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Papers by Shafiul Alam

Bangladesh Journal of Neurosurgery

Background: Spontaneous pyogenic spondylodiscitis is an uncommon clinical condition. But in our c... more Background: Spontaneous pyogenic spondylodiscitis is an uncommon clinical condition. But in our country it is not infrequent. High level of clinical suspicion is necessary for diagnoses of spontaneous pyogenic spondylodiscitis. There is no study regarding this issue in Bangladesh. Objective: The objective of this study was to see the epidemiological feature and types of surgical treatment of spontaneous pyogenic spondylodiscitis in Bangladesh Materials and Methods: This is a retrospective observational study. This study was done in the Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh. The study period was January, 2016 to July, 2021 for a period of 5.5 years. 17 patients who were undergone surgery included in the study. The data were collected from questionnaires and hospital records and analyzed. Results: In our study the highest incidence was found in 4th (23.52%) and 6th (29.42%) decade of life which was around 53%. The male to femal...

Bangladesh Journal of Neurosurgery

Mucormycosis is a fungus found in the environment. In an immunocompetent person, it may cause loc... more Mucormycosis is a fungus found in the environment. In an immunocompetent person, it may cause localized infection. Invasive Mucormycosis has a poor prognosis. We describe a case of cerebral mucormycosis in an immune competent patient. A 46-yearold man was admitted with seizures and headaches. Magnetic resonance imaging (MRI) of the brain showed contrast enhancing lesion at the right frontal region. Excision biopsies showed granulomatous reactions, compatible with mucormycosis. Amphotericin B was begun. The results of testing for human immunodeficiency virus (HIV) were negative. Unfortunately the patient died on twenty-fifth postoperative day. Most cases of invasive mucormycosis show that this organism is pathogenic in immuno-compromised patients; however, some case reports show that invasive mucormycosis may not be so rare in immunocompetent patients. In these patients, virulent and drug-resistant forms of mucormycosis may be responsible for the disease, and treatment with antifunga...

Bangladesh Medical Research Council Bulletin

Background: Rasmussen’s encephalitis is a progressive disease with recurrent drug resistant epile... more Background: Rasmussen’s encephalitis is a progressive disease with recurrent drug resistant epilepsy, unihemispheric brain atrophy, hemiplegia and cognitive decline. Objectives: This is a disconnection surgery which disconnects the diseased lobe from the normal lobe. This helps in development of the normal cerebral hemisphere and also the child becomes seizure free. Methods: A five year old boy was diagnosed with Rasmussen’s encephalitis. He underwent left sided transsylvian functional hemisherectomy. He had uneventful recovery. Results: Before surgery he had recurrent seizures, frequent drop attacks and right sided hemiplegia and impaired cognition. He used to take three drugs for the control of the seizure. After surgery his mental state had improved, seizures were controlled with only sodium valproate. Patient’s mother was happy that he had no drop attacks and was able to sit and speak. Conclusion: Functional hemispherectomy is a good option for drug resistant seizure in Ramussen...

Bangladesh Journal of Neurosurgery

Cavernoma is a benign tumour of the orbit. It results in proptosis, visual disturbance, diplopia ... more Cavernoma is a benign tumour of the orbit. It results in proptosis, visual disturbance, diplopia and ptosis of the eye. It is amenable to surgery without recurrence. We report a case of left orbital cavernoma in a female, who presented with non-pulsatile painless proptosis, without ptosis and no perception of light. Her MRI revealed a cavernoma of the left orbit inferior to the optic nerve. She was operated by the endoscopic transmaxillary orbitotomy. This easily removed the tumour, avoided craniotomy and was cosmetically acceptable. Bang. J Neurosurgery 2021; 11(1): 58-61

Bangladesh Journal of Neurosurgery, 2021

Acute subdural empyema is a surgical emergency. It is life threatening for the patient. It has to... more Acute subdural empyema is a surgical emergency. It is life threatening for the patient. It has to be evacuated as soon it is diagnosed. But subdural empyema in a COVID 19 patient is uncommon. Its management put the surgical team to a new dilemma. On one side the patient’s life was at risk and on the other side the whole surgical team might get infected.In this case report, we describe such a case which saved the patient’s life at same time many doctors, nurses and OT attendants became infected. Abbrevaitions: OPD- Out patient department, COVID 19-Corona Virus Disease 2019, NINS- National Institute of Neurosciences, RT-PCR- Reverse transcription polymerase chain reaction. SDE- Subdural empyema, PNS- para nasal sinuses Bang. J Neurosurgery 2021; 10(2): 206-209

Journal of Science Foundation, 2021

Schwannomas are encapsulated tumors arising from Schwann cells of the nerve sheath, and are usual... more Schwannomas are encapsulated tumors arising from Schwann cells of the nerve sheath, and are usually solitary sporadic lesions. The schwannoma of the ilio-hypogastric nerve especially in the retro-petoneal space is very rare. We are reporting a case of the schwannoma of the left ilio-hypagastric nerve over the psoas muscle. The diagnosis was done by ultarsonogrsphy and MRI. The histopathological study confirmed the diagnosis. The tumour was excised through retro-peritoneal approach. By this approach total excision of the tumour with preservation of ilio-hypogastric nerve is possible. Journal of Science Foundation 2019;17(2):71-74

Bangladesh Journal of Infectious Diseases, 2020

The COVID 19 pandemic has changed the world forever. As healthcare facilities were struggling to ... more The COVID 19 pandemic has changed the world forever. As healthcare facilities were struggling to care for the infected patients, neurosurgeons had to postpone routine surgeries and continue with emergency procedures. They had to take unprecedented measures of protection. The safety and protective measures observed in the hospital for about five months were recorded. These measures were on effect all these time. COVID 19 is very contagious. The preventive and disinfection measures changed our way of consultation in OPD, admission in the wards and surgical and post-operative measures. This changed the practice in our institution. In this paper we look at how the pandemic had changed our practice of neurosurgery. Bangladesh Journal of Infectious Diseases, October 2020;7(suppl_2):S69-S71

Bangladesh Journal of Neurosurgery, 2020

Spheno-orbital dysplasia is almost pathognomic for Neurofibromatosis type 1. Thereis proptosis an... more Spheno-orbital dysplasia is almost pathognomic for Neurofibromatosis type 1. Thereis proptosis and deviation of the eye ball medially. We present a case of a young girlwith neurofibromatosis type 1, who had pulsating exophthalmos of the right eye withdiplopia and severe dysplasia of the sphenoid boneand consecutive herniation of theright temporal lobe. She presented with pulsatile proptosis and deviation of the righteye ball to the right. Her x-ray skull showed widening of the orbit. Her MRI scanshowed an arachnoid cyst behind her right eye ball. We had operated on her andreconstructed the right sphenoid greater wing with titanium mesh and duroplastywith G-patch. This had improved her proptosis and deviation of the eye ball. Bang. J Neurosurgery 2020; 9(2): 156-161

Bangladesh Journal of Neurosurgery, 2019

Background: Cerebral arteriovenous malformation (AVM) is a complex tangled of dilated blood vesse... more Background: Cerebral arteriovenous malformation (AVM) is a complex tangled of dilated blood vessels in which arteries flow directly into veins without capillaries. The main cause of death in patients with cerebral AVM is intraparenchymal hemorrhage. There are multiple imaging tools that can detect the predictors of hemorrhage in cerebralarteriovenous malformation. But nowadays digital subtraction angiography (DSA) is playing a wonderful role to detect these predictors. Objectives: To detect the common predicting factors of hemorrhage from in brain by DSA. Methodology:This observational cross-sectional study was carried out in the department of Neurosurgery, Dhaka Medical College Hospital and study period was from October, 2014 to March, 2016. 76 patients of hemorrhagic stroke with clinical and radiological (CT scan) suspicion of ruptured cerebral AVM were selected by non-probability purposive sampling technique. After that enrolled patients were scrutinized according to selection cr...

Journal of Current and Advance Medical Research, 2018

Background: Determination of the electrocardiographic changes among the hypertensive patients can... more Background: Determination of the electrocardiographic changes among the hypertensive patients can reveal the early cardiac abnormalities especially of left ventricular hypertrophy.Objectives: The purpose of the present study was to find out the P and QRS waves of electrocardiographic (ECG) changes in different grades of hypertensive patients.Methodology: This cross sectional study was conducted among mild to severe grade hypertensive patients attended in the Department of Medicine at Rajshahi Medical College and Hospital, Rajshahi during the period of July 2009 to June 2010 for a period of one year. Data were collected by face to face interview with a pre-designed structured questionnaire. Measurement of the blood pressure and the 12-lead surface electrocardiogram were done among the study group in a resting state.Results: A total number of 400 hypertensive patients were recruited for this study. In mild hypertension, high voltage QRS complex was noted as the main ECG abnormality (2...

Journal of Science Foundation, 2017

Background: Extradural haematoma is due to different etiologies. Objectives: The purpose of the p... more Background: Extradural haematoma is due to different etiologies. Objectives: The purpose of the present study was to see the etiological factors of extradural haematoma. Methodology: This cross sectional study was conducted in the

Bangladesh Journal of Neurosurgery

Background: Arachnoid cysts are fluid-filled sacs that occur on the arachnoid membrane that cover... more Background: Arachnoid cysts are fluid-filled sacs that occur on the arachnoid membrane that covers the brain. In most of the cases these cysts are asymptomatic and do not require any treatment. Only symptomatic arachnoid cysts require treatment. Objectives: The objective of this study was to see the results of microsurgical treatment of intracranial arachnoid cyst. Methods: This retrospective cross sectional study was carried out in the Department of Neurosurgery, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh. Total 15 cases were included in this study for a period of 3 years. Data were collected including their operation procedures and follow up by questionnaires and finally observed the results. Results: Among the 15 patients about one third were presented in the second decades of life with male predominant. Significant clinical improvement was observed among most of the patients. The radiological decrease of the size of the cysts was also found. The results of...

Journal of National Institute of Neurosciences Bangladesh, 2020

Background: Spinal tumor can occur in different anatomical location. Objective: The purpose of th... more Background: Spinal tumor can occur in different anatomical location. Objective: The purpose of the present study was to see the demographic characteristics and anatomical location of spinal tumour. Methodology: This descriptive cross sectional study was conducted in the Department of Neurosurgery at National Institute of Neurosciences & Hospital, Dhaka, Bangladesh from January 2016 to December 2019 for a period of around 04 (four) years. Patients presented with spinal tumor were selected as study population. The demographics characteristics were evaluated among all the patients. Patients were examined by MRI for the detection of anatomical location of the tumor. Result: A total number of 57 spinal tumor cases were recruited for this study. The mean age with SD of the study population was 38.7±13.24 years. The male and female ratio was 1.34:1 Most of the spinal tumor were found in the thoracic region which was 29(50.9%) cases followed by lumbar region which was 20(35.1%) cases. Spina...

Bangladesh Journal of Neurosurgery, 2019

We report a case of a 20 years old female patient, who presented with the complaints of progressi... more We report a case of a 20 years old female patient, who presented with the complaints of progressive quadriparesis which eventually led to quadriplegia. Her weakness started from the right side of the body and then to the left. Her MRI of the neck revealed an extradural lesion extending from the C2 up to C6 vertebral level. It had compressed the dural tube to the left. The lesion continued to the neck through the inervertebral foramen at C6. Her CT angiogram of the neck vessels showed an AVM arising from the right SCA and entering the Spinal canal at C6 level and draining into the right IJV at C2 level. She underwent surgery and the AVF was ligated at the origin. The AVM had collapsed. After 15 days following surgery, she had significant improvement of symptoms. After one and half months she could walk with support. Bang. J Neurosurgery 2019; 9(1): 69-74

Bangladesh Heart Journal, 2019

Objective: Carotid body tumour is a rare tumour. This is a case report of carotid body tumour of ... more Objective: Carotid body tumour is a rare tumour. This is a case report of carotid body tumour of the right side involving the right hypoglossal nerve with MRI appearance and pathological features. The objective is to present a case of Hypoglossal nerve palsy due to carotid body tumour involving the right carotid artery bifurcation. Method: A 18-year old male presented with a welldefined swelling of his right neck, increasing hoarseness, and left ward tongue deviation on protrusion present for two years CT neck and MRI were done. The tumour was identified and the patient underwent surgery. His Histopathology report commented it to be carotid body tumour. Result: The patient showed significant improvement after surgery. His tongue deviation improved and his hoarseness of voice had been begun to improve. Conclusion: Carotid body tumours are benign lesion mimicking other pathology. High level of suspicision, imaging and careful resection is important for avoiding complications. Banglade...

Journal of National Institute of Neurosciences Bangladesh, 2017

Background: Spinal tuberculosis is a great problem in the health sector. Objective: The purpose o... more Background: Spinal tuberculosis is a great problem in the health sector. Objective: The purpose of the present study was to see the see the socio-demographic characteristics of spinal tuberculosis patients. Methodology: This study was designed as descriptive cross sectional study which was carried out in the Department of Neurosurgery at Dhaka Medical College Hospital during the period of January 2002 to December 2004 for a period of two (2) years. All the patients who were presented with spinal tuberculosis at any age with both sexes were included as study population. The details of socio-economic condition were recorded of all the patients. Confirmation of spinal tuberculosis was made by CT-scan and MRI. Finally biopsy was done to confirm the cases by histopathology.Results: In this study, 50 cases of tuberculosis of the spine patients were recruited for this study. The mean age with SD was 25.4±18.65 years. The sex distribution shows male preponderance with a male and female rati...

International Journal of Epidemiology, 2013

Background Arsenic exposure through drinking water is a serious global health issue. Observationa... more Background Arsenic exposure through drinking water is a serious global health issue. Observational studies suggest that individuals who metabolize arsenic efficiently are at lower risk for toxicities such as arsenical skin lesions. Using two single nucleotide polymorphisms (SNPs) in the 10q24.32 region (near AS3MT) that show independent associations with metabolism efficiency, Mendelian randomization can be used to assess whether the association between metabolism efficiency and skin lesions is likely to be causal. Methods Using data on 2060 arsenic-exposed Bangladeshi individuals, we estimated associations for two 10q24.32 SNPs with relative concentrations of three urinary arsenic species (representing metabolism efficiency): inorganic arsenic (iAs), monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). SNP-based predictions of iAs%, MMA% and DMA% were tested for association with skin lesion status among 2483 cases and 2857 controls. Results Causal odds ratios for skin lesions were 0.90 (95% confidence interval [CI]: 0.87, 0.95), 1.19 (CI: 1.10, 1.28) and 1.23 (CI: 1.12, 1.36) for a one standard deviation increase in DMA%, MMA% and iAs%, respectively. We demonstrated genotype-arsenic interaction, with metabolism-related variants showing stronger associations with skin lesion risk among individuals with high arsenic exposure (synergy index: 1.37; CI: 1.11, 1.62). Conclusions We provide strong evidence for a causal relationship between arsenic metabolism efficiency and skin lesion risk. Mendelian randomization can be used to assess the causal role of arsenic

Background: Presenting symptoms, treatment considerations, and outcome are strongly related to th... more Background: Presenting symptoms, treatment considerations, and outcome are strongly related to the extension of vestibular schwannomas (VS). The aim of the current retrospective study was to analyze the clinical features, microsurgical treatment, and outcome of VS with brainstem compression. Methods: Seventy patients presented with VS who had undergone operative procedures performed in our unit from 2017 to 2019. The facial nerve function and hearing assessment was done according to House-Brackmann [HB] grading and pure tone audiometry (PTA) respectively. All patients were operated by retro-mastoid suboccipital approach. Results: Most patients had large tumors and had no useful hearing (85%), had disabling cerebellar ataxia (92.86%) and presented with features of raised intracranial pressure (48.57%). Large sized tumors were in 32.86% and giant sized tumors were in 57.14% cases. Complete tumor excision was carried out 92.86% and anatomical preservation of facial nerve was achieved i...

Journal of National Institute of Neurosciences Bangladesh, 2018

Arteriovenous malformation (AVM) is a rare congenital condition of the brain. In majority of case... more Arteriovenous malformation (AVM) is a rare congenital condition of the brain. In majority of cases AVMs remain asymptomatic and silent till it ruptures. But it can be a cause of cerebral haemorrhage, stroke, seizures, moderate to severe headache, loss of vision, aphasia, numbness or weakness of limbs. In current study, revealed a 25 years age patient of AVM admitted in Department of Neurosurgery at National Institute of Neurosciences (NINS) on December, 2013 with the complaints of loss of consciousness two times before admission, history of generalized seizure started over left side, headache for 2 years and vertigo for 1 year. Following admission the patient was evaluated clinically including all neurological examinations. All routine investigations were done. The patient was further evaluated by MRI, CT scan, CTA. Arteriovenous malformation was found in left frontal region. Under G/A nidus was excised totally in a single mass. Post MRI had shown the total removal of the AVM. Histo...

Bangladesh Journal of Neurosurgery, 2019

Background: Peripheral nerve injury is a common condition. Though it is not life threatening, it ... more Background: Peripheral nerve injury is a common condition. Though it is not life threatening, it may cause disability to a person. In this study we have analysed our experience of anastomosis of injured nerves. Materials and methods: This is an observational study that was done within a period from January 2014 to December 2018. 13 patients with injury to the nerves were operated upon. There were 11 male and 2 female patients. All patients were followed up in OPD upto one and half years. 5 patients were lost from follow up, of these, two were female. Results: After surgery, touch returned in 5 patients. Of motor function,there was no improvement in 1 patient, grade 1 in 1 patient, grade 2 in 4 patients and grade 3 in 3 patients. Those who came earlier had better outcome, so had those with small injury and distal to the limb. Conclusion: peripheral nerve injury has to be repaired as soon as possible. The sooner it can be done the better will be the outcome. Bang. J Neurosurgery 2019;...

Bangladesh Journal of Neurosurgery

Background: Spontaneous pyogenic spondylodiscitis is an uncommon clinical condition. But in our c... more Background: Spontaneous pyogenic spondylodiscitis is an uncommon clinical condition. But in our country it is not infrequent. High level of clinical suspicion is necessary for diagnoses of spontaneous pyogenic spondylodiscitis. There is no study regarding this issue in Bangladesh. Objective: The objective of this study was to see the epidemiological feature and types of surgical treatment of spontaneous pyogenic spondylodiscitis in Bangladesh Materials and Methods: This is a retrospective observational study. This study was done in the Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh. The study period was January, 2016 to July, 2021 for a period of 5.5 years. 17 patients who were undergone surgery included in the study. The data were collected from questionnaires and hospital records and analyzed. Results: In our study the highest incidence was found in 4th (23.52%) and 6th (29.42%) decade of life which was around 53%. The male to femal...

Bangladesh Journal of Neurosurgery

Mucormycosis is a fungus found in the environment. In an immunocompetent person, it may cause loc... more Mucormycosis is a fungus found in the environment. In an immunocompetent person, it may cause localized infection. Invasive Mucormycosis has a poor prognosis. We describe a case of cerebral mucormycosis in an immune competent patient. A 46-yearold man was admitted with seizures and headaches. Magnetic resonance imaging (MRI) of the brain showed contrast enhancing lesion at the right frontal region. Excision biopsies showed granulomatous reactions, compatible with mucormycosis. Amphotericin B was begun. The results of testing for human immunodeficiency virus (HIV) were negative. Unfortunately the patient died on twenty-fifth postoperative day. Most cases of invasive mucormycosis show that this organism is pathogenic in immuno-compromised patients; however, some case reports show that invasive mucormycosis may not be so rare in immunocompetent patients. In these patients, virulent and drug-resistant forms of mucormycosis may be responsible for the disease, and treatment with antifunga...

Bangladesh Medical Research Council Bulletin

Background: Rasmussen’s encephalitis is a progressive disease with recurrent drug resistant epile... more Background: Rasmussen’s encephalitis is a progressive disease with recurrent drug resistant epilepsy, unihemispheric brain atrophy, hemiplegia and cognitive decline. Objectives: This is a disconnection surgery which disconnects the diseased lobe from the normal lobe. This helps in development of the normal cerebral hemisphere and also the child becomes seizure free. Methods: A five year old boy was diagnosed with Rasmussen’s encephalitis. He underwent left sided transsylvian functional hemisherectomy. He had uneventful recovery. Results: Before surgery he had recurrent seizures, frequent drop attacks and right sided hemiplegia and impaired cognition. He used to take three drugs for the control of the seizure. After surgery his mental state had improved, seizures were controlled with only sodium valproate. Patient’s mother was happy that he had no drop attacks and was able to sit and speak. Conclusion: Functional hemispherectomy is a good option for drug resistant seizure in Ramussen...

Bangladesh Journal of Neurosurgery

Cavernoma is a benign tumour of the orbit. It results in proptosis, visual disturbance, diplopia ... more Cavernoma is a benign tumour of the orbit. It results in proptosis, visual disturbance, diplopia and ptosis of the eye. It is amenable to surgery without recurrence. We report a case of left orbital cavernoma in a female, who presented with non-pulsatile painless proptosis, without ptosis and no perception of light. Her MRI revealed a cavernoma of the left orbit inferior to the optic nerve. She was operated by the endoscopic transmaxillary orbitotomy. This easily removed the tumour, avoided craniotomy and was cosmetically acceptable. Bang. J Neurosurgery 2021; 11(1): 58-61

Bangladesh Journal of Neurosurgery, 2021

Acute subdural empyema is a surgical emergency. It is life threatening for the patient. It has to... more Acute subdural empyema is a surgical emergency. It is life threatening for the patient. It has to be evacuated as soon it is diagnosed. But subdural empyema in a COVID 19 patient is uncommon. Its management put the surgical team to a new dilemma. On one side the patient’s life was at risk and on the other side the whole surgical team might get infected.In this case report, we describe such a case which saved the patient’s life at same time many doctors, nurses and OT attendants became infected. Abbrevaitions: OPD- Out patient department, COVID 19-Corona Virus Disease 2019, NINS- National Institute of Neurosciences, RT-PCR- Reverse transcription polymerase chain reaction. SDE- Subdural empyema, PNS- para nasal sinuses Bang. J Neurosurgery 2021; 10(2): 206-209

Journal of Science Foundation, 2021

Schwannomas are encapsulated tumors arising from Schwann cells of the nerve sheath, and are usual... more Schwannomas are encapsulated tumors arising from Schwann cells of the nerve sheath, and are usually solitary sporadic lesions. The schwannoma of the ilio-hypogastric nerve especially in the retro-petoneal space is very rare. We are reporting a case of the schwannoma of the left ilio-hypagastric nerve over the psoas muscle. The diagnosis was done by ultarsonogrsphy and MRI. The histopathological study confirmed the diagnosis. The tumour was excised through retro-peritoneal approach. By this approach total excision of the tumour with preservation of ilio-hypogastric nerve is possible. Journal of Science Foundation 2019;17(2):71-74

Bangladesh Journal of Infectious Diseases, 2020

The COVID 19 pandemic has changed the world forever. As healthcare facilities were struggling to ... more The COVID 19 pandemic has changed the world forever. As healthcare facilities were struggling to care for the infected patients, neurosurgeons had to postpone routine surgeries and continue with emergency procedures. They had to take unprecedented measures of protection. The safety and protective measures observed in the hospital for about five months were recorded. These measures were on effect all these time. COVID 19 is very contagious. The preventive and disinfection measures changed our way of consultation in OPD, admission in the wards and surgical and post-operative measures. This changed the practice in our institution. In this paper we look at how the pandemic had changed our practice of neurosurgery. Bangladesh Journal of Infectious Diseases, October 2020;7(suppl_2):S69-S71

Bangladesh Journal of Neurosurgery, 2020

Spheno-orbital dysplasia is almost pathognomic for Neurofibromatosis type 1. Thereis proptosis an... more Spheno-orbital dysplasia is almost pathognomic for Neurofibromatosis type 1. Thereis proptosis and deviation of the eye ball medially. We present a case of a young girlwith neurofibromatosis type 1, who had pulsating exophthalmos of the right eye withdiplopia and severe dysplasia of the sphenoid boneand consecutive herniation of theright temporal lobe. She presented with pulsatile proptosis and deviation of the righteye ball to the right. Her x-ray skull showed widening of the orbit. Her MRI scanshowed an arachnoid cyst behind her right eye ball. We had operated on her andreconstructed the right sphenoid greater wing with titanium mesh and duroplastywith G-patch. This had improved her proptosis and deviation of the eye ball. Bang. J Neurosurgery 2020; 9(2): 156-161

Bangladesh Journal of Neurosurgery, 2019

Background: Cerebral arteriovenous malformation (AVM) is a complex tangled of dilated blood vesse... more Background: Cerebral arteriovenous malformation (AVM) is a complex tangled of dilated blood vessels in which arteries flow directly into veins without capillaries. The main cause of death in patients with cerebral AVM is intraparenchymal hemorrhage. There are multiple imaging tools that can detect the predictors of hemorrhage in cerebralarteriovenous malformation. But nowadays digital subtraction angiography (DSA) is playing a wonderful role to detect these predictors. Objectives: To detect the common predicting factors of hemorrhage from in brain by DSA. Methodology:This observational cross-sectional study was carried out in the department of Neurosurgery, Dhaka Medical College Hospital and study period was from October, 2014 to March, 2016. 76 patients of hemorrhagic stroke with clinical and radiological (CT scan) suspicion of ruptured cerebral AVM were selected by non-probability purposive sampling technique. After that enrolled patients were scrutinized according to selection cr...

Journal of Current and Advance Medical Research, 2018

Background: Determination of the electrocardiographic changes among the hypertensive patients can... more Background: Determination of the electrocardiographic changes among the hypertensive patients can reveal the early cardiac abnormalities especially of left ventricular hypertrophy.Objectives: The purpose of the present study was to find out the P and QRS waves of electrocardiographic (ECG) changes in different grades of hypertensive patients.Methodology: This cross sectional study was conducted among mild to severe grade hypertensive patients attended in the Department of Medicine at Rajshahi Medical College and Hospital, Rajshahi during the period of July 2009 to June 2010 for a period of one year. Data were collected by face to face interview with a pre-designed structured questionnaire. Measurement of the blood pressure and the 12-lead surface electrocardiogram were done among the study group in a resting state.Results: A total number of 400 hypertensive patients were recruited for this study. In mild hypertension, high voltage QRS complex was noted as the main ECG abnormality (2...

Journal of Science Foundation, 2017

Background: Extradural haematoma is due to different etiologies. Objectives: The purpose of the p... more Background: Extradural haematoma is due to different etiologies. Objectives: The purpose of the present study was to see the etiological factors of extradural haematoma. Methodology: This cross sectional study was conducted in the

Bangladesh Journal of Neurosurgery

Background: Arachnoid cysts are fluid-filled sacs that occur on the arachnoid membrane that cover... more Background: Arachnoid cysts are fluid-filled sacs that occur on the arachnoid membrane that covers the brain. In most of the cases these cysts are asymptomatic and do not require any treatment. Only symptomatic arachnoid cysts require treatment. Objectives: The objective of this study was to see the results of microsurgical treatment of intracranial arachnoid cyst. Methods: This retrospective cross sectional study was carried out in the Department of Neurosurgery, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh. Total 15 cases were included in this study for a period of 3 years. Data were collected including their operation procedures and follow up by questionnaires and finally observed the results. Results: Among the 15 patients about one third were presented in the second decades of life with male predominant. Significant clinical improvement was observed among most of the patients. The radiological decrease of the size of the cysts was also found. The results of...

Journal of National Institute of Neurosciences Bangladesh, 2020

Background: Spinal tumor can occur in different anatomical location. Objective: The purpose of th... more Background: Spinal tumor can occur in different anatomical location. Objective: The purpose of the present study was to see the demographic characteristics and anatomical location of spinal tumour. Methodology: This descriptive cross sectional study was conducted in the Department of Neurosurgery at National Institute of Neurosciences & Hospital, Dhaka, Bangladesh from January 2016 to December 2019 for a period of around 04 (four) years. Patients presented with spinal tumor were selected as study population. The demographics characteristics were evaluated among all the patients. Patients were examined by MRI for the detection of anatomical location of the tumor. Result: A total number of 57 spinal tumor cases were recruited for this study. The mean age with SD of the study population was 38.7±13.24 years. The male and female ratio was 1.34:1 Most of the spinal tumor were found in the thoracic region which was 29(50.9%) cases followed by lumbar region which was 20(35.1%) cases. Spina...

Bangladesh Journal of Neurosurgery, 2019

We report a case of a 20 years old female patient, who presented with the complaints of progressi... more We report a case of a 20 years old female patient, who presented with the complaints of progressive quadriparesis which eventually led to quadriplegia. Her weakness started from the right side of the body and then to the left. Her MRI of the neck revealed an extradural lesion extending from the C2 up to C6 vertebral level. It had compressed the dural tube to the left. The lesion continued to the neck through the inervertebral foramen at C6. Her CT angiogram of the neck vessels showed an AVM arising from the right SCA and entering the Spinal canal at C6 level and draining into the right IJV at C2 level. She underwent surgery and the AVF was ligated at the origin. The AVM had collapsed. After 15 days following surgery, she had significant improvement of symptoms. After one and half months she could walk with support. Bang. J Neurosurgery 2019; 9(1): 69-74

Bangladesh Heart Journal, 2019

Objective: Carotid body tumour is a rare tumour. This is a case report of carotid body tumour of ... more Objective: Carotid body tumour is a rare tumour. This is a case report of carotid body tumour of the right side involving the right hypoglossal nerve with MRI appearance and pathological features. The objective is to present a case of Hypoglossal nerve palsy due to carotid body tumour involving the right carotid artery bifurcation. Method: A 18-year old male presented with a welldefined swelling of his right neck, increasing hoarseness, and left ward tongue deviation on protrusion present for two years CT neck and MRI were done. The tumour was identified and the patient underwent surgery. His Histopathology report commented it to be carotid body tumour. Result: The patient showed significant improvement after surgery. His tongue deviation improved and his hoarseness of voice had been begun to improve. Conclusion: Carotid body tumours are benign lesion mimicking other pathology. High level of suspicision, imaging and careful resection is important for avoiding complications. Banglade...

Journal of National Institute of Neurosciences Bangladesh, 2017

Background: Spinal tuberculosis is a great problem in the health sector. Objective: The purpose o... more Background: Spinal tuberculosis is a great problem in the health sector. Objective: The purpose of the present study was to see the see the socio-demographic characteristics of spinal tuberculosis patients. Methodology: This study was designed as descriptive cross sectional study which was carried out in the Department of Neurosurgery at Dhaka Medical College Hospital during the period of January 2002 to December 2004 for a period of two (2) years. All the patients who were presented with spinal tuberculosis at any age with both sexes were included as study population. The details of socio-economic condition were recorded of all the patients. Confirmation of spinal tuberculosis was made by CT-scan and MRI. Finally biopsy was done to confirm the cases by histopathology.Results: In this study, 50 cases of tuberculosis of the spine patients were recruited for this study. The mean age with SD was 25.4±18.65 years. The sex distribution shows male preponderance with a male and female rati...

International Journal of Epidemiology, 2013

Background Arsenic exposure through drinking water is a serious global health issue. Observationa... more Background Arsenic exposure through drinking water is a serious global health issue. Observational studies suggest that individuals who metabolize arsenic efficiently are at lower risk for toxicities such as arsenical skin lesions. Using two single nucleotide polymorphisms (SNPs) in the 10q24.32 region (near AS3MT) that show independent associations with metabolism efficiency, Mendelian randomization can be used to assess whether the association between metabolism efficiency and skin lesions is likely to be causal. Methods Using data on 2060 arsenic-exposed Bangladeshi individuals, we estimated associations for two 10q24.32 SNPs with relative concentrations of three urinary arsenic species (representing metabolism efficiency): inorganic arsenic (iAs), monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). SNP-based predictions of iAs%, MMA% and DMA% were tested for association with skin lesion status among 2483 cases and 2857 controls. Results Causal odds ratios for skin lesions were 0.90 (95% confidence interval [CI]: 0.87, 0.95), 1.19 (CI: 1.10, 1.28) and 1.23 (CI: 1.12, 1.36) for a one standard deviation increase in DMA%, MMA% and iAs%, respectively. We demonstrated genotype-arsenic interaction, with metabolism-related variants showing stronger associations with skin lesion risk among individuals with high arsenic exposure (synergy index: 1.37; CI: 1.11, 1.62). Conclusions We provide strong evidence for a causal relationship between arsenic metabolism efficiency and skin lesion risk. Mendelian randomization can be used to assess the causal role of arsenic

Background: Presenting symptoms, treatment considerations, and outcome are strongly related to th... more Background: Presenting symptoms, treatment considerations, and outcome are strongly related to the extension of vestibular schwannomas (VS). The aim of the current retrospective study was to analyze the clinical features, microsurgical treatment, and outcome of VS with brainstem compression. Methods: Seventy patients presented with VS who had undergone operative procedures performed in our unit from 2017 to 2019. The facial nerve function and hearing assessment was done according to House-Brackmann [HB] grading and pure tone audiometry (PTA) respectively. All patients were operated by retro-mastoid suboccipital approach. Results: Most patients had large tumors and had no useful hearing (85%), had disabling cerebellar ataxia (92.86%) and presented with features of raised intracranial pressure (48.57%). Large sized tumors were in 32.86% and giant sized tumors were in 57.14% cases. Complete tumor excision was carried out 92.86% and anatomical preservation of facial nerve was achieved i...

Journal of National Institute of Neurosciences Bangladesh, 2018

Arteriovenous malformation (AVM) is a rare congenital condition of the brain. In majority of case... more Arteriovenous malformation (AVM) is a rare congenital condition of the brain. In majority of cases AVMs remain asymptomatic and silent till it ruptures. But it can be a cause of cerebral haemorrhage, stroke, seizures, moderate to severe headache, loss of vision, aphasia, numbness or weakness of limbs. In current study, revealed a 25 years age patient of AVM admitted in Department of Neurosurgery at National Institute of Neurosciences (NINS) on December, 2013 with the complaints of loss of consciousness two times before admission, history of generalized seizure started over left side, headache for 2 years and vertigo for 1 year. Following admission the patient was evaluated clinically including all neurological examinations. All routine investigations were done. The patient was further evaluated by MRI, CT scan, CTA. Arteriovenous malformation was found in left frontal region. Under G/A nidus was excised totally in a single mass. Post MRI had shown the total removal of the AVM. Histo...

Bangladesh Journal of Neurosurgery, 2019

Background: Peripheral nerve injury is a common condition. Though it is not life threatening, it ... more Background: Peripheral nerve injury is a common condition. Though it is not life threatening, it may cause disability to a person. In this study we have analysed our experience of anastomosis of injured nerves. Materials and methods: This is an observational study that was done within a period from January 2014 to December 2018. 13 patients with injury to the nerves were operated upon. There were 11 male and 2 female patients. All patients were followed up in OPD upto one and half years. 5 patients were lost from follow up, of these, two were female. Results: After surgery, touch returned in 5 patients. Of motor function,there was no improvement in 1 patient, grade 1 in 1 patient, grade 2 in 4 patients and grade 3 in 3 patients. Those who came earlier had better outcome, so had those with small injury and distal to the limb. Conclusion: peripheral nerve injury has to be repaired as soon as possible. The sooner it can be done the better will be the outcome. Bang. J Neurosurgery 2019;...