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.

Capacity development and safety measures for health care workers exposed to COVID-19 in Bangladesh.

Abstract: BACKGROUND: The safety of health care workers (HCWs) in Bangladesh and the factors associated with getting COVID-19 have been infrequently studied. The aim of this study was to address this gap by assessing the capacity development and safety measures of HCWs in Bangladesh who have been exposed to COVID-19 and by identifying the factors associated with respondents' self-reported participation in capacity development trainings and their safety practices. METHODS: This cross-sectional study was based on an online survey of 811 HCWs working at 39 dedicated COVID-19 hospitals in Bangladesh. A pretested structured questionnaire consisting of questions related to respondents' characteristics, capacity development trainings and safety measures was administered. Binary logistic regressions were run to assess the association between explanatory and dependent variables. RESULTS: Among the respondents, 58.1% had been engaged for at least 2 months in COVID-19 care, with 56.5% of them attending capacity development training on the use of personal protective equipment (PPE), 44.1% attending training on hand hygiene, and 35% attending training on respiratory hygiene and cough etiquette. Only 18.1% reported having read COVID-19-related guidelines. Approximately 50% of the respondents claimed that there was an inadequate supply of PPE for hospitals and HCWs. Almost 60% of the respondents feared a high possibility of becoming COVID-19-positive. Compared to physicians, support staff [odds ratio (OR) 4.37, 95% confidence interval (CI) 2.25-8.51] and medical technologists (OR 8.77, 95% CI 3.14-24.47) were more exhausted from working in COVID-19 care. Respondents with longer duty rosters were more exhausted, and those who were still receiving infection prevention and control (IPC) trainings were less exhausted (OR 0.54, 95% CI 0.34-0.86). Those who read COVID-19 guidelines perceived a lower risk of being infected by COVID-19 (OR 0.44, 95% CI 0.29-0.67). Compared to the respondents who strongly agreed that hospitals had a sufficient supply of PPE, others who disagreed (OR 2.68, 95% CI 1.31-5.51) and strongly disagreed (OR 5.05, 95% CI 2.15-11.89) had a higher apprehension of infection by COVID-19. CONCLUSION: The findings indicated a need for necessary support, including continuous training, a reasonable duty roster, timely diagnosis of patients, and an adequate supply of quality PPE.

Socio-demographic Profile and Drug Sensitivity Pattern of Suspected Drug Resistant Tuberculosis among Patients in Regional Tuberculosis Reference Laboratory (R.T.R.L) of a Tertiary Hospital

Abstract: Background : Drug resistant tuberculosis has been reported in all regions of the world. In this study we address the socio-demographic profile and drug sensitivity pattern as well as prevalence of drug resistance tuberculosis in a tertiary center (regional TB reference laboratory) in Bangladesh. Method : This Study was carried out in R.T.R.L. (Regional TB Reference Laboratory) in 250 bedded Chittagong General Hospital. Patients who were referred to R.T.R.L during the period July 2012 to July 2013 were included in the study. Total 100 patients with suspected drug resistant tuberculosis (TB) who had any one of 9 criteria of NTP (National Tuberculosis Control Programme) were selected consecutively. Gene xpert MTB/RIF (Rifampicin resistance) test for all sputum positive cases were performed. Sputum sample of Patients with positive microscopy for AFB or positive Xpert/MTB was sent for culture. The samples with positive sputum culture were sent for drug sensitivity test for 1 st line anti- tubercular drug. Result : Among 100 patients 78 were male and 22 were female, majority of the patients (64) were between 15-45 years with poor socio economic condition (73%) and primarily educated. Analysis of our Study result showed that 18% of patients were mono-drug resistant. Among them 13% showed resistance to isoniazid (INH), 4% to streptomycin and only 2% to rifampicin. No patient was found resistant to pyrazinamide (PNZ) and 38% of patient with suspected drug – resistant TB was found to have no drug resistance. 18% of patient had multidrug resistant tuberculosis (MDR-TB) among which 56% were relapse cases (48% after cat -I, 8% after cat II), 24% were non – converter of cat –I, 12% belonged to failure of cat –I, 3% failure of cat –II, 2% return after default and others. 1% of patient had history of contact with MDR –TB patient. Conclusion : Drug-resistance tuberculosis especially MDR-TB, was higher in patients with previously incomplete anti-tuberculosis treatment. A high level of drug resistance among the re-treatment TB patients poses a threat of transmission of resistant strains to susceptible persons in the community. For this reason proper counseling of patients and attention towards the completion of the anti-TB treatment are needed. J MEDICINE July 2017; 18 (2) : 62-67

Problems Leading To Conversion in Laparoscopic Cholecystectomy.

Abstract: In prospective study, the various reasons for conversion in laparoscopic cholecystectomy were shown and recommended various measures to decrease the incidence of conversion and associated complications with this procedure. Fifty cases of conversion in laparoscopic cholecystectomy were studied in Dhaka Medical College Hospital & Bangabandhu Sheikh Mujib Medical University from July 2002 to July 2004. The commonest cause of conversion was dense pericholecystic adhesion or unclear anatomy (24%). Next common cause was accidental injury to surrounding structures (18%) and uncontrolled bleeding (14%) and thick fibrosed gall bladder (14%). Other causes were gall bladder wall perforation (6%), carcinoma gall bladder (6%) and choledocholithiasis (6%), anatomic variation (4%), equipment failure (4%), cholecystoduodenal fistula (2%) and choledochal cyst (2%). Proper case selection, good laparoscopic skill and adequate experience of the surgeon are the prerequisites for safe laparoscopic cholecystectomy and thereby reducing conversion rate.

Wallet Neuritis - An Example of Peripheral Sensitization.

Abstract: Background Wallet neuritis is an example of extra-spinal tunnel neuropathy concerning sciatic nerve. Its clinical appearance often gets confused with sciatica of lumbar spine origin. Wallet- induced chronic sciatic nerve constriction produces gluteal and ipsilateral lower extremity pain, tingling, and burning sensation. It was Lutz, first describing credit-card wallet sciatica in an Attorney, surfaced on Journal of American Medical Association (JAMA), 1978; however, the condition has not been well-studied in various other occupations. Case summary In this write-up, we take the privilege of demonstrating wallet neuritis as an example of peripheral sensitization in three different professionals' namely specialist doctor, driver, and banker first time in Bangladesh. All the three patients' demonstrated aggravated gluteal pain with radiation on the homo-lateral lower extremity while remained seated on heavy wallet for a while, fortunately improved discontinuing such stuff with. Alongside radical wallectomy, piriformis stretching exercise on the affected side had also been recommended and found worthy in terms of pain relief. Conclusion long-standing use of rear pocket wallet may compress and sensitize ipsilateral sciatic nerve, generating features resembling lumbago sciatica; thereby, remains a source of patients' misery and diagnostic illusion for pain physicians as well.

A Study on Bolton Anterior Tooth Size Discrepancies among Different Malocclusion Groups

Abstract: Aim: To investigate the correlation between anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion, as well as their prevalence in Bangladeshi population. This study would act as a reference for diagnosis, treatment planning and assessment of prognosis in some orthodontic cases. Methods: This cross sectional study was conducted in the Department of Orthodontics & Dentofacial Orthopedics, Dhaka Dental College & Hospital. A total number of 200 subjects were selected in Angle's Class l, ll, lll and corresponding normal group. Each group had 50 subjects with males and females. A chi-square test was performed to statistically compare the prevalence of anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion and two genders. Analysis of variance was used to compare the mean Bolton anterior tooth size ratios as a function of angle classification and gender. Statistical differences were determined at the 95% confidence level (p< 0.05). Results: No significant difference was observed in the mean Bolton anterior ratio between normal group and class-I malocclusion group (p = 0.343). Significant differences were observed between Class-II malocclusion and normal group (p=0.001), and also between Class-III malocclusion and normal group (p = 0.001). Individuals with Angle Class lll and Class ll malocclusions showed significantly greater prevalence of tooth size discrepancy than Class l malocclusion and corresponding normal group. Conclusion: The great diversity and ethnic mix of Bangladeshi population should alert our orthodontist to use Bolton analysis as an important diagnostic tool and become aware of the moderate variations that may be present and treated. It may somehow guide planning of this type of study in future. DOI: http://dx.doi.org/10.3329/bjodfo.v1i2.15982 Ban J Orthod & Dentofac Orthop, April 2011; Vol-1, No.2, 1-4