Positivity of COVID -19 Cases among the Patients Attending Flu Corner of Emergency and Casualty Department of Mymensingh Medical College Hospital

Recent COVID-19 pandemic has changed health resource disposal plan and urged relocation of work force to defend the world from devastation of this emerging disease. This cross-sectional observational study aims to categorize and rationalize COVID-19 testing of all patients attending flu corner of One Stop Service (OSS) in the department of Emergency and Casualty (E&C) in Mymensingh Medical College Hospital (MMCH) during 15th April 2021 to 14th May 2021 on 2627 patients as per inclusion and exclusion criteria. Out of 2627 patients 920(35%) were symptomatic cases and 1707(65%) attended for testing without symptom. Out of 920 symptomatic cases 175(19%) were confirmed COVID-19 cases. Among the confirmed cases 38(21.71%) was admitted whereas, from suspected cases 100(13.42%) got admitted, remaining patients from both categories were advised for home isolation. Coverage and justification of COVID-19 testing should be done precisely to ensure proper disease control and COVID care during this pandemic.

Self-Inflicted Pneumomediastinum: A Case Report

Self-inflicted wound can present with various scenarios. It is well known that the purpose of a self-inflicted wound is to avoid obligatory duties. During war, soldiers get self-inflicted wounds to seek medical leave in the hope to save their lives from deadly battle. Self-induced pneumomediastinum from oral lesion with valsalva maneuver was a rare practice among prisoners to get rid of that imprisoned life and to stay in the hospital. Self-inflicted wound is also commonly seen in patient with psychosomatic disorders. It relates observations from forensic medicine and psychiatry to specific clinical symptoms, toxicological circumstances and social influences e.g. stress incurred by everyday life, war, imprisonment etc. In particular cases, it clears up criminal and civil jurisdiction. It also gives importance to private insurers about cases of self-mutilation. There is also concern about insurers, forensic scientists and psychiatrist about their responsibilities and the procedure they follow in the examination, their jurisdiction and the treatment involving the cases of self-inflected injuries. To our knowledge, self-inflicted subcutaneous emphysema causing pneumomediastinum by a normal young boy out of curiosity and without any apparent ill motive, is an unusual finding and possibly no such case report was published before.

Need Assessment for Updating the MBBS Curriculum 2012 of Bangladesh

Curriculum is the road map of any course and an instrument for developing the competencies of the human resources. The MBBS curriculum in our country was last updated in 2012 during the period of Millennium Development Goals (MDGs). Since then it has been under implementation in different government, non-government and Army medical colleges in association with different universities. "Health Professional for a New Century" now asks for a transformation of the education to strengthen the health systems for meeting the challenges of the 21st century. Curriculum reform is an important issue in transformative education and need assessment is the first and essential task to review and update any curriculum. The objective of the study was to assess the need to review and update the MBBS curriculum 2012 of Bangladesh. Review and updating of MBBS curriculum was organized by Centre for Medical Education (CME) and supported by World Health Organization (WHO). CME, DGHS, Dean offices, MOH&FW, BM&DC and all the government and non-government medical colleges were involved in this activity. Duration of study was 7 months from April 2019 to October 2019. Data were collected from academic councils of 102 medical colleges through structured questionnaire and through FGD with teachers and interns. Around 90(88.2%) academic councils agreed and 12(12%) disagreed about the appropriateness of existing four phases of MBBS curriculum. About 80(84.2%) academic councils agreed with 1.5 years duration of Phase I, 84(88.4%) agreed with one year duration of Phase II, 84(94.4%) agreed with one year duration of Phase III and 77(84.6%) agreed with 1.5 years duration of Phase IV. The study suggested the subjects for 2nd phase are, Pharmacology 74(84.1%), Pathology 53(60.3%), Forensic Medicine 46(52.3%), and for 3rd phase are Community Medicine 60(69.8%), Microbiology 54(62.8%). The study revealed that the subjects of overloaded contents are, Anatomy - 24(50%), Community Medicine - 35(72.9%) and Pathology - 19(39.6%). The study suggested incorporation of organized teaching-learning for behavioral science, communication skills, ethics and development of attitude by most of the academic councils. The study suggested that the increased duration of ambulatory care (outdoor/emergency) teaching. The study revealed around 84(83.2%) academic councils recommended that Single Best Answer (SBA) type of questions should be included in MCQ part for all subjects along with multiple true-false response and around 82(81.2%) academic councils recommended that Structured Essay Question (SEQ) should be included in written part along with Short Answer Question (SAQ). The study revealed that 58(58.6%) academic councils recommended that carry-on system should not be in Phase I and 53(53.5%) academic councils opined to introduce grading system in MBBS course. Most of the academic councils agreed about the appropriateness of existing four phases of MBBS curriculum. The subjects for 2nd phase are, Pharmacology - 84.1%, Pathology - 60.3%, Forensic Medicine - 52.3%, and for 3rd phase are Community Medicine - 69.8%, Microbiology - 62.8%. Most of the participants are in favour of the present curriculum components, grading system for assessment but not the carry-on system in Phase I. The study recommended for national level consultations involving the concerned persons for finalization of the MBBS curriculum.

Pregnancy with Klippel-Trenaunay Syndrome: A Critical Case Report

Klippel-Trenaunay Syndrome (KTS) is a rare congenital disease characterized by a triad of cutaneous hemangioma (port-wine stain), varicose veins and bone or soft tissue hypertrophy. Cases of pregnancy complicated by KTS are rare and are associated with an increased risk of thrombo-embolic phenomena and hemorrhage. In this case, 33 years old woman, Para 1 gravida 2 (P1G2) with history of previous cesarean section and diagnosed case of KTS was presented in labour emergency of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh at 36+ weeks of gestation with labour pain. She had also a prominent hypertrophy and multiple venous varicosities on both her lower limbs; more marked on left. Her MRI done just before pregnancy revealed few prominent veins in both adnexa particularly on the left with normal caliber ovarian veins and unremarkable other pelvic structures and excludes pelvic congestion syndrome. USG done at her 35 weeks of gestation had shown numerous dilated and tortuous vessels in the parametrium, indicating pelvic congestion. Emergency caesarean section was done under spinal anesthesia. There was no postpartum hemorrhage (PPH). She was discharged along with her baby without any complication on her 4th postoperative day. Successful management of patients with KTS requires multidisciplinary team approach.

In vitro cytotoxicity and antibiotic application of green route surface modified ferromagnetic TiO2 nanoparticles

The enormous numbers of applications of TiO₂ nanoparticles (NPs) cause concern about their risk to the environment and human health. Consequently, motivated by the necessity of searching for new sources of TiO₂ NPs of low cytotoxicity with antibacterial activity, we synthesized TiO₂ NPs by a green route using a solution of titanium(iv) isopropoxide as a precursor and an aqueous extract of Artocarpus heterophyllus leaf as a reducing and surface modifying agent. We investigated their structure, shape, size, and magnetic properties, and evaluated their antibiotic application and cytotoxicity. The synthesized TiO₂ NPs were applied against two Gram-negative bacteria (E. coli and S. typhimurium) and two Gram-positive bacteria (S. aureus and B. subtilis) to observe their antibacterial activity; and eventually clear zones of inhibition formed by the TiO₂ NPs were obtained. Moreover, after exposing the synthesized TiO₂ NPs to HeLa cells (carcinoma cells) and Vero cells (normal cells), no toxic effect was found up to a dose of 1000 mg L⁻¹, indicating the safe use of the samples up to at least 1000 mg L⁻¹. However, toxic effects on HeLa cells and Vero cells were observed at doses of 2000 mg L⁻¹ and 3000 mg L⁻¹, respectively. These results indicate the safe use of Artocarpus heterophyllus leaf extract mediated synthesized TiO₂ NPs in their potential applications.

Artocarpus heterophyllus leaf extract mediated green synthesized TiO₂ nanoparticles exhibit less toxicity with high antibacterial activity.

Green synthesis of bio-molecule encapsulated magnetic silver nanoparticles and their antibacterial activity

Persuaded by the necessity of finding new sources of antibiotics, silver nanoparticles (Ag NPs) were synthesized by adopting a newly developed green synthesis technique and subsequently, their antibacterial activity against different pathogenic bacteria was evaluated. We have successfully synthesized bio-molecule capped ferromagnetic Ag NPs with an average crystallite size of 13 nm using AgNO₃ solution as a precursor and Artocarpus heterophyllus leaf extract as a reducing and capping agent. The characterization of the synthesized Ag NPs was carried out using various techniques such as UV-visible (UV-Vis) spectroscopy, energy dispersive X-ray (EDX) spectroscopy, Fourier transform infrared (FT-IR) spectroscopy, field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), thermogravimetry (TG), and vibrating sample magnetometer (VSM) analyses. After exposing the synthesized Ag NPs to two Gram-positive bacteria – Staphylococcus aureus and Bacillus cereus and two Gram-negative bacteria – Escherichia coli and Salmonella typhimurium, the zones of inhibition were found to be 15, 16, 19, and 18 mm, respectively. These results imply that the Artocarpus heterophyllus leaf extract mediated green synthesized bio-molecules encapsulated Ag NPs can be considered as a potential antibiotic against human pathogens which is very encouraging.

Persuaded by the necessity of finding new sources of antibiotics, Ag NPs were synthesized by adopting a newly developed green synthesis technique and subsequently, their antibacterial activity against different pathogenic bacteria was evaluated.