Snake bite is a serious global health problem. Incidence is high in Bangladesh and mortality is identified to be one of the highest in the world. Most bites are occurred by nonpoisonous snakes and as many as 40% bites inflicted by venomous snakes do not produce features of envenoming. They need supportive treatment only. Poisonous bites are treated with antivenin. But most people apply tight tourniquet and take useless and harmful treatment from traditional healers before getting admitted in hospital. Delay in diagnosis and treatment causes fatality in many cases. 46 patients admitted in department of Medicine, MMCH from April,07 to March,08 with snake bites were studied. Among them 35% were poisonous and 65% were nonpoisonous bites. Male and female ratio was 3.6:1. Mean age (years) was 34.9 ± 16.2 SD. Mean time of interval between bite and hospitalization (hours) was 7.8 ± 9.5 SD. 94% bites occurred in land and 7% in water. 100% patients applied multiple tourniquets in the affected limb. 24% patients received treatment from traditional healers with development of cellulitis in 64% of them. None received proper first aid management. Most incidences were in July - August. Snakes could not be identified in 50% poisonous and 77% non-poisonous cases. Among the identified poisonous snakes, kraits were 84%. Clinical features were also suggestive of krait bite in 88% poisonous cases. Among poisonous cases, 94% presented with neurological manifestation and ptosis was present in all of them. 75% poisonous snake-bite patients received antivenin and none of them developed anaphylaxis. Among 4 poisonous snake bite patients who did not receive antivenin, 2 survived. Mortality in poisonous cases was 44%. All of the non-poisonous cases improved with supportive treatment. DOI: 10.3329/jbcps.v27i2.4249 J Bangladesh Coll Phys Surg 2009; 27: 70-75

Background. Mass psychogenic illness has been a recurrent phenomenon in Bangladesh over recent times. Objectives. This study was aimed at investigating the demographic characteristics and symptom profile of an outbreak of mass psychogenic illness occurring in a girls' high school. Methods and Materials. In 14 April 2013, a total of 93 students of a girls' high school suddenly developed various symptoms following intake of tiffin cake which resulted in panic and hospital admission. A descriptive, cross-sectional observational survey was done to define various characteristics of the outbreak. Results. No organic explanation for the reported illnesses was found. 93 female students were included who were hospitalized during the incident. Trigger factor was found in 98% of students. Most of the students were 13 years old. Average interval between exposure to the trigger and onset of symptoms was 151.5 minutes. Commonest symptoms were abdominal pain (83%), headache (73%), chest pain (69%), body ache (63%), nausea (69%), and generalized weakness and fatigue (61%). Hospital stay following the incident was about 12 hours on average. Conclusion. To avoid unnecessary panic in the community a prompt, coordinated response is important in resolving widespread community anxiety surrounding these episodes.

Acute stroke is a heterogeneous condition and the risk of death can be gauged by various factors. This study sought to evaluate GCS score on admission as a prognostic tool of outcome among stroke patients, by observing the GCS score following acute stroke and in-hospital outcome at a tertiary level hospital in Bangladesh. Stroke is a major health problem in developed countries as well as developing countries like Bangladesh. This observational study was conducted among 122 consecutive patients, fulfilling the WHO stroke defining criteria, from 1st January 2007 to 30th June 2007. Mean age was 59.28 ± 14.89(SD) years and male female ratio was 2.39: 1. Cerebral infarct was 49.13%. Intracerebral hemorrhage and subarachnoid hemorrhage was 31.89% and 18.96% respectively. Overall in-hospital mortality was 15.57% though mortality in patients with cerebral infarcts was nil. Patients presenting with GCS between 3 and 8 caused 12.07% fatality, whereas, none died with GCS score 13-15.Here GCS score showed an inverse relationship with outcome that varied with type of stroke. We can conclude that GCS score on admission might be incorporated as an valuable prognostic parameter in stroke outcome measurement scale.   doi:10.3329/jom.v10i3.2009   J Medicine 2009; 10 (Supplement 1): 11-14

Pattern of mortality gives a picture of disease burden of a community and helps in evaluation of health care system. A retrospective study was done in medicine wards of a tertiary care hospital in Bangladesh from 1st July 2014 to 30st June 2015 to see the mortality pattern. Data obtained from death and admission registrar. Total 1306 deaths were recorded. Mortality rate was 7%. Male female ratio was 1.65:1. Average age at death was 56.05 years. Highest 11.3% death occurred in January, 48.6% deaths occurred during night shift. Average stay in hospital was 42.1 hours. Non communicable disease causing 87%, communicable disease causing 8.8% deaths and 4.2% were brought dead and undiagnosed. Stroke and IHD caused 54.1% deaths. Among diagnosed causes, ratio of NCD and CD was 9.9:1.Bangladesh J Medicine Jan 2016; 27(1) : 22-26

Stroke in young age is relatively uncommon but has serious impact on the affected family as well as society. The causes are more diversed and differ as compared to the elderly. Overall prognosis is better than elderly but there is still significant morbidity and mortality. We studied consecutive 50 stroke patients between the age of 15-45 admitted in Mymensingh Medical College Hospital. The objective of this study was to evaluate the aetiological pattern, associated risk factors and inpatient outcome. Mean age of the patients was 35.8 ± 7.39 SD ( years ), female male ratio was 1 : 1.27. Infarction was found in 60% cases. Haemorrhage was in 40% cases. Dyslipidaemia was mostly associated risk factor in both infarction (83.3%) and in haemorrhage (75%). In 74% cases aetiology could not be identified. High prevalence of dyslipidemia as associated risk factor may indicate premature atherosclerosis. Overall in-patient mortality was12% .Mortality in haemorrhagic strokes is higher.   DOI = 10.3329/jom.v9i1.1419 J MEDICINE 2008; 9 : 10-15