bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Palliative Radiotherapy Between 20 Gy in 5 Fractions and 30 Gy in 10 Fractions in Superior Vena Cava Syndrome Due to Carcinoma of Lung
Authors: Masud Md Rakibul Islam , Haque Md Nizamul , Khan Mojibur Rahman , Tuly Badrun Nahar , Husna Md Golam Zel Asmaul , Alam Saiful 
Published: February 2023

A quasi-experimental study was conducted to compare palliative radiotherapy between 20 Gy in 5 fractions and 30 Gy in 10 fractions in superior vena cava syndrome due to carcinoma of lung. This study was done in National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh, from September 2017 to August 2018. A total of 60 patients were enrolled in the study – 30 in each group. In Arm A, patients received 20 Gy in 5 fractions in 1 week, while in Arm B, patients received 30 Gy in 10 fractions in 2 weeks. Every patient was evaluated routinely to see the treatment outcome and toxicities. The mean age of Arm-A was 57.53±5.5 years and that of Arm-B was 57.40±5.4 years. After treatment, improvement of symptoms (e.g., edema, venous distension, dyspnea) of SVCS was observed. After 1 month of radiotherapy, complete resolution of venous distension occurred in majority of the patients (73.3% vs. 80%) and partial resolution occurred in rest of them (26.7% vs. 20%) in arms A and B respectively. Most of patients showed complete resolution of edema (83.3% vs. 86.7%), while few had partial resolution (16.7% vs. 13.3%) in arms A and B respectively. Symptoms of SVCS did not recur in any of the patients of both arms. Performance status also improved in all patients. Assessment of tumor response at the last follow-up showed partial response in 66.7% patients of Arm-A and 73.3% patients of Arm-B. Stable disease was observed in 33.3% patients of Arm-A and 26.7% patients of Arm-B. None of the patients showed disease progression. Toxicities included dysphagia (26.7% vs. 33.33%), fatigue (23.33% vs. 20%), nausea and vomiting (16.67% vs. 20%) and skin reaction (16.67% vs. 13.33%) in Arm-A and Arm-B respectively. All of those toxicities were grade-1 and easily controlled. There was no statistically significant difference between two treatment groups in terms of palliation of symptoms of SVCS, tumor response and toxicities. To summarize, although tumor response was not much satisfactory, both 20 Gy in 5 fractions and 30 Gy in 10 fractions are equally effective radiotherapy regimens in palliation of symptoms of SVCS due to lung cancer with tolerable toxicities. Hence, 20 Gy in 5 fractions can be a reasonable treatment choice in a resource-poor country like Bangladesh.
CBMJ 2023 January: Vol. 12 No. 01 P: 33-40
Phenotypic and Genotypic Characterization of Salmonella Typhi isolated from Human Blood with Distribution of Virulence Genes and Sequencing
Authors: Dola Nigha Zannat , Shamsuzzaman SM , Islam Md Saiful , Rahman Asma , Mishu Nafisa Jabin , Nabonee Modina Ansary , Jalil Rafia Afreen 
Published: February 2023

A cross-sectional study was conducted in the Department of Microbiology at tertiary care hospital in Bangladesh from July 2019 to June 2020, to see the phenotypic and genotypic characterization of Salmonella Typhi isolated from human blood with distribution of virulence genes and sequencing. Clinically suspected enteric fever patients irrespective of age and gender who attended either the Department of Microbiology or Medicine out-patient department (MOPD) in a tertiary level hospital in Bangladesh for blood culture and sensitivity test were included in this study. The positive growth S. Typhi was identified by gram straining, colony morphology and biochemical test. Then Salmonella Typhi was identified by using Salmonella specific antisera. Final identification was done by using 16s Rrna by PCR. Virulence factors like hemolysin and siderophore was detected by siderophores production assay. PCR and sequencing of virulence genes were done. A total number of 50 isolated organisms were identified as Salmonella species of which Salmonella Typhi was detected in 40 (48.2%) isolates. Among 40 isolated Salmonella Typhi, no Salmonella Typhi produced hemolysin and 30 (75.0%) isolates have ability to produce siderophore. Among the isolated Salmonella Typhi all isolates 40 (100%) were positive for viaB and staA gene, 21 (52.5%) were positive for iroB. Sequencing of viaB and iroB were done for further validation. In conclusion all isolated Salmonella Typhi carried viaB and staA, iroB genes were responsible for S. Typhi pathogenicity.
CBMJ 2023 January: Vol. 12 No. 01 P: 41-47
Knowledge, Attitudes of Preclinical Medical and Dental Students in Mymensingh towards “COVID-19”: A Cross-sectional Study
Authors: Nazrina Sayeda , Naznin Rubiat 
Published: February 2023

In 2020, a new global pandemic Coronavirus disease (COVID-19) emerged, which was caused by a new strain of coronavirus called severe acute respiratory syndrome-corona virus (SARS-COV-2). This study aims to assess the knowledge and attitudes towards COVID-19 among preclinical medical and dental students of Community Based Medical College (CBMC,B) in Mymensingh, Bangladesh. Data were collected in September 2020. The online questionnaire was created using Google Forms after reviewing previously conducted research and posted on several online platforms accessible by the students. Most of the students (93%) were medical students, and the rest 7% were studying Bachelor of Dental Surgery (BDS). The mean COVID-19 knowledge score was 9.04 (SD: 2.107, Range: 0-12), suggesting an overall 75.33% correct rate. The results showed that knowledge scores are higher in male, MBBS students but the difference are not significant. Analyses showed that the knowledge scores of 1st-year participants were significantly higher than 2nd-year students. Increased knowledge score was noticed in those who were not in direct contact with COVID-19 patients and not infected by COVID-19 than others, though the difference was insignificant (P>0.05). Half of the participants (50.2%) agreed that this disease will finally be successfully controlled. One hundred and sixty-seven participants (65%) had confidence that Bangladesh would get a vaccine soon to prevent the COVID-19 virus. The overall knowledge level of students was generally good. As the global threat of COVID-19 continues to emerge, improvement of knowledge and perceptions among healthcare students is essential.
CBMJ 2023 January: Vol. 12 No. 01 P: 53-59
Type 1 Tympanoplasty by Interlay Technique for Management of Tympanic Membrane Perforation
Authors: Biswas Binoy Krishna , Khan Manjurul Karim , Gupta Subir 
Published: February 2023

Tympanic membrane is the partition between the external ear and middle layer which is a vital component of the human ear. Neglected or maltreated earache, ear discharge and trauma lead to perforation of tympanic membrane. Tympanoplasty is the surgical procedure performed to repair a perforated tympanic membrane, with/without reconstruction of the ossicles, with the aim of preventing reinfection and restoring hearing ability. Type 1 tympanoplasty is the simple closure of the tympanic membrane perforation. To study the outcome of type 1 tympanoplasty operation by interlay technique, a descriptive longitudinal study was conducted among 200 patients in Community Based Medical College Hospital and in private clinics of Mymensingh from January 2012 to December 2021. Our inclusion criteria was population of age ranging from 15 to 55 yrs of both sexes having dry central perforation for at least 6 weeks and exclusion criteria was patient with active stage of chronic suppurative otitis media (CSOM), ossicular discontinuity, sensory neural hearing loss. Data was analyzed by SPSS version 20.0. Prevalence of taking graft was 96.00%. Measured by difference of preoperative air bone gap (ABG) and postoperative ABG of 15 decibel (dB) hearing improvement rate was 90%. Complication was minimal (1%). The complication was infection due to non-compliance with postoperative advice and treatment. Type 1 tympanoplasty done by interlay technique has excellent results both in terms of graft taken and hearing improvement with minimal complications.
CBMJ 2023 January: Vol. 12 No. 01 P: 67-72
Effect of Pregabalin on Succinylcholine Induced Fasciculation, Myalgia and Hyperkalemia in Spine Surgery
Authors: Iqbal Mohammad Jahid , Mahabuzzaman Mohammad , Hossain Gisan , Kabir Mohammod Humayan , Haider Md Ali , Bhowmick Lipon Kanti 
Published: February 2023

A randomized control trial was done between January and December of 2018, in the Department of Anaesthesia, Analgesia, Palliative & Intensive Care Medicine of Dhaka Medical College Hospital, Bangladesh, to evaluate the preventive effect of pregabalin on succinylcholine induced adverse effects, i.e., fasciculation, myalgia and hyperkaliemia in spine surgery. Sixty patients of elective spine surgery under general anaesthesia were selected and divided into two groups. Pregabalin 150 mg was given to one group and matching placebo was given to another group orally with sips of water one hour before surgery. Succinylcholine 1.5 mg/kg was given after induction agent. Muscle fasciculation was observed just after succinylcholine administration. Serum potassium was measured 5 minutes before induction and 5 minutes after succinylcholine administration. After completion of surgery reversal was given. Time of first analgesic demand was recorded. Injection Morphine 0.15 mg/kg intramuscular was given when patient complained about pain. Myalgia (muscle pain not associated with surgery) was observed 24 hours after anaesthesia and total morphine consumption was recorded. Use of pregabalin 150 mg one hour before surgery reduced the severity of fasciculation and the incidence and severity of postoperative myalgia. It also reduced the rise of serum potassium concentration after succinylcholine administration though the rise was within normal limit. Pregabalin also reduced the total opioid consumption after surgery.
CBMJ 2023 January: Vol. 12 No. 01 P: 73-80
Correlation of Serum Vitamin D and Calcium Levels between Outdoor and Indoor Working Professionals in Dhaka City, Bangladesh
Authors: Tasrin Tarana , Ferdousi Shahnila , Sultan Md Kamal , Mozaffor Miliva 
Published: February 2023

A cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh, from July 2018 to June 2019, to compare serum vitamin D levels and observe its correlation with serum calcium levels among the outdoor and indoor working professionals. A total of 101 indoor and outdoor workers of different sectors living in Dhaka city participated in this study. All study subjects were divided into two groups: outdoor workers were in group A (n=35) and indoor workers were in group B (n=66). Estimation of serum vitamin D3 was done by chemiluminescent microparticle immunoassay, while serum calcium was measured using Arsenazo-III dye method. The mean age of the study participants was 38.72±6.88 years, ranging between 25 and 52 years. Among the study participants, 64(63.4%) were male and 37(36.6%) were female. Among outdoor workers, most were from Traffic Police Services (83%) and the rest were street hawkers (17%). Indoor workers were recruited from the hospital – nurses (32%), doctors (27%), administrative employees (21%), hospital ward assistants (12%) and medical technicians (8%). Serum vitamin D3 level was found higher in outdoor workers than that of indoor workers (19.35±5.67 ng/ml vs. 14.17±4.18 ng/ml) and the difference was statistically significant (P<0.001). Serum calcium level was lower in outdoor workers than that of indoor workers (8.82±0.54 mg/dl vs. 9.08±1.08 mg/dl); however, the difference was not statistically significant (P>0.05). Moreover, no significant correlation was observed between serum vitamin D and calcium levels in both outdoor (r= – 0.117; P=0.510) and indoor (r= – 0.163; P=0.196) groups.
CBMJ 2023 January: Vol. 12 No. 01 P: 87-92
Mothers’ Experience and Perceived Barriers to Practice Healthy Feeding to Their School Going Children
Authors: Shahrin Tunazzina , Paul Bijoy Kumer , Sharmin Saida , Begum Munira , Jahan Nusrat , Nusrat Farzana , Rahman Moyeedur 
Published: February 2023

A cross-sectional study was conducted between January and December of 2018 in some randomly selected schools under Dhaka City Corporation, Bangladesh, to examine mothers’ experience and their perceived barriers to practice healthy feeding to their school going children. We adopted convenient sampling technique. A total of 120 mothers participated in this study who had children aged between six and eight years. A pre-tested, semi-structured questionnaire was used for data collection. Questionnaire was formatted in both Bangla and English language. However, the participants chose Bangla version for filling up the survey questionnaire. A modified Likert’s scale was used. Socio-demographic variables, mothers’ feeding practice and perceived barriers were analysed using descriptive statistics. 58.2% of the participants belonged to 30-35 years age group, while 41.8% to 36-40 years age group. Among them, higher secondary passed 3.4%, while 35.3% had their university graduation, and 61.3% completed postgraduation. 6.7% had poor economic status, while 73.3% were semi-elite and 20% were from elite income group. Among them, 75% were Muslim, 14.2% Hindu, 7.5% Christian and 3.3% Buddhist. 21.7% of the mothers found availability of healthy food as 'very easy' and 66.7% found it 'easy', while 9.2% found it 'difficult'; only 2.5% found it 'very difficult'. Only 11.6% of the mothers found preparation of healthy meal inconvenient, while 71.7% found it convenient and 16.7% found it very convenient. Regarding taste of a healthy meal, 2.5% reported as 'very monotonous', 37.5% as 'monotonous', 54.2% reported as 'charming' and only 5.8% stated it as 'very charming'. Preparation cost of a healthy meal was reported as costly by only 15.8% of the mothers, while cost effective by 76.7%, and very cost effective by the rest 7.5%. 42.4% of the mothers stated that their children have the habits of taking meal sitting with the family members, while 48.8% were fed while watching TV, and 8.8% reported that they fed their children while they were playing. Only 37.5% of mothers reported that their children found it pleasant taking healthy food. Regarding time spent on feeding the children, 17.5% stated 'very time consuming', while 68.3% stated 'time consuming', and only 14.2% found it 'timesaving'. Only 20.8% of mothers reported that they could conveniently feed their children healthy food. Difficulties experienced by the mothers were strong aversion (15.8%), fast food preference (22.5%), varieties of food preference (61.7%).
CBMJ 2023 January: Vol. 12 No. 01 P: 93-98
Comparison between Effects of Midazolam and Dexmedetomidine as Sedative in Elective Caesarean Section under Spinal Anaesthesia
Authors: Karim Md Enayet , Rashid RAM Mustafijur , Akram Mohammad Saleh , Ershad Reza 
Published: February 2023

This randomized clinical trial compares midazolam and dexmedetomidine in terms of onset and recovery of sedation, haemodynamic effects, respiratory effects, and adverse effects of both the drugs in elective Caesarian section under spinal anaesthesia. The study included 60 ASA grade-I patients between age 20- and 40-years undergoing elective Caesarean sections under subarachnoid anaesthesia, from January 2022 to June 2022. Patients were randomly allocated to one of the two groups: midazolam group (Group-I, n=30), who received midazolam in a single dose of 0.10mg/kg and Dexmedetomidine group (Group-II, n=30), who received dexmedetomidine in a single dose of 2mcg/kg. Spinal anaesthesia was conducted by injecting a hyperbaric solution of 0.5% bupivacaine 3ml through a 25G spinal needle at L3-4 level. All parameters were documented at 5-minute intervals until arousal of the patient. The onset of sedation i.e., time from IV (intravenous) injection of Midazolam or Dexmedetomidine to closure of eye lids (OAA/S score of 3) and the arousal time from sedation i.e., time from closing of the eye lids to OAA/S score of 5 (patient is awake clinically) were noted. Any complication during operation was documented. The patient’s satisfaction with the sedation was assessed by the 5-point ‘Likert verbal rating scale’. There was no significant difference of mean blood pressure and mean heart rate between the two groups at different time intervals (P>0.05). Time of onset of sedation was significantly delayed in dexmedetomidine group (P<0.05). Duration of sedation was comparable between the two groups (P>0.05). Incidence of peroperative complications were comparable between the two groups (P>0.05). Haemodynamic effects and adverse effects of two drugs were comparable. Therefore, it is recommended that either midazolam or dexmedetomidine can be used for sedation in single dose technique during subarachnoid block for Caesarean section.
CBMJ 2023 January: Vol. 12 No. 01 P: 99-106
When Small Bugs Cause Big Problems: Tropical Insect Bite Led to Myocarditis
Authors: Habib SM Ahsanul , Mohammad Taneem , Alam Mohammad Ashraful 
Published: February 2023

Wasp bite induced allergic reactions or organ dysfunctions are not uncommon in tropical countries. Most people affected with insect bite hardly develop any signs or symptoms; however, about 30 percent of them may show signs of illness which is often overlooked and causes fatality. Among the fatal complications specially anaphylaxis and renal dysfunction have been reported; however, myocardial involvement in the form of myocarditis is very rare. Awareness about such complications is important as these affect the clinical course and outcomes of the patients. We have presented a case of wasp bite induced myocarditis and heart failure here, which was diagnosed at a later stage as patient did not improve being admitted in the emergency department and subsequently transferred to the critical care unit.
CBMJ 2023 January: Vol. 12 No. 01 P: 107-110
Renal Impairment in a Patient with Multiple Myeloma: A Case Report
Authors: Hasan Mahmud Javed , Ray Nitai Chandra 
Published: February 2023

Multiple myeloma (MM) is a type of cancer occurs due to malignant plasma cell that affects with various clinical manifestations including renal impairment, anemia, bone disease and infection. The most common renal presentation of multiple myeloma is myeloma cast nephropathy. We described a case of multiple myeloma along with renal impairment in a 62-year old male patient. His serum B2-Microglobulin was 19.18 mg/L, which is much higher than reference value. His serum creatinine was 2.58 mg/dL. After continuing medication, the patient’s renal function was restored. This case is being reported for clinical knowledge dissemination and building clinical insight.
CBMJ 2023 January: Vol. 12 No. 01 P: 111-114
Peutz–Jeghers Syndrome: A Rare Genetic Cause of Intestinal Obstruction
Authors: Rana Abunur Md Masud , Haque Taufiqul , Dew Kallol Chandra 
Published: February 2023

Peutz–Jeghers syndrome (PJS) is a rare autosomal dominant disorder. The mutation is found in the serine threonine kinase (STK11)/ liver kinase B1 (LKB1) gene on chromosome 19. It impacts 1 out of 50000–200000 individuals. Clinical menifestations include hyperpigmented lesion in oral cavity, lips, fingertips and perianal region. Abdominal pain, Anaemia, Gastrointestinal (GI) bleeding, GI polyp, Intestinal obstruction (mostly due to intussusception) and malignancy are closely interlinked with the disease. We present a 21 years old lady with characteristic hyperpigmented lesions in lips and fingertips with multiple polyps in the GI tract. The patient was presented in general emergency department with abdominal pain and vomiting. Detail workout revealed the diagnosis as PJS. We have plotted the diagnosis according to the WHO criteria due to the lacking of genetic analysis facility. Patients with PJS are at high risk of intestinal and extraintestinal malignancy. Early diagnosis and polypectomy along with surveillance for recurrence may prolong cancer free lifetime.
CBMJ 2023 January: Vol. 12 No. 01 P: 115- 120
Erythema Induratum of Bazin: A Rare Finding in an Old Woman with Subcutaneous Nodules in the Lower Limbs
Authors: Islam Nahida , Islam Md Shahidul , Sharmeen Atia , Sarker Susthir 
Published: February 2023

Erythema induratum of Bazin (EIB) is a chronic nodular eruption that frequently occurs on lower legs of young or middle-aged women. The clinical manifestations of EIB revealed various dermatological disorders that can be easily leads to misdiagnosis. We report a case of a 50-year-old woman who initially presented with EIB. The histopathological specimen was collected from her medial aspect of let leg. The epidermis is unremarkable. The dermis shows fibro fatty tissue, skin adnexae and foci of granuloma with Langhans type of giant cells and some lymphocytic infiltration in the deep dermis which was suggestive of erythema induratum. Her lesions responded to antitubercular therapy (ATT). This case study may help extend the therapeutic regimens for cutaneous tuberculosis.
CBMJ 2023 January: Vol. 12 No. 01 P: 121-123
Health Literacy: Intervention and Outcome in Child Healthcare in Bangladesh
Authors: Sharmin Saida , Nurunnabi Abu Sadat Mohammad , Ashique Shamsi Sumaiya , Jahan Asmay , Begum Munira 
Published: February 2023

Bangladesh made significant improvements in child healthcare and achieved its Millennium Development Goal (MDG) 4 (to reduce child mortality). In 2010, the United Nations recognized Bangladesh for its exceptional progress towards MDG 4 to reduce child and maternal mortality in the face of many socioeconomic challenges. We are also committed to achieve our Sustainable Development Goal (SDG) by 2030. Health education department of Government of Bangladesh prioritized several essential health interventions over the past decades. There were focuses on expanding immunization, tackling diarrhoea and pneumonia, vitamin A campaign, prevention of blindness, iodine deficiency, and improving adolescent health. These programmes and strategies were scaled-up nationwide. The government along with its stakeholders promoted widespread availability and affordability of those health literacy interventions with an emphasis on community-based approaches. As a result, inequities in coverage of specific interventions declined; this may explain the improvements seen amongst even the most disadvantaged populations of the country. Media campaigns played a great role, which were undertaken in Bangladesh for decades and involved a nationally broadcast television supported by radio, television, newspaper, and billboard advertisements and local promotion activities. We expect that ongoing public private partnerships (PPPs) in which the government contracts NGOs and the private sector will enable us greater success and coverage of health information and literacy services throughout the country.
CBMJ 2023 January: Vol. 12 No. 01 P: 124-128