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Background: The concept of eco-toilets in Bangladesh was promoted by an NGO (Practical Action, Bangladesh). The ecotoilets are especially built to collect human excreta for using them as manure on the fields after appropriate treatment for 12 months. Objectives: This study was designed to see the physical properties appropriate for fields and pathogenic potential to ensure the treated human excreta are safe for cultivator’s handling. Methodology: The study was carried out in three phases during 2010 to 2014. A total of 210 composted faecal excreta were examined for physical properties like colour, odour, odour intensity, moisture, bacteriological examination for faecally transmitted potential bacteria and parasitological examination for ova / cysts of faecally - transmitted parasites to recommend whether these composted excreta were suitable for use as manure by the cultivators. Results: Majority of the specimens in all three phases contained remarkable moisture: 22.3-80.0% in all specimens in phase I, a considerable number (16, 53.3%) contained 25% moisture in phase II and high moisture content (66.4%-78.9%) in 6(50.0%) of specimens in phase III. Bacteriological examination revealed no pathogenic organism in any specimen of the phases- although, some specimens in all phases showed growth of non-coliform bacteria. Parasitological examinations in all phases revealed ova/larvae of helminths of Ascaris lumbricoides (AL)/ Trichuris trichiura (TT)/ Strongyloides stercoralis (SS). No cyst or trophozoite of any pathogenic parasite, or oocyst of the cryptosporidium was found. Conclusion: The composted excreta could not be adequately treated by sun-drying as indicated by high moisture content and were found not suitable to use as manure by cultivators in the field. J Monno Med Coll June 2022;8(2): 44-47

Culture fisheries contributes a major share of fisheries production of Bangladesh which is the accumulation of aquaculture production of every fish farms of the country. However, the actual production of cultured fish (finfish and shellfish) and cost-benefit of the farms are not well documented. Moreover, the farms must overcome a lot of constrains for sustainable production. The present study was thus designed to determine the present aquaculture status in some parts of Bangladesh and to identify the problems for the loss of aquaculture production through questionnaire survey between July 2019 and January 2020. The study areas included Bhola, Rangamati, Khulna, Satkhira, Jashore and Madaripur upazila. In the study area, the relationship between different aspects of aquaculture was determined where pond size and production cost per hectare; pond size and profit per hectare and per unit production cost and profit were found to be significantly and positively correlated. The production and production cost per hectare were also determined which were 3.52±0.40 metric tons and 6260±987 USD, respectively. The fish farmers reported some degrees of reduction of profits compare to the profit obtained during 2018-2019. The reduction of expected profit in different regions ranged between 10 and 33%. The major causes of the production loss in the survey regions were related to disease, seed and feed. Among different diseases viral, bacterial and parasitic diseases were reported where diseases were identified based on the symptoms. Findings of the present study suggest that incorporation of management, modern technology and economic aspects for steady growth of aquaculture sector is needed in Bangladesh. Dhaka Univ. J. Biol. Sci. 31(2): 257-271, 2022 (July)

Background: Wound infection is one of the major health problems that occur frequently. Infections of the wound result from entry of the organisms through breached skin. It plays an important role in the development of chronicity, delaying wound healing. It is evident that wound infection is a challenging situation for the physicians. Multiple bacteria can cause wound infection. Both broad spectrum and narrow spectrum antibiotics are available for the treatment. It is ideal to give proper antibiotic after culture and sensitivity of the wound swab. Improper and irrational use of antibiotics can lead to drug resistance. Objective: To isolate and identify the bacteria causing wound infection and to determine the antimicrobial susceptibility pattern. Materials and method: This descriptive cross-sectional study was carried out at the Microbiology Laboratory, Popular Diagnostic Centre Ltd, Dhanmondi, Dhaka, Bangladesh, from November 2019 to January 2020. A total of 62 wound swabs were collected and analyzed for culture and antibiotic sensitivity. Results: From total wound swab samples, 49 (79%) were culture positive. The most common isolated pathogen was Acinetobacter spp. 20 (40.81%). Other isolates were Staphylococcus aureus 10 (20.41%); Escherichia coli 07 (14.29%); Pseudomonas aeruginosa 07 (14.29%); Klebsiella 04 (08.16%) and Proteus 01 (02.04%). Among the Gram negative isolates, Acinetobacter spp showed 100% sensitivity to colistin, 85% to imipenem, 30% to amikacin and 25% to piperacillin + tazobactum. E. coli showed 100% sensitivity to imipenem and colistin and least sensitivity to third generation cephalosporin. Pseudomonas showed 100% sensitivity to piperacillin+tazobactum, 85.71% to imipenem and aztreonam. Among the Gram positive isolates, Staphylococcus aureus showed 100% sensitivity to linezolid, vancomycin, imipenem, cloxacillin, amikacin and least sensitivity to azithromycin. Conclusion: Acinetobacter spp. was the most frequently isolated pathogen from wound swab and the antibiotic sensitivity pattern of various isolates will help the clinician in appropriate selection of antibiotics against wound infection. J Dhaka Med Coll. 2021; 30(2) : 180-188

Twenty-seven advanced lines including three exiting varieties (BARI Gom 21, BARI Gom 32 and BARI Gom 33) were evaluated in alpha lattice design with two replications at Bangladesh Wheat and Maize Research Institute, Dinajpur and regional stations at Joydebpur, Jashore and Rajshahi under irrigated timely sown (ITS) and irrigated late sawn (ILS) conditions. The objective of the study was to find out the heat-tolerant wheat lines for future breeding programme to develop heat-tolerant wheat varieties. The genotypes were evaluated for phenological variation such as heading and maturity, yield and yield components, disease reaction, sterility, visual grain quality, etc. The results showed that the highest grain yield (5951 kg ha-1) was recorded with genotype BAW 1415 at Dinajpur under ITS condition and the lowest grain yield (1923 kg ha-1) was observed in BAW 1416 at Rajshahi under ILS condition. Considering the overall performances, genotypes BAW 1402, BAW 1403, BAW 1406, BAW 1407, BAW 1408, BAW 1411, BAW 1422 and BAW 1425 performed better. Considering disease infestation, genotypes BAW 1374, BAW 1393, BAW 1394, BAW 1397, BAW 1399 and BAW 1401 showed a good level of resistance to both leaf rust (LR) and wheat blast (WB). These genotypes could be selected for future breeding programmes to develop heat-tolerant and diseases resistance varieties. Bangladesh J. Agri. 2022, 47(2): 1-16

Background: Cone-beam Computed Tomography is a useful diagnostic tools for the detection of odontogenic peripheral cysts and granulomas. Objective: The purpose of the present study was to assess the accuracy of CBCT for diagnosing periapical cyst and granuloma. Methodology: This cross-sectional study was conducted from February 2017 to November 2017. Following inclusion and exclusion criteria consecutive patients who were consult in the department of oral and maxillofacial surgery of Dhaka Dental College Hospital and Bangabandhu Seikh Mujib Medical University for periapical infection was selected. Only those patients showing a periapical lesion of minimum 5 mm size was included in the study subject. Intra-oral periapical radiograph showing criteria was presence of apical radiolucency of 5 mm, corticated borders and displacements of roots. The CBCT images were done for those patients. The following features were documented on CBCT like location at the apex of involved tooth, well defined corticated border, shape is curved or circular, internal structure of lesion is radiolucent, displacement and resorption of the roots of adjacent teeth with a curved outline and perforation of cortical plate. Histopathological specimens were obtained for microscopic examination. The findings of histopathological examinations were correlated with the findings of CBCT. Results: Out of 50 subjects, 41(82.0%) subjects were diagnosed as cyst and 9(18.0%) subjects were as granuloma. Postoperative histopathology revealed 37 out of 41 were cysts and 4 were granulomas. Out of 9 granulomas 3 were cysts and 6 were granulomas. In this study we found the PPV 90.2439 and NPV 66.66. Diagnostic Accuracy was measured by calculating TP, TN and total population. The accuracy was 86%. Conclusion: In conclusion Cone-beam Computed Tomography has high accuracy of CBCT for diagnosing periapical cyst and granuloma. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):171-174

Background: Mandibular third molar presence and position may have an effect on the risk of mandibular angle fracture. Objective: The purpose of the present study was to see the effect of mandibular third molar presence and position on the risk of mandibular angle fracture. Methodology: This cross-sectional study was conducted in four centers in Bangladesh from July 2009 to June 2010 for a period of one year. The mandibular angle fractured patients were selected for the study. The medical records and panoramic radiographs of patients with mandibular angle fracture were examined. The presence or absence and degree of impaction of the mandibular third molars were assessed for each patient and related to the occurrence of fracture of the mandibular angle. Data were also collected for age, sex, mechanism of injury, number and location of mandibular angle fractures. Results: A total number of 100 patients with mandibular angle fracture were analyzed. The mean age is 44.36±21.9 years. Among 100 cases, 75 cases had lower third molars and 25 cases had without lower third molars. Within the 75 patients, 64 cases had impacted third molars while 11 cases had erupted third molars. Among the impacted group, 64.1% cases were mesioangular, 15.6% cases were horizontal, 12.5% cases were distoangular and 7.8% cases were vertical. Conclusion: In conclusion mandibular angle that contains an impacted lower third molar is more susceptible to fracture when exposed to trauma than an angle without lower third molar. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):181-184

Background: Serological status of thyroid hormones is important among chronic kidney disease patients. Objective: The purpose of the present study was to see the status of thyroid hormones among chronic kidney disease patients. Methodology: This cross-sectional study was done From January 2013 to December 2013 in the Department of Nephrology, Dhaka Medical College Hospital. A total of 50 diagnosed cases of adult male with different stages of CKD (CKD stage 3, 4, 5 and 5D) patients along with age-matched 51 healthy individuals were included. Serum Thyroid hormone T3 done by [1251] RIA kit, T4 done by T4 [1251] RIA kit, TSH level done by Turbo TSH [1251] IRMA kit. Result: A total number of 101 patients were recruited for this study of which 51 cases were in the group A and the rest of the 50 cases were in the group B. The mean serum T3 level was found 1.85±0.7 nmoL/L in group A and 2.79±0.55 nmoL/L in group B (p

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

Background: Pemphigus vulgaris is an autoimmune, potentially fatal vesiculobullous disease of skin and mucous membranes. The clinical profile and epidemiologic characteristics varies in patients to patients and in different communities. The aim of this study was to evaluate the clinical and epidemiological features, morbidity and mortality of pemphigus vulgaris and to compare that with other studies of different communities. Methods: It was an observational study, conducted on 24 hospital admitted cases of pemphigus vulgaris at the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The duration of the study was from November 2018 to February 2020. Patients who were confirmed as pemphigus vulgaris both histopathologically and direct immunofluroscent test were included for that study. Findings: The mean age (SD) of the patients was 47(15.5) years. Male outnumbered female in that study and male to female ratio was 1.4: 1. The mean (SD) duration of disease was 15(18.6) months. Pain (70.8) was the commonest symptoms. Trunk (92%) was the commonest cutaneous site of involvement followed by oral mucosa (71%). Oral prednisone was the mainstay of treatment and it was given to 24 (100%) of the patients. The immunosuppressant adjuvant was given in 79% cases. Azathioprine (62.5%) was the commonest of them. To avoid osteoporosis calcium supplement with or without vitamin D and bisphosphonate was given in 92% cases. The mean (SD) hospital stay was 5.4(3.3) weeks. Bacterial infection was the commonest complication and it was found in 2 patients. The mortality rate of that study was 4.16%. Conclusion: pemphigus vulgaris is a dermatological emergency and the maximum patients need hospitalization for proper care. Hospital acquired infections are the common complication and that may leads to septicemia and death. To decrease the mortality of pemphigus vulgaris the care givers have to be more watchful about the potential of infections. J Dhaka Med Coll. 2021; 29(1): 24-30

Introduction: Medication noncompliance is a necessary but neglected factor for the negative cardiovascular outcome. Despite various studies on the issue, the factors behind noncompliance still need to be explored properly. Therefore, this study was conducted to determine the magnitude and factors associated with noncompliance with antihypertensive Medication. Materials and Methods: This is a cross-sectional study that was conducted on 200 hypertensive patients in Dhaka Medical College Hospital for six months. Patients were included by purposive sampling, aged 18-70 years, and the duration of diagnosis of at least three months. In addition, demographic data, hypertension diagnosis, antihypertensive drugs, factors related to noncompliance, knowledge of hypertension, perception, and family support were included in the questionnaire. Result: About 85% of the patients were non-compliant with treatment in their course of illness, and the main reason behind it was forgetfulness (48.2%). Other factors were inability to buy, side effects, busy schedule, intentionally, bored, and traveling. The highest prescribed drug was beta blockers (41%). Eighty percent of the patients knew that uncontrolled hypertension could lead to stroke, and 54% knew it could lead to heart disease. The majority (87.5%) of the participant went for follow-up only when they felt hypertensive. Regarding perception, 63% of patients felt hypertension is not a curable disease. Furthermore, though all patients were asked for follow-up by their physician, 94% missed their follow-up. Conclusion: Despite the availability of various types of effective antihypertensive drugs, many patients experience difficulty controlling hypertension due to noncompliance. Patient and family member education efficiently prevented many factors behind the disobedience. However, further studies with large sample sizes in multiple centers could explain this more precisely. TAJ 2022; 35: No-2: 103-110

Background: Vitamin D has received considerable interest from the medical community and the public because of recent evidence for the nonskeletal effects of vitamin D combined with the finding of widespread global deficiency. It has been estimated that almost 1 billion people worldwide suffer from vitamin D deficiency or insufficiency. In addition, neurobiological and neuroendocrinological substrates have been identified that indicate a link between hypovitaminosis D and several psychiatric conditions, including depression. Objectives: This study aimed to assess vitamin D level in patients with depressive disorders and to compare it with normal individuals. Materials & Methods: This cross-sectional type of comparative study was carried out in the Department of Physiology, Rajshahi Medical College, Rajshahi, in collaboration with the outpatient department of Psychiatry Rajshahi Medical College Hospital over 12 months from January 2019 to December 2019 among the Depressive patients and healthy individuals to find out and compare the vitamin D level between the two groups. Approval from the Ethical Review Committee (ERC) was obtained before the commencement of the study. A pA pre-designed, validated, structured questionnaire was used to gather information from 108 respondents by purposive sampling. Out of the 54 were newly diagnosed depressive patients, and 54 were healthy persons. In addition, a blood sample was collected to measure 25(OH)D level, and all values were analyzed statistically. Results: The Result showed a significant difference in mean plasma 25(OH)D level between the patients with depressive disorder and the healthy individuals. Circulating 25(OH)D level was found to be significantly low in the group of patients with depression. Conclusion: The present study demonstrated a significant correlation between hypovitaminosis D in patients with depressive disorders. It is suggested that possible factors such as hypovitaminosis D should be done as a routine investigation to reduce the incidence of depression. Furthermore, vitamin D supplementation might be a complementary treatment for depression. TAJ 2022; 35: No-2: 159-168

Background: Acute poisoning is a common medical emergency in the pediatric unit. It is a common preventable cause of morbidity and mortality in children. Most of the poisoning in children less than five years of age is accidental. This study aimed to determine the associated factors and clinical profile of childhood poisoning. Material & Methods: A cross-sectional descriptive study was carried out among 69 children aged six months to 12 years with a history of poisoning over six months. History, clinical examination, and details of the poisoning were obtained by using a structured questionnaire during admission. Analysis was done through standard statistical tests. Result: Among the 69 children of poisoning, 92.8% were accidental, and 7.2% were suicidal. Most cases (79.7%) were from the 6 - 59 months age group with male-female ratio 1.7:1. Most of the fathers (65.2%) and mothers (75.4%) had primary education, and 75.4% were poor. The most common cause of the poisoning was insecticide (60.9%), and the poison was stored at an available site (91.3%) in an unsealed container (47.8%). Accidental poisoning was more common in younger age group (10 years) in females (80%) patient with h/o familial disharmony (60%). Conclusion: Insecticides and kerosene were the common cause of poisoning. Most of the materials were stored in an unsafe place and stored in an attractive bottle. Poison should be stored in a safe home with a sealed container. Simple and active family preventive measures can reduce accidental poisoning. TAJ 2022; 35: No-2: 75-82

The present investigation was conducted to identify the genetic variability in morphological characteristics among 12 cashew nut germplasm of Bangladesh. The morphological parameters such as nut length, width, single nut weight, and 100-nut weight varied significantly (p ≤ 0.01) among the germplasm studied. The shape and color of the cashew nuts and cashew apples were also variable. The RAPD analysis of the germplasm showed 71.43% polymorphism on average. The cluster analysis results revealed two distinct groups; cluster-I was made up of two genotypes, GP-7 and GP-8, while cluster-II consisted of ten genotypes. The maximum genetic distance (0.50) was exhibited between GP-4 and GP-8, while the minimum (0.107) was between GP-1 and GP-2, and between GP-2 and GP-3. The results of nut morphological characteristics and genetic relationships in cashew nut germplasm may be utilized in describing of new varieties and for plant improvement programs. Plant Tissue Cult. & Biotech. 32(2): 167-180, 2022 (December)

Background: Atherosclerotic risk factors frequently lead to ischemic stroke. The thickness of the carotid intima-media thickness (CIMT) is a significant indicator for early atherosclerosis alterations. The aim of the study is to evaluate the association between ischemic stroke patients and CIMT. Methods: A total of 50 patients were recruited in this cross-sectional descriptive study which was carried out in the Department of Neurology, BSMMU, from January 2015 to June 2016. All patients of ischemic stroke were confirmed by history, examination and CT scan of head/MRI of brain. Carotid ultrasound scan was done to detect intima-media thickness (IMT) of both sided carotid bifurcation, common carotid and internal carotid artery and performed by a single sonographer at the Department of Neurology, BSMMU. Results: This population has a total of 27 male and 23 female with mean age 60.7± 13.6 years. Maximum patients (72%) were found to be above 50 year of age. After risk factor stratification among the study population, HTN, dyslipidemia was the most followed by positive family history, smoker, DM, IHD. Among study population 45 cases were anterior circulation stroke and only 5 cases were posterior circulation stroke. Maximum mean IMT=1.2± 0.3, minimum mean IMT=1.0±0.10 mm and least IMT was 0.7mm. (Normal CIMT value is < 0.8mm). The mean IMT was higher at symptomatic side in comparison to the asymptomatic side. Higher IMT was found mostly at the carotid bifurcation and higher IMT at one site was significantly correlated with other sites (r= +0.435, p=0.002), there was also correlation between IMT and risk factor (r=+0.265, p=0.063). Increased IMT was more marked in patients with risk factors in comparison to without risk factor, like smoker & nonsmoker but not statistically significant (ORR=2.00, 95% CI 0.636- 6.286, p=0.233). Conclusion: The present Study found that extra-cranial carotid artery intima media thickness (IMT) was higher than normal level in ischemic stroke patients. Higher CIMT was found at symptomatic side in comparison to the asymptomatic side. Bangladesh J Medicine 2022; 33: 24-30

Around the world, beef is consumed as a healthy source of protein, fat, niacin, vitamins B6, B12, iron, zinc, and phosphorus. There is mounting evidence that beef is becoming increasingly contaminated with heavy metals, particularly lead (Pb) and chromium (Cr). The purpose of this study was to determine the amounts of the lead (Pb) and chromium (Cr) in beef. Five large markets in Dhaka city—Mirpur-1, New Market, Karwan Bazar, Kaptan Bazar, and town hall market of Mohammadpur—were chosen to gather samples of beef. In this study, the Pb and Cr content in beef was estimated by the Zeeman method using graphite furnace atomic absorption spectrophotometer (GFAAS). The microwave digester finished the digestion of beef. The Pb and Cr content in beef were estimated in mg/kg. Total lead (Pb) content in a beef sample of Mirpur -1, New Market, Karwan Bazar, Kaptan Bazar and Mohammadpur was found to be 0.563±0.084, 0.845±0.127, 0.159±0.024, 0.063±0.009 and 0.143±0.021 mg/kg respectively (Minimum detection limit is 0.06 mg/kg). On the other hand, total chromium (Cr) content in beef sample from Mirpur -1 was found below the detection limit of the method (Minimum detection limit is 0.05 mg/kg). The Cr content in beef from New market, Karwan Bazar, Kaptan bazaar and Mohammadpur was found to be 0.05±0.007, 0.052±0.008, 0.121±0.018 and 0.053±0.008 mg/kg respectively. According to Codex Alimentarium Commission (CAC), the acceptable limit of lead content in beef is 0.1 mg/kg and there is no standard for chromium set by international organization like WHO/FAO, CAC. Brazil has set 0.1 mg/kg as permissible chromium content in beef (Ihedioha et al., 2014). Except for Kaptan Bazar, the chromium content was found to be within Brazil's permissible limit. Surprisingly, only Kaptan Bazar had acceptable lead content that was within the CAC limit. Bioresearch Commu. 9(1): 1196-1202, 2023 (January)

Background: Obesity is a proven independent risk factor for coronary artery disease. There are different Methods for evaluation of obesity. The aim of this study is to evaluate the association between waist hip ratio and the severity of CAD in non-ST-segment elevation myocardial infarction patients. Methods: This cross-sectional observational study was done at the National Institute of Cardiovascular Diseases (NICVD), Dhaka. A total of 100 patients with NSTEMI who underwent coronary angiogram during the indexed hospitalization period were included in this study. On the basis of WHR, study patients were divided into two groups 50 patients of NSTEMI with normal WHR (Male

Capital flight from Turkey throughout the last few decades is one of the major policy concerns for the development prospects of the economy. Several studies address the issue of capital flight from Turkey, but there is no significant study that examines its impact on the economic growth of the economy. The study investigates the effect of capital flight from Turkey on its economic growth during 1981-2019. It measures the extent of capital flight from Turkey adopting the World Bank’s residual method and examines its growth effect in a setting of Barro’s growth model. The study employs the Johansen cointegration approach to determine whether there exists an association between flight capital and the output growth of Turkey in the long run. The study results support the view that the flight of capital from Turkey deteriorates the country’s output growth in the long run. It implies that the government should adopt policies to reduce capital flight, increase domestic investment, and stimulate economic growth. IIUC Business Review Vol. 9, Dec. 2020 pp. 9-26

Background: Left atrial appendage (LAA) is considered the “most lethal human appendage” as it causes significant mortality and morbidity in chronic rheumatic mitral stenosis patients due to cardiogenic cerebral infract. Presence of LAA dysfunction has been shown to be a strong predictor of thrombus formation and the risk of embolic event, even if no clot is found at the time of initial examination. LAA emptying velocity are measured by trans esophageal echocardiography (TEE) represent as a surrogate marker for left atrial(LA) function .LAA emptying velocities (contraction velocity) < 20cm/s are associated with risk of spontaneous echo contrast(SEC), LAA thrombus, and subsequent cardio embolic events. So early detection of low emptying velocity without SEC or LA thrombus can reduce mortality & morbidity related to cardio embolic stroke and also helps in further management procedure like cardio version etc. So we will compare LAA emptying velocity moderate versus severechronic rheumatic mitral stenosis patients in our population for further attention. Objective: To assess emptying velocity of LAA in patient with moderate versus severe chronic rheumatic mitral stenosis, from a Bangladesh health service perspective. Method: This was a cross sectional study which was conducted in UCC, BSMMU during the period of from February 2019 to September 2019 in Echo lab . Study Procedure: We were enrolled 33 CRHD with MS (moderate to severe) patients who underwent TEE and met inclusion & exclusion criteria. The purpose of the study was explained to each subject & informed written consent was obtained. After getting consent relevant history, physical examination and preprocedural investigation was obtained in predesigned structured data collection sheet. TEE was done with Vivid E9® machine. Pulse wave Doppler was position at the tip of the LAA and then emptying velocity of LAA moderate and severe were compared. Outcome measure: Among 33 patients, 3 patients were excluded due to outlier and inadequate data.. In chronic rheumatic mitral stenosis in moderate versus severe cases average LAA emptying velocities were significantly higher moderate CRHD with MS compare to severe CRHD with MS,(26.57±4.91;31.12±5.04), P=0.018. Conclusion:Appendicular emptying velocity of LAA significantly lower in severe CRHD with MS compare to moderate CRHD with MS and it has temporal relation with MS severity. It can be used as a reliable, simple and sami-invasive tool to early predict severity and prevent complication in CRHD with MS as well as for prophylactic measured taken. University Heart Journal 2022; 18(2): 73-79

Background: Primary open-angle glaucoma (POAG) and atherosclerosis both are fairly common diseases among elderly persons, any adverse changes in serum lipids as a result of glaucoma therapy can increase the risk of coronary heart disease many folds. As topical beta blockers are also widely used and often the first line therapy in many patients requiring treatment for glaucoma for a long time, there is also a possible risk that _-blockers such as timolol adversely affect serum lipid profiles. Objective: The study aimed to evaluate the effect of topical timolol on serum lipid profiles. Methods: This cross-sectional observational study was performed in the department of ophthalmology, Bangabandhu Sheikh Mujib Medical University With convenience type of sampling technique 40 patients with newly diagnosed cases of primary open-angle glaucoma were selected. Baseline fasting lipid profiles were estimated and then timolol maleate 0.5%, 1 drop 12 hourly in both eyes were prescribed. At follow-up after 4 and 12 weeks, again fasting lipid profiles were estimated of the same patients. Results: In this study the baseline mean TC, HDL, LDL & TG were 175.4±19.28 , 46.63±5.33, 104.98±18.49,120.48±28.30 (mg/dl±SD) respectively. Baseline TC/HDL was 3.81±0.06. At follow up after 4 weeks there were increased level of TC, LDL,TG, TC/HDL by 0.45% (P=0.822), 0.8% (P=0.807) 1.82%(P=0.375), and 3.14%(P=0.307) respectively and HDL level decreased by 2.68%(P=0.232). At follow-up, after 12 weeks in comparison to baseline lipid levels, there was an increased level of TC, LDL, TG, and TC/HDL by 0.98% (P=0.959), 3% (P=0.996), 2.8% (P=0.104), and 17.0%(P=0.001) respectively and HDL level decreased by 13.61%(P=0.001). Conclusion: Topical timolol significantly lowers the plasma HDL level. Since the low level of HDL is strongly associated with an increased risk of myocardial infarction, our study cautions against the use of timolol in patients with a previous history of coronary heart disease. J Rang Med Col. September 2022; Vol. 7, No. 2:40-46

Fibrosarcoma is a rare malignant mesenchymal neoplasm’s of the fibroblasts which are represents 1% of all malignancies in the head and neck region. In this article we described a case of primary fibrosarcoma of the gingiva in right sided alvulas of the mandible in 16 years old male. Who was presented with a rapidly growing painful lump. Microscopically the tumor mass was composed with atypical proliferation of spindle cells arranged in intersecting fascicles and sterioform pattern. In immunohistochemically the cells showed immuno-reactivity for SAM, while negativity towards the others markers. On the basis of clinical histological and immunohistochemistry our case was diagnosed as a low grade primary fibrosarcoma of gingiva. We performed radical resection with wide margin as a primary treatment of choice without neck dissection. After primary treatment there is no signs of recurrence and metastasis was observed last 3 years follow up. J Bangladesh Coll Phys Surg 2022; 40: 310-313

Introduction: Tubercular lymphadenitis nowadays is the commonest extra pulmonary manifestation of tuberculosis in Bangladesh. Sometimes it causes diagnostic and therapeutic challenge for the clinicians. Occasionally Clinical, laboratory findings and fine needle aspiration cytology (FNAC) is not optimum that creates diagnostic and therapeutic dilemma. FNAC is often inconclusive. Sometimes therapy failed cases and atypical tuberculosis require open biopsy and neck dissection. Objective: To see the effectiveness of lymph node dissection & biopsy for diagnostic purpose and efficacy of the operation in suspected Multi-drug resistant tuberculosis (MDR-TB) for treatment failure due to any reason. Material and Methods: This cross sectional observational study was conducted during the time period of 01st Jan 2014 to 1st Jan 2020 in ENT & Head-Neck Surgery & Pulmonology department, Combined Military Hospital Dhaka on 150 patients who have undergone surgical neck dissection. Results: In this study total number of patients were 216. FNAC was done for all of them and found nonspecific lymphadenitis for 41 cases, lymphoma for 12 cases, sarcoidosis for 08 cases and kikuchi disease for 05 cases. 150 patients were found inconconclusive in FNAC. Inclusion criteria are followings, 1. FNAC is inconclusive & negative 2. Surgery was not done before. Among 150 patients different types of surgery was done like enblock resection, selective neck dissection and modified neck dissection. Histopathologically 06 cases found nonspecific lymphadenitis, 03 cases found lymphoma and 01 case found sarcoid granuloma. 150 cases were found histopathologically tubercular lymphadenitis. They show positive findings in biopsy, caseation necrosis- (100%), C/S +, among the Gene Xpert tests- Gene X-pert (Rif sensitive 83.33%, Rif resistant 16.66%). After completion of anti-tubercular therapy (ATT) (CAT-I HRZE) for total 150 patients, 125 patients were cured and 25 patients were not cured (treatment failure). Out of 25 patients 10 developed multiple cold abscess, 08 developed discharging sinus and 07 had relapse during follow up. 2nd Surgical interventions were done in total 25 patients, 10 TB abscess during ATT (CAT-1 HRZE), 8 discharging sinus and 7 relapse patients along with ATT (CAT-2 SHRZE) and all these patients had no relapse or treatment failure during further follow up. Conclusion: Tuberculous lymphadenitis is best treated with antitubercular medication and in addition surgical neck dissection is more useful in selected cases. So role of surgery is most useful for diagnostic accuracy as well as adjunct to the treatment avoiding prolongation of ATT and noxious side effects of drugs and also to prevent the formation of abscess and sinus. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 86-89

Introduction: Incidence of ACS is increasing in developing countries like Bangladesh. Many factors can influence in hospital outcome of NSTEMI Patient. Platelet count is one of them. The aim of present study was by measuring platelet count to detect the severity of NSTEMI patients and their in hospital outcome. Objective: The aim of present study was to observe the impact of platelet counts on in hospital outcome of NSTEMI. Materials and Methods: The study was conducted in Shahid Sheikh Abu Naser Specialized Hospital, Khulna from January 2021 to November-2021. NSTEMI Patient Presented within 24 hours of chest pain was included in this study. Data were collected by direct interview from Patient and venous blood was drawn for platelet count. Continuous data were expressed as mean ±SD. Categorical data were analyzed with x2 test. Student’s ‘t’ test was used for analysis of Continuous variables. Comparision between groups was done by unpaired t-test. Multiple logistic regression analysis was done to determine the association between lower platelet counts and adverse hospital events in NSTEMI patients. P-values 200000/cmm. Bleeding, Q-wave MI, arrythmia and heart failure were significantly (P

Introduction: Diabetes mellitus (DM) is a common metabolic disorder and is significant for its ability to adverse effect of various organs. Skin manifestations in this condition are due to metabolic derangements, chronic complications and infections, which are commonly observed after developing clinical diabetes mellitus, but may also precede the disease. Aim: The aim of this study was to understand dermatological manifestations in diabetes mellitus relation with demographic parameters. Materials and Methods: It was a hospital based cross sectional study carried out among 80 randomly selected diabetic patients with/without skin lesions. Patients were then asked for their willingness to participate in the study. Skin examination was carried out and skin lesions were identified. All data was recorded in the pre-designed, pre-tested, and semi-structured questionnaire developed for the study. Data was analyzed using SPSS version 26. Frequencies and percentages were calculated for the necessary data. Result: : Mean age of the subjects was 51.0±13.2 years, minimum age 25 and maximum 80 years. It was observed that, out of 80 patients, 52 (65.0%) were aged between 41–60 years. 52 (65%) were female and 28(35%) were male patients. 46(57.5%) were housewives and 16(20.0%) were service holders, 10(12.5%) were farmers and other 8(10%). 41(51.2%) from middle class, 38(47.5%) from lower class and 1(1.3%) were from upper class. 61.2% patients came from rural area and 38.8% patients from urban area. The mean duration of diabetes mellitus was 6.6±5.1 years, 42.5% patients duration had 5-10 years followed by 36.3% below 5 years and 21.3% patients had DM more than 10 years. Out of 80 patients, a total of 39(48.8%) DM patients had skin manifestations and 41(51.2%) had no skin manifestations. Among 39 DM patients with skin disease, 19(48.7%) having a single, while 8(25.5%) had two and 13(30.8%) patients had three or more skin lesions. 22(56.4%) patients found diabetic dermopathy, diabetic foot ulcer 12(30.8%), fungal infections 9(23.1%), bullous lesions 7(17.9%), diabetic foot gangrene 5(12.8%), lypodystrophy 5(12.8%), pruritus 5(12.8%), xerosis 5(12.8%) cases, scleredema 3(7.7%), ichthyosis 2(5.1%) and bacterial infections 2(5.1%). Age, sex, educational level, socioeconomic status, residence found no significant association (p>0.05), but duration of diabetes mellitus was significantly associated with the presence of dermatological manifestations (p=0.001). Conclusion: The spectrum of skin manifestations due to DM in this study population is similar to that in other parts of the world. Diabetic dermopathy, Pruritus and fungal infections are the most common cutaneous manifestations in DM patients. The presence of skin manifestations can highlighten the suspicion for DM enabling early diagnosis and management and thereby can be helpful for preventing complications. Medicine Today 2022 Vol.34(2): 145-149

Background: Decompressive craniectomy (DC) is one of the commonly used treatment modalities for refractory intracranial hypertension after severe traumatic brain injury. Objective: To assess the functional outcome following bilateral decompressive craniectomy (DC) in traumatic head injury based on Glasgow Outcome Scale (GOS). Materials and methods: This is a retrospective study conducted at Enam Medical College & Hospital, from January 2019- December 2020. Data of the patients who had undergone bilateral DC for severe traumatic head injury were reviewed from medical record files. Data were collected pre-designed data collection sheet. Data were analyzed using computer based program statistical package for social science (SPSS) for windows version 25.0 software. Results: This study shows maximum (56.9%) were 16-30 years. The average age was 29.70±14.78 years. Majority were male (94.1%) and only 5.9% were female. Road traffic accidents (RTA) were the most frequent causative event of traumatic injury. Most of the patients (88.2%) were hospital stay 1-5 days then 9.8% were 6-10 days and only 2% were >10 days. The average hospital stays were 3.26±2.43 days. Majority (60.7%) were good recovery, 13.7% were moderate disability, 5.9% were severe disability, 2% were persistent vegetative state and 13.7% were death at home. Conclusion: This study recommends a larger prospective study to assess the longterm functional outcome of bilateral decompressive craniectomy after severe traumatic head injury. Bang. J Neurosurgery 2022; 11(2): 89-93

A 7-year-old girl, 2nd issue of non-consanguineous parents hailing from Rajshahi got attended to our outpatient department of Pediatrics with the complaints of white patches all over the body since early infancy, poor intelligence, and speech problems. There was history of developmental delay but no history of seizures or visual problems or hearing impairment. She also had dental abnormalities. Family history was not significant. For these she treated with several oral and local antibacterial, antifungal and corticostresoid medications, but no improvement. Examination revealed symmetrical hypopigmented patches involving the trunk and upper limbs, and were following Blaschko’s lines. Anthropometry and others examination were normal. The hearing assessment was normal. There were no ocular abnormalities but have delayed dentation with mal-alignment of teeth with carries. She have moderate level of intellectual disability (ID). Our diagnosis was hypomelanosis of Ito (HI); a rare type of neurocuteneous syndrome. Routine investigations were normal, CT scan of the brain showed mild cortical atrophy, EEG was normal. The parents were counseled about the recent level of intellectual functioning, asked to allow the child for learning self-help skills, and referred to a child development center, child psychologist, and speech therapist. Our patients were well and no complications were observed till writing this report. We like to share our experience of diagnosing and treating this very rare disease of HI. KYAMC Journal Vol. 13, No. 02, July 2022: 120-123

Background: Urethral stricture is a chronic and common urological problem in Bangladesh and its management poses a big challenge to urologists. Surgical treatment of urethral stricture diseases is a continuously evolving process, and the superiority of one technique over another has yet to be clearly demonstrated. Urethrotomy is the most commonly used technique but long term results are not satisfactory. Long penile urethral strictures are best treated by substitution urethroplasty. The ideal graft material for substitution urethroplasty is constantly evolving. Buccal mucosa produces excellent result but is associated with many long term donor site complications. Lingual mucosa is an alternative donor site for graft urethroplasty and achieved good functional and aesthetic results. Materials & Methods: A hospital based prospective study was conducted in the department of urology, Dhaka Medical College Hospital from July 2016 to March 2017. Total 40 patients were included in this study. They were divided in two groups, group 1 was treated by lingual mucosal graft and group 2 was treated by buccal mucosal graft. All patients were followed up for six months noting pre and post-operative maximum urine flow rate (Qmax), voiding time and complications at both urethroplasty and donor site. Results: There were no significant differences in overall operative success rate between two groups of patients. But complications at donor site were higher in group 2 patients. Conclusion: Lingual mucosal graft urethroplasty may be preferred to buccal mucosa in anterior urethral stricture as it is easy to harvest and is associated with less short and long term donor site complications without significant difference in operative success rate. KYAMC Journal Vol. 13, No. 02, July 2022: 108-114

Background: Urethral stricture is a narrowing of the urethra which can either be congenital or acquired. In most cases, it is an acquired disorder. Congenital stricture is less common and even less commonly found in paediatric population. Case presentation: A 4-Month-old baby attended outpatient department with complaint of high fever and excessive crying that was more pronounced before and during urination along with whitish discharge mixed with urine. Urine R/M/E detected plenty pus cell. Left ureter appears grossly dilated, tortuous in USG. Constriction is noted in the distal part of urethra with proximal dilatation with bilateral vesico-ureteric reflux. Conclusion: As, no other cause i.e., iatrogenic, traumatic, inflammatory, post-infectious, was found out, there remain only one possibility for this baby having urethral stricture which is idiopathic or congenital cause. Bangladesh Journal of Medical Science Vol. 22 No. 01 January’23 Page : 239-241

not available DS (Child) H J 2021; 37(2): 140-142

Asthma is characterized by chronic airway inflammation leading to respiratory symptoms (dyspnea, wheezing, chest tightness and cough). So direct measure of the level of inflammation can be of paramount importance in the proper understanding of severity of asthma. Nitric oxide (NO) isa product of inflammation in the airways and an important regulator of immune responses that is overproduced in asthma. For this purpose, the measurement of Fractional Exhaled Nitric Oxide (FeNO) has been used since the early years of the current century as a non-invasive, easy-to-assess tool useful for diagnosing and managing asthma. In this narrative review we extended our effort to explain the usefulness of FeNO as a predictor of response to inhaled corticosteroids (ICSs), to monitor adherence and as a diagnostic tool in asthma management. Bangladesh J Medicine 2022; 33: 241-246

Necrotic enteritis (NE) is one of the important enteric diseases in poultry caused by Clostridium perfringens which leads to considerable economic losses for poultry raisers. The present research was carried out to estimate prevalence, risk factors and to confirm molecular pattern, antimicrobial susceptibility status of Clostridium perfringens in layer flocks in Mymensingh and Gazipur districts of Bangladesh, where a total of 287 samples were collected that comprised of water (30), workers’ hand washing (30), and feed (30) as environmental pooled samples; cloacal swab (150) and post mortem sample (intestine) (47) as individual samples, and evaluated by basic (culture, biochemical test), and finally toxinotyping multiplex PCR assays. The flock-level data on potential risk factors were collected through semi-structured interviews with the farm owners and evaluated via univariable and multivariable logistic regression analyses where a p-value of

The use of LED luminaries is increasing day by day and the traditional sources of light are being replaced by this semiconductortechnology. In this study, the interactions of Red, Green and Blue LED light with human-eye are considered to model the temperatureprofile due to the attenuation in the ocular media. The simulation has been done using COMSOL Multiphysics 5.3. The results of thestudy show that Blue LED light causes temperature rise more than the other two colours of light. At the tip of the corneal surface,blue LED light causes the temperature to rise by 0.91⁰C whereas the rise of temperature for green and red LED are 0.85⁰C and0.46⁰C respectively. However, the temperature at the posterior layers of the eye, sclera, choroid and retina undergoes little thermaleffects due to LED light owing to the fact that the heat-flux due blood flow is dominant in that region. Dhaka Univ. J. Sci. 70(1): 34-41, 2022 (January)

Background: Neck Space Infections are serious and common diseases that involve several spaces in the neck. Deep neck space infections can be life threatening in diabetic, immunocompromised and elderly patients and special attention should therefore be given to these groups. Objectives: This study was conducted to assess complications of deep neck space infections and its management, etiology, risk factors, presentation, spaces affected and complications among patients admitted in Department of ENT and Head- Neck Surgery in Dhaka Medical College & Hospital. Methods: This was a Cross Sectional Study conducted in the ENT and Head- Neck Surgery Department, Dhaka Medical College & Hospital from January 2016 to June 2016. A total of 150 patients were included who fulfill the selection criteria. Purposive sampling was used to collect data. Statistical analysis was done by SPSS version 21. Results: More than half of the patients (53.30%) came from middle class. Diabetes Mellitus was the most common risk factor (74.5%). Almost all patients presented with neck pain followed by neck swelling, dysphagia, fever and trismus. Organism isolated from drainage fluid was polymicrobial. Streptococcus (51.34%) and staphylococcus (18.60%) were most common organisms isolated. Airway was secured first and then high doses of antibiotics, immediate surgical drainage under local anesthesia were done in 130 (86%) patients. Commonly used antibiotics were ceftriaxone 132(82%), Metronidazole 113(75%) and flucloxacillin 98(65%). Complications were recorded in 55 patients. Most common was airway complication 40(73%). Tracheostomy was done in 17(11.33%) patients. Mortality occurred in 17(11.33%) patients. Conclusion: Early diagnosis and management is essential to prevent complications. Odontogenic infections, poor oral hygiene, lack of nutrition, smoking and tobacco chewing, DM were associated with neck space infection and we can prevent & control those factors. Bangladesh J Otorhinolaryngol 2022; 28(1): 56-61

Treatment of the tannery wastewater by mixing the effluents in desired ratio, with natural coagulants prepared by using natural elements and small quantity of chemicals is a cost-effective method. Here, indigenous naturalcoagulant named chitosan extracted from shrimp-shell and Morinaga Oleifera seed as a bio-absorbent was used. To the best of knowledge, this comprehensive hybrid method not been investigated yet for tannery effluent treatment. Chitosan can also be used in water processing engineering as a part of a filtration process. Chitosan causes the fine sediment particles to bind together and is subsequently removed with the sediment during sand filtration. The Chitosan and Morinaga seeds extraction works on wastewater treatment in an excellent way. The reduction of BOD, COD, Salinity proves the effectively of these prepared coagulants from natural elements. Resultant coagulant treated wastewater significantly reduced the pollutants were 97% TDS, 46% COD, 10% Salinity and 43% BOD respectively and removal proves the effectivity of these prepared coagulants. Moreover, it will help on the designing a low-cost chemical free treatment technology of the tannery effluent as for attracting the tannery-owner to set up a treatment plant. At the same time, the effect of the treated water to the vegetative seed germination and growth was also examined. That can be identified the impact of application of the treated wastewater for irrigation. Journal of Engineering Science 13(1), 2022, 73-79

This study was conducted to compare the effects of different feed additives namely, organic acid (citric acid), probiotic (navio plus), and antioxidant (Bio-Sel-E) on the growth performance and nutrient digestibility in growing rabbit to convey a clear message on the use of one specific additive in rabbit diet. Thirty-two crossbred New Zealand White growing rabbit (four to five weeks of age) were randomly assigned to four different groups and reared for a period of fifty six days. Rabbit were fed on green grass (Hymenachne pseudointerrupta) and concentrate mixture (2703 Kcal ME/kg, 16.91 % CP). Additives were added at the top of the concentrate mixture, except for the control group. Compared with the control group, rabbit fed different additives showed 9–13% higher growth rate and 7–11% greater growth velocity; and probiotic supplemented group showed the best result (P

Cervical cancer shows a high prevalence among Bangladeshi women. Reports indicated that oxidant-antioxidant balance plays a role in cervical cancer pathogenesis. Therefore, this study explores the change of different blood-derived enzymes, antioxidants, and biomarkers to understand the oxidative stress status of Bangladeshi cervical cancer patients. A clinician recruited the case and control participants for the study based on histopathologic reports. No significant difference was observed in the random blood glucose level, blood pressure, total cholesterol, triglycerides (TGs), HDL cholesterol, LDL cholesterol, and total protein levels in case participants compared to age and sex-matched control subjects. However, serum albumin, vitamins like alpha-tocopherol and ascorbic acid, antioxidant enzymes like SOD, and catalase levels significantly decreased in patients compared to controls. Other parameters, like, ALT, AST, ALP, phospholipid hydroperoxide, TBARS, protein carbonyl content, serum nitric oxide, cholesterol/phospholipid ratio (C/P) of erythrocyte and osmotic fragility were significantly increased in the case subjects compared to control. All of these reflect an oxidant-antioxidant imbalance in this setting. Thus, this study provides a detailed profile of the oxidant-antioxidant levels of the Bangladeshi cervical cancer patients, which revealed that the compromised antioxidant system in cervical cancer patients is associated with damage to various biomolecules and ultimately impairs cellular functions. J. Bangladesh Acad. Sci. 46(1); 117-128: June 2022

The purpose of our study was to achieve the gastro-retentive delivery of Clarithromycin by producing floating pellets to get a better therapeutic effect against gastrointestinal ulcers mostly caused by Hedyotis pylori. Thereby Clarithromycin floating pellets were prepared by utilizing the blending of polymers such as Sodium (Na) Alginate and Hydroxy Propyl Methyl Cellulose (HPMCK4M & HPMC K100LV). The HPMC-alginate blend containing Clarithromycin produced a hydrogel bead that was able to show buoyancy in the simulated gastric fluid. The pellets showed more than 8 hours of buoyancy depending on their polymeric ratio. In addition to the buoyancy test, several other tests like floating time (upto 12 hrs with increasing Na-Alginate), contraction ratio, particle size analysis, were performed that showed the development of acceptable floating pellets. Furthermore, SEM was performed on the prepared Clarithromycin pellet to assess their morphological characteristics. Clarithromycin floating pellets with 1.5% Na-alginate & HPMC K4M: HPMC K100LV (1:2) give the better formulation and produce pharmaceutically acceptable parameters. Dhaka Univ. J. Pharm. Sci. 21(1): 25-31, 2022 (June)

Background and Objectives: Coronary artery disease (CAD) is a worldwide health epidemic. Acute coronary syndrome (ACS) is a potentially life-threatening condition of CAD. Serum high-sensitivity C Reactive Protein (hs- CRP) is being increasingly used as a marker for cardiac risk assessment and as a prognostic tool in acute coronary syndrome. The objective of this study was to evaluate the prognostic value of hs-CRP in predicting cardiovascular outcome in patients presenting with acute coronary syndromes. Methods: This prospective observational study was carried out in the department of cardiology of Chittagong Medical College Hospital (CMCH), Chittagong, from April 2013 to March 2014. Total 100 patients presenting with acute coronary syndromes who fulfilled the selection criteria were included in the study. Serum hs-CRP of all patients was assayed on admission and study population divided into 4 groups according to hs-CRP quartiles. All four groups were followed-up till discharge and occurrence of any cardiovascular events were sought. Results: Mean hs-CRP was 18±2.9mg/L (mean±SD), ranged from 1.6 mg/L to 71.2 mg/L /L. The mortality was significantly higher in quartile-4 (7%, p-0.001) and quartile- 3 (4%, 0.005) as compared to quartile-1 and 2 (0% and 2% respectively). 12% patients developed heart failure in quartile-4 vs 2% in quartile-1 (p-0.045). Similarly other cardiac complications like cardiogenic shock, arrhythmias and heart blocks occurred in increasing frequency among patients of higher quartiles. Conclusions: Elevated hs-CRP is a predictor of adverse outcome in patients with acute coronary syndromes and helps in identifying patients who may be at risk of cardiovascular complications. Bangladesh Heart Journal 2022; 37(1): 34-39

Journal of Bangladesh College of Physicians and Surgeons (JBCPS), all the go by ‘BCPS Journal’, is the official organ of BCPS inclusive of academic, extra-academic and official matters. The journal started its journey in August 1983, now in the fourth decades is embedded in the fanfare of Golden Jubilee of BCPS. It commensurate with the fellows’ desire that a supplement of the JBCPS shall be published as the official organ of the college on behalf of the education, training, research and publication to Showcase the college image in the academic arena. The special editorial board is tasked to marinate a document of the sojourn of the JBCPS, for now and then. The authors have tried to pick up pieces of information from all available local libraries and online resources to build up an edifice to be added on from time to time. It has been tried to fullfill the mandate through expanded and extended search and find the tenets of the emergence and evolution of the JBCPS with an endeavor to bring out a canvas of the paintings of the stories of the Odyssey. Bangladesh Medical Journal (BMJ) published by Bangladesh Medical Association (BMA) is the oldest journal of the country first published 50 years ago in July 1972. Then the Bangladesh Medical Research Council Bulletin (BMRC Bulletin), published in December 1975. JBCPS is the third in this sequence. Prof Golam Rasul was the first editor in chief and so far, fifteen chiefs navigated the journal so far. The first editorial board consisted of five members and present editorial board embracing almost all the subjects including editors from abroad. JBCPS is online since 2004 and is available in the Bangladesh Journals Online (BanglaJOL) since 2006. With Continued relentless untiring efforts of the editorial board and collaboration from the executive committee of BCPS the JBCPS is now one of the top ranked & prestigious peer reviewed journal of the country. The next endeavor shall be to enlist the journal in PubMed which is expected very soon. J Bangladesh Coll Phys Surg 2022; 40: 28-38

The objective of this project was to improve the solubility of poorly water soluble drugs, namely cefuroxime axetil by formulating solid dispersions with hydrophilic polymer. Hydroxypropyl methyl cellulose (HPMC), polyvinyl pyrrolidine (PVP) and polyethylene glycol (PEG) were used as polymeric carriers for the preparation of solid dispersion. Solid dispersions were prepared by the solvent extraction method. Interaction effect of HPMC, PVP and PEG was investigated using a simplex mixture design. A fitted mathematical model was used to express each response as a function of the proportion of the blend components that are able to empirically predict the response to any blend of combination of the components. The synergistic interaction effect of the ternary HPMC: PVP: PEG blend was shown to be strongest among the experimental blends. Nevertheless, an antagonistic interaction effect becomes significant as the HPMC proportion increases in the blends. The study revealed that a mixture design could be a valuable tool in better elucidating and predicting the effects on dissolution beyond the conventional one component blend. Dhaka Univ. J. Pharm. Sci. 20(3): 317-324, 2022 (June) Centennial Special Issue

The first case of COVID-19 in Bangladesh was declared in March 08, 2020 and since then we are fighting against this deadly pandemic under the prudent and dynamic leadership of Hon’ble Prime Minister Sheikh Hasina as Chief Advisor. The active, sincere and dedicated efforts of Prime Minister’s Office, Cabinet Division, Ministry of Health and Family Welfare and other different ministries have proved this COVID battle to be a winning game for our country. All the doctors, nurses and health workers played the pivotal role along with administration, police and all others. Among the frontline doctors, the fellows and members of all specialties of Bangladesh College of Physicians and Surgeons (BCPS) had a significant participation. They remain to be appraised. This review article probes to reveal the enormous contributions of all fellows and members of BCPS in various sectors of the COVID-19 battle in Bangladesh. This paper analyzed all activities of BCPS fellows and members by collecting data from the COVID-19 dedicated hospitals, Directorate General of Health Services, Bangladesh and directly from fellows of BCPS. A systematic search in the net was also performed using specific search words to extract relevant data and articles published on COVID-19 from Bangladesh. A non-probability sampling technique was used without any structured questionnaire. Data were directly included in MS excel spread sheet. Simple description analysis was performed and results were expressed in tables and charts. We found that fellows and members of BCPS took a significant leadership and provided supreme dedicated services in almost all fields of COVID-19 crisis; e.g. frontline patientcare, education and training, national policy making, research and publication and nationwide guidance and awareness build-up. Among the doctors of government COVID-19 dedicated hospitals in Dhaka, about 650 fellows participated in treating about 1.5 lacs admitted patients. First interim guideline on COVID-19 management in Bangladesh was published by fellows in executive committee of Bangladesh Society of Medicine. It was later transformed into national guideline by DGHS. Fellows were the leaders at national level. The National Technical Advisor Committee and Directorate General of Health Services of Bangladesh are the two main bodies who lead the war in the frontline and both are headed by fellows of BCPS. Journal of BCPS was the first in Bangladesh to publish COVID-19 supplement issue on July 31, 2020 with 12 original articles. So far 128 COVID related articles from BCPS fellows have been published in national and international journals. Fellows fought in the frontline in every sector, shoulder to shoulder with all doctors and health workers of Bangladesh. They have triumphed their beloved college, Bangladesh College of Physicians and Surgeons, to be one of the greatest centers of excellence for the medical education and patient care in Bangladesh. J Bangladesh Coll Phys Surg 2022; 40: 19-27

Background: Neonatal sepsis is defined as a clinical condition of bacteremia with clinical features of infection in the first 28 days of life. Neonatal sepsis is an important cause of neonatal deaths worldwide. If detected early and treated aggressively and appropriately with antibiotics with good supportive care, it can be possible to save a life. Objective: The present study is carried out to overview the clinical and investigations profile, and outcome of neonatal sepsis admitted in a neonatal intensive care unit (NICU). Materials and Methods: This is a retrospective descriptive study. This study included newborns diagnosed with neonatal sepsis admitted to the Neonatal Intensive Care Unit (NICU) of Khwaja Yunus Ali Medical College and Hospital, Sirajgonj from October 2020 to January 2022. The case records of 50 neonatal sepsis. The case records of these newborns were thoroughly studied and recorded for relevant information including detailed history including maternal, clinical evaluation, and available investigation. The outcome was also noted. Results: Among the 50 neonatal sepsis cases early-onset neonatal sepsis was 56%; where mostly preterm (74%) and low birth weight (44%). Clinical presentations were mostly reluctant to feed (70%) associated with other septic features. Septicemia only (36%), pneumonia (14%), neonatal intestinal obstruction (10%) were found as the main pattern of sepsis. Among the cases septic screening profile thrombocytopenia 84%, CRP Positive 78%, leukopenia 58%, anemia 26%, leukocytosis 22%, normal 20%, toxic granules or band form neutrophil 14%, positive blood culture 14% were found. Probable risk factors were found mainly low birth weight (78%) and prematurity (74%); overlapping with many other risk factors. Thirty-six percent were death among sepsis. Conclusion: In the neonatal intensive care unit mostly early-onset neonatal sepsis has been observed in outborn, premature, and Low Birth Weight (LBW) babies presenting with reluctance to feed with associated risk factors; where thrombocytopenia invariably found in sepsis screening and survival rate around sixty-five percent KYAMC Journal Vol. 13, No. 01, April 2022: 32-36

Background: Third molars positions and eruption patterns tend to be unpredictable in most cases. Substantial diversity exists globally among modern human races in the prevalence of third molar impaction. Aims and Method: This study aimed to investigate the prevalence and pattern of third molar impaction amongBangladeshi adults. Digital panoramic radiographs of 5923 patientswith the mean age of 35.90 ± 10.76 years olds were retrieved from database and evaluatedusingPlanmecaRomexis software.Demographics, gender and sidedifferences wereanalysed using SPSSversion 26.0. Result:Approximately, 46.2% of the adult population had third molar impaction where significant impaction occurred in the mandible compared to maxillary arch. However, no significant differences were observed among gender and side distribution. The most common type of third molar angulation in the maxilla and mandible was distoangular (55.9%) and mesioangular (36.6%), respectively.Comprehension of demographic and morphological variations in third molar impaction will lead to an understanding of third molar impaction assessment, which will aid in understanding the evolutionary origins of an important condition adversely affecting modern peoples. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 717-729

Background: CT-guided fine needle aspiration cytology (FNAC) is a useful tool for evaluating lung nodules or masses. In view of the relative paucity of published studies regionally, this study was undertaken in the Department of Pathology, Enam Medical College & Hospital to see the use of the technique. Materials and Methods: Two forty six CT guided lung FNACs were performed during January 2017 to December 2018 and cytological diagnoses were made. Reported results and relevant data were recorded in the data sheet and then analyzed by standard statistical method. Results: Total number of cases were 246. Adequate samples were obtained in 228 (92.68%) cases, among the adequate samples 135 (59.41%) were malignant, and 93 (40.49%) were benign or nonmalignant lesions. Among the benign lesions, lung abscess (36;38.70%) was the most common followed by pulmonary TB (27;29.03%). Adenocarcinoma (54;40%) was the most common type of bronchogenic carcinoma followed by squamous cell carcinoma (51;37.78%), small cell carcinoma (21;15.56%), NHL (6;4.44%) and large cell undifferentiated carcinoma (3;2.22%). In male persons, squamous cell carcinoma (42.85%) was the most common type of bronchogenic carcinoma, followed by adenocarcinoma (34.29%). In female, adenocarcinoma was the most common type (18;60%) of bronchogenic carcinoma, followed by squamous cell carcinoma (6;20%). Conclusion: FNAC is a safe method for the evaluation of lung nodules and it enables sub-classification of bronchogenic carcinoma in the vast majority of cases. It is also useful for the diagnosis of tuberculous pulmonary nodules. J Enam Med Col 2020; 10(3): 169-173

Newborn Screening for the diagnosis of Congenital Hypothyroidism (CH) was first started in Bangladesh in 1999 by the Immunoradiometric assay (IRMA). Dissociation enhanced lanthanide fluorescent immunoassay (DELFIA) was started in 1986 due to its superior sensitivity, speed, and non-radioactive methodology. Auto DELFIA 1235 automatic immunoassay system was introduced in the In vitro Division of National Institute of Nuclear Medicine & Allied Sciences (NINMAS) under the ADP Project “Screening of Congenital Hypothyroidism in Newborn Babies (Phase 2)”. It is an automatic system that can minimize the pipetting error. In this experiment, dried blood spots (DBS) were punched into an antibody-coated microtitration well with an automated Panthera Puncher and analyzed by AutoDELFIA. Six different standards of 0.8, 10.3, 24.5, 49.3, 93.2, 239μU/mL were used and the calibration curve was drawn by using these standards. Standard error and Standard deviation were found 12.4 and 30.5. Limit of detection (LOD) and Limit of Quantification (LOQ) of X variables were 0.16 and 0.47. The average of the percent recovery was 96.7. The R2 value of the calibration curve was 0.9985. The accuracy of the standard samples was 96.7 ±10.6. For this assay two Quality Control (QC) of 16.39 μU/mL and 63.09, μU/mL were used. All of the measured values from the calibration curve were close to ±1 standard deviation. All these findings indicate appropriateness of Auto DELFIA System for the CH screening from dried blood spots in the newborn screening laboratory of the In vitro division of NINMAS. Bangladesh J. Nuclear Med. 23(1&2): 15-20, 2020

Fourteen various fish samples i.e., rui Labeo rohita, catla Gibelion catla, striped dwarf catfish Mystus vittatus, stinging catfish Heteropneustes fossilis, walking catfish Clarias batrachus, Ganges river sprat Corica soborna, mola carplet Amblypharyngodon mola, common carp Cyprinus carpio, Nile tilapia Oreochromis niloticus, climbing perch Anabas testudineus, spotted snakehead Channa punctatus, striped snakehead Channa striata, bronze featherback Notopterus notopterus, wallago catfish Wallago attu and mixed juvenile prawns were collected from a pond of closed down DDT (Dichlorodiphenyltrichloroethane) factory area of Chittagong Chemical Complex (CCC) of Bangladesh to assess the concentrations of DDT and its metabolites (4,4'-DDD and 4,4'-DDE). The fish flesh and shell-free prawn muscle samples were extracted by QuEChERS method and these were cleaned up using H2SO4. The cleaned sample extracts were analyzed using a Gas Chromatograph coupled with Electron Capture Detector (GC-ECD). The cultured L. rohita was used as a control which was found to contain no detectable amount of DDTs. Recovery experiments with control samples were spiked with certified DDTs standard at three different concentrations (0.01 mg kg-1, 0.02 mg kg-1 and 0.05 mg kg-1) levels. The percent recoveries were 72-114 % (0.05 mg kg-1), 70-101 % (0.01 mg kg-1) and 87-105 % (0.02 mg kg-1). LOD and LOQ of the standards were found to be 0.0625 μg kg-1 and 0.2063 μg kg-1, respectively and R2 of 4'-DDE, 4,4'-DDD, 2,4'-DDT and 4,4'-DDT were found to be 0.999, 0.999, 0.999 and 0.998, respectively. The concentrations of total DDTs residue in fish and prawn samples ranged between 0.66 ng g-1 in W. attu to 8.90 ng g-1 in H. fossilis. The ratios of 4,4'-DDT/ΣDDTs in the studied fish samples indicated the historical use of DDTs in the adjacent region around the DDT factory of the CCC area. The concentrations of total DDTs in all the samples were within the permissible Maximum Residue Level (MRL) recommended by FAO-WHO. To assess human health risks, Health risk Indexes (HI) of fish and prawn samples were calculated. HIs

Vaccination against severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), the causative agent of corona virus Disease 2019 (COVID-19) is a critical strategy to overcome the COVID-19 pandemic. Multiple SARS-CoV-2 vaccines have been developed in a rapid timeframe to combat the pandemic. As with any other medication, there have been adverse effects associated with the use of vaccines ranging from mild symptoms to life threatening side effects that have led to mortality. One of the more serious adverse effects associated with a number of vaccines such as those produced by AstraZeneca/Oxford and Pfizer BioN-tech is a phenomenon known as vaccine-induced immune thrombotic thrombocytopenia leading to thrombosis and embolism. Our case report highlights bilateral pulmonary embolism, one week after the second dose of the COVID-19 mRNA vaccine (Moderna) in a healthy newly married young women. Bangladesh J Medicine 2022; 33: 213-219

Introduction: Diabetes mellitus (DM) is considered one of the largest emerging threats to health and bacterial infections are more frequent in diabetic patients causing sepsis. Several indicators have been proposed as new diagnostic tests to assess sepsis in hospitalized patients. Aim: This study aims was to compare the efficacy of Procalcitonin (PCT) and high sensitive C-reactive protein (hs-CRP) in the diagnosis of sepsis in diabetic patients. Methods: In this cross-sectional study total of 60 age and sex-matched diabetic patients above 18 years were randomly chosen with at least 2 SIRS (Systemic inflammatory response syndrome) criteria from the indoor department of BIRDEM General Hospital. Basic hematological, biochemical, microbiological laboratory data were recorded from laboratory reports. Sepsis and its different stages were determined according to American College of Chest Physicians (ACCP) guidelines. The PCT was measured by sandwich enzyme immunoassay (Bio-Vendor, Germany) and the hs-CRP level was measured using an immune-turbidimetric assay (Beckman, Carlsbad, CA 92010, USA). Results: The patient’s mean age was 51.90±9.89 years where male 51.2% and female 48.8% and 50-60 years age group was the most common 40%. 38 (63.33%) patients were bacteriological culture-positive and 22 (36.67%) patients were bacteriological culture-negative where the most common organism was Klebsiella (28.95%). Statistically, a significant difference was found in PCT values in the bacteriological culture positive and negative group (p0.05). There was an increasing trend of serum PCT with the developing stages of sepsis. Receiver operating characteristic curve shows the area under the curve for PCT was 0.785 (95% CI; 0.654-0.915), sensitivity 89.47%, specificity 50%, PPV 75.55% and NPV 73.33% with the best cut-off value >753pg/ml which support PCT as a superior and reliable marker of sepsis. Conclusion: Our results suggest that serum PCT is a more reliable diagnostic marker of sepsis than other traditional markers like hs-CRP. Combinatorial use of these biomarkers will help in early diagnosis and also greatly improve outcomes. Bangladesh Crit Care J March 2022; 10 (1): 38-42

Introduction: Chronic hepatitis B virus (HBV) infection is a major health problem because of its worldwide distribution and its potential adverse sequel, including acute-on-chronic liver failure (ACLF), liver cirrhosis and hepatocellular carcinoma. Short term prognosis of patients with spontaneous severe acute exacerbation of CHB leading to ACLF- like presentation is extremely poor, with mortality ranging from 30% to 70%. Therefore, early and rapid reduction of HBV DNA is the essence of therapy in ACLF-B. Methods: Patients with spontaneous reactivation of HBV [(ALT >5 × upper limit of normal or >2 × baseline) and HBV DNA >20,000 IU/ml] were randomized to Tenofovir mono therapy (300 mg/day) or Tenofovir plus Telbivudine (600 mg/day) dual therapy along with standard medical treatment. Clinical and biochemical parameters were evaluated at baseline, 1 week, 4 weeks and at 3 months. Virological evaluation was done at baseline and at 3 months. Primary end point was reduction of HBV DNA. Secondary end point was reduction of liver related complication, therapy related adverse effects and survival at 3 months. Results: 27 patients were enrolled and 15 of them received mono therapy with Tenofovir and 12 patients received dual therapy (Tenofovir plus Telbivudine). Baseline parameters in two groups had no significant difference. Both groups significantly improve s. bilirubin, ALT, INR, CTP score and MELD score. Only MELD score showed significant improvement in patient with dual therapy at 3 months in comparison of mono therapy. 11 patient on Tenofovir mono therapy (n=15) showed undetected HBV DNA (91.7%) at 3 month and one patient had detectable HBV DNA (

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the world, accounting for 30% of deaths globally. CVD is a group of conditions affecting the functions of the heart, blood vessels or both. The major cardiovascular diseases include coronary heart disease (CHD), stroke, hypertension, heart failure and peripheral vascular diseases. Distribution of CHD and stroke is different in different regions of the world, especially western high-income, Asian and other countries. The Asian prevalence also not homogenous. Estimated number of deaths due to CVD worldwide will projected to 23.4 million, comprising 35% of all deaths in 2030. Significant increase in prevalence of coronary heart diseases (CHD) have been observed in the Asia including Bangladesh, but stroke in some regions of the world. Objectives: (1) Identification of cases and risk factors in different geographical area (2) Reduction of morbidity and mortality by proper treatment and management of modifiable risk factors. Materials and Methods: This observational study was done through using evidence from the published study articles of CVD in national and international journals, electronic databases such as MEDLINE, EMBESE and PUBMED. We also manually checked references of relevant publications of stroke and CHD. Study period: Jan2019-Dec2019. Results: Approximately 940 million people in the high income countries, where CHD is the dominant form of CVD which is 2–5 times higher than stroke. In the USA, Canada, Australia, New Zealand, Italy, France and Spain CVD death rates are very low. The highest death CHD rate is in Finland, Ireland, Scotland, Norway, Sweden of the European countries. In Eastern Europe and most of the Asia, the rate of coronary arterial diseases are rapidly increasing. Japan the Asian high income country the death ratio of stroke and CHD is 3:1.The East Asia and the pacific including China CVD is the major cause of death, where stroke dominating. People in South Asia including India and Bangladesh the coronary diseases are increasing alarmingly, where CVD death increase 30%over the preceding decade and the dominant form is CHD. In the central Asia, specially Uzbekistan, Kazakhstan, Tajikistan both CHD and stroke are very high. In Latin America death from CHD (35%) higher than stroke (29%). In the Middle East and North Africa, CHD responsible for 17% and stroke 7%of all death. Conclusion: Asian countries have disproportionately high morbidity and mortality from stroke with increasing tendency to CHD, but CHD in Western countries which may be due to complex interaction of genetic and environmental factors, smoking, hypertension and metabolic abnormalities. Death rate is higher in male sex from both CHD and stroke worldwide. Medicine Today 2022 Vol.34(1): 27-35

Background: In late December 2019, an outbreak of pneumonia with an unknown cause occurs in Wuhan, China. Later, the causative agent was identified as SARS-CoV-2. Early laboratory diagnosis plays an important role in any outbreak by cutting the spread of infection by isolating the infected person. Nucleic acid detection via PCR remains the gold standard because no alternative scientific method for detecting SARS-CoV-2 is available. Objective: The goal of this study was to learn more about the demographic characteristics of SARS-CoV-2-affected people and the sensitivity pattern of the N & ORF-1ab gene among them. Methods: A swab from the nasopharynx for nucleic acid detection was collected from 3183 SARS-CoV-2 suspected cases attending outdoors and indoors at Aichi Hospital and Japan East-West Hospital. Results: 649 (20.4%) were found PCR positive. Among the positive cases, the male was 478 (73.7%) and the female was 171 (26.3%), mean age was 40.35 ± 14.551 years, ranging from 4 – to 90 years. The highest prevalence of SARS-CoV-2 was identified in the 21–40 years old group (50.7%), followed by the 41–60 years old group (33.1%). The N gene was found to be 100% positive and ORF-1ab was 22.03% positive. Conclusion: According to the findings of this study, males and younger generations are at an elevated risk of contracting the virus, and maybe a source of infection for other family members. According to this study, the N gene has higher sensitivity and amplification efficiency than ORF-1ab. Update Dent. Coll. j: 2022; 12(1): 27-31