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Serum C-reactive protein is a marker of systemic inflammation, which has been studied to predict mortality and cirrhosis related complication in decompensated cirrhosis of liver. To evaluate the role of serum C- reactive protein as a predictor of early mortality in patients with decompensated cirrhosis of liver. This was a prospective observational study, carried out in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka between October 2017 to February 2019. A total of 89 patients with decompensated cirrhosis of liver were included in the study. Baseline serum CRP was measured and patients were longitudinally followed for a period of 30 days. Patients were divided into two groups, survival and non-survival. The groups were compared of CRP level, CTP score, MELD score and cirrhosis related complications. Chi-Square test was used to analyze the categorical variables and Student t-test was used to analyze continuous variables. Receiver-operator characteristic curve was used to detect serum CRP level for prediction of mortality within 30 days. The mean age was found 49.02±13.90 years in survival group and 47.52±11.30 years in non-survival group. Male patients were predominant in both groups. Total WBC count, serum CRP, serum sodium, serum bilirubin, CTP score & MELD score were statistically significant (p

The prevalence of Leiomyomas with pregnancy is reported as 0.3-2.9%1.They usually remain asymptomatic during pregnancy, if they are small.In symptomatic one, management is generally expectant and surgical removal is particularly delayed until after delivery. Symptomatic myoma, which does not respond to conservative management need antenatal myomectomy. Second trimester is preferable for its better outcome8,12.We present a case of symptomatic multiple uterine fibroids which include a huge one, diagnosed during pregnancy clinically & ultrasonography confirmed it. The casewas managed successfully by antenatal myomectomy due to failure of conservative management.Totalweight of fibroids was 1500gms. The pregnancy progressed to term uneventfully & elective caesarian section was done on 28/04/2019 for transverse lie. A healthy female baby weighing 03Kg was delivered. The patient was discharged in good condition on 05/05/2019. J Bangladesh Coll Phys Surg 2021; 39(1): 59-61

Nonalcoholic fatty liver disease (NAFLD) is a metabolic disorder characterized by excessive triglyceride accumulation in hepatocytes. NAFLD has a multifactorial etiology and a combination of environmental, genetic and metabolic factors play a role in the development of advanced disease. NAFLD consists of a wide spectrum of conditions, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which can progress to cirrhosis and hepatocellular carcinoma (HCC). Despite the high prevalence and severity of hepatic illness, NAFLD remains underdiagnosed, because of few symptoms, lack of accurate laboratory markers. The accurate diagnosis of NASH remains dependent on specific histological parameters in liver biopsy. Although liver biopsy remains the ‘gold standard’, there are practical limitations, including costs and risks. There is an increasing requirement for simple, less invasive, highly accurate and affordable screening tools. Aspartate aminotransferase (AST) has been proposed as a noninvasive and available marker for assessment of NASH. A hospital based observational study was carried out for a period of two years in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were analyzed by SPSS version 16. Qualitative and quantitative data were analyzed by Chi-square test and student’s t-test respectively. Fifty (50) patients were analysed. Twenty five were NASH and twenty five were non- NASH. AST in NASH group were 55.2 ± 30.1 IU/L and in Non-NASH group were 33.6± 20 IU/L. In NASH group significantly higher percentage of raised AST had NASH compared with normal AST (68% vs.32%).There was significant difference in the NAFLD activity score for diagnosing NASH between elevated and normal AST (P value 0.004). Higher AST values correlated with higher specificity. By multivariate analysis AST were found to be significant. Thus Aspartate aminotransferase (AST) is a good predictor for diagnosing non- alcoholic steatohepatitis (NASH). Bangladesh Med J. 2019 Jan; 48 (1): 44-49

Nonalcoholic fatty liver disease (NAFLD) is a metabolic disorder characterized by excessive triglyceride- accumulation in hepatocytes. NAFLD has a multifactorial etiology and a combination of environmental, genetic and metabolic factors play a role in the development of advanced disease. NAFLD consists of a wide spectrum of conditions, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which can progress to cirrhosis and hepatocellular carcinoma (HCC). Despite the high prevalence and severity of hepatic illness, NAFLD remains under diagnosed, because of few symptoms, lack of accurate laboratory markers. The accurate diagnosis of NASH remains dependent on specific histological parameters in liver biopsy. Although liver biopsy remains the ‘gold standard’, there are practical limitations, including costs and risks. There is an increasing requirement for simple, less invasive, highly accurate and affordable screening tools. Alanine aminotransferase (ALT) has been proposed as a noninvasive and available marker for assessment of NASH. A hospital based observational study was carried out for a period of two years in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were analyzed by SPSS version 16. Statistical inference were done by estimating distribution, Chi-square test and student’s t-test respectively. Fifty (50) patients were analysed.Twenty five were NASH and twenty five were simple steatosis. ALT in NASH group were 97.0±51.5IU/L and insimple steatosis group were 55.5±28.6 IU/L. In NASH group 64% of raised ALT had NASH . In Non-NASH group 16% of raised ALT had no NASH.There was significant difference in the NAFLD activity score for diagnosing NASH between elevated and normal ALT( P value 0.001). Bangladesh Med J. 2019 May; 48 (2): 1-6

Background: Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of conditions ranging from simple steatosis to steatohepatitis, advanced fibrosis, and end stage liver disease. Despite the high prevalence and severity of hepatic illness, NAFLD remains underdiagnosed, because of few symptoms, lack of accurate laboratory markers. Objective: To evaluate a biochemical score for diagnosing non-alcoholic steatohepatitis. Methods: An observational, cross sectional study was carried out for a period of two years in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 43 patients of Non-alcoholic fatty liver disease (NAFLD) attending at department of Hepatology were selected and underwent for biochemical investigations and liver biopsy with NAFLD Activity Score (NAS). Results: A biochemical score (TAAG score) assigned 1 point for each parameter (fasting serum triglyceride >ULN, alanine aminotransferase >ULN, AST/ALT ratio (AAR) ≤1 and gamma-glutamyl transferase >ULN) was evaluated. TAAG score ≥3 was present in 32.5% of study population and 40% of NASH patients. It had a sensitivity of 40%, specificity 26% and AUROC 0.54. Conclusion: Biochemical scoring system comprising traditional biomarkers did not significantly predict NASH. Biopsy is the only way to estimate steatohepatitis and/or fibrosis. Bangladesh J Medicine July 2019; 30(2) : 58-62

Background: Ultrasonographic findings of gastric carcinoma are varied in different population in different region. Objectives: The purpose of the present study was to see the different ultrasonographic findings of stomach cancer patients attended at a tertiary care hospital in Dhaka city. Methodology: This cross-sectional study was carried in the department of Radiology and Imaging of Dhaka Medical College, Dhaka during July 2009 to June 2011for a period of 2(two) years. Clinically suspected gastric carcinoma patients were evaluated by ultrasonography of upper abdomen and or Barium-meal x-ray evaluation. The sonographic findings were noted. Biopsy was performed by endoscopy or by surgical resection to confirm the case. Result: A total number of 60 gastric carcinoma patients were recruited.In all 24 patients of gastric carcinoma (100%) wall layering was completely lost. Wall thickness was increased in all the 24 cases (100%). Patients with gastric carcinoma had a wall thickness ranging from 10mm to 38mm with an average wall thickness of 24.5 mm. There was luminal narrowing and reduced peristalsis seen in all the 24 cases. Heterogeneous intraluminal masses were seen in 20 out of 24 (83.33%) cases of gastric carcinoma. Serosal involvement was seen in 17 out of 23 (70.83%) cases. Conclusion: Ultrasonography of gastric carcinoma shows completely lost of wall layering of stomach with increased thickness of it. Journal of Current and Advance Medical Research 2016;3(2):51-55

Introduction: Rabies is almost invariably fatal zoonotic disease, it can be prevent well with proper management of wound and rabies prophylaxis. This study aims to describe the pattern of rabies prone animal bite, to observe the trends of management and relationship with socioeconomic condition of victims.Method : This is an observational study. Data was collected from patients presenting with animal bite or attendants on structured case record form at Infectious Disease Hospital, Dhaka and emergency department of Mitford Hospital from 1st to 27th February 2010. Patients with category II &III bite were followed up 3 months over phone to observe the outcome.Results: A total 235 animal bite victims attending at Infectious Disease Hospital and Mitford Hospital were enrolled in study. Young patients, around 49.79% population within 18 years age group; male (82.98%) was more affected and mostly from low socioeconomic condition. Dog bite (91.06%) was predominant by stray dogs (94.89%) Exposure was mainly bite (83.82%), which were unprovoked (95.75%) and category – III(86.81%). Local wound care was minimal (wash with soap – 28.93%) and use of nerve tissue and cell culture vaccination was 81.70% and 18.29% respectively.Conclusion : Predominant rabies prone animal bite is stray dog. Victims after bite took ineffective nerve tissue vaccine while missing important rabies immunoglobulin due to economic constraints. The prevention of animal bite need to be addressed for prevention of rabies in Bangladesh.Bangladesh J Medicine Jan 2018; 29(1) : 26-30

Background: Chronic hepatitis is inflammation of the liver that lasts at least 6 months. Knowledge of aetiology and pattern of development of complications of chronic liver disease will help in designing optimal and cost effective control measures of the disease. Methods: The present study was performed to find out the aetiological factors in patients of chronic liver disease. This was a retrospective, cross-sectional study. Patients attending Hepatology Green Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka in 2014 with chronic hepatitis were included. Results: Total 3250 patients were studied, 2310(71.08%) males and 940(28.92 %) females. Most of the patients 1547 (47.6%) belong to age group of 18 to 30 years followed by 922 (28.37%) who were between the age group of 31-40 years. Majority of patients 2012(61.91%) had HBV infection, 1095(33.69%) had nonalcoholic steatohepatitis ( NASH), 81(2.49%) had HCV infection, 7(0.22%) had alcohol abuse, 28(0.86%) had Wilson’s disease, 19(0.58%) had autoimmune hepatitis and no aetiological factors were recorded in 8(0.25%) patients. However in case of females 52.55 % (494/940) due to NASH, while 40.21 % (378/940) due to HBV. Conclusion: HBV infection is the major risk factor for chronic liver disease and NASH challenges HBV in our patients.Bangladesh J Medicine Jan 2017; 28(1) : 24-27

Background: Insulin resistance (IR) has largely been hypothesized as central in multifactorial pathogenesis of nonalcoholic fatty liver disease (NAFLD). This study was aimed to explore the association of IR with NAFLD and nonalcoholic steatohepatitis (NASH).Methods: We enrolled 219 patients of NAFLD with sonographic evidence of fatty changes in liver excluding patients with alcohol intake and other causes of fatty change during June 2012 to July 2014.Liver biopsy was done for 110 patients with elevated ALT of >30 U/L for male and >18 U/L for female. We have measured IR by homeostatic model assessment of insulin resistance (HOMA-IR).Results: Age of the study population was 40.6 ± 10.0 years, male and female was 83 (37.9%) and 136 (62.1%), ALT was 42.0 (16-861) U/L, AST was 32 (16-608) U/L and GGT was 39 (10-243) U/L. According to Asian criteria 54 (25.9%) were non-obese, 139 (64.1%) had metabolic syndrome, 163 (74.8%) were hypertriglyceridemic, 200 (91.3%) had low HDL and 170 (77.4%) had high waist. Hypertensive and diabetic were 58 (26.7%) and 57 (26.1%) respectively. IR was 1.9±1.3 with the range of 0.4 to 9.3 and only 87 (39.7%) were above normal. Of the 110 biopsied, 65 (59.1%) had NASH. Normal and raised IR was associated with 32 (50.8%) and 33 (70.2%) NASH respectively (p < 0.05). Correlation between IR and steatosis, ballooning and fibrosis was not significant except lobular inflammation. IR was similar in NASH (2.2 ±1.6) and non NASH (1.9±1.6).Conclusion: Large proportion of NAFLD patients had normal IR. IR had inconsistent association with histological activity.Bangladesh Crit Care J September 2016; 4 (2): 86-91

Background: Metastasis is frequently occurred among the gastric carcinoma patients. Objectives: The purpose of the present study was to detect the age and sex difference of stomach cancer patients attended at a tertiary care hospital in Dhaka. Methodology: This cross-sectional study was carried in the department of Radiology and Imaging of Dhaka Medical College, Dhaka during the period of July 2009 to June 2011. Clinically suspected gastric carcinoma patients were evaluated by ultrasonography of upper abdomen and or Ba-meal x-ray evaluation. The sonographic findings were noted. All these patients were properly follow up and collect the endoscopic biopsy and or surgical resection biopsy reports. Result: A total number of 60 patients were evaluated with the age ranged between 31-80 years. There were 39(65%) men and 21(35%) women. Among the 27 patients confirmed as gastric carcinoma by histopathological examination, the age ranged between 31-80 years with the highest number of patients in the age group 61-70 years. Out of the 27 patients confirmed as gastric carcinoma by histopathological examination, there were 18(66.7%) men and 9(33.3%) women. Conclusion: Gastric carcinoma is most commonly found in male in the older age group. Journal of Science Foundation 2016;14(2):49-51

Fatty liver is a common cause of chronic liver disease in developed as well as developing countries.We have designed this study to estimate the prevalence and predictors for non alcoholic steatohepatitis (NASH) in non alcoholic fatty liver disease (NAFLD). We have included 493 patients with sonographic evidence of fatty change in liver and 177 of them had done liver biopsy for histopathological study. Other causes of liver disease and alcohol consumption were excluded. Metabolic syndrome and biochemical and anthropometric evaluation was done. Females were predominating 250 (57.0 %). Centrally obese 422 (96.2 %) was more than over all obesity330 (75.1%). NASH was absent in 10 (5.6%) cases and diagnostic of NASH was 75 Journal of Bangladesh College of Physicians and Surgeons Vol. 32, No. 2, April 2014 (42.4 %).Presence of diabetes could significantly (p = 0.001) predicted NASH. Age, sex, BMI, waist circumference, Serum HDL,triglyceride, insulin resistance index, hypertension, metabolic syndrome could not predict NASH. Serum GGT level was significantly (p = 0.05) higher in NASHwith a sensitivity of 45 % and specificity of 68 % only. Serum ALT and AST level could not detect NASH. Females were predominant sufferer of NAFLD in Bangladesh. Prevalence of NASH was much higher42.4%. Diabetes was the main predictor of NASH. GGT was the only biochemical indicator of NASH. We recommend liver biopsy in NAFLD with diabetes and raised GGT.J Bangladesh Coll Phys Surg 2014; 32: 71-77

Callus induction and plant regeneration ability of the dehusked rice genotypes are important tools for varietal improvement. This investigation presents the comparative callus induction and plant regeneration as obtained from the dehusked seeds of rice cultured on MS (Murashige-Skoog) medium. In the experiment conducted in a Complete Randomized Design under laboratory conditions, dehusked seeds of Ranisalute, Chiniatap, Somudrafena, Chiniguri-2 and Katchra rice cultivars grown in South West Bangladesh were tested on autoclaved and agarified MS nutrient medium with four replications to study their callus induction and subsequent plant regeneration ability. Chiniguri-2 yielded the highest calli and plant regeneration.

Deliberate self harm using paraquat is a significant problem in parts of Asia, the Pacific and Caribbean. It is used asherbicide and highly toxic after ingestion. Large amount of paraquat leads to rapid death but smaller doses oftencause a delayed lung fibrosis. A 21-yr-old female patient with paraquat poisoning with complaints of retrosternal andepigastric pain, mild respiratory distress and jaundice was admitted. She was icteric, her pulse was fast, subcutaneousemphysema was found at neck and lung was clear. Her respiratory distress, renal and liver function deterioratedand the patient was shifted to ICU and died on fourth day of poisoning. Methylprednisolone and cyclophosphamidepulse therapy was given but the patient died from multi-organ failure. Paraquat is very toxic and has no antidote.Keywords: Paraquat; gramoxone; herbicides; poisoning; BangladeshDOI: 10.3329/jom.v11i2.5467J MEDICINE 2010; 11 : 176-179