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Background: Bone marrow examination is a safe invasive procedure and can provide sufficient explanation for unexplained cytopenias, leukaemia and other haematological disorders including metastases to the marrow by detailed morphological description of the marrow elements. Objective: To see the importance of bone marrow examination for the diagnosis of haematological disorders. Materials and Methods: It was a descriptive cross-sectional study comprising 196 patients who underwent bone marrow examination for evaluation of haematological disorders in the Department of Haematology, Enam Medical College and Hospital during the period of July 2012 to December 2019. Results: Total number of cases were 196, male to female ratio was 1.56:1 and majority of the patients were >18 years of age (84.69%). Common indications for bone marrow examination were pancytopenia (33.67%) and diagnosis of leukaemia/ myeloproliferative neoplasm (23.98%). In our study, haematological conditions were 79.08%. Among these malignant conditions were 55.10% and nonmalignant conditions were 23.98%. Aplastic anaemia (14.29%) and immune thrombocytopenia (7.65%) were the most common nonmalignant disorders. Common malignant disorders were acute myelogenous leukaemia (20.41%) and multiple myeloma (9.69%). Conclusion: Bone marrow examination is a simple and effective procedure in reaching the final diagnosis of haematological diseases. J Enam Med Col 2021; 11(1): 34-38

Background: Proper feeding practices are essential for attaining and maintaining optimum nutrition, health, and development of infants and children. Exclusive breastfeeding during the first six months of life and continued breastfeeding for two years, together with age-appropriate, nutritionally adequate complementary feeding initiated after six months of age, are optimum Infant and Young Child Feeding (IYCF) practices. However, often many aspects of infant and young child feeding practices are not optimum, with serious consequences for the child. Objective: To determine the impact of Infant and Young Child Feeding (IYCF) practices on the nutritional status of children. Materials and Method: This Cross-sectional descriptive type of study was conducted among 314 children from 6 months to 24 months of age at the Pediatric Outpatient Department and EPI center of Rajshahi Medical College Hospital during the period of January 2017 to December 2018. Collected data were analyzed by using 'SPSS version 16. Result: Among 314 children exclusive breastfeeding (EBF) rate was 68.2% for the first six months, and timely started complementary feeding was 58.5% of cases. In 214 exclusive breastfed infants, only 4.7% and 1.4% of children were moderate to severely wasted and stunted, respectively. On the other hand, among 97 infants who were not exclusively breastfed, the percentage of moderate to severe wasting and stunting was 11.4% and 13.4%, respectively. Among the 175 timely started complementary feeding children, only 12% and 6% were moderate to severely underweight and wasted, respectively, no one was stunted, but among the inappropriately started complementary children, 20.2%, 12.5%, and 12.8% were moderately to severely underweight, wasted and stunted respectively. Conclusion: Most of the children who were given exclusive breastfeeding in the first six months and started complementary food at an appropriate time after six months had normal nutritional status. Both moderate to severe stunting and wasting were common in those children who were non-exclusively breastfed and started complementary feeding either early or late. TAJ 2022; 35: No-2: 83-91

Background: Diabetes is one of the commonest and most important metabolic disorders that affect the health of pregnant women and infants. Diabetic mellitus is one of the most common metabolic disorders complicating pregnancy. The neonatal mortality rate is over five times that of nondiabetic mothers and is higher irrespective of birth weight and gestational age. There has been significant improvement in the outcome of diabetic pregnancies largely due to better metabolic control before and during pregnancy and vigorous neonatal care in developed countries. The management in our country still poses a major challenge. Methods: This case-control study was designed to find out the association between an infant's hypoglycemia and hypocalcemia with maternal diabetes. For the research, a total of 300 neonates were selected, where cases were selected from infants of diabetic mothers, and the control group was selected from infants of nondiabetic mothers. The mothers were interviewed by specific questionnaire, selected neonates were examined, and some biochemical tests were done to find out the outcome. Results: The study included 300 neonates of diabetic and nondiabetic mothers. The mean age of the Mothers of these neonates was 25.36 (SD±5.50) years. Among diabetic mothers 115(76%) had GDM and 36(23.8%) had PGDM. It is revealed that 83 (55%) of 150 mothers took insulin as the treatment. Hypoglycemia in neonates of diabetic and nondiabetic mothers right after birth at their first ½ hour of age 111 (37%). Hypoglycemia was found in 94 (62.3%) of infants of the diabetic mother than only 17(11.4%) in infants of the nondiabetic mother. Where the p-value is

Background: The assessment is an integral part of the clinical teaching-learning process in undergraduate medical education. Methods: This cross-sectional study was conducted to identify the views of fresh MBBS graduates about the present assessment status of 'Allied Subjects of Surgery' in undergraduate medical education in Bangladesh. The study was conducted from January 2021 to December 2021. Self-administered semi-structured questionnaires were administered to collect data from 40 fresh MBBS graduates. Data were collected from purposively selected 40 fresh MBBS graduates who passed the MBBS course with the completion of internship training within five years working in government and private hospitals or giving health care services in their chamber after getting permission from the respondents. Results: This Study revealed that the conditions of different issues like formative assessments, summative assessments (Professional examinations), short answer questions (SAQ), multiple choice questions (MCQ), structured oral examinations (SOE), objective structured clinical examinations (OSCE) and short cases were poor and in case of long cases were very poor in most of the Allied Subjects of Surgery compared to General Surgery, Otolaryngology and Ophthalmology. These differences were also statistically highly significant in all cases. Conclusion: Hence it can be recommended that most of the Allied Subjects of Surgery should get optimum importance during the assessment procedures in undergraduate medical education of Bangladesh according to the health needs of the community and current global health care situation. TAJ 2022; 35: No-2: 27-33

This descriptive type of cross-sectional study was conducted to determine the learning styles of undergraduate medical students and their relation with preferred teaching-learning Methods. The study period was from July 2017 to June 2018. The study was carried out among the students of the 2nd, 3rd, and 4th phases of the MBBS course at three government and four nongovernment medical colleges in Bangladesh. Out of seven medical colleges, four were within Dhaka and three outside Dhaka. The sample size was 1004. Medical colleges were selected purposively, and a convenience sampling technique was adopted for data collection. Bangla translated version of Fleming's VARK (visual, auditory, read/write, and kinesthetic) questionnaire was used to identify the learning styles of students. Linear regression was used to compare the VARK learning styles scores with teaching-learning Methods. The study revealed that out of 1004 medical students 64.2% preferred multimodal learning styles, and the rest, 35.8% preferred unimodal learning styles. Among unimodal learning preferences, auditory (A) and kinesthetic (K) were the most preferred sensory modalities of learning. The most preferred teaching Methods among the students were bedside teaching (29.9%), followed by tutorials (25.9%), and practical sessions (20.6%). The most preferred learning method among the students was mixed Methods (60.3%). A positive correlation was present between VARK modes and teaching-learning Methods (P

The present investigation was carried out to investigate the genetic variability, character association, correlation and path coefficient analysis among thirty accessions of sweet pepper. Significant variations were observed for different morphological traits, yield and yield attributes among the accessions studied. For all the characters, genotypic coefficient of variation (GCV) was smaller than phenotypic coefficient of variation (PCV). The highest genotypic and phenotypic coefficients of variations were recorded in case of number of fruit per plant (46.37 and 47.66%) followed by fruit yield per plant (39.39 and 41.44%), fruit length (31.92 and 32.48%) and dry weight (31.50 and 32.00%). Correlation coefficient study indicated that fruit yield had highly significant and positive correlation with individual fruit weight (r = 0.619) and number of fruit per plant (r = 0.605). In respect of path analysis, number of fruit per plant was contributed by maximum direct effect on sweet pepper (0.603) indicating its importance as a selection parameter. J. of Sci. and Tech. Res. 3(1): 95-102, 2021

Background: Spontaneous pyogenic spondylodiscitis is an uncommon clinical condition. But in our country it is not infrequent. High level of clinical suspicion is necessary for diagnoses of spontaneous pyogenic spondylodiscitis. There is no study regarding this issue in Bangladesh. Objective: The objective of this study was to see the epidemiological feature and types of surgical treatment of spontaneous pyogenic spondylodiscitis in Bangladesh Materials and Methods: This is a retrospective observational study. This study was done in the Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh. The study period was January, 2016 to July, 2021 for a period of 5.5 years. 17 patients who were undergone surgery included in the study. The data were collected from questionnaires and hospital records and analyzed. Results: In our study the highest incidence was found in 4th (23.52%) and 6th (29.42%) decade of life which was around 53%. The male to female ratio was about 2: 1.The present study showed the most common involvement was in lumbar region (35.31%), in dorsal and sacral region it was 23.52% and the cervical region in 17.65%. Regarding surgical treatment in cervical region both anterior (with fixation) and posterior approach was done, in dorsal, lumbar and sacral region posterior approach with or without fixation was done. Conclusion: In Bangladesh the incidence of Spontaneous pyogenic spondylodiscitis is relative high. It is more common in advance age with male predominance. Most frequently affected region was lumber. Surgical technique was individualized for every case. Bang. J Neurosurgery 2022; 11(2): 64-69

The goal of this study was to determine the sensitivity and specificity of the Myocardial Performance Index (MPI)for the assessment of acute right ventricular Infraction. This was a descriptive type of cross-sectional study. The study was carried out in the Coronary Care Unit, Department of Cardiology, Sir Salimulla Medical College, and Mitford Hospital. After exclusion total of 72 patients were included in this study, of which 24 had acute inferior MI with RV involvement diagnosed by ≥ 1mm ST-segment elevation in V3R-V5R of right-sided ECG (group-I) and 48 had acute inferior MI without RV involvement (group-II). All patients underwent echocardiography within 24 hours of admission. The study revealed that RV MPI was significantly increased (0.57± 0.13) in RVMI patients compared to IMI without RVMI (0.24± 0.12). MPI detected RVMI in 08 patients (0.45± 0.09) who did not have ECG findings of RVMI (Group-II). Repeat MPI estimation after 05 days in 21 RVMI (Group-I) and 08 isolated IMI (Group-II) patients who had RVMPI > 0.30showed dramatic reduction of MPI (0.19± 0.07 and 0.22±0.09), respectively. RV MPI ≥ 0.30 has high sensitivity (100%) and specificity (89%) for the diagnosis of RVMI in the presence of acute IMI. The study recommended that MPI may be a new non-invasive echocardiographic gold standard tool in diagnosing acute RVMI and also assessment of right ventricular function in acute inferior myocardial infarction with high sensitivity and specificity. MPI changes can be serially followed in acute RVMI patients to assess changes in RV function. TAJ 2022; 35: No-1: 17-24

Changes in cardiac structure and function detected by echocardiography are common in patients with type 4 cardiorenal syndrome and have been recognized as key outcome predictors. This study aimed to evaluate echocardiographic patterns in severe chronic kidney disease CKD in type 4 cardiorenal syndrome patients. This was a descriptive type of cross-sectional study. The study was carried out in the Cardiology and Nephrology Department of Bangabandhu Sheikh Mujib Medical University, Dhaka. After exclusion total of 44 patients having severe CKD (GFR

Background: Ureterovaginal fistula is a communication between the distal ureter and the vagina. It is a rare but a relatively frequent complication of pelvic surgery. The etiological factors are very important in the treatment procedure of ureterovaginal fistula. We have very few data regarding this issue. Aim of the study: The aim of this study was to assess the etiological factors and outcome of ureterovaginal fistula in women. Methods: This was an observational study and it was conducted in Shaheed Ziaur Rahman medical College Hospital (SZMCH), Bogura, Bangladesh, during the period from May 2016 to December 2018. This study was approved by the ethical committee of the mentioned hospital. In total 48 women with ureterovaginal fistula at the center were included as the study population on the basis of non-probability purposive sampling. The investigative procedures, etiology, clinical presentation and outcomes were recorded. All the data were collected, processed, analyzed and disseminated by MS Office and SPSS version 20 as per need. Result: In analyzing the etiological factors among participants we found that, among the patients of post-hysterectomy 16.67%, 14.58%, 25% and 4.17% were with abdominal hysterectomy for fibroids, abdominal hysterectomy for malignancy, cesarean hysterectomy and rupture uterus with SVD (Spontaneous vaginal delivery). In analyzing the final outcomes among the participants we found most of the patients (n=40; 83%) healed and continent. Then 13% healed with residual incontinence and the rest 4% patients healed ureterovaginal fistula with residual vesicocervicovaginal fistula. Conclusion: In this study the emergency cesarean section was found to be commonest etiological factor and the use of abdominopelvic ultrasound was found to be effective in the confirmation of diagnosis and identifying the affected ureter. Well planned hysterectomy for benign and malignant uterine pathologies may reduce the frequencies of ureterovaginal fistula. Bangladesh J. Urol. 2021; 24(1): 72-76

Bronchiolitis is a viral infection of lower respiratory tract that occurs most commonly in young children (< 2years). It is one of the most common cause of hospitalization of infants. It has a major public health hazard throughout the world exerting significant morbidity and mortality. Methods: This randomized controlled trial study was conducted in the Department of pediatrics, Rajshahi Medical College Hospital. Total 120 patients with acute bronchiolitis were selected who were less than two years of age. Two groups were randomly selected by lottery method. One group was given salbutamol along with prednisolone (Experimental group) another was only salbutamol (Placebo group) to compare the efficacy and evaluate the outcome of both treatment groups. Result: The mean age of the experimental group was7.09±4.71 months and mean age of placebo group was 5.70±4.26 months. The majority number of patients 96(80%) came from middle class family with 30(25%) houses with crowded conditions. About 16(13.3%) patients were born in preterm condition and 18(15%) were low birth weight. Among the family members 21(17.5%) had asthma and 43(35.18%) had smoking history. After treatment notable outcome clinically observed after 3 days of treatment in experimental than placebo group (p-value

Agriculture farmers face abundant risk for crop cultivation at rural area of Bangladesh. About 85% of population in coastal region of Bangladesh, Dumki upazila, related to agriculture for livelihood directly or indirectly. To mitigate the problem facing by the farmers, there are available a lots of climate smart technologies. However, different demographic, socio-economic, production, management and post-harvest determinants influences the adoption of these modern technologies. This study focuses on the identification of farmer’s socio-economic condition, their knowledge, attitude, and perception on improvement of existing livelihood based on selected personal and demographic variables. Both primary and secondary data has been collected from different sources to fulfill the objectives. The results of this study indicated that the farmer’s age, education level and farming experiences significantly influence the adoption of modern technologies. Farmer’s knowledge, perception and attitude differ on different demographic condition like, age, sex, education, farm size, farming year. Results also showed that lacking of quality seeds, lacking/high price of labor and other inputs for crop production hastens the adoption of modern technologies. This study provides some recommendation which might impacts on betterment of farmers’ occupational condition by establishing proper policy and legislation both in local and national level. Asian J. Med. Biol. Res. 2021, 7 (4), 348-358

This descriptive type of cross sectional study was carried out to evaluate the attitude of undergraduate medical students of Bangladesh regarding selected areas of professionalism like honesty and confidentiality. Study period was from July 2017 to June 2018. Sample size was 837 undergraduates medical students of 1st, 2nd, 3rd and 4th phase of MBBS course from four public and four non government medical colleges of Bangladesh. Convenience sampling technique was adopted in this study. Data collection was done by a modified structured situational judgment test (SJT) self-administered questionnaire which was adopted from general medical council (GMC) and by in-depth interview schedule of students. The data were then compiled and analyzed using SPSS Version 19.Among the study participants, 37.20% (310) and 62 .80% (537) were males and females respectively. Attitude towards the two most major issues of professionalism were good, mean score were above three in honesty. Mean score was below three in maintaining confidentiality. Result of the present study shows that female students had higher mean professionalism than male. Female students were better than the male students in regards to all two different professional issues and this difference is statistically highly significant (P=0.00). Mean score of professionalism of 1st phase students in all two issues were greater than the respondents of other three phases and this findings was also statistically significant. Medical undergraduates of Bangladesh have a good understanding of acceptable professional honesty but there is scope of improvement. Study recommended that these two issues of professionalism must be taught in the course of undergraduate medical education and should be incorporated in undergraduate medical curriculum with the details of learning outcome what we craving from a registered medical graduate so that learning can be turned into practice. Bangladesh Journal of Medical Education Vol.11(1) 2020: 3-11

Background: Previous trials showed that diabetic patients had worse in-hospital and long term outcome after coronary artery bypass grafting (CABG) than non diabetic ones. However, the majority of such studies was carried out in western countries and limited information is available for the Asian population. Objective: The present study was intended to determine the impact of diabetes on early and mid-term outcome among patients undergoing CABG surgery in a tertiary care hospital in Bangladesh. Methods: This study was performed at Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh, from January to June 2014. Based on enrollment criteria, 202 patients (115 diabeticsand 87 non-diabetics) were enrolled and evaluated for their early outcome (within 30 days of operation) and midterm (after 30 days post-operatively). Patients with known diabetes or preoperative fasting blood sugar ≥6.4 mmol/L or random blood sugar ≥11.1 mmol/L were considered as diabetics. The outcome measures were ICU stay, reopening for bleeding, atrial fibrilation, cardiac arrest, total hospital stay, left ventricular ejection fraction and mortality. Results: Diabetic patients in this study had higher prevalence of hypertension, hyperlipidaemia, and renal failure. The diabetic and the non diabetic groups received a mean number of grafts of 3.2±1.06 and 2.81±1.21, respectively, Postoperative mortality in diabetic and non-diabetic patients at early and mid-term were not significantly different in univariate analysis (4.3% vs. 2.3%, p= 0.352) and (2.6 % vs. 2.3%,p = 0.630) respectively. The mean intensive care unit (ICU) stay in diabetic and non-diabetic were same (3.5days) but total hospital stay was significantly higher in the former group (one day or more). Re-opening for bleeding, atrial fibrilation and cardiac arrest in ICU were found higher in DM than those in non-DM group (28.7%vs.20.7%,10.4% vs. 8% and 4.2% vs.1.1% respectively). Conclusion: Although the mortality rate of diabetic patients following CABG surgery was in significantly higher than their non-diabetic counterparts. Morbidity was also a bit higher. Strict perioperative glyacemic control could reduce morbidity and mortality in diabetic patients undergoing CABG.

Azo-ester mesogen containing two liquid crystalline compounds C1-C2 having polymerizable acrylate functional group as the terminal were designed and synthesized. The chemical structures and purity of the synthesized compounds were confirmed by different spectroscopic techniques such as FT-IR, 1H NMR and 13C NMR. X-ray crystal structure showed that compound C1 exhibited more stable E configuration with two bulky groups in the opposite sides of the N=N double bond motifs. The 1, 2-diphenyldiazene fragment in the structure of C1 is essentially planar with RMS deviation from planarity of 0.0555 Å. Analysis of the crystal packing of compound C1 revealed its intriguing supramolecular sheet-like multilayer molecular packing stabilized by C-H…O interaction involving the phenyl and acryloyl hydrogen with the carbonyl oxygen and alkoxy oxygen atoms. Thermogravimetric investigation demonstrated that both of the compounds exhibited excellent thermal stability and their thermal degradation was influenced by the terminal substituent. The DSC and POM studies confirmed that compounds C1-C2 exhibited enantiotropic liquid crystalline mesophase behaviour. Optical investigations demonstrated that both of the compounds showed strong absorption band around 300-420 nm and exhibited blue fluorescence emission.

Migraine is a common type of headache. After tension type headache, it is the second common cause of primary headache disorder with a female preponderance.This cross sectional study was done toassess the sociodemographic characteristics of migraine patients in Bangladeshi population and to see the characteristics of headache and associated comorbidities of migraine patients.The study was conducted in a tertiary care hospital (Mymensingh medical college) of Bangladesh.The study subjects consisted of 60 patients with migraine headache seen in neurology OPD.Mean age was 32.03± 11.74 yrs. Male female ratio was 1: 2.7.Most of them are housewives (61.6%). 22% had family history of headache. Most of the patients had severe (53.4%) and frequent (e”3 per month) headache attacks. Aura was present in 25% patients. Depressive illness was the associated comorbid condition which was found in 15% patients. Bangladesh Journal of Neuroscience 2019; Vol. 35 (1): 22-26

Background: AD is the most common cause of dementia in elderly which causes economic burden for the affected individual, caregivers and society. The objective of this study was to see demographic characteristics among AD patients and it will provide magnitude of the problem and planning of health programme for prevention of disease. Methods: This observational analytical study was carried out in the Neurology ward, OPD and Dementia clinic of BSMMU, Dhaka from May’ 15 to February’ 17. A total of 45 patients were recruited as study population after satisfying all the criteria for enrollment. Results: A total of 27 male and 18 female with mean age of 69.20 ± 11.16 years, constituted as cases. Conclusion: The occurrence of AD found more after the age of 65 years. The present study found that lower educational level is associated with more chance of getting AD. Higher rate of Alzheimer’s disease was found in older man than women. Bangladesh Journal of Neuroscience 2019; Vol. 35 (1): 10-13

Background: Alzheimer’s disease is the most common cause of dementia. Metals such as zinc , copper, iron are likely involved in the neurodegeneration of Alzheimer’s disease . Copper can catalyze a flux of reactive oxygen species that can damage functional and structural macromolecules in brain. Most studies found association of high serum copper level with Alzheimer’s disease but also some studies did not. Methods: Total 48 patients of Alzheimer’s disease who were diagnosed according to NIA-AA ( National institute of Aging – Alzheimer’s Association) recommendation ( revised NINCDS-ADRDA) criteria were taken as study population purposively and 42 age and sex matched control were selected. Fasting serum copper level were done for both groups. Comparison of serum copper level of Alzheimer’s patients with that of the control group were done to see association. Results : A total of 28 male and 20 female with mean age of 66.20 ± 9.42 (mean±SD) years, 22 male and 20 female with mean age of 63.54 ± 9.74 (mean±SD) years constituted as case and control groups, respectively. The mean of serum copper in case and control groups were 0.95 ± 0.37 versus 0.92 ± 0.25 mg/L (P > 0.05). The present study found that serum copper levels are non-significantly higher in patients with AD than control group, however it did not show a significant relationship with severity of dementia. Conclusion: So our suggestion was to perform a study work including total serum copper level , serum ceruloplasmin level and free serum copper level comparing between a large Alzheimer’s Disease patients group and age , sex matched apparently healthy control group to understand the copper dyshomeostasis in Alzheimer’ Disease. Bangladesh Journal of Neuroscience 2017; Vol. 33 (2): 96-102

Background: Alzheimer’s disease is the most common cause of dementia. Uric acid is the end product of purine metabolism in humans and acts as a natural antioxidant, accounting up to 60% of the free radical scavenging activity in human blood to prevent free radicals induced oxidative cell injury. This study aimed to explore the association between serum uric acid level and cognitive impairment of Alzheimer’s disease patients compared to those of the non-demented age and sex matched controls. Methods: This case control study was carried out in the department of neurology, BSMMU, Dhaka. Total 116 patients were enrolled as study population after satisfying inclusion and exclusion criteria. Among them, 58 were grouped as case and rest 58 were control. All blood samples for serum uric acid were measured in the Biochemistry lab, Department of Biochemistry, BSMMU, Dhaka. Results: A signiûcant reduction of serum uric acid levels in the AD group was found compared to those of the control group (4.35±1.59 Vs 6.89±1.68) which was statistically significant (p

Background: Alzheimer’s disease is a neurodegenerative disease. It is the most common cause of dementia in individuals older than 60 years of age. Age is the most important risk factor for Alzheimer’s disease. It is important to identify modifiable risk factors. One such important modifiable risk factor is Magnesium, a trace element. The objective of the study was to see the association of serum Magnesium concentration with Alzheimer’s disease patients. Method: It was a case control study carried out in neurology department of BSMMU, Dhaka. Total 68 patients were enrolled as study population after satisfying inclusion and exclusion criteria. Among them, 34 were grouped as case and rest 34 were control. Serum Magnesium concentration was detected. Result: Serum Magnesium concentration was significantly lower in AD patients than that of control group [2.04±0.19 mg/dl vs 2.36±0.21 mg/dl. Conclusion: The results of our study revealed an expression that the trace element, Magnesium concentration has an association with Alzheimer’s disease. Bangladesh Journal of Neuroscience 2017; Vol. 33 (2): 70-75

Typhoid Fever occurs worldwide primarily in developing nations where sanitary conditions are poor. The absence of specific symptoms and signs makes the clinical diagnosis difficult. Definitive diagnosis requires the isolation of S. typhi from blood or other body fluid. But in developing countries culture facilities often not available & diagnosis rely upon clinical features and the detection of antibodies by the Widal test. Numerous studies however have cast serious doubts on the value of the test. The aim of the study was to reassess the utility of a single Widal test in the diagnosis of typhoid fever. The descriptive study was carried out on 100 adult patients with suspected cases of typhoid fever, in the Department of Medicine, Chittagong Medical College Hospital for a period of one year from January to December 2009. Blood samples were collected to perform culture and Widal test. TO titre ?1:160 were considered as significant. AO or BO?1:160 was also considered as significant. The results showed 24 among 100 clinically suspected typhoid fever cases yielded growth of S. typhi. Widal test was found significant in 20(83.33%) out of 24 cultured confirmed cases. Results revealed significant difference in Widal test results between culture positive and negative cases, X2 value 5.601, P value 0.018(

Benign paroxysmal positional vertigo (BPPV) is paroxysms of vertigo occurring with certain head movements, typically looking up or turning over in bed comprising about 20% of Dizziness cases. This study was carried out to evaluate the Efficacy of canalith repositioning procedure(CRP) in BPPV. A randomized clinical trial including 80 patients with BPPV was performed Medicine & Neurology Outpatient Department, Chittagong Medical College Hospital. The patients were randomly divided into two groups. Group A treated by anti-vertigo drug and CRP, Group B treated by anti-vertigo drug alone. All patients were followed up in hospital at one week after & 4 weeks. The rates of effectiveness of CRP treatment and the control treatment for were 86.8% and 59.4%, respectively. There was a significant difference (27.4%) in the outcomes of the CRP & control groups (P

Background: Stroke is serious pathology with a immense impact on the functional and vital prognosis. It is the leading cause of death worldwide. The objective of the study was to observe clinical profile of stroke patients and important risk factors. Methods: It was a cross-sectional descriptive study conducted in the department of Neurology, BangabandhuSheikh Mujib Medical Universiy(BSMMU), Shahbag, Dhaka from August 2014 to November2015. All patients above 18 years of age and both sexes attending the above mentioned department meeting all inclusion and exclusion criterias and confirmed CT/MRI scan of Brain were included in this study. Results: A total of 219 patients were studied. Maximum 93(42.5%) patients were in age group of 61-70 years followed by 51(23.3%) and 30(13.7%), in the age group of 51-60 years and 71-80 years respectively. Male 138(63%) were predominant than female 81(63%). 78(35.61%) patients had weakness in both sides of the body, 66(30.1%) had weakness in the left side and 36(16.4%) had weakness in the right side of the body. 190 (87.7) patients had ischemic stroke and 29(12.3%) had hemorrhagic stroke. Among risk factors dyslipidemia was in 185(84.5%) patients, hypertension, smoking habits, diabetes mellitus and ischemic heart disease were present in 165(75.3%), 120(54.8%), 105(47.9%) and 42 (19.2%) patients respectively. H/O recurrent stroke was present in 55(25%) cases. Conclusion: Stroke cases were male predominant where dyslipidaemia was the most common risk factor, most common type of stroke was ischemic, most common presentation was hemiplegia/monoplegia and commonest age of presentation was seventh decade. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 16-20

Background: Stroke is a major cause of physical disability in the elderly and the second most common cause of dementia. The prevalence of Alhzeimer’s dementia is increasing in western societies. But vascular dementia (VaD) is increasing in developing countries like Bangladesh and in Japan, because of the decline in mortality after stroke and aging of population. Conflicting data shows that hyperlipidaemia, a modifiable risk factor for ischemic stroke is associated with a higher risk of vascular dementia. Objective: The objective of this study was to evaluate association of hyperlipidaemia with vascular dementia. Method: It was a cross-sectional descriptive study conducted in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka from August 2014 to November, 2015. All stroke patients above 18 years of age and both sexes, attending the department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka presenting at least 3 months after stroke were the study population. Patients attending to the above mentioned hospital and after meeting the inclusion and exclusion criteria a purposive sampling technique were applied for selecting cases. Total 73 cases were evaluated. These patients were examined by MMSE for evidence of dementia. Severity and risk factors of vascular dementia were assessed. Serum fasting lipid profile was estimated in all cases and evaluated their association with VaD. Results: In this study it was observed that most of the stroke patients and VaD patients were in the age group of 5th and 6th decade. Among stroke patients it was 17(23.3%) and 31(42.5%) and among VaD patients it was 10(25.6%) and 18 (46.6%). Male outnumbered female (in stroke male-63%, Female-37%; in VaD male-59%, Female 41%). In this study out of 73 patients 40(54.8%) were smoker, 67(91.8%) had hyperlipidemia, 54(74%) had hypertension, 35(47.9%) had diabetes mellitus, 15 (20.5%) had IHD, 64(87.7%) had ischemic stroke, 9(12.3%) had hemorrhagic stroke, 25(34.25%) had recurrent stroke. Most of the patients were house-wife 16((21.9%) and read upto primary level 22 (30%). Out of 73 stroke patients 39(53.4%) had VaD. Of them 12(30.8%) had mild, 16(41%) had moderate and 11(28.2%) had severe dementia. Again out of 39 VaD patients 38(97.4%) had history of ischemic stroke and 1(2.6%) had history of hemorrhagic stroke who was moderately demented. Among VaD and non-vascular dementia patients the mean S. total cholesterol, S. triglyceride, S. LDL-C and S.HDL-C were 185.35±44.07, 149.82±57.05, 133.58±44.53, 31.07±11.16 (mg/dl) and 178.70±48.40, 151.35±76.12, 116.48±42.39, 33.61±11.82 (mg/dl) respectively. Conclusion-: In this study there is a non-significant positive association with high S. total cholesterol, high S. LDL-C, Low S. HDL-C but not with S. triglyceride. So, we can conclude that hyperlipidemia has weak association with VaD. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 1-11

Acute myocardial infarction (AMI) is a common non - communicable disease prevailing in developed as well as in developing countries like Bangladesh, causing a great number of mortality and morbidity and impart a huge economic burden to family as well as to society. This study was designed to see the various complications and outcome of the patients of AMI, admitted in a tertiary care hospital in Bangladesh. In this observational study, 100 patient of AMI admitted in Cardiology ward of CMCH were enrolled. Clinical diagnosis was made from history and clinical examination and confirmed by ECG and biochemical markers. Informed written consent was taken from the patient or from the patient's attendant. Among the 100 cases of AMI, 89% were suffering from STEMI and 11% were from NSTEMI. Most of the patients (39%) were in 50-59 years age group. Majority of patient had chest pain (52%), followed by dyspnoea (23%), palpitation 10%, syncopal attack 7% and cardiac arrest 8% respectively. Important risk factors were history of smoking (37%), Diabetes (33%), Hypertension (31%), Dyslipidaemia (21%) and family history of IHD (16%). ECG showed ST-elevation in 80% of patients. It has been revealed that the important complications were cardiogenic shock(31%) followed by acute LVF(21%), bradyarrythmia (12%), tachyarrhythmia (10%), cardiac arrest(8%) and 12% patients died within 24 hours of admission. Patients with AMI have a substantially increased risk of death after hospitalization when shock, LVF or arrhythmias occur during their hospital stay. These complications should have to be treated promptly to achieve a good outcome.Medicine Today 2016 Vol.28(1): 6-8

Alzheimer’s disease is the most common cause of dementia among elderly people. The major pathological hallmarks of AD are the loss of neurons, occurrence of extracellular senile plaques as well as intracellular neurofibrillary tangles (NFT). Biochemical changes in the brain are reflected in the cerebrospinal fluid (CSF), and intense research efforts have been made to develop biomarkers for the central pathogenic processes in AD that can be used as diagnostic tools. Biomarkers are essential part of disease management as they are essential for diagnosis, monitoring the disease progression, detecting early onset of the disease, monitoring the effect of therapeutic intervention, and also avoiding false diagnosis of the disease. Unfortunately, none of the biomarkers presently available are able to accomplish the disease diagnosis single-handedly. Three CSF biomarkers, Aâ42, Total-tau (t-tau), and phosphorylated-tau (p-tau), have been found to have the highest diagnostic potential. Bangladesh Journal of Neuroscience 2015; Vol. 31 (1): 34-41

Very little is known about the immediate response of nebulized corticosteroid in addition to systemic steroids plus nebulized salbutamol in the early management of acute asthma in children. This study was aimed to observe any immediate effect of nebulized budesonide in the management of acute asthma in children. A total of 106 asthmatic patients aged between 5-12 years were investigated in a prospective single-blind, placebo controlled fashion. All subjects were entered in a randomized manner into one of two groups, Group-1 (Study Group) and Group-II (Control Group). After the Paediatric Asthma Severity Score (PASS) and the Peak Expiratory Flow Rates (PEFR) had been measured in all patients at the beginning of the study, both the study group (Group-1) and the control group (Group-II) received three consecutive doses of nebulized salbutamol (0.15 mg/kg/dose) and one dose of parenteral hydrocortisone (5 mg/kg/dose, intravenous). After this initial treatment, nebulized budesonide (1 mg/dose) was administered to patients in Group-1. One hour latter, the PASS and the PEFR were measured once more and at discharge, the durations of hospital stay (in days) were recorded for comparison between two groups. There were 53 patients in Group-1 (mean age: 7.99€2.12) and 53 patients in Group-II (mean age: 7.45+2.13). Both the groups were comparable for age (p=0.212) and sex (p=0.242)and inhaled steroid prophylaxis rate (p=0.233). No statistically significant difference was detected between the two groups with respect to the decrease in PASS (p=0.851). Yet, there were statistically significant differences between the two groups with respect to the increase in PEFR (p=0.006) and durations of hospital stay in days (p=0.004). The positive immediate effect of nebulized budesonide in addition to systemic steroids and nebulized salbutamol in improving the PEFR as well as durations of hospital stay in asthmatic children is an encouraging finding for further study of its routine use in the paediatric emergency department. JCMCTA 2014 ; 25 (1): 27-31

Background and objectives: Dementia is characterized by loss of or decline in memory and other cognitive abilities and reduces the lifespan of affected people. The number of people with Alzheimer’s Disease and other dementias is increasing every year because of the steady growth in the older population and stable increment in life expectancy and it is expected to increase two-fold by 2030 and three-fold by 2050.In addition to Alzheimer’s disease there are so many reversible and irreversible causes of dementia. This study was aimed to explore the different etiological factors related to dementia patients. Risk factors for dementia, co-morbid conditions were also included. Methods: This cross sectional study was carried out from 2009 to 2014 at dementia clinic (OPD), department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU). A total number of 166 dementia patients, as diagnosed by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and confirmed by Mini Mental State Examination(MMSE) score were recruited in this study. Diagnosis of specific type of dementia was made on the basis of established criteria. Results: Alzheimer’s disease(32.5%) and Vascular dementia(31.9%) were the most common etiological factor followed by Mixed dementia(19.9%), PD with dementia(8.4%) and others(7.2%) like hypothyroidism, head injury, epilepsy etc. Increasing age, hypertension, diabetes mellitus, dyslipidemia, IHD, smoking are potential risk factors for dementia. Conclusion: This study concludes Alzheimer’s disease and Vascular dementia are almost equally occurring dementia. There are also some potential risk factors for development of dementia whose modification can bring a great change in dementia treatment and functional outcome of this group of elderly people of Bangladesh. Bangladesh Journal of Neuroscience 2014; Vol. 30 (2): 77-83

Objective: To find out the relationship of different lipids, lipoproteins and ischemic stroke patients in Bangladesh. Methodology: This case control study was conducted among the patients having ischemic stroke who were admitted in Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from July, 1997 to June, 1999 and age, sex matched apparently healthy volunteers. Sixty ischemic stroke patients confirmed by CT scan of brain and sixty age and sex matched apparently healthy volunteers were enrolled as controls. 12 hours fasting lipid profile (Total cholesterol, LDL-cholesterol, HDLcholesterol and Triglyceride) was done for both ischemic stroke patients and healthy volunteers for comparison. The students (unpaired) t test was used to compare group means for lipids and lipoproteins. Chi square test, odds ratio with confidence interval were done to evaluate differences between the groups for other variables. P

Objectives: To evaluate the association of dementia in ischemic stroke. Methodology: This case control study was carried out in the department of Neurology at BSMMU, Dhaka from 1st January 2010 to 31st December 2011 for duration of two years to evaluate the association of dementia in ischemic stroke. The target population for this study include all patients presented with ischemic stroke at the range of 3 to 6 months after stroke with the age group of 40 to 70 years are included in this study and patients of dementia other than ischemic stroke like Alzhiemer’s disease, vit-B12 deficiency, thyroid dysfunction were excluded from this study. A total number of 120 respondents were included in this study. Age & sex matched 60 patients of ischemic stroke were selected as cases and rest 60 people were taken as control group. Informed written consent was taken from each patient or his/ her attendant. All information regarding history and physical findings; and other risk factors for dementia were collected to fill up the preformed questionnaire. Relevant physical examinations like nervous system examination, selected general and systemic examination were recorded. Result & Observation: Dementia was present in case and control group 18(30.0%) and 2(3.3%) respectively. The difference was statistically significant (p=0.001). Present smoking habit was more in case (45.0%) than in control group (16.7%) which was statistically significant (p=0.001) with a OR of 4.07 with a 95% CI of 1.89-8.75. Past smoking habit was more in case (16.7%) than control group (11.7%). Non-smoker was more in control (71.7%) than case group (38.3%). Diabetes mellitus was more common in case group (38.3%) than control group 5(8.3%) which was statistically significant (p=0.001) with a 6.84 OR and 95% CI of 2.39-19.6. Conclusion: The study permit to conclude that dementia is directly associated with ischemic stroke. We found a correlation between age, family history of dementia, hypertension, diabetes mellitus and dyslipidemia with dementia. Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 35-44

Background: A sample of 60 subjects from population based study participated in a study on carotid color duplex ultrasonography that aimed to assess the relations of coagulation factors to stroke and carotid atherosclerosis. The association between severity of carotid atherosclerosis and high factor viii activity in ischemic stroke is still not clear. Objective: The present study was conducted to find out the association between carotid atherosclerosis and high factor viii activity in ischemic stroke. Methodology: This was a cross sectional analytical study carried out in the department of neurology,BSMMU during the period of july’2009 to june’2011.A total 60 subjects with ischemic stroke were included in this study and data were collected purposively. Chi square test was done and probability value 0.05%) was found between the high factor VIII activity and normal factor VIII activity related to severity of carotid stenosis. Conclusion: The roles of hypertension, hypercholesterolemia, and hypertriglyceridemia have been implicated in the pathogenesis of the carotid atherosclerosis but in the present study did not find any association between the severity of the carotid atherosclerosis with high factor viii activity in ischemic stroke. Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 1-10

Background: The diagnosis of ischemic stroke remains a clinical one, with confirmatory evidence obtained through neuroimaging. ECG changes are common in patients with ischemic stroke. Objective: The objective of this study was to see ECG findings among ischemic stroke patients. Materials and Methods: This study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2006 to October 2008. A total of 36 patients with acute Ischemic stroke were selected by purposive sampling method and diagnosed by history, clinical findings ard was confirmed by CT scan of head. The clinical details, investigations of the respondents were reviewed. Data were recorded in a pre-designed data collection sheet. Result: Majority of the subjects were in 7th decade 12(33.3%) and 6th decade 9(25%) with the male to female ratio was 1.25:1. Among the patients with abnormal electrocardiographic findings, 7(19.4%) patients each had myocardial ischemia, 4(11.1%) had conduction block and ventricular arrhythmias, 7(19.4%) had atrial fibrillation, 5(13.9%) had ventricular hypertrophy, 7(19.4%) had myocardial infarction, 6(16.7%) patients had non-specific ST changes. Conclusion: Myocardial ischemia, atrial fibrillation and myocardial infarction are common electrocardiographic findings of ischemic stroke patients. Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 23-26

The presentation of acute dyspnea after pregnancy is rare, but should bring a number of important conditions to the mind of the attending physician. Pulmonary embolism, amniotic fluid embolism, pneumonia,aspiration pneumonia and pulmonary edema are some of the potentially devastating causes that must be considered. We report a 29 years young lady who presented with progressive severe dyspnoea, haemoptysis with right leg swelling and H/O lower uteraine caesarean section(LUCS) followed by mymectomy one and half months back , initially her ECG, chest –X-ray & echocardiographic findings revealed evidence of pulmonary embolism we treated her with dramatic improvement. Birdem Med J 2013; 3(2): 116-120 DOI: http://dx.doi.org/10.3329/birdem.v3i2.17218

Background: Nearly 40% of patients presenting with Non ST-Segment Elevation Myocardial Infarction (NSTEMI) have Chronic Kidney Disease (CKD). CKD is a powerful predictor of adverse events among NSTEMI patients. CKD is associated with a high prevalence of obstructive coronary artery disease. Objectives: The purpose of the present study was to evaluate the severity of coronary artery disease in patients with Chronic Kidney Disease presenting with Non ST-Segment Elevation Myocardial Infarction. Methods: In this prospective observational study a total of 128 patients with NSTEMI were enrolled. They were divided equally in group I (NSTEMI with CKD) and group II (NSTEMI with normal renal function) on the basis of estimated glomerular filtration rate. Patients were considered to have CKD if he/she had documented history of CKD or estimated glomerular filtration rate

Background: Guillain-Barré syndrome (GBS) usually preceded by infections, in particular cytomegalovirus (CMV). It may occur by primary infection, reinfection or by reactivation of CMV. Objective: The aim of the present study was to evaluate the association of Guillain-Barré syndrome (GBS) with Cytomegalovirus (CMV) infection. Methodology: This case control study was carried out in the indoor and outpatient Department of Neurology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 1st January 2010 to 31st December 2011 for the duration of two years. All patients with GBS, who attended in neurology OPD or inpatient department at BSMMU during the study period, fulfilling the inclusion and exclusion criterias were included in this study. Age & sex matched volunteers, patients attendants, patients other than GBS who were nondiabetic, had no renal or hepatic diseases or family history of polyneuropathy were included in control group. Results: A total number of 78 respondents of which 39 patients were taken as cases and rest 39 were taken as controls who appeared in neurology OPD or inpatient department at BSMMU during the study period, fulfilling the inclusion and exclusion criterias were included in this study. The mean age ± SD of case and control groups were 30.82 ± 12.56 and 31.00 ± 12.77 years respectively (p=0.950). In case group the history of respiratory tract infection was present in 46.2% cases and absent in control group (p=0.001). In case group the history of gastroenteritis was present in 28.2% cases and absent in control group (p=0.001). In case group the history of fever was present in 30.8% cases and absent in control group (p=0.001). Anti-CMV IgM antibody was positive in 5.1% cases. Four fold rise of IgG in case group was present in 10.3% cases and absent in control group (p=0.040). Confirmed CMV infected GBS cases were 15.4% and absent in control group (p=0.011). Conclusion: The findings of this study permit to conclude that there is a significant association of Guillain-Barré syndrome (GBS) with Cytomegalovirus (CMV) infection. Bangladesh Journal of Neuroscience 2013; Vol. 29 (2) : 88-97

Back ground: Treatment compliance in patients with Alzheimer’s disease is particularly important as patients receiving regular treatment have a greater chance of slowing or delaying disease progression. Transdermal delivery has the potential for providing continuous drug delivery and steady plasma levels. Current study aimed to evaluate safety and tolerability of rivastigmine patch, to assess patient compliance and to assess the efficacy of treatment in patients with dementia (with probable Alzheimer’s disease). Methods: A total of 112 dementia patients (with a diagnosis of probable Alzheimer’s disease) from 12 centers were enrolled who were residing with someone in the communities throughout the study. After eligibility, and baseline assessments, patients were entered a 24-week open label treatment phase. All patients were started with application of one 5 cm² patch, followed by an up-titration to the target dose of 10 cm² patch size. Efficacy assessments were performed at weeks 12 and 24 in terms of MMSE and GDS score. Safety was monitored at all assessment points based mainly on the frequency of adverse events. Results: Analysis of baseline and available data until the drop out revealed no significant differentials. Around 95% of the study participants could receive 10 cm² patch size, showing a very high tolerability of the patch. Concurrent medication use also showed significant reduction to 16.3% patient in the end from 25% at baseline. The average MMSE score increased to 19.3 (±3.1) at 12th week and to 20.6(±3.4) at 24th week from 16.8 (±3.2) at baseline. GDS score reduced to 3.7 (±1.4) at 12th week and to 3.2 (±1.3) at 24th week from 4.3 (±1.5) at baseline. Only eight occasions of adverse event was reported (8.2%); no serious adverse event (SAE) were reported. Lost to follow up in the study was 14 (12.5%). Analysis of baseline data shows no significant difference. Their withdrawal seems to be unrelated to the adverse events and treatment outcome. Among the lost to follow up only one 1 (7.1%) had some side effect. Conclusion: Our study supports the pharmacokinetic rationale for the rivastigmine patch, indicating that smooth and continuous delivery of rivastigmine translates into an improved tolerability profile versus conventional oral administration, while maintaining clinical effectiveness. Bangladesh Journal of Neuroscience 2013; Vol. 29 (1) : 5-14

Ibrahim Cardiac Medical Journal 2011; 1(2): 24-28 DOI: http://dx.doi.org/10.3329/icmj.v1i2.13548

Ibrahim Cardiac Medical Journal 2011; 1(2): 10-14 DOI: http://dx.doi.org/10.3329/icmj.v1i2.13545