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ssnimcj2024v9i2c

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

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Kishoreganj, Bangladesh
sadequel@yahoo.com

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

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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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SSNIMCJ 2023 v8 i2 a2

Original Contribution

Forensic Evaluation of Suicidal Deaths due to Organophosphorus Compounds Poisoning

1.Dr. Tasnuva Aziz Munalisa, Assistant Professor, Department of Forensic Medicine, Sylhet Women’s Medical
College, Sylhet 3100, Bangladesh.
2. Dr. Md. Shamsul Islam, Associate Professor and Head, Department of Forensic Medicine, Sylhet MAG Osmani
Medical College, Sylhet 3100, Bangladesh.
3. Dr. Abu Tareq Md Rashel, Assistant Professor, Department of Pharmacology and Therapeutics, Sylhet Women’s
Medical College, Sylhet 3100, Bangladesh.
4. Dr. Tahmina Islam, Assistant Professor, Department of Forensic Medicine, Jalalabad RagibRabeya Medical
College, Sylhet 3100, Bangladesh.
5. *Dr. Mohammad Nurunnabi, Assistant Professor, Department of Community Medicine, Sylhet Women’s Medical
College, Sylhet 3100, Bangladesh. nur.somch@gmail.com
*Correspondence
Abstract
Background: In Bangladesh, agrochemical-related suicides are on the rise. The use of
organophosphorous compounds (OPCs) as insecticides is common and widely used as a suicidal
method in our countries due to their inexpensiveness and easy accessibility.
Methods: The intent of this autopsy study among cases of OPC poisoning deaths was to determine
the evaluation of autopsy reports of 254 OPC poisoning suicidal deaths during 2017 and 2018 at
the mortuary of Sylhet MAG Osmani Medical College, Bangladesh.
Results: Two out of three victims were aged below 30 years, which belongs to the young age
group, and females (58.3%) were predominant. Most of the victims resided in Companygonj
(18.1%), and Gowainghat (15.0%), which represent the rural parts of Sylhet. Three-fourths of the
dead bodies (76.0%) were brought to the morgue under Kotwali police station. The most prevalent
finding of OPC poisoning suicidal deaths was asphyxia (96.8%).
Conclusion: The present study showed that the majority of the patients were young females than
males. The distribution of insecticides to the general population should be strictly regulated by law
and adequate focus placed on the safe usage of pesticides. All age groups need to be made aware of
this poisoning’s potentially fatal effects, but young ones need this information the most.
[Shaheed Syed Nazrul Islam Med Col J 2023, Jul; 8 (2):69-75]
Keywords: Forensic evaluation,OPC poisoning, suicidal deaths, Sylhet, Bangladesh

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SSNIMCJ 2023 v8 i2 a1

Editorial

Deteriorating the Dengue Situation in Bangladesh

Dr. Safia Sultana, MBBS, M Phil (Microbiology), Head & Associate Professor, Department of Microbiology, Shaheed Syed Nazrul Islam Medical College, Kishoreganj.drsafia79@yahoo.com

Abstract: Not available

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SSNIMCJ 2024 V-9 N-1

Shaheed Syed Nazrul Islam Medical College Journal

Volume 9, Issue 1

January, 2024

Front Cover PDF

Index PDF

Contacts PDF
Contents
Editorial
1. Dengue and Acute Kidney Injury
Huda AN

Original Contributions
2.Impairment of Renal Function and Dyselectrolytemia in Perinatal Asphyxia
Begum MH, Hye MA, Majumder B, Albani SA, Nazneen S, Shil PK, Majumder BK, Mazumder M

3. The Pattern and Trends of Burn Related Death
Faizunnahar, Haque M, Iqbal MK
PDF
4. Correlations between Stature and Hand Breadth in Bangladeshi Medical Students
Motaleb M, Mamataj S, Hasan SJ
PDF
Frequency Domain Parameters of Heart Rate Variability in Patients with Gastro-Oesophageal Reflux Disease
Mamataj S, Motaleb M, Azim SF
PDF
Others
6. Information for Contributors
PDF

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