Background: Congenital heart disease (CHD) has already been recognized as one of the important cause of neonatal mortality and morbidity. The reported prevalence of CHD in live newborns tends to vary a lot due to various unrecognizable lesions at birth and lack of technical expertise. Aims & objectives: The ultimate aim of this study was to assess the birth incidence and pattern of congenital heart disease (CHD) using echocardiography in babies born in different government and private hospitals and also in different households. Results: Overall incidence of congenital heart disease in neonate in this study was 4.9 per 1000 live birth. Mean age of diagnosis was 22.5±4.6 days. Average weight of these neonates was 26.70 gm. 61.5 % neonates were female. 30.8% was preterm. Respiratory distress was the most common clinical presentation (76.9%). The commonest type of congenital heart disease was Ventricular septal defect (VSD) (61.5%). Maternal co-morbidity may have influence. 30.8% mothers had gestational diabetes mellitus. Hypothyroidism, hypertension and maternal infection may have co-relation. Conclusion: In this study, we have found that the overall incidence of neonatal congenital heart disease is 4.9 per 1000 live birth. A high index of suspicion and routine neonatal cheek-up may have key role in diagnosis. Mediscope Vol. 8, No. 1: January 2021, Page 27-32

Background & objective: The outbreak of coronavirus disease 2019 (COVID-19) has become a large threat to global health due to its high contagious nature and varied mortality. The number of infected cases and deaths are rising exponentially all over the world, including Bangladesh. This study aims to investigate the epidemiological and clinical features of COVID-19 patients admitted in Gazi Medical College Hospital (GMCH), Khulna, Bangladesh. Methods: In this study, we included 110 RT-PCR positive COVID-19 cases at GMCH, Khulna, Bangladesh from 1 July, 2021 to 31 August, 2021. Demographic, clinical, laboratory and radiological data of the patients were recorded and analyzed. Results: Among 110 study subjects, 51.8% were male. The mean age was 52.6 years, with majority (43.6%) belonging to the age group of 40-59 years. Upon admission, the most frequent symptoms were fever (94.5%), cough (86.4%) and dyspnea (79.1%). Diabetes mellitus (42.7%) and hypertension (33.6%) were the most common comorbidities. Regarding laboratory parameters, neutrophilia and lymphocytopenia were observed in 72.7% and 58.2% cases, respectively. The mean D-dimer (2.9 mg/l) and CRP (61.7 mg/l) levels were above their normal limits. In high resolution CT scan of the chest (HRCT chest), bilateral lung involvement was present in 85.5% cases. Ground-glass appearance was the most frequent (89.1%) radiologic pattern. Among the study subjects, empirical antibiotic, antiviral (remdesivir) drug, and systemic glucocorticoid were given to 97.3%, 83.6% and 56.4% patients, respectively. Total 15 (13.6%) patients were severely affected with COVID-19 and admitted to the ICU, requiring mechanical ventilation. During our study, 12 patients (10.9%) died either due to multiple organ dysfunction syndrome or cardio-respiratory failure. Conclusion: The study provides key information about clinical characteristics and general management of COVID-19 patients, which may help physicians to identify the factors associated with adverse outcomes in this disease. Mediscope 2022;9(1): 9-15

Background: Community-acquired pneumonia (CAP) is the most frequent infectious disease, responsible for significant morbidity and mortality world wide. Poor outcome in CAP patients is directly related to pneumonia also to comorbidities both during hospitalization and long term after discharge. Objective: To determine the incidence of major cardiac complications in CAP patients. . We studied patients with association of CAP and ACE on admission or Patients with CAP on admission, developing ACE after 48 to 72 hours of hospital stay. Patients who were admitted with ACE but developed a CAP after 48 to 72 hours of admission and Patients with severe sepsis with a concomitant elevated troponin were excluded from the study. Results: Out of 1406 patients with CAP, 12.4% presented with cardiovascular events and 87.6% without cardiovascular events. In cardiovascular events, 79.3% patient had heart failure, 17.8% had cardiac arrhythmia and 2.9% had myocardial infarction. Subjects with hyperlipidemia had 2.10 fold more cardiac events than subjects without hyperlipidemia. A Subject with (PSI) <80 vs >80 had 3.16 (95% CI 1.18 to 8.47) times increase in odds having cardiovascular events. Hyperlipidemia and PSI were significantly associated with cardiovascular events. Conclusion: Major cardiac complications occur in a substantial proportion of patients with CAP. Physicians and patients need to appreciate the significance of this association for timely recognition and management of these events. Strategies aimed at preventing pneumonia in high-risk population need to be optimized.

Stroke is a major public health problem and a leading cause of chronic disability and death. There is scarcity of data about electrolytic disturbances in acute stroke, especially in developing countries. The objective of this study is to find out electrolyte disturbances among acute stroke patients and their association with severity of acute stroke and outcome. It was a cross-sectional study, conducted over a period of one year from 01/06/2018 to 31/05/2019, on 80 selected clinically and CT scan proven acute stroke patients at Gazi Medical College Hospital, Khulna. Out of 80 patients, 50 (62.5%) were male and 30 (37.5%) were female. Majority of the patients (38.7%) were above 70 years age group. CT scan findings revealed, 16 (20%) haemorrhagic, 60 (75%) ischaemic and 4 (05%) mixed (both haemorrhagic and ischaemic) stroke. Seventy-two (90%) of patients had unilateral and only 8 (10%) had bilateral lesion. Dyselectrolytemia was evident in 65% of total stroke patients. Thirty-five percent of all patients had hypokalaemia which was the most common dyselectrolytemia. Out of 20 patients with hyponatremia, 14 died and out of 28 patients with hypokalaemia, 14 died. Out of total 80 patients 48 (60%) had improved and 4 (5%) had been unchanged and referred to higher centre. Mediscope 2022;9(1): 20-24

Background: Dengue infection is a major health burden, which can result in mild self-limited febrile illness to highly fatal haemorrhagic disease. Infection is caused by Dengue virus, which is transmitted by the Aedes aegypti mosquito. Objective: The aim of the study was to see the clinical spectrum, laboratory profile and outcome of dengue fever in adult. Methods: This prospective observational study was carried out on 75 patients in the department of medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka from 11/07/2019 to 20/10/2019. All patients above 18 years with confirmed dengue, who were either hospitalized or managed as outdoor patients with NS1 (non-structural protein) antigen and/ or IgM dengue antibody positive were included in the study. The patients with concomitant malaria, typhoid and leptospirosis were excluded from the study. Detailed history and careful clinical examination were performed on each patient. Results: In this study, all patients (100%) had fever. Among them, 70 (93.3%) was suffering from headache, 66 (88.0%) myalgia, 32 (42.7%) abdominal pain, 30 (40.0%) conjuctival suffusion, 29 (38.7%) nausea/vomiting, 27 (36.0%) skin rashes, 14 (18.7%) pleural effusion, 13 (17.3%) ascites, 13 (17.3%) retro-orbital pain, 11 (14.7%) itching, 8 (10.7%) hepatomegaly, 7 (9.3%) splenomegaly. Death occurred in 3 (4.0%) patients. Rate of cure was 58 (77.3%) and ICU admission was required in 14 (18.7%), they were ultimately cured. Conclusion: Fever associated with headache and myalgia were the most common symptoms. Other common clinical features were abdominal pain, conjunctival suffusion, nausea/vomiting, skin rashes and pleural effusion. Regarding laboratory finding, platelet count has little role in management of dengue patients. Mediscope Vol. 8, No. 1: January 2021, Page 33-39