Pub Date : 2022-09-13DOI: 10.3329/nimcj.v12i1.61592
J. Ferdous, N. Begum, B. Yasmeen, R. Laila, Shamim Ahmed
Background : Globally incidence of Type 2 Diabetes Mellitus (T2DM) shows an upward trend which a challenge for physicians and public health specialists. Patients with T2DM have 2- 4-fold increased risk of coronary artery disease (CAD), the leading cause of death among people with T2DM. Dyslipidemia considered an important factor for cardiovascular complication of T2DM. Objective : Assessment of dyslipidemia and its association with T2DM in Bangladeshi subjects. Methods : A case control study was conducted in CARe Medical College Hospital, Dhaka, during the period of July 2018 to June 2019. A total 153 subjects were included in study of which 90 belonged to Group-I were T2DM and 63 subjects were healthy Controls in Group-II. The Fasting glucose, postprandial glucose. Serum Lipid Profile were assayed in patients and controls, using standardized assay methods. Data were analyzed by using SPSS version 21. Results : Fasting plasma glucose levels [mmol/l, (Mean± SD)] of the study group were Control (4.96 ± 0.76) and T2DM (8.27±2.19) difference was statistically significant (p <0.001), 2 hours post prandial plasma glucose level [mmol/l, (Mean± SD)] of the study groups were Control (5.81±0.87) and T2DM (11.79 ± 2.69). A significant difference found between Control vs T2DM (p <0.001). Fasting Triglyceride [mg/dl, (Mean± SD) was higher in T2DM (189±82.06), compared to Control (142±80.14) and statistically significant p=0.001. Total Cholesterol [mg/dl, (Mean± SD), Control (172±45) and T2DM (189±50.76) p=0.029] was significantly higher in T2DM than healthy subjects. HDL cholesterol [mg/dl, (Mean± SD); Control (30.6±8.10) and T2DM (26±9.94), p<0.001] significantly increased in healthy Controls compared to T2DM subjects. LDL cholesterol [kg/m,2 (Mean± SD); Control (114±43.54) and T2DM (118±49.66), p=0.572] which was not significantly different among the study subjects. Conclusion : The present study concludes that important parameter of dyslipidemia, Fasting Triglyceride, total Cholesterol, were higher in T2DM patients and statistically significant. LDL cholesterol higher and not significant on the other hand HDL cholesterol was lower but significant difference between T2DM and healthy control found. Therefore, T2DM is associated with higher incidence of dyslipidemia Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 507-510
{"title":"Assessment of dyslipidemia and its association with Type 2 Diabetes Mellitus in Bangladeshi subjects","authors":"J. Ferdous, N. Begum, B. Yasmeen, R. Laila, Shamim Ahmed","doi":"10.3329/nimcj.v12i1.61592","DOIUrl":"https://doi.org/10.3329/nimcj.v12i1.61592","url":null,"abstract":"Background : Globally incidence of Type 2 Diabetes Mellitus (T2DM) shows an upward trend which a challenge for physicians and public health specialists. Patients with T2DM have 2- 4-fold increased risk of coronary artery disease (CAD), the leading cause of death among people with T2DM. Dyslipidemia considered an important factor for cardiovascular complication of T2DM.\u0000Objective : Assessment of dyslipidemia and its association with T2DM in Bangladeshi subjects.\u0000Methods : A case control study was conducted in CARe Medical College Hospital, Dhaka, during the period of July 2018 to June 2019. A total 153 subjects were included in study of which 90 belonged to Group-I were T2DM and 63 subjects were healthy Controls in Group-II. The Fasting glucose, postprandial glucose. Serum Lipid Profile were assayed in patients and controls, using standardized assay methods. Data were analyzed by using SPSS version 21.\u0000Results : Fasting plasma glucose levels [mmol/l, (Mean± SD)] of the study group were Control (4.96 ± 0.76) and T2DM (8.27±2.19) difference was statistically significant (p <0.001), 2 hours post prandial plasma glucose level [mmol/l, (Mean± SD)] of the study groups were Control (5.81±0.87) and T2DM (11.79 ± 2.69). A significant difference found between Control vs T2DM (p <0.001). Fasting Triglyceride [mg/dl, (Mean± SD) was higher in T2DM (189±82.06), compared to Control (142±80.14) and statistically significant p=0.001. Total Cholesterol [mg/dl, (Mean± SD), Control (172±45) and T2DM (189±50.76) p=0.029] was significantly higher in T2DM than healthy subjects. HDL cholesterol [mg/dl, (Mean± SD); Control (30.6±8.10) and T2DM (26±9.94), p<0.001] significantly increased in healthy Controls compared to T2DM subjects. LDL cholesterol [kg/m,2 (Mean± SD); Control (114±43.54) and T2DM (118±49.66), p=0.572] which was not significantly different among the study subjects.\u0000Conclusion : The present study concludes that important parameter of dyslipidemia, Fasting Triglyceride, total Cholesterol, were higher in T2DM patients and statistically significant. LDL cholesterol higher and not significant on the other hand HDL cholesterol was lower but significant difference between T2DM and healthy control found. Therefore, T2DM is associated with higher incidence of dyslipidemia\u0000Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 507-510","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"126 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123305282","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 : 2022-09-13DOI: 10.3329/nimcj.v12i1.61594
Bodhrun Naher, M. Mazumder, S. Ghosal, A. R. Rahman, A. Karim
Crigler-Najjar syndrome (CNS) was first described in 1952 in Maryland, USA as congenital familial non-hemolytic jaundice with kernicterus by Crigler JF and Najjar VA.1 CNS is a rare genetic disorder characterized by abnormalities in bilirubin metabolism and evident by persistent increase of unconjugated bilirubin. During the first days of life, the syndrome clinically manifests as intense unconjugated hyperbilirubinemia without evidence of hemolysis. It consists of two types, type I and type II. Crigler-Najjar Syndrome is mostly autosomal recessive disorder, but variation may occur in the inheritance of CNS II.2 The key pathogenesis is defect in bilirubin conjugation due to complete or partial deficiency of uridine 5'-diphosphate-glucuronosyl transferase (UGT). This enzyme is required for the conjugation and further excretion of bilirubin from the body. In type I CNS the enzyme activity is completely absent and in type II there is partial absence of the enzyme. Therefore, Type I is more severe form and usually fatal with kernicterus at the age of 1-2 years.3-5 TypeII is less severe and has better prognosis. Patients with CN type II suffer from less jaundice, less neurological impairment, and show a fair response to phenobarbitone therapy (serum bilirubin levels decrease by at least 25%).6 Both males and females are equally affected by CNS. The incidence is approximately 1 in 750,000-1,000,000 in the general population.7 Here we report such a rare case. Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 515-517
{"title":"Crigler Najjar Syndrome - A Rare case of Jaundice in Children","authors":"Bodhrun Naher, M. Mazumder, S. Ghosal, A. R. Rahman, A. Karim","doi":"10.3329/nimcj.v12i1.61594","DOIUrl":"https://doi.org/10.3329/nimcj.v12i1.61594","url":null,"abstract":"Crigler-Najjar syndrome (CNS) was first described in 1952 in Maryland, USA as congenital familial non-hemolytic jaundice with kernicterus by Crigler JF and Najjar VA.1 CNS is a rare genetic disorder characterized by abnormalities in bilirubin metabolism and evident by persistent increase of unconjugated bilirubin. During the first days of life, the syndrome clinically manifests as intense unconjugated hyperbilirubinemia without evidence of hemolysis. It consists of two types, type I and type II. Crigler-Najjar Syndrome is mostly autosomal recessive disorder, but variation may occur in the inheritance of CNS II.2 The key pathogenesis is defect in bilirubin conjugation due to complete or partial deficiency of uridine 5'-diphosphate-glucuronosyl transferase (UGT). This enzyme is required for the conjugation and further excretion of bilirubin from the body. In type I CNS the enzyme activity is completely absent and in type II there is partial absence of the enzyme. Therefore, Type I is more severe form and usually fatal with kernicterus at the age of 1-2 years.3-5 TypeII is less severe and has better prognosis. Patients with CN type II suffer from less jaundice, less neurological impairment, and show a fair response to phenobarbitone therapy (serum bilirubin levels decrease by at least 25%).6 Both males and females are equally affected by CNS. The incidence is approximately 1 in 750,000-1,000,000 in the general population.7 Here we report such a rare case.\u0000Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 515-517","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116637241","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 : 2022-09-13DOI: 10.3329/nimcj.v12i1.61591
Nazma Farhat, S. N. Rahman, Abu Raihan Bhuiyan Albarune, Tanbira Alam
Background: Craniofacial anthropometric values and indices are vital for experts from different walks of science. Variations in such values are evident in racial and geographical attribute. Furthermore, anthropological classification would assist clinicians in planning regional surgeries, forensic identification and many more. Objective: In this study we aimed to measure the head-face landmarks in a particular population and to correlate their association. Methodology: To assess intra population variation, the fronto-occipital circumference, facial height, bizygomatic breadth, bitragion breadth, bigonial breadth, width of mouth, intercanthal width, biocular breadth and body height of 100 Bangladeshi women (age 25-45 years) were measured and craniofacial indices were calculated. Frequencies were observed while comparing the variables by ANOVA using SPSS version 17. Result: The mean values of facial indices revealed as prosopic index 103.8 ± 12cm, zygomandibular index 81.1 ± 7.44cm, canthal index 36.93 ± 2.3cm and circumference-interorbital index 2.26 ± 0.4cm. 86% of subjects were clustered to hyperleptoprosope group (very narrow face) and 69% had wide jaw with closely placed eyes. No significant (p>0.05) correlation was denoted between variables and facial indices. Conclusion: The result of this study would provide an access to baseline data of local standards for anthropometric evaluation which might help the clinicians in planning regional surgeries and forensic experts in identification. Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 503-506
背景:颅面人体测量值和指标对不同科学领域的专家至关重要。这些价值观的差异在种族和地理属性上是明显的。此外，人类学分类将有助于临床医生规划区域手术、法医鉴定和许多其他工作。目的:在本研究中，我们旨在测量特定人群的头-脸标志，并将它们的关联联系起来。方法:测量100名年龄在25-45岁的孟加拉女性的额枕围、面部高度、颧骨宽度、双侧宽度、双侧宽度、口宽、口间宽度、双眼宽度和体高，并计算颅面指数，以评估群体内变异。使用SPSS version 17对变量进行方差分析，观察频率。结果:面部指数均值为:面指数103.8±12cm，颧下颌指数81.1±7.44cm，颊指数36.93±2.3cm，周眶间指数2.26±0.4cm。86%的受试者聚集在超瘦体组(非常窄的脸)，69%的受试者下颌宽，眼睛位置近。各变量与面部指数之间无显著相关(p < 0.05)。结论:本研究结果可为临床医师规划区域手术及法医鉴定提供参考。《北方国际医学院学报》2020年7月第12卷第1期，第503-506页
{"title":"Anthropometric study of facial indices among Bangladeshi women","authors":"Nazma Farhat, S. N. Rahman, Abu Raihan Bhuiyan Albarune, Tanbira Alam","doi":"10.3329/nimcj.v12i1.61591","DOIUrl":"https://doi.org/10.3329/nimcj.v12i1.61591","url":null,"abstract":"Background: Craniofacial anthropometric values and indices are vital for experts from different walks of science. Variations in such values are evident in racial and geographical attribute. Furthermore, anthropological classification would assist clinicians in planning regional surgeries, forensic identification and many more.\u0000Objective: In this study we aimed to measure the head-face landmarks in a particular population and to correlate their association.\u0000Methodology: To assess intra population variation, the fronto-occipital circumference, facial height, bizygomatic breadth, bitragion breadth, bigonial breadth, width of mouth, intercanthal width, biocular breadth and body height of 100 Bangladeshi women (age 25-45 years) were measured and craniofacial indices were calculated. Frequencies were observed while comparing the variables by ANOVA using SPSS version 17.\u0000Result: The mean values of facial indices revealed as prosopic index 103.8 ± 12cm, zygomandibular index 81.1 ± 7.44cm, canthal index 36.93 ± 2.3cm and circumference-interorbital index 2.26 ± 0.4cm. 86% of subjects were clustered to hyperleptoprosope group (very narrow face) and 69% had wide jaw with closely placed eyes. No significant (p>0.05) correlation was denoted between variables and facial indices.\u0000Conclusion: The result of this study would provide an access to baseline data of local standards for anthropometric evaluation which might help the clinicians in planning regional surgeries and forensic experts in identification.\u0000Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 503-506","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126336576","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 : 2022-09-13DOI: 10.3329/nimcj.v12i1.61587
Md Shoeb Ur Rashid, Muslema Begum, Chhamita Sultana Chhanda, F. Parveen, Akm Daud, Aparna Das
Background : An elegant, reliable procedure that can be easily performed is laparoscopic appendicectomy (LA). In patients with undiagnosed abdominal pain requiring more diagnostic investigations, as well as in patients with perforated appendicitis with or without intra-abdominal abscess, this procedure remain useful and safe. Objective : To evaluate the postoperative outcome and complication in laparoscopic appendicectomy. Methods : This prospective observational study was conducted at Rezia Taleb Hospital, Dhaka in Bangladesh. Total 100 cases were included in this study during the period of January 2018 to December 2019. Total 100 admitted uncomplicated acute appendicitis patients who underwent LA were enrolled in this study. Diagnosis is based on patient history (symptoms) and physical examination with an elevation of neutrophilic leukocytosis and raised CRP. In this study inclusion criteria of the cases were- Age <40 years, Alvarado Score 7 or more, Uncomplicated appendicitis, patients who underwent LA for appendicitis, both sexes. Exclusion criteria were - Incidental LA, patients with significant co-morbid medical conditions, patient unwilling to incorporate with the protocol, patients with psychiatric illness, and who lost to follow-up. Results : Out of 100 patients, most of them 63(63%) were in age group <20 years. The mean age was 21.70±6.21 years. Majority 77(77%) were male and 23(23%) were female and male: female ratio was 3.3:1. Among the 100 respondents, majority 95(95%) presented with migratory right iliac fossa pain and 5 (5%) had early postoperative complication. Majority 95(95%) patient’s pain control occurred within1-2 days with NSAID. Out of 95 Uncomplicated patients; Length of Hospital stay was 1-2 days in 90(94.7%) and 3-4 days in 5(5.3%) cases. Conclusion : This study showed that laparoscopic appendicectomy had found to be associated with shorter hospital stay, decreased postoperative pain and wound infection. Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 486-488
{"title":"Postoperative Outcome of Laparoscopic Appendicectomy- A Study of 100 Cases","authors":"Md Shoeb Ur Rashid, Muslema Begum, Chhamita Sultana Chhanda, F. Parveen, Akm Daud, Aparna Das","doi":"10.3329/nimcj.v12i1.61587","DOIUrl":"https://doi.org/10.3329/nimcj.v12i1.61587","url":null,"abstract":"Background : An elegant, reliable procedure that can be easily performed is laparoscopic appendicectomy (LA). In patients with undiagnosed abdominal pain requiring more diagnostic investigations, as well as in patients with perforated appendicitis with or without intra-abdominal abscess, this procedure remain useful and safe.\u0000Objective : To evaluate the postoperative outcome and complication in laparoscopic appendicectomy.\u0000Methods : This prospective observational study was conducted at Rezia Taleb Hospital, Dhaka in Bangladesh. Total 100 cases were included in this study during the period of January 2018 to December 2019. Total 100 admitted uncomplicated acute appendicitis patients who underwent LA were enrolled in this study. Diagnosis is based on patient history (symptoms) and physical examination with an elevation of neutrophilic leukocytosis and raised CRP. In this study inclusion criteria of the cases were- Age <40 years, Alvarado Score 7 or more, Uncomplicated appendicitis, patients who underwent LA for appendicitis, both sexes. Exclusion criteria were - Incidental LA, patients with significant co-morbid medical conditions, patient unwilling to incorporate with the protocol, patients with psychiatric illness, and who lost to follow-up.\u0000Results : Out of 100 patients, most of them 63(63%) were in age group <20 years. The mean age was 21.70±6.21 years. Majority 77(77%) were male and 23(23%) were female and male: female ratio was 3.3:1. Among the 100 respondents, majority 95(95%) presented with migratory right iliac fossa pain and 5 (5%) had early postoperative complication. Majority 95(95%) patient’s pain control occurred within1-2 days with NSAID. Out of 95 Uncomplicated patients; Length of Hospital stay was 1-2 days in 90(94.7%) and 3-4 days in 5(5.3%) cases.\u0000Conclusion : This study showed that laparoscopic appendicectomy had found to be associated with shorter hospital stay, decreased postoperative pain and wound infection.\u0000Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 486-488","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"135 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120980395","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 : 2022-09-13DOI: 10.3329/nimcj.v12i1.61588
A. Das, Md Shoeb Ur Rashid, Chhamita Sultana Chhanda, U. Ghosh, M. Dipa, Fazilatunnesa Naznin, B. Yasmeen
Background : Oligohydramnios is one of the pregnancy associated common complications facing by obstetrician which is associated with adverse maternal and perinatal outcome such as birth defects, miscarriage, intrauterine growth restriction, still birth, preterm birth, increased operative interference etc. Objective: To assess the impact of oligohydramnios on maternal and perinatal outcome. Methods: This cross-sectional descriptive study was conducted at Department of Obstetrics and Gynecology, BSMMU, Dhaka from October 2017 to March 2018.Total 50 patients were enrolled by purposive sampling method according to the inclusion and exclusion criteria. Clinical evidence of oligohydramnios was looked for & confirmed by ultrasonography (USG). Based on Amniotic fluid index (AFI)measurements patients were divided into two groups. Those who have AFI <5cm and 5-8cm. The significance of difference or comparison of means was measured by Chi square test. Maternal and perinatal outcome in pregnancies with oligohydramnios were compared with those with 5-8cm amniotic fluid volume. Results: The mean age of the study population was 23.3±4.06 years and majority of the cases were multipara (56%) and presented at term (58%). Borderline oligohydramnios (AFI 5-8cm) was found in 74% cases and severe oligohydramnios (AFI <5cm) were found in 26% cases. Most common etiological factor was idiopathic. Fifteen cases (30%) had vaginal delivery and caesarean section rate 70%, no maternal mortality occurred in this study, perinatal mortality rate was 10%, low birth weight baby was 63.6% and NICU admission rate was 53.8%. Conclusion: An antepartum or intrapartum oligohydramnios is associated with significantly increased incidence of caesarean section for fetal distress and increased incidence of low-birth-weight babies and increased rate of neonatal complications. Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 489-492
{"title":"A Clinical Study on Maternal and Perinatal Outcome of Oligohydramnios","authors":"A. Das, Md Shoeb Ur Rashid, Chhamita Sultana Chhanda, U. Ghosh, M. Dipa, Fazilatunnesa Naznin, B. Yasmeen","doi":"10.3329/nimcj.v12i1.61588","DOIUrl":"https://doi.org/10.3329/nimcj.v12i1.61588","url":null,"abstract":"Background : Oligohydramnios is one of the pregnancy associated common complications facing by obstetrician which is associated with adverse maternal and perinatal outcome such as birth defects, miscarriage, intrauterine growth restriction, still birth, preterm birth, increased operative interference etc.\u0000Objective: To assess the impact of oligohydramnios on maternal and perinatal outcome.\u0000Methods: This cross-sectional descriptive study was conducted at Department of Obstetrics and Gynecology, BSMMU, Dhaka from October 2017 to March 2018.Total 50 patients were enrolled by purposive sampling method according to the inclusion and exclusion criteria. Clinical evidence of oligohydramnios was looked for & confirmed by ultrasonography (USG). Based on Amniotic fluid index (AFI)measurements patients were divided into two groups. Those who have AFI <5cm and 5-8cm. The significance of difference or comparison of means was measured by Chi square test. Maternal and perinatal outcome in pregnancies with oligohydramnios were compared with those with 5-8cm amniotic fluid volume.\u0000Results: The mean age of the study population was 23.3±4.06 years and majority of the cases were multipara (56%) and presented at term (58%). Borderline oligohydramnios (AFI 5-8cm) was found in 74% cases and severe oligohydramnios (AFI <5cm) were found in 26% cases. Most common etiological factor was idiopathic. Fifteen cases (30%) had vaginal delivery and caesarean section rate 70%, no maternal mortality occurred in this study, perinatal mortality rate was 10%, low birth weight baby was 63.6% and NICU admission rate was 53.8%.\u0000Conclusion: An antepartum or intrapartum oligohydramnios is associated with significantly increased incidence of caesarean section for fetal distress and increased incidence of low-birth-weight babies and increased rate of neonatal complications.\u0000Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 489-492","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"56 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124402246","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 : 2022-09-13DOI: 10.3329/nimcj.v12i1.61589
K. T. Islam, N. A. Banu, Farzana Afrooz, Subhasish Das, Md Shafiul Alam, F. Hussain, Md Fazlul Kader Khan, M. Sultana, Nanda Lal Das
Background : Seizure is common neurological disorder in children. It is one of the common causes of referral of child to hospital and often requires emergency intervention. Rectal diazepam is the established first line drug for this purpose, but seizure recurrence and respiratory depression are the two major side effects. Midazolam is a water-soluble benzodiazepine with anticonvulsive activity at physiologic PH, which facilitates its effects on brain tissue. Midazolam is also easy to use, and no adverse events were reported in relation to the route of administration. Objectives : To compare the efficacy and safety of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in children. Methodology : This prospective randomized study was conducted in the Department of pediatrics, Sir Salimullah Medical College (SSMC) and Mitford Hospital, from March 2018 to December 2018.Fifty (50) patients aged 3 months to12 months who were convulsing and experiencing prolonged seizure (lasted >5 minutes) were included. Patients was randomly assigned to one of the two treatment arms: rectal diazepam and buccal midazolam. Primary and secondary outcome was compared between 2 treatment arms. Primary outcome was: 1. cessation of visible seizure activity within 10 minutes. 2. without recurrence of seizure in the subsequent hour. Secondary outcome included: 1. proportion with cessation of convulsion and exact time needed for cessation of convulsion within 10 minutes2. proportion of seizure recurrence in the sub sequent hours and within 24 hours after initial control and exact time of recurrence within the respective period. Also the safety and adverse effects were also compared. Results : The two groups did not differ significantly in sex, age, type of seizures, temperature, and baseline RBS, respiratory rate and blood pressure. Comparing the 2-treatment group, 13 (52%) patient experienced treatment failure who received rectal diazepam compared with 7 (28%) who received buccal midazolam (P>0 .05). For initial cessation of seizures, 18 (72%) seizures terminated within 10 minutes in the diazepam group compared with 19 (76%) in the midazolam and mean time to cessation of the seizure was 4.02±1.03 minutes and 4.4 ± 1.09 minutes respectively (p>0.05). Among the 18 children in whom seizure was initially controlled within 10 minutes by rectal diazepam, 6 (33.33%) of them experienced a seizure recurrence in the subsequent hour compared with 1 (5.26%) of 19 children in the buccal midazolam group (P<0 .05). children who experienced a seizure recurrence within 1 hour after initial control, the mean time torecurrence was 20.0±5.0 vs 25±0.0 minutes in diazepam group and midazolam group respectively (P =0.478). Seizure recurrence after initial control during the 24 hours after treatment was 5 (41.36%)vs 6 (33.33%).The mean time to recurrence within 24 hours was114.00±39.11.53 vs 320.83±173.10 minutes which was highly significant (P<0 .05) Conclusion : Buccal mida
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Pub Date : 2022-09-13DOI: 10.3329/nimcj.v12i1.61586
B. Yasmeen
Abstract not available Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 484-485
《北方国际医学院学报》2020年7月第12卷第1期，484-485页
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Pub Date : 2021-06-17DOI: 10.3329/nimcj.v11i2.54064
M. Mahbub, Shaoli Sarker, Suraj C Mozumder
Background : Acute disseminated encephalomyelitis (ADEM) is an acute demyelinating disorder of the central nervous system (CNS) occurring predominantly but not exclusively in children. The presence of severe disturbance of consciousness together with multifocal neurological symptoms and signs especially in a child under 10 years of age; favours a diagnosis of ADEM. Neuroimaging is essential investigation for establishing the diagnosis of ADEM. High-dose steroid treatment frequently results in a dramatic clinical improvement. Objective: This study aimed to describe our experience with Acute Disseminated Encephalomyelitis (ADEM) focusing on the clinical features, neuroimaging, and outcome after treatment with high-dose steroid. Method: This retrospective observational study was conducted in children who were admitted as inpatients in Paediatric Neurosciences Department of Dhaka Shishu Hospital (DSH) with the diagnosis of ADEM during the period of 2017- 2019. All patients got high dose IV methylprednisolone for 5 days followed by 2 weeks tapering dose of steroid. Outcome was observed on the 7th day of treatment and 6 months after discharge from hospital. Result: A total of 16 patients who were diagnosed as ADEM were included in this study. Twelve children (75%) had a recent upper respiratory tract illness. Patients presented most often with motor deficits (88%) and secondly with altered consciousness (63% ) followed by seizure ( 50% ). MRI brain was the preferable neuroimaging which mostly (41.7%) showed multifocal symmetrical demyelination patch. On the 7th day of steroid treatment, significant improvement in motor function and level of consciousness occurred (p values were 0.001% and 0.014% respectively). After 6 months of discharge from hospital; no motor deficit, age-appropriate cognitive level and no seizure in 71%, 57% and 71% respectively. Conclusion: High dose corticosteroid treatment in ADEM is significantly effective in improvement of motor impairment and consciousness level on immediate follow up. Northern International Medical College Journal Vol.11 (2) Jan 2020: 468-470
背景:急性播散性脑脊髓炎(ADEM)是一种中枢神经系统(CNS)的急性脱髓鞘疾病，主要发生于儿童，但不限于儿童。存在严重的意识障碍并伴有多灶性神经症状和体征，特别是在10岁以下儿童中;倾向于ADEM的诊断。神经影像学是诊断ADEM的重要手段。大剂量类固醇治疗经常导致显著的临床改善。目的:本研究旨在描述急性播散性脑脊髓炎(ADEM)的临床特征、神经影像学和大剂量类固醇治疗后的预后。方法:对2017- 2019年在达卡石树医院儿科神经科学部(DSH)住院诊断为ADEM的儿童进行回顾性观察研究。所有患者均静脉注射大剂量甲基强的松龙5天，随后2周逐渐减少类固醇剂量。分别于治疗第7天和出院后6个月观察疗效。结果:本研究共纳入16例诊断为ADEM的患者。12名儿童(75%)近期有上呼吸道疾病。患者最常表现为运动障碍(88%)，其次是意识改变(63%)，其次是癫痫发作(50%)。MRI显示多灶性对称脱髓鞘斑块，占41.7%。在类固醇治疗的第7天，运动功能和意识水平出现显著改善(p值分别为0.001%和0.014%)。出院6个月后;无运动缺陷，年龄认知水平，无癫痫发作分别为71%，57%和71%。结论:大剂量皮质类固醇治疗对急性脑损伤患者的运动功能障碍和意识水平有显著改善。北方国际医学院学报Vol.11 (2) Jan 2020: 468-470
{"title":"Immediate and Short-term Outcome of Acute Disseminated Encephalomyelitis (ADEM) after corticosteroid therapy","authors":"M. Mahbub, Shaoli Sarker, Suraj C Mozumder","doi":"10.3329/nimcj.v11i2.54064","DOIUrl":"https://doi.org/10.3329/nimcj.v11i2.54064","url":null,"abstract":"Background : Acute disseminated encephalomyelitis (ADEM) is an acute demyelinating disorder of the central nervous system (CNS) occurring predominantly but not exclusively in children. The presence of severe disturbance of consciousness together with multifocal neurological symptoms and signs especially in a child under 10 years of age; favours a diagnosis of ADEM. Neuroimaging is essential investigation for establishing the diagnosis of ADEM. High-dose steroid treatment frequently results in a dramatic clinical improvement. \u0000Objective: This study aimed to describe our experience with Acute Disseminated Encephalomyelitis (ADEM) focusing on the clinical features, neuroimaging, and outcome after treatment with high-dose steroid. \u0000Method: This retrospective observational study was conducted in children who were admitted as inpatients in Paediatric Neurosciences Department of Dhaka Shishu Hospital (DSH) with the diagnosis of ADEM during the period of 2017- 2019. All patients got high dose IV methylprednisolone for 5 days followed by 2 weeks tapering dose of steroid. Outcome was observed on the 7th day of treatment and 6 months after discharge from hospital. \u0000Result: A total of 16 patients who were diagnosed as ADEM were included in this study. Twelve children (75%) had a recent upper respiratory tract illness. Patients presented most often with motor deficits (88%) and secondly with altered consciousness (63% ) followed by seizure ( 50% ). MRI brain was the preferable neuroimaging which mostly (41.7%) showed multifocal symmetrical demyelination patch. On the 7th day of steroid treatment, significant improvement in motor function and level of consciousness occurred (p values were 0.001% and 0.014% respectively). After 6 months of discharge from hospital; no motor deficit, age-appropriate cognitive level and no seizure in 71%, 57% and 71% respectively. \u0000Conclusion: High dose corticosteroid treatment in ADEM is significantly effective in improvement of motor impairment and consciousness level on immediate follow up. \u0000Northern International Medical College Journal Vol.11 (2) Jan 2020: 468-470","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123791383","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 : 2021-06-17DOI: 10.3329/nimcj.v11i2.54060
Mahfuza Hussain, Nurul Amin, R. Islam
Background : Hand, foot and mouth disease (HFMD) is a contagious disease of children, occurs primarily under five years of age, characterized by a history of brief febrile illness and a typical skin rash over hands and feet with or without sores in mouth, caused usually by Coxsackie virus[1]A16 viruses. It is mainly the disease of tropical and subtropical countries and bears a complex-relation with meteorological variables like temperature, rainfall and relative humidity, although no study has yet been done in Bangladesh to explain the complex relationship of the disease with these variables. Objective : This study sought to describe the occurrence of HFMD and its association with meteorological factors in Dhaka city. Methods : The present cross-sectional study collected data of 231 HFMD cases from the records of the daily register of Out-patient Department of Dhaka Shishu Hospital, Dhaka between January 2018 to December 2019. According to the study protocol a child was identified as having HFMD who had a history of brief febrile illness accompanied by a typical skin rash with or without mouth ulcers. Total numbers of cases treated monthly at OPD during the period were also recorded. Meteorological data were provided by Bangladesh Meteorological Department, which among others, included monthly average temperature, relative humidity and amount of rainfall. While the outcome variable was monthly number of HFMD cases, the predictive variables were average temperature, humidity and rainfall during the study period. Results : Majority (85.3%) children in the present study was < 5 years old. A male preponderance was observed in the series (60%) with male to female ratio being 3:2. A clustering of HFMD cases was observed to occur between June to October when monthly average temperature, total rainfall and humidity all were at their maximum compared to those found between November to April. The clustering of cases was more intense in the year 2019 than that in the year 2018. During the period average monthly temperature was 29.20C, average rainfall was 62.6% (238 mm) of the total annual precipitation and mean relative humidity was 79%. The proportion of HFMD cases out of total cases treated during the period was 2.2% in 2018 and was 4.1% in 2019, which in the dry season (November to April) was 0.4% and 0.5% in 2018 and 2019 respectively. Conclusions : The study concluded that majority of the HFMD cases occur under five years of age and boys are more likely to have the infection than the girls. A seasonality of HFMD occurrence is observed with a higher number of cases occurring in the monsoon season and fewer cases in the dry season.Clustering of HFMD cases occur between May to October when monthly average temperature, total rainfall and humidity all are at peak compared to those in November to April of the year. Northern International Medical College Journal Vol.11 (2) Jan 2020: 453-457
{"title":"Seasonal Pattern of Hand Foot and Mouth Disease in an Out-patient Clinic of a Tertiary Care Pediatric Hospital, Dhaka","authors":"Mahfuza Hussain, Nurul Amin, R. Islam","doi":"10.3329/nimcj.v11i2.54060","DOIUrl":"https://doi.org/10.3329/nimcj.v11i2.54060","url":null,"abstract":"Background : Hand, foot and mouth disease (HFMD) is a contagious disease of children, occurs primarily under five years of age, characterized by a history of brief febrile illness and a typical skin rash over hands and feet with or without sores in mouth, caused usually by Coxsackie virus[1]A16 viruses. It is mainly the disease of tropical and subtropical countries and bears a complex-relation with meteorological variables like temperature, rainfall and relative humidity, although no study has yet been done in Bangladesh to explain the complex relationship of the disease with these variables. \u0000Objective : This study sought to describe the occurrence of HFMD and its association with meteorological factors in Dhaka city. \u0000Methods : The present cross-sectional study collected data of 231 HFMD cases from the records of the daily register of Out-patient Department of Dhaka Shishu Hospital, Dhaka between January 2018 to December 2019. According to the study protocol a child was identified as having HFMD who had a history of brief febrile illness accompanied by a typical skin rash with or without mouth ulcers. Total numbers of cases treated monthly at OPD during the period were also recorded. Meteorological data were provided by Bangladesh Meteorological Department, which among others, included monthly average temperature, relative humidity and amount of rainfall. While the outcome variable was monthly number of HFMD cases, the predictive variables were average temperature, humidity and rainfall during the study period. \u0000Results : Majority (85.3%) children in the present study was < 5 years old. A male preponderance was observed in the series (60%) with male to female ratio being 3:2. A clustering of HFMD cases was observed to occur between June to October when monthly average temperature, total rainfall and humidity all were at their maximum compared to those found between November to April. The clustering of cases was more intense in the year 2019 than that in the year 2018. During the period average monthly temperature was 29.20C, average rainfall was 62.6% (238 mm) of the total annual precipitation and mean relative humidity was 79%. The proportion of HFMD cases out of total cases treated during the period was 2.2% in 2018 and was 4.1% in 2019, which in the dry season (November to April) was 0.4% and 0.5% in 2018 and 2019 respectively. \u0000Conclusions : The study concluded that majority of the HFMD cases occur under five years of age and boys are more likely to have the infection than the girls. A seasonality of HFMD occurrence is observed with a higher number of cases occurring in the monsoon season and fewer cases in the dry season.Clustering of HFMD cases occur between May to October when monthly average temperature, total rainfall and humidity all are at peak compared to those in November to April of the year. \u0000Northern International Medical College Journal Vol.11 (2) Jan 2020: 453-457","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128654229","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 : 2021-06-17DOI: 10.3329/nimcj.v11i2.54062
Iffat Nowshin, Fouzia Alima, Iqbal Bahar Chowdhury, Mahmud Ahmed
Background : Tuberculosis (TB) is a major public health problem in Bangladesh. The use of mass media is one of the important strategies in communicating behavioural change in relation to TB prevention and the treatment. However, most of the mass media public health interventions do not sufficiently engage the people. Due to this, truly little is known about the effects of locally instigated mass media promotion. Objective : To explore role of mass media on knowledge generation about Tuberculosis transmission in Bangladesh. Methods : This cross-sectional study was conducted among 180 adult persons(attendants of patients) of different socio-economic backgrounds attending the outpatient’s departments(OPD) of a tertiary care hospital. Purposive sampling was the process of selecting the subjects. Data were collected using one pretested semi-structured questionnaire through face-to-face interview. Results : A total180 respondents were interviewed. Mean age of the respondents was 28.75 ± 8.55 years. Majority of the respondents were graduate (29.0%).A total of 20.2% respondents had adequate knowledge about TB transmission without any misconceptions. Similarly, regarding the misconceptions on modes of TB transmission, 40.5% replied that TB transmits through utensils,57.6% respondents replied that TB transmits through sharing clothes/bed sheets/towel. About 28.3% respondents had the perception that the cost of TB treatment is high. Among the respondents30.5% had the false perception that it was necessary to go to big hospitals for TB treatment. Highest 140 (77.8%) respondents said television as the source of information in TB prevention. Friends/ relatives/ teachers, newspaper, radio, billboard etc. were the other sources. Twenty did not hear of TB prevention program. Conclusion : The mass media can be effective in getting messages about TB across to the community in developing countries. In this study we found that television, newspapers, and billboards were particularly useful tools for reaching out to them with specific campaigns regarding TB control. Northern International Medical College Journal Vol.11 (2) Jan 2020: 463-467
背景:结核病是孟加拉国的一个主要公共卫生问题。使用大众媒体是传播与结核病预防和治疗有关的行为改变的重要战略之一。然而，大多数大众媒体的公共卫生干预措施没有充分吸引民众。正因为如此，人们对当地煽动的大众媒体宣传的效果知之甚少。目的:探讨大众传播媒介在孟加拉国结核病传播知识传播中的作用。方法:对某三级医院门诊180名不同社会经济背景的成人(患者护理人员)进行横断面研究。有目的抽样是选择被试的过程。采用一份预测半结构化问卷，通过面对面访谈的方式收集数据。结果:共访谈180人。受访者平均年龄28.75±8.55岁。大多数受访者是大学毕业生(29.0%)。共有20.2%的答复者对结核传播有足够的了解，没有任何误解。同样，在对结核病传播方式的误解方面，40.5%的受访者认为结核病是通过餐具传播的，57.6%的受访者认为结核病是通过共用衣服/床单/毛巾传播的。约28.3%的应答者认为结核病治疗费用高。30.5%的受访者有到大医院治疗结核病的错误认识。140名(77.8%)应答者认为电视是预防结核病的信息来源。朋友/亲戚/老师、报纸、广播、广告牌等是其他来源。20人没有听说过结核病预防项目。结论:在发展中国家，大众媒体可以有效地向社区传播有关结核病的信息。在这项研究中，我们发现电视、报纸和广告牌是向他们宣传有关结核病控制的具体活动的特别有用的工具。北方国际医学院学报Vol.11 (2) Jan 2020: 463-467
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