Annals of International Medical and Dental Research (AIMDR)

E-ISSN: 2395-2822 | P-ISSN: 2395-2814

Peer-reviewed International Journal of Advanced Research on Medical and Dental Sciences

Open Access Journal

Annals of International Medical and Dental Research (AIMDR) is indexed in Index Medicus (IMSEAR), Global Index Medicus, Index Copernicus and Google Scholar

Annals of International Medical and Dental Research (AIMDR) 

Vol-7, Issue-3 | May-June, 2021

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Annals of International Medical and Dental Research (AIMDR)

Vol-7, Issue-3 | May-June, 2021

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Comparison Study of Caudal Bupivacaine versus Caudal Bupivacaine with Buprenorphine in Postoperative Paediatric Patients Posted for Inguinoscrotal Surgeries

Smriti Anand1, Mandeep Kaur2, Money Gupta3, Kapil Gupta4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 1-7

Comparison Study of Caudal Bupivacaine versus Caudal Bupivacaine with Buprenorphine in Postoperative Paediatric Patients Posted for Inguinoscrotal Surgeries

Smriti Anand1, Mandeep Kaur2, Money Gupta3, Kapil Gupta4

Abstract

Background: Postoperative pain relief in children has always been very challenging. Various modalities have been tried to provide effective pain relief in paediatric population, caudal epidural being one of the most widely performed techniques. Various adjuncts have been added to local anaesthetics in caudal epidural to enhance its analgesic efficacy. The primary aim of this study was to compare the analgesic efficacy of caudal bupivacaine with caudal bupivacaine plus buprenorphine, the secondary aim being to study any associated side effects. Materials and Methods: 60 patients of ASA I and II physical status, aged 2-12 years posted for inguinoscrotal surgeries were randomly allocated into two groups of 30 each; group A patients received 1ml∕kg of 0.125% bupivacaine while group B patients received 1ml/kg of bupivacaine with 4µg/kg with buprenorphine. Post-operative pain was assessed using Faces Pain Scale -Revised (FPS-R pain scale). At score ≥ 6 rescue analgesic intravenous paracetamol was given. Pain was assessed at 0,30,60 minutes and half hourly thereafter until 2 hours and hourly after that till 24 hrs following surgery. Post-operative sedation was assessed using Paediatric Analog Sedation Scale (PASS). Any side effects were also noted in both the groups. Results: The two groups were comparable with regards to demographic profile (i.e age and sex). The duration of surgery was also comparable in both the groups. However, the duration of analgesia was more in group B (9.833 ± .833 hrs) than in group A (4.866± .571 hrs) the difference being statistically significant. Number of rescue analgesics required was also more in group A (2.33± .479) than group B (1.16± .379), the difference again being statistically significant. More patients reported sedation in group B for prolonged duration albeit none showed a grade 3 or more sedation score. Nausea and vomiting and postoperative agitation were the only side effects reported, former reported more by group B patients and later by group A patient. Conclusion: The addition of buprenorphine to bupivacaine in caudal epidural significantly prolongs the duration of analgesia without producing any side effects.

Caudal Epidural, Bupivacaine, Buprenorphine, Postoperative Analgesia

Effectiveness of Oral Hygiene with Chlorhexidine Mouthwash with 0.12% and 0.2% Concentration on Incidence of Ventilator Associated Pneumonia (VAP) in Intubated Patients – A Parallel arm Double Blind Randomized Controlled Trial

Nagesh Vyas1, Priya Mathur2, Shailesh Jhawar3, Akash Prabhune4, Pradeep Vimal5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 8-20

Effectiveness of Oral Hygiene with Chlorhexidine Mouthwash with 0.12% and 0.2% Concentration on Incidence of Ventilator Associated Pneumonia (VAP) in Intubated Patients – A Parallel arm Double Blind Randomized Controlled Trial

Nagesh Vyas1, Priya Mathur2, Shailesh Jhawar3, Akash Prabhune4, Pradeep Vimal5

Abstract

Background: Patients on mechanical ventilation are on higher risk of developing pneumonia due to multiple factors. Incidence of Ventilator associated pneumonia (VAP) varies from 9 to 27 % for mechanically ventilated patients. Various mouth wash with different concentration are used for oral care to prevent VAP. Aim of this study was to find out the most efficacious concentration of chlorhexidine mouth wash to prevent VAP, with minimum adverse events.Materials and Methods: This double-blind randomized study included 140 patients in critical care unit requiring mechanical ventilation for more than 48 hours. The study was approved by the Institutional Ethics Committee and written informed consent was sought from the patients or next kin relative for comatose cases. Consenting patients were assigned to either group using block randomization and SNOSE allocation in two groups of 70 each. Group I and Group II received oral care with chlorhexidine 0.12% and chlorhexidine 0.2% respectively. The diagnosis of VAP was made by using CPIS. A score of ≥6 considered VAP.Results: In intervention group 7 VAP, 30 discharges, 11 LAMA (Left against Medical Advice), 8 deaths were reported while 2 VAP, 36 discharges, 9 LAMA, 11 deaths were reported in control group. On comparing the above-mentioned indicators and analysis of data we found a significant difference in VAP incidence but the safety, ICU stay, hospital stay, days on ventilator and mortality of both groups was similar.  We found no significant relationship between incidence of VAP and oral microbial load. Conclusions: Oral hygiene with Chlorhexidine 0.12% is less effective than Chlorhexidine 0.20% for prevention of VAP in mechanically ventilated patients.

Chlorhexidine, Mouth Wash, Ventilator Associated Pneumonia, Oral Care, Oral Hygiene.

Comparison of Postoperative Complications in Using Total Intravenous Anesthesia with Propofol and Sevoflurane Inhalation Anesthesia

Dr. Ashit Kumar Das1, Dr.  Mohammad Abdullah Al Mamun2, Dr.Nurul Azim3, Dr. Mohammad Azizul Haque4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 21-27

Comparison of Postoperative Complications in Using Total Intravenous Anesthesia with Propofol and Sevoflurane Inhalation Anesthesia

Dr. Ashit Kumar Das1,Dr.  Mohammad Abdullah Al Mamun2, Dr.Nurul Azim3, Dr. Mohammad Azizul Haque4

Abstract

Background: Patients on mechanical ventilation are on higher risk of developing pneumonia due to multiple factors. Incidence of Ventilator associated pneumonia (VAP) varies from 9 to 27 % for mechanically ventilated patients. Various mouth wash with different concentration are used for oral care to prevent VAP. Aim of this study was to find out the most efficacious concentration of chlorhexidine mouth wash to prevent VAP, with minimum adverse events. Materials and Methods: This double-blind randomized study included 140 patients in critical care unit requiring mechanical ventilation for more than 48 hours. The study was approved by the Institutional Ethics Committee and written informed consent was sought from the patients or next kin relative for comatose cases. Consenting patients were assigned to either group using block randomization and SNOSE allocation in two groups of 70 each. Group I and Group II received oral care with chlorhexidine 0.12% and chlorhexidine 0.2% respectively. The diagnosis of VAP was made by using CPIS. A score of ≥6 considered VAP. Results: In intervention group 7 VAP, 30 discharges, 11 LAMA (Left against Medical Advice), 8 deaths were reported while 2 VAP, 36 discharges, 9 LAMA, 11 deaths were reported in control group. On comparing the above-mentioned indicators and analysis of data we found a significant difference in VAP incidence but the safety, ICU stay, hospital stay, days on ventilator and mortality of both groups was similar.  We found no significant relationship between incidence of VAP and oral microbial load. Conclusions: Oral hygiene with Chlorhexidine 0.12% is less effective than Chlorhexidine 0.20% for prevention of VAP in mechanically ventilated patients.

TIVA, Postoperative complication, Anesthesia, Propofol, Sevoflurane, Inhalation.

Assessment of Knowledge, Attitude and Practices of Teacher Regarding Reproductive Health of Male Adolescents

Rashmi Ranjan1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 28-32

Assessment of Knowledge, Attitude and Practices of Teacher Regarding Reproductive Health of Male Adolescents

Rashmi Ranjan1

Abstract

Background: Adolescents have many doubts and questions about their sexuality, giving rise to anxiety and confusion. The present study was conducted to assess knowledge, attitude and practices of teacher regarding reproductive health of adolescent. Methods: 184 male teachers of school were administered a questionnaire regarding pubertal changes, night fall, genital hygeine, STDs, HIV/AIDS, sex education etc. Response was recorded. Results: Age group 21-30 years had 24, 31-40 years had 56, 41-50 years had 68 and >50 years had 36 Male Adolescents. 100 had Rural and 84 had urban background. Qualification was graduation in 60, post-graduation in 94 and M. Philin 30 subjects. There was increase in knowledge and attitude about reproductive health of adolescent after intervention. The difference was non- significant (P> 0.05).Before intervention sexual knowledge was seen in 154 and after intervention in 170, physical was 148 and 172 and psychosocial was 136 and 178 before and after intervention respectively. Conclusion: Teachers had sufficient knowledge, attitude and practices regarding reproductive health of adolescent.

Attitude, Knowledge, Reproductive Health.

Fast Food Consumption Pattern and Its Association with Overweight among High School Boys

Rashmi Ranjan1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 33-37

Fast Food Consumption Pattern and Its Association with Overweight among High School Boys

Rashmi Ranjan1

Abstract

Consumption of fast foods has become almost a global phenomenon. The present study was conducted to assess fast food consumption pattern and its association with overweight. Methods: 250 school students of both genders were given a semi-structured questions on food frequency intake of fast foods, vegetables and fruits per week, years of fast food consumption, source of information, reasons for consumption, awareness about its health hazards, amount spent in a week on fast foods and parental consumption of fast foods were obtained. Results: Out of 150 subjects, males were 150 and females were 100. Most of the obese (45) and normal subjects (120) were non- veg/mixed. 100 normal and 35 obese subjects used to eat fast food every day, duration of eating was >5 years seen in 45 normal and 22 obese subjects, 110 normal and 21 obese used to eat pizza frequently. The difference was significant (P< 0.05). Conclusion: There was an association between fast food consumption and overweight and obesity.

Caudal Fast Food, Overweight, Obesity.

Functional Improvement in Ankylosing Spondylitis from Pharmacological and Non-Pharmacological Management – an Observational Study

Vasundhara Ghosal1, Firdaus Kamal2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 38-42

Functional Improvement in Ankylosing Spondylitis from Pharmacological and Non-Pharmacological Management – an Observational Study

Vasundhara Ghosal1, Firdaus Kamal2

Abstract

Background: To evaluate the efficacy of pharmacological and non-pharmacological management in Functional improvement in patients of Ankylosing Spondylitis. Methods: Thirty-two (32) Patients of Ankylosing spondylitis diagnosed by international society classification criteria were selected between February 2016 and December 2018 in this prospective study after institutional ethical clearance. These patients divided into two groups randomly and group 1 was given therapeutic exercises only and group 2 was given therapeutic exercises and sulfasalazine. Both were evaluated for chest expansion, BASMI, BASFI, BASDAI, BAS-GLOB at baseline and after 3 months.Results:Ankylosing spondylitis usually affects young adults in between 20-30 years. Male predominance over female is seen. ratio being 7:1. Regular exercise with or without sulphalazine improved the functional parameters but there was no statistically significant improvement in clinical and functional variables between the pharmacological and non –pharmacological group. So sulfasalazine did not show any added benefit in axial Ankylosing Spondylitis. Conclusion: From our study it can be concluded that Ankylosing spondylitis usually affects young adults in between 20-30 years. Male predominance over female is seen. ratio being 7:1. Regular exercise and NSAID improved the functional parameters but there was no statistically significant improvement in clinical and functional variables between the pharmacological and non –pharmacological group. So patients need to be counselled about regular exercise, posture care and life style modification in cases of axial spondylitis.

Ankylosing Spondylitis,Pharmacological, Community Medicine.

Adverse Effects Encountered during the Therapy of Topical Minoxidil combined with Systemic Finasteride and Topical Minoxidil Alone in Male Androgenetic Alopecia

Farhana Rashid Shumi1, SarkerMahbub Ahmed Shamim2, Rabeya Afroz3, Shumana Sharmin4, Sharmin Kabir5, Fahima Mumtaz6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 43-49

Adverse Effects Encountered during the Therapy of Topical Minoxidil combined with Systemic Finasteride and Topical Minoxidil Alone in Male Androgenetic Alopecia

Farhana Rashid Shumi1, SarkerMahbub Ahmed Shamim2, Rabeya Afroz3, Shumana Sharmin4, Sharmin Kabir5, Fahima Mumtaz6

Abstract

Background: Androgenetic alopecia (AGA) is characterized by progressive, patterned hair loss from the scalp. AGA is an extremely common disorder that affects roughly 50% of men by the age of 50 and perhaps as many women older than 40 years. AGA becomes a medical problem only when the hair loss is subjectively seen as excessive, premature, and distressing. Aim of the study: To monitor the adverse effects encountered during the therapy of topical minoxidil with systemic finasteride and topical minoxidil alone in male androgenetic alopecia. Methods: This randomized clinical trial was carried out for a duration of 6 months, spanning from December 2014 to May 2015. A total of 60 patients with AGA were recruited from Shaheed Monsur Ali Medical College and Hospital and Laser Treat, Dhaka, Bangladesh by purposive sampling. 30 patients (group-A) were treated with finasteride 1 mg daily andminoxidil 2% twice daily and 30 patients (group-B) were treated with minoxidil 2% twice daily. Statistical analysis was performed by using windows based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Prior to the commencement of this study, the research protocol was approved by the ethical committee (Local Ethical committee) of BCPS. Results: Patients were clinically assessed for adverse effects, 12 weeks after initiating treatment. In the group given oral finasteride (group A), 8 out of 30 (26.6%) patients reported adverse effects. In the minoxidil only group (group B), 7 out of 30 (23.3%) patients developed adverse effects. The adverse effects disappeared as soon as the treatment was stopped. Conclusion: The occurence of adverse effect was almost same in both groups. It can be concluded that addition of oral finasteride to topical minoxidil is as safe as using topical minoxidil alone in treatment of AGA.

Androgenetic alopecia, Adverse, Topicalminoxidil, Finasteride.

Intrathyroid Injection of Steroid in Benign Thyroid Swellings

Saloni Sinha1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 50-54

Intrathyroid Injection of Steroid in Benign Thyroid Swellings

Saloni Sinha1

Abstract

Background: Thyroid swelling disorders are most common in females, and sometimes are considered as a blemish to their features. The present study was conducted to assess efficacy of intrathyroid injection of steroid in benign thyroid swellings. Methods: 48 patients with thyroid swellings of both genders were administered intrathyroid injection of triamcinolone in the concentration of 40mg/ml (kenacort 40 mg). Results: Out of 48 patients, males were 18 and females were 30. Type of thyroid swelling was Hashimoto’s thyroiditis in 31, colloid goitre in 15 and adenomatous hyperplasia in 2 cases. The difference was significant (P< 0.05). Complications such as haematoma formation was seen in 2, anaphylactic reaction in 5 and infection at the injection site in 1 case. The difference was significant (P< 0.05). Conclusion: Benign thyroid swellings can be managed effectively to reduce its size with minimally invasive technique using intrathyroid injections of triamcinolone.

Thyroid Swellings, Triamcinolone, Hashimoto’s Thyroiditis.

A Comparative Study of Circumferential Subannular Technique versus Conventional Underlay Technique in Chronic Otitis Media

Saloni Sinha1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 55-58

A Comparative Study of Circumferential Subannular Technique versus Conventional Underlay Technique in Chronic Otitis Media

Saloni Sinha1

Abstract

Background: Chronic otitis media with perforation of the tympanic membrane is a common cause of hearing loss and ear discharge. The present study was conducted to compare circumferential subannular technique versus conventional underlay technique in Chronic Otitis Media. Methods: 50 cases of chronic suppurative otitis media were divided into 2 groups of 25 each. Group I were treated with circumferential subannular technique and group II were treated with conventional underlay technique. Results: The mean pre- op PTA was 36.2 db and post op PTA was 25.4 db in group I and 37.4 and 30.1 in group II. The difference was significant (P< 0.05). Conclusion: Circumferential grafting technique is superior in postoperative hearing improvement.

Circumferential Grafting Technique, Hearing, Overlay.

Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in the Diagnosis of the Common Neck Swellings

Manish Kumar1, Md.Tausiful Haque1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 59-64

Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in the Diagnosis of the Common Neck Swellings

Manish Kumar1, Md.Tausiful Haque1

Abstract

Background: Fine-needle aspiration cytology (FNAC) is widely employed as an initial investigative tool in the diagnosis of various types of lesions in the body, neck swellings being one of them. To make accurate surgical interventions for these swelling, it is essential to make a preoperative assessment. The aim of this study was to find out diagnostic accuracy of FNAC in the diagnosis of the common neck swellings. Methods: Patients attending the department of ENT with complaint of neck swelling were included in the study. FNAC and histopathology was performed. The sensitivity, specificity and predictive values of the test were calculated.Results:The mean age was 50.5 (SD±8.70). Most of the patient complaint of neck swelling for 6 month of duration. Histopathologically, 7.1% patients had papillary carcinoma thyroid, 17.8% had pleumorphic adenoma and 21.4% had goitre. The accuracy of FNAC for papillary carcinoma thyroid, pleumorphic adenoma and goiter was 98.8%, 97.6% and 95.2% respectively.Conclusion:FNAC is a sensitive, specific, and accurate initial diagnostic test for the evaluation of patients with neck swellings.

FNAC, Histopathological Examination, Neck Swellings.

Self-Medication in Common Cold: Practices and Perception of Medical under Graduates

Nilank Saroha1, Nitin Tomar1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 65-72

Self-Medication in Common Cold: Practices and Perception of Medical under Graduates

Nilank Saroha1, Nitin Tomar1

Abstract

Background: Self-medication is a global phenomenon. Several studies have been conducted worldwide to study it in general population as well as students. There is paucity of literature on such studies in medical students and even rarer is to find a study focussing self-medication practices in a particular disease. Aim:  This study was undertaken to acknowledge practices of self-medication with regard to common cold among medical undergraduates and their attitude about it in general. Methods: This survey was conducted in a medical college, involving medical undergraduates of 2ndand 3rdyear.  It was a questionnaire based study, executed via online survey after ethical approval. Total 14 questions including demographic profile, practice of self-medication in common cold and perception regarding self-medication were asked. Results were analysed and expressed in counts and percentages. Results: Total 109 students (62.29 %) had practiced self-medication in common cold. The prevalence was marginally higher in 3rd year students (n= 58 out of 93, 62.37%). It was seen more in male students (65.82% v/s 59.38%). Antihistaminic use was seen in 81 (74.31% of those who self-medicated) with levocetrizine preference (n=51, 62.96%). Most common reason for self-medication was ‘minor illness’, quoted by 79 (57.66%), followed by ‘I have good knowledge’, cited by 26 (18.98%). Friends/family were (n=50, 36.5%) were the most opted source of self-medication, books were next in order (n=43, 31.39%). About 95 (54.29%) claimed that ‘self-medication had no adverse effect’. About 48.57% (n=85) believed ‘prevention of supply of medicines without prescription’ could prevent the growing trend of self-medication. Conclusion: There is high prevalence (62.29 %) of self-medication for cold among medical students. The propensity to self-medicate increases with progressive year of study. Though they usually self-medicate for minor illness but about 18.98% (n=26), believe that they have sufficient knowledge to prescribe drugs to themselves. This attitude need to be curtailed as it may prove hazardous to them and society. Another point of concern is the belief of quite a large percentage of them that self-medication has no adverse outcome. They need to be taught about both the pros and cons of self-medication.

Self-Medication; Medical, Undergraduates,  Survey, Common Cold.

Middle Ear Infections among Patients Visiting the Department

Monika Sharma1, Vijayalakshami R2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 73-77

Middle Ear Infections among Patients Visiting the Department

Monika Sharma1, Vijayalakshami R2

Abstract

Background: Assessment of cases of middle ear infections. Methods: Sixty- five patients of either gender with middle ear infection were enrolled and parameters such as residence, socioeconomic status (SES), second hand smoking, exposure to household cooking smoke, and upper respiratory tract infections were recorded. Results: Common middle ear infection was chronic suppurative otitis media in 36 (55.3%) followed by acute suppurative otitis media in 22 (33.8%) and otitis media with effusion in 7 (10.7%). There was no education in 20%, primary level in 65% and secondary level in 15%, socio- economic status was low in 40%, middle in 35% and high in 25%, house hold smoke was seen in 35% sometimes and in 42% always, 43% were from rural and 57% from urban background and upper respiratory tract infection was seen sometimes in 58% and always in 30%. Conclusion: Middle ear infection was mostly seen among 5-15 years with male predominance. Chronic suppurative otitis media was common middle ear infection.

Chronic Suppurative Otitis Media, Middle Ear Infection, Socioeconomic Status, Smoking.

A Clinicopathological Study of Masses in the Nasal Cavity

Ehtesham Ahmad Raushan1, Karthik2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 78-84

A Clinicopathological Study of Masses in the Nasal Cavity

Ehtesham Ahmad Raushan1, Karthik2

Abstract

Background: Objectives: 1) To classify the nasal masses presenting to us on basis of age, sex, ethnicity, site of origin, clinical type. 2) To demonstrate the importance of histopathological study in accurate diagnosis of nasal masses and their further management. Design of study: prospective study. Methods: Data were collected from Admission register of Department of ENT, NMCH Patna over a period of 2 years, with total sample size of 94. Results: 94 cases of nasal mass operated in our operation theatre were segregated. The cases were classified on basis of age, sex, religion, religion, ethnicity, residence, Socio-economic status, symptoms, character of discharge, site of origin of nasal mass, nature of mass in nasal cavity, clinical type of nasal mass and histopathological type. Conclusion: Histopathological examination is necessary for comfirmation of diagnosis of diagnosis of nasal masses and provide accurate measures for treatment.

Ear, Nose, Throat, Nasal Cavity.

A Comparative Study between Diagnostic Nasal Endoscopy (DNE) and CT Scan in Chronic Sinonasal Diseases.

Ehtesham Ahmad Raushan1, Karthik2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 85-93

A Comparative Study between Diagnostic Nasal Endoscopy (DNE) and CT Scan in Chronic Sinonasal Diseases.

Ehtesham Ahmad Raushan1, Karthik2

Abstract

Background: Chronic rhinosinusitis is a very prevalent disease worldwide with great impact on productivity and quality of life. CT scan and endoscopy have revolutionized the diagnosis and management of chronic sinonasal diseases. This study aims to get an insight of advantage of one over the other and if either or both are needed for diagnosis.Methods:Fifty patients attending the otolaryngology outpatient department NMCH, Patna fulfilling the diagnostic criteria for chronic rhinosinusitis and willing to participate in the study were included. After optimal antibiotic course, all patients were subjected to DNE and CT scan and result were compared. Results: CT scan has distinctive advantage of delineating extent of disease, study of anatomical variation and preoperative planning of case. DNE has better diagnostic value for mucosal and mental secretions and office based evaluation. Both are complimentary to each other. Conclusion: This study revealed that sinonasal pathologies are more common in male population in the age group of 20 to 40 years.

DNE, Chronic Sinonasal Diseases.

Prevalence of Hepatitis C in Alcoholic Liver Disease

Sat Pal Aloona1, N.S. Neki2, Rajinderpal Kaur Aloona3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 94-102

Prevalence of Hepatitis C in Alcoholic Liver Disease

Sat Pal Aloona1, N.S. Neki2, Rajinderpal Kaur Aloona3

Abstract

Background: Alcohol consumption and hepatitis C virus (HCV) infection are known hepatotoxic entities and have a synergistic effect if both are present in same individual. The coexistence of these two factors increases the risk of chronic liver disease. The main mechanisms of this effect are increased viral replication and altered immune response, although genetic predisposition may also play an important role. HCV prevalence has been considered to be higher (up to 50%) in alcoholic patients than in the general population.  Patients starting treatment for HCV infection should be specifically advised to stop or reduce alcohol consumption because of its potential impact on treatment efficacy and adherence and may benefit from additional support during antiviral therapy. This recommendation might be extended to all currently recommended drugs for HCV treatment. In Our study on 200 patients of ALD, we found anti HCV ab was positive in 18.6% of patients of ALD. Most of cases had developed cirrhosis and its complications. Of all Anti HCV ab positive patients 55.6% presented with gastrointestinal bleeding and 46.7% with Hepatic encephalopathy. The mean value of SGOT and SGPT were significantly higher in Anti HCV ab positive patients as compared to Anti HCV ab negative patients. The present study concluded that alcoholics who are Anti HCV ab positive are more prone to develop cirrhosis of liver with its various complication.

ALD Alcoholic Liver Disease, HCV Hepatitis C Virus, Anti HCV Ab Anti Hepatitis C Antibodies.

Assessment of Thyroid Dysfunction in Patients with HIV on HAART

Sat Pal Aloona1, Manpreet Singh2, Harmohinder Kumar Attri3, N.S. Neki4, Sapna5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 103-111

Assessment of Thyroid Dysfunction in Patients with HIV on HAART

Sat Pal Aloona1, Manpreet Singh2, Harmohinder Kumar Attri3, N.S. Neki4, Sapna5

Abstract

Background: AIDS, the aquired immunodeficiency syndrome is a serious illness caused by retrovirus named human immunodeficiency virus (HIV) which attacks the immune system and causing various life threatening opportunistic infections, neurological disorders, or unusual malignancies to thrive in the host body. The functioning of thyroid gland may be affected in HIV,drug interaction and the immune reconstitution inflammatory syndrome(IRIS).This study aims to investigate the prevalence of thyroid dysfunction in patients with HIV on HAART. Methods: 100 HIV positive patients on HAART were selected in the out patients attending the general medicine OPD and ART centre, Guru Nanak Dev Hospital Amritsar between November 2018 to November 2020 after applying inclusion and exclusion criteria. Detailed history, physical examination and investigations like CBC,LFT,RFT,CD4 count,FT4, TSH and FBS were done. Results: In this study, the maximum patients were in the age group 41-50 years, followed by 31-40 years. The mean age of the patients was 43.57± 9.4 years with total 52% females and 48% males. The study showed that 85% of patients were euthyroid and 15% of patients were with thyroid dysfunction. The predominant drugs were TLD followed by TLE and ZLN in 33%,32% and 25% of patients. There was an inverse relation seen between CD4 and TSH counts which implies that as the value of CD4 count decreases, the levels of TSH increased but non-significant relation between FT4 and CD4 count was observed. Statistical significance was not seen in association between drug regimen, duration of drug regimen with thyroid dysfunction. Conclusion: In the present study, we observed the prevalence of thyroid dysfunction in the study population to be 15%.Subclinical hypothyroidism was the most common abnormality observed. There was significant variation observed in the CD4 count and thyroid status, signifying that low CD4 count was a risk factor for hypothyroidism.

HIV, HAART, CD4, TSH, FT4.

Essential Hypertension is Associated with Higher Prevalence of Microalbuminuria – A Cross – Sectional Study

Vijay Kumar1, Sweta2, Tarvinderjit Khurana3, Sanjeev Kumar4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 112-120

Essential Hypertension is Associated with Higher Prevalence of Microalbuminuria – A Cross – Sectional Study

Vijay Kumar1, Sweta2, Tarvinderjit Khurana3, Sanjeev Kumar4

Abstract

Background: Hypertension is a major public health problem. The incidence in India is 5-15% in adult population. Essential hypertension produces proteinuria and a significant reduction in renal function in 5-15% of patients. UAE (urine albumin ratio), of higher frequency (25-100%) found in patients with hypertension than in normotensive population.Microalbuminuria has been described as an early sign of vascular damage and renal disease. Endothelial dysfunction has been proposed to be a plausible pathophysiological mechanism of microalbuminuria. Microalbuminuria is a consequence of an augmented intraglomerular capillary pressure; intrinsic glomerular damage and tubular alterations also account for increased urinary albumin excretion. Microalbuminuria was associated with the presence of target organ damage, electrocardiographic abnormalities and retinal vascular changes. Material and Methods: A cross sectional observational study was conducted on 100 subjects including 50 cases diagnosed with essential hypertension and 50 healthy normotensive age and gender matched subjects as control taken from the Medicine OPD of GMC, Patiala. These patients were evaluated for microalbuminuria by ELISA kit method. Results: Prevalence of micro albuminuria in essential hypertensive subjects was 48% as compared to, no microalbuminuria in normotensive people.Microalbuminuria was strongly associated with increased systolic blood pressure in our study, SBP (155.58±9.36 mmHg) in microalbuminurics and SBP (148.76±7.2 mmHg) in normoalbuminurics. Conclusion: This study confirmed that increased urinary albumin excretion is associated with increased systolic blood pressure.

Microalbuminuria, Essential Hypertension.

Bicarbonate Therapy in Severe Diabetic Ketoacidosis

Ritu Baloda1, Tripat Kaur Bindra2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 121-126

Bicarbonate Therapy in Severe Diabetic Ketoacidosis

Ritu Baloda1, Tripat Kaur Bindra2

Abstract

Background: Diabetic Ketoacidosis (DKA) is a known catastrophic complication of Diabetes Mellitus, which requires aggressive management including intravenous fluids, intravenous insulin to treat hyperglycemia, avoidance of hypoglycemia and correction of acid-base balance. Sodium bicarbonate is infused if decompensated acidosis starts to threaten patient’s life, especially when associated with either sepsis or lactic acidosis. However, rapid and early correction of acidosis with sodium bicarbonate may worsen hypokalemia and cause paradoxical cellular acidosis, and has been correlated with cerebral oedema in children. Material and Methods: Two cases of severe DKA in ICU with pH<6.9. Initial treatment was given in form of IV fluids and insulin administration, but there was persistence of kussmaul’s respiration, metabolic acidosis and hemodynamic instability. Then patients were given iv bicarbonate therapy and serial ABG analysis were done to monitor response. Results: After giving the bicarbonate therapy, clinical improvement was seen and acidosis improved in both the patients. No complication was noted. Conclusion: However it can be safely concluded that in severe DKA, it is worthwhile to give intravenous sodium bicarbonate .Our case report and similar case reports by other authors provide evidence in favour of it. However, large scale prospective trials need to be done for establishing routine use of bicarbonate therapy in all cases of DKA.

Diabetic Ketoacidosis, Sodium Bicarbonate.

Interventional Pulmonological Removal of a Foreign Body from Right Lower Lobar Bronchus in a Young Male by Repeated Attempts: Avoiding Surgery

Md. Monir Hossain1, Khondekar Mustaq Adnan2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 127-131

Interventional Pulmonological Removal of a Foreign Body from Right Lower Lobar Bronchus in a Young Male by Repeated Attempts: Avoiding Surgery

Md. Monir Hossain1, Khondekar Mustaq Adnan2

Abstract

Background: Tracheobronchial foreign body (FB) aspiration is an uncommon but potentially life-threatening event in adults. Symptoms typically consist of a choking event followed by cough and dyspnea, however, these findings are inconsistent and symptoms may mimic more chronic lung diseases such as asthma or chronic obstructive pulmonary disease. Chest radiography and computed tomography can provide information regarding the location and characteristics of foreign bodies and aid in diagnosis. Bronchoscopy remains the gold standard for diagnosis and management of FB aspiration. The authors describe the typical clinical presentation, diagnostic evaluation, and bronchoscopic management of foreign bodies in adult airways with a focus on bronchoscopic techniques and potential complications of FB extraction.

Adult, Aspiration, Complication, Bronchoscopy, Foreign Body (FB), Fiber Optic Bronchoscopy (FOB).

The Clinical Status and Hospital Outcome of COVID-19 Patients: A Temporary Covid-19 Care Hospital, Dhaka, Bangladesh

Kabirul Hasan Bin Rakib1, Mohammad Shafiqullah Akbar2, MdSaiful Islam Patwary3, Mazharul Islam4, Abu Salah Mohammamed Sirajum Munir5, Sohel Ahmed6, Ferdous Hossain Rahid7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 132-137

The Clinical Status and Hospital Outcome of COVID-19 Patients: A Temporary Covid-19 Care Hospital, Dhaka, Bangladesh

Kabirul Hasan Bin Rakib1, Mohammad Shafiqullah Akbar2, MdSaiful Islam Patwary3, Mazharul Islam4, Abu Salah Mohammamed Sirajum Munir5, Sohel Ahmed6, Ferdous Hossain Rahid7

Abstract

Background: In this study our main goal is to evaluate the clinical status and hospital outcome of COVID-19 patients in Bangladesh. Methods: This cross-sectional study was carried out at Railway General Hospital,Komlapur, Bangladesh which was set as a temporary covid-19care hospital during the period from Mid-April 2020 to Mid- July 2020. Results: During the study, 36.4% had cough with scanty sputum followed by 12% had cough with running nose, 9.1% had only dry cough, 6.1% had cough with nasal blockage, tastelessness, weakness, breathless.47.8% had fever 5-8 days, followed by 30% had fever 1-4 days, 13% had fever >12 days and 8.7% had fever for 9-12days. For both male and female group most of the patients were in covid-19 mild cases where as among 62 patients only 1 patient had covid-19 with severe case. 47.8% had fever 5-8 days, followed by 30% had fever 1-4 days, 13% had fever >12 days and 8.7% had fever for 9-12days. 36.5% patients stayed in hospital for 10-13 days followed by 33.3% patients stayed in hospital for 14-17 days, 15.9% had stayed in >7 day and 14.3% had stayed 2-5 days. Conclusion: From our study we can say that, most of the patients in this study had mild symptom of COVID-19 and most of the patients discharged with good recovery. Also, middle aged patients were at high risk of infection. Further study is needed for better study.

COVID-19, Pandemic situation, Coronavirus.

Cardiovascular Manifestation of Hyperthyroid Disorder in Bangladesh

Md. Daharul Islam1, Khaleda Akter2, Ferdous Khan3, Md. Sakhawat Hossain4, Muhammad Mahbub Hossain4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 138-145

Cardiovascular Manifestation of Hyperthyroid Disorder in Bangladesh

Md. Daharul Islam1, Khaleda Akter2, Ferdous Khan3, Md. Sakhawat Hossain4, Muhammad Mahbub Hossain4

Abstract

Background: Thyroid hormone directly affects the heart and peripheral vascular system. In hyperthyroidism, cardiovascular manifestations are most profound. The cardiovascular symptoms and signs of thyroid disease are some of the most intense and clinically significant to hyperthyroidism. Hyperthyroidism causes and may present with atrial fibrillation. However, there are limited study was found in our country to identify the cardiovascular manifestation of thyroid disorder. Aim of the study: The aim of the study was to identify the clinical manifestations of hyperthyroidism from a cardiovascular point of view. Methods: This was a descriptive cross-sectional study, conducted in the Department of Medicine, Sir Salmullah Medical College & Mitford hospital from November 2018 to July 2019. A total of 30 hyperthyroid patients were selected for the study. Statistical data were analyzed by the SPSS-20 version. Results: The age of the patients ranged from 16-65 years and the mean age was 38.16±6.56 years. In hyperthyroid cases, the male-female ratio was 1:2.75. The commonest general symptom was found thyroid swelling 93.33%, tremors 90%, weight loss 86.67%, easy fatigability 50%, and heat intolerance 45.33%. The commonest cardiovascular symptom was found palpitation at 86.67%, dyspnoea at 60%, and chest pain 13.3%. Clinical examination of the cardiovascular system revealed tachycardia 90%, wide pulse pressure 73.33%, 36.66% of patients had systolic hypertension, and features of heart failure were found in 10% of patients. The commonest ECG finding was found sinus tachycardia 90%, left ventricular hypertrophy 13.3%, nonspecific ST-T changesm10%, and atrial fibrillation 10%. The commonest abnormal echocardiography findings were chamber enlargement, 3.33% had mitral valve prolapse, and 3.33% had mitral regurgitation. Conclusion: This study found that cardiovascular manifestations in hyperthyroidism are quite common and varied which should be observed in management. Females were more commonly affected than males. Since the patients with thyroid disease usually present with cardiovascular manifestation and cardiovascular manifestation may be the only manifestation of thyroid disorder so it can be recommended that all patients with a thyroid disorder should be searched for cardiovascular manifestation and a thyroid function test should be done in all patients with unexplained cardiovascular disease.

Cardiovascular, Patients, Hyperthyroid, Thyroid, Study, Hyperthyroidism, Found, Manifestation, Cases, Disease.

Clinical Outcome of Single Antibiotic versus Combination Antibiotics in Enteric Fever

Mohammad Mahbubul Haque1, Raihan Rotap Khan2, Mohammad Mushahidul Islam3, Mohammad Shamsul Alam4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 146-154

Clinical Outcome of Single Antibiotic versus Combination Antibiotics in Enteric Fever

Mohammad Mahbubul Haque1, Raihan Rotap Khan2, Mohammad Mushahidul Islam3, Mohammad Shamsul Alam4

Abstract

Background: In recent times the treatment of enteric fever is becoming more and more difficult. The aim of our study was to find out a cost-effective way of treatment of enteric fever and to determine the success rate & fever clearance time of ceftriaxone as monotherapy in comparison to combinations of cefixime plus azithromycin. Methods: Randomized single-blind controlled comparative experimental study carried at the department of Medicine in Sheikh Hasina Medical College and Hospital, Jamalpur, Bangladesh during the period from August 2017 to April 2018. A total of 100 cases of enteric fever patients were included based on inclusion and exclusion criteria. After taking informed written consent data was collected by a questionnaire and relevant investigations were done. The Control group was given inj. ceftriaxone and the experimental group were given cefixime plus azithromycin. Then collected data was analyzed. Main Outcome measures: Age, Sex, response to treatment of Fever, Myalgia, Headache, Anorexia, Constipation, Diarrhoea, Abdominal pain, Cough, Relative bradycardia, Rose spot on the trunk, Splenomegaly, Hepatomegaly, Coated tongue, and treatment failure. Results:  Out of 100 cases the majority of cases were seen in the age group of 18-25 years (30%), followed by 26-33 years (24%). There was a slight male preponderance with 53% male and 47 % female. A majority (48%) of cases were brought to the hospital during the 1st week of illness. Fever was common in all of the cases, followed by headache (63%), anorexia, and nausea (62%), abdominal pain (58%), diarrhea (52%), constipation (29%), and vomiting (8%). Less common symptoms were cough (15%), generalized weakness (8%), jaundice (4%), and bloody diarrhea (2%). None of the patients had G.I bleeding or rash. Coated tongue was present in 83% of patients. Hepatomegaly was present in 67% of patients and more common than splenomegaly (42%). Only 42% of patients were toxic-looking. Abdominal tenderness was present in 25% of patients, while abdominal distention in 19%. Caecal gurgling and relative bradycardia in 10% each. The mean period of defervescence was 5.4±1.09 days for the Ceftriaxone group and 4.2+ 0.91 days for Cefixime plus Azithromycin group, which is statistically significant. (p = .04). Duration of therapy was 9.92+ 4 days in group A and 7+ 0.00 days in group B, this is statistically significant. (p < 0.001). Out of 50 cases in group A, 45 patients become afebrile with ceftriaxone treatment, the success rate was 90%. Out of 50 cases of group B, 2 patients failed to respond and the success rate is 96%, but this is not statistically significant  (p = 0.399).Conclusion: The treatment of enteric fever with a combination of antibiotics like Cefixime plus Azithromycin is not inferior to a single antibiotic like Ceftriaxone but oral combinations of antibiotics provide a less costly and equally safe and effective oral form of treatment alternative to ceftriaxone. Findings of this were also in accordance with the previous studies with enteric fever. As a small number of patients were studied so findings of this study should be cautiously extrapolated into the broader context.

Enteric Fever, Antibiotic, Ceftriaxone, Cefixime, Azithromycin.

Serum Procalcitonin Level as a Predictor of Outcome in Patients with Pulmonary Tuberculosis

Mohammed Kamal Uddin1, Toufiq Ahmed2, Shirajum Monira3, Gulnar Yasmin4, Md Rasul Amin5, Farzana Reza6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 155-164

Serum Procalcitonin Level as a Predictor of Outcome in Patients with Pulmonary Tuberculosis

Mohammed Kamal Uddin1, Toufiq Ahmed2, Shirajum Monira3, Gulnar Yasmin4, Md Rasul Amin5, Farzana Reza6

Abstract

Background: Tuberculosis (TB) is one of the most important causes of mortality in developing countries and is one of the eight leading causes of death due to diseases in the world. Worldwide 9.6 million people are estimated to have fallen ill with TB in 2014. Among them 6 million new cases of TB were reported to WHO. Aim of the study: To evaluate the role of serum procalcitonin level as a predictor of disease outcome in patients with pulmonary tuberculosis. Methods: This prospective observational study was conducted in the department of Internal Medicine of Bangabandhu Sheikh Mujib Medical University Dhaka, from the period of October 2017 to October 2018. A total of 30 patients were included for the study. Sampling technique of this study was convenient sampling. Patients diagnosed as smear positive for AFB or Gene-Xpert for Mycobacterium Tuberculosis Bacilli (MTB) positive pulmonary tuberculosis were selected. Data was entered in Microsoft Excel and analysis was done in STATA version 14. The research protocol was approved by the Institutional Review Board (IRB).Results:The mean age of all patients was 34.6 years with standard deviation of 14.8 years. Median age was found 30 years with minimum and maximum ranges were 19 and 70 years, respectively. Two third (67%) of the patients were male. Fever was found in 83% respondent, which was highest among all four clinical features included in this study. Most of the patients with cough had more than 3 weeks of duration (85%). Hemoptysis was found in 53% of patients and more than two-third of the patients reported weight loss (70%). Total count of WBC was found high in 97% of patients. A strong positive correlation was found in between before and after blood levels of procalcitonin (r=0.92, p <0.001). In comparison with chest x-ray findings, patchy lesion tended to have higher procalcitonin level in before and after TB treatment. Conclusion: This study assessed serum PCT in patients diagnosed with pulmonary tuberculosis at enrollment and after six months of TB treatment to observe the value of PCT reduction with treatment. PCT level was reduced significantly after getting six-months of TB treatment irrespective of age, sex, BMI and other laboratory parameters.

Tuberculosis, Procalcitonin, Predictor.

Prevalence & Severity of Vitamin D Deficiency in Type 2 Diabetic Patients

Rajee Mahmud Talukder1, Anisur Rahman Bhuiyan2, Mahabubur Rahman3, Sobroto Kumar Roy4, Shahriar Kabir Khan5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 165-170

Prevalence & Severity of Vitamin D Deficiency in Type 2 Diabetic Patients

Rajee Mahmud Talukder1, Anisur Rahman Bhuiyan2, Mahabubur Rahman3, Sobroto Kumar Roy4, Shahriar Kabir Khan5

Abstract

Background: The worldwide epidemic of Diabetes Mellitus (DM) is a serious current health problem because of the high toll of vascular complications associated with the condition. It has been estimated that 380 million individuals would be affected with diabetes worldwide by the year 2025. Vitamin D deficiency is increasingly recognized as a global problem and it has been estimated that nearly one billion people have either vitamin D deficiency or insufficiency. As vitamin D has been showed to have effect on pathophysiology of diabetes and diabetics having very high prevalence of vitamin D deficiency. Aim of the study: The aim of the study was to find out the prevalence and severity of vitamin D deficiency in type 2 diabetes mellitus (DM) in patients come in a tertiary care hospital. Methods: This retrospective study was conducted in the Department of Medicine, Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh. Data were collected in the period of October2018 to November 2019. Purposive sampling technique used to collect the sample.156 study people included for the study. Data were analyzed by using SPSS-20 and MS-Excel-2016 version. Results: In patients with controlled diabetes as per HbA1C criteria, the prevalence of sufficient, insufficient and deficient Vitamin D was 7(21.88%), 21(65.63%) and 4(12.5%) respectively, where in patients with uncontrolled diabetes it was 6(13.04%), 30(65.22%) and 10(21.74%) respectively. More number of diabetic patients with uncontrolled status (21.74%) was having overt vitamin D deficiency in comparison to controlled status (12.5%). Conclusion: Vitamin D deficiency is highly prevalent in diabetic patients than the normal healthy population. Maximum affected patients were male and deficiency found most in uncontrolled group.

Prevalence, Severity, Vitamin D deficiency, Diabetes Mellitus.

Glycated Haemoglobin (HbA1c) Level in Non-Diabetic Overt Hypothyroid Patient in Comparison to Control Attending in a Tertiary Care Hospital

Gulnar Yasmin1, Shirajum Monira2, Toufiq Ahmed3,Mohammed Kamal Uddin4, Md.  Asiful Islam5, Md Rasul Amin6, Farzana Reza7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 171-178

Glycated Haemoglobin (HbA1c) Level in Non-Diabetic Overt Hypothyroid Patient in Comparison to Control Attending in a Tertiary Care Hospital

Gulnar Yasmin1, Shirajum Monira2, Toufiq Ahmed3,Mohammed Kamal Uddin4, Md.  Asiful Islam5, Md Rasul Amin6, Farzana Reza7

Abstract

Background: Glycated haemoglobin (HbA1C) is widely used to assess glycemic status of the diabetic patients. The major form of glycated haemoglobin is haemoglobinA1c (HbA1c). The use of HbA1c for the screening and the diagnosis of diabetes has been recently approved by the American Diabetes Association (ADA) and World Health Organization (WHO). Aim of the study: To observe the glycated haemoglobin (HbA1c) level in non-diabetic overt hypothyroid patient. Methods: This hospital-based case-control study was conducted in the Department of Medicine, Dhaka Medical College Hospital from the period of November 2018 to October 2019. Total 170 patients were included for the study. Among them 85 patients were in case group having overt hypothyroidism and 85 patients were in control group with no thyroid dysfunction. Sampling method was convenient sampling. Data were analyzed by the SPSS 20 Windows version (Chicago, Illinois, USA). The protocol was presented and approved by Research Review Committee (RRC) of department of medicine of Dhaka Medical College Hospital.Results:The mean age of the overt hypothyroid cases was 45.79±11.26 years. In case group 12.94%,22.35%, 31.76%, 25.88%, and 7.05% were in 18-30 years, 31-40 years, 41-50 years, 51-60 years and >60 years age group respectively. Among the hypothyroid cases 34.11% were male and 65.88% were female. In case group mean BMI was 26.46±2.84 Kg/m2 and in control group mean BMI was 23.15± 2.72 Kg/m2. In case group mean HbA1c level was 5.80±0.28% and in control group mean HbA1c level was 5.26±0.39%. HbA1c level was statistically significantly more in case group than control group (p<0.001).The mean serum TSH level was 19.32±6.36 and 3.78±0.50 in the case and the control group respectively. There was positive correlation between the level of serum TSH and HbA1c by Pearson correlation coefficient (r=0.414, p<0.05). Conclusion: As the hypothesis is proved, so from the study it is concluded that HbA1c level were significantly higher in hypothyroid patients compared to control individual despite normal glucose level.

Hypothyroidism, Diabetes, HbA1C, Glycemic, Thyroid.

Treatment Experiences of Infertile Women with Endometriosis: A Qualitative Analysis

Shakeela Ishrat1, Farzana Deeba2, Shaheen Ara Anwary3, Jesmine Banu4, Parveen Fatima5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 179-186

Treatment Experiences of Infertile Women with Endometriosis: A Qualitative Analysis

Shakeela Ishrat1, Farzana Deeba2, Shaheen Ara Anwary3, Jesmine Banu4, Parveen Fatima5

 

Abstract

Background: Endometriosis is a chronic, recurrent, inflammatory condition associated with the presence of functioning endometrial tissue outside uterus. Endometriosis affects around 10% of women in reproductive age. The women with endometriosis may be asymptomatic with an incidental finding of chocolate cyst or ovarian endometrioma at sonogram. Aim of the study: To explore the treatment experiences of infertile women with endometriosis. Methods: This was a qualitative study of the infertile women who were counseled in the Endometriosis Clinic of the Infertility unit of the Department of Obstetrics and Gynecology of Bangabandhu Sheikh Mujib Medical University over a period of 5 years from 2014 to 2018. The women were contacted over cell phone in the month of July 2020. Short semi- structured interviews were taken with both open and close ended questions. Data collected from the records of Endometriosis Clinic and from the semi-structured interview were used for qualitative analysis. Results: Only 50 women could be reached for telephone interview among of the 160 women with endometriosis who attended the clinic. Fifty percent of the women did not do any sort of fertility treatment following diagnosis. Pregnancy happened only in 24% women. Most (75%) of the pregnancy were spontaneous. Six women said they were divorced or had strained marital relationship. The persistence or recurrence of pain with or without sonographic diagnosis of cyst occurred in 38% women. Conclusion: Women with infertility and endometriosis have their priorities change with affordability of treatment and as well as severity and impact of symptoms.

Endometriosis, Infertility, Reproductive, Quality of life.

Types of Errors in Discharge Certificate

Toufiq Ahmed1, Shirajum Monira2, Mohammed Kamal Uddin3, Gulnar Yasmin4, Md Rasul Amin5, Farzana Reza6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 187-196

Types of Errors in Discharge Certificate

Toufiq Ahmed1, Shirajum Monira2, Mohammed Kamal Uddin3, Gulnar Yasmin4, Md Rasul Amin5, Farzana Reza6

Abstract

Background: Discharge summary is a document containing patient information and is written during inpatient care and issued when or after a subject of care leaves the hospital. Aim of the study: Aim of the study was to find out the type of errors in discharge certificate. Methods: This Observational study was conducted in the Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Study period was six months after approval of protocol. A total of 100 cases were included as a purposive sampling. Discharge certificate was collected from follow up visit and readmitted patient at medicine and allied department. Questions were asked in Bangla. All documents were preserved confidentially.Results:96% name of department written and rest of 04% were not written name of department in discharge certificate. 96% were completely written diagnosis, followed by 04% were incompletely written in discharge certificate. 80% were completely written hospital course of the patients, followed by 18% were incomplete written hospital course and 02% were not written hospital course in discharge certificate. 87% were completely written investigations of the patients, followed by 10% were incomplete written investigations and 03% were not written investigations in discharge certificate. 94% were completely written treatment on discharge of the patients, followed by 06% were incomplete written treatment on discharge in discharge certificate. Conclusion: Combinations of minor  errors like- name of department, name of units, registration number, Bed number, name of patients, age, sex, incomplete address of patients, date of admission of patients , incomplete diagnosis of patients were found.

Discharge, Certificate, Errors, Document, Information.

A Comparison of Effects of Vaginal Royal Jelly and Vaginal Estrogen on Quality of Life in Menopausal Women

Shweta Verma1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 197-201

A Comparison of Effects of Vaginal Royal Jelly and Vaginal Estrogen on Quality of Life in Menopausal Women

Shweta Verma1

Abstract

Background: Menopause is a stage in a woman’s life that marks the end of the reproductive age. The present study was conducted to compare effects of vaginal royal jelly and vaginal estrogen on quality of life. Methods: 60 menopausal women were divided into 3 groups. Group I were prescribed lubricant, group II Premarin (estrogen 0.625 mg) and group III were given royal jelly 15%. Quality of life was recorded. Results: The mean age was 54.2 years in group I, 53.6 years in group II and 52.8 years in group III. BMI (Kg/m2) was 29.0 in group I, 29.4 in group II and 28.4 in group III. Menopause age was 48.2 years, 49.1 years in group II and 49.5 years in group III. Number of delivery was 5.4 in group I, 5.8 in group II and 4.1 in group III. The difference was significant (P< 0.05).The mean score for vasomotor problem was 8.1, 8.7 and 10.2 in group I, group II and group III respectively. Psychosocial problem score was 14.5 in group I, 17.2 I group II and 18.3 in group III. Physical problem score was 41.0, 41.5 and 50.2 in group I, group II and group III respectively, sexual problem score was 11.2,  12.9 and 12.5 in group I, group II and group III respectively and quality of life score was 77.2, 79.2 and 92.5 in group I, group II and group III respectively. The difference was on- significant (P> 0.05). Conclusion: Vaginal royal jelly was effective in improving symptoms of sexual and urinary problems and quality of life in postmenopausal females.

Estrogen, Menopause, Vaginal.

Level of Awareness and Barriers of Cervical Cancer Screening in Bangladesh

Taslima Nigar1, Md. Monirul Hassan2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 202-209

Level of Awareness and Barriers of Cervical Cancer Screening in Bangladesh

Taslima Nigar1, Md. Monirul Hassan2

Abstract

Background: Cervical cancer is one of the top causes of mortality in the female population of Bangladesh. And it is currently still growing along with our economical and lifestyle changes. The main reason for this is the lack of understanding and awareness about cervical cancer and other types of cancer and the lack of available screening measures. Lack of general education, especially in our demographic, is one of the main reasons behind this. Symptoms of cervical cancer are often misunderstood as other types of diseases, which leads to wrong medication. Aim of the study was to determine the level of awareness and barriers of cervical cancer in women in Bangladesh. Methods: This was a cross-sectional study performed over a period of 4 months in one single center. The study was conducted with only the female population of Dhaka city coming in the Genealogical Department of NICRH. The data was collected via questionnaires and analyzed using SPSS software. Results: The study was conducted with 100 willing and informed female participants. The majority were above the age of 45. The education level was also low. Most of the sample sizes were married and working as housewives. Awareness regarding cervical cancer was scarce among the patients. Conclusion: The study was conducted to learn more about cervical cancer and its awareness in the female population of Bangladesh. Lack of proper awareness regarding cervical cancer was noticed over the duration of the study.

Cancer, Cervical Cancer, Demographic, HPV, Screening, Cancer Screening, Type-16, Type-18.

Biosocial Determinants of Concomitant Strabismus in Children and Adolescents: A Hospital-Based Observational Study

Anupam Singh1, Rupal Verma2, Vartika Saxena3, Ranjeeta Kumari4, Nisheeta Patnaik2, Ajai Agrawal5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 210-220

Biosocial Determinants of Concomitant Strabismus in Children and Adolescents: A Hospital-Based Observational Study

Anupam Singh1, Rupal Verma2, Vartika Saxena3, Ranjeeta Kumari4, Nisheeta Patnaik2, Ajai Agrawal5

Abstract

Background: To study biosocial factors associated with concomitant strabismus in children and adolescents attending the ophthalmic outpatient department of a tertiary health care Institute in north India. Methods: A total of 235 patients of strabismus, aged between 4-19 years and with deviation ≥ 15 prism dioptres were included in this study over three years from July 2017 to June 2020. Data were collected by a predesigned, pretested questionnaire which included various biosocial factors and obstetric history of the patient. Results: The mean age of the study population was 13.01± 5.71years (Range = 4 – 19 years).  Out of 235 patients, 126 (53.6 %) were male and 109 (46.4%) were female.  86 (36.6%) patients had esotropia, 124 (52.85%) had exotropia and 25 (10.6%) were in a miscellaneous group.Only 18 (7.66%) patients had a family history of strabismus and all of them had exotropia. Amongst the obstetric history, there was a statistically significant association between type of strabismus and birth weight, wherein 3(3.5%) of the esotropes, 2(1.6%) of the exotropes, and 3(12.0 %) of the miscellaneous group had a birth weight of <1500grams (p =0.046). Fourteen (16.3%) of the esotropes, 6(4.8%) of exotropes and 1(4.0%) of the miscellaneous group had an illness within 6 months of birth that required hospitalization and medical intervention (p =0.015). Conclusion: There was a statistically significant association between esotropia, miscellaneous type of deviations and birth weight <1500 grams; and also between esotropia and illness requiring hospitalization within 6 months of birth.

Concomitant Strabismus, Biosocial Determinants, Risk Factors of Strabismus, Children, Adolescents.

Cemented Versus Uncemented Hemiarthroplasty in the Management of Fracture Neck of Femur. A Comparative Study

Merli P K1, Naik L K2,Sahu D P3,Sahoo D K4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 221-228

Cemented Versus Uncemented Hemiarthroplasty in the Management of Fracture Neck of Femur. A Comparative Study

Merli P K1, Naik L K2,Sahu D P3,Sahoo D K4

Abstract

Background: The study has been carried out to study the advantages, complications, morbidity and mortality rates, the recovery to physical independence encountered in each of the procedure and to draw a conclusion based on study results as to which of the above type of implant and type of fixation would be better in the management of fracture neck of the femur for elderly. Methods: The prospective comparative study includes 60 cases of displaced intracapsular fracture neck of femur in elderly aged more than 60 years, divided into 2 groups with 30 patients assigned randomly. One group was treated with press-fit uncemented hemiarthroplasty whereas the other group was treated with cemented hemiarthroplasty. Postoperatively cases were followed up for 12 months period and functional evaluation was done at the end of this period using Harris hip score and VAS score. Results: There was no statistical difference in Harris hip score and VAS score between the two groups. A significant statistical difference exists in terms of surgical time (97.63minutes versus 60.83minutes) and blood loss (298.67ml versus 181.83ml) for the cemented cohort than the uncemented. Conclusion: Both cemented and uncemented bipolar hemiarthroplasty provides same functional results at 1-year follow-up for treatment of non-displaced fracture neck of femur. However, cemented hemiarthroplasty has less postoperative pain and complications.

Outcome of Tension Band Wiring Over Malleolar Screw in Medial Malleolus Fractures Tibia: A Prospective Study

Dharam Singh1, Jaspal Singh2, Pranav Mahajan3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 229-236

Outcome of Tension Band Wiring Over Malleolar Screw in Medial Malleolus Fractures Tibia: A Prospective Study

Dharam Singh1, Jaspal Singh2, Pranav Mahajan3

Abstract

Background: Ankle fractures are one of the commonest occurring injuries which if not adequately treated can lead to severe co-morbidities. Various treatment options have been developed since decades for treating these fractures. The study was undertaken to assess the functional outcomes of tension band wiring over malleolar screws in medial malleolus fractures. Methods: 25 cases of medial malleolus fractures treated with tension band wiring over malleolar screw were included in the study between July 2018 and December 2020 at Government medical college, Amritsar. Results: The mean age of the patient was 38.56 years. Right side was predominantly involved. The average time duration of surgery from the time of injury was 2.9 days. The time taken for the fracture radiological Union was 12 weeks in majority 96% patients. As per the AOFAS ankle-hindfoot scoring system, there were 22 (88%) patients with excellent, 03 (12%) patients with good and none patients with fair/poor results respectively. Conclusion: Tension band wiring over malleolar screw has been one of the time tested technique with excellent to good results requiring relatively cheaper implants which are available very easily.

Medial Malleolus, Tension Band Wiring, Ankle Fracture

Comparison of Proximal Femur Nail and Dynamic Condylar Screw in Treating Proximal Femoral Fractures

Md. Matiul Islam1, Md. Monowar Tarik1, Muhammad Arozullah1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 237-245

Comparison of Proximal Femur Nail and Dynamic Condylar Screw in Treating Proximal Femoral Fractures

Md. Matiul Islam1, Md. Monowar Tarik1, Muhammad Arozullah1

Abstract

Background: Proximal femoral fracture is a substantial problem in people of several ages. Dynamic condylar screw (DCS) and proximal femoral nail (PFN) are currently the most commonly used implants for proximal femoral fractures fixation. But we have very few research-based comparative information regarding the effectiveness of both the methods in treating patients with proximal femoral fracture. Aim of the study: The aim of this study was to compare the management and outcomes of dynamic condylar screw (DCS) and proximal femoral nail (PFN) methods in treating proximal femoral fractures.Methods:This was a comparative observational study which was conducted in the Dept. of Orthopaedic & Traumatology, Rajshahiii Medical College & Hospital, Rajshahi, Bangladesh during the period from January 2020 to December2020.In total 50 patients with proximal femoral fractures were enrolled as the study population. For better comparison only cases of subtrochanteric proximal femoral fracture were selected. Among total population 25 underwent dynamic condylar screw (DCS) method denoted as Group I participants whereas the rest 25 treated by proximal femoral nail (PFN) denoted as Group II participants. This study was approved by the ethical committee of the mentioned hospital. Proper written consents were taken from all the participants before starting data collection. A pre-designed questionnaire including the management procedure and outcomes of both the procedures was used in patent data collection. All data were processed, analyzed and disseminated by MS Office and SPSS version as per need. Results: In Group I, for 17, 7 and 1 patients, the operative times were 60-90, 91-120 and 121-150 minutes respectively. On the other hand, in Group II, for 5, 16 and 4 patients, the operative times were 60-90, 91-120 and 121-150 minutes respectively. As the final outcome analysis we observed, among Group I patients, the mean (±SD) Harris Hip scores were 70.5±4.2 after 6 weeks and 80.5±4.8 after 6 months period from surgery. This progress was significantly higher (p<0.0001). Among Group II patients, the mean (±SD) Harris Hip scores were 68.8±3.5 after 6 weeks and 72.7±3.8 after 6 months period from surgery. This progress was also significantly higher (p=0.0004). In analyzing the complications, 4 occurrences were found in Group I and 13 occurrences were found in Group II. Conclusion: Considering lower treatment duration, better increment of Harris Hip scores and lower incidence of complications we can consider dynamic condylar screw (DCS) method as the better option than proximal femoral nail (PFN) methods in treating proximal femoral fractures.

Proximal Femur Nail, Dynamic Condylar Screw, Proximal Femoral Fracture, PFN, DCS.

Comparison of the Clinical and Radiological Outcome of Intramedullary Nailing Versus Plating in Displaced Midclavicular Fracture: A Prospective Study

Aditya Jain1, Ajay Pant2, Amit Saraf3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 246-254

Comparison of the Clinical and Radiological Outcome of Intramedullary Nailing Versus Plating in Displaced Midclavicular Fracture: A Prospective Study

Aditya Jain1, Ajay Pant2, Amit Saraf3

Abstract

Background: Clavicle fractures are generally managed conservatively by ‘Figure of eight bandage’ or by Clavicular brace. Imminent perforation of the skin, displacement of fracture fragments, as well as non-unions are indications for operative treatment. The aim of this prospective study was to compare the clinico-radiological outcome of intramedullary-nail and plates in displaced midclavicular fracture. Methods: A total of 22 patients ranging 18-65 years of age were included in this study. They were randomized into two groups in simple random manner to be treated either by an intramedullary-nail or plate. Both group were compared clinically and radiologically for a minimum period of 6 months with the help of DASH score and radiograph. Intraoperative findings and complication were also noted. Results: There was no significant difference found between two groups with regard to clinical and radiological outcome after fracture union. DASH scores were significantly higher in plating groups at the 1st 6 weeks of follow-up. However, this difference became insignificant after 6 months of follow-up. Higher rate of blood loss, operative time, hypertrophic scar, implant loosening and implant prominence were noted in the plating group and higher rate of skin impingement were noted in nailing group. Conclusion: Clinico-radiological outcome remain same in intramedullary-nailing and plating group. However, intramedullary nailing is advantageous because of- easier technique, faster healing and cosmetically better scars.

Intramedullary Nailing, Displaced Midclavicular Fracture.

Clinico – Etiological Correlation of Simple Febrile Seizures in Children

Deepika Gupta1, Manoj Kumar2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 255-264

Clinico – Etiological Correlation of Simple Febrile Seizures in Children

Deepika Gupta1, Manoj Kumar2

Abstract

Background: To evaluate the risk factors and their correlation with simple febrile seizures in the children. Methods: A total of 30 patients aged < 5 years and > 3 months presenting with the clinical diagnosis of simple febrile seizures which were generalized in nature, and Lasting less than 15 minutes with only one episode during the illness included in this study. Results: In the present study, patients were included in the age group of 3 months and 5 years. Mean age was 26.66 ±12.46 months. At the time of the simple febrile seizure, 3 patients (10%) had a temperature of 101°F, 6 (20%) had 102°F, 12 (40%) patients had 103°F comprising the commonest group and 8 patients (27.7%) had a temperature of I04°F. Only one patient (3.3%) had a temperature of > 105°F, comprising the rarest group. Mean temperature was 102.93 + 12.46 °F. Information about the intensity of fever at the time of seizure was provided by mother or other family members in 60 percent cases and noted within the institute in 40 per cent cases. Nineteen patients (63.3%) had seizure lasting < 5 minutes. Mean duration of seizure was 5.86 + 3.62 minutes. Prevalence of abnormal EEG increased with increasing number of previous febrile seizures. Abnormal EEG was obtained in 66.7% cases with four previous episodes of febrile seizures. Conclusion: It can be concluded that simple febrile seizures are most common in age groups of 13-24 months with slight male predominance. Family history of febrile and non-febrile seizures and perinatal abnormalities are other predisposing factors for simple febrile seizures. Upper respiratory catarrah is the commonest cause of fever. Abnormal EEG is more common with increasing age, in patients with family history of febrile seizures and in those delivered by caesarean section.

Febrile Seizure, Children, EEG, Perinatal, Fever.

Assessment of Effect of Maternal Lipid Level during Late Pregnancy on the Birth of LGA Newborn

Kuldeep Singh Ahlawat1, Amit Kumar Mital2, Neeraj Sharma3, Ved Pal Mahla4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 265-269

Assessment of Effect of Maternal Lipid Level during Late Pregnancy on the Birth of LGA Newborn

Kuldeep Singh Ahlawat1, Amit Kumar Mital2, Neeraj Sharma3, Ved Pal Mahla4

Abstract

Background: Birth weight is a retrospective indicator of fetal growth and maternal health during pregnancy, but also a subsequent predictor of long-term health outcomes for both the mother and her offspring. The present study was conducted to assess effect of maternal lipid level during late pregnancy on the birth of LGA newborn. Methods: 68 post- natal mothers who delivered LGA babies and 68 post- natal mothers who delivered AGA babies were included. Lipid concentration was calculated by the Friedewald equation. Anthropometric parameters of the newborns were measured. Results: Group I comprised of LGA and group II had AGA babies. Each group had 68 patients. The mean total cholesterol level (mg/dl) in group I was 232.6 and in group II was 220.4, triglyceride level (mg/dl) was 256.2 in group I and 184.2 in group II, HDL (mg/dl) was 36.2 in group I and 52.4 in group II, LDL level (mg/dl) was 144.6 in group I and 140.2 in group II. The mean birth weight was 3624.2 grams in group I and 3026.8 grams in group II, birth length was 56.2 cm in group I and 52.2 cm in group II and head circumference was 36.2 cm in group I and 31.2 cm in group II. The difference was significant (P< 0.05).Conclusion: High maternal TG and Low HDL levels in late pregnancy are independently and significantly associated with the birth of LGA infants.

Birth weight, Mothers, Lipid.

A Retrospective Study of Pediatric Dengue Cases in a Tertiary Care Hospital                                                                 

Kuldeep Singh Ahlawat1, Amit Kumar Mital2, Neeraj Sharma3, Ved Pal Mahla4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 270-274

A Retrospective Study of Pediatric Dengue Cases in a Tertiary Care Hospital

 Kuldeep Singh Ahlawat1, Amit Kumar Mital2, Neeraj Sharma3, Ved Pal Mahla4

Abstract

Background: Dengue fever causes a high burden of disease and mortality across tropical and subtropical regions in Southeast Asia, Africa, the Western Pacific, and the Americas. The present study was conducted to determine dengue fever in children reported to tertiary care centre. Methods: 70 reported cases of dengue fever in children of both genders were diagnosed based detection of DENV NS1 antigen ELISA, anti-JEV- and anti DENV-specific IgM antibodies in serum samples and in cerebrospinal fluid (CSF). Clinical and laboratory features were recorded. Results: ICU admission was seen in 45, average ICU days was 4.2 days, number of days of fever was 4.5, fever was present in 70, rashes in 45, headache in 36, vomiting in 24, respiratory distress in 30, pain abdomen in 54 and loose stools in 32. The difference was significant (P< 0.05). The mean hematocrit (%) was 34.2, platelets (per 103 /μl) was 2.64, white blood cells (per103 /μl) was 9.12, neutrophils was 5.02, lymphocytes was 2.13, urea (mmol/L) was 4.12, creatinine (μmol/l) was 68.4, alanine transaminase (IU/l) was 76.5, urine protein (mg/dL) was 12.5 and urine red blood cells was 2.1. Conclusion: Dengue fever in common in children, Assessment of laboratory tests may be helpful in early detection and prompt management of cases.

Dengue, Headache, Platelets.

Acute Liver Failure in Children: Clinico-epidemiological Profile and Prognostic Markers

Gobinda Mondal1, Sandip Sen2, Kaushani Chatterjee3, Soumyadeep Kundu4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 275-284

Acute Liver Failure in Children: Clinico-epidemiological Profile and Prognostic Markers

Gobinda Mondal1, Sandip Sen2, Kaushani Chatterjee3, Soumyadeep Kundu4

Abstract

Background: Prospective observational study to evaluate the clinical, etiological and epidemiological profile as well as different prognostic markers for children with acute liver failure in a PICU of a tertiary care hospital in eastern India. Methods: 54 children were included in the study, using a predesigned structured study proforma. Routine tests including viral markers, autoimmune, metabolic studies and imaging were done. Standard treatment protocol was followed.  Results: Of the 54 children mean age was 7.90 +/- 2.54 years, male female ratio was 1.12: 1. The etiology could be detected in 43 of 54 cases (79.6%). Of them hepatotropic viruses accounted for 35 of 43 cases (81.4%) with known etiology with Hepatitis A, E, both A and E, B accounting for 14(25.9%), 9(16.7%), 6(11.1%) and 6(11.1%) cases respectively. Invasive ventilation was required in 30 of 54 (55.6%) patients and the mortality was 27 of 54 cases(50%). Lower age of presentation, decreased liver span, ascites, cerebral edema, hepatic encephalopathy, bleeding manifestations were significant poor prognostic indicators while gender, presence of prodrome, AKI, SBP were not significant. Peak TSB values, prothrombin time, serum albumin, lowest platelet count achieved were significantly bad prognostic markers but hypoglycemia was not. The mean age, ascites, presence of Stage 4 encephalopathy, cerebral edema differed significantly between survivors and non-survivors. Conclusion: In the subcontinent water borne hepatotropic viruses continue to predominate as the main cause of pediatric acute liver failure and contributes to its mortality. Despite advances in intensive care, there is a lack of affordable hepatic transplant facilities.

Acute Liver Failure, Viral Hepatitis, Wilsons Disease.

Research Progress on Risk Factor in Childhood Asthma: A Systematic Review

Ibne Amin1, CHU ZhongXia2, Ikram Ul Haq3, Iftikhar Ullah4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 285-297

Research Progress on Risk Factor in Childhood Asthma: A Systematic Review

Ibne Amin1, CHU ZhongXia2, Ikram Ul Haq3, Iftikhar Ullah4

 

Abstract

Background: Childhood asthma is complex heterogeneous disorder with multiple factors involved in its causation. The basic aim of the study was to accomplish the systemic review of literature elucidating the recent research on risk factors of childhood asthma and its challenging therapies. Methods: Data sources: The data for this systematic review was collected from three databases namely PubMed, Science direct and Scopus was used to recoup papers examining the risk factor of childhood asthma and related research progress published from 2011 to 2020. All the included references were manually checked and children under 18 years were part of the study. Inclusion criteria: The studies included were original publication in English, meta-analysis, cross-sectional studies, and cohort/case-control studies. The main study interest was a risk factor of childhood asthma/wheeze and targeted folk was under eighteen children. The keywords used to find the relevant literature were asthma risk factor, asthma, childhood asthma, childhood asthma risk factor, childhood asthma prevention, and asthma therapy. Results: Initially, 1051 papers were collected by searching with help of different websites using keywords, and 977 papers were rejected due to irrelevant titles, abstracts, different age groups, and inappropriate estimates. 74 papers were found relevant abstracts which were further studies and more 43 papers were rejected. Finally, 31 papers were met the exact selection criteria. Twenty-two cross-sectional studies, five meta-analyses, and three cohort base studies. Typically increase in risk factor was noticed with OR= 0.60-3.35. Conclusion: Multiple factors are associated with childhood asthma, some of them have a positive effect and few have a role in reducing asthma in childhood. Currently, biomarkers are used to assess the disease and for quality treatment but limited numbers of markers can be used in clinical practice for pediatric patients these are blood and sputum eosinophils, serum IgE, periostin, and FeNO, they may be used individual or in combination for better response.

Asthma, Childhood Asthma, Risk Factor, Analysis

Atypical Case of Spinal Cord Ependymoma Presenting as Recurrent Pain Abdomen in a Child with Post-Operative Follow UP

Shashi Sharma1, Richa2, Aman Arora3, Lakshya Rana3, Natasha Nargotra4, Rohit Sharma5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 298-304

Atypical Case of Spinal Cord Ependymoma Presenting as Recurrent Pain Abdomen in a Child with Post-Operative Follow UP

Shashi Sharma1, Richa2, Aman Arora3, Lakshya Rana3, Natasha Nargotra4, Rohit Sharma5

 

Abstract

Background: Spinal cord ependymomas are the second most common tumor of spinal cord in pediatric age group. These are intramedullary tumors and required to be diagnosed at the earliest for the management to avoid neurological complications. The important issue is of epidemiology and overall survival factors. Case presentation: We present a 14-years old boy who was evaluated for recurrent pain abdomen for eight months of histpry.He was diagnosed to have celiac disease and was put on treatment for the same. The complaint of pain abdomen did not subside .He underwent ultrasonography(USG),barium studies, upper gastro-intestinal tract (GIT) endoscopy, contrast enhanced computerized tomography(CECT) abdomen and magnetic resonance imaging (MRI).He was provisionally diagnosed as having nerve sheath tumor of the distal spinal cord. He underwent surgical excision of the tumor and that turned out be ependymoma. Conclusion:Child presented with recurrent pain abdomen and was treated for different ailments, but the investigations brought out the underlying pathology as spinal cord tumor. These type of tumors can only be diagnosed by cross sectional imaging like MRI and the surgical excision can be done at the earliest before it causes neurological deficit.

Spinal Cord Ependymomas, Neurological Complications, Overall Survival Factors, USG, CECT, MRI, Case Report.

Study on Risk Factors for Assisted Ventilation in Meconium Stained Amniotic Fluid

Balaji Prabu1, Jaspal Singh2, Ashwani Kumar3, Manmeet Kaur4, Hira Lal Khullar5, Neeraj Sehgal5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 305-311

Study on Risk Factors for Assisted Ventilation in Meconium Stained Amniotic Fluid

Balaji Prabu1, Jaspal Singh2, Ashwani Kumar3, Manmeet Kaur4, Hira Lal Khullar5, Neeraj Sehgal5

 

Abstract

Background: Meconium aspiration syndrome (MAS) is a disease of term and near-term babies associated with considerable respiratory morbidity and mortality. The clinical presentation reflects peripartum aspiration of meconium, occurring usually around the time of delivery or in utero, in association with fetal compromise that can predispose to the development of persistent pulmonary hypertension of the newborn. Aims & Objectives: To study the risk factors for assisted ventilation in meconium stained amniotic fluid. Methods: This was a prospective observational study done for a period of 12 months on all mothers with meconium stained liquor admitted in BebeNanki Maternal and Child Care Centre (BNMCC), attached to Government Medical College Amritsar to evaluate the risk factors for the need of assisted ventilation. The detailed antenatal, natal and postnatal history was recorded along with the treatment measures and the data was subjected to statistical analysis. Results: According to the inclusion criteria 200 cases were enrolled. 38 of them required assisted ventilation and among them, 5 cases had anaemia, 5 cases had Pregnancy induced hypertension, 2 cases had Gestational diabetes mellitus, 2 cases had hypothyroidism and 1 case had intrauterine growth retardation as antenatal risk factor. Remaining 23 cases had no risk factor. Thick meconium, multi gravida and APGAR at 1 min were found to be significant (p<0.05) risk factors for the need of assisted ventilation. Conclusion: The knowledge of risk factors, prompt and efficient labour monitoring and delivery can minimize the sequel of meconium aspiration syndrome. Further studies are required to substantiate the results.

Assisted Ventilation, Meconium Aspiration Syndrome, Risk Factors

Routine Laboratory Values of CBC, I/T Ratio, CRP and Blood Culture yields in Umbilical Cord for the Screening of Early Onset Neonatal Sepsis Among those at Risk of Infection

Dr. Mohammad Shakhawat Alam1, Prof. M.A. Mannan2, Dr. Sanjoy Kumer Dey3, Dr. A Z M Raihanur Rahman4 , Prof.Mohammod Shahidullah5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 312-326

Routine Laboratory Values of CBC, I/T Ratio, CRP and Blood Culture yields in Umbilical Cord for the Screening of Early Onset Neonatal Sepsis Among those at Risk of Infection

Dr. Mohammad Shakhawat Alam1, Prof. M.A. Mannan2, Dr. Sanjoy Kumer Dey3, Dr. A Z M Raihanur Rahman4 , Prof.Mohammod Shahidullah5

 

Abstract

Background: Neonatal sepsis contributed to approximately 30 to 40% of neonatal deaths in the low-income countries. Maternofetal bacterial infection is one of the most common causes of neonatal sepsis. The most common risk factor is PROM occurs in 3% of pregnancies. Other risk factors include chorioamnionitis, untreated UTI etc. Many approaches are described to identify sepsis in newborns with initial risk of infection. Previously many studies have been performed by measuring inflammatory markers of sepsis in venous blood usually 12-24 hours after birth predicting severe infections in neonates. Very few studies aimed at testing of these parameters of CBC, I/T ratio, CRP & Blood culture in newborns with PROM and other risk of infection by sampling umbilical cord blood at birth in predicting early onset neonatal sepsis. This study was designed to see the usefulness of screening test to identify early onset neonatal sepsis measured in umbilical cord blood among those at risk of infection. Objectives: To see and compare the routine laboratory values of CBC, I/T ratio, CRP and blood culture yields in umbilical cord blood as well in the venous blood among those at risk of infection and to see the association between the risk factors of early onset neonatal sepsis with the values of routine laboratory parameters measured in umbilical cord blood. Methods: A prospective study was done in labor ward, post-natal ward and NICU, Bangabandhu Sheikh Mujib Medical University from October 2010 to September 2011.Total 147 newborns were enrolled in two group – 76 infants in case group having at risk of infection and the remaining 71 newborns were control group with similar demographic features having not at risk of infection. The Septic newborns were categorized again into 3 (Three) groups – proven sepsis, probable sepsis and no sepsis based on clinical features observed in the first 72 hours and laboratory values of umbilical cord blood at birth and neonatal blood at 24 hours of age and compared with control group. Results: Of the 147-study newborn there were 22 (28.9%) cases found to developed early onset sepsis in case group and only 2 (2.81%) were found in the control group. The differences of which were statistically significant (P value 0.05). In the case group, the septic newborns were categorized into three group- proven sepsis 6(7.89%) and probable sepsis 16 (21.0%) and the remaining 54 (71.1%) were no sepsis.  In the control group only 2 (2.81%) were found to have probable sepsis. Unlike the blood culture yields and total WBC findings, CRP values and I: T ratio were raised in the umbilical cord blood as well in the venous blood among those at risk of infection. The differences were statistically significant (P value 0.05) compared with the control group having not at risk of infection. In the cord blood CRP had sensitivity, specificity, PPV and NPV of 100%, 89.3%, 43.9% and 100% and in the venous blood at 24 hours of age, CRP had sensitivity, specificity, PPV and NPV of 100%, 77.1%, 27.3% and 100% respectively. The ROC curve for the IT ratios unlike the WBC count differed significantly from the line of discrimination. The odd ratio (OR) revealed the IT ratio and CRP values unlike the CBC values and blood culture yields in the umbilical cord blood as well in the venous blood were more likely to be associated with the risk factors of infection. Conclusion: IT ratio and CRP values were found raised in the umbilical cord blood at birth as well in the neonatal venous blood at 24 hrs among those with risk of infection in comparison to those without risk of infection. Negative CRP values were found to be more useful in excluding infection. Cultures obtained in umbilical cord blood at birth are not a good way for etiological diagnosis of early onset sepsis.

Neonatal Sepsis, CBC, CRP, Blood Culture, Umbilical Cord Blood

Changes in the Clinical and Laboratory Parameters in Children with Dengue Syndrome: Experience during Dengue Outbreak in 2019 of Bangladesh

Sayeeda Anwar1, Habiba Khatun2, Fatema Farzana3, Mohammad Shafiqul4, Alam Chowdhury5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 327-335

Changes in the Clinical and Laboratory Parameters in Children with Dengue Syndrome: Experience during Dengue Outbreak in 2019 of Bangladesh

Sayeeda Anwar1, Habiba Khatun2, Fatema Farzana3, Mohammad Shafiqul4, Alam Chowdhury5

 

Abstract

Background: Dengue is an acute febrile disease caused by a flavi virus with four known serotypes (DENV-1, DENV-2, DENV-3 and DENV-4). The infection is transmitted by the bite of female mosquitoes of the genus Aedesaegypti and Aedesalbopictus. Dengue was first reported in Bangladesh in 1964 when it was known as “Dacca Fever”; since then, it has remained endemic. Aim of the study: To assess changes in the clinical and laboratory parameters in children with dengue syndrome in Bangladesh. Methods: This cross-sectional analytical study was conducted at the Department of Paediatrics, Dhaka Medical College and Hospital (DMCH) during the period from April, 2019 to March, 2020.  Total 384 admitted children of both gender between the ages of one month to 12 years and with clinical manifestations of suspected dengue and positive NS1 antigen and/or dengue antibody with serology IgM or IgG or both. Statistical analysis was done by using the statistical package for social science (SPSS-21) program. Every precaution was taken so that study does not cause any harm or delay for treatment of cases. No incentive was given to the participants. Results: Mean age was 7.5±3.2 years with a range of 1 month to 12 years. Males were predominant to females. Fever was present in all patients 384 (100%). All patients were positive with NS1 antigen, however higher number of patients were positive with IgM antibody. IgG was mostly positive in DSS patients. Significantly highest number of patients in DF had haemoglobin level between 10-15 gm/dl. Maximum patients of DF, DHF, DSS and EDS had haematocrit (%) between (35-45) percent. Significantly highest number of patients in DHF had raised SGPT (45-200U/L) & SGOT value (60-200U/L). Half of the patients of EDS had SGPT & SGOT >1000U/L. Low random blood sugar and raised serum creatinine was present in one fourth of the EDS patients. Conclusion: In this study, majority of the cases were DSS. Most common clinical presentation was vomiting, shock, abdominal pain and bleeding manifestations along with fever. Raised HCT, leucopenia and neutropenia were observed in small number of patients.

Dengue, Children, Fever, Febrile, Mosquitoes.

Effect of Sodium Valproate in Children with Epilepsy under 2 Years of Age: Study in a Tertiary Care Hospital, Rajshahi, Bangladesh

Fazlur Rahman1, Md. Mosharrof Hossain1, Md. Ruhul Amin1, Masuda Parvin2, Md. Mostafizur Rahman3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 336-344

Effect of Sodium Valproate in Children with Epilepsy under 2 Years of Age: Study in a Tertiary Care Hospital, Rajshahi, Bangladesh

Fazlur Rahman1, Md. Mosharrof Hossain1, Md. Ruhul Amin1, Masuda Parvin2, Md. Mostafizur Rahman3

 

Abstract

Background: Sodium valproate is proposed for addition to the Model List of Essential Medicines for use in the management of epilepsy in children. This is effective in treating many seizure types, like a generalized tonic-clonic seizure, myoclonic seizure, absence seizure and in other epilepsy syndromes like infantile spasms, Landau-Kleffner syndrome (LKS), etc.  Aim of the study: This study aimed to observe the side effects caused by sodium valproate in children with epilepsy below 2 years of age. Methods: An observational study was conducted in the Department of Pediatrics, Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the period from January 2020 to December 2020. Fifty (50) children below 2 years of age with epilepsy were enrolled in this study. Enrolment was done after informed verbal consent from the mother or the attendant. A detailed history was taken about demographic factors which include children’s age, age at onset of seizure, height, weight. Data were collected in a pre-designed questionnaire. The data was processed and analyzed by the application of SPSS version-22. Results: Male was dominating in the gender distribution and were 54% and female were 46%. A maximum of 46% of patients was diagnosed with epilepsy between 6-12 months. Out of the total studied patients, the maximum 44% started sodium valproate at ages between 7-12 months. Among the total studied patients 40% took 26-30mg/kg/day sodium valproate as their treatment regime. A total of 16% had anemia among the studied patients, whereas for the rest 84% of patients, no other symptoms were found during their general examination. Among the total studied patients, the most dominating side effect of the patients was vomiting which resulted in 1/5th (20%) of all side effects. The side effects of both hair loss and loss of appetite show the same result of 10% for each whereas, only 4% and 2% had abdominal pain and weight gain respectively. Conclusion: In this study, vomiting was found as the most significant side effect, which was similar to other different studies. These findings may be helpful in further research. It was a single-centered study with a small-sized sample.

Effect, Epilepsy, Sodium Valproate.

Interesting and Unexpected Histopathological Findings in Medicolegal Autopsy Cases – An Experience in a Tertiary Care Centre

Harish Chandra Singh1, Kaustav Mohapatra2, Jyotirmayee Mishra3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 345-352

Interesting and Unexpected Histopathological Findings in Medicolegal Autopsy Cases – An Experience in a Tertiary Care Centre

Harish Chandra Singh1, Kaustav Mohapatra2, Jyotirmayee Mishra3

 

Abstract

Background: Autopsy is an important key to reveal the cause and manner of death in medicolegal cases and a source of learning from a pathologist’s perspective. Few of the ailments are diagnosed only at autopsy as they may not cause any functional derangement. Aim: The aim of this study was to determine the spectrum of histopathological findings including neoplastic lesions related to or unrelated to the cause of death. It was also aimed to highlight various incidental and interesting lesions in autopsies. Methods: A retrospective and prospective study of medicolegal autopsies for four years was conducted in a tertiary care centre in western Odisha to study the various spectrum of histopathological findings. Results: The study consisted of 100 autopsy cases and histopathological findings were studied in all the cases. In most of the cases (59 cases) no preliminary cause of death was mentioned. Myocardial infarction (14 cases) was the most common incidental histopathological finding noted followed by fatty liver (9) cases. Neoplastic lesions accounted for 4 number of cases. Conclusion: This study contributed with few important histopathology findings to reach a definitive diagnosis of diseases in some unknown causes of death. Autopsy studies help in better understanding and detection of incidental findings significant enough to change the course of treatment only if the disease was diagnosed prior to death.

Medicolegal Autopsy, Interesting, Histopathological Findings.

Analysis of Histological and Immunohistochemical Follow-Up for Salivary Gland Neoplasm of Uncertain Malignant Potential Proposed By the Milan System for Reporting Salivary Gland Cytopathology: A Case Report

Monika Kalyan1, Amrinder Kaur2, Mohanvir Kaur3, Ramesh Kumar Kundal4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 353-559

Analysis of Histological and Immunohistochemical Follow-Up for Salivary Gland Neoplasm of Uncertain Malignant Potential Proposed By the Milan System for Reporting Salivary Gland Cytopathology: A Case Report

Monika Kalyan1, Amrinder Kaur2, Mohanvir Kaur3, Ramesh Kumar Kundal4

 

Abstract

The Milan System for Reporting Salivary Gland Cytopathology is a tiered classification scheme that includes 6 diagnostic categories. Here we are reporting a case with swelling on the upper palate in minor salivary glands, with short clinical history and increasing size qualified as NUMP with possibility of cellular pleomorphic adenoma on the basis of histopathological diagnosis of surgical resection was kept as Pleomorphic adenoma with solid component of Oncocytoma. On Immunohistochemistry came out to be pleomorphic adenoma with myoepithelioma. Case representing the importance of exact categorization by Milan system of reporting the salivary gland tumour. This case of Pleomorphic Adenoma arising in minor salivary glands highlights a potential diagnostic pitfall, essentially in FNA biopsy but also in histology, in the diagnosis of salivary gland tumors.

Milan System for Reporting Salivary Gland Cytopathology, Myoepithelioma, Neoplasm of Uncertain Malignant Potential, Pleomorphic Adenoma.

Clinical Outcome of Cytokeratin 5/6 by Immunohistochemistry in Basal like Triple Negative (ER, PR and HER2 negative) Breast Carcinoma

Nure Jannat Ferdousi Ara1, MdMustakim Ali2, UmmeKulsum Munmun3, Most. Ishrat Jahan4, Ferdousy Begum5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 360-366

Clinical Outcome of Cytokeratin 5/6 by Immunohistochemistry in Basal like Triple Negative (ER, PR and HER2 negative) Breast Carcinoma

 

Nure Jannat Ferdousi Ara1, MdMustakim Ali2, UmmeKulsum Munmun3, Most. Ishrat Jahan4, Ferdousy Begum5

Abstract

Background: Breast cancer is a heterogeneous disease, which can be classified into biologically, morphologically and clinically meaningful entities. Prognostic indicators based on currently available clinical and histopathologic variables such as tumor size, tumor grade, lymph node status and hormone receptor status already exist and are used to predict a patient’s clinical outcome in certain situations. Classification of breast cancer based on the microarray method is difficult to put into widespread clinical practice due to very high costs. Aim of the study: To evaluate the clinical outcome of cytokeratin 5/6 by immunohistochemistry in basal like triple negative (ER, PR and HER2 negative) breast carcinoma. Methods: This cross sectional study was conducted in the department of BSMMU from January 2016 to December 2017. A total of 41 cases previously diagnosed as TNBC by histological and immunohistochemical examinations were selected for the study. During collecting specimen, all relevant information were recorded systemically in a prescribed proforma. Histopathogical type of tumor was done according to WHO classification of breast tumor, 2012 and grading was done followings Nottingham modification of the Bloom -Richardson Grading System, and recorded. Immunohistochemistry of ER, PR and HER-2/neu expression of all cases were performed using DakoAutostainer Plus at the immunohistochemistry laboratory, of department of Pathology, BSMMU. Statistical analyses of the results were obtained by window based computer software devised with Statistical Packages for Social Sciences (SPSS-20). Prior to the commencement of this study the thesis protocol was submitted to the Institutional Review Board (IRB) of BSMMU, Dhaka for approval and was approved. Results: Out of these 41 cases; most of the cases belong to a range of 31 to 40 years. Minimum age was 26 years, maximum age was 70 years. The mean age was 42. There is no association between age and CK 5/6 immunoreactivity. It is not statistically significant at α = 0.05 level. Cases 1 (2. %) case was grade 1, 24 (59%) cases were grade 2 and 16 (39%) cases were grade 3. It appears that maximum cases belong to grade-II. Number of CK 5/6 positive case was ‘0’(zero) and negative was I (one) in grade-1, number of positive cases were 14 and negative were 10 in grade-II and number of positive cases were 12 and negative cases were 4 in grade-III. It appears that grade-I tumor is negative and only the high grade cases shows positivity. 11 (27 %) cases are highly positive to CK 5/6, 15 (36 %) cases are low positive to CK 5/6 and 15 (37 %) cases are negative to CK 5/6. Conclusion: A significant overlap was observed between the triple-negative breast cancers and basal like breast carcinoma, the “triple negativity” should not be used as a surrogate marker for the basal-like breast cancers. By adding, CK 5/6 and/ or EGFR as the positive markers to the triple negative phenotype, a significantly worse outcome group can be identified among the triple-negative cases.

Clinical Outcome, Breast Carcinoma, Immunohistochemistry, Heterogeneous.

Basal Tone of Blood Vessel: Cyclic Guanosine Monophosphate (cGMP) Dependent or Not? An Experiment with Soluble Guanylyl Cyclase Inhibitor

Renu R Raj1, Vrinda Vijayakumari2, Remya Raj Rajamohanan3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 367-370

Basal Tone of Blood Vessel: Cyclic Guanosine Monophosphate (cGMP) Dependent or Not? An Experiment with Soluble Guanylyl Cyclase Inhibitor

Renu R Raj1, Vrinda Vijayakumari2, Remya Raj Rajamohanan3

Abstract

Background: Nitric oxide (NO) is a signaling molecule that is produced constitutively in endothelium. It maintains the basal tone of blood vessel. It can produce vasodilation through cyclic guanosine monophosphate (cGMP) dependent and independent mechanisms. The aim of our study was to identify whether the basal tone of blood vessel is maintained by cGMP dependent mechanism or not. For this we have used soluble guanylyl cyclase inhibitor, 1H-[1,2,4] oxidiazolo [4,3-a]quinoxalin-1-one (ODQ), which will prevent the formation of cGMP. Methods:Wistar rat isolated hind limb preparation was used in our study. Rat was anaesthetized and the upper half of the body was removed and the abdominal aorta was cannulated. It was perfused with physiological salt solution and the blood pressure was recorded using a pressure transducer connected to CMC data acquisition system (CMCdaq). The rate of perfusion was fixed by using peristaltic pump at 4ml/min. The rat was perfused with ODQ for 10 minutes and was again perfused with extracellular fluid. Results: ODQ did not produce any significant change in the mean arterial pressure. This shows that cGMP is not required for the basal tone of blood vessel as there was no change in the mean pressure even after blocking cGMP production by ODQ. Conclusion: We concluded that basal tone of blood vessel maintained by NO is cGMP independent.

Vascular Tone, Cgmp, ODQ, Nitric Oxide, Soluble Guanylyl Cyclase.

Determination of Normal Dimensions of Pituitary Gland by Magnetic Resonance Imaging Comparison of Age and Gender Groups

Gurinder Bir Singh1, Harjinder Singh Mann2, Arvinder Singh3, Daisy Gupta4, NS Neki5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 371-377

Determination of Normal Dimensions of Pituitary Gland by Magnetic Resonance Imaging Comparison of Age and Gender Groups

Gurinder Bir Singh1, Harjinder Singh Mann2, Arvinder Singh3, Daisy Gupta4, NS Neki5

Abstract

Background: To determine measurements of pituitary gland dimensions in subjects with normal pituitary gland aged 1 to 70 years presenting at Radiodiagnosis and Imaging Department, Government Medical College Amritsar, Punjab. Methods: Total 100 subjects of different age groups (50 males and 50 females) with normal pituitary gland were evaluated using T1 weighted Magnetic resonance imaging. Mid-sagittal and coronal planes were used to measure height, width and depth of pituitary gland. Data was stratified into groups on the basis of age and sex to observe the differences. Results: Mean height, length, width and volume of pituitary was 5.25 ±1.18mm, 8.69±2.17mm, 9.09±2.12mm and 224.56±101.01mm3 respectively. There is significant difference in height (p value .001) and volume (p value .020) of pituitary gland among genders. Among females the mean height of pituitary was highest among 21-30 years subjects (5.86±0.80 mm) and lowest among 61-70 years subjects (3.73±0.42 mm) reflecting the hormonal changes. Conclusions: We have provided reference values for the normal pituitary gland dimensions in northern Indian population which will aid in assessment and diagnosis of patients with abnormalities in pituitary gland function.

Pituitary Gland, Magnetic Resonance Imaging, Height, Length, Width,Volume

CT Quantification of Parenchymal and Airway Parameters on 64 Slice MDCT in Patients of Chronic Obstructive Pulmonary Disease

Gurinder Bir Singh1, Manpreet Kaur2, Arvinder Singh3, Nirmal Chand Kajal4, NS Neki5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 378-387

CT Quantification of Parenchymal and Airway Parameters on 64 Slice MDCT in Patients of Chronic Obstructive Pulmonary Disease

Gurinder Bir Singh1, Manpreet Kaur2, Arvinder Singh3, Nirmal Chand Kajal4, NS Neki5

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) represents an important public health challenge and is a major cause of chronic morbidity and mortality throughout the world. Aim: To quantify CT parenchymal and airway parameters in cases of COPD and to correlate CT parameters with the functional parameters of airway obstruction [FEV1, FVC, FEV1/ FVC]. Methods: An observational prospective study was performed in 100 patients diagnosed of chronic obstructive disease on spirometry. These patients underwent chest X ray in PA and lateral view and NCCT/CECT scan of chest in expiratory and inspiratory phases. 50 controls were selected retrospectively with normal inspiratory NCCT scan. Results: Quantitative CT parameters were found to be significantly different in the COPD cases compared to the controls. Among the quantitative parenchymal parameters, mean lung density, Percentage of Low Attenuation Area <-950HU, Percentage of Low Attenuation Area <-850HU showed significant correlation with FEV1, FVC and FEV1/FVC. Wall area of segmental bronchi demonstrated significant negative correlation with FEV1, FVC and FEV1/ FVC ratio. Wall area % showed significant negative correlation with FEV1 and FVC. Conclusions: In this study, we concluded that the quantitative CT parameters can be used to assess the severity of the COPD, as significant change in these values was noted with change in severity of COPD. Quantitative CT parameters also showed significant correlation with pulmonary function tests and can be used as complementary diagnostic tool.

Chronic Obstructive Pulmonary Disease, Mean Lung Density, Wall Area, Luminal Area (Ai).

Role of HRCT & Chest Radiograph in COVID19 RT-PCR Positive Cases in Assessing the Severity of Lung Involvement

Balakrishna Aggipothu1, Akshay B2, Jayanti Musib3, Yasaswi Devi Satyavada4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 388-394

Role of HRCT & Chest Radiograph in COVID19 RT-PCR Positive Cases in Assessing the Severity of Lung Involvement

Balakrishna Aggipothu1, Akshay B2, Jayanti Musib3, Yasaswi Devi Satyavada4

Abstract

Background: As COVID 19 infection is a pandemic affecting millions of lives all over the world, creating a lot of psychological burden to the families of affected individuals & has become one of the common causes of death in the older population at present due to its severe lung involvement. CT helps in determining presence of lung involvement, categorizing the extent of lung involvement and prognosis based on CT severity score. Methods: This is a prospective study in which we included 500 patients who tested positive for COVID19 infection. Examination performed in 16 slice CT GE scanner and sanitized table and CT room with 0.1 % sodium hypochlorite and UV light disinfection. We graded involvement of the lung in COVID19 positive patients based on CT imaging findings. Chest x ray radiography was taken as a first line investigation in all COVID 19 positive patients who were then referred to CT. Results: Results Out of 500, CT severity score>15 is seen in 48 males, 15 females,CT severity score 8-15 is seen in 83 males and 18 females, CT severity score <8 is seen in 121 males and 69 females, no lung involvement is seen in 101 males and 45 females. Conclusions: CT was found as a sensitive tool in assessing the involvement of lung and prognosis in COVID19 positive patients.

COVID 19 RT PCR positive cases, HRCT, CT severity score

Organ Donation Awareness and Attitude among Graduate (Non-health Care) Population in Suburban Chennai

Jai Vinod Kumar1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 395-402

Organ Donation Awareness and Attitude among Graduate (Non-health Care) Population in Suburban Chennai 

Jai Vinod Kumar1

Abstract

Background: Organ transplantation has recently been the most preferred treatment modality for end-stage organ disease and organ failures. However, the primary hindrance to the organ transplantation programs worldwide is the shortage of donor organs. The need for the transplants is high and the gap between organs available for transplantation and the number of patients waiting for a transplant is widening globally.[3] Because of this low donation rate, patients requiring transplantation must wait for a longer time. The graduates form the majority of the population in the current society and have a big hand regarding decisions in their family. Thus, there is a great need for increasing awareness about the importance of organ donation and the legal provisions related to it. Methods: The participants of the study were either patients or attenders visiting the surgical outpatient department. Questionnaires were provided to them, along with consent forms. The data was tabulated and analyzed. Results: The total number of participants were 210, out of which 152 (72.38%) used the English questionnaire and consent forms. All participants were graduates with minimum bachelor college degrees. Conclusion: It was found that the attitude towards organ donation did not significantly vary between gender, different age groups, education degrees, employment nature or their religion in this population group. However, from the results of this study we could conclude that the knowledge regarding brain death, the current status in this society regarding requirement for organs need to be emphasized to the general public through sensitization programs.

Awareness, Chennai, Graduates, Organ Donation, Transplantation

A Comparative Study between Closure by Layers Vs Mass Closure in Midline Laparotomy Incisions

Darshanjit Singh Walia1, Saurav Mittal2, Kuldip Singh3, Dilpreet Kaur4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 403-410

A Comparative Study between Closure by Layers Vs Mass Closure in Midline Laparotomy Incisions 

Darshanjit Singh Walia1, Saurav Mittal2, Kuldip Singh3, Dilpreet Kaur4

Abstract

Background: The ideal method of abdominal wound closure remains to be discovered. It should be technically so simple that the results are as good in the hands of a trainee as in those of the master surgeon. The best abdominal closure technique should be fast, easy, and cost effective while preventing both early and late complications. Present study is undertaken to compare the two methods (Mass closure and Layered closure) of laparotomy wound closure in relation to post-operative complications, time for wound closure and cost effectiveness in both groups and also to decide the most effective method among the two. Methods: The present study was a prospective comparative trial and conducted on 60 patients of either sex admitted in surgical wards of Rajindra Hospital Patiala, Punjab. On admission, patients suspected of having intra-abdominal pathology, a thorough clinical e and general assessment was done. Necessary radiological and biochemical investigations were done to support the diagnosis. After confirmation of diagnosis patients were subjected for exploratory laparotomy. The laparotomy wound was closed with either by Mass closure or Layered closure technique. Patients were followed up for 3 months in post-operative period for detection of late complications. Results: Total 60 patients of were studied. Majority of patients were in 61 to 65 age group. Male outnumbered the females. Incidence of early complications like seroma, wound infection is more in layered closure group as compared to mass closure. Mean wound closure time is more in layered closure group. Mass closure technique is more cost effective than layered closure group. Conclusion: Mass closure technique is less time consuming, more cost effective and safe for closure of midline laparotomy incision.

Layers Vs Mass, Midline Laparotomy, Surgery

Clinical Profile and Prevalence of Leg Ulcers in our Hospital

Manjit Singh Khalsa1, Parneet2, Gaurav Sharma2, Abhishek Khera3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 411-417

Clinical Profile and Prevalence of Leg Ulcers in our Hospital

Manjit Singh Khalsa1, Parneet2, Gaurav Sharma2, Abhishek Khera3

Abstract

Background: Lower limb ulcers occur due to various conditions such as atherosclerosis and other arterial disorders, venous insufficiency, diabetes, trauma, pressure sores, vasculitis and inappropriate management of acute wounds. Many a time, it’s difficult to ascertain the exact etiology of leg ulcers. Aims and Objectives: This study was done to know the prevalence with respect to age and sex, cause, site of distribution and clinical presentation of leg ulcers. Methods: This was a cross-sectional study done in tertiary hospital of Punjab for a period of two months. A Sample size of 100 was selected. Informed consent of the patients was taken and a detailed history, a complete systemic examination and local examination of lower limbs including the ulcer was done.Results: Majority of patients (57%) with leg ulcer presented after fourth decade with  a male to female  ratio of 1.5:1 .Commonest were found to be diabetic ulcer cases (47%) followed by venous ulcer (27%) cases. Diabetic and traumatic ulcers were occurred on both foot and leg whereas venous ulcers occurred more commonly in Gaiter’s zone. Majority of patients came with complaints of difficulty in walking (81%) and pain (51%). Conclusion: The highest number of cases were found to be ulcers associated with diabetes mellitus. Education and training is vital for all those involved in caring of patients with leg ulceration and patients with Diabetes Mellitus.

Clinical-Profile, Leg Ulcer, Clinical Presentation

A Report on Average Hospital Stay between Patients Managed Conservatively and Operatively In Patients with Abdominal Visceral Trauma – A Prospective Study of 50 Cases

Manjit Singh Khalsa1, Baldev Singh2, Mohan Raj.S.N3, K. D. Singh Aulakh4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 418-426

A Report on Average Hospital Stay between Patients Managed Conservatively and Operatively In Patients with Abdominal Visceral Trauma – A Prospective Study of 50 Cases

Manjit Singh Khalsa1, Baldev Singh2, Mohan Raj.S.N3, K. D. Singh Aulakh4

Abstract

Background: Trauma, a major public health problem worldwide is associated with high morbidity and mortality in every country regardless of level of socialeconomic development. Aim of this study was to assess the average hospital stay in abdominal visceral trauma patients who were managed conservatively and operatively.  Methods: Prospective study enrolling 50 patients of either sex, of all age groups, were allocated to group A(n= 20) undergoing conservative management, and group B(n=30) undergoing operative management. Hospital stay was observed between the two groups and results were statistically analyzed. Results: Among the 50 study group, 20 were managed conservatively (group A) and 30 were managed operatively (group B).Overall hospital stay was observed to be low in patients who underwent conservative management (3.15days) as compared to patients who underwent surgical management (12.03days). Conclusion: Hospital stay was longer in duration in operated cases when compared to conservative cases.

Abdominal Visceral Trauma, Conservative Treatment, Operative Management

Renal Function after Partial Nephrectomy versus Radical Nephrectomy for Renal Cell Carcinoma: A Comparative Study

Md. Enamul Hoque1, Md. Shamim Hossain2, Mohammad Abdus Salam3, Muhammad Serajul Islam1, Akterkamal Perveg1, M A Salam4, A. K. Al Miraj5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 427-445

Renal Function after Partial Nephrectomy versus Radical Nephrectomy for Renal Cell Carcinoma: A Comparative Study

Md. Enamul Hoque1, Md. Shamim Hossain2, Mohammad Abdus Salam3, Muhammad Serajul Islam1, Akterkamal Perveg1, M A Salam4, A. K. Al Miraj5

Abstract

Background: Renal cell carcinoma (RCC) is the third most common malignancy of the genitourinary system characterized by lack of early warning clinical manifestations (asymptomatic) and late triad of symptoms (flank pain, hematuria, and palpable renal mass). It accounts for approximately 2-3% of the adult malignancy and 90% to 95% of neoplasms arising from the kidney. With the improvement in imaging technique, small and asymptomatic RCC is easily diagnosed and treated but advanced RCC is difficult to treat because its inherent resistance to conventional chemotherapy and radiotherapy. Objective: To compare the time-dependent changes of estimated glomerular filtration rate (eGFR) after partial nephrectomy (PN) and radical nephrectomy (RN) for renal cell carcinoma (RCC). Type of study: Randomized controlled clinical trial. Place of Study: Department of Urology, BSMMU and Comfort Nursing Home (Pvt.) Ltd. Dhaka, during the period of June, 2018 to December, 2020. Methods:This prospective randomized controlled clinical trial study is conducted in the Department of Urology, BSMMU and Comfort Nursing Home (Pvt.) Ltd, Dhaka, From June, 2018 to December, 2020. Total 52 patients having renal cell carcinoma (<7cm) and normal contralateral kidney, available preoperative and postoperative serum creatinine and MDRD-eGFR measurements are included in this study, Preoperative MDRD-eGFR<30 ml/min/1.73m2 or serum creatinine level >1.5 mg/dl before surgery is excluded from this study. After detailed explanting about the nature of the study to the participants and with written consent, 52 patients are randomly allocated into two groups by lottery method. In group-A 26 patients are enrolled for partial nephrectomy (PN) and in group-B, 26 patients are enrolled for radical nephrectomy (RN). The enrolled patients are evaluated after surgical intervention under general anesthesia with different surgeons in two institutes by measuring serum creatinine and MDRD-eGFR postoperatively 1, 3, 7 days, and 3 monthly for one year. MDRD-eGFR declining is assessed from the preoperative value to the 1st post-operative value at the end of follow up. During follow up period, out of total 52 patients in both groups 1 patient in group-A and 2 patients in group-B did not come in regular follow up and one patient died in group-A So total 23 patients in each group are followed up after operation. Results: Demographic characteristics, BMI, pre- and post-operative symptoms and sign of the patients, most of the tumor characteristics (location, hydronephrosis and enhancement) are not statistically Significant in both groups but statistically significant changes are found in tumor size (p=0.004) and tumor type (p=0.013). There is no significant difference in pre-operative serum creatinine and eGFR in both groups but the time-dependent changes of eGFR after RN show plateau form initially and then gradually declining form the first post-operative day to the 12 post-operative months. In case of partial nephrectomy (PN), a lowest eGFR is observing in post-operative day 1 and gradually recovered to near pre-operative level for 12 months. The mean (±SD) eGFR decreased more significantly in RN (group-B 18.56 ml/min) than PN patients (group- A 6.31 ml/min) from pre-operative to 12 months after operation and shows statistically significant differences between and within both groups (p<0.001, <0.001 respectively). Conclusion: Time dependent changes of estimated glomerular filtration rate (eGFR) after partial nephrectomy (PN) is better than radical nephrectomy (RN) for renal cell carcinoma (RCC). Partial nephrectomy (PN) is therefore the better procedure for preservation of renal function.

Demographic Characteristics, BMI, Radical Nephrectomy (RN), Renal Cell Carcinoma (RCC), Post-Operative Symptoms

The Impact of Radiological and Pathological Size of Renal Cell Carcinoma on Stage of Disease

Muddasir Hussaain1, Pardeep Kumar1, Mehnaz Jabeen1, Abdul Khalique1, Muhammad Adnan Sarwar1, Asad Shahzad Hasan2, Altaf H Hashmi2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 446-453

The Impact of Radiological and Pathological Size of Renal Cell Carcinoma on Stage of Disease

Muddasir Hussaain1, Pardeep Kumar1, Mehnaz Jabeen1, Abdul Khalique1, Muhammad Adnan Sarwar1, Asad Shahzad Hasan2, Altaf H Hashmi2

Abstract

Background: Renal cell carcinoma is the most common tumour of kidneys and surgery in the form of Radical nephrectomy has been the only curative option for organ confined disease. However with advent modern surgical practices, the potential options for treatment have changed to include nephron sparing partial nephrectomy and local ablative techniques, so as to preserve renal mass and prevent long term chronic renal failure. Objective: “To estimate the frequency of change in stage of renal cell carcinoma based on discrepancy in preoperative radiological and postoperative pathological size”. Study Setting and Duration: This study was conducted at the Department of oncology, Sindh institute of urology and transplantation Karachi for the duration of six months, from June 2020 to December 2020. Study Design: This was a cross-sectional study. Methods: A total of 81 cases with renal cell carcinoma, measured equal to or less than 10 cm on preoperative computerized tomography scan were included in this study. After surgical resection of renal mass, the specimens were sent to pathology department. The preoperative radiological size was used to categorize disease into preoperative rT1a, rT1b or rT2 disease (TNM staging of RCC 2009). The postoperative pathological size was used to categorize disease into postoperative pT1a, pT1b or pT2 (TNM staging of RCC 2010) disease.Results: The average age of the patient was 46.33±8.75 years.  Out of 81 cases, 32(39.51%) changed stages while 49(60.49%) did not change their stages. Conclusion: There was a small over estimation (1 mm) of pathological size by CT overall, but this is of uncertain clinical significance. For some patients, the difference leads to a discrepancy between clinical and pathological staging, which may have implications for pre-operative patient counseling regarding prognosis and choice of treatment strategy.

Renal cell carcinoma, Pathological size, Tumour of kidneys, Radical nephrectomyhas

Impact of Covid-19 Pandemic in Non-Emergent Urological Care: A Single Center Analysis

Md. Sayedul Islam1, Md. IshtiaqulHaque Mortuza2, Md. Salahuddin Faruque3, A. S.M. Shafiul Azam4, Faika Farah Ahmed5, Md. Shafiqur Rahman6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 454-461

Impact of Covid-19 Pandemic in Non-Emergent Urological Care: A Single Center Analysis

Md. Sayedul Islam1, Md. IshtiaqulHaque Mortuza2, Md. Salahuddin Faruque3, A. S.M. Shafiul Azam4, Faika Farah Ahmed5, Md. Shafiqur Rahman6

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the healthcare system of Bangladesh, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing both non-emergent and urgent/emergent conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with non-emergent urological conditions in urology department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Methods: The number of Patients who were presented with non-emergent urological conditions during a4-month period including one reference month and 3 months during peak of the COVID-19 pandemic, in urology outpatient department (OPD) of BSMMU and underwent  surgical procedure were considered representative markers to evaluate the usual non-emergent urological access. ANOVA test were used to quantify these changes. Results: Data from urology department of BSMMU showed a decrease in the total number of surgery done for non-emergent urological casesfrom 182/month just prior to the outbreak to 28/month by the end of the study period. A statistically significant difference was reported between thenumber of non-emergent urological cases (p< 0.05) who underwent surgical intervention by different subspecialties in these months. Conclusion: In BSMMU during the COVID-19 pandemic there has been a decrease in patients seeking help for non-emergent urological conditions. Restructuring the healthcare facilities of this institution is mandatory to cope with COVID-19; moreover the healthcare delivery system should continue to provide adequate levels of care also to patients other conditions.

Covid-19, Urological Care, Pandemic in Non-Emergent

Impact of Routine Second Transurethral Resection on the Long-Term Outcome of Patients with Newly Diagnosed pT1 Urothelial Carcinoma

Md. Sayedul Islam1, Md. Shafiqur Rahman1, Md. Shamim Hossain2, A. S. M. Shafiul Azam3, Md. Salauddin Faruque4, Md. Saiful Islam5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 462-471

Impact of Routine Second Transurethral Resection on the Long-Term Outcome of Patients with Newly Diagnosed pT1 Urothelial Carcinoma

Md. Sayedul Islam1, Md. Shafiqur Rahman1, Md. Shamim Hossain2, A. S. M. Shafiul Azam3, Md. Salauddin Faruque4, Md. Saiful Islam5

Abstract

Background: Transurethral resection (TUR) of bladder tumours is not only mandatory for adequate staging but also crucial in delaying or preventing tumour recurrence and progression. Objective: To evaluate the impact of routine second TUR on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma.  Methods: This prospectively randomized Trial was conducted in urology department of BSMMU, Dhaka, Bangladesh from January 2017 and January 2020. Two hundred ten newly diagnosed T1 bladder cancer patients were prospectively randomized to two groups between January 2017 and January 2020. Second TUR was performed within 2–6 wk. after the initial resection for the patients of group 1. Second TUR was not done in group 2. All patients (groups 1 and 2) received the first instillation of intravesical chemotherapy within 24 h after the initial resection. Urine cytology and follow-up cystoscopy were performed at 3-mo intervals for the first year, biannually for the second year, and annually thereafter. All patients were followed until death or a minimum of 54 months. Results: The mean follow-up period was 66.1 months without a significant difference between the groups. Residual tumour was detected histopathologically in 35 of 105 patients in group 1. Of these patients, eight had upper-stage (pT2) disease. Recurrence was observed in 37 of the 93 patients in group 1 and 70 of the 98 patients in group 2. Median recurrence-free survival was 47 months for group 1 compared with 12 months for group 2. Progression was observed in 6.5% of patients for group 1 compared to 23.5% of patients for group 2 (p = 0.001). Median progress-free survival was 73 months for group 1 compared to 53.5 months for group 2. The overall survival rate was 67.7% and 64.3% in groups 1 and 2, respectively (log rank test result: 0.363). Only 5 of the 30 patients in group 1 died of cancer compared to 11 of the 35 patients in group 2 (p=0.038). Conclusion: We have clearly shown that second TUR, which is performed only after complete first TUR, has significantlydecreasedtherecurrenceandprogressionratesinpatientswithnewly diagnosed T1 disease compared to patients with T1 disease but with no second TUR. This study once more underscores the effect of TUR, which is usually underappreciated.

Urothelial carcinoma, Bladder cancer, Superficial transitional cell carcinoma, Second TUR, Recurrence Progression

Percutaneous Transluminal Angioplasty in the Treatment of Diabetic Foot

Imran Khan1, Zhengjun Cui2*, Gao Ya3, Guo Pengfei3, Qing-nan Meng3, Rongqiang Yang4, Xiaobo Wang5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 472-480 

Percutaneous Transluminal Angioplasty in the Treatment of Diabetic Foot

Imran Khan1, Zhengjun Cui2*, Gao Ya3, Guo Pengfei3, Qing-nan Meng3, Rongqiang Yang4, Xiaobo Wang5

Abstract

Background: Diabetic foot is the foot tissue damage, ulceration, secondary segmental necrosis in diabetic patients. The prevalence of diabetes is predominantly due to long-term high blood sugar, high blood lipids in the state, the systemic arterial prone to atherosclerosis, lower limb arteries are more prone to endometrial damage, and then there is stenosis or occlusion, distal extremity ischemia, Leading to diabetic foot ulcers. Objective: To assess the value of percutaneous transluminal angioplasty (PTA) in the surgical treatment of diabetic foot. Methods: Retrospective analysis of 83 cases of diabetic foot patients, 95 limbs, 95 wounds were conscripted from September 2011 to September 2014 in our hospital. Rendering to whether the PTA treatment is not accepted PTA treatment of the conventional treatment group 43 cases (wound 51) and PTA treatment of PTA group 40 cases (44). The granulation growth rate of the wound was intended at 3, 6, 9, and 12 days after debridement. The spell of wound preparation was logged before operation. According to the Wagner classification, the survival rate of the skin graft and the healing of the suture in the 2 groups were statistically analyzed. Statistics of two groups of patients were followed up for six months, the monthly review of ABI, and ulcer recurrence. Data were processed with χ² test and t test. Results: The good rate of granulation growth of the wound in the conventional treatment group was slower than that of the control group. The good granulation growth rate of the wound was less than 20% on the 12th day after treatment. The granulation growth rate of the wound in the PTA group increased visibly from the 9th day, all grow well. On the 9th and 12th day of treatment, the granulation growth rate of the wound in PTA group was ominously advanced than that in the conventional treatment group (P <0.01). The time of wound preparation was (24 ± 10) days in the conventional treatment group, which was significantly higher than that in the PTA group (15 ± 3) days, t = 5.709, P <0.01. The Wagner 2, 3, 4 grade wounds were suggestively greater in the PTA group than in the conventional treatment group (χ2 = 6.741 ~ 24.498, P <0.01). ABI was significantly higher in the PTA group than in the conventional treatment group (t = 5.411 ~ 9.583, P <0.01). There was no recurrence of ulcer in the 4 months before the follow-up. There were 1 and 2 cases of ulcer recurrence in the 5 and 6 months follow-up. There was no recurrence in the PTA group after 6 months follow-up. Conclusion: PTA is effective in the surgical treatment of diabetic foot patients, and has assured clinical application value.

Diabetic Foot, Angioplasty, Skin Transplantation, Wound Healing.

A Study on the Retrospective Analysis of Gastrointestinal Stromal Tumors

Shabbir Ahmed1*, Asim Shafi2, Umair Tahir3, Rab Nawaz Malik4, Abdul Quddus5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 481-485

A Study on the Retrospective Analysis of Gastrointestinal Stromal Tumors

Shabbir Ahmed1*, Asim Shafi2, Umair Tahir3, Rab Nawaz Malik4, Abdul Quddus5

Abstract

Background: Gastrointestinal stromal tumors (GIST) are rare tumors of the digestive system with different distribution and clinical features. Purpose: The aim of our study is to observe the demographic and clinical characteristics of GIST in our clinical environment. Methods:It was a retrospective analysis of the records of patients hospitalized and treated at Bakhtawar Amin Medical and Dental college Multan for five years duration from January 2016 to January 2021. Results: During the study period, a total of 27 patients diagnosed with GIST based on histopathology were enrolled in the study, there were 15 women and 12 were male with a male to female ratio of 1: 1.3. The mean age was 51 years (range 35-65 years). The most common symptom was abdominal pain at a rate of 60%, followed by a tumor in the abdomen, anemia due to vomiting, and decreasing weight loss. Two patients presented to the emergency department, one with intestinal obstruction and the other with upper gastrointestinal bleeding. However, the symptoms overlapped the patients. Conclusion: GISTs are rare entities with a variety of clinical features, but with a favorable prognosis if diagnosed early. The doctor requires a high degree of suspicion for prompt diagnosis and early treatment.

GIST, Mesenchymal Tumors, Abdominal Mass.

Study to Determine the Effectiveness of Mesh Repair in Inguinal Hernia

Asim Shafi1*, Shabbir Ahmed2, Umair Tahir3, Rab Nawaz Malik4, Abdul Quddus5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 486-493

Study to Determine the Effectiveness of Mesh Repair in Inguinal Hernia

Asim Shafi1*, Shabbir Ahmed2, Umair Tahir3, Rab Nawaz Malik4, Abdul Quddus5

Abstract

Background: Aim: To assess the effectiveness of mesh repair in inguinal hernias. Study Design: A Prospective Study. Place and Duration: The study was conducted from February 2019 to February 2021 for two-years duration at the Department of Surgery of Bakhtawar Amin Medical and Dental college Multan. Methods: A total of 120 patients were included. Inclusion criteria: Patient with clinical symptoms of primary or recurrent inguinal hernia. Exclusion criteria: Patient with other types of inguinal and extra-groin hernia and the patient is too weak to endure surgery. Results: In total, 120 patients were operated on and included in the study. During this initial follow-up, it was especially interesting to learn about the self-esteem of patients regarding their physical limitations in the first month after surgery. 81.66% (n: 98) belong to urban areas and 18.33% (n: 22) from the remote areas. Straining during bowel movements and urination was the main predisposing factor to hernia, i.e., 43.33% (n: 52). Other factors contributing to hernia include smoking 20.83% (n: 25), chronic coughing 15% (n: 18), weight lifting 9.16% (n: 11), and obesity 9.16% (n: 11). No contributing factors were identified in three patients. The incidence of the hernia type was first clinically diagnosed and finally confirmed during surgery. 91 patients (75.83%) had an indirect inguinal hernia, 29 patients (24.17%) had a direct inguinal hernia. There were no significant complications during the procedure or postoperative death. There were complications in 42 (35%). They were all managed conservatively. Conclusion: Inguinal hernia is very common in men, and Lichtenstein repair can be performed safely, quickly, without stress, with excellent results in surgical departments, fewer postoperative complications, and minimal chance of recurrence.

Inguinal Hernia, Lichtenstein Repair, Propylene Mesh, Open Hernia Repair.

Assessment of the Neurological Outcome after External Ventricular Drainage: A Comparative Study in a Tertiary Care Hospital, Chittagong, Bangladesh

Mohammad Nazrul Hossain1*, Mohammad Humayun Rashid2, Md. Manzoorul Islam3, Israt Zerin Eva4, Rumana Kamal5, Mahmudul Hasan6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 494-503

Assessment of the Neurological Outcome after External Ventricular Drainage: A Comparative Study in a Tertiary Care Hospital, Chittagong, Bangladesh

Mohammad Nazrul Hossain1*, Mohammad Humayun Rashid2, Md. Manzoorul Islam3, Israt Zerin Eva4, Rumana Kamal5, Mahmudul Hasan6

Abstract

Background: IVH is classified as either primary, involving the ventricular system and adjacent ependymal lining, or secondary to intracerebral hemorrhage or subarachnoid hemorrhage with extension into the ventricular system. When IVH is large enough to impede normal cerebrospinal fluid (CSF) circulation, acute obstructive or non-communicating hydrocephalus can occur. Many neurosurgical procedures have been enhanced by the application of computer-assisted navigation, using a combination of imaging and patient anatomy. The history of EVD is a great example of technical innovation and evolution in the field of neurosurgery. Aim of the study: To assess the neurological improvement of the patient after external ventricular drainage by assessing the Glasgow coma scale (GCS) score, Glasgow outcome scale (GOS) score, and modified Rankin (mRS) score pre and postoperatively. Methods: This is a Quasi-experimental study conducted in the Department of Neurosurgery, Chittagong Medical College Hospital, Chittagong, Bangladesh during the period from 24th July 2018 to 23rd July 2019. After a detailed history and clinical examination, 150 Patients were selected for this study. The study participants were divided into two major groups- EVD and Conservative; both groups consisted of 44 patients. Based on inclusion and exclusion criteria, 43 patients were excluded, among them 18 patients had GCS 3 with non-reacting pupil, 8 patients needed surgical evacuation of haematoma and 7 patients legal guardian did not want to continue with the study procedure, 10 patients were dropped out due to not attend to follow up schedule.Results: This prospective quasi-experimental study was conducted to compare the outcome of patients with a spontaneous IVH managed with or without EVD. This study also observes demographic and hemorrhagic characteristics among participants. Table I depicts that, both the groups were similar in terms of age and sex distribution. Overall mean age was around 60 years with an age range from 15-85 years. More than three fourth of the patients in both groups were from the age group of >50 years (73.83%). The male to female ratio was almost equal in both groups (p = 0.374). The mean GCS score level was significantly lower in the patients with EVD than their counterparts from 1st post-operative day to 8th post-operative day. However, within-group comparison shows that the GCS score was significantly increased from 1st day to 8th day in both groups of patients. To compare the outcome of EVD and conservative treatment following spontaneous IVH GOS score were assessed at discharge and after 3 months. Among the patients who underwent EVD at discharge, most of the patients (93.3%) were either severely disable or moderately disable. On the contrary, after 3 months majority of the patients (81.5%) were either moderately disable or had a mild disability. After 3 months there was no significant difference in the GOS score category between the patients who underwent EVD or were treated conservatively after spontaneous IVH. During discharge, there was no significant difference in the mRS score category between the patients who underwent EVD or were treated conservatively after spontaneous IVH. Conclusion: EVD is an effective interventional modality in the armamentarium of the neurosurgeon to rapidly reduce life-threatening mass effects. This data can be used to develop evidence-based protocols for EVD use.

IVH, Ventricular System, Neurological Improvement, Glasgow Coma Scale, Glasgow Outcome Scale, Modified Rankin

Demographic and Hemorrhagic Characteristics of Intraventricular Hemorrhage: A Study in a Tertiary Care Hospital, Chittagong, Bangladesh

Mohammad Nazrul Hossain1, Mohammad Humayun Rashid2, Md. Manzoorul Islam3, Israt Zerin Eva4, Rumana Kamal5, Mahmudul Hasan6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 504-512

Demographic and Hemorrhagic Characteristics of Intraventricular Hemorrhage: A Study in a Tertiary Care Hospital, Chittagong, Bangladesh

Mohammad Nazrul Hossain1, Mohammad Humayun Rashid2, Md. Manzoorul Islam3, Israt Zerin Eva4, Rumana Kamal5, Mahmudul Hasan6

Abstract

Background: Intraventricular hemorrhage (IVH) is an acute neurosurgical condition. The incidence of intraventricular hemorrhage (IVH) is increasing nationwide, correlating with an aging and vasculopathic patient population coupled with the widespread use of anticoagulant and antiplatelet medications among which primary IVH occurs in 30% and secondary IVH occurs in 70% of the patients. Aim of the study: the aim of the study is to assess the demographic and hemorrhagic characteristics of Intraventricular hemorrhage. Methods: This is a Quasi-experimental study conducted in the Department of Neurosurgery, Chittagong Medical College Hospital, Chittagong, Bangladesh during the period from 24th July 2018 to 23rd July 2019. After a detailed history and clinical examination, 150 Patients were selected for this study. The study participants were divided into two major groups- EVD and Conservative; both groups consisted of 44 patients. Based on inclusion and exclusion criteria, 43 patients were excluded, among them 18 patients had GCS 3 with non-reacting pupil, 8 patients needed surgical evacuation of haematoma and 7 patients legal guardian did not want to continue with the study procedure, 10 patients were dropped out due to not adhering to the follow-up schedule.Results: This prospective quasi-experimental study was conducted to compare the outcome of patients with a spontaneous IVH managed with or without EVD. This study also observes demographic and hemorrhagic characteristics among participants. The result of the study is presented in the following pages in tables and column charts. Both the groups were similar in terms of age and sex distribution. Overall mean age was around 60 years with an age range from 15-85 years. More than three fourth of the patients in both groups were from the age group of >50 years (73.83%). The male to female ratio was almost equal in both groups (p = 0.374). There were no differences between EVD and conservative groups regarding medical comorbidities. The most prevalent comorbidity among the patients of both groups was hypertension, followed by diabetes and previous ischemic stroke. The distribution of other predisposing factors and risk factors were also similar in both groups. Overall the most frequent symptoms found in the studied patients were vomiting, followed by loss of consciousness, headache and convulsion. After adjustment patients who were treated conservatively were 3.98 times more likely to die within 90 days than the patients who had EVD. Other independent predictors were higher age, lower GCS at admission, and presence of hydrocephalus on CT. Conclusion: All the patients received at least 1 scan during this time frame but they were not performed on the same post bleed day. It is possible that not all worsening or improvement in IVH was included in our analysis. Neuroimaging facilities should be round the clock for providing the earliest intervention where possible. Resuscitation and monitoring facilities should be dynamic.

Intraventricular Hemorrhage, Neurosurgery, Demographic and Hemorrhagic Characteristics, Quasi-Experimental Study

Outcome of Braun Enteroenterostomy after Pancreaticoduodenectomy

Md. Asaduzzaman Nur1*, Bidhan C. Das2, Mortaza Ahsan3, Zabiul Islam4, Emrul Hasan Khan5, Omar  Siddique6, Nur Alam Siddique7, Shovita Rana8, Md. Saief Uddin9, Zulfiqur Rahman Khan10

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 513-519

Outcome of Braun Enteroenterostomy after Pancreaticoduodenectomy

Md. Asaduzzaman Nur1*, Bidhan C. Das2, Mortaza Ahsan3, Zabiul Islam4, Emrul Hasan Khan5, Omar  Siddique6, Nur Alam Siddique7, Shovita Rana8, Md. Saief Uddin9, Zulfiqur Rahman Khan10

Abstract

Background: Importance of Braun anastomosis after pancreatoduodenectomy (PD) is ignored by surgeon as it requires extra time and anastomosis related complications. This study is undertaken to check the outcome of braunenteroenterostomy after PD. Methods: Nineteen patients who underwent PD in BSMMU from July   2018 to June  2019 were included in the study. They were divided into two groups; Group 1: patient with Braun anastomosis after PD (n=9) and Group 2: patient without Braun anastomosis after PD (n=10). Each patient was followed up to three months (1visit/month) after surgery. Clinical symptoms were recorded in every visit. On the 3rd visit endoscopic examination was performed and biopsy was taken from remnant gastric mucosa reports were recorded. All these findings were compared between two groups. Results: Clinical symptoms related to gastric alkaline reflux were noted only in one patient (11.1%) of Group 1, in contrast it was noted in 5 (62.5%) patients of Group 2. No bile reflux to remnant stomach occurred in Group 1 patients, in contrast it occurred in 6 (75%) patients of Group 2 (p <0.05). Gastritis was noted in 2 (25%) patients of Group 1, in contrast it was noted in 5 (62.5%) patients of Group 2. Gastric epithelial changes are seen (hyperplasia, metaplasia) in 2 (25%) patients of Group 1 and in 3 (37.5%) patients of Group 2. Conclusion: Braun anastomosis after PD can reduce the ARG in the remnant stomach and thus it can improve the early postoperative quality of life and can prevent dysplasia-carcinoma sequence in the future.

Outcome, Braun Enteroenterostomy, Pancreaticoduodenectomy

Role of White Test in Prevention of Bile Leakage after Liver Surgery

Mohammad Emrul Hasan Khan1, BidhanChandra Das2, Md. Asaduzzaman Nur3, Arun Kumar Pal4, Abdullah Md Abu Ayub Ansary5, Md. Mashiur Rahman5, S M Mortaza Ahsan5, Md. Armanul Islam6, Md. Zulfiqur Rahman Khan7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 520-528

Role of White Test in Prevention of Bile Leakage after Liver Surgery

Mohammad Emrul Hasan Khan1, BidhanChandra Das2, Md. Asaduzzaman Nur3, Arun Kumar Pal4, Abdullah Md Abu Ayub Ansary5, Md. Mashiur Rahman5, S M Mortaza Ahsan5, Md. Armanul Islam6, Md. Zulfiqur Rahman Khan7

Abstract

Background: Post-operative bile leakage is a troublesome complication following liver surgery, with a reported incidence ranging from 3 to 27% in different series. Bile leak may be prevented by per-operative leakage test. Some studies have shown that bile leakage test using fat emulsion (White Test) is safe and effective. So this study was done to assess the effect of White Test on per-operative detection and post-operative prevention of bile leakage after liver surgery. Methods: This prospective analytic study was conducted in the Department of Hepatobiliary Pancreatic & Liver Transplant Surgery (HBPLTS), Bangabandhu Sheikh Mujib Medical University (BSMMU) from September’ 2018- August 2019. Data is presented in the form of tables, figures and graphs, as necessary. Statistical analyses of the results were done by using statistical software SPSS version 25. Means, standard deviations, percentage frequencies were determined as indicated. Results: Fifty (50) patients of liver surgery for different liver diseases were included, 4 patients were excluded. So, 46 patients were assigned either in Group A (Bile leak test not performed) (n23) or in Group B (White Test performed) (n23). Data of main outcome variables – WT result, number of BL site identified during operation, incidence of post-operative BL, post-operative hospital stay (day) were recorded. Demographic variable and surgical procedure types were similar in both groups. White Test was well tolerated by all patients of Group B. Per-operative identification of bile leak site was significantly higher in Group B (82.60% vs. 30.43%) (p=.001). Incidence of post-operative bile leak was significantly lower in Group B (8.70% vs. 34.87%) (p=.032). Post-operative hospital stay was also significantly higher in Group A {7.09 (± 2.46) vs. 11.78 (± 7.44) days} (p=.006). Conclusion: There was no significant difference of post-operative complications between two groups. White Test was effective in per–operative detection of bile leaks. It can effectively prevent post-operative bile leakage after liver surgery.

White Test, Prevention, Bile Leakage, Liver Surgery

Influence of Temperature on Antimicrobial Efficacy of Various Endodontic Irrigants: An in Vitro Study

Deebah Choudhary1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 529-534

Influence of Temperature on Antimicrobial Efficacy of Various Endodontic Irrigants: An in Vitro Study

Deebah Choudhary1

 

Abstract

Background: Aim: The aim of this study was to compare the antimicrobial efficacy of 5.25% NaOCl, 2% CHX, and 17% EDTA at 25oC, 45oC, and 60oC in extracted bovine incisor teeth. Methods: Two hundred dentin tubes were prepared and infected for 28 days with Enterococcus faecalis. The samples were divided into the following groups: Group I (n=20): 5.25% NaOCl at 25oC, Group II (n=20): 2% CHX at 25oC, Group III (n=20): 17% EDTA at 25oC, Group IV (n=20): 5.25% NaOCl at 45oC, Group V (n=20): 2% CHX at 45oC, Group VI (n=20): 17% EDTA at 45oC, Group VII (n=20): 5.25% NaOCl at 60oC, Group VIII (n=20): 2% CHX at 60oC, Group IX (n=20): 17% EDTA at 60oC, Group X (n=20): Sterile dentin tubes. Dentin chips were collected with round burs in YG broth. After culturing on tryptic soy agar (Difco) for 48 h at 37oC, bacterial colonies were counted and recorded as colony-forming units (CFU). Variables were expressed as means ± standard deviation. Tukey’s multiple post hoc test was used for comparisons among the groups. Significance level was set at p<0.05.Results: The maximum number of CFUs was seen in NaOCl (49.514 at 20oC), thus meaning lower antimicrobial efficacy. The least amount of mean bacterial content was seen for 2% chlorohexidine (12.779 at 60OC). Tukey test showed significant difference between 5.25% NaOCl at 25oC and 45oC, 2% CHX 25oC and 17% EDTA 45oC (p>0.05). Conclusion: All the irrigating solutions showed a significant reduction in the CFU numbers over a temperature rise.

Antimicrobial Efficacy, Enterococcus Faecalis, Endodontic Irrigant, Sodium Hypochlorite

A Comparative Evaluation of Conventional Vs Endovac Irrigation System in Primary Molars

Tanvi Bharti1, Anuradha2, Priyanka Choudhary3, Sidhant Sudan4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 535-539

A Comparative Evaluation of Conventional Vs Endovac Irrigation System in Primary Molars

Tanvi Bharti1*, Anuradha2, Priyanka Choudhary3, Sidhant Sudan4

Abstract

Background: EndoVac irrigation system which was introduced in 2006 and works on the principle of apical negative pressure. The present study was conducted to compare conventional vs Endovac irrigation system in primary molars. Methods: 40 human extracted primary molars which were divided into two groups of 20 in each group with an equal distribution of apical foramen area. Group I roots were treated with Endovac and group II with manual irrigating system. Results: The mean weight of extruded irrigant with group I was 1.21 grams in with group II was 2.31 grams. The percentage of penetration depth of the irrigant into dentin at 2 mm was 15.4%, at 4 mm was 32.6% and at 6 mm was 49.6 mm in group I and 5.48%, 14.8% and 30.5% at 2 mm, 4 mm and 6 mm in group II respectively. The difference was significant (P< 0.05). Conclusion: EndoVac irrigation system found to be superior as compared to the manual irrigation system in primary molars.

Endovac, Molars, Irrigation System

Dentin Hypersensitivity: A Review of its Treatment Modalities

Adel A. Alrusayes1, Nader A. Assal2, Aref M. Althobity3, Yazeed K. Alfraih3, Moath I. Alfraih3, Mohammed S. Aldossary2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 540-553

Dentin Hypersensitivity: A Review of its Treatment Modalities

Adel A. Alrusayes1, Nader A. Assal2, Aref M. Althobity3, Yazeed K. Alfraih3, Moath I. Alfraih3, Mohammed S. Aldossary2

Abstract

Background: An important clinical issue faced in routine dental practice is dentin hypersensitivity (DH). Managing this condition requires a clear understanding of the complexity of the issue, as well as the variety of currently available treatment modalities.In order to assess the evidence supporting the current treatment options, the purpose of this article was to review treatment modalities for DH with various mechanisms of action and delivery modes. Methods: A comprehensive literature review was carried out using electronic databases. Results: Treatment with nerve desensitizers and dentinal tubule occlusion agents will minimize the short-term symptoms of DH, but the long-term outcome of such therapies is unclear. There is also a need to provide DH patients with more effective relief. Conclusion: It is evident from the currently available scientific literature that there is no recognized ideal desensitizing product that offers both fast-acting and long-lasting protection against DH-related pain.

Dentin Sensitivity, Dentin Desensitizing Agents, Oral Health, Dental Care

Radix Entomolaris, A Rare Dental Finding

Dazwinder Kaur1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 554-557

Radix Entomolaris, A Rare Dental Finding

Dazwinder Kaur1*

Abstract

The hard tissue repository of the human dental pulp takes on numerous configurations and shapes. A thorough knowledge of tooth morphology, careful interpretations of eccentric radiographs, proper access preparation and detailed exploration of the interior of the tooth are essential prerequisites of successful treatment outcome. Human permanent molars exhibit a varied anatomy. Mandibular molars play a principal role in mastication and help to maintain the vertical dimension of the face, continuity of the dental arch, maintain the cheeks and tongue in position and sustain a healthy aspect by conserving the filling of the cheeks. It is known that the mandibular first molar can display several anatomical variations and, like the number of root canals, the number of roots may also vary. A major anatomical variant of the two-rooted mandibular first molar is the third root known as Radix Entomolaris (RE). Here we present a rare case report of mandibular first molar having third root known as Radix Entomolaris (Figure 2 and 3) in a 35- year-old female who initially presented with spontaneous pain on lower right side of the mouth and was finally diagnosed having an acute, reversible pulpits with incidental finding of mandibu lar first molar having three roots.

Radix Entomolaris,  SLOB RULE, Peri-Apical Radiography, Distal Caries, Reversible Pulpitis

Complication of Regeneration of Bone in the Extracted Third Molar Sockets Augmented without using Beta Tricalcium Phosphate

Muhammad Mubashirul Haque1, Mostafa Md. Anisuzzaman2, Sajid Hasan3, Nubad Adnan4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 558-565

Complication of Regeneration of Bone in the Extracted Third Molar Sockets Augmented without using Beta Tricalcium Phosphate

Muhammad Mubashirul Haque1*, Mostafa Md. Anisuzzaman2, Sajid Hasan3, Nubad Adnan4

Abstract

Background: Mandibular third molar surgical extraction may not be benefited without using Beta Tricalcium Phosphate complications on the distal aspect of the root of the adjacent mandibular second molar. Patients older than 18 years with using Beta Tricalcium Phosphate pathology on the distal surface of the mandibular second molar and a horizontal/ mesioangular impacted mandibular third molar may benefit from bone regenerative therapy at the time of surgery. Methods: This was an experimental study. 20 patients (Group-A) whose were prepared on Alloplastic bone substitute and another 20 patients (Group-B) whose were without alloplastic bone substitute. 40 patients were selected under group where surgical extraction of mandibular horizontal impacted 3rd molar by using standard conventional method was followed by alloplastic bone substitute, Beta tricalcium phosphate another 20 patients was selected under this group where surgical extraction of mandibular horizontal impacted 3rd molar by using standard conventional method was followed by without alloplastic bone substitute, Beta tricalcium phosphate. Post-operative clinical examination and radiological examination were performed at one day then at 1, 3, 6 months postoperatively. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: Majority of the patients 22(55.0%) were of 18-25 years age group and another 15(37.5%) were at their 26-35 age group. Mean±SD age of the patients were 25.97±4.99 years. Rate of infection are found to be lower among the patients managed with alloplastic bone substitute reinforcement. Statistical test endorses the association between type of management and occurrence of infection. Conclusion: The results suggest that if we use β-TCP/CS at mandibular third molar post-extraction sites, it will be good where bone regeneration methods are indicated. On the other hand, if we don’t use β-TCP/CS on extraction sites, good result will not come.

Mandibular third molars; Bone regeneration; β-tricalcium phosphate; Calcium sulfate; Bone gain.

Comparison of the Percentage of Voids in the Canal by Using Two different Obturation Techniques

Ravinder Kumar Bhagat1, Ankush Jasrotia2, Kanchan Bhagat3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 566-572

Comparison of the Percentage of Voids in the Canal by Using Two different Obturation Techniques

Ravinder Kumar Bhagat1, Ankush Jasrotia2*, Kanchan Bhagat3

Abstract

Background: This study evaluated the sealing ability of obturation technique in type II root canal through the comparison of the presence of voids between the single-cone technique using calcium silicate-based sealer and continuous wave compaction technique using resin-based sealer. Methods: This study used 30 extracted human maxillary single-rooted premolars that were instrumented with rotary nickel-titanium instrument and randomly assigned to two groups. The root canals were obturated with either single-cone technique using calcium silicate-based sealer or with continuous wave compaction technique using resin-based sealer. The presence of voids in the samples in mesio-distal directions were evaluated using radiographs. Results: There were more voids in the total volume and coronal third of the roots in the single-cone technique group than in the continuous wave compaction technique group. However, there was no significant difference in the percentage volume of voids in the middle and apical thirds of the roots between the two groups. Additionally, there was no significant difference between two groups with respect to external voids. Conclusion: Within limitation of this study, SC technique with calcium silicate-based sealer should be used very carefully in type II root canals.

Continuous wave compaction (CWC), Root canal obstruction, Single-cone technique, Voids

Effectiveness of Breathing Exercises in Patients with COPD

Sunita Grover1, Bindu Goyal2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 573-577

Effectiveness of Breathing Exercises in Patients with COPD

Sunita Grover1, Bindu Goyal2

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is one of the most common life-threatening diseases affecting populations globally. The present study conducted to assess effectiveness of breathing exercises in patients with COPD. Methods: 60 COPD patients of both genders (Group I) and equal number of healthy control were also recruited (Group II) Patients were prescribed PLB, VF training, VF plus exercise, singing, DBE, and combined BEs training. Parameters such as ventilation, dyspnea, exercise capacity, and QoL and ventilation-related outcomes included respiratory rate (RR), tidal volume (VT) etc. were recorded. Result: The mean respiratory rate (RR) in group I was 20.4 and in group II was 23.8, tidal volume was 628.2 in group I and 480.4 in group II, inspiratory time was 1.52 in group I and 1.30 in group II, total respiratory time was 4.40 in group I and 3.42 in group II and oxygen consumption was 1024 in group I and 1124.6 in group II. The difference was significant (P< 0.05). Conclusion: There was improvement in all parameters in COPD as well as in control group, hence can be concluded that exercises have great impact on respiratory functions.

Chronic Obstructive Pulmonary Disease, Dyspnea, Quality of Life

A Scientific Study on Assessment and Regulation of Trigunain Context of Quality of Life

Indu Kumari1, Srikanta Kumar Panda2, Nishi Arora3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-3 | May-June, 2021 | Page: 578-538

A Scientific Study on Assessment and Regulation of Trigunain Context of Quality of Life

Indu Kumari1, Srikanta Kumar Panda2, Nishi Arora3

Abstract

Background: The manifestation of the Gunas and their influence on the human mind and behavior has interested psychologists and researchers across the world. The present study was conducted to assess Triguna and quality of life followed by Yogic Kriya intervention. Methods: 60 healthy volunteers were assessed using questionnaire of WHO QOL and David Wolf VPI before and after the intervention of Suryanamaskar and Pranayama. Assessment was done clinically on the basis of improvement of subjective parameters. Triguna and quality of life assessment of volunteers was evaluated on the basis of David Wolf VPI and WHO QoL (BREF) scale before and after the intervention of Yogic Kriya. Results: The mean value of physical health was 59.73 before Yogic Kriya and it is enhanced to 74.53 after Yogic Kriya, mean value of psychological state parameter was 61.67 before Yogic Kriya and it is enhanced to 75.82 after Yogic Kriya, mean value of social relation was 67.18 before Yogic Kriya and it is enhanced to 84.82 after Yogic Kriya. The mean value of Sattva was 43.68 before Yogic Kriya and it is enhanced to 48.25 after Yogic Kriya, the mean value of Raja was 30.72 before Yogic Kriya and it is lowered down to 29.43 after Yogic Kriya, mean value of Raja was 25.63 before Yogic Kriya and it is lowered down to 22.32 after Yogic Kriya. Conclusion: Yoga has the potential to become an essential baseline modality in all health work, be it for cure or prevention or the promotion of positive QoL.

Sattva, Rajas, Yoga