Chittagong Medical College Hospital

About: Chittagong Medical College Hospital is a healthcare organization based out in Chittagong, Bangladesh. It is known for research contribution in the topics: Population & Malaria. The organization has 676 authors who have published 601 publications receiving 7040 citations.

Hyalinizing trabecular adenoma of thyroid - a case report and review of literature

Abstract: Hyalinizing trabecular adenoma of thyroid is a rare tumour first described in 1987. It’s cytological and histopathological features are very close to other thyroid neoplasms specially papillary and medullary carcinoma. So misinterpretation of cytological feature may lead to a total thyroidectomy whereas a lobectomy is enough to cure this benign condition. Here we present such a case in a 30-year-old female patient and review the diagnosis and management DOI: http://dx.doi.org/10.3329/bjo.v18i2.12018 Bangladesh J Otorhinolaryngol 2012; 18(2): 203-206

Reproductive Health and Service Delivery Status in a Rural Area of Bangladesh

Abstract: Background: Reproductive Healthcare Services is a service that contributes to reproductive health and wellbeing through preventing and solving reproductive health problems. Objective of the Study: To find out the reproductive health status and also the service delivery pattern in a rural area. Methodology: It is a cross sectional study done in a village named Kalirbazar, 3km away from the BARD, Comilla, during the period of13th February to 13th March, 2011. Data were collected purposively by Individual interview through a structured questionnaire. A total 30 women of reproductive age group (15-45yrs) were taken. Both adolescent unmarried girls and married women of reproductive age group were included in this study. After collection, data were analyzed, tabulated and presented. Results: Respondents were mostly married( 63%), unmarried 33%; almost all of the women were Muslim (93%) and from low socioeconomic status(77%). Sixty six percent of women got married before 18 yrs of age and 47% were illiterate, more than half of the women (60%) were housewives and 28% dropped out from schools. Forty percent of married women had 2-3 children.Most of the Women had knowledge about contraception, like-OCP (33%), inj. (27%), barrier (17%), female sterilization (06%) and 17% had no knowledge. Among the married women 53% use OCP, 32% injectable contraceptives, 11% sterilization and 04% had vasectomy. Among respondents, 70% had some sorts of menstrual problem, 85% women lacked of antenatal checkup, 95% delivery occurred at home, 90% delivery conducted by local dhai and unexpectedly 73% of women had knowledge of STD/HIVA there were problems in getting the services. Only few of them were satisfied with the services getting either from GO or NGO or from private sector. Almost all the women were buying the reproductive healthcare services (83%). Conclusion: Reproductive health status in the rural area is not at all satisfactory. GO. and NGO often fail to make health services available to the doorstep of the users in the community who are in dire need of it . DOI: http://dx.doi.org/10.3329/bjog.v26i1.13756 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(1) : 27-30

Comparison of short-term efficacy of valproate sustained-release between adult and children as first-line monotherapy in management of partial epilepsy: A multicenter observational open-label study

Abstract: Background: Management of partial epilepsy is an important issue in the field of neurology. Objective: The purpose of the present study was to collect additional clinical data on efficacy and safety of sustained release sodium valproate chrono formulation as first-line monotherapy in patients newly or recently diagnosed with partial epilepsy in Bangladesh under daily practice condition. Methodology: This open-label, multicenter, non-controlled, prospective, observational study enrolled adults and children ? 6 years newly diagnosed with partial epilepsy with or without secondary generalization between March 2010 and February 2011. Patients were treated with sustained release sodium valproate. Primary evaluation criterion was the remission rate i.e. proportion of seizure-free patients at 6 months. Secondary evaluation criteria included retention rate at 6 months, remission rate at 1 and 3 months, investigator's global clinical impression rating, safety profile assessment. Results: A total of 185 adults and 115 children with mean 4.4 months duration of epilepsy were included. At inclusion the mean daily valproate dose in children was 329 mg and 568 mg in adults. The mean treatment duration in both children and adults was 5.5 months. At the end of 6 months 74.7% of the patients were seizure-free (children and adults; 79.1% vs 71.9%). The number of seizure free patients at 1 month was 109 (36.3%) and 175 (58.3%) at month 3. The treatment retention rate at 6 months was 87.3% with small higher trend in adults than children (88.6% vs. 85.2%). Among the patients 9.3% experienced side effects like drowsiness and weight gain. No severe adverse event was reported. Conclusion: Sodium valproate sustained release formulation is effective for the first-line treatment of partial epilepsy in both adults and children with acceptable tolerability J. Natl Inst. Neurosci Bangladesh 2015;1(1):2-4

Outcome of Late Anterior Surgery and Arthrodesis of Lower Cervical Spinal Cord Injury

Abstract: Objective: To evaluate the efficacy and outcome of late anterior surgery and arthrodesis of lower cervical spinal cord injury. Study design: Prospective Analysis. Setting: Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka; Bangladesh. Subjects and Methods: 32 consecutive patients with sub axial cervical spinal cord injury managed surgically from January 2000 to July 2005 by late anterior surgery and autologous bone graft stabilization considered as study unit. The indications of surgery were persistent cervical spinal cord compression and / or instability of cervical spine. Most cases were admitted late and operations were carried out as late 1 week to 27 weeks after injury. All the patients were investigated by radiograph and MRI of cervical spine accordingly. Post operative patient were followed up for twice, just before discharge from hospital and there-after minimum 3 months to 3 years. Quantification of deficit and neurological outcome were rated by American Spinal Injury Association (ASIA) classification system. Results: Males were found predominant with 93.75% over the female 6.25%; with ratio is 15: 1. Minimum age of the patient is 16 years and maximum age is 55 years. Most frequently (37.50%) encountered group were between the age of 31 to 40 years. Mean age is 32.29±10.09 years. Falling due to slip while carrying heavy load on head and / or neck (37.50%) was the most common cause of sub axial cervical spinal injury followed by road traffic accidents (31.25%), which may not be reported elsewhere till to-date. 31.25% suffered a single vertebral level, 62.50% patients suffered two vertebral levels and 6.25% patients suffered three level vertebral levels. The commonest skeletal level was C5/6 (46.87%) followed by C5 (25.00%) but C5 (46.87%) was commonest neurological level followed by C4 (18.75%). 81.25% of patients sustained a neurological injury. Of these, 75.00% had incomplete neurological deficit. After the operative procedure these incomplete neurological deficit patients have shown very attractive neurological recoveries. 6.25% of total population, who had complete neurological deficit, was graded as ASIA grade - A did not show any neurological recovery. In the current series none of the patients had worsening of neurological deficit due surgical intervention. Conclusion: This study offer significant potential for repairing some of the damage caused by cervical spinal cord injury. Further more, though controversy exists as to the ideal approach and timing (early versus late surgery) we have seen that benefits derived from late anterior surgery in our patients. Key words: Spinal Cord Injury; ASIA impairment scale; Neurological outcome. DOI: 10.3329/jdmc.v18i1.6306 J Dhaka Med Coll. 2009; 18(1) : 47-53

Medical Management of Ectopic Pregnancy: An Observational Study

Abstract: Objectives: The aim of this study was to explore the safety and efficacy of medical management of ectopic pregnancy. Materials and methods: This prospective observational study was conducted between February 2011 to August 2013 in Chittagong Medical College Hospital (CMCH) and in different private clinics of Chittagong city. Twenty-seven patients of ectopic pregnancy conceived by fertility treatment were recruited for medical treatment after proper evaluation. Ectopic pregnancy was diagnosed by serum ?-hCG and progesterone level but missing intrauterine pregnancy by transabdominal sonography (TAS). Serum ?-hCG was repeated after 48 hours to observe doubling of the level. If level was not doubled or increment was not at least 66% and serum progesterone level was less than 15ng/ml then it was considered as ectopic pregnancy. Patients were treated with Injection methotrexate 50 mg intramuscularly either by single dose or two doses. After 4 days of 1 st injection ?-hCG was repeated and if level decreased > 15% then patients were assessed weekly till ?-hCG fell to <5lU/L. If drop was <15% after 4 days a second dose of methotrexate was given. Results: Overall success rate was 66.66% . Surgical intervention was needed in 22.22% patients. All patients were treated after hospitalization in CMCH and different private clinics of Chittagong. They got injection methotrexate, antibiotic, antispasmodic and analgesics for abdominal pain. Single dose cured 55.55% patients and 11.11% patients needed second dose, another 11.11% patients were misdiagnosed –later on they were diagnosed as intrauterine pregnancy and medical termination was done. Within one year of treatment 33.33% patients conceived again. There was no side effect or complications of the treatment. Conclusion: This small trial gave a good impression about medical treatment in selective cases. The efficacy should be assessed in a randomized clinical trial with a different set of population Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 32-36