bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etiological Spectrum of Diseases Among the Patients Presenting with per Rectal Bleeding Attending at Surgery Outpatient Department in a Tertiary Level Hospital
Authors: Mahmud Mayin Uddin , Hossain Md Motahhar , Ghosh Ajoy Kumer , Reza Roksana 
Published: July 2023

Background: Per rectal bleeding is a problem that is frequently encountered by doctors. There is marked geographical variation in the frequency of different etiologies. This study was conducted to determine the frequency of various causes of per rectal bleeding in patients attending in a tertiary level hospital in Chittagong, Bangladesh.
Materials and methods : It was a retrospective study, and non-probability purposive sampling was done. All the patients over ten years of age presenting at the Surgery Outpatient Department with the complain of per rectal bleeding were included. A total of 685 patients were included in this study over a period of 2 years.
Results: Mean age of the patients was 36 ± 13 (Mean ± SD) with a range of 10-82 years. Male-female ratio was 1.5:1. Haemorrhoids were the most common cause (34.6%) of per rectal bleeding, followed by chronic anal fissure (26.1%), chronic anal fissure with haemorrhoids (14.9%), colorectal polyps (11.4%) colorectal cancer (8.3%) and Inflammatory Bowel Diseases (IBD) (0.9%). No cause of per rectal bleeding was found in 3.8% of patients. Maximum patients with colorectal cancer presented in their fifth and sixth decades of life.
Conclusion: Haemorrhoids and fissures in ano are the most common causes of per rectal bleeding in our setting. However, the number of colorectal polyps and colorectal cancers are not negligible.
JCMCTA 2022 ; 33 (1) : 9-14
Neonatal Outcome of 100 Cases of Term Pregnancy Having Meconium Stained Liquor in a Tertiary Level Hospital
Authors: Azmi Nusrat Sultana , Nasrin Begum 
Published: July 2023

Background : Presence of meconium in amniotic fluid is potentially a serious sign of fetal compromise and associated with an increased perinatal mortality and morbidities.Meconium stained amniotic fluid is considered a harbinger of fetal compromise because of its direct correlation with fetal distress and increased likelihood of aspiration of meconium with resultant deleterious effects on the neonatal lung. The purpose of the study was to find the neonatal outcome of pregnancy associated with meconium staining amniotic fluid. Outcome variable were birth weight, Apgar score, admission in NICU, neonatal complications, neonatal mortality and morbidity.
Materials and methods : The present prospective observational study was conducted in the Department of Obstetrics and Gynaecology in Bangabandhu Sheikh Mujib Medical University, Dhaka and Dhaka Medical College Hospital. A total of 100 pregnant women admitted in the labour ward with meconium stained liquor were the study population.
Results : Nearly three-quarter (72%) of the patients were between 20 – 30 years followed by 17.2% more than 30 years and 10.8% below 20 years old. Over half (52.2%) of the neonates needed resuscitation and 58.7% had to be admitted in ICU. More than 90% of the neonates had normal birth weight and only 9.7% were of low birth weight. Over half (51.1%) of the neonates developed meconium aspirate syndrome and 10.5% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 5.4%, 4.3% neonates respectively. Ten neonates (10.5%) died early in the neonatal life, while 1(1.1%) was still-born. low APGAR score (< 7) at 1 and 5 minutes of birth was found in 63.6% and 53% of the cases respectively with thick meconium stained amniotic fluid as opposed to 26.3% and 17.7% of the cases respectively having thin meconium stained amniotic fluid (p = 0.002 and p = 0.014 respectively). Thick meconium tend to be associated with meconium aspiration syndrome (p < 0.001). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the latter group (p < 0.001). The incidence of perinatal death was significantly higher in patients with thick meconium stained fluid than that in patients with thin meconium (p = 0.029).
Conclusion : The study concluded that meconium stained amniotic fluid is associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death and their severity depends on the concentration of meconium.
JCMCTA 2022 ; 33 (1) : 15-20
Retrospective Analysis of Neck Masses Diagnosed by Histopathology from Chattogram General Hospital
Authors: Chowdhury Pankaj Kumar , Ahmed Asfaq , Uddin Ahmed SM Tareq , Erfan Uddin Rabiul Alam Md , Biswas Supran 
Published: July 2023

Background: Neck masses are found in all age groups from many causes, ranging from congenital to acquired pathology. There is a wide variation in the presentation of neck masses concerning its site of origin, clinical presentation, and the nature of the progression of the disease. This study was performed to have an idea about the prevalence of various neck masses according to age and sex so that it would help us in diagnosing the neck masses.
Materials and methods: This retrospective study was performed in the Department of Otolaryngology and Head Neck Surgery, Chattogram General Hospital, Chattogram from July 2018 and June 2019, over 97 patients presented with neck mass.
Results: Of 97 cases 69.1% were female and range from 7-77 years. The maximum case holding age group was 21- 30 years (26.8%). The histopathological diagnosis of the neck masses was inflammatory in 68 (70.1%), congenital in 5 (5.2%) and neoplastic in 24 (24.7%) cases. Chronic granulomatous lymphadenitis was the most common inflammatory lesion (50.5%) and a branchial cyst was the most common congenital mass (2.2%). Neoplastic masses were malignant in 10 (10.3%) and benign in 14 (14.4%) cases. The most common malignant neoplastic mass was a follicular carcinoma (6.2%), and the most common benign neoplastic mass was goitre (12.4%).
Conclusions: Cervical lymphadenopathy was the most commonly encountered neck mass. Most of the neck masses are benign. Out of these cervical lymph nodes, tubercular lymphadenopathy was most common.
JCMCTA 2022 ; 33 (1) : 21-24
Outcome of Conventional Linear Versus Purse String Skin Closure of Intestinal Stoma Reversal
Authors: Mostafa Faisal , Bhuiyan Md Nur Hossain , Banik Sreekanta Chandra , Akter Sadia , Abedin Mohammad Ahsanul , Muhsin Syed Md 
Published: July 2023

Background: Stoma closure is one of the most frequently performed surgery. The common complications are surgical site infection (SSI) and poor scar cosmesis. Compared to the conventional linear closure, the pursestring closure technique is expected to have less wound infection, smaller size scar and good patient satisfaction. The aim of this study is to evaluate the feasibility of PSC of stoma site at a tertiary hospital and comparing it with LC of stoma.
Materials and methods: This study was performed in the Department of General Surgery, Chittagong Medical College Hospital for a period of one year with a sample size of 72. About 36 subjects were enrolled in each group, Group-A (Linear closure) and Group-B (Purse string closure). Each patient of both group were observed for wound infection, post-operative pain, scar formation, patient satisfaction, and length of post-operative hospital stay.
Results: The level of pain according to VAS score was 4 in 36 (100.0%) in Group A and 6(16.7%) in Group B. One third (33.3%) patients had wound infection in Group A and 4(11.1%) in Group B. The mean duration of hospital stay was 9.72±3.46 days in Group A and 7.97±2.46 days in Group B which is statistically significant (p<0.05). The mean patient satisfaction score was 17.75±1.59 in Group A and 22.12±0.73 in Group B which is statistically significant (p<0.05). The mean patient scar assessment scale was 42.47±0.99 in Group A and 35.88±2.81 in Group B which is statistically significant (p<0.05). The mean observer scar assessment scale was 41.97±1.28 in Group A and 36.22±2.73 in Group B which is statistically significant (p<0.05).
Conclusion: Purse-string skin closure for stoma reversal had significantly less incidence of surgical wound infection, improved the scar outcome, good patient satisfaction, reduce complications and better cosmesis.
JCMCTA 2022 ; 33 (1) : 25-28
Variation of Carrying Angle of Elbow in Relation to Age, Sex and Dominant Arm in Adolescent Bangladeshi Population
Authors: Chowdhury Urmila , Ashrafuzzaman Md , Bhowmik Baishakhi , Hossain Mohammad Monir , Chowdhury Raju , Sumaiya Sarah Fatima 
Published: July 2023

Background: Elbow carrying angle changes with skeletal growth and maturity, helps in carrying objects and keeps upper limb away from pelvis during movement. Variation of carrying angle value has been observed in relation to age, gender, and some selected anthropometric parameters. Present study was aimed to evaluate the carrying angle in normal adolescents of Bangladesh in relation to age, gender, and hand dominance.
Materials and methods: This cross-sectional observational study was conducted in the Department of Anatomy, Chittagong Medical College, Chattogram, upon 100 male and 100 female adolescents (10-19 years) by dividing them into two groups (Group A: 10-15 years, Group B: 16-19 years) and all were right hand dominant. Recorded data were analyzed by using SPSS version 25. For statistical analysis unpaired student’s ‘t’ test was done. p value was considered significant if it was <0.05 at 95% level of confidence.
Results: Carrying angle of both sides was significantly higher in age group 16 to 19 years and in female (p<0.001) also significant greater value found in dominant hand (p<0.001).
Conclusion: Knowledge of normal carrying angle value is important for management of elbow fracture, designing of total elbow prosthesis, and differentiation of sex in skeletal remain in medicolegal purpose.
JCMCTA 2022 ; 33 (1) : 29-33
Efficacy and Safety of Levofloxacin Prophylaxis During Induction Therapy for Childhood Acute Lymphoblastic Leukemia
Authors: Urmi Rehnuma , Maayenu  , Das Nabanita , Salma Quazi Saminah , Karim A K M Rezaul , Jahangir Selim Md , Samad Rasheda 
Published: July 2023

Background: Infection related complications represent an important cause of morbidity and mortality in pediatric cancer patients, especially in those receiving chemotherapy. Although antibiotic prophylaxis is used in adult leukemic patients, but it is less practiced in pediatric cancer patients. The aim of this study was to evaluate the efficacy and safety of Levofloxacin prophylaxis to reduce infection which occur during induction phase of chemotherapy among pediatric Acute Lymphoblastic Leukemia (ALL) patients.
Materials and methods: This single centered, pilot study in RCT design was conducted in Pediatric HematoOncology Department of Chittagong Medical College Hospital (CMCH). Sixty newly diagnosed ALL patients admitted for chemotherapy were randomly allocated to two groups 30 in each: one group received Levofloxacin prophylaxis (Intervention group) and other group did not receive prophylaxis (Control group). During the whole period of induction, clinical and laboratory features of infection, fever and neutropenia were observed and adverse effects were noted in both groups.
Results: In induction phase of chemotherapy of ALL, significantly lower proportion of patients developed fever in the intervention group than in the control group [(18/30, 60.00%) versus (26/30, 86.67%)]. Incidence of infection was significantly less in intervention group compared to control group (60% versus 86.7%, p=0.039). Also, incidence of febrile neutropenia was significantly less in intervention group compared to control group (p=0.039). No major adverse effects were observed in any of the levofloxacin prophylaxis group except only two patients reported mild lower limb pain.
Conclusion: It may be concluded from this pilot study that, Levofloxacin prophylaxis in children with ALL during the induction phase of chemotherapy is effective in reducing infection, febrile episodes and febrile neutropenia.
JCMCTA 2022 ; 33 (1) : 34-39
Association of Insulin Resistance with Dyslipidemia in Gestational Diabetes Mellitus
Authors: Hasina Hafsa , Islam Md Hafizul , Haque Mahmudul , Karim Razaul , Akter Shammi , Salma Ummey 
Published: July 2023

Background: Gestational Diabetes Mellitus is the most common metabolic condition during pregnancy. Insulin resistance is a known risk factor for development of GDM. Women with Gestational Diabetes Mellitus are at increased risk for developing dyslipidemia. The aim of this study was to evaluate the occurrence of Dyslipidemia among women with GDM.
Materials and methods: This cross-sectional comparative study was conducted in Obstetrics and Gynecology Department, Chittagong Medical College Hospital. 100 patients were taken by non-probability convenience sampling where 70 women with GDM were taken as cases and 30 normal pregnant women as controls.
Results: GDM cases presented significantly higher mean HOMA-IR values and increased serum TC, TG, LDL-C and decreased HDL than those of controls. So from this point of view GDM cases had both insulin resistance and dyslipidemia. GDM patients with Insulin resistance had significantly higher Triglyceride level and decreased serum HDL-C level when compared to non-insulin resistance state of the same. This study revealed significant association of insulin resistance with dyslipidemia (Increased TG and decreased HDL-C, p<0.01) in GDM.
Conclusion: Insulin resistance was significantly associated with dyslipidemia in GDM. Soestimation of fasting lipid profile and fasting insulin in women with GDM may provide baseline information in course of planning and management of GDM patients.
JCMCTA 2022 ; 33 (1) : 40-45
A Six Months Analysis of COVID-19 Death : Experience From a Tertiary Hospital, Chattogram
Authors: Roy Biswas Rajat Sanker , Nath Jishu Deb , Nisha Fatema Emrose , Sarker Prasenjit 
Published: July 2023

Background : COVID 19 pandemic had taken away lots of human life prematurely worldwide and death laid its icy hands also on Bangladesh. So, objectives of this study were to explore the monthly distributions, age, sex, comorbidities, localities and duration of hospital stay among the COVID 19 death cases.
Materials and methods: In this observational study six months hospital death registries were collected and explored for monthly distributions, age, sex, comorbidities, localities and hospital stay. RT-PCR positive confirmed 113 COVID deaths were enrolled and suspected COVID deaths were excluded. Ethical clearance from the hospital authority was taken before hand. Data was compiled and analyzed by SPSS-20.
Results: There was a low frequency of death in the months May-2021 and October-2021(7.1% and 2.7% respectively) but more during June -2021 to September 2021 (12.4%, 16.8%, 42.5% and 18.6% respectively). Female deaths were more than male deaths (53.1% vs 46.9%, p<0.05). Age more than 51 years were the most vulnerable where 26(23%) deaths were at age group 51- 60 years, 39(34.5%) deaths were at 61-70 years and 22(19.4%) deaths were more than 71 years. Mean age of death was found 60.66 years and mean duration of hospital stay was found 9.45 days. Maximum duration of hospital stay was 45 days for one patient. Co-morbidities of death cases revealed 52(46.00%) patients had DM and HTN both, 17(15.0%) patients had HTN, 16(14.1%) had DM, 3(2.6%) had BA and COPD, 4(3.5%) had CKD, 2(1.7%) had cancer, 3(2.6%) had CVD, 19(16.8%) had IHD and 16(14.1%) patients had no co-morbidities. Locality of the death cases revealed 44(38.9%) patients came from rural areas and 69(61.1%) came from urban areas.
Conclusion: Higher age group and multiple comorbidities specially DM, HTN and IHD were related with COVID deaths mostly found in our study.
JCMCTA 2022 ; 33 (1) : 46-49
Correlation of Clinical and Biochemical Parameters with the Stages of Chronic Kidney Disease in Type 2 DM Patients in a Tertiary Care Hospital in Chittagong
Authors: Ahmed Shahryar , Chowdhury Sumon Rahman , Begum Rasheda , Siddiki Amam Zonaed 
Published: July 2023

Background : Microalbuminuria is a term to describe a moderate increase in the level of urine albumin. It occurs when the kidney leaks small amounts of albumin into the urine. The main objective of this study is to determine the correlation between microalbuminuria and diabetic kidney disease at a tertiary care hospital in Chittagong.
Materials and methods : Institutional based cross- sectional study design was conducted on randomly selected diabetic population from Chittagong Diabetic and General Hospital by using systematic random sampling method from 1st June to 30th November 2019.
Results : Out of a total of 160 participants, the prevalence of microalbuminuria was in 59(36.9%) patients. Ten (6.3%) patients had cardiovascular disease, 18(11.3%) had neuropathy, 7(4.4%) had retinopathy, 117(73.1%) had hypertension and 47(29.4%) had duration of diabetes of 610 years. Majority 132(82.5%) patients had stage 1-2 followed by 22(13.8%) had stage 3, 4(2.5%) had stage 4 and 2(1.3%) had stage 5. Gender, age, cardiovascular, retinopathy, hypertension, BMI, albumin to creatinine ratio, fasting sugar, creatinine level and LDL were not statistically significant (p>0.05) when compared to different stages of CKD. Stage 1-2 was significantly higher in no microalbuminuria group than microalbuminuria group (92.1% vs 66.1%). Stage 3 was significantly higher in microalbuminuria group than no microalbuminuria group (23.7% vs 7.9%). Stage 4 was significantly higher in microalbuminuria group 4(6.8%) and Stage 5 was higher in the microalbuminuria group 2(3.4%).
Conclusion: Neuropathy, mean diabetes duration, mean HbA1c, and mean Triglyceride were significantly greater in CKD stage 5 than in other stages of illness in the current research. When comparing different stages of CKD, mean HDL was considerably lower in stage 5. In the microalbuminuria group, CKD Stages 3, 4, and 5 were considerably higher than in the non-microalbuminuria group.
JCMCTA 2022 ; 33 (1) : 50-55
Malnutrition in Children with Uncomplicated Versus Complicated Appendicitis
Authors: Chowdhury Md Tameem Shafayat , Khastagir Rajib , Chowdhury Tahmina Akhter , Al Farooq Md Abdullah , Alam Sarwar Md Khurshid , Chowdhury Tanvir Kabir 
Published: July 2023

Background : Acute appendicitis is one of the commonest surgical emergencies in children and malnutrition is prevalent in the country. This study was designed to compare if complicated appendicitis occurs more in malnourished children.
Materials and methods: This cross-sectional study was conducted in Department of Paediatric Surgery, Chittagong Medical College Hospital from March 2017 to December 2019 with 155 children. Anthropometric measurements (Height, weight, Mid Upper Arm Circumference (MUAC) Triceps Skin Fold Thickness (TSFT) were recorded and biochemical assessment (Haemoglobin, albumin and total lymphocyte count) were done before surgery. Patients were grouped into two groups: Group A (Acute uncomplicated appendicitis; n=65) and Group B (Acute complicated appendicitis, n=90). Anthropometric and biochemical indices were compared between these two groups.
Results: Age ranged from 2 -12 years (Mean 9.2 ±2.5 years) (Male: female- 1.35:1). Among the five anthropometric indices abnormal measurements in Group A vs Group B were respectively. Abnormal TSFT (73.8% vs 80%, p=0.4) wasting (38.5% vs 44.4%, p=0.4) low MUAC for age (13.8% vs 17.8%, p=0.8) low weight for age (30.8% vs 36.7%, p=0.5) and low height for age (21.5% vs 24.4%, p=0.7) low albumin (52.3% vs 83.3%, p<0,001); low haemoglobin (61.5% vs 60.0%, p=0.6)) and low total lymphocyte count (39.5% vs 44.8%, p=0.7).
Conclusions: Malnutrition was widely prevalent in both groups. Although the proportion of malnutrition was more with acute complicated appendicitis, it was not statistically significant. The lower serum albumin level in these patients might be due to the consequence of the disease rather than prevailing malnutrition.
JCMCTA 2022 ; 33 (1) : 66-70
Evaluation of Cervix at Risk with Pap Smear and with Colposcopy
Authors: Ferdous Nasrin , Khanam Mafruha , Mahmud Anika Anan , Iqbal Tajrin , Begum Anjuman Ara , Gupta Chandrika Dash 
Published: July 2023

Background: Unhealthy cervix is a very common finding in Bangladesh due to poor genital hygiene, malnutrition, and multiparity. Cervical Cancer is a serious health problem in Bangladesh and other developing countries. Cervical Cancer is a preventable cancer due to long preinvasive state and available cervical screening program like pap smear, colposcopy etc. Upon detection the treatment of pre-invasive lesions is highly effective. The objective of our study is to observe and evaluate suspicious cervix upon specimen collection by pap smear and viewing them by colposcopy when required.
Materials and methods: This is a descriptive type of observational cross-sectional study conducted in the Department of Obstetrics and Gynecology of BBMH, Chittagong over a period of six months from December 2020 to June 2021. A total of 64 women were selected, who came to hospital outdoor for the treatment of persistent vaginal discharge, post coital bleeding, postmenopausal bleeding. A thorough general, systemic and pelvic examination was done. Pap smear was conducted and colposcopy was done for women who had persistent inflammation on pap smear cases. Multiple variables like age of marriage and first intercourse, parity contraception was taken in consideration. The data obtained were recorded and statistically analyzed.
Results: Out of 64 women the minimum age was 30 and maximum was 62 years with a mean age of 32.6 ± 7.2 years. Of the 64 women with unhealthy, inflammatory pap smear cases, 33 (51.6%) patients were colposcopically positive for CIN. Then histopathological evaluation of the biopsy material of those 33 women were done. It revealed 12 (36.3%) with abnormal cytology. Patients with positive CIN experienced early marriage, early age of child birth, and also had higher parities than patients without CIN.
Conclusion: This study should that cervical lesion is one of the commonest problems among the females worldwide, including Bangladesh. This revealed the importance of emphasizing on proper screening of carcinoma cervix to decline incidence and mortality in developed and developing countries.
JCMCTA 2022 ; 33 (1) : 71-76
Study of Sociodemographic Characteristics, Clinical Profile and Pattern of Pathogens of Meningitis in Children Admitted in A Tertiary Level Medical College Hospital
Authors: Nahar Kamrun , Alam Md Shah , Chowdhury Muhammad Jabed-Bin-Amin , Nahar Najmun 
Published: July 2023

Background: CNS Infection are likely to arouse tremendous anxiety in both the physician and the patients. It is one of the most potentially serious infections occurring in children and important cause of mortality and morbidity in worldwide. Laboratory surveillance of pathogen is crucial in formulating the empirical treatment guidelines. To evaluate sociodemographic characteristics, clinical profile and pattern of pathogens of meningitis in children.
Materials and methods: A descriptive study was carried out in paediatric Inpatient Department of Pediatric CMCH (Chittagong Medical College Hospital) Chattogram during the period of May 2013 to April 2014 where History, clinical examination and CSF sample were obtained from 40 patients of suspected meningitis. Diagnosis was based on the clinical presentation and CSF analysis.
Results: In this study, out of 40 patient, 25 patients were diagnosed as bacterial meningitis and 15 patient were diagnosed as aseptic meningitis based on clinical features and CSF analysis. 20% Culture positive bacterial menigitis was found, S pneumonae was found the leading pathogen. Overall, mortality rate was 2.5 %.
Conclusion: Bacterial meningitis is a medical emergency. Making an early diagnosis and prompt treatment are lifesaving. For Starting early empirical treatment of meningitis, knowledge about the local pathogen is necessary.
JCMCTA 2022 ; 33 (1) :77-81