Author: dhaka-admin

The Importance of Breastfeeding in Bangladesh

In a world grappling with numerous health challenges, breastfeeding emerges as a simple yet powerful solution that can significantly impact the well-being of individuals and entire communities. As of 2023, Bangladesh stands at a critical juncture where promoting and supporting breastfeeding can foster a healthier, more resilient society. The evidence-backed benefits of breastfeeding extend far beyond infancy, making it a lifelong investment in health.

Need for Better Education and Support for Mothers in Bangladesh

In 2023, Bangladesh faces challenges in improving breastfeeding rates. According to recent data from the Bangladesh Demographic and Health Survey (BDHS), exclusive breastfeeding rates for infants under six months remain suboptimal, with only 35.9% of babies being exclusively breastfed. Furthermore, the initiation of breastfeeding within the first hour after birth stands at a mere 36%, indicating a need for better education and support for mothers.

Breastfeeding provides a myriad of immediate and long-term health advantages, both for the infant and the mother. In the short term, breast milk is a complete and easily digestible source of nutrition, protecting infants from infections, diarrhea, and respiratory illnesses. Longer-term benefits include a reduced risk of obesity, type 2 diabetes, and certain childhood cancers.

For mothers, breastfeeding lowers the risk of breast and ovarian cancer and contributes to postpartum weight loss. Investing in breastfeeding can alleviate the strain on Bangladesh’s healthcare system by reducing the burden of preventable diseases and minimizing healthcare costs.

Bangladesh faces significant challenges concerning malnutrition, especially among its young population. In 2023, stunting and wasting rates stand at approximately 12.5% and 27.5%, respectively, among children under five. Breastfeeding plays a crucial role in combatting malnutrition, as breast milk provides essential nutrients and immunological factors that promote healthy growth and development.

Research indicates that breastfeeding is linked to improved cognitive development in children. A study conducted in Bangladesh by the International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), revealed that children who were breastfed for more extended periods showed higher scores in cognitive tests. Such findings underscore how breastfeeding can contribute to the nation’s human capital development and long-term economic prosperity.

Supporting breastfeeding extends beyond the home, with a pressing need for breastfeeding-friendly workplaces. Encouraging employers to provide lactation rooms and flexible break times for breastfeeding can enhance mothers’ ability to continue breastfeeding after returning to work. The benefits of this investment extend to the economy as well, with healthier, more productive workers and reduced absenteeism due to child illnesses.

In 2023, Bangladesh has the opportunity to embrace breastfeeding as a potent tool for improving the health and well-being of its population. By focusing on increasing exclusive breastfeeding rates, promoting early initiation of breastfeeding, and creating a breastfeeding-friendly environment, Bangladesh can pave the way for a healthier future.

Investing in breastfeeding is not just a short-term strategy but a lifelong commitment to building a resilient, prosperous nation. It is a collective responsibility of policymakers, healthcare providers, communities, and families to support breastfeeding and unlock its full potential for the health and development of every Bangladeshi citizen. By doing so, Bangladesh can create a legacy of lifelong health, prosperity, and success for generations to come.

Author:

Dr. Nusrat Farooq

Senior Consultant

Paediatrics & Neonatology

Evercare Hospital Dhaka

References:

https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-018-1076-0

https://www.sciencedirect.com/science/article/pii/S0899900723000266

Overcoming the Challenges of Cancer Care in Bangladesh

As a physician on the front lines of cancer care in Bangladesh, I have witnessed the immense challenges faced by patients and healthcare providers in the battle against this formidable disease. I firmly believe that with the power of technology we can overcome these obstacles and usher in a new era of hope and progress in cancer diagnosis, treatment, and support.

Technology plays an immense role for cancer care in terms of the innovative solutions it brings. But it is undeniable that there are challenges we must address in order to maximize the treatment potential in Bangladesh.

The advent of technology has given us remarkable tools to enhance cancer diagnosis and screening. For example, timely consultations and accurate diagnoses can be conducted through the implementation of telemedicine and telepathology to bridge the gap between patients in remote areas and expert oncologists.

Almost everyone has a smartphone nowadays and the power of the internet in their palms. What’s amazing is that there are specific mobile applications which can provide educational resources to empower individuals, help them recognize early warning signs and seek medical attention promptly. More investment is these technological advancements can help us with the early detection of cancer and save countless lives.

With tele-oncology services, patients can connect with expert oncologists, receive cancer diagnosis, get treatment and follow-up care to ensure that every individual, regardless of their location, has access to specialized care. By embracing these innovative approaches, we can raise the standards of cancer treatment throughout Bangladesh.

Technology and Cancer Treatment

Additionally, technology has revolutionized cancer treatment options in a way that empowers us to provide effective and personalized care to our patients. Advanced radiation therapy techniques, such as IMRT, SBRT and IGRT, precisely target tumors with minimal healthy tissues and side effects, to improve treatment outcomes.

Cancer care extends far beyond medical interventions, as there is a great need for emotional and psychological support for patients and their families. To this extent, there are virtual support groups that can facilitate patients with teleconferencing platforms where they can get a sense of community and emotional support even from remote locations.

Furthermore, mobile health applications can equip patients with tools to manage symptoms, track medications, and access mental health resources. By integrating such technological innovations, we can enhance the overall well-being and quality of life for individuals afflicted with cancer.

While talking about the huge possibilities of positive impact for the greater good of patient care, it is wise to keep an eye out for the challenges we might face in the widespread implementation of cancer treatment in Bangladesh. Firstly, there is very limited healthcare infrastructure for cancer treatment in rural areas.

This issue must be addressed through the establishment of specialized cancer centers and the training of healthcare professionals in Bangladesh. Secondly, enhancing digital literacy and ensuring affordable access to the internet is imperative to ensure that all individuals can benefit from technology-enabled solutions.

Lastly, the privacy and security of patient data must be safeguarded, while awareness and educational initiatives should be launched to familiarize healthcare providers and the general public with these advancements.

To fully harness the benefits of technology, we must confront the challenges head-on through collaborative efforts between the government, healthcare organizations, technology providers, and the society at large.

Technology’s Role in Revolutionizing Cancer Care in Bangladesh:

It is undeniable that the role of technology in cancer care has the potential to revolutionize the landscape of cancer diagnosis, treatment, and support in Bangladesh. By embracing telemedicine, mobile applications, and other technological innovations, we can overcome barriers of distance and limited resources to deliver high-quality cancer care to every corner of our nation. Together, we can empower our patients, save lives, and build a brighter future for cancer care in Bangladesh.

Author:

Dr. Ferdous Shahriar Sayed

Senior Consultant & Coordinator

Medical Oncology

Evercare Hospital Dhaka

2023 Heatwave: A National Crisis

In 2023, summer brought on a series of unexpected heatwaves in Bangladesh, affecting people’s general well-being and worsening pre-existing medical conditions to cause widespread suffering and distress throughout the country.

Just a few weeks ago, one thought was running through the minds of all Bangladeshis – “How much hotter can it get? How do we tackle the extreme heat? Is it possible to die as a result of sweating so much? Well, it turns out the answer is yes.

Heatwaves: A Major Public Health Threat

A Harvard report says nearly an average of 1500 people died between 2003 and 2007 in Bangladesh. This year, about 1000 to 1200 patients were admitted to hospitals every day due to illnesses exacerbated by the heatwaves. So how can we protect ourselves during such heat waves?

Heatwaves are not only unbearable to live in, they are also extremely distressing to our health and well-being. It is important to take measures to tackle the heatwave as they can affect people’s general well-being and worsen pre-existing medical conditions.

Heat Stroke Symptoms and Risk Factors

Heat strokes can occur when body temperature rises to 40 degrees Celsius. At this temperature, people experience exhaustion, lethargy, tightness in the chest, headaches, and restlessness with no perspiration.

Some people are more vulnerable to heat strokes than others. The vulnerable segments of the population are infants, older adults, outdoor workers (including bike riders), athletes, low-income families, and those with pre-existing health issues like diabetes, obesity, cardiovascular disease, pulmonary disease, kidney disease, and mental health issues such as psychiatric disorders and depression.

Some more implications of heatwaves on our health includes dehydration, heat exhaustion, feared heat stroke, edema, syncope and general worsening of existing medical conditions. Extreme heat can also result in serious dehydration, stroke, and the development of clots.

A lot of care and caution is needed when temperatures rise to extremes like 40 °C. There are several measures that should be taken during a heatwave to provide adequate protection against sudden health collapses.

Tips for Staying Cool in Hot Weather

Spend as much time as possible indoors, and do not get out of the house unless it is absolutely necessary. If you are outside, try to be around plants and trees where you can get some natural shade from the sun. Stay as cool as you can, take multiple short showers throughout the day, or splash some water on your face periodically.

Choose your outfits carefully, opt for loose-fit, light-colored and lightweight clothes. Avoid getting involved in high-energy activities like running, jumping and playing sports in the afternoon. Last but not the least, keep yourself hydrated with lots of water and fluids. Keep a water bottle or electrolyte drink with you at all times.

As heatwaves came to us a surprise, we all witnessed for two months how people were falling ill, productivity was decreasing, and hospitals were filling up with patients experiencing ailments brought on by heatwaves sweeping the nation. Temperatures rose as high as 40.4 degrees Celsius in Dhaka, while it was 42.2 degrees in the mid-western side of the country, and similarly hot in other regions as well.

Heatwaves in Bangladesh: A recurring problem

But in fact, heatwaves are not new in Bangladesh. The people of the country experienced their first recorded heat wave in 1972 when the temperature went up to 45.1 degrees Celsius. Again in 1960, the temperature rose to 42.3 degrees Celsius, in 1965 it was 42 degrees Celsius, and so on. There is all the more possibility that we will be facing more heatwaves in the future.

By employing proper measures as stated above, we will be able to save ourselves and our loved ones from a lot of heat exhaustion and suffering. Let’s spread the news against health implications of seasonal heatwaves for a secure and health-positive future.

Author:

Dr. K.F.M. Ayaz

Senior Consultant

Internal Medicine

Evercare Hospital Dhaka

Glioblastoma multiforme (GBM): An aggressive brain cancer

Glioblastoma multiforme (GBM) is a type of brain cancer that is characterized by its aggressive nature and poor prognosis. Unfortunately, there is limited information available on the incidence of GBM in Bangladesh. However, it is estimated that the incidence of brain tumors in general is around 2-3 cases per 100,000 individuals in Bangladesh.

The clinical presentation of GBM can vary depending on the location of the tumor in the brain. Common symptoms of GBM include headache, nausea, vomiting, seizures, cognitive impairment, weakness, and changes in vision or speech.

Magnetic resonance imaging (MRI) is the gold standard imaging modality for the diagnosis of GBM. The typical MRI sequences used for the diagnosis of GBM include T1-weighted, T2-weighted, fluid-attenuated inversion recovery (FLAIR), and gadolinium-enhanced T1-weighted images.

After radiological diagnosis, post-surgery histopathology and molecular testing of the biopsy sample can help to identify specific genetic mutations or biomarkers that may guide treatment decisions. GBM is classified as a grade IV Astrocytoma, which is the most aggressive type of brain tumor. GBM can also be further classified based on specific genetic mutations or biomarkers, such as IDH status.

Available Treatment Facilities for GBM in Bangladesh

The treatment of GBM typically involves a combination of surgery, radiation therapy, and chemotherapy. Surgery is typically the first-line treatment and aims to remove as much of the tumor as possible. Radiation therapy is typically administered after surgery. Radiation therapy is being administered using external beam radiation. Chemotherapy may also be used in conjunction with radiation therapy. Usually oral chemotherapeutic agent is used.

The prognosis for GBM is poor, with a median survival of approximately 15 months. The use of radiation therapy and chemotherapy can improve outcomes. Currently almost all sort of treatment facilities of GMB is readily available in many centers in Bangladesh. Proper quality assurance in radiotherapy is the key concern for outcome.

Dr. Arman Reza Chowdhury

Consultant – Radiation Oncology

Evercare Hospital Dhaka

Email: rezadrarman@gmail.com

During extreme heat it is easy to become dehydrated or for your body to overheat. If this happens, you may develop heat cramps, heat exhaustion or even heatstroke. Extreme heat can also make existing medical conditions worse.
To minimize the impact during the heat wave and to prevent serious ailment or death because of heat stroke, you can take the following measures:
 Avoid going out in the sun, especially between 11.00 a.m. and 3.00 p.m.
 Drink sufficient water and as often as possible, even if not thirsty. If your doctor normally limits your fluids, check with your doctor how much to drink during hot weather.
 Wear lightweight, light-colored, loose, and porous cotton clothes. Use protective goggles, sunscreen, umbrella/hat, shoes while going out in sun.
 Avoid strenuous activities when the outside temperature is high. Avoid working outside between 11.00 a.m. and 3 p.m.
 Cancel or postpone outings. If you absolutely must go out, stay in the shade and take plenty of water with you.
 Avoid alcohol, tea, coffee and carbonated soft drinks, which dehydrates the body.
 Avoid high-protein food and do not eat stale food.
 If you work outside, use a hat or an umbrella and use a damp cloth on your head, neck, face and limbs.
 Keep yourself cool by using damp towels containing ice, putting your feet in cool water and taking cool (not cold) showers.
 Do not leave children or pets in parked vehicles.
 If you feel faint or ill, see a doctor immediately.
 Use ORS, homemade drinks like lassi, lemon water, buttermilk, etc. which helps to re-hydrate the body.
 Keep animals in shade and give them plenty of water to drink.
 Keep your home cool, use fans, curtains, shutters or sunshade and open windows at night.
 Monitor those at high risk- infants and young children, people 65 years of age or older, people who are overweight, people who overexert during work or exercise.

Tips For Treatment Of A Person Affected By A Heatstroke:

 Lay the person in a cool place, under a shade. Wipe her/him with a wet cloth/wash the body frequently. Pour normal temperature water on the head. The main thing is to bring down the body temperature.
 Give the person ORS to drink or lemonade or whatever is useful to rehydrate the body.
 Take the person immediately to the nearest health care centre. The patient needs immediate hospitalization, as heat strokes could be fatal.

Acclimatization:

People at risk are those who have come from a cooler climate to a hot climate. You may have such a person(s) visiting your family during the heat wave season. They should not move about in open field for a period of one week till the body is acclimatized to heat and should drink plenty of water. Acclimatization is achieved by gradual exposure to the hot environment during heat wave.

Article by:
Dr. Nikhat Shahla Afsar
Senior Consultant, Internal Medicine
Evercare Hospital Dhaka

How to Take Care of Children in Summer

Children and elderly are more likely to get sick than others during winter, summer, or monsoon due to seasonal changes in nature. Thus, the type of care for children should also be changed according to the season. But compared to other seasons, summer becomes quite difficult for children. Therefore, taking special care of children to prevent them from getting sick during this time is essential.

Children sweat excessively in summer. If water or liquid food is not given properly, excessive sweating can cause dehydration.

Dehydration can be expressed as a decreased volume or frequency of pee, or it may present as feeling weaker and thirsty than normal. Besides, dehydration can cause many complications in the body.

Other diseases seen mostly during summer are diarrhea, vomiting, cold, pneumonia, and scabies etc.

During summer time, it is suggested to follow the following advice as a way to protect the child from various diseases –

– After bathing with lukewarm water, the child’s head should be thoroughly dried, as child may catch cold with wet hair which may result in fever and cough.

– Give the baby boiled water, fresh fruit juice, or any liquid food now and then to prevent dehydration.

– Infants under six months should be encouraged to breastfeed frequently, and mother should drink liquid adequately.

– The baby should be dressed in loose cotton clothes.

– Sports are essential for the physical and mental development of the child but playing outside in extreme heat can cause excessive sweating that may result in catching cold. Therefore, the child should be allowed to play indoors during extreme heat outside.

– An open, comfortable, well-ventilated room in the house should be set aside for the child.

– Special attention should be given to older children as they usually eat roadside ice cream or juices to quench their thirst. It can cause vomiting, diarrhea, or diseases like typhoid.

– During summer, the possibility of viral fever increases. Antibiotics have no role in viral fever. Paracetamol should be given for fever. Apart from this, plenty of water and liquid should be ensured to maintain adequate hydration.

– Virus infection can also cause cough-cold and pneumonia. There could be nose block for this, which will hamper normal breathing; so, nose should be kept open by applying frequent saline drops in nose.

– If cough, it’s not wise to give cough syrup without a doctor’s advice. It can cause many complications. Drinks made with lemon juice, tulsi leaf juice, and liquor tea are good remedies for coughing.

– Children often suffer from heat rash during summer. Therefore, children should be kept at a normal temperature as much as possible. In extreme hot weather, the baby’s body should be wiped in normal-temperature water and dried with cotton cloth 2-3 times daily.

– The child’s nails should be cut small

Even with these precautions, the child might still get sick, but the chances will be low. A doctor should be consulted immediately if any of the following symptoms appear in the child during their sickness.

– Frequent vomiting, loose stool, and decreased urine output or lethargy in the baby.

– Decreased appetite

– High fever

– Decrease activities and alertness than normal

– Shortness of breath, frequent breathing, or tightness in the chest

All children need care. In extreme heat, children suffer equally as adults. So, it is important to take special care of children so that they will stay healthy in summer.

When Is Radiation Therapy Used?

One of the most widely used treatment for cancer management in the modern age is radiation therapy. It involves the use of high-energy ionizing radiation, such as X-rays or gamma rays, produced by radioactive materials or radiation generators. Through this radiation, the aim is to target and destroy cancer cells in the body.
Not all cancers require radiation treatment, but a good number of cancers need to be treated with radiation at some point during the course of treatment. Whether radiation therapy will be used for a patient depends on the type, stage, and location of the cancer, as well as the patient’s overall health.

Radiation therapy is mainly used to treat cancer locally; however, in some cases, it can also be used as a systemic treatment. Systemic radiation therapy involves the use of radioactive materials that travel throughout the body to kill cancer cells that have spread to other parts of the body.

The Evolution of Radiation Therapy Machines

There are several machines used in radiation treatment. Deep X-ray therapy is one which, although no longer used nowadays, was previously an essential. There is also the Cobalt-60, another old model with limited use. Other machines include the widely used linear accelerator, the high-end Cyber Knife whose use is limited, the Gamma Knife, and the highly sophisticated Proton Beam Therapy which is also used in a limited capacity. Other machines used for radiation therapy include LDR and HDR brachytherapy machine.

Radiation therapy can be delivered using different modalities, such as 2D, 3D-CRT, IMRT, VMAT/Rapid Arc, IGRT, SRS/SRT, SBRT, TBI, and Brachytherapy. These are treatment planning techniques used for suitable patients, depending on the type and location of the cancer.

Although there is no feeling of pain during radiation therapy, it does come with side effects. These include skin pigmentation, sometimes excoriation, and region-wise complaints such as difficulty in swallowing when treatment is given to the neck region. The side effects vary depending on the organ or region being treated.

Radiation Therapy in Bangladesh: Affordability and Availability

The cost of radiation therapy depends on the machine used, treatment planning modality, and quality assurance issues. It is a product of teamwork. Fortunately, compared to other countries, radiation treatment is not very expensive in Bangladesh.

In fact, almost all facilities of radiation treatment are available in Bangladesh. Patients can access various types of radiation machines and treatment planning techniques in different hospitals and cancer centers across the country.
Radiation therapy is a valuable treatment option for cancer management. It is a local treatment that targets cancer cells and can be used in combination with other cancer treatments.

The type of radiation machine and treatment planning modality used may vary depending on the patient’s specific cancer type, location, and stage. It is important for patients to understand the potential side effects of radiation therapy and work closely with their healthcare team to manage any side effects that may occur.

Writer:
Dr. Biswajit Bhattacharjee
Senior Consultant – Clinical & Radiation Oncology
Coordinator-Radiation Oncology

Evercare Hospital Dhaka

Strokes are medical emergencies due to interruption of blood supply in the brain. It can be due to blockage of the blood vessels or rupture of it but not from any traumatic cause.

Brain has different unique parts for different specific functions. Clinical features are depending on which part of the brain is involved in stroke. Think the word F-A-S-T. F -for facial drooping or weakness, A- for any arm weakness, S- for speech problem, T – for time, don’t waste time. Immediately rush to a hospital having stroke treatment facility.
Stroke may be present as sudden Confusion, difficulty in understanding speech, dizziness, unsteadiness, problem in vision and rarely loss of consciousness.

Types of strokes

Stroke may be Ischemic (85% of cases) and hemorrhagic (15% of cases). Treatment is totally different in Ischemic and in Hemorrhagic case.
Sometimes the weakness or deficit does not persist for 24 hours. Then it is called TIA (transient ischemic attack).

Causes of ischemic stroke

A fatty substance called plaque collects in our arteries and narrows them. This process is called atherosclerosis, and it slows the flow of blood. When this Plaque breaks off and lots of cells come to the rescue causing a clot and blocking blood flow through the artery.

Besides atherosclerosis, other things that can raise your chances of getting an ischemic stroke are:

• Atrial fibrillation
• Heart attack
• Problem with heart’s valves
• Injury to blood vessels in neck
• Blood clotting problem

What are the risk factors?

• Age – stroke risk is increased with increasing age.
• High blood pressure –
• Irregular heartbeat
• Diabetes mellitus
• Smoking
• Family history of Stroke
• Lack of physical exercise

Why time is important?

Stroke damages our brain cell. Dying cell can be saved if blood circulation can be restore. There is very little time to treat stroke by restoring circulation in feasible cases. So time is called brain in stroke. In stroke there are dead brain cell in the Centre surrounded by larger area of dying cell called ischemic penumbra.

This penumbra zone can be saved by intervention. Most common and available option is thrombolysis. We get 4.5 hours to save this penumbra zone from the time of onset of stroke if it is a ischemic one (85% is ischemic).

What to do if one has a stroke?

Before reaching to Hospital Ensure breathing. Face should be open. Clean the mouth if food material is present with in mouth. Make loose the clothing if it is tightly fitted. Loose the knot of necktie and belt if present
Keep the patient in horizontal position, Do not use any blood pressure medicine. Do not try to give any thing in mouth. Don’t try to continuously talking with the patient, only give reassurance of better outcomes in hospital.

If there is no pulse in any limb and in neck and BP is not recordable with loss of consciousness, then live-saving measure CPR should be given. Press over lower middle part of the chest forcefully 6 times in 5 seconds followed by once mouth-to-mouth breathing by blowing air as much as possible. Repeat this till the pulse comes back. It should be done on the way before reaching the hospital if required.

What happened if stroke is not treated early?

Following may be the results.
Permanent weakness of the limbs. Permanent problem in forming and understanding of speech. Persistent problem in vision and Seizure in future.

Hemorrhagic stroke

Hemorrhagic stroke can be Subarachnoid and intracerebral. Subarachnoid hemorrhage usually occurs due to rupture of an aneurism (abnormally dilated part of the blood vessel due to developmental defect). Intracerebral hemorrhage usually results from complicated hypertension. Subarachnoid hemorrhage is present as sudden onset of very severe headache, with vomiting consciousness may be lost.

Intracerebral hemorrhage presented with moderate to severe headache with acute weakness of face with or without limbs weakness, disorientation to unconsciousness.

Surgery in stroke

If ischemic part of the brain is very large and causing pressure by brain swelling with edema then decompressive craniectomy (part of the skull bone is removed temporarily for giving space for swelled brain) is done to save the life.
Massive intracerebral hematoma can cause pressure effect like massive stroke and decompressive craniectomy is done to save life.

Physiotherapy and rehabilitation

Physiotherapy and occupational therapy is essential for better outcome after stroke. Maximum improvement can be achieved with one month after stroke. Up to 3 months significant physical improvement can be possible if rehabilitation therapy can be ensured.

Anxiety, depression, anger control problem, agitation, inadequate sleep is common in post stroke states in survivors. Proper medication is needed to combat this situation.

Dr. Khandker Mahbubar Rahman

Senior Consultant & Coordinator

Department: Neurology

Evercare Hospital Dhaka

World Kidney Day is celebrated on 10th March every year. Every year the activities of the day are organized with different objectives. The theme of this year’s Kidney Day is “Bridge the Knowledge Gap to Better Kidney Care”. Children, especially, need to be more aware about kidney disease, treatment, and care.

Kidneys are active while the baby is in the womb. Although the kidneys are less mature after birth and during childhood than in adulthood, they do not cause any hindrance to the normal development of the child. However, children’s kidneys can be easily damaged due to serious illnesses or side-effects from medication. In order to prepare better for any such situation, let us learn some important facts about kidneys.

What are the functions of kidneys in our body?

The kidneys remove accumulated impurities from the blood and retain essential substances; regulate blood pressure in the body; create and assist hormone production; help in blood clotting and keeping bones healthy. Every function of the kidney is very important in keeping the human body healthy. If the kidneys are not healthy, these functions are disturbed and cause severe problems. Let’s find out about these problems, and how they can be especially severe for children.

Congenital Kidney Problems in Children:

Congenital kidney diseases can be detected before the baby is born through ultrasonography. Urethral and bladder structural problems; Obstruction of urethral valves; Absence of kidney; irregularly sized kidneys; displacement and swelling of the kidneys are among some of the problems that may be confirmed through ultrasonography. Urinary tract infection (UTI) is one of the most common diseases in children.

In many cases, proper diagnosis and treatment of this disease is neglected. Repeated infections of the urinary tract can case the child to be at risk of kidney failure. It also increases the risk of high blood pressure for them in the future. In most cases, if the children do not receive proper treatment, their kidney functions deteriorate. However, it is completely possible to prevent or control kidney disease by using appropriate treatment at the right time. But how do you know if the child has kidney problems or not?  s

Symptoms and Treatment of Kidney Disease in Children:

Frequent urination; urinary tract infection; bedwetting (over 6 years of age); passing blood in the urine; abdominal/back pain during urination; excessive water retention/swelling of the body; decreased urination; accumulation of water in the kidneys, enlargement of the kidneys; high blood pressure; congenital defects in kidneys, etc.

These symptoms may appear if someone in your family has kidney disease, if the baby is born prematurely or if the baby’s weight is less than normal after birth. The help of a specialist must be sought out as soon as there is suspicion of any of these symptoms. If the child is suffering from chronic kidney disease (CKD) and needs dialysis or a kidney transplant, there is no reason to worry because treatment for kidney disease is now available in the country.

Dr. Sabina Sultana

Senior Consultant and Coordinator

Department of Pediatrics and Neonatology

Evercare Hospital Dhaka

The Impact of COVID-19 on Our Lives

An invisible enemy of only 125 nanometers in size has taken the whole world in its control. Words such as masks, PPEs, hand sanitizers, social Distancing, lockdowns, and quarantine have become incredibly common nowadays. Educational institutions have been closed, while children are becoming narrow-minded by spending too much time alone at home, their gadget addiction is increasing, and they are going through many behavioral problems as a result.

With the global economic collapse and rising crime rates, our lives seem to be going out of control. Our loved ones are disappearing, so we are also becoming very afraid of our lives. Fear and stress are some natural human emotions during these times, but when we panic for too long, we will become mentally ill. Our lowered mental health also starts to negatively affect our immune system.

The main weapon in this fight against COVID is a stronger immunity. It is important to be mentally strong and to exercise good health practices for a stronger immunity. There are several ways to reduce anxiety and fear, so that we stay healthy and cope with COVID-19.

Spend Quality Time

Family members need to spend quality time with each other. For example, they can listen to music or watch movies together. In this way, one can also learn to respect other people’s choices. This can improve relationships between family members, so that they can enjoy being together.

Light Exercise

Apartments and flat houses are quite small in size, so there is no space for exercise. Those who don’t have an exercise machine at home can move some furniture aside to make room for exercise. Regular exercise will reduce the restlessness of our minds and develop good habits among children.

Religious Practice

Practicing religion helps to calm the human mind. So, the whole family or you alone can start practicing religion. Younger family members will be interested to see you.

Social Media

At this time, we are getting a lot of information from different social media, all of which are not correct. The spread of rumors and misinformation is increasing the restlessness of our minds. Besides, if you see or hear negative news for a long time, there is a chance to get depressed. So, news and social media exposure should be reduced.

Social communication

Due to lack of time we cannot communicate with friends and relatives, but the pandemic has created a space for us to communicate with other and improve our relationships.

Laugh to the Fullest

Laughter is a drug that cannot be bought on the market, but it helps to keep our minds healthy. So, everyone in the family can enjoy their time together and laugh together to boost their immunity.

Breathing Exercise

Take a deep breath through the nose and hold it for a while and release it through the mouth. Do these breathing exercises a few times to reduce the restlessness of the mind.

Use of Language

We all should be aware of our use of language. During the times when are locked up in our houses with each other, we should be careful not to criticize each other but to be kind and understanding towards each other.

Positive Thoughts

It is difficult to think positively during an on-going global crisis. Worrying unnecessarily will not bring solutions, but it will only demotivate us. So, if we extend a helping hand to people, it will help us to maintain a peace of mind. Positive actions increase positive thoughts.

Sleep and Diet

Everyone in the family should be encouraged to get enough sleep and eat nutritious food.

Finally, remember, you are not alone. Millions of people around the world are making sacrifices to fight COVID-19. Hoping and working for a better future is the key to our survival.

Alia Ferdous Azad,

Senior Consultant

Evercare Hospital Dhaka