bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Anal Fistula and Recurrent Abscesses following Management of Perianal Abscess
Authors: Begum Nasrin , Ahmed Quazi Sabran Uddin 
Published: June 2019

Introduction: Most perianal abscesses originate from an infected anal gland. Obstruction of these glands leads to stasis, bacterial overgrowth and ultimately abscess. Approximately 10% of perirectal abscesses are thought not to be due to infected anal glands. It is unclear why some patients completely heal and others have recurrent disease.
Objective: To assess the incidence of anal fistula and recurrent abscess after incision and drainage of perianal abscess.
Materials and Methods: A prospective observational study was done on 140 patients operated upon for perianal abscess in Combined Military Hospital, Dhaka. They underwent for one group only drainage, for other group drainage with primary fistulotomy under general or spinal anesthesia over two years from January 2015 to December 2016. The patients were followed up for an average 13 months (range, 4-18 months) after abscess drainage or until a fistula appears and abscess recurs. Their duration of hospital stay was 1–3 days. After discharge from hospital, they were examined in follow-up within 7 to 14 days. Subsequently, they were examined on a monthly basis until drainage ceased or until it became obvious that a fistula-in-ano had developed.
Results: Total 140 patients were treated for perianal abscess. Those patients were divided into two groups. The first group of 84 patients (60%) who underwent incision and drainage only. The second group consisted of 56(40%) patients who had low fistulas identified at the time of abscess drainage and underwent primary fistulotomy. The incidence of fistula formation after the operative procedures were 37(44.05%) in incision and drainage group and 5(8.93%) were in primary fistulotomy group. The most common site of abscess formation was posterior to anus. The incidence of recurrent abscess were 7(8.33%) in incision and drainage group; 2(3.57%) in primary fistulotomy group. The overall fistula formation (44.05% and 8.93%) and recurrence of abscess (8.33% and 3.57%) is low in primary fistulotomy group.
Conclusion: In this study the overall incidence of anal fistula is much higher than recurrence of perianal abscess following management of perianal abscess. Primary fistulolotomy at the time of drainage for perianal abscess reslult in a fewer persistent fistulas and recurrence of abscess.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 26-29
Nodal Metastasis in Neck: A Clinical Study of 60 Cases
Authors: Hossain Mohammad Kamal , Asaduzzaman AKM , Islam Md Tauhidul , Khan Ahsanuzzaman , Azad Muhammad Ali , Hossain Mohammad Delwar 
Published: June 2019

Introduction: An enlarged neck node is frequently the first clinical manifestation of a neoplastic process in the head and neck region. The earlier the diagnosis is made, the greater the chance of improved survival. A common denominator to all head-neck malignancy is their ability to metastasize. Although metastasis is not a random event, some tumours have the propensity to extensive local invasion without metastasis whereas others metastasize early in their development.
Objective: To evaluate the different primary sites metastasizing to cervical lymph nodes.
Materials and Methods: A prospective observational study was carried out from July 2007 to March 2009 in the department of Otolaryngology and Head-Neck Surgery, Combined Military Hospital, Dhaka among 60 patients who had metastatic neck nodes with known primary in head-neck region and those with unknown primary were included in this study. Metastatic neck disease involving left supraclavicular or scalene nodes with a possible primary arising within the chest or abdomen were excluded from the study. All cases were advised for Fine Needle Aspiration Cytology (FNAC) of enlarged neck nodes. Tissue samples were taken from primary sites for histopathology.
Results: Metastatic neck disease is commonly encountered in Bangladesh. A primary lesion was identified in 53(88.33%) cases however primary sites found undetected in 7(11.67%) cases. Among the primary sites 43(81.13%) cases were seen to arise from squamous lining of upper aero-digestive tract and 10(18.87%) cases were having a nonsquamous origin arising from thyroid gland (13.33%) and parotid gland (3.33%). Among the known primary sites highest incidence of metastatic neck nodes was found with carcinoma- larynx 22(36.66%) and pyriform fossa in 9(15%) cases. Forty seven (78.33%) patients were male and 13(21.67) were female with ratio being 3.6:1 of ages ranging from 20 years to 90 years.
Conclusion: Metastatic neck disease in commonly encountered in Bangladesh. Enlarged cervical nodes in an elderly patient should always be considered as metastatic until proved otherwise.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 56-59
Socio-demographic Status and Mode of Transmission of Avian Influenza among Poultry Farm Workers
Authors: Islam Sheikh Shahidul , Rahman Md Fashiur , Sarker Md Abu Sayeed , Begum Masuda , Kabir SM Humayun , Alam Md Jahangir , Uddin Md Jalal , Banu Selina , Rahman Md Bahanur 
Published: June 2019

Introduction: Avian influenza is considered as serious global public health problem for poultry industry. Literature suggests that when HPAI/H5N1 Avian influenza (AI) outbreaks, humans are prone to increased risk of transmission. The recent pandemic caused by highly pathogenic AIA (H5N1) in domestic poultry is currently rated phase-3 by the World Health Organization on the pandemic alert scale. Every year 244 species of migratory birds visit Bangladesh in the winter season (October-March) of which approximately 21 species may carry the H5N1 or HPAI (Highly Pathogenic Avian influenza) virus.
Objective: To assess socio demographic status and knowledge on mode of transmission of avian influenza among the poultry workers of selected poultry farms in Dhaka city.
Materials and Methods: This was a cross-sectional study carried out among the poultry workers of selected poultry farms in Dhaka city. The study was conducted over a period of six months from January 2008 to June 2008. A total of 150 poultry workers aged 9 years and above irrespective of sexes were interviewed face to face by using semi-structured questionnaire.
Results: Majority of the respondents were male (92%) and nearly 78% of the respondents had educational level from Class-V to SSC. About three fourth of the respondents (68%) mentioned that avian influenza was transmitted by direct contact. Eighty percent (80%) of the respondents had the knowledge on transmission from poultry to human whereas 63% had the knowledge on transmission from human to human. Good, fair and poor knowledge on mode of transmission of avian influenza was found in 21.33%, 42.67% and 36% of the subjects respectively. Among the respondents belonging to <3 years and 3-5 years duration of service, 12% and 13.33% had poor knowledge followed by 14% and 9.33% had fair knowledge whereas 4% and 4.67% had good knowledge.
Conclusion: From the study it was revealed that one third of the workers had poor knowledge on mode of transmission of avian influenza. The study also found that the level of knowledge was found to be good among the older age group having higher educational level and longer duration of service.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 60-65
Severe Cutaneous Adverse Drug Reactions in Bangladesh: A Review in a Tertiary Level Hospital
Authors: Chowdhury Md Niamul Gani , Hoque Mohammad Enamul , Khan Md Abdul Latif , Khan Md Shirajul Islam 
Published: June 2019

Introduction: The Severe Cutaneous Adverse Drug Reactions (SCADRs) are rare but life-threatening as these encompass drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and acute generalized exanthematous pustulosis (AGEP).
Objective: To estimate the incidence of SCADRs and to find out the cause in Bangladesh.
Materials and Methods: 50 patients with SCADRs were studied over a period of 1 year from January 2015 to December 2015 in the Department of Dermatology, Combined Military Hospital, Dhaka. Data were collected from the informant and recorded in structured Case Report Form. Quantitative data were expressed as mean and standard deviation and qualitative data as frequency and percentage.
Results: Clinical diagnosis of the study subjects recognized 46.0% cases as SJS, 28(19.0%) as TEN, 16.0% as DRESS and 10.0% as AGEP. The maximum incidence (46%) was seen in the age group of 31-50 years; mean age of the patient was 37.42+5.3 years. Male and female ratio was 2.84:1. Anticonvulsant group of drugs could give rise to maximum incidence of SCADRs. Carbamazepine was responsible in 22.0% cases of SCADRs, followed by Phenytoin in 16.0% patients and Phenobarbital in 14.0% cases.
Conclusion: SCADRs were seen mostly with the anticonvulsant drugs belonging to Carbamazepine and Phenytoin group. SCADRs deserve continuous monitoring to plan preventive strategies.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 71-75
Role of Acupuncture in Back Pain– Experience in the Department of Physical Medicine, CMH Dhaka
Authors: Haque SM Shahidul , Miah Md Abdul Ali , Rahman Md Fashiur , Yousuf Mohammad , Rahim Hasna Raihan 
Published: June 2019

Introduction: Back pain is one of the common causes of pain after headache and a major debilitation in adult. Low back pain includes dorsal pain at anywhere between 12th thoracic vertebrae and lower buttock up to gluteal folds or anus. In United States, as many as one third of the population suffer from chronic pain conditions. Acupuncture is a recommended treatment for back pain. The action of acupuncture is an analgesic and considered a valuable asset in the specialty of pain management.
Objective: To evaluate the role of acupuncture on back pain and to follow up the quality of life in patients with back pain.
Materials and Methods: This was a prospective experimental study and was carried out at the Department of Physical Medicine, Combined Military hospital (CMH), Dhaka Cantonment from June 2015 to December 2015. A total of twenty two patients were enrolled and were randomly selected who received conservative treatment for pain management for 4 to 6 weeks and did not get improvement. Needling was done at acu-points on average of 15 to 20 needles for a period of 15-30 minutes for three days in a week for 06 weeks. The concise assessment was done for effectiveness in pain management.
Results: The result was observed in terms of the VAS (Visual analog scale) and disability scale. Relief of pain was noted to complete or to moderate in 58% of the cases. After 02 months of acupuncture treatment, 60% patients had relief of pain. After 06 months of acupuncture treatment, about 30% patients remained moderate to complete pain free.
Conclusion: Acupuncture remains one of the alternative medicine disciplines and there is mounting evidence of its effectiveness. Most of the patients were benefitted with acupuncture treatment regime after failure of conservative treatment for duration of 4-6 weeks for back pain.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 85-89
Indoor Patient Satisfaction on Doctor’s Care: A Tool to Improve Quality Service at Tertiary Level Military Hospital, Bangladesh
Authors: Munir AKM Mashiul , Halim AKM Yunus 
Published: June 2019

Introduction: Patient satisfaction Survey has become a regulatory Tool to ensure quality of services and efficient use of resources. To endure quality service In-patient departments, doctors’ care undoubtedly a useful measure in CMH (Combined Military Hospital) where the number of patient flow is increasing day-by-day.
Objective: To find out the perceptions and expectations of the patients from the doctors in a tertiary level military hospital.
Materials and Methods: In this descriptive cross sectional study 372 respondents were selected among the admitted patients of CMH Bogra. Respondents were randomly selected from all wards and were interviewed with a semi-structured questionnaire from May 2015 to December 2015.
Results: Out of 372 respondents, 68.8% were in age group between 25 to 50 years and majority (69%) of them were army personnel. Overall patients’ highly satisfaction levels on doctor’s services were doctors’ attitude (66%), patients’ privacy maintenance (61%), regular Ward visit (70%), counselling (59%) and importance of patients’ opinion (62%). Requirement of increased number of doctors and initiation of professional development program (PDP) for physicians were found important.
Conclusion: In Military Hospital, doctors are more accountable to their work. Therefore a management approach must be higher with more complicated expectation levels. This study showed a higher level of indoor patient satisfaction with doctors care at CMH Bogra.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 76-84
Contrast Sensitivity Change– A Tool of Monitoring Glaucoma Progression
Authors: Kajmina Natasha , Rahman Sayedur , Newaz Golam Shah , Haque Wasim Selimul 
Published: June 2019

Introduction: Glaucoma is a potentially blinding disease,causing gradual loss of sight. It is often associated with increased intraocular pressure that can damage the optic nerve, which transmits images to the brain. Glaucoma can lead to permanent vision loss, if the damage continues. Without treatment, glaucoma can cause total permanent blindness within a few years. Glaucoma is one of the major causes of ocular morbidity and primary open–angle glaucoma is a major health problem. The prevalence of primary open- angle glaucoma (POAG) is estimated as being from 1.1-3% of western populations, over the age of 40 years, in both past and more recent population surveys.
Objective: To evaluate and compare the value of Contrast sensitivity (CS) and automated perimetry among primary open-angle glaucoma (POAG) patients, glaucoma suspects and normal control.
Materials and Methods: It was a prospective observational hospital based study conducted in National Institute of Ophthalmology & Hospital (NIO&H), Dhaka during the period from January 2006 to December 2006. A total of 30 POAG patients, 30 glaucoma suspects and 30 normal control subjects were recruited for the study. After complete baseline evaluation, all the study subjects underwent visual field assessment by Octopus automated field analyzer and CS evaluation by Low Contrast Flip Chart. Outcome measures were baseline CS of POAG patients, glaucoma suspects and normal controls, mean CS of POAG patients at 3 months after treatment, baseline MS of POAG patients, glaucoma suspects and normal controls in Octopus perimetry and retinal mean sensitivity (MS) of POAG patients 3 months after treatment.
Results: Among the POAG patients MS was 22.23 dB, among glaucoma suspects MS was 27.50 dB and among normal controls mean MS was 30.0 dB; among the POAG patients mean CS was 2.99% whereas it was 2.20% and 1.41% respectively among glaucoma suspects and normal controls. Baseline CS had negative correlation with MS among POAG patients (correlation co-efficient, r = -0.908). It indicates that better CS is associated with higher MS. Out of 30 cases of POAG, 20 (66.67%) received medical and 10 (33.33%) received surgical treatment. Mean CS improves to 2.66% from baseline 2.99% after treatment and MS improves to 23.16 dB from base 22.23 dB after treatment. Correlation after three months of treatment was significantly negative (r = -0.86).
Conclusion: As increased loss of MS of perimetry has been found to be associated with increased loss of CS, assessment of CS may become an easy, convenient tool for glaucoma diagnosis.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 90-92
Correlation of Computed Tomographic Scan Findings in Children having Neurodisability– A Study of 100 Cases
Authors: Muid SMA Al , Beauty Anjuman Ara , Jubaida Nishat , Alam Md Taharul 
Published: June 2019

Introduction: Neurodisability is an umbrella term for conditions associated with impairment involving the nervous system. The parents of these children remain worried about the cause of the disability and seek the diagnosis. Nowadays radiological diagnosis by CT scan is possible in most of the cases which may help in the management of such children.
Objective: To correlate between clinical and CT scan findings in neurodisabled children.
Materials and Methods: One hundred children with neurodisability were selected randomly who were scanned by 6, 16 and 128 slice CT scanners. This retrospective study was conducted in CMH Dhaka and Central Hospital Limited, Dhaka in between 2010 to 2014.
Results: Abnormal CT scan was found in 57 cases out of 100 patients having neurodisability. A large number of patients having neurodisability are suffering from psychomotor delay, motor delay, seizure disorder and speech difficulty. Hypoxic ischaemic injury in perinatal period is one of the major causes of the disability.
Conclusion: CT scan is very effective to find out the cause of neurodisability in less time (around 25 to 30 seconds) and is widely available in Bangladesh.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 93-97
A Randomized Controlled Trial Comparing Packing with Nonpacking of Perianal Abscess Cav
Authors: Islam Md Tanvirul , Rahman Md Mahbubur , Begum Nasrin 
Published: June 2019

Introduction: Anorectal abscess is a potentially debilitating condition and one of the common anorectal conditions encountered in practice. Anorectal abscesses are defined by the anatomic space in which they develop and are more common in the perianal and ischiorectal spaces. Traditional management of perianal abscess involves early incision, drainage, curettage and packing of the residual cavity. Cavity packing and dressings are problematic in that they cause significant discomfort and require multiple visits to change the packing until healing. An alternative to the traditional approach is to perform adequate incision and drainage and then to allow healing without the use of cavity dressings.
Objective: To compare the effects of packing with nonpacking of the perianal abscess cavity on patient discomfort and wound healing and subsidiary evaluation of the clinical outcomes.
Materials and Methods: This single centre randomized controlled trial was carried out on 50 patients who were operated upon for perianal abscess in Combined Military Hospital, Dhaka during the period of July 2014 to June 2016. Patients were randomly assigned to receive either packing or nonpacking treatment through allocation by sealed envelope. The packing (control) group was instructed to report to a single nursing staff for subsequent dressing with packing of the residual cavity. The nonpacking group was discharged with a superficial protective dressing; they did not undergo wound dressing but managed their own wounds until follow-up. Outcome measures were time of healing, abscess recurrence, fistula formation and post operative pain.
Results: A total of 54 patients were enrolled (4 lost in follow-up): 24 in the packing and 26 in the nonpacking arm. The two groups were comparable in terms of age and gender distribution, type, size of the abscess, duration of symptoms and length of follow-up. Healing in the non-packing group was faster compared to that of the packing group: mean 24.08 days versus 34.13 days (P=0.000). The rate of abscess recurrence was similar (P=0.664). Post operative fistula rates were similar (P=0.623). Pain scores appeared less in the nonpacking arm and statistically significant (7.25 vs. 4.24, P=0.000).
Conclusion: Small size of the study population was the limitation of this study. In order to obtain a higher level of evidence, an adequately powered multicentre based prospective randomized controlled trial is required to definitely address the question of packing of the cavity and its beneficial outcome following incision and drainage in the management of perianal abscess.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 111-116
Subtotal Gastrectomy for Atypical Carcinoid of Stomach– A Rare Tumour
Authors: Hossain SM Shahadat , Rahman Md Mahbubur , Mahmud Md Rayhan , Jahan Farhana Israt 
Published: June 2019

The term carcinoid was first employed by Oberndorfer in 1907 to describe a group of tumours of the gastrointestinal tract that had a relatively indolent course and that were considered to be intermediate between adenoma and carcinoma in malignant potential. Gastrointestinal carcinoid tumours are a type of cancer that form in the lining of the gastrointestinal tract originating from entero-chromaffin like (ECL) cells. Gastric carcinoid tumours are rare tumors that develop within the gastric mucosa. They can present as an isolated lesion or there can be multiple lesions. The tumours can invade locally into deeper structures of the gastrointestinal tract (GIT) wall. Solitary gastric carcinoids have a greater chance for the development of malignancy and metastases as compared to multiple gastric carcinoids due to hypergastrinemia. A 60 years old man presented with abdominal pain, vomiting and weight loss and was found to have carcinoid tumour of stomach without classic carcinoid syndrome (CS). Despite advances in the understanding of patho-physiology of carcinoid tumour its complications remain enigmatic. Early, accurate diagnosis and aggressive treatment is recommended.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 145-148