Annals of International Medical and Dental Research (AIMDR)
Vol-8, Issue-2 | March-April 2022
Anesthetic Management in a Adult Male with Citrullinemia: A Case Report
Gurdarshan Kamboj1, Mandeep Kaur2*, Rakesh Sadhu3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 1-4 | DOI: 10.53339/aimdr.2022.8.2.1
Anesthetic Management in a Adult Male with Citrullinemia: A Case Report
Gurdarshan Kamboj1, Mandeep Kaur2*, Rakesh Sadhu3
Abstract
Our case report is regarding a patient who is a k/c/o citrullinemia type 1 which is a defect in urea cycle posted for facture patella reduction surgery (tension band wiring). He was intellectual disabled because of persistent hyperammonaemia before diagnosis that was controlled with benzoate and L- arginine. Patient preoperative fasting was kept to the minimum and taken as 1st case in the operation theatre. Drugs taken orally on routine basis were continued along with serum ammonia monitoring. Clonidine with midazolam along with propofol infusion to decrease protein hypercatabolism due to stress and to get co-operation of the patient for femoral sciatic block. Postoperative ammonia levels were normal. Sedation is considered useful for preventing hyper ammonemia. Preoperative endocrinology consultation, perioperative serum ammonia level monitoring and coordination between various health departments (nephrologist and endocrinologist) for appropriate care in case of hyper ammonemia and hyperglycaemia perioperatively.
Type I Citrullinemia, urea cycle, fracture patella, sciatico-femoral block.
Evaluation of Microalbuminuria in Patients with Urinary Tract Infection
Mohid Raza1, Maninder Kaur2, Harjinder Singh3, Ravinder Khaira4*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 05-10 | DOI: 10.53339/aimdr.2022.8.2.2
Evaluation of Microalbuminuria in Patients with Urinary Tract Infection
Mohid Raza1, Maninder Kaur2, Harjinder Singh3, Ravinder Khaira4*
Abstract
Background: Urinary tract infection is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. There are wide range of factors identified that can increase susceptibility to UTI, like sexual intercourse, congenital abnormalities, urinary obstruction, prior history of UTI, diabetes, urogenital surgery, estrogen deficiency. Diabetes mellitus has been a significant risk factor for complicated UTI. Presence of microalbumin in urine in patients of urinary tract infection may be a predictor of intrinsic renal pathology and its presence is a predictor of ongoing progressive damage to kidneys. Microalbuminuria is also associated with cardiovascular events and diabetic nephropathy. Early diagnosis of microalbuminuria will decrease the incidence of end stage renal disease and cardiovascular events. The present study was thus conducted to evaluate prevalence of microalbuminuria in patients diagnosed with urinary tract infections.Material & Methods:The present hospital based case control study was conducted on 60 patients visiting the outpatient clinic (OPD) of Department of Urology, Government Medical College and Rajindra Hospital, Patiala and diagnosed with UTI and the control group consisted of 20 age and gender matched individuals. Estimation of urine microalbumin was done by Enyme linked immunoassay(ELISA) kit method in Department of Biochemistry, GMC Patiala.Results:Out of 60 cases of UTI included in the present study, prevalence of microalbuminuria was observed in 43.3% among cases of UTI . A total of 85% of the cases with positive urine culture had microalbuminuria (p<0.01).Conclusions:Microalbuminuria and ACR can be recommended for predicting ESRD at an early stage of kidney disease.
Urinary tract infection, Albumin creatinine ratio, Microalbuminuria.
Vidyalakshmi S1, Smriti Anand2*, B S Sekhon3, Rakesh Sadhu4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 11-14 | DOI: 10.53339/aimdr.2022.8.2.3
Anesthetic Management of A Patient with Hypertrophic Cardiomyopathy Posted For Non–Cardiac Surgery – Case Report
Vidyalakshmi S1, Smriti Anand2*, B S Sekhon3, Rakesh Sadhu4
Abstract
Hypertrophic cardiomyopathy (HOCM) is a complex cardiac disorder of genetic origin. Though the patients may be asymptomatic the stress of surgery and anaesthesia is known to exacerbate the left ventricular outflow tract (LVOT) obstruction leading to catastrophic complications. We hereby report a successful anaesthetic management of a patient with left intertrochantric fracture diagnosed with HOCM. Careful and meticulous strategies to prevent LVOT obstruction led to entire uneventful introperative and perioperative course.
Hypertrophic cardiomyopathy, Left ventricular outflow tract, Intertrochantric fracture, Spinal anaesthesia
Ritwiza Thakur1, Smriti Anand2*, Rakesh Sadhu3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 15-18 | DOI: 10.53339/aimdr.2022.8.2.4
Anaesthetic Management of a Patient During Transurethral Resection of Prostate with Iatrogenic Intraperitoneal Bladder Explosion: An Atypical Event
Ritwiza Thakur1, Smriti Anand2*, Rakesh Sadhu3
Abstract
Transuretheral resection of prostate (TURP) is one of the most commonly performed urological procedure. Though considered to be safe, it is sometimes associated with atypical complications. We hereby report a successful anaesthetic management of bladder explosion, a very rare complication of TURP, occuring towards the end of the procedure at the time of removal of resectoscope. The prompt recognition and management of the same led to uneventful postoperative course.
Transuretheral resection of prostate, Benign prostatic hyperplasia, Bladder explosion
Ocular Prosthesis – For Beginners
Nazmul Mazumder1, Saima Ahsan Mazumder2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 19-24 | DOI: 10.53339/aimdr.2022.8.2.5
Ocular Prosthesis – For Beginners
Nazmul Mazumder1, Saima Ahsan Mazumder2*
Abstract
Background: The Ocular Prosthesis device is very important toprovide the best possible functional & cosmetic results. It is important to have a firm understanding of management of the anophthalmic socket & when to make appropriate referrals to the Ophtahlmic Surgeon. The Objectives In this review, the author will discuss about one of the component of Ocular Prosthesis ie. Orbital implants.Material & Methods:The patients who requires ocular prosthesis are selected as per the need & requirement, also on the basis of types of available implants.Results:One should follow the components& scenario for optimal outcome.Conclusions:An eye care professional should be aware of the entire structure & all the recent development involved in it. They also have to be empathetic and have a creative oulook in management of such conditions by using all the available resources.
Ocular Prosthesis/ Orbital Implants.
Anterior Segment Optical Coherence Tomography In Scleral Lens Fitting
Saima Ahsan Mazumder1, Nazmul Mazumder2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 25-33 | DOI: 10.53339/aimdr.2022.8.2.6
Anterior Segment Optical Coherence Tomography In Scleral Lens Fitting
Saima Ahsan Mazumder1, Nazmul Mazumder2*
Abstract
Background: AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. The Objectives In this review, the author will discuss the clinical applications of AS-OCT in the scleral contact lens fittings.Material & Methods:Pre-Scleral lens fit and post fit ASOCT done on 30 patients to assess the normal fitting and compare it with the slit lamp evaluation.Results:ASOCT gives a Quantitative measurement of the fit.Conclusions:ASOCT comes out as a helpful tool for beginners particularly for a good assessment of a contact lens fit. The author also presents some interesting cases demonstrated via AS-OCT.
Scleral Lenses, Central and Peripheral clearances, edge assessment using ASOCT
Non Traumatic and Non Hypertensive Intracerebral Bleed: Causes and Imaging Evaluation
Renu Yadav1*, Meenu Amar2, Prateek Madaan3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 34-42 | DOI: 10.53339/aimdr.2022.8.2.7
Non Traumatic and Non Hypertensive Intracerebral Bleed: Causes and Imaging Evaluation
Renu Yadav1*, Meenu Amar2, Prateek Madaan3
Abstract
Background: Cross-sectional observational study was done in patients with non-traumatic, non-hypertensive intracerebral bleed undergoing cerebral angiography to study its different causes.Material & Methods:Patients with all age groups presenting to the emergency with acute non-traumatic intra-cerebral bleed undergoing cerebral angiography in our institution for a time period of 6 months with a total of 200 patients were included in the study. Data collected were analyzed with respect to causes, distribution of aneurysms. Suspected cases of hypertensive bleed were excluded from the study population.Results:Non-contrast computed tomographic images showed positive findings in the form of either intra-axial/extra-axial bleed or infarct in 95% of patients. However angiographic findings were positive in 52% of patients. Aneurysms were the most common positive angiographic findings (43% cases) with 95% of aneurysms were located in the circle of Willis. Majority of patients had solitary aneurysm while 6% had multiple aneurysms.Conclusions:Among all non-traumatic, non-hpertensive intracerebral bleed aneurysms accounts for majority of the causes. Other causes include intraparenchymal arterio-venous malformations, cerebral venous thrombosis with hemorrhagic infarct and dural arteriovenous malformations (AVM).
Intracerebral bleed, Aneurysms, cerebral angiography.
Novel biomarkers for Diagnosis of Pulmonary Tuberculosis and Tuberculous Pleural Effusion
Eman Alsayed Abouahmed1*, Samar Mansour2, Ali Omar Abdelaziz3, Naglaa M Farag4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 43-51 | DOI: 10.53339/aimdr.2022.8.2.8
Novel biomarkers for Diagnosis of Pulmonary Tuberculosis and Tuberculous Pleural Effusion
Eman Alsayed Abouahmed1*, Samar Mansour2, Ali Omar Abdelaziz3, Naglaa M Farag4
Abstract
Background: The present study aimed to evaluate the importance of serum, pleural adenosine deaminase (ADA), and Gene Xpert in Diagnosis of TB and TB Pleural Effusion (TB-PLE.).Material & Methods:The study was done with 75 TB cases, 50 cases of them were diagnosed as Pulmonary TB and 25 cases as TB pleural effusion, collecting also 50 non-TB pleural effusion, Malignant and acute bacterial infection comprise 21 and 29 cases respectively. Cases with transudative pleural effusion were excluded from the study. Finally, 75 were healthy control group.Results:There was a highly significant difference between the mean age of TB-PE Patients and Patients non-TB-PLE (P-value <0.001), while there was a non-significant difference with patients with P-TB (P-value >0.05). Mean of Serum ADA level were highest 53.16 U/L in TB-PE cases, shown to be statistically significant when compared to 43.2 U/L in P-TB and 25.4 U/L in non TBpleural effusion. With p-value of 0.02 and 0.001respectively.Conclusions:We concluded that GeneXpert can be a useful diagnostic method in patients with suspected pulmonary tuberculosis. Serum and pleural fluid ADA level is a very helpful test to rule out a TB and can help differentiate tubercular etiology from non-tubercular.
TB, Pleural Effusion, pleural ADA, GeneXpert.
Bolaji Damilola Agboola1*, Joel Olayiwola Faronbi2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 52-62 | DOI: 10.53339/aimdr.2022.8.2.9
Correlates Between Health Seeking Behaviour and Health Status; A Cross-Sectional Study Among the Elderly Group in Nigeria
Bolaji Damilola Agboola1*, Joel Olayiwola Faronbi2
Abstract
Background: The aim of this study was to examine the correlates between health seeking behavior and health status among the Elderly group in Osun State, Nigeria.Material & Methods:A cross-sectional study was conducted in Osun State between July-October 2020. A multistage sampling method was used to select 433 people aged 60 years and older. The participants were interviewed face-to-face using a well-structured questionnaire. Both descriptive and inferential statistics was used to analyse data. Results:Findings from the study revealed that majority (77.8%) of the respondents had poor health status. Key findings showed that majority (72.4%) of respondents had good health seeking behaviour. Furthermore, age (p<0.05), marital status (p<0.05), educational status (p<0.05) and monthly income (p<0.05) were statistically associated with the health status of the elderly people.Conclusions:An adequate understanding of health seeking behaviour and its correlates with health status especially among the elderly people is needed to improve the health care in Nigeria. Although the elderly people have a good health seeking behaviour, it does not however translate to good health status. Therefore, strategies to improve the health status including improving their financial status should be developed with adequate health literacy. Elderly people should learn the importance of regular health examinations to promote health, prevent diseases, and slow the progress of chronic diseases.
Health seeking behavior, elderly people, morbidity pattern, health status, Nigeria.
Shalan Kaul1*, Kamna Gorka2, Haridarshan Singh Sidhu3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 63-69 | DOI: 10.53339/aimdr.2022.8.2.10
An In Vitro Study to Assess the Root Canal Morphology of Human Primary Molars Using Computerised Tomography
Shalan Kaul1*, Kamna Gorka2, Haridarshan Singh Sidhu3
Abstract
Background: A virtuous consideration of root canal morphology is required. Complications all through and after endodontic therapy are frequently caused by variances in the anatomy of root canals in primary teeth. The goal of present study was to determine the number and shape of root canals in primary incisors and molars, as well as the pertinency of cone beam computerised tomography (CBCT) in doing so.Material & Methods:On a total of 60 primary molars and incisors with complete root length, CBCT was used to assess the number of roots, number of canals, width of root canal at cementoenamel junction and middle-third, length and angulations of roots. The information was statistically analysed. Results:The CBCT revealed that 13 percent of mandibular incisors had bifurcation of the root canal in the middle third, while 20% of mandibular molars had two canals in the distal root. The distobuccal root canal diameter of maxillary molars and the mesiolingual canal diameter of mandibular molars were determined to be the smallest.Conclusions:Cone beam computed tomography (CBCT) is a comparatively new and effective technology that can be used in conjunction with conventional radiography to examine variations in root canal morphology in primary teeth.
Pedodontics, Preventive Dentistry Cone beam computerized tomography, CBCT, primary teeth, root canal morphology.
Bone Marrow Aspiration Findings in Hematological Disorders in Children
Jaswir Singh1, Manpreet Sodhi2*, Ramesh Kundal3, Pooja H.M4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 70-78 | DOI: 10.53339/aimdr.2022.8.2.11
Bone Marrow Aspiration Findings in Hematological Disorders in Children
Jaswir Singh1, Manpreet Sodhi2*, Ramesh Kundal3, Pooja H.M4
Abstract
Background: Primary objective was to study bone marrow aspiration(BMA) findings in hematological disorders in children with secondary objective to find correlation between peripheral blood film (PBF) findings with BMA.Material & Methods:It was observational and cross-sectional study conducted on 65 children in age group of 1-18 yrs admitted to Pediatrics Department of Government Medical College, Patiala over period of 1 yr. Inclusion criteria was based on clinical and laboratory parameters. Children were of anaemia, leucopenia and pancytopenia. Complete hemogram, reticulocyte count, PBF smear and bone marrow aspiration were done. The data was analyzed using IBM Statistical Packages for Social Sciences SPSS software version 22.Results:The mean age of study population was 10.39±6.29yrs. 93.8% children presented with pallor followed by fever in 84.6% and lethargy in 66.2%. 62 children were severely anaemic, 33 had bicytopenia, 23 children had pancytopenia. Bone marrow was hypercellular in 59 (90.8%) children. 40 (61.5%) children had megaloblastic anaemia on BMA followed by dimorphic anaemia in 8, Idiopathic thrombocytopenic purpura in 6 children. 4 children each had Megaloblastic anaemia with gelatinous transformation and micronormoblastic anaemia. 2 children had acute lymphatic leukemia and one had aplastic anaemia. The predominant PBF was dimorphic in 30 children, out of whom 22 had megaloblastic anaemia and 8 had dimorphic anaemia on BMA. Conclusions:Bone marrow was megaloblastic in majority (61.5%) of children. There was no significant association found between PBF findings and bone marrow diagnosis.
Anaemia, Bicytopenia, Pancytopenia, Megaloblastic anaemia.
An Observational Study for Causes of Surgical Jaundice at Tertiary Care Hospital
Priyanka yadav1*, Naveen Kumar Singh2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 79-90 | DOI: 10.53339/aimdr.2022.8.2.12
An Observational Study for Causes of Surgical Jaundice at Tertiary Care Hospital
Priyanka yadav1*, Naveen Kumar Singh2
Abstract
Background: The etiological pattern of obstructive jaundice varies from one region to another due to higher incidence being noticed in the Northern region of India. Very limited studies have been carried out in the western regions of Uttar Pradesh. The various etiological parameters ranges from malignant biliary stricture, stone in the CBD and even secondaries lymph node compression at porta hepatis. Due to the transition from open surgery to the minimum invasive laproscopic surgery. The etiology related to surgical jaundice also become more common in relation to procedure related complications like CBD injury that leads to surgical jaundice.Material & Methods:This present study has been conducted in the department of general surgery in TMMC and RC of a Tertiary Care hospital. In this observatory study the patients having clinical records of surgical jaundice who had attended the surgical Out Patient Department are going to be included. The time period of the study was from 1 jan 2020 to 30 sept 2021 . Overall, 44 patients were being considered. The selection of subject was done randomly and any type of special consideration regarding the gender of the patients was not being considered while selecting for the study.Results:In our study from 44 patients according to frequency distribution of etiology maximum of the subjects were having choledocholitheasis along with cholelitheasis that are 34.5 % and choledocholitheasis with obstructive jaundice was the 2ndmost common cause with 31.78%.The 3rdmost common etiology was found carcinoma of gall bladder with 11.35%.Conclusions:It can be concluded that for the cases of malignant surgical jaundice good survival benefit usually depends upon the detection of the disease early during the course period. It has also been found that in malignant cases the stage of disease with jaundice were advanced. As per our study results it has been observed that there are various etiological factors contributing to development of surgical jaundice which needs multiple modes of precise investigations and further evaluations further studies and research needed to cover various factor responsible for surgical jaundice.
Surgical Jaundice.
Sanjeev Gupta1, P.K. Pandove2, Vikram Garg3*, Samidha Jindal4, Karamjot Sandhu5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 91-98 | DOI: 10.53339/aimdr.2022.8.2.13
To Evaluate the Feasibility of Flip Technique in Dissection of Gall Bladder from the Liver Bed in Laparoscopic Cholecystectomy and Its Comparison with Standard Laparoscopic Cholecystectomy
Sanjeev Gupta1, P.K. Pandove2, Vikram Garg3*, Samidha Jindal4, Karamjot Sandhu5
Abstract
Background: Laparascopic cholecystectomy is one of the commonly performed surgery and is the procedure of choice for gall bladder disease. Time to time advancements are being made in this procedure to ease this surgery and also decrease its complication rate. And with the same purpose, a special technique named as “Flip Technique” has been introduced in which, in order to make the dissection of gall bladder easier near the fundus, the gall bladder is flipped over the liver surface after initial dissection of the gall bladder from the liver bed. The study to find out the feasibility of this flip technique of gall bladder removal in laparoscopic cholecystectomy was done in 100 patients admitted in department of general surgery, Govt Medical College and Rajindra Hospital, Patiala. Aim: This study aims to evaluate the feasibility of Flip technique for dissection of gall bladder from the liver bed in laparoscopic cholecystectomy with regard to operative time, intraoperative bleeding, bile duct injury, liver bed injury, injury to gall bladder wall, duration of hospital stay and mortality (if any).Methods:The present study was prospective, observational and comparative trial and was conducted on 100 patients of either sex diagnosed as case of GBD and planned for laparoscopic cholecystectomy, admitted in surgical ward of Rajindra Hospital, Patiala.Results:Latrogenic GB rupture occurred in 2% of patients in group A (cases) and 12% of patients in group B (control). The difference was statistically significant (p value 0.05). Site of rupture in group A is fundus of gall bladder in 2% of patients and none of gall bladder rupture is seen at body or Hartman’s pouch. In group B gall bladder rupture was found at fundus in 6% of patients, at body in 4% patients and Hartman’s pouch in 2% of patients.Conclusions:The use of Flip technique was more advantageous as compared to standard method of gall bladder dissection from liver bed in laparoscopic cholecystectomy with the mean duration of surgery being shorter in Flip technique.
Gall Bladder, Laparoscopic Cholecystectomy.
Study of Relationship between HbA1c and Microalbuminuria of Diabetic Patients
Suman Kanti Chowdhury1*, Shibani Datta2, Muhammad Tanvir Mohith3, Soumitra Roy4, Md. Jalal Hossain5, Nahida Zafrin6, Mahmudur Rahman7, Abdullah Md Abu Ayub Ansary8
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 99-108 | DOI: 10.53339/aimdr.2022.8.2.14
Study of Relationship between HbA1c and Microalbuminuria of Diabetic Patients
Suman Kanti Chowdhury1*, Shibani Datta2, Muhammad Tanvir Mohith3, Soumitra Roy4, Md. Jalal Hossain5, Nahida Zafrin6, Mahmudur Rahman7, Abdullah Md Abu Ayub Ansary8
Abstract
Background: Globally, as of 2010, an estimated 285 million people had diabetes, with type 2 making up about 90% of the cases. Its incidence is estimated to almost double, by 2030. Diabetic nephropathy is a consequence of long standing diabetes. The prevalence of microalbuminuria predicts progression to diabetic nephropathy. Measurement of glycated hemoglobin (HbA1c) has become the preferred method of diagnosis as well as assessing long-term glycaemic control. The present study was conducted to determine the magnitude and prevalence of microalbuminuria in relation to HbA1c in a group of diabetic patients admitted in Comilla Medical College Hospital of Bangladesh. Objectives: The relationship between HbA1c and microalbuminuria of diabetic patients was assessed in a hospital-based cross-sectional study in a tertiary level hospital.Material & Methods:A hospital-based cross-sectional descriptive study was carried out in department of Medicine, Comilla Medical College Hospital from 1st July, 2011 to 30th June, 2012. One hundred known admitted diabetic patients with age 25–84 years were included in this study.Results:Microalbuminuria had a significant correlation with HbA1c (p<0.05) (r=0.24). Increasing HbA1c was associated with increasing microalbuminuria above optimal cut-off points of HbA1c 7%. The prevalence of microalbuminuria was 33.33 % at HbA1c(6.1-6.9)%, whereas it was 75% at HbA1c (7.1-7.9)%. Microalbuminuria was 38.74 ± 9.76 mg/gm (p<0.05) at HbA1c <7%, whereas it was 65.86 ± 21.29 mg/gm (p<0.05) at HbA1c ≥7%.Conclusions:The present study found an early onset of microalbuminuria in the selected community which could be due to poor glycaemic control (high HbA1c ≥ 7%) after excluding other causes of microalbuminuria. Screening for microalbuminuria and HbA1c test should be done in both newly and already diagnosed diabetic patients as an early marker of renal dysfunction and glycaemic control.
HbA1c & Microalbuminuria, ACR , Diabetes mellitus, Diabetic nephropathy.
S.M. Shahidul Islam1*, Huihui Li2, S.M. Abdul Alim3, Sabina Yasmin4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 109-112 | DOI: 10.53339/aimdr.2022.8.2.15
Acupuncture Treatment in Rheumatoid Arthritis Patients in a Specialized Acupuncture Center in Dhaka Bangladesh: A Case Report
S.M. Shahidul Islam1*, Huihui Li2, S.M. Abdul Alim3, Sabina Yasmin4
Abstract
Background: Two recognized antibodies, Rheumatoid Factor (RF) and Anti-Citrullinated Peptide Antibody (ACPA), are produced in rheumatoid arthritis to target common autoantigens that are expressed in and around the joints. Tobacco and microorganisms, as well as the relationship between genetics and environment, play a critical role in the progression of the illness (e.g. Porphyromonas gingivalis). Rheumatoid arthritis is visualized as a Th1 and Th17 illness in the first stages of the disease. There is a significant role for inflammatory cytokines in the hierarchy of RA processes. Additionally, RA-related joint degradation is mediated by the Wnt system and osteoprotegerin’s impact on osteoclasts, as well as the matrix synthesis dysregulation that causes cartilage degeneration. Rheumatoid arthritis is a disease in which both innate and adaptive immunity have been shown to play a key role, thanks to the development of effective therapies for TNF-, IL-6 receptor, IL-1, CD20 B cells, and T-cell/Dendritic cell interactions.
Rheumatoid, Arthritis, Diabetic, Physiotherapy
Rejaul Hasan1*, Shawkat Mahmood2, Sayeda Begum Panna3, Md. Shamim Hossain Apel4, Mohammad Zohanul Islam5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 113-119 | DOI: 10.53339/aimdr.2022.8.2.16
A Comparative Study between Thoracic Epidural and Conventional Methods of Pain Management in Post Thoracotomy Patients
Rejaul Hasan1*, Shawkat Mahmood2, Sayeda Begum Panna3, Md. Shamim Hossain Apel4, Mohammad Zohanul Islam5
Abstract
Background: Postoperative discomfort has a negative impact on the outcome of thoracic surgical procedures, which are among the most painful operations. Controlling pain after a thoracotomy enhances patient satisfaction while lowering postoperative morbidity. Aim of the study: The aim of the study was to evaluate the effects of thoracic epidural and conventional pain management methods in post-thoracotomy patients.Material & Methods:A randomized cross-sectional comparative study was conducted among 260 patients of post thoracotomy between January 2018 and December 2020 in a single tertiary-care hospital of Dhaka, Bangladesh. Outcomes of surgery were evaluated using the visual analogue score (VAS) at resting and coughing time.Results:We divided all 260 patients into two groups (group A: thoracic epidural 130; group B: conventional/control 130). The mean age of the patients was 49.74±23.46 years in group A and 50.48±56.23 in group B. There were 61% male patients and 39% female patients, and the male: female ratio was 81:48 in group A, and 78:53 in group B. Mean duration of surgeries was 2.95± 67.92 hours and 2.84± 57.31 hours in group A and B respectively and mean follow up was 1.9 years and 1.4 years in group A and B respectively. The maximum number (36.9%%) of patients were in the age group of 50 to 54 years, and the minimum number (4.61%) of patients were in the age group of 35 to 39 years. In group A, the maximum number (31) of patients had gone through open window formation, and a minimum number of patients (4) had gone through segmentectomy. And in group B, the maximum number (33) of patients had gone through open window formation, and a minimum number (4) had gone through hydatid cyst removal surgery. The change between comparative values of postoperative mean VAS scores at resting time and coughing time of both groups of patients was significant in this study.Conclusions:In thoracotomy surgery, the efficacy of thoracic epidural anesthesia is more evident than in other types of surgery. Although managing thoracotomy pain might be challenging, the advantages of proper pain management are substantial.
Thoracic Epidural, Pain Management, Thoracotomy.
Mostofa Showkat Imran1*, Amitav Saha2, Faruque Ahmed3, Masudur Rahman4, S.M. Mostafa Kamal5, Golam Kibria6, Md. Shamim Hossain7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 120-127 | DOI: 10.53339/aimdr.2022.8.2.17
Diagnosis and Antimicrobial Susceptibility of Mycobacterium Tuberculosis in a Tertiary Care Hospital in Bangladesh
Mostofa Showkat Imran1*, Amitav Saha2, Faruque Ahmed3, Masudur Rahman4, S.M. Mostafa Kamal5, Golam Kibria6, Md. Shamim Hossain7
Abstract
Background: Tuberculosis (TB) is a common condition all over the world but more common in developing countries like Bangladesh38. This is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. In 2013, 9 million people fell ill with TB and 1.5 million died from the disease globally. Approximately 15-20 % of total TB cases are extrapulmonary in non-HIV patients. Among extrapulmonary TB, abdominal tuberculosis (ATB) accounts for 11%-16%. Abdominal TB is difficult to diagnose because of its lack of specific symptoms, low yield of acid-fast bacilli (AFB) on smear and culture due to paucibacillary lesion; and variable manifestations depending upon anatomical localization of the disease. The diagnosis of abdominal TB classically requires histopathological, microbiological and culture confirmation of Mycobacterium tuberculosis. Investigations like Imaging (Ultrasound, Barium X-Rays, and CT scan) and the Mantoux test have only supportive value. Aim of the study: The aim of the study was to diagnose modalities and antimicrobial susceptibility in abdominal tuberculosis patients.Material & Methods:This cross-sectional hospital-based observational study was carried out among 73 adult patients with the diagnosis of abdominal TB who met the selection criteria and attended in Gastroenterology department of DMCH through either admission or referral from May 2015 to April 2016.Results:The most frequent symptoms were weight loss (96.9%), abdominal pain (75%), and fever (75%). The most frequent signs were anaemia (34.4%), followed by ascites (27.9%). Basis of diagnosis in abdominal tuberculosis was histolopathogy in 37.5%, Gene Xpert in 28.1%, Positive AFB on culture in 9.4%, ADA value in ascitic fluid (Cutoff >40 IU/L) in 25%, and good clinical response (Based on weight gain and general improvement in wellbeing) to a therapeutic trial of anti-TB treatment in 18.7% patients. Drug sensitivity pattern was analyzed in all three AFB culture-positive patients; resistance was detected in one which showed multidrug resistance (MDR TB).Conclusions:The result of this study highlighted the diagnostic yield of various investigation modalities, particularly newer modalities (Gene Xpert, culture sensitivity in Bactec MGIT 960) and basis of diagnosis in abdominal TB. This study also determined the MTB culture positivity from tissue biopsies in patients with abdominal TB and demonstrated drug-resistant MTB in culture-confirmed abdominal TB.
Abdominal Tuberculosis, Susceptibility, Multidrug resistance.
Tube Thoracostomy Surgery among COVID-19 Positive Patients in a Tertiary Care Hospital in Bangladesh
Heemel Saha1*, Mohammad Ata Ullah2, Redoy Ranjan3, Rakibul Hasan4, Asit Baran Adhikary5, Debjany Sikder6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 128-134 | DOI: 10.53339/aimdr.2022.8.2.18
Tube Thoracostomy Surgery among COVID-19 Positive Patients in a Tertiary Care Hospital in Bangladesh
Heemel Saha1*, Mohammad Ata Ullah2, Redoy Ranjan3, Rakibul Hasan4, Asit Baran Adhikary5, Debjany Sikder6
Abstract
Background: Acute respiratory distress syndrome requiring invasive mechanical ventilation may occur in COVID-19 patients. Barotrauma causes clinically severe pneumothorax, necessitating a chest tube thoracostomy. Acute respiratory syndrome coronavirus 2 is aerosolized during the process, hence specific precautions must be taken to minimize exposure risks to health care workers. Objectives: The objective of the study to diagnosis of Tube thoracostomy during the COVID-19 pandemic to detect and diagnose patients who are positive with the virus.Material & Methods:In Bangladesh, researchers from a tertiary care hospital’s thoracic surgery section did a retrospective analysis. In total, we had 34 participants. All COVID-19 cases requiring thoracic surgery consultation and management that were admitted to the ICU between July 2020 and January 2022 were included in this study. Iatrogenic pneumothorax and other critical cases not associated with COVID-19 were also eliminated.Results:Thirty-four individuals sought thoracic surgery consultation. Pneumothorax (29.4%), traumatic hemothorax (8.8%), hydropneumothorax (5.9%) and extensive pleural effusion were the causes (55.9%). No post-thoracostomy complications. 6 patients died 3 days after tube thoracostomy who were on artificial breathing and both had more than 81 percent lung involvement (fibrosis) confirmed by CT scan of chest. Surviving patients with thoracostomy tube insertion had better survival than those treated conservatively.Conclusions:In COVID-19 disease, non-iatrogenic pneumothorax, subcutaneous and mediastinal emphysema are associated with worse prognosis and outcomes. Pneumothorax may have a better prognosis and outcome than surgical and mediastinal emphysema.
Tube Thoracostomy Surgery, COVID-19, Pneumothorax, Acute respiratory syndrome.
Predictors of Initial Glaucoma Therapy: Laser Trabeculoplasty Versus Medication
Zakia Sultana Shahid1*, M. Nazrul Islam2, Ishtiaque Anwar3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 135-144 | DOI: 10.53339/aimdr.2022.8.2.19
Predictors of Initial Glaucoma Therapy: Laser Trabeculoplasty Versus Medication
Zakia Sultana Shahid1*, M. Nazrul Islam2, Ishtiaque Anwar3
Abstract
Background: Glaucoma is the most common cause of blindness in the world. If not recognized and treated early enough, open-angle glaucoma can be a severe ocular illness that can lead to blindness. A gradual loss of ganglion cells leads to the optic nerve head cupping, which is the pathogenic process. Objective: The main aim of this study was to determine if selective laser trabeculoplasty (SLT) is superior to topical medication as the first-line treatment for open-angle glaucoma.Material & Methods:This prospective comparative study was conducted in 225 patients (450 eyes) at Deen Mohd. Eye Hospital & Research Center from July 2019 to July 2021.The patients were randomly divided into two groups; Selective laser trabeculoplasty (SLT group)and medical therapy group.Results:The study was conducted between 25 to 85 years of patients where the majority were between 46 to 65 years age group;58% patientswere male, and 42% were female. The mean intraocular pressure (IOP) was 18.2mm Hg for the SLT group and 17.6mm Hg for the medical therapy group. Overall, mean pressures and IOP lowering were not statistically different between the two treatment groups.Conclusions:In the last follow-up, 11% of the eyes had been stepped to additional SLT in the SLT arm, and 27% of the eyes in the medical arm required more medications to reach the target IOP range. The main risk factor is high intraocular pressure; however additional potential risk factors include optic nerve vascular insufficiency, neuronal degeneration, and hereditary factors. More research and prospective trials on intraocular pressure control and disease progression are needed to understand the long-term implications.
Tube Thoracostomy Surgery, COVID-19, Pneumothorax, Acute respiratory syndrome.
Maksud Ahmmad1, Md. Samiul Islam2*, Md. Ehteshamul Choudhury3, Mohd. Sayedul Islam4, Md. Asaduzzaman5, Khan Ashabul Haque6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 145-156 | DOI: 10.53339/aimdr.2022.8.2.20
Comparative Study of Arthroscopic Anterior Cruciate Ligament Reconstruction by Quadrupled Semitendinosus-Gracilis and Tripled Semitendinosus Auto Graft
Maksud Ahmmad1, Md. Samiul Islam2*, Md. Ehteshamul Choudhury3, Mohd. Sayedul Islam4, Md. Asaduzzaman5, Khan Ashabul Haque6
Abstract
Background: The anterior cruciate ligament (ACL) is the most frequently disrupted ligament of the knee. Arthroscopic ACL reconstruction is one of the most common orthopaedic procedures now-a-days and has become the gold standard method of treatment in complete ACL tear. Though the choice of graft for ACL reconstruction and the methods of its fixation are matters of debate, hamstring tendon is considered as the favorable graft. Common options for the choice of graft are quadrupled semitendinosus-gracilis and tripled semitendinosus auto graft. Aim of our study is to compare the outcome of arthroscopic ACL reconstruction by quadrupled semitendinosus-gracilis and tripled semitendinosus auto graft.Material & Methods:In this prospective interventional study purposive sampling was done. Sixty patients with complete ACL tear were included in this study from May 2017 to August 2019 at NITOR, strictly considering the inclusion and exclusion criteria. Thirty of them treated with quadrupled semitendinosus-gracilis (group 1) and thirty with tripled semitendinosus (group 2) auto graft. Evaluation by Lysholm knee score was done before and after surgery. Final outcome was evaluated at 24th week post-operatively.Results:Preoperative Lysholm Knee Score was almost similar in group 1 (63.2±2.1) and in group 2 (63.1±2.5). This difference was not statistically significant (p=0.582). Postoperative Lysholm Knee Score at 24th week was slightly higher in group 1 (95.0±2.0) in comparison to group 2 (94.4±3.2). This difference was also not statistically significant (p=0.361). But excellent functional outcome was more in group 1 (80.0%) in comparison to group 2 (73.3%) whereas no poor or fair outcome was reported in group 1 but fair outcome was reported in 6.7% of patients in group 2. Overall complication rate was 6.67% with no significant intergroup difference.Conclusions:Quadrupled semitendinosus-gracilis auto graft has yielded more excellent results than tripled semitendinosus graft. But as this difference was not significant, it can be said that, both the procedure can be performed for arthroscopic reconstruction of ACL.
Arthroscopic reconstruction, ACL, quadrupled semitendinosus-gracilis, tripled semitendinosus, graft.
A Comparative Study between E-TEP vs IPOM Hernia Repair
Deb Prosad Paul1*, Debashis Paul2, ASM Zahidur Rahman3, Karina Rahman4, Sonia Akter5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 157-163 | DOI: 10.53339/aimdr.2022.8.2.21
A Comparative Study between E-TEP vs IPOM Hernia Repair
Deb Prosad Paul1*, Debashis Paul2, ASM Zahidur Rahman3, Karina Rahman4, Sonia Akter5
Abstract
Background: A ventral hernia is a hernia which can be occur at any location along the midline (vertical center) of the abdomen wall. It can be classified as spontaneous (primary) or acquired (secondary). Also, there are basically 3 types of ventral hernia and these are: Epigastric or stomach area hernia, Umbilical or belly button hernia and the Incisional hernia.Material & Methods:This was a prospective observational comparative study. The total sample size for this study 38 and among these 18 cases were from e-TEP and 20 cases were from IPOM. The study period was from December 2019- December 2021. The stratified sampling method was followed for this study as an eligibility criterion for age of the respondents was set for this study.Results:The presence of co-morbidities was found in both e-TEP and IPOM. High blood pressure was seen in 7(38.89%) cases in e-TEP and 8(40%) cases in IPOM and followed by stroke in 4(22.22%) and 5(25%), Hypothyroidism in 1(5.56%) and 1(5%), Cancer in 2(11.11%) and 2(10%), Diabetes in 4(22.225) and 4(20%). Location of Hernia in right 7(38.89%) and 8(40%) and in left side was 11(61.11%) and 12(60%). In assessing the condition of disease, it was found that ventral hernia was in 4(22.22%) and 5(25%), Umbilical hernia in 6(33.33%) and 6(30%), Epigastric hernia 8(44.44%) and 9(45%). The Mean and SD of Defect size of lesion 71.4±47.1 and 76±53.2.Conclusions:The above study showed that the e-TEP repair had shown promising results and was being widely accepted. It results less presence of co-morbidities and less complications when compared to IPOM repair.
Ventral hernia, e-TEP, IPOM.
Determinants of Observance to Osteoporosis Treatment in Clinical Practice in a Single Center Study
Ehteshamul Haque1*, Homayera Rahman2, Md Mobaraque Hossain Khan3, Sayeda Niger Sultana4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 164-173 | DOI: 10.53339/aimdr.2022.8.2.22
Determinants of Observance to Osteoporosis Treatment in Clinical Practice in a Single Center Study
Ehteshamul Haque1*, Homayera Rahman2, Md Mobaraque Hossain Khan3, Sayeda Niger Sultana4
Abstract
Background: Improve compliance to prescribed medications is common in clinical practice, and it can lead to potentially fatal outcomes. This continues to be a common issue in the treatment of osteoporosis, although the causes of discontinuation and low compliance are complicated and understudied.Material & Methods:A survey was conducted in 101 patients at Narsingdi Sadar Hospital, Narsingdi, Dhaka, Bangladesh for osteoporosis management for a follow-up assessment, one year (July 2020 to June 2021) after having been prescribed a treatment with one of the following drugs: Calcium+vitamin D supplements alone (CaVitD), hormone replacement therapy (HRT), risedronate 5 mg/day (RIS), alendronate (ALN OW), Ibandronic acid monthly and Zolindronic acid I/V inj yearly.Results:Overall, 19.1 % stopped taking their prescribed medication before their bone mass reevaluations, with more than half of them doing so within the first 6 months. The dropout rate differed dramatically between regimens. ALN-OW was by far the least interrupted (6.9 %; p0.001 versus any other treatment). The most common causes for cessation were drug-related side effects, a lack of willingness to continue therapy, and a fear of negative effects. The reasons for discontinuation differed by treatment: safety concerns were very common for HRT, lack of motivation was the most common cause for CaVitD and drug-related side effects were the most common cause for RIS, ALN, Ibandronic acid and Zolindronic acid . Patients having a history of vertebral fractures, densito-metric osteoporosis, or who were using corticosteroid or anti-inflammatory medications had a considerably greater rate of treatment adherence. Patients on benzodiazepine or gastroprotective drugs, as well as those for whom a bone measurement was not easily accessible, had a considerably greater probability of treatment interruption. ALN OW and HRT had the highest compliance to recommended dosing (p0.001 versus any other) and CaVitD had the lowest (p0.01 versus any other). Poor treatment compliance (50 percent medicine taken) was strongly associated with benzodiazepine and gastroprotective usage, whereas significantly higher compliance was associated with established osteoporosis risk factors: early menopause, low bone mass values, and past vertebral fractures. Adherence was lowest when treatments were prescribed by general practitioners (GPs) and orthopaedic surgeons (p0.01 compared to the global mean).Conclusions:According to the conclusions of this large survey of Bangladeshi osteoporotic women, the kind of medicine provided is the most important factor of both persistence
Observance, Adherence, Compliance, Osteoporosis, Persistence, Treatment.
Adenotonsillectomy Operation in Children is Effective to Improve Otitis Media with Effusion
Md. Mostafa Kamal Hossain Bhuiyan1*, Salma Hossain2, Mohammad Amzad Hossain3, Mohammad Anamul Haque4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 174-179 | DOI: 10.53339/aimdr.2022.8.2.23
Adenotonsillectomy Operation in Children is Effective to Improve Otitis Media with Effusion
Md. Mostafa Kamal Hossain Bhuiyan1*, Salma Hossain2, Mohammad Amzad Hossain3, Mohammad Anamul Haque4
Abstract
Background: OME usually present because of the associated hearing impairment, defective speech and sometimes with a preceding history of fever and otalgia consequent on an episode of acute otitis media. Objective: The aim of the study was to evaluate adenotonsillectomy operation in children is effective to improve otitis media with effusion.Material & Methods:This was a clinical study done in the otolaryngology department of medical college for women and hospital, Uttara, Dhaka from January 2003 to December 2005 for three years. Children with 4 to 15 years of age admitted with chronic tonsillitis and enlarged adenoid having otitis media with effusion were included in the study. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22).Results:All of these patients underwent adenotonsillectomy operation and were followed up for up to six months. The overall success rate of resolution of middle ear effusion was 81% at six months post operatively.Conclusions:Our findings demonstrated that adenotonsillectomy operation is effective for the treatment of persistent otitis media with effusion due to chronic tonsillitis with enlarged adenoid.
Adenoids; adenoidectomy; tonsillectomy, otitis media with effusion.
Md Durul Hoda1*, ChaudhuryMeshkat Ahmed2, Harisul Hoque3, A.K.M. Azad Hossain4, Md. Emran Hossain5, Sabina Hashem6, Nilufar Fatema7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 180-191 | DOI: 10.53339/aimdr.2022.8.2.24
Mitral Annular Calcification Detected by Transthoracic Echocardiography is a Marker for High Prevalence and Severity of Angiographically Proven Coronary Artery Disease
Md Durul Hoda1*, ChaudhuryMeshkat Ahmed2, Harisul Hoque3, A.K.M. Azad Hossain4, Md. Emran Hossain5, Sabina Hashem6, Nilufar Fatema7
Abstract
Background: MAC was defined as a dense, localized, highly reflective area at the base of the posterior mitral leaflet detected by TTE. Obstructive CAD was defined as either 50% reduction of the internal diameter of the left main coronary artery or 70% reduction of the internal diameter of the left anterior descending, right coronary, or left circumflex artery distribution. Objective: The aim of the study was to evaluate the role of echocardiographically detected MAC as a predictor of coronary artery disease (CAD).Material & Methods:In this prospective, observational, case-control study, coronary angiography was done in 50 patients with MAC and equal number of patients without MAC, detected with transthoracic echocardiography. Analysis was done to observe the association and correlation of MAC with angiographic findings.Results:Mean age of the case control was 55.16 ± 10.73 years and control was 49.80 ± 8.84 years. In this study 34% of patients with MAC and 32% patients without MAC had single vessel disease, 16% of patients with MAC and 24% patients without MAC had double vessel disease, 42% of patients with MAC and 22% patients without MAC had triple vessel disease (TVD), 16% of patients with MAC and 4% patients without MAC had Left main coronary artery disease and 8% of patients with MAC and 22% patients without MAC had no significant CAD.Multivariate analysis shows MAC (p=0.049) as an independent predictor for coronary artery disease (CAD).Conclusions:Transthoracic echocardiographically detected MAC is an independent predictor of coronary artery disease. The low cost, portable and radiation free nature of the ultrasound approach make MAC an attractive parameter in the ongoing search for the ideal marker of coronary artery disease (CAD).
Transthoracic Echocardiography, Mitral Annular Calcification, Angiographically, Coronary, Artery.
Muhammad Shamsul Arefin1*, Asif-Ur-Rahman2, Md. Enamul Hoq3, Saifuddin AZM4, MdShahnewazParveg Tareq5, Anisur Rahman6, Daliya Nowsin7, Taima Rashika8, Numera Siddiqui9, MD. Mazharul Alam10,Mohammed Mohidur Rahman11
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 192-199 | DOI: 10.53339/aimdr.2022.8.2.25
The Outcome of Covid-19 Positive Patients in a Covid Dedicated ICU, Associated with Comorbid Diseases: A Cross-Sectional Study
Muhammad Shamsul Arefin1*, Asif-Ur-Rahman2, Md. Enamul Hoq3, Saifuddin AZM4, MdShahnewazParveg Tareq5, Anisur Rahman6, Daliya Nowsin7, Taima Rashika8, Numera Siddiqui9, MD. Mazharul Alam10,Mohammed Mohidur Rahman11
Abstract
Background: Patients with Coronavirus Disease (COVID-19) have a significant death rate due to comorbid diseases. As a result, identifying risk factors associated with poor outcomes in COVID-19 patients is important. Objective: The aim of this study was to evaluate the admission and outcome status of the patients confirmed with Covid-19.Material & Methods:This cross-sectional study was conducted at Mugda Medical College & Hospital, Dhaka, Bangladesh during the period from April 2020 to September 2020. Total 205 patients with covid-19 were included in this study. Collection of data were checked and cleaned. After cleaning, the data were entered into computer and statistical analysis of the results being obtained by using windows-based computer software devised with Statistical Packages for Social Sciences version 24.Results:In this study among 205 patients. Most of the study people 41(20.0%) confirmed with covid-19 were admitted in September 2020. Followed by 20(9.76%) in April 2020, 33(16.09%) in May 2020, 35(17.07%) in June 2020, 38(18.53%) in July 2020, 37(18.04%) in August 2020 and 41(20.0%) in September. 23(11.21%) highest death with covid-19 were admitted in July 2020. Most of the patients 104(50.73%) were discharged with advice and 101(49.26%) patients had expired. Out of 101 expired patients 92 (91%) had comorbidities. The most common comorbidity amongst ICU admitted patients was respiratory syndrome (55 in number) and least common was hypertension (6 in number).Conclusions:The death rate for COVID-19 hospitalized patients is 49.26%. The most prevalent comorbidities in individuals who died as a result of COVID-19 were respiratory syndrome, chronic kidney disease, hypertension, cardiovascular disease, and diabetes.
Admission Status, Outcome Status and Covid-19 Patients.
Musammat Sufia Akther1*, Mirza AbulKalam Mohiudden2, Shamshad Khan3, RatulSakaobe Shefa4, Ayesha Mubashshira Labiba5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 200-208 | DOI: 10.53339/aimdr.2022.8.2.26
Differences between Men and Women in Terms of Clinical Features of ST-Segment Elevation Acute Myocardial Infarction
Musammat Sufia Akther1*, Mirza AbulKalam Mohiudden2, Shamshad Khan3, RatulSakaobe Shefa4, Ayesha Mubashshira Labiba5
Abstract
Background: Several research have investigated further into differences in clinical characteristics of acute myocardial infarction between men and women (AMI). Prospective studies, on the other hand, are few, and sex-related variations in AMI symptoms are unknown. We studied at the variations in clinical characteristics of ST-segment elevation AMI between men and women.Material & Methods:We evaluated at 151 patients with ST-segment elevation AMI who were hospitalized within 24 hours of symptom onset (70 women and 81 males). Within 48 hours of hospitalization, all patients were interviewed by many of the same cardiologist.Results:Women exhibited higher rates of hypertension (70 vs 56 percent, p=0.010), diabetes mellitus (36 vs 26 %, p=0.047), and hyperlipidemia (51 vs 38 %, p=0.019) than males (72 vs 62 years, p0.001). Non-specific symptoms (45 vs 34%, p=0.033), non-chest discomfort (pain in the mouth, throat, neck, shoulder, arm, hand, and back), moderate pain (20 vs 7%, p0.001), and nausea (49 vs 36 percent, p=0.013) were all more common in women than in males. The severity of coronary artery lesions was equal in both sexes on coronary angiography. Women had a considerably greater in-hospital death rate than males (6.6 vs. 1.4%, p=0.003).Conclusions:Women and men with AMI have different clinical profiles and presentations. AMI symptoms are less common in women than in males.
Gender, Myocardial infarction, Prognosis.
Omar Sadeque Khan1*, Rezwanul Hoque2, Md. Mostafizur Rahman3, Jesmeen Morshed4, Heemel Saha5, Nasif Imtiaz6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 209-218 | DOI: 10.53339/aimdr.2022.8.2.27
Acute Phase Response and its Effect on Short Term Outcome of Bangladeshi patients after On-Pump Cardiac Surgery
Omar Sadeque Khan1*, Rezwanul Hoque2, Md. Mostafizur Rahman3, Jesmeen Morshed4, Heemel Saha5, Nasif Imtiaz6
Abstract
Background: Throughout any surgical procedure, the immune system is generally activated as a physiological response to the surgical trauma. Cardiopulmonary bypass can trigger the inflammatory response in three ways: direct contact activation of the immune system due to exposer of blood to foreign surfaces, ischaemia-reperfusion injury to vital organs as a result of aortic cross clamping, and splanchnic hypoperfusion. Objective: The aim of the study was to observe the acute phase response variables in Bangladeshi patients and to assess the acute phase response and morbidity of the patients after prolonged bypass surgery.Methods:This cross sectional study was conducted in the Department of Cardiac Surgery, BSMMU from January 2009 to December 2010. Fifty patients were selected for the study and were divided into 2 groups on the basis of cardiopulmonary bypass time. Group I was cardiopulmonary bypass time less than 90 minutes and Group II was more than 90 minutes. Data were stored and analyzed with standard computer software (SPSS-15). P < 0.05 was considered statistically significant.Results:The mean duration of cardiopulmonary bypass (CPB) time (55.76±10.8 in group I, 131±31.35 in group II; P<0.001) and Aortic cross clamp time (28.48±8.31 in group I, 83.48±30.99 in group II; P<0.001) was higher in group II than group I. Analysis of outcome variables showed that mean postoperative ventilation time was 6.24±1.20 in group I and 9.16±2.33 in group II. There was significant difference in the ventilation time between two groups (P<0.001). This study showed that there is a definite relationship of wound infection with the prolonged cardiopulmonary bypass time (P<0.001) and also persistently rising CRP increases the chance of wound infection.Conclusions:We may conclude that prolonged cardiopulmonary bypass time is associated with increased acute phase response and morbidity of Bangladeshi patients.
Acute phase response, On-Pump Cardiac Surgery, Cardiopulmonary bypass.
Pattern of Tumor Lysis Syndrome in Patients with Acute Lymphoblastic Leukemia
Tanjina Afrin1*, Abdul Aziz2, Salahuddin Shah3, A B M Yunus4, Amin Lutful Kabir5, Md. Adnan Hasan Masud6, Kazi Md Kamrul Islam7, A.Q.M. Ashraful Haque8, Zannatun Nesa9
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 219-232 | DOI: 10.53339/aimdr.2022.8.2.28
Pattern of Tumor Lysis Syndrome in Patients with Acute Lymphoblastic Leukemia
Tanjina Afrin1*, Abdul Aziz2, Salahuddin Shah3, A B M Yunus4, Amin Lutful Kabir5, Md. Adnan Hasan Masud6, Kazi Md Kamrul Islam7, A.Q.M. Ashraful Haque8, Zannatun Nesa9
Abstract
Background: Prevention and treatment of tumor lysis syndrome (TLS) depends on immediate recognition of patients at risk. Therefore, we conducted this study to determine the frequency and risk factors of TLS in patients with acute lymphoblastic leukemia (ALL). Objective: The aim of the study was to observe the frequency of Tumor lysis syndrome in patients with Acute Lymphoblastic Leukemia.Material & Methods:This cross-sectional study was conducted at the department of Haematology in Bangabandhu Sheikh Mujib Medical University (BSMMU), over a period of 12 months following approval of this protocol. Total 50 patients admitted with ALL were included in this study after careful history taking, examination and appropriate investigations fulfilling inclusion and exclusion criteria, irrespective of their gender, race, ethnic group and age. Ethical issues were ensured properly. After briefing the aims and objectives and potential risk and benefits, written informed consent was taken from each subject. Interviews were done by investigator herself using separate case record form. After editing and encoding, data was analyzed by computer with the help of SPSS 24.Results:The mean age of patients was 21.24±13.83 (SD) years with majority aged less than 20 years (54%) and male gender (62%). Prevalence of TLS was found to be 26% (n=13), wherein spontaneous onset (n=8, 61.54%) and lab TLS (n=9, 69.23%) was more frequent than therapy induced TLS (n=5, 38.46%) and clinical TLS (n=4, 30.77%). The most common biochemical changes occurred within 3 days before chemotherapy and 7 days after initiation of chemotherapy among TLS patients was hyperuricemia (69.23 and 76.92% respectively) and hyperkalaemia (61.54 and 69.23% respectively) with significant differences compared to non-TLS patients (p value <0.05). Initial WBC count and serum LDH of all patients was 52.51±78.70 x109/L and 1591.53±2195.47 U/L respectively, wherein majority patients with TLS had significantly higher WBC count ≥50 x109/L (61.54%) and serum LDH ≥1000 U/L (92.31%) compared to non-TLS patients (16.22 and 21.62% respectively, p value <0.05). Multivariate analysis showed that serum LDH ≥1000 U/L was the significant independent predictors of developing TLS (OR=13.07, 95% CI: 1.93-101.23).Conclusions:TLS was commonly found in patients with ALL, wherein spontaneous onset and lab TLS was more common than therapy induced TLS and clinical TLS. However, a large multicenter study is needed to corroborate these findings.
Tumor, Lysis Syndrome, Acute Lymphoblastic, Leukemia.
Insulino Mimetic Selenium in Type II Diabetes: Correlation with Blood Glucose
Quamrun Nahar1*, Nayeema Siddiqua2, Sheikh Khalid Saifullah Sadi3, Sheikh Nazrul Islam4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 233-237 | DOI: 10.53339/aimdr.2022.8.2.29
Insulino Mimetic Selenium in Type II Diabetes: Correlation with Blood Glucose
Quamrun Nahar1*, Nayeema Siddiqua2, Sheikh Khalid Saifullah Sadi3, Sheikh Nazrul Islam4
Abstract
Background: Selenium has been reported to be insulinomimetic and to reduce blood glucose level in type 2 diabetes.Material & Methods:This study describes an inverse correlation of serum selenium with blood glucose level. This is a case control study conducted among 30 low BMI and 70 normal BMI diabetes and 50 low BMI non-diabetic controls. Serum selenium concentration was determined by atomic absorption graphite spectrophotometry.Results:Serum selenium concentration was estimated to be 44±16µg/L, 48±15µg/L and 59±33µg/L respectively in low BMI (<18.5) and normal BMI (18.5-24.9) diabetics and low BMI non-diabetics controls. A trend of inverse correlation was found between serum selenium and blood glucose levels. Serum selenium level at > 40 (41-60) µg/L was found to be inversely correlated (p<0.05) with blood glucose level.Conclusions:Lower serum selenium was observed in the diabetic patients and it was inversely correlated with blood glucose level.
Insulino, Mimetic, Selenium, Blood Glucose.
Assessment of Effect and Safety of Beta Blockers in Hypertensive Patients
Rohit Mishra1, Aishwarya Singh2*, Huzaifa Mulla3, Sugandh Jain4, Rajeev Ranjan5, Rajesh Ranjan6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 238-244| DOI: 10.53339/aimdr.2022.8.2.30
Assessment of Effect and Safety of Beta Blockers in Hypertensive Patients
Rohit Mishra1, Aishwarya Singh2*, Huzaifa Mulla3, Sugandh Jain4, Rajeev Ranjan5, Rajesh Ranjan6
Abstract
Background: To assess effect and safety of beta blockers in hypertensive patients.Material & Methods:One hundred twelve adult patients who were diagnosed cases of hypertension of either gender were divided into 2 groups. Each group contained 56 patients. Group I received 25 mg atenolol twice daily and group II received 25 mg metoprolol tartrate twice daily. History of diabetes, kidney disease, lipid disorder, incident cardiovascular (CV) events etc. was recorded. Blood pressure (systolic and diastolic) was recorded before starting and after starting the drug therapy.Results:Age group 20-40 years had 12 in group I and 11 in group II, 41-60 years had 14 in group I and 17 in group II and >60 years had 30 in group I and 28 in group II. There were 40 males and 16 females in group I and 38 males and 18 females in group II. A significant difference in males and females within the group (P< 0.05) and non- significant intergroup difference was observed (P> 0.05). The mean SBP found to be 149.4 mm Hg in group I and 146.7 mm Hg in group II and DBP was 85.4 mm Hg in group I and 83.6 mm Hg in group II at baseline and SBP was 135.4 mm Hg in group I and 134.6 mm Hg in group II and 78.2 mm Hg in group I and 78.0 mm Hg in group II at 6 months. Diabetes mellitus was seen in 12 in group I and 19 in group II, lipid disorders 17 in group I and 28 in group II, chronic kidney disease 11 in group I and 16 in group II and CV event 2 in group I and 4 in group II. Conclusions:Both beta blockers found to be equally effective in management of patients with hypertension.
Beta blockers, CVDs, hypertension.
Vipul Goel1, N.K. Singh2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-2 | March-April 2022 | Page: 245-251| DOI: 10.53339/aimdr.2022.8.2.31
Co-Relation of Risk Factors for Surgical Site Infection in Patients Undergoing Surgery For Carcinoma of Breast
Vipul Goel1, N.K. Singh2*
Abstract
Background: Breast malignancy is one of the highest ranked malignancy occurring among Indian females, overall incidence being 25 per 1, 00,000 females varying across different states. Breast cancer surgeries are one of the commonest surgeries being conducted which is considered to be a clean procedure pretending to be at lower risk of complications. However it is has been observed that patient develops surgical site infection at an increased rate approximately 19% which leads to poor quality of life, increased hospital stay and delay in commencement of adjuvant therapies. The aim is to Co-relate risk factors for surgical site infection in patients undergoing surgery for carcinoma of breast. The objective of this study was to observe the relation of surgical site infection and its associated risk factors in the patient undergoing surgery for carcinoma breast.Material & Methods:We analyzed 50 patients diagnosed with carcinoma breast and operated for the same in Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh. Patients were divided into two groups, Group A who develop surgical site infection and Group B who don’t develop surgical site infection. All the predisposing factors including age, BMI, Addiction, co morbidity, Neo-adjuvant therapy, preoperative total leucocyte count were recorded. An observation was done with above mentioned risk factors and correlated with development of surgical site infection.Results:In our study we found that the risk factors associated with surgical site infection post breast cancer surgeries were age, BMI, co morbidity, Addiction and Neo-adjuvant therapy.Conclusions:Patients of Age more than 50years or who underwent Mastectomy or having associated co-morbidity with co-relation to Smoking & BMI more than 30, with Increased TLC count or who have received Neo-adjuvant chemotherapy are associated with increased risk of SSI following breast surgery which has led to increased hospital stay. There are many other studies who also concluded the relation of above factors with development of SSI post breast surgery, however further research is needed to elucidate the effect of prior manipulation and radiation therapy in development of SSI.
Breast Cancer,SSI,risk factors, BMI, Diabetes Mellitus