Pub Date : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62648
Md. Shakhawat Hossain, Md Mahfuj Ul Anwar, -. Maknunnahar, Md Abdul Motin, Md Shafiul Alam, J. Hossain, Md. Naushad Ali, A. Rana
Eating disorders are common and frequently missed behavioral disorders associated with significant physical, mental and social morbidity and mortality. Among psychiatric illness, mortality rate of anorexia nervosa and bulimia nervosa is about 10% and 1% at 10 years of diagnosis respectively. All clinicians should ask about eating habits (such as dieting, binge-eating, and weight control behaviors etc) and weight concerns in high risk groups, even when they have no concerns about eating or weight. The DSM-5 and ICD-11 list 6 distinct eating disorders: 1) Anorexia nervosa, 2) Bulimia nervosa, 3) Binge-eating disorder (BED), 4) Avoidant/restrictive food intake disorder (ARFID), 5) Rumination disorder and 6) Pica. Since the incidence of eating disordered patients in appears to be rising, it is a time demanding issue to deliver multidisciplinary treatment for them. As eating disorders frequently involve multi-system disorders such as gastrointestinal, neurological and endocrine, early screening and assessment of patients with eating disorders is essential. Treatments for eating disorders depend on its types and focus on behavioral change, targeting normalizes the weight and eating habits. Depending on the severity of malnutrition and associated medical conditions, eating disorders may be treated with patient education , cognitive behavioral therapy (CBT), family-based treatment (FBT), specialist supportive clinical management (SSCM) and Pharmacotherapy (TCAs, MAOIs, and SSRIs). J Rang Med Col. September 2022; Vol. 7, No. 2:63-68
饮食失调是一种常见的、经常被忽视的行为障碍,与显著的身体、精神和社会发病率和死亡率有关。在精神疾病中,神经性厌食症和神经性贪食症在诊断后10年的死亡率分别约为10%和1%。所有临床医生都应该询问高危人群的饮食习惯(如节食、暴饮暴食和体重控制行为等)和体重问题,即使他们对饮食或体重没有任何担忧。DSM-5和ICD-11列出了6种不同的饮食障碍:1)神经性厌食症,2)神经性贪食症,3)暴饮暴食症(BED), 4)回避/限制性食物摄入障碍(ARFID), 5)反刍障碍和6)异食癖。由于饮食失调患者的发病率似乎在上升,这是一个迫切需要为他们提供多学科治疗的问题。由于进食障碍经常涉及胃肠道、神经系统和内分泌等多系统疾病,因此对进食障碍患者进行早期筛查和评估至关重要。饮食失调的治疗取决于它的类型,并侧重于行为改变,目标是使体重和饮食习惯正常化。根据营养不良的严重程度和相关的医疗条件,饮食失调可以通过患者教育、认知行为疗法(CBT)、基于家庭的治疗(FBT)、专家支持性临床管理(SSCM)和药物治疗(TCAs、MAOIs和SSRIs)来治疗。J Rang Med Col. 2022年9月;第七卷,第2章63-68节
{"title":"Eating Disorders: Reviews on Update in Diagnosis and Management","authors":"Md. Shakhawat Hossain, Md Mahfuj Ul Anwar, -. Maknunnahar, Md Abdul Motin, Md Shafiul Alam, J. Hossain, Md. Naushad Ali, A. Rana","doi":"10.3329/jrpmc.v7i2.62648","DOIUrl":"https://doi.org/10.3329/jrpmc.v7i2.62648","url":null,"abstract":"Eating disorders are common and frequently missed behavioral disorders associated with significant physical, mental and social morbidity and mortality. Among psychiatric illness, mortality rate of anorexia nervosa and bulimia nervosa is about 10% and 1% at 10 years of diagnosis respectively. All clinicians should ask about eating habits (such as dieting, binge-eating, and weight control behaviors etc) and weight concerns in high risk groups, even when they have no concerns about eating or weight. The DSM-5 and ICD-11 list 6 distinct eating disorders: 1) Anorexia nervosa, 2) Bulimia nervosa, 3) Binge-eating disorder (BED), 4) Avoidant/restrictive food intake disorder (ARFID), 5) Rumination disorder and 6) Pica. Since the incidence of eating disordered patients in appears to be rising, it is a time demanding issue to deliver multidisciplinary treatment for them. As eating disorders frequently involve multi-system disorders such as gastrointestinal, neurological and endocrine, early screening and assessment of patients with eating disorders is essential. Treatments for eating disorders depend on its types and focus on behavioral change, targeting normalizes the weight and eating habits. Depending on the severity of malnutrition and associated medical conditions, eating disorders may be treated with patient education , cognitive behavioral therapy (CBT), family-based treatment (FBT), specialist supportive clinical management (SSCM) and Pharmacotherapy (TCAs, MAOIs, and SSRIs). \u0000J Rang Med Col. September 2022; Vol. 7, No. 2:63-68","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128385444","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 : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62636
Safina Akhter, C. Sarkar, Atm Zoadur Rahim Zahid, Neaz Ahmed
Background: The World Health Organization has announced overweight and obesity as a global epidemic that has strong associations with renal function impairment. Objectives: To evaluate the serum creatinine and urea status in adult female individuals with previous normal renal function and to observe the correlation of serum creatinine and urea with body mass index (BMI). Methods: This cross-sectional analytical study was conducted in the Department of Physiology, Rangpur Medical College, Rangpur. After briefing about the objectives, adult female subjects who met the inclusion and exclusion criteria were enrolled in the study with permission. The study included 90 subjects who were divided into three groups- apparently healthy adult females with normal weight (Group-A), apparently healthy overweight adult females (Group-B), and apparently healthy obese adult females (Group-C). The subjects were selected from different areas of Rangpur city. Their body mass index, serum creatinine, and urea were measured. For statistical analysis, one way ANOVA (post-Hoc) test and Pearson’s correlation coefficient test were performed as applicable by computer-based SPSS-25.0 for windows. Regarding the interpretation of results, p_0.05 was accepted as significant. Results: The mean serum creatinine level was significantly (p_0.001) higher in overweight and obese female adults than in normal-weight female adults. It was also significantly (p_0.05) higher in obese female adults than in overweight female adults. Again, the mean serum urea level was significantly (p_0.05) higher in overweight female adults than normal-weight female adults and in obese female adults than in overweight female adults. It was also significantly (p_0.001) higher in obese female adults than in normal-weight female adults. This study also found highly significant (p_0.001) positive correlation of serum creatinine (r=0.499) and urea (r=0.396) with body mass index. Conclusion: Serum creatinine and urea were elevated in overweight and obese female adults and both parameters were positively correlated with BMI. Regular body mass index screening is recommended to assess body weight easily and effectively. J Rang Med Col. September 2022; Vol. 7, No. 2:25-30
背景:世界卫生组织宣布超重和肥胖是一种与肾功能损害密切相关的全球性流行病。目的:评价既往肾功能正常的成年女性血清肌酐和尿素水平,并观察血清肌酐和尿素水平与体重指数(BMI)的相关性。方法:横断面分析研究在Rangpur医学院生理学系进行。在简要介绍了研究目的后,经许可,符合纳入和排除标准的成年女性受试者被纳入研究。该研究包括90名受试者,他们被分为三组——体重正常的明显健康成年女性(a组)、明显健康超重的成年女性(b组)和明显健康肥胖的成年女性(c组)。研究对象选自Rangpur市的不同地区。测定他们的体重指数、血清肌酐和尿素。统计分析采用单因素方差分析(post-Hoc)检验和Pearson相关系数检验,适用计算机软件SPSS-25.0 For windows。对于结果的解释,接受p_0.05为显著性。结果:超重和肥胖成年女性的平均血清肌酐水平明显高于正常体重的成年女性(p_0.001)。肥胖的成年女性比超重的成年女性高(p_0.05)。同样,超重女性成年人的平均血清尿素水平显著高于正常体重女性成年人,肥胖女性成年人的平均血清尿素水平显著高于超重女性成年人。肥胖的成年女性也显著高于正常体重的成年女性(p_0.001)。血清肌酐(r=0.499)和尿素(r=0.396)与体重指数呈极显著正相关(p_0.001)。结论:超重和肥胖成年女性血清肌酐和尿素升高,且两者与BMI呈正相关。建议定期进行身体质量指数筛查,以方便有效地评估体重。J Rang Med Col. 2022年9月;第七卷2:25-30
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Pub Date : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62640
Sarowat Hossain, S. Alam, Mahabubul Islam, Shahgahan Miah, Md. Abu Hanifa, Z. H. Sarker, Taslim Fatema, Munira Begum, Labib Hasan
Background: Community clinics (CC) have been restarted in 2009 by the government of Bangladesh through a project called “Revitalization of Community Health Care Initiatives in Bangladesh” (RCHCIB) to accomplish the ambitious project of establishing 18,000 community clinics. Since then 10,723 Community clinics have been established and they provide free health and family planning services to rural people (for every 6000 population one CC). Objective: The study aimed to assess the prevalence of access and utilization of services provided through community clinics by rural people. Methods: This cross-sectional descriptive study was conducted in Palashbari, Gaibandha district from 15th March 2019 to 20th April 2019. 568 respondents were selected conveniently from the catchment area of 6 community clinics (CCs). Data were collected by face-to-face interviews with a pretested structured questionnaire. Results: Among 568 respondents, majority ware in the age group of 31-50 years (45.4%),female (83%) and housewives (76.8%).93.5% of the respondents visited community clinics. And 85.6% were benefited from the community clinic service. Maternal and child health service utilization was poor (pregnancy registration 27.6%, ANC and PNC 45.2%, family planning services 49.3%) and there is no normal delivery service in the community clinic. 66.2% of the respondents availed EPI Services, 45.8% received Health Education, 65.3% received Vitamin-A Supplementation, 59.9% availed Child Care Services, 71.7% received Treatment of Minor Illness and Diseases, 17.4% availed Referral Services. Conclusion: The CCs are well located in terms of access. According to the Respondents' services provided by the community, the clinic was average. Maternal and child health services, pregnancy, and birth registration were below the mark. There is no normal delivery service and according to the respondent’s opinion referral system was also poor. J Rang Med Col. September 2022; Vol. 7, No. 2:20-24
背景:社区诊所(CC)重启2009年孟加拉政府通过一个项目叫做“振兴社区卫生保健计划在孟加拉国“(RCHCIB)完成建立18000个社区诊所的雄心勃勃的计划。自那时以来,建立了10,723个社区诊所,向农村人口提供免费保健和计划生育服务(每6,000人有一个社区诊所)。目的:本研究旨在评估农村人口通过社区诊所获得和利用服务的流行程度。方法:本横断面描述性研究于2019年3月15日至2019年4月20日在Gaibandha地区Palashbari进行。从6个社区诊所的集水区方便地选择了568名受访者。数据通过面对面访谈和预先测试的结构化问卷收集。结果:568名调查对象中,以31 ~ 50岁年龄组(45.4%)居多,女性(83%)和家庭主妇(76.8%)居多,93.5%的调查对象到社区诊所就诊。85.6%的人受益于社区诊所服务。妇幼保健服务利用率低(妊娠登记27.6%,产前和产前检查45.2%,计划生育服务49.3%),社区诊所没有正常的分娩服务。66.2%的受访者接受了扩大免疫服务,45.8%接受了健康教育,65.3%接受了维生素a补充,59.9%接受了儿童保育服务,71.7%接受了小病治疗,17.4%接受了转诊服务。结论:cc在可及性方面定位良好。从被调查者获得的社区服务来看,诊所的服务水平一般。妇幼保健服务、怀孕和出生登记均低于标准。没有正常的快递服务,而且根据被调查者的意见转诊系统也很差。J Rang Med Col. 2022年9月;第七卷2:20-24
{"title":"Services Provided Through Community Clinic: Access and Utilization by Rural People","authors":"Sarowat Hossain, S. Alam, Mahabubul Islam, Shahgahan Miah, Md. Abu Hanifa, Z. H. Sarker, Taslim Fatema, Munira Begum, Labib Hasan","doi":"10.3329/jrpmc.v7i2.62640","DOIUrl":"https://doi.org/10.3329/jrpmc.v7i2.62640","url":null,"abstract":"Background: Community clinics (CC) have been restarted in 2009 by the government of Bangladesh through a project called “Revitalization of Community Health Care Initiatives in Bangladesh” (RCHCIB) to accomplish the ambitious project of establishing 18,000 community clinics. Since then 10,723 Community clinics have been established and they provide free health and family planning services to rural people (for every 6000 population one CC). \u0000Objective: The study aimed to assess the prevalence of access and utilization of services provided through community clinics by rural people. \u0000Methods: This cross-sectional descriptive study was conducted in Palashbari, Gaibandha district from 15th March 2019 to 20th April 2019. 568 respondents were selected conveniently from the catchment area of 6 community clinics (CCs). Data were collected by face-to-face interviews with a pretested structured questionnaire. \u0000Results: Among 568 respondents, majority ware in the age group of 31-50 years (45.4%),female (83%) and housewives (76.8%).93.5% of the respondents visited community clinics. And 85.6% were benefited from the community clinic service. Maternal and child health service utilization was poor (pregnancy registration 27.6%, ANC and PNC 45.2%, family planning services 49.3%) and there is no normal delivery service in the community clinic. 66.2% of the respondents availed EPI Services, 45.8% received Health Education, 65.3% received Vitamin-A Supplementation, 59.9% availed Child Care Services, 71.7% received Treatment of Minor Illness and Diseases, 17.4% availed Referral Services. \u0000Conclusion: The CCs are well located in terms of access. According to the Respondents' services provided by the community, the clinic was average. Maternal and child health services, pregnancy, and birth registration were below the mark. There is no normal delivery service and according to the respondent’s opinion referral system was also poor. \u0000J Rang Med Col. September 2022; Vol. 7, No. 2:20-24","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114688990","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 : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62642
Tasnim Sarwar, Tamanna Hamid
Background: Maternal obesity is associated with various antepartum, intrapartum, postpartum, and neonatal complications. Increasing rates of overweight among pregnant women become a significant public health concern with various implications for prenatal care and supervision of delivery. Objective: The study aimed to determine the adverse maternal and fetal outcomes in primigravid overweight and obese women delivering singleton babies. Methods: A prospective comparative study was conducted for one year at the Department of Obstetrics and Gynecology, Combined Military Hospital, Rangpur, during the period between July 2019 to June 2020. Primigravid women with a singleton uncomplicated pregnancy with a cephalic presentation at _37 weeks of gestation with accurate information regarding height and weight recorded at the booking visit were included in the study. Comparisons were made between 50 primigravidas with BMI _25 and 50 uncomplicated primigravidas with BMI between 18.5 - 24.99. Statistical analysis was done using SPSS version 16.0. Data were analyzed by the Pearson Chi-square test and Fisher’s exact test. Results: There was a significant increase in risk of developing gestational hypertension (RR=3.667; CI=1.63-8.27), preeclampsia (RR=7; CI=0.89- 54.83), gestational diabetes (RR=7; CI=0.89-54.83), failed induction of labour (RR=5.50; CI=1.28-23.55), failure to progress (R=6, CI= 1.41-25.44), macrosomia (RR=8, CI=1.04-61.62), NICU admissions (RR=2.45; CI=1.37-4.39), perineal lacerations (RR=7; CI=0.89-54.83), wound infection (RR=8;CI=1.04-61.62) among overweight mothers compared to non-obese mothers. Conclusions: It is concluded that obesity defined by Asian Indian guidelines (BMI _25 kg/m2) is associated with adverse maternal and fetal outcomes. J Rang Med Col. September 2022; Vol. 7, No. 2:31-34
{"title":"A Comparative Study of the Effect of Body Mass Index on Pregnancy Outcomes in Normal and Overweight Women","authors":"Tasnim Sarwar, Tamanna Hamid","doi":"10.3329/jrpmc.v7i2.62642","DOIUrl":"https://doi.org/10.3329/jrpmc.v7i2.62642","url":null,"abstract":"Background: Maternal obesity is associated with various antepartum, intrapartum, postpartum, and neonatal complications. Increasing rates of overweight among pregnant women become a significant public health concern with various implications for prenatal care and supervision of delivery. \u0000Objective: The study aimed to determine the adverse maternal and fetal outcomes in primigravid overweight and obese women delivering singleton babies. \u0000Methods: A prospective comparative study was conducted for one year at the Department of Obstetrics and Gynecology, Combined Military Hospital, Rangpur, during the period between July 2019 to June 2020. Primigravid women with a singleton uncomplicated pregnancy with a cephalic presentation at _37 weeks of gestation with accurate information regarding height and weight recorded at the booking visit were included in the study. Comparisons were made between 50 primigravidas with BMI _25 and 50 uncomplicated primigravidas with BMI between 18.5 - 24.99. Statistical analysis was done using SPSS version 16.0. Data were analyzed by the Pearson Chi-square test and Fisher’s exact test. \u0000Results: There was a significant increase in risk of developing gestational hypertension (RR=3.667; CI=1.63-8.27), preeclampsia (RR=7; CI=0.89- 54.83), gestational diabetes (RR=7; CI=0.89-54.83), failed induction of labour (RR=5.50; CI=1.28-23.55), failure to progress (R=6, CI= 1.41-25.44), macrosomia (RR=8, CI=1.04-61.62), NICU admissions (RR=2.45; CI=1.37-4.39), perineal lacerations (RR=7; CI=0.89-54.83), wound infection (RR=8;CI=1.04-61.62) among overweight mothers compared to non-obese mothers. \u0000Conclusions: It is concluded that obesity defined by Asian Indian guidelines (BMI _25 kg/m2) is associated with adverse maternal and fetal outcomes. \u0000J Rang Med Col. September 2022; Vol. 7, No. 2:31-34","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125373253","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 : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62646
Md. Shahin Shah, Md Abdul Hamid, Md Hamidul Islam
Background: The scalp is a unique part of the human body and various etiological factors, such as tumor extirpation, avulsion, infection, burns, or trauma, can lead to scalp defects. Primary closure, skin grafting, local flaps, tissue expansion or free tissue transfer is modalities available for scalp reconstruction. Local flap coverage is best option for full thickness loss with exposed bone. Among various local flap transposition flap is reasonable and flexible option with good outcome for scalp reconstruction. Objective: The purpose of this study was to evaluate the geometric design of transposition flap for scalp reconstruction concerning the dimension of the defect and outcome the surgery. Methods: This was a prospective observational study, conducted in the Burn & Plastic Surgery department of Rangpur medical college hospital, Rangpur and different private hospitals of Rangpur city over a period of three years from June 2018 to July 2021 through purposive sampling. All aged patients having single full thickness scalp wound with loss of pericranium were included in this study. In all cases transposition flaps were used. All the flaps were elevated through sub galeal lose areolar plane. Flap donor site was covered with split thickness skin graft taken from thigh. Surgical technique, patient factors and outcome were evaluated. Results: A total 50 patients were operated. The age range was 07-68 years, among them 36% patient were in the age range of 21 – 30 years. 80% patients in this series were male. In this series 64 % patients were construction and electric worker by profession. Electric burn was the main (64%) cause of soft tissue defect of scalp. The majority (46%) of the patients had a wound dimension of 51-70 cm2, smallest was (5x6) = 30cm2 and largest was (9x15) = 135cm2, indicating that extent of soft tissue defects in this series is quite extensive. 12 (24%) patients had complication and all were due to infection, seven patients had infection in flap recipient site, 2 patients had infection in flap donor site and 3 patients developed infection in skin donor site. There was no flap loss in our study. Conclusion: Sound knowledge of flap geometry and clear evaluation of the defect is mandatory for successful reconstruction of scalp defect. A local transposition flap with donor site skin grafting is reliable option for reconstruction of full thickness scalp defect in most instances. J Rang Med Col. September 2022; Vol. 7, No. 2:52-57
背景:头皮是人体的一个独特部位,各种病因,如肿瘤切除、撕脱、感染、烧伤或创伤等,都可能导致头皮缺损。初级闭合、皮肤移植、局部皮瓣、组织扩张或自由组织转移是头皮重建的可行方式。局部皮瓣覆盖是全层骨缺损的最佳选择。在各种局部皮瓣中,转位皮瓣是头皮重建中合理、灵活、效果好的选择。目的:探讨调换皮瓣的几何设计对头皮缺损尺寸及手术效果的影响。方法:采用前瞻性观察研究方法,于2018年6月至2021年7月3年间,在Rangpur医学院附属医院烧伤整形外科、Rangpur市各私立医院进行有目的抽样。本研究纳入了所有单发全层头皮创面伴包皮丢失的老年患者。所有病例均采用转位皮瓣。所有皮瓣均通过galal下失乳平面升高。皮瓣供区覆盖大腿厚皮片。评估手术技术、患者因素及预后。结果:共手术50例。年龄范围为07-68岁,其中21 - 30岁占36%。本研究中80%的患者为男性。本组病例中,64%的患者职业为建筑和电气工人。电烧伤是头皮软组织缺损的主要原因(64%)。绝大多数(46%)患者创面尺寸为51 ~ 70 cm2,最小的为(5x6) = 30cm2,最大的为(9x15) = 135cm2,说明该系列患者软组织缺损程度相当广泛。术后并发症12例(24%),均为感染所致,皮瓣受区感染7例,皮瓣供区感染2例,皮肤供区感染3例。本研究未见皮瓣丢失。结论:良好的皮瓣几何知识和对缺损的清晰评价是成功重建头皮缺损的必要条件。在大多数情况下,局部转位皮瓣与供区皮肤移植是重建全层头皮缺损的可靠选择。J Rang Med Col. 2022年9月;第七卷,第2章52-57节
{"title":"Geometric Design and Outcome of Transposition Flaps for Scalp Reconstruction","authors":"Md. Shahin Shah, Md Abdul Hamid, Md Hamidul Islam","doi":"10.3329/jrpmc.v7i2.62646","DOIUrl":"https://doi.org/10.3329/jrpmc.v7i2.62646","url":null,"abstract":"Background: The scalp is a unique part of the human body and various etiological factors, such as tumor extirpation, avulsion, infection, burns, or trauma, can lead to scalp defects. Primary closure, skin grafting, local flaps, tissue expansion or free tissue transfer is modalities available for scalp reconstruction. Local flap coverage is best option for full thickness loss with exposed bone. Among various local flap transposition flap is reasonable and flexible option with good outcome for scalp reconstruction. \u0000Objective: The purpose of this study was to evaluate the geometric design of transposition flap for scalp reconstruction concerning the dimension of the defect and outcome the surgery. \u0000Methods: This was a prospective observational study, conducted in the Burn & Plastic Surgery department of Rangpur medical college hospital, Rangpur and different private hospitals of Rangpur city over a period of three years from June 2018 to July 2021 through purposive sampling. All aged patients having single full thickness scalp wound with loss of pericranium were included in this study. In all cases transposition flaps were used. All the flaps were elevated through sub galeal lose areolar plane. Flap donor site was covered with split thickness skin graft taken from thigh. Surgical technique, patient factors and outcome were evaluated. \u0000Results: A total 50 patients were operated. The age range was 07-68 years, among them 36% patient were in the age range of 21 – 30 years. 80% patients in this series were male. In this series 64 % patients were construction and electric worker by profession. Electric burn was the main (64%) cause of soft tissue defect of scalp. The majority (46%) of the patients had a wound dimension of 51-70 cm2, smallest was (5x6) = 30cm2 and largest was (9x15) = 135cm2, indicating that extent of soft tissue defects in this series is quite extensive. 12 (24%) patients had complication and all were due to infection, seven patients had infection in flap recipient site, 2 patients had infection in flap donor site and 3 patients developed infection in skin donor site. There was no flap loss in our study. \u0000Conclusion: Sound knowledge of flap geometry and clear evaluation of the defect is mandatory for successful reconstruction of scalp defect. A local transposition flap with donor site skin grafting is reliable option for reconstruction of full thickness scalp defect in most instances. \u0000J Rang Med Col. September 2022; Vol. 7, No. 2:52-57","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116411015","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 : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62644
Md. Mizanur Rahman, Md Mufakh Kharul Islam, M. K. Hossain, A. Mamun, N. Khan, Md Shafiqul Islam
Background: Primary open-angle glaucoma (POAG) and atherosclerosis both are fairly common diseases among elderly persons, any adverse changes in serum lipids as a result of glaucoma therapy can increase the risk of coronary heart disease many folds. As topical beta blockers are also widely used and often the first line therapy in many patients requiring treatment for glaucoma for a long time, there is also a possible risk that _-blockers such as timolol adversely affect serum lipid profiles. Objective: The study aimed to evaluate the effect of topical timolol on serum lipid profiles. Methods: This cross-sectional observational study was performed in the department of ophthalmology, Bangabandhu Sheikh Mujib Medical University With convenience type of sampling technique 40 patients with newly diagnosed cases of primary open-angle glaucoma were selected. Baseline fasting lipid profiles were estimated and then timolol maleate 0.5%, 1 drop 12 hourly in both eyes were prescribed. At follow-up after 4 and 12 weeks, again fasting lipid profiles were estimated of the same patients. Results: In this study the baseline mean TC, HDL, LDL & TG were 175.4±19.28 , 46.63±5.33, 104.98±18.49,120.48±28.30 (mg/dl±SD) respectively. Baseline TC/HDL was 3.81±0.06. At follow up after 4 weeks there were increased level of TC, LDL,TG, TC/HDL by 0.45% (P=0.822), 0.8% (P=0.807) 1.82%(P=0.375), and 3.14%(P=0.307) respectively and HDL level decreased by 2.68%(P=0.232). At follow-up, after 12 weeks in comparison to baseline lipid levels, there was an increased level of TC, LDL, TG, and TC/HDL by 0.98% (P=0.959), 3% (P=0.996), 2.8% (P=0.104), and 17.0%(P=0.001) respectively and HDL level decreased by 13.61%(P=0.001). Conclusion: Topical timolol significantly lowers the plasma HDL level. Since the low level of HDL is strongly associated with an increased risk of myocardial infarction, our study cautions against the use of timolol in patients with a previous history of coronary heart disease. J Rang Med Col. September 2022; Vol. 7, No. 2:40-46
背景:原发性开角型青光眼(POAG)和动脉粥样硬化都是老年人相当常见的疾病,青光眼治疗引起的任何血脂的不良变化都可使冠心病的风险增加数倍。由于局部-受体阻滞剂也被广泛使用,并且经常是许多需要长期治疗青光眼的患者的一线治疗,也可能存在-受体阻滞剂如噻莫洛尔对血脂谱不利的风险。目的:探讨局部应用噻洛尔对大鼠血脂的影响。方法:本横断面观察研究在孟加拉班班杜谢赫穆吉布医科大学眼科进行,采用方便式抽样技术选择40例新诊断的原发性开角型青光眼患者。估计基线空腹血脂,然后开0.5%马来酸替洛尔,双眼每12小时滴1滴。在4周和12周后的随访中,再次对相同患者的空腹脂质谱进行估计。结果:基线平均TC、HDL、LDL、TG分别为175.4±19.28、46.63±5.33、104.98±18.49、120.48±28.30 (mg/dl±SD)。基线TC/HDL为3.81±0.06。随访4周时,TC、LDL、TG、TC/HDL分别升高0.45% (P=0.822)、0.8% (P=0.807)、1.82%(P=0.375)、3.14%(P=0.307), HDL下降2.68%(P=0.232)。随访12周后,与基线脂质水平相比,TC、LDL、TG和TC/HDL水平分别上升0.98% (P=0.959)、3% (P=0.996)、2.8% (P=0.104)和17.0%(P=0.001), HDL水平下降13.61%(P=0.001)。结论:局部使用噻洛尔可显著降低血浆HDL水平。由于低水平的HDL与心肌梗死的风险增加密切相关,我们的研究警告有冠心病病史的患者不要使用替马洛尔。J Rang Med Col. 2022年9月;第七卷2:40-46
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Background: Arm span is one of the most reliable body parameters for predicting the stature of an individual. It is useful in an age-related loss in stature and in identifying individuals with disproportionate growth abnormalities and skeletal dysplasia. Objectives: The present study was undertaken to determine whether there is any correlation between stature and arm span and estimate stature from arm span by using multiplication factor and assess the effectiveness of the above estimation by comparing the ‘estimated’ values with the measured values. Methods: This is a cross-sectional analytical study done in the Department of Anatomy, Rangpur Medical College, Rangpur, from January to December 2018 on purposively selected 700 medical students (350 male and 350 female). Arm span along with their stature was measured directly from the subjects by using an anthropometric technique by a measuring tape. Multiplication factors were estimated for estimating stature and comparison were made between measured and estimated stature using paired “t” test. Results: The mean normal value of arm span was 170.48±7.38 cm in males and 156.13±5.98 cm in females and the stature was 168.93±0.06 cm in males and 156.23±0.05 cm in females. The multiplication factor was estimated for the same hand measurements with the stature. A significant positive correlation was found in the case of arm span with stature. Conclusion: Arm span is a valid measure of stature for both adult males and females. J Rang Med Col. September 2022; Vol. 7, No. 2:47-51
背景:臂展是预测个体身高最可靠的身体参数之一。它在年龄相关的身材下降和识别不成比例的生长异常和骨骼发育不良的个体是有用的。目的:研究身高与臂幅之间是否存在相关关系,利用乘数因子对身高进行估算,并将估算值与实测值进行比较,评价估算值的有效性。方法:本研究是2018年1 - 12月在Rangpur医学院解剖学系进行的横断面分析研究,有针对性地选择了700名医科学生(男350名,女350名)。臂展和身高是用人体测量学技术用卷尺直接测量的。估算身高的乘法因子,用配对“t”检验比较实测身高与估算身高。结果:男性臂展平均值为170.48±7.38 cm,女性为156.13±5.98 cm;男性身高平均值为168.93±0.06 cm,女性为156.23±0.05 cm。对于同样的手部测量和身高,乘法系数是估算出来的。臂幅与身高呈显著正相关。结论:臂展是衡量成年男性和女性身高的有效指标。J Rang Med Col. 2022年9月;第七卷第2章47-51节
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Pub Date : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62639
Md Hamidul Islam, Minim Parvin Mishu, Nusrat Afroze, M. Mahmud, Md Shariful Islam, Md. Shahin Shah
Background: Surgical site infections (SSIs) is a major problem in both developed and developing countries. In developing countries like Bangladesh, infection in surgical patients has been appearing as a serious risk due to insurgence of drug resistance. Surgical site infections (SSIs) contribute significantly to increased health care costs in terms of prolonged hospital stay and lost working days. The problem was largely unexplored in Rangpur Medical College and Hospital, Rangpur. Objective: The aim of the study was to evaluate the bacteriological study on surgical site infections in Rangpur Medical College & Hospital. Methods: This cross-sectional observational study was conducted in the Department of Surgery at Rangpur Medical College Hospital. 72 patients of all ages, sex who developed surgical site infection were included through purposive sampling for observation and clinical follow up and wound swab was microbiologically evaluated. Results: Of the 72 cases, SSI developed 30.6% (22) following elective surgery and 69.4% (50) following emergency surgery. 7 cases were associated with co-morbid conditions like diabetes mellitus (2), malignancy (4) and tuberculosis (1). Most common organisms were Escherichia coli (30 /54) followed by Staphylococcous aureus (14/54), Pseudomonas (07/54) and Klebsiella (03/54).The antibiogram pattern of the organism isolated from wound swab of SSIs were analyzed with commonly used antibiotics. Resistance of Escherichia coli to Amoxycillin, Cotrimoxazole, Doxycycline and Nalidixic acid were 100%, 91.5%, 71.4% and 60.5% respectively. In case of, Staphylococcus aureus 87.5% were resistant to penicillin and Cotrimoxazole. Resistance of Pseudomonas spp. to Ciprofloxacin, Ceftazidime and Gentamicin were 31.2%. 6.3% and 50% respectively. In case of Klebsiella spp, it showed that 100% strains were resistant to Amoxycillin like Esch. coli but all strains were sensitive to both Ceftriaxon and Imipenem. Conclusion: The study emphasizes the need for the evidence-based infection control and antibiotic prescription policies in the hospital. J Rang Med Col. September 2022; Vol. 7, No. 2:12-19
背景:手术部位感染(ssi)是发达国家和发展中国家的一个主要问题。在孟加拉国等发展中国家,由于耐药性的增加,手术患者的感染已经成为一个严重的风险。手术部位感染(ssi)在延长住院时间和损失工作日方面大大增加了医疗保健费用。这个问题在Rangpur的Rangpur医学院和医院基本上没有被研究过。目的:对兰浦尔医学院外科手术部位感染的细菌学研究进行评价。方法:本研究采用横断面观察方法,在Rangpur医学院附属医院外科进行,通过目的取样观察和临床随访,收集72例不同年龄、性别的手术部位感染患者,并对伤口拭子进行微生物学评价。结果:72例SSI患者中,30.6%(22例)在择期手术后发生,69.4%(50例)在急诊手术后发生。7例合并糖尿病(2例)、恶性肿瘤(4例)和结核病(1例)。最常见的病原菌为大肠杆菌(30 /54),其次为金黄色葡萄球菌(14/54)、假单胞菌(07/54)和克雷伯菌(03/54)。用常用抗生素对伤口拭子分离的细菌进行抗菌谱分析。大肠杆菌对阿莫西林、复方新诺明、强力霉素和钠利地酸的耐药率分别为100%、91.5%、71.4%和60.5%。87.5%的金黄色葡萄球菌对青霉素和复方新诺明耐药。假单胞菌对环丙沙星、头孢他啶和庆大霉素的耐药率为31.2%。分别为6.3%和50%。以克雷伯氏菌为例,它显示100%的菌株像埃施一样对阿莫西林耐药。但所有菌株对头孢曲松和亚胺培南均敏感。结论:本研究强调了医院循证感染控制和抗生素处方政策的必要性。J Rang Med Col. 2022年9月;第七卷2:12-19
{"title":"Bacteriological Study on Surgical Site Infection in Rangpur Medical College and Hospital","authors":"Md Hamidul Islam, Minim Parvin Mishu, Nusrat Afroze, M. Mahmud, Md Shariful Islam, Md. Shahin Shah","doi":"10.3329/jrpmc.v7i2.62639","DOIUrl":"https://doi.org/10.3329/jrpmc.v7i2.62639","url":null,"abstract":"Background: Surgical site infections (SSIs) is a major problem in both developed and developing countries. In developing countries like Bangladesh, infection in surgical patients has been appearing as a serious risk due to insurgence of drug resistance. Surgical site infections (SSIs) contribute significantly to increased health care costs in terms of prolonged hospital stay and lost working days. The problem was largely unexplored in Rangpur Medical College and Hospital, Rangpur. \u0000Objective: The aim of the study was to evaluate the bacteriological study on surgical site infections in Rangpur Medical College & Hospital. \u0000Methods: This cross-sectional observational study was conducted in the Department of Surgery at Rangpur Medical College Hospital. 72 patients of all ages, sex who developed surgical site infection were included through purposive sampling for observation and clinical follow up and wound swab was microbiologically evaluated. \u0000Results: Of the 72 cases, SSI developed 30.6% (22) following elective surgery and 69.4% (50) following emergency surgery. 7 cases were associated with co-morbid conditions like diabetes mellitus (2), malignancy (4) and tuberculosis (1). Most common organisms were Escherichia coli (30 /54) followed by Staphylococcous aureus (14/54), Pseudomonas (07/54) and Klebsiella (03/54).The antibiogram pattern of the organism isolated from wound swab of SSIs were analyzed with commonly used antibiotics. Resistance of Escherichia coli to Amoxycillin, Cotrimoxazole, Doxycycline and Nalidixic acid were 100%, 91.5%, 71.4% and 60.5% respectively. In case of, Staphylococcus aureus 87.5% were resistant to penicillin and Cotrimoxazole. Resistance of Pseudomonas spp. to Ciprofloxacin, Ceftazidime and Gentamicin were 31.2%. 6.3% and 50% respectively. In case of Klebsiella spp, it showed that 100% strains were resistant to Amoxycillin like Esch. coli but all strains were sensitive to both Ceftriaxon and Imipenem. \u0000Conclusion: The study emphasizes the need for the evidence-based infection control and antibiotic prescription policies in the hospital. \u0000J Rang Med Col. September 2022; Vol. 7, No. 2:12-19","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116492955","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 : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62637
Shahed Jahan, SM Nurun Nabi
Abstract not available J Rang Med Col. September 2022; Vol. 7, No. 2:1-3
J Rang Med Col. 2022年9月;第七卷第2:1-3号
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Pub Date : 2022-11-03DOI: 10.3329/jrpmc.v7i2.62643
Asm Mazedul Islam, M. Muttalib, Md Nazrul Islam, M. Haque, Mohammad Rafiqul Hoque, -. Maknunnahar
Background: Non-alcoholic fatty liver disease (NAFLD) comprises a spectrum of liver diseases characterized by simple steatosis to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. It is the most common cause of cryptogenic cirrhosis. NAFLD is associated with obesity, insulin resistance, hypertension, type 2 diabetes mellitus, and dyslipidemia. Objective: The study aimed to assess the changes in lipid profile and aminotransferases (ALT and AST) in Non-alcoholic fatty liver disease (NAFLD). Methods: This observational cross-sectional study was carried out in the department of Biochemistry, Mymensingh Medical College in cooperation with the Centre for Nuclear Medicine and Ultrasound, Mymensingh from January 2012 to June 2013 after the approval of the protocol. A total of 120 subjects were included through purposive sampling, among them, 60 subjects were with fatty liver disease (group-I) and another 60 were without fatty liver (group-II) with ultrasonography. The sampling method was purposive (non-random). Relevant laboratory investigations were performed by using established methods to achieve the objectives. Results: The majority of the subjects with NAFLD (33.33%) were in 51-60 years (in Group-I). Mean serum total cholesterol, triacylglycerol, LDL-cholesterol, and HDL-cholesterol were 203.33±21.83, 184.41±33.31, 126.28±18.75, and 40.17±6.32 mg/dl in group-I and 167.65±9.83, 128.77±11.65, 101.74±9.29 and 40.16±3.55 mg/dl in group-II respectively. Significant differences were found in the case of total cholesterol (p<0.001), triacylglycerol (p<0.001), and LDL-cholesterol (<0.001), but no significant difference was found in the case of HDL-cholesterol (p>0.05). Serum ALT and AST were 49.43±16.98, 45.20±13.56 U/L in group-I and 32.83±4.54, 28.68±4.31 U/L in the group- II respectively. Significant differences were found in case of ALT (p <0.001) and AST (p <0.001). Conclusion: Nonalcoholic fatty liver disease is associated with dyslipidemia and with the elevation of serum ALT and AST. J Rang Med Col. September 2022; Vol. 7, No. 2:35-39
{"title":"Study of Serum Lipid Profile and Aminotransferases (ALT and AST) in Non-obese, Non-diabetic Nonalcoholic Fatty Liver Disease","authors":"Asm Mazedul Islam, M. Muttalib, Md Nazrul Islam, M. Haque, Mohammad Rafiqul Hoque, -. Maknunnahar","doi":"10.3329/jrpmc.v7i2.62643","DOIUrl":"https://doi.org/10.3329/jrpmc.v7i2.62643","url":null,"abstract":"Background: Non-alcoholic fatty liver disease (NAFLD) comprises a spectrum of liver diseases characterized by simple steatosis to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. It is the most common cause of cryptogenic cirrhosis. NAFLD is associated with obesity, insulin resistance, hypertension, type 2 diabetes mellitus, and dyslipidemia. \u0000Objective: The study aimed to assess the changes in lipid profile and aminotransferases (ALT and AST) in Non-alcoholic fatty liver disease (NAFLD). \u0000Methods: This observational cross-sectional study was carried out in the department of Biochemistry, Mymensingh Medical College in cooperation with the Centre for Nuclear Medicine and Ultrasound, Mymensingh from January 2012 to June 2013 after the approval of the protocol. A total of 120 subjects were included through purposive sampling, among them, 60 subjects were with fatty liver disease (group-I) and another 60 were without fatty liver (group-II) with ultrasonography. The sampling method was purposive (non-random). Relevant laboratory investigations were performed by using established methods to achieve the objectives. \u0000Results: The majority of the subjects with NAFLD (33.33%) were in 51-60 years (in Group-I). Mean serum total cholesterol, triacylglycerol, LDL-cholesterol, and HDL-cholesterol were 203.33±21.83, 184.41±33.31, 126.28±18.75, and 40.17±6.32 mg/dl in group-I and 167.65±9.83, 128.77±11.65, 101.74±9.29 and 40.16±3.55 mg/dl in group-II respectively. Significant differences were found in the case of total cholesterol (p<0.001), triacylglycerol (p<0.001), and LDL-cholesterol (<0.001), but no significant difference was found in the case of HDL-cholesterol (p>0.05). Serum ALT and AST were 49.43±16.98, 45.20±13.56 U/L in group-I and 32.83±4.54, 28.68±4.31 U/L in the group- II respectively. Significant differences were found in case of ALT (p <0.001) and AST (p <0.001). \u0000Conclusion: Nonalcoholic fatty liver disease is associated with dyslipidemia and with the elevation of serum ALT and AST. \u0000J Rang Med Col. September 2022; Vol. 7, No. 2:35-39","PeriodicalId":370900,"journal":{"name":"Journal of Rangpur Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132538669","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}