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Autism Spectrum Disorder in Children with Epilepsy: A Case-Control Study in a Tertiary Care Hospital in Bangladesh 癫痫儿童的自闭症谱系障碍:孟加拉国一家三级护理医院的病例对照研究
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62296
M. M. Hossain, S. Akhter, Md Mizanur Rahman, K. Fatema, Mohammad SI Mullick, A. Siddika, Mohammad Zahir Uddin
Background: Autism spectrum disorders (ASD), a neurodevelopmental deficit, is often associated with epilepsy. Previous literature suggested that ASD and epilepsy share a common pathophysiological basis. Considering the scarcity of studies regarding ASD in children with epilepsy, this study was conducted with an aim to evaluate the association of ASD with epilepsy.Materials and Methods: This case-control study was conducted in the Department of Pediatric Neurology, Institute of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University, Dhaka, from September’ 2018 to December 2019. In total, 68 epileptic children, age ranged from five to 16 years, were enrolled as case. Similar number of non-epileptic, age, sex and socio-demographic status matched children were enrolled as control. Parent, teacher and self version of Bangla Development and Well-Being Assessment were used to assess the psychiatric disorders particularly ASD and diagnosis was assigned as Diagnostic and Statistical Manual of Mental Disorders (DSM-V).Results: The mean age of cases and controls were 9.66±3.13 and 9.26±3.11 years respectively with slight male predominance in both groups (64.7 and 57.35%, respectively). Focal seizure was predominant seizure type (51.5%) among cases. Higher proportion of psychiatric illness was found among the cases compared to controls (83.82 vs 20.59%; p<0.001). Neurodevdevelopmental and emotional disorders were significantly more frequent among cases than controls (29.42 vs 1.5%, and 50 vs 8.82%, respectively, p value <0.001). ASD was prevalent among 8.83% epileptic children, while none of the controls had ASD. Most common types of seizure in ASD children was focal epilepsy .Conclusions: This study observed the significant association of ASD with epilepsy in studied children. However, further larger multicenter study is recommended.Bangladesh Medical Res Counc Bull 2022; 48: 112-119
背景:自闭症谱系障碍(ASD)是一种神经发育缺陷,通常与癫痫有关。既往文献表明,ASD与癫痫具有共同的病理生理基础。鉴于目前关于癫痫患儿ASD的研究较少,本研究旨在评估ASD与癫痫的相关性。材料与方法:本病例对照研究于2018年9月至2019年12月在达卡Bangabandhu Sheikh Mujib医科大学儿科神经障碍与自闭症研究所儿科神经内科进行。共68例癫痫患儿,年龄5 ~ 16岁。同样数量的非癫痫、年龄、性别和社会人口状况相匹配的儿童作为对照。采用家长、教师和自我版本的孟加拉发展和幸福评估来评估精神障碍,特别是ASD,并根据精神障碍诊断与统计手册(DSM-V)进行诊断。结果:病例和对照组的平均年龄分别为9.66±3.13岁和9.26±3.11岁,两组男性均有轻微优势(分别为64.7%和57.35%)。局灶性发作是主要的发作类型(51.5%)。病例中精神疾病的比例高于对照组(83.82 vs 20.59%;p < 0.001)。病例中神经发育障碍和情绪障碍的发生率明显高于对照组(分别为29.42% vs 1.5%, 50% vs 8.82%, p值<0.001)。8.83%的癫痫患儿有自闭症,而对照组无自闭症。结论:本研究观察到ASD患儿与癫痫的显著相关性。然而,建议进一步进行更大规模的多中心研究。孟加拉国医疗援助理事会2022年公报;48: 112 - 119
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引用次数: 0
Community Clinic: Reach to unreached population 社区诊所:接触未接触人群
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62291
Md Anisur Rahman Anjum, S. Hossain, Md Ruhul Amin
Abstract not availableBangladesh Medical Res Counc Bull 2022; 48: 81-82
摘要不可用Bangladesh Medical Res Counc Bull 2022;48:81-82
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引用次数: 0
HLA-DR Association of Anti-dsDNA and Anti-Sm Autoantibodies in Bangladeshi Patients with Systemic Lupus Erythematosus 孟加拉国系统性红斑狼疮患者抗dsDNA和抗Sm自身抗体的HLA-DR相关性
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62300
S. Khatun, Humayun Sattar, Shafinaz Khan, F. Johora
Background: Rheumatic disorders are one of the largest health problems in the world in both developed and developing countries. Among systemic rheumatic disorders, systemic lupus erythematosus (SLE) is very much common. This debilitating disease most commonly affects females, especially at a young age. Though the exact etiology for the development of SLE still remains vague but genetic factors especially, HLA-DR plays an important role particularly in the development of autoantibodies in SLE cases.Objective: This study was undertaken to find out the association of HLA-DR with anti-dsDNA and anti-Sm autoantibodies among patients with SLE.Methods: Buccal swabs for HLA-DR typing and blood samples for detection of anti-dsDNA and anti-Sm were collected from 46 SLE cases. HLA-DR typing was carried out by end point polymerase chain reaction (PCR) with sequence specific primers. Autoantibodies were detected by using ELISA.Results: Out of 46 cases with SLE 44 (95.65%) were female and 2 (4.35%) were male with female: male ratio was 22: 1. Their mean age at study entry was 27.05 ± 8.17 years (mean ± SD), ranging from 12.5-45 years. AntidsDNA was positive in 38 (82.61%) cases and negative in 8 (17.39%) cases. Anti-Sm was positive in 19 (41.30%) cases and negative in 27 (58.70%) cases. The most frequently identified HLA-DR was DR2 (86.96%). When Anti-dsDNA positive cases were compared with Anti-dsDNA negative cases significant association was found with HLA-DR2 (94.73% vs 50%, p value = 0.0044, pc = 0.044, RR = 18.0000). No positive association of HLA-DR was found with anti-Sm autoantibody in this study. The above data suggest that HLA-DR2 has a role in anti-dsDNA production in Bangladeshi patients with SLE.Bangladesh Medical Res Counc Bull 2022; 48: 138-145  
背景:在发达国家和发展中国家,风湿病都是世界上最大的健康问题之一。在系统性风湿性疾病中,系统性红斑狼疮(SLE)非常常见。这种使人衰弱的疾病最常见于女性,尤其是在年轻时。尽管SLE发生的确切病因仍不清楚,但尤其是遗传因素,HLA-DR在SLE患者自身抗体的发生中起着重要作用。目的:探讨SLE患者HLA-DR与抗dsDNA和抗Sm自身抗体的关系。用序列特异性引物进行终点聚合酶链式反应(PCR)进行HLA-DR分型。结果:46例SLE患者中女性44例(95.65%),男性2例(4.35%),男女比例为22∶1。他们进入研究时的平均年龄为27.05±8.17岁(平均值±标准差),范围为12.5-45岁。抗dsDNA阳性38例(82.61%),阴性8例(17.39%)。抗Sm阳性19例(41.30%),阴性27例(58.70%)。最常见的HLA-DR是DR2(86.96%)。当将抗dsDNA阳性病例与抗dsDNA阴性病例进行比较时,发现HLA-DR2与HLA-DR2显著相关(94.73%对50%,p值=0.0044,pc=0.044,RR=18.0000)。本研究中未发现HLA-DR与抗Sm自身抗体呈正相关。上述数据表明,HLA-DR2在孟加拉国SLE患者的抗dsDNA产生中发挥作用。Bangladesh Medical Res Counc Bull 2022;48:138-145
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引用次数: 0
Assessment of Vitamin D Status and Response to Vitamin D Supplementation in Obese and Non-obese Children at a Tertiary Care Hospital 某三级医院肥胖与非肥胖儿童维生素D状况及对维生素D补充的反应评估
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62292
Suraiya Begum, F. Sharmin, Kohinoor Jahan Shayamaly, D. Biswas, Anika Chowdhury, S. Parveen, Tanjida Chowdhury
Background: Obesity seems to be a critical issue nowadays because of its high prevalence and its adverse effects on health. There is some evidence indicating the relationship between obesity and lower serum 25- hydroxyvitamin D concentration. Objectives: The objectives of this study were to assess the vitamin D status and estimate the response to vitamin D in obese and non-obese children after vitamin D supplementation.Methods: This was a Quasi experimental study, done in Paediatric Endocrinology Clinic and Paediatric Outdoor, Bangabandhu Shiekh Mujib Medical University (BSMMU) from August 2018 to February 2019. Vitamin D was measured in 20 obese and 20 non-obese children aged 10-18 years. Hypovitaminosis D was observed in all (100%) obese children and 15 (75%) non-obese children. Four thousand IU was given orally daily in obese and non-obese vitamin D deficient children for 3 months. Serum levels of vitamin D, calcium, inorganic phosphate, Alkaline Phosphatase (ALP) and Parathormone (PTH) also measured before and after vitamin D supplementation.Results: The mean age was 11.64±1.40 years in obese and11.15±2.40 years in non-obese children, and male female ratio was 1:1.3. Hypovitaminosis D was present in 100% in obese and 75% in non-obese children. Vitamin D deficiency (VDD) was observed in 85% and vitamin D insufficiency (VDI) was in 15% in obese children. In non-obese children VDD was observed in 86.7% and VDI in 13.3% cases. In both the groups serum vitamin D was increased, alkaline phosphatase and parathormone levels were decreased significantly, and serum calcium was increased and serum inorganic phosphatase was decreased but not statistically significant after four thousand IU daily vitamin D supplementation for three months. After vitamin D supplementation, vitamin D status were found normal in 60% obese and 53.3% non-obese children, VDI were in 30% obese/overweight and 26.7% in non-obese children, and VDD were in 10% obese/overweight and 20% in non-obese children.Conclusion: VDD was observed in both obese and non-obese children. Therapeutic responses were observed with 4000 IU/day vitamin D supplementation for three months in both the groups.Bangladesh Medical Res Counc Bull 2022; 48: 90-96
背景:肥胖似乎是当今的一个关键问题,因为它的高患病率和对健康的不利影响。有证据表明肥胖与血清25-羟基维生素D浓度降低有关。目的:本研究的目的是评估肥胖和非肥胖儿童在补充维生素D后的维生素D状况和对维生素D的反应。方法:本研究为准实验研究,于2018年8月至2019年2月在Bangabandhu sheikh Mujib医科大学(BSMMU)儿科内分泌科门诊和儿科户外科完成。研究人员测量了20名10-18岁的肥胖儿童和20名非肥胖儿童的维生素D含量。所有(100%)肥胖儿童和15(75%)非肥胖儿童出现维生素D缺乏症。肥胖和非肥胖的维生素D缺乏儿童每天口服4000国际单位,持续3个月。补充维生素D前后测定血清维生素D、钙、无机磷酸盐、碱性磷酸酶(ALP)和甲状旁腺激素(PTH)水平。结果:肥胖儿童平均年龄为11.64±1.40岁,非肥胖儿童平均年龄为11.15±2.40岁,男女比例为1:1.3。肥胖儿童中维生素D缺乏症发生率为100%,非肥胖儿童中为75%。肥胖儿童中维生素D缺乏(VDD)占85%,维生素D不足(VDI)占15%。非肥胖儿童VDD发生率为86.7%,VDI发生率为13.3%。每天补充4000 IU维生素D 3个月后,两组血清维生素D水平均显著升高,碱性磷酸酶和甲状旁腺激素水平显著降低,血清钙升高,血清无机磷酸酶降低,但均无统计学意义。补充维生素D后,60%的肥胖儿童和53.3%的非肥胖儿童的维生素D状态正常,30%的肥胖/超重儿童和26.7%的非肥胖儿童的VDI正常,10%的肥胖/超重儿童和20%的非肥胖儿童的VDD正常。结论:肥胖儿童和非肥胖儿童均存在VDD。在两个组中,观察到每天补充4000 IU维生素D三个月的治疗效果。孟加拉国医疗援助理事会2022年公报;48: 90 - 96
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引用次数: 0
Role of prophylactic fresh frozen plasma in critically ill neonate to prevent bleeding in disseminated intravascular coagulation: a randomized controlled trial 预防性新鲜冷冻血浆在危重新生儿预防弥散性血管内凝血出血中的作用:一项随机对照试验
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62301
Nusrat Kamal, M. Al Mamun, M. M. Hossain
Background: Disseminated intravascular coagulation (DIC) has a high prevalence in critically ill neonates. In suspicion of DIC based on abnormal coagulation parameter is a common trigger to transfuse fresh frozen plasma (FFP), even in absence of bleeding. In past years, use of FFP has increased and has expanded to include prophylactic use in neonates especially in neonatal intensive care units (NICUs) as it contains several coagulation factors. Several studies suggest that, prophylactic use of FFP has no role to prevent bleeding in disseminated intravascular coagulation (DIC), but carries increase risk of transfusion related mortality and morbidity.Objective: To assess the effectiveness of prophylactic use of FFP in critically ill neonate to prevent bleeding in DIC. Methods: This randomized, open-label, blinded end-point study was conducted in Bangladesh Institute of Child Health and Dhaka Shishu (Children) Hospital from July, 2019 to June, 2021. Term, critically ill neonates who had underlying disease, suspected to develop DIC were conveniently selected. Later, they were randomly allocated using software in intervention group, who received 10 ml/kg of FFP along with standard management and control group, who received only standard management. Coagulation parameters were checked before and 24 hour after intervention in both groups. Outcome was occurrence of bleeding as a indicator of DIC.Results: The mean age was 8.55 ± 3.5 days in intervention and 8.92 ± 6.1 days in control group. Male patients were predominant. There was no significant difference in baseline characteristics between two groups. The difference of mean ± SD of coagulation parameters between two groups were nonsignificant before intervention. Even after FFP transfusion, DIC developed among 40.1% neonates in intervention and without FFP transfusion among 48.9% neonates in control group without any significant difference (P-value >0.05).Conclusion: Study result found no role of prophylactic use of FFP in critically ill neonate to prevent bleeding in DIC.Bangladesh Medical Res Counc Bull 2022; 48: 146-153
背景:弥漫性血管内凝血(DIC)在危重新生儿中有很高的患病率。基于异常凝血参数怀疑DIC是输注新鲜冷冻血浆(FFP)的常见诱因,即使在没有出血的情况下也是如此。在过去的几年里,FFP的使用有所增加,并已扩大到包括新生儿的预防性使用,尤其是在新生儿重症监护室(NICU),因为它含有多种凝血因子。几项研究表明,预防性使用FFP对预防弥散性血管内凝血(DIC)出血没有作用,但会增加与输血相关的死亡率和发病率。目的:评价危重新生儿预防性应用FFP预防DIC出血的效果。方法:这项随机、开放标签、盲法终点研究于2019年7月至2021年6月在孟加拉国儿童健康研究所和达卡石树(儿童)医院进行。有潜在疾病、怀疑发展为DIC的足月危重新生儿被方便地选择。随后,使用软件将他们随机分配到干预组,干预组接受10ml/kg的FFP,标准管理组和对照组只接受标准管理。两组在干预前和干预后24小时检查凝血参数。结果:干预组平均年龄8.55±3.5天,对照组平均年龄8.92±6.1天。男性患者占主导地位。两组之间的基线特征没有显著差异。干预前两组凝血参数的平均值±标准差无显著性差异。即使在输注FFP后,干预组中40.1%的新生儿出现DIC,对照组中48.9%的新生儿在不输FFP的情况下出现DIC,没有任何显著差异(P值>0.05)。结论:研究结果发现,在危重新生儿中预防性使用FFP对预防DIC出血没有作用。Bangladesh Medical Res Counc Bull 2022;48:146-153
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引用次数: 0
Study of Homocysteine, Vitamin B12 and Folate in children with autism spectrum disorder 自闭症谱系障碍儿童同型半胱氨酸、维生素B12和叶酸的研究
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62297
A. Nesa, G. S. Sultana
Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that usually begins at or before the age of 3 years. The etiology of these disorders, includes environmental factors such as vitamins which have important role in central nervous system functioning. Vitamin B12 and folate are involved in the methionine-homocysteine pathway and some studies have shown a relationship between folate, vitamin B12 and homocysteine and various psychiatric diseases including ASDs.Objective: To evaluate the homocysteine, vitamin B12 and folate status in children with ASDs in Bangladesh.Methodology: This case control study included 50 ASD cases and 50 age matched healthy controls, according to inclusion criteria. After taking informed written consent from guardian, a structured questionnaire was filled up for each subject including socio-demographic history, family history, birth history and milestone of development. 5cc venous bloods were collected with all aseptic precautions in clot activator tube and serum homocysteine, vitamin B12 and folate levels were estimated. Collected data was checked, edited and processed with the help of SPSS (23).Results: The mean age of autism children was 5.71±2.06 years and in control group, it was 6.00±1.99 years. Mean S.Vit B12 (pg/ml) and S.Folic acid (ng/mL) were found significantly lower in autism children compared to control children (241.46±60.51 Vs 302.58±76.66 and 7.12±2.16 Vs 9.72±2.96). On the other hand, the mean S. Homocystiene (μmol/L) was found significantly higher in cases than controls (8.08±2.11 Vs 6.12±1.71). Conclusion: This study revealed that serum vitamin B12 and folate levels were significantly decreased, and serum homocysteine were significantly increased in children with autism spectrum disorders (ASDs) compared to normal healthy children. So, screening of serum homocysteine, vitamin B12 and folate in children with autism spectrum disorders is recommended for early management of complications related to the disease process.Bangladesh Medical Res Counc Bull 2022; 48: 127-132
背景:自闭症谱系障碍(ASD)是一种复杂的神经发育障碍,通常开始于3岁或之前。这些疾病的病因包括环境因素,如在中枢神经系统功能中起重要作用的维生素。维生素B12和叶酸参与蛋氨酸-同型半胱氨酸通路,一些研究表明叶酸、维生素B12和同型半胱氨酸与包括asd在内的多种精神疾病有关。目的:了解孟加拉国自闭症儿童的同型半胱氨酸、维生素B12和叶酸水平。方法:根据纳入标准,本病例对照研究包括50例ASD病例和50例年龄匹配的健康对照。在获得监护人的知情书面同意后,每位受试者填写了一份结构化的问卷,包括社会人口统计史、家族史、出生史和发展里程碑。在凝块激活管中采集5cc静脉血,测定血清同型半胱氨酸、维生素B12和叶酸水平。使用SPSS(23)对收集到的数据进行核对、编辑和处理。结果:自闭症患儿平均年龄为5.71±2.06岁,对照组平均年龄为6.00±1.99岁。自闭症儿童S.Vit B12 (pg/ml)和s.v ic acid (ng/ ml)的平均值分别为241.46±60.51 Vs 302.58±76.66和7.12±2.16 Vs 9.72±2.96,显著低于正常儿童。与对照组相比,实验组的平均同型半胱氨酸含量(μmol/L)显著高于对照组(8.08±2.11 Vs 6.12±1.71)。结论:与正常健康儿童相比,自闭症谱系障碍儿童血清维生素B12和叶酸水平显著降低,血清同型半胱氨酸水平显著升高。因此,自闭症谱系障碍儿童的血清同型半胱氨酸,维生素B12和叶酸的筛查被推荐用于与疾病过程相关的并发症的早期管理。孟加拉国医疗援助理事会2022年公报;48: 127 - 132
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引用次数: 0
A Predictive Score after Neoadjuvant Chemotherapy for Optimal Cytoreduction at Interval Debulking Surgery in Advanced Epithelial Ovarian Cancer 晚期上皮性卵巢癌间歇减癌手术新辅助化疗后最佳细胞减少的预测评分
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62302
Pabina Afroz Parveen, F. Hossain, Shah Mahfuzur Rahman, Rezwana Sharmin Lima, Anjuman Sultana, N. Sultana
Background: Ovarian cancer is the seventh most common cancer and eighth most common cause of death of female. More than 75% patients are diagnosed at Stage (III - IV) and their 5-year survival rate is (25-50%) . Primary debulking surgery (PDS) followed by adjuvant chemotherapy is the cornerstone treatment for advanced ovarian cancer. Unfortunately, primary debulking surgery is not always feasible and not associated with optimal cytoreduction. Recently, neoadjuvant chemotherapy followed by Interval Debulking Surgery (NACT- IDS) is increasingly adopted. (NACT-IDS) improves optimal cytoreduction and reduces complications in comparison with PDS . However, a significant proportion of patients cannot be optimally cytoreduced even after NACT-IDS and causes futile laparotomy. So, it is necessary to develop a Predictive Score for Cytoreduction (PSC) after NACT for optimal cytoreduction at (IDS).Objective: To find out a predictive score after NACT for optimal cytoreduction at IDS in advanced epithelial ovarian cancer.Method: This was a prospective observational study conducted among 55 patients of advanced ovarian cancer to develop a predictive score after NACT at IDS in department of Gynecological Oncology of BSMMU, from January 2020 to December 2020.Result: Among the 55 patients with advanced epithelial ovarian cancer 44(80%) could be optimally cytoreduced whereas in 11(20%) suboptimal cytoreduction occurred. The sensitivity, specificity, Negative predictive value (NPV), Positive predictive value (PPV) and accuracy of CA-125 for prediction of optimal cytoreduction was 87.5%, 30.8%,85.7%,34.1% and 47.3% respectively. It was observed that 37 (84.1%) have peritoneal cancer index within 0-16 in optimal cytoreduction (R0) and 3 (27.3%) in non-R0 (p value 0.001). The sensitivity, specificity, NPV, PPV and accuracy of Peritoneal Cancer Index (PCI) for prediction of optimal cytoreduction was 62.5%, 89.7%, 85.4% 74.1% and 81.8% respectively. PSC after NACT for optimal cytoreduction at (IDS) was 3 and it indicates 83.3% Patients could be optimally cytoreduced limiting the rate of suboptimal cytoreduction in 16.7%.Conclusion: The result of the present study showed that PSC after NACT influences Optimal cytoreduction (R <1cm) at (IDS). So, this study concluded that IDS after NACT should be performed in patients with a PSC up to 2 to avoid suboptimal cytoreduction.Bangladesh Medical Res Counc Bull 2022; 48: 154-159        
背景:癌症是癌症第七大常见病,女性死亡原因第八大常见病。超过75%的患者被诊断为III-IV期,其5年生存率为(25-50%)。初级减瘤手术(PDS)后辅助化疗是晚期癌症的基础治疗。不幸的是,初次减瘤手术并不总是可行的,也与最佳的细胞减少无关。近年来,新辅助化疗加间隔脱瘤手术(NACT-IDS)越来越多地被采用。(NACT-IDS)与PDS相比,可改善最佳细胞减少并减少并发症。然而,即使在NACT-IDS之后,仍有相当一部分患者不能最佳地减少细胞,并导致无效的剖腹手术。因此,有必要制定NACT后细胞减少预测评分(PSC),以实现最佳细胞减少(IDS)。目的:找出晚期上皮性卵巢癌症NACT后最佳细胞减少预测分数。方法:对55例晚期癌症患者进行前瞻性观察研究,结果:在55例晚期上皮性卵巢癌症患者中,44例(80%)可获得最佳的细胞减少,而11例(20%)出现次优的细胞减少。CA-125预测最佳细胞减少的敏感性、特异性、阴性预测值(NPV)、阳性预测值(PPV)和准确率分别为87.5%、30.8%、85.7%、34.1%和47.3%。结果发现,腹膜癌症指数在最佳减容(R0)0~16范围内者37例(84.1%),在非R0范围内者3例(27.3%)(p值0.001),腹膜癌症指数(PCI)预测最佳减容的敏感性、特异性、NPV、PPV和准确度分别为62.5%、89.7%、85.4%、74.1%和81.8%。NACT后PSC在(IDS)的最佳细胞减少率为3,表明83.3%的患者可以获得最佳细胞减少,将次优细胞减少率限制在16.7%。结论:本研究结果表明,NACT后的PSC影响(IDS)处的最佳细胞减少率(R<1cm)。因此,本研究得出结论,NACT后的IDS应在PSC高达2的患者中进行,以避免次优的细胞减少。孟加拉国医学研究理事会2022;48:154-159
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引用次数: 0
In-Hospital outcome of acute coronary syndrome in patients with Diabetes Mellitus with and without chronic Kidney disease 糖尿病合并和不合并慢性肾脏疾病患者急性冠状动脉综合征的住院疗效
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62299
Chowdhury Ali Adnan, Mohammad Hasanur Rahman, Syeda Fahmida Afrin
Background: Chronic kidney disease (CKD) and Diabetes Mellitus (DM) are highly prevalent, morbid diseases in every population. They are even more common among patients presenting with acute coronary syndromes (ACS). Objective: The present study was, conducted to see the outcome of ACS patients with concurrent DM and CKD. Methods: The cohort study was carried out in the Department of Medicine, Dhaka Medical College & Hospital, Dhaka over a period six months from July 2017 to December 2017. All acute coronary syndrome patients having DM with or without CKD admitted in Medicine and Cardiology (CCU) Departments were the study population. ACS patients with concurrent DM with CKD formed the cohort group (n = 75) and DM without CKD were termed as control group (n = 75). Result: The study was concluded that the ACS patients with concomitant CKD and DM (cohort) are usually older and more often hypertensive than the ACS patients with CKD alone (control) (63.9 vs. 55.9 years, p < 0.001 and 92% vs. 64%, p < 0.001 respectively). The typical chest pain is less commonly observed (68% vs. 86.7%, p = 0.003) and dyspnoea is more often present in this cohort than those in the control (92% vs. 52%, p < 0.001). NSTEMI is significantly present in the cohort compared that in the control group (p < 0.001). Serum Troponin I, CKMB and eGFR were significantly higher in the former group than those in the latter group (p = 0.044, p = 0.050 and p < 0.001 respectively). Almost all the outcome parameters demonstrated their significance. Conclusion: The diabetic with CKD (cohort group) is less likely to have ST elevations but is significantly prevalent having NSTEMI. Typical angina is less and dyspnea is more in cohort group. Bangladesh Medical Res Counc Bull 2022; 48: 133-137
背景:慢性肾脏疾病(CKD)和糖尿病(DM)在每个人群中都是高度流行的病态疾病。它们在急性冠脉综合征(ACS)患者中更为常见。目的:本研究旨在观察ACS合并DM和CKD患者的预后。方法:在达卡医学院医学系进行队列研究;在2017年7月至2017年12月的六个月期间,达卡医院。所有在内科和心脏病科(CCU)住院的急性冠状动脉综合征合并糖尿病或不合并CKD的患者均为研究人群。ACS合并DM合并CKD的患者为队列组(n = 75),无CKD的DM为对照组(n = 75)。结果:研究得出,ACS合并CKD和DM患者(队列)通常比ACS合并CKD患者(对照组)年龄更大,更常发生高血压(63.9 vs. 55.9, p <0.001和92%对64%,p <0.001分别)。典型胸痛的发生率较低(68% vs. 86.7%, p = 0.003),呼吸困难的发生率高于对照组(92% vs. 52%, p <0.001)。与对照组相比,NSTEMI在队列中显著存在(p <0.001)。前一组血清肌钙蛋白I、CKMB、eGFR显著高于后一组(p = 0.044、p = 0.050、p <0.001分别)。几乎所有的结果参数都显示了它们的显著性。结论:CKD合并糖尿病患者(队列组)ST段升高的可能性较小,但NSTEMI发生率明显较高。队列组典型心绞痛较少,呼吸困难较多。孟加拉国医疗援助理事会2022年公报;48: 133 - 137
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引用次数: 0
Service availability and readiness assessment of COVID-19 disease management at different tiers of health service delivery in Bangladesh 孟加拉国不同卫生服务层级COVID-19疾病管理的服务可得性和准备情况评估
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62303
H. Rashid, Nazneed Akhter, A.H.M Rasheduzzaman, HM Miraz Mahmud, R. Banik, SM Sayadat Amin, Md Ruhul Amin
Background: The world is passing through a hard time due to the highly infectious COVID-19 pandemic. Like other countries in the world, the Bangladesh government has taken various preventive measures. As part of this, the availability and readiness of different health facilities is crucial.Objective: The study aimed to assess availability and readiness based on logistics, workforce, clinical management, and IPC. Methods: A cross-sectional quantitative study was conducted from August 20 to September 30, 2021, which comprised a health facility survey with a sample of 210. The health facilities included all three tiers of hospitals, covering 24 districts of eight divisions. All COVID-19 dedicated hospitals were included in this survey. The questionnaire consisted of a standard checklist developed by WHO, DGHS, and CDC.Results: The overall scores for ICU, HDU, and ventilation service were 76.8%, 87.5%, and 85.7%, respectively, but they were almost missing in Upazila health complex and below the average in non-dedicated hospitals. All (100%) secondary and tertiary level hospitals had a 24-hour staffed emergency unit, with dedicated hospitals outperforming non-dedicated hospitals (99.2% vs 98.7%). Above 90% of hospitals in different tiers had hand hygiene supplies and respiratory hygiene supplies for staff and patients, 98% of the primary level hospitals displayed instructions on hand and respiratory hygiene practices. On the other hand, 94.9% of secondary level hospitals had clearly identified and separated COVID-19 isolation areas from non-COVID-19 areas; 82.1% of secondary level hospitals had service providers (MOs) who used PPE; 97.4% had routine cleaning and disinfection of ambulances done according to IPC guidelines; and 64.1% had staff of laboratory, laundry, food services, and waste management teams who used appropriate PPE. Secondary level hospitals had a better availability of PPE compared to primary and tertiary level hospitals, which consisted of protective gowns (87.8%), disposable latex gloves (examination) (92.5%), goggles, protective (82.9%), face shields (72.5%), respirator masks (N95 or FFP2) (75.0%), and masks, medical/surgical (97.6%) available for all health service providers. Almost 26.2% facility have PCR testing lab and almost all (96.7%) the facilities have specimen collection system in their facility.Conclusion: The service availability and readiness regarding COVID-19 among different tiers of health facilities in Bangladesh are not adequate. We need more support for disease detection capacities through provision of technical expertise, laboratory equipment and increase capacity of the secondary and primary health care tier along with national capacity for covid-19 testing.Bangladesh Medical Res Counc Bull 2022; 48: 160-171       
背景:由于传染性很强的COVID-19大流行,世界正在经历一段艰难时期。与世界上其他国家一样,孟加拉国政府采取了各种预防措施。作为其中的一部分,各种卫生设施的可用性和准备程度至关重要。目的:本研究旨在评估基于物流、劳动力、临床管理和IPC的可用性和准备情况。方法:于2021年8月20日至9月30日进行横断面定量研究,包括对210个样本的卫生机构进行调查。保健设施包括所有三级医院,覆盖24个县的8个区。本次调查包括所有COVID-19专科医院。问卷由世卫组织、dhs和CDC制定的标准清单组成。结果:ICU、HDU和通气服务的总得分分别为76.8%、87.5%和85.7%,但Upazila卫生综合医院几乎缺失,非专科医院低于平均水平。所有(100%)二级和三级医院都有24小时配备急救人员的科室,专科医院优于非专科医院(99.2%对98.7%)。90%以上的各级医院为医护人员和患者配备了手卫生用品和呼吸卫生用品,98%的基层医院有手卫生和呼吸卫生指导。另一方面,94.9%的二级医院明确划分了新冠肺炎隔离区和非新冠肺炎隔离区;82.1%的二级医院存在使用个人防护装备的服务提供者;97.4%的救护车按照感染预防和控制准则进行了例行清洁和消毒;64.1%的实验室、洗衣、食品服务和废物管理团队的工作人员使用了适当的个人防护装备。与一级和三级医院相比,二级医院拥有更好的个人防护装备,包括防护服(87.8%)、一次性乳胶手套(检查)(92.5%)、护目镜、防护服(82.9%)、面罩(72.5%)、呼吸器口罩(N95或FFP2)(75.0%)以及所有卫生服务提供者可获得的医用/外科口罩(97.6%)。几乎26.2%的设施有PCR检测实验室,几乎所有(96.7%)的设施都有标本采集系统。结论:孟加拉国各级卫生机构对COVID-19的服务可得性和准备程度不足。我们需要通过提供技术专长、实验室设备、提高二级和初级卫生保健层的能力以及国家covid-19检测能力,为疾病检测能力提供更多支持。孟加拉国医疗援助理事会2022年公报;48: 160 - 171
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引用次数: 0
Effect of Oral Administration of Syzygium cumini Seed Powder on the Hepatic Function-related Enzymes of the Alcoholic Transport Laborers 孜然籽粉口服对酒精运输工人肝功能相关酶的影响
Q4 Medicine Pub Date : 2023-05-28 DOI: 10.3329/bmrcb.v48i2.62293
S. Hossain, Bazlul Karim Chowdhury, M. Hossain, Azizur Rahman, Ishtiaq Mahmud
Background: Syzygium cumini (locally known as Kalo Jam) seed powder is being used as folk medicine in various diseases since unknown times in Bangladesh. However, data on the systematic studies in human subjects are rare.Objective: To determine the effect of Syzygium cumini seed powder on the hepatic function-related enzymes of the alcoholic transport laborers.Methods: Here, we investigated the effects of oral administration of Syzygium cumini seed powder on hepaticfunction markers that included activities of Gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and renal-function markers such as creatinine and urea along with lipid profile, blood pressure and body mass index (BMI) upon chronic alcoholic human volunteers.Results: The levels of serum ALT, AST and GGT levels decreased, respectively, by 15.0, 8.5 and 23.0% after oral administration of the S. cumini powder in the alcoholic subjects. However, the levels of creatinine and urea were not altered significantly. In contrast, the effects of administration of S. cumini on the hepatic ALT, AST and GGT enzymes in the non-alcoholic control subjects were less prominent than those found in the alcoholic subjects. Blood pressure decreased only by 5-4 mmHg, while BMI was not altered in either the alcoholic or the non-alcoholic groups. Furthermore, there were significant reduction in the levels of TC (by 10%) and LDL-C (by >20%) and elevation of HDL-C (by 11%) in the S. cumini-prescribed alcoholic subjects. TC and LDL-C levels also decreased in the non-alcoholic subjects, but the rate was not statistically significant.Conclusions: Our results suggest that S. cumini seed extract ameliorated GGT, ALT and the atherosclerotic lipid parameters TC and LDL-C without having a significant side effect on the kidney functions, as indicated by the unaltered levels of serum creatinine levels in the alcoholic human subjects without any effect on BP and BMI of the same subjects. Thus, alcohol drinkers can be advised to intake S. cumini seed powder to protect against the oxidative hepatic damage.Bangladesh Medical Res Counc Bull 2022; 48: 97-104
背景:在孟加拉国,从未知的时代起,茴香(当地称为Kalo Jam)种子粉末就被用作治疗各种疾病的民间药物。然而,关于人类受试者的系统研究数据很少。目的:探讨茴香子粉对酒精运输工人肝功能相关酶的影响。方法:本研究研究了口服茴香籽粉对慢性酒精中毒人类志愿者肝功能指标的影响,包括γ -谷氨酰转移酶(GGT)、丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)的活性,以及肾功能指标,如肌酐和尿素、血脂、血压和体重指数(BMI)。结果:酗酒者口服鱼尾草散后血清ALT、AST和GGT水平分别下降15.0%、8.5%和23.0%。然而,肌酐和尿素水平没有明显改变。相反,给药茴香对非酒精对照组肝脏ALT、AST和GGT酶的影响不如酒精对照组明显。血压仅下降了5-4毫米汞柱,而酒精组和非酒精组的BMI都没有改变。此外,在S. cumini规定的酒精受试者中,TC水平显著降低(10%),LDL-C水平显著降低(20%),HDL-C水平显著升高(11%)。非酒精受试者的TC和LDL-C水平也有所下降,但差异无统计学意义。结论:我们的研究结果表明,茴香籽提取物改善了GGT、ALT和动脉粥样硬化脂质参数TC和LDL-C,而对肾功能没有明显的副作用,这一点可以从酗酒者的血清肌酐水平没有改变而对血压和BMI没有任何影响中看出。因此,可以建议饮酒者摄入茴香籽粉以防止氧化性肝损伤。孟加拉国医疗援助理事会2022年公报;48: 97 - 104
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引用次数: 0
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Bangladesh Medical Research Council Bulletin
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