M Rukunuzzaman

Bangabandhu Sheikh Mujib Medical University, Mujib City, Dhaka, Bangladesh

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Publications (14)1.12 Total impact

  • M Rukunuzzaman · M B Karim
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    ABSTRACT: Hepatitis B Virus (HBV) infection is prevalent worldwide. The prevalence is lowest (0.2-0.5%) in countries having high standard of living. About 10 million people are chronically infected with HBV in Bangladesh and it is possible that most infections occur during childhood. Overall prevalence is about 3% in Bangladesh. Perinatal transmission is more common in hyper-endemic areas of South East Asia. Chronic hepatitis B infection evolves through five phases. Most of the children belong to immune tolerant phase. About 57% patients of chronic hepatitis B are asymptomatic. Treatment of chronic hepatitis B is difficult. Decision regarding when, whom and how to treat in children is complex. Moreover, there are only limited drugs that can be used in treating chronic hepatitis B in children. Goal of therapy are to reduce viral replication, to minimize liver injury, to reduce consequence of liver injury like cirrhosis, hepatocellular carcinoma and to reduce infectivity of HBV. Treatment should be considered in chronic hepatitis B if patient have persistently elevated ALT of more than twice normal and evidence of viral replication. There are some special circumstances where treatment of chronic hepatitis B can be given in absence of standard criteria. These conditions are cirrhosis, chemotherapy, immunosuppression, presence of co-infection (HBV-HIV), family history of HCC and pregnant women with high viral load. Sero-conversion occurs in about 17-32% cases if treated with oral nucleot(s)ide analogue and in about 58% cases if treated with interferon. These expensive drugs with limited treatment success are not suitable for the people of Bangladesh. Therefore, risk factors identification and prevention of HBV infection is the logical and rational approach for a country like Bangladesh. Vaccination against HBV play central role in preventing infection. HBV vaccine has been incorporated in EPI schedule since 2004 in Bangladesh. Immunoprophylaxis of babies of HBsAg positive mother and post exposure prophylaxis are effective ways of prevention.
    No preview · Article · Jul 2015 · Mymensingh Medical Journal
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    Md Rukunuzzaman
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    ABSTRACT: To evaluate clinical and laboratory profile of Wilson's disease (WD) in children. This cross sectional study was conducted at Bangabandhu Sheikh Mujib Medical University Hospital. Bangladesh, over a period of 3 years. One hundred consecutive children of WD between 3 to 18 years of age were evaluated. Mean age was 8.5±1.5 years. Male female ratio was 2:1. Ninety-one percent of patients were Muslim and 9% Hindu. A total of 53% cases of hepatic WD presented between 5 to 10 years of age and most of the neurologic WD manifested in 10-15 years age group. Sixty-nine children presented only with hepatic manifestations, 6 only with neurological manifestations, 14 with both hepatic and neurological manifestation, 10 children was asymptomatic and 1 patient presented with psychiatric features. WD presented as chronic liver disease (CLD) in 42%, CLD with portal hypertension in 34%, acute hepatitis in 20% and fulminant hepatic failure in 4% cases. Stigmata of CLD were found in 18% patients. Keiser-Fleischser ring was found in 76% total patients. Elevated serum transaminase was found in 85% cases, prolonged prothrombin time in 59% cases and hypoalbuminaemia in 53% cases. A total of 73% patients had low serum ceruloplasmin, basal urinary copper of >100 µg/day was found in 81% cases and urinary copper following penicillamine challenge of >1,200 µg/day was found in 92% cases. Majority of studied WD children presented with hepatic manifestation of which 76% presented with CLD. Any child presented with jaundice after the age of 3 years should be investigated for WD.
    Preview · Article · Jun 2015

  • No preview · Article · Dec 2014
  • M W Mazumder · M B Karim · M Rukunuzzaman
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    ABSTRACT: Wilson's disease (WD) is one of the most common metabolic liver diseases encountered in children. Early diagnosis of the disease is essential because specific treatment can be offered, that will prevent further hepatocellular injury and neurologic complications. There is no single diagnostic test that can exclude or confirm the disease with certainty. Penicillamine challenge has proved itself to be a useful diagnostic test in the detection of WD. The main purpose of this study was to observe the reliability of penicillamine challenge test, in the diagnosis of WD. The cross sectional study was done with a case control design in the department of paediatric gastroenterology & Nutrition, BSMMU, Dhaka. The study was carried out on 60 patients of CLD. Along with other physical findings and laboratory investigations, 24 hours urinary copper excretions were estimated before and after penicillamine challenge. Study results were analyzed statistically. Thirty CLD patients who fulfilled the inclusion and exclusion criteria of WD were considered as cases (Group I) and remaining 30 CLD patients were considered as non-Wilsonian CLD and was labeled as control (Group II). Among the control group, 12 CLD patients were found to be HBsAg positive, 1 had hepatitis-C virus infection, 1 had autoimmune hepatitis and the remaining 16 CLD patients were Cryptogenic. The (mean±SD) age of WD patients was 9.90±28 years; male female ratio was 1.5:1. Most common presentation was ascites (70%). K-F ring was found in 86.7% cases. Serum ceruloplasmin level was found significantly lower in WD patients (mean±SD, 0.1197±23g/L, p<0.001). Baseline urinary copper excretion of WD patients differed significantly from controls (Median 219.0μg/24hour, range 35-2018μg/24hour, versus median 44μg/24hour, range 20-238μg/24hour, p<0.001). Baseline urinary copper excretion above 100μg/24hour was observed in 80% WD patients whereas it was 10% in controls. post penicillamine urinary copper excretion was significantly greater in WD patients than controls (Median 2635μg/24hour, range 648-6222μg/24hour, versus median 423μg/24hour, range 91-1250μg/24hour, p<0.001). Post penicillamine urinary copper above 1600μg/24hour observed in 70% of WD patients whereas not a single patient reached the value in control group. Twenty four hours urinary copper estimation after penicillamine challenge was found to be a valuable test in the diagnosis of WD.
    No preview · Article · Jul 2014 · Mymensingh Medical Journal
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    M Rukunuzzaman · M B Karim · M M Rahman · M S Islam · M W Mazumder
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    ABSTRACT: Wilson's disease (WD) is an autosomal recessive disease affecting copper metabolism causing copper induced organ damage. Common organs involved are liver and central nervous system. But RBC, eye, kidneys and bone may also be affected. In WD main defect remains in copper transporter protein p type ATPase resulting from gene mutation in chromosome 13. Neurological manifestations in WD develop due to deposition of copper in different brain areas like basal ganglia, cerebral cortex, corticospinal and corticobulbar pathway. Different types of neurological manifestations develop in WD but visual impairment is very rare. A 14 years old boy of WD presented to us with blindness, tremor and slurred speech along with end stage liver disease. Blindness was thought to be due to optic neuropathy which reversed after drug treatment.
    Full-text · Article · Feb 2013 · Mymensingh Medical Journal
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    ABSTRACT: Tuberculosis (TB) is a major public health problem in most developing countries. The present study was carried out among 100 clinically suspected pulmonary TB patients. One hundred sputum specimens were collected one from each of the suspects attending DOT'S corner of Mymensingh Medical College Hospital, Mymensingh, Bangladesh. The aim of the study was to evaluate the sensitivity and specificity of a polymerase chain reaction (PCR) based method detecting IS6110 sequence present in all Mycobacterium tuberculosis strains using sputum samples in comparison to culture on Lowenstein-Jensen mediums. The PCR was done using primers mtb1 & mtb2 which commonly target an insertion sequence of the organism (IS6110). Out of 100 samples, 18 (18%) showed PCR positive, whereas culture in Lowenstein-Jensen media were positive in 19(19%). In PCR 1 was false negative but none was false positive. In present study, sensitivity and specificity of PCR found 94.74% and 100% respectively. Analyzing the findings of the present study, it can be concluded that the PCR technique is a rapid and alternative method of culture on Lowenstein-Jensen medium for the diagnosis of pulmonary tuberculosis. In the present study, only presence or absence of M. tuberculosis was determined.
    No preview · Article · Jul 2012 · Mymensingh Medical Journal
  • M Rukunuzzaman · A Afroza
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    ABSTRACT: Hepatitis B virus infection is prevalent worldwide. Overall prevalence is about 3 percent in Bangladesh. This prospective study aimed to find out the clinical, biochemical & virological profile of chronic HBV infection in children. It was conducted on patient attending the Department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University. A total of 90 cases were studied from October 2007 to October 2009. Univariate analysis was done. The study showed that most of the patients of chronic HBV are clinically asymptomatic, biochemically normal or near normal. Most of the chronic HBV infected patients are virologically HBeAg positive (77.8%). Therefore screening for asymptomatic HBV infection is essential for early diagnosis and treatment.
    No preview · Article · Jan 2012 · Mymensingh Medical Journal
  • Md Rukunuzzaman · A S M Bazlul Karim
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    ABSTRACT: Ulcerative colitis (UC) is a chronic idiopathic inflammatory disorder of colon. Frequency of UC is gradually increasing over few years worldwide. Prevalence is 35 to 100/100,000 people in USA, 1% of them are infants. UC develops in a genetically predisposed individual with altered intestinal immune response. An eight-month-old girl presented with loose bloody stool, growth failure, and moderate pallor. The girl was diagnosed as a case of UC by colonoscopy and biopsy. Treatment was thereafter started with immunosuppressive drugs. After initial induction therapy with parenteral steroid and infliximab, the patient is now on remission with azathioprine and mesalamine. UC is rare in Bangladesh, especially in children, and it is rarer during infancy. Several conditions like infective colitis, allergic colitis, Meckel's diverticulitis, Crohn's disease, etc. may mimic the features of UC. So, if a child presents with recurrent bloody diarrhea, UC should be considered as differential diagnosis.
    No preview · Article · Nov 2011 · Saudi Journal of Gastroenterology
  • M Rukunuzzaman · A Afroza
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    ABSTRACT: Hepatitis B infection (HBV) is prevalent worldwide. Overall prevalence is about 3 percent in Bangladesh. Treatments of chronic HBV infection by antiviral drugs are costly and outcome of treatment is also restricted. Therefore risk factors identification is the logical & rational approach to prevent HBV infection. This case control study aimed to find out certain risk factors related to HBV infection in children. It was conducted on patients attending the Department of Paediatric Gastroenterology & Nutrition and Department of Virology of BSMMU and Khidmah Hospital, Dhaka. A total of one hundred cases and one hundred suitably matched controls were studied between October 2007 to May 2009.Variables used for the purpose of the study were younger age, use of mosquito nets, history of undergoing surgical procedures, history of taking intravenous drug and blood transfusion, maternal infection, dental procedures and abrasion during hair cut in barber shops. Chi-square test was done to measure the level of significance. Odds ratio was calculated to correlate the disease risk. Backward conditional logistic regression was also done for multivariate analysis. The study result showed that the frequency of HBV infection among the study population was higher (62.0%) among children of 7 to 12 years age group. In younger age group (0-6 years) prevalence was 18.0%. Respondents who did not use mosquito net during sleep on a regular basis had higher risk of developing HBV infection than those who used it regularly (p value 0.028). Children who underwent surgical procedures for any reason were significantly associated with HBV infection (p value 0.005). Intravenous drug use (p value 0.001), mother to child transmission (p value 0.001) and history of abrasion during hair cut in barber shops (p value 0.04) were also identified as significant risk factors. No significant association was observed with blood transfusion (p value 0.138) and dental procedures (p value 0.315). From this study it may be concluded that irregular use of mosquito nets, history of surgical procedures, history of parenteral medication, transmission from infected mothers and abrasion during hair cut in barber shops are the probable important risk factors of HBV infection in children.
    No preview · Article · Oct 2011 · Mymensingh Medical Journal
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    Ainun Afroze · M Rukunuzzaman · S Hasan · A Rahman

    Preview · Article · Jan 2010
  • M Rukunuzzaman · Me Rahman
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    ABSTRACT: This case control study was carried out to determine certain clinical and epidemiological risk factors related to childhood visceral leishmaniasis (VL). Study was conducted in paediatric wards of Mymensingh Medical College Hospital. Dependable variables are sex, age, housing, use of mosquito net, malnutrition, sleeping habit and seasonality. A total of 60 cases and 60 suitably matched controls were studied between January 2000 to December 2000. The exposure rate of VL is more in boys (70%) than in girls (30%). The frequency rate of VL was higher in children >10 years of age group (66.6%) than in other age groups. Mud house dwelling is significantly associated with the development of VL (81.6%) and carries 28.9 times greater risk of developing VL, than those dwelling in bamboo house (13.3%). The difference of this proportion is statistically significant (p<0.001, OR=28.9). The exposure rate of VL was slightly higher (51.6%) in mosquito net non-users than the mosquito net users. Grade III malnutrition was found significantly associated with (83.3%) VL (p<0.005). The frequency rate of VL was higher in children sleeping on floor than in children sleeping on Chowki or Khat (OR=2.07). Rainy season is significantly associated with VL (60%) and carries 2.4 times greater risk of developing VL than other seasons (p<0.05, OR=2.4). It can be concluded that mud house dwelling, grade III malnutrition, sleeping on floor and seasonality (rainy season) are the important risk factors of VL in children.
    No preview · Article · Feb 2008 · Mymensingh Medical Journal

  • No preview · Article · Jan 2008

  • No preview · Article · Jan 2008
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    A Afroza · S Hasan · M Rukunuzzaman · SA Hussain · R Amin
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    ABSTRACT: Carcinoma rectum is a very uncommon malignancy in childhood. The incidence of colon cancer is found to be 1.3 cases per million children. An eleven years old boy with carcinoma rectum was admitted in the Department of Paediatric Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU). The boy presented with irregular fever, altered bowel habit, poor appetite, gradual weight loss and abdominal pain. His abdomen was tender with no organomegaly. The rectal wall was tender and hard mass could be felt in the surrounding area on direct rectal examination. Diagnosis was confirmed by biopsy of the tissue from the growth. Surgical resection and anastomosis was done. After one month of surgery chemotherapy was started. Since carcinoma rectum in children has not been reported in Bangladesh we share the information with professionals.
    Full-text · Article · Aug 2007 · Mymensingh Medical Journal

Publication Stats

24 Citations
1.12 Total Impact Points

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  • 2011-2015
    • Bangabandhu Sheikh Mujib Medical University
      Mujib City, Dhaka, Bangladesh