Osmani Medical College Research Articles

Wichita Psychiatrist Assaulted, Murdered by Patient, Police Say

Wichita Psychiatrist Assaulted, Murdered by Patient, Police Say

Obstructe d Labour: A Life Threatening Complication

Obstructed labour is an important cause of maternal death in developing countries. Obstructed labour also causes significant maternal morbidity mainly due to infection and hemorrhage and foetal death from asphyxia is also common. Objectives are to reduce maternal and newborn complications by early detection and rapid interventions and to reduce maternal and perinatal morbidity and mortality. This Hospital-based prospective cross-sectional study was conducted from June 2013 to June 2014 in Sylhet, MAG Osmani Medical College Hospital. 100 obstructed labour cases were selected those who were admitted in Inpatient department of Obstetrics and Gynaecology, SOMCH. 100 obstructed labour cases were recorded. The majority (80%) were residents of rural areas in which transportation were difficult, the occupation of the women were housewives mostly (90%) and remaining (10%) were tea-garden worker.75% of the obstructed labour cases did not have any ante-natal follow-up. Most of the cases (70%) were visited Osmani Medical College Hospital by their attendant. 70% Visited at 12-24 hours of labour, (80%) came from a distance of 10-50 kilometers. Cepholo-pelvic disproportion was the major cause of obstructed labour (78%) and cesarean section was the main way of delivery (95%). PPH (4%), puerperal sepsis (4%), rupture uterus (2%), VVF (2%), rupture uterus with shock (1%), were the main complications and maternal death (1%). Obstructed labour was the major causes of poor perinatal outcome and perinatal death (7%). This study revealed high incidence of maternal morbidity and perinatal morbidity and mortality.Medicine Today 2017 Vol.29(1): 12-14

A study on prevalence of anaemia and various factors influencing anaemia among adolescent girls in urban and rural field practice areas of Osmania Medical College

Background: Adolescents in India represent over 1/5th (22.3%) of total population. Iron deficiency anaemia is the commonest medical disorder and is a problem of serious public health condition with epidemic proportions. It has significant impact on physical, psychological development, immunity, behaviour, and work performance. The objectives of the study were to determine prevalence of anaemia among adolescent girls and to study the various factors associated with anaemia in urban and rural field practice areas of Osmania Medical CollegeMethods: A total of 760 adolescent girls (380 in each area) were interviewed and examined. BMI was calculated with anthropometric calculator available in WHO anthroplus. Method of haemoglobin estimation is by cyneamethe-heamoglobin. Anaemia was classified based on WHO classification. Results: The prevalence of anaemia was 74.5% and 82.6% in rural and urban area respectively. In rural area, 84 (87.5%) of girls were anaemic who were menstruating more than 7 days and only 31 (45.6%) were anaemic who were menstruating less than 3 days. Majority of married subjects were anaemic in both urban (82.4%) and rural (95.8%) area. Religion did not have significant relation with anaemia. Prevalence of anaemia was more in lower and lower middle class. In the present study majority of thin girls were anaemic in both rural (97.4%) and urban (94.8%) area with significant statistical association. In present study those who were taking meat more than once a week had less percentage of anaemia 38 (36.9). Those respondents who never took green leafy vegetables have more prevalence of anaemia in both areas. All were statistically associated. Conclusions: Anaemia which is a very serious problem in adolescent girls requires urgent action and practicable interventions

Role of Bronchial Brush Cytology in Diagnosis of Central Bronchial Carcinoma

Background : Despite the advances in imaging techniques and treatment modalities, the prognosis of lung cancer remains poor, with five-year survival of 14% at early stages and less than 5% in locally advanced stages. Before starting treatment a clear distinction between small cell and nonsmall cell carcinoma must be made, for that histopathology remains the mainstay of confirmation of diagnosis. To combat the disease successfully, it should be diagnosed at earliest possible stage. If bronchial brush cytology yield comparable diagnostic specificity, then it may easy for the patient and physician to manage this fatal disease.Purpose : The study was designed to evaluate the diagnostic yield of bronchial brush cytology in central (endoscopically visible) bronchial carcinomaSubjects and methods: This cross sectional study was done in the Department of Medicine, and Respiratory Medicine units of Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from July 2012 to June 2014.Thirty seven patients with clinically suspected bronchial carcinoma were enrolled in this study fulfilling the inclusion and exclusion criteria. In all cases bronchial brush cytology and endo-bronchial biopsy were performed and results of both techniques were comparedReasults: The mean age of the patients with bronchial carcinoma was 59.65 (SD 12.95) years; 28 (75.7%) patients were 51 years or above with a ratio of male to female of 17.5:1. The sensitivity of bronchial brush cytology in the diagnosis of central bronchial carcinoma was 89.2% and that of endobronchial biopsy was 67.6%, no true negative cases were detected. Five (13.5%) patients developed respiratory distress and minor bleeding in 4 (10.8%) as a complications of bronchoscopy procedure.Conclusion: The diagnostic yield of bronchial brush cytology is non inferior to than that of endobronchial biopsy in the diagnosis of central bronchial carcinoma.J Bangladesh Coll Phys Surg 2017; 35(2): 68-74

Status of Serum Copper and Zinc in Pre-Eclampsia

Pre-eclampsia is a multisystem and multifactorial disease that affects both mother and fetus by endothelial dysfunction and intrauterine growth retardation. It is thought that pre-eclampsia is associated with an imbalance of increased lipid peroxides and decreased antioxidants. Dietary deficiency or excess of copper, zinc or other micronutrients play important role in the pathogenesis of pre-eclampsia because nutrients can modulate oxidative stress by increasing or decreasing free radicals or antioxidants and providing substrates for formation of free radicals.This study was carried out in the Department of Biochemistry, Sylhet MAG Osmani Medical College during the period from July 2014 to June 2015 to evaluate the status of serum copper and zinc in pre-eclamptic patients. For this study 85 age-matched women were selected and grouped as 30 pre-eclamptic patients, 27 normal pregnant and 28 nonpregnant women. serum copper and zinc level were measured in all study subjects by AAS. Data were analyzed with the help of SPSS version 17.0. Mean (±SD) level of serum copper and zinc were 1.43±0.49 mg/l and 2.43±2.89 mg/l in pre-eclamptics, while in normal pregnant women the levels were 1.51±0.47 mg/l and 2.87±2.23 mg/l and in non-pregnant women these were 0.85±0.28 mg/l and 3.70±2.61 mg/l respectively. Serum copper significantly increased in pre-eclamptics and normal pregnant women when compared with that of non-pregnant women [F (2, 82) =19.763; p<0.001], but there was no significant difference between pre-eclamptic and normal pregnant group. No significant difference of serum zinc among three groups were observed [F (2, 82) =1.774; p=0.176]. The study showed increased trend of serum copper and decreased trend of serum zinc in pregnancy (both preeclampsia and without pre-eclampsia) compared with non-pregnant women, and both were reduced in pre-eclampsia compared to normal pregnancy. As our study did not show any significant difference in copper and zinc level in pre-eclamptics and normal pregnant women hence it can be concluded that there may not be any significant association of serum copper and zinc level with pre-eclampsia.Bangladesh J Med Biochem 2015; 8(2): 49-54

Effect of Egg Consumption on Serum Lipid Profile in Young Adults

Egg is an easily available, inexpensive and a major source of proteins, fats, vitamins and minerals, but its cholesterol content is high (about 200 mg per egg) and it is frequently blamed for atherosclerosis with consequent cardiovascular diseases. Eggs are very popular to young people and parents are always concerned with their daily consumption. The aim of the study was to evaluate the effect of consumption of eggs on serum lipid profile of healthy young adults. It was a prospective comparative study carried out in the Department of Biochemistry, Sylhet MAG Osmani Medical College, during the period from January to December, 2014. Eighty (80) non-diabetic, normotensive healthy young adults of 18-30 years of age were enrolled as study population. Among them 40 randomly selected subjects consumed one egg/day (Intervention group) and 40 subjects did not consume egg for 4 weeks' study period (Control group). Baseline BMI, BP, fasting blood glucose and lipid profile were estimated. After 4 weeks, lipid profile was estimated in each group. Informed written consent was taken from each participant. Permission was taken from Ethical Committee of the Institute. Data were analyzed by SPSS. Chi-square test, unpaired and paired 't' test were done. In the intervention group, serum total cholesterol (TC) and LDL cholesterol (LDL-C) significantly decreased at the end of 4th week, but serum HDL cholesterol (HDL-C) and serum triglyceride (TG) did not differ significantly from baseline. In control group, serum HDL-C significantly decreased at the end of 4th week but serum TC, LDL-C and TG did not differ significantly. It may be concluded that daily consumption of one egg does not unfavorably influence on lipid profile in young adults. Further studies with larger sample size with and without risk factors may be conducted on middle and old age subjects.Bangladesh J Med Biochem 2015; 8(1): 05-09

Etiologies and posttreatment conditions of thyrotoxic patients in Sylhet division, Bangladesh: A clinical series.

Objective:The endeavor of the study was to analyze the posttreatment (postradioactive iodine therapy [RAI]) conditions of thyrotoxic patients in a tertiary level hospital.Materials and Methods:A retrospective study of 186 patients was conducted from 2012 to 2014 in Institute of Nuclear Medicine and Allied Sciences (INMAS), Sylhet MAG Osmani Medical College Campus. Patients' information regarding the etiologies and their disease status after getting RAI therapy was recorded.Results:In this study, 29.57% patients were male and 70.43% were female where the mean ages were 44.57 and 43.46 accordingly. The most vulnerable group was in between 41 and 50 years of age, which is 25.81%. The patients were categorized according to the etiologies as Graves' disease (GD), multinodular goiter (MNG), and single toxic nodule (STN). In primary stage, 60.22% patients had GD, 26.88% had MNG, and 12.90% had STN. After 6 months of RAI therapy, the disease status of 51.61% patients became euthyroid, 19.35% became hypothyroid, and 29.03% remained thyrotoxic. Thus, a second dose of RAI therapy was given to those patients for next 6 months. After 12 months from the beginning of the therapy of each patient, the total recovery was found to be 72.04%. However, though all the GD patients improved to either euthyroid or hypothyroid state after 6 months, on a 12-month observation, 17.86% of them regained the thyrotoxicosis due to discontinuation of the treatment.Conclusion:The findings show an overall significant recovery of thyrotoxic patients taking RAI therapy in INMAS and important points to improve the rate.

Obstetrical Outcome of Grand Multipara

Intruduction: Pregnancy in grand multipara has been considered as high risk because there are higher chance of complication during pregnancy, labour and puerperium.Objective: To evaluate various maternal and fetal complication associated with a grand multipara during pregnancy, delivery and puerperium.Methods: This prospective study was carried out from 1st January 2008 to 31st December 2008 in Obstetrics & Gynecology Department of Sylhet MAG Osmani Medical College & Hospital, Sylhet. 300 grand multipara pregnant patients were selected those who got admitted in Department of Obstetrics & Gynecology, SOMCH during that period.Result: It was found that incidence of grand multipara was 6.60%. Majority of the patient were between 31–35 years old (43%). 66% patients never had anternal checkup, Caesarean section was high about 47%. Complications during labour were also high. It was about 51.67%. Maternal morbidity was about 16%. Perinatal mortality was about 11%.Conclusion: This study showed that grand multipara is a major risk for obstetrical outcome and needs strick supervision and good antenatal, intranatal and postnatal care.J Bangladesh Coll Phys Surg 2016; 34(4): 184-187

Glycemic Status and its Effect in Neonatal Sepsis in a Tertiary Care Hospital

Introduction: Neonatal sepsis can alter the glucose level and both hypoglycemia and hyperglycemia may occur. A high or low blood glucose level may have a significant effect on the outcomes in patients of neonatal sepsis.Objective: To see the glycemic status and its effect on outcome of neonatal sepsis.Methods: This prospective observational study was done in the department of paediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet from July 2013 to December 2013. Clinically suspected neonatal sepsis cases were enrolled in the study. Venous blood was collected before giving any intravenous fluid or antibiotics for blood sugar, full blood counts, CRP levels and blood culture and send to labouratory within half hour of collection. All patients included in this study were treated accordingly and followed up strictly. Blood glucose level and mortality of neonates having hypoglycemia and hyperglycemia were analyzed among CRP and culture positive patients. Quantitative data were expressed as mean and standard deviation. Qualitative data were expressed as frequency and percentage and comparison carried by Chisquare (÷2) test.Results: A total of 62 patients clinically diagnosed as neonatal sepsis were studied. Fifty two (83.9%) patients were found CRP positive and 21(33.9%) patients were blood culture positive. Glycemic status was analyzed among CRP and culture positive patients. Majority (71.2%) patients were found normoglycemic, 13.5% were found hypoglycemic and 15.3% were found hyperglycemic in this study. Fifty one (82.2%) patients were cured and 9(17.8%) were died. Mortality was high in hypoglycaemic patients (42.8%) compare with normoglycaemic patients (10.8%), but the difference was not statistically significant (p>0.05) between two groups whereas mortality was also high in hyperglycaemic patients (50%) compare with normoglycaemic patients (10.8%) and the difference was statistically significant (p<0.05) between two groups.Conclusion: Alteration of glycemic status occurred in septic newborn. Mortality is higher among the septic newborn with hyperglycemia.Bangladesh J Child Health 2016; VOL 40 (1) :21-25

Macroscopic Study of the Isthmus of the Thyroid Gland in Bangladeshi People: A Postmortem Study

Background: The position and size of isthmus of thyroid gland varies considerably in human with age, sex, physiologic state, race and geographical location and sometimes the isthmus may be absent. So this study was designed to find out the macroscopic differences in isthmus of thyroid gland of different age and sex groups in Bangladeshi people.Objective: To record the macroscopic characteristics of isthmus of thyroid gland with advancing age in both sexes with a view to help establishing normal standard of Bangladeshi people.Materials and Methods: This descriptive cross-sectional study was carried out on 54 autopsied human thyroid glands aged 5 to 65 years. Thyroid glands were collected from unclaimed dead bodies autopsied in the morgue of Sylhet M. A. G. Osmani Medical College, Sylhet. The collected specimens were divided into groups –– A (20 years and below), B (21 to 50 years) and C (50 years and above). All specimens were examined morphologically by careful gross dissection method.Results: The isthmus was absent in 5.56% cases. In most of the cases (35.29%) it was against the 1st–4th tracheal rings. There was significant difference in length between Group A and Group C (p<0.05) and in breadth between Group A and Group C and between Group B and Group C (p<0.05). No significant difference was found in length, breadth and thickness of isthmus of the thyroid gland between males and females.Conclusion: The presence or absence, positional change and variation in gross dimension of isthmus of thyroid gland were evident in human. The macroscopic difference was found with increasing age but not with sex.J Enam Med Col 2017; 7(1): 15-19

Cranio-cerebral Trauma

As head is the most prominent exposed part of human body by virtue of its Situation, it bears the brunt of violence namely accidents, suicidal and homicides. The diagnosis of the exact lesion due to trauma is a difficulty even to the neuro-physician. The treatment is an enigma to Neuro-surgeon. And the evaluation of mechanism is a puzzle to the medico-legal expert. the present study conducted in 200 cases in the department of forensic medicine, Osmania Medical College, Hyderabad. During the period of June 2009 to the end of May 2012. Number of cranio cerebral trauma case are more in male especially in the age group of 21–30 years.this trauma is mainly due to RTA. 46% cases have fissured fracture and 51% cases have subdural haemorrhage.

Comprehensive Study of Suicidal Deaths due to Insecticidal Poisons in Females

Suicide is nothing but self-killing which is a growing problem in developing as well as developed countries. Developing countries are suffering with suicide by agricultural poison whereas in developed countries it is by drugs. To analyze the situation of suicides by insecticide in females the present study is conducted in Hyderabad in department of forensic medicine, osmania medical college, hyderabad. 25 female cases of suicide by insecticides are observed. In this most of the deaths are in the age group of 21–30 years with health related problems. 80% of female are committed suicide by consuming organophospharus compounds in this study.

Management of Eclampsia and Imminent Eclampsia, Maternal and Perinatal Outcome in 666 Cases—2003-2007 at Government Maternity Hospital in Hyderabad

Objective: This is an audit to evaluate the maternal and perinatal outcome in eclampsia and imminent eclampsia with the management adopted at a tertiary hospital. Methods: During a period of 34 months, from 2003-2007 at Government maternity hospital, Osmania medical college, Hyderabad, 666 women with eclampsia and imminent eclampsia were managed. The number of eclampsia and imminent eclampsia (IE) was 532 and 134, respectively. We have analyzed the clinical profile, parity, age, degree of proteinuria, the period of gestation in weeks, the antenatal care, the number of antenatal visits, referrals from other hospitals, the diastolic B.P. at the time of admission, the recurrence of convulsions and the complications. 1) All the cases of eclampsia and IE were managed with magnesium sulphate as an anticonvulsant. 2) Oral nifedipine, IV labetalol, sublingual nifedipine and nitroglycerine infusion were used to control severe hypertension. 3) Prostaglandin E1 (PGE1) was used for induction of labour (IOL), 25 mcg × 4th hrly, vaginal route and 50 mcg for less than 28 weeks gestation, in 290/424 cases of IOL. Other methods of IOL were employed in 134 cases. Results: Eclampsia (n = 532) occurred antepartum in 407 (75.56%), intrapartum in 76 (14.28%), post partum in 46 (8.64%) and intercurrent in 3 (0.5%) patients. The period of gestation was 34 weeks in 340 patients. Induction of labour with misoprostol was done in 290 with vaginal delivery in 235 (81%) and lower segment caesarean section (LSCS) for failed IOL in 55 (19%) and other methods of IOL were used in 134. The total number of deliveries was 656, with vaginal deliveries in 336 (66.46%) patients, ceasarean deliveries in 220 (33.54%) patients. Ten patients died undelivered. Maternal mortality was 17/666—2.55%. Cerebrovascular events were responsible in 13/17 (76.46%) patients, pulmonary embolisim in 2, aspiration pneumonia in one and sepsis in one. The perinatal mortality was 167/582 (28.69%), PNM when birth weight was >1.5 kg was 59/426 (13.84%), intrauterine fetal deaths at admission were 54 (8.5%), there were four sets of twins. Conclusions: 1) More effective measures to control hypertension and routine administration of anticonvulsant, magnesium sulphate to women with eclampsia should be practised from the first referral unit itself. 2) Our caesarean delivery rate of 33.54% in the very high risk cases of eclampsia and imminent eclampsia is very low compared to others. 3) Induction of labour with misoprostol was successful in 81% with consequent reduction in caesarean section rate and morbidity and mortality associated with caesarean deliveries. Misoprostol has proved to be a safe and effective inducing agent in eclampsia. 4) The maternal mortality in our series is 2.55%.

Role of Parental Smoking in Severe Bronchiolitis: A Hospital Based Case-Control Study.

Objective. Bronchiolitis is one of the commonest causes of hospitalization of infants and young children in Bangladesh. About 21% of under 5 children attending different hospitals of Bangladesh have bronchiolitis. Fifty percent (50%) men and three percent (3%) women of Bangladesh are smokers. Parental smoking is an important risk factor for both susceptibility and severity of bronchiolitis. The aim of this study was to find out the role of parental smoking in severe bronchiolitis. Design. Case-control study. Place and Duration of Study. The study was conducted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Bangladesh, from July 2013 to December 2015. Patients and Methods. Sixty-four patients admitted into the ward with severe bronchiolitis were enrolled as cases and sixty-four suitably matched apparently healthy children attending EPI centre and outpatient department presenting with nonrespiratory illness were enrolled as controls. Sample size was calculated using Guilford and Frucher formula. The technique was systematic random sampling. Every second case satisfying the inclusion and exclusion criteria was enrolled in the study. Results. The mean age of the patients was 7.53 (SD ± 4.75) months. Forty (62.5%) patients were male and twenty four (37.5%) patients were female. Male-to-female ratio was 1.7 : 1. Most of the cases (60.95%) came from low socioeconomic background. More than half of the cases (53.13%) were not exclusively breastfed babies. Mean length of hospital stay was 6.41 (SD ± 2.82) days. Thirty eight (59%) cases and twenty six (34%) controls were exposed to parental smoking. Result was highly significant (p = 0.005). Odds ratio was 2.8 (95% CI from 1.36 to 5.72). Conclusion. Exposure to parental smoking causes a statistically significant (p = 0.005, odds ratio = 2.8) increase in the risk of developing severe bronchiolitis in the first year of life.

Role of Single Dose Preoperative Ceftriaxone in the Control of Surgical Site Infection in a Tertiary Level Hospital

Post-surgical wou infection is a crucial factor in surgical practice. Prolong use of postoperative antibiotic is common practice in our surgical world. This causes financial burden to our patients a antibiotic resistance. But international journals a literatures suggest using antibiotics as prophylaxis only at the time of operation a no further postoperative antibiotic is needed in clean contaminated surgery. This comparative cross-sectional study was done at the department of surgery, Sylhet MAG Osmani Medical College Hospital from 1st July 2007 to 30th June 2008. A total number of 100 patients of clean-contaminated elective laparotomy were selected. Patients were ra omly divided into two groups, in Group-I (got single dose preoperative Inj. Ceftriaxone) a in group-II (got single dose preoperative Inj. Ceftriaxone followed by Inj. Ceftriaxone for 2 days a then Cap. Cefxime for next 5 days). There is no statistically significant difference in outcome between two groups. So, single dose preoperative Inj. Ceftriaxone (1gm) is sufficient as a prophylaxis of surgical site infection in clean-contaminated elective surgery.Faridpur Med. Coll. J. Jan 2016;11(1): 6-10

Hypocalcaemic Tetany After Total Thyroidectomy

Hypocalcaemic tetany is one the commonest complication after total thyroidectomy. It may cause significant morbidity. Early detection and treatment have better out come. The main objective of the study is to find the incidence of hypcalcaemic tetany in post operative period after total thyroidectomy and average interval period of hypocalcaemia following surgery. This was an observational study conducted in the department of Otolaryngology & head-Neck Surgery Sylhet M.A.G. Osmani Medical College Hospital during 1st January 2006 to 31st December 2007. Pre-operative routine investigation, Thyroid Function test, Ultrasonography thyroid gland and cytological evaluation by FNAC were done in all patients. Ten patient developed hypocalcaemia after surgery. Among them only one suffered from permanent hypocalcaemia. Most of the patient developed symptoms about 48 hours after surgery. The Incidence and time interval of development of hypocalcaemic tetany after total thyroidectomy found in the series fully coincides with the results of other researchers globally.Faridpur Med. Coll. J. Jul 2015;10(2): 59-62

Clinical Study of Cardiac Tumors - Myxoma in a Government Tertiary Hospital

Cardiac tumors are assumed to be a rare entity. Metastases to the heart are more frequent than primary lesions. Retrospective study was carried out in Department of C.T.Surgery, Osmania Medical College/ Osmania General Hospital Hyderabad from January 1 st 2004 –December 31 st 2012, based on the available hospital records. Distribution of cardiac myxomas per age, showing a peak of incidence in people 45–60 years of age.

Evaluation of Tutorials As A Teaching Learning Method In Pharmacology for 2nd Year MBBS Students

Background:-The students are in the best position to comment on the effectiveness of any teaching system and they may be regarded as the best judges to assess the teaching and evaluation methods. The aim of this study was to elicit the perception and feedback regarding tutorials as teaching learning method in pharmacology along with their excellence in university examination. Methods:-This cross sectional study was carried out by the department of pharmacology at osmania medical college , Hyderabad, Telangana, India. A total of 126 third year MBBS students who have appeared for second professional MBBS degree examination in February, 2016 participated in the study. Students were interviewed with a structured questionnaire on tutorials. Analysis was done on percentage wise distribution of various parameters used in the questionnaire. Results:- Out of 126 students, 102 students completed questionnaire were included in the study. 97% of students agreed to have tutorials. 94% of students responded that tutorials helped them in understanding the topic better. 43students have scored 75-85% marks in pharmacology, 56students have scored 65-74% marks and 3 students scored less than 64%. Conclusion:-With ever increasing strength of students in the MBBS classes a single lecturer may not able to convey the content of the topic to all the students in an impressive way. So in order to impress up on the students the importance in clinical correlation of pharmacology, it is better to conduct tutorials so that it becomes more an interactive session.

Efficacy of Probiotics Versus Placebo in the Prevention of Necrotizing Enterocolitis in Preterm Very Low Birth Weight Infants: A Double-Blind Randomized Controlled Trial.

To evaluate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis (NEC) in preterm very low birth weight (VLBW) infants. Arandomized double blind controlled trial. The Paediatrics Department of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet Bangladesh, from July 2012 to June 2015. Preterm (28 - 33 weeks gestation) VLBW (birth weight 1000 - 1499 g) neonates were enrolled. The study group was fed with probiotics once daily with breast milk from first feeding, and the control group with only breast milk without the addition of probiotics. Both the groups received other standard care. The primary outcome was the development of NEC (stage II and III), categorized by modified Bell's classification. In 108 neonates, development of NEC was significantly lower in the study group than that of control group [1 (1.9%) vs. 6 (11.5%); p=0.044]. Age of achievement of full oral feeding was significantly earlier in the study group than that in the control group (14.88 ±3.15 and 18.80 ±4.32 days; p < 0.001). Duration of hospital stay was significantly short in the study group compared to the control group (15.82 ±2.94 days vs. 19.57 ±4.26 days; p < 0.001). Probiotic supplementation reduces the frequency of necrotising enterocolitis in preterm neonates with very low birth weight. It is also associated with faster achievement of full oral feeding and short duration of hospital stay.

Frequency of ischemic heart disease within metabolic syndrome

Background: The common clustering of glucose intolerance, abdominal adiposity, high triglyceride level, low high­density lipoprotein cholesterol level and high blood pressure in a single individual is referred to as Metabolic Syndrome (MS) and it is associated with ischaemic heart disease (IHD). Objectives: To find out the relationship between MS and lHD. Design: Cross sectional observational study. Materials: 100 subjects were selected following simple random sampling technique. 50 patients of MS and another 50 non MS were enrolled as case and controlled respectively in the department of medicine and cardiology at Sylhet M.A. G. Osmani medical college hospital. Results: Proportion of IHD was found to be high among the MS (40%) compared to non MS (16%) and the difference was statistically significant (p=0.008) indicating there is a relationship between MS and lliD. Among the components of MS proportion of hyperten­sion (39.2%), diabetes mellitus (41.9%), dyslipidernia (42.6%) and family history of cardiovascular disease (47.1 %) had significant higher association with patients with IHD (p&lt;0.05). Conclusion: The MS has a significant association with IHD by electrocardiogram criteria.