Search

Background: Acute confusional state or delirium is a frequent cause of hospital admission in the elderly. It is characterized by an acute fluctuating impairment of cognitive functions and inattention. Recognition and prompt treatment is crucial to decrease the morbidity and mortality of hospitalized elderly patients. Aim of this study was to evaluate the distribution of common medical conditions related to acute confusional state among elderly hospitalized Patients. Methods: This was a cross sectional study. We enrolled 380 patients from different medicine wards in Dhaka Medical College Hospital. We included patients with acute confusional state/delirium of less than 7 days duration. The enrolled patients fulfilled the diagnostic criteria of an acute confusional state. A predesigned checklist was used for data collection. Head injury was excluded by history and CT scan of brain. Patients with preexisting illnesses, such as dementia, psychiatric illnesses and recurrent seizures, and any case of poisoning was excluded. All findings were noted and recorded. A written informed consent was taken from the attendant and relatives. Result: Among 380 patients, most of confusional state developed after the age of 65 years and the mean age was 69 +/-7.6 years. Associated medical conditions were uncontrolled hypertension (63.2%), fever & infection (41.6%), uncontrolled DM (36.6%), CVD (28.4%), CKD & electrolytes abnormalities (10.5%), joint diseases & pain (13.7%). Most of the patients used plyphormacy (76.6%) out of which antihypertensive (60%) were common. The mean duration of presentation was 6.1+/-0.6 days, and among all patients about 63.7% were improved, 29.50% was in persistant symptom of confusion and 6.8% of them died. Conclusion: Acute confusional state was common after 65 years. Uncontrolled hypertension, fever & infection, uncontrolled diabetes, CVD, CKD & electrolytes abnormalities and polypharmacy were found commonly in patients with acute confusional state. J MEDICINE JAN 2021; 22 (1) : 41-45

Importance: Hypokalemia is a neglected common manifestation in COVID-19 patients admitted in hospital though it has serious consequences. Coronavirus may cause hypokalemia through disruptions of rennin-angiotensin system, gastrointestinal loss or other unknown mechanisms. Objective: To investigate the prevalence of hypokalemia among patients with moderate to severe COVID-19 and its association with other clinical and laboratory parameters. Design, Setting, and Participants: This was cross sectional observational study conducted at Dhaka medical College Hospital of Bangladesh from June, 2020, to August 2020. Participants were included who were positive for rt-PCR for COVID-19 according to the national guideline. The patients were classified as having severe hypokalemia (plasma potassium 3.5 mmol/L). Results: Prevalence of hypokalemia among patients with COVID-19 was 20.2%, severe hypokalemia (2 patients [1.5%]) and hypokalemia (25 patients [18.7%]). One thirty four (134) patients with positive COVID-19 were included. The mean [SD] age of these 134 patients according to different potassium levels appear to be : 68 [2.83] years for severe hypokalemia , 51.93[11.68] years for hypokalemia and 50.73[14.7] years for normokalemia. Among them, 46 patients were females [34.32%]) and rest were males [65.68%]. Within the total sum of 134 patients, 107 were identified having normokalemia, [79.9%]. 25 patients [18. 7%] had hypokalemia and only two patients [1.5%] were found having normokalemia. Among 134 patients, three commonest symptoms were fever (132 patients [98.5%]), dry cough (123 patients (91.79%) and shortness of breath (122 patients [91.04%]), followed by less common symptoms like fatigue (89 patients [66.410%]), sore throat (60 patients [44.77%]), and diarrhea (44 patients, [32.83%]). Shortness of breath was associated with grades of hypokalemia (P=0.022). Only 26 patients (19.4%) manifested having vomiting/Nausea. The predominant comorbidities found among these 134 participants were Hypertension (68 patients [64.2%]), Diabetes (54 patients [52.9%]), Ischemic heart disease (37 patients [38.1%]) and Asthma (27 patients [31.0%]). The prevalence of comorbidities was not associated with Hypokalemia. Conclusions Prevalence of hypokalemia among patients with COVID-19 is high (20.2%) and appropriate treatment is highly required. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 131-137

Dengue fever first identified as ‘Dhaka Fever’ in 1964 & became endemic around 2000. The most recent spreading of dengue in 2019 was also notable for change in the presenting features of the patients attributed by some to the fact that causative virus might be of different serotype. Our study aims to assess the current pattern of presentation of dengue virus infection, done in inpatient of Department of Medicine of Dhaka Medical College Hospital Dhaka. This was a crosssectional, observational, descriptive study conducted between 1st August and 30th September 2019. A total 70 subjects, age >12 years were included in this study. Among them 55 were male & 15 were female, with a mean age of 28.33(±12.15) years. Comorbidities noticed in few cases such as DM (2, 2.90%), HTN (3, 4.35%), IHD (1,1.45%), CKD & COPD (1,1.45%). The most common presentation were fever (64, 91.43%), headache (62, 88.57%) anorexia (59, 85.51%), generalised pain (51, 73.91%), nausea (49, 71.01%). Examination findings at admission were temperature was high but not very high, pulse were normal, both systolic & diastolic pressure were somewhat normal, among the warning signs, severe abdominal pain (27.54%), persistent vomiting (21.74%), lethargy /restlessness /sudden behavioural change (21.74%) were most common. The common haematological parameters & routine investigation values were not deviated from expected range. As dengue is likely to continue to constitute a serious public health problem in Bangladesh, this study may help the practitioners to understand the changing pattern & to manage patients accordingly. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 199-207

Psoriasis is a common, chronic, immune mediated inflammatory disease that involves the innate immunological system (keratinocyte, dendritic cell, histiocytes, mast cells and endothelial cells) and acquired immunological system (T lymphocytes). Essential trace elements like iron (Fe), copper (Cu) undergo redox cycling and have physiological significance in inflammatory process. This study is aimed at measuring the level of copper, ceruloplasmin, iron and transferrin in psoriasis patient and to assess its relationship with the severity of the disease. This is an observational cross sectional study. It was conducted at the department of Dermatology and Venereology, BSMMU, Dhaka. Age range of the patient was 18 to 65 years. The mean age of the patients was 39.1±13.54 years, 57.9% patients were male and 42.1% were female. Male: female ratio was 1.4:1. Male patients were predominant. Mean duration of disease 5.36±4.05 years with range from 1.0 to 14 years. Most of the (76.3%) patients had mild disease followed by 23.7% had moderate to severe disease. Serum level of trace elements was compared between mild and moderate to severe group of psoriasis patients but difference were not statistically significant (p>0.05). Weak negative correlation was found between PASI score and serum levels of copper (r = “0.134, P = 0.423), iron (r = –0.080, p = 0.632), transferrin (r = –0.079, p = 0.638) and weak positive correlation was found with ceruloplasmin (r = 0.228, p = 0.168). The results of the present research provide valuable information and correlation between the measured biomarkers and severity of psoriasis. Serum Ceruloplasmin, copper, iron and serum transferrin could serve as a biomarker of psoriasis but not as a marker of psoriasis severity. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 59-68

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may cause severe life-threatening diseases called acute respiratory distress syndrome (ARDS) owing to cytokine storms. The mortality rate of COVID-19-related ARDS is as high as 40% to 50%. However, effective treatment for the extensive release of acute inflammatory mediators induced by hyperactive and inappropriate immune responses is very limited. Many anti-inflammatory drugs with variable efficacies have been investigated. Colchicine inhibits interleukin 1 beta (IL-1β) and its subsequent inflammatory cascade by primarily blocking pyrin and nucleotide-binding domain leucine-rich repeat and pyrin domain containing receptor 3 (NLRP3) activation. Therefore, this cheap, widely available, oral drug might provide an added benefit in combating the cytokine storm in COVID-19. Here, we sought to determine whether adding colchicine to other standards of care could be beneficial for moderate COVID-19 pneumonia in terms of the requirement for advanced respiratory support and mortality. Methods and findings This blinded placebo-controlled drug trial was conducted at the Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 300 patients with moderate COVID-19 based on a positive RT-PCR result were enrolled based on strict selection criteria from June 2020 to November 2020. Patients were randomly assigned to either treatment group in a 1:1 ratio. Patients were administered 1.2 mg of colchicine on day 1 followed by daily treatment with 0.6 mg of colchicine for 13 days or placebo along with the standard of care. The primary outcome was the time to clinical deterioration from randomization to two or more points on a seven-category ordinal scale within the 14 days post-randomization. Clinical outcomes were also recorded on day 28. The primary endpoint was met by 9 (6.2%) patients in the placebo group and 4 (2.7%) patients in the colchicine group (P = 0.171), which corresponds to a hazard ratio (95% CI) of 0.44 (0.13–1.43). Additional analysis of the outcomes on day 28 revealed significantly lower clinical deterioration (defined as a decrease by two or more points) in the colchicine group, with a hazard ratio [95%CI] of 0.29 [0.098–0.917], (P = 0.035). Despite a 56% reduction in the need for mechanical ventilation and death with colchicine treatment on day 14, the reduction was not statistically significant. On day 28, colchicine significantly reduced clinical deterioration measured as the need for mechanical ventilation and all-cause mortality. Conclusion Colchicine was not found to have a significant beneficial effect on reducing mortality and the need for mechanical ventilation. However, a delayed beneficial effect was observed. Therefore, further studies should be conducted to evaluate the late benefits of colchicine. Clinical trial registration Clinical trial registration no: ClinicalTrials.gov Identifier: NCT04527562 https://www.google.com/search?client=firefox-b-d&q=NCT04527562.

Background Wearing masks or personal protective equipment (PPE) has become an integral part of the occupational life of physicians due to the coronavirus disease 2019 (COVID-19) pandemic. Most physicians have been developing various health hazards related to the use of different protective gears. This study aimed to determine the burden and spectrum of various health hazards associated with using masks or PPE and their associated risk factors. Methods This cross-sectional survey was conducted in Dhaka Medical College from March 01–May 30, 2021, among physicians from different public hospitals in Dhaka, Bangladesh. We analyzed the responses of 506 physicians who completed case record forms through Google forms or hard copies. Findings The mean (SD) age of the respondents was 35.4 [7.7], and 69.4% were men. Approximately 40% were using full PPE, and 55% were using N-95 masks. A total of 489 (96.6%) patients experienced at least one health hazard. The reported severe health hazards were syncope, severe dyspnea, severe chest pain, and anaphylaxis. Headache, dizziness, mood irritation, chest pain, excessive sweating, panic attack, and permanent facial disfigurement were the minor health hazards reported. Extended periods of work in the COVID-19-unit, reuse of masks, diabetes, obesity, and mental stress were risk factors for dyspnea. The risk factors for headaches were female sex, diabetes, and previous primary headaches. Furthermore, female sex and reusing masks for an extended period (> 6 h) were risk factors for facial disfigurement. The risk factors for excessive sweating were female sex and additional evening office practice for an extended period. Conclusions Healthcare workers experienced several occupational hazards after using masks and PPE. Therefore, an appropriate policy is required to reduce such risks.

Background/context: Dietary diversity (DD) is universally recognized as a key component of healthy diets. Healthy diet is one of the most important determinants that can influence nutritional status of women of reproductive age. Materials and Methods: This cross sectional study was conducted in Shitpara village of Sreepur Upazila under Gazipur district during February to June 2013 to assess the dietary diversity and nutritional status of women of reproductive age. Convenient sampling technique was adopted to select 181 women. Interview schedule & checklist used as research instrument. Results: The mean(+/-s.d.)age of the respondents was 27.45+/-9.38 years, 133(80%) of them were married and 176(97.2%) are literate. Mean family size was 5.34+/- 2.386 persons and mean family income was 9611.05 Taka per month. Among 133 married women, 68(51%) have 2 or less than two children. Their mean(+/-s.d.) dietary diversity score was 5.13+/- 1.19 and majority 149(82%) of them having medium dietary diversity tercile (4-6). All of them ate carbohydrate types of food, 174(96.1%) protein rich foods & 83(45.9%) vit.A rich vegetables & fruits. Their mean BMI was 22.35 +/- 3.71 kg/ m2. Majority 118 (65%) of them having normal BMI and 22(12%) are under weight. Only 6(3%) of them are obese. Thoughdietary diversity was medium (4-6); relationship between dietary diversity and nutritional status could not be established. Conclusion:The qualitative measurement of dietary diversity is not sufficient enough to identify women at risk of under- or over nutrition. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 36-40

Objective: The objective of the study was to assess the diagnostic usefulness of MRI in evaluation of spinal tumors.Methodology: This cross-sectional study was carried out in Dhaka Medical College Hospital, Dhaka. The data was collected from July 2011 to June 2013 and total 51 patients were included in the study. Data was collected from MRI diagnosed spinal tumors who attended at Radiology and Imaging department of DMCH from OPD and indoor patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI for evaluation of spinal tumors were detected.Results: Out of 51 patients 26 (51%) was intradural extramedullary, 13 (25.5%) was extradural and 12 (23.5%) was intramedullary. Distribution of patients according to MR diagnosis. Among the 51 patients 40 were diagnosed spinal tumor and 11 were not spinal tumor by MRI. Among the 40 spinal tumuor diagnosed 12 (23.5%) were schwannoma, 02 (3.9%) were neuro fibroma, 11(21.6%) were meningioma, 07(13.7%) were ependymoma, 05(9.8%) were astrocytoma, 02(3.9%) were metastasis and 1 (2.0%) was osteoblastoma. Out of all cases 40 were diagnosed as spinal tumour by MRI and among them 39 were confirmed by histopathological evaluation. They were true positive. One case was diagnosed as having spinal tumour by MRI but not confirmed by histopathological findings. That was false positive. Out of 11 cases of non tumour which were confirmed by MRI, 3 were confirmed as spinal tumour and 8 were non-tumour by histopathological findings. They were false negative and true negative respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MRI in the diagnosis of spinal tumour were 92.86%, 88.89%, 97.50%, 72.73% and 92.15% respectively.Conclusion: The present study conducted to assess the diagnostic usefulness of MRI in evaluation of spinal tumors among the Bangladeshi population. Study revealed high sensitivity, specificity and accuracy of the MRI in the diagnosis of spinal tumour. MRI should be the initial procedure in the evaluation of suspected tumors of the spine.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 162-166

Background: Serum tumor markers are convenient, non-invasive, acceptable to patients and play an important role as an ancillary tumor diagnostic tool. CA 19-9 has become a common tumor marker, specific for digestive system tumors. The study was carried out to determine the value of CA 19-9 as a tumor screening marker among healthy individuals. Materials and Methods: This study had been carried in Dhaka Medical college Hospital from January 2016 to January 2018. The serum CA 19-9 level was detected using a microsome luminescence method. Individuals with high CA 19-9 levels underwent further examination, including routine fecal testing, thoracic and abdominal computed tomography (CT) scan, gastroscopy, and colonoscopy. These individuals had regular follow-up examinations. Results: Over a 3-year period, the serum CA19-9 levels of 960 healthy individuals were estimated. The CA 19-9 level of 15 individuals was positive (positive rate: 1.56%), including 7 men (7/699; 1.001%) and 8 women (8/261; 3.06%). There was a significant difference between males and females (p

During Ramadan, Muslims fast from dawn to dusk for one lunar month. Although a majority of Muslim patients with type 2 diabetes fast during the month of Ramadan, there are no accepted guidelines for its management during this period. The few studies on this subject suggest that there are important alterations in energy intake and physical activity, and that most patients change their pattern of drug intake. The objectives of this article is to assist in the task of advising diabetic patients who fast and provide them with guidelines regarding proper management of their diabetes during Ramadan.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 649-652

Background: Glycopeptides such as vancomycin are frequently the choice of antibiotics for the treatment of infections caused by methicillin resistant Staphylococcus aureus (MRSA). For the last 7 years incidence of vancomycin intermediate S. aureus and vancomycin resistant S. aureus (VISA and VRSA respectively) has been increasing in various parts of the world. Objective: The present study was carried out to find out the presence of VISA and VRSA among isolated MRSA strains. Methodology: This cross sectional study was carried out in the Department of Microbiology in Dhaka medical college during period of January 2010 to December 2011 . All S. aureus isolates were screened to detect methicillin resistance and then all MRSA isolates were subjected for MIC testing against vancomycin and oxacillin by agar dilution method, disc diffusion testing and PCR for mecA and pvl genes detection. Result: A total 112 S. aureus were isolated from 500 nasal swab sample collected from adult patients who were admitted in various departments and wards in Dhaka Medical College Hospital. Among 38 MRSA strains out of 112 Staph aureus isolates 3(7.89%) strains were resistance to vancomycin of which 2(5.26%) strains had MIC > 256 mg/mL and one strain had MIC 256mg/mL. All vancomycin resistance strains had MIC of oxacillin > 256 mg/mL. All isolates possess mec-A gene. Conclusion: The present study reveals that emergence of VRSA upon admission at a tertiary care of hospital in Bangladesh. Continuous efforts should be made to prevent the spread and the emergence of VRSA by early detection of the resistant strains and using the proper infection control measures in the hospital setting. Bangladesh Journal of Infectious Diseases 2016;3(1):11-16

Patients colonized with Methicillin resistant Staphylococcus aureus (MRSA) in hospital are considered as one of the risk factors for infection with MRSA. Worldwide spread of MRSA in both hospital setting and community poses public health threat. This study was undertaken to determine the frequency of MRSA colonization among patients at time of hospital admission. Five hundred adult patients were screened within 24 hrs of admission in different wards in Dhaka Medical College Hospital by taking nasal swabs from anterior nares and were analyzed. All isolated Staphylococcusaureus were screened to detect methicillin resistance by modified Kirby-Bauer disc diffusion method using oxacillin and cefoxitin disc and then all MRSA isolates were subjected for MIC testing against oxacillin by agar dilution method and PCR for mecAgene detection. Out of 500 patients Staph aureus nasal colonization was observed among 112 (22.4%) patients and among those 7.6% was MRSA.MRSA colonization rate was 23.29% among patients who had history of prior hospitalization and was 4.92% among community residents who had no previous hospitalization history in last 12 month. A significant number of patients (7.6%) were colonized with MRSA at the time of admission. Screening for MRSA carriers among this population is necessary for hospital acquired infection control.Bangladesh J Med Microbiol 2014; 08 (02): 08-13

Background: Inflammation is playing a major role in the pathophysiology of severe COVID-19 disease. The main causes of mortality are cytokine syndrome and immune thromboembolism. Colchicine is an anti-inflammatory drug but its action is mediated by completely different pathophysiologic routes than that of corticosteroids and non-steroidal anti-inflammatory agents. Colchicine inhibits neutrophil chemotaxis, inhibits inflammasome signaling and reduces interleukin-1β, reduces neutrophil-platelet interaction and aggregation. Colchicine is a readily available, cheap drug, has been used safely for many years. Specific targeted anti-inflammatory drugs like tocilizuma and anakinra are costly. A previous study suggested a significant clinical benefit from colchicine in patients hospitalized with COVID-19. But they did not compare with placebo. So, we have designed this study.Methods: This is a prospective, double-blind, randomized, placebo-controlled clinical trial. The study will be conducted at Dhaka medical college hospital, Bangladesh. Real time-polymerase chain reaction (RT-PCR) positive COVID-19 patients with moderate symptoms will be included in this study. Participants will be randomized into two groups at 1:1 ratio. Patients of one group will be treated with standard treatment along with colchicine for 14 days. The patients in other group will be treated with standard treatment along with placebo for the same duration. The primary outcome of the study will be time to develop clinical deterioration, defined as the time from randomization to a deterioration of two points (from the status at randomization) on a seven-category ordinal scale.Conclusions: Enrolment of participants has begun at the study site. A total of 300 participants will be enrolled.Trial Registration: ClinicalTrials.gov identifier: NCT04527562.

Thrombotic thrombocytopenic purpura is a multisystemic microvascular disorder that may be caused by an imbalance between unusually large vWF multimers and the cleaving protease ADAM TS 131 (A disintegrin and metalloproteinase with a thrombospondin type 13). This disease was first described by Moshococowitz in 1924.2 It is clinically characterized by five typical syndromes: thrombocytopenia, microangiopathic hemolytic anaemia, renal impairment, fluctuating neurological abnormalities and fever. It is a rare disease and fatal in 50 to 80 per cent of cases5. TTP can be idiopathic or secondary. Here we are describing a case who developed fever, purpuric spot, jaundice, renal impairment and fluctuating neurological features. Initially it seems to us as a case of DIC, but later hematological evaluation reveals it as a case of TTP, as the patient fulfills the pentad criteria. Unfortunately we could not do the serum ADAM TS 13 level because of lack of facility in our country and in abroad it is costly.Bangladesh J Medicine Jan 2015; 26 (1) : 35-38

Recirculation in haemodialysis patients is an important factor as it is a correctable cause of under dialysis. This study was a cross sectional study done in the department of Nephrology Dhaka Medical College and hospital during the period Sept 2010 to Oct 2011 with a view to estimate recirculation in AV fistula among the Haemodialysis patients. This study used two needle urea based method for estimation of recirculation. Total 118 patients were included in this study.Bangladesh J Medicine Jan 2014; 25 (1) : 17-20

Background: Worldwide haemodialysis(HD) is the mostly used method of renal replacement therapy. Arteriovenous fistula use is on rise due to Fistula First Initiative due to least complications of fistulae than catheters.But they are also subjected to many complications. Thereby appropriate surveillance of the fistulae is important. Objectives: To measure the blood flow as well as fistula related complications in study population. Materials and Methods : This was a cross sectional study, conducted in the department of Nephrology, Dhaka Medical College Hospital during September 2010 to December 2011.Total 118 subjects were included in the study. Besides visualization technique colour Doppler ultrasonogram of fistula and echocardiography were performed for each patients. Results : Most of the patients had adequate fistula flow. Aneurysm was most common complication. Many subjects were suffered from primary and secondary fistula failure. Conclusion : Arterio-Venous fistula is subjected to many complications and appropriate surveillance should be launched to detect complications and to prevent fistula failure. DOI: http://dx.doi.org/10.3329/jom.v15i2.20681 J MEDICINE 2014; 15 : 110-113

Background: Urinary tract infections (UTIs) remain the common infections in outpatients as well as hospitalized patients. Current knowledge on antimicrobial sensitivity pattern is essential for appropriate therapy. The aim of the study is to determine the changing pattern of antibiotic sensitivity among uropathogens causing UTI. Methods: Urinary isolates from symptomatic UTI cases attending in Square hospital were processed in the Microbiology lab. Antimicrobial susceptibility testing was performed by Kirby Bauer’s disc diffusion method. Extended spectrum beta lactamase (ESBL) production was determined by double disk synergy test method. Results: Of the 200 tested sample 110 samples showed growth of pathogens among which the most prevalent were E.coli (58.18%) followed by Enterococci (13.6%). The majority (68.18%) of the isolates were from female. ESBL production was observed in 46.87% o E.coli strains and 25% of Klebsiella strains. More than 98% of the isolates are sensitive to Imipenem, Meropenem , while 86.36% are sensitive to Amikacin, 73.63% to Nitrofurantoin and 74.54% to Gentamicin. Very high rate of resistance is seen against amoxicillin (88.19%), cefixime (65.46%), cotrimoxazole (68.19%) and ceftriaxone (63.63%). E. coli showed high sensitivity to meropenem, imipenem and amikacin (100%) followed by Gentamicin (94.1%). Conclusion: The study revealed that E.coli was the predominant bacterial pathogens of UTIs. An increasing trend in the production ESBLs among UTI pathogens in the community was noted. Nitrofurantoin should be used as empirical therapy for primary, uncomplicated UTIs. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19952 Bangladesh Crit Care J March 2014; 2 (1): 21-24

Back ground: Coronary artery disease (CAD) is a major risk of death worldwide. Level of education about this important health problem is poor in our general population. Aims of this study was to find out simple knowledge about coronary disease, and to find the knowledge about risk factors, symptoms, complications and knowledge about prevention of coronary disease among the hospitalized patient who admitted to SSMS and Mitford Hospital and diagnosed as patients of Acute Coronary Syndrome (ACS). Method: A pre tested questionnaire regarding assessment of level of knowledge about CAD was used to studied of the patients was admitted to SSMC and Mitford Hospital with the diagnosis of acute coronary syndrome during the period April 2009 to October 2009. Result: Our study suggests that there is a lack of awareness among a sampled Bangladeshi population regarding CAD and its modifiable risk factors. We found that the low level of knowledge in the majority of patients, the rural and less educated patients had a lower level of knowledge. Conclusion: Our cardiac patients have poor knowledge regarding their disease; improvement of knowledge is needed through much education to prevent CAD. DOI: http://dx.doi.org/10.3329/jom.v14i2.19639 J Medicine 2013, 14(2): 119-122

Objective: To assess the prevalence of gestational diabetes mellitus (GDM) among the pregnant women of Dhaka city and to find out the consequences or effects of GDM on pregnancy outcome. Materials and methods: This was a descriptive type of cross sectional study followed by cohort type of study, conducted in different hospitals in Dhaka city. Initially 960 pregnant women of 24th to 28th weeks were selected purposively; plasma glucose was measured at fasting and two hours after taking 75g oral glucose load. Modified method of Carpenter and Coustan criteria was followed to diagnose GDM. For each GDM case diagnosed, one non-GDM pregnant women was taken as control after matching age and parity. Both groups were followed up to 4 wks after delivery to find out maternal and neonatal mortality and morbidities. Results: Out of 960 pregnant women 72 were GDM positive (7.5%).There was no maternal mortality but morbidities like hydramnions (p

Gitelman'?s syndrome, discovered in 1966 by Gittleman,Graham and Welt, is an autosomal recessive renal tubular disorder and characterized by hypokalemic metabolic alkalosis, hypomagnesaemia, hypocalciuria. This is a rare cause of hypokalemia which has an autosomal recessive inheritance. Here we are reporting a case of a 35 years old lady presented with recurrent attacks of quadriparesis due to hypokalemia and pain in multiple joints. Later we diagnosed the case as Gitelman?'s syndrome.DOI: http://dx.doi.org/10.3329/jom.v16i1.22407 J MEDICINE 2015; 16 : 59-60

The present study was performed to investigate the nephroprotective effects of captopril in experimentally induced nephrotoxicity in rats. To demonstrate this effect, serum level of creatinine and blood urea nitrogen(BUN) was chosen. Histological examination of kidney was also performed. For the purpose of the study 35 long Ivan rats were taken divided into five groups(G-A,G-B,G-C,G-D and G-E)comprising 7 rats each. Group A received .75ml distilled water subcutaneously in addition to normal diet, and served as control . Group B was treated with gentamicin 125mg/kg subcutaneously for 9 days and served as experimental group. Group C,D and E were designed to demonstrate the nephroprotective effect. In this part of experiment, group C was treated with only gentamicin 125mg/kg subcutaneously for 9 days and served as control. Group D and group E were treated with captopril 9mg/kg and 11mg/kg orally respectively, in addition to gentamicin. Mean serum creatinine and BUN level raised highly significantly in group B in comparison to group A after 9 days treatment with gentamicin. Histological findings showed a number of necrosed proximal convoluted tubules in group B whereas normal architecture is preserved in group A. Co administration of captopril prevented significantly gentamicin induced increase serum creatinine and BUN. Though histological findings did not correlate with biochemical findings and there are significant numbers of necrosed proximal convoluted tubules. From the result and observations of the present study and their comparison with the works of other researchers, it may be concluded that captopril is beneficial in protecting gentamicin induced nephropathy. Thus, it could be useful in nephrotoxic conditions, such as hypertension with acute glomerulonephritis, acute renal failure and chronic renal failure. But before establishing captopril as a therapeutically effective nephroprotective agent further studies should be carried out to determine the nephroprotective effect and its cellular mechanism as well as any clinical trial for suitability of using in man. Key Words: Captopril; Gentamicin Induced Nephrotoxicity. DOI: 10.3329/jdmc.v18i1.6297 J Dhaka Med Coll. 2009; 18(1) : 3-7

The ongoing national TB control programme (NTP) of Bangladesh had started from 1993 and had expanded at all upazilas in collaboration with partner NGOs by June 1998. The NTP is following DOTS strategy with target 70% case detection and 85% cure rate. By this time more than a decade has passed but total achievement of NTP is yet remain mask due to absence of exact statistic on tuberculosis situation in our country. doi: 10.3329/taj.v18i2.3175 TAJ 2005; 18(2): 98-105