The term ‘Chikungunya’ often refers to both the virus (CHIKV) and the illness or fever (CHIKF) caused by this virus. Chikungunya fever is a self-remitting febrile viral illness that has been associated with frequent outbreaks in tropical countries of Africa and Southeast Asia. The first outbreak of Chikungunya was in a Swahili village of southern Tanzania in 1952. The name ‘Chikungunya’ derives from the African dialect Swahili or Kimakonde which means ‘to become contorted or bent over’. In Congo, it is referred to as ‘buka-buka’, which means ‘broken-broken’. These terms describe the stooped posture of the sufferers as a consequence of severe chronic incapacitating arthralgia.1,2
{"title":"Talk of the Town - Chikungunya","authors":"Rezwanur Rahman","doi":"10.3329/dmcj.v5i2.33351","DOIUrl":"https://doi.org/10.3329/dmcj.v5i2.33351","url":null,"abstract":"The term ‘Chikungunya’ often refers to both the virus (CHIKV) and the illness or fever (CHIKF) caused by this virus. Chikungunya fever is a self-remitting febrile viral illness that has been associated with frequent outbreaks in tropical countries of Africa and Southeast Asia. The first outbreak of Chikungunya was in a Swahili village of southern Tanzania in 1952. The name ‘Chikungunya’ derives from the African dialect Swahili or Kimakonde which means ‘to become contorted or bent over’. In Congo, it is referred to as ‘buka-buka’, which means ‘broken-broken’. These terms describe the stooped posture of the sufferers as a consequence of severe chronic incapacitating arthralgia.1,2","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"54-56"},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48250117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Fourniers gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. Objective: The main aim of this study was to observe comprehensively the disease profile of Fourniers gangrene, with a specific intent to observe the proportion of patient presenting with Fourniers gangrene. Materials and method: This cross sectional study was done in Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh. By purposive sampling from the admitted patients of department of Surgery 22 patients were finalized according to the eligibility criteria. Patients were thoroughly evaluated and managed and all relevant data were recorded. Data were managed, edited and plotted in tabular and figure form. Data analysis was done by chi square test. p value was significant at <0.05. Results: The mean ±SD age of the patients was 43.9±14.82 years. Among the study subjects 68.2% showed insidious onset whereas remaining showed abrupt onset. Both cutaneous and anorectal factors claimed the highest (36.4%) of etiology. Pain and Oedema were the prime manifestation. In 59% cases testes were not exposed. In 36.4% cases only scrotum was involved whereas in 22.7% cases both scrotum and perineum were involved. After provision of aggressive treatment in 72.7% cases no complication was observed. During treatment 9.1% subjects expired. Conclusion: Elderly and low economic profile people are frequently affected with Fourniers gangrene. To reduce the significant morbidity and mortality aggressive medical and surgical management is mandatory. Delta Med Col J. Jul 2017 5(2): 68-75
{"title":"Fourniers Gangrene: Approaches to the Diagnosis and Treatment","authors":"Ashrafuzzaman, A. Bhattacharjee, Mahbubur Rahman","doi":"10.3329/DMCJ.V5I2.33344","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I2.33344","url":null,"abstract":"Background: Fourniers gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. Objective: The main aim of this study was to observe comprehensively the disease profile of Fourniers gangrene, with a specific intent to observe the proportion of patient presenting with Fourniers gangrene. Materials and method: This cross sectional study was done in Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh. By purposive sampling from the admitted patients of department of Surgery 22 patients were finalized according to the eligibility criteria. Patients were thoroughly evaluated and managed and all relevant data were recorded. Data were managed, edited and plotted in tabular and figure form. Data analysis was done by chi square test. p value was significant at <0.05. Results: The mean ±SD age of the patients was 43.9±14.82 years. Among the study subjects 68.2% showed insidious onset whereas remaining showed abrupt onset. Both cutaneous and anorectal factors claimed the highest (36.4%) of etiology. Pain and Oedema were the prime manifestation. In 59% cases testes were not exposed. In 36.4% cases only scrotum was involved whereas in 22.7% cases both scrotum and perineum were involved. After provision of aggressive treatment in 72.7% cases no complication was observed. During treatment 9.1% subjects expired. Conclusion: Elderly and low economic profile people are frequently affected with Fourniers gangrene. To reduce the significant morbidity and mortality aggressive medical and surgical management is mandatory. Delta Med Col J. Jul 2017 5(2): 68-75","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"68-75"},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/DMCJ.V5I2.33344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49465361","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}
Correction: On 10th August 2017 due to typographical errors, the period of the study was changed from May 2016 to June 2017 and the caption of the red segment in Figure 1 was changed from No UTI, 41% to UTI, 59% Background: Urinary tract infection (UTI) is one of the common bacterial infections in mankind. The changing antimicrobial sensitivity in UTI demands use of appropriate antibiotics. Objective: This study was conducted to determine the distribution and antimicrobial susceptibility of uropathogens. Materials and method: This was a prospective study conducted in Bangladesh Medical College & Hospital, Dhaka, Bangladesh between May 2016 and June 2017 to identify the organisms causing UTI and their antibiotic susceptibility. Clean catch midstream urine samples were collected from 95 patients presenting with symptoms of UTI. Antimicrobial susceptibility was performed by disc diffusion method. Results: Out of 95 urine samples, 56 (58.9%) were found positive. The prevalence was significantly higher in females than in males (females: 58.9%; males: 41%). Age group of >48 years showed higher prevalence of UTI. The most common organisms isolated were Escherichia coli, Klebsiella, Pseudomonas, Proteus and Staphylococcus aureus. These represented 44.6%, 21.4%, 14.3%, 12.5%, and 7.14% of isolates respectively. Imipenem and Meropenem were found the most susceptible drug against isolated uropathogens. Conclusion: Most powerful antibiotics in our study were imipenem and meropenem. In conclusion, one can truly affirm that the choice of drugs in the treatment of UTI is becoming quite narrow today due to the wide scale resistance that the common UTI pathogens show to drugs which have been used previously. Delta Med Col J. Jul 2017 5(2): 57-62
{"title":"Antimicrobial Sensitivity Pattern of Bacterial Pathogens Associated with Urinary Tract Infection","authors":"N. Akhtar, Rezwanur Rahman, S. Sultana","doi":"10.3329/DMCJ.V5I2.33342","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I2.33342","url":null,"abstract":"Correction: On 10th August 2017 due to typographical errors, the period of the study was changed from May 2016 to June 2017 and the caption of the red segment in Figure 1 was changed from No UTI, 41% to UTI, 59% Background: Urinary tract infection (UTI) is one of the common bacterial infections in mankind. The changing antimicrobial sensitivity in UTI demands use of appropriate antibiotics. Objective: This study was conducted to determine the distribution and antimicrobial susceptibility of uropathogens. Materials and method: This was a prospective study conducted in Bangladesh Medical College & Hospital, Dhaka, Bangladesh between May 2016 and June 2017 to identify the organisms causing UTI and their antibiotic susceptibility. Clean catch midstream urine samples were collected from 95 patients presenting with symptoms of UTI. Antimicrobial susceptibility was performed by disc diffusion method. Results: Out of 95 urine samples, 56 (58.9%) were found positive. The prevalence was significantly higher in females than in males (females: 58.9%; males: 41%). Age group of >48 years showed higher prevalence of UTI. The most common organisms isolated were Escherichia coli, Klebsiella, Pseudomonas, Proteus and Staphylococcus aureus. These represented 44.6%, 21.4%, 14.3%, 12.5%, and 7.14% of isolates respectively. Imipenem and Meropenem were found the most susceptible drug against isolated uropathogens. Conclusion: Most powerful antibiotics in our study were imipenem and meropenem. In conclusion, one can truly affirm that the choice of drugs in the treatment of UTI is becoming quite narrow today due to the wide scale resistance that the common UTI pathogens show to drugs which have been used previously. Delta Med Col J. Jul 2017 5(2): 57-62","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/DMCJ.V5I2.33342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48703253","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}
A. Begum, N. Khan, Akm Shafiuzzaman, F. Shahid, Amani Anam, K. S. Ahmed, R. A. Begum, Soniya Fahmi
Background: Hanging is always suicidal unless otherwise proved. It is a form of violent asphyxial death. It produces painless death for the victims so that it is a widely practiced method of suicide. In Bangladesh hanging is one of the commonest methods of suicide. Objective: The objective of this study was to find out socio-demographic characteristics of victims, common ligature materials used by victims and post-mortem findings. Materials and method: A retrospective cross sectional study was done in Dhaka Medical College Mortuary during the period of January 2009 to January 2010. During this period data were collected from 2133 cases of medicolegal autopsies by purposive sampling. Results: A total of 2133 medicolegal autopsies were analyzed of which 78 (3.65%) were deaths due to hanging. Out of these 78 cases maximum 37 (47.44%) deaths due to hanging were in the age group of 21-30 years. Majority of the cases (48; 61.54%) were observed in females. Majority (32; 41.03%) of victims had used Dopatta (orna) as a ligature material. Cyanosis of fingertips and nail beds was the commonest (75; 96.15%) findings in cases of asphyxial death due to hanging. Conclusion: Suicidal hanging is observed in this study mostly within the young age group ranging from 21-30 yrs. So, awareness at the level of family and community should be raised to improve personal and social relation in every sphere. The factors provoking an individual for an attempt to suicide should also be investigated for its prevention. Delta Med Col J. Jul 2017 5(2): 89-93
{"title":"Suicidal Death due to Hanging","authors":"A. Begum, N. Khan, Akm Shafiuzzaman, F. Shahid, Amani Anam, K. S. Ahmed, R. A. Begum, Soniya Fahmi","doi":"10.3329/DMCJ.V5I2.33347","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I2.33347","url":null,"abstract":"Background: Hanging is always suicidal unless otherwise proved. It is a form of violent asphyxial death. It produces painless death for the victims so that it is a widely practiced method of suicide. In Bangladesh hanging is one of the commonest methods of suicide. Objective: The objective of this study was to find out socio-demographic characteristics of victims, common ligature materials used by victims and post-mortem findings. Materials and method: A retrospective cross sectional study was done in Dhaka Medical College Mortuary during the period of January 2009 to January 2010. During this period data were collected from 2133 cases of medicolegal autopsies by purposive sampling. Results: A total of 2133 medicolegal autopsies were analyzed of which 78 (3.65%) were deaths due to hanging. Out of these 78 cases maximum 37 (47.44%) deaths due to hanging were in the age group of 21-30 years. Majority of the cases (48; 61.54%) were observed in females. Majority (32; 41.03%) of victims had used Dopatta (orna) as a ligature material. Cyanosis of fingertips and nail beds was the commonest (75; 96.15%) findings in cases of asphyxial death due to hanging. Conclusion: Suicidal hanging is observed in this study mostly within the young age group ranging from 21-30 yrs. So, awareness at the level of family and community should be raised to improve personal and social relation in every sphere. The factors provoking an individual for an attempt to suicide should also be investigated for its prevention. Delta Med Col J. Jul 2017 5(2): 89-93","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"89-93"},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/DMCJ.V5I2.33347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47777238","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}
Syeda Fahmida Afrin, H. Rahman, Asadul Millat, Shafiul Alam Quarashi, A. Begum, Meherunnesa Begum
Percutaneous Coronary Intervention (PCI) is the most commonly performed invasive therapeutic cardiac procedure and plays an important role in the treatment of ischemic heart disease. Complications of Percutaneous Coronary Intervention (PCI) are relatively infrequent. The most common complications include discomfort and bleeding at the puncture site where the catheter was inserted. Major complications include death, MI, or stroke and other infrequent complications include transient ischemic attacks (minor myocardial injury), vascular complication and contrast induced nephropathy, transient ischemia, or minor myocardial injury (MMI), myocardial necrosis due to compromisation of threatened coronary circulation during balloon inflation. Cardiac Troponin I (cTnI) assays for the assessment of myocardial injury has been demonstrated for the diagnosis of MMI and long term prognosis after PCI. Delta Med Col J. Jul 2017 5(2): 94-98
{"title":"Minor Myocardial Injury: An Early Post Intervention Complication","authors":"Syeda Fahmida Afrin, H. Rahman, Asadul Millat, Shafiul Alam Quarashi, A. Begum, Meherunnesa Begum","doi":"10.3329/DMCJ.V5I2.33348","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I2.33348","url":null,"abstract":"Percutaneous Coronary Intervention (PCI) is the most commonly performed invasive therapeutic cardiac procedure and plays an important role in the treatment of ischemic heart disease. Complications of Percutaneous Coronary Intervention (PCI) are relatively infrequent. The most common complications include discomfort and bleeding at the puncture site where the catheter was inserted. Major complications include death, MI, or stroke and other infrequent complications include transient ischemic attacks (minor myocardial injury), vascular complication and contrast induced nephropathy, transient ischemia, or minor myocardial injury (MMI), myocardial necrosis due to compromisation of threatened coronary circulation during balloon inflation. Cardiac Troponin I (cTnI) assays for the assessment of myocardial injury has been demonstrated for the diagnosis of MMI and long term prognosis after PCI. Delta Med Col J. Jul 2017 5(2): 94-98","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"94-98"},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/DMCJ.V5I2.33348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69489038","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}
Nasreen Akther, Meherunnessa Begum, S. Farah, N. Begum, Nargis Momotaz Lata, Rokshana Sabnom
Background: Early childhood care plays an important role in childrens development and provides a valuable support to young children. High quality child care can have a positive influence on childrens development. Objective: To find out the child care practices among the mothers of below five year children in a semi urban area of Bangladesh and to find its association with some important demographic variables. Materials and method: This descriptive type of cross-sectional study was conducted among 440 respondents who were selected purposively at Purba Chandra, Shafipur Upazilla, Gazipur in Bangladesh in January, 2016. A pre-designed semi structured questionnaire was used to collect data by face to face interview. Results: Majority of the respondents (72.05%) were within the age group of 16-25 years. About 25% (111) children were within 0-12 months of age. Among the respondents 280 (63.64%) were housewives and 141 (32.05%) were garment workers. Maximum mother (72.73%) herself took care of their children and only 86 (19.54%) were cared by their grandmother/father. Majority of the children (87.05%) took colostrum as their first food, 164 (37.27%) children were breast fed up to age of 13-24 months and 302 (68.64%) children received exclusive breast feeding up to 6 months. Most of the children (92.95%) were vaccinated as per EPI schedule. Among them 283 (64.32%) children suffered from disease in last 3 months and 225 (79.51%) took treatment for their illness. Among them 83 (36.89%) took treatment from quack and only 76 (33.78%) children took treatment from private doctor. Conclusion: In this study, most of the mothers did not complete their secondary education and had a lack of knowledge of child rearing practice. This study provided a vivid picture of the child care practice among mothers and could help to the concerned authority in their policy making and planning to alleviate the problem. Delta Med Col J. Jul 2017 5(2): 76-82
{"title":"Child Care Practice of Mother of below Five Years Children in a Selected Semi Urban Area of Bangladesh","authors":"Nasreen Akther, Meherunnessa Begum, S. Farah, N. Begum, Nargis Momotaz Lata, Rokshana Sabnom","doi":"10.3329/DMCJ.V5I2.33345","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I2.33345","url":null,"abstract":"Background: Early childhood care plays an important role in childrens development and provides a valuable support to young children. High quality child care can have a positive influence on childrens development. Objective: To find out the child care practices among the mothers of below five year children in a semi urban area of Bangladesh and to find its association with some important demographic variables. Materials and method: This descriptive type of cross-sectional study was conducted among 440 respondents who were selected purposively at Purba Chandra, Shafipur Upazilla, Gazipur in Bangladesh in January, 2016. A pre-designed semi structured questionnaire was used to collect data by face to face interview. Results: Majority of the respondents (72.05%) were within the age group of 16-25 years. About 25% (111) children were within 0-12 months of age. Among the respondents 280 (63.64%) were housewives and 141 (32.05%) were garment workers. Maximum mother (72.73%) herself took care of their children and only 86 (19.54%) were cared by their grandmother/father. Majority of the children (87.05%) took colostrum as their first food, 164 (37.27%) children were breast fed up to age of 13-24 months and 302 (68.64%) children received exclusive breast feeding up to 6 months. Most of the children (92.95%) were vaccinated as per EPI schedule. Among them 283 (64.32%) children suffered from disease in last 3 months and 225 (79.51%) took treatment for their illness. Among them 83 (36.89%) took treatment from quack and only 76 (33.78%) children took treatment from private doctor. Conclusion: In this study, most of the mothers did not complete their secondary education and had a lack of knowledge of child rearing practice. This study provided a vivid picture of the child care practice among mothers and could help to the concerned authority in their policy making and planning to alleviate the problem. Delta Med Col J. Jul 2017 5(2): 76-82","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"76-82"},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/DMCJ.V5I2.33345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42708083","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}
Ashith Chandra Das, T. Azad, Nure Ishrat Nazme, Jannatul Ferdush Chowdhury, Z. Rahman, F. Rahman
Background: The prevalence of gestational diabetes mellitus (GDM) is 9.7% in Bangladesh. Infants of diabetic mothers (IDM) have a significant chance to develop various complications including glucose instability. Objective: To find out the incidence of IDM among low birth weight (LBW) babies and their relation with blood glucose level during 1st 48 hours of life. Materials and method: This cross sectional study was conducted from July 2012 to June 2013 on 189 LBW babies with birth weight <2500 gram up to 1000 gram admitted within 3 hours of life in the neonatal unit of Jalalabad Ragib Rabeya Medical College Hospital, Sylhet, Bangladesh. Detailed history including maternal history of GDM was taken. Blood glucose level was done during admission and at 3 to <6 hours of age, 6 to <24 hours of age and 24-48 hours of age. Results: Among 189 cases, male baby were 136 and female baby were 53. Preterm babies were 49.2% and term babies were 50.8%. Most of the newborn babies were delivered at hospital (78.3%) and by vaginal delivery (75.1%). Among LBW babies, 5% were infants of diabetic mothers. Hypoglycemia was present in 33.3% of infants of diabetic mothers which was significantly higher than infants of non-diabetic mothers (5.6%) within 3 hours of age. Conclusion: Infants of diabetic mothers may present as LBW and may be delivered prematurely and they have high incidence of hypoglycemia during early periods of life. Delta Med Col J. Jan 2017 5(1): 4-8
{"title":"Incidence and Glycemic Status of Infants of Diabetic Mothers among 189 Hospitalized Low Birth Weight Babies","authors":"Ashith Chandra Das, T. Azad, Nure Ishrat Nazme, Jannatul Ferdush Chowdhury, Z. Rahman, F. Rahman","doi":"10.3329/DMCJ.V5I1.31420","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I1.31420","url":null,"abstract":"Background: The prevalence of gestational diabetes mellitus (GDM) is 9.7% in Bangladesh. Infants of diabetic mothers (IDM) have a significant chance to develop various complications including glucose instability. Objective: To find out the incidence of IDM among low birth weight (LBW) babies and their relation with blood glucose level during 1st 48 hours of life. Materials and method: This cross sectional study was conducted from July 2012 to June 2013 on 189 LBW babies with birth weight <2500 gram up to 1000 gram admitted within 3 hours of life in the neonatal unit of Jalalabad Ragib Rabeya Medical College Hospital, Sylhet, Bangladesh. Detailed history including maternal history of GDM was taken. Blood glucose level was done during admission and at 3 to <6 hours of age, 6 to <24 hours of age and 24-48 hours of age. Results: Among 189 cases, male baby were 136 and female baby were 53. Preterm babies were 49.2% and term babies were 50.8%. Most of the newborn babies were delivered at hospital (78.3%) and by vaginal delivery (75.1%). Among LBW babies, 5% were infants of diabetic mothers. Hypoglycemia was present in 33.3% of infants of diabetic mothers which was significantly higher than infants of non-diabetic mothers (5.6%) within 3 hours of age. Conclusion: Infants of diabetic mothers may present as LBW and may be delivered prematurely and they have high incidence of hypoglycemia during early periods of life. Delta Med Col J. Jan 2017 5(1): 4-8","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"4-8"},"PeriodicalIF":0.0,"publicationDate":"2017-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/DMCJ.V5I1.31420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42107818","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}
Mushfiqur Rahman, Mahbubul Hasan Munir, Raihanuddin, Shafiul Alam Shaheen, A. Khan, K. Sardar, A. Chowdhury
Background: Cardiovascular system may be profoundly affected by spinal anaesthesia due to unavoidable sympathetic blockade which is more prominent in elderly.A restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes. Objective: To assess whether a unilateral spinal anaesthesia using 0.5% hyperbaric bupivacaine will restrict the sympathetic block to avoid the undesired cardio vascular effects. Materials and method: In this prospective study 60 ASA Ill and IV patients aged between 60-90 years undergoing unilateral lower limb surgery were included. Patients were divided into two groups. In group-A, dural puncture was performed with the patient in the lateral decubitus position with 1.5 mL of hyperbaric bupivacaine. In group-B, it was performed with the patient in a seated position using 1.5 mL hyperbaric bupivacaine. Each patient was then placed in supine position. The speed of injection was 1 mL/30s. Patients were placed in the lateral position with operated side down and kept in this position for 10 minutes. Motor and sensory levels were assessed, and haemodynamic alterations were monitored just after block, 5, 10, 15 and 30 minutes of spinal anaesthesia. Results: The demographic data were found similar in both groups. The time to the onset of the sensory and motor block was significantly shorter in group-B. The duration of motor and sensory block was significantly shorter in group-A. Haemodynamically all the parameters revealed better out come in unilateral spinal anesthesia. The incidence of complications (nausea, headache, and hypotension) was also lower in group A. Conclusion: When unilateral spinal anesthesia was performed using a low-dose, low-volume and low-flow injection technique, it provides adequate sensory-motor block and helps to achieve stable hemodynamic parameters during surgery on a lower limb. Furthermore, this technique avoids unnecessary paralysis on the non-operated side. Delta Med Col J. Jan 2017 5(1): 20-24
{"title":"Haemodynamic Effects and Complications of Unilateral Spinal versus Standard Spinal Anesthesia in Elderly with Low Ejection Fraction Undergone Lower-Limb Surgery","authors":"Mushfiqur Rahman, Mahbubul Hasan Munir, Raihanuddin, Shafiul Alam Shaheen, A. Khan, K. Sardar, A. Chowdhury","doi":"10.3329/dmcj.v5i1.31426","DOIUrl":"https://doi.org/10.3329/dmcj.v5i1.31426","url":null,"abstract":"Background: Cardiovascular system may be profoundly affected by spinal anaesthesia due to unavoidable sympathetic blockade which is more prominent in elderly.A restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes. Objective: To assess whether a unilateral spinal anaesthesia using 0.5% hyperbaric bupivacaine will restrict the sympathetic block to avoid the undesired cardio vascular effects. Materials and method: In this prospective study 60 ASA Ill and IV patients aged between 60-90 years undergoing unilateral lower limb surgery were included. Patients were divided into two groups. In group-A, dural puncture was performed with the patient in the lateral decubitus position with 1.5 mL of hyperbaric bupivacaine. In group-B, it was performed with the patient in a seated position using 1.5 mL hyperbaric bupivacaine. Each patient was then placed in supine position. The speed of injection was 1 mL/30s. Patients were placed in the lateral position with operated side down and kept in this position for 10 minutes. Motor and sensory levels were assessed, and haemodynamic alterations were monitored just after block, 5, 10, 15 and 30 minutes of spinal anaesthesia. Results: The demographic data were found similar in both groups. The time to the onset of the sensory and motor block was significantly shorter in group-B. The duration of motor and sensory block was significantly shorter in group-A. Haemodynamically all the parameters revealed better out come in unilateral spinal anesthesia. The incidence of complications (nausea, headache, and hypotension) was also lower in group A. Conclusion: When unilateral spinal anesthesia was performed using a low-dose, low-volume and low-flow injection technique, it provides adequate sensory-motor block and helps to achieve stable hemodynamic parameters during surgery on a lower limb. Furthermore, this technique avoids unnecessary paralysis on the non-operated side. Delta Med Col J. Jan 2017 5(1): 20-24","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2017-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/dmcj.v5i1.31426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47635858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The complications of pregnancy and childbirth are the leading causes of death and disability of reproductive age in developing countries. So, care of critically ill pregnant patients is an important aspect of obstetric services delivered in a tertiary care hospital. Objective: This study was conducted to find out the proportion of obstetric patients treated in ICU over a period of one year, to ascertain the frequency of serious diseases, to identify the risk factors and to determine the maternal mortality of ICU treated patients with an aim to identify the importance of a separate ICU to be incorporated within the labor and delivery suites. Materials and method: This retrospective study was conducted in Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, during the period from January 2008 to December 2008. Total obstetric patients from all four maternity units admitted in ICU were 52 in number. Evaluation of the cases was done from records of obstetric patients treated in ICU. Necessary information was collected in a predesigned clinical sheet and the findings were compiled and necessary statistical analysis was done using SPSS. Results: ICU admission of obstetric patients in the year 2008 in DMCH was 0.82% of total deliveries and total obstetric population represented 14.3% of total ICU population. The main primary factors for ICU transfer were complications of eclampsia (59.6%) and obstetric haemorrhage (26.9%). The common final causes of ICU transfer were pulmonary oedema (35.5%) in eclamptic women and haemorrhagic shock (66.7%) in non eclamptic women. A total of 39 (75%) patients died in ICU. The major cause of death was pulmonary oedema (45.5%) in eclamptic patients and haemorrhagic shock (47.1%) in non eclamptic patients. Conclusion: Thorough evaluation of cases has revealed that many patients needed ICU treatment which could not be provided because of limited facilities. So, incorporation of a separate obstetric ICU in DMCH could be an important component of measures aimed to reduce maternal mortality rate (MMR). Delta Med Col J. Jan 2017 5(1): 15-19
{"title":"Critically Ill Obstetric Patients Treated in Intensive Care Unit: a Study in a Tertiary Care Institution","authors":"R. Haque, Mizanur Rahman, S. Jahan, K. Begum","doi":"10.3329/DMCJ.V5I1.31423","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I1.31423","url":null,"abstract":"Background: The complications of pregnancy and childbirth are the leading causes of death and disability of reproductive age in developing countries. So, care of critically ill pregnant patients is an important aspect of obstetric services delivered in a tertiary care hospital. Objective: This study was conducted to find out the proportion of obstetric patients treated in ICU over a period of one year, to ascertain the frequency of serious diseases, to identify the risk factors and to determine the maternal mortality of ICU treated patients with an aim to identify the importance of a separate ICU to be incorporated within the labor and delivery suites. Materials and method: This retrospective study was conducted in Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, during the period from January 2008 to December 2008. Total obstetric patients from all four maternity units admitted in ICU were 52 in number. Evaluation of the cases was done from records of obstetric patients treated in ICU. Necessary information was collected in a predesigned clinical sheet and the findings were compiled and necessary statistical analysis was done using SPSS. Results: ICU admission of obstetric patients in the year 2008 in DMCH was 0.82% of total deliveries and total obstetric population represented 14.3% of total ICU population. The main primary factors for ICU transfer were complications of eclampsia (59.6%) and obstetric haemorrhage (26.9%). The common final causes of ICU transfer were pulmonary oedema (35.5%) in eclamptic women and haemorrhagic shock (66.7%) in non eclamptic women. A total of 39 (75%) patients died in ICU. The major cause of death was pulmonary oedema (45.5%) in eclamptic patients and haemorrhagic shock (47.1%) in non eclamptic patients. Conclusion: Thorough evaluation of cases has revealed that many patients needed ICU treatment which could not be provided because of limited facilities. So, incorporation of a separate obstetric ICU in DMCH could be an important component of measures aimed to reduce maternal mortality rate (MMR). Delta Med Col J. Jan 2017 5(1): 15-19","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2017-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48354130","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}
A. Momtaz, K. Sharmin, S. Rahman, N. Sultana, R. Sharmin
Background: Diabetes Mellitus is a major health problem not only in urban but also in the rural areas of Bangladesh. Regarding its treatment, a suitable drug is yet to be available which can permanently cure this disease. Over 400 traditional plants have been reported for the treatment of diabetes, but only a small number have received scientific and medical evaluation to assess their efficacy. Objective: The study was performed to compare the anti diabetic effect of Psidium guajava Linn leaves with an oral anti diabetic drug (Glibenclamide), in experimentally induced diabetic rats. Materials and method: The experiment was carried out in the department of Pharmacology & Therapeutics of Dhaka Medical College, Dhaka, Bangladesh from July 2012 to June 2013. Twenty four healthy rats of Long Evans Norwegian strain were divided into 4 groups (group A, B, C and D) comprising 6 rats in each. Group A (normal control) received standard rat food for 14 days. Diabetes was induced by administration of Alloxan 120 mg/kg/body weight in group B, C and D. Group B (diabetic control group) was given standard rat food. Group C and D was treated with ethanol extract of Psidium guajava leaves 100 mg/kg body weight and Glibenclamide 1.5 mg/kg/day orally respectively. Total duration of the experiment was 15 days. Results: Administration of ethanol extract of Psidium guajava leaves in group C and Glibenclamide in group D produced a significant reduction (p<0.001) in blood glucose level as compared to group B (diabetic control group). Conclusion: Ethanol extract of Psidium guajava leaves can be considered as a potential anti diabetic agent like Glibenclamide but it requires further investigations. Delta Med Col J. Jan 2017 5(1): 9-14
{"title":"Comparative Study of the Effect of Ethanol Extract of Psidium Guajava Linn Leaves with Glibenclamide on Experimentally Induced Diabetes Mellitus in Rats","authors":"A. Momtaz, K. Sharmin, S. Rahman, N. Sultana, R. Sharmin","doi":"10.3329/DMCJ.V5I1.31421","DOIUrl":"https://doi.org/10.3329/DMCJ.V5I1.31421","url":null,"abstract":"Background: Diabetes Mellitus is a major health problem not only in urban but also in the rural areas of Bangladesh. Regarding its treatment, a suitable drug is yet to be available which can permanently cure this disease. Over 400 traditional plants have been reported for the treatment of diabetes, but only a small number have received scientific and medical evaluation to assess their efficacy. Objective: The study was performed to compare the anti diabetic effect of Psidium guajava Linn leaves with an oral anti diabetic drug (Glibenclamide), in experimentally induced diabetic rats. Materials and method: The experiment was carried out in the department of Pharmacology & Therapeutics of Dhaka Medical College, Dhaka, Bangladesh from July 2012 to June 2013. Twenty four healthy rats of Long Evans Norwegian strain were divided into 4 groups (group A, B, C and D) comprising 6 rats in each. Group A (normal control) received standard rat food for 14 days. Diabetes was induced by administration of Alloxan 120 mg/kg/body weight in group B, C and D. Group B (diabetic control group) was given standard rat food. Group C and D was treated with ethanol extract of Psidium guajava leaves 100 mg/kg body weight and Glibenclamide 1.5 mg/kg/day orally respectively. Total duration of the experiment was 15 days. Results: Administration of ethanol extract of Psidium guajava leaves in group C and Glibenclamide in group D produced a significant reduction (p<0.001) in blood glucose level as compared to group B (diabetic control group). Conclusion: Ethanol extract of Psidium guajava leaves can be considered as a potential anti diabetic agent like Glibenclamide but it requires further investigations. Delta Med Col J. Jan 2017 5(1): 9-14","PeriodicalId":53280,"journal":{"name":"Delta Medical College Journal","volume":"5 1","pages":"9-14"},"PeriodicalIF":0.0,"publicationDate":"2017-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45815819","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}
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