Case Report of Multisystem Inflammatory Syndrome in a Child Related to COVID-19

Background : Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition that appears to be linked to Coronavirus Disease 2019 (COVID-19). Most children who become infected with the COVID-19 virus have only a mild illness. Aim of this study to evaluate the children who go on to develop MIS-C, some organs and tissues-such as the heart, lungs, blood vessels, kidneys, digestive system, brain, joints, skin or eyes -become severely inflamed. Case Report : 11 years old girl admitted in Paediatric Ward of in Imperial Hospital Chattogram on 12 July 2020 with the complains of fever, loose motion, rash in hands, body and legs, swelling of the wrist and ankle joints which were associated with anorexia, nausea , vomiting and bodyache. For this reason the child was evaluated. Conclusion : Clinical features in children have varied but predominantly include cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-Reactive Protein (CRP) Ferritin, D-dimer and Interleukin-6. MIS-C can lead to shock and multiple organ failure requiring intensive care. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 89-92

Current Status of Adverse Drug Reaction Reporting by the Physicians in A Medical College Hospital

Background: In order to improve the spontaneous Adverse Drug Reaction (ADR) reporting practice by the physicians, there is an obligatory need to investigate the current situation of ADR reporting by them. The study was conducted to observe the ADR reporting pattern among physicians in a tertiary medical college hospital. Materials and methods: This was a descriptive cross sectional study carried out in a tertiary medical college hospital during the study period of March 2020 to October 2020. Data were collected from 100 physicians working on different departments using self designed pretested questionnaire by convenient sampling technique. Results: Among the 100 respondents 70 provided response to questionnaire giving a response rate 70%. Most of the respondents (61.43%) had adequate knowledge on ADR reporting. A good number of respondents showed positive attitude but there is no practice of ADR reporting though most of the respondents (84.3%) had experienced it in last 1 year. Most of the respondents experienced ADR with antibiotic (81.35%), NSAIDs (33.89%) & anticonvulsants (15.25%) and maximum (44.06%) experienced ADR was with skin, 30.50% with GIT and 23.03% with respiratory system involvement. The cause of under reporting was mainly due to inaccessible ADR form, busy schedule, unaware of how and whom to report and lack of motivation to report. The respondents would be encouraged to report ADR if they were provided with simple & available reporting form, regular guideline & bulletin. Conclusion: There is an urgent need for educational training & seminar regarding our national online reporting system to emphasizing ADR reporting. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 8-13

Social Media for the Surgeon

not available Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 1-2

Vitamin D Deficiency and Associated Factors in Adult Females of Chattogram

Background : Vitamin D is an essential nutrient and deficiency of it leads to devastating disorders. This study aimed to find out the associated factors with selected variables of low vitamin D among adult females of Chattogram. Materials and methods : Cross-sectional observational study was conducted from September 2019 to February 2020 at a diagnostic complex of Chattogram. Participants were adult females of Chattogram. All participants gave oral informed consent and answered a questionnaire that included 16 questions covering demographic information, monthly income, educational status, occupation, body weight, duration of sun exposure, dress pattern (Using hijab or burkha, regular dress-up) drug and disease history. Blood samples were collected by cautious aseptic procedure. Serum vitamin D levels were measured by using immunoassay method. Adult females of Chattogram with no religious restrictions, n= 150,aged 31 to 70 years. Results: Overall, 88% had low vitamin D levels with deficient 60.66% and insufficient 27.34%. Sufficient level of vitamin D was found only among 12%. The prevalence of vitamin D deficiency was much higher in females with house-wife status 73.33% (p value of 0.0001) wearing hijab 46.66% (p value of 0.001). It could be due to interference with UVB radiation into skin, short duration of sun exposure, use of sunblock cream or less supplementary intake. Conclusion : Vitamin D deficiency is an emerging but neglected health issue in modern time, particularly more vulnerable are female population. Ironically, abundant sunlight of Bangladesh seems failed to protect the self-imposed concrete prisoner, classically known as home-makers, and practitioner of indoor life style that leads to avoidance of sun light. However, large sample size is mandatory to boost-up the findings of current study. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 74-78

Assessment of Nutritional Status between Children with Autism Spectrum Disorder and Normal Children of Bangladesh

Background : Autism is one of the fastest spreading neuro-developmental disorders in the worldwide.Children with Autism spectrum disorder may be risk of suboptimal development which leads to increases morbidity, poor physical activity and performances. The aim of present study was to compare nutritional status between children with Autism spectrum disorder and normal children of Bangladesh. Materials and methods: It was cross-sectional and observational study. The study population was Group A consists of 100 normal Bangladeshi children and Group B consists of 100 Bangladeshi children with Autism spectrum disorder, aged between 02 and 18 years collected by convenient sampling. Height, weight, triceps skin fold thickness, suprailiac skin fold thickness and Body Mass Index (BMI) were analyzed. Results: Children with autism spectrum disorder had statistically significant lower height and weight; thicker triceps and suprailiac skin fold, were mostly under weight as compared to normal children. Conclusion: The results of this study provide the baseline information about nutritional status of normal children and children with autism spectrum disorder in Bangladesh which will help to monitor nutritional growth of children. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 55-59

Incidence and indications of LSCS among Doctors Community of Chattogram

Background: Lower segment caesarean section (LSCS) is a surgical intervention, which is carried out to ensure the safety of mother and baby when vaginal delivery is not possible or when danger to mother and baby would be greater with vaginal delivery. This study is designed to identify indication of LSCS and detect complications if any among the respondents. Materials and methods: Cross sectional descriptive study where 95 female doctors of Chattogram were selected by convenient sampling without knowing their mode of delivery and if it is LSCS then indication of LSCS , maternal and neonatal complications were noted. Results: Age of the respondents at the time of interview were noted and most of them were between 31- 40 years 52 (55%), regarding income most of them between 100000 -200000 42(44%) most of the delivery occurred in the private clinics 92 (70%) regarding mode of delivery, LSCS was 92 (70%) vaginal delivery 40 (30%) regarding indications of LSCS most common was repeat caesarean section 27 (29%) and second common was LSCS due to maternal interest 18 (20%) and others were severe preeclampsia 10 (11%) fetal distress 08(09%) placenta previa, Diabetes with big baby, cephalopelvic disproportion, PROM with non progression of labour. PPH was the most common complication 05 (63%), next was paralytic ileus 02 (25%) and left ventricular failure 01 (12%). Common neonatal comoplications were low birth weight baby 904 (40%), prematurity 03 (30%) and birth asphyxia 03 (03%). Conclusion: LSCS is a major surgical procedure for delivery. Inspite of its low maternal morbidity and mortality due to improved surgical technique, modern aneasthetic skill and availability of blood and blood products, still it carries a slightly greater risk in subsequent pregnancy, so we should be rational in doing primary caesarean section. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 37-40

Space Closure Rate in Mandibular Canine Retraction by Elastomeric Power Chain: A Clinical Trial

Background : On a daily basis, orthodontic patients present with malocclusions and orofacial imbalance. Often times, teeth must be extracted in order to obtain proper esthetics, occlusion, and stability as well as extraction of teeth is often a need to close residual space, after the initial decrowding and aligning. Pre adjusted fixed orthodontic appliances commonly utilize sliding mechanics for space closure with different types of force delivery systems. A variety of materials have been used as force delivery systems to close spaces between teeth as in the case of canine retraction after the extraction of premolars. Elastomeric auxiliaries are relatively consistent in producing tooth movements. The purpose of the study to evaluate the rate of mandibular canine retraction by elastomeric power chain. Materials and methods : This obervational study was designed as split mouth study. A total number of 20 patients (40 quadrants),who required canine retraction into first premolar extraction sites as part of their orthodontic treatment in the Department of Orthodontics, BSMMU as study population. The quadrants were affixed by elastomeric power chain (Dentaurum) with 200gm force measured by Correx Tension Gauge. Space closure was measured by means of direct measurement from the mesial surface of mesial wing of the 2nd premolar bracket and the distal surface of distal wing of the canine bracket with digital Vernier Calipers. Results: Mean space closer rate in mandibular canine retraction was 0.99 ± 0.08 mm/month in elastomeric power chain method with p value<0.001. Conclusion : This study revealed that space closer rate in mandibular canine retraction was 0.99 ± 0.08 mm/month by elastomeric power chain. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 28-31

Clinical Evaluation of Glass-Lonomer Cement and Giomer for the Management of Cervical Caries

Background: Giomer is a unique class of restorative material has been introduced as the true hybridization of Glass Ionomer (GI) and composite resin and has the distinguishing feature of a stable surface pre-reacted glass ionomer. Glass Ionomer Cements (GIC) are also unique restorative materials with many uses in clinical practice and provide for caries-protective fluoride releasing at the margins of restorations, as well as their ability to have the fluoride within their chemical matrix recharged by outside exposure to other fluoride-containing materials. The present study aim at clinically evaluate the comparison between the glass Ionomer cement and Giomer for the management of cervical caries. Materials and methods: The study was a cross sectional comparative study which was carried out from 01 December 2018 to 31 November 2019 in the Department of Conservative Dentistry and Endodontics, Bangladesh Dental College, Dhanmondi, Dhaka. Total number of cases was 80. The patients were divided into two groups, half of the patient (Group-1) was treated with Glass Ionomer cement and half of the patient (Group-2) was treated with Giomer restoration. The post-operative sensitivity discoloration, dislodgement of filling material and secondary caries formation were recorded. All the patients were assigned and the data were analyzed statistically by SPSS version 21. p-value < 0.05 was taken as significant. Results: The study reveals 60% of the study population was within 41 to 50 years of age group (Group-1) and 62.5% were 51 to 60 years (Group-2) 45% in (Group-1) and 10% in (Group-2) had history of post filling sensitivity, 12% in (Group-1) and 5% in (Group-2) had discoloration after restoration, 2.5% had history of dislodgement of the filling in (Group-1), no history of dislodgement of the filling in (Group-2), 2.5% had history of secondary caries formation in (Group-1) and no history of Secondary caries formation in (Group-2). Conclusion: Patients were more approachable for Giomer restoration than Glass ionomer for the management of cervical caries over a period of 12 month. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 60-64

Substitution Buccal Mucosal Graft Urethroplasty for Long Segment Anterior Urethral Stricture : Our Experience in Dorsolateral Onlay Approach

Background: Currently the most favorable single stage procedure for management of long segment anterior urethral stricture is dorsal onlay technique of urethroplasty. This required circumferential extensive mobilization of the urethra, which might cause ischemia of urethra in addition to chordee. To evaluate the short term outcome of dorsolateral onlay BMG (Buccal Mucosal Graft) urethroplasty by unilateral urethral mobilization for treatment of long segment anterior urethral stricture Materials and methods: A prospective experimental study from January 2016 to December 2018 is carried out in Department of Urology, Chittagong Medical College Hospital (CMCH) Chattogram, Bangladesh. Total 32 patients of long segment anterior urethral stricture were treated by dorsolateral onlay BMG urethroplasty by unilateral urethral mobilization. Stricture >2cm were included; RGU, MCU and Uroflowmetry were the mainstay of assessment. Success was defined as maximum flow rate >15 ml/s, normal RGU and/ urethroscopy. Failure considered as presence of obstructive symptoms, Qmax < 15 ml/s, stricture on RGU and any post-operative urethral intervention. Results: Mean stricture length was 48.72mm (Range: 30-77mm) and mean follow up time was 22.4months (Range: 12-40 months). Three patients were found to develop stricture at proximal anastomotic site during follow up and required optical internal urethrotomy and considered as failure. 01 patients developed Surgical Site Infection (SSI) which resolved after regular dressing. Success rate was 90.7% Conclusion: Dorsolateral onlay BMG urethroplasty by unilateral mobilization is feasible, safe and easily adoptable for long segment anterior urethral stricture with good short term outcome. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 14-17

Placental Polyp : A Rare Case Report

Placental polyp is the retained fragment of placental tissue which presents as a polypoidal or pedunculated mass within the uterus. It is a rare entity and has an incidence of less than 0.25 % of all pregnancies. There are also very few reported cases of the clinical placental polyp. Here,we report a case of 22-year-old P1 woman presenting with vaginal bleeding and something coming down into vagina.Her last pregnancy had occurred one year ago.Laboratory investigation revealed slightly elevated serum b-hCG. Ultrasonography revealed thick endometrium, broad cervix (5.2cm) and a hyperechoic mass within the cervix. Extraction of the placental polyp followed by endometrial curettage were done and tissue sent for histopathology. Definite diagnosis was made by histopathological examination and which was a placental polyp. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 85-88