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This cross-sectional study was carried out at the department of Pediatric Neurology, Institute of Pediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University, Dhaka with the aim to assess the relationship between gross motor function and MRI findings in children with cerebral palsy. The duration of the study was 12 months. All the cerebral palsy cases who met the selection criteria were enrolled. Detailed history taking and physical examination was done. The gross motor function of all cases was evaluated according to Gross Motor Function Classification System- Expanded and Revised (GMECS-E and R). Magnetic resonance imaging of brain was done in all enrolled patients and reports were evaluated. MRI findings were classified as maldevelopment, cortical and subcortical gray matter lesion, periventricular white matter injury, basal ganglia lesion, normal and other findings. A total of 45 children with cerebral palsy aged between 2 to 12 years were included in this study. Mean age of the children was 4.73 (+3.17) years. Male were 31 and female were 14 in number. Functionally majority patients were in GMFCS level IV (26.7%) and level V (20%). MRI findings were abnormal in 35 (77.78%) cases. Most common abnormal MRI finding was cortical and subcortical grey matter lesions 22 (48.9%). This study revealed that cortical and subcortical gray matter lesions were significantly associated with higher level of GMFCS (IV-V) (P=0.038) and maldevelopment of brain were also significantly associated with higher level of GMFCS (P=0.01). Normal MRI findings had significant association with mild to moderate GMFCS level (I-III) (P=0.012). From this study significant relationship was found between gross motor function and MRI of brain findings in children with cerebral palsy. Bangabandhu Sheikh Mujib Medical University Journal 2022;15(4):8-15

Background: Cerebral palsy (CP) is one of the most common causes of chronic childhood disability. To know the aetiopathogenesis, severity and prognosis of CP, neuroimaging is an important modality of investigation. Objective: This study was done to observe the findings in CT scan of brain in children with CP. Materials and Methods: This is a cross-sectional descriptive study. One hundred and ten patients who were clinically diagnosed as cerebral palsy were enrolled in the study. After selection of the subjects, demographic and clinical characteristics were recorded. All other comorbidities including visual and hearing impairments were identified. CT scan of brain was done in all children and reporting had been done by a single qualified radiologist. Results: The mean age of the studied children was 2.6±2.2 years (1 to 14 years). Seven types of CP were found in the study group. Among them quadriplegic CP were the most common (39.1%). History of perinatal asphyxia was found in 81.8% children. Cognitive delay was found in 90% children, speech delay was found in 88.2% children, visual impairment was found in 35.5% children and hearing impairment in 31.8% cases. Epilepsy was found in 44.4% among studied subjects. Most common finding on CT scan of brain was cerebral atrophy (62.7%), followed by encephalomalacia (15.5%), calcification (13.6%), and brain malformations (11.8%). Abnormal CT scan findings were found in 88.2% of study population. Conclusion: This study showed that most common type of CP was quadriplegic CP. Maximum children had abnormal CT scan findings. Most common CT scan finding was cerebral atrophy. J Enam Med Col 2021; 11(1): 18-23

Background: Cerebral Palsy (CP), a complex neurodevelopmental disorder in children, is often accompanied by comorbidities like intellectual impairments besides core motor dysfunction. Aims: To assess the relationship between gross motor and intellectual functions among the children with CP. Methods: A cross- sectional study was carried out in the Institute of PaediatricNeurodisorder and Autism (IPNA), BSMMU, Dhaka, during Oct. 2017 to May 2018 including 82 children up to 12 years of age having CP. The gross motor function of all the children was evaluated using GMFCS. Psychological assessment was done by professional psychologist using age specific psychometric tools. Results: One third of the children (39.0%) belonged to age 2-4 years. Male to female ratio was 1.7:1. More than three fourths of the children (85.4%) were of term gestational age. Perinatal asphyxia (PNA) was associated in 92.7% children.More than half of the children (57.3%) had spastic quadriplegia. Almost half of the children (48.8%) GMFCS level was II and 28.0% children were of GMFCS level III. Nearly a half (48.8%) of the children was with mild intellectual impairment and 22.0% were with moderate intellectual impairment. There is a significant negative Spearman’s correlation (r=-0.639; p=0.001) between GMFCS level and intellectual level. Conclusion: More severe motor impairments in CP might be associated with higher intellectual dysfunction. J Dhaka Med Coll. 2021; 29(1): 9-15

Background: Rasmussens encephalitis (RE) is rare progressive cerebral inflammatory disease predominantly affecting pediatric population. The key clinical features are seizure and hemiparesis. Seizure is mostly focal with or without epileptia partialis continua (EPC). Diagnosis is established by EEG showing epileptic discharges with focal slowing, focal cortical atrophy in neuroimaging and T cell dominated encephalitis in biopsy or autopsy. This study was done to describe the clinical, laboratory features and treatment of RE in Bangladesh perspective. Materials & Methods: This study was done in Department of Pediatric Neurology, IPNA, BSMMU, Dhaka, Bangladesh. Four admitted children who were diagnosed as RE from January 2016 to July 2019 were included in this study. Retrospective detail data of the all four patients were collected and analyzed. Results: The age ranging was 3-12 years, all were male. Cognitive decline, speech disorder, hemiparesis were observed in all the patients. Among them 1 had prodrome of fever. All the patients had seizure, mostly focal onset. Among them 2 had EPC. Treatment was given mainly with immune modulatory drugs (Intravenous methyl prednisolone, IV immunoglobulin, oral steroids) and antiepileptic drugs. On follow up all the patients had consequences in the form of hemiparesis, epilepsy, dysphasia, cognitive disorder etc. Conclusion: Cognitive decline, speech disorder, focal seizure and hemiparesis were the common presentation. EPC was observed in 50% of cases and consequences on follow up in all cases. BANGLADESH J CHILD HEALTH 2021; VOL 45 (3) : 147-154

Alternating hemiplegia of childhood (AHC) is a rare neurological disorder manifested by transient repeated episodes of alternating hemiplegia associated with other neurological events. Though the exact etiology was largely unknown, recently the pathogenic mutation in the ATP1A3 gene encoding for the alpha3 catalytic subunit of Na+/ K+ATPase was found to be the primary cause of AHC. We present the case of 8.5 year old girl with AHC who had a heterozygous de-novo p.Leu839Pro (c.2516T>C) pathogenic mutation of ATP1A3 gene on chromosome 19q13. BANGLADESH J CHILD HEALTH 2021; VOL 45 (3) : 175-177

Introduction: Cerebral palsy (CP) is one of the most common causes of chronic childhood disability. CT scan is helpful for identification of structural abnormalities, etiology, categorize the types of brain lesions and planning of intervention in the child with CP. Objective: This study was done to find relationship between types of CP and CT scan findings of brain. Materials and methods: This cross sectional descriptive study was done among 110 clinically diagnosed CP case from department of Paediatric Neurology & IPNA, BSMMU, during March 2016 to August 2017. Demographic, clinical characteristics & physical examination were done & collected data were recorded. CT scan of brain was done in all cases & all data were analyzed. Results: The mean age of the studied children was 2.6±2.2 years (1 to 14 years). Among them quadriplegic CP were the most common (39.1%), followed by 28.2% cases of hemiplegic CP, 16.4% were of mixed type, 7.3% were diplegic. Most common finding on CT scan of brain was cerebral atrophy (62.7%), followed by encephalomalacia (15.5%), calcification (13.6%), and brain malformations (11.8%). Abnormal CT scan findings were found in 88.2% of studied children. Children with hemiplegic CP had brain atrophy in 87% of cases, calcification was found mostly in quadriplegic CP. Brain malformation was found mostly in mixed type of CP. Conclusion: Most common CT scan finding was brain atrophy and commonly found in hemiplegic CP. Encephalomalacia and calcifications were commonly found in quadriplegic CP. Brain malformation were commonly found in mixed type of CP. BANGLADESH J CHILD HEALTH 2021; VOL 45 (2) : 67-73

Limb girdle muscular dystrophy (LGMD) presents with weakness and wasting of muscles, initially appear at proximal group of pelvic and shoulder girdles and inherited by an autosomal recessive disorder mainly and rarely autosomal dominant trait. We report two young girls of limb girdle muscular dystrophy (LGMD), who presented with gradual onset of weakness in proximal muscle of all four limbs. There was positive family history in one girl. Neurological examination revealed pseudo hypertrophy of both calves, hypotonia in all four limbs, muscle power diminished, more on proximally. All deep tendon reflexes were diminished with planters bilateral flexors. Gower sign was positive and winging of scapula was also present. Electromyography (EMG) showed myopathic pattern. Both had elevated creatinine phosphokinase levels and finally genetic study confirmed the diagnosis. J Enam Med Col 2020; 10(3): 190-194

Primary immune deficiency disorders (PIDs) are not an uncommon entity, but the diagnosis is often delayed or even missed due to lack of awareness. Central nervous system involvements due to various reasons are documented in patients with PIDs. This case report describes a 10- year old boy, diagnosed as X-linked agammaglobulinemia (XLA) who developed progressive encephalopathy. He had severe cognitive impairment along with cerebellar and pyramidal dysfunction. MRI of the brain showed generalized cerebral and cerebellar atrophy. Therefore, this boy was diagnosed as a case of XLA with progressive neurodegenerative syndrome. BANGLADESH J CHILD HEALTH 2021; VOL 45 (1) : 55-58

Adverse neurological event particularly seizure after vaccination is not uncommon. The most linked vaccines are Diphtheria, Pertussis and Tetanus toxoid (DPT), Measles, Mumps and Rubella (MMR) and other combination vaccines. It is documented that increased febrile seizure after DPT and MMR vaccine is due to increase febrile episodes precipitating seizure and it is time related. Concomitant administration of vaccines cause seizure due to synergistic effect of those vaccines. When these vaccines are given separately, the risk of seizure is decreased. These type of vaccines are MMR + varicella (MMRV), DTaP-HepB-IPV etc. Regarding etiology, genetic mutation is most important. Some genes are closely related to vaccine induced FS and afebrile seizure like SCN1A, SCN2A, IFI44L, PCDH19 etc. Other causes are endotoxin mediated endothelial damage, IL-1â production and non CNS infection. It is well evident that consequences of not giving vaccine are far more than the adverse events. So Vaccinations should be performed without contraindication in children with previous febrile and afebrile seizures with proper counseling. Bangladesh J Child Health 2020; VOL 44 (1) :40-47

Introduction: Surgical outcome of spinal tumours varies depending on a number of factors such as: site of tumour compression within the spinal canal, the histological characteristics of tumours, the neurological progression and initial response to corticosteroid therapy, patient’s age, comorbidity, tumour extension, involvement of neighbor structures and organs etc. Materials & Methods: The 46 patients with intradural extramedullary (IDEM) spinal tumour underwent surgery by our team in 7 years (2010-2017) were reviewed retrospectively. Discussion: Analysis of the surgical outcome of our spinal tumour patients was done on different variables like age, sex, presenting symptoms, neuro imaging, comorbidities etc. The aim of surgery was decompression of the spinal cord and total removal of the tumour. Conclusion: The aim of this study is to analyze the data to make conclusion for more effective strategy as per site, size, type, resectibility and histological variety to establish an effective treatment protocol and prevention of per-operative and post-operative complications. Intradural extramedullary tumor can be radically resected with no mortality and minimal peri-operative morbidity J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 205-208

Cockayne syndrome (CS) is a genetic disorder characterized by growth failure, microcephaly, cognitive delay, visual and hearing disorders. Patients usually present with dysmorphism and global delay. It is an autosomal recessive disorder, mutation of two genes ERCC8 and ERCC6 were observed. We report a 4 year old child who was diagnosed as a case of Cockayne syndrome, based on clinical, neuroimaging and genetic study findings. This case had growth failure, dysmorphism, optic atrophy, global developmental delay, intracerebral calcification and mutation of ERCC8 gene. Bangladesh J Child Health 2020; VOL 44 (3) :181-183

A 55 year old female patient presented with progressive back pain of 6 month duration,aggravated on lying down, associated with weakness and numbness of the bothlower limbs for since 4 months. On neurological examination, the tone was foundincreased in both the lower limbs with a subjective power of grade 3/5 in both thelower limbs. Ankle and knee jerks were brisk with hypoaesthesia below D12dermatomes bilaterally, plantars were extensor. A clinical diagnosis of involvement ofD9 spinal level lesion was made. Magnetic resonance imaging (MRI) of the dorsolumbarspine showed an intraduralextramedullary ventrally placed lesion at the D8–D9 vertebral level with significant compression of the spinal cord [Figure 1, 2, 3]. Thelesion appeared hyperintense on T2W image with no contrast enhancement and withsignificant compression and shifting of the cord to the left. After preoperative routinehematological investigations, she underwent operation by laminectomy of D8–D9vertebrae and total excision of the cystic lesion was performed [Figure 4, 5]. Histologicalexamination revealed respiratory type pseudostratified ciliated columnar cells and apathological diagnosis of bronchogenic cyst was rendered [Figure 6]. The patient hadan uneventful postoperative period with subjective improvement of her symptomswith reduced spasticity & improvement of motor grade to 4/5 in both lower limbs. Bang. J Neurosurgery 2020; 9(2): 146-150

Introduction: Surgical outcome of spinal tumour varies depending on a number of factors such as: site of tumour, compression within the spinal canal, the histological characteristics of tumour, the neurological progression and initial response to corticosteroid therapy, patient’s age, comorbidity, tumour extension, involvement of neighboring structures and organs etc. Materials & Methods: The 86 patients with spinal tumour underwent surgery by our team in 7 years (2011-2018) were reviewed retrospectively. Discussion: Analysis of the surgical outcome of our spinal tumour patients was done on different variables like age, sex, presenting symptoms, neuroimaging, comorbidities etc. The aim of surgery was decompression of the spinal cord, total removal of the tumour when possible and spinal stabilization when needed. Out of our 86 patients with spinal tumour, extradural tumour comprises 18, intradural tumour 56 and intramedullary tumour 12. Conclusion: The aim of this study is to analyze the data to made conclusion for more effective strategy as per site, size, type, resectibility and histological variety to establish and effective treatment protocol and prevention of per-operative and post-operative complications. Intradural extramedullary tumour can be radically resected with no mortality and minimal peri-operative morbidity. But resection of intramedullary spinal tumour is difficult, hazardous and usually incomplete, so needs much more skilled and meticulous surgical hands. Bang. J Neurosurgery 2019; 8(2): 63-67

Introduction: Endovascular treatment offers different technique (Balloon assisted coiling / simple coiling, glue embolization) to treat Carotid Cavernous Fistula (CCF). This less invasive approach avoids morbidity and residual fistulas. The choice of treatment depends on the anatomy of the fistulas and cost effectiveness. Objective: To describe different endovascular treatment option of Carotid Cavernous fistulas (CCF), its short term outcome (clinical and angiographical) and to compare between trans-venous coiling and trans-arterial balloon assisted sinus coiling. Method: We have treated nine (9) cases of CCF during a period of three years. Out of them eight patients had direct CCF and one had indirect CCF. In two patients simple coiling done through trans-venous route and in another three patients through trans-arterial route. Balloon assisted coiling through trans-arterial route done in three patients. In two patients trans-arterial glue embolization was done. Results: Successful obliteration of fistula was achieved in all cases. Vision was improved in eight (8) patients. Postoperatively some proptosis remains in two patients. In one patient there was reappearance of proptosis two months after treatment, then balloon assisted coiling was done. One patient died from complication of glue (NBCA). Conclusion: Endovascular treatment is the mainstay of treatment in CCF. Trans-venous is the treatment of choice but recently balloon assisted sinus coiling through trans-arterial route is adopted. Bang. J Neurosurgery 2019; 8(2): 68-76

Cerebral venous sinus thrombosis (CVST) is a rare stroke-like syndrome. Sometimes it may be rarely associated with ophthalmic vein occlusion. We present a 10-year-old girl who had severe headache, diplopia, severe congestion of eye, proptosis and orbital pain. She had no signs of meninigeal irritation, no focal deficit except left sided lateral rectus palsy and altered visual acuity. Investigations regarding vasculitis and thrombophillia were normal except thrombocytosis. MRI of brain showed ‘dense triangle sign’ and thickened superior ophthalmic vein. Magnetic resonance venography (MRV) showed occlusion of superior sagital sinus and transverse sinus. She was treated with paracetamol, acetazolamide, rivaroxaban and antibiotics followed by high dose pulse methyl prednisolone. She made a partial recovery within one week and at 3 months follow-up she was completely normal. J Enam Med Col 2019; 9(2): 127-132

Background: Migraine hampers child's life through school absence, limitation of home and social activities. The goal of prophylactic (preventive) therapy is to reduce headache frequency, headache days, and headache severity with minimum side effects. Objective: To evaluate the efficacy and tolerability of levetiracetam compared to flunarizine as prophylactic treatment of Migraine in children. Methods: This prospective study was carried out in the outpatient department of a tertiary care hospital in Bangladesh. A total of 105 children aged 6-15 years, diagnosed as migraine without aura, were enrolled. Patients were treated with flunarizine or levetiracetam for three months. Headache disabilities were evaluated at baseline and at the end of three months. Results: In flunarizine group, 54 children and in levetiracetam group, 51 children were enrolled. Among them thirty nine children in flunarizine group and 36 children in levetiracetam group completed the study. Headache frequency, headache days, VAS (Visual Analogue Scale) score and PedMIDAS (Paediatric Migraine Disability Assessment Score) score were evaluated at baseline and during the follow up. After three months, headache frequency, headache days, pain severity (Visual Analogue Scale score) reduced significantly compared to baseline (p

Objectives: The aim of this study is to compare patients undergoing single level anterior cervical discectomy without fusion (ACD) versus anterior cervical discectomy with fusion (ACDF). Methods: A retrospective analysis of 50 patients with degenerative cervical spondylosis of them 25 had undergone ACD without fusion and remaining 25 undergone ACDF at either C4-C5, C5- C6 level or at C6-C7 level. Results: The kinematic analysis included the range of motion, intervertebral angulations, anteroposterior translation and disc height assessed for the cervical functional spinal units at the operated level and adjacent levels. At the operated level of C4-C5, C5-C6 and C6-C7, the range of motion and the translation were minimal in the anterior cervical discectomy without fusion (ACD) group, but absent in the cervical discectomy with fusion (ACDF) group. The superior adjacent levels range of motion and the translation were greater in the ACDF group compared with the ACD group. But both groups had almost similar results in term of hospital stay, mean time for improvement and patient satisfaction. Conclusion: The clinical results of anterior cervical discectomy without fusion (ACD) and anterior cervical discectomy with fusion (ACDF) were comparable. In cervical discectomy without fusion, the elastic fibrous intradiscal scar at the operated level allows a small degree of mobility and the adjacent cervical levels are not overstressed. Fusion is not routinely required in single level cervical disc herniation until it is associated with instability, loss of cervical lordosis, hard disc, osteophytic bar and multi-segmental disease. So ACD is a better option in single level cervical disc disorder than ACDF. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 29-35

Background: The pineal gland (epiphysis cerebri) contains cords and follicles of pinealocytes and neuroglia.Objective: To determine the number of the pinealocytes and neuroglial cells per sq. mm of microscopic field in different age group in a Bangladeshi population to view the age related change.Methods: This cross-sectional study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2009 to June 2010, based on the collection of 60 pineal glands from whole human brains of unclaimed dead bodies from the morgue. All the samples were divided into four age-groups: 15-30 years, 31-40 years, 41-50 years and >50 years. Histological slides were prepared by using routine Harris’ Haematoxylin and Eosin (H & E) stain. The number of pinealocytes and neuroglial cells per sq. mm of the microscopic field were determined by point counting technique, using ocular micrometer. For statistical analysis, ANOVA and independent sample t test were used.Results: The mean number of pinealocytes and neuroglial cells were found 10875.00±649.75 and 606.31±94.52 in group15-30 years, 9738.83±761.35 and 631.57±94.52 in group31-40 years 31-40 years, 9637.78±382.02 and 568.41±69.57 in group 41-50 years and 8134.64±358.07 and766.31±248.00 in group >50 respectively. Age related significant differences were found in number of pinealocytes in 15-30 years vs 31-40 years, 15-30 years vs 41-50, 15-30 years vs >50, 31-40 years vs >50 and 41-50 vs >50 years. However, no differences were found in number of neuroglial cells among different age groups.Conclusion: This study showed progressive degeneration of pinealocytes with advancing age. However, no age related changes were found in number of neuroglial cells.Bangladesh Soc Physiol. 2016, June; 11(1): 18-22

not available DOI: http://dx.doi.org/10.3329/bjch.v38i2.21143 Bangladesh J Child Health 2014; VOL 38 (2) : 86-93

Objective: Brain weight varies with age and gender. It decreases with age and also in many diseases. This cross-sectional analytical type of study was carried out to establish normal standard in different age groups in weight of the brain and to see the difference between sexes of adult Bangladeshi people. Materials and Methods: A total of 70 postmortem human brains of adult age groups ranging from 22-58 years in male and 22-48 years in female were collected from the unclaimed dead bodies during postmortem at the autopsy laboratory in the Department of Forensic Medicine, Dhaka Medical College, Dhaka, from January 2010 to December 2010. The samples were divided into four different age groups i.e. Group A (20-29 years), Group B (30-39 years), Group C (40-49 years) and Group D (50-59 years). The weight of the whole brain was measured and significant differences in weight of the whole brain between different age groups and between male and female were determined. Results: In male highest value of weight was 1326.67±41.53 gm in group A and lowest one was 1281.6±40.21 gm in group D. These values of female were 1235.56±48.51 gm in group A and 1197.14±38.61 gm in group C. Significant differences were found in mean weight of the whole brain in male and female in group A (p=0.001), B (p=0.001) and C (p=0.001). The difference of mean weight in different age groups was not statistically significant. Conclusion: The weight of the brain is higher in male than in female and it decreases with age. DOI: http://dx.doi.org/10.3329/bjms.v13i4.20554 Bangladesh Journal of Medical Science Vol.13(4) 2014 p.396-400

Context: The central sulcus, which is located between the primary motor and primary somatic sensory cortex is an important structure and landmark of the cerebral hemisphere. Morphology of the central sulcus varies with age, sex, manual skill, handedness and in many diseases. This study is carried out to establish a normal standard in different age groups in length and depth of the central sulcus. Materials and Methods: A cross-sectional, analytical type of study was conducted in the department of Anatomy, Dhaka Medical College, on one hundred and forty (140) on human cerebral hemispheres. The samples were divided into four different age groups i.e. Group A (20-29 years), Group B (30-39 years), Group C (40-49 years) and Group D (50-59 years). All the samples were studied morphologically. Results: The mean length of central sulcus was 102.89±3.55 mm to 96.83±3.92 mm in male and 98.00±5.17 mm to 96.29±2.56 mm in female. Depth of the central sulcus was 20.02±2.41 mm to 21.50±2.21 mm in male and 20.50±2.57 mm to 21.36±1.87 mm in female. The difference in mean length of the right central sulcus between male and female was statistically significant in group A (p

1. Assistant Professor, Pediatric Neurology, Department of Pediatrics, BSMMU, Dhaka 2. Professor and Head, Pediatric Neurology, Department of Pediatrics, BSMMU, Dhaka 3. Professor, Pediatric Neurology, Department of Pediatrics, BSMMU, Dhaka Correspondence: Dr Kanij Fatema, Assistant Professor, Pediatric Neurology, Department of Pediatrics, BSMMU, Dhaka Introduction: Most of infected infants presenting with Cytomegalovirus (CMV) remain asymptomatic1. Symptoms include growth restriction, microcephaly, seizures, cerebral ventriculomegaly, chorioretin is, hepatitis syndrome, thrombocytopenia, anemia, and pneumonitis2. Approximately 5 to 10% of these infants manifest signs of serious neurological defects at birth, including deafness, mental retardation, blindness, microcephaly, hydrocephalus, and cerebral calcification3,4. In addition, 10 to 15% of congenitally infected infants who are asymptomatic at birth subsequently develop brain disorders such as sensorineural hearing loss.5 One case of congenital CMV disease with developmental delay and leukoencephalopathy has been reported here.

Context: The pituitary gland produces several hormones that regulate growth, metabolism and reproduction. Deviations from the normal functions of the gland certainly derange the harmony of life. Therefore, this study is important to determine the disease conditions of the gland and also for diagnosis and treatment of diseases of other endocrine organs. Many studies suggested that changes in the endocrine milieu may be reflected in pituitary morphology. The pituitary height in females was significantly greater than that in males. The decline in pituitary height with age may also reflect the process of aging and a physiological pituitary atrophy. Dynamic changes occur in the size, shape and signal intensity of the pituitary gland during life. These changes reflect the complex hormonal environment of the gland and are most pronounced at times of hormonal flux, such as menarche and pregnancy. The appearance of the pituitary gland in magnetic resonance imaging (MRI) of newborn infants differs from that of older children and adults. Previous observers have noted changes in the shape of the pituitary gland at different stages of life, which also reflect concurrent changing of hormonal level. Objective: To identify any variation of shape of the pituitary gland in relation to age & sex. Type of Study: A cross-sectional analytical type of study. Place & Period of Study: Department of Anatomy, Dhaka Medical College, Dhaka, from July 2009 to June 2010. Materials: About 60 (40 male and 20 female) postmortem human pituitary glands were collected from unclaimed dead bodies that were under examination in the morgue of the Department of Forensic Medicine, Dhaka Medical College Dhaka. The study was approved by the Ethical Review Committee (ERC) of Dhaka Medical College. Methods: The samples were divided into four groups. i.e. Group-A (20-29 years), Group-B (30-39 years), Group-C (40-49 years) and Group-D (50-59 years). The shape was recorded according to the grading system of Elster et al.(1990) , such as- a) Grade 1- Concave, b)Grade 2- Mildly concave, c)Grade 3 - Flat, d)Grade 4 - Mildly convex, e)Grade5-Moreconvex/rounded/spherical. Results: Grade 1 was found in 1(2.5%) male sample of group B and C & 1(5%) in female sample of group A. Grade 2 was noted in 3 (7.5%), 2 (5%), 3 (7.5%) and 1(2.5%) male samples of group A, B, C and D respectively. Grade 3 was found in 4 (10%), 5 (12.5%), 4 (10%) and 1(2.5%) male samples of group A, B, C and D respectively and about 1(5%), 2(10%) and 1 (5%) female samples of group A, B and C respectively. Grade 4 was noted in 2 (5%), 7(17.5%), 1(2.5%) and 1(2.5%) male samples of group A, B, C and D respectively and in 6(30%), 3(15%) and 1(5%) female samples of group A, B and C respectively. Grade 5 was noted in 2(5%) male samples of group B and D and in 1(5%), 3(15%) and 1(5%) female samples of group A, B and C respectively. Conclusion: The shape of the pituitary gland are tended to be changed in between sexes and with advancing ages. It was revealed in the study that, flat glands are more common in male while in female mildly convex gland was common. Rounded glands were found common in male in 50-59 years age group but could not be compared due to absence of female samples from that group. Further studies to find out the cause of this difference of shape between male & female glands with ages are recommended. DOI: http://dx.doi.org/10.3329/bja.v10i2.17287 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 68-72

Context: The pineal gland is capable of influencing or modifying the activity of the pituitary gland, islets of Langerhans, the parathyroid gland, adrenal gland and the gonads. The pineal gland through its hormone, melatonin influences many functions of the human, like circadian rhythm, mood, psychiatric disorder, sexual maturation, reproduction and aging. Melatonin, a potent antioxidant provides protection against damaging free radicals of oxygen. Various clinical problems occur due to abnormal melatonin secretion by the pineal gland. For the perfect and complete evaluation of various clinical conditions of the pineal gland, detailed morphological knowledge is essential. Study Design: Cross sectional analytical type of study. Place and period of study: Department of Anatomy, Dhaka Medical College, Dhaka from July 2009 to June 2010. Materials: 60 postmortem human pineal glands were collected from unclaimed dead bodies that were under examination in the morgue of the Department of Forensic Medicine, Dhaka Medical College Dhaka. Methods: The samples were divided into four different age groups i.e. Group-A (15-30 years), Group-B (31- 40 years), Group-C (41-50 years) and Group-D (> 50 years). Results: The mean±SD length of the pineal gland were found 8.11±0.83 mm in group A, 7.96±1.06 mm in group B, 7.51±0.55 mm in group C and 7.89±0.14 mm in group D. The mean±SD breadth of the pineal gland were found 4.39±0.34 mm in group A, 4.09±0.46 mm in group B, 4.12±0.58 mm in group C and 3.81±0.34 mm in group D. The mean±SD thickness of the pineal gland were found 2.52±0.64 mm in group A, 2.29±0.54 mm in group B, 2.14±0.32 mm in group C and 2.07±0.18 mm in group D. Conclusion: breadth and thickness of the pineal gland were found to be decreased with advancing age. DOI: http://dx.doi.org/10.3329/bja.v10i2.17286 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 63-67

Bangladesh Journal of Anatomy, January 2012, Vol. 10 No. 1 pp 5-10 DOI: http://dx.doi.org/10.3329/bja.v10i1.15750

Context: The human pineal gland is characterized by the presence of calcified concretions, called ‘pineal acervuli’ or brain sand. These are basophilic extracellular bodies. The study was carried out to describe the microscopic features of pineal calcifications and to find out age related changes. Study Design: Cross sectional descriptive type of study. Place and period of study: Department of Anatomy, Dhaka Medical College, Dhaka, from July 2009 to June 2010. Materials: 60 postmortem human pineal glands were collected from unclaimed dead bodies that were under examination in the morgue of Department of Forensic Medicine, Dhaka Medical College, Dhaka. Methods: The samples were divided into four different age groups, i.e. Group-A (15-30 years), Group-B (31-40 years), Group-C (41-50 years) and Group-D (>50 years). Histological study was carried out on relatively 27 fresh samples. Results: The mean diameter of the pineal calcifications were 351.14±111.69 ?m in group A, 600.00±232.69 ?m in group B, 909.43±124.18 ?m in group C and 1541.67±224.54 ?m in group D. The differences in diameter of the pineal calcifications between group A & C, A & D, B & C, B & D and C & D were statistically significant. Conclusion: Age related changes were found in the diameter of pineal calcifications. DOI: http://dx.doi.org/10.3329/bja.v9i2.15220 Bangladesh Journal of Anatomy 2011 Vol.9(2) pp.71-74

Context: Basilar artery is formed by the union of right & left vertebral arteries at the lower border of pons / mid medullary level which courses upward along ‘Basilar groove’ on the anterior surface of pons & supplies the anatomical structures within the posterior cranial fossa of brain. The Circle of Willis is the principal arterial anastomotic trunk of brain formed by anastomosis between the branches of internal carotid arteries and terminal branch of basilar artery. It is responsible for collateral circulation of brain, specially of old people - who have reduced blood supply to brain due to senile arteriosclerosis. Cerebrovascular diseases due to basilar artery is more common in men than women. Anatomy of basilar artery and its branches are very complex and variable. So, detailed morphogical knowledge is essential for proper diagnosis and treatment of neurological disorder. To identify whether there is any variations in the location of basilar artery in relation to basilar groove on the ventral surface of pons . Materials and Methods: A cross-sectional descriptive type of study was carried out in the Department of Anatomy, Dhaka Medical College, Dhaka, from January 2010 to December 2010. Seventy(70) postmortem basilar arteries were collected from unclaimed dead bodies that were under examination in the morgue of Department of Forensic medicine, Dhaka Medical College Dhaka. The study was approved by the Ethical Review Committee (ERC) of Dhaka Medical College. The position of basilar artery in all the samples were either in the midline, right to midline or left to midline. Formalin fixed brain was washed with plain tap water to remove excess formalin and was kept on metallic tray. Location of basilar artery was examined carefully by hand magnifying glass and noted. Results: In the present study, location of basilar artery was found at midline in 70% brain, right to midline in 17%, left to midline in 13%. Conclusion: Further studies in large scale for preparing a database of anatomy of basilar artery are recommended. DOI: http://dx.doi.org/10.3329/bja.v11i2.20673 Bangladesh Journal of Anatomy, July 2013, Vol. 11 No. 2 pp 68-70

not available DOI: http://dx.doi.org/10.3329/bjch.v37i2.17270 BANGLADESH J CHILD HEALTH 2013; VOL 37 (2) : 127-129

The objective of this study was to develop a simple, efficient, precise and accurate reverse-phase HPLC method for the simultaneous determination of metformin in combination with gliclazide in newly formulated tablets. Chromatographic determination was performed on a reversed phase C18 column (2.6 mm x 250 mm; 5 μm particle size) using a mixture of buffer (1 ml of orthophosphoric acid with 1 ml triethylamine upto 1000 ml with HPLC grade water) and methanol at the ratio of 60:40 as mobile phase at a flow rate of 1ml/min. The UV detection was set at 230 nm. Under the developed conditions, good separation of the analytes was achieved. The calibration curves were linear with coefficient correlation between 0.998 to 1.0 for both drugs over a concentration range of 1 to 50 μg/ml for metformin hydrochloride and 0.16 to 8 μg/ml for gliclazide. The method was also validated in terms of precision (RSD = 0.06 to 3.22%) and accuracy (percent deviation = 0.049 to 2.602%). The proposed method was applied for the analysis of these analytes in newly formulated tablets and potencies were found to be 99.41±0.24% for metformin hydrochloride and 99.77±0.37% for gliclazide which were acceptable. Key words: HPLC; metformin hydrochloride; gliclazide; combination dosage form; tablet. DOI: http://dx.doi.org/10.3329/dujps.v9i2.7884 Dhaka Univ. J. Pharm. Sci. 9(2): 83-89, 2010 (December)

The present study was carried out to develop biodegradable intrascleral implants of Dexamethasone Sodium Phosphate and to evaluate the release pattern of the drug from the prepared implants. Intrascleral implants were prepared by using biodegradable polymer L-PLA (m.wt. 61,200 Da). Sodium chloride (NaCl), gelatin and glycerol monostearate (GMS) were used in various formulations to observe the effects of these additives on the release of Dexamethasone Sodium Phosphate from the prepared L-PLA based intrascleral implants. Five different formulations were prepared for this study and were coded as FD-1 (10%drug+L-PLA), FD-2 (20%drug+L-PLA), FD-3 (10%drug+L-PLA+5%NaCl), FD-4 (10%drug+L-PLA +5%Gelatin) and FD-5 (10%drug+L-PLA+10% GMS). Discs were prepared and made into appropriate shape before submerging into the buffer solution of pH 7.4 in different vials. The in vitro release profile of Dexamethasone Sodium Phosphate from the implants showed a biphasic release pattern with an initial burst followed by a diffusive phase. It was observed that FD-1 and FD-2 showed 19.63% and 29.87% release on the first day and 24.22% and 38.5% release respectively at day 30. The drug loading of FD-1 and FD-2 was 10% and 20% respectively. Among FD-3, FD-4 and FD-5; FD-3 showed highest release (32.1%) at day 30 in which 5% NaCl was used. FD-4 showed 27.45% release at day 30 where gelatin, a hydrophilic agent was used and FD-5 containing GMS, a lipid material, was found to be most retarding (19.22% at day 30). The results of the dissolution study provide an idea that L-PLA may be successfully used for the preparation of biodegradable intrascleral implant of Dexamethasone Sodium Phosphate. Key words: Dexamethasone Sodium Phosphate; Bioidegradable polymer; Intrascleral implants. DOI: 10.3329/sjps.v2i1.5817Stamford Journal of Pharmaceutical Sciences Vol.2(1) 2009: 56-60

The present study was undertaken to investigate the effect of channeling agents on the release profile of Theophylline from METHOCEL K4M based matrix systems. Matrix tablets of Theophylline using METHOCEL K4M were prepared by direct compression process. METHOCEL K4M polymer is hydrophilic in nature. NaCl and PEG 1500 were used as channeling agents. Drug release study was evaluated for eight hours using USP 22 paddletype dissolution apparatus using distilled water as the dissolution medium. The release mechanisms were explored and explained with zero order, Higuchi and Korsmeyer equations. The release rate, extent and mechanisms were found to be governed by channeling agent type and content. Higher channeling agent content (42.49%) in the matrix increased the rate and extent of the drug release because of increased porosity in the tablet matrices, at lower channeling agent (19.76%) level, the rate and extent of drug release was decreased and in absence of channeling agents these were least. NaCl ensures maximum release of drug from low viscosity grade METHOCEL K4M than PEG 1500 when other parameters were kept constant. It was found that type and amount of channeling agent significantly affect the time required for 50% of drug release (T50%), percentage drug release at 8 hours, release rate constant (K) and diffusion exponent (n). Kinetic modeling of dissolution profiles revealed drug release mechanism ranges from diffusion controlled or Fickian transport to anomalous type or non-Fickian transport, which was mainly dependent on the presence of type and amount of channeling agent. These studies indicate that the proper balance between a matrix forming agent and a channeling agent can produce a drug dissolution profile similar to a theoretical dissolution profile.Key words: Channeling agent, Theophylline, Release Profile, Methocel K4MDOI = 10.3329/dujps.v7i1.1214Dhaka Univ. J. Pharm. Sci. 7(1): 27-32, 2008 (June)

In the present study Ciprofloxacin HCl sustained release matrix tablet was prepared by utilizing different grades of hydroxypropyl methylcellulose (HPMC) polymers such as Methocel K4M CR, Methocel K4M Premium & Methocel K15M CR by direct compression method. Different amount of Methocel K15M CR was used to develop matrix builder in the three proposed formulations (F1-F3) for the study of release rate retardant effect at 5%, 6%, and 7% of total weight of tablet matrix respectively. The dissolution study of Methocel K15M CR based tablet matrices of those proposed formulations were carried out in the simulated gastric medium (pH 1.3) for 8 hours using USP dissolution apparatus II. Similarly Methocel K4M premium was used to develop matrix builder in another three proposed formulations (F4-F6). It was found that formulations F-4 (15%), F-5 (17%) and F-6 (18.3%) met the desired release rate of Ciprofloxacin HCl for 8hrs period. The release kinetics of formulation F-4, F-5 and F-6 followed Higuchi kinetic order. Again Methocel K4M premium was used for another three proposed formulations (F7-F9). It was found that formulations F-7 (6.7%), F-8 (12.3%) and F-9 (15.6%) met the desired release rate of Ciprofloxacin HCl for 8hrs period. The release kinetics of formulation F-7, F-8 and F-9 followed Higuchi kinetic order. Among these three polymers, Methocel K4M Premium showed better release retardant effect than Methocel K4M CR and Methocel K15M CR. Key Words: Ciprofloxacin HCl; Direct compression; Controlled release; Methocel K15M CR; Methocel K4M CR; Methocel K4M premium.DOI: 10.3329/sjps.v2i1.5814Stamford Journal of Pharmaceutical Sciences Vol.2(1) 2009: 37-43

Nefopam and Escitalopram are INN drugs and as such it has not been yet included in the BP or USP. The objective of this work is to develop a simple, sensitive, accurate, precise and reproducible UVSpectrophotometric method for quantitative estimation of Nefopam and Escitalopram in tablet dosage forms. Various solvents were used to find out the medium for maximum solubility of each drug. The χmax of Nefopam and Escitalopram was 266nm and 284nm in water respectively. Both drugs obey Beer- Lambert’s law in the range of 50-400μg/ml for Nefopam and 25-200μg/ml for Escitalopram. The correlation coefficients of std. curves were 0.998 and 0.995. The values of SD were 0.131 and 0.081 respectively. %RSD (Relative standard deviation) of interday absorbance of Nefopam was 0.766 and Escitalopram was 0.854. The LOD (Limit of Detection) were 0.393 and 0.243 and LOQ (Limit of Quantification) were 1.310 and 0.810 respectively. The percent potencies were 92.16 and 102.06 for Nefopam and Escitalopram. The potency of these tablets complied with their claimed quantity (±10%). So, based on these data, it may be concluded that these proposed method are simple, sensitive, precise, reproducible and accurate for the analysis of these drugs in tablet dosage form. Key Words: INN drugs; correlation coefficients; LOD; LOQ; Nefopam; Escitalopram. DOI: 10.3329/sjps.v3i1.6791S. J. Pharm. Sci. 3(1): 4-10