Anindita Sarkar, S. M. Asafudullah, Shah Md. Badruddoza, Rebeka Sultana, Sunandita Sarkar, Sujit Kumar Sarker
TAJ, Jan-Jun 2022; 35(1) 01-06
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Background & Objective: Early and accurate diagnosis of thyroid neoplasm is of utmost significance for prolongation of patient survival. A panel of immunomarkers has been tested to overcome the limitation of histopathology. CK-19 is a commonly used immunomarker among them. This study was undertaken to evaluate the diagnostic accuracy of CK-19 in thyroid neoplasm. Methods & Materials: This cross-sectional study was conducted in the Department of Pathology, Rajshahi Medical College, over a period of two years, from July 2017 to June 2019. A total of 44 tissue blocks of histologically confirmed thyroid neoplasm were included in this study. Then immunohistochemistry was done for CK-19 from a significant paraffin-embedded block. Result: In the present study, diffuse and strong positivity of CK-19 was found in papillary thyroid carcinoma (PTC), followed by focal positivity in follicular(FC) and medullary carcinoma (MC). A negative staining pattern was found in all cases of follicular adenoma (FA). The sensitivity and specificity of CK-19 were found to be high in the case of PTC, respectively, 88% and 92%.CK-19 expression was highly specific in differentiating malignant from benign thyroid tumors (100%). Conclusion: The study concluded that CK 19 is a highly sensitive and specific marker in papillary thyroid carcinoma. Diffuse and strong positivity is characteristic of PTC, which can be used in diagnosis with equivocal morphological appearance.
Tanzila Rawnuck, Md Selim Reza, Mohammad Fatteh-Ul- Islam, Shahanaj Parveen, Hasina Begum, Muhammad Mahbub-ul Alam
TAJ, Jan-Jun 2022; 35(1) 07-10
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Background: Dental caries has been a major problem in Bangladesh for decades. Oral diseases are the most common non-communicable diseases related to severe local and systemic disorders. Oral microorganisms can grow and spread in the oral mucosae and most commonly in biomaterials under polymicrobial biofilms, leading to several diseases such as dental caries and periodontal disorders. Aims: This study aimed to detect S. mutants and S. sobrinus by polymerase chain reaction (PCR) amplification and to relate the link between their presence and dental caries. Materials and Methods: Streptococcusmutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) strains were isolated from individuals with no caries. However, they were isolated with high counts of those organisms in saliva samples. The saliva samples were collected from the patients who attended the outdoor Dhaka Dental College Hospital from March 2018 to December 2018. PCR was performed to detect the presence of different organisms. Results: Prevalence of S. mutans and S. sobrinus was, respectively, 19% and 04%. About 68% of the saliva sample was not either positive for both bacterial species, whereas 09% was positive for both bacterial species. Conclusion: This study demonstrated that PCR is an easy, quick, and reliable method for detecting S. mutans and S. sobrinus in epidemiological studies. It was also observed that S. mutans was the most common organism than S. sobrinus to develop caries.
Rajesh Kumar Ghose, Md. Rezaul Karim, Harisul Hoque, Rais Uddin Mondol, Rita Ghosh
TAJ, Jan-Jun 2022; 35(1) 11-16
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Changes in cardiac structure and function detected by echocardiography are common in patients with type 4 cardiorenal syndrome and have been recognized as key outcome predictors. This study aimed to evaluate echocardiographic patterns in severe chronic kidney disease CKD in type 4 cardiorenal syndrome patients. This was a descriptive type of crosssectional study. The study was carried out in the Cardiology and Nephrology Department of Bangabandhu Sheikh Mujib Medical University, Dhaka. After exclusion total of 44 patients having severe CKD (GFR <30 ml/min/1.73 m2) with type 4 cardiorenal syndrome were included in this study. All patients underwent echocardiography. Most of the patients with type 4 cardiorenal syndrome were in the 6th decade (Mean age was 58.9±5.9 (SD)in severe CKD with male predominant. Ischemic heart disease(65.9%), arrhythmia(13.63%), and heart failure(22.72%) were significantly noted in severe CKD in type 4 cardiorenal syndrome patients. Mean systolic blood pressure was 178.2±18.7 mmHg & mean diastolic blood was 97.7±5.9 mmHg among the study subjects. Left ventricular hypertrophy (54.6%), systolic dysfunction (27.3%), pericardial effusion (36.4%), valvular calcification (63.6%), and diastolic dysfunction (54.5%) were most common finding in severe CKD with type 4 cardiorenal syndrome. The study recommended that a Careful analysis of echocardiographic findings in patients with type 4 cardiorenal syndrome may discover the signs of cardiovascular changes. Thus appropriate measures can be taken. From this current study, it is evident that most of the patients with type 4 CRS with severe CKD developed left ventricular hypertrophy, so periodic 24- hour ambulatory blood pressure monitoring may be advised to address the unusual rise of blood pressure and treat it properly.
Md. Rezaul Karim, Md. Afzalur Rahman, Rais Uddin Mondol, Tariq Ahmed Chowdhury, Rajesh Kumar Ghose
TAJ, Jan-Jun 2022; 35(1) 17-24
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The goal of this study was to determine the sensitivity and specificity of the Myocardial Performance Index (MPI)for the assessment of acute right ventricular Infraction. This was a descriptive type of cross-sectional study. The study was carried out in the Coronary Care Unit, Department of Cardiology, Sir Salimulla Medical College, and Mitford Hospital. After exclusion total of 72 patients were included in this study, of which 24 had acute inferior MI with RV involvement diagnosed by ≥ 1mm STsegment elevation in V3R-V5R of right-sided ECG (group-I) and 48 had acute inferior MI without RV involvement (group-II). All patients underwent echocardiography within 24 hours of admission. The study revealed that RV MPI was significantly increased (0.57± 0.13) in RVMI patients compared to IMI without RVMI (0.24± 0.12). MPI detected RVMI in 08 patients (0.45± 0.09) who did not have ECG findings of RVMI (Group-II). Repeat MPI estimation after 05 days in 21 RVMI (Group-I) and 08 isolated IMI (Group-II) patients who had RVMPI > 0.30showed dramatic reduction of MPI (0.19± 0.07 and 0.22±0.09), respectively. RV MPI ≥ 0.30 has high sensitivity (100%) and specificity (89%) for the diagnosis of RVMI in the presence of acute IMI. The study recommended that MPI may be a new non-invasive echocardiographic gold standard tool in diagnosing acute RVMI and also assessment of right ventricular function in acute inferior myocardial infarction with high sensitivity and specificity. MPI changes can be serially followed in acute RVMI patients to assess changes in RV function.
Md. Asadur Rahman, Md. Khorshed Alam, Nazmin Rahman, Ariful Alam, Faisal Alam, Anisur Rahman
TAJ, Jan-Jun 2022; 35(1) 25-31
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Abstract: Sore throat manifested by throat pain is a troublesome issue or discomfort for which physicians are used to prescribing antibiotics, but most often, it is found that the patient is not responding to the drug, which gives rise to the question of drug-resistant or whether there is any infection at all? Nonspecific throat pain also imparts serious public health problems. Selfmedication, inadvertent and inadequate doses of antibiotics frequently prescribed by both village doctors and registered MBBS doctors is really a public health problem in developing countries like Bangladesh. Aims: The aims of this study are to isolate the common organisms in chronic throat infection and to find out the effectiveness of various commonly used antibiotics. Methods: The samples were collected randomly from sore throat patients via a throat swab in 5 ml of 1% sterilized saline water, and the sample was brought to the laboratory and was inoculated within two hours in both blood agar and nutrient agar (NA) media and samples were incubated at 37°C overnight. Then pure colonies were transferred to Mueller Hinton agar, and antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion method. Results: A total of 27(24%) out of 111 samples yield positive growth. In a large number of samples, 84 (76%) did not show any isolation of the pathogenic organism. The predominant organism is a Staphylococcus aureus (55.55%). Thereafter, streptococcus (18.51%), Klebsiellapneumone (14.81%)and Pseudomonas (11.11%).Amoxiclav is the most resistant drug, along with cefuroxime, azithromycin, and doxycycline, respectively. Levofloxacin and ciprofloxacin show intermediate sensitivity. The most sensitive drug used in chronic sore throat found is linezolid though not frequently used, and other sensitive drugs are moxifloxacin and ceftriaxone. Conclusion: Throat pain or soreness does not always indicate that patient has been infected by bacteria. Rationale and ethical prescription, as well as microbiological sensitivity testing, are considered to avoid drug-resistant strains.
Afroza Nazneen, Md. Nafis Alam Adnan
TAJ, Jan-Jun 2022; 35(1) 33-38
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Grade III and Grade IV sacral pressure sores are required surgical closure. The gluteal fascio-cutaneous rotation advancement flap with V-Y closure was performed in our hospital on 50 cases of sacral sore from 2017 to 2019. The largest defects closed with a unilateral flap were up to 14 cm, and a bilateral flap needed to close 15-22 cm in diameter. In 1.5 to 24 months of follow-up time, none of the patients developed wound dehiscence or flap necrosis requiring repeated surgery. The V-Y rotation advancement flap technique is simple, can be performed quickly, has minimal associated morbidity, and has a good outcome. Furthermore, we can use the same flap design in recurrent cases.
Shantona Rani Paul, Mohammad Saiful Islam, Md. Nowshad Ali, S M Ahsan Shahid, Md. Zamil Hossain
TAJ, Jan-Jun 2022; 35(1) 39-44
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Introduction: Splenectomy has long been used to treat benign hematological abnormalities such as immune thrombocytopenia (ITP), some hemolytic anemias- especially hereditary spherocytosis and thalassemia, and prehepatic portal hypertension. The discovery that splenectomized individuals are more vulnerable to encapsulated organism infection has been attributed to the spleen's lack of filtration and the development of anticarbohydrate antibodies. Recent research in such splenectomized patients suggests that the lack of this specific anticarbohydrate antibody in these participants is attributable to a decreased number of Memory B cells (a subgroup of B lymphocytes in charge of T-independent responses). Traditional vaccinations, which are given to splenectomized patients to protect them from being infected by encapsulated organisms, can only act in the presence of both the spleen and its functioning marginal zone. As a result, the study will look at the level of memory B cells in the blood after three months and 1-year post-splenectomy. Aim of the study: The objective of the study was to observe the short- and long-term effects of splenectomy on memory B cells in children. Methods: This prospective case-control study was conducted at the Pediatric Surgery Department of Bangabandhu Sheikh Mujib Medical University, Bangladesh. The study duration was one year, from July 2015 to August 2016. A total of 26 children were selected through a purposive sampling technique for this study, where the control group consisted of 10 children, and the case group consisted of 16 splenectomized children. Result: Among the case group participants, 56.25% were from the oldest age group of 12- 15 years, and 37.5% were from the age group of 8-11-years. Male prevalence was high in both the control and the case group. Beta thalassemia was the primary indication for splenectomy for 81.25% of case group patients. Mean B lymphocyte was 39700.2 in the control group, 3655.3 at the 3-month follow-up of case group participants, and 3381.7 for those who had follow-up1-year after splenectomy. The mean amount of IgM memory B cells in the control group was 17.92%; at the 3-month follow-up of the case, it was 18.96%, and at the 1-year follow-up, it was 4.34%. Conclusion: In post-splenectomy individuals, immunological constitutions in memory B cells do not support a T-independent response and, therefore, vaccination.
Md. Kafil Uddin, Manasi Saha, Md. Nasir Uddin Gazi, Sandip Talukdar, Mir Md Raihan
TAJ, Jan-Jun 2022; 35(1) 45-50
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Introduction: Rape is a neglected public health issue in Bangladesh. Here, the incidence of rape is reported almost every day. However, this study was designed to analyze and explore the statistics of alleged rape cases in the Rajshahi district in 2020. Materials and Methods: This cross-sectional descriptive study was conducted in the Department of Forensic Medicine and Toxicology (DFMT), Rajshahi Medical College (RMC), Rajshahi, Bangladesh, from January 2020 to December 2020. A total of 101 study subjects were included in this study. The data were collected from the alleged rape victims who were sent to the DFMT for medico-legal examination. Informed written consent was signed, and a thumb impression was taken by the victim with her legal guardian when the apparent age of the victim was under 12 years status before data collection. This study explores age, marital status, the pattern of assailants, place of occurrence, religion, opinion based on a physical or genital examination, and corresponding police station with another expert investigative organization such as the Police Bureau of Investigation (PBI) of Rajshahi district. Results: Most of the victims were under 20 years old. Among all victims, 46.53% were unmarried, and 42.57% were married. In maximum cases, the victims were sexually assaulted by the known assailants. Almost two-thirds of alleged rapes occurred in the victim's house and the nearby place of the victim’s house. Only 11.88% of victims were examined with positive signs regarding sexual intercourse. Maximum victims (98.02%) were Muslim. Rape cases were frequent in Godagari, Belpukur, and Chndrima police stations.
Nelofar Yasmin, Shubhra Prakash Paul, Md. Jawadul Haque, Md. Rizwanul Karim, Shathi Kumer Rawsan Kamal Md. Abu Syem Shah Amanath Ullah, Most. Firoza Parvin, Kowsarunnahar
TAJ, Jan-Jun 2022; 35(1) 51-61
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Background: Research is the integral part of post-graduation course curriculum. If steps are not taken at an early stage by medical postgraduates who will walk in the path of research in future, the quality of research and its application may be compromised. Students had variable perceptions towards research. The findings of this study could provide insights to improve research training. Objectives: The aim of this study was to assess knowledge and to find out attitude to biomedical research of the post-graduate medical students in Bangladesh. Materials & Methods: This cross-sectional type of descriptive study was carried out in the community Medicine Department of Rajshahi Medical College over a period of 12 months from January to December 2020 among the post-graduate students of different medical colleges. Approval from the Ethical Review Committee (ERC) was obtained prior to the commencement of the study. Purposive sampling technique was used. Pre-designed, validated, structured questionnaire was used to gather information from 325 participants on knowledge and 5-point Likert scale was used for assessment of attitude. Results: In this study excellent knowledge was considered in ≥ 80% correct answers and positive attitude was considered in ≥ 60 score. Out of the 325 study respondents, majority (53.5%) of them were male and pursuing post-graduation in different subjects. Among the respondents, 145 (44.6%) of students had good knowledge, 119 (36.60%) of students had excellent knowledge and 190 (58.5%) had positive attitude toward medical research. Relationship of level of knowledge on biomedical research was not statistically significant for age, sex, religion, marital status, parental and spouse educational status (P>0.05). But association of knowledge was statistically significant for running post-graduation course, type of research involvement and type of medical college of MBBS passing (P < 0>0.05). But male had more positive attitude to biomedical research than female (P<0.05). Conclusion: The study revealed that the respondents had a good knowledge and positive attitude toward biomedical research but they were not able to transform their knowledge and attitude into actual practices.
Muhatarima Tabassum, Md Kafil Uddin, Md Ahmed Ali, S M Emdadul Haque, Md Raseul Kabir Md Amjad Hossain Pramanik
TAJ, Jan-Jun 2022; 35(1) 63-69
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Background: Stroke is one of the most common, most fatal, and debilitating neurologic diseases. Numerous risk factors are involved in the development of strokes, such as hypertension, cigarette smoking, hyperlipidemia, and diabetes. In addition, other factors may influence the disease's development or course, like uric acid serum level. Objective: To determine the association between serum uric acid (SUA) levels in patients with acute ischemic stroke and clinical outcomes. Material and method: This was a longitudinal descriptive study carried out among one hundred and twenty consecutive patients with acute ischemic stroke (AIS) admitted to the Department of Neuromedicine, Rajshahi Medical College Hospital ( during a period of two years from July'2015 to July' '2017 were included in the study. 12.11 years. Of 120 patients with AIS, 60.8% were male, and 39.2% were female. The study revealed that AIS patients with high SUA levels have significantly lower Glasgow Coma Scale (GCS) scores in comparison to normal SUA levels (p<0>0.05). Conclusion: A significant association was found between high serum uric acid levels and the clinical outcome of AIS patients. Estimation of serum uric acid offers a simple, inexpensive, quick, and non-invasive method for identifying such high-risk patients.