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Hereditary antithrombin III deficiency is a prothrombotic disorder with an associated 50-90% risk of venous thrombosis. It rarely causes cerebral venous thrombosis in adults. Variable clinical presentations make the diagnosis a challenge. Careful clinical history, extensive clinical examinations, comprehensive investigations, and prompt management are necessary to save lives. COVID-19 vaccine-induced immune thrombotic thrombocytopenia may be a risk factor for cerebral venous thrombosis in these cases. Here, we are reporting an adult female with cerebral venous sinus thrombosis after receiving the COVID-19 vaccine. Subsequently, she was diagnosed with hereditary antithrombin III deficiency. J Dhaka Med Coll. 2021; 30(2) : 227-231

Aims: Aim of the study was to know the clinical presentations of biliary ascariasis. Materials and Methods: It was a cross-sectional observational study had been carried out on 50 patients over a period from January 2017 to December 2018 at the Department of Medicine, Sadar Hospital, Cox’s bazar. The clinical presentation, ultrasonographic findings, management and follow up of patients diagnosed to have biliary ascariasis were recorded in a pre-designed case record form and finally all the relevant data were processed and analyzed. Results: This study revealed that maximum patients of biliary ascariasis belonged to 31-40 yrs age group. Number of female patients was more (86%) in comparison to male patients (14%). Among female patients, 20.93% patients were pregnant. Most of the patients 92%came from rural areas. All patients in this study presented with upper abdominal pain. Other complaints were nausea, vomiting, fever and jaundice. Most of the patients (38%) had history of passage of worm with vomitus. Ultrasonographic profile of this study revealed that ascaris was most commonly entrapped in the common bile duct (80%). The percentage of complications was 38%. Acute acalculous cholecystitis was the commonest. The percentage of Cholangitis and acute pancreatitis was also significant. Conclusion: Bangladesh is an endemic zone for ascaris lumbricoides infestations. Ultrasonography is the investigation of choice for diagnosis and follow up of the patient of biliary ascariasis. Majority of the patient can be managed with conservative treatment and mechanical removal of worms by endoscopy. This study recommends that proper hygiene and regular deworming can prevent biliary ascariasis. J Dhaka Med Coll. 2021; 29(1): 87-93

Background: Infestation with Ascaris lumbricoides is worldwide. About one fourth of the world’s population is known to be infected by ascariasis. It is endemic in various parts of Bangladesh. Objectives: To study the various types of clinical presentations, socio-demographic background and sonographic patterns of biliary ascariasis. Materials and Methods: Fifty cases of biliary ascariasis were studied over a period of 2 years, July 2011 to June 2013. All the patients were adult with age 18 years or above. Clinically suspected and ultrasonography evidenced cases of biliary ascariasis were taken as sample in this study. Results: Mean age (mean ± SD) of presentation was 35.3 ± 15.9 years and female were 80%. Ninety percent of patients were from rural areas and 80% were bearing a lower class socioeconomic background. The most common presentation was upper abdominal pain in 100% of patients. History of worm emesis was present in 34% and previous biliary tree pathology in 24% of patients. Ultrasonography demonstrated the commonest site of worm entrapment was common bile duct in 76% of patients and the commonest pattern was stripe sign pattern in 56% of patients. Conclusion: In endemic countries, ascariasis should to be suspected in patients with biliary disease, especially if there is history of emesis of worm or previous history of biliary tree pathology. Ultrasonography is a reliable, easily available and relatively inexpensive modality of investigation for suspected biliary ascariasis. J Dhaka Med Coll. 2021; 29(1): 61-67

Aortopulmonary window (APW) itself is a rare congenital cardiac malformation and its association with Tetralogy of Fallot (TOF) makes it more uncommon. We report a case of APW with TOF who presented at 4-year 10 months of age. As the boy was still in operable state, after thorough preoperative evaluation successful surgical repair was done.

Background: Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of gastric outlet obstruction in infants. This study was conducted to identify the accuracy of ultrasonography in the diagnosis of infantile Hypertrophic pyloric Stenosis. Methods: This cross-sectional descriptive. Study was conducted in Department of radiology and imaging, institute of child and mother health during two year period from 16th September 2016 to 16th September 2018. Fifty patients

Acute heart failure is one of the common causes of morbidity & mortality among the patients admitted in hospital. This prospective observational study was done to characterize sociodemographic, clinical & laboratory characteristics with short clinical outcome. Total 110 patients of acute heart failure were included in this study where mean age was 53.88 (± 14.6) years. Majority of the patients were aged between 51-60 years 35 (32%). 79(72%) of them smoker and 12(11%) were alcoholic. Major comorbidities were hypertension 59 (53.63%), ischemic heart disease 42 (38.18%), DM 39(35.45%), chronic kidney disease 25(22.72%). Most common symptoms at presentation were shortness of breath110(100%) along with palpitation 96(87.27%), orthopnea 85(77.27%), paroxysmal nocturnal dyspnea 59(53.63%), ankle edema 71(64.54%), raised JVP 75(68.18%), bilateral basal crepitation on auscultation 80(72.72%), anemia 19 (17.27%) & oliguria 23(20.90%) where mean duration of symptoms was 11 ± 2 days. Lab investigations revealed decreased Hemoglobin (10.71 ± 1.49) g/dl, proteinuria in 31 (28.18%), ketone body 5 (4.5%), raised creatinine in 23(20.93%), hyponatremia 38 (34.54%), hypernatremia 6 (5.45%), hypokalemia 6 (5.45%), hyperkalemia 3 (2.72%). Regarding cardiac events 37(33.63%) encounter myocardial infarction, cardiogenic shock 29(26.36%), Cardiac arrhythmia 27 (24.5%), cardiac arrest 6 (5.45%), non-cardiac events like stroke 6(5.45%), hyperosmolar hyperglycemic state 2(1.8%), diabetic ketoacidosis 5(5.45%), acute kidney injury 23(20.90%). However, among cardiac arrhythmia atrial fibrillation found 13(11.81%) followed by multiple ventricular ectopic 12 (10.90%), ventricular tachycardia 7 (6.36%), Complete heart block 6 (5.45%), variable heart block 4 (3.63%), long QT 2(1.8%). Regarding short clinical outcome 52(47.27%) were improved, 40 (36.36%) had persistent symptoms & rest 18 (16.36%) expired. Most common causes of those deceased person were cardiogenic shock 9(50%) followed by cardiac arrest 6 (6.33%). In conclusion we can say clinical characteristics are more or less similar but those who have reduced ejection fraction with comorbidities are very prone to develop cardiac arrhythmia causing sudden cardiac death in heart failure. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 192-198

Aim: The study was undertaken with an objective to know the thyroid functions in Type 2 diabetics and to know the spectrum of thyroid dysfunction in Type 2 DM. Methods: The present study included 68OPD and IPD patients of Type 2 DM who attended the Department of General Medicine at Dhaka Medical College Hospital Dhaka. Detailed history and examination were done, fasting blood samples of all the subjects were taken and at the same time samples were tested for HbA1C and thyroid profile (T3, T4 and TSH). Result: in this study 68 established diabetics were screened for thyroid disorders by TFT. Abnormal thyroid function was found in 43 T2DM cases and remaining diabetics had normal thyroid function. Among 68 cases low thyroid function was noted in 20 patients and 18 subjects had Sub-clinical hypothyroidism. Hyperthyroidism was noted in 05 patients. Conclusion: Type 2 diabetes mellitus is a major problem all over the world and many patients of Diabetes Mellitus are associated with thyroid dysfunction. So diabetic patients s should be screened for thyroid disorder especially hypothyroidism. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 149-152

Urinary tract infection is one of the most common bacterial infections seen in clinical practice both in developed and developing countries. The causative agents of Urinary tract infection vary from place to place and they also vary in their susceptibility and resistance patterns. This descriptive study aimed to evaluate the antibiotic susceptibility patterns of pathogens isolated from routine laboratory specimens at Dhaka Medical College Hospital. A descriptive cross- sectional study was done from January 2018 to June 2018. A total of 100 mid-stream urine samples from the suspected UTI patients were tested microbiologically and antimicrobial susceptibility test were performed for the isolated pathogens using Kirby-Bauer disk diffusion method with positivity rate of UTI was 90% (90/100). Escherichia coli (39%) was the most UTI causing bacteria followed by Klebsiella 18(18%), Acinetobacter 12(12%), Staphylococci, 9 (9%), Pseudomonas 6 (6%), Enterococcus species 3 (3%) and Proteus 3 (3%). Female 83 (83%) were more affected in comparison with male. Adult female especially age range 18-30 years were found in high risk. Nitrofurantoin, Amikacin and Meropenem were recorded as most sensitive antibiogram for most of the bacteria’s whereas cephalosporin showed increased resistance. However, for uncomplicated community acquired UTI, Nitrofurantoin (oral) and Amikacin (Injectable) can be chosen as first line medication. J MEDICINE JUL 2020; 21 (2) : 93-97

Absent left pulmonary artery with Tetralogy of Fallot (TOF) with absent pulmonary valve syndrome (APVS), is a rare congenital cardiac anomaly. Here we present such a case of A 2 year 11 month old girl with cyanosis, exertional dyspnoea. Her diagnosis is confirmed by echocardiography and CT angiogram. There are very few cases have been reported till date with high postoperative mortality. Although per operative decision making was challenging regarding pulmonary valve and size of the RPA, we performed ICR with RPA reductionplasty and creation of monocuspid pulmonary valve with success. As it is a rare association and we have overcome the hindrance we came across per operatively, we are reporting this case. Bangladesh Heart Journal 2020; 35(1) : 74-77

Aim: This study aimed to evaluate the incidence of extra-axial cerebellopontine angle tumours and to characterize extra-axial cerebellopontine angle tumours. Methods: The study was carried out in Dhaka Medical College for the duration of 2 years from July 2016 to July 2018. All patients with clinical suspicion of CP angle tumours subjected 1.5 T MR imaging system. Total 30 patients were evaluated during this period. Results: Extra-axial CPA tumours accounts for 7-10% of brain tumours. Most common extraaxial CPA tumour is schwannoma (60%), followed by meningioma (27%), epidermoid (7%), arachnoid cysts (7%). 51-60 years is the most common age group involved. Schwannomas are common extra-axial CPA tumours which are enhancing round masses most commonly arise from the vestibular nerve and associated with enlargement of the internal auditory canal. Meningiomas are the second most common extra-axial CP angle tumours which oval or hemispheric lesions with a broad attachment to tentorium or petrous dura matter. Conclusion: MRI is the most sensitive noninvasive modality to characterize extra-axial CPA tumours. MRI identifies the location and extension of the lesions based on their characteristic signal and enhancement pattern on contrast. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 104-107

Intra uterine fetal death occur in 1% of pregnancy. The patient goes into labour in most of the cases, spontaneously. Retained dead fetus may cause disseminated intravascular coagulation sometimes resulting death of a mother. Objective: The aim was to find out the reults after using intravaginal Misoprostol in Intrauterine fetal death in last trimester of pregnancy. Study design: This was a cross sectional observational study prospective in nature on 160 cases of intra uterine fetal death patients in indoor of department of Gynae and Obstertrics of Sir Salimullah medical college Hospital, Dhaka from 02/01/13 to 01/07/13, for a period of 6 months. Result: 60% of the patients were primi gravida. Mean age of the patients was 22.12±4.3 years 44% were in 33 to 36 weeks of pregnancy when induction was done. 41 (82%) patients having Bishops score d” 6 reqired 21±8.25 hours where as 09 (18%) patients having Bishops score e” 6 needed 10±1,1 hours to complete the delivery. There were no reports of maternal mortality. All the patients delivered per vaginally except one (2%) who needed ceasearean section due to development of chorioamnionitis. Conclusion: Intravaginal misoprostol can aid in vaginal delivery safely. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 90-93

Aim: The study was carried out to see the risk factors of Acute Coronary Syndrome in young patients. Materials and Methods: This is a prospective study which was carried out in 60 young patients (18-40 years of age) with a diagnosis of Acute Coronary Syndrome admitted to Dhaka medical college Hospital, Dhaka. over a period of 02 years from January 2016 to January 2018. Acute Coronary Syndrome was diagnosed by clinical history, ECG evaluation and Serum Cardiac enzyme Troponin I and CK-MB estimation. Result: Most of the patients (73%) had a sedentary lifestyle and 50% had dyslipidemia. 40% patients were taking a diet rich in fats, 37% patients were diabetic, 33% were hypertensive, 37% patients consume oral tobacco, 30% were smokers, 13% were obese and 17% were alcoholics. The family history of premature coronary artery disease was present in only 13% of cases. In our study, none of the patients had consumed oral contraceptive pills. Conclusion: The most important modifiable risk factor is the sedentary lifestyle. The commonest non-modifiable risk factor is Male sex. Smoking, oral tobacco consumption, hypertension, diabetes, dyslipidemia, and diet modification are other important modifiable risk factors in young adults. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 3-6

Lysergic acid diethylamide (LSD) is a potent hallucinogenic drug affecting the mood and perception of an individual. Although LSD‐induced self‐inflicted cut‐throat wounds and self‐harm injuries are extremely rarely reported behaviors, some reports are coming out in recent days that may complicate the depiction of scenarios in forensic psychiatry settings.

Background: Bone marrow aspiration is assessed for cytology and trephine biopsy provides overall cellularity, detection of focal lesion and infiltration. Bone marrow study plays a crucial role in identifying cause of aplastic anaemia in clinical practice. This study was carried out to see the etiological and clinical spectrum of pancytopenia based on bone marrow examination. Materials and Methods: This descriptive study was conducted in the Department of Medicine, Dhaka medical college Hospital, Dhaka, Bangladesh over a 2-year period (August 2016 to July 2018). A total 80 cases of pancytopenia were included in the study. Patients were diagnosed by hemoglobin less than 10 gm/ dL, total leukocyte count less than 4000/Cumm and platelet count less than 150000/cumm. Results: Maximum number of cases were seen in age group of 16-30 years (31.25%) and male to female ratio is 1.1:1. The commonest presenting complaint was fever in 40% (32/80) of the cases. Pallor was present in all the patients, Splenomegaly was seen in 20% (16/80) and hepatomegaly in 12.5% of the cases (10/80). Petechial hemorrhages were present in 5% (4/80). The commonest cause of pancytopenia was megaloblastic anemia (35%) and followed by aplastic anemia (32.5%). Conclusion: Pancytopenia is a common clinical problem encountered in clinical practice and the major differential diagnostic considerations of pancytopenia are aplastic anemia, megaloblastic anemia and hematological malignancies. J MEDICINE JUL 2019; 20 (2) : 68-71

Background: Hanging is the most common form of violent asphyxial death in our country. Typical and atypical variety of hanging depends on position of knot at the victim body. Objective: The objective of this study was to find out the position of knot of ligature material and relation of knot with the working hands in hanging cases along with socio demographical status of the study subjects. Materials and Methods: This retrospective study was conducted among 574 Autopsy cases of hanging victims at the Dhaka Medical College Morgue during the period January 2013 to December 2015. Results: Out of 574 cases, 159 (27.71%) were male and 415 (72.29 %) female. Among them 304(52.96%) were married and 270(47.04%) were unmarried. Most of the victims 269(46.86%) were from the age group 21- 30 years. Considering the knot, most were situated at right side of neck 281 (48.95%), followed by left side 235 (40.94%), at the nape of neck 50(8.71%) and in front of neck below chin 8(1.39%). Most of the study subjects were right handed. Dopatta (orna) was the commonest 237(41.28%) ligature material. 556 (96.86%) cases had some form of ligature mark in neck. Most of the victims 401(69.86%) hanged themselves at night. 545 body (94.95%) were recovered from inside the living rooms. 472 (82.23%) victims had complete suspension and 102 (17.77%) were cases of partial hanging. Conclusion: To reduce the number of suicidal hanging cases a well designed and comprehensive programme is needed, which will identify the causative factors and prevent of suicidal behaviors of affected persons. KYAMC Journal Vol. 10, No.-1, April 2019, Page 17-20

After the Partition of Bengal in 1947, in East Bengal, which later became the Eastern Wing of Pakistan union and was renamed to East Pakistan in 1956 to 16th December 1971. During the 1960s the State Bank of Pakistan had been introducing a new series of bank notes that carried equal amounts of Urdu and Bengali text. The newly independent Bangladesh did not find an international community with a helping hand in its moments of trial. There was a famine and was estimated to have caused the deaths of about 10 million people. This research papers describes that famine by taking into account totally on the basis of market policy of Paper Money and Coins.

Objective: The objective of the study was to assess the diagnostic usefulness of MRI in evaluation of spinal tumors.Methodology: This cross-sectional study was carried out in Dhaka Medical College Hospital, Dhaka. The data was collected from July 2011 to June 2013 and total 51 patients were included in the study. Data was collected from MRI diagnosed spinal tumors who attended at Radiology and Imaging department of DMCH from OPD and indoor patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI for evaluation of spinal tumors were detected.Results: Out of 51 patients 26 (51%) was intradural extramedullary, 13 (25.5%) was extradural and 12 (23.5%) was intramedullary. Distribution of patients according to MR diagnosis. Among the 51 patients 40 were diagnosed spinal tumor and 11 were not spinal tumor by MRI. Among the 40 spinal tumuor diagnosed 12 (23.5%) were schwannoma, 02 (3.9%) were neuro fibroma, 11(21.6%) were meningioma, 07(13.7%) were ependymoma, 05(9.8%) were astrocytoma, 02(3.9%) were metastasis and 1 (2.0%) was osteoblastoma. Out of all cases 40 were diagnosed as spinal tumour by MRI and among them 39 were confirmed by histopathological evaluation. They were true positive. One case was diagnosed as having spinal tumour by MRI but not confirmed by histopathological findings. That was false positive. Out of 11 cases of non tumour which were confirmed by MRI, 3 were confirmed as spinal tumour and 8 were non-tumour by histopathological findings. They were false negative and true negative respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MRI in the diagnosis of spinal tumour were 92.86%, 88.89%, 97.50%, 72.73% and 92.15% respectively.Conclusion: The present study conducted to assess the diagnostic usefulness of MRI in evaluation of spinal tumors among the Bangladeshi population. Study revealed high sensitivity, specificity and accuracy of the MRI in the diagnosis of spinal tumour. MRI should be the initial procedure in the evaluation of suspected tumors of the spine.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 162-166

Our objective of the study was to find out the victims of common age group with relation to their educational and social status to set up a local and national policy to create nationwide awareness and taking necessary steps to stop this heinous crime. This is a cross-sectional descriptive type of study which was done in the Department of Forensic Medicine, Dhaka Medical College from January 2016 to December 2016 with maintaining ethical issues. A total of 69 cases, from 23 police stations of Dhaka Metropolitan area, were sent for a medicolegal opinion regarding forceful sexual intercourse and victims who ultimately agreed to do medicolegal examinations were examined and opinion was given, whether the signs of forceful sexual intercourse were present or not. Our study shows that female of >10-≥20 years of age group were the main victims and 69.6% of the victims belong to this age group followed by 14.5% with >20-≥30 years of age. Majority of the victims, 68.1% were from lower socioeconomic status. Educational knowledge of the victims was poor; 31.9% victims had the primary level of education, 24.6% were completely illiterate followed by 37.7% of victims had the education level as secondary and higher secondary, and 5.8% had the above higher secondary level. Victims of rape lead to very painful lives. They are just the victims of this heinous and supposed to get sympathy and empathy from the family, society, and state. But unfortunately, the victims of rape do not get proper attention from them. Sometimes victims are blamed by their surroundings. As a result, many victims commit suicide following rape. So, it should be addressed properly.Mediscope Vol. 5, No. 2: Jul 2018, Page 8-11

Background: Proof of rape depends not only in the physical findings of the victims but also to the subjective intentions of the assailants.Objective: The purpose of the present study was to find out the medicolegal findings of rape victims in order to point out the visible loopholes of the procedure.Methodology: This was a cross sectional descriptive type of study which was done in the Dept. of Forensic Medicine, Dhaka Medical College, Dhaka, Bangladesh from January to December 2016 with maintaining ethical issues. Rape cases from 23 police stations of Dhaka Metropolitan area were sent for medicolegal examination and victims who ultimately agreed to do medicolegal examinations were examined and opinions were given regarding the issues.Results: A total number of 69 cases from 23 police stations of Dhaka Metropolitan area were studied. In this study, majority (70.0%) of the victims was within 11 to 20 years of age and 65.0% of the victims were unmarried. Almost 68.0% of the victims were examined within 7 days followed by 32.0% of the victims after 7 days to beyond one month after rape; however, 48.0% of the victims showed sign of recent hymeneal tear with bruise and abrasion followed by 52.0% showed sign of old hymeneal tear. Spermatozoa were not found in any of the specimen of high vaginal swab.Conclusion: In conclusion, teenage unmarried girl are the most common victim of rape cases.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 106-109

Background: Road traffic accidents (RTA) are responsible for greatest number of injuries and fatalities world wide by killing around 1.2 million people each year and injuring 50 million. Pedestrians are the most common victims of RTAs.Objectives: This study has been done to find out the epidemiological factors, socio demographic characteristics and the clinical injury pattern among pedestrians injured by Road Traffic Accidents in Dhaka City.Materials & Methods: This descriptive cross sectional study done from December 2015 to September 2016 at three tertiary level referral hospital in Dhaka. One hundred fifty two (pedestrians) were selected purposively as research sample with 95% confidence level and 5% confidence interval. The primary data was collected from the patients who were discharged from hospital by face to face exit interview using a semi-structured questionnaire.Results: Among 152 pedestrian victims interviewed; 88(58%) were male. Maximum accidents occurred at daytime 63 (41.45 %), and on city main roads 68 (44 %). Highest number of accidents were caused by buses 44 (36.09 %) and highest incidence of RTA 60(39.47%) was observed among the age group 21 to 30 yrs. Most of the victims 129( 84.85%) were knocked down by the vehicles while crossing the roads (hit and run injury), 114(75.00%) were from earning group below 15,000 taka per month, 121(79.61%) never use foot over bridge, 78(51.32)% were using mobile phone while crossing the road. 152(100%) victims had multiple abrasion and bruise, 94(61.84%) had lacerations, 64(42.10%) had fracture of upper limb bones, 53(34.87%) had fracture of lower limb bones and 53(34.87%) had haematoma in soft tissue over skull.Conclusion: Road accident and its severity can be prevented by strict application of traffic rules , motivation of public and proper training of drivers.KYAMC Journal Vol. 9, No.-1, April 2018, Page 11-15

Background: Serum tumor markers are convenient, non-invasive, acceptable to patients and play an important role as an ancillary tumor diagnostic tool. CA 19-9 has become a common tumor marker, specific for digestive system tumors. The study was carried out to determine the value of CA 19-9 as a tumor screening marker among healthy individuals. Materials and Methods: This study had been carried in Dhaka Medical college Hospital from January 2016 to January 2018. The serum CA 19-9 level was detected using a microsome luminescence method. Individuals with high CA 19-9 levels underwent further examination, including routine fecal testing, thoracic and abdominal computed tomography (CT) scan, gastroscopy, and colonoscopy. These individuals had regular follow-up examinations. Results: Over a 3-year period, the serum CA19-9 levels of 960 healthy individuals were estimated. The CA 19-9 level of 15 individuals was positive (positive rate: 1.56%), including 7 men (7/699; 1.001%) and 8 women (8/261; 3.06%). There was a significant difference between males and females (p

Aim: The study was carried out to see the Serum Bilirubin, ALT, AST and Alkaline Phosphatase as liver function in liver cirrhotic patient. Method: The study was carried out among 50 well-compensated patients of cirrhosis of liver irrespective of their age, sex, residence & income group. Patient was randomly selected while they were hospitalized in Dhaka Medical College Hospital, Sir Salimullah Medical College & Mitford Hospital and Bangabandhu Sheikh Mujib Medical University. Result: Serum Bilirubin, AST, ALT and Alkaline Phosphatase level were done in 50 (fifty) cirrhotic patient out of whom 38 were male and 12 were female. Mild to severe level of serum bilirubin were documented in 50% patients. Two-fold and fourfold rise of ALT were formed in 48% and 10% cirrhotic patient respectively. Similar pattern of rise of AST also shown in 50% cirrhotic patient. Alkaline Phosphatase value was normal in 92% patient and of 08% two-fold rise of Alkaline Phosphatase Alkaline Phosphatase. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 190-191

Hepatitis B virus infection is a major global health problem. There is no specific treatment for acute hepatitis B infection. A safe and effective vaccine, which has been available for more than 30 years, is 95% effective in preventing the development of chronic infection. The employee of Bangladesh Bank and their family member had received 4 doses of Engirex B according to schedule 0, 1,6,12 months without any prior screening test. They received 4th booster dose in 2009.The goal of this study to find out and compare the efficacy and safety of vaccination against HBV without prior screening test. The employee (more than 50years old) underwent annul health check up and their serum HBsAg and Anti-HBs (quantative) were measured in the Immunology department of Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) and Popular diagnostic center. HBsAg is measured by MEIA method. Anti-HBs (quantative) are measured by chemiluminescence EIA method. 491 subjects have been studied. Among them 480(97.76%) are HBsAg negative and 11(2.24%) cases are HBsAg positive. Ten out of eleven HBsAg positive cases are male. The average anti- HBs titer of the employee is 610.9958(0- >2000 m IU/ml). The average anti-HBs titer of female (n=90) employee is 713(10- >2000 mIU/ml) and average anti-HBs titer of male (n=390) employee is 587.77(0 - >2000 m IU/ml). Female employee developed higher immunity (73.33%) than male employee (56.41%). So it is presumptive that vaccine is safe and effective and we can continue vaccination without prior screening test.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 16-25

Background and Purpose: The development of type 2 diabetes mellitus (T2DM) is caused by a combination of genetic factors and lifestyle factors like obesity, lack of physical activity and stress. T2DM can develop in chronic liver disease (CLD) though its actual mechanism is not fully understood. In case of hepatitis B virus (HBV) related CLD, HBV infection has been directly related to development of abnormal glucose metabolism by pancreatic islets cell injury. Development of Insulin resistance in case of hepatitis C virus (HCV) is the key pathogenesis of development of type 2 diabetes. We aimed to study the magnitude of the problem of T2DM among the patients with various types of CLD and to find out the association of diabetes mellitus with the demographic and clinical characteristics of the patient admitted in Medicine ward in Dhaka Medical College Hospital.Methods: This was an observational cross sectional study of 60 patients admitted into department of Medicine, Dhaka Medical college hospital between June, 2013 to December, 2013. It included all patients ?18 years of age and admitted with CLD. A diagnosis of CLD was made clinically by any 2 stigmata of liver disease and biochemical, ultrasonographic, endoscopic evidence of esophageal varices ± liver biopsy.Results: Of the total 60 CLD patients, 40 (66.7%) suffered from chronic HBV infection, 11 (18.3%) chronic HCV infection and alcoholic liver disease 5 (8.3%), Autoimmune 1 (1.7%), Wilson disease 1 (1.7%) and unknown cause were 2 (3.3%). Among the study subjects 21.67% had overt Diabetes Mellitus and it was found to be highest among those with chronic hepatitis C (36.4%) and those with chronic hepatitis B (20%) alcohol (20%). Type 2 DM was significantly higher among the CLD patients aged more than 50 years or more.Conclusions: It can be concluded that the occurrence of diabetes and impaired glucose tolerance (IGT) could be a matter of great concern in CLD patients, indicating towards the need for regular monitoring of the glycemic status in these patients, which would have a definite role upon the treatment strategy.J MEDICINE July 2017; 18 (2) : 68-74

An observational study was carried out to analyze prevalence of risk factors for ischemic stroke in hospitalized patient in a university hospital. Ninety patients were chosen by using purposive sampling technique. The mean age of patients was 59.01±9.87 years varied from 30 to 75 years and male to female ratio was 1.2:1. Highest incidence of stroke was between the 6th and 7th decade. Patients came from both rural 49 (54.4%) and urban 41 (45.6) area. Most of them belonged to the lower-middle group 70 (84.8%). Regarding education 47 (52.2%) patients had primary level education and 8 (8.9%) patients were illiterate. It was observed that among them current smoker were 30 (33.3%) and ex-smoker 17 (18.9%). It was also observed that 52 (57.8%) patients had hypertension and 32 (35.6%) had diabetes mellitus (DM). Ischemic heart disease was present in 14 (15.6%) patients. By Oxford shire classification of stroke, it was observed that PAC is common 51 (56.7%) among all forms. Majority 38 (42.2%) of patients had hospital stay of 11-15 days. The mean hospital stay was found 13.68±6.6 days. This study found that cigarette smoking, hypertension, diabetes mellitus and ischemic heart diseases are the major risk factors prevalent in our community while other risk factors demand further study. Bangladesh Journal of Neuroscience 2017; Vol. 33 (1): 18-23

Arterial Hypertension is the most common cardiovascular disease and is a major public health problem in both developed and developing countries. The aim of the study was to assess renal involvement in hypertensive patient by renogram, which is not detected by conventional biochemical test. This was a cross sectional observational study. Consecutive 30 hypertensive patients admitted in the medicine wards from March, 2006 to April, 2007 in Rajshahi Medical College Hospital, Bangladesh were taken as case. Informed consent was taken from all the study patients or from their attendants. Detail history was taken from each patient or from their attendants' then clinical examination and relevant investigations were done. Emphasis was laid to find out renal involvement in long standing hypertensive patients by renogram. After initial selection; laboratory investigations like Urine for R/M/E, Blood Sugar 2ABF, S. Creatinine, USG of KUB, ECG and Hb% were done for every patients. All patients included in this study renogram were done. Majority of the patient (40%) were between the age of 41-50 years and Male: Female ratio was 3:2. Most of the patient lead a moderately active life (66.67%). Serum Creatinine was raised in 23.33% patient whereas renal parenchymal insufficiency evidenced by renogram was found in 50% case. In this study, we found that a significant number of cases (26.67%) having renal parenchymal insufficiency were not detected by S. Creatinine level, but detected by renogram. Renogram is superior to conventional biochemical renal function test for early detection of hypertensive nephropathy.Faridpur Med. Coll. J. Jan 2016;11(1): 11-14

Objective: Aim of the study was to know the microorganisms profile and determine the antibiotic resistance pattern of the LRT isolates from mechanically ventilated (MV) patients admitted to the ICU. This prospective observational study was done in Department of Critical Care Medicine (ICU) of BIRDEM General Hospital Dhaka from July, 2011 to December, 2011.Methods: Blind Tracheal Aspirate or Broncho Alveolar Lavage or both from 110 consecutive patients (total 130 samples) admitted to the ICU requiring MV were cultured, identified, and antibiotic sensitivity was performed by standard methods.Results: A total of 130 samples were analyzed. Growth was obtained in 93.8% of the samples yielding 143 organisms. Many (21 samples) yielded more than one organism. The major organism isolated were Acinetobacter sp. (54.5%), Pseudomonas sp.(14.7%), Klebsiella sp. (7.7%).Candida sp. (7.0%), Staphylococcus aureus(7.0%), Escherichia coli (4.9%).Proteus and Flavobacterium accounted for 4.2% of the isolates. All the isolates were highly resistant (>90%) to cephalosporins and >70% to fluoroquinolones. The frequency of third generation cephalosporin resistant E. coli, Klebsiellaand imipenem resistant Pseudomonas and Acinetobacter were>90%. Acinetobacter was remarkably resistant to most antibiotics including imipenem (>90% resistant) and Piperacillin+Tazobactum (>85% resistant), but most of the members of the Enterobacteriacae group and Acinetobacter showed maximum sensitivity to colistin (80%-100%).Conclusion: Nonfermenters Gram Negative Bacilli (GNB)-Acinetobacter sp. & Pseudomonas sp. are the most common etiological agents of LRT infections in ICU. There is an alarmingly high rate of resistance to cephalosporin and ²â-lactamase inhibitor group of drugs. Colistin was found to be the most sensitive drug against all GNB.J MEDICINE July 2016; 17 (2) : 91-94

Objectives: Study of the risk factors associated with stoke due to cardiac disease in age group between 18 to 45 years of age,evaluate the risk factor of hospitalized stroke patients & to search for cardiac disease associated with stroke also appropriate preventive measure applicable for our country.Materials & Methods: Non randomized prospective observational study was carried out in the department of Neurology, Medicine & Cardiology unit of Dhaka Medical College Hospital between the periods of July 2009 to December 2009. Fifty (50) consecutive indoor patients more than 18 years of both sex admitted with suspicion of stroke. Diagnosis of stroke will be made from details clinical history clinical examination and confirmed by CT scan or MRI.Result: Fifty patients were randomly chosen for this study, of which 26 (52%) patients were male, 24 (48%) patients were female & male: female ratio was 1.08:1. Highest incidence of stroke was in between 3rd & 4th decade. The incidence of ischemic stroke 46 (92%) & hemorrhagic stroke 4(8%).Cardio embolism is the major (92%) risk factor for ischemic stroke. Among the cardiac risk factors, valvular disease (64%), MI (16%), &IHD (10%), Atrial fibrillation 8%, Patent foramen ovale 2%.Among the patients 33.33% of women with cerebral infarction were using OCP. Majority of the patients in this study were sedentary worker (45%). Among the stroke patients 8% & 10% had previous H/O stroke & TIA respectively.Conclusion: In this study a number of modifiable risk factors were identified, of which valvular heart disease & HTN are important risk factor next are DM & IHD smoking. Most of the valvular heart diseases are rheumatic in origin, which can be prevented through primary & secondary prevention of rheumatic fever.J MEDICINE July 2016; 17 (2) : 95-99

Background: Non-adherence to anti-hypertensive medications can have a negative impact on long term cardiovascular outcome. Various studies have been conducted on this issue but factors are not yet explored properly, particularly in Bangladesh. This study was conducted to find out the prevalence and factors associated with pattern of compliance to anti-hypertensive medications in a tertiary level hospital.Methods: This descriptive study was done on 146 indoor hypertensive patients, included by purposive sampling in july’2015 who were taking anti-hypertensive for last 6 months. Data were collected through a questionnaire after obtaining informed consent.Results: This study revealed that 55.47% patients were compliant and 44.53% were noncompliant. Age >60 yrs. are more non-compliant (56.6%). Female (65.11%), house wife and urban population are more compliant. Population, with longer duration of hypertension are more non-compliant. Among the co-morbidities diabetic patients are more non-compliant. Population taking two anti-hypertensive are more compliant (76.47%).Conclusion: In our study most of the populations are compliant but yet significant number of populations are non-compliant. Collective participation of physician, patient and health care delivery system can improve the situation more. As consequence of non-compliance to antihypertensive is grave, community based studies should be conducted to explore the extent of non-compliance.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 62-66

Introduction: Enteric fever is highly prevalent in Bangladesh. Multidrug resistant salmonella Typhi is emerging throughout the world as well as in Bangladesh. Observing recent sensitivity pattern will help in choosing proper empirical antibiotics in resource limited country like Bangladesh as culture facilities is not available throughout the country.Materials and Methods: The study included 86 S. typhi isolates from blood cultures of patients suffering from suspected typhoid fever who attended the outpatient clinics or were admitted in Islami Bank hospital in Dhaka during January 2015 to July 2017.Results: A total of 86 S. typhi isolates were included in the study. Mean age of the study population was 22.06±17.1 and there was male 44 (51.2%) predominance. All the isolates of S. typhi were sensitive to Meropenem. Highest resistance was observed against Amikacin (62.4%) closely followed by Co-timoxazole (48.4%) and Amoxiclav (46.5%). The S. typhi isolates showed low-level resistance against Ceftriaxone (1.16%), Cefuroxime (4.6%), Azithromycin(13.9%), Levofloxacin (11.6%).Conclusions: According to findings of this study it can be advised that oral form of Cefuroxime, Levofloxacin and Azithromycin can be used as a first line. Then if patient is nonresponsive Ceftriaxone might be used. Meropeman should be reserved for selective cases.J MEDICINE Jan 2018; 19 (1) : 15-17

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a distinct clinicopathologic entity characterized histologically by a spectrum ranging from simple steatosis to steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma (HCC).Objective: To determine the incidenceand identify the risk factors of NAFLD in non-obese patients.Methods: It was a cross sectional study done in Department of gastroenterology, Nuclear Medicine and ultrasound, Radiology and Imaging, Virology, Biochemistry, BSMMU, Dhaka from March 2012 to June 2014. The patients more or equal to 18 years, non-obese were included. In this study total 190 patients were enrolled.Results: Among them 38 patients were with fatty liver and 152 patients without fatty liver on the basis of ultrasonogram. Where 141 were male and 49 were female with mean age was 49.24 + 9.05 years. Among total, 18.9% had diabetes mellitus, 28.4% had dislipidaemia 24.4% had history of hypertension. Total 18.9% patients having history of diabetes mellitus, normal vs fatty liver disease (20% vs 42.1%, p

Background: Arrhythmias are often a manifestation of structural heart diseases but may occur in the context of non cardiac diseases even in an otherwise normal heart. It may be supraventricular or ventricular. Among the arrhythmias premature complexes (ventricular & atrial) are most common type of arrhythmia occurs in patients with or without significant heart disease.Objective: In this study, the aim was to find out the aetiological pattern of premature ventricular and atrial complexes and their consequence on morbidity and mortality, demographical pattern of patients with ectopic beats, to find out aetiological factors leading to development of premature complexes, to find out common clinical presentations and to differentiate the PVCs which are more benignMethods: It was a cross sectional study. This study was carried out in the Department of Medicine and Department of Cardiology of Sir Salimullah Medical College and Mitford Hospital, Dhaka from 1st May 2008 to 15th September 2008. A total 50 consecutive patients irrespective of age, sex and occupation having atrial and ventricular premature complexes on ECG attending at OPD and admitted in indoor were included in this study. Results: Among the three types of premature complexes 9 patients with APCs (also includes 2 patients of premature junctional complex) and 41 patients with PVCs were included. The ratio of patients with PVCs and APCs in this study.8.2: 1.8. In this study 41 patients of PVCs were studied. Among them 37 patient that is 90.3% patients had structural heart disease and the commonest cause was IHD (63.4%), 9.7% had HTN with LVH, 7.3% had DCM, 4.87% had HOCM, one patient had myocarditis ( 2.4%) and one had MVP with sick sinus syndrome (2.4%). Among the 9 patients of APC 4 patients that is 44.44% were suffering from COPD with corpulmonale which was the most commonest cause of APCs.Conclusions: Ventricular arrhythmias are more common than atrial arrhythmia and IHD is the single most common cause of arrhythmia. Ectopic beats in patients with otherwise normal hearts are more prominent at rest and disappear with exercise. Treatment is not necessary, unless the patient is highly symptomatic.J MEDICINE July 2015; 16 (2) : 97-102

Ankylosing Spondylosis (AS) is a chronic inflammatory disorder of joints predominantly affecting the sacroiliac joints and spine. Besides the joints, it affects many extra articular sites like heart, eye, lungs etc. Neurological complication is very rare in AS. Here we report a case of a 30 years old man of AS with peripheral neuropathy.J MEDICINE January 2016; 17 (1) : 36-38

Background: Antibiotics are available as non-prescription drugs in pharmacies and irrational use is not uncommon. Diagnosis and treatment of most of the bacterial diseases are empirical. Microbial sensitivity patterns of common infections like respiratory tract infection, urinary tract infection, enteric fever, wound infection are not routinely available for decision making in drug selection. Lack of hospital restrictions on antibiotic use and inappropriate usage for prophylaxis are the main reasons for inappropriate therapy. Objective: To determine the pattern of antibiotic use in hospitalized patients of different departments of Dhaka Medical College Hospital. Materials & Methods: In this observational study, hospital records of total 400 patients were surveyed on 2 separate days of December 2013. Patients of both sexes from different departments receiving antibiotics were included in the study. Data was collected in a predesigned data collection sheet. Results: Of the total 400 patients 53.5% were male & 46.5% were female. 21% patients were of paediatric age group (upto 12 years) and 79% were adults. In maximum number of patients empirical antibiotic therapy was started. Culture and sensitivity tests were done before or during the course of treatment in only 48 patients (12%). Most commonly used antibiotic was ceftriaxone (49.75%) followed by metronidazole (17.5%) and ciprofloxacin (12.75%), while 7 patients (1.75%) received anti tubercular regimen. Combined antibiotics were used in 162 patients (40.5%). Conclusion: Most of the patients received empirical antibiotic therapy. Culture and sensitivity tests should be more practiced and emphasized before starting treatment. Energetic measures to stop inappropriate use of antibiotics should be taken to slow down the emergence and spread of antimicrobial resistance. DOI: http://dx.doi.org/10.3329/jom.v16i1.22399 J MEDICINE 2015; 16 : 35-38

Biopsy from the distal second part of duodenum is now widely accepted as a useful and simple way to evaluate patients with malabsorption or other small intestinal diseases.Histological findings of the second part of duodenum in tropical countries are different from that of other countries. Histological appearance of the second part of the duodenum may be changed due toceliac disease, tropical sprue, tropical enteropathy and some other conditions. As Bangladeshi people, we are exposed to different infection always due to its geographical distribution. Normal histological appearance of second part of duodenume.g. standard villous architecture, length, villous crypt ratio, IELcounts of our country in not known. The main objective of our study was to see the normal histological appearance of second part of duodenum in our country so that we can differentiate from abnormal condition. This observational study was carried out in the Department of Gastroenterology & Pathology, Bangabandhu Sheikh Mujib Medical University, (BSMMU)during the period of July 2010 to June 2011. A total of 116 patients were included from out patientdepartment and admitted patient in the department of Gastroenterology during the study period. Among the total numbers, the mean age was 32.7±9.77 (±SD) years.In our study, 48.27% subjects had finger shaped villous with normal height, 27.58% had both normal and broad villous, 22.41% subjects showed mixed findings of normal, broad and blunted villous and only 1.7% subjects showed broad and blunted villous without normal architecture. In our study, the highest IEL count was 62 cells per 100 epithelial cells and lowest value was 16. Mean value IEL/100 cells were 32.52 ±8.63 (±SD) and 95%CI was 1.57. The result of the study was very similar to Asian people but a little different from the western population.DOI: http://dx.doi.org/10.3329/jom.v16i1.22385 J MEDICINE 2015; 16 : 23-26

Background : Tuberculosis is common in our country. It commonly affects the lungs but in up to one third of the cases involve other organs. Abdominal tuberculosis is one of the important extrapulmonary tuberculosis.It has varied presentation, frequently mimicking other common and rare diseases. Materials and Methods :It is a prospective observational study done to see the clinical presentation and treatment outcome of abdominal tuberculosis in medicine, surgery and gastroenterology department Sylhet M A G Osmani Medical College Hospital during Jan 2008-Dec2008. Sample was collected purposively. All patients were undergone detailed history, clinical examination, relevant investigation and follow up till the end of six months anti tubercular chemotherapy.Data recorded in predesigned record form. Statistical analysis was done with SPSS software. All data presented as percentage or mean. Result : From the 50 cases of abdominal TB, 26 (52%) were male and 24 (48%) were female. Male and female ratio was 1.04:1. Here most of the patients were in the age of 21-30 years and mean age was 29.3 years,majority of them were from poor socioeconomic status(18%) had associated pulmonary tuberculosis.The common presentation exhibited by the patients were weight loss (100%), low grade fever (88%), abdominal pain (86%), bowel disturbance (84%), anorexia (80%), nausea and vomiting (70%), abdominal distension (46%), , ascites (42%).Most of the patients were anaemic with raised ESR.Ultrasonography revealed ascites,abdominal lymphadenopathy and thick walled bowel. Colonoscopy found nodularity and ulceration with narrowing. Ascitic fluid was exudative with predominant lymphocyte count. Laparoscopy and laparotomy revealed tubercle on the intestine and the mesentery with thickening and bowel stricture. All the biopsy reports were consistent with tuberculosis. Site of involvement in decreasing frequency were ileocaecal (44%), peritoneal (16%), abdominal lymph node (8%), ascending colon (8%), small bowel (6%),transverse colon (4%), sigmoid colon (2%), rectum (2%), gastric (2%) and duodenal (2%) but multiple site in 6%.The treatment was given as per the WHO guidelines with category I drugs and found- 86% cured with anti TB alone, 4% needed surgery for intestinal obstruction along with anti TB, and 10% drop out from follow up. Conclusion: The clinical presentations of abdominal TB appear not specific for the condition. Thus, careful approach and supportive results are required in order to issue the final diagnosis. If diagnosed early, it can be treated successfully with the conventional anti-TB drugs. DOI: http://dx.doi.org/10.3329/jom.v15i2.20686 J MEDICINE 2014; 15 : 131-134

The aim of the study was to assess the association of metabolic syndrome in patients with acute coronary syndrome and the impact of metabolic syndrome on clinical outcome. Total 210 ACS patients were included in this study and divided in group I & II on the basis of presence or absence of MS respectively. Among the study patients mean age in group I and group II was 52.99 ± 11.49 years and 53.34 ± 12.54 years respectively. Among the risk factors, hypertension (70%vs 15%), dyslipidemia (100 vs. 97%), diabetes mellitus (36.4% vs. 6%) were significant between two groups. Mean waist circumference recorded was 103.12 ± 4.15 in group I and 96.50 ± 6.43 in group II which was significant. Present study showed, in hospital outcome was worse in group I in comparison to group II and was significant, like cardiogenic shock (11% vs. 1%), LVF (28.2% vs. 16%), and CVD (5.45 vs. 0%). But there were no significant difference in heart block, tachyarrhythmia, cardiac arrest, reinfarction and death. Complications were far more in group I than in group II (14.5% vs. 52.0%) which was also highly significant. So, we conclude that the presence of MS in patients suffered from ACS was associated with a greater incidence of in-hospital cardiovascular complications and mortality.DOI: http://dx.doi.org/10.3329/jom.v15i1.19857 J Medicine 2014; 15: 31-35

Chicken pox is a self-limiting, infectious disease caused by Varicella-zoster virus (VZV). In adults though rare, severe form of disease may cause complications like hepatitis, pneumonia, encephalitis. We present here a case of young male with life threatening complications of chicken pox who survived due to prompt & timely management.DOI: http://dx.doi.org/10.3329/jom.v15i1.19873 J Medicine 2014; 15: 55-57

A case of disseminated histoplasmosis in a 62-year immunocompetent healthy male presenting as compressive myelopahty without any pulmonary involvement or travel to endemic zone is described. The patient presented with fever, dull ache pain in the back of the lower chest, weakness of both lower limbs with impairment of emptying of bowel and bladder, physical findings include raised temperature, generalized lymphadenopathy, nontender mild hepatomegaly, spastic paraplegia with sensory level up to D8 and local tenderness over D7 vertebra without any gibbus. Diagnosis was confirmed by presence of histoplasmacapsulatum in the lymph node and soft tissue from the spine. The particular interest of this paper is to present a case of disseminated histoplasmosis especially presenting as spastic paraplegia in an immunocompetent host without pulmonary involvement and illustrates the importance of recognizing the possibility of histoplasmosis in Bangladesh where mimickers of histoplasmosis like tuberculosis is extremely common.DOI: http://dx.doi.org/10.3329/jom.v14i2.19688 J Medicine 2013, 14(2): 201-203

The present study deals with petrology of the detrital gravelly rocks from Bhajanpur area, Panchagarh, Bangladesh. The results of detailed petrography of gravelly rocks indicate the presence of quartz (monocrystalline and polycrystalline quartz), K-feldspar, plagioclase, chlorite, muscovite and biotite as major mineralogical compositions. Other minor minerals are garnet, kyanite, graphite and opaque minerals. Based on definitive mineral assemblages, blueschist and greenschist facies sequences are recognized. Correspondingly, index minerals provide chlorite zone, biotite zone, garnet zone, kyanite zone, and graphite zone. The P-T conditions of the studied rocks demonstrate the possible temperature ranges 300-550°C and pressure ranges 2-10 kbar. Most common varieties of metamorphic rocks in the study area are garnet mica schist, chlorite schist, gneiss and few quartzites. Characteristics of garnet mica schist and chlorite schist are equivalent with the lesser Himalayan metamorphic rock sequence in Sikkim area, whereas gneiss from Bhajanpur area has similar precursor as Darjeeling gneiss. Therefore, the sources of detrital metamorphic rocks in Bhajanpur area obviously come from the lesser Himalayan sequence in Sikkim and Darjeeling areas, India. Key words: Petrology; metamorphic rocks; gravels; P-T conditions; Panchagarh; lesser Himalayan sequence DOI: 10.3329/jles.v5i0.7357 J. Life Earth Sci., Vol. 5: 91-96, 2010