Journal of National Institute of Neurosciences Bangladesh <p>Published by National Institute of Neurosciences Bangladesh.Articles in the Journal of National Institute of Neurosciences Bangladesh are Open Access articles published under the Creative Commons CC BY-NC License (<a href=""></a>). This license permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.</p> National Institute of Neurosciences & Hospital en-US Journal of National Institute of Neurosciences Bangladesh 2410-8030 <p>Copyright on any research article in the Journal of National Institute of Neurosciences Bangladesh is retained by the author(s).</p><p>The authors grant the National Institute of Neurosciences Bangladesh a license to publish the article and identify itself as the original publisher.</p><p>Articles in the Journal of National Institute of Neurosciences Bangladesh are Open Access articles published under the Creative Commons CC BY-NC License (<a href=""></a>)</p><p>This license permits use, distribution and reproduction in any medium, provided the original work is properly cited, and it is not used for commercial purposes.</p> Neurological Manifestations in COVID-19 Patients: Bangladesh Perspective <p>Abstract not available</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 72-73</p> Quazi Deen Mohammad Mohammad Enayet Hussain ##submission.copyrightStatement## 2020-12-13 2020-12-13 6 2 72 73 10.3329/jninb.v6i2.50743 Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh <p><strong>Background: </strong>The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve.</p> <p><strong>Objectives: </strong>The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh.</p> <p><strong>Methodology: </strong>This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN).</p> <p><strong>Results: </strong>The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis.</p> <p><strong>Conclusion: </strong>The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal).</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77</p> Mohammad Enayet Hussain Bithi Debnath AFM Al Masum Khan Md Ferdous Mian Md Nahidul Islam Md Badrul Alam Quazi Deen Mohammad Rajib Nayan Chowdhury ##submission.copyrightStatement## 2020-12-13 2020-12-13 6 2 74 77 10.3329/jninb.v6i2.50744 Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage <p><strong>Background: </strong>In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity.</p> <p><strong>Objective: </strong>This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage.</p> <p><strong>Methodology: </strong>This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study.</p> <p><strong>Result: </strong>Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm.</p> <p><strong>Conclusion: </strong>From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81</p> Md Tauhidul Islam Chowdhury Mohammad Shah Jahirul Hoque Chowdhury Mohammad Sadekur Rahman Sarkar KM Ahasan Ahmed Md Nazmul Kabir Mohammad Rezaul Haque Fahmida Rouf Tanvir Haider Md Nahidul Islam Md Khairul Kabir Patwary Mohammad Selim Shahi Md Badrul Alam ##submission.copyrightStatement## 2020-12-13 2020-12-13 6 2 78 81 10.3329/jninb.v6i2.50745 Bacteriological Profiles with Antibiotic Susceptibility Pattern in Different Clinical Specimens of Specialized Neuroscience Hospital of Bangladesh <p><strong>Background: </strong>Throughout the world multi-drug resistant hospital acquired infections (HAI) are one of the leading causes of deaths and morbidity amongst hospitalized patients.</p> <p><strong>Objective: </strong>The aim of study was to identify prevalence and variations of predominant microorganisms and their drug sensitivity and resistance pattern in a tertiary care public hospital, Dhaka, Bangladesh.</p> <p><strong>Methodology: </strong>The study was conducted in Intensive Care Unit (ICU), High Dependency Unit (HDU), Post-operative ward and general wards of a tertiary care publicNeuro- hospital in Dhaka during 1st January, 2017 to 31st December, 2018. Patients admitted in any of the four units (ICU, HDU, Post-operative and general wards) of the hospital who were clinically suspected of having acquired any infection after 48 hours of admission to the ICUs were included. Depending on the clinical suspicion laboratory samples were collected from the patients. Samples were subjected to the testing and antibiotic sensitivity.</p> <p><strong>Results: </strong>A total number of total 1672 samples from these patients yielded clinically relevant microorganisms. Of these samples, 273 were respiratory specimens were tracheal aspirate; 537 were urine; 377 were blood; 396 were cerebrospinal fluids; and 82 were other clinical samples. More than two-third samples were growth negative (71.4%) and only one-thirdsamples (28.6%) were growth positive. Maximum growth negative in blood samples and about half of samples of urine and tracheal aspirates were growth negative. About 80% were Gram-negative bacteria like <em>Escherichia coli</em>, <em>Pseudomonas </em>spp., <em>Klebsiella </em>whereas gram-positive organisms were about 20%. Most of the pathogens were Multi-drug resistance.</p> <p><strong>Conclusion: </strong>Among HAIs Multidrug-resistant Gram-negative bacteria are the main challenge. Regular updating resistance of microbial are needed to develop antibiotic guideline to combat these infections and reduce morbidity and mortality.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 82-86</p> Uzzwal Kumar Mallick Mohammad Abdullah Yusuf Md Sirajul Islam Abu Nayeem Gurudas Mondal ##submission.copyrightStatement## 2020-12-13 2020-12-13 6 2 82 86 10.3329/jninb.v6i2.50746 Pattern of Stroke among Adult (A-MMD) and Childhood Onset (C-MMD) Moyamoya Disease <p><strong>Background: </strong>Though relatively rare, moyamoya disease (MMD) may have varied presentation in different age group. Different stroke types are major presentation of this enigmatic disease. <strong>Objective: </strong>The aim of this study was to compare the stroke subtypes among adult (A-MMD) and childhood onset (C-MMD) patients with Moyamoya disease (MMD).</p> <p><strong>Methodology: </strong>This was a hospital based observational study, conducted in the department of Neurology, Dhaka Medical College Hospital, Bangabandhu Sheikh Mujib Medical University and National Institute of Neurosciences and Hospital, Dhaka, Bangladesh in between July, 2007 to June, 2016. Sample size included 36 children and 14 adult patients of MMD presenting with either ischemic or hemorrhagic stroke, within one month of the index event.</p> <p><strong>Result: </strong>Majority of participants were below 10 years of age with a mean age at onset of 16.56(±10.6) years. There was a female predominance. Patients younger than 20 years, presented mostly with ischemic stroke (32 versus 4 patients); whereas those above 20 years of age presented mostly with hemorrhagic stroke (6 versus 8 patients). The difference was statistically significant (p value = 0.006). Large artery infarct (15) and hemodynamic infarct (17) were common among patients in children; whereas intracerebral hemorrhage (dICH, lICH, IVH among 3, 4 and 1 patients respectively) was frequent (8) among the adult (p value = 0.006).</p> <p><strong>Conclusion: </strong>While different pattern of ischemic stroke is common among children with MMD, the adults present mostly with hemorrhagic stroke subtypes.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 87-90</p> ATM Hasibul Hasan Kazi Mohibur Rahman Sharif Uddin Khan Shakir Hussain Hakim Mansur Habib Md Badrul Alam Quazi Deen Mohammad ##submission.copyrightStatement## 2020-12-13 2020-12-13 6 2 87 90 10.3329/jninb.v6i2.50747 Frequency and Topography of AstrocyticTumor: Experience of 567 Cases at Referral Neuroscience Hospital in Bangladesh <p><strong>Background: </strong>Glioma is the most commonly occurring malignant brain tumor that varies by age, sex, race or ethnicity. A very few number of records on CNS tumors are available in Bangladesh. National Institute of Neurosciences and Hospital (NINS), Dhaka has a good number of CNS surgeries. Regularly both tumorous and non-tumorous ICSOL samples are examined here.</p> <p><strong>Objective: </strong>The aim of the study was to see the subtypes, frequency and topography of Astrocytic tumors at NINS setting.</p> <p><strong>Methodology: </strong>Data from the department of Neuropathology department of NINS since January 2013 to June 2019 were evaluated. Tissue were fixed in formalin, paraffin embedded, stained with H&amp;E. Histomorphology and WHO 2007 CNS tumor classification were used.</p> <p><strong>Result: </strong>From 3945 routine sample 567 cases were sorted out as Astrocytic tumor. Total male were 61% (346) and female 39% (221), male to female ratio was 1.6:1. The mean age was 32.64 and ranged from 1 to 80 years. Sixty six percent (66%) tumors were in supratentorial compartment, 15% infratentorial, 6.3% spinal and 9.7% in midline areas like thalamus, hypothalamus and seller region. In this study 34.6% (196) cases were Glioblastoma, followed by Anaplastic Astrocytoma 8.3%(47), Diffuse Astrocytoma 29% (165), Pilocytic Astrocytoma 26.6% (151), Pilomyxoid Astrocytoma 0.4% (2), Subependymal giant cell Astrocytoma 0.9% (5) and Pleomorphic Xanthoastrocytoma 0.1 (0.1). Topographically 66% glial tumors are supratentorial. Among the glial tumors 34.6% is Glioblastoma, 8.3% Anaplastic Astrocytoma, 29% Diffuse Astrocytoma and 26.6% Pilocytic astrocytoma. Common age group of Glioblastoma is 41-60 (52%) years, diffuse astrocytoma is 21-40 years 60.60 and Pilocytic Astrocytoma is 1-20 years (66.88). Glioblastoma, Anaplastic Astrocytoma and Diffuse astrocytoma are more common in male than female.</p> <p><strong>Conclusion: </strong>There is no gender difference in case of Pilocytic Astrocytoma.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 91-95</p> Md Nowfel Islam Naila Haq Md Badius Salam Monsur Ahmed Sk Muhammad Ekramullah Md Zahed Hossain Sk Sader Hossain Sadia Shirin ##submission.copyrightStatement## 2020-12-13 2020-12-13 6 2 91 95 10.3329/jninb.v6i2.50748 Relationship of Glycemic Status with Disease Severity in Guillain-Barré Syndrome <p><strong>Background: </strong>Guillain-Barré syndrome (GBS) is an acute autoimmune polyneuroradiculopathy characterized by flaccid paralysis which may lead to respiratory failure requiring intensive care.</p> <p><strong>Objective: </strong>The purpose of the present study was to explore the relationship between the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and disease severity of GBS patients who are not known to have DM.</p> <p><strong>Methodology: </strong>This cross-sectional study included adult GBS patients without having DM [age 35 (22-48) years, median (interqurtile range, IQR); 39 male 22 female] who were admitted to Neurology department, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from July 2018 to June 2019. Demographics, clinical data were noted and FPG, HbA1c were measured. Disease severity were assessed by the GBS disability scale ranging from 0 to 6 with increasing score reflecting increased disability.</p> <p><strong>Results: </strong>Patients with more severe GBS (disability score ≥4, unable to walk) had higher frequency of elevated FPG &gt;5.5 mmol/L (61.2%; 30/49) in comparison to those with less severe GBS (disability score ≤3, able to walk; FPG &gt;5.5 mmol/L in 16.7%, 2/12; p=0.006). But distribution of HbA1c category was not different across the groups (disability score ≥4 vs. ≤3: HbA1c &lt;5.7: 40% vs. 58%; 5.7-6.4: 50% vs. 25%; &gt;6.4: 10% vs. 17%; p=0.296). Participants with elevated FPG were elder [elevated vs. normal FPG: 40 (28-54) vs. 25 (19-43) years; median (IQR), p=0.012] and had higher CSF glucose (p=0.002) than those with normal FPG, but there was no difference in respct of gender, MRC sum score, requirement of assisted ventilation, CSF protein, GBS subtypes and duration of hospital stay (p=not significant for all).</p> <p><strong>Conclusions: </strong>Patients with severe GBS have higher frequency of elevated FPG but not HbA1c. An acute change in glucose metabolism may occur in GBS which needs further study.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 96-100</p> Mohammad Akter Hossain Mashfiqul Hasan Mohammad Atiqur Rahman Murshed Baqui Mahmudul Islam Maliha Hakim ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 96 100 10.3329/jninb.v6i2.50762 Prevalence of Extended Spectrum ß-Lactamase Producing Klebsiella Pneumoniae Isolates in A Tertiary Care Hospital in Bangladesh <p><strong>Background: </strong>Extended-spectrum β lactamases (ESBLs) continue to be a major challenge in clinical setups world over, conferring resistance to the expanded-spectrum cephalosporins.</p> <p><strong>Objectives: </strong>The aim of this study was to determine the prevalence of extended spectrum β-lactamase (ESBL) in strains of <em>Klebsiella pneumoniae </em>isolated from different clinical specimens in Dhaka Medical College Hospital, Dhaka, Bangladesh.</p> <p><strong>Methodology: </strong>This cross sectional study was carried out at the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from July 2016 to June 2017. <em>Klebsiella pneumoniae </em>were isolated from different clinical specimens from adult hospitalized patients. These isolates were screened for ESBL production according to Clinical and Laboratory Standards Institute (CLSI) guidelines. ESBL production was confirmed by the phenotypic confirmatory double disc synergy test (DDST).</p> <p><strong>Results: </strong>Among the 500 collected samples 75 <em>Klebsiella pneumoniae </em>were isolated. Among them, 68 isolates were selected for confirmatory tests of ESBL according to CLSI guidelines. Finally, 19 isolates were confirmed as ESBL producers by DDST (25.33%).</p> <p><strong>Conclusion: </strong>In the present study, a large number of isolates are found to be ESBL producers.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 101-104</p> Suraiya Jahan Sonia Tasnim Ahsan Tafneen Farhana Ahmed Shah Walia Nazneen Kazi Hafiz Uddin SM Shamsuzzaman ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 101 104 10.3329/jninb.v6i2.50763 Ability of Extracts of Spirulina for the Removal of Arsenic from Isolated Liver Tissues of Experimental Rat <p><strong>Background: </strong>Spirulina has several effects in the metabolism of the body.</p> <p><strong>Objective: </strong>The purpose of the present study was to see the ability of extracts of spirulina for the removal of arsenic from isolated liver tissues of rat.</p> <p><strong>Methodology: </strong>This animal study was carried out on isolated liver tissues of Long Evans Norwegian adult healthy male rats weighing 160 to 200 g. The rats were 3 to 6 months of age obtained from animal house of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from 2004 to 2005. Measurements and all tasks were performed in a very careful manner. Atomic Absorption Spectrophotometer with Hydride Generator was used to measure the arsenic level. A set of freshly washed test tubes was taken. All test tubes contained 2ml tyrode solution and twenty small pieces of liver tissue maintaining 00C. No arsenic was added in test tube I. 2.5 μg/ml arsenic trioxide was added rest of the test tubes. They all were incubated for 45 minutes at 370C. Then the tissues were washed properly. The extracts of spirulina was added at 20 μl/ml dose. Second incubation was also for another 45 minutes at 370C. There were duplicates of all test tubes.</p> <p><strong>Result: </strong>The effects of different extracts of spirulina (E1, E2, E4 and E7) on the removal of arsenic from arsenic loaded tissue were recorded. Amount of accumulated arsenic (mean ± se) in blank was 6.04 ± 3.05 μg/g of protein. After administration of 2.5 μg/ml arsenic trioxide in both incubation, the amount of accumulated arsenic was 245.02 ± 22.37 μg/g of protein. Blank was deducted from the standard and the value was considered as control and it was 238.96 ± 19.32 μg / g of protein. The arsenic loaded tissues were incubated with different extracts (E1, E2, E4 and E7) of spirulina in second incubation for another 45 minutes at 370C and each extract was for 20 μl / ml. After E1 extract of spirulina in second incubation, amount of accumulated arsenic was 136.40 ± 14.23 μg / g. There was 14.81% of removal of arsenic. Second incubation with E2 extract of spirulina (20 μl/ml) on arsenic loaded (2.5 μg/ml) tissue showed the amount of arsenic 242.56 ± 16.50 μg/g of protein (mean ± se). There was 12.59% of removal of arsenic.</p> <p><strong>Conclusion: </strong>In conclusion extracts of spirulina has a significant ability to remove arsenic from isolated liver tissues of experimental rat.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 105-109</p> Andalib Mustafa Iqbal Ira Sabina Jesmin Shakila Akhter Mahfuza Mazeda Rowshan Eliza Omar Eva Mir Misbahuddin ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 105 109 10.3329/jninb.v6i2.50764 Histopathological Pattern and Different Stages of Sinonasal Carcinoma Patients: A Study on 40 Cases in Bangladesh <p><strong>Background: </strong>Sino-nasal carcinoma has various histological types presented with different stages.</p> <p><strong>Objectives: </strong>The purpose of this present study was to see the histopathological types and stages of sinonasal carcinoma patients in tertiary level hospital.</p> <p><strong>Methodology: </strong>This cross-sectional study was conducted in the Department of Otolaryngology- Head &amp; Neck Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh and Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2008 to December 2009 for a period of two (02) years.All consecutive cases of sinonasal carcinoma admitted in hospital and outpatient department during the study period. Suspected cases of sinonasal carcinoma was diagnosed from history and clinical examination proved by CT-scan, MRI and histopathological examination.</p> <p><strong>Result: </strong>A total number of 40 cases of sino-nasal carcinoma were recruited for this study. Among these single site involvement was reported in 11 cases and the rest 29 cases were involved in multiple sites. Regarding multiple sites involvement maxillary sinus with nasal cavity involvement was reported in 15(51.72%) cases. Maxillary sinus, nasal cavity with ethmoid sinus involvement was found in 10(34.48%) cases. The presentation of the sinonasal carcinoma at stage T4 was 16(40.05) cases followed by T3, T2, and T1 which were 13(32.5%) cases, 7(17.5%) cases and 4(10.0%) cases respectively. Squamous cell carcinoma was found in 25(63%) cases followed by adenocarcinoma andadenoid cyst carcinoma which were 7 cases, 5 cases respectively.</p> <p><strong>Conclusion: </strong>In conclusion majority of the sino-nasal carcinoma are squamous cell carcinoma involving the multiple sites in the T4 stage.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 110-113</p> Md Momenul Haque Akhil Chandra Biswas Ali Imam Ahsan Md Idrish Ali Md Harun Ar Rashid Talukdar Md Mahbubul Alam Chowdhury ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 110 113 10.3329/jninb.v6i2.50765 Socio-demographic Characteristics of Vesico-vaginal fistula (VVF) patients attended at a tertiary Care Hospital in Bangladesh <p><strong>Background: </strong>Vesico-vaginal fistula can occur in different women with varied socio-economic condition.</p> <p><strong>Objectives: </strong>The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh.</p> <p><strong>Methodology: </strong>This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics &amp; Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics &amp; Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics.</p> <p><strong>Result: </strong>A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery.</p> <p><strong>Conclusion: </strong>In conclusion middle age illiterate women are most commonly suffering from VVF.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117</p> Shimul Akter Naznin Rashid Shewly Kashefa Khatun Rokshana Parvin Nupur Kamrun Nahar Nilufar Sultana Farzana Sharmin ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 114 117 10.3329/jninb.v6i2.50766 Surgical Evaluation of P-Possum and Cr-Possum Scores in Patient Undergoing Colorectal Cancer Operation <p><strong>Background: </strong>"Portsmouth" modification of POSSUM (P-POSSUM) scoring system used to assess mortality in general surgical patients and “Colorectal” Cr-POSSUM scoring system used for mortality assessment for colorectal patient.</p> <p><strong>Objective: </strong>The purpose of the present study was to estimate the validity of the P-POSSUM (Portsmouth-POSSUM) and Cr-POSSUM (Colorectal-POSSUM) score in predicting the risk of mortality in colorectal cancer patient.</p> <p><strong>Methodology: </strong>This was single centre clinical trial was carried out in the Department of Surgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from November 2013 to April 2014 for a period of six (06) months. Patients of both sex who got admitted in the surgery in-patient department for elective colorectal cancer operations were selected as study population. Both the P-POSSUM and Cr-POSSUM, physiological score, operative score, predicted mortality rate were calculated using an online POSSUM calculator. Based on both P-POSSUM and Cr-POSSUM Scoring, patients were categorized into three risk groups. Then a comparative analysis was performed between the observed and the predicted values as well as the Observed/Predicted ratio (O:P) in all the risk groups.</p> <p><strong>Results: </strong>A total of 50 patients with the median age of 50 (ranging 20 to 72) years were studied. 30 days overall observed mortality was 3(6%) patients. The mean P-POSSUM and C-POSSUM physiological scores were 32.49±2.08 and 13.92±1.30 respectively. However, the operative score was 11.59±1.46 and 8.12±0.24 in P-POSSUM and C-POSSUM respectively. The overall mortality predicted by the P-POSSUM model was 5 patients (19.33±2.87) and mortality predicted by the Cr-POSSUM model was 4 patients (20.66±4.09).</p> <p><strong>Conclusion: </strong>In conclusion both model accurately predicted the risk of postoperative death. Cr-POSSUM provided a better fit to observed results than P-POSSUM.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 118-123</p> SM Syeed Ul Alam Ayesha Rahman Akhter Ahmed Muhammad Faridul Haque Nazia Mehnaz Joty Abdur Rabban Talukder ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 118 123 10.3329/jninb.v6i2.50767 Severe Head Injury Management at a Tertiary Care Hospital in Dhaka City <p><strong>Background: </strong>Severe traumatic brain injury can be a serious condition.</p> <p><strong>Objective: </strong>The purpose of the present study was to see the decompressive craniectomy (DC) of severe traumatic brain injury.</p> <p><strong>Methodology: </strong>This clinical trial was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2012 to December 2013 for a period of two (02) years. Patients with the age of 18 years and above, GCS of the patients 8 to 4, severe traumatic brain injury (TBI) with multiple hemorrhagic contusions and midline shift, on CT scan and severe TBI with gradual neurological deterioration were included for this study. Total 60 patients were included.</p> <p><strong>Result: </strong>A total of 60 patients were included in this study. Almost two third 18 (60.0%) patients had favorable outcome (GOS 4 and 5) in group A and exactly two third 20(66.7%) patients had Unfavorable outcome (GOS 1,2 and 3) in group B (p&lt;0.05). In this study 8 patient died among which 5 had GCS 4 and 3 had GCS 5. One patient with GCS 5 became persistent vegetative. Eight patient with good recovery had GCS 8, 7 and 6. Death occurred at mean GCS 9± of midline shift followed by 8± mm in persistent vegetative, 5.67±2.08 mm in severe disability, 4.5±2.88 mm in moderate disability and 3.38±1.06 mm in good recovery.</p> <p><strong>Conclusion: </strong>Group A had better clinical outcome than group B. So based on statistical analysis it can be concluded that DC is preferable to conservative management in case of severe TBI.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 124-128</p> Md Monzurul Haque Monsur Ahmed Fazlul Haque Md Shariful Islam Rustom Ali Modhu Asit Chandra Sarker ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 124 128 10.3329/jninb.v6i2.50779 Factors Associated with Hypertension among Urban Dwellers with Sedentary Lifestyle: A Cross-Sectional Study <p><strong>Background: </strong>Hypertension is a serious public health problem and an important research area due to its worldwide high prevalence and being a prime risk factor for cardiovascular diseases and other complications. In developing countries, hypertension is more prevalent among the urban population who lead a sedentary lifestyle.</p> <p><strong>Objective:</strong>This study aimed to investigate the prevalence and risk factors of hypertension among urban dwellers with sedentary life.</p> <p><strong>Methodology: </strong>This cross-sectional study was conducted among the adult population (18 years and above) living in one of the urban areas of Dhaka (Dania Union, Kadamtali Thana), Bangladesh. The study was conducted from January 2018 to October 2018, using a simple random sampling technique for data collection. The adult respondents were enrolled in this study who were staying at home and leading a sedentary lifestyle. Univariate analysis and binary logistic regression analysis were performed to examine the risk factors of hypertension of the study population.</p> <p><strong>Results: </strong>A total of 149 adults were enrolled in this study. The mean (±SD) age of the study population was 51.20 (±14.65) years. About four out of 10 study population were found to be hypertensive in this study. The adjusted logistic regression analysis revealed that increased age groups, i.e., 50 to 60 years old [AOR: 3.11, 95% CI: 1.01 – 9.66] and 60 years old and above [AOR: 5.83, 95% CI: 1.73 – 20.06], and family history of hypertension (AOR: 3.59, 95% CI: 1.34 - 9.63) had a positive and significant association with hypertension. However, people with high socioeconomic status showed 71 percent less likelihood of being hypertensive than the lower ones.</p> <p><strong>Conclusion: </strong>The prevalence of hypertension among the people leading a sedentary lifestyle was significantly higher in this study. Increasing physical activity, maintaining proper antihypertensive medication, and regular follow-up of hypertension for older adults might inhibit the increased prevalence of hypertension in urban areas.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 129-134</p> Ariful Islam Joardar Md Fakhrul Islam Khaled SM Eare Mahabub Chayan Kumar Singha M Atiqul Haque ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 129 134 10.3329/jninb.v6i2.50780 Demographic Profiles of Animal Bite Cases at a Dedicated Anti-Rabies Hospital in Dhaka City of Bangladesh <p><strong>Background: </strong>Animal bite management are very crucial part in the post prophylaxis treatment.</p> <p><strong>Objective: </strong>The purpose of the present study was to see the demographic profile of animal bite cases at a dedicated anti-rabies hospital.</p> <p><strong>Methodology: </strong>This retrospective chart review based on secondary data received from animal bite register was conducted in the Department of Microbiology at National Institute of Neurosciences &amp; Hospital, Dhaka, Bangladesh from January 2014 to December 2015 for a period of two years. All relevant data were noted from the registered record.</p> <p><strong>Result: </strong>A total number of 17688 cases were collected from the register log book of animal bite. The mean age with standard deviation was 24.42±17.22 with the range of 1 to 99 years. The ratio between male and female was 2.33:1. The most common animal bite was dog bite which was 13574(76.7%) cases followed by cat, monkey, fox and weasel bite which were 3667(20.7%) cases, 163(0.9%) cases, 39(0.2%) cases and 22(0.1%) cases respectively. Lower extremity was the most site of bite by the animals which was 12936(73.1%) cases followed by upper extremity, waist, head &amp; neck, face and trunk which were 3592(20.3%) cases, 428(2.4%) cases, 155(0.9%) cases, 116(0.7%) and 114(0.6%) cases respectively. The most common category of bite was category II which was 11800(66.7%) cases.</p> <p><strong>Conclusion: </strong>In conclusion male young adult person bite by dog with category II are the most common victims of animal bites seeking for treatment.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 135-139</p> Md Abdullah Yusuf Tanzina Jahan AFM Arshedi Sattar Sazzad Bin Shahid Nusrat Sultana AKM Shamsuzzaman ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 135 139 10.3329/jninb.v6i2.50781 Reduction of Antimicrobial Resistance and Limiting Use of Antibiotics by the Application of De-escalation and Streamlining: A Review Update <p>De-escalation is a critical component that lies at the center of antimicrobial stewardship programs. It is a clinically effective concept in reducing infection with drug resistant isolates. Although there is significant and serious shortfalls like establishment of the real impact of de-escalation on antimicrobial resistance development; it is now well demonstrated that there is no harm for patients, whether it genuinely improve clinical outcomes. Further studies are needed to establish the most effective tools to implement de-escalation, particularly in terms of providing clear guidelines to clinicians to enable them to be confident in applying this maneuver in our country. It is interesting that this concept of de-escalation is now being explored in different types of infection.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 140-142</p> Ritu Saha Bhuiyan Mohammad Mahtab Uddin ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 140 142 10.3329/jninb.v6i2.50782 Covid-19 Infection Complicated with Aortic Thrombosis: A Case Report <p>Thromboembolic complications are well recognized events in Covid-19 infection. Most of the case fatalities are due to this event. Although any blood vessels may be involved, larger vessels are less commonly involved in this process. Here we describe a case of thrombosis of the arch of the aorta in association of Covid-19 infection in a hospitalized patient. The aim was to ensure timely identification and therapeutic intervention to prevent distal thromboembolic sequelae.</p> <p>Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 143-145</p> Md Zakirul Islam Anjuman Ara Kaniz Fatema Rifat Taher Anne Md Mostafizur Rahman Mohammad Enayet Hussain Md Abdullah Yusuf ##submission.copyrightStatement## 2020-12-14 2020-12-14 6 2 143 145 10.3329/jninb.v6i2.50783