Pub Date : 2020-12-13DOI: 10.3329/nimcj.v11i1.50733
Md Abbas Uddin Khan, R. Akhtar
Community-acquired pneumonia (CAP) is a potentially serious infection and is the single commonest and leading cause of death in under 5 children in developing countries. But the crucial first step in tackling childhood pneumonia is being able to diagnose it accurately, particularly after introduction of 2 effective vaccines against two major pathogens responsible for childhood bacterial pneumonia. Radiology and determination of hypoxia by pulse oximetry have been considered the optimal methods for diagnosing pneumonia. This review article has updated the important aspects of childhood pneumonia in developing countries. Early recognition and prompt, appropriate and adequate management can reduce the case fatality as well as morbidity associated with pneumonia. Northern International Medical College Journal Vol. 11 No. 1 July 2019, Page 406-410
{"title":"Community Acquired Pneumonia (CAP) in Children in Developing countries -A Review","authors":"Md Abbas Uddin Khan, R. Akhtar","doi":"10.3329/nimcj.v11i1.50733","DOIUrl":"https://doi.org/10.3329/nimcj.v11i1.50733","url":null,"abstract":"Community-acquired pneumonia (CAP) is a potentially serious infection and is the single commonest and leading cause of death in under 5 children in developing countries. But the crucial first step in tackling childhood pneumonia is being able to diagnose it accurately, particularly after introduction of 2 effective vaccines against two major pathogens responsible for childhood bacterial pneumonia. Radiology and determination of hypoxia by pulse oximetry have been considered the optimal methods for diagnosing pneumonia. This review article has updated the important aspects of childhood pneumonia in developing countries. Early recognition and prompt, appropriate and adequate management can reduce the case fatality as well as morbidity associated with pneumonia. \u0000Northern International Medical College Journal Vol. 11 No. 1 July 2019, Page 406-410","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125286515","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 : 2020-12-13DOI: 10.3329/nimcj.v11i1.50738
Maksudur Rahman, B. Yasmeen, N. Jahan, M. Hoque, S. Halder, A. Halder, Nondini Rahman Nupur, I. Zerin, Fatema Akter Rini
Background : In Bangladesh about 67% of under-five mortality is neonatal mortality. One of three major causes of neonatal morbidity and mortality is septicemia. Recently there is increasing incidence of multidrug resistant neonatal organisms which is alarming. Objective : The aim of this study was to see the bacteriological profile and drug sensitivity pattern of neonatal septicemia. Methods : This prospective observational study was done in Dhaka Shishu (children) Hospital over one-year period from June 2018 to May 2019. The admitted neonates were suspected as neonatal septicemia considering the risk factors, clinical profile and investigations (CBC, CRP etc.). Blood from all suspected neonatal septicemia cases were sent for culture and drugs sensitivity along with others necessary investigations. Then data was analyzed with SPSS version-20. Results : Among the suspected cases only 111(10%) patients were culture positive. Preterm were 77(69%) and term 34(31%). One hundred six cases (95%) had sepsis with gram negative organisms and 5(5%) had sepsis with gram positive organisms with more predominant of Klebsiella (76,68%) followed by Acinetobacter (16,14%), Pseudomonas (6,5%), Escherichia coli (3,3%). Majority 80 (72%) cases had Early onset neonatal sepsis (EONS). Klebsiella (57, 51%) was more common organism followed by Acinetobacter (11,10 %) causing EONS and in late onset neonatal sepsis (LONS), similar type of causative organism were found. Ampicillin, Gentamicin and Ceftazidime were mostly resistance to gram negative organisms - 104(94%), 99(89%) and 93(84%) respectively. Besides these, Amikacin (104,94%), Imipenem (85, 77%) and Ciprofloxacin (73, 66%) were more resistance. Klebsiella in 17 cases and Acinetobacter in 4 cases were resistant to all commonly used antibiotics. Conclusion : Klebsiella followed by Acinetobacter and Pseudomonas are now common pathogens of neonatal septicemia found in this study. Ampicillin, Gentamicin and Ceftazidime are more resistant to most of the organisms causing neonatal sepsis. Imipenem is alarmingly resistant. In 19% cases, the organisms are resistance to all commonly used antibiotics. Northern International Medical College Journal Vol. 11 No. 1 July 2019, Page 427-431
{"title":"Recent Trend of Bacteriological Profile and Drug Sensitivity Pattern of Neonatal Septicemia in A Tertiary Care Hospital in Bangladesh","authors":"Maksudur Rahman, B. Yasmeen, N. Jahan, M. Hoque, S. Halder, A. Halder, Nondini Rahman Nupur, I. Zerin, Fatema Akter Rini","doi":"10.3329/nimcj.v11i1.50738","DOIUrl":"https://doi.org/10.3329/nimcj.v11i1.50738","url":null,"abstract":"Background : In Bangladesh about 67% of under-five mortality is neonatal mortality. One of three major causes of neonatal morbidity and mortality is septicemia. Recently there is increasing incidence of multidrug resistant neonatal organisms which is alarming. \u0000Objective : The aim of this study was to see the bacteriological profile and drug sensitivity pattern of neonatal septicemia. \u0000Methods : This prospective observational study was done in Dhaka Shishu (children) Hospital over one-year period from June 2018 to May 2019. The admitted neonates were suspected as neonatal septicemia considering the risk factors, clinical profile and investigations (CBC, CRP etc.). Blood from all suspected neonatal septicemia cases were sent for culture and drugs sensitivity along with others necessary investigations. Then data was analyzed with SPSS version-20. \u0000Results : Among the suspected cases only 111(10%) patients were culture positive. Preterm were 77(69%) and term 34(31%). One hundred six cases (95%) had sepsis with gram negative organisms and 5(5%) had sepsis with gram positive organisms with more predominant of Klebsiella (76,68%) followed by Acinetobacter (16,14%), Pseudomonas (6,5%), Escherichia coli (3,3%). Majority 80 (72%) cases had Early onset neonatal sepsis (EONS). Klebsiella (57, 51%) was more common organism followed by Acinetobacter (11,10 %) causing EONS and in late onset neonatal sepsis (LONS), similar type of causative organism were found. Ampicillin, Gentamicin and Ceftazidime were mostly resistance to gram negative organisms - 104(94%), 99(89%) and 93(84%) respectively. Besides these, Amikacin (104,94%), Imipenem (85, 77%) and Ciprofloxacin (73, 66%) were more resistance. Klebsiella in 17 cases and Acinetobacter in 4 cases were resistant to all commonly used antibiotics. \u0000Conclusion : Klebsiella followed by Acinetobacter and Pseudomonas are now common pathogens of neonatal septicemia found in this study. Ampicillin, Gentamicin and Ceftazidime are more resistant to most of the organisms causing neonatal sepsis. Imipenem is alarmingly resistant. In 19% cases, the organisms are resistance to all commonly used antibiotics. \u0000Northern International Medical College Journal Vol. 11 No. 1 July 2019, Page 427-431","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132858330","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 : 2019-01-10DOI: 10.3329/NIMCJ.V10I1.39314
K. M. N. Ferdous, Md Samiul Hasan, K. Kabir, M. K. Islam, T. Banu
Background : Meconium ileus (MI) is one of the common cause of intestinal obstruction in neonate. It can be present with various complications (about 50%) like volvulus, atresia, and gangrene of the gut, perforation and meconium cyst. Objective : This study aimed to compare various surgical procedures used in the treatment of meconium ileus and to assess their efficacy regarding survival and complications in our center. Methods : This retrospective study was done to all cases of meconium ileus admitted in the Department of neonatal surgery of Dhaka Shishu (Children) Hospital during the past 5 years (2011 to2016). The medical records of all patients with meconium ileus were studied. The surgical procedures were Mikulicz procedure, Bishop-Koop procedure done in case of complicated cases and Mikulicz procedure, Bishop-Koop and T tube ileostomy done in uncomplicated cases. Outcomes were compared between complicated and uncomplicated group and between the surgical procedures. Results : Total patients were 224. Among them 8 were excluded due to incomplete data. The mean age was 3.23 days. Twenty four neonates were preterm. Fifty-two percent were uncomplicatedMI and 48.15% were complicated. Among 112 uncomplicated cases, Mikulicz procedure done in 33 cases, Bishop-Koop procedure done in 37 cases and rest were treated by T tube ileostomy procedures. Among 104 cases of complicated meconium ileus, Mikulicz procedure done in 75 cases and 42 cases were treated by Bishop-Koop stoma. Predominant complications in Mikulicz procedures were high output fistula (67.6%), sepsis (34.84%) and skin excoriation (58.33%), while in Bishop-Koop procedure were sepsis (59.25%), anastomotic leak and reoperation (25.75%). In T tube ileostomy, complications were intra-peritoneal leak with reoperation and sepsis (9.52%). Twenty five (11.6%) stoma prolapse were found in Mikulicz ileostomy. The overall mortality of meconium ileus was 36.6%, in simple MI 23 out of 112 and in complicated MI 56 out of 104. This difference was significant. Conclusion : Considering the study result we concluded that complications occur more frequently in Mikulicz procedure and it is significantly associated with mortality, Bishop- Koop ileostomy can be considered but anastomotic leak is still an important complication of this procedure. In uncomplicated cases T tube ileostomy found as the best option. Northern International Medical College Journal Vol.10(1) Jul 2018: 326-329
{"title":"Management of Meconium Ileus: 5 years' experience at Dhaka Shishu (Children) Hospital","authors":"K. M. N. Ferdous, Md Samiul Hasan, K. Kabir, M. K. Islam, T. Banu","doi":"10.3329/NIMCJ.V10I1.39314","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39314","url":null,"abstract":"Background : Meconium ileus (MI) is one of the common cause of intestinal obstruction in neonate. It can be present with various complications (about 50%) like volvulus, atresia, and gangrene of the gut, perforation and meconium cyst. \u0000Objective : This study aimed to compare various surgical procedures used in the treatment of meconium ileus and to assess their efficacy regarding survival and complications in our center. \u0000Methods : This retrospective study was done to all cases of meconium ileus admitted in the Department of neonatal surgery of Dhaka Shishu (Children) Hospital during the past 5 years (2011 to2016). The medical records of all patients with meconium ileus were studied. The surgical procedures were Mikulicz procedure, Bishop-Koop procedure done in case of complicated cases and Mikulicz procedure, Bishop-Koop and T tube ileostomy done in uncomplicated cases. Outcomes were compared between complicated and uncomplicated group and between the surgical procedures. \u0000Results : Total patients were 224. Among them 8 were excluded due to incomplete data. The mean age was 3.23 days. Twenty four neonates were preterm. Fifty-two percent were uncomplicatedMI and 48.15% were complicated. Among 112 uncomplicated cases, Mikulicz procedure done in 33 cases, Bishop-Koop procedure done in 37 cases and rest were treated by T tube ileostomy procedures. Among 104 cases of complicated meconium ileus, Mikulicz procedure done in 75 cases and 42 cases were treated by Bishop-Koop stoma. Predominant complications in Mikulicz procedures were high output fistula (67.6%), sepsis (34.84%) and skin excoriation (58.33%), while in Bishop-Koop procedure were sepsis (59.25%), anastomotic leak and reoperation (25.75%). In T tube ileostomy, complications were intra-peritoneal leak with reoperation and sepsis (9.52%). Twenty five (11.6%) stoma prolapse were found in Mikulicz ileostomy. The overall mortality of meconium ileus was 36.6%, in simple MI 23 out of 112 and in complicated MI 56 out of 104. This difference was significant. \u0000Conclusion : Considering the study result we concluded that complications occur more frequently in Mikulicz procedure and it is significantly associated with mortality, Bishop- Koop ileostomy can be considered but anastomotic leak is still an important complication of this procedure. In uncomplicated cases T tube ileostomy found as the best option. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 326-329","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114570187","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 : 2018-12-20DOI: 10.3329/NIMCJ.V10I1.39326
S. Mehnaz, M. Chowdhury, B. Yasmeen, Masudur Rahman, R. Akter, Manifa Afrin, M. Begum
Background : Perinatal asphyxia is an insult to the fetus or newborn infant due to lack of oxygen (hypoxia) and/or a lack of perfusion (ischemia) to various organs, which will manifest as difficulty in establishing spontaneous respiration evident by delayed cry after birth, at least after one minute. World-wide, perinatal asphyxia accounts for about 900,000 deaths each year. In Bangladesh it is a major cause of neonatal death. A substantial proportion of the children that survive suffer late effects such as cerebral palsy and epilepsy. Objective : To determine the efficacy of erythropoietin in improving the neurological outcome of term neonates with perinatal asphyxia (HIE stage II and III). Materials and methods : A Randomized Controll Trial was carried out in the Neonatal ward and NICU of Dhaka Shishu Hospital from 1st April 2014 to 30th Sep 2015. A total 68 neonates with perinatal asphyxia (both HIE stage II and III) who fulfill the inclusion criteria were enrolled and randomly assigned to intervention group (n=35) and control group (n=33). Intervention group received rHuEPO 300- 500 U/kg/dose daily subcutaneously for 5 days within first 48 hours of birth along with the standard treatment protocol and control group received standard treatment protocol only. Results : Baseline clinical characteristics, USG of brain during hospital stay were almost similar in both groups. Statistically significant effect was noted in seizure control, tolerance of oral feeding, hospital stay and neurological outcome at 3 months of age (p=008). USG of brain at 3 months of age also improved significantly (p=0.027). Conclusion : This study demonstrates the effectiveness of early administration of rHuEPO to term neonates with moderate to severe asphyxia, beneficial effect on short term outcomes like seizure control, tolerance of oral feeding and neurological outcome at 3 months of age. A large multicenter study would be done for further evaluation of these findings. Northern International Medical College Journal Vol.10(1) Jul 2018: 330-334
背景:围产期窒息是对胎儿或新生儿的一种侮辱，由于缺氧和/或各器官缺乏灌注(缺血)，表现为建立自主呼吸困难，明显表现为出生后延迟哭泣，至少在一分钟后。全世界每年约有90万人死于围产期窒息。在孟加拉国，它是新生儿死亡的一个主要原因。存活下来的儿童中有相当一部分患有脑瘫和癫痫等后期影响。目的:探讨促红细胞生成素对围产儿窒息期(HIE II期和III期)足月新生儿神经预后的改善效果。材料与方法:2014年4月1日至2015年9月30日在达卡石树医院新生儿病房和新生儿重症监护病房进行随机对照试验。入选符合入选标准的围产期窒息新生儿(HIE II期和III期)68例，随机分为干预组(n=35)和对照组(n=33)。干预组在出生后48小时内每日皮下注射rHuEPO 300- 500 U/kg剂量，连续5天，并给予标准治疗方案，对照组仅给予标准治疗方案。结果:两组患者住院期间脑USG及基线临床特征基本相似。在癫痫发作控制、口服喂养耐受性、住院时间和3月龄神经预后方面均有统计学意义(p=008)。3月龄时脑USG也显著改善(p=0.027)。结论:本研究表明，早期给予rHuEPO对中重度窒息足月新生儿有效，对癫痫发作控制、口服喂养耐受性和3月龄时神经学预后等短期预后有有益影响。将进行一项大型多中心研究以进一步评估这些发现。北方国际医学院学报Vol.10(1) july 2018: 330-334
{"title":"Role of Human Recombinant Erythropoietin (rHuEPO) in Perinatal Asphyxia-a randomized controlled trial","authors":"S. Mehnaz, M. Chowdhury, B. Yasmeen, Masudur Rahman, R. Akter, Manifa Afrin, M. Begum","doi":"10.3329/NIMCJ.V10I1.39326","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39326","url":null,"abstract":"Background : Perinatal asphyxia is an insult to the fetus or newborn infant due to lack of oxygen (hypoxia) and/or a lack of perfusion (ischemia) to various organs, which will manifest as difficulty in establishing spontaneous respiration evident by delayed cry after birth, at least after one minute. World-wide, perinatal asphyxia accounts for about 900,000 deaths each year. In Bangladesh it is a major cause of neonatal death. A substantial proportion of the children that survive suffer late effects such as cerebral palsy and epilepsy. \u0000Objective : To determine the efficacy of erythropoietin in improving the neurological outcome of term neonates with perinatal asphyxia (HIE stage II and III). \u0000Materials and methods : A Randomized Controll Trial was carried out in the Neonatal ward and NICU of Dhaka Shishu Hospital from 1st April 2014 to 30th Sep 2015. A total 68 neonates with perinatal asphyxia (both HIE stage II and III) who fulfill the inclusion criteria were enrolled and randomly assigned to intervention group (n=35) and control group (n=33). Intervention group received rHuEPO 300- 500 U/kg/dose daily subcutaneously for 5 days within first 48 hours of birth along with the standard treatment protocol and control group received standard treatment protocol only. \u0000Results : Baseline clinical characteristics, USG of brain during hospital stay were almost similar in both groups. Statistically significant effect was noted in seizure control, tolerance of oral feeding, hospital stay and neurological outcome at 3 months of age (p=008). USG of brain at 3 months of age also improved significantly (p=0.027). \u0000Conclusion : This study demonstrates the effectiveness of early administration of rHuEPO to term neonates with moderate to severe asphyxia, beneficial effect on short term outcomes like seizure control, tolerance of oral feeding and neurological outcome at 3 months of age. A large multicenter study would be done for further evaluation of these findings. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 330-334","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128851594","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 : 2018-12-20DOI: 10.3329/NIMCJ.V10I1.39333
R. Akhter, K. Chowdhury, Saenat Haque, A. Noor, S. Zaman
Abstract not available Northern International Medical College Journal Vol.10(1) Jul 2018: 357-358
《北方国际医学院学报》Vol.10(1) july 2018: 357-358
{"title":"A Newborn with Maple Syrup Urine Disease","authors":"R. Akhter, K. Chowdhury, Saenat Haque, A. Noor, S. Zaman","doi":"10.3329/NIMCJ.V10I1.39333","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39333","url":null,"abstract":"Abstract not available \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 357-358","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126841740","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 : 2018-12-20DOI: 10.3329/NIMCJ.V10I1.39330
A. A. Kabir, Farjana Akhter, Mahbuba Sharmin, K. Akhter, Mosammat Beauty Begum, A. Saha, I. Ahmed
Introduction : Hospital acquired Infections (HAIs) are called those infections that were not present at the time of patient’ hospitalization in a hospital and have been acquired after hospitalization. Nurses are an important part of the any healthcare team who play a unique role in the control of Hospital acquired infections. Objective : The aim of this study was to investigate the level of knowledge, attitudes, and practices of staff nurses about preventing the spread of hospital acquired infections (HAIs) at tertiary care Hospital of Dhaka city. Methods and Materials : This descriptive cross-sectional study was done among nurses having two years experience from two tertiary level hospitals in Dhaka city during January to June 2017. Self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used as a tool for data collection. Questionnaire was supplied to all staff nurses available at different in-patient wards of these two hospitals. Only 234 staff nurses who completed and returned the questionnaire were included in this study. Data were analyzed using Microsoft excel 2013 software. Result : Staff nurses were found to have good knowledge, moderately positive attitude but poor practice in prevention of hospital acquired infections. About 95% of the participants considered that prevention of HAIs were a valuable part of their role. About 65% of the staff nurses had received formal training regarding hand hygiene. The 100 % of participants felt that they would be less likely to transmit infection to the patients if they performed hand-hygiene. About 64% of them argued that hand hygiene agents were not readily available in current settings. Regarding practice, only 6% performed hand hygiene before patients contact and 27% of the staff nurses reported that they often forgot to perform hand hygiene. Conclusion : The finding of this study revealed a good knowledge of infection prevention among the majority of participants with relatively minimal level of practice. For strengthening the knowledge, attitude and practice towards HAIs, there is in need of developing regular training program and monitoring on performance feedback regarding hand hygiene is recommended. Northern International Medical College Journal Vol.10(1) Jul 2018: 347-350
医院获得性感染(HAIs)是指患者住院时不存在的感染，住院后发生的感染。护士是任何医疗团队的重要组成部分，在控制医院获得性感染方面发挥着独特的作用。目的:调查达喀市三级医院护理人员预防医院获得性感染(HAIs)传播的知识、态度和实践水平。方法和材料:本描述性横断面研究于2017年1月至6月在达卡市两家三级医院进行了两年经验的护士。采用自我管理的问卷作为数据收集工具，问卷包含了一系列关于医疗卫生知识、态度和实践的不同问题。向这两家医院不同住院病房的所有工作人员护士提供了调查问卷。仅234名完成并返回问卷的护理人员被纳入本研究。数据分析采用Microsoft excel 2013软件。结果:护理人员对医院获得性感染的预防知识较好，态度一般积极，但实际操作较差。约95%的参与者认为，预防艾滋病是他们工作的重要组成部分。约65%的护理人员接受过手部卫生方面的正式培训。100%的参与者认为，如果他们进行手卫生，他们将不太可能将感染传播给病人。其中约64%的人认为，在当前环境中不容易获得手卫生剂。在实践方面，只有6%的人在接触病人前进行手卫生，27%的工作人员护士报告说他们经常忘记进行手卫生。结论:这项研究的发现揭示了感染预防的良好知识在大多数参与者相对最低水平的做法。为加强对卫生保健人员的认识、态度和行为，建议制定定期培训计划，并对有关手卫生的绩效反馈进行监测。北方国际医学院学报Vol.10(1) july 2018: 347-350
{"title":"Knowledge, Attitude and Practice of Staff nurses on Hospital Acquired Infections in tertiary care Hospital of Dhaka city","authors":"A. A. Kabir, Farjana Akhter, Mahbuba Sharmin, K. Akhter, Mosammat Beauty Begum, A. Saha, I. Ahmed","doi":"10.3329/NIMCJ.V10I1.39330","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39330","url":null,"abstract":"Introduction : Hospital acquired Infections (HAIs) are called those infections that were not present at the time of patient’ hospitalization in a hospital and have been acquired after hospitalization. Nurses are an important part of the any healthcare team who play a unique role in the control of Hospital acquired infections. \u0000Objective : The aim of this study was to investigate the level of knowledge, attitudes, and practices of staff nurses about preventing the spread of hospital acquired infections (HAIs) at tertiary care Hospital of Dhaka city. \u0000Methods and Materials : This descriptive cross-sectional study was done among nurses having two years experience from two tertiary level hospitals in Dhaka city during January to June 2017. Self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used as a tool for data collection. Questionnaire was supplied to all staff nurses available at different in-patient wards of these two hospitals. Only 234 staff nurses who completed and returned the questionnaire were included in this study. Data were analyzed using Microsoft excel 2013 software. \u0000Result : Staff nurses were found to have good knowledge, moderately positive attitude but poor practice in prevention of hospital acquired infections. About 95% of the participants considered that prevention of HAIs were a valuable part of their role. About 65% of the staff nurses had received formal training regarding hand hygiene. The 100 % of participants felt that they would be less likely to transmit infection to the patients if they performed hand-hygiene. About 64% of them argued that hand hygiene agents were not readily available in current settings. Regarding practice, only 6% performed hand hygiene before patients contact and 27% of the staff nurses reported that they often forgot to perform hand hygiene. \u0000Conclusion : The finding of this study revealed a good knowledge of infection prevention among the majority of participants with relatively minimal level of practice. For strengthening the knowledge, attitude and practice towards HAIs, there is in need of developing regular training program and monitoring on performance feedback regarding hand hygiene is recommended. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 347-350","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124806334","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 : 2018-12-20DOI: 10.3329/nimcj.v10i1.39332
Suraiya Begum, F. Sharmin, D. Biswas, I. Jahan, Munira Hossain
Abstract not available Northern International Medical College Journal Vol.10(1) Jul 2018: 355-356
北方国际医学院学报Vol.10(1) july 2018: 355-356
{"title":"Androgen Secreting Adrenal Adenoma – A Case report","authors":"Suraiya Begum, F. Sharmin, D. Biswas, I. Jahan, Munira Hossain","doi":"10.3329/nimcj.v10i1.39332","DOIUrl":"https://doi.org/10.3329/nimcj.v10i1.39332","url":null,"abstract":"Abstract not available \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 355-356","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128028334","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 : 2018-12-20DOI: 10.3329/NIMCJ.V10I1.39327
N. Sultana, S. Rahman, F. Ahmed, S. Ullah
Background : Premature Rupture of Membrane (PROM) is a significant obstetric emergency where a normal pregnancy suddenly becomes a high risk one. It can cause serious complications of mother and fetus. Patient’s history, per speculum vaginal with Nitrazine paper test and Fern test considered as gold standard for diagnosis of PROM. But these multiple tests are hazardous and time consuming. Therefore Alpha-Feto Protein (AFP) test is a single sensitive test for proper diagnosis of PROM. Objective : To evaluate the accuracy of Alpha-Feto protein in vaginal fluid as a diagnostic tool of PROM. Method : It was a cross sectional study, carried out among 120 pregnant women who had the gestational age between 28th to 40th week of pregnancy. Sample was collected purposively and divided into two groups. In group-I-62 suspected PROM patients were selected who gave the history of per vaginal watery discharge and was found positive in per speculum examination (P/S). In group-II-58 non PROM pregnant patients were selected. Then in group-I, Nitrazine paper test and Fern test were done to confirme PROM patients. Both groups AFP test was done by AxSYM auto analyzer. Finally the accuracy of AFP was evaluated against the gold standard test. Result : It was found that AFP concentration was significantly higher in group-I of suspected PROM patients (30- 502ng/ml) than in group-II (0-40ng/ml). Among 62 suspected PROM patients 49 were found gold standard (Nitrogen paper test and Fern test) positive. Out of these 49 confirmed PROM patients 48 was found positive in Alpha-Feto protein test. The sensitivity of AFP test was found 98%, specificity was 84.6% and accuracy was 95.1%. Conclusion : As Alpha-Feto protein in vaginal fluid was found highly accurate (95.1%) for diagnosis of PROM. Therefore, AFP test can be used as a single sensitive test for diagnosis of PROM. Northern International Medical College Journal Vol.10(1) Jul 2018: 335-338
{"title":"Alpha Feto Protein in vaginal fluid as a diagnostic marker of Premature rupture of membrane","authors":"N. Sultana, S. Rahman, F. Ahmed, S. Ullah","doi":"10.3329/NIMCJ.V10I1.39327","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39327","url":null,"abstract":"Background : Premature Rupture of Membrane (PROM) is a significant obstetric emergency where a normal pregnancy suddenly becomes a high risk one. It can cause serious complications of mother and fetus. Patient’s history, per speculum vaginal with Nitrazine paper test and Fern test considered as gold standard for diagnosis of PROM. But these multiple tests are hazardous and time consuming. Therefore Alpha-Feto Protein (AFP) test is a single sensitive test for proper diagnosis of PROM. \u0000Objective : To evaluate the accuracy of Alpha-Feto protein in vaginal fluid as a diagnostic tool of PROM. \u0000Method : It was a cross sectional study, carried out among 120 pregnant women who had the gestational age between 28th to 40th week of pregnancy. Sample was collected purposively and divided into two groups. In group-I-62 suspected PROM patients were selected who gave the history of per vaginal watery discharge and was found positive in per speculum examination (P/S). In group-II-58 non PROM pregnant patients were selected. Then in group-I, Nitrazine paper test and Fern test were done to confirme PROM patients. Both groups AFP test was done by AxSYM auto analyzer. Finally the accuracy of AFP was evaluated against the gold standard test. \u0000Result : It was found that AFP concentration was significantly higher in group-I of suspected PROM patients (30- 502ng/ml) than in group-II (0-40ng/ml). Among 62 suspected PROM patients 49 were found gold standard (Nitrogen paper test and Fern test) positive. Out of these 49 confirmed PROM patients 48 was found positive in Alpha-Feto protein test. The sensitivity of AFP test was found 98%, specificity was 84.6% and accuracy was 95.1%. \u0000Conclusion : As Alpha-Feto protein in vaginal fluid was found highly accurate (95.1%) for diagnosis of PROM. Therefore, AFP test can be used as a single sensitive test for diagnosis of PROM. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 335-338","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126027270","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 : 2018-12-20DOI: 10.3329/NIMCJ.V10I1.39329
F. Chowdhury, B. Yasmeen, S. Rahman
Back ground : Exclusive breastfeeding (EBF) means that the infant receives only breast milk for the first six months of life after birth. In Bangladesh, 55% of children less than 6 months of age are exclusively breastfed according to BDHS 2014. Objectives : To assess the exclusive breast feeding practice and associated factors among children in an urban area ofBangladesh. Method : This cross-sectional study was conducted in Popular Medical College, Dhanmondi, Dhaka, among 80 mothers having infants aged 7-12 months, attending the outpatient department were selected purposively for the study during the period of 1st August 2017 to 31st December 2017. Sample were selected purpasively for the study and predesigned questionnaire were used for data collection. Data analysis was done by using SPSS software version 22. Result : It was found that only 30(37.5%) mother went for regular antenatal checkup and remaining 50 (62.5%) had irregular antenatal check up. But none of them got breastfeeding advice during antenatal visit. Breastfeeding was initiated with in 1 hour of birth in 36(40%) cases and 44 (60%) cases after 1hour of birth. Exclusive breastfeeding (EBF)was found in 40 (50%) children. Among them 30 (75%) were children of housewife mothers. Mixed feeding (breast milk plus formula/ cow’s milk) was given to 30 children among them18 (60%) were the children of housewife mothers.Only formula milk was given to 10 children of them 8(80%) were the children of housewife mothers.Exclusive breast milk was not given by 18(45%) mothers due to job or other occupation whereas 22 (55%) mother did not give EBF due to insufficient breast milk. Conclusion : In the study rate of exclusive breast feeding was 50%. This study also showed that frequency of exclusive breast feeding practice was lower in working mothers than housewife mothers. This study also showed that the speculation of not getting sufficient milk was one of the main reasons for not giving exclusive breastfeeding. Northern International Medical College Journal Vol.10(1) Jul 2018: 343-346
背景:纯母乳喂养(EBF)是指婴儿在出生后的头六个月只接受母乳。根据《2014年儿童健康调查》，在孟加拉国，55%的6个月以下儿童接受纯母乳喂养。目的:评估孟加拉国城市地区儿童的纯母乳喂养做法及其相关因素。方法:本横断面研究在达卡Dhanmondi的Popular Medical College进行，有目的地选择2017年8月1日至2017年12月31日在门诊部就诊的80名7-12个月婴儿的母亲进行研究。本研究有目的地选取样本，采用预先设计的问卷进行数据收集。采用SPSS软件22进行数据分析。结果:仅有30例(37.5%)产妇定期进行产前检查，其余50例(62.5%)产妇不定期进行产前检查。但在产前检查期间，没有人得到母乳喂养的建议。36例(40%)在出生1小时内开始母乳喂养，44例(60%)在出生1小时后开始母乳喂养。40名(50%)儿童发现纯母乳喂养(EBF)。其中30人(75%)是家庭主妇的子女。对30名儿童进行了混合喂养(母乳加配方奶/牛奶)，其中18名(60%)是家庭主妇母亲的孩子。只给10个孩子喂配方奶，其中8个(80%)是家庭主妇的孩子。18名(45%)母亲由于工作或其他职业而没有提供纯母乳，而22名(55%)母亲由于母乳不足而没有提供EBF。结论:本研究纯母乳喂养率为50%。这项研究还表明，职业母亲纯母乳喂养的频率低于家庭主妇母亲。这项研究还表明，没有得到足够的牛奶是不进行纯母乳喂养的主要原因之一。北方国际医学院学报Vol.10(1) july 2018: 343-346
{"title":"Study on Exclusive Breastfeeding practice and related factors among mothers attending in a tertiary care hospital of Bangladesh","authors":"F. Chowdhury, B. Yasmeen, S. Rahman","doi":"10.3329/NIMCJ.V10I1.39329","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39329","url":null,"abstract":"Back ground : Exclusive breastfeeding (EBF) means that the infant receives only breast milk for the first six months of life after birth. In Bangladesh, 55% of children less than 6 months of age are exclusively breastfed according to BDHS 2014. \u0000Objectives : To assess the exclusive breast feeding practice and associated factors among children in an urban area ofBangladesh. \u0000Method : This cross-sectional study was conducted in Popular Medical College, Dhanmondi, Dhaka, among 80 mothers having infants aged 7-12 months, attending the outpatient department were selected purposively for the study during the period of 1st August 2017 to 31st December 2017. Sample were selected purpasively for the study and predesigned questionnaire were used for data collection. Data analysis was done by using SPSS software version 22. \u0000Result : It was found that only 30(37.5%) mother went for regular antenatal checkup and remaining 50 (62.5%) had irregular antenatal check up. But none of them got breastfeeding advice during antenatal visit. Breastfeeding was initiated with in 1 hour of birth in 36(40%) cases and 44 (60%) cases after 1hour of birth. Exclusive breastfeeding (EBF)was found in 40 (50%) children. Among them 30 (75%) were children of housewife mothers. Mixed feeding (breast milk plus formula/ cow’s milk) was given to 30 children among them18 (60%) were the children of housewife mothers.Only formula milk was given to 10 children of them 8(80%) were the children of housewife mothers.Exclusive breast milk was not given by 18(45%) mothers due to job or other occupation whereas 22 (55%) mother did not give EBF due to insufficient breast milk. \u0000Conclusion : In the study rate of exclusive breast feeding was 50%. This study also showed that frequency of exclusive breast feeding practice was lower in working mothers than housewife mothers. This study also showed that the speculation of not getting sufficient milk was one of the main reasons for not giving exclusive breastfeeding. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 343-346","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134239020","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 : 2018-12-20DOI: 10.3329/nimcj.v10i1.39328
N. Begum, N. Begum, Sk Akbar Hossain, Afm Ashik Imran, Mst Laizuman Nahar
Background : Antenatal care (ANC) is an important determinant of high maternal mortality rate and one of the basic components of maternal care on which the life of mothers and newborn babies depend. Objective : To study the Antenatal care practice among pregnant women in a selected rural area. Methodology : This descriptive cross-sectional study was conducted among pregnant women in a selected rural area from July 2016 to December 2016. Total sample was 121. Purposive sampling technique was followed. Data collection was done by face to face interview by using pretested structured questionnaire. Data was analyzed by SPSS version 17.0. Results : A total of 121 women were interviewed. Sixty nine (57.02%) pregnant women were registered for ANC. Among them 47(68.11%) of respondents completed more than 4ANC visits. For the current pregnancy 56(46.28%) preferred Upazila Health Complex (UHC) and home delivery was preferred by 34(28.09%) respondents. Among the respondent age group 25-30 yrs were 61(50.41%) and educated upto primary level were 59(48.76%). Monthly income between 5000-10000 taka was among 48(39.66%) respondents. Most of their husbands (52.06%) were educated up to primary level and 25.61 % of them were garments worker and 23.96 % were day laborers. Conclusion : ANC practice was not satisfactory. Only half of the pregnant women attended for ANC and completed minimum four visits. Nearly half of the pregnant women preferred UHC. Educated women from lower economic status were found to attend for ANC. Northern International Medical College Journal Vol.10(1) Jul 2018: 339-342
背景:产前保健是产妇死亡率高的一个重要决定因素，也是母亲和新生儿生命所依赖的产妇保健的基本组成部分之一。目的:了解某农村地区孕妇产前保健情况。方法:本描述性横断面研究于2016年7月至2016年12月在选定的农村地区对孕妇进行。总样本数为121。采用目的抽样技术。数据收集采用面对面访谈，采用预测结构化问卷。数据分析采用SPSS 17.0版本。结果:共采访121名女性。69名(57.02%)孕妇进行了非分娩性妊娠登记。其中47人(68.11%)完成了4次以上的anc访问。对于目前的怀孕，56人(46.28%)倾向于Upazila保健中心(UHC)， 34人(28.09%)倾向于在家分娩。在受访年龄组中，25-30岁的有61人(50.41%)，小学及以上学历的有59人(48.76%)。月收入在5000-10000塔卡之间的受访者有48人(39.66%)。她们的大多数丈夫(52.06%)受过小学以上教育，其中25.61%是制衣工人，23.96%是临时工。结论:ANC实践不理想。只有一半的孕妇参加了产前检查，并完成了至少四次检查。近一半的孕妇更喜欢全民健康覆盖。经济地位较低的受过教育的妇女也参加了非国大。北方国际医学院学报Vol.10(1) july 2018: 339-342
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