Annals of International Medical and Dental Research (AIMDR)
Vol-9, Issue-2 | March-April 2023
Ajay Kumar1*, Rubeena Anjum2, Mandeep Kaur3, Nidhi Khajuria4, Ashanka Bhardwaj5, Ettishree6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 1-8 | DOI: 10.53339/aimdr.2023.9.2.1
Detection and Comparision of Cytopathological Changes in Smokers and Non-Smokers: A Comparative Study
Ajay Kumar1*, Rubeena Anjum2, Mandeep Kaur3, Nidhi Khajuria4, Ashanka Bhardwaj5, Ettishree6
Abstract
Background: Oral cancer is one of the sixth most common cancers in the world. Oral exfoliative cytology is one of the popular screening tool for oral cancer. Use of tobacco in any form are documented as the most common cause as initiators for dysplastic changes in oral mucosa. The purpose of the study was to detect the cytological changes in buccal mucosa, tongue and palate among non-smokers & smokers. Material & Methods: Smears sample were collected according to site (buccal mucosa, tongue & palate) from 100 subjects among smokers & non-smokers. Smears were then stained using Papanicolaou staining technique. Results: Among the smokers and non-smokers the results were statistically significant. Conclusion: Recent advances in the clinical visualization and detection of the oral mucosa have made the viability of cytological procedures more specific and sensitive. Contact endoscopy and use of autofluorescence devices are the forerunners in this group. The fluorescence characteristics of tissues depend upon their biochemical composition and histomorphological architecture, both of which undergo a change during malignant transformation. These changes are detectable as an alteration in the fluorescence spectral profile of the tissues21. Due to low feasibilities of such devices the benchmark of diagnosis will be microscopic tissue examination. Hence cytological smears will always be highly specific, sensitive, easy to use and reproducible procedures in routine screening of population for potentially and malignant conditions of the oral cavity.
Oral cancer, Exfoliative cytology, PAP Satin.
Clinical Profile and Quality of Life of Incident Hemodialysis Patients
Insha Firoz1, Ravindra Prabhu2, Indu Rao3, Veena N.K4, Megha Nagaraj Nayak5, Basir Ameeque Quadri6*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 9-14 | DOI: 10.53339/aimdr.2023.9.2.2
Clinical Profile and Quality of Life of Incident Hemodialysis Patients
Insha Firoz1, Ravindra Prabhu2, Indu Rao3, Veena N.K4, Megha Nagaraj Nayak5, Basir Ameeque Quadri6*
Abstract
Hemodialysis is the most commonly used treatment modality for end stage renal disease. A 6 months observational study was conducted in the Dialysis unit of Kasturba Hospital, Manipal to study the clinical profile, quality of life with the help of KDQoL SF 36 questionnaire and factors affecting quality of life of hemodialysis patients. A total of 45 participants were included who initiated dialysis in the year 2018 and 2019 and were receiving dialysis in our hospital. Out of 45 participant 77.8% were males and 22.2% were females, the mean age was 55.29 (11.29) years. 23 patient-initiated dialysis in the year 2018 22 patients-initiated dialysis in the year 2019. The prevalence of hypertension, diabetes mellitus and cardiovascular diseases in this population were found to be 95.2%, 35.6% and 8.9% respectively. The mean scores of the sub scales were analyzed with the help of scoring manual and descriptive statistics. In the result it was found the hemoglobin, intradialytic weight gain were found to be positively correlated with the Physical component summary (PCS) and Mental component summary (MCS). Effects of kidney disease was found to be very strongly and positively correlated with dialysis vintage. In the result of the study due to its smaller population we cannot determine more factors which were affecting the Quality of life scores.
Hemodialysis (HD), chronic kidney disease (CKD), Quality of life (QoL), Intradialytic Weight Gain (IDWG), Hb, Physical component summary (PCS), Mental component summary (MCS), Effects of Kidney Disease (EKD), Burden of Kidney Disease (BKD), Symptoms Problems of Kidney Disease (SPKD).
Menstrual Abnormalities Among Adolescent Females Attending a Tertiary Care Hospital in North India
Farhana Fayaz1, Nadia Khurshid2, Haamid Ismail3*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 15-19 | DOI: 10.53339/aimdr.2023.9.2.3
Menstrual Abnormalities Among Adolescent Females Attending a Tertiary Care Hospital in North India
Farhana Fayaz1, Nadia Khurshid2, Haamid Ismail3*
Abstract
Background: To study the menstrual abnormalities among adolescent females attending a gynaecolocial outpatient department (OPD) in a tertiary care hospital. Material & Methods: It was a cross sectional study which was carried at outpatient department (OPD) of obstetrics and gynaecology, Government medical college Srinagar over a period of 6 months. A total of 90 adolescent females in the age group 10-19 years were included in the study. Along with the demographic profile, menstrual abnormalities were evaluated with the help of self-structured questionnaire. Results: The mean age of the study population was 15.6 ± 2.8 years. Majority of the adolescent females were in the age group of 16-19 years (44.4%), literate with formal education above 10th class (37.8%) and from rural background (56.7%).Dysmenorrhea was the most common menstrual morbidity in 64.4% of adolescent females followed by menorrhagia (26.7%). Pain abdomen was the most common premenstrual symptom encountered by 62.2% of females. Conclusion: Menstrual abnormalities are common in the adolescent females with dysmenorrhea being the commonest.
Dysmenorrhea, Amenorrhea, Premenstrual symptoms.
Akshatha P Nayak1, Insha Firoz2*, Ravindra Prabhu3, Jayanth Nayak4, Veena NK5, Megha Nagaraj Nayak6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 20-23 | DOI: 10.53339/aimdr.2023.9.2.4
Development of Immunity to Hepatitis B Virus Following Hepatitis B Vaccination in Hemodialysis Patient
Akshatha P Nayak1, Insha Firoz2*, Ravindra Prabhu3, Jayanth Nayak4, Veena NK5, Megha Nagaraj Nayak6
Abstract
Background: Hepatitis B infection is common in Dialysis population. Hemodialysis patients have high risk of hepatitis B virus transmission not only due to frequent blood or blood product transmission, decreased response to Hepatitis B vaccine and length on hemodialysis but also due to their immunosuppressed state. Hepatitis B vaccination has the potential to reduce the risk of HBsAg infection in dialysis units. Effective vaccination, blood donor screening, the use of erythropoietin and the isolation of HBV carriers have successfully regulated HBV infection in hemodialysis units (1). This study aims to assess the immunity to HBV & the seroconversion of HBsAg infection in hemodialysis unit. This retrospective observational study evaluated serological markers, hepatitis B vaccination status and co morbidities which can affect the immunity levels of patients undergoing hemodialysis. The patient’s data were collected from laboratory investigations and patient record for analysis. Out of 153 CKD-5D patients on maintenance hemodialysis, 39 patients had anti HBs titer <10U/ml, 30 patients had anti HBs titer between 10-100U/ml, 38 patients had anti HBs titer between100-1000 U/ml, 21 patients had anti HBs titer >1000U/ml and 24 patients didn’t check their titer value. Hypertension was the common co morbidity followed by anaemia and diabetes mellitus.
Hepatitis B virus, chronic kidney disease, Hepatitis B vaccination, Hemodialysis.
Afreen Nadaf1, Rezhat Abbas2*, Suheel Hamid Latoo3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 24-30 | DOI: 10.53339/aimdr.2023.9.2.5
To Assess the Interobserver Variability in Mitotic Figure Counting in Various Grades of Oral Squamous Cell Carcinoma
Afreen Nadaf1, Rezhat Abbas2*, Suheel Hamid Latoo3
Abstract
Background: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, representing up to 80–90% of all malignant neoplasms of the oral cavity. The increasing cases of oral cancer are the most important concern for community health. Defects of mitosis result in various nuclear abnormalities namely micronuclei, binucleation, broken egg appearance, pyknotic nuclei, and increased numbers of mitotic figures. The rationale for mitotic counting is that it is frequently used for classification and grading of tumors, prediction of prognosis of tumors and even advocated as a decision point for treatment. Reproducibility of the mitotic counting is paramount for the assessment of malignancy on a histologic scale. Considering this, we decided to assess the inter-observer variability in mitotic figure counting in various grades of oral squamous cell carcinoma. Material & Methods: A retrospective study was carried out on 48 formalin fixed paraffin embedded tissue blocks of the confirmed cases of Oral squamous cell carcinoma in the archives of department of oral pathology, Govt. Dental College & Hospital, Srinagar. Mitotic figure counting was done by two independent, mutually blind observers. The data was assessed for inter-observer variability in counting of figures. Results: Least difference was seen in cases of WDSCC up to the maximum difference of 3 mitoses. MDSCC showed modest differences in observations, with a maximum difference of 4 mitoses. PDSCC cases had the highest inter-observer variability, with a maximum difference of 5 mitoses. Conclusion: Mitosis counting has been shown most convincingly to provide independent prognostic value and is the most well established component of the histological grading systems of OSCC. Reproducibility of the mitotic counting is paramount for the assessment of malignancy on a histologic scale.
Oral squamous cell carcinoma, mitotic figure, interobserver variability
Afreen Nadaf1, Rezhat Abbas2*, Suheel Hamid Latoo3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 31-36 | DOI: 10.53339/aimdr.2023.9.6
Comparison between Anneroth’s & Broder’s Grading Systems in Oral Squamous Cell Carcinoma in Relation to Histopathological Prognostic Factors
Afreen Nadaf1, Rezhat Abbas2*, Suheel Hamid Latoo3
Abstract
Background: Oral squamous cell carcinoma (OSCC) is a commonly occurring head and neck cancer. It has a high prevalence, and is associated with a high mortality rate. OSCC occurs due to many etiological factors, but smoking and alcohol remain the most common risk factors. The histological grading of tumors has been used to predict the clinical behaviour of OSCC. Broder’s initiated quantitative grading in cancer. Anneroth’s and Hansen developed another grading system for grading of OSCC’s. With this background, a study was undertaken to compare between Anneroth’s & Broder’s grading systems in oral squamous cell carcinoma in relation to histopathological prognostic factors. Material & Methods: A retrospective study was carried out on 50 formalin fixed paraffin embedded tissue blocks of the confirmed cases of Oral squamous cell carcinoma in the archives of department of oral pathology, Govt. Dental College & Hospital, Srinagar. The cases were evaluated on the basis of Broder’s & Anneroth’s grading systems for OSCC & the comparison of the systems was made pertaining to histopathological prognostic parameters. Results: In our study according to Anneroth’s system maximum cases comes under grade III while in Broder’s system maximum cases are in grade I & II. Conclusion: Anneroth’s classification provides us a detailed analysis of grading the cases according to scoring of each parameter. Thus, it is more informative than Broder’s grading system.
Oral squamous cell carcinoma, Broder’s grading system, Anneroth grading system
Lens Subluxation Following Trivial Trauma
Aakanksha Sharma1, Neha Mohammed2, Kritika Katoch3*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 37-39 | DOI: 10.53339/aimdr.2023.9.7
Lens Subluxation Following Trivial Trauma
Aakanksha Sharma1, Neha Mohammed2, Kritika Katoch3*
Abstract
Trauma is the main cause of subluxation or dislocation of the lens followed by ocular surgery and spontaneous dislocation due to hypermature cataract. Other causes are Marfan’s, Homocystinuria, Ehler Danlos syndrome and pseudoexfoliation. We report a case of dislocated lens by a trivial trauma with a wooden stick which was left unattended unless patient noticed decreased vision in that eye.
Subluxation of lens, Trivial trauma, zonules
A Rare Case of Posterior Ischemic Optic Neuropathy after Appendicectomy
Aakanksha Sharma1, Neha Mohammed2, Indu Bala3*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 40-42 | DOI: 10.53339/aimdr.2023.9.8
A Rare Case of Posterior Ischemic Optic Neuropathy after Appendicectomy
Aakanksha Sharma1, Neha Mohammed2, Indu Bala3*
Abstract
Ischemic optic neuropathy is classified into anterior and posterior ischemic optic neuropathy depending upon the part of optic nerve involved. In anterior optic neuropathy, optic nerve head is involved and in posterior ischemic optic neuropathy(PION) retrobulbar portion is involved. There is sudden loss of vision in both the entities but there are optic disc changes in anterior optic neuropathy while in posterior ischemic optic neuropathy optic disc is normal initially. Etiologically, posterior ischemic optic neuropathy is divided into non arteritic non-surgical, arteritic and perioperative non arteritic posterior ischemic optic neuropathy.
Posterior Ischemic Optic Neuropathy, Appendicectomy.
Orbital Apex Syndrome – A Case Report
Aakanksha Sharma1, Neha Mohammed2, Indu Bala3*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 43-45 | DOI: 10.53339/aimdr.2023.9.9
Orbital Apex Syndrome – A Case Report
Aakanksha Sharma1, Neha Mohammed2, Indu Bala3*
Abstract
Orbital apex syndrome is characterized by vision loss and ophthalmoplegia due to the involvement of the orbital apex. The signs and symptoms vary depending upon the involvement of the structures within the orbital apex, the superior orbital fissure or the cavernous sinus. Clinical evaluation is the key to the diagnosis which is aided by neuro-imaging modalities including brain and orbital Magnetic Resonance Imaging and Computed Tomography scans. In rare instances, a biopsy may be needed to aid in diagnosis. Treatment depends on what the nature of the lesion.
Orbital Apex Syndrome, Ophthalmoplegia, Cranial Nerves
Stability of Denture Base Acrylic Resin to Tea, Coffe and Turmeric Solutions: An in Vitro Study
Nitin Gautam1, Monica Kotwal2, Rimsha Ahmed3*, Anupama Gaur4, Sunny Sharma5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 46-49 | DOI: 10.53339/aimdr.2023.9.10
Stability of Denture Base Acrylic Resin to Tea, Coffe and Turmeric Solutions: An in Vitro Study
Nitin Gautam1, Monica Kotwal2, Rimsha Ahmed3*, Anupama Gaur4, Sunny Sharma5
Abstract
Background: The color stability of commercially available denture base acrylic resins (Lucitone-199, DPI and Travelon-HI) was studied in vitro. Material & Methods: The specimens were exposed to tea, coffee and turmeric solutions at 37 ± 1 °C. Colour measurement of the specimens from each brand of denture base acrylic resin recorded by spectrophotometer. The specimens were washed under distilled water and dried before measuring the colour on 0, 10, 20 and 30 days of immersion and color differences were calculated. Results: Statistically the colour change was significant between and within the groups of different heat cure denture base acrylic resins. Conclusion: Where as Lucitone-199 heat cure showed the highest colour variation in tea and coffee followed by DPI and Travelon-HI.
Denture, Turmeric Solutions, Acrylic Resin to Tea
Reconstruction Plate Fracture: Mechanism and Recent Advances
Monika Parmar1, Manish Kumar Sharma2*, Anupriya Sharma3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 50-55 | DOI: 10.53339/aimdr.2023.9.11
Reconstruction Plate Fracture: Mechanism and Recent Advances
Monika Parmar1, Manish Kumar Sharma2*, Anupriya Sharma3
Abstract
Reconstruction plates with or without bone grafts are used to restore mandibular continuity, form and function following segmental resection of mandible. Fracture of reconstruction plate is observed in 2.9 % to 10% of cases reported in the literature excluding other complications. In this case, we report the fracture of stainless steel reconstruction plate used without bone graft and its management using locking reconstruction plate with non vascularised iliac crest graft following removal of the fractured plate. Review of literature describing incidence, pattern and causes of reconstruction plate fracture and its management is discussed.
Mandibular Reconstruction plate, Reconstruction plate fracture, Non- vascularised iliac crest bone graft, Mandibular segmental resection, Odontogenic keratocyst
Techniques of Maxillary Sinus Floor Elevation
Manish Kumar Sharma1*, Archna Sharma2
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 56-60 | DOI: 10.53339/aimdr.2023.9.12
Techniques of Maxillary Sinus Floor Elevation
Manish Kumar Sharma1*, Archna Sharma2
Abstract
Posterior maxillary region is often limited for standard implant placement because of reduced residual vertical bone height. An elevation of the maxillary sinus floor is one option in solving this problem. This article describes the various surgical techniques that can be used to enter the sinus cavity, elevating the sinus membrane and placing the bone grafts for placement of dental implants in the resorbed posterior maxillary region.
Maxillary sinus, Dental implants, Direct sinus floor elevation, Indirect sinus floor elevation, Lateral antrostomy, Crestal approach
Nadia Khurshid1, Farhana Fayaz2, Insha Jan Khanyari3*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 61-67 | DOI: 10.53339/aimdr.2023.9.13
A Retrospective Analysis of Fetal and Maternal Outcome in Patients with Intrahepatic Cholestasis of Pregnancy
Nadia Khurshid1, Farhana Fayaz2, Insha Jan Khanyari3*
Abstract
Background: Introduction: Intrahepatic cholestasis of pregnancy (ICP), is the most common liver disease specific to pregnancy. Previous studies of fetal effects have suggested that ICP is associated with a higher rate of adverse neonatal outcomes including preterm birth, neonatal respiratory distress syndrome (RDS), meconium-stained amniotic fluid, neonatal intensive care unit admission, and stillbirth. Material & Methods: This was a 4 year retrospective observational study including 43,344 female who delivered in our hospital out of which 1126 cases of ICP were identified, who were compared with 1136 age and parity matched controls. Results: : Previous history and family history of ICP was significant in the ICP group. Gestational diabetes and preterm labour were more frequent in the ICP group. Mean birth weight was lower in the ICP group, rate of small for gestational age foetuses was not significantly different. Cesearean section and post-partum haemorrhage was more frequent in the ICP group. Adverse neonatal outcomes i.e. respiratory distress syndrome (RDS) and need for NICU admission were more in the ICP group. Conclusion: ICP is associated with increased rate of preterm delivery, post-partum hemorrhage and increased neonatal morbidity. Management of patients with ICP should be individualized based on the severity of symptoms and associated medical complications.
Intrahepatic cholestasis of pregnancy, Bile acid, hepatitis, liver disease, pruritis
Low Dose Aspirin for Primary Prevention of Adverse Pregnancy Outcome
Ummay Sufia Akther1*, Jakaria Kabir2, Liaquat Ali3, Nazia Haque Setu4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 68-75 | DOI: 10.53339/aimdr.2023.9.14
Low Dose Aspirin for Primary Prevention of Adverse Pregnancy Outcome
Ummay Sufia Akther1*, Jakaria Kabir2, Liaquat Ali3, Nazia Haque Setu4
Abstract
Background: Pregnancy is associated with various complications such as pre-eclampsia, SGA, preterm birth etc. Low dose aspirin is a possible medication to minimize these adverse outcomes. The aim of this study was to evaluate the use of low dose aspirin for primary prevention of adverse pregnancy outcome. Material & Methods: This cross-sectional study was conducted in department of Gynaecology, North Bengal Medical College Hospital, Mirjapur Bkash Hospital, Mirjapur, Tangail, Bangladesh, during the period from June 2021 to August 2022. Total 200 pregnant women were included in this study. Results: In this study, the mean (±SD) age of the study subjects were 25.12 ± 5.49 years and 25.00 ± 4.83 years in LDA group and control group, respectively. There was no statistically significant (p>0.05) difference in age between the groups. The rate of caesarean section was higher in control group (68%) compared to LDA group (59%) but there was no statistically significant (p>0.05) difference among the groups. In our study, 8% pregnant women in LDA group and 19% pregnant women in control group had gestational hypertension, pre-eclampsia was seen in 6% and 13% pregnant women in LDA group and control group, respectively, preterm birth was seen in 8% and 17% pregnant women in LDA group and control group, respectively, SGA was seen in 19% and 32% pregnant women in LDA group and control group, respectively, and fetal distress was seen in 2% pregnant women in both LDA group and control group. There were statistically significant (p<0.05) differences in complications except fetal distress. Mean (±SD) neonatal birth weight was 2.88±1.03 kg and 2.74±0.85 kg in LDA group and control group, respectively and there was no statistically significant (p>0.05) difference. Conclusion: We found that low dose aspirin could significantly reduce the risk of adverse outcomes, especially for pre-eclampsia, SGA and preterm birth.
Low Dose Aspirin, Primary prevention, and Adverse Pregnancy Outcome
Fouzia Alima1*, kawsar Jahan Moon2, Samantha Afrin3, Sarah Binte Noor4, Mohammed Ruhul Amin5, Rumana Afroz6, Faria Ferdouse7, Syeda Fateha Noor8
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 76-86 | DOI: 10.53339/aimdr.2023.9.15
Assessment of Knowledge and Attitude Toward Antibiotic Use and Resistance among 4th Year Students of Shaheed Monsur Ali Medical College
Fouzia Alima1*, kawsar Jahan Moon2, Samantha Afrin3, Sarah Binte Noor4, Mohammed Ruhul Amin5, Rumana Afroz6, Faria Ferdouse7, Syeda Fateha Noor8
Abstract
Background: The misuse and overuse of antibiotics can lead to antibiotic resistance. Thus, it is important to have adequate knowledge and attitude toward antibiotic use and resistance for all specially the medical students who are the future healthcare practitioners. The aim of this study was to assess the knowledge and attitude toward antibiotic use and resistance among 4th year students of Shaheed Monsur Ali medical college. Material & Methods: This cross-sectional study was conducted in Shaheed Monsur Ali medical college, Dhaka, Bangladesh from October 2022 to December 2022. A structured questionnaire was administered to 126 randomly selected undergraduate medical students. Results: In our study, the percentage of male and female was same. Majority of the participants (55.56%) always get a prescription before starting antibiotics. Most of the participants (60.32%) never stop taking the prescribed antibiotics after their symptoms improved. Majority of the participants (54.76%) sometimes completed the course of the prescribed antibiotic treatment. In our study, majority of the participants (54.76%) sometimes take the correct dose of their antibiotics at the right time for the full duration. In this study, majority of the participants (47.62%) never save the remaining antibiotics for next time they get sick. Majority of the participants (73.02%) sometimes give leftover medication to friends or family if they get sick. For cough or sore throat, majority of the participants (48.41%) sometimes prefer taking an antibiotic. Most of the participants (69.05%) never buy the same antibiotics if they are sick that helped them get better when they had the same symptoms before. Most of the participants (96.03%) always check the expiry date of the antibiotic before using it. Knowledge level of antibiotic in majority of the participants (47.62%) was very good. Knowledge level of antibiotic resistance in majority of the participants (54.76%) was very good. Attitude level of antibiotic usage in majority of the participants (34.13%) was average, followed by 32.54% had bad, 32.54% good attitude level. Conclusion: From the findings of the study, it can be concluded though the knowledge level of the medical students is adequate, they are not careful about the usage of antibiotics and often misuse it. The students tend to not follow the rules of the usage guideline of antibiotics which ultimately results in antibiotic resistance. They should be more conscious to follow the guidelines of antibiotic usage.
Knowledge, attitude, antibiotic Use, antibiotic resistance, and Students
Mesenteric Cysts in Children: Review of 55 Cases in A Tertiary Hospital
Kazi Md Noor-ul Ferdous1*, S M Mahmud2, Sadia Sultan3, Ferdousi Akter4, Nusrat Jahan Mona5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 87-94 | DOI: 10.53339/aimdr.2023.9.16
Mesenteric Cysts in Children: Review of 55 Cases in A Tertiary Hospital
Kazi Md Noor-ul Ferdous1*, S M Mahmud2, Sadia Sultan3, Ferdousi Akter4, Nusrat Jahan Mona5
Abstract
Background: Mesenteric cysts are rare, benign, fluid-filled tumors that occur in the mesentery, a thin layer of tissue that supports the intestines. The management of mesenteric cysts in children typically involves surgical intervention. The aim of this study was to evaluate the prevalence, the clinical presentation and management of mesenteric cysts in children. Material & Methods: This retrospective study was conducted in the Division of Pediatric Surgery, Bangladesh Shishu Hospital & Institute, Dhaka from July 2016 to June 2022. A total of 18,326 patients admitted in the Division of Pediatric Surgery, hospital records of 55 patients diagnosed with mesenteric cysts were evaluated and included in this study.
Results: The prevalence of mesenteric cyst in our study was almost 1 per 333 pediatric surgical admissions. In our study, the mean (± SD) age of the patients was 36.5±13.5 months ranged between 2 days to 12 years. Majority of the patients were male (58.2%). Of the total of 55 patients, 18 patients required emergency surgery and 37 underwent elective surgery. Abdominal pain was the main presenting symptom, present in 52.7% of the patients. Fifteen of the emergency surgery were done on preoperative diagnosis of appendicitis or perforated appendicitis with peritonitis. Majority of patients (76.4%) had multiple numbers of cysts. The cysts were located in the small bowel mesentery in 23 cases, the base of the mesentery having retroperitoneal extension in 18 cases, the transverse mesocolon in 14 cases. Complete cyst excision was done in majority of the patients (65.5%) and complete excision with intestinal resection was required in 19 (34.5%) patients. With a mean follow-up of 9 months, we encountered no recurrences. Some patients are still under follow-up.
Conclusion: Mesenteric cysts are usually symptomatic and CT scan is the investigation of choice. Complete surgical excision is the optimal treatment. Prognosis is excellent after complete surgical excision; long-term follow-up is needed due to the possibility of recurrence, even in adulthood. Though mesenteric cysts are a rarity in children in the literature, but it is not so uncommon in our experience.
Management, Mesenteric Cysts in Children
Md Abu Abdullah Hossain Mazumder1*, Md.Sazzad Hossain2, Sujit Paul3, Md Jahangir Alom Suzon4, Md. Sazzad Hosen5, Mohammad Mahsin6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 95-103 | DOI: 10.53339/aimdr.2023.9.17
Functional Outcome of Unstable Intertrochanteric fracture Treated with Proximal Femoral Nail Anti-Rotation
Md Abu Abdullah Hossain Mazumder1*, Md.Sazzad Hossain2, Sujit Paul3, Md Jahangir Alom Suzon4, Md. Sazzad Hosen5, Mohammad Mahsin6
Abstract
Background: Intertrochanteric fractures are one of the most disabling injuries, most commonly observed among the elderly, and shows a challenging problem for orthopedic surgeons. Nowadays, intertrochanteric fractures are being treated with different extramedullary and intramedullary devices. Among them, intramedullary fixations show the best outcome, and are widely used for different treatment of unstable intertrochanteric fractures (type 31A2, 31A3). A new device designed by AO/ASIF, the Proximal Femoral Nail Anti-Rotation (PFNA) represents a unique intramedullary nail system for improved management, with decrease in the number of complications. Material & Methods: This prospective hospital based clinical trial was conducted at the Department of Orthopaedic Surgery, Chittagong Medical College Hospital, Chattogram, Bangladesh. The study duration was 2 years, from January 2018 to December 2019. During this period, a total of 48 patients who were admitted in the study place with unstable intertrochanteric fracture of femur were included in the study. Patients were followed up for 24 weeks, and overall outcome was measured using Kyle’s Criteria. Results: 48 patients were treated for unstable intertrochanteric fractures. The majority were between 50-80 years old (62.5%), with a mean age of 58.38. Gender distribution was even, with 50% male and 50% female. 75% of fractures were caused by a fall from height and 25% by a road traffic accident. 68.75% of fractures were type 31A3 and 31.25% were type 31A2. 68.75% of patients did not have comorbidities. The mean time interval for fixation was 12.6 days, and the majority of operations lasted between 45-90 minutes. 87.5% had a closed reduction and 12.5% had an open reduction. 64.58% of patients had radiation time between 2.5-3.3 minutes. At 2 weeks follow-up, 21.28% had poor functional outcome, 78.72% had fair functional outcome, and none had good or excellent outcomes. At 6 months follow-up, 2.17% had poor outcomes, 8.70% had fair outcomes, 34.78% had good outcomes, and 54.35% had excellent outcomes. 16.67% of patients experienced complications such as infection, varus, delayed union, and lateral migration. Conclusion: Most patients achieved good to excellent functional outcomes after treatment, with minimal complications.
Fracture, Unstable, Intertrochanteric, Outcome
Muhammad Moinul Alam Talukder1*, Marshia Rahman Mitu2
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 104-111 | DOI: 10.53339/aimdr.2023.9.18
Risk Factors Associated with Severity of COVID-19 Infections Among Older Patients – A Prospective Study
Muhammad Moinul Alam Talukder1*, Marshia Rahman Mitu2
Abstract
Background: The coronavirus disease 2019 (COVID-19) is a novel coronavirus infection disease causing respiratory failure and a high death rate in vulnerable populations. Prior studies have identified age, male sex, and metabolic comorbidities, such as hypertension and diabetes as risk factors for poor outcomes in patients with COVID-19. These comorbidities are more common among older age groups, and overwhelming evidence from around the world suggests that age itself is the most significant risk factor for severe disease and death from COVID-19. The aim of this study was to determine the associated risk factors of severe COVID-19 infections among older patients. Material & Methods: This was a prospective study and was conducted in the Department of Pharmacology of Shaheed Syed Nazrul Islam Medical College Hospital, Kishoreganj, Bangladesh during the period from March, 2021 to March, 2022. In this study, we took 80 confirmed cases of COVID 19 positive who attended and took admission in Shaheed Syed Nazrul Islam Medical College Hospital, Kishoreganj, Bangladesh. Results: In our study we found majority (48.75%) of our study patients were aged between 65-74 years old, most of our patients were male (61.25%). The mean age of our patients was 76.54 ± 21.04 years. Among all patients, 89% had respiratory difficulty, 86% came with nausea & vomiting, 83% came with fever, 74% had ache all over body, 76% & 64% came with chest pain & running nose respectively. We found 51% patients with DM,80% with CKD, 70% with respiratory failure, 49% with arrhythmia, 74% with IHD, 46% with Sepsis, 55% with acute liver injury, 26% with coagulopathy. Some risk factors co-exist among our patients. Conclusion: In our study, we included the elderly patients with COVID 19 associated with severe illness who had a high mortality rate. We found aged above 80 years, male gender, DM, CKD, respiratory failure, arrhythmia, IHD, Sepsis, acute liver injury are most common risk factors that triggers the severity of COVID 19 infections.
COVID, Severity, Risk factor
Posterior Urethral Valve: Factors Affecting the Renal Outcome
Ipsita Biswas1*, Khondaker T2, Chakraborty AK3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 112-119 | DOI: 10.53339/aimdr.2023.9.19
Posterior Urethral Valve: Factors Affecting the Renal Outcome
Ipsita Biswas1*, Khondaker T2, Chakraborty AK3
Abstract
Background: Posterior urethral valve (PUV) is the most common cause of lower urinary tract obstruction in male children with associated sequlae. Different factors, such as age at presentation, initial and nadir serum creatinine, renal parenchymal echogenicity on initial USG, vesicoureteric reflux (VUR) , recurrent UTI, bladder dysfunction and the presence or absence of pop-off mechanism like VURD have significant impact on ultimate renal outcome. The main aim of the study was to observe the effects of different prognostic factors like age of presentation and preoperative VUR of the PUV respondents on postoperative long term renal outcome as well as changes of renal function status on the basis of initial and postoperative serum creatinine level in our settings. Material & Methods: This was a quasi-experimental study and conducted in the Department of Pediatric urology of Bangladesh Shishu Hospital and Institute, Dhaka. We enrolled 58 male children of different ages having posterior urethral valve, who were admitted in the pediatric urology department from July,2018 to Dec,2021. Results: Total 58 patients included in our study. Among all patients 53.4% were aged between 1 month to 1 year, 39.7% of them were more than 1 year old and 6.9% of them were neonates. Among 31 respondents, 32.3 % had poor renal function & 35.5 % of them also had moderately impaired renal function. Again, out of 23 respondents, 30.4% had poor renal function & 6% had moderately impaired renal function. The relation between age category and postoperative renal function status (On the basis of postoperative eGFR) of the posterior urethral valve respondents were statistically not significant. Patients who had no VUR, 66.7% of them had normal renal function, 25% had moderately impaired renal function and 8.3% had poor renal function. Respondents who had bilateral VUR, 55% of them had poor renal function and 35% had moderately impaired renal function. Among respondents who had unilateral VUR, 28.6% of them had poor renal function and 28.6% had moderately impaired renal function but 42.9% had normal renal function. The relation between preoperative VCUG findings and postoperative long term renal function status of the PUV patients were statistically significant. 7 (100%) respondents who had preoperative abnormal renal function, more than 71.4% of them had returned to normal renal function after operative procedure. But abnormal renal function was present in 2 (28.6%) patients during follow up. In our study we found 29.3% of our patients had poor renal outcome and 29.3% patients had moderately impaired renal function within the mean follow up period of 19.33±12.38 months (ranges from 9months to 4 years). Conclusion: Our research highlights the significance of age at presentation, despite its statistically negligible effect on long-term renal outcomes. However, among the children with PUV following valve ablation and with a long-term follow-up, beginning serum creatinine and the presence of various types of VUR on initial VCUG had a significant effect (p.05) on postoperative renal function on the basis of serum creatinine.
PUV, Cystoscopic valve fulgartion, VCUG, VUR
Evaluation of Glaucoma in Patients with Diabetes and Hypertension: A One-Year Observational Study
Md. Sanwar Hossain1*, Tasnim Khanom2, Sharmin Jahan3, Rukhsana Najnin4, Md. Nazmul Hasan5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 120-126 | DOI: 10.53339/aimdr.2023.9.20
Evaluation of Glaucoma in Patients with Diabetes and Hypertension: A One-Year Observational Study
Md. Sanwar Hossain1*, Tasnim Khanom2, Sharmin Jahan3, Rukhsana Najnin4, Md. Nazmul Hasan5
Abstract
Background: Glaucoma is a group of eye diseases that damage the optic nerve, leading to vision loss. The elevated blood sugar levels in diabetes and high blood pressure in hypertension can both contribute to the development and progression of glaucoma. Effective management of both diabetes and hypertension can also help to reduce the risk of developing glaucoma. The aim of this study is to assess the evaluation of glaucoma in patients with diabetes and hypertension. Material & Methods: This cross-sectional observational study was carried out in the admitted and outpatient department (OPD) patients in the Department of Ophthalmology, Dr. Sirajul Islam Medical College and Hospital Ltd, Dhaka, Bangladesh from January 2021 to December 2022. Total 160 patients with glaucoma were included in this study. Results: In our study, mean (±SD) age of the study subject were 50.5±9.25 years. Majority of the patients had (27.5%) followed by 22 (13.8%) had diabetes and 14 (8.8%) had both. For the group with DM and HTN, the mean IOP was 16.25 with a 95% Confidence Interval (CI) of 13.25 to 18.43, mean HVFA was -9.12 with a 95% CI of -16.78 to -1.31 and mean CDR was 0.69 with a 95% CI of 0.55 to 0.82. For the group without DM and HTN, the mean IOP was 15.62 with a 95% CI of 14.83 to 16.35, mean HVFA was -5.01 with a 95% CI of -5.86 to -3.75 and mean CDR for this group was 0.60 with a 95% CI of 0.53 to 0.68. In the patients with DM and HTN group, there are 13 patients (13.8%) with moderate/severe VFD and 1 patient (1.1%) with mild VFD. In the patients without DM and HTN group, there are 26 patients (26.7%) with moderate/severe VFD and 54 patients (57.4%) with mild VFD. There were statistically significant differences (p<0.05) between the groups both moderate/severe and mild VFD. Conclusion: We determined that patients with HTN and DM had a greater extreme structure of glaucoma when in compared with the patients besides these risk factors. Hypertension was more common than diabetes.
Glaucoma, Diabetes Mellitus and Hypertension
Ocular Status with Chronic Kidney Disease- a Hospital Based Two Year Study on 150 Cases
Tasnim Khanom1*, Md. Sanwar Hossain2, Md. Saif Bin Mizan3, Mohammad Solaiman Tanveer4, Dilara Khatun5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 127-138 | DOI: 10.53339/aimdr.2023.9.21
Ocular Status with Chronic Kidney Disease- a Hospital Based Two Year Study on 150 Cases
Tasnim Khanom1*, Md. Sanwar Hossain2, Md. Saif Bin Mizan3, Mohammad Solaiman Tanveer4, Dilara Khatun5
Abstract
Background: Chronic Kidney Disease (CKD) is a growing public health problem affecting millions of people worldwide. Along with its well-known systemic effects, CKD has been associated with various ocular abnormalities, including uveitis, macular edema, and retinal vascular changes. Early detection and management of these ocular complications can prevent significant visual loss and improve the quality of life of patients with CKD. This highlights the importance of regular ophthalmic examinations as part of the comprehensive management of CKD. The aim of this study was to evaluate the ocular status of chronic kidney disease. Material & Methods: This was an observational study. The present study was conducted on 150 Patients attending the Department of Ophthalmology at Dr. Sirajul Islam Medical College and Hospital Ltd, Dhaka, Bangladesh. The duration of the study was 2 years. All collected data was entered in MS Excel and Statistical analysis was done using the SPSS-24 version. Results: The study analyzed a population between the ages of 40-59 years, with a slight majority of women (52.67%) and moderate CKD (64.00%). The most common cause of CKD in the population was hypertension and diabetes (52.00%). 66.67% of 300 eyes had good vision (6/18 or better), while the remainder had impaired or legally blind vision (increasing as the severity of CKD increases). Ocular anterior segment findings showed that lid oedema and conjunctival pallor were present in 3.5% and 56.9% of the eyes, respectively. Dry eyes and cataract were present in 5.6% and 11.1% of the eyes, respectively. Hypertensive retinopathy was present in 48.00% of eyes in the moderate CKD group, and diabetic retinopathy was present in 32.00% of eyes in the severe and end-stage CKD groups. Maculopathy and vitreous hemorrhage were present in 12.67% and 6.33% of eyes in the end-stage CKD group. Of the 100 eyes with poor or blind visual acuity, 24 (24%) were affected by Maculopathy and 21 (21%) by Cystoid Macular Edema. The causes of visual impairment were also listed with their corresponding percentage. Conclusion: In CRF patients, eye exams can detect ocular problems. Early treatment prevents negative outcomes and those with a history of abnormal renal function need close monitoring due to increased risk of vision loss. Awareness of ocular complications is important, as well as thorough eye exams and control of diabetes and hypertension for maintaining eye health.
Chronic kidney disease (CKD); Ocular pathology; Renal function
Outcome of treatment of Unstable Intertrochanteric Fracture by Proximal Femoral Nail (PFN)
Sujit Paul1*, Md. Sazzad Hossain2, Mohammad Mahsin3 , Md. Sazzad Hosen4, , Md. Jahangir Alom Suzon5, Md. Abu Abdullah Hossain Mazumder6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 139-146 | DOI: 10.53339/aimdr.2023.9.22
Outcome of treatment of Unstable Intertrochanteric Fracture by Proximal Femoral Nail (PFN)
Sujit Paul1*, Md. Sazzad Hossain2, Mohammad Mahsin3 , Md. Sazzad Hosen4, , Md. Jahangir Alom Suzon5, Md. Abu Abdullah Hossain Mazumder6
Abstract
Background: Proximal Femoral Nail (PFN) is a surgical technique used to treat unstable intertrochanteric fractures, which are fractures that occur in the upper portion of the thigh bone (femur). The procedure involves using a nail-like device that is inserted into the femur and secured in place with screws to stabilize the fracture and promote healing. It is a commonly used treatment option for this type of fracture and can lead to good outcomes in most cases. The aim of the study was to observe the outcome of Unstable Intertrochanteric fracture by Proximal Femoral Nail (PFN). Material & Methods: This prospective observational study was conducted at the Department of Orthopedics, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh. The study duration was 2 years, from July 2017 to June 2019. A total of 34 cases were included in the study sing purposive sampling (non-randomized) according to availability of the patients and considering inclusion and exclusion criteria. Results: The participants’ age range was 16-90, with a mean of 56.91 ± 17.76. Most (35.29%) were 61-75 years old. 61.76% were female and 38.24% were male. 50% were housewives, 14.71% ex-service holders, 14.71% service holders, 11.76% businessmen, 5.88% students, and 2.94% farmers. The leading cause of injury was falls on slippery ground (55.88%), followed by motor vehicle injuries (44.12%). 70.59% of injuries occurred on the right side and 29.41% on the left. 76% had Kyle Type III fractures, 24% had type IV. 85.29% had open reduction, 14.71% had closed reduction. The mean duration of injury to operation was 15.59 days and the mean hospital stay was 19.15 days. 70.59% had no complications and 55.88% reported no pain at last follow-up. 58.82% had a good Harris hip score and 58.82% had excellent outcomes by final follow-up. Conclusion: The majority of patients in this study were in the 61-75 age range and female, with the most common cause of injury being falls on slippery ground. The most common fracture type was Kyle type IV, with a major portion of cases requiring open reduction. The rate of complications was relatively low, and the functional outcomes were acceptable and comparable to other studies. The duration of injury to operation and hospital stay were slightly longer than other studies, likely due to the busy nature of the study location. Overall, the Proximal Femoral Nail is a safe and effective treatment option for unstable proximal femoral fractures.
Intertrochanteric, Fracture, Proximal, Femoral
Prevalence of antibiotic resistant UTI in immunocompromised patients
Meherunnesa Mukta1*, Sajalendu Biswas2, Mohammad Ashaduzzaman3, Mohammad Sadaqul Islam Sikder4, Amitav Saha5, Laila Sultana6, Obayedur Rahman7
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 147-156 | DOI: 10.53339/aimdr.2023.9.23
Prevalence of antibiotic resistant UTI in immunocompromised patients
Meherunnesa Mukta1*, Sajalendu Biswas2, Mohammad Ashaduzzaman3, Mohammad Sadaqul Islam Sikder4, Amitav Saha5, Laila Sultana6, Obayedur Rahman7
Abstract
Background: Urinary tract infections (UTIs) are amongst the most common bacterial infections, affecting about 150 million individuals per year.Urinary tract infection (UTI) is one of the most common diseases in human societies which occur in women more than men. Women of all ages are more likely to experience such an infection than men, while half of them may be affected by a uropathogen once in their lives, and 25-30% may develop recurrent UTIs not associated with any functional or anatomical abnormality. The aim of this study was to explore the prevalence of antibiotic resistance of urinary tract infections in immunocompromised patients. Material & Methods: This was a retrospective observational study and was conducted in the Department of Medicine of Dhaka Central International Medical College and Hospital, and National Institute of Kidney Diseases & Urology, Dhaka, Bangladesh during the period from June, 2021 to June, 2022. We included 70 immunocompromised patients with UTI. Results: In our study we found 44% patients were aged between 18-30 years old and 83% of our patients were female. Among all respondents, 58 patients were culture positive. We found 38% & 62% and 33% & 67% had history of upper & lower UTI in female and male patients respectively, 29% & 36% and 17% & 25% had urethritis & cystitis in female and male patients respectively. We found culture positive patients with E. coli (41%), Klebsiella spp.(19%), Enterobacter spp.(16%) and 12% with Pseudomonas spp in our study. We found amoxicillin showed resistance to E. coli (58.3%), Staphylococcus (75%), & Klebsiella (36.4%) and amikacin showed resistance mostly to E. coli(50%), Klebsiella (54.5%) & Pseudomonas (42.9%). Conclusion: In our study, we found the most common MDR pathogen among patients with UTI in our institution was E. coli & Staphylococcus. We discovered that being above 40 years old, having DM, CKD and previously received antibiotic medication inappropriately were risk factors for the development of MDR infection. Given the high prevalence of multidrug resistant uropathogens among immunocompromised patients, the growth in Penicillin resistance is alarming. We discovered the significant incidence of MDR bacterial strains, adherence to currently suggested empiric therapy is extremely challenging and is linked with high failure rates.
Urinary tract infections, Uropathogen, Immuncompromised
Md. Sazzad Hossain1*, Sujit Paul2, Mohammad Mahsin3, Md. Jahangir Alom Suzon4, Md. Sazzad Hosen5, Md. Abu Abdullah Hossain Mazumder6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 157-163 | DOI: 10.53339/aimdr.2023.9.24
Pre and Postoperative Complication of Anterior Cervical Decompression and Interbody Fusion by Stand Alone Anchored Spacer in Cervical Degenerative Disc Disease
Md. Sazzad Hossain1*, Sujit Paul2, Mohammad Mahsin3, Md. Jahangir Alom Suzon4, Md. Sazzad Hosen5, Md. Abu Abdullah Hossain Mazumder6
Abstract
Background: The anterior cervical decimpression and fusion (ACDF) surgery was first described by Smith and Robinson and Cloward RB in the 1950s. This procedure has since become the standard for treating degenerative cervical disc disease. Material & Methods: This Prospective Quasi-Experimental Study was conducted at the department of National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) and Dhaka Medical College Hospital, Bangladesh. The study was conducted during the period of 06 May 2019 to 05 May 2020 and 24 Patients were included by non-randomized purposive sampling according to the availability of the patient and strictly considering the inclusion and exclusion criteria. The analysis was done by SPSS 20.0 for windows software. Results: The age range of patients was 32 to 68 years, with a mean age of 51.67 (±11.15) and male-female ratio was 11:1. Occupation of the subjects demonstrates that service holder comprised the main bulk 8 (33.3%). Other occupants were farmer 6 (25.0%), businessman 4 (16.7%), driver 2 (8.3%), house wife 2 (8.3%) & manual labour 2 (8.3%). 4 (16.7%) patients had per-operative hemorrhage. There were no dural injuries or recurrent laryngeal nerve palsy. It was observed that 4 (16.7%) patients developed dysphagia, 2 (8.3%) patient had infection and 6 (25%) patients had neck pain. There was no temporay hoarseness or respiratory problems. Conclusion: The study shows that the anterior cervical decompression and interbody fusion by stand-alone anchored spacer are relatively easy, safe and an effective procedure for patients with cervical degenerative disc disease with good neurological and radiological outcome. It provides immediate stability to the affected area, reduces the risk of graft extrusion, avoids the need for extended post-operative external immobilization, and significantly shortens the rehabilitation period.
Decompression, Fusion, Interbody, Cervical, Anchored
Maternal Characteristics of Full-Term Birth Asphyxia Neonates
MD Shamsuzzaman Prodhan1*, Abu Zafur Md Azad2, Ayesha Sultana3, MD Monwarul Islam4, Shah MD Moazzem Hossian5, Mostafa Zaman6, Ummey Wahida Sultana7
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 164-171 | DOI: 10.53339/aimdr.2023.9.25
Maternal Characteristics of Full-Term Birth Asphyxia Neonates
MD Shamsuzzaman Prodhan1*, Abu Zafur Md Azad2, Ayesha Sultana3, MD Monwarul Islam4, Shah MD Moazzem Hossian5, Mostafa Zaman6, Ummey Wahida Sultana7
Abstract
Background: In developing countries, perinatal hypoxia is still a leading cause of mortality and disability. In 2011, the infant mortality rate dropped from 92 per 1000 live births in 1991 to 43 per 1000 live births. However, neonatal mortality in Bangladesh remains high, accounting for more than half of all deaths under the age of five and more than two-thirds of infant mortality. As a result, any qualities that can operate as a risk factor for prenatal asphyxia can be quite beneficial. The aim of the study was to observe the maternal characteristics of perinatal asphyxia in full-term pregnancies. Material & Methods: This cross-sectional descriptive study was conducted at the Department of Obstetrics and Pediatrics, Rangpur Medical Collage, and Hospital, Rangpur, Bangladesh. The study duration was 2 years, from January 2012 to December 2013. The study was conducted with a total of 60 cases of birth asphyxia, who were delivered or admitted into the study hospital. Results: In 70% of cases, the mother was Primipara. Among the neonates, 61.67% were male, and 38.33% were female. Only 33% of the case neonates had received regular antenatal check-ups, while 55% had irregular check-ups, and 11.67% had no antenatal checkups. According to the grading of asphyxia, 51.67% of neonates had moderate asphyxia, 20% had mild asphyxia, and 28.33% had severe asphyxia. The mean serum sodium value in mild, moderate, and severe asphyxia were 135.33, 123.42, and 121.53 mmol/L respectively. Mean serum potassium values were 4.11, 4.86, and 5.51 mmol/L respectively. Mean serum creatinine 0.72, 1.00, and 1.83 mg/dl respectively. Mean blood urea levels were 36.17, 58.97, and 88.06 mg/dl respectively. A significant difference was observed between the mean values of serum electrolytes and patients’ asphyxia grade. Conclusion: The study findings revealed that birth asphyxia was more common among vaginal deliveries and irregular or no neonatal care cases. Primipara patients had a higher likelihood of neonatal asphyxia. Serum electrolyte levels varied significantly based on the grade of asphyxia.
Asphyxia, Neonatal, Maternal, Perinatal, Antenatal
Md. Mofazzol Hossain1*, Showkat Hayat2, Mohammad Bokhtier Howlader3, Nazmul Hamid4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 172-179 | DOI: 10.53339/aimdr.2023.9.26
Hearing and Visual Impairment in Children with Cerebral Palsy, A Study in Tertiary Level Hospital in Bangladesh
Md. Mofazzol Hossain1*, Showkat Hayat2, Mohammad Bokhtier Howlader3, Nazmul Hamid4
Abstract
Background: Cerebral palsy (CP) is a diagnostic term used to describe a group of motor syndromes resulting from disorders of early brain development. CP remains unexplained in most cases and is typically diagnosed outside the neonatal period. Visual impairment decreases the quality of life and hearing impairment hampers linguistic development. This study aimed to observe the visual and hearing impairment of children with cerebral palsy associated with developmental disabilities. Material & Methods: This is a cross-sectional observational descriptive study carried out in the department of Paediatric Neurology CMH Dhaka from March 2018 to February 2022. The participants (N=120) were from birth to 12 years of age. Detailed information was obtained in each case according to protocol. The pediatric neurologist based on the study definition crosschecked the diagnosis. The hearing assessment was done with the help of an Otolaryngologist in the department of Otolaryngology and the ophthalmological evaluation was done with the help of an ophthalmologist of the department of ophthalmology of CMH Dhaka. Hearing impairment, Ophthalmological motor disturbance, and developmental disabilities were correlated. A convenience sampling technique was used in this study. Relevant data were collected from hospital records. All the information was recorded in the fixed protocol. Collected data were classified, edited, coded, and entered into the computer for statistical analysis by using SPSS 2021. Results: In this study, among the 120 children with CP, the mean age of the study was 5.57(SD±3.89) age range of 2-12 years Males were 82(68%) and females were 38(32%), male-female ratio (sex M: F 2.15: 1). Spastic quadriplegia constitutes the predominant group 59(49%), followed by Spastic diplegia 21(18%), Spastic hemiplegia 20(17.5%), dyskinetic CP 09(8%), 7(6%) were mixed CP and 4(3%) were hypotonic CP. Hearing impairment was found in 87 (72%) cases and visual impairment was detected in 92(76%). Among them, the child with Spastic Quadriplegic (83%) and diplegic CP (62%) children had a hearing impairment. Regarding vision, no fix and follow were observed in 69(57%) cases. Among the studied CP child (n=120) 16 children (13.33%) had normal eye finding and 104 (86%) had abnormal eye findings. Refractive error (32.5%) and Squint (19%) were the most common ocular defect among studied patients. Other ocular defect were nystagmus(10%), optic atrophy(12.5%), microphthalmia(10%), corneal opacity(3%), optic hypoplasia(4.1%), cataract(2.5%), pigmentary retinopathy(5%), retro-lental fibroplasias(3.3%) and ptosis(2.5%). In children with hypotonic (athetoid) and mixed CP, almost all (11 of 11) children had visual impairment. Spastic quadriplegic CP children (80%) and Spastic diplegic CP children (90%) had one or more domains of visual impairment. Conclusion: Cerebral Palsy is a non-progressive various form of neurological disorder in children. Early visual screening and hearing assessment can help CP children to minimize mental retardation, learning difficulties, and speech delay.
Cerebral palsy, Hemiplegia, Nystagmus, Hearing impairment
MD Mahbub Hossain Khan1*, Nusrat Zarin2, AFM Helal Uddin3, MD Lutfar Rahman4, MD Abdul Alim5, Shams-El-Arefin6, Kamrun Nahar7, Mohammad Mahabub Hossain8
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 181-189 | DOI: 10.53339/aimdr.2023.9.27
Thyroid Dysfunction in Adults with Newly Detected Type 2 Diabetes Mellitus: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh
MD Mahbub Hossain Khan1*, Nusrat Zarin2, AFM Helal Uddin3, MD Lutfar Rahman4, MD Abdul Alim5, Shams-El-Arefin6, Kamrun Nahar7, Mohammad Mahabub Hossain8
Abstract
Background: Thyroid disorders and diabetes mellitus are common endocrine disorders that often coexist and can significantly impact each other’s management. The American Diabetes Association recommends that people with diabetes be periodically screened for thyroid dysfunction due to the strong link between the two conditions. It is important for individuals to be aware of the risk factors for both conditions and to seek appropriate medical care if necessary, and for healthcare providers to consider testing for thyroid dysfunction in adults with newly detected type 2 diabetes mellitus. The aim of the study was to find out thyroid dysfunction in adults with newly detected type 2 diabetes mellitus. Material & Methods: This cross-sectional, descriptive study was conducted at the Departments of Medicine and Endocrinology at Sir Salimullah Medical College and Mitford Hospital in Dhaka. The study period lasted six months, from May to October 2019. A total of 102 adult patients (above 20 years old) with newly diagnosed type 2 diabetes mellitus who were attending the Endocrinology and Medicine Outpatient Department participated in the study. Results: Out of 102 adults with newly detected type 2 diabetes mellitus, the majority (86.3%) had normal thyroid function (euthyroid), while a smaller number (13.7%) had thyroid dysfunction. The most common subgroup of thyroid dysfunction was subclinical hypothyroidism (7.8%), followed by hypothyroidism (3.9%), subclinical thyrotoxicosis (1.0%), and hyperthyroidism (1.0%). The majority of the study population was male (66%) and from urban areas (88%), with a mean age of 45.1 years, a mean BMI of 25.0 kg/m2, and a mean waist circumference of 98.4 cm. About 45% had a family history of diabetes mellitus and 37% were smokers. The blood pressure of the study population was within normal limits. A minority (30%) had co-morbidities such as hypertension, dyslipidemia, and ischemic heart disease. The predictors of thyroid dysfunction were observed Age (OR=0.785), F/H of thyroid disorder (OR=0.495) BMI (OR=1.059), Anti-TPO Ab(OR= 0.021). Conclusion: Thyroid dysfunction and diabetes are commonly associated with each other and can impact clinical presentation and laboratory results. It is important to routinely screen for thyroid function in all patients with type 2 diabetes mellitus to detect, treat, and prevent complications of both these conditions.
Thyroid, Diabetes, Endocrine, Hypothyroidism, Hyperthyroidism
Cardiovascular Challenges in Geriatric Anesthesia after Induction of GA
Mohammad Shahidul Islam1*, Abdullah Al Maruf2, Md. Masudul Alam Mazumder3, Md. Aminur Rahman4, Sadat Bin Siraj5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 191-196 | DOI: 10.53339/aimdr.2023.9.28
Cardiovascular Challenges in Geriatric Anesthesia after Induction of GA
Mohammad Shahidul Islam1*, Abdullah Al Maruf2, Md. Masudul Alam Mazumder3, Md. Aminur Rahman4, Sadat Bin Siraj5
Abstract
Background: Advanced age is associated with the physiologic process of aging and decreased functional reserve of organs. These patients are often frail and have several comorbid conditions. The physiological changes in the aging cardiovascular system affect the arterial and venous vasculature, myocardium, and autonomic nervous system, making the older person more prone to cardiovascular instability. In addition to the physiological changes, the cardiovascular status of the older person tends to be compromised by associated pathological conditions that are more common with increasing age. This study aimed to analyze cardiovascular challenges in geriatric anesthesia after induction of GA. Material & Methods: This prospective study was conducted at the Department of Anesthesia, Combined Military Hospital (CMH), Dhaka, Bangladesh. The study was carried out from April 2016 to September 2016. A total of 60 subjects were selected as per inclusion criteria. Subjects were divided into 2 groups to compare the parameters among the non-elderly and elderly respondents, Group A (age ≤60 years) and Group B (age >60 years). Statistical analysis of the results was obtained by using Statistical Packages for Social Sciences (SPSS-17) software. Results: In this study, 30 (50%) patients belonged to group A with ≤60 years of age and 30 (50%) patients belonged to group B with >60 years of age. Among the respondents 20 were male and 10 were female in group A, and 23 were male and 7 were female in group B. Regarding pre-existing cardiovascular co-morbid conditions, most patients (5, 16.67%) suffered from hypertension, followed by atherosclerosis (2, 6.67%) and 1 patient (3.33%) had cardiac arrhythmias in group A. Most of the patients (7, 23.33%) suffered from hypertension followed by congestive heart failure (6, 20.0%), 5 patients (16.67%) had atherosclerosis, 5 patients (16.67%) had coronary artery disease, 4 patients (13.33%) went through cardiac arrhythmias and the rest 3 (10.0%) patients suffered from aortic stenosis. The mean difference of SBP between the groups 20 minutes before and after induction of general anesthesia showed a statistically significant difference at 5,10,15 and 20th-minute follow-ups. (P=<0.05). The mean difference of DBP between the groups 20 minutes before and after giving general anesthesia showed a statistically significant difference at 5, 10, 15, and 20th-minute follow-up. (P=<0.05) The mean difference in heart rate between the groups 20 minutes before and after induction of general anesthesia showed statistically significant differences at 10, 15, and 20th minute follow up. (P=<0.05).
Conclusion: T This study revealed that elderly patients suffered the most from hypertension followed by heart failure and coronary artery diseases. These pre-existing cardiovascular diseases along with hemodynamic instability during the surgical procedure after general anesthesia pointed towards a great challenge. Thus, care of the elderly patient requires thorough preoperative assessment and planning regarding both anesthetic and surgical techniques and the involvement of a multidisciplinary clinical team knowledgeable about and interested in the management of the elderly surgical patient.
Anesthesia, Geriatric, Cardiovascular, Hemodynamic
Relationship of Serum Lipid Profile and Blood Pressure with Body Mass Index (BMI)
Md. Atiar Rahman1*, Chandra Rani Sarkar2, A.T.M Zoadur Rahim Zahid3, Md. Mamun Or Rashid4, Sultana Yasmin5, Most. Khadiza Parvin6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 197-209 | DOI: 10.53339/aimdr.2023.9.29
Relationship of Serum Lipid Profile and Blood Pressure with Body Mass Index (BMI)
Md. Atiar Rahman1*, Chandra Rani Sarkar2, A.T.M Zoadur Rahim Zahid3, Md. Mamun Or Rashid4, Sultana Yasmin5, Most. Khadiza Parvin6
Abstract
Background: Obesity and overweight is a disorder of unusually increased body fat generally resulting from increased energy intake relative to energy expenditure and is a primary sustenance-related disorder globally. The extensive increase in its prevalence in current years and its association with reduced life expectancy has made obesity one of the most vital public health problems. The purpose of the study was to determine the relationship between serum lipid profile and blood pressure with body mass index (BMI). Material & Methods: A cross-sectional study was carried out in the Department of Physiology and Biochemistry, Rangpur Medical College, Rangpur from January 2013 to December 2013. A purposive sampling technique was followed. A total number of 90 people from 18 to 45 years old were included in the study, categorized into three groups, such as Group-A:(Control 30): Healthy subject of normal weight, Group-B:(Experimental 30): Healthy subject of overweight & Group-C(Experimental-30): Healthy subjects of obese. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using the “t” test, “r” test & Statistical Package for the Social Sciences (SPSS) Version 25.0. Results: In group A, the mean BMI of patients was 18.5-22.9, in group B mean BMI of patients was 23.0-24.9, and in group C, the mean BMI of people was 25.0 or greater. The mean ± SD serum LDL-C levels were 107.77 ± 26.720 mg/dl in group A and 134.70 ± 41.787 mg/dl in group B. There was a significant difference (p<0.001) between the two groups. The mean ± SD pulse pressure levels were 38 ± 6.644 mmHg in group A and 41.67 ± 11.167 mmHg in group B. There was no significant difference (p>0.05) between the two groups. Serum total cholesterol levels were positively correlated in groups A & B but the relationship of serum total cholesterol levels was statistically significant in groups A and B. Blood pressure levels were positively correlated in groups A &C but the relationship was statistically non-significant. Conclusion: In this current content, it is difficult to define the specific mechanism involved for significantly higher serum total cholesterol, serum triglyceride, and serum LDL-C levels and non-significantly lesser serum HDL-C levels in overweight & obese people and also non-significantly higher blood pressure in overweight people but significantly higher blood pressure in obese subjects.
Obesity, Overweight, Cholesterol, BMI
Assessment of the Severity of CAD Regarding Number of Vessels Involved
Sayem Bin Latif1*, Prabir Kumar Das2, Anisul Awal3, Saurav Das4, Khondaker Md. Ismail5, Md. A B K Bashiruddin6, Abu Sayem Mohammad Omar Faroque7, Debabrata Bhattacharya8, Md. Sawkat Hossan9, Partha Bhattacharyya10
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 210-217 | DOI: 10.53339/aimdr.2023.9.30
Assessment of the Severity of CAD Regarding Number of Vessels Involved
Sayem Bin Latif1*, Prabir Kumar Das2, Anisul Awal3, Saurav Das4, Khondaker Md. Ismail5, Md. A B K Bashiruddin6, Abu Sayem Mohammad Omar Faroque7, Debabrata Bhattacharya8, Md. Sawkat Hossan9, Partha Bhattacharyya10
Abstract
Background: Coronary artery disease (CAD) is characterized by atherosclerotic plaque accumulation in the epicardial arteries. The dynamic nature of the CAD process results in various clinical presentations. Red blood cell distribution width (RDW) is a practical, widely available marker for assessing the severity of coronary artery disease and helps in the risk stratification of patients with CAD. This study aimed to analyze the severity of CAD regarding the number of vessels involved. Material & Methods: This descriptive cross-sectional study included 124 purposively selected patients who underwent elective CAG in the Department of Cardiology, Chittagong Medical College Hospital, Chattogram, from January 2020 to June 2021. SPSS 23.0 software was used for processing and analysis at the end of the data collection period. Results: The age of the patients ranged from 32-75 years with a mean (±SD) age of 53.4 (±9.9) years. The majority of the patients (83.1%) were male with a male-to-female ratio of 4.9:1. On coronary angiography, the majority of the patients (51/124, 41.1%) had triple vessel disease, followed by double vessel disease in 23 (28.5%) patients, single-vessel disease in 31 (25.0%). In 19 (15.4%) patients no significant lesion was observed in any of the vessels. Gensini score ranged between 1 and 176 in the study with a median score of 56.77. The majority of the patients (69.4%) in the present study had a Gensini score ≥30 indicating severe stenosis. A positive correlation between RDW and coronary artery disease severity in terms of Gensini score (r=0.393). With the increase of RDW, the Gensini score increases. It was found statistically significant (p=<0.001) by Pearson’s correlation test. There was a positive correlation between RDW and CAD severity regarding the number of vessels involved (rho =0.5). With the increase of RDW, the number of involved vessels increases. It was found statistically significant (p=<0.001) by Spearman’s correlation test. The Median (IQR) value of RDW was 13.5 (13.0-14.0) in patients with mild stenosis compared to 14.5 (13.9-15.0) in patients with severe stenosis. This difference was statistically significant (p<0.001). The median (IQR) value of RDW was the lowest in patients without any significant stenosis in any of the coronary arteries [13.1% (12.7%-13.5%)] and was the highest in patients with triple vessel diseases [14.5% (14.1%-15.0%)].
Conclusion: This study demonstrated that RDW level was an independent predictor for CAD and the severity of coronary stenosis. So, it can be concluded that RDW is an inexpensive routine laboratory test that might help identify high-risk patients before planning for a more invasive treatment strategy.
Coronary Artery Disease, RDW, Angiography, Anemia
Common Mechanisms of Peripheral Vascular Injuries
Mohammad Khalilur Rahman1*
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 218-223 | DOI: 10.53339/aimdr.2023.9.31
Common Mechanisms of Peripheral Vascular Injuries
Mohammad Khalilur Rahman1*
Abstract
Background: The peripheral arteries and veins of the extremities are among the most commonly injured vessels in both civilian and warfare trauma. Traumatic vascular injury is caused by explosions and projectiles which may affect the arteries and veins of the limbs, and is common in wartime, triggering bleeding and ischemia. This study aimed to analyze the common mechanisms of peripheral vascular injuries. Material & Methods: This was a retrospective study and was carried out among 60 cases who attended the vascular surgery department at the National Institute of Cardiovascular Disease (NICVD), with vascular injury from January 20010 to January 2012. All data were analyzed by SPSS 10 version. Results: In this study, most of the patients (25, 41.6%) were in the 21-30 years age group, followed by 20 patients (33.33%0 were in the 31-45 years age group and the rest 15 (25.0%) patients belonged to 15-20 years age group. Regarding sex distribution, male (48, 80.0%) was more preponderance than female (12, 20.0%). Concerning occupation, most of the subjects (50.0%) were students, followed by businessmen (33.0%) and service holders (17.0%). Regarding the mechanism of injury, most of the patients (25, 41.66%) had bullet injuries, followed by 20 (33.33%) had shrapnel injuries, and the rest 15 (25.0%) patients had blunt injuries. Concerning limb involvement, the upper limb was injured in most of the cases (37, 61.66%), followed by the lower limb (23, 38.33%). Conclusion: In this study, bullet injuries were the commonest mechanism of peripheral vessel injury followed by, shrapnel injuries and blunt injuries.
Peripheral Vessel, Injury, Bullet, Sharpnel
Development of PR & Restenosis after Percutaneous Balloon Pulmonary Valvuloplasty
Mohammad Nazmul Islam Bhuiyan1*, Mahamuda Yasmin2, Md. Ashfaque Ahemmed Khan3, Md. Mofazzol Hossain4, Bijoy Kumar Das5, Ishrat Tanjin6, Khandoker Mohammad Hossain7
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 224-231 | DOI: 10.53339/aimdr.2023.9.32
Development of PR & Restenosis after Percutaneous Balloon Pulmonary Valvuloplasty
Mohammad Nazmul Islam Bhuiyan1*, Mahamuda Yasmin2, Md. Ashfaque Ahemmed Khan3, Md. Mofazzol Hossain4, Bijoy Kumar Das5, Ishrat Tanjin6, Khandoker Mohammad Hossain7
Abstract
Background: Pulmonary stenosis is not an uncommon congenital heart disease in our population. Various age groups present with severe pulmonary stenosis require intervention either surgical or percutaneous catheter-based. Often lifesaving surgical intervention is not feasible considering procedural risk, the patient’s physical condition, and young age. Percutaneous balloon pulmonary valvuloplasty is safe, effective, almost painless, economical, and less hospital stay in any age group with immediate and long-term success. This study aimed to analyze the rate of development of (Pulmonary Regurgitation) PR & restenosis after Percutaneous Balloon Pulmonary Valvuloplasty (PBPV). Material & Methods: This hospital-based prospective observational study was conducted in the Department of Paediatric Cardiology Combined Military Hospital (CMH), Dhaka from January to December 2021. 0-18 years aged 50 population with PS who were referred to the Paediatric Cardiology Department of CMH Dhaka during the study period were selected as study subjects as per inclusion criteria. The purposive Sampling technique was used in this study. Data were collected with a predesigned standard data collection sheet. Statistical significance was set as a 95% confidence level at a 5% acceptable error level. Categorical variables were expressed as frequency and percentages. Mean, standard deviation, and/or medians with interquartile ranges were used to express the continuous variables. Paired t-test was performed in categorical comparison. A p-value of <0.05 was considered statistically significant. Collected data were analyzed using SPSS Version 24. Written informed consent was taken from every parent. Ethical clearance was taken from the Ethics Review Committee of CMH Dhaka for conducting the study. Results: 50(6.39%) had isolated valvular PS. The international standard for the prevalence of isolated PS is 8-10% which is very close to this study’s result. In this study, male predominance was found with the male-female ratio of 3:2 though there was no gender dominance found in other studies. Out of 50 cases, 3(6%) are neonates,7(14%) are infants, 27 (54%) are 1-5 years aged, and 13(26%) are more than 5 years aged. A total of 13(26%) cases developed PR, and all 13 patients developed trivial PR on D1 echo, out of them 1 patient developed mild PR on D30 Echo but in D90 and D180 Echo patients persisted the same mild PR. Out of 50 cases, 46(92%) were successful and 4 cases were procedure failed. None of the successful cases developed restenosis.
Out of 4 procedure failed cases 1 patient developed restenosis on D30 follow up and 2 patients develop restenosis on the D90 follow-up. At D180 follow up none of the patients developed restenosis. All the restenosis cases had dysplastic pulmonary valves. One patient’s PS gradient persisted at 30-50 mm of Hg throughout the follow-up period. Overall restenosis in 180-day follow-up is 3(6%) and the remaining 47(94%) cases lead a healthy life in 6 months follow-up. Reballooning was done immediately after diagnosis of restenosis in stenosed cases. Conclusion: Immediate and intermediate-term (6 months) follow-up with Doppler echocardiography showed excellent outcomes in all cases except 3 (6.0%) restenosis cases and 13 (26.0%) insignificant PR cases. The baby who all had restenosis, had the risk factor, like- dysplastic PV. It may be concluded that balloon valvuloplasty is the procedure of choice for moderate, severe, and critical pulmonary valve stenosis.
Pulmonary Regurgitation, Pulmonary Stenosis, PBPV
Etiology of Hoarseness of Voice Based on FOL
Nripendra Nath Biswas1*, Md. Shafiq-Ur- Rahman2, Debobrata Roy3, ATM Sumaief Ur Rahman4, Ranjit Kumar Rudra5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 232-238 | DOI: 10.53339/aimdr.2023.9.33
Etiology of Hoarseness of Voice Based on FOL
Nripendra Nath Biswas1*, Md. Shafiq-Ur- Rahman2, Debobrata Roy3, ATM Sumaief Ur Rahman4, Ranjit Kumar Rudra5
Abstract
Background: Hoarseness (dysphonia) is the reason for about 1% of all consultations in primary care. Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx. Evaluation of a patient with hoarseness includes a careful history, physical examination, and in many cases, laryngoscopy. This study aimed to analyze the etiology of hoarseness of voice based on a fiberoptic laryngoscope (FOL). Material & Methods: This cross-sectional study was conducted in the Department of ENT, in Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur for 2 years; from January 2017 to December 2018. A total of 75 subjects fulfilling the inclusion criteria were enrolled as study subjects. Data were processed and analyzed using the software SPSS (Statistical Package for Social Sciences) version 11.5. Results: In this study, most of the patients (18, 24.0%) belonged to the age group of 41-50 years, followed by 16 (21.33%) patients in the 61-70 years of age group, and then 15 (20.0%) patients were in 21-30 years of age group. None was from 0-10 years and only 2 (2.66%) patients belonged to the 11-20 years age group. Concerning the sex of the patients, 62 (83.0%) patients were male and the rest 13 (17.0%) were female indicating male predominance. 40 (53.33%) respondents had a smoking habit, and the rest 35 (46.66%) patients did not have a smoking habit. Regarding occupation, most of the patients (24, 32.0%) were farmers, followed by 19 (25.33%) were businessmen, and 10 (13.33%) patients were service holders. Concerning the findings, most of the patients (20, 26.66%) had growth of larynx, followed by 11 (14.66%) patients had polyp/cyst, 10 (13.33%) patients had paresis, 8 (10.66%) patients had nodule, 6 (8.0%) patients had edema, 4 (5.33%) patients had chronic laryngitis, 3 (4.0%) patients had keratosis/leukoplakia and another 3 (4.0%) patients had a phonatory gap. Conclusion: Hoarseness of voice is a symptom, not a diagnosis, and therefore warrants a careful determination of the underlying cause in every case. Fiber optic laryngoscopy was an excellent tool for the diagnosis of hoarseness. Causes of hoarseness included growth in the larynx, polyp/cyst, nodules, edema, chronic laryngitis, keratosis/leukoplakia, and phonatory gaps in this study.
Hoarseness, FOL, Phonation, Laryngitis
Etiology of Hoarseness of Voice Based on FOL
Nripendra Nath Biswas1*, Md. Shafiq-Ur- Rahman2, Debobrata Roy3, ATM Sumaief Ur Rahman4, Ranjit Kumar Rudra5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 232-248 | DOI: 10.53339/aimdr.2023.9.33
Etiology of Hoarseness of Voice Based on FOL
Nripendra Nath Biswas1*, Md. Shafiq-Ur- Rahman2, Debobrata Roy3, ATM Sumaief Ur Rahman4, Ranjit Kumar Rudra5
Abstract
Background: Hoarseness (dysphonia) is the reason for about 1% of all consultations in primary care. Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx. Evaluation of a patient with hoarseness includes a careful history, physical examination, and in many cases, laryngoscopy. This study aimed to analyze the etiology of hoarseness of voice based on a fiberoptic laryngoscope (FOL). Material & Methods: This cross-sectional study was conducted in the Department of ENT, in Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur for 2 years; from January 2017 to December 2018. A total of 75 subjects fulfilling the inclusion criteria were enrolled as study subjects. Data were processed and analyzed using the software SPSS (Statistical Package for Social Sciences) version 11.5. Results: In this study, most of the patients (18, 24.0%) belonged to the age group of 41-50 years, followed by 16 (21.33%) patients in the 61-70 years of age group, and then 15 (20.0%) patients were in 21-30 years of age group. None was from 0-10 years and only 2 (2.66%) patients belonged to the 11-20 years age group. Concerning the sex of the patients, 62 (83.0%) patients were male and the rest 13 (17.0%) were female indicating male predominance. 40 (53.33%) respondents had a smoking habit, and the rest 35 (46.66%) patients did not have a smoking habit. Regarding occupation, most of the patients (24, 32.0%) were farmers, followed by 19 (25.33%) were businessmen, and 10 (13.33%) patients were service holders. Concerning the findings, most of the patients (20, 26.66%) had growth of larynx, followed by 11 (14.66%) patients had polyp/cyst, 10 (13.33%) patients had paresis, 8 (10.66%) patients had nodule, 6 (8.0%) patients had edema, 4 (5.33%) patients had chronic laryngitis, 3 (4.0%) patients had keratosis/leukoplakia and another 3 (4.0%) patients had a phonatory gap. Conclusion: Hoarseness of voice is a symptom, not a diagnosis, and therefore warrants a careful determination of the underlying cause in every case. Fiber optic laryngoscopy was an excellent tool for the diagnosis of hoarseness. Causes of hoarseness included growth in the larynx, polyp/cyst, nodules, edema, chronic laryngitis, keratosis/leukoplakia, and phonatory gaps in this study.
Hoarseness, FOL, Phonation, Laryngitis
Assessment of Bacteriological Pattern and Antimicrobial Susceptibility in Deep Neck Space Abscess
Muhammad Ariful Islam1*, Md. Hasibur Rahman2, Md. Saiful Islam3, Mahmud Asif Rifat4, Md. Abdullah Al Mamun5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 249-255 | DOI: 10.53339/aimdr.2023.9.34
Assessment of Bacteriological Pattern and Antimicrobial Susceptibility in Deep Neck Space Abscess
Muhammad Ariful Islam1*, Md. Hasibur Rahman2, Md. Saiful Islam3, Mahmud Asif Rifat4, Md. Abdullah Al Mamun5
Abstract
Background: Deep neck abscess is a common clinical entity in developing countries like ours. Despite the widespread use of antibiotics, deep neck infections do not disappear and remain one of the most difficult emergencies encountered in daily clinical practice. The extent and severity of the illness could become life-threatening. Therefore, coping with deep neck abscess remain a challenge to otolaryngologists. This study aimed to analyze the bacteriological pattern and antimicrobial susceptibility in deep neck space abscesses. Material & Methods: It was a cross-sectional observational study. 50 patients with deep neck space abscesses fulfilling the inclusion and exclusion criteria admitted to the department of ENT & Head Neck Surgery, Rangpur Medical College Hospital, Rangpur, from 1st July 2017 to 30th December 2017 were enrolled in this study. Pus from deep neck space abscess was collected by either aspiration or incision and drainage with proper aseptic measure and sent by sterile test tube to microbiology department immediately. Data were collected by detailed history taking and clinical examination & investigations with informed written consent and analyzed by SPSS (version 20). Results: In this study most commonly involved deep neck spaces were Submandibular (38%), Peritonsillar (32%), Retropharyngeal (14%), and parapharyngeal (8%) spaces. Streptococcus viridans was the most prominent organism 14 (28%) followed by Klebsiella pneumonia 9(18%) and Staph. aureus 4 (8%). The most effective antibiotic was Ceftriaxone 34(79%) followed by Cefuroxime 30 (70%) and Erythromycin 23(54%). Aerobic organisms were highly sensitive to Cefuroxime (83%) and Ceftriaxone (83%) followed by Erythromycin (48%). Anaerobic organisms were sensitive to Clindamycin (100%), Metronidazole (100%), and Erythromycin (100%) followed by Ceftriaxone (75%). Conclusion: The most frequently isolated organism in deep neck space abscesses were Streptococcus viridans and Staphylococcus aureus and sensitivity results showed the majority of isolates are susceptible to Ceftriaxone and Cefuroxime.
Deep neck abscess, Bacteriology, Sensitivity, Resistance
Socio-demographic Correlation among Patients with Deliberate Self-harm
Md. Tozammel Hoque1*, Mst Rokeya Satter2, Md Mozammel Hoque3, Md. Saidur Rahman4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 256-265 | DOI: 10.53339/aimdr.2023.9.35
Socio-demographic Correlation among Patients with Deliberate Self-harm
Md. Tozammel Hoque1*, Mst Rokeya Satter2, Md Mozammel Hoque3, Md. Saidur Rahman4
Abstract
Background: Deliberate self-harm is a complex behavior of maladaptive response to acute and chronic stress, and likely to be suffering from mental health problems as well as co-morbid general medical conditions, including several non-suicidal intentions to suicide. Deliberate self-harm was previously included in suicide. Sir Thomas Browne first used the word ‘Suicide’ in 1642 in his religion Medici. The word suicide originated from SUI (of oneself) & CAEDES (murder). According to WHO ‘Suicide’ refers to the act of killing oneself intentionally, performed by the person with full knowledge or expectation of the fatal outcome. This study aimed to analyze the pattern of psychiatric disorders among patients with deliberate self-harm. This study aimed to analyze the socio-demographic correlation among patients with deliberate self-harm. Material & Methods: This descriptive cross-sectional study was conducted at the Department of Medicine; emergency & OPD, Rangpur Medical College, Rangpur, Bangladesh. The study duration was 1 year; July 2012- June 2013. A total of 116 deliberate self-harm cases were included in this study as per the inclusion criteria. A convenience sampling technique was undertaken in this study. Results: The correlation of age, sex, economic status, religion, educational status, occupation, marital status, family history of mental illness, previous H/O mental illness, previous H/O physical illness, nature of stress factors, and the total number of DSH was significant between psychiatric disorder and co-morbid general medical condition. Conclusion: There was a significant correlation between sociodemographic parameters among the patients with deliberate self-harm. Bangladesh is a country with a cultural heritage of thousands of years. Traditional values, and social and family bonding are the characteristics of the culture. Traditional value systems are being declined gradually due to the influence of western culture. The social structure is in a period of transition that is characterized by the waning of family ties and social support as well as an increase in urbanization and modernization. This factor together with psychiatric and co-morbid general medical conditions plays an important role in deliberate self-harm.
Co-morbid medical condition, Self-harm, Suicide
Perinatal Outcome According to Gestational Age- A study of 50 Cases
Ferdousi Begum1*, Nargis Sultana2, Yasmin Ara Begum3, Hachina Akhter4, Mosammat Rehana Sultana5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 266-274 | DOI: 10.53339/aimdr.2023.9.36
Perinatal Outcome According to Gestational Age- A study of 50 Cases
Ferdousi Begum1*, Nargis Sultana2, Yasmin Ara Begum3, Hachina Akhter4, Mosammat Rehana Sultana5
Abstract
Background: Gestational age supports predicting a potential due date, informing obstetrical care and testing, and assessing the baby’s health at birth. It is vital to obtain a gestational age in all pregnancies to offer regular care and medical management for both mother and fetus. The ultimate suitable techniques for calculating gestational age are ultrasonography. The study aims to investigate the perinatal outcome according to gestational age. Material & Methods: A Prospective cross-sectional study was carried out in the Department of Obstetrics & Gynecology, Bangabandhu Sheikh Mujib Medical University, Hospital, from January 2008 to June 2008. A total of 50 patients were enrolled in this study following the inclusive criteria. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. Results: Among the study population (N=50), one-fifth of the mothers’ (10,20.0%) age was under twenty. The majority of mothers were (34,68.0%) between 20-30 years old with a mean age of 25.4 ± 4.32 years. Twenty-three patients (23,46.0%) came at 40+ weeks of pregnancy, eighteen patients came at (18,36,0%) on 41 weeks of pregnancy and nine patients (9,18.0%) came at41+ weeks of pregnancy. There was no perineal tear and two patients (2,4.0%) had cervical tears which were repaired. In two patients (2,4.0%) there was postpartum haemorrhage, among them two patients (2,4.0%) needed a blood transfusion. Among the healthy babies, the majority of the babies (20,40.0%) were born at 40 completed weeks of gestation, eighteen babies (18,36.0%) at 41 completed weeks and two babies (2,4.0%) were born at 42 completed weeks of gestation. Conclusion: Many childhood and adult diseases are linked with size at birth and are mostly inclined by early postnatal growth is widely accepted. The evolving fetus formulates itself for post-partum life by reporting to metabolic signals in its uterine environment.
Gestational Age, Neonatal Outcome, Ultrasonography
Nazlima Nargis1*, Iqbal Karim2, Salma Lovereen3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 275-281 | DOI: 10.53339/aimdr.2023.9.37
Evaluation of Laparoscopic Management of Adnexal Mass- An Observational Study in a Tertiary Care Hospital
Nazlima Nargis1*, Iqbal Karim2, Salma Lovereen3
Abstract
Background: Adnexal masses are of increasing distress among women because of high fatality related to ovarian malignancy. Finding masses at the primary stage is of crucial significance and in these cases, adnexal masses could be dangerous. Laparoscopy has seemed as one of the most feasible surgical procedures and is now recommended as the “gold standard” method for the management of a wide range of gynecological complaints. The study aimed to determine the evaluation of laparoscopic management of adnexal mass. Material & Methods: A prospective observational study was carried out in the Department of Gynecology & Obstetrics, Ibn Sina Medical College and Hospital, Kallyanpur, Dhaka from 1st January 2020 to July 2022. A total of 146 patients (N=146) were enrolled in this study. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Results: Among the study population (N=146), the majority of the patients (70,48.0%) belonged to 21-30 years old. Most of the patients (124, 85.0%) were of the reproductive age group & only five patients (5, 3.4%) were of postmenstrual age. Most of the patients (38,26.0%) had ectopic mass, and around one-fourth of the patients (35,24.0%) had a simple cyst. around two-fifths of the patients (63,43.1%) underwent ovarian cystectomy, one-fourth of the patients (37,25.3%) underwent salpingectomy, twenty patients (20,13.7%) underwent excision of chocolate cyst, fourteen patients (14,9.6%) underwent salpingo-oophorectomy and two patients (2,1.4%) underwent conversion to laparotomy. Postoperative fever was seen in only three patients (3,2.0%), and minor port-site infection was seen in three patients (3,2.0%). Conclusion: The diagnosis of adnexal masses is indispensable which may upset all age groups of women. The laparoscopic method is an operative and innocuous procedure for managing patients with adnexal masses. An adequate selection of cases, a laparoscopic surgery-based hospital, and a proficient laparoscopic surgical team are vigorous for good patient consequences.
Adnexal mass, Laparoscopy, Benign, Malignancy
Risk Factors Related to Gestational Trophoblastic Disease
Hafija Akter1*, Minara Parveen2, Salima Akter3, Tamima Akter4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 282-287 | DOI: 10.53339/aimdr.2023.9.38
Risk Factors Related to Gestational Trophoblastic Disease
Hafija Akter1*, Minara Parveen2, Salima Akter3, Tamima Akter4
Abstract
Background: Gestational trophoblastic diseases (GTD) consist of a group of neoplastic disorders arising from placental trophoblastic tissue after normal or abnormal fertilization. The WHO classification of GTD includes hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor, and miscellaneous and unclassified trophoblastic lesions. This study aimed to analyze the risk factors related to the gestational trophoblastic disease. Material & Methods: This prospective study was conducted at the Department of Obstetrics & Gynecology in Uttara Adhunik Medical College & Hospital, Dhaka, Bangladesh for 1 year; from April 2020 to March 2021. A total of 100 subjects were included in this study. Informed written consent was taken from the study subjects. Data was collected using a pre-formed data sheet. Data processing and analysis were done by using SPSS version 17. The test statistics used to analyze the data were descriptive statistics, the McNemar Chi-square test, and Repeated Measure ANOVA statistics. All patients underwent necessary investigations. All information was kept confidential and used only for this study purpose. The ethical Clearance Certificate was obtained from Bangladesh Medical College. Results: The majority of the patients were more than of 38 years age (53, 53.0%). Out of these patients, 50 (50.0%) were para one, while 40 (40.0%) were para more than four, most of the patients (63, 63.9%) were illiterate and 5 (5.0%) were graduates, most of the subjects (73, 73.0%) belonged to the low socioeconomic group. The most common presenting symptom was bleeding per vagina (35, 35.0%) followed by pain in the lower abdomen (24, 24.0%), the passage of moles (16, 16.0%), hyperemesis gravidarum (14, 14.0%) and dyspnea in 11 (11.0%) subjects. Conclusion: The disease was common in extremes of ages, low para, and grand multiparous women. The hydatidiform mole was the commonest type of trophoblastic disease in these patients. The most common presenting complaint was bleeding per vagina followed by pain in the lower abdomen. The hydatidiform mole was diagnosed in 65 (65.0%) patients, the invasive mole in 28 subjects (28.0%), and choriocarcinoma in 7 (7.0%) patients. No patient had a placental site trophoblastic tumor.
Gestation, Trophoblast, HCG, Hydatidiform mole
Evaluation of Immunoglobulin Levels in Lavage Fluid in Active and Inactive Disease
Sajib Muhammad Rayhan1*, Mahfuza Akter2, Md. Imnul Islam3
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 288-294 | DOI: 10.53339/aimdr.2023.9.39
Evaluation of Immunoglobulin Levels in Lavage Fluid in Active and Inactive Disease
Sajib Muhammad Rayhan1*, Mahfuza Akter2, Md. Imnul Islam3
Abstract
Background: Fluid obtained by whole gut lavage usually contains traces of immunoglobulin (lg) G, albumin, and a-1-antitrypsin; higher concentrations have been found in patients with inflammatory bowel disease (IBD). Immunoglobulin (lg) levels increase in the lower respiratory tract of patients with pulmonary sarcoidosis. The aim of this study is to assess the Evaluation of immunoglobulin levels in lavage fluid in active and inactive disease. Material & Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of microbiology and immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. In Bangladesh for the duration of the period from October 2015 to March 2017. Results: This study shows that the according to age of 33 Patients aged 1 to 9 years. Here according to Age distribution, 2(6.1%) were 1-3 years, 10(30.30%) were >3 6 years, 9(27.27%) were >6-9 years and 12(36.4%) were >9 years. And according to gender 13(39.4%) were Male and 20(60.6%) were Female. Conclusion: The study concluded that high and abnormal levels of immunoglobulin (IgG, IgM, and IgA) is present among JIA patient in active disease state which became normal in inactive state.
Immunoglobulin (lg); Inflammatory bowel disease (IBD); Pulmonary sarcoidosis
Outcome of Laparoscopic Cholecystectomy in a District Level Hospital
Ahsan Habib1*, Md. Shofiur Rahman2, Abdur Rahim3, Jafrin Akhter4, Sabina Jahan5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 295-302 | DOI: 10.53339/aimdr.2023.9.40
Outcome of Laparoscopic Cholecystectomy in a District Level Hospital
Ahsan Habib1*, Md. Shofiur Rahman2, Abdur Rahim3, Jafrin Akhter4, Sabina Jahan5
Abstract
Background: Laparoscopic cholecystectomy is a type of surgery that uses smaller incision than open cholecystectomy. LC has been performed as outpatient procedure for many years. Few studies have been conducted with primary focus on patient acceptance and preferences in terms of safety and satisfaction. We tried to explore its feasibility in otherwise healthy individuals undergoing laparoscopic cholecystectomy. The aim of the study of laparoscopic cholecystectomy is significantly affected by acute cholecystitis. Mechanical, biochemical, and bacteriological factors which are believed to participate in this inflammatory process are responsible for the different pathological processes observed in acute cholecystitis and in symptomatic cholelithiasis. Material & Methods: Data from 57 patients between the age group 20 to 70 years with cholelithiasis who underwent laparoscopic cholecystectomy in a private Hospital, Madaripur, Bangladesh from April 2018 to June 2020 as ambulatory surgery (hospital stay 23 Hours) with or without overnight stay were analyzed. Complications, admissions and readmissions, patient satisfaction and treatment expenditure were assessed. Results: There were 48 (84.2%) female and 9 (15.8%) male with a median age of 42 years. Only 2.4% patients required readmission while 9.2% patients had unplanned admission. 76.4% percent patients were highly satisfied with the procedure. Treatment cost was about 15% lower than routine inpatient operation. Conclusion: Laparoscopic cholecystectomy is safe and feasible. LC can be performed as an outpatient procedure with a low rate of complications and admissions/readmissions. Patient acceptance in terms of satisfaction is high.
Laparoscopic cholecystectomy, symptomatic gallstone, chronic gallstone
Md. Selim Sarker1*, Mohammad Rezaul Karim2, Mohammad Emran3, Md. Mosaddak Akbar4, Nur E Dilara Islam5
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 303-309 | DOI: 10.53339/aimdr.2023.9.41
Evaluation of Anaesthetic Challenges in Primary Cleft Lip and Palate Surgeries in a Single Center Study
Md. Selim Sarker1*, Mohammad Rezaul Karim2, Mohammad Emran3, Md. Mosaddak Akbar4, Nur E Dilara Islam5
Abstract
Background: One of the most prevalent congenital malformations and the most frequent craniofacial defects in children is cleft lip and palate. The aim of the study was to investigate the anaesthetic procedures employed and to determine the challenges and postoperative complications associated with cleft lip and palate surgery. Material & Methods: A retrospective review of the anaesthetic procedures carried out from January 2022 to December 2022 at the Dhaka Dental College and Hospital. The hospital records were reviewed in order to learn about every occurrence of orofacial cleft surgery. In this study, a total number of 120 cases were reviewed. Results: Among 120 cases, 53 (44.2%) of the patients were female and 67 (55.8%) were male. The bulk of patients came after their first year of life. About 54(45%) of them were younger than five years old. 68(56.67%) underwent cleft lip surgery, 37(30.83%) for cleft palate surgery and rest 15(12.5%) patients under went for combined cleft lip and cleft palate surgeries. Upper Respiratory Tract Infection (URTI) was reported as the most common pre-existing morbidity. Bronchospasm was the main intraoperative complications occurred in 8 (6.67%) of the cases with URTI. After surgey 6(5%) patients experienced bleeding, 3(2.5%) patients needed to be reintubated. In addition, 2 (1.67%) instances had trouble controlling their pain, only 1(0.83%) patient had trouble swallowing and 1(0.83%) recovered slowly. Conclusion: Anaesthesia for surgical repair of cleft lip or palate in children is challenging. After a thorough preoperative evaluation, a trained anaesthesiologist should administer anaesthesia under strict supervision to minimize postoperative complications.
Anaesthetic Challenges, Cleft Lip, Palate Surgeries, malformation
The Maternal and Fetal Outcome of Placenta Praevia in Term Pregnancy
Rifat Ara Liza1*, Asif-Ur-Rahman2, Farzana Parvin3, Farhin Alam4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 310-321 | DOI: 10.53339/aimdr.2023.9.42
The Maternal and Fetal Outcome of Placenta Praevia in Term Pregnancy
Rifat Ara Liza1*, Asif-Ur-Rahman2, Farzana Parvin3, Farhin Alam4
Abstract
Background: Placenta praevia refers to a placenta that is Inserted either completely or partially in the lower uterine segment. In placenta praevia, placenta is implanted in the lower uterine segment within the zone of effacement and dilatation of cervix, resulting in obstruction to decent of the Presenting part. The aim of this study is to find out the maternal and fetal outcome of Placenta praevia in term pregnancy. Material & Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of obstetrics and gynecology, Dhaka Medical College and Hospital, Dhaka, Bangladesh. In Bangladesh for the duration of the period from January 2013 to June 2013. The duration of the period from Data was entered in MS Excel and Statistical analysis was done using SPSS 24 version. Results: This study shows that Maternal age range was 18 to 45 years and the commonest age group of placentas previa was 25-29 years (60.0%). Four percent were between 20-24 years age group. Twenty percent were more than 35 years of age. Conclusion: The study subjects were selected only who were found high maternal morbidity and perinatal mortality which was 8% due to placenta preavia. So, the observed result of this study might not reflect the expected real outcome. In population therefore further prospective studies with a large sample should be carried out for comprehensive evaluation of placenta Preavia on maternal and neonatal outcome.
Placenta praevia; Uterine; Cervix; Perinatal mortality; Neonatal
Shifat Tanjila1*, A M Fasiul Alam2
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 322-330 | DOI: 10.53339/aimdr.2023.9.43
Comparative Study on Early Postoperative Outcome between Linear Cutting Stapling Device Gastro-Jejunostomy &Amp; Traditional Hand Sewn Gastro-Jejunostomy for Gastric Cancer
Shifat Tanjila1*, A M Fasiul Alam2
Abstract
Background: Gastric cancer (GC) is a heterogeneous, multifactorial disease. It endangers human physical and psychosocial wellbeing, causing a significant public health and economic burden in developed and developing countries. To compare the early postoperative outcome between linear cutting stapling device gastro-jejunostomy & traditional hand sewn gastro-jejunostomy for gastric cancer. Material & Methods: The study was a Prospective observational study which was conducted in Department of Surgery, Dhaka Medical college & Hospital, over Six months period after approval of protocol using a semi-structured questionnaire through face to face interview. Data were analysed using a computer programme SPSS 24.0 version. Results: Total 40 patients were enrolled in this study among them 20 patients underwent traditional hand sewn gastro-jejunostomy (Group-A) and 20 patients underwent Linear Cutting Stapling Device gastro-jejunostomy (Group-B). The mean age of the total participants was 57.45±7.04 years where in Group A mean age was 57.30±7.14 years and in Group B mean age was 57.60±6.83 years. The overall mean BMI of the patients was 21.94±1.61 kg/m2. Among all the respondents 25% had comorbidity. Operation time and time for anastomosis were significantly higher in Group A than Group B but no significant difference was found in relation to hospital stay and post-operative blood loss. About 15% had Anastomotic hemorrhage, 10% had Anastomotic leak, 5% had Intra-abdominal abscess and 5% had bowel obstruction in Group A beside 5% had Anastomotic hemorrhage, 5% had Anastomotic leak and 5% had SSI in Group B. Among all 10% needed blood transfusion in Group A and 5% needed blood transfusion in Group B. No significant difference has been found with post-operative complications between both groups. Conclusion: Observed advantages of Linear Cutting Stapling Device Gastro-Jejunostomy in this study were the significantly reduced operation time and anastomosis time.
BMI, DM, HTN, SSI
Study of Deliberate Self-Poisoning Among Adult Females in A Tertiary Care Hospital
Faisal Bin Yousuf1*, Shyamal Sarker2, Tanzila Ferdous3, Sayeda Moni Chowdhury4
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 331-334 | DOI: 10.53339/aimdr.2023.9.44
Study of Deliberate Self-Poisoning Among Adult Females in A Tertiary Care Hospital
Faisal Bin Yousuf1*, Shyamal Sarker2, Tanzila Ferdous3, Sayeda Moni Chowdhury4
Abstract
Background: Poisoning is a common medico-social problem in our country causing around 300,000 episodes and around 2000 deaths per year. Attempted suicide among adult females are a major public health problem. The number of self-poisoning in females are increasing in our country day by day. The incidence, nature, etiology, age group affected and the outcome of self-poisoning in females of our country is different from that of the western world. Objective: The objective of the study was to analysis the socio-demographic profile & pattern of deliberate self-poisoning among adult females admitted in the Medicine Department, Dhaka Medical College Hospital. Material and Methods: This was a descriptive cross sectional study conducted in the Department of Medicine, Dhaka Medical College Hospital from January 2016 to June 2016. 100 admitted female participants were enrolled in this study as study population. A purposive sampling method was applied for sampling from study population. Results: The age of the participants were from 18 to 55 years with the mean age of 28.19 (± 9.84) years. Most number of the participants were in 21-29 year’s age group (42%) followed by ≤20 year’s (29%). House wife (30%) was the most common occupation followed by student (25%). Most of the participants were from lower economic class (51%), followed by middle class (41%). 48% participants were in primary level, 24% in secondary level and 22% were illiterate. Most of the participants were married (51%), followed by unmarried (35%), divorced (9%) and widow (5%). 62% participants from rural and 38% from urban area. 75% were Muslim and 25% were Hindu. 55% were from the joint family and 45% were from the nuclear family. Most of the self-poisoning occurred between 6 am to 12 pm (42%), followed by 6 pm to 12 am (30%), 12 pm to 6 pm (20%) and 12 am to 6 am (8%). Insecticide was the most common poison materials (43%), followed by drug ingestion (30%), household detergent (13%), rodenticide (6%) and others (8%). Maximum participants reported the reason for self-poisoning was family disharmony (35%) followed by romantic disappointment (27%). 17% participants reported previous suicidal attempt and 11% had previous psychiatric disorder. Nearly half of the participants (43%) sought medical care within 2 hours and one fourth participants (31%) within 4 hours. About two-thirds of the participants (66%) received primary medical care from different govt. hospitals. Most of the female participants with self-poisoning were recovered completely (71%), while 20% participants recovered with complications and 9% participants died. In the study, fatality rate was found 33.3% in rodenticide and 16.3% in insecticide poisoning. Conclusions: As evident from the study, by intervene these problems by various measures might be helpful to prevent many of deliberate self-harm. Early diagnosis and prompt institution of appropriate treatment can make a favorable outcome in deliberate self-poisoning of female participants.
Attempted suicide, Deliberate self-poisoning, Incident, Nature of suicide, Etiology, Age group
Sayeda Moni Chowdhury1*, S M Hafiz2, Tanzila Ferdous3, Sayat Quayum4, Faisal Bin Yousuf5, Debabrata Das6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 345-356 | DOI: 10.53339/aimdr.2023.9.45
Status of Serum Magnesium in Different Stages of CKD Patients: A Tertiary Care Hospital Study in Bangladesh
Sayeda Moni Chowdhury1*, S M Hafiz2, Tanzila Ferdous3, Sayat Quayum4, Faisal Bin Yousuf5, Debabrata Das6
Abstract
Background: In chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal magnesium absorption hence insufficient to maintain homeostasis. But related data are relatively sparse and not readily available, especially in Bangladesh context. Aim of the study: The aim of the study was to assess the pattern of serum magnesium level in different stages of CKD patients. Material & Methods: This descriptive cross-sectional study was conducted in the Department of Medicine and the Department of Nephrology, Dhaka Medical College Hospital (DMCH) for nine months’ period. Approval for the study was taken from the ethical review committee of DMC before the commencement of the study. Diagnosed patients of chronic kidney disease (CKD) were approached for the inclusion of the study. Informed written consent was taken from each patient. All patients were subjected to detailed history taking, physical examination, and relevant investigations. For the study purpose, serum magnesium was done for all patients. Results: After compiling data from all participants, statistical analysis was performed using the statistical package for social science (SPSS) version 22 for windows, and a p < 0.05 was considered statistically significant. Mean age of the patients was 53 years with male predominance (male 64% vs female 36%). Of all, 6.7% of cases had hypomagnesemia and 55.3% had hypermagnesemia. The mean serum magnesium level was 2.68±0.81 mg/dl. Assessment of serum magnesium in a different stages of CKD showed that hypermagnesemia is associated with higher staging (p<0.05), and there is a negative correlation between lower e-GFR with serum magnesium ((r=-0.753, p<0.01). Conclusion: Nearly two-third of CKD patients were found with altered magnesium level in the form of hypomagnesemia or hypermagnesemia in this study. Serum magnesium was found increased in higher stages of CKD. That means serum magnesium level increases along with higher stage of the disease. Urinary magnesium excretion also decreases when eGFR of patient decreased.
Chronic kidney disease (CKD), Renal regulatory mechanisms, Intestinal magnesium, Homeostasis
Ca-125: A Useful Marker to Distinguish Pulmonary Tuberculosis from Bacterial Pneumonia
Tanzila Ferdous1*, Md. Titu Miah2 ,Faisal Bin Yousuf3, Sayeda Moni Chowdhury4, Sayat Quayum5, Nusrat Neherin Khan6
Annals of International Medical and Dental Research (AIMDR)| Vol-9, Issue-2 | March-April 2023 | Page: 357-368 | DOI: 10.53339/aimdr.2023.9.46
Ca-125: A Useful Marker to Distinguish Pulmonary Tuberculosis from Bacterial Pneumonia
Tanzila Ferdous1*, Md. Titu Miah2 ,Faisal Bin Yousuf3, Sayeda Moni Chowdhury4, Sayat Quayum5, Nusrat Neherin Khan6
Abstract
Background: Ca-125 is a large molecular-weight glycoprotein synthesized by different cells originating from the coelomic epithelium. Although classically it has been used to monitor the course of ovarian epithelial cancer, there are other established circumstances associated with high serum Ca -125 levels and pulmonary tuberculosis is one of them. Diagnosing pulmonary tuberculosis, which is not bacteriologically positive often very challenging. Because many procedures are available for such cases but they are of limited use because some of them are lengthy or expensive or need sophisticated equipment, highly skilled personnel, etc. Serum CA-125 is a rapid, relatively inexpensive investigation. Objective: The present study aimed to assess the role of CA-125 in distinguishing pulmonary TB from bacterial pneumonia. Methods: This analytical cross-sectional study was conducted in the Department of Medicine, Dhaka Medical College Hospital for the period of March 2018 to September 2020.100 pulmonary tuberculosis patients were taken in group I, and 100 bacterial pneumonia patients were taken in group II according to selection criteria. Informed written consent was taken from each of the participants. All were subjected to detail clinical and demographic history along with thorough physical examination. Relevant investigations were done including serum CA-125. All final data were collected in the semi-structured and pretested case record form. After data collection, data were checked for errors, and analysis was done. Results: In this study, the mean CA-125 value was 62.29 (SD±31.51) IU/mL in group I(pulmonary tuberculosis). In group II (bacterial pneumonia) mean value was 22.95(±8.25) IU/mL. The mean value of CA-125 was significantly higher (p-value <0.001) in group I patients compared to group II. About 59.0% of patients in group I had a high level of serum CA-125 which had a significant difference from group II (p<0.001). ROC analysis of CA-125 in the diagnosis of patients with active pulmonary tuberculosis showed a cut-off value of ≥31.7 IU/mL had sensitivity, specificity, PPV, NPV, PLR, NLR, and accuracy of 72%, 87%, 84.7%, 75.7%, 5.54%, 0.321%, and 79.5% respectively. Conclusion: This study’s findings stated that serum CA-125 may be a useful marker in distinguishing PTB from bacterial pneumonia. Therefore, further study with a more generalized study population is recommended.
Ca-125, Glycoprotein, Caulomic epithelium, Pulmonary tuberculosis