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Probiotics in gastroenteritis in children: A systematic review 益生菌治疗儿童肠胃炎:系统综述
Pub Date : 2023-06-22 DOI: 10.55010/imcjms.17.020
Elizabeth A.K. Jones, A. Mitra, Anamika Bisht, Precious Patrick Ede, Faith Iseguede, E. Okoye
Background and objectives: Gastroenteritis is the second leading cause of death among children worldwide. It is a preventable and treatable disease, yet it affects 3 to 5 million children and is the cause of approximately 10% of hospitalizations globally. This systematic review aims to identify the effectiveness of probiotics in treating acute gastroenteritis in children globally and also to provide results of quality research to healthcare-related communities about possible therapies of the condition.Methods: This study follows the PRISMA guidelines for systematic reviews of 29 quantitative studies conducted between 2014-2023. A quality appraisal of the selected studies was conducted using CADIMA and a rating scale of 0 to 3 based on a few predetermined criteria.Results: Sample sizes varied from 29 to 1811, with a median of 200. Globally, there are mixed findings about the roles and benefits of probiotics to treat acute gastroenteritis in children. This is possibly due to the type of probiotic, the type of disease, and treatment adherence.Conclusions: Findings from this systematic review suggest that probiotics play a crucial role in improving children’s health outcomes. Therefore, it is important to promote and implement the use of probiotic therapies in the treatment of acute gastroenteritis conditions in children.IMC J Med Sci. 2023; 17(2):010. DOI: https://doi.org/10.55010/imcjms.17.020*Correspondence: Amal K. Mitra, Department of Epidemiology & Biostatistics, Jackson State University, 350 W. Woodrow Wilson Drive, Room 216 Jackson, MS 39213, USA. E-mail: amal.k.mitra@jsums.edu
背景和目的:胃肠炎是全世界儿童死亡的第二大原因。这是一种可预防和可治疗的疾病,但它影响了300万至500万儿童,是全球约10%的住院原因。本系统综述旨在确定益生菌治疗全球儿童急性胃肠炎的有效性,并为卫生保健相关社区提供有关该疾病可能治疗方法的高质量研究结果。方法:本研究遵循PRISMA指南,对2014-2023年间进行的29项定量研究进行系统评价。对选定的研究进行质量评价,使用CADIMA和基于几个预定标准的0到3级评定量表。结果:样本量从29到1811不等,中位数为200。在全球范围内,关于益生菌在治疗儿童急性胃肠炎中的作用和益处,发现不一。这可能是由于益生菌的类型,疾病的类型和治疗依从性。结论:本系统综述的结果表明,益生菌在改善儿童健康结果中起着至关重要的作用。因此,在儿童急性胃肠炎的治疗中推广和实施益生菌疗法具有重要意义。中华医学会医学杂志。2023;17(2): 010。DOI: https://doi.org/10.55010/imcjms.17.020*Correspondence: Amal K. Mitra,流行病学与生物统计学系,杰克逊州立大学,350w。美国伍德罗威尔逊大道,杰克逊216室,邮编39213电子邮件:amal.k.mitra@jsums.edu
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引用次数: 1
Serum adiponectin profile in obese Bangladeshi children attending an obesity clinic 在肥胖诊所就诊的孟加拉国肥胖儿童血清脂联素谱
Pub Date : 2023-06-14 DOI: 10.55010/imcjms.17.019
PalashChandra Sutradhar, T. Haq, M. Hossain, M. Mustari, M. Hasanat, Md. Farid Uddin
Background and objective: Childhood obesity plays major role in the pathogenesis of various cardiovascular and metabolic diseases. Serum adiponectin has been found to be associated with several cardiometabolic risk factors. The study investigated the serum adiponectin levels and its relationship with obesity and cardiometabolic risk factors in Bangladeshi obese children.Material and methods: Overweight or obese children, between 6-18 years of age, attending the obesity clinic of the Department of Endocrinology, BSMMU were enrolled. Waist circumference (WC) and blood pressure (BP) were measured and blood samples were taken for estimation of glucose, insulin, lipid profile and adiponectin. Fasting plasma glucose (FPG), serum insulin and lipid profile were estimated by automated analyzer. Insulin resistance (HOMA-IR) was calculated from fasting insulin and fasting plasma glucose values. Serum adiponectin (total) was measured by ELISA method using DRG ELISA kit, Germany.Results:A total of 78 overweight or obese children of 6-18-year of age were enrolled. The mean (±SD) age of the study population was 12.22 ± 2.56 years and the mean BMI was 28.79 ± 4.54 kg/m2. Mean (±SD) serum adiponectin was 36.93 ± 17.85 µg/ml in 78 overweight/obese children. One way ANOVA showed no significant (P= 0.582) difference of adiponectin levels among children with overweight and different grades of obesity. There was no significant correlation between adiponectin and measures of generalized (r=0.035, p=0.763) or central (r=0.098, p=0.392) obesity. Also, no significant correlation was found between serum adiponectin level and any of cardiovascular risk factors of obesity or metabolic health.Conclusion: The study showed high serum adiponectin level in obese Bangladeshi children. Also, no association was found between serum adiponectin levels with grades of obesity and cardiometabolic risk factors among obese children of Bangladesh. IMC J Med Sci. 2023; 17(2):009. DOI: https://doi.org/10.55010/imcjms.17.019*Correspondence: Palash Chandra Sutradhar, Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Kotwali, Dhaka-1000, Bangladesh. Email: palashdmc@gmail.com
背景与目的:儿童肥胖在各种心血管和代谢疾病的发病机制中起着重要作用。已发现血清脂联素与几种心脏代谢危险因素有关。本研究调查了孟加拉肥胖儿童血清脂联素水平及其与肥胖和心脏代谢危险因素的关系。材料与方法:选取在BSMMU内分泌科肥胖门诊就诊的6-18岁超重或肥胖儿童。测量腰围(WC)和血压(BP),并采血测定血糖、胰岛素、血脂和脂联素。空腹血糖(FPG)、血清胰岛素及血脂测定采用自动分析仪。胰岛素抵抗(HOMA-IR)由空腹胰岛素和空腹血糖值计算。采用德国DRG ELISA试剂盒,采用ELISA法测定血清脂联素(总)。结果:共有78名6-18岁超重或肥胖儿童被纳入研究。研究人群的平均(±SD)年龄为12.22±2.56岁,平均BMI为28.79±4.54 kg/m2。78名超重/肥胖儿童血清脂联素平均值(±SD)为36.93±17.85µg/ml。单因素方差分析显示,超重儿童和不同程度肥胖儿童的脂联素水平差异无统计学意义(P= 0.582)。脂联素与广泛性肥胖(r=0.035, p=0.763)或中枢性肥胖(r=0.098, p=0.392)之间无显著相关性。此外,血清脂联素水平与肥胖或代谢健康的任何心血管危险因素之间没有显著相关性。结论:研究显示孟加拉肥胖儿童血清脂联素水平较高。此外,在孟加拉国肥胖儿童中,血清脂联素水平与肥胖程度和心脏代谢危险因素之间没有关联。中华医学会医学杂志。2023;17(2): 009。DOI: https://doi.org/10.55010/imcjms.17.019*Correspondence: Palash Chandra Sutradhar,内科,Salimullah爵士医学院Mitford医院,Kotwali,达卡1000,孟加拉国。电子邮件:palashdmc@gmail.com
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引用次数: 0
Prevalence and antimicrobial susceptibility of high-level gentamicin resistant enterococci isolated from urine at a hospital in Pune, India 印度浦那一家医院尿液中分离出的高水平庆大霉素耐药肠球菌的流行率和抗菌药物敏感性
Pub Date : 2023-05-25 DOI: 10.55010/imcjms.17.018
Nageswari R. Gandham, Shahzad Mirza, Chanda Vyawahare, Rajashri Patil, Sahjid Mukhida, Sriram Kannuri, Shalini Bhaumik
Introduction: Enterococci are one of the common organisms isolated from hospitalized patients with urinary tract infections. Guidelines recommend testing enterococcifor susceptibility to high-level gentamicin (HLG) and streptomycin. The present study was planned to determine the susceptibility of uropathogenic enterococci to high-level gentamicin in a tertiary care hospital. Materials and Methods: Prospective observational research was carried out at a tertiary care hospital for two years on all isolated enterococci from urine specimens. Identification and antibiotic susceptibility were performed as per standard methods. All the isolated enterococci were tested for high level gentamicin ((120µg) resistance and susceptibility to other recommended antimicrobial agents by standard methods. Results: A total of 320 uropathogenic enterococci were isolated and tested for antibiotic susceptibility. The majority of enterococci were isolated from elderly (34.06%) and admitted patients (69.06%). A total of 68.4% isolated enterococci were HLG resistant. HLG resistant enterococci were highly resistant to erythromycin (96.3%), ciprofloxacin (96.8%) and nalidixic acid (97.7%). Enterococci sensitive to HLG were significantly (p <0.05) less resistant to the other antimicrobial agents except nalidixic acid. Only 20.5% isolated Enterococci were resistant to vancomycin. All isolated enterococci were susceptible to linezolid. Conclusion: The study demonstrated high prevalence of HLG resistant enterococci causing UTI in our hospital setting. Compared to HLG sensitive enterococci, HLG resistant enterococci were more resistant to other antimicrobial agents tested. The findings highlight the need for mandatory testing of enterococci for HLG resistance to determine effective antimicrobials for treatment. IMC J Med Sci. 2023; 17(2):008. DOI: https://doi.org/10.55010/imcjms.17.018 *Correspondence: Dr. Sahjid Mukhida, Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India. E-mail: drssmukhida@rediffmail.com
肠球菌是从尿路感染住院患者中分离出的常见微生物之一。指南建议检测肠球菌对高剂量庆大霉素(HLG)和链霉素的敏感性。本研究计划在三级保健医院确定尿路致病性肠球菌对高剂量庆大霉素的敏感性。材料和方法:在一家三级医院对所有从尿液标本中分离出的肠球菌进行了为期两年的前瞻性观察研究。按标准方法进行鉴定和药敏试验。采用标准方法检测分离肠球菌对庆大霉素(120µg)的高水平耐药性和对其他推荐抗菌药的敏感性。结果:共分离出尿路致病性肠球菌320株,并进行了药敏试验。以老年人(34.06%)和住院患者(69.06%)分离的肠球菌居多。68.4%的分离肠球菌对HLG耐药。耐HLG肠球菌对红霉素(96.3%)、环丙沙星(96.8%)和萘啶酸(97.7%)高度耐药。对HLG敏感的肠球菌对除萘啶酸外的其他抗菌药物的耐药性显著降低(p <0.05)。仅有20.5%的分离肠球菌对万古霉素耐药。所有分离的肠球菌均对利奈唑胺敏感。结论:本研究表明,HLG耐药肠球菌在我院引起尿路感染的发生率很高。与HLG敏感肠球菌相比,HLG耐药肠球菌对其他抗菌药物的耐药性更强。这些发现强调需要对肠球菌进行强制性的HLG耐药检测,以确定有效的抗微生物药物进行治疗。中华医学会医学杂志。2023;17(2): 008。DOI: https://doi.org/10.55010/imcjms.17.018 *通信:Sahjid Mukhida博士,微生物系,D. Y. Patil医学院,医院和研究中心,D. Y. Patil Vidyapeeth博士,印度马哈拉施特拉邦浦那,皮普里。电子邮件:drssmukhida@rediffmail.com
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引用次数: 0
Seroprevalence of hepatitis B virus infection in pre-mass vaccination era among children residing in a rural area of Bangladesh 孟加拉国农村地区儿童大规模疫苗接种前乙型肝炎病毒感染的血清流行率
Pub Date : 2023-05-23 DOI: 10.55010/imcjms.17.017
M. Mohsena, A. Mitra, M. Sayeed, A. Banu, J. Haq
Background and objectives: There are few details available regarding the prevalence of hepatitis B virus (HBV) infection in the general Bangladeshi population. There is a dearth of data on prevalence of HBV infection in children and adolescents who were born before the hepatitis B vaccine was introduced in the Expanded Program on Immunization (EPI). The objective of the current study was to use archived data to describe the seroepidemiology of HBV infection (HBsAg and anti-HBc Antibody) among school children in a particular rural area of Bangladesh. Also, the study correlated serum vitamin A level with the HBV infection status among a subset of children.Materials and method: The study analyzed the archived data of a study conducted in 2003 and 2004. The samples were collected from 1995 children, aged 5 to 15 years, from a purposively selected rural area located about 100 km north-east of capital Dhaka. HBsAg (HBV surface antigen) and anti-HBc antibody were determined by ELISA method. Vitamin A (retinol) in blood was assayed by HPLC technique. The prevalence rates of HBsAg and anti-HBc antibody was determined by simple percentages. All associations between different characteristics were tested by Chi square test.Results: Of the total 1995 children, 988 (49.5%) and 1007 (50.5%) were male and female respectively. Among them, 23 (1.2%) were HBsAg positive or HBV carriers and 79 (8.1%) were anti-HBc antibody positive. Neither HBsAg nor anti-HBc antibody positivity rate showed any difference in male and female children. There was also no significant difference of HBsAg positivity rate amongst children of different age groups; whereas, anti-HBc antibody positivity rate increased significantly (p <0.005) with increase of age. Serum vitamin A was estimated in a subset of children. The mean serum vitamin A concentration was found significantly (p<0.05) lower among HBsAg positive children compared to their age and sex matched healthy control group.Conclusion: This study has demonstrated that rural children are in risk of exposure to HBV infection. Increasing HBV seropositivity with age emphasizes the need for devising prevention strategies and to create awareness among the rural children. Further studies are necessary to find out the hitherto undetected sources namely occult hepatitis B cases and the ways of spread of HBV in the community.IMC J Med Sci. 2023; 17(2):007. DOI: https://doi.org/10.55010/imcjms.17.017*Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh; Email: sayeed1950@gmail.com; J. Ashraful Haq, Department of Microbiology, Ibrahim Medical College, Segunbagicha, Dhaka, Bangladesh; Email: jahaq54@yahoo.com
背景和目的:关于孟加拉国一般人群中乙型肝炎病毒(HBV)感染流行情况的细节很少。关于在扩大免疫规划(EPI)引入乙型肝炎疫苗之前出生的儿童和青少年中乙型肝炎病毒感染流行率的数据缺乏。本研究的目的是利用存档数据描述孟加拉国特定农村地区学龄儿童HBV感染(HBsAg和抗hbc抗体)的血清流行病学。此外,该研究将一部分儿童的血清维生素A水平与HBV感染状况联系起来。材料和方法:本研究分析了2003年和2004年进行的一项研究的存档数据。这些样本是从1995名5至15岁的儿童中收集的,他们来自首都达卡东北约100公里处的一个有意选择的农村地区。ELISA法检测HBV表面抗原(HBsAg)和抗hbc抗体。采用高效液相色谱法测定血液中维生素A(视黄醇)含量。HBsAg和抗hbc抗体阳性率采用简单百分比法测定。不同特征间的关联均采用卡方检验。结果:1995例患儿中,男988例(49.5%),女1007例(50.5%)。其中HBsAg阳性或HBV携带者23例(1.2%),抗hbc抗体阳性79例(8.1%)。男女儿童HBsAg和抗hbc抗体阳性率均无差异。不同年龄组儿童HBsAg阳性率差异无统计学意义;抗hbc抗体阳性率随年龄的增加而显著升高(p <0.005)。对一部分儿童的血清维生素A进行了估计。与年龄和性别匹配的健康对照组相比,HBsAg阳性儿童的平均血清维生素A浓度显著降低(p<0.05)。结论:本研究表明农村儿童存在暴露于HBV感染的危险。随着年龄的增长,乙型肝炎病毒血清阳性反应增加,这强调了制定预防战略和在农村儿童中提高认识的必要性。需要进一步的研究,以找出迄今未被发现的来源,即隐性乙型肝炎病例和HBV在社区中的传播途径。中华医学会医学杂志。2023;17(2): 007。DOI: https://doi.org/10.55010/imcjms.17.017*Correspondence: M Abu Sayeed, Ibrahim医学院社区医学系,1/A, Ibrahim Sarani, Segunbagicha,孟加拉国达卡1000;电子邮件:sayeed1950@gmail.com;J. Ashraful Haq,孟加拉国达卡Segunbagicha易卜拉欣医学院微生物系;电子邮件:jahaq54@yahoo.com
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引用次数: 0
Bacterial co-infection in Covid-19 patients visiting a tertiary care hospital in Maharashtra 在马哈拉施特拉邦一家三级医院就诊的Covid-19患者的细菌合并感染
Pub Date : 2023-04-12 DOI: 10.55010/imcjms.17.016
Background and objectives: Several patients with SARS-CoV-2 infection presents with bacterial co-infection. The aim of the present study was to determine the bacteria responsible for co-infection in Covid-19 infected patients visiting a tertiary care hospital of Maharashtra, India.Material and methods: A cross sectional study was conducted for 3 months at tertiary care center. Covid-19 patients attending the hospital were included in the study. All the specimens were collected either at the time of admission at outdoor or within 24-48 hours of admission. All the specimens were processed for culture and antibiotic susceptibility testing as per institutional policy and standard methods.Results: Total 200 samples were collected out of which 98 (49%) patients were diagnosed with bacterial co-infection. Majority of cases with bacterial co-infection were above 21 years of age. Culture was positive in 80%, 66.7%, 49.2% and 38.8% of tracheal aspirate, pus, blood and urine samples respectively. Out of 98 cases of bacterial co-infection, 62.2% and 37.8% had infection with Gram negative and positive bacteria respectively. Most common organism isolated was Klebsiella pneumoniae (20.4%) followed by Enterococcus species (14.3%). Over 70% of Klebsiella pneumoniae isolates were resistant to aminoglycosides, cephalosporins, fluroquinolones and carbapenems while 100% Acinetobacter was resistant to all antimicrobials tested. Among 57 Of the Gram negative isolates, 5 and 24 isolates were positive for ESBL carbapenemase respectively.Conclusion: The study revealed that bacterial co-infection was present in considerable proportion of Covid-19 patients and the organisms responsible were resistant to several antimicrobial agents.IMC J Med Sci. 2023; 17(2):006. DOI: https://doi.org/10.55010/imcjms.17.016*Correspondence: Sahjid Mukhida, Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India-411018. E-mail: drssmukhida@rediffmail.com
背景与目的:多例SARS-CoV-2感染患者出现细菌合并感染。本研究的目的是确定在印度马哈拉施特拉邦一家三级保健医院就诊的Covid-19感染患者中导致合并感染的细菌。材料与方法:在三级保健中心进行为期3个月的横断面研究。在医院就诊的Covid-19患者被纳入研究。所有标本均采集于患者入院时或入院后24-48小时内。所有标本均按机构政策和标准方法进行培养和药敏试验。结果:共采集样本200例,其中98例(49%)诊断为细菌合并感染。细菌合并感染以21岁以上患者居多。气管抽吸液、脓液、血液和尿液培养阳性率分别为80%、66.7%、49.2%和38.8%。98例细菌共感染中,革兰氏阴性菌感染占62.2%,阳性菌感染占37.8%。最常见的细菌是肺炎克雷伯菌(20.4%),其次是肠球菌(14.3%)。超过70%的肺炎克雷伯菌分离株对氨基糖苷类、头孢菌素、氟喹诺酮类和碳青霉烯类耐药,而100%的不动杆菌对所有测试的抗菌素耐药。57株革兰氏阴性菌株中,5株和24株ESBL碳青霉烯酶阳性。结论:该研究显示,相当比例的Covid-19患者存在细菌共感染,并且导致细菌对几种抗微生物药物具有耐药性。中华医学会医学杂志。2023;17(2): 006。DOI: https://doi.org/10.55010/imcjms.17.016*Correspondence: Sahjid Mukhida,微生物学系,Dr. Y. Patil医学院,医院和研究中心,Dr. Y. Patil Vidyapeeth, Pune, Maharashtra,印度,411018。电子邮件:drssmukhida@rediffmail.com
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引用次数: 0
Estimated glucose disposal rate (eGDR) in rural Bangladeshi population and its correlation with cardiometabolic risks 估计孟加拉农村人口葡萄糖处置率(eGDR)及其与心脏代谢风险的相关性
Pub Date : 2023-03-23 DOI: 10.55010/imcjms.17.015
Nehlin Tomalika, Md Mohiuddin Tagar, Sadya Afroz, M. Mohsena, M. Sayeed
Background and objectives: For decades type 2 diabetes mellitus (T2DM) and insulin resistance (IR) are increasingly gaining importance as an underlying mechanism for increased risk of cardiovascular diseases (CVD). IR is related to various cardiometabolic adverse effects.Hyperinsulinemic-euglycemic clamp technique, the gold standard method for measuring IR, is an invasive and complex procedure. Estimation of glucose disposal rate (eGDR) is an easy alternative tool for measuring IR. There is no known study on eGDR level in Bangladeshi native population. Therefore, this study was undertaken to determine the eGDR values in a healthy working rural Bangladeshi population.Materials and methods: Six villages were selected purposively as the study sites. All healthy working people aged ≥20 years in selected rural community were considered eligible. Those who consented to participate in the study were enrolled. Investigations included a) interviewing for social and clinical history, b) anthropometry and measurement of blood pressure and d) estimation of HbA1c and biochemical indices. The eGDR (mg/kg/min) was calculated using formula: eGDR = 21.158 − (0.09 * WC) − (3.407 * HT) − (0.551 * HbA1c); where WC = waist circumference in cm, HT = hypertension (yes = 1/no = 0), and HbA1c = HbA1c (%).Results: A total of 93 (m/w = 29/64) participants were enrolled in the study. The prevalence rates of hypertension, diabetes and metabolic syndrome (MSyn) were 34%, 31.1% and 16.1%, respectively. The mean eGDR value was 9.9 (±0.149; 95% CI: 9.62–10.2) mg/kg/min. Most of the values of biophysical characteristics were normal. The comparison between participants with and without MSyn showed that the former had significantly lower eGDR (9.05±1.24 vs.10.10±1.37, p<0.01). Inverse correlations of eGDR with the obesity, glycemia and lipidemia (weight, waist, FBG, T-chol, and TG) were significant. Declining eGDR were significant with rising WHR, WHtR, TG/HDLR and T-chol/HDLR (for all, p<0.05).Conclusions: The study revealed the level of eGDR in a healthy working people of a rural community of Bangladesh. Moreover, eGDR was found to decrease significantly with the increasing cardiometabolic risks. The study revealed a higher prevalence of hypertension, diabetes and metabolic syndrome in apparently healthy working people highlighting susceptibility of Bangladeshi natives to non-communicable diseases.IMC J Med Sci. 2023; 17(2):005. DOI: https://doi.org/10.55010/imcjms.17.015*Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: sayeed1950@gmail.com
背景和目的:几十年来,2型糖尿病(T2DM)和胰岛素抵抗(IR)作为心血管疾病(CVD)风险增加的潜在机制越来越重要。IR与各种心脏代谢不良反应有关。高胰岛素-血糖钳夹技术是测量IR的金标准方法,是一种侵入性和复杂的过程。葡萄糖处理速率(eGDR)的估计是测量红外光谱的一种简单的替代工具。目前还没有关于孟加拉国土著人口eGDR水平的已知研究。因此,进行这项研究是为了确定健康的孟加拉国农村工作人口的eGDR值。材料与方法:有目的地选择6个村庄作为研究地点。在选定的农村社区,所有年龄≥20岁的健康劳动人口都被认为是合格的。那些同意参加这项研究的人都登记了。调查包括a)社会和临床病史访谈,b)人体测量和血压测量,d) HbA1c和生化指标的估计。eGDR (mg/kg/min)计算公式为:eGDR = 21.158−(0.09 * WC)−(3.407 * HT)−(0.551 * HbA1c);其中WC =腰围(cm), HT =高血压(是= 1/否= 0),HbA1c = HbA1c(%)。结果:共有93名参与者(m/w = 29/64)被纳入研究。高血压、糖尿病和代谢综合征(MSyn)患病率分别为34%、31.1%和16.1%。平均eGDR值为9.9(±0.149;95% CI: 9.62 ~ 10.2) mg/kg/min。生物物理特征值基本正常。MSyn组与未MSyn组比较,前者eGDR显著降低(9.05±1.24 vs.10.10±1.37,p<0.01)。eGDR与肥胖、血糖和血脂(体重、腰围、FBG、T-chol和TG)呈显著负相关。随着WHR、WHtR、TG/HDLR和T-chol/HDLR的升高,eGDR显著下降(p<0.05)。结论:该研究揭示了孟加拉国农村社区健康劳动人群的eGDR水平。此外,eGDR随着心脏代谢风险的增加而显著降低。研究显示,在表面健康的劳动人群中,高血压、糖尿病和代谢综合征的患病率较高,这突出了孟加拉国本地人对非传染性疾病的易感性。中华医学会医学杂志。2023;17(2): 005。DOI: https://doi.org/10.55010/imcjms.17.015*Correspondence: M Abu Sayeed, Ibrahim医学院社区医学系,1/A, Ibrahim Sarani, Segunbagicha,孟加拉国达卡1000。电子邮件:sayeed1950@gmail.com
{"title":"Estimated glucose disposal rate (eGDR) in rural Bangladeshi population and its correlation with cardiometabolic risks","authors":"Nehlin Tomalika, Md Mohiuddin Tagar, Sadya Afroz, M. Mohsena, M. Sayeed","doi":"10.55010/imcjms.17.015","DOIUrl":"https://doi.org/10.55010/imcjms.17.015","url":null,"abstract":"Background and objectives: For decades type 2 diabetes mellitus (T2DM) and insulin resistance (IR) are increasingly gaining importance as an underlying mechanism for increased risk of cardiovascular diseases (CVD). IR is related to various cardiometabolic adverse effects.\u0000\u0000Hyperinsulinemic-euglycemic clamp technique, the gold standard method for measuring IR, is an invasive and complex procedure. Estimation of glucose disposal rate (eGDR) is an easy alternative tool for measuring IR. There is no known study on eGDR level in Bangladeshi native population. Therefore, this study was undertaken to determine the eGDR values in a healthy working rural Bangladeshi population.\u0000\u0000Materials and methods: Six villages were selected purposively as the study sites. All healthy working people aged ≥20 years in selected rural community were considered eligible. Those who consented to participate in the study were enrolled. Investigations included a) interviewing for social and clinical history, b) anthropometry and measurement of blood pressure and d) estimation of HbA1c and biochemical indices. The eGDR (mg/kg/min) was calculated using formula: eGDR = 21.158 − (0.09 * WC) − (3.407 * HT) − (0.551 * HbA1c); where WC = waist circumference in cm, HT = hypertension (yes = 1/no = 0), and HbA1c = HbA1c (%).\u0000\u0000Results: A total of 93 (m/w = 29/64) participants were enrolled in the study. The prevalence rates of hypertension, diabetes and metabolic syndrome (MSyn) were 34%, 31.1% and 16.1%, respectively. The mean eGDR value was 9.9 (±0.149; 95% CI: 9.62–10.2) mg/kg/min. Most of the values of biophysical characteristics were normal. The comparison between participants with and without MSyn showed that the former had significantly lower eGDR (9.05±1.24 vs.10.10±1.37, p<0.01). Inverse correlations of eGDR with the obesity, glycemia and lipidemia (weight, waist, FBG, T-chol, and TG) were significant. Declining eGDR were significant with rising WHR, WHtR, TG/HDLR and T-chol/HDLR (for all, p<0.05).\u0000\u0000Conclusions: The study revealed the level of eGDR in a healthy working people of a rural community of Bangladesh. Moreover, eGDR was found to decrease significantly with the increasing cardiometabolic risks. The study revealed a higher prevalence of hypertension, diabetes and metabolic syndrome in apparently healthy working people highlighting susceptibility of Bangladeshi natives to non-communicable diseases.\u0000\u0000IMC J Med Sci. 2023; 17(2):005. DOI: https://doi.org/10.55010/imcjms.17.015\u0000\u0000*Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: sayeed1950@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81306527","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}
引用次数: 0
Antimicrobial susceptibility pattern of enterococci isolated from various clinical samples in a tertiary care hospital in India 从印度一家三级保健医院的各种临床样本中分离的肠球菌的抗菌药物敏感性模式
Pub Date : 2023-03-19 DOI: 10.55010/imcjms.17.014
Sameena Khan, Hardik Bansal, N. Gandham, Shahzad Mirza, C. Vyawahare, Rajashri Patil, Sahjid Mukhida, N. Das
Background and objectives: Enterococci are significant human pathogens that are capable of causing various nosocomial infections. This study determined the antibiotic susceptibility pattern of enterococcal species isolated from various clinical specimens with special reference to vancomycin-resistant enterococci.Material and methods: The study was carried out for 6 months on enterococci isolated from various clinical specimens at a tertiary care hospital. Organisms were identified by standard procedures, and subjected to antimicrobial testing as per the standard guidelines.Results: Total 116 enterococci were isolated from various clinical samples. Of the total isolates, 56.9%, 30.2% and 12.9% were isolated from indoor, intensive care unit and non-hosptalized (outdoor) patients respectively.The most common Enterococcus species from blood was E. faecium (72%) followed by E. faecalis (12%) and E. galinarrium (9.4%). Out of 116 enterococci isolates, 31 (26.7%) were resistant to vancomycin and only 1 (0.9%) was resistant to linezolid.Conclusion:The study demonstrated high prevalence of multidrug-resistant enterococci in our hospital setting, thus posing a serious therapeutic challenge. The result would be useful in monitoring the future trends of antimicrobial susceptibility of enterococci in this region.*Correspondence: Dr. Nikunja Kumar Das, Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India-411018. E-mail: nikunjdas3085@gmail.comIMC J Med Sci. 2023; 17(2):004. DOI: https://doi.org/10.55010/imcjms.17.014
背景和目的:肠球菌是一种重要的人类病原体,能够引起各种医院感染。本研究确定了从各种临床标本中分离的肠球菌种类的抗生素敏感性模式,并特别参考了万古霉素耐药肠球菌。材料和方法:对某三级医院各种临床标本分离的肠球菌进行了为期6个月的研究。通过标准程序鉴定生物体,并根据标准指南进行抗菌测试。结果:共分离到116株肠球菌。室内、重症监护病房和非住院(室外)患者分别分离出56.9%、30.2%和12.9%的分离株。血液中最常见的肠球菌是粪肠球菌(72%),其次是粪肠球菌(12%)和加利纳肠球菌(9.4%)。116株肠球菌中,31株(26.7%)对万古霉素耐药,1株(0.9%)对利奈唑胺耐药。结论:该研究表明,多药耐药肠球菌在我院的患病率很高,因此提出了严重的治疗挑战。该结果将有助于监测该地区肠球菌抗菌药物敏感性的未来趋势。*通信:Nikunja Kumar Das博士,微生物学系,D. Y. Patil医学院,医院和研究中心,D. Y. Patil Vidyapeeth博士,浦那,马哈拉施特拉邦,印度,411018。E-mail: nikunjdas3085@gmail.comIMC J Med Sci. 2023;17(2): 004。DOI: https://doi.org/10.55010/imcjms.17.014
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引用次数: 0
Clinical profile, surgical management and outcome of bronchial carcinoids - a single centre experience 支气管类癌的临床概况,手术处理和结果-单一中心的经验
Pub Date : 2023-03-15 DOI: 10.55010/imcjms.17.013
F. Ganie, Shahbaz Bashir Dar, Masarat-ul Gani, H. Z. Ashraf, G. Lone, M. Bhat, Iqra Nazir Naqash
Background and objectives: Bronchial carcinoid tumors are neuroendocrine neoplasms that range from low-grade typical carcinoids to more aggressive atypical carcinoids and, therefore demonstrate a wide spectrum of clinical behaviors, histologic features and outcome. The aim of the present study was to investigate the clinical profile, surgical management and outcome of bronchial carcinoids at a single centre over two years period.Materials and methods: Patients with a final histologic diagnosis of bronchial carcinoid tumor were included in the study. Evaluation comprised of clinical history and physical examination, postero-anterior and lateral chest radiographs, and computed tomographic (CT) scans of the chest and upper abdomen (including liver and adrenal glands). Performance status was assessed by the Karnofsky scale. Pulmonary function tests were performed routinely.Results: A total of 18 patients were included in the study. Out of 18 cases, 10 (55.6%) were female and 8 (44.4%) were males. Sixteen (88.9%) patients had typical carcinoid tumor and 2 (11.1%) had atypical carcinoid tumor. The tumor was located in the right lung in 11 (61.1%) and in the left lung in 7 patients (38.9%). Surgeries included 15 standard lobectomies and 3 bronchial sleeve resection. At one month post surgery, there was 13-22% increase in post operative FEV1 in patients who underwent bronchial sleeve resection while in patients who underwent lobectomy, the post operative FEV1 was 84% of pre-operative FEV1. Post surgery, all patients were in group A as per Karnofsky performance status.Conclusion: Standard care of bronchial carcinoid tumors is surgical resection, and the surgical approach should depend on tumor’s size, location and histology.IMC J Med Sci. 2023; 17(2):003. DOI: https://doi.org/10.55010/imcjms.17.013*Correspondence: Farooq Ahmad Ganie, Department of Cardiovascular and Thoracic Surgery, SKIMS, Soura, Srinagar, Kashmir, India. Email: farooq.ganie@ymail.com
背景和目的:支气管类癌是一种神经内分泌肿瘤,范围从低级别的典型类癌到更具侵袭性的非典型类癌,因此表现出广泛的临床行为、组织学特征和预后。本研究的目的是调查支气管类癌的临床概况,手术治疗和结果在一个中心超过两年的时间。材料与方法:组织学最终诊断为支气管类癌的患者纳入研究。评估包括临床病史和体格检查、胸部后正位片和侧位片以及胸部和上腹部(包括肝脏和肾上腺)的计算机断层扫描(CT)。以Karnofsky量表评估其表现状态。常规进行肺功能检查。结果:共纳入18例患者。18例中,女性10例(55.6%),男性8例(44.4%)。典型类癌16例(88.9%),不典型类癌2例(11.1%)。肿瘤位于右肺11例(61.1%),位于左肺7例(38.9%)。手术包括15例标准肺叶切除术和3例支气管袖切除术。术后1个月,行支气管套筒切除术的患者术后FEV1增加13-22%,而行肺叶切除术的患者术后FEV1为术前的84%。术后按Karnofsky性能评定为A组。结论:支气管类癌的标准治疗是手术切除,手术入路应根据肿瘤的大小、部位和组织学特点而定。中华医学会医学杂志。2023;17(2): 003。DOI: https://doi.org/10.55010/imcjms.17.013*Correspondence:法鲁克·艾哈迈德·加尼,心血管和胸外科部门,SKIMS,苏拉,斯利那加,克什米尔,印度。电子邮件:farooq.ganie@ymail.com
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引用次数: 0
Trends in HIV/AIDS incidence rate in Mississippi, 2008-2019 2008-2019年密西西比州艾滋病毒/艾滋病发病率趋势
Pub Date : 2023-03-14 DOI: 10.55010/imcjms.17.012
Adetoun F. Asala, A. Bhuiyan, A. Mitra, Vincent L Mendy, A. Mawson, Luma Akil
Background and objectives: Despite the decline in new HIV infection across the United States, Mississippi is still experiencing high rates of new HIV infections. Reports highlighted significant variations by geographical locations and socio-demographic factors. This study examined trends of HIV/AIDS incidence rates in Mississippi from 2008 to 2019.Materials and methods: Data on HIV/AIDS diagnosis were extracted from Mississippi Enhanced HIV/AIDS Reporting System database. Data were cleaned and de-identified using Microsoft Excel and SAS 9.4. Overall and annual age-adjusted HIV and AIDS incidence rates were calculated by sex, race, and age using 2000 US population. Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC) were analyzed using Joinpoint regression models.Results: Overall, HIV incidence rate declined from 25.0 in 2008 to 18.79 per 100,000 population in 2019 (24.8% decrease) while AIDS incidence increased from 6.4 in 2008 to 8.2 per 100,000 population in 2019 (28.1% increase). Comparison between sexes of all age groups showed a downward trend of new HIV infection (AAPC: Male:-1.50, Female:-5.17) and an upward trend of AIDS incidence (AAPC: Male: 1.90, Female: 3.70). Age adjusted HIV incidence declined by 26.8% and 12.4% among blacks and whites respectively (AAPC: Blacks: -2.8, Whites:-1.0) but there was no significant change in age-adjusted AIDS incidence among both races from 2008-2019.Conclusion: This study indicated that age-adjusted HIV incidence rate is declining in Mississippi but trends differ by race, gender, and age. More interventions aimed at ensuring early diagnosis, proper linkage to care and preventing the progression of HIV to AIDS particularly among at-risk population are needed in Mississippi.IMC J Med Sci. 2023; 17(2):002. DOI: https://doi.org/10.55010/imcjms.17.012*Correspondence: Adetoun F. Asala, Department of Epidemiology and Biostatistics, School of Public Health, 350 W Woodrow Wilson Dr, Jackson, MS 39213. Email: adetoun.f.asala@students.jsums.edu
背景和目的:尽管美国各地的新艾滋病毒感染率有所下降,但密西西比州的新艾滋病毒感染率仍然很高。报告强调了地理位置和社会人口因素的显著差异。这项研究调查了2008年至2019年密西西比州艾滋病毒/艾滋病发病率的趋势。材料和方法:HIV/AIDS诊断数据提取自Mississippi Enhanced HIV/AIDS Reporting System数据库。使用Microsoft Excel和SAS 9.4对数据进行清理和去识别。使用2000年美国人口,按性别、种族和年龄计算总体和年度年龄调整的艾滋病毒和艾滋病发病率。采用Joinpoint回归模型对年变化百分数(APC)和年平均变化百分数(AAPC)进行分析。结果:总体而言,HIV感染率从2008年的25.0 / 10万人下降到2019年的18.79 / 10万人(下降24.8%),艾滋病发病率从2008年的6.4 / 10万人上升到2019年的8.2 / 10万人(上升28.1%)。各年龄组性别间比较,HIV新发感染率呈下降趋势(男性:-1.50,女性:-5.17),艾滋病发病率呈上升趋势(男性:1.90,女性:3.70)。经年龄调整的艾滋病发病率在黑人和白人中分别下降了26.8%和12.4% (AAPC:黑人:-2.8,白人:-1.0),但在2008年至2019年期间,两种种族的年龄调整艾滋病发病率没有显著变化。结论:本研究表明,密西西比州经年龄调整的艾滋病发病率正在下降,但趋势因种族、性别和年龄而异。密西西比州需要更多的干预措施,以确保早期诊断、与护理的适当联系以及防止艾滋病毒发展为艾滋病,特别是在高危人群中。中华医学会医学杂志。2023;17(2): 002。DOI: https://doi.org/10.55010/imcjms.17.012*Correspondence: adowoun F. Asala,流行病学和生物统计学系,公共卫生学院,350w伍德罗·威尔逊博士,杰克逊,MS 39213。电子邮件:adetoun.f.asala@students.jsums.edu
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引用次数: 0
Vitamin D levels in seven non-identical occupational groups entail redefining of existing vitamin D deficiency diagnostic cut off level for native Bangladeshi population 7个不同职业群体的维生素D水平需要重新定义孟加拉国土著人口现有的维生素D缺乏症诊断临界值
Pub Date : 2023-03-12 DOI: 10.55010/imcjms.17.011
T. Haq, Nehlin Tomalika, M. Mohsena, H. Momtaz, A. Banu, M. M. H. Chowdhury, K. Hashem, Md Mohiuddin Tagar, Md Shahed Morshed, M. Sayeed
Background and objectives: Recent publications have reported alarming prevalence of hypovitaminosis D in South Asian countries including Bangladesh. But, data on vitamin D levels in different occupational groups are lacking. This study addressed the prevalence of hypovitaminosis D in different occupational groups of Bangladesh. Additionally, the study estimated parathyroid hormone, phosphate, calcium and metabolic syndrome in these groups to see the effect of hypovitaminosis D on these parameters.Materials and method: Seven diverse occupational groups (agrarian workers, rickshaw-pullers, young cricketers and footballers, fishermen, dry fish industry workers, garment-workers and medical students) of Bangladesh were selected based on grade of physical activity and level of sun exposure. Blood was collected for the estimation of 25(OH) vitamin D, fasting glucose,lipid profiles, calcium, phosphate, magnesium and intact parathyroid (iPTH) hormone. Multiple comparisons of these variables among the 7 groups were estimated by ANOVA.Results: A total of 785 (m / f = 359 / 426) participants volunteered. Of them, 54.2% had vitamin D deficiency. Metabolic syndrome was 5% and showed no significant association with hypovitaminosis D (x2 = 0.9, p=0.43). For biophysical characteristics, the mean (±SD) values of age, body mass index, waist to hip ratio and waist to height ratio were – 33.8±16.3y, 22.3±4.1 kg/m2, 0.87±0.06 and 0.39±0.16, respectively. The values for vitamin D (ng/ml), calcium (mg/dl), iPTH (pgm/ml) and phosphate (mg/dl) were 20.25±13.1, 9.57±1.85, 38.22±24.54 and 4.18±0.81, respectively. The comparisons of vitamin D and other related variables among the groups (ANOVA) showed vitamin D level in the garments worker was significantly (p<0.01) higher from other 6 groups. Likewise, compared with other six, rickshaw-pullers had significantly higher calcium level. Calcium, phosphate and parathyroid hormone did not show any change with decreasing vitamin D level (high to low quartile: Q4→Q1), though parathyroid hormone increased significantly at the lowest vitamin D level (Q1:<11.8ng/ml: p=0.002).Conclusion: The prevalence of hypovitaminosis D was high irrespective of occupations, site (rural/urban), social class and sun-exposure. Overall, vitamin D level was low though varied among the groups. Despite minimum and maximum sun-exposure, the garments workers had the highest and the fishermen had the lowest vitamin D levels, respectively. Calcium level was normal in all groups. Calcium, phosphate and parathyroid hormone did not show any changes with decreasing vitamin D, though parathyroid hormone increased significantly when vitamin D decreased to the lowest quartile. The findings indicate that the specific cut off value for vitamin D deficiency needs to be determined for population of a given geographic area.IMC J Med Sci. 2023; 17(2):001. DOI: https://doi.org/10.55010/imcjms.17.011*Correspondence: M Abu Sayeed, Department of Community Medicine, I
背景和目的:最近的出版物报道了包括孟加拉国在内的南亚国家维生素D缺乏症的惊人流行。但是,缺乏不同职业人群维生素D水平的数据。本研究探讨了孟加拉国不同职业人群中维生素D缺乏症的患病率。此外,本研究估计了这些组的甲状旁腺激素、磷酸盐、钙和代谢综合征,以观察维生素D缺乏症对这些参数的影响。材料和方法:根据体力活动的等级和阳光照射的程度,选择了孟加拉国七个不同的职业群体(农业工人、人力车夫、年轻板球运动员和足球运动员、渔民、干鱼工业工人、服装工人和医科学生)。采集血液,评估25(OH)维生素D、空腹血糖、血脂、钙、磷酸盐、镁和完整甲状旁腺(iPTH)激素。这些变量在7组间的多重比较采用方差分析估计。结果:共有785名(m / f = 359 / 426)参与者自愿参加。其中54.2%的人缺乏维生素D。代谢综合征占5%,与维生素D缺乏症无显著相关性(x2 = 0.9, p=0.43)。在生物物理特征方面,年龄、体质指数、腰臀比和腰高比的平均值(±SD)分别为- 33.8±16.3y、22.3±4.1 kg/m2、0.87±0.06和0.39±0.16。维生素D (ng/ml)、钙(mg/dl)、iPTH (pgm/ml)和磷酸盐(mg/dl)分别为20.25±13.1、9.57±1.85、38.22±24.54和4.18±0.81。各组间维生素D及其他相关变量比较(方差分析)显示,服装工人维生素D水平显著高于其他6组(p<0.01)。同样,与其他6人相比,人力车夫的钙含量明显较高。钙、磷酸盐和甲状旁腺激素不随维生素D水平的降低而变化(从高到低四分位数:Q4→Q1),甲状旁腺激素在维生素D水平最低时显著升高(Q1:<11.8ng/ml: p=0.002)。结论:与职业、地点(农村/城市)、社会阶层和日照情况无关,维生素D缺乏症的患病率较高。总体而言,尽管各组之间存在差异,但维生素D水平较低。尽管有最少和最多的阳光照射,制衣工人的维生素D含量最高,渔民的维生素D含量最低。各组钙水平均正常。钙、磷酸盐和甲状旁腺激素没有随维生素D的减少而变化,但当维生素D减少到最低四分位数时甲状旁腺激素显著增加。研究结果表明,维生素D缺乏症的具体临界值需要根据特定地理区域的人口来确定。中华医学会医学杂志。2023;17(2): 001。DOI: https://doi.org/10.55010/imcjms.17.011*Correspondence: M Abu Sayeed, Ibrahim医学院社区医学系,1/A, Ibrahim Sarani, Segunbagicha,孟加拉国达卡1000。电子邮件:sayeed1950@gmail.com
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