Shaheed Suhrawardy Medical College Research Articles

Use of Combination of Mifepristone and Misoprostol to Terminate Early Pregnancy: Experience at a Tertiary Care Teaching Hospital

Background: Termination of pregnancy is well prescribed method all over the world to terminate the early pregnancy with the combination of mifepristone and misoprostol tablet orally.Objective: The purpose of this present study was to determine the efficacy of mifipristone (200 mg) for medical termination of early pregnancy with oral misoprostol 800 mcg 24 hours later.Methodology: This observational study was done in the Department of Gynaecology & Obstetrics at Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh among outdoor patients in 6 months period from July 2014 to December 2014. The patients with intrauterine pregnancy up to 9 weeks and blighted ovum were included. Incomplete abortion and extrauterine pregnancy were excluded. Mifepristone 200 mg followed by misoprostol 800 mg after 24 hours had been given.Result: Total 50 patients with 9 weeks of pregnancy were selected over the period of 6 months requesting termination of pregnancy. This study showed termination of early pregnancy up to 9 weeks with tablet mifepristone and tablet misoprostole which was effective as well as the expulsion rate of the product of conception was 92.0% cases and among them 32.0% patients were needed extended dose of misoprostol and 8.0% cases had incomplete abortion who needed surgical evacuation. Some patients had some complications like vomiting, fever, abdominal pain and excessive per vaginal bleeding which were managed accordingly.Conclusion: Mifepristone 200 mg followed by misoprostol 800 mcg orally is an effective method for termination early pregnancy with minimum side effects.Journal of Science Foundation 2017;15(1):9-13

Bacteriological Profiles of Pus with Antimicrobial Sensitivity Pattern at a Teaching Hospital in Dhaka City

Background: The human skin and soft tissue infections (SSTIs) caused by microbial pathogens during or after trauma, burn injuries, and surgical procedures result in the production of pus, a white to yellow fluid comprised of dead WBCs, cellular debris, and necrotic tissues.Objective: The purpose of the present study was to see the frequency and distribution of bacteria isolated from pus and sensitivity pattern.Methodology: This retrospective study was conducted in the Department of Microbiology at Shaheed Suhrawardy Medical College, Dhaka from January 2016 to December 2016 for a period of one (01) year. The pus samples were collected from the patients who were visited in outpatient department and were admitted at IPD in Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka with skin and soft tissue infection. Bacteria were detected by culture and biochemical test and antibiotic susceptibility test done by disc diffusion method.Result: A total number of 212 patients presented with wound infection or pus were recruited for this study. Among 212 patients majority were in the age group of 20 to 40 years which was 89(42.0%) cases. Interestingly male was predominant than female which was 119(56.1%) cases and 93(43.9%) cases respectively. aerobic culture was positive in majority cases which were 131(61.8%) cases.Conclusion: In conclusion the most common isolated bacteria after aerobic culture of pus is the Staphylococcus aureus. However the gram positive cocci is less in number than gram negative bacilli.Bangladesh Journal of Infectious Diseases 2018;5(1):10-14

Effectiveness of Light Emitting Diodes (LED) versus Conventional Phototherapy for Neonatal Jaundice

Background: Phototherapy is crucially an important aspect for the management of most neonatal jaundice. Neonates are prone to develop bilirubin encephalopathy (kernicterus). LED phototherapy is a new option of managing neonatal jaundice. The objective of this study is to compare the efficacy and safety of LEDs with fluorescent phototherapy in the treatment of indirect hyperbilirubinemia.Method: The study was Experimental research design, prospective study. The Study was conducted at Neonatal unit of Shaheed Suhrawardy Medical College Hospital, Dhaka. Total sample size of the study was one hundred neonates. Fifty for conventional phototherapy and fifty for LED phototherapy. Purposive sampling method was used for the study. The data collection tool of the study was pretested structured questionnaire. The modes of presentation, the clinical examination and investigation findings at admission and during daily follow up were recorded for individual patient.Result: The rate of fall of S. bilirubin was more in those neonates who have had LED phototherapy. As a result, duration of phototherapy as well as hospital stay was less in LED group. Furthermore, higher number of neonates developed rashes in LED group than in conventional group with statistically significant difference. Of course, variables regarding other adverse events did not show any statistically significant difference between two groups.Conclusion: Management of neonatal jaundice may be more effective in LED phototherapy than conventional phototherapy. LED device require shorter duration of phototherapy, thus, shorter hospital stay.Bangladesh J Child Health 2018; VOL 42 (2) :62-66

Borderline Papillary Serous Tumour of the Peritoneum

Primary borderline serous peritoneal tumour is a rare lesion found in the absence of ovarian pathology, in the presence of minimal ovarian involvement or in association with benign ovarian tumour. It is thought to arise from the mullerian system, which is embryologically derived from the coelomic and sub-coelomic mesenchyme, and therefore shares histologic similarities with ovarian serous tumours. Such tumours are mostly found in women of reproductive age group although cases have been reported for post-menopausal women. We report a case of a primary peritoneal borderline tumour diagnosed in a middle aged patient with lump and pain the upper abdomen in Shaheed Suhrawardy Medical College & Hospital.J Shaheed Suhrawardy Med Coll, December 2016, Vol.8(2); 69-72

Pregnancy Outcome between Booked and Unbooked Cases in A Tertiary Level Hospital

To achieve the Sustainable Development Goals (SDG’2030) with regards to maternal health, there is need for research on the local causes and factors influencing adverse maternal & foetal outcomes in health institutions. Antenatal care throughout the pregnancy can ensure better feto-maternal outcome. It also contributed to reduction of maternal and infant mortality. This study was an attempt to enable health care providers to know where to focus to overcome adverse maternal outcome.Objectives: To find out the difference in maternal and perinatal outcome and socio-demographic characteristics in booked and unbooked cases. Design: A Cross-sectional observational study.Place of study :Department of Obststrics and Gynaeology , Shaheed Suhrawardy Medical College Hospital.Study period: April’2015 to july’2015. Study population- All patients admitted for delivery and puerperium during study period.Results: Unbooked mothers constituted 39.1% of the 218 deliveries in the studied period. There was no mean age difference between booked mothers and unbooked mothers (26.05±5.5 and 25.44±5.4; P=0.667) .But unbooked cases had a lower educational status (P<0.0036). Majority of the unbooked cases were from low family income group. Unbooked mothers were about less likely to deliver by spontaneous vaginal delivery compared to booked mothers (28% to 39%; P<0.339) and more likely to be delivered by emergency caesarean section than booked mothers. Unbooked mothers were having low birth weight babies than booked mother (2.65±0.595 and 3.02±0.477, p<0.010). Referral to neonatal unit more common in unbooked cases (69.6% to 25.6%). Post partum complications in unbooked and booked cases were (44%and 20.5%).Conclusion: The study showed a positive correlation between socio –demographic factor and lack of proper antenatal care and adverse pregnancy outcome. Improving the availability and accessibility of quality antenatal and delivery care services in all our institutes will improve pregnancy outcome.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 43-48

Rectal Foreign Body in a 30 Year Old Male- A Case Report

Though anorectal foreign body cases are rare, they have become increasingly frequent in recent years. Although entrapped foreign bodies are most often related to sexual behavior, they can also result from ingestion or sexual assault. The diagnosis may be made by rectal examination and metallic objects can be confirmed by plain abdominal radiographs. Transanal removal is only possible for very low-lying objects, while patients with high-lying foreign bodies usually require an operative intervention. An early decision of laparotomy should only be made after subjecting the patient to suitable investigations to determine exact location of the object, in order to avoid any inadvertent damage to the adjoining vasculature as well as anal incontinence. . We report the case of a young male who presented at surgery department of Shaheed Suhrawardy medical college hospital with severe rectal pain due to insertion of an apple into rectum by some eunuchs. It was successfully removed transanally under spinal anesthesia. Post operative period was uneventful and referred for psychiatric consultation.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 35-37

Prescription Pattern In Hypertensive Patients In A Tertiary Care Teaching Hospital, Dhaka, Bangladesh

Background: Irrational drug prescribing is a common practice globally; it results in increased morbidity, mortality & economic burden on society. Drug utilization studies are an important tool to promote rational prescribing.Aims & Objective: To study on drug prescribing pattern in hypertensive patients.Materials and Methods: A drug utilization study was conducted in hypertensive patients by the department of cardiology in OPD at Shaheed Suhrawardy Medical college hospital for 6 months. 645 prescriptions were evaluated for prescribing pattern by using WHO drug use indicators.Results: 645 prescriptions were analyzed. A total of 1828 drugs were prescribed. 697 (38.13%) antihypertensive, 243 (13.30%) anti diabetics, 174 (9.52%) non-steroidal anti-inflammatory drugs (NSAIDs), 154 (8.44%) statins, 114 (6.24%) thyroid hormone, 54 (2.95%) anti-anxiety/ antidepressants and 392(21.44%) miscellaneous drugs were prescribed. 697 antihypertensive drugs were prescribed. 234 (33.57%) angiotensin receptor blockers (ARBs), 117 (16.79%) angiotensin converting enzyme (ACE) inhibitors, 95 (13.63%) Beta blockers, 83 (11.91%) Calcium channel blockers 168 (24.10%) Fixed dose combinations (FDCs) of antihypertensive were included. 2.83 drugs were prescribed per prescription. 225 (32.28%) antihypertensive were prescribed from essential medicine list.Conclusion: Most commonly prescribed drugs were ARBs and ACE inhibitors. Rational prescribing requires consideration to dose and duration and interaction with other medications.J Shaheed Suhrawardy Med Coll, December 2016, Vol.8(2); 39-43

Observation of the Improvement in Nocturnal Asthma Symptoms with Administration of Once Daily Sustained Released Theophylline

Objective: The aims and objective of this study to observe the improvement in Nocturnal Asthma symptoms and Quality of Life (QoL) with administration of once daily sustained release theophylline preparation.Background: Nocturnal symptoms are a common part of the asthma. Nocturnal asthma is defined by a drop in forced expiratory volume in 1 second (FEV1) of at least 15% between bedtime and awakening in patients with clinical and physiologic evidence of asthma, which may include improvement in QoL.Methodology: The patient with Chronic Persistent Asthma, both sex, age >18 to 50 years of age and preferably patients with nocturnal exacerbations were included in the study. All patients were diagnosed on the basis of clinical history, physical examination, chest X-ray and pulmonary function tests, in accordance with the clinical criteria for the diagnosis by the GINA. The recruitment period was between March 2017 and August 2017 Shaheed Suhrawardy Medical College Hospital, Dhaka.Results: It was observed that 65(92.85%) was found exacerbation free night and 5(7.15%) patients were found exacerbation with sustained release Theophylline. There are significantly improved qualities of life between 1st follow up to 2nd follow up, 3rd follow up and 4th follow up p<0.001 which was statistically significant. Spirometry test was gradually improved between 1st visit of FEV1 to 2nd, 3rd and 4th visit of FEV1, (p<0.001) that was statistically significant.Conclusion: Most of the patients were found exacerbation free night. There are significantly improved quality of life between 1st follow up to 2nd follow up, 3rd follow up and 4th follow up in Spirometry test. The value of FEV1 was gradually improve in the lst visit, 2nd, 3rd and 4th visit with sustained release Theophylline.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 74-77

Value of the Resting Electrocardiogram in Assessing Patients with Recent Onset Chest Pain A Study in Tertiary Care Hospital, Dhaka Bangladesh

Background: Chest pain or discomfort caused by acute coronary syndrome (ACS) or angina has a potentially poor prognosis, emphasizing the importance of prompt and accurate diagnosis. To evaluate a clinic set up specifically to assess patients with recent onset chest pain, particularly those presenting with a normal resting electrocargram.Method: The cross-sectional study was carried out from September 2016 to August 2017 in cardiology department of Shaheed Suhrawardy Medical College hospital, Sher-E-Bangla Nagar, Dhaka. Total 1000 consecutive patients with recent onset chest pain were evaluated within 24 hours of general practitioner referral, to find out the clinical diagnosis and management.Results: Total 1000 patients (535 men and 465women, mean age 51.5±11.4 years with range from 32 to 70 years) were assessed over 12 months. Most of the patients 844 (84.4%) had symptoms in duration of ≤30 days. Majority 433 (43.3%) patients had peptic ulcer disease (PUD), 317 (31.7%) patients had chronic stable angina (CSA), 94 (9.4%) had unstable angina (UA), 92 (9.2%) had anxiety neurosis (AN) and 64 (6.4%) had myocardial infarction (MI). Regarding outcome of the patients 525 (52.5%) [PUD: 433+ AN: 91] patients considered to have noncardiac pain and referred to medicine outpatient department (OPD) without further follow up. In a further 317 patients (31.7%, CSA) arrangements were made for outpatient review. Ninety four patients (9.4%, UA) were referred to National Institute of Cardiovascular diseases (NICVD) for admission out of them 61 patients were admitted for medical treatment & 33 patients were discharged from emergency department whose troponin-I were negative. Remaining 64 (6.4%) acute MI patients were admitted into Coronary Care Unit (CCU) of NICVD, out of them 41 patients received streptokinase injection, 23 patients received Enoxaparin injection, after conservative treatment all patients were advised to do coronary angiography within 3 to 4 weeks. Among these 43 patients underwent coronary angiography within 4 weeks, 23 patients had coronary angioplasty, eleven patients had coronary bypass surgery and nine patients refused any intervention and discharged with medicine.Conclusion: This experience highlights the inadequacy of a routine electrocardiogram reporting service in patients with recent onset of chest pain. Clinical diagnosis found were peptic ulcer disease (PUD), chronic stable angina (CSA), unstable angina (UA), anxiety neurosis and myocardial infarction (MI). Regarding outcome of the patients were coronary angiography followed by coronary angioplasty, coronary artery bypass surgery, discharged with medicine and referred to out patients department of medicine unit.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 65-68

Evaluation of Socio-demographic and Lifestyle Factors Among Subtypes of Irritable Bowel Syndrome

Background: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorder with absence of organic damages to the intestine. The pathophysiology of IBS is still not completely understood, but in some cases psychological disorders may affect the onset and outcome of IBS. Some studies have found disparities between subtypes of irritable bowel syndrome (IBS) regarding socio-demographic characteristics and lifestyle factors.Methods: This cross-sectional study aimed to investigate whether there are differences in sociodemographic and lifestyle factors including smoking and physical activity between the subtypes of IBS. The study was performed on outpatients diagnosed as irritable bowel syndrome (from January 2015 to December 2015) in Dhaka Medical College Hospital and Shaheed Suhrawardy Medical College Hospital in Dhaka. A total of purposively selected 208 diagnosed IBS patients were interviewed by semi-structured questionnaire in which subtype of irritable bowel syndrome were measured by Rome-III criteria regarding stool consistency.Results: Mean age of the respondents was 32.3 (+ 10.32) years and majority of them were male (77%), married (66.8%), educated up to secondary level (35.6%), labour (skilled and unskilled) (30%), non- smoker (67.3%) and HEPA (health enhancing physical activity) active (65.9%). Diarrhea predominant irritable bowel syndrome (50%) was found the most common subtype among the irritable bowel syndrome respondents followed by mixed type irritable bowel syndrome (42%) and constipation predominant irritable bowel syndrome (8%) There were no statistical differences found between constipation predominant irritable bowel syndrome ( IBS-C), Diarrhea predominant irritable bowel syndrome (IBS-D), and mixed type irritable bowel syndrome (IBSM) patients regarding to socio-demographic characteristics and lifestyle factors (P<0.05).Conclusion: Our study concluded that there are no different socio-demographic and lifestyle characteristics between IBS subtypes.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 6-9

Hormonal Status of Females in Reproductive Age Group with Benign Breast Disease: A Study of 150 Cases

Background: Benign disorder of breast in female usually seen in reproductive period of life, is thought to be largely hormone induced and there is a dramatic fall in the incidence after menopause due to cessation of ovarian stimulation.Objectives: To find out the relationship between different types of benign breast disease and hormones acting on breast mainly oestrogen, testesteron and prolactin.Methodology: This is a prospective observational study conducted in the department of surgery, Shaheed Suhrawardy Medical College Hospital. Total 150 female patients of reproductive age were included in the study. Serum levels of oestrogen, testosterone and prolactin were done in all patients. Other relevant radiological and cytological investigations were done accordingly where indicated.Results: Mean age of the study subjects were 28 ±8.46 years. Among the study subjects 64 (42.7%) patients used hormonal contraception, on the other hand 86 patients (57.3%) did not used hormonal contraceptive. 68 (45.3%) patients were non parous, 29( 19.3%) were primi parous and 53 ( 35.3%) were multiparous. 87 (58%) had positive history of breast feeding, 63 (42%) patients did not breast fed their babies. Fibrocystic disease was most common diagnosis among study group followed by fibroadenoma. 96 (64%) patients had fibrocystic disease followed by 38 (25.3%) had fibroadenoma. Mean oestrogen, testosterone and prolactin level was 71.16± 57.63 pg/ml, 0.59 ± 0.42 nmol/L and 22.61 ± 16.65 ng/ml respectively.Conclusion: With this small sample size it is difficult to conclude regarding relation between oestrogen, testosterone, prolactin and benign breast disease. But this study can be used as a base line document regarding benign breast disease, hormone profile, type, distribution and frequency of benign breast disease.J Shaheed Suhrawardy Med Coll, December 2016, Vol.8(2); 54-57

Risk Factors of Major Depressive Disorder in Parkinson’s Disease

Depression in idiopathic Parkinson’s disease is highly prevalent that can significantly impair the quality of life. Its exact mechanism of development is still poorly understood. It is well studied in western population but data from Asia especially in the South Asian region is limited. Considering this, to identify the potential risk factors of depression,a cross-sectional study was conducted among Parkinson’s disease patients attending a tertiary care hospital in Bangladesh between July 2013-June 2014, in the Department of Neurology, ShaheedSuhrawardy Medical College and Hospital in Dhaka, Bangladesh. One hundred thirtyseven cases of Parkinson’s disease were enrolled, based on UK Parkinson's Disease Society Brain Bank criteria. Brain MRI was done in all cases, and patients with aphasia, significant cognitive deficits, secondary Parkinsonism were excluded. The overall prevalence of depression in the study population was 42%. There were no significant differences in gender, residence, education, smoking and marital status. In univariate analysis, age≥70 years, un-employed, right side predominantly involved, disease duration ≥5 years, sleep disturbance, postural instability, dose of levodopa ≥500 mg/day, Hoehn and Yahrstage ≥III and moderate to severe disability were significantly associated with depressive disorder. Whereas in multivariate linear stepwise regression model, age ≥70 years), p=0.044), right side predominant involvement (p<0.001); sleep disturbance (p=0.006) and dose of levodopa ≥500 mg/day (p<0.001) were the major risk factors for depressive disorder. A significant proportion of Parkinson’s disease patients suffer from depression. It was identified that depression in Parkinson’s disease was significantly associated with advancing age, predominate right side involvement, sleep disturbance and higher daily dose of levodopa.Bangladesh Med Res Counc Bull 2018; 44(1):9-14

Pattern of Cardiovascular Drugs Use in Outpatient Department in a Tertiary Care Hospital of Bangladesh

Objective: The objective of the present study was to provide recent population-based information on use of cardiovascular drugs in outpatients in a tertiary care hospital of Dhaka, Bangladesh.Methods: A prospective study of cardiovascular prescriptions of Outpatient Department of Department of Cardiology of Shaheed Suhrawardy Medical college hospital Dhaka, Bangladesh was carried out. A total of 215 prescriptions were collected for the study in Shaheed Suhrawardy Medical College Hospital Dhaka, Bangladesh from July 2015 to June 2016. The prescriptions were evaluated for rationality based on WHO model list of essential medicines. The prescriptions were critically analyzed using predetermined parameters.Results: Out of 215 prescriptions collected, 120 drugs were found to be repeatedly prescribed. The results revealed that all single dose formulations prescribed were rationally in accordance with WHO essential drug list whereas fixed dose combinations prescribed remain questionable. A pattern of polypharmacy was clearly evident.Conclusion: Medications are a critical modality for prolongation and improved quality of life. Campaign and intervention should be focused on patients with more than three diagnostic cardiovascular conditions in order to minimize polypharmacy in patients particularly elderly.Bangladesh Heart Journal 2017; 32(2) : 65-69

Clinical Utility of Antibiotic against Uropathogen Isolated at a Tertiary Care Hospital of Dhaka City

Background: The antibiotic sensitivity pattern of uropathogenic bacteria is varied with different frequency. Objective: The purpose of the study was to determine the pattern of antibiotic sensitivity against uropathogens isolated from a tertiary care hospital of Dhaka City. Methodology: A cross-sectional study was conducted in the Department of Microbiology at Shaheed Suhrawardy Medical College, Dhaka, Bangladesh during period of January 2016 to December 2016. Among 307 consecutive urine samples were collected from patients of UTI in the microbiology laboratory. Samples were mid-stream urine specimens obtained by clean catch method received from various outpatient departments and inpatient wards were transported to the microbiology laboratory in sterile leak proof container were processed immediately. Bacteria were isolated and identified by standard laboratory procedure. Results: Of the 307 urine samples processed 170(55.4%) gave significant growth of pathogens. The prevalence of UTI is high among females (58.2%) than males (41.8%). The commonest isolates were Escherichia coli (71.2%), Pseudomonas (12.4%), Staphylococcus aureus (10.6%), Acinotobactor (4.1%) and Klebsiella (1.8%). Majority (92.4%) of (uropathogens) isolates were found to be MDR. Conclusion: The study revealed that E. coli is the predominant uropathogens of UTIs.

A Study on Maternal Weight Gain and its Correlation with Birth Weight of Baby at Term

Background: Maternal weight gain is influenced by several trends in perinatal health that are of great public health concern. Maternal weight gain during the 2nd and 3rd trimesters is an important determinant of fetal growthObjective: To determine the relationship between maternal weight gain and birth weight of baby at term.Methodology : A cross sectional observational study was carried among 50 pregnant women at term were admitted in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital and Anwer Khan Modern Medical College hospital during the period of January 2014 to July 2014. Data were collected pre-designed data collection sheet.Results: This study found maximum (36%) were age group 21-25 years followed by 28% were 20 years, 24% were 26-30 years, 8% were 31-35 years and only 4% were 36-40 years. The average age was 25 years. Among these 50 pregnant women, 2 cases (4%) had BMI <18.5, 15 cases (30%) had a BMI 18.5- 24.9, 19 cases (38%) had a BMI 25-29.9 and 14 cases (28%) had a BMI ≥30. The mean birth weight was 2.77±0.33. kg. Mean weight gain was 10.72±3.72 Kg. Weight increased there was a corresponding increase in the mean birth weight and this relationship was statistically significant (<0.05).Conclusion: This study shows maternal weight gain significantly increased birth weight of the baby at term. Maternal weight should continue to be given importance in monitoring the health of pregnancies and bioelectrical impedance analysis and arm measurements should be further investigated as another simple way to track appropriate body composition changes across gestation, especially in resource-limited settings. Although challenging, public health efforts should continue working to improve the nutritional status of women of reproductive age before they conceive as an apparent way to improve birth outcomes.Anwer Khan Modern Medical College Journal Vol. 9, No. 1: Jan 2018, P 22-28

Prevalence of anti-HBc total positivity in an impoverished Urban Community in Banglades

The infection with the Hepatitis B virus (HBV) is a global health problem. Hepatitis B virus (HBV) infections are rapidly spreading in developing countries due to the lack of health education, poverty, illiteracy and Hepatitis B vaccination. No widespread population based data of HBV is available in the country's aspect. So, a population-based serological survey was done to determine the prevalence of the Hepatitis B core antibody total (IgM+IgG) in an impoverished Urban Community in Dhaka, Bangladesh. A descriptive cross-sectional study was conducted among 384 healthy individuals and age between 18-60 years from the urban slum in Dhaka city. The study was implemented through collaboration with Shaheed Suhrawardy Medical College, Dhaka from January 2013 to June 2013. The study participants were selected through systematic sampling procedure and blood tested for anti-HBc. Anti-HBc estimations were carried out by VITROS Immune diagnostic assay. The study was pertained Ethical permission from Bangladesh Medical Research Council (BMRC) and every participant was informed regarding their written informed consent. Among the 384 respondents, 183(47.6%) individuals were positive for the core antibody of hepatitis B virus (anti-HBc). The anti HBc positive group consisted almost of equal number of male 93, (24.2%) and female 90 (23.4%). There was a significantly increasing prevalence of the core antibody among young adults and middle age of the respondents (28.7%). Major risk factors for exposure to Hepatitis B appeared to be Ear-nose-body piercing, Circumcision by Hajam, unsafe blood transfusion and unsterile dental intervention. High prevalence of hepatitis B Core antibody (47.6%) indicates that the members of this urban community are highly exposed to hepatitis B virus.

Limited Urethral Mobilization Technique in Distal Hypospadias Repair : An Overview

Background: Fistula formation is the most common complication with various rates among different techniques of hypospadias repair. The urethral advancement as an one stage technique for repair of hypospadias is considered a good technique. As no new urethral tube is constructed there is no risk of fistula. We assess the outcomes of the Limited Urethral Mobilization (LUM) technique in distal hypospadias repair.Methods: Our study included 20 patients aged upto 12 years who were treated with Limited urethral mobilization technique for distal hypospadias in Shaheed Suhrawardy Medical College Hospital from December 2014 to December 2015. The urethra proximal to the meatus was mobilized for a distance sufficient to allow it to reach the glans tip without tension. Then the urethra was placed in the glanular bed and glanular reconstruction was performed.Results: Three-fold urethral mobilization was sufficient for construction of tension-free urethra-glanular anastomosis. Cosmetically normal looking circumcised penis with ventrally slit meatus achieved in all but one subcoronal case where the most distal of the glans approximation sutures disrupted leading to a minor detachment in the glans. The minor complications includes preputial edema in one patient, two patients had wound infection, one had meatal stenosis which was treated with gentle dilatations. Postoperative urethro cutaneous fistula, retraction of the urethral meatus or recurrent chordee were not observed.Conclusion: Distal hypospadias repair with the LUM technique can be effective with satisfactory cosmetic and functional results. There is no chance for development of urethro cutaneous fistula, a major postoperative complication of other surgical techniques of creating a neourethra. Postoperative management is simple and a brief hospital stay is sufficient.Chatt Maa Shi Hosp Med Coll J; Vol.16 (1); Jan 2017; Page 37-41

Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

Background: Neurological disorders represent one of the most prominent causes of morbidity and mortality that adversely affect the lifestyle of patients and a major percentage of these diseases exists in developing countries. Purpose: The objective of this study was to examine the prevalence and prescription pattern for outpatients with neurological disorders in Bangladesh. Methods: The study was conducted on 1,684 patients in 6 hospitals (National Institute of Neurosciences and Hospital, Dhaka Medical College and Hospital, Bangabandhu Sheikh Mujib Medical University, Shaheed Suhrawardy Medical College, Sir Salimullah Medical College, and Apollo Hospitals Dhaka) of the Dhaka City from March 2014 to June 2015. Data were collected through a predesigned questionnaire from the patients that contain information about gender, age, marital status, occupation, residential status, affected disease, self-medicated medicines, and prescribed medicines. Results: Out of 1,684 patients, 28.38% patients were aged 51–60 years and male, 57.19% predominance. The study exposed headache and migraine for 29.75% patients, followed by stroke for 23.93% patients and seizure for 7.07% patients. Genetic reason for the neurological disorders was seen only among 12.35% patients. In this study, 16.98% patients had been affected by neurological disorders for more than 2 years and 19% of patients for less than 6 months. Most extensively prescribed medicines were multivitamins and multiminerals used by 17.89% of patients followed by nonsteroidal anti-inflammatory drugs and other analgesic by 14.84%; afterwards antiulcerants were used by 12.62%, subsequently anticoagulants were used by 11.61% followed by antihyperlipidemic medicines by 10.26% and antiepileptic drugs by 8.08% of patients. The crucial reasons for the selection of prescribed medicines were the confidence that patients had with the physician’s prescribed medicines, which was shown for 40.97% patients and knowledge of the medicines was reported for 35.04% patients. The period of prescribed medicine usage was 1–3 months for 39.73% patients and 3–6 months for 29.16% patients. The patient’s compliance for prescribed medicines was satisfactory for 34.56% patients, good for 28.15% patients, and side effects were reported for 23.22% patients. Conclusion: In Bangladesh, it is not surprising to note that neurological diseases are more prevalent than other different diseases among different age groups and genders. Headache and migraine, stroke and seizure are most frequently encountered neurological disorders here. Treatment procedure of these disorders is not quite suitable due to the anomalies of health care management systems. Appropriate management of the health care system, especially the placement of hospital and community pharmacy can overcome the existing inconsistencies as well as increase the knowledge, awareness, and perception of the patients about health and neurological disorders.

Comorbid Risk Factors for Acute Stroke: A Case-Control Study in Tertiary Care Hospital of Bangladesh

Background: There is a high prevalence of coexisting medical conditions in patients with acute stroke; therefore, clinical investigators often need to adjust for comorbidities when assessing the effect of those risk factors on patient outcome. Objective: This study aimed to determines comorbid risk factors in patients with acute stroke.Methodology: A hospital-based case control study was conducted in Shaheed Suhrawardy Medical College Hospital (ShSMCH) and Dhaka Medical College Hospital between January-June 2011. The cases and controls studied consisted of 175 hospitalized patients with stroke (confirmed by computed tomography scan) and 171 matched-age and sex controls that were hospitalized at the study hospital for condition other than stroke. After obtaining written informed consent from the patient or the closest attendant, all the information included to record were age, sex, monthly family income, family size, family history of CVD death, history of hypertension and diabetes mellitus, ECG change, aspirin intake, blood pressure and heart rate, waist and hip circumference and psychosocial factors. The edited data then analyzed by SPSS V. 16.Result: The most predictive independent variables were history of hypertension (OR 4.056), psychosocial stress (OR 4.90) and increased WHR (OR 3.806) were found significant risk factor for developing stroke. Conclusion: Therefore, to recognize comorbid risk factors and to treat them appropriately is the key to establish primary preventive strategies in non-stroke patients or secondary preventive measures to avoid recurrence in stroke victims. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 84-88

Glycemic Status and Lipid Profiles Changes among the Incidentally Diagnosed Fatty Liver Patients

Background: Fatty liver disease is common condition. Objective: The purpose of the present study was to see the glycemic status and lipid profiles changes among the incidentally diagnosed fatty liver patients. Methodology: This was an observational descriptive study conducted in the Department of Gastroenterology at Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh from the duration of January 2010 to July 2010 for a period of six (6) months. Seventy patients attending indoor or outdoor of Shaheed Suhrawardy Medical College & Hospital Dhaka, diagnosed ultrasonographically as fatty liver who were met the inclusion and exclusion criteria were recruited. Those subjects who were presented at the outdoor and/or indoor in the hospital for different health problems and were diagnosed as fatty liver on the basis of USG findings were included for this study. Patients of fatty liver diagnosed incidentally by ultrasound, performed for other purposes were planned for study. Blood samples were taken for analysis of risk factors after completing the physical examinations. Result: A total number of 70 patients were recruited for this study. Among the study population, 48 (68.57%) were between 20-50 years of age, 6 (8.57%) were less than 20 years and 16 (22.85%) were more than 50 years. Regarding Glycemic status, 15(21.42%) cases were Diabetic, 25(35.71%) cases had impaired glucose tolerance and 30(42.85%) cases had normal blood sugar. Regarding dyslipidaemia, 51(72.85%) cases had high triglyceride level (>150 mg/dl); 42(60%) cases had hypercholesterimea (>200 mg/dl); decreased HDL (<40 mg/dl) in 37 (52.85%) cases and increased LDL (>150 mg/dl) in 21(44.28%) cases. Conclusion: In conclusion the abnormal gycemic status and dyslipidemia is present in the incidentally diagnosed fatty liver patients. Journal of National Institute of Neurosciences Bangladesh, 2016; 2(1): 26-29