Dhaka Hospital Research Articles

Long-term sialidase-specific immune responses after natural infection with cholera: Findings from a longitudinal cohort study in Bangladesh.

Immune responses that target sialidase occur following natural cholera and have been associated with protection against cholera. Sialidase is a neuraminidase that facilitates the binding of cholera toxin (CT) to intestinal epithelial cells. Despite this, little is known about age-related sialidase-specific immune responses and the impact of nutritional status and co-infection on sialidase-specific immunity. We enrolled 50 culture-confirmed Vibrio cholerae O1 cholera cases presenting to the icddr,b Dhaka hospital with moderate to severe dehydration. We evaluated antibody responses out to 18 months (day 540) following cholera. We assessed immune responses targeting sialidase, lipopolysaccharide (LPS), cholera toxin B subunit (CtxB), and vibriocidal responses. We also explored the association of sialidase-specific immune responses to nutritional parameters and parasitic co-infection of cases. This longitudinal cohort study showed age-dependent differences in anti-sialidase immune response after natural cholera infection. Adult patients developed plasma anti-sialidase IgA and IgG responses after acute infection (P<0.05), which gradually decreased from day 30 on. In children, no significant anti-sialidase IgA, IgM, and IgG response was seen with the exception of a late IgG response at study day 540 (p=0.05 compared to adults). There was a correlation between anti-sialidase IgA with vibriocidal titers, as well as anti-sialidase IgA and IgG with anti-LPS and anti-CtxB antibody responses in adult patients, whereas in children, a significant positive correlation was seen only between anti-sialidase IgA and CtxB IgA responses. Stunted children showed significantly lower anti-sialidase IgA, IgG, and IgM antibody responses and higher LPS IgG and IgM antibody responses than healthy children. The anti-sialidase IgA and IgG responses were significantly higher in cases with concomitant parasitic infection. Our data suggest that cholera patients develop age-distinct systemic and mucosal immune responses against sialidase. The stunted children have a lower anti-sialidase antibody response which may be associated with gut enteropathy and the neuraminidase plays an important role in augmented immune response in cholera patients infected with parasites.

Towards sustainable energy technologies at a COVID-19 hospital in Dhaka, Bangladesh

The current energy demands in Bangladesh far supersedes the supply. The thesis provides an efficient way to account for the energy deficit by using a renewable hybrid model design. Solar, Wind, and Biogas were the focus of this thesis for their abundance in the study region. Our thesis explored the possibilities of implementing a hybrid energy system in a makeshift COVID-19 hospital in Purbachal, Bangladesh. The COVID-19 situation is getting worse, even after the first case detected in March 2020.. It is tough to manage sufficient hospital beds with minimum facilities in the least developing country like Bangladesh. The hybrid model developed using HOMER software utilized solar, Wind, and Biogas in a configuration that achieved the best COE and NPC values. The model adjusted parameters such as fuel cost, wind speed, solar radiation, electricity price, and component cost for smooth and realistic simulation. From our simulations, we observed that wind energy was not a feasible option for the region of study, and without Biogas, the PV-Wind or only PV system had a COE of 0.492 and 0.516 USD, respectively. We find good optimize results for PV-Bio as a generator-Battery system. We are getting the COE of around 0.176 USD with a considerable amount of initial capital, 82806.25 USD. Even though the model was primarily fashioned for the healthcare sector in Purbachal, Bangladesh. The model can easily be modified for use in any region of the world and be re-purposed for use in other industries.

Socio-Demographic Determinants of Genitourinary Prolapse

Background: Genitourinary prolapse is a common gynecological problem, especially in developing country. Causes and risk factors for uterine prolapse are complex and deeply embedded in the cultural, economic and social conditions of women. Prevalence of depression is higher among women with advanced stages of prolapse. Hence this study aimed to assess the socio-demographic factors among patients with genitourinary prolapse. Methods: A cross-sectional study was conducted from January to December, 2013 among 120 women with genital prolapse who attended at Gynae wards of Dhaka Medical College Hospital, Shaheed Suhrawardy Medical College Hospital, and Mitford Hospital in Dhaka. Women who were admitted with complaints of protruding mass per vagina and diagnosed as case of uterine prolapse were assessed and staged accordingly. A semi-structured questionnaire was used to obtain socio-demographic data and prolapse related data by face to face interview. After collection, data were compiled, summarized, and analyzed using SPSS software. Results: In this study, out of 120 genitourinary prolapsed patients, 31.7% were 40-45 years age group, majority of 79.2 % were illiterate and almost two third had no monthly income. Among all respondents, 64.2 % had more than four children, maximum 96.7% had history of home delivery, and 91.7% history of heavy work during pregnancy or just after delivery. Conclusion: Genitourinary prolapsed patients were illiterate, multipara, economic insolvency, heavy work during pregnancy and home delivery. A holistic management approach is recommended for women having prolapse. JOPSOM 2021; 40(2):26-31

Reproductive Outcome in Women with different Types of Congenital Uterine Anomalies

Introduction: Mullerian ducts are the primordial analogue of female genital tract. They differentiate to form the fallopian tubes, uterine body, cervix and upper part of the vagina. A wide variety of malformation occur when this system is disrupted. The range from uterine agenesis, duplication of uterus to minor cavity abnormalities. All these congenital anomalies have been implicated as a potential cause for impaired reproductive outcome. Our aim was to evaluate the association between different types of congenital anomaly and various reproductive outcome. Material &amp; Methods: This cross sectional descriptive study was conducted at the Department of gynae and obstetrics in Dhaka Medical College and Hospital (DMCH), Ad-din Women’s Medical College and Hospital and Gonoshasthaya Samaj Vittik Medical College and Hospital during the period of March 2012 to September 2022.The study subjects were women with uterine anomalies who were diagnosed during evaluation of causes for bad obstetric history, during infertility work up or incidental findings during antenatal investigations or during Carsarian section . Reproductive outcomes were observed in the form of infertility, miscarriage, preterm delivery, ectopic pregnancy, intra uterine growth retardation (IUGR) and post-partum haemorrhage (PPH). These were recorded in a standard research questionnaire. Data were analyzed regarding types of uterine anomalies and their reproductive performance. Results: During the study period total 84 patients were recruited with uterine anomalies. Regarding distributions of uterine anomalies in study subjects the most common uterine anomaly was bicornuate uterus (n-32,38%), followed by arcuate uterus (n-18,21%), septate uterus (n-16,19%), unicornuate uterus (n-12,14%), and uterine didelphys (n-6,7. 1%).Women with bicornuate uterus was associated with miscarriage (37.25%), term delivery (31.25%) and preterm delivery (25%). Therefore, bicornuate uterus was found more evident with miscarriage. Only two cases of ectopic pregnancy were observed in the study which was found with bicornuate uterus. And in arcuate uterus percentage of preterm delivery was 44.4%, term delivery 33.3%, miscarriage only 22.2%. Therefore, arcuate uterus was more associated with preterm delivery. In septate uterus miscarriage was maximum (37.5%) followed byl term and pre term delivery, 12.5% each We found 12 cases of unicornuateuterus, where pregnancy continued to term in 6(50%) cases,2 aborted and 4(33.3)were delivered before term. Infertility was more associated with canalization defect, 6 cases with septate and 2 with didelphys uterus. Among live births (preterm and term deliveries,) malpresentation (breech, transverse) was more common in bicornuate uterus (44%).PPh was found in 2 cases of didelphys and two of bicornuate uterus. One case of septate and one from bicornuate uterus were associated with IUGR. Conclusion: The study makes clear that congenital uterine anomaly is associated with poor reproductive outcome. The exact effect is dependent on the type of anomaly.

Analysis of Posterior Interventricular Artery in Post Mortem Hearts-A Hospital Based Study

Introduction: Coronary artery recurrently develops over periods. Symptoms may go hidden until a substantial blockage causes complications or a heart attack takes place. The particular anatomy of the myocardial blood supply varies significantly from person to person and generally, there are two prime coronary arteries, the left and the right. The coronary arteries mainly rise from the upper section of the sinus where the wall is fibroelastic and expands up to 16% in systole According to the origin of the posterior interventricular artery (PIVA) if it arises from RCA, then it is right dominance and if PIVA arises from LCA, it is left dominance. Methods: A cross-sectional study was carried out in the Department of Forensic Medicine of Dhaka Medical College and Hospital from September 2017 to January 2019. A total of 120 dead patients' hearts (N=120) were used in this study. All observations were noted in the clinical data sheet. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Result: Among the study population (N=120), one hundred hearts were male &amp; of them, seventy males belonged to Group A (20 to 40 years), sixteen belonged to Group B (41 to 60 years), fourteen belonged to Group C (61 to 75 years) and twenty hearts were of female &amp; of them fourteen belonged to Group A, six belonged to Group B, but no one belonged Group C. In Group A, the posterior interventricular artery arose from the right coronary artery in sixty-four males (64,91.4%), &amp; the left coronary artery in six males (6,8.6%) and, the posterior interventricular artery arose from the right coronary artery in twelve females (12,85.7%). In Group A, the posterior interventricular artery terminated in the distal half of the posterior interventricular groove in fifty- six males (56,80.0%), in the proximal half of the posterior interventricular groove in twelve males ..........

Clinical and Laboratory Presentations of Children with First Time Febrile Seizure: Findings from a Tertiary Level Hospital in Bangladesh

Background: Seizures associated with fever are a leading cause of pediatric hospitalization. The purpose of this study was to explore the clinical characteristics and laboratory findings of children with first time febrile seizure in local settings, which are limited in Bangladesh. Methods: From July 2013 to June 2014, this Cross-sectional, Observational study was conducted at Sir Salimullah Medical College and Mitford Hospital in Dhaka. The study included all admitted children aged 6 months to 60 months who had their first febrile seizure. A thorough history, clinical examination, and laboratory investigations were performed and analyzed. Results: Among the 87 study population, mean age of presentation was 25.62 ± 12.64 months, male were predominant (56%) and 17% had family history of FS. Majority of them presented with respiratory illness-like symptoms(23%). 54% of them experienced two seizures, and 75% of the seizures were generalised. 23% of them revealed chest X-ray features consistent with lung infection, 31% had neutrophilic leukocytosis, and 8% had positive blood culture growth. Streptococcus pneumoniae in Gram stain of 2% CSF and Klebsiella in 2% of the CSF culture cases were identified. Pneumonia was the underlying cause in 20% of case; viral syndrome in17% of cases, meningitis in 13% of cases, and in 15% of cases, the underlying cause could not be identified. Conclusion: The majority of febrile seizures in our study participants were caused by various respiratory illnesses and meningitis. White blood cell counts, blood culture and cerebrospinal fluid analyses can aid in determining the underlying cause and facilitating appropriate and timely management.

Adaptation to the Resource Available in Construction of Stoma in Pediatric Stoma Care in Bangladesh: A Descriptive Analytical Study

Background: Stoma construction is a routine operation in the field of pediatric surgery. Commercially accessible resources, such as ostomy bags (either disposable or with extended lifespans), are often employed to care for these stomas. These may be rather pricey, especially in places like Bangladesh, and it might be difficult to get ones in the right size. Objective: In this study our main objective is to evaluate the efficacy of resource available in construction of stoma in Pediatric stoma care in Bangladesh. Method: From January 2014 through December 2015, a total of 60 patients were included in a prospective research done by the pediatric surgery department at Dhaka Medical College and Hospital. The research group consisted of patients less than 12 years old who had temporary loop colostomy or ileostomy in the pediatric surgical units at Dhaka Medical College &amp; Hospital throughout the study period. Zinc oxide paste was first administered to the Peristomal skin after stoma formation. The stoma was covered with a betel leaf, which had a glossy, smooth outside surface and a rough inner surface. The size of the hole in the betel leaf was adjusted to accommodate the stoma. The stoma is protected by an additional leaf that is still fully intact. When nature calls, one must remove the undamaged leaf above it and wipe away the feces before moving on. The cleaned leaves were put to further use. Ostomy bags (like those made by Convatec) and adhesive paste (Stomahesive) are used to seal the bag to the Peristomal skin. Results: During the study, both the stoma bag and betel leaf groups had a wide range of ages, from one day to 4,320 days. In addition, both group anorectal malformations found as common indication 70% vs 73.33% (stoma bag vs betel leaf) followed by in stoma bag group 23.33% had Hirschsprung’s disease and 6.67% had Colonic atresia. Where as in betel leaf group 20% had Hirschsprung’s disease and 6.67% had Colonic atresia? In stoma bag group majority had ......

Measuring the Effectiveness of COVID-19 Vaccines Used during a Surge of the Delta Variant of SARS-CoV-2 in Bangladesh: A Test-Negative Design Evaluation.

From May to December 2021, Bangladesh experienced a major surge in the Delta variant of SARS-CoV-2. The earlier rollout of several vaccines offered the opportunity to evaluate vaccine effectiveness against this variant. A prospective, test-negative case-control study was conducted in five large hospitals in Dhaka between September and December 2021. The subjects were patients of at least 18 years of age who presented themselves for care, suffering COVID-like symptoms of less than 10 days' duration. The cases had PCR-confirmed infections with SARS-CoV-2, and up to 4 PCR test-negative controls were matched to each case, according to hospital, date of presentation, and age. Vaccine protection was assessed as being the association between the receipt of a complete course of vaccine and the occurrence of SARS-CoV-2 disease, with symptoms beginning at least 14 days after the final vaccine dose. In total, 313 cases were matched to 1196 controls. The genotyping of case isolates revealed 99.6% to be the Delta variant. Receipt of any vaccine was associated with 12% (95% CI: -21 to 37, p = 0.423) protection against all episodes of SARS-CoV-2. Among the three vaccines for which protection was evaluable (Moderna (mRNA-1273); Sinopharm (Vero Cell-Inactivated); Serum Institute of India (ChAdOx1 nCoV-19)), only the Moderna vaccine was associated with significant protection (64%; 95% CI: 10 to 86, p = 0.029). Protection by the receipt of any vaccine against severe disease was 85% (95% CI: 27 to 97, p = 0.019), with protection estimates of 75% to 100% for the three vaccines. Vaccine protection against COVID-19 disease of any severity caused by the Delta variant was modest in magnitude and significant for only one of the three evaluable vaccines. In contrast, protection against severe disease was high in magnitude and consistent for all three vaccines. Because our findings are not in complete accord with evaluations of the same vaccines in more affluent settings, our study underscores the need for country-level COVID-19 vaccine evaluations in developing countries.

#1324169: HbA1c Thresholds for Initiating Insulin Therapy in Patients with Type 2 Diabetes Mellitus Attending A Tertiary Care Hospital - An Observational Study

Insulin therapy is often eventually required to maintain optimal glycaemic control for the patients with type 2 diabetes mellitus (T2DM). An ongoing challenge is to take the decision to initiate insulin in the management of type 2 diabetes in terms of selection of ideal regimen and glycaemic targets. Insulin initiation is an important transition of care from the perspective of both providers and patients. We characterize the level of glycaemic control at which insulin was initiated in patients with T2DM attending a tertiary care hospital in Dhaka , Bangladesh.

Abstract #1325773: A Comparative Study on Postmenopausal Symptoms in Diabetic and Non-Diabetic Women Visiting a Tertiary Care Hospital in Dhaka, Bangladesh

Menopause is a natural phenomenon occurring as women approach middle age. It is characterized by declining of ovarian function and onset of the last menstrual period and subsequent 12-month cessation of menstruation. Menopause is associated with somatic, vasomotor, psychological, and sexual complaints that may affect quality of life. The presence of menopausal symptoms significantly reduces the quality of life, and with more severity, worsens the quality of life. Due to a growing aging population and longer life expectancy, Bangladeshi women will spend a significant portion of their lives in postmenopause.

Antimicrobial resistance in shigellosis: A surveillance study among urban and rural children over 20 years in Bangladesh.

Antimicrobial resistance against shigellosis is increasingly alarming. However, evidence-based knowledge gaps regarding the changing trends of shigellosis in Bangladesh exist due to the scarcity of longitudinal data on antimicrobial resistance. Our study evaluated the last 20 years antimicrobial resistance patterns against shigellosis among under-5 children in the urban and rural sites of Bangladesh. Data were extracted from the Diarrheal Disease Surveillance System (DDSS) of Dhaka Hospital (urban site) and Matlab Hospital (rural site) of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) between January 2001 and December 2020. We studied culture-confirmed shigellosis cases from urban Dhaka Hospital (n = 883) and rural Matlab Hospital (n = 1263). Since 2001, a declining percentage of shigellosis in children observed in urban and rural sites. Moreover, higher isolation rates of Shigella were found in the rural site [1263/15684 (8.1%)] compared to the urban site [883/26804 (3.3%)] in the last 20 years. In both areas, S. flexneri was the predominant species. The upward trend of S. sonnei in both the study sites was statistically significant after adjusting for age and sex. WHO-recommended 1st line antibiotic ciprofloxacin resistance gradually reached more than 70% in both the urban and rural site by 2020. In multiple logistic regression after adjusting for age and sex, ciprofloxacin, azithromycin, mecillinam, ceftriaxone, and multidrug resistance (resistance to any two of these four drugs) among under-5 children were found to be increasing significantly (p<0.01) in the last 20 years in both sites. The study results underscore the importance of therapeutic interventions for shigellosis by appropriate drugs based on their current antibiogram for under-5 children. These observations may help policymakers in formulating better case management strategies for shigellosis.

Bacterial Spectrum and Antibiotic Sensitivity in Patients with Chronic Dacryocystitis Attending at a Tertiary Hospital in Dhaka

Bacterial Spectrum and Antibiotic Sensitivity in Patients with Chronic Dacryocystitis Attending at a Tertiary Hospital in Dhaka

Pattern of Presentation and Outcome in Dengue Fever in Hospitalized Children in A Hospital in Dhaka

Background : A large number of people are becoming infected with dengue fever, which is a mosquito borne viral disease. It is mostly self-limiting, but complications can result with significant morbidity and mortality. In recent years, there has been a significant increase in the number of cases, with the majority of the population being children. There is scarcity of data regarding dengue in children in our country. Hence, to evaluate, the clinical and laboratory profile of Dengue Fever (DF) among the children and their outcome was aim of this research work.&#x0D; Materials and methods: This is a retrospective observational study, performed among the serologically confirmed dengue virus infected 200 children, admitted in Department of Paediatrics, Kurmitola General Hospital (KGH) Dhaka from April 2019 to December 2021. Clinical and laboratory indicators were documented daily in the study cases, and the data were analyzed by SPSS version 25.&#x0D; Result: Out of the 200 cases, 100 patients (50 percent) had classical DF, 61 patients (30.5 percent) had Dengue Hemorrhagic Fever (DHF) while 39 patients (19.5 percent) had Dengue Shock Syndrome(DSS). Mean age of patients were 5.8±3.6 years, male predominance. Most patients belong to urban area and middle socioeconomic background. Gastrointestinal symptoms were more prevalent in DHF patients. Most of the patients had thrombocytopenia and raised hematocrit. Thrombocytopenia, an elevated Hematocrit (hct) an elevated hypertransaminesemia were all found to be statistically significant in DHF. 85% patients were treated with crystalloid and 14% with colloid, found excellent outcome with no death.&#x0D; Conclusion: Dengue fever is a major health problem, with a wide range of symptoms, from mild and self-limiting to severe and fatal. Unrecognized manifestations include a wide range of symptoms spanning multiple organ systems. Doctors should be on the lookout for atypical signs and symptoms.&#x0D; IAHS Medical Journal Vol 4(2), December 2021; 41-45

Evaluation of Blood Requisition Forms Submitted to Transfusion Medicine Department of a Tertiary Care Hospital in Dhaka, Bangladesh

Introduction: Blood requisition form (BRF) analysis is one of the most efficient and effective approaches to assess and monitor rational use of blood and its product. BRF is the first line of communication between the clinicians and transfusion medicine specialists which helps to recognize and evaluate inappropriate use of blood. This issue is frequently underrated by the clinicians which results in increased risk of inappropriate transfusion. The current study is aimed to examine the pattern of completion of blood requisition forms and to ensure safe blood transfusion. Materials and methods: This cross sectional prospective study was conducted from January 2020 to December 2021, at the Department of Transfusion Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh. A total of 32,133 blood requisition forms that were submitted during the study period were compiled and reviewed anonymously. The data were analyzed using Microsoft Excel. Results: During the study period, a total of 32,133 Blood requisition forms were analyzed. Only 15.2% of these forms were duly completed. Rest of the forms had one or more important parameters left blank. The most common incomplete BRF items were the clinical history or differential diagnosis of the patient (52.66%), presumed date and time of transfusion (95.19%), previous transfusion history (95.9%), and referring doctor’s name and designation (88%). Blood requests were more for females (52.02%) than males (47.98%) during the period. Requisitions were more for adults (90%) than pediatric patients. Conclusion: The current study provides evidence that the rate of completion of BRFs is not satisfactory. The request forms evaluated were not covering acceptable demographic and clinical data of the patients. Both the Hospital Transfusion Committee (HTC) and the Department of Transfusion Medicine can help to improve and standardize transfusion practice by working together. Sir Salimullah Med Coll J 2022; 30: 142-147

Microbial Pattern and their Sensitivity of Ventilator Associated Pneumonia in an Intensive Care Unit of a Ter-tiary Care Hospital in Dhaka

Background: ICU admission imposes great risk of nosocomial infections on the patients due to various invasive interventions. Patients treated in these units receive invasive procedures such as endotracheal intubation and mechanical ventilation which predispose to a nosocomial pneumonia of a special entity named as ‘Ventilator Associated Pneumonia’. Almost half of all the cases of hospital acquired pneumonia are due to VAP and about half of all antibiotics administration in ICU are for treatment of Ventilator Associated Pneumonia. Objectives: objective of the current study was to study the local microbiological profile of ventilator associated pneumonia and their sensitivity pattern in the Critical Care department of BIRDEM general hospital. Design: Cross-sectional study. Setting: ICU of an academic tertiary care hospital in the period of July 2017 to June 2018. Methods: All consecutive patients who were intubated and mechanically ventilated for a period of at least 48 hours within the study period were evaluated for the selection criteria of the study. The included study participants were followed up daily for signs of development of VAP. Once VAP was suspected pertinent investigations were sent to confirm the diagnosis. Tracheal aspirate was collected using conventional specimen trap and aseptic endotracheal suctioning technique and sent for Gram staining and culture and sensitivity testing. Results: In this study total 92 patients out of 625 intubated patients during the study period after fulfilling the inclusion criteria were selected as study participants. 35 participants out of 92developed VAP. Only 1 (2.9 %) patient did not yield any microbial growth in the tracheal aspirate sample and 34 (97.2 %) participants had growth of organisms in their tracheal aspirate samples. Total growths of 45 organisms were found in respiratory secretions of 34 VAP patients. The commonest organism was Acinetobacter which was grown in 21 (46.7%) samples followed by Pseudomonas in 10 (22.2%) samples; Klebsiella in 8 (17.8%) samples; Staphylococcus aureus in 3 (6.7%) samples; Candida in 2 (4.4%) and Enterococcus in 1 sample (2.2%). Most of the bacteria grown in the tracheal aspirates of VAP positive participants were sensitive to less than three antibiotic classes. Conclusion: Multidrug resistant organisms are mostly responsible for both early and late onset VAP in ICU. Bangladesh Crit Care J September 2022; 10(2): 122-126

Impact of SARS-CoV-2 Infection during Pregnancy and Perinatal Outcome: Findings from Private Hospitals at Dhaka, Bangladesh

Introduction: The pandemic novel corona virus (SARS-CoV- 2) infects pregnant women and affects pregnancy outcome. The perinatal outcome of COVID positive pregnancies attended at private hospitals during the last epidemic peak at Dhaka is unknown. The purpose of the study was to evaluate perinatal outcome among COVID positive and COVID negative pregnant women who delivered in the 2 study hospitals at Dhaka during the last epidemic wave. Methods: This retrospective study was conducted in 2 eminent private medical college&amp; hospitals in Dhaka,namely Popular medical college &amp;hospital (PMCH) and Greenlife medical college hospital (GLMC) over a period of 3 months from July 2021 to September 2021. COVID positive and COVID negative pregnant women who delivered in the study hospitals during the study period were included in this study. Outcome variables were COVID related maternal morbidity mortality, rate of caesarean delivery, stillbirth, preterm birth, low birth weight, neonatal COVID-19 positivity, neonatal death. Results: This study included 60 COVID positive and 60 COVID negative pregnant cases. COVID positive pregnant women delivered at earlier gestational age (weeks) than COVID negative cases(34.46±3.58 vs 36.50±3.20; p=0.001) Among COVID infected pregnancies,severe disease was observed in 15%; O2 support was needed in 68.3% and ICU admission required in 16.7% cases.The caesarean delivery rate ((93.3% vs 80%; p-.032) and preterm delivery rate (63.3% vs 35%; p-.002) were significantly higher among COVID positive cases. About 8.3% COVID affected pregnancies ended up with stillbirth.Maternal death rate due to COVID related complications was 5%.Proportion of low birth weight (LBW) was significantly more in infected pregnancies (65% vs 35%; p 0.001).No newborn from COVID positive mother was tested positive by RT-PCR at 24 hours of age. Conclusion: SARS-CoV-2 infection during pregnancy cancause moderate to severe disease requiring ICU admission and maternal death in 5% among COVID positive cases .It gives rise to more still birth, preterm birth, increasing number of LUCSand LBW. However maternal to neonatal transmission is not evident at 24-hour RT-PCR testing. J Bangladesh Coll Phys Surg 2022; 40: 270-278

Socio-Demographic Profile Analysis of Patients with Knee Osteoarthritis: A Study in a Tertiary Care Hospital in Bangladesh

Background: Osteoarthritis (OA) is a degenerative joint disease which affects joint cartilage. It is the most common type of rheumatic disease which is a leading cause of disability. Because of its progressive as well as chronic nature, socio-economic impacts in many developing and developed countries are enormous. In Bangladesh, we have very limited research-based information regarding the socio-demographic status of patients with knee osteoarthritis. Aim of the study: The aim of this study was to prepare a socio-demographic profile of patients with knee osteoarthritis. Methods: This was a randomized clinical trial conducted among purposively selected 55 patients suffering from knee osteoarthritis (OA) attending at the Physical Medicine and Rehabilitation outpatient department, Dhaka Medical College and Hospital (DMCH), Dhaka, Bangladesh during July 2020 to June 2021. Proper written consent was taken from all the participants before data collection. All data were processed and analyzed by using MS Office and SPSS version 23. Results: According to the study, the male-female ratio was 1:2.2. We observed that, 35%, 38% and the rest 27% of participants were from ≤50-, 51-60- and 61-70-years’ age groups respectively. Majority of the participants were homemakers which was 65%. In this study in analyzing the BMI (Kg/m2) of the participants we found that majority of the patients were with overweight status which was 55%. Then 27% were with normal BMI and the rest 18% were obese. As per the Kellgren-Lawrence grade distribution, 95% cases were with grade 2 whereas the rest 5% were with grade 3 status. Among all of our participants, in 56% right side was involved whereas in 44% involvement of left side was found. Conclusion: The frequency of knee osteoarthritis among overweight people was found higher in this study, Majority of the patients from a single profession may be considered as an indicator of involving one’s working environment and posture of regular activities .....

Clinical Staging for Accurate Preoperative Clinical Assessment of Patients with Nasopharyngeal Angiofibroma

Background: The location of the tumor and its accompanying symptoms, which include substantial epistaxis and nasal obstruction, cause the Nasopharyngeal Angiofibroma, a histologically and physiologically benign tumor with aggressive activity. Methods: The Otolaryngology &amp; Head Neck Surgery division at Bangabandhu Shiekh Mujib Medical University, Dhaka Medical College Hospital, and Shaheed Suhrawardy Medical College Hospital in Dhaka carried out this retrospective cross-sectional study. The research was done in 2012, from February to November. 30 people made up the study's entire sample size. Result: The majority of individuals (54%) who have nasopharyngeal angiofibroma are between the ages of 16 and 20. People living in rural area (53.33%) are more sufferers from nasopharyngeal angiofibroma. The majority of patients have similar symptoms such epistaxis, nasal blockage, nasal discharge, anemia, and masses in the nasal cavity. Maximum (90%) has varying degree anaemia at presentation. All patient has soft tissue mass in Nasopharynx, half of the patient has pterygopalatine fossa extension at presentation. Maximum (56.66 %) patient admitted with stage II nasopharyngeal angiofibroma. Conclusion: It is necessary to acquire preoperative clinical staging and imaging parameters from data of one of the largest NA case series.

Socio-demographic Characteristics of Patients with Nasopharyngeal Angiofibroma: A Cross-sectional Observational Study in BSMMU, Bangladesh

Background: A rare head and neck tumor that makes up about 0.5% of all head and neck neoplasms is the nasopharyngeal angiofibroma. They are benign, non-encapsulated, highly vascular tumors with a high incidence of persistence and recurrence from a histological standpoint, but they are also locally invasive tumors. Methods: This retrospective cross-sectional study was conducted by the Otolaryngology &amp; Head Neck Surgery division at Bangabandhu Shiekh Mujib Medical University, Dhaka Medical College Hospital, and Shaheed Suhrawardy Medical College Hospital in Dhaka. The study was conducted from February through November of 2012. The total sample size for the study was 30. Result: The majority of individuals (54%) who have nasopharyngeal angiofibroma are between the ages of 16 and 20. The middle class people (40%) are more sufferers from nasopharyngeal angiofibroma. People living in rural area (53.33%) are more sufferers from nasopharyngeal angiofibroma. The majority of patients have similar symptoms such epistaxis, nasal blockage, nasal discharge, anemia, and masses in the nasal cavity. Conclusion: It is hypothesized that the affected patients' socioeconomic status and geographic location may have an impact on the biologic behavior of nasopharyngeal angiofibroma.

Post traumatic stress disorder and the associated factors among the survivors of road traffic accident attending in a specialized hospital in Dhaka

Background: Post traumatic stress disorder (PTSD) is the most common mental disorder occurring among survivors of road traffic accidents (RTA). It could result in long-term adverse consequences if left untreated, mainly leading to social and functional impairments of RTA survivors, which finally results in a poor quality of life. Objectives: To assess the prevalence of PTSD among the RTA survivors and the associated factors of it. Materials &amp; methods: An institution-based cross-sectional study was carried out among 202 admitted RTA patients in the inpatient department of a specialized hospital in Dhaka city for one year duration. Data were collected from these patients using a semi structured interview administered questionnaire where the Diagnostic and Statistical Manual-IV DSM-IV(PCL-S) checklist used to assess PTSD. The collected data were analyzed by using SPSS software (Version 21) and p &lt; 0.05 considered as significant. Results: A total 202 RTA patients were included in the study and the prevalence of probable PTSD among RTA survivors was 41.1% according to DSM-IV(PCL-S) checklist. The mean age of RTA survivors found 37.6 (±13.2) years, majority 57.4% belongs to 18-30 years age group. The mean PTSD score found was 44.1(±8.2), 9.2% RTA survivors had previous history of known depressive symptoms. Among the socio-demographic attributes, age and occupation were significantly associated with the PTSD; other accident related factors like time since accident and type of accident were strongly associated with the PTSD. Conclusion: This study found a high prevalence of PTSD among RTA survivors with some associated significant sociodemographic and accident-related factors. The findings suggest a need for early screening for PTSD among the survivors of RTA. Update Dent. Coll. j: 2022; 12(2): 14-18