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Plant growth-promoting rhizobacteria (PGPR) are multipurpose entities in case of crop quality and yield improvement. This study evaluated the impact of PGPR inoculation in root zone nutrient release, rice yield, and grain nutrient (P, Fe, Mn, and Zn) content in two popular rice varieties of Bangladesh (viz., BRRI dhan49 and Binadhan7). It was a single factor (bacterial treatment) experiment where B0, B1, B2, and B3 treatments represented the inoculated control, indole acetic acid (IAA) producing bacteria consortium, phosphorus solubilizing bacteria (PSB) consortium, and combination of B1 and B2 treatments, respectively. Nutrients released in pore water was higher at 5 days after transplanting (DAT), compared to 25 DAT. Mostly B2 and B3 treatments performed significantly in the number of tillers/pots, straw yield, grain yield, grain P, Mn, Fe content, and all four nutrients uptake. The highest grain yield observed in B3 treatment is in both Binadhan7 (42.10±1.76 g/pot) and BRRI dhan49 (36.20±1.57 g/pot). PSB containing B2 treatment bio-fortified the largest amount of P in both rice varieties. On the other hand, the B3 treatment stored the highest amount of Mn (46.70±1.30 and 44.30±1.37 mg/kg) and Fe (45.30±2.90 and 25.70±2.37 mg/kg) in Binadhan7 and BRRI dhan49, respectively. The B3 treatment resulted in maximum nutrient content (P, Mn, and Fe) and uptake (P, Mn, Fe, and Zn) in both rice varieties. These bacterial isolates seemed promising for rice yield and quality improvement in an eco-friendly and sustainable way. Res. Agric. Livest. Fish. 10(1): 73-81

Introduction: Infantile hypertrophic pyloric stenosis (IHPS) is one of the most common surgical conditions of infancy. It`s prevalence ranges from 1.5 to 4 per 1000 live births. Different treatment modalities and procedures have been tried for the management of this common condition. Many innovations and approaches have been carried out for surgical management of IHPS. Open extramucosal pyloromyotomy, the original operation used to correct IHPS. Aim of the Study: The aim of this study was to evaluate and compare the outcome of Pyloromyotomy surgery among children with antibiotics or no antibiotics. Methods: This was a comparative study and was conducted in the Faculty of Pediatric Surgery of Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh during the period from January, 2020 to December, 2022. In our study we took 120 cases of Pyloromyotomy. All patients were randomized into two groups – Group A (Patients with antibiotics Ceftazidime) and Group B (Patients with no antibiotics). Periumbilical semicircular incision was made in all patients. Result: In total 120 patients from both the groups completed the study. In our study we found majority (67.5%) were less than 1 month & majority of our patients were male (75%) compared to female (25%). The Mean Age of group A & B was 33.5 ±11.2 & 32.1 ± 12.4 days respectively. Mean weight was 3.97 ± 0.8 & 4.02 ± 0.7 kg in group A & B respectively. Majority (13.33% & 10%) of patients had vomiting in group A & B respectively. Wound infection was 5% in group A & 6.67% in group B, stitch abscess was found 1.67% &1.67%, suture granuloma 5% & 1.67% in patients with antibiotics & no antibiotics respectively. Skin dehiscence was 6.67% in antibiotic group & 5% in no antibiotic group. Conclusion: In this study, we found major complications like wound infection, stitch abscess &skin dehiscence was present in our patients. However, there were no significant differences of these complications between antibiotic or no antibiotic .....

Introduction: Caesarean section (CS) is now one of the most commonly performed major operations in pregnant women throughout the world. While regional or general anaesthesia (GA) are both acceptable for caesarean delivery, use of GA has decreased dramatically in the past few decades due to a higher risk of anaesthesia-related maternal mortality. As a consequence, spinal anaesthesia (SA) is now the technique of choice for CS. It has become the preferred anesthetic technique when providing anesthesia for patients undergoing elective cesarean section as the risk of maternal and fetal complications associated with spinal anesthesia is less than with general anesthesia. Aim of the study: The aim of this study was to compare the effects of general & spinal anesthesia for elective cesarean section in diabetic pregnant women. Methods: This was a comparative observational study and was conducted in the Department of Anaesthesiology of Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh during the period from January,2022 to December,2020.In our study we included 120 pregnant women with diabetes who were given spinal and general anesthesia during C-section surgery. Our patients were equally divided into two groups – i) Group A (Patients were given general anesthesia) & ii) Group B (Patients were given spinal anesthesia). Result: In total 120 patients from both the groups completed the study. In our study we found the mean age and BMI was 34.48± 11.79 years & 38.48± 14.89 kg/m2 respectively. Among all patients 16%, 58% & 27 % patients had Type 1, Type 2 & gestational diabetes respectively. The mean blood glucose level was significantly lower in SA (80.9 ±17.7) compared to GA (121.1± 17.4) after one hour of surgery. The mean of mother’s perioperative difference was significantly lower in SA (4.0 ± 0.19) compared to GA (9.4 ± 0.21). Conclusion: In our study, we found that general anaesthetic had a substantially higher influence on blood glucose concentrations ..

Introduction: A cross-sectional prospective clinical study was done to evaluate the inner ear anomalies in candidates undergoing cochlear implantation. Materials and Methods: Study was carried out over a period of 07 years (Jan 2013 to Dec 2019) at Cochlear Implant Centre, Combined Military Hospital Dhaka. A total 206 deaf candidates, both pre and post lingual, were included in convenient sampling method. Result: The sample consisted of 206 candidates, of whom 117 (56.80%) were female and 89 (43.20%) were male. All candidates had severe to profound bilateral deafness. 182 (88.35%) of them were pre and 24 (11.65%) were in post lingual group. All patients diagnosed audiologically as profound deafness underwent HRCT scan of temporal bone with 3D reconstruction of cochlea and MRI of internal auditory canal & brain. Radiological examination revealed that 36 (17.47%) candidates had ear anomalies. Mondini deformity 14 (06.80%), cochlear ossification 11 (5.34%), large vestibular aqueduct 04 (1.94%), high jugular bulb 04 (1.94%) and anteriorly placed sigmoid sinus 03 (1.45%) were noted. During intervention, 42 (20.39%) candidates had anomalous intra operative findings. Among them CSF gusher 19 (9.23%), ossification of basal turn 12 (5.83%), isolated rotated Cochlea 02 (0.97%), high jugular bulb 04 (1.94%), anteriorly placed sigmoid sinus 03 (1.45%), and very high facial nerve 02 (0.97%) were observed. During surgery, electrode insertion difficulty due to high CSF gusher was experienced in19 (9.23%) cases, full length of electrode insertion was not possible due to ossified basal turn 12 (5.83%), difficult to find out round window membrane due to rotated cochlea 02 (0.97%), prevented direct visualization of the round window due to high jugular bulb 04 (1.94%), difficult to approach round window due to very high facial nerve 02 (0.97%). and approach to round window membrane was compromised due to anteriorly placed sigmoid sinus 03 (1.45%). Most of these difficulties were effectively managed during surgery. Conclusions: This study highlights the importance of preoperative radiological scanning in the assessment of patients undergoing cochlear implantation. It provides vital information on cochlear status and in ruling out non cochlear causes where cochlear implantation is not feasible. Detection of anatomical abnormalities with appropriate evaluation, specially imaging should be mandatory in every patient undergoing cochlear implantation. J Dhaka Med Coll. 2021; 30(2) : 167-175

Objective: This study was focused on the assessment of patient’s improvement in hearing, as measured by pure tone audiometry after stapedotomy for primary otosclerosis. Materials and Methods: This prospective clinical study was performed in a total of 156 patients diagnosed with Primary Otosclerosis, who underwent Stapedotomy at the Department of ENT & Head-Neck Surgery, Combined Military Hospital Dhaka between January 2013 to January 2019. All patients were evaluated as per the candidacy criteria for stapedotomy and selected patients underwent surgery during the study period and were followed up for a period of 12 months in the Otology clinic. Pre and Post-operative audiometric evaluation was done using conventional pure tone audiometry with standard calibrations. Post-operative audiometry was performed at 03 month, 06 months and 12 months. The bone-conduction & air conduction thresholds and the Air-Bone gap (ABG), were documented and analyzed at 0.5 KHz, 1 KHz, 2 KHz and 4 KHz frequencies respectively. The subjective outcomes in hearing were also recorded with a patient satisfaction questionnaire to assess improvement in quality of hearing after stapedotomy. Results: Overall, the frequency specific pre-operative mean averaged Air Conduction thresholds were 63.3dB at 500Hz, 57.5dB at 1 KHz, 55.1dB at 2 KHz and 45.7dB at 4 KHz. The frequency specific post-operative mean averaged Air conduction thresolds were 34.6 dB at 500Hz, 28.9 dB at 1Kz, 30.5dB at 2Kz and 33.3dB at 4Kz.The frequency specific mean average post operative Air Bone Gap (ABG) closure was achieved by 28.7dB at 500Hz, 27.6 dB at 1KHz, 24.6 dB at 2KHz and 12.4 dB at 4KHz by the time of completion of the study at 01 year. A successful closure of AB gap to less than 10dB was achieved in the speech frequencies of 2 KHz and 4 KHz in 83.97% of cases. Overall, the frequency specific bone-conduction thresholds were unchanged postoperatively in all cases except 03, showing that no significant sensori-neural impairment had occured due to the stapedotomy procedure. 04 patients developed post-op severe vertigo which was self-limiting after six weeks. 01 patient developed transient facial weakness which was subsided over a time period of 03 months. Patients included in our study had significant subjective audiological improvement and responded satisfactorily to the questionnaire formulated to assess their hearing quality after stapedotomy. Conclusions: Our case study confirms that stapedotomy is a safe and successful procedure providing long-term hearing improvement in primary otosclerosis. Our study shows that meticulous selection of cases for stapedotomy will result in highly successful audiological outcomes. J Dhaka Med Coll. 2021; 30(2) : 156-160

Background: Ventricloperitoneal (VP) shunt is the most commonly used shunt procedure in children because of the capacity of the peritoneum to resorb fluid like Cerebrospinal fluid (CSF). Primary and subsequent peritoneal catheter placement is relatively easy procedure to be done. VP shunt procedures are associated with varieties of complications. Methods: A prospective study was done from July 2017 to June 2021 in Faculty of Paediatric Surgery, Bangladesh Shishu Hospital & Institute. A total number of cases underwent VP shunt surgery were 192. We had analyzed 82(42.71%) patients of VP shunt surgery who had various shunt related complications and analyzed the predisposing risk factors and spectrum of complications. Results: The mean age was 16±14 months and median age was11.75 months. Out of 82 patients 56 (68.29%) were male and 26(31.71%) were female. Seventy (85.37%) patients had single complication and 12(14.63%) had more than 1 complications. Twenty four (29.27%) patients had infective complication and 58(70.73%) had mechanical complication. Infective complications (24, 29.27%) include shunt tract abscess (41.66%), CSF leak (16.67%) exposure of shunt tube through anus (16.67%), wound infection (16.67%). Mechanical complications were present in 58(70.73%) cases and 40(48.78%) had ventricular end malformation, 24(29.27%) peritoneal end and 18(21.95%) had both end malformation. Conclusion: With this prospective study of complications of VP shunt, age at initial shunt surgery, insertion and important patient-related predictors of shunt failure. The different predominant etiological factors the interval between the age of initial shunt placement and onset of complications were the most responsible for early and late shunt failure were infective and mechanical complications respectively. DS (Child) H J 2021; 37(2): 129-134

Intravascular embolization of bullets and other foreign bodies is a rare complication of penetrating trauma. It can represent a diagnostic challenge because it may present in various and unexpected ways. We report the case of a 65-year-old male who sustained shotgun pellet emboli to left ulnar artery following a right and left upper extremity gunshot injury. Pulse volumel.11 January-December 2018-2019 p.33-37

Rupture of the ventricular septum, a rare but potentially fatal complication of acute myocardial infarction, is usually observed in the setting of acute myocardial infarction associated with major coronary artery occlusion. It is often accompanied by severe circulatory failure. In this paper we describe a case of a 70-year-old lady who presented with cardiogenic shock 7 days after acute myocardial infarction and was found to have ventricular septal rupture. Pulse volumel.11 January-December 2018-2019 p.27-32

Background: Patients with bacterial meningitis (BM) frequently present with febrile seizures (FS) without any signs or symptoms of BM. To perform a lumbar puncture on all FS patients to rule out meningitis is still debatable. The goal of this study was to estimate the frequency of meningitis among first-time febrile seizures (FTFS). Methods: From July 2013 to June 2014, a cross-sectional study was conducted at Sir Salimullah Medical College and Mitford Hospital, Dhaka. CSF and blood reports and detailed histories and examinations were examined in children aged 6 months to 36 months with FTFS (simple or complex). Results: The first complex febrile seizure (FCFS) and the first simple febrile seizure (FSFS) occurred in 58% and 42% of the 73 children included in this study. 11 (15%) cases had meningitis based on CSF and blood reports, where 2 (3%) had confirmed BM, 2 (3%) had probable BM, and 7 (10%) had viral meningitis (PVM). One of two children with confirmed BM had Klebsiella spp. in CSF culture and Streptococcus pneumoniae in CSF gram stain. Others with probable BM had CSF pleocytosis with low sugar and high protein levels. Leukocytosis was found in all four children with BM. Two of the seven children with PVM had isolated pleocytosis, one had low sugar, and four had high protein CSF. Blood cultures were negative in all 11 meningitis cases. Conclusion: Although meningitis is common in FCFS, this study found no cases of BM children with FSFS, though PVM was not uncommon. Sir Salimullah Med Coll J 2022; 30: 108-114

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

Genetic diversity of Ralstonia solanacearum, on seeds of tomato and brinjal from different seed sources in Bangladesh were studied with Random Amplified Polymorphic DNA (RAPD) marker. The primers viz., OPA02, OPA08, OPA09, OPA10, OPA18 and OPE19 were used in this study and were also evaluated on the basis of intensity and resolution of the band. The genetic variations in 24 isolates of R. solanacearum were analyzed with (OPA18) RAPD marker in Polymerase Chain Reaction (PCR). The percentage of polymorphic loci was 100.00 for both tomato and brinjal. Combined Dendrogram based on Nei’s (1972) genetic distance in Unweighted Pair Group Method of Arithmetic Means (UPGMA) segregated the 24 isolates of R. solanacearum into two main clusters: RsT-6, RsB-2 and RsB-3 in cluster 1, and rest of the 24 isolates were grouped in cluster 2. The isolate of brinjal (RsB-8) was close to the isolate RsB-12 and the isolate RsB-11 was near to RsT-5 (tomato) with the least genetic distance (0.000), while the brinjal isolate RsB-4 was also close to RsB-5 with the low genetic distance (0.0606). The coefficient of gene differentiation (Gst) was obtained at 1.0000 which reflects the existence of higher genetic variations among 24 isolates of R. solanacearum. Comparatively higher genetic distance (1.7346) and the lower genetic identity (0.1765) were observed in RsB-1 vs. RsT-12, whilst the higher genetic identity (1.000) and the lower genetic distance (0.000) were estimated in RsB-8 vs. RsB-12 and RsB-11 vs. RsT-5, respectively. Consequently, interactive significant genetic variations in 24 isolates of R. solanacearum of tomato and brinjal seed sources were found to be evident in both the crop species’ of diversified different varieties as the genetic variability of specific crop species. Bangladesh J. Bot. 51(3): 519-526, 2022 (September)

This study investigates the kinetics data of glass wool (GW) and extruded polystyrene (XPS) insulation materials used in cladding systems using a systematic framework. The determination of appropriate kinetic properties, such as pre-exponential factors, activation energy and reaction orders, is crucial for accurately modelling the full-scale fire performance of insulation materials. The primary objective of this research is to extract thermal and kinetics data of XPS and GW insulation materials employed in high-rise buildings. To obtain these properties, thermogravimetric analysis (TGA) is conducted at four different heating rates: 5, 10, 15 and 20 K/min. The TGA results serve as the basis for determining the kinetic properties using a combination of model-free and model-based methods. The outcomes of this study are expected to be highly beneficial in defining the pyrolysis reaction steps and extracting kinetics data for fire modelling of such insulation materials. This information will enhance the understanding of the fire behaviour and performance of these materials during fire incidents, aiding in developing more accurate fire models and improving fire safety strategies for cladding systems in high-rise buildings.

Background: Otitis media with effusion(OME) is a common ear problem among children characterized by accumulation of secretion in the middle ear. The pathophysiology of OME is negative pressure due to eustachian tube dysfunction. In children adenoid enlargement is associated with enlargement of the tonsils. Surgical treatment is advocated when conservative treatment fails. Surgical treatment consists of adenotonsillectomy with myringotomy. Negative middle ear pressure is expected to improve after surgical intervention. Objectives: To see the pressure changes after surgical treatment of OME. Methods: Among 68 subjects with OME, 88 ears were operated. Adenotonsillectomy was done in all subjects. In addition myringotomy was done in 65 ears and myringotomy with grommet insertion was done in 23 ears. In post-operative period all patient were followed up at end of 1 month, 3 month and 6 month with tympanometry. Results: Pre operatively type B tympanogram was 67(76.13%) whereas type Atympanogram was 0(0%). At end of 6 month type A curve was 49(61.27%) and type B tympanogram was 9(11.25%) that indicates improvement of middle ear function after operation. Conclusion: Tympanometric improvement was significant after 6 month of surgery. Bangladesh J Otorhinolaryngol 2022; 28(1): 22-28

Objective: To see the clinical presentation of thyroglossal cysts and sinuses. Methods: Observational type of Cross sectional study. Department of ENT & Head-Neck Surgery in Sher-E-Bangla Medical College Hospital, Barishal from September 2014 to February 2015. All patients attended in the Department of ENT and Head Neck Surgery in Sher-E-Bangla Medical College Hospital, Serum TSH, USG of thyroid swelling and FNAC were done for diagnoses and for evaluation. Results: Thyroglossal cysts and sinuses were found in 23(63.9%) and 13(36.1%) cases respectively. The mean age of presentation was found 16.6±11.3 years in cysts group and 15.5±7.2 years in sinus group. Regarding the site of cysts 4(17.4%) cases was suprahyoid, 11(47.8%) infrahyoid and 8(34.8%) at the level of hyoid. Regarding the site of sinus 1(7.7%) case was suprahyoid, 9(69.2%) infrahyoid and 3(23.1%) at the level of hyoid. All the patients had normal thyroid gland in both group, all of them had normal serum TSH level. FNAC was done in all cyst patients and shows normal cystic lesion with no malignancy. But in sinus patients only one FNAC was done and reported as cystic lesion. Conclusion: Thyroglossal cysts and sinuses were more common in 2nd decade and male predominant. Majority of the cysts are Infrahyoid and on the right side of midline and majority of sinuses are Infrahyoid and on the right side. Development of sinuses is due to operation following abscess formation in majority of cases. Bangladesh J Otorhinolaryngol 2022; 28(1): 7-15

Nitrogen deficiency in rice has so far received limited attention in Bangladesh. Balanced fertilization is a pre-requisite for better rice production and it is necessary to determine optimum combination of fertilizer dose and varieties. The field experiment was carried out during the period from November 2020 to May 2021 at the Agronomy Field Laboratory, Bangladesh Agricultural University (BAU), Mymensingh to study the SPAD value and yield performance of boro rice varieties at different nitrogen levels. The experiment comprised of four boro rice varieties viz., BRRI dhan28, BRRI dhan58, BRRI dhan74, BRRI dhan81 and four level of nitrogenous fertilizers viz. 50 kg N ha-1, 100 kg N ha-1, 150 kg N ha-1 and 200kg N ha-1. The experiment was laid out in a randomized complete block design with three replications. SPAD value ranged from 34.01 to 42.12 for variety and 37.81 to 42.15 for nitrogen application, while leaf nitrogen ranged from 2.98 to 3.67 % for variety and 2.94 to 3.48%. The yield contributing parameter varied significantly with variety and nitrogen rate. The highest grain yield (6.13 t ha-1) was found in BRRI dhan58 and the lowest (3.89 t ha-1) was observed in BRRI dhan28. In terms of fertilizer management, the highest grain yield (5.35 t ha-1) was obtained due to the application of 150 kg N ha-1 and the lowest grain yield (4.72 t ha-1) was recorded from50 kg N ha-1. The interactive effect of variety and fertilizer application exerted that the yield of BRRI dhan58 with 150 kg N ha-1 was the highest (6.59 tha-1) and the lowest performance (3.42 tha-1) in grain yield was found in BRRI dhan28 with 50 kg N ha-1. Thus, the variety BRRI dhan58 with 150 kg N ha-1 was superior for attaining the highest yield.

Introduction: To find out the audiometric outcome after stapedotomy patients with clinical diagnosis of otosclerosis. Methods: This prospective observational study was performed in a total of 142 patients diagnosed with primary Otosclerosis, who underwent Stapedotomy at the Department of ENT & Head-Neck Surgery, Combined Military Hospital, Dhaka between January 2013 to January 2018. All patients were evaluated as per the candidacy criteria for stapedotomy and selected patients underwent surgery during the study period and were followed up for a period of 12 months in the Otology clinic. Pre-operative and Post-operative audiometric evaluation were done using conventional pure tone audiometry with standard calibrations. Post-operative audiometry was performed at 03 month, 06 month and 12 month. Results: Overall, the frequency specific pre-operative mean average Air-Bone gap was 51.6 dB at 500Hz, 35.7 dB at 1000 Hz, 40.5 dB at 2000 Hz, 38.9 dB at 4000 Hz and the frequency specific postoperative mean average Air- Bone Gap closure was achieved by 28.1 dB at 500Hz, 30.3 dB at 1000 Hz, 12.5 dB at 2000 Hz, 10.8 dB at 4000 Hz, by the time of 1 years of follow up. The difference was statistically significant (p

Introduction: Complete assessment of biliary obstruction requires the use of various imaging modalities to confirm the presence, level and cause of obstruction which can help in treatment planning. Commonly used procedures include Ultrasonography (USG), Computed Tomography (CT) and Magnetic Resonance Cholangiopancreatography (MRCP). Objective: To determine the accuracy, sensitivity and specificity and to compare the diagnostic accuracy of USG, CT scan and MRCP in assessing the level and cause of obstruction in patients with obstructive jaundice. Materials and Methods: This cross sectional descriptive study in 50 patients who presented in the department of Radiology and Imaging, Combined Military Hospital (CMH), Dhaka with symptoms and signs of obstructive jaundice above the age 20 years was carried out during the period from 01 October 2012 to 30 April 2013. The accuracy, sensitivity and specificity of each modality in assessing the level and cause of obstruction were determined. Results: MRCP detected level of obstruction in 100%, CT scan in 95.8% and USG in 90% cases. For detection of cause of obstruction, MRCP had the highest sensitivity (96.2%); followed by CT scan (88.4%) and USG (62.5%). The diagnostic accuracy for detection of cause of obstruction was the highest for MRCP (93.1%); followed by CT scan (89.8%) and USG (66%). Conclusion: MRCP has highest diagnostic accuracy and sensitivity by detecting the level and cause of obstruction most accurately. JAFMC Bangladesh. Vol 17, No 1 (June) 2021: 10-13

Introduction: Middle ear barotrauma is a common medical problem related to aviation; because the aviation environment exposes the aviator to a rapidly changing ambient pressure. Middle ear barotrauma occurs when the Eustachian tube failed to equalize middle ear pressure with ambient pressure during flight. Objective: To determine the prevalence of middle ear barotraumas among aircrew on Bangladesh Air Force (BAF) and to find the risk factors of middle ear barotrauma. Materials and Methods: This cross-sectional study was carried out on middle ear barotrauma in aircrew of BAF from February 2018 to January 2019. Aircrew who experienced fullness in the ear or ear pain during flight and visited the flight surgeon was enrolled in this study. Modified TEED scale used for grading of middle ear barotrauma. Results: The study revealed middle ear barotrauma in the aircrew was 12.0% with a higher prevalence among the student pilots (14.2%) compared with trained pilots (5.9%), the mean age of aircrew was 23.2 ± 3.6 years. The right ear (43.5%) was affected in most of the cases than the left ear (34.8%). Most of the symptoms developed at a stage of descending (60.9%). The duration (mean± SD) of sickness was 7.6±3.7 days. Conclusion: Middle ear barotrauma or ear block is common in trainee aircrew but it is also seen in the experienced pilots who fly with upper respiratory tract infection (URTI) or a common cold. Appropriate training on ear physiology related to pressure changes inside the hypobaric altitude chamber can prevent the incidence of middle ear barotrauma. JAFMC Bangladesh. Vol 17, No 1 (June) 2021: 14-17

The development of an effective and profitable exploration and production depends heavily on the quality of the reservoir. The primary goal of this study was to evaluate the reservoir quality of the Neogene Surma Group at the Srikail Gas Field, which is situated in the western part of the eastern folded belt of the Bengal Basin, Bangladesh. Wire-line logs, core analysis, petrography, X-Ray diffraction (XRD) and a scanning electron microscope (SEM) were used to understand the depositional and diagenetic controls of the quality of the reservoir. The Surma Group of the Srikail Gas Field was deposited in a delta system with a dominant influence of tide. The subarkosic to sublitharenitic Neogene Surma Group sandstones have primary porosities ranging from 0% to 25.8%, with an average of 21.5%, and the secondary porosity is approximately 7%. The range of log porosity ranges from 15% to 22.2%, while log permeability and core permeability vary from 3.01 to 54.09 mD and 0.1 to 76 mD, respectively. The primary porosity had been destroyed mainly by mechanical and ductile grain compaction. Most of the clay minerals (illite/illite-smectite, chlorite and kaolinite) in sandstone occur as grain coatings, grain lining (rim) and a few occur as pore-filling. This study reveals that the reservoir quality is predominantly controlled by the depositional environment (sediment texture and facies, ductile grain supply, clay content), and diagenetic process (mainly mechanical and ductile grain compaction followed by clay cement). The information gathered from this research will be useful for future petroleum production and for enhancing predictability in order to find new prospects.

Five long-chain hydrocarbons and a new brominated nitrogenous terpenoid were isolated from the acidic and basic fraction respectively of an ethanol extract of the male flowers of Carica Papaya for the first time. It was collected from Bangladesh Agriculture Development Corporation, Gazipur. J. Bangladesh Acad. Sci. 45(2); 181-186: December 2021

Maize as well as baby corn is an exhaustive crop in terms of nutrient and water uptake from soil hence soil health become deteriorate easily and as different amounts and forms of nutrient supply in baby corn affect the productivity of baby corn so combination of organic and inorganic sources of nutrient is beneficial for soil heath and to maximize the productivity of baby corn thus an experiment was conducted at the Agronomy Field Laboratory, Bangladesh Agricultural University, Mymensingh during November 2017 to February 2018 to investigate the effect of varieties and sources of nitrogen fertilizer on yield and yield contributing characters of baby corn. The experiment was laid out in randomized complete block design (RCBD) with three replications. The experiment consisted of two varieties viz., BARI Sweet corn-1(V1), Baby star (V2) and five sources of nitrogen fertilizer viz.,100% recommended N from urea(N1),75% N from urea + 25% N from cowdung (N2), 50% N from urea + 50% N from cowdung (N3), 75% N from urea + 25% N from poultry manure(N4),50% N from urea + 50% N from poultry manure(N5).Yield and yield contributing characters of baby corn were significantly influenced by variety, sources of nitrogen fertilizer and their interactions. The highest number of cob plant-1 (1.67), cob length (13.50 cm), cob girth(3.84 cm), cob yield with husk (14.66 t ha-1), cob yield without husk (3.52 t ha-1), and fresh fodder yield (42.50 t ha-1) were recorded when Baby star was fertilized with N2 (75% N from urea + 25% N from cowdung) treatment. Therefore, it may be concluded that Baby star is the promising baby corn variety when coupled with (75% N from urea + 25% N from cowdung) for maximizing baby corn production and improving soil health.

Introduction: Obstructive jaundice is frequently encountered worldwide including Bangladesh. Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP) is one of the procedures to manage obstructive jaundice. Objectives: To ascertain the outcome of obstructive jaundice patients who underwent ERCP. Materials and Methods: It was a hospital based cross sectional observational study, carried out in Gastroenterology Department of Combined Military Hospital (CMH) Dhaka from May 2017 to May 2019. Total 200 patients were included in the study. Verbal consents were taken from patients. Data were collected with a checklist and analyzed by using SPSS 20. Results: Total 200 patients’ mean age±SD was 56.5±14.5 years with range 21 to 92 years and majority were 41 to 60 years 80(40%) followed by 61 to 80 years 78(39%). Etiology of obstructive jaundice were, benign 137(68.5%) and malignant 63(31.5%). Among the benign: 69(34.5%) were choledocholithiasis, 45(22.5%) biliary stricture, 20(10.0%) papillary stenosis and 3(1.5%) biliary warms. Among the malignant: 24(12.0%) were distal cholangiocarcinoma, 21(10.5%) periampullary tumors, 10(5.0%) Klatskin tumor, 4(2.0%) carcinoma head of pancreas, and 4(2.0%) other malignancy. Mean serum bilirubin level 17.6 mg/dl with minimum 0.6mg/dl, maximum 41.3mg/dl; mean alkaline phosphatase (ALP) level 351.4U/L with minimum 111U/L and maximum 1262U/L; mean alanine aminotransferase (ALT) level 118.8 U/L with minimum 28 U/L, maximum 521 U/L; ERCP were successfully done in 188(94.0%) patients with single attempt 171 (85.5%), repeated sessions 17(8.5%) and 12(6.0%) patients unsuccessful ERCP; complications occurred in 17(8.5%)patients, of whom post-ERCP pancreatitis 9(4.5%) and post procedure cholangitis 4(2.0%)patients. Conclusion: Benign etiologies of obstructive jaundice were more common than malignant one. Both benign and malignant etiology of obstructive jaundice can be successfully managed with ERCP with few complications. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 27-30

Malrotation of the gut is a surgical problem. Clinical presentation is asymptomatic to symptomatic likes vomiting, abdominal distension, constipation, or sub-acute or acute intestinal obstruction. Rotational anomalies occur due to the arrest of normal rotation of the embryonic gut. Intestinal malrotation occurs when the normal embryological process of bowel rotation happens incorrectly or incompletely. Malrotation of gut was diagnosed by clinical features plus contrast radiograph and/or laparotomy. Our patient 40 days old infant presented with recurrent choking attack after breastfeeding with fever, cough, and respiratory distress. Infant was treated a case of aspiration pneumonia with gastroesophageal reflux, with keeping in mind trachea esophageal fistula and achalasia cardia like rare entity after exclusion of common etiology of choking. Pneumonia improved by treatment but choking persisted. Finally it was diagnosed as a case of partial malrotation of upper gut per-operatively. BANGLADESH J CHILD HEALTH 2021; VOL 45 (1) : 51-54

Background Percutaneous transvenous mitral commissurotomy (PTMC) is the standard of treatment for symptomatic severe rheumatic mitral stenosis (MS). PTMC has the standard Inoue technique, but we have to modify the procedure in many technically challenging cases, especially to cross the mitral valve. Methodology Two over-the-wire strategies to enter the LV were taken in 80 complex cases of PTMC. The first one was done by exchanging the J-shaped wire from the balloon, introducing the spring wire into it, and pushing it into LV. The second one-removal of balloon keeping the spring wire in LA and the Mullin's sheath was introduced, and the tip of the wire was pushed into LV, and the balloon was introduced over the wire. We also changed the left atrium (LA) graphy in the RAO view instead of the AP view to facilitating entry into LV. Results We succeeded in 76 (95 %) cases. Strategy one was applied to all but successful in only 25 cases (31 %), and strategy 2 was applied in the remaining. Strategy 1 required less procedural time and fluoroscopic time in comparison to strategy 2 (40 ± 10 vs 60 ± 16 min, 25 ± 7 vs 35 ± 8 min). After modification of taking the LA graphy in RAO view, our rate of facing the difficulties decreased from 21 % to 9 %. Critical MS (31 %) and the giant LA (30 %) were the topmost causes of difficulties. No major complications were recorded. Conclusion Over-the-wire entry into LV is cost-effective, requiring no new equipment and is safe and can be used in complex cases.

Ultrasonography is a safe and effective method of diagnosing early pregnancy and determining the position of the gravid uterus. 2080 pregnant women with amenorrhea for three months and a positive pregnancy test were chosen. The study was conducted in the Radiology & Imaging department of Failaria & General Hospital from Jan 2016 to Dec 2019. Results were presented in tables and charts and expressed as percentages and average. The objective of our study is to investigate the Sonographic findings of first trimester pregnancies detecting the retroverted gravid uterus, normal, abnormal and complicated pregnancies. In the present study out of 2080 pregnancies. In our study, 190 (9.13%) of the 2080 pregnancies with sonographic diagnosis were fetal losses. The diagnosis of early normal intrauterine pregnancy (IUP) was 1890 (90.87%), Incomplete abortion 95 (4.57%), Missed abortion 35 (1.68%), Blighted ovum 39 (1.88%), ectopic pregnancy 14 (0.67%) and Hydatiform mole 7 (0.34%) cases.

Background: Metabolic Syndrome is already one of the major public health problems around the world; it may be more grievous when associated with any cardiac emergency like myocardial infarction (MI). Objective: To evaluate the association of metabolic syndrome and its angiographic effects on patients with Acute ST-Elevation Myocardial Infarction (acute STEMI). Methods: This prospective observational study was done in the Department of Cardiology of the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, between July and December of 2013. A total 233 patient were selected for data collection; of them 109 were in group I (acute STEMI patients with metabolic syndrome) and 124 in group II (acute STEMI patients without metabolic syndrome). Initial evaluation of the patients was done by history taking and clinical examination. Baseline investigations like ECG, CK(MB), lipid profile, fasting blood sugar, serum creatinine and echocardiography were done. Coronary angiogram (CAG) was done in the Cardiac Cath-Lab facility of the same hospital. Data was analyzed by using SPSS version 16.0. Comparison between groups was done by unpaired t-test, while categorical data was analyzed with Chi-square (c2) test. Results: In patients with metabolic syndrome (group I), most of them (68.9%) had more than 2 metabolic components out of 4; the combinations were: high TG + low HDL (54.6%), DM + high TG (46.9%), raised BP + high TG (38.5%), DM + low HDL (33.6%), raised BP + low HDL (26.4%) and raised BP and DM ( 24.3%).ECG shows that the inferior wall acute myocardial infarction (MI) was 41.28% and 44.55% in group I and group II respectively, while anterior wall was involved 58.71 % and 55.65% cases respectively, which was not statistically significant. Heart failure was significantly more in patients of group I than group II (46.79% vs. 20.97%; p

Heavy metal contamination in soil is considered a global crisis and its bulk proportion are in developing countries like Bangladesh. Five heavy metals such as Cd, Cr, Pb, Cu and Ni were investigated in the soil of Savar tannery industrial estate. The decreasing trend of metals was observed in soil as Cr>Cu>Ni>Pb>Cd. According to US EPA guideline, Cr was heavily polluted at the selected locations. Cu was highly polluted, whereas Cd and Pb were not polluted and Ni was moderately polluted. On the basis of Pearson’s correlation Cd-Pb, Cd-Cu, Cu-Ni, Ni-Cu, Ni-Pb were significantly correlated. From the pollution index, metal pollution of sediments was found in the order as Cr>Cu>Pb>Cd. Degree of contamination and modified degree of contamination were higher in the dumping zones. The geo-accumulation index for Cr showed moderate to extremely contaminated. Ecological risk arrayed in the order of Cr>Cu>Ni>Pb>Cd in the soil of study area. Geographic information system (GIS) was also used to map the spatial distribution of heavy metal contamination in the soil. This study recommended that continuous monitoring of heavy metal contamination should be directed to assess their risk in the soil of tannery industry at Savar. Chemical Engineering Research Bulletin 21(2020) 106-113

Introduction: Acute viral hepatitis (AVH) incidence had suddenly increased at Artillery Centre and School (AC&S) at Halishahore under Chattogram (Ctg) cantonment area from 16 April 2018 to 25 June 2018. Total 1304 cases of AVH got admitted and received treatment from Combined Military Hospital (CMH), Ctg during that period. Aim: To find out the incidence, cause, predisposing factors, clinical course and to prevent such outbreaks in future. Methods: This retrospective observational study was conducted from 16 April 2018 to 25 June 2018. Total 1304 acute viral hepatitis cases were studied for epidemiological analysis to find out the causes, mode of spread, laboratory findings and outcome. Results: Among 1304 AVH cases 90% belonged to age group of 18-45 years and most of them were combatants and the age range was 5 to 60 years with mean age 30.31±11.29 years. HEV was 99% etiological factor and patients’ hospital stay were 10 to 55 days. Thirteen cases developed hepatic encephalopathy, 01 case developed acute pancreatitis and 108 cases had thrombocytopenia. No specific source of contamination was detected within AC&S, although coliform bacteria were identified in drinking water supplied to the area by WASA of Ctg city. Conclusion: We came to the conclusion that the source of infection was contaminated water supplied by WASA of Chattogram city. As we had also found that high incidence of AVH due to HEV were prevailing in Ctg city area during the same period of the outbreak. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 3-7

Introduction: Noise-induced hearing loss is a significant, often unrecognized health problem among the military pilots. Advanced aircraft are powerful and more efficient but generate high noise causing noise-induced hearing loss (NIHL) among military pilots. Aim: To determine the prevalence of noise-induced hearing loss among pilots of the Bangladesh Air Force (BAF) and its association with aircraft type and flying hours. Methods: This cross-sectional study was carried out at Central Medical Board (CMB), Bangladesh Air Force (BAF) Dhaka from April 2017 to March 2018. The audiometry was done in the ENT department of CMB, BAF. Pure-tone audiometry was used to measure hearing thresholds and following pure tone frequencies were used for the test: 0.25, 0.5, 1, 2, 3, 4, 6 and 8 kHz. The association between flight hours and the development of noise-induced hearing loss was analyzed in the different age groups. Results: The study revealed NIHL in the aircrew was 16.5% with a higher prevalence among the helicopter pilots (18.6%) as compared with fighter (16.7%) and transport (11.5%) pilots. The left ear was affected in most of the cases than the right ear. Pilots of more than 40 years old and ≥1500 flying hours had a significantly higher hearing threshold compared with other categories. Conclusion: Exposure to noise in aircrew is unavoidable. By avoiding prolonged exposure to loud noise environments and utilization of personal hearing safety devices can prevent noise-induced hearing loss. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 12-15

Mucormycosis is an invasive fungal infection caused by different saprophytic environmental fungus occurring predominantly among immunosuppressed patients. Pulmonary mucormycosis is the second most common form after rhino-cerebral mucormycosis and may accompany with other infections. Coronavirus disease 2019 (COVID-19) itself and its treatment with immunosuppressive drugs and oxygen delivery systems etc. are setting the scenes for opportunistic and co-infections with fungus and other pathogens. A middle aged Bangladeshi man, with background diabetes mellitus, hypertension, bronchial asthma and COVID-19, presented with fever, respiratory symptoms and cavitary lung lesion. Diagnostic work-up confirmed pulmonary mucormycosis and he responded with liposomal amphotericin B. To the best of our knowledge, this is the first case of post-COVID mucormycosis reported from Bangladesh. Bangladesh J Medicine July 2021; 32(2) : 156-160

Background: Diagnosis of extra-pulmonary tuberculosis (TB) is often delayed because of diverse clinical presentations and difficulties in establishing the bacteriological diagnosis. This study aimed to evaluate usefulness of GeneXpert MTB/RIF in the diagnosis of extra-pulmonary TB in Bangladeshi patients. Methods: This cross-sectional study was done in BIRDEM General Hospital, Dhaka, Bangladesh from 2013 to 2016 as a part of Bangladesh Diabetic Somiti (BADAS)-USAID-TB Care-II project. Representative samples from 590 clinically suspected extra-pulmonary TB cases were tested for GeneXpert MTB/RIF along with conventional methods. Results: Total patients were 590 [mean age 43.9 (range 1-95) years] with male predominance (326, 55.3%). Most (513, 86.9%) patients were diabetic and new (574, 97.3%) TB suspects; while 16 (2.7%) patients had past history of TB. Common samples were pleural fluid (125, 21.2%), urine (110, 18.6%), cerebrospinal fluid (CSF) (91, 15.4%), pus (82, 13.9%), tracheal aspirates (57, 9.7%), ascitic fluid (45, 7.6%), gastric lavage (31, 5.3%), broncho-alveolar lavage (BAL) (18, 3.1%), lymph node aspirates (11, 1.9%) and synovial fluid (8, 1.4%). Among 590 samples, 68 (11.5%) were positive for Mycobacterium tuberculosis. Diagnostic yield was common for lymph nodes (4/7, 57.1%), pus (25/82, 30.5%), BAL (4/18, 22.2%), tracheal aspirates (8/57, 14.0%), urine (7/110, 6.4%), CSF (6/91, 6.6%) and pleural fluid (7/125, 5.6%). Of the 68 GeneXpert MTB/RIF positive samples, 52 (76.1%) were rifampicin sensitive, 16 (23.9%) showed intermediate sensitivity and none of the samples was resistant to rifampicin. Conclusions: GeneXpert MTB/RIF appeared as useful tool for diagnosing extra-pulmonary TB. Birdem Med J 2021; 11(2): 121-124

Background & Objective: The purpose of the study was to evaluate the clinical presentation and severity of community acquired pneumonia in adults. Methods: The present cross-sectional study was conducted in Sir Salimullah Medical College & Mitford Hospital, Dhaka over a period of 1 year. Patients admitted with the symptoms and signs suspected of pneumonia and confirmed by clinical examination and necessary investigations were the study population. The baseline characteristics, patients’ behavioural factors, presenting complaints, co-morbidities, examination findings and investigations were recorded. Data were processed and analyzed using software SPSS (Statistical Package for Social Sciences), version 11.5. The test statistics used to analyze the data were descriptive statistics. Result: In the present study, a large proportion of patients were 50 years or more than 50 years with mean age of the patients being 46.4 ± 13.3 years. A male predominance (58%) was observed in the series. Over half (56%) of the patients was smoker and 8% were alcoholic. Fever (90%) and purulent sputum (70%) were the common complaints. The second most common complaints were chest pain and haemoptysis (each of 44%). Thirty eight percent of the patients had dyspnoea and a very few had other symptoms. Eighteen percent of the patients had COPD, another 18% had diabetes and 4% had cardiac insufficiency. About one-quarter (24%) of the patients had agitation stupor, 88% bronchial breathing and 68% crackles. Right lower lobe (31%) and right middle lobe (26%) were commonly affected by pneumonia of the patients detected with a chest X-ray. Assessment of severity pneumonia by CURB-65 score shows that 83% of the patients had mild (score 0 – 1) CAP, 12% had moderate (score 2) and 5% had severe CAP (score 3 or more).Over two-thirds (68.5%) of the patients exhibited positive sputum for Gram’s stain. Conclusion: The study concluded that CAP is more likely to occur in older males with preexisting comorbidities like diabetes and COPD. Fever and purulent cough are the predominant presentation of CAP followed by chest pain and haemoptysis. Pneumonic consolidation on chest X-ray and +ve gram stain are diagnostic of CAP, while raised total count of WBC with neutrophilic leucocytosis are supportive to it. Assessing pneumonia severity by CURB-65 scoring system revealed that severe pneumonia (score 3 or more) is now a rarity. Patient evaluation should focus on severity of illness, patient age, comorbidities, clinical presentation, epidemiologic setting, and previous exposure. The majority of patients with CAP are treated empirically based on the most common pathogen(s) associated with the condition. Ibrahim Card Med J 2020; 10 (1&2): 51-56