Community Based Medical Journal最新文献

{"title":"Effectiveness of Erector Spinae Plane Block for Postoperative Analgesia in Modified Radical Mastectomy","authors":"M. Kabir, Mohammad Mahabubuzzaman, Lipon Kanti Bhowmick, M. Islam, Md Ruhul Amin, M. A. Rahim","doi":"10.3329/cbmj.v11i2.61224","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61224","url":null,"abstract":"Postoperative pain control in breast cancer surgery has become one of the most important goals for anesthesiologists. Several techniques have been trialed for providing postoperative analgesia after breast surgery. This randomized control study was designed to evaluate the postoperative analgesic effect of ultrasound-guided erector spinae plane (US-guided ESP) block for modified radical mastectomy surgery. To evaluate the postoperative analgesic effect of pectoral nerves block and erector spinae plane block for modified radical mastectomy surgery. This prospective, randomized, controlled trial was conducted at the Department of Anaesthesia, Analgesia, Palliative & Intensive Care Medicine in Dhaka Medical College and Hospital. A total 46 patients who were to undergo modified radical mastectomy, fulfilling selection criteria were included in the study following confirmation of the informed written consent and randomly divided into two groups- where each group include 23 Patients. Group A received ultrasound guided ESP and group B received ultrasound guided PECS block. All patients of both groups received GA after confirmation of block. All relevant information including demographic criteria, medical history, clinical evaluation during and after performance of block were collected. All patients were observed peri-operatively and data were recorded into the preformed questionnaires form. Finally, data was analyzed by SPSS version 22.0. Mean age of study population was 52.07±7.08 years with majority in age group 50-59 years. No significant difference was noted between patient’s characteristics, duration of surgery and heart rate and mean arterial pressure of patient during and after operation between two groups (p>0.05). The mean VAS score was significantly low in ESP block as compared to the PECS block at all-time interval (p<0.05) except at 12 hours. Patients with ESP block had significantly late demand of 1st analgesic (12.13±2.45 hours vs 8.89±3.35 hours) (p<0.05) and significantly less total opioid consumption (5.17±0.57 mg vs 10.18±1.82 mg) (p<0.05) compared to patients with PECS block. Post-operative complication was noted significantly higher among patients with PECS block compared to ESP block. These findings from our study depict ESP block performed in patients scheduled for MRM (modified radical mastectomy) results in better pain control and less postoperative opioid consumption in the first 24 hours than PECS block. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 86-95","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86771117","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}

{"title":"Visual Outcome after Cataract Surgery in Phacolytic Glaucoma","authors":"Mohammad A. Islam, M. Rasul, S. Haque, Faisal Chowdhury, Afroza E Alam, Mohammad Farid Hossain, M. Hasan, Polash Kanti Mistry","doi":"10.3329/cbmj.v11i2.61229","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61229","url":null,"abstract":"A prospective study was conducted between March 2021 and February 2022 in the National Institute of Ophthalmology & Hospital, Dhaka, Bangladesh involving 30 patients who underwent cataract surgery for phacolytic glaucoma. The aim of this study was to see the postoperative visual outcome of cataract surgery in patients with phacolytic glaucoma. Visual acuity and development of any postoperative complications were recorded. The mean age of the patients was 60.7 years. Female to male ratio was 1.3:1. Most of the patients (67%) presented after 1 week of symptoms. On the first visit, mean preoperative intraocular pressure (IOP) was 37.5 mm of Hg. Following surgery, 93.33% had an intraocular pressure less than 21 mm Hg at discharge. Visual acuity (VA) as perception of light (PL) was found doubtful in 2 (6.67%), while PL was positive in 17 (56.66%) and HM <3/60 was in 11 (36.66%) preoperatively. At discharge, 73.33% achieved VA 6/24 or better, 5 (16.67%) had less than 6/24 and 3 (10%) less than 3/60. Cataract surgery is effective to restore visual acuity and lowering the intraocular pressure (IOP) in patients with phacolytic glaucoma. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 120-124","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80088877","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}

{"title":"Novel Agents to Treat Renal Anemic Patient","authors":"Mahmud Hasan","doi":"10.3329/cbmj.v11i2.61222","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61222","url":null,"abstract":"Abstract not available \u0000CBMJ 2022 July: vol. 11 no. 02 P: 77-79","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73518669","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}

{"title":"Potential Attenuating Effect of Single Bolus Dose of Esmolol on Cardiovascular Stress Response in Elective Neurosurgical Cases","authors":"Md Zahedul Islam, Suraya Akter, S. Kamal","doi":"10.3329/cbmj.v11i2.61225","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61225","url":null,"abstract":"A prospective, double blind and randomized study was conducted in the Department of Anesthesiology of Dhaka Medical College Hospital, Dhaka, Bangladesh, between January 2013 and January 2014, to assess the efficacy of single bolus dose of esmolol (1.5mg/kg) to attenuate the cardiovascular stress response in elective neurosurgical cases. A total of 100 elective neurosurgical patients were enrolled in this study. Patients were randomly allocated equally into two groups: group A and group B, having 50 patients in each group. Patients of group A received intravenous esmolol (1.5mg/kg), 3 minutes before induction, while patients of group B received intravenous 10 ml of normal saline 3 minutes before induction. Parameters like heart rate, systolic and diastolic blood pressure were recorded before induction and every alternative minute for 10 minutes after endotracheal intubation. There were no differences in baseline demography of the patients (P>0.05). However, our data showed that in group A, there were significant reductions in heart rates immediately after induction, 1 minute, 3 minutes and 5 minutes after endotracheal intubation (P<0.01), as well as significant reductions in systolic and diastolic blood pressure after 1 minute, 3 minutes and 5 minutes of endotracheal intubation (P<0.01) respectively, in comparison to group B. Besides, reductions in rate pressure product were observed immediately after induction and 1 minute, 3 minutes and 5 minutes after endotracheal intubation respectively in group A, as compared to group B (P<0.01). In summary, a single bolus dose of esmolol (1.5mg/kg) effectively attenuates the cardiovascular stress response during and after laryngoscopy and endotracheal intubation in elective neurosurgical cases. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 96-101","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85486734","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}

{"title":"Left Ventricular Noncompaction Cardiomyopathy (LVNC): A Case Report","authors":"T. Ahmed, Amdadul Haque, Parvez Khan","doi":"10.3329/cbmj.v11i2.61289","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61289","url":null,"abstract":"Left ventricular noncompaction is a rare congenital cardiomyopathy. It can occur in isolation or coexist with other cardiac anomalies. Clinical presentation varies from patients to patients. LVNC is commonly diagnosed by echocardiography. We descried the case of a man with heart failure for the first time at 55 years of age. Transthoracic echocardiography shows trabeculation and intertrabecular recesses communicate with the ventricle cavity. The patient was relatively well after medical management. This case is reported for clinical awareness and share experience. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 162-166","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"199 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78137863","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}

{"title":"Knowledge and Practice of Personal Hygiene Among the High School Students in A Rural Area of Mymensingh, Bangladesh","authors":"M. Begum, Fakir Sameul Alam, Md Tufael Hossain, A. Hasan","doi":"10.3329/cbmj.v11i2.61283","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61283","url":null,"abstract":"This cross-sectional descriptive study was conducted during November 2019 to assess knowledge and practice of personal hygiene among the high school students in a rural area of Mymensingh. Proper knowledge and practice of personal hygiene plays critical role in avoiding communicable diseases and benefit the high school students to enjoy healthy life with excellent academic career. Respondents were 244 high school students of different schools in Churkhai, Bhavokhali, Mymensingh who were selected purposively. Age ranged from 10 years to 17 years, mean age 13.32 years with SD ± 1.505 years; boys predominant (boy: girl ratio 146.5: 100). Data were collected on a predesigned questionnaire by direct interviewing the students. Knowledge and practice of personal hygiene were measured using scoring based on correct answers. Data analysis was done by SPSS version 20.0. Most of them (217) 88.93% were apparently healthy. Based on presenting symptoms and signs the diagnosed illnesses were ARI (7) 2.87%, diarrhea (5) 2.05%, head lice (5) 2.05%, scabies (4) 1.64%, injury (3) 1.23%, dental caries (2) 0.82% and peptic ulcer disease (1) 0.41%. Important personal hygiene practices inquired were frequency of regular bathing with use of soap or shampoo, combing hair, brushing teeth, hand washing, trimming nails, wearing shoes, clean clothes, avoidance of smoking and appropriate allocation of time for study, outdoor, indoor activities, rest and sleep. Based on aggregate items 80.74% had excellent knowledge and practice on personal hygiene and 19.26% had good knowledge and practice. Knowledge and practice were concordant in all elements inquired except smoking. Knowledge about harm of smoking was 100.00% though avoidance of smoking was 97.95%. Knowledge and practice scores were influenced by educational grade (class VIII at peak), literate parents, better socioeconomic condition and absence of illness. The results are better than the findings of studies conducted in our country and neighboring countries. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 136-143","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"360 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76438016","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}

{"title":"Pattern of Clinicopathological Features of Head and Neck Cancer Patients in a Tertiary Level Specialized Hospital in Dhaka, Bangladesh","authors":"Md Rakibul Islam Masud, M. Khan, Md Jahin Tareq Bhuiyan, Badrun Nahar Tuly, Mohammad Saiful Islam Pathan","doi":"10.3329/cbmj.v11i2.61227","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61227","url":null,"abstract":"A cross-sectional, descriptive study was conducted to see the pattern of clinicopathological features of head and neck cancer patients in a tertiary level hospital. The study was conducted between January and April of 2017 in National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh. Data was collected from a total number of 69 histopathologically and clinically confirmed patients. A male predominance (2.14:1) was noted except for oral cavity cancer (1:1). Mean age for males and females were (56.15±11.47) years and (54.50±7.16) years respectively. Positive history of associated factors like smoking (60.34%), betel nut and betel leaf (81.36%), smokeless tobacco (56.90%) was prevalent among majority of the participants except for alcohol (6.90%). Smoking was prevalent only among males. Knowledge regarding the role of associated factors was very poor, e.g., smoking (10.61%), betel nut & leaf (7.58%), smokeless tobacco (6.06%), alcohol (7.58%) for causing cancer. 10.71% patients gave positive family history of cancer (1st degree relative). 27.59% patients gave history of treatment by homeopathy/traditional healers. The most common sites of cancer in males were larynx (27.3%) followed by oral cavity (20.5%). In case of female patients, most common sites were oral cavity (40.9%) followed by larynx (22.7%). Most common histopathological type was squamous cell carcinoma (91.94%). Lymph node metastasis were present in 47.62% patients, whereas only 1.56% patients had distant metastasis and 3.13% had recurrent/residual disease. 18.64% patients gave history of definitive surgery. To conclude, most of the patients usually reported with advanced stages of cancer; however, preventable factors were found among all of them. Unfortunately, they had very poor knowledge about those preventable factors which warrants an immediate and elaborate public health program to fill up this vast gap of knowledge. Prevention and early diagnosis should be main arsenal to combat head and neck cancer. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 108-113","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79144562","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}

{"title":"Common Health Problems Among Agricultural Workers in A Selected Rural Area of Mymensingh, Bangladesh","authors":"A. Hasan, Md Tufael Hossain, M. Begum, M. Islam, Fakir Sameul Alam","doi":"10.3329/cbmj.v11i2.61230","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61230","url":null,"abstract":"This cross-sectional descriptive study was conducted in Churkhai village of Bhavokhali union during December 2018 to find out common health problems among 200 agricultural workers in a selected rural area of Mymensingh as a part of Residential Field Site Training by 3rd year MBBS students session 2016-17. 63 percent of population lives in rural area. Agricultural workers have illnesses common to general population. Moreover socioeconomic and work condition poses extra burden. The study was carried out on 200 agricultural workers who were selected purposively. Data were collected on a predesigned questionnaire by face to face interviewing agricultural workers. Data analysis was done by SPSS version 20.0. Age distribution of respondents ranged from 19 years to 80 years; mean age 46.53 years and standard deviation 14.891 years. Males were predominant (male: female ratio 506.06: 100. Majority of them (57.50%) were literate. Most of them (65.00%) belonged to middle class family. More than half (55.00%) of agricultural workers were suffering from illness. Respiratory illnesses 16.00% were predominant followed by skin disease 10.50%, gastrointestinal disease 6.50%, conjunctivitis 6.00%, arthritis 6.00%, hypertension 6.00%, diabetes mellitus 5.00%, anemia 4.50% and hearing loss 0.50%. In summer heat exhaustion (14.50%) was predominant followed by heat syncope (10.00%. In rainy season ARI (12.00%) was predominant followed by diarrheal diseases (10.50%). In winter mild hypothermia (27.00%) was predominant followed by ARI (4.50%). In recall of last 1 year the important events were crop loss 12.50%, damage to house 10.00%, and unemployment 2.50%. There was no case of anthrax and bird flu. Prevalence of occupational accidents was 5.00%. which includes fall from height 0.50%, heavy object fallen on body 1%, domestic fire 1%, electrocution in house 1%, electrocution by power pump 0.50%, cattle hitting by horn 0.50% and accidental insecticide poisoning 0.5%. Most of the injury occurred in the current week. Majority of the workers (66.50%) had partial tetanus toxoid immunization. Morbidity in this study was better than several studies conducted in Bangladesh and India. By knowing health problems we can give health care to agricultural workers which will prevent diseases and illnesses of them, prolong their healthy life, promote their health and efficiency. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 125-130","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79187574","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}

{"title":"Teaching and Learning Medical Ethics: How to Bring Positive Change","authors":"A. S. M. Nurunnabi, Mahmud Hasan, Asm Ruhul Quddus, M. T. I. Khan, M. T. Sultan, S. Sharmin, M. Rahman, Kaminee Kumar Tripura, Sadia Nusrat Alamgir","doi":"10.3329/cbmj.v11i2.61290","DOIUrl":"https://doi.org/10.3329/cbmj.v11i2.61290","url":null,"abstract":"Decision making in healthcare does not depend only on mastery of knowledge, clinical skills, and technical competencies, rather it is largely influenced by ethical competences of the physicians. Teaching medical ethics in undergraduate medical education (MBBS programme in Bangladesh) helps medical students recognize the importance of being sensitive to ethical issues within everyday clinical practice and develop in them the ability to effectively address the concerns of patients and families, as well as participants in health research and larger society. In medical practice, its ethical component is treated as an obligatory one, no matter what the specialty is. The importance of ethics in medicine is increasing greatly day by day; its dimensions are also changing. In this review paper, we have tried to discuss some effective changes in medical ethics curriculum, methods of teaching and learning, faculty development, and institutional culture. All stakeholders should think about it and take necessary actions into that direction, which will ultimately lead to building a more ethical, more patient-centred, more professional medical community in the country. \u0000CBMJ 2022 July: vol. 11 no. 02 P: 167-175","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87120429","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}

{"title":"Malnutrition in Elderly Population: Screening Tools and Management","authors":"S. Tanira, M. Tanzil, Sadia Nusrat Alamgir, R. Amin, Md. Abdul Muqueet, S. F. Sazib","doi":"10.3329/cbmj.v11i1.60324","DOIUrl":"https://doi.org/10.3329/cbmj.v11i1.60324","url":null,"abstract":"Malnutrition is a common, potentially serious, and frequently under-diagnosed condition among elderly people. Age-related physiologic changes in combination with organic and psychological disease processes contribute to the development of malnutrition in older adults. Profound malnutrition and serious illnesses often present concurrently, and each can accelerate the progression of the other. Early detection and careful interventions are very important to prevent further deterioration. However, Prompt diagnosis relies on physicians‟ clinical suspicion and available screening tools. We consider that systematic screening and early treatment of malnutrition are integral parts of global geriatric care. Hence, this paper aims to review the prevalence and aetiology of malnutrition among ageing population with a special focus on some of the commonly used screening tools in clinical practice. Some of the non-pharmacologic and pharmacologic interventions are also highlighted that are used to manage malnutrition in elderly patients. \u0000CBMJ 2022 January: vol. 11 no. 01 P: 61-68","PeriodicalId":10576,"journal":{"name":"Community Based Medical Journal","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90706970","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}