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.

Incidence of and risk factors for hospital-acquired diarrhea in three tertiary care public hospitals in Bangladesh.

Abstract: During April 2007-April 2010, surveillance physicians in adult and pediatric medicine wards of three tertiary public hospitals in Bangladesh identified patients who developed hospital-acquired diarrhea. We calculated incidence of hospital-acquired diarrhea. To identify risk factors, we compared these patients to randomly selected patients from the same wards who were admitted > 72 hours without having diarrhea. The incidence of hospital-acquired diarrhea was 4.8 cases per 1,000 patient-days. Children < 1 year of age were more likely to develop hospital-acquired diarrhea than older children. The risk of developing hospital-acquired diarrhea increased for each additional day of hospitalization beyond 72 hours, whereas exposure to antibiotics within 72 hours of admission decreased the risk. There were three deaths among case-patients; all were infants. Patients, particularly young children, are at risk for hospital- acquired diarrhea and associated deaths in Bangladeshi hospitals. Further research to identify the responsible organisms and transmission routes could inform prevention strategies.

Designing an Electro-Mechanical Ventilator Based on Double CAM Integration Mechanism

Abstract: This paper proposes a simplified structure of microcontroller based mechanical ventilator integrated with a Bag-Valve-Musk (BVM) ventilation mechanism. Here, an Ambu bag is operated with computer-aided manufacturing (CAM) arm that is commanded via a microcontroller and manual switches by sending a control signal to the mechanical system and according to this control signal, the mechanical computer-aided manufacturing (CAM) arm simultaneously compresses and decompresses the Ambu bag. It is a self-inflating bag and like a one-way valve around its inlet and outlet corner. By compressing the Ambu bag it delivers air and by relaxing, it takes air from the environment through a mechanical scavenger. The control signals are designed with three modes named adult mode, pediatric mode, and child mode based on the respiratory rate. The device is in assist controlled mode by dint of fixing the tidal volume for all unique control signals. The control signal is visualized by a platform known as the BIOPAC student’s lab system. The proposed device is portable, compact, low weight, and efficient performable. It can be supplied around the rural area hospitals for immediate medication with cost efficiency and risk avoidance. Anyone can operate it as no need to study or training of ventilation rules like ICU ventilator. The proposed system is safe, riskless, and repairable. The angle, volume, and respiratory measurement have found 95%, 92%, and 90% accuracy respectively. By applying this portable ventilator system immediate attention can be taken up in rural or general hospitals and in ambulances.

Efficacy of a high-dose in addition to daily low-dose vitamin A in children suffering from severe acute malnutrition with other illnesses.

Abstract: Background Efficacy of high-dose vitamin A (VA) in children suffering from severe acute malnutrition (SAM) has recently been questioned. This study compared the efficacy of a single high-dose (200,000 IU) in addition to daily low-dose (5000 IU) VA in the management of children suffering from SAM with diarrhea and/or acute lower respiratory tract infection (ALRI). Methods In a randomized, double-blind, controlled clinical trial in icddr,b, Bangladesh during 2005–07, children aged 6–59 months with weight-for-height <−3 Z-score and/or bipedal edema (SAM) received either a high-dose VA or placebo on admission day. Both the groups received 5,000 IU/day VA in a multivitamins drop for 15 days and other standard treatment which is similar to WHO guidelines. Results A total 260 children (130 in each group) were enrolled. All had diarrhea, 54% had concomitant ALRI, 50% had edema, 48.5% were girl with a mean±SD age of 16±10 months. None had clinical signs of VA deficiency. Mean±SD baseline serum retinol was 13.15±9.28 µg/dl, retinol binding protein was 1.27±0.95 mg/dl, and pre-albumin was 7.97±3.96 mg/dl. Median (inter quartile range) of C-reactive protein was 7.8 (2.1, 22.2) mg/L. Children of the two groups did not differ in any baseline characteristic. Over the 15 days treatment period resolution of diarrhea, ALRI, edema, anthropometric changes, and biochemical indicators of VA were similar between the groups. The high-dose VA supplementation in children with SAM did not show any adverse event. Conclusions Efficacy of daily low-dose VA compared to an additional single high-dose was not observed to be better in the management of children suffering from SAM with other acute illnesses. A single high-dose VA may be given especially where the children with SAM may leave the hospital/treatment center early. Trial Registration ClinicalTrials.gov NCT00388921

Rationality of drug uses: its Bangladeshi perspectives.

Abstract: This review article was made on the basis of different articles, government & non- government documents. Clinically inappropriate & inefficient use of medicine is a very serious problem. It is estimated that more than half off medicines are inappropriately prescribed, dispensed or sold. Lack of access to medicines and inappropriate dose result in serious morbidity & mortality. WHO provided adequate guidelines for formulation of national use of drugs by every nation. Accordingly, Bangladesh still trying to achieve the standard, even with all hindrance. Government has given emphases on price, quality, safety, efficacy & access to drugs. Some new drugs are always introducing again some drugs are withdrawing such as rofecoxib. Monitoring use of medicines, a mandated multidisciplinary activities and sufficient government funding is critical to success.

Clinical profile of acute pancreatitis in a teaching hospital

Abstract: Background: Acute pancreatitis is a potentially fatal disease. Mortality and morbidity depends on severity of the disease Objective : To find out the clinical presentation and to optimize the treatments. Method: This hospital based cross sectional descriptive study was performed to find out the clinical presentations of acute pancreatitis from the available clinical, biochemical, haematological and radiological data. Results: A total of 50 cases were studied. Age range was 13 to 74 yrs, with a peak incidence in the fourth decade. Male to female ratio were 1.78:1. Among the known aetiological factors 18% were due to gallstone disease and 10% due to alcoholism. Most common symptoms were upper abdominal pain (96%) and nausea, vomiting (88%). Among the clinical signs most common were abdominal tenderness (92%) and muscle guard (66%). In this study 82% patients had mild and 18% had severe acute pancreatitis. Overall mortality rate was 6%. Mortality was significantly higher (33.33%) in severe acute pancreatitis (33.3% vs 0%). Conclusion: A higher mortality was associated with concomitant medical or surgical diseases, but not to age or sex. A higher mortality was associated with leucocytosis but not to haemoglobin level. Among the biochemical parameters tested, a high blood glucose and serum creatinine level and a lower serum albumin and calcium level were significantly associated with a higher mortality. Bang Med J (Khulna) 2016; 49 : 7-12