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Background: Ankylosing spondylitis is a chronic inflammatory-type arthritis that forms part of the group of spondyloarthritides. It primarily affects the spine and pelvis but peripheral arthritis and enthesitis are also common features. Onset of AS often occurs at a relatively young age and that is accepted as a greater risk of hip involvement. THA in AS patients is a challenging procedure owing to multiple factors. The aim of this study was to evaluate the clinical, radiological & functional outcomes of total hip arthroplasty among patients with Ankylosing Spondylitis. Methods: This was a prospective cohort study and was conducted in the Department of Orthopaedic Surgery of Ibn Sina Medical College Hospital, Dhaka, Bangladesh during the period from June, 2021 to May, 2022. In this study we included fifty patients with ankylosing spondylitis who underwent total hip arthroplasty. Result: In our study we found the highest prevalence (36%) was present in aged between 31-40 years old. The mean±SD of age among patients was (37±12). We found the mean±SD of Harris hip score was 44.2±12.3 & 87.2±17.4 during preoperative & postoperative phase respectively. Conclusions: In our study, we found that total hip arthroplasty is a safe and effective treatment of advanced hip involvement in patients with AS. It results in significant improvements in objective outcome measures such as HHS, patient mobility & reduced the difficulty level of patients in their day-to-day activities.

Diabetes mellitus is the seventh leading cause of death globally, and it is a disease that is progressing with deadly implications on a global scale. Furthermore, the treatment regimen is not affordable to all socioeconomic groups. As a result, scientists are working to develop cheaper, more effective phytochemical-based medications. Spondias mombin is a tree and flowering plant in the Anacardiaceae family that is commonly known as the “tapereba” or “caja” tree in Brazil. It is found in both the Atlantic Forest and the Amazon in upland and floodplain forest environments, and it is also present in inhabited areas, albeit in a sub-spontaneous state. The purpose of this study was to determine the anti-diabetic properties of crude ethanol extracts of Spondias mombin obtained in three seasons of the year: following winter, summer, and the rainy season. The goal of this study is to determine which season of the year the plant under consideration has the most anti-diabetic action, change in body weight, and serum lipid profile. The anti-diabetic effects were assessed using a one-touch glucometer after administration of 500 mg/kg doses of the extracts from each seasonal extract at the following time intervals: 1h, 2h, 4h, 6h, 12h, 24h, and 72h. The extract following the rainy season showed optimum anti-diabetic efficacy with a serum lipid profile at a dose of 500 mg/kg. However, the 500 mg/kg extract following winter and summer did not show any significant benefits in diabetes or serum lipid profiles. This study discovered that the anti-diabetic properties of Spondias mombin vary seasonally.

In this study attempts made to show the types of abortion and their consequences admitted in Mymensingh Medical College Hospital (MMCH) in the year 2019. For this study 100 patients of abortion were selected on a random pattern. Special importance has been given on finding out the incidence and prevalence of abortion with respect to their age, socio­ economic status, and parity. Then attempts have been made to find out aetiology. Some suggestions have been given as to what could be done to reduce the incidence of abortion. Some reflection of the effect of abortion on mortality has also been highlighted. The mode of management of abortion patients in MMCH has also been analysed with their outcome. In this study it has been seen that around 47.8% of gynaeclogy patient are of abortion. Though majority is of spontaneous abortion, septic abortion patients are the most critical ones. The majority of cross section of patients is illiterate and very poor. These are the patients who come to the hospital after complications have taken place. All these can be saved by improving socio economic condition, education, finally planning and modernization of existing laws of the land relating to abortion.

Background: Peripheral spondyloarthropathy refers to spondyloarthropathy with predominant peripheral (arthritis, enthesitis or dactylitis) involvement which leads to significant disability. Objective: To assess the quality of life in patient with peripheral spondyloarthropathy (pSpA). Methodology: The study was a cross sectional study conducted in the Department of Physical Medicine and Rehabilitation, BSMMU, Dhaka, from March 2021-February 2022. A total of 105 patients diagnosed with pSpA attending the study place were purposively selected for the study. Patients with concurrent systemic inflammatory rheumatic disease such as RA, SSc, lupus, Dermatomyositis were excluded from the study. Disease activity was measured by the validated Bengali version of The Ankylosing Spondylitis Disease Activity Score (ASDAS), including C-reactive protein (ASDAS-CRP) while health related quality of life was assessed by the validated Bengali version of Short Form Health Survey (SF) 12v2 instrument. Results: The mean age of the study participants was 38.8(±9.8) years where 68 (64.8%) were male. The mean duration of disease was 4.3(±3.3) years where 55 (52.4%) had up to 3 years’ duration of disease. The mean ASDAS-CRP was 3.9 ±0.8 where 69(65.7%) had very high Disease Activity Score. All (100.0%) study participants had arthritis and inflammatory back pain. HLA B27 was present in most of the study participants (N=101, 96.2%) and 99 (94.3%) had enthesitis. The mean Physical Component Summary (PCS) and Mental Component Summary (MCS) was 34.0(±7.8) and 41.3 (±7.7) respectively. There was weak negative correlation between age and PCS of SF-12 scores (r=-0.233, p=0.017). There was negative correlation between duration of the disease and PCS of SF-12 scores (r=-0.339, p

Background: More disability and incapacity to work and a poorer quality of life in spondyloarthritis (SpA) in the presence of enthesitis is associated with higher disease activity. Objective: To find out the co-relation between disease activity and quality of life among patients with peripheral spondyloarthropathy. Methodology: From March 2021 to February 2022, the Department of Physical Medicine and Rehabilitation at BSMMU, Dhaka, performed a cross-sectional research. A total of 105 individuals diagnosed with pSpA who were included in the trial were chosen on purpose. Excluded from the research were patients with concomitant systemic inflammatory rheumatic diseases such as RA, SSc, lupus, and Dermatomyositis. The validated Bengali version of The Ankylosing Spondylitis Disease Activity Score (ASDAS), including C-reactive protein (ASDAS-CRP), was used to measure disease activity, while the validated Bengali version of the Short Form Health Survey (SF) 12v2 was used to evaluate health-related quality of life. Results: The participants' mean age was 38.8(±9.8) years, and 68(64.8%) were male. The mean duration of sickness was 4.3(±3.3) years, with 55.4% of cases lasting less than 3 years. The mean ASDAS-CRP was 3.9(±0.08), with 69(65.7%) individuals having a very high Disease Activity Score. 100% of the individuals in the research experienced arthritis and inflammatory back pain. The majority of research subjects had the HLA B27 gene (N=101, or 96.2%), and 99(94.3%) had enthesitis. Physical Component Summary (PCS) and Mental Component Summary (MCS) mean scores were 34(±7.8) and 41(±7.7), respectively. A slight negative association existed between age and PCS scores on the SF-12 (r=-0.233, p=0.017). There was a negative connection between illness duration and PCS (r=-0.339, p=0.001) and MCS (r=-0.290, p=0.003) SF-12 scores. Again, there was a moderate negative connection between ASDAS-CRP and the PCS and MCS scores of the SF-12 (r=-0.406, p=0.001) and the MCS scores of the SF-12 (r=-0.461, p0.001). Conclusion: The Disease Activity Score of the majority of individuals with peripheral spondyloarthritis was very high. The psychological health of these patients was superior to their physical health. Both physical and mental health components were negatively linked with illness duration. There was a moderate inverse connection between ASDAS-CRP and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the SF-12.

Introduction: Osteoporosis is a silent disaster among postmenopausal women worldwide and carries the highest contribution to morbidity and mortality, especially with concomitant Diabetes Mellitus. Materials and Methods: This was a cross-sectional observational study conducted to evaluate Osteoporosis in postmenopausal women having diabetes mellitus attending outdoor in the department of Physical Medicine & Rehabilitation, BSMMU. The study was conducted from July 2020 to June 2021. A total of 54 patients were included in the study. Results: Osteoporosis of the lumbar spine and femoral neck were present among 72.2% and 55.6% of respondents. Osteoporosis of at least one site was present among 83.3% of respondents. Statistically, a significant relationship was found between osteoporosis and co morbidity, BMI, age of onset of menstruation, age of onset of menopause, and duration of menopause (p=0.025, 0.01, 0.049, 0.043, and 0.032 respectively). Conclusion: This study showed postmenopausal women are susceptible to Osteoporosis. J MEDICINE 2022; 23: 132-138

Background: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. Introduction of platelet-rich plasma (PRP) injection has been viewed as an advance in the management of OA knee. Objective: To compare the effectiveness of PRP and Hyaluronic Acid (HA) in the treatment of mild and moderate OA knee Methods: The present randomized clinical trial had been conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 2018 to 2019. A total of 154 patients with mild and moderate OA knee were randomly allocated into two groups: group A (received PRP injection) and group B (received HA injection) where 133 patients completed the follow-up schedule. Outcomes were measured by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed-up for 6 months. Results: There was no significant statistical difference at the baseline between the groups regarding age, sex, grading of OA knee, side involvement, mean duration of the disease, VAS scores and WOMAC scores. After one month, VAS score significantly decreased in PRP group compared to HA group (p

Mutations in ATP13A2 (PARK9), an autophagy-related protein, cause Kufor–Rakeb syndrome, an autosomal recessive, juvenile-onset form of parkinsonism. α-Synuclein (α-syn) is a presynaptic neuronal protein that forms toxic aggregates in Parkinson’s disease (PD). We studied α-syn aggregation and autophagic flux in ATP13A2-knockdown Drosophila expressing either wild-type (WT) or mutant α-syn. Dopaminergic (DA) neuron loss was studied by confocal microscopy. Sleep and circadian activity were evaluated in young and old flies using a Drosophila activity monitor. Thirty-day-old ATP13A2-RNAi A53T-α-syn flies had increased Triton-insoluble α-syn levels, compared to control A53T-α-syn flies without ATP13A2-RNAi. Whole-brain staining revealed significantly fewer dopaminergic (DA) neurons in the PPL2 cluster of 30-day-old ATP13A2-RNAi flies expressing WT-, A30P-, and A53T-α-syn than in that of controls. In ATP13A2-RNAi A53T-α-syn flies, autophagic flux was decreased, as indicated by increased accumulation of Ref(2)P, the Drosophila p62 homologue. ATP13A2 silencing decreased total locomotor activity in young, and enhanced sleep features, similar to PD (decreasing bout length), in old flies expressing A53T-α-syn. ATP13A2 silencing also altered the circadian locomotor activity of A30P- and A53T-α-syn flies. Thus, ATP13A2 may play a role in the autophagic degradation of A53T-α-syn.

Pseudomonas aeruginosa is one of the most widespread gram-negative microorganisms identified in the clinical samples and most common causes of hospital acquired infection. P. aeruginosa is affecting both indoor and outdoor patients throughout the world. Due to frequent mutation in P. aeruginosa highly resistant strain developed rapidly. The aim of the study to determine the prevalence of P. aeruginosa species in different samples isolated from a Tertiary care Hospital as well as determination their diverse antibiotic resistance pattern. This cross-sectional study was carried out to determine in-vitro resistance pattern of P. aeruginosa isolates to common antimicrobial agents by disc diffusion method. Various clinical samples were collected from Bangladesh Health Sciences Hospital (BIHS) General Hospital, Dhaka. This research was carried out in the Department of Microbiology of Bangladesh University of Health Sciences (BUHS). Isolation, identification and antibiogram were performed for P. aeruginosa following standard microbiological laboratory procedure. A total of 218 P. aeruginosa were isolated from 3062 different clinical specimens which are statistically significant (p

A 37-year-old Bangladeshi woman presented with low back and several joints pain and swelling for months together; there was significant morning stiffness for more than two hours. Repeated abortions, dry eye, hair fall, photosensitivity, and oral ulcer were the additional complaints. Clinical examination unveiled asymmetrical peripheral and both sacroiliac joint tenderness, positive modified Schober’s test, and limited chest expansion. Schirmer’s test was positive. The history of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) among 1st-degree relatives was also significant. Biochemical analysis revealed pancytopenia, raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and mild microscopic proteinuria. The patient was seropositive for rheumatoid factor (RF), antibodies against cyclic citrullinated peptides (anti-CCP), antinuclear antibody (ANA), anti-Sm antibody, anti-Sjögren’s-syndrome-related antigen A and B (anti-SSA/SSB), antiphospholipid (aPL-IgG/IgM), and HLA B27; however, serum complement (C3 and C4) levels were normal. Basal cortisol level measured elevated. Besides, X-ray and MRI of lumbosacral spines demonstrated sacroiliitis. There was radiological cardiomegaly, echocardiography unveiled atrial regurgitation, and ascending aorta aneurysm. Based on the abovementioned information, RA, AS, and systemic lupus erythematosus (SLE) have been diagnosed. Moreover, the patient developed Sjogren’s syndrome (SS), antiphospholipid lipid syndrome (APS), Cushing syndrome, ascending aorta aneurysm, and atrial regurgitation. Her disease activity score for RA (DAS28), DAS for AS (ASDAS), SLE disease activity index (SLEDAI), and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) scores were 3.46, 2.36, 23, and 5, respectively. The patient received hydroxychloroquine (200 mg daily), pulsed cyclophosphamide, prednisolone (20 mg in the morning), and naproxen 500 mg (twice daily). To our best knowledge, this is the first report documenting RA, AS, and SLE with secondary SS and APS.

Background:Uncontrolled blood pressure (BP) is a major healthcare issue and responsible for high risk of cardiovascular disease (CVD) mortality and morbidity. Physicians of Bangladesh had been usingamlodipine and Olmesartan combination for a long period of time but have very limited evidence-based information regarding the efficacy and safety of this combination.The aim of this study was to evaluate the efficacy and safety of fixed dose combination of olmesartan/amlodipine in hypertensive patients. Methods:This open-label, non-randomized, non-comparative observational study was conducted in different centers of Bangladesh during the period from January 2020 to November 2020. In total 443 Bangladeshi adult patients with hypertension were selected as the study population. Proper written consent was taken from all the participants before collecting data. Inter-group differences in the baseline characteristics were compared using analysis of variance (ANOVA). Two-tailed p-values of less than 0.05 were considered to be statistically significant. Statistical analyses were conducted by using SPSS for Windows, version 25 (SPSS Inc., Chicago, IL, USA). Results:Among all the participants, more than 70% were above 46 years of age and 55% were male. More than 60% of them were either overweight or obese. Among them, dyslipidemia, diabetes, and Chronic renal failure (CRF) was found among 14.22%, 28.44%, and 4.29% participants respectively Mean systolic (SBP) and diastolic blood pressures (DBP) were reduced to 36.61 and 18.69 mm of Hg respectively after 12 weeks of therapy. Besides these, the targeted SBP was achieved among 92% and targeted DBP was achieved among 98.3% of participants after 12 weeks. Achievement of BP goal in respect to Body mass index (BMI) of the patient (P-value 0.019), family history of hypertension (P-value 0.028), and dose of the drug in initial visit (P-value 0.001) was found statistically significant. There was no discontinuation of study medication due to intolerance or adverse events. Conclusion:Olmesartan/Amlodipine is an effective combination for reducing the blood pressure along with achievement of BP goal. Future studies on Olmesartan/Amlodipine in Bangladesh could be conducted with a longer treatment duration to examine the maintenance of effect and long-term safety.

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

Odontomas are one of the most common tumours of odontogenic origin. They are usually asymptomatic but may be associated with retained primary teeth or missing permanent teeth. Though the exact aetiology is unknown, the postulated causes include trauma, infection, inheritance and genetic mutation. Early diagnosis and management will result in fewer complications. Conservative surgical excision is the treatment of choice. This case report presents a treated case of compound odontoma associated with delayed eruption of the permanent central incisor in a nine-year-old boy. Keywords: Compound Odontoma. Continuous...

Background: Cervical spondylosis is the results of disc degeneration with associated osteophytosis. Cervical traction is widely used to treat neck disorders. Rehabilitation treatment like cervical traction along with other measures at home may play an important role to reduce symptoms of the patients with cervical spondylosis. Objective: A randomised clinical trial was conducted among 125 patients having cervical spondylosis to find out the effects of manual continuous home cervical traction. Methods: The patients were selected on the basis specific selection criteria. They were subdivided into two groups. In Group-A (manual continuous home cervical traction group), 61 patients were treated with exercise, cervical collar, neck support, manual continuous home cervical traction, NSAID, warm moist compression and instruction in posture. In Group-B (conventional treatment receiving group), 64 patients were treated with exercise, cervical collar, neck support, warm moist compression, NSAID and instruction in posture. Results: Among the subjects there were 68 (54.4 %) male and 57 (45.6 %) female. The mean age of the subjects was 45.94 ± 11.65 years. There was marked improvement of symptoms of the patients of Group-A in response to treatment for 6 weeks (p < 0.007). It indicates that manual home cervical traction was found effective to reduce the sign and symptoms of cervical spondylosis. There was improvement after treatment in Group-B also (p < 0.01). It indicates that conventional treatment was also found effective. In comparison, there was no significant difference between two groups (p < 0.36, 95% CI= ‐0.56 to 1.51) found after first week. But there was significant improvement in Group-A than Group-B after six weeks of treatment (p < 0.003, 95% CI= -2.40 to -0.51). Conclusion: It may be concluded that manual continuous home cervical traction is beneficial for the patients with cervical spondylosis. Bangladesh Med Res Counc Bull 2020; 46(2): 128-133

Loom-dye effluent discharge has constituted a major environmental threat to the people of Belkuchi Upazila of Sirajganj District. The present study was conducted to characterize loom-dye effluents and investigate their health implications by the growth analysis of rice and red amaranth seedlings along with a survey study among the individuals associated with loom-dyeing, weaving, and crop farming activities. A total of twenty-eight loom-dye effluent samples were collected for physicochemical characterization; among them, only three loom-dye effluents, i.e. pink, violet, and black dyes, at concentrations of 0, 10, 25, 50, 75, and 100% were applied as irrigation water to rice and red amaranth. The plant growth experiment was laid out following a completely randomized design with three replicas. Chemical analyses of loom-dye effluents showed the presence of a significant amount of plant nutrients and heavy metals. The mean concentrations of Pb, Cd, Cr, Fe, Mn, Zn, and Cu were 0.938, 0.046, 0.212, 7.109, 0.609, 0.351, and 0.191 mg L−1, respectively. Among the metals, the concentrations of Pb, Cr, Fe, and Mn were above the recommended limit proposed by the irrigation water guideline value. Application of ≤ 25% pink and violet dye effluent and ≤ 10% black dye effluent had significant (p

Peripheral giant cell granuloma is a relatively uncommon benign reactive gingival lesion of the oral cavity. A 9-year boy presented with a painless, slow-growing, reddish-blue, soft tissue lesion on attached gingiva adjacent to maxillary right first and second premolars, which was interfering with eating. A periapical radiograph demonstrated focal alveolar bone loss and slight teeth displacement adjacent to the lesion. Diagnosis of peripheral giant cell granuloma was made through clinical and radiographic evaluation, by its typical presentation and correlation with histopathologic findings. Complete excision was carried out down to the underlying bone. A follow-up visit was scheduled after 7 days and deep scaling was performed. There was no recurrence three months post-excision. Timely detection and excision of this lesion is important to avoid future dentoalveolar problems. Key Words: Giant cell granuloma, Benign, Peripheral, Child.

Lymphedema is a life-long sequelae to several neglected tropical diseases (NTD). In Bangladesh the main cause is lymphatic filariasis (LF) and Ethiopia is endemic for both LF and podoconiosis. The World Health Organization (WHO) recommends daily self-care including meticulous washing and drying of affected skin and attention to entry lesions, limb exercises and elevation. Adherence to this regime reduces secondary infections which cause disabling episodes of acute dermato-lymphangitis (ADL). Self-care practices must be integrated into family life, supported by community and monitored by health staff; however, little is known about the influence of personal and socio-demographic factors on adherence. People affected by lymphedema (n=272), adult caregivers (n=272), and health workers (n=68) in Bangladesh and Ethiopia were trained in lymphedema management according to WHO recommendations. Surveys on the causes and management of lymphedema were collected at baseline and 24-weeks, and patients completed a daily journal of self-care activities and symptoms. At baseline knowledge on causes and management of lymphedema was greater among health workers (>70%) than patients and caregivers (

Background: Limited contemporary data exist regarding the impact of SYNTAX score on procedural outcomes undergoing primary percutaneous coronary intervention(PCI) in acute STEMI patients. Objectives: To evaluate the significance of the SYNTAX score for predicting procedural outcome after primary PCI in patient with acute STEMI. Methods: This perspective observational study was conducted in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from September, 2015 to September, 2016. 42 patients with acute STEMI who underwent primary PCI were considered for the study. But 2 patients were excluded from the study due to failure of primary PCI. The patients were divided into two groups: Group I (low Syntax score d”22) and Group II (high Syntax score > 22). The Syntax score of all patients were calculated from an initial coronary angiogram before primary PCI. Procedural outcome was observed in between two groups. Results: Among study patients 57.5% were in SYNTAX score d”22 (Group I) and 42.5% were in SYNTAX score >22 (Group II). Among traditional cardiovascular risk factors diabetes was significantly more prevalent in the Group II than Group I ( 82.4% vs 34.8%, p  0.003). Angiographic profile revealed maximum (69.6% vs 17.6%) culprit lesion in LAD artery in Group I and maximum culprit lesion (64.7% vs 21.7%) in RCA in Group II, these were the statistically significant between Group I and Group II (P

A pot experiment was carried out with tomato variety BINA Tomato-3 in the net house of the Department of Agricultural Chemistry, Bangladesh Agricultural University (BAU), Mymensingh from March to August, 2010 to study the effect of Indole Acetic Acid(IAA) and Boron(B) on the nutrient contents of BINA Tomato-3. There were four doses of IAA viz. 0, 20, 40 and 60 ppm and B viz. 0, 1.5, 2.0 and 2.5 kg ha-1. The experiment was laid out in a Completely Randomized Design (CRD) with 3 replications. The result revealed that nutrient contents of tomato fruits and plants such as N, P, Ca, Mg and B were significantly influenced by the application of IAA and B. The highest N (0.70%), Ca (0.69%), Mg (0.80%) in tomato fruits and highest N (0.40%), Ca (0.93%), Mg (0.90%) in tomato plants were obtained in 60 ppm IAA along with 2.0 kg B ha-1 and the lowest was obtained in the control treatment. In tomato fruits the highest P (0.41%) was found in IAA40B2.0 treatment, while the lowest P (0.18%) was recorded in IAA0B0.0. The lowest B (4.55µgg-1) was recorded in control, while the highest B (15.72µgg-1) was found in IAA20B2.0in tomato fruits. In tomato plants the highest P (0.34%) was recorded in IAA60B1.5 and the lowest P (0.20%) was found in control. The lowest B (4.15µgg-1) was recorded in IAA0B0.0, while the highest B(13.33µgg-1) was found in IAA40B2.0 in tomato plants. The overall results suggest that treatment IAA60B2.0 was the best from other treatments.

Background: Primary percutaneous coronary intervention (PPCI) has been performed traditionally by using femoral approach. Transradial approach has become increasingly popular as it is likely to be less complicating, more comfortable and relatively cost effective having mortality and morbidity benefits. The aim of the study was to compare the in-hospital outcomes of transradial PPCI with that of transfemoral route. Methods: A total of 80 patients with ST elevation myocardial infarction (STEMI) who underwent PPCI were enrolled in the study. Patients were divided in two groups. Group-I: transradial PPCI; and Group-II: transfemoral PPCI. All patients were followed up during the period of hospital stay and adverse outcomes were observed and compared between the groups. Results: The result showed that bleeding took place in 2.5% patient of Group-I and 15% patients of Group- II. Vascular complications occurred in 2.5% and 12.5% patients of Group-I and Group-II, respectively. In Group-II, 7.5% patients died with none in Group-I. In Group-II, 37.5% patients experienced some sort of adverse outcomes whereas only 15% of the patients of Group-I did have such experiences (p

Lymphatic filariasis causes disfiguring and disabling lymphoedema, which is commonly and frequently exacerbated by acute dermatolymphangioadenitis (ADLA). Affected people require long-term care and monitoring but health workers lack objective assessment tools. We examine the use of an infrared thermal imaging camera as a novel non-invasive point-of-care tool for filarial lower-limb lymphoedema in 153 affected adults from a highly endemic area of Bangladesh. Temperature differences by lymphoedema stage (mild, moderate, severe) and ADLA history were visualised and quantified using descriptive statistics and regression models. Temperatures were found to increase by severity and captured subclinical differences between no lymphoedema and mild lymphoedema, and differences between moderate and severe stages. Toes and ankle temperatures detected significant differences between all stages other than between mild and moderate stages. Significantly higher temperatures, best captured by heel and calf measures, were found in participants with a history of ADLA, compared to participants who never had ADLA, regardless of the lymphoedema stage. This novel tool has great potential to be used by health workers to detect subclinical cases, predict progression of disease and ADLA status, and monitor pathological tissue changes and stage severity following enhanced care packages or other interventions in people affected by lymphoedema.

Background: Lymphatic filariasis (LF) is a major cause of lymphedema, affecting over 16 million people globally. A daily, hygiene-centered self-care protocol is recommended and effective in reducing acute attacks caused by secondary infections. It may also reverse lymphedema status in early stages, but less so as lymphedema advances. Lymphatic stimulating activities such as self-massage and deep-breathing have proven beneficial for cancer-related lymphedema, but have not been tested in LF-settings. Therefore, an enhanced self-care protocol was trialed among people affected by moderate to severe LF-related lymphedema in northern Bangladesh. Methods: Cluster randomization was used to allocate participants to either standard- or enhanced-self-care groups. Lymphedema status was determined by lymphedema stage, mid-calf circumference, and mid-calf tissue compressibility. Results: There were 71 patients in each group and at 24 weeks, both groups had experienced significant improvement in lymphedema status and reduction in acute attacks. There was a significant and clinically relevant between-group difference in mid-calf tissue compressibility with the biggest change observed on legs affected by severe lymphedema in the enhanced self-care group (∆ 21.5%, &minus, 0.68 (&minus, 0.91, &minus, 0.45), p &lt, 0.001). Conclusion: This study offers the first evidence for including lymphatic stimulating activities in recommended self-care for people affected by moderate and severe LF-related lymphedema.

Background Spread of malaria and antimalarial resistance through human movement present major threats to current goals to eliminate the disease. Bordering the Greater Mekong Subregion, southeast Bangladesh is a potentially important route of spread to India and beyond, but information on travel patterns in this area are lacking. Methods Using a standardised short survey tool, 2090 patients with malaria were interviewed at 57 study sites in 2015–2016 about their demographics and travel patterns in the preceding 2 months. Results Most travel was in the south of the study region between Cox’s Bazar district (coastal region) to forested areas in Bandarban (31% by days and 45% by nights), forming a source-sink route. Less than 1% of travel reported was between the north and south forested areas of the study area. Farmers (21%) and students (19%) were the top two occupations recorded, with 67 and 47% reporting travel to the forest respectively. Males aged 25–49 years accounted for 43% of cases visiting forests but only 24% of the study population. Children did not travel. Women, forest dwellers and farmers did not travel beyond union boundaries. Military personnel travelled the furthest especially to remote forested areas. Conclusions The approach demonstrated here provides a framework for identifying key traveller groups and their origins and destinations of travel in combination with knowledge of local epidemiology to inform malaria control and elimination efforts. Working with the NMEP, the findings were used to derive a set of policy recommendations to guide targeting of interventions for elimination.

Objective: Coronary artery disease (CAD) is rising in South Asia and is taking a more malignant proportion in South Asians than in Caucasians. Having a similar socioeconomic and cultural background, the scenario is same in Bangladesh. Obesity, especially abdominal is concerned as an important and modifiable risk factor for CAD which is now also raising both in developed and under developed countries. Waist-Hip ratio (WHR) is considered as an important tool for assessing abdominal obesity. The aim of this study is to evaluate the association between WHR and the severity of CAD of acute ST-segment elevation myocardial infarction (STEMI) patients so that primary prevention, early detection and proper management strategy can be taken to reduce the disease burden, morbidity and mortality.Methods: This cross sectional observational study was carried out among 105 patients with acute STEMI who received thrombolytic and underwent coronary angiography (CAG) at National Institute of Cardiovascular Diseases (NICVD), Dhaka from May, 2016 to November, 2016. They were divided into two groups, Group I (normal WHR) = 51 and group II (increased WHR) = 54, according to WHR level. Angiographic severity of coronary artery disease was assessed by vessel score and Genseni’s score.Results: Significant positive correlation was found between WHR and vessel score (r= 0.62, p=0.003). Moderate to severe CAD patients were significantly higher in increased WHR group than in normal WHR group (77.8% vs. 29.4%, p=

Pigmented villonodular synovitis (PVNS) is a rare disorder where abnormal synovial proliferation and insidious swelling are the characteristic features. As insidious joint swelling has many common causes and PVNS is rare entity, so that it may be missed or under evaluated. Here inconclusive biopsy findings at an early stage and features resembling spondyloarthritis (SpA) delayed the diagnosis. A 28-year-old young man presented with insidious swelling of knee. Here repeated aspiration and synovial fluid analysis with routine serological and radiological examination were inconclusive. Then he was labeled and treated as spondyloarthritis (SpA) for four years without improvement. After four years of sufferings he admitted here and reached the diagnosis of PVNS with the help of MRI and synovial biopsy. Sometimes rare disease diagnosis is complicated by the absence of typical features and inconclusive reports. Common differentials may mimic the diagnosis and rare disease may loss the attention. Here PVNS was treated as SpA for four years before being diagnosed. Bangladesh Med J. 2017 May; 46 (2): 53-55

The Madhabdi municipality in the Narsingdi district of Bangladesh is a well-known area for textile, handloom weaving, and dyeing industries. These textile industries produce a considerable amount of effluents, sewage sludge, and solid waste materials every day that they directly discharge into surrounding water bodies and agricultural fields. This disposal poses a serious threat to the overall epidemic and socio-economic pattern of the locality. This research entailed the collection of 34 handloom-dyeing effluent samples from different handloom-dyeing industries of Madhabdi, which were then analyzed to determine the contents of the heavy metals iron (Fe), zinc (Zn), copper (Cu), chromium (Cr), manganese (Mn), lead (Pb), and cadmium (Cd). Average concentrations of Fe, Cr, Cu, Pb, Mn, and Zn were 3.81, 1.35, 1.70, 0.17, 0.75, and 0.73 mg L-1, respectively, whereas Cd content was below the detectable limit of the atomic adsorption spectrophotometer. The concentrations of Fe, Cr, Cu, Pb, and Mn exceed the industrial effluent discharge standards (IEDS) for inland surface water and irrigation water guideline values. A biosorption experiment of the heavy metals (Fe, Cr, Cu, Mn, and Zn) was conducted without controlling for any experimental parameters (e.g., pH, temperature, or other compounds present in the effluent samples) by using four agricultural wastes or byproducts, namely rice husk, sawdust, lemon peel, and eggshell. Twenty grams of each biosorbent was added to 1 L of effluent samples and stored for 7 days. The biosorption capacity of each biosorbent is ranked as follows: eggshell, sawdust, rice husk, and lemon peel. Furthermore, the biosorption affinity of each metal ion was found in the following order: Cu and Cr (both had similar biosorption affinity), Zn, Fe, Mn. The effluents should not be discharged before treatment, and efficient treatment of effluents is possible with eggshell powder or sawdust at a rate of 20 g of biosorbent per liter of effluents.

not available Bangladesh Journal of Infectious Diseases 2020;7(1):1-2

For countries aiming for malaria elimination, travel of infected individuals between endemic areas undermines local interventions. Quantifying parasite importation has therefore become a priority for national control programs. We analyzed epidemiological surveillance data, travel surveys, parasite genetic data, and anonymized mobile phone data to measure the spatial spread of malaria parasites in southeast Bangladesh. We developed a genetic mixing index to estimate the likelihood of samples being local or imported from parasite genetic data and inferred the direction and intensity of parasite flow between locations using an epidemiological model integrating the travel survey and mobile phone calling data. Our approach indicates that, contrary to dogma, frequent mixing occurs in low transmission regions in the southwest, and elimination will require interventions in addition to reducing imported infections from forested regions. Unlike risk maps generated from clinical case counts alone, therefore, our approach distinguishes areas of frequent importation as well as high transmission.

A 51 year old woman while treated on methotrexate (MTX) and leflunomide (LEF) for rheumatoid arthritis (RA), developed exertional breathlessness and undue tiredness followed by fever and cough, at her 11 years of suffering. Her respiratory symptoms developed around 12 weeks after leflunomide intake. She improved with steroid treatment. The Leflunomide (LEF) induced interstitial pneumonitis is an uncommon condition in absence of prior lung disease but potentially fatal. We report a case of Leflunomide (LEF) induced interstitial pneumonitis.Bangladesh Med J. 2017 Jan; 46 (1): 38-40

Riset ini menyajikan hubungan antara konsep tauhid dan politik pada masyarakat Bone. Dengan memilih tiga kecamatan di Kabupaten Bone sebagai objek penelitian, riset ini diharapkan dapat mengurai problematika ketauhidan dalam dinamika sosial politik masyarakat Kabupaten Bone, dan memahami persepsi masyarakat Bone terkait tema yang diteliti. Untuk menemukan bentuk relasi tauhid dan politik dalam masyarakat Kabupaten Bone, peneliti melakukan langkah pengumpulan data dengan teknik purposive sampel, menganalisis data-data yang dikumpulkan dengan menggunakan pendekatan al-siyasah al-syar’iyyah, lalu menyajikannya secara deskriptif historis dan fakta empiris.Berdasarkan analisis data penelitian yang dilakukan menunjukkan bahwanilai-nilai ketauhidan secara komprehensif belum aktual dalam kehidupan sosial politik pada masyarakat Kabupaten Bone, sebab persepsi masyarakat Bone mengenai relasi tauhid dan politik cenderung masih dimaknai terpisah, dalam arti tauhid masih bersifat metafisis-ritualis dan politik masih bersifat tentatif. Dengan temuan tersebut, prinsip “kontinum realitas” menjadi penting dibumikan di Bone agar interaksi politik tidak minim spirit ketauhidan.

Aims and objectives. To identify the association of following variables with radiographic findings in rheumatoid arthritis cases in Bangladesh: Age at onset, Duration of suffering, Sex, Clinical indexes of disease activity & Rheumatoid factorMethods. In this observational study, 100 consecutive rheumatoid arthritis patients who met ACR criteria 1987 were enrolled from rheumatology OPD of BSMMU from the period of August 2009- April 2010. Clinical evaluations and laboratory investigations were done in all cases. Final evaluation was done on 96 patients, because 4 patients were dropped out, due to inconclusive radiological report. Radiographs of hands and wrists were scored by Van der Heijde modification of Sharp scoring method.Results. Out of 96 patients 73 were female and 23 male with female male ratio of 3.1:1. Age of onset was 41.0±11.0 (mean ± SD) in male and 37.7±12.9 in female. 90 patients had severe RA among them 21 (23.3%) were male and 69 (76.6%) were female. Rose Waaler (RW) test was positive in 68 cases. Bony erosions were observed in 58 cases, out of them 15 (65.2%) were male and 43 (58.9%) female. Bony erosions were observed in 60.3% cases of positive Rose Waaler and 69.8% in patients whose age at onset was < 45 yrs. Hemoglobin level (gm/dl) was 12.2±1.6 in male and 10.9±1.5 in female. Platelet count was 312142±111233 in male and was 379114±115574 in females.Conclusion: Hemoglobin levels were significantly lower among the anemic women than anemic men. Thrombocytosis was also more in women than men. Higher percentage of bony erosions was observed among the cases of positive RW and whose age at onset was < 45 but it was not statistically significant.Bangladesh J Medicine Jan 2015; 26 (1) : 13-17

Intensive care unit (ICU) based rehabilitation has become an important evidence-based component in the management of patients with critical illness. In addition to critical illness, prolonged bed rest and immobility may lead to severe physical deconditioning and loss of muscle mass and muscle weakness. Intensive care unit acquired weakness is associated with increased duration of mechanical ventilation and weaning, longer ICU and hospital stay, and increased mortality. These physical impairments may last for years after ICU discharge. Early Physical Medicine and Rehabilitation (PM&R) interventions in the ICU may attenuate or prevent the weakness and physical impairments occurring during critical illness. This article reviews the effects of prolong bed rest and inactivity, early PM&R interventions, their safety, feasibility, benefits and future directions for early PM&R in the ICU.Bangladesh Crit Care J September 2015; 3 (2): 63-66

Background: Aim of our study was to predict the effect of subvalvular changes on mitral valve leaflets excursion in a patient with mitral stenosis following percutaneous trans-venous mitral commissurotomy.Methods: Total of 60 patients of severe mitral stenosis were enrolled in the study. Transthoracic echocardiography was done on the day before percutaneous trans-venous mitral commissurotomy and 24-48 hours after percutaneous trans-venous mitral commissurotomy. Subvalvular area, anterior and posterior leaflets excursion were recorded.Results: Following percutaneous trans-venous mitral commissurotomy there were significant increase in anterior leaflet excursion from 1.8 ± 0.2 to 2.2 ± 0.2cm (p=

An experiment was carried out to isolate, screen and characterize bacteria collected from an industrially polluted site of Bhaluka under the Mymensingh district and to evaluate their phosphorus (P) solubilizing capacity. About ten plant and soil samples from six different spots were collected from the site. Thirty four bacterial isolates were screened and pure cultures of the different bacterial isolates were prepared. Among the bacterial isolates 25 were gram negative and 9 were gram positive. About 31 bacterial isolates had catalase producing capacity and remaining 3 were negative to catalase test. Bacterial isolates were grown on a NBRIP media to determine their phosphorus solubilizing capacity. About 25 bacterial isolates were shown P solubilizing capacity. Isolate SB8 gave the highest result about 11.42 PSI (phosphorus solubilizing index), whereas other bacterial isolates showed moderate P solubilizing capacity (PSI 1.75-6.35). A plant trial with selected isolates (SB8, SB15, SB25) were also done and SB8 achieved 10% higher P content in comparison with control which supports the in vitro P solubilization assays. DOI: http://dx.doi.org/10.3329/ralf.v1i1.22353 Res. Agric., Livest. Fish.1(1): 27-35, Dec 2014

Aims: The crude methanol extract of whole plant of Blumea lacera (Burn.f.) DC. has been investigated for anti-diarrheal, antimicrobial, anxiolytic, anti-atherothrombosis, membrane stabilizing and alpha-amylase inhibitory activities. Place and Duration of Study: The study was carried out in 2013 in the Department of Pharmacy, Southern University Bangladesh, Chittagong, Bangladesh. Methodology: Test for anti-diarrheal activity was carried out by castor oil-induced diarrhea in mice. The preliminary antimicrobial activity was determined by the agar disc diffusion method. The anxiolytic activity was examined in mice by using the hole board test and open field test (OFT). The anti-atherothrombosis activity was evaluated using standard streptokinase. The membrane stabilizing activity was assessed by using hypotonic solution induced hemolysis of human erythrocyte. The plant extract was also assessed for anti-diabetic ability using In vitro α-amylase inhibitory potential. The αamylase inhibitory activity of B. lacera was measured using the starch-iodine method.

not availableBangladesh Journal of Infectious Diseases, 2015;2(1):1-2

A study of 1,436 Saudi children and 1,174 parents was carried out in September - October 1987 at the Children's outpatient clinic of King Faisal Hospital, Gurayat. This is the only hospital in the Gurayat town having a pediatric outpatient clinic for a population of 50,000. Of 1,436 Saudi children, 51% were male, 49% female, and 82% below five years of age. Eighty-six percent of five to 12 year old Saudi children had complete or partial immunization compared to 93% below one year of age. Only 60% of 1,174 Saudi parents knew the purpose of vaccination. Seventy percent of the fathers are educated, 34% belong to class I, II, and III and 66% to class IV and V. The main reason for delayed or no vaccination was due to sickness of the child, medical deferral, parental ignorance, and transport problem. Strict implementation of World Health Organization's (WHO) Expanded Program on Immunization (EPI) will further increase the immunization coverage as well as consolidate the success already achieved.

The aim of the study was to assess the clinical outcome of surgically treated patients with posterior fossa tumor with hydrocephalus with symptoms and sings of raised intracranial pressure without pre-operative ventriculo-peritoneal shunt by comparing two groups (one group-with pre-operative ventriculo-peritoneal shunt and other group-without preoperative ventriculo-peritoneal shunt) in respect to complications, duration of hospital stay and final outcome at 1 month post-operative follow up. This clinical study was carried out at the department of neurosurgery, BSMMU from November 2008 to April 2010 on patients with posterior fossa tumor with hydrocephalus with symptoms and signs of raised intracranial pressure (ICP) who underwent surgery without preoperative ventriculo-peritoneal shunt. A total of 32 patients were included in this study. Patients were divided into two groups, control group (group-A) underwent ventriculoperitoneal shunt prior to tumor surgery and experimental group (group-B) were not treated with ventriculo-peritoneal shunt prior to tumor surgery. Both groups were followed up during hospital stay and after 1 month of tumor resection. Clinical studies include analysis of the following parameters: i) duration of hospital stay, ii) post-operative complications include cerebrospinal fluid leakage, pseudomeningocele, seizure, meningitis, and shunt blockage and, iii) final outcome at 1 month follow up in modified karnofsky performance scale. We also observed whether or not, use of ventriculo-peritoneal shunt to drain cerebrospinal fluid was useful and safe. The mean duration of hospital stay were 95.1±12.6 days with ranged from 70 to 120 days and 71.5±12.6 days ranged from 36 to 88 days in group-A and group-B respectively. The majority of the patients had no complications in both group, which were 12(70.6%) and 9 (60.0%) in group A and group B respectively. Final outcome at 1 month follow up in modified karnofsky performance scale in both groups were similar. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9963 BMJ 2011; 40(1): 43-47

Rheumatoid arthritis (RA) is a chronic heterogeneous autoimmune disorder of unknown etiology. Genetic factors play an important role in susceptibility to RA as the heritability of RA is between 50% and 60%, with the human leukocyte antigen (HLA) locus accounting for at least 30% of overall genetic risk. It is conceivable that there is more than one susceptible gene(s) operative in RA, and an interaction of the relevant genes may predispose the offspring to develop the disease under certain conditions .Outside the major histocompatibility complex (MHC) region, some additional risk loci have been identified and validated including PTPN22, STAT4, PADI4, CTLA4 and others Genetic factors are also important in RA pharmacotherapy due to the gene-dependent activity of enzymes involved in the pharmacokinetics and/or pharmacodynamics of RA medications. Indeed, there is great variability in drug efficacy as well as adverse events associated with any anti-rheumatic therapy and genetics is thought to contribute significantly to this inter-individual variability in response. The ability to screen the entire genome for association to complex diseases has great potential for identifying gene effects. DOI: http://dx.doi.org/10.3329/jom.v13i1.10048 JOM 2012; 13(1): 51-54

The reactions of [Ni(NO2)XL2][X = Cl, L =½ dppe (dppe = Ph2PCH2CH2PPh2), PPh3, PPrn3, OPPh3, or NC5H5; X = Br, L =½ dppe or PPh3; X = NO2, L =½ dppe] and trans-[M(NO2)2L2](M = Pd, L = PEt2Ph or PEt3; M = Pt, L = PEt2Ph, PEt3, or PBun3) with carbon monoxide have been examined. The nickel compounds react to produce the corresponding nitrosyl compounds [Ni(NO)XL2] and CO2. The palladium and platinum compounds react with CO to form [M(CO)2L2] complexes and subsequently higher clusters, except for [Pt(NO2)2(PEt3)2] where evidence for the formation of [Pt(NO)(NO2)(PEt3)2] and [Pt(NCO)(NO2)(PEt3)2] has been found. On reaction with dioxygen the compounds [Ni(NO)XL2] afford the nitro-complexes [Ni(NO2)XL2] exclusively, the rate of the reaction depending on L. The compound [Pt(NO)(NO3)(PPh3)2], prepared from the reaction of N2O4 with [Pt(PPh3)4] in toluene, reacts with O2 to produce trans-[Pt(NO3)2(PPh3)2]. In solution, [Pt(NO)(NO3)(PPh3)2] undergoes an intramolecular reaction to form [Pt(NO2)2(PPh3)2]. The complex [Pt(N2O2)(PPh3)2] reacts with [NO][PF6] to form [{Pt(PPh3)2}2N2O2][PF6]2.

Die Nitrose-Komplexe (I) reagieren mit Silbertetrafluoroborat (II) und Acetonitril (III) zu den Komplexen (IV), deren Acetonitril-Liganden in stereospezifischer Weise durch Trideuteroacetonitril ausgetauscht werden.