The aim of this study was to examine the gender differential effects of eating habits and physical activity on overweight and obesity among school-aged adolescents in Bangladesh. Nationally representative data extracted from the 2014 Global School-based Student Health Survey (GSHS) were utilized. The survey collected information related to physical and mental health from 2989 school-aged adolescents in Bangladesh. An exploratory data analysis and multivariate logistic regression model were employed in this study. Female adolescents were at a lower risk of being overweight or obese (AOR=0.573) than males, with a prevalence of 7.4% (males: 9.9%). The results showed that high consumption of vegetables (both: AOR=0.454; males: AOR=0.504; females: AOR=0.432), high soft drink consumption (both: AOR=2.357; males: AOR=2.929; females: AOR=1.677), high fast food consumption (both: AOR=2.777; males: AOR=6.064; females: AOR=1.695), sleep disturbance (both: AOR=0.675; males: AOR=0.590; females: AOR=0.555) and regular walking or cycling to school (both: AOR=0.472; males: AOR=0.430; females: AOR=0.557) were vital influencing factors for being overweight or obese among adolescents for both sexes. Sedentary activities during leisure time were also identified as significant predictors of being overweight or obese for males. Regular fruit and vegetable consumption, the avoidance of soft drinks and fast food, an increase in vigorous physical activity, regular attendance at physical education classes and fewer sedentary leisure time activities could all help reduce the risk of being overweight or obese for both sexes.

Background: Atrial Septal Defects (ASD) can be closed surgically using conventional midline sternotomy or minimal invasive technique. This study was done to evaluate the outcome and safety of the minimal invasive cardiac surgical (MICS) approach using right vertical infra axillary incision (RVAI) for the repair of ASD. Methods: We performed a prospective observational cross-sectional analysis on 50 patients who were diagnosed as ASD of various types and not amenable to device closure. Their surgery was done RVAI using central cardiopulmonary bypass. Outcome of the study was evaluated using the following variables: length of the incision, satisfaction of patients, mortality, infection of surgical site, blood transfusion, duration of total operation, intensive care unit (ICU) stay, mechanical ventilation, hospital stay and aortic occlusion. Operations were done between December 2013 to December 2020. All the recruited patients were treated through RVAI as per patient’s choice. Results: Mean age was 11.4± 6.4 years. 18(36%) were male and 32(64%) were female. Body weight ranged from 10 to 65 kg. Mean length of incision was 6.2±0.8 cm. Mean aortic occlusion time was 42±14 min. ASD closed directly, using autologous treated pericardial patch or dacron patch. Mean total operation time was 4.08±0.6 hours and mean mechanical ventilation time was 8.3±5 hours. Average ICU stay was 35.6±6 hours and total hospital stay was 7.2±0.9 days. There was no significant blood loss. Only 10 patients required intravenous (IV) analgesics in the post-operative period. One patient required re-exploration, one conversion to median sternotomy and one suffered from superficial skin infection. There were no operative or late mortalities. Patient satisfaction was excellent. Conclusions: MICS technique using RVAI for surgical repair of ASD revealed a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard median sternotomy. Cardiovasc j 2021; 14(1): 37-43

Background: Despite the high level of awareness about the importance of post-operative pain management, lot of investigations and study results show an unacceptable high rate of incidence of pain after surgery. Pre- emptive pain control is regional or systemic analgesics, applied before starting the surgical procedure. The effect is achieved by suppressing, central or peripheral nociceptors, either together or separately by sensitization. We studied the effect of intravenous Paracetamol as pre-emptive analgesic in patients undergoing laparoscopic cholecystectomy. Method: A total number of 60 adult patient with ASA physical status I & II scheduled for Laparoscopic cholecystectomy under general anaesthesia were randomly enrolled in this study. Patients were randomly allocacated equally into two groups A and B according to computerized random table, 30 in each group. Patients of Group A (n=30) received I.V Paracetamol 10mg/kg(100ml) 10 min before skin incision and Group B (n=30) received 100 ml of Normal saline 10 min before skin incision. It was a single blind, randomized, prospective, case-control study. Observation and management of pain, nausea, vomiting, respiratory depression, allergic reaction, amount of opioid requirement and time of analgesic demand after operation were carried out in data collection sheet. Result: The total dose of postoperative opioid needed in Group-A was significantly lower than that in the Group- B(p=0.012). The pain scores were comparatively low in case of group-A than that in Group-B from beginning to 24 hours of evaluation following operation(p=0.027). About one-third (32%) of the patient in each group experienced nausea at 1 hour interval post operatively. However, the complaint of nausea at 6 and 12 hours was much less in the Group-A than that in the Group-B. Vomiting was negligible in either group. Majority (80%) of patient in Group-B demanded analgesic (pethedine) 10 minutes earlier after operation as opposed to only 8% of patients in Group-A (p<0.001). No other side effects were recorded in either of the groups. Conclusion: Our findings indicate that pre-emptive administration of iv Paracetamol (10mg/kg) in patients undergoing Laparoscopic Cholecystectomy ensures an effective postoperative analgesia, increases the time to first analgesic requirement and reduces opioid consumption. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 159-163

Background: The objective of this study was to see whether there is an association between high blood glucose levels after operation under CPB and post-operative morbidity and mortality. Methodology: This cohort study was carried out in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Sher-e-Bangla Nagar, Dhaka from January, 2012 to December, 2013 for a period of twenty four (24) months. A total number of 110 patients who underwent MVR operation with CPB were enrolled in this study as per inclusion and exclusion criteria. Patients were divided into two groups according to their blood glucose levels, recorded within first 60 hrs after Mitral Valve Replacement Surgery under Cardiopulmonay Bypass. Patients having blood glucose level of less than 10.1 mmol/L (unexposed) and patients having blood lactate level of 10.1 mmol/L or more (exposed) were grouped. Post operative variables were observed and recorded during the hospital course of the patient. Result: A total number of 110 patients were enrolled in this study. Blood glucose levels lower than or equal to10 mmol/L after MVR were present in 55(50%) patients (Group A) Blood glucose levels higher than 10 mmol/L after MVR were present in 55(50%) patients. Postoperative morbidity was higher in this group (Group B) than in the patients who had peak blood glucose levels of less than or equal to 10 mmol/L MVR (p=0.001). Postoperative ICU stay was prolonged in patients with elevated levels of blood glucose after MVR under CPB compared with of patients with lower blood glucose levels (p=0.001). Other common morbidities are Neurological complication (p=0.04), Renal dysfunction (p=0.01), wound infection (p=0.04), Post-operative hospital stay (p=0.004). also higher in group B patient, as well as mortality (p=0.31). Conclusions: Blood glucose concentration of 10.1 mmol/L or higher after MVR under CPB is an important issues related to postoperative morbidity and mortality Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 114-120

Background: Cardiovascular diseases, the part of non communicable diseases are the 30% death in Bangladesh. Many patients undergoing coronary artery bypass graft surgery have previous cardiovascular risk factors which could be prevented. Objectives: To assess the prevalence of cardiovascular risk factors in the patients undergoing coronary artery bypass graft surgery. Materials and Methods: All patients who had coronary artery bypass grafting between January 2018 to June 2018 data were collected retrospectively in six month duration time at a tertiary cardiac care hospital in Dhaka, Bangladesh. The prevalence rate of conventional risk factors are presented for observational study. Results: Out of 305 patients, 251 (82.3%) were male and 54 (17.7%) were female. The age ranged from 31 to 78 years old. The mean age was(56.72 ± 3.6). Hypertension was present in 249 (81.6% ),diabetes 211 (69.2%), Dyslipidemia had 200 ( 65.6% ), smoking habits had 105 (34.4%) and strong family history 9 (3%). As far as the obesity was concern 149 (48.9%)normal weight,128 (42.0%) patients were overweight and 25(8.2%) were obese. Majority of the patients had 3 risk factors together 136(44.6%), 2 risk factors 82 (26.9%), 1 risk factor 41(13.4%), 4 risk factors 38(12.5%) and 8(2.6%) had no risk factors. As compared to using the bypass technique there were 242(79.4%) On pump arrest heart, 40(13.1%) by On pump beating and 23(7.5%) were by Off pump beating. Mortality was 2.3%.Out of them 3(42.86%) patients had 3 risk factors, 2 (28.57%) patients had 2 risk factors and 2(28.57%) patients had 1 risk factor. Conclusion: The most common risk factors were hypertension, followed by diabetes, dyslipidemia , male gender, smoking, obesity and positive family history. These patients are recommended to be trained regarding lifestyle changes. Also, prevention strategies can play an important role in reducing patients' morbidity and mortality. KYAMC Journal Vol. 11, No.-1, April 2020, Page 9-13