Laser Circumcision

Dear Dr Haque

I am writing to seek your kind guideline as we wish to undertake laser circumcision of my son who is 10 years old. It could not be performed earlier due to some constraints but we wish to have it done sometime next time. As we have seen various posts from you on the subject, we would greatly appreciate if you could provide us possible options available in Dhaka and also suggest your valued recommendations on the subject.

We applaud your kind gesture to our community and society. We hope that many would follow the instance you have created.

Best wishes,

Asad

Ten months old baby not sleeping throughout the night

Hello Dr,

My baby is ten months old and he has not been sleeping uninterruptedly throughout the night for almost 4-5 months. He wakes up every one hour interval and starts crying. We have to get up and either rock him back to sleep or my wife nurses him to sleep. These days nursing does not even work. We have to rock him for about 15 – 20 minutes before he goes back to sleep again and this event occur several times a night. He is feeding well, pooping well. I am not sure what is wrong with him. Initially the problem was during the night time and now he cannot sleep more than an hour at a stretch even during the day.

Please help!

Hydronephrosis of my baby

rUSGEC scan-1EC scan-2MCUG

My boy is 21 months old. He was diagnosed as having mild hydronephrosis of left kidney at his mother’s womb. The doctor said it would be resolved automatically after his birth. We waited til his birth. Then we did ultrasonography two times but the problem persisted and not resolved. We did not observe any abnormality while urinating in the mean time. He never had urinary tract infection(UTI). His birth weight was 2.6 kg and now he is 12 kg. Last April when he was 19 months old we visited Calcutta. We consulted  Dr. Rajiv sinha (Peadiatric nephrologist). We said him in detail and he asked to perform a series of investigation to understand his condition. First of all an USG of KUB and urine culture and sensitivity(C/S) test. The USG  reported hydronephrosis of left kidney with Pelvis diameter 18 mm. The doctor said 18 mm is significant and so he need further evaluation. His Urine C/S showed no infection. The third test was micturating cystourethrogram MCUG and the report was-

1. No vesico-ureteric reflux noted

2. Significant post void residue

The doctor said it was not a problem and he asked for renal EC scan. The report was-

1. Split function 49.88(left) and 50.12(Right) kidney.

2. Normal global renal function

3.Normally functioning non obstructed Left kidney with functional stasis at pelvis.

4. Normally functioning non obstructed Right kidney.

Taking all the reports in consideration the doctor said that my child is ok and he does not require further treatment right now. He instructed to do USG and URINE C/S after 4 months.

Now 1.5 months passed. My baby suddenly cried while urinating at yesterday morning. We became worried and have collected sample for analysis. This afternoon i noticed his body temperature was 99 degree Fahrenheit. We have given him a dose of Paracetamol(Napa). We have consulted here with Dr. Jhulan Das Sharma (Ex. Head of Dept of Paediatrics, CMC) at chittagong. He suggested to start antibiotic Cefixime DS. Just now we have received his URINE R/M/E report where pus cell was 40-50 HPF, which means significant amount of infection (UTI). Please note that he has constipation since last one month and stools was very hard. Is it the cause of his current UTI or else?

Please help me to find out future course of action. I am feeling very nervous right now.

Regards

Dr. Happy Biswas

BCS Health(33rd BCS)

Frequent Stool Passing of my baby

My baby is 1.5 year old. Weight 12 kg. Birth weight was 3 kg. He took exclusive breast milk up to 6 months and then up to 1 year he breast fed occasionally. Now he is on formula milk(NAN3), corn flakes, khichuri, rice and lentils. He passes stool 6-8 times a day for 2/3 days. Next day it stops and reappear after 2/3 days. This is happening from January 2016. There is no blood mixed with stool but some undigested food particle present with foul smell. Semi solid in 60% cases and watery for 40% cases. No vomiting tendency and abdominal pain observed. Stool R/M/E was done two times. Here is the latest reports. Rota virus vaccine has been taken.

Can you please advise me about his treatment.

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