Coronary arteay disease (CAD) is an important cause of morbidity and mortality in developed as well as developing countries like Bangladesh. In this study, the status of serum apolipoprotein A-I (Apo A-1) and apolipoprotein B (Apo B) levels were assessed in Bangladeshi patients with coronary artery diseases. The study was carried out in the Department of Cardiology, University Cardiac Centre (UCC), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total study population was 100, of which 50 were patients with CAD and 50 were individuals without CAD (control). The patients with CAD and controls were enrolled following the inclusion and exclusion criteria. About 5 ml blood was collected by venepuncture from each individual and apolipoprotein A-1 and B were determined by automated nephelometry. The mean age of total study population was 51.4 ± 10.8 years while the mean age of the patients and control was 51.3 ± 10.9 and 51.4 ± 10.9 years respectively. The Apo A-I level was significantly (p<0.01) different in CAD patients compared to control group (95.10 ± 20.50 mg/dl vs 113.47 ± 20.96 mg/dl). The ratio of Apo B and Apo A1 was also significantly higher (p<0.01) in CAD patients than that of controls (1.25 ± 0.40 vs 0.95 ± 0.26 while Apo B levels was not different among the two groups. The study revealed significant alteration of serum Apo A-I level and Apo B/Apo A-I ratio in patients with CAD compared to those without CAD. Further large-scale study is needed to evaluate the exact influence of apolipoproteins on coronary artery disease in Bengali ethnic population. Ibrahim Med. Coll. J. 2015; 9(1): 31-33
冠状动脉疾病(CAD)是发达国家和孟加拉国等发展中国家发病率和死亡率的重要原因。本研究对孟加拉国冠心病患者血清载脂蛋白A-I (Apo A-1)和载脂蛋白B (Apo B)水平进行了评估。该研究是在达卡Bangabandhu Sheikh Mujib医科大学(BSMMU)大学心脏中心(UCC)心内科进行的。研究总人数为100人，其中CAD患者50人，非CAD患者50人(对照组)。CAD患者和对照组按照纳入和排除标准入组。每人静脉穿刺取血约5ml，自动比浊法测定载脂蛋白A-1和B。总研究人群的平均年龄为51.4±10.8岁，患者和对照组的平均年龄分别为51.3±10.9岁和51.4±10.9岁。冠心病患者Apo A-I水平与对照组(95.10±20.50 mg/dl vs 113.47±20.96 mg/dl)比较差异有统计学意义(p<0.01)。冠心病患者Apo B和Apo A1的比值(1.25±0.40 vs 0.95±0.26)也显著高于对照组(p<0.01)，而Apo B水平在两组间无显著差异。研究显示，与非冠心病患者相比，冠心病患者血清载脂蛋白A-I水平和载脂蛋白B/载脂蛋白A-I比值有显著变化。需要进一步的大规模研究来评估载脂蛋白对孟加拉民族人群冠状动脉疾病的确切影响。易卜拉欣·迈德，上校。j . 2015;9(1): 33节
{"title":"Apolipoprotein A-I and B levels in Bangladeshi patients with coronary artery disease","authors":"A. Chowdhury, A. Shafique, Z. Rahman","doi":"10.3329/IMCJ.V9I1.27638","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I1.27638","url":null,"abstract":"Coronary arteay disease (CAD) is an important cause of morbidity and mortality in developed as well as developing countries like Bangladesh. In this study, the status of serum apolipoprotein A-I (Apo A-1) and apolipoprotein B (Apo B) levels were assessed in Bangladeshi patients with coronary artery diseases. The study was carried out in the Department of Cardiology, University Cardiac Centre (UCC), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total study population was 100, of which 50 were patients with CAD and 50 were individuals without CAD (control). The patients with CAD and controls were enrolled following the inclusion and exclusion criteria. About 5 ml blood was collected by venepuncture from each individual and apolipoprotein A-1 and B were determined by automated nephelometry. The mean age of total study population was 51.4 ± 10.8 years while the mean age of the patients and control was 51.3 ± 10.9 and 51.4 ± 10.9 years respectively. The Apo A-I level was significantly (p<0.01) different in CAD patients compared to control group (95.10 ± 20.50 mg/dl vs 113.47 ± 20.96 mg/dl). The ratio of Apo B and Apo A1 was also significantly higher (p<0.01) in CAD patients than that of controls (1.25 ± 0.40 vs 0.95 ± 0.26 while Apo B levels was not different among the two groups. The study revealed significant alteration of serum Apo A-I level and Apo B/Apo A-I ratio in patients with CAD compared to those without CAD. Further large-scale study is needed to evaluate the exact influence of apolipoproteins on coronary artery disease in Bengali ethnic population. Ibrahim Med. Coll. J. 2015; 9(1): 31-33","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125040598","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}
Objectives of this cross sectional descriptive study was to evaluate critically the current status of structured oral examination (SOE) format as practiced in the professional examination of undergraduate medical course (MBBS) and views of the faculties regarding the concept of SOE as an assessment tool. The study was conducted in 9 medical college examination centers of Dhaka University in July 2007. There were 36 examiners in 18 SOE board, 26 of them were interviewed with a semi-structured questionnaire and SOE boards were observed with a checklist. A total of 2455 questions used in SOE to assess 123 students, were recorded and analyzed using another checklist. These questions were used to assess learning hierarchy and content coverage using forensic medicine as a reference subject. Analysis of the questions revealed majority (97%) were of recall type, only 3% were interpretation and problem solving types. The questions for 119 (97%) examinee did not address 10%-50% content area. About 38% examiners responded that they had no clear idea regarding learning objectives and none had idea regarding test blueprint.The examiners marked the domain of learning measured by SOE in favor of cognitive skill (61%), communication skill (38.5%), motor skill (11.5%), behavior and attitude (19%). No examiner prepared model answer of SOE questions by consensus with other examiner. Though more than 80% examiner agreed with the statement that pre-selection of accepted model answer is an important element for success of SOE. But no examiners of any SOE boards practiced it. Similarly, none of the examiners of SOE board kept records of individual question and the answer of the examinees. No boards maintained equal time for a candidate during SOE by using timer or stop watch. Examiners of 8 boards (44%) did not use recommended rating scale to score individual response of examinee rather scored in traditional consolidated way at the end of the candidate’s examination. Majority (94%) boards scored the prompted answer and allowed another questions when a candidate failed to answer. During SOE conduction, 22% examiner were absent from the board for a prolonged period and 3% was engaged in marking the written scripts. About 56% of the examiners arrived late than schedule time. Behaviors of 14% examiner showed abusing to the candidates. The study revealed that the objectives of introducing SOE as assessment tool in undergraduate medical curriculum was not achieved and it was not appropriately implemented. The various elements of SOE were not followed in most of the sessions of examinations. However, the reasons for not implementing vis a vis following the attributes of SOE were not explored. The study was done only in forensic medicine but similar situations may exist in other subjects. It is recommended that further study may be instituted to determine the causes of not achieving the objective of SOE in undergraduate medical evaluation system. The examiners should be motiva
{"title":"Evaluation of structured oral examination format used in the assessment of undergraduate medical course (MBBS) of the University of Dhaka","authors":"S. Alam, T. Begum","doi":"10.3329/IMCJ.V9I1.27633","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I1.27633","url":null,"abstract":"Objectives of this cross sectional descriptive study was to evaluate critically the current status of structured oral examination (SOE) format as practiced in the professional examination of undergraduate medical course (MBBS) and views of the faculties regarding the concept of SOE as an assessment tool. The study was conducted in 9 medical college examination centers of Dhaka University in July 2007. There were 36 examiners in 18 SOE board, 26 of them were interviewed with a semi-structured questionnaire and SOE boards were observed with a checklist. A total of 2455 questions used in SOE to assess 123 students, were recorded and analyzed using another checklist. These questions were used to assess learning hierarchy and content coverage using forensic medicine as a reference subject. Analysis of the questions revealed majority (97%) were of recall type, only 3% were interpretation and problem solving types. The questions for 119 (97%) examinee did not address 10%-50% content area. About 38% examiners responded that they had no clear idea regarding learning objectives and none had idea regarding test blueprint.The examiners marked the domain of learning measured by SOE in favor of cognitive skill (61%), communication skill (38.5%), motor skill (11.5%), behavior and attitude (19%). No examiner prepared model answer of SOE questions by consensus with other examiner. Though more than 80% examiner agreed with the statement that pre-selection of accepted model answer is an important element for success of SOE. But no examiners of any SOE boards practiced it. Similarly, none of the examiners of SOE board kept records of individual question and the answer of the examinees. No boards maintained equal time for a candidate during SOE by using timer or stop watch. Examiners of 8 boards (44%) did not use recommended rating scale to score individual response of examinee rather scored in traditional consolidated way at the end of the candidate’s examination. Majority (94%) boards scored the prompted answer and allowed another questions when a candidate failed to answer. During SOE conduction, 22% examiner were absent from the board for a prolonged period and 3% was engaged in marking the written scripts. About 56% of the examiners arrived late than schedule time. Behaviors of 14% examiner showed abusing to the candidates. The study revealed that the objectives of introducing SOE as assessment tool in undergraduate medical curriculum was not achieved and it was not appropriately implemented. The various elements of SOE were not followed in most of the sessions of examinations. However, the reasons for not implementing vis a vis following the attributes of SOE were not explored. The study was done only in forensic medicine but similar situations may exist in other subjects. It is recommended that further study may be instituted to determine the causes of not achieving the objective of SOE in undergraduate medical evaluation system. The examiners should be motiva","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121637070","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}
T. Yasmin, A. Hossain, S. K. Paul, G. Mowla, S. Sultana
Extended spectrum beta lactamases ( ESBLs) produced by Gram negative bacteria are mainly mediated by three important genes, namely TEM, SHV and CTX-M. In this study, we used a multiplex PCR to determine the prevalence of CTX-M and its subgroups CTX-M-3, CTX-M-14, among the members of Enterobacteriaceae family and in Pseudomonas spp that were isolated from different clinical samples in a tertiary care hospital in Bangladesh. A total of 300 culture positive clinical isolates were selected for the study. Out of these, 216 from urine, 45 from wound swab, 39 from pus aspirates. The ESBL status was determined by double disc diffusion test (DDDT) as recommended by Clinical Laboratory Standard Institute 2010 (CLSI) and by multiplex PCR for TEM, SHV and CTX-M, CTX-M-3, CTX-M-14 genes. Out of 300 isolates tested, 71.3% were positive for ESBL production by DDDT. The rate of positivity for TEM, SHV and CTX-M genes in 107 randomely selected isolates was 83.2%. Among these, 56.2% (50/89) was positive for CTX-M. Among the CTX-M positive isolates, CTX-M-3 and CTX-M- 14 were 78.0% (39/50) and 80.0% (40/50) respectively. Our study demonstrated that CTX-M variants were common in Enterobacteriaceae and Pseudomonas spp prevalent in the hospital of Bangladesh. Ibrahim Med. Coll. J. 2015; 9(1): 26-30
{"title":"Prevalence of CTX-M ? lactamases among Gram negative bacteria in a tertiary care hospital in Bangladesh","authors":"T. Yasmin, A. Hossain, S. K. Paul, G. Mowla, S. Sultana","doi":"10.3329/IMCJ.V9I1.27637","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I1.27637","url":null,"abstract":"Extended spectrum beta lactamases ( ESBLs) produced by Gram negative bacteria are mainly mediated by three important genes, namely TEM, SHV and CTX-M. In this study, we used a multiplex PCR to determine the prevalence of CTX-M and its subgroups CTX-M-3, CTX-M-14, among the members of Enterobacteriaceae family and in Pseudomonas spp that were isolated from different clinical samples in a tertiary care hospital in Bangladesh. A total of 300 culture positive clinical isolates were selected for the study. Out of these, 216 from urine, 45 from wound swab, 39 from pus aspirates. The ESBL status was determined by double disc diffusion test (DDDT) as recommended by Clinical Laboratory Standard Institute 2010 (CLSI) and by multiplex PCR for TEM, SHV and CTX-M, CTX-M-3, CTX-M-14 genes. Out of 300 isolates tested, 71.3% were positive for ESBL production by DDDT. The rate of positivity for TEM, SHV and CTX-M genes in 107 randomely selected isolates was 83.2%. Among these, 56.2% (50/89) was positive for CTX-M. Among the CTX-M positive isolates, CTX-M-3 and CTX-M- 14 were 78.0% (39/50) and 80.0% (40/50) respectively. Our study demonstrated that CTX-M variants were common in Enterobacteriaceae and Pseudomonas spp prevalent in the hospital of Bangladesh. Ibrahim Med. Coll. J. 2015; 9(1): 26-30","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128096557","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}
Polycystic ovary syndrome (PCOS) is one of the common disorders in women at child bearing age. The purpose of the present study was to investigate the lipid profile in patients with polycystic ovary syndrome. A total of 103 women with PCOS of 15-36 years of age were included in the present study. Of the 103 PCOS women, 50% were overweight or obese, 29.1% had impaired glucose tolerance (IGT) and 4.9% had type2 diabetes mellitus (T2DM). The mean BMI was generally higher (25.8±5.5 kg/m 2 ). The mean serum cholesterol levels ranged from182 mg/dl to 236 mg/dl in all groups of women. The results of our study showed that women with PCOS had altered lipid profile and glycemic status. Therefore, evaluation of metabolic status is necessary for better management of women with PCOS. Ibrahim Med. Coll. J. 2014; 8(2): 47-49
{"title":"Lipid Profile of Women with Polycystic Ovary Syndrome Attending a Tertiary Care Hospital of Dhaka City","authors":"R. Laila, N. Mahmud, M. Nargis, T. Chowdhury","doi":"10.3329/IMCJ.V8I2.26678","DOIUrl":"https://doi.org/10.3329/IMCJ.V8I2.26678","url":null,"abstract":"Polycystic ovary syndrome (PCOS) is one of the common disorders in women at child bearing age. The purpose of the present study was to investigate the lipid profile in patients with polycystic ovary syndrome. A total of 103 women with PCOS of 15-36 years of age were included in the present study. Of the 103 PCOS women, 50% were overweight or obese, 29.1% had impaired glucose tolerance (IGT) and 4.9% had type2 diabetes mellitus (T2DM). The mean BMI was generally higher (25.8±5.5 kg/m 2 ). The mean serum cholesterol levels ranged from182 mg/dl to 236 mg/dl in all groups of women. The results of our study showed that women with PCOS had altered lipid profile and glycemic status. Therefore, evaluation of metabolic status is necessary for better management of women with PCOS. Ibrahim Med. Coll. J. 2014; 8(2): 47-49","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123712880","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}
K. Shadia, A. Ahmed, L. Barai, F. Rahman, Nusrat Tahmina, J. Haq
Mecillinam is one of the very few oral antibacterial agents used against extended spectrum β- lactamase (ESBL) producing Escherichia coli (E. coli) causing urinary tract infection (UTI)). It is reported that, resistance to mecillinam can be reversed to some extent by adding beta lactamase inhibitor like clavulanic acid. The present study was aimed to determine in-vitro activity of mecillinam and mecillinam-clavulanic acid combination on the susceptibility of ESBL producing and non-ESBL producing E. coli . Total 124 E. coli (78 ESBL positive and 46 ESBL negative) isolates from urine samples of patients with UTI were included in the study. Organisms were isolated from patients attending BIRDEM General Hospital from July 2012 to December 2012. ESBL production was tested by double disc synergy test. Minimum inhibitory concentration (MIC) of mecillinam and clavulanic acid against E. coli was determined by agar dilution method. Of the total E. coli isolates, 62.9% was ESBL positive and 37.1% was negative for ESBL. Out of ESBL positive isolates, 75.6% was sensitive to mecillinam while ESBL negative isolates showed the sensitivity as 67.4%. The sensitivity to mecillinam of ESBL positive and negative isolates increased to 85.9% and 86.9% respectively by addition of clavulanic acid with mecillinam. The MIC values of intermediate and resistant isolates converted to sensitive MIC range after addition of clavulanic acid with mecillinam. Conversion of resistance of ESBL producing isolates by adding clavulanic acid was also evident by the reduction of MIC 50 and MIC 90 from 4μg/ml to ≤1 μg/ml and from 128 μg/ ml to 64 μg/ml respectively. Similar trend of reduction of MICs was also observed in non-ESBLs. In conclusion, both ESBL positive and negative E. coli demonstrated considerable sensitivity to mecillinam and the sensitivity increased significantly (p<0.05) by adding clavulanic acid with mecillinam. Ibrahim Med. Coll. J. 2014; 8(2): 56-60
{"title":"Activity of Mecillinam and Clavulanic Acid on ESBL Producing and Non- ESBL Producing Escherichia Coli Isolated From UTI Cases","authors":"K. Shadia, A. Ahmed, L. Barai, F. Rahman, Nusrat Tahmina, J. Haq","doi":"10.3329/IMCJ.V8I2.26680","DOIUrl":"https://doi.org/10.3329/IMCJ.V8I2.26680","url":null,"abstract":"Mecillinam is one of the very few oral antibacterial agents used against extended spectrum β- lactamase (ESBL) producing Escherichia coli (E. coli) causing urinary tract infection (UTI)). It is reported that, resistance to mecillinam can be reversed to some extent by adding beta lactamase inhibitor like clavulanic acid. The present study was aimed to determine in-vitro activity of mecillinam and mecillinam-clavulanic acid combination on the susceptibility of ESBL producing and non-ESBL producing E. coli . Total 124 E. coli (78 ESBL positive and 46 ESBL negative) isolates from urine samples of patients with UTI were included in the study. Organisms were isolated from patients attending BIRDEM General Hospital from July 2012 to December 2012. ESBL production was tested by double disc synergy test. Minimum inhibitory concentration (MIC) of mecillinam and clavulanic acid against E. coli was determined by agar dilution method. Of the total E. coli isolates, 62.9% was ESBL positive and 37.1% was negative for ESBL. Out of ESBL positive isolates, 75.6% was sensitive to mecillinam while ESBL negative isolates showed the sensitivity as 67.4%. The sensitivity to mecillinam of ESBL positive and negative isolates increased to 85.9% and 86.9% respectively by addition of clavulanic acid with mecillinam. The MIC values of intermediate and resistant isolates converted to sensitive MIC range after addition of clavulanic acid with mecillinam. Conversion of resistance of ESBL producing isolates by adding clavulanic acid was also evident by the reduction of MIC 50 and MIC 90 from 4μg/ml to ≤1 μg/ml and from 128 μg/ ml to 64 μg/ml respectively. Similar trend of reduction of MICs was also observed in non-ESBLs. In conclusion, both ESBL positive and negative E. coli demonstrated considerable sensitivity to mecillinam and the sensitivity increased significantly (p<0.05) by adding clavulanic acid with mecillinam. Ibrahim Med. Coll. J. 2014; 8(2): 56-60","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121740856","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}
Background: Bangladesh is experiencing a plateau phase in fertility decline after its dramatic reduction in early nineties. Aspects of contraceptive use dynamics have important influences on fertility. Methods: This study used data from the 2004 Bangladesh Demographic and Health Survey and applied Multinomial Logistic Regression model to examine the determinants of use of modern methods of contraception. Results: The results showed that individual level characteristics had strong influence on contraceptive use. These variables included educational level of the couples, autonomy of woman, male child preference, woman’s membership with an NGO, visit by family planning worker, region and type of residence. Conclusion: The analysis indicated that further increase of contraceptive prevalence rate to achieve decline in fertility level depended on the improvement of educational status of couples and as well as increase in societal value of girl child. It was evident that household visit by a family planning worker was a significant factor in contraceptive use. Influences of Muslim religion were found to be declining in the case of several methods of contraception use. NGOs could take this opportunity to advocate condom use among their credit clients, which would also benefit the country as a policy against sexually transmitted diseases and AIDS. Ibrahim Med. Coll. J. 2014; 8(2): 34-40
{"title":"Determinants of Contraceptive Use in Bangladesh","authors":"M. Mohsena, Nashid Kamal","doi":"10.3329/IMCJ.V8I2.26676","DOIUrl":"https://doi.org/10.3329/IMCJ.V8I2.26676","url":null,"abstract":"Background: Bangladesh is experiencing a plateau phase in fertility decline after its dramatic reduction in early nineties. Aspects of contraceptive use dynamics have important influences on fertility. Methods: This study used data from the 2004 Bangladesh Demographic and Health Survey and applied Multinomial Logistic Regression model to examine the determinants of use of modern methods of contraception. Results: The results showed that individual level characteristics had strong influence on contraceptive use. These variables included educational level of the couples, autonomy of woman, male child preference, woman’s membership with an NGO, visit by family planning worker, region and type of residence. Conclusion: The analysis indicated that further increase of contraceptive prevalence rate to achieve decline in fertility level depended on the improvement of educational status of couples and as well as increase in societal value of girl child. It was evident that household visit by a family planning worker was a significant factor in contraceptive use. Influences of Muslim religion were found to be declining in the case of several methods of contraception use. NGOs could take this opportunity to advocate condom use among their credit clients, which would also benefit the country as a policy against sexually transmitted diseases and AIDS. Ibrahim Med. Coll. J. 2014; 8(2): 34-40","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130286343","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}
The present study was undertaken to determine the drug resistance pattern of M. tuberculosis isolated from 225 pulmonary and 45 extrapulmonary tuberculosis cases. The samples were cultured on Lowenstein Jensen (L-J) media for isolation of M. tuberculosis . Drug resistance to first line anti tubercular drugsnamely isoniazid (INH), rifampicin (RIF), Ethambutol (ETH) and streptomycin (SM) were determined by indirect proportion method. The overall drug resistance of M. tuberculosis was 53.6% to any of the first line anti tubercular drugs. Rate of multi drug resistant tuberculosis (MDR-TB) among the untreated cases was 4.2%, while it was 36.0% in previously treated cases. It was found that 83.3% rifampicin resistant M. tuberculosis was cross resistant to one or more of other first line anti-tubercular drugs, while cross resistance of INH, ETH and SM resistant isolates was much low. The present study revealed that high level of drug resistance exists to individual anti tubercular drugs and MDR-TB is an emerging problem, particularly in treated cases. Rifampicin resistance could be used as a surrogate marker for drug resistance to other first line anti tubercular drugs. Ibrahim Med. Coll. J. 2014; 8(2): 41-46
{"title":"First Line Anti-Tubercular Drug Resistance Pattern of Mycobacterium Tuberculosis Isolated From Specialized Hospitals of Dhaka City","authors":"M. Mohiuddin, J. Haq","doi":"10.3329/IMCJ.V8I2.26677","DOIUrl":"https://doi.org/10.3329/IMCJ.V8I2.26677","url":null,"abstract":"The present study was undertaken to determine the drug resistance pattern of M. tuberculosis isolated from 225 pulmonary and 45 extrapulmonary tuberculosis cases. The samples were cultured on Lowenstein Jensen (L-J) media for isolation of M. tuberculosis . Drug resistance to first line anti tubercular drugsnamely isoniazid (INH), rifampicin (RIF), Ethambutol (ETH) and streptomycin (SM) were determined by indirect proportion method. The overall drug resistance of M. tuberculosis was 53.6% to any of the first line anti tubercular drugs. Rate of multi drug resistant tuberculosis (MDR-TB) among the untreated cases was 4.2%, while it was 36.0% in previously treated cases. It was found that 83.3% rifampicin resistant M. tuberculosis was cross resistant to one or more of other first line anti-tubercular drugs, while cross resistance of INH, ETH and SM resistant isolates was much low. The present study revealed that high level of drug resistance exists to individual anti tubercular drugs and MDR-TB is an emerging problem, particularly in treated cases. Rifampicin resistance could be used as a surrogate marker for drug resistance to other first line anti tubercular drugs. Ibrahim Med. Coll. J. 2014; 8(2): 41-46","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117167377","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}
P. Khanam, T. Begum, M. A. Khan, S. Iqbal, A. Banu, M. M. Rhaman, M. Sayeed
Chronic kidney disease (CKD) with diabetes mellitus is one of the most common and major public health problems globally. In Bangladesh, several studies indicate an increasing prevalence of diabetes though very few studies are available on CKD. For CKD, diagnostic method, criteria or cutoffs still remained undecided. This study aimed to determine the prevalence of CKD among the hospitalized patients and to compare the diagnostic approach practiced in the hospital. Methods: All patients admitted to the Department of Nephrology at BIRDEM from May 1 to July 31, 2012 were selected for investigation. An almost equal number of patients were also selected from other units of Medicine. The information included were age, sex, social class, blood pressure, height, weight, blood glucose, creatinine, triglycerides, total cholesterol, high-density lipoproteins and electrolytes. The CKD creat was diagnosed based on creatinine (>1.2mg/dl) and the CKD gfr based on estimated GFR ( 1.2 mg/dl) groups. Similar comparisons were also made between CKD gfr and non-CKD gfr (>60 vs. ≤ 60 ml/min/1.732) groups. Results: A total of 4172 patients got admitted in the study period of 90 days; and 442 patients (m / f = 256 / 186) were investigated. Of the total (n=4172), 241 (5.8%) had CKDcreat and 272 (6.5%) had CKD gfr . Of the investigated 442 patients, 241 (54.5%) had CKD creat and 272 (61.5%) had CKD gfr . The differences of characteristics between CKD creat and non-CKD creat groups were almost similar to the differences between CKD gfr and non-CKD gfr groups. Higher age, higher social class and higher blood pressure showed significant (p 1.2 mg/dl and CKD gfr : <90 ml/min/1.73 2 ). Thus, a large proportion remained either under- or over-diagnosed depending on the criterion used. Conclusion: The prevalence of CKD among the hospitalized patients was found not negligible. The comparisons of two diagnostic criteria did differ and eGFR (K/DOQI) could detect higher proportion of CKD, which might be an over-diagnosis. Further study taking microalbuminuria, gross proteinuria, albumin-creatinine ratio and cystatin C may validate the method for the diagnostic accuracy of CKD, which my help assessing the prevalence of CKD accurately. Ibrahim Med. Coll. J. 2014; 8(2): 50-55
{"title":"Is Estimated Glomerular Filtration Rate (eGFR) a Better Predictor than Creatinine Cutoff to Detect Chronic Kidney Disease (CKD)","authors":"P. Khanam, T. Begum, M. A. Khan, S. Iqbal, A. Banu, M. M. Rhaman, M. Sayeed","doi":"10.3329/IMCJ.V8I2.26679","DOIUrl":"https://doi.org/10.3329/IMCJ.V8I2.26679","url":null,"abstract":"Chronic kidney disease (CKD) with diabetes mellitus is one of the most common and major public health problems globally. In Bangladesh, several studies indicate an increasing prevalence of diabetes though very few studies are available on CKD. For CKD, diagnostic method, criteria or cutoffs still remained undecided. This study aimed to determine the prevalence of CKD among the hospitalized patients and to compare the diagnostic approach practiced in the hospital. Methods: All patients admitted to the Department of Nephrology at BIRDEM from May 1 to July 31, 2012 were selected for investigation. An almost equal number of patients were also selected from other units of Medicine. The information included were age, sex, social class, blood pressure, height, weight, blood glucose, creatinine, triglycerides, total cholesterol, high-density lipoproteins and electrolytes. The CKD creat was diagnosed based on creatinine (>1.2mg/dl) and the CKD gfr based on estimated GFR ( 1.2 mg/dl) groups. Similar comparisons were also made between CKD gfr and non-CKD gfr (>60 vs. ≤ 60 ml/min/1.732) groups. Results: A total of 4172 patients got admitted in the study period of 90 days; and 442 patients (m / f = 256 / 186) were investigated. Of the total (n=4172), 241 (5.8%) had CKDcreat and 272 (6.5%) had CKD gfr . Of the investigated 442 patients, 241 (54.5%) had CKD creat and 272 (61.5%) had CKD gfr . The differences of characteristics between CKD creat and non-CKD creat groups were almost similar to the differences between CKD gfr and non-CKD gfr groups. Higher age, higher social class and higher blood pressure showed significant (p 1.2 mg/dl and CKD gfr : <90 ml/min/1.73 2 ). Thus, a large proportion remained either under- or over-diagnosed depending on the criterion used. Conclusion: The prevalence of CKD among the hospitalized patients was found not negligible. The comparisons of two diagnostic criteria did differ and eGFR (K/DOQI) could detect higher proportion of CKD, which might be an over-diagnosis. Further study taking microalbuminuria, gross proteinuria, albumin-creatinine ratio and cystatin C may validate the method for the diagnostic accuracy of CKD, which my help assessing the prevalence of CKD accurately. Ibrahim Med. Coll. J. 2014; 8(2): 50-55","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133118453","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}
Squamous cell carcinoma of the gall bladder is rare. It accounts for less than 12.7 % of all cases of gall bladder cancer. Pure squamous cell carcinoma is even less common with a reported incidence of 3.3%. We present a case of 70 years-old man with decreased appetite, vomiting and fever associated with right upper quadrant pain for two months. Ultrasonography of the abdomen revealed a distended gallbladder with multiple calculi along with large hyperechoic area of sludge. Provisional diagnosis was cholelithiasis with empyema of gall bladder. Cholecystectomy was done. Histopathological examination revealed well to moderately differentiated squamous cell carcinoma of the gall bladder without evidence of metastasis. Ibrahim Med. Coll. J. 2014; 8(2): 61-63
{"title":"Primary Squamous Cell Carcinoma of Gall Bladder: A Case Report","authors":"S. Ferdousi, S. Khan","doi":"10.3329/IMCJ.V8I2.26681","DOIUrl":"https://doi.org/10.3329/IMCJ.V8I2.26681","url":null,"abstract":"Squamous cell carcinoma of the gall bladder is rare. It accounts for less than 12.7 % of all cases of gall bladder cancer. Pure squamous cell carcinoma is even less common with a reported incidence of 3.3%. We present a case of 70 years-old man with decreased appetite, vomiting and fever associated with right upper quadrant pain for two months. Ultrasonography of the abdomen revealed a distended gallbladder with multiple calculi along with large hyperechoic area of sludge. Provisional diagnosis was cholelithiasis with empyema of gall bladder. Cholecystectomy was done. Histopathological examination revealed well to moderately differentiated squamous cell carcinoma of the gall bladder without evidence of metastasis. Ibrahim Med. Coll. J. 2014; 8(2): 61-63","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123196718","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}
M. Khan, A. Mohibullah, Z. Alam, A. Safdar, S. Hoque, A. K. Chowdhury
The first stage of diabetic cardiomyopathy is represented by left ventricular diastolic dysfunction (LVDD) with preserved systolic function, in an asymptomatic patient. B-type Natriuretic Peptide (BNP) is a cardiac neurohormone predominantly released from the cardiac ventricles in response to left ventricular volume expansion and pressure overload. The diagnostic role of BNP for detecting LVDD in asymptomatic diabetic patients is still debated and this study was undertaken to find out this relationship of plasma BNP level with LVDD in asymptomatic diabetic patients. First 100 patients who had type 2 diabetes for more than 5 years and had no known cardiac disease other than LVDD (grade-1 & 2), admitted in BIRDEM Hospital were recruited. Plasma BNP was measured by fluorescence polarization immunoassay (FPIA) method using AXSYM auto analyzer. Twodimensional, M-mode, spectral, and color flow Doppler echocardiograms was repeated on the same day of blood collection for plasma BNP measurement. After processing of all available data, statistical analysis of their significance was done with the help of computer based SPSS (Statistical Program for Social Science) program. Male female distribution of the study participants was 46% and 54% respectively. Mean plasma BNP level in all participants was 150 pg/ml. In male and female participants the values were 168 and 135 pg/ml respectively. The distribution did not show any significant association (p=0.491). Of the 100 study participants 89% had E/A ratio <1. Distribution of participants with abnormal E/A and E/e did not show any significant association (p=0.955 and 0.844 respectively). Study participants with varying level of plasma BNP level were analyzed in terms of E/A and E/e ratio. Distribution of participants between BNP Groups and E/A and E/e groups did not show statistically significant association (p=0.529). We concluded that plasma BNP has no relation with LVDD (grade- 1 and 2) in patients with type 2 diabetes mellitus (T2DM) who had no known cardiac disease. Ibrahim Med. Coll. J. 2014; 8(1): 1-5
糖尿病性心肌病的第一阶段表现为左心室舒张功能不全(LVDD)，在无症状患者中保留了收缩功能。b型利钠肽(BNP)是一种主要由心室释放的心脏神经激素，是对左心室容量扩张和压力过载的反应。BNP在无症状糖尿病患者LVDD检测中的诊断作用仍存在争议，本研究旨在探讨无症状糖尿病患者血浆BNP水平与LVDD的关系。首先招募100例在BIRDEM医院住院的2型糖尿病患者，患者病程超过5年，除LVDD(1级和2级)外无其他已知心脏疾病。采用AXSYM自动分析仪，荧光偏振免疫分析法(FPIA)检测血浆BNP。在取血当天重复二维、m型、光谱和彩色血流多普勒超声心动图，测量血浆BNP。在对所有可用数据进行处理后，利用基于计算机的SPSS (statistical Program for Social Science)程序对其显著性进行统计分析。研究参与者的男女分布分别为46%和54%。所有参与者的平均血浆BNP水平为150 pg/ml。在男性和女性参与者中，数值分别为168和135 pg/ml。分布无显著相关性(p=0.491)。在100名研究参与者中，89%的E/A比<1。E/A异常和E/ E异常受试者分布无显著相关性(p分别=0.955和0.844)。对血浆BNP水平不同的受试者进行E/A和E/ E比值分析。BNP组与E/A组和E/ E组之间的受试者分布无统计学意义(p=0.529)。我们得出结论，血浆BNP与没有已知心脏疾病的2型糖尿病(T2DM)患者LVDD(- 1级和2级)无关。易卜拉欣·迈德，上校。j . 2014;8 (1): 1 - 5
{"title":"Plasma B-type Natriuretic Peptide (BNP) as a marker of left ventricular diastolic dysfunction in diabetic patients","authors":"M. Khan, A. Mohibullah, Z. Alam, A. Safdar, S. Hoque, A. K. Chowdhury","doi":"10.3329/IMCJ.V8I1.22981","DOIUrl":"https://doi.org/10.3329/IMCJ.V8I1.22981","url":null,"abstract":"The first stage of diabetic cardiomyopathy is represented by left ventricular diastolic dysfunction (LVDD) with preserved systolic function, in an asymptomatic patient. B-type Natriuretic Peptide (BNP) is a cardiac neurohormone predominantly released from the cardiac ventricles in response to left ventricular volume expansion and pressure overload. The diagnostic role of BNP for detecting LVDD in asymptomatic diabetic patients is still debated and this study was undertaken to find out this relationship of plasma BNP level with LVDD in asymptomatic diabetic patients. First 100 patients who had type 2 diabetes for more than 5 years and had no known cardiac disease other than LVDD (grade-1 & 2), admitted in BIRDEM Hospital were recruited. Plasma BNP was measured by fluorescence polarization immunoassay (FPIA) method using AXSYM auto analyzer. Twodimensional, M-mode, spectral, and color flow Doppler echocardiograms was repeated on the same day of blood collection for plasma BNP measurement. After processing of all available data, statistical analysis of their significance was done with the help of computer based SPSS (Statistical Program for Social Science) program. Male female distribution of the study participants was 46% and 54% respectively. Mean plasma BNP level in all participants was 150 pg/ml. In male and female participants the values were 168 and 135 pg/ml respectively. The distribution did not show any significant association (p=0.491). Of the 100 study participants 89% had E/A ratio <1. Distribution of participants with abnormal E/A and E/e did not show any significant association (p=0.955 and 0.844 respectively). Study participants with varying level of plasma BNP level were analyzed in terms of E/A and E/e ratio. Distribution of participants between BNP Groups and E/A and E/e groups did not show statistically significant association (p=0.529). We concluded that plasma BNP has no relation with LVDD (grade- 1 and 2) in patients with type 2 diabetes mellitus (T2DM) who had no known cardiac disease. Ibrahim Med. Coll. J. 2014; 8(1): 1-5","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133660182","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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