Health Problems Among Forcibly Displaced Myanmar Nationals (FDMNs) Admitted To The Medicine Ward of Cox’s Bazar Medical College Hospital

Abstract Background Forcibly displaced Myanmar nationals (FDMNs) or Rohingya refugees are one of the vulnerable groups suffering from different kinds of health problems but have been less reported yet. Therefore, the study was designed to delineate the health problems among FDMNs admitted to Cox’s Bazar Medical College Hospital. Methods This hospital-based cross-sectional study was conducted at the Medicine ward, Cox’s Bazar Medical College Hospital, for a six-month period following approval. Rohingya refugees who were admitted during the study period were approached for inclusion. Informed written consent was ensured prior to participation. A structured questionnaire was used during data collection. Collected information was recorded in case record form. A total of 290 subjects were interviewed. Analysis was performed using the statistical package for social science (SPSS) version 20. Results The mean age of the participants was 48.76±18.67 years (range: 16-91), with a clear male predominance (60.7%). Family size ranged 6-8. All of the participants reported at least one of the illnesses. Of all, 29.66% patients reported disease of the respiratory system, and 26.9% reported disease of the gastrointestinal disease and hepatobiliary system. Accidental injury or injury due to electrocution or thin falls or snake bites was present in 10.4% of the cases. Among the single most common diseases, COPD (20%) was the most frequently observed, and the rest of them were chronic liver disease (13.1%), pulmonary TB (5.5%), ischemic stroke (5.5%), CAP (4.1%), acute coronary syndrome (3.4%), thalassaemia (3.4%) and hepatocellular carcinoma (3.4%). Among the top 6 reported diseases, PTB was more common in elderly individuals (p=0.29). The disease pattern was similar across the sexes among the refugees except community acquisition pneumonia (CAP), which was commonly observed among males (p=.004). Considering different age groups, genitourinary problems were more common in males aged >60 years, and rheumatology and musculoskeletal problems were equally affected in females aged between 40-60 years. Conclusion COPD, CLD and CAP were the most prevalent diseases in FDMN patients who attended the medicine ward of Cox’s Bazar Medical College Hospital. Further exploration is warranted before any policy making and comprehensive plan.

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An Epidemiological Study of Laboratory Confirmed COVID-19 Cases Admitted in Dhaka Medical College Hospital

Journal of Medicine ◽

10.3329/jom.v21i2.50208 ◽

2020 ◽

Vol 21 (2) ◽

pp. 69-75

Author(s):

Mohammad Murad Hossain ◽

Sayeef Hossain Khan Mark ◽

AKM Humayon Kabir ◽

Partha Pratim Das ◽

Md Khairul Islam ◽

...

Keyword(s):

Medical College Hospital ◽

Large Sample Size ◽

National Guidelines ◽

College Hospital ◽

Case Record ◽

Male Predominance ◽

Medical College ◽

Ethical Approval ◽

Epidemiological Characteristics ◽

Overall Mortality

Background: The objective of the study was to report the epidemiological characteristics of symptomatic laboratory confirmed COVID-19 patients seeking care from Dhaka Medical College Hospital (DMCH). Methods: This observational study was conducted in department of Medicine, DMCH for the period of 2 months following ethical approval. Total 100 RT-PCR confirmed COVID-19 patients were included and interviewed. Informed written consent was ensured before participation. Collected data were entered in a predesigned case record form and subsequently analyzed by SPSS-20. Results: Average age of presentation was 37.20±10.02(SD) years with male predominance (77%). Urban presence was in 90%. Thirty-two percent of the patients had comorbidities, with diabetes (16%) and hypertension (19%) being the most frequently observed.The most commonly observed symptoms was fever (65%), followed by cough (58%), breathlessness (42%), Dysgeusia (40%) and fatigue (33%). Mean duration of illness was 8.74±4.8 (SD) days. Overall mortality was 9%. All patients were managed according to the national guidelines and only 7% required ICU support. Conclusion: Patients were mostly middle-aged and male. Typical presentations were fever, cough, breathlessness and dysgeusia. Overall mortality was 9% among the admitted patients and requirement of ICU was 7%. Further study with large sample size is recommended to get a more precise picture. J MEDICINE JUL 2020; 21 (2) : 69-75

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Smartphone-based tele-electrocardiography support for primary care physicians reduces the pain-to-treatment time in acute coronary syndrome

Journal of Telemedicine and Telecare ◽

10.1177/1357633x17719395 ◽

2017 ◽

Vol 24 (8) ◽

pp. 540-546 ◽

Cited By ~ 3

Author(s):

Vivek Chauhan ◽

Prakash C Negi ◽

Sujeet Raina ◽

Sunil Raina ◽

Mukul Bhatnagar ◽

...

Keyword(s):

Primary Care ◽

Acute Coronary Syndrome ◽

Primary Care Physician ◽

Primary Care Physicians ◽

Intervention Group ◽

Care Physician ◽

Medical College Hospital ◽

College Hospital ◽

Medical College ◽

Coronary Syndrome

Background The Himachal Pradesh state acute coronary syndrome registry recorded a median delay of 13 h between the time of onset of pain to the time of making the diagnosis and giving treatment for acute coronary syndrome. We conducted a pilot study on providing 24-h tele-electrocardiography (Tele-ECG) services in the district Kangra of Himachal Pradesh, with the aim to reduce the time taken for diagnosis of acute coronary syndrome. Methods The intervention group for the study included eight rural community health centres, each with one to three primary care physicians, who were all unskilled in electrocardiogram interpretation. We provided them with 24-h Tele-ECG support. The primary care physicians used their smartphones to transmit the electrocardiogram image to the command centre, which was then read by the skilled specialist physicians in our medical college hospital and the report sent back within five minutes of having received the electrocardiogram. Antiplatelets were given by the primary care physician to patients diagnosed with acute coronary syndrome, who was then transported to the medical college hospital. The urban sub-divisional hospitals ( n = 6) formed the control group for the study. These hospitals had five to fifteen unskilled primary care physicians and one to two skilled specialist physicians; no intervention was done in this group. A pilot was run from February 2015–January 2016. Results We received 819 Tele-ECG consultations within the intervention group; 157 cases of acute coronary syndrome were confirmed and transferred to our medical college hospital facility. Similarly, we admitted 177 cases of acute coronary syndrome at the medical college hospital, who were first attended to by the primary care physician in the control group. Aspirin was administered to 91% and 58% of patients with acute coronary syndrome in the intervention and the control groups, respectively ( p < 0.0001). The median hospital-to-aspirin time (h) in the intervention and the control groups was 0.7 ± 1.45 h and 3.5 ± 10 h, respectively ( p < 0.0001). In the intervention group, 72% of the ST elevation myocardial infarction patients were diagnosed within 12 h by the primary care physician using Tele-ECG support. Interpretation and conclusions Smartphone-based Tele-ECG support for primary care physicians reduced the hospital-to-aspirin time in acute coronary syndrome significantly ( p < 0.0001). This is an effective low cost strategy and is easily replicable anywhere in the world.

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Epidemiological Profile of Pandemic Influenza A (H1N1) 2009 at Dhaka Medical College Hospital

Journal of Medicine ◽

10.3329/jom.v11i1.4259 ◽

1970 ◽

Vol 11 (1) ◽

pp. 3-6

Author(s):

Quazi Tarikul Islam ◽

Azizul Kahhar ◽

Syed Mohammad Arif ◽

Ahmedul Kabir ◽

Khan Mohammed Arif ◽

...

Keyword(s):

Pandemic Influenza ◽

Influenza A ◽

Medical College Hospital ◽

College Hospital ◽

Case Record ◽

Suspected Infection ◽

Medical College ◽

First Case ◽

Influenza A H1n1 ◽

Epidemiological Characteristics

The first case of 2009 pandemic influenza A (H1N1) virus infection in Bangladesh was documented on June 18. Subsequently, persons with suspected cases of infection and contacts of those with suspected infection were tested. Individuals in whom infection was confirmed were hospitalized and quarantined, and some of them were closely observed for the purpose of investigating the nature and duration of the disease. In Dhaka Medical College Hospital, there were 28 admitted patients in flu ward and 2335 registered suspected H1N1 influenza cases attended in flue corner but 833 highly suspected cases were recorded in case record form. We describe the epidemiological characteristics of 28 indoor (flu ward) and 833 outdoor (flu corner) patients. Most of them were in between 20 to 30 years age group. Among 833 outdoor patients 611(73.34%) were male and 222(26.65%) were female. 354 (42.49%) patients were student, 195 (23.40%) were service holder. No patients (indoor) had any serious underlying medical conditions. Keywords: Pandemic influenza A (H1N1), Dhaka Medical College Hospital, Bangladesh, epidemiology. DOI:10.3329/jom.v11i1.4259 J Medicine 2010: 11: 3-6

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Clinical Study of Snakebite Cases Admitted in Dhaka Medical College Hospital

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v13i1.19410 ◽

2014 ◽

Vol 13 (1) ◽

pp. 7-12

Author(s):

Prabal Chakraborty ◽

Jishu Deb Nath ◽

MA Faiz ◽

Anannya Das ◽

Abdul Qayum Chowdhury

Keyword(s):

Rural Areas ◽

Health Hazard ◽

Medical College Hospital ◽

Snake Bite ◽

College Hospital ◽

Venomous Snake ◽

Medical College ◽

Snake Bites ◽

Important Health ◽

Seeking Behavior

Background: Snake bite is an important health hazard which may lead to fatality in rural areas of Bangladesh. An epidemiological study estimated the incidence of snake bite in Bangladesh about 8,000 per year with 22% mortality. In majority of cases the victims die before entrance to hospital because of their treatment seeking behavior from Ohzas. Present study is to see the clinical profile of snake bite cases admitted in Dhaka Medical College Hospital and also to find out problems in diagnosis and management and outcomes.Methods: Fifty patients of snake bites treated in Dhaka Medical College Hospital, Dhaka, Bangladesh between July 2005 and December 2006 were studied. A questionnaire, containing information on bite, physical examination and identification of snake brought was used.Results: Among the patients venomous snake was 6 (50%) with cobra and 6 (50%) with suspected krait bite. Males were bitten more frequently than females 42(82%) versus 9(18%). Regarding occupation, 28 (56%) was farmer. Majority 37(74%) came from rural areas. Highest number of bite occurred in evening 20(40%). Most snake bite occurred during rural foot walking (30%) followed by sleeping (14%).Total 54% of bite occurred during outdoor activities. Most common site of bite is lower limb 35(70%). Tight tourniquet used in 45(90%) cases and in 8(16%) cases limb was immobilized. Twenty eight (56%) of the patients received treatment from Ohzas. All venomous bites (12) presented with features of neurotoxicity with local envenoming in 6(50%) cases. In 6(50%) cases there were only neuroparalysis. Four (33.34 % of venomous snake) patients required respiratory support and 10(83% of venomous bite) patients required antivenom. There were no anaphylactic reactions and only 2 patients suffered pyrogenic reaction. The outcome was excellent with only one death and only one case of residual effects.Conclusion: To develop an appropriate prevention and control strategy, reliable and timely information has a crucial role. A functional mechanism should be developed to gather information not only about the cases and deaths but other aspects of the snakebite epidemiology.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19410

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Clinico-Demograhic Profile, Treatment Outline and Clinical Outcome of 236 Confirmed Hospitalized COVID- 19 Patients: A Multi-Centered Descriptive Study in Dhaka, Bangladesh

Bangladesh Journal of Medicine ◽

10.3329/bjm.v31i2.48532 ◽

2020 ◽

Vol 31 (2) ◽

pp. 52-57

Author(s):

Quazi Tarikul Islam ◽

HT Hossain ◽

FR Fahim ◽

Mu Rashid

Keyword(s):

Clinical Outcome ◽

Treatment Protocol ◽

Descriptive Study ◽

Medical College Hospital ◽

College Hospital ◽

Case Record ◽

Medical College ◽

Global Pandemic ◽

Age Range ◽

Taste And Smell

Introduction :In Bangladesh, the first confirmed case of COVID1 9 was detectedon 8th March’2020, almost 3 months after the initial outbreak in late December’ 2019 in Wuhan, China.The number of affected cases and deaths both have become exponential during this global pandemic. Clinical data on COVID 19 in Bangladesh is still lacking. The objective of our study was to evaluate clinico-demograhic Profile, treatment Outline & clinical outcome within a defined period among COVID-19 Bangladeshi Patients. Methods: We conducted a retrospective multicenter descriptive study on epidemiological & clinical profile along with treatment outcomes of 236 Rt-PCR confirmed patients of COVID 19 from COVID dedicated units of 3 hospitals- Dhaka Medical College Hospital ( DMCH)(n-87), Kuwait Bangladesh Moitry Hospital ( KBMH)(n-50),Popular Medical College Hospital ( PMCH)(n-99) during the period of May to July 2020 with a pre-determined case record form. Results: Among the total 236 patients, highest percentage of patients (26%) belonged to 50-59 years age range, however it was found that no age was immune.Regarding gender distribution, two-third patients were male (65%) & one-third patients were female (35%).The predominant symptoms of our enrolled patients were fever (89%), cough (85%) & dyspnea (76%) ,fatigue (23%), chest pain (23%)& anosmia (19.5%), followed by gastro-intestinal symptoms. Almost half of the patients had been suffering from Hypertension (48%) and Diabetes (47%) Regarding treatment, 100% patients received tromboprophylaxis with low molecular weight Heparin (LMWH)& around 2/3 patients received steroid in different forms following treatment protocol of our national guideline. 20% patients required ICU support & death rate was 4.7%. Around two-third patients could be discharged in < 10 days’ time. Conclusion: Covid-19 in Bangladesh is presented in adult male with fever, cough and dyspnoea predominantly with occasional lack of taste and smell. Supportive care was effective with predominantly good outcome Bangladesh J Medicine July 2020; 31(2) : 52-57

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Demographic and Clinical profile of 190 COVID-19 Patients in a Tertiary Care Private Hospital of Dhaka, Bangladesh: An Observational Study

Journal of Medicine ◽

10.3329/jom.v21i2.50210 ◽

2020 ◽

Vol 21 (2) ◽

pp. 82-88

Author(s):

Homayara Tahseen Hossain ◽

Tasmina Chowdhury ◽

Maksudul Islam Majumder ◽

Arfa Rahman Ava ◽

Quazi Audry Arafat Rahman ◽

...

Keyword(s):

Tertiary Care ◽

Term Treatment ◽

Medical College Hospital ◽

Clinical Profile ◽

P Value ◽

Short Term Treatment ◽

College Hospital ◽

Case Record ◽

Medical College ◽

Significant Difference

From late December’19 till the end of August 2020, in this nine months period, world has lost more than eight hundred thousands people due to COVID-19 pandemic. Clinical data on COVID-19 in Bangladesh is less. The objective of our study was to evaluate demographic and clinical profile with in a defined period among COVID-19 Bangladeshi Patients in a Tertiary Care Private Medical College Hospital of Dhaka. We conducted a retrospective descriptive study on epidemiological & clinical profile along with short term treatment outcomes of 190 COVID-19 patients from COVID dedicated unit of Popular Medical College Hospital (PMCH) during the period of 18th June to 22nd August 2020 (2 months) with a pre-determined case record form (CRF).Among this 190 patients, mean age was found to be 53 years. Highest percentage of patients (44%) belonged to 41-60 years of age. Regarding gender distribution, two-third patients were male (65%) & one-third patients were female (35%). The predominant symptoms of our enrolled patients were fever (88%),cough (81%) , dyspnoea (58%) & fatigue( 50%). Around half of the patients had been suffering from Hypertension (54%) and Diabetes (47%). Almost half of our patients belonged to moderate severity (48%).The duration of Hospital stay was from 1-36 days, mean was 7 days. There was significant difference for severe and non-severe cases (p value 0.01). J MEDICINE JUL 2020; 21 (2) : 82-88

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Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

Journal of Surgical Sciences ◽

10.3329/jss.v22i2.44075 ◽

2020 ◽

Vol 22 (2) ◽

pp. 110-117

Author(s):

Md Mahmudul Islam ◽

Khondkar AK Azad ◽

Md Aminul Islam ◽

Rivu Raj Chakraborty

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Chest Trauma ◽

Road Traffic ◽

Tube Thoracostomy ◽

Rib Fracture ◽

Medical College Hospital ◽

College Hospital ◽

Medical College ◽

The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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