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) Wed, 02 Sep 2020 10:41:21 +0000 OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 COVID-19 in Bangladesh: Measures for containment https://www.banglajol.info/index.php/BMRCB/article/view/47460 <p>Coronavirus disease (COVID-19) is an infectious disease caused by the most recently discovered novel coronavirus, renamed as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). <sup>1</sup> It was unknown before the outbreak began in Wuhan, China, in December 2019. <sup>2</sup> The outbreak was linked epidemiologically to the Hua Nan seafood and wet animal wholesale market in Wuhan, and the market was subsequently closed on 1 January 2020. <sup>3</sup> The virus rapidly spread to all provinces in China, as well as a number of countries overseas, and was declared a Public Health Emergency of International Concern by the Director General of the World Health Organization on 30 January 2020.<sup>4</sup> Subsequently, on 11 March 2020, the WHO declared COVID-18 a pandemic.<sup>5 </sup>It<sup>&nbsp;&nbsp; </sup>is the first pandemic caused by a coronavirus. <sup>6</sup></p> <p>Around the globe, hundreds of thousands have been infected and tens of thousands people died including frontline workforce including physicians, nurses and others. <em>Bangladesh</em>&nbsp;reported its&nbsp;<em>first</em>&nbsp;confirmed&nbsp;<em>COVID</em><em>-</em>19&nbsp;<em>case</em>&nbsp;on 8 March 2020, after three people, two men and a woman tested positive for the coronavirus. Two of the infected are recently returned from Italy, and the other one is a female family member of the infected male. On the 18 March, 2020, Bangladesh confirmed the first death from COVID-19. <sup>7 </sup>In Bangladesh, till 30 March 2020, 49 confirmed cases and there were five deaths due to COVID-19.<sup>8</sup></p> <p>This pandemic-a global calamity, is not only a health concern, it is a threat to life and livelihoods worldwide. In addition to health, major disruptions are also occurred in business, education, transports and others areas.&nbsp; It causes interruption in every aspect of day to day life.</p> <p>To prevent and control infections, the immediate challenges ahead are to conduct the tests, isolation of infected cases, tracing of the contacts and quarantine, and appropriate measures for the overseas returnees. An effective risk communication with community engagement is critical to reduce the stigma, fake news, psychological stress. It is essential to bring courage and mental strength of the frontline fighters, and support for the poor and daily wage earners etc.</p> <p>Aimed at preventing and control of SARS-COV-2, government of Bangladesh has already initiated steps including enhancement of public awareness on hand hygiene, respiratory hygiene, social distancing, wearing of masks, avoidance of public gatherings, campaign against myths, fake news and stigma; preparing the health care services including expansion of hospital facilities, training and protective measures for the health workforce and other frontline fighters. Furthermore, steps are being taken conducting RT PCR tests, isolating infected cases, tracing contacts, quarantine the contacts and overseas returnees, and other necessary measures. The government has declared the general holiday in Bangladesh including closure of the educational institutes and office and workplaces, to prevent and control of infections. Necessary steps have been initiated for the social and economic protections of the vulnerable including expansion of the existing social safety net programmes. Aimed at adequate and timely response to the COVID-19, the Directorate General of Health Services (DGHS), the Ministry of Health and Family Welfare, developed a number of guidelines and manuals for &nbsp;&nbsp;the containment of this pandemic disease. For an effective and timely preparedness and response, the DGHS has developed ‘National Preparedness and Response Plan for COVID-19, Bangladesh’.<sup>9</sup></p> <p>For better response, well-coordinated and cooperated global efforts, including exchange of information, scientific knowledge, research findings, expertise and best practices are important. All countries should implement WHO guidelines and recommendations.&nbsp;</p> <p>In Bangladesh, the Ministry of Health and Family Welfare alone cannot mitigate this pandemic. Strengthening of the coordinated efforts among the ministries, and effective and timely engagement of the non-government and private sectors are strongly recommended. Intensification of RT-PCR lab tests for case detection, and isolation and management of cases, and to trace the contacts and ensure quarantine, surveillance, and research, serological tests &nbsp;&nbsp;to detect SARS-CoV-2 specific immunoglobulins (IgG and IgM) to estimate the population exposure, strengthening public awareness and&nbsp; risk communication, strict implementation of personal hygiene, use of face mask, social distancing&nbsp; and other measures are thus suggested to prevent and control COVID-19 in Bangladesh.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 01-02</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/47460 Wed, 10 Jun 2020 00:00:00 +0000 COVID-19 pandemic and Bangladesh https://www.banglajol.info/index.php/BMRCB/article/view/47461 <p>COVID-19 is now a pandemic, as the WHO Director General Tedros Adhanom Ghebreyesus declared during a media briefing on Wednesday, 11 March, 2020.</p> <p>Bangladesh situation as on 27 March, 2020, total affected 44 out of which died 5. Some of them have returned from abroad and others had come in contact with those coming from abroad. So, community spread has already been started. 1st three cases detected on 8 March and 1st death declared on 18th March, 2020.</p> MA Jalil Chowdhury ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47461 Wed, 10 Jun 2020 00:00:00 +0000 Neonatal surgery: Demand and survival both are on increase- an experience of seventeen years in Dhaka Medical College Hospital, Bangladesh https://www.banglajol.info/index.php/BMRCB/article/view/47462 <p><em>Purpose:</em> In order to achieve the Sustainable Development Goal (SDG) 3 target of reduction in under-five mortality below 25 per thousand live birth by the year of 2030, major reductions are going to be required in neonatal mortality. Congenital anomalies have become the fourth cause of neonatal deaths and most of these are curable. &nbsp;The largest public hospital of Bangladesh is serving the poor and lower middle class people where surgery and medical facilities are mostly free of cost. This study was done to see the types of neonatal surgical patients admitted in this hospital and their management out come with limited facilities and find out some new ideas and information and the ways to improve the scenario to contribute in achieving the SDG 3.</p> <p><em>Materials &amp; Methods:</em> This was a descriptive study with retrospective record review of all admitted neonates done over a period of 17 years from July 2001 to June 2018 and carried out in the Department of Pediatric Surgery. A total of 2492 neonates were admitted during this period and it was the 16.16% of total number of 15414 pediatric surgical admission upto12 years of age. Data was collected from hospital records and analyzed retrospectively. Detail history of each patient was collected and recorded in a pre-designed, semi-structured questionnaire. Statistical assessments were done by SPSS version 22. An Ethical clearance had been sought.</p> <p><em>Results:</em> Out of these 2492 neonates, 1932 (77.53%) were admitted for Neonatal Intestinal Obstruction (NIO) and Intestinal atresia 246 (09.87%), Omphalocele 163 (06.54%), Meconium ileus 154 (06.18%), Volvulous neonatoram 125 (05.02%), Septicemia 114 (04.57%), Posterior urethral valve 78 (03.13%), Gastroschisis 75 (03.01%), Abscess 57 (02.29%), Congenital Diaphragmatic Hernia 54 (02.17%), Ectopia vesicae 50 (02.01%), Infantile pyloric stenosis 42 (01.68%), Tracheo-oesophageal fistula 24 (0.96%), Prune belly syndrome 8 (0.32%), Neonatal injury 5 (0.20%), Conjoint twin 4 (0.16%). The most common cause of NIO was anorectal malformation (ARM) 806 (32.34%). Among them 516 (64.02%) patients had high variety and 290 (35.98%) patients had low variety ARM. Next was Hirschsprungs disease and 487 (19.54%) neonates presented with this. One hundred and forteen (4.57%) patients presented with septicemia and 246 (9.87%) presented with intestinal atresia, 154 (6.18%) neonates had meconium ileus and 125 (5.02%) patients presented with volvulus neonatorum. Total 1791 (71.86%) patients were managed surgically. Most of the surgerical procedures were pelvic colostomy 541 (21.71%), transverse colostomy and biopsies 376 (15.09%), resection and anastomosis 261(10.47%), anoplasty 239 (9.59%), primary repair 135 (5.42%) and ileostomy 104(4.17%). Out of 2492 patients, 351 died, so mortality was 14.09%, before surgery 127 (5.10%) and after surgery was 224 (14.85%).</p> <p><em>Conclusion:</em> Pediatric surgeons by their skill and teamwork greatly improved the neonatal surgical service and contributing significantly in reducing infant mortality rate to achieve SDG 3. But to improve further, neonatal intensive care unit (NICU) and other support systems are essential as well as support from UNICEF and World Health Organization (WHO) to include pediatric surgery and surgeons in their activities especially in developing countries. Due to socio-political and economic reasons of the developing countries the roll of pediatric surgeons are multidimensional.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 05-11</p> Abdul Hanif, Kaniz Hasina, Muhammad Abdur Rouf, KM Shaiful Islam, Nazmus Sakib Ferdous, Jaglul Gaffer Khan, Md Ashraful Huq Kazal ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47462 Wed, 10 Jun 2020 00:00:00 +0000 Serum homocysteine level in children with Juvenile Idiopathic Arthritis https://www.banglajol.info/index.php/BMRCB/article/view/47463 <p><em>Background:</em> Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease of childhood and a leading cause of short and long-term disability. Abnormal level of serum homocysteine (Hcy) may be found in Juvenile idiopathic arthritis (JIA) patients. Some studies were done on serum homocyestine levels in children with JIA which showed conflicting results. So far, no study regarding the Hcy level in JIA patients was done in Bangladesh.</p> <p><em>Objectives: </em>The study was aimed to assess the homocysteine level in children with different subtypes of JIA.</p> <p><em>Methods:</em> It was a cross sectional and case control study. Fifty newly diagnosed cases of JIA attending the Pediatric Rheumatology <strong>c</strong>linic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January 2016 to March 2017 were included. Fifty age and sex matched controls were selected. Serum homocysteine levels were measured in both cases and controls.</p> <p><em>Results:</em> Among JIA patients, 36% had high serum homocysteine (Hcy) level whereas 100% of controls had normal level. Mean hcy level was significantly (<em>p</em>&lt;0.05) higher among cases than controls. Significantly higher number and level of hyperhomocystaeinemia was found among JIA patients having duration of illness more than 1 year than duration less than 1 year. Mean homocysteine level of polyarticular RF positive cases was found as 14.38±3.79 µmol/L and that of SJIA was found as 13.0±4.66 µmol/L. When compared with homocysteine levels of control group these two groups had significantly higher homocysteine level.</p> <p><em>Conclusion:</em> More than one third of JIA patients had hyperhomocysteinaemia. Mean hcy level of JIA cases was significantly higher than that of controls. Significant association of hyperhomocysteinaemia was present with duration of illness and certain types of JIA.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 12-16</p> Md Fakhrul Alam, Mohammed Mahbubul Islam, Mujammel Haque, Shahana A Rahman ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47463 Wed, 10 Jun 2020 00:00:00 +0000 Outcome of paediatric rhabdomyosarcoma attended in a tertiary care hospital, Dhaka, Bangladesh https://www.banglajol.info/index.php/BMRCB/article/view/47464 <p><em>Background: </em>Rhabdomyosarcoma (RMS) is a malignant tumor of mesenchymal origin, is the most common form of paediatric soft tissue sarcoma. It is the third most common solid tumor comprising 4.5% of all childhood cancer with an annual incidence of 4.5 cases per million children. There is so no statistical data on RMS in Bangladesh because no study has done in Bangladesh.</p> <p><em>Objective:</em> To evaluate the clinical characteristics and treatment outcome of children with rhabdomyosarcoma among tertiary care.</p> <p><em>Methods: </em>A retrospective study carried out analysing the medical records of 39 patients with rhabdomyosarcoma from the BSMMU tumor registry. Medical records of children with rhabdomyosarcoma were reviewed over a period of 6 years from June 2011 to May 2017.&nbsp; Most patients received multimodality therapy (chemotherapy, surgery, radiotherapy).</p> <p><em>Results:</em> The male female was ratio 1.2:1. More than half of cases presented with a mass at varying sites The predominant complaint 12.0% was pain. The primary site of disease was the head and neck in 46.0% followed by pelvis 40.0%. Pathologically most frequent histological subtype was in 46.0% embryonal rhabdomyosarcoma followed by alveolar rhabdomyosarcoma 23.0%, botryoid type 5.0%, spindle cell type 5.0% and unspecified 21.0%.&nbsp; At the time of diagnosis 64.0% of patients were TNM stage 3 next frequency is stage IV 23.0%. The survival rate from diagnosis to subsequent demise was poor – between 13 days and 3.5 years. The overall 5-year survival rate was 41.0% which is may be due to advanced stage of disease.</p> <p><em>Conclusion: </em>The majority of presentations were in the advanced stages of disease but sensitive to multimodality therapy. Poor survival rate is correlated with the advanced stage of the disease. The clinical characteristics of rhabdomyosarcoma at BSMMU&nbsp;Hospital are similar to worldwide countries, but not like developed countries. Further multicentre studies are needed to report our experiences with rhabdomyosarcoma.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 17-21</p> ATM Atikur Rahman, Momena Begum, CSH Kibria, Mehnaz Akter, Khurshida Azad Siddiqua, Farzana Siddiqua, Choudhury Yakub Jamal, Salahuddin Shah ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47464 Wed, 10 Jun 2020 00:00:00 +0000 Mycobaterial interspersed repetitive units-variable number of tandem repeats analysis and pattern of drug resistance in extended drug resistant (XDR) TB isolates from pulmonary tuberculosis patients in Bangladesh https://www.banglajol.info/index.php/BMRCB/article/view/47465 <p><em>Background:</em> To investigate the spread of specific genotypes in a defined geographical area and to determine any relationship of these genotypes with drug resistance the most essential method is molecular typing. It allows a rapid and precise species differentiation.</p> <p><em>Objective:</em> This study was intended to observe the genotypes of XDR mycobacterium tuberculosis by determining 24 loci MIRU-VNTR analysis.</p> <p><em>Methods:</em> To gain an insight about molecular typing of MTB and drug resistance-associated mutations in XDR-TB isolates a total of 98 multi drug resistant tuberculosis (MDR-TB) isolates collected through Xpert MTB/RIF assay. They were subjected to 2<sup>nd</sup> line (Fluoroquinolones, kanamycin, capreomycin and amikacin) drug susceptibility testing through line probe assay (LPA) in a view to detect extensively drug resistant tuberculosis (XDR-TB). Genotyping was done for XDR-TB isolates using 24 loci Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) using the online tool at http://www.MIRU-VNTRplus.org.. Out of 98 MDR-TB isolates 11(11.23%) &nbsp;XDR-TB isolates were typed and analysed.</p> <p><em>Results:</em> Twenty four loci MIRU-VNTR genotyping involving similarity searching and phylogenetic tree analysis revealed that six (54.60%) XDR-TB isolates belonged to Beijing strain, Other MTB strain also detected were Delhi/CAS two(18.20%), Haarlem two(18.20%) and New-1, one (9.10%) in number. Minimum spanning tree analysis showed two strain of Beijing family form a clonal complex. Beijing strains were more common among younger age group and within urban population. Beijing strains were also predominant in treatment failure patient. Only one new case of XDR-TB belongs to Delhi/CAS family. Second line mycobacterial drug resistance (MTBDRsl) detected by LPA showed the most prevalent mutations involved in Fluoroquinolones drug resistance (FQ) was Asp94Gly in <em>gyr</em>A gene (54.55%) in quinolone resistance determining region (QRDR) and for Injectable 2<sup>nd</sup> line Drug resistance (ISL) was A1401G, C1402T in 16S <em>rrs</em> gene (100%)..&nbsp; All XDR-TB isolates showed resistance to Levofloxacin in 2<sup>nd</sup> line LPA but Moxifloxacin showed low level resistance to some cases.</p> <p><em>Conclusion:</em> Molecular typing of XDR- TB isolates and pattern of drug resistance associated mutations in XDR-TB isolates in Bangladesh have not been reported previously. The result of this study highlights the need to reinforce the TB policy in Bangladesh with regard to control the spread and transmission as well as detection and treatment strategies regarding XDR-TB.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 22-28</p> Shirin Tarafder, Md Bayzid Bin Monir ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47465 Wed, 10 Jun 2020 00:00:00 +0000 Effect of glycemic control on thyroid hormones level in type 2 diabetic patients https://www.banglajol.info/index.php/BMRCB/article/view/47466 <p><em>Background:</em> Thyroid dysfunction, a common endocrine disorder that increasing day by day. Hypothyroidism occasionally occurs in diabetic patients especially those with poor glycemic control.</p> <p><em>Objectives:</em> The objective of the study was to observe the effect of glycemic control on thyroid hormones level in type 2 diabetic patients &amp; to determine selected socio-demographic characteristics of the respondents.</p> <p><em>Methods:</em> This was a case control study carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC), Dhaka from July 2016 to June 2017. Total sixty subjects of both male and female age ranged from 40 to 60 years were included in this study. Among them thirty were type 2 diabetic patients (both uncontrolled and controlled) and another thirty were included for comparison as control and were matched by age, sex, and body mass index (BMI). Both case and control group were selected purposively based on selection criteria. Serum TSH, FT<sub>4</sub> and FT<sub>3</sub> levels were measured by chemiluminescent micro particle immunoassay (CMIA) method. Fasting blood glucose level was estimated by glucose oxidase (GOD) method and blood HbA<sub>1c</sub> level was estimated by ion exchange high performance liquid chromatography (HPLC) method. The statistical analysis was done by ANOVA test, Bonferroni test and Pearson’s correlation coefficient test. Data quality control was done by using a checklist.</p> <p><em>Results:</em> In this study, mean serum TSH level was significantly higher in uncontrolled diabetic patients than that of controlled diabetic patients. Serum FT<sub>4</sub> level was significantly lower in uncontrolled diabetic patients in comparison to that of controlled diabetic patients. Besides these, serum TSH level was positively correlated (r = +0.575), serum FT<sub>4</sub> and FT<sub>3 </sub>levels were negatively correlated (r = &nbsp;̶ 0.588, r = &nbsp;̶ 0.527) with HbA<sub>1c</sub> level in uncontrolled diabetic patients and all these relationships were statistically significant p≤0.05 respectively.</p> <p><em>Conclusion:</em> The present study revealed that hypothyroidism occurs in type 2 diabetic patients which were found only in uncontrolled diabetic patients due to their poor glycemic control.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 29-34</p> Kamrunnahar Alo, Mahmuda Begum, Md Mahfuzar Rahman ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47466 Wed, 10 Jun 2020 00:00:00 +0000 Sero-prevalence of human brucellosis in high risk individuals and normal individuals of Sylhet District in Bangladesh https://www.banglajol.info/index.php/BMRCB/article/view/47467 <p><em>Background:</em> Brucellosis is an important re-emerging zoonosis which remains an uncontrolled public health problem worldwide because of serious diminution of manpower, animals and essential foodstuffs. Transmission to human can occurs through contact with infected animals or animal products. It is a poorly recognised health problem in this country though there is persistence of large reservoirs of the organism among livestock such as sheep, goat and cows creating fertile field for unabated transmission. But data on it’s transmission potential and prevalence in this country specially in Sylhet region remained scarce. In the absence of supportive epidemiological information physicians on most of the cases have to depend on their clinical judgement to suggest relevant tests. &nbsp;</p> <p>Objective: The study was conducted to compare the sero-prevalence of human brucellosis among high risk and normal individuals.</p> <p><em>Methods:</em> This cross-sectional, comparative study was conducted amongst a total of randomly selected 90 participants including 65 high risk individuals during the period of July 2016-June 2017. Brucella IgM and IgG antibody in the serum were determine by Enzyme Linked Immunosorbent Assay (ELISA) technique.</p> <p><em>Results:</em> Among the 65 participants of the high risk group, Brucella IgM and IgG seropositivity were found in 6 (9.2%) and 32(49.2%) cases respectively.&nbsp; On the other hand, no IgM seropositivity, but 10 (40.0%) IgG seropositivity cases were found in normal group. No significant difference (<em>p</em>&gt;0.05) was found between the groups. Considering occupations, the highest 11 (61.1%) Brucella IgG seropositivity was found among the 18 dairy farm workers (p&gt;0.05). Participants with 0-5 years duration of job had highest seropositivity 7 (70%) among high risk group and 3 (50%) among normal group. No significant association was identified between seropositivity and duration of occupation, education (<em>p</em>&gt;0.05).</p> <p><em>Conclusions:</em> Based on the study findings, it may be concluded that the extent of human brucellosis should not be ignored, and measures like awareness building, vaccination, transboundary screening needed to prevent and control the disease in animals and limit human transmission.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 35-40</p> Jasmin Akhtar, Osul Ahmed Chowdhury, Premananda Das, Shib Prasad Sinha ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47467 Wed, 10 Jun 2020 00:00:00 +0000 Enterotoxic, neurotoxic and cytotoxice demonstrated by shiga toxin (2d) producing escherichia coli in experimental models https://www.banglajol.info/index.php/BMRCB/article/view/47468 <p><em>Background:&nbsp;</em>Shiga toxin (Stx) producing <em>Escherichia coli</em> (STEC) colonize human intestinal tract and their infections have asymptomatic clinical manifestations which cause local and systemic pathological changes.</p> <p><em>Objectives: </em>This study intended to establish the role of Shiga toxin (Stx2d) in developing clinical manifestations in STEC infections using experimental models.</p> <p><em>Methods:&nbsp;</em>A total 300 stool samples were screened from hospitalised diarrhoeal patients enrolled in 2% surveillance system at International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). The <em>stx</em> gene profile including their variants was identified byPCR.<em>stx<sub>2d</sub></em> gene positive STEC PT187 was selected for toxin (s) preparation.Toxin was prepared by centrifugation of culture supernatant. Enterotoxicand paralytic-lethal activities were tested in rabbit ileal loops and mice, respectively. &nbsp;Histopathological study of the rabbit ileal loop segments and different tissues of mice &nbsp;by paraffin embedded method and stained by H &amp; E staining. Cytotoxic effect was performed on &nbsp;HeLa cells.</p> <p><em>Results: </em>Nine STEC strains were identified for <em>stx<sub>2</sub></em> gene positive.&nbsp; Among them STEC PT187 was found <em>stx<sub>2d</sub></em> gene positive strain and selected for toxic activities. Toxin (s) responsible for causing accumulation of fluid in rabbit ileal loops and its segments showed inflammation and enterocytenecrosis. In mouse model, toxin(s) was found to cause hind limbs paralysis and death. Brain, spinal cord and kidney tissue of mice showed histopathological changes. Toxin (s) also showed positive cytotoxic activity in HeLa cell.</p> <p><em>Conclusion:&nbsp;</em>In this study, results indicated that Stx2d producing <em>E. coli </em>exhibit not only enterotoxic activity, but also cause impaired neurological functions and cytotoxic effect.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 41-47</p> Chowdhury Rafiqul Ahsan, Kohinur Begum, Enamul Kabir, Alam Nur-E- Kamal, Kaisar Ali Talukder ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47468 Wed, 10 Jun 2020 00:00:00 +0000 Evaluation of colposcopic and histopathological findings in precancerous cervical lesions https://www.banglajol.info/index.php/BMRCB/article/view/47469 <p><em>Background: </em>Cervical cancer is the most frequent cancer in women worldwide. It is a preventable and curable disease with proper screening. After primary screening Colposcopy is a valuable tool in the detection and treatment of precancerous cervical lesions. Histopathology is the gold standard method of diagnosis of Precancerous lesions.</p> <p><em>Objective: </em>The objective of this study was to evaluate the performance of colposcopy in the diagnosis and to make correlation between colposcopic &amp; histopathological findings in precancerous cervical neoplasia (CIN).</p> <p><em>Materials and Method: </em>It was a cross sectional study, conducted at the Colposcopy Clinic, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Study was done for a period of one year from January, 2016 to December, 2016. Sixty two married women having following complaints: positive visual inspection of cervix (VIA + ve) with 3-5% Acetic acid, postcoital bleeding, postmenopausal bleeding, and intermenstrual bleeding were recruited for the study. Written informed consent was obtained from the participants. The questionnaire was pretested, corrected and finalized. The data collection was done using the interviewer administered questionnaire. Colposcopic examination of cervix was done in 62 participants. Colposcopy guided punch biopsy/Loop electrosurgical excision procedure (LEEP) from acetowhite area was taken in cases of VIA +ve women and random four quadrants (1, 5, 7 &amp; 11 O’ clock position) cervical biopsy in cases of VIA – ve women having other indications. Histopathological examinations of specimens were done in the Department of Pathology, BSMMU. Descriptive analysis, chi-square test (X<sup>2</sup>) and Fisher’s exact test were performed. P value&lt;0.05 was taken as statistically significant.</p> <p><em>Result: </em>The mean age of the study population was 36.8±11.9 years ranging from 20 to72 years. Out of 62 participants, 40.3% (n=25) had VIA positive, 41.9% (n=26) had postcoital bleeding among which 24 was VIA positive and 2 was VIA negative, 8.1% (n=5) had intermenstrual bleeding with positive VIA and 9.7% (n=6) post-menopausal bleeding among which 4 was VIA positive and 2 was VIA negative. Among total 62 participants</p> <p>Sensitivity of colposcopy to diagnose histopathologically confirmed CIN I was 82.6%, CIN II was 25% and CIN III was also 25%. The specificity to diagnose CIN I was 42.4%, CIN II was 91.4% and CIN III was 93.1%. PPV of colposcopy to diagnose histologically confirmed CIN I was 55.8%, CIN II was 16.7% and CIN III was 20%. The NPV to diagnose CIN I was 73.7%, CIN II was 94.6% and CIN III was 94.7%. The colposcopic accuracy to diagnose CIN I was 61.3%, CIN II was 87.1% and CIN III was 90.3%. There was statistically significant (P value &lt;0.05) correlation for colposcopic diagnosis of histopathologically confirmed CIN I,CIN II and III.</p> <p><em>Conclusion:&nbsp;</em>The accuracy of colposcopy to diagnose histopathologically confirmed precancerous cervical lesions was quite high. Patients presenting with postcoital bleeding and postmenopausal bleeding should have colposcopy and biopsies even if the screening test result normal. Moreover colposcopy has high sensitivity, so we can easily adopt the see and treat method to reduce the dropout.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 48-54</p> Namkha Dorji, Shirin Akter Begum, Tasfia Mahmud, Mehriban Amatullah ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47469 Wed, 10 Jun 2020 00:00:00 +0000 Anaemia in hypothyroidism https://www.banglajol.info/index.php/BMRCB/article/view/47470 <p><em>Background:</em> Anaemia is very common in hypothyroid patient. The results of the type of anaemia in hypothyroid patient studied outside may not be similar on Bangladeshi population. So far, there is no such study regarding the types of anaemia in hypothyroid patients in Bangladeshi population.</p> <p><em>Methods:</em> This was a cross sectional study in patients with hypothyroidism who was attending in the thyroid and endocrine clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka over a period of one year. All newly diagnosed cases were selected considering inclusion and exclusion criteria. A structured questionnaire was used for data collection.</p> <p><em>Results:</em> Fifty newly detected hypothy sroid patients were studied among the study population, 52.0%&nbsp; &nbsp;was between 05 to 35 years and another 48.0% were in 36 to 65 years. 76.0% were female. Bradycardia was found in 20.0% cases. Puffiness of face, peripheral oedema and cold intoleran ce were found in 78.0%, 68.0% and 82.0% cases respectively. Hoarseness of voice, delayed relaxation of tendon reflexes and paraesthesia were found in about 80.0% cases. Myxoedema and vitiligo were found in 54.0% and 6% cases. FT4 level was reduced in 100.0% cases (Normal range of FT4-9.14-23.81 pmol/L). The mean of FT4 was 5.10 pmol/L. On the other hand TSH level increased in all cases (Normal range of TSH-0.47-5.0l mIU/L). The mean of TSH was 109.88 mIU/L. 50 cases were positive anti TG-Ab and also anti PO­-Ab was positive in Fifty cases. Hemoglobin concentration was reduced in 70.0% cases. The mean of haemoglobin concentration was 10.67 gm/dl. In this present study, association of serum anti TG Ab and anti PO Ab of the patients with hypothyroidism and their corresponding hemoglobin concentration were found significant (p&lt;0.05) but on the other hand there was no association between serum FT4 of the patients with hypothyroidism and their corresponding haemoglobin concentration (p&gt; 0.05). Normocytic normochromic anaemia were found in 64.0% cases, and Microcytic hypochromic anaemia in 32% and Macrocytic anaemia in 4.0% of the cases. Iron deficiency was found in 90.0% and chronic blood loss in 44.0% of the cases.</p> <p><em>Conclusion:</em> &nbsp;Anaemia is frequently found in hypothyroid patients. So, hypothyroidism should be excluded in anaemia of nonspecific origin.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 55-60</p> Md Salahuddin Shah, Masuda Begum, Mossammat Diluba Akter, ATM Atikur Rahman, Md Farid Uddin, Md Jalilur Rahman ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47470 Wed, 10 Jun 2020 00:00:00 +0000 Brain Abscess with Situs Inversus and Dextrocardia: A Case Report https://www.banglajol.info/index.php/BMRCB/article/view/47471 <p>Background: Brain abscess is a neurosurgical emergency. It has to be evacuated without any delay. Though these patients may have congenital heart diseases with ASD and VSD, presence of situs inversus and dextrocardia are relatively uncommon in neurosurgical practice.</p> <p>Objective: The aim was to present the case with multiple episodes of convulsions and gradual deterioration of consciousness without history of fever.</p> <p>Methods: The case was carefully evaluated with taking history and examining the patient. Diagnosis was confirmed with a MRI of the brain. It had shown a large ring enhancing lesion in the left temporal lobe which was diagnosed as brain abscess.</p> <p>Results: The patient underwent left temporal craniotomy and the abscess was totally removed along with the capsule. He made an uneventful recovery.</p> <p>Conclusion: Dextrocardia and cardiac congenital anomalies are serious conditions especially when they are accompanied with brain abscess. But prompt surgery and careful intraoperative and postoperative care can help the patient to recover early without any adverse event.</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 61-63</p> Kaisar Haroon, T Taher, M Rahman, KK Barua ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47471 Wed, 10 Jun 2020 00:00:00 +0000 Technological Advancements to Reduce the Influence of Absorption and Scattering on the Optical Imaging https://www.banglajol.info/index.php/BMRCB/article/view/47472 <p>No abstract available</p> <p>Bangladesh Med Res Counc Bull 2020; 46(1): 64-65</p> Al Timimi Zahra ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BMRCB/article/view/47472 Wed, 10 Jun 2020 00:00:00 +0000