Ibn Sina Medical College Research Articles

The Prevalence Pediatric Patients Attending in A Tertiary care Hospital in Dhaka, Bangladesh

Introduction The incidence of skin conditions in young people typically varies between nations and within a single nation’s regions based on social, economic, racial, and environmental factors. A significant public health issue is the morbidity that skin diseases cause in children. There is a dearth of research on this pediatric issue in our nation, which is either centered on a condition, a community, or a particular population group. Objective To evaluate the dermatological complaints of the pediatric patients attending a dermatology outpatient department in a tertiary care hospital. Materials And Methods We retrospectively analyzed a total of 2472 pediatric patients who were in age range 0-18 years and came to the OPD of dermatology & venereology department of Ibn Sina Medical College Hospital, Dhaka, Bangladesh, over a period of 1½ year from January, 2020 to June, 2021. Data were collected on special proforma and analyzed with appropriate method. Results Among 2472 patients 1157 (46.8%) were male and 1315 (53.2%) were female and most of the patients belonged to the age group 12-18 year (52.6%). Male female ratio was 0.88:1. All diseases were broadly classified into noninfectious (71.2%) and infectious dermatoses (28.8%). Dermatitis (38.9%), infections (28.8%) and acne (14.44%) came out to be the top most common cause for OPD attendances. For the specific skin diseases, 20.1% were atopic dermatitis, 14.44% were acne, and 11.8 % were fungal infections. Atopic dermatitis was the most common condition below 12 years of age. In 12-18 years of age group, the most common condition was acne; females were more affected than males. Among the viral infections, wart was the most common (22.1%). Conclusion Atopic dermatitis was found to be the most common noninfectious disease and fungal infection was the most common infectious disease in all age groups and genders. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1054-1059

Metabolic and Hormonal Parameters in Polycystic Ovary Syndrome: A Cross-sectional, Multicenter Study in Bangladesh

ABSTRACT Introduction: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women globally, characterized by metabolic, hormonal, and reproductive disturbances. This study aims to elucidate the specific metabolic and hormonal intricacies of PCOS within the Bangladeshi demographic, addressing a noticeable dearth of comprehensive investigations in this population. Methodology: A cross-sectional study was conducted at the Endocrine Department of Ibn Sina Medical College Hospital and the National Healthcare Network Uttara Executive Center from January 2022 to March 2023. The study included 237 participants diagnosed with PCOS based on the modified Rotterdam criteria. Data collection encompassed demographic details, clinical parameters, and laboratory investigations recorded systematically through history taking, physical examinations, and laboratory analyses. Statistical analyses were performed using the Statistical Analysis Software Studio Version. Results: The study revealed a mean age of 25.1 years among 237 participants, with 70.5% married and 33.5% having children. Hormonal assessments uncovered intriguing patterns, including elevated luteinizing hormone (LH) levels and an increased LH:follicle-stimulating hormone (FSH) ratio. Weight distribution highlighted a significant association between obesity and fatty liver. Despite an elevation in thyroid-stimulating hormone levels among obese PCOS individuals, FSH, LH, and testosterone levels showed no significant differences between obese and nonobese groups. Conclusion: In-depth analysis of metabolic and hormonal parameters in Bangladeshi PCOS patients contributes to the global understanding of PCOS, while offering insights specific to this demographic. The study has implications for tailored therapeutic interventions and refined diagnostic criteria, potentially improving clinical outcomes for individuals affected by PCOS in Bangladesh and beyond.

Association between Thyroid Autoantibodies and Abnormal Thyroid Function and Structure of Thyroid Gland

Introduction: Antithyroperoxidase antibody (TPOAb), antithyroid receptor antibody (TRAb) and antithyroglobulin antibody (TgAb) are common thyroid autoantibodies in patients with autoimmune thyroid disease. Studies have demonstrated that the serum presence of thyroid autoantibodies is correlated with the presence of lymphocytic infiltration and the severity of histological thyroiditis. However, one or more of these antibodies are frequently detected in the general population. Abnormalities in thyroid function and structure are common in the population. Aim of the study: The aim of this study was to evaluate the association between thyroid autoantibodies and abnormalities in thyroid function and structure. Methods: This was a multi-center, cross-section, observational study and was conducted in the Department of Endocrinology of Ibn Sina Medical College Hospital, Dhaka, Bangladesh and Enam Medical College, Savar, Dhaka, Bangladesh during the period from September, 2022 to September, 2023. In our study we included 324 patients with thyroid dysfunction. The patients were selected consecutively attending tertiary care hospitals. The study participants provided demographic and clinical data. Thyroid function, thyroid ultrasonogram and serum concentration of TPOAb, TRAb, and TgAb were measured. Result: A total 324 patients were included in this study. Most of the study population were female (79%) and mean age were 37.0± 12.4 years. 58.6% belonged to the 21-40 age group. The mean BMI was found 22.0±4.5 kg/m2 in positive TRAb and 26.5±5.0 kg/m2 in negative TRAb. 229 (70.7%) were hypothyroid and 95 (29.3%) were hyperthyroid patients. Among the study population 211 (65.1%) patients were TPOAb, 112 (34.6%) were TgAb and 80 (24.7%) were TRAb positive. Among the TPOAb positive patients, 78.7% were hypothyroid and 21.3% were hyperthyroid. On the contrary, among the TRAb positive patients, 97.5% were hyperthyroid. Most (158) of the patients have normal ultrasonogram of thyroid. ..

Total hip arthroplasty in ankylosing spondylitis in a tertiary care hospital: a prospective COHORT study

Background: Ankylosing spondylitis is a chronic inflammatory-type arthritis that forms part of the group of spondyloarthritides. It primarily affects the spine and pelvis but peripheral arthritis and enthesitis are also common features. Onset of AS often occurs at a relatively young age and that is accepted as a greater risk of hip involvement. THA in AS patients is a challenging procedure owing to multiple factors. The aim of this study was to evaluate the clinical, radiological & functional outcomes of total hip arthroplasty among patients with Ankylosing Spondylitis. Methods: This was a prospective cohort study and was conducted in the Department of Orthopaedic Surgery of Ibn Sina Medical College Hospital, Dhaka, Bangladesh during the period from June, 2021 to May, 2022. In this study we included fifty patients with ankylosing spondylitis who underwent total hip arthroplasty. Result: In our study we found the highest prevalence (36%) was present in aged between 31-40 years old. The mean±SD of age among patients was (37±12). We found the mean±SD of Harris hip score was 44.2±12.3 & 87.2±17.4 during preoperative & postoperative phase respectively. Conclusions: In our study, we found that total hip arthroplasty is a safe and effective treatment of advanced hip involvement in patients with AS. It results in significant improvements in objective outcome measures such as HHS, patient mobility & reduced the difficulty level of patients in their day-to-day activities.

Case Report: Acute myocardial infarction with acute left ventricular failure and acute renal damage following mRNA-1273 vaccination: Possible adverse effect of COVID-19 vaccination?

Background: Evaluating potential vaccine side effects is often a prerequisite to combat the coronavirus disease 2019 (COVID-19) pandemic more effectively in a low-resource setting where herd immunity could be the most feasible option. Case report: Here, we present, an 80-year-old man with multiple comorbidities was admitted into the coronary care unit at Ibn Sina Medical College Hospital (Dhaka, Bangladesh) with severe central chest pain and respiratory distress after receiving the first dose of Moderna vaccine on July 26, 2021. On admission, his blood pressure was 110/70 mmHg, pulse 90 beats/min, respiratory rate 22 breaths/min, temperature 36.7°C. He had a vesicular breath sound with bilateral basal crepitations and normal heart sounds. On the ECG, significant changes were observed. Other lab findings were significant troponin-I: 1.72 ng/ml, trace protein and glucose in the urine, total white blood cell count: 12820/cm3; HbA1c, 7.5%; serum creatinine, 1.56 mg/dl; serum electrolytes: sodium 133 mmol/L, chloride 92 mmol/L. The patient had a medical history of prior myocardial infarction, diabetes mellitus, and hypertension but no chronic kidney disease, cerebrovascular disease, or bronchial asthma. After admission, he was treated conservatively with necessary medications and monitored periodically. The patient was diagnosed with acute myocardial infarction with left ventricular failure with acute kidney injury on chronic kidney disease with diabetes mellitus and hypertension. He was discharged from the hospital on day six with proper medicinal support with full recovery. Conclusions: Though acute cardiac complications following COVID-19 vaccines are unusual, this case report can contribute to further molecular research to identify the possible role of vaccine compounds in triggering such complications among the general population.

Assessment of COVID severity by measuring D-dimer and Serum Ferritin level in selected Tertiary Care Hospitals of Dhaka city

Aim: This study was aimed to evaluate the association between serumD-dimer, serum Ferritin with disease severity in patents havingCOVID-19. Methods:Total 80 confirmed COVID-19 patients were enrolled in this cross sectional study. Samples were assessed by positive SARSCoV- 2 by RT-PCR testing and were collected from two tertiary Hospitals(IbnSina Medical College Hospital and Ibrahim Cardiac Hospital and Research Institute).We also performed CT findings of COVID patients with or without pulmonary involvement. COVIDpositive patients were divided into two groups (Group 1 and Group2) according to lungs involvement confirmed by CT-scan. In this analysis, several variables such as gender, age, D-dimer and serum ferritin were taken. Results: The Mean of D-dimer in Group-1 subjects was 4.26±3.60mg/L and in Group-2, this was 0.59±1.08mg/L. So D-dimer level was significantly raised in COVIDpneumonic patient (P value = <0.001). The mean of ferritin(554.65±515.841)ng/ml for pneumonic patient was also highly significant than the mean(133.70±109.22)ng/ml of COVID without pneumonia. Conclusion:D-dimer and S. ferritin were elevated in patients with COVID-19. These two reliable biomarkers are correlate with the disease severity and useful for better management of COVIDpositive patients. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.166-170

The Study of Laparoscopic Cholecystectomy in Acute Cholecystitis, Complication and Management: Analysis of 150 Cases in the Ibn Sina Medical College, Bangladesh

Background: Laparoscopic Cholecystectomy has now become a better option instead of the Open Cholecystectomy for treatment of Cholelithiasis that it has been a gold standard for the Cholelithiasis condition throughout the Globe. Last century was the most fruitful era for the treatment of the biliary tract disease as it has already proved the progress from the open to laparoscopic surgery with a single port surgery.
 Methods: The purpose of our study is to grading of the Laparoscopic Cholecystectomy in Acute Cholecystits and has been studying the outcome of problematic and challenging Laparoscopic Cholecystectomy cases, its’ complication (s) and management to decide when to converting Laparoscopic Cholecystectomy to Open Cholecystectomy. The study analyzes the conversion rate of Laparoscopic Cholecystectomy in the Ibn Sina Medical College, Kallyanpur, Dhaka, Bangladesh. This is a retrospective study of 150 patients (Male - 75% and Female - 25%) which was conducted during the period from January 2015 to January 2017.
 Results: Out of the 150 cases 140 (93%) had been successfully operated by Laparoscopic Cholecystectomy. And, only 10 (7%) cases (out of a total of 150) got converted from the Laparoscopic to Open Cholecystectomy and they belonged to Grade - E with severely contracted gallbladder, morbid adhesion, short cystic duct and bile duct injury.
 Conclusions: The Laparoscopic Cholecystectomy has familiar as a unique procedure of choice for the management of symptomatic gall bladder. Laparoscopic Cholecystectomy intra operatively for grade A to E where Grade A is very easy level to perform Gall Bladder Surgery to Grade E where conversion is 115% due to bad.
 Bangladesh Journal of Medical Science Vol.20(2) 2021 p.318-322

Intussusception in Adult due to Lipomatous Polyp - An Uncommon Case Report

Intussusception, invagination of a segment of the gut into an adjacent one, is a relatively common cause of the intestinal obstruction in children but a very rare and uncommon clinical entity in the adults accounting to 1% and near about 65% of these are caused by malignant lead point. The Lipomatous polyp accounts for 4% of all benign tumors of the gut. In most of the cases, these are seen particularly in large intestine, usually sub mucosal and around ileocecal valve. These are mostly and very often asymptomatic. Mrs. Rahima Begum aged 65 years, previously was a healthy Bangladeshi housewife, with the history of recurrent abdominal colic of moderate intensity for the last 6 months, associated with the appearance of mass in the right lower quadrant with features of sub-acute intestinal obstruction got admitted into the Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, Bangladesh. The required and most relevant investigations revealed the Ileocolic intussusception and underwent the right hemicolectomy. Postoperative recovery of the patient was uneventful excepting the hypertension only. Histopathology investigations revealed lipomatous polyp arising from the Ileocecal junction. This study reports intussuception in the adult due to lipomatous polyp, a very rare case presenting with sub acute intestinal obstruction.
 Bangladesh Journal of Medical Science Vol.20(1) 2021 p.204-207

Clinicopathological Study of Thyroglossal Cyst

Background: Thyroglossal cyst is a congenital malformation that occurs due to incomplete closure of the thyroglossal duct. Apart from quiescent embryological remnant, it presents clinically as a midline cystic swelling that moves with tongue protrusion; present at any age, often requires surgical excision.
 Objective: To evaluate the clinical features and treatment outcomes of patients with a thyroglossal duct cyst.
 Material and methods: This observational study was carried out in the Department of Surgery, Dept. of Otolaryngology, Ibn Sina Medical College, Dhaka, A total 40 cases of both sexes with the age 6-67 years, during the period of 2013 to 2018 (5 years)
 Results: A total 40 cases of thyroglossal cyst with mean age of 24.37 years were included in study. Of the total 40 cases, 20 (50%) patients were male and 20(50%) were female. Most common clinical presentation was painless midline cystic swelling was the main complaint in 30 patients (75%), followed by dysphagia 5 (12.5%), Sore throat 3 (7.5%) and globus 2 (5%) in descending order. Most common location of cyst was in infrahyoid region in 26 patients (65%), suprahyoid in 14 patients (35%).
 Conclusion: The most common presentation of thyroglossal cyst is a midline cystic swelling that moves with tongue protrusion. The standard surgical approach to thyroglossal cyst is Sistrunk’s operation with low recurrence rate. Malignancy within thyroglossal cyst is very rare but should be rule out in all cases.
 Bangladesh J Otorhinolaryngol; October 2020; 26(2): 153-157

Maternal Fetal Health

Maternal Fetal Health

Observation of Birth Weight of Babies in relation on maternal age, parity and gestational age in Tertiary Level Hospital

Background: Birth weight of an infant is the most important determinant of its chances of survival, healthy growth, and development. It depends on many maternal factors. Maternal age, parity and gestational age have been shown to increase the risk of adverse neonatal outcome, such as intrauterine growth retardation, prematurity, mortality and low birth weight.
 Objective: This study was planned to observe the incidence of low birth weight baby and to correlate the maternal age, parity and gestational age on birth weight of babies.
 Methodology: It was a retrospective study. Data were collected from medical records. Total 2850 live births new born baby were enrolled in this study during the period January 2013 to December 2018 in Ibn Sina medical college and hospital, Dhaka, Bangladesh with inclusion criteria. The weights of the newborns were measured without clothes on a digital weighing scale soon after the birth. Parameters such as birth weight, gender of baby, maternal age, parity and gestational age of the mother were noted. Data were analyzed statistically.
 Results: 52.99% baby was male and 47.01% were female. Low birth weight baby were 33.3% in the age group of less than 18 years of aged mother. With increasing the age of mother, birth weight of babies increase. Primipara mother delivered 15.52% low birth weight baby and 84.48% normal birth weight baby. With increasing parity birth weight of baby increased. The birth weight of <2.5 kg was 19.27% and 80.73% baby’s birth weight >2.5 kg in mother more than 37 weeks of gestation. Baby born by 35-37 weeks of gestation had 27.69% low birth weight and 72.31% were normal birth weight. Incidence of low birth weight was 79.3% and normal birth weight 20.7% found by 32-34 weeks of gestation.
 Bangladesh Journal of Medical Science Vol.19(2) 2020 p.291-295

Efficacy of an herbal product (Habb-E-Munish) in treatment of ED Using IIEF-5 scores and it’s effect on liver and renal functions

Background and Rationale: Incidence of erectile dysfunction is rising in both developing and developed countries including Bangladesh. Even in this 21st century people attracted to the herbal and/alternative medicine. The present study was aimed to evaluate the effect of Haab-e-Munish in the treatment using the International Index of Erectile Function-5 (IIEF-5) questionnaire.
 Material and Methods: A total 33 married male subjects participated in this study. The study was approved by the Research and Ethics Committee of the Ibn Sina Medical College & Hospital. Informed written consent was obtained from each participant. Data were expressed as mean±SD and were managed by SPSS for Windows Version 17. P<0.05 was considered significant.
 Results: Mean (SD) age of the participants was 36.8±7.7. Basic data like pulse, blood pressure, serum creatinine, urea and alanine aminotransferase (ALT) were unchanged compared to the baseline. IIEF Score of all five functional domain demonstrated significant improvement from the baseline.
 Conclusion: Herbal preparation Haab-e-Munish has positive effect in improving erectile dysfunctions and is safe for liver and kidney function on short term basis.
 Bangladesh Journal of Medical Science Vol.19(1) 2020 p.176-179

Psychiatric morbidity among the patients with acne Vulgaris in a tertiary care Hospital

Background: Acne vulgaris is a chronic inflammatory skin disorder which has a high prevalence among adolescence and young adults. Although acne does not cause direct physical impairment, it can produce a significant psychosocial burden. As the face is almost always the site of involvement of acne, its presence can alter one’s perception of body image. Increased levels of anxiety, anger, depression, and frustration are also observed in patients with acne. Acne affects social, vocational, and academic performance of teenagers & young adult.
 Objective: To identify socio-demographic profile and to evaluate the psychiatric morbidity in patients with acne vulgaris in a tertiary care hospital.
 Materials and Methods: This cross sectional study was conducted from June 2017 to December 2017 among the patients of acne vulgaris attending outpatient department of Dermatology in Ibn Sina Medical College Hospital, Dhaka. Purposive sampling technique was used. The sample size of the study was 181. Data were collected by using semi structured socio-demographic questionnaire and the SRQ to screen psychiatric symptoms. The Self Reporting Questionnaire (SRQ), is a psychiatric case finding instrument, was developed by World Health Organization (WHO) to screen for psychiatric disturbance especially among developing countries. The data obtained was collected, tabulated and subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS), for windows version 20.
 Results: Study was conducted on 181patients comprising 135(74.6%) were female & 46(25.4%) were male. Age group between 16 to 22 years carried maximum incidence 100(55.2%). Among the patients Psychiatric morbidity was found in86(48%) of the study population. Psychiatric morbidity was found more in young and females patients. Among the types of psychiatric morbidity Anxiety disorders were 57(66.3%) & Major Depressive Disorder(MDD) was 29(33.7%).Anxiety disorders were included social phobia (26.7%), generalized anxiety disorder (GAD) (18.6%), panic disorder (14%) and obsessive compulsive disorder (OCD)(7%).
 Conclusion: Patients with acne vulgaris in whom psychiatric morbidity is present, should be routinely evaluated and their psychiatric morbidity need to be treated adequately for maximize their health.
 Bangladesh Journal of Medical Science Vol.18(4) 2019 p.773-778

Status of Vitamin D by measuring 25 - Hydroxyvitamin D level in Dhaka City

Background and aims: Vitamin D deficiency is associated with skeletal as well as extraskeletal diseases. Aim of this study was to find out the status of Vitamin D level in a densely populated area like Dhaka.
 Method: This descriptive cross sectional study was conducted in Ibn Sina Medical College Hospital in Kallyanpur, Dhanmondi Ibn Sina Hospital and Ibn Dina Diagnostic Laboratory in Dhanmondi. Total 500 subjects who went for vitamin D assay were included in this study. Serum Vitamin D (25 - Hydroxyvitamin D) levels were measured by chemiluminescence immunoassay method. The respondents were divided in 4 age groups: ( 0-20) years, (21-40) years, (41-60) years and (61-rest) years. Data were presented by frequency distribution tables & graphs.
 Result: Out of the 500 respondents, 10.6% were in 0-20 age group, 30.8% were in 21-40 age group, 41.2% were in 41-60 age group and 17.4% were in 61-rest age group respectively. Mean age of total study subjects was 43.7 years. Male and female ratio was 33.2:66.8. Of the total 218(43.8%) participants had deficient level, 187(37.2%) had insufficient level, 90(18%) had sufficient level and only 5(1%) had toxic level of vitamin D.
 Conclusion: High prevalence of vitamin D deficiency was observed in 41 to 60 years age group people and female are more suffered than male. That’s why vitamin D status screening in this age group should be a routine test.
 Bangladesh Journal of Medical Science Vol.18(3) 2019 p.624-627

Evaluation of safety of caesarean myomectomy: A prospective study

Background: Uterine myomas are the most common benign tumour of female reproductive tract and the prevalence of myomas in pregnancy has been reported to be 2%to 5% . Myomectomy during cesarean section has traditionally been discouraged due to risk of intractable haemorrhage and fear of hysterectomy. But recently large scaled studies indicated that cesarean myomectomy could be safely performed in majority of cases without any serious or life threatening complications.
 Materials and Methods: This prospective study was done at Ibn Sina Medical College Hospital, Dhaka, Bangladesh between January 2016 and December 2016. Fifty patients were recruited into the study, 25 patients had undergone myomectomy during cesarean section and 25 patients had undergone only cesarean section.
 Results: Average value of haemoglobin both pre and post-operatively was 12.31±1.22 g/dl and 10.64±1.51 g/dl for patients who had cesarean section with myomectomy and 11.61±1.3 g/dl and 10.3±1.7 g/dl in the other group in which cesarean section without myomectomy was performed. The difference in average haemoglobin for patients who had a cesarean section and myomectomy was 1.41 while those who had caesarean section alone was 1.32±1.12. This was not significant. The average duration of operation was longer in patient who had cesarean section and myomectomy (54.32±18.06 mins) than those who had caesarean section alone (38.54±8.42mins). The incidence of hemorrhage was5.45±1.23% and 5.23±1.03% respectively and the mean length of postoperative hospitalization was2.42±1.45and 2.17±0.70 days and no hysterectomy was needed in any group. Blood transfusion was given in 6 patients with 3 patients in each group. Sixty eight percent of the fibroids were subserous and in the body of the uterus.
 Conclusion: Cesarean myomectomy is a safe and effective procedure and does not increase the incidence of intraoperative and postoperative complications.
 Bangladesh Crit Care J March 2019; 7(1): 40-43

The prevalence of skin and venereal diseases among the geriatric patients attending in a tertiary care Hospital in Dhaka, Bangladesh

Background: The prevalence of skin and venereal diseases among geriatric populations generally differ in different countries and within various regions of a country depending upon social, economic, racial & environmental factor. The morbidity in elderly associated with skin and venereal diseases makes them an important public health problem. Very scanty literature was found on this geriatric problem in our country which is either disease based, community based or specified population group based.
 Objective: To assess the dermatological & venereal complaints of the elderly attending a dermatology outpatient department in a tertiary care hospital.
 Materials and Methods: We retrospectively analyzed a total of 1303 geriatric patients who were 60 years and above and came to the OPD of dermatology & venereology department of Ibn Sina Medical College Hospital, Dhaka, Bangladesh, over a period of 3½ year from January, 2014 to June, 2017. Data were collected on special proforma and analyzed with appropriate method.
 Results: Among 1303 patients 676 (51.88%) were male and 627 (48.12%) were female and most of the patients belonged to the age group 60-69 year (73.6%), mean age being 66.8 ± 7.06 year. The most commonly presented skin complaints were eczematous dermatitis (42.6%), fungal infection (19.14%), generalized pruritus (5.06%), seborrheic dermatitis (5.06%), urticaria (4.75%) and viral infections (4.29%) respectively. Tinea corporis (29.3%) was the most common of fungal infections and herpes zoster (82.14%) was the most frequent of viral infections.
 Conclusion: Eczematous dermatitis was found to be the most common noninfectious disease and fungal infection was the most common infectious disease in all age groups and genders.
 Bangladesh Journal of Medical Science Vol.18(1) 2019 p.130-135

NS-1 antigen positive Dengue Infection and molecular characterization of Dengue Viruses in a private Medical College Hospitalin Dhaka, Bangladesh

Introduction: Detection of dengue virus infection as soon as possible is critical for management of dengue virus infected patients. Immuno-chromatographic (ICT) tests are easy, cost effective method for dengue virus antigen detection.The sensitivity and specificity of ICT should compare with a gold standard test like RT-PCR. Aim of this study was to compare two test methods (ICT and RT-PCR), observe dengue serotype and seasonal impact on dengue infection.Methodology & result: The patients of Ibn Sina Medical College Hospital from October 2015 to October 2017 were tested for dengue NS1 antigen by ICT method. Out of 3201 sample tested 32.39% were found positive and 89 of which were re-tested for RT-PCR for comparison. Eighty eight of 89 NS1 positive cases showed positive by RT-PCR method giving an accuracy of 98.87%. Among the RT-PCR positive cases 45 were further analyzed for serotype. DEN-1, DEN-2 or both DEN- 1 and DEN-2 were found in 21, 23 and 1cases respectively. No cases of DEN-3 or DEN-4 were detected.Conclusion: This study showed that easily available and cost effective dengue NS1 antigen detection method (ICT) is as effective as molecular test (RT-PCR). DEN-1 and DEN-2 serotype were prevalent during last few years in Bangladesh. Continuous monitoring of dengue virus serotype is important for prevention and control of sudden epidemic by other serotype. Alert to be more during post monsoon when the peak of dengue virus infection was observed.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.669-673

Maternal and Neonatal outcome in premature rupture of membranes

Objective: The objective of the study was to assess the maternal and neonatal outcome in premature rupture of membranes.Material and Methods: A prospective study was carried out in the department of Obstetrics &Gynae in Ibn Sina Medical College hospital from October’15 to September’16. The sample size was 110. The maternal and neonatal outcome of pre-labour rupture of membranes in both term and preterm pregnancies was observed and statistically analyzed.Results: Incidence of PROM (premature rupture of membrane) was commonly in primigravida (62.7%). Term PROM was higher (70.92%) than PPROM (29.09%). Aetiological analysis revealed cause is unknown in most of the cases. Infection in 26.4% cases, previous history of PROM 16.3% and history of recent coitus 9.09% cases. Patient delivered by vaginal route 70.91% and LSCS 29.09%. The PROM had higher maternal morbidity (27.8%) like post partum fever 11.8%, wound infection 4.5% and chorioamnionitis 3.6%. Also higher perinatal mortality (4.5%) and morbidity (26.4%) like respiratory distress syndrome 9.09%, birth asphyxia 4.5%, septicemia 5.8%.Conclusion: Antenatal diagnosis to prevent PROM by identifying the risk factors is an important tool in management. Steroid for fetal lung maturity, antibiotics to prevent fetal and maternal infection, induction and/or augmentation of labour in due time and skilled NICU support will speed delivery, reduce hospital stay and infection as well as decrease maternal morbidity and perinatal morbidity and mortality.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.479-483

Prevalence of thyroid disorders among infertile women with menstrual irregularities

Background: The infertility problem is more common phenomenon among the women now a days and has increased over past 30 years. The present study was carried out to see the prevalence of thyroid disorders among infertile women with menstrual irregularities.Methods: It was a cross sectional study conducted at the Department of Obstetrics and Gynecology, Ibn Sina Medical College, Dhaka from January to December 2016. After taking informed consent, total 160 infertile women and 100 normal fertile women volunteers were selected on OPD basis between age group of 18-45 years. Out of 160 infertile women, 100 were of primary infertility and 60 of secondary infertility. Participants were selected on the basis of detailed history, clinical examination and laboratory investigations. Detailed history of participants including age, menstrual history, obstetric history, history of any medications were taken.Results: There was a higher prevalence of hypothyroidism in the infertile women as compared to the fertile one in the study group, particularly in secondary infertility. Oligomenorrhoea was most common in infertile women. Hypothyroidism is commonly associated with ovulatory failure. Hence, assessment of serum TSH is mandatory in the work up of all infertile women, especially those presenting with menstrual irregularities. So the basic approach should be to identify those hypothyroid individuals who have greatest risk for the development of infertility.Conclusion: Long standing hypothyroidism may develop ovulatory dysfunction. So identifying and treating hypothyroidism at an earlier stage before the appearance of ovulatory dysfunction can have potentially great preventive value.Bangladesh Crit Care J March 2018; 6(1): 22-25

Study on Clinical and Histopathological Changes of Alopecia Areata

Alopecia areata is a common, unpredictable, nonscarring form of hair loss. It is characterized by rapid and complete loss of hair in one or more round or oval patches, usually on the scalp, bearded area, eyebrows, eyelashes and less commonly on other hairy areas of the body. The present study was undertaken in the department of Dermatology and Venereology of Ibn Sina Medical College, Dhaka from July 2014 to June 2015 to observe the histopathological changes in different stages of alopecia areata. For this purpose 30 patients with age ranged from 18 to 45 years were enrolled. Of them 17 were males and 13 were females. A 4 mm punch biopsy from the involved scalp taken from each patient and histopatological changes were examined. The study revealed that anagen hairs decreased but catagen and telogen hair increased in all stages of alopecia areata. Telogen hairs increased in acute and chronic stage and catagen hair increased markedly in subacute stage. Although miniaturized (atrophic) follicle was frequently found in chronic stage. It was absent in acute and subacute stages. Moderate to dense peribulbar infiltration of lymphocytes were observed in acute stage and mild to moderate infiltration in subacute stage. In chronic stage either no or mild infiltrations were observed. Peribulbar infiltration of eosinophils and macrophages was seen in all stages of alopecia areata. Thus we can conclude that alopecia areata can be diagnosed with some confidence, even when inflammatory infiltrate is absent, based on increasing numbers of telogen hairs in the acute and subacute stages and increasing miniaturized hairs in chronic stage.Medicine Today 2018 Vol.30(1): 30-33