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Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh

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Shaheed Syed Nazrul Islam Medical College is a government medical college in Bangladesh, established in 2011. It is located at Josodal, Kishoreganj Town. The college is affiliated with University of Dhaka as a constituent college. Location of Kishoreganj, is 24.7617°N 90.3993°E. It offers 5 years MBBS degree programme and admits 52 students every year.


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ssnimcj.2026.11.1.i

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Editorial

Revisiting Medical Ethics Teaching in Undergraduate Medical Education in Bangladesh: A Curriculum Requirement or a Professional Necessity?

*Nurunnabi M

Medical ethics is a core pillar of medical professionalism and clinical competence, providing physicians with frameworks to navigate patient autonomy, beneficence, non-maleficence, justice, confidentiality, and accountability. Undergraduate education must cultivate ethical values alongside scientific knowledge and clinical skills. With advances in biomedical technology, healthcare commercialization, and rising medico-legal scrutiny, ethical dilemmas are increasingly complex. Global authorities stress that ethical competence is essential for safe, patient-centred care, making medical ethics a fundamental, not peripheral, component of medical training.

The World Federation for Medical Education (WFME), supported by the World Health Organization (WHO), recognizes professionalism and ethics as core competencies in global medical education standards, requiring graduates to demonstrate ethical reasoning, respect for patient rights, and socially accountable behaviour.1,2 Despite this, in many South Asian and other low- and middle-income countries (LMICs), ethics education remains inconsistently implemented. Teaching is often limited to isolated lectures with minimal assessment and weak clinical integration, reducing ethics to a curriculum formality rather than a transformative learning process. Such superficial implementation undermines the intent of WFME–WHO standards and risks producing graduates ill-prepared for ethical challenges in real-world practice.3

In South Asia, medical ethics education is hindered by large class sizes, exam-focused curricula, limited trained faculty, and hierarchical clinical cultures. In Bangladesh, the DGME-approved MBBS curriculum includes professionalism and ethics within subjects such as community medicine, forensic medicine, and clinical disciplines.4 However, ethics is not structured as a longitudinal, competency-based discipline. It shows that while students possess basic knowledge of ethical principles, gaps persist in applied reasoning, communication, and professional behavior during clinical training. Ethics teaching is also largely confined to preclinical years, with minimal reinforcement during internship, when ethical dilemmas are most frequent. In contrast, high-income countries integrate ethics as a continuous, assessable component of undergraduate training. In the United Kingdom, the General Medical Council (GMC) mandates ethics and professionalism as core outcomes, assessed through workplace evaluations and reflective portfolios. The United States integrates ethics into problem-based learning, standardized patient encounters, and clinical ethics consultations, while Singapore emphasizes early patient exposure and mentorship, and Iran has nationally coordinated curricula with trained faculty and formal assessments. These examples demonstrate that ethics education is most effective when longitudinal, clinically integrated, and systematically assessed.5

Evidence shows that structured medical ethics education enhances professionalism, doctor–patient communication, and ethical decision-making through methods such as case-based discussions, reflective writing, and ethics rounds strengthen moral reasoning. However, the “hidden curriculum” can undermine learning when unethical practices are observed. In LMICs, where resource constraints and systemic challenges are common, robust ethics training is essential. It should address real-world issues, including informed consent, equity, end-of-life care, and professional integrity.6

Bridging the gap between WFME-WHO standards and clinical reality in Bangladesh requires re-conceptualizing ethics as a professional competency rather than a theoretical subject.1,4 Ethics education should be vertically integrated throughout undergraduate training, reinforced during clinical rotations, and contextualized to local socio-cultural realities.2 Faculty development in medical ethics and professionalism is essential to ensure effective teaching and positive role modeling. Assessment should extend beyond written exams to include objective structured clinical examinations (OSCEs), reflective portfolios, and multisource feedback, evaluating ethical competence alongside clinical skills.

Medical ethics should be embedded as a longitudinal, competency-based component in the DGME-approved undergraduate curriculum, aligned with WFME standards. Nationwide faculty development in ethics and professionalism is essential. Ethics must be integrated into clinical training through case-based discussions, simulations, and bedside teaching. Ethical competence should be formally assessed with due weight in professional examinations. Additionally, institutional ethics committees and student-led forums can promote sustained ethical reflection and accountability.

Revisiting medical ethics in undergraduate education reveals a gap between formal curriculum inclusion and true professional formation. Although WFME-WHO standards identify ethics as a core competency, implementation in South Asia, including Bangladesh, remains fragmented and poorly contextualized. Evidence indicates that ethically competent physicians are best developed through longitudinal, experiential, and clinically integrated training. Strengthening ethics education in Bangladesh is therefore vital, not only to meet global standards, but also to address local healthcare challenges and restore public trust. Medical ethics must be regarded as a foundational professional necessity, not merely a curricular requirement.

References

  1. Global standards for quality improvement in medical education: basic medical education. Ferney-Voltaire: WFME Office. WFME: 2020. Available from: https://wfme.org/wp-content/uploads/2022/03/WFME-BME-Standards-2020.pdf (Cited on September 14, 2025)
  2. Transforming and scaling up health professionals’ education and training: World Health Organization guidelines 2013. Geneva: WHO: 2013. Available from: https://iris.who.int/server/api/core/bitstreams/64d1ae96-1780-4cf8-a4cb-67fcbc2dbcfd/content (Cited on September 14, 2025)
  3. General Medical Council (GMC). Outcomes for graduates. London: General Medical Council; 2018. Available from: https://www.gmc-uk.org/cdn/documents/outcomes-for-graduates-a4_pdf-77470228.pdf (Cited on September 14, 2025)
  4. Curriculum for MBBS course in Bangladesh. Dhaka: Directorate General of Medical Education. (DGME), Ministry of Health and Family Welfare: 2023. Available from:  http://dgme.portal.gov.bd/pages/static-pages/6922e04a933eb65569e265a8 (Cited on September 14, 2025)
  5. Siegler M. The Importance of Formal Education and Training in Clinical Medical Ethics for the 21st Difficult Decisions in Surgical Ethics: An Evidence-Based Approach. 2022;30:9-26.
  6. Thirumoorthy T. The ethics of medical education-the ethical and professional issues in teaching and learning medicine. Annals of the Academy of Medicine of Singapore. 2017;46(9):331-332.
  7. de la Garza S, Phuoc V, Throneberry S, Blumenthal-Barby J, McCullough L, Coverdale J. Teaching medical ethics in graduate & undergraduate medical education: a systematic review of effectiveness. Academic Psychiatry. 2017;41(4):520-525.

*Dr. Mohammad Nurunnabi, MBBS, MPH, Assistant Professor, Department of Community Medicine and Public Health, Sylhet Women’s Medical College, Sylhet 3100, Bangladesh. nur.somch@gmail.com, ORCiD: https://orcid.org/0000-0001-9472-9369

DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.i

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ssnimcj.2026.11.1.ii

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Editorial Commentary

Indexed Does Not Mean International: Perspectives for Bangladesh Medical Publishing
*Talukder SI

In more than 25 years of editing medical journal articles, a persistent challenge has been misconceptions regarding journal classification—especially what distinguishes a national journal from an international one, and how indexing relates to academic evaluation. This issue is particularly relevant in Bangladesh, where academic promotion and research assessment are guided by the Bangladesh Medical & Dental Council (BMDC) and university authorities.
A national journal is typically published by a local institution or professional body, with editorial leadership, authorship, and readership predominantly drawn from within the country. Such journals play an essential role in strengthening national research capacity and professional discourse. An international journal, however, is characterized by sustained global engagement, including multinational authorship, an internationally representative editorial board, a research scope extending beyond national boundaries, and consistent visibility in major international indexing databases.

Indexing services are often mistakenly interpreted as indicators of international status. PubMed functions as a search interface that includes citations from MEDLINE and other sources, whereas MEDLINE is a selectively curated database maintained by the U.S. National Library of Medicine through a rigorous evaluation process. Inclusion in MEDLINE reflects editorial quality and scientific merit, but it does not automatically confer international status if the journal’s scope and participation remain primarily national.

Similarly, Crossref provides Digital Object Identifiers (DOIs) to ensure persistent article identification and citation linking. While DOI assignment is an important technical standard, Crossref does not evaluate peer-review quality, editorial independence, or international reach. Databases such as Scopus and Web of Science apply structured selection criteria and are frequently used by universities as indicators of broader international visibility.

In Bangladesh, the BMDC recognizes a number of medical journals published by medical colleges, universities, and professional societies for academic purposes. BMDC recognition confirms acceptability for professional and academic evaluation but does not imply international indexing or global scope. Confusion arises when indexing status, recognition, and international classification are treated as interchangeable, leading to inconsistent academic judgments.

In conclusion, indexing and international status are related but distinct concepts. PubMed/MEDLINE indexing reflects editorial and scientific standards; Crossref indexing reflects technical publishing infrastructure; and true international status reflects global participation and reach. Clear understanding of these distinctions is essential for fair academic assessment, responsible editorial practice, and alignment with BMDC and university promotion policies. 

*Dr. Sadequel Islam Talukder, Senior Consultant and Head, Hospital Clinical Pathology, Community Based Medical College Hospital, Winnerpar, Mymensingh, Bangladesh. sadequel@yahoo.com

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ssnimcj.2026.11.1.13

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Pattern of Blood Culture Positivity and Associated Clinical Characteristics in Febrile Neutropenic Patients: A Cross-Sectional Study
*Rahman M,1 Sultana R,2 Pinki SN,3 Azad MK,4 Hassan MK,5 Sharmeen Lipi SS6

Abstract
Background: Febrile neutropenia constitutes a medical emergency due to the heightened risk of bloodstream infection and rapid clinical deterioration. Patterns of causative organisms vary across institutions, underscoring the importance of local epidemiological data to guide empirical therapy.
Objective: This study aimed to determine the pattern of blood culture positivity and its association with clinical characteristics among febrile neutropenic adults.
Methods: This cross-sectional study included 50 adult patients with documented febrile neutropenia admitted to a Tertiary Hospital from October 2022 to September 2023. Blood samples were obtained under aseptic conditions and processed for aerobic culture. Clinical and hematologic parameters were recorded using a structured data sheet. Statistical analysis was conducted using SPSS, with significance set at p<0.05.
Results: Blood cultures were positive in 15 patients (30%). Gram-positive bacteria accounted for 53.3% of isolates, with Staphylococcus epidermidis being the most frequent pathogen. Gram-negative organisms represented 46.7% of isolates, predominantly Pseudomonas aeruginosa. No significant associations were observed between culture positivity and age, gender, fever duration, temperature, hemoglobin, WBC, ANC, platelet count, or ESR. Patients receiving chemotherapy showed no significant difference in positivity rate compared to those not receiving chemotherapy. All Gram-positive isolates were fully sensitive to vancomycin and linezolid, whereas Gram-negative isolates showed inconsistent susceptibility patterns to carbapenems and antipseudomonal antibiotics.
Conclusion: In febrile neutropenic patients, Gram-positive bacteria were the leading cause of bloodstream infections, although Gram-negative pathogens continued to play a significant clinical role. These findings highlight the need for institution-specific surveillance to guide empirical antibiotic therapy.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):94-101]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.13

 Keywords: Febrile neutropenia, blood culture, Gram-positive bacteria, Gram-negative bacteria.

  1. *Dr. Mizanur Rahman, Associate Professor (in situ), Department of Medicine, Shaheed Sayed Nazrul Islam Medical College Hospital, Kishoreganj, Bangladesh. mizan59dmc@yahoo.com
  2. Dr. Rebeka Sultana, Junior Consultant (CC), Directorate General Health Services (OSD), Bangladesh Medical University, Dhaka, Bangladesh.
  3. Dr. Sumaiya Nousheen Pinki, Lecturer, Department of Pharmacology, Holy Family Medical College and Hospital, Dhaka, Bangladesh
  4. Dr. Md. Abul Kalam Azad, Pro Vice Chancellor (Administration), Bangladesh Medical University (BMU), Dhaka, Bangladesh
  5. Dr. Md. Kamrul Hassan, Associate Consultant, Department of Hematology, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh
  6. Dr. Shahnaz Sharmeen Lipi, Assistant Professor, Department of Microbiology, Shaheed Syed Nazrul Islam Medical College, Kishorganj, Bangladesh

*For correspondence

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ssnimcj.2026.11.1.12

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Association of High Sensitive C- Reactive Protein with Female Metabolic Syndrome Patients in Bangladesh
*Mohammad S,1 Begum S,2 Saad MN,3 Naha S4

Abstract
Background: Raised level of high sensitive C-reactive protein (hsCRP) is found in Metabolic Syndrome patients (MS).
Objective: To observe association of serum hsCRP with Metabolic Syndrome in female patients.
Methods: This cross–sectional study was conducted from March 2019 to July 2020 in the Department of Physiology, Bangladesh Medical University (BMU), Shahbagh, Dhaka, Bangladesh. Female (n=30, 25 to 45 year) were diagnosed with MS in the study according to the criteria of International Diabetes Federation (IDF). Apparently healthy female (n=30, age matched) were included in the study as control. Serum hsCRP level was measured by Immuno-turbidimetric method and Chi-square test was done to observe associations of serum hsCRP with MS.
Results: Median value of hsCRP was found significantly higher (p value ≤0.01) in MS patients than that of control subjects. Around 53.3% of MS patients were found to have elevated level of hsCRP.

Conclusion: This study may conclude that elevated hsCRP was associated with MS.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):87-93]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.12 

Keywords: Metabolic syndrome (MS), High sensitive C-reactive protein (hsCRP), Female, Bangladesh.

  1. *Dr. Sumaiya Mohammad, Department of Physiology, Shaheed Syed Nazrul Islam Medical College,     Kishoreganj, Dhaka, Bangladesh. wajeeh@gmail.com
  2. Dr. Shelina Begum,, Department of Physiology, Bangladesh Medical University, Dhaka, Bangladesh.
  3. Dr. Mir Nur Us Saad, Department of Community Medicine & Public Health, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Dhaka, Bangladesh.mirsaad81@gmail.com
  4. Dr. Susmita Naha, Associate Professor, Department of Pathology, Shaheed Syed Nazrul Islam Medical College, Kishoreganj.

 *For correspondence

Full Article in PDF

 

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ssnimcj.2026.11.1.11

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Adenoid Hypertrophy: Correlation between Clinical and Radiological Findings
*Haque MA,1 Asad MK,2 Mahmud M,3 Islam MR,4 Islam MM,5 Akanda MH,6 Reza SS7

Abstract
Background: Adenoids, part of Waldeyer’s ring, play a key role in immune defense. Adenoid hypertrophy (AH) is a common pediatric condition that can cause otitis media, sleep apnoea, cognitive and craniofacial complications if untreated. As the nasopharynx is not directly visible, AH is commonly assessed using clinical and radiological methods.
Objective: To determine the correlation between clinical assessment and grading of AH with radiographic findings in children diagnosed with AH.
Methods: This observational, cross-sectional study was conducted in the Department of Otolaryngology – Head & Neck Surgery, Chittagong Medical College Hospital, Chattogram, Bangladesh, from June 2022 to August 2023. Fifty pediatric patients with adenoid hypertrophy were selected consecutively using purposive sampling. Clinical scoring of mouth breathing/dyspnoea, sleep apnoea, and snoring was categorized as mild, moderate, or severe and compared with lateral nasopharyngeal radiographs assessed by Fujioka and Cohen methods. Data were analyzed in SPSS v26, with results expressed as mean ± SD, frequency, and percentage, and associations tested using ANOVA (P < 0.05).
Results: Among 50 children with adenoid hypertrophy (mean age 5.94 ± 0.72 years; 78% male), common clinical features were mouth breathing/dyspnoea (62%), snoring (58%), and apnoea (76%). Fujioka ANR ratios were mild 10%, moderate 58%, severe 32%, correlating with clinical severity (P = 0.0017; ROC cut-off 0.61: 76% sensitivity, 79% specificity). Cohen AC:SP ratios were mild 14%, moderate 62%, severe 24%, also correlating with clinical grading (P = 0.0261; ROC cut-off 0.66: 68% sensitivity, 57% specificity). Fujioka method showed higher reliability than Cohen.
Conclusion: Lateral radiographs of the nasopharynx are reliable and valid for evaluating children with AH in accordance with their clinical symptoms or grading. A strong correlation between clinical scores and radiological findings was observed. The Fujioka method demonstrated better accuracy than the Cohen method in terms of diagnostic validity and reliability.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):75-86]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.11

Keywords: Adenoid Hypertrophy, Clinical Assessment, Radiological Evaluation.Dr.  

  1. *Dr. Md. Aminul Haque, Junior Consultant (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College Hospital, Kishoreganj, Bangladesh. aminul49rmc@gmail.com.
  2. Professor Dr. Md. Khalid Asad, Department of ENT, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
  3. Dr. Muddassir Mahmud, Assistant Professor (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
  4. Dr. Muhammad Rafiqul Islam, Assistant Professor (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
  5. Dr. Md. Mizanul Islam, Assistant Registrar (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College Hospital, Kishoreganj, Bangladesh
  6. Dr. Md. Mobarak Hosen Akanda, Registrar (ENT), Department of ENT, Mymensingh Medical College Hospital, Mymensingh, Bangladesh
  7. Dr. SM Shohan Reza, Registrar (ENT), Department of ENT, Universal Medical College & Hospital, Dhaka, Bangladesh

*For correspondence

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ssnimcj.2026.11.1.10

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Postoperative Complications of Mastoid Surgery: A Hospital-Based Cross-Sectional Study
Mahdee SN,1 Efa SS,2 Kali F,3 *Nurunnabi M4

Abstract
Background: Mastoid surgery is a common procedure in otolaryngology, but postoperative complications can occur, affecting patient outcomes. Evaluating the incidence and clinical profile of these complications is essential for improving surgical care.
Objective: This study aimed to evaluate the incidence and types of complications following mastoidectomy.
Methods: A hospital-based cross-sectional study was conducted in the Department of Otolaryngology and Head-Neck Surgery at Sylhet MAG Osmani Medical College Hospital, Sylhet, from December 2014 to May 2015. All patients undergoing mastoid surgery during the study period were included using purposive sampling, excluding those with previous mastoid surgery, pre-existing middle ear complications, or unwillingness to participate. Mastoid surgeries included cortical, modified radical and radical mastoidectomies.
Results: Postoperative complications occurred in 7 patients (14%). Complications were more frequent in younger patients, with a mean age of 16.8±10.9 years. Minor complications (71.4%) were more common than major complications (28.6%). Modified radical mastoidectomy was the most performed procedure (84%), followed by radical (12%) and cortical mastoidectomy (4%). Complications were highest after radical mastoidectomy (33.3%). Specific complications included wound infection/gap (8%), meatal stenosis (4%), and major complications such as facial nerve paralysis, meningitis, and minor dural injury (2% each). Follow-up showed that most patients were complication-free at 1 week (88%), while 3-month follow-up indicated dry cavities (14%), discharging cavities (20%), and meatal stenosis (4%), with 64% lost to follow-up.
Conclusion: Postoperative complications after mastoidectomy were relatively low and mostly minor. Younger patients and more extensive surgeries had higher complication rates, emphasizing the need for careful monitoring and follow-up.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):68-74]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.10

Keywords: Postoperative complications, radical mastoidectomy, modified radical mastoidectomy, Sylhet, Bangladesh. 

  1. Dr. Syed Nafi Mahdee, Assistant Professor, Department of Otolaryngology and Head-Neck Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh.
  2. Dr. Syeda Sumaiya Efa, Deputy Director, Program & Research, BADAS TB Initiative Diabetic Association of Bangladesh.
  3. Dr. Fatema Kali, Assistant Professor, Department of Anaesthesia, Analgesia and Palliative Care, National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh.      
  4. *Dr. Mohammad Nurunnabi, Assistant Professor, Department of Community Medicine and Public Health, Sylhet Women’s Medical College, Sylhet, Bangladesh. nur.somch@gmail.com

 *For correspondence

Full Article in PDF

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ssnimcj.2026.11.1.9

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026
Clinicopathological Characteristics of Early-Onset Colorectal Cancer among Young Adults in Northeast Bangladesh: A Hospital-Based Cross-Sectional Study
Alam MI,1 Hoque N,2 Husna MA,3 *Nurunnabi M4

Abstract
Background: Colorectal cancer (CRC), historically predominant in older populations, is increasingly identified in individuals below 50 years of age, a subset classified as early-onset colorectal cancer (EOCRC), which frequently presents with advanced-stage disease and distinct clinicopathological features in young adults.
Objective: To observe the demographic, clinical, and pathological characteristics, risk factors, and treatment outcomes of EOCRC in young adults in Northeast Bangladesh.
Methods: A hospital-based cross-sectional study was conducted at the Department of Clinical Oncology, Mount Adora Hospital, Sylhet, from July 2023 to December 2024. Patients were purposively selected, and data were extracted from hospital records. The study included 112 histopathologically confirmed colorectal cancer patients aged 18-40 years, with information on demographics, family history, clinical presentation, tumor characteristics, tumor markers, treatments, and treatment response analyzed.
Results: The mean age of EOCRC patient’s was 32.8±3.2 years; 68.0% were male, and 71.0% resided in urban areas. Obesity (34.0%) and smoking (24.0%) were the most common risk factors, while family history (13.0%) and inflammatory bowel disease (9.0%) were less frequent. The leading symptoms were combined per-rectal bleeding and abdominal pain (77.7%), generalized weakness with anorexia and pallor (59.8%), rectal bleeding (50.0%), and altered bowel habits (42.9%). The rectum was the predominant tumor site (51.0%), followed by the distal colon (33.0%). Most tumors were adenocarcinoma NOS/Grade 1–2 (66.0%), and the majority presented at Stage III (58.0%). Total neoadjuvant therapy was the most common treatment (48.0%). Partial and complete responses were observed in 39.0% and 27.0% of patients, respectively, while 13.0% showed disease progression.
Conclusion: Young adults with EOCRC in Sylhet frequently present with advanced-stage, distal tumors and exhibit modifiable lifestyle risk factors such as obesity and smoking. Early recognition and targeted interventions are critical to improve outcomes in this population.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):60-67]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.9

Keywords: EOCRC, clinicopathological characteristics, young adults, risk factors, treatment outcomes. 

  1. Dr. Md. Ishtiaque Alam, Associate Professor and Head, Department of Oncology, Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet, Bangladesh. raseldr@yahoo.com
  2. Dr. Nusrat Hoque, Assistant Professor, Department of Oncology, Green Life Medical College and Hospital, Dhaka, Bangladesh.
  3. Dr. Md. Golam Zel Asmaul Husna, Medical Officer, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh.
  4. *Dr. Mohammad Nurunnabi, Assistant Professor, Department of Community Medicine and Public Health, Sylhet Women’s Medical College, Sylhet, Bangladesh. nur.somch@gmail.com

*For correspondence

Full Article in PDF

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ssnimcj.2026.11.1.8

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Clinical and Functional Outcomes of Open Tibia-Fibula Fractures Managed with Ilizarove External Fixation: A 20 Case Study at CBMCHB Orthopedics Department
Chowdhury MR,1 Haque MA,2 Hasan S,3 *Uthsha TR4

Abstract
Background: The management of open tibia-fibula fractures, particularly those of higher Gustilo-Anderson grades, remains a significant challenge due to high rates of complications like infection and non-union. The Ilizarov external fixator (IEF) offers a versatile, minimally invasive technique allowing for early weight-bearing and excellent soft-tissue access. This study retrospectively evaluated the clinical and functional outcomes of open tibia-fibula fractures treated with IEF at our institution.

Methods: We retrospectively reviewed 20 consecutive patients with open tibia-fibula fractures treated definitively with the IEF at CBMCHB between [January 2023] and [January 2025]. The mean follow-up period was 24 months. Outcomes were assessed using the Association for the Study and Application of the Methods of Ilizarov (ASAMI) criteria for bone and functional results. Complications, time to union, and duration of external fixation were recorded.
Results: The mean time to radiologic union was 4.5  more or less 1.2 months (range, 3–7 months). According to the ASAMI criteria for bone results, 16 (80 %) cases achieved Excellent or Good outcomes. Functional results showed 15 (75%) patients had Excellent or Good outcomes. Pin-tract infection was the most common complication, observed in 4 (20%) cases, all of which were managed successfully with oral antibiotics and local wound care. No cases of deep infection or unacceptable malunion were recorded.
Conclusion: The use of the Ilizarov external fixator as a primary and definitive treatment for open tibia-fibula fractures, even in higher-grade injuries, yielded high rates of bone union and satisfactory functional outcomes. The ability to manage soft tissues and permit early weight-bearing makes the Ilizarov technique a valuable modality in this challenging patient population.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):54-59]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.8 

Keywords: Open fracture, Tibia, Fibula, Ilizarov, External Fixation, ASAMI, Functional Outcome

  1. Dr. Mamunur Rashid Chowdhury, Associate Professor, Department of Orthopedics, CBMCHB. mamunakua@gmail.com
  2. Dr. Md. Anwarul Haque, Professor, Department of Orthopedics, CBMCHB
  3. Dr. Sabbir Hasan, Registrar, Department of Orthopedics, CBMCHB
  4. *Dr. Tanmoy Ray Uthsha, Medical Officer, Department of Orthopedics, CBMCHB. druthsha@gmail.com

*For correspondence

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ssnimcj.2026.11.1.7

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

An Outbreak of Diarrhoea Attributed to Consumption of Street-Foods- Bangladesh, March 2018
*Afreen N,1 Faruque AM,2 Jony MK,3 Flora MS4

Abstract
Background: Diarrhoea outbreaks are common in Bangladesh and usually reported through event-based surveillance. Increased admission of diarrhoea cases was noticed in Upazila-health-center in early March, 2018 and reported to IEDCR on 11 March.  The event was investigated to confirm outbreak, identify possible exposures and provide control measures.
Methods: We investigated outbreak since 12-14 March; conducted informal interviews, reviewed clinical records, created area-maps of case-patients, tested stool and water samples. For case-control study, we defined case-patients as “Any resident of that sub-district having ≥3 loose stools in 24 hours since 25th February’18 to date of investigation” and recruited 16 recently admitted case-patients mainly (most previous case-patients lacked contact information) and 32 neighborhood unmatched controls. Calculation of odds ratio and logistic regression were done to identify possible exposures with 95% confidence interval.

Results: Outbreak started since 3rd March; median age of line-listed case-patients (n=251) was 35 years (IQR 25-50) with male predominance (67%). Most case-patients were from municipality (53%, n=207). For case-patients versus controls, median age was 35 years (IQR 23-45.5) (versus 30 years (IQR 24-45)); 75% male (versus 31%); 60% (9/15) had occupations exposing them frequently to municipality (versus 19%). Odds ratios of consuming street-foods between 25 February-12 March (aOR 14.19, 95% CI 1.11-181.35) and similar illness among family members (aOR 35.4, 95% CI 2.71-461.98) were higher adjusting for sex and occupation. Interviews revealed that many people consumed available street foods in a fair occurred at this municipality from 2-10 March (prior to outbreak notification).
Conclusion: Duration of fair and outbreak showed that consumption of street foods from the fair was most likely source of this outbreak. Similar illness among family members might be due to person-to-person transmission or sharing same street food among family members. We suggested safety monitoring of street food sold in large gatherings (e.g., fair) to prevent similar outbreaks in future.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):42-53]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.7 

Keywords: Diarrhoea, Outbreak, Gatherings, Street food, Bangladesh 

  1. * Dr. Nawroz Afreen, Assistant Professor, Department of Epidemiology, National Institute of Preventive and Social Medicine. nawroz.afreen@gmail.com.
  2. Dr. Abdullahel Maruf Faruque, Upazila Health and Family Planning Officer, Bahubal Upazila Health Complex.
  3. Dr. Manjur Hossain Khan Jony, Assistant Professor, Department of Virology, Institute of Epidemiology, Disease Control and Research.
  4. Dr. Meerjady Sabrina Flora, Former Additional Director General, Planning and Research, Directorate General of Health Services.

 *For correspondence

Full Article in PDF

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ssnimcj.2026.11.1.6

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Evaluation of Postoperative Wound Infection in Diabetic Patients Undergoing Minor Surgery
*Huda AK,1 Sheme ZA,2 Akhter L3

Abstract
Objective: To evaluate the incidence, risk factors, and clinical outcomes of postoperative wound infection (PWI) in diabetic patients undergoing minor surgical procedures.
Methods: A prospective observational study was conducted on 40 diabetic patients who underwent minor surgeries at the Department of Surgery, Rangpur Medical College and Hospital, from January 2019 to December 2019. Data collected included demographic characteristics, glycemic control (HbA1c), perioperative glucose levels, type and duration of surgery, and postoperative wound outcomes. PWI was defined according to CDC ( Center for disease control and prevention) criteria, and patients were followed for at least 30 days postoperatively.
Results: PWI was observed in 6 patients (15%). Poor preoperative glycemic control (HbA1c >8%), perioperative hyperglycemia (>180 mg/dL), and longer operative duration (>1 hour) were significantly associated with infection (p<0.05). Two patients required wound drainage, and all infected wounds eventually healed without major complications.
Conclusion: Diabetic patients undergoing minor surgical procedures remain at substantial risk for postoperative wound infection. Careful preoperative glycemic optimization, strict intraoperative monitoring, and vigilant postoperative care are essential to minimize complications and ensure timely wound healing.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):37-41]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.6
Keywords: Postoperative Wound Infection, Diabetic Patients, Minor Surgery

  1. *Dr. AKM Kamrul Huda. Assistant Professor (Surgery), Army Medical College Rangpur Bangladesh. doctorapple2109@gmail.com
  2. Dr. Zinat Afrin Sheme, Associate Professor (Biochemistry), Army Medical College, Rangpur, Bangladesh.
  3. Dr Latifa Akhter. Associate Professor, Department of Dermatology, Rangpur Medical College, Rangpur, Bangladesh.

 

*For correspondence
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