Search

Background/Aims: Acute stroke is one of the leading causes of mortality and morbidity worldwide. The adverse outcome following acute stroke depends not only on severity of the neurological defects but also on other co-morbidities. Associated renal impairment has been found to be a major predictor of different outcome following acute stroke in several studies. The aim of this study was to evaluate the impact of the serum creatinine on the outcome of hospitalized patients after acute stroke. Methods: This was a Prospective cohort study conducted on 100 consecutive adult patients who were admitted in the Neurology department of Dhaka Medical College Hospital following acute stroke during January 2018 to December 2019.The patients were followed up for two weeks after the incident stroke. Results: Among the 100 patients with acute stroke 57(57%) were ischaemic and 43(43%) were haemorrhagic stroke. Mean age(SD) was 60.4(10.6) years. Patients with ischaemic stroke were older compared to haemorrhagic stroke (61.1(9.6); 53.8(9.4) years respectively; p

Introduction: Carpal tunnel syndrome (CTS) is a clinical syndrome that results from compression of median nerve within the carpal tunnel at the wrist. The aim of this study was to review the clinical and demographic characteristics and electrophysiological patterns of CTS patients who presented to a tertiary care hospital in Bangladesh. Methodology; A descriptive cross-sectional study was conducted on 150 CTS patients at the neurology department, Dhaka Medical College Hospital between January, 2019 to March , 2020 . All the subjects had clinical evaluation and standardized nerve conduction studies of upper limbs (300 limbs) using the same protocol. Results: 228 hands were found to have clinical and electrophysiological features consistent with CTS. There was female predominance (90%) and the highest occurrence of CTS was in the 45-55 years age group. Bilateral CTS was found in the majority of cases ie 78 (52%) and the rest had unilateral CTS. Among those with unilateral CTS, right hand was affected more (41, 57%) than left hand (31, 43%). Most of the cases were idiopathic. Neurophysiological studies showed most patients had mild CTS (121 hands, 53%). Most of the cases were idiopathic (102, 68%). Where a risk factor was found diabetes was commonest one (32) followed by hypothyroidism (12) and pregnancy (4). Conclusion: There was marked female predominance and the 45-55 years age group was predominantly affected. Majority of cases had mild CTS. Bilateral involvement was more common. Right hand was more affected than the left hand. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 96-99

Background: The National Institutes of Health Stroke Scale or NIH Stroke Scale (NIHSS) is a widely used tool for assessing stroke severity. We conducted this study to determine the severity of stroke patients admitted in a tertiary care hospital.Methods: This is a cross sectional study conducted in Department of Neurology, Dhaka Medical College Hospital from April 2016 to October 2016 involving 91 acute stroke patients.Result: About half (44%) of the patients were older than 60 years of age and mean age of the patients was 60.34(±16.1) years at onset and there is a slight female predominance (51.6%). Majority had hypertension (75.8%) followed by physical inactivity (67%), diabetes (37.4%), smoking (33%), obesity (23.1%), family H/O stroke (20.9%) and dyslipideamia (15.4%). Many patients were found to have hyperglycemia (14.3%) followed by hyperthermia (13.2%), hypotension (4.4%) and low oxygen saturation (3.3%) at the time of admission. Most of them had ischemic stroke (60%), followed by intracerebral hemorrhage (35%) and subarachnoid hemorrhage (5%). After leveling with NIHSS score more than half of the patients (51%) were found to be moderate grade on admission. Although, there was no association between risk factors of stroke and admission NIHSS score level, significant association was found between hypoxia and admission NIHSS score severity.Conclusion: Acute stroke patients, mostly have moderate grade of NIHSS score on admission. Hypertension, physical inactivity, diabetes, smoking, obesity, family H/O stroke and dyslipideamia are common risk factors observed among the patients which have no significant association with admission stroke severity determined by NIHSS score. There is significant association between hypoxia and admission NIHSS score severity.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 90-93

Objective: To determine the pattern of neurologic disorder in the specialized neurology out patient at tertiary care level.Methods: This observational study was carried out in specialized neurology outpatient clinic of Dhaka Medical College Hospital from July 2015 to July 2016, which included 8892 patients. Data were collected through a predesigned questionnaire from the hospital database kept at the clinic.Result: A total of 8892 patients were seen in neurology OPD in one year. About one third of the patients presented at 21-30 years of age. There was a male dominance (53%) with a male to female ratio of 1.12:1. Most of the patients had hypertension (3201, 36%) followed by diabetes and ischemic heart disease (1956, 22%; 1423, 16%) as co-morbid condition. Majority had Headache (4090, 46%) followed by vertigo (1067, 12%); vomiting (711, 8%) and neck and/ back pain (702, 8%) as presenting symptom at onset. Majority of the patients (46%) were diagnosed as headache disorder (Tension type headache in 33.5%, Migraine 7.5% and mixed headache in 5%) followed by ischemic stroke (896, 10%); polyneuropathy (446, 5%); vestibular disorder (441, 5%); movement disorder (267, 3%) and anxiety/depression (254, 3%). About 15% (1346) patient were undiagnosed at initial visit.Conclusion: Neurological diseases are not uncommon even at middle aged patients. Headache, vertigo, neck/back pain are common presenting symptom. Headache disorders and stroke are the commonest neurologic diagnosis at OPD.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 53-57

Objective: To measure the changes in electro encephalogram (EEG) along with its sensitivity and specificity with clinical seizure among epilepsy patients referred to an electrophysiology lab in a tertiary care hospital of Bangladesh. Methods: This retrospective chart review was carried out in the electrophysiology laboratory of Dhaka Medical College Hospital from January 2011 to December 2013, which included 1154 patients. EEG was obtained through scalp electrodes following international 10/20 system. Information regarding patients was collected from the laboratory register with the help of a checklist. The EEG findings and clinical seizure events were then compared. Result: Among the 1154 patients, age varied from birth to 75 years. The mean age at presentation was 17±11.4 years and most of the patients were less than 10 years old (44.4%). The male predominated in our study (59.2%). Clinically diagnosed seizure was present in 970 patients (84.1%), among which Generalized tonic clonic seizure (GTCS) was the most common clinical type of seizure, followed by secondary generalized seizure in 19.4% (n=224) and focal seizure in 2% (n=30) patients and 6.8% (n=79) patients had pseudoseizure. Among the abnormal EEG (59%), generalized epileptiform discharge was found in 29%, whereas focal and secondary generalized discharge was found in 30%. The most common site of origin of epileptiform discharge was temporal lobe (28.3%). The overall sensitivity of EEG was 66% (ranged from 62% to 68% with a confidence interval (CI) at 95%) and specificity was 79% (72- 84% at 95% CI). The positive predictive value was 58% (55-61% at 95% CI) and negative predictive value was 41% (38-44% at 95% CI). Conclusion: Our study brings out the fact that EEG has a reasonable sensitivity and specificity as a diagnostic test and the superiority being the higher specificity of EEG. J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 215-222