Shaheed Suhrawardy Medical College Research Articles

Assessment of knowledge and skill of health care providers in management of child abuse in different level hospital in Bangladesh

Challenges to the health of our children have been changing in recent decades as we have taken control over different diseases through immunization and child health program . But newer problems are uncovered. Child Abuse and Neglect is one of them . World community has given emphasis on this very old but unnoticed problem ,this problem is received very less emphasis in South East Asia. With the objectives -to assess the knowledge and skill of working doctors and nurses of concern department in managing child abuse and to help the service providers to improve their knowledge and skill to deal with child abuse and to identify the laps and gaps in the area where abused children are dealt with, this study was carried out in two Medical College Hospitals, two District Hospitals and two Upazilla Health Complexes from November 2005 to July 2006. Selected departments for study were - Obstetrics & Gynaecology, Paediatrics, Orthopaedics. Burn, Casualty, Psychiatry and OCC, (DMCH) in Medical College level; Obstetrics & Gynaecology, Paediatrics, Surgery in district level and all from Upazilla level. Working doctors of all level and senior staff nurses were included in this study. Assessment of knowledge and skill was done before and after intervention by observation and face to face interview by using a pre tested prepared questionairre .Laps and gaps were identified by observation and interview. Intervention was given by a one day workshop in each level of hospital . About 155 care providers participated in pre and post intervention interview . Of them- 109 were doctor and 46 were nurses. Among them 71 (Doc. 55 + Nurse 16) from two Medical College Hospitals, 42 (Doc. 33 + Nurse 9) from two District Hospitals & 42 (Doc. 21 + Nurse 21) from 2 Upazilla Health Complexes . It was surprising that only 11 % health care provides correctly knows that who are the children , only 10 % providers knows about the different types of abuse and only 15 % providers believe that they have sufficient knowledge to manage an abused child. Knowledge level is much higher among the doctors working in teaching hospitals and poorest in UHC. Nurses are less knowledgeable than doctors . Score of nurses is more or less similar in all level of hospitals. The pre and post intervention changes were analyzed by using unpaired student's t test and p value was significant .On job training of care providers on management of abused child is very important and inclusion of this issue in medical and nursing curricula is necessary. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12166 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.2-5

Bacteriological profiles of Blood culture isolates by BacT/ALERT 3D automated system

Automated sensor based blood culture system is superior to traditional two steps or biphasic methods regarding time of isolation and avoiding contamination. The present study documented various aspects of blood culture isolates done in a well set automated system (BacT/ALERT 3D, BIOMERIUX, USA) at Dhaka city. As per monthly distribution of samples, number of samples showed increased trend from March and declining trend in November with peak in July, August, September and October. Average detection time was found as 20 hours. Among the bacterial pathogens isolated, Salmonella typhi was the most common (66.62%) followed by Salmonella paratyphi (S. paratyphi A & B 22.21%). Antibiotic susceptibility patterns (%) of the isolated organisms are shown in Table - VI. The results are not much divergent in respect of particular pathogens. The mostly focused results of common blood culture pathogen Salmonella typhi and Salmonella paratyphi show sensitivity pattern of over 95% towards Amoxyclav (98.0% & 99.36%), Aztreonam, Amikacin, Cefaclor, Cefixim, Cettazidime, Ceftriaxone, Cephalexine and Ciprofloxacin. Almost all the strains were found resistant towards Azithromycin. No satisfactory sensitivity was obtained towards Cotrimoxazole, Gentamicin, Mecillinam and Nalidixic acid. Gram negative bacteria including Escherichia coli as blood culture isolates were resistant towards used panel of antibiotics except Ciprofloxacin, Cotrimoxazole, Gentamicin and Mecillinam. Over 90% strains showed resistant towards Amoxycillin and Azithromycin. The study established that blood culture reports with positive growth and antimicrobial susceptibility can be generated within maximum of 72 hours by automated culture system. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12162 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.21-26

The Employer-Employee and Teacher-Student Communication

DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12165 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.1

Management of congential muscular toticollis under one year of age

Background and study aim: Torticollis is the postural deformity of head and neck. Congenital Muscular Torticollis (CMT) is a postural deformity of head and neck detected at birth or shortly after birth, primarily resulting from unilateral shortening of Sternocleidomastoid muscle (SCM), In neonates and infants, patient may cure conservatively by physiotherapy but surgery is the treatment of choice for children and adolescents. Here we show our experience regarding management of congenital muscular torticollis with physiotherapy. Patients and Methods: This is an observational descriptive study. Verbal consent from parents was taken. Patients of congenital muscular torticollis with other disease or other congenital anomaly were excluded from study. Twenty patients of congenital muscular torticollis were treated. The cases were enrolled between Nov' 2005 to Oct' 2008 in Bangabandhu Sheikh Mujib Medical University, Gonosasthaya Somaj Vittik Medical College Hospital, ZH Sikder Women's Medical College Hospital, Shaheed Shurawardy Medical College Hospital. Neonates and infants were treated conservatively with physiotherapy and non responsive cases were referred for surgery. Results: Patients age range from 5 days to 1 year of which eleven were females and nine were males. Sternocleidomastoid muscle (SCM) was shortened in all cases (12 on right side and 8 on left side). Of 20 patients 6 neonates, rest 14 infants within 1 year age. Out of 20 neonates and infants 17 were cured conservatively with physiotherapy and rest 3 were referred for surgery. Conclusion: Most of the patient of congenital muscular torticollis can be treated conservatively during infancy. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12157 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.2-5

Repair of incisional hernias - Experience with a combined fascial and prosthetic mesh repair

Repairs of incisional (ventral) hernia is one of the commonly performed operation in Bangladesh. This is a prospective study conducted in Shaheed Suhrawardy Hospital, Dhaka and a private Hospital (BDM Hospital) at Dhaka city from June 2001 to 31st May 2004 with a total period of 3 years and with total patients 43. Incisional hernias develop in upto 11% of surgical abdominal wounds with a possible recurrence, following repairs of 44%. There are several methods of repair of incisional hernias, including laparoscopic method of repair which is gaining popularity day by day. But we describe our experience with a combined fascial and prosthetic mesh repair. Of total 43 patients treated, 27 were female & 16 were male. The original operation was gynaecological in 27, bowel related surgery in 15 cases & biliary surgery in 4 patients. The incisions were midline in 31 patients, transverse in 10 patients and paramedian in 2 patients. The hernias were considered subjectively to be large in 21, medium in 16 and small in 6 patients. A parameter was compiled for each patient, noting intraoperative and post postoperative complications , post operative hospital stay and analgesic requirements. Post operative complications included seroma formation in 6 patients. One patient developed wound infection and require removal of the mesh 10 Control infection. Post operative hospital stay ranged from 2 to 17 days. Of total 43 patients 36 were available for follow- up. Seven drops from follow up. Follow up was from 6 months to 36 months. One (2.5%) of these patients complained of persistent lump and one reported persistent pain. Hernia recurrence in one patient (2.5%) , 35 was found to have no recurrence. We advocate these technique because it is applicable to all hernias,most of the mesh is behind the rectus sheath and has two points of fixation, it is relatively pain free allowing early mobilization has a less complication rate and low recurrence rate.DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12158 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.6-9

Millennium Developmental Goal and Child Survival: Bangladesh perspective

In September 2000, meeting at the United Nation (UN) Millennium summit, the world's leaders agreed to remarkable document, the Millennium Declaration1,2,3. The Millennium Developmental Goals (MDGs) agenda were adopted by the world leaders reaffirmed their share duty to "All the world's people, especially the most vulnerable and in particular, the children of the world, to whom the future belongs." They subsequently pledged to set a specific goals, the MDGs, that focus their collective efforts in the coming year as they undertake the challenges of poverty reduction and sustainable development1,4 DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12170 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.18-21

Breakthroughs and Issues in HPV Genital Infections in relation to Cervical Cancer

The field of cervical cancer prevention is rapidly evolving because of identification of the cause of disease. Human Papilloma Virus (HPV) has been recognized as a necessary cause of cervical cancer, and the association applies equally to both squamous cell and adenocarcinoma and is consistent worldwide. HPV 16 and 18 together attribute 70% of world's cervical cancer. HPV is highly prevalent among sexually active women and traceable in its natural history with technology that can detect HPV DMA at all stages of infection and neoplastic process. HPV DMA testing represents the scientifically obvious next step after Pap test for secondary prevention. A clinically validated and FDA approved HPV test has proven a substantial gain in sensitivity with a limited loss in speciality as compared to the standard Pap smear. We are now in the fortunate position of having two highly promising HPV vaccines in the pipeline. These vaccines today represent new hope for protection against cervical cancer, pre-cancerous cervical lesions and other HPV related condition for the current generation of adolescents, for the young and middle aged women as well as for the future generations. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12163 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.27-30

Indications of Caesarean Section - Study of 100 cases in Mymensingh Medical College Hospital

This study was a prospective descriptive one. It was done in MMCH from January 1996 to march 1996. A total of 714 deliveries occurred of which 225 deliveries by Caeserean section, incidence of LSCS was 30.36%. The commonest age group of patients being operated ranged from 20 - 30 yrs (77%). Most of the patients who had undergone LSCS were multigravida (45%). The section were due to various indications, the commonest cause in this study was previous caesarean section, foetal distress and obstructed labour. The rate of primary section was more (84%) while repeat section being 16%. The peak range of operations were done in patients with 5 feet 2 inches height. The rate of elective operation was 37% . where emergency operations were done in 63% of cases. Regarding foetal outcome. 92% survived and 8% had perinatal death. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12167 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.6-10

Maternal and Foetal Outcome of Eclampsia in Mymensingh Medical College Hospital

This prospective cross-sectional study is undertaken to evaluate the maternal and foetal outcome of patients admitted in Mymensingh Medical College Hospital from November 2002 to April 2003. Among 5175 obstetric patients admitted to the hospital, 212 were eclamptic, yielding an incidence of 4.1%. The antepartum, intrapartum and postpartum incidences of eclampsia were 50%, 26.5% and 23.5% respectively. Among the patients with eclampsia, 56.85% had good prognosis without any added complication and 45.85% had complications. The case fatality rate of eclampsia was 5%, which was lower than that of the previous studies. In this study out of 200 patients, foetal death was 23.98%. Changing the ante convulsant from diazepam to magnesium sulfate the incidence of death in eclampsia patients have significantly reduced. But reduction of the risk of death was difficult when patients had developed complications. Most of the patient who died was in complicated group, these complications developed as a result of a delayed treatment. Therefore, efforts should be directed at developing awareness to receive treatment at an appropriate time to reduce the mortality from eclampsia and its complications. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12169 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.14-17

Effective Under graduate Medical Curriculum -A prerequisite for production of Quality Doctor

DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12156Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.1

Embryonal Rhabdomyosarcoma of Adult Hypopharynx

Adult rhabdomyosarcoma in the head & neck is extremely rare & carries a poor prognosis. They should be considered as a distinct clinical entity. The authors report a case of embryonal rhabdomyosarcoma in an adult female in Hypopharynx treated with chemo-radiotherapy & surgical excision., The patient responded to treatment & 7 yrs later she is still alive with no signs of metastatic disease. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12171 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.22-24

Transvaginal ultrasonography is the diagnostic method for evaluation of abnormal uterine bleeding

Objective: The objective of this study is to assess the utility of transvaginal ultrasonography in patients presenting abnormal uterine bleeding Materials and methods: Between July 2000 to December 2000, 50 patients underwent transvaginal sonography (TVS) for abnormal uterine bleeding. All patients had transvaginal sonography before histopathology. On TVS, the sonographic appearance of the endometrium was classified according to the following parameters: normal or abnormal thickness, homogeneous or heterogeneous echogenicity, bulbous contour, discontinuous, or obscured. A comparison was performed between TVS with histopathology. Results: The most common causes for the abnormal uterine bleeding were leiomyoma in TVS (42.0%). Other causes were dysfunctional uterine bleeding (28.0%). adenomyosis (6.0%), endometrial polyp (4.0%), thin atrophic endometrium (8.0%), endometrial hyperplasia (8.0%), and endometrial carcinoma (4.0%). After histopathologic evaluation 40.0% patients had leiomyoma, 24.0% DUB, 10.0% adenomyosis, 8.0% endometrial polyp, 8.0% thin atrophic endometrium, 6.0% endometrial carcinoma and 4.0% endometrial hyperplasia. Comparing the TVS with histopathologic findings, TVS had a sensitivity of 94.3%, specificity of 80.0%. accuracy of 90.0%, PPV of 91.6% and NPV of 85.7%. Conclusion: TVS is an easy, safe, rapid and tolerable procedure. It has an excellent diagnostic accuracy in the diagnosis of uterine pathology responsible for abnormal uterine bleeding. Abbreviation: TVS transvaginal sonography; AUB abnormal uterine bleeding; DUB dysfunctional uterine bleeding, PPV positive predictive value, NPV Negative predictive value. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12168 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.11-13

Big placenta and anaemia in pregnancy

Background: Birthing process is the journey of the spirit/ soul. The Placenta is the home for this spirit/ soul for nine months. Placenta has a huge role to play throughout the pregnancy acting as the kidneys, lungs and intestines all in one1. Placenta is an organ that is essential to the survival and growth of the fetus of the mammals. Anaemia in pregnancy is common and one of the risk factors in pregnancy. Maternal anaemia result in fetal hypoxemia and also stimulates placental growth. In anaemia, significant changes both in gross morphology and in histology of the placenta can occur. Type of study: Descriptive. Place of study: Department of Anatomy, Dhaka Medical College, Dhaka. Study period: July 2005 to June 2006. Methods: Sixty (60) placentas of Bangladeshi pregnant women were studied. Out of 60 placentas, anaemic and control group were 40 and 20 respectively. The study was designed to determine, morphological changes of placenta which is influenced by maternal anaemia. Macroscopic dimension of the placenta were measured with observation and dissection method. The samples were divided into group A (control), group B1 (mild anaemia), group B2 (moderate anaemia) and group B3 (severe anaemia). The severe group was not found in present study. Result: In anaemia, placental diameters, surface area and thickness were increased. Conclusion: There were morphological changes of the placenta in association with maternal anaemia. However, comprehensive work considering the physiological, biochemical, genetic as well as further gross, light, electron microscopic and morphometric placental studies are needed in order to support the findings of present study. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12161 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.17-20

Effect of cigarette smoking on HDL-C in adolescent

Objective: A case control study was carried out in the Department of Physiology in Dhaka Medical College during the period of January 2005 to December 2005 to evaluate the effect of smoking on serum HDL-C in adolescent male smokers. Method: Total 80 male subjects with age range 12-19 years were included in this study, out of them 60 were case and remaining 20 were age matched healthy nonsmoker control. Cases were divided into three subgroups on the basis of consumption of sticks per week [mild (Group-l) 1-19, moderate (Group-ll) 20 - 59 and heavy [(Group-Ill) 60)]. Serum HDL-C was measured and compared between case and control and among the subgroups of case. Unpaired-t test & Bonferroni test were done to determine the significance level between the groups and among the subgroups respectively. Pearson's correlation test was performed to determine correlation coefficient and level of significance in case regarding serum HDL-C with number of stick consumption. Result: Mean ± SD HDL-C level was 31.72±8.99 mg/dL & 55.60±6.81 mg/dL in case & control respectively. Serum HDL-C was significantly lower (p<0.001) in case than control. Mean ± SD HDL-C level in the subgroups were 33.95±8.77 mg/dl, 31.50±8.22 & 29.70±9.84. But no statistically significant difference was observed among the subgroups. Negative correlation was observed between serum HDL-C with number of stick consumption. Conclusion: From the study it can be concluded that cigarette smoking in adolescent is associated with low level of cardio protective lipoprotein HDL-C and low trend is related with increased consumption of cigarette, which might lead to occurrence of several coronary artery diseases. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12160 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.14-16

Outcome of Teenage Pregnancy Associated with Medical Conditions

Objective: This study was carried out to evaluate the Maternal and fetal outcome of teenage Pregnancy with different medical conditions during Pregnancy in the selected high risk hospital population of Bangladesh. Methods: This was a cross sectional study. The study was done on 50 (fifty) teenage pregnant adolescent admitted in the Dhaka medical college Hospital and Bangabandhu sheikh Mujib Medical University Hospital during the study period July 2004 to June 2005. Samples were selected randomly from the admitted patients. Results: Seventy five percent of the mother had complication during delivery, of them 21.42% had PPH, 14.28% had inadequate lactation, 10.71% had post partum eclampsia, another 10.71% had wound dehiscence, 7.14% had post spinal headache. Eighty four percent of the babies were alive, of them Forty percent required resuscitation. Ten percent were dead and 6% were still born. Fourty eight percent of the new born had birth weight less than 2.5 kg, 32% had more than 2.5kg. APGAR score at one minute varied between 5-7 in 75% of cases and was 8-9 in 22.5%. Only 2% has <5. APGAR score at five minutes varied between 8-9 in 92.5% of cases. 40% of the babies developed jaundice, 30% babies were birth asphyxiated, IUGR 8%, prematurely 6%, congenital anomalies 4%.Conclusion: Outcome of teenage pregnancy with medical conditions is poor. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12159 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.10-13

Outcome of Dapsone in the Treatment of Ashy Dermatosis

Background: Ashy dermatosis or Erythema Dyschromicum Perstans is a rare disorder of unknown etiology characterized by asymptomatic,slowly progressive, ashen-gray macular pigmentation of the skin. Various therapies have been tried without any benefit. The anti-inflammatory activity of dapsone on Erythema Dyschromicum Perstans may be the first oral treatment option. Objective: The aim of the present study was to evaluate the efficacy of dapsone in the treatment of ashy dermatosis. Methodology: This study was carried out on total thirty (30) cases having ashy dermatosis & age group 20-60 years were selected for the study of which 16 females & 14 males during the period of January 2010 to December 2011 in the Department of Dermatology & Venereology of Shaheed Suhrawardy Medical College Hospital and Bangabandhu Sheikh Mujib Medical University at Dhaka city of Bangladesh. All the cases were diagnosed clinically & confirmed by histopathological examination. The patients were given Dapsone 100 mg daily for three months & follow up was done for the next 3 months. Results: 16(53.33%) females & 14(46.66%) males were included in the study. Out of thirty patients, two patients (6.66%) shown excellent response, seven patients (23.33%) shown good response, eight (26.66%) patients shown fair response, 8 patients (26.66%) shown poor response & remaining five patients (16.66%) did not show any response clinically. So improvement was shown in 25(83.33%) cases and 5(16.66%) cases show no improvement at all. Conclusion: This study suggests that dapsone has significant efficacy profile for treatment option of ashy dermatosis. DOI: http://dx.doi.org/10.3329/jssmc.v4i1.11998 J Shaheed Suhrawardy Med Coll, 2012;4(1):18-21

Association of Metabolic Factors with Essential Hypertension

Background-Metabolic syndrome is a risk factor for cardiovascular disease, so it should call attention. South Asian person has preponderance to it.
 Objectives-The proper findings of metabolic syndrome are a key to prevent cardiovascular disease. Hypertension is a component of metabolic syndrome with which patients are at increased risk for cardiovascular disease.
 Methods-This study was carried out in cardiology outdoor of Shaheed Suhrawardy medical college hospital, Dhaka. A total of 322 patients were enrolled from January 2008 to December 2010. Metabolic syndrome was defined as three of the followings: (a) Abnormal fasting serum level of glucose (≥110 mg/dl or 6.1 mmol/L), ( b) abdominal obesity (waist circumference >102 cm in men and >88 cm in women), (c) Triglycerides (≥150 mg/dl), (d) High density lipoprotein cholesterol (<40 mg/dl in men and <50 mg/dl in woman), (e) Hypertension, which was common in all patients.
 Results- Among hypertensive’s patients 31.8% had hyperglycemia, 37.9% had high waist circumference, 69.8% had low HDL cholesterol and 54.3% high triglycerides. As per definition of NCEP-ATP-III, metabolic syndrome had been detected in 17% of male, 37% of female and 27% of the total population.
 Conclusion- Metabolic factors are a common association in hypertensive cases. These patients are at increased risk of coronary and cerebro-vascular disease and require more vigorous prevention. Furthermore in all hypertensive patients metabolic screening is recommended.
 TAJ 2011; 24(1): 21-25

A Community Survey on the Prevalence of Suicidal Attempts and Deaths in a Selected Rural Area of Bangladesh

Background : Suicide is a public health problem too often neglected by researchers, health policy makers and the medical profession. In the year 2000, approximately one million people died of suicide which represents a global mortality rate of 16 per 100,000. According to WHO estimates for the year 2020 and based on current trends approximately 1.53 million people will die from suicide and 10-20 times more people will attempt suicide worldwide. The aim of this study was to describe the community prevalence of suicidal attempts and deaths in rural area of Bangladesh and to find out the relationship between suicide and socio-demographic variables. Study Design and Setting : A Community based survey was carried out by members of the Department of Medicine, Shaheed Suhrawardi Medical College and Hospital at Mominpur union under Sadar Upazilla of district Chuadanga. Statistical analyses were performed using SPSS 16. Results : A total of 3551 households were surveyed covering 12422 individuals. A total of 35 individuals attempted suicide in last one year and of them 16 died and rest of he 19 survived. One year incidence of suicidal attempt in the study area was 281.8 per thousand population and the incidence of suicidal deaths was 128.8 per 100000 population. Median age of the people attempted or committed suicide was 30.36(range12 to 70 years). Most (42.9%) suicide was attempted by people at their twenties (20–29 years). Male to female ratio was around 1:4. Around 33.3% of the people who attempted or committed suicide studied up to secondary level, 28.6% studied up to primary level. Most (55.2%) of the people who committed or attempted suicide were housewives,10.3% were daily basis worker, 6.9% were students, another 6.9% engaged in agricultural work and 3.4% were disabled. Majority (45.7%) of the people who committed or attempted suicide was of lower class, 37.1% were of lower middle class, 14.3% were of middle class and 2.9% were of upper class. Majority (82.9%) of the person attempted suicide or died of suicide were married. Around 57% had discord in the family, around 23% had at least one relative died of suicide, around 17% of them were suffering from chronic diseases. Two of them were substance abuser. One of them had preexisting mental disorder, two (5.8%) were orphan and around seven (20%) made an attempt before the current one. Conclusion: Community survey in a rural area of South-West Bangladesh revealed that suicide is a major cause of mortality, especially in young females. Although this study results were from a small population of a community, the high rate of deaths from suicide are alarming and warrants further studies in regional and national level to find out the risk factors. DOI: http://dx.doi.org/10.3329/jom.v13i1.10042 JOM 2012; 13(1): 3-9

Endoscopic sinus surgery: experience of 60 cases

Objective: To study the quality of life in patient who underwent ESS operation. Design and setting: A prospective study conducted over a period of one(01) year; from July 2004 to June 2005 in Otolaryngology – Head & Neck Surgery Department of Shaheed Suhrawardy Medical College Hospital and Dhaka Medical College Hospital, Dhaka, Bangladesh. Results: Hospital admitted 60(Sixty) cases of ESS patients were included and analyzed. 42 cases were male; whereas 18 cases were female in this study. 21-40 years (44 cases) were the commonest age group of study people. No significant/ alarming complications were recorded during post operative period. Conclusion: Instead of all limitations, outcome of ESS is more acceptable in comparison with conventional sinus surgery. The main symptoms, like nasal obstruction, discharge, headache and facial pain get relieved off dramatically which is compatible with other recognized study. Key words: Endoscopic sinus surgery; open the sinuses; restore normal air flow. DOI: http://dx.doi.org/10.3329/bjo.v17i2.8849 BJO 2011; 17(2): 104-109

Maternal Socioeconomic and Nutritional Determinants of Low Birth Weight in Urban area of Bangladesh

Objectives: Globally about 15.5% of all births are born with low birth weight (LBW) and in Bangladesh, LBW rate is quite high. The present study was conducted to determine the socioeconomic and nutritional factors affecting LBW in urban community of Bangladesh.Methods: This case control study was done at Department of Obstetrics & Gynaecology of Shaheed Suhrawardy Medical College Hospital, Dhaka. Normally delivered singleton live births babies from January 2003 to January 2005 were selected purposively and after enrollment all newborns birth weight was measured. Then from the total (N=583) study populations childmother pairs formed and were divided in LBW group (n=135) and NBW group (n=448). Data were collected regarding maternal socioeconomic and nutritional factors by interviewing the mothers and family members. Variables were analyzed to find out significant maternal factors affecting LBW.Results: The LBW incidences in this study was found 23.2%. And 51.1% of the LBW came from the mother of <20year of age group, 50% mothers of LBW were found illiterate, socioeconomic status was significantly more poor, maternal anaemia was found significantly more common in LBW and iron & vitamin supplementation during pregnancy were found significantly less among the mothers of LBW babies in comparison to NBW. Significant relationship was found between early maternal age, poor educational and socioeconomic status, anaemia, iron & vitamin supplementation during pregnancy with LBW. No relationship was found between LBW and maternal height but significant relationship was found with maternal weight and BMI.Conclusion: These findings suggest that selectively targeted interventions such as delay age at first pregnancy (at >20 year of age), improving maternal education and nutrition, iron and vitamin supplementation can prevent LBW in Bangladesh.. Key words: LBW (Low Birth Weight); NBW (Normal Birth Weight); IUGR(intrauterine growth retardation). DOI: 10.3329/jdmc.v17i2.6588J Dhaka Med Coll. 2008; 17(2) : 83-87