ABSTRACT
Background: Sweet syndrome or acute febrile neutrophilic dermatosis is a recurrent and rare skin disease caused by the release of cytokines, with diverse possible etiologic causes mainly being associated with infections, malignancy and drugs, with a reported incidence of 0.08 pediatric cases Historically, the Von den Driesch diagnostic criteria has been used to diagnose sweet syndrome. Case Presentation: We report a 6 month-old African female infant who presented with features of sweet syndrome. This case illustrates the typical presentation, diagnosis, and treatment outcome of this highly misdiagnosed condition. Conclusion: Due to the limited resources and knowledge about this under-reported disease in resource –constrained settings, the characteristic manifestation of sweet syndrome can be easily missed and thus requires a high index of suspicion for earlier diagnosis and management.

ABSTRACT
Median nerve neuropathy, which is characterized by pain, reduced muscular strength, and restricted nerve movement, is increasingly associated with long-term computer use. This study investigated in symptomatic computer users the effect of muscle strengthening exercises alone vs a combination of strengthening exercises and median nerve manipulation in 30 symptomatic computer users. Before conducting the four-week experiment, volunteers in Group A were split into two groups and had been selected out of 90 individuals to receive conservative treatment (muscle strengthening exercises) whilst Group B received both muscle strengthening and Butler's median nerve mobilization procedure. Pain and muscle strength were assessed using Visual Analog Scale (VAS) and Medical Research Council (MRC) grading respectively. Both groups separately showed significant improvement (p < 0.001) though Group B had a relatively more reduction in discomfort and gain in muscle strength than Group A and recommends that in computer users, a synergy of neural mobilization with usual strengthening exercises is more effective in moderating median nerve neuropathy signs. They recommend larger scale studies with objective evaluations in the future.

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Abstract: Introduction: Adolescent girls are at risk of anemia. Anemia is a condition where hemoglobin levels in the blood are below normal. Based on data from the Kupang City Health Office as of March 2023, 38% (371) of 965 junior high school girls screened had anemia. One of the factors that influence the occurrence of anemia is physical activity. Aims: Analyzing the relationship between physical activity and the incidence of anemia among junior high school girls in Kupang City. Methods: The analytic observational study with cross-sectional design. The research instrument used was the IPAQ-Short Form questionnaire to measure physical activity and blood sampling using EasyTouch GcHb to measure hemoglobin levels. The sampling technique used was probability sampling technique, namely proportionate stratified random sampling and got 100 respondents. Data analysis used was univariate and bivariate analysis using the Chi-Square test. Results: Based on physical activity, out of 100 respondents, 20% were in the heavy category, 44% in the moderate category, and 36% in the light category. Based on the incidence of anemia, out of 100 respondents, 33% were anemic and 67% were not anemic. The results of bivariate analysis of the relationship between physical activity and the incidence of anemia showed a p value = 0.684 (p>0.05). Conclusion: There was no significant relationship between physical activity and the incidence of anemia among junior high school girls in Kupang City.

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Background: Septic arthritis is a potentially debilitating condition in young infants, and the optimal duration of antimicrobial therapy to prevent complications remains a clinical dilemma. This study compared long-term outcomes of short and long courses of parenteral antimicrobial s and identified predictors of unfavorable outcomes in infants with septic arthritis. Methods: This randomized controlled trial was conducted at the Department of Paediatrics, Dhaka Shishu Hospital, Bangladesh, from July 2021 to June 2023. Sixty-nine infants aged 0–2 months with septic arthritis were randomized into two groups: Group A received long-term parenteral antimicrobial treatment (14 days) and Group B received short-term antimicrobial treatment (7 days). Data were collected using purposive sampling. Patients were followed up at 3, 6, and 12 months. Variables included clinical improvement, radiological recovery, haematological parameters, and complications. Statistical analysis used SPSS v26, with significance at p < 0.05. Results: Group A included 35 participants and Group B 34 participants. Follow-up attrition occurred in both groups. At 3 months, 83.9% of Group A and 78.6% of Group B showed clinical improvement (p=0.602). Radiological recovery at 6 months was similar between groups (89.7% vs. 92.3%, p=0.999). After 12 months, 85.2% of Group A and 80.0% of Group B had favorable outcomes (p=0.722). Predictors of unfavorable outcomes included delayed treatment initiation and polyarticular involvement. Conclusion: Short- and long-term antimicrobial therapies showed comparable outcomes in infants with septic arthritis. The duration of antimicrobial therapy did not significantly affect long-term complications, suggesting that a shorter course may be sufficient in most cases.

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Background: The World Health Organization (WHO) has approved a protocol advocating for the inclusion of psychosocial stimulation in the management strategy to mitigate the lasting negative developmental effects of Severe Acute Malnutrition (SAM). Aims: To assess the impact of structured play therapy along with nutritional support on physical growth of children with SAM. Methods: This randomized controlled trial was carried out the in the Department of Pediatrics, Sir Salimullah Medical College Mitford Hospital (SSMC MH), Dhaka from June 2019 to June 2020. This study enrolled a total of 174 children with severe acute malnutrition (SAM) between 6 months to 59 months and randomly allocated to intervention group (n=87) and control group (n=87). Intervention group received structured play therapy as psychosocial stimulation along with standard treatment and control group received standard treatment along with psychosocial stimulation in conventional way. Growth outcomes were measured in both groups during admission and during follow up at 15 days, 1 month, 2 months and 3 months after discharge. Results: Intervention group achieved improvement compared to control group from baseline in terms of the WAZ, LAZ, WLZ and MUAC after 1st, 2nd and 3rd month follow up. Among 72 children of intervention group, 51(70.8%) were found to achieve improvement in term of MUAC, WAZ, LAZ/HAZ and WLZ/WHZ and remaining 21(29.2%) could not achieve improvement. Children who received family food (43.1%) followed by formula (38.9), breast milk (13.9%) and other food (4.2%). Conclusion: Children afflicted with SAM demonstrated notable improvements in achieving catch-up growth when provided with psychosocial stimulation through structured play therapy in conjunction with nutritional support.

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Background: Heavy physical activities could be affected the cardiovascular systems and might be caused cardiovascular disorders. Objective of this study was the effects of heavy manual work on cardiovascular disorders. Methods: It was a review study and was done by research in text and related articles; metabolic equivalent tasks (METs), cardiovascular disorders assessed. Data were analyzed with SPSS 16, t-test, ANOVA and Chi-2 were calculated with considering P<0.05 as significant level. Relative risks were calculated with confidence interval 95%. Results: Arrhythmia, varicose veins, unstable angina and stable angina were the most in heavy workers. Relative risks were the most in heavy physical activities for arrhythmia and relative risk of varicose veins. Conclusions: Heavy physical activities could be caused arrhythmia and varicose veins and may be related to unstable angina and stable angina too. Prevention and suitable exercises should be useful in this situation.

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Introduction: Vitamin D is crucial for bone growth, mineralization, and various metabolic processes in the body. Consequently, a deficiency or insufficiency of this vitamin can lead to long-term consequences, especially in children. Aim of the Study: The aim of this study was to identify the prevalence and risk factors associated with vitamin D deficiency in rural children. Methods: This was an observational study and was conducted in the Department of Pediatric in Santhia Upazila Health Complex, Pabna, Bangladesh during the period from January 2022 to July 2022. In total 100 children presenting with symptoms of vitamin D deficiency who visited the pediatrics department at our institution. Statistical analysis was done by using SPSS (Statistical Package for Social Science) Version 23 for windows 10. Result: Participants were categorized into four age groups: infants (up to 1 year), children (2–5 years), prepubertal (6–11 years), and adolescents (12–16 years), with a mean age of 12.84 ± 3.98 years. Most children (60%) were female, and 70% had less than 30 minutes of daily sun exposure. Vitamin D deficiency (<10 ng/ml) was most prevalent in children aged 12-16 years (61.76%), followed by 2-5 years (60%) and 6-11 years (47.62%). Deficiency was also observed in 50% of infants up to 1 year old. Children with insufficient vitamin D (10-29 ng/ml) had intermediate height (124.81 cm) and weight (26.12 kg), while those with deficiency had the lowest height (104.62 cm) and weight (22.57 kg). Conclusion: This study shows that vitamin D deficiency is high among our study children. A comprehensive action plan, including supplementation and food fortification, is crucial to prevent this deficiency in Bangladesh.