Chattagram Maa-O-Shishu Hospital Medical College Journal
A multi-disciplinary peer-reviewed journal published by Chattagram Maa-O-Shishu Hospital Medical College. Full text articles available
Chattagram Maa-O-Shishu Hospital Medical College
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Predictors of Secondary Postpartum Hemorrhage: A Hospital-Based Cross-Sectional Study
Background: Hemorrhage has been a leading cause of maternal deaths in Bangla desh over the past decade. Postpartum Haemorrhage (PPH) is one of the leading causes of maternal death worldwide. It is a life-threatening condition and a serious obstetric emergency. The aim of the study is to explore the predictors of secondary postpartum haemorrhage in a medical college hospital. Materials and methods: A hospital-based cross-sectional study was carried out with 40 purposively selected women aged 18 and older who were diagnosed with secondary postpartum hemorrhage and admitted more than 24 hours after childbirth or during the puerperal period. A pre-tested semi-structured questionnaire was used to interview these women in the Department of Obstetrics and Gynaecology at Sylhet MAG Osmani Medical College Hospital in Bangladesh. Results: Three-quarters of the participants (75.0%) were in the 18–30 age range, with an average age of 27.6±4.7 years.Among the patients, 20.0% reported issues during a previous pregnancy, and 65.0% experienced complications in their last delivery.Among the patients, 32.5% delivered in a hospital, while 67.5% gave birth at home. Of the total, 25.0% underwent a cesarean section, while 75.0% had a vaginal delivery. Additionally, 70.0% of the patients with secondary postpartum hemorrhage experienced varying degrees of anemia, ranging from mild to severe. Retained placental fragments were the primary cause of secondary PPH, accounting for 52.5% of cases, while endometritis and subinvolution each contributed to 15% of the cases. Conclusion: Enhancing awareness of the predictive factors for secondary PPH could significantly contribute to the recognition and management of postpartum morbidity and mortality Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 3-7
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Myocarditis in Admitted Patients with Dengue Fever in a Tertiary Care Hospital of Bangladesh
Background: Severe dengue may be associated with fatal cardiac complications including myocarditis. The incidence of cardiac complications in patients with dengue illness varies greatly from one series to another and there is a paucity of available data on the prevalence of dengue- associated myocarditis in Bangladesh. This study aimed to investigate the occurrence and association of myocarditis in adult patients with dengue in a public tertiary-level hospital in Chattogram, Bangladesh. Materials and methods: A prospective observational study was conducted among 268 admitted patients 18 years of age having confirmed dengue fever at Chittagong Medical College Hospital (CMCH) fromJanuary 2023 to December 2023. Electrocardiography (ECG) cardiac biomarkers, and echocardiography were done for all patients. Diagnosis of myocarditis was as per European Society of Cardiology (ESC) 2013 criteria. Outcome was assessed at in-hospital mortality or discharged. Results: The mean age of 34.6±15.5 years and 66.8% were males. ECG abnormalities were observed in 44 (24%) patients, biomarkers were elevated in 27 (10.1%) patients and 24 (9%) patients had echocardiographic abnormalities. According to ESC 2013 criteria, dengue fever with myocarditis was diagnosed in 40 [14.9% (95% CI: 10.9 19.8%] patients. The patients with myocarditis were more likely to have comorbidity, chest pain and respiratory distress. In-hospital mortality rate was 2.5% and 3.9% in patients with and without myocarditis, respectively (p=0.656). Conclusion: Myocarditis among admitted dengue patients is not uncommon. However, further study is needed to understand its effect on morbidity and mortality among hospitalized dengue patients Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 8-12
Status of Medical Records in a Tertiary Care Hospital
Background: Medical record, health record and medical chart often to refers to the comprehensive documentation of a patient's medical history and care within a spe cific healthcare provider's domain. A medical record encompasses various types of "notes" created over time by healthcare professionals, including observations, drug and therapy administration details, orders for treatments, test results, X-rays, and other reports.The aim of the study was to evaluate the status of Medical Record keeping among healthcare providers in a tertiary healthcare hospital service. Materials and methods: A retrospective observational study was conducted by recording data from secondary sources i.e. admission form, history sheet on admission, details recorded by nurses, progress sheets recorded by physicians, referral record sheets, reports of pathology, reports of radiology, informed consent form, operation notes, discharge certificates from the Record Department of Chattagram Maa-O-Shishu Hospital Medical College. The data were collected by data collectors after visiting the Record department and filling up a questionnaire after taking permission from the Record keeper on approval of Ethical Review Board of CMOSHMC. Record of the patients admitted to the indoor of various Departments were selected by systematic random sampling technique. Four days from the month of July and August 2024 were randomly selected and all the medical records of those days were used to fill up the questionnaire developed according to guidelines and frameworks provided by World Health Organization (WHO). Patients confidentiality was maintained. A total of 400 secondary data from the medical Record Department were selected to complete the questionnaire. Collected data was managed by a professional data manager. After completing the questionnaire the data were input into IBM SPSS (Version 24) and analyzed by frequencies and percentages. Results: Occupation of the patients were not recorded in the medical record. Name and signature of the receiving physicians was not recorded in 19.5% and 31% files. Family history was not recorded in 87 % medical records. 95% of files did not have differential diagnosis recorded in it. 80% files did not have informed consent collected from patients. Signature of surgeon were absent in the operation note. History of alcohol, smoking, sexual history, exercise, dietary habits were absent. The report of pathology was not preserved in the files. Diseases among relatives and causes of death of relatives were absent 95% medical records. 47% patients were discharged on request. Conclusion: Accurate recording of information in medical records can help prevent future litigations and medical negligence cases. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 13-19
Exploring the Prevalence and Pattern of Migraine and Tension Headache and Its Association with Depression among Medical Students
Background: A migraine is a headache that can cause intense throbbing pain or a pulsing feeling usually on one side of the head and Tension Type Headache (TTH) is a neurological characterized by headache attacks ranging in severity from mild to moderate dull aching bitalteral pain around the temporal region feeling not onlike a pressing or tightening band around the forehad, neck, shoulder and sometimes be hind the eyes. The purpose of the study was to explore prevalence and pattern of migraine and Tension Type of Headache (TTH) and its’ association with depression among medical students at Chattagram Maa-O-Shishu Hospital Medical College. Materials and methods: This cross sectional study included students of 1st year to 5th year which comprises 560 students. Among them 500 students answered a questionnaire from January to July 2024. The Students’’ symptoms were classified as migraine or tension-type headache by the principal author according to the 2nd Edition of International Classification of Headache Disorders II criteria and students’ depression was identified by PHQ questionnaire. Results: The prevalence of headache among students was 71.6%. The prevalence of Migraine, and both migraine and TTH were 26.81%, 20.25% and 12.29% respectively. Compared to male students (42.45%), female students (57.54%) experienced headache much more frequently. Stress (74.86%) and lack of sleep (75.13%) were the leading triggering factors. About half of the students (54.6%) had mild to severe degree of depression and this depression is statistically significant with headache (p=0.000) Conclusion: Our study has shown that relatively large percentage of medical students suffer from headache which was more frequent among female. Migraine and Tension Type of Headache (TTH) were more prevalent than other types. Mild to severe degree of depression was observed among the students. There is a strong association between depression and migraine and TTH. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 20-25
Characteristics of Electrolyte Imbalance in Patients with Chronic Kidney Disease Stage 4-5
Background: Chronic Kidney Disease (CKD) is characterized by the presence of kidney damage or an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m² and persisting these conditions for 3 months or more. In case of CKD progressive loss of kidney function occurs. The kidneys play a vital role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base occur which contribute to poor patient outcomes. The objective of this study was exploring the characteristics of electrolyte imbalance in patients with chronic kidney disease stage 4-5. Materials and methods: A cross-sectional study was conducted at East West Medical College, from July to December 2023. A total of 100 respondents were included in this study where data were collected through structured interviews and medical record reviews. Results: The prevalence of CKD by the gender group where 46% were male and 54% were female. According to aged group 42% were from 51-60 years of age and 23%, 14% and 10%, 11% were from 41-50 years, 31-40 years, 21-30 years and >60 years accordingly. At the level of educational status 33% completed secondary level, 21% completed primary, 20% completed higher secondary level and 15%, 12%, and 4% completed Graduation, able to read and write and illiterate accordingly. Among all respondents 52% were employed and 48% were unemployed. According to economic status 44% belongs to low economic status, 40% from middle income and 16% from high income status. Majority 63% were overweight, 26% and 11% were from Normal weight and underweight accordingly. Family history of CKD 62% had positive family history and 38% had negative history. According to personal habit of excess salt intake 65% had this habit and 35% did not take excess salt. Among all respondents most of the patients had DM which was 51%, HTN were 42%, hypothyroidism and hyperthyroidism were 24% and 06% accordingly. The prevalence of electrolyte imbalance in patients with CKD where mild hyponatraemia were 32%, moderate and severe hyponatraemmia were 16% and 4% were accordingly. Hypernatraemia and hypokalaemia were 18% and 21%. The stages of hyperkalaemia were mild, moderate and severe and prevalence were 19%, 09% and 3% accordingly. Majority 65% were metabolic acidosis and 11% were metabolic alkalosis. Among all respondent’s hyperphosphatemia, hyperparathyroidism, hypoparathyroidism, hypocalcemia, hypercalcaemia, hypomagnesemia and hypermagnesemia deficiency were 71%, 79%, 21% 61%, 17%, 21% and 8% accordingly. Conclusion: If we maintain the screening process at early of life for case detection of CKD and established early treatment of all cases, electrolytes related complication can reduce which improve health outcome of these patients. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 26-30
Intramuscular Loading Dose versus Combined Intravenous and Intramuscular Loading Dose of Magnesium Sulphate in the Management of Eclampsia
Background: Eclampsia is a common obstetrical emergency, remains a leading cause of maternal and perinatal morbidity and mortality in Bangladesh. Combined Intramuscular (IM) and Intravenous (IV) regime of MgSO4 is commonly used in the treatment of eclampsia. However, IM loading dose of MgSO4 could be a suitable al ternative for community intervention of the management of eclampsia. This study aimed to compare the efficacy of theloading total IM regime of injection MgSO4 with the standard loading combined IV and IMregime for prevention of recurrent convulsions in the treatment of eclampsia. Materials and methods: Anopen labeled randomized clinical trial was conducted in the Department of Obstetrics and Gynaecology, Chittagong Medical College Hospital, Bangladesh from January 2017 to December 2017 including 120 patients with eclampsia. Patients were randomly allocated to either of the two groups: one group received standard loading combined IV and IM regime and other group received loading IM regime. The primary outcome measure was the rate of recurrent convulsions. Results: Both the groups were comparable in terms of their baseline demographic, obstetric and clinical characteristics. The recurrent convulsion rate was similar in two groups (15% vs.13.3%, p=0.756). The mean number of recurrent convulsion was 1.67±0.71 and 1.88±1.12 in IM and IM+IV group, respectively (p=0.65). Maternal mortality was 1.7% in both groups. Live birth rate was 85% in IM and 80% in IM+IV group (p=0.542) and low APGAR score at 5 minutes was found in 60.8% and 62.5% of the neonates in IM and IM+IV group, respectively (p=0.558). Conclusions: Loadingtotal IM regime of MgSO4 was found equally effective to the loading combined IV and IM regime in terms of prevention of recurrent fits in eclampsia. So it could be used by the field level workers before referral. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 31-35
Comparative Study on Outcome between Orthogonal and Parallel Plating in the Treatment of Distal Humeral Intra-Articular Fractures
Background: Intra articular distal humerus fractures are complex injuries that can comsiderably limit elbow function if not treated properly. In the treatment of distal humerus intra articular fractures double plate osteosynthesis is the standard treat ment method. However, controversy still exists concerning the plate positions in terms of providing optimal stability of these kind of fractures. This study is aimed at finding any significant difference in outcome of these orthogonal and parallel plat ing methods of fracture fixation. Materials and methods: This quasi experimental study was undertaken to compare the differences between these two dual plating methods. It was conducted in Department of Orthopedics and Traumatology of Chittagong Medical College Hospital, Chattogram, for a period of fifteen months. 36 patients were enrolled conveniently according to inclusion and exclusion criteria. Patients were followed up for 6 months and overall outcomes were measured by MEPS. Depending on the overall functional outcome patients were grouped as having excellent to good outcome and fair to poor outcome. Results: At 6th month follow up, mean MEPS in the parallel plating group was 87.89±6.50 (Mean ± SD) and in the orthogonal group it was 83.72±7.45. There was no significant (p=0.785) difference between two groups in functional outcome but in parallel plating group MEPS was better. The mean union time was 6.17±0.383 weeks in parallel plating group and 6.22±0.548 weeks in orthogonal plating group. p value was 0.549. Regarding complications, elbow stiffness developed in 3(13.89%) in parallel and 4(19.44%) in orthogonal group, superficial infection developed 1 in parallel and 3 in orthogonal group. Conclusion: This study shows that, parallel plating group was superior to the orthogonal group, as of better functional outcome, less union time and less complications Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 36-41
Measles in Young Children: A Study of Clinical Features and Immunization Status at a Tertiary Facility
Background: Measles remains to be a significant contributor to morbidity among young children all over the world, with the existence of effective vaccines. Improving vaccination strategies requires an understanding of the clinical and demographic characteristics of vulnerable children. This study aimed to assess the socio demo graphic patterns, clinical features and vaccination status of children under 5 years with measles in Chattogram, Bangladesh. Materials and methods: A descriptive cross-sectional study was conducted at the Department of Paediatrics, Chattogram Maa-Shishu O General Hospital from October 2020 to April 2021. Children aged 5 years and below with a history of measles were included based on WHO diagnostic criteria. A semi-structured questionnaire was used to collect data on age, sex, socioeconomic status and vaccination history. Data were analysed using SPSS version 22. Results: A total of 100 children were studied, with a mean age of 12.2 months with standard deviation (±5.7) months. The findings consisted of 67% boys and 33% girls. Most respondents lived in rural areas (58%) and had mothers with low education levels. All children presented with fever and rash, while 56% exhibited Koplik’s spots. Vaccination data showed that 69% had incomplete or no vaccination, with only 31% having completed two doses. Conclusion: The study emphasizes notable differences in children's measles vaccination, especially in rural environments. Protecting these vulnerable groups and preventing future outbreaks depend on improving vaccination awareness and education. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 42-46
Effect of Cement Dust Exposure duration on Liver Function Parameters in Cement Factory Workers
Background: Production of cement is a dusty industrial process which includes emission of particulates, gases, solid waste, etc. Cement industries are regarded as one of the major source of environmental pollution. Cement factory workers are prone to occupational hazards. They encounter detrimental impact on their health due to prolong and repeated exposure to cement dust. This study was aimed at evaluating the effect of cement dust exposure duration on liver function parameters (Serum bilirubin, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase) in cement factory workers. Materials and methods: Across-sectional comparative study design was adopted in this work. It was conducted in Department of Physiology, Chittagong Medical College in collaboration with Confidence cement factory Ltd. Chattogram from July 2022 to June 2023. Apparently healthy total 96 male subjects, aged between 20-50 years with BMI 18.5-27.5kg/m2 were included in this study by simple random sampling using lottery technique. Among them 48 cement factory workers, who were directly exposed to cement dust for at least 5 years and 48 subjects, engaged in desk job/office work, not directly exposed to cement dust in their working environment were enrolled in this study. To assess liver function serum ALT, AST, ALP and serum bilirubin were estimated. Unpaired Student’s t-test and ANOVA test were done for statistical analysis. Results: Mean values of serum ALT and AST were significantly higher in workers exposed for 10-14 years. Other parameters showed non significant changes between groups. Conclusion: The results of this study suggests that duration of exposure to cement dust might not cause significant differences in the liver function of cement factory workers. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 47-51
Antibiogram of Sputum Collected from Patients with Acute Exacerbation of Asthma
Background: Despite optimal guideline-directed treatment and irrespective of under lying disease severity, patients with asthma experience exacerbations due to variety of reasons including infections. Exacerbations continue to occur and impose consider able morbidity and mortality on patients and constitute a significant burden on healthcare resources. This study aimed to assess bacterial etiology in acute exacerba tion of asthma and their antibiotic resistance pattern isolated from sputum samples. Materials and methods: A cross-sectional study was conducted from September 2018 to February 2019, including 70 patients with acute exacerbation asthma from the Department of Medicine of Chittagong Medical College Hospital. Sputum samples were collected from the patients and analyzed by Gram staining, microscopy and culture. Results: Sputum culture positivity was observed in 18 cases (25.7%) and all of them were gram negative bacteria. E. coli was the most common organism isolated (44.4%), followed by Klebsiella (33.3%) and Pseudomonas (22.2%). Isolated bacteria were resistant to Ceftriaxone, Ceftazidime, Doxycycline and Tetracycline while sensitive to amikacin, ciprofloxacin, meropenem, and colistin. Patients with positive culture were older than their counterparts (51.22±7.29 vs. 40.00±13.35, p=0.001). Smoking status, presence of comorbidities and steroid use had no association with culture positivity. Conclusion: Sputum culture and sensitivity testing can be rational in patients with acute exacerbation of asthma to know its role in exacerbation as well as to know the antibiotic sensitivity as regularly used antibiotics were found resistant in most isolates. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 52-57
Leucopenia as An Early Predictor of Thrombocytopenia and Hemorrhagic Manifestations in Dengue Fever: An Observational Study
Background: Dengue fever is an endemic disease in Bangladesh that has shown in creasing incidence eachpassing year. Dengue has a wide range of clinical presenta tions and laboratory findings. Thrombocytopeniais a common finding in dengue-in fected patients along with other findings like leukopenia and hemorrhage in several forms. Thrombocytopenia is an indicator of disease severity andcan lead to severe bleeding manifestations. This study aims to find the association of leukopenia with thrombocytopenia and hemorrhagic manifestations. Materials and methods: This prospective observational study was conducted in a tertiary care hospital in Chattogram, Bangladesh for a period of six months. A total of 100 patients with confirmed dengue infection who fulfilled the inclusion criteria were followed from the day of admission to recovery. Clinical and laboratory findings, Total Leucocyte Count (TLC) and platelet counts were noted. Pearson’s Correlation Test was performed for correlation identification between leukopenia with thrombocytopenia and hemorrhagic manifestations in Dengue Fever. Results: Around 60.72% of the patients with bleeding manifestations had a low Platelet count (<150000/cmm) and among them 91.2% had leucopenia (><4000/cmm). A significant correlation was observed among low TLC, thrombocytopenia and hemorrhagic manifestation (p value ><0.001). Conclusion: Leucopenia has the potential to serve as an additional laboratory marker to predict thrombocytopenia and subsequent hemorrhagic manifestation in patients with dengue fever.><150000/cmm) and among them 91.2% had leucopenia (<4000/cmm). A significant correlation was observed among low TLC, thrombocytopenia and hemorrhagic manifestation (p value ><0.001). Conclusion: Leucopenia has the potential to serve as an additional laboratory marker to predict thrombocytopenia and subsequent hemorrhagic manifestation in patients with dengue fever><4000/cmm). A significant correlation was observed among low TLC, thrombocytopenia and hemorrhagic manifestation (p value <0.001).Conclusion: Leucopenia has the potential to serve as an additional laboratory marker to predict thrombocytopenia and subsequent hemorrhagic manifestation in patients with dengue fever. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 58-61
Comparative Analysis of Profile and Outcome of Dengue Patients Admitted in a Pediatric Intensive Care Unit of Chattogram, Bangladesh, during 2022 and 2023 Outbreak
Background: Bangladesh has been experiencing large dengue outbreaks since 2019, the 2023 outbreak is the largest on record. Comparing dengue profiles and out comes between outbreaks is crucial for enhancing our understanding of dengue and improving clinical and public health responses to future outbreaks. This study com pared the profile and outcome of dengue patients admitted to the Pediatric Inten sive Care Unit (PICU) of a tertiary-level hospital in Chattogram, Bangladesh, during the 2022 and 2023 outbreaks. Materials and methods: This record-based study included 81 laboratory-confirmed dengue children admitted to the PICU of Chittagong Medical College Hospital. Using SPSS Windows version 23.0, the demographics, clinical manifestations, and outcomes of the cases were compared between two outbreaks. Results: Twenty-three and 58 patients were admitted between 2022 and 2023, respectively. Median age of children was 5 years in both years. Males were affected more, with a male-female ratio of 1.5:1 in 2022, which was reversed in 2023 with a male-to-female ratio of 0.9:1. Persistent vomiting and abdominal pain was noticed to be significantly higher among patients in 2023. The median length of PICU stay was significantly higher in 2023 than in 2022 (8 vs. 5 days, p<0.001). The PICU mortality rate was lower in 2023 than in 2022 (13.8% vs. 21.7%), though it was not statistically significant. Conclusion: Though the number of PICU-admitted cases is increasing, the mortality rate is decreasing with appropriate management. So, for district-level hospitals in Bangladesh, establishing a pediatric intensive care unit is the demand of time to manage this severe variety of dengue pediatric cases. ><0.001) The PICU mortality rate was lower in 2023 than in 2022 (13.8% vs. 21.7%), though it was not statistically significant. Conclusion: Though the number of PICU-admitted cases is increasing, the mortality rate is decreasing with appropriate management. So, for district-level hospitals in Bangladesh, establishing a pediatric intensive care unit is the demand of time to manage this severe variety of dengue pediatric cases Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 62-65
Prediction of Independent Risk Factors for Non-Alcoholic Fatty Liver Disease Based on Regression Analysis
Background: Nonalcoholic Fatty Liver Disease (NAFLD) is a common liver disease globally, but there are no optimal methods for its prediction or diagnosis. Diagnostic markers for NAFLD are still needed for screening individuals at risk. The present cross-sectional study proposes a non-invasive tool for NAFLD screening. To establish a risk prediction model of NAFLD by Multivariable logistic regression analysis, to identify the independent risk factors for NAFLD and thus provide management strategies for preventing this disease. Materials and methods: This cross-sectional study was conducted inthe Department of Biochemistry in collaboration with Institute of Nuclear Medicine and Allied Sciences (INMAS) Chittagong Medical College Hospital (CMCH) for a period of one year from June-2017 till June- 2018. One hundred and fifty (150) subjects aged between 18 to 60 years were enrolled using a non-probability consecutive sampling method. The variables of interest were Age, Body Mass Index (BMI) Central Obesity, Fasting Blood Glucose/Sugar (FBS) Fasting Plasma Insulin (FPI) Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) AST, ALT Total Cholesterol (TC) Triglycerides (TG) and High-density Lipoprotein Cholesterol (HDL-c). NAFLD subjects were identified through ultrasonography and Insulin Resistance (IR) was evaluated using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Results: It revealed that after multivariate adjustment, only Age, BMI, FBS, FPI and HOMA-IR >2.6 have significant predictive value for NAFLD. Respondent who had age more than 40 years, BMI ≥25kg/mt2, Central obesity, FBS ≥100 mg/dl, FPI >15mIU/L and HOMA-IR >2.6 were significantly more likely to have NAFLD than their counterpart. Conclusion: The predictive indicators can have a certain effect on the early screening and the timely prevention of the progress of related complications. As a result, introducing the predictive indicators is useful for the prediction of NAFLD individuals. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 66-71
Pattern of Viruses among the Jaundiced Patients Admitted in a Tertiary Care Hospital Chattogram, Bangladesh
Background: Jaundice is the commonest presenting features of hepatitis and it is a common clinical condition in Bangladesh. As a country of the Asia Pacific region Bangladesh is considered to be a high risk country for developing hepatitis by differ ent hepatotropic viruses. This study represents the patterns and types of viruses among the patients admitted in a tertiary care hospitals in Bangladesh who were presented with jaundice. Materials and methods: Present cross sectional observational study done during a one year study period from July 2022 to June 2023 in a tertiary care hospital, Chattogram, Bangladesh among 114 patients. All patients who had clinical jaundice or having serum bilirubin > 2 mg/dl were recruited in the study. Clinical data were collected from all of them and viral serology were also done by ICT or ELISA. Informed written consent were taken from all patients and permission for the study were taken from ERB of the medical college. Results: Among 114 study subjects, male were 73(64%) and female were 41(36%) and male to female ratio was 1: 0.56. Among all, maximum were in the age range of <20 years and 21- 30 years which were 46(40.4%) and 44(38.6%) respectively. Regarding clinical features, 109(95.6%) had jaundice and 89(78.1%) had fever and 74(64.9%) had nausea and these were three dominant clinical features found. Viral serology study revealed frequency of HAV, HBV, HCV and HEV infection were 43(37.7%), 9(7.9%), 1(0.9%) and 26(22.8%) respectively. There were viral coinfections with (HAV+HEV), (HAV+HBV) and (HBV + HEV) and it were 8(7.0%), 4(3.5%) and 3(2.6%) respectively. Among all 20(17.5%) cases were tested negative for hepatotropic viruses. Again 6(5.3%) had Anti HBc Positivity and 2(1.8%) cases were found coinfected with HIV. Conclusions: In a year round, HAV and HEV are two common viral infection causing jaundice among the locality. HBV had a significant level of infection with low level HCV causing jaundice. Two HIV coinfection is an alarming condition found among the jaundice patients which need further exploration and risk factor evaluations. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 72-75
Topical Application of NaCl Tablet in Treatment of Umbilical Granuloma
Background: Umbilical Granuloma is a benign abnormality of the umbilicus and can be defined as a moist, fleshy, and pink granulation tissue at the center of the umbili cus. Considering the safe and effective treatment of umbilical granuloma more re cently common salt or NaCl tablets are gaining popularity over conventional meth ods of chemical cauterization with copper sulphate. Therefore, this study aimed to determine the outcome of NaCl tablets in managingUG. Materials and methods: This was a retrospective study and was conducted in the Department of Pediatric Surgery, Bangladesh Shishu Hospital and Institute and other two Private Clinics in Dhaka, Bangladesh during the period from July 2020 to June 2022. In our study, we included 80 patients with clinically evident umbilical granuloma who sought treatment from the investigators and NaCl tablet powder was applied tropically for the treatment. Results: The mean age was 9.88±9.7 weeks. Most (58%) of our patients were male. At the end of the 3rd day, 7th and 28th day, complete regression was found in 76.67%, 81.67%, and 91.67% of cases respectively. The common side effects were local irritation (3.33%) and wound infection (0.83%). At the last follow-up, no recurrence was found in our study patients. The majority (96.67%) of patients showed excellent response to the treatment. Conclusion: In our study, we showed that topical application of NaCl tablet powder could be a good alternative for treating neonatal umbilical granuloma due to its simplicity, safety, and effectiveness. Applying common salt is an easy, and reasonably priced therapy option that doesn't include synthetic drug use or surgical side effects Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 76-80
Efficacy of 3% Hypertonic Saline Nebulization in Acute Bronchiolitis versus Salbutamol Nebulization: A Randomized Controlled Trial
Background: Acute bronchiolitis is a leading cause of hospitalization in infants, often managed with bronchodilators and supportive care. Hypertonic Saline (HS) has emerged as a potential therapy, but its efficacy compared to salbutamol remains debated. The aim of the study is to compare the efficacy of 3% Hypertonic Saline (HS) nebulization versus salbutamol nebulization in reducing hospitalization dura tion and clinical severity in infants with acute bronchiolitis. Materials and methods: A Randomized Controlled Trial (RCT) was conducted at BGC Trust Medical Collee Hospital, Chattogram from January 2022 to December 2023, involving 200 infants (100 cases, 100 controls) diagnosed with bronchiolitis (WHO criteria). Patients were randomized into two groups: Group I (3% HS, 4 mL nebulized every 6 hours) and Group II (0.3ml salbutamol diluted in 3 mL normal saline every 6 hours). Clinical severity was assessed using the Respiratory Distress Assessment Instrument (RDAI) and Wang Clinical Severity Score (CSS). Results: The mean hospitalization duration was significantly lower in the HS group (3.5 ± 1.2 days) vs. salbutamol (4.8 ± 1.5 days, p < 0.001). Mean CSS improved more in the HS group at 24 and 48 hours (p < 0.05). Adverse events (Tachycardia, tremors, restlessness) were more frequent in the salbutamol group (p < 0.01). Conclusion: Nebulized 3% hypertonic saline significantly reduces hospitalization duration and clinical severity in bronchiolitis compared to salbutamol, with fewer adverse effects. It should be considered as a first-line therapy for acute bronchiolitis. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 81-85
Effect of Cement Pollution on Serum Creatinine and Blood Urea in Cement Factory Workers
Background: Cement dust is one of the major air pollutants and its exposure causes multiple health hazards. It can invade human body through different routes and enter into systemic circulation which affects microstructure of different organ like liver, lung and kidney. Aim of this study was to assess the effect of cement pollution onserum creatinine and blood urea in cement factory workers of Chattogram City. Materials and methods: This was ananalytical (Comparative) cross-sectional studyconducted from July 2022 to June 2023 in the Department of Physiology, Chittagong Medical College, Chattogram. Total 76 male subjects aged between 20 50 years were included in this study by simple random sampling. 38 workers of selected cement factory in Chattogram who were directly exposed to cement dust and another age and BMI matched apparently healthy 38 subjects who were not directly exposed to cement dust in their working environment were enrolled in this study. Serum creatinine and blood urea were assessed for kidney function. Unpaired student’s t-test and Pearson’s correlation coefficienttest were done for statistical analysis. Results: Mean value of serum creatinine was significantly higher in cement dust exposed group in comparison to unexposed group (p<0.05). Blood urea showed no significant changes when compared between two selected groups (p>0.05). No significant changes were observed in serum creatinine and blood urea regarding duration of exposure to cement dust. There were no significant correlation between serum creatinine and blood urea with duration of job exposure (p>0.05). Conclusion: The result of this study concludes that exposure to cement dust significantly alter serum creatinine level. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 86-90
Assessing the Characteristics of Vaginal Discharge: A Critical Perspective on Women’s Health
Background: Vaginal discharge is a common gynecological problem of varying etiol ogies affecting women's health. This study aimed to assess the characteristics of vaginal discharge in women and aimed to bridge the gap by assessing knowledge, attitude and practice related to menstrual and puerperal hygiene. Materials and methods: This cross-sectional study was conducted at the outpatient department of Obstetrics and gynecology at Chattagram Maa-O-Shishu Hospital Medical College, from July to December 2018 and included 91 women presenting with vaginal discharge and related problems. Data were collected through pretested semi structured questionnaires, clinical examinations, High Vaginal Swab (HVS) Pap Smear and Urine Routine and Microscopic Examination (RME) and Culture Sensitivity (C/S). Results: The majority of participants were in the 20-24 (34.07%) and 25-29 (26.37%) age groups, predominantly married (90.11%), largely housewives (75.82%) with education below higher secondary level (59.34%). Over half (51.65%) were overweight. Oral contraceptives were the most common contraceptive method (35.16%). Good menstrual hygiene and puerperal hygiene practiced by 43.96% participants and poor menstrual and puerperal hygiene by 56.04%. HVS results showed Candida and mixed infections (10.99% each) Trichomonas (8.79%) and Bacterial Vaginosis (BV) (3.30%). Pap Smear indicated a range of infection severity and Urine RME& C/S revealed infection rate 30.77%. Conclusion: The study highlights the need for accurate diagnosis and comprehensive reproductive healthcare and practice of healthy menstrual and puerperal hygiene to manage vaginal discharge effectively. It emphasizes the significance of various factors such as lifestyle, educational background and clinical characteristics for accurate diagnosis and treatment. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 91-96
Incidence of Rotavirus and Adenovirus Infection among Under-2 Children with Acute Watery Diarrhoea at a Tertiary Care Hospital
Background: Diarrhea is a leading cause of childhood death in the world, account ing for 5-10 million deaths per year. Worldwide, rotavirus is estimated to cause more than 111 million cases of diarrhea annually in children younger than 5 year of age. It is considered as a major cause of childhood morbidity and mortality particu larly in developing countries like Bangladesh. Considering the high morbidity and significant mortality, this study was designed to determine the incidence of rotavirus and adenovirus associated diarrhea among under 2 years. Materials and methods: This cross-sectional study was conducted in the Department of Pediatric Gastroenterology, Chattogram Maa-O-Shishu Hospital Medical College from 1st September 2022 to 28th February 2023. Total of 150 patients were enrolled in this study who were admit with acute watery diarrhoea. Stool samples were obtained and assayed for rotavirus antigen by Immunochromatography Test (ICT) – ICT Quick Rotavirus kits (Arco Biotech, Germany) were used to detect rotavirus antigen in stool samples. Results: Viral antigens were detected in 116 (77.33%) out of 150 samples analysed during the study period. Of the antigen-positive samples,70(60.3%) belonged to boys and 46 (39.65%) belonged to girls. Of the total antigen-positive samples the Rotavirus antigen was identified in 101 (87.06%) specimens, the Adenovirus antigen was identified in 11 (9.48%) and Rota adeno was identified in 4 (3.44%) specimens. The high prevalence of rotavirus and adenovirus between the ages of 7 and 12 was found 47 (40.51%) and 6 (5.17%) respectively which is to be statistically significant (p < 0.05). High incidence rate of rotavirus infections in winter months was determined. This was found to be statistically significant (p < 0.05). Conclusion: This study showed a high prevalence of Rotavirus (67.33%) infection in patients under 2 years of age. Peak age incidence under 12 months and in January . Using the rotavirus vaccine in this population can reduce diarrhoea prevalence and eliminate unnecessary antibiotic use. Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 97-101
Abstract not available Chatt Maa Shi Hosp Med Coll J; Vol.24 (2); July 2025; Page 1-2