Comparison of Nutritional Status of Children with Congenital Heart Diseases with Minor Illness of Other Children in a Tertiary Level Hospital.

This cross sectional comparative analytical study was undertaken with the objectives to find out the nutritional status of children with congenital heart disease by anthropometric measurement and was compared it with those of children having minor illness and without any congenital heart disease in indoor and outdoor Department of Paediatrics of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from December 2015 to November 2016. Purposive sampling was done. One hundred children aged 6 to 60 months with congenital heart disease confirmed by echocardiogram were taken as Group A and one hundred children of same age and sex matched having minor illness and without any congenital heart disease were taken as Group B. Age of the patients ranged from 6 to 60 months. There was no obvious difference of socio-demographic status between two groups. Most of the patient (64.0%) had acyanotic congenital heart disease among them VSD was commonest (68.8%). Thirty-six percent (36.0%) patient had cyanotic congenital heart disease and among them Tetralogy of Fallots (83.3%) was commonest. There were significant differences regarding weight, height and MUAC values in between two Groups. Underweight (51%), Stunting (50%) and Wasting (29%) all were higher in congenital heart disease than that of Group B where they were 28%, 31% and 13% respectively and the differences were statistically significant (p<0.05). The findings of this study imply that malnutrition is very common among children with congenital heart disease. So, anthropometric measurement should be done in each and every child with congenital heart disease.

Morphological Changes of Length of Prostate in Different Age Groups of Bangladeshi Cadaver.

Benign prostatic hyperplasia is the most common prostatic problem for men older than age 50. It is a condition in men in which the prostate is enlarged but it is not cancerous. The prostate goes through 2 (two) main growth periods as a person ages. The first happens early in pubescence, when the prostate doubles in size. The second stage of growth begins around age twenty five and continues throughout most of a man's life. Benign prostatic hyperplasia often occurs with second growth phase. In the treatment of prostatic disorders, estimation of the length of prostate has been used to select the surgical approach. Transurethral resection of prostate (TURP) is preferred for small glands and open prostatectomy for larger ones. As the prostate gland is dependent on androgen for its growth, the prostatic length reflects the hormonal status of the subjects. This cross sectional descriptive study was conducted in Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh from April 2015 to September 2015 to find out the difference in length of the prostate of Bangladeshi people in relation to age. The present study was performed on 67 postmortem human prostate glands collected from the morgue in the Department of Forensic Medicine, Mymensingh Medical College, by non random purposive sampling technique. The specimens were collected from Bangladeshi dead body, age starting from 10-80 years. All the specimens were classified into 3(three) classes - Group A (upto 18 years), Group B (19-45 years) and Group C (>45 years) according to age. Dissection was performed according to standard autopsy techniques. The length of the prostate was measured and recorded. The mean±SD length of the prostate was 1.76±0.60cm, 2.65±0.56cm and 2.88±0.70cm in Group A, B and C respectively. The maximum mean length of the prostate was in Group C (2.88cm) and minimum was in Group A (1.76cm). It was observed that the length of the prostate was increased with age. Variance analysis shows that mean differences of length of the prostate were highly significant among all age groups. The length of prostate gland was found to be increase with age. For statistical analysis, variations between age groups were analyzed by students unpaired 't' test. The present study will help to increase the information pool on the length of prostate gland of Bangladeshi people.

Helicobacter Pylori Stool Antigen Assay in Hyperemesis Gravidarum.

Hyperemesis gravidarum is the most severe form of nausea and vomiting in pregnancy that seriously affects the pregnancy outcome. It is a disease with unknown etiology and varieties of contributing factors like hormonal changes, psychological and immunological factors. A significantly high prevalence of Helicobacter pylori among pregnant women with Hyperemesis gravidarum has been revealed recently. A descriptive, cross-sectional study was carried out at antenatal ward, Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Mymensingh for a period of twenty-one months among purposively selected thirty-six patients with Hyperemesis gravidarum with a view to assess the involvement of H. pylori in Hyperemesis gravidarum. Data were collected through interview, physical examinations and laboratory investigations by using case record form. Statistical analysis was performed using SPSS version 20.0 for Windows. Highest number 16(44.44%) of respondents were in age group 20 to 24 years with a mean of 23.81 years and a standard deviation (SD) of 4.55 years. Majority 29(80.56%) of the women had education less than 12 years, as many as 28(77.78%) women were housewives, and at least 14(38.89%) women had unplanned pregnancies. An overwhelming majority 29(80.56%) of women had their pregnancy duration between 8 to 12 weeks with a mean duration of 10.64 weeks and a standard deviation of 2.35 weeks. Majority 20(55.56%) of women were pregnant for first time, as many as 19(52.78%) women had duration of illness for 5 to 9 weeks. Of 16 multi-gravid women, 7(43.75%) had history of similar condition in their previous pregnancies. As many as 9 (25.00%) women had family history of similar condition in their mothers and sisters. First trimester was time of manifestation of the condition.At least 11 (30.56%) stool samples were positive for H. pylori stool antigen. Family history of Hyperemesis gravidarum and presence of H. pylori stool antigen are statistically associated (p<0.05). Pregnancy at young age, low educational status of women, nulliparity, unplanned pregnancy, past history, family history and H. pylori infection are the identified risk factors of Hyperemesis gravidarum.

Variations of Weight of Prostate Gland in Different Age Groups of Bangladeshi Cadaver.

Now a days, benign prostatic hyperplasia and carcinoma of the prostate are the most common disorders in men. A cross sectional descriptive study was conducted in Department of Anatomy, Mymensingh Medical College, Mymensingh to find out the difference in weight of the prostate gland of Bangladeshi people in relation to age. The present study was performed on 67 postmortem human prostate gland collected from the morgue in the Department of Forensic Medicine, Mymensingh Medical College by non random purposive sampling technique. The specimens were collected from Bangladeshi cadaver of age ranging from 10 to 80 years. All the specimens were grouped into three categories - Group A (upto 18 years), Group B (19 to 45 years) and Group C (above 45 years) according to age. Dissection was performed according to standard autopsy techniques. The weight of the prostate gland were measured and recorded. The mean weight of the prostate gland was 10.13gm in Group A, 17.27gm in Group B and 22.50gm in Group C. Variance analysis shows that mean differences of weight of the prostate were highly significant among all age groups. The weight of prostate gland was found to increase with increased age. For statistical analysis, differences between age groups were analyzed by using students unpaired 't' test. The present study will help to increase the information pool on the weight of prostate gland of Bangladeshi people.

Histomorphological Study on Number of Acini of the Prostate Gland of Bangladeshi Cadaver.

The prostate is made up of 30 to 50 compound tubuloalveolar glands that are embedded in a framework of fibromuscular tissue and arranged in three concentric groups (mucosal, submucosal and main prostatic gland). The prostate consists of peripheral, central and transitional zone accounting for approximately 70%, 20% and 5% of the glandular substances. Benign prostatic hyperplasia affects the transitional zone and carcinoma of the prostate affects the peripheral zone. The glandular tissue consists of numerous acini with frequent internal papillae. Follicular epithelium is variable but predominantly columnar and either single-layered or pseudostratified. This cross sectional descriptive study was conducted in Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh to find out the difference in number of acini of the prostate gland of Bangladeshi people in relation to age. The present study was performed on 67 postmortem human prostate gland collected from the morgue in the Department of Forensic Medicine, Mymensingh Medical College by non random purposive sampling technique. The specimens were collected from Bangladeshi cadaver of age ranging from 10 to 80 years. All the specimens were grouped into three categories: Group A (up to 18 years), Group B (19 to 45 years) and Group C (above 45 years) according to age. Dissection was performed following standard autopsy techniques. In the present study, total 60 slides were made for histological study from both central and peripheral zone of the prostate which were examined under low power objectives. The number of the acini of the prostate gland were counted and recorded. The mean number of the acini of the prostate gland was 16.45, 43.54 and 42.45 in Group A, B and C respectively in central zone and 30.08, 51.35 and 44.16 in Group A, B and C respectively in peripheral zone of the prostate. Variance analysis shows that mean differences were highly significant between Group A & B and Group C & A and non significant between Group B & C in central zone of the prostate. Mean differences were non significant among all three groups in peripheral zone of the prostate. The number of the acini of prostate gland was increased up to certain age limit but decreased in extreme age. In statistical analysis, differences between age groups were analyzed by using students unpaired 't' test. The present study will help to increase the information pool on the number of the acini of the prostate gland of Bangladeshi people at different age group.

Association genetics, geography and ecophysiology link stomatal patterning in Populus trichocarpa with carbon gain and disease resistance trade-offs.

Stomata are essential for diffusive entry of gases to support photosynthesis, but may also expose internal leaf tissues to pathogens. To uncover trade-offs in range-wide adaptation relating to stomata, we investigated the underlying genetics of stomatal traits and linked variability in these traits with geoclimate, ecophysiology, condensed foliar tannins and pathogen susceptibility in black cottonwood (Populus trichocarpa). Upper (adaxial) and lower (abaxial) leaf stomatal traits were measured from 454 accessions collected throughout much of the species range. We calculated broad-sense heritability (H(2) ) of stomatal traits and, using SNP data from a 34K Populus SNP array, performed a genome-wide association studies (GWAS) to uncover genes underlying stomatal trait variation. H(2) values for stomatal traits were moderate (average H(2) = 0.33). GWAS identified genes associated primarily with adaxial stomata, including polarity genes (PHABULOSA), stomatal development genes (BRASSINOSTEROID-INSENSITIVE 2) and disease/wound-response genes (GLUTAMATE-CYSTEINE LIGASE). Stomatal traits correlated with latitude, gas exchange, condensed tannins and leaf rust (Melampsora) infection. Latitudinal trends of greater adaxial stomata numbers and guard cell pore size corresponded with higher stomatal conductance (gs ) and photosynthesis (Amax ), faster shoot elongation, lower foliar tannins and greater Melampsora susceptibility. This suggests an evolutionary trade-off related to differing selection pressures across the species range. In northern environments, more adaxial stomata and larger pore sizes reflect selection for rapid carbon gain and growth. By contrast, southern genotypes have fewer adaxial stomata, smaller pore sizes and higher levels of condensed tannins, possibly linked to greater pressure from natural leaf pathogens, which are less significant in northern ecosystems.

Sling for correcting uterine prolapse: twelve years experience.

Pelvic organ prolapse is a common morbidity among Bangladeshi women. Both patient and surgeon prefer vaginal hysterectomy for the treatment of this condition and occasionally they choose Fothergill's operation. Uterine suspension is suitable for the young women to preserve the uterus. This observational study was carried out in three teaching hospitals and two other non government hospitals for the period of 12 years among 280 patients with 1st, 2nd and 3rd degree uterine prolapse. Follow up done at 6th week , 6th month, 1st year, 5th year, 10th year and 12th year for recurrence of prolapse, dragging pain and dyspareunia. Among 280 patients >60% patients were of 26-30 years age group. In last follow up at 12th year 2(0.71%) women complained feeling of some descend of uterus, 1(0.36%) complained dragging pain in abdomen and I (0.36%) complained dyspareunia. All patients expressed satisfaction which indicates psychological well being. Uterine sling is an effective procedure to save uterus in young women to improve their quality of life.

A friendly approach to repair fourth degree perineal tears.

This observational study was done to make the Gynecologists familiar with the procedure of continuous repair of rectal mucosa and repair of the anal sphincter by other than figure of 8 sutures and to assess the effectiveness of the procedure. This study was carried out in two teaching hospitals and other two private hospitals in Dhaka city and out side. Total 20 patients were included in this study. All had fourth degree perineal tear and were repaired with the new approach. Follow up was carried out at 6th week, 12th week, and 24th weeks. Among 20 patients a large number of women were mother of one child and were of 21-25 years age group. At post operative period - wound infection was nil. Perineums were well established in all cases. On follow up at 24th week - pain in perineum and dyspareunia was nil in all cases, though this was present at early weeks in few cases. Faecal incontinence was absent in all patients by 24 weeks postoperatively. In follow up visits there was no complaint of faecal incontinence. In few cases pain was present in early post operative periods but dyspareunia was absent. So, continuous repair of anal mucosa and repair of anal sphincters other than figure of eight seems better regarding technical easiness, better compliance for the surgeon and less traumatic to the rectal mucosa and ultimately better results.

Maternal outcome of grand multipara.

This prospective comparative study was conducted to determine the incidence of grand multiparity, compare the maternal outcome of grand multiparity to low parity and identify the frequency of maternal mortality associated with obstetrical complications of grand multiparity. It was carried out in the Obstetric and Gynaecology department of Rangpur Medical College Hospital, Rangpur, during the period of 1st January to 30th September' 2003. All pregnant (>28 weeks) parous women were included and primigravida were excluded. A total 2728 pregnant patients were initially recruited on the study. From them 200 cases were randomly selected. Among them 100 cases were grand multipara (parity 4 and above) comprising study groups and 100 cases were non grand multipara (parity 1-3) consisting of control group. All relevant maternal parameter were recorded and then compared between study group and control group. According to this study the incidence of grand multiparity is 9.8%. Among the grand multipara patient 95% were suffering from anaemia of different severity (p<0.05). The incidence of hypertension and gestational diabetes in grand multipara were significantly higher than non grand multipara (45% vs. 12%) and (12% vs. 02%) respectively. The other complications like placenta praevia, abruptio placentae, multiple pregnancy, malpresentations, postpartum haemorrhage, ruptured uterus were significantly higher among grand multipara and statistically significant results were observed. Proportion of women who underwent caesarean section was also high in study group (32% vs. 21% p<0.05). During the study period 7 maternal death were observed in grand multipara and 1 maternal death in non grand multipara (p<0.05).

Male urethral cancer.

A 55 years old man presented with long standing voiding obstructive symptoms like poor stream, frequency of micturition, straining at micturition and a sense of incomplete evaluation since 2002. He was clinically diagnosed a case of stricture urethra. Later he developed a swelling in the penoscrotal region with retention of urine in March 2005 and was treated by dilatation. But on removal of the catheter he developed retention again for several times and ultimately for gross periurethral sepsis, urinary diversion was required in May 2005. In October 2005, biopsy from the scrotal abscess wall established the diagnosis of urethral carcinoma. In November 2005 extensive penoscrotectomy was done followed by chemo-radiotherapy. But the prognosis was so bad that the patient died in November 2006. Urethral carcinoma is a rare disease diagnosed in the department of urology, Mymensingh Medical College Hospital, the prognosis of which is also poor even after extensive operations.