Background: Incidence of congenital heart disease is 8-10/1000 live birth which is established by many studies carried out in many centers worldwide. In Bangladesh no incidence study was carried out so far. Newborn children presenting with various forms of congenital heart disease is a common problem now a days. Neonatologists and paediatricians are now more conscious about early detection and treatment of newborn with congenital heart diseases. Diagnostic facilities are also available in many places. So an individual incidence record from an ideal center of our country is a demand of the time which led carrying out this study. Methods: This prospective study was carried out in Combined Military Hospital (CMH) Dhaka over a period of three years (2004 – 2006). All five thousand six hundred and sixty eight live births weighing more than 500 gm and more than 28 weeks gestational period were subjected to a thorough clinical examination within 72 hours of birth. Those suspected to have any form of congenital heart disease (CHD) were followed up every 4-6 wks for a period of 12 months. Echocardiography with color Doppler was performed in all these newborn including those who reported late but were delivered in obstetrics department of Combined Military Hospital Dhaka. Result: One hundred forty two babies out of 5668 live birth had CHD, ie, 25/1000 live births. Incidence of CHD was higher in pre terms as compared to full term live birth. Some of the patients (18.30%) has other associated somatic anomalies among which Down’s syndrome was commonest (9.15%). Most common congenital heart lesions were Atrial Septal Defect (ASD-26%), Ventricular Septal Defect (VSD-16.9%), Patent Ductus Arteriosus (PDA-18%), Tetralogy of Fallot (TOF-14%), Pulmonary Stenosis (PS-7.75%) etc. Those who were found to have congenital heart disease were managed accordingly. Some patients had spontaneous closure of defects in first year follow up period. Conclusion: The incidence of Congenital Heart Disease (CHD) depends upon various factors like nature of the samples (all live birth or all birth) or on the spot examination by a Paediatric cardiologist. A hospital which has Obstetric, Neonatal and Paediatric cardiology unit can carried out this kind of study successfully. In this study screening of asymptomatic high risk neonates also contributes in early detection of many trivial lesions. Severe lesions were also detected by the paediatric cardiologist who usually expire before being referred from other hospitals and before being diagnosis is established. So a higher incidence rate is recorded in this study. Key words: Congenital heart disease; Echocardiography DOI: http://dx.doi.org/10.3329/cardio.v1i1.8199 Cardiovasc. j. 2008; 1(1) : 14-20

Caesarean section rate is increasing day by day. Incidence of caesarean scar pregnancy (CSP) is also increasing. Prompt and multidisciplinary approach towards diagnosis of the condition is required to reduce associated morbidity. Major haemorrhage and hysterectomy are the main risks associated with CSP. Therefore, adequate counseling and availability of surgical expertise and blood transfusion should be part of a comprehensive management strategy. There are many single reports in literature but only few case series. In this paper, 10 cases of caesarean scar pregnancy treated in Obstetrics and Gynaecology department of CMH Dhaka, CMH Jashore and Hightech Multicare Hospital Private Limited over 10 years are analyzed. Three of 10 patients had mild pain in their lower abdomen and vaginal bleeding. Seven of them had profuse bleeding during D&C for miscarriage as they were not diagnosed at the time of admission. All patients had 1 or 2 caesarean sections. Gestational age of the pregnancy was estimated from 8 to 12 weeks by the last menstrual period. 9 patients were treated surgically. Eight of them had local resection of ectopic pregnancy mass with conservation of the uterus. One patient was treated with D&C followed by intrauterine balloon catheter insertion to control excessive bleeding. There was no total or subtotal hysterectomy. One patient was treated with Inj. Methotrexate. Common symptoms of caesarean scar pregnancy are pain in the lower abdomen and variable degree of vaginal bleeding. The treatment depends on severity of symptoms, gestational age and experience of the obstetrician dealing these cases. J Bangladesh Coll Phys Surg 2019; 37(4): 191-195

Introduction: Urethral catheterization is done as a routine procedure in cesarean section. It is associated with great discomfort, high incidence of urinary tract infection, delayed ambulation and longer hospital stay.Objectives: To determine the feasibility and safety of cesarean section without urethral catheterization.Materials and Methods: A prospective, observational study was carried out from April 2012 to March 2013, in the Department of Obstetrics and Gynaecology, CMH Dhaka and IBN Sina Hospital Dhaka among 65 patients who had undergone cesarean section without catheterization. There were some limitations of this study. We had excluded previous cesarean from our study, so the results of this study cannot be generalized.Results: Firs void discomfort was not significantly associated without the use of indwelling catheter. Hospital stay was shorter (94% was discharged on 3rd post operative day). None of the patients had bladder injury. Mean duration of surgery was 45 minutes (44%) and ambulation time 11-14 hours (60%). Average estimated blood loss was 500 ml (41%) and time of 1st voiding was 5-8 hrs (58%). Need for catheterization was significantly low (3%).Conclusion: Cesarean section can be done safely without urethral catheterization with reduced morbidities.Journal of Armed Forces Medical College Bangladesh Vol.11(1) 2015: 3-6

Ciguatoxin (CTX) is a visibly unidentifiable, colourless, odourless, heat stable and lipid soluble polyether marine biotoxin associated with human illness. Marine dinoflagellates under the genus Gambierdiscus are responsible for producingciguatoxins (CTX). The ciguatoxin gets accumulated in herbivorous fishes, gets biotransformed in carnivorous fishes and finally reach fish consumers. In January 2016, individuals who consumed red snapper in Trivandrum, Kerala, India weresuspected to be intoxicated with ciguatera based on characteristic symptoms as assessed by medical team from Trivandrum Medical College, Kerala, India. The red snapper species was identified and confirmed as Lutjanus bohar by DNA barcoding. Mouse bioassay was carried out to detect the presence of ciguatoxin and the tested mice showed symptoms related to suspected CTX toxicity. Significantly higher level of ciguatoxin lethal dose was estimated which was found equivalent to 16.25 ng of CTX-1 which led to 13% of weight loss in tested mice. Medical professionals also investigated clinical manifestations of suspected toxicity in hospitalised individuals. This study indicated that there is a need for regular surveillance of seafood landed across the coast and consumer’s awareness for their safety.

Introduction: Corona virus is a new pathogen of high contagious abilities. Pregnant women are at an increased risk due to physiologic changes in their immune, cardiopulmonary and coagulation systems. This study was designed to evaluate the fetomaternal outcome of the pregnant patients with COVID-19. Methods: This retrospective observational study was conducted in CMH Dhaka from May 2020 to July 2020. Total 81 hospitalized pregnant patients with confirmed COVID-19 were enrolled. Relevant data were recorded in a preformed data collection sheet and analyzed by SPSS version 20. Results: Total patients were 81 with a mean age of 27 years; 49.1% were in third trimester, 83% were in 35-40 weeks of gestation and 48% were asymptomatic. Common symptom severe cough (26%) and fever(14%); 7.4% patients had multiorgan failure, 81% hadlymphopenia, 7.4% patients under went chest CT and had in filtrates in both lungs. Mild to moderate disease was common and 7.4 % had severe disease, 3.7% needed mechanical ventilation. There was a single maternal death. Most (92.6%) patients were treated in Corona ward and 7.4% in Corona HDU and ICU. There were 3 spontaneous abortions; 64.2% delivered during the study period, 80.8% underwent a Caesarean section, 2.4% had hysterotomy, 15.1% underwent normal vaginal delivery (NVD), 15.4% patients underwent premature termination of pregnancy. Ongoing pregnancy was 26 (32.1%).Four neonates were found COVID-positive. There was 47 livebirths, 3 intrauterine deaths (IUD) and 2 neonatal deaths. Their hospital stay was 13.1 days (SD±6.37).Mean interval of breastfeeding was 13.3 days (SD±6.44). Conclusion: From the study findings, it can be concluded that, COVID-19 had adverse fetomaternal outcomes. COVID-19 pandemic has exerted immense stress on health care system. With this study we can further modify our treatment strategy and reduce the load on our health system. J Bangladesh Coll Phys Surg 2021; 39(2): 100-105

Background: During pregnancy, there are many superstitions throughout the world, especially in the developing countries like Bangladesh. Objective: This study was aimed to know the status of superstitions related to pregnancy among people. Methodology: This descriptive type of cross-sectional study was conducted in the outpatient of department in Combined Military Hospital, Dhaka, Bangladesh from January 2018 to March 2018 for a period of three months. Total 96 persons were recruited after taking verbal consent. Result: Among the study group having at least one superstition was in 69.8% of total participants showing in figure 1. In 25 to 40 years of age group the superstitions were more common and it was 85.0% showing in table1. On the educational background, illiterate group having more superstitions 81.13%, primary education group 65.21%, SSC 50% and above SSC 33.33% showing in table 3. On the basis of gender, male (58.233%) and Female (71.42%) were superstitious in at least one superstition. On the basis of socioeconomic status, lower class 92.72%, lower middle class 54.54% and middle class 21.05% were superstitious in at least one superstition. On the basis of occupation, housewives (89.90%), students (16,66%), service holder(30%) and farmer(50%) having at least one superstitious. On the basis of religion; the superstitious individuals were Muslim 59%, Hindu 97%, and others 67.16%. Conclusion: Superstitions related to pregnancy are very common in Bangladesh. Superstitious are more related to illiteracy, low socioeconomic condition and with house wives who remain inside. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 172-176

Introduction: Down syndrome (DS) is the most common chromosomal aneuploidy to result in a live birth. Prenatal diagnosis of the affected fetuses can be performed using variety of sonographic features. Within the 11 to 14 weeks gestational age (GA) window, increased nuchal translucency has been the hallmark for identifying fetuses with Down syndrome. Objective: To estimate the Nasal Bone Length (NBL) of fetuses at 18 to 22 weeks GA in Bangladeshi population and establish the Nomogram of it and finally compare it with that of Caucasian population. Materials and Methods: The prospective observational study was conducted in Aklima General Hospital Limited, Mirpur, Dhaka, Bangladesh in the Feto-maternal Medicine Unit under Obstetrics and Gynaecology Department for tenure from February 2014 to June 2019. After considering the inclusion and exclusion criteria, 500 antenatal subjects married to Bangladeshi partners with singleton pregnancies attending the routine antenatal outpatient department for an anomaly scan (18-22 weeks) were included and followed up in the study. The nasal bone length was measured from the base of the nose closest to the frontal bones to the farthest extent of ossification on the nose. Results: The nasal bone lengths of the fetuses at 18 to 22 weeks were measured in 500 cases where for 19 cases of 18 weeks of GA fetuses have a mean NBL of 4.6 mm, 75 cases of 19 weeks of GA fetuses have a mean NBL of 4.8 mm, 161 cases of 20 weeks of GA fetuses have a mean NBL of 5.1 mm, 169 cases of 22 weeks of GA fetuses have mean NBL of 5.8 mm and 76 cases of 22 weeks of GA fetuses have mean NBL of 6.2 mm which is significantly shorter than those of Caucasian population. Conclusion: The nasal bone lengths of the fetuses at 18 to 22 weeks were significantly shorter to those of the Caucasian population. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 48-50

Introduction: Amniocentesis is a procedure in which amniotic fluid is collected from the amniotic cavity for testing or treatment. Amniotic fluid is the fluid that surrounds and protects a baby during pregnancy. Amniotic fluid contains fetal cells and various proteins and provides valuable information about baby's health. Aim: To evaluate the risk and associated complications during diagnostic amniocentesis. Methods: This prospective study was conducted by performing amniocentesis among pregnant ladies of early second trimester at Dhaka CMH, and Aklima General Hospital Limited, Mirpur, Dhaka from July 2016 to June 2019. A total of 50 patients were selected by age of the patient, history of previous pregnancy outcome, parental haemoglobinopathy and few other factors triggered these cases to be put under this study. Results: No major complications have been observed during and after the procedure because of appropriate pre-operative and post-operative management. Conclusion: There are some common and known risks which are associated with amniocentesis like miscarriage, amnionitis, fetal trauma etc. Through skilled execution with the help of real-time ultrasound guidance and proper pre-operative and post-operative care, we can avoid complications and get benefit from amniocentesis. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 42-45