Chattagram Maa-O-Shishu Hospital Medical College Journal
A multi-disciplinary peer-reviewed journal published by Chattagram Maa-O-Shishu Hospital Medical College. Full text articles available
Chattagram Maa-O-Shishu Hospital Medical College
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Correlation between Modified Tal Score and Oxygen Saturation Values Detected by Pulse Oximeter in Children with Bronchiolitis
Background: A number of clinical scoring systems have been used for risk stratification of children with bronchiolitis, most of them have not validate in our setting. Modified Tal’s Score (MTS) is one of such clinical score. This study aimed to determine the relation between MTS and oxygen saturation (SpO2) measured by pulse Oximeterin children with acute bronchiolitis patients admitted to a tertiary-level hospital in Bangladesh. . Materials and methods: This cross-sectional study included 251 children aged <24 months with bronchiolitis from the department of pediatrics of Chittagong Medical College Hospital from April 2021 to March 2022. Severity was assessed by MTS and simultaneously SpO2 of patients were seen and recorded in a case record form. Correlation between MTS and SpO2 was assessed. Results: MTS showed a strong negative linear correlation with SpO2 (r = 0.82, 95% CI: -0.857 to -0.775). Linear regression analysis showed that 58.5% of the variation in SpO2 can be explained by the model containing only MTS. The mean (± SD) SpO2 value was 96.3±2.4% in children with a score of 2–5 (n=140), 90.65±5.6% in those with a score of 6–7 (n=48) and 86.6±4.7% in children with a score of 8 or more(n=63), (p < 0.001 by Bonferroni’s multiple comparison, when all two-way comparisons were done for each pair of results). With the cutoff value of 6, the MTS had 96.61% sensitivity, 71.88% specificity, and 98.57% negative predictive value to detect hypoxaemia. Conclusions: As modified TAL’s clinical scoring system strongly correlates with the SpO2, in absences of pulse oximetry MTS can be used to confirm severity of hypoxaemia in infants with bronchiolitis. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 3-7
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A Study on Components of Metabolic Syndrome among the Non-Diabetic Obese
Background: Metabolic syndrome is a cluster of interrelated metabolic abnormalities, including central obesity, insulin resistance, hypertension, dyslipidemia, and elevated fasting blood glucose levels. It significantly raises the risk of cardiovascular diseases and other health complications. This study focuses on the components of metabolic syndrome among non-diabetic obese individuals, who are particularly vulnerable to these metabolic disturbances due to excess adiposity. To assess the prevalence and associations of metabolic syndrome components among non-diabetic obese individuals. Materials and methods: A cross-sectional study was conducted at Chittagong Medical College Hospital from July 2020 to June 2021. The study enrolled 100 nondiabetic obese individuals aged 30 to 70 years, excluding those with diabetes, infections, liver or renal diseases, cardiovascular conditions, malignancies, endocrine disorders, or those on certain medications. Data on socio-demographic characteristics, anthropometric measures, serum lipid profiles, and fasting blood glucose levels were collected and analyzed using Microsoft Excel and IBM-SPSS v.20. Statistical significance was determined using the Student's ‘t’ test and chi-square (c2) test with a p-value < 0.05. Results: The majority of participants were under 40 years of age, predominantly female and mostly service holders. Elevated blood pressure was observed in 25% of participants. Anthropometric measures showed a mean BMI of 32.57 kg/m² and a mean waist circumference of 104.63 cm. Metabolic syndrome was present in 52% of participants. Dyslipidemia was prevalent, with 50% exhibiting elevated triglycerides and 46% having decreased HDL cholesterol. Notably, 42% of participants were prediabetic. Significant associations were found between metabolic syndrome and elevated triglycerides (p < 0.001), increased LDL cholesterol (p < 0.05), and decreased HDL cholesterol (p < 0.05). Conclusion: The study underscores the high prevalence of metabolic syndrome and associated dyslipidemia among non-diabetic obese individuals. The significant correlation between these metabolic abnormalities highlights the need for early detection and management strategies to mitigate the progression to type 2 diabetes and cardiovascular diseases. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 8-11
Serum Vitamin B12 and Folic Acid Status of Patients with Type II DM on Metformin
Background: Over the last decades, long term treatment with metformin has been recognized as a possible cause of alterations in serum B12 and folic acid value of type 2 diabetic patients. Metformin can affect the absorption of vitamin B12 and folic acid which ultimately results in neurological and hematological complications has been designed to assess serum vitamin B12 and folic acid status of type II diabetic patients on metformin. Materials and methods: This hospital based cross sectional study was conducted in Department of Physiology, Chittagong Medical College in collaboration with Department of Medicine and Department of Endocrinology, Chittagong Medical College Hospital from July 2021 to June 2022. Total 70 diagnosed type 2 diabetic patients were included in the study among which 35 patients aged between 45-55 years and on metformin therapy for more than 2 years were taken as case group and in control group age and sex matched 35 diagnosed diabetic patients not treated with metformin were included. Serum vitamin B12 and folic acid were measured in all patients. Collected data was analyzed by SPSS-26. Results: Values of serum vitamin B12 were significantly lower in metformin exposed diabetic patients compared to metformin unexposed patients (p<0.001). Folic acid levels of metformin exposed diabetic patients were also decreased but it was not statistically significant (p>0.05). Duration and dose of metformin had significant negative correlation with vitamin B12 level. But serum folic acid levels were not correlated with dose and duration of metformin use. Conclusion: The results of this study concludes that long term use of metformin can alter vitamin B12 and folic acid level in type 2 diabetic patients. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 12-16
Knowledge about Cervical Cancer among Women of Reproductive Age Attending a Tertiary Level Hospital in Bangladesh
Background: Cervical cancer is the fourth mostfrequent malignancy in women worldwide. The highest rate of this cancer incidence and mortality are in low- and middle-income countries. It is thesecond leading cause of cancer-related deaths among women in Bangladesh. To assess the level of knowledge among women of reproductive age about cervical cancer. Materials and methods: This descriptive cross-sectional study was conducted from September 2019 to December 2019 in the Gynecology and Obstetrics Outpatient Department (OPD) of Sir Salimullah Medical College and Mitford Hospital. The sampling technique was purposive. A total of 300 women of reproductive age (15 to 49 years) were interviewed using a pretested semi-structured questionnaire. Results: Most participants (75%) did not know aboutcervical cancer. Only 34.7% of women reported understanding symptoms and one-fourth (25%) knew the causes of cervical cancer. Conclusion: Knowledge about cervical cancer among women was revealed to be remarkably poor. Health education and community-based intervention should focus on informing risk factors, symptoms, screening and cervical cancer vaccination. In the future, this study will assist with planning various strategies including sexual health, participation in screening and preventive services. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 17-21
Adolescent Endometriosis: Diagnosis and Treatment Approaches
Background: Endometriosis is a chronic gynaecological disorder that affects a large number of adolescents, causing, dysmenorrhea and impaired quality of life. To evaluating diagnosis and treatment approaches for adolescent endometriosis. Materials and methods: This was a cross-sectional study 150 adolescent girl, aged 13 to 19, in purposively selected healthcare settings in Sylhet, including Jalalabad Ragib-Rabeya Medical College and Hospital, Oasis Hospital etc. Results: The participants had a mean age of 16.4 years, an average BMI of 22.6 kg/m², and an average age at menarche of 12.5 years. A family history of endometriosis was reported in 26.7% of cases. Diagnostic methods used included laparoscopy (66.7%), MRI (20.0%) and ultrasound (13.3%). Treatment strategies comprised hormonal therapy (73.3%), NSAIDs (60.0%), laparoscopic surgery (33.3%), complementary therapies (20.0%), psychological counseling (26.7%), and physical therapy (13.3%). The mean PedsQL score was 65.2, the EPDD score was 6.8 and the HADS score averaged 14.3. Half of the participants experienced delays in diagnosis, which significantly impacted timely treatment. Improved outcomes were associated with early menarche, hormonal therapy, and laparoscopic surgery. Conclusion: This study underscores the significant diagnostic delays and the profound impact of endometriosis on the quality of life of adolescents in Bangladesh. Enhancing diagnostic protocols, promoting early intervention, and strengthening support systems are essential for improving the management of adolescent endometriosis. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 22-26
Health Hazards and Health Seeking Behaviors among Tannery Workers Residing at Tannery Industrial Area
Background: The leather industry and its products have a substantial impact on the economy of Bangladesh and have been recognized as a highly significant sector. Nevertheless, tannery poses potential risks to workers due to exposure to harmful chemicals and pollutants linked with tannery activities. The objective of this study was to evaluate the health hazards and healthcare-seeking behavior experienced by tannery workers residing in close proximity to the tannery area. Materials and methods: This cross-sectional study was carried out among tannery workers residing in the vicinity of the tannery industrial area in Hemayetpur, Savar, Dhaka. A total of 402 participants were conveniently interviewed in person using a pre-tested semi-structured questionnaire from January to December 2023. Results: The majority of participants were male (88%) predominantly young adults aged 20-30. In terms of employment, 34.6% worked in machinery-related tasks, with 66.4% having done so for 3-8 years. Self-reported health issues included joint pain (49.0%), frequent fever (33.3%), allergies (43.0%), chronic headaches (35.8%), itching (35.8%), rashes (19.9%), and coughing (35.8%). Statistically significant associations were found between these health problems and the duration of stay, department of work, and gender (p<0.005). The study also found that 70% of workers used personal protective equipment (PPE), mainly masks, and 61% received formal safety training. Regarding health-seeking behavior, 89.3% relied on allopathic medicine, with pharmacists being the main healthcare provider (89.3%). Furthermore, primary healthcare services (93.5%) were more commonly sought than specialized care. Conclusion: Policymakers and public health professionals can utilize these insights to develop strategies aimed at mitigating environmental hazards, enhancing healthcare facilities and promoting preventive measures. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 27-32
Fetomaternal Outcomes in Placenta Previa with and without Coverage of a Uterine Scar in a Tertiary Hospital in Chattogram, Bangladesh
Background: Placenta Previa (PP) is a significant cause of maternal and fetal morbidity and mortality, especially in patients with scared uterus. This study aimed to compare the maternal and neonatal outcomes of PP with and without coverage of a uterine scar in a tertiary hospital in Chattogram, Bangladesh. Materials and methods: A prospective observational study was conducted from January 2024 to June 2024 in Chittagong Medical College Hospital. Consecutively admitted 38 singleton pregnancies with PP with a history of Cesarean Section (CS) or myomectomy were included and divided into two groups: the PP with coverage of a uterine scar group (PPCS group) and the PP without coverage of a uterine group (Non-PPCS group). Maternal and neonatal outcomes between two groups were compared by statistical methods. Results: There were 38 patients with with PP on scared uterus and were further classified into two groups: PPCS (n=23) and Non-PPCS (n=18). Both the groups were comparable in terms of their baseline sociodemographic and clinical characteristics. Placenta accreta spectrum was (95.7% vs. 20%.0, p<0.001), hemorrgage (91.3% vs. 46.7%, p=0.006), urinary bladder injury (26.7% vs. 0%, p=0.031), peripartum hysterectomy (65.2% vs. 6.7%, p=0.001), ligation of uterine artery (56.5% vs. 93.3%, p=0.014) and use of uterine compression suture (30.4% vs. 66.7%, p=0.028) had a significant difference between PPCS group and Non-PPCS group. Neonatal outcomes in terms of prematurity, low birth weight, low APGAR score, need for NICU admission, and perinatal death were similar between two groups. Conclusion: The PPCS group had poorer maternal outcomes than the Non-PPCS group. To counsel their patients appropriately, healthcare providers should be aware of possible complications of placenta previa lying over the uterine scar. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 33-36
Seropositivity of HBV and HCV among the Family Members of Chronic Viral Hepatitis Patients
Background: Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection are the global public health challenge. Family members of the HBV and HCV infected patients have a high risk of exposure to many blood-borne diseases including Hepatitis B, and Hepatitis C viral infections as well. So the objectives of the present study was to see the seropositivity of HBV and HCV among the family members of chronically infected viral hepatitis patients. Materials and methods: This cross sectional descriptive study was conducted among 80 family members of 50 patients with chronic HBV and HCV infection. After ethical clearance and written consent, 1stdegree family members of those chronically infected hepatitis patients were explained about the objectives of the study and a standard questionnairewere introduced and recorded. Venous blood samples was taken from every participant with universal precautions and was tested by Enzyme Linked Immunosorbent Assay (ELISA) for Hepatitis B surface antigen, anti HCV. Data analysis was done later by SPSS. Results: Eighty (80) family members of HBV[45(90%)] and HCV[5(10%] positive cases were screened. Among the family member, male were 45(56.3%) and female were 35(43.8%) and male to male ratio 1.28:1. Total 23(28.8%)family members were vaccinated against HBV. HBsAg and Anti HCV screening status of the relatives revealed HBsAg and anti HCV was found positive in 4(5%) and 1(1.3%) cases respectively. Conclusion: Relatives of the HBV and HCV infected patients are also at risk. So they should take proper preventive measures and should be vaccinated. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 37-40
Functional Outcomes of Tension Band Wiring Using Cannulated Screws in Transverse Patellar Fracture
Background: The most commonly used surgical intervention for treatment of patellar fractures is open reduction and internal fixation with Kirschner wire (K-wire) tension band. To overcome some disadvantages related to K-wire, a new technique has evolved replacing K-wire with cannulated screw. The aim of this study was to evaluate effectiveness and safety of open reduction and internal fixation of closed transverse patellar fractures with Tension Band Wiring (TBW) using parallel cannulated compression screws. Materials and methods: This prospective study was conducted in the Department of Orthopedic Surgery of Chittagong Medical College Hospital from January 2019 to December 2019. Twenty consecutive patients of closed transverse patellar fractures were enrolled in the study and treated with vertical skin exposure, fracture open reduction and internal fixation by anterior TBW through 4.0 mm Cannulated screws. The patients were followed post-surgery for 6 months to evaluate time required for radiographic bone union, knee joint Range of Motion (ROM) loss of fracture reduction, material failure and the overall functional result of knee using Bostman scoring. Results: The mean age of the patients was 38.91 ±12.01years and 80% were male. At final follow up 15 (75%) patients had full extension and ROM 120 degree and 5 (25%) patients had ROM 90-120 degree. The main postoperative complication was knee stiffness observed in 10% patients. Almost 95% patients had no pain and returned to their original job after 18 weeks of fixation with no significant limitations. The fractures united at a mean of 8.0±2.4 weeks (Range 6 to 10 weeks) and no case of non-union was observed. Evaluation of outcome at 24 weeks after fixation showed that 60% of the patients had excellent outcome (Bostman Score 28- 30) and 40% had good outcome (Bostman Score 20-27). Conclusion: TBW with cannulated compression screws is a safe and effective technique for the treatment of closed transverse patellar fractureswith less chance of implant failure and soft tissue irritation. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 41-45
Serum Calcium Level among Children with Simple Febrile Seizures Admitted in Chittagong Medical College Hospital
Background: Febrile seizure is one of the most common form of seizure occurring in children. Water and electrolyte imbalance occur during acute febrile illness and hypocalcaemia is one of them. It has been found that change in serum calcium might enhance the susceptibility to seizure. This study is aimed to evaluate the association of serum calcium level and febrile seizure among hospitalized children. Materials and methods: This cross-sectional case control study was conducted among 100 hospitalized children of febrile illness in Department of Paediatrics of Chittagong Medical College Hospital, Chattogram, Bangladesh from June 2022 to November 2022. Febrile patients of 6- 60 months of age were enrolled during this study period in two groups, one with seizure and another without seizure. Serum calcium was measured by automated biochemistry analyzer, in a method of Arsenazo-III photometry principle. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS v23. Statistical significance was defined as p < 0.05 and confidence interval level was set at 95%. Results: The mean age was 20.3±13.1 months in case group and 18.0±12.7 months in control group. Overall male patients were predominant, 29(58.0%) and 30(60.0%) in case and control group respectively. Age, sex, religion, residence and gestational age were not comparable in two groups. The difference of mean birth weight was statistically significant between two groups, 2176.0±293.1 grams in case group and 2328.0±249.9 grams in control group. Most (96.0%) of the patients developed seizures within 7-12 hours of onset of fever. Duration of seizure was 6-10 minutes in half of the patients. Generalized tonic clonic seizure was found to be the predominant seizure type (96%). Cough and cold as presenting features were more in control group than case group (78.0% vs 46.0%). Hypocalcaemia (<8.8 mg/dl) was found significantly higher in case group (50.0% vs 10.0%) with OR (9.0 and 95% CI 3.06-26.44%).Higher mean serum calcium level was significantly documented in control group (8.8±0.9 mg/dl vs 9.4±0.5 m/dl in case and control group respectively). Conclusion: Significant association was found between serum calcium levels and the occurrence of febrile seizures. Low serum calcium levels and occurrence of febrile seizure showed significant association. Presence of low serum calcium levels of less than 8.8 mg/dl was more in patients with febrile seizure. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 46-50
Call for Action to a Pandemic: Perception, Attitude and Practice among Adults with Chronic Diseases towards COVID- 19 at South-East Bangladesh
Background: Public awareness is the mainstay to control an emerging pandemic. This study investigated the knowledge, attitudes and practices of COVID-19 among chronic disease patients during the pandemic. Materials and methods: A cross-sectional study was conducted from June-October 2021 at Chittagong Medical College Hospital, Southern Bangladesh. This study included 1537 chronic disease patients by convenient sampling using a pre-structured questionnaire. Multivariable logistic regression analyses were performed to identify factors associated with poor knowledge and practice towards COVID-19. The strength of the association between the dependent and independent variables was demonstrated by computing Odds Ratio (OR) with a 95% Confidence Interval (CI). Correlation between knowledge, attitude and practice scores were done by using Pearson correlation coefficient. p-value <0.05 was considered as statistically significant. Microsoft Xcel and SPSS version 23 was used for analysis. Results: The prevalence of poor attitude and poor practice was high (49.4%, 83.4%). Age >55 years reported poor knowledge. Educational status of “can’t read and write”, unemployment, multi-morbidity (OR= 3.06, 1.40, 2.06 with 95% CI and OR=2.95, 2.19, 2.22 with 95% CI respectively) and low monthly family income (p =<.05) were significantly associated with poor knowledge and practice. Female, married, illiterate and rural participants (OR=2.09, 2.55, 2.6, 1.3) had significant less optimistic attitude. Poor knowledge was correlated significantly with poor attitude and practice. Conclusions: Targeted health education towards the current COVID-19 pandemic, among adults with chronic diseases is necessary to reduce disease severity as well as economic burden. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 51-56
Feto-Maternal Outcome in Antepartum Hemorrhage : A Study in A Tertiary Care Hospital
Background: Antepartum Hemorrhage (APH) is a terrible obstetric emergency associated with maternal and fetal morbidity and mortality worldwide. Objective of this study was to asses the maternal and fetal outcomes as well as to formulate the preventive measures for reducing maternal and fetal complications in patients with APH. Materials and methods: This prospective observational study was conducted at Chattagram Maa-O-Shishu Hospital Medical College, from January to December 2021, on all admitted pregnant women with APH more than 28 weeks gestation. Detailed history, clinical examination, associated conditions, mode of delivery, fetal conditions and investigations were analyzed. Results : A total of 113 APH Cases were reported amongst 5724 pregnant women with its incidence about 2%. The most common cause of APH was placenta previa 80(70.8%) followed by abruptio placenta 28 (24.8%), unexplained 3 (2.7%) and local 2(1.7%) causes. APH was found commonly in patients 72(64%) with age group between 26-30 years, multigravida 95(84%), pregnancy induced hypertension 36 (PIH 32%) previous history of caesarean section 34(30%) and curettage 22(19.2%). Most of the cases 83 (73.5%) were terminated at 34-36 weeks of gestation. There was 1( 0.9%) maternal mortality. However, pregnancy complications were remarkably higher, most common maternal complications were postpartum hemorrhage 45(40%) and maternal shock 6 (5.1%). The commonest mode of delivery was caesarean section 83(73.5%) and in 1(0.9%) case peripartum hysterectomy was needed. Perinatal complications were prematurity 94 (83.1%), perinatal asphyxia 51(45%), stillbirth 26( 23%) and most common causes of early neonatal death were prematurity and neonatal sepsis. Conclusions: APH is associated with significant maternal and fetal morbidity as well as mortality which could be reduced by regular antenatal care, early detection and early referral to higher centers. Better facilities for caesarean section, availability of blood bank and multidisciplinary approach with a good NICU can improve maternal and fetal outcome of APH patients. The incidence of fetal mortality due to abruptio placenta still remains high. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 57-62
Socio-Demographic Profile, Knowledge and Awareness Level of Teenage Mothers
Background: Teenage pregnancy is coming up as one of the most important social and public health problem in both developed and developing countries. Lack of knowledge and poor awareness lead to increase number of teenage pregnancy. To assess the knowledge and awareness level of teenage mothers and its consequences. Materials and methods: A cross-sectional observational study was conducted at the Obstetrics and Gynaecology Department of Chittagong Medical College Hospital, Chittagong for a period of six months from 10th October 2013 to 9th April 2014. One hundred teenage mothers (Aged 15-19 completed years at delivery) who got herself admitted to the department of Obstetrics and Gynaecology were included in this study. Predesigned data collections sheet was used and relevant informations were recorded. Results: Among 100 patients, 60 % mothers were in age group of 17-18 years. 25% 19 years, 15% in <17 years. 88% were Muslim, 80% were housewives, 12% garments workers, day laborer 4%, service holder only 1%. Majority of patients (58%) came from low income group families. 26% low middle class, only 6% from upper income group. 60% of mother were upto primary education who had same knowledge about consequence of teenage pregnancy. Can sign only 18%, illiterate 16% who had no knowledge about that. Most of them 64% were unplanned pregnancy. Only 36% were planned. 64% of them never use of any contraceptives. 17% of them use were by herself, used by husband only 6%. Data were analyzed by both manually and by SPSS-18. Conclusion: Teenage are the future of the nation. Not only there should be efforts to improve the socio-demographic environment of pregnant teenagers to improve the reproductive outcome but also decrease the incidence of teenage pregnancy Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 63-66
Antimicrobial Susceptibility Pattern in Blood Culture at Chattogram
Background: Blood stream infection is a predominant cause of morbidity and mortality in Bangladesh and needs urgent treatment with antimicrobial drugs. Blood culture is the gold standard for the diagnosis of blood infection. Patient's final outcome might be improved with detailed and organized surveillance studies on bloodstream isolates and their resistance. The present study deals with the isolation of blood culture isolates from patients of a hospital in Chattogram,Bangladesh and their antibiotic susceptibility pattern. Materials and methods: A purposive cross sectional retrospective study was conducted with a total 100 suspected bacteremia patients in 6 months duration in different lab of Chattogram to determine bacteriological profile of blood culture and antibiogram of the isolates. Bacterial isolates and their antibiotic sensitivity test were done according to standard microbiological techniques. Results: Approximately 53% of the cases are female and 75% in the under 5 years of age group. 36% of the culture isolates were Acinetobacter and other common isolates were Klebsiella (22%), Pseudomonas (18%), Salmonella typhi (17%), Staphylococcus aureus (4%), E.coli (3%). However, all the tested isolates were found mostly sensitive against Vancomycin, Gentamycin, Tazobactum. Penicillin had the highest overall resistance of (100%), followed by Ampicillin (100%) and Ceftazidime (90%). Cefepime, Cefuroxime, Cefixime, had overall resistance rates of 89%, 85%, 83% respectively. Highest drug resistance was found with Ampicillin (100%) and Penicillin (100%) against Acinetobacter. There were no isolates completely resistant to all the antibiotics tested. Conclusion: This study highlights that surveillance detection of causative agents of blood stream infections and their antibiogram should be done regularly in the hospital.We expect our present work will be helpful for the healthcare professionals to provide improved treatment. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 67-71
Antibiogram of Urinary Isolates in Chattogram
Background: Despite the widespread availability of antibiotics, Urinary Tract Infection (UTI) is one of the most important causes of morbidity in general population and also the common cause of nosocomial infection among hospitalized patients. This is due to resistance of antibiotics and the ever changing pattern of the sensitivity. The purpose of the study was to identify the recent pattern of antibiogram and sensitivity and to help physician in prescribing empirical therapy against the newest sensitivity pattern. Materials and methods: This cross-sectional study was carried out in the Department of Microbiology of Chattagram Maa Shishu-O-General Hospital, National Hospital Chattogram and Max Hospital Laboratory, Chattogram from February to July 2022. Sample size was 100 positive urine culture reports from each lab. Results: The male to female ratio of the patients was 1:2.22. Escherichia coli was the dominant isolate (53%) followed by Klebsiella spp. (19%), Enterococcus spp. (16%), both Coagulase negative Staphylococcus and Pseudomona (5%) and Proteus (2%). The three most frequently isolated bacteria had resistance rates of 100% to Penicillin and sensitivity rates of 20-89% to Amikacin,67%-100% to Tigecycline, 42%- 88% to Nitrofurantoin and 80%- 89% to Meropenam. E.coli and Klebsiella also had resistance rates of 69%- 94% to Cefixime and 83%-88% to Cefuroxime. Conclusion: In the study area resistance rates to Penicillin, Cefixime and Cefuroxime were high. Since most isolates were sensitive to Tigecycline, Nitrofurantoin and Meropenam, they are considered as appropriate antimicrobials for empirical treatment urinary tract infections. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 72-76
School Absenteeism of Adolescent Girls during Menstruation in Khagrachari, Bangladesh
Background: Adolescent girls in underdeveloped nations often struggle with menstrual hygiene, especially when they are in school. Poor menstrual hygiene in impoverished nations has not received enough attention up until now. This study aimed to find the state of adolescent girls who miss school when menstruating and the association between school absenteeism and various factors related to menstruation. Materials and methods: A descriptive type of cross-sectional study was conducted during the period January to December 2019 with 300 adolescent school girls in a rural hilly area in Bangladesh. A self-administered questionnaire was used to collect data and analysis of results was done according to standard statistical analysis by using SPSS version 22. Results: Among 300 students, only 82 (27.3%) respondents remained absent during menstruation, among those 27.3% respondents, more than two-thirds of the students (74.4%) were absent from school/college due to physical discomfort or lower abdominal pain. One seventy-four (58%) girls used other than sanitary pads (cloth or rags) during menstruation. Out of 174 non-pad users, 118(67.8%) were of (the 16-18) years group.Among the respondents who used sanitary pads, 36.5% were Hindu, 95.2% were unmarried and 20.6% were from the upper class.The chisquare test revealed menstrual hygiene was strongly associated with ethnicity, religion and SES but school absenteeism was not influenced by menstrual hygiene (c2= 0.410, p0.522 ). Conclusion: School authorities implementation of school health programs for adolescents should emphasise menstrual hygiene, which is especially related to the use of sanitary pads, not unhygienic rags or clothes. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 77-82
Evaluation and Strengthening of Consciousness in Secondary School Students about Hygiene and Common Health Hazards
Background: Knowledge of hygiene and common health hazards is a must to know during schooling. It would be efficient to use a school as the basis of such public health activities, and it would also have a major impact on the community. But there is no record of such previous formal studies in our context. So objective of the present study was to search consciousness in secondary school students regarding health education. Materials and methods: It was a cross sectional observational study done in five schools. Of these schools, 100 high school students were selected by random lottery method during a period of six months from July 2023 to December 2023. Prior consent was taken from all the school authorities and students were all explained. A pretest was taken with a questionnaire by using Likert scale in some questions, where scoring was done from 1 to 5 and in some questions, in dichotomous style, scoring 1 for correct answer and 0 for wrong answer. After collection of data it was compiled and analyzed by SPSS 20. A posttest was also taken using the same questionnaire and the results were analyzed similarly. Results: Post intervention tests were higher than the pretest scores in all aspects. The mean pre-test score of 100 students of the five schools was 70.9900 with a standard deviation of 3.97846, the mean post-test score of that of was 94.0300, with a standard deviation of 1.20147. This increment in the score was highly significant (p value <0,001). The comparison between scores of male and female students in case of both pre-test and post-test showed no significant differences. Mean pre-test score of male students was 71.6750 with a standard deviation of 4.31091 and mean pre-test score of female students was 70.5333 with a standard deviation of 3.70738, p value being 0.161.Mean post-test score of male students was 93.9000 with a standard deviation of 1.31656 and mean post-test score of female students was 94.1167 with a standard deviation of 1.12131, this finding is not significant, p value being 0.280. Conclusions: The integration of practices in the areas of health and education considering the prospect of continuing education for educators and students, and the consequent exchange of knowledge that emerges in this context, allows us to reframe the relationship which historically had been constituted between health and education. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 83-86
Treatment Outcome of West Syndrome with Low-Dose ACTH Therapy in A Tertiary Care Center in Bangladesh
Background: Corticosteroids, Adrenocorticotrophic Hormone (ACTH) and vigabatrin are considered to be the first-line drug for the treatment of West Syndrome (WS). There are little consensus regarding the definitive dose, efficacy or duration of treatment of these agents in comparison to each other. So this study aimed to assess the effectiveness of low-dose ACTH in the treatment of WS. Materials and methods: A prospective observational study was conducted in the Department of Child neurology of Chattagram Maa Shishu-O-General Hospital from January 2021 to December 2022. One hundered and five children with WS aged two months to two years old enrolled in the study population. Treatment was initiated with low dose ACTH (20IU-40IU/day) and clinical and Electroencephalographic (EEG) responses were assessed at two and four weeks. Results: The mean ±SD age of the patients was 11.21 ± 7.86 months and 74.28% were male. The mean ±SD age of onset of epileptic spasm and time interval between the onset of the epileptic spasm and initiating ACTH therapy was at 6.00 ± 5.01 and 5.26 ± 4.36 months, respectively. Symptomatic epileptic spasm 76(72%) was the major category of spasm. Clinical cessation of epileptic spasm was found in 55(52.38%) and 71(67.61%) patients at two and four weeks follow-up, respectively. Cessation of hypsarrythmia in EEG was noticed in 24(27%) and 66(62.8%) patients at two and four weeks, respectively. Majority (65.71%) of the patients did not have any adverse effect. Irritability, sleep disturbance, infection and hypertension was found in 21(20%), 7(6.6%), 5(4.7%) and 3(2.8%) patients. Relapse after four weeks was found in 12 (11.4%). Conclusion: Low dose ACTH was effective in cessation of spasm and resolution of hypsarrhythmia in with children WS. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 87-90
Role of Intrapartum Cardiotocography to Predict the Fetal Outcome in High-Risk Patients : A Prospective Study
Background: Labour is a very short period of life of a fetus but poses physiological stress to all the fetus. Fetal distress is a progressive condition that, if not corrected, can increase the chance of fetal death. So routine and continuous monitoring of fetal heart rate by doing Cardiotocography in labour in high risk pregnancies has become an established obstetric practice. The aim of the study is to evaluate the predictive value of the admission CTG in detecting fetal hypoxia at the time of admission during labour and to correlate its result with fetal outcome in high risk pregnancies. Materials and methods: This prospective observational study was held in ChattogramMaa O Shishu Hospital Medical College from March 2022 to August 2022. A total of 65 gravid women with high risk pregnancies of >37 weeks gestation with cephalic presentation in the first stage of labour were taken. Result was assessed in the form of APGAR SCORE at 5 min, NICU admission, perinatal mortality and mode of delivery. Statistical analysis was done by using SPSS 20. Chi square test was used and p< 0.05 is considered statistically significant. Results: A total of 65 high risk obstetric patients were recruited. The admission CTG were reactive in 45 patients (69.23%) and non-reactive in 20 patients (30.77%). APGAR SCORE <7 at 5 minutes was higher in nonreactive group (60%) as compared to reactive group (60% v/s 17.78%). Occurrence of fetal distress, NICU admission and perinatal mortality was also higher in nonreactive group to reactive group (NICU admission 35% v/s 6.67% and perinatal mortality 15% v/s 0%). Incidence of vaginal delivery vaginal delivery was more common when the test was reactive (64.44% v/s 10%). Sensitivity, specificity, positive predictive value and negative predictive value of Admission CTG for these high risk cases were 68%, 76%, 54% and 85% respectively. Conclusion: Admission CTG is a simple and easy test and an effective screening test to identify groups of women with greater risk of intrapartum fetal hypoxia and to predict fetal outcome and thus prevents unnecessary delay in intervention. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 91-95
The Alarming Rise in Antifungal Medication Resistance and Its Prospects
Abstract not available Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 1-2