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.

Prevalence of Chronic Kidney Disease in adult Disadvantageous Population

Abstract: Key words: CKD (Chronic Kidney Disease); DM (Diabetes mellitus); HTN (Hypertension); BMI (Body Mass Index); C-G (Cockcroft-Gault) formula; MDRD (Modification of Diet in Renal Disease) equation DOI: 10.3329/jcmcta.v21i2.7733 Journal of Chittagong Medical College Teachers' Association 2010: 21(2):25-29

Mortality from Surgical Conditions in Children: An Insight from a Tertiary-Level Government Hospital in Bangladesh

Abstract: Aims: While the developed world has significantly reduced mortality from surgical conditions in children, there is lack of adequate data on the outcome of children’s surgical conditions in the developing world. This study aims at assessing the spectrum of mortalities from children’s surgical conditions in a low-middle income country (LMIC). Methods: Mortality data were collected for a period of 12 years (2008 to 2019) among 0 to12-year old children to analyse the diseases which had higher mortality trends, age -group specific mortality trends and categorize those according to body system. Results: Among a total of 30,301 admitted children, 1228 (4.05%) patients died. Among them 53.01% were neonates, 20.28% were infants and 26.71% were children. Male to female ratio was 1.95:1. Mortality from neonatal surgical conditions was 24.21%. Infant mortality rate was 5.65% Original Research Article Chowdhury et al.; AJPR, 4(3): 26-34, 2020; Article no.AJPR.61394 27 and child mortality rate was 1.41%. Neonatal surgical admission and mortality had a higher yearly trend. Anorectal malformation (ARM) was the most common cause of death (12.05%), followed by intestinal obstruction (11.40%) and gastroschisis (8.63%). Tracheo-oesophageal fistula/ oesophageal atresia (TOF/OA) had the highest mortality rate (83.33%), followed by gastroschisis (80.92%) and intestinal atresia (42.535) among the respective admissions. Other important causes of mortality were jejuno-ileal atresia (5.37%), trauma (5.05%), Hirschsprung disease (4.64%), intestinal perforation (4.48%), omphalocele (4.15%), burn (4.07%) and posterior urethral valves (PUV), 3.58%. Conclusion: Overall mortality rate was much higher than developed countries and lower than some African countries. Neonatal mortality rate was very high and among them TOF/OA and gastroschisis had extremely high mortality rates.

Studies on severe malaria are still possible and essential.

Abstract: To the Editor—We were very interested in the recent editorial by Shanks [1], [Q1]which asserted that clinical studies on severe malaria may no longer be possible. Two main reasons were outlined. The first, that any such study should include support equivalent to that provided by most intensive care units (ICUs),[Q2] is far from universally agreed. Most countries in which malaria is endemic manage patients with severe malaria in the absence of an ICU. The challenge is to design research aimed at cost-effectively improving case fatality rates and morbidity in settings where most of the disease occurs; that is evidently not in Western travelers returning home from a tropical holiday. Relevant topics include, for instance, optimizing antimalarial and fluid therapy, timing of enteral feeding in comatose but nonin-tubated patients, and affordable adjunctive therapies. In general, the results of a trial performed in a highly sophisticated setting cannot be directly translated to the developing world. The requirement for high-level ICU facilities could even be interpreted as derogatory for brilliant clinical researchers who happen to be based in developing countries that lack these facilities. The large South East Asian Quinine Ar-tesunate Malaria Trial (SEAQUAMAT) [Q3]trial [2] was the first trial involving adult severe malaria to show an important impact on mortality, with a 34.7% reduction in favor of artesunate over quinine. Recruitment was in general medical units across Asia, with very few patients reaching an ICU. Another large trial with a similar design (the African Quinine Artesu-nate Malaria Trial [AQUAMAT] trial) is now underway involving African children [3] and is recruiting in 8 countries. A large multinational fluid trial is also ongoing. We agree that the number of mortality– end point trials involving malaria is limited by the available research capacity, but we do not think that the planned RTS-S [Q4]vaccine trial " will fully occupy most of the research capacity of Sub-Saharan Africa for at least 3 years " [1].[Q5] Also, if ICU care were a prerequisite for research on severe diseases in developing countries, neither SEAQUAMAT nor AQUAMAT would have been possible. The second proposed threat to severe malaria research in the editorial is the reduction of malaria incidence attributable to successful control measures in countries such as Vietnam and Thailand. However, there are still an estimated 1 million deaths annually [3] from severe malaria, and malaria elimination in many countries where malaria is endemic is unlikely to happen in the …

Primary Nongestational Choriocarcinoma of the Ovary

Abstract: Pure primary ovarian choriocarcinoma is an extremely rare and aggressive tumor. It can be of gestational or nongestational in origin. The gestational type can arise from an ovarian pregnancy or can be of metastatic origin from uterine choriocarcinoma. The nongestational type is a very rare germ cell neoplasm. It is important to distinguish between two types of choriocarcinomas as nongestational origin is highly malignant and has worse prognosis than gestational type. But it is very difficult to differentiate by routine histological examination. Nongestational choriocarcinoma has been found to be resistant to single agent chemotherapy. It occurs usually around 13 years of age and is mainly confined to females under 20. Here we report a case of primary pure nongestational choriocarcinoma of the ovary in an unmarried girl of 14 years, diagnosed in 2001 and treated successfully with surgery and combination chemotherapy and remained disease-free till last reporting in September 2013. DOI: http://dx.doi.org/10.3329/jemc.v4i1.18070 J Enam Med Col 2014; 4(1): 56-59

Gene therapy: A veracity or myth!

Abstract: Gene therapy is a novel approach to treat, cure, or ultimately prevent disease by changing the expression of a person's gene. It involves the transfer of a therapeutic or working gene copy into specific cells of an individual in order to repair a faulty gene copy. Thus it may be used to replace a faulty gene, or to introduce a new gene whose function is to cure or to favorably modify the clinical course of a condition. The scope of this new approach to the treatment of a condition is broad, with potential in the treatment of many genetic conditions. Though single gene disorders are best treated than multifactorial disorder; the challenge of developing successful gene therapy for any specific condition is considerable. The problem of ‘gene delivery’ into the desired tissues is very complex and challenging. Some of the ‘vectors’ for delivering the working copy of the gene to the target cells include using harmless viruses and non viral vectors. Till date, in gene therapy, only somatic cells and not the germ cells are targeted for treatment. The possible genetic manipulation of the germ cells remains the subject of intense ethical and philosophical discussion. Though some devastation was recorded in gene therapy trial; the potential benefits of new treatments must always be balanced against such risks. In particular, safety will appropriately remain an important consideration as the field of gene therapy evolves. The purpose of this review is to focus on merit and demerit of gene therapy and to provide information about its future prospective.