Annals of International Medical and Dental Research
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
Annals of International Medical and Dental Research (AIMDR) is indexed in Index Medicus (IMSEAR), Global Index Medicus, Index Copernicus and Google Scholar
Screening of Proteinuria by Urinary Specific Gravity in Nephrotic Syndrome
Israt Zahan Ima1*, Ishtiaq Azad2, Shabnam Sharmin3, Mohammad Tareq Imtiaz4, Subrata Roy5, Mohammed Anwar Hossain Khan6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 1-7 | DOI: 10.53339/aimdr.2023.9.4.1
Screening of Proteinuria by Urinary Specific Gravity in Nephrotic Syndrome
Israt Zahan Ima1*, Ishtiaq Azad2, Shabnam Sharmin3, Mohammad Tareq Imtiaz4, Subrata Roy5, Mohammed Anwar Hossain Khan6
Abstract
Background: Nephrotic syndrome is the commonest glomerular disease in children and is often characterized by multiple relapses. Twenty-four hours urinary protein estimation is the accepted method used in the quantification of proteinuria, but it’s a time-consuming, inconvenient and cumbersome and difficult in very young children. This study emphasized screening of proteinuria by urinary specific gravity in nephrotic syndrome. Material & Methods: This cross-sectional study was conducted in the Department of Pediatric Nephrology (NIKDU), Dhaka, Bangladesh from October 2019 to June 2021. A total of 153 patients with nephrotic syndrome were enrolled as the study subjects after taking written consent. Urine samples were collected for both 24 hours and spot for estimation of urinary protein, urinary creatinine (Ucr) and specific gravity by dipstick method. Spot and 24-hour urinary protein creatinine ratio (PCR) were also estimated. From urinary specific gravity, estimated urinary creatinine (estUcr) and estimated urinary protein creatinine ratio (est PCR) were measured. A descriptive method was used and data were processed by using SPSS version 22.0. Results: Among 153 study subjects, the maximum (44.4%) were from the 2-5 years age group followed by 58 (37.9%) from 5-10 years and 27 (17.6%) from >10 years age groups. Boys (61.4%) were more predominant than girls (38.6%) in number. Spot and 24-hour urinary specific gravity have a significant positive correlation with urinary creatinine. Urinary creatinine was estimated by using the equation (Ucr = 1.25×1000 Usg – 1.24×1000). Both spot and 24-hour estimated urinary PCR (est PCR) measured by using urinary specific gravity have a significant positive correlation with corresponding urinary PCR. Conclusion: This study concluded that spot urinary specific gravity has a significant positive correlation with spot urinary protein and spot urinary creatinine. PCR can be estimated from dipstick urinary specific gravity instead of urinary creatinine in the cumbersome laboratory. Therefore, the study may establish an easy, rapid, inexpensive and alternative method for the detection of proteinuria in nephrotic syndrome so that it will help for early detection of relapse and prevent further complications related to nephrotic syndrome.
Screening, Proteinuria, PCR, Creatinine, Urinary specific gravity.
Md Shazzad Hossain1*, Shaheda Akter2, Mohammad Nazmul Islam Bhuiyan3, Bijoy Kumar Das4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 8-17 | DOI: 10.53339/aimdr.2023.9.4.2
Complications Associated with Transcatheter Device Closure of Atrial Septal Defect Cases in Pediatric Cardiology Center of Combined Military Hospital Dhaka, Bangladesh
Md Shazzad Hossain1*, Shaheda Akter2, Mohammad Nazmul Islam Bhuiyan3, Bijoy Kumar Das4
Abstract
Background: In Bangladesh, ASD device closure has been started in various centers for about a decade. Still, to date, few studies concern the complications associated with transcatheter device closure of ASD. Material & Methods: From January 2016 to December 2016, patients with suspected and confirmed ASD cases reported to the Department of Paediatric Cardiology Center of Combined Military Hospital, Dhaka, Bangladesh were evaluated. Osteum second ASD cases that were suitable for device closure were selected. Data of patients who underwent device closure were recorded in a predesigned data collection sheet. Results: During the study period, a total of 48 patients were found with second ASD and tried for transcatheter device closure, and 46 (95.83%) were successfully closed. There were 6/46 (13.04%) complications, of which 2 were major, and 4 were minor. The only major complication was device embolization occurring in 2/46 (4.37%) cases; 1 (2.1%) required surgical retrieval, while in the remaining case, the device was retrieved by catheter technique. Another important complication is the formation of a thrombus on the device. Among minor complications, arrhythmia was most common and occurred in 2/46 (4.34%) of cases. In one of these 2, atrial fibrillation required electrical cardioversion, and the other one recovered spontaneously. Post-procedural lower respiratory tract infection occurred in 1/46 (2.17%) patients, for which no apparent reason was found. Transient hypoxemia occurred in one case, 1/46 (2.17%), which also recovered spontaneously. Conclusion: In summary, it is stated that transcatheter ASD device closure is a safe and effective procedure.
Atrial Septal Defect (ASD), Congenital heart disease, Transcatheter ASD device closure, Paediatrics.
Shahreen Barkat1*, Mohammad Monir Hossain2, Mahfuza Shirin3, Tanima Mahmud Shetu4, Mohammad Al Mahmud5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 18-25 | DOI: 10.53339/aimdr.2023.9.4.3
Use of the WINROP Screening Algorithm for the Prediction of Retinopathy of Prematurity (ROP): A Hospital-Based Study
Shahreen Barkat1*, Mohammad Monir Hossain2, Mahfuza Shirin3, Tanima Mahmud Shetu4, Mohammad Al Mahmud5
Abstract
Background: Retinopathy of prematurity (ROP) may be the blinding disease that affects the retina of neonates. WINROP utilizes the rate of postnatal weight increase as a replication of IGF-1 or uses weight increase and IGF-1 levels together as highly analytical markers for those infants at increased risk for the development of proliferative ROP. So this study was undertaken to find out the sensitivity and specificity of this algorithm concerning international screening guidelines to predict retinopathy of prematurity. Material & Methods: A prospective cross-sectional study was carried out in the Department of Neonatology, Bangladesh Shishu Hospital & Institute from January 2017 to December 2018. A total of 50 neonates (N=50) with proper documentation following the inclusion and exclusion criteria were confirmed as the study population. Informed written consent was obtained from all the parents or guardians after they were thoroughly briefed about the nature and purpose of the study. Data were processed and analyzed using statistical package for social sciences (SPSS-22 version) software (SPSS Inc., Chicago, IL, USA). The ethical review board of the Bangladesh Institute of Child Health approved the protocol of this study. Results: The mean gestational age was 29±1.17 weeks in ROP-positive cases and 31.79±0.51 weeks in ROP-negative cases. The mean weight was 1121.9±94.34 grams in ROP-positive cases and 1302.7±139.72 grams in ROP-negative cases. It was observed that the majority 92.3% of the ROP positive cases had weight gain ≤10gm/kg/day for 4 weeks but 87.5% of the ROP negative cases had weight gain >10gm/kg/day. The validity test of WINROP for the prediction of retinopathy has a sensitivity of 92.3%, specificity of 87.5%, and positive predictive value of 88.9% and negative predictive value of 91.3%. Low-grade ROP – In zone II or III and stage 1. High-grade ROP – In zone I and stage 2 or more and plus disease. Conclusion: Retinopathy of prematurity (ROP) is a severe eye infection that can affect premature neonates. In this study, WINROP predicted 92.3% sensitivity and 88.9% positive predictive value in comparison to the gold standard screening method for detecting ROP within 2 weeks of birth.
Retinopathy of prematurity, Birth- weight, Neonates.
Md. Mustafezur Rahman1*, Sheuli Akter2, SM Ali Hasan3, Sk. Mahmudur Rahman4, Suman Dey5, Habib Iftekhar Ahmad6, Dewan Saifudin Ahmed7
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 26-34 | DOI: 10.53339/aimdr.2023.9.4.4
Association of Gastrointestinal Manifestations with Socio-demographic, Lifestyle & Clinical Factors in HIV/AIDS Patients
Md. Mustafezur Rahman1*, Sheuli Akter2, SM Ali Hasan3, Sk. Mahmudur Rahman4, Suman Dey5, Habib Iftekhar Ahmad6, Dewan Saifudin Ahmed7
Abstract
Background: Gastrointestinal abnormalities in people with HIV/AIDS have been reported since the advent of AIDS. This study aimed to analyze the gastrointestinal manifestations in HIV/AIDS patients in terms of sociodemographic, lifestyle, and clinical characteristics with the association of GI manifestations. Material & Methods: This observational cross-sectional analytical study was conducted at the ART corner and Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka among adult HIV-infected or AIDS patients aged more than 18 years. A total of 122 patients were taken as per inclusion criteria. The study took place from March 2018 to February 2019. Continuous variables were reported as the mean ± standard deviation. The correlation of several GI symptoms with CD4 count was done by the Spearman rank test. Sociodemographic variables (gender, age, income, and education level), lifestyle variables (smoking status, risk consumption of alcohol, and physical activity level), and clinical variables (antiretroviral therapy – duration and class, duration of HIV infection) were assessed through a pre-tested and standardized questionnaire. The chi-square test was used to test the statistical significance of associations, considering a p-value ≤0.05 as statistically significant. All of the data were analyzed and calculated using the Statistical Package for Social Sciences (SPSS version 20.0) and Microsoft Excel 2016. Results: Among the patients, male preponderance was seen with the frequency of 66% (31) and 61.3% (46) with and without GI symptoms respectively. Patients aged 40-49 years old were more frequent with (31.9%) and without (25.3%) GI symptoms. The patients of primary level of education had GI symptoms and had no GI symptoms were 61.7% and 45.3% respectively of the total. Statistically significant (p=0.03) indicating that low CD4+ cell count (≤ 350 cells/mm3) can be considered as an associated risk factor for the occurrence of GI manifestations in HIV infected patients. There was less statistically significant difference in other clinical characteristics between patients with current GI manifestations and without GI manifestations. Here, the statistically significant p-value ≤0.05 is considered. Conclusion: This study concluded that, smoking and low CD4 count (<350cell/mm3) were found significantly associated with the occurrence of presenting GI symptoms. Other sociodemographic, lifestyle, and clinical factors were not significantly associated with the occurrence of GI manifestations.
Gastrointestinal, manifestations, sociodemographic, HIV, AIDS.
Outcome of Pregnancies with Severe Oligohydramnios in the 3rd Trimesters
Mahin Rahman1*, Mst. Nazmunnaher Mina2, Taposhi Sarker3, Samira Areen4, Tanwir Iqbal Ibn Ahamed5, Kanta Chowdhury6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 35-43 | DOI: 10.53339/aimdr.2023.9.4.5
Outcome of Pregnancies with Severe Oligohydramnios in the 3rd Trimesters
Mahin Rahman1*, Mst. Nazmunnaher Mina2, Taposhi Sarker3, Samira Areen4, Tanwir Iqbal Ibn Ahamed5, Kanta Chowdhury6
Abstract
Background: Amniotic fluid volume (AFV) of less than 200 ml is considered as insufficient, and is referred as significant oligohydramnios. Approximately 8% of pregnant women may experience low amniotic fluid levels ( less than normal / AFI < 8 cm ) But among them about 4% of pregnant women are diagnosed with severe or significant oligohydramnios. A range of unfavorable perinatal outcomes, including fatal growth restriction meconium aspiration of fetus, fetal distress and surgical intervention for foetal distress in labour and even perinatal death, are linked to oligohydramnios which are found during the antepartum period of pregnancy. The purpose of the study was to determine the outcome of pregnancies with severe oligohydramnios in the 3rd trimester. Material & Methods: This prospective observational study was carried out on the admitted patients in the Department of Gynecology & Obstetrics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from February to July 2013 (6 months). A total of fifty women (N=50) having Oligohydramnios in pregnancy were included in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for Social Sciences (SPSS) Version 25.0. The ethical clearance of this study was obtained from the Institutional Review Board (IRB) of BSMMU, Dhaka, Bangladesh. Results: Mean age of the mothers was 25.8 years and two-fifths of the mothers (20, 40.0%) belonged to 21-25 years old. Twenty-three mothers (23, 46.0%) were nulliparous. Of fifty mothers (N=50), eighteen (18, 36.0%) had borderline oligohydramnios & thirty-two (32, 64.0%) had severe oligohydramnios. Normal CTG tracing was found in eighteen patients (18, 36.0%) and abnormal CTG was found in thirty-two patients (32, 64%). Based on fetal outcome (N=50), 23 babies (23, 46.0%) were admitted to the NICU, of whom 7 (7, 14.0%) had birth asphyxia, 8 (8, 16.0%) had neonatal sepsis, 4 (4, 8.0%) had neonatal jaundice, 2 (2, 4.0%) had meconium aspiration syndrome, 4 had stillbirths, and 5 had died as neonates. Conclusion: Nowadays, routine obstetric USG is more routinely used to detect oligohydramnios. In the third trimester of pregnancy, PIH and postdated pregnancies are the most common causes of decreasing amniotic fluid. Unfavourable perinatal outcomes can be avoided with careful fetal heart rate monitoring during antenatal period and at labour. Every case of oligohydramnios necessitates a comprehensive prenatal assessment, parental counselling, and a personalized delivery time and technique. This study found no connection between meconium-stained liquor and oligohydramnios and found that caesarean section deliveries were considerably more common in these women.
Outcome of Pregnancies, Oligohydramnios, Amniotic fluid volume.
A K M Monzur Morshed1*, Md Abdul Wahab2, Samina Sharmin3, Mst. Farhana Yasmin4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 44-51 | DOI: 10.53339/aimdr.2023.9.4.6
Clinical Profile of Vernal Keratoconjunctivitis (VKC) Patients: A Retrospective Study at a Peripheral Combined Military Hospital in Bangladesh
A K M Monzur Morshed1*, Md Abdul Wahab2, Samina Sharmin3, Mst. Farhana Yasmin4
Abstract
Background: Vernal keratoconjunctivitis (VKC) is an allergic eye disease that especially affects young boys. The most common symptoms are itching, photophobia, burning, and redness. This study was conducted to assess the clinical profile of vernal keratoconjunctivitis (VKC) among the local population reported at a peripheral combined military hospital over 1 year. This study aimed to analyze the cases of vernal keratoconjunctivitis at a peripheral combined military hospital. Material & Methods: This is a retrospective study carried out in the Department of Ophthalmology at Combined Military Hospital, Saidpur. A total number of 110 patients with VKC were diagnosed based on their history, clinical features, and characteristic symptoms and sign over a period of 1 year from Jan 2021 to Dec 2021. Best-corrected visual acuity (VCVA) was assessed and each patient was thoroughly examined with a Slit Lamp Bi microscope, Fluorescein staining, and Tear film break-up time. Follow-up was done every 4 weeks, 3 months, and 6 months for 01 year. A purposive sampling technique was used in this study. Data was collected by a pre-designed questionnaire. All data were analyzed using SPSS version 20 (IBM Corp, Armonk, NY, USA) results were compiled in the frequency distribution table. Informed written consent was taken from all participants. Ethical clearance was obtained by the ethical committee of CMH. Results: Out of 110 patients, 80 (72.72%) were male and 30 (27.27%) were female. The highest incidence of VKC occurred in the age group of 11–15 years. In maximum cases 70 (63.63%) had palpebral form followed by mixed form 25 (22.72%) and then bulbar form 15 (13.63%). Corneal complications occurred in 27 (24.54%) patients; Out of 27, 25 patients had minor complications and 2 had major complications. The minor complications were usually superficial punctate keratopathy (SPK) or other epithelial disturbance. Major complications were superior pannus and pseudogerontoxon. Although patients with VKC often give a history of allergies or atopic diseases such as allergic rhinitis, asthma, or hay fever, in the present study, coexisting allergic conditions could be detected only 40 (36.36%) patients. Conclusion: VKC is a common form of allergic conjunctivitis among the age group of 11–15 years of male patients. The most common is the palpebral form followed by mixed and then bulbar forms. Some cases showed a history of atopy and other allergic conditions.
Bulbar, Palpebral, Vernal keratoconjunctivitis.
Demographic and Clinical Profile of Hypertensive Pregnant Women
Rifat Sultana1*, Elora Yasmin2, Salma Rouf3, Saima Yeasmin Eva4, Lima Shampa5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 52-58 | DOI: 10.53339/aimdr.2023.9.4.7
Demographic and Clinical Profile of Hypertensive Pregnant Women
Rifat Sultana1*, Elora Yasmin2, Salma Rouf3, Saima Yeasmin Eva4, Lima Shampa5
Abstract
Background: Preeclampsia, which complicates 2 to 4% of pregnancies globally, is progressive, unpredictable, and serious. It is a relatively common pregnancy disorder that originates in the placenta and causes variable maternal and fetal problems. In the worst cases, it may threaten the survival of both mother and baby. There are several risk factors of preeclampsia and the severity of mortality or morbidity can be minimized by identifying the risk factors. So, this study aimed to assess the risk factors of preeclampsia. Material & Methods: It is a cross-sectional study carried out in the Department of Obs & Gynae in DMCH from July 2017 to December 2018. The study included 50 cases. The selection criteria were 28 to 42 weeks of pregnancy with hypertension with proteinuria. Data was collected by history taking, clinical examination, and relevant biochemical tests. A purposive sampling technique was used in this study. Data was collected by a pre-designed questionnaire. Quantitative data were expressed as mean. Data were processed and analyzed by SPSS version 22.0. Informed written consent was taken from all participants. Ethical clearance was obtained by the ethical committee of DMCH. Results: In this study, most of the patients (16, 32%) were in the 16-20 years age group, followed by (13, 26%) 21-25 years age group and the mean age was (SD±) 24.5±6.3 years. Most of the patients (35,70%) were primigravida, and the rest (15, 30%) were multigravida. In the present study, most of the patient’s (20, 40%) gestational age at delivery was 33-38 weeks, followed by (18, 36%) 38-40 weeks. 64% of patients did not have a positive family history. Out of 50 patients, only a few (4, 8%) underwent regular antenatal care, and 72% had no antenatal care. Regarding systolic blood pressure, the range was 140.0-200.0 mmHg and mean±SD 159.0-9.08, and diastolic blood pressure was 90.0-120.0 mmHg and mean±SD 103.80-7.39. Conclusion: This study concluded that, most of the hypertensive pregnant women belonged to 16-20 years of age and most of them were primigravida. A greater part of the patients presented with hypertension at 33-38 weeks of pregnancy and only a few of them had a positive family history of hypertension. Considering antenatal care, they were unaware of it showing that, the most of the patient did not get proper antenatal care.
Preeclampsia, Primigravida, HTN, Antenatal Care.
Md. Mostafizur Rahman1*, Md. Shakhawat Hossain2
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 59-64 | DOI: 10.53339/aimdr.2023.9.4.8
Ideal Wound Closure Methods for Minimizing Scarring after Surgery: A Study in a Tertiary Care Hospital
Md. Mostafizur Rahman1*, Md. Shakhawat Hossain2
Abstract
Background: The healing of open cutaneous wounds involves the generation of vascularized granulation tissue that closes the gap in the skin. Thereafter, an effective epidermal barrier is created over the granulation tissue. Wounds in which sutures have approximated the edges also undergo granulation, albeit less than in open wounds that must heal by secondary intention. In both cases, the adherence of the wound edges becomes stronger over time. This study aimed to analyze the ideal wound closure methods for minimizing scarring after surgery. Material & Methods: This prospective observational study was conducted at Ibn Sina Medical College Hospital in Kallyanpur, Dhaka, Bangladesh from January 1st to December 30th, 2022. The study included a sample of 50 patients. A subcutaneous super-tension-reduction suture was used to minimize wound-closing tension by applying maximum tension reduction on both the dermis and subcutaneous tissue, away from the incision. The sampling technique used in this study was based on the operative technique. This suturing technique resulted in elevated wound edges centrally, creating a bump after tying the buried knot. Informed written consent was obtained from all study participants, and ethical clearance was obtained from the hospital’s ethical review committee. Results: The wounds healed primarily in 49 cases. The bump at the incision began to flatten out after 2 to 3 months and was almost completely flat by 12 months postoperatively. The use of a subcutaneous super-tension-reduction suture can greatly decrease tension on the dermis and the subcutaneous tissue. Conclusion: To reduce tension on the dermis, much deeper structures should be accessed, such as the superficial and deep fascia, and suture them. Another way to prevent pathological scar formation in high-tension areas is to use zigzag suturing techniques such as Z-plasty.
Wound, Suture, Scarring, Dermis, Fascia.
Jahir Uddin Mahmud1*, Md Feroj Ali2, Abu Bakar Siddique3, Md Naiem Hossain4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 65-72 | DOI: 10.53339/aimdr.2023.9.4.9
Effect of Excessive Use of Digital Devices on the Vision of Growing Children Between 5-20 Years of Age
Jahir Uddin Mahmud1*, Md Feroj Ali2, Abu Bakar Siddique3, Md Naiem Hossain4
Abstract
Background: The widespread use of digital devices among children has raised concerns about the potential adverse effects on their vision. This study aimed to investigate the impact of digital devices on the vision of growing children in Bangladesh, focusing on the prevalence of various vision problems and the effect of a -0.50 D Spherical Concave Lens on these issues. Material & Methods: This cross-sectional study was conducted in a private chamber of Dhaka, Bangladesh, over 16 months (March 2021-July 2022). A total of 428 children aged 5-20 years were selected, and data was collected using a structured questionnaire through in-person interviews with participants and their legal guardians. Informed consent and ethical approval were obtained. Data analysis was conducted using SPSS V.25 software. Results: The study found a high prevalence of myopia (26.87%), asthenopia (10%), eye strain (8%), and mild astigmatism (5%) among the participants. Autorefraction measurements ranged from -2.00D to -10.00 Diopters, with minimal final correction required. The use of a -0.50 D Spherical Concave Lens demonstrated significant improvements in asthenopia, eye strain, and mild astigmatism. Conclusion: Our findings highlight the adverse effects of digital devices on the vision of growing children and the potential benefits of interventions, such as the use of a -0.50 D Spherical Concave Lens, in alleviating these issues. Further research and the development of public health policies and educational programs are needed to promote eye health and reduce the adverse effects of digital device use on children’s vision.
Digital Device, Ocular, Myopia, Technology, Student
Risk Factors for Skin Infection in Patients with Systemic Lupus Erythematosus (SLE)
Mohammad Ziaul Haider1*, Md. Nazrul Islam2, A.T.M. Asaduzzaman3, Muhammad Shoaib Momen Majumder4, Md Nahiduzzamane Shazzad5, Mohammad Jahangir Ul Alam6, Nira Ferdous7, Minhaj Rahim Choudhury8, Syed Atiqul Haq9
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 73-82 | DOI: 10.53339/aimdr.2023.9.4.10
Risk Factors for Skin Infection in Patients with Systemic Lupus Erythematosus (SLE)
Mohammad Ziaul Haider1*, Md. Nazrul Islam2, A.T.M. Asaduzzaman3, Muhammad Shoaib Momen Majumder4, Md Nahiduzzamane Shazzad5, Mohammad Jahangir Ul Alam6, Nira Ferdous7, Minhaj Rahim Choudhury8, Syed Atiqul Haq9
Abstract
Background: Systematic lupus erythematosus (SLE) is an autoimmune chronic disease that sometimes leads to serious life-threatening condition. The occurrence of SLE was about 5 million worldwide by 2022. The overall frequency of SLE across Asian countries ranged from 0.9 to 3.1 per 100,000. Infection is one of the grave condition in SLE patients. This study intended to evaluate risk factors for skin infections in patients with systematic lupus erythematosus. Material & Methods: This observational prospective study was carried out in the Department of Rheumatology, BSMMU, Dhaka, Bangladesh from November 2014 to April 2016. A total of 131 patients with systematic lupus erythematosus were enrolled in this study as study subjects following the inclusive criteria. Data were collected using the predesigned semi-structured questionnaire. Proper written consent was taken from all the participants, before recruiting. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Univariate and multivariate analyses were performed to identify the predictive of infection in patients with systemic lupus erythematosus (SLE) where P<0.05 was considered as the level of significance with 95%CI. Results: Among the total study population (N=131), skin infections were found in 27% of cases (n=35) whereas 73% of cases were non-infected (n=96). In the infected group, the mean age of the respondents was 28.2±8.7 years. Taeniasis was the most common skin infection (15, 42.9%), and herpes infection was found in 12 patients (34.3%). Higher SELENA SLEDAI scores were more frequent in skin infected group than that in the non-infected group. Skin infections were significantly higher among the participants who used I.V. cyclophosphamide. In skin infected group, immunosuppressive drugs were used significantly in higher frequency (94.3% versus 24.0%) than in the non-infected group. In the multivariate analysis, higher disease activity (SELENA-SLEDAI score >3, (P=0.049) (OR=21.44), higher daily doses of prednisolone intake (>10mg/day, P=0.046) (OR=16.69), low serum C3/C4 (P=0.004) (OR=147.82) and use of any immunosuppressive drugs either in present or previously (P value= 0.042) (OR=22.58) were found as significant risk factors. Conclusion: In this study, taeniasis and herpes infections were found as the most common skin infections among patients with systemic lupus erythematosus (SLE). Higher disease activity, a higher dose of prednisolone, use of any immunosuppressive therapy either present or past and low complement level were the risk factors for skin infections.
SLE, Diagnosis, Drugs, Skin Infection.
Mohammad Abul Kalam Basir1*, Mahboob Hasan2, Shormin Momtaj3, Sohel Ahmed4, Mohammad Tarequl Islam5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 83-88 | DOI: 10.53339/aimdr.2023.9.4.11
Assessing Patient’s Factors for the Delay in Operative Treatment for Acute Intestinal Obstruction and Postoperative Complications
Mohammad Abul Kalam Basir1*, Mahboob Hasan2, Shormin Momtaj3, Sohel Ahmed4, Mohammad Tarequl Islam5
Abstract
Background: Acute intestinal obstruction is one of the most common surgical emergencies worldwide. Mortality and morbidity increase markedly with late presentation. So, it demands an increased awareness regarding the danger of delaying the treatment. This study aims to explore the causes of delay in operative treatment for Acute Intestinal Obstruction. We carried out the study in the Department of Surgery, Combined Military Hospital, Chattogram Cantonment, Bangladesh. A total of 50 patients were prospectively studied, evaluated, and managed. Patients of acute intestinal obstruction attend in Department of Surgery, Combined Military Hospital Chattogram (CMH Chattogram). The patients were divided into six age groups. A maximum of 18(36%) number was found in 51-60 years, and the mean(±SD) age of the study patients was 39.9±16 years with a range from 1-65 years. In the sex distribution of the study patients, it was observed that 41 (82%) were male and 09 (18%) were female. Forty patients (80%) had no history of previous abdominal operations. Ten patients (20%) develop a single complication, while 13(26%) develop multiple complications. Acute intestinal obstruction is one of the most typical surgical emergencies worldwide. A large proportion of patients with acute intestinal obstruction do not receive appropriate treatment due to pre-admission delay resulting in poor outcomes.
Acute Intestinal Obstruction, operative treatment, postoperative complications.
Failure Factors of Bubble CPAP in Neonates with Respiratory Distress
Sabrina Afrin1*, Mahfuza Shirin2
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 89-97 | DOI: 10.53339/aimdr.2023.9.4.12
Failure Factors of Bubble CPAP in Neonates with Respiratory Distress
Sabrina Afrin1*, Mahfuza Shirin2
Abstract
Background: Respiratory distress is the most frequent presenting complaint of newborn encountered within the first 48–72 hours of life. An infant who is breathing on instinct is given non-invasive respiratory support called Bubble Continuous Positive Airway Pressure (Bubble CPAP) to help them to maintain a long volume during expiration. The study aimed to identify failure factors of Bubble CPAP in neonate with respiratory distress. Material & Methods: From April to September 2017, a cross-sectional study was carried out at the Department of Neonatal Medicine in Bangladesh Shishu Hospital & Institute. One hundred and eight (N=108) newborns with respiratory distress who were given Bubble CPAP were enrolled for the study. After receiving the parent’s or guardian’s written informed consent, all the necessary information were recorded in a predesigned proforma that included the patient’s specifics. Then completed data forms were reviewed, updated, and prepared for computer data input. The “t” test, “r” test and Statistical Package for the Social Sciences (SPSS) Version 23.0 were used to analyze the data. Results: Among study patients (N=108), most of the neonates 49 (45.4%) belonged to age ≤24 hours and the neonates with respiratory distress which needed Bubble CPAP support 18 (16.7%) had RDS, 18 (16.7%) had PNA, 15(13.9%) had pneumonia, 14(13.0%) had PPHN, and 10(9.3%) had sepsis. More than three-fourths of the patients (85) were found successfully weaned and one-fifth of the patients (23) failed. Conclusion: The most frequent causes of respiratory distress were RDS, PNA, PPHN, Sepsis, congenital pneumonia, and pneumonia. Grunting respiration, higher RR, lower SPO2, higher FiO2 and cyanosis were substantially associated with Bubble CPAP failure among the respiratory distress symptoms. PPHN and sepsis have a causal relationship with Bubble CPAP failure. More duration of Bubble CPAP and more hospital stay also have relation with Bubble CPAP failure. The majority of patients were weaned, however, patients who failed Bubble CPAP died more frequently.
Respiratory Distress, Neonate, Bubble CPAP, failure factor, Sepsis, PPHN.
Shain Fariya Shetu1*, Sharmin Sultana2, Shanjida Sultana3, Mst. Sharifa Akter4, Hasnat Zaman Zim5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 98-104 | DOI: 10.53339/aimdr.2023.9.4.13
Comparison of Transvaginal Sonographic Cervical Length with Neonatal Outcomes among Pregnant Women Presented with Preterm Premature Rupture of Membrane
Shain Fariya Shetu1*, Sharmin Sultana2, Shanjida Sultana3, Mst. Sharifa Akter4, Hasnat Zaman Zim5
Abstract
Background: Preterm premature rupture of membranes (PPROM) is a significant complication in pregnancy, contributing to maternal, fetal, and neonatal morbidity and mortality. Identifying those at increased risk is crucial to address the problem of prematurity. Transvaginal sonography has emerged as an effective tool for assessing cervical length and predicting preterm delivery. The purpose of the present study was to compare the cervical length measured by transvaginal sonography with neonatal outcomes among pregnant women presented with premature rupture of the membrane. Material & Methods: This comparative cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from October 2017 to April 2018 for six months. A total of 44 Women who were admitted with premature rupture of membranes after completion of 28 weeks of gestation and before 37 weeks of gestational age, irrespective of their parity and were admitted in labor and antenatal ward were selected as the study population. The study population was divided into two groups designated as Group A where the cervical length of the fetus measured by transvaginal sonography was less than 2 cm and Group B where cervical length was more than 2 cm. Each group had 28 patients respectively. The collected data were analyzed using Statistical Package for Social Sciences (SPSS), version-23, 0. Chi-square tests were performed to compare the results, between the groups where p<0.05 considered, the level of significance with 95% CI. The ethical clearance of this study was obtained from the Institutional Review Board (IRB) of Dhaka Medical College and Hospital (DMCH), Dhaka, Bangladesh. Results: A total number of 44 pregnant women were recruited for this study of which 22 cases were in group A who had the cervical length less than 2 cm and the rest of the 22 cases were in group B who had the cervical length more than 2 cm. The mean age of the patients in Group A is 25.91±3.66 years and in Group B it is 24.32±3.34 years (P >0.05). Mean birth weight was 1.7±0 .37kg in group A and 2.1±0.2kg in group B (p=0.015). In this study, 36.6% baby needed resuscitation in group A whereas only 13.6% needed resuscitation in group B. Regarding neonatal complications in group A, (22.72%) neonates had pneumonia and followed by RDS (36.36%), neonatal sepsis (9.09%), hypoglycemia (9.09%). In group B, 36.36% neonates developed complications which were pneumonia (4.55%), RDS (9.09%), neonatal sepsis (13.63%), hypoglycemia (4.55%) and others (4.55%).Regarding neonatal outcome among the study population, in group A, 1-Min Apgar score <7 was observed in 59.01%) neonates, while in group B, 7(31.81%) was observed(p=0.073). 5- Min Apgar score <7 was observed in 18.18% neonates in group A, while in group B, 4.54% was observed (p=0.158) In group A, (77.27%) neonates needed to be admitted to NICU, while in group B, 36.36% neonates needed to be admitted to NICU(p=0.006). In group A, 77.27% neonates had complications whereas, in group B, only 36.36% neonates had complications (p=0.006).
Both in group A and in B, no neonatal death was observed. Conclusion: In conclusion, neonatal complications are significantly associated with the cervical length measured by transvaginal sonography with perinatal outcomes among pregnant women presented with premature rupture of the membrane.
Transvaginal, Sonography, Cervical-length, Pregnant, Women.
Lazina Muna1*, Md Abdul Hannan Sheikh2, Prokash Chandra Sarkar3, Fahim Iqbal Jagidar4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 105-112 | DOI: 10.53339/aimdr.2023.9.4.14
The Type of Tobacco Consumption Habits & Related Health Problem Among the Tobacco Users – A Retrospective Study
Lazina Muna1*, Md Abdul Hannan Sheikh2, Prokash Chandra Sarkar3, Fahim Iqbal Jagidar4
Abstract
Background: Tobacco is the leading preventable cause of death in Bangladesh and worldwide. Tobacco use leads most common diseases affecting the heart and lungs. Smoking being a major risk factor for heart attacks, strokes, chronic obstruc-tive pulmonary disease (COPD), emphysema, and cancer. The aim of this study was to evaluate tobacco consump tion habits among users and identify associated health problems. Material & Methods: This cross-sectional study was conducted in the Department of Health Education of National Institute of Preven-tive and Social Medicine, Dhaka, Bangladesh. Results: In total respondents who were adult male and female were included in the study. We found the Mean ± SD of age was 38.93 ±2.04. According to Sex, 89.30% were male and 10.70% were female and the majority 103.36% respondents of pattern of tobacco consumtion were smokless. 58.68% consumed Zarda, 54.67% cigarette, 27.34% Gul, 17.34% white tobacco, 8.67% Bidi, and rest of 3.34% consumed tobacco as various method. Tobacco con-sumption showed that a majority of knowledge of problem 50.67% were had cough and health problem the majori-ty 34.67% had dental pain. Conclusion: Health problem of tobacco use among the respondents they still consumed tobacco, so an effective awareness pro-gram to discourage the consumption of tobacco to protect people from the devastating consequences of tobacco usages for own and for the passive smoker.
Tobacco consumption, Habits, Health related problems, Tobacco users
Md. Mustafizur Rahman1*, Arindam Das2, Md. Masud Rana Bhuiyan3, Sayidul Haque4, Haridas Saha5, Md. Arifuzzaman6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 113-122 | DOI: 10.53339/aimdr.2023.9.4.15
Short-Term Outcome of Laparoscopic Intraperitoneal Hernioplasty of Incisional Hernia in Khulna Medical College Hospital
Md. Mustafizur Rahman1*, Arindam Das2, Md. Masud Rana Bhuiyan3, Sayidul Haque4, Haridas Saha5, Md. Arifuzzaman6
Abstract
Background: Herniorrhaphies that apply a large prosthetic mesh appear to have a lower failure rate, but extensive dissection of soft tissue contributes to an increased incidence of wound infections and wound-related complications. The method of laparoscopic incisional hernia repair was developed in the early 1990s. This technique is based on the same physical and surgical principles as the open underlay procedure. Therefore, this operation has increased in popularity promising shorter hospital stay, improved outcome and fewer complications than traditional open procedures. The aim of the study was to see the short-term outcome of laparoscopic intraperitoneal hernioplasty of incisional hernia in Khulna medical college hospital. Material & Methods: This study was prospective single-cantered observational study carried out at the department of surgery; Khulna Medical College Hospital included 30 patients of incisional hernia those who underwent laparoscopic intraperitoneal on lay mesh (IPOM) technique using polypropylene mesh and the mesh was fixed with Tacker. The duration of the period from January, 2013 to June, 2013. Data was collected by researcher himself with face-to-face interview using a prepared structured questionnaires & checklist and analyzed on SPSS 22. Results: The study was done on 30 patients among which 13 (43.3%) were male and 17 (56.6%) were female patients. Among them the maximum male and female came from 41-50 years age group. Among the 30 patients 16 belonged vertical incisional hernia, whereas 13 patients belonged transverse incisional hernia and the size of the defect of hernia in 27 were medium (defect is 5-10cm) and in 3 were small (defect is <5cm). 21 patients underwent emergency surgery, whereas 9 patients underwent elective surgery for different diseases previously. Every patient in this study group had some predisposing factors to appear incisional hernia. Of them, 16 (53.33%) patients were suffering from Diabetes mellitus, 6 (20%) patients were suffering from chronic cough 2 (6%) patients from chronic retention of urine, 4(13.33%) from chronic constipation and 8 (26.67%) patients from immunocompromised condition due to diseases or drugs taken by them. In case of preoperative complication, only 1 (3.3%) patient each experienced omental haemorrhage, visceral haemorrhage, bowel injury and open conversion whereas 2 (6.6%) patients featured port site bleeding. As postoperative complication, the study shows that 4 (13.3%) patients developed paralytic ileus in followed by port site infection in 3(10%) patients. Conclusion: Laparoscopic hernioplasty is safe and convenient repair in short-term in our clinical setup. But to reach a precise conclusion a long-term case control study with conventional mesh hernioplasty in multiple centres should be done.
Herniorrhaphies, Laparoscopic, Incisional hernia
Risk Factors for Low Birth Weight Babies in Women Delivered in a Tertiarry Referral Hospital
Shahida Akhtar1*, Faria Zaman2, Mahmuda Begum3, Bushra Fatema4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 123-132 | DOI: 10.53339/aimdr.2023.9.4.16
Risk Factors for Low Birth Weight Babies in Women Delivered in a Tertiarry Referral Hospital
Shahida Akhtar1*, Faria Zaman2, Mahmuda Begum3, Bushra Fatema4
Abstract
Background: Low birth weight is an important indicator of reproductive health and general health status of population. LBW is considered as the single most important predictor of infant mortality, especially of deaths within the first month of life. It is also a significant determinant of infant and childhood morbidity, particularly of neurodevelopmental impairments such as mental retardation and learning disabilities. This study aimed to determine the risk factors associated with low birth weight. Material & Methods: It was a prospective cross sectional observational study carried out in the Department of Obstetrics & Gynaecology, Dhaka Medical College, Dhaka, during the period of January 2012 to June 2012. Total 308 samples were included in this study. All women ≥28 weeks of pregnancy who delivered a LBW baby during six months of study period were selected. The database was processed by the application of statistical package SPSS for windows version 24. Results: This study shows most frequent maternal age group was 20-25 years. The mean maternal age was 23.86±4.82 years. Fifty three percent (53%)were female and 46.76% were male babies. Low birth weight was associated with inadequate Antental care, pre-delivery weight <55 kg, height <145 cm, low socio-economic status, and anemia. ln LBW babies’ mother having regular antenatal care (23.8%\. The incidence of mild anemia was 10.71 o/o, moderate anemia 32.79% and there were 2.60% cases of severe anemia. Maternal factors including maternal height (27.92%), maternal weight (36.36%), anaemia (43.50%), placenta praevia (12.18%), eclampsia (20.29%), PROM (24.35%), preterm labour (15.42%), severe PET (8.12%), twin pregnancy (17.86%), heart disease (2.44%) and DM (1.620/o) were associated with low birth weight. 62.01% mothers had average food intake, 37.99o/o had poor food intake. Conclusion: The incidence of low birth weight is 19.05%. Maternal height, maternal weight, ANC, anemia, eclampsia, preeclampsia, PROM, preterm labor, sever PET, twin pregnancy and heart disease were associated with low birth weight. There is a need for national prospective research project to study the low birth weight problem at the national level. There is also a need to discourage teenage pregnancies and to encourage utilization of mother and child health services, and treat concomitant illnesses during pregnancy. Maternal malnutrition, inadequate antenatal care and poor weight gain during pregnancy are significant predictors for delivery of a low birth weight neonate.
LBW, ANC, Anemia, Eclampsia, Preeclampsia, PROM, Preterm labor, Sever PET
Uddin MS1*, Sobhan SA2, Sakib A3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 133-139 | DOI: 10.53339/aimdr.2023.9.4.17
Evaluating the Impact of Surgical Occurrence of Bile Duct Injuries in Laparoscopic Cholecystectomy- A Retrospective Observational study
Uddin MS1*, Sobhan SA2, Sakib A3
Abstract
Background: Laparoscopic cholecystectomy (LC) is the gold standard for treating gallstone disease, offering numerous benefits over traditional open cholecystectomy. However, bile duct injuries (BDIs) are a significant complication, contributing to substantial morbidity and mortality. This study aims to evaluate the incidence, causes, risk factors, treatments, and outcomes of BDIs in laparoscopic cholecystectomy in Bangladesh. Material & Methods: This retrospective observational study was conducted at the Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Bangabandhu Sheikh Mujib Medical University, Al-Manar Hospital Limited, and Abeer General Hospital, Dhaka, Bangladesh. During this period, a total of 1255 complete hospital records of laparoscopic cholecystectomy conducted over the last 5 years at the study hospital were selected for the study following inclusion and exclusion criteria. Results: Out of laparoscopic cholecystectomy cases, 20 (1.64%) patients experienced BDIs. The most common cause of BDI was clipping or transection of the duct (33.33%), followed by mistaken anatomy (22.22%) and ischemic injury due to clip (18.52%). Acute cholecystitis was the most prevalent risk factor (37.04%). Standard laparoscopic cholecystectomy was performed in 83.33% of BDI cases, with the remaining 16.67% undergoing single-incision laparoscopic cholecystectomy. The majority of patients (74.07%) had no complications after BDI treatment, while 18.52% experienced minor complications, 5.56% had major complications, and 1.85% resulted in mortality. Conclusion: This study highlights the importance of meticulous surgical technique, early recognition, and appropriate management of bile duct injuries in laparoscopic cholecystectomy. By continually refining our understanding of the factors contributing to BDIs and implementing evidence-based strategies to prevent and manage this complication, we can optimize patient outcomes and ensure the highest standards of care in laparoscopic cholecystectomy.
Bile, Gallstone, Cholecystectomy, Injury, Laparoscopic
Ferdousi Begum1*, Dipi Barua2, Ayesha Nigar Nur3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 140-147 | DOI: 10.53339/aimdr.2023.9.4.18
Assessment of Contraceptive Usage Patterns and Associated Factors among Women in Bangladesh: A Hospital-Based Observational Study
Ferdousi Begum1*, Dipi Barua2, Ayesha Nigar Nur3
Abstract
Background: The use of contraceptives is crucial in managing family size, improving maternal health, and enhancing socio-economic development. Despite progress in promoting contraceptive use, challenges persist in countries like Bangladesh, where socio-cultural dynamics can affect the uptake and usage patterns. This study aimed to assess contraceptive usage patterns and associated factors among women attending a hospital in Bangladesh. Material & Methods: This prospective observational study was conducted at the Outpatient Department of Obstetrics and Gynecology, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh, from January 2021 to December 2022. The study included 150 women of reproductive age (18-45 years) who visited the hospital for gynecological problems or regular check-ups. Data was collected through structured interviews using validated questionnaires assessing knowledge and usage of contraceptive methods. Descriptive statistics and Chi-square tests were used for data analysis. Results: Among the participants, 66.00% reported regular contraceptive use, 10.67% reported irregular usage, and 23.33% stated they were not using contraception. Oral contraceptive pills were the most common method (43.48%). There was a significant association between contraceptive usage patterns and education level, age group, marital status, and number of children. In contrast, residence did not significantly associate with contraceptive practice. Conclusion: Despite high awareness levels, there exists a gap between knowledge and consistent contraceptive use. Education level, age, marital status, and number of children significantly influence contraceptive usage patterns. This study highlights the importance of integrating these socio-demographic factors in the planning and implementation of family planning policies to promote effective contraceptive use in Bangladesh. Future research should investigate the reasons behind irregular or non-use of contraceptives among informed women and devise strategies to bridge the knowledge-practice gap.
Contraceptive, Birth-Control, Family Planning, Pregnancy
Pediatric Laparoscopic Cholecystectomy: Clinical Significance of Cases
Md. Nooruzzaman1*, A.K.M. Zahid Hossain2, Mohammad Kamrul Hassan Shabuj3, Susankar Kumar Mondal4, Noor Mahammad5, K M Saiful Islam6, Umme Habiba Dilshad Munmun7, Tarafder Mohammad Atiquzzaman8
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 148-156 | DOI: 10.53339/aimdr.2023.9.4.19
Pediatric Laparoscopic Cholecystectomy: Clinical Significance of Cases
Md. Nooruzzaman1*, A.K.M. Zahid Hossain2, Mohammad Kamrul Hassan Shabuj3, Susankar Kumar Mondal4, Noor Mahammad5, K M Saiful Islam6, Umme Habiba Dilshad Munmun7, Tarafder Mohammad Atiquzzaman8
Abstract
Background: Cholecystectomy in children is relatively uncommon, despite being one of the most common surgical procedures in adults. However, the number of cholecystectomies in children has increased over the past two decades. The most common reason for juvenile patients to have cholecystectomy, according to a few research conducted on Western cultures, is biliary dyskinesia. However, in the majority of pediatric patients, gallstones are the cause of symptomatic gallbladder illness. The aim of this study was to describe the characteristics of pediatric patients who underwent laparoscopic cholecystectomy. Material & Methods: This was a retrospective study and was conducted in the Department of Pediatric Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from May,2017 to February, 2020. In our study, we included 24 cases with gallbladder illness who underwent pediatric laparoscopic cholecystectomy. Results: A total 24 pediatric patients underwent laparoscopic cholecystectomy during the study period. Out of them 17 (70.8%) were 10 to 18 years old and 7 were below 10 years old. The cases comprised 10 male (41.7%) and 14 female (58.3%). Mean body weight was 53.3 Kg. Mean height was 151.3 cm and mean BMI was 24.43 Kg/m2,with 15 patients(62.5%) being overweight. Fever (83.3%) and vomiting (79.2%) were the most common presenting feature. Most of the cases (87.5%) presented with multiple gall stone. 33.3% of patient comes with anemia ,where hemolytic disorder is predominant comprising 29.3% of patient. Comparison between overweight and non overweight patients reveal that preoperative complications like CBD dilatation, CBD stone and choledocholithiasis were significantly high in overweight patients. Conclusion: In conclusion, cholecystectomy is rarely performed in pediatric populations. We found Laparoscopic cholecystectomy (LC) is a safe and effective treatment for pediatric cholelithiasis. The cause of the increased incidence of pediatric cholelithiasis is obesity and life style as well as its natural history, must be investigated further.
Gallbladder, Pediatric, Laparoscopic cholecystectomy
The correlation between ABO Blood Groups and Oral Cancer susceptibility- An Observational Study
Fithrath-E- Qudrath1*, Dilbanu Trishna2, Farabi Ahmed3, Quazi Zakia Nusrat4, Jesmin Sultana5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 157-162 | DOI: 10.53339/aimdr.2023.9.4.20
The correlation between ABO Blood Groups and Oral Cancer susceptibility- An Observational Study
Fithrath-E- Qudrath1*, Dilbanu Trishna2, Farabi Ahmed3, Quazi Zakia Nusrat4, Jesmin Sultana5
Abstract
Background: Oral cancer (OC) in Bangladesh accounts for about 40% of all cancers of the body. Since the majority of human cancers are derived from epithelial cell changes in blood group antigens, it is an important aspect of human malignancies. Recently, it has been suggested that the ABO blood group may affect the development of oral cancer. The aim of this study was to evaluate the association between ABO blood group type and OC. Material & Methods: This observational study was conducted in the Labaid Cancer Hospital and Super Speciality Center, Dhaka, Bangladesh during the period from April 2021 to January 2023. Results: In total 110 patients from both male and female patient who were histopathologically diagnosed of oral cancer were included in the study. In our study we found the most common age group affected in OC was 51-60 years and more in males. The most common site affected by OC was buccal mucosa. Blood group A patients were more common in OC. Conclusion: The presence of antigen A on cells may increase the risk of oral cancer according to our study, while blood type O was less common in these patients.
Oral cancer, ABO blood group, Rh
Nibash Chandra Ghosh1, Tamanna Nawshin2, Kamrun Nahar Hurain3, Shah Sohel4, Sabyasachi Talukdar5, Sheikh Mohammad Tanjil ul Alam6, Tasnim Khanom7
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 163-172 | DOI: 10.53339/aimdr.2023.9.4.21
Frequency and severity of general and ear nose throat (ENT)- related symptoms in COVID-19 patients in a tertiary care hospital – A retrospective observational study
Nibash Chandra Ghosh1, Tamanna Nawshin2, Kamrun Nahar Hurain3, Shah Sohel4, Sabyasachi Talukdar5, Sheikh Mohammad Tanjil ul Alam6, Tasnim Khanom7
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a contagious respiratory and vascular disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a specific type of coronavirus. This human RNA coronavirus was isolated in December 2019 in the city of Wuhan, China. In March 2020, World Health Organization (WHO) declared that COVID-19 is a pandemic disease. The aim of this study was to determine the frequency and severity of the general symptoms of patients diagnosed with SARS-CoV-2, as well as the frequency and severity of ENT-related symptoms. Material & Methods: This was a retrospective observational study and was conducted in the Department of Otolaryngology & Head Neck Surgery of Dr Sirajul Islam Medical College & Hospital, Dhaka, Bangladesh during the period from July, 2020 to June,2021. In this study, we included 250 patients who had a history of SARS-CoV-2 infection, confirmed by PCR testing. Results: The majority (26.8%) of our patients were aged > 65 years, & most of our patients were male (55%). Mean age was 50.35 ± 17.41 years. Majority (38.4%) of our patients had HTN, 33.6% had DM, & only 15.2% had asthma. Among all patients, runny nose (81.6%), fever (74.8%), loss of sense of smell (73.6%) , loss of sense of taste (67.6%) were the most common symptoms. Olfactory dysfunction (78.4%) was the most common. We found severe cases of taste disturbance while dyspnea & headache indicates a moderate level of severity. Sore throat, runny nose & tinnitus were assessed as mild levels of severity. Conclusion: In our study, we found patients infected with SARS-CoV-2 may present to hospitals with a variety of general and ENT symptoms. Age, vertigo/dizziness, sore throats, and tinnitus was significantly related to frequency & severity of ENT symptoms associated with COVID-19 infection. Symptoms related to the sense of smell, taste and hearing are some of the most common symptoms in the course of COVID-19, which is important in the therapeutic and epidemiological management of patients.
COVID, Frequency, Severity, ENT
A study on Bacteriological Profile of Neonatal Septicemia and Antibiotic Sensitivity Pattern
Rozina Akhter1*, Shaifa Lubna Mili2, Nawsin Farzana Hossain3, Saifa Kismat4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 173-182 | DOI: 10.53339/aimdr.2023.9.4.22
A study on Bacteriological Profile of Neonatal Septicemia and Antibiotic Sensitivity Pattern
Rozina Akhter1*, Shaifa Lubna Mili2, Nawsin Farzana Hossain3, Saifa Kismat4
Abstract
Background: Neonatal septicemia, a critical neonatal illness, involves multiple bacteria types, frequently Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. Antimicrobial susceptibility varies, however, increased resistance against commonly used antibiotics, such as ampicillin and gentamicin, poses significant challenges. Timely diagnosis and appropriate antibiotics selection, informed by current bacterial profiles and sensitivity patterns, are crucial for improving neonatal outcomes. The aim of this study was to assess the bacteriological profile of neonatal septicemia and antibiotic sensitivity pattern. Material & Methods: This cross-sectional study was conducted in Department of Neonatal Intensive Care Unit (NICU), Dr. Sirajul Islam Medical College, Dhaka, Bangladesh, during the period from October 2021 to February 2023. Total 243 neonates with septicemia were included in this study. Results: The study sampled 243 subjects, 207 (85.2%) ≤72 hours old, and 36 (14.8%) >72 hours with a female predominance (89.7%). Positive bacterial cultures were seen in 46 (18.9%) individuals, predominantly Pseudomonas (28.2%). Organism incidence varied between early (35 occurrences, 76.1%) and late (11 occurrences, 23.9%) onset groups. More bacteria were observed in females (39 cases, 84.8%) than males (7 cases, 15.2%). Antibiotic sensitivity showed Pseudomonas was most responsive to Cephalosporin (20 cases, 43.5%). Acinetobacter showed the highest resistance to Cephalosporin (10 cases, 21.7%). Conclusion: From the findings of this study, it can be concluded that early-onset septicemia had higher bacterial presence than late-onset, and females exhibited more bacterial presence than males. Pseudomonas was the most frequent organism which was most responsive to Ceftazedime.
Bacteriological Profile, Neonatal Septicemia, and Antibiotic Sensitivity Pattern
Shakila Nazreen Banu U1*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 184-196 | DOI: 10.53339/aimdr.2023.9.4.23
Determining the Correlation Between Maxillary Anterior Teeth Size with Bitragion Width, Wrist Width, Interpupillary Width, Nasal Height in Indian Population and Using These Anthropometric Measurement as A Guide For Selecting Maxillary Anterior Dimensions
Shakila Nazreen Banu U1*
Abstract
Background: The vast number of combinations such as face form and size, Sex, Personality, and Age factor are utilized for determining the anterior tooth dimension. Whenever possible, it is advisable to record the form and shape of the natural teeth before extracting them. However, several anatomic entities and anthropometric measurements are used as a guide to select anterior teeth dimensions, but which is the most reliable indicator to determine the maxillary anterior teeth dimensions remains unclear. The study aimed to determine the correlation between maxillary anterior teeth size (Right Maxillary central incisor Length, Right Maxillary central incisor Width, Intercanine distance) with Bitragion width (BW), wrist width (WW), interpupillary width (IPW), Nasal height (NH) in Indian population. Material & Methods: Measurements of intraoral and extraoral landmarks made using Digital vernier caliper & Measuring tape in 173 subjects with an age range from 19 to 87 years were randomly selected fulfilling the inclusion and exclusion criteria. Results: The present study found that statistically significant difference (0.001) and strong correlation between Right maxillary central incisor length & width, and Intercanine distance with wrist width, nasal height & interpupillary distance, whereas, it is not significant between Right central incisor length & width, and Intercanine distance with Bitragion width. Conclusion: The results suggested that a high degree of correlation was seen between Wrist width, interpupillary width, nasal height, and maxillary anterior teeth dimensions. Hence, these anthropometric measurements can also be used for determining the maxillary anterior dimension in edentulous patients.
Bitragion width, Wrist width, Nasal height, Interpupillary width, Central incisor length, Central incisor width, Intercanine distance, Anthropometric measurements
Kapil Rampal1, Garima Mal2*, Harkanwalpreet3, Parampreet Singh4, Meghna Sharma5, Sudhir Khichy6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 197-202 | DOI: 10.53339/aimdr.2023.9.4.24
A Comparative Study of Bedside Index for Severity in Acute Pancreatitis (BISAP) and Acute Physiology and Chronic Health Evaluation II (Apache II) Score in Assessing the Severity of Acute Pancreatitis
Kapil Rampal1, Garima Mal2*, Harkanwalpreet3, Parampreet Singh4, Meghna Sharma5, Sudhir Khichy6
Abstract
Background: Acute pancreatitis is a common gastrointestinal disorder with substantial burden on the healthcare system. Since 1974, various scores have been developed using clinical and radiological parameters to assess the severity of acute pancreatitis. BISAP and APACHE II score have been developed for evaluation and to assess the severity of patients with acute pancreatitis. To evaluate BISAP and APACHE II score of patients with acute pancreatitis, compare sensitivity and specificity of BISAP and APACHE II score and to see predictive accuracy of BISAP and APACHE II score to analyse severity in acute pancreatitis. Material & Methods: The study was conducted in the department of General Surgery, GGS Medical College and Hospital, Faridkot, on 40 diagnosed patients of acute pancreatitis. Results: The ROC analysis for organ failure showed BISAP score has AUC of 0.927, sensitivity of 100%, specificity of 75%, PPV of 30%, NPV 100% and diagnostic accuracy of 77.5%; whereas APACHE II score has AUC 0.983, sensitivity of 100%, specificity of 94.4%, PPV of 66.6%, NPV of 100% and diagnostic accuracy of 95%. The ROC analysis for pancreatic necrosis showed BISAP score has AUC of 0.882, sensitivity of 100%, specificity of 75%, PPV of 30.7%, NPV 100% and diagnostic accuracy of 77.5%; whereas APACHE II score has AUC 0.924, sensitivity of 100%, specificity of 77.7%, PPV of 33.3%, NPV of 100% and diagnostic accuracy of 80%. The ROC analysis for prediction of mortality has AUC (0.730, 0.735), sensitivity (66.6, 66.6%), specificity (73.53%, 79.41%), PPV (30.7%,33.6%), NPV(92.59%,93.1%)and diagnostic accuracy(72.5%, 77.5%), for BISAP and APACHEII scores, respectively. Conclusion: BISAP score was found to have sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy as close to APACHE II score in predicting the severity of acute pancreatitis. Even though APACHE II score is stronger to predict organ failure than BISAP but BISAP being simple, easy to calculate, economical and reliable can be used as preliminary tool to stratify patients and to manage accordingly for better outcome. Hence, using BISAP score, patients having probability of progressing to severe disease can be assessed early.
Acute pancreatitis, BISAP, APACHE II.
Clinical Profile of Patients with Carcinoma Gall Bladder a North Indian Perspective
Kapil Rampal1, Harkanwalpreet Kaur2, Parampreet Singh Sandhu3, Nitesh Snehi4, Ankush Kumar5, Meghna Sharma6*, Sudhir Khichy7
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 203-209 | DOI: 10.53339/aimdr.2023.9.4.25
Clinical Profile of Patients with Carcinoma Gall Bladder a North Indian Perspective
Kapil Rampal1, Harkanwalpreet Kaur2, Parampreet Singh Sandhu3, Nitesh Snehi4, Ankush Kumar5, Meghna Sharma6*, Sudhir Khichy7
Abstract
Background: Gallbladder cancer (GBC), although rare, is the most common of biliary tract malignancy. It has been thought to be fatal disease with an extremely poor prognosis. Gallbladder cancer is often discovered incidentally after cholecystectomy performed for gall stone disease. Material & Methods: It is an retrospective observational study conducted in our surgical unit of Guru Gobind Singh Medical College and Hospital, Faridkot, India. Case records of 106 patients, from June 2017 to December 2022 were analyzed. Results: A total of 56% cases were in more than 60 years of age group and the mean age recorded was 58 years. 54.7% cases were females and 62.3% cases had a rural background. 59.4% of the cases were from lower socio-economic strata. A body mass index of more than 30 was recorded in 72.7% cases. 62.3% patients gave history of tobacco abuse. 39.6% cases were natives of Punjab and 37.8% cases were migrants from the Gangetic belt (Uttar Pradesh and Bihar). Pain abdomen was the most common presenting symptom found in 67.9% cases. 54.7% cases presented with abdominal mass. Majority of the patients (67.9%) reported in Stage 4 of the disease. Fundus involvement was seen in 45.3% cases. 94.3% cases had associated gall stones with 64.2% cases having multiple stones. Conclusion: We studied the clinical profile of the patients with gall bladder carcinoma and found its high incidence in the fifth decade of life and its association with female sex, low socio economic status, obesity, local and Gangetic belt ethinicity, gall stones and a late stage at presesentation.
Hospital milieu, Healthcare associated infections
Clinical Profile of Necrotising Soft Tissue Infection Patients in a North Indian Hospital
Kapil Rampal1, Harkanwalpreet Kaur2, Parampreet Singh Sandhu3, Nitesh Snehi4, Ankush Kumar5, Meghna Sharma6*, Sudhir Khichy7
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 210-217 | DOI: 10.53339/aimdr.2023.9.4.26
Clinical Profile of Necrotising Soft Tissue Infection Patients in a North Indian Hospital
Kapil Rampal1, Harkanwalpreet Kaur2, Parampreet Singh Sandhu3, Nitesh Snehi4, Ankush Kumar5, Meghna Sharma6*, Sudhir Khichy7
Abstract
Background: Necrotizing soft tissue infections (NSTIs) or necrotizing fasciitis are infections of the subcutaneous tissue and fascia with variable involvement of the overlying skin and underlying muscle. They can be initiated by trivial injuries and can be idiopathic. Material & Methods: It is an retrospective observational study conducted in our surgical unit of a tertiary care centre, from January 2017 to December 2022, were observed for age, gender, occupation, socioeconomic status, body mass index (BMI) clinical features, radiological findings (size, site, status, involvement of tissue compartments and bone). A total of 118 patient records were analyzed. Results: 60% patients were over 50 years of age and 64.2% were males. 69.85 cases had body mass index more than 30 kg/m2. 50.9% patients had history of alcohol abuse and 32.1% cases gave history of intravenous drug abuse. 73.6% cases had foul smelling discharge on presentation while fever and sepsis was seen in 64.2% and 52.8% cases, respectively. Lower limb and perineal involvement was seen in more than two third of the cases. 69.4% cases were anaemic while 44.1% had hypoalbuminemia. More than 85% cases had leucocytosis. 40.7% cases required ionotropes and 22.03% cases needed ventilatory support on admission. Diabetes mellitus was the most common associated co morbidity, seen in 53.4% cases. Conclusion: The necrotizing soft tissue infections are a significant health problem and carry high mortality and morbidity rates. The condition carries high association with modifiable risk factors like anaemia, hypoalbuminemia, diabetes mellitus and obesity.
Necrotizing soft‑tissue infections (NSTIs), necrotizing fasciitis, hypoalbuminemia, Fournier’s gangrene, Ludwig’s angina
Study of Clinico- Epidemiological Profile of Patients with Gallbladder Perforation
Kapil Rampal1, Parampreet Singh2*, Harkanwalpreet3, Harinder Singh4, Meghna Sharma5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 218-225 | DOI: 10.53339/aimdr.2023.9.4.27
Study of Clinico- Epidemiological Profile of Patients with Gallbladder Perforation
Kapil Rampal1, Parampreet Singh2*, Harkanwalpreet3, Harinder Singh4, Meghna Sharma5
Abstract
Background: Gallbladder perforation (GBP) is rare but a potentially fatal disease; its presentation can vary and hence is difficult to diagnose early. It is usually a complication of acute cholecystitis with or without gallstones. Most perforations are subacute, producing a pericholecystic collection. Acute free perforation with biliary peritonitis and chronic perforation with an internal biliary fistula are rare. The fundus of the gallbladder is the most common site of perforation because of its poor blood supply. Material & Methods: This retrospective observational study included all cases of gallbladder perforation that presented to general surgery ward from January 2019 to January 2022. Cases of traumatic gallbladder perforation and gangrenous gall bladder were excluded. The patients were assessed for epidemiological and clinical parameters like age, gender, socio economic status, presenting complaints, history of substance abuse, co- morbidity, hemoglobin, total leucocyte count, renal function tests, liver function tests, history of fever, fever on presentation, pulse, blood pressure and respiratory rate on presentation, type and site of perforation, method of management, diagnostic procedures(ultrasound and contrast CT abdomen findings), duration of hospital stay, and post-operative complications if any were evaluated. Results: This study included 14 patients ( 4 males and 10 females). The mean age of patients was 63.7 years. Gallbladder perforation was most common in the 5th and 6th decade of life. Two Patients had type l perforation and 12 patients had type ll perforation(Neimer’s classification) . Cases were diagnosed on the basis of contrast enhanced CT scan. Patients were managed with carbapenems, intravenous fluids and analgesics . 11(79%) patients were managed conservatively. One patient presented with impending rupture of anterior abdominal wall abscess that was communicating with pericholecystic abscess. Patients on conservative management were managed empirically with Carbapenem antibiotics and recovered well. Two patients underwent cholecystostomy. The mean hospital stay was 11.5 days for conservatively managed group and 18 days for patients who underwent upfront surgery. There was no reported mortality. All patients underwent interval open cholecystectomy after 06 weeks.Mean post operative hospital stay was 4 days in these patients. Each patient was followed up for 06 months in outpatient department and through telecommunication. Conclusion: Gallbladder perforation represents a special diagnostic and surgical challenge. Careful selection and management of patients with broad spectrum antibiotics can help us manage patients conservatively.
Acute cholecystitis, cholecystostomy, gall stones, pericholecystic abscess, subcutaneous abscess
Syed Saima1*, Ishrat Parveen2, Suhail Majid Jan3, Roobal Behal4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-4 | July-August 2023 | Page: 226-232 | DOI: 10.53339/aimdr.2023.9.4.28
Comparison of Diode Laser and Scalpel technique in the treatment of Gingival Melanin hyperpigmentation
Syed Saima1*, Ishrat Parveen2, Suhail Majid Jan3, Roobal Behal4
Abstract
Background: A smile can bring happiness into one’s life and also create positivity in the surrounding environment. Black or brown gums is a very common problem among all races of men and women that one complains to a periodontist. Depigmentation of melanin hyperpigmented gingiva can be carried out using scalpel and diode laser. Material & Methods: 10 patients having uniformly dense band of bilateral physiologic gingival hyperpigmentation on the facial aspect of maxillary and mandibular gingiva were included in this study. Each patient underwent initial phase 1 therapy (oral hygiene instructions, scaling and root planning) 1 week before the depigmentation procedure. A split mouth study was followed. In test group depigmentation was done by Laser and in control group depigmentation was done by scalpel. Followup was done at 1 week,1 month , 3 months and 6 months. Results: There was no statistical significance in plaque and gingival index in both the groups. At 6 months in group A, repigmentation was seen in 7 patients and in group B, repigmentation was seen in 6 patients. Conclusion: The methods used here produced desired results and above all, the patients were satisfied with the outcome, which is the ultimate goal of any therapy. The scalpel remains the gold standard because of its convenience and cost effectiveness, but with proper adhesion to safety measures, the diode laser can also be used to remove gingival pigmentation efficiently.
Gingival depigmentation, laser, scalpel
