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Co-relation between Sepsis Score and Blood Culture Report in Neonatal SepticaemiaS Afroza & F Begum6. Hull D, Johnston DI editors. Essential Paediatrics. 2"dedition, Churchill Livingstone; 1990.7. John P Clohery, Ann R Stark editors. Manual of NeonatalCare. 4`h edition. Lippincott Raven Publishers,Philadelphia; 1998.8. Soman M, Green B, Daling J. Risk factors for early neonatalsepsis. Am J Epiodemiol 1985; 121: 712-19.9. Pyati SP. Foetal and Neonatal Infections. In: Vidyasagar Deditor. Textbook of Neonatology. Interprint, Mehta OffsetWorks, New Delhi 1987; p. 32-50.10. Schlegel RJ, Bellante JA. Increased susceptibility of male toinfection. Lancet 1969;2:826.11. Tollner U. Early diagnosis of septicaemia in the newborn:clinical studies and sepsis score. Euro J Pediatr 1982; 138:331-37.12. Rashid MA. Neonatal Sepsis (An Update Review).Dissertation for FCPS Part II, 1988.13. Purtillo DT, Sullivan JL. Immunological basis for superiorsurvival of females. Am J Dis Child 1979; 128: 407.14. Nyhan WL, Fousek KD. Septicaemia in the newborn.Pediatrics 1958; 22: 268-78. 15. Gandi GM, Roberton NRCeditors. Lecture notes on Neonatology. Blackwell ScientificPublications Ltd. 1987.16. Mokuolu AO, Jiya N, Adesiyun 00. Neonatal septicaemia inIllorin: bacterial pathogens and sensitivity pattern.. Afr JMed Sci 2002; 31: 127-30.17. Kumher GD, Ramachandran VG, Gupta P. Bacterialanalysis of blood culture isolates from neonates in a tertiarycare hospital in India. J Health Popul Nutr. 2002; 20: 343-7.18. Modi N, Carr R. Promising strategies for reducing burden ofneonatal sepsis. Arch Dis Child (Fetal and Neonatal Ed)2000; 83: F 150-53.82
REVIEW ARTICLESJuvenile Idiopathic ArthritisEssential Elements of CareMR AlamSummary:The chronic arthritides in childhood remain a poorlyunderstood group of conditions. Their classification has beena source of much confusion over the years with differencesin terminology used by different research groups. Childhoodarthritis is an important cause of short term morbidity inchildren and can lead to long term joint destruction anddisability. Proper diagnosis and early aggressive interventionIntroduction & Nomenclature:Juvenile idiopathic arthritis (JlA) is a relatively raredisease affecting 1 in 1000 children in UK 1 .Important changes have occurred in the last decaderegarding the course of juvenile idiopathic arthritisand resultant long-term disabilities. Published studiesdemonstrate that at least 50 percent of all childrenwith JIA continue with active disease as they enteradulthood. Persistent synovitis leads to jointdestruction in children much sooner than previouslythought, often within 2 years of the onset of disease.The long-term impacts on the ability to function andthe effects of chronic disability can be profound.Additionally, juvenile idiopathic arthritis can havedetrimental effects on the physical and psychologicalgrowth of a child. There may be disruption of thefamily unit, divorce and other psychological stressesthat affect all members of the family. The aboveconsiderations have prompted pediatricrheumatologists to treat children with juvenileidiopathic arthritis early and aggressively. The currenttreatment goal is resolution of disease with return tonormal growth, development and activities 7 . In orderto do this, patients must be accurately diagnosed asearly as possible and then treated persistently untiltheir disease resolves. It is widely thought that acomprehensive team approach is associated with asuperior outcome. There has been too little awarenessof the major role played by modem treatment regimenin JIA where methotrexate has transformed theoutlook for most children with severe disease 4, 5 .Juvenile idiopathic arthritis is the umbrella term for agroup of chronic childhood arthritis of unknownAddress of correspondence: Prof (Dr) Md Rajibul Alam, MBBS,FCPS, MD, Professor of Medicine, Dhaka Medical CollegeReceived: 17 February, 2008 Accepted: 20 April, 2008can minimize both the short and long term morbidity of thedisease, thereby improving outcome during childhood as wellas in adulthood. The various sub-types of JIA with theirclinical features, diagnosis and differential diagnosis havebeen described. An outline of current management strategiesand outcome of treatment are given and potential futuredevelopments are highlighted.(J Bangladesh Coll Phys Surg 2008; 26: 83-90)causes in children below sixteen years of age &persisting for at least six weeks 2, 19, 24 . The earliestformal description of this disease was given by SirGeorge Frederick Still in 1897. this work was donewhen he was a registrar at the hospital for sickchildren, Great Ormond Street, London. In this initialdescription of 19 patients, he identified three patternsof arthritis, one of which came to be known later asStill’s Disease (now known as systemic onset JIA) 67,68 . Subsequently different classifications were givenby researchers.According to American College Of Rheumatology itis called Juvenile rheumatoid arthritis (JRA) lasting atleast six weeks with several subtypes e.g.1. Puciarticular (1 to 4 joints involved)2. Polyarticular (5 or more joints involved)3. Systemic JRA4. SpondyloarthropathiesAccording to European League against RheumaticAssociation it is called JCA (juvenile chronicarthritis) lasting at least 3 months with followingsubtypes●●Puciarticutar (1 to 4 joints involved)Polyarticular (5 or more joints,RF negative)●. Systemic JCA● SpondyloarthropathiesFinally the term JIA (Juvenile Idiopathic Arthritis)was first proposed in 1994 & later revised in 1997 bythe International league against rheumatism ascompromise for the American term JRA & theEuropean term JCA 50,51,52 . Because the American &European classification of the disease were
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