Osmani Medical College Research Articles

Study of serum ferritin levels in preterm labour and its perinatal outcome in tertiary care centre

Pregnant women at risk of preterm birth may be easily identified and sent to tertiary care centres for further therapy. Numerous biomarkers are being investigated for their ability to predict preterm labour; serum ferritin is one of these indicators. It is an intracellular protein that has a role in iron storage and is also an acute phase reactant that is increased during acute and chronic infections. To evaluate serum ferritin levels in preterm labour and perinatal outcome in a tertiary care centre during 2 years.A case control study was conducted in collaboration with the Department of Obstetrics and Gynecology at Osmania Medical College, Hyderabad, from 2019 to 2022. After receiving permission, one hundred participants with an average age of 25 years who visit Niloufer hospital are included in the research and separated into case (Group 1) and control (Group 2) groups. Group 1 consists of women who had spontaneous preterm labour, whereas Group 2 consists of pregnant women of the same gestational age who are considered controls. Among 50 instances of preterm labour, 39 (78.0 percent) were classified as preterm (32 to 36 weeks), whereas 11 (22.0 percent) were classified as very preterm (28 to 32 weeks). The majority of the 50 patients included in the research, 31 (62.0 percent), were born by normal vaginal delivery, while 19 (38.0 percent) were delivered using emergency LSCS. CRP was positive in two patients (4.0 percent). The mean WBC levels in cases were much greater than those in controls, and the difference is statistically significant. Serum ferritin levels were 40.298 19.64 in cases and 20.343 6.82 in controls. Serum ferritin levels were substantially higher in cases than in controls on average. The mean WBC levels were greatest in extremely preterm infants, followed by preterm infants; however, this difference was determined to be statistically insignificant. Ferritin levels are much higher in preterm labour patients than in low-risk women of the same gestational age. Serum ferritin levels may be utilised as a biomarker in high-risk premature labour.

Study of p40 is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma on cytological smears

Background: Histology and genetically driven management are the current standard in carcinoma lung. Adequate tissue is a challenge in a few cases. While liquid biopsy is an, it’s an always preferred to get an initial cyto/histo morphological confirmation. While the immune-histo chemistry (IHC) is a proven method to differentiate the squamous vs adeno carcinoma, the role of various “immuno-cyto-chemical” makers were not studied widely. Methods: This is a retrospective (July 2018 to December 2018) for random sample collection and prospective (Jan 2019-August 2019) study conducted from in the Department of pathology, govt. chest hospital Osmania medical college, Hyderabad as a part of PG dissertation, 120 subjects with cytological diagnosis of non-small cell lung carcinoma were analyzed during this period and others were excluded. Results: Out of 120 cases 80-adenocarcinoma (ADC) and 40-squamous cell carcinoma (SCC). Most of the patients are in 61-70 years, 20 are 71-80 years, 20 between 51-60 and 10 are between 40-50 years. In this study sensitivity of p63 and p40 is equal, but specificity and positive predictive value are higher for p40 for diagnosis of SCC. Conclusions: Immuno-cyto-chemistry is still a valid option in selected cases where getting a biopsy is difficult. Our findings recommend the use of p40 immuno staining rather than p63 as a squamous cell marker.

Circadian Variation of Stroke in a Tertiary Level Hospital

Introduction: Stroke, a primary global health concern, is the fifth leading cause of death in Bangladesh, with a prevalence of 0.3%. While 85% of stroke cases globally are cerebral infarctions, Asian countries exhibit stroke patients on average 15 years younger than developed countries. Survival studies reveal strokes exceeding coronary events in hypertensive patients. Observational data suggests circadian, circaseptan, and circannual variations in stroke occurrence, with a morning peak. Circadian rhythm in ischemic stroke is higher in the early morning. Thrombotic strokes, influenced by platelet aggregation and fibrinolysis, often occur in the morning. Haemorrhagic strokes result from blood vessel ruptures. Population-specific circadian patterns remain unconfirmed.
 Aim of the Study: The study aims to find out the relation of circadian variation of stroke.
 Methods: This cross-sectional study, conducted at Sylhet MAG Osmani Medical College Hospital, Bangladesh, analyzed 100 stroke patients over six months. Ethical approval was obtained, and informed consent was taken. Inclusion criteria covered patients with clinical and imaging stroke diagnoses, while exclusion criteria excluded transient ischemic attack, previous stroke, head injury history, and refusal to participate. Stroke onset time was categorized into four six-hour intervals. Demographic data, risk factors, and comorbidities were recorded, and brain CT scans were performed. Data analysis used SPSS version 22, employing descriptive statistics, Chi-square Test, and Student's t-test. Significance was set at p<0.05. Results were presented in tables.
 Results: The study involves 100 participants, primarily aged 60-70 (50%), predominantly male (76%), residing 62% in urban and 38% in rural areas. Occupationally, 35% are businessmen, 24% are housewives, and 15% are service holders and laborers. Smoking status shows 58% smokers. Stroke types include 57% ischemic strokes and 39% hemorrhagic strokes. Hypertension (72%) is the significant risk factor. Stroke symptoms predominantly occur between 06:01 and 12:00 (46%). These insights comprehensively understand the study population's demographics, lifestyle, and clinical characteristics.
 Conclusion: The study established circadian patterns in stroke onset, with the highest frequency between 06:00-12:00 and the lowest between 18:01-24:00. Ischemic stroke was the most common subtype, followed by hemorrhagic stroke and fewer subarachnoid hemorrhages. Managing blood pressure and coagulation during peak onset times could aid stroke prevention, but further extensive studies are needed for validation.

Correlation Between Magnitude of ST Segment Elevation and the Proximal Right Coronary Artery Lesion in Acute Inferior Myocardial Infarction

Introduction: The determination of the probable site of occlusion within RCA in acute inferior MI is very important because proximal occlusions are likely to cause greater myocardial damage and an early invasive strategy may be planned in such cases. Furthermore, identification of infarct-related artery and its site in acute inferior myocardial infarction not only guide decision regarding the urgency of revascularization but also guide to avoid therapy that may adversely affect the outcome. Objective: To predict the site of lesion in right coronary artery in acute inferior myocardial infarction by the magnitude of ST segment elevation in inferior leads (II, III and aVF). Methodology: This cross-sectional study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, from January 2014 to December 2015. A total of 50 consecutive patients with inferior MI who present within 12 hours of symptom onset and received fibrinolytic therapy were selected according to inclusion and exclusion criteria. Using 12-lead ECG, height of ST segment elevation in leads II, III and aVF were measured & coronary angiography(CAG) was performed during index hospital period .CAG which showed culprit lesion in RCA were only taken for the study. The sum of STsegment elevation in inferior leads were then correlated with the proximal lesion in RCA. Results: The age of the patients ranged from 31 to 70 years with the mean age of 51.1 (SD 9.2) years. Majorities (88%) of the patients were male and ratio of male to female was 7.33:1.Out of 50 patients, 26(52%) had the lesion in proximal, 19 (38%) in mid and 05 (10%) in distal RCA. Patients with proximal RCA lesion showed a mean ST segment elevation of 12.5(SD 1.07) mm, with mid RCA lesion 8.5 (SD 0.80) mm and distal RCA lesion 6.5(SD 0.42) mm. There was a positive correlation of sum of ST segment elevation in inferior leads II, III and aVF to the proximal lesion in RCA (r=0.923, P < 0.05). Conclusion: From the study it is concluded that the magnitude of ST segment elevation in inferior leads (II,III, aVF) can predict site of lesion in RCA in acute inferior wall myocardial infarction; the greater the sum of the height of ST segment elevation in inferior leads, the higher is the probability of lying the lesion in proximal right coronary artery. Bangladesh Heart Journal 2024; 39(1): 44-48

A Study on Antibody Response among COVID-19 Noninfected Population – Need for Hour

Abstract Introduction: In the year 2020, COVID-19 emerged as a pandemic resulting in millions of deaths worldwide and negatively impacted the health, infrastructure, and economy of the globe. The disease was believed to be acquired from animals (Bats), however, man-to-man transmission happened through aerosols o/or and direct contact. Seroprevalence studies in different countries among various populations were conducted to understand the immune responses against the virus; also, to estimate the proximity in reaching herd immunity. Aim: The aim of this study was to study antibody response among the COVID-19 noninfected population. Materials and Methods: A prospective cross-sectional study was done during the months of January–February 2023. The study was conducted in the Viral Research and Diagnostic Laboratory, Department of Microbiology, Osmania Medical College. Nursing and Diploma in Medical Laboratory Technology (DMLT) students who did not test positive for COVID-19 reverse transcription–polymerase chain reaction during and after the pandemic were included in the study. Blood samples were tested for COVID-19 immunoglobulin (Ig) G antibodies using commercial enzyme-linked immunosorbent assay kit. A comparison among vaccinated and nonvaccinated groups was performed. Results: A total of 90 blood samples were tested, of which 45 belonged to the vaccinated group and the other 45 were of the nonvaccinated group. Among the vaccinated group, total of 45 samples tested positive for COVID-19 IgG antibodies (100%). Whereas 38 (84.4%) among the nonvaccinated group showed positive COVID-19 IgG antibodies; while 7 (15.6%) samples of nonvaccinated group tested negative for antibodies. A total of 83 out of 90 (92.2%) showed evidence of COVID-19 IgG antibodies. Conclusion: Despite the controlled COVID-19 pandemic situation, the novel disease has posed serious challenges to the medical field. Although the population in this study showed good serological response, herd immunity to COVID-19 can be achieved if more than 80% of the entire population becomes immune. In this study, 84.4% of the population showed positive for COVID-19 IgG antibodies hinting toward achieving herd immunity. However, regular vaccination and sero-surveillance studies are needed for sustaining community protection.

Immunoexpression of p53 and Ki-67 in Urinary Bladder Carcinoma and Their Association with Tumor Grade and Muscle-invasiveness

Background: Urinary bladder carcinoma is one of the threatening causes of human morbidity and mortality. Various molecular studies and prognostic biomarkers are helpful to assess the outcome of urinary bladder carcinoma. High expression of p53 and Ki-67 represents the aggressiveness of the disease and indicates poor prognosis. Methods: This cross-sectional study was conducted at the Department of Pathology, Sylhet MAG Osmani Medical College from September 2018 to July 2020 to observe the immunoexpression of p53 and Ki-67 in urinary bladder carcinoma and their association with tumor grade and muscle-invasiveness. Total 57 transurethral resection (TURBT) samples of radiologically and clinically suspected bladder tumor cases were diagnosed histopathologically included in the study. Results: Age of the study patients ranged from 35 to 80 years with a mean of 60.60 ± 11.14 and male to female ratio was 4.7:1. There were 31 (54.4%) high grade and 26 (45.6%) low grade urinary bladder carcinomas on histopathological examination. Thirty (52.6%) cases were histopathologically muscle invasive bladder carcinoma (MIBC) and 27 (47.4%) cases were non-muscle invasive bladder carcinoma (NMIBC). Positive p53 expression was observed in 24 (77.4%) cases of high grade carcinoma while only in 6 (23.1%) cases of low grade urinary bladder carcinoma. Positive p53 expression was seen in 22 (73.3%) cases of MIBC and 8 (29.6%) cases of NMIBC. Ki-67 expression was found positive in 27 (87.1%) cases of high grade carcinoma while only in 7 (26.9%) cases of low grade urinary bladder carcinoma. Positive Ki-67 expression was seen in 25 (83.3%) cases of MIBC and 9 (33.3%) cases of NMIBC. Statistically significant association (P<0.05) was observed in histopathological grades and muscle invasiveness of UBC with p53 and Ki-67 expression. Conclusion: p53 and Ki-67 immunomarker may be helpful to provide additional prognostic information in urinary bladder carcinoma.

Relationship between Etiology and Radiological Findings in Case of Moderate and Severe Head Injury Patients.

Introduction: Traumatic brain injury (TBI) or head injury is one of the leading causes of mortality and disability in the world. The common causes of TBI are usually motor vehicle accident, fall and physical assault. Methodology: This was a prospective cohort study to find out the relationship between etiology and the radiological findings in moderate and severe head injury patients. The places of the study were the Neurosurgery department of Sylhet M A G Osmani Medical College Hospital, Sylhet Women’s Medical College Hospital (SWMCH) and King Faisal Hospital (KFH), Taif, KSA. The Sample size was 104. The study period was 3 years (July 2021 to December 2022). On the basis of radiological findings, the participants were divided into three groups or arms. The different arms were diffused traumatic brain injury (arm-1), focal traumatic brain injury (arm-2) and both (diffused and traumatic) types traumatic brain injury (arm-3). Results: Mean age was significantly higher in female (51.83%). Overall mean age was 40.28 year. Highest frequency (23%) was in the below 20-year age group followed by the 41-50-year age group (20.2%). Road traffic accident (RTA) was the commonest (63.5%) etiology followed by fall (21.2%). At the end of 1 month 68.3% of participants showed improvement. Conclusion: Post head injury disability is a huge psychological and financial burden for any nation or family. RTA contributes the major risk for the moderate and severe head injury

SARC-F Score: A Quick Bedside Tool to Screen Sarcopenia in Patients With Cirrhosis

Sarcopenia is often ignored in clinical practice despite being an important prognostic marker. SARC-F is a simple bedside score to assess muscle abnormalities in cirrhosis patients. However, there is limited Indian data on the validity of this score. Hence, we aimed to assess the validity of SARC-F score in a tertiary care center. A prospective observational study including consecutive 100 cirrhosis patients attending the gastroenterology outpatient department in Osmania Medical College and Hospital, Hyderabad, India, was conducted from Jan 2018 to Dec 2019. The primary aim was to assess the mean muscle volume loss (MVL) by computed tomography and handgrip (HG) strength for muscle strength decline (MSD) and compare the SARC-F score with standard cut-off values. We included 100 cirrhosis patients (mean age: 45 years; males: 86%; child-pugh class B/C: 42/58). Sixty-nine percent of the patients had a SARC-F score of ≥4, whereas MVL and MSD were noted in 62% and 86% patients, respectively. Mid-arm circumference, skin-fold thickness, mid-arm muscle circumference (MAMC), and HG strength were significantly lower in patients with SARC-F score ≥4 than in those with SARC-F score <4 (P<0.05). The Pearson correlation plot suggested a significant inverse correlation between the SARC-F score and MSD and SARC-F score and MVL. A SARC-F score of ≥4 had a sensitivity and specificity of 80.7% and 50% for MVL and 75.6% and 71.4% for MSD, respectively, whereas it was 83.3% and 52.5% for MSD and MVL combined, respectively. Area under the receiver operating characteristic curve for SARC-F as a predictor of MVL was 0.75 (95% confidence interval: 0.64-0.82; P=<0.001). On multivariate analysis, a high SARC-F score and low MAMC were predictive of MVL in cirrhosis patients. SARC-F score has good sensitivity as a bedside screening tool for sarcopenia in patients with cirrhosis. A high SARC-F score and low MAMC indicates the presence of MVL and warrants further evaluation for sarcopenia.

Caregiver Burden in Substance Use Disorders Patients

Background: Substance Use Disorders (SUDs) impose significant challenges not only on individuals grappling with addiction but also on the caregivers who provide support and care. The caregiving role is associated with multifaceted burdens that require understanding and targeted interventions. Recognizing the diverse dimensions of caregiver burden is crucial for offering effective support. Objective: The study aimed to find out the caregiver burden in substance use disorder patients, examining severity and socio-demographic correlations, contributing insights into effective support strategies. Methodology: The cross-sectional observational study took place at Sylhet MAG Osmani Medical College's Psychiatry Department and a private psychiatric and drug rehabilitation center in Sylhet from September 1, 2018, to August 31, 2020. The research focused on substance use disorder patients and their caregivers, involving 50 eligible patients selected through inclusion and exclusions criteria. Diagnoses followed DSM IV criteria. Socio-demographics were gathered via semi-structured questionnaires. Caregiver burden was assessed using the Bengali Zarit Burden Interview (ZBI) scale through approximately hour-long interviews, with 1-2 daily. Ethical procedures encompassed informed consent and confidentiality assurance. Result: The study included 50 male participants. Patients mean age was 31.92 (±8.21) and caregivers mean age was 41.68 (±12.89). Mainly, caregivers were mothers (40%) and wives (34%). Caregivers experiencing moderate to severe burden were 58%, mild to moderate burden were 26%, and severe burden were 16%. Mean ZBI score was 48.22±13.55. Higher burden correlated with illiteracy, low family income, excessive drug spending, prolonged substance use, and multiple drug usage. Alcohol users faced more burden than other substance users. Female caregivers, younger age, and housewives experienced heightened burden. No burden links were found with marital status, habitat, religion, family type, or drug administration method. Conclusion: This study concluded that Substance use heightens caregiver burden, notably among female, young, and housewife caregivers. Addressing these trends is vital for effective care of substance use

Epidemiological Evaluation of Suicidal Deaths due to Organophosphorus Compound Poisoning

Background: One of the most widespread suicide methods, especially emerging in developing countries like Bangladesh, is poisoning. Organophosphorus compound (OPC) is a common chemical used for self-poisoning that is also inexpensive and easily accessible. Objectives: To evaluate the demography of suicidal deaths due to OPC poisoning. Methods: This was a retrospective study with the departmental records of autopsy among deaths due to OPC poisoning. The study was carried out to ascertain the epidemiological evaluation of 242 OPC poisoning suicidal deaths during January, 2016 to December, 2017 at the mortuary of Sylhet MAG Osmani Medical College, Bangladesh. Results: Majority of the victims (184, 76.03%) were below 40 years of age and females were predominant (142, 58.67%). Most of the victims resided in Companygonj (47, 19.42%), followed by Kotwali (40, 16.52%), and Gowainghat (35, 14.52%) of Sylhet district. Most of the dead bodies (192, 79.33%) were brought to the morgue under Kotwali police station. The most common (218, 90.08%) cause of death was respiratory failure. Conclusion: Suicide with OPC was the most common in younger women. Establishment of national suicide surveillance is now a time demanded step and responsible authority should take some necessary steps to address it. Journal of Monno Medical College, June 2023; 9 (1): 20-23

Comparison of in Hospital Complications and Mortality between Diabetic and Non-Diabetic Patients Admitted with Acute Anterior MI

Background: Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack, occurs when blood flow stops to a part of the heart causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Objective: To see the comparison in hospital complications and mortality between diabetic and non-diabetic patients of acute anterior MI. Methodology: This cross-sectional observational study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet over a period of two years from July 2015 to June 2017. A total of 100 acute anterior MI patients (50 diabetic and 50 non diabetic) were included in this study. Acute anterior MI patients admitted after 6 hours of symptom onset or who did not receive streptokinase were excluded. Results: Male predominance was obvious in both groups [40 (80%) versus 42 (84%); p&gt;0.05] in diabetic and non-diabetic group respectively. Mean age was 53.34 ± 11.32 and 54.84 ± 14.12 years in diabetic and non-diabetic groups respectively. Dyslipidemia [6 (12%) versus 6 (12%); p &gt;0.05], Smoking [32 (64%) versus 34 (68%); p &gt;0.05] and Family history of cardiovascular disease [6 (12%) versus 4 (8%); p &gt;0.05] were similar among diabetic and non-diabetic respectively. Hypertension was found more among non-diabetic [27 (54%) versus 19 (38%); p&gt;0.05] but difference was not statistically significant. Diabetic group had more acute MR [2 (4%) versus 0 (0%); p&gt;0.05] but was not significant. Death was more in diabetic group than that of non-diabetic group [7 (14%) versus 3 (6%); p&gt;0.05] but it was statistically not significant. Conclusion: Post MI angina was higher in diabetic than non-diabetic patients. Mechanical complications were also more in diabetic patients. However rate of reinfarction was higher among non-diabetic than that in diabetic patients. Mortality rate was higher in diabetic than that in non-diabetic patients. So, it may be concluded from the present study that in-hospital complications and mortality of acute anterior myocardial infarction are comparatively more in diabetic patients than in non-diabetic patients.

Different Infective and Non-Infective Etiology of Exudative Pleural Fluid Effusion: Experience of 50 Cases in Bangladesh

Background: Several diseases are responsible for the causation of exudative pleural fluid effusion among patients. Objective: The purpose of the present study was to identify the etiologies of exudative pleural fluid effusion. Methodology: This cross-sectional study was carried out at medicine indoor department of Sylhet MAG Osmani Medical College Hospital, Sylhet over a period of six month from October 2009 to March 2010. Patients who were admitted with pleural effusion were selected as the study population. Pleural fluid was collected by a physician. The laboratory tests were performed in the Department of Laboratory medicine of the Hospital. The different etiologies were determined by the different diagnostic tests. Results: A total of 50 cases were selected consecutively in the study. Out of 50 patients, 28.0% was in the range of 41 to 50 years followed by 26.0% between 31 to 40 years. Tuberculosis was the most common cause of exudative pleural effusion and among 50 cases of effusion 30 were due to tuberculosis (60%). Malignancy was found as the 2nd common cause of exudative pleural effusion (24.0%). Pneumonia was found as the 3rd common cause of exudative pleural effusion (10.0%). Conclusion: In conclusion tuberculosis is the most common cause of exudative pleural effusion followed by malignancy. Bangladesh Journal of Medical Microbiology, January 2023;17(1):10-14

Outcome of Transvaginal Local Repair of Vesicovaginal Fistula

Background: Vesicovaginal fistula (VVF) is a significant cause of physical &amp; psychological disability with social stigmatization especially in low- and middle-income countries. Over 80% of such cases result from neglected prolonged and obstructed labour. Objective: The purpose of the study was to observe the outcome of transvaginal local repair of vesicovaginal fistula (VVF). Methods: This descriptive study was carried out at the Department of Obstetrics &amp; Gynaecology, Sylhet M.A.G. Osmani Medical College Hospital, Bangladesh, from July 2007 to June 2008, on 50 patients of vesicovaginal fistula. We included women who were suffering from VVF and who were operated before and diagnosed as a failed repair of VVF. We excluded those patients who had VVF with associated problem like rectovaginal fistula (RVF), any repair through transabdominal route and unwilling to take part in this study. Before surgery, each woman was assessed by medical and surgical history, examination and necessary investigations. Typically, regional anesthesia was utilized for the fistula surgery. However, general anesthesia was given when required. During surgery, transvaginal approach was taken for repair. The vagina was packed for haemostasis. Vaginal pack was removed after 1-2 days depending on instruction of the surgeon. Repacking of vagina was also done sometimes when there was some leaking during post-operative period. Few patients developed severe constipation post operatively. Results: The participants aged between 16 and 70 years. Among them, majority of the patient belongs to the age 31-35 years (26%) followed by 2nd common group 26-30 years of age (20%) and 3rd one in between 21-25 years of age (16%). Among them 44% patients were primipara and 22% patients were grand multipara. The mobilization during operation was excellent in 30%, satisfactory 64% cases and not enough in 6% cases. After mobilization fistula closed in double layer in 10% and in single layer 90% cases, labial fat graft was given 38% and peritoneal graft was given in 2% cases. During operation bleeding was minimum in 92% cases and in 34% cases catheter was block, urine leakage occurred in 30% cases. Among all patients 14% suffered from fever postoperatively. There was vaginal discharge in 10% cases and UTI in 12%cases which was evidenced by urine culture. Operation was fully successful in 60 percent cases, urethral incontinence in 22% cases &amp; failed in 18% women. Conclusion: In this study, majority of the transvaginal local repair of VVF operations were successful; however, few difficult cases were observed. Mugda Med Coll J. 2023; 6(1): 25-29

Comparison of Pulse Rate and Blood Pressure between Obese and Non-Obese Young Adults

Obesity has been reported to be associated with a number of cardiovascular diseases. Some researchers forecast that obesity may contribute to increase prevalence of high blood pressure in young adults. To compare pulse rate and blood pressure between young obese and non-obese subjects, this cross-sectional analytical study was done in the Department of Physiology, Sylhet MAG Osmani Medical College from January to December 2017. Fifty obese (BMI ≥27.5 kg/m2) and age-sex matched non-obese (BMI 18.5-22.9 kg/m2) young adult were selected. The age (35.56 ± 3.02 years versus 32.40 ± 4.20 years; p=0.116) and sex 26 (52.0%) male versus 31 (62.0%) male; p=0.313) were not differ between obese and non-obese subjects. The mean resting pulse rate (82.98 ± 3.50 beats /minute versus 72.64 ± 3.58 beats/minute; p&lt;0.001), systolic blood pressure (130.20 ± 10.00 mm Hg versus 107.30 ± 10.60 mm Hg; p&lt;0.001) and diastolic blood pressure (80.90 ± 7.19 mm Hg versus 67.90 ± 7.22 mm Hg; p&lt;0.001) were higher in obese compared to non-obese participants. Obesity increases pulse rate and blood pressure in young adults. Bangladesh Med J. 2021 Sept; 51(1): 47-51

Short Term Outcomes of Laparoscopic Versus Open Appendicectomy in Patients with Acute Appendicitis

A prospective, observational study was carried out in the Department of Surgery of Sylhet MAG Osmani Medical College, Bangladesh, from May 2019 to May 2020, to compare the short-term outcomes of laparoscopic versus open appendectomy for acute appendicitis. A total of 120 patients who were diagnosed with acute appendicitis and underwent surgery were included in this study. The selected patients underwent appendectomy either by laparoscopic or using open method under general anesthesia. The patients were divided into two groups – 60 patients underwent laparoscopic appendectomy as group-I and the other 60 patients underwent open appendectomy as group-II. The mean age was 26.25±7.83 years in group-I and 22.88±6.92 years in group-II. The difference was statistically significant (P&lt;0.05). Male predominance was found: 40(66.67%) in group-I and 44(73.33%) in group-II. However, the difference was not statistically significant (P&gt;0.05). The mean operating time was 65.05±8.76 min in group-I and 40.08±4.82 min in group-II. The mean time resumption of diet was 7.3±0.9 hours in group-I and 25.4±4.5 hours in group-II. The mean postoperative pain was 1.32±0.47 in group-I and 3.27±0.69 in group-II. 1(1.7%) patient had wound infection in group-II; however, no patients in group-I developed wound infection. The mean duration of hospital stay was 2.20±0.40 days in group-I and 3.62±0.98 days in group-II. The majority (81.7%) of the patients had the best quality of the scar in group-I and 48(80%) in group-II. The mean quality of the scar was 4.82±0.39 in group-I and 2.90±0.44 in group-II. All those differences except wound infection were statistically significant (P&lt;0.001). This study demonstrated that laparoscopic appendectomy is as safe and effective as the open procedure. The overall benefit of laparoscopic appendectomy is more, as it results in less postoperative pain, shorter duration of hospital stays, better wound healing, as well as cosmetic outcome as compared to open procedure. CBMJ 2023 July: Vol. 12 No. 02 P: 157-163

Association of Maternal Serum Magnesium Level with Preterm Labour

Background: Preterm labour is a major health problem in obstetrics. The cause of preterm labour is still unknown. The role of magnesium is also not clear. Recently, involvement of magnesium in physiological and pathological process of labour has been clearly demonstrated. Aims and Objectives: To see the association between maternal scrum magnesium level and preterm labour. Materials and Method: This cross-sectional comparative study was conducted in Department of Obstetrics and Gynecology, Sylhet M.A.G. Osmani Medical College Hospital, between January 2017 and December 2018. Thirty-five pregnant women with preterm labour were selected as case and 35 preterm age and gestational age matched pregnant women without having preterm labour were selected as control group. Serum magnesium concentration was measured. Results: The mean age (25.43 ± 4.62 years versus 24.40 ± 3.99 years; p=0.332) and the gestational age (31.31 ± 1.78 weeks versus 31.34 ± 1.84 weeks; p=0.974) did not differ between preterm labour group and control group. Serum magnesium level (mg/dl) was significantly lower in prelabour group compared to control group (0.90 ± 0.37 versus 1.69 ± 0.33; p&lt;0.001). Conclusion: It is strongly suggested that maternal serum magnesium associated with preterm labor of unknown etiology

Clinical Spectrum of Major Infection in Hospitalized Children with Nephrotic Syndrome at a Tertiary Care Hospital

Background : Children with Nephrotic Syndrome (NS) are exposed to multiple infections resulting in significant morbidity and mortality. Besides being a common cause of mortality, infections may also be responsible for a poor response to steroid therapy or induce relapse in a child with Nephrotic Syndrome.&#x0D; Aims: To assess the clinical spectrum of major infection in hospitalized children with Nephrotic Syndrome.&#x0D; Materials and Methods: This hospital based cross-sectional study was done in the Department of Paediatrics, Sylhet M A G Osmani Medical College Hospital, Sylhet, Bangladesh. In this study, sample size was 44 diagnosed cases of Nephrotic Syndrome with infection. After taking consent, detailed history and thorough physical examination were done in each patient. All data were collected in a preformed questioner and finally collected data were expressed in tabulated form.&#x0D; Results: In our study total 44 children with Nephrotic Syndrome were enrolled with the mean age of 5.98 ± 2.93 years and most of the childhood Nephrotic Syndrome was aged between 2 to 8 years (75.0%); 23 (52.3%) patients were male, and 21 (47.7%) patients were female with a ratio of male to female of 1.1:1. The common clinical symptoms of major infection were fever (79.5%) and cough (70.5%). Other clinical presentations were throat pain (18.2%), abdominal pain (15.9%), runny nose (11.4%), burning micturition (9.1%), respiratory distress (6.8%), vomiting (4.5%) and leg pain (4.5%). Relapse of Nephrotic Syndrome was found in 33 (75.0%) cases. The most common major infection was pneumonia (50.0%), followed by urinary tract infection (20.5%), Upper respiratory tract infection (15.9%), pneumonia with UTI (6.8%), cellulitis (4.5%) and pneumonia with UTI with spontaneous bacterial peritonitis (2.3%). The most common isolated organisms in urine were Escherichia coli (27.3%), followed by Klebsiella pneumoniae (2.3%).&#x0D; Conclusion: The common symptoms of major infection in Nephrotic Syndrome are fever and cough. The most common major infection was pneumonia and urinary tract infection.&#x0D; Northern International Medical College Journal Vol. 12 No.2 Jan 2021, Page 544-547

Giardiasis among Under Five Children Living in Tea Plantation Colony at Sylhet District of Bangladesh

Background: Giardia lamblia infection is still frequently encountered especially in children living in crowded and unhygienic conditions leading to various public health problems. Objective: The purpose of the study was to detect giardiasis among under five children living in tea plantation colony. Methodology: This cross-sectional observational study was conducted in the Department of Microbiology, Sylhet MAG Osmani Medical College, Sylhet during the period from January 2019 to December 2019. For this purpose children were selected according to inclusion and exclusion criteria irrespective of sex. Four tea garden from Sylhet district namely Malnicherra, Lackatoorah, Tarapur and Burjan were selected randomly for sample collection. Stool samples were collected in sterile, disposable, plastic containers with proper labeling without any preservatives. Cyst of Giardia was determined in stool through microscopic examination. Giardia antigen in stool was detected using ELISA kits. Results: Out of 120 cases, Giardia cyst was found positive in 18(15.0%) cases by microscopy. Giardia antigen was found positive in 23(19.17%) cases by ELISA. ELISA showed sensitivity of 94.13% and specificity of 95.0% when compared with microscopy. Giardia infection was highest in male children (20.0%) than female children. The infection rate was higher (24%) among age group of 36 to 59 months. Conclusion: Giardiasis constitutes a major concern in symptomatic children as well as in asymptomatic children because it causes various public health problem. Bangladesh Journal of Infectious Diseases, December 2022;9(2):53-58

On Examination and Radiological Findings of Tubercular and Malignant Pleural Fluid Collected from Patients Presented with Exudative Pleural Effusion

Background: The on examination and radiological findings of tubercular and malignant pleural fluid may vary among patients with exudative pleural effusion. Objective: The purpose of the present study was to assess the on examination and radiological findings of tubercular and malignant pleural fluid collected from patients presented with exudative pleural effusion. Methodology: This cross-sectional study was carried out at medicine indoor department of Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh from October 2009 to March 2010. Patients who were admitted with pleural effusion were selected as the study population. Pleural fluid was collected and laboratory tests were performed in the Department of Laboratory Medicine of the Hospital. The clinical features and haematological findings of tubercular and malignant pleural fluid were assessed. Results: A total of 50 cases were selected consecutively in the study. Among 30 tuberculars pleural effusion, chest movement and expansion decreased in 26 cases. However, in 12 malignant pleural effusion cases, most of the patients’ chest movement and expansion were found diminished which was in 9 cases. Radiological findings showed that more than half (54.0%) of the patients had right sided pleural effusion. Conclusion: In conclusion chest movement and expansion as well as vocal resonance are decreased in both tubercular and malignant pleural effusion patients with absent of breath sound. Journal of Current and Advance Medical Research, July 2022;9(2):74-78

Comparison Between Open and Closed Methods of Establishing Pneumoperitoneum for Laparoscopic Cholecystectomy

Background: The initial phase in laparoscopic surgery, including cholecystectomy, is pneumoperitoneum. There are two widely utilized procedures to produce pneumoperitoneum closed and open techniques. Both have advantages and disadvantages. Aims: Comparing open and closed techniques of creating a pneumoperitoneum for laparoscopic cholecystectomy is the goal. Methods: The Surgery Department of Sylhet MAG Osmani Medical College Hospital conducted this prospective comparative observational study from September 2018 to August 2019. This study comprised a total of 138 hospitalized patients, of whom had symptomatic gallstone disease and required cholecystectomy. The patients were split into two groups; 69 were chosen for the closed approach and were referred to as Group A, while the remaining 69 were chosen for the open method and were referred to as Group B. Results: The average age was 44.88 ±12.61 in Group A and 47.12 ±11.62 in Group B. In groups A and B, the male-to-female ratio was 1:2.3 and 1:1.6, respectively. The difference between the two groups was statistically insignificant (p&gt;0.05). The average access time was 7.43 minutes for Group A and 3.14 minutes for Group B. The average access time was substantially longer in group A (p &lt;0.05). 27 patients (39.1%) in group A and 38 patients (55.1%) in group B had gas leaking. The difference was not statistically significant (p&gt;0.05) between the two groups. 15 (21.7%) patients in group A and 5 (7.2%) patients in group B had extraperitoneal insufflation. Extraperitoneal insufflation in group A was considerably (p&lt;0.05) greater. The average surgery was 81.83± 20.21 minutes for Group A and 53.42± 11.63 minutes for Group B. The mean time frames spent on wound closure in groups A and B were 6.61± 1.49 and 2.55 ±0.8 respectively. The mean duration of the procedure and the mean time to close the wound were considerably (p&lt;0.05) higher in group A. No group had any cases of visceral damage, conversion need, haematoma, seroma, subcutaneous emphysema, gas embolism, or port site hernia. In groups A and B, respectively, one (1.4%) patient each had wound discharge and wound infection. The difference between the two groups was not statistically significant (p&gt;0.05). Conclusion: It was preferable to create pneumoperitoneum openly. Considering access time, operating time, times for wound closure, primary port infection, and haemorrhage.