Background: Plateletpheresis is a process in which healthy donor blood is passed through an apparatus that separates platelets, returning the remaining components to circulation. Objective: To determine the frequency of adverse donor reactions during plateletpheresis procedure. Materials and method: This retrospective study was carried out in Department of Transfusion Medicine of BIRDEM General Hospital at Dhaka, Bangladesh,from January 2020 to December 2021. A total of 275 healthy male blood donors participated after providing informed written consent and were selected according to the national guideline's Standard Operating Procedure (SOP). Data on adverse effects experienced by donors during the plateletpheresis procedure were recorded and analyzed retrospectively. Results: Among the participants, 12(4.36%) donors encountered various reactions. Specifically, 7(2.54%) donors had mild hypocalcemic symptoms, 3(1.09%) donors developed local reactions like hematoma and swelling at the venipuncture site and 2(0.73%) donors reported mild vasovagal reactions. Among those affected 8 (66.6%) donors were undergoing plateletpheresis for the first time, while 4(33.4%) donors were repeat donors. Conclusion: Effective training for technical personnel and supervision by transfusion specialists are crucial for minimizing donor reactions during apheresis procedures. Close monitoring and timely interventions improve the donor experience, ensuring safety and comfort throughout the procedure. Delta Med Col J. Jul 2022;10(2): 39-44

Background: A major cause of illness worldwide is chronic respiratory disorders. There is a strong upward trend towards the global incidence of these diseases. An additional 500 million people are affected by it. Objective: The research aimed to quantify chronic obstructive pulmonary disease (COPD) incidence in the slum of Dhaka City. Materials and method: A population-based survey was conducted using a well designed questionnaire. The research included all persons older than 20 years who live and intend to engage in the analysis in the identified slums in Dhaka City. Total 584 samples were calculated using a minimum prevalence of 4.7% at 95% confidence intervals with an allowable error of 20%. Results: The prevalence of COPD was found to be 3.25%. This study also found that there were high rates of illiteracy and low levels of education which tended to accompany limited awareness of COPD and hygiene. Therefore, slum dwellers in Dhaka city live with high health risks and at the same time they have limited knowledge about how to alleviate these risks. Conclusion: Slum population in Dhaka city is expected to continue to have COPD-related respiratory symptoms. When health problems arise, they have limited knowledge about first aid, what treatments and services are available, and where they are available. Delta Med Col J. Jan 2022;10(1): 14-19

Background: Lactation encompasses the process of milk production and secretion by mammary glands. It significantly influences the levels of serum iron, calcium, and phosphorus, thereby elevating the risks of osteoporosis, malnutrition, and other maternal complications. Objective: the aim of this study was to evaluate serum iron, calcium and phosphorus status in lactating women in Bangladesh. Materials and method: This case control study was carried out in the department of Biochemistry, Mymensingh Medical Collcge, Mymensingh, with the collaboration of the department of Gynaecology and Obstetrics, Mymensingh Medical College Hospital, Mymensingh, during the period of July 2016 to June 2017. A total of 60 apparently healthy lactating women were selected as case and 60 apparently healthy non-lactating women were selected as control. Serum iron, calcium and phosphorus levels were measured for both groups. Statistical analyses of the results were obtained by using Statistical Packages for Social Sciences (SPSS-22) software. Results: The mean ± SD serum calcium levels were estimated to be 7.74±0.67 mg/dL in lactating women and 8.75±0.78 mg/dL in non-lactating women respectively, and the difference was statistically significant (p<0.05). But the serum iron and serum phosphorus were not significantly changed between two groups. Conclusion: There is no significant difference in serum iron and phosphorus levels between lactating and non-lactating women but significantly decreased serum calcium level is observed in lactating women. Delta Med Col J. Jan 2022;10(1): 25-30

Glanzmann thrombasthenia is a rare inherited bleeding disorder resulting from mutation in platelet membrane glycoprotein (GP) IIb or IIIa leading to impaired platelet function which is characterized by defective platelet aggregation and diminished clot retraction. Glanzmann thrombasthenia patients commonly visit to physician with features of bleeding. Here we discuss about the case of a 32-years-old young female presented with menorrhagia, ecchymosis and occasional gum bleeding. Her coagulation profile was in favor of Glanzmann thrombasthenia. This rare disease has a good outcome if early diagnosis and proper management can be ensured. Delta Med Col J. Jan 2021;9(2): 101-103

Background: Acute confusional state (ACS) or delirium is a clinical condition categorized by troubled consciousness, cognitive function, or perception. The key to the management of cases of ACS lies in recognizing a cause or other contributing illness and alleviating it. Objective: To evaluate the patients of ACS intending to identify the clinical presentation of the ACS along with the outcome evaluation of its prognostic importance. Materials and method: A total of 50 patients of ACS fulfilling the DSM-4 criteria were enrolled purposively. It was a hospital-based cross-sectional type of observational study conducted among adult patients of more than 18 years of age for nine months period in the medicine department of Dhaka Medical College Hospital. Results: The mean age of patients was 63.18±9.8 years. Majority of the patients (66%) were male. Hypertension was the most common (46%) associated condition followed by obesity (22%). Fever was common in the majority of cases (78%) followed by disorientation (64%). Among the patients with cerebrovascular accidents, 70.59% had multiple infarcts and 29.42% showed hemorrhage in CT scans of the brain. Most of the patient's (76%) recovery was without any sequelae. Only 6% of patients died during the hospital stay. Conclusion: Acute confusional state (ACS) is among the most common problems in general medicine. Hence, treatment and further workup should run parallel to avoid the morbidity and mortality related to these circumstances. Delta Med Col J. Jan 2021;9(2): 75-79

Background: Suicide by poisoning is the act of intentionally killing oneself by using various chemical substances and it is the most common and widely used method in developing countries like Bangladesh. Objective: The objectives of this study were to find out the socio-demographic characteristics and possible reasons among the chemical suicidal victims. Materials and method: This was a descriptive type of cross-sectional study, held in the Morgue of department of Forensic Medicine of Dhaka Medical College (DMC), Dhaka, Bangladesh, from July 2016 to June 2018. Victims were selected purposively according to the availability in the morgue of Dhaka MedicalCollege. Data were collected from the relatives of the victims and the verbal consent of the doctors who performed autopsy at DMC morgue. Results: A total of 50 victims of suicide using chemical substances as revealed by autopsy findings from the DMC morgue were enlisted in this study. Victims of suicide not using chemicals were excluded from this study. Half (50.0%) of the suicidal deaths by poisoning cases were aged 20 or below. Majority (66.0%) of the victims was male. Organophosphorus compound was found in 58.0% cases, followed by diazepam (8.0%) and barbiturates (4.0%), after receiving chemical analysis report. Conclusion: Pesticides are the most commonly used suicidal agent particularly in low and middle-income countries like ours. So, social awareness regarding this issue is very much needed. Delta Med Col J. Jan 2021;9(1):23-27

The outbreak of coronavirus disease 2019 (COVID_19) is an emerging global health threat. The healthcare workers are facing challenges in reducing the severity and mortality across the world. Patients with severe form of COVID_19 are generally treated in the intensive care unit, while mild or non_severe patients are treated in the isolation ward or at home. It is important to identify early and give treatment to reduce the disease severity and improve the outcomes. There is no credible and convenient biomarker to predict the severity of the disease. Therefore, the exploration of biomarkers is deemed necessary. We aimed to review the diagnostic and early prognostic value of C-reactive protein (CRP) in COVID-19 patients. In a number of studies, CRP showed different distribution feature and differences existed in various ages, clinical types and outcomes of COVID-19 patients. The present study reviews the role of CRP level as a marker in indicating the severity of patients with COVID_19.
 Delta Med Col J. Jul 2020 8(1): 41-45

Background: Cauda equina syndrome (CES) is a relatively uncommon condition typically associated with a large, space occupying lesion within the canal of lumbo-sacral spines. This syndrome is characterized by varying pattern of low back pain, sciatica, lower extremity sensorimotor loss, saddle anaesthesia and bowel and bladder dysfunction.
 Objective: The objective of this study was to evaluate clinical and functional outcome and operative complications in case of CES who underwent surgical decompression by laminectomy and discectomy.
 Materials and method: This prospective interventional study was carried out at National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) and different private hospitals in Dhaka from January 2017 to December 2019. Patients were selected on the basis of history, clinical examinations and Magnetic Resonance Imaging (MRI) findings. Patients with fracture and compression due to other than disc prolapse were excluded from the study.
 Results: Out of 23 patients, 18 patients (78%) were male and 5 patients (22%) were female, age ranged from 20-60 years, with the average age 37.5 years. Twenty one patients (91%) had single level and 2 patients (9%) had two level disc herniation. The mean follow up duration was 9 months (range 6-12 months). Patients were evaluated with respect to age, time to surgery and scoring system for CES before and after operation. Those who were treated within 48 hours and those after 48 hours showed significant difference in outcome (p <0.05). Complete recovery was documented in 12 patients (52%). There was infection in 01 case (4%), 03 patient (13%) had persistent low back pain, 02 patients (9%) had sciatica, 01 patients (4%) had bowel and bladder dysfunction and 01 patients (4%) had saddle anaesthesia in delayed operative group. Evaluation of final outcome was satisfactory in 17 patients (74%).
 Conclusion: Laminectomy and discectomy is an effective, safe and acceptable modality of treatment in CES.
 Delta Med Col J. Jul 2020;8(2): 83-85

Background: Diabetic foot is a common and potentially disastrous complication that can rapidly progress to irreversible septic gangrene, necessitating foot amputation.
 Objectives: To assess the clinical outcome of treatment of diabetic foot in diabetic patients based on random blood glucose (RBG) and HbA1c level.
 Materials and method: This prospective observational study was conducted in the Department of Surgery, BIRDEM General Hospital, Shahbag, Dhaka, Bangladesh, from July 2018 to December 2018. A total of 350 patients with diabetic foot were enrolled in the study based on inclusion and exclusion criteria. The patients were divided into four groups based on RBS and HbA1c level. A complete history was taken, thorough clinical examination was done and relevant investigation reports were collected. Collected data were classified, edited, coded, and entered into the computer for statistical analysis using SPSS version 23.
 Results: Mean age was 47.6±13.3 years in group A, 48.2±12.7 years in group B, 46.7±13.1 years in group C, and 49.9±12.5 years in group D. Male to female ratio was 2.3:1 in group A, 3.5:1 in group B, 1.5:1 in group C and 2.9:1 in group D. One hundred eight patients were found to have Wagner ulcer grading I. Among them, 2(20.0%) were in group A, 9(33.3%) were in group B, 12(36.4%) were in group C, and 85(30.4%) were in group D. Twenty-two patients were found to have Wagner ulcer grading IV. Among them, 1(3.0%) of group C and 21(7.5%) of group D. The difference was statistically significant (p<0.05) among the four groups. Two hundred eighty-eight patients had wound healing time of 2-6 weeks. Among them were 1(10.0%) in group A, 25(92.6%) in group B, 29(87.9%) in group C, and 233(83.2%) in group D. The mean wound healing time was found to be 1.5±0.7 weeks in group A, 3.1±1.3 weeks in group B, 3.6±1.2 weeks in group C and 4.9±1.8 weeks in group D. The difference was statistically significant (p<0.05) among four groups. One hundred six patients underwent amputation at a different level. Among them, 1(10.0%) in group A, 5(18.5%) in group B, 13(39.4%) in group C and 87(31.1%) in group D. The difference were not statistically significant (p>0.05) among four groups.
 Conclusion: Elevated HbA1c was associated with slower and incomplete foot healing in diabetic patients. Random blood glucose and HbA1c parameters can be used as dependable predictors of foot ulcer healing in the diabetic patients.
 Delta Med Col J. Jul 2020;8(2): 86-92

Background: Hypothyroidism is a common hormonal disorder affecting various organs including lungs and pulmonary dysfunction in hypothyroid patients has been noted.
 Objective: To observe maximum voluntary ventilation (MVV) in hypothyroid female patients.
 Materials and method: This cross-sectional study was carried out in the Department of Physiology, BSMMU, Dhaka, Bangladesh, from 1st July 2008 to 30th June 2009 on 60 hypothyroid female patients of 30-50 years old. Based on treatment, hypothyroid patients were divided into B1 (untreated patients on their 1st day of diagnosis) and B2 (patients treated for at least 12-18 months). For comparison, 30 age and BMI matched apparently healthy subjects (Group A) were also studied. The study group was selected from the Out Patient Department of Endocrinology, BSMMU, Dhaka, Bangladesh, and the control group was selected by personal contact. Serum TSH and serum FT4 levels were measured by Microparticle Enzyme Immunoassay (MEIA) principle in AxSYM system. Maximum voluntary ventilation (MVV), which is a lung function parameter, was measured by a digital MicroDL spirometer. Data were analyzed by one way ANOVA test, independent sample t-test and Pearson’s correlation coefficient test.
 Results: The mean percentage of predicted values of lung function parameter of MVV in control subjects and treated hypothyroids were within normal ranges. However, this value was significantly lower in untreated hypothyroid subjects in comparison to those of control and treated hypothyroid subjects. In addition, MVV showed negative correlation with serum TSH level and positive correlation with serum FT4 level and these relationships were statistically significant in control group and treated hypothyroid subjects.
 Conclusion: This study reveals that MVV may be lower in untreated hypothyroid female patients compared to control and treated hypothyroids and the deterioration may be positively correlated with serum FT4 level and negatively correlated with serum TSH level. Treatment of hypothyroids may reverse these changes.
 Delta Med Col J. Jul 2020;8(2): 55-60