Northern International Medical College Journal 2019-08-16T16:07:20+00:00 Prof. Dr B H Nazma Yasmeen Open Journal Systems An official Journal of the Northern International Medical College. Full text articles available. Liver dialysis: a bridge to liver transplantation or regeneration 2019-08-16T16:07:20+00:00 BH Nazma Yasmeen <p>Abstract not available</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 324-325</p> 2018-12-19T00:00:00+00:00 ##submission.copyrightStatement## Management of Meconium Ileus: 5 years' experience at Dhaka Shishu (Children) Hospital 2019-08-16T16:06:22+00:00 Kazi Md Noor ul Ferdous Md Samiul Hasan Kh Ahsanul Kabir M Kabirul Islam Tahmina Banu <p><strong>Background : </strong>Meconium ileus (MI) is one of the common cause of intestinal obstruction in neonate. It can be present with various complications (about 50%) like volvulus, atresia, and gangrene of the gut, perforation and meconium cyst.</p> <p><strong>Objective : </strong>This study aimed to compare various surgical procedures used in the treatment of meconium ileus and to assess their efficacy regarding survival and complications in our center.</p> <p><strong>Methods : </strong>This retrospective study was done to all cases of meconium ileus admitted in the Department of neonatal surgery of Dhaka Shishu (Children) Hospital during the past 5 years (2011 to2016). The medical records of all patients with meconium ileus were studied. The surgical procedures were Mikulicz procedure, Bishop-Koop procedure done in case of complicated cases and Mikulicz procedure, Bishop-Koop and T tube ileostomy done in uncomplicated cases. Outcomes were compared between complicated and uncomplicated group and between the surgical procedures.</p> <p><strong>Results : </strong>Total patients were 224. Among them 8 were excluded due to incomplete data. The mean age was 3.23 days. Twenty four neonates were preterm. Fifty-two percent were uncomplicatedMI and 48.15% were complicated. Among 112 uncomplicated cases, Mikulicz procedure done in 33 cases, Bishop-Koop procedure done in 37 cases and rest were treated by T tube ileostomy procedures. Among 104 cases of complicated meconium ileus, Mikulicz procedure done in 75 cases and 42 cases were treated by Bishop-Koop stoma. Predominant complications in Mikulicz procedures were high output fistula (67.6%), sepsis (34.84%) and skin excoriation (58.33%), while in Bishop-Koop procedure were sepsis (59.25%), anastomotic leak and reoperation (25.75%). In T tube ileostomy, complications were intra-peritoneal leak with reoperation and sepsis (9.52%). Twenty five (11.6%) stoma prolapse were found in Mikulicz ileostomy. The overall mortality of meconium ileus was 36.6%, in simple MI 23 out of 112 and in complicated MI 56 out of 104. This difference was significant.</p> <p><strong>Conclusion : </strong>Considering the study result we concluded that complications occur more frequently in Mikulicz procedure and it is significantly associated with mortality, Bishop- Koop ileostomy can be considered but anastomotic leak is still an important complication of this procedure. In uncomplicated cases T tube ileostomy found as the best option.</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 326-329</p> 2019-01-10T00:00:00+00:00 ##submission.copyrightStatement## Role of Human Recombinant Erythropoietin (rHuEPO) in Perinatal Asphyxia-a randomized controlled trial 2019-08-16T16:07:14+00:00 Syeda Mehnaz MAK Azad Chowdhury BH Nazma Yasmeen Md Masudur Rahman Rowshan Jahan Akter Manifa Afrin Mahmuda Begum <p><strong>Background : </strong>Perinatal asphyxia is an insult to the fetus or newborn infant due to lack of oxygen (hypoxia) and/or a lack of perfusion (ischemia) to various organs, which will manifest as difficulty in establishing spontaneous respiration evident by delayed cry after birth, at least after one minute. World-wide, perinatal asphyxia accounts for about 900,000 deaths each year. In Bangladesh it is a major cause of neonatal death. A substantial proportion of the children that survive suffer late effects such as cerebral palsy and epilepsy.</p> <p><strong>Objective : </strong>To determine the efficacy of erythropoietin in improving the neurological outcome of term neonates with perinatal asphyxia (HIE stage II and III).</p> <p><strong>Materials and methods : </strong>A Randomized Controll Trial was carried out in the Neonatal ward and NICU of Dhaka Shishu Hospital from 1st April 2014 to 30th Sep 2015. A total 68 neonates with perinatal asphyxia (both HIE stage II and III) who fulfill the inclusion criteria were enrolled and randomly assigned to intervention group (n=35) and control group (n=33). Intervention group received rHuEPO 300- 500 U/kg/dose daily subcutaneously for 5 days within first 48 hours of birth along with the standard treatment protocol and control group received standard treatment protocol only.</p> <p><strong>Results : </strong>Baseline clinical characteristics, USG of brain during hospital stay were almost similar in both groups. Statistically significant effect was noted in seizure control, tolerance of oral feeding, hospital stay and neurological outcome at 3 months of age (p=008). USG of brain at 3 months of age also improved significantly (p=0.027).</p> <p><strong>Conclusion : </strong>This study demonstrates the effectiveness of early administration of rHuEPO to term neonates with moderate to severe asphyxia, beneficial effect on short term outcomes like seizure control, tolerance of oral feeding and neurological outcome at 3 months of age. A large multicenter study would be done for further evaluation of these findings.</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 330-334</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement## Alpha Feto Protein in vaginal fluid as a diagnostic marker of Premature rupture of membrane 2019-08-16T16:07:08+00:00 Nasreen Sultana Shamima Rahman Fakhruddin Ahmed SK Ashraf Ullah <p><strong>Background : </strong>Premature Rupture of Membrane (PROM) is a significant obstetric emergency where a normal pregnancy suddenly becomes a high risk one. It can cause serious complications of mother and fetus. Patient’s history, per speculum vaginal with Nitrazine paper test and Fern test considered as gold standard for diagnosis of PROM. But these multiple tests are hazardous and time consuming. Therefore Alpha-Feto Protein (AFP) test is a single sensitive test for proper diagnosis of PROM.</p> <p><strong>Objective : </strong>To evaluate the accuracy of Alpha-Feto protein in vaginal fluid as a diagnostic tool of PROM.</p> <p><strong>Method : </strong>It was a cross sectional study, carried out among 120 pregnant women who had the gestational age between 28th to 40th week of pregnancy. Sample was collected purposively and divided into two groups. In group-I-62 suspected PROM patients were selected who gave the history of per vaginal watery discharge and was found positive in per speculum examination (P/S). In group-II-58 non PROM pregnant patients were selected. Then in group-I, Nitrazine paper test and Fern test were done to confirme PROM patients. Both groups AFP test was done by AxSYM auto analyzer. Finally the accuracy of AFP was evaluated against the gold standard test.</p> <p><strong>Result : </strong>It was found that AFP concentration was significantly higher in group-I of suspected PROM patients (30- 502ng/ml) than in group-II (0-40ng/ml). Among 62 suspected PROM patients 49 were found gold standard (Nitrogen paper test and Fern test) positive. Out of these 49 confirmed PROM patients 48 was found positive in Alpha-Feto protein test. The sensitivity of AFP test was found 98%, specificity was 84.6% and accuracy was 95.1%.</p> <p><strong>Conclusion : </strong>As Alpha-Feto protein in vaginal fluid was found highly accurate (95.1%) for diagnosis of PROM. Therefore, AFP test can be used as a single sensitive test for diagnosis of PROM.</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 335-338</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement## Antenatal care practice among Pregnant Women in a selected rural area of Bangladesh 2019-08-16T16:07:01+00:00 Nadia Begum Nasreen Begum Sk. Akbar Hossain AFM Ashik Imran Mst Laizuman Nahar <p><strong>Background : </strong>Antenatal care (ANC) is an important determinant of high maternal mortality rate and one of the basic components of maternal care on which the life of mothers and newborn babies depend.</p> <p><strong>Objective : </strong>To study the Antenatal care practice among pregnant women in a selected rural area.</p> <p><strong>Methodology : </strong>This descriptive cross-sectional study was conducted among pregnant women in a selected rural area from July 2016 to December 2016. Total sample was 121. Purposive sampling technique was followed. Data collection was done by face to face interview by using pretested structured questionnaire. Data was analyzed by SPSS version 17.0.</p> <p><strong>Results : </strong>A total of 121 women were interviewed. Sixty nine (57.02%) pregnant women were registered for ANC. Among them 47(68.11%) of respondents completed more than 4ANC visits. For the current pregnancy 56(46.28%) preferred Upazila Health Complex (UHC) and home delivery was preferred by 34(28.09%) respondents. Among the respondent age group 25-30 yrs were 61(50.41%) and educated upto primary level were 59(48.76%). Monthly income between 5000-10000 taka was among 48(39.66%) respondents. Most of their husbands (52.06%) were educated up to primary level and 25.61 % of them were garments worker and 23.96 % were day laborers.</p> <p><strong>Conclusion : </strong>ANC practice was not satisfactory. Only half of the pregnant women attended for ANC and completed minimum four visits. Nearly half of the pregnant women preferred UHC. Educated women from lower economic status were found to attend for ANC.</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 339-342</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement## Study on Exclusive Breastfeeding practice and related factors among mothers attending in a tertiary care hospital of Bangladesh 2019-08-16T16:06:55+00:00 Farzana Rahman Chowdhury BH Nazma Yasmeen Shabnam Rahman <p><strong>Back ground : </strong>Exclusive breastfeeding (EBF) means that the infant receives only breast milk for the first six months of life after birth. In Bangladesh, 55% of children less than 6 months of age are exclusively breastfed according to BDHS 2014.</p> <p><strong>Objectives : </strong>To assess the exclusive breast feeding practice and associated factors among children in an urban area ofBangladesh.</p> <p><strong>Method : </strong>This cross-sectional study was conducted in Popular Medical College, Dhanmondi, Dhaka, among 80 mothers having infants aged 7-12 months, attending the outpatient department were selected purposively for the study during the period of 1st August 2017 to 31st December 2017. Sample were selected purpasively for the study and predesigned questionnaire were used for data collection. Data analysis was done by using SPSS software version 22.</p> <p><strong>Result : </strong>It was found that only 30(37.5%) mother went for regular antenatal checkup and remaining 50 (62.5%) had irregular antenatal check up. But none of them got breastfeeding advice during antenatal visit. Breastfeeding was initiated with in 1 hour of birth in 36(40%) cases and 44 (60%) cases after 1hour of birth. Exclusive breastfeeding (EBF)was found in 40 (50%) children. Among them 30 (75%) were children of housewife mothers. Mixed feeding (breast milk plus formula/ cow’s milk) was given to 30 children among them18 (60%) were the children of housewife mothers.Only formula milk was given to 10 children of them 8(80%) were the children of housewife mothers.Exclusive breast milk was not given by 18(45%) mothers due to job or other occupation whereas 22 (55%) mother did not give EBF due to insufficient breast milk.</p> <p><strong>Conclusion : </strong>In the study rate of exclusive breast feeding was 50%. This study also showed that frequency of exclusive breast feeding practice was lower in working mothers than housewife mothers. This study also showed that the speculation of not getting sufficient milk was one of the main reasons for not giving exclusive breastfeeding.</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 343-346</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement## Knowledge, Attitude and Practice of Staff nurses on Hospital Acquired Infections in tertiary care Hospital of Dhaka city 2019-08-16T16:06:48+00:00 ASM Anwarul Kabir Farjana Akhter Mahbuba Sharmin Khaleda Akhter Mosammat Beauty Begum Arup Kumar Saha Imtiaz Ahmed <p><strong>Introduction : </strong>Hospital acquired Infections (HAIs) are called those infections that were not present at the time of patient’ hospitalization in a hospital and have been acquired after hospitalization. Nurses are an important part of the any healthcare team who play a unique role in the control of Hospital acquired infections.</p> <p><strong>Objective : </strong>The aim of this study was to investigate the level of knowledge, attitudes, and practices of staff nurses about preventing the spread of hospital acquired infections (HAIs) at tertiary care Hospital of Dhaka city.</p> <p><strong>Methods and Materials : </strong>This descriptive cross-sectional study was done among nurses having two years experience from two tertiary level hospitals in Dhaka city during January to June 2017. Self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used as a tool for data collection. Questionnaire was supplied to all staff nurses available at different in-patient wards of these two hospitals. Only 234 staff nurses who completed and returned the questionnaire were included in this study. Data were analyzed using Microsoft excel 2013 software.</p> <p><strong>Result : </strong>Staff nurses were found to have good knowledge, moderately positive attitude but poor practice in prevention of hospital acquired infections. About 95% of the participants considered that prevention of HAIs were a valuable part of their role. About 65% of the staff nurses had received formal training regarding hand hygiene. The 100 % of participants felt that they would be less likely to transmit infection to the patients if they performed hand-hygiene. About 64% of them argued that hand hygiene agents were not readily available in current settings. Regarding practice, only 6% performed hand hygiene before patients contact and 27% of the staff nurses reported that they often forgot to perform hand hygiene.</p> <p><strong>Conclusion : </strong>The finding of this study revealed a good knowledge of infection prevention among the majority of participants with relatively minimal level of practice. For strengthening the knowledge, attitude and practice towards HAIs, there is in need of developing regular training program and monitoring on performance feedback regarding hand hygiene is recommended.</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 347-350</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement## Thiamine deficiency - Beriberi – A forgotten disease 2019-08-16T16:06:42+00:00 Mahmuda Hassan Hamidur Rahman BH Nazma Yasmeen Afsana Mukti Hakimul Haque Masuma Khan Marium Begum Sudipta Roy Taslim Uddin Ahmed Ashraf Uddin Ahmed Sadia Tabassum ARM Luthful Kabir <p>Thiamine (vitamin B1) was the first B vitamin which has been identified. It serves as a cofactor for several enzymes involved in energy metabolism. The thiamine-dependent enzymes are important for the biosynthesis of neurotransmitters and for the production of reducing substances used in oxidant stress defenses, as well as for the synthesis of pentose used as nucleic acid precursors. Thiamine also plays a central role in cerebral metabolism. There are 2 major manifestations of thiamine deficiency(TD): cardiovascular disease (wet beriberi) and nervous system disease (dry beriberi and Wernicke–Korsakoff syndrome). In wet beriberi, cardiomyopathy with edema and lactic acidosis and in dry beriberi, peripheral neuropathy occurs. Manifestations of Wernicke–Korsakoff syndrome, consist of nystagmus, ophthalmoplegia and ataxia evolving into confusion, retrograde amnesia, cognitive impairment and confabulation. Thiamine deficiency is now very rare in developed countries, but still common in South East Asia specially in developing countries like Bangladesh. It is an important public health problem with potentially fatal consequences. Now a days highly polished rice (Minicut rice) is a popular staple food and other primary dietary sources of thiamine are in short supply. In wet beriberi myocardial disease is prominent which causes a high cardiac output with peripheral vasodilation and warm extremities. Before heart failure, tachycardia, a wide pulse pressure, sweating, warm skin and lactic acidosis develop leading to salt and water retention by the kidneys. The resulting fluid overload leads to edema of the dependent extremities. If it is left untreated the severity of potential outcome will be increased even up to death. Therefore, makes it essential for physician, cardiologists and Paediatrician to have an understanding of this condition and its optimal treatment. Patients on a strict thiamine-deficient diet display a state of severe depletion within 18 days. The most common cause of thiamine deficiency in affluent countries is either alcoholism or malnutrition in nonalcoholic patients especially in children. Treatment by thiamine supplementation is beneficial for diagnostic and therapeutic purposes.</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 351-354</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement## Androgen Secreting Adrenal Adenoma – A Case report 2019-08-16T16:06:35+00:00 Suraiya Begum Farzana Sharmin Dhiraj Chandra Biswas Ismat Ara Jahan Munira Hossain <p>Abstract not available</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 355-356</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement## A Newborn with Maple Syrup Urine Disease 2019-08-16T16:06:28+00:00 Rowshan Jahan Akhter Kanta Chowdhury Saenat Haque Ayesha Noor Shekufe Zaman <p>Abstract not available</p> <p>Northern International Medical College Journal Vol.10(1) Jul 2018: 357-358</p> 2018-12-20T00:00:00+00:00 ##submission.copyrightStatement##