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Objectives: To analyze post operative complications, local recurrence, functional outcome of speech & swallowing and survival rate following total laryngectomy. Methods: This prospective observational study was done in four major tertiary care medical college hospitals of Bangladesh from July 2000 to December 2019. All operations were done by a single surgeon, one of the authors of this study based on the personal experience. 45 patients were selected who underwent total laryngectomy for biopsy proven advanced (T3 and T4) laryngeal cancer as primary case & recurrent cases following radiotherapy. Patients were followed up monthly for three months and then six monthly for two years and yearly for rest of their life. Results: Age of the patients ranged from 42 to 80 years with mean age 56.7 years. In postoperative period 03 (6.6%) patients developed wound infection, 03 (6.6%) stomal stenosis, 03 (6.6%) stomal recurrence, 02 (4.4%) seroma, 02 (4.4%) pharyngo-cutaneous fistula and 01 (2.2%) case developed pharyngeal stenosis. In post laryngectomy voice rehabilitation 33 (73.3%) cases used esophageal voice, 07 (15.5%) cases used electrolarynx and 05 (11.1%) cases used bloom singer valve. Out of oesophageal speech, 2 patients had poor speech, Regarding swallowing all patients had very good swallowing except one patient who got pharyngeal stenosis, needed dilation. 3 patients died in subsequent 2 years follow-up and overall survival was 93.3%. Conclusion: Outcome of total laryngectomy depends on site and size of tumour, nodal metastases, recurrent cases and co-existing co-morbidities. Total laryngectomy with or without radiotherapy offers significantly higher local control and survival benefit with advanced laryngeal cancer, compared to radiotherapy only. Bangladesh J Otorhinolaryngol 2021; 27(2): 139-144

A case of full thickness defect involving left ala of nose reconstructed with nasolabial flap for the coverage of skin and mucosal lining, along with simultaneous insertion of septal cartilage, which completes the reconstruction. Bangladesh J Otorhinolaryngol 2021; 27(2): 184-187

Objective: The incidence of thyroid cancer has rapidly increased in the United States (US) and other developed countries over the past 30 years but there is no study to find out the true incidence of thyroid cancer in Bangladesh. The aim of this study is to compare FNAC with histopathology reports and to find out the true incidence of thyroid malignancy in thyroidectomy patients presenting with thyroid swelling. Methods: This is a prospective study of 200 thyroid swelling patients underwent thyroid surgery done at Shaheed Suhrawardy Medical College Hospital, a tertiary Care Hospital in Dhaka from July 2017 to December 2020. FNAC and histopathology reports were studied to find out the incidence of benign and thyroid malignancy among the thyroid swelling. Results: The age of the patients ranged from 8 to 75 years. The mean age was 37.2 years. There were 156 female and 44 male patients with female male ratio 3.54:1. Diagnostic categorization of 200 thyroid swelling underwent surgery, FNAC based on Bathesda classification showed that 163 (81.5%) cases were cytologically benign, 37 (18.5%) cases were malignant category. Out of 200 cases histopathology showed134 cases(67.0%) are benign and 66(33.0%) are malignant thyroid swelling. Among the benign lesions96.31% are colloid goiter and among the malignant lesions 93.4% are papillary thyroid carcinoma. Conclusion: Although FNAC is an essential diagnostic test to rule out thyroid malignancy but histopathological examination is the only way to give true incidence of thyroid malignancy among the thyroid swelling and it is observed that there is high incidence of thyroid malignancy(33.0%) among the thyroid swelling patient underwent thyroid surgery. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 12-16

Background: Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) is in Pandemic form and has affected people of 215 countries. It produces symptoms like fever, cough, shortness of breath, sore throat, headache, loss of taste, smell or appetite and many other rare symptoms. But the most important symptom is shortness of breath due to hypoxia. In a normal individual oxygen saturation (SpO2) is at least 95% and patient feels shortness of breath when SpO2 falls below 90% with some exception. SARS-CoV-2, a newly emergent coronavirus has the peculiarity to produce silent hypoxia, meaning SpO2< 90% or less like 80%, 70%, 60% without shortness of breath. Silent hypoxia can be diagnosed by monitoring SpO2 with pulse oximeter. For management of COVID-19, early symptoms like fever & cough, SpO2 should be monitored by pulse oximeter, followed by immediate correction of hypoxia by O2 supplementation and prophylactic oral or injectable anticoagulant to prevent thromboembolism and thus death rate can be reduced. Case summary: A 72-year-old man presented with the complaints of fever and headache followed by cough, fatigue, anorexia, loss of taste and appetite in next few days but no shortness of breath. The patient was clinically diagnosed as a case of COVID-19 & positive result of Real time-Polymerase Chain Reaction (RT-PCR) test confirmed the diagnosis. From the first day, SpO2 was regularly monitored with pulse oximeter and SpO2 on day 1, it was 96-98%. On day 8, SpO2 fell to 89-93%, pulse 96/min, respiratory rate>30/min, temperature 101o F, taste sensation was reduced. According to sign and symptoms, the patient was diagnosed as COVID-19 with severe pneumonia. Management was started at home with continuous monitoring, lying in prone position for 5-6 hours/day, supplemental oxygenation to maintain level of SpO2 between 94-96%, injectable anticoagulant enoxaparin to prevent venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC) was given. Prophylactic antibiotics and symptomatic treatment were also given. Results: According to this case report, patient’s SpO2 was monitored by pulse oximeter on first day; on day 08, SpO2 fell to 89-93% & on day 10, further dropped to 85-88% which indicated severe pneumonia but there was no complaint of breathlessness as it was silent hypoxia. Sometimes the patient spent 30 minutes or more in toilet and SpO2 used to fall to 82-83% without any subjective shortness of breath but with only mild heaviness of chest and cough. Therefore SpO2 monitoring by pulse oximeter is essential in early diagnosis of silent hypoxia. Correction of hypoxia by supplemental oxygenation and prevention of VTE and DIC by using anticoagulant was the mainstay of treatment and patient had significant improvement on day 14. The patient was managed completely at home except X-ray being done in a hospital. Conclusion: Fall of SpO2 in COVID-19 i.e. hypoxia (usually present as shortness of breath) or silent hypoxia can be diagnosed early by pulse oximeter or smart phone pulse oximetry apps. Early management by isolation, supplemental oxygenation and oral/injectable anticoagulation can prevent further events like Acute Respiratory Distress Syndrome (ARDS), respiratory failure followed by multiple organ failure (that may cause death). The authors advocate further clinical trial and research. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 55-67

Introduction: Loss of balance causes the sensation of vertigo. Balance is maintained by vestibular afferent from labyrinth, eyes and proprioceptors and their central integration. For diagnosis of vertigo, along with history different vestibulometric tests can be done to identify the specific anatomical part that is involved. Material and methods: A cross sectional study was done among 82 patients who did video Head Impulse Test (vHIT) and among 75 patients who did Vestibular Evoked Myogenic Potential (VEMP) test at AudiovestibularCentre(AVC) at Bangladesh ENT Hospital Ltd. during the period from April 2018 to September 2019. Results: Age range of the sample was 16 to 80 years. Among the 82 patients who did vHIT 62(75.6%) had abnormality in either Semi Circular Canal. Among 75 patients who did VEMP 27(36%) were detected to have abnormality in either in saccule or utricle. Conclusion: For diagnosis of cause of vertigo the appropriate test for individual part of vestibule is essential. vHIT and VEMP are two tests which are complementary to each other in explaining common peripheral causes of vertigo. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 5-9

Mesenchymal Chondrosarcomas of the parotid are extremely rare tumours. They are broadly classified under extra skeletal form of mesenchymal chondrosarcomas and account for less than 1% of all sarcomas. It is characterized by a multinodular architecture, abundant myxoid matrix, and malignant chondroblast like cells arranged in cords. The tumor is an entity from chondrosarcomas of bones, commonly found in the soft tissues of the lower extremities at 80%. There are very limited reports of this tumor in the head and neck, especially in the parotid gland. We report a rare case of a parotid mesenchymal chondrosarcoma in a 55 years old man and discuss the pathogenesis, clinical presentation and management of such a rare tumour Bangladesh J Otorhinolaryngol; October 2020; 26(2): 158-160

This prospective study was carried out in the Department of ENT and Head Neck Surgery, Sheikh Hasina medical college, Tangial, Bangladesh in a period of 6 months from January 2017 July 2017 among those complaining hearing loss attending in ENT out patient department. The aim of the study was to find the out pattern of hearing loss and hearing level comparison between noisy area (such as bazaar, bus stands, factory, school etc) to silent area. In this study 103 cases of hearing impaired people were taken and the data were collected by interviewing the cases as per questionnaire from history, examination and investigation report. Working place of most of the hearing impaired people was in noisy area 88 (85.4%). Among them most of the patients was male (58%) and female was (42%) and male:female ratio 1.4:1. The commonest type of hearing loss was sensorineural type. In the right ear 55 cases (53.4%) of sensorineural type deafness, 19 cases (18.4%) of mixed type of deafness and 21 cases (20.4%) of conductive type deafness. In the left ear 46 cases (47.7%) of sensorineural type deafness, 18 cases (17.5%) of mixed type deafness and 24 cases (23.3%) of conductive type deafness. This study showed that male (58%) were mostly affected than female (42%) and vehicle drivers (25.5%) were commonest group of people. From this study we got both ears were involved by disease process in 77.6% of patients and only right ear was 14.6% and only left ear was 10% of the patient of hearing loss. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 159-163

Background: Cervical cancer remains a major public health problem worldwide – particularly in less developed countries. Around 85% of their new cases and 86% of deaths occur in less development countries (IARC, 2012). In Bangladesh, Cervical cancer is the second most common disease among female with an estimated 11,956 new cases and 6,582 deaths in 2012. Objectives: The present study was undertaken to identify the Effects of Human Papillomavirus infection with Pre-invasive cervical lesions in Bangladesh. Methods: This cross sectional study was carried out at the colposcopy clinic of Gynaecology and Obstetrics department of Bangabandhu Sheikh Mujib Medical University during the study period January 2015 - December 2015. A total of 65 consecutive women with VIA +ve cases of all three grades of CIN (CIN I, CIN II, CIN III) were enrolled in this study. Women having invasive cervical disease and women who not interested were excluded from this study. Results: More than one third (35.3%) patients were in 3rd decade. More than one third (35.4%) patients had normal colposcopic findings followed by 23(35.4%) was CIN I, 11(16.9%) was CIN II and 8(12.3%) was CIN III. Majority (42.6%) patients was found CIN I, 11(26.1%) was CIN II, 8(19.4%) was CIN III and 5(11.9%) had normal in Histopathology. CIN I histopathological finding was found 18 cases, among them 8(44.4%) in positive HC-2/Viral load/ RLU index. In multivariate analysis CIN III was significantly increased 1.34 times in HC-2/Viral load/RLU index positive (human Papillomavirus) cases (95% CI 0.22 – 8.9%

Background: Myringoplasty is one of the surgical techniques for the management of chronic suppurative otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction. Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery. Materials and Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. A total of 100 patients with dry central tympanic membrane perforations of various sizes were included in this study. Results: Myringoplasty was performed in total of 100 patients. Male were (45%) and females were (55%). Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases. Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 99-102

This cross-sectional study was conducted to find out the views of some stakeholders in regarding the current quality assurance activities in different government and non-government dental institutions of Bangladesh. Students, intern doctors, teachers and head of the institutions were the respondents. Semi-structured self-administered questionnaire, interview schedules and a checklist were used for data collection. The sampling technique was convenience and purposive. The study was conducted in 2015 and 2016. The study revealed that teachers were satisfied with the overall educational environment, but students are not certain about this mater and the students' opinion were negative in regards to hostel and library facilities. Only few teachers were engaged in research activities in which authorities do not provide any assistance. Almost all dental institutions are deficient in their quality assurance activities. Other than academic council most of the quality assurance bodies are absent or non-functioning. The study recommends that quality assurance activities in undergraduate dental institutions in Bangladesh should be strengthened and it should be evaluated by the national quality assurance body.Bangladesh Journal of Medical Education Vol.8(2) 2017: 7-11

Background: For the first 20 years or so after formal education in dentistry commenced at Glasgow in 1879, the manner of learning technical and clinical procedures was little different from what it had been since immemorial. In other words dental students learned by watching others until it was felt that they could be trusted to perform the procedure themselves. Rationale: The intern year is the first level of hands-on training in dentistry and is an essential step in every dental surgeon's career. Opportunity to apply, consolidate and expand one's clinical knowledge, skills and also progressively increase one's responsibility for providing safe, high-quality patient care. Opportunity to develop overall patient management skill especially for the general dental practitioner. The intern year should provide a balance between education, training and clinical responsibility, enabling interns to develop the professional and personal competencies that result in good patient care and provide a foundation for lifelong learning. Objectives: The present study was undertaken to identify the Competency based internship training programme in undergraduate dental education in Bangladesh: Clinical teachers and intern doctors' perception Methods: This descriptive type of cross sectional study was conducted in six public and private dental colleges of Bangladesh. A semi-structured questionnaire based on 5-point Likert scale was used to collect the clinical teachers and inter doctors' perceptions. The semi-structured questionnaire was prepared on the basis of logbook based internship training programme. Before administering the questionnaires to the respondents the investigator gave them an introductory idea about the purpose of the research. Results: competencies acquired by the intern doctors were satisfactory but some problematic areas such as less duration of training period, no community placement, availability of training aid, lack of supervision as well as feedback etc were highlighted which interfered in achieving their satisfaction on their competencies. Conclusion: To ensure excellence in all aspects of internship training programme, it can be concluded that intern doctors must need to acquire sufficient competencies in most of the clinical areas for their daily practice. There are many areas for further improvement through evaluating and developing the internship training programme as well as the logbook and strengthening the clinical environment in the institutes. Bangladesh Journal of Medical Education Vol.8(1) 2017: 9-13

Background: Bachelor of dental surgery course curricula need to be constantly analyzed and evaluated in order to offer dental courses in accordance with current technical innovations of dentistry as well as the demands of community oral health. Under the assumption that it is important to comprehend some students' perceptions, the present study aims to analyze students' perceptions regarding dental courses, embracing the academic environment, and describe the current scientific published literature about this research object. Specifically, it aims to access and synthesize the scientific knowledge involving students' perceptions regarding dental courses, by means of constructing thematic categories classifying its levels of evidences. Objectives: The present study was undertaken to identify the teachers and students perception about the present status of undergraduate dental curriculum in Bangladesh. Methods: This descriptive type of cross sectional study was conducted in seven public and private dental colleges of Bangladesh after getting written permission from the principal of the respective dental colleges. Voluntary participation of the students was ensured and the names of the students' as well as teachers were kept confidential. The teachers and students of final years from the different dental colleges were the study population; among them four hundred (400) students and one hundred twenty teachers (120) were taken as sample by convenient sampling. Data collection instrument was a semistructured questionnaire with 5-point Likert scale with maximum score 5 and minimum score1for final year students' and in depth interview was used for teachers. Results: 87% teachers mentioned that the total hours for practical/clinical classes in individual subject are inadequate. 63 % teachers mentioned that the total hours for lecture classes in individual subject are inadequate . The overall results regarding the competency acquired by the newly passed dental graduate from the BDS course was satisfactory but some problematic areas were highlighted which interfered in achieving their satisfaction on their competencies Conclusion: In this study, the students reported that they have acquired greater practical and clinical experiences in few areas from the curriculum of BDS course. The majority of the students were not satisfied on their acquired competencies in most of the areas after their graduation. This was due to shortage of course duration in comparison to number of subjects and contents, improper distributions of the subjects, inadequate duration of community placement, less allocation of hours in practical and clinical classes etc. According to their opinion, lack of supervision and feedback in the clinical class, improper method of clinical assessment system of the students in all level are the responsible factors so that the students were not satisfied with the overall undergraduate BDS curriculum. Bangladesh Journal of Medical Education Vol.7(2) 2016: 28-33

This cross sectional descriptive study was conducted among the health policy makers, health administrators, doctors including medical teachers, intern doctors, clinically exposed medical students and patients. The study was conducted at government and non government medical colleges of Dhaka and outside Dhaka from 1st July 2014 to 30th June 2015. Total respondents were 372 and information was collected through in-depth interview schedule and self administered semi structured questionnaire. The qualitative information was collected from health policy makers including administrators by in-depth interview which was complimentary to the findings obtained by self administered semi structured questionnaire. Out of 372 respondents 280 (75.3%) and 92 (24.7%) were engaged in government and non- government hospitals/ organizations respectively. Among the respondents 164 (44.1%) agreed and 98 (26.3%) strongly agreed that introduction of licensing examination for the medical and dental practitioners are justified in the present context of Bangladesh. Of the total, 294 (79%) agreed and 40 (10.8%) strongly agreed that licensing examination shall be useful for individual professional development and also agreed that this will help in overall professional development, shall improvement of professional competency and shall enrich doctors with updated professional knowledge. Majority of the respondents (70.6%) mentioned that doctors may not be interested. Of the same respondents 99.1% opined that the registration shall be on the basis of degree or the examination shall only be for person graduated from abroad or foreigner graduates. About 73% respondents were in agreement with 5 years validity period for an examination. Of the total 84.4% respondents agreed that the examination will improvement of standard of medical and dental education offered by all medical and dental colleges of Bangladesh. There are many direct and indirect benefits of introducing licensing examination for the registration of medical and dental graduates/practitioners and there are a few barriers to implement that too.Bangladesh Journal of Medical Education Vol.8(1) 2017: 2-8

Background: Curriculum planning and designing is not a static process, rather a continuous process done regularly through a system. More than one decade have elapsed since the Centre for Medical Education (CME), in 1988, developed a national Undergraduate Dental Curriculum which was supposed to be community-oriented and competency based. The curriculum was partially implemented with the advancement of dental health science and application of newer techniques in dental practices in developed and developing countries. Rationale: A healthcare curriculum must be up-to-date, fit for purpose and relevant to the population it serves wherever that population might be, worldwide. It needs to assess the general and dental health needs of our local population and to propose a set of core skills of the dentists will need on graduation and in the future. The Health Science including Oro-dental science is changing with the advancement of health science, educational science & applied technology. Global changes are happening in health science and dental education in accordance and conformity of these advancements and changes. With the application of these knowledge and skills of dental science, future dentists should satisfy their patients with the changing needs of the community. The need to develop a community-oriented and competency-based curriculum was felt by all concerned. Objectives: The present study was undertaken to identify the Opinion of Bangladeshi teachers and undergraduate clinical students regarding the course duration of BDS curriculum. Methods: This descriptive type of cross sectional study was conducted in seven public and private dental colleges of Bangladesh after getting written permission from the principal of the respective dental colleges. Voluntary participation of the students was ensured and the names of the students' as well as teachers were kept confidential. The teachers and students of final years from the different dental colleges were the study population; among them four hundred (400) students and one hundred twenty teachers (120) were taken as sample by convenient sampling. Data collection instrument was a semistructured questionnaire with 5-point Likert scale for final year students' and in depth interview was used for teachers. Results: The study revealed that the 98% teachers mentioned that the course duration (4 years) in comparison to number of subjects and contents was not adequate and 98% teachers' opinion was that the total course duration should be 5 years. Nearly 75% of students mentioned that the total course duration should be 5 years. Conclusion: In this study, the students reported that they have acquired greater practical and clinical experiences in few areas from the curriculum of BDS course. The majority of the students were not satisfied on their acquired competencies in most of the areas after their graduation. This was due to shortage of course duration in comparison to number of subjects and contents, improper distributions of the subjects, inadequate duration of community placement, less allocation of hours in practical and clinical classes etc. Bangladesh Journal of Medical Education Vol.8(1) 2017: 18-21

Background: For the first 20 years or so after formal education in dentistry commenced at Glasgow in 1879, the manner of learning technical and clinical procedures was little different from what it had been since immemorial. In other words dental students learned by watching others until it was felt that they could be trusted to perform the procedure themselves. Rationale: The intern year is the first level of hands-on training in dentistry and is an essential step in every dental surgeon's career. Opportunity to apply, consolidate and expand one's clinical knowledge, skills and also progressively increase one's responsibility for providing safe, high-quality patient care. Opportunity to develop overall patient management skill especially for the general dental practitioner. The intern year should provide a balance between education, training and clinical responsibility, enabling interns to develop the professional and personal competencies that result in good patient care and provide a foundation for lifelong learning. Objectives: The present study was undertaken to identify the clinical teachers and intern doctors' perception about the effectiveness of ongoing internship programme in undergraduate dental education in Bangladesh. Methods: This descriptive type of cross sectional study was conducted in six public and private dental colleges of Bangladesh. A semi - structured questionnaire based on 5-point Likert scale was used to collect the clinical teachers and intern doctors perceptions. The semi-structured questionnaire was prepared on the basis of logbook based internship training programme. Before administering the questionnaires to the respondents the investigator gave them an introductory idea about the purpose of the research. Results: The study revealed that the majority of the clinical teachers 97.4% mentioned that the duration of internship training programme (one year) is not adequate and according to 94.9% teachers' opinion the duration of internship training programme should be 2 years. On the other hand 87.4% intern doctors mentioned that the duration of internship training programme (one year) is not adequate 94.6% intern doctors mentioned that the duration of internship training programme should be two. Majority 55 % of the teachers mentioned that the training environment was almost supportive. Majority of the intern doctors mentioned that the environment was supportive to ensure adequate patients service. Conclusion: To ensure excellence in all aspects of internship training programme, it can be concluded that intern doctors must need to acquire sufficient competencies in most of the clinical areas for their daily practice. There are many areas for further improvement through evaluating and developing the internship training programme as well as the logbook and strengthening the clinical environment in the institutes. Bangladesh Journal of Medical Education Vol.7(2) 2016: 23-27

Objectives: To evaluate 113 cases of nasal foreign body removal with regard to type of foreign body, location, complications, techniques for removal, age , genderand to present the results of theevaluation. Methods: Between April 2009 to May 2011, a total of 113 nasal foreign bodies were attended inOutpatient Department ofENT, Head and Neck Surgery in Sir Salimullah Medical College, MitfordHospital,Dhaka. A retrospective reviewwas undertaken to evaluate the parameters related to the nasal foreign body and their removal and the data wereanalyzed. Results: 113 cases of nasal foreign bodies were attended in Outpatient department of ENT, Head and Neck Surgery in Sir Salimullah Medical College, Mitford Hospital, Dhaka. Of these 113 cases, 101cases were removed in outpatient department and 12 cases were admitted and were removed under general anaesthesia. We found higher incidence in patients between ages 2 and 5 years. The distribution of nasal foreign body was 44.25% in male and 55.75% in female. Conclusion: Nasal foreign bodies are encountered daily in our routine clinical practice in the pediatric age group. General anaesthesia is required in uncooperative agitated patients or impacted foreign body to avoid complications.Button batteries and penetrating foreign body must be treated immediately. Bangladesh J Otorhinolaryngol; October 2015; 21 (2): 102-109

Diabetes has demonstrated as the main chronic disease and crucial problem in Bangladesh. According to a data of International Diabetes Federation (IDF) Bangladesh is the 10th in terms of diabetes patients in the world and diabetes prevalence in Bangladesh would reach from present 7 to 12 million by 2035 posing a colossal challenge to the health care system. People of all ages are being affected with diabetes, which has become a silent killer. Objective of this study is to develop a module with assistance of doctors and CE/BME which will be used to identify the actual number of diabetes patients and measure the potential risk on health index. The goal of this study is to bring as much people as possible within survey and find the potential diabetic patients together with the peoples who might not have diabetes now but possess the credible risk factors. We will be able to provide preventive information to these populations and motivate and suggest for more care on individual health to avoid diabetes. An optimized software and database is designed for performing several tasks to analyze the patients’ data collected from various hospitals’ of Bangladesh. The numerical statistic will represent the overall patients’ health index for diseases and assessment will allow us to determine the actual patients’ number with appropriate threat in categories of diabetes diseases. Findings can confirm both individuals with diabetes and the control group with possible diabetes threat. Proper Diagnosis and treatment then can be assured for these individuals and national precautionary action will accomplish through regulatory control. Future assessment and intervention can be further explored from the perspectives of patients and diabetes information processing which can improve the patients’ indexing, safety and health care management in many developing countries.

In this prospective study 30 case of CSOM with cholesteotoma, admitted in 3 tertiary level hospitals, where modified radical mastoidectomy with type III tympanoplasty were done, then results of operation were assessed in follow up. The objectives of study to assess the clearance of disease, recurrence of disease and the cavity problem and to find the take rates of graft and improvement of hearing level after surgery. In this study most of the cases were younger age group (40%), male (60%), poorsocio- economic condition (73:33%), Illiterate (46.67%), day laborer (26.67%) & rural peoples (80%). It was observed that hearing status was improved 46.67%, unchanged 33.33% and deteriorated 20% cases. The mean, hearing gain was 10.79 dB. Also post mastoidectomy discharging ear was 20%, facial palsy 3.33%, recurrence of cholesteatoma 13.33%, dead ear 0%. Early detection and management of CSOM with cholesteatoma should be our goal to prevent complications. If good tympanomastoid surgery is done meticulously there will be improvement of hearing and less complications. DOI: http://dx.doi.org/10.3329/bjo.v20i1.22013 Bangladesh J Otorhinolaryngol; April 2014; 20(1): 20-26

Objective : To find out the clinical presentation of metastatic neck node with unknown primary. Methods : A cross-sectional study done on the admitted patient from four tertiary level hospitals in Dhaka city from January 2010 to September 2010. Results : Most of the cases were squamous cell carcinoma (68.75%). the next common was adenocarcinoma (15.62%) and undifferentiated carcinoma (12.5%). Melanoma was a rare condition (3.13%). The commonest age group was 6th decade (40.63%) which was followed by 5th decade (28%). None of the case was found bellow the age of 30 years. The male to female ratio was 2:1. Commonest metastatic group of lymph node was Level II (50%), followed by Level- III (22%) Level- IV (19%), Level- V (6%) and Level- I (3%). Staging of lymph nodes were N2A (35%), N1 (31%), N2B (16%), N3 (12.5%) and N2C (6.25%) in decreasing order of frequency. About 72% cases are smoker. Conclusion : Metastatic carcinoma with unknown primary tumour commonly present in elderly age group and majority of cases are squmous cell carcinoma . DOI: http://dx.doi.org/10.3329/bjo.v19i2.17631 Bangladesh J Otorhinolaryngol 2013; 19(2): 94-98

Background Ongoing armed conflict in Syria has caused large scale displacement. Approximately half of the population of Syria have been displaced including the millions living as refugees in neighboring countries. We sought to assess the health and nutrition of Syrian refugees affected by the conflict. Methods Representative cross-sectional surveys of Syrian refugees were conducted between October 2 and November 30, 2013 in Lebanon, April 12 and May 1, 2014 in Jordan, and May 20 and 31, 2013 in Iraq. Surveys in Lebanon were organized in four geographical regions (North, South, Beirut/Mount Lebanon and Bekaa). In Jordan, independent surveys assessed refugees residing in Za’atri refugee camp and refugees residing among host community nationwide. In Iraq, refugees residing in Domiz refugee camp in the Kurdistan region were assessed. Data collected on children aged 6 to 59 months included anthropometric indicators, morbidity and feeding practices. In Jordan and Lebanon, data collection also included hemoglobin concentration for children and non-pregnant women aged 15 to 49 years, anthropometric indicators for both pregnant and non-pregnant women, and household level indicators such as access to safe water and sanitation. Results The prevalence of global acute malnutrition among children 6 to 59 months of age was less than 5 % in all samples (range 0.3–4.4 %). Prevalence of acute malnutrition among women 15 to 49 years of age, defined as mid-upper arm circumference less than 23.0 cm, was also relatively low in all surveys (range 3.5–6.5 %). For both children and non-pregnant women, anemia prevalence was highest in Za’atri camp in Jordan (48.4 % and 44.8 %, respectively). Most anemia was mild or moderate; prevalence of severe anemia was less than or equal to 1.1 % in all samples of children and women. Conclusions Despite the ongoing conflict, results from all surveys indicate that global acute malnutrition is relatively low in the assessed Syrian refugee populations. However, prevalence of anemia suggests a serious public health problem among women and children, especially in Za’atri camp. Based on these findings, nutrition partners in the region have reprioritized response interventions, focusing on activities to address micronutrient deficiencies such as food fortification. Electronic supplementary material The online version of this article (doi:10.1186/s13031-016-0093-6) contains supplementary material, which is available to authorized users.

This study investigates existing water supply scenario, and evaluates the performance of pond sand filter (PSF) in meeting drinking water demand of Dacope Upazila in southwest coastal Bangladesh. Questionnaire survey to the villagers reveals that PSF is the major drinking water sources (38 %) of the study area followed by tubewells (30.4 %), rainwater harvesting (RWH) systems (12.6 %), ponds (10.3 %) and others (8.7 %). The spot test and laboratory analysis show that odour, colour, pH, dissolved oxygen, hardness, calcium, magnesium, nitrate, sulphate and phosphate of the PSFs water meet Bangladesh standard. The efficiency of PSF in reducing total dissolved solids (TDS) (15 %) and potassium (8.2 %) is not enough to meet the standard of 20 % PSFs for TDS and one-third PSFs for potassium. The study proves that PSF is unable to remove coliform bacteria by 100 % from highly contaminated water. Hence, disinfection should be adopted before distribution to ensure safe drinking water. Majority of the PSF’s users (80 %) are either partially satisfied or dissatisfied with the existing system. The beneficiary’s willingness to pay for drinking water technologies seems that the combination of PSF and RWH could ensure sustainable drinking water in coastal region of Bangladesh.

In Bangladesh, transport sectors are developing rapidly to meet the increasing demand for transporting passengers and freight inside and outside the country. But there is not such development in railway transport system. The Bangladesh Railway transport system is still using an old technology to monitor and control signalling, scheduling, operations etc. This paper describes various problems in the existing systems and also solutions have been provided considering the existing railway transport systems of Bangladesh. A new system has been developed to control and monitor the total railway transport system from remote locations. While designing the system, various sensors and actuators have been introduced and also Information and Communication Technologies (ICTs) have been applied in the field of railway transport. So a Machatronics aspect of system has been designed to ensure a collision free, safe and efficient operation and management of railway transport system. This system is not only for monitoring and controlling of railway transport but also ensures efficient asset management. As a result face-to-face accidents, cross-road accidents and accidents due to railway line displacements or breakage can be avoided and there will be no loss of assets and valuable human lives.Copyright © 2008 by ASME

A cross sectional, observational study was carried out on myringoplasty at a tertiary level hospital, with the aims to see the outcome of surgery. The study included 100 myringoplasty in central dry perforations of tubotympanic variety of CSOM. Age range of patients was from 15 years to 45 years; male was 56%.There was insignificant influences of age or sex on success rate. The surgeries were done under either local or general anaesthesia by underlay technique with temporalis fascia as a graft in all cases with different approaches without any significant influences on outcome. Site and size of the perforations had significant effect on surgical outcome. The overall graft take rate was 84%. The mean preoperative and postoperative air conduction threshold in the successful cases were 35.2dB & 24.1dB respectively with a mean audiological improvement of 11.1dB & air bone gap improvement was 12.4dB. Key words: Myringoplasty, outcome. DOI: 10.3329/bjo.v15i2.5054 Bangladesh J Otorhinolaryngol 2009; 15(2): 40-44