Bangladesh Medical Research Council Bulletin https://www.banglajol.info/index.php/BMRCB <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="mailto:info@bmrcbd.org">info@bmrcbd.org</a>.</strong></p> <p><strong><a title="PubMed" href="https://www.ncbi.nlm.nih.gov/nlmcatalog/7607686">NLM ID=7607686</a></strong><br> <strong><a href="https://www.scimagojr.com/journalsearch.php?q=19900192321&amp;tip=sid" target="_blank" rel="noopener">Scimago Journal Rank</a>&nbsp;(2017): 0.12</strong> <a title="SCImago Journal &amp; Country Rank" href="https://www.scimagojr.com/journalsearch.php?q=28155&amp;tip=sid&amp;exact=no"><br><img src="https://www.scimagojr.com/journal_img.php?id=28155" alt="SCImago Journal &amp; Country Rank" border="0"></a></p> en-US <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="http://creativecommons.org/licenses/by/4.0/" rel="license"><img style="border-width: 0;" src="https://i.creativecommons.org/l/by/4.0/88x31.png" alt="Creative Commons Licence" /></a><br /></em>Articles in the Bangladesh Medical Research Council Bulletin are licensed under a <a href="http://creativecommons.org/licenses/by/4.0/" 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="http://opcit.eprints.org/oacitation-biblio.html" target="_new"><span style="color: #337755;">The Effect of Open Access</span></a>).</p> editor@bmrcbd.org (Dr. Shah Md. Mahfuzur Rahman) banglajol.info@gmail.com (Md Fahmid Uddin Khondoker) Fri, 27 Mar 2020 04:20:46 +0000 OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 Diet related NCDs: Time for action https://www.banglajol.info/index.php/BMRCB/article/view/44641 <p>Noncommunicable diseases (NCDs) are the leading cause of mortality and morbidity, and posing significant challenges both in developed and developing countries including Bangladesh. In 2016, of the total 56.9 million global deaths, 71.0%, were due to NCDs. Some 85.0% of premature deaths from NCDs, are in low and middle income countries, where greater burden of undernutrition and infectious diseases exist.<sup>1-3 </sup>Evidence suggests a higher age specific mortality for NCDs among Bangladeshi population compared to Western populations, which putting burden on healthcare systems. <sup>4</sup> Bangladesh NCD Risk Factors Survey, 2018 showed that among the adult population, the mean salt intake was 16.5 gram per day and the prevalence of dislipidaemia was 28.4 %.<sup>5</sup> Sugar consumption also continues to rise, driven by increased intake of beverages, biscuits, sweets and confectionary items. Industrially produced transfat in some food items is also an important issue in the country.</p> <p>Malnutrition is a key risk factor for NCDs. Globally, nearly one in three people has at least one form of malnutrition, and this will reach one in two by 2025, based on current trends.<sup>6-8</sup> All forms of malnutrition are caused by unhealthy, poor quality diets. Unhealthy diets that include high sugar, salt and fat intake, malnutrition, and NCDs are closely linked. Not only on the health, malnutrition and diet related NCDs pose a substantial burden on the economy and development.</p> <p>Food systems worldwide face major challenges, such as population growth, globalisation, urbanisation, and climate change. Today’s food systems are broken and do not deliver nutritious, safe, affordable, and sustainable diets; they undermine nutrition in several ways, particularly for vulnerable and marginalised populations. Billions of dollars are spent annually marketing foods high in calories, fats, sugars, and salt, and intake has increased globally, including in low income countries.<sup>8</sup></p> <p>United Nations (UN) is well committed to prevent and control noncommunicable diseases through adopting series of resolutions in its General Assembly.&nbsp; In 2013, Member States of the World Health Organization (WHO) resolved to develop and implement national action plans, in line with the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013–2020).<sup>9</sup> NCDs are also embedded in sustainable development goal (SDG) target 3.4, that is, to reduce by one-third the premature mortality from noncommunicable diseases by 2030. NCDs are also linked to other SDGs, notably SDG 1 to end poverty. In 2017, the WHO Global Conference on Noncommunicable Diseases reaffirmed noncommunicable diseases as a sustainable development priority in the Montevideo roadmap 2018–2030.<sup>10</sup></p> <p>Bangladesh has also developed the Multisectoral Action Plan for Prevention and Control&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; of Noncommunicable Diseases 2018-2025, with a three-year operational plan.<sup>11</sup> Earlier the country has developed National Nutrition Policy, 2015, Second National Plan of Action for Nutrition, 2016-2025, Dietary Guidelines and other policies, strategies and action plan. The country is putting efforts for the prevention and control of malnutrition and NCDs.</p> <p>Furthermore,&nbsp; to prevent and control the diet related noncommunicable diseases across the life cycle nutrition labelling, re-formulation of food standards with limiting high sugar, salt and fat, and banning industrial transfats; restriction of food advertising particularly marketing of unhealthy foods to children, imposing tax on sugar sweetened drinks, junk food etc. Aimed at behavior change communication, mass-media campaigns, nutritional advice and nutrition education on NCDs in general and diet related NCDs in particular are thus recommended.</p> Shah Md Mahfuzur Rahman, Shah Monir Hossain, Mahmood uz Jahan ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44641 Mon, 30 Dec 2019 00:00:00 +0000 Role of XmnI polymorphism in HbF induction in HbE/β and β-thalassaemia patients https://www.banglajol.info/index.php/BMRCB/article/view/44642 <p><em>Background:</em> Thalassaemia is one of the most common genetic blood disorders worldwide. Patients with β-thalassaemia major and HbE/β-thalassaemia are blood transfusion dependent. Foetal haemoglobin or HbF can play a role in disease manifestations in these patients and there is evidence that a homozygous state for <em>XmnI</em> polymorphic site, associated with increased expression of <em>Gγ-gene</em>, may play an important role among other factors in ameliorating the clinical severity of homozygous β-thalassaemia and thalassaemia intermedia. The aim of this review was to provide a comprehensive review of the role of <em>XmnI</em> polymorphic site for increased HbF production in HbE/β and β-thalassaemia patients.</p> <p><em>Methods:</em> Published literatures were reviewed on the allelic frequency of <em>Xmn1 </em>polymorphism and its effect on HbF induction among thalassaemia patients of different countries.</p> <p><em>Results:</em> In all β<strong>-</strong>thalassaemias, Hb F levels are relatively increased due to the selective survival of the erythroid precursors that synthesize relatively more <strong>γ-</strong>chains. The expression of HbF level is dominated by three different loci: HBG2: γ -158C&gt;T, BCL11A, and HBS1L-MYB intergenic region. Genetic determinants influencing Hb F response can be within the <em>β</em><em>-globin</em> complex or trans-acting. The published literature showed that the C&gt;T substitution (rs7482144) at position –158 of the <em>G</em><strong>γ-</strong><em>globin</em> gene, referred to as the Xmn<em>I-G</em><strong><em>γ</em></strong> polymorphism, is a common sequence variant in all population groups, present at a frequency of 0.32 to 0.35. It was found in some studies, response to Hydroxyurea (HU) has been shown to be largely associated with the presence of the C&gt;T polymorphism at -158 <em>XmnI</em> site (<em>HBG2</em>:c.- 53-158C&gt;T) upstream of the Gγ-globin gene and HU therapy exerts a 2- to 9- fold increase in γ-mRNA expression in β-thalassaemia patients.</p> <p><em>Conclusion:</em> A number of various study groups around the world suggests that <em>XmnI</em> polymorphism is an important key regulator of disease severity of HbE/β and β-thalassaemia patients.</p> Kaiissar Mannoor, Mohabbat Hossain, Farjana Akther Noor, Golam Sarwer Bhuyan, Syeed Saleheen Qadri ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44642 Mon, 30 Dec 2019 00:00:00 +0000 A new therapeutic option for chronic hepatitis B: Reduced dose and shorter duration of a combination therapy with pegylated interferon and entecavir https://www.banglajol.info/index.php/BMRCB/article/view/44643 <p><em>Background: </em>Although several drugs are available for treatment of chronic hepatitis B (CHB), the outcome is still far from being satisfactory. The study was conducted to develop a therapeutic strategy for CHB by a combination therapy with reduced dose and duration of antiviral drugs.</p> <p><em>Objectives:</em> Therapeutic effects of reduced dose and shorter duration of combination of pegylated interferon (Peg-IFN) and entecavir were evaluated in patients with CHB with two control groups.</p> <p><em>Methods:</em> Fifty-four patients with CHB were treated with reduced dose of Peg-IFN (90 microgram in spite of standard dose of 180 microgram) and standard dose of entecavir (0.5 mg) for reduced duration of 24 weeks (Case of group). There were two control groups that adhered to inclusion and exclusion criteria. Patients of Control group-1 (n=50) received regular doses (180 microgram) of Peg-IFN, once weekly for 48 consecutive weeks. Patients of Control group-2 (n=50) were treated with regular does of entecavir (0.5 mg, daily) for 48 weeks.</p> <p><em>Results:</em> The treatment regimens were safe for all patients. At the end of therapy (EOT), hepatitis B virus DNA negativity (HBV DNA &lt;250 copies/mL) was found in 67%, 50% and 80% of patients of Control Group-1, Control group-2, and case group, respectively. HBV DNA negativity was found in more patients in cases (89% from 67%) 24 weeks after EOT. However, it declined in patients of Control group-1 (80% to 56%) and remained almost similar in Control group-2 (50% versus 56%). There was no significant difference in alanine transaminase (ALT) negativity and hepatitis E antigen (HBeAg) seronegativity among 3 groups at EOT and 24 weeks after EOT.</p> <p><em>Conclusion:</em> A patient-friendlytherapeutic strategy with reduced dose of Peg-IFN and regular dose of entecavir for shortened duration for CHB patientshave been documented and it would be also cheap for usage of patients with CHB.</p> Mamun Al Mahtab, Shahina Tabassum, Afzalun Nesa, Munira Jahan, Md. Sakirul Islam Khan, Sheikh Mohammad Fazle Akbar ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44643 Mon, 30 Dec 2019 00:00:00 +0000 Difficulties in breastfeeding: Easy solution by Oketani breast massage https://www.banglajol.info/index.php/BMRCB/article/view/44644 <p><em>Background:</em> Breastfeeding is universally recommended feeding method for promoting child survival. Many mothers in developing countries do not practice optimum breastfeeding due to difficulties in the breast that may lead to temporary or permanent cessation of breastfeeding. Oketani breast massage approach is one such technique to overcome those difficulties for successful lactation to promote child growth.&nbsp;&nbsp; The aim of this study was to assess the difficulties in breastfeeding and mother’s expression on benefits of Oketani breast massage.</p> <p><em>Methods:</em> A cross sectional study was conducted at lactational management center (LMC) in the Institute of Child Mother Health (ICMH), Dhaka, Bangladesh during March to August 2015. A total of 98 mothers (having 0-12 month’s old children) who had breast problems or difficulty in breastfeeding were included in the study. The mothers agreed to undertake Oketani massage. This is a breast massage that promotes breast milk production and helps the lactating mothers to overcome certain difficulties in the breast. Mothers who received Oketani massage were interviewed using a semi-structured questionnaire.</p> <p><em>Results:</em> Ninety-eight mothers were interviewed for this study. About two-thirds (66.3%) of babies were girls of which 57.1% were less than 2 months.&nbsp; More than two-thirds (78.6%) mother ages were more than 25 years. Half of the mothers completed secondary school certificate (SSC) in which non-working (63.3%) mothers were more than working mother (36.7%). The proportion of exclusive breastfeeding practice was 50.0%. Most common difficulties included breast engorgement (22.4%), followed by sore nipple (17.3%) and insufficient milk (14.3%). After receiving Oketani massage mother’s perception of getting confidence improved to 80.6%. About 69% said that the baby can be fed well, 61.2% felt that there was increase in breast milk production and 56.1% mothers expressed feeling good after the massage. Study findings revealed that Breast feeding significantly improved with the Oketani breast massage (p=0.001).</p> <p><em>Conclusion:</em> Oketani massage is considered as a useful technique to build confidence and improved milk secretion among mothers facing difficulty during lactation. A multicentre study with detailed assessment of quality, the quantity of breastmilk as well as baby’s growth and nutritional assessment is recommended.</p> S. K. Roy, Saria Tasnim, Ms. Khurshid Jahan, Summyia Nazmeen, Sumon Chandra Debnath, A.B.M Muzharul Islam ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44644 Mon, 30 Dec 2019 00:00:00 +0000 Early and mid-term outcome of CABG surgery in diabetic and non-diabetic patients in a tertiary care hospital in Bangladesh https://www.banglajol.info/index.php/BMRCB/article/view/44645 <p><em>Background: </em>Previous trials showed that diabetic patients had worse in-hospital and long term outcome after coronary artery bypass grafting (CABG) than non diabetic ones. However, the majority of such studies was carried out in western countries and limited information is available for the Asian population.</p> <p><em>Objective</em>: The present study was intended to determine the impact of diabetes on early and mid-term outcome among patients undergoing CABG surgery in a tertiary care hospital in Bangladesh.</p> <p><em>Methods: </em>This study was performed at Ibrahim Cardiac Hospital &amp; Research Institute, Dhaka, Bangladesh, from January to June 2014. Based on enrollment criteria, 202 patients (115 diabeticsand 87 non-diabetics) were enrolled and evaluated for their early outcome (within 30 days of operation) and midterm (after 30 days post-operatively). Patients with known diabetes or preoperative fasting blood sugar ≥6.4 mmol/L or random blood sugar ≥11.1 mmol/L were considered as diabetics. The outcome measures were ICU stay, reopening for bleeding, atrial fibrilation, cardiac arrest, total hospital stay, left ventricular ejection fraction and mortality.</p> <p><em>Results: </em>Diabetic patients in this study had higher prevalence of hypertension, hyperlipidaemia, and renal failure.&nbsp; The diabetic and the non diabetic groups received a mean number of grafts of 3.2±1.06 and 2.81±1.21, respectively, Postoperative mortality in diabetic and non-diabetic patients at early and mid-term were not significantly different in univariate analysis (4.3% vs. 2.3%, <em>p</em>= 0.352) and (2.6 % vs.&nbsp; 2.3%,<em>p</em> = 0.630) respectively. The mean intensive care unit (ICU) stay in diabetic and non-diabetic were same (3.5days) but total hospital stay was significantly higher in the former group (one day or more). Re-opening for&nbsp;&nbsp; bleeding, atrial fibrilation and cardiac arrest in ICU were found higher in DM than those in non-DM group (28.7%vs.20.7%,10.4% vs. 8% and 4.2% vs.1.1% respectively).</p> <p><em>Conclusion: </em>Although the mortality rate of diabetic patients following CABG surgery was in significantly higher than their non-diabetic counterparts. Morbidity was also a bit higher. Strict perioperative glyacemic control could reduce morbidity and mortality in diabetic patients undergoing CABG.</p> Md. Mazibur Rahman, Md. Rezaul Karim, Md. Hamidur Rahman, Masoom Siraj, Jamal Uddin, Md. Nurul Amin, M. A Rashid ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44645 Mon, 30 Dec 2019 00:00:00 +0000 Outcome of heart valve prosthesis in Bangladesh: A retrospective study https://www.banglajol.info/index.php/BMRCB/article/view/44646 <p><em>Background</em>: Prosthetic heart valve for middle aged patients requiring valve replacement remains controversialBecause of the co-morbidities and limited life expectancy, bioprosthesis is the likely choice for older aged patients.</p> <p><em>Objective:</em> The aim of the study was to quantify long term survival rate and major morbidity in patients undergoing heart valve replacement and to optimise selection criteria of biologic versus mechanical valve prostheses.</p> <p><em>Methods:</em> This retrospective cohort study evaluated among 565 patients of 45 to 65 years of age &nbsp;undergoing isolated, primary heart valve replacement in either aortic or mitral position using mechanical or bioprosthetic valve.</p> <p><em>Results:</em>Long time survival benefit was similar between aortic valve replacement (AVR) versus mitral valve replacement (MVR) patients regarding replacement with either mechanical and bioprosthetic valve. Postoperative incidence of morbidities like valve related complications, endocarditis, and bleeding were statistically not significant in this study. There was no significant difference in terms mortality after both AVR and MVR regarding use of bioprosthesis versus mechanical valve. Although, most common causes of mortality were prosthesis related and haemorrhage that was observed in both study group. Follow up at 10 years observed mean survival rate were 86.6%, 90.3% in mechanical AVR and MVR respectively, whereas patients with bioprosthesis demonstrate survival rate of 82.3% after AVR and 76.9% following MVR.</p> <p><em>Conclusion:</em>&nbsp;With a life expectancy of at least 15 years, mechanical prostheses should be considered in patients below 50 years in Bangladesh. However, patients more than 50 years of age or with multiple comorbidities like coronary artery disease, renal disease, lung disease, coronary disease, or a life expectancy less than 15 years, bio prostheses may be good options for better outcome.</p> Asit Baran Adhikary, Redoy Ranjan, Musfiqur Rahman, Dipannita Adhikary, Sanjoy Kumar Saha, Heemel Saha ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44646 Mon, 30 Dec 2019 00:00:00 +0000 Tumor necrosis factor-α polymorphism in helicobacter pylori associated gastric carcinoma https://www.banglajol.info/index.php/BMRCB/article/view/44647 <p><em>Background:</em> Gastric cancer (GC) is the leading cause of cancer death in the world. Chronic inflammation is a predisposing factor of gastric carcinogenesis. TNF-α is a key pro-inflammatory cytokine secreted by macrophages and causes development of malignant diseases. It also plays an important role in chronic inflammation caused by Helicobacter Pylori. Therefore, TNF-α polymorphisms is studied in Helicobacter Pylori infected gastric cancer.</p> <p><em>Objective:</em> To find out the high risk group of Helicobacter Pylori infected gastric cancer cases in Asian and Caucasian people.</p> <p><em>Methods: </em>A total of 130 GC cases and 103 healthy controls from Jichi Medical School, Japan were studied. TNF-α genotype and allele frequency were studied by Restriction Fragment Length Polymorphism (RFLP).</p> <p><em>Results: </em>Among the study population TNFa-308A was less frequent in Asian people than those of Caucasian. TNFa-238G allele was more frequent in H. pylori positive GC (<em>p</em>&lt;0.036) cases.</p> <p><em>Conclusion: </em>Findings of the study suggest that TNF-238G polymorphism of TNF-α gene may be closely associated with susceptibility to Helicobacter Pylori infected gastric cancer in Asian patients.&nbsp; This might be due to high cytokine production by TNF-238G allele.</p> Rita Rani Barua, Sushanta Barua, Hena Rani Barua, Ajoy Kishore Barua, M.A. Jalil Ansari, J-M Chong, Hiroshi Uozaki, Masashi Fukayama ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44647 Mon, 30 Dec 2019 00:00:00 +0000 Sympathetic cardiovascular function status of chronic obstructive pulmonary disease (COPD) https://www.banglajol.info/index.php/BMRCB/article/view/44648 <p><em>Background</em>: Chronic obstructive pulmonary disease (COPD) is a chronic progressive obstructive airway disease which is often associated with cardiovascular diseases. Sympathetic dysfunction may complicate the cardiovascular diseases which may in turn increase the morbidity and mortality in COPD patients.</p> <p><em>Objective</em>: Aim of this study was to evaluate sympathetic cardiovascular function status of COPD patients to reduce the cardiovascular complication in those patients.</p> <p><em>Methods</em>: This comparative cross-sectional study was carried out at the department of Physiology and department of Medicine, Rajshahi Medical College, Rajshahi from July 2013 to June 2014.</p> <p><em>Results</em>: A total number of 80 subjects aged 40-55 years were selected, among which 40 were clinically diagnosed COPD patients (case) and 40 were age, sex and BMI matched apparently healthy persons for comparison (control group). To observe sympathetic cardiovascular function status resting pulse rate, resting systolic BP, resting diastolic BP, decline of systolic BP in response to standing from lying position (orthostatic test) and rise of diastolic BP in response to sustained hand grip for 5 minutes (isometric exercise test) were measured. For statistical analysis Independent sample t-test, and Pearson’s correlation coefficient test were performed.&nbsp; In this study resting pulse rate, systolic BP, diastolic BP and rise of diastolic blood pressure in isometric exercise test were significantly increased in COPD than in healthy control group. On the other hand, decline of systolic blood pressure in orthostatic test was significantly decreased in COPD than in control group.</p> <p><em>Conclusion</em>: This study concludes that sympathetic cardiovascular function is overactive in COPD and sympathetic over activity correlates with severity of the disease.</p> Sohel Baksh, Shahin Akhter, Obaidullah Ibne Ali, Momena Khatun Munna, Nihad Rownak, Sakhawat Mahmud Khan ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44648 Mon, 30 Dec 2019 00:00:00 +0000 Repair of inguinal hernia by Desarda technique in both elective and emergency setting https://www.banglajol.info/index.php/BMRCB/article/view/44649 <p><em>Background</em>: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair.</p> <p><em>Objectives</em>: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia.</p> <p><em>Methods</em>: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016.</p> <p><em>Results</em>: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%).</p> <p><em>Conclusion</em>: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.</p> S.M. Iftekhar Uddeen Sagar, Muhammad Syeef Khalid, Abu Sayeed Md. Feroz Mustafa, SM Nazrul Islam ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44649 Mon, 30 Dec 2019 00:00:00 +0000 Status of self-medication among the patients attending outpatient department in selected private hospitals in Dhaka city https://www.banglajol.info/index.php/BMRCB/article/view/44650 <p><em>Background</em>: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair.</p> <p><em>Objectives</em>: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia.</p> <p><em>Methods</em>: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016.</p> <p><em>Results</em>: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%).</p> <p><em>Conclusion</em>: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.</p> Md. Riyadh Hasan, Nawzia Yasmin, Nuhad Raisa Seoty, Md. Maniul Hasan, Maj. Gen. (Retd) Dr. M Shahjahan ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44650 Mon, 30 Dec 2019 00:00:00 +0000 Accuracy of SpO2 measurements by placing probes on newborns' wrist and ankle https://www.banglajol.info/index.php/BMRCB/article/view/44651 <p><em>Background</em>: Pulse oximetry is a noninvasive technique of measuring oxygenation of the blood that is used worldwide to assess critically ill patients. The accuracy of pulse oximetry reading may be related to the site of pulse oximeter probe placement; but this may be difficult in sick neonates. In neonates, palm and sole are commonly used site for probe placement.</p> <p><em>Objective</em>: This study was conducted to assess the accuracy of pulse oximeter oxygen saturation (SpO<sub>2</sub>) from probe placement at wrist and ankle as an alternative to palm and sole in neonates.</p> <p><em>Methods</em>: This cross sectional study was carried out in SCABU of Dhaka Shishu (Children) Hospital from December 2012 to March 2013. A total of 169 neonates were enrolled in this study. Two pulse oximeters were used for simultaneous paired SpO<sub>2 </sub>measurements. The SpO<sub>2</sub> was measured at 0 sec, then at 30 sec and at 1 min over the palm and ipsilateral wrist, both side and repeated the same procedure over the sole and ipsilateral ankle, both side and were recorded in the case record form. Two tailed, Student’s t-test was performed for analysis of continuous, normally distributed variables. Regression analysis was performed to determine the relationship between paired SpO<sub>2</sub> measurements.</p> <p><em>Results</em>:&nbsp; A total of 169 patients (birth weight 2530.8±772.2 g, gestational age 36.7±3.9 weeks, mean age 7.7 days and age range 1-27 days) were enrolled. There was a good correlation between SpO<sub>2</sub> measured at the palm versus the wrist (r= 0.92, <em>p</em>&lt;0.0001 (right); r= 0.88, <em>p</em>&lt; 0.0001 (left)) and between SpO2 measured at the sole versus the ankle (r=0.90, <em>p</em>&lt;0.0001 (right); r= 0.98, <em>p</em>&lt;0.0001 (left)). There was also a good agreement between paired SpO<sub>2</sub> measurements from these sites. The bias and precision for SpO<sub>2</sub> at the right palm and right wrist was 0.08 ± 0.65% and for the left palm and left wrist 0.05 ± 0.79%. Similarly, the bias and precision for SpO<sub>2</sub> at the right sole and right ankle was -0.11 ± 0.63% and for the left sole and left ankle was 0.56 ± 0.32%.</p> <p><em>Conclusion: </em>The wrist and ankle can be used as alternative sites, to measure SpO<sub>2</sub> in newborn infants in place of the routinely used palm or sole.</p> Gule Tajkia, Mahfuza Shirin, M Monir Hossain, Mohammad Abdullah Al Mamun ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44651 Mon, 30 Dec 2019 00:00:00 +0000 Prediction of the stone free rate by using the guy's stone score after percutaneous nephrolithotomy https://www.banglajol.info/index.php/BMRCB/article/view/44652 <p><em>Background</em>: Urolithiasis is one of the common diseases of the urinary system, with an incidence of approximately 5-10% among the general population. Among the minimally invasive surgeries, percutaneous nephrolithotomy (PCNL) is the gold standard therapy for large and/or complex renal stones.</p> <p><em>Objective</em>: The study was carried out to predict the stone-free rate after PCNL by using the Guy's stone score.</p> <p><em>Methods</em>: This prospective cross-sectional study was conducted in the Department of Urology, Bangabandhu Sheikh Mujib Medical University, (BSMMU), Dhaka from February 2016 to January 2017. The patients with renal stone attending the outpatient department who met the criteria of standard PCNL.</p> <p><em>Results</em>: Atotal of 52 patients with renal stone were included in this study.&nbsp; The mean age was to be found 45.3±14.0 with range of 18 to 73 years. Male to female ratio was 3.3:1. Almost three fourth (74.5%) patients had normal body mass index. All patients had normal anatomy. More than half 27 of the (51.9%) patients had found grade I, 10 (19.2%) Grade II, 11(21.2%) Grade III and 4 (7.7%) Grade IV. Nearly two third 34 (65.4%) patients were found total stone cleared and 18(34.6%) had residual stone. Cleared stone was found 23(85.2%) in grade I, 7(70.0%) grade II, 3(27.3%) in grade III and 1(25.0%) in grade IV.</p> <p><em>Conclusion</em>: Based on the study findings, it may be concluded that higher the GSS less the stone free rate.It will help in better patient counseling preoperatively, and to predict the need for ancillary treatment.</p> Mohammad Shafikul Islam, Muhammad Hossain, Md. Saiful Islam, AKM Khurshidul Alam, Md. Habibur Rahman Dulal, A.T.M. Aman Ullah, Mohammad Shafiqur Rahman, Faruk Hossain ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44652 Mon, 30 Dec 2019 00:00:00 +0000 Squamous cell carcinoma arising in a dermoid cyst of the ovary: A case series https://www.banglajol.info/index.php/BMRCB/article/view/44653 <p><em>Background: </em>Malignant transformation in a dermoid cyst of the ovary is a rare complication, occurring in only 1-2% of cases, with squamous cell carcinoma being the most common type. Preoperative diagnosis is difficult because of the lack of specific symptoms and signs to suggest malignancy. The prognosis is generally poor when disease has spread beyond the ovary. &nbsp;</p> <p><em>Objective: </em>This study was conducted to review experience with this disease and describe the current treatment modality.</p> <p><em>Methods: </em>It was identified 4 women with this diagnosis during 2013-2018. This is a descriptive study, looking at the patient’s characteristics, mode of presentation, the role of tumor markers and radiological imaging in diagnosis. It was also examined the stage and pathological features of the presentation and subsequent course of the disease.</p> <p><em>Result: </em>The median age was 45 (range: 32-63 yrs). Three cases were stage I and one case was stage III. The average tumor diameter was 14.1cm. All patients were under surgery. Two patients not received any adjuvant therapy and two patients received adjuvant chemotherapy. One patient had recurrent disease in the pelvis during adjuvant chemotherapy and died at 8 month of her diagnosis. Other three patients were disease free for last 3 years. The overall 2 yrs survival was 70%.</p> <p><em>Conclusion: </em>Squamous carcinomas arising in mature cystic teratomas are commonly large ovarian tumors that occur in perimenopausal women often present as an incidental finding. There are no reliable diagnostic tools or prognostic indicators. The behaviour of these tumors is unpredictable. Conservative surgery may be considered in women wishing to preserve fertility. The role of chemotherapy and radiotherapy remains unclear in the adjuvant or metastatic setting.</p> Nasrin Hossain, Uma Nag, Mohammad Sharif Mahmud ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44653 Mon, 30 Dec 2019 00:00:00 +0000 Haematohidrosis with headache- a rare phenomenon of sweating blood: A case report https://www.banglajol.info/index.php/BMRCB/article/view/44654 <p><em>Background:</em> Haematohidrosis is an extremely rare clinical condition in which the patient experiences sweat mixed with blood. Till date only a few cases of haematohidrosis have been reported in national and international medical journals. Pathogenesis of the condition is not yet established but rupture of the blood vessels of sweat glands due to activation of sympathetic nervous system from stress, anxiety or any other reason have been proposed as the cause of bleeding.</p> <p><em>Objective:</em> It was aimed to present the case who presented with episodes of sweat mixed with blood from different sites of her body.</p> <p><em>Methods:</em> A case of haematohidrosis who experiences bloody sweat which comes with episodes of headache, was studied during in Bangabandhu Sheikh Mujib Medical University, Dhaka.</p> <p><em>Results:</em> Interestingly, it was to be found that a child of the patient, who is a 4 year old boy and a nephew of her, are suffering from the same condition. No family history was found in any of the previous cases. All other history and the investigations were insignificant. It was to be diagnosed the headache as migraine.</p> <p><em>Conclusion:</em> The patient was treated with propranolol and paracetamol. Her bloody sweat decreased significantly in both severity and frequency with the treatment.</p> Amit Roy Chowdhury, Mohammed Rafiqul Islam, Hasan Zahidur Rahman, Maftahul Jannat, Md. Habibur Rahman ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44654 Mon, 30 Dec 2019 00:00:00 +0000 Achieving universal health coverage by 2030: The role of parliaments in ensuring right to health https://www.banglajol.info/index.php/BMRCB/article/view/44655 <p>In October 2018, on behalf of the Bangladesh Parliament, I proposed to the 139<sup>th</sup> Assembly of the Inter Parliamentary Union (IPU) to adopt a resolution on “Achieving universal health coverage by 2030: The role of parliaments in ensuring the right to health” (Annex-1). After the acceptance of my proposal, I worked as a co-rapporteur along with Mr. Christian Lohr, Member of the National Council, Switzerland and Ms. Mariana Carvalho, Member of the Chamber of Deputies, Brazil for a year to consult with and gather inputs from the parliaments and parliamentarians across the world.</p> <p>After several intensive discussions, debates and consultations in different parts of the world, we presented a draft proposal to the IPU member parliaments before presented it to the IPU assembly. Later, following the final debate and discussion, 141<sup>st</sup> IPU assembly 2019 in Belgrade, Serbia approved this resolution. I believe this global tool will enable parliaments and parliamentarians to contribute in ensuring the highest attainable standard of health and global health targets by 2030.</p> <p>I am grateful to the Hon’ble Prime Minister of Bangladesh Jononetry Sheikh Hasina MP and the Hon’ble Speaker of Bangladesh Parliament Dr. Shirin Sharmin Chaudhury MP for their encouragement. I am also thankful to IPU President Ms Gabriela Cuevas Barron, IPU Secretary General Mr Martin Chungong and World Health Organization Director General Dr Tedros Adhanom Ghebreyesus for their regular guidance towards this initiative. My sincere appreciation goes to the colleagues from the Bangladesh Parliament, Ministry of Health and Family Welfare of Bangladesh, Ministry of Foreign Affairs of Bangladesh, IPU Secretariat and WHO Secretariat for their contribution in the process.</p> <p>I hope our parliaments and parliamentarians will take full advantage of this resolution in their work to make the right decisions when it’s come to those health issues.</p> <p>I am now looking forward to working together with my fellow parliamentarians from home and abroad to deliver the commitment we have made through the IPU resolution on universal health coverage. I would appreciate your comment, suggestion and advice in this regard.</p> Md. Habibe Millat, Mr. Christian Lohr, Ms. Mariana Carvalho ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44655 Mon, 30 Dec 2019 00:00:00 +0000 Dengue Fever in Bangladesh https://www.banglajol.info/index.php/BMRCB/article/view/44656 <p>a</p> Tahmina Shirin ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/44656 Mon, 30 Dec 2019 00:00:00 +0000