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It is currently unknown how effective the COVID-19 vaccine is at preventing new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among the general population. The study suggests that a safe and efficient vaccination against the COVID-19 could help manage this pandemic if widely distributed. The present study aimed to investigate the effectiveness of the ChAdOx1 nCoV-19 vaccine in between vaccinated and unvaccinated cohorts. A retrospective multicenter cohort study comprised 1244 COVID-19 positive patients enrolled in this study from three different hospitals among patients who had been appropriately vaccinated or not between April and June 2021. Data were collected by face-to-face survey, and clinical investigations were obtained by observation. Descriptive statistics and the Cox proportional hazard model of survival analysis were performed in the study. Among the participants, 69% of vaccinated cohorts did not require hospitalization, and 97% successfully recovered from the infection. In respect of age, compared with unvaccinated cohorts, the vaccine effectiveness varied from 81% to 92%. The ChAdOx1 nCoV-19 vaccine was more effective among those aged 60-69 years old and reduced 92% hazard of death than the unvaccinated group [HR ratio - 0.081(.036-.179), P=0.0001]. The study found the ChAdOx1 nCoV-19 vaccine is highly effective for receivers. The COVID-19 vaccination demonstrated a significant correlation with a reduced probability of disease severity, hospital admission rate, early recovery from illness, and mortality. Asian J. Med. Biol. Res. 2022, 8 (4), 251-263

Background: COVID 19 era is continuing globally even one and half years of turning out and claiming lives and startled with newly emerged variants. Many studies regarding COVID 19 treatment were published but some options were beneficiary in early stage and later were contradictory to apply it, making clinicians to dim. So this study was carried out reveal potential efficacy of commonly prescribed regimen in COVID unit. Materials and methods: This observational study conducted in three dedicated COVID hospital in Chattogram, Bangladesh. Total 209 cases with RT-PCR positive and symptomatic cases with RT-PCR negative subjects were enrolled in this study. Results: Half of the patients 53% (n=111) who got antiviral remdisivir, 53.6% n=103 were improved, 46.7% n=7 was died and p value < 0.01,comparing to 28.2% (n=59) got favipiravir in whom, 27.6% n=53 were improved, 40% n=6 was died. 16.3% (n=34) patient got Tocilizumab, in whom 73.52% n=25 were improved, 23.52% n=8 was died. 8.6% (n=18) got convalescent plasma in whom 6.3% n=12 was improved, 40% n=6 was died and p value was significant. Those who were given both Tocilizumab and Remdisivir, 76.9% n=20 were improved and 19.2% n=5 were died in comparison to patient treated with Remdisivir only 97.6% n=83 were improved and 2.3% n-2 were died. Conclusion: Even after 18 months of starting COVID, only established treatment options are oxygen and dexamethasone. As data about efficacy of antiviral and others are so changing according to COVID variants and different country. So emphasize should be about prevention and avoiding injudicious use of anti COVID medications. IAHS Medical Journal Vol 5(1), June 2022; 56-59

Background: In order to improve the spontaneous Adverse Drug Reaction (ADR) reporting practice by the physicians, there is an obligatory need to investigate the current situation of ADR reporting by them. The study was conducted to observe the ADR reporting pattern among physicians in a tertiary medical college hospital. Materials and methods: This was a descriptive cross sectional study carried out in a tertiary medical college hospital during the study period of March 2020 to October 2020. Data were collected from 100 physicians working on different departments using self designed pretested questionnaire by convenient sampling technique. Results: Among the 100 respondents 70 provided response to questionnaire giving a response rate 70%. Most of the respondents (61.43%) had adequate knowledge on ADR reporting. A good number of respondents showed positive attitude but there is no practice of ADR reporting though most of the respondents (84.3%) had experienced it in last 1 year. Most of the respondents experienced ADR with antibiotic (81.35%), NSAIDs (33.89%) & anticonvulsants (15.25%) and maximum (44.06%) experienced ADR was with skin, 30.50% with GIT and 23.03% with respiratory system involvement. The cause of under reporting was mainly due to inaccessible ADR form, busy schedule, unaware of how and whom to report and lack of motivation to report. The respondents would be encouraged to report ADR if they were provided with simple & available reporting form, regular guideline & bulletin. Conclusion: There is an urgent need for educational training & seminar regarding our national online reporting system to emphasizing ADR reporting. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 8-13

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Background: Late intrauterine foetal death (IUFD > 28 weeks) is a tragedy to mothers and family members. The first step to reduce IUFD is to obtain an accurate and detailed data for IUFD. The present study was done to identify the probable causes of foetal death and determine the risk of recurrence, prevention or corrective action. Methods: This prospective observational study was conducted in a tertiary hospital during a period of one year in Chattogram Maa-O-Shishu Hospital Medical college, from January to December 2018, on all admitted pregnant women with intrauterine foetal death (>28 weeks). Detailed history, clinical examination, associated conditions, mode of delivery, foetal conditions, placenta, condition of cord and investigation reports were analyzed. Results: A total of 188 IUFD were reported amongst 8013 deliveries with its incidence 23.46/1000 live birth and recurrence rate 8.5%. Maximum (89.89%) occurred in antepartum period. Mean maternal age 26.03 years. 59% unbooked cases, 48.93% belonging to lower class family and maximum (59%) from slum and rural area. Most of the cases were Multigravidas (59.6%) and preterm (52.7%) gestation. Regarding causes of IUFD hypertensive disorders in pregnancy (45.2%) were commonest, followed by unexplained 24.5%, diabetes Mellitus and gestational diabetes mellitus (23.9%), anaemia 20.7%, hypothyroidism 11.2%, oligohydramnios 11.2%, maternal infection 9.6%, antepartum haemorrhage 8.5%, malpresentation 7.44%, intrauterine growth retardation 4.8%, fetal congenital anomalies 4.8% & cord accident 4.3%. Maternal complications occurred 14.9% cases. Those were postpartum haemorrhage 11.2%, sepsis 2.6%, acute renal failure 0.53% and disseminated intravascular coagulation (DIC) 0.53%. Most of the patients (86.2%) delivered vaginally. Maximum number of IUFD was seen in birth weight between 1 - 1.5 kg (31.4%), followed by 2 - 2.5 kg (21.8%). Conclusions: HDP, GDM and anaemia were major causes of IUFD. Most of the causes of IUFD may have been preventable by pre-conceptional councelling, regular antenatal checkup, proper screening, early diagnosis and treatment. Large number IUFD remained unexplained. So, to unravel the complex pathophysiology of IUFD further study is needed.

Background : Premature Rupture of Membrane (PROM) is one of the most common complication of pregnancy. A woman with premature rupture of membrane is at risk of perinatal morbidity and mortality and also associated with maternal morbidity and psychological stress. Objective of this study was to determine incidence and risk factors of pregnant woman with PROM admitted in a tertiary hospital at Chattogram, Bangladesh. Materials and methods : This prospective observational study conducted in the Department of Obstetrics and Gynaecology at Chattogram Maa-O-Shishu Hospital Medical College (CMOSHMC) Chattogram from 1stJanuary 2018 to 31st December 2018. In this period total admitted antenatal patients were 8117. Among the pregnant patients with PROM were 665 and their weeks of gestation were > 28 weeks. Data was collected by interviewer with semi structured questionnaire & check list. Results : Incidence of PROM was 8.2%. PROM was found to be frequent (53%) in younger age group between 20-24 years. It was also commonly in primigravida (61.8%). Term PROM was higher (69.2%) than pre-term PROM (30.8%). 93.3% were singleton pregnancies, 6.4% were twins and .3% were triplets. Analysis of risk factors revealed ectiology was unknown in 46 (6.8%) low socioeconomic condition (60.6%), anaemia (45 %), lower genital tract infection (35.6%) UTI (31%) previous history of PROM (27.9%) malpresentation (15%) multiple pregnancy (6.7%) polyhydramnios (6%) history of recent coitus (12%) DM and GDM (10.5%) were commonly associated with PROM. Conclusions : Early identification of various risk factors causing PROM and their management can prevent premature deliveries and its complications to some extent as well as serious maternal complication like Chorioamnionitis. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 5-8

Introduction: Breast cancer is a common malignancy among female in Bangladesh.But its molecular subtypes are not evaluated due to lack of expert investigationsupport. So objectives of the present study are to evaluate the molecular subtypesof breast cancer patients according to St Gallen classification in our contest. Materials and methods: It is retrospective study done among histopathologicallyproved 40 breast cancer patients visiting Medical Oncology and Radiotherapydepartment of Chattogram Maa-O-Shishu Hospital. Molecular subtypes wasevaluated by immunohistochemistry according to St Gallen Classification. Results: In this study a total of 40 cases of invasive female breast cancers wereincluded. Age of the patients ranged from 31-62 years, with a mean age of 41 ±13.5 years. ER expression was seen in 60% and PR in 55% of cases and Her-2/neupositivity in 16%. Majority (52.5%) of the tumors were located in the left breast. Thepercentage of ER but not PR positivity increased with age, though this differencewas not statistically significant. Majority of the cases were diagnosed at stage IIwith a percentage of 42.5%. Stage II tumors showed more ER and PR positivity.Among all 57.9% of ER positive and 49.5% of PR positive tumors were present while72.2% of tumors were negative for Her-2/neu. The triple-negative breast tumorswere more commonly found at grade 2. Regarding luminal status 14(35%) wasLuminal A, 5(12.5%) was Luminal B, 9(22.5%) was TNBC and 12(30%) was HER 2positive. Conclusion: In this study luminal A was the commonest molecular subtypes. LuminalA subtypes tumors had a long term risk of distant matastatic disease which can bereduced by hormonal treatment. Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 55-58

Background COVID 19 pandemic had taken away lots of human life prematurely worldwide and death laid its icy hands also on Bangladesh. So, objectives of this study were to review the death cases in terms of monthly distributions, age, sex, co-morbidities, localities and duration of hospital due to the COVID 19 infection. Results There was a low frequency of death in the months May-2021 and October-2021(7.1% and 2.7% respectively) but more during June − 2021 to September 2021 (12.4%, 16.8%, 42.5% and 18.6% respectively). Female deaths were more than male deaths(53.1% vs 46.9%, p

Background: The prevalence of chronic kidney disease (CKD) has been rapidly increasing worldwide, and its early screening is vital to prevent the development of end-stage renal failure. Population-based studies on detection at early stage of kidney disease and its prevalence are scanty in our country. Hence, taking advantage of the observance of the World Kidney Day 2019, we conducted a screening program for kidney disease organized at the Chattagram Maa-O-Shishu Hospital premises among a low-income group of hospital staffs. Methods: This was a cross-sectional observational study among a low-income group of hospital staffs, working at our hospital. Age, body weight, height, body mass index (BMI), and blood pressure were documented, and urinary protein and serum creatinine were measured at a single sitting. Kidney function was estimated by calculating the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease formula. Kidney function was classified according to the estimated GFR (eGFR) and Kidney Disease Outcomes Quality Initiative guidelines. Results: A total of 101 hospital staffs were studied. Majority of the participants (38%) were in the age group of 30–39 years. Among all, 24% of the participants had proteinuria (trace to ≥1 plus). The distribution of eGFR was symmetrical, with the majority (79%) of participants in the 60–89 ml/min category, 6.9% in the 30–59 ml/min category, and only 13.9% of the study population had eGFR >90 ml/min. An inverse relation between eGFR and age and a direct relation between eGFR and BMI were observed. Conclusion: Proteinuria, low GFR levels, and consequently the possibility of high burden of CKD are prevailing in the studied participants, and further targeted population-based studies are warranted to clarify these issues.

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BackgroundChronic kidney disease (CKD) is an important public health problem. Renal replacement therapy (RRT) is needed to patients who goes to end stage renal disease(ESRD). Most of the evidence on its costs relates to patients receiving dialysis or kidney trans-plants, which shows that, in these phases, CKD poses a high burden to payers. The aim of this study was to estimate the financial burden of patients with CKD on maintenance hemodialysis.MethodsIt is one -year observational study, carried out to collect data on 105 patients with CKD on dialysis taking from different centers of Chittagong Bangladesh. After collection of sociodemographic informations financial status were collected from patients who gave informed written consent to be included in the study. Data were analyzed by SPSS 20.ResultsRegarding gender distribution, male was 73(69.5%) and female was 32(30.5%). Male to female ratio was 2.28:1. Age group distribution revealed 10(9.5%) patients were at 71 years age. Among all most were involved in service 40(38.1%) and business 23(21.9%). Socio economic status of the patients revealed 42(40.0%) patients were from upper middle class, 50(47.6%) were from lower middle class. Among all, 33(31.4%) patients took treatment from abroad. Regarding bearing of cost of the dialysis 24(22.9%) were self financed and 35(33.3%) got help from others(non family member), 11(10.5%) took loan and 13(12.4%) sold their stable land property. Regarding tenure of dialysis 31(29.5% patients are getting dialysis 30000 taka/month in 34(32.4%) patients and after start of dialysis present monthly income was zero(o) per month in 67(63.8%) patients and >30000 taka/month in 13(12.4%) patients. Regarding expenditure for each dialysis showed 2(1.9%) had zero(0) taka and 46(43.8%) patients needed 1000-2000 taka/session and 41(39.0%) needed 2000-3000 taka /session.ConclusionDialysis in CKD patients is a huge financial burden to the patients himself and the family. Government assistance should be provided to all patients who are unable to bear the cost.

IntroductionCOVID 19 is an unknown virus affecting mankind creating a deadly experience to all. It is true for Bangladesh also. So the objectives of the present study is to find the clinicopathological features and outcome of COVID patients admitted in three COVID dedicated hospitals of Chittagong, Bnagladesh.MethodsThis was an observational study where a total of 209 patients admitted in three COVID dedicated hospital were recruited. Clinicopathological data were recorded and patients were under observation till discharge and thus outcome were recorded. Prior consent was taken from the patients and ethical clearance was also taken. Data was compiled and analyzed by SPSS-20.ResultsAmong 209 patients most of them were male 139(66.5%) and male to female ratio was 1.98:1. Age group distribution revealed more were aggregated in age group 41-50 years 36(17.2%), 51-60 years 54(25.8%) and 61-70 years 57(27.3%). Among all 92(44%) patients were RT-PCR positive and 117(56%) were probable cases. Fever was present in 195(93.3%) cases, cough in 180(86.1%), respiratory distress in 105(50.2%) anosmia in 123(58.8%), aguesea in 112 (53.58%) and lethargy was present in 143(68.42%). Chest X-ray findings revealed 73(34.9%) had bilateral patchy opacities, 20(9.6%) had unilateral opacities 65(31.1%) had consolidations, 6(2.9%) had ground glass opacities and 2(1.0%) had pleural effusion. Supplemental O2 was given in 173(82.8%) patients, Favipiravir in 59(28.2%), Remdisivir in 111(53.1%), Methylprednisolone in 87(41.6%), Dexamethasone in 93(44.5%), Antibiotics in 204(97.60%), Toccilizumab in 34(16.3%), plasma in 18(8.6%) and LMWH in 200(95.7%) patients. Regarding outcome of the COVID patients admitted, 85(92.4%) patients improved, 6(6.5%) died who were RT-PCR positive and 107(91.15%) improved, 9(7.7%) died who were probable cases. Total death rate was 7.1%.ConclusionPresent study findings were some early activities among COVID patients in the years 2020. Male were more affected and middle age group people were the most victims.

IntroductionPeoples all around the world are waiting for vaccination against COVID -19 infection. In Bangladesh, Astra-Zeneca (AZ) vaccine was provided, but patients had infections of SARS-COV-2 even after vaccination. We focused on observing the severity, oxygen requirement and outcome of the COVID-19 infected patients who took the first dose or completed the immunization regimen.MethodsThis is an observational study done among 174 COVID-19 patients from three COVID-19 dedicated hospitals of Chattogram, Bangladesh, who took AZ vaccines 1st dose or completed the schedule. All patients were Real-Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) positive for COVID-19. Patients were enrolled after receiving written informed consent. Suspected cases or unwilling patients were excluded from the study. Ethical approval was granted by the CMOSH–ERB. SPSS-20 was used to analyze the information gathered.ResultsAmong 174 vaccinated patients, 55(31.61%) completed the vaccination schedule, and 119(68.39%) took their 1st dose of the COVID-19 vaccine. Gender distributions revealed 67(38.5%) female and 107(61.5%) male got the vaccine, and 55 patients completed the full two doses, and 119 patients took the 1st dose. Most of the patients were 40 years and above. In the completed vaccination group, 33(60.0%) out of 55 in and in the first dose vaccinated group, 75(63.0%) out of 119 had a mild COVID-19, and severe and critical cases were found very minimum. Among the patients who have completed the vaccination, 32(58.2%) needed no oxygen, and who was given the first dose, 78(65%) needed no oxygen. No death occurred who completed the vaccine, and 3(2.5%) patients died who took 1st dose of the vaccine.ConclusionVaccine provided in Bangladesh to the people so far seems safe and effective. Severe and critical COVID-19 is low, and the need for oxygen to admitted patients is less, and the death rate is minimal.

Introduction: Hepatitis E Virus (HEV) causes outbreaks of jaundice and it is associated with morbidity and higher maternal mortality. There is a recent outbreak of hepatitis in the Chittagong city and present study is aimed to observe the clinical and serological trends along with outcome of hepatitis cases visiting two tertiary care hospitals Chittagong, Bangladesh. Methods: It was an observational study done in two tertiary care hospital of Chittagong in a period of 3 months (May, June & July 2018) among 230 patients of hepatitis. After inclusion with written informed consent patients were introduced a questionnaire. Their demographic data, risk behaviors were noted, history related to hepatitis were recorded. Examination was done and evaluation regarding presence of hepatic encephalopathy at bed site was noted. Later serological findings were evaluated. After collection of all data it were compiled and analyzed by SPSS- 20. Results: Among 230 cases age group, gender and locality of the study patients were analyzed where younger age groups specially 21-30 years 114(49.6%) and 31-40 years 38(16.5%) were the most affected group. Gender distribution was found mostly same. Halishahar area which is located in western part of the Chittagong city was found mostly affected 196(85.2%). Use of water from WASA (Water and Sewerage Authority) supply was 168(73%) and deep tubewel water was 56(24.3%). Among them 80(34.8%) subjects do not boil water Anorexia (74.8%) nausea (77.4%) vomiting (83.5%) history of fever (89.6%) passage of dark color urine (99.1%) and weakness (97.4%) were some common presenting complaints. Family history of jaundice was found in 40.9% of cases. Among all 216(93.91%) had clinical jaundice, 91(39.56%) had right upper quadrant of the abdomen pain, 41(17.8%) had hepatomegally, 14(6.1%) had spleenomegally, 24(10.4%) had signs of hepatic failure and 34(14.8%) female were pregnant. Anti HEV was found positive in 164(71.3%) cases, 12(5.2%) were positive for anti HAV, 6(2.6%) were positive for HBsAg. None was found anti HCV positive. Among all 4(1.8%) cases died due to hepatic failure or multi-organ failure with AKI. All of them were pregnant. Two pregnant lady had missed abortion. Among all 11(4.7%) cases loosed follow and 213(92.60%) cases had uneventful recovery. Conclusion: This outbreak of HEV was of usual pattern of morbidity and mortality, and therefore points to water supply and sanitation issues. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 2-5

Background: Peripartum cardiomyopathy (PPCM) is a potentially life-threatening condition marked by left ventricular (LV) dysfunction and heart failure. The disease incidence is rising and most of the cases are identified now due to availability of widespread echocardiography and possible suspicion by cardiologist. Materials and Methods: This was hospital-based study conducted in the department of medicine of a tertiary hospital, Bangladesh. The study population consisted of postpartum patients admitted to medicine ward for evaluating dyspnea from January 2012 to January 2017. Totally 31 patients were diagnosed as PPCM and taken as a sample after exclusion of all criteria. Results: Most of the patients belonged to 20–24 years of age group (51.6%, n = 16) and most patients developed PPCM in primigravida (51.6%). About 67.7% admitted from rural area and 32.3% from urban area. Exertional breathlessness (45.1%, n = 14) and orthopnea (32.2%, n = 10) are the predominant symptoms in all age groups, while exertional breathlessness was 50% presentations from early age group and 14.3% from elder group, while orthopnea was Observed 70% from early age group. Nearly 9.3% of participants in the study had twin pregnancy. Association of gestational hypertension and diabetes mellitus was found in this study group as 12.9%, n = 4, and 16.1%, n = 5. Majority of the patients (35.5%, n = 11) had no specific electrocardiography changes; sinus tachycardia and ST-T changes were found equally (22.5%, n = 7). About one-third of the patients (29%, n = 9) were found to have severe LV systolic dysfunction (ejection fraction [EF]

Background: There are two common surgical options i.e. Burr hole aspiration and Excision with capsule with craniotomy in the treatment of brain abscess. The purpose of the study is to compare the two surgical methods (Burr hole and craniotomy) used as treatment for cerebral abscess and its outcome in terms of radiological clearance on brain CT, improvement of neurological status, the need for repeated surgery, and mortality and morbidity at six months after surgery. Materials and methods: The study was conducted in the Neurosurgery ward of Chittagong Medical College Hospital in a period (July 2012 to June 2014) of 24 months period. A total of 34 patients were taken as study subjects where two groups were made. Group A (n=20) patients were treated by bur rhole aspiration under general anesthesia and Group B (n=14) patients were treated by craniotomy and excision with capsule under general anesthesia. Peroperative and postoperative outcome was evaluated and compared. The clinical success of the both procedures, length of hospital stay, surgery related complications and neurological outcome were analyzed. Results: Among the 34 patients in both groups postoperative clinical data showed in group B there are more incidence of headache, vomiting, neurological deficit and seizure in three postoperative days than Group A patients. Few cases of fever was found in both groups. Two cases of wound infection was found in Group B at 7 postoperative days. Post operative GCS where Glasgow Coma Scale (GCS) was found to be gradually improving in Group A patients whereas in Group B 2 cases had GCS within 8-12 after 7 postoperative days. Regarding outcome during discharge improved GCS(>12) were found all in group A patients but it was less in Group B patients. Vomiting also found nil in Group A patients whereas in group B it was present in 2 cases during discharge. Seizure and neurological deficit was found nil in Group A patients but 4 cases in Group B had seizure and neurological deficit. There was one case in Group B who had wound infection. Evaluation of post operative hospital stay among the 34 patients in both groups were statistically significant less time was needed in Group A patients than Group B (p

Background: Antiphospholipid antibodies have been associated with a clinical syndrome consisting of thrombosis and recurrent, unexplained fetal loss. Stroke may be caused by Antiphospholipid Antibodies (APLA) especially in young persons without other conventional risk factors like Diabetes mellitus, Hypertension, Dyslipidemia, Smoking etc. The aim of this study was to evaluate the association of antiphospholipid antibodies (Anticardiolipin antibody and lupus anticoagulant) in young ischemic stroke patients presenting with sudden neurological deficit. Materials and methods: This was a case-control study performed in Medicine and Neurology department of Chittagong Medical College Hospital, Chittagong, a tertiary care government hospital. A total no. of 195 respondents consisting of 95 consecutive young patients (Age less than 45 years) diagnosed as ischemic stroke and 100 age and sex matched healthy controls were included in this study. The clinical details and related investigations of the respondents were reviewed. Anticardiolipin antibodies (IgM, IgG isotypes) were evaluated by an Enzyme-Linked Immunosorbent Assay (ELISA) and lupus anticoagulant by phospholipid dependent coagulation test Activated Partial Thromboplastin Time (APTT). When APTT was found more than 5 sec prolonged than control value, mixing studies using a 50:50 mixture of patient and normal plasma were performed and the result was considered positive if prolongation of APTT was not corrected which were needed to be confirmed after 12 weeks. The tests of Anticardiolipin antibodies (aCL) were repeated after 12 weeks when prior results were abnormal and the tests were considered positive when both results of aCL were found above normal value (IgM > 7.2 MPL/ml, IgG>14.4 GPL/ml). Results: Anticardiolipin antibodies Anticardiolipin antibodies (aCL) were present in 10.5% of the patients (IgM in 3 cases, IgG in 6 cases, IgM/IgG both in 1 case) and in 1% (IgG type) of control, but none of the study subjects were found LA positive. The odds ratio of aCL was 11.647 (95% Confidence interval= 1.461 – 92.852). Overall, the risk factors profile in cases were, Hypertension (32.6%) Diabetes mellitus (10.5%) Cigarette smoking (26.3%) and Dyslipidaemia (25.3%). Among the 10 aCL positive cases, 3 were Hypertensive, 1 was Diabetic, 2 were Smoker and 2 were Dyslipidemic but anticardiolipin antibody positive group did not differ significantly with respect to distribution of major risk factor frequency from anticardiolipin antibody negative group. Conclusion: Anticardiolipin antibodies are associated significantly with ischemic stroke in young patients less than 45 years of age (p= 0.004). Hence screening for anti-cardiolipin antibodies in young patients with stroke is recommended. JCMCTA 2017 ; 28 (2) : 27-33

Background : Anthropometry is the study of human morphology. Physical variation between the people of different ethnic groups can be recorded by anthropometry. This study was done to establish the anthropometric difference by measuring the nasal parameters among Bengali and Chakma School Going Children. The data of nasal parameters provide important information in plastic surgery, aesthetics and, nationality study and medical jurisprudence.Methods : It was an observational and cross sectional study, convenient sampling was done to select the 50 Bengali and 50 Chakma School Going Children, age ranging from 5-16 yrs old. Data were collected by using standard anthropometric methods with a sliding caliper. Values were expressed as mean ± Standard Deviation (SD).Student T test was used to compare the results.Results : In both sex, among the two ethnic groups, the mean total length and protrusion of nose in the Bengali group was significantly (

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Background: Dermatological problems are common among patients of different ages visiting the out patient departments of tertiary care centers. So the objective of the study to see the spectrum of pediatric and adult dermatoses in out patient skin department of Chattagram Maa hishu O General Hospital. Methods: The medical records of children and adult attending the dermatology outpatient clinics of Chattagram Maa-O-Shishu Hospital for the year September 2015 to September 2016 were retrieved. Data of 8534 patients were included. Demographic data (Age and sex) and diagnoses were collected and analyzed. Results: Among 8534 patients attended in OPD, majority of the patients were female and children (2500, 56% &, 3622, 42%). Infection constituted most of the dermatosis (31%) of which scabies was found most common (46%), eczema comes after (20%) and contact dermatitis prevailed (18%). Regarding seasonal variations majority of the patient peaked in summer 855 (10%). Among all 14 patients of epidermolysis bullosa were found. Leprosy and skin tuberculosis were found. Rare diseases including epidermal nevus syndrome 1case, tuboeruptive xanthoma in children, 2 cases, subcutaneous fat necrosis in neonate -2 cases, atypical presentation of erythema multiforme were found. Conclusion: Many children and almost all adult presents with uncommon presentation of common disease due to frequently visiting non professional and traditional medicine practitioners and homeopathic and traditional medicine. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 47-49

Pachydermoperiostosis (PDP) is a rare genetic disorder. Finger clubbing, skin changes and bony changes are the main three features of it. Here we present a 26-year-old male patient who was admitted for some other neurological disorder and diagnosed clinically as PDP. We diagnosed the condition clinically as gene analysis is not available in Bangladesh for a confirm diagnosis.Birdem Med J 2018; 8(2): 181-183

Background Both clinical and subclinical low level vitamin D is common1. Various kinds of health hazard including musculoskletal symptoms are frequently seen among the Vitamin D deficients. It is also not uncommon even in a sunny country. Lack of sun exposure, particularly female using veil may be an important cause. Objectives To assess the relationship between using veil and serum vitamin D3 (cholecalciferol) level Methods This prospective cross-sectional descriptive study was conducted during July 2017 to June 2018. Patients with common complaints related to lack of Vitamin D (muscle cramp, myalgia, fatigue, bone pain, generalized weakness, difficulty in getting up, climbing stairs and pain in weight bearing joints) were enrolled. Patient having other disease were excluded from study. Serum cholecalciferol was measured for each patient. Race, occupation, educational status, skin complexion, body mass index, sunlight exposure, covering of body with clothing’s and use of sunscreen were taken under consideration in final analysis. Correlation of serum cholecalciferol level with different types of veils (Burkha, halve sleeve, full sleeve, quarter sleeve and Hijab) of individual’s was analyzed. Results A total 79 female patients were enrolled after screening 108. All of them were of multi-ethnic Asian origin. Age distribution of them is 17 to 39 years 34.2%, 40 to 50 years 38%, 51 to 70 years 26.6% and above 70 years 1.3%. Maximum (93.7%) of them were house wife, 91.1% had no adequate sun exposure and 81% had no skin exposure to sunlight. Among clothing 79.7% used Burkha, 5.1% halve sleeve, 2.5% full sleeve and 12.7% quarter sleeve. Among Burkha 28.6% (18), 55.6% (35) & 15.9% (10) and among quarter sleeve 50% (5), 40% (4) & 10% (1) had deficient, insufficient & sufficient vitamin D level respectively while 2 (100%) female with full sleeve and 4 (100%) female with halve sleeve had deficient and insufficient vitamin D level respectively. The cholecalciferol level among the users of veil is shown in Table-1. There was no significant difference between different types of clothing’s (Table: 2). Conclusion Main source of Vitamin D is sunlight. Proper exposure to sunlight is essential for adequate vitamin D level even in a sunny country. Regarding in vitamin D absorption from sunlight, there may be no difference between Burkha and other covered dressings. Further study needed to have a conclusion. Reference [1] Jones AN, Hansen KE. Recognizing the musculoskeletal manifestations of vitamin D deficiency.J Musculoskelet Med. 2009; 26(10): 389 – 96. Disclosure of Interests None declared

Background: Chronic Obstructive Pulmonary Disease (COPD) is of public health importance. Indoor biomass (wood, cowdung etc) smoke exposure from cooking is associated with respiratory conditions and may predispose to COPD. The objective of this study was to evaluate the risk of biomass smoke exposure and COPD.Methods: A cross sectional study was conducted at a rural setting of Bangladesh. Rural women over 40 years and exposed to biomass fuel, liquid petroleum gas or natural gas smoke were evaluated using a questionnaire and their lung function was assessed using a portable spirometry.Results: The overall prevalence of COPD in the rural women was 20.4%. It was significantly higher in women using biomass fuel for cooking than in those using natural gas/LPG (p

Introduction: Little is known about the epilepsy patients attending in a psychiatry outpatient department (OPD) in the context of Bangladesh. Hence, the aim of our study was to see the frequency and pattern of patients of epilepsy attending in a psychiatry OPD in our context. Methods: One-year patient data were explored from January 2016 to December 2016 recorded in a register book of the psychiatry OPD by consultants themselves and data were extracted manually. The diagnosis was collected, and data were analyzed by Microsoft Xcel. Results: Among the total of 1474 patients visiting the OPD in the year 2016 at the psychiatry OPD, total epilepsy cases were found in 209 (14.2%) patients. Among them, generalized tonic–clonic seizure was found 144 (9.8%), absence seizure 38 (2.6%), partial seizure 5 (0.3%), temporal lobe epilepsy 4 (0.3%), myoclonus 1 (0.1%), and unclassified 17 (1.2%). Electroencephalography confirmation was done in 60 cases which was 4.1% of total patients. Hence, confirmed cases of epilepsy were 4.1%, and probable cases were 10.1% of total patients attending OPD. Conclusion: In conclusion, we can say that visiting of epilepsy patients in a psychiatry OPD is a common behavior and we need to develop expertise in this field more.

Background: Incidence of metabolic syndrome and superficial mycotic infection is progressively increasing worldwide. Skin disorders, usually neglected and frequently underdiagnosed in patients with metabolic syndrome. So, the objective of the study is to linkup between metabolic syndrome and superficial mycotic infections.Methods: Total 300 diagnosed patients of superficial mycotic infection out of 1000 patients in a 5 months period from January 2019 to May 2019 who gave consent were chosen at random from the patients attending the OPD consultancy. Thorough clinical evaluation and routine hematological investigations, oral glucose tolerance test (OGTT), fasting lipid profile were tested and BMI and blood pressure were recorded to diagnose metabolic syndrome. Fungal infections were confirmed by KOH mount.Results: Among 1000 patients attended in OPD consultancy, majority of the patients were female (60%). Among them 300 patients have got different superficial fungal infections (female was 223 and male 77). Among this 300-study population, age variation is significant. There were highest female patients in age group from 36 yrs- 45 yrs. Tinea corporis was the most frequent fungal infection in female (65%), Tinea cruris is highest in male (21%). The most alarming is that among that 300 patients 45% patients have got raised OGTT,91% patient has increased BMI, female predominant. 59.3% has raised blood pressure and increased serum cholesterol in 70.1% patients. Conclusions: Superficial fungal infections are epidemic worldwide. In our study the new era is that presence of metabolic syndrome among patients with superficial mycotic infections. So early detection and treatment of metabolic syndrome helps in cure of superficial mycotic infections.

Background Patients suffering from generalised aches and pains, not adequately responding to treatment are usually considered as fibromyalgia, depression, chronic fatigue syndrome etc. But those patients need further evaluation and low vitamin D is often the underlying cause. Both clinical and subclinical low level vitamin D is common.1 Objectives To assess the relationship between musculoskeletal complaints and serum vitamin D3(cholecalciferol) level. Methods This prospective cross-sectional descriptive study was conducted during July 2017 to December 2017 in Chittagong, Bangladesh. Patients with common musculoskeletal complaints were enrolled. Each patient was screened to exclude common possibilities. Serum cholecalciferol was measured for each patient. Race, occupation, skin complexion, body mass index, sunlight exposure, covering of body with clothing’s and use of sunscreen were taken under consideration in final analysis. Visual analogue scale (VAS; 1–10) was used to quantify all complaints. Correlation of serum cholecalciferol level with VAS score of individual complaints was analysed. Results A total of 110 patients (79 Female and 31 Male) were enrolled after screening 165. All of them were Bangladeshi of multi-ethnic Asian origin. Mean age was 46.5±12.8 years. Their skin complexions were pale white to white skin 45.5%, light brown 30%, moderate brown 11.8% and dark brown 12.7%. Most had (90.9%; n=100) inadequate sunlight exposure and 77.2% (n=61) women used Burkah (full covered dress). Mean vitamin D3 level was 25.2±7.3 ng/ml. Vitamin D deficiency was (mean 17.3±2.8 ng/ml) observed in 30 (27.3%), insufficiency (mean 25.1±2.7 ng/ml) in 62 (56.4%) and normal level (mean 34.8±4.4 ng/ml) in 18 (16.4%). After classifying Vitamin D level in relation to symptoms it was found that majority of patients (81.2% to 90.3%; depending on complaints) had insufficient or deficient cholecalciferol level (table 1). Significant negative correlation was found between the serum cholecalciferol level and VAS for difficulty in getting up from squatting position (r=−0.253, p=0.008) and positive correlation was found for muscle cramps (r=0.220, p=0.021). Correlations with remaining symptoms were not statistically significant. Conclusions Vitamin D status directly and indirectly influences musculoskeletal health. Hypovitaminosis D should consider in every patient with muscle cramp. Reference [1] Jones AN, Hansen KE. Recognizing the musculoskeletal manifestations of vitamin D deficiency. J Musculoskelet Med. 2009; 26(10): 389 – 96. Acknowledgements Hafsa habiba, Rayhana Begum Disclosure of Interest M. A. Razzaque Consultant for: research, G. Dewan Consultant for: research, R. biswas Consultant for: research, M. karim Consultant for: research, I. sultan Consultant for: research

Dilated Cardiomyopathy (DCM) is a form of cardiomyopathy characterized by left ventricular or biventricular dilatation and impaired ventricular contractility. This results in systolic dysfunction of the heart with decreased left ventricular ejection fraction and progressive cardiac failure. This case report describes the successful anaesthetic management of a parturient with Dilated cardiomyopathy underwent Caesarian section under spinal anaesthesia. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 52-53