Introduction: Spirulina stands out as a sustainable bioactive microalga with health-promoting properties, and an important active ingredient of natural cosmetics products. Spirulina is a unicellular blue-green alga rich in vitamins, minerals, pigments, proteins, polysaccharides, which indicates a high potential use in anti-aging cosmetic products as well as for skin protection. Preliminary studies showed antioxidant potential, immediate benefits on the skin microrelief and hydration and skin compatibility of formulations containing Spirulina extract. Objective of this study: To assess the clinical profile of Spirulina on Skin Diseases-A Study In Tertiary care Hospital, Bangladesh. Methods: It is a descriptive study conducted at Dermatology and Venereology OPD in 250 bedded Mohammad Ali Hospital, Bogura and Rangpur Medical College Hospital, Rangpur, Bangladesh for the period from 1st January, 2020 to 31st December 2020. Fifty (50) healthy male and female participated in the clinical efficacy study, aged between 18-65 yrs. The gel-cream formulation, supplemented, or not (vehicle - FGV) with 0.1% (w/w) of Spirulina extract (FGA) was applied twice daily on the volunteers face region. The effects were evaluated in terms of skin hydration, transepidermal water loss-TEWL, skin micro relief, sebum content and morphological and structural epidermal features before and after a 28-day-period of application of the formulations. Results: A total of 50 patients were included in the study conducted over a period of 1 year, of which 25 (50.0%) were male and 25 (50.0%) were females. 50 healthy male and female participated in the clinical efficacy study, aged between 18-65 yrs. After 28 days of application of the formulation containing Spirulina extract, a significant increase of the stratum corneum water content was observed in both groups. This effect was more pronounced on the mature skin group. The formulation containing Spirulina extract increased stratum corneum water content and reduced the TEWL in both groups. However, a significant reduction in the older group, that received the formulation with Spirulina extract, was observed when compared to the younger group and to the vehicle formulation. Only the formulation containing the active ingredient under study reduced significantly the sebum content on the volunteer’s skin. It was also noted an improvement of the skin microrelief by the reduction of the surface roughness and after the treatment the keratinocytes were more uniformly distributed and homogeneous. Conclusion: The formulation containing Spirulina extract improved skin conditions and provided long term skin benefits such as hydration, protection of the skin barrier function and oil control. Finally, Spirulina extract stands out as a unique active ingredient for effective multifunctional dermocosmetic formulations for the care of young and mature skin.

Background: Acute myocardial infarction (MI) in young patients is a significantly raising problem particularly in Bangladesh. This has aroused considerable interest in recent years and being recognized with increasing frequency. The chest pain in younger age group may be misdiagnosed for other diseases. In addition, the various aspects of myocardial infarction such as risk factor profiles, clinical presentations and prognosis differ significantly in young people when compared to older patients. Objective: To study the clinical profile, risk factor profile and outcome of acute MI in young adults patients in Bangladesh. Material and Methods: This was a prospective study carried out at the Department Of Cardiac Surgery in Bangabandu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2018 to December 2019. 50 young persons below the age of 40 years admitted in ICCU for acute MI in young patients. The patients above the age of 40 years and below the age of 18 years along with those who had associated valvular heart disease and anemia have been excluded from the study. After a detailed history and thorough clinical examination routine investigations were done. Other investigations like ECG, serum cardiac markers such as CPK-MB, Troponin-I, LDH, SGOT and 2-D Echo was done to diagnose MI. A special attention was paid to risk profile. All the patients were given necessary treatment and they were followed up till the discharge from the hospital. These patients were also observed for development of any complication after the myocardial ischemia. Results: Out of 50 young MI patients, 47 patients were male and 03 patients were female. The mean age of the patients with acute MI was 34.33 ± 5.67 years, with a maximum number of patients (21, 42.0%) belonging to the age of 31–35years. Majority of the patients (47, 94.0%) were male. The most common presenting symptom (45, 90.0%) was chest pain. One or more risk factors were found to be present in 42 (84.0%) patients. Smoking was the most common (32, 64.0%) risk factor for MI followed by hyperlipidemia (21, 42.0%), hypertension (12, 24%), obesity (12, 24%) and diabetes mellitus (10, 20%). The most common type of MI was STEMI which was present in 46 (92.0%) patients. In that, Anterior wall MI was the commonest type seen on ECG (37, 74.0%). Arrhythmias were the commonest complication followed by left ventricular failure. All the patients responded well to the medical line of treatment except 3 who died because of cardiogenic shock. Conclusion: The incidence of acute MI in young patients is increasing day by day which was thought earlier less common among young individuals. This may be because of their lifestyle. Young MI is found to be more common in male gender. Smoking, dyslipidemia and obesity are found to be most common modifiable risk factors for MI. It is important to recognize these patients for the purpose of risk factor modification and secondary prevention in younger patients. Education of patients about smoking cessation and also education about modification of other risk factors in youngsters can serve as primary prevention for the disease.

Background: The uncinate process is a thin sickle shaped, hook like projection on the lateral wall of nose and medially it covers the maxillary and frontal sinus ostium. It is the key in the bony structures of the ethmoid in the lateral nasal wall, defining the semilunar hiatus together with the ethmoid bulla. Aim Of This Study: The aim of this study is to investigate the frequency of these variations in patients with sinonasal symptoms. Materials and Methods: This study was conducted in the Department of Otolaryngology at Combined Military Hospital, Rangpur and Border Guard Hospital, Dhaka during the period from April 2019 to July 2020. A total of 116 patients with the symptoms of nasal obstruction, nasal discharge, post nasal drip and headache patients who have been diagnosed clinically with chronic rhinosinusitis and nasal polyp willing to undergo endoscopic sinus surgery and high-resolution computerized tomographic (HRCT) scanning of paranasal sinuses were included in the study. Results: Among the 116 cases, normal angulation were found in 86 (74.13%) cases on the right side and 91(78.44 %) cases on the left side. Among the study population pneumatization were identified in 34 (14.65 %) cases. Among the study population pneumatization were identified in 34 (14.65 %) cases. Regarding the variations in the superior insertion lamina papyracea were most common on both right and left side. Conclusion: A sound knowledge of its variations is important not only for diagnosis but also for planning surgery in order to avoid complications. The study was performed to be investigate the frequency of anatomical variations of uncinate process on CT.

Background: Movement disorder is one of the commonly encountered problems in the course of pediatric neurology practice. The urge to understand the causes, clinical spectrum of pediatric movement disorders are increasing day by day as treatment has been largely based on clinical experience rather than evidence based as the clinical trials are limited. Objective: The objective of this study is to investigate the types of involuntary movements and its association with different neurological diseases. At the same time this study will also try to identify the relation of age, sex and perinatal insult with movement disorder. Method: A retrospective analysis was conducted with the secondary data obtained from the records of the patients with movement disorder in the Paediatric neuroscience department of Dhaka Shishu (children) Hospital over a period of 2years(January 2009 to January 2011). Result: Total 120 children were studied. Among them 86(72%) were male & 34(28%) female. Maximum 56 (47%) involuntary movement was present in children of 1-5 year age group. Regarding involuntary movement, dystonia 58(48%) was highest followed by chorea 26(22%). Dyskinetic cerebral palsy was 66(55%) the most represented cause followed by sequele of encephalitis 20 (16%). Perinatal insult was present in 92 (77%) children.

Introduction: The number of cancer survivors has steadily increased as a result of improved cancer treatments and early detection. Caregiver is an individual who has the responsibility of meeting the physical and psychological needs of the dependent cancer patient. High stress levels in family caregivers also can interfere with their ability to provide the, physical, emotional or logistical and financial support patients need. Aim of the study: The main aim of the study is to assess the effects of cancer caregiver’s demographics on Quality Of Life (QOL) and Strain Burden (SB) and there inter-relation on overall wellbeing of cancer care givers. Cancer is the most common condition followed by Dementia, Alzheimer’s disease associated with care giving. As cancer treatment progresses, the of care strain burden givers (CG) is likely to increase. Methods: This is a prospective observational study, carried out at Dept. of Clinical Oncology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh between January 2019 to December 2019 were included in the study. 120 caregivers of patients undergoing cancer treatment irrespective of type of cancer. The CG Quality of Life-Cancer Scale (CQOLC) and the Modified CG Strain Index (CSI) were used to assess QOL and SB of CG respectively. Appropriate statistical tests were used to assess interrelation of QOL and SB. Results: A significant correlation was found between CQOLC and CSI (R2=0.76). One way ANOVA revealed a significant difference in CQOLC and CSI of CG with respect to their relationship with the patient and their marital status (p<0.001). However, no such significant difference was found with respect to gender of the CG. Conclusion: This study examined many causes of CG’s QOL and SB, like gender, relationship and marital status. As the cancer intensifies, the QOL of CG reduced and was found to be directly proportional to SB. Structured CG counseling is required to improve their QOL.

Background: Osteoarthritis (OA) is a leading cause of disability and frequent visits to primary care practitioners for those with the condition in comparison to those without. OA affects the knee more often than any other joint of the human body. Platelet-rich plasma (PRP) which is also known as autologous conditioned plasma is a concentrate of platelet-rich plasma protein derived from whole blood, centrifuged to remove red blood cells. Now it is used in treating OA also. Aim of the study: The aim of this study was to evaluate Effectiveness of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis with WOMAC Score. Materials and methods: This prospective observational study was conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from 15th July 2017 to 30th June 2019. In total 120 patients more than 40 years of age, diagnosed with grade I and II arthritis were included in this study as the study population. To all the participants three PRP injections were injected in the knees at 4-week interval. Patients were followed up and were assessed for pain and physical activity associated with arthritis using the Western Ontario and McMaster University Arthritis Index (WOMAC) score at the time of induction in the study and at 6 months interval. Results: The mean WOMAC score before the starting of treatment was 82.94 (±5.12) and after 6 months it was reduced to 37.87 (±4.73), which was statistically significant (p= 0.0001). WOMAC score was improved more in the subgroup with patients having symptoms less than 2 years (p=0.0254). On the other hand, in case of subgroups with Kellgren-Lawrence grade 1 or 2 the p value was 0.0730 and there was not any significant difference in the WOMAC score at 6 months among males or females (p=0.1511). Conclusions: The proper sequential use of PRP injection for the treatment of osteoarthritis of knee-joint proved to be effective in our study. The findings of this study may be helpful in the treatment arena of osteoarthritis and in further similar researches.

Background: Intra-cytoplasmic sperm injection (ICSI) is used in assisted reproductive technology (ART) laboratories. However, there is no consensus regarding the precise time intervals within ICSI cycles [oocyte pick up (OPU), oocyte denudation (DN), and ICSI], and results are inconsistent and contradictory. Thus, we aim to evaluate whether there is a concordance regarding the time intervals used in different laboratories and a concrete time that gives better laboratory and reproductive results. Methods: A systematic review of the literature until December 31, 2020, was performed with the keywords “Oocyte Denudation/Denudation/Oocyte,” “Intra-cytoplasmic Sperm Injection/ICSI,” “Oocyte/Oocyte maturation/ cumulus,” and “Cumulus removal/ removal.” Articles and abstracts in English and involving human subjects referring to the effects of oocyte DN time on embryo development and clinical outcomes were included. Results: Of the 250 evaluated articles, 20 (including 15 full articles and 5 abstracts) were included in this review. Fifteen studies analysed the effect of OPU-DN time on embryo development and clinical outcomes. Most of these studies concluded that OPU-DN time did not influence ICSI outcomes, but some suggested that oocytes should be incubated for a short time before DN to improve oocyte maturity and enhance ICSI outcomes. In addition to reports on positive or negligible effects, adverse effects were reported in 8 studies on DN-ICSI timing. Neither OPU-DN nor DN-ICSI time could improve live birth rate. Conclusions: Oocytes should be pre-incubated for a short duration (preferably < 4 h) before DN according to the ART laboratory schedule. More randomised controlled trials are warranted to clarify the effect of DN-ICSI timing on ICSI outcomes.

Background: Percutaneous Coronary Intervention (PCI) is the preferred method of revascularization in Acute ST Elevation Myocardial Infarction (STEMI). Primary Percutaneous Coronary Intervention has emerged as the therapy of choice in STEMI and selected cases of Non-ST Elevation Myocardial Infarction (NSTEMI). As Percutaneous coronary intervention (PCI) enters its fourth decade of use, it is now the most commonly performed revascularization therapy worldwide. Objective: To find out the Complications and In-Hospital Mortality Rates after Percutaneous Coronary Intervention in ST Elevation Myocardial Infraction. Methods: It is a retrospective, single centre study, performed at Department of Cardiology, Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur, Bangladesh. All patients who underwent PCI for STEMI from November 2018 to July 2020 were enrolled in this study. All the data were collected from hospital registry and cath lab records. Results: The Study showed that out of 175 patients who presented with STEMI, 74.5% were male with average age of 56.50 years. The mean time of presentation after onset of symptom/s was 17.5 hours. About 68% patients presented in less than 12 hours of symptoms onset, 21.7% presented at 12-24 hours of symptoms onset and 10.3% patients presented late. PCI was done in 88.5% of patients. Almost all patients (98.3%) underwent coronary artery stenting with drug eluting stents. Multivessel PCI during index procedure was done in 7 patients. TIMI III flow following PCI was achieved in 97% cases. Average LVEF at discharge was 44.73%. Among the traditional cardiovascular risk factors, smoking was the commonest. Nearly 50% of the patients smoked while 36% were hypertensive, 27.2% diabetic, 2.6% had known dyslipidemia and 3.6% had family history of MI. 88.4% of patients presented in Killip class I while 5.6% patients presented in Killip class IV. Anterior wall STEMI was commonest accounting for 53% followed by Inferior wall, 41.8%. Angiography revealed SVD in 36%, DVD in 32.3%, TVD in 28.1%. Left Main Coronary Artery involvement was seen in 5 cases and 1, Left Main angioplasty was done. There were 3 deaths, all after Primary PCI. In-hospital mortality rates for patients presenting with and without cardiogenic shock were 38.46% and 1.59% respectively. The overall mortality rate was 3.98%. Conclusion: This study has reemphasized that PCI is effective in the management of STEMI cases in Bangladesh with improving mortality rates and decreasing complications. Minimizing the delayed presentation after the onset of symptoms should be one of the prime focuses for effective management of STEMI.

Introduction: Encephalitis is a severe central nervous system infection of the brain parenchyma leading to neurologic dysfunction, such as headaches and altered levels of consciousness. Acute encephalitis is one of the important causes of PICU admission. In most cases causes are unidentified, but causes are thought to be viral in many cases. Objective: To assess the clinical aspects and outcome in children admitted to PICU with acute encephalitis. Methods: This is a retrospective study conducted in the PICU of Dhaka Shishu (Children) Hospital in cases admitted over a period of one year, from January 2019-December 2019. Age group included was from 2 month to 12 years. All cases admitted with symptoms suggestive of acute encephalitis were included. History and relevant factors were collected from history sheet including clinical examination findings and were analyzed. Results: More cases are found in 1-5 years age group with mean age being 3.5±3.3 years. Similarity was seen regarding death in case of infant and older children. Male to female ratio was 1.6:1. Seizure was the most common presentation 34(91.66%) but it has no statistical significance related to mortality. GCS was <8 during presentation in 22(45.83%) cases. Viral analysis done in CSF of 12 patients (25.0%) where Herpes virus was found in 16.6%. Number of patients improved with sequel 68.75% & improved without any sequel 31.25%. Hyponatremia, shock & need of mechanical ventilation was statistically significant regarding mortality. Hypernatremia didn’t seem to influence the mortality significantly. Conclusion: Hyponatremia being significantly associated with mortality among children with Acute Encephalitis, warrants detailed evaluation to define its association with etiology and appropriate management. Maintaining euvolemia, prompt identification of shock and appropriate use of inotropes is of utmost importance. Patients presenting with low GCS score & those who need mechanical ventilation high supervision should be provided due to their poor outcome. Diverse and changing etiologies pose a diagnostic challenge and to find out etiology should be emphasized.

Introduction: Clubfoot or talipes equinovarus (TEV) is the most common and significant congenital orthopedic deformaties present in pediatric surgery. The incidence is 1:900 and about 5000 child born with clubfoot in Bangladesh per year. Etiology of clubfoot is not clear yet, most commonly idiopathic but there are many theories that favors both genetic and environmental factors are responsible. Other risk factor includes oligohydromnios, family history, first baby, male baby, twin pregnancy. Neglected clubfoot deformity leads to long-term disability for the children, limited socialization, limited opportunities to work and burden for a family in lower middle income country (LMIC). As talipes equinovarus is an obvious deformity, no specific investigation is required to diagnose although it can be diagnosed prenatally by high resulation ultrasonogram during second trimester of pregnancy. Ponseti method of treatment is considered gold standard for clubfoot deformity. Methods and Results: It is a retrospective study and sample was taken from Dhaka shishu (children) hospital, which is the largest dedicated children hospital in Bangladesh. Clubfoot child attend at surgery out patient department (SOPD) and manage at TEV clinic. The child with clubfoot assessed by surgeon and classified by Pirani score. All clubfoot patient below the age of three months included and who had arthogryposis multiplex congenita, spine deformity and had history of surgical intervention were excluded from this study. A total of 322 patient attened at TEV clinic from January’19 to December’19. Among them 93 patient were enrolled as new in this study year. Other patients were continuing their treatment and follow up. Among these new patients, male 55(59.14%) child were pre-dominant that is 1.69:1. Mean age was 23days. Bilateral involvement were 36(38.71%), Total 71 (76.34%) patients needed tenotomy. Most of the patients’ needs 6 to 7 serials of plaster (30.10 to 36.56%). Conclusion: Nonsurgical management of clubfoot patients has good outcome and less complications if they attend in health center early of age. Ponseti methods is effective and less chances of recurrence and reduce the need of surgical treatment. Effective awareness campaign and counseling of parents can show good compliance to treatment.

Background: Preeclampsia (PE) especially severe or early PE, is a leading cause of morbidity and mortality among the mothers and infants. To determine the maternal risk factors and fetomaternal outcome of severe preeclampsia. Objective: To find out the Risk factors of Gestational Hypertension-Preeclampsia in Pregnant Women Patients aged within 20-35 Years with Fetomaternal Outcome & Its Perioperative Management. Methods: It was a case control study, done in a Department of Anaesthesiology and ICU, Shaheed ziaur Rahman Medical College & Hospital, Bogra, Bangladesh during a period of six months from January to Jun-2018. Among 131 patients with severe preeclampsia and normal pregnant women admitted. Sampling technique were consecutive sampling methods. Singleton pregnancy between 28 to 40 weeks of gestation with severe preeclampsia was selected as study patients. Written informed consent was obtained. A questionnaire was completed for each patient including patient's age, gestational age, and parity, History of hypertension in family, weight and Body Mass Index (BMI) and PIH time level. Results: This study was out of 131 pregnant women with PIH 51 (38.93%), severe PIH 45 (34.35%), Eclampsia 24(18.32%) and Ch. Hypertension 11(8.39%) were age variation. Among the 81 cases and 50 controls regarding different risk factors age 20-35 Yrs. BMI, history of precelampsia, were found significant (p<0.05) between two groups. Among the case group, patients developed eclampsia 2(4.0%) abruptio placenta 3(6.0%) HELLP syndrome 2(4.0%) ascites 4(8.0%) and oliguria1 (2.0%). Among the 81 cases and 50 controls regarding different risk factors age 20-35 Yrs. BMI, history of precelampsia, were found significant (p<0.05) between two groups. Among the case group, patients developed eclampsia 2(4.0%) abruptio placenta 3(6.0%) HELLP syndrome 2(4.0%) ascites 4(8%) and oliguria1 (2.0). 64 (48.5%) pregnant women with PIH were having gestation time less than 28 weeks, 52(39.6%) of pregnant women with PIH were gestation time between 28-37 weeks, 11 (8.3%) of pregnant women with PIH were gestation time between 37-40 weeks, 4 (3.0%) of women with PIH were P1L1. Most 56.0% of the neonates had APGAR score 4-6 at 1 minute in case group and 12(24.0%) in control group. Showing different risk factors where regarding age 35> years, 15 patients found in case group and 4 patients in control group. Significant (p<0.05) difference was found between two groups. Patients had 4.93 times more likely to developed preeclampsia. Take baby in home safely in 35(70.0%) in cases group and 50(100.0%) in control group. Early neonatal death was found in 5(10.0%) in case group and not found in control group. Still birth was 10(20.0%) case group and not found control group. Statistically significant (p<0.05) difference was between two groups. There was found to be that still eclampsia and severe PIH contribute significantly to foetal and maternal morbidity and mortality. Conclusion: Preeclampsia is a leading cause of both fetal and maternal morbidity and mortality in the developing countries. Maternal and fetal outcome are worse in severe preeclampsia.

Background: Trochanter fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. Fracture of the proximal part of the femur are an important cause of morbidity and mortality in all age groups, especially the elderly. Proximal femoral nail and dynamic hip screw system are two widely used methods in treating trochanter fracture of femur. Objective: The aim of this study was to evaluate postoperative outcome of elderly patients with trochanter fracture. Methods: The present prospective comparative study has been done in Sheikh Hasina Medical College and Hospital (SHMCH), Jamalpur, Bangladesh during the period from January 2019 to December 2020. During this period obeying inclusion and exclusion criteria 30 patients of unstable intertrochanteric fractures of femur were finalized as the study people. Among them 14 cases were treated with PFN and 16 with DHS. All statistical analysis of different variables was analyzed according to standard statistical method by Fisher’s Exact Test and Student t-Test and done by using SSPS method in computer. Results: In this study 63.3% of the subjects were 65 or above 65 years and 10% below 50 years of age. Sixty percent (60%) were male whereas 40% were female. House-wife comprised the main bulk (40%) as occupation. Other occupants were service holders (13.3%), businessman (13.3%), farmer (10%) and day-laborer (3.3%). The rest 20% were involved with other informal jobs. Causes of injury revealed that 26.7% trochanter fractures were caused by RTA and 36.7% by fall from height and 36.7% by accident at home. Two-third (66.7%) of the injuries had right-sided involvement. More than half (53.3%) of subjects were operated within 7 days of the incident. Conclusion: In this study, the highest cases of Trochanter Fracture of Femur were found from aged people. Involvement of male patients was higher than female. Involvement of housewives was also alarming. Two third portion of involvement of right sided fractures was also noticeable in this study.