Sylhet MAG Osmani Medical College Research Articles

Assessment Of The Follicles in Different Age Groups in Post Mortem Human Ovary

Ovary is one of the essential reproductive organs in human being. A detailed histomorphological feature of ovary is an un-debatable for diagnostic and therapeutic purpose for ovarian disease. The standardization of the morphological and histological measurements of ovary in general in Bangladeshi people is essential to increase the knowledge regarding anatomical variation in our population. So a research work on detailed anatomical parameters of ovary is an un-debatable.
 Objective: To find out the follicles in different age groups post mortem human ovary.
 Methodology: The cross-sectional observational study was carried out in the Department of Anatomy, Sylhet MAG Osmani Medical College, Sylhet in collaboration with the Department of Forensic Medicine, Sylhet MAG Osmani Medical College during the period from January 2016 to December 2016. Sixty pairs of human postmortem ovaries were collected. The inclusion criteria were dead bodies autopsied within 36 hours of death. Considerable signs of decomposition or decomposed dead body, presence of gross ovarian disease and any history of poisoning cases were excluded. All the specimens were examined for morphological parameters but only 18 specimens were examined histological parameters.
 Results: The highest total numbers of the follicles were found in the age group A and lowest total numbers of the follicles were in the age group C. The differences of total numbers of the follicles were significant between group-A and group-B (p<0.001); and group-A and group-C (p<0.001); but no significant difference was observed between group-B and group-C (p=0.080).
 Conclusion: Histomorphologically, the total number of the follicles is found maximum at reproductive years and is declined through perimenopause and postmenopause.
 Central Medical College Journal Vol 5 No 2 Jul 2021 PP 84-87

Effects of Hypofractionated Radiotherapy in Advanced Stage of Non-Small Cell Type Bronchogenic Carcinoma

Introduction: Bronchogenic carcinoma accounts for about one-third of all cancer deaths among males. The inclination is such among females as well. This disease is more communal in males than females. Decreasing the number of fractions required for palliative care should be of understandable advantage for both individual patients and the usage of radiotherapy resources. Methods: This prospective study was carried out in Sylhet MAG Osmani Medical College & Hospital from 1st July 2020 to 30th June 2021 to determine the effects of hypofractionated radiotherapy in an advanced stage of bronchogenic carcinoma. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Result: The age of the patients ranged from 41-70 years and the maximum prevalence of the disease was seen above the 50s. The male- to-female ratio was 6:1 in the intervention arm and 14:1 in the control arm. The male gender is predominant. All the male patients were tobacco smokers and the females were passive smokers. Lung cancer was found most in cultivators in this study. Cough, chest pain, dyspnoea and haemoptysis were considered as parameters of symptoms. Most of the patients presented with cough, chest pain, dyspnoea and some with haemoptysis. In Arm A, 67% of patients got relief from all the symptoms during treatment time. In the rest 33%, early side effects were developed and treated accordingly. Ultimately 87% of patients got relief from all the symptoms within 2 weeks of completion of treatment. In 13% of cases, there was no relief. In Arm B, 74% of cases got relief from all the symptoms during treatment time. In the rest 26% of cases, adverse reactions developed. These subsided automatically in some cases and others, supportive treatment was required. Finally, 83.33% of cases became free of symptoms and 16.67% of cases were having no symptomatic relief. ..........

Sacralization of Coccygeal Vertebra: A Descriptive Observational Study in Bangladesh

Background: In the sacrococcygeal region, anatomical variation is due to the sacralization of the coccygeal vertebra, which is the due union of/fusion of the fifth sacral with the first coccygeal vertebra of five couples of sacral foramina under-detected or asymptomatic beyond radiological assessment. That is why it is challenging to know the cause of coccydynia, caudal block failure, the difficult second stage of labor, and perineal tears. The present study aims to improve knowledge about the anatomical variation of sacralization of the coccygeal vertebra. Additionally, to find the prevalence of sacralization of coccygeal vertebra in Sylhet, Bangladesh.Methods: This study was performed on 60 parched, totally calcified, typical sacra of mature-age individuals of undetermined sexes, fulfilling the inclusion criteria from the bone bank of the osteology museum of the Department of Anatomy, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh, from July 2017 to June 2018. Sex determination of the collected unknown sacra was conducted using discriminant function analysis. It was found that 50% (30) were male and 50% (30%) were female. The unpaired t-tests and chi-square were utilized to determine the statistical significance.Results: Out of 60 sacra, eight (13.33%) samples presented with sacralization. This study found that males had significantly higher straight (p=0.05) and curved (p=0.05) lengths of sacrococcygeal vertebrae. The sacrococcygeal curvature index (SCI) showed statistically significant (p=0.05) differences between the sexes.Conclusion: Sacralization may exert an impact on the caudal block. It could extend the second stage of the labor process with perineal tears. Therefore, knowledge about the anatomical variation of the coccygeal vertebra is essential.

Clinicopathological Study of Sinonasal Malignancy-Experience in a Tertiary Level Hospital in Bangladesh

Objectives: To assess the clinical presentation and histopathological types and extensions of the disease at the time of presentation.
 Methods: Cross sectional observational study of 40 patients with sinonasal malignancy from the department of otolaryngology and Head neck surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet Bangladesh, period from May 2019 to April 2020. The patients were examined after admission into hospital pre-operatively and in the postoperative period. The surgical specimens were sent for Histopathology.
 Results: Majority patients were at 4th to 6th decade where male outnumbered the female with male female ratio was 3.4:1. Out of 40 patients, the majority of patients complaints of nasal obstruction followed by nasal discharge, facial pain, facial swelling and headache. About the site of the lesion maximum patients having the lesion in Maxillary sinus (60%) followed by nasal cavity (15%) multiple sinuses (12.5%) involvement in Ethmoidal sinus (10%) lateral wall of nose (2.5%)
 Conclusion: Sinonasal Malignancy is usually a disease of middle age and elderly people. Most of the patients (in this study 65% patients come at T3 & T4 stage) presented late with multiple symptoms.
 Bangladesh J Otorhinolaryngol 2022; 28(1): 37-42

Diagnostic Value of Inflammatory Markers in Acute Appendicitis

Background: Appendicitis in children is a common surgical emergency and its diagnosis remains challenging. Diagnosisusing blood inflammatory markers is still debatable. The purpose of this study was to determine the effectiveness of bloodinflammatory markers obtained during routine blood tests in diagnosing acute appendicitis in childrenin addition torespondent's demographic data as well. Methods: This was a descriptive cross-sectional study conducted between January 2018 to June 2019 at the Department ofSurgery of Sylhet MAG Osmani Medical College Hospital to determine the value of blood inflammatory markers in thediagnosis of acute appendicitis. The study enrolled 246 patients who underwent surgery for acute appendicitis based onclinical/ultrasonographic diagnosis. Prior to surgery, white blood cell (WBC) count and C-reactive protein (CRP) levels of thepatients were measured, and their sensitivity was analyzed based on histopathological diagnosis. Results: The mean age of the 246 study participants was 28.31±10.12 years. Histological confirmation of acute appendicitiswas obtained in 212 cases. The male-female ratio was 2.21:1 in 212 cases of confirmed appendicitis. WBC counts had asensitivity of 84% and CRP 76% while those were elevated alone. But the sensitivity and specificity increased to 91% and 75%,respectively when both the WBC counts and CRP levels were raised. Conclusion: When only the WBC count or CRP is performed, no additional information can be obtained to help the diagnosisof acute appendicitis. However, the diagnostic sensitivity increases when both WBC count and CRP level are raised. Keywords: Acute appendicitis, Laboratory diagnosis, Children, White blood cell, C-reactive protein

Psychiatric morbidity among the patients of first ever ischemic stroke

Ischemic stroke is one of the leading causes of mortality and morbidity worldwide and third common cause of death in developed countries which consumes annually a great cost, directly or indirectly and stroke produces a wide range of psychiatric disorders. This was a cross sectional study, conducted in the department of Psychiatry, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from 1 July 2013 to 30 June 2014 to evaluate the psychiatric morbidity among the patients of first ever ischemic stroke. For this purpose, 66 ischemic stroke patients of first attack between 2 weeks to 2 years of stroke, aged above 18 years irrespective of sex and 66 accompanying healthy persons of the patients and other patients without any kind of stroke matching age and sex fulfilling inclusion and exclusion criteria were taken in Group[1]A and Group-B respectively. Psychiatric assessment was done using General Health Questionnaire (GHQ12) as a screening tool and all GHQ12 positive cases were evaluated using mental state examination. Diagnoses of psychiatric disorders of all respondents were confirmed by psychiatrist according to Diagnostic and statistical manual of mental disorders (DSM) 5 criteria. Ethical issues were maintained properly and an informed written consent was taken from every patient. After collecting data, editing was done manually and was analyzed with statistical package for social sciences (SPSS) version 21. The result showed that, the mean age of the respondents was 57.6 (SD±5.5) years which was almost identical to control group (p=0.130). Most (87.9%) of the patient were below the age of 65 years. Co-morbid psychiatric disorder was found in (34.8%) patients with ischemic stroke and (13.6%) control subjects (p=0.004). The most common psychiatric disorder was generalized anxiety disorder (13.6%) and major depressive disorder (21.2%) in ischemic stroke group. The results of this study suggested that, a significant number of patients with ischemic stroke were suffering from psychiatric disorders than the age and sex matched control. Bang J Psychiatry 2022;36(1):11-17

Study Of Serum Triglyceride And Ldl-cholesterol Among Patients Suffereing From Liver Cirrhosis And Its Relation With Severity of The Disease

Background: Cirrhosis is characterized by abnormal structure and function of the liver. Liver synthesizes the various lipoproteins involved in transporting cholesterol and lipids throughout the body. This makes liver an important site for lipid metabolism as well as its transport. Thus liver cirrhosis is associated with lipid abnormalities and the amount of decrement is expected to be significantly correlated with increasing severity of liver damage.
 Aims and objectives: To determine serum TG and LDL-C in patients with cirrhosis and study their relationship to the severity of cirrhosis.
 Materials & Method: This cross-sectional study was carried out in the Department of Biochemistry, Sylhet MAG Osmani Medical College, Sylhet during the period from January to December 2016. Fifty cirrhosis of liver patients fulfilling the inclusion criteria were enrolled as group-A and 50 age-sex matched healthy adults were selected as the control group (group-B).
 Result: Fasting serum TG and LDL-C were estimated. Severity of liver Cirrhosis was categorized according to Child-Pugh scoring system and increasing severity was categorized as Child Pugh class A, B and C. TG and LDL-C were decreased in patients with liver cirrhosis. The level of severity of liver damage significantly affects the serum LDL-C level in cirrhosis; and may be considered as marker of severity of liver damage in cirrhosis.
 Conclusion: It may be concluded that hypolipidemia exists in patients with liver cirrhosis and screening for severity of cirrhosis by LDL-C is important for intervention with appropriate therapy to reduce the severity of the disease.
 Central Medical College Journal Vol 5 No 1 Jan 2021 PP 25-29

Psychiatric Morbidity Among the Patients of First Ever Ischaemic Stroke

AimsTo evaluate psychiatric morbidity among the patients of first ever ischemic strokeMethodsThis sectional comparative study was carried out in the Department of Psychiatry, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from 1st July 2013 to 30th June 2014. Sixty six ischaemic stroke patients of first attack between 2 weeks to 2 years of stroke, aged above 18 years irrespective of sex and 66 accompanying healthy person of the patients and other patients without any kind of stroke matching age and sex fulfilling inclusion and exclusion criteria were taken in Group-A and Group-B respectively. Diagnosis of ischaemic stroke was made in these patients by the consultant neurologists reviewing the history, clinical examination and accompanying investigations reports specially CT scan of brain. Psychiatric assessment was done using General Health Questionnaire (GHQ12) as screening tool. All GHQ12 positive cases were evaluated using mental state examination and recorded in a MSE sheet. Diagnosis of psychiatric disorders of all respondents was confirmed by psychiatrist according to DSM-5 criteria.ResultsThe patients with ischaemic stroke and control subjects were similar in age [57.6 (SD ± 5.5) years vs 57.1 (SD ± 4.5) years; p > 0.130] and sex [48 (72.7%) male and 18 (27.3%) female vs 45 (68.2%) male and 21 (31.8%) female; p = 0.567]. Comorbid psychiatric disorder was found in 23 (34.8%) patients of ischaemic stroke and 9 (13.6%) control subjects. The comorbid psychiatric disorder was significantly higher in patients of ischaemic stroke than that of control g subjects (p = 0.004). Comorbid specific psychiatric disorders were generalized anxiety disorder in 9 (13.6%) and major depressive disorder in 14 (21.2%) in stroke group; while comorbid specific psychiatric disorders were generalized anxiety disorder in 2 (3.0%) and major depressive disorder in 7 (10.6%) respondents in control group (p < 0.013).ConclusionComorbid psychiatric disorders are quite common among patients with first ever ischaemic stroke in the form of major depressive disorder and generalized anxiety disorder. Therefore, attention should be paid to the anxiety and depressive symptoms in stroke units and try to relieve the patients’ emotional stress and personal suffering, which could improve their neurological outcome.

Seroprevalence of Diphtheria IgG Antibody in Relation with Socio-demographic Change at a Tertiary Care Hospital in Bangladesh

Background: Seroprevalance of diphtheria antibody may vary in different socioeconomic people.
 Objective: The purpose of the present study was to determine the seroprevalence of diphtheria IgG antibody and to identify the relationship between diphtheria seroprevalence and several sociodemographic characteristics.
 Methodology: This cross-sectional study was conducted in the Department of Microbiology at Sylhet MAG Osmani Medical College, Sylhet, Bangladesh from July 2016 to June 2017 for duration of one year. Apparently healthy individuals were enrolled in this study as study population by following a set of inclusion and exclusion criteria. For laboratory procedure, anti-diphtheria antibody titer was measured by ELISA method.
 Result: A total number of 200 healthy individuals were recruited for this study. The mean serum IgG level was 0.23±0.26 IU/mL in participants of aged between 18 to 25 years which was much lesser in participants of aged between 26 to 32 years and 33 to 38 years group (p=0.001). Mean serum IgG level was 0.12±0.12 IU/mL in male participants. Majority participants have been come from lower middle class having mean serum IgG level of 0.10±0.21 IU/mL.
 Conclusion: In conclusion diphtheria IgG level is most commonly found among young male adult person in upper middle class socioecomonic condition.
 Journal of National Institute of Neurosciences Bangladesh, July 2021, Vol. 7, No. 2, pp. 156-160

Correlation of Atd-Angle Between non-Insulin Dependent Diabetes Mellitus and Normal Individuals in Bangladeshi Population

Dermatoglyphics is the study of configuration of the epidermal ridges in palms, soles and digits. Development of dermatoglyphic pattern in under genetic control, it does not change throughout the life once development being completed. As a diagnostic aid, Dermatoglyphic pattern analysis can successfully predict onset of many diseases, which has a strong hereditary basis. Diabetes mellitus (DM) is a condition of partial genetic background. The aim of this study was to compare the atd-angle of dermatoglyphicsin order to identify as a risk factor to predict diabetes in future.This observational cross-sectional study was conducted in Sylhet MAG Osmani Medical College from July 2018 to June 2019. There were a total of 200 subjects recruited in this study; among them 100 were healthy individuals and the rest 100 were the diagnosed patients of type II DM.The studied groups were matched for age and sex of the study subjects. Paper and ink method was used for making print of fingers and palms. The prints were examined using mounted hand lens. The mean atd-angle was higher in cases in both hands compared to the control. On the left hand, the mean 43.23±2.14 in cases and 41.11±1.65 in control; and 42.87±2.25 in cases and 41.19±1.89 in control on the right hand. Unpaired t-test showed statistical significant mean differences between the studied groups both in left hand (t = -7.844, p = <0.001, 95% confidence interval: -2.651 to -1.585) and right hand (t = -5.749, p = <0.001, 95% confidence interval: -2.267 to -1.109). So,based on the result of this study, it can be concluded that the atd-angle would be a helpful parameter to find out high risk individuals for NIDDM in future.

Relationship between Obesity and Sympathetic Nerve Function Status

In order to assess the effect of obesity on sympathetic nervous system a cross-sectional observational study was carried out in the Department of Physiology, Sylhet MAG Osmani Medical College between January 2017 and December 2017. Fifty obese and age-sex matched 50 non-obese subjects were included. Two non-invasive cardiovascular sympathetic function tests like blood pressure response to postural change (orthostatic test) and blood pressure response to sustained handgrip were done to assess sympathetic nerve function status.The fall in systolic blood pressure (SBP) in orthostatic test of obese group (9.02 ± 2.29 mmHg) was significantly higher compared to non-obese group (4.84 ± 0.96) (p<0.001). Increase in diastolic blood pressure (DBP) in handgrip test of obese group (12.36 ± 2.78 mmHg) was significantly lesser than that of non-obese group (20.12 ± 2.64 mmHg) (p<0.001). The results of this study suggested that obese adults have reduced sympathetic activity.

Evaluation of Caesarean Section Rates at Sylhet MAG Osmani Medical College Hospital Using the Robson Ten Group Classification System

Evaluation of Caesarean Section Rates at Sylhet MAG Osmani Medical College Hospital Using the Robson Ten Group Classification System

Efficacy and Safety of Gabapentine and Duloxetine in Diabetic Peripheral Neuropathic Pain

Introduction: Diabetic peripheral neuropathy (DPNP) is not uncommon now a days. As the pathophysiology is not completely understood, symptoms relief is still the main goal of treatment. Gabapentine and Duloxetine are being using around the world for this purpose. But clinical data regarding its efficacy and safety are not sufficiently available. Materials and Methods: This prospective comparative clinical study conducted in Sylhet MAG Osmani Medical College and Sylhet Diabetic Hospital, Bangladesh from January 2013 to December 2013. Diagnosis of DPNP confirmed by Michigan Neuropathy Screening Instrument (MNSI) and Douleur Neuropathic en-4 (DN4). Patients were treated by Gabapentine (Group-A) and Duloxetine (Group-B); and followed up at 4th, 8th and 12th week of treatment using 11-point numerical pain rating scale (NRS), clinical global impression of change (CGIC) score and patient’s global impression of change (PGIC) score. Results: A total of 72 patients with DPNP were recruited. Final comparison was done in 64 patients – 33 in Group-A and 31 in Group-B. Changes in NRS (p = <0.001), CGIC (p = <0.001) and PGIC (p = <0.001) were statistically significant during the course of treatment. However, inter-group variation of NRS, CGIC and PGIC were not statistically significant at the beginning and 4th, 8th and 12th week of treatment. Insignificant adverse effects were noted between the groups in this study except constipation (p = 0.022) and nausea-vomiting (p = 0.01) of Duloxetine taking group. Conclusion: Gabapentine and Duloxetine are equally effective in the treatment of DPNP with good safety profile. Medicine Today 2021 Vol.33(2): 108-113

Non-viral Microbial Keratitis in a Tertiary Care Hospital in Bangladesh

Introduction: Microbial keratitis is a serious ocular infectious disease that can lead to significant visual loss and ophthalmic morbidity. Objectives were to see the profile of non-viral microbial keratitis in a tertiary care hospital in Bangladesh. Materials and Methods: This cross-sectional study was conducted in the Department of Ophthalmology, Sylhet MAG Osmani Medical College Hospital, Sylhet between January 2015 and December 2016. Results: The mean age of the patients was 46.7 ± 16.5 years with male preponderance (54.4%). The most common predisposing factors were trauma (66.7%), and chronic dacryocystitis (25.6%). Fungal growth was more frequent compared to bacterial growth 70 (77.7%) versus 30 (33.3%), p<0.01). Gram positive organisms were Staphylococcus epidermidis (11.1%), Staphylococcus aureus (3.3%); gram negative organisms were Pseudomonas aeruginosa (12.2%), Klebsiella species (3.3%) and Escherichia coli (3.3%). Aspergillus species (71.4%) was the commonest fungus. Others were Penicillium species (7.1%), Fusarium species (8.6%), Mucor (10.0%) and Rhizopus (2.9%). Conclusion: Fungi are more frequent cause of non-viral keratitis. Watering, redness, pain or burning sensation, corneal opacity and dimness of vision are clinical profiles of non-viral microbial keratitis. Medicine Today 2021 Vol.33(2): 133-137

Prevalence of rotavirus infection and its association with socio-demographic characteristics among under-five children admitted with acute diarrhoea in a tertiary care hospital of Bangladesh

Background: Rotavirus has been recognized as the most common cause of acute watery diarrhoea among under-five children worldwide. It is considered as a major cause of childhood morbidity and mortality particularly in developing countries like Bangladesh. Considering the high morbidity and significant mortality, this study was designed to evaluate the prevalence of rotaviral diarrhoea among children less than five years in Sylhet region of Bangladesh. Methods: This cross-sectional study was conducted in the Department of Microbiology, Sylhet MAG Osmani Medical College from 1st January to 31st December, 2018. Total 184 under-five children admitted in paediatrics department of the same institute with acute watery diarrhoea were enrolled in this study by convenient sampling. Stool samples were obtained and assayed for rotavirus antigen by sandwich type enzyme linked immunosorbent assay (ELISA). Results: Rotaviral antigen was found positive in 86 cases and disease prevalence was 46.74%. The rotavirus infection was found highest in age group of 7 to 12 months (50.56%) and in male (59.30%) children. Prevalence of infection was associated with age (p= 0.004), socio-economic condition (p=0.001) and exclusive breastfeeding of children (p=0.01). Conclusion: Rotavirus was a significant cause of acute watery diarrhoea and mainly affected children below 12 months age. BIRDEM Med J 2021; 11(3): 186-190

Frequency and Treatment Outcomes of Isolated Ventricular Hemorrhage Cases Among Traumatic Intracranial Hemorrhage Patients

Background: Bleeding into the ventricular system of brain is called intraventricular hemorrhage (IVH). It may be associated with brain parenchyma. Cases of isolated ventricular hemorrhages are found less. Ventricular hemorrhage due to trauma is more commonly seen in premature babies and infants than adults. Uncertainty in recovery is a important issue for such cases. Aim of the study: The aim of this study was to evaluate the frequency and the treatment outcomes of isolated ventricular hemorrhage cases among patients with traumatic intracranial hemorrhage. Methods: This prospective observational study was directed in the neurosurgery department of Sylhet MAG Osmani Medical College, Sylhet, Bangladesh from January 2015 to December 2020. In total 890 Admitted diagnosed cases of traumatic intracranial hemorrhage were chosen for this study as study population. Ultrasonography CT scan, MRI of the brain, MRA, MRV, and CSF were performed according to the patient’s status. Those were collected, processed, analyzed, and disseminated by using MS office and SPSS version 23 as per need. Results: According to this study, in total participants, the highest number was with parenchymal hemorrhage which was 34% (n=302). Besides these, cases with extradural hemorrhage were 33% (n=298), cases with subdural hemorrhage were 17% (n=149%), cases with subarachnoid hemorrhage were 14% (n=124) and cases with isolated ventricular hemorrhage (IVH) were 2% (n=17). So, in this study, the frequency of IVH was found only 2% among all types of traumatic intracranial hemorrhage cases. Among a total of 17 IVH patients, most of the cases were infants or baby which was 59%. And 41% of the IVH patients were adults. In analyzing the outcomes among the IVH patients we observed, early recovery was found in 1 child (5.88%) and in 2 adults (11.76%). Besides these, death was occurred in 6 children (35.29%) and in 3 adults (17.65%). Conclusion: Traumatic isolated ventricular hemorrhage (IVH) causes the worst prognosis in most cases. The survival rate with no residual effect is very minimum. In this study in 2 patients’ history of long coma, for more than 12 weeks was found. Besides these, moderate to severe morbidity was found in some cases.

Incidence of surgical site infections after emergency laparotomy for perforation peritonitis

Background: Generalized peritonitis as a result of gastrointestinal perforation is a common surgical emergency and one of important morbidity is surgical site infection (SSI). Objectives: to evaluate the incidence of SSI after emergency laparotomy for perforation peritonitis. Methodology: A prospective interventional study was conducted in the Department of Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet from December 2019 to November 2020. Ninety patients who underwent emergency laparotomy for perforation peritonitis aged 18 years or above were included. After laparotomy standard closure technique was applied in all cases and subcutaneous closed suction drain was given in 43 cases. Results: The mean age of the patients was 32.59 ± 11.88 years, 58.9% of patients were in 21-40 years and male preponderance (66.7%). Peritonitis was most commonly due to peptic ulcer perforation (38.7%) followed by burst appendix (27.8%). Incidence of SSI was 26.7%. Subcutaneous closed suction drain was used in 47.8% of cases and its use reduced the incidence of SSI [OR=0.344 (95% CI=0.126-0.937) χ2=4.543; p=0.033]. Conclusion: Perforation peritonitis is associated with higher incidence of SSI and subcutaneous closed suction drain is effective in reducing the chances of SSI.

Port-site infiltration of bupivacaine in reduction of postoperative pain after laparoscopic cholecystectomy

Background: Port site pain remains prevalent complaint of early postoperative period after laparoscopic cholecystectomy. Objectives: to see the analgesic efficacy of port-site infiltration of bupivacaine in laparoscopic cholecystectomy. Methodology: This randomized controlled clinical trial was conducted in the Department of Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet from September 2017 to March 2018. Sixty patients underwent laparoscopic cholecystectomy were randomized into experimental group and control group by odd and even number respectively. Infiltration of 0.5% bupivacaine was at port sites subcutaneously in experimental group and none in control group. Postoperative pain intensity was measured using Numeric Rating Scale (NRS) at 6, 12, 24 and 48 hours. Results: Pain score was lesser in experimental group compared to control group at 6, 12, 24 and 48 hours (p< 0.001). The amount of opioid analgesic needed (p=0.006) and hospital stay (p=0.048) were significantly lesser in experimental group. Less frequent nausea/vomiting (p=0.034) and bladder dysfunction (p=0.012) were in experimental group. Conclusion: Port-site infiltration of bupivacaine is effective in reduction of postoperative pain in laparoscopic cholecystectomy.

Clinical and Bacteriological Profile of UTI Patients in Medicine Department in a Teaching Hospital of Bangladesh

Introduction: Urinary tract infections (UTIs) encompass a wide array of infections, accounting for a vast number of community as well as hospital acquired infections. This study was undertaken to evaluate the clinical presentations and bacteriological profile of UTI patients in indoor setting.&#x0D; Methods: This 6 months cross-sectional study enrolled 100 patients admitted in Medicine department of Sylhet MAG Osmani Medical College Hospital with symptoms and signs of UTI subsequently confirmed by compatible investigations including urine culture.&#x0D; Results: Among 100 patients of UTI, maximum were females (67%) and the male female ratio was 0.49: 1. The most common age group was 46–60 years (34%). Majority (68%) of the patients had upper UTI while lower UTI constitutes 32%.66% of the patients had complicated while 34% have uncomplicated UTI.18% of the patients had recurrent UTI. Most of the patients had fever (55%), followed by loin pain (37%) as their presenting symptoms. The most common risk factor was loss of host defense 38% (diabetes mellitus/ use of immunosuppressive drugs).Out of 100, 60 urine samples were positive for pathogenic organisms. Escherichia coli was isolated in 41 (68.3%) of the positive samples, followed by Klebsiella sp 13 (21.6%), Pseudomonas sp 3 (5%) Proteus sp 2 (3.3%) Staph. Aureus 1(1.66%).&#x0D; Conclusion: The most common clinical presentations of UTI in admitted UTI patients are fever and loin pain. Diabetes mellitus is the most important risk factor. Mainly Gram negative bacilli were found to be responsible for UTI and most frequent isolated bacteria was E-coli.&#x0D; J Bangladesh Coll Phys Surg 2021; 39(2): 106-113

A Comparative Study on Serum Magnesium in Pre-eclampsia and Non Pregnant Women

Introduction: There are many Hypertensive disorders in pregnancy like preeclampsia, eclampsia etc. Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Some studies have implicated that low serum calcium levels may have a role in pre-eclampsia but other studies failed to find relation between low levels of these trace elements and pre-eclampsia.&#x0D; Materials and Methods: This cross sectional study was carried out in the Department of Biochemistry, Sylhet MAG Osmani Medical College in collaboration with the Department of Obstetrics and Gynaecology, Sylhet MAG Osmani Medical College Hospital during the period from January 2016 to December 2016. This Study was occured in among 31 pre-eclampsia patients, aged 20 to 40 years, and gestational age ranges from 20 to 40 weeks and 31 age matched normotensive non-pregnant women having no proteinuria. Serum magnesium was measured by Colorimetric method.&#x0D; Results: The mean serum magnesium level was 3.24 (±1.42) mg/dl in pre–eclampsia and was 3.30 (±1.5) mg/dl in normal women. The mean serum magnesium level did not differ significantly between the subjects of pre–eclampsia and normal women (t=0; p&lt;.05).&#x0D; Conclusion: The means of both data sets are equal. So we can conclude that there is no significant difference between them.&#x0D; Medicine Today 2021 Vol.33(1): 58-60