Bangladesh Medical Journal Khulna Official journal of the Bangladesh Medical Association, Khulna Branch. Bangladesh Medical Association Khulna Branch en-US Bangladesh Medical Journal Khulna 1012-8751 Copyright is normally held by the author of the article. Health threat of global warming <p>Abstract not available</p> <p>Bang Med J (Khulna) 2018; 51 : 1-2</p> CH Rasul ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 1 2 10.3329/bmjk.v51i1-2.40457 Safety and efficacy of ultrasound guided percutaneous needle aspiration of liver abscess <p><strong>Background: </strong>Liver abscesses, both amoebic and pyogenic, continue to be an important cause of morbidity and mortality in tropical country. Traditionally for many years they were treated with antimicrobial alone, blind percutaneous aspiration or surgical exploration. This conception gradually changes into guided percutaneous aspiration or drainage with development of advanced diagnostic imaging modality.</p> <p><strong>Objectives: </strong>To evaluate the safety and efficacy of management of liver abscess by Ultrasound (US) guided percutaneous needle aspiration.</p> <p><strong>Methods: </strong>From August 2009 to July 2018 a total 380 patients with liver abscess were referred to the department of radiology and imaging for US guided percutancous aspiration. All patients were evaluated clinically and by USG. Aspiration of the abscess was carried out under strict aseptic precaution.</p> <p><strong>Results: </strong>A total of 380 patients with liver abscess were successfully treated, consisting of 338 males and 42 females, male female ratio 8:1. The age ranges from 11 to 80 years. Majority (78%) had single abscess and 22% had two or more. Most of the abscess are located in the right lobe of liver (79%). Single needle aspiration were needed in 30% of patient, second aspiration were needed in 38% of patients and third aspiration in 32% of patients. Average aspiration per patient was 2.02. The amount of aspirated pus ranged from 250 to 2450 ml.</p> <p><strong>Conclusion: </strong>Ultrasound guided percutaneous needle aspiration of liver abscess is a safe and successful therapeutic approach in the treatment of liver abscess whether pyogenic or amoebic.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 3-6</em></p> G Salahuddin Sadika Parvin Md Kutub Uddin Mollick Syed Mozammel Hossain ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 3 6 10.3329/bmjk.v51i1-2.40458 A comparative study of nature of adnexal masses by ultrasonography and histopathology <p><strong>Background: </strong>Adnexal masses are common lesions in women across the globe. This is also important for woman in Bangladesh. The incidence of adnexal malignancy ranks only after the carcinoma of cervix and endometrium. So their accurate and early diagnosis is necessary for design management and treatment protocol.</p> <p><strong>Objective: </strong>The aim of the study is to assess the correlation between histopathological examination and ultrasonographic evaluation in making early and confirm diagnosis of adnexal masses.</p> <p><strong>Methodology: </strong>Eighty four women with different ages having adnexal mass, diagnosed by ultrasonographic evaluations and followed by surgery were included in this study between january 12 to December, 14. The morphologic characteristics of the masses were evaluated with gray scale Ultrasonography (USG). Specimens were collected after surgical resection in a container containing 10% formalin. The specimens were processed by paraffin embedding method and stained by routine Haematoxylin and Eosin stain for microscopic examination. The results of this study were calculated by standard statistical formula.</p> <p><strong>Results: </strong>Histopathological examination revealed that 68 masses (80.95%) were benign, two (2.38%) were borderline malignant, and 16 (19.05%) were malignant. USG enabled correct diagnosis of 63 of the 68 benign masses (92.65%) and all 16 malignant masses (100%).</p> <p><strong>Conclusion</strong>: There is a correlation between histopathological examination and ultrasonographic evaluation of adnexal masses in most cases. Therefore the imaging analysis of internal architectural appearance by USG and histopathological examination increases the specificity in the diagnosis of adnexal masses.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 7-11</em></p> Md Mahabubur Roshed Mst Dalia Akhter Syed Mozammel Hossain ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 7 11 10.3329/bmjk.v51i1-2.40459 Outcome of laparoscopic appendicectomy for acute appendicitis in tertiary level hospitals <p><strong>Background: </strong>In the very recent years, laparoscopic appendicectomy is widely accepted for the surgical procedure of acute appendicitis. Though the application of laparoscopic technique for appendicectomy is expanding very rapidly and now performed in almost all major cities and tertiary level hospitals in our country, but the reports are scanty and conflicting in our surgical practice.</p> <p><strong>Objective: </strong>This prospective clinical study was conducted to evaluate the outcome of laparoscopic appendicectomy in acute appendicitis in terms of complication, post surgical pain, conversion rate, negative appendicectomy and duration of hospital stay.</p> <p><strong>Methods: </strong>The study was carried out taking a total number of 93 patients of which 53 fulfilled the inclusion criteria admitted in BIRDEM General Hospital, Dhaka and 40 such patients from Khulna Medical College Hospital Khulna and a private clinic in Khulna City during the period from April, 2016 to August, 2018 with the patients of laparoscopic appendicectomy (LA) for acute appendicitis. Data was collected on history and clinical examination, investigation, histopathological examination and post operative complication.</p> <p><strong>Results: </strong>Among total 93 patients, majority of the patients were in age group of 20 to 30 years in both sexes and 65.6% were male and 34.4% were female. In case of 06(6.5%) patients negative appendicectomy were done and in 09(9.7%) patients conversion to open appendicectomy was required. Post operative complications like port site bleeding and infection were 4.3% and 2.1% respectively. Majority (87.10%) patients were discharged within 72 hours of LA.</p> <p><strong>Conclusion: </strong>This study reveals that laparoscopic appendicectomy is a minimally invasive and relatively safe procedure for acute appendicitis.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 12-15</em></p> Proshanta Kumar Biswas Syed Mozammel Hossain Md Faruquzzaman ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 12 15 10.3329/bmjk.v51i1-2.40460 Variation of blood pressure during change of posture <p><strong>Background: </strong>Many factors can influence blood pressure, one of which is body position. The aim of present study was to establish a specific pattern of blood pressure (BP) changes in accordance with posture changes in healthy adults.</p> <p><strong>Objective: </strong>Aim of present study was to establish a specific pattern of blood pressure (BP) changes in accordance with posture changes in healthy adult male and females.</p> <p><strong>Methods: </strong>Blood pressure was recorded by aneroid sphygmomanometer in supine, sitting and standing posture on both arms. Mean ± standard deviation of the observation for all the parameters were calculated and comparison in supine, sitting and standing position was done by repeated measures Analysis was done by ANOVA test and tukey's post hoc test.</p> <p><strong>Results: </strong>Fifty healthy males and fifty healthy female took part in this study. BP varies according to body position. Both Systolic blood pressure and diastolic blood pressure was significantly decreased (P&lt;0.05) while changing posture from supine to standing. But blood pressure changes during change of posture from supine to sitting or from sitting to standing was not significant (P&gt;0.05).</p> <p><strong>Conclusions: </strong>Change in body posture changes systolic blood pressure as well as diastolic blood pressure.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 16-20</em></p> Md Nazrul Islam SK Kamal Md Sirajul Islam Sk Amir Hossain ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 16 20 10.3329/bmjk.v51i1-2.40461 Emerging threat in antifungal resistance on superficial dermatophyte infection <p><strong>Background: </strong>Dermatophytosis are most common fungul infection globally and according to WHO the prevalence is about 20-25% and does not spare people of any race or age. Over the past few years antifungal resistance has been emerged due to irrational use of antifungal drugs in cutaneous mycosis.</p> <p><strong>Objective: </strong>The aim of the study is to evaluate the efficacy of different antifungul drugs (Terbinafin. Fluconazole, Itraconazole, Griseofulvin) on superficial mycosis depending on various factors.</p> <p><strong>Methods: </strong>This prospective study was conducted among the Superficial fungul infected patients from April' 2017 to October 2017 in Khulna Medical College Hospital (KMCH) and dermatologist's private chamber in Khulna city. All the enrolled patients were put on oral Terbinafin, Fluconazole, Itraconazole and Griseofulvin. Each patient was given single antifungal drug orally. These cases were thus followed up after two months of treatment to look for persistent infection, cure or any relapse clinically.</p> <p><strong>Result: </strong>Among 194 patient 89 were given Tab. Terbinafin (250mg) where resistance cases were 20.22%. More cases (33.96%) were resistant to Cap. Fluconazol (50mg). High percentage of cases were resistant to Cap. Itraconazole (76.47%). Griseofulvin resistant cases were observed in 25.71%. Drug response is very poor (69%) in patient who had been suffering from diabetes mellitus.</p> <p><strong>Conclusion: </strong>Appropriate antifungal drugs should be chosen with strict indication, dose, duration, selection of perfect local preparation and taking laboratory facilities where necessary.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 21-2</em><em>4</em></p> Razia Sultana Md Wahiduzzaman ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 21 24 10.3329/bmjk.v51i1-2.40469 Causative agents for diarrhoea in under 5 children in a tertiary care hospital <p><strong>Background: </strong>nfectious diarrhoea is a major public health problem in developing countries like Bangladesh. Bacteria and parasites are important etiological agents for diarrhoea in infants and children.</p> <p><strong>Objectives: </strong>To isolate and identify the causative organisms of diarrhoea from diarrhoeal stools in under 5 children.</p> <p><strong>Methodology: </strong>This was an observational cross sectional study carried out at Microbiology Department of Sir Salimullah Medical College, Dhaka. A total of 217 diarrhoeal patients upto 5 years age, attending Pediatric unit of Sir Salimullah Medical College and Mitford Hospital, Dhaka and Dhaka Shishu Hospital, Dhaka during the period of July 2015 to June 2016, were enrolled in the study. For isolation of enteric bacteria, diarrhoeal stools were inoculated on Mackonkey agar media and for Campylobacter spp. diarrhoeal stools were inoculated on selective Modified Campy-BAP media and nonselective Blood agar media with membrane filter. Positive culture was confirmed by Gram stain morphology and standard biochemical tests. Oocysts of Cryptosporidium were identified by Modified Ziehl Neelsen staining and other parasites were identified by wet mount preparation.</p> <p><strong>Results: </strong>Out of 217 diarrhoeal stools bacteria were isolated from 97 (44.7%) patients. Among 97 cases, Escherichia coli were detected in 51(52.58%) patients; Campylobacter spp. were detected in 23(23.71%) patients; Shigella spp. were detected in 15(15.46%) patients and Salmonella spp. were detected in 8(8.25%) patients. Microscopic finding of diarrhoeal stools were detected by pus cells with or without RBCs in 90(70.31%) samples. Cysts of Giardia intestinalis were found in 9(4.14%) samples, cysts of Entamoeba histolytica in 2(0.9%) samples, eggs of Trituris trichiura in 2(0.9%) samples and oocysts of Cryptosporidium were found in.5(2.30%) samples.</p> <p><strong>Conclusion: </strong>Escherichia coli was the most common bacteria and Giardia intestinalis was predominant parasite causing diarrhoea in under 5 children.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 25-28</em></p> Mst Khashruba Pervin Sanya Tahmina Jhora Shikha Paul Akhtarun Naher Dipika Sarkar ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 25 28 10.3329/bmjk.v51i1-2.40470 Magnitude of electric burns at a burn center in tertiary level hospital <p><strong>Background: </strong>Burns are a public health problem throughout the world. Electrical injury is a major cause of burn injury which causes significant functional disability, disfigurement and mortality. In Bangladesh, the number of electrical injuries are increasing but they are typically underreported.</p> <p><strong>Aims: </strong>This study was conducted to analyze the epidemiological variables of electrical burn injuries and identify preventable measures through them in Khulna region of Bangladesh.</p> <p><strong>Methods: </strong>This descriptive study is a prospective analysis of patients suffering from electrical burns admitted at Burn and plastic surgery department from July 2017 to June 2018. The study population consists of 68 patients who sustained electrical injuries irrespective of age and time with cutaneous burns, admitted at this Center. Patients with electrocution but no electrical cutaneous burn injuries were excluded from this study.</p> <p><strong>Results: </strong>Majority were males (77.94%) of working age and injuries were work related (52.94%) of which 32.36% were construction workers. The primary cause in majority of the cases (57.35%) was accidental direct contact with electric wire followed by secondary contact with electrical power lines by metal rods and electrification of different metallic equipments (42.64%). Most of the patients admitted were high voltage electrical injuries (54.42%). Among them 16.17% had severe electrical burns and 2.94% had associated traumatic injuries. There was a delay in time of injury to hospital admission, 35.29% arrived at the emergency room 8 or more hours after the injury. Most (63.24%) of the patients underwent surgery, majority of which had moderate to severe burns. Length of hospital stay was 3-102 days. Two patients (2.94%) died during this study period due to renal failure and septicaemia.</p> <p><strong>Conclusion: </strong>Most of the electric burn patients acquired injury at working place and primary cause was direct or secondary contact with powerline. Immediate preventive measures should be taken to reduce the incidence of electric burns.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 29-34</em></p> Md Tarikul Islam Mizanur Rahman SM Zulker Nayeem Md Farid Uddin ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 29 34 10.3329/bmjk.v51i1-2.40471 Comparison between flunarizine and levetiracetam in paediatric migraine prophylaxis <p><strong>Background: </strong>Migraine hampers child's life through school absence, limitation of home and social activities. The goal of prophylactic (preventive) therapy is to reduce headache frequency, headache days, and headache severity with minimum side effects.</p> <p><strong>Objective: </strong>To evaluate the efficacy and tolerability of levetiracetam compared to flunarizine as prophylactic treatment of Migraine in children. Methods: This prospective study was carried out in the outpatient department of a tertiary care hospital in Bangladesh. A total of 105 children aged 6-15 years, diagnosed as migraine without aura, were enrolled. Patients were treated with flunarizine or levetiracetam for three months. Headache disabilities were evaluated at baseline and at the end of three months.</p> <p><strong>Results: </strong>In flunarizine group, 54 children and in levetiracetam group, 51 children were enrolled. Among them thirty nine children in flunarizine group and 36 children in levetiracetam group completed the study. Headache frequency, headache days, VAS (Visual Analogue Scale) score and PedMIDAS (Paediatric Migraine Disability Assessment Score) score were evaluated at baseline and during the follow up. After three months, headache frequency, headache days, pain severity (Visual Analogue Scale score) reduced significantly compared to baseline (p&lt;0.05). PedMIDAS score was also reduced from 60.35(±16.36) to 30.13(±14.28) in flunarizine group and from 64.25(±19.63) to 25.91(±18.6) in levetiracetam group (p&lt;0.05). Some minor side effects were also reported by both groups, but were well tolerated by the patients and need not withdrawal of medication.</p> <p><strong>Conclusion: </strong>Levetiracetam is as effective as flunarizine in paediatric Migraine Prophylaxis.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 35-39</em></p> Sk Masiur Rahman Gopen Kumar Kundu Kanij Fatema Shaheen Akhter Md Mizanur Rahman ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 35 39 10.3329/bmjk.v51i1-2.40472 Effectivity of imatinib therapy for the management of chronic myeloid leukemia patients <p><strong>Background: </strong>First generation tyrosine kinase inhibitor, imatinib revolutionized the treatment of chronic myeloid leukaemia, and is now the front line therapy. Imatinib provides substantial cytogenetic and molecular remission, with minimal normal hematopoiesis suppression or side effects and is now first line therapy.</p> <p><strong>Objective: </strong>The aim of this prospective study was to determine the efficacy of imatinib therapy in the management of chronic myeloid leukemia in Bangladesh.</p> <p><strong>Methods: </strong>This prospective study was done from June 2012 to May 2018. In this period we treated eight chronic myeloid leukaemia patients with imatinib, in Khulna division, Bangladesh.</p> <p><strong>Results</strong>: Majority of the patients (50%) were in the age group of 21-30 years. Three patients died as because those patients were too poor to continue drugs. Another 5 patients were in good health and continuing follow up monthly. Among five patients, one patient have two healthy son.</p> <p><strong>Conclusion: </strong>Imatinib therapy is an effective treatment regimen in the management of chronic myeloid leukaemia. The best result can be obtained if CML is dignosed earlier.</p> <p><em>Bang Med J (Khulna) 2018; 51 : 40-43</em></p> Md Mokter Hossain Mollah Obayedullah Baki Tamanna E Nur Zannatul Ferdous Jesmin ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 40 43 10.3329/bmjk.v51i1-2.40479 Abstract From Current Literature 51(1-2) <p>Abstract not available</p> <p><em>Bang Med J (Khulna) 2018; 51 : 44-47</em></p> - - ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 44 47 10.3329/bmjk.v51i1-2.40478 Association News Vol.51(1-2) <p>Abstract not available</p> <p><em>Bang Med J (Khulna) 2018; 51 : 50</em></p> - - ##submission.copyrightStatement## 2019-03-04 2019-03-04 51 1-2 50 50 10.3329/bmjk.v51i1-2.40480