bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of Early Oral Feeding after Primary Repair of Traumatic Intestinal Injury: Prospective Observation in a Tertiary Hospital in Bangladesh
Authors: Khan Sifat Zereen , Tabassum Tanzin , Hossain AZM Mostaque
Published: October 2022

Introduction: A period of starvation is common practice after intestinal anastomosis. Starved patient became malnourished and underwent catabolic state, impairing the host immune response and thus increasing the risk of postoperative infections thereby long hospital stay.
Objective: To observe the outcome of early oral feeding in patients having primary repair of traumatic intestinal injury and to assess its beneficial effect.
Methods: This prospective observational study was conducted on 80 patients who underwent urgent intestinal resection with or without covering stoma in the Department of Casualty Surgery at Dhaka Medical College Hospital.
Results: Early oral feeding is safe in the recently performed anastomosis even in emergency situations as there were no cases of clinical anastomotic dehiscence and no increase in morbidity. Among 80 patients 58(72.5%) patients had no complaints; rest 22(27.5%) patients had complication. Wound infection seen in 14(17.5%) patients among them 8(10%) patients had burst abdomen and 1(1.25%) patient had intraabdominal abscess. 14(17.5%) patients had chest infection. 10(12.5%) patients complained nausea and among them 8(10%) patients suffered from few episodes of vomiting. 1(1.25%) patient had diarrhoea. Abdominal distension was seen in 9(11.25%) patients. Hospital stay was significantly shorter in with a mean length of stay (9 ± 1) days. No hospital readmission rate was recorded.
Conclusion: Early postoperative feeding is timely, safe and tolerable after emergency intestinal resection anastomosis without raised morbidity and mortality and has a considerable reduction in hospital stay with its physical, psychological and fiscal benefits.
JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 75-79
Perception and Preventive Behaviour about COVID-19 Pandemic among the Members of a Selected Cantonment in Bangladesh
Authors: Irfan SM Nurul , Mithun Sangita , Abbas Md Golam
Published: October 2022

Introduction: Appropriate knowledge, attitude and practice against any infectious disease improve perception and consequently adopt preventive practices toward disease transmission. Good perception and preventive practice is the key to prevent infectious disease like COVID-19.
Objective: To assess the perception and protective behaviour against COVID-19 among the members of Shaheed Salahuddin Cantonment, Ghatail.
Materials and Methods: This cross-sectional study was conducted at Shaheed Salahuddin Cantonment from March 2022 to May 2022 among conveniently selected 1315 respondents. Data were collected through face-to-face interview using a pretested semi-structured questionnaire.
Results: The majority (79.8%) of the respondents were male, residing in the sainik line (72.3%) having monthly income of <15000 taka. Three-fourth of the respondents were lance corporal/sainik, 30.8% were currently married having secondary school certificate level of educational qualification. Study revealed that more than two-third (62.5%) respondents had moderate perception about COVID-19 and about 87.3% respondents showed good preventive behaviour. Preventive behaviour is significantly associated with male gender (χ2=2.49; p < .05), lower age group (<20 years) respondents (χ2=9.93, p < .05) who were qualified in secondary school certificate education (χ2=8.54, p<.05), married (χ2=4.97, p < .05), stayed in sainik line (χ2=9.19, p<.05) and in lance corporal/sainik respondents (χ2=13.12, df =4, p =.01)
Conclusion: Extensive health education program should be undertaken to create good perception and preventive behaviour among susceptible respondents like female gender, aged, unmarried respondents of Shaheed Salahuddin Cantonment.
JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 80-85
Dissection of Tubercular Neck Node for Diagnosis as well as Therapy- A Study of 150 Cases in CMH Dhaka
Authors: Azad Muhammad Ali , Mamun Abdullah Al , Uddin Md Kabir , Hossain Mohammad Delwar , Nur Laila
Published: October 2022

Introduction: Tubercular lymphadenitis nowadays is the commonest extra pulmonary manifestation of tuberculosis in Bangladesh. Sometimes it causes diagnostic and therapeutic challenge for the clinicians. Occasionally Clinical, laboratory findings and fine needle aspiration cytology (FNAC) is not optimum that creates diagnostic and therapeutic dilemma. FNAC is often inconclusive. Sometimes therapy failed cases and atypical tuberculosis require open biopsy and neck dissection.
Objective: To see the effectiveness of lymph node dissection & biopsy for diagnostic purpose and efficacy of the operation in suspected Multi-drug resistant tuberculosis (MDR-TB) for treatment failure due to any reason.
Material and Methods: This cross sectional observational study was conducted during the time period of 01st Jan 2014 to 1st Jan 2020 in ENT & Head-Neck Surgery & Pulmonology department, Combined Military Hospital Dhaka on 150 patients who have undergone surgical neck dissection.
Results: In this study total number of patients were 216. FNAC was done for all of them and found nonspecific lymphadenitis for 41 cases, lymphoma for 12 cases, sarcoidosis for 08 cases and kikuchi disease for 05 cases. 150 patients were found inconconclusive in FNAC. Inclusion criteria are followings, 1. FNAC is inconclusive & negative 2. Surgery was not done before. Among 150 patients different types of surgery was done like enblock resection, selective neck dissection and modified neck dissection. Histopathologically 06 cases found nonspecific lymphadenitis, 03 cases found lymphoma and 01 case found sarcoid granuloma. 150 cases were found histopathologically tubercular lymphadenitis. They show positive findings in biopsy, caseation necrosis- (100%), C/S +, among the Gene Xpert tests- Gene X-pert (Rif sensitive 83.33%, Rif resistant 16.66%). After completion of anti-tubercular therapy (ATT) (CAT-I HRZE) for total 150 patients, 125 patients were cured and 25 patients were not cured (treatment failure). Out of 25 patients 10 developed multiple cold abscess, 08 developed discharging sinus and 07 had relapse during follow up. 2nd Surgical interventions were done in total 25 patients, 10 TB abscess during ATT (CAT-1 HRZE), 8 discharging sinus and 7 relapse patients along with ATT (CAT-2 SHRZE) and all these patients had no relapse or treatment failure during further follow up.
Conclusion: Tuberculous lymphadenitis is best treated with antitubercular medication and in addition surgical neck dissection is more useful in selected cases. So role of surgery is most useful for diagnostic accuracy as well as adjunct to the treatment avoiding prolongation of ATT and noxious side effects of drugs and also to prevent the formation of abscess and sinus.
JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 86-89
New Smokers and Quitters Transitions in Smoking Status in a National Population
Authors: Kamal Pasha AKM Mustafa
Published: October 2022

Background: Few studies have examined individual transitions in smoking status in national populations.
Methods: A representative sample of 21,970 men and women aged 15-64 were questioned regarding current smoking status and smoking status of 12 months ago.
Results: 1.6% of respondents had started to smoke and 1.6% had quit smoking. Becoming a smoker was significantly associated with younger age and lower social economic status (SES). Among women, many new smokers were between the age of 30 and 34, presumably due to relapse after pregnancy. High SES smokers quit at a younger age than lower SES groups.
Conclusion: To reduce smoking prevalence in the Netherlands, more attention should be given to women aged 30-34 years and to people from the lower SES groups, especially those under the age of 45.
JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 90-93
Acute Intermittent Porphyria – A Rare Case with Neurovisceral Symptoms
Authors: Razzak Md Abdur , Amin Ikramul , Uddin Md Salim , Rahman Quazi Audry Arafat
Published: October 2022

Acute intermittent porphyria (AIP) is an autosomal dominant disorder resulting from partial deficiency of the porphobilinogen deaminase affecting the production of heme. It produces acute neurovisceral symptoms. The diagnosis of AIP is difficult. Symptoms are often nonspecific.As the penetrance is low in AIP, positive family history of disease may be absent. So high index of suspicion is required to diagnose AIP. Combination of neurologic and visceral symptoms gives clue to the diagnosis. In December 2018, we have diagnosed a case of Acute intermittent porphyria who presented with acute abdomen, hypertension, tachycardia and convulsion. His urine colour turned to purple red on exposure to sunlight. He had hyponatremia. MRI of brain revealed features of Posterior Reversible Encephalopathy Syndrome (PRES) and EEG was suggestive of focalseizure. Urine porphoblinigen was positive. He was treated with IV glucose, DNS, high carbohydrate diet, newer antiepileptic drug, opioid analgesic, antihypertensive medication and other supportive and symptomatic measures. Ultimately his condition improved gradually and discharged with advice to continue medicine and periodic follow up.
JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 94-96
Down Syndrome and Van Wyk-Grumbach Syndrome: A Rare Presentation
Authors: Jesmin Eva , Mohsin Fauzia
Published: October 2022

Van Wyk-Grumbach Syndrome (VWGS) is presented by juvenile hypothyroidism, delayed bone age and isosexual precocious puberty. All of the features will be reversed with treatment of the underlying thyroid hormone deficiency. It has been described, a 3- year-old girl with Down Syndrome who presented with per vaginal bleeding. Physical examination showed typical morphologic features of Down Syndrome and hypothyroidism. Pubertal developments in tanner stages were: breast at stage II and pubic hair at stage I. Serum TSH level was very high. Serum FSH, LH and Estrogen level were also high for her age. On radiological examination her bone age was 2 years. Her pelvic sonogram revealed enlarged uterus with ovarian cysts. These findings confirmed the diagnosis of VWGS. Treatment with Levothyroxine, her vaginal bleeding did not recur and ovarian cyst size decreased after 4 weeks and disappeared after 2 months. In conclusion, thyroid hypo-function must be investigated in children who have precocious puberty with multicystic enlarged ovaries.
JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 97-99
Cytopenia in T Cell Subsets: A Predictor of Severe COVID-19
Authors: Giti Susane , Bhuiyan Mohammed Nuruzzaman , Muntasir Hossen Mohammad Shameem , Rahman Md Moshiur , Afroj Nadia
Published: October 2022

Introduction: The outbreak of Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has posed great threat to human health. T cells play a critical role in antiviral immunity but their numbers and functional state in COVID-19 patients remain largely unclear. The present study was carried out at Armed Forces Institute of Pathology (AFIP), Dhaka to assess the degree of cytopenia of T cell subsets in COVID 19 and its association with severity of the disease. The aim of this study is to assess the degree of reduction of T cell subsets in both non severe and severe COVID 19 patients.
Methods: Total 100 patients having positive result of RTPCR for SARS-CoV-2 and lymphopenia were recruited for this study. Patients were grouped as ICU and non- ICU according to the severity of clinical conditions, consisting of 50 patients in each group. Data of T cell subsets were obtained by flow cytometric analysis of peripheral blood using monoclonal antibodies.
Results: In this study, the absolute value of CD3+ T cells was below the normal range in 47 (94%) ICU patients. Compared to the non-ICU group, the median absolute value of CD3+ T cells was significantly lowered (P=0.019) in the ICU group. The absolute value of CD4+ T cells was also below the normal range in 91patients (91%). All the patients in the ICU group showed low CD4+ T cell counts. Moreover, a significantly lower median absolute value of CD4+ T cells was observed in the ICU group compared to the non-ICU group (P = 0.004). The absolute value of CD8+ T cells was below the normal range in 64 patients (64%). Similar to CD4+ T cells, compared to the non-ICU group, the median absolute value of CD8+ T cells was significantly lower in the ICU group (P = 0.028).
Conclusion: Significant reduction of T cell subsets occurs in severe COVID-19. Flow cytometric analysis of T cell subsets in COVID 19 patients with absolute lymphopenia can guide the physician to predict the severe outcome of the disease.
J Bangladesh Coll Phys Surg 2022; 40: 217-222
Fibro Sarcoma of the Gingiva: A Rare Presentation
Authors: Mamun Md Talal , Rob Chowdhury Foyzur
Published: October 2022

Fibrosarcoma is a rare malignant mesenchymal neoplasm’s of the fibroblasts which are represents 1% of all malignancies in the head and neck region. In this article we described a case of primary fibrosarcoma of the gingiva in right sided alvulas of the mandible in 16 years old male. Who was presented with a rapidly growing painful lump. Microscopically the tumor mass was composed with atypical proliferation of spindle cells arranged in intersecting fascicles and sterioform pattern. In immunohistochemically the cells showed immuno-reactivity for SAM, while negativity towards the others markers. On the basis of clinical histological and immunohistochemistry our case was diagnosed as a low grade primary fibrosarcoma of gingiva. We performed radical resection with wide margin as a primary treatment of choice without neck dissection. After primary treatment there is no signs of recurrence and metastasis was observed last 3 years follow up.
J Bangladesh Coll Phys Surg 2022; 40: 310-313
Assessment of Quality of Sexual Life in Male Patients with Psoriasis
Authors: Uddin Md Rokon
Published: October 2022

Abstract not available
J Bangladesh Coll Phys Surg 2022; 40: 216
Quantification of T Cell Subsets in Bangladeshi COVID-19 Patients Creating Prospects towards Broader Research and Improved Patient Care
Authors: Ahmed Firoz , Sultana Samina
Published: October 2022

Abstract not available
J Bangladesh Coll Phys Surg 2022; 40: 213-215
Vitamin D Deficiency in Infertile Males with Oligospermia: A Cross-sectional Comparative Study
Authors: Islam Farzana , Ishrat Shakeela , Fatima Parveen , Dey Shaabati , Ara Rowshan , Nandi Eva Rani
Published: October 2022

Introduction: The male factor responsible for infertility includes oligospermia. According to WHO criteria, oligospermia is sperm concentration less than 15 million per millilitre of semen. Vitamin D is a steroid hormone synthesized in the skin and derived from the diet. A serum level less than 20 ng/dl is regarded as vitamin D deficiency. The deficiency of vitamin D has been linked to many reproductive disorders. This study was designed to analyze the association between serum vitamin D level and oligospermia.
Methods: A cross-sectional comparative study was conducted in the Department of Reproductive Endocrinology and infertility of Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of July 2018 to June 2019. There are 157 infertile males with oligospermia in one group and 157 infertile males with normozoospermia in another group. A base line semen analysis for evaluation of male infertility was done, and serum vitamin D level was estimated.
Results: The mean vitamin D level is 16.75+5.75 ng/ml in males with oligospermia and 19.83+5.33 ng /ml in males with normozoospermia. By the threshold defined, all the infertile males are deficient in vitamin D. The difference between the circulating levels of vitamin D in the two groups is statistically significant (p<0.05). VitaminD deficiency is 4.25 times more in infertile males with oligospermia than in males with normozoospermia.
Conclusion: Vitamin D deficiency is associated with oligospermia in infertile males.
J Bangladesh Coll Phys Surg 2022; 40: 253-256
Altemeier’s Procedure, an Easy Solution for Rectal Prolapse
Authors: Khalil Mohammad Ibrahim , Alam ABM Khurshid , Jahan Sharker Kamrun , Saleh Abu Zaffor
Published: October 2022

Introduction: Rectal prolapse is an embarrassing clinical condition. Most of the time patients get emergency hospital admission. Full thickness rectal prolapse demands surgical treatment. Many surgical procedures and techniques were described but none is adopted as standard. It is challenging to choose appropriate surgical procedure in the emergency situations as many patients come after trial of reduction and maltreatment. We have treated 64 patients of full thickness rectal prolapse by Altemeier’s procedure in emergency admissions. This study was designed to observe the outcomes of Altemeier’s procedure (perineal proctosigmoidectomy) in full thickness rectal prolapse as emergency surgery.
Methods: This prospective study was done in Dhaka Medical College Hospital and Cumilla Medical College Hospital over the period of January 2013 to July 2018. Total 64 patients were included in this study. Alteimer’s procedure was done in all patients. Patients were followed up on 2 weeks, 1 month, 3months, 6 months and 1 year. Patients were evaluated by complain of pain, per rectal bleeding, mucous discharge, bowel movement and incontinence. Postoperative data was collected and evaluated.
Results: Reduction was achieved in all patients and they were satisfied about their prolapse correction. Two patients needed blood transfusion and laparotomy. Anastomotic disruption and bleeding from the mesenteric vessels were found on laparotomy. All patients had improved evacuation as assessed by history of satisfactory evacuation. No recurrence was reported during the follow up period. Gas and liquid incontinence were noted in 3 patients who improved with sphincter exercise within 3 months.
Conclusion: In our series, we found Altemeier’s procedure is safe, effective for complete rectal prolapse specially in emergency situation and can be done under regional anesthesia.
J Bangladesh Coll Phys Surg 2022; 40: 229-232
Upper Limb Amputations Following Electric Burn: Experience Sharing from Tertiary Hospitals in Bangladesh
Authors: Begum Nurunnahar , Ahmed Tanveer , Moni Zahangir Alom , Kalam Md Abul
Published: October 2022

Introduction: High voltage electrical burn is one of the most devastating burn injuries involving upper limbs in Bangladesh. It causes serious disfigurement and may lead to loss of the whole upper limb. The aim of this study was to see the severity of electric burn injury involving upper limbs pausing amputations at different levels in two tertiary level referral hospitals of Bangladesh.
Methods: A prospective observational study was designed to collect the data from Burn and Plastic Surgery Unit, Dhaka Medical College Hospital and Sheikh Hasina National Institute of Burn and Plastic Surgery from January 2019 to December 2019. One hundred and sixty-nine (169) patients with high voltage electrical burn injury involving upper limb underwent amputation were analyzed according to the severity based on clinical assessment.
Results: Male predominance (89%) was observed where right upper limb was involved in 49% of the cases and in 11% cases amputation was bilateral. The most alarming finding was 57.4% patients were below the age of 21 years. Below elbow amputation was done in 48.5% cases followed by above elbow amputations in 32.54% cases.
Conclusion: Male sex and younger age are the two most common association with electric burn and subsequent limb amputation. The incidence in higher in upper limbs. This study will help us to create the awareness and for prevention of electric burn.
J Bangladesh Coll Phys Surg 2022; 40: 279-286
Outcome of Venous Supercharged Pedicled Anterolateral Thigh Flap for Reconstruction of Soft Tissue Defect around the Knee Joint
Authors: Arju Khondokar Shohana , Dash Pradip Chandra , Ahmed Tanveer , Reza Humayun Kabir , Biswas Gobinda , Khan Md Noazesh
Published: October 2022

Introduction: Soft tissue defects around the knee are common following motor vehicle accidents, burns especially electric burn, excision of malignancy etc. Reconstruction of soft tissue defect around the knee needs thin, pliable and tough skin. Recently distally based pedicled anterolateral thigh flap has been used for soft tissue reconstruction for its several advantages like long pedicle, sufficient amount of soft tissue and less donor site morbidity. But it has tendency towards venous congestion and this can be overcome with venous supercharging. This study was designed to evaluate the effectiveness of venous supercharging in reducing venous congestion in pedicled anterolateral thigh flap for reconstruction of soft tissue defect around the knee joint.
Methods: This prospective observational study was carried out at Department of Plastic Surgery and Burn Unit, Dhaka Medical College Hospital and Sheikh Hasina National Institute of Burn and Plastic Surgery (SHNIBPS), Dhaka from August 2017 to June 2019. Twenty (20) patients who presented with defect around the knee were included in this study according to inclusion and exclusion criteria.
Results: Maximum patients 5(25%)were day labour and wounds were created by MVA in most of the cases10(50%).Most common site was anterior aspect of knee joint 8(40%).The dimension of the wound size ranged from 5×3cm upto 7×14cm. Majority of the wounds ranged from 15×13cm to 17×14cm. The flap size ranged from 6×3.5cm upto 20×18cm. 18 (90%) flaps had no venous congestion, but 2(10%) cases had it. All flaps (20) survived well, 18 cases had acceptable scar and in 2 cases infection occurred. Regarding functional outcome of knee joints, 15 (75%) patients had full range of motion and 5(25%) patients had 5p -10p restriction in flexion of knee joints. Final outcome was found excellent in 16(80%) and satisfactory in 4(20%) cases.
Conclusion: Venous supercharging in pedicled anterolateral thigh flap for soft tissue defect around the knee joint have shown to be effective in reducing venous congestion.
J Bangladesh Coll Phys Surg 2022; 40: 233-239
Electromyographic Patterns in Children presented as Floppy Baby: Experience in a Neurophysiology Laboratory of a Tertiary care hospital in Bangladesh
Authors: Debnath Bithi , Hussain Md Enayet , Saha Narayan Chandra , Nayeem Abu , Chowdhury Rajib Nayan
Published: October 2022

Introduction: Electromyography (EMG) is an invaluable diagnostic tool to reach a diagnosis in patients with hypotonia. The objective of this study was to observe the EMG patterns in children presented as floppy baby.
Methods: It was a cross-sectional study conducted in the neurophysiology department of the National Institute of Neurosciences and hospital over 4 years. Floppy children, aged 1 month to 5 years, referred to the laboratory for EMG were enrolled in the study. Hypotonia due to acute flaccid paralysis or children having drugs that could cause decreased muscle tone were excluded from the study. Thereafter, children were categorized into groups of central, peripheral, and uncategorized/mixed hypotonia. EMG was done in all patients and an electro-diagnostic impression was made.
Results: Out of 72 patients, 54.17% were male and 45.83% were female. Their average age of performing EMG was 26.81±18.12 months. Clinically it was observed that central and peripheral hypotonia were present in 18.05% and 70.83% of cases respectively and in 11.11% of cases, hypotonia could not be differentiated. EMG revealed Spinal muscular atrophy (SMA) in 38.89% of cases, followed by myopathy (26.39%), peripheral neuropathy (9.72%), and neuromuscular disorder (2.78%). In 19.44% of cases, EMG findings remained normal.
Conclusion: Hypotonia of peripheral origin was the most common EMG finding in floppy children. SMA is the commonest electro-diagnostic impression followed by myopathy.
J Bangladesh Coll Phys Surg 2022; 40: 240-245
Assessment of Quality of Sexual Life in Male Patients with Psoriasis
Authors: Aslam Azmiree Binte , Khan Rashed Mohammad , Abdullah Md Shayekh , Khan Md Alauddin
Published: October 2022

Introduction: Psoriasis is a global burden of disease characterized by the presence of well circumscribed erythematous papule & plaque of various size & shape, covered by silvery scales. It not only hampers the quality of life but also hampers the sexual function. Men who have psoriasis may be more likely to have sexual problems, such as sexual apathy, orgasmic dysfunction, erectile dysfunction (ED), etc. Stress tends to be a triggering or aggravating factor in psoriasis. In addition, the disease itself can generate emotional stress because of its lesions. It is thought that chronic inflammation.
Results in metabolic diseases and proinflammatory cytokines give rise to the development of atherogenesis. Pelvic arterial atherosclerosis is another cause of sexual dysfunction. This study was designed to determine the impact of moderate to severe psoriasis on quality of life and sexual dysfunction in male patients.
Methods: This case control study was conducted in Department of Dermatology and Venereology, Dhaka Medical College Hospital, among the 100 patients. Group- A was cases (male married patients age between 24 years and 60 years with history of moderate to severe psoriasis) and group-B were control (male married patients age between 24 years and 60 years without psoriasis). Then variables were analyzed and compared. Data was processed and analyzed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Comparison was done by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc.
Results: It was found that majority of the patients i.e. 46% were between 34-43 years, mean age was found to 41.7±11.3 years. No significant difference in age and other demographic profile was observed between groups. Prevalence of IHD (8.0%), stroke (14.0%), dyslipidaemia (54.0%), neuropathy (26.0%) and PVD (8.0%) were higher in case or psoriatic patients. On evaluation of Dermatology Life Quality Index (DLQI), majority of patients (54%) score was 6-10, followed by 24.0% had score 2-5 and 22.0% of patients had score 11-20 or very large effect on patient’s life. Prevalence of erectile dysfunction was 36.0%, prevalence of orgasmic dysfunction was 24.0%. On multivariate analysis which was done by ordinal logistic regression procedure. The attributes found to be positively associated with sexual dysfunction severity in the multivariate model were patient’s age, disable status, sedentary work, duration of illness, etc.
Conclusion: Erectile dysfunction and orgasmic dysfunction are common in psoriatic male patients. There is association with other comorbidities.
J Bangladesh Coll Phys Surg 2022; 40: 233-228
Distribution of ABO Blood Group System, Presentations, Comorbidities, Disease Severity and Outcome of COVID- 19 Patients in Jashore, Bangladesh
Authors: Acherjya Goutam Kumar , Ali Mohammad , Tarafder Keya , Paul Shuprio , Mou Sharmin Sultana , Kar Subrata Prokash , Dutta Debasish , Sarker Marufa , Sultana Afroza , Roy Gobinda Chandra , Kabir Ahmedul
Published: October 2022

Introduction: The whole world has been crippled by COVID- 19 for a long period of time and a lot of its issues still remain unknown. The study was designed to assess the distribution of ABO blood group system, presentation, comorbidities, disease severity and outcome of COVID-19 patients in Jashore, Bangladesh.
Methods: This retrospective type of observational study recruited 928 RT-PCR positive COVID-19 patients above 18 years living in the district of Jashore, Bangladesh.
Results: Mean age of the study population was 41.55±13.59 years including a significant age difference (p: <0.001) in disease severity and insignificant gender difference were observed (p: 0.291). Fever was frequently presenting symptoms (83.1%) in our study associated with cough 47.1%, fatigue 39.2%, myalgia 38.0%, distaste 35.3%, anosmia or hyposmia 33.3%. Diabetes (p: <0.001), hypertension (p: <0.001), chronic respiratory illness (p: <0.001), coronary artery diseases (p: 0.003) and malignancy (p: 0.003) played as potential risk factors for developing COVID-19 severity. Out of the total study patients, 36.9%, 29.1%, 22.5 and 11.5% COVID- 19 patients came from blood B, O, A an AB respectively. On the other hand 95.5% COVID-19 patients were Rhesus positive. However, we did not found any significant association between disease severity and different ABO and Rh blood group (p: 0.379 and p: 0.092 respectively). A 97.6% of our patients had significantly (p: <0.001) been recovered from COVID-19 where most of the patients (81.1%) were managed at home. Though, 2% and 1.9% of our patients developed severe pneumonia and critically ill COVID-19, we had noticed significantly low mortality rate (1.4%, p: <0.001) in this current study.
Conclusion: In this recent study, blood group B constituted the highest number of the COVID-19 patients. Fever, cough and fatigue were the most common presenting feature of COVID-19 patients. Preexistent diabetes, hypertension, chronic respiratory diseases, coronary artery diseases and malignancy played as significant potential risk factors of diease severity of COVID-19. A majority of the patients were significantly managed at home. A minimum portion of the COVID-19 patients developed severe pneumonia and critical illness; and a significant low case fatality occurred in our study.
J Bangladesh Coll Phys Surg 2022; 40: 246-252
Risk factors of late-onset Neonatal Sepsis in Special Care Neonatal Unit of a Tertiary Care Hospital in Bangladesh
Authors: Parvin Ruma , Afroze Sharmin , Ferdoucy Sultana Amena , Rahman Khadija , Bashar AHM Khairul , Sultana Razia
Published: October 2022

Introduction: Late-onset neonatal sepsis is one of the most common causes of neonatal deaths in hospital as well as community in developing country like Bangladesh. It can present asmeningitis, pneumonia, pyelonephritis, or gastroenteritis. Various risk factors play important role in its causation. In this study our main goal was to evaluate the risk factors of late onset neonatal sepsis in SCANU (Special Care Newborn Unit) of a tertiary care hospital.
Methods: This cross-sectional study was done in the SCANU of Dr. M.R. Khan Shishu Hospital and Institute of Child Health, Mirpur-2, Dhaka for 6 months. A total of 59 neonates with late onset sepsis in SCANU were included during the study period.
Results: The socio-demographic status of the neonates with late onset sepsis shows that, most of the neonates (44.1%) were between 24 to 28 days. Also, 54.24% patients were male and 57.6% patients belong to middle economic status group. In the study, 79.7% had Cough with respiratory distress followed by 23.7% had cough only, 6.8% had fever, 52.5% had vomiting, abdominal distension, and 8.5% patients had Jaundice. Only 1.7% patients used bottles for feeding. Among neonates, the highest (49.15%) came with the risk factor of poor hygiene. The Majority (95%) of low-birthweight neonates had patchy opacity resembling pneumonia in chest x-ray.
Conclusion: Poor hygiene is a high-risk factor for neonates with late onset sepsis. Bottle feeding had comparatively higher risk in developing late onset sepsis than formula feeding with spoon. Poor cord care is another risk factor.
J Bangladesh Coll Phys Surg 2022; 40: 257-262
Impact of SARS-CoV-2 Infection during Pregnancy and Perinatal Outcome: Findings from Private Hospitals at Dhaka, Bangladesh
Authors: Moni Sadeka Choudhury , Saha Joysree , Ahmed Qumrun Nassa , Jahan Ismat , Jahan Mosammad Alpana , Sheela Farhana Afroze , Mannan MA , Shahidullah Mohammod
Published: October 2022

Introduction: The pandemic novel corona virus (SARS-CoV- 2) infects pregnant women and affects pregnancy outcome. The perinatal outcome of COVID positive pregnancies attended at private hospitals during the last epidemic peak at Dhaka is unknown. The purpose of the study was to evaluate perinatal outcome among COVID positive and COVID negative pregnant women who delivered in the 2 study hospitals at Dhaka during the last epidemic wave.
Methods: This retrospective study was conducted in 2 eminent private medical college& hospitals in Dhaka,namely Popular medical college &hospital (PMCH) and Greenlife medical college hospital (GLMC) over a period of 3 months from July 2021 to September 2021. COVID positive and COVID negative pregnant women who delivered in the study hospitals during the study period were included in this study. Outcome variables were COVID related maternal morbidity mortality, rate of caesarean delivery, stillbirth, preterm birth, low birth weight, neonatal COVID-19 positivity, neonatal death.
Results: This study included 60 COVID positive and 60 COVID negative pregnant cases. COVID positive pregnant women delivered at earlier gestational age (weeks) than COVID negative cases(34.46±3.58 vs 36.50±3.20; p=0.001) Among COVID infected pregnancies,severe disease was observed in 15%; O2 support was needed in 68.3% and ICU admission required in 16.7% cases.The caesarean delivery rate ((93.3% vs 80%; p-.032) and preterm delivery rate (63.3% vs 35%; p-.002) were significantly higher among COVID positive cases. About 8.3% COVID affected pregnancies ended up with stillbirth.Maternal death rate due to COVID related complications was 5%.Proportion of low birth weight (LBW) was significantly more in infected pregnancies (65% vs 35%; p 0.001).No newborn from COVID positive mother was tested positive by RT-PCR at 24 hours of age.
Conclusion: SARS-CoV-2 infection during pregnancy cancause moderate to severe disease requiring ICU admission and maternal death in 5% among COVID positive cases .It gives rise to more still birth, preterm birth, increasing number of LUCSand LBW. However maternal to neonatal transmission is not evident at 24-hour RT-PCR testing.
J Bangladesh Coll Phys Surg 2022; 40: 270-278
Fear and anxiety in Dental Practice: A Review
Authors: Sadat SM Anwar , Nishi Nowrin Jahan , Palash Md Jahidul Islam , Rita Sufia Nasrin
Published: October 2022

Fear is expressed as an unpleasant emotion caused by threat of danger, pain and harm. Anxiety is an emotional state of a person such as doubt, mental-conflict, and disappointment. Phobia is persistent, unrealistic and intense fear of a specific stimulus, leading to absolute avoidance of the perceived danger. Corah’s Dental Anxiety Scale (CDAS), Modified Dental Anxiety Scale (MDAS), and Dental Fear Survey (DFS) are the tools to assess fear and anxiety. Dental fear and anxiety can be managed by change in dental set up and office environment, improving communication skill of practitioner and trust building among patients. Other approaches like behaviour-management techniques e.g., technique of relaxation, attention distraction, hypnotherapy, positive reinforcement, systematic desensitization and pharmacological management e.g., general anaesthesia and conscious sedation are also used to prevent and treat dental fear and anxiety in dental practice.
J Bangladesh Coll Phys Surg 2022; 40: 292-298
Rosai-Dorfman Disease: A Case Report
Authors: Halder Amrita Lal , Mollah Md Abid Hossain
Published: October 2022

Rosai-Dorfman disease (RDD) is a type of sinus histiocytosis. It is a rare disease (1:200000), particularly in children and commonly presents with massive, painless and usually bilateral cervical lymphadenopathy along with fever and weight loss. Leukocytosis, elevated erythrocyte sedimentation rate and hypergammaglobulinemia are common. A definitive diagnosis can only be made by histological analysis of affected lymph nodes. Emperipolesis and a typical immunohistochemical pattern characterized by positivity for S-100 protein and CD68 antigen and negativity for CD1a antigen are diagnostic for RDD. Here we report a case of RDD occurring in a 10-month-old child with progressive cervical lymphadenopathy and persistent fever. Histopathological and immunohistochemistry studies of a lymph node biopsy established the diagnosis. A watchful follow-up resulted in the resolution of fever and lymphadenopathy.
J Bangladesh Coll Phys Surg 2022; 40: 299-301
Glomus Tumor of Finger Pulp - A Case Report
Authors: Rahman Md Moklesur , Akhter Nasima , Iqbal Abu Khaled Muhammad , Waheed SM Shameem , Rahman AKM Sharifur , Alam Md Nur
Published: October 2022

Glomus tumors are rare, vascular,benign, painfulneoplasm, originating from glomus bodies and comprise just 1% of tumors arising in the hand, with fewer than 10% in the volar pulp of digits. Hallmark symptoms of glomus tumors include hypersensitivity to cold, heightened pinprick sensitivity and paroxysmal pain. We report this case due to its rarity and it’s potentialto be included among the differential diagnosis if the lesion is painful. We report here a rare case of a 59-years male presenting with08-years history of pain in the palmer surface of distal phalanx of right little finger. The fingertip was incredibly sensitive to touchand the pain increased at night. He could not recollect any history of trauma. Palpation of the finger revealed tenderness with feeling of no lump. Magnetic resonance imaging(MRI) of the right little finger revealed a small altered signal intensity lesion measuring about 8.0x4.0mm at the ventral aspect of distal phalanx ofright little finger. After I/V contrast- moderate enhancement of the lesion is seen. An incision was made in the mid-axial plane. A circumscribed mass removed with careful &blunt dissection. It was a tan-yellow, soft tissue nodule of about 1- cm in diameter without stalk or adherences to joint capsule or bone. Histopathological examination revealed the mass as a glomus tumor. Symptoms improved on removal and the wound healed without complications. Glomus tumors in the volar digital pulp can be difficult to diagnose. Complete surgical excision of the tumor is the only effective treatment to achieve pain relief and low recurrence.We also emphasize the importance of keeping this tumor in mind among the possibilities of differential diagnosis of painful digital nodules.
J Bangladesh Coll Phys Surg 2022; 40: 306-309
Vanishing White Matter Disease- Report of two Cases
Authors: Kundu Gopen Kumar , Islam Rumana , Saba Noor A
Published: October 2022

Vanishing white matter (VWM) disease is a chronic progressive childhood onset leukodystrophy that result in central nervous system demyelination, often precipitated by some stressful events. There is wide phenotypic variation buy typical MRI findings are diagnostic in most of the patients. Here we report two cases of vanishing white matter disease with typical MRI findings.
J Bangladesh Coll Phys Surg 2022; 40: 314-317
An Uncommon Presentation of Opc (Organophosphate Compound) Poisoned Patient With Ventilatory Support
Authors: Begum Mosammat Makshuda , Hossain Md Azmal
Published: October 2022

An 18 years old girl with history of ingestion of unquantified amount of insecticide was admitted in the intensive care unit with unconsciousness, hurried respiration. It was diagnosed as a case of organo-phosphate compound poisoning and treated accordingly. After the crisis over, the patient developed respiratory failure. The patient had no fever, no change in X-ray chest or blood count. It is now recognized as a complication of organo-phosphate compound poisoning named Intermediate Syndrome. Manifestations in this particular case is that only the respiratory muscles were involved and repeated respiratory insufficiency developed which was overcome by positive pressure ventilation.
JCMCTA 2015 ; 26 (1) : 52-54
Geriatric Care: New Dimensions
Authors: Uddin Md Nizam
Published: October 2022

Abstract not available

JCMCTA 2015 ; 26 (1) : 1- 3
A Clinical Study on Rabies
Authors: Akter Farhana , Hoque Mohammad Mahfuzul , Ahmed Ershad Uddin , Faiz Md Abul
Published: October 2022

Rabies is a fatal but easily preventable disease became one of the major public health problems in Bangladesh. This study carried out in Infectious Disease Hospital (IDH) Dhaka, Bangladesh-to see different clinical presentation of rabies, to evaluate the incubation period and the interval between appearance of symptoms and time of death of the patients. All the clinically diagnosed cases of rabies referred to IDH were included in the study. The data was collected from the patient attendant by using a structured questionnaire. Among 101 patients-most of the cases (85.2%) came from rural area and children less than 15 years were major victims (61.4%). Majority of cases (87.1%) of rabies had history of dog bite. Though 50.5% patients received wound treatment, in only 5.9% cases it was adequate. Out of 23.8% patients having history of post-exposure vaccination, 75% of them received Nerve Tissue Vaccine (NTV) and 54% took vaccine in adequate doses and duration. Although 89.1% patient had history of WHO category III bite, none of them received Rabies Immunoglobulin (RIG). Furious rabies was seen in 97% cases. Majority (69.3%) patient develop rabies within 60 days of exposure and most of the rabies cases (68.4%) died within 72 hours. To prevent further human death from rabies and economic loss, educating people about preventive measures, Tissue Culture Vaccine (TCV) and RIG should be immediately introduced at primary health care level of Bangladesh.

JCMCTA 2015 ; 26 (1) : 4-8
Hydrostatic Reduction With Barium Enema Is A Preferred Treatment Option for Uncomplicated Intussusception : Five Years Experience in Cmch
Authors: Bhuiyan Md Akbar Husain , Chowdhury Tanvir Kabir , Chowdhury Tahmina Akhtar , Rahman MA Mushfiqur , Farooq Md Abdullah Al , Sajid Md Minhajuddin , Sarwar Khurshid Alam , Khastagir Rajib , Habib Md Golam , Banu Tahmina
Published: October 2022

Intussusception is a common cause of intestinal obstruction in young children and is a common emergency in infants and children. Hydrostatic reduction of intussusception is a less invasive procedure for both diagnosis and treatment of it. We describe our experience with hydrostatic reduction of intussusception. A retrospective review of the patients of Intussusception admitted in the department of Pediatric Surgery Chittagong Medical College Hospital (CMCH) Chittagong, Bangladesh from January 2009 to December 2013 was done. Patients underwent hydrostatic reduction were evaluated separately. Data were analyzed with regard to success and failure of hydrostatic reduction, necessitating laparotomy, complication and mortality. There were 231 patients of Intussusception. Age range was lmonth to 15 years with median age of 8 months. Male to Female ratio was 2.9:1. Mean duration of presentation was 40 hours after onset of symptoms. Hydrostatic reduction was attempted in 142 patients and was successful in 107 patients, 35 patients needed surgery in whom per-operative manual reduction was done in 28 patients and intestinal resection anastomosis was done in in 7 patients. There were 2 cases of recurrence following hydrostatic reduction and no case of perforation due to hydrostatic reduction. 2 patients died following

JCMCTA 2015 ; 26 (1) : 9-13
Anemia of Chronic Disease in Rhenumatoid Arthritis And Its Realationship With Disease Activities
Authors: Waezi Mohammad Shakeel , Chowdhury MA Jalil , Uddin Mohammed Jashim , Hasan Kazi Mohammad Abrar , Rouf Mohammad Abdur
Published: October 2022

Anemia is a frequent cause of morbidity in patients with Rheumatoid Arthritis (RA) that reduces quality of life. This observational cross sectional study was carried out in Rheumatology OPD and Medicine Indoor of Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2009 to December 2010 to find out the frequency of Anemia of Chronic Disease (ACD) and relative frequency of pure ACD and ACD with coexistent Iron Deficiency Anemia (IDA) in RA and to describe the relationship between ACD and disease activity of RA patients. For this purpose a total of 130 RA patients were enrolled according to the inclusion and exclusion criteria of the study and divided into ACD group and non anemic group on the basis of hemoglobin level (11g/dl in females and <12g/dl in males). ACD group of patients again divided into pure ACD and ACD with co-existent IDA subgroups on the basis of ratio of Soluble Transferrin Receptor (sTfR) to log ferritin (sTfR­F index).Patients with sTfR-F index value<1 were classified as pure ACD and sTfR-F index value >1 were classified as ACD with coexistent IDA. Disease activity were assessed by modified Disease Activity Score (DAS-28), Tender joint count, Swollen joint count, Morning stiffness in minutes, Health Assessment Questionnaire (HAQ) Erythrocyte Sedimentation Rate (ESR) in mm in 1st hour and Rheumatoid Factor (RF) positivity. Out of 130 patients, estimated frequency of ACD was 59%.Among the ACD patients, 16% were found to have pure ACD and 84% had both ACD and IDA. Disease activity parameters were compared between ACD group and non anemic group and then pure ACD and ACD with co­existent IDA subgroups of patients. We found significantly higher mean DAS-28 score ,tender joint count, swollen joint count, HAQ score and mean ESR in ACD group of patients as compared to non anemic RA patients. When differing levels of disease activity indices were compared, we also found significant difference between ACD and non anemic groups. Patients with pure ACD subgroups had significantly higher mean DAS-28, tender joint count, swollen joint count and HAQ score as compared to ACD with co-existent IDA subgroups of patients. When comparing differing levels of disease activity indices, no significant difference was observed between pure ACD and ACD with coexistent IDA patients with RA. This it can be said in conclusion that ACD is frequently encountered with high frequency of iron deficiency anemia among rheumatoid arthritis patents. RA patents with ACD tend to have severe disease than non anemic RA patents but pure ACD patints not necessarily had severe disease as compared to combined ACD and IDA.
JCMCTA 2015 ; 26 (1) : 14-20
Orbital and Ocular Manifestations of Acute Leukemia: Clinical Analysis in a Tertiary Care Hospital
Authors: Islam Ahmed Tanjimul , Rabbani Mohammad Golam , Dey Subrata
Published: October 2022

To determine the prevalence of orbital and ocular manifestations in acute leukemia at the time of presentation, sixty (60) patients diagnosed with acute leukemia were examined for ocular lesions by within two weeks of diagnosis before starting chemotherapy. The detailed ocular examination of both eyes was carried out by the ophthalmologist irrespective of the presence or absence of eye symptoms in all cases. Only 3 out of 60 patients presented with eye symptoms (5%). However, ocular changes were found in 16 patients (26%), 11 with lymphoblastic and 5 with myeloid leukemia. The ocular lesions observed were Intraretinal hemorrhages, decreased Visual acuity, Proptosis, Macular hemorrhage, Cotton wool spots, Papilloedema, Vitrious hemorrhage and Sixth nerve palsy. In view of the high prevalence of asymptomatic ocular lesions in acute leukemia, routine Ophthalmic Examination should be included as a part of evaluation at the time of diagnosis.
JCMCTA 2015 ; 26 (1) : 21-24