Bangladesh Medical Journal The official organ of the <a title="BMA" href="" target="_blank">Bangladesh Medical Association</a>. Full text available. Bangladesh Medical Association en-US Bangladesh Medical Journal 0301-035X Effect of Infrared Radiation (IRR) on Patients with Bell’s Palsy <p>This prospective study was conducted to determine the effect of Infrared Radiation on the patients presented with Bell’s palsy attended at the Department of Physical Medicine and Rehabilitation, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January 2012 to June 2012. By dividing in equal two groups ‘A’ and ‘B’ (30 patients in each group) a total of sixty (60) patients with Bell’s palsy were included in this study according to the selection criteria. Group- A patients were received Infrared Radiation (IRR) including Proprioceptive Neuromuscular Fascilitation (PNF) exercise, Drugs (Prednisolone &amp; Acyclovir) and Counseling for their recovery, where Group- B didn’t receive IRR but received rest of management. In Group- A, 25(83.33%) patients recovered completely and among them 12 (40%) patients recovered early (within 2 months). In Group- B, 23(76.67%) patients recovered completely, among them 7 (23.33%) patient recovered early. The difference was statistically significant. The outcome of early recovery is better with the patients treated with combined effect of IRR, PNF exercise and drugs compared with combined effect of PNF, exercise &amp; drugs. The patients who attended with facial nerve paralysis House-Brackmann (HB) Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 1-6</p> Hashina Bilkish Banu Sohely Rahman Shahadat Hossain - Jebunnesa Ehsanul Haque Khan Khurshid Mahmood DM Lutfur Rahman Monjur Ahmed ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 1 6 10.3329/bmj.v46i1.34630 Carbetocin and Oxytocin in the Active Management of third Stage of Labor after Vaginal Birth of Baby <p>Postpartum hemorrhage (PPH) is one of the major contributors to maternal mortality and morbidity worldwide. Active management of the third stage of labor has been proven to be effective in the prevention of PPH. Carbetocin; a long-acting Oxytocin agonist appears to be a promising agent for the prevention of PPH. In this study Carbetocin is used for the active management of third stage of labor to prevent PPH. Two hundred pregnant women from July 2015 to December 2015 at Rangamati Medical College Hospital, Rangamati, Bangladesh were included in this study. The patients were divided into two groups: Group- 1 (100 women) were received 100μg Carbetocin intravenously and group- 2 (100 women) received 10 IU Oxytocin intramuscularly and both doses were single. These uterotonics were injected at anterior shoulder after the delivery of the baby. Significant difference was observed between the Carbetocin and Oxytocin receiving groups regarding amount of blood loss (335.70 ± 117.71 versus 375.12 ± 145.30), PPH (3 % versus 12%), need of use of other uterotonics (18% versus 30%) and the difference in hemoglobin percent before and after delivery (0.58 ± 0.34 versus 0.97± 0.52). All these parameters were lower in Carbetocin group except hemoglobin level which is higher in group- 2 during 24 hours after delivery. Moreover, blood transfusion was not indicated in group- 1. In conclusion, Carbetocin is superior to Oxytocin in prevention of post partum hemorrhage at the third stage of vaginal delivery with minimal homodynamic changes and side effects.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 7-10</p> Hena Rani Barua Rita Rani Barua Sushanta Barua Ajoy Kishore Barua Kohinoor Begum ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 7 10 10.3329/bmj.v46i1.34631 Protective Effect of Terminalia Chebula Extract on Serum Total Protein against <p>Terminalia Chebula extract is used for regeneration of hepatic cells and protection of liver against damage due to its active component. This study aims to observe the protective effect of Terminalia Chebula against Paracetamol induced change of serum total protein level in Wister Albino rats. The study was carried out in the Department of Physiology, Dhaka Medical College (DMC) during January 2013 to December 2013. A total number of 44 rats, age ranging from 90 to 120 days, weight between 150 to 200 gm (initial body weight) were selected for the study. After acclimatization for 14 days, they were divided into control groups and experimental groups. Before sacrifice, final body weights of all the rats were measured. then all the rats were sacrificed on 22nd day and then blood samples were collected. For assessment of liver function, serum total protein level was done by using standard laboratory kits. The mean serum total protein level was significantly (p&lt;0.001) lower in paracetamol treated control group in comparison to those of baseline control group. Serum total protein level of all experimental groups were significantly (P&lt;0.001) higher than Paracetamol treated control group. From the results of this study, it may be concluded that Terminalia Chebula may have some protective effect against Paracetamol induced liver damage in rats.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 11-14</p> Tania Yeasmin Kazi Shamima Akhter Masud Imtiaz ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 11 14 10.3329/bmj.v46i1.34632 Profile of Patients Attending at the Department of Physical Medicine and Rehabilitation in a Specialized Hospital of Bangladesh <p>Physician’s documentation has become the critical component in rehabilitation of patients. The scope of Physical Medicine and Rehabilitation (PMR) encompasses more than a single organ system. Attention to the whole person is paramount. The aim of the study was to appraise the disease pattern and demographic information of the patients received outpatient rehabilitation services at the department of PMR, National Institution of Neuroscience and Hospital, Dhaka, Bangladesh. This is a retrospective study carried out for the period of two years July 2013 to June 2015. Total number of patients was 29678, among them 57.02% were male and 42.98% were female. Maximum patients (26.15%) were in age group 41-50 years and in housewife (37.76%) in occupation, where majority (56.33%) of them came from Dhaka city. Regarding disease pattern, 56.32% was neurological, 33.46% was musculoskeletal and 7.25% of patients were suffering from rheumatologic problem. Among leading diseases, largest disease group was stroke (20.02%), 10.48% was non-specific low back pain, 9.92% was Bell’s palsy, 5.35% was lumbar spondylosis, 5.13% was carpal tunnel syndrome, 4.11% was prolapsed lumber inter-vertebral disk (PLID), 3.72% was cerebral palsy. Knowledge about the existing disease pattern and health seeking behavior is essential to provide need based health care delivery to any population.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 15-19</p> Prasanta Kumar Chakraborty Md Shahadat Hossain Md Jahidul Islam Md Shahadat Hossain Monzur Ahmed Md Ruhul Amin Dilir Jamal ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 15 19 10.3329/bmj.v46i1.34633 Effect of Dyslipidaemia on Arrhythmia in Diabetic Patients <p>Dyslipidaemia is an important risk factor for cardiovascular morbidity and mortality. This cross-sectional study aims to find out the effect of dyslipidaemia on arrhythmia in diabetic patients. A total of sixty (60) diabetic patients, 31 were male and 29 were female, mean age was 59.58±11.38 (range 40 to 84) years with arrhythmia were selected at the department of Cardiology at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder(BIRDEM) General Hospital, Dhaka over a period of six months from January to July 2014. All the patients were accomplished with 24 hours Holter ECG monitoring, among them 40 were dyslipidaemia with mean age 60.7±13.1years and 20 were without dyslipidaemia with mean age 58±10.3 years (p-value was 0.424). Mean pulse, systolic and diastolic blood pressure were 78±15 (range 55-98) beats/min, 132±20 (range 90-180) mm of Hg and 79±8 (range 60-100) mm of Hg respectively. Mean maximum and minimum heart rate were 114±22 and 57±14 beats respectively. Mean cholesterol level was 222.58±55.51 mg/dl, mean triglyceride 241.26±98.81 mg/dl, LDL 135.53±35.61 mg/dl and HDL 41.46 ±15.46 mg/dl. Mean supraventricular beats in 24 hours was 12031± 4201 with dyslipidaemia and 8522± 2099 without dyslipidaemia which was statistically significant. Mean ventricular beats in 24 hours was 13472 ± 4872 with dyslipidaemia and 8754 ± 2689 without dyslipidaemia which was also statistically significant. Arrhythmia was found more common among diabetic patients having dyslipidaemia than without dyslipidaemia.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 20-24</p> Shabnam Jahan Hoque Aparna Rahman Md Babul Miah Md Zahid Alam SM Rezaul Irfan AMB Safdar ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 20 24 10.3329/bmj.v46i1.34635 Knowledge and Acceptance of HPV Vaccination among Women Attending at Out Patient Department of Dhaka Medical College Hospital <p>Vaccination is a part of primary prevention to prevent cervical cancer. The causative agent of cervical cancer is Human Papilloma Virus (HPV). The purpose of this study was to assess the knowledge and awareness regarding cervical cancer prevention by HPV vaccination and acceptance of vaccination among women attending at outpatient department of Dhaka Medical College Hospital. A qualitative study was undertaken using face to face in depth interviews from July 2015 to December 2015. A total of 229 women were included and their mean age was 34.07±7.92 ranging from 18 to 60 years. Awareness and knowledge about cervical cancer was very poor. Only 22.7% participants were aware of HPV vaccination. Knowledge was high among women coming from high socioeconomic condition which was 31.5% (p=0.03). Participants who were highly educated had more knowledge on vaccination about 66.7% (p=0.001). There was a high acceptance (83.8%) of HPV vaccination among participants. The findings focus on the importance of awareness development on cervical cancer and its risk factors. Continuous screening of cervical cancer for early diagnosis and prompt treatment and publicity of awareness development program by mass-media (television, cable line add etc.), poster, billboard and most importantly through health education could play an important role in cervical cancer prevention.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 25-31</p> Lutfa Begum Lipi Mohammed Mizanur Rahman Nibedita Shaha Meher Sultana Iffat Ara ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 25 31 10.3329/bmj.v46i1.34636 Correlation of Estrogen with Serum Insulin and Blood Glucose Levels in Post-menopausal Women <p>Hyperglycemia is a major risk factor for cardiovascular diseases in postmenopausal women. Increased incidence of cardiovascular diseases in postmenopausal women may be due to hyperglycemia caused by lower level of estrogen hormone. This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh during the period of January to December 2011 to observe the correlation of estrogen with fasting serum insulin (FSI) and fasting blood glucose (FBG) levels in postmenopausal women. A total of 90 women were selected from different areas of Dhaka city, among them, 60 postmenopausal women of age group 50 to 60 years were taken as study group and 30 apparently healthy premenopausal women of age group 20 to 30 years were included as comparison group. The study parameters fasting blood glucose level was estimated by enzymatic method in both groups. Serum insulin level was estimated by Enzyme Linked Immunosorbent Assay (ELISA) and serum estrogen level by RIA method in order to assess the hormonal level of both groups. Data was analyzed by Unpaired Student’s‘t’ test and Pearson's correlation co-effcient (r) test as applicable. Mean serum fasting insulin level and mean blood glucose level was higher in postmenopausal women than premenopausal and result was statistically significant. In postmenopausal women serum estrogen level was lower than premenopausal and serum estrogen level showed negative correlation with serum fasting insulin level. Blood glucose level also showed negative correlation with serum estrogen level. All these correlation were statistically non-significant. It may be concluded that the serum fasting insulin and blood glucose levels are significantly higher in postmenopausal women that may be due to low level of estrogen.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 32-37</p> Nahid Yeasmin Qazi Shamima Akhter Sayeeda Mahmuda Mahmudul Hasan Rukhshana Rabbani Rumana Afroz ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 32 37 10.3329/bmj.v46i1.34637 Leflunamide Induced Pneumonitis in Rheumatoid Arthritis - A Case Report and Review of Literature <p>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.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 38-40</p> Sumon Kanti Mojumdar Md Nazrul Islam Abul Khair Ahmedullah Md Abu Shahin Md Masudul Hassan ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 38 40 10.3329/bmj.v46i1.34638 Acute Lymphoblastic Leukemia Presenting as Acute Low Back Pain in a Young Man- A Case Report <p>Here we describe a case of a 20-year-old, otherwise healthy man, who consulted a physician due to acute low back pain presenting for a couple of days. Pain appeared suddenly, without any preceding trauma. Physical examination was unremarkable. Initial laboratory tests showed elevated inflammatory marker and thrombocytopenia. Patient was treated conservatively but due to increasing pain MRI of spine with contrast was advised which showed feature suggestive of infiltrative disease. Eventually patient was diagnosed as a case of acute lymphoblastic leukaemia on further peripheral blood film and bone marrow study.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 41-43</p> Khaza Amirul Islam Nazmul Hassan Sharmin Mafruha Munim Ahmed Kazi Mohammad Kamrul Islam Amin Lutful Kabir ABM Yunus ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 41 43 10.3329/bmj.v46i1.34640 The Basics of Ultrasonography <p>Ultrasound is sound whose frequency is above the human hearing range. It is nowadays widely used for the evaluation of a patient’s internal organs. Ultrasound waves are transmitted into the human body by an instrument called the transducer. Inside the body the sound waves are reflected and scattered differently by the different tissues and organs. The reflected sound waves are used by the computer to form an image of the internal structures and tissues. Use of ultrasound is safe with negligible bio-effects.</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 44-47</p> Sabrina Q Rashid ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 44 47 10.3329/bmj.v46i1.34641 Obituary News Vol 46(1) <p>Abstract not available</p><p>Bangladesh Med J. 2017 Jan; 46 (1): 48</p> The Editor ##submission.copyrightStatement## 2017-11-21 2017-11-21 46 1 48 48 10.3329/bmj.v46i1.34643