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Using Magnesium Sulfate to Prevent Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery: A Single Centre Experience in Bangladesh

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World Journal of Cardiovascular Diseases 2023年第9期13卷 565-577页

作者： Manoj Tiwari md. Abir Tazim Chowdhury Hema Poudel Munama Magdum md. Mostafizur Rahman Vivek Kumar Jha md. Ahaduzzaman md. Abul Bashar Maruf Department of Cardiovascular and Thoracic Surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Dermatology and Venerology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Ibn Sina Specialized Hospital Dhaka Bangladesh

Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0th, 1st, 2nd, and 3rd days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the poten

关键词： Atrial Fibrillation (AF) Coronary Artery Bypass Grafting (CABG) Postopera-tive Atrial Fibrillation (POAF) Magnesium Sulfate Bangladesh.

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Pattern of Presentation of Iatrogenic Biliary Injury Following Laparoscopic Cholecystectomy

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Open Journal of Clinical Diagnostics 2022年第4期12卷 55-62页

作者： Fahmid-Uz-Zaman Mohammad Aminul Islam md. Saba Al Galib md. Mashkurul Alam md. Shamsuddoha Khan Muhammad Tanvir Alam Akhanda Sania Hossain Laila Siddika Mohammad Emrul Hasan Khan Abul Bashar md. Jamal Department of Surgery Dhaka Medical College Hospital Dhaka Bangladesh Department of Surgery Shaheed M. Monsur Ali Medical College Hospital Shirajgonj Bangladesh Department of Pediatric Surgery Dhaka Medical College Hospital Dhaka Bangladesh Department of Surgery Shaheed Suhrawardy Medical College Hospital Dhaka Bangladesh National Institute of Cancer Research and Hospital Dhaka Bangladesh Department of Laboratory Medicine Sheikh Russel National Gastroliver Institute and Hospital Dhaka Bangladesh Mugda Medical College and Hospital Dhaka Bangladesh

Background: Cholecystectomy is one of the most now common abdominal surgeries performed every day. The incidence of bile duct injury (BDI) following open cholecystectomy is only 0.1% - 0.2%. After the introduction of laparoscopic cholecystectomy, the incidence has gone up to 0.4% - 0.7%. The present study is a prospective analysis of all patients with bile duct injury who were admitted to Dhaka Medical College Hospital during or at a variable period following cholecystectomy. Methods: To determine the pattern of presentation of iatrogenic biliary injury following cholecystectomy in the department of surgery of Dhaka Medical College Hospital, a total of 30 patients were purposively selected from May 2018 to November 2018. Patient particulars, records of physical and clinical evaluation, and operative details were collected by individual researchers. Data analysis was done by SPSS for windows version 21. Results: BDI was found very common among the age group 21 - 30 yrs (36%) and female dominant (60%). Majority of the patients presented with abdominal pain (96%), intra-abdominal collection (88%), biliary peritonitis (68%), cholangitis (60%), and obstructive jaundice (40%), and biliary fistula (40%). Laparoscopic cholecystectomy (84%) was the principal cause of biliary injury in our study. 48% of patients experienced clinical features within 7 days post-cholecystectomy. Per-operative diagnosis was done in only 12% of cases. 44% of patients in this study were recognized as Bismuth grade-3, followed by 36%, grade-2 patients. Management outcomes included wound infection (41.66%), minor bile leak (25%), peritonitis (8.33%), and renal impairment (8.33%). Conclusion: The effect of BDI is an extremely distressful clinical condition for the patients and their family members, hence proper care and management protocol should be followed.

关键词： Bile Duct Injury Laparoscopic Cholecystectomy Post-Operative Complications Bangladesh

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Outcomes of Early Primary Endoscopic Realignment and Delayed Reconstruction in the Management of Posterior Urethral Injury in Male

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Journal of Biosciences and Medicines 2019年第10期7卷 1-16页

作者： Mohammad Nazmul Huda Prodyut Kumar Saha A. K. M. Shahidur Rahman Mohammad Ibrahim ali A. S. M. Humayun Kabir Munirunnessa Yeasmin Akter md. Mostafizur Rahmen Jannate Shaina Islam Nahid Kamal Department of Urology Dhaka Medical College Hospital (DMCH) Dhaka Bangladesh Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Gynecology and Obstetrics Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) Mitford Dhaka Bangladesh Department of Gynecology and Obstetrics Combined Military Hospital (CMH) Dhaka Bangladesh Department of Urology Medical College for Women & Hospital Uttara Dhaka Bangladesh Department of Pathology National Institute of Ophthalmology & Hospital Sher-E-Bangla Nagar Dhaka Bangladesh District Hospital Sherpur Bangladesh

Background: Posterior urethral injury usually occurs in male patients with pelvic fractures. Posterior urethral injuries are associated with considerable morbidity including urinary incontinence, erectile dysfunction and urethral stricture. Objective: To compare the outcomes between early primary endoscopic realignment and delayed reconstruction in the management of male patients of posterior urethral injury. Methodology: This prospective study was conducted in the department of urology and department of casualty, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2015 to June 2017 among 50 male patients with posterior urethral injury. Fifty patients were randomly allocated into two groups;the group A consisted of 24 patients underwent early primary endoscopic realignment within 10 days after posterior urethral injury and the group B consisted of 26 patients underwent delayed reconstruction in form of anastomotic urethroplasty after 3 months. All patients were followed up at 3rd, 6th and 9th month after the procedure. Outcome variables were post-operative urethral stricture, urinary incontinence and erectile dysfunction. Data were analyzed and compared by statistical tests. Results: The mean (±SD) age of the study patients was almost similar between the groups (28.8 ± 8.4 vs. 27.4 ± 7.2 years, p = 0.486). In group A, 83.33% patients developed postoperative urethral stricture, none of them developed urinary incontinence and 20.83% developed erectile dysfunction;On the other hand, in group B, these rates were 38.46%, 23.07% and 38.46% respectively. Postoperative urethral stricture formation was significantly higher in Group A (p = 0.0012) but urinary incontinence and erectile dysfunction rates were significantly higher in Group B (p = 0.018 and p = 0.042 respectively). Conclusion: Early primary endoscopic realignment is better than delayed reconstruction in the management of male patients with posterior urethral injury. It provides less postoperative complica

关键词： Endoscopic Realignment Erectile Dysfunction Urinary Incontinence Urethral Injury Urethral Stricture

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Comparison of Sternal Wound Complication after Off-Pump CABG between Skeletonized and Pedicled LIMA Harvesting: A Single Centre Experience in Bangladesh

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World Journal of Cardiovascular Surgery 2023年第6期13卷 101-110页

作者： M. Asmaul Alam Al Nur md. Aslam Hossain md. Abir Tazim Chowdhury Farhat Tabassum Nishat Munama Magdum Department of Cardiac Surgery National Institute of Cardiovascular Diseases Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Casualty Dhaka Medical College Hospital Dhaka Bangladesh Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh

Background: Off-pump coronary artery bypass grafting (OPCAB) is a surgical procedure that has gained popularity due to its potential benefits over traditional coronary artery bypass grafting, including reduced morbidity and mortality. However, sternal wound complication (SWC) remains challenging following the procedure. The technique of left internal mammary artery (LIMA) harvesting has been shown to impact the incidence of SWC. This study aimed to compare the incidence of SWC between two techniques of LIMA harvesting, i.e., skeletonized and pedicled. Methods: The study was conducted at the Department of Cardiac Surgery, Bangabandhu sheikh Mujib Medical University, and included 60 patients who underwent OPCAB. The patients were divided into two groups of 30 each based on the technique of LIMA harvesting used, i.e., skeletonized (group A) or pedicled (group B). The postoperative ICU care was given to each patient as per the protocol. The statistical analysis was conducted using the SPSS version 26.0 for Windows software. Results: The results showed that 5 (8.33%) patients developed SWC, with 1 (1.67%) patient in group A and 4 (6.66%) patients in group B. However, the occurrence of SWC was not statistically significant between the two groups (p = 0.35). The mean age, gender distribution, and comorbidities such as hypertension, diabetes, dyslipidemia, and anemia were also not statistically significant between the two groups. The number of smokers was statistically significant between the two groups (p = 0.03), and the occurrence of SWC was found to be higher in smoker patients in group B (p = 0.04). Preoperative and postoperative parameters such as duration of operation, duration of mechanical ventilation, duration of chest drains, duration of the central venous line, and amount of postoperative mediastinal bleeding were also not statistically significant between the two groups. The distribution of wound complications, duration of ICU stays, and hospital stay between t

关键词： Sternal Wound Complication (SWC) Off-Pump Coronary Artery Bypass Grafting (OPCAB) Left Internal Mammary Artery (LIMA) Skeletonized LIMA Harvesting Pedicle LIMA Harvesting

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Effects of Combined Spinal Epidural Anaesthesia and Spinal Anaesthesia on Peri-Operative Pulmonary Status in Geriatric Patients in Lower Extremity Surgery

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Journal of Biosciences and Medicines 2020年第10期8卷 132-147页

作者： Sharmin Ara Begum A. K. M. Akhtaruzzaman Dilip Kumar Bhowmick Debabrata Banik md. Afzalur Rahman A. K. M. Shahidur Rahman md. Saydur Rahman Khandoker Moynul Hasan Mohammad Kamrul Ahsan md. Imrul Islam Muhammad Shamsul Arefin Tahmidul Islam Department of Anaesthesiology National Institute of Traumatology and Orthopedic Rehabilitation (NITOR) Dhaka Bangladesh Department of Anaesthesia Analgesia and Intensive Care Medicine Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Neuro-Anaesthesia National Institute of Neurosciences and Hospital (NINS) Sher-e-Bangla Nagar Agargaon Dhaka Bangladesh Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Anaesthesia Asgor Ali Hospital Dhaka Bangladesh Department of Pediatric Surgery Shaheed Suhrawardy Medical College and Hospital Dhaka Bangladesh Holy Family Red Crescent Medical College Hospital (HFRCMCH) Dhaka Bangladesh Department of Anaesthesiology and Intensive Care Unit (ICU) Rajshahi Medical College Hospital (RMCH) Rajshahi Bangladesh Department of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh

Background: Lower extremity surgeries performed in elderly people usually have high prevalence of peri-operative medical problems related to anaesthesia. The overall objective of peri-operative care of geriatric population is to fast recovery from anaesthesia and avoid functional decline. Objective: To compare the peri-operative pulmonary status of combined spinal epidural anaesthesia (CSEA) and spinal anaesthesia (SA) in geriatric patients underwent lower extremity surgeries. Methods: This prospective comparative study was conducted at Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2016 to June 2018. A total of 70 geriatric cases that underwent lower extremity surgeries were included in this study. Cases were randomly allocated into two groups;35 in Group A (CSEA) and 35 in Group B (SAB). The different outcome variables between the groups like-duration of anaesthesia, respiratory rates (RR), oxygen saturation (SpO2), end tidal CO2 (EtCO2), peak expiratory flow rate (PEFR), breath holding test (BHT), peri-operative side effects of anaesthesia and post-operative visual analogue score (VAS) were analyzed and compared by statistical tests. Results: The mean age, weight, BMI of Group A and Group B patients were not significantly different (p > 0.05). No significant differences were observed in duration of surgery, gender and ASA grade between the groups (p > 0.05). Mean duration of anaesthesia, mean time to achieve target level of sensory block and mean time to achieve complete motor block were significantly higher in Group A (p 2, PEFR and BHT of both groups were not significantly different (p > 0.05). Peri-operative side effects of anaesthesia and post-operative VAS were significantly less in group A patients (p <

关键词： Combined Spinal Epidural Anaesthesia (CSEA) Geriatric Patients Spinal Anaesthesia (SA)

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Prevalence of Depression in Pre-Dialytic Chronic Kidney Disease Patients Attending at a Tertiary Care Hospital in Bangladesh

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Journal of Biosciences and Medicines 2020年第12期8卷 135-148页

作者： A. K. M. Shahidur Rahman Mohammad Shamsul Ahsan Mohammad Kamrul Ahsan A. B. M. Mobasher Alam Tanvir Rahman Shahida Mullah md. Mustafizur Rahman Salahuddin Feroz Amir Mohammad Kaiser md. Shariful Haque Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Holy Family Red Crescent Medical College Hospital (HFRCMCH) Dhaka Bangladesh Department of Nephrology Rangpur Medical College Hospital (RMCH) Rangpur Bangladesh Department of Nephrology United Hospital Limited Dhaka Bangladesh Department of Medicine Sarkari Karmachari Hospital Dhaka Bangladesh Department of Nephrology Sheikh Hasina Medical College Tangail Bangladesh sheikh Hasina National Institute of Burn and Plastic Surgery Dhaka Bangladesh Department of Nephrology & Dialysis Gonoshaystha Somazvittik Medical College and Gonoshaystha Nagar Hospital Dhaka Bangladesh Department of Nephrology Shaheed M. Monsur Ali Medical College Sirajgonj Bangladesh

Background: Depression is a common and serious medical illness around the world. It occurs more frequently in patients with chronic illness than in the general population. It is a common psychiatric problem in patients with chronic kidney disease (CKD). Objective: To assess the level of depression in pre-dialytic CKD patients attending at a tertiary care hospital in Bangladesh. Methodology: This cross sectional study was conducted at Department of Nephrology, Bangabandhu sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2020 to June 2020. A total of 100 pre-dialytic CKD patients were selected by convenience sampling technique and their level of depression was assessed by Zung Self-Rating Depression Scale (ZSDS). Data were collected by existing questionnaire with face to face interview and analyzed by statistical test. Results: The mean age of the participants was 49.70 ± 11.80 years. Among them 64% were male, 95% were muslim, 98% were married, 65% were completed secondary/above higher secondary level education, 65% were unemployed and 55% were lived in urban area. It was observed that 65% participants were economically dependent to their family, only 6% were engaged in regular exercise, 14% had family history of depression, 8% were smoker and 12% were alcohol/drug abuser. According to the Zung Self-Rating Depression Scale (ZSDS) we found 29% participants were mildly depressed, 39% participants were moderately depressed and 18% participants were severely depressed. Prevalence of depression was 86% in pre-dialytic CKD patients. Of them, 7% was in CKD stage-I, 17.4% was in CKD stage-II, 19.8% was in CKD stage-III, 22.1% was in CKD stage-IV and 33.7% was in CKD stage-V. Conclusion: Depression is highly prevalent in pre-dialytic CKD patients and more frequent in the advanced stages of CKD.

关键词： Chronic Kidney Disease (CKD) Depression Zung Self-Rating Depression Scale (ZSDS)

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Journal of Diabetes Mellitus 2022年第4期12卷 243-251页

作者： md. Motiur Rahman Hafiza Sultana Farkhanda Mah Jebin Tanmoy Saha Wahida Yasmeen Foisal Mohammad Mosiul Alom Syeda Tahmina Ferdous Jinia Syed Ahmed Laiak Ahammed sheikh Sayera Khatun Medical College and Hospital Gopalganj Bangladesh National Institute of Preventive & Social Medicine (NIPSOM) Dhaka Bangladesh Khwaja Yunus ali Medical College Sirajganj Bangladesh Tooth Fairy Foundation Dhaka Bangladesh Udayan Dental College Rajshahi Bangladesh National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) Dhaka Bangladesh Institute of Epidemiology Disease Control and Research (IEDCR) Dhaka Bangladesh Bangabandhu sheikh Mujib Medical College Fraidpur Bangladesh

Introduction: The health related quality of life (HRQoL) has an important role in adults suffering from diabetes. Objective: To assess the health related quality of life in adult with type 2 diabetes mellitus. Materials and methods: A cross-sectional study was conducted to assess diabetic patient’s HRQoL on 119 purposively selected type-2 DM patients (aged ≥ 18 years and duration of diabetes ≥ 1 year). Data were collected by face-to-face interview and by medical record review through a Bangle version of SF-36 semi-structured questionnaire and a checklist. Place and period of study: The study was conducted at outpatient department in Gopalganj 50 bedded diabetic hospital from 1st January, 2018 to 31st December 2018. Results: The mean age of the respondents was 52.34 (SD ± 10.19) years. Age group shows a significant difference associated with all domains of quality of life except role emotion (>0.05), gender shows the significant in social and pain domain (0.05) respectively co-morbidity shows the significant difference with all domains expect pain (>0.05). Physical functioning, emotional, pain and general health of the quality of life show the significant difference associated with use of insulin (Conclusion: The overall QoL of type-2 DM patients was poor and had lower score of health related quality of life.

关键词： Type 2 Diabetes Mellitus Health Related Quality of Life Diabetes Mellitus

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Comparison of Serum Lipid Profile between Gestational Diabetes Mellitus and Pregnant Women with Normal Glucose Tolerance

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Journal of Biosciences and Medicines 2020年第6期8卷 148-159页

作者： Mahmudul Hossain A. K. M. Shahidur Rahman Samira Mahjabeen Mohona Zaman Mohaiminul Abedin Tahseen Mahmood md. Abdur Razzaque Ummul Khair Alam Department of Medicine Kurmitola General Hospital Dhaka Bangladesh Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Endocrinology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Endocrinology Monno Medical College Hospital Manikganj Bangladesh Department of Anatomy Abdul Malek Ukil Medical College Noakhali Bangladesh Department of Endocrinology BRB Hospital Limited Dhaka Bangladesh Department of Dermatology Khwaja Yunus Ali Medical College and Hospital (KYAMCH) Sirajganj Bangladesh Department of Maternal and Child Health (MCH) National Institute of Preventive and Social Medicine (NIPSOM) Dhaka Bangladesh

Background: Aberrant lipid metabolism presumed to have important relationship with gestational diabetes mellitus (GDM), though previous studies revealed inconsistent results on this area. Objectives: To identify the difference of serum lipid profile between gestational diabetes mellitus (GDM) and pregnant woman with normal glucose tolerance (NGT). Methods: This cross sectional study was conducted from January 2017 to December 2017 at Department of Endocrinology, Bangabandhu sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with 31 GDM and equal number of NGT pregnant women diagnosed on the basis of WHO criteria-2013, during 24 - 40 weeks of gestation. Glucose was measured by glucose oxidase method and fasting serum lipid profile [Total cholesterol (TC), High Density Lipoprotein-cholesterol (HDL-C) and Triglyceride (TG)] was measured by enzymatic-colorimetric method. Data were analyzed and compared by statistical tests. Results: Among total sixty-two (62) study subjects, 31 were GDM (age: 27.52 ± 4.8 years, body mass index (BMI): 27.17 ± 3.3 kg/m2) and 31 were pregnant women with NGT (age: 24.94 ± 4.2 years, BMI: 25.43 ± 6.5 kg/m2). Mean age of GDM group was significantly higher than that of NGT group (p = 0.028). Women with GDM showed relatively higher BMI than NGT women but that was not statistically significant (p = 0.194). Fasting lipid profiles between GDM and NGT (GDM vs. NGT;total cholesterol: 194.21 ± 42.18 vs. 208.52 ± 42.18 mg/dl, p = 0.187;HDL-C: 47.50 ± 16.17 vs. 47.18 ± 11.71 mg/dl, p = 0.928;LDL-C: 109.25 ± 28.80 vs. 119.30 ± 34.76 mg/dl, p = 0.220 and triglyceride 204.78 ± 58.50 vs. 202.34 ± 79.18 mg/dl, p = 0.891) were not significantly different. The variations in all lipid fraction values were not statistically significant among GDM women when analyzed between BMI groups holding BMI cut-off at 23 kg/m2. No significant differences of any valu

关键词： Gestational Diabetes Mellitus (GDM) Normal Glucose Tolerance (NGT) Serum Lipid Profile

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