Dr. Md. Alim Al Razy, Md. Habibullah Sarkar, Sheikh Mohd. A. Hakim, Dr. Md. Rokonuzzaman, Manzurur Rahman Choudhury
TAJ, Jan-Jun 2024; 37(1) 1-7
DOI: https://doi.org/10.62469/taj.v037i01.001
Background: Breast cancer is the most prevalent cancer affecting women worldwide. The immunohistochemical status of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) plays a crucial role in determining breast cancer treatment options and prognosis. These receptor statuses are known to be influenced by menopausal transition. Objective: This cross-sectional comparative study aimed to assess the frequency of ER, PR, and HER2/Neu positivity or negativity and their association with menopausal status among female breast carcinoma patients. Methodology: The study was conducted over one year, from September 2021 to August 2022, at the Department of Surgery, Rajshahi Medical College, Rajshahi. A total of 50 female patients with breast carcinoma were included in the study, divided into two groups: Group A (Premenopausal women) and Group B (Postmenopausal women). Specimens were collected after modified radical mastectomy and sent to renowned laboratories for histopathological and immunohistochemical receptor assays. Data were collected through a predesigned semi-structured questionnaire and analyzed using SPSS (version 24.0). Results: The study found no significant relationship between receptor status and menopausal status or increasing age. However, a significant histopathological association was observed with receptor status, with ER and PR positivity associated with grade II tumors (p-value <0.011). The most common histopathological type was ductal cell carcinoma, and its incidence increased with parity (p-value <0.009). Conclusions: This study revealed no significant difference in hormone receptor and HER2 Neu expression between premenopausal and postmenopausal breast carcinoma patients. Further research with a larger sample size is recommended for a more comprehensive understanding of this relationship.
Sadia Afrin, Zannatul Ferdousi, D. H. M. F. Rabbi, Abul B. M. Reza
TAJ, Jan-Jun 2024; 37(1) 8-13
DOI: https://doi.org/10.62469/taj.v037i01.002
Background: A racial variation of paranasal sinus growth is observed with age and sex. Methods: This cross-sectional type of descriptive study was carried out in the Department of Anatomy, Rajshahi Medical College, Rajshahi over a period of 1 year among the apparently healthy people within the age of 11- 60 years. CT scan machine and Computer were used to gather data from 100 respondents by convenient sampling technique. Results: The height of the maxillary sinuses (both right and left) was observed to be significantly heterogeneous with maximum height being attained at 3rd decade and minimum at 6th decade of life (p = 0.045 and p = 0.024, respectively). While width of the left maxillary sinus was significantly greatest at 3rd decade, it is shortest at 2nd decade of life (p = 0.037) and depth of the left maxillary sinus was significantly greatest at 5th decade, it is shortest at 2nd decade of life (p = 0.019). Except width of the left maxillary sinus, all the dimensions were significantly greater in male than female (p < 0.05) and right sided all dimensions in both sexes were found to bear linear relationship with those of their left side. Conclusion: This study might help us in creating a database of our country people which provide an important role during maxillary sinus surgery.
Madhusudan Saha, Md. Abdul Mumit Sarkar, Sadhu Uttam Kumar, Malay Kumar Sur Chowdhury, Bimal Chandra Shil
TAJ, Jan-Jun 2024; 37(1) 14-20
DOI: https://doi.org/10.62469/taj.v037i01.003
Background: This cross-sectional study was designed to see the frequency and associated factors of gastric polyps among patients undergoing endoscopic examination of the upper gastrointestinal tract. Methods: Consecutive patients who underwent endoscopic examination of upper GIT were included. Epidemiologic information, indication, history of proton pump inhibitor intake with duration, and endoscopic findings were recorded in a standard data sheet. SPSS version 20 was used for statistical analysis. Percentage, mean and SD were calculated for continuous data and the chi-square test was applied to see the relation of polyps with age, sex, duration, regularity, and dose of PPI use, Results: A total of 432 patients (Mean age 42.99±15.53) were included in this study. Of them, 198 (45.8%), 233 (53.93%), and 01 (0.23%) respectively were male, female, and third gender. 427 (98.9%) patients were taking PPI. A total of 109 (25.23%) patients had single or more polyps. of them, 90 (82.56%) patients had polyps limited within cardia and or fundus. Polyps were found more common among patients of age above 45 years (69; 63.30%), and females (70; 64.22%). The detection rate of gastric polyps increases with the duration of PPI intake of more than one year (102; 93.58%), regular intake (69; 63.30%), and twice daily doses (93; 85.32%) of PPI intake. Conclusions: Gastric polyps especially at fundus and cardia are common. Age, female sex, prolonged period, and regular and twice daily intake of PPI are found to be associated factors of gastric polyps.
Khondokar Seheli Nasrin Lina, Nishat Anam Borna, Wahida Khatun, Mst. Rokeya Khatun
TAJ, Jan-Jun 2024; 37(1) 21-27
DOI: https://doi.org/10.62469/taj.v037i01.004
Background: Obstructed labor is a significant maternal health concern in public health facilities, often leading to adverse outcomes for both mothers and infants. This study aimed to analyze the prevalence, causes, and contributing factors of obstructed labor at RMCH during the period from February 2021 to November 23. Objective: The primary objective was to assess the extent of obstructed labor cases, identify their root causes, and understand the factors contributing to their occurrence at RMCH. Methods: A comprehensive retrospective analysis of 612 patient records from RMCH was conducted. Data included patient demographics, medical history, diagnostic findings, and outcomes. Descriptive and statistical analyses were performed to determine the prevalence, causes, and contributing factors. Percentage values were calculated for key findings. Results: The study revealed a prevalence of obstructed labor cases at 18.4% during the study period. The majority of patients were aged 15-34 years (90%), Primary causes included cephalopelvic disproportion (45.7%), delivery by unskilled birth attendants (15.9%), Contracted Pelvis (11.1%), malposition (20.3%), and other causes (7.0%). Contributing factors encompassed delayed access to care (44.2%), inadequate prenatal care (21.6%), home delivery (13.4%), lack of awareness (18.6%), and other factors (2.1%). Conclusions: This study underscores the significance of obstructed labor as a maternal health challenge at RMCH. Efforts should focus on improving timely access to healthcare services and enhancing prenatal care to mitigate the occurrence of obstructed labor cases. These findings can inform public health policies to reduce maternal morbidity and mortality.
Zannatul Ferdousi, Sadia Afrin, Md. A. A. Mohimen, Tunajjina Kawser
TAJ, Jan-Jun 2024; 37(1) 28-33
DOI: https://doi.org/10.62469/taj.v037i01.005
Background: The orbits are craniofacial structures and situated in the skull on either side of sagittal plane. The orbits enter the facial and cranial regions equally and each orbital cavity acts as a socket for the eyeball essentially. It also supports associated muscles, vessels, nerves, fascial strata, lacrimal apparatus, soft pad of fat and lodges the visual apparatus. Bony orbit is a very important area for anatomists, forensic experts, anthropologists as well as surgeons. Methods: This cross-sectional analytical study was carried out in the Department of Anatomy, Dhaka Medical College, Dhaka over a period of one year from January 2020 to December 2020. The study was conducted on 70 dry fully ossified human skulls and height, weight and index of orbit were measured and compared between right and left side. Data were analyzed by SPSS software, version-24 and p value < 0.05 was considered statistically significant for all tests. Results: The study revealed that in the right side, the mean orbital height, width and index were 33.64±0.88 mm, 39.63±1.66 mm and 85±3.45%, respectively. In the left side, the mean orbital height, width and index were 33.54±1.0 mm, 39.48±1.25 mm and 85.03±3.13%, respectively. There was no statistically significant difference of orbital height, width and index between right and left side (p = 301, p = 328 and p = 954, respectively). Conclusion: The present study was an attempt to produce a morphometric data on different variables (Orbital height, width and index) of fully ossified dry human orbital cavities.
Farid Hossain, Be-Nazir Ahmmad, Rejaul Karim, Ruhul Amin, Muhammad Solaiman Mollah, Rustam Ali, Afiqul Islam
TAJ, Jan-Jun 2024; 37(1) 34-40
DOI: https://doi.org/10.62469/taj.v037i01.006
Background: During the induction phase of childhood acute lymphoblastic leukemia infections are the major cause of morbidity and mortality. The infection risk is high during induction phase because of the use of intravenous line, mucositis and chemotherapy induced profound neutropenia and immunodeficiency. Methods: This hospital based observational study was done from February 2015 to June 2015 in the Department of Pediatric Hematology-oncology in BSMMU to observe the type, frequency and outcome of infections and to determine the microbiological profile involved in infections during induction therapy of childhood acute lymphoblastic leukemia. Total 20 diagnosed cases of childhood ALL who were admitted for chemotherapy aged <12 yrs. of both sexes included in this study. Children with fever ≥ 38○ C lasting for 1 hour once with or without local symptoms of infection like cough, dysuria, diarrhea, cellulitis etc. during induction therapy were included. All baseline investigations were done for evaluation. Results: Mean age of the patients was 5.4±4 years having male predominance. 36 episodes of infections among 20 patients were observed. Isolated febrile episodes 27.8% and clinically documented infections 72.2%. The most common site was the Respiratory system (33.2%) of episodes then thrombophlebitis (13.9%), GIT (13.9%), Genitourinary system (5.6%), soft tissue infection (2.8%), ear infection (2.8%). ANC <500/mm3 was the major risk of infections. Microbiologically documented infections found 7 episodes (19.4%) out of 36 episodes. Gram negative bacilli such as Pseudomonas (42.9%), E. coli (28.4%) was predominant organism. Conclusion: Children less than 5 years were mostly vulnerable. Most of the infections occurred during induction associated with neutropenia (ANC <500/mm3). Gram negative bacteria were predominant organisms involved in infections. The Respiratory system was the commonest site of infection. Outcome of infectious episodes were satisfactory with or without modification of antibiotic regimen.
Wahida Khatun, Abu Hena Mostafa Kamal, Khondokar Seheli Nasrin Lina
TAJ, Jan-Jun 2024; 37(1) 41-48
DOI: https://doi.org/10.62469/taj.v037i01.007
Background: The menstrual cycle is intricately governed by hormonal changes and organ responses. Imbalances in this finely tuned system can result in various menstrual problems. Thyroid dysfunction, including hypothyroidism, hyperthyroidism, and subclinical hypothyroidism, has been identified as a potential cause of menstrual irregularities. Objective: To assess the frequency of thyroid function disorders in patients presenting with menstrual disturbances and to investigate the association between thyroid function disorders and specific types of menstrual abnormalities. Methods: Conducted as a non-interventional study, research was carried out within the Obstetrics and Gynecology department of Rajshahi Medical College Hospital from January 2009 to December 2010. A total of 166 female patients aged 16-45 years with a history of menstrual disturbances were included, adhering to predetermined inclusion and exclusion criteria. Data were collected using a structured questionnaire encompassing all pertinent variables. Data analysis involved descriptive statistics and the Chi-square (x2) test. Results: Out of the 166 patients examined through a comprehensive process involving history, examination, and relevant laboratory tests (including T3, T4, and TSH), 28 were diagnosed with thyroid disorders. At the same time, 138 were found to have euthyroid status. The frequency distribution of thyroid function among these cases revealed 138 (83.1%) were euthyroid, 18 (10.8%) were hypothyroid, 4 (2.4%) were hyperthyroid, and 6 (3.6%) exhibited subclinical hypothyroidism. Conclusions: Thyroid dysfunction is intricately linked with menstrual irregularities, impacting various aspects of the menstrual cycle. Menorrhagia, oligomenorrhea, hypomenorrhea, amenorrhea, and Polymenorrhoea were among the common menstrual disturbances observed in patients with thyroid disorders. Thus, a comprehensive evaluation of individuals with menstrual disturbances should incorporate thyroid assessment, detailed medical history, and thyroid examination. Moreover, specific thyroid function tests should be administered to these patients
Effat A. Lipi, Latifa Hosna, Md. M. Hasan, Momtaj Parvin, Anik Barua, Shahin Mahmuda
TAJ, Jan-Jun 2024; 37(1) 49-54
DOI: https://doi.org/10.62469/taj.v037i01.008
Background: Nutritional status is a unique technique for assessment of consumption and utilization of nutrients. Malnutrition affects several aspects of physiology of the body and it is responsible for imbalance of serum estrogen level in women. Methods: This cross-sectional type of descriptive study was carried out in the Department of Physiology in Rajshahi Medical College, Rajshahi over a period of 12 months from July 2021 to June 2022 among the adult females aged 18 to 40 years in Rajshahi city. Pre-designed, validated, structured questionnaire was used to gather information from 150 women residing in Rajshahi City. Results: Out of 150 respondents, BMI wise distribution of the serum estrogen levels revealed that 12.5%, 7.7%, 0% & 8.3% had low level and 25%, 3.8%, 10.0% & 12.5% had high level of estrogen in underweight, normal weight, overweight & obese group, respectively. Relationship between serum estrogen level and nutritional status of the respondents was found statistically non-significant (p > 0.05). Conclusions: This study might create awareness about nutritional status of adult females and make them conscious to lead a healthy life.
Shah Md. Ahsan Shahid, Md. Nowshad Ali, Shantona Rani Paul, Md. Zamil Hossain, Abdullah Al Mamun
TAJ, Jan-Jun 2024; 37(1) 55-62
DOI: https://doi.org/10.62469/taj.v037i01.009
Background: Pediatric solid tumors pose a significant health challenge worldwide, with variations in prevalence and distribution across different regions. Understanding these tumors' demographic and clinical characteristics is essential for guiding effective management strategies and improving outcomes. Objective: This study aimed to investigate the demographic profile and distribution of pediatric solid tumors among patients attending the Department of Pediatric Surgery at Rajshahi Medical College Hospital, Bangladesh, from January 2022 to December 2022. Methods: An observational study was conducted to collect and analyze data from pediatric patients aged 0 to 13 years presenting with clinical suspicion of abdominal masses. Patients with acute inflammatory conditions were excluded. Demographic information, including age and gender, as well as tumor types, were recorded and analyzed. Results: A total of 62 pediatric patients were included in the study, with a male-to-female ratio of 1.2:1. The majority of patients (50%) fell within the age range of 1-5 years. Sacrococcygeal teratoma was the most common tumor type observed, accounting for 35.5% of cases, followed by Wilms' tumor (33.9%). Other tumor types included neuroblastoma (4.8%), retroperitoneal tumor (8.1%), soft tissue sarcomas (6.5%), and adrenal tumor (3.2%). Conclusions: The study provides valuable insights into the demographic profile and distribution of pediatric solid tumors at Rajshahi Medical College Hospital. Sacrococcygeal teratoma and Wilms' tumor were the predominant tumor types, emphasizing the need for tailored management approaches and further research to improve outcomes in pediatric oncology in Bangladesh.
Md. Ahsanul Haque, Md. Sirazum Munir
TAJ, Jan-Jun 2024; 37(1) 63-70
DOI: https://doi.org/10.62469/taj.v037i01.010
Background: The threat of Multidrug resistant bacteria on the overall health sector has led to its recognition as the deadliest bacteria in the world. Most of the multidrug resistant bacteria are resistant to commonly used antibiotics including 3rd generation of cephalosporin, Fluroquinolones and carbapenems also. So, treatment of different infections caused by multidrug resistant bacteria are gradually becoming difficult and it also increased the mortality and morbidity. Objective: The aim of the study was to detect multidrug resistant bacteria isolated from infected wound patients in Rajshahi region. Materials and Methods: A cross sectional type of descriptive study was done during the period of July 2017 to June 2018. Wound swab was collected in different surgical units of Rajshahi Medical College Hospital. The specimens were inoculated in blood agar, nutrient agar and MacConkey’s agar media and incubated aerobically at 370 C for 24 hours. Susceptibility tests of the bacterial isolates were done by using the modified Kirby Bauer disk diffusion method on Mueller Hinton agar media. Multidrug resistant bacteria were identified by disk diffusion method against different classes of antimicrobials. Results: Out of total 250 samples, Culture yielded growth were 213(85.2%) and total 231 bacteria were identified. Among them 136 (58.8%) isolates were gram negative and 95 (41.2%) isolates were gram positive. S. aureus was the predominant organism 71(30.8%) followed by E.coli 48(20.8%), Aeruginosa 47(20.3%) and Klebsiella spp.20 (8.7%).Overall, 231 bacterial isolates were obtained and 135 (58.4%) were identified as MDR. The overall MDR among gram positive and gram-negative bacterial isolates were 55.8% and 60.3% respectively. Among gram positive bacteria’s. aureus, Cons, and Enterococcus spp.39(55%),08(57.1%) and 06(60%) were identified as MDR respectively. Among gram negative bacteria, E.coli, Aeruginosa, Klebsiella spp., Proteus spp. and Acinetobacter spp. 28(58.3%), 30(63.8%), 12(60%), 08(57.1%) and 04(57.1%) were identified as MDR respectively. Vancomycin, linezolid and Imipenem were the most sensitive drugs against gram positive bacteria. Colistin and Imipenem were the most sensitive drugs against gram negative bacteria. Conclusion: The study highlights a high rate of multidrug-resistant bacterial pathogens causing wound infections, emphasizing the urgent need for effective antimicrobial stewardship and infection control measures.
Mst. Mousumi Marjiara Begum, Ashim Kumar Ghosh, Md. Anwarul Haque
TAJ, Jan-Jun 2024; 37(1) 71-79
DOI: https://doi.org/10.62469/taj.v037i01.011
Locally advanced non-small cell lung cancer (NSCLC) poses a significant therapeutic challenge, often managed with concurrent chemoradiotherapy (CRT). Evaluating treatment outcomes in real-world settings is crucial for optimizing patient care. Objective: This study aimed to assess the treatment outcomes of concurrent CRT in patients with locally advanced NSCLC treated Method: A prospective analysis was conducted on 90 patients at the Department of Radiation Oncology, Rajshahi Medical College Hospital, Rajshahi, from July 2020 to June 2022, with locally advanced NSCLC who received concurrent CRT during the period. Data on patient demographics, tumor characteristics, treatment regimens, response rates, and toxicities were collected from medical records. Treatment response was evaluated using RECIST criteria, and toxicities were graded based on CTCAE v5.0. Results: Among the 90 patients included, the median age was 60 years (range: 45-75 years), with 65
Farhana Yasmin, Muhammad Zubayer Alam, A. K. M. Shamsul Alam
TAJ, Jan-Jun 2024; 37(1) 80-89
DOI: https://doi.org/10.62469/taj.v037i01.012
Background & Objective: In rural Bangladesh, stunting and wasting in children aged one to five were a serious concern due to childhood malnutrition. The study examined the complicated variables that led to malnutrition, such as socioeconomic inequality, restricted access to healthcare, and inadequate nutrition education. The goals were to determine the determinants, evaluate the prevalence, and provide guidance for focused actions. Methods: Conducted in Pythia Upazila, Rajshahi, from August to October 2023, the community-based cross-sectional study focused on 510 children aged 1–5 years. Data collection involved anthropometric measurements, vaccination assessments, and a semi-structured questionnaire. Statistical analyses, employing logistic regressions and chi-square tests, were executed using SPSS and ENA for SMART software. Results: The study, involving 510 respondents with an average age of 35.90 months, revealed varied health indicators. Stunting prevalence was 16.1% severe, 24.7% marginal, 25.7% moderate, and 33.9% normal. Wasting prevalence showed 15.7% severe, 23.5% slight, 22.2% moderate, and 38.6% normal. Low birth weight increased the risk of stunting, while hospital delivery reduced it. Male gender raised the risk, and a 'rich-in-protein-diet' lowered it. For wasting, factors like age (24-35 months), gender, birth order (OR: 0.004), early weaning, and a 'rich-in-protein' diet (OR: 0.438) significantly impacted the results (p<.008, p<.000). Conclusion: This study provided important insights for interventions by illuminating the multifaceted causes that drove childhood malnutrition in rural Bangladesh. The intricate relationship between demographic and socioeconomic variables highlighted the necessity of focused interventions. The substantial correlations revealed, notably between stunting and gender, underlined the importance of diverse interventions to successfully combat malnutrition in this population
Kowsarunnahar, Md. J. Haque, Nelofar Yasmin, Afsana Ali
TAJ, Jan-Jun 2024; 37(1) 90-97
DOI: https://doi.org/10.62469/taj.v037i01.013
Background: Under or over consumption of calories tend to result in malnutrition and now it is a problem in both developed and developing countries. Health education, health awareness and knowledge about food habit could minimize this issue. Methods: This cross-sectional type of descriptive study was carried out in the Department of Community Medicine, Rajshahi Medical College, Rajshahi over a period of 12 months from January to December 2019 on 300 medical students in Rajshahi city. Pre-designed, validated, semi-structured questionnaire was used to gather information from the medical students. Results: Seventy percent medical students took breakfast regularly and 57.3% consumed meal three times in a day. Around 89.0% and 78.0% students took fruits and plenty of vegetables each day, respectively. Only 13.3% consumed fast food regularly. Around 9.0% students were underweighted, 29.0% overweighted and 23.0% stunted. Conclusions: By improvement of socioeconomic status, mother’s education, health awareness and health education, stunting of the students might be reduced.
Sumona R. Nadi, Mousumi Mahjabin, Fatema T. Zohora, Sahanaj Parvin, Quazi T. Haque
TAJ, Jan-Jun 2024; 37(1) 98-105
DOI: https://doi.org/10.62469/taj.v037i01.014
Background: Vulvovaginal candidiasis is a major public health problem worldwide and its incidence and prevalence has increased in recent years. Materials and Methods: This cross-sectional type of descriptive study was conducted on 100 females over a period of one year from July 2021 to June 2022 in Rajshahi Medical College hospital. Before commencement of the study, ethical clearance was obtained from the Ethical review committee of Rajshahi. Data were collected by a semi structured questionnaire and data analysis were done by SPSS software, version-24. Results: The most common isolates were C. albicans 27 (27.00%) followed by C. tropicalis 8 (8.00%) and C. cruise 4 (4.00%). compounding was the most sensitive and fluconazole was the most resistant antifungal drugs. Non-albicans Candida species showed more antifungal resistance than C. albicans. Conclusion: Both Candida albicans from other Candida species showed a wide range of susceptibility towards different antifungal agents and fluconazole was found to be fewer sensitive drugs.
Md. Tamjid Ali, Quazi Tamanna Haque, Abdus Sabur, Mohammad Fattah Ul Islam
TAJ, Jan-Jun 2024; 37(1) 106-113
DOI: https://doi.org/10.62469/taj.v037i01.015
Background: Osteoarthritis (OA) of the knee is common and can affect a patient's ability to move and perform daily tasks. There is hope for managing knee OA with minimally invasive treatments such as hyaluronic acid (HA) injections and platelet-rich plasma (PRP). Patients with mild to moderate knee OA were enrolled in this study at a tertiary-level hospital in Bangladesh to compare the effects of intra-articular PRP and HA injections. Methods: Forty patients participated in this clinical research; twenty got HA injections, and twenty got PRP injections. The Rajshahi Medical College Hospital's Department of Physical Medicine & Rehabilitation accepted patients from January 2022 to December 2022. A visual analog scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score were utilized in clinical examinations before injection and three to six months and twelve months following injection (KOOS). The knee's range of motion and crepitation were assessed at every checkup. Post-test results were compared to pre-test results. Results: After comparing platelet-rich plasma (PRP) injections with hyaluronic acid (HA) injections for knee osteoarthritis, PRP was the safer and more practical choice. Over a 12-month follow-up period with indicated PRP injections, PRP showed sustained benefits in patient-reported outcomes, such as pain reduction and increased daily function. The PRP group showed considerable improvements in pain levels and quality of life, as evidenced by raised ratings across KOOS subscales and reduced Visual Analog Scale (VAS) scores. Additionally, the PRP group outperformed the HA group in terms of crepitation improvement; at the first follow-up, 80% of PRP patients had gone from coarse to fine crepitation, while only 40% of HA recipients had done so. Conclusion: Patients with knee OA benefit from intra-articular PRP and HA injections. Compared to HA, PRP therapy improved most outcome indicators better and longer. PRP injections may be a better knee OA treatment in this patient cohort
Md. Ruhid Hossain, Md. Safiqul Islam, Samina Akter, A.H.M. Anisuzzaman, Md. Abdullah-Al-Maruf, Noor Mohammed
TAJ, Jan-Jun 2024; 37(1) 114-120
DOI: https://doi.org/10.62469/taj.v037i01.016
Background: Multidrug-resistant tuberculosis (MDR-TB) presents a significant global health challenge, with Bangladesh being no exception, experiencing a rise in drug-resistant cases. The study focuses on the correlation between drug non-compliance and patients' educational backgrounds as a contributing factor to the emergence of MDR-TB. Objective: This study aims to assess the impact of non-compliance with medication regimens on the development of MDR-TB among individuals from varying educational backgrounds. The goal is to increase awareness regarding this crucial issue among patients, families, healthcare providers, and policymakers. Methodology: A retrospective cross-sectional analysis of 50 MDR-TB patients who had received at least three months of treatment at Dhaka's National Institute of Disease of the Chest and Hospital between October 2011 and March 2012. Results: The results of the study revealed that 64% of MDR-TB patients had a history of drug non-compliance, with a majority of them (72%) being male. Drug non-compliance was more common among individuals with lower educational backgrounds, as 72% of non-compliant MDR-TB patients had completed only primary education or less. In contrast, among compliant MDR-TB patients, 70% had completed secondary education or higher. Conclusion: It highlights that individuals with higher educational backgrounds tend to be more health-conscious and adherent to their medication regimens, resulting in a lower incidence of MDR-TB among this group
Md. Sirazum Munir, Md. Ahsanul Haque
TAJ, Jan-Jun 2024; 37(1) 121-125
DOI: https://doi.org/10.62469/taj.v037i01.017
Background: Antimicrobial resistance (AMR) is a worldwide disaster to health community. Uropathogenic E.coli is increasingly related with multidrug resistance (MDR), including the resistance to the last resort carbapenems. This study aims to determine the antibiotic resistant pattern and detection of carbapenemase producing imipenem resistant E.coli in Dhaka Medical College and Hospital. Methods: An observational study was done over a period of one year in Dhaka Medical College that involve 280 patients. The gram positive and gram-negative bacteria were identified, their antimicrobial resistant patterns were determined and detection of antimicrobial resistant pattern from urine samples. Results: A total of 280 microorganisms were identified among 83 culture positive cases. The microorganisms identified were 92.77% (n=77) gram negative and 7.23% (n=6) gram positive. Antibiotic susceptibility pattern was determined by double disk method for all the isolated E.coli strains. The most resistance was found against cotrimoxazole (90%) and lowest resistant was found against tigecyline (6.67%). Phenotypic detection of imipenem resistant Esch.coli, 55.56
Maryeum Islam, Sabiha Y. Moni, Md. A. Razzaque, Md. Murshid U. Rahman, K. M. R. Hassan, Sabrina Razzaque
TAJ, Jan-Jun 2024; 37(1) 126-131
DOI: https://doi.org/10.62469/taj.v037i01.018
Background: Systemic arterial hypertension is the leading cause of mortality and morbidity worldwide and among the antihypertensive drugs, Telmisartan and Losartan are the more commonly used anti-hypertensive drugs. Methods: This quasi-experimental study was conducted on 90 patients of mild to moderate hypertensive patients at the department of Pharmacology in collaboration with the Department of Medicine, Rajshahi Medical College and hospital, Rajshahi. Data were collected by a semi structured questionnaire and analysis were done by SPSS version-24. Results: Telmisartan is more effective in reducing systolic blood pressure than Losartan and it was statistically significant (p < 0> 0.05). Conclusion: The study concluded that both Telmisartan and Losartan were found effective in reducing blood pressure but Telmisartan was more effective than Losartan.
Md. Murshid-Ur-Rahman, Shahin Ara, Md. Yousuf Ali, Lotifa Hoque, K.M. Rockybul Hasan, Maryeum Islam, Arika Jannat
TAJ, Jan-Jun 2024; 37(1) 132-139
DOI: https://doi.org/10.62469/taj.v037i01.019
Background: Cycloplegia is the paralysis of the ciliary muscle of the eye, which causes pupil dilation and accommodation paralysis. This can be accomplished by injecting cycloplegic drugs into the conjunctival sac, such as atropine, cyclopentolate, and tropicamide. The aim of this study was to compare the cycloplegic effects of atropine and tropicamide in young children with refractive error. Methods: This quasi-experimental study was conducted at the Department of Pharmacology and Therapeutics in collaboration with the Ophthalmology Department of Rajshahi Medical College Hospital, Rajshahi. This study was conducted over 1 year from July 2021 to June 2022. The study involved 49 young children (98 eyes) with an age range of 2-10 years and refractive error at least in one eye as minimum inclusion criteria. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) software, version-23.0. Results: A total of 49 young children (98 eyes) with refractive errors were enrolled in the study. Among 59.2% of the respondents' age was between 6 to 8 years. More than half of the respondents were girls, which was proportionately more than boys. Among the respondents 53% had myopia and the remaining had hypermetropia. Here on hyperopic young children (n=23) mean (±SD) value for cycloplegic refraction of both eyes after using 1% atropine eye drop was + 2.98 (±1.85) D and +2.79 (±1.89) D after using 1% tropicamide eye drop. Again, on myopic young children (n=26) mean (±SD) value for cycloplegic refraction of both eyes after using 1% atropine eye drop was -4.88 (±2.86) D and -5.28 (±3.37) D after using 1% tropicamide eye drop. None of the drugs caused constipation or any psychological problem. 1% tropicamide eye drop caused eye irritation and redness in 12% of the respondents. Using 1% atropine eye drops 38.8%, 4.1% and 2% of young children suffered from fever, dry mouth, and palpitation respectively. Comparing cycloplegic effect of both eye drops on hyperopic and myopic young children difference was found statistically significant (p<0.05). Conclusions: It was found that atropine had significantly (P< .05) more cycloplegic effect than tropicamide on both hyperopic and myopic young children but atropine produced more adverse effects.
Ibrahim Hoshen, AKM Shamsul Alam, Be-Nazir Ahmmad, Ruhul Amin, Bijoy Talukder, Tanjila Akter, Sayeeda Anwar
TAJ, Jan-Jun 2024; 37(1) 140-147
DOI: https://doi.org/10.62469/taj.v037i01.020
Background: In children, Idiopathic Nephrotic Syndrome (NS) is a very common kidney disease. Massive proteinuria with high urinary protein-creatinine ratio is typical laboratory finding. Apart from it hypoalbuminemia, hypercholesterolemia and hypovolemia contribute to hypercoagulable states. In children and adults, the risk of thromboembolism is significant. Objective: To determine the coagulation profile among the children with idiopathic nephrotic syndrome. Methodology: This cross-sectional study was done at the Department of Paediatrics, Dhaka Medical College Hospital, from October 2018 to September 2019 and a total 52 subjects were enrolled. Fifteen cases were initial attack and thirty-seven were relapse cases selected by purposive sampling technique. Prothrombin time (PT), activated partial thromboplastin time (APTT), total platelet count (TPC), serum albumin, serum total cholesterol and protein- creatinine ratio were performed. Data were collected, recorded and analysed by SPSS. Result: In this study mean age of the children was 5.0±2.44 year. 73% subjects were in 2-6 years age group with male to female ratio being 1.4:1. Increased platelet count (>400000/mm3), prolonged PT (>16 sec) and APTT (>36 sec) were more in relapse cases than in initial attack cases (76% vs. 24%, p<0.001; 3% vs. 0%, p 0.52 and 14% vs. 0%, p 0.13 respectively). The Mean±SD of platelet count was significantly higher in relapse cases than initial attack cases (466081±175989 vs. 352066±103378/mm3, p 0.023). In relapse cases APTT showed significant positive correlation with protein-creatinine ratio (p <0.001) and negatively with s. albumin (p <0.025). Conclusion: Hypercoagulable state is more prone to develop in relapse cases than in initial attack cases. So, early detection is important to avoid related complications.
Shah Md. Ahsan Shahid, Md. Nowshad Ali, Md. Habibullah Sarkar, Md. Hafizur Rahman
TAJ, Jan-Jun 2024; 37(1) i-iii
DOI: https://doi.org/10.62469/taj.v037i01.021
In scientific communication, integrity and authenticity are paramount, forming the bedrock of scholarly discourse. Plagiarism, the unauthorized use of another's work, poses a grave threat to this foundation, jeopardizing the credibility of research and eroding public confidence. 1This editorial delves into the critical imperative of safeguarding authenticity in scientific communication. We examine the nuanced manifestations of plagiarism and explore diverse strategies to detect and deter this unethical practice. By illuminating the significance of integrity in scholarly endeavors, we aim to underscore the collective responsibility of researchers, institutions, and publishers to uphold the principles of academic honesty and transparency. Through proactive measures and collaborative efforts, we endeavor to preserve scientific inquiry's integrity and ensure scholarly communication's reliability and credibility.
Md. A. A. Mohimen, Nazia N. Ria, Zannatul Ferdousi, Sumaiya S. Zaman, Md. N. Sadat
TAJ, Jan-Jun 2024; 37(1) 148-154
DOI: https://doi.org/10.62469/taj.v037i01.022
Background: Acute myocardial infarction (AMI) is a significant contributor to global mortality, with ischemic heart disease being the predominant form. Risk factors for cardiovascular disease have been linked to elevated serum uric acid levels. This study investigates the relationship between AMI patients serum uric acid and troponin I levels. Objective: The study sought to determine the correlation between serum uric acid and troponin I levels in patients with AMI and to evaluate the difference in uric acid levels between different types of AMI. Methods: A cross-sectional comparative study was conducted at Dhaka Medical College over one year, involving 100 AMI patients aged 30 to 70. Serum uric acid and troponin I levels were measured, and demographic data, including age, gender, BMI, smoking status, and hypertension, were recorded. Statistical analyses were performed using SPSS software. Results: The mean serum uric acid level was significantly higher in AMI patients (6.03 ± 1.68 mg/dl) compared to healthy individuals (4.65 ± 1.19 mg/dl), with a positive correlation between uric acid and troponin I levels (r=0.621, p < 0.001). Additionally, serum uric acid levels were significantly higher in ST-segment elevated MI (STEMI) patients (7.45 ± 0.81 mg/dl) compared to non-STEMI patients (4.61 ± 0.96 mg/dl). Conclusions: Hyperuricemia appears to be a potential risk factor for AMI development. Regular screening of serum uric acid levels may aid in prognostic assessment and cardiovascular risk management. The results highlight the need for prompt action to detect and treat AMI in its early stages.
Farhana Rahman, Swati Sarker, Fatema Tuz Zohura, Shahin Mahmuda, Md. Mohimanul Hoque, Amena Akter
TAJ, Jan-Jun 2024; 37(1) 155-160
DOI: https://doi.org/10.62469/taj.v037i01.023
Background: Peak expiratory flow rate, or PEFR, is one of the most crucial pulmonary function tests. It is accurately evaluated with a spirometer and serves as a predictor of life expectancy. Healthy people who practice yoga have better respiratory efficiency, and it can be a vital component of a balanced lifestyle. Methods: This cross-sectional type of comparative study was carried out in the Department of Physiology, Rajshahi Medical College, Rajshahi over a period of one year from July 2022 to June 2023 among 30-50 years aged male and female who were the resident of Rajshahi City. A semi-structured questionnaire and Spirometer were used to gather information from 260 respondents, among them 130 were yogic and 130 were sedentary workers. Results: Out of 260 respondents, the mean age of the yogic respondents was 36.59 ± 4.46 years and the sedentary worker respondents was 37.41 ± 5.01 years. The mean BMI of the sedentary workers was higher than the yogic respondents and it was statistically significant. Yogic respondents had higher PEFR value than the sedentary worker and it was statistically highly significant (p < 0.001). Conclusion: This study emphasized the need of change our sedentary lifestyle and practice of yoga on regular basis irrespective of age and gender.
Nousin T. Ferdous, Sharmin Ferdousi, Jannatul Maua, Rabiul Awal, Gobinda Chowdhury
TAJ, Jan-Jun 2024; 37(1) 161-167
DOI: https://doi.org/10.62469/taj.v037i01.024
Background: Breast cancer is the most common cancer among women all over the world. Recently many scientists have been trying to evaluate the usefulness of the Wilms’ tumor protein (WT1) as a promising therapeutic target in breast cancer. Methods: This cross-sectional study was conducted in the Department of Pathology, Rajshahi Medical College, Rajshahi over a period of 12 months from March 2022 to February 2023. A total of 65 biopsy samples from the patients with a histopathological diagnosis of breast carcinoma were included in the study. Expression of WT1 was evaluated in formalin fixed and paraffin embedded specimens by immunohistochemistry. WT1 expression was categorized as negative, mild, moderate and strong. Results: The mean (±SD) age of the patients was 48.4 (±6.6) years and range 36-65 years. WT1 expression was present in 28/65 (43.1%) patients and WT1 staining expression was found to be mild, moderate and strong in 16.9%, 13.9% and 12.3% of the samples, respectively. Positive WT1 expression was significantly higher in grade I tumor than in the grade II and III tumor (78.6% versus 33.3%, p=0.01). Conclusions: WT1 expression in breast carcinoma is found to be a common occurrence and its expression has been negatively related with tumor grade.
Najmus Sakeb, Md Monowar Tarik
TAJ, Jan-Jun 2024; 37(1) 168-174
DOI: https://doi.org/10.62469/taj.v037i01.025
Background: Degenerative Lumbar Spondylolisthesis (DLS) may present with significant disability due to instability. Interbody fusion (IBF) is advocated to achieve the highest possible functional recovery. Objective: To assess the clinical-radiological outcomes and perioperative complications of conventional open Transforaminal Lumbar Interbody Fusion (TLIF) in elderly (age >65 years) patients with single-segment unstable DLS (UDLS). Methods: Between March 2015 and October 2023, records of 79 patients, 22 men and 57 women, aged 65 to 75 years who underwent single-level TLIF for UDLS were reviewed. The patient’s Body Mass Index (BMI) and co-morbidity status were recorded. The study sample was divided into Group A (Male) and Group B (Female). Perioperative clinical outcome was assessed by Visual Analogue Score (VAS) and Oswestry Disability Index (ODI). Radiological fusion was assessed by Brantigan and Steffee criteria and the overall outcome by Wang-Bohlman criteria. Perioperative complications were recorded and analyzed concerning age, sex, and co-morbidities. Statistical analysis was performed using SPSS. Results: Female patients of 65-70 years presented late and had significantly higher BMI, and medical co-morbidities. In both groups, the Mean VAS score [Group-A, 7.9±1.5 to 1.1±1.8; Group B, 7.8±1.7 to 1.3±1.6] and ODI score, [Group-A, 78.5±6.5 to 11.5±7.2; Group B, 76.5±7.5 to 13.6±9.3] had highly significant improvement at last post-operative follow-up. The Mean Operative time, intraoperative blood loss, and postoperative complications had no significant difference between the groups and were not statistically associated with age, sex, or BMI. In both groups, fusion [Group-A, (n=20, 90.91%); Group-B, (n=54, 94.74%] and the overall outcome was satisfactory [Group-A, n=19(86.37%), Group-B, n= 53(92.98%)]. Conclusion: Transforaminal Lumbar Interbody Fusion (TLIF) for single-segment Unstable Degenerative Lumbar Spondylolisthesis (UDLS) can provide satisfactory and favorable outcomes in carefully selected elderly and results in minimum complication.
Latifa Hosna, Effat A. Lipi, Md. M. Hasan, Momtaj Parvin, Anik Barua, Shahin Mahmuda
TAJ, Jan-Jun 2024; 37(1) 175-181
DOI: https://doi.org/10.62469/taj.v037i01.026
Background: After menopause, the quality of life for women is one of the major health issues. In postmenopausal women, rapid bone loss occurs due to hormonal factors which is responsible for increasing risk of fractures. Methods: This cross-sectional type of descriptive study was carried out in the Department of Physiology, Rajshahi Medical College, Rajshahi over a period of 1 year from July 2021 to June 2022 among the 60 pre and postmenopausal women in Rajshahi city. Pre-designed, validated structured questionnaire, measuring tape, weight measuring machine and blood collection set were used to gather data. Results: The mean serum calcium level was not significantly decreased (p>0.05) in postmenopausal women but serum magnesium level was significantly decreased (p=0.04) in postmenopausal women in comparison to premenopausal women. Conclusions: Estimation of serum Ca and Mg should be done at regular basis in postmenopausal women to prevent various diseases like postmenopausal osteoporosis and cardiovascular diseases.
Md. Ariful Alam, Md. Habibullah Sarkar, Md. Baharul Islam, Asim Sarkar, Most Tanzilal Lisha, Chandan Kumar Kundu
TAJ, Jan-Jun 2024; 37(1) 182-186
DOI: https://doi.org/10.62469/taj.v037i01.027
Surgical mop retained in the abdominal cavity following surgery is a serious but avoidable complication. The condition may manifest either as an exudative inflammatory reaction with formation of abscess, or aseptically with a fibrotic reaction developing into a mass. This case report documents the successful extraction of a retained surgical mop from duodenum in a 50 years old lady, who presented with features of gastric outlet obstruction 11 months following open cholecystectomy. This case underscores the importance of vigilance for gossypiboma in post-operative patients and highlights endoscopy as a valuable diagnostic and therapeutic tool which can avoid invasive surgical interventions.
Md Abdul Barik, Rukshana Amin, Md Mesbah-ul Alam, Md Asadul Islam, Md Mohimanul Hoque, Abu Shahin Mohammed Mahbubur Rahman
TAJ, Jan-Jun 2024; 37(1) 187-191
DOI: https://doi.org/10.62469/taj.v037i01.028
Hemophagocytic lymph histiocytosis (HLH) is a rare serious life-threatening condition due to reactive hyperactivity of cytotoxic cells, leading to cytokine storm. Subsequently leads to multiorgan dysfunction and ultimate failure. it could be primary (hereditary) or secondary (acquired) to various conditions including infections. It may occur due to dengue infection carries a grave prognosis even with appropriate treatment. Therefore, a high degree of clinical suspicion is crucial in diagnosing HLH. We report here a case of a patient infected with the dengue virus who developed HLH during hospitalization. A 30-year-old man was admitted to a tertiary care hospital in Rajshahi, Bangladesh with a 4-day history of fever, headache, and alteration of consciousness level. He was hemodynamically stable, and the serological investigation confirmed a dengue infection. On the fifth day of fever, he entered the critical phase of dengue infection, confirmed by ultrasound evidence of plasma leaking. However, he had ongoing high fever spikes during the crucial phase, and even after the critical phase was over, the fever spikes continued. Simultaneously, hepatosplenomegaly was noticed, and he showed persistent thrombocytopenia, neutropenia, and anemia despite the resolution of the critical phase. Further, the workup revealed a serum ferritin level of > 10500 ng/mL triglyceride level of 540 mg/dL. Secondary HLH was diagnosed based on criteria used in the HLH-2004 trial and successfully managed with intravenous dexamethasone 10 mg/body surface area/day for the first 2 weeks, followed by a tapering regimen over 8 weeks.
Md. Zamil Hossain, Md. Nowshad Ali, Shah Md. Ahsan Shahid, Shantona Rani Paul, Abdullah Al Mamun
TAJ, Jan-Jun 2024; 37(1) 192-200
DOI: https://doi.org/10.62469/taj.v037i01.029
Background: Gastroschisis is a congenital abdominal wall defect requiring complex surgical intervention. Its management remains challenging, especially in resource-limited settings. Objective: The primary objective was to evaluate the outcomes and associated factors in treating gastroschisis patients at Rajshahi Medical College Hospital from January 2020 to December 2021. Methods: We conducted a retrospective analysis of 50 gastroschisis cases. Patient data were collected, including demographics, mode of delivery, place of birth, term/preterm status, antenatal history, treatment modalities, surgical procedures, post-operative events, outcomes, associated illnesses, post-operative complications, and duration of stay. Percentages were calculated for various variables to provide insights into the patient population and outcomes. Results: The study 50 patients examining gastroschisis outcomes and management. Gender distribution revealed 29 males (58.3%) and 21 females (41.7%). Regarding mode of delivery, 32 patients (63.9%) underwent Normal Vaginal Delivery (NVD), while 18 (36.1%) had Caesarian Section. Most patients (90.3%) were born out of hospitals. Gestational age distribution showed 70.8% term and 29.2% preterm births. Among the patients, 61.1% had a birth weight over 2.5 kg. Operative treatment was administered to 45 patients (90%), while 5 (10%) died before surgery. Primary repair was the most common treatment (57.7%), followed by Silo closure with staged repair (33.41%). These findings suggest a need for tailored interventions based on patient characteristics. Conclusions: This study highlights the challenges in managing gastroschisis at our institution, particularly in cases with high cardiac arrest and mortality rates. Improving pre-operative care, surgical techniques, and post-operative monitoring are needed to enhance patient outcomes.
Atiquzzaman, Shayla Sharmin, Ferdous Towhid, Shyamal Chandra Banik, Prof. A. K. M. Murshed
TAJ, Jan-Jun 2024; 37(1) 201-207
https://doi.org/10.62469/taj.v037i01.030
Background: Enteric fever, primarily caused by Salmonella Typhi and Paratyphi, remains a significant public health issue in Bangladesh. Objective: The study's objective was to identify modifiable risk factors for enteric fever and assess related complications in patients admitted to a tertiary hospital in Bangladesh. Methods: A cross-sectional study was conducted between January 2022 and January 2023, involving 200 patients diagnosed with enteric fever. Data on demographics, symptoms, diagnostic results, and complications were collected. Clinical investigations, including the Widal test and blood cultures, were used to assess risk factors and complications. Results: The majority of patients (52%) were aged 18-22, and 57% were female. Fever was observed in all cases, with common symptoms such as headache (94%), myalgia (84%), and constipation (57%). The Widal test was positive in 65% of cases, while blood cultures were positive in 18%. Key risk factors included contaminated food and water (72.5%), malnutrition (54.5%), and poor sanitation (42.5%). Complications were present in 39.5% of cases, with febrile seizures (20.25%) and enteric encephalopathy (12.66%) being the most frequent. Conclusion: Contaminated food and water, malnutrition, and poor sanitation are modifiable risk factors for enteric fever in Bangladesh.
Md. Atiqul Islam , Mohammed Jafar Iqbal, Mirza Md. Ziaul Islam, Prof. Sheuly Begum
TAJ, Jan-Jun 2024; 37(1) 208-2018
https://doi.org/10.62469/taj.v037i01.031
Background: Dengue Fever is a mosquito-borne viral disease that poses a significant health threat, particularly in pediatric populations in tropical and subtropical regions. Understanding the clinical presentations and hematological profiles of affected children is crucial for effective management and treatment strategies. Methods: A prospective observational study was conducted at a tertiary hospital from June 2022 to May 2023. Pediatric patients (aged ≤14 years) with laboratory-confirmed dengue infection via NS1 antigen or IgM antibody tests were included. Data collection involved clinical assessments, structured questionnaires, and laboratory investigations monitoring hematocrit, platelet counts, liver enzymes, ferritin, and D-Dimer levels. Results: Fever (85%), nausea (56.5%), and headache (36%) were the most common symptoms. Thrombocytopenia was observed, with a mean platelet count of 150.2 x10^3/μL. Mild liver involvement was indicated by elevated SGPT (45.0 U/L) and SGOT (48.0 U/L). Inflammatory markers like CRP (mean 10.0 mg/L) and D-Dimer were mildly elevated, suggesting an inflammatory response. Bleeding showed a negative correlation with platelet count (-0.35). Older children had lower platelet counts and higher serum creatinine, indicating age-related differences in disease severity. Conclusion: The study underscores the diverse clinical and hematological manifestations of Dengue Fever in children.
Popy Akter, Pandora Glory, Md. Al Mamun Hossain, Zannat-ul- Sarmin
TAJ, Jan-Jun 2024; 37(1) 219-223
https://doi.org/10.62469/taj.v037i01.032
Background: EPTB receives less attention than PTB because of its low infection potential. Clinically EPTB is still under recognized and diagnosis are often delayed due to its paucibacillary nature and atypical presentation. Proper diagnosis needs isolation of organism, that is always not possible by doing AFB staining, culture of different body fluid, biopsy only. Gene Xpert MTB/RIF Ultra (Xpert Ultra) was evolved to prevail over this limitation. Materials & Methods: In this prospective, single center, cross-sectional, diagnostic performance study which was conducted at the department of Paediatrics in Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh over 1 year period. Different body fluid (CSF, ascetic fluid, pleural fluid, pus etc) for AFB staining, micobacterialculture, Xpert MTB/RIF Ultra, biopsy for histopathology of children presenting with presumptive extra pulmonary tuberculosis were tested with Adenosine deaminase (ADA) & other baseline investigations. Total 80 children having the clinical features of extra pulmonary tuberculosis were enrolled and evaluated. Diagnostic performance (sensitivity, specificity, positive & negative predictive value) of Gene Xpert MTB/RIF Ultra were analyzed. Results: From January, 2021 to december, 2021 total 80 patients were evaluated. Among them, 17.5% were diagnosed as TBM & 11.3% were TB lymphadenitis, 6.3% were abdominal TB, 3.8% were pleural TB, 1.25% were spinal TB. AFB staining positive in 4.8% (3 of 62), culture growth positive in 8.06% (5 of 62) & Gene Xpert Ultra positive in 37.97% (30 of 79) cases. Against the mycobacterial culture results and AFB staining, Xpert Ultra had sensitivity of 100.0% (69.2 – 100.0; p 0.001) &100.0% (26.2 to 87.8; p 0.01), respectively. Xpert Ultra had specificity of 73.7% and 71.2% respectively. Conclusion: Xpert Ultra detected extra pulmonary tuberculosis with higher sensitivity than culture and AFB staining in paediatric population.
Md. Abul Hasnat, Ashraful Islam Rana, Azizur Rahman, Md. Homyonur Rahman
TAJ, Jan-Jun 2024; 37(1) 224-228
https://doi.org/10.62469/taj.v037i01.033
This study evaluates the outcomes of Percutaneous Nephrolithotomy (PCNL) performed under spinal anaesthesia. We analyze The Challenges and Strategies with safety, efficacy, and patient satisfaction associated with this anaesthetic technique, comparing it to general anaesthesia in both Supine and prone position terms of complications, recovery time, and patient comfort. Methods: A retrospective cohort study was conducted at Shahjalal Hospital Sylhet, analyzing outcomes of PCNL under spinal anaesthesia over 2 years. Data collected included patient demographics, stone characteristics, procedural details, complications, and recovery metrics. Results: A total of 144 patients underwent PCNL under spinal anaesthesia. The overall success rate was 90%, with a complication rate of 7%. Patient satisfaction was high, with an average postoperative pain score of 4/10 and an average recovery time of 2 hours. Conclusion: PCNL under spinal anaesthesia is a safe and effective alternative to general anaesthesia, offering advantages in recovery and patient comfort.
Miftahul Hossain Chowdhury, Md. Golam Faruk Hossain, Shamima Siddiqui, Mazharul Hoque Bhuiyan
TAJ, Jan-Jun 2024; 37(1) 140-147
https://doi.org/10.62469/taj.v037i01.020
Background: Diabetes mellitus (DM) is a global health challenge, significantly increasing the risk of complications such as diabetic retinopathy, a leading cause of low vision and blindness. The World Health Organization emphasizes the need for early detection and treatment, particularly in low- and middle-income countries. Objectives: To assess the prevalence of low vision in diabetic patients and identify related demographic and clinical risk factors. Method and Materials: This cross-sectional study involved 132 diabetic patients at the Ophthalmology Department of Shaheed Tajuddin Ahmed Medical College from January 2021 to December 2022. Data were collected through interviews, clinical examinations, and reviews of medical records, focusing on visual acuity, duration of diabetes, and comorbidities, with analyses performed using SPSS software. Ethical approval was obtained, ensuring informed consent and participant confidentiality. Result: The study population comprised 132 diabetic participants, with a mean age of 56.4 years. The majority had been living with diabetes for over 10 years (43.2%) and displayed moderate low vision (30.3%). Comorbidities included hypertension (56.8%) and diabetic retinopathy (68.2%). The average HbA1c level was 8.2%, indicating poor glycemic control in 39.4% of participants. Most utilized low vision aids like magnifying glasses (30.3%), while 28% did not use any aids. Conclusion: This study reveals a high prevalence of low vision in diabetic individuals, emphasizing the impact of diabetic retinopathy, poor glycemic control, and comorbidities on vision impairment.
Md. Abdullah Al Maruf, Md. Zahidul Hoque, Nazrul Islam, Shorif Uz Zaman, Md. Nazmul Islam Nissan, A. F. M. Julfikar
TAJ, Jan-Jun 2024; 37(1) 148-155
https://doi.org/10.62469/taj.v037i01.021
Background: Postoperative infections, particularly surgical site infections (SSIs), are common complications following open reduction and internal fixation (ORIF) surgeries. Objectives: To determine postoperative infection rates in ORIF for fractures, identify risk factors, evaluate infection onset time, and compare infection rates across study centers. Materials and Methods: This prospective, cross-sectional observational study was conducted from January 2021 to December 2024 at Dashmina Upazila Health Complex, Patuakhali. Fifty patients undergoing ORIF for fractures were included. Baseline data, including demographics, comorbidities, and surgical details, were collected. Postoperative wound assessments were done at 7, 30, and 90 days to monitor surgical site infections, following CDC guidelines. Result: Out of 50 patients, 15 (30%) developed surgical site infections (SSIs). The distribution of fractures showed 20 femoral fractures (7 infected, 13 non-infected), 18 tibial fractures (5 infected), and 12 "other" fractures (3 infected). Prolonged surgeries (>2 hours) were associated with infections in 10 patients (66.7%), while 13 patients received preoperative antibiotics, with 11 (86.7%) developing infections. Diabetes mellitus (OR=3.2, p=0.04) and prolonged surgery (OR=4.5, p=0.01) were significant risk factors. Conclusion: This study provides valuable insights into the incidence of postoperative infections following open reduction and internal fixation (ORIF) for fractures, emphasizing the significant risk factors contributing to surgical site infections (SSIs).
Al-Imran Mahmud, Abdullah-Al- Noman, M. C. Pal Mintu
TAJ, Jan-Jun 2024; 37(1) 156-163
https://doi.org/10.62469/taj.v037i01.022
Background: Avascular necrosis (AVN) of the femoral head is a progressive condition leading to joint collapse and severe pain, particularly in young adults. Total hip arthroplasty (THA) is the standard treatment for advanced AVN, offering pain relief and functional restoration. Objectives: Evaluate long-term outcomes of THA in young Bangladeshi patients with AVN, focusing on pain relief, function, complications, and quality of life. Method and Materials: This retrospective cohort study includes young adults aged 18-45 with AVN of the femoral head who underwent THA at Dhaka Medical College Hospital between July 2021 and June 2022. Data on demographics, clinical history, surgical outcomes, and complications will be collected. Functional recovery will be assessed using the Harris Hip Score at 6 months, 1 year, and 2 years. Statistical analysis will utilize SPSS version 25. Results: The study found that most patients were aged 26-35 years (35.7%), predominantly male (66.7%), with office workers representing 42.9%. Avascular necrosis symptoms were present for 6-12 months in 35.7% of patients. Comorbidities were common, with hypertension (28.6%) and diabetes (21.4%) most prevalent. Surgical complications were rare, with dislocation (11.9%) being the most frequent. Post-surgery, 83.3% reported significant pain relief, and 71.5% had good to excellent functional outcomes. Conclusion: This study has highlighted the outcomes of total hip arthroplasty (THA) in young Bangladeshi patients with avascular necrosis (AVN) of the femoral head, emphasizing the effectiveness of the procedure in improving both pain relief and functional recovery.
N I Bhuiyan, Mohammad Hasibul Islam, Md. Abdullah Al Mamun
TAJ, Jan-Jun 2024; 37(1) 164-171
https://doi.org/10.62469/taj.v037i01.023
Background: Renal stones are a common urological condition requiring advanced management strategies. Ultra Mini PCNL (UMP), utilizing an 11–14 Fr tract, offers an effective, minimally invasive solution for moderate-sized renal stones, reducing complications like bleeding and recovery time compared to standard PCNL. Objectives: The general objective of this study was to evaluate the effectiveness, safety, and clinical outcomes of Ultra Mini Percutaneous Nephrolithotomy (UMP) in the management of renal stones. Methods and Materials: This prospective observational study was conducted at Square Hospital, Dhaka, Bangladesh from January 2017 to December 2022, involving 94 patients aged 25–65 years undergoing Ultra Mini PCNL (UMP) for renal stones. Patients were selected using convenience sampling. Data were collected through clinical evaluations, imaging studies, and intraoperative findings. Descriptive and inferential statistics were performed using SPSS (v23). Ethical approval was obtained, and all participants provided written informed consent. Result: The study of 94 participants (66.0% male, 34.0
Md. Mahin, Mahmud Hussain, Md. Ferdaus Qamruddin
TAJ, Jan-Jun 2024; 37(1) 172-179
https://doi.org/10.62469/taj.v037i01.024
Background: Knee osteoarthritis (OA) is a common degenerative joint disease, particularly in older adults, resulting in pain, disability, and reduced quality of life. Early-stage OA can benefit from non-surgical treatments like platelet-rich plasma (PRP) and hyaluronic acid (HA). Objective: This study aims to compare the efficacy of autogenous PRP versus HA injections in managing pain, improving function, and enhancing patient satisfaction in early knee OA (Kellgren-Lawrence grade 1 and 2). Method: A total of 122 patients diagnosed with early knee OA were randomly assigned to receive either PRP or HA injections. Each patient received three injections at three-week intervals. Pain was measured using the Visual Analog Scale (VAS), and functional improvement was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patient satisfaction was evaluated via a self-reported questionnaire at baseline, 3-, 6-, and 12-months post-treatment. Results: At 12 months, both groups demonstrated significant improvements in pain and function. The PRP group showed a 40% reduction in VAS scores and a 35% improvement in WOMAC scores, while the HA group showed a 30% reduction in VAS and a 25% improvement in WOMAC. Patient satisfaction was higher in the PRP group, with 80% reporting significant improvement compared to 65% in the HA group. Conclusions: PRP injections provided superior pain relief, functional improvement, and patient satisfaction compared to HA injections, suggesting PRP as a more effective treatment for early knee OA.
Shamima Siddiqui, Md. Mifftahul Hossain Chowdhury, Momtaj Begum
TAJ, Jan-Jun 2024; 37(1) 180-187
https://doi.org/10.62469/taj.v037i01.025
Background: Oral cancer particularly squamous cell carcinoma is a very common problem in Bangladesh. A significant portion of patients present at late stage mostly due to initial symptomless behavior of lesion and lack of awareness. The tumor commonly involves buccal mucosa of mandible and in more advance stage. Objectives: The study aims to determine the utility of computed tomography in diagnosing oral cavity carcinoma, including the frequency of different types of malignant oral cavity carcinomas. Methods and Materials: This cross-sectional study was conducted in the Department of Radiology and Imaging at BSMMU from July 2016 to June 2018, enrolling 60 patients with suspected malignant oral cavity carcinoma. Informed written consent was obtained, ensuring ethical standards were maintained throughout the study. Data were collected using a preformed questionnaire and personal file analysis, and were subsequently analyzed using SPSS 23. Results: The study included 60 patients, with 36.7% aged 65-74 years and 56.7% male. Socio-economically, 73.3% had below-average income. Betel nut/quid chewing was prevalent in 63.33% of cases (p = 0.028), indicating a strong association with oral cancer. Tumor size averaged 4.3 cm, and 53.33% of tumors were in the advanced T4 stage. CT scans showed 70% of lesions were isodense, and the diagnostic accuracy of CT for oral carcinoma was 91.67%, with a sensitivity of 94.87%. Conclusion: CT plays a crucial role in diagnosing oral cavity carcinoma, particularly in elderly males, with most patients suffering from the disease for an average of three years or more.