bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Outcome Difference Following Acute Myocardial Infarction between Rural and Urban Patients
Authors: Rahim Mohammed Abdur , Bashiruddin A B K , Mahmud Iqbal , Bhattacharya Debabrata , Awal Anisul , Das Prabir Kumar , Islam Neena , Rouf Md Abdur , Alam Muhammed Syedul
Published: July 2023

Background: Different factors may influence management, complications and outcome of both rural and urban patients following Acute Myocardial Infarction (AMI). Aim of the study was to identify the factors influencing outcome following AMI between rural and urban population is lacking in our country.

Materials and methods: This was a cross sectional study carried out in the Department of Cardiology, CMCH from June 2018 to May 2019. One hundred and ninety-eight consecutively admitted AMI (STEMI) patients from both urban and rural area were included. Demographic, anthropometric, risk factors, presentation profile, inhospital complications and outcome were recorded and compared between the groups.

Results: Out of 198 patients 23.23% female and 76.23% were male. Mean age was significantly higher in Rural group (55.5±11.6 years) than the Urban (49.3±11.2 years) p value 0.037. Urban patients were more sedentary (68.8% vs. 43.8%, p=0.001) and having higher BMI (>25kg/m2 was 48.8% vs 30.6%, p=0.024). Rural patients presented late after symptom onset (5 hours vs. 13 hours) long distance to travel was mentioned as prime cause of delay by them. Inhospital mortality was higher among rural patients (12.4% and 3.9%; p=0.045). Adverse outcome was associated with increasing age, male sex and poor LV function in urban patients, while in rural patient it was related to lower education level, delayed presentation and poor LV function.

Conclusion: Outcome of AMI differs between rural and urban patients. This finding of different factors influencing outcome in two groups could be used to design specific preventative measures.

JCMCTA 2021 ; 32 (2) : 20-24
Comparison between Clinical and Bacteriological Profile of Febrile Neutropenic and Non Neutropenic Pediatric Leukemic Patients
Authors: Karim A K M Rezaul , Maayenu  , Urmi Rehnuma
Published: July 2023

Background: Infection is an important cause of morbidity and mortality in children with leukemia. To improve the quality of care and survival, it is important to understand the clinical presentation and bacteriological profile during febrile episodes of these patients. The aim of this study was to compare the clinical presentation and bacteriological profile of febrile neutropenic and nonneutropenic pediatric leukemic patients.
Materials and methods: This was a cross sectional observational study conducted at Chittagong Medical College Hospital (CMCH) over a period of 12 months. Study population (n=60) were all hospitalized pediatric leukemic patients who were febrile and on anticancer chemotherapy. By purposive sampling two groups were made. Group A (n=30) was febrile neutropenic and group B (n=30) was febrile non-neutropenic patients. The Clinical presentation, bacteriological profile and antibiotics susceptibility patterns in both groups were analyzed.
Results: Mean (±SD) age of the patients was 6.41±3.05 years. Acute Myeloid Leukemia (AML) patients were high in Group-A (60%) and Acute Lymphoblastic Leukemia (ALL) patients were high in Group-B(80%). Gastroenteritis, skin infection and sepsis were more in group A than group B (p<0.05). Upper respiratory tract infections were significantly more in group B than group A (p<0.05). Among 60 samples, 7 (12%) were blood culture positive for bacteria. The isolated organisms were E. coli, Klebsiellaspp, Salmonella, Staph aureus and others. Amikacin Meropenem and Vancomycin were the effective agents.
Conclusion: Febrile neutropenic episodes were more common in AML patients undergoing chemotherapy. Gram negative sepsis, gastroenteritis and skin infection were high in febrile neutropenia, but upper respiratory tract infections were high in febrile non neutropenia.
JCMCTA 2021 ; 32 (2) : 25-29
Long Term Effects of COVID-19 among RT-PCR Positive Bangladeshi Patients
Authors: Islam Neena , Rahim Mohammed Abdur , Das Prabir Kumar , Mostafa Golam , Alam A K M Manzurul
Published: July 2023

Background: COVID-19 was an unknown disease previously. This pandemic has affected almost all countries of the world and creating a deadly experience to all. It leads to long term squeals among many affected people with consequent loss of productivity and quality of life. This entity is called long COVID syndrome. The objectives of the present study is to find out the long term sequels of COVID-19 patients.

Materials and methods: This was an observational study where a total of 56 patients of COVID-19 were recruited. Demographic data and long term sequelae were recorded from these patients. All the patients were confirmed cases of COVID-19 by RT-PCR. Prior consent from the patients and ethical clearance was taken. Data were analyzed by SPSS-20.

Results: Among 56 cases male was 31(55.4%) and female was 25(44.6%). Male to female ratio was 1.24:1. Age group distribution showed <20 years was 4(7.1%), 21-30 years was 10(17.9%) 31-40 years was 12(21.4%) 41-50 years was 14(25.0%) and 51-60 years was 16(28.6%) Regarding occupation majority were service holder 34(60.7%).Fifty two(92.9%) were from urban areas Among 56 cases 48(85.7%) took treatment at home for COVID-19. Regarding vaccination history 4(7.1%) got no vaccination 18(32.1%) took Astra-Zenaca, 12(21.4%) took Moderna Biotech and 22(39.3%) took Sinovac vaccine. Regarding analysis of postcovid sequelae among 56 cases 25(44.6%) had fatigue, 7(12.5%) had cough, 4(7.1%) had shortness of breath, 12(21.4%) had chest pain or tightness, 22(39.3%) had memory impairment, 8(14.3%) had insomnia, 22(39.6%) had joint pain, 8(14.3%) had muscle pain or headache, 8(14.3%) had palpitation and 16(28.6%) had minor psychiatric illness like,depression or anxiety.

Conclusion: Present study showed post COVID complications among significant number of COVID-19 patients.Thus COVID-19 is not only associated with loss of life but also with long term complications and loss of productivity that needs proper attention.

JCMCTA 2021 ; 32 (2) : 30-33
Clinico-epidemiological Study on Self-induced Poisoning Caused by Substances Other than Organophosphorus Compound
Authors: Ara Ismat , Erfan Uddin Rabiul Alam Md , Ghose Aniruddha
Published: July 2023

Background: Though Organophosphorus Compounds (OPC) are mostly used for self-induced poisoning, non- OPC poisoning cases are increasing day by day. This study was done to describe clinical pattern and outcome of poisoning other than OPC.

 Materials and methods: This observational study was conducted in the Medicine Ward of Chittagong Medical College Hospital. Data were collected in structured case record forms. Total 204 patients (n=204) were included in the study after fulfilling the inclusion criteria. Data were analyzed with SPSS and expressed as percentage, mean with standard deviation as appropriate.

Results: Out of 204 patients, most were female (60.8%). Most of the patients were young, 56.9% patients were unmarried, 60.8% poisoned patients resided in metropolitan area, most were with low educational level, 57.4% patients came from the middle class socioeconomic group, 82.4% patients were poisoned by a single agent and 17.6% by multiple agents. Offending agents were identified in 96.6% cases. Poisoning by drugs was the highest (47.1%) followed by rat killer poisoning (22.5%) poisoning by non-OPC insecticides (6.9%) corrosive poisoning (6.4%) chemical poisoning (3.9%) and alcohol poisoning (1%). Family disharmony was the underlying cause of self-harm in 47.1% cases, financial constraints in 8.3%, social crisis in 7.8%, failure in love affairs in 6.4% and academic failure in 2.5% patients. 14.7% patients poisoned themselves to gain some benefit by the act of self-harm. 81.4% patients were discharged with advice, 2.9% died.

Conclusion: Burden of Non-OPC poisoning is high. Outcome is not so fatal as OPC, but the problem has to be addressed in large scale.

JCMCTA 2021 ; 32 (2) : 34-40
Prevalence of Overweight among the Students of A Selected Urban School
Authors: Zulfiquer Ali A S M
Published: July 2023

Background: Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body Mass Index (BMI) is a simple index for weight for height that is commonly used to classify overweight and obesity in adults. It is defined as a person’s weight in kilogram divided by the square of his height in meters (kg/m2). To estimate the prevalence of overweight and obesity among the students of Bangladesh International School and College, Mohakhali, Dhaka.

Materials and methods : This descriptive cross-sectional study was conducted from July 2019 to November 2019 among purposively selected 201 students of class VI to X of Bangladesh International School, Mohakhali, Dhaka. Data were collected through face to face interview using pre-tested structured questionnaire. Data were checked for quality control and analyzed by computer by using SPSS software version 23.

Results: Mean age of the students was 13.42 ± 0.38 years. Out of 201 respondents 45 from class VI, 41 from class VII, 39 from class VIII, 36 from class IX and 40 students from class X. The highest 20.9% respondents are from 14 years age. Majority (51.2%) respondents were female and rest 48.8% were Male. The overall proportion of overweight among the respondents was found to be 18.4%. Association between overweight and age, sex, class, Occupation of mothers of respondent, monthly family income, frequency of snacks and daily calorie intake, and duration of outdoor games or physical activity were found significant.

Conclusion: In this study it was revealed that the prevalence of overweight among the students of selected school was 18.4%. Boys were more overweight than the girls. Higher percentage of overweight adolescent was found among the affluent families. Adolescent students who took more calorie in daily diet the prevalence of overweight was more in them.

JCMCTA 2021 ; 32 (2) : 41-46
Association of Blood Pressure with Overweight in Young Adult Student
Authors: Barua Debjane , Noor Nazia , Begum Momtaz , Akhter Shahin , Barua Shuvramoy , Jafrin Nilima
Published: July 2023

Background: Obesity and overweight in young adult is rising & its deleterious health hazard is becoming a major threat now a days. It is one of the major public health problems globally. Overweight may cause metabolic and endocrinological changes. If untreated, hypertension, cardiovascular disease, hyperglycemia, dyslipidemia, atherosclerosis, metabolic syndrome, cancer may occur. Hypertension is more common in obese and overweight people. This study aimed to observe the association of blood pressure with overweight in young adult students.

Materials and methods: This case control study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram. Total 120 students, aged between 18-24 years were included in the study. 60 young adult students with a Body Mass Index (BMI) of 25- 29.9kg/m2 were included in case group as overweight subject and 60 students of same age with a BMI of 18.5- 24.9kg/m2 were taken as a control group. General physical examination was done, anthropometric measurements- Height, weight, BMI and pulse, systolic blood pressure and diastolic blood pressure were measured. Pulse Pressure (PP) and mean arterial pressure were calculated. For statistical analysis unpaired student’s ‘t’ test, chisquare test and correlation coefficient were done by using SPSS for windows version-25.

Results: Systolic Blood Pressure (SBP) Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) were significantly high in overweight (Case) students (p<0.001). Frequency of prehypertension was more in overweight group (p<0.001) comparing to normal weight group. Significant positive correlations (p<0.05) were observed among BMI with SBP, DBP and MAP in overweight young adult students.

Conclusion: According to present results it was concluded that apparently healthy overweight young adult students were associated with increased blood pressure than normal weight students.

JCMCTA 2021 ; 32 (2) : 47-52
Associated Biochemical Changes and Outcome of Acute Kidney Injury in ICU Patients and Impact on Rifle Classes
Authors: Ul Islam Syed Mahtab , Arjumand Marina , Huda Md Nurul , Kamal Rosanna Bintey , Haider MS
Published: July 2023

Background: Acute Kidney Injury (AKI) has an independent impact on outcome, even after correction of all other variables in critically ill patients . AKI in ICU is often associated with different biochemical metabolic derrangements as a result of sepsis and non-renal organ system failure. Adequate informations are essential to develop effective measures to prevent and control morbidity and mortality. This study was done to detect AKI with their associated biochemical abnormalities and outcome among admitted patients in intensive care unit of BSMMU.

Materials and methods: This prospective observational study was carried out in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, during the period of September 2015 to October 2016. A total of 105 patients who were admitted in the Department of Anesthesia, Analgesia and intensive care medicine, BSMMU were included in this study. Patients who had pre-existing CKD, those on maintenance dialysis, with history of renal transplantation, Feature suggestive of chronic kidney disease were excluded. Baseline data were recorded accordingly. The study population was divided initially into two group (No AKI and AKI) then sub groups into risk, injury, failure and followed up till discharge or death.

Results: Incidence of AKI was 37.14%. Mean increase in Serum creatinine was 64.53%, 132.87% and 375.01% from baseline for risk, injury and failure respectively. Subgroup analysis revealed risk (20%) injury (6.67%) and failure (10.47%). Associated acid base disorder, electrolytes imbalance, hepatic dysfunction, haemotogical disorder and hypoalbuminemia were found statistically significant between two groups. Logistic regression analysis showed that associated haematological abnormalities were positively correlated to the development of AKI. But among these no variables showed significant effect on RIFLE class population. Our study revealed overall morality is (53.8%). Mortality was highest in Failure class and most patients from risk class achieved renal recovery.

Conclusion: The incidence of AKI in critically ill patient is high. Associated biochemical changes should be addressed properly to minimize fatality. RIFLE classification for AKI might help in recruitment of patients for predicting prognosis.

JCMCTA 2021 ; 32 (2) : 53-58
Role of Mometasone Furoate Nasal Spray Combined with Montelukast Sodium in the Treatment of Adenoids Hypertrophy in Children
Authors: Faruquee Mahmud Ullah , Anwar Mostafa Mahfuzul , Khin U Kyaw , Chakma Mitan , Alauddin Sharif Sayed Muhammad , Banerjee Sudhangshu , Biswas Supran
Published: July 2023

Background: Adenoidectomy is currently considered the treatment of choice for children with severe symptoms caused by Adenoids Hypertrophy (AH). Non-surgical alternative treatment options are considered in less severe cases to avoid the untoward effect of surgery. This study was aimed to evaluate the efficacy and safety of Mometasone Furoate nasal spray combined with Montelukast Sodium in children with AH.

 Materials and methods: This trial included 118 patients aged 3 to 13 years having symptomatic AH from the OPD of Otolaryngology and Head Neck Surgery of CMCH from May 2019 to April 2020. They were allocated to either Mometasone Furoate nasal spray combined with Montelukast Sodium (Group A: 59) or Mometasone Furoate nasal spray alone (Group B: 59) randomly for 8 weeks. Outcome measures were changes in the severity of symptoms and changes in the adenoid size from baseline. Out of 118 enrolled children, 109 children completed the study per protocol.

Results: The mean total clinical symptom score before and after treatment in group A was respectively 10.04 (±1.78) and 4.92 (±1.65). In group B the corresponding figures were respectively 9.42 (±1.33) and 5.48 (±1.36). Clinical symptom scores as well as Adenoidalnasopharyngeal ratio dropped significantly in both groups without any statistical significance between two groups with 8 weeks of treatment.

Conclusion: Mometasone Furoate nasal spray with and without oral Montelukast Sodium showed similar efficacy in symptom alleviation and adenoid size reduction without any superiority of combination therapy.

JCMCTA 2021 ; 32 (2) : 59-63
Assessment of Neurodevelopmental Status and Risk Factors for Adverse Neurodevelopmental Outcome in Late Preterm Infants at 6 Months Corrected Age : An Prospective Observational Study
Authors: Hoq Tanjina , Chowdhury Pranab Kumar , Barua Sanat Kumar , Hasan Syeda Humaida , Biswas Suman , Datta Mitra , Ahmed Farid Uddin
Published: July 2023

Background: Late Preterm (LP) infants, previously considered low risk, have been identified to be at risk of developmental problems in infancy and early childhood. There is limited information on the outcome of these infants in low and middle income countries. This study was aimed to assess the neurodevelopmental status of LP born neonates and to determine factors associated with adverse neurodevelopmental outcome in a tertiary hospital of Chattogram, Bangladesh.

Materials and methods: In this prospective observational study, 108 LP (34 to <37 completed weeks gestation at birth) infants were enrolled from the Special Care Neonatal Unit (SCANU) Chittagong Medical College Hospital (CMCH) from June 2018 to May 2019. Neurodevelopmental assessment was done by Rapid Neurodevelopmental Assessment (RNDA) at 1, 3, and 6 months of Corrected Age (CA).

Results: Of the 108 enrolled children, 30 (27.8%) attended all 3 follow-up, 69 (63.9%) had incomplete follow-up, and 9 (8.3%) died. At final follow-up, out of 30 infants, 25 (83.3%) had no abnormality in all 8 domains of RNDA. Three infants (10.0%) had abnormalities in one domain and 2 (6.7%) had abnormalities in 5 domains. Gross motor abnormality was most common abnormality (13.4%), followed by speech (10.0%), and cognition (6.7%). Small for gestational age was found to be the only independent predictive factor for Neurodevelopmental Abnormality (NDA) in LP infants.

Conclusion: This study demonstrates that 16.7% of the LP infants had evidence of neurodevelopmental impairment at 6 months of corrected age. SGA was an important risk factor of adverse neurodevelopmental outcome. Thus, LP infants in Bangladesh require long-term follow-up to monitor developmental outcome.

JCMCTA 2021 ; 32 (2) : 70-74
Male Factor Infertility and Semen Analysis among Infertile Male Subjects
Authors: Hussain Nafeesa Binti , Zinan Aklima Zakaria
Published: July 2023

Background: The prevalence of infertility in the general population is 15% -20%,of this the male factor is responsible for 20%-40%. Semen analysis is an indispensable diagnostic tool in the evaluation of male partner of infertile couple.Every single couple out of 10 is in search of medical care because of infertility. Men older than 40 years and Women older than 30 years are at an increased risk of infertility. So objective of the present study was to see the different risk factors and sperm count of male infertility.

Materials and methods: Current cross sectional observational study is design to figure out existence, problems and causes, associated with male infertility among 120 male subjects done during two years study period from January 2018 to December 2020 in a Teriarty Medical College and some private chambers of Bangladesh. After consent different health data were recorded and semen analysis was done For this purpose, survey has been conducted at different private hospitals and private chambers were selected for further studies.Semen sample were analyzed by manual method. Ethical clearance was taken from the hospital authorities to conduct the study

Results: Among 120 subjects 76(63.3%) subjects was at age group 31-40 years and 44(36.7%) was at age group 41 50 years. Different occupations of the study subjects revealed 42(35.0%) were banker, 37(30%) were doing business and 41(34.2%) were involved in other services. Regarding different comorbidities, HTN was present in 18(15%), 3(2.5%) had bronchial asthma, 3(2.5% had DM, 3(2.5%) had HTN with DM and 90(75%) had none and 54(45%) were smoker. Sperm analysis revealed 50(41.7%) had asthenozoospermia, 12(10%) had Asthenozoospermia +Teratospermia, 16 (13.3%) had oligopsermia, 17(14.2%) had Oligospermia+ Asthenozoospermia 8(6.7%) had Oligospermia +Teratospermia and 17(14.2%) had teratospermia. Sperm count among the subjects revealed 23(19.2%) had <10 million/ml, 18(15%) had 11-20 million/ml, 18(15%) had 21-30 million/ml, 15(12.5%) had 31-40 million/ml, 9(7.5%) had 41-50 million/ ml, 13(10.8%) had 51-60 million/ml and 24(20%) had >60 million/ml.

Conclusion: It is concluded that male infertility is independent on the age factor but excessive use of tobacco, sedentary life style like Banking , stress or psychological disturbances might provoke issues of infertility.

 JCMCTA 2021 ; 32 (2) : 75-78
Knowledge, Attitude and Practice Regarding COVID-19 among Healthcare Workers in Chattogram, Bangladesh
Authors: Dutta Mukesh Kumar , Barua Bidduth , Rubayat Rahnuma , Nasreen Hasina , Biswas Suman
Published: July 2023

Background: The coronavirus disease 2019 (COVID-19) is a pandemic respiratory disease caused by the highly contagious novel coronavirus (SARS-CoV 2). COVID-19 pandemic continues to challenge healthcare services worldwide. Healthcare Workers (HCWs) are more susceptible to COVID-19 infection than the general population due to frequent contact with infected individuals. This study was aimed to assess the knowledge, attitude and practice among HCWs towards COVID-19 in some COVID dedicated hospitals of Chattogram, Bangladesh.

Materials and methods: This descriptive cross-sectional study was conducted at three hospitals (Chittagong Medical College Hospital, Chattogram 250 Bed General Hospital, and Bangladesh Institute of Tropical and Infectious Disease) in Chattogram, from January 2021 to August 2021. The study included 393 HCWs (Physicians and nurses) by a non-probability convenient sampling method. An interview administered questionnaire was used to evaluate their knowledge, attitude and practices regarding COVID-19 and their associations with the participants’ characteristics.

Results: Participants were predominantly female (230/393, 58.0%) and physicians (313/393, 77.0%). Almost all had sufficient knowledge (85.8%) and good preventive practice (92.1%) towards COVID-19, however, there was also a rather low level of positive attitude recorded, at 69.0%. Factors associated with KAP were, Knowledge: being a physician and higher education. Attitude: age >40 years, Practice: being a physician.

Conclusion: The findings demonstrated sufficient knowledge and good preventive practice towards COVID-19, however, positive attitude was lower. Therefore, it is an identified requirement to continue with additional education and training strategies to offer a positive viewpoint of the pandemic for all HCWs.

JCMCTA 2021 ; 32 (2) : 79-84
Martius Graft Repair of Vesico-Vaginal Fistula: Experience at A Tertiary Care Center in Bangladesh
Authors: Sultana Nargis , Begum Rokeya , Yasmin Farida , Akhter Shamima , Sultana Nazmin , Sharmin Reshma , Begum Khatija
Published: July 2023

Background: Vesico-Vaginal Fistula (VVF) is a pathology with severe social repercussions. Resolution of VVF can be achieved through multiple surgical, abdominal or vaginal techniques, which will generally depend on the fistula's characteristics and the surgeon's experience. In this study we describe our experience with vaginal approach to treat VVF using Martius graft repair.

Materials and methods: This prospective observational study included 50 VVF patients operated in the fistula center of Chittagong Medical College Hospital, during the period of January 2013 to December 2014. The success rate and complications of Martius graft repair of VVF.

Results: The leading age group was 26 to 35 years (50.0%) and age range from 16 to 60 years with a mean age of 32.1 (±SD 8.10) years. The majority (72.0%) was from low socioeconomic class and had short stature (64.0%).48% fistula was midvaginal, 28% was juxtracervical and 54% was <2 cm in size and 40% were associated with vaginal stenosis and urethral avulsion. In 36% cases postoperative complication were developed. 82% patients were fully cured, 6% cured with urethral incontinence, 2% cured with vaginal stenosis and in 10% cases surgery was failed.

Conclusions: The vaginal technique for the treatment of VVF reinforced by Martius graft is safe and effective with low rate of complications.

JCMCTA 2021 ; 32 (2) : 85-89
A Comparative Study between Intravenous Tramadol Versus Lidocaine Pretreatment in Reducing Pain on Propofol Injection
Authors: Roshid Mohammad Harun Or , Islam Md Shahjahan , Nath Ranjan Kumar , Datta Pronoy Kumar , Begum Shamim Ara , Chowdhury Gulshan Ara
Published: July 2023

Background: Propofol gains popularity due to its smooth induction and rapid recovery. But one of its side effects is pain during injection. So, the aim of this study was to compare the efficacy of tramadol and lidocaine pretreatment for alleviation of pain on propofol injection in our setting.

Materials and methods: 80 patients of either sex (ASA grade I and II, age 20-50 years) who underwent elective Surgery under general anaesthesia were randomized into two equal groups (n=40). Group L (Control group) received pretreatment injection 2% lidocaine 40mg (2ml) Group T received pretreatment injection tramadol 50 mg (2ml). After that, 1/4th of calculated induction dose of propofol (2mg/kg) was administered. The level of pain was evaluated by four point verbal response scale.

Results: The overall incidence of pain on propofol injection was lower in lidocaine (20%) than in tramadol group (22.5%). The incidence of score ‘0’ (No pain) was higher in lidocaine (80%) than in tramadol group (77.5%) but it is not statistically significant (p >0.05).

Conclusion: pretreatment with 2% lignocaine and tramadol effectively reduced the incidence and severity of propofol injection pain.  

JCMCTA 2021 ; 32 (2) : 90-94
Pregnancy Outcome in COVID 19 Infected Patients: In a COVID Dedicated Hospital of Chattogram, Bangladesh
Authors: Chowdhury Fahmida Islam , Shirin Fahmida , Sultana Nahid , Ara Sarwat , Sultana Munawar , Deb Aporna , Amin Chowdhury Muhammad Jabed Bin , Chowdhury Shanaj Jahan , Karim Tanjila , Ferdous Jannatul , Akter Shamima , Begum Nasima
Published: July 2023

Background: Corona Virus Disease (COVID-19) a pandemic has become a global health concern. Pregnant women are at an increased risk due to physiologic changes in their immune, cardiopulmonary and coagulation systems. This study was designed to evaluate the fetomaternal outcome of the pregnant patients with COVID-19.

Materials and methods: This cross-sectional type of observational study was conducted in Obstetric and Gynecology Department of Chittagong Medical College Hospital from July 2021 to September 2021. Total 51 hospitalized pregnant patients with confirmed COVID-19 were enrolled. Relevant data were recorded in a preformed data collection sheet and analyzed by SPSS version 26.

Results: Total patients were 51 with a mean age of 28 years, 73.5% patients were in third trimester, 35.3% were in >37 weeks of gestation . Common symptoms were fever( 33.3%), cough (19.6%) and respiratory distress(29.4%). There were two maternal deaths who were treated in ICU. There were 2 spontaneous abortions. 69.23% underwent caesarean section, 30.77% underwent Normal Vaginal Delivery (NVD) 9.8% patients underwent premature termination of pregnancy. Ongoing pregnancy were 19 (37.3%). There were 17 live births and 3 Intrauterine Deaths (IUD) and 2 neonatal deaths. Among the mothers, 29(56.8%) had no associated complications, 19.65% had Preeclampsia and 5.9% had Gestational Diabetes Mellitus. About 10 babies had birth weight less than 2.5 kg and were transferred to NICU.

Conclusion: During this study, it was found that pregnancy outcome was not good in COVID positive pregnant women . For the infected mothers early medical supervision and availability of ICU in critical condition is needed for better pregnancy outcome.

JCMCTA 2021 ; 32 (2) : 95-99
A Radiological Study of Ossification at the Lower End of Humerus for Estimation of Age among Girls in Chattogram, Bangladesh
Authors: Chowdhury Raju , Ashrafuzzaman Md , Datta Arunima , Nur E Azam Nazmun , Chowdhury Urmila , Chowdhury Md Shamsudduha
Published: July 2023

Background: Estimation of the age of an individual from the appearance and the fusion of the ossification centers is considered as a reasonable well accepted method in the field of medical and legal professions. Age estimation is essential during employment, marriage, fixation of criminal responsibility, judicial punishment, exercise of adult franchise and many other purposes. Bony age can be determine by the study of ossification centers of long bones through the appearance and fusion of epiphysis with diaphysis. The challenges during estimation of bony age are varying from place to place depending on geographic terrain, climatic, dietetic, hereditary, disease and other factor. So this study aimed to look out the status of fusion of ossification centers at the lower end of humerus for estimation of age among girls in Chattogram.

Material and methods: This cross sectional observational study was performed in the period of July 2018 to June 2019on normal healthy student of 12 to 20 year age from the Prabartak School and College, Chattogram and Chittagong Medical College, Chattogram. The students (50 girls) were taken as subject and they were divided in eight groups according to their age. X-ray of the right elbow joint of each and every subjects were taken in antero-posterior and lateral view. The x-ray films were studied radiologicallyand interpreted to estimate the age byunion of ossification centers.

Results: The average age of epiphyseal union in Chattogram was found as follows:Fusion of lateral epicondyle with capitulum in girls at 12-13 years. Fusion of capitulum withtrochlea in girlsat 12-13 years. Fusion of distal conjoint epiphyses with shaft in girls at 12-13 years. Fusion of medial epicondyle with shaft in girls at 13-14 years.

Conclusion: In general the union of the ossification centers occurwithin 12-14 years in girls.

JCMCTA 2021 ; 32 (2) : 100-104
Evaluation of Antithyroid Antibodies in Polycystic Ovarian Syndrome of Reproductive Women
Authors: Akhter Salma , Tasnim Nayeema , Islam Mohammed Hafizul , Akter Pervin , Karmakar Pijush , Salma Ummey
Published: July 2023

Background: Polycystic Ovarian Syndrome (PCOS) is common but a treatable cause of infertility in reproductive women. Thyroid hormone abnormality is commonly seen in Polycystic Ovarian Syndrome of reproductive women. Antithyroid antibodies have been detected in women with PCOS. The aim of the present study is to evaluate the antithyroid antibodies in Polycystic Ovarian Syndrome (PCOS) of reproductive women.

Materials and methods: A hospital based cross-sectional comparative study was conducted in the outpatient Department of Obstetrics and Gynaecology in CMCH, Institute of Nuclear Medicine and Allied Subject and the Department of Biochemistry in CMC. Eighty (80) PCOS women diagnosed by ultrasonography were taken by nonprobability convenient sampling, considered as group A and another twenty (20) healthy women were taken, considered as group B. Important variables in this study were serum anti-TPO antibody, anti-Tg antibody, TSH, age, menstrual history, hirsutism, waist circumference and BMI.

Results: This study revealed a statistically significant higher prevalence of autoimmune thyroiditis in PCOS cases in comparison to healthy group (32.5 % and 37.5% patients had increased anti-TPO and anti-Tg antibodies respectively). Mean serum anti-TPO and anti-Tg antibodies were increased significantly in PCOS cases than that of healthy women group. Mean serum TSH was not increased significantly in PCOS cases than that of healthy group.52.5%, 47.5% patients had oligomenorrhea and amenorrhea respectively, 21.2% had hirsutism, 68.8% cases were overweight & obese and 77.5% were central obese.

 Conclusion: High prevalence of thyroid autoimmunity in euthyroid PCOS patients refers to the importance of screening not only thyroid hormone levels but also thyroid antibody level during the investigation of PCOS of reproductive women and thereby early diagnosis and management of infertility associated with PCOS.

JCMCTA 2021 ; 32 (2) : 105-110
Status of Giardia Infection with Other Intestinal Parasites among Paediatric Patients in Tertiary Medical College Hospitals
Authors: Nipa Nusrat Jahan , Karim Chowdhury Abu Hena Md Saiful
Published: July 2023

Background: Paediatric diarrhoea, the burning issue of nowadays, drastically affects the child mortality and morbidity. Apart from virus and bacteria, parasites also play an important role in causing diarrhoea at that age group. Giardiasis, the most prevalent among the parasitic infections, though neglected yet carries significance because of its long term health issues. The aim of the study was to identify the intestinal parasites by wet mount preparation and further detection of the flagellated protozoan parasite, Giardia by special staining - Trichrome staining technique.

Materials and methods: It was an observational cross sectional study which was carried between the periods of July 2019 to June 2020, where a total of 200 diarrhoeic patients up to 18 years were enrolled. Direct microscopic method was done where parasites were detected by wet mount preparation and further Trichrome stainning was performed for the detection of Giardia.

Results: Out of 200 faecal samples, cysts of Giardia, ova of Ascaris Lumbricoides (AL) Trichuris Trichiura (TT) and both AL and TT were identified in 2.5%, 1.5%, 0.5% and 1.0% samples respectively by wet mount preparation. By Trichrome staining method we detected 3.5% of Giardia cysts.

Conclusion: Staining technique could be applied in addition to wet mount preparation of stool samples. So that we could recover the undetected Giardia cyst in the aforesaid samples.

JCMCTA 2021 ; 32 (2) : 111-114
Antimicrobial Sensitivity and Resistance Pattern in Surgical Site Infections following Gynaecological and Obstetrical Operations
Authors: Sultana Tazeen , Begum Kamrun Nesa , Runa Kamrun Nessa
Published: July 2023

Background: Surgical Site Infections (SSIs) are one of the common problem in obstetrical and gynaecological operations. It is related to the increasing cost, morbidity and mortality. Objectives of this study were, find out the rate of surgical site infection, frequencies of various pathogens causing SSIs and their antibiotic sensitivity and resistance pattern in gynaecological and obstetrical operations in the Department of Obs & Gynae Chittagong Medical College, Chattogram.

Materials and methods: This hospital based prospective longitudinal study was carried from January 2021 to July 2021 in the Department of Gynaecology and Obstetrics, Chittagong Medical College, Chattogram, Bangladesh. After operation, patients’ surgical wounds were inspected first on 5-7 th day and there after weekly up to 30 postoperative- day. If there had any features of wound infection, pus or discharge would have been collected from the wound. A total 100 pus or discharge were collected from the wound after obtaining written informed consent and according to the inclusion and exclusion criteria. Samples were processed following the standard laboratory technique.The isolates were identified by colony morphology, Gram’s staining and biochemical test according to standard laboratory test methods.

Results: In this study most of the surgical site infections were caused by gram negative organisms (90%). Pseudomonas aeruginosa (36%) was the commonest organism responsible for SSIs. Staphylococcus species were responsible for SSIs in 6% of cases. In case of gram negative bacteria Amikacin and Imipenem were sensitive to about 89% and 91% microorganisms. While in case of gram positive organisms it were about 78% and 89%. Commonly used antibiotics in our set up included Ceftriaxone, Cefixime, Ciprofloxacin and Cefuroxime were sensitive in gram positiveorganisms 45%, 33%, 33% and 33% respectively. Butin case of gram negative organisms it were 76%, 63%, 79%, and 66%.

Conclusion: Surgical site infections are the reflection of quality of hospital services. Once it was thought that the organisms responsible for the SSIs were derived from normal bacterial flora of the skin. But in last few years, it has been shown that the gram negative organisms are the main pathogens responsible for SSIs. Most of them are derived from the hospital environment.So the strict surgical ritual has come to mainstay in the management of the patients instead of being used antibiotics irrationally, which not only increases the chance of resistance to the micro-organisms but also glooming our future.

JCMCTA 2021 ; 32 (2) : 115-121
Incidence and Associated Risk Factors of Endotracheal and Tracheostomy Tube Blockage in Intensive Care Unit
Authors: Das Sanjoy , Dutta Pranay Kumar
Published: July 2023

Background : Different studies had been carried out at different hospitals through- out the world to find out incidence and to assess the risk factor of ETT and TT blockage at ICU setup. The aim of our study was to reach a consensus and to find out the best diagnostic tool to assess the incidence and associated risk factors ETT and TT blockage at ICU setup. To assess the incidence and associated risk factors ETT and TT blockage at ICU setup.

Materials and methods : Endotracheal Tube (ETT) and Tracheostomy Tube (TT) blockage is a common phenomenon at the Intensive Care Unit (ICU) setup of hospital . This is a cross sectional study carried out in the Medical Centre Hospital Between July 2018 to June 2019. Total 60 patients were included in the study. Data were analyzed and presented as both qualitative and quantitative data as applicable using SPSS version 20.The quantitative data were analyzed by mean, standard deviation. The qualitative data were analyzed by Mc NEMAR test (Mc NEMAR X2 test). For all analytical test, the level of significance was set at 0.05 and p value equal or less then 0.05 was considered as significant, p value more than 0.05 was considered as not significant.

Results : A total 60 patients were included in the study, who required mechanical ventilation support for different purposes either though ETT and/or TT. The Incidence of ETT/TT blockage was 9(15%). From those ETT was 6(10%) and TT was 3(05%) (p=0.042). Most causes of tube blockage was mucus 5(55.56%), debris 3(33.33%) and kinking of the tube 1(11.11%). The incidence of partial blockage was 5(55.56%) and complete blockage was 4(44.44%) consecutively (P=0.025). so it is statistically significant. During the night shift tube blockage was 6(66.67%) was slightly higher than the day shift, which was 3(33.33%).

Conclusion : ETT and/or TT blockage is an expected outcome in ICU setup . In spite of all measures, keen observation is very important to find out the blockage problem for early intervention.

JCMCTA 2021 ; 32 (2) : 132-136
Functional Outcome of Proximal Fibular Osteotomy in Medial Compartment Osteoarthritis of The Knee Joint
Authors: Das Chandan Kumar , Rahman Chowdhury Md Mizanur , Ghosh Saikat , Matin Mohammad Qausarul , Choudhuri Md Nazrul Islam , Islam Md Somirul
Published: July 2023

Background: Proximal Fibular Osteotomy (PFO) has been proposed as a new surgical option for pain relief in patients with medial compartment knee osteoarthritis. It is simple, safe and affordable. To assess functional outcome of proximal fibular osteotomy in medial compartment osteoarthritis of knee joint.

Materials and methods: This prospective hospital based clinical trial was carried out in the Department of Orthopedic Surgery Chittagong Medical College Hospital (CMCH) Chattogram from July 2019 to June 2020. A total of 30 patients with knee osteoarthritis were enrolled through inclusion and exclusion criteria by purposive sampling. Proximal fibular osteotomy was done after taking written informed consent. Data was recorded in a predesigned case record form. All the patients were followed up to 6 months when final outcome was assessed by Oxford Knee Score. All the data were analyzed statistically by using Statistical Package for Social Sciences (SPSS-25). The result was expressed as frequency, percentage and mean ± SD. Level of significance was calculated at p<0.05.

Results: In this study, out of 30 cases, majority of the cases (57.7%) was in 55-64 years of age group. Mean ± SD pre-operative and post-operative VAS score were 7.13 ± 1.408 and 2.10 ± 0.803 respectively. According to Oxford Knee Score (OKS) pre-operative and postoperative mean ± SD were, 18.00 ± 2.117 and 36.53 ± 2.403. Mean ± SD pre-operative and post-operative Tibio Femoral Angle were 182.97 ± 1.810 and 178.63 ± 1.377 respectively. Mean ± SD pre-operative and post-operative Medial Joint Space (mm) were 1.223 ± 0.378 and 3.816 ± 0.982 respectively. Mean ± SD pre-operative and postoperative Lateral Joint Space (mm) were 6.640 ± 1.209 and 5.050 ± 0.897 respectively.

Conclusion: After analyzing the results of present study, it can be concluded that proximal fibular osteotomy is a new, simple procedure in the management of medial compartment osteoarthritis of the knee which may delay the need for definitive knee procedures like unicompartmental knee arthroplasty or total knee replacement.

JCMCTA 2021 ; 32 (2) : 137-141
Cardio Pulmonary Resuscitation (CPR) : A Global Issue of Lack of Knowledge and Skill among Medical Students and Health Care Personnel
Authors: Mallick Pranab Kanti , Chowdhury Kakoli
Published: July 2023

Abstract not available

JCMCTA 2021 ; 32 (2) : 1-2
Comparative Study of facial Measurement between Bengali and Manipuri Adult Male Comparative Study of facial Measurement between Bengali and Manipuri Adult Male
Authors: Dutta Kanta Sree , Chowdhury Pratik , Ashrafuzzaman Md , Khan Md Habib , Nahar Nurun
Published: July 2023

Background: From the human face, we can identify their gender, age group, ethnicity etc. So facial morphometric study can be taken as part of anthropometric evaluation and it is an important parameter in observing inter population of faces among the same ethnic group or different group. If we can calculate the different craniofacial variables of different ethnic groups these can be used in future research or clinical purposes. To measure the facial variables among Bengali and Manipuri adult male and to compare these variables between two ethnic group.

Methods and materials: A cross sectional, observational and analytic type of study was conducted on 200 sample which were collected by convenience sampling where 100 were Bengali adult male and remaining 100 from Munipuri adult male, aged between 18 to 50 years. Data for Bengali and Munipuri adult male were collected from Chattogram city and Kamolgonj, Sylhet respectively. The study was carried out in the Department of Anatomy, Chittagong Medical College from July 2016 to June 2017.

Results: This study showed that mean morphological face height of Bengali and Manipuri were respectively 11.46 cm ± .53 and 11.82 cm ± .49, mean maximum facial breadth respectively13.04 cm ± .48 and 13.62 cm ± .45, mean facial index respectively 87.93 ± 2.58 and 86.89 ± 2.09. According to facial height, most common type in Bengali was low type (47%) and in Manipuri was medium type (39%). According to facial breadth most common type in Bengali was narrow type (63%) and in Manipuri was medium type (53%). Bengali have leptoprosopic (Narrow face) 53% followed by mesoprosopic face (Medium face) 43%. Manipuri have mesoprosopic face 59% followed by leptoprosopic type 31%.

Conclusion: The results of the present anthropometric study on the adult Bangladeshi population can provide the basic framework for formulating standards of the facial dimension and indices for adult male of the Bengali and Manipuri population. JCMCTA 2021 ; 32 (2) : 122-127
A Case Report on Kikuchi-Fujimoto Disease: A Rare Lymphohistiocytic Disorder of Unknown Etiology
Authors: Karim Mohammad Masud , Nasir Tareak Al , Banik Pratik Kumar , Hoque Tasnia
Published: July 2023

Background: Reported first in 1972, histiocytic necrotizing lymphadenitis, also known as Kikuchi- Fujimoto Disease (KFD), is an infrequent and selfrestricting disorder of lymph nodes, predominantly found in the Southeast Asian region. The common presentation of this disease is a young Asian individual presenting with painful cervical lymph node enlargement. Due to this disease's uncommon nature, it is often misdiagnosed by clinicians as Systemic Lupus Erythematosus (SLE) malignant lymphoma, or tuberculosis. Although there are numerous hypotheses about the etiology of this illness being viral or autoimmune in nature, strong evidence is yet to be established. To let our readers to know about the disease so that we can deal patients with lymphadenopathy keeping this rare disease in our mind.

Case Presentation: Here we present A 20 years-oldfemale hailing from the hill tracts of Bandarban in Bangladesh presented with three months history of rightsided inguinal lymphadenopathy, which was progressive and non-tender in nature. Associated symptom includes low-grade fever. There was no history of night sweats, weight loss, cough and no other group of lymphadenopathies. So, lymphnode biopsy done and report came as Kikuchi-Fujimoto disease. The patient made full recovery with supportive care only.

Conclusion: Fever with lymphadenopathy may be due to wide range of etiologies. Although Kikuchi-Fujimoto disease is rare, it is important to diagnose it accurately. So, we can prevent further costly investigations and imaging at the same time we can avoid potential harmful treatments and psychological stress to the patient.

JCMCTA 2021 ; 32 (2) : 142-146
Modified Bentall’s Procedure for Aortic Root Aneurysm : A Case Report
Authors: Gupta Saikat Das , Hoque Mujibul , Mandol Bhabesh C , Islam Md Ashraful , Chanda P K
Published: July 2023

Background: The modified Bentall(M Bentall) procedure is considered as the gold standard for patients requiring aortic root replacement, where the native aortic valve is required to be replaced.

Case Presentation: We hereby present a case report of a patient who was diagnosed having moderate to severe Aortic Regurgitation (AR) with aortic root aneurysm. He was treated successfully by us with the M.Bentall procedure.

Conclusion: As the aortic disease detection and surgical expertise improved in our country, a M.Bentall procedure is a suitable and safe treatment option for Aortic root aneurysm.

JCMCTA 2021 ; 32 (2) : 147-150
Women's Reproductive Health during COVID-19
Authors: Bhattacharjee Seema
Published: July 2023

Background : Reproductive health of women is considered as the central feature of human development. A healthy child is one of the best gift of good female reproductive system ensuring the survivor off spring to withstand the changing global diverse situations. Even though now-a-days some organizations decided and are planning that teachers and parents should be involved as primary sex educators through friendship.This review article is aimed to design to provide and insight the update information and the relationship between women’s reproductive health and COVID-19 is necessary for optimum management of such condition.

Methodology : In this narrative review, literature search done by using PubMed, Medline, Google Scholar and Cochrane date bases of systemic review and citation list of relevant publication.

Conclusion : In the pandemic high risk situation it is necessary that health care teams to focus more on women’s mental health, domestic violence, sexual relationships, use of contraceptive methods and intending for child bearing. Providing virtual group educations and use of national media, could enhance the awareness of women’s reproductive health. Further study may reveal more clearly the various aspects of women’s reproductive health during COVID-19.

JCMCTA 2021 ; 32 (2) : 3-7