Professor Dr. Borhan Uddin Ahamed | University of Dhaka, Bangladesh (original) (raw)

Papers by Professor Dr. Borhan Uddin Ahamed

Context: Retroperitoneal location of kidney implies much difficulties in management of renal dise... more Context: Retroperitoneal location of kidney implies much difficulties in management of renal diseases, specially for surgeons. Appropriate knowledge on three dimensional morphological status of kidney may be helpful for successful surgery of this region. So this study was performed to evaluate the age related changes in length, breadth and thickness of kidney collected from Bangladesh. Materials and methods: A cross sectional analytical type of study was conducted at the department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh. A total of 70 (seventy) fresh human of right & left kidneys of both sexes were collected from the morgue of Mymensingh Medical College. The selected cases were between 5 to 60 years of age. The samples were divided into 3 different age groups (A: 05-15 years, B: 16-35 years, C: 36- 60 years) to observe the variations in length, breadth and thickness of kidney. Results: Statistically significant differences were found in the values of length, ...

Journal of Shaheed Suhrawardy Medical College, 2017

Background: Undergraduate medical education is part of a continuum of education and training. Obj... more Background: Undergraduate medical education is part of a continuum of education and training. Objective: This study was carried out to explore the views of intern doctors regarding the current undergraduate medical curriculum. Methodology: A partially descriptive open ended questionnaire was distributed among intern doctors of both public and private medical colleges in Bangladesh and was returned by 663 intern doctors. Results: Most of the participants (94%) suggested for changes in overall existing MBBS curriculum. However, they were satisfied with present pattern of administration test, present course content, duration, evaluation system and internship training. Majority of intern doctors did not experienced any difficulty in different phases. The study also reveals that most participants were in favor of 'Carry on' system and against the concept of pre-medical education. Conclusion: Student's evaluation may prove useful if analyzed further to overcome the shortcomings of existing MBBS curriculum. [

Bangladesh Journal of Anatomy, 2015

Context: Examination of bone is important for identification of sex of an individual. The present... more Context: Examination of bone is important for identification of sex of an individual. The present study was planned to collect data regarding sagittal length of human dry ossified second cervical vertebrae and to find out possible variations in male and female. Materials & Methods: A cross-sectional analytical type of study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka, from January 2012 to December 2012. The study materials consist of 156 human dry ossified second cervical vertebrae of unknown sex. The study samples were distributed in male and female sex groups by discriminant function analysis technique. Results: Among 156 vertebrae 55.77% was male and 44.23% was female. The mean (±SD) sagittal length of second cervical vertebrae was greater in male than that of female (P<0.001). Conclusion: Sagittal length of second cervical vertebra was greater in male compared to female. The differences in length can be useful in sex differentiation. DOI: http://d...

Pulse, 2014

Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in... more Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in intensive care units (ICUs) despite the advances in critical care medicine. Procalcitonin (PCT) is an innovative valuable laboratory marker in this regard. Objectives This study was undertaken to introduce PCT as a routine tool in regional hospitals by evaluating the utility of PCT in early diagnosis as well as in assessment of severity in septic patients in comparison to the traditional methods and inflammatory markers like cultures and C-reactive Protein (CRP). Method & Materials PCT and CRP were simultaneously measured in 73 medico-surgical ICU patients. The results of PCT, CRP and microbiological cultures were compared according to the five categories of PCT concentrations and the American College of Chest Physicians (ACCP) criteria based study groups. Results The clinical presentation of 75.3 % cases revealed a range of systemic inflammatory responses (SIRS). The diagnostic accurac...

Journal of Armed Forces Medical College, Bangladesh, 2012

Introduction: Nephropathies, as one of the multiple extrahepatic features of Hepatitis E virus (H... more Introduction: Nephropathies, as one of the multiple extrahepatic features of Hepatitis E virus (HEV) infection, can occur in clinically improved HEV hepatitis patients which in majority of the cases remain clinically silent for a long period. By the time these are reported, patients have already developed renal insufficiency which may even lead to renal replacement therapy. Proteinuria, a simple test in practice, can be a useful tool for early detection of the underlying renal impairment. Objective: The aim of this study was to detect the presence of proteinuria and to evaluate the degree of proteinuria in HEV-hepatitis patients during post-icteric state. Materials and Methods: This cross sectional study was conducted on 50 diagnosed patients of clinically improved HEV-hepatitis at the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) with active cooperation of the Department of Hepatology, BSMMU, between July 2006 and June 2007. Cases were chosen carefully, to exclude the acute state of illness and the patients of HEV were selected during their third or fourth follow-up, in their post-icteric phase. The study subjects were grouped according to equal age ranges in group-I (18-26 year) and group-II (27-35 year). Depending on the level of spot urinary protein (mg/dl) the subjects were also categorized as having trace, mild and moderate proteinuria. Results: The mean age of HEV infected subjects was 24.72±2.59 years. The mean spot urinary protein in age group-II patients was raised compared to age group-I and the difference was highly significant (p<0.001). Moreover, there was no significant difference (p>0.05) of spot urinary protein of male and female. Majority of HEV patients (42%) presented with mild proteinuria and mostly (53.3%) was of age group-I. Conclusion: Spot urinary protein concentration should be checked in every HEV-hepatitis patient to detect the presence and level of proteinuria.

Bangladesh Journal of Medical Biochemistry, 2013

Bicarbonate (HCO3-) measurement in serum or plasma from a sample of venous blood is routinely pra... more Bicarbonate (HCO3-) measurement in serum or plasma from a sample of venous blood is routinely practiced in hospital patient management. HCO3status can also be assumed from Blood gas analysis requiring arterial blood as sample which is cumbersome for both patients and doctors. This study was undertaken to evaluate the extent of agreement among biocarbonate values obtained during venous, arterial blood gas analysis and conventionally measured serum bicarbonate levels in a group of intensive care unit (ICU) patients to determine whether conventionally measured serum HCO3-(from peripheral venous blood) and calculated HCO3values (from arterial blood gas [ABG] analyzers) can be used interchangeably. A total of 51 adult patients with diverse medical conditions, presenting at a tertiary health centre ICU were enrolled in this study when deemed by the treating physician to have an ABG analysis. Arterial and venous samples were taken as close in time as possible for blood gas analysis and routine blood tests. Bland-Altman analyses were used to compare the three methods. The HCO3levels from ABG, Venous Blood gas (VBG) and tconventionally measured serum HCO3showed acceptably narrow 95% limits of agreement using the Bland-Altman method. VBG reveals higher level of agreement with the ABG bicarbonate values compared to measured serum HCO3-. Thus, venous blood can be an alternate for arterial blood where ABG analyzer is available. conventionaly serum HCO3measurements can also be useful and used as substitute for an expensive ABG analyzer in resource constrained health care sectors when required.

Pulse, 2014

Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic... more Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic dilemma due to its association with a wide range of clinical conditions. However, the significance of ALP in these clinical conditions in routine practice is often underestimated or overrated. Objectives: This study was determined to assess the pattern of ALP with an aim to elucidate its clinical utility among hospitalized patients. Method & materials: The inpatients with high ALP level were enlisted & analysed between January to December 2012 excluding cases of (a) patients who have bone involvements with malignancies and (b) HIV-seropositive patients attending a tertiary care Hospital at Dhaka. Extremely high levels of ALP were defined as being more than 1000 U/L. These patients were divided into different groups according to their final diagnosis. Results: A total of 154 hospitalized patients with eligible medical records were identified (98 male and 56 female, mean age 36 years). Th...

Bangladesh Journal of Obstetrics & Gynaecology, 2013

Background and objective: The objective of this study was to detect the incidence of chorioamnion... more Background and objective: The objective of this study was to detect the incidence of chorioamnionitis in PPROM and to evaluate the pattern of foetal outcome in these cases at a tertiary care hospital in Bangladesh. This study is also aimed to analyze the influence of the demographic variables predisposing to chorioamnionitis in PPROM in a locality. Materials and Methods: This single centre cross-sectional study was conducted on 110 pregnant women with preterm rupture of membranes at a tertiary care hospital in Dhaka, Bangladesh. The study group was divided according to the presence or absence of clinical chorioamnionitis defined as the presence of two or more of the following criteria: maternal temperature >38°C on two or more occasions ³1 h apart, maternal tachycardia (³120 beats/min), uterine tenderness, foul smelling amniotic fluid, maternal leukocytosis ³20,000 mm–3 with bands and positive C reactive protein. Antibiotics and tocolysis were used according to the hospital proto...

Bangladesh Journal of Medical Education, 2014

Background: Undergraduate medical education is part of a continuum of education and training. Obj... more Background: Undergraduate medical education is part of a continuum of education and training. Objective: This study was carried out to explore the views of intern doctors regarding the current undergraduate medical curriculum. Methodology: A partially descriptive open ended questionnaire was distributed among intern doctors of both public and private medical colleges in Bangladesh and was returned by 663 intern doctors. Results: Most of the participants (94%) suggested for changes in overall existing MBBS curriculum. However, they were satisfied with present pattern of administration test, present course content, duration, evaluation system and internship training. Majority of intern doctors did not experienced any difficulty in different phases. The study also reveals that most participants were in favor of 'Carry on' system and against the concept of pre-medical education. Conclusion: Student's evaluation may prove useful if analyzed further to overcome the shortcomings of existing MBBS curriculum. [

Acta Medica International

International Journal of Critical Illness and Injury Science, 2014

Background: Early diagnosis and appropriate therapy of sepsis is a daily challenge in intensive c... more Background: Early diagnosis and appropriate therapy of sepsis is a daily challenge in intensive care units (ICUs) despite the advances in critical care medicine. Procalcitonin (PCT); an innovative laboratory marker, has been recently proven valuable worldwide in this regard. Objectives: This study was undertaken to evaluate the utility of PCT in a resource constrained country like ours when compared to the traditional inflammatory markers like C-reactive protein (CRP) to introduce PCT as a routine biochemical tool in regional hospitals. Materials and Methods: PCT and CRP were simultaneously measured and compared in 73 medico-surgical ICU patients according to the American College of Chest Physicians (ACCP) criteria based study groups. Results: The clinical presentation of 75% cases revealed a range of systemic inflammatory responses (SIRS). The diagnostic accuracy of PCT was higher (75%) with greater specificity (72%), sensitivity (76%), positive and negative predictive values (89% and 50%), positive likelihood ratio (2.75) as well as the smaller negative likelihood ratio (0.33). Both serum PCT and CRP values in cases with sepsis, severe sepsis and septic shock were significantly higher from that of the cases with SIRS and no SIRS (P < 0.01). Conclusion: PCT is found to be superior to CRP in terms of accuracy in identification and to assess the severity of sepsis even though both markers cannot be used in differentiating infectious from noninfectious clinical syndrome.

Original Research Paper, May 1, 2014

Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic... more Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic dilemma due to its association with a wide range of clinical conditions. However, the significance of ALP in these clinical conditions in routine practice is often underestimated or overrated. Objectives: This study was determined to assess the pattern of ALP with an aim to elucidate its clinical utility among hospitalized patients. Method & materials: The inpatients with high ALP level were enlisted & analysed between January to December 2012 excluding cases of (a) patients who have bone involvements with malignancies and (b) HIV-seropositive patients attending a tertiary care Hospital at Dhaka. Extremely high levels of ALP were defined as being more than 1000 U/L. These patients were divided into different groups according to their final diagnosis. Results: A total of 154 hospitalized patients with eligible medical records were identified (98 male and 56 female, mean age 36 years). Their ALP levels are ranging from 1,006 to 3,067 IU/L; very extreme values of > 3000 IU/L being rarely (only about 2%) documented. Patients with sepsis can have an extremely high alkaline phosphatase level (1,648.2 ± 328.4 IU/L) and a normal bilirubin. Conclusion: High serum ALP levels in hospitalized patients were commonly found in three major groups having obstructive biliary diseases, infiltrative liver disease and sepsis. A variety of other causes were also noted. This routine laboratory test should receive more attention in clinical decision-making than has previously been given.

Original Research Paper, Apr 12, 2014

This study was carried out to get an idea about the views of medical educators and intern doctors... more This study was carried out to get an idea about the views of medical educators and intern doctors regarding the current undergraduate medical curriculum. A partially descriptive open ended questionnaire was distributed among teachers of all three phases and intern doctors in undergraduate curriculum in different public and private medical colleges in Bangladesh and was returned by 120 teachers and 663 intern doctors. Qualitative analysis of data was done. Among teachers 70% agreed to need for changes, 68.4% were in favor of present internship training system and 85% were against 'carry on' system. But 94% and 51% of intern doctors were in favor of need changes of curriculum and present internship training respectively. 91% were against 'carry on' system.

Pulse Medical Journal of Apollo Hospital Dhaka, Apr 5, 2013

Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in... more Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in intensive care units (ICUs) despite the advances in critical care medicine. Procalcitonin (PCT) is an innovative valuable laboratory marker in this regard. Objectives This study was undertaken to introduce PCT as a routine tool in regional hospitals by evaluating the utility of PCT in early diagnosis as well as in assessment of severity in septic patients in comparison to the traditional methods and inflammatory markers like cultures and C-reactive Protein (CRP). Method & Materials PCT and CRP were simultaneously measured in 73 medico-surgical ICU patients. The results of PCT, CRP and microbiological cultures were compared according to the five categories of PCT concentrations and the American College of Chest Physicians (ACCP) criteria based study groups. Results The clinical presentation of 75.3 % cases revealed a range of systemic inflammatory responses (SIRS). The diagnostic accuracy of PCT was higher (75.34%) with greater specificity (72.2 %), sensitivity (76.36%), positive and negative predictive values (89.36 % and 50%), positive likelihood ratio (2.75) as well as the smaller negative likelihood ratio (0.33). Both serum PCT and CRP values in cases with sepsis, severe sepsis and septic shock were significantly higher from that of the cases with SIRS and no SIRS (p< 0.01). Conclusion The diagnostic utility of both PCT and CRP are close yet PCT is found to be superior to that of CRP or microbiological culture in terms of accuracy in identification of patients with sepsis and to assess the severity of sepsis as well.

Context: Retroperitoneal location of kidney implies much difficulties in management of renal dise... more Context: Retroperitoneal location of kidney implies much difficulties in management of renal diseases, specially for surgeons. Appropriate knowledge on three dimensional morphological status of kidney may be helpful for successful surgery of this region. So this study was performed to evaluate the age related changes in length, breadth and thickness of kidney collected from Bangladesh. Materials and methods: A cross sectional analytical type of study was conducted at the department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh. A total of 70 (seventy) fresh human of right & left kidneys of both sexes were collected from the morgue of Mymensingh Medical College. The selected cases were between 5 to 60 years of age. The samples were divided into 3 different age groups (A: 05-15 years, B: 16-35 years, C: 36- 60 years) to observe the variations in length, breadth and thickness of kidney. Results: Statistically significant differences were found in the values of length, ...

Journal of Shaheed Suhrawardy Medical College, 2017

Background: Undergraduate medical education is part of a continuum of education and training. Obj... more Background: Undergraduate medical education is part of a continuum of education and training. Objective: This study was carried out to explore the views of intern doctors regarding the current undergraduate medical curriculum. Methodology: A partially descriptive open ended questionnaire was distributed among intern doctors of both public and private medical colleges in Bangladesh and was returned by 663 intern doctors. Results: Most of the participants (94%) suggested for changes in overall existing MBBS curriculum. However, they were satisfied with present pattern of administration test, present course content, duration, evaluation system and internship training. Majority of intern doctors did not experienced any difficulty in different phases. The study also reveals that most participants were in favor of 'Carry on' system and against the concept of pre-medical education. Conclusion: Student's evaluation may prove useful if analyzed further to overcome the shortcomings of existing MBBS curriculum. [

Bangladesh Journal of Anatomy, 2015

Context: Examination of bone is important for identification of sex of an individual. The present... more Context: Examination of bone is important for identification of sex of an individual. The present study was planned to collect data regarding sagittal length of human dry ossified second cervical vertebrae and to find out possible variations in male and female. Materials & Methods: A cross-sectional analytical type of study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka, from January 2012 to December 2012. The study materials consist of 156 human dry ossified second cervical vertebrae of unknown sex. The study samples were distributed in male and female sex groups by discriminant function analysis technique. Results: Among 156 vertebrae 55.77% was male and 44.23% was female. The mean (±SD) sagittal length of second cervical vertebrae was greater in male than that of female (P<0.001). Conclusion: Sagittal length of second cervical vertebra was greater in male compared to female. The differences in length can be useful in sex differentiation. DOI: http://d...

Pulse, 2014

Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in... more Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in intensive care units (ICUs) despite the advances in critical care medicine. Procalcitonin (PCT) is an innovative valuable laboratory marker in this regard. Objectives This study was undertaken to introduce PCT as a routine tool in regional hospitals by evaluating the utility of PCT in early diagnosis as well as in assessment of severity in septic patients in comparison to the traditional methods and inflammatory markers like cultures and C-reactive Protein (CRP). Method & Materials PCT and CRP were simultaneously measured in 73 medico-surgical ICU patients. The results of PCT, CRP and microbiological cultures were compared according to the five categories of PCT concentrations and the American College of Chest Physicians (ACCP) criteria based study groups. Results The clinical presentation of 75.3 % cases revealed a range of systemic inflammatory responses (SIRS). The diagnostic accurac...

Journal of Armed Forces Medical College, Bangladesh, 2012

Introduction: Nephropathies, as one of the multiple extrahepatic features of Hepatitis E virus (H... more Introduction: Nephropathies, as one of the multiple extrahepatic features of Hepatitis E virus (HEV) infection, can occur in clinically improved HEV hepatitis patients which in majority of the cases remain clinically silent for a long period. By the time these are reported, patients have already developed renal insufficiency which may even lead to renal replacement therapy. Proteinuria, a simple test in practice, can be a useful tool for early detection of the underlying renal impairment. Objective: The aim of this study was to detect the presence of proteinuria and to evaluate the degree of proteinuria in HEV-hepatitis patients during post-icteric state. Materials and Methods: This cross sectional study was conducted on 50 diagnosed patients of clinically improved HEV-hepatitis at the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) with active cooperation of the Department of Hepatology, BSMMU, between July 2006 and June 2007. Cases were chosen carefully, to exclude the acute state of illness and the patients of HEV were selected during their third or fourth follow-up, in their post-icteric phase. The study subjects were grouped according to equal age ranges in group-I (18-26 year) and group-II (27-35 year). Depending on the level of spot urinary protein (mg/dl) the subjects were also categorized as having trace, mild and moderate proteinuria. Results: The mean age of HEV infected subjects was 24.72±2.59 years. The mean spot urinary protein in age group-II patients was raised compared to age group-I and the difference was highly significant (p<0.001). Moreover, there was no significant difference (p>0.05) of spot urinary protein of male and female. Majority of HEV patients (42%) presented with mild proteinuria and mostly (53.3%) was of age group-I. Conclusion: Spot urinary protein concentration should be checked in every HEV-hepatitis patient to detect the presence and level of proteinuria.

Bangladesh Journal of Medical Biochemistry, 2013

Bicarbonate (HCO3-) measurement in serum or plasma from a sample of venous blood is routinely pra... more Bicarbonate (HCO3-) measurement in serum or plasma from a sample of venous blood is routinely practiced in hospital patient management. HCO3status can also be assumed from Blood gas analysis requiring arterial blood as sample which is cumbersome for both patients and doctors. This study was undertaken to evaluate the extent of agreement among biocarbonate values obtained during venous, arterial blood gas analysis and conventionally measured serum bicarbonate levels in a group of intensive care unit (ICU) patients to determine whether conventionally measured serum HCO3-(from peripheral venous blood) and calculated HCO3values (from arterial blood gas [ABG] analyzers) can be used interchangeably. A total of 51 adult patients with diverse medical conditions, presenting at a tertiary health centre ICU were enrolled in this study when deemed by the treating physician to have an ABG analysis. Arterial and venous samples were taken as close in time as possible for blood gas analysis and routine blood tests. Bland-Altman analyses were used to compare the three methods. The HCO3levels from ABG, Venous Blood gas (VBG) and tconventionally measured serum HCO3showed acceptably narrow 95% limits of agreement using the Bland-Altman method. VBG reveals higher level of agreement with the ABG bicarbonate values compared to measured serum HCO3-. Thus, venous blood can be an alternate for arterial blood where ABG analyzer is available. conventionaly serum HCO3measurements can also be useful and used as substitute for an expensive ABG analyzer in resource constrained health care sectors when required.

Pulse, 2014

Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic... more Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic dilemma due to its association with a wide range of clinical conditions. However, the significance of ALP in these clinical conditions in routine practice is often underestimated or overrated. Objectives: This study was determined to assess the pattern of ALP with an aim to elucidate its clinical utility among hospitalized patients. Method & materials: The inpatients with high ALP level were enlisted & analysed between January to December 2012 excluding cases of (a) patients who have bone involvements with malignancies and (b) HIV-seropositive patients attending a tertiary care Hospital at Dhaka. Extremely high levels of ALP were defined as being more than 1000 U/L. These patients were divided into different groups according to their final diagnosis. Results: A total of 154 hospitalized patients with eligible medical records were identified (98 male and 56 female, mean age 36 years). Th...

Bangladesh Journal of Obstetrics & Gynaecology, 2013

Background and objective: The objective of this study was to detect the incidence of chorioamnion... more Background and objective: The objective of this study was to detect the incidence of chorioamnionitis in PPROM and to evaluate the pattern of foetal outcome in these cases at a tertiary care hospital in Bangladesh. This study is also aimed to analyze the influence of the demographic variables predisposing to chorioamnionitis in PPROM in a locality. Materials and Methods: This single centre cross-sectional study was conducted on 110 pregnant women with preterm rupture of membranes at a tertiary care hospital in Dhaka, Bangladesh. The study group was divided according to the presence or absence of clinical chorioamnionitis defined as the presence of two or more of the following criteria: maternal temperature >38°C on two or more occasions ³1 h apart, maternal tachycardia (³120 beats/min), uterine tenderness, foul smelling amniotic fluid, maternal leukocytosis ³20,000 mm–3 with bands and positive C reactive protein. Antibiotics and tocolysis were used according to the hospital proto...

Bangladesh Journal of Medical Education, 2014

Background: Undergraduate medical education is part of a continuum of education and training. Obj... more Background: Undergraduate medical education is part of a continuum of education and training. Objective: This study was carried out to explore the views of intern doctors regarding the current undergraduate medical curriculum. Methodology: A partially descriptive open ended questionnaire was distributed among intern doctors of both public and private medical colleges in Bangladesh and was returned by 663 intern doctors. Results: Most of the participants (94%) suggested for changes in overall existing MBBS curriculum. However, they were satisfied with present pattern of administration test, present course content, duration, evaluation system and internship training. Majority of intern doctors did not experienced any difficulty in different phases. The study also reveals that most participants were in favor of 'Carry on' system and against the concept of pre-medical education. Conclusion: Student's evaluation may prove useful if analyzed further to overcome the shortcomings of existing MBBS curriculum. [

Acta Medica International

International Journal of Critical Illness and Injury Science, 2014

Background: Early diagnosis and appropriate therapy of sepsis is a daily challenge in intensive c... more Background: Early diagnosis and appropriate therapy of sepsis is a daily challenge in intensive care units (ICUs) despite the advances in critical care medicine. Procalcitonin (PCT); an innovative laboratory marker, has been recently proven valuable worldwide in this regard. Objectives: This study was undertaken to evaluate the utility of PCT in a resource constrained country like ours when compared to the traditional inflammatory markers like C-reactive protein (CRP) to introduce PCT as a routine biochemical tool in regional hospitals. Materials and Methods: PCT and CRP were simultaneously measured and compared in 73 medico-surgical ICU patients according to the American College of Chest Physicians (ACCP) criteria based study groups. Results: The clinical presentation of 75% cases revealed a range of systemic inflammatory responses (SIRS). The diagnostic accuracy of PCT was higher (75%) with greater specificity (72%), sensitivity (76%), positive and negative predictive values (89% and 50%), positive likelihood ratio (2.75) as well as the smaller negative likelihood ratio (0.33). Both serum PCT and CRP values in cases with sepsis, severe sepsis and septic shock were significantly higher from that of the cases with SIRS and no SIRS (P < 0.01). Conclusion: PCT is found to be superior to CRP in terms of accuracy in identification and to assess the severity of sepsis even though both markers cannot be used in differentiating infectious from noninfectious clinical syndrome.

Original Research Paper, May 1, 2014

Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic... more Background: Persistent elevation of serum ALP is frequently encountered and can pose a diagnostic dilemma due to its association with a wide range of clinical conditions. However, the significance of ALP in these clinical conditions in routine practice is often underestimated or overrated. Objectives: This study was determined to assess the pattern of ALP with an aim to elucidate its clinical utility among hospitalized patients. Method & materials: The inpatients with high ALP level were enlisted & analysed between January to December 2012 excluding cases of (a) patients who have bone involvements with malignancies and (b) HIV-seropositive patients attending a tertiary care Hospital at Dhaka. Extremely high levels of ALP were defined as being more than 1000 U/L. These patients were divided into different groups according to their final diagnosis. Results: A total of 154 hospitalized patients with eligible medical records were identified (98 male and 56 female, mean age 36 years). Their ALP levels are ranging from 1,006 to 3,067 IU/L; very extreme values of > 3000 IU/L being rarely (only about 2%) documented. Patients with sepsis can have an extremely high alkaline phosphatase level (1,648.2 ± 328.4 IU/L) and a normal bilirubin. Conclusion: High serum ALP levels in hospitalized patients were commonly found in three major groups having obstructive biliary diseases, infiltrative liver disease and sepsis. A variety of other causes were also noted. This routine laboratory test should receive more attention in clinical decision-making than has previously been given.

Original Research Paper, Apr 12, 2014

This study was carried out to get an idea about the views of medical educators and intern doctors... more This study was carried out to get an idea about the views of medical educators and intern doctors regarding the current undergraduate medical curriculum. A partially descriptive open ended questionnaire was distributed among teachers of all three phases and intern doctors in undergraduate curriculum in different public and private medical colleges in Bangladesh and was returned by 120 teachers and 663 intern doctors. Qualitative analysis of data was done. Among teachers 70% agreed to need for changes, 68.4% were in favor of present internship training system and 85% were against 'carry on' system. But 94% and 51% of intern doctors were in favor of need changes of curriculum and present internship training respectively. 91% were against 'carry on' system.

Pulse Medical Journal of Apollo Hospital Dhaka, Apr 5, 2013

Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in... more Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in intensive care units (ICUs) despite the advances in critical care medicine. Procalcitonin (PCT) is an innovative valuable laboratory marker in this regard. Objectives This study was undertaken to introduce PCT as a routine tool in regional hospitals by evaluating the utility of PCT in early diagnosis as well as in assessment of severity in septic patients in comparison to the traditional methods and inflammatory markers like cultures and C-reactive Protein (CRP). Method & Materials PCT and CRP were simultaneously measured in 73 medico-surgical ICU patients. The results of PCT, CRP and microbiological cultures were compared according to the five categories of PCT concentrations and the American College of Chest Physicians (ACCP) criteria based study groups. Results The clinical presentation of 75.3 % cases revealed a range of systemic inflammatory responses (SIRS). The diagnostic accuracy of PCT was higher (75.34%) with greater specificity (72.2 %), sensitivity (76.36%), positive and negative predictive values (89.36 % and 50%), positive likelihood ratio (2.75) as well as the smaller negative likelihood ratio (0.33). Both serum PCT and CRP values in cases with sepsis, severe sepsis and septic shock were significantly higher from that of the cases with SIRS and no SIRS (p< 0.01). Conclusion The diagnostic utility of both PCT and CRP are close yet PCT is found to be superior to that of CRP or microbiological culture in terms of accuracy in identification of patients with sepsis and to assess the severity of sepsis as well.