Understanding progressive rubella pan encephalitis: a rare neurological disorder

Progressive rubella panencephalitis (PRP) is a rare late complication of rubella that affects mainly teenagers. It is characterized by progressive white matter destruction, gliosis and cerebral atrophy, similar to subacute sclerosing panencephalitis (SSPE) and congenital rubella syndrome. This paper examines the complexity of PRP, its clinical manifestations, pathogenesis, diagnostic criteria, treatment and prophylaxis. PRP should be considered in adolescents with progressive dementia with pyramidal and cerebral dysfunction. With respect to the most affected children, survival and recovery is expected to be poor, with high mortality rates, especially in the first six months of life. The development of progressive spasticity, ataxia, mental deterioration and convulsions in late childhood and early childhood with mothers' rubella or stigmata histories is the subject of research on PRP. Therefore, continued efforts to understand and address PRP are important to improve the quality of diagnosis, treatment and ultimately the quality of life of affected persons.

Homicidal poisoning with para-phenylenediamine hair dye: a case report

Paraphenylenediamine (PPD) is a widely used chemical in various hair dye formulations. Due to its cheap price and easy availability, it emerges as a major cause of suicidal poisoning. It carries high morbidity and mortality and does not have any specific antidote. We reported an unusual type of poisoning of a 44-year-old man with PPD and how he was managed with an excellent outcome.

Knowledge, attitude, practice, and perceived barriers of colorectal cancer screening among primary care physicians in the Kingdom of Bahrain

Background: Colorectal cancer (CRC) is one of the lethal cancers all over the world. Early detection of colorectal cancer has been shown to reduce incidence and mortality. Primary care physicians have a crucial role in early detection of cancer. This study aims to explore the knowledge, attitude and practice of primary care physicians in Bahrain towards CRC screening and to determine the barriers related to CRC screening. Methods: A cross sectional study was carried out among primary care physicians working at primary health care centers in Bahrain. It included 174 physicians. A self-filled questionnaire that includes demographic information, knowledge scale, attitude scale, practice scale items and barriers of not performing CRC screening was used as the study tool. Results: The overall knowledge score revealed that 51.7% had poor knowledge score and 48.3% had adequate knowledge score. Majority of the participants (93.7%) agreed to have a structured screening program for colorectal cancer rather than an opportunistic one. Most of the physicians (60%) reported that less than 25% of those eligible patients truly receive a screening. Physician抯 lack of time was the top barrier of not performing CRC screening. Conclusions: This study showed that most primary care physicians have poor knowledge regarding CRC screening and the majority do not screen their eligible patients for CRC.

Adoption and standardization of attitude scale for polio framed on oversees population from underdeveloped area of West Bengal

Background: Study revealed fear from polio vaccination programme yet not completely has eradicated from the minds of immigrated communities resides in backward areas of Bengal. Due that, pre-established attitude tool was adopted for the formation of new tool for targeted population. Methods: Interestingly, attitude tool found almost similar result after 5 years of its first administration (on minorities). Foundation of tool was set on 3-point Likert type scaling style. Classical test theory (CTT) was followed in which popularity index and discrimination index were taken for item-analysis for pilot study. Results: CTT rejects 6 items and test-retest reliability with high r value 0.94 suggests the tool has excellent reliability. Standardized tool finally comes in 31 items with 9 different dimensions. Conclusions: CTT method as handy method for small sample item-analysis where popularity index and discrimination index used to refine values on which item-total correlation was administered on Pearson抯 correlation at 99% confidence interval. Application of the same tool after some years in CTT method in constructing attitude tool have successfully applied.

Knowledge, attitude and practicing behavior regarding antimicrobial use and awareness of antimicrobial resistance among interns and postgraduates in a tertiary care hospital

Background: Irrational use of antimicrobials and inaccurate practicing behavior leads to the issue of antibiotic resistance. This can be tackled by spreading awareness with the assistance of future medical practitioners. Hence, the present study was taken to determine the knowledge, attitude, and practicing behavior regarding antimicrobial use and awareness of antimicrobial resistance among interns and postgraduates., , Methods: The study was conducted on interns and postgraduates in a tertiary care hospital. A standardized questionnaire was distributed to 120 participants and Ethical approval was taken before the study. Data was analyzed using SPSS software. For data comparisons, Chi-square tests were used, p?0.05 is considered significant., , Results: The study showed a majority in the 25 to 34 years of age group with female predominance. The subject of antibiotic resistance was moderately relevant to a majority, which highlighted a need for an increase in awareness workshops. The actual knowledge of respondents seems to be accurate in the study, a fair amount of attitude and practicing behavior was observed as well. A significant difference between the interns and postgraduates in knowledge (?2=13.736, p=0.03), attitude (?2=68.091, p=0.01), and practice (?2=34.821, p=0.01) were noticed., , Conclusions: Accurate knowledge and practicing behavior were observed in postgraduates and a fair attitude was observed in interns towards antimicrobial use and resistance. The awareness must be extended regarding this issue by conducting educational programs and by updating guidelines. Advancement in antibiotic prescribing pattern is required.

Antimicrobial activity of essential oils of Curcuma longa and Syzygium aromaticum against multiple drug-resistant pathogenic bacteria

@#The present study was conducted to investigate the antimicrobial potential of essential oils of Curcuma longa and Syzygium aromaticum against multidrug-resistant pathogenic bacteria. Four identified bacterial isolates including Methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii were selected and their antibiotic sensitivity was checked by disc diffusion assay. C. longa and S. aromaticum were subjected to steam distillation to obtain their essential oils. The crude essential oils were fractioned by employing column chromatography. Crude essential oils and their fractions were evaluated for their antibacterial activity by agar well diffusion assay and minimum inhibitory concentrations were calculated. All the selected bacterial isolates showed resistance to three or more than three antibiotic groups and were declared as multidrugresistant (MDRs). Crude essential oils of C. longa and S. aromaticum exhibited antimicrobial activity against all selected isolates but S. aromaticum activity was better than the C. longa with a maximum 19.3±1.50 mm zone of inhibition against A. baumannii at 1.04 µL/mL MIC. GC/MS analysis revealed the abundance of components including eugenol, eugenyl acetate, b- caryophyllene, and a- Humulene in both crude oil and fractions of S. aromaticum. While the main components of C. longa essential oil were Ar-tumerone, a–tumerone, b- Tumerone, I-Phellandrene, a-zingibirene, b- sesquiphellandrene, and p- Cymene. This study highlights that plant-based essential oils could be a promising alternative to antibiotics for which pathogens have developed resistance. C. longa and S. aromaticum carry compounds that have antimicrobial potential against multiple drug-resistant bacteria including MRSA. E. coli, K. pneumoniae and A. baumannii.

Antibacterial activity of plant essential oils against indigenously characterized methicillin-resistant Staphylococcus aureus (MRSA)

@#Plant essential oils were evaluated for antimicrobial activity against Methicillin-resistant Staphylococcus aureus (MRSA). The isolates (n=03) were procured from Institute of Microbiology, UVAS Lahore, Pakistan. After biochemical and 16S rRNA gene-based PCR characterization, accession numbers were retrieved from NCBI i.e. MW344063.1, MW344064.1 and MW344065.1. These isolates exhibited molecular positivity by multiplex PCR for mecA, coa and eta toxin genes. Moreover, these isolates exhibited resistance to cefoxitin, ampicillin, amoxicillin, penicillin, amoxicillin clavulanate, ciprofloxacin, erythromycin and gentamicin. The antibiotic resistant isolates were evaluated for antimicrobial activity of plant essential oils. The highest zone of inhibition (mean ZOI±S.D.) was measured for Cinnamomum verum (22.67±1.52 mm) followed by Eucalyptus globulus (18.67±2.51 mm) and Syzygium aromaticum (12.67±2.51 mm). Lowest mean MIC value (0.33±0.11 mg/mL) was recorded for E. globulus. Eucalyptus globulus was processed for fractionation by column chromatography and n-hexane, chloroform, n-hexane + chloroform and ethyl-acetate fractions were evaluated for antibacterial activity. Lowest mean MIC (10.04±5.80 mg/mL) was recorded for E. globulus n-hexane fraction. Cell survival percentage of BHK21 cell line was 51.7% at 54.87mg/mL concentration of E. globulus n-hexane fraction. Through gas chromatography-mass spectrometry (GC-MS) analysis of n-hexane fraction, benzene was found abundant (29.9%) as active compound. It was concluded that E. globulus n-hexane fraction exhibited significantly promising results against MRSA.

Molecular detection and phylogenetic analysis of Leishmania major in stray dogs in Riyadh Province, Saudi Arabia

@#Dogs can act as a reservoir of canine leishmaniasis disease, which is caused by Leishmania species. The study aimed to identify and document the genotype of cutaneous leishmaniasis (CL) in the stray dogs in Riyadh Province using kinetoplast DNA (kDNA) as a target gene by using nested polymerase chain reaction (nPCR). This cross-sectional investigation was conducted over the course of two years, from March 2016 to July 2018, in different districts of Riyadh Province, Saudi Arabia. A total of 237 dogs were examined, only 18 of the dogs were suspected clinically of cutaneous leishmaniasis due to the presence of cutaneous nodules and cutaneous lesion. Biopsy tissue collections were performed and DNA was extracted. CSB2XF and CSB1XR primers were used to amplify the Leishmania kDNA regions. The Leishmania species were detected by specific 13Z and LIR primers by applying nested PCR assay. Nine dogs were found to be positive for Leishmania major. The examined dogs were negative for other Leishmania spp. The phylogenetic analysis and blast results of kDNA showed that the 9 isolates L. major is closely related (99.9%) to the L. major isolate CMG_irfan5, accession number HQ727556.1 from human, Pakistan. This is the first molecular study on dog leishmaniasis from Saudi Arabia confirmed that dogs have a L. major infection. Further epidemiological and molecular investigations are required to study domestic and wild canine infections with L. major and other Leishmania spp in endemic and nonendemic areas of Saudi Arabia as part of leishmaniasis control

Effect of organic amendment on stem canker and black scurf disease of potato (Solanum tuberosum) / Efeito da alteração orgânica sobre o cancro da haste e doença dos tuberculos pretos da batata (Solanum tuberosum)

An experiment was conducted at Tuber Crops Research Centre, BARI, Bogra during 2008-2009 to evaluate the organic amendment for controlling the stem canker and black scurf of potato. The different kinds of organic amendments were: T1 =Poultry refuse (PR) at 4 t ha-1, T2 =PR at 5 t ha-1, T3 =PR at 6 t ha-1, T4 =Mustard oil cake (MOC) at 300kg ha-1, T5 =MOC at 500kg ha-1, T6 =Neem oil cake (NOC) at 300kg ha-1, T7 =NOC at 500kg ha-1, T8 =Sawdust burning and T9 = Control. The experiment was laid out in a randomized complete block design (RCBD) with four replications. The organic amendment significantly influenced the disease incidence, yield attributes and yield of potato. The lowest disease incidence (17.5%) and per cent disease index (9.99) were found in T3 (poultry waste at 6 t ha-1). The minimum russet, deformed and Sclerotia infected tubers were also recorded in poultry waste at 6 t ha-1. The highest healthy tubers and tuber yield were found in the same treatment. Therefore, poultry manure 6 t ha-1 along with recommended dose of chemical fertilizer can be recommended to produce healthy tubers and maximum tuber yield of potato.

O experimento foi conduzido no (Centro de Pesquisa em Tubérculos ) Tuber Crops Research Centre, Bari, Bogra durante 2008-2009 para avaliar a alteração orgânica e controlar o cancro da haste e Black Scurf da batata. Os diferentes tipos de alterações orgânicas foram: T1 = Poultry recusar (PR) a 4 t ha-1, T2 = PR a 5 t ha-1, T3 = PR em 6 t ha-1, T4 = bolo de óleo de mostarda (MOC) em 300 kg ha-1, T5 = MOC em 500 kg ha-1, T6 = bolo de óleo de Neem (NOC) em 300 kg ha-1, T7 = NOC em 500 kg ha-1, T8 = queima de serragem e T9 = Controle. O delineamento experimental foi em blocos casualizados (RCBD) com quatro repetições. A alteração orgânica influenciou significativamente a incidência da doença, os atributos de rendimento e produtividade da batata. A menor incidência da doença (17,5%) por cento do índice de doença (9,99) foram encontrados em T3 (resíduos de aves a 6 t ha-1). O russet mínimo, deformado e Sclerotia tubérculos infectados também foram registrados em resíduos de aves a 6 t ha-1. O rendimento mais elevado tubérculos saudáveis e tubérculos foram encontrados no mesmo tratamento. Portanto, aviário 6 t ha-1, juntamente com a dose recomendada de fertilizante químico pode ser recomendado para a produção de tubérculos saudáveis e rendimento máximo dos tubérculos de batata.

Fungal Infections in Aseer Central Hospital: A Retrospective Laboratory-based Study of 340 Cases during the Years 2011 to 2015.

Objectives: The incidence of fungal infections is increasing due to increasing episodes of risk factors such as immune competence; broader used of antibiotics and longer hospital stays. This study aimed to analyze fungal isolates from patients admitted to Aseer Central Hospital between 2011 and 2015 and to shed light on practical recommendations based on scientific evidence for improving laboratory diagnosis. Methods: Retrospectively, for a period of 4 years (2011-2015), we analyzed 340 specimens submitted to the Microbiology Laboratory, at Aseer Central Hospital, Abha, Saudi Arabia. The study involved the isolation and identification of fungi using standard methods. Cultures were done on Sabouraud dextrose agar (SDA) plates and Brain Heart Infusion Agar + 5% Sheep Blood (BHIA) according to the type of the clinical specimens. Suspected mold and yeast cultures were identified on the basis of colony morphology appeared on SDA and on microscopic features as per standard criteria. Resulted were analyzed using SPSS investigating prevalence among specimens types, sex, age groups and hospital wards. Results: Of the 340 specimens, positive fungal cultures were obtained in 105 (30.88%), no growth was seen in 218 plates (64.12%) and 17 plates (5%) had been contaminated or overgrown by bacteria. Out of the 105 positive fungal cultures, yeast represented 47 cases (44.76%) of which 23 samples (21.9%) belonged to the genus Candida. Dermatophytes were 18 isolates (17.14%) of which Trichophyton tonsurans was the dominant species 9 patients (8.57%). Aspergillus species were 13 cases (12.38%); Zygomycetes 9 (8.57%); Penicillium species, only 1 case (0.95%) and unidentified molds were 17 (16.19%). Gender showed significant differences (p=0.034) but no differences among ages groups (p = 0.187). Specimens derived from skin represented the highest percentage of fungal infections followed by the lower respiratory tract and subcutaneous tissue. Significance differences were recorded among hospital wards (p = 0.001) nonetheless male and female medical and surgical words revealed relatively higher rates of fungal infections. Conclusion: These fungi represent a considerable hazard to patient health. What is needed in the region is to increase detection rate, by improving sample quality and expanding laboratory capacity in order to enhance patient's health.

Association of Left Atrial Spontaneous Echocardiographic Contrast with Inflammatory Markers in Mitral Stenosis Patients.

Background: Spontaneous echocardiographic contrast (SEC) is a risk factor for left atrial thrombus formation and an important indicator of potential systemic embolism originated from heart. An established relation exists between the inflammatory status and the prothrombotic state. The present study was conducted to evaluate the association between left atrial spontaneous echocardiographic contrast with inflammatory markers in mitral stenosis patients. Methods: This observational analytical study was undertaken in the department of Cardiology, National Institute of Cardiovascular diseases (NICVD), Dhaka. A total of 70 patients with mitral stenosis were categorized into two groups: group I with left atrial SEC and group II without left atrial SEC. All patients underwent transthoracic as well as transoesophageal echocardiography. Complete blood count with ESR was done and neutrophil lymphocyte ratio was calculated. The high sensitive C-reactive protein (hs-CRP) was assayed. Results: The hs-CRP levels were significantly greater in the SEC-positive group (5.6±2.1vs 1.5±0.7, p=0.001). The mean ESR level was significantly greater in the SEC-positive group (32.6±15.5 mmvs15.8±4.7 mm).The neutrophil levels ((76.1±1.9 vs 63.7±3.3) were significantly greater in the SEC-positive group, and the lymphocyte levels (33.3±3.0 vs 21.5±1.3) were significantly greater in the SEC-negative group (p=0.001 for each). The neutrophil/lymphocyte (N/L) ratio was also significantly greater in the SEC-positive group (3.4±0.4 vs2.1±0.6, p=0.001).On multivariate analysis hs-CRP, neutrophil/lymphocyte ratio, raised ESR, mitral valve area and left atrial diameter were independent risk factors for SEC in patients with mitral stenosis. Conclusion: From this study it may be concluded that left atrial SEC is associated with raised inflammatory markers in majority of patients with mitral stenosis. So, SEC may be considered as a reflection of ongoing inflammatory process in patients with mitral stenosis.

Effect of Statin Therapy In Ventricular Arrhythmias In Patient With Acute Anterior Myocardial Infarction.

Background: Though statins are widely used in acute coronary syndrome (ACS), there is a paucity of information on the efficacy of high dose statin therapy in reducing the incidence of ventricular arrhythmias after acute myocardial infarction. Arrhythmias are relatively common in acute myocardial infarction (AMI) anterior, and sometimes progress to cardiac arrest. This study was planned to evaluate the role of high dose atorvastatin therapy in prevention of ventricular arrhythmias after acute anterior myocardial infarction. Methods: This study was conducted in NICVD from December 2010 to October 2011. Total 200 patients with newly diagnosed acute anterior myocardial infarction who received thrombolytic therapy were included in the study. They were divided into two groups. Group I (n=100) was selected for high dose atorvastatin therapy and group II (n=100) was selected for conventional doses of atorvastatin therapy. 24 hours Holter monitoring was performed 48 hours after hospital admission to evaluate arrhythmia. Results: Majority of the patients belonged to age range of 40 to 59 years with a male predominance. Patient characteristics regarding age, sex, drug use, risk factors for ventricular arrhythmia, body mass index, left ventricular ejection fraction were similar in two study groups. There was no electrolyte imbalance or renal impairment in any patient in either group. A significant difference in frequency of ventricular arrhythmias was found between the two groups. Ventricular premature beats were found in 66% patients in group I and 97% patients in group II (p=0.001) whereas non sustained ventricular tachycardia were observed in 0% and 4% in group I and group II respectively. Conclusion: High dose atorvastatin therapy is associated with lower frequency of ventricular arrhythmias after acute anterior myocardial infarction.

Evaluation of Efficacy and Tolerability of Perindopril 8 mg in Bangladeshi Hypertensive Patients: Results from an Open-label, Observational, Multi-center Study (CONTROL).

Background: The CONTROL (COversyl in Newly diagnosed stage-II & unconTROlled hypertensive patients triaL) was performed with an objective to evaluate the blood pressure (BP) lowering efficacy and tolerability of Perindopril 8mg in newly diagnosed stage II patients and uncontrolled hypertensive patients among Bangladeshi population. Methods: This was an open-label, observational, multi-center study conducted in consultation centers for out-patients located in different cities of Bangladesh. Adults, aged above 18 years with newly diagnosed stage-II hypertension or uncontrolled hypertension, were recruited. Patients were treated with Perindopril 4mg daily for first 1 week, afterwards uptitrated to Perindopril 8 mg daily and continued treatment for 12 weeks. Patients were followed-up at week-1, week-4, week-8 and week-12. Results: In total, 245 patients were enrolled. Among them, 88 were newly diagnosed stage-II (Group- I) and 157 were uncontrolled (Group-II) hypertensive patients. Male and female distribution was 57% and 43% respectively. Mean age of patients was 54.5 ±11.7 years. After 12 weeks treatment, there was a significant reduction in BP from baseline (p<0.001) in overall population as well as in Group I and in Group II. In overall population, the mean BP reduction was -31/-15 mmHg (from 163.7/96.8 mmHg to 132.4/81.7 mmHg. In Group I, the reduction was -33/-16 mmHg (from 166.5/98.2 mmHg to 133.4/82.0 mmHg) and in Group II, -30/-14 mmHg (from 159.3/ 95.6 mmHg to 129.1/81.6 mmHg). 10 patients (4.1%) had to discontinue the treatment due to adverse effects. Dry cough (2%) and hypotension (1.2%) were the main cause of discontinuation. Perindopril 8mg was well tolerated as indicated by the high proportion of physicians (81%) reporting ‘good’ to ‘excellent’ tolerability at week 12. Conclusion: This study suggests that Perindopril 8mg is effective and safe in the treatment of hypertension in Bangladeshi patients.

Atrial Tachycardia: A Rare Type of Supra Ventricular Tachycardia.

Atrial tachycardia is a relatively uncommon form of SVT. Atrial tachycardia can be observed in persons with normal heart and in those with congenital heart disease and particularly after surgery for repair or correction of congenital or valvular heart disease. Atrial tachycardia tends to be refractory to pharmacologic therapy and is therefore frequently treated with ablative therapy. If untreated, it may lead to tachycardia-induced cardiomyopathy. So, atrial tachycardia needs to be discussed for recognition and appropriate management. We have gone through different journals to review the latest informations about atrial tachycardia

Radiofrequency Catheter Ablation of Left Free Wall Accessory Pathways: Comparison Between Retrograde and Transeptal Approach.

Background : This study was conducted to compare the conventional retrograde arterial approach (RAA) with the transeptal approach (TSA) for radiofrequency catheter ablation (RFA) of left accessory pathways (AP). Materials and Methods: Sixty consecutive patients (44 male; mean age of 35.60 ± 11.63 years) with 60 left APs (39 overt and 21 concealed) underwent catheter ablation using the TS method (30 patients) and the RA method (30 patients) in an alternate fashion. The analysis was performed according to the intention-to-treat principle. Results : The transeptal puncture was successfully performed in 29 patients (96%). This access allowed primary success in the ablation in all the patients without any complication. When we compared this approach with the RAA there was no difference as regards the primary success (p = 0.103), fluoroscopy time (p = 0.565) and total time (p = 0.1917). Three patient in the RAA group presented a vascular complication. The TSA allowed shorter ablation times (p=0.006) and smaller number of radiofrequency applications (p = 0.042) as compared to the conventional RAA. The patients who had unsuccessful ablation in the first session in each approach underwent with the opposite technique (cross-over), with a final ablation success rate of 100%. Conclusion : The TS and RA approaches showed similar efficacy and safety for the ablation of left accessory pathways. The TSA allowed shorter ablation times and smaller number of radiofrequency applications. When the techniques were used in a complementary fashion, they increased the final efficacy of the ablation.

Coronary Angiographic Profile in Patients with Conduction System Disorder Requiring Permanent Cardiac Pacing.

Background: The association between conduction disturbances and atherosclerotic coronary artery disease has been investigated in a few small studies in the early 1970s and the study result was inconclusive. Thereafter some investigators found in their separate study that a group of patients with conduction disturbances that required permanent pacemaker who had coronary atherosclerotic disease that might be responsible for conduction disturbances. Method: 40 consecutive patients that required permanent pacemaker and 40 control patients were investigated. The coronary angiographic study was performed in both groups which included classification of pathological coronary anatomy, qualitative assessment of flow and stenosis severity. Results: The location of the lesions was found significantly different between two groups. 14 patients(35%) of 40 study patients had type IV lesion, whereas only 2 patients(5%) of 40 control patients had type IV lesion (p=0.001). Flow quality was found poor in more patients in study group specially that had type IV lesion. Severity of the lesions in the LAD & RCA was found identical in both groups. Conclusion: It may be concluded that the location of the lesions rather than diffuse coronary atherosclerosis might be responsible for a subset of patients with conduction disturbances that required permanent pacemaker.

Early detection of cervical intraepithelial lesions by simple visual inspection after acetic acid among women in Rajshahi medical college hospital.

Aim: To evaluate the performance of visual inspection of acetic acid (VIA) in the detection of precancerous and early cancerous lesions of cervix. Materials and methods: Total 5593 eligible women who randomly came to the Gyenae out patient department (OPD) of RMCH (Rajshahi Medical College Hospital) were examined by VIA. Detection of well defined, opaque, acetowhite lesions close to the squamocolumner junction or in transitional zone or dense acetowhitening of ulceroproliferative growth on the cervix constituted a positive VIA. Those who had abnormal results in screening test & those who had clinically suspicious lesions were sent for colposcopic evaluation (n= 442) & directed biopsy were taken from colposcopically suspected areas (n=214). The final diagnosis was based on histology. Results: Out of 5593 patients, 442 (7.20%) were VIA positive. 442 patients were colposcopically evaluated .Among them, 228 (51.58%) were normal and 202(45.70%) had different stages of cervical intraepithelial lesions (CIN) and 12 ( 2.71 % ) had carcinoma of cervix. Out of 214 patients biopsied, 23.36 % patients had a final diagnosis of CIN lesions, 5 (2.33%) had carcinoma in-situ & 17 cases (7.94%) had invasive carcinoma. Besides to find out the predictable factors of cervical lesions data have been collected from VIA positive patients regarding age of first coitus and first delivery, history of extra marital exposure and STI, use of contraceptive methods and family history of cancer. Age of first coitus between 12 to 15 years and 16 to 20 years were observed among 203 (46 %) and 40 % (177) women respectively. More than half of the patients (62%) were experienced with their first delivery within the age 15-20 years which was below 15 years of 12 % (53) patients. Fifty four percent patients used OCP and barrier methods used were only 10 %. Family history of cancer was observed among 09 % women. 58% patients were belonged to lower middle class and upper group were only 9% (table 1) Conclusion: In our study detection of different grades of intraepithelial lesions (CIN-I, CIN-II, CIN-III, invasive carcinoma) of cervix by VIA was comparable to that of colposcopy. So VIA is suitable for detection of precursor lesions of cervical cancer in low resource settings and also for diagnosis, follow up treatment and epidemiological studies of cervical cancer.

Coronary Angiographic Characteristics of Patients with First Myocardial Infarction Admitted in a Tertiary Care Cardiac Hospital in Bangladesh.

Background: Coronary artery lesion characteristics of patients with First myocardial infarction (First MI) of Indian subcontinent origin in UK, is different from indigenous white population. The present study was aimed to observe coronary angiographic profile of first MI patients, hospitalized in a tertiary care hospital, in Bangladesh and to compare the results with published data of study done home and abroad. Methods: This is a prospective observational study. A total of 100 cases of First MI patients were included in this study. Clinical history, physical examination, major risk factors, relevant investigations including ECG & Echocardiogram and coronary angiogram of all patients were recorded. Results: The coronary angiographic features of 100 patients revealed that 88% of the study population had significant coronary artery lesion (stenosis e”70%). Normal coronary arteriogram was found in 5 patients (5%); although they had myocardial infarction previously. Insignificant lesion (stenosis < 70%) was detected in 7 patients (7%). Left anterior descending (LAD) arteries were affected in most of the patients (78%), followed by right coronary artery (62%) and left circumflex artery (55%). Single vessel disease (33%) and triple vessel diseases were equally prevalent among the study population. Conclusion: Present study observed that triple vessel disease, diffuse pattern of lesions and combined type of lesions were more prevalent among the first MI patients. Increase in the number of risk factors was associated with progressive increase in severity of disease as defined by number of significant stenosis. Comparison of results of present study population with that of study done abroad shows that single vessel disease was more prevalent among European white patients who had first MI but triple vessel disease was more prevalent among our patients.

Long-Term Follow -Up After Radiofrequency Catheter Ablation of Fascicular Ventricular Tachycardia at National Institute of Cardiovascular Diseases.

Introduction: Verapamil-sensitive, idiopathic left ventricular tachycardia (ILVT) with right bundle branch block configuration and left-axis deviation is known to be due to re-entry mechanism but the exact nature of reentrant circuit in ILVT is not fully elucidated. In this study we evaluate the results of long-term clinical outcome in patients who underwent radiofrequency catheter ablation of idiopathic fascicular ventricular tachycardia in National Institute of Cardiovascular Diseases. Methods: Electrophysiological studies and radiofrequency ablation were performed in 46 consecutive patients (42 men,04 women), age ranging from 16 to 36 years (mean 20±5 years) with verapamilsensitive ILVT and structurally normal hearts. VT could be terminated by the intravenous administration of verapamil in all patients. Mapping was performed using a Bard electrophysiology system. The target site for ablation was the mid-septum of left ventricle where the earliest Purkinje potentials were recorded during VT. RF current was applied to the target site with or without late diastolic potential during VT in all patients to meet the ablation endpoints which were termination of the VT and non-inducibility of the tachycardia. Results: All 46 patients had successful ablation of the ILVT. During 3 years follow up 02 patients had recurrence. Conclusion: Idiopathic left ventricle tachycardia occurs most commonly in young population. Prompt recognition of this arrhythmia is important since radiofrequency ablation can cure this rhythm problem. This can be achieved in a country like Bangladesh where resources are limited.

Comparison of haematological values among different groups of low birth weight babies and normal birth weight babies.

This prospective cross sectional study was carried out in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. This study was undertaken to compare the haematological value (reference range) among Small for gestational age-low birth weight (SGA-LBW), Appropriate for gestational age-low birth weight (AGA-LBW) and Normal birth weight (NBW) babies. Total 90 (ninety) newborn babies were enrolled in this study. They were ultimately divided into three groups as a) Group I (SGA-LBW), b) Group II (AGA-LBW), c) Group III (NBW). Study period was one year (December 2003 to December 2004), Relevant informations were collected from the guardian of the babies before inclusion in the study. In group I, 19(63.3%) were preterm and 11(36.7%) were term. In group II, 30(100%) were preterm and in group III, 30(100%) were term. Mean Hb, and HCT levels were highest in group I (SGA-LBW) and the value was 17.14+/-1.41 gm/dl (Hb) and 0.51+/-0.04 (HCT) respectively. Mean Hb and HCT value were lowest in group II (AGA-LBW) and the value was 14.57+/-1.78 gm/dl (Hb) and 0.43+/-0.05 (HCT) respectively. In between value was found in group III (NBW) and the value was 16.14+/-1.09 gm/dl (Hb) and 0.48+/-0.04 (HCT) respectively. Differences were statistically significant. On the contrary, MCV Values were highest in group II (AGA-LBW) and the value was 103.23+/-4.99 (fl). Lowest MCV value was in group III (NBW) and the value was 98.13+/-3.93 (fl). In between result of MCV value was found in group I (SGA-LBW) and the value was 99.27+/-10.73 (fl). Differences were also statistically significant. MCH and MCHC level was also highest in group I (SGA-LBW). Difference was also statistically significant. No significant differences of TC of WBC and platelet counts were not found among different groups. Hb and HCT level had significant positive correlation with gestational age. Other parameters had no Positive correlation with gestational age.