Faridpur Medical College Journal https://www.banglajol.info/index.php/FMCJ Official journal of Faridpur Medical College Teachers Association. Full text articles available.<br /> Faridpur Medical College Teachers Association en-US Faridpur Medical College Journal 2079-3553 Dengue Fever- New Threats from Old Enemy https://www.banglajol.info/index.php/FMCJ/article/view/48998 <p>Abstract Not Available</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 1-2</p> Faruk Ahammad ##submission.copyrightStatement## 2020-09-09 2020-09-09 15 1 1 2 10.3329/fmcj.v15i1.48998 Ligation of the Intersphincteric Fistula Tract (LIFT) Technique in the Treatment of Complex Perianal Fistula: Experience of First 50 Cases https://www.banglajol.info/index.php/FMCJ/article/view/48999 <p>Perianal fistula is a common disease and surgery is the only treatment option. Many surgical techniques have been described. Ligation of intersphincteric fistula tract (LIFT) is a sphincter saving surgical technique in which fistula tract is ligated and excised through intersphincteric approach. The aim of study is to present our experience of first 50 LIFT procedures particularly healing rate, recurrence rate and complications from the procedure. This is a prospective observational study started from March 2018 on whom underwent LIFT procedure for primary complex perianal fistula of infective origin at Faridpur Central Hospital and Faridpur Medical College Hospital. In this study, 50 patients (42 male and 8 female) of average age of 39±7.6 years with complex fistula were included. The mean operative time was 34.7±5.67 minutes and most of the fistulas were transsphincteric variety (90%). Median wound healing time was 21.45±6.34 days for intersphincteric wound and 26.78±6.93 days for the external opening of the fistula. Mean follow up period was 10.5 months. Seven patients of our series developed recurrent fistula, making the overall success of 86%. None of the patient in our series developed incontinence. LIFT procedure has the advantage of preservation of anal sphincter, minimal tissue injury, shorter healing time, relatively easy to perform, and high success rate. It's a good choice for treatment of complex perianal fistula.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 3-7</p> Swapan Kumar Biswas ASM Tanjilur Rahman Muhammad Mofazzal Hossain Saiful Islam Khan ##submission.copyrightStatement## 2020-09-09 2020-09-09 15 1 3 7 10.3329/fmcj.v15i1.48999 Sociodemographic Status and Pattern of Poisoning in a Tertiary Level Hospital https://www.banglajol.info/index.php/FMCJ/article/view/49000 <p>Poisoning is responsible for a large number of hospital admissions in Bangladesh. Sociodemographic status and pattern of poisoning are changing day by day. That's why poisoning related mortality and morbidity are varying. This study was carried out in the Medicine department of Faridpur Medical College Hospital (FMCH) from January to June 2017, to observe the sociodemographic status, such as age, sex, residence, occupation, level of education of patient, mode and pattern of poisoning. Cases were selected randomly in ward and data were collected in a data sheet with consent. Sample size was 100 and age range was from 15 to 65 years. Among them female were 60(60%). Maximum number (64%) of cases was on age range from 15 to 25 years that comprises 41% female and 23% male. Subsequently second highest number (20%) was on range from 26-35 years. Most of the female (60%) were housewives and maximum (40%) of male were student. Highest number (60%) of patients studied academically below SSC. Regarding mode of poisoning suicidal attempted was highest (85%) and among them about 68% were female. Organophosphorus compound (OPC) was most common (52%) poisoning agent and most of them (67%) were female. Street poisoning was observed in 11(11%) cases and all were male. Subsequently sedative and harpic poisoning occurred in same number (10 in each) of cases. History of gul poisoning was found in 8% cases and most of them were female. Besides them paracetamol, savlon and others poisoning were documented in 4%, 2% and 3% respectively.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 8-11</p> Md Anisur Rahman Howlader Suranjit Kumar Saha Md Towhid Alam MM Shahin Ul Islam Md Abdullah Al Kafee Mohammad Iqbal Hossain Ahmed Manadir Hossain Mohammad Abu Bakar Siddque ##submission.copyrightStatement## 2020-09-09 2020-09-09 15 1 8 11 10.3329/fmcj.v15i1.49000 Incidence and Risk Factors of Neonatal Hypoglycemia During the First 48 Hours of Life in a Tertiary Level Hospital https://www.banglajol.info/index.php/FMCJ/article/view/49001 <p>Neonatal hypoglycemia is one of the common metabolic problems causing neonatal mortality and neurodevelopmental impairments. In developing countries, where the classic risk factors for neonatal hypoglycemia prevail; understanding the prevalence and association of hypoglycemia in different settings is essential. Our aim of this study was to identify the incidence and associated risk factors that predicted the occurrence of neonatal hypoglycemia during the first 48 hours of life. This hospital-based prospective case-control study was undertaken in the Department of Pediatrics in Faridpur Medical College Hospital, Bangladesh; from June 1, 2019 to July 31, 2019. Blood glucose levels of all the admitted newborns were noted on two occasions at 24 hours apart. Hypoglycemic neonates were selected as case and 3 euglycemic neonates for each case with similar age and sex were selected as control. Clinical characteristics of the mother and the baby were analyzed statistically in relation to the occurrence of hypoglycemia. We have found the incidence of neonatal hypoglycemia was 17.2%. Prematurity, low birth weight, small and large for gestational age, perinatal asphyxia, hypothermia, and delay in the initiation of breast feeding were significant neonatal factors. Maternal factors such as gestational diabetes mellitus, eclampsia, and fever during delivery had strong association as well. Understanding the incidence and risk factors may help prompt identification of hypoglycemic baby may also help to take early and effective measures to prevent the sequels of neonatal hypoglycemia.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 12-15</p> Md Kamrul Hassan Abu Faisal Md Pervez Rajib Biswas Shuvo Debnath Khalid Ahmed Syfullah ##submission.copyrightStatement## 2020-09-09 2020-09-09 15 1 12 15 10.3329/fmcj.v15i1.49001 Comparative Study on Fetomaternal Outcome after Lower Uterine Segment Caesarean Section and Vaginal Delivery in Eclamptic Patient https://www.banglajol.info/index.php/FMCJ/article/view/49002 <p>Eclampsia has a high prevalence in our country with a high mortality rate. Eclampsia is uniquely a disease of pregnancy and regardless of gestational age. It is recognized that termination of pregnancy is the only definitive care of pathophysiological event in eclampsia. This study was done to observe fetomaternal outcome in Lower Uterine Segment Caesarean Section (LUCS) and vaginal delivery in eclamptic patient. This cross sectional analytical study was carried out in eclampsia department of Obst and Gyane in Dhaka Medical College Hospital from July 2016 to June 2018. A uniform protocol was followed in all cases to have appropriate history, physical findings and laboratory investigations. In this study 98.0% patients were conscious on admission in group I and 96.0% in group II. This study showed significant difference in recurrence of convulsion after delivery between two groups. Recurrence of convulsion was 30% in vaginal delivery group and 6% in the cesarean section group. Total complications were found in 46.0% and 16.0% patients in group I and group II respectively in this study. The difference was statistically significant (p&lt;0.05) between two groups. In this study PPH was the most common complication in both the groups. Abruptio placenta was found more common among the vaginal delivery group. On the other hand, electrolyte imbalance was found more in cesarean section group. Maternal death was only 2% and 1% in group I and group II respectively. In this study live birth was found 64.0% and 79% in group I and group II respectively. Asphyxia was more in neonates in group I than group II which was statistically significant. Referral of asphyxiated babies to NICU was found 63.0% and 56.0% in group I and II respectively. The difference was statistically not significant between two groups.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 16-20</p> Monika Khandoker Swapna Biswas Joy Sanjoy Kumar Das Ananta Kumar Biswas ##submission.copyrightStatement## 2020-09-09 2020-09-09 15 1 16 20 10.3329/fmcj.v15i1.49002 Prevalence of Coronary Artery Atherosclerosis in Different Age Groups: A Post-Mortem Study https://www.banglajol.info/index.php/FMCJ/article/view/49005 <p>Coronary artery atherosclerosis (CAA) leads to ischemic heart disease and that is the most common cause of cardiac deaths worldwide. The incidence is more among the elderly people, but now gradually increasing among the young. The study was done to evaluate the prevalence of CAA in different age group by post-mortem study. An observational study was conducted in the department of Pathology of Faridpur Medical College (FMC). In this study total 53 postmortem histopathological examination of heart were done and analyzed, of them 37 were male and 16 were female. Among all, CAA was found in 8 cases and all were male. Regarding age, 4(50%) cases were in the age group from 41 to 50 years, 3 cases were in age of above 60 years and one case was in the age group from 51 to 60 years. Left CAA was observed in 6(75%) cases, both right and left CAA was found in remaining 2(25%) cases but none was found to involve only right coronary artery. Lowest age of involvement of CAA was 42 years that involved left coronary artery. This study shows that the prevalence of CAA is increasing among the younger age group.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 21-23</p> Nasir Uddin Ahmed Suranjit Kumar Saha Kamal Uddin Ahmed Gias Uddin Ahmed Syed Golam Kibria ##submission.copyrightStatement## 2020-09-10 2020-09-10 15 1 21 23 10.3329/fmcj.v15i1.49005 Pattern of Serum Electrolytes Imbalance among Patients with Acute Exacerbation of COPD Admitted in a Tertiary Level Hospital https://www.banglajol.info/index.php/FMCJ/article/view/49006 <p>Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease and there is not yet a cure. Not only in Bangladesh but also worldwide the incidence of COPD is increasing. The disease is associated with some metabolic derangement such as electrolytes imbalance. Those factors further worsen the disease course. As a result COPD related morbidity, mortality and cost to health systems are also increasing. This cross-sectional observational study was conducted in Faridpur Medical College Hospital (FMCH) over 6 months among 100 patients who were admitted with acute exacerbation of COPD. The mean age was (58.13 ± 9.96) years. In this study serum electrolytes were found below the normal range in 68 (68%) cases and within normal range in 32(32%) cases. Isolated hyponatremia was observed in 36(53%) and 15(22%) had isolated hypokalaemia. Both hyponatremia and hypokalaemia was found in 17(25%) cases. The mean serum sodium level was (133.82±2.52) mmol/l. Among patients with isolated hyponatremia, 24(67%) had mild hyponatremia and 12(33%) got moderate hyponatremia. Again the mean serum potassium was (3.45±0.23) mmol/l. Among patients with isolated hypokalaemia, 10(67%) had mild hypokalaemia and 5(33%) had moderate hypokalaemia. Both hyponatremia and hypokalaemia was observed in one fourth of total electrolytes depleted cases and all were within the mild range. No patient had severe hyponatremia or hypokalaemia.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 24-27</p> Suranjit Kumar Saha Md Yusuf Ali MM Shahin Ul Islm Khan Mohammad Arif Mohammad Anisur Rahman Hawlader Mohammad Rezaul Quader Prativa Saha ##submission.copyrightStatement## 2020-09-10 2020-09-10 15 1 24 27 10.3329/fmcj.v15i1.49006 Antimicrobial Resistance Situation in SCANU of Faridpur Medical College Hospital, a Tertiary Level Hospital in Bangladesh https://www.banglajol.info/index.php/FMCJ/article/view/49007 <p>Considering the high risk of neonatal sepsis in low and middle-income countries, empirical antibiotic therapy is commonly employed in most cases to clinically suspected septic neonates without the aid of culture and antibiotic sensitivity report. Increasing antimicrobial resistance is posing a threat to these practices and urges the obligation for understanding the causative organisms and their changing resistance pattern at the local level. Aim of this study was to identify the pathogens responsible for neonatal sepsis and understand their current antimicrobial resistance pattern. This prospective study was undertaken in the Special Care Newborn Unit of the Faridpur Medical College Hospital from October 2017 to November 2018. Venous blood culture and antimicrobial susceptibility of 56 suspected neonatal sepsis cases were studied. Among the 56 clinically suspected cases 86% had culture positive isolates in the specimen. Predominant isolates were Klebsiella (42%) and coagulase-negative staphylococci (25%). Of all the identified bacteria, 88% were resistant to &gt;_ 3 classes of antibiotics. Eighty-five percent of Klebsiella isolates were found to be carbapenem-resistant along with 100% of E. coli isolates and 95% of Klebsiella isolates had possible extended spectrum b -lactamase production. Seventy-five percent of Acinetobacter isolates were multidrug-resistant and 100% of coagulase-negative staphylococci were methicillin resistant. The array of causative organisms and their increasing resistance to commonly practiced antibiotics are alarming. It is urgent to develop strategies focusing on all healthcare levels to cease the spread of antimicrobial resistance in an effort to reduce the burden of neonatal sepsis.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 28-33</p> Abu Faisal Md Pervez Kyu Han Lee Farzana Islam Md Kamrul Hassan Rajib Biswas ##submission.copyrightStatement## 2020-09-10 2020-09-10 15 1 28 33 10.3329/fmcj.v15i1.49007 Breast Conserving Surgery-What, When and for Whom? https://www.banglajol.info/index.php/FMCJ/article/view/49008 <p>Breast conservation surgery and radiation therapy to the breast has revolutionized the treatment of breast cancer over the last few decades. Surgical direction had seen a heightened interest in the performance of cosmetically superior partial and segmental resections in breast conservation as well as increased demand by patients for breast preservation. The broadening of approaches to delivery of breast irradiation from whole breast to accelerated partial breast has allowed more patients to opt for breast conservation and allowed for what appears to be comparable measurable outcomes in emerging data. As well, the addition of state-of-the-art chemotherapeutic and hormonal therapies has allowed improved outcomes of patients from both local regional recurrence and overall survival standpoints. This paper will provide an overview of BCS including patients selection, prerequisit, indications, contraindications, procedures, complications and follow up.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 34-37</p> Mohd Mejbahul Bahar Mosammat Mira Pervin Swapan Kumar Biswas ##submission.copyrightStatement## 2020-09-10 2020-09-10 15 1 34 37 10.3329/fmcj.v15i1.49008 Understanding Obsessive Compulsive Disorder and Management Options https://www.banglajol.info/index.php/FMCJ/article/view/49009 <p>Obsessive compulsive disorder is a common mental health problem. It is characterized by obsession and compulsion. Obsession can be defined as unwanted, intrusive, recurrent and persistent thoughts, images or impulses which are not voluntarily produced, but are experienced as events that invade a person's consciousness. Compulsion can be defined as repetitive and seemingly purposeful behavior that is performed according to certain rules or in a stereotyped fashion and is not an end in itself but is usually intended to prevent some event or situation. The obsessions or compulsions interfere significantly with the person's normal routine, occupational functioning, usual social activities, or relationships. Obsessive-compulsive disorder and several related disorders are now put together into separate chapter in Diagnostic and Statistical Manual of Mental Disorders, 5<sup>th</sup> Edition (DSM-5). Literature search was performed with the key words "Obsessive Compulsive Disorder", "Obsession", "Compulsion", "Treatment of Obsessive-Compulsive Disorder". Representative and leading researches from last 25 years were included in the study. Modern concepts of OCD began to evolve in the nineteenth century. Obsessions, in which insight was preserved, were gradually distinguished from delusions, in which it was not. The core features of OCD are remarkably similar from one country to the next, but its manifestations may differ for reasons of culture and experience. OCD is typically a chronic disorder with a waxing and waning course. In classical psychoanalytic theory, OCD was considered a regression from the Oedepal phase to the anal psycho-sexual phase of development. Functional brain imaging studies have produced a model for pathophysiology of OCD which involves hyperactivity in certain subcortical and cortical regions. The idea that abnormality in serotonergic neurotransmission underlies OCD arose from the observation that clomipramine, which inhibits serotonin and norepinephrine reuptake, relieved symptoms, whereas noradrenergic reuptake inhibitors did not. During the last 40 years there has been considerable progress in the pharmacological management of OCD. Behavioral therapy is also considered as an effective way of controlling OCD. Cognitive Behavioral Therapy (CBT) is a well-documented intervention for children, adolescents, and adults with OCD. Other biological approaches for obsessive-compulsive disorder include neurosurgery, deepbrain stimulation, electroconvulsive therapy, and repetitive transcranial magnetic stimulation. The neurosurgical techniques of cingulotomy and capsulotomy may provide clinical improvement among some patients with treatmentrefractory obsessive-compulsive disorder. Overall, stereotactic surgery should be viewed as a last option in treating refractory obsessive-compulsive disorder.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 38-42</p> Noor Ahmed Giasuddin Md Jahangir Hossain ##submission.copyrightStatement## 2020-09-10 2020-09-10 15 1 38 42 10.3329/fmcj.v15i1.49009 Crigler Najjar Syndrome Type 2: a Case of Unexplained Jaundice in an Adult https://www.banglajol.info/index.php/FMCJ/article/view/49011 <p>Crigler-Najjar Syndrome (CNS) type 2 is a rare genetic disorder which is characterized by non-hemolytic unconjugated hyperbilirubinaemia. It is caused by defect in bilirubin conjugation due to complete or partial deficiency of uridine 5'-diphosphate-glucuronosyltransferase (UGT). Affected individuals are usually asymptomatic apart from the jaundice and investigations reveal isolated indirect hyperbilirubinemia. Genetic testing of the UGT1A1 gene for mutations is the definitive diagnostic tool which is not available everywhere. It can be alternatively diagnosed by evaluating the response to phenobarbitone in terms of fall in bilirubin level. Here, we report one such rare case.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 43-45</p> Mohammad Ashiqur Rahman MM Shahin Ul Islam Nazifa Tasnim ##submission.copyrightStatement## 2020-09-10 2020-09-10 15 1 43 45 10.3329/fmcj.v15i1.49011 A Patient with Chronic Lumbar Pain Diagnosed as Giant Calcified Splenic Hydatid Cyst https://www.banglajol.info/index.php/FMCJ/article/view/49012 <p>Hydatid cyst is a zoonotic disease, caused by Echinococcus Granulosus, mostly found in sheep rearing area of the world but not commonly found in our country. Hydatid disease commonly affects the liver and less frequently the lungs and other organs. Among them splenic hydatid disease has been reported to be 0.5-4%. Here we report a case of a giant calcified splenic hydatid cyst presented with only chronic lumbar pain. A 45 year old female presented with left lumbar pain for the last 1 year. She had no other complaint. She had no pet dog or sheep at home. Physical examination showed no abnormality. A computerized scan revealed a mass in the spleen with round calcification at its margin measuring 7.56×7.96 cm in diameters. Indirect haemagglutination (IHA) for hydatid disease test was negative. Complete blood count, renal and liver function tests were within the normal limit. The patient was clinically diagnosed as splenic hydatid disease and managed by splenectomy after proper immunization. There was a hard calcified mass involving almost whole of the spleen, only thin rim of splenic tissue was present in superior surface. The rest of the abdominal organs including the liver were normal. Total splenectomy was done. Post operative period was uneventful and the patient was discharged on 12<sup>th</sup> post operative day. Histopathology confirmed the diagnosis of hydatid disease. The patient was followed up for two years without any further development of hydatosis in any organ.</p> <p>Faridpur Med. Coll. J. Jan 2020;15(1): 46-49</p> AKM Shafiul Alam Muhammad Mofazzal Hossain Swapan Kumar Biswas ##submission.copyrightStatement## 2020-09-10 2020-09-10 15 1 46 49 10.3329/fmcj.v15i1.49012