bluuebunny/crossref_metadata_2025 huggingface dataset:
CHARACTERIZATION AND ANTIBIOGRAM STUDY OF CLOSTRIDIUM CHAUVOEI ISOLATED FROM FIELD CASES OF BLACK LEG IN CATTLE
Authors: Jowel M. S. , Khan M. S. R. , Parvej M. S. , Ali M. Y. , Ara M. S. , Nazir K. H. M. N. H , Khan M. F. R. , Rahman M. , Rahman M. T. , Rahman M. B.
Published: December 2016

Clostridium chauvoei is the etiological agent of black quarter (BQ), an infectious disease affecting mainly young cattle and sheep. The present study was designed with a view to isolate and identifies Cl. chauvoei from field cases. A total of 4 clinically suspected samples were collected during the period from January 2013 to November 2013 from Monohardi, Narshindi (n=1); Sujanagar, Pabna (n=1) and Veterinary Clinic of Bangladesh Agricultural University, Mymensingh (n=2). The samples were processed and were cultured anaerobically on blood agar. Gram stain and hanging drop techniques were performed with the cultured bacteria. Biochemical properties of the isolates were studied, and antibiotic sensitivity test was done by disk diffusion method. In Gram stain, all isolates showed numerous short, thick, straight, round-ended, gram positive rod occurs singly or in short chains. The spores of the organism were elongated, oval, sub terminal or terminal and wider than the cell, giving a typical pear-shaped appearance. All the Cl. chauvoei isolates fermented dextrose, maltose, lactose and sucrose and produced acid and gas. In case of mannitol fermentation, only acid was produced. Catalase, oxidase, methyl red, Voges-Proskauer and indole tests were found to be negative. All isolates were resistant to oxytetracycline, amoxicillin and ciprofloxacin, whereas the isolates were sensitive to penicillin and gentamicin. In conclusion, penicillin and gentamicin can be the drugs of choice for effective treatment of BQ in cattle of Bangladesh.
IMPACT OF CLINICAL MASTITIS IN DAIRY FARMING AT KESHABPUR UPAZILLA IN JESSORE IN BANGLADESH
Authors: Hossain S. , Reza M. A. , Hasan M. N. , Sorwar M. G. , Billah M.
Published: December 2016

The study was conducted at upazilla veterinary hospital, Keshabpur, Jessore during the period of March 2013 to August 2013 to estimate the impact of clinical mastitis in dairy cows. Clinical mastitis was diagnosed on the basis of clinical signs and strip cup test (SCT). A total of 432 cases of dairy animals were recorded among them 65 cases were mastitis. The overall prevalence of mastitis was 15.05%. The prevalence of mastitis was 12.04% and 3.01% in cows and does respectively. In doe, the prevalence was 7.14% in Jamunapari goat and 4.46% in Black Bengal goat. Reproductive stages enhanced the prevalence of mastitis. The prevalence of mastitis was also significantly affected by floor conditions where 10.42% in cows and 8.04% in does in the farms with brick-block floor and 6.51% in cows and 3.57% in does with soil floor. The efficacy of Ceftriaxone and amoxicillin was better than gentamicin and streptomycin. Hygienic condition showed lower prevalence of mastitis 1.63% and 1.79% in cow and does respectively than the unhygienic farm.
PREVALENCE OF COXIELLA BURNETII INFECTION IN CATTLE, BLACK BENGAL GOATS AND TICKS IN BANGLADESH
Authors: Chakrabartty A. , Bhattacharjee P. K. , Sarker R. R. , Rahman A. K. M. A. , Henning K. , Neubauer H. , Rahman M. S.
Published: December 2016

The objectives of this study were to determine the prevalence of Coxiella burnetii infection in domestic ruminants and to detect Coxiella burnetii DNA from ticks and serum samples. A total of 24 ticks, 91 goats and 81 cattle serum samples with the history of abortion and reproductive disorders were collected from the different areas in Bangladesh. The serum samples were tested by CHEKIT Q-Fever Antibody ELISA Test Kit and Coxiella burnetii DNA was detected by multiplex quantitative real- time PCR. The overall prevalence was 7.6% and 6.1% in goats and cattle, respectively. However, none of seropositive samples and tick samples was positive in quantitative real-time PCR.
THE OCCURRENCE OF GASTRIC LESIONS IN SLAUGHTERED PIGS AT THE KUMASI ABATTOIR, GHANA
Authors: Laryea M. A. , Emikpe B. O. , Attoh-Kotoku V. , Omotosho O. O. , Asare D. A. , Asenso N. T. , Yeboah R. , Adejumobi O. A. , Mensah M. , Okai D. B.
Published: December 2016

Information on the occurrence of gastric lesions in pigs in Ghana is lacking in literature. This study was designed as a preliminary investigation to determine the occurrence and pattern of gastric lesion in pigs in Ghana. Ante-mortem animal assessment and post-slaughter stomach evaluation were conducted on 75 pigs out of a total of 694 slaughtered between October, 2014 and March, 2015 at the Kumasi abattoir. The gross lesions observed on the gastric mucosa were graded using standard technique. Stomach contents were assessed and tissue sections were used for histopathology evaluation. The data obtained were cross tabulated and analyzed using Chi-square and One-way ANOVA. Significance was determined at p < 0.05.The prevalence of gastric lesions in the sampled population was 25.3% while the non-glandular stomach (pars oesophagea) and glandular had a prevalence of 17.3% and 21.3% respectively. The predominant lesions observed were epithelial changes in the pars oesophagea and ulcers in glandular region of the stomach. Epithelial changes were restricted to the non-glandular region and it affected 8 (42.1%) of the stomachs with lesions. Erosions and ulceration were observed in the pars oesophagea and glandular stomach while mucosa damage was restricted to the glandular stomach. Lesions were observed in the two breeds studied and the stomach contents of the pigs were mostly finely grounded compounded feed, millet/maize chaff or cassava based feed. Histopathological evaluation of gastric mucosa tissues revealed erosion, multifocal ulcerations with occasional presence of silver staining micro-organisms. There was no significant association between breed, age, sex and occurrence of gastric lesions in pigs. Stomach content volume and feed type were identified as risk factors. Evidence of stomach infection with spirochetes was also observed. Our findings reveal the occurrence of gastric lesions in pigs in Ghana and its associated risk factors. It is therefore recommended that stake-holders should adopt on-farm and abattoir periodic monitoring of the condition as well as improved animal welfare and hygiene practices both on farm and in transit.
PHYTOCHEMISTRY, TOXICITY AND IN VITRO ANTITRYPANOSOMAL EFFICACY OF CRUDE AQUEOUS EXTRACT OF GUIERA SENEGALENSIS STEM BARK
Authors: Biu A. A. , Buratai L. B. , Onyedim P. N. , Hambali I. U. , Ngulde S. I. , Zakariah M. , Lawal J. R.
Published: December 2016

The crude aqueous extract of Guiera senegalensis stem bark was evaluated for its phytochemistry, acute toxicity and in vitro antitrypanosomal efficacy in this study. Tests for alkaloids, flavonoids, tannins, phlabotannins, saponins, steroids, cardenolides, terpenoids, cardiac glycosides, and anthraquinones were conducted. A total of 15 albino rats of both sexes were used and grouped into 5 (A to E) of 3 rats each. Groups A-D were intraperitoneally treated with graded doses of 100, 200, 400, 800mg/kg body weight of the crude aqueous extract of G. senegalensis stem bark. Group E was treated with Physiological Saline Solution serving as the control. All groups were observed for 24 hours for clinical signs and death to determine the median lethal dose (LD50). An in vitro experiment was carried out with 2 drops of blood from a donor rat added to 5 ml of phosphate buffer glucose solution out of which 0.2ml was finally used at 40, 20, 10, 5, 2.5, 0.625, 0.313, 0.156 and 0.078 concentrations of the extract. The phytochemical screening for bioactive substances had tannins, terpenoids, alkaloids, flavonoids, saponins, anthraquinones and cardiac glycosides.  Phlabotannins and cardenolides were not detected. The clinical signs observed were sluggishness, awkward posture, loss of appetite, starry hair coat and terminal death within 24 hours with LD50 value of 600mg/kg. The in vitro antitrypanosomal efficacy of the extract showed 100% inhibition of motility against Trypanosoma brucei at 20mg/ml. In conclusion, the crude aqueous extract of G. senegalensis stem bark contains phytochemical components that exhibit inhibitory trypanosomal activity.
Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication: Updated October 2007
Authors: Editor The
Published: December 2016

Bangabandhu Sheikh Mujib Medical University Journal (BSMMU J) publishing this Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication - Updated October2007 as a special article on good faith; as the ICMJE welcomes any organizations to reprint this document for non-profit educational purposes only.BSMMU J 2008; 1(1): 39-61
Preemptive Analgesia
Authors: Chowdhury AYF Elahi
Published: December 2016

Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.1-2
Evaluation of Tip Holed Spinal Needle - A Comparative Study
Authors: Chowdhury Iqbal Hossain , Begum Hasina , Begum Asia , Akhtaruzzaman AKM , Iqbal KM
Published: December 2016

Background: The performance and post dural puncture headache were assessed in this randomised clinical study. Methods. Total 100 patients of ASA physical status I and II undergoing elective caesarean section were enrolled for the study. Patients in the controlled group Group-A. Patients in the trial group (Group-B). ABSTRACT: Regional block has its own unique place in modem anesthetic practice increasing popularity over 30-40 years has followed better understanding of the technique and acceptance than the incidence of side effects is tow. These depend not only on the correctly performed procedures but the correct design of the needle is also important. The purpose of this clinical study is to evaluate the performance of tip hole spinal needle (25G) in comparison with widely used Quincke spinal needle (25G). Clinical effects, performers satisfaction, side effects and complications were assessed over 100 pts who were decided into group A (Qiuncke gr) & Group B (tip hole gr) undergoing emergency & elective C.S. under spinal anaesthesia. Ease of insertion of the needle, number of attempts for successful insertion, appearance of CSF flow through needle, bending of needle, quality of analgesia, clinical effects & PDPH were assessed. No significant changes in pulce, BP. & SPO2 in 1 minute & 5 minuets were found in pre-operative & per-operative period in Group A & also in Group B. In terms of ease of insertion there was no significant change in Group A (100%) & Group B (90%). It was found that in less than 1 second no CSF fluid appeard in Group A but in Group B, CSF appeard in 30%, in less than 2 seconds, the values among Gr A & Gr B were 4% & 52%, in less than 3 seconds. 50% & 18% respectively. In less than 4 seconds & 5 seconds in Group A 38% & 8% respectively and no CSF fluid appeard in Group B in that period. In Group A 52% cases required 1 attempt, 28% cases 2 attempts, 16% of cases 3 attempts & 4% cases 4 attempts were required. In Group B it was 86%, 14% & no 3rd & 4th attempts required. In terms of bending of needles during insertion, the performance of Group B was better (7% in Group A and no in Group B). The incidence of PDPH was found absolutely nil among the gr B & negligible (2%) in gr A subjects. Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.3-8
Use of Oral Bromazepam as Premedicant and its Effects in Peri-operative Period - A Comparative Study with Oral Diazepam
Authors: Islam Md Sirajul , Banik Debabrata , Akhtaruzzaman AKM , Sarker Paresh Chandra , Igbal Kazi Mesbahuddin
Published: December 2016

Anaesthetic management begins with the pre operative psychological preparation of the patient and administration of a drug or drugs selected to produce specific pharmacological responses prior to the induction of anaesthesia. Preoperative medication should increase the likelihoods that patient will enter the preoperative period free from apprehension, sedated but easily arousable and fully co-operative. A prospective randomized controlled trial was performed in adult patient of different surgical approach to see the effectiveness of bromazeparn as a premedicant and the haemodynarnic changes in patients at perioperative period. Ninety patients of ASA grade I and II, aged 20 to 50 years of both sexes undergoing different type of surgery under general anaesthesia of 30 to 150 minutes duration and were divided randomly into three groups. Control group (Group-C) has no medication preoperatively. Group-D were given oral diazepam 5 mg at night before the operation and 5 mg at morning on the day of operation and Group- B were given bromazeparn 3 mg at night before and 3 mg at morning on the day of operation. Observations were carried in during preoperative assessment on the day before surgery, in the anaesthetic room at morning, before induction and in postoperative ward (after extubation). Anxiety level was measured by Visual Analogue Scale (VAS), which was reduced significantly at morning on the day of operation, before induction and 24 hrs after operation in Group-B (p< 0.001). Pulse rate, blood pressure (systolic and diastolic) at different time in perioperative period (in Group-D and group Group-B) was stable in comparison to Group-C (p<0.001). Sedation score that was measured at morning on the day of operation before induction in different groups was seen and found that in Group-D, (36.66%) patients were drowsy but responds to verbal commands in comparison to Group-B (6.66%) (p<0.001). Recovery statuses were measured by Aldrete Recovery Score and have seen recovery scores was better in bromazepam taken group (73.33%) in comparison to diazepam taken group (56.66%). Postoperatively nausea was more in diazepam taken group (20.00%) than bromazepam taken group (16.16%). It was concluded that oral bromazepam at divided dose as a premedicant relief anxiety, and patients are haemodynamically stable in perioperative period with a well recovery.   Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.22-30
Study of Haemodynamic Status after Anticholinergic Premedication During Electroconvulsive Therapy  A Comparative Study Between Atropine and Glycopyrolate
Authors: Shahjahan Md , Islam Md Shahidul , Akhtaruzzaman AKM , Iqbal KM
Published: December 2016

Electroconvulsive therapy (ECT) is a highly successful treatment for severe depression and some other psychiatric disorder. 70%-80% patients respond to pharmacological therapy and at least 50% who do not respond to antidepressants do respond favourably to ECT. ECT is quicker, safer and more effective and has fewer side effects than drug therapy. ECT needs general anaesthesia; therefore interactions between psychotropic drugs, ECT and anaesthetic agents can occur. ECT is often associated with acute hyperdynamic response. CNS stimulants on the other hand may prolong seizure, also dysrrhythmias and elevate haemodynamic responses. Initial vagal responses immediately after application of current may lead to bradycardia and salivation, which may cause laryngospasm, bronchospasm and airway obstruction. There may be even asystole and hypoxic episodes. To prevent possible asystole, bradycardia and airway obstruction during ECT, atropine as premedication can be considered. Atropine premedications produces anticholinergic mediated tachycardia, which is in addition to intense sympathetic response after ECT stimulus that contributes to greater myocardial workload. On the other hand, glycopyrolate is a long acting muscarinic antagonist five to six times as potent as atropine. It does not cross blood brain barrier, placenta and eye. It controls secretions with doses that don't cause marked changes in heart rate. Its effect on blood pressure is less than atropine. Atropine crosses blood brain barrier and thus affecting CNS. Our present study was performed to compare haemodynamic status after anticholinergic premedication with atropine and glycopyrolate during ECT. This study was randomized, prospective study. 90 patients for ECT, age 15-50 years, ASA grading I&II, and receiving antipsychotic therapy with major depressive illness were randomly selected by blind envelop method and divided into three groups of 30 patients each. Group-I received atropine, group-II received glycopyrolate and group-III received no premedication. Results of the study showed that anticholinergic premedication is not essential for safe and effective ECT therapy, if at all needed glycopyrolate is the therapy of choice. Key words: ECT; Atropine premedication; glycopyrolate Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.31-37
Recovery Status in Children after General Anaesthesia: Role of Pre-emptive Local Anaesthetic Infiltration
Authors: Isa Md Maqsud , Yasmin Rubina , Syeeda Nur , Enam Suraiya , Isiam Md Manowarul , Iqbal KM
Published: December 2016

This prospective clinical study was carried out in the dept. of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU. Dhaka during the period of January 04 to September 04. The study was done to emphasize the importance of giving analgesics preemptively instead of waiting for the child to complain or express their pain and to improve post operative recovery status and associated response by reducing the immediate post operative pain with simple local anaesthetic infiltration. The children scheduled for elective herniotomy operation through a hernial incision under general anaesthesia were recruited in this study. Immediate recovery status in children was compared with preemptive (group-1 and without preemptive (group-II) local infiltration of 0.25% bupivacaine in herniotomy operation. No. of patients was 20 in each group. Pulse, systolic, diastolic and mean pressure, oxygen saturation, pain (scored by TPPPS), anaesthetic recovery (scored by steward recovery system) and mental status if the children were observed postoperatively at different time interval up to one hour. Pulse, systolic, diastolic, mean pressure were stable in group-1 then group-II. Oxygen saturation in both the groups were in clinically acceptable range but in group-11 5 mins after extubation fall more than that of group- l and statistically significant. Pain score (TPPPS) in group-1 was lower all the time period but in group-II the score was high, all the children required rescue pethidine within 10 mins after extubation, mean dose reqd, in group-II was 23.6+3.6mg. Steward recovery score in both group was not significant at early period but after 10 mins. P value become significant The mental state of group-I was calm & quite only 3 were excited, on the other hand in group-11 all children were excited & irritable and required rescue pethidine. So preemptive local infiltration of 0.25 bupivacaine improved the recovery status in children by reducing the immediate postoperative pain and there by decrease in postoperative morbidity. Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.38-44
Anaesthetist in SBTP (Safe Blood Transfusion Programme)
Authors: Amin Md Nurul
Published: December 2016

Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.45-47
Unconsciousness as a Complication of Local Anaesthetic in Peribulbar Block
Authors: Islam Md Rezaul , Alam ABM Maksudul , Begum Rabeya , Ambia Golam
Published: December 2016

Unconsciousness in seventy-five year old male after peribulbar block is reported.The patient was hypertensive, non diabetic, not well oriented, non sedated became unconscious, nonresponsive to painful stimuli without excitatory effect like convulsion. Key words: Peribulbar block, Unconsciousness, Local anaesthetics. Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.48-49
Anaesthetic Management of a case of Heriditary Spherocytosis for Splenectomy and Cholecystectomy
Authors: Afroza Shahnaz , Aziz Lutful
Published: December 2016

Objectives:Hereditary spherocytosis is a heterogeneous group of disorder that results in the formation of abnormal red blood cells with fragile cell walls causing anaemia, jaundice, splenomegaly and ultimately gall stone formation. Most children have mild disease do not require splenectomy. Splenectomy is reserved for those with severe disease or who develop symptomatic gall stone. Individuals with symptomatic gallstones usually have a cholecystectomy and at the same time splenectomy if indicated. Case Report: A 20 years old female diagnosed as hereditary spherocytosis since age of one year. After 19 years she was diagnosed as splenomegaly with cholelithiasis. After proper investigations and vaccination patient was posted for surgery splenectomy and cholecystectomy at the same time which is challenging from the anaesthetic point of view because the sickling oriented anaesthetic approach. Commonly recommended perioperatoive management includes preemptive erythrocyte transfusion, aggressive hydration and avoidance of hypoxia, aplastic crisis, hypothermia and acidosis. Conclusion: Patients with Hereditary spherocytosis, as they are more prone to develop infection, were meticulously controlled through out the perioperative period. Removing the spleen does not cure the disease, but it does allow the red blood cells to live longer so that a child no longer became anaemic during periods of stress or infection. It is very important that all these patients should receive all of the normal childhood immunizations and a few special immunizations (pneumococcal and meningococcal) to prevent infection. Key Words: Hereditary Spherocytosis, Splenectomy, cholecystectomy, aplastic crisis. Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.50-53
Palliative Care Service in Bangladesh  First step of miles to go
Authors: Ahmad Nezam Uddin
Published: December 2016

Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.1-2
Outcome of Guillain-Barre Syndrome in DMCH ICU - A 5 Years Experience
Authors: Begum Hasina , Basu Manash Kumar , Rahman Md Siddiqur , Talukder Moumita , Khatun UH Shahera
Published: December 2016

Guillain - Barre Syndrome (GBS) is the commonest peripheral neuropathy causing ventilatory failure. In this study, all the patients clinically diagnosed as a case of Guillain - Barre Syndrome (GBS) admitted in DMCH between January 2002 to December 2006, were analysed to evaluate the prognostic value and to understand the morbidity and mortality associated with ICU care. Total 406 patients were admitted in DMCH in last 5 years, of which 167 (41.13%) needed ICU care, which was about 10.01% of total ICU admission. 112 patients (67.07%) improved and leave ICU with or without some residual effects like weakness of both legs, persistent tracheostomy, malnutrition etc. and 55 patients (32.93%) were expired. The age of the subjects treated in ICU were 0-10 years 28(16.76%), 11-20 years 49 (29.34%), 21- 30 years 38 (22.75%), 31-40 years 24 (14.37%), 41-50 years 18 (10.77%) and 50 years and above 13 (7.78%). The duration of ICU stay were 0-10 days 88 (55.69%), 11-20 days 22 (13.17%), 21-30 days 12 (7.18%), 31- 40 days 6 (3.59%), 41-50 days 9 (5.38%) and > 50days 30 (17.96%). 39 patients (23.35%) needed tracheostomy. 77 patients (46.10%) needed mechanical ventilation. The median duration of mechanical ventilation was 35 days. The patients were ventilated more than 30 days usually developed ventilator - associated pneumonia and / or sepsis, malnutrition etc. Complications were uncommon if ICU stay were less than 3 weeks. Only 4 patients had history of readmission for second attack between this period. Only 7 patients were treated with immunotherapy which did not produce significant extra benefit. No patient was managed with plasma exchange (PE). Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.9-13
Effect of Low Dose Propranonol on Perioperative Stress Induced Hemodynamic Changes in Upper Abdominal Surgery
Authors: Saha Dilip Kumar , Kader Md Abdul , Kamal Md Mostofa , Akhtaruzzaman AKM , Iqbal KM
Published: December 2016

Stress response is accompanied by an increased traffic in sympathetic efferent tracts resulting in potentially severe hypertension, tachycardia and is associated with post-operative morbidity. Study establishes the assumption that ‘stress free' general anesthesia is necessarily advantageous. A recent study has suggested that different pre-medication may lead to an alteration in sympatho-adrenal stress response during surgery. Several agents and regimens have been devised to control this stress induced haemodynamic responses including alphablocker droperidol, lignocaine, low dose opioid and cervical extradural blockade. It has been demonstrated that beta-adrenoceptor blocker, in therapeutic doses, caused only modest reduction in cardiac output while decreasing the incidence of arrhythmia and myocardial ischaemia after laryngoscopy and intubation. It is recommended that their administration to be continued until the day of surgery. Even a single dose of a beta-blocker given as a premedication decreases the incidence of episodes of myocardial ischaemia. Atenolol, a selective beta-blocker, per oral significantly reduces cardiovascular morbidity in non-cardiac surgery. Propranolol, a non-selective beta-blocker, has an added advantage of alleviating effect in anxiety. In addition, cost of propranolol is generally low and the systems required to use them according to the protocol used in this study are already in place. This prospective study was performed to establish its effects on per-operative haemodynamic response in non-cardiac surgery. The effect of propranolol on heart rate, systolic arterial pressure and derived value rate pressure product (RPP) on peri-operative period was significantly different from that of placebo effect. The result showed that propranolol significantly reduces heart rate, SAP & thus RPP & reduces peri-operative morbidity and mortality.   Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.14-19
Intravenous Granisetron, Ondansetron and Metoclopramide in the Prevention and Treatment of Post Operative Nausea and Vomiting after Laparoscopic Cholecystectomy - A Comparative Study
Authors: Yeasmeen Sabina , Yasmin Rubina , Akhtaruzzaman AKM , Khatun UH Shahera
Published: December 2016

Postoperative nausea and vomiting are the common morbidity after general anaesthesia and surgery. One of the essential goals of anaesthetic management is to prevent postoperative nausea and vomiting. The consequence of prolonged postoperative nausea and vomiting (PONV) ranges from unexpected admission of day patients with its economic implications to physical, metabolic and psychological effects on the patients which slow their recovery and reduced their confidence in future surgery and anaesthesia. The present study was designed to compare the efficacy of Granisetron with that of Ondansetron and Metoclopramide in the treatment and prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. This study was also done to observe the incidence of nausea and vomiting in the postoperative period, to observe the requirement of rescue antiemetic, to find out the haemodynamic stability, saturation of arterial oxygen in these groups of subject and to detect the patients satisfaction by verbal rating scale after 24 hours of surgery. A total number of 90 patients, sex female, age range 30-50 years undergoing laparoscopic cholecystectomy were selected. They were equally divided into three groups of 30 patients. They received a standard general anaesthesia. Group I received injection Granisetron (1mg), Group II received injection Ondansetron (8mg), Group III received injection Metoclopramide (10mg) 10 minutes before reversal of anaesthesia. Postoperative analgesia was provided with injection pethidine (1.5mg/kg/bd.wt.) intramuscularly 8 hourly. In the recovery room occurrence of nausea and vomiting was assessed for 24 hours. The incidence of emesis free (no nausea) was significantly higher in patients who received Ganisetron (90.0%, 27/ 30) than in those who received Ondansetron [(66.7%, 20/30), p=0.028] or metoclopramide [(40.0%, 12/30), p= 0.000].The incidence of vomiting free was significantly higher in patients who received Granisetron (93.3%, 28/30) than in those who received Ondansetron [73.3%, 22/30), p= 0.037] or Metoclopramide [46.7%, 14/30), p= 0.000]. Granisetron was associated with greater patients' satisfaction than Ondansetron and Metoclopramide 40%, 20% and 10% of patients respectively. No need for another rescue antiemetic medication was achieved in 86.7% of patients with granisetron, 70.60% with Ondansetron and 53.3% with Metoclorpramide. The haemodynamic variables, heart rate, blood pressure, SpO2 were recorded carefully in different time intervals. There was no significant difference among the study. So, it can be concluded that Granisetron is more effective than Ondansetron and Metoclopramide in the prevention and treatment of postoperative nausea and vomiting after laparoscopic cholecystectomy. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p20-27
Comparative Study of Haemodynamic Changes between Endotracheal Intubations and LMA Insertion
Authors: Harun-or-Rashid Md , Meftahuzzaman ASM , Islam Manirul , Aktaruzzaman AKM
Published: December 2016

To compare the haemodynamic changes between LMA insertion & endotracheal intubation, 60 patients were assigned randomly to one of the two groups of thirty each. They were grouped randomly by card sampling. Every patient included in the study was allowed a card preoperatively. According to the card number patients were grouped. Group A. Airway was maintained by LMA. Group B: Airway was maintained by ETT. Haemodynamic parameter i.e. pulse rate, systolic blood pressure, diastolic blood pressure and presence of any dysrhythmia were monitored after 1,3,5 & 10 minutes after LMA insertion or ETT intubations. There was statistically significant changes (P<0.05) in pulse rate, systolic blood pressure, diastolic blood pressure and (appearance of dysrhythmia in some patients) in group ti patients whereas there was less changes in pulse rate, systolic blood pressure, diastolic blood pressure whose airway was maintained by LMA insertion (Group-A). We conclude that LMA insertion causes less Haemodynamic changes than that of endotracheal intubation. So LMA insertion is safer than ETT intubations in some selected patients.   Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.28-32
Needs of Terminally ill Patients and their Families: An Experience with Fifty-three Patients Attending a Newly Organized Palliative Care Service in Bangladesh
Authors: Ahmad Nezamuddin , Kamal Mustafa , Anwar AHM Mostak , Rahman AKM Shafiqur
Published: December 2016

Objective: To identify the needed care of the terminally ill patients and their families in Bangladesh Design: Retrospective, descriptive cross-sectional study Setting: Out Patient Consultation, referred admitted patients and home care visits by the same palliative care team of Bangabandhu Sheikh Mujib Medical University (BSMMU) Participants: 53 terminally ill cancer patients registered with the palliative care service of BSMMU Results: Age range of 22 to 80 years, mostly from middle to poor class. Most of the patients needed relief from pain, anxiety, sleeplessness and constipation along with other symptom relief. Major concern of patients was financial whereas major concern of family members was not to inform the patient of the disease status.. Preferred site of care was at home when uncertainty about the disease status was reduced. Conclusion: even if a ‘good life' is not possible for all the people of Bangladesh, ‘a good death for most of the patients suffering from incurable diseases can be an affordable reality. Key words: need, symptom assessment, palliative care, Bangladesh   Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.38-43
Randomised Comparison of General Anaesthesia & Subarachnoid Block for Caesarean Delivary in Pregnancies Complicated by Eclampsia
Authors: Basu Manash Kumar , Begum Hasina , Karim Md Abdul , Rahman M Khalilur
Published: December 2016

General anaesthesia & subaracnoid block were used randomly in women with eclampsia who required caesarian delivery to evaluate the maternal and foetal effects of the two anaesthetic methods. The haemodynamic parameters, level of consciousness of the mothers and APGAR scores of the neonates were assessed. A total 60 women with eclampsia underwent caesarean section were allocated randomly received either of the techniques. Both the techniques provided good quality anaesthesia. At arrival in OT, there was no significant difference of MAP between two groups. But following induction there developed significant difference between two groups & within the same group. There was no significant difference of neurological status between two groups within 24 hours after operation. There were significant difference of Apgar scores in 1 min. after birth & at 5 min. no significant difference were found between the two groups. Out of 30 infants of GA group II had to resuscitate with Ambu-mask ventilation & 6 babies had to sent special care unit. From SAB group 2 infants received resuscitation & one baby had to sent special care unit. In the context of Bangladesh, General anaesthesia as well as Subaracnoid block are equally acceptable for LUCS in eclamptic mothers, if steps are taken to ensure a careful approach to either method. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.44-50
Paramedian Approach for Subarachnoid Blockade  A Marvellous Technique having Less Attention
Authors: Islam Md Rafiqul , Hossain Mozaffer , Kabir Quazi Arefin , Alim Abdul
Published: December 2016

At present central neuroaxial blockade, e.g. subarachnoid blockade (SAB) or epidural blockade (EB), especially the former one, is widely used by the clinical anaesthesiologists due to its procedural simplicity, low cost & better physiological benefits and thus reduced complications than that of general anaesthesia (GA). Subarachnoid or epidural spaces can be traversed from the posterior aspect of the body either through a midline approach (MA) or a paramedian approach (PMA). There is another approach described as ‘lumbosacral puncture' or Taylor's approach, which actually is a variant of conventional paramedian approach. Theoretically, subarachnoid & epidural spaces can also be approached through the paravertebral foramen or even via an anterior intraoperative approach through the intervertebral discs1. The most common & popular technique is the MA. But the PMA (both conventional & Taylor's) is also a very easy & effective technique that can be practiced routinely as well as for some clearly indicated cases. The requirement for this procedure is the same as for the MA except having some ideas about the offmidline anatomy. Keywords: Blockade, subarachnoid; approach, paramedian. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.51-53
Case Report on Cardiac Arrest Under Spinal Anesthesia in a Case of Caesarean Section
Authors: Bari Sumia , Islam Aminul , Khan Md Rafiqul Hasan , Chowdhury SN Samad
Published: December 2016

A 33 years old multiparous woman was admitted in Dhaka National Medical Institute Hospital with the complaints of 37 weeks pregnancy and less fetal movement. She was a known case of DM & had a previous history of caesarean section. She had under gone an emergency caesarean section under spinal anesthesia. Patient developed sudden severe hypotension with respiratory distress within 3-4 minutes after the anesthetic procedure, while she was in supine position. Subsequently she developed cardiac arrest. She was managed by cardiopulmonary resuscitation which included prompt tracheal intubation, ventilation with 100% oxygen, cardiac message & ionotropic drug. Cardiac arrest was revived. The operation was completed under general anaesthesia & was reversed uneventful. She was kept in CCU under close monitoring. The patient was discharged on her 7th postoperative day with a healthy baby and a healthy physical status. Key words: Cardiac arrest, Spinal anaesthesia, Supine hypotensive syndrome. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.54-56
Intensive Care Unit: Bangladesh Perspective
Authors: Alam AKMS
Published: December 2016

Journal of BSA, Vol. 20, No. 1, January 2007 p.1-2
Glucose, C-peptide and Cortisol Response To Surgery Under General Anesthesia In Diabetic Subjects with Treatment Variability
Authors: Sardar K , Khatun UHS , Ali L , Chowdhury NN , Iqbal KM
Published: December 2016

Diabetic patients are considered to be at increased risk of perioperative morbidity and mortality because of the involvement of their vital organs and the autonomic nervous system in the natural course of the disease. Various aspects of anesthesia and surgery cause stress induced hemodynamic, endocrine and metabolic changes in type 2 diabetic subjects. The present study was designed to investigate the surgical stress response difference between the patients groups those who are treated with only insulin and with insulin-oral hypoglycaemic drugs combination before surgery. Stress response was measured with the changes of blood glucose, C-peptide and cortisol. A total number of 30 subjects who were admitted in BIRDEM hospital in fit physical condition (ASA Class I & II) were selected for the present study. Among them 15 patients were treated with only insulin and 15 patients were treated with insulin- OHA combination before surgery. All of the subjects were received total abdominal hysterectomy under general anesthesia. Three samples were collected from each subject. The first sample (control, PT0) was collected just before anesthesia; second sample (PT1) collected 10 minutes after incision and third sample (PT2) collected 10 minutes after extubation. Plasma glucose was measured by glucose oxidase method, serum C-peptide and cortisol by chemiluminescent based ELISA technique. The mean±SD age and BMI were 44±6 years and 24.4±3.0 kg/m2 respectively. In insulin treated group, the plasma glucose level was significantly higher in PT2 and it was about 147% whereas in insulin-OHA group, the plasma glucose level was significantly higher in both PT1 (111%) and PT2 (196%). The serum C-peptide values were decreasing tendency but not significant in both groups. The serum cortisol level was increased gradually and significantly higher in PT2 in both groups. The data suggest that a) insulin treatment alone is more effective than insulin-OHA combination to control blood glucose in type 2 diabetic subjects undergoing surgery under general anesthesia, b) lower abdominal surgery under general anesthesia in well controlled type 2 diabetic subjects is accompanied by a hyperglycemic response which results from rise of insulin antagonists like cortisol rather than fall of insulin secretion, but the two treatment modalities lead to similar cortisol response. Key words: General anesthesia, Serum glucose, cortisol, Total abdominal hysterectomy Journal of BSA, Vol. 20, No. 1, January 2007 p.3-8
Role of Dexamethasone on Reducing Post Tonsillectomy Morbidities
Authors: Yasmin Rubina , Khan Zamir Hossain , Alam SM Shafiqul
Published: December 2016

Pain, nausea, vomiting, oedema and poor oral intake are the most common morbidities after general anesthesia and surgery like tonsillectomy. This study was done to evaluate the effectiveness of intravenous dexamethasone (0.15mg/kg) at induction of anaesthesia on post tonsillectomy morbidities. In this prospective randomized double blind study, sixty children of age between 8-12 years, ASA I & II undergoing tonsillectomy under general anaesthesia were randomly assigned into two equal groups of 30 each. They received dexamethasone IV or saline (control) following induction of anaesthesia. Both anesthetic and surgical techniques were standardized. Post operative pain was assessed by visual analogue scale (VAS). Inj. Tramadol 1mg/kg in first 6 hrs and oral paracetamol 10mg/kg in next 24 hrs were administered as rescue analgesic. Incidence of nausea, vomiting, time and quantity of first oral intake were also noted. Patients receiving dexamethasone experienced significantly less pain, nausea and vomiting than control group throughout 24 hrs. Lesser patients required rescue analgesics (23.33% vs. 46.67%) in first 6 hrs. So, it is found that, single intravenous dose of dexamethasone (0.15mg/kg) provided significant analgesia, reduced nausea, vomiting and improved quality of oral intake in paediatric patients who underwent tonsillectomy.   Journal of BSA, Vol. 20, No. 1, January 2007 p.13-17
Nutritional Support To Critically Ill Patients - A Comparative Study Between Branded and Homemade Preparations
Authors: Lateef Kazi Ashkar , Maruf Abdullah Al , Chowdhury Iqbal Hossain , Reza Sayeed Mahmud Ali , Rahman AKM Shafiqur
Published: December 2016

We have evaluated the effectiveness of nutritional support to critically ill patients undergoing treatment in ICU. We provided commercially prepared branded food in one group and compared this, with those of homemade preparations. Fifty adult critically ill patients getting treatment in ICU aged between 20 to 60 years having no diabetes, hypertension, ischaemic heart disease and chronic renal failure, were scheduled for providing enterai nutritional support. They were randomly allocated into two groups. Group A (n=25) received commercially prepared branded food containing balanced food consisting of protein, fat, and carbohydrate in calculated proportion. The aim was to provide 2500 Kcal of energy per day for an average adult in his/her critical state. Group B (n=25) received homemade food preparations in proper proportion of those of group A and of equal calories. The purpose of the study was to assess, formulate and compare the efficacy, tolerability and cost effectiveness of homemade prepared food with commercially formulated branded food in maintaining nutritional status of critically ill patient in ICU. Patient's nutritional assessment was done before the commencement of nutritional support, Nutritional assessment was repeated weekly for successive two weeks. Group A showed better result than Group B, significant improvement has been observed also in group B and the differences between two groups are statistically not significant Both the methods of nutritional support were adequate and effective in maintaining the nutritional status. Considering the poor socioeconomic environment in an under developed country like Bangladesh, a less costly homemade preparation can be an effective alternative over the branded food.   Journal of BSA, Vol. 20, No. 1, January 2007 p.18-23
Comparison of Pre-emptive Use of Diclofenac, Ketorolac and Tramadol for Post-operative Pain in Laparoscopic Cholecystectomy
Authors: Khan Md Rafiqul Hasan , Islam Md Zohirul , Hossain Md Sazzad , Aziz Lutful , Choudhury SN Samad
Published: December 2016

Under treatment of postoperative pain has been the topic of several recent editorials. The prevention, recognition, and management of postoperative pain in adults, as well as in children, have been receiving a great deal of interest. The poor outcome obtained with current regimens is primarily due to the inadequacies of drug administration techniques rather than the qualities of opioids themselves. In this prospective study comparison of preemptive use of diclofenac, ketorolac and tramadol was done for postoperative pain in laparoscopic cholecystectomy. 60 patients were divided into three groups. Group A received injection Diclofenac (3mg/kg) 75mg maximum at a time. Group B received injection Ketorolac (30 mg). And group C patients received injection Tramadol (100 mg). All drugs were given intravenous half an hour before induction. Analgesic efficacy was measured in VAS scale. In addition pulse, systolic blood pressure, diastolic blood pressure, mean blood pressure, total pethidine requirement and time of first pethidine requirement were recorded Patients received an increment of 10-20 mg of pethidine when pain score was 3-4. In this study, total pethidine consumption in group A is 56.5±5.14, in group B is 46.75±4.65 and in group C is 49±5.42. It shows that group B and group C have same analgesic effectiveness and which is better than group A. On the basis of present prospective clinical study postoperative pain can be managed by preemptive use of diclofenac, ketorolac and tramadol. The analgesic efficacy of ketorolac and tramadol is same and better than diclofenac. Key Words: Pre-emptive analgesia, Laparoscopic cholecystectomy. Journal of BSA, Vol. 20, No. 1, January 2007 p.24-29
Anaesthesia: Dimension, Importance and Status
Authors: Islam Md Aminul
Published: December 2016

Journal of BSA, Vol. 20, No. 2, July 2007
Study on Efficacy of Nalbuphine Hydrochloride as Pre-Emptive Analgesic  Comparison With Diclofenac Sodium after Open Cholecystectomy
Authors: Islam Md Quamrul , Begum Hasina , Akhtaruzzaman AKM , Khatun UH Shahera
Published: December 2016

Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The aim of this study was to evaluate the effects of preemptively used nalbuphine and diclofenac on postoperative pain and opioid consumption. Seventy five patients scheduled for open cholecystectomy were investigated by randomized study. Patients were divided into three groups. In group I, patients received Inj. Nalbuphine Hydrochloride (0.3 mg/kg bw IV) before induction. In group II, patients received Inj. Diclofenac Sodium (1 mg/kg bw IV) before induction and in group III patients received placebo before induction. General Anesthesia was given in all groups with Inj. Thiopental sodium 5mg/kg and Inj. Succninylcholine 1.5mg/kg to facilitate endotracheal intubation. Anesthesia was maintained with halothane 0.5% and nitrous oxide 66% in oxygen. Muscle relaxation was maintained by Inj.Vecuronium 0.1 mg/kg. Intraoperative proper hydration was maintained by lactate ringer's solution.In post operative period patients in all three groups received Inj. Pethidine 10mg IV till the patients got relieved from pain. The minimum interval of giving pethidine was 10 minutes. Through our study we have found that, pethidine consumption in 24 hours in group-I (Nalbuphine group) was 54.00±1.0, in group-II (Diclofenac group) was 74.00±1.0 and in group-III (Placebo group) was 112.0±2.0 and p-value <0.001, which is highly significant (measured in mg). Time of first pethidine demand in group-I was 45.83±10.93, in group-II was 34.20±5.44and in group-III was 16.21±3.62 and p-value<0.001 which is also highly significant (measured in minute). Overall patients satisfaction was high in nalbuphine group. Under the condition of present study, we can conclude that preemptively used nalbuphine hydrochloride decreases post operative pain and opioid demand. Journal of BSA, Vol. 20, No. 2, July 2007 p.39-44
Sedation for ERCP - Comparison Between Ketamine Diazepam Combination with Propofol Fntanyl Combination
Authors: Chowdhury Iqbal Hossain , Maruf Abdullah Al , Lateef Kazi Ashkar , Reza Sayeed Mahmud Ali , Hye M Abdul
Published: December 2016

For Endoscopic Retrograde Cholangio-pancreatography, an anaesthesiologist usually administers sedation to patient and search for more suitable regimen continues. This prospective randomized study was carried out to compare the efficacy, safety, tolerability and cost effectiveness of ketamine, diazepam combination to propofol, fentanyl combination for sedation during ERCP. One hundred and fifty patients of both sex, age between 18 to 70 years, ASA physical status I and II scheduled to undergo ERCP were included in this study. Patients were randomly allocated into two groups. Group A (n=75) sedated with ketamine 1.5mg/Kg body weight and diazepam 5-10 mg intravenously. Group B (n=75) sedated with propofol 1mg/Kg body weight and fentanyl 1μg/Kg body weight intravenously and intravenous infusion of propofol maintained at 50μg/Kg body weight/min throughout procedure. Both groups showed satisfactory sedating condition for ERCP. Incidences of hypertension and tachycardia were more in group A than group B and differences between two groups were statistically significant (P< 0.01). Agitation and nightmares were found in 10 (13.33%) patients in group A. Mean recovery time was more in group A than group B and difference between two groups was statistically highly significant (P<0.001). Sedation regimen of group B found 7 times more costly than group A. Both regimens found safe, effective, and tolerable for ERCP. However, recovery time is more with ketamine, diazepam but it found more cost effective than propofol fentanyl that is a concern in developing country like Bangladesh. Key Words: Endoscopic Retrograde Cholangiopancreatography (ERCP), Sedation, Ketamine, Diazepam, Propofol, Fentanyl, Intravenous.   Journal of BSA, Vol. 20, No. 2, July 2007 p.45-50