bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introducing Problem- Based Learning as an Effective Learning Tool to Medical Students: An Approach in Bangladesh
Authors: Jeenia Fatiha Tasmin , Hoque Afroza , Khanom Mehrunnissa , Md Jahangir Selim , Hoque Rozina , Parveen Kohinoor , Ferdoush Jannatul , Ata Maliha , Tanin Md Jamal Uddin 
Published: March 2021

Background: Bangladesh, A country with scintillating beauty of nature burdened with a dense population. Along with infectious diseases, tropical diseases are also prevalent here with a higher trend of non- communicable diseases as a result of industrialization. Practicing and prescribing as a doctor is a quite challenging profession here particularly when to deal with vast rural populations in a low resource facility. Medical education system is well developed in Bangladesh which follows traditional curriculum of teaching learning. Students are not accustomed with problem-based learning as it does not exist in curriculum. In order to confront with diverse disease pattern and overloaded population in this arduous backdrop of Bangladesh, problem- based learning can be a very effective tool for preparing medical students as an efficient, self- directed and insightful prescriber. This study was a primary step to introduce problem- based learning (PBL) to medical students of Bangladesh to evaluate the effectiveness of PBL in context of Bangladesh.
Methods: Around 117 students of 4th year from 6 different medical colleges were randomly assigned for this study. Among them, half of the students attended PBL session for three days on a topic of Pharmacology and other students participated traditional lecture class. Following classes, odds ratio of performance was determined. MCQ, SAQ and total scores of assessment were compared. Comparison of scores was also done between male and female students of PBL group.
Results: PBL students performed better than the LBL students. Odds ratio of their assessment performance was 252.08; with 95% confidence interval and lower range 53.89 and upper range 1179.28. The odds ratio showed strong association between PBL and student performance in Bangladesh context. Mean of total score was 30.7 ± 4.3 in PBL group and 17.2 ± 4.8 in LBL group. Total score was significantly higher (p= 0.000) in PBL group. Mean SAQ score in PBL and LBL group was 17.2 ± 2.2 and 5.3 ± 1.9 respectively which was extremely significant (p= 0.000). MCQ score mean was 13.4 ± 3.4 in PBL group versus 11.8 ± 3.7 in LBL group which was significantly higher in PBL group (p= 0.02). Among PBL group, total score and SAQ score was significantly higher in female students over male students.
Conclusion: Significant findings of this study revealed PBL as an effective tool in Bangladesh context. Thereby, it is recommended from this study to take approaches for further study and initiative to incorporate PBL in curriculum as well.
Bangladesh Journal of Medical Education Vol.12(1) 2021: 22-31
Teachers’ Opinion about Pharmacology Written Question Papers of MBBS Professional Examinations
Authors: Chowdhury Dipak Kumer Paul , Saha Debashish , Habib Md Ahsan 
Published: March 2021

Written examination is an important method for juddering the learning of medical students. Short Answer Questions (SAQ) and multiple choice questions (MCQ) are introduced in MBBS curriculum to assess student cognitive domain. This cross sectional descriptive study was conducted to get the teachers’ opinion about Pharmacology professional written short answer question papers of different Universities of Bangladesh. For this purpose, opinion of total 56 purposively selected teachers of the Department of Pharmacology & Therapeutics of 20 Medical Colleges were collected through self-administered semi-structured questionnaire. Most of the teachers (66% & 61%) were in favour of existing distribution of different types of question in curriculum (recall-60%, understanding -30% and problem based-10%) for short answer question paper (SAQ). Majority of the teachers (66% & 54%) were satisfied with the present coverage of recall and understanding type questions respectively but only 41% teachers were satisfied with the coverage of problem based type questions. Seventy-seven percent teachers were satisfied with content coverage in SAQ papers. Eighty-seven percent teachers were satisfied with present marking scheme on SAQ paper. Findings of this study may be used to redefine the distribution of different types question in SAQ papers and to improve the quality of question papers by ensuring their coverage.
Bangladesh Journal of Medical Education Vol.12(1) 2021: 40-49
A Re-design Proposal for the ‘Occupational’ & ‘Environmental’ Medicine syllabus under ‘Community Medicine’ subject of the third-year MBBS curriculum in Bangladesh: Suggesting to apply ‘PBLs’, ‘Blended-learning (or, flipped classroom)’ and ‘Guest-lectures’
Authors: Malek Sharafat 
Published: March 2021

The reported illnesses and injuries attributed to environmental and occupational factors is a major health challenge being experienced globally over the years.1 In current decade, Bangladesh has experienced a number of environmental and occupational health-related hazards that not only have cost huge government involvement, medically and financially but also caused international bodies to intervene into local affairs (see Table 1). These unprecedented events often question how prepared are young Bangladeshi doctors if they are to receive and manage disaster-victims at real time.2 Globally, ‘Occupational and Environmental Medicine (OEM)’ subject is lectured at third-year of the MBBS course during ‘Population Health’ or ‘Community Medicine’ rotation. Efficient, effective and enjoyable learning on OEM-topics can equip future doctors with important basic knowledge and required practical skills that are necessary to manage cases/victims from pandemic, work-hazards or disasters. Students’ positive engagement with OEM may raise their interest with specialist careers in Community Medicine (Com-Med). Some developed-country studies3-7 reported that students who went through problem-based-learning (PBL) tutored classes made better academic performance on Preventive Medicine, Public Health and Community Health topics than those who had experienced traditionally lecture-tutored curriculum. An Indian study done by Joseph et al.8 documented similar findings. The purpose of this review paper is to appraise current OEM-syllabus under the Com-Med curriculum in Bangladesh and scope, whether the PBLs or case-based-learning (CBLs) model could be appropriate if applied through ‘blended-learning’ or, ‘flipped-classroom (backed by audio-video supports)’ format. This literature-evidenced, student-centred teaching model expectedly would improve students’ practically-oriented learning via their in-class working over real-life cases/problems. Ideally, these cases would be constructed by content-experts and delivered initially by guest-lecturers.
Bangladesh Journal of Medical Education Vol.12(1) 2021: 50-67
Clinical and Electrophysiological Profile of Carpal Tunnel Syndrome: A Study in a Tertiary Care Hospital
Authors: Ahmed Kazi Gias Uddin , Alam Iftikher , Sina Hashmi , Md Arifuzzaman - , Mahmud Reaz , Dhali Sabbir Ahmed , Hossain Ahmed , Saha Konol , Azad Khan Abul Kalam 
Published: March 2021

Introduction: Carpal tunnel syndrome (CTS) is a clinical syndrome that results from compression of median nerve within the carpal tunnel at the wrist. The aim of this study was to review the clinical and demographic characteristics and electrophysiological patterns of CTS patients who presented to a tertiary care hospital in Bangladesh.
Methodology; A descriptive cross-sectional study was conducted on 150 CTS patients at the neurology department, Dhaka Medical College Hospital between January, 2019 to March , 2020 . All the subjects had clinical evaluation and standardized nerve conduction studies of upper limbs (300 limbs) using the same protocol.
Results: 228 hands were found to have clinical and electrophysiological features consistent with CTS. There was female predominance (90%) and the highest occurrence of CTS was in the 45-55 years age group. Bilateral CTS was found in the majority of cases ie 78 (52%) and the rest had unilateral CTS. Among those with unilateral CTS, right hand was affected more (41, 57%) than left hand (31, 43%). Most of the cases were idiopathic. Neurophysiological studies showed most patients had mild CTS (121 hands, 53%). Most of the cases were idiopathic (102, 68%). Where a risk factor was found diabetes was commonest one (32) followed by hypothyroidism (12) and pregnancy (4).
Conclusion: There was marked female predominance and the 45-55 years age group was predominantly affected. Majority of cases had mild CTS. Bilateral involvement was more common. Right hand was more affected than the left hand.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 96-99
A Retrospective Clinicopathological Study of Malignant Ovarian Tumors: A 3 Year Experience in a Tertiary Health Care Center of Dhaka, Bangladesh
Authors: Saha Joysree , Siddique Sohana , Akter Sumaya , Quader Md Abdul , Prasad Indrajit , Siddique Sharmina , Alam Saleha , Mehzabin Shafinaz 
Published: March 2021

Background: Ovarian tumors are a heterogeneous group of neoplasm that have become increasingly important now-a-days because of their large variety of neoplastic entities and gradually increased rate of mortality due to female genital cancers.
Objectives: The aim of this study was to analyze the histopathological pattern and clinical presentation of malignant ovarian tumors according to the WHO classification of ovarian tumors [2003] in a tertiary care center of Dhaka, Bangladesh.
Materials and Methods: This retrospective study included and studied a total of 54 cases of malignant ovarian tumors at the Department of Obstetrics and Gynecology, Popular Medical College Hospital, Dhaka, Bangladesh over a period of 3 years from Jan 2015 to Dec 2017.
Results: The mean age was 47.44±14.24 years old (age ranged from 20-70 years). Of the 54 malignant ovarian tumors studied, the commonest histological pattern observed in the study was serous cyst adenocarcinoma constituting 26 cases (48.15%) followed by adenocarcinoma of ovary (25.9%), mucinous cyst adenocarcinoma (14.8%), endometriod adenocarcinoma (3.7%), dysgerminoma (3.7%) and ovarian choriocarcinoma (3.7%). High level of serum CA125 was found in most of the cases (n=48; 88.89%). The chief complaints were abdominal pain (n=38; 70.37%) and abdominal distension (n=29; 53.70%). Majority were admitted with less than one month duration of symptoms. The size of the tumor varied from 2.2 to 20 cm. All the patients were admitted in III and IV stage.
Conclusions: Serous cyst adenocarcinoma was the common finding of this study. The prognosis and varying therapeutic strategies of malignant ovarian tumors necessitate an accurate histopathological evaluation.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 100-105
Aetiological Pattern of Gastrointestinal Perforations: A Prospective Observational Study
Authors: Das Prosunto Kumar , Rahman Chowdhury Md Mushfiqur , Rahman AZM Mahfuzur , Dewan Md Nayeem , Islam Md Mahmudul , Saha Kalyan Kuman , Mamun Abu Masud Al 
Published: March 2021

Introduction: Peritonitis secondary to gastrointestinal perforation is one of the commonest surgical emergencies encountered all over the world. This study was done to highlight the spectrum of perforation peritonitis encountered in surgery unit of Dhaka Medical College Hospital.
Method: It was observational prospective of 100 cases of perforation peritonitis treated in our hospital. All cases of perforative peritonitis whether spontaneous, infective or neoplastic pathology were included in this study.
Results: The maximum numbers of patients were in age group between 31 to 40 years (39 %) with mean age 35 years. Male female ratio was 9:1. The most common aetiology of perforation peritonitis was peptic ulcer disease (73%) followed by enteric fever (12%), appendicitis (10%), tuberculosis (3%) and malignancy (2%). The most common sites of perforation were in descending order of frequency - first part of the duodenum (65%), terminal ileum (12%), appendix (10%), gastric antrum (9%), jejunum (3%) and rectum (1%). Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (96%), muscle guard and rigidity (100%) were the common signs. Approximately 15-20% presented late with features of shock. Mortality rate was 2% and was significantly high in patients coming hospital late.
Conclusion: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever have highest morbidity. Early recognition and timely appropriate intervention is very important in reducing morbidity and mortality.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 106-109
Clinicopathological Study of Change of Voice
Authors: Md Arifuzzaman - , Fattah Shaikh Nurul , Islam Mohammad Nazrul , Hasan Md Mehedi , Islam Md Monirul , Tabassum Chowdhury Tamanna , Monira Shirajum , Mohammad Tanvir Sardar , Mohammad Farhad - 
Published: March 2021

Background: Change of voice is one of the common complaints in ENT practice and hoarseness of voice is the commonest symptom of changed voice quality. Hoarseness is invariably the earliest manifestation of conditions directly or indirectly affecting the voice apparatus. Though most common causes of hoarseness are benign and vocal abuse is the commonest among them, but we should always investigate for more sinister pathology like malignancy.
Objectives: To find out the symptoms, signs and pathological incidence, leading to change of voice for early diagnosis and interventional purpose.
Methods: Total 87 patients of change of voice, studied in 06 months duration from 1st January 2016 to 30th June 2016 in the Department of ENT & Head-Neck Surgery, Dhaka Medical College Hospital, Dhaka. The cases were selected according to the eligibility criteria by purposive sampling. Then the data were collected by the active participation of the patients interviewed by the preformed proforma of data collection sheet.
Results: Maximum number of cases of change of voice were due to carcinoma larynx (37.93%), then chronic laryngitis (20.99%), followed by vocal cord nodules (19.54%) and vocal cord polyps (8.05%.). Laryngopharyngeal reflux was found in 45.95% patients of chronic laryngitis. Males were affected more than females (1.81:1). Most of the patients were in the age group of 21 to 50 years. Peak incidence was in the 4th decade. Labourers/ daily wage earners formed the predominant group. Majority of patients were from low socioeconomic class. Smoking, vocal abuse, smoking and infections were the common predisposing factors.
Conclusion: Hoarseness of voice is just a symptom with a very diverse etiology. The etiological data varies in different geographical location and from one center to other, so every case should be carefully and thoroughly evaluated to know the diagnosis and underlying pathology for early and prompt management.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 116-125
Pain and Functional Outcome with Single dose 25% Dextrose Intra-Articular Injection in Patients with Primary Osteoarthritis of the Knee
Authors: Chowdhury Ziaur Rahman , Mohammad Salek Abul Khair , Khasru Moshiur Rahman , Shoma Farzana Khan , Islam SM Mazharul , Hasan Md Israt , Elias SM Abu , Islam Md Faizul , Rab Masuma , Ahmed Toufiq , Hossain Farzana 
Published: March 2021

Introduction: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. The introduction of 25% Dextrose injection has been viewed as an advance in the management of OA knee.
Methods: A prospective, randomized clinical trial was conducted with 84 cases in the Physical Medicine and Rehabilitation (PMR) department of BSMMU. Group A, 42 patients received single dose 25% Dextrose injection intra articular 8ml, exercise and ADL; Group B, 42 patients received exercise and ADL. Outcomes were measured by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed up for 6 months.
Result: At the initial stage and in week 4, there was no statistical difference between two groups regarding VAS score (as p value was >0.05). But in week 12 and 24, there was highly significant statistical difference regarding VAS score between two groups as the p value was <0.001. Again at the initial stage and week 4, there was no statistical difference between two groups regarding stiffness and physical function score. But in week 12 and 24, there was significant statistical difference regarding stiffness and physical function score between two groups as the p value was less than 0.05.
Conclusion: Intra-articular injection of 25% dextrose administered to patients with OA knee has significant effects in pain reduction and functional improvement.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 138-144
Pattern of Electrolyte Abnormalities in Preterm Low Birth Weight Neonates
Authors: Islam Md Saiful , Banerjee Manisha , Khan Tafazzal Hossain , Shaha Chandan Kumar , Uddin Md Zahir , Ali Md Ramzan , Haq Shah Mohammad Mohaimenul 
Published: March 2021

Prematurity and low birth weight contributes to 27.8% of neonatal deaths in rural areas of Bangladesh. Fluid, electrolyte and metabolic abnormalities are the commonest derangements encountered in preterm infants due to their renal immaturity and relatively immature skin. Premature infant are at increased risk of developing dehydration or overhydration4. Therefore, high index of suspicion, prompt recognition and thorough understanding of common electrolyte abnormalities are necessary to improve neonatal outcome. Appropriate fluid and electrolyte management is essential for better neonatal outcome.
Objectives: To identify the serum electrolytes abnormalities in preterm low birth weight neonates.
Methodology: It was a cross- sectional study and carried out in the Department of Neonatology, Dhaka Medical College Hospital, Dhaka between January 2017 to August 2017. Information was collected who gave consent and participated in the study willingly. The sample size was 50. Patients admitted in the above mentioned hospital and after meeting the inclusion and exclusion criteria a simple random sampling technique was applied for selecting the study subjects.
Results: Fifty preterm LBW neonates fulfilling the inclusion criteria were studied during this study period. Abnormal electrolytes were documented in 20(40%) out of 50 preterm LBW neonates and electrolyte status was normal in 30(60.0%) cases. Of 20 neonates who had abnormal electrolytes, hyperkalemia was the predominant electrolyte abnormality found in 8(16.0%) neonates, hyponatremia was found in 7(14.0%), hypokalemia in 3(6.0%) and hypernatremia 2(4.0%).
Conclusion: Electrolyte abnormalities are common in preterm LBW neonates. So, identification of electrolyte abnormalities and proper management of fluid and electrolytes and close monitoring are important.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 145-148
Prevalence of Thyroid Dysfunction in Type 2 Diabetes Mellitus
Authors: Biswas Prodip Kumar , Saha Gopal Chandra , Hossain Mohammed Shahadat , Uddin Md Nasir , Rahman Muhammad Faizur , Jahan Nur Wa Bushra , Md Ashrafuzzaman - , Mazumder Mohammad Kamruzzaman , Ghosh Shuvra , Paul Pijush , Chowdhury Ahmed Hossain 
Published: March 2021

Aim: The study was undertaken with an objective to know the thyroid functions in Type 2 diabetics and to know the spectrum of thyroid dysfunction in Type 2 DM.
Methods: The present study included 68OPD and IPD patients of Type 2 DM who attended the Department of General Medicine at Dhaka Medical College Hospital Dhaka. Detailed history and examination were done, fasting blood samples of all the subjects were taken and at the same time samples were tested for HbA1C and thyroid profile (T3, T4 and TSH).
Result: in this study 68 established diabetics were screened for thyroid disorders by TFT. Abnormal thyroid function was found in 43 T2DM cases and remaining diabetics had normal thyroid function. Among 68 cases low thyroid function was noted in 20 patients and 18 subjects had Sub-clinical hypothyroidism. Hyperthyroidism was noted in 05 patients.
Conclusion: Type 2 diabetes mellitus is a major problem all over the world and many patients of Diabetes Mellitus are associated with thyroid dysfunction. So diabetic patients s should be screened for thyroid disorder especially hypothyroidism.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 149-152
Missed Diagnosis of Phyllodes Tumour And Its Implications - A Case Report
Authors: Das Prosunto Kumar , Rahman AZM Mahfuzur , Sina Md Nayeem Dewan , Mamun Abu Masud Al 
Published: March 2021

Phyllodes tumours are rare fibroepithelial tumours that accounts for less than 1% of all breast tumours. Phyllodes tumours tend to grow quickly but they rarely spread outside the breast. Although most phyllodes tumours are benign, some are malignant and some are borderline. It is often underdiagnosed by pathologists and under treated by surgeon. Its heterogenicity makes phyllodes tumour a challenge for the clinicians and the pathologists. Accurate preoperative diagnosis by Fine Needle Aspiration Cytology or by Core biopsy or peroprative diagnosis by Frozen section biopsy is essential for adequate surgical treatment. This case describes a missed diagnosis of phyllodes tumour both by cytopathologically and histopathologically.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 182-184
Ensino de física em uma comunidade rural de São João do Triunfo PR: aulas de reflexão da luz no rio Iguaçú
Authors: Drabeski Regiane Gordia , Bernardes Luiz Antônio Bastos 
Published: March 2021

Trabalhar física em uma escola do campo requer do professor um engajamento com situações cotidianas que o aluno pode encontrar. Nesta pesquisa, foi realizada uma sequência didática, com aulas dinâmicas de conteúdo e observação de fenômenos de reflexão da luz, em objetos cotidianos e também com registros de imagens no rio Iguaçu. Trabalhar com temas geradores conforme proposto por Freire torna o aluno sujeito do aprendizado, interagindo com conhecimentos prévios e científicos apresentados pelo professor, resultando em uma aprendizagem significativa. O uso de tecnologias possibilita ao aluno da educação no campo compreender e analisar fatos que influenciam sua vida junto ao meio ambiente. A comunidade rural de Vila Palmira no interior de São João do Triunfo fica às margens do rio Iguaçu, tendo este grande importância na execução deste trabalho. A sequência didática realizada teve duração de seis horas- aula, distribuídas em três semanas. A atividade realizada dentro e fora de sala uniu física, arte e tecnologia, visando estudar leis da reflexão e casos específicos onde ela ocorre. Os alunos apresentaram bom desenvolvimento de conceitos e aprendizado acerca do tema estudado. Vale ressaltar que na literatura atual não se encontra nenhum trabalho publicado tratando destes temas e de tal maneiraIncluir o resumo.