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
Mohit Gera1, Parminderjeet Singh Bhullar2, Basant Rai3*, Dixit Bansal4, Sombit Bandyopadhyay5, Aarush Paul6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 01-06 | DOI: 10.53339/aimdr.2022.8.6.1
Comparitive Analysis of Outcome of Proximal Femoral Nail Antirotation II (PFNA-II) and Dynamic Hip Screw (DHS) in the Management of Intertrochanteric Fractures of Femur
Mohit Gera1, Parminderjeet Singh Bhullar2, Basant Rai3*, Dixit Bansal4, Sombit Bandyopadhyay5, Aarush Paul6
Abstract
Background: To compare the clinical and radiological outcomes of patients with intertrochanteric fractures treated with PFNA-II versus DHS.
Material & Methods:50 adult patients with inter-trochanteric fractures, >20 years old, were randomly distributed into the PFNA-II and DHS groups. DHS with side-plate and proximal femoral nail A-II of appropriate size was used. The patients were regularly followed up till 1 year post-operatively. The clinical, radiological and functional evaluations were done at regular intervals. The peri-operative, early and delayed complications were recorded, and the final outcome of either group was evaluated using the Harris Hip Score.
Results:In the DHS group, the mean Harris Hip Score was slightly lower than that of the PFNA-II group at six month follow-up. However, at the 1 year follow-up, both the groups achieved similar Harris Hip Scores.
Conclusion:PFNA-II provides a significantly shorter operative time with a smaller incision that leads to lesser blood loss and wound-related complications. However, the incidence of procedural errors was significantly higher in PFNA-II when compared with DHS as it is a technically more demanding procedure that leads to more implant failures and consequent re-operations.
Intertrochanteric Fractures, Proximal Femoral Nail A-II(PFNA-II), Dynamic Hip Screw(DHS), Harris Hip Score(HHS).
Shruti Dhale1, Priya Chavan2*, Aneesh Kulkarni3, PrachetaNarwate4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 07-14 | DOI: 10.53339/aimdr.2022.8.6.2
Outcome of Early Versus Late Surfactant Therapy in Preterm Neonates with Respiratory Distress Syndrome at a Tertiary Care Centre
Shruti Dhale1, Priya Chavan2*, Aneesh Kulkarni3, PrachetaNarwate4
Abstract
Abstract
Background: Respiratory distress syndrome (RDS) or hyaline membrane disease (HMD), has been recognized as the most common co-morbidity of prematurity. Prematurity and RDS largely contribute to early neonatal morbidity and mortality. With adequate antenatal steroid and early continuous positive airway pressure, early surfactant therapy improve survival outcome.Material & Methods:Prospective interventional study included newborns with prematurity 28-36 weeks(GA) with clinical Respiratory distress syndrome and birth weight(BW)>650 gm. All subjects were preferably provided early surfactant therapy (within 2hours after birth). Surfactant (survanta) was delivered by INSURE technique (Intubate- Surfactant administration- Extubate) and only those who required further respiratory support were ventilated. Records on birth weight, gestational age, timing of therapy (early/late), sepsis, complications, and survival/death outcome were collected and data was analyzed using SSPS version 20 software.Results:Out of 76 neonates (42 male, 34 female), 46 received early surfactant therapy and 30 obtained it late; Although mortality was observed with both early(36.66%) and late therapy(63.33%), there was significantly higher survival with early therapy. higher mortality occurred in lower Birth weight(LBW) /Gestational age (GA) subgroups. Culture positive sepsis was found in 52.6% with higher association with late therapy . Hypotension was most common complication with late intervention , whereas there was no difference for pulmonary haemorrhage or apnea.Conclusion:Early surfactant administration improved survival with minimal complications in RDS except for extremely premature/LBW babies.
Preterm neonates, RDS, Surfactant therapy, Early administration, Survival outcome.
Shruti Dhale1, Aneesh Kulkarni2*, Priya Chavan3, Pracheta Narwate4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 15-22 | DOI: 10.53339/aimdr.2022.8.6.3
Outcome of Neonates with Meconium Aspiration Syndrome on High Frequency Oscillatory Ventilation in NICU of Tertiary Care Centre
Shruti Dhale1, Aneesh Kulkarni2*, Priya Chavan3, Pracheta Narwate4
Abstract
Abstract
Background: Meconium Aspiration Syndrome (MAS) is a complex respiratory disease of the term and near-term neonate. Inhalation of meconium causes airway obstruction, atelectasis, epithelial injury, surfactant inhibition and pulmonary hypertension, the chief clinical manifestations of which are hypoxemia and poor lung compliance. Supplemental oxygen is the mainstay of therapy of MAS, with around one-third of infants requiring mechanical ventilation. For those ventilated, high ventilator pressures, as well as relatively long inspiratory time and slow ventilatory rate, may be necessary to achieve adequate oxygenation. High frequency ventilation may offer a benefit in infants with refractory hypoxemia and/or gas trapping. High-frequency oscillatory ventilation (HFOV) is a lung-protective strategy that can be utilized in the full spectrum of patient populations ranging from neonatal to adults with acute lung injury. HFOV uses low tidal volumes and constant mean airway pressures in conjunction with high respiratory rates to provide beneficial effects on oxygenation and ventilation, while eliminating the traumatic “inflate–deflate” cycle imposed by CV. Few studies have shown that, HFOV can effectively improve lung ventilation and oxygenation function, shorten ventilator treatment time and reduce the incidence of air leakage for neonatal MAS, making it a safe and effective treatment method. Objective:To study the Outcome of Neonates with Meconium Aspiration Syndrome on High Frequency Oscillatory Ventilation (HFVO).Material & Methods:It is a Prospective Observational Study of 10 neonates >34 weeks of gestation and birth weight >1500gm with meconium-stained liquor with respiratory distress requiring mechanical ventilation. Study was conducted over a period of 10months from August 2021 to May 2022. These neonates requiring mechanical ventilation were electively first hand put on SensorMedics 3100A High Frequency Oscillatory Ventilator after taking informed written consent from parents and given appropriate Intensive care. Data was analyzed at the end of the study duration and looked for outcome in the form of successful weaning from mechanical ventilation and discharge from NICU, and Death.Results:8 out of 10 (80%) neonates with MAS that were ventilated via HFOV were successfully weaned from mechanical ventilation and discharged, while death was reported in 2 out of 10 (20%) of the neonates included in the study.Conclusion:80% of neonates with MAS that were provided mechanical ventilation in the form of HFOV were effectively weaned off from mechanical ventilation, whereas 20% neonates died. This shows clinical effectiveness of HFOV in MAS making it a safe and effective treatment modality in neonates with MAS.
High Frequency Oscillatory Ventilation and HFOV and Meconium Aspiration Syndrome and Outcome.
Sheikh Masud1*, MahbubulAlam Choudhury2, Sirajul Islam Mondol3, Md. SazzadHaider Shahin4, Shihab Mahmud Shahriar5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 23-30 | DOI: 10.53339/aimdr.2022.8.6.4
A comparison between Different Surgical Approaches of Nasopharyngeal Angiofibroma: A Cross-Sectional Observational Study in BSMMU, Bangladesh
Sheikh Masud1*, MahbubulAlam Choudhury2, Sirajul Islam Mondol3, Md. SazzadHaider Shahin4, Shihab Mahmud Shahriar5
Abstract
Background: The Otolaryngologist is currently dealing with a dramatic problem the nasopharyngeal angiofibroma. The posterolateral wall of the nasal cavity, close to the superior margin of the sphenopalatine foramen, is where the tumor commonly first appeared.Material & Methods:The Otolaryngology & Head Neck Surgery department at Bangabandhu Shiekh Mujib Medical University, Dhaka Medical College Hospital, and Shaheed Suhrawardy Medical College Hospital in Dhaka undertook this retrospective cross-sectional study. The research was done from February 2012 to November 2012. The study’s overall sample size was 30.Results:The majority of individuals (54%) who have nasopharyngeal angiofibroma are between the ages of 16 and 20. the majority of patients have similar symptoms such epistaxis, nasal blockage, nasal discharge, anemia, and masses in the nasal cavity. At presentation, anaemia is present to various degrees in 90% of cases. The lateral rhinotomy method is employed (40%) more often than other approaches. Three blood units were to be transfused into a maximum of 36.66% of the patients throughout the surgery.Conclusion:Nasopharyngeal angiofibroma is currently a difficult issue for otolaryngologists. When endoscopy was used instead of open techniques, we discovered that the mean length of the procedure was shorter, which may be related to endoscopy’s decreased morbidity.
Surgical Approaches, Nasopharyngeal Angiofibroma, Juvenile Nasopharyngeal Angiofibroma, Otolaryngology.
Roobal Behal1*, Suhail Majid Jan2, Huda Hussain3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 31-37 | DOI: 10.53339/aimdr.2022.8.6.5
Evaluation of Dentine Hypersensitivity in Adult Population with Chronic Periodontitis Visiting Government Dental College & Hospital, Srinagar
Roobal Behal1*, Suhail Majid Jan2, Huda Hussain3
Abstract
Background: A working knowledge of the prevalence of hypersensitivity in chronic periodontitis patients, is imperative to adequate prognostication, treatment planning and outcome. The present study, is a primary report of the prevalence of dentinal hypersensitivity, in relation to various patient characteristics (demographic and clinical) in chronic periodontitis patients visiting Government Dental College and Hospital, Srinagar, J&K.Material & Methods:A cross-sectional study design was used to evaluate 100 male and 100 female patients diagnosed with chronic periodontitis both by questionnaire and clinical test for the presence of dentinal hypersensitivity, in relation to various features.Results:An overall prevalence of 34% was found for self-reported and 42 % for actual dentinal hypersensitivity in chronic periodontitis patients. It was highest in females, undergraduates, rural subjects and canine teeth. The most common provoking stimulus was cold, and duration of hypersensitivity was less than 6 months. Clinical attachment loss was found to be more often associated with hypersensitivity than clinical gingival recession.76% of the patients reporting hypersensitivity also reported the use of desensitizing toothpaste.The reported prevalence of hypersensitivity was in concordance with other reports from dental college clinics. The particular geo-social background of the study location could have contributed to the observed difference in precipitating factors, effect of diet, and treatment seeking behaviour. Conclusion: The prevalence of dentine hypersensitivity in chronic periodontitis patients was 34% according to questionnaire and 42% according to the results of clinical test. Periodontal attachment loss was found to be could be an earlier indicator or a possible risk factor of DH, indicating the need for clinical initiative in the management of hypersensitivity in chronic periodontitis patients.
Dentinal hypersensitivity, chronic periodontitis, gingival recession.
Jesmin Akter1*, Begum Hosne Ara2, Dilruba Akter3, Marufa Akter4, Shamima Afroje5, Sumona Parvin6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 38-45 | DOI: 10.53339/aimdr.2022.8.6.6
Necessity of Parietal Peritoneum Layer Closure to Prevent Severe Adhesion in Repeat Caesarean Section
Jesmin Akter1*, Begum Hosne Ara2, Dilruba Akter3, Marufa Akter4, Shamima Afroje5, Sumona Parvin6
Abstract
Background: Repeated cesarean section involves various complication and one of the most common is adhesion. Some studies suggest that by closing the parietal peritoneum layer, the adhesion rate after surgery can might be decreased. The aim of this study was to assess the necessity of parietal peritoneum layer closure to prevent severe adhesion in repeat caesarean section.Material & Methods:This cross-sectional study was conducted in department of obstetrics and gynaecology, Care Medical College Hospital, Dhaka, Bangladesh from 2020 to 2022. Total 100 pregnant women were included in this study. These patients were divided into two groups where each groups contained 50 pregnant women. Here the two groups are parietal peritoneum layer closure and of parietal peritoneum layer non-closure.Results:Mean age of the pregnant women was 28.6 years (SD±4.50 years) in parietal peritoneum layer closure group and 30.4 years (SD±4.91 years) in parietal peritoneum layer non-closure group. 58% pregnant women in parietal peritoneum layer closure group and 60% in parietal peritoneum layer non-closure group had short inter delivery interval. The commonest comorbidity was hypertension in both groups (22% and 20%). Mean operating time was 35.6 minutes (SD±8.93 minutes) in parietal peritoneum layer closure group and 32.4 minutes (SD±9.50 minutes) in parietal peritoneum layer non-closure group. Mean hospital stay was 4.2 days (SD±1.01 days) in parietal peritoneum layer closure group and 4.8 days (SD±1.02 days) in parietal peritoneum layer non-closure group. The adhesion rate was 12% in parietal peritoneum layer closure group and 28% in parietal peritoneum layer non-closure group. The parietal peritoneum layer closure group had adhesion commonly in fascia to uterus (4%) and omentum to uterus (4%). The parietal peritoneum layer non-closure group had adhesion commonly in omentum to fascia (12%).Conclusion:Closure of the parietal peritoneum layer in caesarean section resulted in less adhesion formation. Thus, it is necessity to perform parietal peritoneum layer closure to prevent severe adhesion in repeat caesarean section.
Parietal Peritoneum Layer Closure, Severe Adhesion and Repeat Caesarean Section.
Anharur Rahman1*, Zulfiqur Rahman Khan2, Mohammad Saief Uddin3, Abu Taher4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 46-54 | DOI: 10.53339/aimdr.2022.8.6.7
The Outcome of Patients with Different Pancreatic Tumors Treated by Whipple’s Operation at Bangabandhu Sheikh Mujib Medical University
Anharur Rahman1*, Zulfiqur Rahman Khan2, Mohammad Saief Uddin3, Abu Taher4
Abstract
Background: Whipple’s Operation was first introduced by Allan Whipple in the 1930s. During 1960s and 1970’s the mortality rate for the Whipple operation was very high. Pancreatic tumors are one of the important indications for Whipple’s operation. About 85% of patients had adenocarcinoma tumor of the pancreas. 15% of patients had other tumors in the head region. In the Whipple’s operation the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum is removed. The aim of the study was to find the outcome of patients with different benign and malignant pancreatic tumor who undergone Whipple’s surgery and compare the preoperative finding and postoperative complication.Material & Methods:This study was a cross-sectional observational study which was carried out at the Department of Hepatobiliary and Pancreatic Surgery in Bangabandhu Sheikh Mujib Medical University (B.S.M.M.U), Dhaka, Bangladesh. The study was conducted during the period of August 2010 to July 2012. There were a total of 20 cases.Results:100% having solid pseudo papillary tumor age below 35yrs. After Whipple’s operation for solid pseudo papillary tumor of the pancreas, or benign tumor group, 25% of patients had developed wound infection. But in the case of Whipple’s operation for adenocarcinoma pancreas, 62.25% of patients developed wound infection. At a follow-up after 1 year of Whipple’s surgery, none of the benign tumor cases needed readmission, as all 100% had normal liver function tests, normal levels of CA 19-9, and normal USG findings in the abdomen. On the other hand, 25% of the malignant tumor cases had some form of complication and needed readmission.Conclusion:Most pancreatic tumors were located in the head of the pancreas which can be treated by Whipple’s operation. Adenocarcinoma of the head is the most common indication of surgery and is surgically resect able.
Pancreatic tumor, Whipple’s Operation, Carcinoma.
Pneumonia in Pediatric Outpatients: Cause and Clinical Manifestations
Md.Abul Hashem1*, BimalChadra Das2, Gazi Golam Mostofa3, Mohammad Zahirul Islam4, Kartick Chandra Halder5, Mohammad Khairul Alam6, Sohel Sarwar7, Yakub Ali Munshi8
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 55-63 | DOI: 10.53339/aimdr.2022.8.6.8
Pneumonia in Pediatric Outpatients: Cause and Clinical Manifestations
Md.Abul Hashem1*, BimalChadra Das2, Gazi Golam Mostofa3, Mohammad Zahirul Islam4, Kartick Chandra Halder5, Mohammad Khairul Alam6, Sohel Sarwar7, Yakub Ali Munshi8
Abstract
Background: The majority of children with pneumonia are managed as outpatients. Pneumonia is indeed an acute respiratory illness that mostly affects the lungs. When a healthy individual breathes, the lungs are made up of little sacs called alveoli, which fill with air. Pneumonia can occur at any age, and it is much more common in children under the age of five. Pneumonia accounts for 13% of all infectious diseases in babies under the age of two. Pneumonia in newborns is characterized by poor feeding and respiratory distress, as well as tachypnea, retractions, grunting, and hypoxemia. In contrast, the majority of published material on pneumonia, particularly bacterial pneumonia, has come from hospitalized patients. This circumstance implies a lack of straightforward, accurate ways of establishing a bacterial illness diagnosis in the outpatient context. The aim of the study was to observe the possible causes and clinical manifestations of pneumonia among pediatric patients.Material & Methods:This cross-sectional observational study was conducted at the Department of Pediatrics, Abdul Malek Ukil Medical College, Noakhali, Bangladesh. The study duration was August 2021- July 2022. A total of 76 infants and children with WHO ARI classified pneumonia were included in the study.Results:Among the participants, over half [61.84%] of participants had been less than 1 year of age, and 59.21% of the participants were male. All the participants presented with cough, and fever was also extremely common among the participants. 36.84% of the participants also had convulsions, while respiratory infections, headaches, and feeding problems were each present in 22.37% of the participants. 40.79% had crepitation in the lung, 42.11% had rhonchi or wheezing sounds, and 10.53% had both crepitation and rhonchi. Among the symptoms present in the participants, all 100 had a cough, 94.74% had a fever alongside cough, and 39.47% had fast breathing. Among the participants, 18.42% had respiratory rates of 41-50 per minute, 52.63% had a respiratory rate of 51-60, and 28.95% had a rate of over 60 per minute. The mean heart rate was 91.69 among the participants. 71.05% had grade 1 protein-energy malnutrition, 53.95% were breastfed, 38.16% were bottle-fed, and 7.89% had discontinued feeding. Poor sanitation was observed in 44.74%. 14.47% had LPG cooking gas being used in their home, while 85.53% had used non-LPG gas.Conclusion:The study showed that the majority of the children were under 1 year of age, and male prevalence was observed among participants. Cough and fever were extremely common clinical presentations and symptoms of pneumonia, and rhonchi and crepitation
were common signs of symptoms. Grade 1 protein malnutrition, unsanitary living space, and use of non-LPG gas might have a hand in the incidence of pneumonia among the participants. Among the different types of pneumonia, bacterial and viral were the most prevalent among children.
Pneumonia, Rhonchi, Respiratory, Viral, Bacterial.
Shahana Pervin1*, Shafeya Khanam2, MdShafiq Ullah3, Zakia Begum4, Samiya Alam5, Swapna Biswas Joy6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 64-69 | DOI: 10.53339/aimdr.2022.8.6.9
UTI among patients attending IPD and its relation with preterm labor in Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur
Shahana Pervin1*, Shafeya Khanam2, MdShafiq Ullah3, Zakia Begum4, Samiya Alam5, Swapna Biswas Joy6
Abstract
Background: Urinary tract infections (UTIs) now have become a severe public health problem because of the morbidity and treatment cost. UTI can be occur in all age groups, but women are more prone to develop UTI in comparison to men, due to several factors like short urethra, absence of prostatic secretions, pregnancy and easy infection in the urinary tract with fecal flora.Material & Methods:This study was a retrospective cross-sectional study which was conducted at the department of Obstetrics and Gynaecology, Bangabandhu Sheikh Muzib medical college hospital, Faridpur, Bangladesh. The study was conducted during the period of January 2021- January 2022. The total sample size for this study was 197.Results:Most of the respondents 87(44.2%) were aged between 25-29 years and followed by 16(8.1%) were aged 20-24 years, 81(41.1%) were 30-34 years and 13(6.6%) were aged >34 years. According to gravida, 4th gravida were 65(33.0%), 3rd gravida 37(18.8%), 2nd gravida 62(31.5%) and 1st gravida were 33(16.8%). The most common isolated organism was E. coli which was found in 135(68.5%) cases and followed by S. Aureus in 21(10.7%), Coagulase negative staph in 20(10.2%), Klebsiella in 9(4.6%) and GBS in 12(6.1%) cases. Majority of the patients 192(97%) had no complications onwards and only 5(3%) case was found with pyelonephritis.Conclusion: UTI in pregnancy has a major influence on pregnancy outcome. The unsolicited miseries of the pregnant mothers and their progenies might easily be legitimate by early diagnosis and treatment of UTI during pregnancy.
UTI, IPD, Preterm labor.
Mahbuba Akhter1*, Shahryar Waheed2, Mohammad Syfur Rahman3, MD. Sorowar Hossain4, Shah Newaz Dewan5, Nirupama Saha6, Masud Iqbal7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 70-77 | DOI: 10.53339/aimdr.2022.8.6.10
Comparison of Outcomes Between High and Standard Dose of N-acetylcysteine in Prevention of AKI in Patients with CKD
Mahbuba Akhter1*, Shahryar Waheed2, Mohammad Syfur Rahman3, MD. Sorowar Hossain4, Shah Newaz Dewan5, Nirupama Saha6, Masud Iqbal7
Abstract
Background: Patients with chronic kidney disease (CKD) are at a common risk for contrast-induced acute kidney damage (CI-AKI) because of various complications. Intravenous N-acetylcysteine (NAC) in high doses (1200mg) is considered more effective than its conventional dose (600mg) to prevent CIN and related complications. Objective: The study aimed to compare the effectiveness of high dose versus standard dose of intravenous N-acetylcysteine (NAC) in the prevention of Acute Kidney Injury in patients with chronic kidney disease.Material & Methods:A total of 60 (sixty) patients diagnosed with CKD went to coronary angiography and/or percutaneous coronary intervention (PCI) were selected by simple random technique and categorized into two groups – Group A (30 patients) received high dose NAC (1200mg) and Group B (30 patients) – received standard dose NAC (600mg). For evaluation of renal damage serum creatinine level for at least >3 months, renal imaging revealed bilateral small echogenic kidneys, eGFR (<60 to 15ml/min/1.73m², measured by MDRD formula) and also by ACR >30 mg/gm, associated with IHD, admitted for percutaneous intervention (PCI) were taken in account. Statistical analysis was done by SPSS version 20 with taking 95% confidence interval. The quantitative data were expressed as mean and standard deviation and qualitative data were expressed as frequency distribution and unpaired t-test, Chi-square test, and Fisher exact analytic test were done.Results:The observed mean age group of the patients was 65 ± 8 years and 62 ± 7 years in group A and group B respectively with male predominance in both groups. Primary renal disease diabetic nephropathy (DN) more (36.66%) in group A than in group B (30.00%) but patients with Hypertensive nephropathy were the same (33.33%) in both groups. After interventions, S. Creatinine (mg/dl) level, e, GFR (ml/min/1.73m²), were statistically significant in cases of group A patients (P-value 0.001& 0.003 correspondingly) compared to group B Patients (P-value 0.075 & 0.001 respectively). Again, the mean of pre-intervention S. Creatinine was 1.7 ±0.5 in group A whereas this was 1.9 ± 0.8 (p-value, 0.599) in group B and after 48 hours of intervention this was 1.6 ± 0.5 and 2.0 ± 0.5 (p-value, 0.697) In group A and group B respectively. Overall, no patients were detected with nephropathy for high dose NAC whereas 27 (90%) out of 30 had developed CIN in standered dose.Conclusion:High-dose N-acetylcysteine (1200mg) is more potent and effective than the standard dose (600mg) in reducing contrast-induced acute kidney injury (CI-AKI) in patients with CKD.
N-acetylcysteine, AKI, CKD.
Abdullah Al Mamun Khan1*, Nasrin Parvin Zahan2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 78-86 | DOI: 10.53339/aimdr.2022.8.6.11
Survival and Success of Immediate Implant Placement Followed by Tooth Extraction a Retrospective Study
Abdullah Al Mamun Khan1*, Nasrin Parvin Zahan2
Abstract
Background: Dental Implant originally utilized for aesthetic and functional rehabilitation, this treatment option have transformed oral rehabilitation techniques and are now regarded as the gold standard of treatment for replacing single, partial, and full-arch teeth. With improvements in osteotomy technique, implant macro- and micro-geometry, surface treatment, types of implant prosthetic connections, and other aspects, the overall treatment duration has also been greatly shortened.Material & Methods:This study was carried out in two implant centers and is retrospective and descriptive. It was done in the Implant Surgery Centers of Banasree Dental and German Dental, Dhaka, Bangladesh. The research was carried out from January 2010 to June 2022. 63 people made up the entire sample for this study.Results:Most of the patients 21(33.3%) were aged between 51-60 years where most of the patients 36(57%) were female and 27(43%) were male. Maxilla was done in 45(71.4%) patients, mandible was done in 48(76.2%). 69(74.2%) implants were done on the anterior site and 24(25.8%) was done on posterior site. All the patients had a good primary stability of implant with an insertion torque of 30 N/cm or more. There were 100% survival rate after the implants and in good functional condition. All patients were happy with their implant.Conclusion:This approach of osteotomy preparation’s greater primary stability appears to have a minimal detrimental effect on implant success.
Immediate Implant Placement, Ridge Splitting Techniques, Osseointegration, Osseodensification, Survival and Success, Tooth Extraction.
A Cadaveric Based Morphometric Analysis of the Sciatic Nerve with Clinical Implications
Shuvagata Aditya1*, Jagadeesh Dhamodharan2, Kartik Saxena3, Arulmoli Radhakrishnan4, ElvySuhanaMohd Ramli5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 87-96 | DOI: 10.53339/aimdr.2022.8.6.12
A Cadaveric Based Morphometric Analysis of the Sciatic Nerve with Clinical Implications
Shuvagata Aditya1*, Jagadeesh Dhamodharan2, Kartik Saxena3, Arulmoli Radhakrishnan4, ElvySuhanaMohd Ramli5
Abstract
Background: The sciatic nerve is one of the very vital nerves of the body, which has importance not only in the field of Anatomy but also in various clinical fields such as Orthopaedics, Anaesthesia, Plastic & Reconstructive Surgery, and Neurosurgery. This study was the first attempt to analyze the different dimensions of the anatomically normal sciatic nerves at different levels, involving Malaysian cadavers.Material & Methods:The study was conducted on 78 adult, both cadaveric and disarticulated lower limb specimens belonging to both genders. The morphometric analysis was done in 64 specimens having anatomically normal sciatic nerves. The dimensions were measured by a digital Vernier caliper, a measuring tape, and thread.Results:The average width, thickness and circumference of the nerve at the lower border of piriformis muscle (PM) were 15.86 mm ± 1.47 (right) & 16.56 mm ± 1.08 (left); 4.22 mm ± 0.29 (right) & 4.10 mm ± 0.20 (left) and 27.70 mm ± 2.02 (right) & 27.72 mm ± 2.39 (left), respectively. Similarly, at the level between ischial tuberosity (IT) and greater trochanter (GT), the mean width was 11.59 mm ± 1.43 (right) & 11.50 mm ± 1.53 (left); thickness was 3.48 mm ± 0.18 (right) & 3.35 mm ± 0.17 (left) and circumference was 27.08 mm ± 2.79 (right) & 27.22 mm ± 2.87 (left). At bifurcation, the mean width was 8.66 mm ± 0.65 (right) & 8.90 mm ± 0.81 (left); thickness was 2.41 mm ± 0.12 (right) & 2.31 mm ± 0.15 (left) and circumference was 19.75 mm ± 1.44 (right) & 19.99 mm ± 1.45 (left). The average distance between IT and GT was 50.37 mm ± 4.47 (right) & 47.73 mm ± 4.24 (left); between lateral border of IT and medial border of sciatic nerve was 15.43 mm ± 1.45 (right) & 14.66 mm ± 1.37 (left); and between medial border of GT and lateral border of the nerve was 27.13 mm ± 1.38 (right) & 25.07 mm ± 1.73 (left). The average length of the nerve was 328.20 ± 26.26 (right) & 332.31 ± 21.89 (left); and that of the thigh was 412.19 ± 24.50 (right) & 407.24 ± 25.82 (left).Conclusion: This knowledge will not only aid future researchers but also will assist surgeons, orthopaedicians, anaesthetists, reconstructive surgeons, and neurosurgeons by preventing iatrogenic nerve injuries.
Sciatic nerve, width, thickness, circumference, distance
Swapan Kumar Paul1*, Rakibul Islam2, Paritosh Kumar Ghosh3, Prosanto Kumar Biswas4, Md. Ayub Ali5, Ipsita Biswas6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 97-104 | DOI: 10.53339/aimdr.2022.8.6.13
Study of Effectiveness of Double J (D-J) Stent and Transanastomotic BMI Tube Stent in Anderson Hynes (A-H) Pyeloplasty for The Management of Unilateral Pelvi-Ureteric Junction (PUJ) Obstruction in Children
Swapan Kumar Paul1*, Rakibul Islam2, Paritosh Kumar Ghosh3, Prosanto Kumar Biswas4, Md. Ayub Ali5, Ipsita Biswas6
Abstract
Background: Hydronephrosis is a major urological health problem in children. Pelviretic junction (PUJ) obstruction is common among the congenital causes of hydronephrosis. A-H pyeploplasty is the most popular and common technique. There are different modalities of using trans-anastomotic stent in A-H pyeloplasty. Some surgeons use external drainage like nephrostomy tube, pyelostomy tube or trans-anastomotic stent and others use internal drainage D-J stent. In this study, D-J stent and BMI feeding tube were used for trans anastomotic drainage. We analyzed the data to find out which method of stenting in A-H pyeloplasty is more effective and safer and also to reduce the morbidity by reducing stent related complications.Material & Methods:A prospective interventional study was conducted in the faculty of Paediatric Surgery inBangladesh Shishu Hospital and Institute during the period from January 2016 to December 2019. A total of 60 patients under 12 years of age were included in this study were diagnosed as uni-lateral hydronephrosis for PUJ obstruction. Patients were divided into two groups by random lottery method and all patients underwent A-H pyeloplasty under general anaesthesia (G-A). In group-A, A-H pyeloplasty were done with using Double (D-J) stent and in group-B, 5Fr or 6Fr BMI tube were used as trans-anastomotic drainage. Patients were followed up after 2 weeks of operation, at 3 months and them at 6 months. The variables of the post-operative follow up study were patency of anastomosis, urinary tract infection, (UTI), urinary leakage and post-operative hospital stay and statistical analysis were done.Results:In group-A (30 cases), Anderson-Hynes pyeloplasty were done using D-J stent and in group-B (30 cases) with using trans-anastomotic BMI tube. In group-A most (73.33%) patients were below 5 years and in group-B 48 patients (80%) were below 5 years. In group-A mean age was 3.57+ 3.11 years and in group-B mean age was 3.31+3.21 years. There is no statistically significant difference in age distribution. In group-A left kidney were involved 66.7% cases and in group B in 80% cases left kidney were involved. In the early post-operative period, no urinary obstruction in group-A, however in 20% cases developed urinary obstruction in group-B but that was not statistically significant. In group-B continuous urinary leakage through drain tube was for 0-15 days but in group-B
leakage was only or 0-1 day. It was statistically significant (p=0.037). In group-A, range of time of removal of drain tube was 4 days but in group-B range was 8-27 days. It was statistically significant (p=0.0001). Hospital stay in group-A was 4-8 days and in group B 9-29 days. It was also statistically significant (p=0.0001).Conclusion: In A-H pyeloplasty, morbidity of the patients can be reduced by using D-J stent which is more effective and safer. We found definite statistically significant difference in terms of urinary leakage, post-operative UTI, and hospital stay.
Hydronephrosis, Uni-lateral PUJ obstruction, A-H pyeloplasty, stenting.
Mohammed Mosharraf Hossain1*, Md. Akram Ahsan2, Syed Muzibur Rahman3, Rafiqul Islam4, Asfaq Bin Rahman5, Masuma Amanullah6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 105-112 | DOI: 10.53339/aimdr.2022.8.6.14
Evaluation of Trifarotene 50 μg/g Cream in the Treatment of Facial and Truncal Acne Vulgaris: A Single Centre Study
Mohammed Mosharraf Hossain1*, Md. Akram Ahsan2, Syed Muzibur Rahman3, Rafiqul Islam4, Asfaq Bin Rahman5, Masuma Amanullah6
Abstract
Background: Acne vulgaris is a frequent skin condition of the face and trunk that negatively influences the quality of life. It frequently impacts the face, shoulders, chest, and back, however, the cure for nonfacial acne has no longer been fastidiously studied. Trifarotene is a new first-in-class fourth-generation topical retinoid that has been uniquely studied in the treatment of each facial and truncal acne. Through selective agonism of the retinoic acid receptor (RAR)-γ, the most predominant RAR-γ isotype in the epidermis, trifarotene exerts extra targeted, skin-specific outcomes than earlier-generation retinoids. The aim of the study to assess the safety and efficacy of trifarotene 50 μg/g cream, a novel topical retinoid, in moderate facial and truncal acne.Material & Methods:Clinical samples were analyzed between 36 weeks in Shahid Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh. The patient informations and sources were retrospectively collected. 120 patients were detected in the department of Skin & venereal disease, at Shahid Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh. This cross-sectional study was done among patients to the evaluation of trifarotene 50 μg/g cream in the treatment of facial and truncal acne vulgaris.Results:Out of 120 patients, the study population of patients according to age, where 46(38.33%) were 12 to 20 years and 74(61.67%) were 21 to 30 years. And according to sex, where 60% were female and 40% were male. Most of the patients belong to the female.Conclusion:We focus on efficacy, safety, and tolerability records and highlight exceptional life outcomes and patient-reported satisfaction. Future medical trials and the clinical applicability of this novel medication in the treatment of acne are additionally discussed.
Acne vulgaris, Trifarotene, Retinoid, Truncal acne.
Side Effects of Oral Valacyclovir and Oral Acyclovir in the Treatment of Herpes Zoster
Sharmin Kabir1*, SarkerMahbub Ahmed Shamim2, Farhana Rashid Shumi3, RabeyaAfroz Shoma4, Shumana Sharmin5, Nadia Sharleen6, Shams Ibne Maksud7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 113-119 | DOI: 10.53339/aimdr.2022.8.6.15
Side Effects of Oral Valacyclovir and Oral Acyclovir in the Treatment of Herpes Zoster
Sharmin Kabir1*, SarkerMahbub Ahmed Shamim2, Farhana Rashid Shumi3, RabeyaAfroz Shoma4, Shumana Sharmin5, Nadia Sharleen6, Shams Ibne Maksud7
Abstract
Background: Herpes Zoster is a more sporadic disease than a doe’s primary VZV infection. Herpes Zoster is typically transmitted person to person by direct contact. The lifetime risk of developing Herpes Zoster is between 25% and 30%, rising to 50% in those aged at least 80 years. The aim is to identify the side effects of oral valacyclovir and oral acyclovir in the treatment of herpes zoster.Material & Methods:This randomized clinical trial was conducted in the Department of Dermatology and Venereology, ShaheedSuhrawardy Medical College and Hospital, Dhaka, from April 2016 to September 2016. A total of 60 patients with herpes zoster were enrolled in the study. Group A Valacyclovir was 30 patients, and Group B Acyclovir was 30 patients.Results:In Group-A, it was observed that 6(20.00%) patients had nausea found to be the highest, 4(13.33%) patients had Headache, 3(10.00%) patients had vomiting, 2(6.67%) patients had Diarrhea,0(0.00%) patients had anorexia, 3(10.00%) patients had abdominal pain, and 1(3.33%) patients had dyspepsia found to be lowest in Group-A, and 8(26.67%) patients had nausea found to be highest, 5(16.67%) patients had Headache, 4(13.33%) patients had vomiting, 3(10.00%) patients had Diarrhea,1(3.33%) patients had anorexia, 5(16.67%) patients had abdominal pain, and 1(3.33%) patients had dyspepsia found to be lowest in Group-B of study patients as side effects.Conclusion:The rate of cessation of abnormal sensations, rash healing, and complications or adverse effects was not similar with both the treatments. There were no clinically significant differences in the nature and frequency but there were clinically significant differences in severity of adverse/side events between the two treatment groups. Thus, we conclude that in the management of herpes zoster, valacyclovir accelerates the resolution of pain and offers simpler dosing, and maintains a favorable safety profile than acyclovir.
Side Effects, Valacyclovir, Acyclovir, Herpes Zoster, Lesions.
Clinical and Bacteriological Profile of Neonatal Sepsis- A Retrospective Study
Mrinal Kanti Das1*, Suravi Sarkar2, Md. Fazlul Kader3, Dilruba Sultana4, Md. Yousuf Ali5, Md. Rustam Ali6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 120-131 | DOI: 10.53339/aimdr.2022.8.6.16
Clinical and Bacteriological Profile of Neonatal Sepsis- A Retrospective Study
Mrinal Kanti Das1*, Suravi Sarkar2, Md. Fazlul Kader3, Dilruba Sultana4, Md. Yousuf Ali5, Md. Rustam Ali6
Abstract
Background: Neonatal sepsis is a major cause of mortality and morbidity in newborn in developing countries. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship. Objective: To assess the clinical and bacteriological profile of neonatal sepsis.Material & Methods:A retrospective study was conducted at Department of Pediatrics, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from January to June 2019. Of the 207 neonates with clinical suspicion of sepsis, 55 neonates included. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results:Of the 207 neonates with clinical suspicion of sepsis, 55 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9%) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus (MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusion:In conclusion, gram positive sepsis was found to be common in present study, although mortality was high in gram negative sepsis. Careful measures have to be taken to overcome the change in trend of organisms causing sepsis, and selection of antibiotics should be prudent.
Antibiotic stewardship, Blood culture, Neonatal sepsis.
Atypical Clinical Features in Paediatric Dengue Patients: Is There a Changing Trend?
Saira Khan1*, Marufa Hossain2, Mahbub Mutanabbi3, Israt Jahan Chaudhury4, Shirin Akter5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 132-139 | DOI: 10.53339/aimdr.2022.8.6.17
Atypical Clinical Features in Paediatric Dengue Patients: Is There a Changing Trend?
Saira Khan1*, Marufa Hossain2, Mahbub Mutanabbi3, Israt Jahan Chaudhury4, Shirin Akter5
Abstract
Background: Dengue fever is the most rapidly spreading mosquito borne viral disease worldwide. It is estimated that the incidence has increased 30-fold over the last five decades. Recently, the reappearance of dengue in the pediatric population is a matter of concern among pediatricians, especially due to the presence of atypical features, leading to delayed diagnosis. There are few studies regarding the changing trendof paediatric dengue patients due to under reporting of the cases.Material & Methods:This prospective study was conducted among forty-five paediatric dengue patients below 15 years of age(n=45)at MH Samorita Hospital & Medical College, Dhaka over a period of 6 months from July 2021 to December 2021. Neonates and patients with co-infection were not included in the study. All clinical and laboratory details were collected during their hospital stay in a structured questionare form.Results:Forty-five paediatric dengue patients below 15 years of age were enrolled in the study (n=45). Out of the 45 cases 35 patients were non-severe dengue (undifferentiated fever, dengue fever with warning signs, and dengue fever without warning signs) and 10 patients were of severe dengue (DHF and DSS) according to WHO guidelines. The male to female ratio was 1.6: 1 in our study group. The majority of the cases 25 (55.5%) were within 6 to 10 years of age. Patients having features of severe dengue were also seen mostly (17.7%) in this age group. The mean age of hospitalized patients was 8.9 years. In our study there were 16 patients (35.6%) with classical dengue fever, 23 (51.1%) patients with dengue hemorrhagic fever without shock and 6 patients (13.3%) with features of dengue shock syndrome. Atypical clinical features were seen in 17 cases (37.8%). The most common atypical features found in twelve children were acalculous cholecystitis (26.7%). Renal impairment and hepatitis were present in 17.8% and 13.3% of patients. Among neurological manifestations two patients (4.4%) developed impaired consciousness and one patient (2.2%) had seizure. Conclusion:Atypical manifestations of DF can be fatal in many paediatric patients. There should be a high index ofsuspicion among clinicians for timely detection and management of atypicalmanifestation of severe dengue infection to prevent mortality.
Dengue, Infection, Hemorrhage, Shock.
Suriya Shahaly1*, Md. Jahidul Islam2, Mohammad Moniruzzaman3, Md. Humayun Kabir Sarker4, Md. Iftakharul Alam5, Sayat Quayum6, Nashid Nawshin7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 140-153 | DOI: 10.53339/aimdr.2022.8.6.18
Outcome of Single Intra-Articular Injection of High- Molecular-Weight Hyaluronic Acid in Patients with Knee Osteoarthritis
Suriya Shahaly1*, Md. Jahidul Islam2, Mohammad Moniruzzaman3, Md. Humayun Kabir Sarker4, Md. Iftakharul Alam5, Sayat Quayum6, Nashid Nawshin7
Abstract
Background: Osteoarthritis (OA) is the most common type of rheumatic disease and a leading cause of disability. Current treatments aim at alleviating these symptoms by several different methods: non-pharmacological and pharmacological treatments and invasive interventions. Among the regenerative methods, hyaluronic acid (HA) is popular now-a-days where differences exist in concentration, molecular weight, dosage, expected duration of effects and added formulations. Based on HA molecular weight, these products are classified in two groups (high and low). Due to cost effectiveness, low molecular weight HA is commonly used. To find out the outcome of single intra-articular injection of high-molecular- weight HA in patients with knee osteoarthritis.Material & Methods:This was a randomized clinical trial conducted among purposively selected 55 patients suffering from Knee OA attending at the Physical Medicine and Rehabilitation outpatient department, DMCH during July 2020 to June 2021. Patients were randomly allocated into two groups; group A received single dose of high molecular weight HA and designed exercise program and group B received same exercise program only. Pre-treatment and 3 weekly post treatment assessment were done up to 12 weeks in each group. In each follow up visit, pain, and functional status were measured in Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) respectively and compared between group A and group B where was considered as significant (p value <0.050.Results:The mean age of the participants in group A and group B were 56.8 (±9.8) and 53.3 (±7.4) years respectively where majority of the patients in both groups were female patients with overweight. In group A, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with high-molecular-weight HA (P<0.001). In group B, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with conservative management (P<0.001). After 6 weeks of intervention, the mean VAS scores of the patients became 4.9 ±1.1 and 6.0±1.0 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the VAS score was significantly decreased in group A (2.8±1.3) than group B (4.9±1.7) (P<0.001). After 3 weeks of intervention, the mean WOMAC scores of the patients became 71.2±6.6 and 75.0 ±4.9 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the WOMAC score was significantly decreased in group A (61.9±6.6) than group B (68.1±4.6) (P<0.001).
Conclusion:Single intra-articular injection of high-molecular-weight Hyaluronic Acid is effective in patients with knee osteoarthritis in reducing pain and improving functional impairment. Long term and large scale research studies are needed to establish the effectiveness and safety of this procedure in patients with knee osteoarthritis.
eoarthritis (OA), High-molecular-weight Hyaluronic acid (HMW-HA), Conservative management, Visual Analogue Scale (VAS), and Western Ontario and McMaster Universities (WOMAC).
Sunanda Biswas1*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 154-160 | DOI: 10.53339/aimdr.2022.8.6.19
Psychological Attributes and Socio-Demographic Profile of Completed Suicidal Victims: A Single Center Study in Bangladesh
Sunanda Biswas1*
Abstract
Background: Suicide is the self-inflicted human act of intentional cessation of one’s own life. Different psychological attributes like anxiety disorder, major depression, adjustment disorder, bipolar disorder, alcohol use disorder, and even schizophrenia are considered some major risk factors for suicide. It is said that previous history of suicidal attempts is associated with an increased risk for future suicide. Prior concepts regarding the psychological attributes and socio-demographic characteristics of completely suicidal victims may be helpful in preventing suicidal occurrences. The aim of the study was to evaluate the psychological attributes and socio-demographic characteristics of completely suicidal victims.Material & Methods:This observational study was conducted in the Department of Forensic Medicine, Sher-E-Bangla Medical College, Barisal, Bangladesh during the period from July 2017 to June 2019. A total 87 completed suicidal cases were included as study subjects. Besides forensic investigation report related more data were collected from the concerned police departments. As per the exclusion criteria of this study, when refusal was encountered or the family of a suicide victim could not be traced, those cases were rejected. Data were analyzed regarding suicide and its relationship with various socio‑demographic variables, significant family history, and mental illness.Results:In this study, among a total of 87 victims, 45% were male and 55% were female. The mean ±SD age of the victims was 23.56±11.51 years. The majority of the victims were married which was 48%. The majority of our victims (76%) had achieved a primary or above level of education and 79% lived with someone whereas only 21% lived lonely. The majority of the victims were unemployed (51%). In this study, 48%, 36%, and 16% of victims were from lower-, middle- and upper-class families respectively. The majority of the victims were with major depression which was in 59% an7% of victims were with alcohol use disorder which was also noticeable. Besides these adjustment disorder (13%), schizophrenia (10%), anxiety disorder (9%), and bipolar disorder (6%) were found in some cases. In total 7 cases were found without any psychological attribute.Conclusion:Females are dominating in number among completed suicidal victims. As per the findings of this study we can conclude that younger people are vulnerable to the suicidal incidence in Bangladesh. The frequency of suicidal incidence among married people is alarming. Government as well as socio-economic policymakers should take necessary steps to ensure proper treatment for depressive patients as well as to control alcohol addiction among the younger population.
Psychological, Attributes, Socio-demographic, Profile, Completed suicidal victim.
A Study of Dose-Adjusted EPOCH Chemotherapy in Diffuse Large B-Cell Lymphoma
Quazi Smita Haq1*, Marufa Akter2, Md. Maksudul Islam Mazumder3, Mohiuddin Ahmed Khan4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 161-168 | DOI: 10.53339/aimdr.2022.8.6.20
A Study of Dose-Adjusted EPOCH Chemotherapy in Diffuse Large B-Cell Lymphoma
Quazi Smita Haq1*, Marufa Akter2, Md. Maksudul Islam Mazumder3, Mohiuddin Ahmed Khan4
Abstract
Background: Worldwide, diffuse large B-cell lymphoma (DLBCL) represents the most common subtype of non-Hodgkin lymphoma (NHL), accounting for 30%-40% of all newly diagnosed cases. The response rate to currently available chemotherapy in DLBCL is much unsatisfactory. Dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH) was developed in an effort to improve outcome in patients with diffuse large B-cell lymphoma. To assess the efficacy and safety of DA-EPOCH chemotherapy in patients with diffuse large B-cell lymphomas.Material & Methods:This quasi experimental study was conducted in the department of Hematology, DMCH, from January 2016 to December 2017. 20 patients with diffuse large B-cell lymphomas were treated with etoposide, vincristine, and doxorubicin for 96 hours with bolus doses of cyclophosphamide and oral prednisone (DA-EPOCH chemotherapy). The doses of etoposide, doxorubicin and cyclophosphamide were adjusted to achieve a nadir absolute neutrophil count below 0.5× 109/L. Cycles were repeated after 21 days. After 3rd and 6th cycle patients were evaluated for interim analysis and response evaluation respectively. Evaluation was done in aspect of clinical parameter (lymph node size, physical complaint), laboratory parameter (CBC) and radiological imaging (CT scan of chest and abdomen). The median age of the patient was 46.5 years (range, 25-62 years); 20% were older than 50 years; and 25% were at high-intermediate risk according to International Prognostic Index (IPI) criteria. The statistical analyses were done by appropriate methods.Results:There was a complete response in 73.7% of patients and partial response 10.5% of patients, which were evidenced by significant reduction of size of the lymph nodes after chemotherapy. The mean Serum LDH was also significantly lower after chemotherapy in comparison to before chemotherapy in those patients who achieved complete or partial response. Moreover, size of the liver and spleen were significantly lower after chemotherapy in response group patients who had either hepatomegaly or splenomegaly or both. Doses were escalated in 12.50% cycles and toxicity levels were acceptable.Conclusion:DA-EPOCH chemotherapy is an effective regimen for treatment of diffuse large B-cell lymphoma patients.
Diffuse large B-cell lymphoma patients, DA-EPOCH chemotherapy regimen, and toxicity
Hemanta I Gomes1*, CM Shaheen Kabir2, Syed Dawood Md. Taimur3, Md. Jabed Iqbal4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-6 | November-December 2022 | Page: 169-175 | DOI: 10.53339/aimdr.2022.8.6.21
Echocardiographic Wall Motion Abnormalities in Hypertensive Patients with Electrocardiographic Left Ventricular Hypertrophy
Hemanta I Gomes1*, CM Shaheen Kabir2, Syed Dawood Md. Taimur3, Md. Jabed Iqbal4
Abstract
Background: During the cardiac cycle with the effect on cardiac function, Echocardiographic wall motion abnormalities are kinetic alterations in the cardiac wall motion. It can be characterized as per their grades and their distribution pattern like segmental or global. It can be attributed to a coronary territory or follow a non-coronary distribution. Aim of the study: The aim of the study was to evaluate the patterns of echocardiographic wall motion abnormalities among hypertensive patients with electrocardiographic left ventricular hypertrophy.Material & Methods:This was prospective observational study which was conducted in the Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2020 to January 2021. In total 76 hypertensive patients with electrocardiographic left ventricular hypertrophy were included as the study subjects for this study. This study was approved by the ethical committee of the mentioned hospital. A predesigned questioner was used in data collection. All data were collected, processed and analyzed by using MS Office and SPSS version 23 programs as per necessity.Results:In this study, in analyzing the status of wall motion abnormalities (WMA) among the participants we observed that, 22% of the patients were with segmental wall motion abnormalities, 18% were with global dysfunction and 59% were fully free from any type of WMA. Among patients with global dysfunctions, 71% were with mild and 12% were with moderate-to-severe dysfunction whereas this ratio was 47:24 in segmental abnormality patients. On the other hand, in analyzing the severity and location of patients with segmental WMA we observed that 47%, 24%, 53%, 41%, 18%, 24%, 29%, 47%, 35%, 53% and 41% were with mild dysfunction, moderate-to-severe dysfunction, inferior wall dysfunction, antero-septal dysfunction, anterior wall dysfunction, lateral wall dysfunction, posterior wall dysfunction, posterior septal dysfunction, LV base dysfunction, LV mid-cavity dysfunction and LV apical dysfunction respectively.Conclusion:In this study, majority of the participants were found free from any type of wall motion abnormality. ‘Mild dysfunction’, inferior wall dysfunction, anterior wall dysfunction, lateral wall dysfunction, posterior septal dysfunction, LV base dysfunction, LV mid-cavity dysfunction and LV apical dysfunction are found as some more frequent dysfunctions among patients with WMA.
Echocardiographic, Wall motion abnormalities, Hypertension, Left ventricular hypertrophy.
