Use of antimicrobials in caesarean section has become an accepted practice to minimize the incidence of postoperative complications. Not many studies are available in Bangladesh regarding the using pattern of antibiotics in caesarean section. The objectives of the study was to find out the pattern of use of antibiotic prophylaxis in caesarean section and also the frequency of postoperative morbidity. The prospective cross-sectional study included 356 patients undergoing caesarean section in Prime Medical College Hospital, Rangpur and 10 different private clinics in Rangpur city. Patients demographics, perioperative data, antibiotic used with dosage and schedules were recorded. Investigations like pus, blood and urine culture and sensitivity were recorded for patients with postoperative complications. Change of antimicrobial following culture sensitivity report was noted. Most of the patients, 197 (55.3%), came from lower middle socioeconomic status. Major indication of cesarean section was emergency in 314 (88.2%) patients. The use of third generation cephalosporin (ceftriaxone) in majority of the patients, 209 (58.7%), was observed. Two drugs combination commonly included third generation cephalosporin and metronidazole, and in addition gentamicin was added when three drugs combination was used. Fifty five (15.5%) patients had postoperative complications which included fever, wound infection, urinary tract infection and endometritis. The mean duration (SD) of antibiotic administration was 12.4 (3.5) days in infected patients and 8.0 (2.1) days in non-infected patients, and the difference was statistically significant (p < 0.01). The mean duration (SD) of hospital stay was 15.4 (5.5) and 9.1 (3.9) days for infected and non-infected patients, respectively; and the difference was statistically significant (p < 0.01). Isolated micro-organisms from wound infection, urinary tract infection and lochia were gram-negative, and Escherichia coli, 16 (41.0%), was the common which was resistant to third generation cephalosporin and sensitive to amikacin. Obstetricians should utilize clinically effective antibiotics. Whenever possible, single drug rather than combination therapy should be used. Periodic surveillance of antimicrobial prophylaxis is essential to detect the emergence of antibiotic resistance.Mediscope Vol. 3, No. 1: January 2016, Pages 8-15

Introduction: Diabetes mellitus (DM), particularly Type 2 DM is now recognized as a major chronic public health problem throughout the world. Different anti-diabetic agents, oral or injectable are used to regulate patients’ glycemic status as monotherapy or in combination. Objectives: To observe the prescribingpattern ofanti-diabetic agents and to collect demographic and disease details of type 2 DM patients. Materials and Methods: This descriptive cross-sectional study was conducted from January to August 2017 in the outpatient department of Border Guard Hospital, Pilkhana; a tertiary level hospital in Dhaka. The study enrolled 172 type 2 diabetic patients purposively on specified criteria. Demographic data,drug prescribing pattern, disease pattern were collected by an interview and from patients’ prescriptions. Results: Among 172 respondents,70 (40.70%) were male and 102 (59.30%) were female. The mean age of patients was 54.21±10.09 years. Eighty seven (50.58%) patients were either overweight or obese. Eighty two (47.67%) patients had family history of DM. Majority of patients (84.89%) had duration of diabetes >5 years and 84 (48.84%) patients had co-morbidities. Majority of the patients 135(78.49%) were prescribed oral drugs either alone or in combination. Among them 83 (63.48%) patients were prescribed oral monotherapy and 52(38.52%) patients were prescribed oral combination therapy. Metformin was the most prescribed oral anti-diabetic drug as monothearpy (71.08%). Among combined anti-diabetic drugsbased on class, metformin+Dipeptidyl peptidase 4 inhibitors(DPP4i) (36.11%), combination was the most commonly prescribed combination. The findings can lead to select the formulation and combination of anti-diabetic drugs in this part of the world for developing & marketing a new anti-diabetic drug. Conclusion: Metformin was the most commonly prescribed drug both as monotherapy as well as combination therapy and monotherapy was predominant over combination therapy. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 139-143

Introduction: Acute myocardial infarction (AMI) is the most important form of ischemic heart disease (IHD). Coronary artery disease (CAD) is an increasingly important medical and public health problem and is the leading cause of mortality in Bangladesh. AMI is the rapid development of myocardial necrosis caused by a critical imbalance between the oxygen supply and demand of the myocardium. Total occlusion of the coronary arteries for more than 4-6 hrs results in irreversible myocardial necrosis, but reperfusion within this period can salvage the myocardium and reduce morbidity and mortality. Objectives: To assess the role of carvedilol in prevention of adrenaline induced cardiac damage in experimental animal. Materials and Methods: This experimental study was carried out in the department of pharmacology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for a period of One year spanning from July 2004 to June 2005. Fifty two healthy rats of Long Evan Norwegian strains, 3-4 months of ages of both sexes, weight between 180-220g were used. The experiment was divided into two parts: Part-I and Part-II. Thirty two rats were selected for Part-I experiment and subdivided into Group-I and Group-II. In Part-II experiment, 20 rats were selected and placed as Group-III. Group-I (12 rats) of control group was treated with 02 doses of inj distilled water (D/W) subcutaneously (S.C.) 24 hrs apart and serum creatine kinase-MB (CK-MB) level and hepatic and cardiac reduced glutathione (GSH) contents were estimated from 06 (Group-Ia) rats after 12 hrs and serum aspartate aminotransferase (AST) level and hepatic and cardiac reduced GSH contents were estimated from 06 (Group-Ib) rats after 24 hrs of 2nd inj of D/W. Group-II (20 rats) was treated with 02 doses of inj adrenaline (2mg/kg) S.C. in 24 hrs interval and in above mentioned way serum CK-MB level, GSH (hepatic and cardiac) contents and serum AST and GSH (hepatic and cardiac) contents were estimated 12 hrs and 24 hrs after the 2nd inj of adrenaline respectively. In experimental group (Group-III) all the rats (20) were treated with carvedilol (1 mg/kg) orally for 14 consecutive days and then were given 02 doses of inj adrenaline with the interval of 24 hrs and again serum CK-MB level and GSH (hepatic and cardiac) contents were estimated from half of the rats (10) after 12 hrs of injection and serum AST level and GSH (hepatic and cardiac) contents were measured from half of the rats (10) after 24 hrs of 2nd injection of adrenaline. Results: Adrenaline (2mg/kg) induced myocardial damage was evaluated biochemically by significant (P˂0.001) increase in CK-MB and AST levels. Free radical production following adrenaline induced myocardial damage was reflected by significant (P˂0.001) depletion in hepatic and cardiac reduced glutathione (GSH) contents. Cardioprotection provided by carvedilol pretreatment in adrenaline induced myocardial infarction was assessed by significant prevention of increase in serum CK-MB and AST levels. Antioxidant property of carvedilol was evaluated by significant (P<0.001) prevention of depletion in hepatic and cardiac GSH contents. The results of the study indicated that carvedilol pretreatment provided effective prevention in adrenaline induced myocardial damage and also provided effective antioxidative action. Conclusion: This study indicated that adrenaline administration induced myocardial damage as evidenced by increase in serum CK-MB and AST levels which was associated with free radical production as reflected by depletion in hepatic and cardiac GSH contents. It was observed that carvedilol through their antioxidant property in addition to their β-blocking effect prevents free radical mediated injury of catecholamine assault following MI. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 127-134

Introduction: Positive symptoms become perceptible in patients as schizophrenia progresses. If schizophrenia goes untreated catatonic motor behaviors are develops. Now a day’s catatonia which is a type of disturbed behavior is observed, with less frequency than in past years due to advances in treating schizophrenia. Treatment of schizophrenia by olanzapine and risperidone shows diverse outcomes. Objectives: To assess the response on positive symptoms of schizophrenia by olanzapine and risperidone. Materials and Methods: This study was conducted in Department of Pharmacology and Department of Psychiatry of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period from September 2013 to January 2015. A total of 179 schizophrenia patients fulfilling the inclusion criteria were enrolled and of them 75 patients completed the study, where 40 were in olanzapine treated group and 35 were in risperidone treated group in a 12-weeks assessment where Scale for Assessment of Positive Symptoms (SAPS) was applied. After statistical analysis of scores between intergroup and intra group p<0.05 was considered significant. Results: Treatment with both the olanzapine and risperidone were remarkably effective for progress of positive symptoms of schizophrenia patients but in olanzapine treated group the score was reduced more than that of risperidone treated group and the difference was significant (p<0.05). Conclusion: Olanzapine has responded better on positive symptoms of schizophrenia patients than that of risperidone. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 58-60

The objective of the present prospective cross sectional descriptive study was to evaluate the prescribing pattern of analgesic drug by orthopaedic surgeons in outdoor patients. This study was conducted in the orthopaedic outpatient department (OPD) of the Department of Orthopaedics, Border Guard Hospital, Pilkhana, Dhaka for six months period from January 2016 to June 2016. Randomly selected 324 prescriptions were collected from the attending patients on OPD and analyzed. The details of prescribed drugs, various analgesics, monotherapy or combined therapy and use of generic name were analyzed. Among the 324 study prescriptions, males and females were 63.9% and 36.1%, respectively. Majority of patients (80.8%) were within 31-60 years of age. Different classes of drugs were prescribed: non-selective non-steroidal anti-inflammatory drugs (NSAIDs) use was 45.2%, selective NSAIDs 2.9%, opioid analgesics 7.3%, H2 blockers 13.6%, proton pump inhibitors 17.1%, muscle relaxants 4.0%, benzodiazepines 8.1%, and other adjuvants 1.9%. Among individual analgesics: diclofenac 23.5%, aceclofenac 6.0%, ketorolac 6.9%, naproxane 10.8%, ibuprofen 3.7%, indomethacin 3.5%, etoricoxib 6.2%, tramadol 15.4% and paracetamol 24.0% were used. Of the 324 patients, 33.6% received combination of analgesics: diclofenac+paracetamol 37.6%, aceclofenac+paracetamol 14.7%, ketorolac+ paracetamol 20.2%, tramadol+paracetamol 22.9% and diclofenac+tramadol 4.6%. Use of trade names was for 80.5% drugs and generic names for 19.5% drugs. NSAIDs were widely prescribed drugs. Use of selective was less comparing to non-selective NSAIDs. Tramadol was the most commonly prescribed opioid drug. Gastro protective agents were used with NSAIDs. Prescribers need to be encouraged to prescribe drugs only using generic names.Mediscope Vol. 4, No. 1: Jan 2017, Page 11-17