Annals of International Medical and Dental Research (AIMDR) 

Vol-9, Issue-3 | May-June, 2023

Breast Self-Examination: An Early Familiar Diagnostic Test of Breast Cancer

Husneara Begum1*, Md Asadullah2, Sharmin Hossain3

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 1-8 | DOI: 10.53339/aimdr.2023.9.3.1

Breast Self-Examination: An Early Familiar Diagnostic Test of Breast Cancer

Husneara Begum1*, Md Asadullah2, Sharmin Hossain3

Abstract

Background: Among female patients’ breast cancer are a growing threat for over a century. In women, breast cancer is the most common malignancy universally such as 154 of 185 nations. Breast self-examination (BSE) is a simple, very low-cost, non-invasive early detection method used to detect early breast cancer, which involves the woman herself looking at and feeling for any change in their breast as early as possible, which yields a better survival rate. BSE should be done for all women older than 20 years. This study intended to determine knowledge, attitude, and practice (KAP) of breast cancer among medical and non-medical undergraduate students. Material & Methods: A descriptive cross‑sectional study was conducted from October to November 2019 to assess the knowledge, attitude, and practice of BSE. The target population consisted of undergraduate female medical and non‑medical students. A total of 154 (N=154) undergraduate female students participated in this study. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Results: Among the study population (N=154) with an early familiar diagnosis of breast cancer ”breast self-examination, the mean age of them was 20.434±4.38. Of seventy-eight respondents (n=78), breast cancer screening test was heard by around half of the medical students (42, 53.8%) & of seventy-six non-medical respondents (n=76), around three-fifth of them (46, 60.5%) did not hear about breast cancer screening test. There was no significant relationship between them (p=0.394). Forty medical students (40, 51.3% and twenty-five non-medical students (25, 32.9%) had no idea, twenty-four medical students (24, 30.8%) & forty-three (43, 56.6%) non-medical students had monthly BSE done. Conclusion: Initial diagnosis and treatment of breast cancer have a definite survival benefit. So early detection is an issue of necessity to be uplifted. The results of the present study suggested that knowledge regarding breast cancer, its risk factors, sign symptoms, prevention measures, and performance of BSE is insufficient.

Diagnosis, Breast cancer, BSE, Females.

The Socio-Demographic Factors and Causes of Substance Abuse Relapse: 36 Cases

Shah Mohammad Ashek Uddin Bhuiyan1*, Md. Azizul Islam2, A H M Kazi Mostofa Kamal3, Mahbuba Akhter Jahan4

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 9-15 | DOI: 10.53339/aimdr.2023.9.3.2

The Socio-Demographic Factors and Causes of Substance Abuse Relapse: 36 Cases

Shah Mohammad Ashek Uddin Bhuiyan1*, Md. Azizul Islam2, A H M Kazi Mostofa Kamal3, Mahbuba Akhter Jahan4

Abstract

Background: Relapse is frequent among substance abusers all across the world, and Bangladesh is no exception. Drug-related issues are gradually becoming a hot topic in Bangladesh, from a social, economic, and medical standpoint. The present study aimed to find out sociodemographic factors associated with relapse amongst substance abuser. Material & Methods: This descriptive type of observational study conducted in the Combined Military Hospital and other Government/Private Hospital/Institute especially Central Drug Addict Treatment Center, Dhaka with a total sample size of 36 participants. Detailed information was obtained in each case according to protocol through complete history from patients or their accompanying attendants using a data collection sheet which was read out to them in Bangla. All the information was recorded in the pre fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS-23. Results: The study found that yaba was the most commonly abused drug among 36 participants, with 27.78% reporting abuse. 27.78% of participants had a psychiatric illness, with the majority being male (97.22%) and Muslim (88.89%). The largest group of participants were aged 31-40 (47.22%) and most were unemployed (83.33%) and married (94.44%). Peer pressure and family problems were the most commonly reported causes of relapse (91.67% and 83.33%, respectively). Other factors such as unemployment, depression, and failure in life also contributed to relapse. Conclusion: Yaba was the most prevalent substance of abuse and the majority of participants were male, had a psychiatric illness, and were unemployed. Peer pressure and family problems were the main causes of relapse.

Drugs, Substance-Abuse, Rehabilitation, Relapse.

Clinical and Laboratory Characteristics of Infertile Women with Premature Ovarian Insufficiency

Nazia Sultana1*, Priyanka Podder2, Mst. Nurjahan Begum3, Mitra Biswas4, Rafiq- Ul- Alam5

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 16-22 | DOI: 10.53339/aimdr.2023.9.3.3

Clinical and Laboratory Characteristics of Infertile Women with Premature Ovarian Insufficiency

Nazia Sultana1*, Priyanka Podder2, Mst. Nurjahan Begum3, Mitra Biswas4, Rafiq- Ul- Alam5

Abstract

Background: Premature ovarian insufficiency (POI) is the preferred term for the condition that was previously referred to as premature menopause or premature ovarian failure. The condition differs from menopause in that there are varying and residual ovarian functions. This study aimed to analyze the clinical characteristics of infertile women with premature ovarian insufficiency. Material & Methods: This prospective study was conducted at the OPD of Impulse Fertility Center, Impulse Hospital, Dhaka, Bangladesh. The study was conducted for a period from January 2022 to December 2022. A total of 23 patients who received outdoor treatment during the study period were purposively selected as sample size. A purposive sampling technique was followed in this study. After approval by the Ethics committee of the Hospital, informed consent from the respondents was obtained after explaining the purpose of the study to them. To be included in the study, respondents should have met the classical definition of infertility defined by the WHO as the inability of a sexually active non-contraceptive using woman to have a live birth after 12 or more months of regular sexual intercourse without a malefactor. Women who had male-factor infertility were excluded. In this study live birth was used as a measure of proven fertility (Because couples desire children, not simply pregnancies, infertility affects couples regardless of whether the etiology lies in conception or the progression of the pregnancy). All the necessary laboratory investigations were done. A questionnaire was developed and data were collected by interviewing the patients and some data were collected from the laboratory results. Data were processed and analyzed by SPSS 19 version. Results: All patients had normal puberty, and menarche occurred at ages 11–15, followed by a regular menstrual cycle. Women who presented with oligomenorrhea were younger than patients with infertility. The mean period of oligomenorrhea before diagnosis was 0.9 years in the oligomenorrhea group and 1.8 years in the infertility group. The mean age when the infrequent periods started was 28 years in the group with oligomenorrhea and 29 years in the group with infertility, and their anthropometric characteristics were not different. In most patients, the FSH levels on day 3 of their menstrual cycle were less than 25 mU/ml. FSH levels >25 mU/ml were confirmed in two patients with oligomenorrhea and five patients in the infertility group. AMH levels were low than 1.0 ng/ml (considered to be in poor ovarian reserve ranges: from 0.13 to 1.0 ng/ml in patients with oligomenorrhea and from 0.13 to 0.9 ng/ml in the infertility group.

Transvaginal ultrasound-determined AFC on menstrual cycle days 4–8 was accessed in all patients. We consider AFC < 6 small follicles (diameters 3–9 mm) as a low ovarian reserve indicator. The lowest AFC (one small follicle) was noted in one infertile patient with oligomenorrhea. Conclusion: This study concluded that the subjects usually present with menstrual irregularity (oligomenorrhea) or infertility, and after proper evaluation, their poor ovarian reserve can be confirmed and an occult form of POI established. women who presented with only oligomenorrhea were younger than infertile patients; therefore, menstrual irregularity may be the earliest clinical symptom of occult POI.

Premature Ovarian Insufficiency (POI), AMH, FSH.

Clinical Profile, Laboratory Parameters & Complications in Pregnancy with Jaundice: A Study in DMCH, Dhaka, Bangladesh

Farjana Sharmin1*, Zinat Begum2, Nurunnahar Khanam3, Farhana Ahasan4

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 23-32 | DOI: 10.53339/aimdr.2023.9.3.4

Clinical Profile, Laboratory Parameters & Complications in Pregnancy with Jaundice: A Study in DMCH, Dhaka, Bangladesh

Farjana Sharmin1*, Zinat Begum2, Nurunnahar Khanam3, Farhana Ahasan4

Abstract

Background: Pregnancy with jaundice is considered a high-risk pregnancy. It is the most usual health complaint in pregnant women found more often in developing countries than in developed ones. Jaundice can be concurrent with 1st trimester due to pathological infection for instance viral hepatitis or gall stones or due to the drug administered during pregnancy. These patients may feel better if initial diagnosis and suitable management are provided. This present study intended to evaluate the clinical profile & complications of jaundice during pregnancy. Material & Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2012 to June 2012. A total (N=50) of pregnant women with symptoms of jaundice were enrolled in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 16.0. Descriptive inferential statistics were performed to determine the results of this study. Results: Among the study population (N=50), the majority of patients (34, 68.0%) age were between 20 to 24 years. The mean gestational age of patients was 35.3±3.2 weeks and twelve patients (12, 24.0%) underwent caesarean delivery. Based on clinical features, twenty-seven respondents (27, 54.0%) had mild jaundice, fourteen respondents (14, 28.0%) had moderate jaundice & about one-fifth of the patients (9, 18.0%) had severe jaundice. Fifteen pregnant (15, 30.0%) women had a fever, around two-fifth of the patients (19, 38.0%) had vomiting, pruritus in one patient (1, 2.0%), vaginal bleeding in twelve patients (12, 24.05), & more than half of the patients (27, 54.0%) had ruptured membrane. The causes of jaundice during pregnancy were viral hepatitis in forty-three patients (43, 86.0%). The majority of the patients (27,54.0%) had serum bilirubin less than 10mg, fourteen patients (14,28.0%) had 10 to 15mg of serum bilirubin & only one patient (1,2.0%) had serum bilirubin more than 20mg. SGOT & SGPT was found 100-500 IU/ml in twenty-three patients (23,46.0%) & 500-1000 IU/ml in ten patients (10,20.0%). Alkaline was raised in eighteen cases (18, 36.0%) Based on maternal complications, the majority of patients (31, 62.0%) had a postpartum haemorrhage, and ten patients (10, 20.0%) experienced encephalopathy. Thirty-eight babies (38, 76.0%) were born alive, intrauterine death was in seven cases (7, 14.0%), and stillborn in five cases (5, 10.0%). Conclusion: Hepatitis E was the most common cause of viral hepatitis in our study. Major complications were postpartum haemorrhage and encephalopathy. This study also prevailed, jaundice in pregnancy is related to an increase in maternal mortality and morbidity, obstetric complications, and perinatal complications.

Pregnancy, Jaundice, Maternal, Fetal, Prenatal, Complications

Pott’s Disease– When & How to Operate?

Md. Ruhul Kuddus1*, Shamiul Alam Siddique2, Robert Ahmed Khan3, Hafiz Asif Raihan4, Md. Bashir Ahammed5, Abdullah Al Mahbub6, Md. Hasanur Rahman7

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 33-39 | DOI: 10.53339/aimdr.2023.9.3.5

Pott’s Disease– When & How to Operate?

Md. Ruhul Kuddus1*, Shamiul Alam Siddique2, Robert Ahmed Khan3, Hafiz Asif Raihan4, Md. Bashir Ahammed5, Abdullah Al Mahbub6, Md. Hasanur Rahman7

Abstract

Background: Pott’s disease is a rare form of extrapulmonary tuberculosis that manifests in a variety of clinical patterns. Delays in diagnosis and treatment can lead to serious complications. About 10-40% of patients with spinal tuberculosis may have a neurological deficit. Urgent measures are needed to halt the progression of the disease and deformity, especially to prevent and overcome paraplegia. In regards to management, every case is different and has a unique procedure. It includes simple medical management, simple decompression and debridement, anterior approach, and posterior approach, etc. Surgical decompression of the cord and instrumentation are needed in many cases besides chemotherapy. Although the anterior approach is used for cervical Pott’s disease but this procedure is very time-consuming and technically difficult in the lumbar and dorsal spine, especially in compromised patients and morbidity is more. The posterior approach alone is enough for achieving adequate decompression, debridement, reduction, fusion, reconstruction of the body, and maintaining sagittal alignment in the dorsal and lumbar Pott’s spine. The aim of the study was to describe the treatment modality and observe the outcome of treatment methods and incidence rate of infection sites among the patients of Potts spine. Material & Methods: This retrospective study was conducted at the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh. The study duration was 7 years, from March 2016 to January 2023. During this period, a total of 30 cases of Pott’s disease were included in the study following inclusion and exclusion criteria. Results: 53.33% had been from the youngest age group of 15-34 years, and 80 % were male. Very few participants had been female in the present study. Back pain was the primary complication for 50% of cases, while spinal infection was observed in the cervical region for 16.67% of cases, 43.33% had infections in the dorsal region, and 30 % in the lumbar region. 10.00% of the participants had been treated with non-surgical methods, with only anti-TB medication for 18 months or more. Posterior decompression was the most common treatment method, with 23.33% having only posterior decompression, and 40.00% having posterior decompression with the use of additional instruments. Conclusion: The study observed that Pott’s disease was most common among young adult males, and the most common sites of spinal infections were in the dorsal and lumbar regions in the present study population, contradictory to the general findings. Decompression treatment, with and without additional instruments, was the most common form of treatment among the present study population.

Tuberculosis, Spinal, Pott’s Disease, Infection.

MRI as a Diagnostic Tool for the Determination of Acute Ischaemic Stroke: A Study in a Tertiary Care Hospital

Md Tanshed Arafat1*, Syed Zuherul Alam2, Tanjima Yeasmin Liza3, Tanshina Afrin4, Muhammad Minhaz Rashid Bhuiya5

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 40-47 | DOI: 10.53339/aimdr.2023.9.3.6

MRI as a Diagnostic Tool for the Determination of Acute Ischaemic Stroke: A Study in a Tertiary Care Hospital

Md Tanshed Arafat1*, Syed Zuherul Alam2, Tanjima Yeasmin Liza3, Tanshina Afrin4, Muhammad Minhaz Rashid Bhuiya5

Abstract

Background: Stroke is a prevalent and potentially fatal medical condition that affects individuals worldwide. Ischemic strokes, caused by arterial blockages, are the most common type, accounting for about 80% of all cases. Hemorrhagic strokes, on the other hand, are less frequent but can have more severe consequences. Accurate and timely diagnosis of stroke is critical for effective treatment and optimal patient outcomes. In this context, diffusion-weighted imaging (DWI) has emerged as a valuable tool for identifying and monitoring ischemic stroke. This article provides an overview of the role of DWI in stroke assessment and management, with a focus on early detection and intervention. The aim of this study is to investigate the reliability of diffusion-weighted MRI (DWI) as an imaging modality in the evaluation of acute ischemic stroke. Material & Methods: This prospective cross-sectional study was conducted at the Department of Radiology and Imaging at the Combined Military Hospital (CMH) in Dhaka, Bangladesh, between June 2020 and June 2021. The study aimed to examine 120 patients clinically diagnosed with acute ischemic stroke. Prior to the study, verbal consent was obtained from all patients. The Study subjects were identified in the emergency and casualty department and had undergone an MRI of the brain in the Department of Radiology and Imaging at CMH, Dhaka. . Data were collected on pre-designed forms, and the relevant information was compiled on a master chart for statistical analysis using SPSS software. Descriptive analysis and frequency of results were presented in the form of tables, pie charts, and bar graphs. The ethical clearance of this study was obtained from the Institutional Ethics Committee of CMH, Dhaka, Bangladesh. Results: The study included 64 males and 56 females with a mean age of 65.2 ± 7.83 years. The majority of patients had an acute ischemic lesion (88.30%) in the MCA (50.0%) with small-sized lesions (41.7%) and low ADC values (90.0%). The most common clinical presentation was hemiplegia (100%), and diffusion-weighted MRI had a high diagnostic accuracy in detecting acute ischaemic lesions (96.3%). Overall, these findings highlight the importance of MRI in the evaluation of stroke patients and can guide clinical decision-making. Conclusion: The present study concluded that DWI in conjunction with ADC map MR imaging is a gold standard diagnostic modality in the evaluation and management of acute ischaemic stroke.

Ischaemic-stroke, MRI, DWI Diffusion, Weighted, Reliable, Modality, evaluation.

Correlation between Colposcopic Findings and Histopathological Results from Colposcopy Directed Biopsy in VIA(+VE) Cases

Mitra Biswas1*, Syma Akter2, Beauty Begum3, Salma Khatun4

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 48-57 | DOI: 10.53339/aimdr.2023.9.3.7

Correlation between Colposcopic Findings and Histopathological Results from Colposcopy Directed Biopsy in VIA(+VE) Cases

Mitra Biswas1*, Syma Akter2, Beauty Begum3, Salma Khatun4

Abstract

Background: Cervical cancer is a major global health problem, with a high burden in developing countries. Early detection and management of precancerous conditions, such as cervical intraepithelial neoplasia (CIN), can help to prevent the development of cervical cancer. Colposcopy, which involves the visualization of the cervix through optical instruments, is considered the gold standard for the diagnosis of cervical abnormalities. The aim of the study was to assess the correlation between colposcopy findings and histopathological results in cases where visual inspection of the cervix with acetic acid (VIA) was positive. Material & Methods: This cross-sectional study was conducted at the Department of Gynecology, Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh. The study duration was 1 year, from November 2017 to October 2018. Participants were recruited from the hospital’s gynecology outpatient department and included 95 women who had a positive VIA test. A Purposive consecutive sampling method was followed for the selection of the participants.  Results: The study included 95 patients in Bangladesh who had a positive VIA test. The age distribution of the patients ranged from 25 to 60 years, with a mean age of 35.89±8.88 years. The majority of patients (85.3%) had acetowhite areas, followed by 11 (11.5%) punctuation and 3 (3.2%) mixed (acetowhite area and mosaicism). Histopathological findings revealed that one-third (33.6%) of patients had chronic cervicitis, with 36 (378.8%) having moderate dysplasia, 16 (16.8%) having mild dysplasia, 7 (7.5%) having invasive carcinoma, and 4 (4.2%) having chronic cervicitis with sq. metaplasia. Among the cases, the comparison between colposcopy-directed biopsy results and Colposcopy findings. It was observed that more than one-fourth of 24(29.7%) patients were chronic cervicitis in pure acetowhite area, 8(72.7%) in punctuation, and all patients were mild dysplasia in mixed (acetowhite area and mosaicism). Among 81 patients 53 patients presented with pre-cancerous lesions. The difference was statically significant (p<0.05) in the study patients.  Conclusion: Colposcopy, which involves the visualization of the cervix through optical instruments, was found to be an effective tool for the diagnosis of cervical abnormalities in these cases. These findings highlight the importance of colposcopy as a diagnostic tool for cervical abnormalities, particularly in resource-limited settings where access to other screening methods may be limited.

Colposcopy, Histopathology, Cervical-Cancer.

Frequency of Acid-Base Derangements Among the Neonates Admitted to the Intensive Care Unit

Ahmed Hosain1*, Mohammad Mohsin2, Sharmin Hussain3, Tahsina Jasmine4, Sarah Alam5, Muhammed Anisur Rashid6, Sufia Khatun Sumi7

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 57-64 | DOI: 10.53339/aimdr.2023.9.3.8

Frequency of Acid-Base Derangements Among the Neonates Admitted to the Intensive Care Unit

Ahmed Hosain1*, Mohammad Mohsin2, Sharmin Hussain3, Tahsina Jasmine4, Sarah Alam5, Muhammed Anisur Rashid6, Sufia Khatun Sumi7

Abstract

Background: Every year deranged acid-base physiology drives admission to a critical care arena for a vast number of neonates. The neonatal intensive care unit is a fundamental sector for the survival of high-risk newborns. The acid-base disorder must always be considered in the clinical setting. The clinician should, in most cases, be able to predict the type of acid-base imbalance before the blood gas is available. Arterial blood gases (ABG-s) are the gold standard for assessing the adequacy of oxygen delivery, ventilation, and pH. This study aimed to assess the frequency of acid-base derangements among neonates admitted to the intensive care unit. Material & Methods: This was an observational cohort study that was conducted in the Neonatal Intensive Care Unit (I.C.U.) of Dhaka Shishu Hospital, Dhaka, Bangladesh during the period from October 2009 to September 2010. In total 230 neonates admitted to the Neonatal Intensive Care Unit, after fulfilling the inclusion criteria were enrolled in this study as study subjects. For each baby, a detailed history was recorded in a questionnaire form (enclosed herewith) from the mother or other caregiver. It was filled up by the researcher himself containing history (including antenatal history), physical examinations and laboratory findings. Arterial blood gas analysis was done (in a clinical biochemistry laboratory using an automatic analyzer machine) for each neonate at admission and that report was recorded for this study. Results: Among the total study subjects, 127 newborn babies (55.2%) had acid-base imbalances. Mixed acidosis prevailed in the highest frequency (23.9%) Then metabolic acidosis cases were at 17.8% and respiratory acidosis was at 13.9%. Metabolic alkalosis and respiratory alkalosis were absent. Normal blood gas was observed in 44.3% of newborns. All the neonates with pH <7 were dead. After Chi-Square analysis (at df=1), we found a highly significant correlation between mortality outcome with pH <7.35, CO2 >45, HCO3 < 22 mol/l and Base deficit >-10. All modalities of acid-base imbalances were significantly associated with mortality. Conclusion: In this study, a significant number of neonates who were admitted to the intensive care unit, can develop acid-base derangement. Mixed acidosis was found in the highest frequency.  Metabolic, respiratory and mixed acidosis all has a significant correlation with death in a NICU. Metabolic alkalosis and respiratory alkalosis were found absent at admission.

Frequency, Acid-base derangements, Neonates, ICU, Respiratory acidosis

Vascular Endothelial Growth Factor Expression in Breast Carcinoma and its Association with Expression of Estrogen Receptors, Progesterone Receptors and HER-2/neu and Molecular Subtypes

Shakila Jannat1*, Moushumi Ahmed2, Sifat Syeed3, Halima Khatun4, Nazma Afroze5

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 65-73 | DOI: 10.53339/aimdr.2023.9.3.9

Vascular Endothelial Growth Factor Expression in Breast Carcinoma and its Association with Expression of Estrogen Receptors, Progesterone Receptors and HER-2/neu and Molecular Subtypes

Shakila Jannat1*, Moushumi Ahmed2, Sifat Syeed3, Halima Khatun4, Nazma Afroze5

Abstract

Background: The management of breast carcinoma depends on several molecular markers and tumor stages. In the last decades, estrogen receptors (ER), progesterone receptors (PR), and HER-2/neu have shown good therapeutic responses. Among other molecular markers, vascular endothelial growth factor (VEGF) is becoming more widely used as a prognostic indicator in patients with breast carcinoma. Anti-VEGF therapy already has been proven as an effective chemotherapeutic agent in some other carcinomas. The study aimed to find out the immunohistochemical expression of Vascular Endothelial Growth Factor (VEGF) in breast carcinoma and its possible correlation with the expression of ER, PR, and HER-2/neu and molecular subtypes to evaluate its prognostic value. Material & Methods: This study was conducted in the Department of Pathology, BIRDEM General Hospital, Dhaka, from March 2018 to January 2020. In this study, 45 diagnosed cases of breast carcinoma were enrolled. Slides of all cases were stained with ER, PR, HER-2/neu, and VEGF antibodies following the avidin-biotin-peroxidase staining method. Results: Among 45 cases, 60% showed positive immunohistochemical expression of VEGF. Most of these cases (71.1%) were ER/PR positive. VEGF did not show a significant association with other molecular markers or molecular subtypes. Conclusion: Although, the potential prognostic value of VEGF has not been confirmed. Based on the findings of the current study, it can be assumed that VEGF plays an important role in the pathogenesis of breast cancer.  So, it may serve as a useful biomarker for immuno-targeting therapy in patients with breast cancer.

Breast-Carcinoma, VEGF, ER, PR, Molecular-subtypes

Association of Clinical Presentation at Different Stages of Carcinoma Cervix

Hachina Akhter1*, Ferdousi Begum2

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 74-81 | DOI: 10.53339/aimdr.2023.9.3.10

Association of Clinical Presentation at Different Stages of Carcinoma Cervix

Hachina Akhter1*, Ferdousi Begum2

Abstract

Background: Cancer cervix is the most common cancer in women in developing countries where screening facilities are inadequate. The incidence of cervical cancer is steadily declining in the developed world. The rate of cervical cancer is decreasing day by day due to their awareness of cervical cancer, especially its risk factors, and undertaking measure like routine screening tests. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stage. This study aimed to analyze the association of clinical presentation at different stages of carcinoma cervix. Material & Methods: This descriptive study was conducted in Chittagong Medical College Hospital, taking 100 randomly selected patients of carcinoma cervix over one year (July 2019 to June 2020). The research protocol was approved by the research committee (Local Ethical committee). Informed written consent was taken from each patient. Results: Among the study subjects, most of the respondents (32, 32.0%) belonged to 51-60 years old followed by (24, 24.0%) 41-50 years and >60 years of age. Most (76, 76.0%) of the patients presented with blood-stained vaginal discharge. Significant numbers of the patient presented with foul smelling per vaginal discharge (72, 72.0%) and post-coital bleeding (68, 68.0%). Only 8% of the patients had haematuria signifying the advanced stage of the disease. Most of the patients about 72.0% sought medical advice within one year of developing symptoms. 56.0% of patients were menopausal, only 20.0% of patients had regular menstruation, and 24.0% of patients had irregular menstruation. 24.0% of patients had metrorrhagia and 2.0% of patients had dysmenorrhoea. Some degree of anemia was present in almost all patients. Only 16.0% of the patients had severe anemia 6.0% of the patients had dependent edema and 4.0% had lymphadenopathy. Most of the patients had cauliflower-type (54.0%) lesions in the cervix followed by 36.0% of patients who had the ulcerative type of growth in the cervix. Among the respondents, 96.0% of the patients had squamous cell carcinoma and only 4% had adenocarcinoma. Most (44, 44.0%) of the patients presented in the hospital with stage II ca cervix, followed by stage III (40, 40.0%). Conclusion: Most common presentation was blood-stained per-vaginal discharge, followed by foul-smelling per-vaginal discharge and post-coital bleeding. All the patients were clinically anemic, some showed severe anemia. The majority of the patient in this series showed a cauliflower-like lesion, followed by an ulcerative lesion. Among all patients majority (96.0%) had squamous cell carcinoma and the remaining had adenocarcinoma. Most of the patients presented in the hospital with stage II ca cervix, followed by stage III.

Metrorrhagia, Dysmenorrhea, Anemia, Squamous cell carcinoma

Evaluation of Clinical & Functional Outcomes Bristow Latarjet Procedure in the Management of Recurrent Anterior Shoulder Dislocation

S. M. Yousuf Amin1*, Krishna Priya Das2, Md. Ashraful Islam3, Muhammad Monjun-Ul-Alam4, Md. Nashid Rahman5, Md. Taiyabur Rahman6

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 82-89 | DOI: 10.53339/aimdr.2023.9.3.11

Evaluation of Clinical & Functional Outcomes Bristow Latarjet Procedure in the Management of Recurrent Anterior Shoulder Dislocation

S. M. Yousuf Amin1*, Krishna Priya Das2, Md. Ashraful Islam3, Muhammad Monjun-Ul-Alam4, Md. Nashid Rahman5, Md. Taiyabur Rahman6

Abstract

Background: Glenohumeral joint is highly susceptible to dislocation due to its wide range of movements. Recurrent anterior shoulder dislocations are common in young adults. The Bristow Latarjet procedure is one of the effective techniques for the treatment of recurrent anterior shoulder dislocation.  This study aimed to assess the clinical and functional outcome of the Bristow Latarjet procedure in the management of recurrent anterior shoulder dislocation. Material & Methods: This prospective interventional study was conducted in the Department of Orthopaedic Surgery, BSMMU, from October 2017 to September 2019. Within this period, a total of 40 cases of recurrent anterior shoulder dislocation that meet inclusion criteria were taken as a sample. Patients were evaluated both pre and postoperatively for functional outcomes according to Rowe’s score for instability. A purposive non-randomized sampling technique was used in this study. All the data were compiled and sorted properly and the quantitative data were analyzed statistically by using Statistical Package for Social Science (SPSS-25). The results were expressed as frequency, percentage and mean ± SD. Paired Student’s‘t’ test was performed to compare pre and final postoperative follow-up. The level of significance was calculated at a confidence interval of 95% and p-value <0.05. Results: : In this study age of the patient ranged from 18-40 years and the mean age was 28.2±6.3. 29(72.5). Surgery was done within 4-6 months of the first dislocation in 5 patients, within 6-12 months in 21 patients and after 12 months in 14 patients. The mean (±SD) Rowe score for instability was significantly (p<0.001) higher 6 months after the Bristow Latarjet procedure at 91.87(±9.00) in comparison to preoperative periods 52.62(±18.40). Results were excellent in 32(80%), good in 4(10%), fair in 3(7.5%) and poor in 1(2.5%) patients. 36(90%) patients were in the satisfactory group and only 4(10%) in the unsatisfactory group. Only 1(2.5%) patient developed screw migration, 2(5%) patients developed subluxation, and 1(2.5%) patient developed postoperative arthritis. Conclusion: It can be concluded that the Bristow-Latarjet procedure is a very effective and safe procedure with reduced complications, presenting very satisfactory functional results in the treatment of recurrent anterior shoulder dislocation.

Recurrent anterior shoulder dislocation; Bristow Latarjet procedure

Socio-Demographic, Clinical and Diabetes Status of Foot Ulcer Patients

Md. Ashraful Alom1*, Md. Azizul Islam2, Md Shohidul Islam3, Iftekhar Md. Kudrat-E-Khuda4, Monishankor Roy5, Md Saiful Islam6, Sk Shamim Ahmed7

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 90-96 | DOI: 10.53339/aimdr.2023.9.3.12

Socio-Demographic, Clinical and Diabetes Status of Foot Ulcer Patients

Md. Ashraful Alom1*, Md. Azizul Islam2, Md Shohidul Islam3, Iftekhar Md. Kudrat-E-Khuda4, Monishankor Roy5, Md Saiful Islam6, Sk Shamim Ahmed7

Abstract

Background: Foot ulcers are considered as a serious complication, especially for patients with diabetes. People with diabetes and people with peripheral vascular disease are more likely to develop foot ulcers. If an infection occurs in an ulcer and is not treated in the proper way, it can develop into cellulitis, osteomyelitis, or gangrene that may require some part of the toe, foot, or lower leg to be amputated. The aim of this study was to find the socio-demographic, clinical, and diabetes status of foot ulcer patients. Material & Methods: This prospective observational study was conducted in the Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, during the period from March 2012 to August 2012. In total 100 patients with foot ulcers in the different surgical units of the mentioned hospital were enrolled in this study as study subjects. Data from the study regarding age, sex, occupation, smoking habit, and socio-demographic condition were recorded in the prescribed questionnaire. The purposive sampling technique was used for this study. All data were processed, analyzed, and disseminated using MS Excel and SPSS version 23 programs as necessary. Results: In this study, the male-female ratio of the participants was 2:1. The maximum number of patients (42%) were from the age of 51-60 years and the highest number of patients were housewives (28%), followed by farmers (22%). Among the total male patients, 87.88% were smokers. Low HDL was found in 51% of patients and 68% of patients had been suffering from diabetes mellitus,18% from Buerger’s disease and 6% from atherosclerosis, and 8% from malignant foot ulcer. Most of the diabetic patients (95.59%) were hyperglycemic on admission and 55.88% had diabetes for 6-10 years. On admission, 3 patients (4.41%) had controlled blood sugar and 65 patients (95.59%) had uncontrolled blood sugar. Conclusion: The frequency of foot ulcers among the male population was higher than that in females. Concerning occupation of the patients, housewives and farmers were the most prevalent. Smokers were most affected groups among the study population. Pre-diagnosed diabetes mellitus for a long period was one of the major clinical issues in most of the patients. Uncontrolled blood sugar was also seen in majority of the patients regarding clinical background.

Socio-demographic, Clinical status, Diabetes, Foot ulcer, Blood sugar

The Association of Asymptomatic Urinary Tract Infection (UTI) with Diabetes Mellitus (DM) in Pregnant Women

Abdullah Al Kafi1*, Mst. Asia Khatun2, Belona Nasrin Shoshi3

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 97-105 | DOI: 10.53339/aimdr.2023.9.3.13

The Association of Asymptomatic Urinary Tract Infection (UTI) with Diabetes Mellitus (DM) in Pregnant Women

Abdullah Al Kafi1*, Mst. Asia Khatun2, Belona Nasrin Shoshi3

Abstract

Background: Urinary tract infection (UTI) is a common infection of diabetic pregnant women because of excess urine glucose excretion and lowered immunity. UTI during pregnancy is directly proportionate to maternal and neonatal complications. Diabetes mellitus (DM) and urological health problems are closely related during pregnancy. DM patients are prone to UTI, bladder issues and sexual dysfunction. The intent of the study was to find out the association of asymptomatic urinary tract infection (UTI) with diabetes mellitus (DM) in pregnant women. Material & Methods: A prospective cross-sectional study was carried out in the Department of Public Health of Varendra University in Bangladesh for the duration of 4 months in the summer session from May 2018 to August 2018. All the pregnant mothers (N=119) with diabetes mellitus in Chapai Nawabganj during the study period constituted the study population. Ethical clearance was taken from the hospital. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Results: Among the study population (N=119), the mean age of the respondents was 25.14 ± 4.82 years, and most of the respondents were in the age group of below 25 years. It was observed that around one-third of the respondents (36,30.3%) monthly income was up to 15,000 taka. Regarding the duration of gestation, it was observed that the mean duration of gestation was 19.06 ± 5.62 weeks. Around one-fourth of the respondents (33,27.7%) had good but unhygienic sanitation and the majority of them (78,65.5%) had good and hygienic sanitation conditions. It was recognized that the majority of the respondents (82,68.9%) had 6-8 times of micturition per day. Sixty-two respondents who had DM did not know about UTI and the relationship between the pattern of DM and urinary tract infection was not found statistically significant (p>0.05). Conclusion: In the case of pregnancy, in women with DM, UTI is the most commonly noticed maternal infection. The findings provided by the analysis might help in the management of asymptomatic urinary tract infections during pregnancy.

UTI, DM, Pregnant women.

Maternal and Perinatal Complications in Eclampsia Patients: Study in a Private Medical College, Dhaka, Bangladesh

Parvin Rahman1*, Marmarin Hamid Rawli2

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 106-112 | DOI: 10.53339/aimdr.2023.9.3.14

Maternal and Perinatal Complications in Eclampsia Patients: Study in a Private Medical College, Dhaka, Bangladesh

Parvin Rahman1*, Marmarin Hamid Rawli2

Abstract

Background: Eclampsia is a serious pregnancy complication that can lead to seizures and potentially fatal outcomes for both mother and baby. It is most common in developing countries but improved antenatal care and early intervention have significantly decreased its incidence in developed countries. Risk factors for eclampsia include pre-eclampsia, hypertension, obesity, and renal disease, and early detection and management are crucial for preventing adverse outcomes. Magnesium sulfate is the preferred treatment for seizures, and delivery timing depends on disease severity, gestational age, and fetal well-being. Maternal and perinatal mortality rates vary by country, highlighting the need for continued efforts to improve outcomes for those affected by eclampsia. The study aimed to observe the maternal and perinatal complications in eclampsia patients. Material & Methods: This observational study was conducted at the Department of Gynecology, Gonoshasthaya Nagar Hospital, Dhaka, Bangladesh during the period of January 2020 to June 2020. We included a total of 270 patients with eclampsia who were admitted to a tertiary care hospital. A Purposive consecutive sampling method was followed for the selection of the participants. Results: This study analyzed the demographic and clinical characteristics, maternal and perinatal complications, and risk factors of 270 patients with eclampsia. The majority of patients were aged between 20-34 years (77.8%), and 61.1% were multiparous. Over half of the cases (55.6%) presented with eclampsia between 28-36 weeks of gestation, and 38.9% had a history of preeclampsia in a previous pregnancy. The most common symptoms reported were headaches (88.9%). All cases involved hypertensive disorders, and maternal death was reported in 1.9% of cases. Perinatal complications included low birth weight (44.4%), preterm delivery (36.3%), NICU admission (34.8%), stillbirth (4.4%), and early neonatal death (3.0%). Maternal mortality rates were highest among women aged 20-34 years (56.5%), while perinatal mortality rates were highest among women aged under 20 years (20.0%). The highest maternal mortality rate was observed among women with severe eclampsia (91.4%), and time to treatment was a crucial factor in maternal mortality rates. These findings underscore the need for timely and appropriate care to improve maternal and perinatal outcomes, particularly in high-risk populations. Conclusion: Eclampsia is a serious complication of pregnancy that can result in significant maternal and perinatal morbidity and mortality. Early detection, prompt management, and close monitoring of high-risk pregnancies are crucial in preventing adverse outcomes. Further research is needed to identify effective interventions for preventing and managing eclampsia.

Eclampsia, Pregnancy, Maternal, Perinatal, Morbidity, Mortality

Monitoring of Air and Water Bacterial Load in the Operation Theatres and Intensive Care Units of Selected Hospitals in Dhaka city: A Cross-Sectional Study

Adeeba Khanduker1*, Md. Asaduzzaman Rajib2, Lovely Barai3, Nabila Khanduker4, Mohammad Haroon Or Rashid5

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 113-122 | DOI: 10.53339/aimdr.2023.9.3.15

Monitoring of Air and Water Bacterial Load in the Operation Theatres and Intensive Care Units of Selected Hospitals in Dhaka city: A Cross-Sectional Study

Adeeba Khanduker1*, Md. Asaduzzaman Rajib2, Lovely Barai3, Nabila Khanduker4, Mohammad Haroon Or Rashid5

Abstract

Background: Hospital milieu monitoring is an essential component for controlling healthcare associated infections (HCAIs) as it serves as the reservoir for pathogenic microbes. Aim of this study was to identify the bacterial load in Intensive care units (ICU) and Operation theaters (OT) air and water sources of selected tertiary care hospitals. Material & Methods: The study was organized in Microbiology department, BIRDEM General Hospital. A sum total 28 air samples & 6 water samples were collected from three selected hospitals and those were processed according to the set of protocols. Results: From air sampling, highest load of bacteria was found 480 CFU/dm²/hr in Hospital C ICU, 38.40 ± 9.99 CFU/dm²/hr in pre-OT samples & 218.2±43.35 CFU/dm²/hr in intra OT samples of Hospital C. From water sampling, unacceptable level of coliforms was found in all three hospitals. Among the non-pathogens, 24% – 37% Micrococcus spp. (normal flora) and 2% -18% Bacillus spp. (contaminants) were found in the OTs. Whereas pathogens found were Acinetobacter spp. (20.7%) followed by Pseudomonas spp. (19.4%), Klebsiella spp. (12.1%) &amp; S. aureus (9.2%) in the ICUs. Conclusion: It could be deduced from the study that environmental sources such as air and water contaminations with multidrug resistant pathogens are an ultimate risk factor for all related to the healthcare settings, specially the indoor patients.

Hospital milieu, Healthcare associated infections.

Comparison of Characteristics among Suspected ACS Patients by Normal and Elevated Hs-Troponin Levels

Md. Golam Mahfuz Rabbani1*

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 123-130 | DOI: 10.53339/aimdr.2023.9.3.16

Comparison of Characteristics among Suspected ACS Patients by Normal and Elevated Hs-Troponin Levels

Md. Golam Mahfuz Rabbani1*

Abstract

Background: Acute coronary syndrome (ACS) is a life-threatening condition that requires prompt diagnosis and treatment. However, some patients with ACS may have normal levels of high-sensitivity cardiac troponin (hs-cTn), a biomarker of myocardial injury, at presentation. This study aimed to compare the characteristics and outcomes of ACS patients with normal and elevated hs-cTn levels using different assays and thresholds. Material & Methods: This 2-year retrospective observational study was conducted in Bangladesh, using data from hospital records of 420 suspected ACS patients. Patients were divided into two groups based on their Hs-Troponin levels, with group 1 having 60 patients with Hs-Troponin ≤0.014 ug/L, and group 2 having 360 patients with Hs-Troponin >0.014 ug/L. Patients less than 18 years old and those with incomplete records were excluded. Ethical approval was obtained, and SPSS v.25 was used for analysis. Results: Group 1 had a significantly younger mean age of 41.8±14.3 compared to Group 2’s mean age of 68.4±12.6, with a p-value less than 0.001. Group 2 had a higher percentage of male patients (70.56%) compared to Group 1 (31.67%), with a p-value of less than 0.01. Group 2 had a significantly higher mean heart rate of 80.18±20.64 beats per minute compared to Group 1’s mean heart rate of 71.02±12.21, with a p-value less than 0.001. There were no significant differences between the two groups in terms of systolic blood pressure, diastolic blood pressure, BMI, history of smoking, history of AMI, hypertension, and diabetes mellitus. Group 1 had a significantly lower percentage of patients with hypercholesterolemia (55.00%), but a higher percentage of patients with a history of ACS (25.00%), and a family history of CAD (70.00%) compared to Group 2, with p-values less than 0.001. Group 2 had a significantly higher percentage of patients with known renal failure (21.67%) compared to Group 1 (1.67%), with a p-value less than 0.001. Creatinine levels were significantly higher in Group 2 (98±53 µmol/L) compared to Group 1 (76±17 µmol/L) with a p-value of less than 0.001, and eGFR was significantly lower in Group 2 (76±27 mL/min/1.73 m2) compared to Group 1 (97±23 mL/min/1.73 m2) with a p-value of less than 0.001. The cardiac Troponin T (cTnT) levels were significantly higher in Group 2 (0.28±1.68 ug/L) compared to Group 1 (0.01±0.01 ug/L) with a p-value of less than 0.001, indicating worse kidney function and cardiac damage in Group 2 compared to Group 1. Conclusion: The study found that very few patients presenting with ACS symptoms had normal Hs-Troponin levels, and ultimate diagnosis proved that they did not have ACS, indicating the usability of Hs-Troponin as a biomarker for ACS. Significant differences were observed in age, gender, heart rate, hypercholesterolemia, family history of ACS, family history of CAD, and renal failure between the two groups. The study also found a consistent association between elevated creatinine levels and lower eGFR with higher Hs-Troponin levels.

Cardiac, Troponin, Coronary, Syndrome.

The Role of E-learning in Medical Education during the COVID-19 Pandemic: A Cross-Sectional Study of Student Perception

Rumana Ahmed1*, Sadia khanduker2, Farhana Khondker3, Al Aharama4, Rubayea Afrin Ruba5, Gulshan -Ara Begam6

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 131-140 | DOI: 10.53339/aimdr.2023.9.3.17

The Role of E-learning in Medical Education during the COVID-19 Pandemic: A Cross-Sectional Study of Student Perception

Rumana Ahmed1*, Sadia khanduker2, Farhana Khondker3, Al Aharama4, Rubayea Afrin Ruba5, Gulshan -Ara Begam6

Abstract

Background: In march 2020, with the declaration of COVID-19 as a global pandemic, the schools, colleges, and universities of the highly contagious areas of the world were instantaneously closed to mitigate the deleterious effects of COVID-19. Moreover, as a result of social distancing, the most effective preventative strategy since the emergence of COVID-19, medical education has been profoundly disturbed. In light of the prevailing pandemic, an abrupt shifting of the educational system was made from face-to-face learning to online methodologies to provide uninterrupted education to the students of the affected countries. By and large, traditional education was replaced by various forms of e-learning. The aim of this study was to evaluate the perception of e-learning in undergraduate medical students at Medical Colleges during covid pandemic. Material & Methods: This was a cross-sectional questionnaire-based study and was conducted from December, 2020 to February, 2021 in the CARe Medical College, Dhaka, Bangladesh. In the present study we included 270 undergraduate medical students as our participants and students who were not willing to participate were excluded from our study. Results: In our study we found the mean age of the respondents was 23.05 ± 1.28 years and majority of our students were female (68%) compared to male (32%). Most of the students (67%) had moderate grade of IT skills. We found major advantage of e-learning was the ability to record classes 67% and  the disadvantage was poor internet speed (68.9%). Among all students, 51.1% & 6.7% students were able to increase knowledge, 62.6% & 3% were able to increase clinical skill and 37.8% & 7.4% were able to increase social skill via conventional & e-learning methods respectively. Majority (88.1%) students preferred face-to face learning method and 11.9% preferred e-learning method. Conclusion: In our study, we evaluated the student’s perception of e-learning and its associated advantages and disadvantages in terms of learning outcomes. While comparing e-learning and face-to-face learning among undergraduate medical students,we found face-to-face learning was considered the most effective way of learning to increase knowledge, practical skills and social skills. Therefore, most of our students preferred the face-to-face learning method compared to e-learning.

COVID, Pandemic, Face-to-Face learning, E-learning

Efficacy of Neoadjuvant Chemotherapy on Locally Advanced Gastric Adenocarcinoma in Terms of Downstaging and Resectability in a Tertiary Cancer Hospital

Suzon Kumar Mazumder1*, Laila Shirin2, Chittaranjan Das3, Sushmita Bardhan4, Ranada Prasad Roy5, SM Sakib Kabir6, Kallol Dey7

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 141-150 | DOI: 10.53339/aimdr.2023.9.3.18

Efficacy of Neoadjuvant Chemotherapy on Locally Advanced Gastric Adenocarcinoma in Terms of Downstaging and Resectability in a Tertiary Cancer Hospital

Suzon Kumar Mazumder1*, Laila Shirin2, Chittaranjan Das3, Sushmita Bardhan4, Ranada Prasad Roy5, SM Sakib Kabir6, Kallol Dey7

Abstract

Background: Neoadjuvant chemotherapy (NACT) in carcinoma stomach was introduced in an effort to eliminate micro-metastasis and to improve resectablity before surgery which improves R0 resection rates. The aim of the current study was to evaluate the effect of neoadjuvant chemotherapy on downstaging and resectability rate in locally advanced gastric cancer. Material & Methods: This was a single-center quasi-experimental study conducted in the Department of Surgical Oncology in collaboration with the Departments of Medical Oncology, Radiation oncology, and Pathology at the National Institute of Cancer Research and hospital, Dhaka, which is a tertiary care cancer hospital in Bangladesh, between January 2021 and June 2022.Patients with locally advanced adenocarcinoma stomach staged by contrast-enhanced computed tomography (CECT) were randomly included in this study by purposive sampling. Patients in Group I underwent upfront surgery Patients in Group II were started on neoadjuvant chemotherapy, either XELOX or FLOT regimen. Surgery was done following the response assessment CECT. We assessed R0 resection rate, age, sex, comorbidities, tumour size, TNM stage and complications were compared between the two groups. Response to NACT was assessed in Group II. Results: The mean age of patients in groups 1 & 2 was 56 ± 11.06 and 55.70 ± 10.46 years of age respectively (p > 0.05). Majority of the respondents (55/74) were male and 19 patients (26%) were female. Male to female ratio was (24/37 &31/37) in group 1 and (31/37 & 6/37) groups respectively (p > 0.05). Out of 37 patients who received NACT, in 9 patients (24.32%) complete response was noted. Partial response was found in 20 cases (54.05%), p-value (<.0001) while a stable disease was reported in three (8.1%) cases. 5 patients (13.51%) had progressive disease. In the upfront surgery group, R0 resection was feasible in 16 (43.2%) cases, and in the NACT plus surgery group, R0 resection was done in 29 (78.4%) cases. In group 1, R1 resection was done in considerable numbers (19/37) compared to group 2 (5/37), P=0.001. Three patients (8.1%) in group 2 and one (2.7) in group 1 had irresectable lesions. Conclusion: In this study it can be concluded that neoadjuvant chemotherapy could downstage tumour and increase tumor resectability rate in patients with locally-advanced gastric adenocarcinoma. However, further studies are necessary to confirm the effect of this modality on patients’ overall survival. We await survival analysis to further validate the role of NACT.

Locally advanced gastric cancer, Gastrectomy, Neoadjuvant chemotherapy, Carcinoma stomach, Surgical outcome

Evaluation of the Outcome of Modified Open Sandwich Technique and Conventional Composite Resin Restoration: For Managing Class II Cavity of Primary Molars Among 4- 8 years Old Children

Saosun Binta Rob1*, Sarjana Yeasmin2, Shammi Akhtar3, Tanzila Ferdous4, H. M. Shahriar Rubel5, Nazia Mehanaz6, Mohammad Ali Asgor Moral7, Jebun Nessa8

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 151-158 | DOI: 10.53339/aimdr.2023.9.3.19

Evaluation of the Outcome of Modified Open Sandwich Technique and Conventional Composite Resin Restoration: For Managing Class II Cavity of Primary Molars Among 4- 8 years Old Children

Saosun Binta Rob1*, Sarjana Yeasmin2, Shammi Akhtar3, Tanzila Ferdous4, H. M. Shahriar Rubel5, Nazia Mehanaz6, Mohammad Ali Asgor Moral7, Jebun Nessa8

Abstract

Background: Dental caries is the most prevalent disease in humans, especially during early childhood. The restoration of such an extensive carious lesion should be done properly to reestablish their anatomy and hence their masticatory, phonetic, esthetic, and space-maintainer functions in the dental arches. Composite resins are the most commonly used tooth-colored restorative material, but many difficulties occur particularly when used directly in posterior restorations. The objective of the study was to compare the clinical effectiveness of the Modified Open Sandwich Technique and Conventional Composite Resin Restoration for managing class II caries on primary molars. Material & Methods: This was a randomized control trial and was conducted in the Department of Pedodontics, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from October, 2021 to September, 2022. In our study we included 68 patients with proximal dental caries of primary molars with reversible pulpitis. The patients were divided by using random sampling technique into two groups – Group A (The modified open sandwich technique, n=34) and Group B (The conventional composite resin restoration, n=34). Results: In total 68 patients from both the groups completed the study. In our study we found mean±SD of age was 5.37±1.24 years. 76.5% of cases of the modified open sandwich technique restorations were & 82.4% of the conventional composite resin restoration were < 6 years. Mandibular primary molars were 64.7% and 53% for the modified open sandwich technique and conventional composite resin restoration respectively. Conventional composite resin restorations showed 32.4% postoperative sensitivity and the modified open sandwich technique restorations showed 11.8%. After 12 months of follow-up, no secondary caries developed. Good marginal adaptation in 100% of cases were found in the modified open sandwich technique and 88.2% for conventional composite restorations. Conclusion: In our study we found that postoperative sensitivity developed more in conventional composite restorations in comparison to the modified open sandwich technique. Initially marginal adaptation showed better in the modified open sandwich method technique. So, conventional and modified open sandwich composite resin techniques were acceptable for primary molar teeth considering secondary caries and marginal adaptation.

Masticatory, phonetic, esthetic, dental arches

Dyslipidemia Associated with Hypertension Increases the Risks of CHD among cardiac patients: A Case-Control Study

Sumanta Kumer Saha1*, Shiblee Sadik Pathan2 ,Tamanna Tabassum Moni3, Md. Rezaul Kadir4, Aliva Haque5, Sabiha Tabassum Mithila6

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 159-167 | DOI: 10.53339/aimdr.2023.9.3.20

Dyslipidemia Associated with Hypertension Increases the Risks of CHD among cardiac patients: A Case-Control Study

Sumanta Kumer Saha1*, Shiblee Sadik Pathan2 ,Tamanna Tabassum Moni3, Md. Rezaul Kadir4, Aliva Haque5, Sabiha Tabassum Mithila6

Abstract

Background: Coronary Heart Disease (CHD) is one of the largest contributors to mortality and morbidity worldwide. Globally, CHD accounts for 17.5 million deaths in 2012, with over 75% of deaths occurring in developing countries. By 2015, 16% of all female and male deaths were caused by CHD. Dyslipidemia is the most common risk factor of CHD for the excessive level of lipids in blood. Most dyslipidemias are hyperlipidemias in developing countries; that is, an accumulation in blood lipids. CHD was 18 times more likely to grow according to hypertension with dyslipidemia category than with non-dyslipidemias.  The aim of this study was to assess the effect of dyslipidemia associated with hypertension for coronary heart disease and identify risk factors for CHD among cardiac patients. Material & Methods: This was a case control study and was conducted in the Department of Medicine, LABAID Specialized Hospital, Dhaka, Bangladesh during the period from May,2022 to March,2023. We included 170 cardiac patients in our study. The patients were divided into two groups – Case group (Patients diagnosed with CHD) & Control group. Results: In total 170 patients from both the groups completed the study. In our study we found most of our patients were male (58%) compared to female (42%). We found the mean age was 46.1±11.3 & 47.1±9.3 years in case & control group respectively. Family history of hypertension was significantly higher in case group (52%). Among all patients, BMI was higher in case group. Cholesterol, systolic & diastolic bp was found significantly higher in case group than control group. HDL was found lower & LDL was found higher in case group. Among 85 cases, majority (68%) had dyslipidemia associated with hypertension. We found dyslipidemia was 55% & 36% in case & control group respectively. Hypertension was also found significantly higher in case group.  Age ≥ 60 years, family history of CHD, smoking, diabetes & obesity were also individual risk factors of CHD among cardiac patients. In dyslipidemia with hypertension group 68 patients were diagnosed with CHD which is higher than non-hypertension group.  Conclusion: In our study, we found that dyslipidemia, hypertension, age ≥ 60 years, family history of CHD, smoking, diabetes & obesity are individual risk factors of CHD development. Relationship of dyslipidemia with coronary heart disease in hypertension is significant. We also found dyslipidemia with hypertension is an established risk factor of prime importance that increased the risks of CHD among cardiac patients.

CHD, Dyslipidemia, Hypertension

The Clinical Outcome of Brolucizumab in the Treatment of Neovascular Age-Related Macular Degeneration – A Prospective Observational Study

Ziaul Ahsan Mukta1*, Dilara Khatun2, Tasnim Khanom3, Mashrur Al Bashir4, Al- Nawaz5, Nabila Noor Dutee6

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 168-176 | DOI: 10.53339/aimdr.2023.9.3.21

The Clinical Outcome of Brolucizumab in the Treatment of Neovascular Age-Related Macular Degeneration – A Prospective Observational Study

Ziaul Ahsan Mukta1*, Dilara Khatun2, Tasnim Khanom3, Mashrur Al Bashir4, Al- Nawaz5, Nabila Noor Dutee6

Abstract

Background: Neovascular age-related macular degeneration (nAMD), also known as wet AMD, is a chronic eye disease that affects the macula, which is the central part of the retina responsible for sharp, central vision. Brolucizumab is a type of anti-vascular endothelial growth factor (VEGF) drug, which works by blocking the activity of a protein called VEGF that promotes the growth of abnormal blood vessels under the macula in neovascular AMD. The aim of this study was to evaluate the clinical outcome of brolucizumab in the treatment of neovascular age-related macular degeneration. Material & Methods: This prospective observational study was conducted in Department of Ophthalmology, Bangladesh Eye Hospital & Institute Ltd, Dhaka, Bangladesh, during the period from February 2022 to February 2023. Total 60 patients with neovascular AMD were included in this study who were treated with brolucizumab. Results: The mean age of the patients was 74.3 (SD±9.8) years. Majority of the study subjects were (51.7%) female patients in the study. In our study, majority (38.3%) of the patients had only their right eye affected. In optical coherence tomography (OCT) findings, we found that a high percentage of patients had subretinal fluid (85%), intraretinal fluid (61.7%), and sub-RPE fluid (83.3%). The BCVA showed a significant change after 12 weeks of treatment, as indicated by the P-value of 0.0007. Here improvement of vision was seen in patients with AMD with active Choroidal neovascularization (CNV). But in case of AMD with macular scar, no improvement of vision was seen. In addition, the SRT, FCP, and CMT parameters also showed a statistically significant (P<0.001) improvement after brolucizumab treatment. In our study, 4 patients (6.7%) experienced intraocular inflammation, which is inflammation within the eye, 2 patients (3.3%) reported cloudy vision, and 3 patients (5%) experienced eye redness as a complication of the treatment. The majority of the patients, 51 (85%) did not experience any complications from the treatment. After treatment, improved vision was seen in most of the study patients (70%) and 30% had no improvement. Conclusion: From the findings of our study, it can be concluded that brolucizumab may be an effective treatment for neovascular AMD, as it can improve the best-corrected visual acuity and structural outcomes of the retina such as subfoveal retinal thickness, foveal center point, and central macular thickness. There was also a tolerable complication rate after treatment.

Clinical Outcome, Brolucizumab, Treatment, and Neovascular Age-Related Macular Degeneration

Associated Risk Factors and Clinical Outcomes of Acute Coronary Syndrome Patients in A Tertiary Care Hospital

Monish Saha Roy1*, MD. Rokun Uddin2, Haripada Roy3, Goutam Chandra Bhowmik4, Rita Das5, Purna Jiban Chakma6, Mirza Nurul Karim7

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 177-185 | DOI: 10.53339/aimdr.2023.9.3.22

Associated Risk Factors and Clinical Outcomes of Acute Coronary Syndrome Patients in A Tertiary Care Hospital

Monish Saha Roy1*, MD. Rokun Uddin2, Haripada Roy3, Goutam Chandra Bhowmik4, Rita Das5, Purna Jiban Chakma6, Mirza Nurul Karim7

Abstract

Background: Acute coronary syndrome (ACS) is a significant cause of morbidity and mortality worldwide. Identifying the risk factors, clinical outcomes, and complications of ACS patients is crucial for optimal patient management and resource allocation. This study aimed to investigate these factors in a tertiary care hospital in Bangladesh. Material & Methods: This cross-sectional observational study was conducted with a sample of 100 ACS patients at the Department of Cardiology, Cumilla Medical College Hospital, Cumilla, Bangladesh. The study duration was 6 months, from March 2013 to August 2013. Data were collected on socio-demographic characteristics, physical measurements, risk factors, presenting symptoms, ACS types, and outcome complications. Descriptive statistics were used to analyze the data. Results: The study population comprised 76% males and 24% females, with a mean age of 55.4 years. The most prevalent risk factors were smoking (59%), hypertension (41%), and diabetes mellitus (10%). Chest pain was the most common presenting symptom (86%). STEMI (48%), unstable angina (44%), and NSTEMI (8%) were the identified ACS types. Complications observed included heart failure (9%), cardiogenic shock (8%), conduction defects (10%), and arrhythmias (13%), with no reported deaths. Conclusion: Our findings emphasize the importance of addressing modifiable risk factors such as smoking, hypertension, and diabetes mellitus through targeted interventions and public health initiatives. Additionally, the study highlights the need for healthcare providers to be aware of both typical and atypical presentations of ACS to facilitate prompt diagnosis and treatment. Further research with larger, multicenter studies is needed to better understand the complexities of ACS risk factors and outcomes in Bangladesh and other low- and middle-income countries.

Coronary, Heart, Ischemic, Cardiac, Risk, Syndrome

Successful Outcome of a Rare Complication of Vaginal Birth: A Case Report

Munira Ferdausi1*, Alpana Adhikary2, Begum Sultana Hasina Rashed3, Mehbuba Yasmin4

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 186-190 | DOI: 10.53339/aimdr.2023.9.3.23

Successful Outcome of a Rare Complication of Vaginal Birth: A Case Report

Munira Ferdausi1*, Alpana Adhikary2, Begum Sultana Hasina Rashed3, Mehbuba Yasmin4

Abstract

Uterine inversion is a condition in which the interior surface of the relaxed uterus protrudes through the vaginal entrance. Its causes are divided into two categories: puerperal and non-puerperal, with puerperal uterine inversion being more common than non-puerperal uterine inversion. The most common variety is acute inversion, which occurs immediately or within 24 hours after delivery. Chronic Uterine Inversions (CUI) that occur more than four weeks after delivery are uncommon. In this study we discuss a case of a 30-year-old woman who came with the complaints of feeling of a mass in the vagina after her last confinement which was gradually coming down through the vagina and remain outside the introitus for 5 years. Based on clinical and sonographic evaluation, she was diagnosed with CUI and developed post partum haemorrhage. We adopted Haultain’s method for correction of CUI. Since, CUI as a painless vaginal mass in the delayed post-partum period is uncommon and hence documented.

Chronic Uterine Inversions, Haultain’s method, Inverted uterus

A Comparative Analysis Between Spinal and General Anesthesia for Orthopedic Surgery

Shariful Islam Seraji1*, Samar Chandra Saha2, Arjumand Sultana3, Md. Alauddin4, Md. Abdur Rahman5

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 191-200 | DOI: 10.53339/aimdr.2023.9.3.24

A Comparative Analysis Between Spinal and General Anesthesia for Orthopedic Surgery

Shariful Islam Seraji1*, Samar Chandra Saha2, Arjumand Sultana3, Md. Alauddin4, Md. Abdur Rahman5

Abstract

Background: Many surgeries can be performed with spinal anesthesia (SA) or general anesthesia (GA). However, there are only limited and confounding data available regarding costs and anesthesia-related times. Hip or knee replacement are common orthopedic surgeries that can be performed using SA or GA without differences regarding mortality or morbidity. Observational studies have suggested that spinal anesthesia may be associated with lower risks of death, delirium and major medical complications and with shorter lengths of stay in the hospital than general anesthesia. The aim of this study was to assess and compare the effects of spinal versus general anesthesia on postoperative outcomes in patients undergoing orthopedic surgery. Material & Methods: This was a comparative observational study and was conducted in the Department of Anesthesiology of Holy Family red crescent Medical College Hospital, Dhaka, Bangladesh during the period from March,2021 to March,2023. In this study we included 200 patients undergoing orthopedic surgery. The patients were randomly divided into two groups – Group A (Patients who were given general anesthesia) & Group B (Patients who were given spinal anesthesia). Results: In total 200 patients from both the groups completed the study. In our study we found majority (44.5%) of our patients were aged 60-69 years and most of our patients were female (56%) compared to male (44%).The mean age of our patients was 61.73 ± 7.92 years. The mean BMI was 31.67±3.24 kg/m.2Among all patients ,48% had mild systemic disease and followed by 31.5% had severe systemic disease. Majority (43.5%) of our patients had hypertension, 31% had diabetes. Vomiting was found 47% in group A on contrary only 23% had vomiting in spinal group. We found the mean anesthesia induction time was significantly higher in spinal group. Anesthesia time was lower in spinal group while PACU time was higher in group B. Time duration of surgery was significantly lower in spinal group. After 24 hours, spinal group showed less pain score than general anesthesia group. Conclusion: In our study, we found that SA is associated with less fixed and variable costs and lower postoperative pain scores during the stay in the PACU. Therefore, SA is a more reasonable alternative to GA in the immediate postoperative period for patients undergoing hip or knee replacement.  When compared to general anaesthesia, spinal anaesthesia provides better operating circumstances, better postoperative pain control, and faster postoperative recovery.

Hip replacement, TKA, Spinal anesthesia, General anesthesia

The Effects Between Spinal and General Anesthesia for Pre-Eclamptic Mothers Underwent Caesarean Delivery in a Tertiary Care Hospital- A Comparative Study

Samar Chandra Saha1*, Shariful Islam Seraji2, Arjumand Sultana3

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 201-210 | DOI: 10.53339/aimdr.2023.9.3.25

The Effects Between Spinal and General Anesthesia for Pre-Eclamptic Mothers Underwent Caesarean Delivery in a Tertiary Care Hospital- A Comparative Study

Samar Chandra Saha1*, Shariful Islam Seraji2, Arjumand Sultana3

Abstract

Background: Preeclampsia is a multisystem disorder characterized by new onset of hypertension systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and proteinuria >300 mg/24 h arising after 20 weeks of gestation in a previously normotensive woman and associated with significant maternal and neonatal morbidity and mortality worldwide. Women with preeclampsia have an increased rate of cesarean section consequent upon the high incidence of intrauterine growth restriction, fetal distress, and prematurity. The aim of this study was to determine and compare maternal & neonatal outcome among pre-eclamptic women following caesarian delivery under general and spinal anesthesia. Material & Methods: This was a comparative observational study and was conducted in the Department of Anesthesiology of Holy Family red crescent Medical College Hospital, Dhaka, Bangladesh during the period from February,2020 to February,2023. In this study we included 250 preeclamptic women undergoing cesarean delivery. The patients were randomly divided into two groups – GA group (Patients who were given general anesthesia) & SA group (Patients who were given spinal anesthesia). Results: In total 250 patients from both the groups completed the study. In our study we found majority (44.8%) of our patients were aged 28-32 years. The mean age was 27.13 ± 3.76 years. Majority (62.8% ) of our patients  were cases of emergency caesarean delivery &  37.2% were elective caesarean delivery classes. Most of the students (41.2%) used magnesium sulfate. Intraoperative systolic BP, diastolic BP was significantly lower in SA group than GA group. We found headache, vomiting, fever and wound gaping, postpartum hemorrhage & lower respiratory tract infection was significantly higher in GA group. On contrary, hypotension & pulmonary edema was higher in SA group. Apgar score at 1st, 5th & 10th minutes was significantly higher in GA group than SA group. In GA group, neonatal mortality at 48 h was 10.4% whereas it was 4.8% in SA group. Conclusion: In our study, we found intra-operative blood pressure and pulse rate was observed significantly higher in GA group than SA. Severe preeclamptic mothers receiving general anesthesia and their babies required more critical care support. Maternal as well as neonatal mortality was significantly higher with general anesthesia. Therefore, spinal anesthesia is a safer alternative to general anesthesia among women with severe preeclampsia following caesarean delivery with less postoperative morbidity and mortality.

Preeclampsia, Caesarean delivery, Spinal anesthesia, General anesthesia

Efficacy Evaluation of DENTE91 Anti-Stain Toothpaste: Review of In-Vitro Studies

Harsh Shah1*, Ankit Singh2

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 211-219 | DOI: 10.53339/aimdr.2023.9.3.26

Efficacy Evaluation of DENTE91 Anti-Stain Toothpaste: Review of In-Vitro Studies

Harsh Shah1*, Ankit Singh2

Abstract

Background: Tooth stains on the front teeth are a common esthetic issue caused by tooth discoloration. Good oral hygiene habits, such as brushing your teeth twice daily with fluoride toothpaste and after meals, flossing daily, and using a whitening toothpaste, can help reduce staining and prevent cavities. Material & Methods: Many in-vitro studies has conducted to develop Dente91 Anti-Stain Toothpaste that can help in resolving the issue of demineralization, hypersensitivity, microbial strains, plaque, dental caries/tooth decay, and dental stain more effectively than other marketed products. Its composition includes ingredients such as Sodium Hexametaphosphate (SHMP), Polyvinylpyrrolidone (PVP), Tetrasodium Pyrophosphate, Covarine Blue, Zinc Citrate, Potassium Citrate, and Xylitol. Results: DENTE91 Anti-Stain toothpaste has over 99.9% significant antimicrobial efficacy and effectively reduces demineralization while enhancing the remineralization process. It also provides protection against acid attacks, promotes cell proliferation in NIH/3T3 cells, and shows significant healing activity on dental cavities. Additionally, it has the ability to occlude dentine disc lesions and reduce hypersensitivity. The findings of this study suggest that the toothpaste after using it twice a day for three days removes 63.02 % stains and also shows 80.33% improvement in teeth whitening from baseline.Conclusion: These in-vitro studies of dente91 anti-stain toothpaste concluded that toothpaste helps in resolving demineralization, hypersensitivity, plaque, dental caries/tooth decay, and dental stains. It has antimicrobial activity and teeth whitening effect too.

Tooth Stain, Toothpaste, Whitening

Demographic and Clinical Profile of Patients with Low Vision: A Hospital Based Study

Saroj Bala1, Prempal Kaur2, Mohanpreet Singh Bhatia3*, Karamjit Singh4, Manveen Kaur5, Chewang Uden Bhutia6

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 220-227 | DOI: 10.53339/aimdr.2023.9.3.27

Demographic and Clinical Profile of Patients with Low Vision: A Hospital Based Study

Saroj Bala1, Prempal Kaur2, Mohanpreet Singh Bhatia3*, Karamjit Singh4, Manveen Kaur5, Chewang Uden Bhutia6

Abstract

Background: Vision impairment is a significant problem in our country. The purpose of this study was to evaluate the causes and to record the demographic profile of patients with low vision. Material & Methods: After taking permission from ethical committee, the study was conducted on 250 patients presenting in low vision clinic of Regional Institute of Ophthalmology punjab in north India .A detailed examination and information regarding the demographic and clinical characteristics of the patients were recorded .the visual acuity of all the patients were determined using Snellen chart followed by anterior and posterior segment examination using a slit-lamp bio microscope and direct and /or indirect ophthalmoscope.Refraction was done in all the subjects and Best corrected visual acuity was recorded. Their demographic and clinical profile were analyzed using SPSS software. Results: Majority of the patients presenting with low vision were found to be above 56 years of age with higher prevalence in rural (54.40%) than in urban (45.60%) population. Male (65.60%)were predominant than females(34.40%) .Major etiological causes were  Diabetic retinopathy  76 (30 .40%) followed by Pathological Myopia (21.20%), ARMD (14.80%), Retinitis pigmentosa (6.80%) and Glaucoma (6.00%). Conclusion: Diabetic retinopathy and  pathological myopia were the predominant causes of low vision. Patients from rural background  were more  affected than urban areas.

Diabetic Retinopathy, Low vision, myopia, Retinitis pigmentosa

Categorization Format for YouTube Medical Educational Videos: An Experience with Embryology

Zobayer Mahmud Khan1, Zinnat Ara Yesmin2, Khondker Manzare Shamim3*

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 228-242 | DOI: 10.53339/aimdr.2023.9.3.28

Categorization Format for YouTube Medical Educational Videos: An Experience with Embryology

Zobayer Mahmud Khan1, Zinnat Ara Yesmin2, Khondker Manzare Shamim3*

Abstract

Background: Users of YouTube videos face considerable difficulty in handling the rapidly growing uploaded material. Videos can fall into various genres, and a single video can possess a number of characteristics. Rationale- Customized selection of the most appropriate videos for learning, teaching or research is hard to achieve. Appropriate tagging of videos for different characteristics by the uploaders for helping audience in their selection warrant meticulously designed structured format for categorizing the videos based on multiple characteristics. But no complete structured format is available for such categorization. Material & Methods: A cross-sectional analysis of 120 YouTube medical educational videos on Embryology selected through a multiphase systematic method using search terms chosen from selected focus areas of Embryology was done. This was aimed at identifying video characteristics of four functional natures: basic, academic, technical and esthetic. Using the ‘identified’ and related ‘identifiable’ characteristics, a “Proposed categorization format” was developed. Feedback on this document was obtained from five stakeholder groups i.e., anatomists, medical educationists, medical video creators, film/video/graphics experts and postgraduate students of Anatomy through a multiple-group discussion session. Results: Consensuses built on their opinions and lone voices were incorporated to develop the “Final version” of the format that possesses 38 Broad Characteristics, 179 Options, 59 Suboptions and fourteen Sub-suboptions. Conclusion: This format should be helpful in establishing a comprehensive database of medical educational videos on Embryology and with slight customization, on other anatomical subdivisions and other disciplines. But before that validation of the format by putting them into use should be justified.

Categorization Format, YouTube, Medical educational videos, Video characteristics

A Follow up Study Among Patients on Opioid Substitution Therapy (OST) in Terms of Relapse Rate, Factors Affecting Relapse Rate and HCV Incidence

Neeru Bala1, Gaurav Naib2, Manjit Singh3, Manmeet Kaur4, Amarbirpal Singh5, Sumanjeet Kaur6*

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 243-248 | DOI: 10.53339/aimdr.2023.9.3.29

A Follow up Study Among Patients on Opioid Substitution Therapy (OST) in Terms of Relapse Rate, Factors Affecting Relapse Rate and HCV Incidence

Neeru Bala1, Gaurav Naib2, Manjit Singh3, Manmeet Kaur4, Amarbirpal Singh5, Sumanjeet Kaur6*

Abstract

Background: Many countries are facing a serious problem with opioid dependence. Opioid Substitution Therapy (OST) is prescribed to dependent opioid users to diminish the use and effects of illicitly acquired opioids. The high relapse rate has been affecting the effectiveness of anti-drug work all over the world.Material & Methods:In this study, 200 patients were taken by simple random sampling technique. 100 patient on Buprenorphine substitution therapy and 100 on Methadone maintenance treatment were studied. Patients diagnosed as cases of Opioid dependence as per ICD-10 were selected within the first 3 months and followed up to 1 year at 3, 6 and 9 months. The study was conducted after approval from the institutional ethics and thesis committee. A 14-item questionnaire based on a four-point scale describing the number of times certain events had occurred in the previous week for relapse was used to find factors affecting relapse.Results:The relapse rate among patients in the BPN group at 3, 6 and 9 months relapse was 29.33%, 20.34% and 19.51% while in the Methadone group, it was 24.05%, 15.87% and 12% respectively. The overall HCV Incidence was 75% among patients on Opioid Substitution Therapy. Conclusion:The findings of the study highlight the role of multiple determinants in opioid dependence and relapse. The obtained results showed that HCV infection was an alarming problem among IV opiate drug users in Punjab.

OST, Relapse, HCV, Opioid.

Assessment of Mental Wellness Amongst the Faculty and Students of an Educational Institute in the State of Himachal Pradesh, India — Post Lockdown during COVID-19

Marwaha Urvi1*, Kalra Tarun2, Sikri Arpit3, Avasthi Avijit4, Gupta Bhavika5, Verma Shagufta6

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 249-262 | DOI: 10.53339/aimdr.2023.9.3.30

Assessment of Mental Wellness Amongst the Faculty and Students of an Educational Institute in the State of Himachal Pradesh, India — Post Lockdown during COVID-19

Marwaha Urvi1*, Kalra Tarun2, Sikri Arpit3, Avasthi Avijit4, Gupta Bhavika5, Verma Shagufta6

Abstract

Background: The COVID-19 pandemic had a significant effect on the mental health of human beingsworld wide. There is a lack of information pertaining to the mental wellness of students  and faculty in dental institutions in India. This study aimed to assess the overall mental well being of students and faculty of dental institution after return to normalcy post-lockdown period during COVID-19. Material & Methods: A self reporting online questionnaire was designed by the authors after speaking with various therapists and mental health coaches. This questionnaire was anonymously filled out by 492 participants which included under graduate students, post graduate students, academic staff, paramedical and clerical staff in a dental institution. Results: Majority of the subjects felt the need for counseling in their work place (53.4%). A greater number felt they were getting insufficient sleep (48.3%) and (31.5%) of the participants experienced depression and anxiety which further affected their emotional well being and their day to day activities. One-fifth (16.8%) of the participants perceived that mental health affected their relationships and  20.1% observed that physical health restricted their day to day activities. Mental wellness of females was significantly more affected than males. Additionally marital status also influenced the mental wellness of the subjects. Conclusion: Literary evidence suggests that mental wellness is not given enough importance in our country in general. This study only proved the ramifications of COVID-19 on mental wellness and suggested the provision of counselling  which could’ve protected the participants from slipping into a negative frame of mind.

COVID-19 Pandemic, Anxiety, Depression and Counselling

Invitro Comparative Analysis of the Flexural Strength of 4 Different Commercially Available Provisional Materials Used in Fixed Partial Dentures – An Original Research

Nitin Gautam1, Monica Kotwal2, Sunny Sharma3*, Anupama Gaur4, Rimsha Ahmed5, Shivani Jandial6

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 263-268 | DOI: 10.53339/aimdr.2023.9.3.31

Invitro Comparative Analysis of the Flexural Strength of 4 Different Commercially Available Provisional Materials Used in Fixed Partial Dentures – An Original Research

Nitin Gautam1, Monica Kotwal2, Sunny Sharma3*, Anupama Gaur4, Rimsha Ahmed5, Shivani Jandial6

Abstract

Background: Provisional Prosthesis in fixed partial dentures are subjected to Flexure under stress. Selection of appropriate material for fabrication of Provisional is of utmost importance as the Provisional prosthesis has to remain in function till definitive prosthesis is delivered. Material & Methods: Bar type specimens of four different commercially available brands for provisional restorations fabricated according to ADA specification No. 27 and immersed in artificial saliva. The specimens were fractured under 3-point loading test. Results: The flexural strength ranged between 60 to 110 Mpa. BisGMA Auto polymerizing composite resin from Dentsply Caulk shows the highest flexural strength. Conclusion: Within the limitations of this study, the flexural strengths were material specific rather than category one. The BisGMA composite based resin shows significantly higher flexural strength over other materials.

Provisional restoration, Fixed Partial Denture, PMMA, Bis-GMA composite, Urethane Di Methacrylate

An Observational Study on Cutaneous Appendageal Tumours with Pilar Differentiation

Umera Ikram1, Maryia Shafiki2, Lateef Ahmad Wani3, Sheikh Bilal4, Sami Ullah Mujoo5*

Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-3 | May-June, 2023 | Page: 269-275 | DOI: 10.53339/aimdr.2023.9.3.32

An Observational Study on Cutaneous Appendageal Tumours with Pilar Differentiation

Umera Ikram1, Maryia Shafiki2, Lateef Ahmad Wani3, Sheikh Bilal4, Sami Ullah Mujoo5*

Abstract

Background: Cutaneous  appendageal tumours belong to a diverse group of tumours with specific histo pathology.The aim of this study is to determine the pattern, age,gender and site distribution of Pilar differentiation tumours. Material & Methods: The study was conducted in the department of Pathology,Government Medical College Srinagar for a period of 18 months. It was an observational cross sectional study.Formalin fixed,paraffin embedded tissue sections were stained with hematoxylin and eosin stain for histopathological analysis. Results: A total of 112 cases of Pilar tumours were studied.108 were benign and 4 were malignant with male to female ratio of 1.07:1. The maximum number of benign cases were observed in 11 -20 years of age group and the malignant tumours age ranges from 35-45 years and the tumour usually presented in the eighth decade.Head and Neck was the most common site. Conclusion: Histopathological examination of Pilar Tumours is the gold standard to differentiate between benign and malignant tumours. It is also useful for exact categorization of cutaneous appendageal tumours.

Cutaneous appendageal tumours, Pilar differentiation tumours, Pilomatricoma