Background: Despite the advances made in asepsis, antimicrobial drugs, sterilization and operative techniques, surgical site infection (SSI) continues to be a major problem in all branches of surgery in the hospitals. However, there is no infection control policy that runs effectively in our country. Aim:This study was designed to see the correlation among sterilization, antibiotic resistance and malnutrition with surgical site infection in a tertiary level hospital. Methods: This cross-sectional observational study was conducted in the Department of Surgery, Shaheed Suhrawardy Medical College and Hospital. Informed written consent, detailed history, physical examination and necessary investigations were performed. Total 160 admitted patients undergoing different surgical procedure were included in this study, irrespective of their age, sex, race and ethnic group. Data were collected by using a semi-structured questionnaire. Collected data were analyzed by the SPSS 25. Results: Average age of all patient was 36.10±12.15 years (range: 13-65 years), wherein maximum patients were aged <40 years, male gender (56.3%), had normal BMI (61.3%) and non-smoker (62.07%). About 1/4th patients had diabetes mellitus. Maximum patients had undergone abdominal surgery (34.4%) followed by orthopaedic and traumatology (20.6%),General surgery other than abdominal surgery (18.8%), Neurosurgery (13.8%), Vascular surgery (12.5%). Pre-operative waiting period for surgery was <3 days in most of the cases (48.8%), followed by 3-7 days (31.3%) and >7 days (20%). Mean operation duration was 1.49±0.73 hours. Twenty-nine patients (18%) developed SSI, of which 7% had deep incisional SSI, 6% had superficial incisional SSI and 5% had organ/space SSI. SSI culture reports showed that majority (93.1%) had positive culture growth, wherein 66.7% had single microorganism and rest 33.3% had multiple growth. Staphylococcus aureus (34.48%) was the most frequently found microorganism. surgical team sterility was properly maintained in maximum surgical procedures (71.9%). Besides, OT room and surgical instruments were also properly sterilized in most of the cases (65.6% and 70%, respectively). Older age, abnormal BMI, smoking history, DM, longer pre-operative waiting period and operation duration was significantly associated with development of SSI. Besides, surgical team sterility, OT room sterility and Instrument sterility were not properly maintained in most of the surgical procedures among SSI patients (65.52%, 68.97% and 58.62%, respectively). Conclusion: Abnormal BMI (underweight and overweight or obese) and poor sterilization had significant association with development of SSI. However, further studies are needed to establish and use the findings. J Shaheed Suhrawardy Med Coll 2021; 13(2): 143-149

This prospective observational comparative study was conducted in department of Obstetrics and Gynaecology (OBGyn) of Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka. It was carried out from April 2019 to September 2019. The objectives was to compare the feto-maternal outcome of postdated pregnancy (40+1- 41+6 weeks) with pregnancy at term(37-40 weeks). Pregnant women admitted in ShSMCH with or without labour pain were considered as study population. Following ethical clearance from the local ethical committee and written informed consent, 59 cases of post-dated pregnancy (case) and 59 cases of term pregnancy (control) were included inthis study. Cases and control were selected by random sampling method according to inclusion and exclusion criteria. Inclusion criteria were: 1) Patients who have excellent EDD(dated by early ultrasonogram) , 2) Patients having regular menstrual cycle prior to present pregnancy and can remember exact LMP, 3) Postdated pregnancy as case and pregnancy at term as control. Exclusion criteria were: 1) Patients with eclampsia, systemic hypertension, heart disease, diabetes mellitus and renal disease, 2) Patients with multiple gestation and any congenital anomaly, 3) Pregnancy occurred during lactational amenorrhoea, 4) Pregnancy with veneral disease, 5) pregnancy with blood group incompatibility. Data were collected with a pre-designed structured questionnaire. A full assessment were done by history[age, occupation, menstrual and obstetric history, medical, surgical and family history, antenatal care(ANC)], physical examination (general, abdominal and vaginal) and ultrasonogram (USG) to assess gestational age and liquor volume. After proper counselling, induction of labour given to patients without labour pain and fetal distress. Mode of delivery, post-delivery maternal and fetal outcome and complication were recorded.This study showed that maximum number of patients in term pregnancy (control) belonged to age group (21-30 years) [control 71.2%, case 62.7%] and in post-dated pregnancy (case) belonged to >30 years [control 15.5%, case 23.7%]. In both groups, maximum number of women were housewives, control 48(81.4%), case 46(78%) and service-holder 11(18.6%) in control, 13 (22%) in case. In control group 36 (61%) were primi-gravida and 23 (39%) were multi-gravida. In case group 29(49.2%) were primi-gravida, 30(50.8%) multi-gravida. Family history of post-dated pregnancy were present in 14(23.7%) of control group and 13(22%) of case group. Most of the women of both control (93.2%) and case (89.8%) received regular ANC. Large fetus were seen in 6(10.2%) of control and 9(15.3%) of case group. Vertex was common presenting feature in both control (94.9%) and case (88.1%). Liquor volume was adequate in maximum number of women of both control (69.5%) and case (62.7%) group. Uterine irritability was present in 16(27.1%) of control and 17 (28.8%) of case group. Associated complication, such as CPD and elderly primi were present in 10 (16.9%) of control and 9 (15.3%) of case group. Induction of labour was required in 33(55.9%)of control and 41 (69.5%) of case group. Normal vaginal delivery was achieved in 41 (69.5%) of control and in 33 (55.9%) of case group women. LSCS required in 18 (30.5%) of control and 25 (42.4%) of case group women. Cause of LSCS is fetal distressin (54.5%) of control and (42.4%) of case group. Post-operative complication were more in case (16.9%), versus (3.4%) in control. Fetal complication were more in case group (22%), versus control (6.8%) regarding birth asphyxia, RDS, neonatal jaundice, neonatal septicemia, meconium aspiration syndrome, macrosomia and neonatal death. So this study showed that maternal and fetal perinatal morbidiy were quite high in post-dated pregnancy. There is scope for further improvement of clinical care practices of post-dated pregnant womenwith acceptable maternal and fetal outcome. J Shaheed Suhrawardy Med Coll 2021; 13(2): 130-136

Cancer patients are the vulnerable group of population and have more chances of contracting Corona virus disease 2019 (COVID-19). They are at great risk of passing through very stressful events during this COVID-19 pandemic that may lead to different psychological problems. Different psychological symptoms of breast cancer patients are evaluated in this study during the COVID- 19 pandemic. Consecutive fifty women selected with a non-metastatic breast cancer, scheduled to receive cancer treatment in the upcoming days/weeks not. Received treatment in the past, completed the Impact of Event Scale-Revised(IES-R), the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the Fear of Cancer Recurrence Inventory (FCRI). and the Insomnia Severity Index (ISI) and questionnaires. The study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from the 1st July 2020 to the 30th June 2021.. Patients were investigated about their worries regarding the impact of COVID-19 on their lives as carcinoma breast patients. Since the 1st July 2020 to the 30th June 2021, Consecutive 50 patients were prospectively evaluated. They were diagnosed with non-metastatic breast cancer. The mean age was 42.3 (range 30–70). Most of the patients (90%, n. 45) are married, 8% (n.4) patients are single and 2% (n. 1) patients are widowed. Among the patients 24 (48%) patients have high school or less education level, 19 (38%) have college experience and 7 (14%) have university degrees. Ten patients (20%) lived alone, 8 (16%) with one or two family members, and 32 (64%) with three or more family members. Concerning their working life, 36 (72%) were not working (namely housewives, retired, unemployed, or students) and 14 (28%) was occupied. In consideration of economic status 52% (n. 26) patients have annual family income in BDT 250001- 350000. On the other hand 22% (n. 11) within BDT 350001- 450000, 14% (n. 7) within BDT 150000- 250000, 6% (n. 3) within BDT 450001-550000 and 6% (n. 3) within BDT >550000 respectively. We found that 62% of patients had anxiety (HADS-A), 66% depression (HADS-D), and 68% fulfilled the diagnostic criteria for mild post-traumatic stress disorder (PTSD), 2% patients for moderate and 2% patients for severe PTSD. Results revealed that 50% (n.25) patients were suffering from subthreshold insomnia. On the other hand 46% (n.23) patients had no clinically significant Insomnia but 2% (n.1) patients had moderate and severe insomnia in each category. The Fear of Cancer Recurrence Inventory (FCRI) score was 14.7(SD±6.2) which was more than the cut-off value..Breast cancer patients pass through many stressful events that may develop significant psychological symptoms during this COVID-19 pandemic. The outcome of this study definitely contributes to understand the psychological distress of cancer patients and a to formulate a better plan for their management and psychological support. BSMMU J 2021; 14 (COVID -19 Supplement): 36-41

Background: Surgical site infections (SSIs) has been reported to be one of the most common causes of nosocomial infections which accounting for 20% to 25% worldwide. Despite recent advances in aseptic techniques, SSIs continue to be a major source of morbidity and mortality in developing countries and continue to represent about a fifth of all healthcare-associated infections. The aim of the study was to assess the pattern and etiological factors of surgical site infection among the patients who had undergone in surgery.Methods: This study was a cross-sectional study conducted at the department of surgery in Sir Salimullah Medical College and Mitford Hospital (SSMC and MH), Dhaka, Bangladesh from August 2017 to July 2018. Total 160 admitted patients who had undergone surgical procedures during the study period were assessed and interviewed.Results: The mean±SD age of the participants was 51.79±11.30 SD years. About 59% were male and 41% were female. Most of them came from rural areas (61%).  Surgeries were done in different indications and 21% developed SSI. Of all SSIs, 73% were superficial and 27% were deep infections. The most common organism involved in SSI was S. aureas (42.4%), followed by E. coli (27.3%), P. aeruginosa (12.1%), bacteroids (12.1%), and Klebsiella spp. (6.1%). Meropenem was the most sensitive drug followed by Ceftriaxone. Gentamycin showed cent percent sensitivity on the gram-negative organisms.Conclusions: The incidence of SSIs was found in about one-fifth of the post-surgical cases, where Staphylococcus aureus was the most prevalent organism.

Surgical site infections (SSIs) are the second most common nosocomial (hospital-acquired) infections after urinary tract infections. Despite recent advances in aseptic techniques, till now SSI has been considered as a major source of morbidity and mortality in developing countries and continued to represent about one fifth of all healthcare-associated infections. This cross-sectional study was conducted to analyze the pattern & aetiological factors of SSI among patients undergoing surgery at Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh involving 160 admitted patients during the study period. Of all SSIs, 73.0% were superficial and 27.0% were deep infections. Among the risk factors, Hypertension (29.4%), Diabetes Mellitus (24.4%), old age (>60 yr) [19.4%], anaemia (28.7%), and below average nutrition (13.8%) were the most common and had statistically significant relation with SSIs (p<.05). Moreover, incidence of SSIs was significantly higher in patients who required more duration of operation. The most common organism involved in SSI was S. aureas (42.4%), followed by E. coli (27.3%), P. aeruginosa (12.1%), bacteroids (12.1%) and Klebsiella spp. (6.1%). However, Meropenem was the most sensitive drug followed by Ceftriaxone according to culture and sensitivity screening. Gentamycin was 100% sensitive for gram-negative organism only. The incidence of SSIs are about one fifth of the post-surgical cases, where Staphylococcus aureus was the most prevalent organism. Meropenem and Gentamicin were the two most sensitive drugs against infections. BSMMU J 2021; 14(3): 50-56