bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Human Granulocyte Colony-Stimulating Factor (G-CSF) in Consolidation Chemotherapy in Adult Acute Myeloid Leukaemia (AML)
Authors: Rumi Muhammad Shahidul Islam Sikder , Yunus ABM , Kabir Amin Lutful , Begum Masuda , Irshadullah Naseeb Muhammad , Wasim Mohammed , Chowdhury Md Sazzad Zayed , Hossain Mohammed Murad , Rahman Md Safiur , Islam Khaza Amirul , Hasan Nazmul 
Published: October 2019

Acute myeloid leukaemia (AML) is treatable and potentially curable disease. Significant morbidity is related to the prolonged, severe neutropenia resulting from the disease as well as the intensive chemotherapy. The administration of granulocyte - colony stimulating factor (G-CSF) is recommended to reduce the neutropenic period. But the current information and guidelines are insufficient about the most appropriate time to start G-CSF and the optimum duration of treatment after chemotherapy in consolidation phase. This study explores better timing to start G-CSF after completion of chemotherapy in consolidation phase of AML patient. This prospective study was conducted in the department of Haematology, Bangabandhu Sheikh Mujib Medical University among AML patients, who received consolidation chemotherapy (high dose cytarabine). Samples were grouped into two arms. Arm-A (Absolute Neutrophil Count >1000/cmm) received prophylactic G-CSF and Arm-B (Absolute Neutrophil Count <1000/cmm) received G-CSF during neutropenia. Filgrastim was used as G-CSF and daily 300 micrograms were given subcutaneously according to study protocol. Statistical analysis was done by parametric (t test) test and appropriate using computer based SPSS (21) Program. Total sample was 19, out of which 6 in prophylactic G-CSF group (Arm-A) and 13 in delayed G-CSF group (Arm-B). Most of the patients were male (63.16%), male to female ratio 1.7:1 and mean age of sample 35 years. Mean ANC at the 1st day of G-CSF application in Arm-A 1170.5/cmm & in Arm-B 272.6/cmm (p=<0.001); mean requirements of G-CSF accordingly 11.5 and 5.9 (p=0.0014), mean 1st day of G-CSF application 9.5th day and 14.5th day (p=0.001). Outcomes in Arm-A and Arm-B were accordingly, mean duration of ANC recovery 10 and 9.85 days (p=0.913), febrile neutropenia 2.67 and 2.57 days (p=0.961), hospital stay 20 and 20.3 days (p=0.259), red cell concentrate transfusion 1.83 and 1.46 units (p=0.550), platelets concentrate transfusion 11.83 and 7.77 bags (p=0.2405), and there was no death case in two arms. Differences of timing to start G-CSF and its requirements between two groups were significant, but the outcomes did not show any statistically significant difference.
Bangladesh Med J. 2018 May; 47 (2): 23-28
Aetiological Diagnosis of Pleural Eusion: A cross sectional study
Authors: Hossain Md Billal , Alam Md Rafiqul , Paul Harasit Kumar , Biswas Sunil Kumar , Shahin Md Abu 
Published: October 2019

Pleural effusion is a common clinical problem with different possible causes. It can be due to local, systemic, infectious or non-infectious causes. Aetiological diagnosis is important for proper treatment. To evaluate the aetiological diagnosis of pleural effusion of hospitalized adult patients this cross-sectional, descriptive study conducted from April to September 2012 at Bangabandhu Sheikh Mujib Medical University (BSMMU). A total of 100 cases were selected by purposive sampling. Data were collected using a structured questionnaire. Complete history was taken either from patient or accompanying attendants. Clinical examination was done and relevant investigations report were collected. Data were analyzed using statistical package for the social sciences (SPSS). The mean age of the patient was 41.2 SD± 7.4 years with a male to female ratio of 3:1. Over half (52%) of the patients were poor, 34% were middle class and 14% were rich. Over two-third (67%) of the patients were smoker and the remaining 33% were non smoker. Out of 100 patients with pleural effusion, 52 had tuberculosis and 16 patients had malignancy. Among the malignant cases 14 were found to have bronchial carcinoma and 2, had lymphoma. The remaining 32 patient had other causes of pleural effusion which included nephrotic syndrome 14, congestive cardiac failure 5, cirrhosis of liver 4, rheumatoid arthritis 3, amoebic liver abscess 2, and undiagnosed 4. Tuberculosis is the predominant cause of pleural effusion in our country and the second leading cause is malignancy.
Bangladesh Med J. 2018 May; 47 (2): 29-34
Non-small Cell Carcinoma of Lung in a 19-year-old Male Presented as Malignant Pleural Effusion
Authors: Kabir Ahmed Imran , Sarkar Shish Mohammad , Hasan Md Nazmul , Hossain AKM Mosharraf 
Published: October 2019

Bronchial carcinoma is rare in younger age group. Smoking, environmental and occupational exposure are the major risk factors. Radiological imaging, bronchoscopy, FNAC and biopsy are the main mode of investigations. Surgery, radiotherapy and chemotherapy are the treatment of choice. Here, we report a case of 19-yearrs-old male and diagnosed as a case of non-small cell carcinoma of lung (NSCC). Cytological examination of pleural fluid showed non-small cell carcinoma. This may be indicating the changing trend of developing NSCC in young adults.
Bangladesh Med J. 2018 May; 47 (2): 41-43
Evans Syndrome: A Case Report
Authors: Biswas Sunil Kumar , Biswas Tonmoy , Khondoker Noornabi , Alam Md Rafiqul , Rahim Md Abdur , Paul Harasit Kumar , Shahin Md Abu , Hasan Md Nazmul , Bhuiyan AKM Motiur 
Published: October 2019

Evans syndrome, a combined clinical condition of autoimmune haemolytic anaemia (AHA) and idiopathic thrombocytopaenic purpura (ITP) and has non-specific pathogenesis. The clinical cases are extremely rare, since only 4% of AHA or ITP are incorporated with Evans. It is distinguished from differentials, such as lupus, IgA deficiency, and acquired immunodeficiency, by peripheral blood film, bone marrow, Coombs test, and coagulation profile. A case of adult female from Pabna, Bangladesh is documented in this report. She complained of high grade intermittent fever, exertional dyspnea, icteric skin and sclera. Other features included mild splenomegaly, dark urine, and profuse sweating after fever. Investigation reports were consistent with AHA and ITP, with normal coagulation and viral profile. However, the patient was treated with corticosteroids, platelet and blood transfusion. And in follow-up visits, there was a pattern of gradual decline in erythrocyte sedimentation rate (ESR) and reticulocyte count, with normalization of haemoglobin, red cell, and white cell count. No association with other diseases was found in this case.
Bangladesh Med J. 2018 Jan; 47 (3): 37-40
Painful, Tender Loin Mass is an Atypical Presentation of Perforation of Retrocaecal Appendix - A Case Reoirt
Authors: Hossain M Mosarraf , Mizan Mizanur , Maruf Maruful , Md Jabed - , Ullah Md Sk Shahid 
Published: October 2019

Right painful, tender loin mass is an unusual presentations of acute appendicitis that arises difficulty in surgical practice. This "case of right painful, tender loin mass results from perforation of retrocaecal appendix with known case of diabetes mellitus patient 50 years old age. This case facilitates the significance of contrast for abdominal computerized tomography scan for critically ill patient.
Bangladesh Med J. 2018 Jan; 47 (3): 41-43
Effect of Perioperative Administration of Tranexamic Acid on Postoperative Bleeding Following on Pump CABG
Authors: Shahidullah AYM , Rahim AM Asif , Hossain ASM Iftekher , Islam Syed Monirul , Bari Md Sajedul , Hosain Nazmul 
Published: October 2019

Background: One of the main causes of post-operative morbidity in cardiac surgical patient is excessive bleeding requiring transfusion of blood component after CPB. Re-exploration due to bleeding occurs in 2% to 7% of post bypass patient and 50% to 80% of these patients not having any identifiable surgical bleeding source. Tranexamic acid is competitive inhibitor of plasminogen activator and at higher concentration a non-competitive inhibitor of plasmin. It is 10 times more potent than Epsilone Aminocaproic Acid in preventing post-operative haemorrhage following CPB.
Methods: This study was conducted in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh between January 2009 and December 2010. The Study population was divided into two groups. Group A comprised of 35 patients, who had received Tranexamic Acid 10 mg /kg after induction and then 1 mg/kg/hour till time of protamin infusion and Group B comprised of 35 patients who had received same amount of normal saline 0.9% NaCl as placebo.
Results: The postoperative bleeding during both 1 to 4 hours and 4 to 24 hours was significantly lower in the Tranexamic Acid group as compared to the placebo group (p value <0.001). There was no significant difference between groups in terms of platelet count and prothrombin time.
Conclusion: From the study, we conclude that “Perioperative Administration of Tranexamic acid reduces post operative bleeding and also reduces the need for postoperative blood transfusion in CABG patents using Cardiopulmonary bypass”. Therefore it is recommended that routine prophylactic use of Tranexamic Acid should be carried out to decrease the postoperative hemorrhage and requirement blood transfusion.
Cardiovasc. j. 2019; 12(1): 20-23
Serum Lipid Profile in Young Adults admitted with Myocardial Infarction in the Chittagong Region
Authors: Imam Hasan , Hosain Suman Nazmul , Chowdhury Ibrahim , Murshed AKM Manzur 
Published: October 2019

Background: Ischemic heart disease (IHD) is a common cardiac disorder and significant cause of mortality and morbidity Worldwide. Dyslipidemia plays an important role in the pathogenesis of young MI as evidenced from different studies. This present descriptive study is designed to evaluate the pattern of dyslipidemia in young patients of Chittagong region, suffering from MI.
Methods: 100 patients of young myocardial infarction diagnosed by clinical, biochemical and ECG criteria were included in the study. Fasting lipid profile was measured in the patients with age less than 40 years.
Results: Among the patients 44% patient had hypertension, 15% were diabetic, 40% patients had history of smoking and 12% patient were obese. Change of socioeconomic status found to have an influence in lipid profile like low density lipoprotein (LDL), total cholesterol (TC) and triglyceride (TG) (p<0.05) but high density lipoprotein (HDL) had no change (p>0.05). LDL was changed in relation with nature of works. TG was significantly found higher in rural community and advanced age group (p<0.05). HDL level was found varied with gender and others were found insignificant.
Conclusion: Varied lipid profile was found among the young victims of MI in Chittagong region. It might be concluded that control of blood lipid might lower the coronary events among young patients.
Cardiovasc. j. 2019; 12(1): 30-32
Characteristics of Children Hospitalized with Infective Endocarditis at Dhaka Shishu Hospital
Authors: Rima Rezoana , Mamun Mohammad Abdullah Al 
Published: October 2019

Background: The characteristics of infective endocarditis (IE) have significantly changed in pediatric age group during last few decades. The present study was conducted to study the clinical & lab profile, risk factors, site of cardiac involvement and outcome of infective endocarditis in the largest children hospital of Bangladesh.
Methods: This prospective cross-sectional study was conducted in cardiology department with a diagnosis of IE from February 2014 to August 2016. Twenty- four children fulfilled the modified Duke diagnostic criteria.
Results: Definite IE was found in 58% (14/24) patients, while the rest had possible IE. The most common presenting symptom was prolonged fever (> 2 weeks) & heart murmur. Most commonly encountered risk factors included congenital heart disease (54%), most commonly ventricular septal defect (21%). Two patients (8.3%) had history of rheumatic heart disease. Other important risk factors include post cardiac surgery (16.7%), prolonged ICU stay of neonates (20.8%). Nineteen patients (79%) were classified as having culture-negative endocarditis and five (21%) as culture positive. The most frequently isolated organisms were streptococci and followed by staphylococci and candida. Fifteen (62.5%) patients had right-sided cardiac involvement. Seven (29%) patients died of endocarditis or its complications.
Conclusion: Clinicians should have a high index of suspicion of endocarditis in persistently febrile patients with congenital heart disease and send blood cultures or refer appropriately before prescribing antibiotics.
Cardiovasc. j. 2019; 12(1): 33-39
Clopidegrol Resistance in Patients Undergoing Percutaneous Coronary Intervention (PCI): our experiences at Apollo Hospitals Dhaka
Authors: Islam AHM Waliul , Munwar Shams , Hossain Azfar , Reza AQM , Talukder Sahabuddin , Ahmed Tamzeed , Rahman Mizanur 
Published: October 2019

Background: Dual antiplatelet (DAPT) treatment with Clopidegrol and Aspirin after percutaneous coronary intervention(PCI) is common practice for the interventionist to prevent thrombotic event after coronary stent placement. In spite of this, significant number of thrombotic events still occur. Exact data on our population regarding the thrombotic events after successful PCI and uses of DAPT not yet available. Therefore, we have carried out this study to see sensitivity resistance in our population by measuring Clopidegrol resistance test (CYP2C19 assay).
Methods: Total 351 patients were enrolled in this observation non randomized prospective cohort. Patient who had percutaneous coronary intervention (PCI) at our center or elsewhere, and on Clopidegrol with Aspirin, were selected for the study. Clopidegrol resistance were measured by PCR assay for CYP2C19 at our hospital molecular lab.
Results: Among the 351 patients, male 292 and female 59. Average age for the male: female was 59:61years. Clopidegrol resistant test was performed by Real Time PCR for CYP2C19. Total 57%(200) patients are Clopidegrol resistant or positive and 43%(151) patients are Negative. Among the resistant case 9.1%(32) patients are Homozygous Positive with probable genotype CYP2C19*2 (*2/*2) and 168 (47.8%) patients were Heterozygous positive with probable genotype CYP2C19(*1/*2). Among the CAD risk factors, Dyslipidemia were more, followed by HTN, DM, FH and smoking. Among the studied group; PCI territory Left Anterior Descending (LAD), total number of Percutaneous Coronary Intervention (PCI) and number of vessel that is Single Vessel Disease (SVD) were more in Heterozygous, Homozygous and CYP2C19 Negative group.
Conclusion: In this single center, observational prospective cohort, we found quiet a significant (57%) number of patients are Clopidegrol resistant. Therefore, we may need to double the Clopidegrol dose and or to start other antiplatelet such as Ticagrelor or prasugrel in addition to Aspirin. Thus, to prevent stent thrombosis or restenosis.
Cardiovasc. j. 2019; 12(1): 45-52
Dilated Cardiomyopathy in Paediatric Population: A Review
Authors: Fatema Nurun Nahar , Nazmi Nure Ishrat 
Published: October 2019

Dilated cardiomyopathy (DCM) is a common cardiac diagnosis in children that may result as a consequence of diverse genetic and environmental insults. The differential diagnosis remains quite broad and as a result the approach to diagnosis and management may, at times, be quite difficult. A rigorous work-up can exclude alternative causes of left ventricular (LV) dilation and dysfunction, identify etiologies that may respond to specific treatments, and guide family screening. Assessment of myocardial detection of pre-clinical DCM could significantly reduce morbidity and mortality by allowing early instigation of cardio protective therapy. This review article discusses genetic and acquired causes of DCM, diagnostic modalities and therapeutic implications in the hope of informing physicians of a clinical entity that afflicts a substantial number of children worldwide.
Cardiovasc. j. 2019; 12(1): 64-74
Use of intra-urethral steroid clobetasol cream to prevent the recurrence of urethral stricture after optical urethrotomy: Randomized clinical trial
Authors: Ahmed M , Hossain SM , Islam MT , Kobir G , Basu BK 
Published: October 2019

Background: One of the most frequently used treatments of urethral strictures is the optical internal urethrotomy (OIU). About 20%-60% of urethral stricture patients develop recurrent stricture after Urethrotomy. Glucocorticoids have proved anti-proliferative effect and thereby used to reduce the formation of scar tissue. In urethral stricture, the main pathology is scar tissue formation.
Objective: The aim of this study is to see the influence the local application of steroid clobetasol cream after Urethrotomy.
Method: Between January to December 2016, all Bulbar urethral stricture patients attended to the hospital and private clinics, were included in this study. They were placed in two groups alternatively. They underwent standard OIU. First group (35 patients) offered clean intermittent self-catheterization (CISC) postoperatively without any steroid cream in urethra. The second group (35 patients) practiced CISC in the same way but used clobetasol cream with catheter. Both groups used topical anaesthesic Lidocain HCL for lubrication of urethra.
Result: No patient developed recurrence with clobetasol cream after 3 months, but two patients developed recurrence without steroid. At 6 months, this result is 6 (17.14%) and 10 (28.57%) accordingly.
Conclusion: Topical steroid clobetasol cream reduces urethral stricture recurrence.
Mediscope Vol. 6, No. 2: Jul 2019, Page 59-63
Neonatal Outcome in Meconium Stained Amniotic Fluid (MSAF): A Study in a Neonatal High Dependency Unit (NHDU) of a Medical College Hospital
Authors: Ali MB , Maruf AA , Naher N , Islam S 
Published: October 2019

Background: Meconium-stained amniotic fluid (MSAF) is a potential sign of fetal hypoxia as well as a potential toxin if the fetus aspirates with a gasping breath in utero or when it takes its first breaths following birth.
Objective: To evaluate the outcome of neonates with meconium-stained amniotic fluid (MSAF).
Material and Methods: This prospective observational study was carried out in the department of pediatrics of Gazi medical college Hospital, Khulna during one calendar year from 01 July 2016 to 30 June 2017. Maternal risk factors for MSAF, modes of delivery of neonates were recorded. All neonates born with MSAF were included in this study: they were shifted to neonatal high dependency unit for observation and monitoring as per the pediatrician’s advice. Neonatal outcomes like birth asphyxia, neonatal jaundice, aspiration pneumonia, septicemia, meconium aspiration syndrome (MAS), hypoxic-ischemic encephalopathy (HIE) and death were observed and recorded.
Result: A total of 157 babies were included during the study period. Modes of delivery of babies were: normal delivery 86(54.78%), caesarean section 48(30.57%) and instrumental delivery 23(14.65%). Maternal risk factors were postdated pregnancy 51(32.48%), previous caesarian section 20(12.74%), pregnancy-induced hypertension (PIH) 20(12.74%), premature rupture of membranes 18(11.46%), gestational diabetes mellitus (GDM) 17(10.83%), intrauterine growth retardation (IUGR) 14 (8.92%), cephalopelvic disproportion 9(5.73%) and anemia 8(5.10%). Outcome of babies were: 118(75.16%) babies were discharged without any complications, 10(6.37%) developed neonatal jaundice, 10(6.37%) meconium aspiration syndrome (MAS), 8(5.10%) birth asphyxia, 4(2.55%), aspiration pneumonia, 3(1.91%) hypoxic-ischemic encephalopathy (HIE), 2(1.27%) septicemia and 2(1.27%) baby died in early neonatal period.
Mediscope Vol. 6, No. 2: Jul 2019, Page 65-71
Pretreatment with Magnesium Sulfate to Alleviate Pain on Propofol Injection: A Prospective Randomized Double Blind Study
Authors: Hossain Muhammad Sazzad , Rashid Md Mamunur , Rashid Mohammad Mamunur , Babu Md Anisur Rahman , Sultana Afsana , Saha Devashis , Hasan Mohammad IftaKhiarul 
Published: October 2019

Background and aim of study: Propofol is one of the most frequently used medications for inducing and maintaining anesthesia. However, propofol injection causes pain and discomfort in more than 70% of patients. This study was performed to determine the effect of magnesium sulfate on reducing pain at the onset of anesthesia induced by propofol injection.
Materials and methods: A total of 80 healthy adult patients were selected in this study with either sex, scheduled for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 30 mg/kg of intravenous magnesium sulfate in 5 ml. Group II (placebo group) received 5ml of 0.9% intravenous normal saline 1 minute before propofol injection. The patients were asked to report their pain during injection of propofol. For all statistical tests, p<0.05 was taken to indicate a significant difference.
Results: The incidence of pain experienced in magnesium sulfate group was 30% patients and in saline group was 60% patients, which is statistically significant p<0.05. The severity of POPI was also lower in magnesium sulfate group than the saline group (p<0.05). The incidence of mild and moderate pain in groups I versus group II was 22.5% versus 37.5% and 7.5% versus 22.5% respectively p<0.05. There was no severe pain recorded in any groups.
Conclusion: Magnesium sulfate can be used before induction of anesthesia to reduce pain on propofol injection.
Mediscope Vol. 6, No. 2: Jul 2019, Page 73-77
Suicide kills more peoples than any form of violence
Authors: Sadek A , Anam AMA , Rashid MSA , Akber EB , Khan NT 
Published: October 2019

“Suicide is a tragic global public health problem. Globally, WHO said the death toll from suicide – at almost one million people per year – accounts for half of all violent deaths. Estimates suggest fatalities could rise to 1.5 million by 2020. Recently it’s been a great concern to examine suicide trends among teenage people. They are emotional and can’t tolerate difficult situation. They think it is a permanent problem so suicide is the only solution. Last year (2017) large number of SSC candidate students committed suicide in different districts due to not getting expected result. So this is the time to create awareness among society and also family support to child, otherwise no one can predict it. One day these victims will be their family members. Our review articles focuses on causes, risk factors and prevention of teenage suicide in country.
Mediscope Vol. 6, No. 2: Jul 2019, Page 87-92