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-3 | May-June, 2022

Assessment of Effect and Safety of Ripasudil (0.4%) in  patients of Primary Open Angle Glaucoma / Ocular Hypertension

Ishwar Singh1, Harsimran Singh2, Talvir Sidhu3, Neha Chhabra4*, Rohit Raina5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 1-7 |DOI: 10.53339/aimdr.2022.8.3.1

Assessment of Effect and Safety of Ripasudil (0.4%) in  patients of Primary Open Angle Glaucoma / Ocular Hypertension

Ishwar Singh1, Harsimran Singh2, Talvir Sidhu3, Neha Chhabra4*, Rohit Raina5

Abstract

Background: The aim is to evaluate the intraocular pressure-lowering efficacy and tolerability of Ripasudil (0.4%) ophthalmic solution in patients of primary open-angle glaucoma/ocular hypertension.Material & Methods:In this prospective, interventional, single-arm, open-label study, 50 patients of POAG/ocular hypertension attending the Outpatient Department of Ophthalmology, Government Medical College, Patiala were included.Results:Mean value of numerical change in IOP at four weeks, at eight weeks, at twelve weeks in IOP were 3.61 ± 2.05, 3.98 ± 1.47, 4.44 ± 1.53 respectively. Among side effects, conjunctival hyperemia, blepharitis, and allergic conjunctivitis were reported among 62%, 10%, and 8% of the subjects at four weeks. Final results after 12 weeks showed that only conjunctival hyperemia was reported as a side effect among 16% of the subjects. Conclusions:Our present study showed significant IOP-lowering effects and safety of ripasudil (0.4%) over 12 weeks in patients with primary open-angle glaucoma/ocular hypertension. For the treatment of glaucoma and OHT, ripasudil is regarded as a possible second-line choice in spite of the high occurrence of conjunctival hyperemia.

Ripasudil, IOP, Conjunctival Hyperemia.

Deaths Due to Road Traffic Injuries- A Forensic Autopsy Study

Jatinder Pal Singh1, Kuldip Kumar2, Jaspinder Pratap Singh3*, Merry Pal Kaur Chawla4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 8-15 |DOI: 10.53339/aimdr.2022.8.3.2

Deaths Due to Road Traffic Injuries- A Forensic Autopsy Study

Jatinder Pal Singh1, Kuldip Kumar2, Jaspinder Pratap Singh3*, Merry Pal Kaur Chawla4

Abstract

Background: Injuries due to road traffic injuries (RTIs) depend upon various factors that include human, vehicle and environmental factors that plays a vital role before, during and after a fatal vehicular accident. Road traffic injuries involve high human suffering and monetary costs in terms of ultimately deaths, injuries and loss of potential income. Aims and Objective: The aims and objective of study was to study the incidence of death due to road traffic injuries, demographic profile including various contributary factors of victims and vehicles and to analyse the magnitude of deaths.Material & Methods:The present retrospective and cross sectional study was conducted in Forensic Medicine & Toxicology Department, Government Medical College, Amritsar. All the autopsies conducted on road traffic injuries victims during the period from Jan, 2016 to Dec, 2020 were studied. Results:Majority of cases taken up for study were males (80%) followed by females (20%), majority cases belonged to the age group of 21 -30 years (34.72%). The majority of cases (70.61 %)that met with road traffic injury happened at evening time period. Head injury was the cause of death in 42.45% cases followed by 33.88% cases having multiple injuries.Conclusions:Motorization though has enhanced the lives in this era but that has come up with some price. High priority is demanded towards the alarming rate of human loss due to RTIs. Awareness at every level including the strict formation of policies that would prevent such RTIs in future.

Road traffic injuries, Vehicular accidents, Road Safety, Pediatrian deaths.

Scapulothoracic Bursitis or the Snapping Scapula Syndrome May Mimic with Shoulder Pain

Md Anamul Haque1*, Sukalyan Kumar Kundu2

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 16-22 |DOI: 10.53339/aimdr.2022.8.3.3

Scapulothoracic Bursitis or the Snapping Scapula Syndrome May Mimic with Shoulder Pain

Md Anamul Haque1*, Sukalyan Kumar Kundu2

Abstract

Background: The scapulothorasic joint plays an important role in overall shoulder function by providing a stable base for glenohumeral rotation. Snapping scapula syndrome, a likely under diagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is difficult to understand, sometimes mimic with shoulder pain. Dysfunctioning of any of muscles, ligament, bursa may cause abnormal scapular motion and predispose to scapulothoracic joint disorders. Accurate recognition of the syndrome may lead to prompt and long-term relief of symptoms by conservative or noninvesiveintervension treatment.Results:The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, boney abnormalities, muscle microtrauma or atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses. However, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be conservative. Intevension procedure is best for treating modalitis for scapulothoracic dysfunction, most reports have demonstrated well to excellent outcomes in a significantly high percentage of patients.Conclusions:Clearly, the best initial approach to these conditions is a conservative treatment like nonsteroidal antiinflammatory drugs plan that combines scapular strengthening, postural reeducation, and core strength endurance. If an appropriate trial of nonoperative management proves unsuccessful, local non invesiveintervension can produce good results.

Shoulder Pain, Scapulothoracic Bursitis, Snapping Scapula, Intervension.

Role of External Ventricular Drainage (EVD) in Treating Spontaneous Intraventricular Haemorrhage

Md. Mahfuzur Rahman1*, Md. Shamiul Alam Siddique2, Md Shafiqul Islam3, Asit Chandra Sarker4, Sukriti Das5, Fazle Elahy6, Md. Zillur Rahman7

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 23-31 |DOI: 10.53339/aimdr.2022.8.3.4

Role of External Ventricular Drainage (EVD) in Treating Spontaneous Intraventricular Haemorrhage

Md. Mahfuzur Rahman1*, Md. Shamiul Alam Siddique2, Md Shafiqul Islam3, Asit Chandra Sarker4, Sukriti Das5, Fazle Elahy6, Md. Zillur Rahman7

Abstract

Background: There is no consensus in the literature on the effects of the development of hydrocephalus on survival and disability after intracerebral haemorrhage (ICH) and the benefits of external ventricular drainage (EVD). This study is planned to describe the role of external ventricular drainage in treating patients of spontaneous, either primary or secondary, intraventricular haemorrhage with hydrocephalus.Material & Methods:A hospital based prospective interventional study was conducted in the Department of Neurosurgery of Dhaka Medical College Hospital, which is a tertiary level hospital, from April 2016 to September 2017.Total 42 patients of spontaneous intraventricular haemorrhage, either primary or secondary, with hydrocephalus were selected for this study. All the collected data were entered into IBM SPSS software, Version 24. For statistical analysis, paired t-test to compare the preoperative GCS with postoperative GCS at 24 hours was done.Results:Among 42 patients, age range was 26-75 years with the mean age 65.2 ± 10.87 years. Male were 26 (61.9%) and female were 16 (38.1%). Male-Female ratio was 1.625:1. No patient needed conversion of EVD into VP shunt. EVD drain became blocked in 5 cases which were managed accordingly.  5 patients developed ventriculitis among which 2 patients died and rest 3 improved with antibiotics.Conclusions:The results of present study shows that EVD has a good role in the treatment of spontaneous IVH with hydrocephalus when ICH volume is low (<30ml) and modified Graeb Score is low (≤10 found in this in this study. Preoperative higher GCS or initial improvement in GCS or initial improvement in GCS at 24 hours positively correlates with Glasgow outcome scale which is an indication of good function outcome.

External Ventricular Drainage (EVD), Intraventricular Haemorrhage (IVH), hydrocephalus, intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH).

Efficacy and Safety of Low Dose, Short Course Eltrombopag in Management of DF and DHF

Md. Mobinur Rahman1*, Mizanur Rahman2, Salina Akhtar3, Kamrun Nahar4, Abu Umar Al Fattah5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 32-39 |DOI: 10.53339/aimdr.2022.8.3.5

Efficacy and Safety of Low Dose, Short Course Eltrombopag in Management of DF and DHF

Md. Mobinur Rahman1*, Mizanur Rahman2, Salina Akhtar3, Kamrun Nahar4, Abu Umar Al Fattah5

Abstract

Background: Dengue is the most widespread aedes mosquito borne viral disease which infects more than 50 million people every year. The clinical symptoms of dengue may vary from mild fever to life-threatening incidents. Eltrombopag, a non-peptide, oral TPO-R agonist, small molecular weight is quandaries with the transmembrane domain of a TPO receptor and persuades the Janus Kinase/Signal transducer and activator of transcription pathway, with a significant rise in platelet production.Material & Methods:This study was a cross-sectional observational study which was conducted at Tairunnesa Memorial Medical College and Hospital (TMMCH), Gazipur and Shin Shin Japan Hospital, Uttara, Dhaka. The study was conducted in between July 2021- December 2021. The sample size for this study was 100.Results:The mean age in group 1 was 25±7, in group 2 29±8 and in control group 29±7. The mean Baseline PLT * 109 /L for group 1 was 57±23, for group 2, 51±28 and for control group 54±29. Mean of systolic baseline BP (mmHg) for group 1 was 103.55± 5.04 for group 2 was 105.38±18.34 and for control group was 101.97±8.28 and followed by the mean of diastolic baseline BP (mmHg) was 72.83±6.56, 72.84±12.93 and 71.97±4.75. AEs was found in 4(12.1%) cases of group 1 where in group 2 it was 2(5.9%) and in control group was 3(9.1%). In day 7, the recovery rate of group 1 was 93.9% and in group 2 the recovery rate was 94.1%.Conclusions:Dengue is a vector-borne viral disease which needs medical assistance because it may lead to life-threatening outcome. Eltrombopag can be considered as a therapeutic option to increase the PLT counts in DF and DHF patients in the management of thrombocytopenia.

Dengue fever, Dengue Haemorrhagic Fever, Eltrombopag.

Prevalence and Echocardiographic Predictors of Left Atrial Appendage Inactivity in Patients of Mitral Stenosis

Mohammad Solaiman Tanveer1*, Abdullah Al-Shafi Majumder2, Mohammad Ullah3, AQM Reza4, Tasnim Khanom5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 40-47 |DOI: 10.53339/aimdr.2022.8.3.6

Prevalence and Echocardiographic Predictors of Left Atrial Appendage Inactivity in Patients of Mitral Stenosis

Mohammad Solaiman Tanveer1*, Abdullah Al-Shafi Majumder2, Mohammad Ullah3, AQM Reza4, Tasnim Khanom5

Abstract

Background: Mitral stenosis (MS) is a common valvular heart disease. Thromboembolism is one of the most serious consequences of mitral stenosis, particularly when it is accompanied with atrial fibrillation (AF). When linked with Left atrial appendage inactivity (LAAI), patients with sinus rhythm (SR) are also at risk for this condition. In mitral stenosis, LAA inactivity determined by S-wave is an independent predictor of thromboembolism. The aim of the study was to evaluate the Prevalence and Echocardiographic Predictors of Left Atrial Appendage inactivity in patients of Mitral Stenosis.Material & Methods:Sixty MS patients were evaluated by transthoracic echocardiography (TTE) and all patients underwent transesophageal echocardiography (TEE). The annular systolic (S-wave) and diastolic (Em- and Am-waves) velocities were recorded by tissue Doppler imaging (TDI). LAA inactivity was defined as LAA emptying velocity <25 cm/second determined by pulse wave Doppler at the junction of LA & LAA (TEE). Patients were divided into three groups; group A I (n = 18). Sinus rhythm (SR) and LAA emptying velocity ≥25 cm/sec, group A II (n -22): SR and LAA emptying velocity <25cm/sec and group B (n = 20): atrial fibrillation.Results:Thrombus was detected in 14 patients and spontaneous echo contrast (SEC) was detected in 43 patients. Both S-wave and peak LAA emptying velocities were decreasing, while SEC frequency and density were increasing from group A to group B. There was a positive correlation between LAA emptying vs. S-wave and LAA emptying vs. Am velocities (p < 0.001, r= 0.708 and p<0.001, r=0.495). Multivariate regression analysis showed that only S-wave is the independent predictor of inactive LAA (p = 0.001, odds ratio = 0.133, 95% Cl =0.032-0.556). In patients with SR, the cutoff value of S-wave was 10 cm/sec for the prediction of the presence of inactive LAA (sensitivity: 92.3%, specificity: 95.3%).Conclusions:In individuals with severe mitral stenosis in sinus rhythm, there is a significant prevalence of left atrial appendage inactivity. The mean pressure gradient across the mitral valve, as well as S-wave are independent predictors of left atrial appendage inactivity. Inactivity of the left atrial appendage is an independent predictor of left atrial/left atrial appendage smoke and associated thrombus.

Mitral stenosis (MS), Left atrial appendage (LAA) function, annular systolic velocity (S-wave).

Outcome of Longitudinal Pancreatico-Jejunostomy on Pain Control and Pancreatic Function in Chronic Pancreatitis

S M Mortaza Ahsan1, Bidhan C. Das2, Asaduzzaman Nur3, Noor E Zannat4, Rasel Mahmud5, NurAlam Siddique6, Sarwar Ahmed Sobhan7, Emrul Hasan Khan8, Omar Siddique9

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 48-54 |DOI: 10.53339/aimdr.2022.8.3.7

Outcome of Longitudinal Pancreatico-Jejunostomy on Pain Control and Pancreatic Function in Chronic Pancreatitis

S M Mortaza Ahsan1, Bidhan C. Das2, Asaduzzaman Nur3, Noor E Zannat4, Rasel Mahmud5, NurAlam Siddique6, Sarwar Ahmed Sobhan7, Emrul Hasan Khan8, Omar Siddique9

Abstract

Background: Outcome of drainage operation for chronic pancreatitis are variable. The present study is taken to observe effect of longitudinal pancreatico-jejunostomy (LPJ) on pain control and pancreatic function in chronic pancreatitis in our setting.Material & Methods:Thirty-three patients who underwent LPJ for symptomatic chronic pancreatitis for one year period presented with abdominal pain (100%), steatorrhoea (30.3%), diabetes (66.7%) and weight loss (78.8%). Definitive diagnosis was made on the basis of ultrasonography and MRCP findings. LPJ (Partingtong-Rochelle) operation was done in all patients. Pain (using visual analoge scale), glycemic status (using FBS, 2hABF, HbA1c), body weight, serum zinc levels (as a marker of exocrine function), and serum insulin level (as a marker of endocrine function) were measured immediately after admission and 3 months after operation.Results:Three months after operation pain was completely disappeared in 23 (69.7%) patients, it persisted in different grade in 10 (30.3%) patients and the pain reduction rate was significant. Twenty two patients who had diabetes prior to surgery, their glycemic status significantly decreased and serum insulin level significantly increased (preoperative; 7.1±5.1 µU/L, postoperative; 14.3±4 µU/L) in 22 patients with DM after surgery. Serum zinc level increased (preoperative; 80.8±24.5 µg/dl, postoperative; 85.3±24.7 µg/dl) 3 months after surgery but the difference was not significant (p=0.571). However the body weight of all patients were significantly increased after operation.Conclusions:LPJ reduces abdominal pain and improves both exocrine and endocrine function in patient with chronic pancreatitis. Serum zinc levels can be considered as a tool of exocrine function.

Chronic pancreatitis, LPJ, Pain control, pancreatic function.

Prevalence of Community-Acquired Pneumonia in Diabetic Patients in a Tertiary Care Hospital of Bangladesh

Mohammad Shahadat Hoshen1*, AJM Emrul Kayesh2, Masum Ahmed3, Anwar Hossain4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 55-60 |DOI: 10.53339/aimdr.2022.8.3.8

Prevalence of Community-Acquired Pneumonia in Diabetic Patients in a Tertiary Care Hospital of Bangladesh

Mohammad Shahadat Hoshen1*, AJM Emrul Kayesh2, Masum Ahmed3, Anwar Hossain4

Abstract

Background: For nearly two centuries, pneumonia has been recognized as a frequent and sometimes fatal illness. Community-acquired pneumonia and diabetes mellitus are frequently associated, and this relationship bears the burden of both diseases. Objective: The present study was conducted to access the Prevalence of community acquired pneumonia in diabetic patients in a tertiary care hospital in Bangladesh.Material & Methods:This study was conducted among 110 controlled diabetic and 70 uncontrolled diabetic patients who were admitted to the Department of Medicine of Sher-E-Bangla Medical College Hospital in the period between January 2021 and June 2021. The data were analyzed using the SPSS version 25.0.Results:In this study of 110 controlled diabetic patients, 45% were men and 55 % were women. There were 57 % males and 43 % females among 70 uncontrolled diabetic patients. Controlled diabetic patients were 52% older than 60 years old, while uncontrolled diabetic patients were roughly 50 %older than 60 years old. . CAP associated with uncontrolled DM cases showed significantly more fever, RBS, ESR, pleural effusion and hospitalization days. There was no significant difference between controlled diabetic and uncontrolled diabetic CAP patients regarding cough, fever, chest pain, and pulse. The prevalence of CAP among 70 uncontrolled patients was 48% and among controlled diabetic patients was 45%.Conclusions:Specific care for diabetes patients with community-acquired pneumonia, as well as close monitoring for its control, will result in a reduction in infection exposure and, if any infection occurs, will a milder infection.

Pneumonia, controlled diabetes, uncontrolled diabetes.

Analysis of Medical and Social Causes of Obstructed Labour

Tahmina Hossain1*, Nasima Akter2, Ruma Akter3

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 61-71 |DOI: 10.53339/aimdr.2022.8.3.9

Analysis of Medical and Social Causes of Obstructed Labour

Tahmina Hossain1*, Nasima Akter2, Ruma Akter3

Abstract

Background: Obstructed labour is one of the major causes of maternal mortality (8%) in Bangladesh. It is also responsible for high rate of maternal and fetal morbidity. If we can identify the medical and social causes of obstructed labour in our country it may be helpful to find out the way to prevent this disease. Objectives: This study was to find out the medical and social causes of obstructed labour in our country. It also finds out the cause of delay in seeking care.Material & Methods:This study is a prospective observational study has been done in Dhaka Medical College Hospital, Dhaka from August 2004 to December 2005. One hundred patients who were admitted with obstructed labour during study period were included in this study.Results:In this study prevalence of obstructed labour was 3.59%. Among the patients who were admitted with obstructed labour 52% were within 20 to 25 years of age, 55% were primigravida, only 30% were on regular antenatal checkup. The medical causes of obstructed labour were cephalopelvic disproportion in 30%, malposition and malpresntation in 69% and cervical fibroid in 1 %. In this study 72% of study population had monthly income below 3,000 BTD, 27% had 3,001 – 5,000 BDT and only 1 % had above 5,000 BDT. Among them 8% patient had crossed the primary level of education and 35% were illiterate. The patients who were admitted with obstructed labour could not utilize the health facility in time and they had to go for trial of home delivery first. In 25% cases their husband and family members did not agree to bring them to hospital, 31.3% was because of ignorance, 14% was due to economic constraints, 13.3% wanted to avoid operative delivery, 9.4 % patient herself did not agree to come to hospital because it would disrupt house hold work and the rest 7% could not come due to long distance between home and health center and tertiary hospital. Modes of delivery were LSCS in 85%, craniotomy in 9% and evisceration in 4%. Maternal outcome was WF in 7% and puerperial sepsis in 18%. Perinatal death was 45%, MMR was 3% due to obstructed labour.Conclusions:SThe causes of obstructed labour are not only due to medical causes but also have social causes. The social causes depend on the socio-economic status and the level of education.

Obstructed labour, cephalopelvic disproportion, prenatal morbidity.

Periprosthetic Femur Fracture in a 73-Year-Old Female: A Case Report

Pervez Ahsan1*, Rafi Ahmed2

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 72-81 |DOI: 10.53339/aimdr.2022.8.3.10

Periprosthetic Femur Fracture in a 73-Year-Old Female: A Case Report

Pervez Ahsan1*, Rafi Ahmed2

Abstract

Increasing use of joint replacement for various conditions has led to a new group of fractures- the periprosthetic fractures. Periprosthetic fractures are considered which are associated with an orthopaedic implant. Worldwide incidence of Periprosthetic fractures is increasing due to increased number of primary joint arthroplasties and other revision surgeries. Periprosthetic femoral fracture can be classified as intraoperative & post-operative. The intraoperative periprosthetic fractures usually occur during the insertion of the femoral stem, often preceded by an area of increased cortical thickness. The management of these fractures are complex and usually needs application of basic principles to fit an individual situation rather than having a fixed set of rules. Standard treatment protocol includes use of locking plate with encirclage wires. In this study, we provide a case of periprosthetic femur fracture pain. A 75-year-old woman presented to us with pain in her right hip and thigh. The patient was a homemaker who had cemented total hip replacement surgery due to a femoral neck fracture 27 days back. After the primary replacement surgery, the patient appeared to be doing well and adhering to the hip precautions. While getting out of bed, she tripped and fell carelessly in the morning & complained of severe pain in her right hip. After assessment of all her medical conditions and physical examination, she was advised for revision surgery. An open reduction and internal fixation of the fracture with revision of the femoral component was planned. Risks, benefits, and alternatives were discussed at length with her and her family. The patient and her family agreed to the operative plan.

Periprosthetic Femur Fracture, revision surgery, hip arthoplasty

Prevalence of Cardiotoxicity Induced by Chemotherapy Measured by Dobutamine Stress Echocardiogram (DSE) in BSMMU

S M Ear-E-Mahabub1, Happy2*, Nazir Uddin Mollah3, Mahir Mubir4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 82-90 |DOI: 10.53339/aimdr.2022.8.3.11

Prevalence of Cardiotoxicity Induced by Chemotherapy Measured by Dobutamine Stress Echocardiogram (DSE) in BSMMU

S M Ear-E-Mahabub1, Happy2*, Nazir Uddin Mollah3, Mahir Mubir4

Abstract

Background: Cardiotoxicity related to cancer treatment is an alarming source of significant morbidity and mortality, and may differ from subclinical myocardial dysfunction to irreversible heart failure or even death. DSE is a safe, feasible, and accurate modality for finding of myocardial ischemia and prognostication in patients with known or suspected coronary artery disease, particularly when they have limited exercise capacity.Materials& Methods:This study is a cross-sectional observational study which was conducted at the department of Cardiology, in BSMMU, Dhaka from June 2019- December 2019. The sample size for this study was 50.Results:The mean age was 56±12 where 17(34%) of the respondents were <65 years and 33(66%) were >65 years. The male respondent was 35(70%) where female was 15(30%). Diabetes was found in 3(6%) cases and followed by Acute ischemia, Hypertension 6(12%), Coronary Artery Disease (CAD) 4(8%), ACE-inhibitors 5(10%), Beta-blockers 3(6%), Nitrates 3(6%). Acute leukemia was found in 13(26%). in M12-18 was 45±2 and followed by mean of LVESD (mm) was 27±4, 29±4, 29±4, 30±2, 30±3, 31±2. Mean of IVSd (mm) was 9±1, 9±1, 9±1, 9±2, 8±2, 8±3. Mean of Peak E (cm/s) was 80±10, 76±11, 74±16, 73±12, 66±9, 63±15 and the p-value was seen <0.001 which denotes a significant improvement in treatment (p<0.005).Conclusions:The early discovery of cardiotoxicity may ensure the improved chemotherapeutic process and timely management of the treatment of cardiomyopathy, such as beta-blockers and ACE inhibitors.

Cardiotoxicity, Chemotherapy, Dobutamine Stress Echocardiogram (DSE).

The Clinical Profile and Risk Factors of Pneumonia in Children

Gazi Golam Mostofa1, Bimal Chandra Das2*, Begum Shaira Sharifa3, Md. Abul Hashem4, Sohel Sarwar5, Muhammad Sazedul Karim6, Anupam Mazumdar7, H. M Hasan Imam8

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 91-97 |DOI: 10.53339/aimdr.2022.8.3.12

The Clinical Profile and Risk Factors of Pneumonia in Children

Gazi Golam Mostofa1, Bimal Chandra Das2*, Begum Shaira Sharifa3, Md. Abul Hashem4, Sohel Sarwar5, Muhammad Sazedul Karim6, Anupam Mazumdar7, H. M Hasan Imam8

Abstract

Background: The problem of increased ARI morbidity and mortality has arisen as a result of modernization, industry, and urbanization. There is a deficiency of epidemiological studies on risk factors and treatment. There is a significant vacuum in our understanding of these issues, which must be filled by methodical research. The purpose of this study is to evaluate the risk factors developing pneumonia in our area.Material & Methods:This was a prospective clinical study of pneumonia conducted on 90 children who were admitted to Paediatric ward in Abdul MalekUkil Medical College, Noakhali, Bangladesh in study duration. Epidemiological factors affecting the same were studied and bronchoscopy was done whenever it was needed. A detailed history of the relevant symptoms, such as fever, cough, rapid breathing, refusal of feeds, noisy breathing, bluish discolouration etc., was collected.Results:The most affected children belonged to the age group of 1 year to 3 years (64.9%). Bronchopneumonia (86.2%) was the most common clinical diagnosis made at admission. According to WHO ARI control programme, 28.7% had pneumonia, 54.3% had severe pneumonia and 17% very severe pneumonia. It was found that younger age group, malnutrition, kutcha house, crowding, poor sanitation facilities, cooking with fuel other than LPG (indoor pollution) and low socio economic status and high respiratory rate were significant risk factors for pneumonia in children.Conclusions:One of the leading causes of mortality and death in children is particularly pneumonia. In newborns and preschool children, bronchopneumonia is the most common symptom.

Children, Malnutrition Pneumonia, Morbidity, Mortality, Risk factors.

Relationship between Urinary Albumin Creatinine Ratio and Severity of Coronary Artery Disease in Non-Diabetic Patients

Amanat Hasan1*, Mashrufa Sultana2, Mohammad Khurshadul Alam3, Mir Shahadat Hossain4, Sami Nazrul Islam5, Md. Estakur Rahman6, Afshana Rahman7, Mohammad MonzurulAlam Bhuiyan8, Shirajum Monira9

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 98-106 |DOI: 10.53339/aimdr.2022.8.3.13

Relationship between Urinary Albumin Creatinine Ratio and Severity of Coronary Artery Disease in Non-Diabetic Patients

Amanat Hasan1*, Mashrufa Sultana2, Mohammad Khurshadul Alam3, Mir Shahadat Hossain4, Sami Nazrul Islam5, Md. Estakur Rahman6, Afshana Rahman7, Mohammad MonzurulAlam Bhuiyan8, Shirajum Monira9

Abstract

Background: Coronary artery disease (CAD) is leading cause of mortality worldwide. CAD accounts for 20% of all deaths in the South Asia region. The burden of CAD is emerging as a public health concern in developing countries like Bangladesh. There are some new biomarkers for detection of CAD. The aim of this study was to find out the relationship between ACR and severity of coronary artery disease in non-diabetic.Material & Methods:This cross-sectional analytical study was conducted in the department of cardiology, National Heart Foundation Hospital and Research Institute from April, 2018 to March, 2019. Purposive sampling was done to select a total 101 study subjects. Data were collected in a predesigned data collection form through clinical history, examination, laboratory findings and coronary angiogram report. Study population was divided into two groups: Group–A: Non-diabetic patients with ACR > 30mg/g Group–B: Non-diabetic patients with ACR ≤ 30mg/g.Results:Participants had a mean age of 52.5 ± 9.9 years with 75.24% men. Group A patients had higher ACR level (49.98±15.83 vs 13.36±7.08; p<0.01) than group B patients. Relation between urinary ACR and severity of CAD remained significant. Conclusions:In this study, there found a significant relationship in ACR and severity of coronary artery disease in non-diabetic patients.

ACR; Coronary artery disease; Coronary Angiogram; Non-diabetic patients.

Use of Red Cell Distribution Width Index for Screening and Differentiation of Iron Deficiency Anemia and Beta Thalassemia Trait

Biva Rani Mondal1*, Mohammad Kamrul Hossain2, Alamgir Ahmed3, Lotifur Rahman4, Kishor Chandra Pal5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 107-113 |DOI: 10.53339/aimdr.2022.8.3.14

Use of Red Cell Distribution Width Index for Screening and Differentiation of Iron Deficiency Anemia and Beta Thalassemia Trait

Biva Rani Mondal1*, Mohammad Kamrul Hossain2, Alamgir Ahmed3, Lotifur Rahman4, Kishor Chandra Pal5

Abstract

Background: Iron deficiency anemia (IDA) is one of the common nutritional disorders in the world. In the subcontinent Microcytic hypochromic anemia is usually caused by beta thalassemia trait (BTT) and iron deficiency anemia (IDA). IDA may be confused with BTT. It is important to distinguish between the above conditions to avoid unnecessary iron therapy in thalassemia carriers.  Red cell distribution width index (RDWI) are a simple, easy, and cost effective method to get a primary and valuable information regarding the diagnosis of IDA and BTT. Objective: To assess the predictive value of Red cell distribution width index (RDWI)) for differentiation of Iron Deficiency Anaemia and Beta Thalassaemia Trait.Material & Methods:The study was a cross-sectional descriptive study which was conducted in Department of Clinical Pathology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh. Over a period of April 2019 to September 2020. The newly clinically diagnosed cases of BTT and IDA were selected for this study. The sample size was 110. Among them 46 cases were identified as BTT and 64 were IDA. Data were analysed using a computer programme SPSS 25.0 version.Results:Total 110 respondents were included in the study. Among them 46.4% were female and 53.6% were male. About 72.72 % of respondents were aged 1 to 10 years old, while 10% were aged 11 to 20 years old and 10% were aged 21 to 30 years old. 4.54 % were between the ages of 31 to 40, as well as those over 40. The average age (SD) was 22.0 ± 32.52. Mean (±SD) age was 22.0 ± 32.52. RDWI had both sensitivity and specificity more than 80% in detection of BTT and IDA. Sensitivity, specificity of RDWI index for detection of BTT was found 81.0%, 83.8%. In case of IDA, sensitivity and specificity was found 83.8% and 81.0% respectively.Conclusions:The current study found that multiple discriminants can be used to differentiate between iron deficiency anemia and the Beta Thalassaemia Trait. RDWI could be a better way to tell the difference between BTT and IDA.

RWDI, IDA,BTT.

Bone Mineral Density in an Urban Hospital in Dhaka City of Bangladesh

Quamrun Nahar1*, Tasnu Ara2, Fariha Islam3, Matiur Rahman4, ShamimMomtazFerdousi Begum5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 114-121 |DOI: 10.53339/aimdr.2022.8.3.15

Bone Mineral Density in an Urban Hospital in Dhaka City of Bangladesh

Quamrun Nahar1*, Tasnu Ara2, Fariha Islam3, Matiur Rahman4, ShamimMomtazFerdousi Begum5

Abstract

Background: Osteoporosis behaves as a silent killer. Therefore, a high percentage of the affected people are not aware they have this chronic condition. In this way, the burden of osteoporosis is the burden of its clinical outcome: osteoporotic fractures, which are generally characterized by low-trauma fractures resulting from low bone mineral density (BMD). Objectives: The present study aimed to assess BMD distribution among urban and rural subjects and its relationship with key foods.Material & Methods:In this study, a total of 140 subjects were studied from the study BMD lab of the study hospital. Data were analyzed using Mean, SD, % and correlation by SPSS 24.Results:Mean±SD value of age (yr), BMI, WHR, Lumber-T score, Lumber-BMD, Right Femur -T score, Right Femur-BMD, Left Femur-T score, Left Femur-BMD, Supplementation of the study participants were 54±19, 25±5, 1.0±0.25, -1.0±1.0, 1.0±0.2, -1±1, 1±0.2, -1±1, 1±0.15.Age (yrs), BMI, waist (cm), hip (cm), WHR, Lumber T-score, Lumber Z-score, Lumber BMD (g/cm²), Rt. Fem Neck T-score,Rt. Fem Neck Z-score, Rt. Fem Neck BMD (g/cm²), Lt. Fem Neck T-score,Lt. Fem Neck Z-score, Lt. Fem Neck BMD (g/cm²) of the urban study participants were 51±13, 30±5, 88±16, 95±20, 1±20, -1.6±1.6, -1±1.6, 0.9±0.2, -0.9±1.3, -0.2±1.9, 0.9±0.2, -1±1.2, -0.3±1, 0.8±0.1 respectively and for rural participants the values were 54±14, 25±2.5, 86±9, 92±10, 1±0.2, -2.4±1.5, 0.8±0.2, -1.5±1.3, -0.6±1, 0.7±0.2, -1.6±1.2, -0.7±1 and 0.8±2 respectively. About 48.18% rural subjects had osteoporosis, 34.54% had osteopenia and 17.27% had normal bone health. Again, 28.57% of the urban subjects had osteoporosis, 41.40% had osteopenia and 30% had normal bone density. Fish, egg and meat were associated with BMD.  Fish intake had a positive association with lumber T score (r=0.194, p=0.009), LumZ (r=0.016, p=0.031), Lumber BMD (r=0.183, p=0.014). Milk intake has positive association with Lumber t and Lumber BMD (p=0.027, 0.049). Similarly, egg intake has positive association with Lumber BMD, Rt BMD, Lt BMD (p= 0.035, 0.01, 0.019).Conclusions:Nearly 48.18% rural subjects have osteoporosis, 34.54% have osteopenia and 17.27% have normal bone health. Again, 28.57% urban subjects have osteoporosis, 41.40% have osteopenia and 30% have normal bone density. The prevalence of osteoporosis is higher in rural area than urban peopleand osteopenia is higher in urban area than rural area. Fish, milk and egg consumption positivelyassociated with BMD.

Osteoporosis, Bone Mass Density, Osteopenia, Normal bone health.

Nutrient Consumption among the Bangladeshi Children with Autism

Quamrun Nahar1*, Naznin Sultana Moushumi2, Fariha Islam3, Shamima Akon Shammy4, Rehana Begum5

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 122-129 |DOI: 10.53339/aimdr.2022.8.3.16

Nutrient Consumption among the Bangladeshi Children with Autism

Quamrun Nahar1*, Naznin Sultana Moushumi2, Fariha Islam3, Shamima Akon Shammy4, Rehana Begum5

Abstract

Background: The prevalence of Autism in South Asia is 1 in 93 children, where, prevalence is much higher, 3% in Dhaka city of Bangladesh. Consumption of daily required nutrient is essential for these children like normal ones but sometimes may be neglected. Objectives: This study was undertaken to assess the macro and micronutrient consumption among the children with autism in Dhaka city and compared to the requirement.Material & Methods:In this cross-sectional study, 100 subjects where male-female ratio was 3:2, were studied from urban autism centers Dhaka, Bangladesh. Anthropometric parameters height, weight, BMI and 24-hour dietary recall (individual 3days) were collected following predesigned questionnaire. Data was collected from face to face interview from both parents and center’s teacher as appropriate. Nutritive value of food was calculated using Food Composition Table for Bangladesh, 2014 using a food software. For statistical analysis, SPSS 20 was used.Results:The average age and BMI of subjects were 11 yrs and 21 kg/m2 respectively. The mean ±SDvalues (g/day) of protein, fat and carbohydrate intake were 38±15, 47±12 and 116±38 respectively. The average intake of (mg/day) thiamine, riboflavin, vitamin C, calcium, magnesium, iron, niacin, and zinc was 0.68±0.32, 0.46±0.23, 33±24, 144±87, 137±55, 6.5±2, 11±4 and 5.2±2 respectively. About 94% children consumed only 33% of the required calcium. Nearly 42% children took 67% of the required magnesium. Similarly, half of the children failed to consume 33% thiamine and zinc of the requirement. Conclusions:Consumption of calcium, thiamine, folic acid, and zinc are seemed to be lower than their requirement.

Autism; micronutrients, 24-hour dietary recall; Food Composition Table; BMI.

Prevalence of Hepatitis A and E Infection in a Suburban Tertiary Care Hospital

PhudangRebon Tokbipi1, Kirti Malpekar2, Gajanan Khote3, Kishore Bisure4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 130-138 |DOI: 10.53339/aimdr.2022.8.3.17

Prevalence of Hepatitis A and E Infection in a Suburban Tertiary Care Hospital

PhudangRebon Tokbipi1, Kirti Malpekar2, Gajanan Khote3, Kishore Bisure4

Abstract

Background: Acute viral hepatitis causes  high morbidity in children and young adults. Hepatitis A and E can lead to fulminant hepatitis in 0.1% -2%. Objective: To find prevalence of HAV and HEV among suspected cases of acute viral hepatitis and to co-relate the laboratory findings with clinical presentations, over a one year periodMaterial & Methods:A retrospective analysis of 396 suspected acute viral hepatitis cases, whose samples were received in the laboratory during over a period of 1 year was performed. All sera samples were tested for IgM anti HAV & IgM anti HEV using commercially available solid phase ELISA, in Microbiology laboratory, at our hospital.Results:Majority infected were male (69%) and   young adults (98 %). Clinical presentations included fever (92%), jaundice/icterus (74%), nausea/vomiting (60%), hepatomegaly (45%), abdominal pain (40%), darkcoloredurine(15%), itching/rash (8.3%). ELISA revealed overall positivity :21.2% ; HAV: 38% ,HEV:62% and  dual infection:5%. Increased serum bilirubin, AST and ALT occured in 68%.Conclusions:Awareness regarding sanitation and hygiene is imperative  to curb the spread of acute viral hepatitis, especially in developing countries. Laboratory diagnosis is an essential supplementary tool in confirmation of suspected clinical cases and reduce transmission of this infection.

Acute Viral Hepatitis.

Assessment of Cases of Congenital Obstructive Uropathy in Children

Harshindar Kaur1*, Sukhmani Kaur2, Sanjana Saholi3, Pehal Goyal4

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 139-144 |DOI: 10.53339/aimdr.2022.8.3.18

Assessment of Cases of Congenital Obstructive Uropathy in Children

Harshindar Kaur1*, Sukhmani Kaur2, Sanjana Saholi3, Pehal Goyal4

Abstract

Background: The aim is to assess cases of congenital obstructive uropathy in children.Material & Methods:Sixty- five children in age ranged 5-12 years of either gender with congenital obstructive uropathy were recruited for the study. In all cases, ultrasonography was done in all cases. Growth of the child was monitored and height standard deviation score (Ht-SDS) was calculated annually. Glomerular filtration rate (ml/min/1.73 m2) was calculated.Results:Out of 65 patients, males were 40 and females were 25. Etiology found to be ureteropelvic junction obstruction (PUJO) in 12, posterior urethral valve (PUV) in 14, PUJO + PUV in 30 and obstructive megaureter in 9 cases. Symptoms were fever in 34, pain abdomen in 20, burning micturition in 45, poor urinary stream in 21 and flank pain in 15 cases. Treatment given was pyeloplasty in 14, nephrectomy in 20, PUV fulguration in 11, ureterocele decompression          in 12 and ureteric reimplantation in 8 cases.Conclusions:Most common etiologies for congenital obstructive uropathy in children were congenital uretero-pelvic junction obstruction and posterior urethral valve. Male preponderance was seen with burning micturition.

Congenital Obstructive Uropathy, Children, Posterior Urethral Valve.

A Study on the Parenting Styles and Parental Stress of Parents of (Attention Deficit Hyperactivity Disorder) ADHD Children

Ashutosh Kumar Chaubey1*, Neha Pandey2

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 145-161 |DOI: 10.53339/aimdr.2022.8.3.19

A Study on the Parenting Styles and Parental Stress of Parents of (Attention Deficit Hyperactivity Disorder) ADHD Children

Ashutosh Kumar Chaubey1*, Neha Pandey2

Abstract

Background: There are several steps involved in deciding if a child has ADHD. No single test is available to diagnose ADHD and many other problems such as depression, anxiety, sleep problems and certain types of learning disabilities can also have similar symptoms.  One of the process involves doing a medical examination, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosis of ADHD includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child itself. Aim & Objectives: To know the prevalence of psychiatric co-morbidities in ADHD  and to assess parental stress and parenting style among parents of children having ADHD.Material & Methods:A total of 78 children (6 to 18 years of age) and their parents were selected for the completion this study. The study was carried out in the Department of Psychiatry, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. Bivariate table and chi-square/Fisher Exact test were used. Correlation test has also been applied to know the association between demographic variables and their responses. Conclusions:We conclude that specific scales of the CBCL may help to identify specific comorbidities within ADHD cases in the primary care setting.

ADHD, CBCL, Bisphenol A, Daydream.

Different Types of ‘Background’ of Illustration-based PowerPoint Slides: Anatomy Postgraduate Students’ Preferences and Perceived Influence on Learning

Shafinaz Gazi1*, Khondker Manzare Shamim2

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 162-174 |DOI: 10.53339/aimdr.2022.8.3.20

Different Types of ‘Background’ of Illustration-based PowerPoint Slides: Anatomy Postgraduate Students’ Preferences and Perceived Influence on Learning

Shafinaz Gazi1*, Khondker Manzare Shamim2

Abstract

Background: ‘Background’ is an important visual element for creating multimedia (e.g., PowerPoint) slides on which text and illustrations are placed. Although some general guidelines for the background for textual materials on PowerPoint slides are available, detailed and specific guidelines on the background for illustrations are almost lacking. As part of a broader research, this qualitative study was designed to assess the preferences of Anatomy postgraduate students towards different types of background of illustration-based PowerPoint slides and their perceived influence on learning.Material & Methods:An FGD was conducted among eight Anatomy postgraduate students from two medical colleges of Bangladesh. Seven PowerPoint slides with one same pair of Neuroanatomy illustrations but seven different types of background dealing with the following characteristics were shown to them: White/light-coloured homogeneous/Dark-coloured homogeneous; Slightly decorated/Heavily decorated; Related to subject/Not related to subject. The discussion was on which background they liked most and why, and whether they think that the background would enhance students’ learning.Resultsand Conclusion:Six broad ‘themes’ emerged from the FGD: 1. No single type of background yielded a unanimous preference. 2. Coloured homogeneous backgrounds seemed to be the most preferred type with no clear-cut difference between the light-coloured and dark-coloured ones.  3. Preferences for white or slightly decorated background was moderate. 4. Among the slightly decorated backgrounds, preference for those related to the subject was greater than for those not related. 5. No preference was shown for the heavily decorated background not related to the subject. 6. Despite some positive comments regarding the influence of slide background on learning, no definitive conclusion could be drawn. While these results provide some baseline answers to the research questions, further studies addressing more specific issues of background and viewer characteristics are recommended.

Slide background, illustration, FGD, preferences, influence on learning.

Different Types of ‘Background’ of Illustration-based PowerPoint Slides: Anatomy Teachers’ Preferences and Perceived Influence on Learning

Shafinaz Gazi1*, Khondker Manzare Shamim2

Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-3 | May-June, 2022 | Page: 175-189 |DOI: 10.53339/aimdr.2022.8.3.21

Different Types of ‘Background’ of Illustration-based PowerPoint Slides: Anatomy Teachers’ Preferences and Perceived Influence on Learning

Shafinaz Gazi1*, Khondker Manzare Shamim2

Abstract

Background: Teachers are often in dilemma on how to use illustrations effectively in teaching Anatomy using multimedia (for e.g., PowerPoint) slides. ‘Background’ is an important element for creating illustration-based PowerPoint slides but is often overlooked when designing such slides. Some general guidelines on the PowerPoint slide background for presenting textual materials are available, but guidelines on the background for presenting illustrations in PowerPoint slides are almost nil. This descriptive type of observational study was part of a broader research that was designed to assess the preferences of Bangladeshi Anatomy teachers towards different types of background of illustration-based PowerPoint slides and their perceived influence on learning.Material & Methods:A survey was conducted among 39 Anatomy teachers from Bangladesh. Seven PowerPoint slides with one same pair of Neuroanatomy illustrations but seven different types of background dealing with the following characteristics were shown to them to collect their preferences and perceived influence on learning: White/Light-coloured homogeneous/Dark-coloured homogeneous; Slightly decorated/Heavily decorated; Related to subject/Not related to subject. Resultsand Conclusion:The survey revealed that most of the participants preferred either light-coloured homogeneous background (around 64%) or white background (around 60%). The least preferred (about 18%) one was the heavily decorated background not related to the subject. Some interesting trends of preference were also observed, including those related to male and female teachers as well as to their length of experience. In most Anatomy teachers’ perceptions, learning would be influenced by using their preferred ‘backgrounds’. Although the results of the present study reveal some insight into the preferences of Anatomy teachers and their perceived influence of different illustration-based PowerPoint slide ‘backgrounds’ on learning, further studies are recommended on larger samples focusing on more specific issues of PowerPoint slide backgrounds before making any conclusive comments on these issues.

Anatomy teachers, slide background, illustration, survey, preferences, influence on learning.