Ovarian hyperstimulation syndrome is an iatrogenic complication of ovarian stimulation cycle commonly used for in vitro fertilisation. Fluid shift due to capillary leakage causes a wide spectrum of presentation. The lung complication of ovarian hyperstimulation syndrome are reported in about 10 per cent of severe cases and isolated pleural effusion without ascites is rare. Herein we report two cases of severe ovarian hyperstimulation syndrome with pleural effusion. Both of them were normal responder of ovarian stimulation and presented with dyspnoea, nausea and vomiting. Clinical findings revealed reduced air entry of lung field and pleural effusion without significant ascites. Symptomatic management and thoracocentesis prevented further deterioration and helped in satisfactory recovery.

Smoking among school children is becoming a serious problem in developing countries, including Bangladesh. The early initiation of smoking needs urgent intervention to protect this vulnerable group and preventing them to be addicted. This study aims to determine the age at initiation of smoking and factors affecting it. A two-stage cluster sampling was used with a selection of schools on probability proportional to enrolment size followed by stratified random sampling of government and private schools and then a random start in classes VIII, IX and X of each school targeting the students aged 13 years and above. Data collected from secondary school students using self-administered structured questionnaire. All analyses were performed with SPSS version 20.0. Missing value was treated by multiple imputations. A total of 6877 data were analysed in which 84.7% were non-smoker, 9.5% were ever smoker and 5.8% were current smokers. Among the ever smoker (n=823), 38% were current smokers, 56.5% former and 5.5% were recent quitters. The mean (SD) age at initiation of smoking was 10.9 (0.2) years. Multinomial regression analysis revealed that class grade, peer pressure and offered free cigarette appeared to be significant predictors of smoking initiation (p<0.05). Parental smoking and type of schools appeared as significant factors for smoking initiation by bi-variate analysis, but regression analysis did not significantly influence (p>0.05). Promotion of smoking resistance skills among children and teens through comprehensive approaches designed to enhance general personal competence by teaching an array of personal and social life skills is recommended.
Smoking ; Schools ; Students ; Developing Countries