Pub Date : 2023-05-30DOI: 10.3329/bmrcb.v48i3.62430
S M Yasir Arafat, Mohammad Muntasir Maruf, Md Faruk Hossain
Background: Literacy and stigma of suicide have been poorly assessed across the groups in Bangladesh even though they affect help-seeking behavior and have an enduring effect on suicide prevention. Objectives: We aimed to determine the status of literacy and stigma of suicide along with associated factors among medical students of Bangladesh. Methods: This study was conducted from January to June 2022 among 172 undergraduate medical students in Bangladesh by Google form. Literacy and stigma were assessed by the Bangla literacy of suicide scale (LOSS[1]B), and the Bangla stigma of suicide scale (SOSS-B). Results: The mean age of the participants was 22.81 ± 1.8 (range 19-28) years, 64% were females, and 95% were unmarried. The LOSS-B score ranged from 0-10 with a mean of 4.72 ± 1.97. The literacy was significantly higher in married students, students with chronic physical illness and psychiatric disorder, lifetime suicidal thoughts, and suicidal thoughts in the past year while stigma was significantly lower among females, with mental disorders, with a family history of suicide attempts, and students with suicidal thoughts in a lifetime and past year. Conclusions: The study determines the level of suicide literacy and stigma towards suicide among medical students of Bangladesh. Having history of previous mental health services consumption of mental health services and past suicidal behavior revealed a better level that indicates the effectiveness of mass media campaigns for raising awareness and reducing stigma. Bangladesh Medical Res Counc Bull 2022; 48(3): 225-230
{"title":"Literacy and Stigma of Suicide among Medical Students of Bangladesh: Status and Associated Factors","authors":"S M Yasir Arafat, Mohammad Muntasir Maruf, Md Faruk Hossain","doi":"10.3329/bmrcb.v48i3.62430","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.62430","url":null,"abstract":"Background: Literacy and stigma of suicide have been poorly assessed across the groups in Bangladesh even though they affect help-seeking behavior and have an enduring effect on suicide prevention. Objectives: We aimed to determine the status of literacy and stigma of suicide along with associated factors among medical students of Bangladesh. Methods: This study was conducted from January to June 2022 among 172 undergraduate medical students in Bangladesh by Google form. Literacy and stigma were assessed by the Bangla literacy of suicide scale (LOSS[1]B), and the Bangla stigma of suicide scale (SOSS-B). Results: The mean age of the participants was 22.81 ± 1.8 (range 19-28) years, 64% were females, and 95% were unmarried. The LOSS-B score ranged from 0-10 with a mean of 4.72 ± 1.97. The literacy was significantly higher in married students, students with chronic physical illness and psychiatric disorder, lifetime suicidal thoughts, and suicidal thoughts in the past year while stigma was significantly lower among females, with mental disorders, with a family history of suicide attempts, and students with suicidal thoughts in a lifetime and past year. Conclusions: The study determines the level of suicide literacy and stigma towards suicide among medical students of Bangladesh. Having history of previous mental health services consumption of mental health services and past suicidal behavior revealed a better level that indicates the effectiveness of mass media campaigns for raising awareness and reducing stigma. Bangladesh Medical Res Counc Bull 2022; 48(3): 225-230","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135479095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.3329/bmrcb.v48i3.65201
Md Ruhul Amin, Sharfuddin Ahmed, Shah Monir Hossain, Anisur Rahman
Endocrine disruptors are the substances or environmental factors which causes destruction of different endocrine glands.1 Endocrine-disrupting chemicals contribute to several disease and dysfunction, and incur high associated costs of more than 1% of the GDP of European Union.2 As the endocrine glands are formed by soft, delicate and vulnerable cells, they are prone to the easy destructions by different types of noxious substance like dioxin in meat, flame retardants in furniture, electronics and multipurpose use plastics; frequently used pesticides in food water and soil. Bangladesh Medical Res Counc Bull 2022; 48(3): 172-173
{"title":"Endocrine Disruptors: A Silent Kill","authors":"Md Ruhul Amin, Sharfuddin Ahmed, Shah Monir Hossain, Anisur Rahman","doi":"10.3329/bmrcb.v48i3.65201","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.65201","url":null,"abstract":"Endocrine disruptors are the substances or environmental factors which causes destruction of different endocrine glands.1 Endocrine-disrupting chemicals contribute to several disease and dysfunction, and incur high associated costs of more than 1% of the GDP of European Union.2 As the endocrine glands are formed by soft, delicate and vulnerable cells, they are prone to the easy destructions by different types of noxious substance like dioxin in meat, flame retardants in furniture, electronics and multipurpose use plastics; frequently used pesticides in food water and soil. Bangladesh Medical Res Counc Bull 2022; 48(3): 172-173","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135643092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.3329/bmrcb.v48i3.63809
Nazneen Naher Islam, Shuvo Chandra Das, Mohabbat Hossain, Sabrina Alam Seuti, Razia Sultana, Mahmood Ahmed Chowdhury
Background: Thalassemia is an inherited blood disorder that affects hemoglobin’s structure and functions. Among several forms of this life-threatening disorder, HbE/β and β-thalassemia are most common in Bangladesh and worldwide as well. But the molecular and clinical data are not adequate regarding the underlying cause of this genetic disorder in Bangladesh. So, we aimed to identify the genetic mutations within β-globin gene (HBB) and to investigate the correlation of the mutations with HBB mRNA structure, gene transcription and hematological status among the patients with blood transfusion dependent HbE/β and β-thalassemia in Bangladesh. Methods: A total of 40 blood samples were collected from the patients with blood transfusion dependent HbE/β and β-thalassemia prior to taking their consent. Detection of mutations within HBB gene was carried out by polymerase chain reaction followed by Sanger DNA sequencing method. Identification and characterization of mutations along with their effects on HBB gene were analyzed by various bioinformatics approaches. In addition, complete blood count (CBC), and hemoglobin electrophoresis were done for hematological analysis. Results: c.92+5G>C, c.79G>A and c.9T>C genetic mutations were identified within the HBB gene, where c.92+5G>C was the most common mutation among the study patients. Mutations along with hematological status and putative transcription factor binding sites revealed that the severity of the disease depends upon the mutation type and its location in the HBB gene sequence. In addition, mRNA structure analysis showed that the identified mutations contribute to its structural diversity by altering folding mechanism that ultimately affects the stability and function of the HBB protein among the patients with blood transfusion dependent HbE/β and β-thalassemia. Conclusions: The study showed the underlying cause of HbE/β and β-thalassemia in genetic level by identifying rare and common mutations within HBB gene and their effects on with HBB gene transcription and mRNA structure. We hope study will contribute in designing effective molecular medicine and other therapeutics for the patients with HbE/β and β-thalassemia to improve their health condition. Bangladesh Medical Res Counc Bull 2022; 48(3): 180-188
{"title":"Identification and Integrative Bioinformatics Analysis of Common and Rare Mutations in the Patients with Transfusion Dependent HbE/b and b-thalassemia in Chittagong, Bangladesh","authors":"Nazneen Naher Islam, Shuvo Chandra Das, Mohabbat Hossain, Sabrina Alam Seuti, Razia Sultana, Mahmood Ahmed Chowdhury","doi":"10.3329/bmrcb.v48i3.63809","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.63809","url":null,"abstract":"Background: Thalassemia is an inherited blood disorder that affects hemoglobin’s structure and functions. Among several forms of this life-threatening disorder, HbE/β and β-thalassemia are most common in Bangladesh and worldwide as well. But the molecular and clinical data are not adequate regarding the underlying cause of this genetic disorder in Bangladesh. So, we aimed to identify the genetic mutations within β-globin gene (HBB) and to investigate the correlation of the mutations with HBB mRNA structure, gene transcription and hematological status among the patients with blood transfusion dependent HbE/β and β-thalassemia in Bangladesh. Methods: A total of 40 blood samples were collected from the patients with blood transfusion dependent HbE/β and β-thalassemia prior to taking their consent. Detection of mutations within HBB gene was carried out by polymerase chain reaction followed by Sanger DNA sequencing method. Identification and characterization of mutations along with their effects on HBB gene were analyzed by various bioinformatics approaches. In addition, complete blood count (CBC), and hemoglobin electrophoresis were done for hematological analysis. Results: c.92+5G>C, c.79G>A and c.9T>C genetic mutations were identified within the HBB gene, where c.92+5G>C was the most common mutation among the study patients. Mutations along with hematological status and putative transcription factor binding sites revealed that the severity of the disease depends upon the mutation type and its location in the HBB gene sequence. In addition, mRNA structure analysis showed that the identified mutations contribute to its structural diversity by altering folding mechanism that ultimately affects the stability and function of the HBB protein among the patients with blood transfusion dependent HbE/β and β-thalassemia. Conclusions: The study showed the underlying cause of HbE/β and β-thalassemia in genetic level by identifying rare and common mutations within HBB gene and their effects on with HBB gene transcription and mRNA structure. We hope study will contribute in designing effective molecular medicine and other therapeutics for the patients with HbE/β and β-thalassemia to improve their health condition. Bangladesh Medical Res Counc Bull 2022; 48(3): 180-188","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135643319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.3329/bmrcb.v48i3.63808
Maftahul Jannat, MA Hannan, Sheikh Mahbub Alam
Background: Guillain Barre Syndrome (GBS) is an acute post infectious immune mediated peripheral neuropathy with a marked variation in pathology, clinical presentation and prognosis. Autonomic dysfunction is one of the important manifestations of GBS which may lead to significant morbidity and mortality. Objective: The aim of the study is to assess the autonomic involvement, to determine its frequency and pattern of involvement in adult patients with GBS Methods: An observational, descriptive, cross sectional study was carried out in the Department of Neurology, BSMMU, Dhaka from March, 2015 to September, 2017. Total 43 patients of GBS and 35 apparently healthy controls were recruited as the study population. On the basis of nerve conduction study patients were classified into different groups: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN) and other variants. Disability status at the time of autonomic testing was measured by Hughes functional grading scale. The following tests of autonomic nervous system were performed in both patients and controls 1) resting heart rate and heart rate on changing posture (30: 15 ratio) 2) supine blood pressure and blood pressure on changing posture 3) heart rate response to valsalva maneuver 4) heart rate response to deep breathing and E: I ratio 5) sphincter disturbance by symptoms questionnaire. Results: The mean age of patients was 35±12 years (range18 to 65 years) and 58.1% were male. Around 88.4 % of patients showed some sort of autonomic dysfunction. Variation of heart rate by different maneuver like posture change, deep breathing and valsalva maneuver was found commonly. Among them 30:15 ratio was abnormal in majority of the patients (82.4%) followed by abnormal max-min HR/min (58.1%) and abnormal valsalva ratio (37.2%). Other abnormalities were postural hypotension (38.2%), sinus tachycardia (25.6%), hypertension (16.3%), hypotension (2.7%), sinus arrhythmia (4.7%), constipation (30%), urinary retention (7%) and urinary incontinence (4.7%). Conclusion: In this study different patterns of autonomic dysfunction was found in 88.4% of patients with GBS involving both sympathetic and parasympathetic components. The present study found no significant association between autonomic dysfunction and motor disability scores. Thus autonomic function assessment is essential in every patient with GBS in addition to motor & sensory function. Bangladesh Medical Res Counc Bull 2022; 48(3): 174-179
{"title":"Pattern of Autonomic Involvement in Adult Patients with Guillain Barre Syndrome in a Tertiary Hospital","authors":"Maftahul Jannat, MA Hannan, Sheikh Mahbub Alam","doi":"10.3329/bmrcb.v48i3.63808","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.63808","url":null,"abstract":"Background: Guillain Barre Syndrome (GBS) is an acute post infectious immune mediated peripheral neuropathy with a marked variation in pathology, clinical presentation and prognosis. Autonomic dysfunction is one of the important manifestations of GBS which may lead to significant morbidity and mortality. Objective: The aim of the study is to assess the autonomic involvement, to determine its frequency and pattern of involvement in adult patients with GBS Methods: An observational, descriptive, cross sectional study was carried out in the Department of Neurology, BSMMU, Dhaka from March, 2015 to September, 2017. Total 43 patients of GBS and 35 apparently healthy controls were recruited as the study population. On the basis of nerve conduction study patients were classified into different groups: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN) and other variants. Disability status at the time of autonomic testing was measured by Hughes functional grading scale. The following tests of autonomic nervous system were performed in both patients and controls 1) resting heart rate and heart rate on changing posture (30: 15 ratio) 2) supine blood pressure and blood pressure on changing posture 3) heart rate response to valsalva maneuver 4) heart rate response to deep breathing and E: I ratio 5) sphincter disturbance by symptoms questionnaire. Results: The mean age of patients was 35±12 years (range18 to 65 years) and 58.1% were male. Around 88.4 % of patients showed some sort of autonomic dysfunction. Variation of heart rate by different maneuver like posture change, deep breathing and valsalva maneuver was found commonly. Among them 30:15 ratio was abnormal in majority of the patients (82.4%) followed by abnormal max-min HR/min (58.1%) and abnormal valsalva ratio (37.2%). Other abnormalities were postural hypotension (38.2%), sinus tachycardia (25.6%), hypertension (16.3%), hypotension (2.7%), sinus arrhythmia (4.7%), constipation (30%), urinary retention (7%) and urinary incontinence (4.7%). Conclusion: In this study different patterns of autonomic dysfunction was found in 88.4% of patients with GBS involving both sympathetic and parasympathetic components. The present study found no significant association between autonomic dysfunction and motor disability scores. Thus autonomic function assessment is essential in every patient with GBS in addition to motor & sensory function. Bangladesh Medical Res Counc Bull 2022; 48(3): 174-179","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135691283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.3329/bmrcb.v48i3.62672
Md Abidur Reza Chowdhury, Amal Kumar Choudhury, Zillur Rahman, Abdul Momen
Background: Systemic embolism is one of the most common complications of mitral stenosis (MS). Systemic embolism in patients with MS is caused by left atrial (LA) thrombus. Trans Esophageal Echocardiography (TEE) is considered the most reliable in ruling out LA thrombus, however, it is semi-invasive, operator-dependent, and not widely available. On the other hand, D-dimer is an indirect marker of fibrin formation. It reflects the activation of coagulation system. Objective: To measure D-dimer levels in patients with and without LA thrombus and find out predictive value of D-dimer levels to detect LA thrombus. Methods: In this cross-sectional observational study 50 patients with rheumatic severe mitral stenosis have been assessed. Patients underwent Trans Thoracic Echocardiography (TTE) and TEE to rule out LA thrombus. If TTE showed LA thrombus, TEE was not done. Patients were divided into two groups based on presence of LA thrombus; group I- patients with LA thrombus, and group II- patients without LA thrombus. D-dimer level was measured in two groups and comparison was done. Results: D-dimer was significantly elevated in group I compared to group II (2.8±1.9 µg/ml vs. 0.43±0.13µg/ml, p<0.001). Receiver Operator Characteristic (ROC) Curve showed D-dimer level > 0.6 µg/ml can predict LA thrombus with sensitivity of 84% & specificity of 88%. Conclusion: A higher level of D-dimer can predict LA thrombus in patients with rheumatic severe MS, and can be used as a noninvasive marker to rule out LA thrombus in patients with rheumatic severe MS. Bangladesh Medical Res Counc Bull 2022; 48(3): 231-235
{"title":"Predictive Value of D-dimer Levels for Detection of Left Atrial Thrombus in Patients with Rheumatic Severe Mitral Stenosis","authors":"Md Abidur Reza Chowdhury, Amal Kumar Choudhury, Zillur Rahman, Abdul Momen","doi":"10.3329/bmrcb.v48i3.62672","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.62672","url":null,"abstract":"Background: Systemic embolism is one of the most common complications of mitral stenosis (MS). Systemic embolism in patients with MS is caused by left atrial (LA) thrombus. Trans Esophageal Echocardiography (TEE) is considered the most reliable in ruling out LA thrombus, however, it is semi-invasive, operator-dependent, and not widely available. On the other hand, D-dimer is an indirect marker of fibrin formation. It reflects the activation of coagulation system. Objective: To measure D-dimer levels in patients with and without LA thrombus and find out predictive value of D-dimer levels to detect LA thrombus. Methods: In this cross-sectional observational study 50 patients with rheumatic severe mitral stenosis have been assessed. Patients underwent Trans Thoracic Echocardiography (TTE) and TEE to rule out LA thrombus. If TTE showed LA thrombus, TEE was not done. Patients were divided into two groups based on presence of LA thrombus; group I- patients with LA thrombus, and group II- patients without LA thrombus. D-dimer level was measured in two groups and comparison was done. Results: D-dimer was significantly elevated in group I compared to group II (2.8±1.9 µg/ml vs. 0.43±0.13µg/ml, p<0.001). Receiver Operator Characteristic (ROC) Curve showed D-dimer level > 0.6 µg/ml can predict LA thrombus with sensitivity of 84% & specificity of 88%. Conclusion: A higher level of D-dimer can predict LA thrombus in patients with rheumatic severe MS, and can be used as a noninvasive marker to rule out LA thrombus in patients with rheumatic severe MS. Bangladesh Medical Res Counc Bull 2022; 48(3): 231-235","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135692974","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}
Distorted terminal portion of QRS complex on initial electrocardiogram in ST segment elevation myocardial infarction is a strong predictor of in hospital adverse outcome This observational prospective study was carried out in the department of cardiology, BSMMU, Dhaka from July 2014 to June 2015 to analyse admission ECG in patients of STEMI based on terminal portion of QRS complex and find out inhospital death, heart failure, cardiogenic shock and recurrent myocardial infarction, with GRACE scoring assessment. Total 60 patients with STEMI (age 54.33±10.37, 55M/5/F) were included in this study after analysing the selection criteria. We defined two ECG groups according to absence of distortion of terminal QRS (Group-I) and presence of distorted terminal QRS (Group-II) in two or more adjacent leads. Group-II further divided into pattern-A – J point originating at ³50% of height of R wave in leads with qR configuration and pattern B- S wave is absent in leads with RS configuration. Global Registry of Acute Coronary Events (GRACE) risk score was evaluated and compared in between two groups. Out of 60 patients of STEMI, 30 patients had distortion of QRS complex. There were 7 deaths, 16 heart failure, 3 cardigenic shock and no recurrent myocardial infarction. Hospital mortality and heart failure were found to be significantly higher in distorted QRS group (1 vs. 6 patients p=0.04; 4 vs. 12 patients p=0.02; respectively), cardiogenic shock of both groups did not show significant difference (0 vs. 3 patients p=0.075). Multiple logistic regression analysis using hospital mortality as dependable variable and all studied risk factors were independent variables, QRS distortion on admission ECG and Killip class were only variable found to be statistically significant (OR=7.25, p value < 0.05 ; OR=16.25, p value< 0.05 respectively). GRACE risk score was significantly high in distorted QRS group and low in without QRS distorted group (6 vs 15 patients p=0.014; 6 vs 16 patients p=0.007; respectively). Intermediate GRACE score did not show any statistically significant difference between two groups (p=0.77). Careful analysis of ECG which is simple, cheap, universally available bed side investigation may offer important prognostic information in patients with STEMI and would help in deciding which patients should go urgent myocardial revascularization procedure. Assessment of GRACE risk scoring is strongly encourage in everyday clinical practice as it provides reliable identification of STEMI patients who are at high risk of death. Bangladesh Medical Res Counc Bull 2022; 48(3): 211-218
ST段抬高型心肌梗死初始心电图QRS复合物末端扭曲部分是院内不良结局的有力预测因子。本研究于2014年7月至2015年6月在达卡BSMMU心内科开展观察性前瞻性研究，基于QRS复合物末端部分分析STEMI患者入院心电图，了解院内死亡、心力衰竭、心源性休克和复发性心肌梗死。使用GRACE评分评估。经筛选标准分析，共纳入60例STEMI患者(年龄54.33±10.37,55M/5/F)。我们根据两个或多个相邻导联中没有终端QRS失真(i组)和存在终端QRS失真(ii组)来定义两个ECG组。第二组进一步分为a - J型点，起源于qR型引线中R波高度的³50%，RS型引线中没有B- S型波。评估并比较两组急性冠状动脉事件全球登记(GRACE)风险评分。60例STEMI患者中，30例出现QRS复合物畸变。死亡7例，心力衰竭16例，心源性休克3例，无心肌梗死复发。扭曲QRS组的住院死亡率和心力衰竭显著高于对照组(1例vs. 6例p=0.04;4 vs. 12例p=0.02;(分别)，两组心源性休克发生率无显著差异(0 vs. 3例p=0.075)。以住院死亡率为可靠变量，所有危险因素均为自变量进行多元logistic回归分析，入院心电图QRS失真和Killip分级是唯一具有统计学意义的变量(OR=7.25, p值<0.05;OR=16.25, p value<0.05分别)。QRS扭曲组GRACE风险评分显著高，无QRS扭曲组GRACE风险评分显著低(6 vs 15例p=0.014;6 vs 16例p=0.007;分别)。两组间GRACE中期评分差异无统计学意义(p=0.77)。仔细分析心电图是一种简单、廉价、普遍可用的床边检查，可以为STEMI患者提供重要的预后信息，并有助于决定哪些患者应该进行紧急心肌血运重建术。在日常临床实践中强烈鼓励GRACE风险评分评估，因为它为STEMI患者提供了高死亡风险的可靠识别。孟加拉国医疗援助理事会2022年公报;48 (3): 211 - 218
{"title":"Comparison of in hospital outcome of patients with and without distorted terminal portion of QRS complex on initial electrocardiogram in ST segment elevation myocardial infarction with GRACE scoring assessment","authors":"Khandaker Aisha Siddika, Dipal Krishna Adhikary, Tanjima Parvin, Shamaim Ahsan, Md Ashraf Uddin Sultan","doi":"10.3329/bmrcb.v48i3.62908","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.62908","url":null,"abstract":"Distorted terminal portion of QRS complex on initial electrocardiogram in ST segment elevation myocardial infarction is a strong predictor of in hospital adverse outcome This observational prospective study was carried out in the department of cardiology, BSMMU, Dhaka from July 2014 to June 2015 to analyse admission ECG in patients of STEMI based on terminal portion of QRS complex and find out inhospital death, heart failure, cardiogenic shock and recurrent myocardial infarction, with GRACE scoring assessment. Total 60 patients with STEMI (age 54.33±10.37, 55M/5/F) were included in this study after analysing the selection criteria. We defined two ECG groups according to absence of distortion of terminal QRS (Group-I) and presence of distorted terminal QRS (Group-II) in two or more adjacent leads. Group-II further divided into pattern-A – J point originating at ³50% of height of R wave in leads with qR configuration and pattern B- S wave is absent in leads with RS configuration. Global Registry of Acute Coronary Events (GRACE) risk score was evaluated and compared in between two groups. Out of 60 patients of STEMI, 30 patients had distortion of QRS complex. There were 7 deaths, 16 heart failure, 3 cardigenic shock and no recurrent myocardial infarction. Hospital mortality and heart failure were found to be significantly higher in distorted QRS group (1 vs. 6 patients p=0.04; 4 vs. 12 patients p=0.02; respectively), cardiogenic shock of both groups did not show significant difference (0 vs. 3 patients p=0.075). Multiple logistic regression analysis using hospital mortality as dependable variable and all studied risk factors were independent variables, QRS distortion on admission ECG and Killip class were only variable found to be statistically significant (OR=7.25, p value < 0.05 ; OR=16.25, p value< 0.05 respectively). GRACE risk score was significantly high in distorted QRS group and low in without QRS distorted group (6 vs 15 patients p=0.014; 6 vs 16 patients p=0.007; respectively). Intermediate GRACE score did not show any statistically significant difference between two groups (p=0.77). Careful analysis of ECG which is simple, cheap, universally available bed side investigation may offer important prognostic information in patients with STEMI and would help in deciding which patients should go urgent myocardial revascularization procedure. Assessment of GRACE risk scoring is strongly encourage in everyday clinical practice as it provides reliable identification of STEMI patients who are at high risk of death. Bangladesh Medical Res Counc Bull 2022; 48(3): 211-218","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135643070","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: Co-existence of a hydatidiform mole with a normal fetus is extremely rare and is considered as a high risk pregnancy. Methods: It was an observational study conducted during July 2020 to march 2021 Case report: A 23 year old primigravida, referred with a diagnosis of 27 weeks pregnancy with gestational choriocarcinoma. She was booked patient. USG report at 9 weeks with a single gestational sac and single fetal pole. Her complains were lower abdominal pain and brownish vaginal discharge. Thoroughly evaluated the patient to exclude distal metastasis. Serum Beta HCG was 3,23,280 IU/L. USG and fetal MRI report were single graved fetus, no anomaly detected and a large hyper echogenic soft tissue mass (10*7cm) interposed with multiple tiny cystic spaces near to placenta. Diagnosis was 28 weeks pregnancy with partial mole and high rising β HCG level. Proper counseling, the pregnancy was continued as per the patient’s desire. The pregnancy was closely monitored with serial serum β HCG, and USG. Spontaneously labour pain start at 36 weeks pregnancy and delivered a live baby per vaginally at 36 weeks with near normal Apgar score. The placenta with molar tissue was sent for histopathological examination. The histopathologically confirmed partial mole with normal placenta. Beta HCG was 20,000 ml/L at 7 days and normal at 8 weeks after delivery. Close surveillance for 6 months. After 6 month follow-up, both mother and development of her baby are alright. Conclusion: The diagnosis, management and monitoring of this condition will remain challenging because of its rarity. Though the general trend is to terminate pregnancy with coexistent mole in anticipation of complications, under close surveillance, optimal outcomes can be achieved. Bangladesh Medical Res Counc Bull 2022; 48(3): 249-253
{"title":"Molar pregnancy with a co-exist normal viable fetus and successful pregnancy outcome: a case report","authors":"Nasrin Hossain, Faria Anjuman, Mohammod Sharif Mahmud, Shamin Hossain","doi":"10.3329/bmrcb.v48i3.62689","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.62689","url":null,"abstract":"Background: Co-existence of a hydatidiform mole with a normal fetus is extremely rare and is considered as a high risk pregnancy. Methods: It was an observational study conducted during July 2020 to march 2021 Case report: A 23 year old primigravida, referred with a diagnosis of 27 weeks pregnancy with gestational choriocarcinoma. She was booked patient. USG report at 9 weeks with a single gestational sac and single fetal pole. Her complains were lower abdominal pain and brownish vaginal discharge. Thoroughly evaluated the patient to exclude distal metastasis. Serum Beta HCG was 3,23,280 IU/L. USG and fetal MRI report were single graved fetus, no anomaly detected and a large hyper echogenic soft tissue mass (10*7cm) interposed with multiple tiny cystic spaces near to placenta. Diagnosis was 28 weeks pregnancy with partial mole and high rising β HCG level. Proper counseling, the pregnancy was continued as per the patient’s desire. The pregnancy was closely monitored with serial serum β HCG, and USG. Spontaneously labour pain start at 36 weeks pregnancy and delivered a live baby per vaginally at 36 weeks with near normal Apgar score. The placenta with molar tissue was sent for histopathological examination. The histopathologically confirmed partial mole with normal placenta. Beta HCG was 20,000 ml/L at 7 days and normal at 8 weeks after delivery. Close surveillance for 6 months. After 6 month follow-up, both mother and development of her baby are alright. Conclusion: The diagnosis, management and monitoring of this condition will remain challenging because of its rarity. Though the general trend is to terminate pregnancy with coexistent mole in anticipation of complications, under close surveillance, optimal outcomes can be achieved. Bangladesh Medical Res Counc Bull 2022; 48(3): 249-253","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135643603","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}
Prader Willi Syndrome (PWS) is one of the most common genetic condition of childhood morbid obesity. Absence of expression of the paternally active genes on the long arm of chromosome 15 is responsible for this syndrome. A 4-year-old girl, presented with excessive weight gain since early infancy. She has developmental delay, mental retardation and Her physical features were suggestive of Prader-Willi syndrome. MS PCR detected deletion of the specific chromosomal region 15q11.2-q13 in the paternal allele which is causative of Prader-Willi syndrome. The syndrome has no cure but multidisciplinary approaches are available to improve associated problems. We confirm the case of Prader Willi Syndrome by genetic analysis, which is important for those who present with obesity and mental retardation. Bangladesh Medical Res Counc Bull 2022; 48(3): 244-248
{"title":"Prader -Willi Syndrome: Deletion of Chromosome 15q11.2-q13 in Paternal Allele","authors":"Suraiya Begum, Farzana Sharmin, Dhiraj Chandra Biswash, Anika Tasneem Chowdhury","doi":"10.3329/bmrcb.v48i3.63823","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.63823","url":null,"abstract":"Prader Willi Syndrome (PWS) is one of the most common genetic condition of childhood morbid obesity. Absence of expression of the paternally active genes on the long arm of chromosome 15 is responsible for this syndrome. A 4-year-old girl, presented with excessive weight gain since early infancy. She has developmental delay, mental retardation and Her physical features were suggestive of Prader-Willi syndrome. MS PCR detected deletion of the specific chromosomal region 15q11.2-q13 in the paternal allele which is causative of Prader-Willi syndrome. The syndrome has no cure but multidisciplinary approaches are available to improve associated problems. We confirm the case of Prader Willi Syndrome by genetic analysis, which is important for those who present with obesity and mental retardation. Bangladesh Medical Res Counc Bull 2022; 48(3): 244-248","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135690197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.3329/bmrcb.v48i3.63811
Md Rashidul Haque, Towhidul Islam, Abul Hasnat Milton, Tanvir Abir
Background: The current Pandemic situation has the potential to impact mental health unfavourably. As a by and large new infection, much still needs to be had some significant awareness of Coronavirus. Following openness to the SARS-CoV-2 infection contamination, the vast majority of the people stay asymptomatic or foster gentle indications. Coronavirus cases can make complexities that will require hospitalization. Coronavirus patients revealed conditions like intense respiratory pain disorder, cardiovascular breakdown, liver harm, renal disappointment, shock, and multiorgan disappointment. During the current Coronavirus pandemic, general clinical issues have pulled in more highlight. Diverged from that, the psychological wellness outcomes of Coronavirus pandemic have gotten less thought. Methods: This study will follow a cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress during the initial stage of the COVID-19 pandemic among the Bangladeshi population. Results:Self-reported information on socio-demographics, illness and mental health status was obtained predominantly through a Facebook-based Coronavirus related page named 'Coronabarta' from 30th April to eight May 2020. Mental health status was assessed using the Depression, Anxiety and Stress Scale (DASS-21). A total of 420 individuals participated in this study who were relatively young and highly educated. The study finding suggests that COVID-19 pandemic may increase the risk of depression, anxiety, and stress in Bangladesh. The prevalence of depression, anxiety, and stress were 46.7% (95% Confidence Interval, CI:42.1% - 51.8%), 39.1(95% CI:34.3% – 43.9%), and 34.8% (95% CI:30.2 – 39.5%), respectively. Females and individuals with physical illness are at higher risk of developing adverse psychological consequences. Gossiping with family members is protective against depression (OR: 0.5, 95% CI:0.3 – 0.7). Watching television reduces stress (OR:0.6, 95% CI:0.4-0.9). Large cohort studies are recommended to confirm the association between COVID-19 pandemic and adverse mental health status. Necessary measures should be considered to improve psychological well-being during the COVID-19 pandemic. Conclusion: To find out the mental health status of the population during COVID-19 pandemic in Bangladesh, this study finding may form a basis for the development of a mental health support strategy in Bangladesh. Bangladesh Medical Res Counc Bull 2022; 48(3): 195-202
{"title":"Mental Health Status Of A Population During COVID-19 Pandemic in Bangladesh: A Cross-Sectional Study","authors":"Md Rashidul Haque, Towhidul Islam, Abul Hasnat Milton, Tanvir Abir","doi":"10.3329/bmrcb.v48i3.63811","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.63811","url":null,"abstract":"Background: The current Pandemic situation has the potential to impact mental health unfavourably. As a by and large new infection, much still needs to be had some significant awareness of Coronavirus. Following openness to the SARS-CoV-2 infection contamination, the vast majority of the people stay asymptomatic or foster gentle indications. Coronavirus cases can make complexities that will require hospitalization. Coronavirus patients revealed conditions like intense respiratory pain disorder, cardiovascular breakdown, liver harm, renal disappointment, shock, and multiorgan disappointment. During the current Coronavirus pandemic, general clinical issues have pulled in more highlight. Diverged from that, the psychological wellness outcomes of Coronavirus pandemic have gotten less thought. Methods: This study will follow a cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress during the initial stage of the COVID-19 pandemic among the Bangladeshi population. Results:Self-reported information on socio-demographics, illness and mental health status was obtained predominantly through a Facebook-based Coronavirus related page named 'Coronabarta' from 30th April to eight May 2020. Mental health status was assessed using the Depression, Anxiety and Stress Scale (DASS-21). A total of 420 individuals participated in this study who were relatively young and highly educated. The study finding suggests that COVID-19 pandemic may increase the risk of depression, anxiety, and stress in Bangladesh. The prevalence of depression, anxiety, and stress were 46.7% (95% Confidence Interval, CI:42.1% - 51.8%), 39.1(95% CI:34.3% – 43.9%), and 34.8% (95% CI:30.2 – 39.5%), respectively. Females and individuals with physical illness are at higher risk of developing adverse psychological consequences. Gossiping with family members is protective against depression (OR: 0.5, 95% CI:0.3 – 0.7). Watching television reduces stress (OR:0.6, 95% CI:0.4-0.9). Large cohort studies are recommended to confirm the association between COVID-19 pandemic and adverse mental health status. Necessary measures should be considered to improve psychological well-being during the COVID-19 pandemic. Conclusion: To find out the mental health status of the population during COVID-19 pandemic in Bangladesh, this study finding may form a basis for the development of a mental health support strategy in Bangladesh. Bangladesh Medical Res Counc Bull 2022; 48(3): 195-202","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135691675","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: Cervical cancer develops from well-defined precursor lesions in a variable period of time. Detecting in early or pre invasive stages, cervical cancer is preventable and curable, so detection of preinvasive lesions is very important. Objectives: The aim of our study was to correlate of Pap smear and colposcopy in relation to histopathological findings in detection of preinvasive lesion of cervix. Methods: This was a cross-sectional study of 110 women to attend in department of Gynecological Oncology OPD of Bangabandhu Sheikh Mujib Medical University Hospital from July 2016 to June 2017. Inclusion criteria were age of 30 to 60 years, who had unhealthy cervix, intermenstrual or post coital bleeding and excessive vaginal discharge. Exclusion criteria were any cervical growth, bleeding at the time of examination, pregnant women. Result: In present study sensitivity of Pap smear for detecting lesions above LSIL was 11(10.0%), specificity 68.38%, PPV was 94.44%, negative predictive value 71.86%. The incidence of preinvasive lesions (LSIL and HSIL) was 33.64% with LSIL 21(19.09%) and HSIL 16(14.55%) and of carcinoma were 10(9.09%). Conclusion: With a comprehensive approach to make awareness and doing proper screening by Paps smear, colposcopy and colposcopy directed biopsy; cervical cancer can be eliminated as a public health problem within a generation. Bangladesh Medical Res Counc Bull 2022; 48(3): 189-194
{"title":"Correlation of Pap Smear and Colposcopy in Relation to Histopathological Findings in Detection of Preinvasive Lesion of Cervix in Bangabandhu Sheikh Mujib Medical University Hospital Dhaka Bangladesh","authors":"Noor-e- Ferdous, Shirin Akter Begum, Mehriban Amatullah, Shereen Yousuf, Tasfia Mahmud, Latifa Akhter, Farzana Sharmin, Khairun Nahar, Afroza Khanom","doi":"10.3329/bmrcb.v48i3.63810","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i3.63810","url":null,"abstract":"Background: Cervical cancer develops from well-defined precursor lesions in a variable period of time. Detecting in early or pre invasive stages, cervical cancer is preventable and curable, so detection of preinvasive lesions is very important. Objectives: The aim of our study was to correlate of Pap smear and colposcopy in relation to histopathological findings in detection of preinvasive lesion of cervix. Methods: This was a cross-sectional study of 110 women to attend in department of Gynecological Oncology OPD of Bangabandhu Sheikh Mujib Medical University Hospital from July 2016 to June 2017. Inclusion criteria were age of 30 to 60 years, who had unhealthy cervix, intermenstrual or post coital bleeding and excessive vaginal discharge. Exclusion criteria were any cervical growth, bleeding at the time of examination, pregnant women. Result: In present study sensitivity of Pap smear for detecting lesions above LSIL was 11(10.0%), specificity 68.38%, PPV was 94.44%, negative predictive value 71.86%. The incidence of preinvasive lesions (LSIL and HSIL) was 33.64% with LSIL 21(19.09%) and HSIL 16(14.55%) and of carcinoma were 10(9.09%). Conclusion: With a comprehensive approach to make awareness and doing proper screening by Paps smear, colposcopy and colposcopy directed biopsy; cervical cancer can be eliminated as a public health problem within a generation. Bangladesh Medical Res Counc Bull 2022; 48(3): 189-194","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135690885","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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