Medicine Today 2022-04-24T13:26:25+00:00 Prof. N.A. Kamrul Ahsan FACS, MS Open Journal Systems <p>A professional medical journal recognised by the Bangladesh Medical and Dental Council (BMDC).</p> Serum Bilirubin Level and Associated Factors in Patients of Self Reporting Jaundice without Evidence of Clinical Jaundice 2022-03-12T12:08:39+00:00 Madhusudan Saha Sadhu Uttam Kumar Shasanka Kumar Saha Md Abdul Mumit Sarkar Bimal Chandra Shil <p><strong>Introduction with objective: </strong>This study was done to see the serum bilirubin level of patients with self reporting jaundice without clinical jaundice.</p> <p><strong>Materials and Methods: </strong>This study was done from January 2019 to January 2020 at Popular Medical Centre, Sylhet. Consecutive patients claiming to have jaundice without clinical icterus were included. Demographical information and presenting symptoms were noted. Serum bilirubin and relevant laboratory investigations were done and results were noted. Statistical analysis was done using SPSS 20.</p> <p><strong>Results: </strong>Total 177 patients, age varying from six years to 80 years (mean 28.54) were included. Of them 134 (75.7%) were male. Common symptoms for were anorexia (90; 50.8%), pain abdomen (76; 42.9%), weakness (49; 27.7%), nausea (45; 25.4%), fullness of abdomen (35; 19.8%), gas (34; 19.2%) and vomiting (16; 9%). Of them 164 (92.7%) initially visited kabiraj. Serum bilirubin level of them varied from 0.04 mg/ dl to 2.67 mg / dl (mean 0.814±0.577) and ALT level varied from 10 iu/ dl to 2944 iu/ dl (mean 71.55±270.09). In this series 143 (80.0%) patients had no jaundice biochemically. Among others, 08 (4.52%) were case of acute hepatitis and 13 (7.34%) were possible cases of Gilbert’s syndrome. Patients’ attitude regarding informal caregivers significantly differed with education level.</p> <p><strong>Conclusion: </strong>Most of patients claiming to have jaundice without icterus had no evidence of liver disease. Consulting kabiraj they are wasting money and sometimes inviting health related disasters. So mass education and motivation may increase awareness of people regarding liver disease and prevent health hazards.</p> <p>Medicine Today 2022 Vol.34(1): 01-05</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Spectrum of Haematological & Non Haematological Disorder Diagnosed by Bone Marrow Examination: A Study of 115 Cases 2022-03-12T12:34:29+00:00 Samira Taufique Reshma Salina Haque Zulfia Zinat Chowdhury Mohammad Iqbal Kabir Mohammad Golam Rabbani Md Atiqul Islam Rabby <p><strong>Introduction: </strong>Haematological and nonhaematological diseases affecting the bone marrow may be primarily or a secondarily spread to the marrow. In most of the cases, diagnosis can be arrived at by a detailed history, physical examination and few simple investigations. Bone marrow examination is a very useful tool in the diagnosis of hematological and non-hematological diseases.</p> <p><strong>Materials and Methods: </strong>This retrospective study was done in the department of haematology, in a specialized diagnostic centre from July 2018 to July 2021. A total of 115 cases were included in this study. Clinical parameters were assessed, peripheral blood smear along with necessary haematological investigations were done.</p> <p><strong>Results: </strong>Majority patient were male (70%). In total cases 44.4% patients were under 30 years of age. Among them 23(20%) were under 10 years. The most common indication for bone marrow examination was diagnosis &amp; management of Acute Leukaemia 27(23.48%), Major presenting complaints were fever 49(42.61%), fatigue 46(40.0%) &amp; bleeding manifestation 22(19.13%). On systemic examination, pallor was found in majority of the cases. Hematological malignancies were found in 77(66.96%) cases, non-malignant haematological disorders were found in 33(28.70%) cases. Acute leukaemic condition (ALL, AML) were the most common malignant conditions, 22(19.13%) &amp; 17(14.78%) respectively. Most common nonmalignant haematological conditions were hypocellular marrow 17(14.78%).</p> <p><strong>Conclusion: </strong>Acute Leukemia is a major indication of BME. Among the pathological condition malignant condition are commonly seen. And male are predominantly suffering more from haematological disorders than female. In majority cases acute leukaemic condition are seen in BME.</p> <p>Medicine Today 2022 Vol.34(1): 7-11</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Bacteriology and Antibiotic Sensitivity Pattern of Sputum in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease 2022-03-12T12:38:54+00:00 Md Mahabubul Islam Majumder Pinki Shaha Mostaque Ahmed Mohammad Nazim Uddin Mahabubur Rahman Tarek Ahmed <p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. Nowadays investigators need culture studies for proper selection of antibiotic, but it is a time consuming process. The choice of the antibiotic should be constituted on the bacterial sensitivity and resistance pattern.</p> <p><strong>Objective: </strong>To identify the causative bacteriology and antibiotic sensitivity of sputum of chronic obstructive pulmonary disease patients with acute exacerbation.</p> <p><strong>Materials and Methods: </strong>It was a prospective study in department of medicine Cumilla Medical College Hospital during the period of July 2019-2020. All the patients included in this study were above 37 years of age, diagnosed as acute exacerbation of COPD (AECOPD) were included in this study. Those patients were on antibiotic was advised to stop antibiotic for 48 hours and were included in this study. Fresh spot specimen as well as overnight collection of sputum samples were collected from each 257 patients of different age and sex groups in a sterile screw capped universal container. The specimen was labeled and transported to the microbiology laboratory for processing and cultured within half an hour of collection. Antibiotic susceptibility pattern was done following Kirby-Bauer disc diffusion method of clinical laboratory science (CLS) program.</p> <p><strong>Results: </strong>Majority (45.5%) of the patients had growth of Klebsiella pneumoniae. All the isolated organisms except Acintobactor are mostly sensitive to Meropenum, Imipanum and Amikacin. In vitro sensitivity pattern against these antibiotics was more than 85%.</p> <p><strong>Conclusion: </strong>Male is predominating and majority of them are older age group. Klebsiella pneumoniae, Pseudomonas and E. coli are common isolated organisms.</p> <p>Medicine Today 2022 Vol.34(1): 12-16</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Bacteriological Profile of Suspected Neonatal Septicaemia and Its Relationship with Selected Risk Factors 2022-03-13T09:37:54+00:00 Md Shamsul Alam Sanaul Haque Mia Md Belal Uddin <p><strong>Introduction: </strong>Neonatal septicaemia is one of the major problem in neonatology with a high case fatality rate. Manifestations of neonatal septicaemia are subtle &amp; non-specific. Blood culture is the “gold standard” in the diagnosis of neonatal septicaemia, a high index of suspicion with or without laboratory evidences of infection is the key for early diagnosis. Early diagnosis &amp; introduction of antibiotic may reduce mortality and morbidity.</p> <p><strong>Objective: </strong>To explore the bacterial organisms among the suspected neonatal septicaemic cases and its relationship with selected risk factors.</p> <p><strong>Materials and Methods: </strong>A Cross sectional descriptive type of study was carried out on all suspected cases of neonatal septicaemia patients admitted in the paediatric wards of Rajshahi Medical College Hospital during the period of july 2008 to june 2010 .Total 60 sixty cases who had non- specific symptoms of septicaemia were enrolled in this study. After a clinical evaluation and management of the patient blood culture was performed on all neonates with risk factors or signs suggestive of sepsis.</p> <p><strong>Results: </strong>Out of sixty cases of suspected neonatal septiceamic newborns 18.33% were culture positive for bacteria. Both gram negative and gram positive bacteria were responsible for neonatal septicaemia. Majority of the organisms were gram negative (54.5%) and most common organisms was E.coli (54.5%) .Other gram-positive organisms were streptococcus spp(27.3%) and staph aureus(18.2%) respectively. Among blood culture positive cases 82% were early onset neonatal septicaemia &amp; 18% were late onset septisaemia. Gestational age, Low birth weight, Low socioeconomic status of mother, mode of delivery and birth asphyxia were risk factor for both early onset neonatal sepsis &amp; late onset neonatal sepsis.</p> <p><strong>Conclusion: </strong>Septicaemia is one of the major causes of death &amp; its manifestations are subtle and non specific. Both gram negative &amp; gram positive bacteria are responsible for neonatal septicaemia. Most isolated bacteria E.coli. Risk factors may be the factor for NNS. Although blood culture is the “gold standard” in the diagnosis of NNS, a high index of suspicion with or without laboratory evidences of infection is the key for early diagnosis. If we can avoid risk factors for NNS by antenatal check up of pregnant mother and thereby number of septicaemia could be reduced.</p> <p>Medicine Today 2022 Vol.34(1): 17-21</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Study on Seasonal Variation in Stroke 2022-03-13T10:44:38+00:00 Md Lokman Hossain Talukder Md Sakhawat Hossain Asadullahil Galib Md Daharul Islam Nadia Nasrin Badal Kumar Saha <p><strong>Introduction</strong>: After coronary artery disease and cancer, stroke is the third commonest cause of death in the developed countries. There have been descriptions of a seasonal variation in the frequency of different types of stroke. This variation may be related to a variation in the frequency of risk factors of stroke.</p> <p><strong>Objective: </strong>To find out the seasonal variation of different type of strokes.</p> <p><strong>Materials &amp; methods: </strong>This cross sectional observational study was carried out at the department of medicine, mymensingh medical college hospital, mymensingh over a period of one year between June 2011 to May 2012. A total 292 patients of CT scan proven acute stroke of both sexes who were hospitalized within one weeks of acute stroke were included in this study within this period. data were processed and analyzed by computer software SPSS. Level of significance was considered as p value less than 0.05.</p> <p><strong>Results: </strong>The frequency of ischaemic stroke during summer (62.4%) was significantly greater than that during winter (37.8%). The frequency of haemorrhagic stroke during winter (62.2%) was significantly greater than that during summer (37.6%). Hypertension was the most important risk factor and other risk factors were smoking, diabetes mellitus, tobacco chewing, ischemic heart disease, dyslipidemia, oral contraceptive pill, alcohol consumption, atrial fibrillation and past history of stroke.</p> <p><strong>Conclusion: </strong>This study found stroke is influenced by the variation of seasons. The frequency of ischaemic stroke during summer was significantly greater than winter. The frequency of haemorrhagic stroke during winter was significantly greater than summer.</p> <p>Medicine Today 2022 Vol.34(1): 22-26</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Stroke and Coronary Heart Diseases, Global and Asian Trend and Risk Factors -A Perspective 2022-03-13T10:56:06+00:00 Sk Mamun Ar Rashid SK Moazzem Hossain <p><strong>Introduction: </strong>Cardiovascular disease (CVD) is the leading cause of death in the world, accounting for 30% of deaths globally. CVD is a group of conditions affecting the functions of the heart, blood vessels or both. The major cardiovascular diseases include coronary heart disease (CHD), stroke, hypertension, heart failure and peripheral vascular diseases. Distribution of CHD and stroke is different in different regions of the world, especially western high-income, Asian and other countries. The Asian prevalence also not homogenous. Estimated number of deaths due to CVD worldwide will projected to 23.4 million, comprising 35% of all deaths in 2030. Significant increase in prevalence of coronary heart diseases (CHD) have been observed in the Asia including Bangladesh, but stroke in some regions of the world. Objectives: (1) Identification of cases and risk factors in different geographical area (2) Reduction of morbidity and mortality by proper treatment and management of modifiable risk factors.</p> <p><strong>Materials and Methods: </strong>This observational study was done through using evidence from the published study articles of CVD in national and international journals, electronic databases such as MEDLINE, EMBESE and PUBMED. We also manually checked references of relevant publications of stroke and CHD.</p> <p><strong>Study period: </strong>Jan2019-Dec2019.</p> <p><strong>Results: </strong>Approximately 940 million people in the high income countries, where CHD is the dominant form of CVD which is 2–5 times higher than stroke. In the USA, Canada, Australia, New Zealand, Italy, France and Spain CVD death rates are very low. The highest death CHD rate is in Finland, Ireland, Scotland, Norway, Sweden of the European countries. In Eastern Europe and most of the Asia, the rate of coronary arterial diseases are rapidly increasing. Japan the Asian high income country the death ratio of stroke and CHD is 3:1.The East Asia and the pacific including China CVD is the major cause of death, where stroke dominating. People in South Asia including India and Bangladesh the coronary diseases are increasing alarmingly, where CVD death increase 30%over the preceding decade and the dominant form is CHD. In the central Asia, specially Uzbekistan, Kazakhstan, Tajikistan both CHD and stroke are very high. In Latin America death from CHD (35%) higher than stroke (29%). In the Middle East and North Africa, CHD responsible for 17% and stroke 7%of all death.</p> <p><strong>Conclusion: </strong>Asian countries have disproportionately high morbidity and mortality from stroke with increasing tendency to CHD, but CHD in Western countries which may be due to complex interaction of genetic and environmental factors, smoking, hypertension and metabolic abnormalities. Death rate is higher in male sex from both CHD and stroke worldwide.</p> <p>Medicine Today 2022 Vol.34(1): 27-35</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Laparoscopic versus Open Appendicectomy in a District Hospital 2022-03-13T11:03:08+00:00 Md Rafiqul Islam SM Golam Azam Md Showkat Ali Md Ridwanul Islam <p><strong>Introduction</strong>: Appendicitis is one of the most common clinical conditions requiring surgical intervention in day-to-day practice, which is indicated for both acute appendicitis and recurrent acute appendicitis. Appendicectomy can be performed using several surgical techniques like laparotomy (open), laparoscopic appendicectomy.</p> <p><strong>Materials and Methods: </strong>We have done 110 cases in one year from July 2019 to June 2020.</p> <p><strong>Results: </strong>Out of the 110 patients, 42 (38%) underwent laparoscopic surgery and 68 (62%) open appendicectomy.</p> <p><strong>Conclusion: </strong>Female are predominant than male patients. Postoperative hospital stay, postoperative complications like wound infections are much less in laparoscopic procedure. The acceptance of laparoscopic appendicectomy gradually increases among the surgeons as well as the patients.</p> <p>Medicine Today 2022 Vol.34(1): 36-38</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Outcome of Laparoscopic Cholecystectomy in Acute Calculous Choleycystitis – Analysis of 100 cases 2022-03-13T11:10:38+00:00 Md Ahad Ali Mahalder Md Joynal Abeden Rehnuma Karim Md Rafiqul Islam <p><strong>Introduction: </strong>Gallbladder disease is one of the most common surgical problems worldwide. About 10-15% of the adult western population has gallstone diseases . More than half a million cholecystectomies are performed per year in United States alone. Laparoscopic cholecystectomy (LC) is currently the most widely used surgical procedure for the treatment of gallstones.</p> <p><strong>Aims and Objectives: </strong>To observe the cause of difficulties, the sequele , identify and find out the nature &amp; rate of per operative complications and find out the type &amp; frequency of early post-operative complications following laparoscopic cholecystectomy in acute calculous cholecystitis.</p> <p><strong>Materials and Methods: </strong>This is a prospective interventional study which was conducted at Jashore Medical College Hospital &amp; some clinics of the city from Sept 2019 to Feb 2020. A total of 100 patients underwent Laparoscopic cholecystectomy for acute calculous cholecystitis within 7 days of admission.</p> <p><strong>Results:</strong>Among 100 patients, 80 females &amp; 20 males with maximum age group were in the fourth decade, Laparoscopic cholecystectomy was done in 97 (97%) cases &amp; in 3(3%) cases conversion were needed, none of the patients were developed major Per &amp; postoperative complications. Peroperative complication rate was 22 (22%) with conversion was 03(3%) cases. All of the above complications were managed accordingly &amp; successfully.</p> <p><strong>Conclusion: </strong>Laparoscopic Cholecystectomy is a safe, effective procedure for the early management of patients with acute calculus cholecystitis. Meticulous dissection &amp; good exposure of callot’s triangle, posterior clearance may prevent bile duct injuries.</p> <p>Medicine Today 2022 Vol.34(1): 39-43</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Effects of Exposure of Cement Dust on Platelet Count in Workers of a Cement Mill 2022-03-13T11:15:07+00:00 Rahnuma Ahmad Qazi Shamima Akhter Mahmuda Abira Farhana Rahman Suparna Bhowmik Farhana Hussain Sadia Tahmina Akter <p><strong>Introduction</strong>: Cement dust is emitted during the different steps of cement production. This dust is composed of chemical components that may have unfavourable effects on the haematological system. The workers in these factories are exposed daily to this toxic dust. Those exposed to the cement dust may suffer from changes in platelet count and eventually suffer from damaging effects on the cardiovascular system.</p> <p><strong>Objective: </strong>Assess the effects of cement dust on platelet count of cement mill workers.</p> <p><strong>Materials and Methods: </strong>Conduction of this cross sectional study took place in the Department of Physiology, Dhaka Medical College, Dhaka between July 2017 to June 2018. After fulfilling the ethical consideration, 46 apparently healthy male cement mill workers, working for 2 or more years in a cement mill , with range of age of 20 to 50 years (study group) and 46 BMI, age and socioeconomic condition matched apparently healthy male subjects from Dhaka city were control group. The platelet count was estimated using automated haematology analyzer in Dhaka Medical College Hospital, Dhaka. Data was collected in a pre-designed structured questionnaire form. Unpaired Student’s ‘t’ test and Pearson’s correlation coefficient test were performed for statistical analysis.</p> <p><strong>Results: </strong>In this study, the platelet count was significantly (p &lt; 0.05) higher than those of control group. The platelet count was directly related with duration of cement dust exposure.</p> <p><strong>Conclusions: </strong>This study concludes that the cement dust has harmful effect on the platelet count and the duration of exposure to cement dust also has an effect on this parameter.</p> <p>Medicine Today 2022 Vol.34(1): 44-46</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Thyroid Function Status during Different Trimesters in Bangladeshi Women 2022-03-13T11:20:50+00:00 Shyamal Chandra Banik Mahmuda Begum Farjana Ahmed Md Shamsuzzaman Kartick Chandra Saha <p><strong>Introduction: </strong>Gradual alteration of thyroid function occurs during different trimesters of gestation.</p> <p><strong>Objective: </strong>To observe thyroid function status in normal pregnancy.</p> <p><strong>Materials and Methods: </strong>This cross sectional study was conducted in the Department of Physiology, Sir Salimullah Medical College, Dhaka from July 2016 to June 2017. The study was approved by Institutional Ethical Committee. Total 120 female subjects, age ranged from 20 to 35 years were included in this study, among them 90 were healthy pregnant women and 30 were nonpregnant women. Serum TSH, FT4 &amp; FT3 levels were measured. The statistical analysis was done by ANOVA test and Bonferroni test.</p> <p><strong>Results: </strong>In this study, mean serum TSH level was lower in 1st &amp; 2nd trimester and higher in 3rd trimester than that of nonpregnant group. Again it was gradually higher from 1st to 3rd trimesters of gestation and the difference was statistically significant (p&lt;0.05, p&lt;0.001, p&lt;0.01) in between the groups. Mean serum FT4 &amp; FT3 levels were higher in 1st trimester and lower in 2nd &amp; 3rd trimesters of gestation than that of nonpregnant group. Again, both these levels were gradually lower from 1st to 3rd trimesters of gestation and the difference was statistically significant (p&lt;0.001, p&lt;0.001, p_0.01) in between the groups.</p> <p><strong>Conclusion: </strong>Gradual alterations of thyroid function status were observed during pregnancy. Serum TSH level was gradually higher and both serum FT4 &amp; FT3 levels were gradually lower from 1st to 3rd trimesters of gestation.</p> <p>Medicine Today 2022 Vol.34(1): 47-50</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Bacteriological Profile and Their Antimicrobial Susceptibility Pattern of Urinary Tract Infection Patients Attending at the Nephrology Department of Enam Medical College and Hospital, Savar, Dhaka. 2022-03-13T11:24:43+00:00 Md Shamimur Rahman Mejbah Uddin Ahmed Bhuiyan Mohammad Mahtab Uddin Rezaul Karim Chowdhury Harun Ur Rasid Amina Begum <p><strong>Introduction: </strong>Urinary tract infection (UTI) is one of the common bacterial infections encountered by clinicians in clinical practice. Distribution and susceptibility of UTI-causing pathogens change according to time and place. Area-specific studies to gain knowledge about the type of pathogens and their resistance patterns may help the clinician to choose the proper antimicrobials for empirical treatment.</p> <p><strong>Objective: </strong>This study was conducted to determine the distribution and antimicrobial susceptibility of uropathogens.</p> <p><strong>Materials and Methods: </strong>This study was conducted in the Enam Medical College &amp; Hospital, savar, Dhaka between January 2021 to June 2021 to identify the organisms causing UTI and their antibiotic susceptibility. Clean catch midstream urine samples were collected from 476 clinically suspected UTI patients and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed by Kirby-Bauer disk diffusion method.</p> <p><strong>Results: </strong>The prevalence of UTI was higher in females than in males. Out of the 170 culture positive bacterial isolates Escherichia coli was the most common 51.76% organism, followed by Staphylococcus aureus 28.82%, Staphylococcus saprophyticus 11.17%, Klebsiellaspp 8.23 % and Enterococcusspp 4.70%. Meropenem (100%) followed by Imipenem (92.86% to 100%) were found most susceptible drugs. While Trimethoprim-sulfamethoxazole and Cephradine were the most resistant drug against the isolated uropathogens.</p> <p><strong>Conclusion: </strong>As bacterial drug resistance is an evolving process, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs.</p> <p>Medicine Today 2022 Vol.34(1): 51-56</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Prevalence of Oral Candidiasis among Children Caused by Different Candida Species 2022-03-13T11:31:47+00:00 Tanzila Rawnuck Md Selim Reza Rajib Ahmed Mohammad Fatteh Ul Islam ABM Iftekhar Hossain Negar Sultana Shabiha Monwar <p><strong>Introduction: </strong>Oral candidiasis, which is caused by Candida species by the involvement of hard and soft palates, tongue, buccal mucosa, and floor of the mouth, is becoming a very common threat to oral health. Although in the majority of the cases, this infection is caused by Candida albicans which is a normal commensal organism in humans, however, it might be also caused by other Candida species, such as C. glabrata, C. tropicalis, and C. krusei.</p> <p><strong>Objectives: </strong>This study aimed to evaluate the prevalence of oral candidiasis among children and to compare the type of causative candida species among them.</p> <p><strong>Materials and Methods: </strong>This prospective observational study was conducted in the Shishu Hospital, Shamoly, Dhaka, spanned January 2016 through December 2016. A total of 286 oral swab samples were collected, and three methods including direct wet mount smear, staining, and culture were used for laboratory investigation of Candida infections.</p> <p><strong>Results: </strong>Among 286 respondents, 161 (56.29%) were culturally and microscopically confirmed to have oral candidiasis. Among all of the detected species, C. Albicans was by far the highest species with 139(86.34%) followed by C. tropicalis with 14 (8.68%). Whereas 05(3.12%) cases were infected by C. krusei. On the other hand, the least detected species were C. glabrata and C. guilliermondii with 01(0.62%) and 02(1.24%) respectively.</p> <p><strong>Conclusion: </strong>These days accurate and prompt identification of the infectious candida strains is crucial because isolates of Candida species differ extremely, both in their ability to produce infection and also in their susceptibility to antifungal agents.</p> <p>Medicine Today 2022 Vol.34(1): 57-60</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Laboratory Parameters of Dengue Infection in a Medical College Hospital 2022-03-13T11:56:29+00:00 Sabikun Nahar Chowdhury Md Nazrul Islam Md Mahabubur Roshed Md Mokter Hossain Sukumar Saha <p><strong>Introduction &amp; objective: </strong>Dengue is an acute illness caused by Aedes mosquito, commonly caused by Aedes aegypti. It is an endemic disease in South East Asian countries especially in Bangladesh. In 2019 a outbreak occurred in Bangladesh. The objective of the study was to see the laboratory parameter and outcome of dengue fever in a tertiary medical college hospital. Early diagnosis and laboratory investigations is essential to prevent the mortality associated with this disease.</p> <p><strong>Materials &amp; Methods: </strong>This prospective study was conducted on dengue ward at Khulna medical college hospital from 1 July 2019 to 31 December 2019. The diagnosis of dengue infection was confirmed by serology. Sera were processed by dengue ELISA. Investigations like haemoglobin estimation, haematocrit, platelet count, total count; differential leukocyte count, peripheral smear, coagulation profile were performed.</p> <p><strong>Results: </strong>Total number of cases was 98. Of them 62 (63.2%) was male and 36 (36.73%) was female. Fever was most common (100%) manifestation and duration of fever ranges from 5 to 8 days with a mean duration of 6.31 (± 0.95) days. Blood for NS1 was positive in 90 (91.83% ) cases; most cases 71 (72.44%) become positive between 2nd to 4th day. 90 (91.83%) cases developed thrombocytopenia and it starts at 5th day in 45 (45.91%) cases. Anti IgM was positive in 4 (4.08%) cases; 2 at 4th day and 2 at 5th day of illness. IgG was positive in case at 8th day of illness.</p> <p><strong>Conclusion: </strong>These findings help physicians in early diagnosis of dengue by suspecting these features as of dengue and can prevent morbidity and mortality associated with dengue.</p> <p>Medicine Today 2022 Vol.34(1): 61-64</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Common Microorganisms Present in Diabetic Foot Infection and It’s Spectrum of Antibiotic Sensitivity 2022-03-13T12:00:54+00:00 Md Ziaur Rahman Mir Jalal Uddin Abdul Hamid Mollah Himika Hasan khan AKM Ziaul Kabir <p><strong>Introduction: </strong>Diabetic patients have foot problems secondary to neuropathy, micro-vascular changes and impaired resistance to infection. They are at increased risk of infection and ulceration. Diabetic ulcers are frequently involved in both aerobe and anaerobe microorganisms. It is important to culture the specimen on several different media. The Gram stain can provide valuable information regarding the range of organisms under consideration. The aim of this study is to identify the sensitive antibiotics to the specific aerobic bacteria, to prevent the random misuse of broad spectrum antibiotics and make awareness about diabetic foot care.</p> <p><strong>Materials and Methods: </strong>This study was a retrospective analysis and was carried out in general surgery and diabetic wards at North Bengal Medical College Hospital (NBMCH), Sirajganj, Bangladesh from August, 2019 to July, 2020. To identify common aerobic microorganism and spectrum of antibiotic sensitivity from 54 cases of diabetic foot ulcers, wound swabs taken and cultured using standard aerobic microbiological techniques. Antibiotic sensitivity testing to different antimicrobial agents were carried out using the disc diffusion method.</p> <p><strong>Result: </strong>Among 54 aerobic bacterial isolates, Gram negative bacteria 41(75.9%) and Gram positive bacteria 13(24.1%). Escherichia Coli 28(51.9%), Proteus spp 09(16.7%), Pseudomonas 03(5.6%), Klebsiella spp 01(1.9%) were isolated Gram negative bacteria. Staphylococcus aureus 13(24.1%) was only Gram positive bacteria. Gram negative bacterial isolates were sensitive to Imipenem, while Vancomycin showed good activity against Gram positive bacteria.</p> <p><strong>Conclusion: </strong>The antibiogram results of this study suggest that bacteria remain sensitive to a limited number of used agents, while found resistant to a number of widely used agents. Imipenem was most effective against Gram negative bacilli and also effective against Gram positive cocci.</p> <p>Medicine Today 2022 Vol.34(1): 65-69</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Antibiotic Sensitivity in Complicated and Uncomplicated UTI in Potuakhali Medical College Hospital 2022-03-13T12:05:26+00:00 FM Atiqur Rahaman Sheikh Anika Rahman Tohfatun Nesa Nitu Faria Sharif Jamil Khan <p><strong>Introduction</strong>: Urinary tract infection (UTI) is a common reason for attending hospital emergency departments (ED). A complicated urinary tract infection (UTI) is associated with structural or functional abnormalities of the genitourinary tract or presence of any underlying disease.</p> <p><strong>Objective: </strong>To assess the antibiotic sensitivity in complicated and uncomplicated UTI.</p> <p><strong>Materials and Methods: </strong>The study was carried out in the Department of Medicine and Department of Microbiology. The urine samples were collected from the OPDs (outpatients departments). These sample collection sites were chosen as they mostly covered the urban area of the city. The duration of the study was one and a half year from July 2018 to January 2020. The urine samples of 200 patients, comprised of 60 males and 140 females, who attended the outpatient departments (OPDs) of three hospitals and had clinical evidence of urinary tract infection, determined by treating physicians, were included in this study.</p> <p><strong>Results: </strong>Most common isolated pathogen was Eschericia coli 170(85.0%) followed by staphylococcus aureus 40(20.0%) and Klebsiella (10%). Multiple organisms were found few cases. Regarding drug sensitivity it was observed that maximum sensitivity was to Amikacin 94.0% followed by Nitrofurantoin 92.0%, Levofloxacin 90.0%, Meropenam 88.0%, Amoxicillin+Clavulanate 70.0% and Cefixim 70.0%.</p> <p><strong>Conclusion: </strong>Female patients were predominant most common isolated pathogen were Eschericia coli, staphylococcus aureus and Klebsiella. Amikacin, Nitrofurantoin, Levofloxacin, Meropenam and Amoxicillin+Clavulanate were more sensitive antibiotic.</p> <p>Medicine Today 2022 Vol.34(1): 70-74</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Sonological Evaluation of Ectopic Pregnancy-an Analysis of 50 Cases 2022-03-13T12:10:33+00:00 Dipu Das Sandip Kanungo Shahina Akhter Natia Rahnuma <p><strong>Introduction: </strong>Ectopic pregnancy is the implantation of a fertilized egg in a location outside of the uterine cavity, including the fallopian tubes, cervix, ovary, cornual region of the uterus, and the abdominal cavity.</p> <p><strong>Objective: </strong>To evaluate the sonological findings of ectopic pregnancy.</p> <p><strong>Materials and Methods: </strong>A descriptive study was carried out at ultrasound unit in Lab-Aid diagnostic, Comfort Medical Services and Green View Diagnostic Complex in Sylhet city between January 2012 to January 2014. We included all cases with confirmed diagnosis of ectopic pregnancy, all antenatal mothers who are present in antenatal unit in a selected Hospital and excluded mothers with other associated medical condition.</p> <p><strong>Results: </strong>Common clinical pattern were shock, marked pallor ness, abdominal pain, amenorrhea and irregular vaginal bleeding 52%, 66%,62%,54% and 38% respectively. Risk factor of ectopic pregnant in this study, 40% had history of infertility, 06% had Non tuberculous PID, 70% had no risk factor, 04% had tuberculous PID, 14% had previous abdominal pelvic surgery, 18% had previous ectopic and 10% had endometriosis.</p> <p><strong>Conclusion: </strong>Common clinical pattern were shock, marked pallor ness, abdominal pain, amenorrhea and irregular vaginal bleeding. History of infertility, Non tuberculous PID, no risk factor, tuberculous PID, previous abdominal pelvic surgery, previous ectopic and endometriosis were risk factor of ectopic pregnant in this study.</p> <p>Medicine Today 2022 Vol.34(1): 75-78</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today Contraceptive Methods Used by the Selective Rural Tea Garden Workers of Sylhet 2022-03-13T12:13:30+00:00 Rifat Jahan Md Monjurul Habib Choudhury ASM Mashrurul Haque Md Oliur Rahman Chowdhury Shah Ferdous Chowdhury Progya Laboni Tina <p><strong>Introduction: </strong>This study was focused on contraceptive methods used by the selective Tea garden workers of Sylhet. The aim was to explore the used of the contraceptive methods and factors influencing the use of the contraceptive methods along with socio-demographic profile of the tea garden workers.</p> <p><strong>Materials and Methods: </strong>It was descriptive type of cross-sectional study carried out in some selective tea garden of Sylhet from July-December, 2020. 150 respondents were selected by purposive type of non-probability sampling method. Data were collected by a pretested mixed type questionnaire.</p> <p><strong>Results: </strong>The study revealed that 90 (60%) of workers belonged to of 20-29 years age group. The mean age was 33.87 ± 8.97. Most of the respondents 104 (69.3%) were female, 117 (78%) were followers of Hinduism, 109 (72.7%) were illiterate, 136 (90.7%) were from the nuclear family and 129 (86%) were belonged to lower class. Majority of the workers 136 (90.7%) were using contraceptive methods, among them 78 (57%) were using injectable contraceptive but no one use permanent methods. Most of them used contraceptive methods for prevent unwanted pregnancy and reduced family expenditure that was 46 and 40 (34% and 29%). The survey assessed the positive association between use of contraceptive methods and sex, religion (p&lt;0.05).</p> <p><strong>Conclusion: </strong>Due to covid situation, the present study was conducted among only 150 respondents. Large scale survey is necessary to find out the exact pattern of contraceptive methods use throughout the tea garden workers.</p> <p>Medicine Today 2022 Vol.34(1): 79-82</p> 2022-04-24T00:00:00+00:00 Copyright (c) 2022 Medicine Today