PAHMC Journal

Background: Aspiration is a well-established cause of pulmonary disease and frequently occurs in patients with altered consciousness. Mortality from aspiration pneumonia ranges from approximately 1% in outpatient settings to as high as 25% in hospitalized patients, and up to 70% if not properly managed.

Objective: To determine the prevalence of aspiration pneumonia in stroke patients with altered consciousness admitted to the medicine department of President Abdul Hamid Medical College Hospital (PAHMCH).

Methods: A prospective observational study was conducted from May 2018 to March 2019, including 52 adult stroke patients with altered consciousness who developed aspiration pneumonia.

Results: Among the patients, 76.92% developed pneumonitis, 13.46% developed lung abscesses, and 9.62% developed acute respiratory distress syndrome (ARDS). The overall mortality rate was 23%. Mortality was 8.33% when only one lobe was involved, whereas involvement of two or more lobes was associated with mortality ranging from 25% to 91%.

Conclusion: Physicians and healthcare personnel can reduce the incidence of aspiration pneumonia by ensuring comatose patients are not left unattended, checking nasogastric tube placement, positioning patients properly, and adhering to routine patient care precautions.

Keywords: Aspiration pneumonia, Pulmonary involvement, Stroke with altered consciousness

Background: The neonatal period is a critical phase for a child’s survival, with neonatal deaths accounting for approximately half of all under-five mortalities in developing countries. Disease patterns among neonates can vary across regions and over time.

Objective: Analyzing admission patterns in healthcare settings helps identify gaps in care and strategies to reduce neonatal morbidity and mortality.

Methods: This hospital-based retrospective study assessed admission patterns and outcomes in the neonatal care unit of President Abdul Hamid Medical College Hospital, Kishoreganj, reviewing medical records from March 2022 to February 2023, covering 408 neonates.

Results: Of the 408 neonates admitted, 249 (61%) were male and 159 (39%) were female. The leading causes of admission were birth asphyxia (35.2%) and prematurity (32.4%), followed by meconium aspiration (14.7%) and sepsis (9.8%). Of the admitted neonates, 250 (61.3%) improved and were discharged, while 89 (21.8%) died, with prematurity and low birth weight as the primary cause of mortality (35.9%), followed by sepsis (30.4%) and perinatal asphyxia (24.7%).

Conclusion: Strengthening antenatal care and ensuring prompt neonatal resuscitation at the community and delivery room levels are essential strategies to reduce neonatal mortality and improve survival outcomes.

Keywords: Low birth weight, Morbidity, Mortality, Perinatal asphyxia, Prematurity

Background: Self-harm is a complex and multidimensionally neglected public health problem, posing a significant risk for 40-50% of people who commit suicide. This problem is common in Bangladesh, specifically among students, but there is a severe scarcity of data about its prevalence and pattern among them.

Objective: To find out the prevalence of self-harm among 16 to 18-year-old students in Dhaka city and its relation to psychosocial stressors and psychiatric co-morbidities.

Methods: This cross-sectional study was conducted in the Department of Psychiatry, BSMMU, Dhaka, at two colleges. Students completed the self-harm inventory scale and the Dhaka Stress Scale for adolescents, with those reporting self-harm further assessed using the Development and Well-Being Assessment scale.

Results: 15.87% of respondents had a history of deliberate self-harm, more common among female students (18.57%) than male students. 70% of students who had self-harmed had at least one psychiatric illness, most commonly generalized anxiety disorder (34.0%). 73.0% of students had severe stress levels, with a significant difference in stress levels between the self-harm and non-self-harm groups (p<0.05).

Conclusion: This study emphasizes the importance of qualified student counselors in colleges and the urgent need for holistic, institution-based mental health initiatives.

Keywords: Self-harm, Psychosocial stressors, Psychiatric morbidity, Adolescents, Stress

Background: Intertrochanteric fractures are among the most frequent types of hip fractures, particularly in elderly individuals with osteoporotic bones. The Dynamic Hip Screw (DHS) remains the gold standard for managing these fractures.

Objective: To compare the functional and radiological outcomes of unstable intertrochanteric fractures treated with Proximal Femoral Locked Compression Plate (PFLCP) versus DHS.

Methods: A prospective comparative study was carried out on patients undergoing either PFLCP or DHS treatment between January 2020 and December 2022 at President Abdul Hamid Medical College Hospital (PAHMCH), with functional outcomes assessed using the Harris Hip Score (HHS) at 3, 6, and 12 months postoperatively.

Results: DHS treatment was associated with higher blood loss (159 ml), longer operative time (105 minutes), and delayed mobilization. PFLCP resulted in lower blood loss (73 ml), shorter surgery duration (91 minutes), and earlier mobilization. Limb shortening was greater in the DHS group (9.33 mm) compared to the PFLCP group (4.72 mm).

Conclusion: PFLCP demonstrated advantages over DHS in managing unstable intertrochanteric fractures, including reduced blood loss, shorter operative time, earlier weight bearing and mobilization, shorter hospital stay, lower infection rates, and fewer complications.

Keywords: Dynamic Hip Screw (DHS), Proximal Femoral Locked Compression Plate (PFLCP), Intertrochanteric fracture

Bell’s palsy (BP) is a common condition affecting the facial nerve, often resulting in facial weakness or paralysis. While its exact cause remains unknown, several factors, including pregnancy, can increase the risk. This case report presents a 26-year-old pregnant woman who developed BP in her third trimester, with facial droop, difficulty closing her eye, and slurred speech. Considering expenses, the patient refused further detailed investigations and neurology consultation. After thorough counseling, she was treated with corticosteroids for three weeks with a tapering dosage along with iron and calcium supplements. Her condition improved and she delivered a healthy baby vaginally, with both mother and baby found healthy at five-week follow-up. This case highlights the importance of early diagnosis and appropriate management of BP in pregnant women, and the complexities of receiving treatment through referral services in low-resource settings.

Keywords: Bell’s palsy, Pregnancy, Third trimester, Outcomes

The Russell’s viper (Daboia russelii) is a severely venomous land snake commonly found throughout South Asia and certain areas of Southeast Asia. It contributes to a significant number of snakebite-related injuries and deaths within its habitat due to its common presence, defensive behavior, and potent hemotoxic venom. This snake frequently inhabits open terrain, grasslands, farmlands, and areas near human settlements, increasing the likelihood of encounters with people. Its venom consists of a sophisticated blend of enzymes and toxins that lead to blood clotting disorders, extensive local tissue injury, kidney failure, and widespread systemic effects. While the Russell’s viper serves a valuable ecological function by controlling rodent numbers, it remains a major public health issue in numerous rural areas of Bangladesh. Ongoing scientific focus on enhancing antivenom efficacy, protecting its habitat, and minimizing human-snake interactions remains vital for addressing the dangers posed by this species.

Keywords: Bangladesh, Public health, Toxins, Venomous, Venom