Evaluation of Pelvic Lymphadenectomy during Radical Hysterectomy for Cervical Cancer.

Cervical cancer is the most common cancer in women in developing countries comprising 20-30% of female cancer. More than 70% of cervical cancer patients of Bangladesh attend in hospital in inoperable stages (IIB, III & IV). Only 30% cases can be treated by primary surgery. This prospective cross-sectional study was conducted by Gynaecologic Oncology Division of the Department of Obstetrics & Gynaecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from November 2011 to May 2012. The objectives of this study were to evaluate the number of pelvic lymph nodes removed, to determine the rate of pelvic lymph node involvement & also to evaluate the relationship between parametrial invasion and pelvic lymph node metastasis. During this period 105 cases underwent type III radical hysterectomy with bilateral pelvic lymph nodes dissection. Majority of the patients (60%) were in the age group of 31-50 years. Regarding histological type, most of the cases were invasive squamous cell carcinoma (85%), followed by adenocarcinoma (9%) and adenosquamous type (2%). According to grading of the tumours, grade I, II, III were 45%, 43%, 8% respectively and in 3% cases grading could not be identified.

Determination of Insulin Secretory Defect and Insulin Sensitivity in Type 2 Diabetic Subjects in Bangladesh.

Diabetes mellitus (DM) is defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. This study was undertaken to explore the basic defect in type 2 diabetes patients in Bangladesh. This was an observational study with case control design, was conducted in the Biomedical Research Group, Research Division, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine Metabolic Disorders (BIRDEM), Dhaka, Bangladesh, during the period of July 2008 to June 2009. A total of 153 subjects were included in study of which 63 belonged to type 2 diabetes mellitus group and 90 were healthy controls. Fasting and 2 hours postprandial blood glucose, serum insulin, HOMA%B, HOMA%S, QuickI, Glucose /insulin ratio, TG were measured and age, BMI, WHR were recorded. Waist-hip ratio (WHR), was significantly higher in T2DM as compared to control subjects [WHR, mean±SD, 0.94±0.12 vs. 0.88±0.06, p<0.001]; Glucose and insulin ratio of T2DM was significantly higher as compared to control subject [Glu: Ins, Median (range) of 0.54 (0.17-2.33) vs. 0.37(0.06-1.52)]. Insulin secretion (HOMA%B) was significantly lower in diabetic as compared to control subjects [HOMA%B, median (range), 71(4.90-391) vs. 180(59-634) p<0.001]; The quantitative insulin sensitivity check Index (QUICKI) of diabetic subjects were significantly higher as compared to control [QUICKI median (range) 39.90(4.80-138.10) vs. 0.55(0.36-0.85), <0.001]. Triglyceride (TG) and cholesterol (Chol) were significantly higher [(mg/dl), (mean±SD), TG (142±80.14) vs. (142±80.14); Chol (189±50.76) vs. (172±45), p=0.029] in T2DM as compared to control subjects. Those with diabetes showed significant association with insulin secretory defect (HOMA%B, p=0.006) and insulin resistance as assessed by GINR (p<0.001) and QuickI (p<0.001) but not by HOMA%S (p=0.127). The present data suggest that both insulin secretory defect and insulin sensitivity are present in T2 diabetic subjects of Bangladesh.

Attitude and practice of cervical cancer screening among the women of Bangladesh.

Cervical cancer is the second most common cancer in women worldwide, but 80% of cancer occurs in developing countries. Bangladesh, like other developing countries faces a burden of diseases, in spite of having established screening program. This cross-sectional study was done to determine the knowledge, attitude and practice of cervical cancer screening among the women attending outpatient department of Obstetrics and Gynaecology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Two hundred women were enrolled in this study by purposive sampling. All the information was collected in a pre-designed structured questionnaire by an interviewer. Data were analyzed using statistical program SPSS version 17.0. About 12% of women had good knowledge regarding cervical cancer screening. Seventy eight percent of women did not ever have a screening test and 78.5% of women had no access to the facility of having a screening test. Seventy five percent of women had never been suggested by a doctor to have a screening test. The more the participants' age, low level of education and poor knowledge, the less the practice of cervical cancer screening (p<0.05). The most common reason cited for not having screening test was the lack of information. The women studied here demonstrated a very low coverage of the screening test and a poor knowledge regarding its utility. Improving the awareness is imperative for better implementation of cervical cancer screening program in Bangladesh.

Clinical and haemato-pathological characteristics of adult acute lymphoblastic leukaemia.

Acute lymphoblastic leukaemia (ALL) is a heterogeneous group of disorders. It varies with respect to the morphologic, cytogenetic, molecular and immunologic features of the neoplastic cells reflecting the variable clinical-pathologic presentations and outcome of the patients. The aim of the study was to observe the clinical and haemato-pathological characteristics in newly diagnosed adult ALL patients. A total number of 61 patients morphologically diagnosed as acute lymphoblastic leukaemia aged 15 and above assigned for this observational study. The study was carried out in the Department of Haematology, BSMMU from January 2007 to December 2008. Among 61 patients, aged 15 to 80 years with median age 25 years, 79% were male and 21% were female. Most of the patients presented with anaemia (67%), fever (66%), lymphadenopathy (64%) and splenomegaly (57%). Other common clinical findings were hepatomegaly (39%), bone tenderness (44%) and bleeding manifestations (34%). Among haemato-pathological findings 67% patients had Hb level ≤10gm/dl, 46% patients had WBC count ≥30×109/L, 67% patients had platelet count ≤100×109/L, 93% patients had blast in peripheral blood and 61% patients had ≥90 % blasts in the bone marrow at the time of diagnosis. In this study adult ALL patients were analyzed only for their clinical and haemato-pathological characteristics. But their biologic characteristics were not analyzed due to lack of availability of facility. A progressive understanding of the biologic and genetic characteristics of ALL will allow us to identify different prognostic subgroups with specific molecular and cellular features. All the necessary measures have to be developed in our country in order to identify prognostically distinct subgroups of patients.

Miliary nodules in a patient of allergic bronchopulmonary aspergilosis.

Allergic bronchopulmonary aspergilosis (ABPA) is immunological pulmonary disease caused by hypersensitivity of aspergillus fumigatus usually occurs in patients with chronic asthma, cystic fibrosis and bronchiactasis. This disease may present with divers radiological presentation like; fleeting pulmonary opacities, bronchiactasis, mucoid impaction, perihilar opacity (hailer lymphadenopathy), and lung mass or pleural effusion. We describe the case of a 30 year old housewife who presented with progressive dysponea, low grade fever, dry cough, weight loss and miliary nodule in chest radiograph and high-resolution CT (HRCT) in a tertiary level hospital of Bangladesh. A diagnosis of ABPA was established on the basis of sputum routine microscopy and culture examination for fungus (Aspergillus).

Women's Overall Satisfaction with Childbirth Experience in a Tertiary Level Hospital of Bangladesh.

Women's satisfaction with care in labour is a positive indicator for the woman herself, as well as healthcare organization as a whole. This study was aimed to find out the women's satisfaction with their childbirth. It also tried to identify significant differences across various mode of delivery and satisfaction related to women's childbirth experience. It was a descriptive type of cross-sectional study conducted among 278 post-natal mother who give live birth at government tertiary hospital namely Mymensingh Medical College Hospital, Bangladesh. The study was conducted in the department of Obstetrics and Gynaecology during the period of January 2020 to December 2020. Data were collected from the respondents by face to face interview using a self-administered semi-structured questionnaire including Salmon's Item List. Level of overall satisfaction with childbirth was assessed by Salomon's Item List. Data analysis was carried out by SPSS version 25.0. The dimension of physical discomfort, emotional distress and fulfilment had a Cronbach's alpha of 0.746, 0.966 and 0.982 respectively. The internal consistency of each dimension was found to be acceptable and reliable. The mean scores of the dimensions in Salmon's Item List for Fulfilment, Emotional distress and Physical discomfort was found to be 69.20, 50.85 and 50.40 respectively. Higher total scores indicate a more positive evaluation of the childbirth experience and lower scores indicate a more negative evaluation. In this study the Overall mean scores of the three dimensions was 50.75. The mean scores of 'fulfillment' was higher in normal vaginal delivery (NVD) and scores of both "emotional distress" and "physical discomfort" were higher in lower uterine cesarean section (LUCS). Among all the three dimensions, mean scores of 'fulfillment' was higher in NVD indicating more satisfaction with NVD than LUCS and instrumental delivery. On the other hand, scores of "physical discomfort" and "emotional distress" were lower in NVD indicating less satisfaction with NVD than LUCS.

Forty-two years impact of chemical fertilization on soil phosphorus partition and distribution under rice-based cropping systems.

Understanding of soil phosphorus (P) transformation is crucial to minimize its edge-of-field loss associated with ecosystem disservices. A sequential chemical extraction procedure was used to assess the impact (42 years) of organic and chemical fertilizations on soil P partition and distribution under subtropical rice based cropping systems. Experimental treatments were control, N, NP, NK, NS, NZn, NPK, NSZn, NPKSZn, and N+FYM (farmyard manure). Composite soils were collected from 0-5, 20-25 and 40-45 cm depths, extracted, and analyzed for soluble P, NaHCO3-P (inorganic and organic), NaOH-P (inorganic and organic), acid soluble (H2SO4), and residual P fractions. The NPKSZn significantly increased the concentration of soil inorganic P compared to other treatments. When FYM was applied together with N fertilizer, the organic P concentration increased, which was statistically identical to NPKSZn and NPK treatments. While the labile (NaHCO3-Pi, NaOH-Po), residual, and total P concentrations were stratified at 0-5 cm depth, the concentration of NaHCO3-Po, NaOH-Pi, and acidic P fractions increased with soil depth. The soluble, NaHCO3 (Pi and Po), NaOH-Pi and NaOH-Po, acidic, and residual P fractions constituted about 0.4, 6.6, 1.7, 21.3, 37.7, and 8.3%, respectively, of the total P. A higher concentration of the labile P at the surface soil indicated that the impact of chemical fertilization stratified the available P for plant uptake or susceptible to edge-of-field loss. The NPKSZn and N+FYM both had higher NaHCO3-Po and NaOH-Po concentrations within 40-45 cm and 0-25 cm depths, suggesting that N+FYM could promote the transformation of non-labile P into labile P pool, by reducing P fixation by soil and transport them at 20-45 cm depth. It is concluded that long-term fertilization increased the concentration of P pools especially labile P by saturating the soil adsorption sites especially in surface soil.

Evaluation of Antibacterial Activities of Aqueous Extract of Black Pepper (Piper nigrum L) Seeds against the Gram Positive Staphylococcus aureus and Gram-Negative Escherichia coli.

Antibiotic resistance (AMR) represents a serious threat to public health and poses challenges in disease prevention and treatment despite various efforts to combat it. Evaluation of the in vitro antibacterial activity of aqueous extracts of black pepper seeds (Piper nigrum L.) against two infectious pathogens: Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. The Department of Pharmacology and Therapeutics and the Department of Microbiology of Mymensingh Medical College conducted the study from Octy 2022 to June 2023. The antibacterial activity of Aqueous black pepper seed extract (ABPE) was evaluated at different doses using disk diffusion and broth dilution methods. The extract was prepared using 10.0% dimethyl sulfoxide (DMSO) and water as solvent. The commonly used antibiotic ciprofloxacin was used in the broth dilution method and the results were compared with those for aqueous extracts. To confirm a more precise range of antimicrobial susceptibility of the extracts, ABPE was used at seven different concentrations (100, 80, 60, 40, 20, 10 and 5 mg/mL). Selected concentrations were then used as needed. ABPE showed an inhibitory effect on the above bacteria at doses of 90 mg/ml and higher. The Minimum inhibitory concentration (MIC) values for Escherichia coli and Staphylococcus aureus were 85 and 90 mg/ml ABPE, respectively. The MIC of ciprofloxacin against Staphylococcus aureus and Escherichia coli was currently 1µg/ml. The MIC of ciprofloxacin was lowest for the organisms tested compared to the MIC of ABPE. This work clearly demonstrates the antibacterial sensitivity of Staphylococcus aureus and Escherichia coli to an aqueous extract of black pepper seeds.

Relation of different grades of esophageal varices with Child-Pugh classes in cirrhosis of liver.

This cross-sectional observational study was conducted in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh over a period of 6 months from October 2011 to April 2012 and was carried out to evaluate the relation of different grades of esophageal varices with Child-Pugh classes of cirrhosis of liver patients. A total 37 patients were included. Child-Pugh score and esophageal varices of each patient were noted. Relation was carried out using the Chi-square test through determining the association of different variables. P value <0.05 was considered significant. Among 37 patients, 27(73%) were male and 10(27%) were female and their frequency of age were found, 7(18.9%) from 18-38 years, 18(48.7%) from 39-59 years and 12(32.4%) from 60 years of age and above. The etiology of liver cirrhosis revealed 18(48.7%) hepatitis B virus, 3(8.1%) hepatitis C virus and 16(43.2%) others causes. Child-Pugh classes were observed 3(8.2%) Class A, 17(45.9%) Class B and 17(45.9%) Class C and grades of esophageal varies were 13(35.1%) F1, 20(54.1%) F2 and 4(10.8%) F3 patients among total. A statistically significant positive relation was found that higher grade of esophageal varices was seen in the more advanced class of Child-Pugh classes with a p value 0.001.

Diagnostic evaluation of supraclavicular lymphadenopathy.

Patients presented with the supraclavicular lymphadenopathy in the medicine department have a strong suspicion of serious illness like tuberculosis, sarcoidosis, toxoplasmosis and malignancy of lymphnode, blood, lung, upper GIT, breast, ovary, testes, and other sites of body. This prospective type of observational study carried out in the indoor and out patient department of medicine of Mymensingh Medical College Hospital over a period of 6 month from April 2011 to September 2011 to diagnose the causes of supraclavicular lymphadenopathy. Patient of either sex, 18 years or above presented with supraclavicular lymphadenopathy were included. Biopsy or FNAC were done. The study showed that mean age of the patient of supraclavicular lymphadenopathy that finally diagnosed as malignant was 49.7 years and that of non malignant was 33.7 years. Male patient have suffered more (60%) from malignant disease than that of female patient (40%). Discrete, hard, non tender either fixed or non fixed supraclavicular lymphadenopathy was found malignant (18 of 18 cases, 100%) and discrete, firm, tender lymphnode were found non malignant (5 of 5 cases, 100%). Increased frequency (11 of 28, 39.3%) of granulomatous inflammation from the tuberculoid lymphadenitis were found among the patient undergone supraclavicular lymphnode biopsy. FNAC result was also of simillar type and finally it was found that frequency of tuberculosis (20 of 53, 37.7%) was highest and bronchial carcima was the second most frequent diagnosis (14 of 53, 26.4%). This study showed that supraclavicular lymphadenopathy is associated mostly with serious disease like tuberculosis and malignancy.

Pattern of poisoning in a tertiary level hospital.

This cross sectional observational study was carried out in the Department of Medicine, Mymensingh Medical College Hospital over a period of 4 months from January 2012 to April 2012 to assess the clinico-epidemiological condition of different types of poisoning and to evaluate immediate hospital outcome. Suspected case of poisoning aged 12 years or above of either sex was included. Patients of paediatric age group, having other co-morbid condition and died before clinical evaluation were excluded. This study revealed that rural people (76.9%), aging 20-30 years (46.3%) were mostly affected in poisoning. Patients belong to low socioeconomic group (65.3%), illiterate (26.5%) and educated up to primary level (29.9%) were mostly identified. Regarding the occupation this study showed student (30.6%) and farmer (25.2%) were predominantly involved. In this series organophosphorus compound (63.9%) poisoning was in the top of the list followed by benzodiazepine (6.8%). Suicidal attempt (81.6%) was found as a motive of poisoning in maximum cases. Among the precipitating factors quarrel with spouse, girl or boy friend (46.9%) were significant in number. In this study outcome was measured as complete recovery (92.5%) and death (3.4%).

Occurrence and determinants of postpartum maternal morbidities and disabilities among women in Matlab, Bangladesh.

The burden of maternal ill-health includes not only the levels of maternal mortality and complications during pregnancy and around the time of delivery but also extends to the standard postpartum period of 42 days with consequences of obstetric complications and poor management at delivery. There is a dearth of reliable data on these postpartum maternal morbidities and disabilities in developing countries, and more research is warranted to investigate these and further strengthen the existing safe motherhood programmes to respond to these conditions. This study aims at identifying the consequences of pregnancy and delivery in the postpartum period, their association with acute obstetric complications, the sociodemographic characteristics of women, mode and place of delivery, nutritional status of the mother, and outcomes of birth. From among women who delivered between 2007 and 2008 in the icddr,b service area in Matlab, we prospectively recruited all women identified with complicated births (n=295); a perinatal mortality (n=182); and caesarean-section delivery without any maternal indication (n=147). A random sample of 538 women with uncomplicated births, who delivered at home or in a facility, was taken as the control. All subjects were clinically examined at 6-9 weeks for postpartum morbidities and disabilities. Postpartum women who had suffered obstetric complications during birth and delivered in a hospital were more likely to suffer from hypertension [adjusted odds ratio (AOR)=3.44; 95% confidence interval (CI)=1.14-10.36], haemorrhoids (AOR=1.73; 95% CI=1.11-3.09), and moderate to severe anaemia (AOR=7.11; 95% CI=2.03-4.88) than women with uncomplicated normal deliveries. Yet, women who had complicated births were less likely to have perineal tears (AOR=0.05; 95% CI=0.02-0.14) and genital prolapse (AOR=0.22; 95% CI=0.06-0.76) than those with uncomplicated normal deliveries. Genital infections were more common amongst women experiencing a perinatal death than those with uncomplicated normal births (AOR=1.92; 95% CI=1.18-3.14). Perineal tears were significantly higher (AOR=3.53; 95% CI=2.32-5.37) among those who had delivery at home than those giving birth in a hospital. Any woman may suffer a postpartum morbidity or disability. The increased likelihood of having hypertension, haemorrhoids, or anaemia among women with obstetric complications at birth needs specific intervention. A higher quality of maternal healthcare services generally might alleviate the suffering from perineal tears and prolapse amongst those with a normal uncomplicated delivery.

Clinical profile of periodic paralysis.

This cross sectional descriptive study was done to find out common clinical presentations, etiologies and laboratory investigation abnormalities in patients of periodic paralysis. Study was carried out in 30 patients with an age range from 8 to 70 years who were enrolled from July 2008 to June 2009 in Mymensingh Medical College Hospital (MMCH) medicine unit. Individuals who were admitted with sudden onset generalized muscle weakness, had history of previous attack and serum potassium level <3mmol/l or >5.5mmol/l were included in this study. In this series, majority of the patients were male (66.67%). Male: female ratio was approximately 2:1. The mean age of the patients was 27.4±4.5 years. Majority (26.67%) of them were in age range of 31-40 years. About 30% of the patients experienced the first attack of paralysis at the age of 20-24 years. Majority of patients (53%) were from middle class family with occupation of private service (26.66%) and farmer (20%). Positive family history was reported in 20% of patients. Regarding the precipitating factors, majority of patients (83.3%) were related to high carbohydrate meal, 56.67% related to temperature, 41.67% to exercise. Flaccid muscle weakness with variables muscle power (MRC grade 4/5 to 2/5 in 60% and 1/5 to 0/5 in 40%) was found. Cerebellar functions, all modalities of sensations and functions of cranial nerves were intact in all patients. In this series, laboratory investigations revealed reduced serum potassium level (<3mmol/l) in 90% of patients. Serum potassium value >5.5mmol/l was found in only 3.33% of patients. Creatine kinase (MM) was raised in 23% of the patients and Thyroid stimulating hormone (TSH) level was 0.8-2mmol/l in 6% of the patients. More than half of the patients (56%) showed variable ECG changes. Impaired nerve conduction function was found in 28.00%. So, careful history taking, meticulous clinical examination and simple laboratory investigations is sufficient to make a prompt diagnosis and rapid management of patients with periodic paralysis.

Fasting glycaemic and lipidaemic status in acute coronary syndrome patients within 24 hours of onset of chest pain.

This is a descriptive type of cross sectional study done in Mymensingh Medical College Hospital during the period of June 2008 to November 2009 to estimate and analyze the fasting blood glucose (FBG) and fasting lipid profile of acute coronary syndrome (ACS) patients within 24 hours of onset of chest pain. Total 50 patients of either sex diagnosed as acute coronary syndrome whose fasting blood sample would have been collected within 24 hours of chest pain were included. Among 50 patients 42(84%) were male and 8(16%) were female. Age range was 30-80 years with a mean ± SD of 50.74 ± 12.05 years. Among 50 ACS patients, 9 patients (18%) suffered from unstable angina (US), 2(4%) from non-ST segment elevation myocardial infarction (NSTEMI) and 39(78%) suffered from ST segment elevation myocardial infarction (STEMI). Study results revealed 41(82%) patients had euglycemia (70-110 mg/dl), 2(4%) patients had impaired fasting glucose (IFG) (110-125 mg/dl), and 7(14%) patients had hyperglycemia (>126 mg/dl). Dyslipidemia found in 38(76%) patients. Among them total cholesterol (TC) >200mg/dl in 14(28%), decreased level of HDL-C (< 40 mg/dl in male and <50mg/dl in female) in 22(44%), increased level LDL-C ≥ 130 mg/dl in 13(26%), and TG >150 mg/dl was found in 16(32%) patients.

Tracking Side Effects of the COVID-19 Vaccine in Mymensingh District of Bangladesh.

The Coronavirus disease 2019 (COVID-19) has turned into a worldwide human tragedy and economic devastation. There had an intensive search for an effective drug against the coronavirus but not led to any breakthrough agents. Only one choice was left namely an effective and safe vaccine. Many people are ambivalent regarding corona vaccines because they also fear possible side effects from vaccination. This study was designed to track the side effects after first and second dose of the Oxford-AstraZeneca vaccines used in Mymensingh district of Bangladesh. This cross-sectional descriptive type of observational study was conducted in Mymensingh Medical College, Mymensingh, Bangladesh during the period of five months from 1 February, 2021 to 30 June, 2021 among 293 purposively selected vaccine recipients who received two doses of the Oxford-AstraZeneca vaccines. Data were collected by face to face interview of the selected vaccine recipients using a semi-structured questionnaire. Data were inputted into SPSS version 26.0. Qualitative data were summarized by percentage and quantitative data were summarized by mean and standard deviation. Necessary bivariate and multivariate analysis was done. Mean age of the respondents was 40.3 years with a standard deviation of ±8.7 years. Among the vaccine recipients female were 159(54.3%) and male were 134(45.7%). The most of the vaccine recipients were graduate and master 256(87.3%) and more than half of the vaccine recipients (156, 53.2%) were government service holder. The most of the vaccine recipients (242, 86.0%) were from urban area and 263(89.8%) vaccine recipients were non-smoker. Sixty eight (23.2%) of the vaccine recipients had different types of co-morbidities. It was found that 217(74.1%) vaccine recipients had side effects after first dose while 162(55.3%) had side effects after second dose. The difference in occurrence of side effects of first and second dose was statistically highly significant (p<0.001). Pain on the injection site was present in 172(58.7%) vaccine recipients after first dose and in 142 (48.5%) after second dose. Fever was prevalent in 98 (33.4%) after first dose and in 61 (20.8) after second dose. Headache was in 61(20.8%) and in 22(7.5%) after first and second dose respectively. Thirty one (10.6%) vaccine recipients had loose motion after first dose and 26(8.9%) had this after second dose. First dose of vaccination caused nausea in 28(9.6%) and second dose caused it in 16(5.5%) vaccine recipients. Joint pain was prevalent in 24(8.2%) after first dose and in 15(5.1%) after second dose. Rash was present in 9(3.1%) and in 3(1.0%) after first and second dose respectively. Cough was present in 5(1.7%) after first dose and in 2(0.7%) after second dose. Each 2(0.7%) had history of fainting and bodyache and 1(0.3%) reported intense weakness after first dose only. Side effects of first dose of AstraZeneca vaccine were more prevalent in female (124, 78.0%) than male (93, 69.4%). The side effects of second dose of AstraZeneca vaccine were also more prevalent in female (103, 64.8%) than male (59, 44.0%). The study results revealed that 217(74.1%) vaccine recipients had side effects after first dose while 162(55.3%) had side effects on second dose of the Oxford-AstraZeneca vaccine. Commonly experienced side effects were pain in the injection site, fever, headache, diarrhoea and joint pain. Most of the people tolerated these side effects and did not use any medicine.

Status of HIV infection among the pregnant women attending in outpatient department.

Human immunodeficiency virus (HIV) infection has been spreading rapidly in the developing countries and vertical transmission also taking place. This study has been done to find out the prevalence of HIV infection among the pregnant women, so that necessity of routine screening test can be identified. It is a cross sectional study. Five hundred two pregnant women were included. Three ml venous blood was taken and then HIV screening test was done by ELISA method. All reactive tests were confirmed by Western blot antibody testing. The positive cases were followed up and necessary treatment was given. Delivery was conducted in this hospital. Baby's blood was tested to see vertical transmission after 18 months. Most of the subject were educated housewife, mean age was 25 years. Six (6%) husband was overseas service holder, 12% were smoker and 1.6% had drug addiction. Eight (8%) subject had previous history of blood transfusion and 49% subject or her husband had history of surgery or got parental therapy. 2% subject gave the history of familial disharmony and 2% had multiple sex partners. HIV infection was found in 2 patients (0.4%). Both of them got infection from their husband. One husband was over seas service holder and another one was injecting drug user. For the prevention of spread, reduction of vertical transmission and providing early management to the positive patient all pregnant women should be screened for HIV routinely.

Osteopetrosis.

A 15 years old Bangladeshi boy presented with hepatosplenomegaly, anaemia, multiple fractures (symptomatic and asymptomatic) without jaundice was investigated. Laboratory findings revealed leukoerythroblastic blood picture with reduced haemoglobin (7.7 gm/dl). Skeletal survey showed generalized increased bone density, sclerosed medulary space, Rugger-Jersey spine and diploic space filled with dense materials. Overlapping clinical features of both intermediate autosomal recessive and adult autosomal dominant variety of osteopetrosis were found in this patient but diagnosis were made on the basis of typical radiological finding which was mostly consistent with the adult autosomal dominant variety. The patient was treated conservatively and specialist consultation was taken in managing bony abnormalities. This patient was discharged with advised of subsequent follow-up.

Vaccination against COVID-19 in Bangladesh: Perception and Attitude of Healthcare Workers in COVID-dedicated Hospitals.

Healthcare professionals are the crucial and influencing source of information for vaccines and their communication among patients and communities that can accelerate successful vaccination in a country. This cross-sectional study was one of the first and foremost ones in Bangladesh to observe the basic perception and attitudes towards vaccination against COVID-19 among the healthcare workers (HCWs) - doctors, interns, nurses, ward boys, cleaners, and medical technologists of major COVID-dedicated hospitals. The cross-sectional questionnaire-based study was conducted in February 2021 among 550 HCWs to assess the perception and attitude towards vaccination against COVID-19. The study participants were targeted as the priority group for COVID-19 vaccination, working in two major COVID-dedicated hospitals, Holy Family Red Crescent Medical College Hospital (HF-center), and Sheikh Russel National Gastro-liver Institute and Hospital (SR-center) in Dhaka, Bangladesh during the pandemic. The questionnaire was structured with a three-point scale of responses from 'true', 'false', and 'do not know'. The responses were calculated on point-score as +1 for the correct response, -1 for the wrong response, and 0 for 'do not know' with an overall highest and the lowest possible score of +5 to -5. Absolute (n) and relative frequencies (%) were presented for qualitative variables, while quantitative variables were presented as mean (± standard deviation). Chi-square test was done for univariate analysis of qualitative variables and Student's t-test for quantitative variables. With the 95.27% response rate, including 204 males and 320 were female and the male: female ratio was 1: 1.56. The majority of the participants were doctors (45.8%) followed by nurses (27.9%), and MLSS (26.3%) respectively. The respondents were between 18 to 64 years of age with a mean of 36.17±10.94 years. Most of the respondents (95.99%) responded correctly about the cost-free availability of a vaccine against COVID-19 in the country, 87.40% preferred vaccination as safe and effective. Again 29.77% HCWs think the vaccine might not be safe or effective due to emergency authorization. Only 38.93% of respondents could respond correctly about the necessity of vaccines for children, 31.10% think the vaccination was not required instead of natural immunity. The positive perception and attitude of the frontline HCWs in COVID-dedicated hospitals in Bangladesh are crucial which will positively influence motivation and wide acceptance among the general population for the attainment of the nationwide vaccination program, and adopt effective strategic modification to minimize the gaps for a low-middle income country like Bangladesh with its resource constrain.

MEASUREMENT OF EXTREMITY DOSES OF NUCLEAR ENERGY WORKER BY USING RING DOSIMETER.

Finger doses can serve as a guide to suggest any needed modification in work practice to minimise radiation doses to the extremities. In the present study, radiation doses at the base of the middle finger of both hands of 20 nuclear energy workers handling 99mTc-labelled compounds,125I and131I during various diagnostic and therapeutic procedures in nuclear medicine were measured. The laboratory assessments were carried out by means of thermoluminescence ring dosimetry in Health Physics Division, Atomic Energy Center, Dhaka. The recorded extremity doses were then compared to their routinely monitored whole-body doses. The average annual finger doses recorded in this study were found to be 10.7 ± 8.2 and 12.7 ± 12.9 mSv, respectively, for the left- and right-hand fingers, which are at least 12-fold higher than the average whole-body dose. There was, however, no extreme case found of health hazard to the workers' hand, which exceeds maximum dose limit 500 mSv/year given by the International Commission on Radiological Protection. On comparing the average annual finger doses at different labs, significantly higher average dose was recorded at isotope-dispensing lab (19.6 ± 12.6 mSv/year) and then followed by gamma camera lab (13.2 ± 12.1 mSv/year) and radioimmunoassay lab (7.0 ± 5.5 mSv/year). These observations are fairly in good agreement with the reported results. The observations of the present study, therefore, may be implemented for the betterment of safety for the occupational workers in nuclear medicine facilities.

Clinicopathologic Features of Gastric and Gastrooesophageal Junction Adenocarcinoma.

Gastric cancer (GC) is one of the most common tumors and remains the second leading cause of cancer mortality in the world. The incidence of gastric carcinoma is declining in the last few years in some areas like USA, UK, Canada etc, because of reduction in chronic H. pylori infection, smoking, decrease use of smoked and salted food. The gastric carcinoma still remains a burden for Bangladesh as the prevalence of H. Pylori has not substantially decreases. Among the gastric carcinomas, adenocarcinomas are the most common type. So the study was performed to observe the location and histomorphologic pattern of Gastric and gastrooesophageal junction (GEJ) adenocarcinoma. This descriptive cross sectional study was carried out at the Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh from January 2013 to December 2014. A total of 130 patients with primary gastric and GEJ adenocarcinomas were included in this study. All the cases were evaluated for routine histological examination. The age range of the patients was 17 to 80 years and male to female ratio was 2.25:1. Antrum is the most common (66.9%) site being affected, followed by GEJ (19.2%), body (13%) and fundus (0.76%). Tumors of the antrum and GEJ were found mostly in the late age. On macroscopic examination, the ulcerated tumor mass (69.2%) was most frequent then the others. Regarding histological examination, 84(64.6%) cases were intestinal type, 32(24.6%) diffuse and 14(10.8%) mixed type by Laurens classification. According to WHO classification, about half of the cases (49.2%) were tubular carcinoma and rest were others. Most of the intestinal type carcinoma (71.4%) was presented with moderately differentiated and 25.0% with well differentiated. Where as the diffuse type presented with poorly differentiated in 96.9% cases.