Dhaka Medical College Hospital Research Articles

Correlation of Ultrasound Guided (USG) Fine Needle Aspiration Cytology (FNAC) With Postoperative Histopathology in the Diagnosis of Thyroid Swelling

Background: Thyroid swelling is a common problem in Bangladesh. Early and systematic evaluation of a nodular thyroid swelling is necessary as it is a frequent presentation of thyroid neoplasia. USG Guided Fine needle aspiration cytology (FNAC) is one of the diagnostic tools for early evaluation of thyroid nodules. USG Guided FNAC is considered as a cost-effective, simple, minimally invasive and easily repeatable procedure for preoperative screening in the diagnosis for most of the thyroid lesions. The objective of this study is to determine the sensitivity and specificity of USG Guided fine needle aspiration cytology (FNAC) and compare the efficacy with histopathology in diagnosis of thyroid swellings. Objective: To evaluate the sensitivity and specificity of USG Guided fine needle aspiration cytology (FNAC) and histopathology for the diagnosis of thyroid swelling. Method: This Observational Prospective Study was performed in the department of Otolaryngology & Head Neck Surgery, Dhaka Medical College Hospital. Dhaka over 6 month’s duration from January 2019-June 2019. Total 50 patients with thyroid swelling was selected after taking informed written consent and fulfilling the inclusion criteria. Smears was taken by standard procedure and then was stained with papanicolaou stain and haematoxylin and eosine stain. The smears was classified into categories like benign, indeterminate, malignant and unsatisfactory. Sensitivity, specificity, positive and negative predictive value and accuracy of USG Guided FNAC was calculated and compared to already available data. Appropriate statistical analysis was done to make comparison between final histopathological findings with initial USG Guided FNAC findings. Result: During the study period a total 73 were found eligible for USG Guided FNAC. Most of the patients (52%) were from 20-39 years age group. Among them 67.12% were female and rest (32.87%) were male. In this government hospital 75.34% were from low income group. ......

Comparison of Surgical Outcomes between Endoscopeassisted Evacuation and Conventional Burr Hole Aspiration of Brain Abscess at a Tertiary Care Hospital

Background: Brain abscess is a major health problem with a reasonable morbidity and mortality rate. Objective: The objective of this study was to compare the efficacy between endoscope-assisted evacuations of brain abscess with burr hole aspiration method in a tertiary health care center. Methodology: This non-randomized clinical trial was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh during the period of July 2016 to December 2017. Patients with the age group of more than or equal to 18 years of both gender presented with brain abscess were enrolled in this study. The endoscope-assisted evacuation of abscess was done on group A patients and burr hole aspiration was done on group B patients. Outcome of the patients was assessed using GCS and MRC muscle power grading and by GOS. Patients were evaluated by contrast enhanced CT scan of head at pre-operative, 1st and 30th postoperative day. Both groups received best available medical treatment along with surgery. Results: The mean age of was 13.0 ± 6.3 years in burr hole group and is 13.1 ± 6.4 years in endoscope-assisted group. The patients presented with GCS was 66.7% in burr hole group and 93.3% in endoscope assisted group. The study showed e”75.0% evacuation of brain abscess at 1st post-operative day in 13(92.9%) patients in endoscope-assisted group and 5(33.3%) patients in burr hole group. The study showed mortality rate of 6.7% in both the groups. Mean residual volume at 30th post operative day was 0.75ml in endoscope-assisted group and 1.75ml in burr hole aspiration group. Conclusion: In conclusion endoscope-assisted procedure has better rate of abscess evacuation, less chance of residual and repeated surgeries than conventional burr hole. Bang. J Neurosurgery 2023; 13(1): 14-19

Imaging Patterns of Breast Cancer in Women of Reproductive Age

Background: While breast cancer is less common in younger women compared to older age groups, it can still occur, necessitating careful evaluation of imaging findings. Imaging patterns of breast cancer in women of reproductive age can vary, presenting unique challenges in diagnosis and management. This study aimed to assess the imaging patterns of breast cancer in women of reproductive age. Methods: This prospective observational study was conducted in the Department of Radiology and Imaging Uttara Adhunik Medical College & Hospital and Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2019 to December 2023. In this study, 67 women of reproductive age who had been diagnosed with breast carcinoma and had undergone preoperative breast imaging were enrolled purposively. Data analysis was conducted using MS Office tools. Results: Mammographic findings: 42% had heterogeneously dense breasts, 30% scattered composition; and 87% had high mass density. Irregular mass shape: 43% (mammography), 69% (ultrasonography). In total 85% of cases were pleomorphic. Ultrasonography evaluation: 69% had a single US background. Echogenicity distribution: 61% hypoechoic among patients. MRI findings: 37% mild, 31% moderate, 22% minimal. Besides, 87% showed heterogeneous mass enhancement; 63% had segmental non-mass distribution. Conclusion: In breast cancer cases, imaging findings often include masses exhibiting suspicious features such as irregular shape and spiculated margins on mammograms, and irregular shape with angular margins on ultrasound. MRI features commonly involve masses with irregular shapes and heterogeneous enhancement.

Comparison between Highly Sensitive C - Reactive Protein in Subjects with Preeclampsia with Severe Features and Preeclampsia without Severe Features

Background: Preeclampsia (PE) develops in 4-5% of pregnancies in humans. It appears after 20 weeks of gestation and is defined by increased blood pressure and proteinuria. When convulsions occur or the hemolysis, high liver enzymes, and low platelet count (HELLP) condition materializes, PE can lead to eclampsia. It is well recognized that eclampsia and HELLP syndrome are linked to serious side effects include liver hemorrhage, lung edema, brain hemorrhage, and renal failure. Objective: The aim of this study is to compare between highly sensitive c- reactive protein in subjects with preeclampsia with severe features and preeclampsia without severe features. Methods: This case-control study was carried out in the Department of Obstetrics & Gynecology of Dhaka Medical College Hospital, Dhaka, from January 2023 to December 2023. A total of 68 patients were enrolled and analyzed in this study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, maximum study subjects were in 21 – 30 years age group. Mean age of the study subjects was 26.12 ± 4.02 and 24.04 ± 4.32 years in PE with severe features and PE without severe features respectively. Majority of the patients 27(79.4%) and 25 (73.5%) were housewife in both cases. Illiterate 2 (5.9%), higher secondary 9(26.5%) and graduate 10(29.4%) were higher in PE with severe features than PE without severe features. Most of the patients 25 (73.5%) and 21 (61.8%) came from rural area. Nullipara was higher in PE with severe feature and multigravida was higher in PE without severe features. Antenatal care was found more irregular in PE patients with severe features subjects than PE without severe features. Preterm pregnancy was higher in PE with severe feature than PE without severe features. Systolic and diastolic blood pressure were found significantly higher in PE patients with severe features than without severe features. hsCRP was found significantly higher in PE with severe features than PE without severe features. APGAR score of the neonate was significantly better of PE patients without severe features than with severe features patients both at birth and at 5 minutes. Average birth weight of the neonate was found higher of the PE patients without severe features than with severe features patients. There was 6(17.6%) very LBW of neonates of PE with severe features patients but none in PE without severe features patients. Intrauterine growth retardation, and prematurity were found higher in PE with severe features patients comparing PE without severe features. Conclusion: Women with PE have higher serum hsCRP levels. Clinical and biochemical markers of PE are linked with elevated serum levels of hsCRP in preeclamptic women. Serum hsCRP levels can be measured to determine the severity of PE.

High Sensitivity C-Reactive Protein as an Independent Risk Factor for Preeclampsia with Severe Features

Background: One of the most dangerous complications of pregnancy and a major contributor to maternal and perinatal morbidity and death is preeclampsia. The goal of the current study was to measure the level of inflammation in severe preeclampsia by measuring serum high-sensitive C-reactive protein (hs-CRP) and establishing a relationship between hs-CRP and blood pressure. Objective: The aim of this study is to evaluate the impact high sensitivity C-reactive protein as an independent risk factor for preeclampsia with severe features. Methods: The cross-sectional study was carried out in the Department of Obstetrics & Gynecology of Dhaka Medical College Hospital, Dhaka, from July 2022 to June 2023. A total of 200 patients were enrolled and analyzed in this study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, majority 95 (47.5%) of the patients were in 21 – 30 years age group and 60 (30.00%) patients were in >30 years age group, Mean±SD of age was 27.12 ± 4.12 years. Most of the patients 150 (75.00%) were housewife and 50 (25.00%) patients were service holder. About 55 (27.5) patients were completed their graduation, 50 (25.00%) were completed higher secondary and 20 (10) were illiterate, most of the patients 145 (72.5%) came from rural area and 55(27.5) patients came from urban area. Nullipara was found in 75 (37.5%) patients and multigravida was found in most of the patients 110 (55.00%). Antenatal care was found irregular in 105 (52.5%) patients. Preterm pregnancy was found in majority 145 (72.5%) of the patients. Systolic and diastolic blood pressure were found higher and hsCRP was also found higher in PE with severe features. APGAR score was found less in 65 (32.5%) neonate at birth and APGAR score was found good in 55 (27.5%) neonate at 5 minutes. Average birth weight was found in 75 (37.5%) neonates, LBW was found in 85 (42.5) neonates and very LBW was found in 40 (20.00%) neonates of PE with severe features patients. Intrauterine growth retardation and prematurity were found in 75 (37.5%) and 20 (10.00%) neonates, admission to NICU was needed for 45 (22.5%) neonates, birth asphyxia was found in 15 (7.5%) neonates and stillbirth was occured in 35 (17.5%) cases. Conclusion: An exaggerated systemic inflammatory response, which may produce reactive oxygen species and worsen endothelial dysfunction, is present in preeclampsia. Clinical signs of hypertension and proteinuria in preeclampsia result from this. Preeclampsia-related maternal mortality and systemic complications may be reduced with early identification. hsCRP may therefore be a valuable gauge of preeclampsia severity.

Predictive modeling for breast cancer classification in the context of Bangladeshi patients by use of machine learning approach with explainable AI

Breast cancer has rapidly increased in prevalence in recent years, making it one of the leading causes of mortality worldwide. Among all cancers, it is by far the most common. Diagnosing this illness manually requires significant time and expertise. Since detecting breast cancer is a time-consuming process, preventing its further spread can be aided by creating machine-based forecasts. Machine learning and Explainable AI are crucial in classification as they not only provide accurate predictions but also offer insights into how the model arrives at its decisions, aiding in the understanding and trustworthiness of the classification results. In this study, we evaluate and compare the classification accuracy, precision, recall, and F1 scores of five different machine learning methods using a primary dataset (500 patients from Dhaka Medical College Hospital). Five different supervised machine learning techniques, including decision tree, random forest, logistic regression, naive bayes, and XGBoost, have been used to achieve optimal results on our dataset. Additionally, this study applied SHAP analysis to the XGBoost model to interpret the model’s predictions and understand the impact of each feature on the model’s output. We compared the accuracy with which several algorithms classified the data, as well as contrasted with other literature in this field. After final evaluation, this study found that XGBoost achieved the best model accuracy, which is 97%.

Comparison between Home-Based Exercise and Hospital-Based Supervised Exercise in the Early Rehabilitation of Stroke Patients

Introduction: Stroke is one of the leading causes of death and disability worldwide and more so in underdeveloped countries like Bangladesh, where health support systems including rehabilitation not expectedly available. Early initiation of rehabilitation procedures can enable a greater return of neurological function and improve long-term outcomes and quality of life. In this study, we aimed to compare the effects of home-based exercise and hospital-based supervised exercise in the early rehabilitation of stroke patients. Methods: This was a prospective observational study and was conducted in the Department of Physical Medicine and Rehabilitation, Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from January, 2014 to June, 2014. In our study, we included 250 patients, and the patients were divided into two groups – Group A (Patients who got home-based exercise) and Group B (Patients who got hospital-based exercise). Result: We found the mean age of the patients of Group A & Group B was 56.75± 9.45 and 55.46± 10.58 years respectively. Among the patients, 41% were female,59% were male and 168 (67.2%) patients had been suffering from ischemic stroke and 82 (32.8%) patients from hemorrhagic stroke. The most common risk factors were HTN, dyslipidemia, and obesity. Mean FIM gain in Group A was 37.97 ± 17.52 and in Group B was 48.56 ± 21.22 which was significantly higher than that of Group A patients. Conclusion: In our study, we found that hospital-based supervised exercise is superior to home-based exercise within 4 weeks of stroke in early rehabilitation of stroke patients.

The 2023 Dengue Outbreak in Bangladesh: Exploring the Epidemiology in Hospitalized Patients.

For the past two decades, Bangladesh has faced recurrent dengue outbreaks, with the most recent occurring in 2023. We investigated the socioeconomic, clinical, and laboratory aspects of patients diagnosed with dengue during this outbreak. This observational study was conducted from July to September 2023 at Dhaka Medical College Hospital and Chittagong Medical College Hospital, and included 450 confirmed cases of dengue. Sociodemographic information was collected via face-to-face interviews, clinical examinations, and laboratory testing, which was done within 24 hours of admission. Dengue severity was classified according to the 2009 WHO dengue guidelines. Notably, 17% of patients experienced severe dengue, and 89% of those with nonsevere cases exhibited at least one warning sign. Most patients were young adults (mean age, 33 years), with a nearly equal male-to-female ratio. Common clinical presentations included fever (95%), myalgia (62%), and headache (58%), whereas warning signs such as vomiting (54%) and abdominal pain (39%) were prevalent. Plasma leakage indicators, including ascites, pleural effusion, and edema, were found predominantly in severe cases. Laboratory findings revealed leukopenia, thrombocytopenia, and elevated hepatic enzymes (alanine aminotransferase and aspartate aminotransferase) in nearly half the patients. An elevated hematocrit level was associated with severe dengue. We report that a substantial number of patients developed severe dengue during the epidemic in 2023, and provide detailed clinical-epidemiological profiles of the patients, offering valuable insight into management of dengue cases.

Prevalence of Ear and Nasal Diseases in Bangladeshi Patients

Background: The magnitude of health problems related to ear and nose in Bangladesh has not been estimated in a larger scale and very little is known about the prevalence and types of ENT diseases. Commonest cause of hearing impairment in our country is middle ear infection. Conductive type of deafness mostly occurs due to otitis media with or without its complications. Goal of primary health eare services is to achieve "Sound hearing by 2030" will never be achieved if we could not find out possible association of middle ear disease with other health conditions. Objective: To determine the prevalence of ear and nasal diseases in Bangladeshi patients. Methods: Two hundred patients complaining of middle ear discharge and or nasal symptoms were included in this study, to see the association of COM with nasal disorders. This cross sectional study was conducted in Dhaka Medical College Hospital from July 2012 to June 2014.Sample was taken by purposive sampling. Sample was divided into four groups as exposed and diseased, exposed and not diseased, not exposed diseased and not exposed and not diseased. Results: Two hundred patients were studied in the department of ENT and Head Neck Surgery of Dhaka Medical College Hospital complaining of either COM or Sinonasal disease. Among them 107 were female and 93 were male and male female ratio was 1:1.15. On analyzing age distribution it was ranging from 10 years to 50 years with mean age 30±7.86% clustering around 25 years. This study revealed that 65 % of COM is in the age group of 10-30 years. Conclusion: A study on the prevalence of the Ear Nose throat and Head and Neck diseases in developing country like Bangladesh can provide basic data which can be relevant and beneficial to the development of medical ENT curriculum in the regional setup and subsequent medical practice.

Association of Deviated Nasal Septum with Chronic otitis Media

Background: The existence of a pathophysiologic connection between nose and rniddle ear is widely accepted so that chronic purulent middle ear disease (CPMED) could be expected to be usually associated with chronic nasal disease or impaired function. Nevertheless such association is less frequently observed in clinical practice than one could expect, possibly because of inadequate evaluation of nasal function. Objective: To observe the association of deviated nasal septum with COM Methods: Two hundred patients complaining of middle ear discharge and or nasal symptoms were included in this study, to see the association of COM with nasal disorders. This cross sectional study was conducted in Dhaka Medical College Hospital from July 2012 to June 2014.Sample was taken by purposive sampling. Sample was divided into four groups as exposed and diseased, exposed and not diseased, not exposed diseased and not exposed and not diseased. Results: Along with DNS age, sex, smoking and abusing of nasal drug were compared. Number of patients with septal deviation with a convexity to the same side as affected ear in COM was compared with Chi-square test. Septal deviation founded more frequently on the same side of ear pathology (p<00l), Therefore, septal deviations must be carefully investigated during the management patients with COM. Conclusion: Septal deviations must be carefully investigated during the preoperative assessment of patients with COM. Along with DNS age, sex, smoking and abusing of nasal drugs were evaluated. Smoking was found to be associated with the development of COM.

Experience of pediatric palliative care among children with cancer in a tertiary care hospital in Bangladesh

Background: Palliative care is a holistic approach which can improve patients and their family’s quality of life through the prevention and relief of physical symptoms as well as support for emotional, social and spiritual suffering. Despite the substantial need for palliative care there is very limited access in Bangladesh, with only a few palliative care services focused on children including several hospital-based services as well as home and hospice-based services, within the capital city of Dhaka. The aim of the study was to evaluate the effect of pediatric palliative care on quality of life in children with cancer. Methods: This was an institutional based descriptive study conducted in the department of pediatric hematology and oncology and pediatric palliative care unit, Dhaka medical college hospital, Dhaka, from May to August 2023. A total of thirty child and parent pairs were taken as the study population according to inclusion and exclusion criteria. Outcome was evaluated by the CPOS-2 questionnaires for symptom and Lanskys performance status scale for assessment of activity level. Results: The median age of the children were 5.7 years where 70.0% were male. The duration of disease of the patients was up to 6 months in 63.3% cases. One third of the patients had ALL, 13.3% had NHL, and 10.0% had Ewing sarcoma while another 10.0% having neuroblastoma. Conclusions: There is significant improvement in the quality of life of pediatric cancer patients and their parents, as well as the enhanced performance status of patients with cancer after receiving pediatric palliative care.

Role of Ultrasound Guided Pneumatic Reduction of Intussusception in Children Under 3 Years with Early Presentation

Background: Intussusception remains the most common cause of intestinal obstruction in children under 3 years of age. Objective: To evaluate the role of ultrasound guided pneumatic reduction of intussusception in children under 3 years with early presentation. Methods: This prospective interventional study was carried out at the Department of Pediatric Surgery in Dhaka Medical College Hospital, Dhaka from July, 2020 to June, 2022 for a period of 24 months. A total number of 22 patients with intussusception scheduled for Ultrasound Guided Pneumatic Reduction procedure to reduce intussusception were enrolled for this study after fulfilling the selection criteria. After Ultrasound Guided Pneumatic Reduction, patients were evaluated with duration of reduction, hospital stay and mass existence. Results: The mean age of the patients was 1.28 ± 0.83 years, ranging from 4 months to 3 years. Of them, 54.5% were below or equal to 1 year and the rest, 45.5% were above 1 year. All patients had abdominal pain and 86.4% palpable abdominal mass. Most of the mass situated at right hypochondrium (59.1%). The mean duration of reduction was 6.45 ± 1.29 minutes, ranging from 4 to 8 minutes. The mean duration of hospitalization was 15.90 ± 1.57 hours, ranging from 14 to 18 hours. In 9.1% of cases, the mass remained after the procedure. Conclusion: Intussusception can be effectively treated using pneumatic reduction, which is also quicker, less messy, and risk-free.

Effect of Perioperative Allogeneic Blood Transfusion in Causing Surgical Site Infection in Elective Gastrointestinal Surgeries: A Comparative Study among the Pediatric Population in A Tertiary Care Hospital of Bangladesh

Background: Allogeneic blood transfusion (ABT) has been reported as a major risk factor for surgical site infection (SSI) in patients undergoing elective gastrointestinal surgery. Objective: To find out whether perioperative allogeneic blood transfusion is a significant risk factor for surgical site infection in children undergoing elective gastrointestinal surgery. Methods: This prospective observational study was carried out at the Department of Pediatric Surgery in Dhaka Medical College Hospital, Dhaka, from January, 2021, to June, 2022, for a period of 18 months. According to CDC standards, patients who underwent elective gastrointestinal surgical procedure or clean-contaminated surgical wound (class II) were chosen as the study population. Total 256 patients were divided into two groups according to the blood transfusion as transfused and non-transfused group. Preoperative and postoperative day 1 CBC were done to observe the lymphocyte count. Blood transfusions were recorded during the perioperative period. After surgery, patients were followed up to check for surgical site infection and anastomotic leakage. Pus or wound swab for C/S was done in all the patients who developed SSI. The duration of the hospital stay after surgery was also noted. Results: Most of the study subjects in both the groups were ≤5 years(p=0.095). Males were predominant than females in both groups (p=0.014). Infection was found significantly higher among the transfused group (34.6%) than non-transfused group (14.6%) (p=0.001). In both the groups common infection was superficial SSI (12.0% in transfused group and 6.5% in non-transfused group). Among the infections, bacterial growth was 39.1% in Group A and 38.9% in Group B (p>0.786). Postoperative duration of hospital stay was 10.56 ± 4.05 days and 8.47 ± 2.67 days in Group A and Group B respectively (p<0.001). Mean lymphocyte count in Group A and group B was (2353.9±1647.7 vs 3792.5±1455.9; p<0.001). Conclusion: Allogeneic blood ........

Evaluation of Outcomes of Subcutaneous Negative Suction Drain in Emergency Laparotomy in Children with Peritonitis

Background: Emergency laparotomy for peritonitis is associated with the highest rates of infective complication, especially surgical site infection (SSI) and it's linked to higher morbidity, mortality, and healthcare costs. Aim of the Study: The aim of this study was to evaluate the outcome of subcutaneous negative suction drain in emergency laparotomy in children with peritonitis. Methodology: This prospective interventional study was conducted in the Department of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka from January, 2020 to December 2021 over a period of two years. A total of 64 patients who underwent emergency laparotomy with features of peritonitis were enrolled in this study as per selection criteria. They were divided into two groups equally. Subcutaneous negative suction drain was used in Group A patients, and in Group B patient’s standard of care was provided. Patients were followed up to 30thpostoperative day. Outcome was evaluated by superficial surgical site infection (s-SSI), wound dehiscence, secondary suturing and duration of hospital stay. Superficial surgical site infection(s-SSI) assessed by CDC criteria of surgical site infection on 3rd, 5th, 7th, 14th& 30thpostoperative day. Microsoft Excel was used for data analysis. Results: Mean age of the study populations in Group A was 8.41 ± 2.27 years and Group B was 8.95 ± 2.27 years. Male were predominant than female in both the two groups. s-SSI was observed significantly(p=0.016) lower in Group A (9.4%) than Group B (34.4%). Culture & sensitivity growth was observed significantly(p=0.020) lower in Group A (6.3%) than Group B (28.1%). Wound dehiscence was (9.4%) in Group A and (28.1%) in Group B. Secondary suturing was (3.1%) and (15.6%) in Group A and Group B respectively. Duration of hospital stay was found significantly (p=0.011) lesser in Group A than Group B (6.68 ± 2.14 vs 8.50 ± 3.29) days. Conclusion: Subcutaneous negative suction drain reduces the post-operative superficial ..

Comparative Demographic and Clinical Profile of Preeclamptic and Normal Pregnant Women in the Third Trimester

Background: Preeclampsia is a pregnancy-specific, multi-system disorder characterized by elevated blood pressure and proteinuria after 20 weeks of gestation. Its exact etiology remains unknown, and globally, it stands as a prominent cause of maternal and infant morbidity and mortality. This study aimed to assess the comparative demographic and clinical profile of preeclamptic and normal pregnant women in the third trimester. Methods: This case-control study took place in Bangabandhu Sheikh Mujib Medical University Hospital and Dhaka Medical College Hospital, Dhaka, Bangladesh, spanning from July 2011 to June 2012. The study enrolled 100 pregnant women, with 50 cases diagnosed with preeclampsia and 50 controls representing normal pregnant women. Data analysis was conducted using SPSS version 23.0. Results: The mean ages of cases (25.8 ± 4.4 years) and controls (27.1 ± 3.1 years) were similar (P=0.177). A predominant proportion of cases (74%) and controls (66%) belonged to a lower social class (P=0.383). BMI assessment showed no significant difference (P= 0.645). Most participants in both groups were preterm (P=0.235) and primigravida (P= 0.422). The case group exhibited significantly higher mean serum ferritin than the control group (P<0.001). Hemoglobin and hematocrit levels showed no significant differences (P=0.761 and P=0.231, respectively). Elevated serum ferritin (>20 ng/ml) was prevalent in 76% of cases and 44% of controls (P=0.001). The odds of elevated serum ferritin in preeclampsia were approximately 4 times higher than in normal pregnancies (95% CI=1.7–9.5). Variations in serum ferritin levels across gestational ages are illustrated. Conclusion: The study found no significant correlation between preeclamptic and normal pregnant women's demographic and clinical status in the third trimester, except for serum ferritin levels. Further research is needed to obtain a clearer understanding of these relationships.

Did the COVID-19 pandemic affect levels of burnout, anxiety and depression among doctors and nurses in Bangladesh? A cross-sectional survey study

IntroductionCOVID-19 has caused severe disruption to clinical services in Bangladesh but the extent of this, and the impact on healthcare professionals is unclear. We aimed to assess the perceived levels...

Association of Heart Failure Admission with Age, Sex, Risk Factors and Co-Morbidities in Tertiary Care Hospital in Bangladesh

Background: Heart failure is a significant medical and societal concern worldwide. It continues to be a major source of morbidity and mortality and causes a significant and rising cost on the health care system. There is a seasonal fluctuation in the number of people who are admitted to hospitals for heart failure, with winter seeing the highest rate. Objective: To assess the seasonal variation of heart failure admission with age, sex, risk factors and co-morbidities in tertiary care hospital in Bangladesh. Materials and Methods: This cross-sectional study was carried out among the patients hospitalized with heart failure at the Department of Cardiology, Dhaka Medical College Hospital (DMCH), Dhaka, between April 2015 and March 2016. The history, clinical characteristics, and investigational data were used to diagnosis the patients. Statistical tests were used to examine the impact of seasonal fluctuation on patients admitted with heart failure. Results: In the age range of 41 to 60 years, 302 patients with heart failure at the highest level (51.7%) were hospitalized. Heart failure admission patients were 2.8 times more likely to be male than female, with a mean age of 55.18±12.42 years. Heart failure patients in the age ranges of 20 to 40, 41 to 60, and 61 to 80 years were hospitalized more frequently in the winter and post-monsoon. Seasons and gender had a statistically significant relationship (p=0.030). Smoking is the greatest risk factor compared to other risk factors in all seasons, and all risk factors were more prevalent in the winter than they were in other seasons. Conclusion: This study may help improve the healthcare system and alter how easily accessible hospital resources such as emergency rooms are throughout the winter. More information regarding the heart failure events that occur throughout the winter should be made available to patients and general practitioners.

Prevalence of Heart Failure Patients Admitted in the Winter and Other Seasons in a Tertiary Care Hospital Bangladesh

Background: As a leading global cause of death and disability, heart failure places a significant strain on the healthcare system. It has been observed that in some countries, there is a seasonal increase in the number of people admitted to hospitals with heart failure during winter. However, there is a dearth of population-based statistics for Southeast Asia and Bangladesh. with regards to this subject. Objective: To determine the number of patients with heart failure admitted during the winter and other seasons in Bangladesh's tertiary care hospitals. Materials and Methods: This study used a cross-sectional, observational design. The study was carried out at the Cardiology Department of Dhaka Medical College Hospital (DMCH). The research took place over the course of a year, from April 2015 to March 2016. Patients with heart failure who are admitted to the DMCH's Cardiology Department constitute the study population. This study made use of a systematic sampling strategy. All 584 patients who visited the hospital's cardiology department were counted. Patients' demographics, medical histories, symptoms, and test results were recorded on a standard data collection form. The statistical software package SPSS 22.0 was used to analyze the data (Statistical Package for Social Science). Results: Heart failure patients were most prevalent in the 41 to 60 age group, with 74.3% being men and 25.7% being women. The winter season saw the largest number of patient admissions (n=207, 35.5%). Compared to other seasons, the winter had higher concentrations of all risk variables. It is statistically significant, with the exception of thyroid issues and dyslipidemia (p-values of <0.222, <0.001, <0.001, <0.001, and <0.006). Conclusion: General practitioners might learn how to handle heart failure patients' responses to the cold and hone their abilities in this area. This research may also be useful for modifying the wintertime accessibility of hospital resources like emergency rooms.

Bacteriological Study and Antibacterial Susceptibility in Ludwig’s Angina in a Tertiary Level Hospital in Dhaka, Bangladesh

Background: The knowledge of the local pattern of infection and antibacterial sensitivity in Ludwig’s angina is essential to enable efficacious treatment for it. Objective: To find out the pattern of bacteria responsible for developing Ludwig’s angina and their antibacterial susceptibility. Methods: It is a prospective, observational type of study carried out in the Department of Otolaryngology & Head-Neck Surgery, Dhaka Medical College Hospital, Dhaka, and the Department of Clinical Microbiology, ICDDR, B, Dhaka, Bangladesh, between April and September of 2016. A total of 100 patients were included in this study. Results: This study was done among 100 patients. In this study, 42 cases (42%) were in the 31-45 years age group. The male patients were 60 (60%) and females were 40 (40%). Majority of patients 70(70%) came from poor class family with educational level up to HSC (75%), maximum 35(35%) patients use meswak to clean teeth, 70 (70%) patients came from rural area, 70 (70%) patients had dental infection, 25 (25%) patients had diabetes mellitus, all the cases (100%) presented with swelling in the floor of the mouth and neck, pain and tenderness and fever. The major complication was necrotizing fasciitis 8 (8%), 36 (36%) patients were discharged within 1-2 weeks after treatment, Streptococcus 40 (40%) was the most common organism and the most effective antibiotic was Ceftriaxone (65%). Conclusion: The most frequently isolated organism in Ludwig’s angina is Streptococcus and sensitivity results showed a majority of isolates are susceptible to Ceftriaxone. Mugda Med Coll J. 2023; 6(2): 71-76

Evaluation the role of supplementation of oral zinc on systolic and diastolic blood pressure in type 2 diabetic patients

Background: Zinc is an important trace element and a potent antioxidant. Its deficiency causes a common comorbidity with numerous chronic diseases including hypertension and diabetes mellitus, associated with development and progression of various complications. Objective: The present study has been undertaken to evaluate the effects of zinc supplementation on blood pressure in type 2 diabetic patients. Methods: This prospective interventional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka between January 2016 to December 2016. In this study, a total number of 46 diagnosed type 2 diabetic patients of both sexes were selected with age ranging from 40 to 55 years. Among them, 26 type 2 diabetic patients with supplementation of oral zinc (40mg/day) for 12 weeks were considered as study group (Group B). Another 25 age matched type 2 diabetic patients without supplementation of oral zinc were considered as control group (Group A) for comparison. All subjects were selected from Outpatient Department of Endocrinology, Dhaka Medical College Hospital, Dhaka on the basis of inclusion and exclusion criteria. Their blood pressure (BP) was measured and serum zinc level was estimated by Spectrophotometric method accordingly. These parameters were studied 2 times in all subjects of control and study groups i.e. at the beginning of study (base line) and after 12 weeks of study period. Data were collected in pre-designed structured questionnaire form by the researcher herself. For statistical analysis, paired Student’s ‘t’ test and unpaired Student’s ‘t’ test were performed as applicable using SPSS for windows version 22.0. Results: In this study, after zinc supplementation resulted in a significant (p<0.001) decrease in both systolic and diastolic blood pressure in study group but there was no significant change observed in control group. Conclusions: After analyzing the results of the study, it can be concluded that oral zinc supplementation can be useful for improving blood pressure in type 2 diabetic patients. Central Medical College Journal Vol 7 No 1 January 2023 Page: 41-46