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Smokeless Tobacco Consumption and Breast Cancer in Women: Findings of a Case-Control Study 无烟烟草消费与女性乳腺癌:一项病例对照研究的结果
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.3329/bmrcb.v49i2.62921
Munmun Mustafa, Md Ziaul Islam
Background: Breast cancer is the most commonly occurring cancer in women and the second most common cancer overall. Among the various risk factors of breast cancer, smokeless tobacco is the neglected potential one. Hence the study was conducted to assess the association between smokeless tobacco consumption & breast cancer risk among the women. Objective: The objective of the study was to assess the association between smokeless tobacco consumption and breast cancer in women and to compare the pattern of smokeless tobacco consumption, relevant other factors of breast cancer and the socio-demographic characteristics between the cases and controls. Methods: This case control study was conducted in 302 women of two tertiary hospitals of Dhaka city from January to December’2020. The study enrolled 151 breast cancer patients as cases and another 151 non cancer age-matched women as controls. Convenient technique was used for data collection. A pre-tested semi-structured questionnaire and a checklist were used for face to face interview and to review the medical record respectively. The data were analyzed by SPSS software. Quality control checks of the data were done at all stages of the study. All ethical issues were maintained strictly and informed written consent was taken from each case and control. Results: The mean (±SD) age of cases and controls was 44.4(±10.56) &44.82(±10.2) years respectively (p=0.769). Maximum cases (90.1%) were married in comparison to controls (76.2%) and the association was significant (p=0.003). Majority of the cases (63.58%) had monthly income of 21000-50000tk compared to controls (51.66%) and this difference was significant (p=0.01).Among the cases, 36.4% were exposed to smokeless tobacco in comparison to 33.8% controls. Though this association was not significant (p=0.630) but maximum cases (70.9%) were found to be exposed for 16-30 years in comparison to controls (43.9%) and it was statistically significant (OR: 7.58, 95%CI: 0.865-66.404). Among the cases, who were exposed to zarda were 3.25 times more likely to have it >10 times in comparison to 2.6% controls (OR: 3.25, 95% CI: 1.05-9.99, p=0.040). Conclusion: Increased frequency and duration of smokeless tobacco intake is found significantly associated with breast cancer so specific preventive intervention is required for prevention of smokeless tobacco consumption among women to alleviate breast cancer. Bangladesh Medical Res Counc Bull 2023; 49(2): 83-90
背景:乳腺癌是女性中最常见的癌症,也是第二常见的癌症。在乳腺癌的各种危险因素中,无烟烟草是被忽视的潜在因素。因此,进行这项研究是为了评估无烟烟草消费与健康之间的关系。女性患乳腺癌的风险。目的:本研究的目的是评估无烟烟草消费与女性乳腺癌之间的关系,并比较无烟烟草消费模式、乳腺癌的相关其他因素以及病例和对照组之间的社会人口统计学特征。方法:对2020年1 - 12月在达卡市两所三级医院就诊的302名妇女进行病例对照研究。该研究招募了151名乳腺癌患者作为病例,另外151名非癌症年龄匹配的女性作为对照。数据采集采用便捷技术。面对面访谈采用预测半结构化问卷,病历回顾采用核对表。采用SPSS软件对数据进行分析。在研究的所有阶段都对数据进行了质量控制检查。严格遵守所有道德问题,并从每个病例和控制中获得知情的书面同意。结果:病例和对照组的平均(±SD)年龄分别为44.4(±10.56)岁和44.82(±10.2)岁(p=0.769)。与对照组(76.2%)相比,已婚者最多(90.1%),相关性显著(p=0.003)。大多数病例(63.58%)的月收入为21000 ~ 50000tk,高于对照组(51.66%),差异有统计学意义(p=0.01)。在这些病例中,36.4%的人接触过无烟烟草,而对照组的这一比例为33.8%。虽然这种相关性不显著(p=0.630),但与对照组(43.9%)相比,暴露于16-30年的最多病例(70.9%)具有统计学意义(OR: 7.58, 95%CI: 0.865-66.404)。在这些病例中,暴露于zarda的人患该病的可能性是对照组的3.25倍(10倍)(OR: 3.25, 95% CI: 1.05-9.99, p=0.040)。结论:吸烟频率和持续时间的增加与乳腺癌有显著相关性,因此需要采取针对性的预防干预措施,预防女性吸烟以减轻乳腺癌。孟加拉国医疗资源理事会2023号文件;49 (2): 83 - 90
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引用次数: 0
Efficacy of Loop Electrosurgical Excision Procedure in the Management of Cervical Intraepithelial Neoplasia (CIN) –in A Tertiary Level Hospital 某三级医院环形电切术治疗宫颈上皮内瘤变的疗效观察
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.3329/bmrcb.v49i2.66003
Ayesha Siddiqua, Shirin Akhter Begum, Salma Rouf, Faujia Sharmin, Mehriban Amatullah, Tasfia Mahmud
Background: Cervical intraepithelial neoplasia (CIN) is the potentially premalignant transformation and abnormal growth of surface epithelial cells of the cervix. CIN is a precancerous condition and curable. Loop electrosurgical excision procedure (LEEP) is a simple, outpatient procedure of removing the transformation zone of cervix. The aim of our study was to evaluate the efficacy of large loop electrosurgical excision procedure (LEEP) as a treatment procedure for cervical intraepiethelial neoplasia. Methods: This prospective observational study was conducted at Colposcopy clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from June, 2017 to May, 2019. All consecutive patients having colposcopicaly and histopathologicaly proven high grade lesion by colposcopy directed punch biopsy were included in this study. All eligible patients with high grade lesion were underwent LEEP and followed up on 15 days post-procedure, 6 months, 12 months with colposcopy. Results: Sixty (60) cases were undergone LEEP, among them 48 (80%) cases were diagnosed as CIN2 and 12 (20%) cases were CIN3 by colposcopy- directed biopsy. One patient (1.7%) needed hospital admission to controll intra-operative bleeding and in postoperative period 7 (11.7%) patients had mild to moderate post-operative bleeding which was controlled well after application of morsel’s pastes and electro-cautery, one patient (1.7%) had pelvic infection. On 6 months follow-up, in case of CIN2 patients, cure rate was 93.5% (43 of 46) and 1 (2.2%) patient had persistent CIN-2. Patient with persistent CIN2 had re-excision and followed up at 12 month with colposcopy. Among case of CIN-3, the cure rate was 81.8% (9 of 11) and 1 (9.1%) case had CIN2. P-value was 0.244, which was not statistically significant. Overall cure rate on 6 month follow-up was 91.2%. On 12 months follow-up cure rate for CIN2 was 97.8% and for CIN3 was 90.9%. Overall cure rate was 96.5%. P-value was 0.352, which was not statistically significant. Conclusion: Loop electrosurgical excision procedure (LEEP) has a good outcome as a diagnostic and treatment procedure for cervical intraepithelial neoplasia. Bangladesh Medical Res Counc Bull 2023; 49(2): 113-119
背景:宫颈上皮内瘤变(CIN)是宫颈表面上皮细胞潜在的癌前转化和异常生长。CIN是一种可治愈的癌前病变。环形电切术(LEEP)是一种简单的,门诊手术切除宫颈变形区。本研究的目的是评估大环电切术(LEEP)作为宫颈上皮内瘤变的治疗方法的有效性。方法:本前瞻性观察研究于2017年6月至2019年5月在Bangabandhu Sheikh Mujib医科大学(BSMMU)阴道镜门诊进行。所有经阴道镜检查和组织病理学证实经阴道镜定向穿刺活检为高级别病变的连续患者均纳入本研究。所有符合条件的高级别病变患者均行LEEP,并于术后15天、6个月、12个月进行阴道镜随访。结果:60例患者行LEEP手术,经阴道镜穿刺活检诊断为CIN2 48例(80%),CIN3 12例(20%)。术中出血需住院控制1例(1.7%),术后轻度至中度出血7例(11.7%),应用morsel糊剂和电烧灼后出血控制良好,盆腔感染1例(1.7%)。随访6个月,CIN2患者治愈率为93.5%(43 / 46),1例(2.2%)患者持续存在CIN-2。持续性CIN2患者再次切除,随访12个月后行阴道镜检查。CIN-3的治愈率为81.8% (9 / 11),cin - 2的治愈率为1例(9.1%)。p值为0.244,差异无统计学意义。6个月随访总治愈率为91.2%。随访12个月,CIN2治愈率为97.8%,CIN3治愈率为90.9%。总治愈率为96.5%。p值为0.352,差异无统计学意义。结论:环形电切术(LEEP)作为宫颈上皮内瘤变的诊断和治疗方法具有良好的效果。孟加拉国医疗资源理事会2023号文件;49 (2): 113 - 119
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引用次数: 0
Antibiotic Consumption Behaviour of Dental Patients Attending in Tertiary Hospital 三级医院牙科患者抗生素消费行为分析
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.3329/bmrcb.v49i2.65990
Md Salim Uddin, Towhida Ahsan, Hafiza Sultana
Background: The consumption of antibiotics is increasing globally and in dentistry, it is increasing day by day at an alarming rate. The irrational consumption of antibiotics results not only in the emergence of antibiotic resistance but also in various adverse reactions and imposes financial burden on health system. Objective: The aim of the study was to assess the antibiotic consumption behaviour of dental patients attending in tertiary hospital. Methods: This cross-sectional study was conducted at Dhaka Dental College Hospital from July 2020 to June 2021 among 195 dental patients. After obtaining informed written consent, data were collected by face to face interview using a pretested semi-structured questionnaire and checklist. Data were analyzed using SPSS 26 version. Pearson’s Chi-square test and Likelihood Ratio were done to assess the association with 5% level of significance. Results: In this study, mean (±SD) age of the dental patients was 41.11 (±14.09) years. Majority of the patients were male (52.8%). More than half (52.8%) of the patients’ monthly family income was ≤20000 BDT with predominant urban dwellers (72.8%). Mean (±SD) antibiotic consumption behaviour score of the patients were 10.96 (±3.879) and behaviour categories were good behaviour (35.9%), average behaviour (32.8%) and poor behaviour (31.8%) respectively. More than half of the patients (56.4%) sometimes forgot or missed any of their antibiotics and about one-fourth (26.7%) of the patients were not aware that they were prescribed antibiotics for their dental conditions. Antibiotic consumption behaviour showed significant association with educational status (p<0.001), occupation (p<0.010), residence (p<0.002), family income (p<0.001) and awareness about antibiotics (p<0.001). Conclusion: This study revealed improper antibiotic consumption behaviour among a large number of dental patients. Behaviour change communication measures focusing on both prescribers and dental patients is recommended to reduce inappropriate consumption of antibiotics and to promote rational usage. Bangladesh Medical Res Counc Bull 2023; 49(2): 91-97
背景:抗生素的消费量在全球范围内不断增加,在牙科领域,它正以惊人的速度与日俱增。抗生素的不合理使用不仅会导致抗生素耐药性的出现,还会产生各种不良反应,给卫生系统带来财政负担。目的:了解三级医院牙科患者的抗生素消费行为。方法:本横断面研究于2020年7月至2021年6月在达卡牙科学院医院对195名牙科患者进行。在获得知情书面同意后,采用预先测试的半结构化问卷和检查表进行面对面访谈。数据分析采用SPSS 26版本。采用Pearson卡方检验和似然比,以5%的显著性水平评估相关性。结果:本组患者的平均(±SD)年龄为41.11(±14.09)岁。患者以男性居多(52.8%)。超过一半(52.8%)的患者家庭月收入≤20000 BDT,以城市居民为主(72.8%)。患者抗生素消费行为平均(±SD)得分为10.96(±3.879)分,行为类别分别为良好行为(35.9%)、一般行为(32.8%)和不良行为(31.8%)。超过一半的患者(56.4%)有时会忘记或遗漏抗生素,约四分之一(26.7%)的患者不知道他们的牙齿状况开了抗生素。抗生素消费行为与受教育程度(p<0.001)、职业(p<0.010)、居住地(p<0.002)、家庭收入(p<0.001)和抗生素认知(p<0.001)显著相关。结论:本研究揭示了大量牙科患者的不当抗生素使用行为。建议采取以开处方者和牙科患者为重点的行为改变沟通措施,以减少抗生素的不当使用并促进合理使用。孟加拉国医疗资源理事会2023号文件;49 (2): 91 - 97
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引用次数: 0
Impact of Adipokines and Inflammatory Cytokines on Abnormal Glucose Tolerance in Young 脂肪因子和炎性细胞因子对年轻人异常糖耐量的影响
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.3329/bmrcb.v49i2.67909
Nusrat Sultana, Indira Roy, Mashfiqul Hasan, Amrit Rijal, M A Hasanat
Background: Adipokines and inflammatory cytokines may have an important impact on rising trend of obesity and abnormal glucose tolerance (AGT) in young across the globe. The aim of the study was to see serum adiponectin, leptin, resistin, tumor necrosis factor-alpha (TNF-α) and C-reactive protein (CRP) in young Bangladeshi with AGT. Methods: This case-control study included 40 young participants with AGT [age 26 years (IQR 24-29); 60.0% female] and 40 with normal glucose tolerance [NGT; age 25 years (IQR 22-28); 44.0% female] encompassed following the oral glucose tolerance test (OGTT) and HbA1c. Insulin resistance (IR) was calculated by homeostasis model assessment (HOMA). The measurement of serum adiponectin, leptin, resistin and TNF-α was done by ELISA whereas CRP by Chemiluminescent test. Results: Level of TNF-α, leptin, and adiponectin as well as frequency of raised resistin and CRP were statistically similar between AGT and NGT (p=NS for all). Positive correlation of TNF-α [body mass index (BMI) in AGT: r=0.354, p=0.025)], leptin [BMI in AGT r=0.760, p<0.001 and NGT 0.675, p<0.001; waist circumference (WC) in AGT: r=0.675, p<0.001 and NGT 0.493, p=0.001] and CRP (NGT group: BMI: 0.579, p<0.001; WC: 0.553, p<0.001) but negative correlation of adiponectin [waist-hip ratio (WHR) in NGT: r=-413, p=0.008] and resistin (WHR in AGT: r=-0.607, p=0.003) with measures of obesity were observed. No adipokines or inflammatory cytokines had any significant correlation to glycemic measures, except negative correlation in AGT with leptin (FPG: r=-0.405, p=0.010; 2hPG: r=-0.431, p=0.006; HbA1c: r=-0.399, p=0.011) and CRP (2hPG; r=-0.490, p=0.021). Fasting insulin or IR had a positive correlation with leptin (in AGT: insulin r=0.545, p<0.001 & IR r=0.337, p=0.034) and CRP (in NGT r=0.318, p=0.045 & r=0.323, p=0.042), negative correlation with adiponectin (in NGT insulin r=-0.350, p=0.027 & IR r=-0.352, p=0.026) and resistin (IR in NGT: r=-0.340, p=0.032) while no significant correlations with TNF-α. None of the cytokines or inflammatory markers were independent predictors of AGT in youth. Conclusions: The serum levels of cytokines do not differ significantly between AGT and NGT subgroups of young subjects and none of the cytokines was observed to be independent predictor over AGT in young. Bangladesh Medical Res Counc Bull 2023; 49(2): 126-133
背景:脂肪因子和炎症细胞因子可能对全球年轻人肥胖和异常糖耐量(AGT)上升趋势有重要影响。本研究的目的是观察孟加拉青年AGT患者血清脂联素、瘦素、抵抗素、肿瘤坏死因子-α (TNF-α)和c反应蛋白(CRP)的变化。方法:本病例对照研究纳入40例AGT年轻患者[年龄26岁(IQR 24-29);60.0%女性]和40例糖耐量正常[NGT;年龄25岁(IQR 22-28);包括口服糖耐量试验(OGTT)和糖化血红蛋白(HbA1c)。胰岛素抵抗(IR)通过稳态模型评估(HOMA)计算。ELISA法测定血清脂联素、瘦素、抵抗素、TNF-α,化学发光法测定CRP。结果:AGT组与NGT组血清TNF-α、瘦素、脂联素水平及抵抗素、CRP升高频率差异有统计学意义(p=NS)。TNF-α [AGT体重指数(BMI) r=0.354, p=0.025]、瘦素[AGT体重指数r=0.760, p= 0.001]与NGT 0.675, p=0.025;AGT组腰围(WC): r=0.675, p=0.001; NGT组腰围(WC): r= 0.493, p=0.001;WC: 0.553, p= 0.001),但脂联素[NGT腰臀比(WHR): r=-413, p=0.008]和抵抗素(AGT腰臀比:r=-0.607, p=0.003)与肥胖指标呈负相关。除AGT与瘦素呈负相关(FPG: r=-0.405, p=0.010)外,脂肪因子和炎症因子与血糖指标均无显著相关性;2hPG: r=-0.431, p=0.006;HbA1c: r=-0.399, p=0.011)和CRP (2hPG;r = -0.490, p = 0.021)。空腹胰岛素或IR与瘦素呈正相关(AGT:胰岛素r=0.545, p<0.001 &IR r=0.337, p=0.034)、CRP (NGT r=0.318, p=0.045;r=0.323, p=0.042),与脂联素呈负相关(NGT胰岛素r=-0.350, p=0.027 &IR r=-0.352, p=0.026)和抵抗素(NGT IR: r=-0.340, p=0.032),而与TNF-α无显著相关性。没有细胞因子或炎症标志物是青年AGT的独立预测因子。结论:血清细胞因子水平在年轻受试者的AGT和NGT亚组之间没有显著差异,并且没有观察到细胞因子是年轻受试者AGT的独立预测因子。孟加拉国医疗资源理事会2023号文件;49 (2): 126 - 133
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引用次数: 0
A Case Control Study on Prevalence, Sleep Disorder & Life Style of Children with Autism of Bangladesh 睡眠障碍患病率与睡眠障碍的病例对照研究孟加拉自闭症儿童的生活方式
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.3329/bmrcb.v49i2.67966
Md Fakhrul Alam, A S M Sarwar, Khandarker Sabit Bin Razzak, Sayadat Amin, Shamima Akter, Anika Bushra
Background: This research analyzes the sleeping conditions of children with autism spectrum disorder (ASD) and examines the relationship between common sleep disorders, core symptoms, and developmental phases. Objectives: To investigate the prevalence, sleep disorder & life style of children with autism of Bangladesh. Methods: This case-control study used qualitative and quantitative (Mix-Method) approaches. Sources were primary and secondary. The study conducted in 08 districts in Bangladesh such as Dhaka, Chittagong, Jassore, Mymensingh, Rajshahi, Rangpur, Barisal, Sylhet. This study included 400 school going children and the age group was within 3-12 years old and 200 children were from Autistic Spectrum Disorder and 200 children were from Traditionally Developed Children. Results: In case group among the 200 respondents who were the guardian of the children of ASD highest (74%) were mother followed by (24.50%) were father and only (1.50%) were other like brother or sister. In control group (TDC) highest (71%) respondents were mother followed by (16.50%) were father and only (12.50%) were from other like sister or brother. Highest (58.50%) ASD children were within the age of 9 to 12 years and 32.50% were 6 to 8 years old. Only 9% were from (3 to 5) years old. In control group highest (58%) TDC were within the age of 9 to 12 years and 29% were 6 to 8 years old. Only 13% were from (3 to 5) years old. Highest (67%) were male and (33%) were female on the other hand in control group (54%) were male and (46%) were female. In case group, highest (50.50%) were classical autism and highest (69.00%) were referred for test. According to children’s response to social response’s in case group rarely response was 35%, sometimes response was 27.5%, often response was 14.0%, maximum time response was 11.5%, always response was 12.0%. Chi-Square Tests results shows that both slip duration and taking pill among ASD children and TDC are significant which indicate there is certain association of ASD and sleep disorder. Conclusion: ASD Children have certain sleep disorder and challenging life style. Early detection by using effective diagnosis and test required for ASD. ASD children need special care with proper lifestyle management. This study observed that the ASD children have certain creativity especially in handicraft, art and cultural activities. Proper skill development training can improve their creativity. Therefore it is necessary to support them from all part of society. Bangladesh Medical Res Counc Bull 2023; 49(2): 134-142
背景:本研究分析自闭症谱系障碍(ASD)儿童的睡眠状况,探讨常见睡眠障碍、核心症状和发育阶段之间的关系。目的:了解青少年睡眠障碍的患病率及影响因素。孟加拉国自闭症儿童的生活方式方法:本病例对照研究采用定性和定量(混合方法)相结合的方法。资料来源分为第一手资料和第二手资料。该研究在孟加拉国的08个地区进行,如达卡、吉大港、雅索尔、迈门辛格、拉杰沙希、朗布尔、巴里萨尔、锡尔赫特。这项研究包括了400名学龄儿童年龄在3-12岁之间200名儿童来自自闭症谱系障碍200名儿童来自传统发育儿童。结果:在病例组中,200名ASD患儿的监护人中,母亲最多(74%),其次是父亲(24.50%),兄弟姐妹等其他监护人仅占1.50%。在对照组(TDC)中,母亲的比例最高(71%),其次是父亲(16.50%),其他如姐妹或兄弟的比例仅为12.50%。9 ~ 12岁儿童占58.50%,6 ~ 8岁儿童占32.50%。只有9%是3 - 5岁。对照组TDC以9 ~ 12岁最高(58%),6 ~ 8岁最高(29%)。只有13%是3 - 5岁。男性占67%,女性占33%,而对照组男性占54%,女性占46%。病例组中,典型自闭症发生率最高(50.50%),转诊检查发生率最高(69.00%)。从儿童对社会反应的反应来看,个案组很少反应为35%,有时反应为27.5%,经常反应为14.0%,最大时间反应为11.5%,总是反应为12.0%。卡方检验结果显示,ASD患儿的滑动持续时间、服药时间和TDC均显著,提示ASD与睡眠障碍存在一定关联。结论:ASD患儿存在一定的睡眠障碍,生活方式具有挑战性。通过有效的诊断和测试来早期发现ASD。ASD儿童需要特别照顾和适当的生活方式管理。本研究发现,ASD儿童具有一定的创造力,特别是在手工艺、艺术和文化活动方面。适当的技能发展培训可以提高他们的创造力。因此,有必要从社会各方面支持他们。孟加拉国医疗资源理事会2023号文件;49 (2): 134 - 142
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引用次数: 0
Status of Quality and Compliance to Inpatient Quality Indicators and Patient Safety Indicators in a Selected Private Corporate Hospital at Dhaka City Bangladesh 孟加拉国达卡市一家选定的私营企业医院的住院病人质量指标和病人安全指标的质量和遵守状况
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.3329/bmrcb.v49i2.65993
Abu Sayed Mohammad Giasuddin, Mohammad Shahjahan, Nuhad Raisa Seoty, Sayma Hossain
Background: The stutus of quality and compliance to inpatient quality indicators (IQIs) and patient safety indicators (PSIs) in corporate hospitals at dhaka city Bangladesh are not known as they are not adequately studied. Objective: The present descriptive cross-sectional study was therefor undertaken to know the status of quality and compliance to selected IQIs and PSIs in a selected private (corporate) hospital at Dhaka City Bangladesh. The period of study and hospital data collection period were May to August 2019 and January to March 2019 respectively. Methods: Selected IQIs and PSIs developed by Agency for Healthcare Research and Quality (AHRQ), USA and hospital facilities utilization parameters were investigated. Data were collected using questionnaires and checklists for the period of January to March 2019 from the purposively selected private (corporate) hospital. Sociodemographic information of randomly selected junior doctors and nurses were taken. Randomly selected senior clinicians, nurses and executives were interviewed regarding knowledge about selective IQIs, PSIs, JCIS, ISO relevant to quality healthcare. Data were analysed by SPSS programme version 20. Results: The hospital has all relevant admistrative and clinical departments, bed patterns and has efficient admission and discharge processes for inpatients. Bed utilization was 87.5% of total 159 available beds. Patients visited OPD: 2434 per day, admitted: 28 per day and discharged with successful outcome: 27 per day. Average length of stay (ALS), hospital acquired infection (HAI) and hospital deaths were 3.6 days, 1.76% (18/1000 cases), and 124 (01 per day) respectively during data collection period. Tests done in Laboratory Medicine were 267637 with Clinical Biochemistry tests highest (51.21%) and investigations in Radiology-Imaging departments were 74997 with X-rays being highest (40.22%). Of the five selected IQIs, total CABG cases done were 191 with 04 hospital deaths i.e. 2.1% (21 per 1000 cases) and total AMI cases done were 140 with 12 hospital deaths i.e. 8.5% (85 per 1000 cases). No casualties were reported for caesarean deliveries or primary/normal deliveries. None of the five selected PSIs were traced over the data collection period. Conclusion: These findings suggested that the selected hospital’s services were demanding and it was concerned about quality healthcare services. However, comparative studies with other private corporate hospotals at Dhaka City including larger number of respodents are warrented. Bangladesh Medical Res Counc Bull 2023; 49(2): 98-112
背景:孟加拉国达卡市企业医院的质量和住院病人质量指标(IQIs)和病人安全指标(psi)的遵守情况尚不清楚,因为它们没有得到充分的研究。目的:因此,进行了本描述性横断面研究,以了解孟加拉国达卡市一家选定的私立(公司)医院选定的IQIs和psi的质量状况和遵守情况。研究期和医院数据收集期分别为2019年5月至8月和2019年1月至3月。方法:选取美国卫生保健研究与质量局(AHRQ)制定的IQIs和psi及医院设施利用参数进行调查。采用问卷调查和清单收集2019年1月至3月期间的数据,这些数据来自有目的选择的私营(企业)医院。随机抽取初级医生和护士的社会人口学信息。随机选择高级临床医生、护士和管理人员进行访谈,了解与优质医疗保健相关的选择性IQIs、psi、JCIS和ISO的知识。数据分析采用SPSS软件第20版。结果:医院行政、临床科室齐全,床位布局合理,住院患者入院、出院流程高效。159张床位的使用率为87.5%。门诊就诊患者:每天2434例,入院患者:每天28例,出院患者:每天27例。数据收集期内平均住院时间(ALS)为3.6天,医院获得性感染(HAI)为1.76%(18/1000例),医院死亡人数为124人(01人/天)。检验医学检查267637例,临床生化检查最多(51.21%);放射影像学检查74997例,x线检查最多(40.22%)。在5个选定的IQIs中,完成的CABG病例总数为191例,医院死亡人数为04例,即2.1%(每1000例21例),完成的AMI病例总数为140例,医院死亡人数为12例,即8.5%(每1000例85例)。剖腹产或初产/正常分娩无伤亡报告。在数据收集期间,没有对五个选定的psi进行跟踪。结论:所选医院服务要求高,注重医疗服务质量。然而,与达卡市的其他私营企业医院进行比较研究,包括更多的受访者,是值得注意的。孟加拉国医疗资源理事会2023号文件;49 (2): 98 - 112
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引用次数: 0
Down’s Syndrome Presented with Transmission of Maternal Translocation of 2; 21 Chromosomes. A Case Report 唐氏综合征与母体2易位遗传的关系21号染色体。病例报告
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.3329/bmrcb.v49i2.62712
Mohammad Moniruzzaman, Pallab Kumar Das, Mhabuba Akter, Jasmin Nur, Zeenat Farzana Rahman, Md Sohrab Alam, Mansura Khan, M Sawkat Hasan
Background: Down's syndrome is a genetic condition marked by distinctive physical characteristics and some degree of cognitive impairment. Down's syndrome is mostly caused by trisomy of chromosome 21, while chromosome translocations are also frequent. Objective: To evaluate a rare 2;21 translocation in the proband's family that was associated with Down syndrome. Methods: Chromosomal analysis was carried out using the G-banding technique and traditional peripheral lymphocyte culture. Case: The proband was a 9 months baby boy of non-consanguineous parents. The doctors clinically diagnosed him as having Down's syndrome with all typical features. The proband was found to have trisomy 21 associated with a 2;21 translocation inherited from his mother because his mother has the same type of translocation without any phenotypic features. Maternal age at the time of the study was 35 years and first pregnancy ended in stillbirth at 26th weeks of gestation, the proband was the second issue. His maternal aunt and cousin brother both had the same type of translocation. In chromosomal analysis, the proband's father and uncle had normal genotypic distribution. The current example was a Down's syndrome case with one normal 21 no chromosome and one Reciprocal translocation t (2;21). Conclusion: The present case of Down’s syndrome occurs due to reciprocal translocation (2;21) probably has arisen by familial transmission. Once an imbalanced translocation in the fetus/child has been found, the prenatal cytogenetic analysis is critical for the next pregnancies. Bangladesh Medical Res Counc Bull 2023; 49(2): 143-147
背景:唐氏综合症是一种以明显的身体特征和一定程度的认知障碍为特征的遗传病。唐氏综合症主要由21号染色体三体引起,染色体易位也很常见。目的:探讨先证者家族中罕见的与唐氏综合征相关的2;21易位。方法:采用g带技术和传统的外周血淋巴细胞培养进行染色体分析。案例:先证者是一对非近亲父母的9个月大男婴。医生临床诊断他患有唐氏综合症,具有所有典型特征。先证者被发现患有21三体,并遗传自其母亲的2;21易位,因为其母亲具有相同类型的易位,但没有任何表型特征。研究时的母亲年龄为35岁,第一次怀孕在妊娠26周时以死产告终,先证者是第二个问题。他的姨妈和表兄都有相同类型的易位。在染色体分析中,先证者的父亲和叔叔基因型分布正常。当前的例子是一个唐氏综合症病例,一条正常21无染色体,一条反向易位t(2;21)。结论:本例唐氏综合征的发生是由于相互易位(2;21),可能是家族遗传所致。一旦发现胎儿/儿童的不平衡易位,产前细胞遗传学分析对下次怀孕至关重要。孟加拉国医疗资源理事会2023号文件;49 (2): 143 - 147
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引用次数: 0
Knowledge of Unani and Ayurveda Practitioners Regarding Pharmacovigilance 乌纳尼和阿育吠陀从业者关于药物警戒的知识
Q4 Medicine Pub Date : 2023-05-30 DOI: 10.3329/bmrcb.v48i3.62419
Zulia Sultana, Rafaat Choudhury, Hafiza Sultana, Aysha Haque, Mohammad Rashidul Alam, Md Golam Abbas
Background: Pharmacovigilance is concerned with public health and adverse drug reactions. The essence of pharmacovigilance is the reporting of adverse drug reactions (ADRs). All health care professionals should have knowledge about pharmacovigilance. Objective: To assess knowledge of unani and ayurveda practitioners regarding pharmacovigilance. Methods: A cross sectional study was conducted among 190 selected Unani and Ayurveda practitioners who graduated from Govt-Unani and Ayurvedic medical college. Purposive sampling method was applied for sampling. A semi-structured questionnaire was developed and the respondents were interviewed face to face maintaining confidentiality and privacy. Study places were Govt-Unani and Ayurvedic Medical College of Dhaka and Sylhet and Private medical chambers of Unani and Ayurveda practitioners. Results: This study revealed that out of 190 respondents 60% belonged to age group of 20-34 years and 3.7% were within the age group greater than 54 years and mean age were 34.55±7.42 years. 64.7% of the respondents were Unani practitioners and 35.3% were Ayurvedic practitioners. Regarding concept of pharmacovigilance, 22.6% of the respondents had good knowledge whereas 22.1% of the respondents had good knowledge about ADR and drug safety. Out of total 190 respondents 34.7% had good knowledge regarding pharmacovigilance, 35.8% of respondents had fair knowledge and 29.5% had poor knowledge regarding pharmacovigilance. Conclusion: This study revealed that majority of Unani and Ayurveda practitioners had fair knowledge regarding pharmacovigilance. Education and training programs are necessary to improve knowledge of Unani and Ayurveda practitioners. Bangladesh Medical Res Counc Bull 2022; 48(3): 219-224
背景:药物警戒涉及公共卫生和药物不良反应。药物警戒的本质是报告药物不良反应(adr)。所有卫生保健专业人员都应具备药物警戒知识。目的:评估乌纳尼和阿育吠陀从业者对药物警戒的认识。方法:采用横断面研究方法,选取190名毕业于政府乌纳尼和阿育吠陀医学院的乌纳尼和阿育吠陀医生。采用目的抽样法进行抽样。制定了半结构化问卷,并对受访者进行面对面访谈,以保证保密和隐私。学习地点是达卡和锡尔赫特的乌纳尼政府和阿育吠陀医学院,以及乌纳尼和阿育吠陀医生的私人医疗室。结果:190名调查对象中,年龄在20 ~ 34岁的占60%,年龄大于54岁的占3.7%,平均年龄34.55±7.42岁。64.7%的受访者为乌纳尼从业者,35.3%的受访者为阿育吠陀从业者。在药物警戒概念方面,22.6%的受访者了解,22.1%的受访者了解药品不良反应和药品安全。190名受访者中,34.7%的人对药物警戒有良好的了解,35.8%的人对药物警戒有一般的了解,29.5%的人对药物警戒有较差的了解。结论:本研究表明,大多数乌拉尼和阿育吠陀从业者对药物警戒有一定的了解。教育和培训计划对于提高乌纳尼和阿育吠陀从业者的知识是必要的。孟加拉国医疗援助理事会2022年公报;48 (3): 219 - 224
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引用次数: 0
Emergence of fosfomycin resistance among isolates of multidrug-resistant Enterobacter species at a tertiary care hospital in Dhaka, Bangladesh 在孟加拉国达卡的一家三级保健医院,多重耐药肠杆菌分离株中出现了磷霉素耐药性
Q4 Medicine Pub Date : 2023-05-30 DOI: 10.3329/bmrcb.v48i3.63812
Nazmun Nahar Munny, SM Shamsuzzaman, Tamzeed Hossain
Background: The emergence of multidrug-resistant Enterobacter species as a worrying resistant pathogen seriously threatened human health. The rising rate of resistance to commonly used antibiotics limit the choice hence it is urgent to evaluate the antimicrobial activity of older drug like Fosfomycin. Objective: The study aimed to seek the frequency of fosfomycin resistance in the clinical isolates of Enterobacter species and to detect the fosfomycin resistance gene along with antibiotic resistance pattern. Methods: This cross-sectional study was conducted in the Department of Microbiology of a tertiary care hospital in Bangladesh from July 2018 to June 2019. Enterobacter spp. was isolated from a total of 350 samples by a standard microbiological method. Antibiotic susceptibility was performed by the disk diffusion technique. Antibiotic susceptibility and minimum inhibitory concentration (MIC) of fosfomycin were determined by the agar dilution method. Fosfomycin resistance gene fosA, fosA3, fosA4, fosA5, fosB, fosB2, fosC, fosC2 and fosX among fosfomycin‑resistant Enterobacter spp detected by polymerase chain reaction (PCR) using specific primer. Sequencing of fosA and fosA₅ was performed by capillary method, and the nucleotide sequence of fosA₅ has been deposited to GenBank. Results: Out of 28 Enterobacter spp. 7 (25%) fosfomycin resistant Enterobacter spp. were detected by agar dilution method. Out of 7 fosfomycin-resistant strains, 4 (57.14%) were isolated from urine samples. Fifteen (53.57%) isolates of Enterobacter spp. were multidrug-resistant detected by disc diffusion technique. All of the fosfomycin-resistant isolates were MDR. A significant rise in the MIC was found between 256µg/ml- ≥4096 µg/ml to fosfomycin. PCR revealed that 100% of fosfomycin resistant isolates are positive for fosA, 71.43% and 28.57% were positive for fosA₅ and fosB₂ respectively. Sequencing of fosA₅ gene established the FosA family fosfomycin resistance glutathione transferase gene. Conclusion: The results of this study showed a high proportion of fosfomycin resistance among multidrug-resistant Enterobacter spp. irrespective of fosfomycin usage in Bangladesh. FosA family fosfomycin resistance glutathione transferase gene emerging in Bangladesh. Bangladesh Medical Res Counc Bull 2022; 48(3): 203-210
背景:多重耐药肠杆菌的出现是一种令人担忧的耐药病原菌,严重威胁着人类健康。常用抗生素的耐药率不断上升,限制了人们的选择,因此迫切需要对磷霉素等老药的抗菌活性进行评估。目的:了解临床分离的肠杆菌对磷霉素的耐药频率,并检测其耐药基因及耐药模式。方法:本横断面研究于2018年7月至2019年6月在孟加拉国一家三级医院微生物科进行。采用标准微生物学方法从350份样品中分离出肠杆菌。采用纸片扩散法进行药敏试验。采用琼脂稀释法测定磷霉素的药敏和最低抑菌浓度。采用特异性引物聚合酶链反应(PCR)检测耐磷肠杆菌中磷霉素耐药基因fosA、fosA3、fosA4、fosA5、fosB、fosB2、fosC、fosC2和fox。通过毛细管法对fosA和fosA₅进行测序,并且fosA₅的核苷酸序列已存入GenBank。结果:28株肠杆菌中,琼脂稀释法检出耐磷霉素肠杆菌7株(25%)。7株磷霉素耐药菌株中,4株(57.14%)从尿液中分离得到。圆盘扩散法检出15株肠杆菌(53.57%)多重耐药。所有耐磷菌素菌株均为耐多药。磷霉素的MIC在256µg/ml-≥4096µg/ml之间显著升高。PCR结果显示,100%的磷霉素耐药菌株对fosA呈阳性,71.43%和28.57%的菌株对fosA₅和fosB₂呈阳性。fosA₅基因测序建立了fosA家族磷霉素抗性谷胱甘肽转移酶基因。结论:本研究结果显示,在孟加拉国,无论磷霉素的使用情况如何,耐多药肠杆菌中磷霉素耐药的比例都很高。孟加拉国出现的FosA家族磷霉素耐药谷胱甘肽转移酶基因。孟加拉国医疗援助理事会2022年公报;48 (3): 203 - 210
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引用次数: 0
Health Literacy Status and Preventive Behavioral Perception of Dental Patients Regarding COVID-19 Pandemic in Selected Tertiary Hospitals of Bangladesh 孟加拉国部分三级医院牙科患者健康素养状况及对COVID-19大流行的预防行为认知
Q4 Medicine Pub Date : 2023-05-30 DOI: 10.3329/bmrcb.v48i3.62675
Towhida Ahsan, Md Golam Abbas, Md Salim Uddin, Aysha Hauqe, Mohammad Rashidul Alam, Hafiza Sultana, Rafaat Choudhury
Background: COVID-19 has declared a public health emergency as a global crisis. In this situation dental patients are at high risk because of direct person to person transmission. Dental treatment requires very close contact elsewhere there are some other factors such as waiting room, ventilation system of hospital, gathering and so on which make the condition more critical. Objectives: The purpose of this study was to assess the health literacy status and preventive behavioral perception of dental patients regarding the COVID-19. Methods: Data were collected from total 342 respondents by self-administered semi-structured questionnaire and face to face interview was conducted. Systematic random sampling was done in Dhaka Dental College Hospital and Chattogram International Dental College Hospital during data collection. Informed written consent was taken from each participants. Frequencies, percentages, charts, and diagrams were used to present the analysis, which was carried out using SPSS. Results: In this study, majority of dental patients were within 25-34 years age. Mean (±SD) age was 36(±13.32) years. Maximum patients (85.1%) had more accurate health literacy related perception regarding COVID-19 and there were significant association between educational status, occupational status of the dental patients and their health literacy status (p <0.05) regarding COVID-19. More than 80% patients were aware about preventive aspects of COVID-19 and had good preventive behavior related perception but they expressed that it was not possible to maintain every precautionary behavior in reality. About 53.8% agreed staying at home would play a significant role in preventing COVID-19 but a big portion disagreed with this. Approximately 15% disagreed with the issue that keeping a physical distance in public places and avoiding social events reduces the spread of novel corona viruses. Conclusion: In this study a significant portion of good health literacy related and preventive behavioral perception of dental patients regarding COVID-19 was recorded. However a comprehensive awareness-raising program should be continued to hold this optimistic perception and inspire them to practice this perception in reality. Bangladesh Medical Res Counc Bull 2022; 48(3): 236-243
背景:COVID-19已宣布为全球危机的突发公共卫生事件。在这种情况下,由于人与人之间的直接传播,牙科患者的风险很高。牙科治疗需要在其他地方进行非常密切的接触,还有一些其他因素,如候诊室,医院的通风系统,聚集等,使情况更加危急。目的:了解牙科患者对新型冠状病毒肺炎的健康素养状况和预防行为认知。方法:采用自填式半结构式问卷和面对面访谈法对342名调查对象进行资料收集。在数据收集过程中,在达卡牙科学院医院和Chattogram国际牙科学院医院进行系统随机抽样。每位参与者都获得了知情的书面同意。频率,百分比,图表和图表被用来呈现分析,这是使用SPSS进行的。结果:本组牙科患者以25 ~ 34岁年龄段居多。平均(±SD)年龄为36(±13.32)岁。最多患者(85.1%)对COVID-19健康素养相关感知更为准确,牙科患者的教育程度、职业状况与其COVID-19健康素养相关感知存在显著相关性(p <0.05)。超过80%的患者对COVID-19的预防方面有所了解,并有良好的预防行为相关认知,但他们表示不可能在现实中保持每一种预防行为。约53.8%的人认为呆在家里会对预防COVID-19发挥重要作用,但很大一部分人不同意这一点。约15%的人不同意在公共场所保持身体距离和避免社交活动可以减少新型冠状病毒的传播。结论:本研究记录了相当一部分牙科患者对COVID-19的良好健康素养和预防行为认知。然而,应该继续开展一个全面的意识提升计划,以保持这种乐观的看法,并激励他们在现实中实践这种看法。孟加拉国医疗援助理事会2022年公报;48 (3): 236 - 243
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引用次数: 0
期刊
Bangladesh Medical Research Council Bulletin
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