Level Hospital In Bangladesh Research Articles

Surgical Outcome of Penile Fracture Management in a Tertiary Level Hospital in Bangladesh

Background: Fracture of the penis is a urological emergency which occurs as a result of abrupt trauma to an erect penis. Immediate surgical repair is the standard of care and is superior to non- operative management due to excellent long term outcomes. Objective: The aim of this study was to investigate surgical and functional outcomes in patients who underwent penile fracture repair. Methods: A cross sectional descriptive study was conducted during the period of July 2017-June 2018 to find out the pattern of surgical management of fracture penis among the patients admitted in the urology department of Dhaka Medical College Hospital. A total 50 patients of fracture patients were selected purposively. Outcome of surgical management was investigated by using semi structured and International Index of erectile function questionnaire. Results: The study reveals that the mean age of the patients were 34.26±9.96 (range: 18–65), predominantly married (70%). The mean follow-up period was 12 weeks. Patients ‘history and clinical examination were highly sensitive and accurate in predicting a tunical tear. 15 patients (30%) received surgical treatment within six hours from the hospital admission, while 31 patients and 4 others seek surgical intervention within 6-24 hours and more than 24 hours respectively. It was revealed that the presenting symptoms were pain (72%), penile swelling (100%), eggplant deformity (100%), and hematuria (22%) with associated urethral injury in 22% of patients. Post- operative complications found were infection (14%), penile nodule (26%), chordee (14%), painful erection (16%) and erectile dysfunction (34%). There is a significant relationship between having painful erection and erectile function of the patients at the time of interview [X²=23.44, df=4, p=0.000], The relationship between the time elapsed from hospital admission to surgery and erectile function at the time of interview was not significant [X²=10.39, df=8, p=0.239]. The relationship ..

Outcome of PHILOS Plate Application in Type III and Type IV Proximal Humeral Fracture: Tertiary Level Hospital in Bangladesh

Background: More over 10% of all fractures in people over the age of 70 are in the proximal humerus, making it the third most commonly non-vertebral osteoporotic fracture behind proximal femur and collies' fractures. Many different methods of treatment, including closed reduction with percutaneous K-wire fixation, open reduction with subsequent fixation using Transosseous sutures, tension band wire, T plate, locking plates and screws, intramedullary nails, and prosthetic replacement, have been documented. Objective: The aim of our study was to functionally evaluate the Proximal Humerus Type II and type IV Fracture treated with PHILOS plate with early joint mobilization. To achieve maximum functional activity at shoulder joint. Material and Methods: This prospective study was conducted in the department of orthopedic surgery, Rajshahi Medical College, Bangladesh with Matricentred base Study from January June 2020 to July 2022. A total (n=176) cases of proximal humerus fracture treated by PHILLOS plate. Results: In our study of 179 cases, Male patients predominated female patients 100 (56%) males to 79 (44%) females, and the average age of patients is 39 years with the range being 25–65 years. Road traffic accident and fall from height were the commonest cause of the trauma 71 (39.66%). Neer classification system was used to classify the fractures. During the follow–up functional parameters were assessed using Constant-Murley scoring system. The study shows 60 (33.52%) excellent, 51 (28.49%) good, 24 (13.41%) satisfactory, Adequate 28 (15.64%) and 13 (7.26%) poor results on Constant Murley Score. The most common complications surgical site infection 3 (1.68%). Conclusion: A proximal humerus fracture can be stabilized with the use of a PHILOS plate.

Estimation of Lost Man Days among the Viral Hepatitis Patients Attended at a Tertiary Level Hospital in Bangladesh

Introduction: Viral hepatitis can cause a range of health problems and can be fatal. It is also prevalent in Bangladesh Armed Forces personnel and causing significant number of loss of man days. Objective: To assess the total loss of man days due to viral hepatitis of army personnel admitted/treated in hospital. Methods: This cross sectional study was conducted at Combined Military Hospital (CMH), Dhaka among military persons. Total 103 hepatitis patients were selected by simple random sampling from June to November 2014. Data were collected by semi-structured questionnaire and analyzed by using ‘Statistical Package for Social Science (SPSS) version -19. Results: The age range was between 20 to 43 years and mean age was 33.2 ± 5.8 years. Most of them suffered from hepatitis B (68.9%). Considering the rank structure, majority (51.4%)were Non Commissioned Officers (NCOs) and stayed in sainik line (46.6%). Due to reporting at Out Patient Department (OPD), 76.7% got 1-7 days sick rest and 73.8% have lost 1-7 man-days. Mean total man days lost was 55 ± 36 days. Mean admission days at hospital were 17 ± 13.7 days and the highest percentage was NCO (47.1%) followed by Sainik (39.7%). Total admission days of Sainik was not significantly association with admission days of NCO. But significant association was found within losing total man days between these two groups (χ2 = 4.88, p < .05). Conclusion: The results confirm the significant loss of man days due to viral hepatitis infection in Armed Forces Personnel which should be considered as a public health problem. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 30-33

Treatment Options of Temporomandibular Joint Ankylosis at a Tertiary Level Hospital in Bangladesh: A Two-Year Retrospective Analysis

Introduction: The study compares the surgical treatment options utilized to treat temporomandibular joint ankylosis at a tertiary level hospital in Bangladesh from 2016 to 2017. Materials and Methods: In this retrospective analysis, 18 patients (28 joints) were studied. History, radiological and physical examinations, and mouth opening were all part of the preoperative and postoperative evaluation. Age, sex, underlying cause, affected joint (s), surgery modality, complications, and follow-up durations were all taken into consideration. The data was analyzed using the SPSS 22.0 statistical software. The degree of mouth opening before and after different surgical techniques in different patient categories was compared using a one-way ANOVA followed by Tuky's HSD test. Results: Temporomandibular joint ankylosis was found to be in several forms (fibrous, fibro-osseous, and osseous), with trauma (61.11%) being the most common cause. The patients ranged in age from 5 to 30 years old, with females accounting for 55.55% of the total. The mean mouth opening significantly increased from 3.11 mm pre-operatively to 31.17 mm in the first month following surgery (p = 0.00001). In 55.55% of the instances, temporary facial nerve paresis occurred. Conclusions: Temporomandibular joint ankylosis can be successfully managed with early excision of the ankylotic mass, restoration of the ramus height by bone grafting, interpositional arthroplasty, and intensive physiotherapy. Update Dent. Coll. j: 2022; 12(2): 7-13

Tibial Plateau Injury: Mechanical Implantation with Plates and MIPO Approach Tertiary Level Hospital in Bangladesh

Introduction: Proximal tibial injuries are challenging to treat because of articular surface involvement, frequent congestion, and precariat soft tissue conditions, particularly after high-energy traumas. The treatment is intended to restore the unity of the joint surfaces that supports the typically depressed tibial plateau cartilage, use a strong device to stabilize the fracture and prevent further damage, to enable early recovery. We describe our treatment approach, using closed or open decrease and internal fixation, polyaxy plates, automatic bone-gloss, or other osteoconductive material enhanced by autologous platelet gel, where required. Surgery depends on the timing of the soft tissue and is typically done directly or under the guidance of a skilled surgeon using tissue-sparing techniques as much as feasible. Materials and Methods: A prospective analysis of all (n=58) proximal tibial fractures at the Islamic Bank Medical College Hospital and multicentral tertiary level hospital, Rajshahi, Bangladesh, from January 2019 to June 2021. Patient data were collected by evaluating hospital diagrams, office records, preoperative and after operative radiograph. Fractures were classified in the classification of OTA/AO. In 78 % of the 12-month post-surgery group, the Rasmussen score's evaluation of functional outcomes found positive to outstanding results. Results: Total Number of patient n=58 tibial proximal (intra-articular) fractures have been identified. The mean age was 43 years (range 19–79) at surgery, whereas women and 39 men were 19. The most frequent injury mechanism was linked to traffic accidents (RTA), representing 75% of cases. 09 (18.4%) AO/OTA types A, 31 (53.5%) AO/OTA type B and 18, (31.1%) AO/OTA type C fractures have been identified. Most (90 %) cases (44) were treated with open reduction and internal fixation, using polyaxially anatomical angular stability locking Plates. Conclusions: Internal fixing using locking plates, following the MIPO principles (Minimally Invasive Percutaneous Osteosynthesis), offers an acceptable reduction of fractures with excellent outcomes for the medium-term clinical results. Medicine Today 2022 Vol.34(2): 93-98

Maternal & Fetal Outcome of Preterm Premature Rupture of the Membranes in Secondary Level Hospital in Bangladesh

Background: Premature rupture of membrane (PROM) is linked to significant fetal and maternal morbidity and mortalities. The maternal and fetal outcomes in PROM are very important to decrease maternal and child mortality and for better management and prevention of complications. Objective: To find out maternal & fetal outcomes of preterm premature rupture of the membranes. Methods and Material: This is a cross-sectional observational study carried out in the Department of Obstetrics & Gynaecology, 250 Beded District Hospital, Chapainawabganj, Rajshahi, Bangladesh from January 2016 to July 2016. 50 pregnant women with preterm premature rupture of the membranes. Result: The majority of patients with preterm PROM (30%) belong to the age group 31-35 years. The mean age of the patients and SD were 26.4±6.58. 60% of respondents were multipara and 40% primipara. Most of the patients had irregular antenatal checkups (56%), 24% had regular antenatal checkups, and 20% had no antenatal checkups. Twenty percent of patients developed labor pain within 15 hours of rupture of membrane, 24% within 16-30 hours, 56% within 31-45 hours, 10% within 46-60 hours, and 12% without the onset of labour pain. 37 (74%) patients with preterm PROM had a normal vaginal delivery, and 13(26%) delivered by caesarian Section. Forty-three percent of patients delivered within 24 hours of the ruptured membrane, followed by 24% of patients within 24-48 hours, and 28% of patients within more than 48 hours. Among 50 patients, 12 (24.0%) had a previous history of abortion, 24 (48%) had H/O preterm delivery due to PROM, 2 (4.0%) had H/O MR, and 6 (12.0%) had H/O D & C. Among 50 respondents with PPORM 4 (8.0%) had diabetes mellitus, (12.0%) had HTN, 15 (2.0%) had urinary tract infection and 10 (20.0%) had lower genital tract infection. In this study, the total number of the alive baby was 42, and the stillborn baby was 2. Out of 42 alive babies, 18(42.86%) were affected by the consequence of preterm PROM and the birth process. Among 48 alive babies, 6(12.50%) developed birth asphyxia, 5(10.42%) developed jaundice, 3(6.25%) developed neonatal sepsis, and 4 (8.33%) developed respiratory distress syndrome. Maternal morbidity were chorioamnionitis 4(8%) puerperal sepsis 5(10%), postpartum endometritis 2(4%), abruptio placenta 1(2%) and wound infection 2(4%). Conclusion: The incidence of preterm PROM was more in multipara. The majority of the patients were from lower- and middle-class families. This study found some factors, e.g., Coitus, the recent history of abortion, M.R., D & C, and previous history of PROM. The study was done with a small population, but it introduces us to certain risk factors that can be prevented. Proper health education, patient motivation, improved health hygiene, and adequate maternity and childcare services are needed to reduce morbidity and mortality.

Clinicopathological Study of Sinonasal Malignancy-Experience in a Tertiary Level Hospital in Bangladesh

Objectives: To assess the clinical presentation and histopathological types and extensions of the disease at the time of presentation.
 Methods: Cross sectional observational study of 40 patients with sinonasal malignancy from the department of otolaryngology and Head neck surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet Bangladesh, period from May 2019 to April 2020. The patients were examined after admission into hospital pre-operatively and in the postoperative period. The surgical specimens were sent for Histopathology.
 Results: Majority patients were at 4th to 6th decade where male outnumbered the female with male female ratio was 3.4:1. Out of 40 patients, the majority of patients complaints of nasal obstruction followed by nasal discharge, facial pain, facial swelling and headache. About the site of the lesion maximum patients having the lesion in Maxillary sinus (60%) followed by nasal cavity (15%) multiple sinuses (12.5%) involvement in Ethmoidal sinus (10%) lateral wall of nose (2.5%)
 Conclusion: Sinonasal Malignancy is usually a disease of middle age and elderly people. Most of the patients (in this study 65% patients come at T3 & T4 stage) presented late with multiple symptoms.
 Bangladesh J Otorhinolaryngol 2022; 28(1): 37-42

Pattern of Antibiotic Use among Hospitalized Patients according to WHO Access, Watch, Reserve (AWaRe) Classification: Findings from a Point Prevalence Survey in Bangladesh.

For supporting antibiotic stewardship interventions, the World Health Organization (WHO) classified antibiotics through the AWaRe (Access, Watch, and Reserve) classification. Inappropriate use of antimicrobials among hospital-admitted patients exposes them to the vulnerability of developing resistant organisms which are difficult to treat. We aimed to describe the proportion of antibiotic use based on the WHO AWaRe classification in tertiary and secondary level hospitals in Bangladesh. A point prevalence survey (PPS) was conducted adapting the WHO PPS design in inpatients departments in 2021. Among the 1417 enrolled patients, 52% were female and 63% were from the 15–64 years age group. Nearly 78% of patients received at least one antibiotic during the survey period. Third-generation cephalosporins (44.6%), penicillins (12.3%), imidazoles (11.8%), aminoglycosides (7.2%), and macrolides (5.8%) were documented as highly used antibiotics. Overall, 64.0% of Watch, 35.6% of Access, and 0.1% of Reserve group antibiotics were used for treatment. The use of Watch group antibiotics was high in medicine wards (78.7%) and overall high use of Watch antibiotics was observed at secondary hospitals (71.5%) compared to tertiary hospitals (60.2%) (p-value of 0.000). Our PPS findings underscore the need for an urgent nationwide antibiotic stewardship program for physicians including the development and implementation of local guidelines and in-service training on antibiotic use.

Evaluation and Outcome of IA Hyaluronic Inj. vs. Corticosteroid Therapy for OA Knee: Tertiary Level Hospital in Bangladesh

Background: There are many types of arthritis, but osteoarthritis (OA) is one of the most frequent. IA injections of corticosteroids into the knee joint may improve pain and impairment by relieving joint inflammation. Purpose: To evaluate the effectiveness and safety of hylastan, a novel viscosupplements, with a single intra-articular corticosteroid injection in the treatment of knee osteoarthritis pain (OA). Because of its large molecular weight, the sodium hyaluronate in Hylastan is more likely to stay in the joint for an extended period of time than other viscosupplements. Methods: Multicentered based randomized quasi-experimental comparative study was performed in Shah Mokhdum Medical College, Rajshahi, Bangladesh, from January 2019 to December 2021. Enrolled patients aged ≥40 years. Patients were randomized 1:1:1 to one of three arms: 2 X 4 mL hylastan (n = 129; arthrocentesis then IA hylastan Day 0, same treatment Week 2); 1 X 4 mL hylastan (n = 130; arthrocentesis then IA hylastan Day 0, arthrocentesis only Week 2); steroid (n = 132; arthrocentesis then IA methylprednisolone acetate 40 mg Day 0, arthrocentesis only Week 2). The primary clinical outcome measure was changed from baseline in WOMAC A pain score overall postbaseline visits to Week 26. Results: Statistically significant pain reduction was observed in all three arms, with similar mean (95 % CI) changes in WOMAC A: 2 X 4 mL hylastan -0.9 (-1.0, -0.7); 1 X 4 mL hylastan -0.8 (-0.9, -0.7); steroid -0.9 (-1.0, -0.8); all p < 0.0001 versus baseline. Changes in secondary outcomes were similar in all three arms. Target knee adverse events were comparable for all treatments. Conclusions: An acceptable safety profile and effective pain relief were found with both IA hylastan injection regimens. The hypothesis of better pain relief with IA hylastan was not met compared to IA corticosteroid. The effectiveness and safety of hylastan compared to other viscosupplements require more investigation. Level of evidence Therapeutic study, Level I.

Patient’s Satisfaction and Barrier to Seek Services From the Nurses in a Tertiary Level Hospital

This Quantitative study was conducted among the patients of BIRDEM, Dhaka. The study's goal was to determine user expectations, client satisfaction levels, and the quality of health care supplied in a tertiary level hospital in Bangladesh. A total of 100 respondents were chosen by systematic random sampling and interviewed. The study's findings suggest that client happiness is influenced by providers' behavior, particularly respect and politeness. A reduction in waiting time (on average to 30 min) was more important to clients than a prolongation of the quite short consultation time (on average 2 min, 22 sec), with 75% of clients being satisfied. patients spend 10 minutes or less than that for checkup. Delays in service may be acceptable due to the high volume of patients, existing facilities, and the large number of service providers. Overpopulation at the healthcare facility was named as the cause by 29.8% of respondents, while lack of trained manpower and doctors were named as the causes by 22.5 percent and 19.7 percent, respectively. Finally, the study suggests that boosting resources, as well as effective supervision and monitoring, could help enhance the hospital's service quality.

Ameloblastoma of the Jaws: A Retrospective Observational Study of 131 Cases at a Tertiary Level Hospital in Bangladesh

Aim: The purpose of this study is to evaluate the incidence, radiological features, histological variant, and different treatment options of patients with ameloblastoma of the jaws treated at a tertiary-level hospital in Bangladesh. Materials and Methods: Age, gender, tumor location, radiologic features, histological pattern, and treatment modalities were all evaluated in this retrospective observational study. The frequency and percentages of these study variables were analyzed using descriptive statistics. Results: A total of 131 patients were included in this study, 66 of them were female, with a male-to-female ratio of 1:1.01. The patients had a wide age range from 4 to 70 years, a mean age (±standard deviation) of 26.61 (±13.34) years, and a significant incidence in the third decade of life. The left side of the jaws was the most frequently involved site. The mandible (n = 125, 95.42%) was the most frequently affected site, with the body–angle–ramus (n = 73, 58.5%) area being the most frequently involved location. Multilocular radiolucency was seen in most cases (n = 73, 55.73%) on radiography. The most common histological pattern (n = 71, 54.2%) was follicular. The most preferred treatment was the dredging (n = 90, 68.70%) method. The recurrence rate of the dredging treatment method was 5.56%. Conclusions: Ameloblastoma was found to be more common in patients in their third decade of life, with a wide age range. The follicular ameloblastoma was the predominant histological type, with most of them occurring in the mandible's body–angle–ramus area. Most of the patients were treated by the dredging method.

Mode of Delivery of Women with Complicated Pregnancy in a Tertiary Level Hospital in Bangladesh

Introduction: Every year, a great number of women die from pregnancy or childbirth related complications, which can be prevented. In developing countries, they don’t have access to maternal health services and cannot afford high quality care. Maternal death is usually occurs due to three delays: in decision making to seek care, reaching care and receiving care. Right decision at the right time regarding mode of delivery has a direct impact on healthy outcome of pregnancy as well as the maternal wellbeing. Objectives: To find out the outcome of complicated pregnancy. Materials and Methods: This cross-sectional observational study was conducted at obstetrics and gynaecology department of Dhaka Medical College Hospital from January to June 2011. Total 107 mothers who delivered recently with or without pregnancy complications were selected purposively. Data were collected by face to face interview with semi structured questionnaires. Verbal consents were taken prior to interview. Results: Among the respondents about 68.2% had antenatal complications and about 31.8% had no antenatal complication. Among the women having antenatal complications, 83.6% delivered by caesarean section and only 16.4% delivered by normal vaginal delivery. There was significant association of antenatal complications with mode of delivery by caesarean section. Conclusion: Women having antenatal complications had significant association with caesarean section. Though every pregnancy is at risk but early detection of complications, timely referral and timely intervention can save lives of many women during the process of child birth. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 31-34

Peptic Ulcer Diseases in Patients with Liver Cirrhosis and Portal Hypertension: Experience in a Tertiary Level Hospital in Bangladesh

Introduction: Cirrhosis of liver and peptic ulcer disease (PUD) are very common in Bangladesh. PUD may coexist with cirrhosis and portal hypertension. Haematemesis and melaena in cirrhosis of liver are not always from ruptured oesophageal varices; rather it may be due to bleeding peptic ulcer disease. Objective: To find the prevalence of PUD among patients with liver cirrhosis and portal hypertension. Materials and Methods: This cross sectional, descriptive study was conducted on 96 patients of cirrhosis of liver diagnosed with oesophageal varices at endoscopy unit of Kurmitola general hospital, during endoscopic evaluations in 4 months period from september 2017 to december 2017. Results: Total cirrhotic patients enrolled were 96 (M=61, F=35), mean age was 51.8 ± 14.2 yrs (18-86years). Hepatitis B virus (HBV) was the leading cause of cirrhosis in 54.1%, Hepatitis C virus (HCV) 5.2 %, proven non-alcoholic steatohepatitis (NASH) were 11.5% and rest were from unknown aetiology. Their average Child-Turcotte-Pugh (CTP) score were 8.6 (12-5), 37.6% associated with portal hypertensive gastropathy. Grade-III oesophageal varices found in 52 patients, whereas grade-II in 25 patients. Among this 96 patients 39 (40.6%) revealed peptic ulcer disease more in the form of gastric ulcer (n=23) than duodenal ulcer (n=10) and both (n=6). Most of the ulcers belonged to Forrest class III (76.9%). Conclusions: Variceal bleeding and portal hypertensive gastropathy are the common causes of bleeding and anaemia in patients with cirrhosis of liver. Peptic ulcer disease has been found to be one of the potential causes of haematemesis, melaena, and anaemia among these patients in Bangladesh. Large multicenter controlled studies are needed to confirm the reports. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 68-71

Management outcome of blunt renal trauma in a tertiary level hospital of Bangladesh

Background: The kidney is the commonly injured genitourinary and abdominal organ. Renal injuries are classified by their mechanism: blunt or penetrating. Failure to perform appropriate evaluation and treatment of these injuries may result in significant long term patient morbidity. Objective: To evaluate blunt renal trauma cases at a tertiary level hospital to find out management practices along with patient outcomes. Methods: This prospective observational study was conducted in the Department of Urology of Dhaka Medical College Hospital during the period of January 2011 to December 2012 to observe the management outcome of blunt kidney injuries. Sampling technique was purposive and sample size was 110. After management of blunt kidney injury by either conservatively or by surgical means, some patients were followed up for 2 years and others for less than 2 years. Results: In this study, 90.1% patients were diagnosed and staged by contrast enhanced CT scan. Most of the early grade injuries (grade I-III) were treated conservatively and outcome in terms of surgical conversion and short term complications were favourable. Few bluntly injured grade IV and V required operative interventions. Overall nephrectomy rate was only 3.6%. Haemodynamic instability, associated organ injury, higher grade injury - all were predictive indicators of operative interventions. The study showed that rates of complications were more in higher grade injury, with concomitant other organ injuries and in patients who required blood transfusion (indicator of hemodynamic instability). Conclusion: Most of the blunt kidney injuries can be managed in conservative way with favourable outcome. Mediscope 2021;8(2): 103-111

The Demand of Whole Blood in Casualty Management at a Tertiary Level Hospital in Bangladesh

Efficient blood transfusion facility in the casualty wards is essential to minimize the morbidity and mortality of the injured patients. Proper knowledge of blood transfusion demand in a facility can help forecast future demands and facilitate the planning of existing resources allocation for best injury care. This cross-sectional study was conducted at the causality wards of Dhaka Medical College Hospital from July 2018 to December 2018. During this period, patients who attended the casualty wards and needed whole blood transfusion were selected as the study population. Relevant information regarding the required blood units, blood group, and blood collection source were recorded and analyzed. During our study period, 1619 units of whole blood were required by 896 patients. Most of the study population were from the age group of 31-40 years. Male group was the predominant at a 3.9:1 male-female ratio. Majority of the patients (55.13%) required only one unit of blood, and 28.57% of the patients required two units. O+ve blood group was the most demanded (34.65%) followed by B+ve, A+ve, AB+ve, O-ve, B-ve and A-ve (31.87%, 23.72%, 7.6%, 1.42%, 0.49% and 0.25%, respectively). The patients' relatives donated around 85% of blood, and the rest were from voluntary donors. The average daily and weekly requirement of whole blood for the causality departments of Dhaka Medical College Hospital was around 9 and 62 units respectively. Evidence-based expert guideline for the use of whole blood in the casualty management and social awareness for blood donation may save thousands of valuable lives. Faridpur Med. Coll. J. 2021;16(1):8-11

Pattern of Complementary Feeding Practices among Mothers Attending at a Tertiary Level Hospital in Bangladesh

Optimal growth and development of a child depends mostly on proper breastfeeding and complementary feeding practices. However, many children yet suffer from malnutrition and the recommended practices of complementary feeding have yet not been established among the majority of the population. In this observational study, we looked for the causes behind the improper complementary feeding practices among the mothers attending the outdoor and indoor units of the Department of Pediatrics, Faridpur Medical College Hospital, Faridpur, Bangladesh, from January 2018 to January 2019. A total of 447 mothers were interviewed regarding their complementary feeding practices and data were analyzed to find out the demographic and social influences. The majority of the respondents were between the age group of 21-25 years (54%). Thirty five percent were illiterate, 60% were from the rural area, 78% were housewives, 64% came from a nuclear family, and 87% had a monthly family income of 5000-20000. Most of the deliveries were conducted at home (58%) and the most common source of feeding related information was healthcare workers (66%). Only 41% of the mothers started complementary feeding at the age of 6 months. The most common complementary food was Suji, 60% of them lacked the knowledge of food preparation and 35% of them practice forceful feeding to the children. The promotion of proper complementary feeding needs to be ensured to achieve the children's catch-up growth and development. Faridpur Med. Coll. J. 2021;16(1):30-33

Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

BackgroundNeuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions.ResultsA total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud’s phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations.ConclusionNP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted.

Clinical Profile of Cerebral Palsy: A Study in Tertiary Level Hospitals of Bangladesh

Introduction: Cerebral palsy (CP) is the most common motor neurodevelopmental disorder among children which incurs a huge economic burden in respect of treatment and rehabilitation. Aim: To assess the clinical profile of CP in the outdoors of tertiary level hospitals in Bangladesh. Methods: This cross-sectional study was carried out in two hospitals, namely Child Development Center, CMH Dhaka and Institute of Pediatric Neurodisorder and Autism, BSMMU, Dhaka from October 2019 to January 2020. A total of 134 cases were included by convenient sampling. Data were collected from the parents of the children by face to face interviews through a pretested semi-structured questionnaire. Results: CP was found more prevalent in male children (76.1%) than female children (23.9%). Most of the families (83.6%) belonging to CP children have monthly income ≤ Taka 24000.00. The majority of the parents were HSC qualified or less which accounted for 76.9% for father and 91.8% for mother respectively. Among the etiologies; perinatal asphyxia ranked highest (78.4%). The spastic variety was the most common (78.4%) presentation of which 41.0% suffered from quadriplegia. The majority of the CP cases (83.6%) were associated with intellectual disability. Conclusion: CP has a wide range of presentation, association and co-morbidities. Physicians should be aware of these diversified presentations and co-morbidities of CP and deal accordingly for better outcome of the patients. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 19-21

Pattern of UTI in Chronic Kidney Disease: Experience from A Tertiary Care Hospital, Bangladesh

Background: Urinary Tract Infection (UTI) is common and higher in prevalence in patients with Chronic Kidney Disease (CKD). To find out the frequency and clinicobacteriological pattern of UTI in CKD patients.&#x0D; Materials and methods: A cross-sectional study was done on 1000 of CKD patients attending Nephrology Department of Chattogram Medical College Hospital (CMCH) a tertiary level hospital in Bangladesh during January to December, 2017. Cleancatch midstream urine samples were collected from study populations irrespective of symptoms. Macroscopic and microscopic examinations were done. Urine samples were then inoculated in Blood agar and Mac’Conkey agar and incubated aerobically at 37 °C for 18-24 hours. Microscopic observations and conventional biochemical tests were done to identify the isolated organisms. Significant growth of organisms in urine was defined as UTI. The isolated organisms were tested for antimicrobial susceptibility by using modified Kirby Bauer technique.&#x0D; Results: The prevalence of UTI was 61.8%. with significant asymptomatic UTI for 28%. Gram-negative organisms were most frequent 564 (93%) with predominant Escherichia coli 399 (64%) followed by Klebsiella 113(18%) and Pseudomonas 39(6%). Among Gram positive isolates, Staphylococcus (6%) was the dominant organism isolated. Regarding antibiotic susceptibility, Gram-negative microorganisms were found to be most sensitive to carbapenem and amikacin whereas Gram-positive microorganisms were most sensitive towards carbapenem, colistin and linezolid.&#x0D; Conclusion: In CKD patients, asymptomatic UTI was detected significantly. E.coli was found to be predominant organisms and resistant towards most of the studied common antibiotics.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 41-45

Comparative efficacy of Amoxycillin Vs Cefixime in the treatment of Childhood enteric fever in a tertiary level Hospital in Bangladesh

Comparative efficacy of Amoxycillin Vs Cefixime in the treatment of Childhood enteric fever in a tertiary level Hospital in Bangladesh