Mymensingh medical journal : MMJ最新文献

Adequate knowledge about the causes of chronic kidney disease and their potential prevention can improve poor clinical outcome in chronic kidney disease (CKD) patients. The study was designed to evaluate the serum albumin and C-reactive protein (CRP) levels in hospitalized patients with Chronic Kidney Disease. This cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, Bangladesh with the collaboration of the Department of Nephrology, Mymensingh Medical College Hospital, Mymensingh, from January 2021 to December 2021. The subjects were selected on the basis of inclusion and exclusion criteria by purposive and convenient sampling method. A total of 110 subjects were included in this study. Among them, 55 were diagnosed CKD patients denoted as Group I and 55 were normal healthy individuals denoted as Group II. In this study, serum albumin and CRP levels were measured. All values were expressed as Mean±SD. All statistical analysis was done by using SPSS (statistical package for social science) windows package version 21.0. Statistical significance of difference between Group I and Group II were evaluated by using student's unpaired 't'-test and the significance was defined as p<0.05. Correlation was done by using Pearson's correlation coefficient test. Mean age of Group I was 52.65±4.93 and Group II was 51.15±6.32 (p=0.165). The mean±SD of BMI was 24.46±1.84 for Group I and 24.50±1.05 for Group II (p=0.886). The mean±SD values of serum albumin were 3.62±0.26g/dl and 4.16±0.69g/dl in Group I and Group II respectively. We found highly significant (p<0.001) decrease in serum albumin. The mean±SD values of CRP were 24.00±16.73mg/L and <6.0±0.00mg/L in Group I and Group II respectively. So, we found significant (p<0.05) increase in CRP levels. There was negative correlation between serum albumin and CRP. Analyzing the findings of this study, significant decrease in serum albumin and significant increase in CRP levels were observed in CKD patients.

The present invitro type of study has done to check the effect of blood contamination & chlorhexidine combination on the bond strength of brackets bonded with self-etch primer technique. The study consisted of ninety sound human upper premolars (extracted for orthodontic purpose) fixed in a self-cure acrylic block and segregated into three groups of 30 samples each. 0.022 slot metal MBT brackets (Gemini series-3M unitek) were bonded with self-etch primer using Transbond XT composite, CA, USA and light cure for 40 seconds) on clean buccal surface. Teeth were divided into 3 groups-Group A/Control group, Group B, Group C. A computer was used to record the force applied to debond the bonded bracket in the unit of Newton. The analysis of variance indicated that there were significant differences (F value = 6.891, p value=0.002) in bond strengths between the various groups tested. The highest value of shear bond strength occurred when chlorhexidine (Group C) was used to remove the blood contamination (mean=15.874 MPa). When bonding was done in ideal condition (Group A), shear bond strength obtained was slightly lower (mean=14.497 MPa) as compared to Group C. On the other hand, lowest shear bond strength among all three groups occurred when blood contamination (Group B) was removed with water (mean=11.059 MPa). Analysis of the study showed that shear bond strength of orthodontic brackets to enamel significantly decreased during bonding with self-etch primer in blood contamination condition. Self-etch primer displayed considerably superior performance with the use of chlorhexidine instead of water to wash the blood contamination.

Porphyria cutanea tarda is a rare disorder of heme metabolism due to deficiency of the enzyme uroporphyrinogen decarboxylase which is manifested as some typical dermatological features and hepatic dysfunction. The Hepatitis-C virus co-infection is common and it can be aggravated by other environmental factors. We report a case of porphyria cutanea tarda in a 37-year-old woman, who presented with recurrent skin blisters and has concomitant Hepatitis-C virus infection. She was taking oestrogen containing oral contraceptive pill for a long duration. The diagnosis of porphyria cutanea tarda was considered on the basis of clinical features and high level of urine porphyrin level. She was put on hydroxychloroquine and combination drugs for Hepatitis-C virus with significant improvement after 3 months of therapy.

Congenital coronary ostial stenosis or atresia (COSA) is a spectrum of rare developmental conditions with different pathophysiologic mechanisms and clinical implications. Although COSA includes various entities, these entities have two features in common. First the defect is congenital, although it may progress during pre-natal and post natal life. Second the developmental defect may cause ostial or proximal coronary obstruction (that is stenosis or atresia). Coronary ostial stenosis or atresia affects the left coronary (L-COSA) more frequently than it does the right coronary artery. Systemic Lupus Erythematosus (SLE) is not an uncommon disease in young female, but combination of congenital coronary ostial stenosis with systemic lupus erythematosus make the case very rarer. Here we presented A 17 years old girl got admitted to Bangabandhu Sheikh Mujib Medical University, Bangladesh for evaluation of on and off chest pain of CCS-III to CCS-IV for 1 day on 17 September 2019.

The BMI and fasting serum glucose was estimated in chronic kidney diseased patient to observe low body mass and the frequency of high in fasting serum glucose level in chronic kidney diseased patient (CKD). BMI fluctuations may indicate other serious comorbid conditions. Wasting is prevalent among patients with chronic kidney disease. It is to be distinguished from chronic inflammation and malnutrition, which is defined as the consequence of insufficient food intake. Diabetes is the most common cause of kidney disease. The chronic hyperglycemia of diabetes mellitus is associated with long-term damage, dysfunction and failure of kidneys, blood vessels, nerves, heart. This cross sectional study was carried out in the department of Physiology of Mymensingh Medical College, Mymensingh from July 2014 to June 2015. In this study total 200 subjects were selected with age ranged from 25 to 60 years and divided into 100 healthy persons as control group and 100 CKD patients as study group. Both control and study group were further divided into 50 male and 50 female. Unpaired student's t test was used for Statistical data analysis. The mean±SE BMI of control group male and study group male were 25.04±0.13 and 23.87±0.41 kg/m² respectively. In study group male, mean±SE BMI was decreased. Result was statistically significant (p<0.05). The mean±SE BMI of control group female and study group female were 24.13±0.43 and 22.90±0.27 kg/m² respectively. In study group female, mean±SE BMI was decreased and result was significant (p<0.05). BMI was decreased in study group than in control group. The results were statistically significant. Fasting serum glucose was evaluated by the Enzymatic, colorimetric, GOD-PAP method. The results showed that the mean±SE fasting serum glucose of control group male & study group male were 5.31±0.17mmol/L and 7.56±0.37mmol/L respectively. In study group male, mean±SE FSG was increased. Result was statistically highly significant (p<0.0001). The mean±SE FSG of control group female & study group female were 5.11±0.11mmol/L and 7.37±0.33mmol/L respectively. In study group female, mean±SE FSG was increased & result was highly significant (p<0.0001). According to the above result, FSG was increased in study group than in control group. The results were statistically significant. Fasting serum glucose levels increased significantly in chronic kidney disease patients than the normal healthy persons. The increasing frequency of blood glucose level in CKD may predispose the patients to diabetes and increasing the other complications.

CHADS₂ and CHA₂DS₂-VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA₂DS₂-VASC-HSF score promote atherosclerosis and associated with severity of CAD. Objective of the study was to find out the association of the CHA₂DS₂-VASC-HSF score with the severity of CAD in patients with ST elevation myocardial infarction (STEMI). One hundred (100) patients with STEMI were enrolled in this study after considering inclusion and exclusion criteria over a one year period from October, 2017 to September, 2018 in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. Coronary angiogram was done within index hospitalization and coronary artery disease severity was assessed by SYNTAX score system. Patients were divided into two groups on the basis of SYNTAX score. Patients with SYNTAX score ≥23 assigned as Group I and SYNTAX score <23 assigned as Group II. The CHA₂DS₂-VASC-HSF score was calculated. Cut-off value of high CHA₂DS₂-VASC-HSF score was ≥4.0. In this study mean age of study population was 51.8±9.8, male patients were predominant (79.0%). Among the studied patients, highest percentage had history of smoking followed by hypertension, diabetes mellitus and family history of CAD in Group I patients. It was found that DM and family history of CAD and history of stroke/TIA were significantly higher in Group I than Group II. An increasing trend of SYNTAX score was observed according to the CHA₂DS₂-VASc-HSF score. SYNTAX score was significantly higher in CHA2DS2-VASc-HSF score ≥4 than CHA₂DS₂-VASc-HSF score <4 (26.3±6.3 vs. 12.1±7.7, p<0.001). Patients with CHA₂DS₂-VASC-HSF score ≥4 had severe coronary artery disease than CHA₂DS₂-VASC-HSF score <4 assessed by SYNTAX score with 84.4% sensitivity and 81.9% specificity (AUC:0.83, 95% CI: 0.746-0.915, p<0.001). CHA₂DS₂-VASc-HSF score was positively correlated with the severity of CAD. This score could be considered as a predictor of coronary artery disease severity.

Skin is the largest organ and outer covering of human body. It plays a great role in our visible appearance. Humans are more conscious about skin disease because it has a cosmetic priority. The cases that fulfil the selection criteria will be enrolled as study samples with a view to see correlation with glycosylated Hb, vascular changes and duration of DM. This cross-sectional study was performed in the Department of Skin and VD and the Department of Pathology of BIRDEM, Dhaka, Bangladesh from March 2017 to February 2019. Study population was all diabetic patients with skin diseases attending dermatology department of BIRDEM hospital. Among them 90 patients were selected who will do skin biopsy with diabetes mellitus. Skin biopsy tissue and blood sample were taken as materials to determine the type of skin lesion in patients with satisfactory and unsatisfactory glycaemic control; the relationship of diabetic skin lesions with duration of diabetes; and assessing the cutaneous or dermal capillary vascular changes was in Diabetes Mellitus and its correlation with HbA1c level and duration of Diabetes Mellitus. Among 90 cases age ranged from 31 to 85 years with mean age of the patients 55.06 ± 12.10 years. Maximum patients were in age group 41-50 years (32.2%). Skin disorders in Diabetes mellitus are more common in female in this study. Almost three fourth of the patients glycemic status was unsatisfactory. Satisfactory glycemic patients were 17 cases (18.9%) and unsatisfactory glycemic patients were 73 cases (81.1%). Mean HbA1c shows unsatisfactory glycemic status among 90 cases in this study. Mean HbA1c is more unsatisfactory in female patients in this study. Most common group of lesion was 37.7 % belong to miscellaneous group followed by skin diseases with strong to weak association with DM. There were no significant differences in different types of skin lesions between satisfactory and unsatisfactory blood glucose patients. Majority of the cases (37.8%) occurred after 10 years of diagnosis of DM. Mean duration of DM was highest among the patients with skin reaction to diabetic treatment (10.04±6.19). There is marked variation in thickness of dermal capillary basement membrane with duration of diabetes. There was a significant inverse correlation between perivascular infiltration and capillary basement membrane thickness.

Colorectal carcinoma is the most common cancer of the gastrointestinal tract. More than 95.0% of the cancer is adenocarcinoma. Mucinous adenocarcinomas account for about 10.0% of all colorectal cancers. The expression of mucin themselves may play a role in the ability of tumors cells to escape the effect of systemic therapy and the process of tumor progression, invasion, survival and protection against the host immune response. The mucin lakes may also be a physiological barrier for the delivery of targeted therapy to the tumors cells. The aim of this study was to evaluate and compare the morphologic and histologic prognostic factors of mucinous and non-mucinous adenocarcinoma of the colon and rectum. In this descriptive cross-sectional type of observational study a total of 98 samples with colorectal adenocarcinoma were evaluated on the basis of presence or absence of the mucin from 2017 and 2018. The study was conducted in paraffin-embedded tumor tissue whose slides were stained using the hematoxylin-eosin technique. Mucin was evaluated by Periodic acid schiff and Diastase periodic acid schiff stain. Totally, 27 of 98 patients with colorectal adenocarcinoma (27.6%) had mucinous histologic subtype. Statistical significant results found in this research are as follows: Mucinous subtype tended to have present with moderate anaemia, history of low vegetable diet and larger tumor size, proximal colon involvement, infiltrative morphology and higher stage II compared to non-mucinous histologic subtype. Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer.

The goal of this study was to analyze the efficacy of the Ommaya reservoir within all the different types of hydrocephalus in pediatric patients. At the same time, it's safe for repeated aspirations or long-term retention of the reservoir in the body. This retrospective, cross-sectional study was performed from January 2019 to December 2021, 33 consecutive cases of reservoir implantation were taken into the study irrespective of the etiology of hydrocephalus in the Neurosurgery Department of Bangladesh Medical College Hospital, Dhaka, Bangladesh. These were mostly placed along with endoscopic third ventriculostomy and some were placed as an intermediary procedure to combat shunt complications in emaciated infants. Cerebrospinal fluid (CSF) aspiration was done in case of failed endoscopic third ventriculostomy and the frequency of aspiration depended upon the production of cerebrospinal fluid. Acetazolamide was routinely administered in each patient to reduce the frequency of aspiration. Most of the patients required ventriculo-peritoneal (VP) shunt while they had sufficient body weight and few required no surgery. The average age at presentation was 76.88 days. All the neonates and infants had less weight in terms of their age. 42.4% of babies needed aspiration 2 times per week. Among all cases, 9.1% developed reservoir complications. Complications were not related to the number and volume of aspiration or duration of the reservoir in the body. Two (2) patients died after one year of reservoir implantation due to unknown etiology. Out of the 31 survivors, 3 patients did not need any further aspiration and 19 patients needed a ventriculo-peritoneal shunt, but the reservoir was kept in situ for a future emergency. The rest of them is waiting for a definitive shunt procedure. Other findings include low socioeconomic group was more prone to low birth weight and they carried the burden of congenital hydrocephalus and meningomyelocele. Most affected babies had their prenatal period in arsenic-affected areas in Bangladesh. Overall folic acid supplementation was started after the formation of the neural tube irrespective of socioeconomic status. Ommaya reservoir placement along with endoscopic third ventriculostomy plays a vital role in delaying shunt in endoscopic third ventriculostomy failure. It is a 'time buying' procedure until the baby has sufficient weight for successful shunt surgery. It has been found very effective intermediary intervention for managing shunt infection and it also helps revive a channel in shunt obstruction.

The novel corona virus causing severe acute respiratory symptoms appeared in China at the end of year 2019 and soon spread globally resulting in Pandemic. The susceptibility to novel corona virus infection and severity of symptoms in an individual is an outcome of immune system of the host. The Human leucocyte Antigen (HLA) of an individual is responsible for regulation of immune system. Thus, genetic variability of the HLA can affect the individual's response to Novel corona virus infection in terms of susceptibility and severity. The memory B cells which persist in the body after initial infection protect by faster response to repeat infection by the virus. However viral mutations prevent recognition by memory B cells and therefore repeat infection by virus leads to slow immune response as immunity to the mutated virus is not present.