Author: ssnimc

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ssnimcj2024v9i2a1

Original Contribution

Prediction of Oesophageal Varices by Serum Albumin Level among Patients with Cirrhosis of Liver

 

*Ullah P,1 Bhowmik RC,2 Keya SA,3 Rahut A,4 Aftab H5

 

  1. *Dr. Parash Ullah, Medical Officer, Department of Gastroenterology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh. ullahdrp@gmail.com
  2. Ratan Chandra Bhowmik, Registrar, Department of Gastroenterology, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh.
  3. Shamim Ara Keya, Junior consultant, Department of Pathology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.
  4. Antora Rahut, Medical Officer, Department of Gastroenterology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.
  5. Hafeza Aftab, Professor and Head, Department of Gastroenterology, Dhaka Medical College Hospital, Dhaka, Bangladesh.

 

* For correspondence

Abstract

Background: Oesophageal varix is a common complication of liver cirrhosis. Endoscopy is the gold standard test to detect varices but it is unpleasant for patients. The aim of the study was to determine the predictive value of serum albumin for the prediction of oesophageal varices.

Methods: It was a cross-sectional observational study, conducted in gastroenterology department, Dhaka Medical College Hospital, Dhaka on recently diagnosed cirrhotic patients. It was based on routine test for cirrhosis of liver. So, every patient was underwent routine investigations including complete blood count, viral markers, serum albumin, ultra-sonogram of abdomen, upper gastrointestinal endoscopy. Statistical analysis was done using SPSS software version 23.

Results: A total number of 150 patients were included. Age of the patient (mean ± SD) was 47.89 ± 14.77 years, while 113 (75.3%) were men. More than half (56.7%) patients had HBV followed by 53(35.3%) was unknown and 12(8.0%) had HCV. Oesophageal varices were observed in 90% of the patients. The mean value of albumin ratio was 2.78 ±0.49 in patients having oesophageal varices and 3.11±0.68 in patients without oesophageal varices which was statistically significant (p<0.05). The correlation of serum albumin with different grades of oesophageal varices was also statistically significant. Considering low serum albumin as below 3.5 gm/dl, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 82.22%, 20.00%, 90.24%, 11.11%, and 76.00% respectively.

Conclusion: Serum albumin is a useful noninvasive routine test which can predict the presence of oesophageal varices in cirrhotic patients. It can never replace the gold standard endoscopy test but it can help physicians to predict a high probability of esophageal varices. It may also help for selection of patient who need urgent endoscopy when endoscopy facilities are limited like Covid-19 pandemic situation.

[Shaheed Syed Nazrul Islam Med Col J 2024, Jul; 9 (2):36-43]

DOI: https://www.doi.org/10.69699/ssnimcj2024v9i2a1

Keywords: Liver cirrhosis, Oesophageal varices, Serum albumin

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ssnimcj2024v9i2c

Shaheed Syed Nazrul Islam Medical College Journal
Volume 9, Issue 2
July, 2024

Annual subscription for institution: BDT 1000.00
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Overseas patrons: US$ 50.00Send manuscript via email to:Editor (Online)Shaheed Syed Nazrul Islam Medical College JournalShaheed Syed Nazrul Islam Medical College

Kishoreganj, Bangladesh
sadequel@yahoo.com

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For subscription, advertisements, sales, and other promotional activities please correspond with editor (Online)

 

Copyright© 2016-24, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh

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ssnimcj2024v9i2b

Shaheed Syed Nazrul Islam Medical College Journal
Volume 9, Issue 2
July, 2024

Sl No Contents Page
Original Contributions
1 Prediction of Oesophageal Varices by Serum Albumin Level among Patients with Cirrhosis of Liver

Ullah P, Bhowmik RC, Keya SA, Rahut A, Aftab H

 

 36
2 Adolescent Students’ Distress and Noise Exposure in Classrooms near an Industrial Area

Pritom MJ, Joy YA, Tabassum N, Shadman R, Talukdar MS, Rahman MM, Sattar S, Abbas MG

 

 44
3 Association of Microalbuminuria with Duration of Type-2 Diabetes Mellitus

Haque MJ, Ahammod T, Asaduzzaman M, Kawsar IA

 

 54
4 Prevalence of Psychiatric Disorders – An Evaluation from a Psychiatric Outdoor Department with ICD-10 Diagnostic Criteria for Research (DCR)

Bashar MK, Kulsum U,Talukder MM, Mitu MR Naser MJ, Sultana N6

 

 62
5 Analysis of Road Traffic Accident Deaths at a Medical College Mortuary in Sylhet

Rahman MF, Poly TB, Uddin NM, Nurunnabi M

 

 72
6 Prevalence of Morbidity Pattern & Immediate Outcome of Perinatal Asphyxia in a SCANU of 250 Bed District Hospital in Jamalpur

Khaleque MA, Islam MT, Mridha S, Begum S,Asaduzzaman M,Jahan MS

 

 79
7 Biochemical and Serological Characteristics of Incidentally Detected Chronic Hepatitis B Infection

Alam MJ, Mahtab M, Rahman MM, Ahmed MU, Rahman MO, Chowdhury MK, Shaha M

 

 86
8 Sociodemographic and Etiological Profile of Patients with Metabolic Acidosis Admitted in an Intensive Care Unit of a Specialized Hospital in Bangladesh

Rahman MM, Islam U, Mamun AA

 

 94
Others
9 Information for Contributors 103

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SSNIMCJ 2023 v8 i2 a8

Original Contribution

Biochemical and Hematological Changes in Patients of Chronic Kidney Disease

1. Dr. Abu Ayub Md. Nazmul Huda, Associate professor, Department of Nephrology, Shaheed Sayed Nazrul Islam
Medical College, Kishoreganj, Bangladesh. a2mnhuda71@gmail.com
2. Dr. Tofael Ahammod, Assistant Professor, Department of Nephrology, Shaheed Sayed Nazrul Islam Medical
College, Kishoreganj
3. Dr. Hasan Mahmud, Assistant Professor, Department of Nephrology. Shaheed Sayed Nazrul Islam Medical
College, Kishoreganj
*For correspondence

Abstract
Background: Chronic kidney disease-CKD is a major public health problem and cause of
morbidity and mortality worldwide. In Bangladeshi population, the prevalence of CKD is
unexpectedly high, because Diabetes and Hypertension are common in Bangladesh. CKD is
defined as impaired glomerular filtration rate (GFR) or elevated albumin excretion in the urine, and
has been recognized as an important risk factor contributing to cardiovascular disease and death.
There are many causes of CKD. Glomerulonephritis, diabetes mellitus, hypertension, interstitial
nephritis, Polycystic kidney disease are important causes.
Methods: This was a prospective observational study done Shaheed Sayed Nazrul Islam Medical
College, Kishoreganj from January 2022 to December 2022 to evaluate the biochemical profile in
patients of chronic kidney disease as compared to healthy controls. Analysis of lipid profile ( Total
cholesterol, HDL-C, LDL-C and Triglycerides), Renal profile (Creatinine, Electrolytes, Calcium,
Inorganic phosphate, Uric acid) and Hematological parameters including PTH were carried out in
CKD patients (n=100) and compared to the healthy individuals (n=100). Results were analyzed
statistically using SPSS 20 program for windows.
Results: Low level of hemoglobin which was statistically significant compared to the control
group (p<0.05). High level of PTH, serum creatinine, Potassium, inorganic phosphate, Uric acid
accompanied by low levels of calcium, were found statistically significant compared to the control
group (p<0.05).
Conclusion: Glomerulonephritis, diabetes and hypertension are the main causes of CKD. We
suggest stringent hematological and biochemical testing in the patients of CKD for proper
evaluation and accurate management to reduce the morbidity and mortality.

[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):123-128]
Keywords: Chronic Kidney Disease (CKD), Hematological profile, Renal profile

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SSNIMCJ 2023 v8 i2 a7

Original Contribution

Evaluation of Organism in Vaginal Discharge of PPIUCD Users Versus Non-Users

1. Dr. Most. Asma Khatun, Medical Officer, Department of Obstetrics and Gynecology, Dhaka Medical College
&Hospital, Dhaka, Bangladesh
2. *Dr. Nadira Haque, Senior Consultant and Head of the Department of Obstetrics and Gynecology, Kuwait-
Bangladesh Friendship Government Hospital, Dhaka, Bangladesh. dr.nadira1@yahoo.com
3. Dr. Eti Saha, Associate Professor, Department of Obstetrics and Gynecology, Khulna medical College &
Hospital, Khulna, Bangladesh.
4. Dr. Mausumi Paul, Medical Officer, Department of Obstetrics and Gynecology, Khulna Medical College &
Hospital, Khulna, Bangladesh.
5. Dr. Md. Farid Uddin, Medical Officer, Department of Anesthesiology, Khulna Medical College & Hospital,Khulna, Bangladesh.
6. Dr. Khadija Khan Toma, Registrar, Department of Obstetrics and Gynecology, Kuwait-Bangladesh Friendship
Government Hospital, Dhaka, Bangladesh.
7. Dr. Nurun Nahar, Registrar, Department of Obstetrics and Gynecology, Kuwait-Bangladesh Friendship
Government Hospital, Dhaka, Bangladesh.
*For correspondence

Abstract
Background: Immediate Post-Partum Intrauterine Contraceptive Device (PPIUCD) is a novel
approach to contraception which integrates maternal-child health and family planning services but
it has less acceptance in the community.
Methods: This cross-sectional comparative study was conducted in the Department of Obstetrics
& Gynecology, Khulna Medical College Hospital between 1st June 2019 and 28th February 2020. A
total of 66 women between 20 and 35 years of ageat postpartum period were enrolled in the study
and divided into two groups. Among them 33 women who agreed to take PPIUCD were considered
as group-I (n=33) and rest 33 women who were PPIUCD non-users were considered as group-II
(n=33). Purposive sampling was done according to the availability of the participants who had
voluntarily joined this study. The purpose and procedure of study was discussed with the
participants and informed written consent was taken. An interviewer administered questionnaire
was used for data collection.Statistical analysis of the results was obtained by using Windows
based computer software devised with Statistical Packages for Social Sciences (SPSS-22).
Results: Among 66 patients, majority of patients were in the age group of 20-25 years (51.7% in
group I and 57.6% in group II). Majority of patients using PPIUCD were multiparous (57.6%)
while 63.6% non-users were primiparous. Most common complaints among study population were
abnormal vaginal discharge, vaginal itching, dyspareunia, dysmenorrhea and backache with a
higher frequency in PPIUCD users without statistical significance. Among PPIUCD users, 48.5%
had scanty vaginal discharge, 27.3% had average discharge, 24.2% had profuse vaginal discharge
with mean duration of vaginal discharge of 31.94±13.97 days. Gram stain findings of vaginal
discharge between PPIUCD users and non-users showed only more gram-positive cocci in
PPIUCD users than non-users with statistical significance (p=0.036) while culture of vaginal
discharge showed significantly positive culture for Staphylococcus aureus in group-I while
Neisseria was significantly more in group -II, non-user group.
Conclusion: In this study, IUCD use during immediate postpartum period altered normal vaginal
flora with higher frequency of Gram-Positive Cocci and lesser frequency of yeast isolation.

[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):115-122]
Keywords: PPIUCD, Vaginal discharge

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SSNIMCJ 2023 v8 i2 a6

Original Contribution

Prevalence and Spectrum of Congenital Heart Disease in Children Admitted
into Tertiary Care Hospital of Kishoreganj: A Multicenter Study

1. *Dr Mohammad Nuruzzaman, Senior Consultant (Paediatrics), Shaheed Syed Nazrul Islam Medical College
Hospital, Kishoreganj. nuruzzamansomc31@gmail.com
2. Dr Mohammad Solaiman Tanveer, Assistant Professor(Cardiology), Shaheed Syed Nazrul Islam Medical
College, Kishoreganj
3. Dr AKM Masudul Gani Bhuiyan, Junior consultant (Paediatrics), Shaheed Syed Nazrul Islam Medical College
Hospital, Kishoreganj
4. Dr AHM Muslima Akter, Assistant professor(Paediatrics), President Abdul Hamid Medical College, Kishoreganj
5. Dr Md. Arafat Rahman Royal, Registrar(Paediatrics),Jahurul Islam Medical College Hospital, Kishoreganj
*For correspondence

Abstract
Background: Birth defect is one of the important cause of morbidity and mortality in children.
Congenital heart disease (CHD) is the most common birth defect that causes significant childhood
mortality. This study was done to find out the prevalence of CHD and their type in Children
admitted into district tertiary care hospital of Kishoreganj.
Methods: This prospective cross sectional study was carried out in the department of Pediatrics of
3 medical college hospital of Kishoreganj. This study was done over a period of 1year from
January 2022 to December 2022. Children with the confirmed diagnosis of CHD with the age
ranging from 1st day of life to 12 years were analyzed considering the type of CHD.
Results: In our study prevalence of CHD was 12.56 per 1000 admitted child. In the present study
total 267 cases of CHD were found. Maximum cases of CHD were admitted between 2 month
to12month age group. Out of 267 cases 125(46.82%) were male and 142 (53.18%) were female.
The male-female ratio was 1:1.4.In the present study 75.66% (202) patient had acyanotic CHD and
24.34% (65) patient had cyanotic CHD. The commonest CHD was found VSD (28.46%) which
was followed by ASD (18.35%), Multiple acyanotic CHD (13.11%), PDA(11.24%), TOF and it
variant Pentalogy of Fallot (10.5%), Complex cyanotic CHD (6%), d-TGA (4%) and PS(3%).
Conclusion: In the present study wide ranges and significant number of CHD cases were found.
Acyanotic CHD is the commonest type of CHD. Increase number of multiple acyanotic CHDand
complex cyanotic CHD found in the present study.

[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):107-114]
Keywords: Prevalence,Congenital heart disease, Echocardiography

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SSNIMCJ 2023 v8i 2 a5

Original Contribution

Health Problems among the Agricultural Workers in a Selected Area of
Manikganj District

1. *Dr. Afsana Mahjabin, Associate Professor, Community Medicine, Monno Medical College, Manikganj.
afsana.aqsa@gmail.com
2. Professor Dr. Khondoker Mohammad Ali, Professor, Community Medicine, Monno Medical College, Manikganj
3. Professor Dr. Md. Jahangir Alam, Professor, Community Medicine, Monno Medical College, Manikganj
4. Dr. Mohammad Tariqul Islam, Associate Professor, Physical Medicine & Rehabilitation, Bangabandhu Sheikh
Mujib Medical University, Shahbag, Dhaka
5. Dr. Tamanna Tasneem, Senior Assistant Secretary, Ministry of Information and Broadcasting, Peoples Republic of
Bangladesh
6. Dr. M. A. Muhaimin Al Zihan, Senior Assistant Secretary, Ministry of Public Administration, Peoples Republic of
Bangladesh
*For correspondence

Abstract
Background: Health problems are well recognized problems among the agricultural workers all
over the world specially in developing countries. For an agricultural country like Bangladesh
injuries during cultivation of land are the significant causes of slump. This paper represents the
main causes of agricultural injuries among the Bangladeshi farmers.
Objectives: The study was conducted with an aim to assessing the health problems of the
agricultural workers in a rural area of Manikganj.
Methods: This was a cross-sectional study carried out in different villages of Manikganj during the
period of October, 2022 to March, 2023 by the Department of Community Medicine, Monno
Medical College, Manikganj.
Results: The study revealed that out of 316 respondent’s majorityi.e. 95 (30.66 %) belonged to the
age group (51-60) years. Most of the respondents i. e. 251(52.3%) were male, 89 (28.2%) illiterate
followed by 86 (27.2%) studied up to primary grade. Majority i.e. 144 (45.6%) had monthly family
income (5000-10,000) tk. Regarding duration of agricultural work 210 (66.4%) had been working
for (2-20) years. About 246 (77.4%) had knowledge of occurring physical injury followed by 90
(28.3%)respondents knew about insect bite.Regarding source of injury 150 (47.2%) were injured
by sickle and 111(31.8%) were injured by spade. Regarding common site of injury, majority i. e.
215(67.6%) said that injuries occur in lower limbs and 206 (64.8%) said in upper limb. About 187
(58.8%) respondents injured due to overload of work followed by 126(39.6%) which was due to
lack of knowledge. Regarding preventive measures of health problems 114 (35.9%) farmers used
mathal followed by 120(37.7%) used gamcha. This study revealed that physical injury occurred in
224 (31.9%) farmers followed by heat injury and skin disease in 91(12.9%) & 79(11.3%) farmers
respectively.
Conclusion: Majority of the farmer‘s suffer from different type of injury/accident without taking
necessary preventive measure.

[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):98-106]
Keywords: Health problems, agricultural workers, Manikganj, Bangladesh

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SSNIMCJ 2023 v8 i2 a4

Original Contribution

Evaluation of Haematological Parameters and their Correlation with
Histological Grade and Stage of Colorectal Cancer

1. *Dr. Susmita Naha, Assistant Professor, Department of Pathology, Shaheed Sayed Nazrul Islam
Medical College, Kishoreganj. dr.susmitanaha@yahoo.com.
2. Prof. Dr. AFM Saleh, Professor and Head, Department of Pathology, President Abdul Hamid
Medical College, Kishoreganj.
3. Dr. Dulal Chandra Das, Assistant Professor, Department of Medicine, Shaheed Sayed Nazrul Islam
Medical College, Kishoreganj.
4. Dr. Halima Khatun Doly, Assistant Professor, Department of Pathology, Khwaja Yunus Ali Medical College,
Sirajganj.
*For correspondence
Abstract
Background: Colorectal cancer (CRC) is a common and lethal disease worldwide which is
increasingly being reported in the developing countries. Prognosis is largely dependent on its
histological grade and stage. TNM staging system has been regarded as standard but there are still
variations between patients who have the same stage. There is need for more efficient biomarkers
that are low-cost, highly efficient and sensitive in the preoperative period, beneficial in clinical
usage and with both prognostic and predictive value. The aim of this study was to evaluate
preoperative haematological parameters including haemoglobin level (Hb), total leukocyte count,
neutrophil to lymphocyte ratio (NLR), platelet count (PC) and their correlation with histological
grade and stage of colorectal cancer.
Methods: This cross-sectional study was carried out in the Pathology department of Mymensingh
Medical College, Mymensingh, during March 2018 to December 2019 and a total of 45 patients
were included. Preoperative blood samples were evaluated from patients diagnosed as colorectal
carcinoma by colonoscopy in Surgery department of MMCH who underwent colectomy and all the
resected specimens were sectioned, stained and studied. Tumors were graded as well, moderately
and poorly differentiated as per WHO criteria. Staging was done according to TNM classification
as per AJCC Cancer Staging Manual.
Results: Histologically most of the cancers are adenocarcinoma (93.3%). Hb level had a negative
significant correlation with grade and a negative non-significant correlation with stage.NLR had a
positive non-significant correlation with grade but a positive significant correlation with stage.
ROC curve analysis of NLR with area under curve (AUC) 0.694 and a cut off value 3.07
demonstrated 63.6% sensitivity and 78.3% specificity for prediction of regional lymph node
involvement (N stage). Platelet count showed a positive significant correlation with grade but a
positive non-significant correlation with stage.
Conclusion: So, some commonly done preoperative haematological parameters may play a role in
predicting grade and stage of CRC and may be used as adjunct to clinical, radiological and
pathological findings in disease evaluation.

[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):88-97]
Keywords: Hemoglobin, platelet, white blood cell, NLR, colorectal cancer, tumor grade, tumor
stage.

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SSNIMCJ 2023 v8 i2 a3

Original Contribution

Pattern of Utilization of Personal Protective Equipment among Doctors and
Nurses during COVID-19 Pandemic

1.Dr. Humaira Tul Jannat, MPH Fellow (Hospital Management), Department of Public Health and Hospital
Administration, National Institute of Preventive and Social Medicine (NIPSOM), Mohakhali, Dhaka 1212,
Bangladesh. humaira.sdc@gmail.com
2. Professor Dr. Baizid Khoorshid Riaz, PhD, Additional Director General (Administration), Directorate General of
Medical Education (DGME), Mohakhali, Dhaka 1212, Bangladesh.
3. Dr Nushrat Choudhury, MPH Fellow, Department of Health Education, National Institute of Preventive and Social
Medicine (NIPSOM), Mohakhali, Dhaka 1212, Bangladesh.
4. Dr. Muhammad Abdul Hadi Khan, Assistant Professor (Dental Public Health) and Deputy Program Manager
(Admin & Finance), National TB Control Program (NTP), Leprosy Hospital Compound, TB Gate, Mohakhali,
Dhaka 1212, Bangladesh.
5. Dr. Muhammad Syeeful Ameen, Assistant Professor, Department of Paediatrics, Sheikh Hasina Medical College,
Jamalpur 2000, Bangladesh.
6. Dr. Ummul Khair Alam, Assistant Professor and Head, Department of Maternal and Child Health, National
Institute of Preventive and Social Medicine (NIPSOM), Mohakhali, Dhaka 1212, Bangladesh.
7. *Dr. Md Golam Abbas, PhD, Assistant Professor, Department of Occupational and Environmental Health (OEH),
National Institute of Preventive and Social Medicine (NIPSOM), Mohakhali, Dhaka 1212, Bangladesh.
abbasgolam@yahoo.com
*For correspondence

Abstract
Background: Personal protective equipment (PPE) is necessary that helps to protect healthcare
workers (HCWs) from coming toward contact with or being exposed to diseases that are
transmissible. It became the leading issuefor HCWs, who worked with patients with COVID-19
infection in Bangladesh. Therefore, proper utilization of PPE is crucial.
Methods: The cross-sectional study was directed to assess the pattern of utilization of PPE among
157 doctors and nurses working in two COVID-19 dedicated hospitals during COVID-19
pandemic from January 2020 to December 2020 through face-to-face interview by a pre-tested
questionnaire.
Results: The mean age of the doctors was 36.8±5.9 years and the nurses was 34.3±7.9 years. All
the respondents wore medical masks. Among the doctors and nurses, 97.1% and 95.5% used N-95
respirator; goggles or face-shields were used by most of the doctors (98.6%) and nurses (93.2%).
About two-thirds of the respondents (73.9% and 65.9%) mentioned that they followed the correct
sequence of steps during donning and doffing of PPE. Regarding reuse, 69.3% of nurses and 59.4%
of doctors reported reusing. Respondents who reused any PPE material, among them, 65.6% of
nurses reused within ≤4 days while 51.2% of the doctors reused within 5-8 days. 91.3% of doctors
and 87.5% of nurses maintained aseptic precaution during donning and doffing. 73.9% of the
doctors and 79.5% of nurses had correct knowledge about the doffing steps. There were
statistically significant association of sequence of wearing multiple masks, duration of reusing the
PPE, influencing factors regarding provision of PPE by the authority and knowledge of doffing
steps (p<0.05) with the doctors and nurses.
Conclusion: To achieve the proper utilization of PPE among doctors and nurses, periodic formal
training programs should be reinforced and raise more awareness about the importance of wearing
PPE.

[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):76-87]
Keywords: Utilization, personal protective equipment, covid-19 pandemic, Bangladesh

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