Bangladesh Journal of Neuroscience 2013-11-30T11:21:05+00:00 Professor Md Ruhul Amin Miah Open Journal Systems <p>As far as we aware, this journal is no longer being published.</p><p>Official Organ of the Bangladesh Society of Neurosciences. Full text articles available.</p> Duplex Study of Carotid Artery in Patients with Ischemic Stroke 2013-11-30T11:21:05+00:00 Nasreen Sultana AKM Faslul Bari Touhidul Karim Majumder Md Rafiqul Islam Ferdous Ara Hossain <p><strong>Objective: </strong>To determine the frequency and characteristics of carotid artery stenosis in acute ischemic stroke patients and to assess the significance of common risk factors for carotid stenosis in these patients.</p> <p><strong>Method: </strong>It was cross-sectional observational study which was carried out in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of January 2010 to December 2011 and one hundred patients admitted with acute ischemic stroke were included in the study. Doppler ultrasound was performed during hospitalization to find out carotid artery stenosis. Statistics analysis was done with SPSS - 14.</p> <p><strong>Results: </strong>Out of one hundred (100) patients, eighty (80%) were males and twenty were (20%) were females. The patients were dividing into two groups with and without carotid stenosis. Less than 50% carotid artery stenosis (insignificant stenosis) was seen in 40% ( n=40) cases and significant stenosis was seen in 60% (n=60) patients. Overall 86% (n= 46) out of 60 patients were found to have carotid artery stenosis on the ipsilateral side corresponding to the ischemic lesion and 19% (n=11) had stenosis on the contralateral side. Out of significant stenosis ,mild (50% stenosis) in 12% (n=7) patients, moderate ( 51-69% ) stenosis in 50%( n= 30 ) patients and severe (&gt;70%) stenosis in twenty (n=33%) patients . Near total occlusion was seen in three (5%) patients. The presence of stenosis was significantly correlated with older age and the presence of multiple risk factors.</p> <p><strong>Conclusion: </strong>Carotid artery stenosis is strongly associated with ischemic stroke. Doppler studies are recommended for the high risk patients for the primary as well as secondary prevention of ischemic stroke.</p><p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 67-73<strong><em> </em></strong></p> 2013-11-30T08:53:15+00:00 ##submission.copyrightStatement## Association of Serum Folic Acid with Ischemic Stroke 2013-11-30T11:21:05+00:00 Hasan Zahidur Rahman Md Rafiqul Islam Moniruzamman Bhuyian Masud Rana Rashed Imam Abu Jafar Md Salauddin Khairul Kabir Patwary Muhammad Salah Uddin <p><strong>Background: </strong>Stroke is the third commonest cause of death in developed countries and is responsible for the physical disability of a large population. The study was designed to see the association of serum folic acid with ischemic stroke. It was concluded that the low levels of folic acid are associated with ischemic stroke.</p> <p><strong>Aim and objectives: </strong>To evaluate the association of serum folic acid level with ischemic stroke and to measure and compare the serum folic acid level among the cases and control subjects.</p> <p><strong>Material and method: </strong>This study was a case-control study which was conducted in the Department of Neurology and Department of Biochemistry of BSMMU, Dhaka, between the period of 1st January 2010 and 31st December 2011 for duration of two years. A total number of 60 patients presented with ischemic stroke and 60 control person were enrolled in this study. All patients of both sexes, aged between 20 years and above presented with ischemic stroke, from 0 day to 1 month that was confirmed by CT scan of head/MRI of brain. Blood sample was collected from the cases and the controls and analyzed at the Dept. of Biochemistry, BSMMU for estimation of serum folic acid, serum homocysteine fasting blood sugar. Fasting lipid profile for cases only.</p> <p><strong>Result: </strong>The mean ± SD of age of the cases was 58.42 ± 11.47 and among the cases 45 (75.0%) were male and 15 (25.0%) were female. Among the control male and female were 43 (71.7%) and 17 (28.3%) respectively. The mean (±SD) serum folate level of case and control group was 6.26(± 4.06) and 8.07(± 4.70) respectively. Statistically significant differences was observed between case and control group in term of Serum folate (p&lt;0.05). This study showed serum folate level was deficient at the early period of ischemic stroke.</p> <p><strong>Conclusion: </strong>Low serum folate concentration is significantly and independently associated with increased risk for ischemic stroke.</p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 74-80<strong><em> </em></strong></p> 2013-11-30T09:11:55+00:00 ##submission.copyrightStatement## Sodium Valproate is More Effective than Pizotifen in the Prophylaxis of Migraine Patients 2013-11-30T11:21:05+00:00 Md Masud Rana AKM Anwarullah Quazi Deen Mohammad Md Rafiqul Islam Hasan Zahidur Rahman Moniruzzaman Bhuiyan Ferdous Jahan Hasan Imam AKM Shoab Sharif Uddin Ahmed Abdul Alim Samsun Nahar <p><strong>Background and objectives: </strong>Migraine is now ranked as number 19 among all diseases causing disability by WHO1 which is characterized by recurrent attacks of various combinations of headache and neurological, gastrointestinal and autonomic symptoms2 accompanied by photophobia, phonophobia and vomiting3. The treatment of migraine involves acute, preventive drugs and non-pharmacological strategies. The basic principle in management of migraine is avoiding the trigger factors, blocking the mediators and splinting the end organ4. Though there is no significant curable treatment but there are some internationally proven and well accepted prophylactic medication which reduces headache severity, frequency, duration and risk for rebound5. Sodium valproate and pizotifen are commonest of them6, where sodium valproate is more effective than pizotifen in the prophylaxis of migraine patients.</p> <p><strong>Methods: </strong>This study was a single blind randomized clinical trial carried out in the neurology outpatient department of Bangabandhu Sheikh Mujib Medical University, Dhaka (BSMMU) for the period of 2 years, among adult patients between the age of 16-50 years.</p> <p><strong>Results: </strong>A total of 120 patients were included &amp; divided into two groups such as group-A(60 patients) treated by sodium valproate &amp; group-B(60 patients) treated by pizotifen for a period of 6 months and followed up every two months for 3 times and showed sodium valproate is more effective than pizotifen.</p> <p><strong>Conclusion: </strong>This study permit to conclude that efficacy of sodium valproate is more than pizotifen in the prophylaxis of migraine patients.</p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 81-87</p> 2013-11-30T09:23:57+00:00 ##submission.copyrightStatement## Comparative Study of Risk Factors Between Lacunar and Non-lacunar Ischemic Strokes 2013-11-30T11:21:05+00:00 Dewan Md Elyas Aminur Rahman Quazi Deen Mohammad Badrul Alam Mondol Sakhawat Hossain Sirajee Shafiqul Islam Mohammad Selim Shahi Morshed Baki Mohammad Abdus Sattar Sarker <p><strong>Background: </strong>Stroke is a leading cause of mortality and morbidity in both developed as well as developing countries The risk factors in lacunar stroke differ in comparison to nonlacunar strokes. In this study risk factors of lacunar stroke in comparison to non-lacunar were evaluated.</p> <p><strong>Objectives: </strong>The aim of the study was to compare the risk factors among lacunar stroke and non-lacunar stroke.</p> <p><strong>Methodology: </strong>This comparative study conducted in the department of Medicine and Neurology, Dhaka Medical College Hospital, Dhaka from September 2010 to August 2011. MRI of brain was done in 151 patients above 18 years of age with ischemic stroke and Lacunar stroke was found in 31 patients and non-lacunar stroke was detected in 120 patients. Based on the inclusion and exclusion criteria from them 30 patients with lacunar stroke were selected as Group-A patients and equal number of non-lacunar stroke same ages as group B were compared of. The risk factors of stroke were defined as hypertension, diabetes mellitus, hypercholesterolemia, smoking, history of transient ischemic attack, myocardial infarction, atrial fibrillation and carotid artery stenosis<strong>. </strong></p> <p><strong>Results</strong>: Out of 151 patients with ischemic stroke non-lacunar stroke was predominant, which was 79.47% and lacunar stroke was 20.52%. The mean age was found 60.9±10.2 years in Group A and 56.2±11.8 years in Group B, which was almost similar between two groups (p&gt;0.05). Male were predominant, which was 63.33% and 76.67% in lacunar and non-lacunar stroke respectively. Male and female ratio was 2.3:1. Regarding the risk factors hypertension was observed most common risk factor among the patients having lacunar and non-lacunar strokes. Hypertension and diabetes mellitus were common in lacunar stroke and myocardial infarction, carotid artery stenosis and hypercholesterolemia were common in non-lacunar stroke which were statistically significant (p&lt;0.05) between the both groups. However, the percentage of smoking, previous TIA and atrial fibrillation were not significantly (p&gt;0.05) different between lacunar and non-lacunar stroke<strong>. </strong></p> <p><strong>Conclusion: </strong>Hypertension and diabetes mellitus were common in lacunar stroke, and myocardial infarction, whereas carotid artery stenosis and hypercholesterolemia were common in non-lacunar stroke and the both groups were statistically significant (p&lt;0.05) . So modification of risk factors may reduce the incidence of ischemic stroke.<strong> </strong></p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 88-95</p> 2013-11-30T09:33:42+00:00 ##submission.copyrightStatement## Comparison of Clinical Diagnosis of Stroke with Computed Tomographic Scan of the Brain 2013-11-30T11:21:05+00:00 Sirajee Shafiqul Islam Aminur Rahman Md Manzur Alahi Md Ahmed Ali Md Kafiluddin Md Kafiluddin Md Pervez Amin Quamruddin Ahmad Dewan Md Elyas Md Ziaul Karim Mohammad Shaheen Wadud Md Rafiqul Islam <p><strong>Background and purpose</strong>: Stroke is a leading cause of mortality and morbidity in both developed as well as developing countries. The clinical presentation of stroke depending on the site and extent of lesions. For the management purpose it is important to know whether we are dealing with a bleed or an infarct<strong>. </strong></p> <p><strong>Methodology: </strong>Computed Tomography <strong>(</strong>CT scan) is available most of the tertiary level hospitals in Bangladesh. This study was carried out to compare clinical diagnosis of stroke with Computed tomography (CT) scan findings in ascertaining the type of stroke (hemorrhagic or ischemic). Materials and methods: This cross-sectional comparative study was conducted in the Department of Neurology, Rajshahi Medical College Hospital during the period of January 2010 to December 2010. Total 200 stroke patients were selected by purposive sampling technique on the basis of inclusion and exclusion criteria as the study sample. . CT brain scan was done for all the patients. The clinical diagnosis was compared with the results of CT scan and performance test was done.</p> <p><strong>Results</strong>: Clinically 67 patients were diagnosed as hemorrhagic stroke and 133 patients were diagnosed as ischemic stroke. Out of these 67 hemorrhagic patients CT scan revealed that 56 patients had intracerebral hemorrhage, 5 had infarct, 4 had subarachnoid hemorrhage and 2 had space occupying lesions in the brain. Out of these 133 ischemic patients CT scan revealed that 119 patients had infarction, 6 had intracerebral hemorrhage and 8 had space occupying lesions in the brain. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of hemorrhagic stroke were 90.32%, 92.03%, 83.58%, 92.02% and 91.5% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of ischemic stroke were 95.96%, 81.58%, 89.47%, 92.53% and 90.5% respectively.</p> <p><strong>Conclusion: </strong>The diagnosis of stroke in clinically with high accuracy, but perform a CT scan will help to confirm and differentiate to type stroke. Thus CT scan should be done in all cases stroke to specify the diagnosis.<strong> </strong></p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 96-101</p> 2013-11-30T09:58:49+00:00 ##submission.copyrightStatement## Posterior Decompression with Fusion & Fixation by Pedicle Screw and Rod of Thoraco Lumbar Spine: A Study of 15 Cases 2013-11-30T11:21:05+00:00 Haradhan Deb Nath Kanak Kanti Barua Zillur Rahman Md Rezaul Amin Malay Kumar Das Ranjit Kumar <p><strong>Background &amp; Objectives: </strong>Thoraco-lumbar fracture is one of the common problems in spinal injury patients. It’s early management can prevent complication after injury and can improve neurological function. The treatment plan of unstable fracture is controversial.</p> <p><strong>Methods: </strong>The study was carried out at the department of neurosurgery, Bangabandhu Sheikh Mujib Medical University from June 2010 to July 2011 among the patients admitted with thoraco-lumbar spine fracture.</p> <p><strong>Results: </strong>A total number of 15 patients with thoracolumbar spine fracture were included in the study. Among the 15 patients, 13(86.66%) were male. The highest number of patients were in age group of 1-20(40%) and 21-40(40%) years. The commonest cause of Thoraco-lumbar spine injuries were fall from height which was 8(53.33%) in number. The commonest site of injury was L1 fracture in 4(60%) patients. It was documented that bladder dysfunction and lower limb weakness were the commonest sign. It was evident that, 10(66.70%) and 4(26.66%) of the patients were partially and completely improved after surgery respectively and 3(10%) of patients had wound infection.</p> <p><strong>Conclusion: </strong>Thoraco-lumbar spine fracture with incomplete injury, early surgery can improve many of the patient’s life.<strong> </strong></p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 102-107</p> 2013-11-30T10:05:43+00:00 ##submission.copyrightStatement## Early Post-operative Visual Outcome in Patient with Pituitary Adenoma 2013-11-30T11:21:05+00:00 Md Rezaul Amin Haradhon Deb Nath M Afzal Hossain Kanak Kanti Barua <p><strong>Background: </strong>Pituitary adenoma, which accounts for 17.4% of all brain tumors, is the third most frequently diagnosed brain tumor, following intracranial glioma and meningioma. The visual disturbance in pituitary adenoma ranged from blurring of vision with or without headache to total loss of vision. In patients with visual field defects, bitemporal hemianopia was the commonest visual field defect. Early improvement of visual function is one of the major indication surgery.</p> <p><strong>Objective: </strong>The purpose of this study was to comparison between the pre and post-operative visual parameters and to find out the value in assessment of the prognosis of early postoperative visual function and also to find out the factor which influence the early post-operative visual outcome.</p> <p><strong>Methods: </strong>A prospective study was done from September 2010 to April 2012 in the department of neurosurgery, Bangabandhu Sheikh Mujib Medical University, 30 cases of pituitary adenoma had been included in this study of those who were presented with visual symptoms. Visual assessment was done before the operation and outcome was analyzed at discharged from hospital.</p> <p><strong>Results: </strong>Within 60 eyes, 13 (43.3%) patients presented with blindness of one or both eyes. 10 (33.3%) presented with uniocular and 3 (10.0%) presented with binocular blindness. Duration of the symptoms ranged from 2 months to 48 months. Patients underwent either transcranial or transsphenoidal tumor decompression. At discharge out of 30 patients, 23 (76.7%) showed improvement, 2 (6.6%) patients were deteriorated post-operatively. P value was &lt;0.001, in z ‘test’, Z=91.5, which was highly significant. Post-operative visual status was analyzed with age, sex, duration of symptoms, suprasellar extension, and methods of surgery and extent of tumor resection to find out that any other factor influenced the visual outcome. In bivariate analysis it was shown that only duration of the symptoms only other factor that influenced the visual outcome (statistically significant, p value 0.017).</p> <p><strong>Conclusion: </strong>With this study it was statistically proved that pre-operative visual status is the main factor for improvement of early post-operative visual outcome in pituitary adenoma and duration of symptoms had also influence the early post-operative visual outcome. Duration less than 12 months had a favorable outcome.<strong> </strong></p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 108-115</p> 2013-11-30T10:11:37+00:00 ##submission.copyrightStatement## Neuropathy in Chronic Renal Failure 2013-11-30T11:21:05+00:00 Md Munzur Alahi Md Pervez Amin Md Ahmed Ali Md Kafiluddin Quamruddin Ahmad <p>Peripheral neuropathy is common in chronic renal failure patients and it’s early detection and treatment reduces the sufferings of these patients. Studies of neuropathy in ESKD have demonstrated prevalence rates which vary from 60 to 100%. The striking pathologic features of peripheral neuropathy in patients of CRF are axonal degeneration in the most distal nerve trunks with secondary segmental demyelination. The most frequent clinical features are those of large-fiber involvement, with paresthesias, reduction in deep tendon reflexes, impaired vibration sense, weakness and muscle wasting. Patients of CRF may present with mononeuropathies or autonomic failure also. The exact cause of nerve involvement has not been identified but the middle molecule hypothesis is widely accepted. Dialysis in any form fails to improve the neuropathy but renal transplantation does improve the neurological complications. This review details the various features of neuropathy in patients of chronic renal failure.<strong> </strong></p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 116-127</p> 2013-11-30T10:55:05+00:00 ##submission.copyrightStatement## Arsenic Intoxication Presenting as Peripheral Neuropathy 2013-11-30T11:21:05+00:00 Sharif Uddin Ahmed Md Masud Rana Md Rafiqul Islam Hasan Zahidur Rahman Moniruzzaman Bhuiyan Nirmalendu Bikash Bhowmic <p>Chronic Arsenic Toxicity may have varied clinical presentations ranging from non-cancerous manifestations to malignancy of skin and different internal organs. Chronic arsenic exposure results in dermatologic manifestations prior to overt clinical neuropathy. Arsenic neuropathy causes painful paresthesias and, with higher level or continued exposure, length-dependent weakness. We are reporting two cases of chronic arsenic poisoning who presented initially as peripheral sensory motor neuropathy and skin manifestations. Arsenic poisoning was suspected because many of the other family members also developed similar symptoms simultaneously. The hair samples of these patients contained markedly elevated levels of arsenic. Also the water samples from their household and the neighboring households were found to have alarming levels of inorganic arsenic. Provision of arsenic free drinking water halt further deterioration of symptoms and there was significant improvement of their dermatological &amp; neurological conditions.<strong> </strong></p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 128-131</p> 2013-11-30T11:03:54+00:00 ##submission.copyrightStatement## A Case of Idiopathic Chronic Inflammatory Demyelinating Polyradiculoneuropathy 2013-11-30T11:21:05+00:00 Moniruzzaman Bhuiyan Mohammad Najim Uddin Md Masud Rana Anis Ahmed Md Rafiqul Islam Hasan Zahidur Rahman AKM Anwarullah <p>A 40 years old man presented with progressive weakness and distal paraesthesia of limbs with difficulty in walking for last seven years. As the patient was not investigated thoroughly, a diagnostic dilemma was persisted. This patient went abroad &amp; investigated thoroughly and yet not reached to a confirm diagnosis. Subsequently this patient reported to us and diagnosed it to be a case of Idiopathic Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) responded to oral steroid therapy. After follow-up, this patient showed marked improvement. So diagnostic dilemma that persisted with such a patient that showed improvement with treatment and a challenge to a treatable condition had encouraged us to report the case.<strong> </strong></p> <p>DOI: <a href=""></a></p> <p>Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 132-140</p> 2013-11-30T11:18:16+00:00 ##submission.copyrightStatement##