Khulna Medical College

About: Khulna Medical College is a healthcare organization based out in Khulna, Bangladesh. It is known for research contribution in the topics: Hysterectomy & Cancer. The organization has 266 authors who have published 203 publications receiving 964 citations. The organization is also known as: Khulna Medical College, Khulna & KMC.

Tension Free Mesh Repair is an Effective Treatment of Inguinal Hernia: An Observational Study

Abstract: Inguinal hernias are common and the results of surgical repair are often satisfactory but recurrence rate are variable. To prevent recurrences prosthetic materials have been increasingly used in hernia repair. In this study Lichtenstein technique of tension free mesh repair for inguinal hernia done in 140 cases in the period from July 2010 to June 2012 and outcome measured in terms of early and late morbidity especially recurrences. Seroma developed in 08 patients (5.6%) and haematoma and transient testicular swelling developed in 06 patients (4.2%) and 15 patients (10.6%) respectively. Only 2 patients (1.4%) developed wound infection and 01 patients (.71%) developed recurrences of hernia. Post operative neuralgia developed in 05 cases (3.5%). During follow up period no mesh rejection and discharging wound sinus related to presence of foreign body is observed in the study. So Lichtenstein tension free repair of inguinal hernia is safe and effective method where recurrence rate is reasonably low. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15900 Medicine Today 2013 Vol.25(1): 6-8

Correlation of B-Type Natriuretic Peptide Level with Severity of Coronary Artery Disease in Non St Elevated Acute Coronary Syndrome with Normal Left Ventricular Function

Abstract: Background : Coronary artery disease (CAD) is predicted to be the most common cause of death and disability globally by 2020. In Bangladesh, for better management of coronary artery disease and to reduce the burden of acute coronary events patients with non ST elevated acute coronary syndrome (NSTE–ACS) should be focused. B-type natriuretic peptide (BNP) can be suggested as a tool to predict severity of coronary atherosclerotic lesion even with normal left ventricular (LV) function and thus to categorize the patients for appropriate referral and invasive evaluation. Aims : This study is designed to assess the relationship between level of BNP and severity of coronary artery disease assessed with SYNTAX score in NSTE-ACS patients with normal LV function. Methods: This cross sectional observational study was conducted at UCC, BSMMU during the period of May 2014 to April 2015 among the patients with non ST elevated myocardial infarction (NSTEMI) and unstable angina. 116 patients were enrolled by non-random purposive sampling who was admitted for coronary angiogram. All the data were recorded in structured questionnaire including details of medical history, coronary risk factors and physical findings. In NSTE-ACS patients with normal LV function venous blood samples were collected for BNP and later SYNTAX scoring was assessed during coronary angiogram. The relationship between level of BNP and SYNTAX score in patients with both UA and NSTE-MI was assessed statistically to evaluate the validity of BNP as a tool to predict severity of coronary atherosclerotic lesions among the patients with NSTE-ACS. Results : The mean age was 57.84±8.82 years. Among the 116 patients, highest frequency of patients was in the age group 51-60 years 55(47.4%) .In which 88(75.9%) were male. Male:Female ratio is 3.1:1.The percentage of risk factors was higher in NSTEMI group and difference with UA was statistically significant (p <0.05). Serum BNP in UA 64.9±13.07 and in NSTEMI 107.2±11.53. The mean difference of serum BNP between two groups is statistically significant. In UA group the SYNTAX score was found 13.2±11.1 and in NSTEMI 19.9±13.5 which is statistically significant. In UA group maximum patients were found two vessel disease and in NSTEMI maximum patients in three vessel disease. 70.0% of patients of three vessel disease had e” 80pg/ml of BNP. The association is statistically significant (p< 0.05). Higher the level of BNP reflect higher the vessel involvement and SYNTAX score irrespective of UA and NSTEMI. Conclusion : Our study reveals BNP is a candidate for entry into the setting of principal risk scores. Our findings indicate that the level of BNP may reflect the severity of ischemic insult even when irreversible injury and systolic dysfunction have not occurred. University Heart Journal Vol. 12, No. 1, January 2016; 17-22

Chorionic Villus Sampling (CVS) for Prenatal Diagnosis of Genetic Disorders in Bangladesh

Abstract: Objective(s): The aim of the study was to identify safety and outcome of trans abdominal Chorionic Villus Sampling (CVS) for prenatal diagnosis of genetic disorders. Materials and methods: This is a retrospective analytical study on women who had undergone trans abdominal CVS. All CVS were done at Fetal medicine centre, Family Foundation, Green Road, Dhaka, from June 2013 to December 2016. A total of 286 couples, who were referred for prenatal diagnosis of various genetic disorders were studied. Trans abdominal CVS was done under local anesthesia and real-time ultrasound guidance. A 18G/88mm Spinal Needle (B Braun, Germany) was used. All CVS were performed with the “2 operators” technique. The needle was introduced trans abdominally into the placenta in its longitudinal direction. Once the needle was adequately placed, the chorionic villi were aspirated with a to and fro jiggling movement of the aspiration needle and a suction force was applied through a syringe. Results were recorded and analyzed for descriptive statistics. Results: A total of 286 CVSs were performed as outdoor basis. The most common indication was detecting Beta-thalassaemia (82.5%). Other indications were for diagnosis of aneuploidy (9.7%), Hemophilia (3.1%), Spinal muscular atrophy (SMA) (2.4%), Duchenne Muscular Dystrophy (DMD) (2%). Most procedures were done between 11 and 13 weeks (range 11- 14 weeks). Most aspirations (95.1%) were easy; however, in 4.8% cases the aspiration was difficult due to a variety of factors. The overall success rate was 100%. Minor complications like placental hematoma and pervaginal (P/V) bleeding occurred in 2% and 1.3% respectively, which were subsided by conservative management. The procedure related miscarriage within three weeks not occurred in any cases. Conclusion: Trans abdominal CVS under real-time sonography is a useful outdoor procedure for prenatal diagnosis in early pregnancy without significant risk to the mother and the fetus. Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 63-69

Diurnal Variation in the Occurrence of Stroke and its Relation with Diabetes Mellitus

Abstract: Objective- To observe diurnal variation in stroke onset and its relation to diabetes mellitus. Methods - A consecutive series of 139 patients with stroke was admitted at a reference hospitals; the time of onset of symptoms were noted. We compared the diurnal variations between stroke onset both in the diabetic and non-diabetic subjects. Results - Time of occurrence of stroke was highest in the second quadrant of the 24 hour clock and lowest in the first quadrant. There was no significant association between time of occurrence of stroke and diabetes mellitus Conclusions - Our study contributes further evidence for a susceptibility stroke event between 6 AM and noon and gives further insights into the possible mechanisms leading to cerebrovascular ischemia. This study also concludes that there is no association between diurnal variation in the occurrence of stroke and diabetes mellitus.

Interstitial lung disease: A case report

Abstract: A 65 years old farmer was admitted in Medicine ward with the complaints of progressive exertional breathlessness, non-productive cough and recurrent episodes of fever. The patient had clubbing and chest examination revealed end inspiratory crackles. Chest x-ray, CT scan of chest and spirometry revealed the features of interstitial lung disease (ILD). So we diagnosed the case as idiopathic pulmonary fibrosis variety of ILD. We reported this rare case for developing awareness among the clinicians. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14118 Medicine TODAY Vol.24(1) 2012 pp.52-54