Pub Date : 2023-04-04DOI: 10.3329/jrpmc.v8i1.65033
M. E. Karim, Ram Mustafijur Rashid, Mohammad Saleh Akram Akram, R. Ershad
Background: Regional anaesthesia has become an important anaesthetic technique now a days. The use of spinal (subarachnoid) anaesthesia is often limited by the unwillingness of patients to remain awake during surgery. Pharmacologically induced tranquility improves acceptance of regional technique. Objective: This study compares Ketofol (Ketamine+Propofol) and Fenofol (Fentanyl+ Propofol) in terms of onset and recovery of sedation, haemodynamic effects, respiratory effects and adverse effects of both the drugs during elective Caesarian section under spinal anaesthesia. Methods: This randomized clinical trial included 60 ASA (American Society of Anaesthesiologists) grade I or II patients between age 20-40 years undergoing elective Caesarean sections under Subarachnoid anaesthesia during the period of January 2022 to June 2022. Patients were randomly allocated to one of two groups: Ketofol group (Group KP, n=30), who received Ketofol in a single dose of 0.5mg/kg (Ketamine- 0.5mg/kg+Propofol-0.5mg/kg) and Fenofol group (Group FP, n=30), who received Fenofol in a single dose of Fentanyl-0.5mcg/kg+Propofol-0.5mg/kg. Spinal anaesthesia was conducted by injecting a hyperbaric solution of 0.5% bupivacaine 3ml through a 25G spinal needle at L3-4 level. All parameters were documented at 5 min intervals until arousal of the patient. The onset of sedation i.e. time from iv (intravenous) injection of Ketofol or Fenofol to closure of eye lids and the arousal time from sedation i.e. time from closing of the eye lids to OAA/S score of 5 (patient is awake clinically) were noted. Any complication during operation was documented. Patient’s satisfaction with the sedation was assessed by the 5 point ‘Likert verbal rating scale. Results: There was no significant difference of mean blood pressure and mean heart rate between the two groups (P>0.05). Time of onset of sedation was comparable between the two groups (P>0.05). Duration of sedation was significantly less in Fenofol group (p value=<0.001). Significant percentage of patients required oxygen supplementation after sedation with Fenofol due to hypoventilation (66.66% vs 10%, p value <0.001). Incidence of nausea and vomiting was significantly more with Fenofol (46.66% vs 10%, p value >0.001). Conclusion: The study showed that the arousal time i.e. duration of sedation was significantly more with Ketofol than Fenofol which is beneficial for the patient in single dose technique for sedation. Fenofol was associated with significantly high incidence of nausea, vomiting. Moreover, significantly higher percentage of patients required O2 supplementation due to hypoventilation during sedation with Fenofol. Thus it is recommended that Ketofol is a better choice than Fenofol for sedation in single dose technique during subarachnoid block for Caesarean section. J Rang Med Col. March 2023; Vol. 8, No. 2:20-26
背景:区域麻醉已成为一种重要的麻醉技术。脊髓(蛛网膜下腔)麻醉的使用常常受到患者在手术期间不愿意保持清醒的限制。药理学诱导的平静提高了局部技术的接受度。目的:比较酮酚(氯胺酮+异丙酚)和非诺酚(芬太尼+异丙酚)在脊髓麻醉下择期剖宫产时镇静起效和恢复、血流动力学效应、呼吸效应及不良反应。方法:本随机临床试验包括60例年龄在20-40岁之间的ASA(美国麻醉学会)I级或II级患者，于2022年1月至2022年6月在蛛网膜下腔麻醉下进行选择性剖腹产。患者随机分为两组:酮酚组(KP组，n=30)，酮酚单次剂量0.5mg/kg(氯胺酮-0.5mg/kg +异丙酚-0.5mg/kg);非诺酚组(FP组，n=30)，非诺酚单次剂量芬太尼-0.5mcg/kg+异丙酚-0.5mg/kg。脊髓麻醉通过25G脊髓针在L3-4水平注射0.5%布比卡因3ml高压溶液。每隔5分钟记录一次所有参数，直到患者醒来。记录镇静的开始时间，即从静脉注射酮酚或非诺酚到闭上眼睑的时间，以及镇静的觉醒时间，即从闭上眼睑到OAA/S评分为5(患者临床清醒)的时间。记录手术过程中任何并发症。采用李克特5分口头评定量表评估患者对镇静的满意度。结果:两组患者平均血压、平均心率比较，差异均无统计学意义(P>0.05)。两组患者镇静起效时间比较，差异有统计学意义(P>0.05)。非诺福尔组镇静时间明显缩短(p值=0.001)。结论:酮酚的唤醒时间即镇静持续时间明显长于非诺酚，有利于单剂量镇静。非诺福尔与恶心、呕吐的发生率显著增高有关。此外，在非诺酚镇静期间，由于低通气而需要补充氧气的患者比例明显更高。因此，在剖宫产术中，单剂量镇静技术中，酮fol优于非诺酚。J Rang Med Col. 2023年3月;第八卷2:20-26
{"title":"Comparison Between Effects of Ketofol and Fenofol as Sedative in Elective Caesarean Section Under Subarachnoid Anaesthesia","authors":"M. E. Karim, Ram Mustafijur Rashid, Mohammad Saleh Akram Akram, R. Ershad","doi":"10.3329/jrpmc.v8i1.65033","DOIUrl":"https://doi.org/10.3329/jrpmc.v8i1.65033","url":null,"abstract":"Background: Regional anaesthesia has become an important anaesthetic technique now a days. The use of spinal (subarachnoid) anaesthesia is often limited by the unwillingness of patients to remain awake during surgery. Pharmacologically induced tranquility improves acceptance of regional technique.\u0000Objective: This study compares Ketofol (Ketamine+Propofol) and Fenofol (Fentanyl+ Propofol) in terms of onset and recovery of sedation, haemodynamic effects, respiratory effects and adverse effects of both the drugs during elective Caesarian section under spinal anaesthesia.\u0000Methods: This randomized clinical trial included 60 ASA (American Society of Anaesthesiologists) grade I or II patients between age 20-40 years undergoing elective Caesarean sections under Subarachnoid anaesthesia during the period of January 2022 to June 2022. Patients were randomly allocated to one of two groups: Ketofol group (Group KP, n=30), who received Ketofol in a single dose of 0.5mg/kg (Ketamine- 0.5mg/kg+Propofol-0.5mg/kg) and Fenofol group (Group FP, n=30), who received Fenofol in a single dose of Fentanyl-0.5mcg/kg+Propofol-0.5mg/kg. Spinal anaesthesia was conducted by injecting a hyperbaric solution of 0.5% bupivacaine 3ml through a 25G spinal needle at L3-4 level. All parameters were documented at 5 min intervals until arousal of the patient. The onset of sedation i.e. time from iv (intravenous) injection of Ketofol or Fenofol to closure of eye lids and the arousal time from sedation i.e. time from closing of the eye lids to OAA/S score of 5 (patient is awake clinically) were noted. Any complication during operation was documented. Patient’s satisfaction with the sedation was assessed by the 5 point ‘Likert verbal rating scale.\u0000Results: There was no significant difference of mean blood pressure and mean heart rate between the two groups (P>0.05). Time of onset of sedation was comparable between the two groups (P>0.05). Duration of sedation was significantly less in Fenofol group (p value=<0.001). Significant percentage of patients required oxygen supplementation after sedation with Fenofol due to hypoventilation (66.66% vs 10%, p value <0.001). Incidence of nausea and vomiting was significantly more with Fenofol (46.66% vs 10%, p value >0.001).\u0000Conclusion: The study showed that the arousal time i.e. duration of sedation was significantly more with Ketofol than Fenofol which is beneficial for the patient in single dose technique for sedation. Fenofol was associated with significantly high incidence of nausea, vomiting. Moreover, significantly higher percentage of patients required O2 supplementation due to hypoventilation during sedation with Fenofol. Thus it is recommended that Ketofol is a better choice than Fenofol for sedation in single dose technique during subarachnoid block for Caesarean section. \u0000J Rang Med Col. March 2023; Vol. 8, No. 2:20-26\u0000 ","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"385 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126736849","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: Stroke is a leading cause of death and disability globally and particularly in low and middle-income countries, and the burden is increasing. To prevent complications and permanent defects in stroke, early diagnosis is the key that can easily obtained by a CT scan of brain. However, quick access to CT scanning is not available in every country and hospital specially in Bangladesh, various clinical findings especially neurological signs and symptoms and risk factors differentiation are helpful in differentiating the types of stroke. Objective: This study aimed to see the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis in the detection of stroke subtype. Methods: This hospital based cross-sectional comparative study was conducted in Department of Medicine, Rangpur medical college hospital, Rangpur, Bangladesh from January 2010 to December 2011 on three hundred (300) suspected acute stroke patients selected by purposive sampling technique. The clinical diagnosis of type of stroke was made on the basis of mode of presentation, risk factors and signs and confirmed by CT scan of brain within 1 week of attack. Then the clinical diagnosis was compared with the results of CT scan. Statistical analyses related with this study were performed by using of SPSS-19 package program. Results: Among the 300 patients, 73(24.3%) patients were clinically diagnosed as hemorrhagic stroke and 227(75.6%) patients were as infarctive stroke. Out of 73 clinically diagnosed haemorrhagic stroke patients, CT scan revealed that 61 (83.6%) patients had intracerebral hemorrhage, 5 (6.8%) had infarct. And out of 133 diagnosed ischemic stroke patients, CT scan revealed that 203 (89.4%) patients had infarction, 6 (2.6%) had intracerebral hemorrhage. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of hemorrhagic stroke were 91.0%, 94.8%, 83.6%, 97.4% and 94.0% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of infarctive stroke were 97.6%, 73.9%, 89.4%, 92.2% and 90.3% respectively. Conclusion: CT scan of brain remains the gold standard for differential diagnosis, but the availability of CT scan is not always feasible, and it is virtually impossible to submit all stroke patients to CT scan. Adequate knowledge on risk factors, clinical features and initial investigations may contribute to such a differentiation of cerebral infarction from intracerebral hemorrhage with high accuracy where rapid access to Computed Tomography (CT) is lacking. J Rang Med Col. March 2023; Vol. 8, No. 2:33-39
背景:中风是全球，特别是低收入和中等收入国家死亡和残疾的主要原因，而且负担正在增加。早期诊断是预防中风并发症和永久性缺陷的关键，CT扫描可以很容易地获得。然而，并不是每个国家和医院都能快速获得CT扫描，特别是在孟加拉国，各种临床发现，特别是神经体征和症状以及危险因素的区分有助于区分中风的类型。目的:观察临床诊断在脑卒中亚型检测中的敏感性、特异性、阳性预测值、阴性预测值及准确性。方法:选取2010年1月至2011年12月在孟加拉国Rangpur医学院附属医院内科采用有目的抽样方法对300例疑似急性脑卒中患者进行横断面比较研究。根据表现方式、危险因素及体征，临床诊断脑卒中类型，发病1周内行脑CT扫描确认。然后将临床诊断结果与CT扫描结果进行比较。本研究的相关统计分析采用SPSS-19软件包程序进行。结果:300例患者中，临床诊断出血性卒中73例(24.3%)，梗死性卒中227例(75.6%)。73例临床诊断出血性脑卒中患者中，CT扫描显示61例(83.6%)有脑出血，5例(6.8%)有梗死。133例诊断为缺血性脑卒中的患者中，CT扫描显示梗死203例(89.4%)，脑出血6例(2.6%)。出血性脑卒中临床诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为91.0%、94.8%、83.6%、97.4%和94.0%。临床诊断梗死性脑卒中的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为97.6%、73.9%、89.4%、92.2%和90.3%。结论:脑CT扫描仍然是鉴别诊断的金标准，但CT扫描的可用性并不总是可行的，几乎不可能使所有脑卒中患者都接受CT扫描。在缺乏快速计算机断层扫描(CT)的情况下，对危险因素、临床特征和初步调查的充分了解可能有助于准确区分脑梗死和脑出血。J Rang Med Col. 2023年3月;第八卷2:33-39
{"title":"Sensitivity, Specificity, Predictive Values and Accuracy of clinical diagnosis of Acute Stroke","authors":"M. Anwar, Sajeda Afrin, Md. Shakhawat Hossain, Shahed Jahan, Md Mahfuzer Rahman","doi":"10.3329/jrpmc.v8i1.65038","DOIUrl":"https://doi.org/10.3329/jrpmc.v8i1.65038","url":null,"abstract":"Background: Stroke is a leading cause of death and disability globally and particularly in low and middle-income countries, and the burden is increasing. To prevent complications and permanent defects in stroke, early diagnosis is the key that can easily obtained by a CT scan of brain. However, quick access to CT scanning is not available in every country and hospital specially in Bangladesh, various clinical findings especially neurological signs and symptoms and risk factors differentiation are helpful in differentiating the types of stroke.\u0000Objective: This study aimed to see the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis in the detection of stroke subtype.\u0000Methods: This hospital based cross-sectional comparative study was conducted in Department of Medicine, Rangpur medical college hospital, Rangpur, Bangladesh from January 2010 to December 2011 on three hundred (300) suspected acute stroke patients selected by purposive sampling technique. The clinical diagnosis of type of stroke was made on the basis of mode of presentation, risk factors and signs and confirmed by CT scan of brain within 1 week of attack. Then the clinical diagnosis was compared with the results of CT scan. Statistical analyses related with this study were performed by using of SPSS-19 package program.\u0000Results: Among the 300 patients, 73(24.3%) patients were clinically diagnosed as hemorrhagic stroke and 227(75.6%) patients were as infarctive stroke. Out of 73 clinically diagnosed haemorrhagic stroke patients, CT scan revealed that 61 (83.6%) patients had intracerebral hemorrhage, 5 (6.8%) had infarct. And out of 133 diagnosed ischemic stroke patients, CT scan revealed that 203 (89.4%) patients had infarction, 6 (2.6%) had intracerebral hemorrhage. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of hemorrhagic stroke were 91.0%, 94.8%, 83.6%, 97.4% and 94.0% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of infarctive stroke were 97.6%, 73.9%, 89.4%, 92.2% and 90.3% respectively.\u0000Conclusion: CT scan of brain remains the gold standard for differential diagnosis, but the availability of CT scan is not always feasible, and it is virtually impossible to submit all stroke patients to CT scan. Adequate knowledge on risk factors, clinical features and initial investigations may contribute to such a differentiation of cerebral infarction from intracerebral hemorrhage with high accuracy where rapid access to Computed Tomography (CT) is lacking.\u0000J Rang Med Col. March 2023; Vol. 8, No. 2:33-39","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114170130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-04DOI: 10.3329/jrpmc.v8i1.65056
NNoor e Nazar Mst Munira Begum, Shahjadi Nasreen Sultana, Shafiqus Saleheen, A. Ferdous, Majedul Islam, Khadiza Parvin
Background: Epilepsy is a medical condition that requires long-term treatment with antiepileptic drugs. Different epidemiological studies revealed an increased risk of atherogenic cardiovascular diseases in patients under antiepileptic therapy. The possible etiologic suggestion is alterations of the serum homocysteine, folate, and vitamin B12 metabolism. Objective: To evaluate serum homocysteine, folate, and vitamin B12 level in patients under antiepileptic monotherapy. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College from July 2017 to June 2018 through purposive sampling. In this study, forty diagnosed patients under antiepileptic monotherapy and forty age and sex-matched apparently healthy control were selected according to selection criteria, from OPD of the Neurology department, Dhaka medical college hospital. Results: In patients under antiepileptic therapy, mean (±SD) of serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 14.15±3.4, 13.61±2.02, 361.78±41.26 respectively. In the healthy control group, serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 8.78±2.59, 16.71±2.06 and 366.69±44.15 respectively. Serum homocysteine level was found higher and folate level was found lower in patients with antiepileptic therapy which were statistically significant (p<0.001). But serum B12 level difference was found statistically non-significant. Serum homocysteine level has a positive correlation (p-value 0.001, r value 0.71) and serum folate has a negative correlation (p-value 0.001, r value -0.65) with the duration of antiepileptic therapy. Conclusion: A higher level of serum homocysteine and a lower level of folate was found in patients under antiepileptic therapy. But there was no significant change in the serum vitamin B12 level of these patients. J Rang Med Col. March 2023; Vol. 8, No. 2:44-48
背景:癫痫是一种需要长期使用抗癫痫药物治疗的疾病。不同的流行病学研究显示，接受抗癫痫治疗的患者患动脉粥样硬化性心血管疾病的风险增加。可能的病因提示是血清同型半胱氨酸、叶酸和维生素B12代谢的改变。目的:评价抗癫痫单药治疗患者血清同型半胱氨酸、叶酸和维生素B12水平。方法:采用目的抽样方法，于2017年7月至2018年6月在达卡医学院生物化学系进行横断面研究。本研究选取达卡医学院附属医院神经内科门诊40例经诊断接受抗癫痫单药治疗的患者和40例年龄、性别明显匹配的健康对照。结果:抗癫痫治疗组血清同型半胱氨酸(μmol/L)、叶酸(ng/ml)、维生素B12 (pg/ml)均值(±SD)分别为14.15±3.4、13.61±2.02、361.78±41.26。健康对照组血清同型半胱氨酸(μmol/L)、叶酸(ng/ml)和维生素B12 (pg/ml)分别为8.78±2.59、16.71±2.06和366.69±44.15。抗癫痫治疗组血清同型半胱氨酸水平较高，叶酸水平较低，差异有统计学意义(p<0.001)。但血清B12水平差异无统计学意义。血清同型半胱氨酸水平与抗癫痫治疗时间呈正相关(p值0.001,r值0.71)，血清叶酸水平与抗癫痫治疗时间呈负相关(p值0.001,r值-0.65)。结论:抗癫痫治疗患者血清同型半胱氨酸水平升高，叶酸水平降低。但这些患者的血清维生素B12水平没有明显变化。J Rang Med Col. 2023年3月;第八卷2:44-48
{"title":"Serum Level of Homocysteine, Folate, and Vitamin B12 in Adult Epileptic Patients Under Antiepileptic Therapy","authors":"NNoor e Nazar Mst Munira Begum, Shahjadi Nasreen Sultana, Shafiqus Saleheen, A. Ferdous, Majedul Islam, Khadiza Parvin","doi":"10.3329/jrpmc.v8i1.65056","DOIUrl":"https://doi.org/10.3329/jrpmc.v8i1.65056","url":null,"abstract":"Background: Epilepsy is a medical condition that requires long-term treatment with antiepileptic drugs. Different epidemiological studies revealed an increased risk of atherogenic cardiovascular diseases in patients under antiepileptic therapy. The possible etiologic suggestion is alterations of the serum homocysteine, folate, and vitamin B12 metabolism.\u0000Objective: To evaluate serum homocysteine, folate, and vitamin B12 level in patients under antiepileptic monotherapy.\u0000Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College from July 2017 to June 2018 through purposive sampling. In this study, forty diagnosed patients under antiepileptic monotherapy and forty age and sex-matched apparently healthy control were selected according to selection criteria, from OPD of the Neurology department, Dhaka medical college hospital.\u0000Results: In patients under antiepileptic therapy, mean (±SD) of serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 14.15±3.4, 13.61±2.02, 361.78±41.26 respectively. In the healthy control group, serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 8.78±2.59, 16.71±2.06 and 366.69±44.15 respectively. Serum homocysteine level was found higher and folate level was found lower in patients with antiepileptic therapy which were statistically significant (p<0.001). But serum B12 level difference was found statistically non-significant. Serum homocysteine level has a positive correlation (p-value 0.001, r value 0.71) and serum folate has a negative correlation (p-value 0.001, r value -0.65) with the duration of antiepileptic therapy.\u0000Conclusion: A higher level of serum homocysteine and a lower level of folate was found in patients under antiepileptic therapy. But there was no significant change in the serum vitamin B12 level of these patients.\u0000J Rang Med Col. March 2023; Vol. 8, No. 2:44-48","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128348934","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: Bronchiolitis is the most common cause of lower respiratory tract infections within the first 2 years of life. Despite tantalizing efforts, an effective optimized treatment for bronchiolitis still remains elusive. Nebulized hypertonic saline may improve clinical severity scores and reduce length of hospital stay among infants with non-severe acute bronchiolitis. Objective: The objective of this study was to evaluate efficacy of 3% hypertonic saline in reducing the length of hospital stay in children with bronchiolitis. Method: This randomized control trial was conducted in the department of Paediatrics, Rangpur Medical College Hospital between July 2018 to June 2020. After acceptance and ethical clearance, 72 infants and young children fulfilling the selection criteria were enrolled into this study. Children were randomly divided into two groups, designed as group–A and group–B. Patients in group A were nebulized with 3% hypertonic saline and group B with normal saline. Patients in each group were nebulized three times 8 hourly during hospital stay. Each group received the same standard supportive measures. Data was analyzed through SPSS (version 23.0) software using chi-square test, student t' test, where applicable. Statistical significance was set as 0.05 level. Results: Among the 72 children, 72.22% (26/36) of group A and 58.33% (21/36) of group B were male, with a male female ratio of 1.88:1. Mean age of the children of group A (7.5±1.94 months) was significantly higher than that of group B (5.8±2.01 months) (p=0.032). Baseline clinical characteristics were almost similar, except oxygen saturation (p<0.001) between the two groups. 88.9% (32/36) patients of group A and 41.7% (15/36) from group B recovered and were discharged within 72 hours. After 72 hours, 11.1% (4/36) from group A and 58.3% (21/36) from group B recovered and were discharged (p<0.001). Mean length of hospital stay was shorter in the hypertonic saline group (2.28 ± 0.45 days) than that in the normal saline group (3.72 ±0.45 days). Conclusion: The length of hospital stay was effectively reduced by 3% nebulized hypertonic saline in children with bronchiolitis. J Rang Med Col. March 2023; Vol. 8, No. 2:40-43
背景:毛细支气管炎是2岁以内下呼吸道感染的最常见原因。尽管做出了诱人的努力，但毛细支气管炎的有效优化治疗仍然难以捉摸。雾化高渗生理盐水可以改善非严重急性毛细支气管炎婴儿的临床严重程度评分并缩短住院时间。目的:本研究的目的是评估3%高渗盐水对减少毛细支气管炎患儿住院时间的疗效。方法:随机对照试验于2018年7月至2020年6月在Rangpur医学院附属医院儿科进行。经接受和伦理审查后，72名符合入选标准的婴幼儿被纳入本研究。儿童随机分为两组，分别为a组和b组。A组给予3%高渗生理盐水雾化，B组给予生理盐水雾化。两组患者住院期间每小时雾化3次。各组接受相同标准的支持措施。数据分析采用SPSS (version 23.0)软件，适用的卡方检验、学生t检验。统计学意义设为0.05水平。结果:72例患儿中，A组72.22%(26/36)为男性，B组58.33%(21/36)为男性，男女比例为1.88:1。A组患儿平均年龄(7.5±1.94个月)显著高于B组(5.8±2.01个月)(p=0.032)。除了血氧饱和度(p<0.001)外，两组患者的基线临床特征几乎相似。A组患者中88.9%(32/36)、B组患者中41.7%(15/36)在72 h内康复出院。72h后，A组11.1%(4/36)、B组58.3%(21/36)痊愈出院(p<0.001)。高渗盐水组平均住院时间(2.28±0.45 d)短于生理盐水组(3.72±0.45 d)。结论:3%高渗盐水雾化治疗可有效缩短毛细支气管炎患儿的住院时间。J Rang Med Col. 2023年3月;第八卷2:40-43
{"title":"Randomized Control Trial of 3% Nebulized Hypertonic Saline in Reducing the Length of Hospital Stay in Children with Bronchiolitis","authors":"Nafisa Zaman, Bedanta Majumder, Md Mazharul Islam, B. Majumder, Shahana Afreen, Prahlad Kumar Shil","doi":"10.3329/jrpmc.v8i1.65055","DOIUrl":"https://doi.org/10.3329/jrpmc.v8i1.65055","url":null,"abstract":"Background: Bronchiolitis is the most common cause of lower respiratory tract infections within the first 2 years of life. Despite tantalizing efforts, an effective optimized treatment for bronchiolitis still remains elusive. Nebulized hypertonic saline may improve clinical severity scores and reduce length of hospital stay among infants with non-severe acute bronchiolitis.\u0000Objective: The objective of this study was to evaluate efficacy of 3% hypertonic saline in reducing the length of hospital stay in children with bronchiolitis.\u0000Method: This randomized control trial was conducted in the department of Paediatrics, Rangpur Medical College Hospital between July 2018 to June 2020. After acceptance and ethical clearance, 72 infants and young children fulfilling the selection criteria were enrolled into this study. Children were randomly divided into two groups, designed as group–A and group–B. Patients in group A were nebulized with 3% hypertonic saline and group B with normal saline. Patients in each group were nebulized three times 8 hourly during hospital stay. Each group received the same standard supportive measures. Data was analyzed through SPSS (version 23.0) software using chi-square test, student t' test, where applicable. Statistical significance was set as 0.05 level.\u0000Results: Among the 72 children, 72.22% (26/36) of group A and 58.33% (21/36) of group B were male, with a male female ratio of 1.88:1. Mean age of the children of group A (7.5±1.94 months) was significantly higher than that of group B (5.8±2.01 months) (p=0.032). Baseline clinical characteristics were almost similar, except oxygen saturation (p<0.001) between the two groups. 88.9% (32/36) patients of group A and 41.7% (15/36) from group B recovered and were discharged within 72 hours. After 72 hours, 11.1% (4/36) from group A and 58.3% (21/36) from group B recovered and were discharged (p<0.001). Mean length of hospital stay was shorter in the hypertonic saline group (2.28 ± 0.45 days) than that in the normal saline group (3.72 ±0.45 days).\u0000Conclusion: The length of hospital stay was effectively reduced by 3% nebulized hypertonic saline in children with bronchiolitis.\u0000J Rang Med Col. March 2023; Vol. 8, No. 2:40-43","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129649389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-04DOI: 10.3329/jrpmc.v8i1.65061
Sharmin Sultana, C. Sarkar, Atm Zoadur Rahim Zahid, R. Barman
Background: Sedentary lifestyle is an issue of great concern because of its deleterious health implication. It is associated with limited physical activity. Regular physical activity with good physical fitness are widely accepted as factors that reduce all cause of mortality and improve number of health outcome. Objective: To assess the cardiovascular sympathetic nerve function status by the cold pressor test in healthy adult male sedentary workers. Methods: This cross-sectional analytical study was conducted from January 2019 to December 2019 in the Department of Physiology, Rangpur Medical College, Rangpur. After obtaining permission, a total 60 subjects who were met the inclusion criteria was enrolled in the study after briefing them objectives of the study. Among them 30 were healthy adult male heavy workers (Group-A) and 30 were healthy adult male sedentary workers (Group-B). The basal systolic and diastolic blood pressure was recorded in resting condition. The evaluation of sympathetic nerve functions in selected individuals was done by cold pressor test. The individuals were selected from different areas of Rangpur district. For statistical analysis unpaired t-test was performed by computer-based software SPSS-23.0 version for windows. Results: The resting systolic and diastolic blood pressure are non-significant in selected individuals. Diastolic blood pressure response by cold pressor test was significantly lower in sedentary workers. (p< 0.05). Conclusion: The study thus concluded that decreased diastolic blood pressure response by cold pressor test in sedentary individuals indicate impairment of the sympathetic nerve function. J Rang Med Col. March 2023; Vol. 8, No. 2:59-64
背景:久坐的生活方式是一个非常关注的问题，因为它对健康有害。它与体力活动有限有关。有规律的身体活动和良好的身体素质被广泛认为是减少所有死因和改善许多健康结果的因素。目的:通过冷压试验评价健康成年男性久坐工人的心血管交感神经功能状况。方法:本横断面分析研究于2019年1月至2019年12月在Rangpur医学院生理学系进行。在获得许可后，在向符合纳入标准的受试者简要介绍研究目的后，共有60名受试者入组。其中健康成年男性重体力劳动者30人(a组)，健康成年男性久坐劳动者30人(b组)。静息状态下记录基础收缩压和舒张压。采用冷压试验对部分受试者交感神经功能进行评价。这些个体来自Rangpur区的不同地区。统计分析采用计算机软件SPSS-23.0进行非配对t检验。结果:部分患者静息期收缩压和舒张压无显著差异。冷压试验对久坐工作者的舒张压反应明显较低。(p < 0.05)。结论:久坐不动的人通过冷压试验降低了舒张压反应，表明交感神经功能受损。J Rang Med Col. 2023年3月;第八卷，第2:59-64
{"title":"Evaluation of Cardiovascular Sympathetic Nerve Function Status by Cold Pressor test in Healthy Adult Male Sedentary Individuals","authors":"Sharmin Sultana, C. Sarkar, Atm Zoadur Rahim Zahid, R. Barman","doi":"10.3329/jrpmc.v8i1.65061","DOIUrl":"https://doi.org/10.3329/jrpmc.v8i1.65061","url":null,"abstract":"Background: Sedentary lifestyle is an issue of great concern because of its deleterious health implication. It is associated with limited physical activity. Regular physical activity with good physical fitness are widely accepted as factors that reduce all cause of mortality and improve number of health outcome.\u0000Objective: To assess the cardiovascular sympathetic nerve function status by the cold pressor test in healthy adult male sedentary workers.\u0000Methods: This cross-sectional analytical study was conducted from January 2019 to December 2019 in the Department of Physiology, Rangpur Medical College, Rangpur. After obtaining permission, a total 60 subjects who were met the inclusion criteria was enrolled in the study after briefing them objectives of the study. Among them 30 were healthy adult male heavy workers (Group-A) and 30 were healthy adult male sedentary workers (Group-B). The basal systolic and diastolic blood pressure was recorded in resting condition. The evaluation of sympathetic nerve functions in selected individuals was done by cold pressor test. The individuals were selected from different areas of Rangpur district. For statistical analysis unpaired t-test was performed by computer-based software SPSS-23.0 version for windows.\u0000Results: The resting systolic and diastolic blood pressure are non-significant in selected individuals. Diastolic blood pressure response by cold pressor test was significantly lower in sedentary workers. (p< 0.05).\u0000Conclusion: The study thus concluded that decreased diastolic blood pressure response by cold pressor test in sedentary individuals indicate impairment of the sympathetic nerve function.\u0000J Rang Med Col. March 2023; Vol. 8, No. 2:59-64","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133446865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-04DOI: 10.3329/jrpmc.v8i1.65065
Hriday Ranjan Roy
Non Scalpel Vasectomy (NSV) is used extensively for male sterilization by the family planning industry in Bangladesh. But if NSV needs a reverse procedure (recanalization), variable rates are observed in different studies. We collected articles from Hinari, Pubmed and Banglajol with extensive searches. We compared these results between articles and recommended the best vasectomy reversal (NSV) procedure for male clients. J Rang Med Col. March 2023; Vol. 8, No. 1:69-71
非手术刀输精管结扎术(NSV)被孟加拉国计划生育行业广泛用于男性绝育。但如果NSV需要反向手术(再通)，在不同的研究中观察到不同的速率。通过广泛的搜索，我们收集了来自Hinari, Pubmed和Banglajol的文章。我们比较了这些文章的结果，并推荐了男性患者的最佳输精管结扎逆转(NSV)手术。J Rang Med Col. 2023年3月;第8卷第1章69-71节
{"title":"Fertility Outcome of Vasectomy Recanalization: A Review","authors":"Hriday Ranjan Roy","doi":"10.3329/jrpmc.v8i1.65065","DOIUrl":"https://doi.org/10.3329/jrpmc.v8i1.65065","url":null,"abstract":"Non Scalpel Vasectomy (NSV) is used extensively for male sterilization by the family planning industry in Bangladesh. But if NSV needs a reverse procedure (recanalization), variable rates are observed in different studies. We collected articles from Hinari, Pubmed and Banglajol with extensive searches. We compared these results between articles and recommended the best vasectomy reversal (NSV) procedure for male clients.\u0000J Rang Med Col. March 2023; Vol. 8, No. 1:69-71","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116400178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-04DOI: 10.3329/jrpmc.v8i1.65027
Abu Said Md Rahenur Mondol, T. Zaman, M. Anwar, Md Helal Miah, Md Al Fatah Al Adiluzzaman, A. Banu, Shahed Jahan, Md Mahfuzer Rahman
Background: Hypertension is a growing issue of public health problem of the adult population in both developed as well as developing world, is a serious medical condition that significantly increases the risks of heart, brain, kidney, and other diseases. There is a strong association between Microalbuminuria (MA) and hypertension. Microalbuminuria (MA) is the independent risk factor for developing cardiovascular and cerebrovascular morbidity and mortality in hypertension, suggesting that microalbuminuria (MA) could be a useful marker to assess the risk management of cardiovascular disease and renal disease. Objective: To assess the frequency of microalbuminuria in hypertension and to evaluate its association with left ventricular hypertrophy (LVH), ischemic heart disease (IHD), retinopathy, and stroke. Methods: This cross-sectional descriptive study was conducted at the Hypertension & Research Centre, Rangpur from January 2010 to January 2012. A total of 75 hypertensives without diabetes mellitus and/or other conditions causing microalbuminuria were purposively selected. Urine albumin was assessed and microalbuminuria was defined as albumin excretion between 20-200 microg/min. The relationship of microalbuminuria with the duration, severity, body mass index (BMI), lipid profile, and target organ damage (TOD) like left ventricular hypertrophy (LVH), ischemic heart disease (IHD), hypertensive retinopathy, and stroke was assessed by univariate analysis. Results: The patients were in between the age of 20-79 years with mean age of 52.98±12.2. Out of 75 subjects, 47 (62.7%) patients were male and 28 (37.3%) were female. Of the study group, 53 patients had stage 1 and 22 patients had stage 2 hypertension. Among the stage-1 hypertensive (53), 5 patients had microalbuminuria and 6 patients had microalbuminuria in stage-2 hypertensive (22) (p=0.047). Microalbuminuria was significantly higher in those with longer duration and greater severity of hypertension (p =0.039). Older age (p =0.008), and adverse lipid profile (p =0.003) were the other identifiable risk factors for microalbuminuria. Stroke (OR=9.77), echocardiography-proven LVH (OR=6.25), ECG and/or echocardiographyproven IHD (OR=8.71) and hypertensive retinopathy (OR=4.14) were significantly higher in those with microalbuminuria. Conclusion: The prevalence of microalbuminuria in hypertensive subjects is high and patients with microalbuminuria have high odds of developing TOD like stroke, LVH, IHD, and hypertensive retinopathy. So the early detection of microalbuminuria in hypertensive as well as prompt treatment may reduce the burden of TOD. J Rang Med Col. March 2023; Vol. 8, No. 2:3-10
背景:高血压是发达国家和发展中国家成年人日益严重的公共卫生问题，是一种严重的疾病，可显著增加心脏、大脑、肾脏和其他疾病的风险。微量白蛋白尿(MA)与高血压有很强的相关性。微量白蛋白尿(MA)是高血压患者心脑血管发病和死亡的独立危险因素，提示微量白蛋白尿(MA)可作为评估心血管疾病和肾脏疾病风险管理的有用指标。目的:探讨高血压患者微量白蛋白尿的发生频率及其与左心室肥厚(LVH)、缺血性心脏病(IHD)、视网膜病变和脑卒中的关系。方法:本横断面描述性研究于2010年1月至2012年1月在Rangpur高血压研究中心进行。共有75例无糖尿病和/或其他引起微量白蛋白尿的高血压患者被有意选择。评估尿白蛋白，微量白蛋白尿被定义为白蛋白排泄在20-200微克/分钟之间。通过单变量分析评估微量白蛋白尿与病程、严重程度、体重指数(BMI)、血脂、靶器官损伤(TOD)如左心室肥厚(LVH)、缺血性心脏病(IHD)、高血压性视网膜病变和脑卒中的关系。结果:患者年龄20 ~ 79岁，平均年龄52.98±12.2岁。75例患者中，男性47例(62.7%)，女性28例(37.3%)。在研究组中，53名患者为1期高血压，22名患者为2期高血压。1期高血压患者(53例)中微量白蛋白尿5例，2期高血压患者(22例)中微量白蛋白尿6例(p=0.047)。高血压病程长、严重程度高的患者微量白蛋白尿显著增高(p =0.039)。年龄较大(p =0.008)和不良血脂(p =0.003)是微量白蛋白尿的其他可识别的危险因素。卒中(OR=9.77)、超声心动图证实的LVH (OR=6.25)、心电图和/或超声心动图证实的IHD (OR=8.71)和高血压性视网膜病变(OR=4.14)在微量白蛋白尿患者中显著升高。结论:高血压患者微量白蛋白尿患病率高，发生TOD样卒中、LVH、IHD、高血压视网膜病变的几率高。因此，高血压患者微量白蛋白尿的早期发现和及时治疗可以减轻TOD的负担。J Rang Med Col. 2023年3月;第八卷，第2:3-10
{"title":"Prevalence of Microalbuminuria and its Association with Left Ventricular Hypertrophy (LVH), Ischemic Heart Disease (IHD), Retinopathy, and Stroke in Hypertension","authors":"Abu Said Md Rahenur Mondol, T. Zaman, M. Anwar, Md Helal Miah, Md Al Fatah Al Adiluzzaman, A. Banu, Shahed Jahan, Md Mahfuzer Rahman","doi":"10.3329/jrpmc.v8i1.65027","DOIUrl":"https://doi.org/10.3329/jrpmc.v8i1.65027","url":null,"abstract":"Background: Hypertension is a growing issue of public health problem of the adult population in both developed as well as developing world, is a serious medical condition that significantly increases the risks of heart, brain, kidney, and other diseases. There is a strong association between Microalbuminuria (MA) and hypertension. Microalbuminuria (MA) is the independent risk factor for developing cardiovascular and cerebrovascular morbidity and mortality in hypertension, suggesting that microalbuminuria (MA) could be a useful marker to assess the risk management of cardiovascular disease and renal disease. \u0000Objective: To assess the frequency of microalbuminuria in hypertension and to evaluate its association with left ventricular hypertrophy (LVH), ischemic heart disease (IHD), retinopathy, and stroke. \u0000Methods: This cross-sectional descriptive study was conducted at the Hypertension & Research Centre, Rangpur from January 2010 to January 2012. A total of 75 hypertensives without diabetes mellitus and/or other conditions causing microalbuminuria were purposively selected. Urine albumin was assessed and microalbuminuria was defined as albumin excretion between 20-200 microg/min. The relationship of microalbuminuria with the duration, severity, body mass index (BMI), lipid profile, and target organ damage (TOD) like left ventricular hypertrophy (LVH), ischemic heart disease (IHD), hypertensive retinopathy, and stroke was assessed by univariate analysis. \u0000Results: The patients were in between the age of 20-79 years with mean age of 52.98±12.2. Out of 75 subjects, 47 (62.7%) patients were male and 28 (37.3%) were female. Of the study group, 53 patients had stage 1 and 22 patients had stage 2 hypertension. Among the stage-1 hypertensive (53), 5 patients had microalbuminuria and 6 patients had microalbuminuria in stage-2 hypertensive (22) (p=0.047). Microalbuminuria was significantly higher in those with longer duration and greater severity of hypertension (p =0.039). Older age (p =0.008), and adverse lipid profile (p =0.003) were the other identifiable risk factors for microalbuminuria. Stroke (OR=9.77), echocardiography-proven LVH (OR=6.25), ECG and/or echocardiographyproven IHD (OR=8.71) and hypertensive retinopathy (OR=4.14) were significantly higher in those with microalbuminuria. \u0000Conclusion: The prevalence of microalbuminuria in hypertensive subjects is high and patients with microalbuminuria have high odds of developing TOD like stroke, LVH, IHD, and hypertensive retinopathy. So the early detection of microalbuminuria in hypertensive as well as prompt treatment may reduce the burden of TOD. \u0000J Rang Med Col. March 2023; Vol. 8, No. 2:3-10","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121569667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-04DOI: 10.3329/jrpmc.v8i1.65063
Shapna Rani Roy, C. Sarkar, Atm Zoadur Rahim Zahid, Neaz Ahmed
Background: The use of tobacco has been significantly increased globally in recent decades. Easy availability and the low price gives rise to high consumption of tobacco smoking. Tobacco use is a leading preventable cause of premature mortality and morbidity.. Previous studies described the detrimental effects of tobacco smoking on liver function. Objectives: To observe the effects of tobacco consumption on the levels of serum alanine aminotransferase and alkaline phosphatase levels in smokers. Methods: The cross-sectional analytical study was conducted from January 2017 to January 2018 in the department of physiology, Rangpur Medical College, Rangpur. A total number of 60 subjects were selected, among them 30 were apparently healthy non-tobacco chewer non-smoker subjects as control group ( group A) and 30 were apparently healthy smoker non-tobacco chewer subjects ( group B). The subjects were selected from different area of Rangpur city. The effects of cigarette smoking on liver function were studied by measuring the levels of serum alanine aminotransferase and alkaline phosphatase levels. For statistical analysis independent sample “t” test was performed by computer based software SPSS-17.0 version for windows. Results: Serum alanine aminotransferase and alkaline phosphatase levels were significantly higher (p<0.001) in smoker non-tobacco chewer subjects as compared with the healthy control subjects. Conclusion: The increased serum alanine aminotransferase and alkaline phosphatase levels in smoker non-tobacco chewer subjects were evidence of development of liver function impairment due to tobacco smoking and this might offer a new preventive approach to liver function impairment in population with tobacco smoking. J Rang Med Col. March 2023; Vol. 8, No. 1:65-68
背景:近几十年来，全球烟草使用显著增加。容易获得和价格低廉导致了吸烟的高消费。烟草使用是导致过早死亡和发病的一个可预防的主要原因。先前的研究描述了吸烟对肝功能的有害影响。目的:观察吸烟对吸烟者血清丙氨酸转氨酶和碱性磷酸酶水平的影响。方法:于2017年1月至2018年1月在Rangpur医学院生理学系进行横断面分析研究。共选取60例受试者，其中30例为明显健康非烟草咀嚼非吸烟受试者作为对照组(A组)，30例为明显健康吸烟者非烟草咀嚼非吸烟受试者(B组)。受试者分别来自Rangpur市不同地区。通过测定血清丙氨酸转氨酶和碱性磷酸酶水平，研究吸烟对肝功能的影响。统计分析采用SPSS-17.0软件进行独立样本“t”检验。结果:吸烟者、非咀嚼者血清丙氨酸转氨酶和碱性磷酸酶水平显著高于健康对照组(p<0.001)。结论:吸烟非咀嚼者血清丙氨酸转氨酶和碱性磷酸酶水平升高是吸烟导致肝功能损害的证据，可能为吸烟人群肝功能损害的预防提供新的途径。J Rang Med Col. 2023年3月;第8卷第1章65-68节
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Pub Date : 2023-04-04DOI: 10.3329/jrpmc.v8i1.64967
Shahed Jahan
Abstract not available J Rang Med Col. September 2023; Vol. 8, No. 1:1-2
[摘要]不可用[J];第八卷，第1:1-2号
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Background: Successful treatment in patients with hypothyroidism depends on adequate knowledge, a positive attitude, and appropriate practices. Deficiency in any domain may lead to the persistence of symptoms, difficulty issues in pregnancy, as well as adverse effects on offspring in female patients. Objective: To evaluate the knowledge, attitude, and practice (KAP) of reproductive-aged adult (18 – 45 years) females with hypothyroidism and their associations with current treatment status. Methods: This cross-sectional questionnaire-based KAP survey was done at seven places across Bangladesh in government hospitals and private chambers among 393 hypothyroid patients [age: 30.0 (25.0-36.0), years, median (IQR)]. Adult females who could read and understand the Bangla language were included. Patients with known dementia, illiterate, severely ill, and unwilling to participate were excluded. The knowledge domain consisted of ten single-best multiple-choice questions (MCQs: 3-4 choices). The attitude domain had five statements with a five-point Likert scale ranging from strongly agree to strongly disagree. The practice domain had also ten single best MCQs (3-5 choices) to assess the patients’ most common practice behaviors. The questionnaire was supplied to each patient and advised to put a tick mark at the appropriate option. Patients’ treatment status was considered by current serum TSH levels (0.4 – 4.0 mIU/mL). Results: The percent of over-replacement, appropriate replacement, and under-replacement was around 12%, 47%, and 41% of the study population respectively. Around 39% had good knowledge, 78% were highly concerned about thyroid disorders, and only 22% were highly cautious about their practice. Age and educational status might be associated with all three domains. Conclusions: More than half of the reproductive-aged adult females’ treatment status was inappropriate. Discrepancies among the three domains might be associated with the age and knowledge status of the participants. The study findings will help clinicians to manage patients with hypothyroidism more efficiently. J Rang Med Col. March 2023; Vol. 8, No. 2:11-19
背景:甲状腺功能减退症患者的成功治疗取决于充分的知识，积极的态度和适当的做法。任何领域的缺乏都可能导致症状持续存在，妊娠困难问题，以及对女性患者后代的不利影响。目的:了解育龄女性(18 ~ 45岁)甲状腺功能减退症患者的知识、态度和行为(KAP)及其与治疗现状的关系。方法:在孟加拉国7个地方的政府医院和私人病房对393名甲状腺功能减退患者进行了横断面问卷调查[年龄:30.0(25.0-36.0)，年龄，中位数(IQR)]。能够阅读和理解孟加拉语的成年女性也包括在内。已知痴呆患者、文盲、重症患者和不愿参与的患者被排除在外。知识领域包括10个单最佳选择题(mcq: 3-4个选择题)。态度领域有五个陈述，用李克特五点量表从非常同意到非常不同意。实践领域也有10个单一的最佳mcq(3-5个选择)来评估患者最常见的实践行为。问卷发给每位患者，并建议在适当的选项上打勾。通过当前血清TSH水平(0.4 - 4.0 mIU/mL)来考虑患者的治疗状态。结果:过度替代、适当替代和不足替代的比例分别约为12%、47%和41%。约39%的人有良好的知识，78%的人高度关注甲状腺疾病，只有22%的人对他们的做法非常谨慎。年龄和教育程度可能与这三个领域有关。结论:半数以上育龄成年女性的治疗状况不恰当。三个领域之间的差异可能与参与者的年龄和知识状况有关。该研究结果将有助于临床医生更有效地管理甲状腺功能减退症患者。J Rang Med Col. 2023年3月;第八卷2:11-19
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