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.

Use of Intravenous Ketorolac as Postoperative Analgesic in Neonates: A Prospective Study in Chittagong, Bangladesh

Abstract: Introduction: Painful exposures have the potential for deleterious consequences upon neonates. Although Opioids and NSAIDs play important role in postoperative pain control, those are associated with side effects. We have studied use of ketorolac as postoperative analgesic in Bangladeshi neonates. Methods: This prospective study was undertaken in the Department of Pharmacology & Therapeutics and Department of Pediatric Surgery, Chittagong Medical College, Chittagong, Bangladesh from July 2013 to June 2014. All postoperative neonates received either ketorolac intravenously or acetaminophen per rectally every 8 hrs for 72hrs. Pain was assessed every 8 hours and as-needed basis by CRIES scale. Results: Out of 60 patients, 30 patients were in Ketorolac group and 30 in Acetaminophen group. Pain score was significantly low in Ketorolac group. However, heart rate, respiratory rate and temperature did not change much in either group. Four patients had unusual bleeding tendency in Ketorolac group and bleeding time in this group was significantly low on 1st postoperative day. Serum creatinine showed no significant change in either group. Two patients in each group developed edema. One patient in each group expired due to sepsis. Conclusions: Ketorolac has better analgesic efficacy than acetaminophen as postoperative analgesic in neonates, although associated with bleeding tendency. Chatt Maa Shi Hosp Med Coll J; Vol.14 (2); Jul 2015; Page 11-16

Profile of Molecular Subtypes of Breast Cancer Among Bangladeshi Women - Audit of Initial Experience

Abstract: Background Receptor status and molecular subtyping of breast cancer are crucial for patient management. We present here our initial experience on the status of different molecular subtypes and clinicopathological characteristics of invasive breast carcinomas in Bangladeshi population especially in Chittagong zone. Materials and methods A total of 59 histopathologically confirmed cases of invasive ductal carcinoma were selected for this study. Fifteen out of 59 cases were reported as HER2 equivalent and could not be categorized into any subtype because of the lack of availability of fluorescence in situ hybridization. The remaining 44 cases were distributed into different molecular subtypes and then the clinicopathological characteristics were compared for each molecular subtype. Results Age ranges from 24-70 years with a mean age of 43.95 years. Most of the patients were in 41-50 years age group. Among the 44 cases, most common subtype was HER2/neu amplification (13 cases, 29.55%). Luminal A, luminal B and basal like subtypes were 11 (25%), 10 (22.73%) and 10 (22.73%) respectively. The mean tumor size was 3.46 cm and the highest mean tumor size was in basal-like subtype (4.01cm). Twenty five out of 59 cases (42.37%) showed axillary lymph node metastasis. Lowest axillary lymph node metastasis was found in luminal A subtype (3/11=27.27%). Conclusion HER2/neu amplification subtype was found to be more common in this region. Luminal A subtype was found to be more favorable in comparison to the other subtypes in terms of axillary lymph node metastasis.

Evaluation of the Operative Treatment in Chronic Haematogenous Pyogenic Osteomyelitis by Sequestrectomy and Saucerisation in Children

Abstract: Background: Complete resolution occurs in many other types of infections with the use of antibiotics but not always with chronic pyogenic osteomyelitis. Objective: The aim of the present study was to evaluate the effectiveness of most conventional method of surgical treatment of chronic pyogenic osteomyelitis by sequestrectomy and saucerisation in Children. Methodology: This present study was a prospective study conducted at Bangabandhu Shekh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2015 to December 2016 for a period of two (2) years. Patients aged up to 16 years were included in the study. Purposive sampling was done. Only chronic osteomyelitis of haematogenous origin were included after proper selection of the patients. Sequestrectomy and saucerisation was done. Wound was kept open and allowed to heal from bottom and sides of the wound. Result: A total 36 patients aged up to 16 years were included in the study. Among the cases two third were male 26(72.23%) and rest were female 10(27.77%). The male female ratio was 2.6:1.Therefore the incident was significantly high in males (p<0.01). Most of the patients 28(77.77%) were in 6 to 16 age group, which was significantly high (p<0.01) and mean age was 9.83years. Average time taken for wound healing was 3.75 weeks. Regarding antibiotics, Cap Flucloxacillin was the maximum choice. Patients were followed up to maximum 2 years and evaluated clinically and radiologically. Maximum patients 31(86.10%) had satisfactory (good and fair) outcome, but only 5(13.88%) patients had poor outcome. There was a significant association among sequestrectomy and saucerisation with final outcome (p<0.001). Conclusion: It was concluded that describing operative technique is still method of choice for surgical treatment of chronic haematogenous pyogenic osteomyelitis. Bangladesh Journal of Infectious Diseases 2018;5(1):15-20

Is low total cholesterol associated with primary intracerebral hemorrhage in Bangladeshi population

Abstract: Background: This study was carried out to see the association of the low total cholesterol level with primary Intracerebral Hemorrhage (ICH) in Bangladeshi population. Materials and Methods: This was a case–control study carried out in the department of Neurology, Chittagong Medical College and Hospital from January 2013 to December 2013. Total of 132 patients were enrolled where 67 patients of hemorrhagic stroke were in the experimental group and 65 age and sex matched persons were in the control group. Low total cholesterol was designated as level less than 200mg/dl. Data were analyzed and compared by SPSS version 19. Results: The proportion of ICH patients with low total cholesterol was significantly higher than the controls (74.6% vs. 32.3%). Mean total cholesterol was also significantly low in ICH patients compared with controls (180 mg/dL vs. 217 mg/dl; P-value = 0.001). Low-density lipoprotein cholesterol (LDL-c) and triglycerides were also significantly low in ICH patients compared with controls. Mean LDL-c in the ICH patient group was 106 mg/dL, whereas it was 128.5 mg/dL in the control group (P-value = 0.001). There was no significant difference in the high-density lipoprotein (HDL) levels in both groups. Although lower mean cholesterol was seen in both young and older individuals in the ICH group than in controls, the difference was significant only in the older group (age >60 years). In multivariate analysis, odds ratio of low cholesterol in the hemorrhage cases was 6.03 (95% CI = 2.1–16.059) which was adjusted other risk factors of hemorrhagic stroke. Conclusions: The inference of this study is that, there is an increased risk of primary ICH associated with low total cholesterol, especially in older individuals. Bangladesh Crit Care J March 2018; 6(1): 26-30

Evaluation of intrarenal resistive index by duplex color doppler ultrasonography in patients with diabetic nephropathy – comparison between healthy adult control subjects

Abstract: Background: Renal Doppler Ultrasonography (USG) has become a useful adjunct to gray scale sonography in the evaluation of renal function in various pathophysiological conditions like diabetic nephropathy. We can diagnose diabetic nephropathy by serum creatinine level and creatinine clearance rate. But early stage diagnosis of diabetic nephropathy is not always possible. In this study we have focused on resistive index of interlobar arteries of kidney to see changes of renal parenchyma for early stage diagnosis of diabetic nephropathy. Objectives: To observe the difference between values of intrarenal resistive index measured by duplex color Doppler USG in type 2 diabetic patients having diabetic nephropathy and in healthy adult control subjects. Materials and methods: This cross sectional observational study was conducted in the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 65 diabetic nephropathy patients were taken as study group and 65 healthy subjects were included as healthy control subjects. Duplex Color Doppler Ultrasonography of interlobar artery was carried out in both groups to measure the peak systolic velocity, the end diastolic velocity and arterial Resistive Index. Results: The Resistive Index of interlobar artery of left kidney in control group was 0.58±0.08 and the mean RI of interlobar artery of left kidney in diabetic nephropathy patients was 0.74±0.53. The difference of Resistive index of interlobar artery of left kidney in the two groups were statistically significant and the RI of right kidney of control & that of case groups were 0.60±0.09 and 0.76±0.03 respectively. In between control and case groups the RI of right kidney were statistically significant. So, resistive index of interlobar artery was increased in type 2 diabetic nrphropathy patients compared to control group. Conclusion: It can be concluded in present study that resistive index remains significantly higher in patients with diabetic nephropathy than in controls. Thus Duplex Doppler ultrasonography allows the rapid, noninvasive evaluation of the intrarenal vasculature and can be used as an easily available parameter of the evolution and a predictor in patients with clinical diabetic nephropathy. Keywords: Doppler Ultrasonography, Intrarenal Resistive Index, Diabetic Nephropathy