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 en-US Chattagram Maa-O-Shishu Hospital Medical College Journal 2305-7890 Authors of articles published in CMOSHMC Journal retain the copyright of their articles and are free to reproduce and disseminate their work. Doctor and Media <p>Abstract not available</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 1</p> Md Badruddoza ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 1 1 10.3329/cmoshmcj.v17i2.39767 A Documentation of Hepatitis Outbreak in Chittagong <p><strong>Introduction: </strong>Hepatitis E Virus (HEV) causes outbreaks of jaundice and it is associated with morbidity and higher maternal mortality. There is a recent outbreak of hepatitis in the Chittagong city and present study is aimed to observe the clinical and serological trends along with outcome of hepatitis cases visiting two tertiary care hospitals Chittagong, Bangladesh.</p> <p><strong>Methods: </strong>It was an observational study done in two tertiary care hospital of Chittagong in a period of 3 months (May, June &amp; July 2018) among 230 patients of hepatitis. After inclusion with written informed consent patients were introduced a questionnaire. Their demographic data, risk behaviors were noted, history related to hepatitis were recorded. Examination was done and evaluation regarding presence of hepatic encephalopathy at bed site was noted. Later serological findings were evaluated. After collection of all data it were compiled and analyzed by SPSS- 20.</p> <p><strong>Results: </strong>Among 230 cases age group, gender and locality of the study patients were analyzed where younger age groups specially 21-30 years 114(49.6%) and 31-40 years 38(16.5%) were the most affected group. Gender distribution was found mostly same. Halishahar area which is located in western part of the Chittagong city was found mostly affected 196(85.2%). Use of water from WASA (Water and Sewerage Authority) supply was 168(73%) and deep tubewel water was 56(24.3%). Among them 80(34.8%) subjects do not boil water Anorexia (74.8%) nausea (77.4%) vomiting (83.5%) history of fever (89.6%) passage of dark color urine (99.1%) and weakness (97.4%) were some common presenting complaints. Family history of jaundice was found in 40.9% of cases. Among all 216(93.91%) had clinical jaundice, 91(39.56%) had right upper quadrant of the abdomen pain, 41(17.8%) had hepatomegally, 14(6.1%) had spleenomegally, 24(10.4%) had signs of hepatic failure and 34(14.8%) female were pregnant. Anti HEV was found positive in 164(71.3%) cases, 12(5.2%) were positive for anti HAV, 6(2.6%) were positive for HBsAg. None was found anti HCV positive. Among all 4(1.8%) cases died due to hepatic failure or multi-organ failure with AKI. All of them were pregnant. Two pregnant lady had missed abortion. Among all 11(4.7%) cases loosed follow and 213(92.60%) cases had uneventful recovery.</p> <p><strong>Conclusion: </strong>This outbreak of HEV was of usual pattern of morbidity and mortality, and therefore points to water supply and sanitation issues.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 2-5</p> Rajat Sanker Roy Biswas Fahim Ul Hasan Aklima Sultana Md Kamal Uddin Debashis Chowdhury Serajun Noor Rosy Shaikh Md Hasan Mamun ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 2 5 10.3329/cmoshmcj.v17i2.39768 Clinico-Pathological Evaluation of Fever More Than Three Weeks : A Cross Sectional Study in A Tertiary Care Hospital <p><strong>Background: </strong>Fever is a common clinical presentation of a number of diseases. A sustained unexplained fever &gt;38.3°C lasting for &gt;3 weeks without an established diagnosis despite intensive diagnostic evaluation is referred to as Fever of Unknown Origin (FUO). Fever more than three week remains a clinical challenge for physicians, as it may be attributed to a wide range of disorders, mainly infections, malignancies, non-infectious inflammatory diseases and miscellaneous diseases. The evaluation of the condition of a patient with fever of unknown origin requires a knowledge of those disorders that produce this syndrome, an awareness of the potential significance of subtle findings in the history and physical examination, and an appreciation of the value in this clinical setting of specific diagnostic procedures. In this report, we review these aspects of fever of unknown origin and outline a diagnostic approach to the persistently febrile patient.</p> <p><strong>Objective: </strong>Purpose of this study was to clinico-pathological evaluation of fever more than three weekswith its aetiology and clinical spectrum.</p> <p><strong>Methods: </strong>This cross-sectional study was conducted amongst adult males and females patients suffering from the fever of more than three weeks over period of two years at Combined Military Hospital, Chattogram Cantonment from January, 2016 to December, 2017. Sample was selected by purposive sampling technique. Inclusion criteria were H/O fever or body temperature greater than 38.3°C on several occasions, accompanied by more than three weeks of illness and failure to reach a diagnosis after one week of inpatient investigation. Total 72 cases were enrolled according to selection criteria. Routine hematological, biochemical, imaging test were done and mid-stream urine samples were collected from these patients and subjected to culture. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously.</p> <p><strong>Results: </strong>In this study age of participants at entry was &gt;20years, mean age was 38.04±11.08. Female sex were significant number, sex ratio (F: M) was 1.25:1. Most common clinical presentations were persistent fever and generalized weakness (100.0%), followed by arthralgia/ arthritis (51.3%) anorexia (44.4%) and headache (34.7%). The focused fever of unknown origin diagnostic approach is based on hallmark clinical features characteristic of each disorder. Diagnostic significance of nonspecific clinical findings is enhanced when considered together. Of the infectious diseases that are associated with FUO, tuberculosis (Especially in extrapulmonary sites) was most common cause (eg. 13.8%) and in malignant aetilogy, lymphoma was the major cause (eg. 11.1%) of fever of unknown origin. Abdominal and or Pelvic abscesses (5.6%) Colorectal carcinoma (5.6%) Drug-induced fever (4.1%) UTI (5.6%) SLE (5.6%) Rheumatoid arthritis (9.7%) Dental abscesses (2.7%) and Osteomyelitis (4.1%) were the others common cause of fever of unknown origin.</p> <p><strong>Conclusion: </strong>Fever is a common presenting complaint in hospital admitted patients. Most febrile illnesses either resolve before a diagnosis can be made or develop distinguishing characteristics that lead to a clinical dilemma. Fever of Unknown Origin (FUO) is dynamic in its origin and will be an ongoing challenge to the clinician because of shifting disease epidemiology. In this study infection was predominant aetiology for febrile illness. Proper evaluation, rationale use of drugs and health awareness reduced the burden of Fever of unknown origin.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 6-13</p> Md Shameem Haidar ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 6 13 10.3329/cmoshmcj.v17i2.39769 Subclinical Hypothyroidism During Valproic Acid Therapy in Children with Epilepsy <p><strong>Background : </strong>Valproic Acid (VPA) is an effective anticonvulsant widely used for the treatment of epilepsy in children, but there are pitfalls in VPA therapy, especially in case of various endocrine organs like thyroid. So the aim of this study was to evaluate the thyroid dysfunction in terms of subclinical hypothyroidism during Valproic Acid (VPA) therapy in children with epilepsy.</p> <p><strong>Methods: </strong>The study was conducted in the Department of Paediatrics, and Shishu Bikas Kendra, Chittagong Medical College Hospital (CMCH) over one year duration on 50 newly diagnosed idiopathic epileptic children who were decided to start Valproate at the dose of 20mg/kg/day. At the same time similar number (n=50) of age and sex matched children visited the paediatric OPD for other health events(e.g. acute upper respiratory infection, Influenza like illness and Acute watery diarrhoea) other than epilepsy were included in the study as control group. Thyroid function status like serum levels of Thyroid-Stimulating Hormone (TSH) Free Triiodothyronine (FT<sub>3</sub>) and Free Thyroxin (FT<sub>4</sub>) were evaluated at baseline and after six months. Moreover, serum VPA level was also measured in children receiving valproate at follow up visit. Anti thyroid peroxidise antibody (Anti TPO ab) was checked at follow up visit in those having TSH level beyond normal reference range. After collecting all data it was analyzed by SPSS-19.</p> <p><strong>Results: </strong>In the current study, cases consisted of 30(60%) male and 20(40%) female children. Male to female ratio was 1.5:1. Gender and age were matched in cases and control group (p&gt;0.05). Most of the population in the cases were from rural areas 29(58%) and most of them 40(80%) belonged to middle class family. The mean±SD of TSH level significantly increased after six months in comparison with base line values (1.76±0.57μIU/ml vs. 2.70±1.50μIU/ml, p&lt;0.05) and with control group at follow up visit (1.74±0.73μIU/ml vs 2.70±1.50μIU, p&lt;0.05). On the other hand, in the control group there were no significant changes of TSH level in comparison with base line (1.82±0.55μIU vs 1.74±0.73μIU/ml, p=0.16). The mean±SD of FT<sub>4</sub> value decreased significantly in the cases after six months though remained within normal reference range (1.24±0.27ng/dl vs1.11±0.13ng/dl, p&lt;0.05) FT<sub>3</sub> level remained unchanged. Five (10%) epileptic children in the cases were found to have subclinical hypothyroidism at follow up who had TSH level beyond the normal reference range. Anti thyroid peroxidase antibody was negative among them. In contrast, no one in control group was found to have TSH level beyond the normal limit. All cases were clinically euthyroid. No significant correlations were found between TSH level and serum VPA level (r<sup>2</sup> = 0.035 p= 0.193).</p> <p><strong>Conclusion: </strong>Subclinical hypothyroidism develops in children with epilepsy during VPA therapy. Proper attention should be given so that development of overt hypothyroidism can be avoided.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 14-20</p> Dhananjoy Das Meah Monjur Ahmed Pranab Kumar Chowdhury Pradip Kumar Dutta MA Chowwdhury ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 14 20 10.3329/cmoshmcj.v17i2.39770 Pattern of Immunophenotype Among the Cases of Lymphoma Attending in A Tertiary Level Hospital <p><strong>Background : </strong>To explore the relative frequency and different forms of lymphoma in tertiary level hospital.</p> <p><strong>Methods: </strong>This descriptive observational study was carried out in the Department of Hematology at Dhaka Medical College Hospital, Dhaka. Patients attended with solid tissue lymphoma in Outpatient, Inpatient and Lymphoma Clinic services of Department of Hematology and Bone Marrow Transplant, Dhaka Medical College Hospital, Dhaka were taken as study population as per inclusion criteria. A total of 63 patients with lymphoma diagnosed by histopathologically were selected initially, among them 53 were confirmed by immunohistochemistry taken as study population finally.</p> <p><strong>Results: </strong>Mean age was 39.2 ± 15.5 years, median age was 36 years within the range of 14 – 75 years. Males were predominant. Male female ratio was 4.3:1. Most of the samples were collected from cervical lymph node (84.1%). Most of the patients came with fatigue and significant weight loss. Maximum 42 (79.24%) cases were Non-Hodgkin’s lymphoma and 11 (20.75%) cases were Hodgkin’s lymphoma. Out of 42 non-Hodgkin’s lymphoma, 27 (64.3%) were B-cell lymphoma and 15 (35.7%) were T-cell lymphoma. Among B-cell lymphoma, 19 (45.2%) were diffuse large B cell lymphoma, three (7.1%) were follicular lymphoma, three (7.1%) were mantle cell lymphoma, one (2.4%) was spleenic marginal zone lymphoma and one (2.4%) was Burkitt lymphoma. Among T-cell lymphoma, nine (21.4%) were peripheral T-cell lymphoma and six (14.3%) were adult T lymphoblastic lymphoma. Out of 11 Hodgkin’s lymphoma, 10 (90.9%) were classical Hodgkin’s lymphoma and one (9.1%) nodular lymphocyte predominant. Among classical Hodgkin’s lymphoma, five (45.5%) were mixed cellularity, three (27.3%) were lymphocyte predominant and two (18.2%) were Nodular sclerosis. Out of 42 non-Hodgkin’s lymphoma, 13 (30.95%) were indolent, 21 (50.00%) were aggressive and eight (19.05%) were very aggressive.</p> <p><strong>Conclusion: </strong>In our study, it was found that 79.3% were non-Hodgkin lymphoma of which 64.3% were B-cell lymphoma &amp; 35.7% were T-cell lymphoma and 20.7% cases were Hodgkin lymphoma of which 90.9% were classical Hodgkin’s lymphoma, 9.1% nodular lymphocyte predominant Hodgkin’s lymphoma.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 21-25</p> Shirajam Munira Salama Afroze Akhil Ranjon Biswas MA Khan ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 21 25 10.3329/cmoshmcj.v17i2.39771 Role of Intraoperative Scrape Cytology in Diagnosis of Palpable Breast Lump <p><strong>Background: </strong>Diseases of the breast constitute a significant proportion of surgical cases and frequently, the need arises to distinguish benign from malignant lesions prior to definitive treatment. So far, Frozen Section (FS) is the standard technique with high level of validity. However, intraoperative scrape cytology can be adopted when special facilities of FS are not available.</p> <p><strong>Methods: </strong>This study designed with the aim to evaluate the value of Intraoperative Scrape Cytology (IOSC) in providing rapid and accurate diagnosis for breast lump and to compare its diagnostic yield with that of paraffin sections. This cross sectional descriptive study was carried out in the Department of Pathology, Chittagong Medical College in collaboration with Department of Surgery of this institution from October 2013 to September 2014. The study conducted on 123 patients with breast lumps who underwent operative treatment. Scrapings were taken from each specimen before formalin fixation and stained by rapid Papanicolaou staining. In each case their accuracy was compared to histopathological diagnosis. Statistical analysis done employing c<sup>2</sup> test.</p> <p><strong>Results: </strong>Out of 123 cases studied, 122 could be correctly differentiated into benign and malignant tumors with an accuracy rate of 99.19%.</p> <p><strong>Conclusion: </strong>Intraoperative Scrape Cytology (IOSC) is a simple, accurate, rapid and cost-effective diagnostic tool, not requiring specific instruments in contrast to frozen section, can be used peroperatively for both diagnosis and management of breast lump.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 26-30</p> Shahe Systa Mosarrat Md Zillur Rahman M Shahab Uddin Ahamad Pradip Bhattacharjee Sayeeda Nasreen Ismail Hossain Md Didarul Alam ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 26 30 10.3329/cmoshmcj.v17i2.39773 Efficacy and Safety of Fentanyl as An Adjuvant with Bupivacaine and Lignocaine in Supraclavicular Brachial Plexus Block <p><strong>Background: </strong>Adding narcotics to local anesthetic is very effective in prolonging the analgesic effects. The aim of this study is to evaluation the efficacy and safety of fentanyl as an adjuvant with bupivacaine-lignocaine in supraclavicular block.</p> <p><strong>Methods: </strong>This analytical study was carried out in the department of anesthesiology in Chittagong Medical College Hospital in collaboration with the department of orthopedic surgery over a period of 22 months starting from January 2012 to December 2014. A total 130 adult patients of either sex with American Society of Anesthesiology (ASA) health status I-II were selected for upper limb surgery under supraclavicular brachial plexus block was randomly allocated in to two groups of 65 patients in each. Group- C was received Distilled water 2ml and Group-F was received fentanyl 2ml (100 g) in 38ml of bupivacaine and lignocaine with adrenaline (Total volume of 40ml).</p> <p><strong>Results: </strong>The mean onset of sensory &amp; motor block was 10.49±0.75 min &amp; 9.41±0.76 min in group-C and 7.60±3.711min &amp; 9.23±5.114min in group-F. The duration of analgesia in group-C was 3.81±0.88 hrs and in group-F was 8.62±1.747 hrs.</p> <p><strong>Conclusion: </strong>There was significantly prolonged duration of analgesia and better onset of sensory and motor block in fentanyl group without any unwanted effects.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 31-35</p> Sanjida Hasan Ahmed Abu Nasar Chowdhury Syeda Nafisa Khatoon Md Harun OR Rashid Md Rezaul Hoque Tipu KM Baki Billah Kalyan Barua AKM Shamsul Alam ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 31 35 10.3329/cmoshmcj.v17i2.39774 Antibiotics Prescribing Pattern at Outpatient Department of A Tertiary Medical College Hospital <p><strong>Background: </strong>In order to improve the prescription quality and promoting rational prescription pattern, there is an obligatory need to investigate the factors that affect doctors' prescription patterns. The study was conducted to observe the antibiotics prescribing pattern at outpatient department of a tertiary medical college hospital.</p> <p><strong>Methods: </strong>This was a descriptive cross sectional study in a tertiary medical college hospital during the period of January 2018 to June 2018 which was conducted on 300 prescriptions collected from different outpatient department.</p> <p><strong>Results: </strong>Average number of drugs prescribed per encounter was 3.70 (Optimal value 1.6–1.8). Antibiotics (Oral, injectable and topical) were prescribed 46% (Optimal value 20.0–26.8%) and antibiotic as only injected form 19.71% (Optimal value 13.4–24.1% of total injectable drug). Drugs prescribed from the Essential Drugs List( EDL) equated to 52.90% (Optimal value 100%). The antibiotics given in most of the patients ( 91%) were without doing culture sensitivity test before prescribing. Out of 46% prescriptions with antibiotics, 79.9% had one antibiotic, 19.6% included two antibiotics and 0.7% had three antibiotics. Cefuroxime was the most commonly prescribed antibiotics (22.5%) followed by Azythromycin (11.6%) Cefixime (11.5%) Ciprofloxacin (10.9%) Flucloxacillin (10.9%) and Metronidazole (8.7%).</p> <p><strong>Conclusion: </strong>This study revealed that percentage of antibiotic was high and most of the antibiotic was given without culture and sensitivity.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 36-39</p> Maliha Ata Rozina Hoque Rajat Shankar Roy Biswas Asma Mostafa Faheem Ul Hasan Happy Rani Barua ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 36 39 10.3329/cmoshmcj.v17i2.39775 Knowledge and Practice of Contraceptive Among Lactating Mothers Attending at Radda Maternal and Child Health and Family Planning Centre at Mirpur, Dhaka <p><strong>Background: </strong>As a natural child-spacing method breast feeding is very effective during the early post partum period. In Bangladesh it is believed that conception occurs very rarely during post partum and lactation period. Mothers nurse their children for long period, believing this is an easy, practical and natural method to delay or prevent a subsequent pregnancy. Since child-spacing effect of breast feeding gradually diminishes over time depending on personal and social circumstances breast feeding women during lactation need contraceptive methods which must be effective and safe and must not affect lactation.</p> <p><strong>Methods: </strong>A descriptive type of cross sectional study was carried out, from July 2012 to December 2012, among 110 lactating mothers at RADDA Maternal and Child Health (MCH) and Family planning Centre, Mirpur, Dhaka with the objective of assessing their knowledge and practice on contraceptive methods.</p> <p><strong>Results: </strong>Out of 110 respondents, 92 respondents having 1-2 children (83.64%) 79.35% were practicing contraception and 20.5% were not practicing any method and rest of 18 respondents having &gt;2 children (16.36%), 77.78% were practicing contraception and 22.22% were not practicing contraception. Of the 91 respondents having children 1-2, 75.4% had average and above average knowledge and the rest 8.1% had below average knowledge on contraceptive methods. Of the 19 respondents having &gt;2 children, 16.3% had average and above average knowledge and the rest (0.2%) had below average knowledge on contraceptive methods. The difference between the two groups in respect of practice and knowledge of contraception were found statistically insignificant.</p> <p><strong>Conclusion: </strong>The study shows significant relation between the knowledge and practice of contraceptive with number of the children. There is significant difference between the knowledge among primary and secondary educated mothers and the practice of contraception varied with their education levels. All the respondents had knowledge about contraceptive methods but 20.9% were not practicing any methods due to various reasons.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 40-46</p> Mohammad Taslim Uddin Shaibal Barua ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 40 46 10.3329/cmoshmcj.v17i2.39776 Age, Sex and Seasonal Variations of Dermatosis Attending in Dermatology Department of A Tertiary Care Hospital <p><strong>Background: </strong>Dermatological problems are common among patients of different ages visiting the out patient departments of tertiary care centers. So the objective of the study to see the spectrum of pediatric and adult dermatoses in out patient skin department of Chattagram Maa hishu O General Hospital.</p> <p><strong>Methods: </strong>The medical records of children and adult attending the dermatology outpatient clinics of Chattagram Maa-O-Shishu Hospital for the year September 2015 to September 2016 were retrieved. Data of 8534 patients were included. Demographic data (Age and sex) and diagnoses were collected and analyzed.</p> <p><strong>Results: </strong>Among 8534 patients attended in OPD, majority of the patients were female and children (2500, 56% &amp;, 3622, 42%). Infection constituted most of the dermatosis (31%) of which scabies was found most common (46%), eczema comes after (20%) and contact dermatitis prevailed (18%). Regarding seasonal variations majority of the patient peaked in summer 855 (10%). Among all 14 patients of epidermolysis bullosa were found. Leprosy and skin tuberculosis were found. Rare diseases including epidermal nevus syndrome 1case, tuboeruptive xanthoma in children, 2 cases, subcutaneous fat necrosis in neonate -2 cases, atypical presentation of erythema multiforme were found.</p> <p><strong>Conclusion: </strong>Many children and almost all adult presents with uncommon presentation of common disease due to frequently visiting non professional and traditional medicine practitioners and homeopathic and traditional medicine.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 47-49</p> Shamsun Nahar Binte Mannan Md Zahangir Alam Rajat Sanker Roy Biswas ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 47 49 10.3329/cmoshmcj.v17i2.39777 Socio-demographic Study for Prevalence of b-Thalassaemia and Haemoglobinopathies in Chattagram Maa Shishu-O-General Hospital <p><strong>Background: </strong>Hemoglobin E beta thalassaemia is common hemolytic anemia in South-East Asia. Though Bangladesh is situated in a Thalassaemia prone region but there is no published data regarding spectrum of disease pattern of Hemoglobinopathies. This study done to see the prevalence of b Thalassaemia and other haemoglobinopathies in patient attended the Chattagram Maa-Shishu O General Hospital.</p> <p><strong>Methods: </strong>This is a retrospective descriptive study that was carried out in Chattagram Maa Shishu-O-General Hospital. Patient with Thalassaemia and other Hemoglobinopathies (n=290) of different ages attended the Thalassaemia ward during the period from 2011 July to 2013 June were enrolled as study subject. Detailed history and hemoglobin electrophoresis result were obtained from patient register book. Analysis was done with the help of Statistical Package for Social Science (SPSS Version 12.0) software package.</p> <p><strong>Results: </strong>It was observed that the onset of Haemoglobinopathies was significantly high from infant to childhood period (1-10 yr) with a percentage of 53% (p&lt;0.05). Male and female difference was found statistically insignificant (p&gt;0.05). The prevalence of HBE b Thalassaemia patients was found highest in percentage (40.34%).</p> <p><strong>Conclusion: </strong>Hb E b-Thalassaemia was the most common variety among all types of Hemoglobinopathies.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 50-52</p> Razia Sultana Anjir Anwar Jahangir Alam Mahmood A Chowdhury ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 50 52 10.3329/cmoshmcj.v17i2.39778 Uterine Didelphys with Pregnancy Outcomes: A Case Report <p>A didelphys uterus also known as a “double uterus” is one of the least common Mullerian duct anomalies. Uterine didelphys is a congenital malformation that result from complete failure of fusion of the ipsilateral Mullerian duct during embryonic development. Ideally, diagnosis should be made before pregnancy and labour to prevent adverse outcomes. Here reporting a case who was a 19 years old, 4thgravida, Para: 0+3 (Spontaneous abortion) referred to Bangabandhu Memorial Hospital (BBMH) USTC, Chittagong at 35 weeks of pregnancy with severe abdominal pain by local physician from Raozan, Chittagong. On vaginal examination a longitudinal vaginal septum and two vagina were found. Uterine Didelphys was confirmed during emergency caesarean section and delivered 1.5 kg male baby with APGAR score 7/10 and was referred to Neonatal Intensive Care Unit (NICU). Post operative recovery of the mother was uneventful. The baby was also discharged at the age of seven days with establishment of breast feeding. To avoid delayed diagnosis and associated adverse outcome clinicians should have high index of suspicion of uterine anomaly when assessing cases of dysfunctional labour.</p> <p>Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 53-55</p> Shahanaj Sharmin Didarul Alam Farzana Rahman ##submission.copyrightStatement## 2019-01-14 2019-01-14 17 2 53 55 10.3329/cmoshmcj.v17i2.39779