Pub Date : 2022-09-05DOI: 10.3329/bmrcb.v48i1.60658
Md. Towhid Belal, N. Zico, T. Chowdhury, M. Rahman, Nazim Uddin Md Arif, Md. kamrul Islam
Background: Kidney recipients constitute a vulnerable group of population and may have high risk of morbidity and mortality when infected with COVID-19. Objective: To a assess the overall outcome as well as the incidence and impact of COVID-19 among recipients who underwent transplantation during the pandemic Methods: A pre-designed follow up protocol was set to prospectively analyse the data obtaining from the recipients who underwent renal transplantation since 8 March 2010, the first appearance of COVID-19 in Bangladesh till 31 December, 2020. Outcome parameters were renal functional status; surgical, urological, immunological and medical complications; and incidence of COVID-19 and its outcome during the first 12 weeks post-transplant period. Results: Out of 100 patients, 82.0% were male and 18.0% were female. Serum creatinine levels (μmol/L) at 4, 8 and 12 weeks post-transplant were 200 in 6.0%, 5.0% and 6.0% respectively. Graft nephrectomy was done in 3 cases due to vascular complications. Five (5.0%) patients presented with symptoms of COVID-19, among them, 2 cases were confirmed with RT-PCR. There were 6 death cases, and septicaemia was the most common cause of death. The overall mortality rate was 6.0% in our study population but in COVID-19 confirmed cases it was 50.0%. Conclusion: During this pandemic, the overall outcome of renal transplantation was excellent and the incidence of symptomatic COVID-19 among transplant recipients was not higher than the incidence observed in general population of Bangladesh. But among the COVID-19 confirmed recipients, mortality rate was significantly higher. Bangladesh Med Res Counc Bull 2022; 48(1): 33-40
{"title":"Outcome of Kidney Transplant Recipients During Covid-19 Pandemic","authors":"Md. Towhid Belal, N. Zico, T. Chowdhury, M. Rahman, Nazim Uddin Md Arif, Md. kamrul Islam","doi":"10.3329/bmrcb.v48i1.60658","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i1.60658","url":null,"abstract":"Background: Kidney recipients constitute a vulnerable group of population and may have high risk of morbidity and mortality when infected with COVID-19.\u0000Objective: To a assess the overall outcome as well as the incidence and impact of COVID-19 among recipients who underwent transplantation during the pandemic\u0000Methods: A pre-designed follow up protocol was set to prospectively analyse the data obtaining from the recipients who underwent renal transplantation since 8 March 2010, the first appearance of COVID-19 in Bangladesh till 31 December, 2020. Outcome parameters were renal functional status; surgical, urological, immunological and medical complications; and incidence of COVID-19 and its outcome during the first 12 weeks post-transplant period.\u0000Results: Out of 100 patients, 82.0% were male and 18.0% were female. Serum creatinine levels (μmol/L) at 4, 8 and 12 weeks post-transplant were 200 in 6.0%, 5.0% and 6.0% respectively. Graft nephrectomy was done in 3 cases due to vascular complications. Five (5.0%) patients presented with symptoms of COVID-19, among them, 2 cases were confirmed with RT-PCR. There were 6 death cases, and septicaemia was the most common cause of death. The overall mortality rate was 6.0% in our study population but in COVID-19 confirmed cases it was 50.0%.\u0000Conclusion: During this pandemic, the overall outcome of renal transplantation was excellent and the incidence of symptomatic COVID-19 among transplant recipients was not higher than the incidence observed in general population of Bangladesh. But among the COVID-19 confirmed recipients, mortality rate was significantly higher.\u0000Bangladesh Med Res Counc Bull 2022; 48(1): 33-40 ","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49066179","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 : 2022-09-05DOI: 10.3329/bmrcb.v48i1.60659
M. I. Islam, Sanjida Pervin Sonia, M. Haque, K. Laila, M. K. Talukder, Mohammed Mahbubul Islam, S. Rahman
Background: The clinical course of juvenile idiopathic arthritis (JIA) is unpredictable and characterised by periods of disease inactivity followed by active disease states with on or off medication. Objectives: To assess the disease activity state of JIA patients in our centre and compare them with other available reports. Methods: A retrospective cohort study carried out in the department of paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2010 to December 2019 . A total of 1782 JIA patients, fulfilling ILAR criteria, who have completed at least three years of follow-up were enrolled in this study. Disease activity states were assessed according to Wallace’s criteria. Results: The mean age at presentation of disease was 8.33±4.8 years and M:F ratio was 1.4:1. Enthesitis related arthritis (ERA) was the commonest (38.0%) subtype, followed by systemic arthritis and RF–ve polyarthritis. Eighty-three percent of the JIA patients were treated with MTX followed by sulfasalazine (30.0%) and leflunamide (13.0%). Only 12.0% received biological agents and other drugs including thalidomide and tofacitinib. At 3 years follow-up, 39.2% had active disease and 60.7% had non-active disease states. Inactive disease states, clinical remission on medication (CRM) and clinical remission off medication (CR) were maintained by 27.1%, 20.1 %, and 13.3% of JIA patients respectively. Conclusion: Most (60.7%) of the JIA patients maintained CRM, CR and inactive disease states. Active disease was found in 39.2% of JIA patients. The highest rate of remission was achieved in persistent oligoarthritis cases. RF+ve polyarthritis patients had the lowest remission rate. Bangladesh Med Res Counc Bull 2022; 48(1): 41-47
{"title":"Disease Activity States of Juvenile Idiopathic Arthritis in a Referral Centre in Bangladesh","authors":"M. I. Islam, Sanjida Pervin Sonia, M. Haque, K. Laila, M. K. Talukder, Mohammed Mahbubul Islam, S. Rahman","doi":"10.3329/bmrcb.v48i1.60659","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i1.60659","url":null,"abstract":"Background: The clinical course of juvenile idiopathic arthritis (JIA) is unpredictable and characterised by periods of disease inactivity followed by active disease states with on or off medication.\u0000Objectives: To assess the disease activity state of JIA patients in our centre and compare them with other available reports. Methods: A retrospective cohort study carried out in the department of paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2010 to December 2019 . A total of 1782 JIA patients, fulfilling ILAR criteria, who have completed at least three years of follow-up were enrolled in this study. Disease activity states were assessed according to Wallace’s criteria.\u0000Results: The mean age at presentation of disease was 8.33±4.8 years and M:F ratio was 1.4:1. Enthesitis related arthritis (ERA) was the commonest (38.0%) subtype, followed by systemic arthritis and RF–ve polyarthritis. Eighty-three percent of the JIA patients were treated with MTX followed by sulfasalazine (30.0%) and leflunamide (13.0%). Only 12.0% received biological agents and other drugs including thalidomide and tofacitinib. At 3 years follow-up, 39.2% had active disease and 60.7% had non-active disease states. Inactive disease states, clinical remission on medication (CRM) and clinical remission off medication (CR) were maintained by 27.1%, 20.1 %, and 13.3% of JIA patients respectively.\u0000Conclusion: Most (60.7%) of the JIA patients maintained CRM, CR and inactive disease states. Active disease was found in 39.2% of JIA patients. The highest rate of remission was achieved in persistent oligoarthritis cases. RF+ve polyarthritis patients had the lowest remission rate.\u0000Bangladesh Med Res Counc Bull 2022; 48(1): 41-47 ","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42248320","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 : 2022-09-05DOI: 10.3329/bmrcb.v48i1.60661
Mohammad Al Forkan, Md Omar Hasan Chowdhury, Rahee Hasan Chowdhury, Fahmida Binta Wali, Amit Datta, Md Nezam Uddin, Md. Jibran Alam, L. Khaleda
Background: The deleterious impact of arsenic (As) contaminated groundwater on human health has been reported worldwide. Epidemiological studies have identified adverse association of arsenic exposure with the risk of cardiovascular diseases (CVD). Telomere dysfunction is emerging as an important factor underlying the pathogenesis of various cardiovascular complications. Objective: The aim of the study was to investigate the effect of arsenic exposure on human telomerase reverse transcriptase (hTERT) gene expression and telomere length in arsenic-exposed cardiovascular disease patients of Bangladesh. Methods: A total of 53 CVD patients from known As-affected and unaffected areas of Bangladesh and subjected to open heart surgery were recruited. Nail samples were collected and analysed for arsenic content as a biomarker of chronic exposure. RNA and DNA extracted from blood samples were used for hTERT expression analysis and telomere length measurement respectively, using real-time polymerase chain reaction. Results: The patients from known As-affected areas (As-exposed patients group) showed approximately 9.7 fold higher expression of hTERT gene and approximately 1.4 fold higher telomere length than the patients from known As-unaffected areas (As-unexposed patients group). We found significant association of both hTERT expression (r= 0.407, p= 0.001) and telomere length (r=0.437, p=0.003) with as concentration in nail samples. Of the total study population, the coronary artery disease (CAD) patients in particular showed approximately 3.4 fold higher expression of hTERT gene and approximately 1.5 fold higher telomere length than the non-CAD patients group. Conclusion: Our findings suggest that chronic arsenic exposure is positively associated with increased hTERT expression and telomere length in As-exposed CVD patients of Bangladesh and that this association in turn can influence the cardiovascular outcomes of prolonged arsenic exposure. We also suggest that Asinduced CVD possibly adopts a mechanism that is different from that of As-independent CVD. Findings of this study will pave the way to unfold the mechanism behind As-induced CVD through more in-depth research. Bangladesh Med Res Counc Bull 2022; 48(1): 56-63
{"title":"Effect of Arsenic Exposure on Human Telomerase Reverse Transcriptase (hTERT) Gene Expression and Telomere Length in Cardiovascular Disease Susceptibility","authors":"Mohammad Al Forkan, Md Omar Hasan Chowdhury, Rahee Hasan Chowdhury, Fahmida Binta Wali, Amit Datta, Md Nezam Uddin, Md. Jibran Alam, L. Khaleda","doi":"10.3329/bmrcb.v48i1.60661","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i1.60661","url":null,"abstract":"Background: The deleterious impact of arsenic (As) contaminated groundwater on human health has been reported worldwide. Epidemiological studies have identified adverse association of arsenic exposure with the risk of cardiovascular diseases (CVD). Telomere dysfunction is emerging as an important factor underlying the pathogenesis of various cardiovascular complications.\u0000Objective: The aim of the study was to investigate the effect of arsenic exposure on human telomerase reverse transcriptase (hTERT) gene expression and telomere length in arsenic-exposed cardiovascular disease patients of Bangladesh.\u0000Methods: A total of 53 CVD patients from known As-affected and unaffected areas of Bangladesh and subjected to open heart surgery were recruited. Nail samples were collected and analysed for arsenic content as a biomarker of chronic exposure. RNA and DNA extracted from blood samples were used for hTERT expression analysis and telomere length measurement respectively, using real-time polymerase chain reaction.\u0000Results: The patients from known As-affected areas (As-exposed patients group) showed approximately 9.7 fold higher expression of hTERT gene and approximately 1.4 fold higher telomere length than the patients from known As-unaffected areas (As-unexposed patients group). We found significant association of both hTERT expression (r= 0.407, p= 0.001) and telomere length (r=0.437, p=0.003) with as concentration in nail samples. Of the total study population, the coronary artery disease (CAD) patients in particular showed approximately 3.4 fold higher expression of hTERT gene and approximately 1.5 fold higher telomere length than the non-CAD patients group.\u0000Conclusion: Our findings suggest that chronic arsenic exposure is positively associated with increased hTERT expression and telomere length in As-exposed CVD patients of Bangladesh and that this association in turn can influence the cardiovascular outcomes of prolonged arsenic exposure. We also suggest that Asinduced CVD possibly adopts a mechanism that is different from that of As-independent CVD. Findings of this study will pave the way to unfold the mechanism behind As-induced CVD through more in-depth research.\u0000Bangladesh Med Res Counc Bull 2022; 48(1): 56-63 ","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43366880","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 : 2022-09-05DOI: 10.3329/bmrcb.v48i1.60655
Wong Khung Ying, Md Mamunur Rahman, A. Kiyu
Background: Social networking sites (SNSs) have changed the ways that we interact with each other. The use of social networking sites by adolescents is addictive, with numerous negative consequences. Various factors influence social networking sites addiction among adolescents. Objective: We aimed to determine the prevalence of gender-specific social networking sites addiction among adolescents and the factors influence social networking sites addiction. Methods: A quantitative, cross-sectional community-based research was conducted by face-to-face interviews among adolescents in all 11 administrative divisions of Sarawak, Malaysia. The multistage cluster sampling technique was followed, with an adolescent selected systematically from each household. An adapted and validated questionnaire, which included 20 items of social networking sites addiction, was used to collect data. We analysed 1344 adolescent’s data using IBM SPSS Version 22.0. A partial least square structural path with mediation analysis was done using WarpPLS version 7.0. Results: Three-quarters of the adolescents (76.2%) used social networking sites, but only two-fifths of them (40.4%) were addicted, with 15% having moderate-severe addiction to social networking sites. The most frequently used social networking sites was YouTube (77.9%), followed by Facebook (75.2%) and Instagram (59.0%). Self-esteem had a negative correlation, while adolescent risk behaviours directly affected social networking sites addiction (p<0.001). The most potent predictors for social networking sites addiction were YouTube, Instagram, and Pinterest (p<0.05). Conclusion: Tackling risk behaviours and enhancing adolescents’ self-esteem would reduce the tendency to be addicted to social networking sites. Bangladesh Med Res Counc Bull 2022; 48(1): 10-20
{"title":"Addiction Among Adolescents to Social Networking Sites in Malaysia: A Hierarchical Multiple Linear Regression Analysis","authors":"Wong Khung Ying, Md Mamunur Rahman, A. Kiyu","doi":"10.3329/bmrcb.v48i1.60655","DOIUrl":"https://doi.org/10.3329/bmrcb.v48i1.60655","url":null,"abstract":"Background: Social networking sites (SNSs) have changed the ways that we interact with each other. The use of social networking sites by adolescents is addictive, with numerous negative consequences. Various factors influence social networking sites addiction among adolescents.\u0000Objective: We aimed to determine the prevalence of gender-specific social networking sites addiction among adolescents and the factors influence social networking sites addiction.\u0000Methods: A quantitative, cross-sectional community-based research was conducted by face-to-face interviews among adolescents in all 11 administrative divisions of Sarawak, Malaysia. The multistage cluster sampling technique was followed, with an adolescent selected systematically from each household. An adapted and validated questionnaire, which included 20 items of social networking sites addiction, was used to collect data. We analysed 1344 adolescent’s data using IBM SPSS Version 22.0. A partial least square structural path with mediation analysis was done using WarpPLS version 7.0.\u0000Results: Three-quarters of the adolescents (76.2%) used social networking sites, but only two-fifths of them (40.4%) were addicted, with 15% having moderate-severe addiction to social networking sites. The most frequently used social networking sites was YouTube (77.9%), followed by Facebook (75.2%) and Instagram (59.0%). Self-esteem had a negative correlation, while adolescent risk behaviours directly affected social networking sites addiction (p<0.001). The most potent predictors for social networking sites addiction were YouTube, Instagram, and Pinterest (p<0.05).\u0000Conclusion: Tackling risk behaviours and enhancing adolescents’ self-esteem would reduce the tendency to be addicted to social networking sites.\u0000Bangladesh Med Res Counc Bull 2022; 48(1): 10-20 ","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42192509","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 : 2022-05-17DOI: 10.3329/bmrcb.v47i1.55806
Maftahul Jannat, S. Dey
Background: Anton’s syndrome is a rare syndrome characterised by denial of blindness by a patient who obviously cannot see. Visual anosognosia and usually caused by bilateral occipital infarct. Rarely caused by demyelination or haemorrhage. Objective: The aim was to report a case of Anton’s syndrome due to bilateral occipito-parietal lobar haemorrhage following percutaneous coronary intervention due to myocardial infarction. Methods: The case was thoroughly evaluated clinically then diagnosis was confirmed by CT scan of head showing bilateral occipito-parietal haemorrhage. Result: The possible cause of bilateral lobar haemorrhage was due to use of Heparin during procedure and duel antiplatelet after percutaneous coronary intervention. Conclusion: A suspicion of cortical blindness and Anton’s syndrome should be raised in patients with atypical visual loss and evidence of bilateral occipital lobe injury. Though infarction is the common cause but any other cause that leads to bilateral occipital damage like haemorrhage in this patient may cause this syndrome. Drug induced extensive intracerabral haemorrhage is difficult to manage in the setting of myocardial infarction. Bangladesh Med Res Counc Bull 2021; 47(1): 98-100
{"title":"Anton’s Syndrome Due to Bilateral Occipito-Parietal Haemorrhage: A Case Report","authors":"Maftahul Jannat, S. Dey","doi":"10.3329/bmrcb.v47i1.55806","DOIUrl":"https://doi.org/10.3329/bmrcb.v47i1.55806","url":null,"abstract":"Background: Anton’s syndrome is a rare syndrome characterised by denial of blindness by a patient who obviously cannot see. Visual anosognosia and usually caused by bilateral occipital infarct. Rarely caused by demyelination or haemorrhage.\u0000Objective: The aim was to report a case of Anton’s syndrome due to bilateral occipito-parietal lobar haemorrhage following percutaneous coronary intervention due to myocardial infarction.\u0000Methods: The case was thoroughly evaluated clinically then diagnosis was confirmed by CT scan of head showing bilateral occipito-parietal haemorrhage.\u0000Result: The possible cause of bilateral lobar haemorrhage was due to use of Heparin during procedure and duel antiplatelet after percutaneous coronary intervention.\u0000Conclusion: A suspicion of cortical blindness and Anton’s syndrome should be raised in patients with atypical visual loss and evidence of bilateral occipital lobe injury. Though infarction is the common cause but any other cause that leads to bilateral occipital damage like haemorrhage in this patient may cause this syndrome. Drug induced extensive intracerabral haemorrhage is difficult to manage in the setting of myocardial infarction.\u0000Bangladesh Med Res Counc Bull 2021; 47(1): 98-100 ","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43935567","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 : 2022-05-17DOI: 10.3329/bmrcb.v47i2.57785
M. Hussain, A. Bashar, A. H. Z. H. Shikder
Background: Root canal treatment is the usual management of acute irreversible pulpitis of mature permanent teeth. MTA Pulpotomy can be used to treat acute irreversible pulpitis of an adult HIV-Positive patient alternative to root canal treatment as it is less invasive and one-step endodontic therapy. Objective: The aim was to evaluate the outcome of MTA Pulpotomy alternative to root canal treatment to manage acute irreversible pulpitis of an adult HIV-positive patient. Methods: Based on history, clinical and radiological examination the case was diagnosed as acute irreversible pulpitis on the mandibular left 2nd molar tooth in a patient who was HIV-positive and under treatment for 16 years. After anaesthetising and isolation with rubber dam coronal pulp was completely removed and MTA (Angelus, Brazil) was placed over the pulp chamber floor covering the canal orifices, and the rest of the cavity was sealed with glass-ionomer filling over the set MTA. The severity of postoperative pain was assessed by a visual analog scale after 24 hours, 48 hours, 72 hours, and 7 days. The incidence of any clinical symptoms or periapical pathology was determined using clinical and radiographic evaluation after 3-month, 6 months, and 1-year intervals. Results: Throughout the follow-up period, the patient was asymptomatic and there was no periapical pathology at the radiograph even at the end of one year. Conclusion: As a less invasive and single sitting short procedure, MTA pulpotomy can be done to treat acute irreversible pulpitis in the HIV-positive patient as an alternative to root canal treatment. Bangladesh Med Res Counc Bull 2021; 47(2): 230-234
{"title":"Alternative Management of Acute Irreversible Pulpitis of an Adult HIV-Positive Patient: A Case Report","authors":"M. Hussain, A. Bashar, A. H. Z. H. Shikder","doi":"10.3329/bmrcb.v47i2.57785","DOIUrl":"https://doi.org/10.3329/bmrcb.v47i2.57785","url":null,"abstract":"Background: Root canal treatment is the usual management of acute irreversible pulpitis of mature permanent teeth. MTA Pulpotomy can be used to treat acute irreversible pulpitis of an adult HIV-Positive patient alternative to root canal treatment as it is less invasive and one-step endodontic therapy.\u0000Objective: The aim was to evaluate the outcome of MTA Pulpotomy alternative to root canal treatment to manage acute irreversible pulpitis of an adult HIV-positive patient.\u0000Methods: Based on history, clinical and radiological examination the case was diagnosed as acute irreversible pulpitis on the mandibular left 2nd molar tooth in a patient who was HIV-positive and under treatment for 16 years. After anaesthetising and isolation with rubber dam coronal pulp was completely removed and MTA (Angelus, Brazil) was placed over the pulp chamber floor covering the canal orifices, and the rest of the cavity was sealed with glass-ionomer filling over the set MTA. The severity of postoperative pain was assessed by a visual analog scale after 24 hours, 48 hours, 72 hours, and 7 days. The incidence of any clinical symptoms or periapical pathology was determined using clinical and radiographic evaluation after 3-month, 6 months, and 1-year intervals.\u0000Results: Throughout the follow-up period, the patient was asymptomatic and there was no periapical pathology at the radiograph even at the end of one year.\u0000Conclusion: As a less invasive and single sitting short procedure, MTA pulpotomy can be done to treat acute irreversible pulpitis in the HIV-positive patient as an alternative to root canal treatment.\u0000Bangladesh Med Res Counc Bull 2021; 47(2): 230-234","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42256470","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 : 2022-05-17DOI: 10.3329/bmrcb.v47i2.57772
I. Jahan, Shah Nizam Uddin Shaon, D. Saha, S. Moni, S. Dey, M. Shahidullah
Background: Despite improvement in overall survival, neonatal period is not free of complications. Ventilator associated Pneumonia (VAP) is a serious complication and account for 6.8 - 32.2 % of healthcare associated infections among neonates. Objective: The objective of the study was to document the effectiveness of an educational programme for neonatal intensive care (NICU) service provider in preventing occurrence of ventilator associated pneumonia in NICU. Methods: It was a prospective cohort study compared with historical control taken from the hospital records. All neonates admitted to the NICU during 12 months period from May 2019 to April 2020 were enrolled. Prospective enrollment of ventilated baby after educational interventions was subjected to the VAP educational care bundle. Eligible neonates who spent more than 48 h on MV were followed up and monitored closely for the development of VAP. Detail history, thorough clinical examination, relevant investigation including chest radiography were carried out on all enrolled infants. Results: A total of 54 neonates ventilated newborn, 41 met the inclusion criteria and were enrolled in the current study; 22 cases in pre-intervention phase and 19 cases in the post- intervention phase. Among enrolled mechanically ventilated newborn, 18 patients (18/41, 44%) developed at least single episode of VAP during the ventilated period. Baseline characteristics were comparable in both the groups. The primary indication of mechanical ventilation was sepsis related complications during both the phases (9/22, 41% and 8/19, 42.1%). Next to sepsis, perinatal asphyxia (5/22, 22.7%) was the indication of MV in pre-intervention period whereas respiratory distress syndrome (7/19, 36.8%) was the second leading causes of MV during post-intervention period. Significant reduction in VAP incidence rate was observed after implementation of VAP interventions, as 13/22, 59 % episodes of VAP were diagnosed in pre-intervention period compared to 5/19, 26.3% were diagnosed during implementation period. (p = 0.035). Non-significant reduction in mean duration of MV days was observed in the post-intervention period when compared to pre-intervention counterpart (7.23±4.48 days versus 5.16±2.77 days, p = 0.089). There was no significant reduction in NICU length of stay (13.05±8.16 versus 11.58±7.75 days in pre and post intervention period respectively, p = 0.56). The difference in overall mortality rates between the two phases were 15/22, 68.18% and 10/19, 52.63% respectively and found to be non- significant. Gram negative bacteria were the most commonly isolated micro-organisms, Acinetobacter was the leading causative pathogen. Conclusion: It demonstrates that an educational program including bundle of infection control practice can reduce the occurrence of VAP during ventilation period. These educational programs for NICU care providers can be expanded to other NICU s of the country to prevent ventilator associated pneumonia.
{"title":"Effectiveness of Educational Intervention in Preventing Ventilator Associated Pneumonia in Neonatal Intensive Care Unit: A Cohort Study","authors":"I. Jahan, Shah Nizam Uddin Shaon, D. Saha, S. Moni, S. Dey, M. Shahidullah","doi":"10.3329/bmrcb.v47i2.57772","DOIUrl":"https://doi.org/10.3329/bmrcb.v47i2.57772","url":null,"abstract":"Background: Despite improvement in overall survival, neonatal period is not free of complications. Ventilator associated Pneumonia (VAP) is a serious complication and account for 6.8 - 32.2 % of healthcare associated infections among neonates.\u0000Objective: The objective of the study was to document the effectiveness of an educational programme for neonatal intensive care (NICU) service provider in preventing occurrence of ventilator associated pneumonia in NICU.\u0000Methods: It was a prospective cohort study compared with historical control taken from the hospital records. All neonates admitted to the NICU during 12 months period from May 2019 to April 2020 were enrolled. Prospective enrollment of ventilated baby after educational interventions was subjected to the VAP educational care bundle. Eligible neonates who spent more than 48 h on MV were followed up and monitored closely for the development of VAP. Detail history, thorough clinical examination, relevant investigation including chest radiography were carried out on all enrolled infants.\u0000Results: A total of 54 neonates ventilated newborn, 41 met the inclusion criteria and were enrolled in the current study; 22 cases in pre-intervention phase and 19 cases in the post- intervention phase. Among enrolled mechanically ventilated newborn, 18 patients (18/41, 44%) developed at least single episode of VAP during the ventilated period. Baseline characteristics were comparable in both the groups. The primary indication of mechanical ventilation was sepsis related complications during both the phases (9/22, 41% and 8/19, 42.1%). Next to sepsis, perinatal asphyxia (5/22, 22.7%) was the indication of MV in pre-intervention period whereas respiratory distress syndrome (7/19, 36.8%) was the second leading causes of MV during post-intervention period. Significant reduction in VAP incidence rate was observed after implementation of VAP interventions, as 13/22, 59 % episodes of VAP were diagnosed in pre-intervention period compared to 5/19, 26.3% were diagnosed during implementation period. (p = 0.035). Non-significant reduction in mean duration of MV days was observed in the post-intervention period when compared to pre-intervention counterpart (7.23±4.48 days versus 5.16±2.77 days, p = 0.089). There was no significant reduction in NICU length of stay (13.05±8.16 versus 11.58±7.75 days in pre and post intervention period respectively, p = 0.56). The difference in overall mortality rates between the two phases were 15/22, 68.18% and 10/19, 52.63% respectively and found to be non- significant. Gram negative bacteria were the most commonly isolated micro-organisms, Acinetobacter was the leading causative pathogen.\u0000Conclusion: It demonstrates that an educational program including bundle of infection control practice can reduce the occurrence of VAP during ventilation period. These educational programs for NICU care providers can be expanded to other NICU s of the country to prevent ventilator associated pneumonia.\u0000","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46362196","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 : 2022-05-17DOI: 10.3329/bmrcb.v47i2.57776
Fatema Nurjahan, Mahfuja Begum Shumi, S. Begum
Background: Metabolic syndrome (MetS) is a complex metabolic disorder and with debilitating effects on many organs including lung function impairment. Hyperhomocysteinaemia is caused by nutritional deficiency of vitamin B12 and folic acid can increase this risk further. Both the metabolic syndrome and hyperhomocysteinaemia adversely affect the lung function. But no study was found in Bangladeshi MetS in this regard. Objective: To assess the relationship of lung function with serum homocysteine, vitamin B12 and folic acid level in metabolic syndrome. Methods: This cross-sectional study was conducted in the department of physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from November, 2019 to April, 2020. A total of 60 female subjects were selected with the age ranging from 25-45 year by purposive sampling. Among them 30 metabolic syndrome patients were included in the study group (group A) and 30 age and sex matched apparently healthy subjects constituted comparison group (group B). Serum homocysteine, vitamin B12, folic acid and other biochemical parameters and the lung function of all subjects were assessed. Data were expressed as mean±SD. Spirometric measures were expressed as percent of predicted value. Statistical analysis was done by Independent sample ‘t’ test and Pearson’s correlation coefficient test. Results: In this study, the mean percentage of predicted value of FVC, FEV1 and, PEFR were significantly lower (p<0.001) in group A than those of group B. The mean serum homocysteine level was higher and vitamin B12 and folic acid level were lower in metabolic syndrome patients compared to comparison group and the difference was statistically significant only for homocysteine (p<0.05). In addition, the FVC and FEV1 were significantly negatively correlated (p<0.05) with serum homocysteine and FVC was significantly positively correlated (p<0.05) with serum folic acid level in group A. Conclusion: The present study reveals that impairment of lung function is related to higher level of homocysteine and lower level of folic acid in metabolic syndrome. Bangladesh Med Res Counc Bull 2021; 47(2): 175-180
{"title":"Relationship of lung function with homocysteine, vitamin B12 and folic acid level in metabolic syndrome","authors":"Fatema Nurjahan, Mahfuja Begum Shumi, S. Begum","doi":"10.3329/bmrcb.v47i2.57776","DOIUrl":"https://doi.org/10.3329/bmrcb.v47i2.57776","url":null,"abstract":"Background: Metabolic syndrome (MetS) is a complex metabolic disorder and with debilitating effects on many organs including lung function impairment. Hyperhomocysteinaemia is caused by nutritional deficiency of vitamin B12 and folic acid can increase this risk further. Both the metabolic syndrome and hyperhomocysteinaemia adversely affect the lung function. But no study was found in Bangladeshi MetS in this regard.\u0000Objective: To assess the relationship of lung function with serum homocysteine, vitamin B12 and folic acid level in metabolic syndrome.\u0000Methods: This cross-sectional study was conducted in the department of physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from November, 2019 to April, 2020. A total of 60 female subjects were selected with the age ranging from 25-45 year by purposive sampling. Among them 30 metabolic syndrome patients were included in the study group (group A) and 30 age and sex matched apparently healthy subjects constituted comparison group (group B). Serum homocysteine, vitamin B12, folic acid and other biochemical parameters and the lung function of all subjects were assessed. Data were expressed as mean±SD. Spirometric measures were expressed as percent of predicted value. Statistical analysis was done by Independent sample ‘t’ test and Pearson’s correlation coefficient test.\u0000Results: In this study, the mean percentage of predicted value of FVC, FEV1 and, PEFR were significantly lower (p<0.001) in group A than those of group B. The mean serum homocysteine level was higher and vitamin B12 and folic acid level were lower in metabolic syndrome patients compared to comparison group and the difference was statistically significant only for homocysteine (p<0.05). In addition, the FVC and FEV1 were significantly negatively correlated (p<0.05) with serum homocysteine and FVC was significantly positively correlated (p<0.05) with serum folic acid level in group A.\u0000Conclusion: The present study reveals that impairment of lung function is related to higher level of homocysteine and lower level of folic acid in metabolic syndrome.\u0000Bangladesh Med Res Counc Bull 2021; 47(2): 175-180","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45137398","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 : 2022-05-17DOI: 10.3329/bmrcb.v47i1.55795
Sharmin Afroz, S. Begum, S. Shahjadi, Umme Raihan Siddiqi, Nusrat Mahruba
Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that may cause lifelong disability. The aetiology of ASD involves gene-environmental interaction. Vitamin D plays an important role in brain development and maturation. Objective: This study was aimed to compare serum vitamin D in children with autism spectrum disorder with that of the healthy control. Methods: This case-control study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Blood sample from 50 diagnosed children with ASD and 50 apparently healthy children among 3 to 10 years age group, were tested for serum 25(OH) D. To assess the association independent t test and chi square test were done by using SPSS. Results: The mean serum vitamin D levels of both the groups were lower than the normal reference value. Again, the mean serum vitamin D was lower in ASD compared to that of control, but the difference was statistically non-significant. Among ASD children, 38.0% had deficient, 42.0% had insufficient and 20.0% had sufficient serum vitamin D. Among healthy children, 36.0% had deficient, 30.0% had insufficient and 34.0% had sufficient serum vitamin D level. However, vitamin D deficiency and insufficiency was not associated with ASD. Conclusion: It may be concluded that, vitamin D deficiency is prevalent in Bangladesh among both ASD children and apparently healthy control and the mean serum vitamin D was lower in ASD children compared to that of healthy control, but the difference was statistically non-significant. Therefore, for proper growth and development more outdoor activity and adequate dietary intake of vitamin D rich food are recommended to overcome the situation. Bangladesh Med Res Counc Bull 2021; 47(1): 29-33
{"title":"Evaluation of Serum Vitamin D in Children with Autism Spectrum Disorder","authors":"Sharmin Afroz, S. Begum, S. Shahjadi, Umme Raihan Siddiqi, Nusrat Mahruba","doi":"10.3329/bmrcb.v47i1.55795","DOIUrl":"https://doi.org/10.3329/bmrcb.v47i1.55795","url":null,"abstract":"Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that may cause lifelong disability. The aetiology of ASD involves gene-environmental interaction. Vitamin D plays an important role in brain development and maturation.\u0000Objective: This study was aimed to compare serum vitamin D in children with autism spectrum disorder with that of the healthy control.\u0000Methods: This case-control study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Blood sample from 50 diagnosed children with ASD and 50 apparently healthy children among 3 to 10 years age group, were tested for serum 25(OH) D. To assess the association independent t test and chi square test were done by using SPSS.\u0000Results: The mean serum vitamin D levels of both the groups were lower than the normal reference value. Again, the mean serum vitamin D was lower in ASD compared to that of control, but the difference was statistically non-significant. Among ASD children, 38.0% had deficient, 42.0% had insufficient and 20.0% had sufficient serum vitamin D. Among healthy children, 36.0% had deficient, 30.0% had insufficient and 34.0% had sufficient serum vitamin D level. However, vitamin D deficiency and insufficiency was not associated with ASD.\u0000Conclusion: It may be concluded that, vitamin D deficiency is prevalent in Bangladesh among both ASD children and apparently healthy control and the mean serum vitamin D was lower in ASD children compared to that of healthy control, but the difference was statistically non-significant. Therefore, for proper growth and development more outdoor activity and adequate dietary intake of vitamin D rich food are recommended to overcome the situation.\u0000Bangladesh Med Res Counc Bull 2021; 47(1): 29-33","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42394310","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 : 2022-05-17DOI: 10.3329/bmrcb.v47i2.57779
M. Khalil, Narayan Chandra Kundu, Serajoom Munira, M. Jahan, Md. Ridwanur Rahman
Background: Parkinson’s disease dementia (PDD) is a common consequence during the course of the disease. It deeply influences patients’ prognosis, quality of life, caregiver burden and economic strain. However, effective treatment for PDD is currently unclear. Clinical and demographic predictors for this comorbidity are not well studied. Objectives: To investigate putative risk factors for the development of dementia in patients with Parkinson’s disease (PD) attending a tertiary care and teaching hospital in Bangladesh. Methods: One hundred thirty-one consecutive PD cases were enrolled in this cross-sectional study; whose disease duration was more than a year. Comparison was done between demented and non-demented PD cases. Structural CNS diseases including secondary parkinsonism were excluded by clinically and MRI of brain for all cases. Dementia was evaluated based by DSM-IV and assessed using mini-mental state examination (MMSE) score and Parkinson’s disease dementia short screen (PDD-SS) score. Severity of disease was evaluated by Hoehn and Yahr stage (H-Y I to V). Depression was assessed using DSM-IV. Data were analysed on a logistic regression model using SPSS v 23. Results: The overall frequency of dementia was 38%. The mean (SD) age of the demented and non-demented PD cases was 73.32(8.86) and 63.98 (6.19) years respectively. On multivariate logistic regression model, age ³70 years [OR=4.25, p=0.031], diabetes [OR=5.37, p=0.019], hypertension [OR=7.63, p=0.011], disease duration ³5 years [OR=10.01, p<0.001], H-Y stage e” 3 [OR= 9.52, p<0.001] and depression [OR=8.79, p<0.001] were significantly associated with PDD. Conclusion: In this study of PD cases, overall risks of dementia were advancing age, diabetes, hypertension, longer disease duration, higher disease stage and presence of depressive illness. Bangladesh Med Res Counc Bull 2021; 47(2): 192-198
{"title":"Predictors of Parkinson’s disease Dementia in a Sample of Bangladeshi Patients","authors":"M. Khalil, Narayan Chandra Kundu, Serajoom Munira, M. Jahan, Md. Ridwanur Rahman","doi":"10.3329/bmrcb.v47i2.57779","DOIUrl":"https://doi.org/10.3329/bmrcb.v47i2.57779","url":null,"abstract":"Background: Parkinson’s disease dementia (PDD) is a common consequence during the course of the disease. It deeply influences patients’ prognosis, quality of life, caregiver burden and economic strain. However, effective treatment for PDD is currently unclear. Clinical and demographic predictors for this comorbidity are not well studied.\u0000Objectives: To investigate putative risk factors for the development of dementia in patients with Parkinson’s disease (PD) attending a tertiary care and teaching hospital in Bangladesh.\u0000Methods: One hundred thirty-one consecutive PD cases were enrolled in this cross-sectional study; whose disease duration was more than a year. Comparison was done between demented and non-demented PD cases. Structural CNS diseases including secondary parkinsonism were excluded by clinically and MRI of brain for all cases. Dementia was evaluated based by DSM-IV and assessed using mini-mental state examination (MMSE) score and Parkinson’s disease dementia short screen (PDD-SS) score. Severity of disease was evaluated by Hoehn and Yahr stage (H-Y I to V). Depression was assessed using DSM-IV. Data were analysed on a logistic regression model using SPSS v 23.\u0000Results: The overall frequency of dementia was 38%. The mean (SD) age of the demented and non-demented PD cases was 73.32(8.86) and 63.98 (6.19) years respectively. On multivariate logistic regression model, age\u0000³70 years [OR=4.25, p=0.031], diabetes [OR=5.37, p=0.019], hypertension [OR=7.63, p=0.011], disease duration\u0000³5 years [OR=10.01, p<0.001], H-Y stage e” 3 [OR= 9.52, p<0.001] and depression [OR=8.79, p<0.001] were significantly associated with PDD.\u0000Conclusion: In this study of PD cases, overall risks of dementia were advancing age, diabetes, hypertension, longer disease duration, higher disease stage and presence of depressive illness.\u0000Bangladesh Med Res Counc Bull 2021; 47(2): 192-198","PeriodicalId":8704,"journal":{"name":"Bangladesh Medical Research Council Bulletin","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46089264","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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