Rajshahi Medical College

Rājshāhi, Bangladesh

Rajshahi Medical College

Rājshāhi, Bangladesh
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Siddiq A.B.,Feni Diabetes Hospital FDH | Al Hasan S.,Rajshahi Medical College | Khan A.U.A.,Chittagong Medical College
Korean Journal of Pain | Year: 2011

Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties. © The Korean Pain Society, 2011.


Ali I.K.M.,University of Virginia | Haque R.,International Center for Diarrhoeal Disease Research Bangladesh | Alam F.,Rajshahi Medical College | Kabir M.,International Center for Diarrhoeal Disease Research Bangladesh | And 2 more authors.
Clinical Microbiology and Infection | Year: 2012

The results of Entamoeba histolytica infections range from asymptomatic colonization to variable disease outcomes. However, markers that may predict infection outcomes are not known. Here, we investigated sequence types of a non-coding tRNA-linked locus R-R to identify surrogate markers that may show association with infection outcomes. Among 112 clinical samples-21 asymptomatic, 20 diarrhoea/dysentery and 71 liver abscesses-we identified 11 sequence types. Sequence type 5RR was mostly associated with asymptomatic samples, and sequence type 10RR was predominantly associated with the symptomatic (diarrhoea/dysentery and liver abscess) samples. This is the first report that identifies markers that may predict disease outcomes in E. histolytica infection. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.


Khan M.G.M.,International Center for Diarrhoeal Disease Research Bangladesh | Bhaskar K.R.H.,International Center for Diarrhoeal Disease Research Bangladesh | Salam M.A.,Rajshahi Medical College | Akther T.,International Center for Diarrhoeal Disease Research Bangladesh | And 2 more authors.
Parasites and Vectors | Year: 2012

Background: Visceral leishmaniasis (VL) remains as one of the most neglected tropical diseases with over 60% of the world's total VL cases occurring in the Indian subcontinent. Due to the invasive risky procedure and technical expertise required in the classical parasitological diagnosis, the goal of the VL experts has been to develop noninvasive procedure(s) applicable in the field settings. Several serological and molecular biological approaches have been developed over the last decades, but only a few are applicable in field settings that can be performed with relative ease. Recently, loop-mediated isothermal amplification (LAMP) has emerged as a novel nucleic acid amplification method for diagnosis of VL. In this study, we have evaluated the LAMP assay using buffy coat DNA samples from VL patients in Bangladesh and compared its performance with leishmania nested PCR (Ln-PCR), an established molecular method with very high diagnostic indices. Methods. Seventy five (75) parasitologically confirmed VL patients by spleen smear microcopy and 101 controls (endemic healthy controls -25, non-endemic healthy control-26, Tuberculosis-25 and other diseases-25) were enrolled in this study. LAMP assay was carried out using a set of four primers targeting L. donovani kinetoplast minicircle DNA under isothermal (62 °C) conditions in a heat block. For Ln-PCR, we used primers targeting the parasite's small-subunit rRNA region. Results: LAMP assay was found to be positive in 68 of 75 confirmed VL cases, and revealed its diagnostic sensitivity of 90.7% (95.84-81.14, 95% CI), whereas all controls were negative by LAMP assay, indicating a specificity of 100% (100-95.43, 95% CI). The Ln-PCR yielded a sensitivity of 96% (98.96-87.97, 95% CI) and a specificity of 100% (100-95.43, 95% CI). Conclusion: High diagnostic sensitivity and excellent specificity were observed in this first report of LAMP diagnostic evaluation from Bangladesh. Considering its many fold advantages over conventional PCR and potential to be used as a simple and rapid test in the VL endemic areas of the Indian subcontinent, our findings are encouraging, but further evaluation of LAMP is needed. © 2012 Khan et al.; licensee BioMed Central Ltd.


Salam M.A.,Rajshahi Medical College | Khan M.G.M.,International Center for Diarrhoeal Disease Research | Mondal D.,International Center for Diarrhoeal Disease Research
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2011

This prospective study evaluated the usefulness of the kala-azar latex agglutination test (KAtex) for the diagnosis and laboratory assessment of initial cure of visceral leishmaniasis (VL) (or kala-azar) patients following 30 days of sodium antimony gluconate treatment at Rajshahi Medical College Hospital (Bangladesh). KAtex detects a low molecular weight, heat-stable, carbohydrate antigen in the urine of VL patients. KAtex was performed using freshly voided urine samples obtained from 36 parasitologically confirmed cases of VL before and after treatment as well as from 40 healthy controls (20 each from kala-azar-endemic and non-endemic zones). KAtex was found to be positive in 27 (75%) of the 36 patients at diagnosis and was negative in all the controls. The diagnostic sensitivity and specificity of KAtex were 75% (95% CI 57-87%) and 100% (95% CI 89-100%), respectively. Following treatment, all 36 VL cases were negative for Leishman-Donovan bodies by splenic smear microscopy and 34 (94.4%) were negative by KAtex. This limited study suggests that KAtex is a satisfactorily sensitive, highly specific, rapid and completely non-invasive urine-based antigen detection test for the diagnosis of VL. Currently, this is the only non-invasive laboratory tool useful for the assessment of initial cure in VL patients. © 2010 Royal Society of Tropical Medicine and Hygiene.


Salam M.A.,Rajshahi Medical College | Khan M.G.M.,International Center for Diarrhoeal Disease Research | Bhaskar K.R.H.,International Center for Diarrhoeal Disease Research | Afrad M.H.,International Center for Diarrhoeal Disease Research | And 2 more authors.
Journal of Clinical Microbiology | Year: 2012

Confirmative diagnosis of visceral leishmaniasis (VL) is still a challenge at the primary health care facilities in most of the rural areas of endemicity in the Indian subcontinent. Conventional methods for parasitological confirmation are risky and require skilled personnel, and hence they are unavailable to the poor people in the regions of endemicity. Buffy coat smear microscopy, as a minimally invasive, simple alternative for the parasitological diagnosis of VL, was evaluated in this prospective study. One hundred twelve VL patients were enrolled in this study. The buffy coat was separated from peripheral blood of all enrolled subjects using Histopaque-1119 solution. Leishman-stained buffy coat smears were examined for Leishmania donovani bodies, and buffy coat was also utilized for detection of parasite DNA by Leishmania nested PCR (LnPCR) for all cases. Concomitant splenic smears could be examined for L. donovani bodies in 66 cases, and the parasite load was graded on a scale of 1 + to 6 + for L. donovani-positive smears. All splenic smear-positive cases were also found to be positive by LnPCR. Of 112 enrolled VL cases, 103 (92%) were found to be positive for L. donovani bodies in buffy coat smear microscopy, which is promising as a confirmative diagnosis tool. We have also found a significant association of the buffy coat smear positivity with parasitic burden in the spleen smear. In this preliminary observation in Bangladesh, buffy coat smear microscopy has been found to be very simple, minimally invasive, and risk-free method of parasitological diagnosis of VL with a good diagnostic accuracy and potential for field use. Copyright © 2012, American Society for Microbiology. All Rights Reserved.


Akter M.L.,Islami Bank Medical College | Haque R.,Islami Bank Medical College | Salam M.A.,Rajshahi Medical College
Pakistan Journal of Medical Sciences | Year: 2014

Objective: Urine is the most frequent specimen received for culture/sensitivity by clinical laboratories. The microbiological performance of HiCrome UTI agar medium was compared with Blood agar and MacConkey agar for isolation and presumptive identification of bacteria from urine culture. Methods: A total of 443 consecutively collected midstream and/or catheter-catch urine samples from patients attending the Islami Bank Medical College Hospital, Rajshahi,Bangladesh during January to December, 2012 were cultured. Urine samples showing pus cells ≥ 5/HPF were inoculated on to Blood agar (BA), MacConkey agar (MAC) and HiCrome UTI agar (CA) media simultaneously and incubated overnight aerobically at 37 0 C. Rate of isolation and presumptive identification of bacterial species were compared for different media. Results: Culture yielded a total of 199 bacterial isolates from 189 (42.67%) positive plates including 179 (40.40%) unimicrobial and 10 (2.26%) polymicrobial (mixed growth of pair of bacteria) growths. Both HiCrome UTI agar and Blood agar media supported 100% growths while 151 (75.88%) growths were observed on MacConkey agar. The rate of presumptive identification was found significantly higher on HiCrome UTI agar (97.49%) than MAC agar (67.34%) (P<0.001) as primary urine culture medium. Of 199 isolates, E. coli was found to be the leading uropathogen isolated from 118 (59.30%) samples with its presumptive identification rate of 95.76%, 93.22% and 5.93% on CA, MAC and BA respectively. All 10 (100%) polymicrobial growths were demonstrated distinctly on CA against only 01(10%) on each BA and MAC. Conclusion: HiCrome UTI agar was found to be more useful as primary urine culture medium in both higher rate of isolation and presumptive identification of uropathogens in comparison to conventional media. Its inherent characteristics in demonstrating polymicrobial growth and ease of rapid identification by distinct colony colour are unique.


Mahmud S.,Rajshahi Medical College
Mymensingh medical journal : MMJ | Year: 2011

The objective of this study was to correlate hyperlipidemia during initial remission of nephrotic child with relapse. This observational prospective study was carried out among 26 children, between 1 to 8 years age with first attack idiopathic nephrotic syndrome, who was seen at Paediatric Nephrology Department of BSMMU and Paediatric Nephrology Department, NIKDU, from December'2005 to August'2006 and were followed-up for at least 6 months after initial attack. Twenty two age and sex matched hospitalized children, suffering from non-renal diseases, were enrolled as controls. Fasting blood samples for lipid profile were taken at the time of diagnosis of both cases and controls and also during remission of cases only. These patients were divided into two groups based on serum lipid profile during remission. Group-I consisted 16 patients who had normal lipid profile during remission and Group-II consisted 10 patients who had abnormal lipid profile during remission. Both Groups I & II had higher mean levels of serum cholesterol, LDL, TG and Lp(a) than those of controls during initial diagnosis. Between two groups on remission, Group-II patients showed higher mean serum cholesterol (332.9±105.19 mg/dL vs. 183.13±16.89 mg/dL; p<0.001), serum LDL (252±101.67 mg/dL vs. 119.19±21.33mg/dL; p<0.001), and serum TG (182.8±73.83 mg/dL vs. 93.31±20.95 mg/dL; p<0.001). Five patients out of 10 patients of Group-II (19% of total case) developed subsequent relapse within 6 months follow-up. Among the relapsers, mean cholesterol (334±46 vs. 232±34 mg/dL; p<0.05) was significantly higher than that of non-relapsers of Group-II patients. On the other hand, no patient of Group-I developed relapse within 6 months follow-up. It may be concluded from this study that hyperlipidemia in general at remission, specifically serum total cholesterol, may be regarded as predictor of relapse in childhood idiopathic nephrotic syndrome.


Haque R.,Islami Bank Medical College | Salam M.A.,Rajshahi Medical College
Pakistan Journal of Medical Sciences | Year: 2010

Objective: Extended spectrum ß-lactamases (ESBLs) represent a major group of lactamases currently being identified in large number worldwide mostly produced by gram-negative bacteria. The present study was done to see the frequency of ESBLs in gram-negative bacterial isolates causing nosocomial wound infections from a tertiary care hospital in Bangladesh. Methodology: A total of 125 wound swabs were collected from surgical site infections and burn cases, admitted in Rajshahi Medical College Hospital (RMCH), during January to June, 2008. Swabs were cultured for aerobic bacteria and antimicrobial susceptibility testing was carried out using the Kirby-Bauer agar diffusion method. Gram-negative isolates were tested for ESBLs on Mueller Hinton agar by both modified double disc and phenotypic confirmatory methods. Results: Culture yielded 71 (56.8%) bacterial growths with 60 (84.51%) gram-negative and 11 (15.49%) gram-positive bacteria (Staph aureus). Gram-negative isolates included 23 (32.39%) E. coli, 19 (26.76%) Klebsiella spp., 16 (22.54%) Pseudomonas spp., and 02 (2.82%) Proteus spp. The number of ESBL producing bacteria in modified double disc and phenotypic confirmatory methods were 28 (46.67%) and 25 (41.66%) respectively. Highest rate of ESBLs was observed in Klebsiella spp. (57.89%) followed by Proteus spp. (50.0%), E. coli (47.83%) and Pseudomonas spp. (31.25%), which showed significantly increasing resistance to 3rd generation cephalosporins, aminoglycoside, quinolone and trimethoprim-sulfamethoxazole. Conclusion: Significant number of nosocomial wound infections is caused by ESBL bacteria; those are not detected by routine antimicrobial susceptibility testing. It is recommended that clinical microbiology laboratory should take urgent measure for ESBLs detection as routine to enhance hospital infection control programme.


Habib M.A.,Rajshahi Medical College
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2012

To obtain a recent and comprehensive insight into the pattern of glomerular diseases in the Bangladeshi population, we studied 95 adequate renal biopsies done during July 2008 to June 2009, by light and direct immunofluorescence microscopy in the Department of Pathology, Rajshahi Medical College, Northern Region of Bangladesh. Of these, 38 (40%) were males and 57 (60%) were females, with a male to female ratio of 1:1.5. The most frequent clinical presentation was nephrotic syndrome (67.37%). Primary glomerular disease accounted for 91.25% of all glomerular disease and, of them, focal and segmental mesangial proliferative glomerulonephritis was the most common histological lesion in 29.47%. Diffuse mesangial proliferative glomerulonephritis (GN) was the second most common lesion (15.79%), followed by focal segmental GN (11.58%), minimal change disease (10.53%), membranous GN (7.37%), IgA nephropathy (6.85%), chronic sclerosing GN (2.11%) and crescentic GN (2.11%). Lupus nephritis was the most prevalent among secondary GN.


Haque M.M.,Rajshahi Medical College
Mymensingh medical journal : MMJ | Year: 2013

Metastatic squamous cell carcinoma of spleen is a very rare occurrence and a very small number of cases have been reported so far, mostly in autopsy series. More commonly observed metastasis to the spleen are from breast, lungs, colorectal organs and ovaries. Interestingly enough the spleen is very unusual site of metastasis from an esophageal malignancy, only very few cases (four cases up to 2005) being reported in the literature. A case of splenic metastasis from carcinoma of the esophagus in a 60 years old woman is presented in this report. Extraordinary merit of this case is that carcinoma of the esophagus was diagnosed after the patient had been operated for splenic abscess and was histologically diagnosed as metastatic squamous cell carcinoma of spleen. The patient underwent splenectomy and recovered well. Only during post operative period endoscopic examination of upper GIT with biopsy revealed carcinoma of the esophagus. Further investigations failed to delineate any other organ involvement. So, this case is being reported as metastatic squamous cell carcinoma of spleen from carcinoma of esophagus.

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