Sylhet Women's Medical College

Background: Ludwig’s angina is a rapidly progressive cellulitis of the submandibular space that may lead to lifethreatening airway compromise. Understanding its clinical presentation and microbial pattern is essential for early diagnosis and effective management. Objective: To evaluate the clinical spectrum of Ludwig’s angina and its association with microbial pattern, along with socio-demographic characteristics of affected patients. Methods: A hospital-based cross-sectional study was conducted on 50 patients with Ludwig’s angina admitted to three tertiary hospitals in Dhaka between January and June 2014. Patients with other causes of neck swelling, including lymphangioma, haemangioma, cystic hygroma, lymphoma, or submandibular gland neoplasm, were excluded. Data on socio-demographic characteristics, clinical features, and aerobic microbial culture results were collected using a structured data sheet and analyzed to evaluate the clinical profile and microbial pattern of Ludwig’s angina. Results: The mean age of patients was 34.8±17.7 years, with the highest proportion (40%) in the 21-40 years age group. All patients (100%) presented with neck swelling, pain, and tenderness, while fever (90%) and dysphagia (72%) were common systemic and local symptoms. Respiratory distress was observed in only 6% of cases. Aerobic culture showed mixed bacterial growth in 76% and isolated Streptococcal growth in 24% of patients. A significant association was found between gender and microbial pattern (χ²=4.20, p=0.041), with mixed growth more common in males and Streptococcal growth more frequent in females. Mean age was significantly higher in patients with Streptococcal growth (42.5±15.8 years) compared to mixed growth (33.4±17.2 years) (t=2.33, p=0.024). Conclusion: Ludwig’s angina predominantly affected young adult males from lower socioeconomic, rural backgrounds. The infection was mostly polymicrobial, emphasizing the need for broad-spectrum empirical antibiotics, with age and gender significantly influencing microbial patterns Journal of Dentistry and Allied Science, Vol. 9 No 1: 8-13

Background: Student-based evaluation of teaching is an important component of quality assurance in undergraduate medical education and can identify strengths and areas requiring faculty development. Objective: This study aimed to assess students’ perceptions of teachers’ performance and determine whether evaluations differed across phases of undergraduate medical education. Methods: This cross-sectional study was conducted among undergraduate medical students in Mymensingh Medical College, Bangladesh, in 2024. A total of 268 lecture sessions delivered by 61 teachers were evaluated using a structured student feedback questionnaire covering preparation and classroom management, teacher–student interaction, and professionalism and learning environment. Results: The overall mean evaluation score was 70.72±7.28, with a statement-wise mean of 4.42±0.45. The highest “almost always” ratings were observed for accepting own mistakes (77.6%), respecting students’ opinions (72.8%), clear language and pronunciation (65.3%), and stating session objectives (64.9%). Lower ratings were observed for checking previous knowledge (43.3%), encouraging active participation (41.8%), and assessing students’ learning (39.9%). First-phase students provided the highest mean score (72.74±5.82), whereas third-phase students provided the lowest (68.17±8.80). Student phase was significantly associated with checking previous knowledge, active participation, provision of references, assessment of learning, cooperative teaching, acceptance of mistakes, respect for students’ opinions, academic environment, and role modeling (p<0.05). Conclusion: Teachers received generally favorable evaluations, but learner-centered teaching, formative assessment, prior-knowledge assessment, and role modelling require strengthening through targeted faculty development.

Background: Tuberculosis (TB) is an emerging global health burden in low- and middle-income countries (LMICs), where diagnosis often relies on sputum microscopy is a method with low sensitivity that misses numerous cases. Objective: This study directed to assess the diagnostic performance of GeneXpert in detecting pulmonary TB among presumptive cases and compare it with conventional sputum microscopy. Methodology: This cross-sectional study assessed 887 presumptive TB patients from two resource constrained Upazila, Bhaluka and Kishoreganj, Bangladesh, between January and June 2020. TB diagnosis was performed using both GeneXpert and sputum microscopy, with results compared across age groups, genders, and sputum types at primary local diagnostic centers. Results: The study population was predominantly male (67.4%), with most patients aged ≥45 years. GeneXpert identified 132 TB cases (14.9%), detecting 32 more cases than sputum microscopy (11.3%). Across all age groups and both genders, GeneXpert showed higher sensitivity, particularly in the 15 to 29 and 45 to 59 year groups. Regarding sputum types, the highest TB positivity was found in purulent specimens, with GeneXpert again demonstrating superior performance, especially in mucopurulent samples. Conclusion: GeneXpert significantly outperformed sputum microscopy in detecting pulmonary TB across all demographic and clinical subgroups. Its higher sensitivity, particularly in younger and middle-aged adults and varied sputum types, supports its broader implementation as the initial diagnostic tool in resource-constrained settings. Bangladesh Journal of Infectious Diseases, June 2026;13(1):43-50

Background: Postoperative pain remains a major challenge after surgery and may delay mobilization, prolong hospital stay, and adversely affect patient satisfaction and recovery. Ketamine, an N-methyl-D-aspartate receptor antagonist, has been increasingly used as an adjunct to conventional analgesia because of its potential analgesic and opioid-sparing effects. This study compared perioperative ketamine with standard analgesia in terms of postoperative pain and recovery outcomes. Objective: To compare the effects of perioperative analgesic dose of ketamine and standard analgesia on postoperative pain, rescue analgesic requirement, early recovery, adverse effects, and patient satisfaction among patients undergoing surgery. Methods: This comparative clinical study was conducted at Sylhet Women’s Medical College & Hospital, Sylhet, Bangladesh, from June 2024 to May 2025. A total of 60 patients were included and divided into two groups of 30 each. Group A received perioperative ketamine in addition to standard analgesia, while Group B received standard analgesia alone. Postoperative pain was assessed at predefined time points. Rescue analgesic requirement, time to first ambulation, hospital stay, overall recovery score, adverse effects, and patient satisfaction were compared between the groups. Data were analyzed using SPSS version 23, with p<0.05 considered statistically significant. Results: The groups were comparable regarding baseline demographic and clinical characteristics. Postoperative pain scores were significantly lower in the ketamine group from immediate recovery through 24 hours (24-hour pain score: 1.6±0.6 vs. 2.3±0.7, p<0.001). Rescue analgesia was required by 40.0% of patients in Group A compared with 73.3% in Group B (p=0.011). The ketamine group had a longer time to first rescue analgesia (7.2±3.1 vs. 4.6±2.4 hours, p=0.001), earlier ambulation (11.8±4.2 vs. 15.6±5.1 hours, p=0.003), shorter hospital stay (3.8±1.1 vs. 4.7±1.4 days, p=0.008), and higher recovery scores (82.4±8.7 vs. 74.6±9.3, p=0.001). Overall adverse effects were comparable (46.7% vs. 50.0%, p=0.796). Patient satisfaction was higher in Group A (83.3% vs. 60.0%, p=0.048). Conclusion: Perioperative ketamine as an adjunct to standard analgesia was associated with improved postoperative pain control, reduced rescue analgesic requirement, earlier ambulation, shorter hospital stay, and better overall recovery, without a significant increase in adverse effects.

Background: Minimally invasive management may reduce patient suffering and complications. Tube thoracostomy is commonly used for pneumothorax, but conservative management is an option for selected patients with small pneumothorax. Objectives: To evaluate conservative management of small pneumothorax following blunt chest trauma and compare outcomes with tube thoracostomy. Methods: This prospective observational study was conducted in the Department of Surgery, Sylhet MAG Osmani Medical College Hospital, from November 2021 to October 2022. A total of 116 patients with small pneumothorax due to blunt chest trauma were included; 58 were allocated to conservative management (Group A) and 58 to tube thoracostomy (Group B). Results: Road traffic accidents were the commonest cause of pneumothorax. Mean pneumothorax size was comparable between Groups A and B (1.75±0.08 vs. 1.77±0.066 cm). Mean lung re-expansion rates were 1.06±0.053% and 1.21±0.04%, respectively. Only 7% of conservatively managed patients required conversion to tube thoracostomy. Complications occurred in 55% of tube thoracostomy patients, with tube kinking being most common (29%). Mean hospital stay was significantly shorter in Group A (3.14±1.37 vs. 6.38±2.88 days, p=0.022), as was treatment cost (1732.8±896.04 vs. 6513.8±1815.1-taka, p=0.024). For pneumothorax <1.8 cm, re-expansion did not differ significantly (p=0.86), whereas a significant difference was observed for >1.8 cm (p<0.00001). Hospital arrival within 6 hours was associated with significantly different re-expansion rates (p=0.006). Conclusion: In small pneumothorax due to blunt chest trauma, before undergoing tube thoracostomy conservative management with watchful observation can be a preferred approach as this reduces the length of hospital stay, reduces the cost of treatment and avoids tube related complications with an insignificant rate of re-expansion of the lung.