Pub Date : 2020-06-01DOI: 10.3329/jcmcta.v31i1.66752
R. H. Chowdhury, S. Chowdhury, Tasnuva Tanzil, M. Alam
A 61-year-old man known to have metastatic prostate adenocarcinoma was seen at Changi General Hospital, Singapore, because of severe hypokalaemia due to ACTH dependent Cushing’s syndrome. He underwent a Dotate PET CT which showed increased DOTA-NOC-avidity in the right side of the prostate gland. Subsequent immunohistochemical staining of prostate biopsy sample documented ACTH, synaptophysin and CD 56 positivity. He was suggested medical management for prostate cancer complicated by Cushing's syndrome. Unfortunately, Cushing’s syndrome was not controlled and the patient’s clinical condition progressively worsened. Subsequently, he developed fatal sepsis due to immunocompromised state. This case report describes a case of Cushing’s syndrome due to metastatic adenocarcinoma of the prostate, a tumour with very few therapeutic options and negative prognosis. JCMCTA 2020 ; 31 (1) : 125-129
在新加坡樟宜总医院，一名61岁男性因ACTH依赖性库欣综合征导致的严重低钾血症而被确诊为转移性前列腺癌。他接受了Dotate PET CT检查，显示前列腺右侧dota - noc贪婪度增加。随后前列腺活检样本的免疫组化染色显示ACTH、synaptophysin和cd56阳性。医生建议他进行前列腺癌合并库欣综合征的治疗。不幸的是，库欣综合征没有得到控制，患者的临床状况逐渐恶化。随后，由于免疫功能低下，他发生了致命的败血症。本病例报告描述了一例因转移性前列腺腺癌引起的库欣综合征，这种肿瘤治疗选择很少，预后不良。Jcmcta 2020;31 (1): 125-129
{"title":"Ectopic Cushing’s Syndrome From Prostatic Adenocarcinoma: A Rare Clinical Entity","authors":"R. H. Chowdhury, S. Chowdhury, Tasnuva Tanzil, M. Alam","doi":"10.3329/jcmcta.v31i1.66752","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.66752","url":null,"abstract":"A 61-year-old man known to have metastatic prostate adenocarcinoma was seen at Changi General Hospital, Singapore, because of severe hypokalaemia due to ACTH dependent Cushing’s syndrome. He underwent a Dotate PET CT which showed increased DOTA-NOC-avidity in the right side of the prostate gland. Subsequent immunohistochemical staining of prostate biopsy sample documented ACTH, synaptophysin and CD 56 positivity. He was suggested medical management for prostate cancer complicated by Cushing's syndrome. Unfortunately, Cushing’s syndrome was not controlled and the patient’s clinical condition progressively worsened. Subsequently, he developed fatal sepsis due to immunocompromised state. This case report describes a case of Cushing’s syndrome due to metastatic adenocarcinoma of the prostate, a tumour with very few therapeutic options and negative prognosis. \u0000JCMCTA 2020 ; 31 (1) : 125-129","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90244606","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.65827
Md Khurshid Alam Sarwar, T. Chowdhury, M. G. Habib, Rajib Khastagir, Adnan Walid
Background: Hypospadias a very common condition in the children and the incidence is increasing. Here we present our experience of managing hypospadias patients over the last five years. Materials and methods: It was a retrospective study from 2014 to 2018 in the Department of Pediatric Surgery, Chattogram Medical College Hospital. Records of all hypospadias patients were analyzed and type of hypospadias, age at repair, type of repair and admission with complication of hypospadias were recorded. Results: A total of 492 boys were admitted with the diagnosis of hypospadias and 272 boys underwent hypospadias surgery. Distal penile hypospadias (148 patients, 30%) was the commonest variety followed by coronal hypospadias (144 patients, 29%). Age at surgery ranged from 6 months to 19 years with a mean age of 7±4 years. General anesthesia was given in 133 patients (64.7%) spinal anesthesia in 93 patients (31.8%) local anesthesia in 7 patients (2.4%) and caudal block in 3 patients (1%). Urethro-cutaneous fistula, failed urethroplasty and meatal stenosis are the admissions with hypospadias complications. Conclusion: Hypospadias is still common with substantial number of complications. Health education is necessary to reduce age at surgery. JCMCTA 2020 ; 31 (1) : 38-41
{"title":"Hypospadias Repair in Children: A 5-Year Experience from a Pediatric Surgery Department of Chittagong Medical College","authors":"Md Khurshid Alam Sarwar, T. Chowdhury, M. G. Habib, Rajib Khastagir, Adnan Walid","doi":"10.3329/jcmcta.v31i1.65827","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.65827","url":null,"abstract":"Background: Hypospadias a very common condition in the children and the incidence is increasing. Here we present our experience of managing hypospadias patients over the last five years. \u0000Materials and methods: It was a retrospective study from 2014 to 2018 in the Department of Pediatric Surgery, Chattogram Medical College Hospital. Records of all hypospadias patients were analyzed and type of hypospadias, age at repair, type of repair and admission with complication of hypospadias were recorded. \u0000Results: A total of 492 boys were admitted with the diagnosis of hypospadias and 272 boys underwent hypospadias surgery. Distal penile hypospadias (148 patients, 30%) was the commonest variety followed by coronal hypospadias (144 patients, 29%). Age at surgery ranged from 6 months to 19 years with a mean age of 7±4 years. General anesthesia was given in 133 patients (64.7%) spinal anesthesia in 93 patients (31.8%) local anesthesia in 7 patients (2.4%) and caudal block in 3 patients (1%). Urethro-cutaneous fistula, failed urethroplasty and meatal stenosis are the admissions with hypospadias complications. \u0000Conclusion: Hypospadias is still common with substantial number of complications. Health education is necessary to reduce age at surgery. \u0000JCMCTA 2020 ; 31 (1) : 38-41","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83255310","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.66339
Md. Razibul Alam, M. S. Arefin, Md Abdul Mumit Sarkar, Ma Ohab, M. Rahman, Md. Anwarul Kabir
Background: Clarithromycin resistance globally has challenged the success of conventional Clarithromycin based triple therapy for Helicobacter Pylori eradication. Levofloxacin has primarily been considered as a second-line treatment but may also be used as primary therapy. Recently, some studies have evaluated its efficacy as a valid alternative to standard antibiotics as first-line therapy for H. pylori infection. This study was intended to assess the eradication success of Levofloxacin based first-line triple therapy and also to see it’s compliance & adverse effect profile. Materials and methods: This non-randomized single-arm clinical trial was carried out in the Department of Gastroenterology, BSMMU from March 2016 to March 2017 involving 123 H. pylori-positive patients with endoscopically proven peptic ulcer disease to assess the eradication success of levofloxacin based first-line triple therapy and also to see its compliance and adverse effect profile. H. pylori status were detected by urea breath test. Patients were treated with amoxycillin 1 gm 12 hourly, levofloxacin 500 mg 12 hourly and omeprazole 20 mg 12 hourly for 14 days and were followed-up at 2 months after completion of therapy for repeat urea breath test. Results: A total of 97 patients returned for followup. Male proportion was 63.41% and female was 36.58% with the median age of 57 years. On intention-to-treat analysis, the eradication rate of H. pylori was 65.85% and on per-protocol analysis, it was 83.50%. Total 15.44% patients developed adverse effects, all were mild to moderate in nature. One patient discontinued treatment because of epigastric pain and vomiting. Conclusion: Levofloxacin-based therapy was effective, well-tolerated and compliance was excellent; but the eradication rate was not satisfactory. JCMCTA 2020 ; 31 (1) : 102-107
{"title":"Helicobacter Pylori Eradication by Levofloxacin Based Triple Therapy in Patients with Peptic Ulcer Disease","authors":"Md. Razibul Alam, M. S. Arefin, Md Abdul Mumit Sarkar, Ma Ohab, M. Rahman, Md. Anwarul Kabir","doi":"10.3329/jcmcta.v31i1.66339","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.66339","url":null,"abstract":"Background: Clarithromycin resistance globally has challenged the success of conventional Clarithromycin based triple therapy for Helicobacter Pylori eradication. Levofloxacin has primarily been considered as a second-line treatment but may also be used as primary therapy. Recently, some studies have evaluated its efficacy as a valid alternative to standard antibiotics as first-line therapy for H. pylori infection. This study was intended to assess the eradication success of Levofloxacin based first-line triple therapy and also to see it’s compliance & adverse effect profile. \u0000Materials and methods: This non-randomized single-arm clinical trial was carried out in the Department of Gastroenterology, BSMMU from March 2016 to March 2017 involving 123 H. pylori-positive patients with endoscopically proven peptic ulcer disease to assess the eradication success of levofloxacin based first-line triple therapy and also to see its compliance and adverse effect profile. H. pylori status were detected by urea breath test. Patients were treated with amoxycillin 1 gm 12 hourly, levofloxacin 500 mg 12 hourly and omeprazole 20 mg 12 hourly for 14 days and were followed-up at 2 months after completion of therapy for repeat urea breath test. \u0000Results: A total of 97 patients returned for followup. Male proportion was 63.41% and female was 36.58% with the median age of 57 years. On intention-to-treat analysis, the eradication rate of H. pylori was 65.85% and on per-protocol analysis, it was 83.50%. Total 15.44% patients developed adverse effects, all were mild to moderate in nature. One patient discontinued treatment because of epigastric pain and vomiting. \u0000Conclusion: Levofloxacin-based therapy was effective, well-tolerated and compliance was excellent; but the eradication rate was not satisfactory. \u0000 JCMCTA 2020 ; 31 (1) : 102-107","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"14 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78402528","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.65863
Tanuja Tanzin, Md Iftekher Iqbal
Background: To assess the efficacy of pterygium excision and conjunctival autograft surgery among patients underwent autologous blood clot or using sutures (10-0 monofilament nylon). Materials and methods: A randomized controlled trial was done at Department of Ophthalmology, Chittagong Medical College Hospital, with a study period from February 2017 to November 2018 was conducted with 60 eyes from 60 patients having primary nasal pterygium. They were selected according to inclusion and exclusion criteria and randomized into two groups for conjunctival autograft. Group A (30) was treated with autologous blood clot and Group B (30) was treated with sutures (10-0 monofilament nylon). All surgeries were performed by a single surgeon at single center. Standard examinations were performed preoperatively and postoperatively, preoperative and postoperative outcomes were evaluated and compared statistically where follow up was done at 1st day,7th days, 1-month, 3-month, and 6-month post operation. The mainoutcome variables were postoperative discomfort, graft stability and complications. Results: This study included 60 patients (60 eyes) with a mean age of 46.77±7.04 (SD) (Range 33 to 58 years) in Group A (30) and 46.17±7.53 (SD) (Range 22 to 58 years) in Group B (30). In Group A, male was 22 (73.3%) and female was 8 (26.7%) where Group Bcontained male 20 (66.7%) and female 10 (33.3%). Follow-up at 1st and 7th post operation days showed marked discomfort in Group B (Mean rank 41.82 and 40.62) compared to Group A (Mean rank 19.18 and 20.38) respectively (p<0.001). At 1st post operation day there were 3 (10%) graft retraction in Group Aonly. Within 6 months follow-up, all grafts were stable and there wasonly 1 (3.3%) granuloma in Group B. Conclusion: In primary pterygium excision, autologous blood clot showed excellent post- operative outcomes with much comfort, more stableas well as fewer complications. So, it appears to be an effective means to treat primary pterygium surgically. JCMCTA 2020 ; 31 (1) : 42-47
{"title":"Efficacy of Autologous Blood Clot in Primary Pterygium Excision Compared with Suture Technique","authors":"Tanuja Tanzin, Md Iftekher Iqbal","doi":"10.3329/jcmcta.v31i1.65863","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.65863","url":null,"abstract":"Background: To assess the efficacy of pterygium excision and conjunctival autograft surgery among patients underwent autologous blood clot or using sutures (10-0 monofilament nylon). \u0000Materials and methods: A randomized controlled trial was done at Department of Ophthalmology, Chittagong Medical College Hospital, with a study period from February 2017 to November 2018 was conducted with 60 eyes from 60 patients having primary nasal pterygium. They were selected according to inclusion and exclusion criteria and randomized into two groups for conjunctival autograft. Group A (30) was treated with autologous blood clot and Group B (30) was treated with sutures (10-0 monofilament nylon). All surgeries were performed by a single surgeon at single center. Standard examinations were performed preoperatively and postoperatively, preoperative and postoperative outcomes were evaluated and compared statistically where follow up was done at 1st day,7th days, 1-month, 3-month, and 6-month post operation. The mainoutcome variables were postoperative discomfort, graft stability and complications. \u0000Results: This study included 60 patients (60 eyes) with a mean age of 46.77±7.04 (SD) (Range 33 to 58 years) in Group A (30) and 46.17±7.53 (SD) (Range 22 to 58 years) in Group B (30). In Group A, male was 22 (73.3%) and female was 8 (26.7%) where Group Bcontained male 20 (66.7%) and female 10 (33.3%). Follow-up at 1st and 7th post operation days showed marked discomfort in Group B (Mean rank 41.82 and 40.62) compared to Group A (Mean rank 19.18 and 20.38) respectively (p<0.001). At 1st post operation day there were 3 (10%) graft retraction in Group Aonly. Within 6 months follow-up, all grafts were stable and there wasonly 1 (3.3%) granuloma in Group B. \u0000Conclusion: In primary pterygium excision, autologous blood clot showed excellent post- operative outcomes with much comfort, more stableas well as fewer complications. So, it appears to be an effective means to treat primary pterygium surgically. \u0000JCMCTA 2020 ; 31 (1) : 42-47","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85685332","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.65874
Sharmista Bhattacharjee, M. Ashrafuzzaman, Ruma Chakraborty
Background: Foot is a complex, multi-segmented structure. Each segment act in a coordinated manner to provide support and absorb shock during locomotion. Foot morphology differs among population groups. The objectives of this study were to determine the selected foot dimensions and foot shape of adult Bangalee females to find out any ethnic characteristics of their own. Materials and methods: The study was conducted on 200 Bangalee adult females within 18-44 years age. Foot length and foot breadth were measured by slide caliper. Foot index was calculated from foot length and foot breadth. Foot shape was determined from foot index by using a pre determined formula. Results: The mean value for length, breadth and index of foot in Bangalee females were 22.91±0.79 cm, 8.55±0.4cm and 37.35±1.92 respectively. Most of the participants (68%) had standard foot shape. 17.5% women had slender foot whereas14% had broad foot shapes. Conclusion: The results of this study should be useful for anatomists, anthropologists and forensic experts. JCMCTA 2020 ; 31 (1) : 54-57
{"title":"Anthropometric Analysis of Foot Length, Breadth and Shape in Adult Bangalee Females of Chattogram: An Observational Study","authors":"Sharmista Bhattacharjee, M. Ashrafuzzaman, Ruma Chakraborty","doi":"10.3329/jcmcta.v31i1.65874","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.65874","url":null,"abstract":"Background: Foot is a complex, multi-segmented structure. Each segment act in a coordinated manner to provide support and absorb shock during locomotion. Foot morphology differs among population groups. The objectives of this study were to determine the selected foot dimensions and foot shape of adult Bangalee females to find out any ethnic characteristics of their own. \u0000Materials and methods: The study was conducted on 200 Bangalee adult females within 18-44 years age. Foot length and foot breadth were measured by slide caliper. Foot index was calculated from foot length and foot breadth. Foot shape was determined from foot index by using a pre determined formula. \u0000Results: The mean value for length, breadth and index of foot in Bangalee females were 22.91±0.79 cm, 8.55±0.4cm and 37.35±1.92 respectively. Most of the participants (68%) had standard foot shape. 17.5% women had slender foot whereas14% had broad foot shapes. \u0000Conclusion: The results of this study should be useful for anatomists, anthropologists and forensic experts. \u0000JCMCTA 2020 ; 31 (1) : 54-57","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76590409","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.66741
Shakera Ahmed, Rivu Chakraborty, O. S. Pulock, Shahed Anwar, F. Ahmed, A. Awal
Background: Doctors with inadequate knowledge and unfavorable practice in their own life will be sub-optimal in their performance in community. This study aimed to determine the Knowledge, Attitudeand Practice (KAP) regarding Brest Self Examination (BSE) Clinical Breast Examination (CBE) and mammographyas screening test for breast carcinoma among female doctors. Materials and methods: This cross-sectional study was conducted on working female doctors of Chittagong Medical College Hospital, a tertiary care hospital of Bangladesh. A semi-structured self-administered questionnaire was used for data collection which was consisted of four parts: i) Demographic characteristics ii) KAP about BSE iii) KAP about CBE iv) KAP about mammography. A total of 100 forms were distributed and 84 were returned back. Results: The mean (SD) age of the female doctors was 38.92 ±7.52 (Range, 27-59 years).Family history of Breast cancer was positive in 15.5% and 96.4% of the doctors were married, Out of those with positive family history, 4 (30.76%) were 1st degree relatives of the respondents. Regarding to their knowledge proportion of doctors had heard about BSE, CBE and mammography were 100%, 97.6% and 100% respectively. But proportion of doctors did not know the exact starting age for BSE and mammography were 61.9% and 11.9% respectively. Moreover, 13.1% didn’t know who should do the BSE, 11.9% reported that, trained nurse should do CBE, about 41% reported that CBE should be done by either mammography or ultrasonography. Regarding attitude majority considered BSE (100%), CBE (96.4%) and mammography (91.7%) as useful tool for early detection of breast cancer. Out of 36 doctors age 40 years 23.8% never practiced BSE and only 11.1% done mammography for themselves. Conclusion: Though doctors had positive attitude towards BSE, CBE and mammography as screening tests their knowledge and practices regarding these test were not optimal. Emphasis should be laid on BSE and CBE in undergraduate and postgraduate courses for doctors. JCMCTA 2020 ; 31 (1) : 48-53
{"title":"Knowledge, Attitudes and Practices Related to Breast Cancer Screening Among Female Doctors of a Tertiary Care Hospital in Bangladesh","authors":"Shakera Ahmed, Rivu Chakraborty, O. S. Pulock, Shahed Anwar, F. Ahmed, A. Awal","doi":"10.3329/jcmcta.v31i1.66741","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.66741","url":null,"abstract":"Background: Doctors with inadequate knowledge and unfavorable practice in their own life will be sub-optimal in their performance in community. This study aimed to determine the Knowledge, Attitudeand Practice (KAP) regarding Brest Self Examination (BSE) Clinical Breast Examination (CBE) and mammographyas screening test for breast carcinoma among female doctors. \u0000Materials and methods: This cross-sectional study was conducted on working female doctors of Chittagong Medical College Hospital, a tertiary care hospital of Bangladesh. A semi-structured self-administered questionnaire was used for data collection which was consisted of four parts: i) Demographic characteristics ii) KAP about BSE iii) KAP about CBE iv) KAP about mammography. A total of 100 forms were distributed and 84 were returned back. \u0000Results: The mean (SD) age of the female doctors was 38.92 ±7.52 (Range, 27-59 years).Family history of Breast cancer was positive in 15.5% and 96.4% of the doctors were married, Out of those with positive family history, 4 (30.76%) were 1st degree relatives of the respondents. Regarding to their knowledge proportion of doctors had heard about BSE, CBE and mammography were 100%, 97.6% and 100% respectively. But proportion of doctors did not know the exact starting age for BSE and mammography were 61.9% and 11.9% respectively. Moreover, 13.1% didn’t know who should do the BSE, 11.9% reported that, trained nurse should do CBE, about 41% reported that CBE should be done by either mammography or ultrasonography. Regarding attitude majority considered BSE (100%), CBE (96.4%) and mammography (91.7%) as useful tool for early detection of breast cancer. Out of 36 doctors age 40 years 23.8% never practiced BSE and only 11.1% done mammography for themselves. \u0000Conclusion: Though doctors had positive attitude towards BSE, CBE and mammography as screening tests their knowledge and practices regarding these test were not optimal. Emphasis should be laid on BSE and CBE in undergraduate and postgraduate courses for doctors. \u0000JCMCTA 2020 ; 31 (1) : 48-53","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90858410","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.66344
Md Ataul Karim, Md. Habibur Rahman, Md Habib Hassan, A. Zahed, M. Uddin, S. Sarkar
Background: Acute Kidney Injury (AKI) previously referred to as acute renal failure complicates acute care hospital admissions and intensive care unit patients. In AKI associated with sepsis and multiple organ failure, mortality is high and the outcome is usually determined bythe severity of the underlying disorder and other complications, rather than by kidney injury itself. Aim of our study was to evaluate the etiological profile of AKI in a tertiary care hospital like Chittagong Medical College Hospital (CMCH). Materials and methods: This observational study was conducted among 100 hospitalized patients in different wards of CMCH from November 2018 to April 2019. Patients were selected based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria of AKI. An increase in serum creatinine >0.3 mg/dl or >1.5 times the baseline and a fall of urine output <0.5 ml/kg/h for 6–12 h were the criteria for selection. A structured questionnaire was completed andbaseline level of serum creatinine, urine output were documented. Results: Out of 100 patients, 56 were males and 44 were females. Mean age of the patients was 40.89±12.74 years. Diabetes mellitus and Hypertension were the common comorbidities. Hypovolaemia and Sepsis were found to be most common cause which included diarrheal illness (27 patients) followed by Urinary Tract Infection (9 patients) and Community-Acquired Pneumonia (4 patients). Eleven patients had Surgical causes and only 8 had Obstetrical causes. Conclusion: Causes of AKI arepreventable and treatable. Timely appropriate management will reduce the incidence and improve the outcome of AKI. JCMCTA 2020 ; 31 (1) : 108-112
{"title":"Etiology of Acute Kidney Injury in Hospitalized Patients in a Tertiary Care Hospital","authors":"Md Ataul Karim, Md. Habibur Rahman, Md Habib Hassan, A. Zahed, M. Uddin, S. Sarkar","doi":"10.3329/jcmcta.v31i1.66344","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.66344","url":null,"abstract":"Background: Acute Kidney Injury (AKI) previously referred to as acute renal failure complicates acute care hospital admissions and intensive care unit patients. In AKI associated with sepsis and multiple organ failure, mortality is high and the outcome is usually determined bythe severity of the underlying disorder and other complications, rather than by kidney injury itself. Aim of our study was to evaluate the etiological profile of AKI in a tertiary care hospital like Chittagong Medical College Hospital (CMCH). \u0000Materials and methods: This observational study was conducted among 100 hospitalized patients in different wards of CMCH from November 2018 to April 2019. Patients were selected based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria of AKI. An increase in serum creatinine >0.3 mg/dl or >1.5 times the baseline and a fall of urine output <0.5 ml/kg/h for 6–12 h were the criteria for selection. A structured questionnaire was completed andbaseline level of serum creatinine, urine output were documented. \u0000Results: Out of 100 patients, 56 were males and 44 were females. Mean age of the patients was 40.89±12.74 years. Diabetes mellitus and Hypertension were the common comorbidities. Hypovolaemia and Sepsis were found to be most common cause which included diarrheal illness (27 patients) followed by Urinary Tract Infection (9 patients) and Community-Acquired Pneumonia (4 patients). Eleven patients had Surgical causes and only 8 had Obstetrical causes. \u0000Conclusion: Causes of AKI arepreventable and treatable. Timely appropriate management will reduce the incidence and improve the outcome of AKI. \u0000JCMCTA 2020 ; 31 (1) : 108-112","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85053019","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.65495
Mafruha Khanam, Aditi Banerjee, J. Jerin, Mohamed Mazih Fazyl
Background: The global infertility rates are increasing at an alarming pace.Standard semen analysis is the basic and initial investigation in clinical practice for understanding male infertility. The objective of this study is to evaluate male infertility by studying the quality of semen according to the WHO protocols, identify the semen abnormalities to correlate the relationship between semen parameters and infertile couples. Materials and methods: This is a cross-sectional prospective study conducted in Surgiscope Fertility Centre, Chattogram, Bangladesh over 9 months on 1348 couples who received services from the fertility centre from November 2018 to July 2019. Multiple variables were selected such as, patient parameters like age of the couple, smoking history, duration of infertility, semen abnormalities which were recorded and statistically analyzed. The procedure and reference values were according to the WHO guidelines 2010. Results: The minimum age of the patients was 19 and the maximum age of the patients was 60 with a mean age of 33.3 +/- 0.5 years.The majority of the patients whose wives conceived were between the ages of 34 to 44 years and the lowest number of patients whose wives conceived were 55+ years. Moreover,359 patients (26.63%) conceived while 989 patients (73.37%) did not conceive.No significant relationship between number of conceptions and addiction was recorded. There is a statistically significant negative relationship between total motile sperm and age of patient and a marginally positive relationship between the number of sperm and total motility. Conclusion: This study showed a higher incidence of abnormal semen quality among husbands of infertile couples in our population. This revealed the importance of emphasizing on the need for managing male infertility. JCMCTA 2020 ; 31 (1) : 13-18
{"title":"The Study of Semen Quality for Evaluation of Male Factor Infertility","authors":"Mafruha Khanam, Aditi Banerjee, J. Jerin, Mohamed Mazih Fazyl","doi":"10.3329/jcmcta.v31i1.65495","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.65495","url":null,"abstract":"Background: The global infertility rates are increasing at an alarming pace.Standard semen analysis is the basic and initial investigation in clinical practice for understanding male infertility. The objective of this study is to evaluate male infertility by studying the quality of semen according to the WHO protocols, identify the semen abnormalities to correlate the relationship between semen parameters and infertile couples. \u0000Materials and methods: This is a cross-sectional prospective study conducted in Surgiscope Fertility Centre, Chattogram, Bangladesh over 9 months on 1348 couples who received services from the fertility centre from November 2018 to July 2019. Multiple variables were selected such as, patient parameters like age of the couple, smoking history, duration of infertility, semen abnormalities which were recorded and statistically analyzed. The procedure and reference values were according to the WHO guidelines 2010. \u0000Results: The minimum age of the patients was 19 and the maximum age of the patients was 60 with a mean age of 33.3 +/- 0.5 years.The majority of the patients whose wives conceived were between the ages of 34 to 44 years and the lowest number of patients whose wives conceived were 55+ years. Moreover,359 patients (26.63%) conceived while 989 patients (73.37%) did not conceive.No significant relationship between number of conceptions and addiction was recorded. There is a statistically significant negative relationship between total motile sperm and age of patient and a marginally positive relationship between the number of sperm and total motility. \u0000 Conclusion: This study showed a higher incidence of abnormal semen quality among husbands of infertile couples in our population. This revealed the importance of emphasizing on the need for managing male infertility. \u0000JCMCTA 2020 ; 31 (1) : 13-18","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78781977","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: Metabolic syndrome is associated with both the development of Hypertension, Diabetes Mellitus and an increased risk of adverse cardiovascular outcome. It is considered aspro inflamatory state linked with low grade systemic inflammation. C- reactive protein is a powerful biomarker of chronic systemic inflammation. Aim of this study is to evaluate the relationship of Highsensitivity C-reactive Protein (hs-CRP) with the components of Metabolic Syndrome (MetS) among hospitalized patients. Materials and methods: 50 patients of 18 years and above with metabolic syndrome, attending outdoor or admitted to Medicine Department of Chittagong Medical College Hospital from January 2016 to December 2016 were enrolled for this cross sectional study. The National Cholesterol Education Panel (NCEP) ATP – III, 2001 criteria was used for the diagnosis of MetS. Results: hsCRP level was found increased in almost every components of MetSin univariate analysis but the differences were not statistically significant. Patients with MetS had higher value of hs-CRP than without MetS (5.18±1.98 Vs 3.51± 1.63mg/l) with a p value 0.023. Conclusions: Patients with metabolic syndrome had higher levels of hs-CRP than those without metabolic syndrome and hs-CRP levels increased directly with increasing number of its components. JCMCTA 2020 ; 31 (1) : 71-75
背景:代谢综合征与高血压、糖尿病的发展以及心血管不良结局的风险增加有关。它被认为是一种与低度全身炎症相关的炎性状态。C反应蛋白是慢性全身性炎症的一个强有力的生物标志物。本研究旨在探讨高敏c反应蛋白(hs-CRP)与住院患者代谢综合征(MetS)各组成部分的关系。材料与方法:选取2016年1月至2016年12月在吉大港医学院附属医院内科就诊或室外就诊的50例18岁及以上代谢综合征患者进行横断面研究。国家胆固醇教育小组(NCEP) ATP - III, 2001标准被用于诊断MetS。结果:在单因素分析中，几乎所有成分的hsCRP水平均升高，但差异无统计学意义。MetS患者hs-CRP高于无MetS患者(5.18±1.98 Vs 3.51±1.63mg/l)， p值为0.023。结论:代谢综合征患者hs-CRP水平高于无代谢综合征患者，且hs-CRP水平随其组分数量的增加而直接升高。Jcmcta 2020;31 (1): 71-75
{"title":"Relationship of High-Sensitivity C- Reactive Protein (Hs-Crp) with the Components of Metabolic Syndrome","authors":"Mirzaie Amir, Md. Abdur Rouf, Md Habib Hassan, Anupam Barua","doi":"10.3329/jcmcta.v31i1.65909","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.65909","url":null,"abstract":"Background: Metabolic syndrome is associated with both the development of Hypertension, Diabetes Mellitus and an increased risk of adverse cardiovascular outcome. It is considered aspro inflamatory state linked with low grade systemic inflammation. C- reactive protein is a powerful biomarker of chronic systemic inflammation. Aim of this study is to evaluate the relationship of Highsensitivity C-reactive Protein (hs-CRP) with the components of Metabolic Syndrome (MetS) among hospitalized patients. \u0000Materials and methods: 50 patients of 18 years and above with metabolic syndrome, attending outdoor or admitted to Medicine Department of Chittagong Medical College Hospital from January 2016 to December 2016 were enrolled for this cross sectional study. The National Cholesterol Education Panel (NCEP) ATP – III, 2001 criteria was used for the diagnosis of MetS. Results: hsCRP level was found increased in almost every components of MetSin univariate analysis but the differences were not statistically significant. Patients with MetS had higher value of hs-CRP than without MetS (5.18±1.98 Vs 3.51± 1.63mg/l) with a p value 0.023. \u0000Conclusions: Patients with metabolic syndrome had higher levels of hs-CRP than those without metabolic syndrome and hs-CRP levels increased directly with increasing number of its components. \u0000JCMCTA 2020 ; 31 (1) : 71-75","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90532476","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 : 2020-06-01DOI: 10.3329/jcmcta.v31i1.66338
Anjan Kumer Dey, F. Ahmed, S. Paul
Background: Different scoring systems are currently in use to stratify the severity of the acute pancreatitis to guide clinicians in triaging patients with the aim of improving outcomes. The Neutrophil-Lymphocyte Ratio (NLR) provides a rapid indication of the extent of an inflammatory process. Its value to predict the severity of acute pancreatitis has not been well studied. The aim of this study was to investigate the prognostic value of the NLR in acute pancreatitis patients. Materials and methods: This hospital based observational study was conducted at Medicine ward of Chittagong Medical College Hospital (CMCH) for one year period from January 2015 to December 2015. One hundred and four adult patients with a diagnosis of acute pancreatitis who fulfilled the defined inclusion and exclusion criteria were selected for the study. After obtaining informed consent clinical interviewing and physical examination were done according to predesigned case record form. Then blood was collected within one hour of admission. After getting the result, final selection were done following exclusion criteria. The patients were arranged into three groups according to NLR tertiles. Main outcome measures were intensive Care Unit (ICU)/High Dependency Unit (HDU) admission, Length of Stay (LOS) in the hospital and in-hospital mortality. Results: According to NLR tertiles, patients in the 3 tertile (NLR³7.6) had significantly more ICU/HDU admissions (40.6% vs. 0%), longer average LOS (7.91 vs. 4.03 days) and more death (12.5% vs. 0%) compared with those in the 1rd tertile (NLR< 3.6). The higher the NLR tertile, the Modified Early Warning Score (MEWS) also increased significantly. According to the ROC curve, NLR values were superior in predicting ICU/HDU admission and hospitalization for ³ 7 days compared to WBC and MEWS values. Conclusion: Elevation of the NLR during admission was significantly associated with severe acute pancreatitis and is a negative prognostic indicator in acute pancreatitis. It is superior to total WBC and modified MEWS in predicting adverse outcomes of acute pancreatitis. JCMCTA 2020 ; 31 (1) : 90-95
背景:目前使用不同的评分系统对急性胰腺炎的严重程度进行分层，以指导临床医生对患者进行分诊，以改善预后。中性粒细胞-淋巴细胞比率(NLR)提供了炎症过程程度的快速指示。其预测急性胰腺炎严重程度的价值尚未得到很好的研究。本研究的目的是探讨NLR在急性胰腺炎患者中的预后价值。材料与方法:本研究以医院为基础，于2015年1月至2015年12月在吉大港医学院附属医院内科病房进行为期一年的观察性研究。104名诊断为急性胰腺炎的成年患者符合定义的纳入和排除标准，被选为研究对象。在获得知情同意后，按照预先设计的病例记录表进行临床访谈和体格检查。入院后一小时内采血。得到结果后，按照排除标准进行最终选择。根据NLR分位数将患者分为三组。主要结局指标为重症监护病房(ICU)/高依赖病房(HDU)住院情况、住院时间(LOS)和院内死亡率。结果:与NLR< 3.6分位的患者相比，NLR³7.6分位的患者ICU/HDU入院率(40.6% vs. 0%)、平均LOS (7.91 vs. 4.03天)和死亡率(12.5% vs. 0%)均显著高于NLR< 3.6分位的患者。NLR分值越高，修正预警评分(MEWS)也显著增加。根据ROC曲线，与WBC和MEWS值相比，NLR值在预测ICU/HDU入院和住院³7 d方面优于WBC和MEWS值。结论:入院时NLR升高与严重急性胰腺炎显著相关，是急性胰腺炎的一个阴性预后指标。在预测急性胰腺炎的不良结局方面，它优于总白细胞计数和改良的MEWS。Jcmcta 2020;31 (1): 90-95
{"title":"Neutrophil Lymphocyte Ratio as a Prognostic Factor in Acute Pancreatitis","authors":"Anjan Kumer Dey, F. Ahmed, S. Paul","doi":"10.3329/jcmcta.v31i1.66338","DOIUrl":"https://doi.org/10.3329/jcmcta.v31i1.66338","url":null,"abstract":"Background: Different scoring systems are currently in use to stratify the severity of the acute pancreatitis to guide clinicians in triaging patients with the aim of improving outcomes. The Neutrophil-Lymphocyte Ratio (NLR) provides a rapid indication of the extent of an inflammatory process. Its value to predict the severity of acute pancreatitis has not been well studied. The aim of this study was to investigate the prognostic value of the NLR in acute pancreatitis patients. \u0000Materials and methods: This hospital based observational study was conducted at Medicine ward of Chittagong Medical College Hospital (CMCH) for one year period from January 2015 to December 2015. One hundred and four adult patients with a diagnosis of acute pancreatitis who fulfilled the defined inclusion and exclusion criteria were selected for the study. After obtaining informed consent clinical interviewing and physical examination were done according to predesigned case record form. Then blood was collected within one hour of admission. After getting the result, final selection were done following exclusion criteria. The patients were arranged into three groups according to NLR tertiles. Main outcome measures were intensive Care Unit (ICU)/High Dependency Unit (HDU) admission, Length of Stay (LOS) in the hospital and in-hospital mortality. \u0000Results: According to NLR tertiles, patients in the 3 tertile (NLR³7.6) had significantly more ICU/HDU admissions (40.6% vs. 0%), longer average LOS (7.91 vs. 4.03 days) and more death (12.5% vs. 0%) compared with those in the 1rd tertile (NLR< 3.6). The higher the NLR tertile, the Modified Early Warning Score (MEWS) also increased significantly. According to the ROC curve, NLR values were superior in predicting ICU/HDU admission and hospitalization for ³ 7 days compared to WBC and MEWS values. \u0000Conclusion: Elevation of the NLR during admission was significantly associated with severe acute pancreatitis and is a negative prognostic indicator in acute pancreatitis. It is superior to total WBC and modified MEWS in predicting adverse outcomes of acute pancreatitis. \u0000JCMCTA 2020 ; 31 (1) : 90-95","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89766220","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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