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ssnimcj2026v11i2s2


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A Comparative Study on the Outcomes of Mid-shaft to Distal Hypospadias Repair with Stented and Unstented Urethra
*Uddin MZ,1 Rajib MA,2 Khan SS,3 Bari AA,4 Tareq SA,5 Joarder MA,6 Sanaullah M7

  1. *Dr. Muhammad Zia Uddin, FCPS (Urology), Registrar, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka,, Bangladesh. drjia1980@gmail.com. ORCID 0009-0009-9101-7046
  2. Dr. Asaduzzaman Rajib, MS (Urology), Assistant Professor, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0000-001-8110-5629
  3. Dr. Sharif Md. Shahadat Ali Khan, MS (Urology), Medical Officer, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka. Bangladesh. ORCID 0009-0009-0231-3434
  4. Dr. AKM Akramul Bari, MS (Urology), Medical Officer, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0009-0009-3786-5925
  5. Dr. Shah Adiluzzaman Md. Tareq, FCPS (Urology), Assistant Registrar, Department of Urology, Dinajpur Medical College, Dinajpur, Bangladesh. ORCID 0009-0001-4283-6012
  6. Dr. Abdul Baten Joarder, MS (Urology), Assistant Professor, Department of Paediatric Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0009-0000-0077-9614
  7. Dr. Sanaullah, MS (Urology), Resident Surgeon, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0009-0006-3269-0597

*For correspondence
Abstract
Background: The role of catheter or stent placement for urinary diversion in mid-shaft to distal hypospadias repair remains controversial. Thus, the decision depends on the individual surgeon’s preference and there has been little scientific evidence behind the choice.
Objective: To determine whether the presence or absence of a catheter affects postoperative complications and evaluation of the efficacy and safety of a non-catheter repair.
Methods: This quasi experimental study was carried out from December 2018 to
November 2023 at Department of Urology of National Institute of Kidney Diseases &
Urology, Dhaka. A total of 140 patients were purposively assigned with mid-shaft to coronal
hypospadias. They were grouped into 2 groups, 70 patients in each group. Patients in
group A underwent stented hypospadias repair, group B underwent unstented repair. Variables were type of hypospadias, age at repair, stent usage, and complications of hypospadias repair. Relative risk was determined, and a P-value less than 0.05 was regarded as statistically significant.
Results: No significant statistical differences were found in the parameters measured in either group. Some early complications included urinary retention requiring urethral catheter insertion occurred in 2 patients, bleeding in 2 unstented repair patients, and swelling of the penis, dysuria in 7 unstented repair patients, all of which were managed conservatively. In terms of late complications, out of the 115 patients assessed (56 in the stented repair group and 59 in the unstented repair group), 21 patients (18.26%) developed urethro-cutaneous fistula, with 11 (19.64%) in the stented repair group and 10 (16.95%) in the unstented repair group which showed no significant difference (P = 0.81, RR = 0.86). Meatal stenosis occurred in 5 patients (1 stented repair, 4 unstented repair), with statistically non-significant difference between the groups (P = 0.36, RR = 3.8), and glans dehiscence occurred in 8 patients (3 stented repair, 5 unstented repair) with no significant difference observed (P = 0.71, RR = 1.58).
Conclusion: No significant differences were detected in short-term complications observed between hypospadias repairs with and without stenting. However, in long-term outcomes, higher relative risk for the occurrence of meatal stenosis in unstented hypospadias repair procedures.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):105-111]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.2

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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.2026.11.1.8

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

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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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ssnimcj.2026.11.1.5

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

Association of  Thyroid-Stimulating Hormone (TSH) Levels with Glycemic Control in Type 2 Diabetes Mellitus:An Analytical Study of 50 Patients
*Sheme ZA,1 Huda AK,2 Akhter L3

Abstract
Background: Diabetes mellitus (DM) and thyroid dysfunction are two of the most prevalent endocrine disorders that frequently coexist. Both conditions share several pathophysiological pathways that may influence each other’s progression and management.
Objectives: To analyze the relationship between thyroid stimulating hormone (TSH) levels and glycemic control in patients with type 2 diabetes mellitus (T2DM).
Methods: This cross-sectional analytical study included 50 diabetic patients attending the Department of  Medicine, Rangpur Medical College Hospital, between  January 2024 to  December 2024. Demographic data, fasting blood sugar (FBS), HbA1c, and serum TSH levels are recorded.
Results: Among 50 patients (28 males, 22 females; mean age 52.3 ± 9.4 years), 34% had abnormal TSH levels. Hypothyroidism was more common (26%) than hyperthyroidism (8%). Poor glycemic control (HbA1c > 8%) was significantly associated with elevated TSH (p < 0.05).
Conclusion: Subclinical hypothyroidism is frequent among T2DM patients and correlates with poor glycemic control. Routine screening for thyroid dysfunction is recommended for better management of diabetic patients.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):32-36]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.5Keywords: Thyroid stimulating hormone ( TSH ), Diabetes Mellitus 

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

*For correspondence.

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ssnimcj.2026.11.1.4

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

Parasympathetic Nerve Function Status in Chronic Tobacco Users
*Tasnim R,1 Khondoker F,2  Sheme ZA,3 Alam KI,4 Ferdous J,5 Sarfunnahar6

Abstract
Introduction: Tobacco use is one of the most widely spread bad habits. It is one of the leading preventable causes of premature death, disease and disability. The World Health Organization reported that tobacco smoking killed 100 million people worldwide in the 20th century and warned that it could kill one billion people around the world in 21st century. Bangladesh ranked among top tobacco consuming countries where 57,000 people over the age of 30 die each year from tobacco-related illness.

Objective: To assess the effects of tobacco use on parasympathetic nerve function status.

Methods: A total number of 150 male subjects were selected, among them 50 were apparently healthy non-tobacco chewer non-smoker subjects (group A) – control, 50 were apparently healthy tobacco smoker non-chewer (group B) – experimental, 50 were apparently healthy tobacco chewer non-smoker  (group C)- experimental. For statistical analysis one way ANOVA (post-hoc) test were performed by computer based software SPSS- 23.0 version for windows. Significance for the statistical test would be predetermined at a probability value of less than 0.05 (p<0.05). Ethical consideration was achieving an informed consent after briefing objectives. Quality was assured through avoidance of missed data, filling of code, regular entry of data and careful data analysis.
Result: In this study smokers revealed significant decreased level of parasympathetic function status in tobacco smokers as compared to tobacco nonsmokers.
Conclusion: Decrease in heart rate occur in tobacco smokers than tobacco nonsmokers.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):24-31]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.4

Keywords: Tobacco use, Parasympathetic nerve function test.

  1. Rukhsana Tasnim, Assistant Professor, Department of Physiology, Army Medical College, Rangpur. tasnimrukhsana@gmail.com
  2. Farzana Khondoker, Associate Professor, Department of Physiology, Army Medical College, Rangpur.
  3. Zinat Afrin Sheme, Associate Professor, Department of Biochemistry, Army Medical College, Rangpur.
  4. KH Imranul Alam, Clinical Trust Fellow SHO ST1/ST2, General Medicine, Medway Maritime Hospital, Medway NHS Foundation Trust Gillingham, England, UK, ME7 5NY.
  5. Jannatul Ferdous, lecturer, Department of Physiology, Army Medical College, Rangpur.
  6. Sarfunnahar, Lecturer, Department of Physiology, Army Medical College, Rangpur.

*For correspondence
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ssnimcj.2026.11.1.3

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

Acute Watery Diarrhoea Outbreak from Contaminated Municipal Water Supply in Jashore, Bangladesh, 2015

*Billah MM,1 Rahaman MR,2 Samad MS,3 Habib ZH,4 Billah SB,5 Rahman M6

Abstract

Background: Diarrhoeal outbreaks commonly occur during pre- and post-monsoon seasons in Bangladesh. On October 12, 2015, the Superintendent of the 250-bedded General Hospital, Jashore, informed the Institute of Epidemiology, Disease Control and Research, Bangladesh, of an increase in admission of patients with acute watery diarrhoea from Jashore Municipality. We investigated the event to ascertain the cause of the outbreak and its associated risk factors.
Methods: We conducted a descriptive study followed by a case–control study in Jashore Municipality from October 13 – 20, 2015. We defined a case as any person living in Jashore Municipality having three or more episodes of loose motion per day with symptoms lasting ≤7 days. A control was defined as any person living in Jashore Municipality without a history of loose motion in the preceding 7 days. Stool samples of untreated patients were tested for a rapid dipstick test for Vibrio cholerae O1 and culture sensitivity. Water samples from the municipal water pump and households were tested for microbial contamination. Cases were enrolled from hospitals and asymptomatic controls were identified by convenience sampling from the same hospitals’ outpatient clinics, matched by municipal residence and household access to municipal water. Descriptive analysis and logistic regressions were performed. We calculated adjusted odds ratios (AOR) and 95% confidence intervals (CI).
Results: Between 9–14 October, 214 patients were admitted to the hospital; 115 (53.7%) lived in Jashore municipality. Cases were from all age groups, with 57% males. We enrolled 27 cases and 49 controls. Drinking municipal supplied water in the preceding 24 hours was significantly associated with illness (AOR 4.5; 95% CI: 1.3–15.3; p=0.015). In stool samples, Vibrio cholerae O1 was identified by rapid test in 3/8 (37.5%) samples and two were confirmed by culture. Household-level municipal water had total coliforms up to 8,000 CFU/ml. Environmental inspection found multiple breaches in water supply pipes running through open drains.
Conclusion: The investigation confirmed a cholera outbreak in Jashore district, most likely spread through the contaminated municipal water supply. We recommended repairing leakages, chlorination, and public education to prevent future outbreaks in similar urban settings.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):14-23]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.3
Keywords: Acute Watery Diarrhoea, Cholera, Water Supply, Disease Outbreaks, Case-Control Studies, Environmental Monitoring, Bangladesh

 

  1. *Dr. Mallick Masum Billah, MSc in Applied Epidemiology, MPH (Epidemiology), MBBS, Resident Advisor, Field Epidemiology Training Program, Nepal, South Asia Field Epidemiology and Technology Network Inc. (SAFETYNET) https://orcid.org/0000-0002-8545-2879 . drmasumbillah@yahoo.com
  2. Md Rezanur Rahaman, PhD, MSc in Applied Epidemiology, MPH, Assistant Professor National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2601, Australia https://orcid.org/0000-0003-4782-4149
  3. Mohammad Sohel Samad, PhD, MPH; MS, Associate Professor & Head (Community Medicine & Public Health, Mugda Medical College, Dhaka, https://orcid.org/0000-0003-4502-8747
  4. Zakir Hossain Habib, Professor of. Microbiology & Chief Scientific Officer, Department of. Microbiology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka https://orcid.org/0000-0003-2163-3600
  5. Syed Md Baqui Billah, PhD, MPH (Epidemiology), MBBS, Deputy Director, Directorate General of Medical Education, Mohakhali, Dhaka, Bangladesh https://orcid.org/0000-0001-9337-9627
  6. Professor Mahmudur Rahman, PhD, MPH, Former Director, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka https://orcid.org/0000-0002-3698-4852

*For correspondence

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ssnimcj.2026.11.1.2

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026
Vitamin D Status in Polycystic Ovary Syndrome Women of Rural Area of Bangladesh

*Rahman M,1 Sultana R,2 Pinki SN,3 Azad MK4

Abstract
Background: Polycystic Ovary Syndrome is the most common endocrine disorder and vitamin D deficiency is common in the general population as well as PCOS women in many parts of the world. Vitamin D deficiency is associated with calcium dysregulation, which contributes to the development of follicular arrest in women with PCOS and results in menstrual and fertility dysfunction.
Aim: This study aimed to determine the vitamin D status among women with polycystic ovary syndrome (PCOS) living in a rural area of Bangladesh and to compare it with age-matched non-PCOS controls.
Methods: A case–control study was conducted at a tertiary outpatient clinic in Kishoreganj, Bangladesh, from July 2023 to June 2025. A total of 202 women were enrolled, including 101 women with PCOS diagnosed and 101 age-matched controls. Anthropometric measurements were recorded, and serum 25-hydroxyvitamin D levels were measured by immunoassay. Vitamin D status was classified according to Endocrine Society guidelines. Data were analyzed using SPSS version 26, with p<0.05 considered statistically significant.
Results: The mean age of study participants were 24.27±6.49 years and 24.30 ±6.54 in case and control groups respectively, with the mean BMI was 22 in cases and 20.5 in control group (15-32 kg/m2). Vitamin D status was found insufficient with the mean of 19.28±6.10 ng/ml among PCOS women whereas the mean vitamin D status among control women was 27.45±5.87 ng/ml which was significantly higher (<0.001). Vitamin D deficiency was more profound in 21-30 years of age group (48.5%) and overweight PCOS women were found to be more deficient (48.5%) compared to control group. Earlier studies have indicated that lower vitamin D levels may be linked to greater metabolic disturbances in women with PCOS.
Conclusion: We found the evidence from this case control study that there is an association between low vitamin D level and PCOS. Therefore, further research with high quality randomized controlled trials is warranted to establish the impact of vitamin D deficiency in PCOS and it’s supplementation on the management of PCOS.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):7-13]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.2
Keywords: PCOS, 25 (OH) D.

1. * Dr. Mizanur Rahman, Associate Professor (In situ), Shaheed Sayed Nazrul Islam Medical College Hospital Kishoreganj. mizan59dmc@yahoo.com.
2. Dr. Rebeka Sultana, Junior Consultant (CC), Directorate General Health Services (OSD), BMU, 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.

*For correspondence

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