Medicine Today <p>A professional medical journal recognised by the Bangladesh Medical and Dental Council (BMDC).</p> National Doctors Forum en-US Medicine Today 1810-1828 Keratoacanthoma, Verruca Vulgaris Arising over Porokeratosis of Mibelli : A New Association <p><strong>Introduction: </strong>This case report highlighting the presence of keratoacanthoma and verruca vulgaris over the lesion of porokeratosis of mibelli.</p> <p><strong>Case Report: </strong>In this case a 50-year-old housewife came with large well-defined asymptomatic plaque over the upper part of back of the trunk for last 10 years. After evaluation we got the presence of keratoacanthoma and verruca vulgaris on the plaque of porokeratosis of mibelli.</p> <p><strong>Discussion: </strong>Porokeratosis is a clonal expansion of keratinocytes. Among the neoplasm squmous cell carcinoma (SCC) is the most commonly reported malignancy in porokeratosis. But in our case we didn’t find lesion of SCC. Porokeratosis of Mibelli, Keratoacanthoma and Verruca vulgaris have an association with human papilloma virus(HPV). This eithopathogenesis may be related to our clinical finding.</p> <p><strong>Conclusion: </strong>There were reporting of squmous cell carcinoma or keratoacanthoma on Porokeratosis of Mibelli. But in our case we found both Keratoacanthoma and Verruca Vulgaris over Porokeratosis of Mibelli.</p> <p>Medicine Today 2021 Vol.33(2): 172-175 </p> ATM Asaduzzaman Mohammad Lutfur Rahman Rahat Mohammad Jamal Uddin Mohammod Abu Hena Chowdhury AKM Rejaul Haque Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 172 175 10.3329/medtoday.v33i2.56068 Determination of Red Blood Cell Distribution Width in Patients with Primary Cutaneous Vasculitis Compared to Systemic Vasculitis <p><strong>Introduction: </strong>Red blood cell distribution width (RDW) has been considered as an inflammatory marker in various disorders. Evaluation of RDW value can also be used as a novel and additional marker for differentiating systemic vasculitis from primary cutaneous vasculitis. Objective: To compare RDW value between patients with cutaneous vasculitis with systemic vasculitis, thereafter to find out it's role as an effective indicator to distinguish both forms of vasculitis.</p> <p><strong>Materials and Methods: </strong>This cross sectional observational study was conduct between from July 2016 to December 2017. Total of 48 patients were divided into primary cutaneous vasculitis and systemic vasculitis. Blood was collected in EDTA tube to measure RDW value. Patient’s disease activity also scored and plotted according to Birmingham vasculitis activity score. Statistical analysis was performed by using SPSS.</p> <p><strong>Results: </strong>Significantly high mean RDW were found in patients with systemic vasculitis compared to primary cutaneous vasculitis (15.09±0.92 vs. 13.48±1.1, p = 0.000). BVAS was significantly greater (13.93±5.10 vs. 4.87±2.69, p = &lt; 0.001) in systemic vasculitis as well as in patients with high RDW group (11.73±5.71 vs. 5.37±3.96, p = &lt; 0.001). Optimal RDW cut off point for differentiating systemic vasculitis from cutaneous vasculitis was 14.2 with 81.3% sensitivity and 81.2% specificity.</p> <p> <strong>Conclusion: </strong>Present study revealed importance of RDW monitoring along with disease activity in patients with any form of vasculitis. Systemic vasculitis had higher level of RDW. So RDW can be considered as a marker to discriminate systemic vasculitis from primary cutaneous vasculitis.</p> <p>Medicine Today 2021 Vol.33(2): 84-89</p> Farhana Wahab Mohammad Jamal Uddin ATM Asaduzzaman Mohammod Abu Hena Chowdhury Hasan Mahmud Rehnuma Nasim Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 84 89 10.3329/medtoday.v33i2.56049 Space Closure Rate in Mandibular Canine Retraction by Ni-Ti Closed Coil Spring: A Clinical Trial <p><strong>Introduction: </strong>In Majority of patients seeking orthodontic treatment, teeth must be extracted in order to obtain proper esthetics, occlusion, and stability as well as extraction of teeth is often a need to close residual space, after the initial decrowding and aligning. Pre adjusted fixed orthodontic appliances commonly utilize sliding mechanics for space closure with different types of force delivery systems. A variety of materials have been used as force delivery systems to close spaces between teeth as in the case of canine retraction after the extraction of premolars. Among all sliding or frictionless methods of canine retraction, super-elastic nickel titanium coil spring has a particular property in producing light continuous force at a long range of action, compared with previously available materials. Nickel-titanium closed coil spring, with a continuous action, might have some advantages in fixed appliance space closure mechanics.</p> <p><strong>Materials and Methods: </strong>Over the period of one year from May 2015 to April 2016, this clinical trial was carried out and A total number of 20 patients (40 quadrants), who required canine retraction into first premolar extraction sites as part of their orthodontic treatment in the Department of Orthodontics of BSMMU selected as study population. The quadrants were affixed by nickel titanium closed coil springs (medium force, Ni-Ti extension spring, Ormco) with 200gm force measured by Correx Tension Gauge. Space closure was measured by means of direct measurement from the mesial surface of mesial wing of the 2nd premolar bracket and the distal surface of distal wing of the canine bracket with digital Vernier Calipers.</p> <p><strong>Results: </strong>Mean space closer rate in mandibular canine retraction was 1.07 ± 0.12 mm/month by nickel-titanium (Ni-Ti) closed coil spring method with p value&lt;0.001.</p> <p><strong>Conclusion: </strong>This study revealed that space closer rate in mandibular canine retraction by nickel-titanium (Ni-Ti) closed coil spring is 1.07 ± 0.12 mm/month.</p> <p>Medicine Today 2021 Vol.33(2): 90-93</p> Md Kamrul Hasan Gazi Shamim Hassan Samira Rahman Md Sher Ali Md Azizur Rahman Md Mahfuj Hasan Rokeya Rahman Tani Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 90 93 10.3329/medtoday.v33i2.56050 Coexistence of Pelviureteric Junction Obstruction and Vesicoureteral Reflux <p><strong>Introduction: </strong>The most common upper urinary tract problem in children is obstruction at the pelviureteric junction. It happens with varying degrees of seriousness. Ultrasonography and DTPA (Diethylene Triamine Penta-acitic Acid) renography are commonly used to detect it. Objective: To find out the coexistence of ipsilateralpelviureteric junction obstruction with vesicourenteral reflux.</p> <p><strong>Materials and Methods: </strong>This prospective study was conducted in the Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2006 to May 2007 over a period of 1 year 5 months. Thirty-five patients with unilateral hydronephrosis due to PUJ obstruction were included in this study (age: 1 month-15 years). Results were analyzed using Statistical Package for Social Science (SPSS).</p> <p><strong>Results: </strong>Incidence of Vesicoureteral reflux (VUR) among pelviureteric junction (PUJ) obstruction patients was 8.6%. Of them Grade-I VUR was 33.3% and grade-II VUR was 66.7%. Mean age of the patients was 4.71 ± 1.97 years and with VUR was 9.33 ± 4.93 years. Male to female ratio was 4:1. Only 5.7% mothers had regular antenatal checkup and 28.5% had irregular. Majority of the patients 28 (80%) were presented with painless loin mass, 6 (17.1%) with fever, 8 (22.9%) with loin pain and 8 (22.9%) with failure to thrive. Three patients (8.6%) showed abnormal R/M/E and all of the abnormal R/M/E samples showed positive culture.</p> <p><strong>Conclusions: </strong>Incidence of Vesicoureteral reflux (VUR) among pelviureteric junction (PUJ) obstruction patients was 8.6%.</p> <p>Medicine Today 2021 Vol.33(2): 94-97</p> Md Asaduzzaman SM Abdullah Mohammad Abu Hanif Md Hasanuzzaman Rifat Naoreen Islam Shahnoor Islam Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 94 97 10.3329/medtoday.v33i2.56051 A Clinical Study of Visual Outcome after Nd YAG Laser Capsulotomy <p><strong>Introduction: </strong>Posterior capsular opacification is caused by migration and proliferation of cuboidal epithelium from remnant of anterior capsule and equatorial part of the lens capsule. Posterior capsular opacification also called after cataract is a nagging post surgical complication following phacoemulsification or non phaco cataract surgery (small incision cataract surgery or conventional cataract surgery) ECCE with posterior chamber intraocular lens implantation. Posterior capsular opacification is actually misnomer. Though there are many factors suggested to reduced posterior capsular opacification. The incidence of PCO still exists considerably. Aims and Objective are to find out the visual improvement after Nd yag laser posterior capsulotomy.</p> <p><strong>Materials and Methods: </strong>The prospective study was conducted in the department of ophthalmology of Ad-din Women Medical College Hospital, Dhaka, Bangladesh from June 2014 to June 2018. 175 patients of 189 eyes with significant PCO. Before laser capsulotomy all patients were assess by routine slit lamp examination, IOP measurement and posterior segment examination done for every patient for exclusion of Gross posterior segment pathology.</p> <p><strong>Results: </strong>The study had female preponderance (58.86%). Most of the patients 165 were 40 to 80 years old (87.31%). The patients had pre laser visual acuity 6/9 to 6/18 (31.75%) 6/24 to &lt;6/60 (68.25%). After laser capsulotomy functional visual acuity upto 6/8 were 169 (89.42%) and 6/24 to &lt;6/60 were 20 (10.58%). The mean pre and post laser capsulotomy visual functional score were 54.45±36.44 and 94.16±50.36 respectively.</p> <p><strong>Conclusion: </strong>Nd YAG laser capsulotomy is safe, non-invasive and effective procedure.</p> <p>Medicine Today 2021 Vol.33(2): 98-101</p> Md Abdul Matin Mahbubur Rahman Shahin Zakia Farhana Sajed Abdul Khaleque Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 98 101 10.3329/medtoday.v33i2.56052 Maternal Outcome of Anemic Pregnant Mother at Private Hospitals in Dhaka City <p><strong>Introduction: </strong>The study carried out among the pregnant women who had anemia during pregnancy with the objectives to determine their maternal outcome at private hospitals in Dhaka city.</p> <p><strong>Materials and Methods: </strong>The total sample size was 110. Data was collected by interviewing the respondents with a structured pre-tested questionnaire. The study was conducted in pregnant women with anemia at or after 28 weeks of gestation and had delivered at Obstetrics Department of Ad-Din Barrister Rafique ul-Huq Hospital, Jurain and Bashundhara Ad-Din Medical College Hospital South Keranigonj.</p> <p><strong>Results: </strong>Most of the respondents (38.2%) belonged to the age group between 16-20 years. The mean age was 23.74±5.127 years. Almost (49.1%) up to primary &amp; (38.2%) were up to secondary/higher secondary level. Most of the respondents were homemaker (87.3%); Monthly income means was 19340.91±12459.647. Most (90.9%) of the respondents had received ANC and 79.1% respondent’s hemoglobin level was below 10 gm. /dl. Among them 90.9% of the respondent’s fetal outcome were healthy &amp; alive baby. More than half (51.8%) of the respondent’s baby were _ 2.5 kg birth weight. Study also shows that 55.5% respondents had anemia after delivery, 28.2% had sickness and 22.7% were sulfured with complications after delivery. There was a significant relationship with low birth weights (LBW) to less high education.</p> <p><strong>Conclusion: </strong>All women should be given advice regarding diet in pregnancy with details of foods rich in iron. Dietary changes alone are not sufficient to correct an existing iron deficiency in pregnancy and iron supplements are necessary.</p> <p>Medicine Today 2021 Vol.33(2): 102-107</p> Muhammad Zahangir Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 102 107 10.3329/medtoday.v33i2.56053 Efficacy and Safety of Gabapentine and Duloxetine in Diabetic Peripheral Neuropathic Pain <p><strong>Introduction: </strong>Diabetic peripheral neuropathy (DPNP) is not uncommon now a days. As the pathophysiology is not completely understood, symptoms relief is still the main goal of treatment. Gabapentine and Duloxetine are being using around the world for this purpose. But clinical data regarding its efficacy and safety are not sufficiently available.</p> <p><strong>Materials and Methods: </strong>This prospective comparative clinical study conducted in Sylhet MAG Osmani Medical College and Sylhet Diabetic Hospital, Bangladesh from January 2013 to December 2013. Diagnosis of DPNP confirmed by Michigan Neuropathy Screening Instrument (MNSI) and Douleur Neuropathic en-4 (DN4). Patients were treated by Gabapentine (Group-A) and Duloxetine (Group-B); and followed up at 4th, 8th and 12th week of treatment using 11-point numerical pain rating scale (NRS), clinical global impression of change (CGIC) score and patient’s global impression of change (PGIC) score.</p> <p><strong>Results: </strong>A total of 72 patients with DPNP were recruited. Final comparison was done in 64 patients – 33 in Group-A and 31 in Group-B. Changes in NRS (p = &lt;0.001), CGIC (p = &lt;0.001) and PGIC (p = &lt;0.001) were statistically significant during the course of treatment. However, inter-group variation of NRS, CGIC and PGIC were not statistically significant at the beginning and 4th, 8th and 12th week of treatment. Insignificant adverse effects were noted between the groups in this study except constipation (p = 0.022) and nausea-vomiting (p = 0.01) of Duloxetine taking group.</p> <p><strong>Conclusion: </strong>Gabapentine and Duloxetine are equally effective in the treatment of DPNP with good safety profile.</p> <p>Medicine Today 2021 Vol.33(2): 108-113</p> Hussain Ahmad KM Hafizur Rahman Miftaul Jannat Chowdhury Monharul Islam Bhuiya Nurjahan Ferdous Md Abu Nayeem Chowdhury Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 108 113 10.3329/medtoday.v33i2.56054 Lipid Profile in Relation to Body Mass Index among Medical College Students in Dhaka, Bangladesh. <p><strong>Introduction: </strong>In Bangladesh, adolescents have unhygienic eating habits; often eating nutritionally unbalanced and junk &amp; fast food diet that is low in dietary fibre and high in cholesterol, simple sugars, fats and additive. These types of dietary habit lead to obesity and dyslipidaemia. Obesity is a worldwide health problem and it is associated with dyslipidaemia and other metabolic syndrome. Objectives: To observe the relationship between Body Mass Index (BMI) and lipid profile among medical college students in Bangladesh.</p> <p><strong>Materials &amp; Methods: </strong>This cross sectional observational study was conducted in Department of Medicine, Sir Salimullah Medical College &amp; Mitford Hospital, Dhaka, among the 100 undergraduate medical students. Detailed history, clinical examination and thorough investigations were done and the findings were recorded on a proforma. Data was processed and analysed with the help of computer program SPSS and Microsoft excel.</p> <p><strong>Results: </strong>Maximum subjects (57.0%) were in the age group 21-23 years. Mean age was 23.42±4.5 years. The prevalence of the different abnormal lipid profile including hypercholesterolaemia, low level of HDL, high level of LDL and hypertriglyceridaemia were: 22.0%, 31.0%, 30.0% and 28.0% respectively. Hypercholesterolaemia and hypertriglyceridaemia levels were significantly associated with increasing body mass index.</p> <p><strong>Conclusion: </strong>Overweight and obesity is common among the study subjects and those with higher BMI particularly the older ones tend to have abnormal lipid profile. Therefore adequate dietary control, food habit &amp; life-style modification is needed for prevention of dyslipidemia at early life.</p> <p>Medicine Today 2021 Vol.33(2): 114-119</p> Md Sakhawat Hossain Md Daharul Islam Asadullahil Galib Roksana Malek Khaleda Akter Maksuda Khanam Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 114 119 10.3329/medtoday.v33i2.56055 Colonoscopic Yield in Patients with Lower Gastrointestinal Bleeding – A Study of 309 Cases <p><strong>Introduction: </strong>This retrospective study was done to see colonoscopic yields in patients presenting with lower gastrointestinal bleeding.</p> <p><strong>Materials &amp; Methods: </strong>Reports of patients undergoing colonoscopy due to bleeding per rectum were retrieved from endoscopy records. Patients’ particulars and colonoscopic findings were recorded in a data sheet. Analysis was done using SPSS 20 version.</p> <p><strong>Results: </strong>A total of 309 patients (male 211 (68.3%) and female 98 (31.7) with mean age 40.3 years %)) were included in this study. According to colonoscopic yield, causes of LGIB were haemorrhoids 137 (44.33% ), rectal and colonic growth 58(18.77% ) rectal and colonic polyps 54 (17.47% ), anal fissure 38 (12.29% ), proctitis 18 (5.82%), colitis 18(5.82%), ileal ulcer and ileitis 34(11.0%). Colorectal growth was more common among patients age 26 to 60years. Among male rectal growth was slightly higher than female.</p> <p><strong>Conclusion: </strong>Lower gastrointestinal bleeding is more common among males. Commonest cause of LGIB are internal haemorrhoids, rectal growth, rectal and colonic polyps and anal fissure. Colorectal neoplasm, proctitis, colitis and ileal inflammation and ulcers constitute small part.</p> <p>Medicine Today 2021 Vol.33(2): 120-122</p> Madhusudan Saha Md Anisur Rahman Mohammad Zakaria Musammat Aklima Akter Hely Nasrin Aktar Habib Ullah Abir Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 120 122 10.3329/medtoday.v33i2.56056 Echocardiographic Right Heart Study in Patients with Chronic Obstructive Pulmonary Disease <p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes. Aims: We aimed to prospectively study the patients with diagnosed COPD with echocardiogram for evaluating the right heart.</p> <p><strong>Materials &amp; Methods: </strong>Our study was an observational, cross sectional study was done on 50 patients with COPD who were admitted at Department of Cardiology, CMCH and underwent echocardiographic evaluation from November 2017 –October 2018. All echocardiogaphic parameters focused on right heart and its function were assessed.</p> <p><strong>Results: </strong>Out of total 50 COPD patients studied, majority of them were male (46 patients ,92%). The mean age group of the studied patients was 58.4 ±7.7 years. Pulmonary hypertension defined as sPAP&gt;30 mmHg was evident in all of the patients; with 30 patients (60%), 14 (28 %) and 6(12 %) patients having severe, moderate and mild pulmonary hypertension respectively. RV dysfunction was evident with reduced average TAPSE values (1.59± 0.38 cm) and elevated RIMP values (0.58±0.16).</p> <p><strong>Conclusion: </strong>Majority of COPD patients had evidence of pulmonary hypertension. Echocardiogram can be a helpful tool to assess early changes on the right heart size and function in patients with COPD and also monitor these patients for rapid progression of the illness.</p> <p>Medicine Today 2021 Vol.33(2): 123-128</p> Kazi Shamim Al Mamun Mohammad Ibrahim Chowdhury Muhammad Khurshed Alam Syedul Alam Khuryshi SM Ifteakharul Islam Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 123 128 10.3329/medtoday.v33i2.56057 A Study on Seasonal Variation of Bell’s Palsy in a District Area of Bangladesh <p><strong>Introduction: </strong>Bell’s palsy is a common cranial neuropathy causing acute onset of unilateral lower motor neuron type of seventh cranial nerve palsy that result in ipsilateral facial muscle weakness. The aim of this study was to determine the possible correlation of Bell’s palsy and seasonal influence in a district area of Bangladesh.</p> <p><strong>Materials &amp; Methods: </strong>This is an observational study in which we collect, compiled and analyzed the patients information who attended in outpatient department of neuromedicine unit at Cumilla medical college hospital Cumilla from January 2018 to December 2019.</p> <p><strong>Results: </strong>In our study, out of 214 patients male were 117(54.7%) and female were 97(45.3%). Age range from 4 to 90 yrs, median age was 40.0±17.6 Number of patients with Bell’s palsy presented in various seasons include 44% during winter, 35% during summer, 9% during fall monsoon and 12% during autumn period. We analyzed the data by using Mean±SD and chi-square test. A significant association was evident in winter and summer season (P=0.04 and P=0.045) respectively.</p> <p><strong>Conclusion: </strong>In our present study we found significant relation between seasonal variation and occurrence of Bell’s palsy.</p> <p>Medicine Today 2021 Vol.33(2): 129-132</p> Panchanan Das Nazmul Hasan Chowdhury Abdullah Al Hasan Mohammad Abul Kalam Azad ANM Ilias Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 129 132 10.3329/medtoday.v33i2.56058 Non-viral Microbial Keratitis in a Tertiary Care Hospital in Bangladesh <p><strong>Introduction: </strong>Microbial keratitis is a serious ocular infectious disease that can lead to significant visual loss and ophthalmic morbidity. Objectives were to see the profile of non-viral microbial keratitis in a tertiary care hospital in Bangladesh.</p> <p><strong>Materials and Methods: </strong>This cross-sectional study was conducted in the Department of Ophthalmology, Sylhet MAG Osmani Medical College Hospital, Sylhet between January 2015 and December 2016.</p> <p><strong>Results: </strong>The mean age of the patients was 46.7 ± 16.5 years with male preponderance (54.4%). The most common predisposing factors were trauma (66.7%), and chronic dacryocystitis (25.6%). Fungal growth was more frequent compared to bacterial growth 70 (77.7%) versus 30 (33.3%), p&lt;0.01). Gram positive organisms were Staphylococcus epidermidis (11.1%), Staphylococcus aureus (3.3%); gram negative organisms were Pseudomonas aeruginosa (12.2%), Klebsiella species (3.3%) and Escherichia coli (3.3%). Aspergillus species (71.4%) was the commonest fungus. Others were Penicillium species (7.1%), Fusarium species (8.6%), Mucor (10.0%) and Rhizopus (2.9%).</p> <p><strong>Conclusion: </strong>Fungi are more frequent cause of non-viral keratitis. Watering, redness, pain or burning sensation, corneal opacity and dimness of vision are clinical profiles of non-viral microbial keratitis.</p> <p>Medicine Today 2021 Vol.33(2): 133-137</p> Mohammed Selim Reza Shamsul Alam Chowdhury Paritush Kanti Talukder Md Tabibul Islam Md Altaf Hossain Nizam Jamil Hussain Azima Aktar Jhuma Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 133 137 10.3329/medtoday.v33i2.56059 Evaluation of Gartland Type-III Closed Supracondylar Fracture of Humerus in Children Treated by Lateral Percutaneous K-Wires under C-Arm Guidance <p><strong>Introduction: </strong>This study has been designed to evaluate the success rate of closed reduction and stabilization by two lateral parallel percutaneous K-wires with the help of C-arm in the management of Gartland type-III closed supracondylar fracture of humerus in children.</p> <p><strong>Materials and Methods: </strong>A prospective quasi experimental study was conducted from January 2015 to December 2016 in NITOR. A total of 30 patients of Gartland type-III closed supracondylar fracture of humerus in children presenting between ages 3-12 years. Informed written consent was taken from patient’s guardian. Regular follow up was targeted for at least 6 month’s. Result was evaluated according to Flynn’s grading.</p> <p><strong>Results: </strong>Mean age was 6.85± 2.37 years, number of patients ware 30, Male patients were more affected 22 (73.33%) than female 8(26.67%), left side patients were more affected. Mean loss of elbow flexion was 9.53 degrees, mean loss of carrying angle was 8.5 degrees. Complications included four (13.33%) cases of pin tract infection, four (13.33%) cases of fracture blister, one (3.33%) case of median nerve palsy, two (6.66%) cases of inadequate pin fixation at first attempt. There were six excellent (20%), eighteen good (60%), three (10%) fair and three (10%) poor results according to Flynn’s grading. The overall 90% satisfactory result and rest 10% unsatisfactory result.</p> <p><strong>Conclusion: </strong>Closed reduction and stabilization by two lateral parallel percutaneous K-wires is a better method for treatment of Gartland type-III closed supracondylar fracture in children.</p> <p>Medicine Today 2021 Vol.33(2): 138-142</p> Md Insanul Alam Sheikh Firoj Kabir Md Faridul Islam Md Ismail Hossain Md Omar Faruque Hosne Ara Md Rezaul Alam Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 138 142 10.3329/medtoday.v33i2.56060 Outcome of Preterm Labour in SSMC Mitford Hospital, Dhaka. <p><strong>Introduction: </strong>: Preterm birth as a consequence of preterm labour is the major clinical problem associated with perinatal mortality, serious neonatal morbidity and moderate to severe childhood disability and two-thirds of all perinatal deaths. Moreover, preterm labour comprises a large number of low birth weight babies. Global incidence of preterm labour is 5-10% of all births. The aim of this study was to determine the clinical profile and to find out pregnancy outcomes of preterm labour.</p> <p><strong>Materials &amp; Methods: </strong>This cross-sectional study was conducted in Sir Salimullah Medical College Mitford Hospital, Dhaka from January 2005 to December 2005. A total 103 gravid women who got admitted with established premature labour pain were included as study patients. Preterm labour associated with severe pre-eclampsia, eclampsia, antepartum haemorrhage and intrauterine fetal death were excluded. Data were collected in a pre-designed questionnaire and analyzed by SPSS software.</p> <p><strong>Results: </strong>Incidence of preterm labour was found 6.3%. Among maternal morbidities, puerperal sepsis found to be highest (14.56%) followed by UTI (7.77%), PPH (6.80%), wound infection (5.83%) and retained placenta (3.88%). This study found perinatal mortality 32.0% and morbidity 49.5% of which RDS contributed highest (24.27%) followed by neonatal jaundice (11.65%), septicemia (8.73%), neonatal convulsion (2.91%) and umbilical sepsis (1.94%).</p> <p><strong>Conclusion: </strong>Preterm labor followed by preterm birth significantly contributes to maternal morbidity and perinatal morbidity and mortality.</p> <p>Medicine Today 2021 Vol.33(2): 143-146</p> Mamata Manjari Lipika Ghosh Rokhshana Khatun Jahanara Akter Md Mohim Ibn Sina Mohammad Mizanoor Rahman Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 143 146 10.3329/medtoday.v33i2.56061 Correlation of Carotid Artery Intima-Media Thickness with Age, Body Mass Index and Glomerular Filtration Rate in Chronic Kidney Disease Patients <p><strong>Introduction: </strong>Ultrasound measurements of the intima media thickness (IMT) in the carotid arteries is a strong predictor for cardiovascular events both in the general and diseased population.</p> <p><strong>Materials &amp; Methods: </strong>This cross-sectional analytic study was conducted to observe correlation of CIMT with age, body mass index (BMI) and glomerular filtration rate (GFR) in chronic kidney disease (CKD). The study was done in Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, on 80 chronic kidney disease patients, from July 2014 to June 2015. All the biochemical parameters were measured according to the standard laboratory techniques. Body mass index (BMI) was calculated by person’s body weight divided by height. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease (MDRD) formula. CIMT measurement was done by duplex study of carotid vessels through high resolution B-mode ultrasound.</p> <p><strong>Results: </strong>Mean age of the patients was 36.1±9.5 years. 20 (25%), 26 (32.5%) and 34 (42.5%) patients were in CKD stage 3, 4 and 5 respectively. Age, serum creatinine and GFR showed statistically significant difference among stage 3, 4 and 5 CKD patients (p&lt;0.001). However, no difference was evident in BMI and mean CIMT among stage 3, 4 and 5 CKD patients. Significant positive correlations were found between age and CIMT (r=+0.332; p=0.003) and BMI and CIMT (r=+0.294; p=0.008). However, no significant correlation was evident with estimated glomerular filtration rate (eGFR) and CIMT (r=–0.181; p=0.109).</p> <p><strong>Conclusion: </strong>Age, serum creatinine and estimated glomerular filtration rate showed statistically significant difference among different stages of CKD patients (stage 3, 4 and 5). There were significant positive correlations found in between age and CIMT as well as BMI and CIMT in chronic kidney disease patients, with an exception to GFR and CIMT.</p> <p>Medicine Today 2021 Vol.33(2): 147-151</p> Amir Mohammad Kaiser Rafi Nazrul Islam Miliva Mozaffor Salahuddin Feroz Md Mustafizur Rahman Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 147 151 10.3329/medtoday.v33i2.56062 Early Neonatal Outcome of Clinically Diagnosed Fetal Distress in Low Resource Areas <p><strong>Introduction: </strong>Fetal distress is a high risk obstetric situation associated with increased perinatal morbidity and mortality. It is also a major contributor to operative interventions in the majority hospitals of developing countries. The objective of this study was to observe clinically diagnosed fetal distress and early neonatal outcome after delivery.</p> <p><strong>Materials and Methods: </strong>This hospital based cross-sectional study was carried out in Department of Obstetrics and Gynecology at Bashundhara Addin Medical College Hospital, Keraniganj during the period of January to December 2019. 212 women in active phase of labor at term pregnancy who met the inclusion and exclusion criteria were enrolled. Fetal distress was diagnosed by abnormal FHR and /or presence of meconium in amniotic fluid after rupture of membrane. Neonatal outcome was assesss by 1st &amp; 5th mins Apgar Scores after delivery, babies requiring immediate resuscitation and admission to neonatal care unit &amp; recorded.</p> <p><strong>Result: </strong>Among fetal distress 11.32% babies had Apgar score &lt;7 as compared to babies without fetal distress that had 5.66% apgar score &lt;7 at 5th minutes(p&lt;0.05). 28.3% fetal distressed born babies required NICU admission rather than only 9.44% of without fetal distress.</p> <p><strong>Conclusion: </strong>This study shows relative adverse neonatal outcome for fetal distressed babies than without distress.</p> <p>Medicine Today 2021 Vol.33(2): 152-155</p> Arifa Akhter Asma Begum Nadira Sultana Shampa Saha Mubina Nuzhat Chowdhury ANM Saifullah Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 152 155 10.3329/medtoday.v33i2.56063 Clinical Profile and Outcome of Acute Poisoning Cases in Children Living in a Rapidly Urbanizing Area <p><strong>Introduction: </strong>Acute poisoning is a common childhood emergency in Bangladesh. In many cases history and clinical features fail to identify the offending agent. This study was done to identify the specific clinical findings related with the source of poisoning and assess the outcome.</p> <p><strong>Materials and Methods: </strong>It was a prospective study done from January to June 2020, among 75 indoor children of Tangail District Hospital. A preformed structured questionnaire was filled up by data collected from direct interview with the parents or caregivers, hospital records, during clinical examination.</p> <p><strong>Results: </strong>We found the mean age of the study population 5.5±1.5 years having male preponderance 1.6:1 in ratio. Kerosene 16(21.33%) and organophosphorus compound 15(20%) were the most common etiological agents and accidental (85%) was the most common mode of poisoning. Most of the cases were asymptomatic 25(33.3%). We encountered only 5(6.6%) death having 62(82.6%) complete recovery.</p> <p><strong>Conclusion: </strong>Acute poisoning still remains a major cause of child death in Bangladesh. History remains the main information for early diagnosis. We should take necessary steps to prevent exposure to poisonous material in children to reduce related burden of hospitalization, mortality and morbidity.</p> <p>Medicine Today 2021 Vol.33(2): 156-159</p> Md Nurul Islam Naimur Rahman Ringku Md Saiful Islam Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 156 159 10.3329/medtoday.v33i2.56064 Clinical Outcome and Operative Findings with Ectopic Pregnancy at Tertiary Medical College & Hospital <p><strong>Introduction: </strong>An ectopic pregnancy is an emergency condition worldwide now a days which defined as a pregnancy that progresses after implantation of the blastocyst anywhere other than the endometrium lining the uterine cavity. Objective: In this study our main goal is to identify clinical outcome and operative situation in patients.</p> <p><strong>Materials and Methods: </strong>This descriptive study was performed from January 2015 to December, 2018 at tertiary medical College &amp; Hospital. During the study 200 patients were evaluated and data was extracted from socio-demographic, menstrual, obstetric and clinical history of the patients.</p> <p><strong>Results: </strong>most of the patients belong to 30 years (19.7%) age group and history of pelvic infection (26.26%), induced abortion (17.4%), previous MR (16.26%) and sub fertility (11.25%) were common risk factor in ectopic pregnancy found in the study. Also majority of the patients faced laparotomy followed by right sided salphinogectomy (40.40%) which was the most common operation.</p> <p><strong>Conclusion: </strong>quick diagnosis, classifying of risk factors and timely intervention in the form of surgical treatment is necessary for reduction mortality rate in ectopic pregnancy.</p> <p>Medicine Today 2021 Vol.33(2): 160-164</p> Fahmida Sultana Gulshan Ara Sayma Afroz Rokshana Parvin Nupur Mashah Binte Amin Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 160 164 10.3329/medtoday.v33i2.56065 Teacher-Student Relationship in Obstetrics and Gynaecology Department in Different Medical Colleges of Bangladesh <p><strong>Introduction: </strong>Teacher-student relationship is very important element in education to enhance the effectiveness of teaching and learning process. There are multiple factors affecting this relation. If we analyze these factors and take measures to improve these, there will be better relation; and teaching learning will be improved.</p> <p><strong>Materials &amp; Methods: </strong>This descriptive type of cross-sectional study was carried out in obstetrics and gynaecology department of selected medical colleges of Bangladesh. Five government &amp; three non-government medical colleges were selected purposively situated both in Dhaka and outside during the period of July 2017 to June 2018. Total 170 students and 30 teachers were responded through self-administered semi-structured questionnaire with five points Likert scale. 20 teachers were responded through in-depth interview schedule. Quantitative data analyzed by SPSS version 19. Qualitative data analyzed manually.</p> <p><strong>Results: </strong>Study revealed that multiple factors were related to the relation among medical teachers and students. Mutual respect, empathy, Good listening skill, mutual respect, sharing expectation, self-disclosure, awareness about own role are the most important influencing factors in this relation (mean score &gt;4). Use of drugs/tobacco, speech difficulty, love affair of students, negatively affect communication. Study also revealed barriers of relation fear and shyness, language barrier and discrimination of students by the teachers. Friendly relationship, open minded behavior, student- teachers cooperation, open discussion, morality and religious practice, motivation of by teachers, understanding each other’s, avoidance of student’s politics, responsibility of students &amp; teachers, teachers training with reduced workload have great impact on removing these barriers.</p> <p><strong>Conclusion: </strong>Addressing these issues at all possible levels, proper measures should be taken to improve relation among teachers and students; so that teaching learning process can be enhanced and ultimate goal of medical education can be achieved.</p> <p>Medicine Today 2021 Vol.33(2): 165-168</p> Kazi Taslima Md Humayun Kabir Talukder Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 165 168 10.3329/medtoday.v33i2.56066 Impact of Covid-19 Pandemic on Mental Health <p><strong>Introduction: </strong>The year 2019 will be remembered in the human history by the mark of an unknown diseases plaguing the whole world with its devastation, namely coronavirus disease 2019 (COVID-19). This pandemic caused by a novel strain of RNA virus has caused a catastrophic health outcome for millions of world citizens but in many cases only the physical aspect of the disease came under consideration.</p> <p><strong>Materials &amp; Methods: </strong>This review is based on ample literature search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications.</p> <p><strong>Discussion: </strong>COVID-19 pandemic has caused a variety of health problems including mental health issues. Initial panic about the completely unknown (Novel) virus plaguing the world was soon joined by an array of mental health problems like anxiety, depression, combined anxiety and depression, traumatic stress etc. Amidst the chaos of unpredictability, mortality, overstretched health facilities etc. we often downplay the importance of paying attention to the mental side of the disease spectrum. As a result, outcomes like child abuse, domestic violence and suicide can increase.</p> <p><strong>Conclusion: </strong>It is of utmost importance to educate mass people about the coping strategies to go through this hard time, to ensure proper news sharing, to screen people who are at risk of developing mental health problems and to provide support to those who are in need. Local and International consensus guideline should be planned to deal with this issue.</p> <p>Medicine Today 2021 Vol.33(2): 169-171</p> Shahida Akhter ASM Rizwan Copyright (c) 2021 Medicine Today 2021-11-07 2021-11-07 33 2 169 171 10.3329/medtoday.v33i2.56067