bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preemptive Use of Low Dose Intravenous Ketamine on Post Operative Pain after Laparoscopic Cholecystectomy
Authors: Maruf Abdullah Al , Ershad Reza , Nazrina Sayeda 
Published: June 2019

Introduction: There is a widespread belief for the efficacy of preemptive analgesia among clinicians. Different drugs and methods are used as preemptive analgesic method for postoperative pain management.
Objective: To evaluate the efficacy of preemptive use of small dose intravenous ketamine on post operative pain on patients undergoing laparoscopic cholecystectomy.
Materials and Methods: Sixty patients of both sexes as per American Society of Anaesthesiologists (ASA) physical status I and II underwent laparoscopic cholecystectomy were randomly allocated into two groups. In the operating room, Group A (n=30) received 0.5 mg/kg body weight of ketamine intravenously 10 minutes before the surgical incision. In Group B (n=30) 0.5 mg/kg body weight of normal saline was injected. Post operative analgesia was maintained with on demand intramuscular pethidine 1.5 mg/kg body weight. The pain intensity was assessed at time 0 (immediately after arousal) and 6, 12, and 24 hours postoperatively using the 10 points visual analogue scale (VAS). Side effects like nausea, vomiting, delirium and hallucination were also recorded.
Results: For all of the evaluated times, the VAS score were significantly lower in Group A with ketamine compared to Group B with normal saline. The interval time for the first analgesic request was 22.9±6.8 (Mean±SD) minutes in Group A and 17.8±7.2 (Mean±SD) minutes in Group B and the difference was statistically significant (P=0.021). The total number of pethidine injections in first 24 hours postoperatively was 0.7±0.6 (Mean±SD) in Group A and 1.9±0.7 (Mean±SD) in Group B and the difference was statistically significant (P=0.037). The mean total cumulative amount of pethidine administered over 24 hrs period following the end of surgery in group A was 97.31±10.12 mg (Mean±SD) and in group B was 151.23±12.02 mg (Mean±SD) and the difference was statistically significant (P=0.008).
Conclusion: A low dose of intravenously administered ketamine had a preemptive effect in reducing pain after laparoscopic cholecystectomy.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 35-39
Audiometric Evaluation of Hearing Loss– A Study of 100 Cases
Authors: Asaduzzaman AKM , Rabbani Sarder Mohammad Golam , Islam Md Tauhidul , Hossain Mohammod Delwar , Alam Shafiul , Azad Muhammad Ali 
Published: June 2019

Introduction: Audiometry is the measurement of hearing acuity. If it is done by using pure tones then it is called pure tone audiometry. It is the most commonly used method for hearing measurement.
Objective: To find out the type and degree of hearing loss.
Materials and Methods: The cross sectional prospective study was carried out in the Audiology unit of the Department of Otolaryngology-Head and Neck Surgery, Combined Military Hospital (CMH), Dhaka, in a period of 06 months from o1.03.2016 to 31.08.2016 among those complaining hearing loss attending in this hospital. 100 cases of hearing impaired people were taken and the data were collected by interviewing the cases as per questionnaire from history, examinations and investigation reports.
Results: This study revealed that people of 21-30 years were most common sufferer of hearing loss and female was predominant (61%). The most common type of hearing loss was conductive type. In the right ear type of deafness were 46 cases (51.11%) of conductive type of deafness, 20 cases (23%) of mixed type of deafness and 17 cases (18.88%) of sensorineural type of deafness. In the left ear it was 53 cases (61.62%) of conductive type of deafness, 20 cases (23.25%) of mixed type of deafness and 13 cases (15.13%) of sensorineural type of deafness. This study showed that other ranks (ORs) families (45%) were commonest group of people. This study also revealed that Chronic suppurative otitis media (CSOM) (39%) was the commonest cause of hearing loss.
Conclusion: This study denoted that commonest type of hearing loss was conductive type, commonest degree of hearing loss was mild degree and commonest causes of hearing losses were CSOM and otitis media with effusion (OME). Since, these conditions are preventable. So, appropriate measures can prevent hearing impairment in this study group.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 30-34
Determination of Risk Behaviour and Health Problems among Rural Adolescents
Authors: Uddin Abu Noman Mohammed Mosleh , Jewel Mehedi Hasan 
Published: June 2019

Introduction: Adolescents are a large and growing segment of the global as well as the own population of a country. To invest in their health and development is actually investing in the greater wellbeing of the country as they constitute the nation’s core resource for renewal and growth.
Objective: To identify the risk behaviour, magnitude, sociodemographic, cultural and economic condition along with common health problems, knowledge about health, hygiene and treatment seeking behaviour among rural adolescents.
Materials and Methods: This descriptive type of cross sectional study was conducted in Baliati village, Saturia upazilla of Manikganj district and Mohashashi village, Dhamrai upazilla of Dhaka district for a period of three months starting from November 2015 to January 2016. Targeted population was 10 to 19 years of both sexes residing in the study place. The sample size was of 510 adolescents. Non-probability purposive type of sampling was followed for this study. Data was collected on a structured interview schedule containing close ended questions keeping in view the selected variables of the study.
Results: In the study, among 510 respondents 35.3% in the 10-12 years age group and majority respondents were males (66.20%). 12.74% were involved in life threatening activities. In most cases they cross busy traffic (20.9%) and quarrel mostly with any issue (23.2%). Only 1.17% adolescents were addicted. Among addicted respondents 66% took Cannabis/ Marijuana. Cause of taking drugs among addicted respondents was by imitating others (83%). Skin disease was observed in 18.6 % respondents. 95.9% adolescents take treatment when they become ill and most of them (53.5%) go to doctors for allopathic treatment.
Conclusion: The magnitude of risk behaviours and health problems is a signal to the society, non-government, government and other international organizations that needs timely and appropriate intervention programs.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 102-106
Aneurysm Characteristics of Patients Presented with Sub-Arachnoid Haemorrhage in Combined Military Hospital Dhaka and Detected at Digital Substraction Angiography
Authors: Alam Syed Zoherul , Islam Md Shafiqul , Alam Md Taharul 
Published: June 2019

Introduction: Digital Substraction Angiography (DSA) is the gold standard for proper diagnosis and further evaluation of intra cranial aneurysm. Intracranial aneurysm rupture leading to Subarachnoid hemorrhage (SAH) may be associated with serious neurological sequelae or even mortality. According to international literature, only aneurysm >7 mm or aneurysm in the posterior circulation require treatment. Retrospective single center studies have however, disputed that the average size of ruptured aneurysms are <7 mm.
Objective: To assess the aneurysm characteristics and demographics of patients who reported to CMH, Dhaka with SAH secondary to an aneurysm detected at Digital Subtraction Angiography (DSA).
Materials and Methods: This retrospective study was conducted among the patients who presented with SAH more than 3 year period, from November 2013 to April 2017. All patients had undergone CT scan of brain in the department of Radiology & Imaging and DSA in the Cath Lab of Combined Military Hospital (CMH), Dhaka. Data about aneurysm characteristics, size and patient demographics were obtained from patients files.
Results: A total of 74 patients underwent DSA and amongst them 32 patients had ruptured aneurysms. Ages ranging from 20 to 75 years (mean 45 years), little more male patients. The mean size of aneurysms was 5.8mm (range 1.2 mm to 20 mm) with 74.5% of aneurysms having size <7 mm. Most aneurysms were noted involving anterior circulation (72%) with the majority arising from the anterior communicating (ACom) artery (36.7%).
Conclusion: An aneurysm is an abnormal dilatation of an artery. It can be found in almost any age and can rupture at size <7 mm. Those are commonly located in the anterior circulation. Findings of this study emphasize the importance of conducting the institutional reviews, to consider adapting the international treatment guidelines.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 107-110
Study on Association between Chronic Idiopathic Urticaria and Helicobacter Pylori Infection in Armed Forces Personnel
Authors: Hasan Md Sayeed , Khan Md Shirajul Islam , Nayeem Jannatun 
Published: June 2019

Introduction: Chronic Idiopathic Urticaria (CIU) has an estimated prevalence of 35-65% and impacts 15 to 25% of the population at some point in their lives. Studies have shown the possible involvement of Helicobacter pylori (H. pylori) infection in chronic idiopathic urticaria (CIU), but the relationship remains controversial.
Objective: To quantitatively assess the association between H. pylori infection and chronic idiopathic urticaria.
Materials and Methods: This was a case-control type of analytical study and 100 patients were enrolled fifty patients of CIU fulfilling inclusion criteria with no identifiable cause were taken as case and patients without urticaria were taken as control, attending in the department of Dermatology & Venereology, CMH Dhaka for treatment from May 2015 to Aug 2016. Helicobacter pylori infection was confirmed by serum IgG for H. pylori test.
Results: The result showed that H. pylori infection significantly affected a high percentage of patients 30 (60%) with chronic idiopathic urticaria. Male respondents were more positive 16(53.3%) than female 14(46.7%), in the middle aged 31-50 year about 18(60%) and triple drug therapy was successful in 16(53.33%) patients in whom H. pylori was detected.
Conclusion: Urticaria is a common clinical disorder with complex triggering factors. Chronic urticaria has provided evidence that enteric infection with H. pylori may induce the disease. In this case control study, it was evident that chronic idiopathic urticaria was associated with positive serum IgG for H. Pylori. A trial of H. pylori eradication therapy may be offered to patients with CIU and evidence of H. pylori infection.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 122-126
Multi-Drug Resistant Chronic Myeloid Leukemia: Report of Two Cases and Review of Literature
Authors: Rahman Md Mizanur , Saha Debashish , Hossain Mohammad Rabiul 
Published: June 2019

Introduction: In the last one decade first generation tyrosine kinase inhibitor (TKI), imatinib mesylate was the choice of treatment in Chronic Myeloid Leukemia (CML) but recently, a considerable number of patients have developed resistance to first as well as second generation TKIs.
Objective: To present two cases which were first and second generation TKIs resistant and to review multidrug resistant CML.
Materials and Methods: Relevant articles and literatures were retrieved from different journals and web pages to find out the mechanism of development of drug resistance in chronic myeloid leukaemia.
Discussion: Two cases of drug resistant CML were found in Combined Military Hospital (CMH), Dhaka cantonment. Extensive review of the literature showed that two mechanisms, namely Breakpoint Cluster Region-Abelson (BCR-ABL) dependent and independent mechanisms, are mainly responsible for multi drug resistant (MDR) CML. In Bangladesh, it is difficult to identify the exact mechanism of development of drug resistance in CML. In a few cases, sample from CML patients are sent overseas to detect any new mutation in TKI binding domain of BCR – ABL fusion gene but it is not possible to find out other mechanisms responsible for drug resistance in CML.
Conclusion: To overcome the drug resistance in CML, it is important to use the conventional drugs used in the treatment of CML meticulously and regularly as irregular use and discontinuation of treatment will permit the development of drug resistance.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 135-140
Sporadic Creutzfeldt Jakob Disease: A Patient with Dementia and Involuntary Movement Myoclonus
Authors: Rahman Mohd Mozibor , Akhter Sanzida , Jabeen Noor E 
Published: June 2019

Creutzfeldt Jakob Disease (CJD) is an incurable, invariably fatal, rapidly progressive neurodegenerative disease caused by an abnormal isoform of a cellular glycoprotein known as the prion protein. CJD occurs worldwide, estimated annual incidence is about one case per million populations per year. Sporadic (sCJD) is a human prion disease; infection with this disease usually leads to death within one year of onset of illness. The characteristic clinical and diagnostic features of rapidly progressive dementia, myoclonus, visual or cerebellar signs, pyramidal and extrapyramidal signs, akinetic mutism and positive result on the presence of 14-3-3 protein in CSF assay, typical EEG features and MRI findings of brain are highly suggestive of diagnosis. Biopsy of brain for histopathological examination is more specific and confirmatory for diagnosis. This article reports a 65 years old lady of sCJD who was diagnosed by characteristic findings of MRI of brain, Electro-encephalography (EEG) and cerebrospinal fluid (CSF) assay at National University Hospital (NUH) Singapore and now admitted at United Hospital Limited (UHL) Dhaka for palliative and supportive management
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 141-144
Epidemiologic Features of Vulvovaginal Candidiasis in Women of Childbearing Age in a Combined Military Hospital
Authors: Nabi Syed Nurun , Rahimgir Md , Khan Arif Ahmed , Fatema Kaniz 
Published: June 2019

Introduction: Vulvovaginal Candidiasis is a reproductive tract infection which remains a common cause of morbidity adversely affecting women’s physical and emotional health. Vaginal discharge in the childbearing age group is the most common complaint encountered every day both by gynaecologists and general practitioners. Among the cases of symptomatic vaginal discharge, Bacterial vaginosis is the commonest cause followed by Candidiasis and Trichomoniasis. It is characterized by curd-like vaginal discharge and itching and is associated with considerable health and economic costs.
Objective: To detect the prevalence of Candida species in patients with complaints of vaginal discharge of reproductive age group attending at Child Welfare Centre (CWC), Gynaecology Outpatient Department (GOPD) and Medical Inspection Room (MI Room) of Combined Military Hospital (CMH) Ghatail.
Materials and Methods: A cross-sectional descriptive study was conducted at CMH Ghatail during the period of April 2017 to October 2017. A total of 183 patients of reproductive age group with the complaints of vaginal discharge attending CWC, GOPD and MI Room of CMH Ghatail were included in this study. Two specimens of High Vaginal Swabs (HVS) were collected from each patient, one for direct microscopy and another for culture. For every patient, two wet film preparations and two Gram’s staining were done. Specimens were cultured on Blood Agar Medium and Sabourad’s Dextrose Agar Medium. Identification of Candida species was carried out by Wet film, Gram’s staining and culture examination.
Results: According to the results of this study, the prevalence of Vulvovaginal Candidiasis (VVC) was found in 57(31.15%) of the cases. The maximum number of patients 126(66.66%) were found between 26 years to 35 years of age group. On the other hand, amongst 57 VVC positive cases, 44(77.19%)were identified as Candida albicans and 13(22.81%) were Candida non-albicans.
Conclusion: Candida albicans is the predominant organism amongst candida species identified from VVC in this study. The high prevalence necessitates adequate screening of woman with vaginal discharge in order to give appropriate treatment and to avoid complications associated with it.
Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 13-16
Pylorus-Preserving Pancreaticoduodenectomy: Evaluation of 50 Cases
Authors: Hossain SM Shakhwat , Rahman Ferdous 
Published: June 2019

Introduction: Pancreaticoduodenectomy is the procedure of choice for periampullary neoplasms. It is considered as a major surgical procedure. It is associated with relatively higher postoperative mortality and morbidity rate, however, with development of technology, proper patient selection, meticulous operative technique, appropriate postoperative care, morbidity and mortality rate has decreased subsequently. Up to the 1970s, the operative mortality rate after pancreaticoduodenectomy approached 20% but it has been reduced to less than 5% in recent reports. This study is designed to evaluate the postoperative outcomes of pylorus-preserving pancreaticoduodenectomy procedure in our set up.
Objective: To evaluate the outcome of the pylorus-preserving pancreaticoduodenectomy procedure with the intention to measure operation time and per-operative bleeding, observing postoperative anastomotic leakage and gastric emptying time. To find out postoperative wound infection and complications to detect the dumping syndrome.
Materials and Methods: A prospective observational study was carried out in the Department of Hepatobiliary Surgery, Combined Military Hospital, Dhaka from July 2013 to January 2017. Fifty patients who underwent pylorus-preserving pancreaticodudenectomy procedure were included in this study.
Results: Out of 50 postoperative patients, 12(24%) patients developed complications. Of these patients, 3(6%) developed wound infection, 2(4%) developed bile leakage and 2(4%) developed postoperative haemorrhage. Pancreatic fistula, vomiting, delayed gastric emptying and abdominal collection all were 1(2%) each. Postoperative mortality was 3(6%).
Conclusion: The present study demonstrated the development of postoperative complications after pylorus-preserving pancreaticoduodenectomy is as similar as published in different studies. Better outcome can be achieved with meticulous pre-operative evaluation of risk factors and per-operative skill maneuvering.
Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 42-45
Clinical Presentation of Cholesteatoma- A Study of 50 Cases
Authors: Khan Md Ahsanuzzaman , Asaduzzaman AKM , Islam Md Tauhidul , Ahmed Bashir , Hossain Mohammad Kamal , Sumon Mohammad Misbah Al Kabir , Rabbani Sarder Mohammad Golam 
Published: June 2019

Introduction: Cholesteatoma is an abnormal accumulation of keratin-producing squamous epithelium in the middle ear, epitympanum, mastoid or petrous apex. It is a threedimensional epidermoid structure exhibiting independent growth, replacing middle ear mucosa, resorbing and replacing underlying bone. Although it is not a neoplastic lesion, it can be insidious and potentially dangerous to the patient.
Objective: To find out the socio-demographic pattern, clinical presentation and complication of cholesteatoma.
Materials and Methods: This prospective study of 50 cases was done in the Department of Otolaryngology and Head-Neck surgery, CMH, Dhaka adopting simple random sampling technique from July 2008 to Dec 2009. Data were collected by personal interview and clinical examination in a pre-designed data sheet and were analyzed by SPSS 20.
Results: In this study, the highest number of patients (44%) was in the age group 11-20 years with a mean age of 17.2 years. Male were more affected (70%) and the male to female ratio was 2.33:1. Commonest symptom was otorrhoea (100%), followed by hearing impairment (80%), otalgia (16%), postauricular painful swelling (12%) and postauricular discharging sinus (10%). Extracranial complications were in 26% and intracranial complications in 12% of patients in this series. Abscess (temporal lobe + extra dural) were found in 02 cases (10%) by CT scan. A maximum number of patients had moderate conductive deafness (74.47%) followed by mild conductive deafness (19.15%) and only a few with severely mixed deafness (6.38%).
Conclusion: Clinical presentation of cholesteatoma in this study was discharge and deafness. The discharge was thick purulent foul smelling, scanty, occasionally blood-stained. Grave intracranial complications in children developed because of illiteracy, poverty, lack of awareness and medical facilities mostly in the rural areas. So early diagnosis and prompt treatment was a necessity.
Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 66-70
Management of Zygomatico-Maxillary Complex Fracture in Military Dental Centre, Dhaka: A Study of 40 Cases
Authors: Sindhi Quazi , Chowdhury Golam Mohiuddin , Rab Md Abdur , Haque Md Emdadul , Mahmud Manjur E , Hossain Mohammad Tofazzal 
Published: June 2019

Introduction: Zygomatic bone is closely associated with the maxilla, frontal, temporal bones which are usually involved when a zygomatic bone fracture occurs. The most common causes of these fractures are from the assaults, road traffic accidents and falls. Aesthetic beauties and functions are greatly hampered with the displacement of the fractured fragments.
Objective: To analyze the aetiology, clinical presentations, surgical intervention and complications associated with zygomatic complex (ZC) fractures in a tertiary level healthcare facility.
Materials and Methods: This descriptive observational study was carried out in the Oral and Maxillofacial Department, Military Dental Centre, Dhaka during the period of January 2016 to December 2016. Data were obtained from clinical notes and surgical records of the patients using standardized data collection form specifically designed to examine the variables and features of zygomatic complex fractures.
Results: Road traffic accidents were the leading cause (75%) of zygomatic fractures. The mean operation time was found 99.5±31.2 minutes with a range from 60 to 125 minutes. Open reduction and two-point internal fixation were employed in more than two-third (67.5%) of the cases. Four (10.0%) patients developed postoperative complications; among them 2(5.0%) cases suffered paresis of temporal branch of facial nerve and trismus. Other complications included paraesthesia, ectropion, scar and palpability of plate. Twenty-five (62.5%) patients were found having limited mouth opening preoperatively and postoperative improvement occurred in 21(52.5%). Thirty three (82.5%) patients had facial asymmetry preoperatively and postoperative improvement occurred in 29(72.5%).
Conclusion: More than two-third of the patients received two point fixations. Only four patients out of forty in this study were found having post operative complications. The functional and Aesthetic outcome was found to be fair in terms of improvement in limitation of mouth opening and correction of facial asymmetry.
Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 71-74