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Background: Pregnancy-induced hypertension (PIH) is a relatively common pregnancy disorder that causes variable maternal and fetal problems. This may increase the number of perinatal asphyxia, sepsis, still birth etc. It also has a significant affect on birth weight which is also related to gestational age. Objectives: To observe the impact of pregnancy induced hypertension on their newborn babies and compare the findings with the babies of normotensive mother. Materias and Methods: This case control study was conducted from July 2016 to December 2016. The study group was selected from the babies of pregnancy induced hypertension (PIH) mothers and control group selected from babies of a normotensive mother attending in Obstetrics department of Dhaka Medical College Hospital, Dhaka having the inclusion and exclusion criteria. The total number of 100 neonates were included consecutively in this study. 50 neonates born to mothers with pregnancy-induced hypertension were grouped as cases and 50 neonates born to normotensive mothers were grouped as control. Results: The study revealed that, the highest frequency of neonatal morbidities were perinatal asphyxia (22%) among the babies of PIH mother. Stillbirth it was found 12 % . The duration of pregnancy were also affected by PIH where most of the babies were preterm (88%) and complete-term pregnancy found only (12%). It should be mentioned that those mother having history of preeclampsia delivered more premature babies (p

Background: Birth trauma usually occurs, particularly in long and difficult labour or fetal mal presentations. Although with advancements in technology and improved obstetric care and liberal use of cesarean section deliveries, serious birth trauma is decreasing worldwide. Appraisement of common triggers of birth trauma is the key ingredient for provision of high quality prenatal & perinatal care to reduce the incidence and severity of birth trauma.Objective: To evaluate the risk factors of birth trauma. Materials and Methods: This case control study was carried out in the department of Neonatology, Dhaka Medical College Hospital from 14th August, 2018 to 14th February, 2019. Total 100 newborns were enrolled in the study. Among them 50 were cases, diagnosed as birth injury & 50 were controlls without birth injury. Results: Most common birth injury encountered, was caput succedaneum15 (30%). The next common injuries were cephalohematoma was 11(22%) & subgalealhemorrhage 11 22%). Other injuries were skin & soft tissue injury in 5 (10%), followed by sternomastoidhemorrhage, accidental cut injury, clavicular fracture, humerus fracture, facial nerve palsy, erbs palsy, subconjunctival Haemorrhage. The predisposing factors for mechanical birth trauma were primiparity (P = 0.005), advanced maternal age (28.99 ± 5.4)> (26.5 ± 4.5) (p value =0.01), mal presentation (P = 0.05), oxytocin use (P < 0.01), Prolonged labor (P < 0.01), large size of the baby (p=0.046), VD(p=0.004). Conclusion: The study concluded that the commonest birth injury was caput succedaeneum and primiparity, advanced maternal age, prolonged labor, large-sized baby, mal presentation were the significant risk factors for birth injury. KYAMC Journal Vol. 13, No. 03, October 2022: 129-133

Background: The advancements in intensive care in recent decades have enabled better survival of newborn. Knowledge of essential newborn care is important for the survival, growth, and development of a newborn. In spite of its essentiality, most health-care professionals do not know and follow the World Health Organization recommendation. Aim and objectives: The aim of this study was to assess the knowledge of nurses regarding essential newborn Care in Special Care Neonatal Units (SCANU). Materials and methods: This observational study was conducted among the nurses working in SCANU of Chattogram Medical College and Hospital, Chattogram Maa- O- Shishu Hospital and Bangabandu memorial hospital of University of Science and Technology, Chattogram (USTC) for 6 months. Purposive sampling technique were applied for selecting the sample. A structured data sheet was predesigned to collect data. Knowledge regarding Essential Newborn Care among the nurses graded as satisfactory or not satisfactory. Results: In this study it was observed that 69.0% nurses had completed diploma in nursing and midwife education, B. Sc in nursing 11.0%, diploma in nursing 7.0%. 56.0% nurses attended special courses/training in neonatology. 94.75% of the nurses had satisfactory knowledge regarding essential newborn care. 58.0% of nurses washed their hands with disinfectant solution before handling the baby, 99.0% mentioned that the baby must be breast feeding within 1st hour of delivery, 92.0% mentioned that baby must be fed 6 months of exclusive breast feed, 91.0% knew how to stabilize body temperature of low birth weight newborn. The knowledge regarding essential newborn care were almost similar with age, gender, religion, marital status, educational level, working place and attending special courses/training in neonatology. Conclusion: Most of the nurses working in SCANU of both Government and non-government hospitals of Chattogram have good knowledge regarding ENC. This knowledge appeared irrespective of their age, gender, religion, marital status, working place and special courses/training in neonatology. J Bangladesh Coll Phys Surg 2021; 39(3): 185-192

Prematurity and low birth weight contributes to 27.8% of neonatal deaths in rural areas of Bangladesh. Fluid, electrolyte and metabolic abnormalities are the commonest derangements encountered in preterm infants due to their renal immaturity and relatively immature skin. Premature infant are at increased risk of developing dehydration or overhydration4. Therefore, high index of suspicion, prompt recognition and thorough understanding of common electrolyte abnormalities are necessary to improve neonatal outcome. Appropriate fluid and electrolyte management is essential for better neonatal outcome. Objectives: To identify the serum electrolytes abnormalities in preterm low birth weight neonates. Methodology: It was a cross- sectional study and carried out in the Department of Neonatology, Dhaka Medical College Hospital, Dhaka between January 2017 to August 2017. Information was collected who gave consent and participated in the study willingly. The sample size was 50. Patients admitted in the above mentioned hospital and after meeting the inclusion and exclusion criteria a simple random sampling technique was applied for selecting the study subjects. Results: Fifty preterm LBW neonates fulfilling the inclusion criteria were studied during this study period. Abnormal electrolytes were documented in 20(40%) out of 50 preterm LBW neonates and electrolyte status was normal in 30(60.0%) cases. Of 20 neonates who had abnormal electrolytes, hyperkalemia was the predominant electrolyte abnormality found in 8(16.0%) neonates, hyponatremia was found in 7(14.0%), hypokalemia in 3(6.0%) and hypernatremia 2(4.0%). Conclusion: Electrolyte abnormalities are common in preterm LBW neonates. So, identification of electrolyte abnormalities and proper management of fluid and electrolytes and close monitoring are important. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 145-148

Background: Nebulized salbutamol is commonly used in treatment of asthma in children. The use of nebulized MgSO4 is one of the different treatment options available during acute exacerbation. Objective: To compare the efficacy of nebulized MgSO4 with nebulized salbutamol in the treatment of acute asthma in children. Materials and method: This randomized controlled study was conducted in Dhaka Medical College Hospital between January to December 2016. Children of 7-12 years with acute exacerbation of asthma were randomized into study group-A (MgSO4 group, n=30) and control group-B (Salbutamol group, n=30). Children of both groups were treated with serial nebulization thrice at 20 minute intervals by either 2.4 ml (4% MgSO4, 96 mg) or salbutamol (0.15 mg/kg minimum 2.5 mg) with 2.5 ml of isotonic normal saline. Results: The mean final PEFR were not different between the two groups (275.0±41.42 L/min in MgS04 group and 263±36.17 L/min in salbutamol group). The increase in PEF was statistically significant and comparable in both groups (by 35.1% in the MgS04 group and by 42.1% in the salbutamol group). Fischl score improvement was comparable and significant in both groups (4.31 to 0.43 in MgS04 group and 4.29 to 0.76 in salbutamol group). Statistically significant increase in oxygen saturation and reduction of heart rate was found in MgS04 group without any side effects. Nebulized MgSO4 was found having significant bronchodilator effect which is comparable to salbutamol. Conclusion: Nebulized MgS04 was found equally effective as nebulized salbutamol in the treatment of severe acute asthma in children. Bangladesh J Child Health 2020; VOL 44 (1) :24-29

Neonatal seizures are common in the first month of life and may impair neurodevelopmental outcome. Phenobarbitone (PB) currently represents the anti epileptic drug (AED) of choice, despite related to cognitive impairment in human subjects and limited efficacy. Intravenous levetiracetam is increasingly being used in the neonatal period to treat seizures. Presently, insufficient data about the efficacy and safety of intravenous levetriacetam in neonates, we have structured a randomized control trial with levetiracetam in the initial treatment of acute neonatal seizure. Objective: To find out the efficacy of levtiraracetam for controlling the convulsions in acute neonatal seizures compared to phenobarbitone. Methodology: The study was a randomized control trial. A total of 100 neonates from 0 day to 28 days of age irrespective of sex with clinical presentation of neonatal seizures admitted in the special care baby unit (SCABU) of Dhaka Medical College Hospital were included in the study and were randomly assigned to either levetiracetam or Phenobarbitone group after matching inclusion and exclusion criteria. The outcome variables were seizure control, times taken to be seizure free, and hospital stay. Outcome was evaluated through routine monitoring up to 48 hours and followed up to discharge or death. Result: The study groups were almost similar with respect to their demographic characteristics like age, sex and gestational age. According to maternal obstetric data i.e- antenatal care (ANC), modes of delivery in the both groups were statistically not significant. Seizures status was nonsignificant in both groups. The study demonstrated that controlling the seizure with levetiracetam & Phenobarbitone were 66.0% and 34.0% respectively. Length of the hospital stay was shorter in levetiracetam group. Eventually the phenobarbitone group required more than one drug to control seizures.. But immediate adverse effect was not significant in both groups. Conclusion: The study concluded that levetiracetum significantly control the convulsion in comparison to phenobarbitone as first line antiepileptic drug in the initial treatment of acute neonatal seizures. Both the modalities of treatment were found to have no adverse effect. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 182-189

Background: Acute bronchiolitis is an acute viral lower respiratory tract infection in early childhood and is the leading cause of hospitalization in infants below 2 years of age. Being a viral disease, there is no effective treatment of this problem other than supportive care. To provide this care, both 3% hypertonic saline and 7% hypertonic saline has been used and found effective. However, which option is more effective to reduce clinical severity and length of hospital stay, still remain unsettled.Objective: To determined the efficacy of 7% hypertonic saline in children with acute bronchiolitis.Methodology: The study was a randomized controlled trial and carried out in the Department of Paediatrics, Dhaka Medical College Hospital (DMCH), Dhaka between January 2015 to December 2016. A total of 135 children from 1 month to 2 years of age irrespective of sex with clinical presentation of acute bronchiolitis admitted in the paediatrics ward of DMCH were included in the study and were randomly assigned to either 7% nebulized hypertonic saline (Group-I = 45) or to 3% nebulized hypertonic saline (Group-II = 90) in ratio (1:2). The main outcome variables were clinical severity score and length of hospital stay. The outcome was evaluated at 12 hourly and 24 hourly intervals till discharge (up to 120 hours)Result: In this study both groups were almost similar with respect to their demographic characteristics like age and sex and baseline clinical characteristics. The study demonstrated that respiratory rate score, wheezing score, retraction score, general condition score and clinical severity score of both treatment modalities were reduced. Children of group-I(7% HS) 40(88.9%) recovered at the end of 72 hours where as 67(74.4%) of the children of group-II(3% HS) recovered from the disease during the same period. Length of hospital stay was shorter in 7% hypertonic saline group compared to 3% hypertonic saline group (56.36±16.33 hours vs63.07±21.48 hours, p=.067). The patients of 7% hypertonic saline group required a shorter duration of oxygen therapy compared to 3% hypertonic saline group (16.53±3.98) hours vs (20.25± 4.15) hours, (p=0.109) respectively.Conclusion: Nebulized 7% hypertonic saline as well as 3% hypertonic saline both were effective in acute bronchiolitis and found no significant difference in efficacy between these options in terms of reducing clinical severity, length of hospital stay and duration of oxygen therapy. No side effect were observed in either group.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 153-156

Background: Undergraduate medical education aims at sculpting the future physicians. Knowledge gained from here will help them to act effectively when they will face different medical problem in future. It is necessary to ensure that students learn what is important and thus it is very important to assess them with right question in the examination. Methods: This is a retrospective analytical study involving evaluation of 2 nd professional MBBS pharmacology written (SAQ) questions held in four universities (Dhaka, Chittagong, Sylhet shahjalal and Rajshahi) of Bangladesh. Written (SAQ) question from July 2008 to July 2016 were analyzed for content coverage, type of question, educational objectives as per 2002 curriculum. Results: Total 56 written questions were analyzed. Each question contains 24 items SAQ arranged in four groups. On the basis of content coverage chemotherapeutic (19%), CNS (16%), GP (15%) and ANS(10%) are the maximum weightage of content area. Some aspect which are clinically important but less practiced in written examination are GIT, respiratory, renal, hemopoietics, lipid lowering agents and miscellaneous. Though the entire question should be SAQ type but some (4%) portion of question became essay type and short notes (5-10%) also common. Most of the questions were recall (90%) type, problem solving questions only 2%. Conclusion: It can be concluded that assessment instrument should be based on structured guidelines to improve the quality of question. To maintain consistency among different university periodic analysis of written questions, test blue printing and table of specification may be used. J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 13-17

Background : Intractable neonatal seizure are common acute medical emergency in neonatal period than at any other period of life. In our daily practice treatment of intractable neonatal seizures still relies primarily on phenytoin, despite an estimated efficacy of less than 50% and concern over neurodegenerative side effects. Several studies indicate value for lidocaine as an anticonvulsant in the treatment of intractable neonatal seizure. Aim : The objective of this study was to compare the efficacy of Phenytoin with Lidocaine in the management of intractable seizure in neonate. Methodology : A Randomized control trial was carried out in the Department of Neonatology, Dhaka Medical College Hospital (DMCH), Dhaka between July 2013 to June 2014. A total of 78 newborn with neonatal seizure. admitted in SCABU & not responding to total doses of Inj. Phenobarbital (40 mg/kg) were included in the study and were randomly assigned to either Inj. Lidocaine (Group A=39) or to Inj. Phenytoin (Group B=39). The main outcome variables were control of seizure, adverse effects, time of cessation of seizure. Results : The study demonstrated that intractable seizure of 24 neonates (75%) were controlled with Inj. Lidocaine and intractable seizure of 20 neonates (57.1%) were controlled with Inj. Phenytoin(P-Value 0.124). Adverse effects of drugs such as apnea, bradycardia, drowsiness and lethargy were observed in 4 patients (12.5%) of Lidocaine group (Group A) and 10 (28.6%) of Phenytoin group (Group=B) (P-Value 0.106). Time required for cessation of intractable seizures were nearly similar in both groups. In group A 75% of patients responded within 24 hours and in group B 71% patients responded in same duration(P-Value 0.931). Length of hospital stay was less in phenytoin group compare to lidocaine group(P-Value 0.352). None of the following results were statistically significant. Conclusion : The study concluded that Inj. Lidocaine is similar to Inj. Phenytoin in controlling intractable neonatal seizure. J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 94-99

Background: Adverse Drug Reactions (ADRs) are global problem of major concern. Spontaneous reporting of ADRs is the cornerstone of pharmacovigilance. However, underreporting is a huge problem due to lack of reporting culture among healthcare professionals. Objectives: the purpose of the present study was to assess the knowledge, attitude and practice of physicians regarding reporting of ADRs, and pharmacovigilance as well as to identify the reasons for under-reporting with suggestion for improvement in the reporting system. Methodology: This cross sectional, observational study was conducted to assess the knowledge, attitudes and practices regarding adverse drug reaction reporting among physicians working in different level hospitals of Bangladesh. Data were collected from 308 physicians during the period of January to December 2012 using structured questionnaire. Result: Response rate was 97%. Majority of the respondent (95%) felt that ADR reporting is necessary and it is a professional obligation. Inadequate knowledge of reporting mechanism, unavailability of reporting form, complex reporting system, lack of time and inadequate expertise were the main reasons cited for underreporting. Majority of the respondents suggested regular training sessions, strengthening the drug administration department, government law, regular follow up and inclusion of ADR reporting exercise in undergraduate and post graduate curriculum may help to improve the situation. Conclusion: The deficiency of knowledge, attitude and practice of physician regarding ADR reporting need urgent attention on priority basis not only for the success of pharmacovigilance program but also for better clinical management of the patient in general. J Shaheed Suhrawardy Med Coll, June 2014, Vol.6(1); 18-22

Climate is the soul and spirit of medical college and students’ experiences of the climate are a useful basis for modifying and improving the quality of educational environment. The present study was undertaken to identify how the students perceive the educational environment in a newly restructured curriculum using the Dundee Ready Education Environment Measure (DREEM). The inventory was administered to 1903 medical students (3rd, 4th and 5th year) of MBBS course adopting purposive sampling. The mean DREEM total score and mean score for five essential domains were found significantly different in different phase of medical students. DREEM total score were found to be highest for 3rd year students (119/200) and lowest for 5th year students (105/200) but all the three groups of students perceive the environment as positive. 3rd year students also scored high than 4th and 5th year students in five domains. All the three groups of students identify problems in environment and give opinion that there are many issues need to improve with special attention to perception of atmosphere and social self perception. The results are the first data obtained from the students about the educational environment and give important feedback to curriculum planners and change managers of the faculty for necessary improvement. DOI: http://dx.doi.org/10.3329/bjme.v1i1.12856 Bangladesh Journal of Medical Education Vol.1(1) 2010 pp.29-36

DOI: http://dx.doi.org/10.3329/jdmc.v20i2.10553 J. Dhaka Med. Coll. 2011; 20(2): 213-217

Background: Students' perceptions of their educational environment are a useful basis for modifying and improving the quality of educational environment. Educational environment is one of the most important factors determining the success of an effective curriculum. The quality of educational environment has been identified to be crucial for effective learning. Identifying the weakness of educational environment and understanding how students perceive the environment will help the institute to facilitate learning and to achieve better learning outcome. Objective: To explore students' perceptions of their educational environment and to find out gender differences in perception. Methods: It was a cross sectional descriptive study. Dundee Ready Education Environment Measure (DREEM) inventory was administered to 1903 medical students (studying in 3rd, 4th and 5th year MBBS course) in 15 medical colleges of Bangladesh adopting purposive sampling. Results: The total mean score for all students was found positive (110/200). Students' perceptions of learning was positive (28/48), perceptions of teachers was moving in right direction (24/44), students academic self perception was positive (19.5/32). Students' perceptions of atmosphere was expressed as many issues need to change (24/48) and social self perceptions was not a nice place (14/28). Female students’ perceptions were significantly higher than male students. Conclusion: Remedial measure should be needed in the subscales of students’ perceptions of atmosphere and social self perceptions for further improvement. Findings from this study may give guideline to curricular planner and faculties/administrators of medical college for further improvement of educational environment. Key words: perception; educational environment; medical college DOI: 10.3329/bsmmuj.v3i2.7060 BSMMU J 2010; 3(2): 97-102