Journal of Enam Medical College <p>Official organ of the Enam Medical College, Savar, Dhaka, Bangladesh. A peer-reviewed journal published three times a year in January, May and September. Full text articles available.</p> <p>Journal of Enam Medical College is included in <a title="DOAJ" href="" target="_blank" rel="noopener">DOAJ</a>.</p> en-US <ul><li>Copyright on any research article is transferred in full to Journal of Enam Medical College upon publication in the journal. The copyright transfer includes the right to reproduce and distribute the article in any form of reproduction (printing, electronic media or any other form).</li><li>Articles in the Journal of Enam Medical College are Open Access articles published under the Creative Commons CC BY License (<a href=""></a>)</li><li>This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.</li></ul> (Prof Md. Aminul Haque Khan) (Md Fahmid Uddin Khondoker) Sun, 23 Feb 2020 07:21:11 +0000 OJS 60 From the Desk of Editor-in-Chief Vol 10(1) <p>Abstract not available</p> <p>J Enam Med Col 2020; 10(1): 3</p> Md Aminul Haque Khan ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Deprescription—Remove the Barriers <p>Abstract not available</p> <p>J Enam Med Col 2020; 10(1): 4-5</p> Rukhsana Parvin ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Uses of Proton Pump Inhibitors and Their Prescribing Pattern among the Patients Attending the Out-Patient Department at a Tertiary Care Hospital in Bangladesh <p><strong>Background</strong>: Proton pump inhibitors (PPIs) are one of the most frequently prescribed classes of drugs in the world in the treatment of peptic ulcer, dyspepsia and gastro-oesophageal reflux.</p> <p><strong>Objectives: </strong>To determine demographic, clinical response and practice characteristics of PPIs among the patients attending the out-patient department of a tertiary care hospital.</p> <p><strong>Materials and Methods</strong>: In this prospective observational study 100 patients attending the out-patient department and taking oral proton pump inhibitors (PPI) for different symptoms and duration were included. Patient’s socio-demographic characteristics, PPI-related information (duration, frequency of use, doses and classes of PPIs) and symptomatic responses after taking PPI were noted. Drugs or diseases that influenced the intake of PPI were also recorded. Investigations done before or during PPI use and their findings were also noted.</p> <p><strong>Results</strong>: Omeprazole (43%) and esomeprazole (35%) were the most frequently prescribed PPIs. Most of the patients (52%) were on PPI therapy for 1−3 months. Majority of the patients (72%) had taken PPIs on daily basis and 19% patients had taken irregularly or occasionally. Dosing frequency of PPIs prescribed were twice daily in most of the patients (77%). Sixty seven percent (67%) patients had taken PPI prescribed by doctors and 33% patients had taken PPI prescribed by non-doctors. Common indications for prescribing PPIs were heart burn (54%), upper abdominal pain/discomfort (38%) and bloating (33%). Symptoms reappeared after stopping the PPI in most of the patients (40%) and 35% patients had satisfactory relief of symptoms with PPI.</p> <p><strong>Conclusions</strong>: Omeprazole and esomeprazole are the most frequently prescribed PPIs. Majority of the patients had taken PPIs on daily basis. In around one-third of the patients PPIs were prescribed by non-doctors. Common indications for prescribing PPIs were heart burn, upper abdominal pain/discomfort and bloating. Symptomatic responses varied after taking PPI and symptoms reappeared after stopping the PPI in most of the patients.</p> <p>J Enam Med Col 2020; 10(1): 10-16</p> Mohammad Quamrul Hasan, Nelson Taposh Mondal, Rukhsana Parvin, Irin Perveen ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Comparison of Laparoscopic VS Open Inguinal Hernioplasty in a Tertiary Care Hospital <p><strong>Background</strong>: Inguinal hernia repair is one of the most common surgical procedures in Bangladesh. The option of surgical treatment remains controversial. Laparoscopic hernia repair has all the benefits of a tension free repair. We aimed to compare postoperative outcome and cost between laparoscopic and open inguinal hernia repair.</p> <p><strong>Objective</strong>: This study was conducted with an objective to compare the effectiveness of each procedure and complications if any.</p> <p><strong>Materials and Methods</strong>: Fifty cases of inguinal hernia admitted in the tertiary care center were selected by nonprobability (purposive) sampling method. All patients with uncomplicated hernia treated by open or laparoscopic method were included. The age/sex, incidence, mode of presentation, surgical treatment and postoperative complications were evaluated and compared with standard published literature.</p> <p><strong>Results</strong>: Postoperative wound infection developed in three cases of open hernioplasty and one case in laparoscopic surgery. Hematoma and seroma at the operated site were found in one case of laparoscopic hernioplasty and in two cases of open hernioplasty. Orchitis was more prevalent in the laparoscopic hernioplasty patient with incidence among two cases as compared to one in open group. The mean duration of hospitalization was 59.62±6.11 hours in case of laparoscopic hernioplasty while 53.33±8.26 hours in open hernioplasty. The mean duration of procedure was 72.33 minutes in laparoscopic group while 64.62 minutes in open surgery. The mean cost for the laparoscopic repair group was around taka 63000/= whereas in the open group it was around 42000/= only with significant difference. Prolonged groin pain was seen in four cases in open group as compared to one in laparoscopically operated cases.</p> <p><strong>Conclusion</strong>: There were less post-operative complications in the laparoscopic group.</p> <p>J Enam Med Col 2020; 10(1): 17-22</p> Md Mahfuzul Momen, Ashok Kumar Sarker, Deb Prosad Paul, Debasis Das, Sonia Akhter, Tarafder Habibullah ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Prescribing Pattern of Antimicrobials in Urinary Tract Infection at Outpatient Department in a Tertiary Care Hospital in Dhaka <p><strong>Background</strong>: Urinary tract infection (UTI) is the most common illness affecting both males and females in almost all age groups. Hence, continuous analysis of prescribing pattern in UTI is vital. <strong>Objective</strong>: The study was designed to determine the prescribing pattern of antibiotics in UTI patients at a tertiary care hospital.</p> <p><strong>Materials and Methods</strong>: A prospective observational study was carried out on 180 patients in Dhaka National Medical College Hospital from January to March 2012 by collecting data from outpatient department of Surgery, Medicine and Gynaecology &amp; Obstetrics.</p> <p><strong>Results</strong>: Analysis of prescribed drugs revealed that use of antibiotics such as nitrofurantoin (30.55%), cefuroxime (22.22%) and ciprofloxacin (16.66%) were significantly higher compared to other drugs. The most common isolated organisms were Escherichia coli (60%), Proteus (20%), Klebsiella (13.33%), and Pseudomonas (6.66%).</p> <p><strong>Conclusion</strong>: Present findings are suggestive of the need for periodic monitoring of antibiotic sensitivity pattern to provide effective treatment.</p> <p>J Enam Med Col 2020; 10(1): 23-26</p> Shima Akter Khatun, Shusmita Shaha ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Study of Association of Serum Lipid Levels with Migraine <p><strong>Background</strong>: Migraine is associated with increased prevalence of cardiovascular risk factors and vascular biomarkers and migraine with aura is associated with increased risk of ischemic stroke. Lipid abnormality is a risk factor for both cardiovascular and cerebrovascular disease. The vast majority of previous studies evaluated the association between lipid levels and migraine among young and middle aged persons abroad. So far we know, no study has been conducted in Bangladesh regarding association of lipid levels with migraine.</p> <p><strong>Objectives</strong>: The present study is aimed to evaluate the association between serum lipid levels in patients with migraine.</p> <p><strong>Materials and Methods</strong>: This observational, cross-sectional study was carried out on 100 patients in outpatient departments of Enam Medical College and Hospital, Dhaka and Mymensingh Medical College Hospital, Mymensingh over a period of one year (December 2017 to November 2018). Patients were selected by purposive sampling. Fifty migraine and 50 non-migraine patients were recruited in the study.</p> <p><strong>Results</strong>: The serum total cholesterol and LDL-C were significantly higher in migraine than in non-migraine group. HDL-C was below normal and triglyceride was within normal range in both groups. Serum total cholesterol and LDL-C were significantly higher in migraine with aura than migraine without aura. HDL-C level was lower in migraine without aura and was of normal level in migraine with aura, which was statistically significant.</p> <p><strong>Conclusion</strong>: Elevated levels of serum total cholesterol and LDL cholesterol were associated with migraine than non-migraine group. Serum total cholesterol and LDL cholesterol were significantly higher in late age of migraine group and migraine with aura.</p> <p>J Enam Med Col 2020; 10(1): 27-32</p> Mohammed Momenuzzaman Khan, Shajal Kumar Shil, Solaiman Hossain, Goutam Saha, Uttam Kumar, ABM Khairul Hasan ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Prediction of Preeclampsia in Pregnant Population Using Diastolic Notch of Uterine Artery by Duplex Color Doppler Study <p><strong>Background</strong>: Use of Duplex Color Doppler Sonography is gaining increasing popularity for assessment of blood vessels in various disease processes around the world. The past 20 years have seen an enormous growth in both technical aspects of Doppler ultrasound and its application in obstetric and fetal medicine.</p> <p><strong>Objective</strong>: This cross-sectional study was carried out to observe Doppler wave form in subjects with preeclampsia. Specific objective was to see RI and PI in different groups of study subjects from 24th to 37th weeks and find out significant difference of different Doppler indices between two groups (i.e., to calculate the proportion of subjects having early diastolic notch in two groups).</p> <p><strong>Materials and Methods</strong>: Enrolling 40 subjects with preeclampsia, this study was done in the Department of Radiology &amp; Imaging, Dhaka Medical College Hospital, Dhaka, over a period of six months from 20th June 2014 to 19th December 2014. A total number of 40 normal pregnancies were also included for comparison.</p> <p><strong>Results</strong>: Majority (35% in normal and 37.5% in preeclampsia) of the respondents were found in the age group of 21−30 years. Unpaired t-test revealed no significant difference between mean age of two groups. Among normal group, mean±SD of PI and RI were 1.12±0.0846 and 0.571±0.058 respectively and in preeclamptic group mean PI and RI were 2.497±0.369 and 0.8255±0.087. There was statistically significant (by unpaired t-test) difference in mean Doppler indices between these two groups. Early diastolic notch was found in 90% subjects with preeclampsia and 5% subjects with normal pregnancy. Chi-square test showed that there was statistically significant difference regarding presence of early diastolic notch between normal regarding subjects and subjects with preeclampsia.</p> <p><strong>Conclusion</strong>: From the study result it was concluded that Doppler indices with presence of early diastolic notch are reliable indicators for early detection of preeclampsia.</p> <p>J Enam Med Col 2020; 10(1): 33-38</p> Sohely Sultana, Tarana Yasmin, Shyamal Kumar Roy, Mohammad Sazzad Hossain, Abdullah Al Amin ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Depression in Physicians: An Overlooked Issue in Mental Health <p>Depression is a common mental disorder that presents with depressed mood, loss of interest, feelings of guilt or low self-esteem. It affects an estimated one in 15 adults (6.7%) in any given year. One in six people (16.6%) will experience depression at some point in their lifetime. It can strike at any time; but usually it first appears during the late teens to mid-20s. Women usually experience depression more than men. Depression is one of the most common mental health issues among physicians worldwide due to high-intensity training and work overload. Recent systematic reviews and meta-analysis indicated that the prevalence of depression among physicians worldwide was around 28.8% which is quite higher than in the rest of the general population. Depressed physician makes more medical error than others. The burden of depression could lead to a low quality of life, ultimately suicidal attempts. So identifying risk factors for depression must be addressed and solved properly with utmost priority. This article reviews the prevalence of depression in physicians based on recently published literature related to this arena.</p> <p>J Enam Med Col 2020; 10(1): 39-42</p> Tamanna Bahar, Shaila Rahman ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Diagnosis of Galactosemia by Simple Technique in a Resource-Constraint Country <p>Galactosemia is an autosomal recessive inheritance and there is cellular deficiency of enzymes leading to defective/impaired metabolism of galactose resulting in toxic byproducts like galactilol, galactose-1-phosphate and galactonate that affect mainly liver, brain, kidneys, lens and gonads. Galactosemia appears as a rare metabolic cause of neonatal cholestasis syndrome (NCS). The classic disease manifestation after the first milk feeding varies in severity from an acute fulminant illness to a more common subacute illness beginning within the first few days of life. Neonatal sepsis is one of the presentations. Galactokinase deficiency results primarily in cataract formation and galactosuria. The preliminary diagnosis of galactosemia in sick neonates and suspected infants is made by Benedict test in several urine specimens and followed by dipstick test to exclude glycosuria. Gold standard test is demonstration of low enzyme activity in erythrocyte. Galactosemia can be detected by newborn screening methods like the Guthrie test using filterpaper blood samples. Classical form of galactosemia should be treated with an absolute galactose restricted diet without waiting for confirmation of the diagnosis. Here we report a case of a 50-dayold boy with features of neonatal cholestasis, diagnosed as galactosemia by using a simple cost effective method.</p> <p>J Enam Med Col 2020; 10(1): 43-48</p> - Md Benzamin, Nazmul Hassan, Rono Mollika, Kaniz Fathema, Khan Lamia Nahid, Rubaiyat Alam ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 A 16-Year-Old Girl with Systemic Lupus Erythematosus (SLE) with Septicaemia as Initial Presentation <p>Sepsis is a life-threatening condition caused by systemic host response to infection. Sepsis or septic shock is considered to be rare as initial presentation of autoimmune disease like systemic lupus erythematosus (SLE). SLE is a multisystem disorder which usually occurs in adolescent girls. So when an adolescent girl presents with septicaemia and multi-organ dysfunction, an autoimmune disease like SLE should be excluded. Here we report a 16-yearold girl initially presenting with septic shock along with multiorgan dysfunction. The patient was thoroughly evaluated and shock was managed effectively according to protocol. Later on she was diagnosed as a case of systemic lupus erythematosus (SLE).</p> <p>J Enam Med Col 2020; 10(1): 49-54</p> Maria Kibtiar, Mahbub Mutanabbi, Farzana Akhter Bornee ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Tectal Plate Cavernous Malformation—A Rare Cavernoma in Brainstem <p>Abstract not available</p> <p>J Enam Med Col 2020; 10(1): 55-57</p> Samar C Sarkar, Mashah Binte Amin ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 College News Vol 10(1) <p>Abstract not available</p> <p>J Enam Med Col 2020; 10(1): 58-59</p> Rukhsana Parvin ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000 Reviewers in this Issue Vol 10(1) <p>Abstract not available</p> <p>J Enam Med Col 2020; 10(1): 60</p> Editor in Chief ##submission.copyrightStatement## Wed, 22 Jan 2020 00:00:00 +0000