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Background: The impacts of socio-demographic characteristics on acute myocardial infarction (AMI) are not well understood and have not yet been studied much more in our country. Acute myocardial infarction is the most common form of coronary heart disease and the single most important cause of premature death worldwide.Objective: The aim of this study was to assess the impacts of the socio-demographic characteristics on AMI patients and to investigate the association between socioeconomic status and its various indicators and the risk of acute myocardial infarction (AMI). This study will help in awareness building in reducing AMI by early detection of socio-demographic variables.Patients and methods: This was a prospective observational study consisted of 325 persons of AMI patients who were aged >20 years. Patients with first time AMI arriving in Coronary Care Unit (CCU) of Rajshahi medical college during the period of 2012-2014, were included. Data were collected through interview.Results: Among the AMI patients, male were more sufferer than female (68.3% vs. 31.7%) and male and female ratio was 2.15:1.0. Highest percentage of education was up to primary level (53.85%). Most of studied subjects (92.0%) monthly income were ≤15000. More than half (59.38%) of the studied population were from rural area, mostly they were Muslim (94.46%) and smokers (50.15%). The mean±SD age of the acute Myocardial infarction patients was 53.75±11.64 years. Mean age of the female patients were a little bit higher than the male patients (female 54.28±11.78 vs. male 53.51±11.63). Highest percentage was in the age group 51-60 years (32%) followed by 41-50 (26.8%) and then age group >60 (23.7%). Among the male patients highest percentage was in the age group 51-60 years (31.1%) followed by 41-50 years (27%) and then age group >60 (24.3%). However, among the female patients, highest percentage were in the age group 51-60 years (34%) followed by 41-50 years (26.2%), and then age group >60 (22.3%). Acute Myocardial infarction patients was more in age group >40 years of age. Interestingly after 60 years of age occurrence of AMI was low in both sexes.Conclusion: Both sex and age influenced AMI. An association was also found among educational level, monthly income, residence area, religion, smoking habit and AMI.TAJ 2016; 29(1): 16-20

Objective: Diabetes mellitus is a growing public health problem in the world. Health education by health workers is a key factor in the prevention of this chronic disease. The objective of the study was to determine nurses understanding of diabetes mellitus.Methodology: This was a cross-sectional descriptive study carried out at Rajshahi Medical College hospital from August 2010 to February 2011. Registered nurses were questioned about the clinical features, diagnosis, complications and management of diabetes mellitus. The results were analyzed using appropriate statistical method.Results: A total of 86 nurses completed the questionnaire. Majorities were below 50 years and were ward nurses. About 97.7% correctly identified the definition of diabetes mellitus (p < 0.01) and 94.2% identified

Non-alcoholic fatty liver disease (NAFLD) is an emerging chronic liver disease and may lead to liver cirrhosis and hepatocellular carcinoma. It is now the most common chronic liver disease in many developed as well as developing countries. This hospital based study was done to see the prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome among patients attending in a tertiary care center in Bangladesh. Here, 334 nonalcoholic subjects of both sex and age were included. Metabolic syndrome was assessed by modified ATP III criteria and fatty liver diagnosis was based on ultrasound findings. 27.2% had the metabolic syndrome and was more common in female. Prevalence of NAFLD was 44% and was more common in female. Metabolic syndrome was found in 61.5% with NAFLD.TAJ 2015; 28(2): 44-51

This study was designed to make a relation between gall bladder wall thickening (GBWT) measured by ultrasonography and esophageal varices (EV) measured byupper gastrointestinal endoscopy in chronic liver disease patients. Itwas cross- sectional descriptive study. 50 cases ofChronic Liver Disease were recruited. GBWT was measured by ultrasonography and upper gastrointestinal endoscopy was done for assessment of the presence and grade of EV in all cases. Among 50 cases, 34 (68%) were male and 16(32%) were female. Mean age (±SD) of the study population was 46.7 (±13.28) years of age. Esophageal varices were found in 42(84%) cases and 8(16%) cases had no varix. Among 42 cases of esophageal varices 9 cases had grade-I, 17 cases had grade-II and 16 cases had Grade-III esophageal varices. Gall bladder wall thickness up to 3mm was considered as normal. In this study GBWT value between (1-3) mm8 cases had no EV GBWT value between (3.1-5.9) mm ,10 cases had EV(9 cases had grade 1 and 1 case had grade 11 EV); GBWT value between (6-8.9) mm, 16 cases had grade 11 EV and GBWT value between (9-12) mm 16 cases had grade 111 EV. A significant statistical correlation was found between the level of GBWT and EV (P

Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the major health problems and causes of chronic morbidity and mortality in Bangladesh as well as worldwide. Echocardiogram was performed to observe changes among the patients of COPD. Objectives: To observe echocardiographic changes among the patients of COPD. Methods: It was a cross-sectional observational study carried out in the Department of Medicine, Rajshahi Medical College Hospital, Rajshahi from July, 2010 to June, 2012. According to inclusion and exclusion criteria 64 people aged 40-70 years having COPD were selected. Thorough history, physical examination and spirometric along with echocardiographic assessment were done. Results: In case of COPD, 22(34.4%) cases showed echocardiographic changes and 42(65.6%) cases showed normal echocardiogram. Conclusion: In this study, Echocardiographic changes were 34.4% in COPD patients which would help in early detection of cardiac morbidity among those patients and to manage them accordingly.TAJ 2015; 28(1): 16-20

Stroke is the third most common cause of death and is the main cause of neurological disability today. This is an observational study conducted at the department of Medicine, Rajshahi Medical College Hospital, Rajshahi, to observe the risk factors of ischaemic stroke and their presentation during hospital admission. Fifty patients of stroke with cerebral infarction confirmed by CT scan of brain were included. Hypertension (74%), diabetes (42%), overweight (22%), alcoholic (12%), past history of stroke (10%), previous history of TIA (16%), Carotid bruit (20%) and hypercholesterolemia (48%) were found as risk factors. Hemiplegia (96%), facial weakness (34%), deglutition problem (38%), speech difficulty (60%) and coma (14%) were observed during hospitalization.TAJ 2015; 28(2): 40-43

Background: Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) impair quality of life (QOL), accelerate the decline in lung function and often require hospitalization, and thus, leading to increased healthcare burden. By identifying factors that may be associated with AE-COPD and managing them rationally, not only the hospital admissions could be avoided but progression of the disease may also be slowed.Objective. The aim of the present study was to determine the factors associated with hospital admissions among adults with AE-COPD.Methods. Seventy-three patients admitted with AE-COPD were administered a structured questionnaire during their hospital stay. Data on body mass index (BMI), smoking, symptoms, co-morbidities course of the disease, spirometry management and outcomes during the hospitalisation were obtained. Factors associated with hospital admissions were analyzed.Results. The hospitalization due to AE-COPD was significantly associated with the reduced forced expiratory volume in one second (FEV1), and peak expiratory flow rates, increasing sputum purulence, number of hospitalizations during previous year for COPD and presence of co-morbidities.Conclusions. The study shows that both disease and healthcare-related factors are predictors for hospitalisation. Identification of risk factors and appropriate management may reduce hospitalisation due to AE-COPD.TAJ 2015; 28(2): 52-57

Patients And Methods: We prospectively randomized 150 patients to treatment with capecitabine 1,250 mg/m2 administered twice daily days 1 to 14 every 3 weeks, or to the 4-weekly Mayo Clinic regimen (5-FU/LV) until disease progression or unacceptable toxicity.Results: The primary objective, to demonstrate at least equivalent response rates in the two treatment groups, was met. The overall response rate was 18.9% for capecitabine and 15.0% for 5-FU/LV. In the capecitabine and 5-FU/LV groups, respectively, median time to disease progression was 5.2 and 4.7 months (log-rank P = .65); median time to treatment failure was 4.2 and 4.0 months (log-rank P = .89); and median overall survival was 13.2 and 12.1 months (log-rank P = .33). The toxicity profiles of both treatments were typical of fluoropyrimidines. However, capecitabine led to significantly lower incidences (P < .00001) of stomatitis and alopecia, but a higher incidence of cutaneous hand-foot syndrome (P < .00001). Capecitabine also resulted in lower incidences (P < .00001) of grade 3/4 stomatitis and neutropenia, leading to a lower incidence of grade 3/4 neutropenic fever and sepsis. Only grade 3 hand-foot syndrome (P < .00001) and uncomplicated grade 3/4 hyperbilirubinemia (P < .0001) were reported more frequently with capecitabine.Conclusion: Oral capecitabine achieved an at least equivalent efficacy compared with IV 5-FU/LV. Capecitabine demonstrated clinically meaningful safety advantages and the convenience of an oral agent.TAJ 2012; 25: 17-25

Stroke patients have significant lipid abnormality and it is associated with formation of carotid artery plaque. This is an observational study conducted at the department of Medicine, Rajshahi Medical College Hospital, Rajshahi, to observe the frequency of carotid artery plaque in ischaemic stroke patients and its correlation with dyslipidaemia. Fifty patients of stroke with cerebral infarction confirmed by CT scan of brain were included. The frequency of significant carotid artery plaque was on right side 52%, on left side 40% and on both side 34%. Both Left and right internal carotid artery showed positive correlation with serum total cholesterol, LDL cholesterol and HDL cholesterol but it was not statistically significant (r

Oesophageal cancer is a gastrointestinal malignancy with insidious onset and poor prognosis. The disease predominantly affects the older age groups with pick incidence between 60 to 70 years of age. The total number of oesophageal cancer patients available for the study within the stipulated time was 43. Among them 60.47% patients were male and 39.53% patients were female, 06.98% belonged to age group 31-40, 16.28% belonged to age group 41-50, 37.21% belonged to age group 51-60, 23.25% belonged to age group 61-70 and 16.28% patients were >70 years of age. Mean age was 59.95 years ± 12.63 SD. In our study, 33.3% survived ≤3 months, 09.1% 4–6 months, 15.2 % 7–9 months, 06.1% 10–12 months, 27.2% 13–24 months and 09.1% >24 months. Among the expired patients, 09.10% got curative treatment and rest of 90.90% got palliative treatment. Those who got curative treatment 66.7% survived 13–24 months and 33.3% > 24 months. Those who got palliative treatment 36.7% survived ≤3 months, 10.0% 4–6 months, 06.7% 10–12 months and 30.0% 13–24 months. Overall median survival was 08 months, for curative treatment 18 months and for palliative treatment 07 months.TAJ 2014; 27(1): 38-43

This was a cross sectional type of descriptive study which was conducted in four villages of Puthia Upozila of Rajshahi district. A preformed interview schedule was used to collect data from a purposively selected sample of 518 respondents. The study revealed that 42.9% children had 1st degree malnutrition, about 19.5% children had 2nd malnutrition and 1.7% had 3rd degree malnutrition. The mean age of the children was 3.45 ± SD 1.33 years. Out of 518 respondents 74.7% had monthly income of Tk. 5000/- or less and 25.3% respondents had monthly income of Tk. 5001/- and above. The mean monthly was Tk. 5039/- ± SD 3869.36.Undernutrition was more in female children (70.1%) than male children (51.2%). In large family size under nutrition were more (68.4%) in comparison to small family size (61.4%). The study would be helpful in future community survey on nutritional status of under five children and in formulating effective national nutrition health program and facilitating their effective implementation.TAJ 2012; 25: 13-16

Background : Subarachnoid hemorrhage (SAH) is a catastrophic neurological event. Aside from its neurological morbidities, SAH is associated with significant medical complications. Cardiac manifestations are common and can impact morbidity and mortality in SAH patients. Myocardial enzyme release occur frequently after Subarachnoid hemorrhage that reflect adverse intracranial events .These changes often are unrecognized or misinterpreted, potentially placing patients at risk for inappropriate management.Objective : The aim of this study was to assess Troponin I changes after acute SAH and these changes were compared with neurological severity. The result of the study might be helpful for better understanding diagnostic and therapeutic implications of acute neurocardiogenic injury after SAH.Patients and methods : This cross sectional descriptive study was conducted over 30 patients with SAH in medicine, neuromedicine and intensive care unit of Rajshahi Medical College Hospital during the period of January 2015 to December 2016. Predictor variables reflecting demographic (age, sex, occupation), hemodynamic (pulse, systolic and diastolic blood pressure) and neurological (WFNS score) informations were recorded. We evaluated their cTnI level, which had been measured at admission. A cTnI level above 0.12 ng/ml was defined as an indicator of cardiac injury following SAH.Results : Out of 30 patients 26.7% were both in between 40-49 years and 60-69 years age group & 50% were male and 50% were female. Among the risk factors 60% of patient had history of hypertension, 40% smoking, 10% Diabetes mellitus and 3.3% alcohol abuse. On admission the mean GCS was 12.53±2.69,. The most frequently occurring WFNS grading were grade 1 and grade 4 (both were 43.3% of patients). Out of Thirty, 43.3% of patients demonstrated elevations of Troponin I. WFNS score ≥ 3 (92.3%, p =

Background: Acute inferior myocardial Infarction frequently involves the right ventricle and associated with significant morbidity and mortality. We hypothesized that right ventricular involvement may affect the prognosis of patients with inferior myocardial infarctions.Methodology: In 100 consecutive patients admitted to the hospital with acute inferior myocardial infarction, we assessed the incidence and prognostic factors for in-hospital outcome. RVMI (Right ventricular myocardial infarction) was diagnosed by ≥1mm ST elevation in lead V4R in right sided electrocardiogram.Result: RVMI was found in 31(31%) of patients of acute inferior myocardial infarctions. Major complications as hypotension and cardiogenic shock occurred in 96.7% and 64.5% patients respectively and in-hospital mortality was 41.9%. Whereas major complications as hypotension and cardiogenic shock occurred in 10.1% and 2.8% patients respectively and in hospital mortality was 2.8% of patients without right ventricular infarction among the inferior myocardial infarction. Multiple logistic regression analysis showed right ventricular infarction to be independent of and superior to all other clinical variables available on admission for the prediction of in hospital mortality (relative risk 88.37 percent, 95% confidence interval 7.33 to 1064.80; p=0.000) and major complications as hypotension (relative risk 394.22, 95% confidence interval 32.04 to 4849.07; p=0.000) and cardiogenic shock (relative risk 272.36, 95% confidence interval, 16.38 to 4526.35; p=0.000).Conclusion: RVMI commonly occurs in inferior myocardial infarction. It is a strong and independent predictor of major complications and in-hospital mortality. Early detection and appropriate monitoring can reduce its high mortality rate.TAJ 2013; 26: 8-13

A prospective and retrospective study had been carried out between January 2013 to December 2015 for evaluation of the overall survival (OS) & disease free survival (DFS) rate of HER2 positive breast cancer patients with Trastuzumab combined with cytotoxic chemotherapy and patients who only takes chemotherapy alone. A randomized control trial was run with the 130 patients having HER2 positive breast cancer in the Rajshahi Medical College and Hospital and different private hospitals and Clinics of Rajshahi city. Among 130 women having HER-2 positive breast cancer 52 women were randomly allocated to the TAC (Taxotere, Doxorubicin and Cyclophosphamide) arm and 61 women were randomly allocated to the TAH (Taxotere, Doxorubicin, Herceptin) arm. TAC arm consists of Taxotere (75mg/m2), as 1 hour infusion preceded by Doxorubicin (50mg/m2) and Cyclophosphamide (500mg/m2), both given as an intravenous bolus. This TAC protocol runs for 6 cycles in every 3 weeks. And TAH arm consists of Taxotere (75mg/m2), Doxorubicin (50mg/m2) and Herceptin (8mg/kg for 1st cycle and 6mg/kg from 2nd cycle). In this arm other combined therapy will run till 6 cycles and Herceptin will run up to 12 cycles in every 3 weeks.TAJ 2013; 26: 30-37

Introduction: Diseases of the spinal cord are called myelopathy. They are frequently devastating. They produce quadriplegia or paraplegia with sensory deficits far beyond the site of damage. Many spinal cord diseases are reversible if recognized and treated at an early stage.Objectives: The aim of this study was to evaluate clinical presentation and aetiology of myelopathy among the patients attending Rajshahi Medical College Hospital with the help of history, clinical examination and investigations.Methodology: This was a cross-sectional type of descriptive study. A total 44 myelopathic patients were evaluated between January 2009 to December 2009.Result: Out of 44 patients, 33 (75%) were male and 11 (25%) were female (ratio 3:1), mean aged 35 ± 13.9 years (range 13-65 years). Among them 24 (54.5%) patients had paraparesis and 20 (45.5%) patients had quadriparesis. It was observed that majority 33 (75%) of them had compressive type and 11 (25%) patients had non-compressive type of involvement. Out of 33 compressive myelopathy, the commonest cause was cervical spondylotic myelopathy 14 (42.4%) in number. 2nd cause was Pott’s disease 8 (24.2%) in number. Syringomyelia was detected in 5 (11.4%) patients, disc herniation was in 2 (6.1%) patients, schwannoma was in 2 (6.1%) patients, lipoma was in 1 (3%) patient and 1 (3%) patient was metastasis to the vertebra. Out of 11 non-compressive myelopathy, acute transverse myelitis was detected in 9 (81.8%) patients and familial spastic paraplegia in 2 (18.2%) patients.Conclusion: All patients with myelopathy should be investigated for potentially treatable causes.TAJ 2013; 26: 48-52

Liver metastases are the leading cause of death in patients with colorectal cancer Despite advances in chemotherapy, surgical resection of hepatic metastases is still considered the only curative treatment the majority of patients have inoperable disease at presentation. Perioperative chemotherapy is the most successful way for improved selection of patients for resection. The aim of the study was to demonstrate if and to what extent does bevacizumab, introduced in chemotherapy, increase response rates, and development of liver metastases. Our study included 25 patients who were divided in two groups. The experimental group included patients who were treated with bevacizumab plus chemotherapy and the control group included patients who were treated with chemotherapy only. The comparison showed that the patients who were treated with bevacizumab became candidates for resection of liver metastases in higher percentage (85%:52%). On the otherhand distribution of patients regarding the development of metastases resulted in statistically significant difference. Ratio between the patients with good response from the experimental and the control group was 67%:39%. Ratio of patients with stable disease was 26%:48%, and of patients with progressive disease, it was 7%:3%. The estimate of margin after resection was statistically insignificant.TAJ 2011; 24(2): 101-105

Five hundred and seventy seven patients with diabetes mellitus showed ABO blood group frequencies closely similar those expected from the controls. Four hundred and eleven patients with diabetes mellitus showed frequencies of secretion and non-secretion of the ABH (O) substances in the saliva closely similar to those expected from the controls. three hundred and two patients with diabetes mellitus gave MN blood groups frequencies very similar to those expected from the controls.TAJ 2012; 25: 38-41

Background: Acute myocardial infarction is the most common form of coronary heart disease and the single most important cause of premature death worldwide. A large proportion of patients with coronary disease have metabolic syndrome, although the frequency and association of its different components are not well understood. The risk of the metabolic syndrome on AMI has not been well evaluated.Objective: The aim of this study was to assess the prevalence of the metabolic syndrome and its association with AMI patients. This study will help in awareness building in reducing AMI by early detection of metabolic syndrome.Patients and methods: This was a prospective observational study consisted of 222 persons of male AMI patients who were aged >20 years. Patients with first time AMI arriving in CCU of Rajshahi medical college during the period of 2012-2014, were included. Data were collected through interview, clinical examination, and laboratory tests. Five components of metabolic syndrome were defined according to criteria set by modified NCEP ATP III (according to ethnic variation) which had abdominal obesity (waist circumference), FBS, HDL-C, Triglyceride, and hypertension were measured within 24 hrs of AMI.Results: A total of 222 patients diagnosed with AMI were inducted in the study. The mean±SD age of the male was 53.51±11.63 years. Among the male patients highest percentage was in the age group 51-60 years (31.1%) followed by 41-50 years (27%) and then age group >60 (24.3%). Study showed that acute Myocardial infarction patients was more in age group >40 years of age. Highest percentage was observed in abdominal obesity (52.3%) followed by high blood pressure (50.0%) and FPG (46.4%). The Metabolic syndrome was 37.4 % (n=83).Conclusion: The metabolic syndrome was associated with an increased risk of AMI. The metabolic syndrome had a high prevalence in patients with AMI.TAJ 2014; 27(1): 57-61

Right Ventricular Infarction (RVI) complicating inferior wall myocardial infarction (MI) is common and associated with significant morbidity and mortality. We try to systematically assess the incidence, clinical presentation and in hospital outcomes of right ventricular myocardial infarction in a tertiary-care set up. This study was a descriptive, cross sectional observational series of consecutive patients with RVMI. All patients with acute inferior myocardial infarction (n=100) were enlisted. RVMI was diagnosed by ≥1mm ST elevation in lead V4R in right sided electrocardiogram. RVI occurred in 31% (n=31) of patients of acute inferior infarctions. Patients with isolated inferior myocardial infarction served as controls (n=69). Echocardiography was performed within 24 hours of admission. From both groups, 51% were qualified for thrombolysis. The incidence of hypotension (96.7%), cardiogenic shock (64.5%), bradycardia and heart block were much higher in RVI than in inferior myocardial infarction. Clinically manifest RV dysfunction (raised jugular venous pulse, hypotension and tricuspid regurgitation) and right ventricular dilatation detected by echocardiography was seen in a variable number of patients. In hospital mortality rate was significantly higher (n=13, 41.9%) in right ventricular infarction group than in inferior myocardial infarction group (n=2, 2.9%)TAJ 2012; 25: 42-46

The risk of diabetes mellitus and coronary heart disease is high among South-Asian population. In this study, our objective was to measure blood glucose level during acute coronary syndrome of previously known non-diabetic patients that will give the information about the frequency of acute hyperglycemia in acute coronary syndrome (ACS) among Bangladeshi population. It is an observational cross sectional study performed in Rajshahi Medical College Hospital. A total of 248 non-diabetic subjects with ACS got admitted into hospital. FBS and standard OGTT within 3 days of ACS were done. This study was done to find out glucose abnormalities among ACS patients. Out of 248 study population, 135(54.44%) had glucose abnormalities. Male was 87.10% (216). Among male, IGT (prediabetic) was 31.94% (69) and diabetic 24.54% (53). Mean age (±SD) of our study population was 51.71±11.84 years. Normal glucose tolerance (NGT) was found in 45.6% (113) cases, IGT (prediabetic) and diabetic were detected among 30.6% (76) and 23.8% (59) cases respectively. Non-diabetic Bangladeshi patients showed a high prevalence of hyperglycemia in acute coronary syndrome (ACS). We should create awareness about a new risk factor- acute hyperglycemia during acute coronary syndrome and take appropriate and effective measures to reduce morbidity as well as mortality as a consequence of acute hyperglycemia during ACS with or without diabetes.TAJ 2012; 25: 30-34

Idiopathic Intracranial Hypertension is a disease of unknown aetiology common in obese females and presents with headache, papilledema, raised CSF opening pressure, no abnormalities in CSF examination and no abnormality on CT scan or MRI of the Brain. Sinovenous abnormalities are commonly detected in patients of IIH by different neuroimaging techniques. But the exact role of these sinovenous abnormalities in the causation of the disease or whether they are an effect of the disease is not yet known. Nor has a ‘gold standard’ investigation been established yet for detection of the sinovenous abnormalities. This study was done to detect the presence of sinovenous abnormalities in IIH patients by performing a Magnetic Resonance Venography of the brain. All 33 patients of IIH who presented to Rajshahi Medical College Hospital during the study period from June 2009 to May 2010 were included in the study. There were 30 females and 3 males having a F:M ratio of 10:1. 91% of the patients were between 20 and 35 years of age and most of them were married housewives. 63.64% patients had history of use of oral contraceptives. Unusually 51.52% of the patients had a BMI less than 25 indicating that they were not even overweight (BMI 25 to 30). Only 6% of the patients had BMI > 30 indicating that they were obese. Headache and papilloedema were present in all patients but visual difficulties were present only in 54.54% of the patients. Abnormalities in MRV of the brain were detected in 27.27% (9/33) of the patients and transverse sinus hypoplasia was the commonest finding (88.89% - 8/9 patients). There was no statistically significant difference in the findings of MRV abnormalities between the males and females or among the patients having BMI less or more than 25TAJ 2013; 26: 53-56

Introduction: Obesity is becoming a major health hazard in developed and developing countries. Besides the well-known complication like Diabetes mellitus, hypertension. ischemic heart disease, obesity can affect thorax, diaphragm, abdominal muscles, thereby resulting in altered pulmonary functions.Objective: To evaluate the effects of obesity on lung functionsMethods: We studied 208 adults of both sex with the age range of 18 to 60. 104 obese subjects were taken as test group (BMI ≥ 25 Kg/m2) & 104 non obese individuals (BMT 18.5-24.9 Kg/m2) as control group. Spirometry was performed by using computerized spirometer. Data were expressed as mean & standard deviations. Data were analysed by the help of SPSS version-16. non pair student’s ‘t’ test (P values ≤ .05 were considered significant) Pearson correlation analysis & multiple linear regression tests were applied.Results: FVC% (mean & standard deviation), in obese group (Group A) and non obese group (Group B) were 73.42±8.24, 84.05±5.94 respectively. FEV1% (mean & standard deviation), in obese group (Group A) and non obese group (Group B) were 74.65±7.29. 84.22±5.95 respectively. FEV1/FVC% (mean & standard deviation), in obese group (Group A) and non obese group (Group B) were 101.30±9.87, 99.57±11.50 respectively. PEF% (mean & standard deviation), in obese group (Group A) and non obese group (Group B) were 65.98±14.21. 93.53±13.21 respectively. There are statistically significant differences of spirometry results in absolute values and in percentage predicted between two groups, except FEV1/FVC. There were also significant negative correlation between obesity indices (BMI. WC) and spirometric variables except FEV1/FVC%.Conclusion: Obesity independently affects pulmonary functions.TAJ 2014; 27(2): 14-21

This study aims at finding the presence of psychiatric illness of the santals, an ethnic minorities of the northern part of Bangladesh and their belief towards mental illness. Among the 77 patients, 39 (50.64%) were male and 38 (49.35%) were female. The majority of the respondents were in between the age of 16-35 years. Most (80%) believed that possession by Bonga/Kali caused the illness. In the present study, 45 (59.74%) had major mental disorder, 18 (23.37%) had minor mental disorders and 13 (16.88%) had psychotic disorder due to general medical condition (viz. Epilepsy). Observations suggest that change of awareness and perception regarding mental disorder, should be a high priority, as right mental health is one of the key component of total delivery of health care.TAJ 2011; 24(2): 76-81

Background: Non specific low back pain (NSLBP) has been identified as one of the commonest rheumatic disorders in prevalence surveys in Asia-PacificObjective: Development of a core questionnaire for identification of risk factors of NSLBP at community level.Methods: Following steps were followed: 1) item generation from literature survey, existing Nordic questionnaires and patient focus group discussions, 2) development of a preliminary APLAR-COPCORD English questionnaire, 3) translation into target language, back translation and development of a synthetic target language version, 4) adaptation of the synthetic target language version through tests of comprehensibility, content validity test-retest reliability, and 5) finalization of the English questionnaire. .Results: 45 items were generated. A preliminary English questionnaire was developed.Conclusion: The developed English questionnaire will serve as an efficient tool for identification of risk factors of NSLBP in Asia-Pacific communities.TAJ 2011; 24(2): 85-90

not availableTAJ 2012; 25: 90-96

Fixed drug eruption (FDE) is a distinctive type of cutaneous drug reaction that characteristically recurs in the same site or sites each time a particular drug is taken. FDEs are among the most frequent problems encountered by the dermatologists. The present study was carried out to recognize offending drugs, to educate the patients and to avoid self-administration of drugs and re-administration of the offending drugs. The study was conducted in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi over a period of one year. One hundred ten cases with established FDE were evaluated clinically. The causative drugs were identified and confirmed by provocation tests. Cotrimoxazole (25%) was the most common cause of FDE. Other drugs incriminated were NSAID (21.8%), Tetracycline (15.4%), Ciprofloxacin (10%), Amoxicillin (7.2%), Metronidazole (5.4%), Griseofulvin (2.7%) and Fluconazole (1.8%). The lesions were found to be distributed on the oro-genital mucosa, trunk and the acral regions.The main presentation of FDE was circularhyperpigmented lesion.TAJ 2014; 27(1): 29-33

An experiment was carried out at farmer’s field of Kushtia district under High Ganges River Floodplain Soil (AEZ-11) during Rabi seasons of 2013-14, 2014-15 and 2015-16. The objectives of the study were to evaluate the effect of boron on the yield of hybrid maize (cv. BARI Hybrid Bhutta-9) and to find out the optimum dose of boron for higher yield and economic return. There were 6 treatments comprising 6 levels (0, 0.5, 1.0, 1.5, 2.0 and 2.5 kg B ha -1 ) of boron along with a blanket dose of N 256 P 65 K 45 S 27 Zn 3 kg ha -1 and cowdung 5 tha -1 . Boron fertility of the initial soil was in medium level (0.33 μg g -1 ). The experiment was conducted in RCB design with three compact replications. Results of three years study revealed that hybrid maize responded significantly to added boron for the first two years but for the third year the effect was statistically non significant. The highest grain yield was obtained with 2.5 kg B ha -1 , which was marginally significant with boron control but statistically identical to rest of the boron levels. Although, the yield increased linearly up to 2.5 kg ha -1 but the effect was relatively better fitted with quadratic response function (R 2 = 0.943). The mean highest grain yield found to be 8.55 t ha -1 for 2.5 kg B ha -1 against 8.20 t ha -1 from 0.5 kg B ha -1 and 7.84 t ha -1 from boron control. Considering the boron fertilty of soil, response of maize to boron and economic return, the optimum dose of boron may be 0.5 kg ha-1 for the cultivation of hybrid maize for medium level boron fertile soil under AEZ-11 of Kushtia district or alike. Bangladesh J. Agril. Res. 43(2): 281-288, June 2018

This was a descriptive cross-sectional comparative study carried out in Department of Medicine, Rajshahi Medical College Hospital and Rajshahi Diabetic Association Hospital from July 2008 to June 2010. 100 (one hundred) diagnosed type2 diabetic patients and 30 apparently healthy people were included. All of those study population were free from taking any hepatoxic drugs and free from any preexisting liver disease. This exclusion was done by history, through clinical examination and relevant investigations. The prevalence of abnormal serum bilirubin, ALT, AST, Alkaline phosphatase, prothrombin time and S. albumin were 6%, 30%, 7%, 6%, 54% and 12% respectively in type2 diabetic patients and 00%, 3.3%, 00%, 6.7%, 10% and 3.3% respectively in normal people. All the LFTs of type 2 diabetic patients were mildly abnormal except 2 patients (2%) had moderate elevation of ALT, 7 patient (7%) had markedly prolonged PT, and 1 patient (1%) had moderately decreased s. albumin. In normal people all LFTs abnormalities were mild.TAJ 2016; 29(1): 21-23

Ulcerative colitis is an idiopathic inflammatory bowel disease characterized by continuous mucosal inflammation that starts in the rectum and extends proximally. Ulcerative colitis is considered frequent in majority of European and North American population and exceptional in most of the developing Asian countries. The present study was designed to estimate the disease severity and colonic involvement of ulcerative colitis in a tertiary care hospital of Rajshahi Medical College. The study population includes of 60 ulcerative colitis patients. Patients were categorized on the basis of disease severity ; moderate : 34, and severe: 26 and involvement of colon: 28 (46.40%) pancolitis, 20 (33.96%) left sided colitis and had 12 (19.61%) proctosigmoiditis.TAJ 2015; 28(2): 58-60

Breast TB is a very rare form of extrapulmonary TB. So, case reviews are also less common. 12 breast TB cases diagnosed and treated between June 2011- June 2014 in the private chamber were retrospectively reviewed. All cases were female, their mean age was 34.4 years. All were new cases and only one had pulmonary TB. Patients presented with hard, irregular breast lump (83.3%), swelling of the breast (25%), secretion from the involved breast (33.3%), breast pain (50%). Montaux test was negative in 83.3% patients and chest x-ray findings was positive only in one case. ESR was raised and FNAC showed granulomatous changes in all cases. All received Directly Observed Treatment Short Course regimen for a duration of 6 months. Segmental resection was not done. Small lump persisted in only 2 eases after treatment. From the above findings it can be said that breast TB should be considered as a differential diagnosis of breast neoplasia and it can be successfully treated by anti-TB drugs.TAJ 2013; 26: 24-26

This cross sectional descriptive study was conducted to assess cytological characteristics of bronchial carcinoma in 60 patients from various region of Rajshahi Division presenting with clinical features consisting with the diagnosis of lung carcinoma. They were admitted to Rajshahi Medical College Hospital from January 2013 to December 2013. Our observations reveals that the most prevalent malignancy among these patients was non small cell lung carcinoma including squamous cell carcinoma and large cell carcinoma in males patients. The common site of bronchial carcinoma in the upper lobe of lung. The proper treatment of bronchial carcinoma depends on the cytological pattern of bronchial carcinoma.TAJ 2013; 26: 27-29

The patients present to their physician with their somatic symptoms which are attributable to some medical illness. This is not always true. Sometimes a few patients present with the complaints of prolonged fever for months to year duration. As fever is an important vital sign it gains attention of the physician to work up and reveal the cause. In this study apparently healthy patients who complained of prolonged fever were clinically assessed, routine investigations were done and found normal. Then they were provided with a temperature chart to note down body temperature with a thermometer for one week from first visit. Afebrile such fifty patients complaining of fever were referred to psychiatrist for evaluation. All patients showed some sort of psychiatric illness. 20 (40%) were of generalized anxiety disorder, 10 (20%) depression, 5 (10%) mixed anxiety and depression, 5 (10%) obsessive compulsive disorder, 10 (20%) somatoform disorder. The practicing physician may encounter many patients of prolonged fever which are not febrile at all so they need psychiatric assessment and treatment to relieve their distress.TAJ 2014; 27(1): 1-3

Kikuchi’s disease is a rare, benign, self-limiting disorder, characterized clinically by fever and regional lymphadenopathy. Histopathologic features of lymph nodes in Kikuchi’s disease are characteristic and permit differentiation of this benign condition from lymphomas, systemic lupus erythematosus and infectious lymphadenopathies. We report a female patient presenting with fever and tender cervical lymphadenopathy. An excisional biopsy of the lymph node reveale lymphadenitis, consistent with Kikuchi’s disease.TAJ 2012; 25: 81-83

This study was done to find out the prevalence of fatty liver in type2 Diabetic patients. This was a descriptive cross-sectional comparative study carried out in Department of Medicine, Rajshahi Medical College Hospital and Rajshahi Diabetic Association Hospital from July 2008 to June 2010. 100 (one hundred) diagnosed type2 diabetic patients were included. All of those study population were free from taking any hepatoxic drugs and free from any preexisting liver disease. This exclusion was done by history, through clinical examination and relevant investigations. Among 100 type2 diabetic patients, 66 (66%) had normal, 25 (25%) had mild fatty change, 6 (6%) had moderate fatty change in liver; 2 (2%) had mild hepatomegally and 1 (1%) had congested liver. Non had cirrhosis or hepatocellular carcinoma.TAJ 2014; 27(2): 11-13

This was a hospital based study done to see the prevalence of metabolic syndrome in acute myocardial infarction patients in Bangladesh. A total of 325 acute myocardial infarction patients attending in coronary care unit Rajshahi medical college hospital were included in this study. According to modified NCEP ATP III criteria 48.5% of subjects aged ≥ 20 years had the metabolic syndrome and it was more commonly seen in women than in men (72% vs 37.4%). The metabolic syndrome is associated with an increased risk of acute myocardial syndrome.TAJ 2011; 24(2): 82-84

Background: Gallstone disease one of the major health problems and causes of morbidity in Bangladesh as well as worldwide. Ursodeoxycholic acid is a bile acid which is used for dissolving gallstones.Objectives: To observe dissolution of gallstones among the patients of gallstone disease by use of ursodeoxycholic acid. Methods: It was a cross-sectional observational study carried out in the Department of Medicine, Rajshahi Medical College Hospital, Rajshahi from July, 2014 to June, 2016. According to inclusion and exclusion criteria 12 people having gallstone disease were selected whose stone size were

The experiment was conducted at farmers’ field of On-Farm Research Division (OFRD), Bandarban during Rabi season of 2014-15 to find out suitable combination of hybrid maize and chilli intercropping system to increase system productivity and economic return. The experimental design was Randomized Complete Block (RCB) design with six dispersed replications. The maize var. BARI Hybrid Maize-9 and chilli (local) were used in the experiment. Two intercropping combinations viz., Maize single row (100 cm x 25 cm) + 2 rows chilli (50 cm x 40 cm) and Maize single row (150 cm x 25 cm) + 3 rows Chilli (50 cm x 40 cm) were evaluated against their sole crops. The highest gross return (Tk. 435040 ha-1), net return (Tk. 366290 ha-1) and benefit cost ratio (6.33) were recorded in maize single row (150 cm x 25cm) + 3 rows Chilli (50 cm x 40 cm) combination. Cob yield of hybrid maize and green fruit yield of Chilli were the highest in the respective sole crops. The results revealed that maize single row (150 cm x 25 cm) + 3 rows Chilli (50 cm x 40 cm) combination might be suitable and economically profitable for the hilly areas.Bangladesh Agron. J. 2016, 19(1): 45-48

Effectiveness is important quality factor to testability measurement of object oriented software at an initial stage of software development process exclusively at design phase for high quality product. It will help developer’s design capability to achieve the specified functionalities, characteristics, better design quality and behavior using appropriate object oriented design (OOD) concepts and procedures. Metric based model for ‘Effectiveness Quantification Model of Object Oriented Design’ has been proposed by establishing the correlation between effectiveness and OOD constructs. Later ‘Effectiveness Quantification Model’ is empirically validated and statistical significance of the study considers the high correlation for model acceptance. The aim of this research work is to encourage researchers and developers for inclusion of the effectiveness quantification model to access and quantify software effectiveness quality factor at design time.

The quality of any object oriented design is critical because it has a great influence on overall quality of finally delivered software product. Testability quantification early in the software development process is a criterion of crucial important to software development team. Testability has always been an indefinable concept its correct measurement, quantification or evaluation is a difficult task because of its potential factors. Testability analysis of object oriented software at an initial stage of software development process has been identified as a key factor for high quality product. A best suited object oriented design (OOD) properties and its associated metrics are helpful if applied in the early stage of development process .This paper describes an improved testability quantification framework using the identified set of potential factors, OOD properties and OOD metrics for software products at early phase, exclusively at design time. The proposed framework relates OOD properties to high level quality attributes/constructs using appropriate information to develop quality product and it may used to benchmark software products according to their key attribute. The objective of this research work to encourage researchers and developers to provide a framework to access and quantify software testability at early stage of development life cycle.

Wolff-Parkinson-White syndrome is a disorder characterized by presence of an accessory pathway which predisposes patients to tachyarrhythmias and sudden death. Among patients with WPW syndrome, atrioventricular reentrant tachycardia (AVRT) is the most common arrhythmia, accounting for 95% of re-entrant tachycardias. It has been estimated that one-third of patients with WPW syndrome have atrial fibrillation (AF). AF is a potentially life-threatening arrhythmia. If an accessory pathway has a short anterograde refractory period, then rapid repetitive conduction to the ventricles during AF can result in a rapid ventricular response with subsequent degeneration to ventricular fibrillation (VF). The study population included a total of 255 patients in whom 175 (68.62%) were men and 80 (31.38%) were women. Demographic data and clinical characteristics are depicted in Table 1. Left and right WPW syndrome were existing in 70.59% and 29.41% of patients respectively. Documented narrow QRS SVT was present in 96.86%, broad QRS SVT was in 2.75% and AF was in 3.14% of patients. Antiarrhythmic drugs most frequently used were Digitalis, Metoprolol, Sotalol, Amiodarone and Verapamil DOI: http://dx.doi.org/10.3329/bmj.v41i2.18809 Bangladesh Medical Journal 2012 Vol. 41 No. 2: 50-53

Background The study was designed to assess the prevalence of asymptomatic gallstone disease in North-East part of Bangladesh. Materials and methods Randomly selected asymptomatic persons, unknown to have gallstone disease, from both rural and urban areas were enrolled. They were subjected to abdominal ultrasonography and findings were recorded in a data sheet. Results Total 1,019 persons (316 males and 703 females) were examined. Age of them varied from 18 to 80 years with mean age of 37.22 years. Out of them, 61 (6%) persons were found to have gallstone. Among them, 14 were males and 47 were females. Both male and females of age below 40 years were more affected. Gallstone disease was found more commonly among housewives and middle class people. Among 61 patients with gallstone, seven were underweight (11.47%), 32 (52.45%) had normal weight and 22 (36.06%) were overweight, obese or extremely obese. But, this difference was not statistically significant (p = 0.894). Conclusion Prevalence of asymptomatic gallstone disease was found in 6% apparently healthy subjects of North-East part of Bangladesh. It was more prevalent among housewives and middle class group of population. It is also common among the people of age group below 40 years. How to cite this article Saha M, Nahar K, Hosen MMA, Khan MH, Saha SK, Shil BC, Rahman MH. Prevalence and Risk Factors of Asymptomatic Gallstone Disease in North-East Part of Bangladesh. Euroasian J Hepato-Gastroenterol 2015;5(1):1-3.

Background-Metabolic syndrome is a risk factor for cardiovascular disease, so it should call attention. South Asian person has preponderance to it. Objectives-The proper findings of metabolic syndrome are a key to prevent cardiovascular disease. Hypertension is a component of metabolic syndrome with which patients are at increased risk for cardiovascular disease. Methods-This study was carried out in cardiology outdoor of Shaheed Suhrawardy medical college hospital, Dhaka. A total of 322 patients were enrolled from January 2008 to December 2010. Metabolic syndrome was defined as three of the followings: (a) Abnormal fasting serum level of glucose (≥110 mg/dl or 6.1 mmol/L), ( b) abdominal obesity (waist circumference >102 cm in men and >88 cm in women), (c) Triglycerides (≥150 mg/dl), (d) High density lipoprotein cholesterol (

Background: Spondyloarthropathies include a wide spectrum of disease. The study was conducted with the aim of observing the efficacy of SSZ and MTX in different subclasses of spondyloarthropathies and to compare the treatment response of the two drugs. Methods: This study was conducted in the Department of Medicine and Rheurnatology clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) between January 1999 and July 2001.A total number of one hundred twenty five patients was included in the study. Patients with active disease more than three months, regularly taking NSAIDs and not on DMARD in the last three months were included in the study. Monthly follow up of the patients was done for 6 months. Result: One hundred twenty five patients were included in this study. Male female ratio was 11.5:1. Mean age of patients was 24.17±7.15 years. The mean disease duration was 47.8±32.8 months. The present study categorized the patients into responder and non responder. Among the 78 patients in AS subclass, after completion of 6 month trial 55.6% patients in SSZ group and 39.4% patients in MTX group were categorized responder. The difference of response between drug groups was not significant (p=0.158). In the JCA subclass 81.82% in SSZ and 50% in MTX group were responder. The numbers of patient in Reiter's/Reactive Arthritis in our study were too small to make a definite comment. Conclusion: It can be concluded from this study that both the SSZ and MTX are effective DMARDs for spondyloarthropathies. Statistical analysis did not prove superiority of one drug over another, though the response rates were numerically higher in SSZ group. TAJ 2011; 24(1): 43-47