Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64284
Md Rakibul Islam Masud, Md. Nizamul Haque, M. Khan, Badrun Nahar Tuly, Md Golam Zel Asmaul Husna, S. Alam
A quasi-experimental study was conducted to compare palliative radiotherapy between 20 Gy in 5 fractions and 30 Gy in 10 fractions in superior vena cava syndrome due to carcinoma of lung. This study was done in National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh, from September 2017 to August 2018. A total of 60 patients were enrolled in the study – 30 in each group. In Arm A, patients received 20 Gy in 5 fractions in 1 week, while in Arm B, patients received 30 Gy in 10 fractions in 2 weeks. Every patient was evaluated routinely to see the treatment outcome and toxicities. The mean age of Arm-A was 57.53±5.5 years and that of Arm-B was 57.40±5.4 years. After treatment, improvement of symptoms (e.g., edema, venous distension, dyspnea) of SVCS was observed. After 1 month of radiotherapy, complete resolution of venous distension occurred in majority of the patients (73.3% vs. 80%) and partial resolution occurred in rest of them (26.7% vs. 20%) in arms A and B respectively. Most of patients showed complete resolution of edema (83.3% vs. 86.7%), while few had partial resolution (16.7% vs. 13.3%) in arms A and B respectively. Symptoms of SVCS did not recur in any of the patients of both arms. Performance status also improved in all patients. Assessment of tumor response at the last follow-up showed partial response in 66.7% patients of Arm-A and 73.3% patients of Arm-B. Stable disease was observed in 33.3% patients of Arm-A and 26.7% patients of Arm-B. None of the patients showed disease progression. Toxicities included dysphagia (26.7% vs. 33.33%), fatigue (23.33% vs. 20%), nausea and vomiting (16.67% vs. 20%) and skin reaction (16.67% vs. 13.33%) in Arm-A and Arm-B respectively. All of those toxicities were grade-1 and easily controlled. There was no statistically significant difference between two treatment groups in terms of palliation of symptoms of SVCS, tumor response and toxicities. To summarize, although tumor response was not much satisfactory, both 20 Gy in 5 fractions and 30 Gy in 10 fractions are equally effective radiotherapy regimens in palliation of symptoms of SVCS due to lung cancer with tolerable toxicities. Hence, 20 Gy in 5 fractions can be a reasonable treatment choice in a resource-poor country like Bangladesh. CBMJ 2023 January: Vol. 12 No. 01 P: 33-40
采用准实验方法比较20 Gy分5段和30 Gy分10段姑息放疗对肺癌上腔静脉综合征的治疗效果。该研究于2017年9月至2018年8月在孟加拉国达卡的国家癌症研究所和医院(NICRH)完成。共有60名患者参加了这项研究，每组30名。在A组中，患者在1周内接受5次20 Gy的治疗，而在B组中，患者在2周内接受10次30 Gy的治疗。对每位患者进行常规评估，以了解治疗结果和毒性。a组平均年龄57.53±5.5岁，b组平均年龄57.40±5.4岁。治疗后，观察到SVCS症状(水肿、静脉扩张、呼吸困难)改善。放疗1个月后，A组和B组绝大多数患者静脉扩张完全消退(73.3% vs. 80%)，其余患者静脉扩张部分消退(26.7% vs. 20%)。在A组和B组中，大多数患者水肿完全消退(83.3% vs. 86.7%)，少数患者部分消退(16.7% vs. 13.3%)。两组患者均未出现SVCS症状复发。所有患者的运动状态均有改善。最后一次随访时肿瘤反应评估显示，a组66.7%患者部分缓解，b组73.3%患者部分缓解。a组33.3%的患者病情稳定，b组26.7%。所有患者均未出现疾病进展。a臂和b臂的毒性分别为吞咽困难(26.7%对33.33%)、疲劳(23.33%对20%)、恶心和呕吐(16.67%对20%)和皮肤反应(16.67%对13.33%)。所有这些毒性均为1级，易于控制。两个治疗组在SVCS的症状缓解、肿瘤反应和毒性方面无统计学差异。综上所述，尽管肿瘤反应不太令人满意，但在缓解毒性可耐受的肺癌引起的SVCS症状方面，5分20 Gy和10分30 Gy都是同样有效的放疗方案。因此，在孟加拉国这样资源贫乏的国家，5份20戈瑞可能是一种合理的治疗选择。中华医学杂志2023 1月12期01期33-40页
{"title":"A Comparison of Palliative Radiotherapy Between 20 Gy in 5 Fractions and 30 Gy in 10 Fractions in Superior Vena Cava Syndrome Due to Carcinoma of Lung","authors":"Md Rakibul Islam Masud, Md. Nizamul Haque, M. Khan, Badrun Nahar Tuly, Md Golam Zel Asmaul Husna, S. Alam","doi":"10.3329/cbmj.v12i1.64284","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64284","url":null,"abstract":"A quasi-experimental study was conducted to compare palliative radiotherapy between 20 Gy in 5 fractions and 30 Gy in 10 fractions in superior vena cava syndrome due to carcinoma of lung. This study was done in National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh, from September 2017 to August 2018. A total of 60 patients were enrolled in the study – 30 in each group. In Arm A, patients received 20 Gy in 5 fractions in 1 week, while in Arm B, patients received 30 Gy in 10 fractions in 2 weeks. Every patient was evaluated routinely to see the treatment outcome and toxicities. The mean age of Arm-A was 57.53±5.5 years and that of Arm-B was 57.40±5.4 years. After treatment, improvement of symptoms (e.g., edema, venous distension, dyspnea) of SVCS was observed. After 1 month of radiotherapy, complete resolution of venous distension occurred in majority of the patients (73.3% vs. 80%) and partial resolution occurred in rest of them (26.7% vs. 20%) in arms A and B respectively. Most of patients showed complete resolution of edema (83.3% vs. 86.7%), while few had partial resolution (16.7% vs. 13.3%) in arms A and B respectively. Symptoms of SVCS did not recur in any of the patients of both arms. Performance status also improved in all patients. Assessment of tumor response at the last follow-up showed partial response in 66.7% patients of Arm-A and 73.3% patients of Arm-B. Stable disease was observed in 33.3% patients of Arm-A and 26.7% patients of Arm-B. None of the patients showed disease progression. Toxicities included dysphagia (26.7% vs. 33.33%), fatigue (23.33% vs. 20%), nausea and vomiting (16.67% vs. 20%) and skin reaction (16.67% vs. 13.33%) in Arm-A and Arm-B respectively. All of those toxicities were grade-1 and easily controlled. There was no statistically significant difference between two treatment groups in terms of palliation of symptoms of SVCS, tumor response and toxicities. To summarize, although tumor response was not much satisfactory, both 20 Gy in 5 fractions and 30 Gy in 10 fractions are equally effective radiotherapy regimens in palliation of symptoms of SVCS due to lung cancer with tolerable toxicities. Hence, 20 Gy in 5 fractions can be a reasonable treatment choice in a resource-poor country like Bangladesh. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 33-40","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81486881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64269
Zeenatul Momena, M. Rahman, R. Perveen, Rebeka Shahin, M. Chowdhury, Shaila Mahmud
The scapula is a complex anatomical unit; it connects the humerus with the clavicle. The scapula presents several variations, based on race, sex and region. Sexual dimorphism plays a key role in forensic anthropology. The scapula is sexually dimorphic and can potentially be used in forensic investigations. A cross-sectional study was conducted under Department of Anatomy, Dhaka Medical College, Dhaka, between July 2017 and June 2018, to observe the morphometric pattern of the left scapula in adult male and female Bangladeshi people for establishment of a baseline anatomical data for future studies. Shoulder radiograph of anterior-posterior view were taken from 100 apparently healthy adult male and female patients aged between 25 and 50 years who were attending the Department of Radiology & Imaging, Dhaka Medical College Hospital, Dhaka. From these images morphological measurements like the length and breadth of left scapula, the lengths of infraspinous line and scapular spine were measured by software named RadiAnt DICOM Viewer. The length and breadth of left scapula, the length of coracoid process, as well as the lengths of infraspinous line and scapular spine were found significantly higher in males. To summarize, a significant difference was observed in morphological measurements of the left scapula between the sexes in Bangladeshi people. CBMJ 2023 January: Vol. 12 No. 01 P: 12-16
{"title":"Gender Variation of Scapula in a Bangladeshi Population – A Radiological Study","authors":"Zeenatul Momena, M. Rahman, R. Perveen, Rebeka Shahin, M. Chowdhury, Shaila Mahmud","doi":"10.3329/cbmj.v12i1.64269","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64269","url":null,"abstract":"The scapula is a complex anatomical unit; it connects the humerus with the clavicle. The scapula presents several variations, based on race, sex and region. Sexual dimorphism plays a key role in forensic anthropology. The scapula is sexually dimorphic and can potentially be used in forensic investigations. A cross-sectional study was conducted under Department of Anatomy, Dhaka Medical College, Dhaka, between July 2017 and June 2018, to observe the morphometric pattern of the left scapula in adult male and female Bangladeshi people for establishment of a baseline anatomical data for future studies. Shoulder radiograph of anterior-posterior view were taken from 100 apparently healthy adult male and female patients aged between 25 and 50 years who were attending the Department of Radiology & Imaging, Dhaka Medical College Hospital, Dhaka. From these images morphological measurements like the length and breadth of left scapula, the lengths of infraspinous line and scapular spine were measured by software named RadiAnt DICOM Viewer. The length and breadth of left scapula, the length of coracoid process, as well as the lengths of infraspinous line and scapular spine were found significantly higher in males. To summarize, a significant difference was observed in morphological measurements of the left scapula between the sexes in Bangladeshi people. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 12-16","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91038839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64397
S. Sarkar, N. C. Ray
The SARS-CoV-2 virus has been spreading rapidly within the range of infected patients, with an alarming fatality rate, so it has become a global pandemic and public health concern. As a result of this situation, an accelerated track for vaccine development has been set in motion. A vaccine, which is made from biological products, would be the ultimate weapon against the coronavirus and the best way to return to normal life. Several SARS-CoV-2 vaccine candidates have been identified in preclinical models and are currently being tested in clinical trials. SARS and the virus that causes Covid-19, SARS-CoV-2, are nearly identical, and both use spike proteins to bind to a specific receptor found on cells in human lungs. Based on previous involvement in the development of SARS-CoV vaccines, the SARS-CoV-2 immunization is currently being developed instantly in a variety of ways. Shortcuts in any of the steps of the research and development process can result in significant health hazards as well as a decrease in social confidence in the benefits of a vaccine. The purpose of this comprehensive review was to represent the developmental stages and challenges of various vaccine varieties used in the COVID-19 disorder. CBMJ 2023 January: Vol. 12 No. 01 P: 129-135
{"title":"A Review of SARS-CoV-2 Vaccine Developmental Stages and Immunization Challenges","authors":"S. Sarkar, N. C. Ray","doi":"10.3329/cbmj.v12i1.64397","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64397","url":null,"abstract":"The SARS-CoV-2 virus has been spreading rapidly within the range of infected patients, with an alarming fatality rate, so it has become a global pandemic and public health concern. As a result of this situation, an accelerated track for vaccine development has been set in motion. A vaccine, which is made from biological products, would be the ultimate weapon against the coronavirus and the best way to return to normal life. Several SARS-CoV-2 vaccine candidates have been identified in preclinical models and are currently being tested in clinical trials. SARS and the virus that causes Covid-19, SARS-CoV-2, are nearly identical, and both use spike proteins to bind to a specific receptor found on cells in human lungs. Based on previous involvement in the development of SARS-CoV vaccines, the SARS-CoV-2 immunization is currently being developed instantly in a variety of ways. Shortcuts in any of the steps of the research and development process can result in significant health hazards as well as a decrease in social confidence in the benefits of a vaccine. The purpose of this comprehensive review was to represent the developmental stages and challenges of various vaccine varieties used in the COVID-19 disorder. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 129-135","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73788100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64375
A. M. M. Rana, Taufiqul Haque, Kallol Chandra Dew
Peutz–Jeghers syndrome (PJS) is a rare autosomal dominant disorder. The mutation is found in the serine threonine kinase (STK11)/ liver kinase B1 (LKB1) gene on chromosome 19. It impacts 1 out of 50000–200000 individuals. Clinical menifestations include hyperpigmented lesion in oral cavity, lips, fingertips and perianal region. Abdominal pain, Anaemia, Gastrointestinal (GI) bleeding, GI polyp, Intestinal obstruction (mostly due to intussusception) and malignancy are closely interlinked with the disease. We present a 21 years old lady with characteristic hyperpigmented lesions in lips and fingertips with multiple polyps in the GI tract. The patient was presented in general emergency department with abdominal pain and vomiting. Detail workout revealed the diagnosis as PJS. We have plotted the diagnosis according to the WHO criteria due to the lacking of genetic analysis facility. Patients with PJS are at high risk of intestinal and extraintestinal malignancy. Early diagnosis and polypectomy along with surveillance for recurrence may prolong cancer free lifetime. CBMJ 2023 January: Vol. 12 No. 01 P: 115- 120
{"title":"Peutz–Jeghers Syndrome: A Rare Genetic Cause of Intestinal Obstruction","authors":"A. M. M. Rana, Taufiqul Haque, Kallol Chandra Dew","doi":"10.3329/cbmj.v12i1.64375","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64375","url":null,"abstract":"Peutz–Jeghers syndrome (PJS) is a rare autosomal dominant disorder. The mutation is found in the serine threonine kinase (STK11)/ liver kinase B1 (LKB1) gene on chromosome 19. It impacts 1 out of 50000–200000 individuals. Clinical menifestations include hyperpigmented lesion in oral cavity, lips, fingertips and perianal region. Abdominal pain, Anaemia, Gastrointestinal (GI) bleeding, GI polyp, Intestinal obstruction (mostly due to intussusception) and malignancy are closely interlinked with the disease. We present a 21 years old lady with characteristic hyperpigmented lesions in lips and fingertips with multiple polyps in the GI tract. The patient was presented in general emergency department with abdominal pain and vomiting. Detail workout revealed the diagnosis as PJS. We have plotted the diagnosis according to the WHO criteria due to the lacking of genetic analysis facility. Patients with PJS are at high risk of intestinal and extraintestinal malignancy. Early diagnosis and polypectomy along with surveillance for recurrence may prolong cancer free lifetime. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 115- 120","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84177000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64290
S. Nazrina, Rubiat Naznin
In 2020, a new global pandemic Coronavirus disease (COVID-19) emerged, which was caused by a new strain of coronavirus called severe acute respiratory syndrome-corona virus (SARS-COV-2). This study aims to assess the knowledge and attitudes towards COVID-19 among preclinical medical and dental students of Community Based Medical College (CBMC,B) in Mymensingh, Bangladesh. Data were collected in September 2020. The online questionnaire was created using Google Forms after reviewing previously conducted research and posted on several online platforms accessible by the students. Most of the students (93%) were medical students, and the rest 7% were studying Bachelor of Dental Surgery (BDS). The mean COVID-19 knowledge score was 9.04 (SD: 2.107, Range: 0-12), suggesting an overall 75.33% correct rate. The results showed that knowledge scores are higher in male, MBBS students but the difference are not significant. Analyses showed that the knowledge scores of 1st-year participants were significantly higher than 2nd-year students. Increased knowledge score was noticed in those who were not in direct contact with COVID-19 patients and not infected by COVID-19 than others, though the difference was insignificant (P>0.05). Half of the participants (50.2%) agreed that this disease will finally be successfully controlled. One hundred and sixty-seven participants (65%) had confidence that Bangladesh would get a vaccine soon to prevent the COVID-19 virus. The overall knowledge level of students was generally good. As the global threat of COVID-19 continues to emerge, improvement of knowledge and perceptions among healthcare students is essential. CBMJ 2023 January: Vol. 12 No. 01 P: 53-59
{"title":"Knowledge, Attitudes of Preclinical Medical and Dental Students in Mymensingh towards “COVID-19”: A Cross-sectional Study","authors":"S. Nazrina, Rubiat Naznin","doi":"10.3329/cbmj.v12i1.64290","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64290","url":null,"abstract":"In 2020, a new global pandemic Coronavirus disease (COVID-19) emerged, which was caused by a new strain of coronavirus called severe acute respiratory syndrome-corona virus (SARS-COV-2). This study aims to assess the knowledge and attitudes towards COVID-19 among preclinical medical and dental students of Community Based Medical College (CBMC,B) in Mymensingh, Bangladesh. Data were collected in September 2020. The online questionnaire was created using Google Forms after reviewing previously conducted research and posted on several online platforms accessible by the students. Most of the students (93%) were medical students, and the rest 7% were studying Bachelor of Dental Surgery (BDS). The mean COVID-19 knowledge score was 9.04 (SD: 2.107, Range: 0-12), suggesting an overall 75.33% correct rate. The results showed that knowledge scores are higher in male, MBBS students but the difference are not significant. Analyses showed that the knowledge scores of 1st-year participants were significantly higher than 2nd-year students. Increased knowledge score was noticed in those who were not in direct contact with COVID-19 patients and not infected by COVID-19 than others, though the difference was insignificant (P>0.05). Half of the participants (50.2%) agreed that this disease will finally be successfully controlled. One hundred and sixty-seven participants (65%) had confidence that Bangladesh would get a vaccine soon to prevent the COVID-19 virus. The overall knowledge level of students was generally good. As the global threat of COVID-19 continues to emerge, improvement of knowledge and perceptions among healthcare students is essential. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 53-59","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83708619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64240
Mohammad Saiful Islam Pathan, M. Khan, T. Sultana, Mohammad Ashraf-Us-Zaman Mahmud, Dipok Saha, Atm Shazzaeatur Rahaman, Md Rakibul Islam Masud, Mohammad Arifur Rahman, Mohammed Shorfuddin Patowary, Altaf Hossain, Sarker Md Tanvir, Suman Paul, Mukti Rani Datta, Nahid Naznin Rinky
A quasi-experimental study was conducted at Radiation Oncology Department of National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh, between November 2020 and October 2021, to determine the efficacy of cryotherapy in comparison to standard oral care to prevent oral mucositis in head and neck cancer patients during receiving CCRT. A total 100 Patients (50 patients in each arm) were included in this study according to inclusion and exclusion criteria by purposive sampling technique. All patients in Arm A and Arm B received total 66 Gray in 33 daily fractions, 1 fraction per day, 5 fractions per week and inj. Cisplatin 40mg/m² was given intravenously 2/3 hours before radiotherapy on 1st day and then weekly. Arm A received cryotherapy and Arm B received standard oral care. Intervention started from the 1st day of CCRT up to the end of CCRT. WHO oral mucositis grading and visual analogue scale (VAS) were employed to determine the effects. All the information was recorded in a pre-tested semi-structured questionnaire. Total 100 patients (50 patients in each arm) were enrolled. Mean age of the patients of Arm A and Arm B was 55.28±7.82 and 55.92±8.33 respectively. Male and female ratio was 6.14:1 in two Arms. Other demographic profile, baseline characteristics were statistically not significant in both arms (P>0.05). The grade-3 mucositis appeared after 5th week in Arm B and after 6th week in Arm A. The incidence of grade- 3 mucositis after 5th week during CCRT to 4 weeks after completion of therapy was 6% vs 0%, 14% vs 6%, 22% vs 10%, 14% vs 6%, 8% vs 2%, respectively for arm B and Arm A (P<0.05). Total number of patients suffering from grade 3 mucositis was 6 (12%) and 12 (24%) for Arm A and Arm B respectively (p value was <0.05). The mean duration of grade-3 or more mucositis between Arm A and Arm B was 2.04±1.78 and 10±1.72 days respectively (P<0.05). The difference of median pain intensity between two arms was not statistically significant for 1st and 2nd week (P>0.05). However, it was significant after 3rd week during CCRT to 4 weeks after completion of CCRT (P<0.05). Cryotherapy during CCRT may be beneficial to prevent oral mucositis and pain than maintaining standard oral care. CBMJ 2023 January: vol. 12 no. 01 P: 03-11
{"title":"Efficacy of Cryotherapy in Comparison to Standard Oral Care to Prevent Oral Mucositis during Concurrent Chemoradiotherapy in Head and Neck Cancer Patients","authors":"Mohammad Saiful Islam Pathan, M. Khan, T. Sultana, Mohammad Ashraf-Us-Zaman Mahmud, Dipok Saha, Atm Shazzaeatur Rahaman, Md Rakibul Islam Masud, Mohammad Arifur Rahman, Mohammed Shorfuddin Patowary, Altaf Hossain, Sarker Md Tanvir, Suman Paul, Mukti Rani Datta, Nahid Naznin Rinky","doi":"10.3329/cbmj.v12i1.64240","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64240","url":null,"abstract":"A quasi-experimental study was conducted at Radiation Oncology Department of National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh, between November 2020 and October 2021, to determine the efficacy of cryotherapy in comparison to standard oral care to prevent oral mucositis in head and neck cancer patients during receiving CCRT. A total 100 Patients (50 patients in each arm) were included in this study according to inclusion and exclusion criteria by purposive sampling technique. All patients in Arm A and Arm B received total 66 Gray in 33 daily fractions, 1 fraction per day, 5 fractions per week and inj. Cisplatin 40mg/m² was given intravenously 2/3 hours before radiotherapy on 1st day and then weekly. Arm A received cryotherapy and Arm B received standard oral care. Intervention started from the 1st day of CCRT up to the end of CCRT. WHO oral mucositis grading and visual analogue scale (VAS) were employed to determine the effects. All the information was recorded in a pre-tested semi-structured questionnaire. Total 100 patients (50 patients in each arm) were enrolled. Mean age of the patients of Arm A and Arm B was 55.28±7.82 and 55.92±8.33 respectively. Male and female ratio was 6.14:1 in two Arms. Other demographic profile, baseline characteristics were statistically not significant in both arms (P>0.05). The grade-3 mucositis appeared after 5th week in Arm B and after 6th week in Arm A. The incidence of grade- 3 mucositis after 5th week during CCRT to 4 weeks after completion of therapy was 6% vs 0%, 14% vs 6%, 22% vs 10%, 14% vs 6%, 8% vs 2%, respectively for arm B and Arm A (P<0.05). Total number of patients suffering from grade 3 mucositis was 6 (12%) and 12 (24%) for Arm A and Arm B respectively (p value was <0.05). The mean duration of grade-3 or more mucositis between Arm A and Arm B was 2.04±1.78 and 10±1.72 days respectively (P<0.05). The difference of median pain intensity between two arms was not statistically significant for 1st and 2nd week (P>0.05). However, it was significant after 3rd week during CCRT to 4 weeks after completion of CCRT (P<0.05). Cryotherapy during CCRT may be beneficial to prevent oral mucositis and pain than maintaining standard oral care. \u0000CBMJ 2023 January: vol. 12 no. 01 P: 03-11","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85847260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64277
M. Hasan, Hasiba Begum, Akm Rashedul Hasan
A cross-sectional, descriptive study was conducted in the Department of Ophthalmology, Combined Military Hospital (CMH), Dhaka Cantonment, Bangladesh, between November 2017 and May 2018, to assess the keratometric results of clear corneal incision on the steep meridian in patients with preoperative astigmatism during phacoemulsification cataract surgery. After obtaining written informed consent, a total of 40 cataract patients with age ranged between 40 and 70 years were selected. All patients were examined pre- and postoperatively after 1 week and 3 months for evaluation of astigmatism. Keratometry was done by using an autorefractometer and an autokeratometer. Astigmatism was calculated from keratometric data using vector analysis. The mean age of the study participants was 52±9.1 years. Male predominance was observed as male-female ratio was 1.7:1. The change in astigmatism in between pre- and post-operative were 0.44±0.20 in temporal incision group and 0.19±0.00 in superior incision group; both were statistically significant (P<0.001). The difference in mean astigmatism between the groups was 0.375 (P<0.001). Postoperative astigmatism <0.5D was observed in 16(40%) patients when incision was given at temporal site and in 8(20%) patients when incision was given at superior site. Astigmatism was significantly (P<0.05) decreased more when incision given at temporal site in comparison to superior site. Our data suggest that preexisting astigmatism was significantly decreased postoperatively in majority of patients when incision was placed on steep meridian and temporal incision has less surgically induced astigmatism than superior incision. CBMJ 2023 January: Vol. 12 No. 01 P: 27-32
本研究于2017年11月至2018年5月在孟加拉国达卡军营军队联合医院眼科进行横断面描述性研究，评估白内障超声乳化术术前散光患者陡经处角膜透明切口的角膜测量结果。在获得书面知情同意后，选取40例年龄在40 ~ 70岁之间的白内障患者。术后1周和3个月分别对患者进行术前和术后散光检查。角膜测量采用自折射仪和自角膜屈光度仪。用矢量分析方法从角膜测量数据计算散光。研究参与者的平均年龄为52±9.1岁。男性优势，男女比例为1.7:1。颞部切口组和上切口组术后散光变化分别为0.44±0.20和0.19±0.00;两者均有统计学意义(P<0.001)。两组平均散光差为0.375 (P<0.001)。颞部切口16例(40%)术后散光<0.5D，上部切口8例(20%)术后散光<0.5D。颞部切口较上侧切口的散光明显减少(P<0.05)。我们的数据表明，大多数患者术后存在的散光明显减少，当切口位于陡峭经络和颞部切口时，手术引起的散光比上切口少。中华医学杂志2023 January . 12卷01期:27-32
{"title":"Effects of Corneal Incision on Steep Meridian with Preexisting Astigmatism in Cataract Surgery by Phacoemulsification","authors":"M. Hasan, Hasiba Begum, Akm Rashedul Hasan","doi":"10.3329/cbmj.v12i1.64277","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64277","url":null,"abstract":"A cross-sectional, descriptive study was conducted in the Department of Ophthalmology, Combined Military Hospital (CMH), Dhaka Cantonment, Bangladesh, between November 2017 and May 2018, to assess the keratometric results of clear corneal incision on the steep meridian in patients with preoperative astigmatism during phacoemulsification cataract surgery. After obtaining written informed consent, a total of 40 cataract patients with age ranged between 40 and 70 years were selected. All patients were examined pre- and postoperatively after 1 week and 3 months for evaluation of astigmatism. Keratometry was done by using an autorefractometer and an autokeratometer. Astigmatism was calculated from keratometric data using vector analysis. The mean age of the study participants was 52±9.1 years. Male predominance was observed as male-female ratio was 1.7:1. The change in astigmatism in between pre- and post-operative were 0.44±0.20 in temporal incision group and 0.19±0.00 in superior incision group; both were statistically significant (P<0.001). The difference in mean astigmatism between the groups was 0.375 (P<0.001). Postoperative astigmatism <0.5D was observed in 16(40%) patients when incision was given at temporal site and in 8(20%) patients when incision was given at superior site. Astigmatism was significantly (P<0.05) decreased more when incision given at temporal site in comparison to superior site. Our data suggest that preexisting astigmatism was significantly decreased postoperatively in majority of patients when incision was placed on steep meridian and temporal incision has less surgically induced astigmatism than superior incision. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 27-32 \u0000 ","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78969879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64304
Mohammad Jahid Iqbal, Mohammad Mahabuzzaman, G. Hossain, Mohammod Humayan Kabir, Md Ali Haider, Lipon Kanti Bhowmick
A randomized control trial was done between January and December of 2018, in the Department of Anaesthesia, Analgesia, Palliative & Intensive Care Medicine of Dhaka Medical College Hospital, Bangladesh, to evaluate the preventive effect of pregabalin on succinylcholine induced adverse effects, i.e., fasciculation, myalgia and hyperkaliemia in spine surgery. Sixty patients of elective spine surgery under general anaesthesia were selected and divided into two groups. Pregabalin 150 mg was given to one group and matching placebo was given to another group orally with sips of water one hour before surgery. Succinylcholine 1.5 mg/kg was given after induction agent. Muscle fasciculation was observed just after succinylcholine administration. Serum potassium was measured 5 minutes before induction and 5 minutes after succinylcholine administration. After completion of surgery reversal was given. Time of first analgesic demand was recorded. Injection Morphine 0.15 mg/kg intramuscular was given when patient complained about pain. Myalgia (muscle pain not associated with surgery) was observed 24 hours after anaesthesia and total morphine consumption was recorded. Use of pregabalin 150 mg one hour before surgery reduced the severity of fasciculation and the incidence and severity of postoperative myalgia. It also reduced the rise of serum potassium concentration after succinylcholine administration though the rise was within normal limit. Pregabalin also reduced the total opioid consumption after surgery. CBMJ 2023 January: Vol. 12 No. 01 P: 73-80
{"title":"Effect of Pregabalin on Succinylcholine Induced Fasciculation, Myalgia and Hyperkalemia in Spine Surgery","authors":"Mohammad Jahid Iqbal, Mohammad Mahabuzzaman, G. Hossain, Mohammod Humayan Kabir, Md Ali Haider, Lipon Kanti Bhowmick","doi":"10.3329/cbmj.v12i1.64304","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64304","url":null,"abstract":"A randomized control trial was done between January and December of 2018, in the Department of Anaesthesia, Analgesia, Palliative & Intensive Care Medicine of Dhaka Medical College Hospital, Bangladesh, to evaluate the preventive effect of pregabalin on succinylcholine induced adverse effects, i.e., fasciculation, myalgia and hyperkaliemia in spine surgery. Sixty patients of elective spine surgery under general anaesthesia were selected and divided into two groups. Pregabalin 150 mg was given to one group and matching placebo was given to another group orally with sips of water one hour before surgery. Succinylcholine 1.5 mg/kg was given after induction agent. Muscle fasciculation was observed just after succinylcholine administration. Serum potassium was measured 5 minutes before induction and 5 minutes after succinylcholine administration. After completion of surgery reversal was given. Time of first analgesic demand was recorded. Injection Morphine 0.15 mg/kg intramuscular was given when patient complained about pain. Myalgia (muscle pain not associated with surgery) was observed 24 hours after anaesthesia and total morphine consumption was recorded. Use of pregabalin 150 mg one hour before surgery reduced the severity of fasciculation and the incidence and severity of postoperative myalgia. It also reduced the rise of serum potassium concentration after succinylcholine administration though the rise was within normal limit. Pregabalin also reduced the total opioid consumption after surgery. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 73-80","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90205067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64395
N. Islam, Md. Shahidul Islam, A. Sharmeen, Susthir Sarker
Erythema induratum of Bazin (EIB) is a chronic nodular eruption that frequently occurs on lower legs of young or middle-aged women. The clinical manifestations of EIB revealed various dermatological disorders that can be easily leads to misdiagnosis. We report a case of a 50-year-old woman who initially presented with EIB. The histopathological specimen was collected from her medial aspect of let leg. The epidermis is unremarkable. The dermis shows fibro fatty tissue, skin adnexae and foci of granuloma with Langhans type of giant cells and some lymphocytic infiltration in the deep dermis which was suggestive of erythema induratum. Her lesions responded to antitubercular therapy (ATT). This case study may help extend the therapeutic regimens for cutaneous tuberculosis. CBMJ 2023 January: Vol. 12 No. 01 P: 121-123
{"title":"Erythema Induratum of Bazin: A Rare Finding in an Old Woman with Subcutaneous Nodules in the Lower Limbs","authors":"N. Islam, Md. Shahidul Islam, A. Sharmeen, Susthir Sarker","doi":"10.3329/cbmj.v12i1.64395","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64395","url":null,"abstract":"Erythema induratum of Bazin (EIB) is a chronic nodular eruption that frequently occurs on lower legs of young or middle-aged women. The clinical manifestations of EIB revealed various dermatological disorders that can be easily leads to misdiagnosis. We report a case of a 50-year-old woman who initially presented with EIB. The histopathological specimen was collected from her medial aspect of let leg. The epidermis is unremarkable. The dermis shows fibro fatty tissue, skin adnexae and foci of granuloma with Langhans type of giant cells and some lymphocytic infiltration in the deep dermis which was suggestive of erythema induratum. Her lesions responded to antitubercular therapy (ATT). This case study may help extend the therapeutic regimens for cutaneous tuberculosis. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 121-123","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76735604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-19DOI: 10.3329/cbmj.v12i1.64288
Md. Rashedur Rahman, Md. Harun Ar Rashid, Farzana Anar, Sultana Razia Khanam, Md Mukhlachur Rahman, Khaled Mohammad Islam
A cross-sectional, observational study was conducted in the Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital, Dhaka, Bangladesh, from 2014 to 2015, to assess the site-specific clinical behaviour of the lesion in patients with odontogenic keratocyst in the jawbone. The study was conducted on 25 patients who were clinically diagnosed with Odontogenic keratocyst of the jaw. Samples were selected by convenient sampling technique. Data were collected through pretested semi-structured questionnaire & analyzed by using the statistical packages of social science (SPSS) version 25.0. The mean age of the total 25 patients was 23.56± SD years and ranges from 10 to 50 years. The highest proportions of patients (44%) were from less than 20 years of age and a few (8%) of them were from more than 41 years. The study showed that 80% were male and 20% were female. In most of the cases (64%), the tooth was present in the series. Among the patients, the majority (84%) had an absence of syndrome, history of absence of tooth displacement was found 66% and absence of root resorption was 80%. Most of the keratocyts (36%) were in body and angle of the mandible, second most (24%) site was in the body of the Mandible. The knowledge about the clinical presentation of odontogenic keratocyst is needed for accurate diagnosis and prognostic assessment. CBMJ 2023 January: Vol. 12 No. 01 P: 48-52
{"title":"Site-Specific Clinical Behavior of the Lesions in Patients with Odontogenic Keratocyst in the Jawbone","authors":"Md. Rashedur Rahman, Md. Harun Ar Rashid, Farzana Anar, Sultana Razia Khanam, Md Mukhlachur Rahman, Khaled Mohammad Islam","doi":"10.3329/cbmj.v12i1.64288","DOIUrl":"https://doi.org/10.3329/cbmj.v12i1.64288","url":null,"abstract":"A cross-sectional, observational study was conducted in the Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital, Dhaka, Bangladesh, from 2014 to 2015, to assess the site-specific clinical behaviour of the lesion in patients with odontogenic keratocyst in the jawbone. The study was conducted on 25 patients who were clinically diagnosed with Odontogenic keratocyst of the jaw. Samples were selected by convenient sampling technique. Data were collected through pretested semi-structured questionnaire & analyzed by using the statistical packages of social science (SPSS) version 25.0. The mean age of the total 25 patients was 23.56± SD years and ranges from 10 to 50 years. The highest proportions of patients (44%) were from less than 20 years of age and a few (8%) of them were from more than 41 years. The study showed that 80% were male and 20% were female. In most of the cases (64%), the tooth was present in the series. Among the patients, the majority (84%) had an absence of syndrome, history of absence of tooth displacement was found 66% and absence of root resorption was 80%. Most of the keratocyts (36%) were in body and angle of the mandible, second most (24%) site was in the body of the Mandible. The knowledge about the clinical presentation of odontogenic keratocyst is needed for accurate diagnosis and prognostic assessment. \u0000CBMJ 2023 January: Vol. 12 No. 01 P: 48-52","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79086639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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