Tertiary Medical College Hospital Research Articles

Bacterial Profile in Urine Culture and Amikacin Sensitivity and Emergence of Carbapenem-Resistant Pathogens in Tertiary Medical College Hospital, Bangladesh

Background: Urinary tract infection (UTI) is one of the most common encounters both in the outpatient department and inpatient department. It is important to know the bacteriological etiology according to urine culture and to know the antibiotic sensitivity. Objective: Our study was carried out to observe the urine culture and sensitivity pattern to commonly used injectable antibiotics such as amikacin and to look for the emergence of carbapenem-resistant uropathogens.Materials and methods: A total of 150 patients of UTI being culture-positive were isolated and identified by random selection. Samples were collected throughout January 2022 to March 2022. Standard microbiological techniques were used to identify the bacteria and test for susceptibility to various antibiotics. Data were entered into MS Office Excel 2016 for analysis and visualization.Results: The most common urine culture positive was E. coli, 108 (72%) followed by Pseudomonas sp., 16 (11%) and staphylococcus saprophyticus, 15 (10%). The rest of 7% urine culture was positive were other bacterial species. Around 90% of the total cultured E. coli was sensitive to amikacin. Staphylococcus saprophyticus 8 cases (53%), E. coli 15 cases (14%) and Pseudomonas sp. single cases (6%) were resistant to carbapenem. Resistance to vancomycin was common among most of the pathogens, with 88 cases (81%) of E. coli and 12 cases (75%) of Pseudomonas sp. being resistant. In contrast, Staphylococcus saprophyticus had a higher sensitivity to vancomycin, with only 3 cases (20%) being resistant and 12 cases (80%) being sensitive.Conclusion: The study focused on the commonest uropathogens causing UTI and antibiotic resistance in urine isolates may be useful guidelines for clinicians initiating empirical antibiotic therapy as well as help in the formulation of antibiotic therapy strategy. KYAMC Journal Volume: 15, No: 01, April 2024: 16-19.

Outcome of Empirical Antibiotic Prescription for the Treatment of Community Acquired Pneumonia

Background: The primary cause of illness and death in Bangladesh is community acquired pneumonia (CAP). Many hospitals in Bangladesh lack the resources to perform sputum cultures and sensitivity tests, making it difficult to identify the etiological agent of an infection. As a result, antibiotics are prescribed on a "empirical basis" rather than as part of a specific anti microbial treatment. The optimal antibiotic for treating CAP should be chosen using an empirical approach. Objective: The purpose of this study is to evaluate the effectiveness of various empirical antibiotic choices in the management of CAP. Methods: Eighty-two patients with CAP were included in this prospective observational research at a tertiary medical college hospital in Bangladesh. Inclusion and exclusion criteria were used to choose patients. Chest x-rays confirmed the diagnosis of CAP. The antibiotic was chosen based on clinical experience, which is an empirical method. The majority of patients received a combination antibiotic, whereas the remaining handful received monotherapy. The result served as an evaluation of the empiricism used in selecting the antibiotic. During the research, data were recorded in standardized formats. SPSS was used for the statistical analysis. Results: A total of 82 people were treated, and of them, 62 (or 76%) were men and 20 (or 24%) were women. The average age was 54.4% (9.6%). The round of antibiotics was supposed to last for a week. There were no unwanted medication reactions. No cases of lung abscess or parenchymal damage to the lungs occurred, and only one patient had paraneumonic effusion. Every single person made a full recovery. Conclusion: In many hospitals in Bangladesh, the choice of antibiotic for treating CAP is made on a "empirical" basis. Selecting an appropriate antibiotic requires better sputum culture and sensitivity testing in hospital labs.

Surgical Site Infections: Prospective Study in a Medical College Teaching Hospital at Port Blair, India

Abstract Objectives: Surgical site infections (SSIs) continue to be a prevalent and pervasive issue, contributing to healthcare expenditures, extended hospital stays, and significantly increased morbidity and death. The purpose of the current study was to evaluate the risk factors and prevalence of SSIs amongst patients undergoing various surgical procedures at a tertiary care facility in Port Blair, India. Materials and Methods: This prospective study was conducted at a tertiary medical college hospital setting in Port Blair, India, within the Department of Microbiology. The study was conducted from January 2018 to June 2018. Results: During the study period, 776 individuals underwent various surgeries, including both elective and emergency procedures. The total prevalence of the SSI rate during the study period was 12.88% (n = 776) based on the documentation of approximately 100 SSIs. Amongst these, 44% were associated with obstetrics and gynaecology surgery. The category of post-lower segment caesarean section (LSCS) stitch line had the greatest prevalence rate of SSIs (34 patients out of 175 developed infections; LSCS approximately 19.42% of these patients developed SSIs). Conclusions: In Indian adult patients undergoing any form of surgical procedure, the SSI prevalence was 12.88%. SSIs occurred more frequently after obstetrics and gynaecology operations. Following any type of surgery, patients who are women, younger, had emergency surgery, have diabetes, and require a lengthy hospital stay are more likely to experience SSIs. The most commonly encountered pathogens were Staphylococcus aureus and coagulase negative Staphylococcus.

A Mixed-Method Study of the Utilization and Determinants of Private Health Insurance Schemes in the Residents of Rural Communities in Central India: A Study Protocol.

Background Private health insurance plays a critical role in healthcare financing, yet its utilization and determinants in rural settings still need to be studied, particularly in Central India. This study aims to address this gap by investigating the utilization and determinants of private health insurance schemes among residents of rural communities in Central India. Materials and methods A convergent parallel mixed-method study design, consisting of quantitative and qualitative approaches, will be employed. Quantitative data will be collected through structured questionnaires administered to residents aged 18 and above within the field practice area of a tertiary medical college hospital. Qualitative data will be gathered through in-depth interviews with key stakeholders. Statistical analysis will include descriptive and inferential statistics, while thematic analysis will be employed for qualitative data (CTRI Number CTRI/2024/06/069155). Conclusion The findings of this study will provide valuable insights into the utilization and determinants of private health insurance schemes in rural communities of Central India. By identifying barriers and facilitators to insurance uptake, policymakers and healthcare providers can develop targeted interventions to improve healthcare access and affordability in rural areas. In addition, the study will contribute to the existing literature on private health insurance utilization in India, informing future research endeavors and policy initiatives.

Free flap reconstruction at a rural-based tertiary medical college hospital: Barriers and outcomes.

In a rural-based setting, providing optimal treatment is often difficult owing to the limited resources and financial constraints being rampant in cancer care delivery. Oncological resections often result in large, complex defects requiring free flap reconstruction to achieve cosmetic and/or functional goals. This article focuses on our experience of starting and promoting microvascular reconstruction in a rural tertiary medical college hospital. Retrospective observational study of patients undergoing free flap reconstruction for oncological indications was included. Standard oncological principles were followed for cancer extirpation. Free flap reconstruction was done using loupes of 4× magnification. Flap-related outcomes and barriers in doing free flap reconstruction were analysed. A total of 56 patients were included. The most common free flap undertaken was free anterolateral thighflap in 21 (37.5%) patients. The mean duration of reconstruction was 438 min. Re-exploration was undertaken in 17 patients (30.4%). Nonsalvageable flap loss was 19.64%. Adjuvant treatment was administered in all patients as per oncological indications, albeit with some delay in 12.5%. Barriers to reconstruction were noted in the pre-, intra- and postoperative periods. Reconstruction with free flaps is feasible in a resource-constrained setup with careful planning and a multidisciplinary team approach to overcome the barriers.

Maternal Mortality and Morbidity Following Unsafe Abortion in a Tertiary Medical College Hospital

Background: Unsafe abortion refers to the termination of an undesired pregnancy by individuals lacking the requisite skills in an environment lacking minimal medical standards, or both. It stands as a prominent contributor to pregnancy-related mortality in Bangladesh. Notably, approximately one-third of all births in Bangladesh are unplanned and unwanted. The initiation of unsafe abortion may be attributed to the woman herself, an unqualified practitioner, or health workers operating in unhygienic conditions. Objectives: The primary aim of this study was to implement interventions aimed at mitigating maternal mortality and morbidity resulting from unsafe abortion. Materials and Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Khulna Medical College and Hospital, Khulna, spanning from July 2010 to June 2011. After applying exclusion criteria, which involved cases of medical termination of pregnancy and individuals with known medical conditions, a total of 145 abortion cases were admitted to two maternity units at Khulna Medical College Hospital. These cases exhibited a history of menstrual regulation (MR) and induced abortion performed by unskilled individuals, in unhygienic conditions, or both, throughout the study period. The primary outcome variables assessed in this study included age, marital status, education level, socio-economic status, parity, duration of amenorrhea, methods of induction, and maternal complications. Results: In this study, it has been seen that 588 (29.80%) of gynecological admissions are of abortion, and the incidence of unsafe abortion is 145 (24.65%) of all abortion patients. The majority are primarily educated and their socio-economic status is below average. Most of them are multipara. They had come to the hospital after the development of complications. Among the unsafe abortions, 9 (6.20%) expired and 136 (93.79%) improved after experiencing some sort of minor or major suffering. Conclusion: Maternal mortality is a key women’s health indicator. Reducing it is a global goal, but tracking progress is challenging, especially in developing countries with weak health data systems. Unsafe abortions are underreported, and many deny the truth even when in dire conditions. To address this, promoting modern contraceptives, training personnel for abortions, and emphasizing contraception’s importance is vital. Relaxing abortion laws may be necessary, as women may seek abortions regardless, risking their lives. Ensuring safe abortion access is essential for women’s rights and preventing harm to them and their families. Reducing unplanned pregnancies and providing safe abortion services are critical.

Association between Polycystic Ovary Syndrome (PCOS) and Pregnancy Complications

Background: Polycystic ovarian syndrome (PCOS) pregnant women appear to be more vulnerable to poor maternal and neonatal outcomes. The purpose of this study was to assess the outcome of pregnancies in women with PCOS. Methord: This descriptive study was conducted at a tertiary care hospital Jashore Medical College hospital, Jashore Bangladesh, on 115 pregnant PCOS patients. SPSS version 20 was used for data analysis on the recent pregnancy, PCOS, and maternal and perinatal outcomes. Parity and others perinatal and maternal outcomes were examined as categorical variables. Result: The average age was 25.07 years, 82% had a history of primary infertility, and 66% had a high BMI. The percentage of pregnant women with hypertensive problems was 18.26%, PROM was 33.91%, and the low APGAR score at five minutes was 12.17%. gestational diabetes (23.47%), miscarriage (2.1%), preterm delivery (13.91%), caesarean delivery (37.39%), low birth weight babies (2.6%), macrosomia (0.7%), PPROM (19.52%), perinatal mortality (1.73%) and NICU admission (21.74%). Conclusion: Pregnant women with PCOS were identified with either similar or lower rates of GDM, miscarriage, preterm delivery, meconium-stained liquor, caesarean delivery, small for gestational age/IUGR, macrosomia, PPROM, perinatal mortality, NICU admission, and congenital anomalies, but higher rates of hypertensive conditions of pregnancy, PROM, low birth weight babies, and low five-minute APGAR scores.

Trends of antihypertensive use in a tertiary care hospital in Nadia district of West Bengal, India

Background: Being a major non-communicable disease hypertension contributes significantly to disease burden and mortality. Poor control of blood pressure (BP) increases the chance of recurrent stroke and mortality. Although various guidelines have been published to inform practitioners about hypertension and its management, it is necessary to monitor to how much extent the guidelines are being followed. Aims and Objectives: The study aimed to observe antihypertensive medication prescription pattern among indoor patients in a tertiary medical college hospital and to know whether such trend of prescription is relevant and in conformity with the national and international guidelines. Materials and Methods: A prescription-based survey was conducted over 6 months among patients admitted to the medicine ward in a medical college hospital in Nadia district of West Bengal. Relevant data were collected and used for analysis. Results: A total of 500 prescriptions were evaluated. Two hundred and seventy-three patients were female (54.6%) and 227 patients were male (45.4%). About 56.2% of patients were in the senior age group with a higher contribution by the female subjects. Only 17% of patients had Grade 1 hypertension reflecting poor BP control among hypertensive patients. Combination drug was advised in more than half of cases (54.6%), whereas single drug was advised in 44.2% of cases. Amlodipine was the highest prescribing drug (66%) both as monotherapy and in combination followed by Lasix (54.6%), labetalol (31.6%), and telmisartan (11.4%). The thiazide group of drugs was used only in 1% of cases. Conclusion: Overall, the management guidelines for hypertension were adhered in the prescriptions. The underutilization of thiazide-type diuretics remains an area of concern and needs necessary action. The public health delivery system may need to take appropriate measures to make people aware of BP control.

A Comparative Study of Lung Involvement Among Vaccinated and Unvaccinated Covid - 19 Patients

COVID-19 caused by a novel agent SARS-CoV-2 progressed to a pandemic condition and resulted in a major public health concern worldwide, leading to social and economic issues at the same time. Vaccinated people getting infected with SARS-COV2 brings a dilemma among the population whether to get vaccinated or not. The primary objective of this study is to evaluate the impact of vaccination by comparing the lung involvement in vaccinated and un vaccinated Covid – 19 patients. Retrospective anonymised data of COVID-19 inpatients who underwent HRCT scan during the second wave of pandemic were collected through a validated data collection form, from the medical records of tertiary care private medical college hospital. Vaccinated and non-vaccinated COVID-19 positive participants of 33 each were included in the study. CT severity score (CTS), D-dimer, IL-6 level, oxygen requirement and duration of hospital stay were statistically analysed using appropriate methods. The mean age of the study participants were 56.93 ± 16.01 years. There was no statistical significance between both the groups with respect to gender distribution in vaccinated and unvaccinated groups. There was a statistically significant difference in mean CTS score(p<0.001) and oxygen requirement(p<0.05) among vaccinated and unvaccinated patients. There was no statistical significance between CORADS, IL-6, D – Dimer and duration of hospital stay. In COVID-19 patients, vaccination reduces the extent of lung involvement and the need for oxygen. The COVID-19 vaccination conundrum is somehow resolved by this study, which also gives us a clear picture of the vaccine's efficacy. Keywords COVID­19, Vaccination, HRCT Scan, CORADS Severity

Premature rupture of membrane - Evaluation of incidence and risk factors in a tertiary Medical College Hospital

Background: Premature rupture of membrane (PROM) is defined as rupture of membrane before onset of true labour pain and one of the most common complications of pregnancy. It is associated with maternal morbidity and perinatal morbidity and mortality. Objective of this study is to determine the incidence and risk factors of pregnant woman with PROM admitted in a tertiary medical college in Bangladesh. Materials and methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology at Khawaja Younus Ali medical college, Sirajgonj from 1st January 2021 to 31st December 2021. In this period total admitted antenatal patients were 8117. Among the pregnant patients with PROM were 665 and their weeks of gestation were > 28 weeks. Data was collected by an interviewer with semi structured questionnaire & check list. Results: Incidence of PROM was 9.3%. PROM was found to be frequent (39.1%) in younger age group between 21-25 years. Majority of the patients were housewife (71%). Maximum (61%) patient’s education level was up to secondary. PROM is extremely influenced by low socioeconomic status which was (49.1%) of cases in our study. It was also common in multigravida (67.2%) and term PROM was higher (56.4%) than preterm PROM (43.6%). Analysis of risk factors revealed etiology was unknown in 53 (48%) cases, anemia (16 %), lower genital tract infection (7.2%), UTI (19%), previous history of PROM (26.3%), malpresentation (15%) multiple pregnancy (6.7%) DM and GDM (10.5%) were commonly associated with PROM. Conclusions: Early identification of various risk factors causing PROM and their management can prevent premature deliveries and its complications to some extent as well as serious maternal complication like Chorioamnionitis. Bangladesh Crit Care J September 2023; 11 (2): 109-112

Prescription Pattern of Different Groups of Antibiotics at Out Patient Department of a Tertiary Medical College Hospital in Dhaka City

Background: Drugs prescription pattern is very important at outpatient department in the tertiary care hospital. Objective: The purpose of the present study was to evaluate the distribution of patients and antibiotic prescribing trends in OPD of a Tertiary Medical College hospital. Methodology: This cross-sectional study was undertaken in the medicine, surgery, gynaecology & obstetrics and paediatrics Out Patient Department of Shaheed Suhrawardy Medical college hospital, Dhaka. The duration of the study period was 5 weeks (25th March, 2017 to 29th April, 2017). The study was designed to obtain information regarding prescribing pattern of drugs by physicians and also to analyze basal information of the prescription. The prescription were observed from the hospital’s OPD and few prescriptions were from each unit. Results: A total 320 prescription were observed from the hospital’s OPD where 80 prescriptions were from each unit. The mean age of the patients was 24.50±14.976 years. The most commonly prescribed antibiotics at medicine OPD was Cephalosporin which was 19(51.4%) cases followed by others antibiotics and azithromycin which was 9(24.3%) cases and 8(21.6%) cases respectively. In surgery OPD, the most commonly used antibiotics were flucloxacillin and cephalosporin which was 66(82.5%) cases and 24(30.0%) cases respectively. In Gynae & obstetrics OPD, the most commonly prescribed antibiotics were quinolones as well as other groups of antibiotics which were 23(46.0%) cases and 27(54.0%) cases respectively. Conclusion: In conclusion most commonly used antibiotic are Cephalosporin, azithromycin and Flucloxacillin in different OPD of the hospital. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):54-58

Evaluation of CRP as Predictor of Chorioamnionitis in Premature Rupture of Membranes

Background: Early identification of sepsis is essential as the mother has a risk of chorioamnionitis. C-reactive protein levels are done along with placental histopathology to detect chorioamnionitis. It is one of the most significant causes of high perinatal morbidity and mortality. Aim and Objective: To determine c-reactive protein levels and placental histopathology in premature rupture of membranes for maternal chorioamnionitis. Methodology: A prospective study was conducted in a tertiary care university medical college hospital and research center in western Maharashtra. A total of 250 pregnant women were reported per vaginal leak during the study period and CRP levels were sent along with urine culture sensitivity and high vaginal swab, post-delivery the placenta was sent for histopathology and were included in the study analysis. Results: The histopathology was done in all 250 pregnant women, and chorioamnionitis was evident in 46 pregnant women. This gives the incidence of 18.4% of chorioamnionitis in the study population. The sensitivity for CRP was calculated to be 15.22%, with a specificity of 99.02%, positive and negative predictive values of 77.78% and 83.82%, respectively, with an accuracy of 83.60%. Conclusion: Normal CRP level has good predictive values to rule out maternal chorioamnionitis. A raised single CRP level has low sensitivity to predict histological chorioamnionitis prior to its clinical expression.

Pattern and seasonal variations of snake bite in southern part of Bangladesh

Background: Snake bite is one of the leading causes of mortality and morbidity in many regions, notably the rural tropics, and is a globally overlooked occurrence. Present study is aimed to find the pattern and seasonal variations of snakebite in the southern part of Bangladesh.
 Methods: A one-year retrospective survey was done on 554 venomous or non-venomous snake bite patients admitting in a tertiary care hospital Chittagong Medical College Hospital, Bangladesh. Through the administration of a questionnaire, data on snake bites and kinds, date and time of bite and envenomation characteristics were obtained from respondents over a twelve-month period. After data collection, SPSS-20 was utilized for analysis.
 Results: In the present study male (64.1%) were found more affected than female and the vast majority of snake bite victims are younger Regarding pattern of envenomation, 400(72.2%) patients had no features of envenomation, 37(6.7%) local envenomation with spontaneous bleeding, 35(6.3%) had systemic envenomation, 74(13.4%) had local envenomation and 8(1.4%) had local swelling with neurotoxicity. Most of the patients were male (64.1%), female was mostly housewives (24.9%) and 68.1% were from poor socioeconomic status. Regarding monthly distribution of study patients where most patients were found during May to September and venomous bite were also more common during the month of May to August. Analysis of species of snakes revealed 89(16.1%) were pit viper, 87(15.7%) were dora snake, 23(4.2%) were cobra and 355(64.1%) snake bite were remained unidentified.
 Conclusions: During the monsoon season (May to September) in Bangladesh, the incidence of both nonvenomous and venomous snake bites is much high and poisonous snake bites are prevalent during this time. Poor access to health services and superstition regarding dealing with Ozahs are also a common finding in our study.
 Central Medical College Journal Vol 6 No 2 Jauly 2022 Page: 71-76

A Study on etiology and outcome of acute kidney injury patients requiring haemodialysis in a rural tertiary medical college hospital, Kishoreganj

Background and objectives: AKI is an increasingly common complication of critical illness, with some researches showing that as high as 1 in 5 adults and 1 in 3 children experiencing AKI per hospital admission. Whether occurring in the community or in the hospital, the clinical and public health importance of AKI is well established due to the association with high mortality and its separate independent effect on the risk of death and resource use. This study was aimed to find out the etiology and outcome of acute kidney injury patients requiring haemodialysis.
 Methods: A retrospective study was done on 70 patients of AKI who required haemodialysis support in dialysis unit of medicine department of Jahurul Islam Medical College Hospital, Kishoreganj during the time period from Jan - 2018 to Dec – 2020. All patients of age 13 and above with AKI and have been dialyzed at least once during the study period were included.
 Results: In this study, there was an overall male preponderance (70%) with age range of 13-40 years (48.57%). Most common features of presentation were oliguria, cough, respiratory distress, drowsiness, disorientation, reddish urine, pedal edema, fever and high blood pressure. The most common causes of AKI were sepsis (30%), hypovolemia (21.42%), acute glomerulonephritis (AGN) (14.29%) and pregnancy related causes (10%). Common indications for haemodialysis of AKI patients were refractory fluid overload (70%), features of uraemic encephalopathy (22.86%). In this study, 78.57% of AKI patients requiring haemodialysis were improved and discharged, 08.57% patients were progressed to end stage renal disease, 07.15% patients were expired and 05.71% patients were absconded.
 Conclusion: It is concluded that sepsis, hypovolemia, AGN, obstetric causes, surgical causes and nephrotoxins were the primary causes of AKI patients requiring haemodialysis in this study. Most of these causes can be prevented with simple interventions such as appropriate management of infections, health education on oral rehydration, quality prenatal and emergency obstetric care and taking appropriate precautions when prescribing potentially nephrotoxic medications. Majority of the patients of AKI with complications were improved with haemodialysis. So, expansion of haemodialysis services to all parts of the country is necessary.
 AKMMC J 2021; 12(2): 98-103

A prospective study on foreign bodies in the oropharyngeal/ nasopharyngeal pathways done in the ENT department of a tertiary care private medical college hospital in the year 2022

To do a prospective study on foreign bodies(FB) in the oropharyngeal (OP) / nasopharyngeal (NP) pathways done in the ENT department of a tertiary care private medical college hospital in the year 2022.To analyse, categorize, correlate the demographic data of patients presenting with FB in OP/ NP pathways with the nature of FB, clinical features, method of removal, duration of hospital stay in the ENT department of a tertiary care private medical college hospital in the year 2022.Study method: Prospective studyStudy centre: Saveetha Medical College, ThandalamStudy population: patients with nasopharyngeal foreign body attending the ENT departmentStudy duration: 8 months from January to August 2022Sample size: 50 1. Age more than 6 months 2. Both male and female subjects 3. Patients presenting to ENT department with oropharyngeal/nasopharyngeal foreign body. 1. Age less than 6 months 2. Patients presenting to ENT department with diagnosis other than FB in the OP/NP pathways.OP/NP FB has been seen frequently in the males than females. Most of them were single in number in the OP pathway. Highest number of patients are seen in the 30-39yrs age group of LIG, MIG coming from urban and sub-urban population in our study when compared to other studies which showed highest frequency in children. Fishbone was the frequently encountered FB. Almost all of them are acute cases presenting within 24 to 48hrs. With regards to symptoms, all of them except the persons with NP FB presented with dysphagia. In children upto 4yrs the symptoms were incessant cry, refusal to feed and excess salivation were seen. All OP FB were treated with either IDL or DL scopy. All NP FB treated with FOB. Anaesthesia was either local or short GA depending on the merits of each case. The duration of hospital stay was mostly 24 to 48hrs, except 3 cases who were geriatric people with co-morbidities. In our study Foreign bodies in the OP pathway were common in the adult male population in the middle age unlike children in other studies. Fish and chicken bones were common and in the low and middle income group coming from urban and sub-urban locality. Further studies are needed with larger sample size and longer duration to generalize the results to wider population.

An Immunohistochemical study of CD83 positive dendritic cell density in human benign and malignant uterine specimens

Introduction and Aim: Dendritic cells (DCs) are heterogenous group of accessory cells that function as specialized forms of antigen-presenting cells in human body. A thorough knowledge of the DC population of the human uterus, especially the CD83 population would be very useful for an effective understanding of the immune protection of the endometrium during different phases of menstrual cycle and in the pathological conditions of the uterus. Materials and Methods: A prospective study was conducted in a tertiary care referral medical college hospital in South India. Women in the age group of 35 to 50 years, who underwent hysterectomy were included in the study. Immunohistochemical study on the presence of mature CD83+DCs was carried out in the processed uterine specimens. The number of CD83 cells/20 high power fields in each of the specimen was calculated and reviewed by two independent reviewers. Results: About 43 hysterectomy specimens obtained from patients undergoing hysterectomy for benign and malignant conditions of uterus were included in the study. Fibroid uterus was the most common indication for hysterectomy. The minimum and maximum DCs were 12 and 720 DCs per 20 HPF respectively, with an overall mean of 109.28. The mean DCs amongst benign specimens was 1.2 DCs and in the malignant specimens was 22.65 DCs per HPF, with a P value of 0.0001. Conclusion: Mature dendritic cells are seen in abundance in malignant and pre-malignant tissues of human uterus. A reduction in number of CD83+ DCs was observed in patients with proliferative and secretory endometrium.

Evaluation of performance in the pre-analytical phase of a clinical biochemistry laboratory in a Tertiary Medical College Hospital

Background: Pre-analytical phase is the major source of errors in a clinical biochemistry laboratory. Aims and Objectives: The study aims to determine the quality of laboratory performance in the pre-analytical phase using quality indicators (QI) specified by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group on Laboratory Errors and Patient Safety and sigma metric scale for both the inpatient and outpatient samples received in the clinical biochemistry laboratory. Materials and Methods: All samples and requisition forms received in the laboratory were examined before analysis. The percentages of the seven QI were calculated. The frequency, percentage, and defects per million rates of each pre-analytical error were calculated. Sigma value was obtained using an online sigma calculator. The laboratory performance was then categorized by the IFCC-based performance levels and sigma-based values. Results: Out of 30,546 samples received during a period of 6 months, pre-analytical errors occurred in 2.8% of them. The highest number of pre-analytical errors was due to hemolysis (29.9%). The outpatient samples showed a desirable to optimum performance with a good sigma value. There were more errors and lower quality-based performance, in the case of inpatient samples. Errors were highest in September at the start of the study followed by a gradual decrease over the next 5 months. Conclusion: The laboratory performance in the pre-analytical phase was found to be favorable and consistent with the international specifications.

A study on profile of patients using inhalants attending in a tertiary care center of East India

Background: There is a slow but steady increase in inhalant use in India among adolescent age group. There is a very few studies regarding inhalant use disorder in India. No study has been reported from West Bengal. Aims and Objectives: In our study, we aimed to study the sociodemographic and clinical profile of patients using inhalants. Materials and Methods: A cross-sectional clinic-based study conducted in a tertiary care center medical college hospital of West Bengal. All patients attending in the outpatient department with a history of inhalant use were taken in this study irrespective of diagnosis and purpose of visit. Duration of the study was 18 months. Sociodemographic and clinical profiles were obtained using asemi-structured pro forma. Results: We studied 26 patients. All were unmarried male from urban background, middle to lower socioeconomic status. Most of them were from nuclear family. Mean age was 15.2 years. Most of them were studying (69.2%). Inhalant was the preferred substance for all of them. Tobacco was the most common substance used along with inhalants. The most common inhalants substance was glue (Dendrite) 84.6%. Sniffing (80.8%) was the most common form of inhalation. For all of the patients, inhalation was out of curiosity. Only 23.1% had a positive family history of substance dependence. The most common comorbidity found was conduct disorder (30.8%). Motivation for quitting was poor for most of the patients. Conclusion: Inhalant use disorder is an important but still unexplored research area in West Bengal. Although not common, inhalant use disorder is not rare in clinical setting.

Incidence and etiology of abdominal surgical site infections among emergency postoperative patients in a tertiary medical college hospital, Faridpur, Bangladesh

This prospective study was conducted to provide data of the incidence, risk factors and microbiological pattern associated with SSIs among 112 patients who underwent emergency abdominal operations in Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur in Surgery Unit: 2 between January 2020 and March 2021. After fulfilling the recruitment criteria all patients were consecutively enrolled with their consent and their preoperative, intraoperative, and postoperative data were collected. Wound discharge/pus were collected and sent for culture and sensitivity testing. Follow-ups were done in the unit assistant register’s room. Data were analyzed using IBM SPSS version 28.0.0.0. The overall incidence of SSI was 15.2%. Male (64.7%) are affected more than female (35.3%). Underweight patients (47.1%) and appendectomy related cases had most SSI (41.2%). All SSIs are detected between 2 and 7 post-operative day. Most of the wounds are clean-contaminated, contaminated and dirty types. Chances of SSI increase when duration of surgery exceeds three hours. was the most predominant organism (82.4%) followed by (11.8%) and (5.8%). Amikacin (100%), Levofloxacin (93.2%) and Moxifloxacin (92.3%) had maximum sensitivity patterns whereas commonly prescribed drugs like Ceftriaxone and Cefuroxime had high resistance (100%). The incidence of SSI in this tertiary hospital is very high. is the predominant organism responsible. Amikacin, levofloxacin and moxifloxacin are very potent antibiotics against organisms that cause SSI in our hospital.

Laboratory Parameters of Dengue Infection in a Medical College Hospital

Introduction & objective: Dengue is an acute illness caused by Aedes mosquito, commonly caused by Aedes aegypti. It is an endemic disease in South East Asian countries especially in Bangladesh. In 2019 a outbreak occurred in Bangladesh. The objective of the study was to see the laboratory parameter and outcome of dengue fever in a tertiary medical college hospital. Early diagnosis and laboratory investigations is essential to prevent the mortality associated with this disease. Materials & Methods: This prospective study was conducted on dengue ward at Khulna medical college hospital from 1 July 2019 to 31 December 2019. The diagnosis of dengue infection was confirmed by serology. Sera were processed by dengue ELISA. Investigations like haemoglobin estimation, haematocrit, platelet count, total count; differential leukocyte count, peripheral smear, coagulation profile were performed. Results: Total number of cases was 98. Of them 62 (63.2%) was male and 36 (36.73%) was female. Fever was most common (100%) manifestation and duration of fever ranges from 5 to 8 days with a mean duration of 6.31 (± 0.95) days. Blood for NS1 was positive in 90 (91.83% ) cases; most cases 71 (72.44%) become positive between 2nd to 4th day. 90 (91.83%) cases developed thrombocytopenia and it starts at 5th day in 45 (45.91%) cases. Anti IgM was positive in 4 (4.08%) cases; 2 at 4th day and 2 at 5th day of illness. IgG was positive in case at 8th day of illness. Conclusion: These findings help physicians in early diagnosis of dengue by suspecting these features as of dengue and can prevent morbidity and mortality associated with dengue. Medicine Today 2022 Vol.34(1): 61-64