Hemiplegia and hemiparesis are the most common deficits caused by stroke. A few small clinical trials suggest that Fluoxetine enhances motor recovery but its clinical efficacy is unknown in our setting. A randomized placebo-controlled trial was conducted at Neurology and medicine ward of Chittagong Medical College Hospital from 1/1/2013 to 31/12/2013. One hundred and twenty eight patients, aged between 40-60 years with a diagnosis of acute ischaemic stroke who fulfilled the defined inclusion and exclusion criteria were selected for the study. Eligible patients were randomly assigned, using a simple lottery method, in a 1:1 ratio to Fluoxetine (20 mg once per day, orally) or placebo group for 3 months starting within 10 days after the onset of stroke. The primary outcome was the mean change in the Rivermead Mobility Index (RMI) score between inclusion (day 0) and day 90. RMI score was significantly changed from D 0 to D 90 in Fluoxetine group in comparison to placebo group (p<.001) and mean (±SD) improvement of RMI score in 90 days were significantly greater in the Fluoxetine group, than in the placebo group [7.08 (±3.26) vs. 4.40 (±2.53)]. Patients treated with Fluoxetine were nearly 3.2 times more likely to show motor improvement than placebo group and the NNT was 2. In patients with acute ischaemic stroke and with motor deficit, the early administration of Fluoxetine with physiotherapy enhanced motor recovery after 3 months.

Background: Neurological disorders are a common and significant public health problem globally, and innovative strategies are needed to address the epidemic in resource-poor settings in Bangladesh. The aim of this study was to evaluate the burden and features of neurological diseases requiring hospitalization in a tertiary care hospital in Chittagong, Bangladesh. Methods: This study was a prospective observational study conducted from January to June 2021 on patients admitted to the adult neurology unit of a hospital in Chittagong, Bangladesh. Data was collected through face-to-face interviews, laboratory data, and previous medical records, and in-hospital complications and outcomes were recorded. The data was cleaned and analysed using SPSS and presented in tables. Results: In this study, stroke was the most common neurological condition requiring hospitalization, accounting for 74% of cases and leading to death in 73% of cases. The most frequent in-hospital complication was urinary tract infection (26%), mostly in stroke patients. Of stroke patients, 88% had incomplete recoveries at discharge, while 7% died. Hypertension was the most common risk factor present in both acute confusional state and stroke cases. The median duration of hospital stay was longest among patients with central nervous system infections. Conclusions: Stroke dominates the burden of neurological diseases requiring hospitalization in tertiary care hospitals in Bangladesh. The most frequent in-hospital complication was urinary tract infections, mostly in stroke cases. The overall in-hospital mortality was 7%, most patients recovered incompletely at discharge (82%).

Background: This study was carried out to see the association of the low total cholesterol level with primary Intracerebral Hemorrhage (ICH) in Bangladeshi population.Materials and Methods: This was a case–control study carried out in the department of Neurology, Chittagong Medical College and Hospital from January 2013 to December 2013. Total of 132 patients were enrolled where 67 patients of hemorrhagic stroke were in the experimental group and 65 age and sex matched persons were in the control group. Low total cholesterol was designated as level less than 200mg/dl. Data were analyzed and compared by SPSS version 19.Results:The proportion of ICH patients with low total cholesterol was significantly higher than the controls (74.6% vs. 32.3%). Mean total cholesterol was also significantly low in ICH patients compared with controls (180 mg/dL vs. 217 mg/dl; P-value = 0.001). Low-density lipoprotein cholesterol (LDL-c) and triglycerides were also significantly low in ICH patients compared with controls. Mean LDL-c in the ICH patient group was 106 mg/dL, whereas it was 128.5 mg/dL in the control group (P-value = 0.001). There was no significant difference in the high-density lipoprotein (HDL) levels in both groups. Although lower mean cholesterol was seen in both young and older individuals in the ICH group than in controls, the difference was significant only in the older group (age >60 years). In multivariate analysis, odds ratio of low cholesterol in the hemorrhage cases was 6.03 (95% CI = 2.1–16.059) which was adjusted other risk factors of hemorrhagic stroke.Conclusions: The inference of this study is that, there is an increased risk of primary ICH associated with low total cholesterol, especially in older individuals.Bangladesh Crit Care J March 2018; 6(1): 26-30

Background: Globally, neurologic disorders are very common and describe a significant public health problem. Innovative strategies are needed to cease the progression of the neurologic epidemic in resource-poor settings in Bangladesh. Clear concept of socio-demographic and clinical profile of neurological patients may be helpful in the management of such patients. But in Bangladesh, we have very limited research-based data regarding these issues. aThe aim of this study was to form the socio-demographic and clinical profile of neurological patients. Methods: This was a prospective observational study which was conducted from January 2021 to June 2021 by consecutive sampling technique on the patients admitted to the adult Neurology unit of Chittagong Medical College & Hospital, Bangladesh. For this intervention, the ethical clearance was obtained from BMRC. Data were collected and recorded from appropriately consented cases by maintaining confidentiality by face-to-face interviews (or from attendants if the patient cannot respond appropriately), laboratory data from hospital records and pre-hospital treatment from previous records with the patient. All data were cleaned and analyzed by SPSS version 22.0 and presented in tables. Results: In this current study, among total participants, 53% were male and 47% were female. Most of our participants were educated up to SSC level (50%) and the majority of them were Muslims (84%). The mean ±SD age of the participants was 55±0.73 years and most of them were from rural areas (74%). Among total acute confusional state patients (6%), the most common presenting symptom was decreased alertness: 88%. Among 74% stroke patients, 5% cases with CNS infections and among 15% patients with other diseases, the most frequent presenting symptoms were muscle weakness in 90%, decreased alertness in 68% and again decreased alertness in 52% respectively. In this study, majority of the patients had a stroke (74%), followed by others: 58 (10%), ...

Bilateral Optic Neuritis (ON) is an alarming feature for the patient and not commonly faced by clinicians. Acute Disseminated Encephalomyelitis (ADEM) is a demyelinating disease that commonly underdiagnosed due to features sharing that of stroke. But progressive clinical course, behavioral change, features of bilateral Upper Motor Neuron (UMN) lesion, convulsion, bilateral optic neuritis (Sometimes unilateral) can help clinician to think quickly that ADEM could be a possibility. Among its clinical presentation optic neuritis is least common (6%) whereas behavioral change is universal (100%). Acute disseminated encephalomyelitis is suspected in this adult male patient because of progressive painful visual impairment, urinary retention, limb weakness which were associated with behavioral change. After clinical evaluation and relevant investigations he was diagnosed as a case of ADEM, & treated with intravenous methylprednisolone followed by oral prednisolone. During follow up (After 9 weeks) his symptoms and signs improved about 80% whereas MRI lesions regressed about 50%.   JCMCTA 2015 ; 26 (2) : 77 - 78