased chance of abnormal epileptiform activity on EEG, irrespective of the presence of epilepsy. There is a lack of understanding of their intricate relationship and possible associations. Hence, we conducted this study to evaluate the prevalence and types of epilepsy and its association with abnormal EEG findings in children with ASD. MATERIALS AND METHODS:This cross-sectional observational study was conducted at the autism clinic in the Department of Pediatric Neurology at the National Institute of Neurosciences and Hospital, Dhaka, from July 2020 to December 2020. Following informed written consent from parents or legal guardians, 100 children with ASD aged 1-17 years were included in this study, irrespective of sex, race, or ethnicity, after meeting the inclusion and exclusion criteria. Ethical clearance was obtained from the Bangladesh Medical Research Council before the commencement of the study. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), was used to confirm the diagnosis of ASD. Then, data were collected using a structured questionnaire. EEG was performed on each study patient using a digital EEG machine. After collection, the data were analyzed using SPSS Statistics version 24.0 (IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.). RESULTS:The mean age of the participants was 4.47 ± 2.35 years, with a male predominance. Among them, 20 (20%) patients had epilepsy. Out of these children having epilepsy, 12 (12%) had a focal seizure, and the rest had other types of seizures. The average age at seizure onset was 25.14 ± 26.09 months. Among comorbidities, hyperactivity was at the top, followed by sleep disturbance, intellectual disability, and attention-deficit/hyperactivity disorder. EEG revealed that 62 (62%) patients had abnormal electrographic changes, where focal epileptiform discharges were documented in 35 (35%) patients. Additionally, 42 (42%) children with abnormal EEG findings had no clinical seizure. A significant association was found between clinical seizures and EEG abnormalities (p < 0.05). ASD children with epilepsy showed a significant association (p < 0.05) with hyperactivity in this study. CONCLUSIONS:We found that one-fifth of children with ASD had clinical epilepsy, where the focal seizure was the predominant seizure type. Although EEG abnormalities were found in two-thirds of patients with ASD, there were many cases in which seizures were not detected clinically. A significant association was found between clinical seizures and EEG abnormalities. Further analysis could deepen the understanding of this finding and its implications.

Cholera, a disease caused by Vibrio cholerae, remains a pervasive public health threat, particularly in regions with inadequate water sanitation and hygiene infrastructure, such as Bangladesh. This review explores the complex interplay between water pollution and cholera transmission in Bangladesh, highlighting how contaminated water bodies serve as reservoirs for V. cholerae. A key focus is the potential role of probiotics as a novel intervention approach for cholera prevention and management. Probiotics are promising as an adjunctive approach to existing therapies as they can enhance gut barrier function, induce competitive exclusion of pathogens, and modulate host immune responses. Recent probiotic advancements include engineering strains that disrupt V. cholerae biofilms and inhibit their virulence. Integrating probiotics with traditional cholera control measures could significantly enhance their effectiveness and provide a multifaceted approach to combating this persistent disease. This review aims to shed light on the potential of probiotics in revolutionizing cholera management and to offer insights into their application as both preventive and therapeutic tools in the fight against this enduring public health challenge.

The risk factors associated with autism spectrum disorder (ASD) have been the subject of extensive research, though conclusive evidence remains elusive. This case-control study aimed to identify potential risk factors for ASD in children, conducted at the Department of Pediatric Neurology, National Institute of Neurosciences and Hospital, Dhaka, from July 2020 to June 2021. The study included 80 diagnosed ASD cases (ages 2-14 years) and 160 age- and sex-matched healthy controls. The findings indicated that the average paternal age was significantly higher in cases compared to controls (32.44 +/- 5.58 vs. 30.30 +/- 4.47 years). Additionally, there was a higher proportion of cases with a family history of ASD (5% vs. 0.6%), maternal antenatal stress (35 vs. 11.3%), and smoking exposure (15 vs. 1.9%), as well as neonatal factors such as seizures (7.5 vs. 0.6%), jaundice (50 vs. 16.9%), infection (12.5 vs. 3.8%), and birth asphyxia (23.8 vs. 5.6%). Early screen exposure within the first year of life was also significantly higher among cases (90 vs. 56.9%). Multivariate logistic regression analysis identified maternal antenatal stress, smoking exposure, neonatal jaundice, and early screen exposure as independent risk factors for ASD after adjusting for other variables (p < 0.05). While these findings provide important insights, further research is needed to confirm these associations and guide public health strategies aimed at reducing the prevalence of ASD in Bangladesh.

Background: Though stroke in the pediatric age group is not as common as in adults, it is now recognized as an important cause of morbidity and mortality in children. For proper management of childhood stroke, it is very important to know about the spectrum of clinical presentation, risk factors, and neuroimaging features that can affect the outcome following stroke. The aim of the study was to identify predictors of outcomes in children with ischemic stroke treated at a referral neuroscience hospital in Bangladesh. Methods: A one-year prospective cohort study was conducted at the department of pediatric neurology, national institute of neurosciences and hospital (NINS and H), Dhaka, from March 2021 to February 2022. It involved 42 consecutive pediatric ischemic stroke patients aged 1 month to 18 years. Post-operative outcomes were assessed clinically, biochemically, and with imaging at discharge, 1 month, and 6 months post-discharge using the PSOM scale. Statistical analysis was performed using SPSS version 23.0, with significance set at p<0.05. Results: In our pediatric ischemic stroke study (n=42), most patients (76.2%) were aged 1-5 years, with iron deficiency anemia (59.5%) as the predominant risk factor. Anterior circulation stroke was common (90.5%), and PSOM assessments showed 28.6% favorable outcomes at discharge, increasing to 76.2% at 6 months. Seizure, speech difficulty, altered consciousness, and CNS infection were linked to poorer outcomes (p<0.005). Conclusions: Childhood stroke poses significant morbidity, with variable neurological outcomes. Factors like seizure, speech difficulty, altered consciousness, and CNS infection predict poorer outcomes.

Background: The metabolic syndrome (Met-S) is a cluster of some interrelated common clinical disorders, including central obesity, dyslipidemia, hypertension, and glucose intolerance. Central obesity, accompanied by insulin resistance, is a key factor for the development of metabolic syndrome. Adiponectin is an adipose-specific plasma protein, secreted from adipocyte with anti-atherogenic and insulin-sensitizing activities. Purpose: This study aimed to investigate the relationship of plasma adiponectin levels with metabolic syndrome, related disorders and it's drug repurposing through in silico approach. Materials and Methods: For this study, 269 individuals were recruited with written consent. The participants were selected based on their full medical history, clinical examination, and laboratory reports. Anthropometric measurements as well as blood pressure was measured before sample collection. Fasting blood samples were collected for the estimation of lipid profile, blood glucose, and serum adiponectin levels. Results: Our results show that the adiponectin levels in the subjects with Met-S were significantly lower than those of without Met-S (p <0.0001). Among the metabolic syndrome risk factors, adiponectin levels were associated with hypertriglyceridemia and reduced HDL-cholesterol (p<0.0001). Three drugs (Saquinavir, Candesartan and Glimepiride) were suggested to control the plasma adiponectin level in the subjects with Met-S. Conclusions: Since the plasma adiponectin levels are significantly lower in patients with Met-S, it might be used as diagnostic & prognostic marker for Met-S disorder and adiponectin targeted drugs might be minimize the Met-S of the subjects. ### Competing Interest Statement The authors have declared no competing interest.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by various brain abnormalities, although its exact cause remains unknown. Epilepsy is commonly associated with ASD, and children with ASD often exhibit paroxysmal EEG abnormalities, even without clinical seizures. Both ASD and epilepsy have a significant impact on a child's well-being and contribute to the burden on the family. This study aimed to assess the association of autism spectrum disorder with epilepsy and abnormal electroencephalogram in children. Methods: This comparative cross-sectional study was conducted in the outpatient Department of Pediatric Neurology, National Institute of Neurosciences (NINS), Dhaka, Bangladesh from January 2021 to July 2022. The study included a total of 60 children aged 31 months to 14 years diagnosed with autism spectrum disorder (ASD) at the pediatric outpatient department (OPD) in NINS, selected purposively. Data analysis was performed using the SPSS version 25.0 program. Results: In the ASD with epilepsy group, 50% of children had moderate ASD, and 50% had high ASD. In the ASD with abnormal EEG group, 66.67% had high ASD, and 33.33% had moderate ASD. In the ASD-only group, 81.25% had moderate ASD, 12.5% had high ASD, and 6.25% had low ASD. When comparing these groups with their corresponding comparison groups, the ASD with abnormal EEG group exhibited significantly more severe autism than children with ASD and normal EEG (p<0.001). Conversely, the ASD-only group had less severe autism than children with ASD and epilepsy/abnormal EEG (p<0.001). Conclusion: Children with ASD and abnormal EEG had a higher severity of autism, with 66.67% categorized as high severity. In contrast, children with ASD only experienced less severe autism, with 81.25% categorized as moderate. This indicates that ASD-only children tend to have a milder presentation of autism compared to those with ASD and comorbid epilepsy or abnormal EEG.

The Traveling Salesman Problem (TSP) is classified as a non-deterministic polynomial (NP) hard problem, which has found widespread application in several scientific and technological domains. Due to its NP-hard nature, it is very hard to solve effectively and efficiently. Despite this rationale, a multitude of optimization approaches have been proposed and developed by scientists and researchers during the last several decades. Among these several algorithms, heuristic approaches are deemed appropriate for addressing this intricate issue. One of the simplest and most easily implementable heuristic algorithms for TSP is the nearest neighbor algorithm (NNA). However, its solution quality suffers owing to randomness in the optimization process. To address this issue, this study proposes a deterministic NNA for solving symmetric TSP. It is an improved version of NNA, which starts with the shortest edge consisting of two cities and then repeatedly includes the closest city on the route until an effective route is established. The simulation is conducted on 20 benchmark symmetric TSP datasets obtained from TSPLIB. The simulation results provide evidence that the improved NNA outperforms the basic NNA throughout most of the datasets in terms of solution quality as well as computational time.

Background and objectives:Hypertension (HTN) is a leading cause of non-communicable disease in low- and middle-income countries, including Bangladesh. Thus, the objectives of this study were to investigate the associated risk factors for HTN and develop with validate a monogram model for predicting an individual's risk of HTN in Bangladesh. Materials and methods:This study exploited the latest nationally representative cross-sectional BDHS, 2017-18 data, which consisted of 6569 participants. LASSO and logistic regression (LR) analysis were performed to reduce dimensionality of data, identify the associated risk factors, and develop a nomogram model for predicting HTN risk in the training cohort. The discrimination ability, calibration, and clinical effectiveness of the developed model were evaluated using validation cohort in terms of area under the curve (AUC), calibration plot, decision curve analysis, and clinical impact curve analysis. Results:The combined results of the LASSO and LR analysis demonstrated that age, sex, division, physical activity, family member, smoking, body mass index, and diabetes were the associated risk factors of HTN. The nomogram model achieved good discrimination ability with AUC of 0.729 (95 % CI: 0.685-0.741) for training and AUC of 0.715 (95 % CI: 0.681-0.729)] for validation cohort and showed strong calibration effects, with good agreement between the actual and predicted probabilities (p-value = 0.231). Conclusion:The proposed nomogram provided a good predictive performance and can be effectively utilized in clinical settings to accurately diagnose hypertensive patients who are at risk of developing severe HTN at an early stage in Bangladesh.

Child marriage is a pressing global concern, and Bangladesh is no exception to this social reality. Undoubtedly, child marriage significantly hinders worldwide women’s empowerment, constituting a severe violation of human rights. In developing countries, including Bangladesh, as a result of child marriage on education and health, social indicators of women’s empowerment are affected, which creates obstacles to reaching sustainable development goals. The main purpose of this study is to identify the effects of child marriage on education and health of women and explore the relationships among child marriage, women empowerment and sustainable development goals. A mixed methodology was applied to this study. By using Snowball sampling techniques, data was collected from 35 respondents 4 male and 31 female, who were read in primary (27) and secondary (8) school.The findings of the study identified that the education and health of women in Naogaon at Sapahar are seriously affected due to child marriage. As a result of child marriage, girls are dropping out of school, deprived of education, creating gender inequality, and hampering women’s empowerment; on the other hand, girls are losing physical and mental health, suffering malnutrition and long-term health diseases, increasing their risk of maternal and child mortality. We was found child marriage as the main and only reason for female students dropping out of school both Primary and secondary school Here, 100 percent of the total female respondents dropped out of child marriage. The health condition of the girl’s respondents of this study is more vulnerable because the girl’s age of marriage is very low. In the study area, the average age of marriage of total respondent was 13, (the age of male respondentis 15 and female student was 11). Lowest age of female was 9 (eleven case) and lowest age of male was 14 (two case). These findings can serve as valuable insights for academics and policymakers, guiding the development of effective plans and programs to address child marriage. Ultimately, the goal is to contribute to achieving sustainable development goals (SDGs) and creating a better future for women in Bangladesh.

Rheumatoid arthritis (RA) is the most common inflammatory polyarthritis in Bangladesh. Bangladesh Rheumatology Society (BRS) proposes these management recommendations to treat the considerable burden of RA in the resource -constrained situation based on the best current evidence combined with societal challenges and opportunities. BRS formed a task force (TF) comprising four rheumatologists. The TF searched for all available literature, including updated American College of Rheumatology (ACR), European Alliance of Associations for Rheumatology (EULAR), and Asia -Pacific League of Associations for Rheumatology (APLAR) and several other guidelines, and systematic literature reviews until October 2023, and then a steering committee was formed, which included rheumatologists and internists. We followed the EULAR standard operating procedures to categorize levels of evidence and grading of recommendations. This recommendation has two parts -- general (diagnosis of RA, nomenclature of disease -modifying antirheumatic drugs [DMARDs], disease activity indices) and management portion. The TF agreed on four overarching principles and 12 recommendations. Overarching principles deal with early diagnosis and disease activity monitoring. Recommendations 1-5 discuss using glucocorticoids, NSAIDs, and conventional synthetic DMARDs (csDMARD). Recommendations 6-9 stretch the use of targeted synthetic DMARDs (tsDMARDs) and biological DMARDs (bDMARDs). The suggested DMARD therapy includes initiation with methotrexate (MTX) or another csDMARD (in case of contraindication to MTX) in the first phase and the addition of a tsDMARD in the second phase, switching to an alternative tsDMARDs or bDMARDs in the subsequent phases. The TF included the Padua prediction score for the thromboembolism risk estimation. Recommendations 10-12 cover infection screening, vaccination, and DMARD tapering. Bangladesh has a higher prevalence of RA. This recommendation will serve as a tool to treat this high burden of patients with RA scientifically and more effectively.

Background: Prostate cancer is a leading cause of death in men. Nodular hyperplasia and adenocarcinoma are common causes of prostatic enlargement. Diagnosis of these lesions on routine biopsies can be difficult for pathologists. Immunohistochemical stain p63 can help, but it is costly and not widely available. The present study aimed to evaluate the usefulness of mucin histochemistry in relation to p63 expression in differentiating nodular hyperplasia and adenocarcinoma of prostate. Methods: This study was conducted in the department of pathology at Dhaka medical college from July 2018 to June 2020. 50 cases of prostatic lesions (25 NHP and 25 adenocarcinoma) were examined using histomorphology. The sections were stained with periodic acid Schiff (PAS) to identify neutral mucins and Alcian blue (2.5 pH) to identify acidic mucins. Additionally, p63 antibody was used in immunohistochemistry. Results: NHP showed positivity for neutral mucin (96% with PAS stain) but not for acidic mucin (Alcian blue stain), while prostatic carcinoma showed positivity for both neutral mucin (28%) and acidic mucin (44%). The grade group 1 tumors of prostatic carcinoma showed 100% positivity for acid mucin, with a decrease in Alcian blue staining as the grade increased. P63 was positive in 100% of NHP cases and negative in 100% of prostatic carcinoma cases. Conclusions: Positivity for acidic mucins with Alcian blue stain can be a helpful diagnostic tool to differentiate well differentiated adenocarcinomas from benign lesions where facility for p63 immuno-stain is not available and poor people who cannot afford the cost of immunohistochemistry.

Background: Urinary bladder cancer is one of the most common forms of all cancers in the world. It is the ninth leading cause of death from cancer among men. The incidence of urinary bladder cancer in Bangladesh is increasing day by day. The aim of the study was to evaluate different clinic-pathological parameters of urothelial carcinoma of urinary bladder with the grade of the tumor. Methods: This study was a cross sectional study done over a period of two years, from March 2018 to February 2020 at the department of pathology, Dhaka medical college, Dhaka. Total 73 samples were collected, fixed overnight in 10% buffered formalin and stained with hematoxylin and eosin staining. Pathological grading was confirmed and different clinic-pathological parameters were evaluated. Results: Most of the cases (22 cases, 30.1%) were found in the fifth decade (51-60). Mean age of the patients was found to be 60.85 (±12.72) years, 58 (79.5%) cases were male and 15 (20.5%) cases were female with male to female ratio of 3.9:1. Most of the cases (49 cases, 67.1%) were smokers. Most common clinical presentation was hematuria (91.8% cases), most frequent tumor location was the lateral wall of the urinary bladder and 75.3% cases were reported as high-grade urothelial carcinoma. Conclusions: Different clinic-pathological parameters with histologic grading were evaluated in this study which may have a significant impact in epidemiology, diagnosis and assessment of biological behavior of urothelial carcinoma.

Background: Cervical carcinoma is one of the most common causes of mortality among women. This mortality rate can be reduced by early detection of cervical neoplasm by different screening tests. The main objective of this study was to diagnose cervical diseases by colposcopy, by pap smears for cytological examination as well as correlate these findings as screening tests with histopathological diagnosis. Methods: In this cross-sectional observational study, total 143 cases were included. History was taken and clinical examination was done. Colposcopy and VIA test was done, pap smear sample was collected and reporting was made. Cytological findings were correlated with histopathology. Results: Mean age of the study cases was 41.2±11.5 years. VIA test was positive in 98 study cases (68.5%). On colposcopy, most of the cases show neoplastic proliferation (80 cases, 55.9%). Among them, most cases were diagnosed as cervical intraepithelial neoplasia-I (CIN-I). Sixty-three (63) cases (44.1%) were non-neoplastic. Most of the biopsies was diagnosed histopathologically as cervical intraepithelial neoplasia-I (CIN-I) (20 cases, 14.0%). Association of colposcopy findings with histopathological diagnosis was done which was significant. Sensitivity of diagnosis of cervical malignancy by colposcopy was 33.33% and specificity was 98.57%. Conclusions: The study provides good cyto-histopathology correlation in detecting different cervical lesions and malignancy with colposcopy. Although colposcopy sensitivity was low but it can be increased by adequate training and avoiding technical errors. Bethesda system is strongly recommended for adequacy of sampling to minimize inconsistency. Early and regular screening should be advised for reduction of mortality rates from cervical carcinoma.

Background: We describe patient characteristics and response to initial treatment in a large case series of children presenting with infantile epileptic spasms syndrome to a tertiary-care hospital with a pediatric neurology service in Bangladesh. The purpose of the study was to add to the growing body of literature on infantile epileptic spasms syndrome in low-and middle-income countries. Methods: We enrolled 212 infants with new-onset infantile epileptic spasms syndrome (IESS) at the time of initial presentation to the National Institute of Neurosciences and Hospital (NINS) in Dhaka, Bangladesh, between January 2019 and August 2021. We collected data about seizure type and frequency, etiology, medication dosage, and available neuroimaging. Results: Median age at initial presentation to NINS was 9 months. Developmental delay and regression prior to presentation were found in 83% and 36%, respectively. Prior to their pre-sentation at NINS, 197 (93%) patients had received anti-seizure medication to treat spasms, of whom only 8 (4%) had received standard therapy with ACTH, prednisolone, or vigabatrin. At NINS, 207 (98%) of patients received standard therapy, most frequently ACTH in 154 (73%). Median time between seizure onset to receipt of first-line therapy was 5 months. Of the 169 patients who were seen in follow-up at average of 5 weeks, 92 (54%) reported absence of clinical epileptic spasms. No serious adverse events requiring hospitalization were reported. Conclusions: This study highlights the long lead times to treatment for IESS in a low-and middle -income country, and the need for early referral of children with suspected epileptic spasms to epilepsy care centers.

Abstract The sessional variation of heavy metals pollution and potential health risks in sediments to local people were studied using a flame atomic absorption spectroscopy (FAAS). Ten (10) different khals that serve as the natural drainage of Chittagong City were chosen for collecting the surface sediments samples from the confluence of the Karnaphuli River. The mean concentration of Cu, Cr, Cd, Pb, Ni, Mn, As and Zn in sediments samples were 38.83, 46.92, 2.18, 42.98, 43.39, 63.04, 1.34 and 91.93 mg kg− 1 respectively for the wet session, while the respective values in dry season were found 51.12, 59.23, 2.52, 61.04, 49.66, 58.54, 2.21 and 104.44 mg kg− 1. The enrichment factor (EF), contamination factor (CF), modified contamination degree (mCd), degree of contamination (Cd), geoaccumulation index (Igeo), potential ecological index (PERI) and nemerow pollution index (PN) were calculated to estimate the pollution level of the study areas. Potential carcinogenic and non-carcinogenic health risks through dermal contact were also calculated using respective mean values of heavy metals. Statistical analyses were applied in order to findout the establish the association and source of heavy metals between pollutants in river sediments. The results showed that concentration of heavy metals was higher in the dry season than in the wet season at most of the locations. The obtained comprehensive data for toxic heavy metals in the surface sediment of the Karnafuly River along the Chittagong City Corporation may help the policy maker to take effective legislation for monitoring and protecting the ecological risks of the Karnafuli River.

Background: Vitamin D plays a pivotal role in supporting the immune system, helping to reduce the risk of infections and certain autoimmune diseases.Adequate vitamin D levels may be associated with a reduced risk of certain health conditions like pre-eclampsia, gestational diabetes, and postpartum depression.Brittle bones, osteoporosis in the elderly, and osteomalacia in young children are all symptoms of vitamin D insufficiency.Additionally, it contributes to problems linked to gum disease, including an increase in dental cavities, alveolar bone loss around the teeth, and other problems.It could lead to depression, tiredness, and a loss of appetite.In this study, urban children and adolescents in Dhaka city, Bangladesh are examined for vitamin D deficiency, insufficiency, and sufficiency.Methods: The Study was a crosssectional study conducted under Dhaka National Medical College and Hospital, Dhaka and additionally included two other health centers Medinova Medical Services and Monoara General Hospital Service Golap bag, Dhaka from October 2020 to November 2021.The study location was at the 3 (Three) different hospitals which was located in Dhaka City.In this cross-sectional study, Participants will be selected purposively and conveniently based on the age categories from 0 -19 years of age at the outdoor department of the hospital.The study included the secondary dataset of ambulatory individuals who came to the 3 (three) hospitals, randomly to evaluate serum vitamin D levels on referral from a general out-patient-department (OPD).They were examined for laboratory findings of serum 25 hydroxyvitamin D levels to determine vitamin D deficiency, insufficiency, and sufficiency among children

Background: This study examined the association between media exposure and mental health during the second wave of lockdown among the general population of Bangladesh.Methods: A total of 449 adult participants were enrolled in the study to evaluate their levels of exposure to total media, electronic media, and social media. Mental health was assessed using a 7 -item generalized anxiety disorder (GAD-7) scale. A multivariate logistic regression model was constructed to explore the relationships between media exposure levels and anxiety. The models included covariates such as sex, daily working hours, health problems, media distraction, and income from social media.Results: The results showed that 44.5%, 39.2%, and 16.3% of participants reported low, medium, and high levels of exposure to different media during the COVID-19 period, respectively. Addi-tionally, 96.4%, 2.7%, and 0.9% of participants had low, medium, and high levels of exposure to electronic media, respectively, and 89.1%, 10.5%, and 0.4% of participants had low, medium, and high levels of exposure to social media, respectively. The overall prevalence of anxiety was 25.38% among the respondents. Participants with high levels of total media exposure were significantly more likely to experience anxiety, with an odds ratio of 2.75 (95% CI = 1.40-5.14, p < 0.01). Females were 2.26 times more likely to experience anxiety than males (95% CI = 1.37-3.74, p < 0.01), and participants with health problems were also more likely to develop anxiety compared to those who did not.Conclusion: Our results show a positive relationship between increased media exposure and anxiety levels, providing useful insights for both academics and public health practitioners.

Background: Guillain-Barre syndrome (GBS) is the leading cause of acute flaccid paralysis in children. This study was aimed to compare the clinical spectrum and shortterm outcome of children with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN) subtypes of GBS in children. Methods: The study was a prospective cohort study done in a tertiary neurology hospital for 3 years. Children under 18 years of age fulfilling the Brighton diagnostic criteria for GBS were enrolled in the study. Based on the nerve conduction study, patients were subclassified as AIDP, AMAN, AMSAN, and others. Finally, a comparison was done in children with AIDP and AMAN subtypes. Results: A total of 102 children have fulfilled the Brighton diagnostic criteria of GBS during that study period. Among them, 83 children were included in the final analysis as NCS findings suggestive of AIDP and AMAN were found in 29(28.43%) and 54(52.94%) of cases respectively. No patient died in this cohort and follow-up was done at 3 months after discharge. A comparison of clinical data between the two groups revealed similar clinical features in most of the cases. The mean age difference between the two groups was statistically significant and AIDP was found to be more frequent in the 1-5 years age group. There was a significant association between gastroenteritis and AMAN subtypes. On symptom analysis, pain and tingling sensation were found predominantly in AMAN subtypes. Children having AMAN variants developed respiratory distress more than AIDP. Assisted ventilation were needed in 14.45% of cases and the majority of them were from the AMAN group. The mean duration of hospital stay and the mean disability scores at three months after discharge were significantly higher in the AMAN group. Conclusions: AMAN was the commonest GBS subtypes in children. AIDP was more frequent in the younger age group. Children with AMAN appeared to have higher short-term morbidity and slower recovery than those with AIDP. Bang. J Neurosurgery 2022; 11(2): 94-100