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.

Problems and Immediate Outcome of Infants of Diabetic Mothers

Abstract: Objective: The present study was undertaken to evaluate the problems and immediate outcome of infants of diabetic mothers (IDMs) in early neonatal period and to compare the results between infants of gestational and pregestational diabetic mothers. Design: A hospital based prospective study. Setting: The study was done in Chittagong Medical College Hospital, a tertiary hospital in Chittagong city. Method: Within one hour of delivery 52 infants of diabetic [pregastational & gestational] mothers consecutively admitted were enrolled in the study. Study period was January 2002 to August 2002. Results: Total number of IDMs were 52. Among them 31 were gestational and 21 were of pregestational diabetic mothers. Significant number 82.6% of IDMs were delivered by caesarean section. The mean birth weight of IDMs was significantly high (3212±563g), 21% of IDMs had birth weight>4000 g. Total 23% of the IDMs developed perinatal asphyxia. The 23% of IDMs developed hypoglycaemia. The incidence of hypoglycaemia was higher in infants of pregestational diabetic mothers as compared to that of gestational diabetic mothers (38.09% and 12.9% respectively), the difference was statistically significant (P<0.05).In majority (66%) of IDMs cases hypoglycaemia was symptomatic. Significant number (19.2%) of IDMs had hypocalcaemia. The incidence of polycythaemia was higher in infants of gestatational diabetic mothers(GDMs) as compared to infants of pregestational diabetic mothers (25.8% and 9.5% respectively), difference was statistically significant (P<0.001). 3(5.7%) out of 52 IDMs had congenital malformation (each one in number polydactyly, cleft palate & preauricular skin tag). Total death was 3 (5.7%) all of them died within 72 hours of birth. Causes of death 1 each number: perinatal asphyxia, respiratory distress syndrome and meconium aspiration syndrome. 11 IDM was macrosomic, among them 1 had birth injury ( Erb's palsy), hypoglycaemia and meconium aspiration syndrome and expired within first 24 hours of life. Conclusion: Among the important problems the present study revealed perinatal asphyxia, hypoglycaemia, hypocalcaemia, polycythaemia top the list. These babies should be delivered at hospitals where special neonatal care available for management of high risks babies to reduce the morbidity and mortality. Screening for GDMs should be performed in all pregnant women. All diabetic women should have planned pregnancy and proper antenatal care in order to maintain strict glycaemic control, to have a satisfactory outcome in infants of diabetic mothers. DOI: 10.3329/jbcps.v26i2.4183 J Bangladesh Coll Phys Surg 2008; 26: 62-72

The geography of malaria elimination in Bangladesh: Combining data layers to estimate the spatial spread of parasites

Abstract: Malaria control programs face difficult resource allocation decisions. Of particular concern for countries aiming for malaria elimination, the regular movement of individuals to and from endemic areas undermines local interventions by reintroducing infections and sustaining local transmission. Quantifying this movement of malaria parasites around a country has become a priority for national control programs, but remains methodologically challenging, particularly in areas with highly mobile populations. Here, we combined multiple data sources to measure the geographical spread of malaria parasites, including epidemiological surveillance data, travel surveys, parasite genetic data, and anonymized mobile phone data. We collected parasite genetic barcodes and travel surveys from 2,090 patients residing in 176 unions in southeast Bangladesh. We developed a genetic mixing index to quantify the likelihood of samples being local or imported. We then inferred the direction and intensity of parasite flow between locations using an epidemiological model, and estimated the proportion of imported cases assuming mobility patterns parameterized using the travel survey and mobile phone calling data. Our results show that each data source provided related but different information about the patterns of geographic spread of parasites. We identify a consistent north/south separation of the Chittagong Hill Tracts region in Bangladesh, and found that in addition to imported infections from forested regions, frequent mixing also occurs in low transmission but highly populated areas in the southwest. Thus, unlike risk maps generated from incidence alone, our maps provide evidence that elimination programs must address ongoing movement of parasites around the lower transmission areas in the southwest.

Detecting and segmenting overlapping red blood cells in microscopic images of thin blood smears

Abstract: Automated image analysis of slides of thin blood smears can assist with early diagnosis of many diseases. Automated detection and segmentation of red blood cells (RBCs) are prerequisites for any subsequent quantitative highthroughput screening analysis since the manual characterization of the cells is a time-consuming and error-prone task. Overlapping cell regions introduce considerable challenges to detection and segmentation techniques. We propose a novel algorithm that can successfully detect and segment overlapping cells in microscopic images of stained thin blood smears. The algorithm consists of three steps. In the first step, the input image is binarized to obtain the binary mask of the image. The second step accomplishes a reliable cell center localization that utilizes adaptive meanshift clustering. We employ a novel technique to choose an appropriate bandwidth for the meanshift algorithm. In the third step, the cell segmentation purpose is fulfilled by estimating the boundary of each cell through employing a Gradient Vector Flow (GVF) driven snake algorithm. We compare the experimental results of our methodology with the state-of-the-art and evaluate the performance of the cell segmentation results with those produced manually. The method is systematically tested on a dataset acquired at the Chittagong Medical College Hospital in Bangladesh. The overall evaluation of the proposed cell segmentation method based on a one-to-one cell matching on the aforementioned dataset resulted in 98% precision, 93% recall, and 95% F1-score index.

Microvascular Free Tissue Transfer at Chittagong Medical College Hospital - A Milestone

Abstract: Introduction: A defect in any part of the body involving extensive soft tissue loss adversely affects the functional ability. With the advent of microvascular free tissue transfer in the reconstruction of large defects, the problem is going to be solved. However, studies are still going on about the different aspects of its success and failure. The present study is one such step to share our early experience. Methods: The study was carried out in the Department of Plastic Surgery, Chittagong Medical College Hospital from August 2009 to April 2010. We reviewed the operative experiences of free tissue transfer on 5 cases. Standard microvascular anastomotic techniques as well as peroperative & postoperative heparinization were maintained in all the cases. Follow up results were evaluated at varying periods following standard protocol. Results: Of the 5 cases reconstructed, 4(80%) had lesions in the maxillofacial region and 1(20%) in the ankle region. In terms of diseases they suffered, 3(60%) had squamous cell carcinoma and 2(40%) sustained mechanical injury. The outcome of treatment demonstrates that 3(60%) cases recovered uneventfully, one developed slight loss of sensation on the left thumb (20%) and another one failed to recover (20%). Conclusion: In this study successful microvascular free tissue transfer was possible in 80% cases. With the increase in experience we can expect increased success rate as well. DOI: http://dx.doi.org/10.3329/bdjps.v1i1.6485 Bangladesh Journal of Plastic Surgery (2010) Vol. 1 (1) pp.3-8