Background and objectives: Teaching methods used in medical education should be evaluated from time to time to improve the quality of future doctors. So, this study was conducted to know the preclinical student’s preferences and perception about the current teaching and learning process. Methods: The present study was conducted at Adesh Medical College and Hospital, Shahabad among 150 students of second year MBBS course. A predesigned and prevalidated questionnaire was used to assess students’ preferences and perception of teaching, learning and assessment methods. Students’ opinion about the quality of a good teacher was also sought. Results: Out of 150 students, 54% and 62% chose lecture and chalk and board combined with power point presentation (PPT) respectively as the most preferred teaching method and aid. About half (53%) of the students chose written assessments as the most preferred assessment method. Very few students (6%) expressed that ability to generate curiosity in students as a quality of a good teacher. Conclusion: The present study suggested that lectures by chalk and board supported by PPT and written assessment were the most preferred teaching learning and assessment methods. IMC J Med Sci 2022; 16(1): 010 *Correspondence: Rashmi Chandel, Department of Physiology, Adesh Medical College and Hospital, Shahabad, India. Email: unique_ras@rediffmail.com
{"title":"Preferences and perceptions of teaching and learning methods of preclinical medical students","authors":"Rashmi Chandel, Garima Shivhare, Archana Goel","doi":"10.55010/imcjms.16.008","DOIUrl":"https://doi.org/10.55010/imcjms.16.008","url":null,"abstract":"Background and objectives: Teaching methods used in medical education should be evaluated from time to time to improve the quality of future doctors. So, this study was conducted to know the preclinical student’s preferences and perception about the current teaching and learning process.\u0000\u0000Methods: The present study was conducted at Adesh Medical College and Hospital, Shahabad among 150 students of second year MBBS course. A predesigned and prevalidated questionnaire was used to assess students’ preferences and perception of teaching, learning and assessment methods. Students’ opinion about the quality of a good teacher was also sought.\u0000\u0000Results: Out of 150 students, 54% and 62% chose lecture and chalk and board combined with power point presentation (PPT) respectively as the most preferred teaching method and aid. About half (53%) of the students chose written assessments as the most preferred assessment method. Very few students (6%) expressed that ability to generate curiosity in students as a quality of a good teacher.\u0000\u0000Conclusion: The present study suggested that lectures by chalk and board supported by PPT and written assessment were the most preferred teaching learning and assessment methods.\u0000\u0000IMC J Med Sci 2022; 16(1): 010\u0000\u0000*Correspondence: Rashmi Chandel, Department of Physiology, Adesh Medical College and Hospital, Shahabad, India. Email: unique_ras@rediffmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"52 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90661771","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}
Hasan Sultanoğlu, Yilmaz Safi, M. Demirel, M. Demir, H. B. Altınsoy, M. Boğan, Hasan Gümüşboğa
Background and objective: Hyoscine-N-butyl bromide (HBB) and paracetamol (acetaminophen)are widely used in emergency departments for abdominal pain and cramps. However, there is not enough data on the efficacy, safety, and superiority of each other in treating acute gastroenteritis (AGE) related abdominal pain and cramps. In this study HBB and paracetamol were compared for the treatment of abdominal pain and cramps related to acute gastroenteritis. Materials and methods: The study was conducted in a tertiary university hospital emergency department as a prospective, randomized-controlled, and double-blind study. Intravenous (IV) 1000 mg paracetamol and IV 20 mg hyoscine-N-butyl bromide (HBB) were used to treat abdominal pain and cramps related to AGE. Visual analogue scale (VAS) was used to evaluate the degree of abdominal pain before and after treatment. Results: HBB and paracetamol groups consisted of 123 and 158 cases respectively. In both groups, it was observed that the VAS score gradually decreased from the 0th hour to the 1st and 2nd hours (p<0.001).When comparing each time within itself, it was observed that HBB and paracetamol measurements had similar values (p>0.05). No severe side effects were observed in any of the patients. Conclusion: HBB and paracetamol were used for symptomatic treatment in AGE patients presenting with abdominal pain and cramps. A significant reduction in pain and cramps was achieved in both patient groups. There was no difference between the two drugs in terms of treatment efficacy and side effects. IMC J Med Sci 2022; 16(1): 009 *Correspondence: Hasan Gümüşboğa, Department of Emergency, Şehitkamil State Hospital, Gaziantep, Turkey, Posta code: 27500; Email: profhasan@hotmail.com; ORCID:0000-0003-2097-7102.
{"title":"Comparison of paracetamol and hyoscine-N-butylbromide in the treatment of abdominal pain and cramps due to acute gastroenteritis","authors":"Hasan Sultanoğlu, Yilmaz Safi, M. Demirel, M. Demir, H. B. Altınsoy, M. Boğan, Hasan Gümüşboğa","doi":"10.55010/imcjms.16.007","DOIUrl":"https://doi.org/10.55010/imcjms.16.007","url":null,"abstract":"Background and objective: Hyoscine-N-butyl bromide (HBB) and paracetamol (acetaminophen)are widely used in emergency departments for abdominal pain and cramps. However, there is not enough data on the efficacy, safety, and superiority of each other in treating acute gastroenteritis (AGE) related abdominal pain and cramps. In this study HBB and paracetamol were compared for the treatment of abdominal pain and cramps related to acute gastroenteritis.\u0000\u0000Materials and methods: The study was conducted in a tertiary university hospital emergency department as a prospective, randomized-controlled, and double-blind study. Intravenous (IV) 1000 mg paracetamol and IV 20 mg hyoscine-N-butyl bromide (HBB) were used to treat abdominal pain and cramps related to AGE. Visual analogue scale (VAS) was used to evaluate the degree of abdominal pain before and after treatment.\u0000\u0000Results: HBB and paracetamol groups consisted of 123 and 158 cases respectively. In both groups, it was observed that the VAS score gradually decreased from the 0th hour to the 1st and 2nd hours (p<0.001).When comparing each time within itself, it was observed that HBB and paracetamol measurements had similar values (p>0.05). No severe side effects were observed in any of the patients.\u0000\u0000Conclusion: HBB and paracetamol were used for symptomatic treatment in AGE patients presenting with abdominal pain and cramps. A significant reduction in pain and cramps was achieved in both patient groups. There was no difference between the two drugs in terms of treatment efficacy and side effects.\u0000\u0000IMC J Med Sci 2022; 16(1): 009\u0000\u0000*Correspondence: Hasan Gümüşboğa, Department of Emergency, Şehitkamil State Hospital, Gaziantep, Turkey, Posta code: 27500; Email: profhasan@hotmail.com; ORCID:0000-0003-2097-7102.","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"167 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73270592","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 and objectives: Computerized tomography (CT) scan with contrast can delineate soft tissue pathologies and is now the first choice in diagnosing sinonasal malignancy and inflammatory lesions. The present study compared the diagnostic nasal endoscopy (DNE) and CT scan to diagnose cases presented with sinonasal mass. Materials and methods: This was a descriptive study conducted on patients with sinonasal masses attending at Government TD Medical College, Alappuzha, Kerala from 1/1/2014 to 30/6/2015. Each patient was examined by diagnostic nasal endoscopy and had undergone preoperative CT scan. Histopathological examination of the specimens was carried out and compared with the findings of DNE and CT scan. Results: A total of 72 cases were enrolled in the study. Age group was from 13-85 years with a male to female ratio of 1.3:1. Nasal obstruction was the commonest symptom. Among the 72 cases, 59 belonged to the non-neoplastic group and 13 to the neoplastic group. Sinonasal polyps (65.3%) formed the majority of the non-neoplastic lesions. Vascular lesions (6.9%) were the commonest benign neoplastic mass and malignancy was seen in 6.9% of cases. Diagnosis by DNE and CT scan was same except in 3 cases. Histopathology and radiological scan result correlated well except in 3 cases. Conclusion: Histopathology still remains the gold standard in the diagnosis of sinonasal masses. Clinical, CT scan and histopathology diagnoses were complementary with each other. However, CT scan is indispensible in studying the anatomical variants and providing the route map prior to and during endoscopic sinus surgeries. IMC J Med Sci 2022; 16(1): 008 *Correspondence: Santhi Thankappan Pillai, Department of Otorhinolaryngology, Government TD Medical College, Vandanam, Alappuzha, Kerala 688005, India. Email: sttpillai@gmail.com
{"title":"Comparison of clinicopathological and preoperative computed tomography findings of sinonasal masses","authors":"Namrata Sasidharan, Abdunnasar Moodem Pilakkal, Santhi Thankappan Pillai","doi":"10.55010/imcjms.16.006","DOIUrl":"https://doi.org/10.55010/imcjms.16.006","url":null,"abstract":"Background and objectives: Computerized tomography (CT) scan with contrast can delineate soft tissue pathologies and is now the first choice in diagnosing sinonasal malignancy and inflammatory lesions. The present study compared the diagnostic nasal endoscopy (DNE) and CT scan to diagnose cases presented with sinonasal mass.\u0000\u0000Materials and methods: This was a descriptive study conducted on patients with sinonasal masses attending at Government TD Medical College, Alappuzha, Kerala from 1/1/2014 to 30/6/2015. Each patient was examined by diagnostic nasal endoscopy and had undergone preoperative CT scan. Histopathological examination of the specimens was carried out and compared with the findings of DNE and CT scan.\u0000\u0000Results: A total of 72 cases were enrolled in the study. Age group was from 13-85 years with a male to female ratio of 1.3:1. Nasal obstruction was the commonest symptom. Among the 72 cases, 59 belonged to the non-neoplastic group and 13 to the neoplastic group. Sinonasal polyps (65.3%) formed the majority of the non-neoplastic lesions. Vascular lesions (6.9%) were the commonest benign neoplastic mass and malignancy was seen in 6.9% of cases. Diagnosis by DNE and CT scan was same except in 3 cases. Histopathology and radiological scan result correlated well except in 3 cases.\u0000\u0000Conclusion: Histopathology still remains the gold standard in the diagnosis of sinonasal masses. Clinical, CT scan and histopathology diagnoses were complementary with each other. However, CT scan is indispensible in studying the anatomical variants and providing the route map prior to and during endoscopic sinus surgeries.\u0000\u0000IMC J Med Sci 2022; 16(1): 008\u0000\u0000*Correspondence: Santhi Thankappan Pillai, Department of Otorhinolaryngology, Government TD Medical College, Vandanam, Alappuzha, Kerala 688005, India. Email: sttpillai@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84092526","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}
Erdal Yavuz, Hakan Kürümlüoğlu, S. Zengin, Ş. Eren, Esat Karaduman, Cuma Önder Yeşildağ, B. Al, C. Yıldırım
Background and objectives: Infrared thermal (IR) camera is used to assess various clinical conditions such as diabetic foot, carotid artery stenosis, and superficial infection. The present study was designed to determine the usefulness of IR thermal camera in scrotal temperature measurement before color Doppler ultrasonography (CDUS) in patients admitted to the emergency department with acute scrotal pain. Method: This study was prospectively conducted on 49 patients with acute scrotal pain and 30 control participants. The findings of CDUS and scrotal temperature measurements by an IR camera were separately evaluated by different physicians. In all patients, temperature measurements with IR camera were made under the same environmental conditions. Results: Of the 49 patients included in the study, four were diagnosed with torsion, 12 with epididymitis, 4 with orchitis, 3 with epididymo-orchitis, and 2 with varicocele. A significant difference was observed between the scrotal temperature of the patients with scrotal pain and the mean testicular temperature of the control group based on the IR camera measurement (p<0.05). IR camera did not detect any difference between the two testicles of the same person in the patient group (p=0.615). Although the lowest temperature was in testicular torsion, the patients’ scrotal temperature did not significantly differ according to their diagnoses (p=0.087). Conclusion: Testicular temperature measured by IR device was lower in patients presenting with scrotal pain compared to normal individuals. Although not statistically significant, the lowest temperature was found in cases of testicular torsion. IR camera may be useful in triage when used in conjunction with physical examination in patients presenting with acute scrotal pain. IMC J Med Sci 2022; 16(1): 007 *Correspondence: Erdal Yavuz, Department of Emergency Medicine, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey. Email: erdal_yavuz15@hotmail.com, Orcid: 0000-0002-3168-6469
{"title":"Use of infrared thermal camera in acute scrotal pain: a prospective study","authors":"Erdal Yavuz, Hakan Kürümlüoğlu, S. Zengin, Ş. Eren, Esat Karaduman, Cuma Önder Yeşildağ, B. Al, C. Yıldırım","doi":"10.55010/imcjms.16.005","DOIUrl":"https://doi.org/10.55010/imcjms.16.005","url":null,"abstract":"Background and objectives: Infrared thermal (IR) camera is used to assess various clinical conditions such as diabetic foot, carotid artery stenosis, and superficial infection. The present study was designed to determine the usefulness of IR thermal camera in scrotal temperature measurement before color Doppler ultrasonography (CDUS) in patients admitted to the emergency department with acute scrotal pain.\u0000\u0000Method: This study was prospectively conducted on 49 patients with acute scrotal pain and 30 control participants. The findings of CDUS and scrotal temperature measurements by an IR camera were separately evaluated by different physicians. In all patients, temperature measurements with IR camera were made under the same environmental conditions.\u0000\u0000Results: Of the 49 patients included in the study, four were diagnosed with torsion, 12 with epididymitis, 4 with orchitis, 3 with epididymo-orchitis, and 2 with varicocele. A significant difference was observed between the scrotal temperature of the patients with scrotal pain and the mean testicular temperature of the control group based on the IR camera measurement (p<0.05). IR camera did not detect any difference between the two testicles of the same person in the patient group (p=0.615). Although the lowest temperature was in testicular torsion, the patients’ scrotal temperature did not significantly differ according to their diagnoses (p=0.087).\u0000\u0000Conclusion: Testicular temperature measured by IR device was lower in patients presenting with scrotal pain compared to normal individuals. Although not statistically significant, the lowest temperature was found in cases of testicular torsion. IR camera may be useful in triage when used in conjunction with physical examination in patients presenting with acute scrotal pain.\u0000\u0000IMC J Med Sci 2022; 16(1): 007\u0000\u0000*Correspondence: Erdal Yavuz, Department of Emergency Medicine, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey. Email: erdal_yavuz15@hotmail.com, Orcid: 0000-0002-3168-6469","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81953184","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}
Wasim Selimul Haque, Shakibul Alam, H. Kabir, Al-Amin Chowdhury
Mycosis fungoides (MF) is the commonest primary cutaneous T-cell lymphoma (CTCL). Classically MF is presented clinically as multilesional disease but occurrence of solitary lesion, though quite rare, is on the record. This rare variant of MF is clinically and histopathologically indistinguishable from classic MF. Due to the rarity of the presentation the clinician may miss the diagnosis and the pathologist may also be in diagnostic dilemma specially if not clinically oriented. Here we describe a case of unilesional/solitary MF (UMF) in a 59 years old male who was initially clinically diagnosed as inflammatory dermatosis and was treated accordingly without any appreciable clinical response for over 4 years. Unresponsiveness to empirical treatment led to biopsy which finally proved it to be UMF. The clinical, light microscopic and immunohistochemical features of UMF are briefly reviewed to create awareness among the clinicians and pathologists about this rare variant of MF. IMC J Med Sci 2022; 16(1): 006 *Correspondence: Wasim Selimul Haque, Head, Department of Histopathology and Cytopathology, Jaber Al-Ahmed Armed Forces Hospital, Kuwait Armed, Forces, Subhan Cantonment, Kuwait. Email: audrirodelawasim@gmail.com
{"title":"Unilesional mycosis fungoides: a case report and review of literature","authors":"Wasim Selimul Haque, Shakibul Alam, H. Kabir, Al-Amin Chowdhury","doi":"10.55010/imcjms.16.009","DOIUrl":"https://doi.org/10.55010/imcjms.16.009","url":null,"abstract":"Mycosis fungoides (MF) is the commonest primary cutaneous T-cell lymphoma (CTCL). Classically MF is presented clinically as multilesional disease but occurrence of solitary lesion, though quite rare, is on the record. This rare variant of MF is clinically and histopathologically indistinguishable from classic MF. Due to the rarity of the presentation the clinician may miss the diagnosis and the pathologist may also be in diagnostic dilemma specially if not clinically oriented. Here we describe a case of unilesional/solitary MF (UMF) in a 59 years old male who was initially clinically diagnosed as inflammatory dermatosis and was treated accordingly without any appreciable clinical response for over 4 years. Unresponsiveness to empirical treatment led to biopsy which finally proved it to be UMF. The clinical, light microscopic and immunohistochemical features of UMF are briefly reviewed to create awareness among the clinicians and pathologists about this rare variant of MF.\u0000\u0000IMC J Med Sci 2022; 16(1): 006\u0000\u0000*Correspondence: Wasim Selimul Haque, Head, Department of Histopathology and Cytopathology, Jaber Al-Ahmed Armed Forces Hospital, Kuwait Armed, Forces, Subhan Cantonment, Kuwait. Email: audrirodelawasim@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74250685","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 and objectives: To prevent the emergence and spreading of antimicrobial resistance, especially multidrug resistance in pathogenic bacteria, the selection of appropriate antibiotics is a prerequisite for the effective treatment of infection.This study aimed to analyze the prevalence and antimicrobial resistance patterns of bacterial isolates from various clinical samples in a tertiary care hospital. Methods: This study was conducted at a teaching hospital of Dhaka city, Bangladesh from January 2020 to March 2021. The results of culture and antimicrobial susceptibility of bacterial isolates from various clinical samples were collected and analysed. Identification of bacteria and antimicrobial susceptibility test were performed according to the standard methods. Results: A total of 1277 bacterial isolates was analyzed. Of them, 1072 (83.95%) were Gram-negative, and 205 (16.05%) were Gram-positive bacteria. Among the isolates, Escherichia coli (n=576), Enterobacter spp. (n=150), Klebsiella spp. (n=140), and Staphylococcus aureus (n=117) were predominant.The Enterobacteriaceae showed higher resistance to cephradine (94.3%) and cefuroxime (76.7%), whereas least resistant to imipenem (10.1%) and meropenem (14.8%). Pseudomonas spp. was highly resistant to ceftriaxone (80.2%), and colistin (70.8%), whereas least resistant to piperacillin-tazobactam (15.1%). Colistin was the most effective agent (resistance 6.7%) against Acinetobacter spp. Linezolid (resistance 1%) and vancomycin (resistance 2%) were highly effective against Gram-positive bacteria. Among the Staphylococcus aureus, 95.7% were methicillin-resistant (MRSA). A total of 889 (69.6%) bacterial isolates were identified as multidrug resistant. Multidrug resistance was more prevalent in Gram-positive isolates (79.5%) than that of Gram-negative bacteria (67.7%). Furthermore, 7.5% of Gram-negative bacterial isolates were resistant to all seven classes of antibiotics tested. Conclusions: This study revealed presence of high rate of resistance to several antimicrobial agents in bacteria isolated from various clinical samples.The findings would help healthcare professionals to select appropriate antibiotics for the effective treatment of infections and to develop antibiotic stewardship protocol. IMC J Med Sci 2022; 16(1): 005 *Correspondence: M. Mahboob Hossain, Microbiology Program, Department of Mathematics and Natural Sciences (MNS), BRAC University, 66 Mohakhali, Dhaka 1212. E-mail: mmhossain@bracu.ac.bd
{"title":"Antimicrobial susceptibility patterns of bacterial isolates from routine clinical specimens of a tertiary hospital in Bangladesh","authors":"Md. Anwar Hossain, M. M. Hossain, N. Begum","doi":"10.55010/imcjms.16.004","DOIUrl":"https://doi.org/10.55010/imcjms.16.004","url":null,"abstract":"Background and objectives: To prevent the emergence and spreading of antimicrobial resistance, especially multidrug resistance in pathogenic bacteria, the selection of appropriate antibiotics is a prerequisite for the effective treatment of infection.This study aimed to analyze the prevalence and antimicrobial resistance patterns of bacterial isolates from various clinical samples in a tertiary care hospital.\u0000\u0000Methods: This study was conducted at a teaching hospital of Dhaka city, Bangladesh from January 2020 to March 2021. The results of culture and antimicrobial susceptibility of bacterial isolates from various clinical samples were collected and analysed. Identification of bacteria and antimicrobial susceptibility test were performed according to the standard methods.\u0000\u0000Results: A total of 1277 bacterial isolates was analyzed. Of them, 1072 (83.95%) were Gram-negative, and 205 (16.05%) were Gram-positive bacteria. Among the isolates, Escherichia coli (n=576), Enterobacter spp. (n=150), Klebsiella spp. (n=140), and Staphylococcus aureus (n=117) were predominant.The Enterobacteriaceae showed higher resistance to cephradine (94.3%) and cefuroxime (76.7%), whereas least resistant to imipenem (10.1%) and meropenem (14.8%). Pseudomonas spp. was highly resistant to ceftriaxone (80.2%), and colistin (70.8%), whereas least resistant to piperacillin-tazobactam (15.1%). Colistin was the most effective agent (resistance 6.7%) against Acinetobacter spp. Linezolid (resistance 1%) and vancomycin (resistance 2%) were highly effective against Gram-positive bacteria. Among the Staphylococcus aureus, 95.7% were methicillin-resistant (MRSA). A total of 889 (69.6%) bacterial isolates were identified as multidrug resistant. Multidrug resistance was more prevalent in Gram-positive isolates (79.5%) than that of Gram-negative bacteria (67.7%). Furthermore, 7.5% of Gram-negative bacterial isolates were resistant to all seven classes of antibiotics tested.\u0000\u0000Conclusions: This study revealed presence of high rate of resistance to several antimicrobial agents in bacteria isolated from various clinical samples.The findings would help healthcare professionals to select appropriate antibiotics for the effective treatment of infections and to develop antibiotic stewardship protocol.\u0000\u0000IMC J Med Sci 2022; 16(1): 005\u0000\u0000*Correspondence: M. Mahboob Hossain, Microbiology Program, Department of Mathematics and Natural Sciences (MNS), BRAC University, 66 Mohakhali, Dhaka 1212. E-mail: mmhossain@bracu.ac.bd","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81182860","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}
P. Upla, B. Sani, N. S. Hadi, F. Y. Al-Mustapha, K. Shuaibu
Rocky Mountain spotted fever (RMSF) is a bacterial infection caused by Rickettsia, a diverse group of small Gram-negative rod-shaped α-proteobacteria, and obligates intracellular pathogens, which are free-living in hosts' cell cytoplasm and are transmitted to humans by arthropod vectors. It is the most acute rickettsial diseases known to human, with significant death rates of over 20–30%. They are distinguished by a strictly intracellular position which has, for long, delayed their comprehensive study. This article attempts primarily to focus on the mechanisms of Rickettsia-host cell interactions and the underlying molecular pathogenesis of RMSF. IMC J Med Sci 2022; 16(1): 004 *Correspondence: Bashiru Sani, Department of Microbiology, Federal University of Lafia, Nasarawa State, Nigeria. Email: bashmodulus@gmail.com
{"title":"Molecular pathogenesis of Rocky Mountain spotted fever: a brief review","authors":"P. Upla, B. Sani, N. S. Hadi, F. Y. Al-Mustapha, K. Shuaibu","doi":"10.55010/imcjms.16.010","DOIUrl":"https://doi.org/10.55010/imcjms.16.010","url":null,"abstract":"Rocky Mountain spotted fever (RMSF) is a bacterial infection caused by Rickettsia, a diverse group of small Gram-negative rod-shaped α-proteobacteria, and obligates intracellular pathogens, which are free-living in hosts' cell cytoplasm and are transmitted to humans by arthropod vectors. It is the most acute rickettsial diseases known to human, with significant death rates of over 20–30%. They are distinguished by a strictly intracellular position which has, for long, delayed their comprehensive study. This article attempts primarily to focus on the mechanisms of Rickettsia-host cell interactions and the underlying molecular pathogenesis of RMSF.\u0000\u0000IMC J Med Sci 2022; 16(1): 004\u0000\u0000*Correspondence: Bashiru Sani, Department of Microbiology, Federal University of Lafia, Nasarawa State, Nigeria. Email: bashmodulus@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81841133","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}
F. Ganie, Sayed Mohsin Manzoor, Masarat-ul Gani, M. Khan, G. N. Ione, M. Bhat, Iqra Nazir Naqash
Background and objectives: Transthoracic esophagectomy is usually associated with significant perioperative bleeding and blood loss. The present study investigated the role of prophylactic tranexamic acid on intra- and postoperative blood loss and the need for blood transfusion in transthoracic esophagectomy (Ivor Lewis esophagectomy). Materials and Methods: Patients who underwent laparotomy and right thoracotomy with intrathoracic anastomosis for esophageal malignancy were enrolled in the study. The enrolled cases were divided into two groups namely Group A and B. Informed consents were obtained from all the enrolled patients. Group A patients received a standard dose of 1 gram of intravenous tranexamic acid one hour before the beginning of surgery while Group B patients did not receive any tranexamic acid before or after the surgery. Peroperative blood loss was estimated and noted. Post-operative blood loss was assessed from the surgical drains. Results: A total of 55 cases were included in the study. Group A and B had 27 and 28 cases respectively. The mean age of the Group A and Group B patients was 60.1 ± 6.2 and 60 ± 6.9 years respectively. Out of 27 cases in Group A, 7 (25%) patients had a postoperative haemorrhage (blood loss) up to 300 ml and among the remaining 20, only 2 (7%) patients required blood transfusion as hematocrit fell below 20%. Compared to Group A, patients in Group B who did not receive preoperative tranexamic acid, 21(75%) patients had postoperative haemorrhage up to 300 ml (Group A vs. Group B: p=0.0002). Regarding intraoperative blood loss no significant (p >0.05) difference was observed among the cases in two groups. Conclusion: The study revealed that administration of prophylactic tranexamic acid resulted into fewer postoperative blood loss in transthoracic esophagectomy. IMC J Med Sci 2022; 16(1): 003 *Correspondence: Farooq Ahmad Ganie, Department of Cardiovascular and Thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar -190011, J & K, India. E-mail: farooq.ganie@yamil.com
{"title":"Role of tranexamic acid in reducing perioperative blood loss in transthoracic esophagectomy","authors":"F. Ganie, Sayed Mohsin Manzoor, Masarat-ul Gani, M. Khan, G. N. Ione, M. Bhat, Iqra Nazir Naqash","doi":"10.55010/imcjms.16.003","DOIUrl":"https://doi.org/10.55010/imcjms.16.003","url":null,"abstract":"Background and objectives: Transthoracic esophagectomy is usually associated with significant perioperative bleeding and blood loss. The present study investigated the role of prophylactic tranexamic acid on intra- and postoperative blood loss and the need for blood transfusion in transthoracic esophagectomy (Ivor Lewis esophagectomy).\u0000\u0000Materials and Methods: Patients who underwent laparotomy and right thoracotomy with intrathoracic anastomosis for esophageal malignancy were enrolled in the study. The enrolled cases were divided into two groups namely Group A and B. Informed consents were obtained from all the enrolled patients. Group A patients received a standard dose of 1 gram of intravenous tranexamic acid one hour before the beginning of surgery while Group B patients did not receive any tranexamic acid before or after the surgery. Peroperative blood loss was estimated and noted. Post-operative blood loss was assessed from the surgical drains.\u0000\u0000Results: A total of 55 cases were included in the study. Group A and B had 27 and 28 cases respectively. The mean age of the Group A and Group B patients was 60.1 ± 6.2 and 60 ± 6.9 years respectively. Out of 27 cases in Group A, 7 (25%) patients had a postoperative haemorrhage (blood loss) up to 300 ml and among the remaining 20, only 2 (7%) patients required blood transfusion as hematocrit fell below 20%. Compared to Group A, patients in Group B who did not receive preoperative tranexamic acid, 21(75%) patients had postoperative haemorrhage up to 300 ml (Group A vs. Group B: p=0.0002). Regarding intraoperative blood loss no significant (p >0.05) difference was observed among the cases in two groups.\u0000\u0000Conclusion: The study revealed that administration of prophylactic tranexamic acid resulted into fewer postoperative blood loss in transthoracic esophagectomy.\u0000\u0000IMC J Med Sci 2022; 16(1): 003\u0000\u0000*Correspondence: Farooq Ahmad Ganie, Department of Cardiovascular and Thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar -190011, J & K, India. E-mail: farooq.ganie@yamil.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82518699","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 and objectives: Diabetes mellitus (DM) is a major health problem in South Asian Region including Bangladesh. Increasing prevalence of DM is likely to cause higher morbidity and mortality. The objective of this study was to find out the prevalence and incidence of diabetic complications in a Bangladeshi diabetic cohort attending BIRDEM, a largest referral center in Bangladesh for endocrine and metabolic diseases. Methodology: The study was conducted in BIRDEM-OPD (outpatient department) from 1 January to 31 December of 1995 and analyzed the data of diabetic cases preserved in BIRDEM registry since 1956. Up to 31 December 1985, the REFERENCE NUMBER (Ref No) of last case was ‘49,510’. Therefore, this retrospective cohort comprised of all those patients having Ref No 49,510 or less and attending BIRDEM-OPD for follow-up. In the year 1995, the cohort had follow-up for at least ten years. The duration of follow-up was 39 years (1956 to 1995). The study also retrieved follow-up data from the guidebook of each registered diabetic patient. All data regarding clinical, anthropometric and biochemical investigations preserved in BIRDEM registry and in the patient's guidebook were retrieved and analyzed. The cohort was categorized into three groups (Gr1, 2 and 3) based on follow-up duration: >15, 10-15 and <10years, respectively. Results: Micro-vascular complications (retinopathy and nephropathy) were the highest among both Gr1 with follow-up >15y and Gr2 with follow-up 10-15y. Compared with the Gr2, retinopathy (34.4 vs. 48.5 %: c2 =11.5, p <0.001) and nephropathy (24.0 vs. 39.2 %: c2 = 15.6, p<0.001) were significantly higher in the Gr1. In contrast, HTN, skin-lesion and periodontal diseases were significantly higher in the Gr2 than in Gr1. All types of complications were found increasing with the duration of follow-up. For Gr1, the increasing trend of cerebrovascular accident (CVD/ stroke) and CHD was significant (p<0.01 and p<0.001). Mean blood glucose of study population revealed moderate to severe hyperglycemia in successive follow-up visits. The comparison between patients with and without severe hyperglycemia (2hPG: <10.0 vs. ³10.0 mmol/l) showed very little difference of complications. The increasing age over 40 years showed significant risk for CHD and hypertension. Conclusion: CHD, stroke and PVD were less frequent compared to those with retinopathy and nephropathy. Compared to microvascular complications the macrovascular events resulted in either early death or complete disability to pursue long-term follow-up. The most important and consistent predictors were female gender and duration of diabetes. IMC J Med Sci 2022; 16(1): 002 *Correspondence: M. Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A Ibrahim Sarani, Segunbagicha, Dhaka-1000. email: sayeed@imc.ac.bd; sayeed1950@gmail.com
背景和目的:糖尿病(DM)是南亚地区包括孟加拉国的一个主要健康问题。糖尿病患病率的增加可能导致更高的发病率和死亡率。本研究的目的是了解在孟加拉国最大的内分泌和代谢疾病转诊中心BIRDEM就诊的孟加拉国糖尿病队列中糖尿病并发症的患病率和发病率。方法:研究于1995年1月1日至12月31日在BIRDEM- opd(门诊部)进行，分析1956年以来BIRDEM登记的糖尿病病例资料。截至1985年12月31日，最后一宗个案的参考编号为“49,510”。因此，该回顾性队列包括所有参考文献编号为49,510或更少并参加BIRDEM-OPD随访的患者。在1995年，对这群人进行了至少10年的随访。随访时间为39年(1956年至1995年)。该研究还从每位登记的糖尿病患者的指南中检索了随访数据。检索并分析保存在BIRDEM登记处和患者指南中的所有临床、人体测量和生化调查数据。根据随访时间将队列分为Gr1、Gr2和gr3组:>15、10-15和15y, Gr2组随访10-15y。与Gr2组相比，Gr1组视网膜病变(34.4比48.5%:c2 =11.5, p<0.001)和肾病(24.0比39.2%:c2 = 15.6, p<0.001)发生率显著高于Gr2组。相比之下，Gr2组的HTN、皮肤病变和牙周病明显高于Gr1组。随着随访时间的延长，各种并发症的发生率均有所增加。Gr1组脑血管意外(CVD/卒中)和冠心病发生率均有显著升高趋势(p<0.01和p<0.001)。在连续的随访中，研究人群的平均血糖显示为中度至重度高血糖。重度高血糖患者与非重度高血糖患者(2hPG <10.0 vs.³10.0 mmol/l)的并发症差异很小。年龄超过40岁的人患冠心病和高血压的风险显著。结论:冠心病、脑卒中和PVD发生率低于视网膜病变和肾病患者。与微血管并发症相比，大血管事件导致早期死亡或完全残疾。最重要和最一致的预测因素是女性性别和糖尿病病程。中华医学会医学杂志2022;16(1): 002*通信:M. Abu Sayeed, Ibrahim医学院社区医学系，1/A Ibrahim Sarani, Segunbagicha, dhaka 1000。电子邮件:sayeed@imc.ac.bd;sayeed1950@gmail.com
{"title":"Prevalence and incidence of micro- and macro-vascular complications in a diabetic population of Bangladesh: a retrospective cohort study","authors":"M. Sayeed, A. Banu, P. Khanam, T. Begum","doi":"10.55010/imcjms.16.002","DOIUrl":"https://doi.org/10.55010/imcjms.16.002","url":null,"abstract":"Background and objectives: Diabetes mellitus (DM) is a major health problem in South Asian Region including Bangladesh. Increasing prevalence of DM is likely to cause higher morbidity and mortality. The objective of this study was to find out the prevalence and incidence of diabetic complications in a Bangladeshi diabetic cohort attending BIRDEM, a largest referral center in Bangladesh for endocrine and metabolic diseases.\u0000\u0000Methodology: The study was conducted in BIRDEM-OPD (outpatient department) from 1 January to 31 December of 1995 and analyzed the data of diabetic cases preserved in BIRDEM registry since 1956. Up to 31 December 1985, the REFERENCE NUMBER (Ref No) of last case was ‘49,510’. Therefore, this retrospective cohort comprised of all those patients having Ref No 49,510 or less and attending BIRDEM-OPD for follow-up. In the year 1995, the cohort had follow-up for at least ten years. The duration of follow-up was 39 years (1956 to 1995). The study also retrieved follow-up data from the guidebook of each registered diabetic patient. All data regarding clinical, anthropometric and biochemical investigations preserved in BIRDEM registry and in the patient's guidebook were retrieved and analyzed. The cohort was categorized into three groups (Gr1, 2 and 3) based on follow-up duration: >15, 10-15 and <10years, respectively.\u0000\u0000Results: Micro-vascular complications (retinopathy and nephropathy) were the highest among both Gr1 with follow-up >15y and Gr2 with follow-up 10-15y. Compared with the Gr2, retinopathy (34.4 vs. 48.5 %: c2 =11.5, p <0.001) and nephropathy (24.0 vs. 39.2 %: c2 = 15.6, p<0.001) were significantly higher in the Gr1. In contrast, HTN, skin-lesion and periodontal diseases were significantly higher in the Gr2 than in Gr1. All types of complications were found increasing with the duration of follow-up. For Gr1, the increasing trend of cerebrovascular accident (CVD/ stroke) and CHD was significant (p<0.01 and p<0.001). Mean blood glucose of study population revealed moderate to severe hyperglycemia in successive follow-up visits. The comparison between patients with and without severe hyperglycemia (2hPG: <10.0 vs. ³10.0 mmol/l) showed very little difference of complications. The increasing age over 40 years showed significant risk for CHD and hypertension.\u0000\u0000Conclusion: CHD, stroke and PVD were less frequent compared to those with retinopathy and nephropathy. Compared to microvascular complications the macrovascular events resulted in either early death or complete disability to pursue long-term follow-up. The most important and consistent predictors were female gender and duration of diabetes.\u0000\u0000 IMC J Med Sci 2022; 16(1): 002\u0000\u0000*Correspondence: M. Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A Ibrahim Sarani, Segunbagicha, Dhaka-1000. email: sayeed@imc.ac.bd; sayeed1950@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86311576","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}
M. Ozdin, H. Kaya, U. Gulacti, Ugur Lok, H. Kafadar, C. Yucetas
Background: Changes in hematological parameters play a role in the pathogenesis of coronavirus disease 2019 (COVID-19). We aimed to investigate the significance of neutrophil-lymphocyte ratio (NLR) and hematologic parameters in determining the severity of COVID-19. Methods: This retrospective cross-sectional study was conducted on adult patients diagnosed with COVID-19 in two pandemic hospitals between 01, April, and 01, July 2020. Using the COVID-19 diagnostic criteria of the world health organization (WHO), the patients were divided into two groups as severe and non-severe. Demographic and clinical characteristics, white blood cell (WBC), neutrophil, lymphocyte and platelet counts, and NLR of all patients were examined at the first admission. Multivariate analyzes were performed to determine the independent predictive data and ROC analysis to test the diagnostic accuracy of the hematological parameters. Results: Of the 381 patients included in the study, 42 (11%) had severe COVID-19 infection. While the mean NLR was 7.61±7.48 in patients with severe COVID-19, the mean NLR of non-severe patients was 2.97±2.37 (95% CI: 2.294 to 6.984, p<0.001). Long duration of hospital stay, elevated NLR ratio, female gender were predictive variables of severe COVID-19 cases (OR =0.833, 95% CI: 0.744 to 0.934, p=0.002; OR=0.195, 95% CI: 0.057 to 0.6731, p=0.010; OR=0.664, 95% CI: 0.501 to 0.881, p=0.005, respectively). In ROC analysis, NLR ratio had 2.625 optimum cut-off value, 60% specificity (95% CI: 54.7 to 65.4), 86% sensitivity (95% CI: 71.5 to 94.6), positive likelihood ratio (PLR) of 4.2 (95% CI: 2.0 to 8.9) and negative likelihood ratio (NLR) of 0.46 (95% CI: 0.4 to 0.6) for severe COVID-19 cases. Conclusion: The results of this study revealed that there might be a relationship between elevated NLR and severity in COVID-19 cases. IMC J Med Sci 2022; 16(1): 001 *Correspondence: Dr. Umut Gulacti, Adiyaman University Training and Research Hospital, Emergency Medicine, Adiyaman, Turkey. E-mail: umutgulacti@gmail.com
{"title":"The diagnostic value of neutrophil to lymphocyte ratio in determining the severity of COVID-19","authors":"M. Ozdin, H. Kaya, U. Gulacti, Ugur Lok, H. Kafadar, C. Yucetas","doi":"10.55010/imcjms.16.001","DOIUrl":"https://doi.org/10.55010/imcjms.16.001","url":null,"abstract":"Background: Changes in hematological parameters play a role in the pathogenesis of coronavirus disease 2019 (COVID-19). We aimed to investigate the significance of neutrophil-lymphocyte ratio (NLR) and hematologic parameters in determining the severity of COVID-19.\u0000\u0000Methods: This retrospective cross-sectional study was conducted on adult patients diagnosed with COVID-19 in two pandemic hospitals between 01, April, and 01, July 2020. Using the COVID-19 diagnostic criteria of the world health organization (WHO), the patients were divided into two groups as severe and non-severe. Demographic and clinical characteristics, white blood cell (WBC), neutrophil, lymphocyte and platelet counts, and NLR of all patients were examined at the first admission. Multivariate analyzes were performed to determine the independent predictive data and ROC analysis to test the diagnostic accuracy of the hematological parameters.\u0000\u0000Results: Of the 381 patients included in the study, 42 (11%) had severe COVID-19 infection. While the mean NLR was 7.61±7.48 in patients with severe COVID-19, the mean NLR of non-severe patients was 2.97±2.37 (95% CI: 2.294 to 6.984, p<0.001). Long duration of hospital stay, elevated NLR ratio, female gender were predictive variables of severe COVID-19 cases (OR =0.833, 95% CI: 0.744 to 0.934, p=0.002; OR=0.195, 95% CI: 0.057 to 0.6731, p=0.010; OR=0.664, 95% CI: 0.501 to 0.881, p=0.005, respectively). In ROC analysis, NLR ratio had 2.625 optimum cut-off value, 60% specificity (95% CI: 54.7 to 65.4), 86% sensitivity (95% CI: 71.5 to 94.6), positive likelihood ratio (PLR) of 4.2 (95% CI: 2.0 to 8.9) and negative likelihood ratio (NLR) of 0.46 (95% CI: 0.4 to 0.6) for severe COVID-19 cases.\u0000\u0000Conclusion: The results of this study revealed that there might be a relationship between elevated NLR and severity in COVID-19 cases.\u0000\u0000IMC J Med Sci 2022; 16(1): 001\u0000\u0000*Correspondence: Dr. Umut Gulacti, Adiyaman University Training and Research Hospital, Emergency Medicine, Adiyaman, Turkey. E-mail: umutgulacti@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73698983","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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