Tertiary Care Hospital In Bangladesh Research Articles

Evaluation of fracture healing status: Union, delayed union, and non-union in a tertiary care hospital in Bangladesh

Evaluation of fracture healing status: Union, delayed union, and non-union in a tertiary care hospital in Bangladesh

Study of Clinical and Biochemical Factors Affecting Early Failure of Arteriovenous Fistula in a Tertiary Care Hospital of Bangladesh

Study of Clinical and Biochemical Factors Affecting Early Failure of Arteriovenous Fistula in a Tertiary Care Hospital of Bangladesh

Outcome of paediatric cardiac surgery in a tertiary care hospital of Bangladesh

Outcome of paediatric cardiac surgery in a tertiary care hospital of Bangladesh

Demographic and clinicopathological profiles of thyroid gland swelling: Insights from a tertiary care hospital in Bangladesh

Demographic and clinicopathological profiles of thyroid gland swelling: Insights from a tertiary care hospital in Bangladesh

Biotin–Thiamin–Responsive Basal Ganglia Disease: A Case Report in a Tertiary Care Hospital in Bangladesh

Biotin–thiamin–responsive basal ganglia disease or biotin–thiamin–responsive encephalopathy type 2 is a rare treatable autosomal recessive neurometabolic disorder of the brain caused by mutations in the SLC19A3 gene manifested as early onset progressive encephalopathy that leads to severe disability, ataxia, dystonia, seizures, and death. Early molecular diagnosis and treatment with a lifelong supplementation of high doses of biotin and thiamin improves disease outcome and life expectancy of these patients. We are presenting a 2-year-old girl with subacute dystonia, dysphagia, and ataxia who was diagnosed as a case of biotin-thiamin-responsive basal ganglia disease and showed significant improvement after early initiation of treatment. This case report aimed to show the importance of early diagnosis and treatment initiation based on a high index of suspicion regarding history, neurological signs, and consistent magnetic resonance imaging (MRI) findings.

Metabolic profile of psychiatric OPD patients at a tertiary care hospital in Bangladesh

Metabolic profile of psychiatric OPD patients at a tertiary care hospital in Bangladesh

Hypotension in Preterm Newborns and Its Short-Term Outcome: Experience of a Tertiary Care Hospital in Bangladesh

Background: Blood pressure values of too low or too high can be related with serious morbidity and mortality. Neonatal hypotension has been found to be related with serious short term as well as significant long-term health complications. Thus, identifying this low blood pressure in preterm neonates with its impacts on neonatal health is crucial. Objectives: To evaluate blood pressure values in preterm newborn and short-term impacts of hypotension on neonatal health. Methods: This prospective observational study was conducted in Neonatal Intensive Care Unit (NICU) of Bangabandhu Sheikh Mujib Medical University a tertiary care hospital of Dhaka city after approval from Institutional Review Board for a period of one years. Neonates having gestation< 37 completed weeks admitted in NICU of BSMMU were enrolled in the study after getting informed consent from the parents. Proper antenatal and postnatal history were recorded in data collection form. Blood pressure was measured by non-invasive oscillometric method in all neonates within 24 hours after birth by ideal procedure. Blood pressure was monitored at an interval of 12 hours or more frequently when required till discharge or death. Information on neonatal mortality and morbidity were recorded in data collection form. Results: A total of 114 preterm neonates were studied during the study period, among them 61 (53.5%) had normal blood pressure and 53 (46.5%) had hypotension. Among the enrolled patients, 15 (13.2%) patients died, 3 (2.6%) left against medical advice, 11 (9.6%) 96 (84.2%) were discharged with advice. Short time outcomes like culture proven sepsis, use of ionotrops, need for oxygen support and assisted ventilation, feeding intolerance, Necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity and duration of hospital stay were significantly higher in hypotensive group. Mortality was also higher in hypotensive group than normotensive group (26.4% vs 3.3%, p <0.001). Conclusion: Hypotension in preterm neonates was associated with significant mortality and morbidity in early post-natal period.

Comparative Study of Postoperative Outcome between Laparoscopic Mesh Repair & Open Mesh Repair of Inguinal Hernia Patient in Tertiary Care Hospital in Bangladesh

Background: Inguinal hernia repair is a commonly performed surgical procedure, and the choice between laparoscopic and open approaches remains a subject of ongoing discussion. This prospective cohort study aimed to compare postoperative outcomes between laparoscopic mesh repair and open mesh repair in inguinal hernia patients in a tertiary care hospital in Bangladesh. Objective: This study aimed to assess and compare the surgical outcomes and patient recovery following laparoscopic and open mesh repair for inguinal hernias. Methods: A prospective study was conducted by Z.H. Sikder Women's Medical College Hospital and Central Hospital Ltd Dhanmondi Dhaka in Bangladesh, spanning from 2022 to 2023. It enrolled 112 individuals, each grappling with inguinal hernias; they were divided into two groups: one undergoing the intricate ballet of laparoscopic mesh repair (n=56) and the other navigating the venerable path of open mesh repair (n=56). With precision, we charted their demographics and chronicled intraoperative nuances. We scrutinized postoperative outcomes to illuminate the interplay between modern innovation and time-tested tradition in hernia care. Results: In our comparative study involving 112 patients (99.5% male, median age 30.8 ± 10.6 years), evaluating postoperative outcomes between laparoscopic and open mesh repair for inguinal hernias in a Bangladesh tertiary care hospital, significant differences were observed. The laparoscopic group demonstrated notably shorter operative durations (p<0.05), a lower incidence of wound infections (p<0.05), and reduced postoperative pain with lower analgesic requirements and shorter hospital stays (p<0.05). Additionally, the laparoscopic group exhibited a faster return to normal activities and Work (p<0.05). However, the mean operative time was significantly longer in the laparoscopic group (20.2 minutes, p<0.001), while the time to return to duty was significantly shorter (2.3 days, p=0.008). Conclusions: Laparoscopic ....

Presentation and Outcome of Children with Kawasaki Disease: Experience in A Tertiary Care Hospital in Bangladesh

Background: Kawasaki disease (KD) is an acute difficult-to-diagnose febrile illness in children caused by self limiting vasculitis in medium and small sized arteries.
 Objetive: This study has been conducted to analyze its presenting symptoms, clinical course, laboratory findings, and therapeutic options in a tertiary hospital in Bangladesh to aid early diagnosis and optimum management.
 Methods: This is a retrospective study where the medical records of 31 children admitted and diagnosed with Kawasaki Disease (KD) in Evercare Hospital Dhaka between 2009 and 2020, were assessed. Through a structured form, the demographic information, clinical profile, laboratory results, and echocardiographic data were obtained from the hospital records and then entered into a Microsoft Excel sheet. Cleaned and verified data were transferred to SPSS program version 23 and analyzed to obtain descriptive statistics.
 Results: Out of total 31 patients with KD enrolled, 64.5% of the patients were between six months to five years of age with a median age of three years; 97% had an age below 6 months. Though 68% of patients met all the required criteria for KD, one-third (32%) were diagnosed as incomplete KD with fewer manifestations. Along with high fever in all cases, the most common clinical features were polymorphous rash (90%) and changes in extremities (90%) followed by changes in the lips and oral cavity (77.4%), cervical lymphadenopathy (68%) and conjunctival injection (61%). Common laboratory abnormalities found were anemia (90%), leukocytosis (65%), thrombocytosis especially in the second week (78%), high ESR (100%), and elevated CRP (84%). About 42% of patients had cardiac abnormalities at the onset. Seven children (63.6%) had coronary artery aneurysms (CAA) whereas 18% had coronary dilatations. In subsequent followups, coronary artery changes remained almost the same up to 6-8 weeks. After 3-6 months, 87.5 % of children recovered from cardiac abnormality.
 Conclusion: A high index of suspicion for KD and an active search for compatible findings in children with unexplained fever can help in early diagnosis. Timely initiation of IVIG treatment is needed to reduce the risk of cardiac complications. Young infants under six months of age need further careful early suspicion and evaluation because of their incomplete presentation and more vulnerability to developing cardiac complications.
 DS (Child) H J 2022; 38(2): 70-78

Frequency and risk factors of retinopathy of prematurity among preterm neonates in a tertiary care hospital of Bangladesh

Background: Retinopathy of prematurity (ROP), a leading cause of childhood blindness, occurs in premature babies. Several factors like perinatal infection, inflammation, hypoxia, hypercapnia, higher oxygen support etc. have been attributed to the cause. Identifying the potentially modifiable risk factors will contribute to making preventive strategy. Objective: To identify the frequency and risk factors of ROP in premature babies. Methodology: This prospective observational study was conducted in the Department of Neonatology of BSMMU after approval from the institutional review board over a period of twelve months. Infants born <35 completed weeks, weighing <2000 g admitted in NICU are included in this study. After enrollment, screening for ROP was done at 20 days for the baby -gestational age of ≤ 30 weeks or birth weight ≤ 1200 g and at 30 days for the baby- gestational age ≤ 35 weeks or birth weight ≤ 2000g. ROP screening test was done by a pediatric ophthalmologist with indirect Ophthalmoscope. The outcome measures were the frequency and risk factors of ROP. Results: Between 2021 and 2022, 154 infants born ≤ 35 weeks gestation, weighing ≤ 2000 g were screened for ROP. Among the studied cases 30 (19.5%) patients had ROP. Among the 30 patients, 16 (53.33%) had AP-ROP, 3 (10%) had plus disease and 3 (10%) had stage IV (6.67%) ROP. Among the newborns diagnosed with ROP, 23 (76.67%) required treatments. Among them, Inj. Avastin was given to 18 (78.26%) patients, 5 (21.7%) needed Laser therapy but none of them required surgery. Univariate analysis showed risk of ROP was significantly higher in lower gestational age and lower birth weight group. Frequency of sepsis, duration of oxygen support, need for CPAP, hospital stay, and Intraventricular hemorrhage (IVH) were significantly higher among ROP group. Antenatal corticosteroid significantly lowered the risk of ROP. Multivariate analysis also showed that antenatal corticosteroid had protective effect against ROP and prematurity, lower birth weight, sepsis, longer duration of oxygen therapy, and longer duration of hospital stay increased the risk of ROP. Conclusions: This prospective observational study showed frequency of ROP was 19.5%. Prematurity, lower birth weight, lack of antenatal-corticosteroid, sepsis, longer duration of oxygen support, and longer hospital stay are some potential risk factors of developing ROP

Characteristics and Outcomes of Abortion Cases at a Tertiary Care Hospital in Bangladesh

Introduction: Abortion is a critical public health issue, particularly in developing countries like Bangladesh, where access to safe abortion services is often limited. This study aimed to analyze the characteristics and outcomes of abortion cases in a tertiary-level hospital setting, providing insights into the demographic profile of patients, nature and type of abortions, treatment methods, and post-abortion complications. Methods: This cross-sectional observational study was conducted at the department of Obstetrics and Gynecology, Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh, from June 2022 to July 2023. A total of 100 patients were consecutively sampled based on specific inclusion and exclusion criteria. Data were collected through patient medical records and interviews, focusing on demographic information, details of the abortion, and subsequent outcomes. Result: The majority of patients were in the 26-30 age group (42%), with 58% being primigravida. Most abortions occurred in the early stages of pregnancy (<13 weeks, 75%). Incomplete abortions were the most common type (83%), and the majority of cases were spontaneous (84%). Surgical intervention (D&C) was the predominant treatment method (83%). While most patients (84%) did not experience complications, a minority faced significant health challenges, including shock (5%) and septicemia (3%). Conclusion: The study highlights a high incidence of incomplete abortions and a preference for surgical treatment in abortion cases at the tertiary hospital level in Bangladesh. These findings underscore the need for improved abortion care, enhanced patient education, and better access to comprehensive abortion services. The study's insights are crucial for informing policy and practice to improve reproductive health services and address the challenges of unsafe abortion practices in Bangladesh.

Clinical, Laboratory Characteristics, and Treatment Outcomes of Histoplasmosis Among Patients Admitted to a Referral Tertiary Care Hospital in Bangladesh.

Histoplasmosis is a systemic mycosis caused byHistoplasma capsulatum(H. capsulatum). Systemic involvement of histoplasmosis usually occurs in immune-compromised patients, patients with AIDS, or those taking immunosuppressive therapy. The present study aims to describe the clinical and laboratory characteristics and treatment outcome of histoplasmosis as the diagnosis is challenging and management protocol differs. This retrospective study was done using a data registry at the medicine department of Dhaka Medical College Hospital. Here, patients received the standard treatment of histoplasmosis.Here, patients received the standard treatment of histoplasmosis, and clinical outcome was assessed at 3 months following starting standard treatment. A total of nine patients were enrolled, six (66.7%) had systemic histoplasmosis. Three were poultry workers, and the most common comorbidity was diabetes 3 (33.3%). Fever 7 (77.7%), weight loss 6 (66.7%), hyperpigmentation 5 (55.5%), cough 4 (44.4%), oral ulceration 4 (44.4%), lymphadenopathy 4 (44.4%), and hypotension 3 (33.3%) were the most common clinical presentations. Seven (77.7%) out of nine patients were cured of histoplasmosis; however, one died before initiating antifungal medications and another one died due to a hypersensitivity reaction to liposomal amphotericin B. Conclusion: For local histoplasmosis, oral itraconazole is an effective antifungal medication.However, in disseminated Histoplasmosis, liposomal amphotericin B followed by oral itraconazole is still one of the preferable and effective treatment options. Clinicians should be aware of hypersensitivity reactions of liposomal amphotericin B and its management before giving an infusion.

Demographic and Clinical Profiles of PCR Positive Rickettsia felis Infected Patients at A Tertiary Care Hospital in Bangladesh

Background: Rickettsial infections remain relatively unexplored, under recognized and under reported due to a lack of awareness and limited access to diagnosis. Objective: The purpose of the present study was to evaluate the demographic and clinical profile of PCR positive Rickettsia felis infected patients attended at a tertiary care hospital. Methodology: This cross-sectional study was conducted in the Department of Microbiology at Mymensingh Medical College, Mymensingh, Bangladesh from July 2013 to June 2014 for duration of one year. Patients with fever (102° to 104°F) more than 15 days of any age and gender, not responding to commonly used antibiotics and any other additional complaints and clinical features including headache, rash, lymphadenopathy or myalgia and eschars on the skin were included in this study. Patients with evident cause of fever like malaria diagnosed by blood smear or immunochromatography were excluded from the study. Blood was collected according to blood collection guidelines. PCR from blood was performed using standard protocol with specific primers to detect Rickettsia up to species level. Results: A total number of 50 respondents were recruited after fulfilling the inclusion and exclusion criteria. Among them 21(42%) cases were PCR positive. Among 21 PCR positive cases, the predominant age group was more than 15 to 30 years which was 11(52.4%), female patients were predominant than male patients which was 11(52.0%). All the cases with Rickettsial infection had fever 21(100.0%). Other associated features like headache was most commonly noticed in 10(47.6%) cases followed by body-ache, Cough and rash which was 7(33.3%) cases, 5(23.8%) cases and 1/21 (4.7%) cases respectively. Conclusion: This study demonstrated high prevalence of Rickettsia felis infection in patients in Bangladesh with unidentified febrile illness and suggests that this infection is endemic to the north-central area of this country. Females are more prone to get infected and most commonly noticed associated features was headache. Bangladesh Journal of Medical Microbiology, July 2023;17 (2):71-76

Perceptions of antibiotic stewardship programmes and determinants of antibiotic prescribing patterns among physicians in tertiary hospitals in Bangladesh: implications for future policy and practice

The concerning growth of antimicrobial resistance (AMR) renders common infections life-threatening due to irrational antibiotic use and a lack of effective antimicrobial stewardship programmes (ASPs). To investigate the awareness, perceptions and practices of physicians regarding ASPs, AMR and antibiotic prescribing in tertiary care hospitals in Bangladesh. This hospital-based cross-sectional survey was conducted in 11 tertiary care hospitals across Bangladesh between September 2020 and January 2021. A semi-structured questionnaire was administered through face-to-face interviews for data collection. Descriptive and multi-variate analyses were performed using STATA Version 13. In total, 559 physicians were enrolled in this survey. Overall, 40.6% [95% confidence interval (CI) 36.5-44.8] of physicians reported being aware of ASPs, and this figure was higher in public hospitals compared with private hospitals (43.8% vs 27.1%). None of the study hospitals had any ASP initiatives. More than half (55.1%) of the participants were willing to receive feedback from an ASP on their antibiotic selection. Only 30.9% of respondents stated that they wait for the findings of microbiological tests before prescribing antibiotics, although challenges included empiric use of broad-spectrum antibiotics, delayed laboratory results and the existence of drug-resistant patients. In contrast, physicians aware of ASPs were 33% (adjusted odds ratio 0.67, 95% CI 0.45-0.98; P=0.033) less likely to wait for laboratory results before prescribing antibiotics. However, 42.5% of physicians considered patient affordability of purchasing antibiotics when prescribing. Physicians' fundamental knowledge of ASPs and rational antibiotic prescription were found to fall short of the standard. Context-specific and integrated ASP activities, availability and use of guidelines, and improved laboratory facilities are required to battle AMR in Bangladesh.

Electrophysiological patterns of diabetic polyneuropathy: Experience from a tertiary care hospital of Bangladesh

Electrophysiological patterns of diabetic polyneuropathy: Experience from a tertiary care hospital of Bangladesh

Distribution of Diseases and their Prescription Pattern at Outpatients Department of Gynecology and Obstetrics in a Tertiary Care Hospital in Bangladesh

Background: Different gynaecological and obstetrics conditions are commonly encountered by the physicians in the outdoor patient. Objective: The purpose of the present study was to observe the distribution of diseases and their prescription pattern at outpatients Department of Gynaecology and Obstetrics in a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out among patients attending the outpatient’s department (OPD) of Obstetrics and Gynaecology from October 2014 to April 2015 in Rajshahi Medical College and Hospital, Rajshahi, Bangladesh. The demographic details, average number of drugs per prescriptions, percentage of drugs prescribed by generic names, percentage of encounters with an antibiotic and an injection prescribed, percentage of drugs prescribed from essential drug list (EDL) of Bangladesh, percentage of encounters with prescription of antiulcerant, NSAID, multivitamin and multimineral, iron preparation and a calcium preparation were noted. Results: A total number of 384 prescriptions were collected from Out Patient Department of Obstetrics and Gynaecology of Rajshahi Medical College and Hospital, Rajshahi, Bangladesh. Among 384 prescriptions date, name and age of the patient was written in 384 prescriptions which was 100.0% cases. Weight was written in 190(49.5%) and absent in 194(50.5%) prescriptions. Strength of drugs were written in 11(2.9%) prescriptions and not written in 373(97.1%) prescriptions. Duration of treatment was written in 100.0% prescriptions. Subscription is absent in 100.0% prescriptions. Direction to the patient was present in all prescriptions, but follow up advice were written only in 9(2.3%) prescriptions. Sign present in all prescriptions. There were about 169(44.0%) prescriptions have written the diagnosis and 215(56.0%) prescriptions did not have any diagnosis written. Conclusion: In conclusion the date, name and age of the patient are written in all prescriptions and strength of drugs are absent in almost all prescriptions. Journal of Current and Advance Medical Research, January 2023;10(1):13-18

Demographic Profile of Patients with Dengue Fever Presented in a Tertiary Care Hospital of Bangladesh

Background: Dengue is an important tropical infection caused by an arbovirus having four serotypes (DENV-1, DENV-2, DENV-3, DENV-4) transmitted through the bite of infected female Aedes mosquito. Dengue is a challenging disease with multisystemic, varied, atypical, and sometimes life-threatening presentations. It presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Each year, thousands of dengue infections are reported and there are several outbreaks of dengue in several countries including Bangladesh and this imply the global importance of this infection. The objectives of this study was to determine the sociodemographic variables of patient suffering from DF during an epidemic outbreak. Methods: This hospital review analyzed the hospital records of DF cases of BIRDEM General Hospital, Dhaka from June 2019 to December 2019. Patients with suspected dengue fever attending at the outdoor/emergency or admitted indoor were taken as study subjects. Data were collected from hospital records. Study protocol was approved by the Institutional Review Board. All the relevant data regarding history and examination findings of the patients, the laboratory reports were collected. Statistical package for social science (SPSS) version 22, was used for data entry and statistical analysis. Results: Total 292 dengue patients were enrolled in this study. Mean age of all patient was 35.63±15.22 years (11-85 year) with male predominance (54.8%). Maximum patients were from urban residence (83.9%), non-smoker (73.6%), had active lifestyle (63.4%) and normal body mass index (68.5%). Overall, 65.1% patients had no comorbidity and 89.4% had no concurrent acute illness. Conclusion: Although the results of this study cannot be generalized to other cities of Bangladesh, our findings will allow public health agencies in Bangladesh to concentrate their efforts to battle against dengue. J Bangladesh Coll Phys Surg 2023; 41: 63-68

Pattern of Childhood Malignancy in a Tertiary Care Hospital

Introduction: Cancer is a leading cause of death for children and adolescent worldwide. The cure rates in low middle-income countries are dismal (20%) in comparison to high income countries (80%). This study attempts to provide spectrum of pediatric malignancies from a tertiary care hospital in Bangladesh. Aim: Aim of this study is to evaluate the pattern of Childhood malignancy in a tertiary care hospital like Dhaka Medical College Hospital(DMCH). Materials and Methods: It is a prospective observational study was done in DMCH, over a period of 1 year (March 2014 to February 2015). After fulfilling the inclusion criteria, total 200 children aged 0-15 years were enrolled in this study. For classification of pediatric malignancies the International Classification of Childhood Cancer (ICCC), was followed. Results: Patients were stratified in 4 groups according to the age; 0-3 years, 3-6 years, 6-9 years and 9-12 years. Most of the patients fell in 6–9-year group (29%), followed by 3–6-year group (25%). Majority of cases, 61% were male. The male to female ratio was 1.55:1. Among200 cases, Leukemia (49%) was the most common malignancy followed by lymphoma, CNS Tumor, Neuroblastoma, Retinoblastoma, Wilms tumor and Malignant bone tumors. Acute lymphoblastic leukemia (ALL) comprises majority (98/200) of leukemia. Conclusion: This study gauges the trend of pediatric malignancies in Bangladesh, which is important in the planning and evaluation of health strategies. In Bangladesh, where there is dearth of high-quality data as we lack a dedicated pediatric cancer registry, such epidemiological studies play a significant part for this small but distinguished group of patients. Medicine Today 2023 Vol.35(2): 95-98

Etiological Pattern & Clinical Presentation of Dysphagia

Background & objective: : Dysphagia can cause significant morbidity and mortality, especially in older and paediatric populations. The study was undertaken to determine the demographic and clinico-pathological profile of the patients diagnosed with oesophageal dysphagia in a tertiary care hospital of Bangladesh. Methods: This cross-sectional study was conducted at the Department of Medicine & Gastroenterology in Sir Salimullah Medical College & Mitford Hospital over a period of 6 months, from March to August 2015. A total of 100 adult (aged ≥ 18 years) patients (respondents) of dysphagia of both sexes were included in the study. However, patients who dropped out before investigations being completed, or unconscious patients (as endoscopy cannot be done in unconscious patients) were excluded from the study. Result: The age distribution shows that patients were predominantly older (60%), male and rural resident. In terms of occupation, retired persons comprised the main bulk (38%). About half (49%) of the patients were middle-class and smoker. Presence of both solid and liquid food dysphagia was more or less common (44%), followed by solid food dysphagia alone (36%) and liquid food dysphagia alone (20%). A substantial proportion (78%) of patients presented with heart-burn as well. Probing the clue to dysphagia, some 7% of the patients gave history of ingesting chemical substances (either accidentally or as an attempt to suicide), 15% had history of taking steroid and 12% taking NSAIDs. History of radiation injury and history of ingesting foreign substances were rare. Over 60% of the respondents had co-morbid conditions like diabetes mellitus (28%), hypertension (23%), candidiasis (6%), lymphoma (3%). Clinical examination revealed 30% of the respondents nutritionally compromised (20% underweight and 10% overweight or obese). Nearly two-thirds (63%) were anaemiac with glossitis and koilonychia being present in 47 and 17% of the patients respectively. About one-third (32%) exhibited cervical lymphadenopathy. Of the 100 respondents, only 4 respondents were found with cardiomegaly, 4 with COPD, 2 with mediastinal widening. Endoscopy of upper GI tract showed 29% with ulceroproliferative lesion, 22% with multiple white patches in the whole length of oesophagus, 18% with stricture & narrowing of the oesophagus, 13% with malignant stricture & narrowing, 10% with proliferative lesion at mid oesophagus with narrowing of lumen and 8% malignant-looking ulcer with elevated margin in the lower oesophagus. Ba-swallow X-ray of oesophagus revealed 47 with filling defect in the lower oesophagus, 5 narrowing in the middle part of oesophagus and only 4 dilatations in the mid oesophagus. Twenty respondents had positive findings on USG of whole abdomen; of them, 10 had multiple solid tumors in liver. Others had hepatoma, mass in the epigastrium, cystitis, intraabdominal lymphadenopathy and splenomegaly. Based on symptoms, signs and laboratory findings, 42% were diagnosed as oesophagial carcinoma, 16% as drug-induced oesophageal ulcer and 11% as diabetes mellitus with oesophageal candidiasis. Conclusion: The most common cause of oesphageal dysphagia is carcinoma of oesophagus followed by drug-induced oesophageal ulcer and diabetes mellitus with oesophageal candidiasis. To reduce morbidity and mortality of various etiologies leading to dysphagia, prompt and early diagnosis is essential. Ibrahim Card Med J 2022; 12 (1): 40-45

Outcomes of Patients with COVID-19 in a Tertiary Care Hospital of Bangladesh

Coronavirus Disease-2019 (COVID-19) has disseminated throughout Bangladesh. This study aimed to provide a detailed account of outcomes of patients with COVID-19 who were hospitalized during 2020-2021 in Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, Bangladesh. This prospective observational study evaluated outcomes of 500 hospitalized patients with COVID-19. Patients with COVID-19, confirmed by positive Reverse Transcriptase Polyremase Chain Reaction (RT-PCR) reports of nasopharyngeal swab were enrolled in this study. Outcomes of the patients were evaluated by 7-point ordinal scale provided by World Health Organization. Mean age of the respondents was 45.70 (±14.50) years. Out of 500 patients, 331 (66.2%) were male and 169 (33.8%) were female. Common comorbidities were overweight or obesity (191, 38.2%), hypertension (173, 34.6%), diabetes mellitus (163, 32.6%), smoking (90, 18.0%), ischemic heart disease (IHD) (70, 14.0%), asthma (36, 7.2%), chronic obstructive pulmonary disease (COPD) (28, 5.6%), chronic kidney disease (CKD) (18, 3.6%), stroke (12, 2.4%), malignancy (6, 1.2%) and chronic liver disease (CLD) (5, 1.0%). Out of 500 patients, 238 (47.6%) patients had mild disease, 124 (24.8%) patients had moderate disease, 130 (26.0%) patients had severe disease and 8 (1.6%) patients developed critical COVID-19. Among the respondents, 299 (59.8%) patients required low flow oxygen by face mask or nasal prongs, 64 (12.8%) patients required high flow (non-invasive) oxygen therapy, 1(0.2%) patient required non-invasive ventilation (NIV). Duration of hospital stay was significantly (p< 0.05) higher in smokers (12.68±8.672 days) than non-smokers (9.79± 6.007 days). During or soon after discharge, 206 (41.2%) patients could not resumed normal activities of daily life. Only 9 (1.8%) patients died at hospital. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 22-28