Shaheed Suhrawardy Medical College Research Articles

Outcome of Myringoplasty in Underlay Technique

Background: Myringoplasty is one of the surgical techniques for the management of chronic supportive otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction.
 Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery.
 Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. About 100 patients with dry central tympanic membrane perforations of various size were included in this study
 Results: Myringoplasty was performed in 100 patients. Male were (45%) and females were (55%).Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases
 Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation
 Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 131-136

Crossed Testicular Ectopia in a 65-year-old man

Crossed testicular ectopia (CTE) is an extremely rare anomaly in which deviation of testicular descent results in unilateral location of both testes. It usually presents as an inguinal hernia on the side of a fully descended testis and an impalpable testis with undeveloped hemiscrotum on the contralateral side. Most often the diagnosis of CTE is not made until surgical exploration. Few reports are available regarding CTE in infants or younger children. Though the patients of CTE usually present at a younger age, we report a case of crossed testicular ectopia in a 65-year-old male who was admitted in the department of surgery, Shaheed Suhrawardi Medical College Hospital (ShSMCH) with right sided inguinal hernia.
 Journal of Surgical Sciences (2015) Vol. 19 (1) : 39-41

Bacteriological Profile of Wound Swab and Their Antimicrobial Susceptibility Pattern in Shaheed Suhrawardy Medical College, Dhaka

Background: Wound infections are global problem in the field of surgery associated with long hospital stay, higher treatment expenditure, morbidity and mortality.
 Objective: To isolate and identify the bacteria causing wound infection and to determine the antimicrobial susceptibility pattern.
 Methods: This retrospective study was conducted in the Department of Microbiology at Shaheed Suhrawady Medical College, Dhaka from January 2017 to December 2017 for a period of one (01) year. A total of 190 wound swabs were collected from the patients who were visited in outpatient department and were admitted at inpatient department with skin and soft tissue infection. Swabs from the wound were inoculated on appropriate media and cultured and the isolates were identified by standard procedures as needed. Antimicrobial susceptibility testing was done by disc diffusion method according to ‘The Clinical Laboratory Standard Institute’ guidelines.
 Results: In this study, out of 190 cases 115 (60.52%) were male and 75 (39.47%) were female and majority 85(44.73%) were in the age group of 16 to 30 years. A total number of 190 isolates were obtained, among which 124 (65.25%) were culture positive cases. Among the isolated organisms predominant bacteria was Staphylococcus aureus 68 (35.79%) followed by Escherichia coli 30 (15.79%), Pseudomonas 14 (7.37%), Klebsiella 6 (3.16%), Proteus 4 (2.10%) and Acinetobacter 2 (1.05%). Staphylococcus aureus was sensitive to linezolid (94.11%), vancomycin (88.23%) and amikacin (70.58%). Among the Gram negative isolates Escherichia coli was predominant and showed sensitivity to imipenem (80%), amikacin (70%), ceftazidime (60%), piperacillin+ tazobactum (56.66%), colistin (53.33%). Pseudomonas showed sensitivity to colistin (78.57%), imipenem (71.42%). Klebsiella showed sensitivity to imipenem (83.33%), amikacin (66.66%), piperacillin+ tazobactum (66.66%), and colistin(66.66%).
 Conclusion: Staphylococcus aureus was the most frequently isolated pathogen from wound swab and the antibiotic sensitivity pattern of various isolates will guide for appropriate selection of antibiotics against wound infection, so as to reduce the spread of resistant bacteria.
 J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 65-68

Outcome after Lateral Pancreaticojejunostomy for Chronic Calcific Pancreatitis: A Short Term Prospective Study

Chronic pancreatitis is a fairly common condition with pain being the major symptom and longitudinal pancreaticojejunostomy (LPJ) is performed for symptomatic relief. The aim of the study is to assess the outcome of LPJ for chronic calcific pancreatitis and to evaluate the factors influencing relief of symptoms. A prospective observational study enrolling 28 patients was conducted in the department of surgery of Shaheed Suhrawardy Medical College Hospital from January 2018 to December 2018. This study involved identification of various risk factors related to chronic pancreatitis, pancreaticojejunostomy, early post-operative outcome and postoperative assessment of pain relief at 1 and 6 months from surgery. Pain was assessed using Visual analogue scale (VAS). In chronic pancreatitis, there is a significant relief of pain in post-LPJ; the degree of relief was less in the alcoholics than non-alcoholics (p=0.09) and in smokers. There was also reduction in analgesic requirement and frequency of acute attacks of pain. In chronic pancreatitis, there is a significant relief of pain in post-LPJ, although the degree of relief is less in the alcoholics and smokers.
 J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 13-16

Clinicopathological Study of Male Breast Malignancy in a Tertiary Care Hospital, Bangladesh

Introduction: Male breast malignancy is a relatively rare condition among all the malignancies. It accounts for 0.2% of all malignant cases & less than 1% of all breast cancer.
 Methods and Materials: A retrospective observational study was done among the male patients with breast malignancy, admitted in Surgery ward in Shaheed Suhrawardy Medical College Hospital, Bangladesh from January 2014 to December, 2018.
 Results: Our series includes 09 patients. The mean age of the patient was 60 years. Most of the patients complaint breast lump with some degrees of skin colour changes. One has previous history of breast surgery (lumpectomy). Eight (8) patients went under simple mastectomy with axillary clearance after tissue diagnosis. One (1) patient got neo- adjuvant chemotherapy followed by surgery. Specimen was sent for histopathological & receptor study. Among them Infiltrating was ductal carcinoma was found in 07 cases, Sarcoma was in 01 (one) case & papillary carcinoma in 01 (one) case with 66.6 % positive oestrogen and progesterone receptor activity.
 Conclusion: Surgeons should be kept in mind that male breast malignancy is not uncommon and all male breast lumps should be evaluated properly before surgery.
 J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 48-51

Thirty Year Old Female Presented with Nipple Destruction: A Case Report

Paget’s disease of the breast is a rare type of cancer of the nipple–areola complex and that is often associated with an underlying in situ or invasive carcinoma. It is often misdiagnosed as eczema of breast and treatment is delayed. Here we present a case where a 30 year old female presented with itching ulceration and destruction of her left nipple. She was treated initially by local physicians by applying local ointments but as her condition did not improve she was admitted to department of surgery Shaheed Suhrawardy Medical College hospital where she was diagnosed as Paget’s disease with infiltrating ductal cell carcinoma. She underwent modified radical mastectomy with axillary clearance and referred to oncology department for further management.
 J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 81-83

Characteristics of Polycystic Ovarian Syndrome in Sub-fertile Woman Attending to GOPD in ShSMCH

Background: Polycystic ovarian syndrome (PCOS) is a condition characterized by menstrual abnormalities (oligo/amenorrhea) and clinical or biochemical features of hyperandrogenism and may manifest at any age. It is a common cause of female subfertility. All the dimensions of PCOS have not been yet completely explored.
 Methods: It was a cross sectional comparative study carried out at-GOPD of Shaheed Suhrawardy Medical College & Hospital from January, 2016 to December 2016 on 162 subfertile women. Among them 54 were PCOS group and 108 were non PCOS group. PCOS was diagnosed by (Rotterdam criteria 2003) (i) Oligo or anovulation (ii) hyperandrogenism (iii) Polycystic ovaries. Study was done to evaluate and compare the demographic characteristics, clinical, biochemical and ultrasoundgraphic features of sub-fertile women with and without PCOS.
 Results: A total of 162 sub-fertile women aged 16-36 years. Mean age was 29.5±5.4. There were significant differences between the two groups in terms of (oligo/amenorrhea), hirsutism, WHR and ovarian ultrasound features. There were no significant differences between two groups in correlations between the level of obesity with the incidence of anovulation, hyperandrogenism or with hormonal features.
 Conclusion: PCOS is one of the important factors causing Infertility. It is an ill-defined symptom complex needed due attention. There is a need to increase awareness regarding. The clinical features of PCOS are heterogenous thus can be investigated accordingly of selection of appropriate treatment modality.
 J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 17-23

Clinical Profiles of Chikungunya Fever Patients Attending at OPD of a Teaching Hospital in Dhaka City

Background: Chikungunya virus was introduced into the Dhaka city of Bangladesh and triggered a massive outbreak which affected millions of lives and forced upon significant damages in socioeconomic factors.
 Objectives: This community based descriptive study was conducted in selected area of Dhaka city to see the clinical profiles of chikungunya patients in Dhaka city.
 Methodology: This prospective observational study was carried out in the Department of Medicine OPD at Shaheed Suhrawardy Medical College & Hospital (ShSMC), Dhaka, Bangladesh. This cross-sectional study was conducted during the peak of chikungunya outbreak (1st March to 31st August, 2018) to document the clinical profiles of confirmed cases (laboratory test positive) and probable cases diagnosed by medical practitioners.
 Results: The study included 1133 patients (Male 51.9%and Female 48.1%). The main symptoms were Fever (66%), higher in patients with Joint pain (82%), Rash (21.3%) and others (10.1%).Sensitivity of the patients by acute chikungunya 14.3% and other 85.7%. Patients had post chikungunya complications 14.3% and no complications 85.7%. Chikungunya patients increasing month are March 0.5%, April 0.5%, May 3.4%, June 25.8%, July 50.8%, August 19.1%. In Dhaka cities the affected area were Mirpur 41.7%, Mohammadpur 28.9%, Agargaon 8.8%, Tejgoan 5.9%, Shamoly 5.7%, Adabar 4.4%, Savar 2.0%, Rayerbazar 0.9%, Dhanmondi 0.8%, Mohakhali 0.8%.
 Conclusions: The result found that gender and age are significantly associated with Chikungunya infection. This study will also help to provide support and services to public health science which will eventually contribute the country for the diagnosis, prevention and control of Chikungunya and similar viral diseases. Overall, it necessitates the importance of utilizing appropriate and reliable diagnostic methods, proper surveillance system and effective control measures that must be implemented to manage the disease outbreak situations.
 Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 148-151

Effects of Transurethral Resection of Prostate (TURP) on Quality of Life in Case of Benign Prostatic Hyperplasia

Background: BPH is one of the most common cause of LUTS which significantly impairs the quality of life. TURP is minimally invasive surgical procedure for Benign Prostatic hyperplasia which has impact on quality of life. Impact on quality of life can be measured by QoL score and effect of TURP can be evaluated.
 Objective: The purpose of the present study was to evaluate the impact of transurethral resection of prostate (TURP) on Quality of Life (QoL) score.
 Methodology: This prospective study was carried out in the Department of Urology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, from July 2015 to June 2016. Total fifty patients between 50 to 72 years attending for the treatment of benign prostatic hypertrophy (BPH) with lower urinary tract symptoms (LUTS) were included for the study according to inclusion & exclusion criteria. All of them were evaluated with baseline international prostate symptoms score (IPSS), QoL score, peak urinary flow rate (Qmax), voided volume, voiding time and PVR and were recorded in a predesigned data sheet. Selected patients underwent Transurethral Resection of Prostate. They were followed after 1 month and 3 months with same parameter and compared with the baseline values.
 Results: The baseline international prostate symptoms score (IPSS) in this study was 25.18±1.45. At one month and three months follow up visits after TURP, the IPSS was decreased to 15.0±1.07 and 8.14±0.76 respectively. There was significant improvement of peak urinary flow rate (Qmax) in the postoperative period, at the 1st follow up visit after one month of TURP (15.78±1.42, p<0.001) and at the 2nd follow visit after three months of TURP (18.78, p <0.001). The mean QoL score was 5.30±0.46 before TURP. After one month of TURP it was 3.20±0.45 and after 3 months of TURP it was 1.86±0.57.
 Conclusion: There is a significant improvement of quality of after TURP.
 Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 143-147

Antimicrobial susceptibility pattern for Salmonella Typhi isolated from blood in Shaheed Suhrawardy Medical College, Dhaka

Background: Typhoid fever remains a public health concern in developing countries. Antibiotic therapy constitutes the mainstay of management and multidrug resistant Salmonella spp has been emerged as a major public health concern.
 Objective: This study was done to evaluate antimicrobial sensitivity pattern of Salmonella typhi isolated from blood in Shaheed Suhrawardy Medical College Hospital.
 Methods: The retrospective study was done from January 2017 to December 2017 at microbiology laboratory, Shaheed Suhrawardy Medical College. A total of 367 samples, 30 isolates of Salmonella typhi obtained from blood culture. Both the indoor and outdoor patients were enrolled in this study.
 Results: During one year study period, total 367 cases were enrolled and the prevalence of Salmonella typhi was 30 (8.2 %). Among them (56.1%) were male with a male to female ratio 1.27:1. The bulk (50.1%) cases were in the age group of 15-30 years, 14.4% cases were in less than 15 years and 6.5% cases were in more than 60 years of age. Regarding antibiotic sensitivity pattern, 70% strains were sensitive to amikacin, 73.33% to azithromycin, 63.33% to ceftazidime, 66.66% to ceftriaxone, 86.66% to ciprofloxacin and 70% were nalidixic acid resistant Salmonella typhi.
 Conclusion: Ciprofloxacin may be used to treat typhoid fever cases and Ceftriaxone, azithromycin may be used as alternative drugs if they are found susceptible in culture and sensitivity testing.
 J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 96-98

Outcomes of Myringoplasty In Underlay Technique

Background: Myringoplasty is one of the surgical techniques for the management of chronic suppurative otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction.
 Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery.
 Materials and Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. A total of 100 patients with dry central tympanic membrane perforations of various sizes were included in this study.
 Results: Myringoplasty was performed in total of 100 patients. Male were (45%) and females were (55%). Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases.
 Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation.
 J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 99-102

Cutaneous Manifestations of Extra pulmonary Tuberculosis

Background: Ulcers and surgical wounds not healing well and expectedly are common problems among patients in countries like us. Ulcers may develop spontaneously or following a penetrating injury. wounds not healing well are common among poor, lower middle class and middle class people. Postsurgical non-healing wound or chronic discharging sinuses at the scar site are also common in that class of people. Suspecting malignancy or tuberculosis in these types of wounds we have sent wedge or excision biopsy for these ulcers in about 500 cases and found tuberculosis in 65 cases. In rest of the cases histopathology reports found as non- specific ulcers, Malignant melanoma, squamous or basal cell carcinoma, Verruca vulgaris.
 Objectives: To find out the relationship of tuberculosis with chronic or nonhealing ulcers.
 Methods: This is a prospective observational study conducted for patients coming to our chambers, OPD of a district general hospital and Shaheed Suhrawardy Medical College Hospital, Dhaka from July 2012 to June 2018.
 Results: Mean age of the study subjects were 28±2. Among the study subjects nonspecific ulcer or sinus tracts were found in 418 (83.6%), tuberculosis in 65 (13%), Malignant melanoma 7 (1.4%), Verruca vulgaris 5(1%), squamous cell carcinoma 3(0.6), basal cell carcinoma 2 (0.4%). Biopsy done only for very suspicious ulcers or wounds.
 Conclusion: With this very small sample size it is difficult to conclude regarding incidence of cutaneous involvement of extra pulmonary tuberculosis , but every clinician should think of it in case of suspicious non healing wounds, ulcers and prolonged discharge from a surgical incision site.
 J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 86-90

Repeat Caesarean Sections: Complications and Outcomes

Background: The rising incidence of caesarean section all over the world has been of great concern both to the patients and obstetrician.1 Repeat caesarean section is one of the major reasons which have contributed greatly to high caesarean section (CS) rate.1,2 Although maternal death as a result of CS is now rare, reports of the short-and long-term consequences of the rising CS rate on the childbearing population are conflicting.3 Available data show that repeat caesarean section is associated with many maternal complications, specially intra-abdominal adhesions, central placenta praevia, uterine rupture, caesarean scar pregnancy, caesarean hysterectomy etc.4
 Objective: To evaluate outcome and complications of multiple repeat caesarean section.
 Methodology: This was a cross sectional prospective study conducted in Shaheed Suhrawardy Medical College Hospital (ShSMCH) from 1st June’2016 to 30th November’2016 for a period of six months. The study population were 102 patients, selected randomly who were admitted in ShSMCH for repeat caesarean section.
 Results: Out of 102 patients admitted with history of previous caesarean section, maternal morbidity was 26 (25.49%), which includes intra-abdominal adhesions 19 (18.62%), excessive blood loss 6(5.88%), placenta praevia 4 (3.94%), placenta accreta 1 (.98%), postpartum haemorrhage 11 (10.78%), wound infection 12 (11.76%) etc.
 Conclusion: As the rate of repeat caesarean section continue to rise, surgeons should be more judgemental in doing caesarean section.
 J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 74-79

Patient Empowerment: An Effective Strategy to Improve Management of GDM

Background: GDM is a public health issue, affecting mostly the South East Asian region, as well in Bangladesh (prevalence 9.7% - 12.9%). It has a significant adverse impact on maternal and foetal outcome. So it needs to be addressed energetically to avoid maternal and foetal morbidity and mortality. Also it will contribute a lot to the pool of Type II Diabetes as substantial number of GDM mother and their offspring may develop type II DM in near future. Self-management of GDM is well-known globally but there is still lacking in adequate handling of diabetes by the patients themselves. Nevertheless the lacking can be minimized through ‘Patient Empowerment’ by clear understanding of the disease and its consequences along with intense learning, training, monitoring and evaluation of the clients involved. Also it will help in emotional stability of the client which is an essential component of diabetes management during pregnancy. The innovative strategy may contribute significantly in GDM management at low cost in a resource constraint setting.
 Objective: To find the effectiveness of ‘patient empowerment’ promoting better self-management of GDM.
 Methodology: This quasi experimental study was done on 96 cases (48 in each group) by purposive sampling technique at Shaheed Suhrawardy Medical College Hospital (ShSMC) as study group & Rajshahi Medical College Hospital (RMCH) as control group, from August 2012 – August 2015. Both group were matched of age, parity, education and income. Ethical clearance was taken from ethical committee of both ShSMC and RMCH
 Result: In the study group good glycemic control achieved with diet & exercise (75%) and Insulin required in only 25% cases, while in control group Insulin given in 75% cases. In the study group NVD (67%) were more than control group (33.3%). There were no obstructed labour in study group but control group (12.50%). Majority of the study group (74.6%) had no or minimum antenatal complication, in comparison to control group (74.66%). Regarding Neonatal outcome, neonatal resuscitation required none in study group but 12 (25%) in control group. So, overall adverse outcome observed less in study group than control group
 Conclusion: Patient empowerment can be an effective tool to manage GDM cases with an outcome of good control of blood sugar; less antenatal, intrapartum and post natal complications, good foetal and neonatal outcome and low requirement of insulin.
 J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 91-94

Clinical Outcomes of Total Laparoscopic Hysterectomy (TLH): Seven Years’ Experience in a Public Hospital

Objective: The aim of the study was to explore the surgical outcomes of total laparoscopic hysterectomy.
 Materials and methods: This was a prospective analysis of total Laparoscopic Hysterectomy (TLH) done between January, 2012 to December, 2018 in Shaheed Suhrawardy Medical College and Hospital. Demographic data, clinical criteria, intra operative and postoperative outcome data were recorded. Data were collected in a predesigned Data collection sheet. Follow up records done during discharge from the hospital, one week and four weeks postoperatively.
 Results: Total 298, laparoscopic hysterectomy were performed during the period. Among them 96 % (n=286) for benign and 4 %( n=12) for malignant condition were included in the study population. Mean age of the patients was 45.4 ± 5.6 years, mean parity was 1.9 ± 0.64 and the mean body mass index was 27.48 ± 0.57. The most common benign disease was leiomyoma, 51.7 %. Among the study cases 21.8% (n=65) had history of at least one previous abdomino-pelvic surgery. Maximum size of uterus removed was 28 weeks and maximum patients, 48% (n=143) had uterine size of 10-14 weeks. The operating time was variable between 50 min to 180 min and in the course of time, the mean operating time dropped from 130 min to 60 min. The mean length of hospital stay was 2 days and the return to normal activities was within 2 weeks. Major complications observed among 3.7 % of cases among them 2(0.67%) bladder injury, 2(0.67%) vesico-vaginal fistula (VVF), 3(1.0%) ureterovaginal fistula (UVF) and 4(1.3%) peroperative hemorrhage requiring blood transfusion. Among the 7 cases of urological complications, one patient with VVF and one patient with UVF needed relaparotomy. Ultimately all cases were managed without any residual problem. Conversion to laparotomy was 0.3 % (n=1) of case.
 Conclusion: TLH offers the benefit of minimally invasive surgery to the patient and is a safe and acceptable alternative to standard hysterectomy for various gynaecological indications.
 Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 28-35

Self-Medication Practice among Medical Students of a Tertiary Teaching Hospital in Dhaka City

Background: Self-medication is a common practice worldwide and the irrational use of drugs is a cause of concern.
 Objective: This present study was designed to assess the rate of self-medication among the medical students in a tertiary teaching hospital in Dhaka.
 Methodology: This descriptive cross-sectional study was conducted in the Department of Pharmacology at Shaheed Suhrawardy Medical College, Dhaka, Bangladesh from October to December 2017 for a period of three (03) months. The participants were briefed about the nature of the study; the consent was taken and a pre‐tested semi‐structured questionnaire was administered to them. The information pertaining to the pattern of self‐medication, indications for self‐medication and drugs used for self‐medication was included in the questionnaire.
 Result: A total of 303 students were included in this study. The rate of self-medication was 100.0%. A larger number of females were self-medicating (81.2%) than males (75.3%). The majority of the students self-medicated because of the illness being too trivial for consultation (43.2%) and previous experience of illness (43.2%). Fever (73.3%) and headache (65%) are the most common cause of self-medication. Antipyretics were most commonly self–medicated by the participants (98%). 45.5% 0f students told that self-medication is not an acceptable practice. 40% of the participants opined that self-medication was a part of self-care.
 Conclusion: In conclusion self-medication is widely practiced among students of the institute
 Journal of Current and Advance Medical Research 2019;6(1):28-31

Occupational stress and work ability among nurses in an academic hospital

Background: Occupational stress is one of the key factors in reducing staff productivity in any organization with physical and psychological impacts on employees. Nursing is among the most stressful professions. Therefore, this study aimed to assess the extent of perceived level occupational stress and its association with work-related and non-work related variables as causes of stress and work ability among nurses in a Public Medical College Hospital.
 Methods: A cross sectional study was done among nurses in Shaheed Suhrawardy Medical College Hospital (ShSMCH) dmi.ng July 2015-June 2016 among 197 nurses, selected through a simple random sampling. Face to face interview was conducted, using a pretested semi-structured questionnaire. Occupational stress and work ability were measured using Expanded Nurses Stress Scale Questionnaire (ENSS) and WorkAbility Index Questionnaire (WAIQ). Appropriate statistical analysis was performed to see the level of significance.
 Results: Majority (69.0%) of the study population were between the age of 21 to 39 years, 94.gG/o were female, 68.0% were married, 79.2% were Muslim, 84.3% had diploma, 91.4% fumily income were equal or more than Tk 40,000, 95.5% did clinical work. Some 25.0% worked in medicine ward, 22.8% worked at surgery ward and 90.9% worked more or less than 50 hours per week. Only 5.1% found to be high stress and 94.6% low stress. Significant difference was found between female and male, occupational stress and religion, educational status, type of work, occupational stress and work ability (p<.0.05).
 Conclusion: Severe occupational stress is associated with reduced work ability. So, it is recommended to decrease occupational stress to increase work ability, although identification of sources of occupational stress seems necessary in order to adopt appropriate stress management strategies.
 Bangladesh Med Res Counc Bull 2018; 44: 113-117

Limitations in Total Laparoscopic Hysterectomy in Bangladesh

Laparoscopic Hysterectomy is achieving great popularity nowadays. Our people are becoming increasingly interested in new advances in this field of surgery. Highly skilled surgical technique, longer operative time and expensive technology are observed to be the factors that impede the advancements in laparoscopic surgery1.Objective: The aim of our study is to analyze the limitations of laparoscopic hysterectomy in our country.Methods: This is a retrospective observational study where we have reviewed demographic data, compliance of the patients, quality of anaesthesia, efficiency of supportive staffs, adequacy of appropriate instruments, continuous training of surgeons and surgical risk factors. Total 80 Total Laparoscopic Hysterectomy (TLH) were done between January’ 2016 to December’2017 in Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka.Result: In this study, we analyzed eighty patients who underwent total laparoscopic hysterectomy for fibroid uterus, adenomyosis, recurrent post-menopausal bleeding, abnormal Uterine bleeding(AUB) etc. We tried to analyze some limitations and challenges which we can overcome. In spite of lack of appropriate instruments, adequate ICU support and repeated training in specialized centre at home and abroad, 87.5% patients recovered well. The aim of our study was to identify the surgical risk factors of the patients and limitations in our theatre environmentJ Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 3-5

Occupational Stress among Nurses in a Public Medical College Hospital

Background: Now a days, there is increased demand and progress in the nursing profession. Along with these stress among the nurses has also increased.Objective: Purpose of the study was to assess the extent of perceived occupational stress and its association with work-related and non-work related causes among nurses.Materials and method: This Cross-sectional study was carried out among 197 nurses of Shaheed Suhrawardy Medical College hospital (ShSMCH), Dhaka, Bangladesh, from the period of 1st July 2015 to 30th June 2016. Sampling method was simple random sampling. Data was collected by face to face interview with the help of semi-structured questionnaire and finally all data were analyzed using SPSS software version 21.Results: It was found that 69% nurses were between the age of 21 to 39 years, 94.9% were female, 68% were married, 79.2% were Muslim, 84.3% had diploma, family income of 91.4% were equal to more than 40,000 Tk. and 95.5% used to do clinical work. Only 5.1% found to experience high stress. Statistically significant difference was found between sex, occupational stress and religion, educational status, and type of work (p < 0.05). Few nurses suffered from high stress but high level of stress were more in male, non Muslim, post graduate nurse and those who were engaged in administrative work.Conclusion: Nurse Managers should take appropriate actions to decrease stress helping their nurses to work efficiently and effectively.Delta Med Col J. Jan 2018 6(2): 86-89

Unusual Presentation of Precocious Puberty Associated with Primary Hypothyroidism in a 8.5 Years Old Girl

Precocious puberty is one of the gynaecological problems in childhood. Children with hypothyroidism generally have delayed pubertal development. But primary hypothyroidism is one of the rare causes of precocious puberty especially in long standing untreated patients. Bilateral ovarian enlargement due to multiple cystic ovaries is a rare complication of primary hypothyroidism. For ovarian enlargement no treatment is required at all. This is a case report of an 8.5 years old girl diagnosed as a case of precocious puberty with benign ovarian tumour at a peripheral hospital and was being prepared to undergo laparotomy. When patient was admitted at Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka, Bangladesh, after thorough investigations primary hypothyroidism was diagnosed. She was given thyroxin replacement and close monitoring was done by doing USG of uterus and adnexae, thyroid function test at monthly interval. USG after 2 months revealed significant reduction of ovarian volume and at 6 month ovarian volume reduced to normal. It was also noticed that the rate of reduction of ovarian volume corresponds to the rate of reduction of serum TSH level measured serially at every 2 months interval.Delta Med Col J. Jan 2018 6(2): 102-105