Bangladesh Medical Research Council Bulletin <p>The official publication of the Bangladesh Medical Research Council. Full text articles available.</p> <p><strong>The BMRCB will no longer accept online submissions to the journal. Please submit your manuscripts to the Editor using the email <a href=""></a>.</strong></p> <p><strong><a title="PubMed" href="">NLM ID=7607686</a></strong><br> <strong><a href=";tip=sid" target="_blank" rel="noopener">Scimago Journal Rank</a>&nbsp;(2017): 0.12</strong> <a title="SCImago Journal &amp; Country Rank" href=";tip=sid&amp;exact=no"><br><img src="" alt="SCImago Journal &amp; Country Rank" border="0"></a></p> Bangladesh Medical Research Council en-US Bangladesh Medical Research Council Bulletin 0377-9238 <p>Authors who publish with this journal agree to the following terms.</p><p>Authors retain copyright and grant the journal right of first publication.<em><strong><br /></strong><br /><a href="" rel="license"><img style="border-width: 0;" src="" alt="Creative Commons Licence" /></a><br /></em>Articles in the Bangladesh Medical Research Council Bulletin are licensed under a <a href="" rel="license">Creative Commons Attribution 4.0 International License</a><em> </em>(CC-BY) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</p><p>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</p><p>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new"><span style="color: #337755;">The Effect of Open Access</span></a>).</p> Mutation Pattern in Beta Thalassaemia Trait Population: A Basis for Prenatal Diagnosis <p>A total of 100 Bangladeshi beta thalassaemia carrier subjects were analysed by allele specific primers using Amplification Refractory Mutation System – Polymerase Chain Reaction.  Among these, four common mutations were found in 90 cases (90.0%), five less common mutations in 9 cases (9.0%) and a rare mutation in 1 case (1.0%). Among the four common mutations, IVS1-5 (G-C) was the most common beta thalassaemia mutation and found in 63.0% cases, followed by Cd 30 (G-C) in 18.0%, Fr 8/9 (+G) in 5.0% and Fr 41/42 (-TTCT) in 4.0% respectively. Among the five less common mutations, Cd16 (-C) was found in 3.0%, -90 (C-T) and IVS1-130 (G-C) were seen in 2.0% each and remaining Cd15 (-T) and Cd15 (G-A) were detected in 1.0% each. The rare mutation was -29 (A-G), observed in one case (1.0%). With the application of this knowledge, it will help us for prenatal diagnosis and genetic counselling in Bangladesh for prevention of the disease.<strong></strong></p> Bilquis Banu Waqar Ahmed Khan Md. Selimuzzaman Golam Sarwardi Salma Sadiya ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 65 70 10.3329/bmrcb.v44i2.38688 Association of High Sensitive C - Reactive Protein with Severity of the Left Ventricular Systolic Dysfunction in Acute Anterior ST Elevation Myocardial Infarction <p>High Sensitive C-reactive protein (hs- CRP) is an established risk marker in coronary artery disease. It is a marker of inflammation activated early after Acute Myocardial Infarction (AMI) and its quantity depends upon extent of myocardial damage. Release of inflammatory marker occur after acute myocardial infarction leading to cardiac remodeling which clinically manifests as Heart failure (HF). Heart failure is a common complication after acute anterior myocardial infarction (AMI). The prevalence of post-infarct Left Ventricular Systolic Dysfunction (LVSD) ranges from 27 to 60 % and half of patients having early post-infarct LVSD subsequently develop chronic heart failure. The purpose of this study is to show association between hs-CRP with LVSD in AMI and early detection of HF. This was a cross-sectional analytical study in which hs-CRP was done among all the study subjects between 24-48 hours after onset of AMI. The study population was categorized into groups I, II, II according to the lowest to highest hs-CRP level. Transthoracic echocardiography was done between 24-48 hours of anterior ST Elevation Myocardial Infarction (STEMI). Then LVSD was assessed between those three groups and searched for association. Severely reduced ejection fraction (EF) was found in patients of group III (highest hs-CRP tertile) only. Severe and moderately reduced EF and FS was found significantly more in group III and II than group I (mid and lowest hs-CRP tertile) (<em>p</em>&lt;0.001). High level of hs-CRP in patient of acute anterior STEMI patients was associated with moderate to severe reduction in EF and Fractional Shortening (FS).  So hs- CRP may be a prognostic marker in acute anterior STEMI complicating LVSD and early management would improved the short and long term prognosis.</p> Aparna Rahman Abdul Wadud Chowdhury Lutfur Rahman Khan Khandkar Md. Nurus Sabah Mohammad Gaffar Amin S.M. Alauddin Al Azad ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 71 76 10.3329/bmrcb.v44i2.38689 DPPH Free-radical Scavenging and Cytotoxic Activities of Leeamacrophylla <p>                        Structural damage inflicted to a wide variety of bioorganic compounds (DNA, protein, carbohydrates, and lipid) may occur as a consequence of oxidative damage which is naturally attributed to our daily lifestyle. A number of mechanisms are exploited to neutralize the reactive oxygen species. Medicinal plant can play a pivotal role of detoxifying the generated ROS. <em>Leeamacrophylla</em> (Leeaceae), a wild medicinal plant, has been taken into consideration of having antioxidant and cytotoxic properties. In this study, <em>in vitro </em>DPPH free radical scavenging activity, total phenolic content and total flavonoid content of methanol extract from the leaves of <em>L. macrophylla </em>were determined with using UV spectrophotometric method. Antioxidant activity of the crude extract was expressed as percentage of DPPH free radical inhibition and IC<sub>50</sub> value (μg/ml). The IC<sub>50</sub> value of <em>L. macrophylla</em> was found to be 152.40μg/ml. Compared to standard ascorbic acid (4.36 μg/ml), <em>L. macrophylla</em> leaf extract has moderate antioxidant property. The total phenolic content was 65.75 mg/g of dry weight of extract, expressed as gallic acid equivalents. The total flavonoid concentration was 59.8 mg/g, expressed as quercetin equivalents. In the brine shrimp lethality test, LC<sub>50</sub>value of crude methanolic extract obtained from the best-fit line slope was 3.06μg/ml which was significant comparing with control (vincristine sulphate). Above results suggested that the <em>L. macrophylla</em> can be regarded as a promising candidate for natural plant sources of antioxidants with high value.</p> Firoj Ahmed Dilruba Akter Md. Abdul Muhit Sheikh Zahir Raihan A B M Faroque ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 77 81 10.3329/bmrcb.v44i2.38690 Medical Errors and Patient Safety Education: Views of Intern Doctors <p>Medical errors and patient safety have become increasingly important in the area of medical research in the recent years. World health Organization and other international committees have long been recommending the early integration of education about errors and patient safety in undergraduate and graduate medical education. To integrate patient safety education into existing curriculum views of the doctors towards patient safety education is an important issue. This descriptive type of cross sectional study was carried out to explore the views of intern doctors regarding medical error and patient safety education in undergraduate medical education of Bangladesh. The study was carried out in seven (three public and four private) medical colleges of Bangladesh over a period from July 2014 to June 2015. Study population was 400 intern doctors. Data were collected by self-administered structured questionnaire. The existing curriculum was also reviewed to find out patient safety issues. The study revealed that the topic medical error and patient safety were mostly neglected in the curriculum. But the intern doctors had positive attitude towards patient safety education. A total of 84.8% of the intern doctors with a high average score of 4.24 agreed that teaching students about patient safety should be a priority in medical students training while 87.8% agreed that learning about patient safety before graduation from medical colleges would produce more effective doctors. Among the respondents 76.6% expected more training on patient safety. Almost half of the participants (52.3%) reported that they had been assigned to tasks for which they were not trained or where medical errors could have happened easily (57.5 %). From this study it can be concluded that, there was a distinct need for more education and training in the field of medical error and patient safety among the intern doctors.</p> Mahmuda Sultana Md. Sazzad Hossain Iffat Ara Jobaida Sultana ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 82 88 10.3329/bmrcb.v44i2.38701 Carrier Detection of Thalassaemia and Haemoglobinopathies in Tribal Population of Bangladesh <p>Tribal population constitutes 1.8 percent of total population of Bangladesh. The study was conducted in the tribal population of Bangladesh to detect haemoglobinopathies and beta thalassemia trait. Another purpose of the study was to create awareness about thalassaemia and haemoglobinopathies among these indigenous groups. It was a cross sectional study conducted from September 2015 to November 2015. A total of 460 random samples were collected from three tribal groups, 175 cases from Chakma, 187 cases from Garo and 98 cases from Marma. Two cc of venous blood were collected in EDTA tube. Haemoglobin variants were studied by HPLC method using Variant Hemoglobin Testing System (Variant II Beta Thalassemia Short Program). Statistical analysis was carried out using SPSS statistical package (version 15). Data was analyzed by frequency distribution. Abnormal Haemoglobin variants were seen in 287 cases (62.4%) out of 460 cases and only173 cases (37.6%) showed normal haemoglobin pattern. Haemoglobin E trait was the most common abnormality seen in 164 cases (35.6%) followed by Haemoglobin E disease which was seen in 101 cases (22%), Beta thalassaemia trait was seen in 22 cases (4.8%).<strong> </strong>This study shows a high percentage of Haemoglobin E trait and Haemoglobin E disease. Beta thalassaemia trait is also higher in comparison with randomly selected general population of Bangladesh. After calculating the estimate burden of child born per year by Harding Weinberg equation, it was to be found that the significant result which shows that 1552 new haemoglobin E beta thalassaemia and 22 new beta thalassaemia patients born per year in the tribal population. So, the tribal population should be properly screened and counseled for thalassaemia and haemoglobinopathies.</p> Salma Sadiya Waqar Ahmed Khan Bilquis Banu Golam Sarwardi Yasir Rahman ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 89 92 10.3329/bmrcb.v44i2.38702 Outcome of Concurrent Chemoradiotherapy and Radiotherapy Alone Following Induction Chemotherapy in Locally Advanced Squamous Cell Carcinoma of Head and Neck <p>Non-operative treatment strategies like radiotherapy and chemotherapy are practiced widely nowadays for the treatment of locally advanced squamous cell carcinoma of head and neck origin. Aim of this study was to compare the response of induction chemotherapy followed by radiotherapy alone with induction chemotherapy followed by concurrent chemoradiotherapy in terms of treatment response and toxicities. A quasi-experimental study was carried out in the Department of Radiation Oncology, National Institute of Cancer Research and Hospital (NICR&amp;H), Dhaka; Department of Radiotherapy, Dhaka Medical College Hospital (DMCH), Dhaka and Department of Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of January, 2014 to December, 2014. Induction chemotherapy by Cisplatin and 5-Fluorouracil was given to all the patients of Arm A and Arm B. Cisplatin was given concurrently during Radiotherapy weekly in case of Arm A. Arm B received radiotherapy alone. The patients were evaluated from the beginning of the treatment up to six months following the completion of treatment. In this study, male to female ratio was 4:1 and mean age of patients were 54.7±9.1 and 56.6±7.9 in Arm A and Arm B respectively. At final follow-up, complete response was seen in 27 (53.3%) patients of Arm A and Arm B respectively. Response rate was significant (<em>p</em> &lt;0.05) for both the Arms. Acute toxicities observed during induction chemotherapy were almost equal in both the Arms, but during radiotherapy, Arm A had more toxicity though it was statistically insignificant. Induction chemotherapy followed by concurrent chemoradiotherapy is more effective than induction chemotherapy followed by radiotherapy alone in loco-regional control of locally advanced squamous cell carcinoma of head and neck origin.</p> Md. Abdul Bari Sarwar Alam Sadia Sharmin Shamsun Nahar Jamal Uddin Nazmul Alam ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 93 97 10.3329/bmrcb.v44i2.38703 An Evaluation of Correction of Idiopathic Kyphoscoliosis by Axial Translation Technique with Pedicle Screw and Rod <p>As sufficient study not available in this subcontinent about correction of idiopathic kyphoscoliosis by axial translation technique, a group of patients of Adolescent Idiopathic Scoliosis (AIS) was selected to evaluate the outcome of rod rotation technique. The curve correction with more screw on the concave site was assessed, patient satisfaction and correction of cobb angle. Post operative radiological and functional outcome were assessed. Twenty consecutive patients (8 males, 12 females) with an age range from 10 to 24 years. Post operatively all were followed-up for 18 months. All patients were under went pedicle screw instrumentation through posterior approach. More screw inserted in the concave side. X-ray evaluation done by pre-operative and 1, 3, 6 ,12 and 18 months after surgery. Scoliosis Research Society (SRS) questionnaire was done for clinical evaluation. Radiological evaluation done by preoperative cobb angle was significantly reduced in postoperative period. The mean postoperative SRS scores were improved from 3.38 to 4.13. These results were statistically significant and so it may be concluded that the axial translation technique with more screw in the concave side is ideal technique with good postoperative outcome both clinically and radiologically.</p> Md. Anowarul Islam Fahad Goni Qumruzzam Parvez ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 98 102 10.3329/bmrcb.v44i2.38704 Immune Response Among the Children to Hepatitis B Vaccination: A Community-based Study in Bangladesh <p>Hepatitis B virus infection is a vaccine preventable infection of liver which remains a key public health burden globally. The development of Anti-HBs titre greater than or equal to 10 IU/L is considered as protective immunity and any titre less than 10 IU/L as non-protective following HBV vaccination. There is no comprehensive and authentic data regarding the immune response even 10 years after the integration of the HBV vaccine in to the EPI programme in Bangladesh and specifically, in Brahmonbaria district. The study was also aimed to assess the long term immune response among HBV vaccinated children. Blood sample from 500 vaccinated children were tested for Anti-HBs, and anti-HBc. Sero negative children were given 1 dose of HBV vaccine as a booster. Samples from booster vaccine were taken one month later and tested for anti Hbs titre. Anti HBs titre was found below protective level in about 46.0% (230/500) participants. Sero-protection rate decreased to 72.2% in 5 to 6 years age group which further decreased to 58.3% in 7 to 9 years age group and increased again to 69.5% in 10 to 12 years age group children. On the other hand, the mean anti Hbs titre was 97.72 IU/L initially and then increased with the increasing of age from 165.40 IU/L to 196.67 IU/L. Breakthrough infection of HBV was seen in 1.2% (6/500) participants measuring by anti HBc which indicated protective efficacy of HBV vaccine was about 98.8% (494/500). Sero negative participants were given a booster dose; 93.6% (131/140) participants showed boosting of mean anti HBs titre upto 804.92 IU/L which was below protective level (&lt;10 IU/L) before booster dose. Anti-HBs titre goes below with the increase of age after vaccination. Most of the participants had immunological memory which will boost antibody titre after any exposure, so routine booster dose is not needed. But non-responder to vaccination should screen after primary vaccination because of chance of breakthrough infection.</p> Mohammad Monir Hossain Ahmed Nawsher Alam Mahmuda Siddiqua Ayesha Siddika Afzalun Nessa ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 103 108 10.3329/bmrcb.v44i2.38705 Stenting in Takayasu’s Arteritis: A Case Report <p>Takayasu arteritis (TA), also known as idiopathic medial aortopathy or pulseless disease, is a granulomatous large vessel vasculitis that predominantly affects the aorta and its major branches. It may also affect the pulmonary arteries. The exact cause is not well known but the pathology is thought to be similar to giant cell arteritis. There is segmental and patch granulomatous inflammation of the aorta which results in stenosis, thrombosis and aneurysm formation. Half of the patients present with an initial systemic illness whereas the other 50% present with late-phase complications. There is a strong female predominance (F: M ~ 9:1), an increased prevalence in Asian populations, and it tends to affect younger patients (&lt;50 years of age). The typical age of onset is at around 15-30 years of age. Here, it is reported a case of 9 years old girl with Takayasu’s arteritis.</p> Mohd Zahid Hussain Md. Tariqul Islam Tahmina Karim Shakhawat Alam Mostafizur Rahman Bhuiyan Shima Bhadra ##submission.copyrightStatement## 2018-11-22 2018-11-22 44 2 109 112 10.3329/bmrcb.v44i2.38706