Annals of International Medical and Dental Research (AIMDR)

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

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-8, Issue-4 | July-August 2022

Prevalence and in vitro susceptibility pattern of MRSA,VRSA, VISA isolates from various clinical samples in tertiary care hospital

Gurpreet Kaur1*, Kanwardeep Singh2, Loveena Oberoi3, Shailpreet Kaur Sidhu4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 1-8 | DOI: 10.53339/aimdr.2022.8.4.1

Prevalence and in vitro susceptibility pattern of MRSA,VRSA, VISA isolates from various clinical samples in tertiary care hospital

Gurpreet Kaur1*, Kanwardeep Singh2, Loveena Oberoi3, Shailpreet Kaur Sidhu4

Abstract

Background: Staphylococcus is notorious for its ability to become resistant to antibiotics. MRSA emerged as nosocomial pathogen in the early 1960. Methicillin Resistant Staphylococcus aureus are implicated in serious infections and nosocomial infection outbreaks, thus limiting the treating options to very few agents such as vancomycin and teicoplanin. Vancomycin has been regarded as the first line drug for the treatment for MRSA but its irrational use lead to emergence of vancomycin resistance. The Aim was to determine the prevalence and resistance of MRSA ,VRSA,VISA isolates from various clinical samples in a tertiary care hospital.Material & Methods:This present prospective study was done in the Microbiology department of Government Medical College. The study was conducted for a period of one and half year i.e from January 2019 to June 2020. All the samples (pus, urine, blood, body fluids, sputum etc) were processed as per standard protocols.Results:Out of 26,471 samples, 6578(24.85%) were found to be culture positive. 1583 isolates were identified as Staphylococcus aureus. Among them 1278(80.7%) were MRSA, 21(1.3%) were VISA and 8(0.5%) were VRSA. Maximum number of MRSA isolates were obtained from orthopaedics ward (22.7%) and Intensive Care Unit and most of them were isolated from pus(45%) followed by blood (19.09%)samples. Among them highest resistance were observed against azithromycin (85.6%), followed by ciprofloxacin (63.5%) and least resistance to rifampicin and doxycycline. Majority of the VISA and VRSA strains were isolated from ICU followed by orthopaedics, surgery. Most of them were isolated from pus followed by blood and urine specimen and most were found to be multidrug resistant while they retained their sensitivity to Linezolid and Teicoplanin.Conclusions:As there is high prevalence of MRSA isolates so the treatment options are limited to vancomycin. Overuse of vancomycin can lead to emergence of VRSA strains. So the need for rational use in the infection-control practices to prevent transmission of MRSA as well as VISA strains. Strict implementation of hand hygiene, decolonization of MRSA carriers,and education of healthcare team will be quite helpful.

Antimicrobial resistance, Staphylococcus aureus,MRSA,VRSA & VISA.

An Online Survey About Awareness and Motivation Regarding Periodontal Health Among Health Care Professionals in J&K

Rafiya Nazir Khan1*, Suhail Majid Jan2, Roobal Behal3

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 9-19 | DOI: 10.53339/aimdr.2022.8.4.2

An Online Survey About Awareness and Motivation Regarding Periodontal Health Among Health Care Professionals in J&K

Rafiya Nazir Khan1*, Suhail Majid Jan2, Roobal Behal3

Abstract

Background: Periodontal disease is one of the most important oral diseases contributing to the global burden of chronic disease.  Motivation in periodontitis patients is thought to play a major role in influencing periodontal health in this patient. This online study focuses on different areas for motivation such as age,cleaning methods, ,frequency of dental visits, knowledge of inter disciplinary relation,frequency of referrals etc.among different health-care professionals. Aim: The main purpose of this study was to assess the medical professional’s knowledge about relation between periodontal and systemic health in health professionals in J&K state.Material & Methods:The study sample consisted of 500 participants ranging between 20 and 60 years old. The questionnaire was prepared and circulated by the mobile application (WhatsApp). A questionnaire consisting of multiple choice questions was used as assessment tool and its content evaluated the patients profile, their knowledge about periodontal disease, the dental professional’s commitment to instruct the patients towards oral hygiene.Results:The result of this study showed that the respondents have moderate awareness regarding the importance of dental, in specific to periodontal health care.Conclusions:Hence, there is an urgent need for comprehensive educational programs to promote good oral health and impart education about the correct oral hygiene practices. There is need for awareness not only in the general population but also in health-care professionals too.

Awareness, Periodontitis, Systemic health etc.

Clinical and Epidemiological profile of SARS-CoV-2 in patients with Severe Acute Respiratory Illness (SARI) at a tertiary care hospital of North India.

Maasha1, Shailpreet Kaur Sidhu2*, Kanwardeep Singh3, Sat Pal Aloona4, Loveena Oberoi5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 20-26 | DOI: 10.53339/aimdr.2022.8.4.3

Clinical and Epidemiological profile of SARS-CoV-2 in patients with Severe Acute Respiratory Illness (SARI) at a tertiary care hospital of North India.

Maasha1, Shailpreet Kaur Sidhu2*, Kanwardeep Singh3, Sat Pal Aloona4, Loveena Oberoi5

Abstract

Background: Severe acute respiratory illness due to SARS-CoV-2 represents great global public health concern. The spectrum of disease ranges from mild to life-threatening. Surveillance of hospitalized patients with severe acute respiratory infections (SARI) is an important public health tool used to identify etiologies to understand the disease, track changes in circulating viruses and as an alert mechanism for potential pandemic viruses.  We aim to find out the rate of SARS-CoV-2 positivity in SARI cases and further study the epidemiological and clinical characteristics of patients.Material & Methods:A Prospective study was conducted on 200 Severe Acute Respiratory Illness patients admitted at tertiary care hospital. The clinical, demographic, epidemiological, risk factors / co-morbidities of all the patients were recorded. Oropharyngeal and nasopharyngeal samples were collected and tested for SARS-CoV-2 by real time reverse transcriptase  (RT-PCR) test.Results:Out of 200 SARI patients, 51 (25.5%) were tested positive for SARS-CoV-2. Maximum cases (54.90%) were in the age group of 41-60 years; males were infected predominantly (52.94%). The most common symptoms of presentation were fever (100%), cough (86.27%), dyspnoea (82.35%) and sore throat (56.86%). Comorbidities associated with COVID-19 were Hypertension (56.86%), Diabetes Mellitus (33.33%), Chronic Obstructive Pulmonary Disease (13.72%) and Coronary Artery disease (9.8%). More than 30% of the patients were admitted in ICU and 9.80% received mechanical ventilation.Conclusions:Evaluation of clinical and epidemiological profiles of SARI patients can help in understanding and managing the outbreak more efficiently. Close monitoring and quarantine will be required to prevent extensive transmission within the community.

SARS-CoV-2, SARI.

Seropositivity For Viral Markers in Patients Undergoing Cataract Surgery Diagnosed Unexpectedly

Ishwar Singh1, Harsimran Singh2, Talvir Sidhu3, Rohit Raina4*, Neha Chhabra5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 27-32 | DOI: 10.53339/aimdr.2022.8.4.4

Seropositivity For Viral Markers in Patients Undergoing Cataract Surgery Diagnosed Unexpectedly

Ishwar Singh1, Harsimran Singh2, Talvir Sidhu3, Rohit Raina4*, Neha Chhabra5

Abstract

Background: To find the prevalence of unexpected seropositive viral markers in the patients undergoing cataract surgery.Material & Methods:It was a longitudinal observational study. Total1180 cataract patients were studied. Patients were discovered unexpectedly positive for hepatitis B antigen, hepatitis C, human immunodeficiency virus during preoperative screening for cataract surgery. HBV and HCV patients were referred for medicine opinion and operated after treatment and clearance. HIV patients were referred to ART center for further management.Results:During the study period 1180 patients, 504 males and 676 females were studied. 34 patients work positive for HIV, twelve patients were positive for hepatitis B and 50 patients were found positive for HCV. The patients accidentally found positive were 18/34 for HIV, 6/12 for hepatitis B and 32/50 for hepatitis C.Conclusions:We concluded that preoperative screening should be done for viral markers before every cataract surgery to prevent spread of such infections. Mass immunization against hepatitis B should be done among health care workers.

Cataract, Viral markers, Unexpectedly diagnosed.

Prevalence of Sars-Cov-2 Detected Through Cartridge-Based Nucleic Acid Amplification Test (Cbnaat) Among Patients of Ili and Sari in Various Districts of Punjab

Saniya Ohri1, Kanwardeep Singh2, Shailpreet K. Sidhu3*

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 33-39 | DOI: 10.53339/aimdr.2022.8.4.5

Prevalence of Sars-Cov-2 Detected Through Cartridge-Based Nucleic Acid Amplification Test (Cbnaat) Among Patients of Ili and Sari in Various Districts of Punjab

Saniya Ohri1, Kanwardeep Singh2, Shailpreet K. Sidhu3*

Abstract

Background: COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. After a December 2019 outbreak in China, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus. Currently, WHO recommends detection of unique sequences of virus RNA by rRT-PCR. ICMR also recommends use of CBNAAT using Cepheid Xpert Xpress SARS-CoV2. The aim of this study is to determine the prevalence of SARS-CoV-2 detected through CBNAAT.Material & Methods:This retrospective study was conducted from July 2020 to December 2021 at VRDL, GMC, Amritsar. The study group consisted of all the patients presenting with symptoms of Influenza Like Illness (ILI) and Severe Acute Respiratory Illness (SARI) who presented to hospital. The data was collected and subjected to statistical analysis.Results:During the present study, a total of 1,259 samples were analyzed  for SARS-CoV-2 by CBNAAT from July 2020 to December 2021. Out of total 1,259 cases which were included in the study, 327 cases (25.97%) were found to be SARS-CoV-2 positive while 870 cases (69.10%) were SARS-CoV-2 negative and 62 cases were found to be inconclusive. 62 inconclusive samples were further tested by RT-PCR. Out of which, 15 were RT-PCR positive and 47 were RT-PCR negative.Conclusions:The COVID-19 pandemic has put forward unprecedented challenge to the public health system across countries to prepare themselves for this current crisis which included isolation, contact tracing, quarantine and enforcement of a nation wide lockdown starting 25th March, 2020.

CBNAAT, SARS-CoV-2, Coronavirus.

Assessment of Pain Experience After Simple Tooth Extraction

Amrit Pal Singh1*, Parveen Akhter Lone2, Sourav Sharma3, Sabiha Parwaiz4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 40-44 | DOI: 10.53339/aimdr.2022.8.4.6

Assessment of Pain Experience After Simple Tooth Extraction

Amrit Pal Singh1*, Parveen Akhter Lone2, Sourav Sharma3, Sabiha Parwaiz4

Abstract

Background: Removal of teeth causes pain, swelling, and difficulty in opening the mouth. The present study was conducted to assess pain experience after simple tooth extraction.Material & Methods:90 patients undergoing extraction of both genders were recorded. Pain assessment was recorded on the 10-mm NS (“No pain” to “Worst pain possible”). The character of pain was indicated (yes/no) using 4 descriptors according to the McGill Pain Questionnaire: constant pain, shooting pain, dull pain, and pain when chewing or biting.Results:Out of 90 patients, males were 40 and females were 50. Pain characters was constant in 30, shooting in 15, mild in 12, when chewing in 8 and none in 25 cases. The difference was significant (P< 0.05). Pain occurred in 52 chronically inflamed teeth and 38 grossly decayed teeth. The difference was significant (P< 0.05).Conclusions:Pain after tooth extraction is common and hence use of analgesics and anti- inflammatory is recommended.

Analgesics, Anti- inflammatory, Pain.

Cardiovascular Comorbidity and its Impact on Patients with COVID-19 in a Tertiary Care Hospital, Bangladesh

Mohammad Shakhawat Hossain1*, Muhammad Abdus Salam2

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 45-56 | DOI: 10.53339/aimdr.2022.8.4.7

Cardiovascular Comorbidity and its Impact on Patients with COVID-19 in a Tertiary Care Hospital, Bangladesh

Mohammad Shakhawat Hossain1*, Muhammad Abdus Salam2

Abstract

Background: People with cardiovascular issues have been shown to be at an elevated risk of acquiring the 2019 new corona virus infection, according to studies (COVID-19). This study’s objective was to determine if cardiovascular disease has any effect on the severity of COVID-19.Material & Methods:Between January 2020 and December 2020, 210 comorbid patients aged over 40 years old diagnosed with COVID-19 admitted in BIRDEM hospital in Bangladesh were recruited purposively for a cross sectional study as per inclusion criteria. A baseline study was created for each patient based on their medical history, physical examination, biochemical tests, and the amount of care they needed (intensive care vs. ward-based care). SPSS 26 was used to analyze the data.Results:Among the 210 comorbid individuals, 74 had cardiovascular comorbidities and the remaining 136 had other comorbidities. Among the respondents, 48% were serious cases and required ICU support within 30 days. Cases with up to 2 comorbidities did not require ICU support. The severity of COVID-19 was predicted by factors such as age above 80 years (OR 35.5, 95 percent CIs 18.7,98.5), male gender (OR 3.14, CI 1.16, 3.50), and a high troponin level in the patient’s blood (OR 1.34, CI 0.84,3.54). It was shown that cardiovascular comorbidities (CI=1.8,3.0) were 2.9 times more likely to be linked to severity. The risk factors also included a history of diabetes, hypertension, and chronic obstructive pulmonary disease. Conclusions:Cardiovascular patients, who were previously grouped together as high risk due to the nature of their ailment, need more tailored counseling and treatment from public health authorities and clinicians.

Cardiovascular patients, who were previously grouped together as high risk due to the nature of their ailment, need more tailored counseling and treatment from public health authorities and clinicians.

Evaluation of Short-term Outcome of Uncut Roux-en-Y Gastrojejunostomy for Distal Gastric Cancer in a Tertiary Care Hospital

Md Setabur Rahman1*, Md Ekramul Haque2, Md Nurujjaman Sarker3

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 57-63 | DOI: 10.53339/aimdr.2022.8.4.8

Evaluation of Short-term Outcome of Uncut Roux-en-Y Gastrojejunostomy for Distal Gastric Cancer in a Tertiary Care Hospital

Md Setabur Rahman1*, Md Ekramul Haque2, Md Nurujjaman Sarker3

Abstract

Background: Gastric cancer is the fifth most common malignancy worldwide and the third leading cause of cancer death. Gastric cancer is one of the most common malignant tumors of the gastrointestinal tract, and it poses a serious threat to people’s survival. Objective: The aim of the study to evaluate the short-term outcomes of Uncut Roux-en-Y Gastrojejunostomy for distal gastric cancer.Material & Methods:This observational study was conducted in the Department of surgical oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka. A total number of 51 cases were included for the study. Purposive sample technique was used. All patients received prophylactic antibiotic using cefuroxime just before the induction of anaesthesia and continued postoperatively for 5 days. All the data were analyzed statistically by using Statistical Package for the Social Sciences (SPSS-26).Results:The mean age of the study subject was 58.58±9.85 years. Majority (42%) of the study subjects were in 51-60 years age group. Among the study cases 37 (74%) were male and 13 (26%) were female. The mean total operation time was 173.70±20.35min. The mean estimated blood loss was 174.30±40.67 ml. The mean time of first flatus pass after operation was 2.08±0.75 days and the mean duration of hospital stay was 9.64±2.67 days. Post-operative complications were observed among 08 (16%) cases. The mean preoperative Hb level of the study subjects was 10.86±0.61 gm/dl and the mean preoperative albumin level of the study subjects was 3.76±0.61 gm/dl. Two patients were lost at final follow up (at 6 months). Among these 48 cases at final follow up poor outcome was observed among 15.69% cases. Conclusions:After analyzing the results of present study, it can be concluded that Uncut Roux-en-Y Gastrojejunostomy is a safe and favorable procedure for treatment of distal gastric cancer.

Gastric Cancer, Gastrojejunostomy, Outcome, Tumor.

Diabetes and Obesity are the Two Strong Risk Factors for Knee OA Progression

Md. Mazharul Alam1*, AKM Akhtaruzzaman2,Sukalyan Kumar Kundu3, Muhammad Shamsul Arefin4, Md Anamul Haque5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 64-71 | DOI: 10.53339/aimdr.2022.8.4.9

Diabetes and Obesity are the Two Strong Risk Factors for Knee OA Progression

Md. Mazharul Alam1*, AKM Akhtaruzzaman2,Sukalyan Kumar Kundu3, Muhammad Shamsul Arefin4, Md Anamul Haque5

Abstract

Background: Osteoarthritis (OA) are common diseases that frequently co-exist, along with overweight/obesity and diabetes. It affects mostly the hips, knees, hands and feet that causes severe disability and loss of quality of life, particularly in the elderly population. Objective: The present study was conducted to access the Prevalence of knee osteoarthritis in diabetes and obese patients.Material & Methods:This case study was conducted among 110 diabetic and 70 obese patients who attended Bangladesh Korea Friendship Hospital and Dhaka Pain Management center, Dhaka, Bangladesh. The data were analyzed using the SPSS version 25.0.Results:Out of 110 diabetic patients 55% were female and out of 70 obese patients 57% were female. Prevalence of knee osteoarthritis among diabetic patients was 50% and 65% for obese patients.Conclusions:Our findings bolster current public health strategies targeted at lowering the burden of knee OA by addressing obesity and diabetes. Obesity and diabetes are linked to knee osteoarthritis, and the risk is especially high among obese adults.

OA, knee osteoarthritis, BMI, Diabetes, Obese.

Prevalence of Pain Conditions in Type 2 Diabetes Mellitus patient: A Cross Sectional Study

Syed Ariful Islam1*, MdAnamul Haque2, Muhammad Shamsul Arefin3, MD. Mazharul Alam4, Mohinee Begum5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 72-85 | DOI: 10.53339/aimdr.2022.8.4.10

Prevalence of Pain Conditions in Type 2 Diabetes Mellitus patient: A Cross Sectional Study

Syed Ariful Islam1*, MdAnamul Haque2, Muhammad Shamsul Arefin3, MD. Mazharul Alam4, Mohinee Begum5

Abstract

Background: Type-2 Diabetes mellitus (T2DM) is a metabolic disease characterized by hyperglycemia and may causes long term organs dysfunctions like retinopathy, nephropathy, neuropathy, cardiovascular and autonomic dysfunction. Musculoskeletal and nervous system can also be affected by T2DM resulting pain, dysfunctions and disabilities. Objectives: This study is to find the prevalence of different pain conditions in patients with T2DM.Material & Methods:The study was conducted in public and private hospitals of four cities (Brahmanbaria, Dhaka, Gazipur and Faridpur) of Bangladesh from 1st April to 31st September, 2021. The patients of type II diabetes mellitus with both gender and age above 40 were included, and patients with other active systemic disease of bones and soft tissues were excluded. A self-structured questionnaire was developed. The questionnaire was distributed among 500 patients, out of whom 450 patients responded. The non-probability convenient sampling technique was used for data collection. The data was analyzed by SPSS and percentages were calculated to estimate the musculoskeletal complications in patients with T2DM.Results:The result showed high prevalence of pain conditions in T2DM patients. Older age groups of 61-65 (24%) years  suffering from T2DM for more than 3 years having higher bloodsugar level 17-19 mmol/L with positive family history of DM were affected mostly. The prevalence of musculoskeletal pain condition in T2DM was 71.11%, while the low back pain was (42.88%), frozen shoulder was 31.33%, diabetic neuropathy was (26.89%) were the most common musculoskeletal problems, followed by knee pain (17.33%). Conclusions:It is concluded that the prevalence of different pain conditions are high among patients of T2DM and low back pain, shoulder pain, peripheral neuropathy and knee pain are common. These are mostly manageable conservatively.

Type 2 DM, pain condition, musculoskeletal, shoulder pain, adhesive capsulitis, diabetic neuropathy, knee pain, low back pain.

Assessment of Qualitative and Quantitative Changes in 5 days stored Platelet Concentrates in a tertiary care Hospital of Bangladesh

Mohammad Mizanur Rahman1*, Md. Quddusur Rahman2, Alamgir Ahmed3, Nishat Sultana4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 86-93 | DOI: 10.53339/aimdr.2022.8.4.11

Assessment of Qualitative and Quantitative Changes in 5 days stored Platelet Concentrates in a tertiary care Hospital of Bangladesh

Mohammad Mizanur Rahman1*, Md. Quddusur Rahman2, Alamgir Ahmed3, Nishat Sultana4

Abstract

Background: The fast growing demand for platelet concentrates (PC) necessitates the storage of these blood products prior to transfusion. Platelets are prepared as concentrates from the whole blood or by plateletpheresis. Qualitative and quantitative assessment of these PCs are an important issue in transfusion medicine. Aim of the study: To assess the qualitative, quantitative changes and bacteriological safety of 5 days stored platelet concentrates (PC).Material & Methods:This prospective study was conducted at the department of Clinical Pathology in collaboration with the department of Transfusion medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during April 2008 to April 2009. A total of 65 healthy donors were included for the study as per the inclusion and exclusion criteria. Therefore, 65 platelet concentrates (bags/units) were prepared from the donors.  Purposive sampling of the units was done.  pH and platelet indices (PLT, MPV, PDW and P-LCR) were measured  and Gram staining of PCs  were performed on day 0 and 5. Statistical significant tests were done at 95% confidence interval using statistical package for social science (SPSS).Results:The mean (±SD) pH was 7.18±0.07   ranging from 7.0 to 7.3 during day 0. During day 5 the mean (±SD) pH was 6.77±0.11 and their range was from 6.5 to 7. The mean pH difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) PLT/unit was 70.56±15.56 x109/unit and it ranged from 38.01 to 110.6 x109/unit during day 0. During day 5 the mean (±SD) PLT/unit level was 68.46±15.52 x109/unit and it ranged from 36.82 to 107.2 x109/unit. The mean PLT/unit difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) MPV was 9.34±0.92 fl and it ranged from 7.5 to 11.5 fl during day 0. During day 5 the mean (±SD) MPV was 9.27±0.99 fl ranging from 7.0 to 11.2 fl. The mean (±SD) PDW was 10.07±1.61 fl and which ranged from 7.4 to 14.4 fl during day 0. During day 5 the mean (±SD) PDW was 10.72±1.71 fl ranging from 7.0 to 15.4 fl. The mean (±SD) PLCR was 18.28±5.67 % and it ranged from 8.0 to 32.5 % during day 0. During day 5 the mean (±SD) PLCR was 21.18±5.91 % and it ranged from 10.0 to 36.3 %. The mean PLT, PDW and PLCR difference were statistically significant (p<0.05) between day 0 and day 5 in unpaired t-test, however the mean MPV difference was not statistically significant (p<0.05) between day 0 and day 5. Gram staining of platelet concentrates on day 0 and day 5 found no bacteria.Conclusions:Storage-induced lesions take place in PCs, when stored for 5 days in second generation storage containers under the currently recommended conditions, but how far these change are clinically relevant need to be investigated.

Platelet concentrates (PC), platelet indices (PLT, MPV, PDW and P-LCR), pH, Gram staining,   storage-induced lesions.

Factors Associated with Maternal Near-miss Among Women Admitted in A Rural Hospital: A Single-Center Study

Nargis Akther1, Shereen Yousuf2*, Tanzila  Halim3, Hasina Khatun4, Rashida Khatun5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 94-104 | DOI: 10.53339/aimdr.2022.8.4.12

Factors Associated with Maternal Near-miss Among Women Admitted in A Rural Hospital: A Single-Center Study

Nargis Akther1, Shereen Yousuf2*, Tanzila  Halim3, Hasina Khatun4, Rashida Khatun5

Abstract

Background: Maternal Near-miss (MNM) is one of the related concepts to maternal mortality. MNM is a special category of survivors, whose stories provide unique insights and valuable information on maternal mortality. Characterizing near-miss morbidity is valuable for monitoring the quality of hospital-based obstetric care and should be calculated regularly for planning, monitoring, and evaluating provided maternal healthcare. Objectives: The study aimed to observe the factors like patterns and predictors related to maternal near-miss in our demographic.Material & Methods:This cross-sectional observational study was conducted at the Department of Obstetrics and gynaecology, Sirajgonj Medical College and Hospital, Sirajgonj, Bangladesh. The study duration was 1 year, from June 2019 to May 2020. During the study period, a total of 1277 deliveries were conducted at the study hospital, among which, 69 cases were of MNM. Results:The rate of maternal near-miss in our study was 5.41% of the total admitted maternal pregnancy cases. The maternal near-miss mortality ratio (MNM: 1 MD) was 1:13.8. Out of the 69 near-miss cases, 82.6% of women met the MNM criteria already at admission, and another 17.4% of near-miss cases were distributed: 10.1% developed near-miss after admission within the first 12 hours of the hospital admission, whereas the occurrence of MNM after 12 hours of the hospital admission was observed in 7.3% of cases. Conclusions:MNM cases are alarmingly high. Hypertensive disorders of pregnancy and obstetric hemorrhage were the two main direct obstetric causes of near-misses that require strict and quick management protocols. A proper antenatal check-up to discourage early marriage and pregnancy and timely referral to well-equipped health facilities with logistic support is necessary for saving human life.

Magnitude; Pattern and Predictor; Maternal; Mortality.

Outcome Analysis of Colostomy Closure in Different Pediatric Surgical Conditions: A Pediatric Tertiary Care Hospital Study in Bangladesh

S. M. Khalid Mahmud1*, Tamanna Mahfuza Tarin2,Aminur Rashid3, Aminul Islam4, Sadia Sultana5, Kazi Hamida Banu6

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 105-113 | DOI: 10.53339/aimdr.2022.8.4.13

Outcome Analysis of Colostomy Closure in Different Pediatric Surgical Conditions: A Pediatric Tertiary Care Hospital Study in Bangladesh

S. M. Khalid Mahmud1*, Tamanna Mahfuza Tarin2,Aminur Rashid3, Aminul Islam4, Sadia Sultana5, Kazi Hamida Banu6

Abstract

Background: A Colostomy is a revocable surgical procedure an incision in the anterior abdominal wall and suturing it into place in which a stoma is formed by drawing the healthy end of the large intestine or colon through. This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body. Due to anatomical defects frequently referred for closure colostomy, colostomies are often used in cases of imperforate anus and other conditions. The neonatal & children who are unable to pass feces normally and safely. pediatrics colostomy. Some neonates require emergency surgery on their tummy in the first few months of life. It is most commonly due to being born prematurely and developing a bowel problem or a blockage of the bowel. As part of this surgery, the ends of the bowel may be brought to the skin surface to divert stool into a bag called a colostomy. Intended to be temporary with reversal, later on, the stoma allows time for the bowel to rest and recover. Aim of the study: To find out the outcome analysis of colostomy closure in different pediatric surgical conditions and were reviewed to look for complications following closure colostomy.Material & Methods:This prospective was conducted in the department of Pediatrics Surgery Bangladesh Shishu Hospital & Institute, Dhaka, and Lubana General Hospital & Cardiac Center, Dhaka, Bangladesh from July 2014 to June 2021. A total of 86 patients who underwent colostomy closure were enrolled in this prospective study as the study population. Data including age, gender, surgical conditions, complications of the patients and oral feeding, and bowel preparation were all collected from the patients’ parents or hospital admission files.Results:Out of 86 cases included the age range from 8 months-10 years. There were 37(43.0%) females and 49(57.0%) males and there were more difficulties with Anorectal malformation (43.02%) than with Hirschsprung disease (40.7%). There was no record of using Necrotizing Enterocolitis, in surgical patients. The risk of wound infection and leakage was greater than any other consequence in the patients. The illness known as colostomy was predominantly encountered in men. No morbidity was recorded in this study. Conclusions:Proper stoma care, the use of well-fitting colostomy bags, and early colostomy closure enhance the prognosis. Prior to surgery, encourage thorough mechanical bowel preparation and antibiotic use. The key to a successful colostomy closure for anti-surgical diseases is appropriate IV feeding after surgery.

Closure of colostomy, Surgery Conditions, Hirschsprung’s disease (HD), Anorectal malformation, Wound Infection.

Role Of Raised C-Reactive Protein (CRP) As the Indicator for Surgical Intervention in Clinically Diagnosed Acute Appendicitis

Mohammad Monjur Hasan Mamun1*, Arun Kumar Pal2, Md. Rajibul Hoque3, Sharmila Mondol4, Syed Abdul Adil5, Mahboob Hasan6, Kaniz Fatima Khan7

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 114-123 | DOI: 10.53339/aimdr.2022.8.4.14

Role Of Raised C-Reactive Protein (CRP) As the Indicator for Surgical Intervention in Clinically Diagnosed Acute Appendicitis

Mohammad Monjur Hasan Mamun1*, Arun Kumar Pal2,Md. Rajibul Hoque3, Sharmila Mondol4, Syed Abdul Adil5, Mahboob Hasan6, Kaniz Fatima Khan7

Abstract

Background: The diagnosis of acute appendicitis relies more on the clinical acumen of the surgeon than on the investigations. As the condition is associated with an acute-phase reaction the analysis of WBC, neutrophil percentage and serum level of CRP has been demonstrated to be important diagnostic tools. Surprisingly the level of CRP becomes proportionately raised with increasing severity of the histopathological variety of the appendix. Aim of the study: The aim of this study was to compare the preoperative CRP level with postoperative histological findings and find out a predictive value of CRP as an indicator for surgical intervention in acute appendicitis.Material & Methods:It was a prospective, cross-sectional, observational study executed in the Department of Surgery, Dhaka Medical College Hospital from January to December of 2015 where 107 patients were included in this study. Preoperative level of CRP and WBC count was done in all selected patients. Histopathological severity of the resected specimen of the appendix was determined postoperatively. The correlation between preoperative clinical factors and the actual histological severity and identification of surgical indication markers was assessed to determine whether only the CRP level significantly differs between the surgical treatment necessary group and the possible non-surgical treatment group.Results:54% (58) of the patients were female out of a total of 107. Peak incidence (25.2%) was in the 16-20 years age group. Neither age nor gender had any significance with the type of appendicitis. Among the patients 28.1% (30) had gangrenous appendicitis. In patients with histopathologically proven acute appendicitis, both the WBC count and serum CRP level were raised. But only the CRP level significantly differs between gangrenous appendicitis and uncomplicated appendicitis (p-value<0.0001). The specificity and sensitivity of serum CRP for gangrenous appendicitis were 97% and 71% respectively. The ROC curve indicated that the cutoff value of CRP for gangrenous appendicitis is 6.2 mg/dl. Conclusions:A normal pre-operative serum CRP measurement in patients with suspected acute appendicitis is most likely associated with a normal or uncomplicated inflammation of the appendix. The rate of unnecessary appendectomies would probably reduce in this patient group by deferring surgery. Only the CRP level is consistent with the severity of appendicitis and can be considered to be a surgical indication marker for acute appendicitis.

Acute appendicitis, C-Reactive protein (CRP), WBC count, Pre-operative, Histopathology, Receiver-operating characteristic (ROC), ALVARADO.

Titanium Elastic Nailing in Pediatric Femoral Shaft Fracture: A Study of 40 cases at NITOR, Bangladesh

Shubha Prasad Das1*, Shyamal Debnath2, Md Kamruzzaman3,SarwarIbne Salam4, Syed Mohammed Shakawat Hossain5, Mohammad Aminul Islam6, Tapas Mandal7, Shahnewas8

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 124-130 | DOI: 10.53339/aimdr.2022.8.4.15

Titanium Elastic Nailing in Pediatric Femoral Shaft Fracture: A Study of 40 cases at NITOR, Bangladesh

Shubha Prasad Das1*, Shyamal Debnath2, Md Kamruzzaman3,SarwarIbne Salam4, Syed Mohammed Shakawat Hossain5, Mohammad Aminul Islam6, Tapas Mandal7, Shahnewas8

Abstract

Background: The Titanium Elastic Nail is mostly used in children to treat diaphyseal and metaphyseal fractures. The age of the patient, as well as the nature and location of the fracture, determine if the TEN is necessary. In some situations of femoral diaphyseal fractures, it is a successful and realistic therapeutic choice. The TEN allows for elastically stable intramedullary nailing.  In terms of patient and parent happiness, as well as shorter confinement to bed and hospital stay, open reduction can produce a significantly better outcome than traction and spica cast or any other treatment. The aim of the study was to observe Titanium Elastic Nailing for treatment of femoral shaft fractures.Material & Methods:This observational study was conducted at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Bangladesh. The study duration was 2 years and 8 months, from April 2019 to December 2021. The study was conducted with a total of 40 cases of femoral shaft fracture in pediatric patients who were admitted to the study hospital.Results:Male prevalence was observed in the present study, with 3.44:1 male: female ratio. Mean±SD age of the participants was 8.8 ± 1.6 years, and sports injuries were the most common cause of fractures. 72.5% of the participants were aged between 5-10 years, and the age range of the participants was 5-13 years. 50% of the participants had fractures at the middle region of the femur, while 45% had fractures at the proximal region. Mean±SD hospital stay duration was 14.5 ± 2.4 days, with 62.58% having hospital stay between 7-14 days. Majority of the participants of the present study faced no complications, while 20% had <1.0 cm of leg length inequality, 2.5% had 1-2 cm leg length inequality, 2.5% faced infection, 5% faced entry site irritation and 1 patient had soft tissue irritation by prominent nail. At 12-monthg follow up, 75% had excellent outcomes while 20% had satisfactory outcomes.Conclusions:The titanium elastic nailing is an effective and viable treatment option in selected cases of femoral shaft fractures in the 5-13 years’ age group. Even if it is done by open reduction it gives much better result than traction & Spica cast or any other methods, in respect to patient & parent’s satisfaction & shorter confinement to bed & hospital stay.

Femoral, Fracture, Distal, Pediatric.

A Comparative Study of Nebulized 3% Hypertonic Saline Versus Nebulized Adrenaline in The Treatment of Acute Bronchiolitis

Nazmul Hasan1*, Farid Ahmed2, AkhandTanzih Sultana3, Md. Naim Hossain Ratan4, Md. Saiful Islam5, Kanta Halder6, ShahrinaAfroze Tisha7, Md. Kamrul Hasan8

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 131-143 | DOI: 10.53339/aimdr.2022.8.4.16

A Comparative Study of Nebulized 3% Hypertonic Saline Versus Nebulized Adrenaline in The Treatment of Acute Bronchiolitis

Nazmul Hasan1*, Farid Ahmed2, AkhandTanzih Sultana3, Md. Naim Hossain Ratan4, Md. Saiful Islam5, Kanta Halder6, ShahrinaAfroze Tisha7, Md. Kamrul Hasan8

Abstract

Background: Acute bronchiolitis is the most common lower respiratory tract infection in young infants and young children. The respiratory syncytial virus is the commonest cause of bronchiolitis. Recently the role of nebulized 3% saline has come into focus. Nebulized adrenaline has also been suggested as another treatment option, its primary role being the reduction of mucosal edema, which is an important part of the disease pathology in bronchiolitis. Objective: To see the effects of nebulized adrenaline in comparison to nebulized 3% hypertonic saline in the treatment of acute bronchiolitis. Material & Methods:This was a randomized controlled trial, carried out in the Department of Pediatrics, Bangladesh Shishu Hospital and Institute from October 2017 to March 2020. A total of 90 children from 1 month to 2 years of age of either sex who were diagnosed and admitted with acute bronchiolitis were enrolled. After enrollment, they were randomly assigned to either 3% nebulized hypertonic saline (group A=45) or to the nebulized adrenaline-1:1000 group (group B=45). Monitoring was done by respiratory distress assessment instrument (RDAI) score at 12 hours interval for 1st 24 hours and then 24 hourly till the patient was ready for discharge. The efficacy was determined by assessing clinical severity score/RDAI score and length of hospital stay. Data were analyzed using SPSS version-23.Results:The mean age was found 6.34±3.89 months in group A and 6.06±3.55 months in group B. The majority of patients were males in both groups. All patients had a cough, breathing difficulty, Ronchi, and chest indrawing in both groups. Changes in heart rate were 5.68±6.61/min in group A and 2.86±5.87/min in group B, which was significantly decreasing in group A than in group B. Mean clinical severity scores at 12 hours and at 24 hours were statistically significant (p<0.05). However, mean clinical severity scores at baseline, at 48 hours, at 72 hours, and at 96 hours were not statistically significant. The mean duration of oxygen therapy was found 15.00±5.36 hours in group A and 24.63±11.64 hours in group B. Which indicates that the duration of oxygen therapy was significantly higher in group B than in group A. Majority of the patients of group A and group B were discharged within 72 hours 39(86.7%) and 28(62.2%) respectively, which was statistically significant.Conclusions:Nebulization with 3% hypertonic saline significantly reduced clinical severity score and length of hospital stay in case of acute bronchiolitis in comparison to nebulized adrenaline.

Acute bronchitis, 3% hypertonic saline, Nebulized adrenaline.

Pattern and Severity of Anaemia in Predialysis Chronic Kidney Disease Patients in Bangladesh: A Tertiary Care Hospital Study

Syed Mahbub Morshed1*, Ratan Das Gupta2, Md. Abdullah Al Mamun3, Md. AnwarulHoque Faraji4, Syed Fazlul Islam5, Md. Mostafizur Rahman6, Mohammad Ruhul Amin7

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 144-160 | DOI: 10.53339/aimdr.2022.8.4.17

Pattern and Severity of Anaemia in Predialysis Chronic Kidney Disease Patients in Bangladesh: A Tertiary Care Hospital Study

Syed Mahbub Morshed1*, Ratan Das Gupta2, Md. Abdullah Al Mamun3, Md. AnwarulHoque Faraji4, Syed Fazlul Islam5, Md. Mostafizur Rahman6, Mohammad Ruhul Amin7

Abstract

Background: Anemia is a common complication in chronic kidney disease (CKD), and is associated with a reduced quality of life, and increased morbidity and mortality. The mechanisms involved in ananaemiassociated with CKD are diverse and complex. They include a decrease in endogenous erythropoietin (EPO) production, absolute and/or functional iron deficiency, and inflammation with increased hepcidin levels, among others. Objective: The objective of our study was to investigate the prevalence and severity of anaemia in pre-dialysis patients, and chronic kidney disease patients in Bangladesh.Material & Methods:This was a case-control prospective study conducted with over 300 Bangladeshi non-patients as the control group A and 87 with different stages of chronic kidney disease (CKD) patients as the case group B in the department of Nephrology BSMMU from April’2004 to June 2006. The normal people who had no history of diabetes mellitus, hypertension, or CKD and were not on any medication were controlled and different stages of the CKD patients who had no history of blood transfusion, erythropoietin and parental iron infusion were cases.Results:Out of 300 normal populations male was 158(52.7%) and the female was 142(47.3%) and the mean haemoglobin level of the male was 13.94 g/dl and the female was 12.29 g/dl. Among males 24(15.2%) and females 55(38.7%) were anaemic and the overall prevalence of anaemia was noted at 26.3%. Of the total anaemic people, 25% was microcytic anemia. Out of 87 CKD patients, 56 (64%) were male and 31 (36%) were female. The overall prevalence of anaemia in CKD patients was 95.4%. The haemoglobin level was <11g/dl in 57.14% patients with CCr 30-59 ml/min/1.73m2 which increases to 87.5 % in patients with CCr 15-29 ml/min/1.73m2, which also increases to 94.2 % in patients with CCr<15 ml/min/1.73m2. Mean haemoglobin was observed at 8.6 g/dl, 9.54 g/dl and 11.25 g/dl in stage V, stage IV and stage III CKD patients respectively. Anaemia appeared at 43.53 ml/min/1.73 m2 of CCR.Conclusions:The results demonstrate that patient with reduced renal function is more likely to have anaemia and the prevalence and severity of anaemia increase with declining kidney function. CCr and TSAT is the important predictor of anaemia. In a significant number of the CKD, patient anaemia was associated with iron deficiency.

Anaemia, Chronic kidney disease (CKD), Predialysis, Haemoglobin, Endogenous erythropoietin (EPO).

Pregnancy with Anxiety and Depression during Covid-19 Pandemic: A single Centre Study

Ferdous Ara Banu1*, Shahidul Islam2, Amina Jannat Peea3, Farjana Yasmin4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 161-169 | DOI: 10.53339/aimdr.2022.8.4.18

Pregnancy with Anxiety and Depression during Covid-19 Pandemic: A single Centre Study

Ferdous Ara Banu1*, Shahidul Islam2, Amina Jannat Peea3, Farjana Yasmin4

Abstract

Background: Corona-virus pandemic has become a major health problem worldwide. It evokes mental health disorders affecting the population globally, especially pregnant women and is associated with adverse maternal and fetal outcomes.The aim of the study was to assess anxiety and depression in pregnant women during the Covid-19 pandemic.Material & Methods:This was a cross-sectional study conducted at Islami Bank Central Hospital Kakrail, Dhaka, Bangladesh. Pregnant women visiting the gynae&obs outpatient department, and women who had recently delivered in the gynae ward (in the past 15 days) were included in the study and asked to fill out a questionnaire.Results:A total of 152 patients were enrolled and analyzed in this study. Out of the total, 108 (71.05%) of the patients were less than 30 years, 38 (25.00%) were between 31 and 35 years old, and only 6 (3.95%) were older than 35 years. We found that 103(67.76%) of pregnant women had developed mental health disorders during this pandemic and there is a need to reform policies for the care and counseling of pregnant women as they are particularly susceptible.Conclusions:This study examined the mental health of pregnant women during the COVID-19 pandemic. The majority of the women thought COVID-19 could affect their pregnancy. Proper screening and diagnosis would bring early treatment to the needy thus preventing complications to both the mother and the newborn.

Corona-virus pandemic, mental health problem, depression, pregnant women.

Impact of Comorbidities on Covid-19 Positive Cases Admitted in ICU at Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh

Nurjahan Akter1, Farhana Naznin2,Lipika Ray3, Shohana Selim4, SK.Tasnuva Alam5*,Susmita Sharmin6

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 170-177 | DOI: 10.53339/aimdr.2022.8.4.19

Impact of Comorbidities on Covid-19 Positive Cases Admitted in ICU at Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh

Nurjahan Akter1, Farhana Naznin2,Lipika Ray3, Shohana Selim4, SK.Tasnuva Alam5*,Susmita Sharmin6

Abstract

Background: The ongoing pandemic COVID-19 is more serious for people with comorbidities and the elderly people. Comorbidities such as hypertension, diabetes, cardiovascular disease, and chronic liver disease affect the majority of COVID-19 patients. COVID-19 affected patients having comorbidities are often admitted to ICU for proper treatment. The aim of this study was to evaluate the impact of co-morbidities on Covid-19 Positive Cases Admitted to ICU. Material & Methods: This cross-sectional study was conducted in the Department of Anesthesia and ICU, Shaheed Sheikh Abu NaserSpecialized Hospital, Khulna, Bangladesh, during the period from June 2020 to July 2021. A total of 87 patients with covid-19 positive admitted to ICU were included in this study.Results:The majority of the study people were in the age group of 60-69. Most of the study people were male in with co-morbidities group (52.87%) and were female in without co-morbidities group (5.75%). Among 87 patients, 78 (89.6%) had different types of co-morbidities. More than half of the study people (64.37%) had diabetes. We found that the majority of the patients (77.30%) stayed in ICU for less than 15 days. 80.95% of patients with hypertension had to stay in ICU for less than 15 days. Among the patients with diabetes, 73.21% stayed in ICU for less than 15 days. About 8.97% of patients with diabetes were discharged from the hospital. 2.56% of patients with hypertension and diabetes were referred to another hospital. Among the death patients, 58.97% had diabetes and 43.59% had hypertension.Conclusions:Patients with comorbidities were more severely affected and had a higher mortality rate. Age, diabetes mellitus, and hypertension were the main factors affecting the survival of patients.

Comorbidities, Covid-19 Positive Cases, and ICU.

Clinico-Pathological Profiles of patients with Dengue Fever in Dhaka, Bangladesh

SK.Tasnuva Alam1*, Sharmin Ahmed Tithy2, Ismot Ara3,Kaniz Afrin4, Rezwana Parveen5,Shohana Selim6

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 178-189 | DOI: 10.53339/aimdr.2022.8.4.20

Clinico-Pathological Profiles of patients with Dengue Fever in Dhaka, Bangladesh

SK.Tasnuva Alam1*, Sharmin Ahmed Tithy2, Ismot Ara3,Kaniz Afrin4, Rezwana Parveen5,Shohana Selim6

Abstract

Background: Dengue viral infections are among the most important mosquito-borne diseases of the Bangladeshi subcontinent and have become a major global public health concern. The spread of the disease has led to increased recognition of atypical manifestations apart from the classical clinical features of dengue infection.This study aimed to provide clinical and biochemical profiles of Bangladesh’s dengue-infected patients.Material & Methods:This cross-sectional study was conducted from January 2021 to December 2021 in different government and private tertiary care hospitals in Dhaka, Bangladesh. We collected information on demographic data, clinical characteristics, and laboratory profiles for 271 confirmed hospitalized acute dengue cases using a structured questionnaire.Results:A total of 271 patients were hospitalized and received treatment for DEVN infection from the respective hospital of our research. Table 1 describes the socio-demographic data of the enrolled patients in the study. As shown in Table-1, out of 271 patients, 164(60.52%) were male and 107(39.48%) were female Almost half of the patients (135(49.82%) were from the age group 20-40 years. Of the 271 patients, around 179(66.05%) patients had a nuclear family and 92(33.95%) patients had a joint family. lab parameters of the blood samples of patients with DENV infection; from the report of leukocyte count, 134(66.01%) patients had >4000/cumm and 69(33.09%) patients had ≤4000/cumm. The pattern of seropositivity and clinical diagnostic method of patients with DENV infection of the study population.Conclusions:Over the last couple of years, dengue fever has become a major health issue in Bangladesh. To reduce the burden of this disease, timely diagnosis and prompt treatment are necessary. This analysis thus yields the clinical features, laboratory profiles, and seropositivity test results of dengue patients from Bangladesh. The research results may help clinicians understand the circumstantial diagnosis of dengue patients and facilitate early intervention.

Clinico-pathological, Profiles, Patients, Dengue Fever.

Maternal Outcome of Eclamptic Patients Admitted in Gazi Medical College Hospital

Amina Jannat Peea1*, Ferdous Ara Banu2, Farhana Shabnam3, Eti Saha4, MahfujaKhanam Luna5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 190-198 | DOI: 10.53339/aimdr.2022.8.4.21

Maternal Outcome of Eclamptic Patients Admitted in Gazi Medical College Hospital

Amina Jannat Peea1*, Ferdous Ara Banu2, Farhana Shabnam3, Eti Saha4, MahfujaKhanam Luna5

Abstract

Background: Eclampsia is one of the major causes of maternal and perinatal mortality. Eclampsia is more common in developing countries compared to developed countries.This study aimed to assess the maternal outcome in eclamptic patients.Material & Methods:This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Gazi Medical College, Khulna, Bangladesh, during the period from September 2017 to February 2019.Results:The mean age of study people was 23.84 years (SD±5.03 years), among them 58% had postpartum eclampsia and 42% had antepartum eclampsia. Most of the study people (62%) did not take regular antenatal check-ups during pregnancy and 47% of study people had 1-4 convulsions before admission, and most of the study people (80%) had high blood pressure stage 2 (≥140/≥90 mmHg), Oedema was presented in 98% of study people, 44% of study people and 3gm/l(+++) albumin in the urine. In this study, 56 % had LUCS delivery and 44% had a vaginal delivery, 7% of study people had pulmonary oedema, 7% had renal failure, 2% had DIC, 7% had CVA, 9% had abruption placenta 16% had PPH, 31% needed admission in ICU. There was no maternal death, mean duration of hospital stay was 7 days (SD±3 days). For most of the study people (56%), BP on discharge was normal (≤120/≤80 mmHg) and for all study people, urine albumin was nil.Conclusions:Eclampsia was a major cause of maternal and fetal mortality and morbidity in Bangladesh. Race and age appear to be risk factors for eclampsia with Bangladeshi women and those at the extremes of reproductive age at greater risk. Antenatal care is important in reducing perinatal mortality and possibly maternal complications.

Maternal Outcome and Eclamptic Patients.

Demographic and Clinical Profile Analysis of Acute Viral Hepatitis

Mohammed Shafiqul Islam Bhuiyan1*, Mohammad Abu Faisal2, Mohammad Jakir Hossain3, Atiquzzaman4, Mohammad Afjal Hossain5, JannatulFerdous Suma6

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 199-205 | DOI: 10.53339/aimdr.2022.8.4.22

Demographic and Clinical Profile Analysis of Acute Viral Hepatitis

Mohammed Shafiqul Islam Bhuiyan1*, Mohammad Abu Faisal2, Mohammad Jakir Hossain3, Atiquzzaman4, Mohammad Afjal Hossain5, JannatulFerdous Suma6

Abstract

Background: Acute viral hepatitis (AVH) is a major health concern in developing countries like Bangladesh regarding morbidity as well as mortality. Usually, acute infections are caused by A, E, hepatitis viruses, and occasionally hepatitis B virus. Infection caused by the hepatitis C virus is usually asymptomatic. Prior knowledge of the demographic and clinical profile of acute viral hepatitis may be helpful for treatment professionals in the management of such patients. Aim of the study: The aim of this study was to assess the demographic and clinical profile of acute viral hepatitis patients in Bangladesh.Material & Methods:This prospective observational study was conducted in the Department of Gastroenterology, US-Bangla Medical College & Hospital during the period from March 2018 to February 2019, in Bangladesh. A total of 59 suspected patients with acute viral hepatitis were included as the study subjects for this study. Ethical approval of the study had been taken from the ethical committee of the mentioned hospital. A predesigned questionnaire was used in data collection. Collected data analyzed by using MS Office and SPSS version 23.0 programs as per need. A P-value, of <0.05 was considered significant.Results:Among 59 participants, the male-female ratio was 3.2:1 and the mean (±SD) age was 23.88±14.83 years. Analyzing hepatitis infection, we found hepatitis E was the highest in number 32(54.24%), followed by hepatitis E virus 20(33.9%), and hepatitis B virus 5(8.47%). In this study, we did not find any patients with hepatitis C virus, and 2 participants didn’t have any hepatotropic virus.  The mean (±SD) Serum bilirubin (mg/dl) was 6.35±1.63, and the mean (±SD) serum alkaline phosphatase (IU/L), serum. creatinine (mg/dl), serum albumin (gm/dl) and plasma glucose random (mg/dl) were found 366.81±257.20, 6.97±14.96, 19.75±22.98 and 10.08±5.49 respectively. Considering dual viruses among the total of 5 patients along with hepatitis E & A viruses in this study, we found all were hepatitis B viruses. Among them, 3 with hepatitis E and the rest 2 were with hepatitis A virus consequently. Among them 3(60%) with hepatitis A and the rest 2(40%) with hepatitis E. In the issue of patients attended with clinical complaints, vomiting was the highest among hepatitis A patients 19(86.4%) followed by jaundice 8(36.4%) and fever8(36.4%). On the other hand, among hepatitis E patients’ jaundice was highest at 19(61.3%) followed by vomiting at 17(54.8%), and fever at 6(19.4%) respectively.Conclusions:The incidence of HEV is found as the most predominant among all the acute viral hepatitis patients and vomiting and jaundice were the most common presenting complaints.

Acute hepatitis virus, Anti HEV IgM, Anti HAV IgM, HBsAg, Anti HCV.

Evaluation of Necessity of Appendectomy After Conservative Treatment of Uncomplicated Acute Appendicitis in Children

Mohammad Syfur Rashid1*, K.M. Shaiful Islam2, Md. Mahbubul Alam3, Kaniz Hasina4, Abdul Hanif Tablu5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 206-215 | DOI: 10.53339/aimdr.2022.8.4.23

Evaluation of Necessity of Appendectomy After Conservative Treatment of Uncomplicated Acute Appendicitis in Children

Mohammad Syfur Rashid1*, K.M. Shaiful Islam2, Md. Mahbubul Alam3, Kaniz Hasina4, Abdul Hanif Tablu5

Abstract

Background: Acute appendicitis is one of the most common emergency clinical conditions among children. It has two-way treatment options, one is surgical procedures, and another is a conservative approach. In the modern arena conservative treatment approach for acute appendicitis is one of the most preferred options. The aim of the study was to find out the solution to clinical conditions and reduce the procedure of injudicious appendectomy.Material & Methods:This prospective observational study was carried out at the Department of Paediatric Surgery, Dhaka Medical College Hospital, Dhaka to assess the necessity of appendectomy following conservatively managed uncomplicated acute appendicitis. A total of 62 children with uncomplicated acute appendicitis were included in the study. Then a conservative treatment started with the combination of inj. Ceftriaxone (100 mg/kgper day), inj. Metronidazole (1.5 mg/kg/ tds) and inj. Amikacin (7.5 mg/kg/ bd) therapy for five days with associated supportive management. The patients were assessed after 24 hours of treatment, who responded to the above management were the continued for same treatment at least five days then discharged and were followed up for 6 months.Results:Mean age was 8.95 ± 2.10 years within range from 4 years12 years. The male-female ratio was 1.58:1. The mean duration of hospital stay was 5.26 ± 0.63 days. On day 5, 59 (95.1%) were discharged and 3 (4.9%) underwent surgery during the conservative treatment period. A total of 8(13of .0%) cases have recurred during the first 6 months after treatment. Conclusions:Antibiotic treatment in patients with acute appendicitis is quite effective, the success rate is 95.1% during the period of treatment, and the recurrence rate is 13.0%.

Acute appendicitis, Surgical procedures, Conservative approach, Appendectomy, Ceftriaxone, Metronidazole.

An Effective Method for Toric Intraocular Lens Implantation Based on Refractive Power Analyzer system and Slit lamp.

Md. Towhid Anwar1*, Mohammad Ghulam Rasul2, Md. Toriqul Alam3, Israt Jahan4, Kousik Chowdhury5, Md. Hafizur Rahman6, Helal Mahmood Arafat7

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 216-224 | DOI: 10.53339/aimdr.2022.8.4.24

An Effective Method for Toric Intraocular Lens Implantation Based on Refractive Power Analyzer system and Slit lamp.

Md. Towhid Anwar1*, Mohammad Ghulam Rasul2, Md. Toriqul Alam3, Israt Jahan4, Kousik Chowdhury5, Md. Hafizur Rahman6, Helal Mahmood Arafat7

Abstract

Background: One of the most widely performed surgical procedures nowadays is cataract surgery combined with monofocal intraocular lens implantation (IOL). Monofocal IOLs can compensate for the spherical refractive error but not astigmatism. Thus, patients with astigmatism are unable to see well after surgery without spectacles. A new generation of IOLs called toric IOLs, improve uncorrected visual acuity in eyes with high astigmatism due to a specific lens design. This study aimed to present a practical method of toric intraocular lens (IOL) implantation based on a refractive power analyzer system and slit-lamp observation.Material & Methods:This prospective study comprised 30 patients who underwent toric IOL implantation with cataract extraction at the Department of Ophthalmology, National Institute of Ophthalmology, Dhaka, Bangladesh. This study was conducted from Jan 2021 to Dec 2021. Approval from the local ethical committee was obtained.Results:The study included 45 eyes of 30 patients. The sex distribution of the study patients where the male was 18(60%) and the female was 12(40%). In the age distribution of the study, 5(16.67%) patients were from the 60-69 range, 10(33.33%) patients were from the 70-79 range, and 15(50.00%) patients were from the 80-89 range. The patients’ demographic variables consequently. Changes in visual acuity and refraction are shown in table-4 thorough preoperative and postoperative. Postoperative IOL alignment methods are shown in table-5, the mean±SD of the slit-lamp target was 2.55±2.76 and in the range, of 0.0 to 12.0, the mean±SD of the corneal analyzer target was 2.55±1.98 and range was 0.0 to 11.0, and the mean±SD of the slit-lamp corneal analyzer was 3.27±2.98 and range was 0.0 to 16.0.Conclusions:We studied 2 methods of assessing toric IOL alignment postoperatively and found no significant difference between them. Both were reliable and predictable. In addition, we found that the simple preoperative marking technique we used yielded toric IOL alignment that was as accurate as that obtained with other commonly used techniques and that was within a clinically acceptable level.

Toric Intraocular Lens, Implantation, Refractive Power, Analyzer system, Slitlamp.

The Outcome of Coverage of Upper Tibia by Medial Gastromyocutaneous Flap

Abul Hasan1*, Mohammad Shahin Akhter2, ABM Golam Faruque3, Syed Khaledur Rahman4, Pankaj Kanti Mondol5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 225-233 | DOI: 10.53339/aimdr.2022.8.4.25

The Outcome of Coverage of Upper Tibia by Medial Gastromyocutaneous Flap

Abul Hasan1*, Mohammad Shahin Akhter2, ABM Golam Faruque3, Syed Khaledur Rahman4, Pankaj Kanti Mondol5

Abstract

Background: The treatment of exposed bone of the upper tibia with local gastrocnemius flaps enables satisfactory results in covering exposed structures, favouring local vascularization and improving the healing. It offers the advantage of treatment in only one stage surgical procedure, an earlier recovery and reduced hospital stay. The standard methods for the reconstruction of soft tissue defects in the upper third of the leg include gastrocnemius but sometimes the wound is as such that gastrocnemyocutanious is small for the wound and taking soleus for the rest of it is too much. Along with length gastrocnemyocutanious also adorable coverage.To evaluate the outcome of coverage of exposed upper tibia by a medial gastrocnemyocutanious flap. Material & Methods:This Quasi-experimental study is to be carried out in the National Institute of Traumatology and Orthopaedic Rehabilitation, Sher-E Bangla Nagar, Dhaka from July 2016 to June 2018. Detailed information was obtained in each case according to protocol. A complete history was taken either from the patient or accompanying attendants. A thorough clinical examination was done. Relevant investigation reports were collected. All the information was recorded in the data collection sheet. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS-23. Results:The mean age was found 35.6113.2 years. The male-female ratio was 9:1. All (100.0%) patients were found with a proximal injury. The majority (75.0 %) of patients were found with a right leg injury and 5(25.0%) with a left leg injury. The majority (90.0 %) of patients were found complete survival, 1(5.0%) was partial necrosis and 1(5.0%) was marginal. necrosis. The mean duration of operation was found 125.0130.0 minutes with a range from 90 to 150 minutes. Two (10.0%) patients had flap infection, 2(10.0%) had recipient site infection, 1(5.0%) had donor site infection, 1(5.0%) had wound discharge and 1(5.0%) had superficial epidermolysis. Majority (85.0%) patients had excellent or good, 2(10.0%) had regular and 1(5.0%) had unsatisfactory.Conclusions:Gastromyocutaneous flap is still one of the best commodities to cover problem wounds in the upper leg, favouring the local blood supply and the improvement of the initial injury. Even in extensive complicated trauma, it is useable. Its harvest does not involve a sacrifice of major blood vessels and has no or little effect on gait.

Outcome, Coverage, Upper Tibia, Medial Gastromyocutaneous, Flap.

Evaluation of Treatment of Congenital Pseudarthrosis of Tibia by IlizarovMethod

Mohammad ShahinAkhter1*, Mst. Maksuda Khatun2, Abul Hasan3, Salma Shahnawaz Parvin4, Md. Towrit Reza5, Shahidul Islam6

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 234-242 | DOI: 10.53339/aimdr.2022.8.4.26

Evaluation of Treatment of Congenital Pseudarthrosis of Tibia by IlizarovMethod

Mohammad ShahinAkhter1*, Mst. Maksuda Khatun2, Abul Hasan3, Salma Shahnawaz Parvin4, Md. Towrit Reza5, Shahidul Islam6

Abstract

Background: Congenital pseudarthrosis of the tibia, a rare but well-known disorder, has been remarkably resistant to all types of therapy designed to promote healing. Successful treatment consists of the union of the pseudarthrosis and maintenance of that union without malunion, re-fracture, or excessive shortening (<2cm) of the leg. The principle of treatment of congenital pseudarthrosis of the tibia (CPT) with the Ilizarov method corrects all angular deformities and maximizes the cross-sectional area of the pseudarthrosis. Nineteen patients with a total of 19 CPT were treated using the Ilizarov apparatus. CPT is the most perplexing challenging pediatric orthopaedic problem especially when the patient of below years of age and has a history of the previous operations and tibia narrow and osteoporotic. Therefore, the purpose of this study was to evaluate the results of treatment of CPT by the Ilizarov method. Material & Methods:The prospective study was done from July 2008 to June 2010 at the National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka. Various forces were used to treat the pseudarthrosis site including compression, distraction, open reduction, resection and shortening, resection and bone transport, and a temporary intramedullary k-wire given through calcaneum and talus into the tibial medullary cavity.Results:Lengthening was performed in all except one of the 19 patients. One patient had developed nonunion in both the pseudarthrosis site and proximal corticotomy site. The deformity was tried to correct in all cases. The union rate was 94.73% with one treatment. There were three early re-fracture. Eight patients. had a persistent residual deformity of ankle valgus from 5-9 degrees and five patients had residual angular deformity at the pseudarthrosis site from 5-10 degrees.Conclusions:One patient’s angulation degree required revision surgery, Ilizarov. All patients were given Previous sites, residual angular deformity, and natural history were considered predisposing factors for re-fracture. Two re-fractures united with months (range 10 months). This technique produced initial pseudarthrosis with the correction associated with deformity inequality. angulation and valgus.

Evaluation, Treatment, Congenital Pseudarthrosis, Tibia, Ilizarov method.

Correlation of Lumbar Intervertebral Disc Degeneration, Abdominal Aortic Calcification on Plain X-ray and Pineal Gland Calcification at CT in Patients with Low Back Pain

Mst. Maksuda Khatun1*, Mohammad Shahin Akhter2, Abul Hasan3, Salma Shahnawaz Parvin4, Md. Towrit Reza5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 243-254 | DOI: 10.53339/aimdr.2022.8.4.27

Correlation of Lumbar Intervertebral Disc Degeneration, Abdominal Aortic Calcification on Plain X-ray and Pineal Gland Calcification at CT in Patients with Low Back Pain

Mst. Maksuda Khatun1*, Mohammad Shahin Akhter2, Abul Hasan3, Salma Shahnawaz Parvin4, Md. Towrit Reza5

Abstract

Background: The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leades the low back susceptible to injury and pain. To find out the correlations among plain radiographic findings of lumbar intervertebral disc degeneration, abdominal aortic calcification & CT findings of pineal gland calcification in low back pain subjects. Material & Methods:This observational analytical study was carried out in the Department of Radiology and imaging of the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) from 1 January 2011 to 31 December 2012. A total of 100 subjects attending the department of Radiology and imaging, BIRDEM for X-ray of the Lumbosacral spine and CT scan of the brain with low back pain were enrolled first for the study. A complete history was taken either from the patient or accompanying attendants. Relevant investigations reports were collected. All the information was recorded in the data collection sheet. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS-23.Results:The mean age of study subjects was 61.26 years with a standard deviation of the mean (SD) of 13.34 years and their age ranged from 41 to 74 years. It was observed that nearly two-thirds (61.7%) of the subjects were male and 38.3% were female and the male-female ratio was 1.6:1. It was seen that majority of the subjects had a density of the Pineal gland ranging from +51 to +150 HU. Only 4 subjects had a density of Pineal gland ranging from +351 to +1000 HU. Meant SD density of the Pineal gland among a total of 30 subjects was 136.98164.11 HU. In Group X, the density of Pineal Gland was 83,57 14.45 HU. The density of the Pineal gland was 134.65±13.23HU and 151.66+21.32 HU in Group Y and Group Z respectively. Some parameters of the degenerative disc disease and aortic wall calcification. had a significant positive association with calcification. with the density of Pineal gland calcification.Conclusions:The study was undertaken to find out the Correlation between lumbar intervertebral disc degeneration, abdominal aortic calcification on plain X-ray and Pineal gland calcification at CT in low back pain subjects. The data obtained showed that the density of pineal gland calcification is statistically significant with increasing age. There was also a positive association between intradiscal calcification and density of pineal gland calcification, but no significant association among other parameters with the density of pineal gland calcification.

Plain X-Ray, Pineal Gland

Causative Organisms of Urinary Tract Infection and Antibiotic Susceptibility Among Patients Attending in Tertiary Care Hospitals of Bangladesh

Md. Mizanur Rahman1*, Roksana Haque2, Mohammad Mobinur Rahman3, Abi Umar – Al -Fattah4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 255-262 | DOI: 10.53339/aimdr.2022.8.4.28

Causative Organisms of Urinary Tract Infection and Antibiotic Susceptibility Among Patients Attending in Tertiary Care Hospitals of Bangladesh

Md. Mizanur Rahman1*, Roksana Haque2, Mohammad Mobinur Rahman3, Abi Umar – Al -Fattah4

Abstract

Background: Urinary tract infections (UTIs) are considered to be the chronic public health problem due to morbidity and financial cost as urological diseases causes the highest health care cost. UTI is known as one of the most common diseases today. UTI can occur in both men and women, but studies found that the incidence of UTI is more common in women especially among the sexually active women. Material & Methods:This study was a retrospective cross-sectional study which was conducted at the department of Medicine in Tairunnessa Memorial Medical College and Hospital, Gazipur, obstetrics and gynecology in Bikrampur Bhuiya Medical College and Hospital, Munshiganj and Medicine in City Medical College and Hospital, Gazipur. The study was conducted during the period of February 2018- January 2022. The total sample size for this study was 131.Results:Most of the respondents 56(42.7%) were aged from 26-35 years. Majority of them 117(89%) were female whereas only 14(11%) were male. Burning sensation of micturition was found in 115 patients where 46(40%) had burning for 0-3 days, 63(54.8%) for 4-7 days and 6(5.2%) for >7 days. In most cases causative organism was E. Coli in this study. According to sensitivity patterns of E. Coli Amoxiclav was used in 77(59%) cases and followed by Amikacin in 94(72%), Azithromycin in 120(92%), Cefixime in 130(99.2%), Ceftriaxone in 83(63.3%), Cefuroxime in 37(28.2%), Imipenem in 62(47%), Ciprofloxacine 64(49%), and Gentamicin in 38(29%) cases. In assessing the antibiotic resistance pattern of E. coli Ampicillin was used in 55(42%) cases and followed by Amoxycillin in 98(75%), Colchicine in 13(10%), Linezolid in 35(26.2%), Amoxiclav in 54(41.2%), Colistin in 16(12.2%), Imipenem in 69(53%) and Novobiocin in 62(47%) cases.Conclusions:Antibiotics are considered to be the only treatment for UTI. But antibiotic resistance is highly prevalent in bacterial isolates around the world, especially in developing countries.

Urinary Tract Infection (UTI), Causative organisms, Antibiotics susceptibility, E. coli.

Clinical and Biochemical Profile of Hepatitis A Virus infection in Children

Shamima Yeasmin1*, Rukunuzzaman2, Fahmida Islam3, Kaniz Sultana4, Abu Sayeed Chowdhury5, Rifat Zaman6, Mohammad Shafiqul Alam Chowdhury7, Fouzia Nasreen8

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 263-269 | DOI: 10.53339/aimdr.2022.8.4.29

Clinical and Biochemical Profile of Hepatitis A Virus infection in Children

Shamima Yeasmin1*, Rukunuzzaman2, Fahmida Islam3, Kaniz Sultana4, Abu Sayeed Chowdhury5, Rifat Zaman6, Mohammad Shafiqul Alam Chowdhury7, Fouzia Nasreen8

Abstract

Background: Acute hepatitis A virus infection in children in developing countries is a matter of concern though the incidence has come down in developed countries.To observe the clinical presentation and biochemical profile of hepatitis A virus infection in children hospitalized in a tertiary care center in Bangladesh.Material & Methods:In this cross-sectional observational study, data were collected from the records of pediatric patients who were admitted due to acute hepatitis. Demographic data were collected, and complete physical examination findings and laboratory data were also taken. Serum samples were tested for LFT, Anti-HAV IgM and other viral markers among them Anti-HAV IgM positive children were included in the study.Results:Among the total of 40 patients suffering from Acute Viral Hepatitis (AVH), male predominated over female with 57.5% vs. 42.5%. The majority of the study population (65%) came from the urban area. In this study, 65% of the patients used tap water and 35% used tube well water for drinking purposes while the majority 70% used boiled water. Most of the patients (80%) consumed both homemade and outside foods and drinks while 20% consumed only homemade food. Positive family history of viral hepatitis was found in 12.5% of cases. Common presentations were fever (100%), jaundice (100%), anorexia, nausea (95%), vomiting (85%), abdominal pain (50%) etc. On examination Jaundice (100%) and hepatomegaly (95%), splenomegaly (5%), and ascites (7.5%). Only 7.5% of patients developed complications like cholestasis,7.5% showed ascites,5% had relapsed and 2.5% develop liver failure.Conclusions:This study showed that poor sanitation and poor hygiene are the main risk factors for hepatitis A. The common presenting features which should alert the clinicians include fever, jaundice, anorexia, nausea, vomiting, diarrhea, abdominal distension, hepatosplenomegaly and ascites. In Bangladesh, safe water supplies and proper sanitation will constitute the best solution to eliminate endemic hepatitis A.

Clinical, Biochemical Profile, Hepatitis A, Virus infection.

Role of Peptic Ulcer Perforation (PULP) score to Predict the Outcome in Patients with Perforated Peptic Ulcer

Anirudha Sardar1*, Polash Kumar Dey2, Asadullahil Galib3, A. K. M. Lutful Haque4, Md. Mahmudul Hasan5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 270-283 | DOI: 10.53339/aimdr.2022.8.4.30

Role of Peptic Ulcer Perforation (PULP) score to Predict the Outcome in Patients with Perforated Peptic Ulcer

Anirudha Sardar1*, Polash Kumar Dey2, Asadullahil Galib3, A. K. M. Lutful Haque4, Md. Mahmudul Hasan5

Abstract

Background: Peptic ulcer disease is a global burden of disease associated with potentially life-threatening complications, including bleeding, perforation and obstruction. Perforated peptic ulcer (PPU) is a frequent emergency condition worldwide with associated morbidity and mortality. Variations in the clinical presentation, as well as delay in diagnosis and work-up at admission to the hospital, may potentially cause a worsening of symptoms and a deterioration of the clinical condition, with a detrimental outcome. Therefore, accurate and early identification of high-risk surgical patients with perforated peptic ulcers (PPUs) is important for triage and risk stratification. Currently, the ASA score and the Boey score are the most frequently used prognostic scoring systems in patients with PPU. Yet, the ASA score is a general surgical risk score not intended for PPU patients in particular. Moreover, the external validation of the Boey score is uncertain. PULP score appears to have the greatest predictability of the outcome of perforated PUD. Aim of the study: The objective of the study was to evaluate the role of the PULP score in the prediction of outcomes in patients with a perforated ulcer.Material & Methods:It is an observational cross-sectional study, carried out in the Department of Surgery, Dhaka Medical College Hospital, Dhaka. Ethical approval was obtained from the Dhaka Medical College ethical review board. Patients aged 18 to 60 years admitted to the emergency department with a clinical diagnosis of perforated peptic ulcer disease, confirmed by different investigation modalities, e.g, imaging, sonography, laboratory test, etc were enrolled in the study. The data regarding sociodemographic, clinical, biochemical, radiological and surgical profiles were recorded. The operation was done by upper midline incision under general anesthesia. A modified Graham’s patch technique was used to repair the duodenal ulcer. Postoperative follow up was conducted meticulously. Patient outcome was assessed during their hospital stay and then OPD follow-up or by telephone interviews up to 30 days after the intervention. All the information is recorded in the data collection sheet. All collected questionnaires were checked very carefully to identify the error in the data. Data processing work consisted of registration schedules, editing computerization, preparation of dummy tables, and analyzing and matching data. Data was processed and analysed with the help of the computer program SPSS and Microsoft excel. Quantitative data are expressed as mean and standard deviation and qualitative data as frequency and percentage. The comparison was done by tabulation and graphical presentation in the form of tables, pie charts, graphs, bar diagrams, histograms &charts etc.Results:Present study

demonstrates that the maximum number of patients (43.0%) was between 51-60 years of age group, mean age of the patient was 49.35 ± 11.7 years. The male and female ratio was 3.54:1. Maximum (57%) patients came from urban, (36%) rural and (7%) urban non-slum areas. In this study, the most common signs were tachycardia (100%), abdominal tenderness (100%), abdominal rigidity (100%), absence of vowel sound (86.2%), and obliteration of liver dullness (78.7%), dehydration (67.5%).  The time lapse between the onset of symptoms and admission to the hospital varied from 4 hours to 4 days. Most of the patients (76.0%) were admitted after 24 hours. In this study, PULP score was assessed according to the operational definition of optimal cut-off point 7, below this considered as low-risk patients. in this study 85% were 0-7 PULP scores and 15% were PULP scores 8-18. Patients’ condition after proper treatment, symptoms, degree of abnormalities or dependence on the daily physiological activity and the clinical outcome had evaluated and measured by follow up and close monitoring. The study shows that 69.0% of the patients recovered completely, but 24.0% of patients had developed complications. The mortality rate in this study was 7.0%. Finally, a correlation of the PULP score with mortality of perforated PUD was carried out. Among the 7 expired cases the, PULP score was correlated with 6 cases like high risk. In 93 cases of recovered, the PULP score was predicted in 84 cases as low risk. So the effectiveness of PULP has proven significant in the prediction of mortality in perforated PUD patients. The Sensitivity and Specificity of the Peptic Ulcer Perforation (PULP) score was 85.7% and 90.3% respectively. Similarly, the positive predictive value and accuracy rate for the same was 40.0% and 90.0% respectively.Conclusion: Patients with perforated peptic ulcer (PPU) often present with acute, severe illness that carries a high risk for morbidity and mortality. Several prognostic scoring systems have been suggested to identify high-risk surgical patients with perforated peptic ulcers accurately and early. The present study demonstrates that the PULP score can be used to predict 30-day mortality accurately in patients operated for PPU. The prognostic predictors included in the PULP score can be readily identified prior to surgery. The PULP score can assist in the accurate and early identification of high-risk patients with PPU.

Peptic Ulcer, Perforation & Perforated Peptic Ulcer.

Prevalence of Depression Among Newly Detected Hypothyroid Patients Attending a Tertiary Care Hospital in Bangladesh

Md. Salman Hossain1*, Khaled Hassan2, Rezwana Laboni3, Ashrafuzzaman SM4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 284-292 | DOI: 10.53339/aimdr.2022.8.4.31

Prevalence of Depression Among Newly Detected Hypothyroid Patients Attending a Tertiary Care Hospital in Bangladesh

Md. Salman Hossain1*, Khaled Hassan2, Rezwana Laboni3, Ashrafuzzaman SM4

Abstract

Background: Hypothyroidism is the most prevalent endocrine disorder worldwide. In patients with endocrine diseases, a high prevalence of mood disorders in general and particularly major depression (MD) has been commonly found, especially in thyroid diseases. Aim of the study: A descriptive, cross-sectional study was conducted from January 2021 to December to estimate the prevalence of depression among hypothyroid patients in Satkhira Medical College hospital a tertiary care hospital in Satkhira, Bangladesh. A total of 115 patients were included and analyzed in this study.Material & Methods:A cross-sectional study was conducted to estimate the prevalence of depression among hypothyroid patients in a tertiary care hospital in Bangladesh. Patients were screened for depression using the Patient Health Questionnaire-9 screening tool, obtaining their sociodemographic data, details of their thyroid function status, and other risk factors for depression. Also, used patient medical files were to get the laboratory results. Data were analyzed using the Statistical Package for the Social Science (SPSS) version 23. Continuous data were displayed using mean and standard deviation; categorical data were expressed in numbers and percentages. The Chi-square test was used to assess the relationship between the variables. A P value of less than 0.05 was considered statistically significant.Results:This is a descriptive cross-sectional study; 115 patients were enrolled and analyzed in this study. The mean age was 42.05 ± 11.49 years, ranging from a minimum of 23 years to a maximum of 72 years. The majority of patients were females (94.78% of patients were female and 83.9% of patients were male, respectively). Two-thirds of patients were married, 76(66.09%) and 64(55.65%) carried bachelor’s or diploma degrees, and only 8(6.96) % were illiterate. More than three quarters, 81(70.43%), were non-working [Table1]. Met a higher percentage of depressed patients among those who experienced stressful life events, with no statistically significant association [Table5].Conclusion: Depression was prevalent among hypothyroid patients, and screening for depression among hypothyroid patients is recommended.

Depression, Hypothyroid &Tertiary.

Risk Association of the Development of Disseminated Intravascular Coagulation (DIC) in Obstetrical Cases

Dipak Kumar Sah1*,Farzana Deeba2, Rani Jha3, Anand Kumar Nayak4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 293-305 | DOI: 10.53339/aimdr.2022.8.4.32

Risk Association of the Development of Disseminated Intravascular Coagulation (DIC) in Obstetrical Cases

Dipak Kumar Sah1*,Farzana Deeba2, Rani Jha3, Anand Kumar Nayak4

Abstract

Background: Disseminated intravascular coagulation (DIC) is a syndrome that can be initiated by a myriad of medical, surgical, and obstetric disorders. Also known as consumptive coagulopathy, DIC is a common contributor to maternal morbidity and mortality and is associated with up to 25% of maternal deaths.Aim of the study: To determine the risk factors associated with the development of disseminated intravascular coagulation (DIC) in obstetrical cases.Material & Methods:This descriptive type of study was carried out in the Department of Obstetrics and Gynecology of Janaki Medical College Teaching Hospital, RamdaiyaBhawadi, Janakpurdham, Nepal from January 2016 to December 2021. A total of 500 pregnant women complicated with DIC admitted for termination of pregnancy were included in this study. History and clinical examination were completed. The adverse obstetrical event that causes DIC is identified from clinical diagnosis and relevant investigations. Statistical analysis of the results was obtained by using windows computer software with Statistical Packages for Social Sciences (SPSS-version 26).Results:More than half (58.0%) of the patients did not receive any antenatal checkup. Regarding the risk factors for the development of DIC; abruptio placenta was associated with 185(37.0%) cases followed by PPH 147(29.4%) and preeclampsia and eclampsia 119(23.8%). Patients with risk factors of DIC were hypertension 360(72.0%), Antepartum heamorrhage 227(45.4%) and PPH 193(38.6%) these are the most common presenting features. More than two-thirds of the patients (68.0%) had spontaneous vaginal delivery. Almost two-thirds (64.0%) of patients stayed in the hospital for 8-14 days. Maternal death was found in 60(12.0%) cases and perinatal death in 121(24.2%) cases.Conclusion:Maternal and perinatal mortality in patients with DIC were 12.0% and 24.0% respectively. The major determinant of survival is prompt identification of the underlying trigger, elimination of the cause and appropriate management.

Disseminated intravascular coagulation, maternal morbidity, maternal mortality, placental abruption, postpartum hemorrhage, preeclampsia, perinatal mortality.

A Comparative Study of Phototherapy Versus Phototherapy Plus Ursodeoxycholic Acid in the Treatment of Indirect Hyperbilirubinemia in Neonate

Md. Naim Hossain Ratan1*, Md.Monir Hossain2, Nazmul Hasan3, Kanta Halder4, ShahrinaAfroze Tisha5, Rumana Shelim6, Md. Kamrul Hasan7

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 306-315 | DOI: 10.53339/aimdr.2022.8.4.33

A Comparative Study of Phototherapy Versus Phototherapy Plus Ursodeoxycholic Acid in the Treatment of Indirect Hyperbilirubinemia in Neonate

Md. Naim Hossain Ratan1*, Md.Monir Hossain2, Nazmul Hasan3, Kanta Halder4, ShahrinaAfroze Tisha5, Rumana Shelim6, Md. Kamrul Hasan7

Abstract

Background: Hyperbilirubinemia is a common neonatal problem. Phototherapy and exchange transfusion is the conventional treatment for indirect hyperbilirubinemia. In the treatment of cholestatic liver disorders, Ursodeoxycholic acid (UDCA) is a bile acid widely used. Few studies have been conducted using UDCA  in indirect hyperbilirubinemia. Aim of the study: This study was planned to assess the additive effect of UDCA on reducing indirect hyperbilirubinemia in neonates receiving phototherapy. Material & Methods:This prospective randomized controlled trial was conducted among neonates with indirect hyperbilirubinemia in the neonatal wards of Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh from June 2018 to July 2020. Finally, 140 neonates were included in the study. Eligible cases were randomized into two groups by the lottery method. Group A (n=70) received phototherapy and Group B (n=70) received UDCA at a dose of 10 mg/kg/day orally twice daily in addition to phototherapy. Total serum bilirubin levels were measured every 12 hours until serumbilirubinlevel falls below 10 mg/dl and then phototherapy was stopped. Demographic data, clinical features, laboratory parameters, outcome variables, and complications were recorded in a pre-format sheet. CBC with PBF, Total and indirect bilirubin, Blood grouping and Rh and typing, CRP, Reticulocyte count, and Coombs test were obtained at enrolment. Comparison of parameters among themselves was done by unpaired t-test and chi-square test. Analyzed outcomes were: time for resolution of jaundice, total duration of phototherapy, length of hospital stays, and adverse effects of the drug. The two groups did not differ statistically in age, sex or weight. The mean total serum bilirubin level measured at 12, 24, 36, 48, and 60 hours of treatment in group A was 16.10±1.43, 14.76±1.45, 13.34±1.68, 11.84±1.35, and, 10.57±0.74 respectively, and in the group, B was,15.18±1.63, 13.18±2.25, 11.39±1.56, 9.84±0.81 and, 9.44±0.46 respectively (p<0.001). The mean duration of phototherapy (64.11±10.8 vs. 47.18±7.51 hours, p<0.001) and length of hospital stay (2.80 ±0.40 vs. 2.19±0.39 days, p=<0.001).Conclusion:The inclusion of UDCA as an adjuvant to phototherapy is more effective in reducing indirect hyperbilirubinemia in neonates.

Hyperbilirubinemia, Phototherapy, Exchange transfusion, Ursodeoxycholic acid (UDCA)

Comparison of the Prevalence of Acute Coronary Syndrome in Male Patients with or Without Vertex Baldness

Md Mojibur Rahman1*, Mohammad Harunor Rashid Howlader2, Mohammad Saifullah Ahtesam3, Masuma Rab4, Nasrin Jahan khan5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 316-322 | DOI: 10.53339/aimdr.2022.8.4.34

Comparison of the Prevalence of Acute Coronary Syndrome in Male Patients with or Without Vertex Baldness

Md Mojibur Rahman1*, Mohammad Harunor Rashid Howlader2, Mohammad Saifullah Ahtesam3, Masuma Rab4, Nasrin Jahan khan5

Abstract

Background: The relation between the extent and progression of baldness and coronary heart disease is not totally clarified yet. Some study reveals that male patients with male pattern baldness are at higher risk of CVD than those without male pattern baldness.The aim of this study was to find the prevalence of Acute Coronary Syndrome in male patients with or without vertex baldness.Material & Methods:This cross-sectional observational study was conducted in the Department of cardiology, Mymensingh Medical College Hospital, Mymensingh from October 2014 to September 2015. A total 100 male patients with or without vertex baldness were included in this study from male patients with a first lack of acute coronary syndrome admitted in the coronary care unit (CCL) of MMCH within 24 hours of onset of symptoms.Results:Mean age was found 45.3±7.2 years in group A and 44.5±6.7 years in group B. The mean age difference was not significant (>0.05). STEMI and NSTEMI were higher in group A than group B on contrast UA was higher in group B than group A. The total mean BMI was observed 22.8±3.0 kg/m2. The mean difference was statistically insignificant in both groups (p=0.31). The mean waist circumference was observed 89.4±8.7 vas 84.5±8.4 cm in group A and group B respectively. The mean was higher in group A than group B with statistically significantly difference (p=0.005). Biochemical status of the study that the mean FBS, total cholesterol, triglyceride and HDL cholesterol level were statistically significant between two groups (p=0.01), but the mean difference of LDL cholesterol was not statistically significant between the two groups (p=0.20).Conclusion:The patients with vertex baldness or male pattern baldness are associated with more risk of CVD than without vertex baldness. Vertex baldness may be a marker for Acute Coronary Syndrome.

Acute Coronary Syndrome and vertex baldness.

Mental Boost up: Is It Life-Changing for Cancer?

Bhaskar Chakraborty1*, Anasuya Dhar2

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 323-337 | DOI: 10.53339/aimdr.2022.8.4.35

Mental Boost up: Is It Life-Changing for Cancer?

Bhaskar Chakraborty1*, Anasuya Dhar2

Abstract

Background: Though human civilization has reached its 21st-century cancer is still considered as the name of a fatal alarm all over the world. More or less, all cancer patients start being haunted by the horror of death from the day of diagnosis. This fear not only weakens their physical and psychological stature; it also has a bad impact on their normal lifestyles. Even this apprehension also affects their treatment as well. However, it is believed that the mind is the driving force of a man, that is, nothing intimidating can happen to a man who possesses a strong mind. Aim of the study: the purpose of this study is to see whether boosting, increasing, or instilling mental strength in cancer patients can bring any further improvement in their treatment and lives.Material & Methods:This prospective study was conducted in a tertiary care hospital where 40 cancer patients were included on the basis of some criteria (isolated, silent, mentally shocked, paralyzed, poor PS, patient with severe pain, end-stage disease). They were taken to a silent room and were asked to follow some interesting instructions for 15 minutes with utmost belief in their GOD for successive three days. Data were collected by using a performed questionnaire from both patients and attendants after 14 days.Results:The result was appreciable. Out of 40 patients, females were more than males. Most of them were educated with a mean age of about 45 years. Patients with advanced disease were more (60%). Among them behavioral changes were observed in almost 80% of patients, improvement in mobility was found in almost 75 % of all paralyzed patients, narcotics dependency was reduced in almost 90 % of patients with severe bone pain, and positive attitudes were built in 80% patients. Therapeutic responses were also increased in some patients. Moreover, among most of the patients some interesting findings like improved healing power, decreased CT-induced toxicities, improvement in a familial relationship, improvement in appetite, and improvement in sleep disturbance were observed.Conclusion:Patients with cancer in spite of craving for life, begin counting/her days after being aware of this disease. As a result, this terror of death creates a sense of hopelessness and this psychological breakdown affects the treatment in such a way that even the best medical care does not work as expected. This study has successfully found that if the mental spirit of a patient can be brought to work with all the medical procedures, a certain success is possible. They just have to be made confident enough to believe that “a man”, as Ernest Hemmingway says, “can be destroyed, but not defeated”.

Mental health condition, Rick Factors, Implications, Sufferings.

The Outcome of Gemcitabine-Cisplatin Versus Gemcitabine-Oxaliplatin in The Treatment of Advanced Biliary Tract Carcinoma

Sharmin Billah1*, Md. Hanif Ulubbee2, Hosne Ara Begum3, Md. Rafiqul Islam4, Mosfika Rahman5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 338-349 | DOI: 10.53339/aimdr.2022.8.4.36

The Outcome of Gemcitabine-Cisplatin Versus Gemcitabine-Oxaliplatin in The Treatment of Advanced Biliary Tract Carcinoma

Sharmin Billah1*, Md. Hanif Ulubbee2, Hosne Ara Begum3, Md. Rafiqul Islam4, Mosfika Rahman5

Abstract

Background: Biliary tract carcinoma is highly fatal and one of the commonest cancers in Bangladesh. Chemotherapy is the mainstay of treatment as it is present in an advanced stage. Gemcitabine-Cisplatin association has been a standard of care for first-line regimens in advanced biliary tract cancer. Nevertheless, the Gemcitabine-Oxaliplatin regimen is frequently preferred. There has been no nationwide study to compare the effectiveness of these two platinum groups. Therefore, this study compared the efficacy and toxicities of Gemcitabine-Cisplatin (Gem-Cis) with Gemcitabine-Oxaliplatin (GEMOX) combination chemotherapy for the treatment of ABTC.Material & Methods:In this quasi-experimental study, a total number of eighty patients (40 patients in arm A and 40 patients in arm B), who had histopathologically or cytopathologically proven ABTC with no history of previous treatment were included. The study has done between the periods of January 2019 to June 2020. The patients received Gemcitabine (1000 mg/m2 i.v. on day 1 and day 8) plus Cisplatin (25 mg/m2i.v. on day 1 and 8) every 3 weeks for 6 cycles in Arm A. In another group, Gemcitabine (1000 mg/m2 i.v. on day 1) plus Oxaliplatin (100 mg/m2 i.v. on day 2) every 2 weeks for 6 cycles in Arm B was given. All the patients were followed up according to the set follow-up criteria up to 6 weeks after completion of treatment.Results:At the end of the treatment, Response rates (CR+PR+SD) were analyzed. No patient from both the arms showed Complete Response (CR). 37.5% and 45% of patients of the Arm A and Arm B groups showed Partial Response (PR) respectively. Meanwhile, 45% and 40% of patients from Arm A and B showed Stable Disease (SD) respectively. P-value was 0.410 (>0.05). Seven patients (17%) in Arm A and six patients (15%) in Arm B developed Progressive disease (PD). The most common treatment-related grade 3 toxicities were more experienced in the Arm A group. For Arm A versus Arm B that were as follows: neutropenia (15% versus 5%), anemia (15% versus 8%), thrombocytopenia (10% versus 2.5%), nausea (10% versus 5%), vomiting (5%versus 2.5%), peripheral neuropathy (0% versus 15%) and renal toxicity (7.5% versus 0%). For none of them, the p-value was <0.05 except for neutropenia, anemia, thrombocytopenia, renal toxicity, and peripheral neuropathy in which the p-value was 0.042, 0.001, 0.014, 0.0001, and 0.00001 respectively. For both Arms, there were no treatment-related Grade 4 toxicities.Conclusion:The study exhibited that treatment with  Gemcitabine-Oxaliplatin regimen was well tolerated, less toxic, and convenient with similar effectiveness compared to Gemcitabine-Cisplatin regimen in loco regional control of advanced biliary tract cancer.

Biliary tract carcinoma, Gemcitabine-Cisplatin (Gem-Cis), Gemcitabine-Oxaliplatin (GEMOX), Exhibited.

Polysomnographic Outcomes of 62 Patients in Dhaka City a Single-Center Study

Md. Mashiur Rahman1*, Md. Ashraful Islam2, Md. Asaduzzaman3, Mahmudul Amin4, Md. Mahmudul Hasan Khan5, Mohammad Wakilur Rahman6

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-4 | July-August 2022 | Page: 350-358 | DOI: 10.53339/aimdr.2022.8.4.37

Polysomnographic Outcomes of 62 Patients in Dhaka City a Single-Center Study

Md. Mashiur Rahman1*, Md. Ashraful Islam2, Md. Asaduzzaman3, Mahmudul Amin4, Md. Mahmudul Hasan Khan5, Mohammad Wakilur Rahman6

Abstract

Background: Obstructive sleep apnea (OSA) is a very common form of sleep disorder with associated health risks. OSA has been accompanied by more insidious conditions, like hypertension, heart disease, diabetes, stroke, and even daytime somnolence. For the diagnosis of sleep disorders, polysomnography is a comprehensive test. It records the patient`s brain waves, the oxygen level in the blood, ‘breathing and heart rate’, and ‘eye and leg movements during the study. Aim of the study: The aim of this study was to assess the effectiveness of polysomnography in the diagnosis of sleep apnea.Material & Methods:This comparative observational study was conducted in the Department of Otolaryngology &, Head Neck Surgery, Bashundara Ad-Din Medical College and Hospital, Bangladesh during the period from July 2020 to June 2021. In total 62 participants were included in the study population for this study. All the participants were divided into two groups. In group A, there were 5 healthy people without obstructive sleep apnea (No OSA group). On the other hand, in group B, there were 57 obstructive sleep apnea patients (OSA group). Ethical approval had been taken from the ethical committee of the mentioned hospital. Data were analyzed by using MS Office and SPSS version 23 programs as per need.Results:In analyzing the sleep scoring between both the groups, in both TRT minutes and total sleep time minutes we did not find any significant correlation (Table: 2). In analyzing the apnea, in comparing mean (±SD) obstructive, total, and AI calculations, we found significant correlations between the groups (Table: 3, Apnea; P values: 0.036, 0.035, and 0.024 respectively. In comparing different parameters of hypopneas (rule 1A), in most of the events, we found significant correlations except mean (±SD) central (Table 3 hypopneas: rule 1A) even, in comparing total mean (±SD) apneas and hypopneas combinedly we found the P-value as 0.002 (Table:3). In the OSA severity comparison between both the groups, in calculating AHI 1 to<15 events/hour, AHI 15 to<30 events/hour, and AHI ≥30 events/hour we found significant correlations (P=.001, Table 3: OSA severity). In assessing the Mean (SD) AHI, OAI, RDI (AI+HI+RI), O2 Desats≥3% and O2 Desats≥3% Index (ODI) we found significant correlations (P values were 0.001, 0.041, 0.001, 0.003, 0.005 respectively). Besides these, in analyzing both the low SpO2 n (%) and snoring: n (%) there was a significant correlation between the group’s patients (P values were .007 and .001 respectively).Conclusion:Polysomnography may be considered an effective method for detecting measuring and treating obstructive sleep apnea (OSA). Sleep scoring and respiratory events analysis plays an important role in assessing the presence and severity of obstructive sleep apnea.

Polysomnographic evaluation, Obstructive sleep apnea, OSA, AHI, Hypopneas.

Annals of International Medical and Dental Research
E-ISSN: 2395-2822 | P-ISSN: 2395-2814
Vol-8, Issue-4 | July-August 2022

Terms: *Corresponding author | DOI Prefix – DOI: 10.53339/aimdr

Copyright: ©The author(s), published in Annals of International Medical and Dental Research, Vol-8, Issue-4. This is an open access journal published under the Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0) license. (https://creativecommons.org/licenses/by-nc/2.0/)