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A Study on Outcome of Wide Local Excision in Chronic Granulomatous Mastitis 慢性肉芽肿性乳腺炎局部广泛切除的疗效研究
Pub Date : 2022-05-10 DOI: 10.3329/jemc.v10i3.59359
S. Akter, K. Rahman, Mahfuzul Momen, D. Paul
Background: Granulomatous mastitis can be divided into idiopathic granulomatous mastitis and granulomatous mastitis occurring as a rare secondary complication of a great variety of other conditions such as tuberculosis and other infections, sarcoidosis and granulomatosis with polyangitis. Idiopathic granulomatous mastitis (IGM) is an uncommon benign chronic inflammatory disease which can clinically and radiographically mimic abscess or breast cancer. Definitive diagnosis was made by histopathology and exclusion of an identifying etiology. Optimal treatment has not been yet established.Objectives: The aim of this study was to report and describe the clinical signs, radiological findings, managements, clinical course, and clinical outcomes after treatment of IGM.Materials and Methods: We conducted a descriptive cross-sectional study on 28 patients with chronic GM in Enam Medical College & Hospital collected in 1 year. The patient characteristics, clinical presentations, radiological findings, microbiological workups, tissue pathology, treatment modalities, outcomes were analyzed. We evaluated only the response of wide local excision and assess the recurrence up to 2 years after surgery on the treatment modalities to find out the proper treatments for chronic GM patient.Results: Twenty eight patients were diagnosed as chronic granulomatous mastitis. FNAC was conducted before excision. Twenty seven patients had chronic granulomatous mastitis and one patient had tuberculosis on histopathology. In the first setting, 28 patients were treated by surgery. Thirteen patients out of 28 had open wound after performing an excision in which healing by secondary intention was done. Ten patients had undergone primary closure and no complications.Conclusion: Chronic GM is an uncommon benign disease which is hardly distinguished from malignancy. There is not a significant difference among treatment modalities in term of time-to-healing and recurrence of disease. The result shows that surgery is outperformed by the shortest healing time. However, the surgical treatment must be chosen with careful due to high rate of wound complications. Multimodality treatment is recommended as the proper treatments for chronic GM patient.J Enam Med Col 2020; 10(3): 174-178
背景:肉芽肿性乳腺炎可分为特发性肉芽肿性乳房炎和肉芽肿性乳炎,后者是多种其他疾病的罕见继发并发症,如肺结核和其他感染、结节病和肉芽肿伴多发性脑膜炎。特发性肉芽肿性乳腺炎(IGM)是一种罕见的良性慢性炎症性疾病,可在临床和放射学上模拟脓肿或癌症。通过组织病理学和排除确定的病因做出最终诊断。最佳治疗方法尚未确定。目的:本研究的目的是报告和描述IGM治疗后的临床症状、放射学表现、治疗方法、临床过程和临床结果。材料和方法:我们对1年内收集的28例慢性GM患者进行了描述性横断面研究。分析了患者特征、临床表现、放射学检查、微生物检查、组织病理学、治疗方式和结果。我们仅评估了广泛局部切除的疗效,并评估了手术后2年内的复发情况,以找出慢性GM患者的正确治疗方法。结果:28例患者被诊断为慢性肉芽肿性乳腺炎。FNAC在切除前进行。27名患者患有慢性肉芽肿性乳腺炎,1名患者患有肺结核。在第一组中,28名患者接受了手术治疗。28名患者中有13名在进行切除术后出现开放性伤口,其中通过次要意图进行了愈合。10名患者接受了初次闭合术,无并发症。结论:慢性GM是一种罕见的良性疾病,与恶性疾病几乎没有区别。在疾病治愈和复发的时间方面,不同的治疗方式没有显著差异。结果表明,手术的疗效优于最短的愈合时间。然而,由于伤口并发症发生率高,必须谨慎选择手术治疗。建议对慢性GM患者采用多模式治疗。《搪瓷医学杂志》2020;10(3):174-178
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引用次数: 0
Microalbuminuria in Metabolic Obesity: A Cross-Sectional Study in a Selected Tertiary Care Hospital of Bangladesh 代谢性肥胖中的微量白蛋白尿:孟加拉国一家选定的三级护理医院的横断面研究
Pub Date : 2022-05-10 DOI: 10.3329/jemc.v10i3.59357
Sharmin Sultana, Md. Matiur Rahman, Rinky Rani Saha, Md Golam Ahad, J. S. Shila, Md. Aminul Haque Khan
Background: Overweight and obese individuals may have no cardiometabolic risk whereas normal weight individuals may present with cardiometabolic risk. The term‘Metabolic obesity’ has been floated to identify hidden metabolic risks irrespective of BMI. The pathophysiology of metabolic obesity can be explained by microvascular dysfunction and microalbuminuria is a wellknown marker of microvascular dysfunction.Objective: The objective of this study was to find out the association of microalbuminuria with metabolic obesity in Bangladeshi adult subjects.Materials and Methods: This cross- sectional analytical study included 200 individuals who attended outpatient department in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from March 2018 to February 2019. The study subjects were divided into metabolically obese (metabolically unhealthy) group and metabolically non-obese (metabolically healthy) group by metabolic syndrome (MetS) criteria. Metabolic syndrome was defined according to the South Asian Modified-National Cholesterol Education Program (NCEP). Microalbuminuria was defined as a urinary albumin to creatinine of 30 to 300 mg/gm. Demographic profile, BP, height, weight, waist circumference etc. were measured and fasting blood glucose, serum triglyceride, serum HDL-C were estimated and albumin to creatinine ratio (ACR) was calculated. Statistical analysis was done using SPSS version 22.0.Results: The frequencies of metabolically obese (metabolically unhealthy) group and metabolically non-obese (metabolically healthy) group were 128 (64%) and 72 (36%) respectively. Mean values for age (p value 0.001), body mass index (p value 0.027), waist circumference (p<0.001), systolic blood pressure (SBP) (p<0.001) and diastolic blood pressure (DBP) (p<0.001), fasting blood glucose (p<0.001) and triglycerides (p<0.001) were significantly higher in the metabolically obese group compared to metabolically non-obese group. Among the study subjects, the prevalence of microalbuminuria was 32.5% and prevalence of microalbuminuria was found very high (38.3%) in metabolically obese group, whereas microalbuminuria in metabolically non-obese group was found 22.2%, which was statistically significant (p value 0.02). Our results showed that diastolic BP (p<0.001), systolic BP (p<0.001), fasting blood sugar (p<0.001) and triglyceride (p<0.008) were significantly correlated with microalbuminuria. In the logistic regression analysis, diastolic BP (p value 0.015) and FBS (p value 0.039) were significantly associated with microalbuminuria. After harmonization of statistical analysis, our study indicated that elevated blood pressure and fasting blood sugar had strong association with microalbuminuria and are likely to be critical components that lead a substantial number of subjects to the prestage of metabolic obesity in the Bangladeshi adult population.Conclusion: Our study concludes that the prevalence of microalbuminuria is significantly high in metabolic obes
背景:超重和肥胖的个体可能没有心脏代谢风险,而正常体重的个体可能存在心脏代谢风险。“代谢性肥胖”一词已被提出,以确定隐藏的代谢风险,而与BMI无关。代谢性肥胖的病理生理学可以用微血管功能障碍来解释,微量白蛋白尿是微血管功能障碍的一个众所周知的标志。目的:本研究的目的是了解孟加拉国成年受试者微量白蛋白尿与代谢性肥胖的关系。材料和方法:这项横断面分析研究包括2018年3月至2019年2月在达卡Bangabandhu Sheikh Mujib医科大学(BSMMU)门诊就诊的200名患者。根据代谢综合征(MetS)标准,研究对象分为代谢性肥胖(代谢不健康)组和代谢性非肥胖(代谢健康)组。代谢综合征是根据南亚改良国家胆固醇教育计划(NCEP)定义的。微量白蛋白尿定义为尿白蛋白与肌酐之比为30至300mg/g。测量人口统计学特征、血压、身高、体重、腰围等,估计空腹血糖、血清甘油三酯、血清HDL-C,并计算白蛋白与肌酐的比值(ACR)。结果:代谢性肥胖(代谢不健康)组和代谢性非肥胖(代谢健康)组的患病率分别为128(64%)和72(36%)。与代谢非肥胖组相比,代谢性肥胖组的年龄(p值0.001)、体重指数(p值0.027)、腰围(p<0.001)、收缩压(SBP)(p<001)和舒张压(DBP)(p<0.001)的平均值、空腹血糖(p<.001)和甘油三酯(p<0.01)显著更高。在研究受试者中,代谢性肥胖组的微量白蛋白尿患病率为32.5%,微量白蛋白尿的患病率非常高(38.3%),而代谢性非肥胖组的微白蛋白尿发病率为22.2%,具有统计学意义(p值0.02),空腹血糖(p<0.001)和甘油三酯(p<0.008)与微量白蛋白尿显著相关。在逻辑回归分析中,舒张压(p值0.015)和FBS(p值0.039)与微量白蛋白尿显著相关。在统一统计分析后,我们的研究表明,血压升高和空腹血糖与微量白蛋白尿有很强的相关性,可能是导致孟加拉国成年人群中大量受试者出现代谢性肥胖的关键因素。结论:我们的研究得出结论,在孟加拉国成年人群中,代谢性肥胖(代谢不健康)中微量白蛋白尿的患病率显著较高。微量白蛋白尿与代谢性肥胖的关系主要归因于高舒张压和空腹血糖。《搪瓷医学杂志》2020;10(3):159-168
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引用次数: 0
From the desk of Editor-in-Chief Vol 10(3) 《总编》第十卷第三期
Pub Date : 2022-05-10 DOI: 10.3329/jemc.v10i3.59353
Md. Aminul Haque Khan
Abstract not availableJ Enam Med Col 2020; 10(3): 135
摘要不可用J Enam Med Col 2020;10(3):135
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引用次数: 0
College News Vol 10(3) 《大学新闻》第10卷(3)
Pub Date : 2022-05-10 DOI: 10.3329/jemc.v10i3.59364
Halima Begum, Sabreena Mohtarin
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引用次数: 0
Role of Ultrasound in the Diagnosis of Hepatocellular Carcinoma in Patients with Chronic Liver Disease 超声在慢性肝病患者肝细胞癌诊断中的作用
Pub Date : 2022-05-10 DOI: 10.3329/jemc.v10i3.59356
Samar C Sarkar, M. H. Ali Biswas, Mashah Binte Amin, Tarana Yasmin, K. K. Shanta, Shamanta Faria
Background: Hepatocellular carcinoma (HCC) is a common cancer in humans. Its mortality ranks third among human malignancies. Cirrhosis of liver is a major contributor to hepatocellular carcinoma, about in 80% of the affected individuals. Fine needle aspiration cytology (FNAC) of the liver which is a minimal invasive procedure is essential to sort out primary and secondary neoplasm of the liver.Objective: The aim of this cross-sectional study was to determine the accuracy of ultrasound for diagnosis of HCC in comparison with FNAC findings.Materials and Methods: This study was done in the Radiology & Imaging Department in Enam Medical College & Hospital, Savar, Dhaka in collaboration with the Department of Pathology of the same institution for FNAC correlation during October 2017 to November 2019. A total number of 50 patients with CLD with known hepatic mass, referred to the department were included in the study. Ultrasound was done with TOSHIBA using low frequency curvilinear probe of 3.5 MHz. USGguided aspirations was performed using 18G needle under full aseptic measure. USG findings were validated by histopathology reports. Analysis was done by SPSS 19.0.Results: Mean age of the study population was 58.6 ± 10.9 years, of whom 37(74%) were male and 13 (26%) were female. Mean size of the hepatic lesions was 4.7 ± 1.08 cm. The lesions were characterized as iso-, hypo- and hyperechoic as compared with hepatic parenchyma. Doppler study shows both central and peripheral vascularity. Compared with FNAC findings, accuracy of USG findings was determined. Sensitivity of USG in detection of HCC was 97.7%, specificity was 66.7%, and positive prediction value 95.6% and negative prediction value 80%.Conclusion: Conventional USG can be used as a screening method in patients with CLD having hepatic masses. However, further workup is required for definite diagnosis.J Enam Med Col 2020; 10(3): 153-158
背景:肝细胞癌(HCC)是人类常见的癌症。它的死亡率在人类恶性肿瘤中排名第三。肝硬化是导致肝细胞癌的主要因素,约占80%的患者。肝细针穿刺细胞学检查是一种微创检查,是鉴别原发性和继发性肝脏肿瘤的重要手段。目的:本横断面研究的目的是确定超声诊断HCC的准确性,并与FNAC结果进行比较。材料与方法:本研究于2017年10月至2019年11月在达卡萨瓦尔伊纳姆医学院和医院放射与影像科与同一机构的病理学系合作进行FNAC相关性研究。本研究共纳入50例就诊于本科的已知肝脏肿块的CLD患者。超声采用东芝3.5 MHz低频曲线探头。采用18G针在全无菌条件下进行超声引导吸痰。USG结果经组织病理学报告证实。采用SPSS 19.0进行分析。结果:研究人群平均年龄58.6±10.9岁,其中男性37人(74%),女性13人(26%)。肝脏病变平均大小为4.7±1.08 cm。与肝实质相比,病变表现为等回声、低回声和高回声。多普勒检查显示中央和外周血管充血。与FNAC结果比较,确定USG结果的准确性。USG检测HCC的敏感性为97.7%,特异性为66.7%,阳性预测值为95.6%,阴性预测值为80%。结论:常规超声心动图可作为CLD合并肝脏肿块的筛查方法。然而,需要进一步的检查来明确诊断。中南大学学报(自然科学版);(3): 153 - 158
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引用次数: 0
CT-Guided FNAC of Lung Lesions and Cytological Sub-Classification of Bronchogenic Carcinoma of 246 cases at a Tertiary Care Hospital CT引导下的FNAC对某三甲医院246例肺癌的诊断及细胞学分型
Pub Date : 2022-05-10 DOI: 10.3329/jemc.v10i3.59358
M. Biswas, Afroz Shirin, A. M. Sikder, Rajib Saha
Background: CT-guided fine needle aspiration cytology (FNAC) is a useful tool for evaluating lung nodules or masses. In view of the relative paucity of published studies regionally, this study was undertaken in the Department of Pathology, Enam Medical College & Hospital to see the use of the technique.Materials and Methods: Two forty six CT guided lung FNACs were performed during January 2017 to December 2018 and cytological diagnoses were made. Reported results and relevant data were recorded in the data sheet and then analyzed by standard statistical method.Results: Total number of cases were 246. Adequate samples were obtained in 228 (92.68%) cases, among the adequate samples 135 (59.41%) were malignant, and 93 (40.49%) were benign or nonmalignant lesions. Among the benign lesions, lung abscess (36;38.70%) was the most common followed by pulmonary TB (27;29.03%). Adenocarcinoma (54;40%) was the most common type of bronchogenic carcinoma followed by squamous cell carcinoma (51;37.78%), small cell carcinoma (21;15.56%), NHL (6;4.44%) and large cell undifferentiated carcinoma (3;2.22%). In male persons, squamous cell carcinoma (42.85%) was the most common type of bronchogenic carcinoma, followed by adenocarcinoma (34.29%). In female, adenocarcinoma was the most common type (18;60%) of bronchogenic carcinoma, followed by squamous cell carcinoma (6;20%).Conclusion: FNAC is a safe method for the evaluation of lung nodules and it enables sub-classification of bronchogenic carcinoma in the vast majority of cases. It is also useful for the diagnosis of tuberculous pulmonary nodules.J Enam Med Col 2020; 10(3): 169-173
背景:CT引导下的细针穿刺细胞学(FNAC)是评估肺部结节或肿块的有用工具。鉴于该地区已发表的研究相对较少,本研究在搪瓷医学院和医院病理学系进行,以了解该技术的使用情况。材料和方法:在2017年1月至2018年12月期间,共进行了46次CT引导下的肺部FNAC检查,并进行了细胞学诊断。报告的结果和相关数据记录在数据表中,然后通过标准统计方法进行分析。结果:总病例数246例。228例(92.68%)获得了足够的样本,其中135例(59.41%)为恶性,93例(40.49%)为良性或非恶性病变。在良性病变中,肺脓肿(36;38.70%)最常见,其次是肺结核(27;29.03%)。腺癌(54;40%)是最常见的支气管癌类型,其次是鳞状细胞癌(51;37.78%)、小细胞癌(21;15.56%)、NHL(6;4.44%)和大细胞未分化癌(3;2.22%)。在男性中,鳞状细胞癌(42.85%)是最常见的支气管癌类型,其次是腺癌(34.29%)。女性支气管癌中腺癌最常见(18;60%),其次是鳞状细胞癌(6.20%)。结论:FNAC是一种安全的评估肺结节的方法,它可以对绝大多数病例进行支气管癌的亚分类。它也可用于诊断结核性肺结节。《搪瓷医学杂志》2020;10(3):169-173
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引用次数: 1
Association of Carpal Tunnel Syndrome with Diabetic Polyneuropathy 腕管综合征与糖尿病多发性神经病变的关系
Pub Date : 2021-05-31 DOI: 10.3329/jemc.v11i2.65189
Sayeda Shabnam Malik, Mohammad Rabiul Karim Khan, Hannan Ma, Sk. Mahbub Alam
Background: Common thought is that diabetic neuropathy is a predisposing factor to entrapment syndromes. Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy.Objectives: To find out association of carpal tunnel syndrome with diabetic polyneuropathy.Materials and Methods: During the period of March 2013 to September 2015, this cross-sectional study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka. A total of 100 adult patients having symptoms and signs of polyneuropathy were recruited as study population. Of them 50 patients grouped into diabetic polyneuropathy (DPN) and the rest 50 patients in non-diabetic neuropathy due to other causes.Results: Out of all patients, the mean age was found 49.60 (13.53) years with 42% female in diabetic neuropathy patients and mean age was 44.64 (15.72) years with 46% female in non-diabetic neuropathy patients. The duration of diabetes was found 8.44 (7.79) years. According to development of Carpal tunnel syndrome (CTS), in diabetic neuropathy patients, about 58% patients developed CTS while in non-diabetic neuropathy patients, that of 14% (p=0.0001). We found diabetic neuropathy patients have 8.48 times higher possibility of development of CTS than non-diabetic neuropathy patients. On adjusted model, age as confounding variable, diabetic neuropathy and female sex were found significantly associated with development of CTS with adjusted odd ratio 10.92 and 3.78 respectfully (p<0.0001).Conclusion: In conclusion, we revealed the higher frequency of CTS in diabetics with DPN. As well we also found DPN and female sex were strongly associated with development of CTS. As DPN is a risk factor for CTS, priority should also be given to the treatment of DPN.J Enam Med Col 2021; 11(2): 78-85
背景:普遍认为糖尿病性神经病变是夹持综合征的易感因素。腕管综合征(CTS)是最常见的压迫性神经病变。目的:探讨腕管综合征与糖尿病多发神经病变的关系。材料与方法:本横断面研究于2013年3月至2015年9月在达卡Bangabandhu Sheikh Mujib医科大学神经内科进行。共有100名患有多发性神经病变症状和体征的成年患者被招募作为研究人群。其中50例为糖尿病多发神经病变(DPN), 50例为其他原因引起的非糖尿病性神经病变。结果:糖尿病神经病变患者的平均年龄为49.60(13.53)岁,女性占42%;非糖尿病神经病变患者的平均年龄为44.64(15.72)岁,女性占46%。糖尿病病程为8.44(7.79)年。根据腕管综合征(Carpal tunnel syndrome, CTS)的发展情况,在糖尿病神经病变患者中,约58%的患者发生了腕管综合征,而在非糖尿病神经病变患者中,这一比例为14% (p=0.0001)。我们发现糖尿病神经病变患者发生CTS的可能性是非糖尿病神经病变患者的8.48倍。在校正模型中,年龄、糖尿病神经病变和女性与CTS的发生有显著相关性,校正奇数比分别为10.92和3.78 (p<0.0001)。结论:糖尿病合并DPN患者发生CTS的频率较高。我们还发现DPN和女性与CTS的发展密切相关。由于DPN是CTS的危险因素,因此也应优先考虑DPN的治疗。中南大学学报(自然科学版);11 (2): 78 - 85
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引用次数: 0
From the Desk of Editor-in-Chief Vol.11(2) 《总编》第11卷(2)
Pub Date : 2021-05-31 DOI: 10.3329/jemc.v11i2.65186
Md. Aminul Haque Khan
Abstract not availableJ Enam Med Col 2021; 11(2): 63
摘要不可用J Enam Med Col 2021;11(2):63
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引用次数: 0
Reviewers in this Issue Vol 11(2) 本期第11卷(2)中的评审员
Pub Date : 2021-05-31 DOI: 10.3329/jemc.v1i2.11474
Editor in Cheif
Abstract not availableJ Enam Med Col 2021; 11(2): 136
摘要不可用J Enam Med Col 2021;11(2):136
{"title":"Reviewers in this Issue Vol 11(2)","authors":"Editor in Cheif","doi":"10.3329/jemc.v1i2.11474","DOIUrl":"https://doi.org/10.3329/jemc.v1i2.11474","url":null,"abstract":"Abstract not available\u0000J Enam Med Col 2021; 11(2): 136","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41629303","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}
引用次数: 0
Chylous Fistula Following Mastectomy 乳房切除术后的乳糜瘘
Pub Date : 2021-05-31 DOI: 10.3329/jemc.v11i2.65196
Mohammad Israt Faisal
Though chyle leakage after axillary dissection is a rare occurrence, sometimes it becomes difficult to manage. All surgeons dealing with breast should be aware with this unusual complication and its management.J Enam Med Col 2021; 11(2): 133-134
虽然腋窝剥离后乳糜漏是罕见的,有时变得难以处理。所有处理乳房的外科医生都应该意识到这种不寻常的并发症及其处理。中南大学学报(自然科学版);11 (2): 133 - 134
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引用次数: 0
期刊
Journal of Enam Medical College
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