Pub Date : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67289
R. Biswas, M. Karim, E. Ullah, Mahmud Hassan Arif, Moinuddin A. Chowdhury, Mohammad Abu Sayeed Chowdhury, Sabrina Yusuf, Fatema Tooj Johra
Background: The COVID-19 pandemic emerged as a major public health emergency affecting the healthcare services all over the world. It is essential to analyze the epidemiological and clinical characteristics of patients with COVID-19 in different parts of our country. This study highlights clinical experience in managing patients with COVID-19 at a tertiary care centre in southeastern Bangladesh. Materials and methods: Clinical characteristics and outcomes of consecutive 199 adult patients admitted to Chittagong Medical College Hospital, Chattogram, Bangladesh, from February 1 to March 31, 2021 were studied in this prospective observational study. The diagnosis of SARS-CoV-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) on throat and/or nasopharyngeal swabs. All patients were managed according to the hospital’s consensus protocol and in accordance with National Guidelines on clinical management of COVID-19. Results: The median age of the patients was 57 years (Range: 20-102 years) and 118 (59.3%) were male. One hundred and thirty two (67.3%) patients had associated comorbid condition and diabetes (44.7%) and hypertension (33.3%) were the most common. Majority (57.3%) was classified as having moderate severity and mortality of 10.1% (20 patients) was observed. Elderly age (>60 years), diabetes mellitus, elevated levels of D-dimer and neutrophillymphocyte ratio were the predictors of mortality. Conclusions: These findings suggest that the mortality rate in elderly COVID-19 patients with comorbidity is high and neutrophil-lymphocyte ratio could be a cost effective predictor of mortality in our context. JCMCTA 2022 ; 33 (1) : 138-143
{"title":"Predictors of Outcome in Hospitalized Adult COVID-19 Patients Admitted to a Tertiary Hospital in Chattogram","authors":"R. Biswas, M. Karim, E. Ullah, Mahmud Hassan Arif, Moinuddin A. Chowdhury, Mohammad Abu Sayeed Chowdhury, Sabrina Yusuf, Fatema Tooj Johra","doi":"10.3329/jcmcta.v33i1.67289","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67289","url":null,"abstract":"Background: The COVID-19 pandemic emerged as a major public health emergency affecting the healthcare services all over the world. It is essential to analyze the epidemiological and clinical characteristics of patients with COVID-19 in different parts of our country. This study highlights clinical experience in managing patients with COVID-19 at a tertiary care centre in southeastern Bangladesh. \u0000Materials and methods: Clinical characteristics and outcomes of consecutive 199 adult patients admitted to Chittagong Medical College Hospital, Chattogram, Bangladesh, from February 1 to March 31, 2021 were studied in this prospective observational study. The diagnosis of SARS-CoV-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) on throat and/or nasopharyngeal swabs. All patients were managed according to the hospital’s consensus protocol and in accordance with National Guidelines on clinical management of COVID-19. \u0000Results: The median age of the patients was 57 years (Range: 20-102 years) and 118 (59.3%) were male. One hundred and thirty two (67.3%) patients had associated comorbid condition and diabetes (44.7%) and hypertension (33.3%) were the most common. Majority (57.3%) was classified as having moderate severity and mortality of 10.1% (20 patients) was observed. Elderly age (>60 years), diabetes mellitus, elevated levels of D-dimer and neutrophillymphocyte ratio were the predictors of mortality. \u0000Conclusions: These findings suggest that the mortality rate in elderly COVID-19 patients with comorbidity is high and neutrophil-lymphocyte ratio could be a cost effective predictor of mortality in our context. \u0000JCMCTA 2022 ; 33 (1) : 138-143","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85391120","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67060
Rehnuma Urmi, Maayenu, N. Das, Quazi Saminah Salma, Md Rezaul Karim, Selim Md. Jahangir, Rasheda Samad
Background: Infection related complications represent an important cause of morbidity and mortality in pediatric cancer patients, especially in those receiving chemotherapy. Although antibiotic prophylaxis is used in adult leukemic patients, but it is less practiced in pediatric cancer patients. The aim of this study was to evaluate the efficacy and safety of Levofloxacin prophylaxis to reduce infection which occur during induction phase of chemotherapy among pediatric Acute Lymphoblastic Leukemia (ALL) patients. Materials and methods: This single centered, pilot study in RCT design was conducted in Pediatric HematoOncology Department of Chittagong Medical College Hospital (CMCH). Sixty newly diagnosed ALL patients admitted for chemotherapy were randomly allocated to two groups 30 in each: one group received Levofloxacin prophylaxis (Intervention group) and other group did not receive prophylaxis (Control group). During the whole period of induction, clinical and laboratory features of infection, fever and neutropenia were observed and adverse effects were noted in both groups. Results: In induction phase of chemotherapy of ALL, significantly lower proportion of patients developed fever in the intervention group than in the control group [(18/30, 60.00%) versus (26/30, 86.67%)]. Incidence of infection was significantly less in intervention group compared to control group (60% versus 86.7%, p=0.039). Also, incidence of febrile neutropenia was significantly less in intervention group compared to control group (p=0.039). No major adverse effects were observed in any of the levofloxacin prophylaxis group except only two patients reported mild lower limb pain. Conclusion: It may be concluded from this pilot study that, Levofloxacin prophylaxis in children with ALL during the induction phase of chemotherapy is effective in reducing infection, febrile episodes and febrile neutropenia. JCMCTA 2022 ; 33 (1) : 34-39
背景:感染相关并发症是儿童癌症患者发病和死亡的重要原因，尤其是那些接受化疗的患者。虽然抗生素预防在成人白血病患者中使用，但在儿童癌症患者中很少使用。本研究旨在评价左氧氟沙星预防小儿急性淋巴细胞白血病(ALL)患者化疗诱导期感染的有效性和安全性。材料与方法:本研究采用随机对照试验设计，在吉大港医学院附属医院儿童血液肿瘤科进行。将60例新诊断的ALL化疗患者随机分为两组，每组30人，一组给予左氧氟沙星预防治疗(干预组)，另一组未给予预防治疗(对照组)。在整个诱导过程中，观察两组患者感染、发热、中性粒细胞减少的临床和实验室特征，并观察不良反应。结果:ALL化疗诱导期，干预组患者出现发热的比例明显低于对照组[(18/ 30,60.00%)对(26/ 30,86.67%)]。干预组感染发生率明显低于对照组(60% vs 86.7%， p=0.039)。干预组发热性中性粒细胞减少发生率明显低于对照组(p=0.039)。左氧氟沙星预防组除两名患者报告轻度下肢疼痛外，未观察到任何主要不良反应。结论:本初步研究表明，ALL患儿化疗诱导期预防左氧氟沙星治疗可有效减少感染、发热发作和发热性中性粒细胞减少。Jcmcta 2022;33 (1): 34-39
{"title":"Efficacy and Safety of Levofloxacin Prophylaxis During Induction Therapy for Childhood Acute Lymphoblastic Leukemia","authors":"Rehnuma Urmi, Maayenu, N. Das, Quazi Saminah Salma, Md Rezaul Karim, Selim Md. Jahangir, Rasheda Samad","doi":"10.3329/jcmcta.v33i1.67060","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67060","url":null,"abstract":"Background: Infection related complications represent an important cause of morbidity and mortality in pediatric cancer patients, especially in those receiving chemotherapy. Although antibiotic prophylaxis is used in adult leukemic patients, but it is less practiced in pediatric cancer patients. The aim of this study was to evaluate the efficacy and safety of Levofloxacin prophylaxis to reduce infection which occur during induction phase of chemotherapy among pediatric Acute Lymphoblastic Leukemia (ALL) patients. \u0000Materials and methods: This single centered, pilot study in RCT design was conducted in Pediatric HematoOncology Department of Chittagong Medical College Hospital (CMCH). Sixty newly diagnosed ALL patients admitted for chemotherapy were randomly allocated to two groups 30 in each: one group received Levofloxacin prophylaxis (Intervention group) and other group did not receive prophylaxis (Control group). During the whole period of induction, clinical and laboratory features of infection, fever and neutropenia were observed and adverse effects were noted in both groups. \u0000Results: In induction phase of chemotherapy of ALL, significantly lower proportion of patients developed fever in the intervention group than in the control group [(18/30, 60.00%) versus (26/30, 86.67%)]. Incidence of infection was significantly less in intervention group compared to control group (60% versus 86.7%, p=0.039). Also, incidence of febrile neutropenia was significantly less in intervention group compared to control group (p=0.039). No major adverse effects were observed in any of the levofloxacin prophylaxis group except only two patients reported mild lower limb pain. \u0000Conclusion: It may be concluded from this pilot study that, Levofloxacin prophylaxis in children with ALL during the induction phase of chemotherapy is effective in reducing infection, febrile episodes and febrile neutropenia. \u0000JCMCTA 2022 ; 33 (1) : 34-39","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84358504","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67413
Hamidpour Hassan, M. S. Ali, Md. Asiful Islam, A. Chowdhury
Background: Risk factors for cardiovascular disease are particular habits, behaviors, circumstances or conditions that increase a person's risk of developing cardiovascular disease, including lack of exercise, unhealthy eating, smoking, diabetes, age and family history. Cardiovascular risk factors were observed and compared to find out their contribution among patients with SLE. Materials and methods: In this case control study, consecutive patients with SLE attending the Department of Medicine Dhaka Medical College Hospital (DMCH) were studied. The control population was recruited from subjects attending the other departments of the hospital and healthy attendants. The prevalence of classic Framingham cardiovascular risk factors, lipid profile, other metabolic risk factors, lifestyle variables, and demographic characteristics were compared between the 2 groups. Results: 80 SLE patients and 80 age and sex matched controls were studied. Patients with SLE had significantly high BMI and waist circumference (p_0.012 and p_0.001 respectively). Hypertension, diabetes were significantly more common among the SLE patients (31.29% versus 11.25%, p_0.023 and 13.75% versus 3.75, p_0.03). In comparison with control, patients with SLE had no significant difference in mean total cholesterol (193.92±23.65 versus 183.66±11.39, p_0.41) and triglyceride (174.77±60.06 versus 149.15±28.68, p_0.11), but had significantly higher low density lipoprotein (120.77±16.07 versus 108.17±11.68, p_0.00) and lower high-density lipoprotein cholesterol (41.37±4.52 versus 43.51±3.34, p_0.00). Conclusion: Patients with SLE have a range of detectable and significant cardiovascular risk factors. JCMCTA 2022 ; 33 (1) : 160-165
背景:心血管疾病的危险因素是增加一个人患心血管疾病风险的特定习惯、行为、环境或条件，包括缺乏运动、不健康饮食、吸烟、糖尿病、年龄和家族史。观察并比较心血管危险因素在SLE患者中的作用。材料和方法:在本病例对照研究中，研究了连续在达卡医学院附属医院(DMCH)内科就诊的SLE患者。对照人群是从医院其他科室的受试者和健康的服务员中招募的。比较两组之间经典Framingham心血管危险因素、血脂、其他代谢危险因素、生活方式变量和人口统计学特征的患病率。结果:研究了80例SLE患者和80例年龄和性别匹配的对照组。SLE患者BMI和腰围明显偏高(分别为p_0.012和p_0.001)。高血压、糖尿病在SLE患者中更为常见(31.29%比11.25%，p_0.023; 13.75%比3.75,p_0.03)。与对照组相比，SLE患者的平均总胆固醇(193.92±23.65 vs 183.66±11.39,p_0.41)和甘油三酯(174.77±60.06 vs 149.15±28.68,p_0.11)差异无统计学意义，但低密度脂蛋白(120.77±16.07 vs 108.17±11.68,p_0.00)和高密度脂蛋白胆固醇(41.37±4.52 vs 43.51±3.34,p_0.00)显著升高。结论:SLE患者具有一系列可检测且显著的心血管危险因素。Jcmcta 2022;33 (1): 160-165
{"title":"Cardiovascular Risk Factors among Patients with Systemic Lupus Erythematosus Presented in a Tertiary Care Hospital","authors":"Hamidpour Hassan, M. S. Ali, Md. Asiful Islam, A. Chowdhury","doi":"10.3329/jcmcta.v33i1.67413","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67413","url":null,"abstract":"Background: Risk factors for cardiovascular disease are particular habits, behaviors, circumstances or conditions that increase a person's risk of developing cardiovascular disease, including lack of exercise, unhealthy eating, smoking, diabetes, age and family history. Cardiovascular risk factors were observed and compared to find out their contribution among patients with SLE. \u0000Materials and methods: In this case control study, consecutive patients with SLE attending the Department of Medicine Dhaka Medical College Hospital (DMCH) were studied. The control population was recruited from subjects attending the other departments of the hospital and healthy attendants. The prevalence of classic Framingham cardiovascular risk factors, lipid profile, other metabolic risk factors, lifestyle variables, and demographic characteristics were compared between the 2 groups. \u0000Results: 80 SLE patients and 80 age and sex matched controls were studied. Patients with SLE had significantly high BMI and waist circumference (p_0.012 and p_0.001 respectively). Hypertension, diabetes were significantly more common among the SLE patients (31.29% versus 11.25%, p_0.023 and 13.75% versus 3.75, p_0.03). In comparison with control, patients with SLE had no significant difference in mean total cholesterol (193.92±23.65 versus 183.66±11.39, p_0.41) and triglyceride (174.77±60.06 versus 149.15±28.68, p_0.11), but had significantly higher low density lipoprotein (120.77±16.07 versus 108.17±11.68, p_0.00) and lower high-density lipoprotein cholesterol (41.37±4.52 versus 43.51±3.34, p_0.00). \u0000Conclusion: Patients with SLE have a range of detectable and significant cardiovascular risk factors. \u0000JCMCTA 2022 ; 33 (1) : 160-165","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89286027","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67184
Shahryar Ahmed, S. Chowdhury, Rasheda Begum, A. Siddiki
Background : Microalbuminuria is a term to describe a moderate increase in the level of urine albumin. It occurs when the kidney leaks small amounts of albumin into the urine. The main objective of this study is to determine the correlation between microalbuminuria and diabetic kidney disease at a tertiary care hospital in Chittagong. Materials and methods : Institutional based cross- sectional study design was conducted on randomly selected diabetic population from Chittagong Diabetic and General Hospital by using systematic random sampling method from 1st June to 30th November 2019. Results : Out of a total of 160 participants, the prevalence of microalbuminuria was in 59(36.9%) patients. Ten (6.3%) patients had cardiovascular disease, 18(11.3%) had neuropathy, 7(4.4%) had retinopathy, 117(73.1%) had hypertension and 47(29.4%) had duration of diabetes of 610 years. Majority 132(82.5%) patients had stage 1-2 followed by 22(13.8%) had stage 3, 4(2.5%) had stage 4 and 2(1.3%) had stage 5. Gender, age, cardiovascular, retinopathy, hypertension, BMI, albumin to creatinine ratio, fasting sugar, creatinine level and LDL were not statistically significant (p>0.05) when compared to different stages of CKD. Stage 1-2 was significantly higher in no microalbuminuria group than microalbuminuria group (92.1% vs 66.1%). Stage 3 was significantly higher in microalbuminuria group than no microalbuminuria group (23.7% vs 7.9%). Stage 4 was significantly higher in microalbuminuria group 4(6.8%) and Stage 5 was higher in the microalbuminuria group 2(3.4%). Conclusion: Neuropathy, mean diabetes duration, mean HbA1c, and mean Triglyceride were significantly greater in CKD stage 5 than in other stages of illness in the current research. When comparing different stages of CKD, mean HDL was considerably lower in stage 5. In the microalbuminuria group, CKD Stages 3, 4, and 5 were considerably higher than in the non-microalbuminuria group. JCMCTA 2022 ; 33 (1) : 50-55
背景:微量白蛋白尿是一个描述尿白蛋白水平中度升高的术语。当肾脏将少量白蛋白泄漏到尿液中时，就会发生这种情况。本研究的主要目的是确定吉大港三级医院微量白蛋白尿与糖尿病肾病之间的相关性。材料与方法:采用系统随机抽样方法，于2019年6月1日至11月30日在吉大港糖尿病综合医院随机抽取糖尿病人群进行基于机构的横断面研究设计。结果:在总共160名参与者中，有59名(36.9%)患者存在微量白蛋白尿。10例(6.3%)有心血管疾病，18例(11.3%)有神经病变，7例(4.4%)有视网膜病变，117例(73.1%)有高血压，47例(29.4%)有糖尿病病程610年。132例(82.5%)患者为1-2期，其次是22例(13.8%)为3期，4例(2.5%)为4期，2例(1.3%)为5期。性别、年龄、心血管、视网膜病变、高血压、BMI、白蛋白/肌酐比、空腹血糖、肌酐水平、LDL与CKD不同分期比较，差异均无统计学意义(p>0.05)。无微量白蛋白尿组1-2期明显高于微量白蛋白尿组(92.1% vs 66.1%)。微量白蛋白尿组3期明显高于无微量白蛋白尿组(23.7% vs 7.9%)。微量白蛋白尿4组的4期发生率显著高于对照组(6.8%)，微量白蛋白尿2组的5期发生率显著高于对照组(3.4%)。结论:在目前的研究中，CKD 5期患者的神经病变、平均糖尿病病程、平均HbA1c和平均甘油三酯显著高于其他疾病阶段。当比较不同阶段的CKD时，5期的平均HDL明显较低。在微量白蛋白尿组中，CKD 3、4和5期明显高于非微量白蛋白尿组。Jcmcta 2022;33 (1): 50-55
{"title":"Correlation of Clinical and Biochemical Parameters with the Stages of Chronic Kidney Disease in Type 2 DM Patients in a Tertiary Care Hospital in Chittagong","authors":"Shahryar Ahmed, S. Chowdhury, Rasheda Begum, A. Siddiki","doi":"10.3329/jcmcta.v33i1.67184","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67184","url":null,"abstract":"Background : Microalbuminuria is a term to describe a moderate increase in the level of urine albumin. It occurs when the kidney leaks small amounts of albumin into the urine. The main objective of this study is to determine the correlation between microalbuminuria and diabetic kidney disease at a tertiary care hospital in Chittagong. \u0000Materials and methods : Institutional based cross- sectional study design was conducted on randomly selected diabetic population from Chittagong Diabetic and General Hospital by using systematic random sampling method from 1st June to 30th November 2019. \u0000Results : Out of a total of 160 participants, the prevalence of microalbuminuria was in 59(36.9%) patients. Ten (6.3%) patients had cardiovascular disease, 18(11.3%) had neuropathy, 7(4.4%) had retinopathy, 117(73.1%) had hypertension and 47(29.4%) had duration of diabetes of 610 years. Majority 132(82.5%) patients had stage 1-2 followed by 22(13.8%) had stage 3, 4(2.5%) had stage 4 and 2(1.3%) had stage 5. Gender, age, cardiovascular, retinopathy, hypertension, BMI, albumin to creatinine ratio, fasting sugar, creatinine level and LDL were not statistically significant (p>0.05) when compared to different stages of CKD. Stage 1-2 was significantly higher in no microalbuminuria group than microalbuminuria group (92.1% vs 66.1%). Stage 3 was significantly higher in microalbuminuria group than no microalbuminuria group (23.7% vs 7.9%). Stage 4 was significantly higher in microalbuminuria group 4(6.8%) and Stage 5 was higher in the microalbuminuria group 2(3.4%). \u0000Conclusion: Neuropathy, mean diabetes duration, mean HbA1c, and mean Triglyceride were significantly greater in CKD stage 5 than in other stages of illness in the current research. When comparing different stages of CKD, mean HDL was considerably lower in stage 5. In the microalbuminuria group, CKD Stages 3, 4, and 5 were considerably higher than in the non-microalbuminuria group. \u0000JCMCTA 2022 ; 33 (1) : 50-55","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73303638","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67224
N. Ferdous, Mafruha Khanam, Anika Anan Mahmud, Tajrin Iqbal, A. Begum, Chandrika Gupta
Background: Unhealthy cervix is a very common finding in Bangladesh due to poor genital hygiene, malnutrition, and multiparity. Cervical Cancer is a serious health problem in Bangladesh and other developing countries. Cervical Cancer is a preventable cancer due to long preinvasive state and available cervical screening program like pap smear, colposcopy etc. Upon detection the treatment of pre-invasive lesions is highly effective. The objective of our study is to observe and evaluate suspicious cervix upon specimen collection by pap smear and viewing them by colposcopy when required. Materials and methods: This is a descriptive type of observational cross-sectional study conducted in the Department of Obstetrics and Gynecology of BBMH, Chittagong over a period of six months from December 2020 to June 2021. A total of 64 women were selected, who came to hospital outdoor for the treatment of persistent vaginal discharge, post coital bleeding, postmenopausal bleeding. A thorough general, systemic and pelvic examination was done. Pap smear was conducted and colposcopy was done for women who had persistent inflammation on pap smear cases. Multiple variables like age of marriage and first intercourse, parity contraception was taken in consideration. The data obtained were recorded and statistically analyzed. Results: Out of 64 women the minimum age was 30 and maximum was 62 years with a mean age of 32.6 ± 7.2 years. Of the 64 women with unhealthy, inflammatory pap smear cases, 33 (51.6%) patients were colposcopically positive for CIN. Then histopathological evaluation of the biopsy material of those 33 women were done. It revealed 12 (36.3%) with abnormal cytology. Patients with positive CIN experienced early marriage, early age of child birth, and also had higher parities than patients without CIN. Conclusion: This study should that cervical lesion is one of the commonest problems among the females worldwide, including Bangladesh. This revealed the importance of emphasizing on proper screening of carcinoma cervix to decline incidence and mortality in developed and developing countries. JCMCTA 2022 ; 33 (1) : 71-76
{"title":"Evaluation of Cervix at Risk with Pap Smear and with Colposcopy","authors":"N. Ferdous, Mafruha Khanam, Anika Anan Mahmud, Tajrin Iqbal, A. Begum, Chandrika Gupta","doi":"10.3329/jcmcta.v33i1.67224","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67224","url":null,"abstract":"Background: Unhealthy cervix is a very common finding in Bangladesh due to poor genital hygiene, malnutrition, and multiparity. Cervical Cancer is a serious health problem in Bangladesh and other developing countries. Cervical Cancer is a preventable cancer due to long preinvasive state and available cervical screening program like pap smear, colposcopy etc. Upon detection the treatment of pre-invasive lesions is highly effective. The objective of our study is to observe and evaluate suspicious cervix upon specimen collection by pap smear and viewing them by colposcopy when required. \u0000Materials and methods: This is a descriptive type of observational cross-sectional study conducted in the Department of Obstetrics and Gynecology of BBMH, Chittagong over a period of six months from December 2020 to June 2021. A total of 64 women were selected, who came to hospital outdoor for the treatment of persistent vaginal discharge, post coital bleeding, postmenopausal bleeding. A thorough general, systemic and pelvic examination was done. Pap smear was conducted and colposcopy was done for women who had persistent inflammation on pap smear cases. Multiple variables like age of marriage and first intercourse, parity contraception was taken in consideration. The data obtained were recorded and statistically analyzed. \u0000Results: Out of 64 women the minimum age was 30 and maximum was 62 years with a mean age of 32.6 ± 7.2 years. Of the 64 women with unhealthy, inflammatory pap smear cases, 33 (51.6%) patients were colposcopically positive for CIN. Then histopathological evaluation of the biopsy material of those 33 women were done. It revealed 12 (36.3%) with abnormal cytology. Patients with positive CIN experienced early marriage, early age of child birth, and also had higher parities than patients without CIN. \u0000Conclusion: This study should that cervical lesion is one of the commonest problems among the females worldwide, including Bangladesh. This revealed the importance of emphasizing on proper screening of carcinoma cervix to decline incidence and mortality in developed and developing countries. \u0000JCMCTA 2022 ; 33 (1) : 71-76","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81006882","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67288
Parvin Aktar, Mohammad Moharam Ali, S. Akter, Md. Hafizul Islam, N. Tasnim, Ripan Kumar Mandal, M. Haque
Background: Glycemic control is the main therapeutic goal for the prevention of diabetes related complications. However, achieving optimal glycemic control on long term basis among patients with Type 2 diabetes remains challenging in developing countries like Bangladesh. The purpose of the study to determine the factors associated with glycemic control among patients with Type 2 diabetes at Chittagong Medical College Hospital, Chattogram, Bangladesh. Materials and methods: This cross sectional study included 120 patients with Type 2 diabetes aged 40-75 years who attended at Outpatient Department of Endocrinology, Chittagong Medical College Hospital between July 2020 to June 2021. Important variables in this study were socio-demographics, fasting blood glucose, HbA1c, BMI, waist circumference, duration of DM, proteinuria and documented history of chronic complications. Patent’s HbA1c were categorized into good glycemic control <7% and poor glycemic control ³7%. Results: 84.2% of the patient’s had poor glycemic control. The mean (±SEM) BMI, waist circumference, SBP, DBP, HbA1c and FBG were significantly higher in patients with poor glycemic control. Majority of patients with poor glycemic control were female and ³60 years old. Patients with a history of higher BMI (65.3%), waist circumference (85.1%), 10 years of diabetes (33%), combination of OHA and insulin (42.6%) had poor glycemic control. There was no significant association with glycemic control and family history of diabetes, history of smoking, other socio-demographic variables. Patients without complications and proteinuria had significantly better glycemic control. Conclusion: The proportion of patients with poor glycemic control was high. Age, duration of diabetes, obesity, anti-diabetic agents and complications were associated with glycemic control. JCMCTA 2022 ; 33 (1) : 132-137
{"title":"Factors Associated with Glycemic Control Among Patients with Type 2 Diabetes at Chittagong Medical College Hospital","authors":"Parvin Aktar, Mohammad Moharam Ali, S. Akter, Md. Hafizul Islam, N. Tasnim, Ripan Kumar Mandal, M. Haque","doi":"10.3329/jcmcta.v33i1.67288","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67288","url":null,"abstract":"Background: Glycemic control is the main therapeutic goal for the prevention of diabetes related complications. However, achieving optimal glycemic control on long term basis among patients with Type 2 diabetes remains challenging in developing countries like Bangladesh. The purpose of the study to determine the factors associated with glycemic control among patients with Type 2 diabetes at Chittagong Medical College Hospital, Chattogram, Bangladesh. \u0000Materials and methods: This cross sectional study included 120 patients with Type 2 diabetes aged 40-75 years who attended at Outpatient Department of Endocrinology, Chittagong Medical College Hospital between July 2020 to June 2021. Important variables in this study were socio-demographics, fasting blood glucose, HbA1c, BMI, waist circumference, duration of DM, proteinuria and documented history of chronic complications. Patent’s HbA1c were categorized into good glycemic control <7% and poor glycemic control ³7%. \u0000Results: 84.2% of the patient’s had poor glycemic control. The mean (±SEM) BMI, waist circumference, SBP, DBP, HbA1c and FBG were significantly higher in patients with poor glycemic control. Majority of patients with poor glycemic control were female and ³60 years old. Patients with a history of higher BMI (65.3%), waist circumference (85.1%), 10 years of diabetes (33%), combination of OHA and insulin (42.6%) had poor glycemic control. There was no significant association with glycemic control and family history of diabetes, history of smoking, other socio-demographic variables. Patients without complications and proteinuria had significantly better glycemic control. \u0000Conclusion: The proportion of patients with poor glycemic control was high. Age, duration of diabetes, obesity, anti-diabetic agents and complications were associated with glycemic control. \u0000JCMCTA 2022 ; 33 (1) : 132-137","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77135399","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67056
Urmila Chowdhury, M. Ashrafuzzaman, Baishakhi Bhowmik, M. M. Hossain, Raju Chowdhury, Sarah Fatima Sumaiya
Background: Elbow carrying angle changes with skeletal growth and maturity, helps in carrying objects and keeps upper limb away from pelvis during movement. Variation of carrying angle value has been observed in relation to age, gender, and some selected anthropometric parameters. Present study was aimed to evaluate the carrying angle in normal adolescents of Bangladesh in relation to age, gender, and hand dominance. Materials and methods: This cross-sectional observational study was conducted in the Department of Anatomy, Chittagong Medical College, Chattogram, upon 100 male and 100 female adolescents (10-19 years) by dividing them into two groups (Group A: 10-15 years, Group B: 16-19 years) and all were right hand dominant. Recorded data were analyzed by using SPSS version 25. For statistical analysis unpaired student’s ‘t’ test was done. p value was considered significant if it was <0.05 at 95% level of confidence. Results: Carrying angle of both sides was significantly higher in age group 16 to 19 years and in female (p<0.001) also significant greater value found in dominant hand (p<0.001). Conclusion: Knowledge of normal carrying angle value is important for management of elbow fracture, designing of total elbow prosthesis, and differentiation of sex in skeletal remain in medicolegal purpose. JCMCTA 2022 ; 33 (1) : 29-33
背景:肘部搬运角度随着骨骼的生长和成熟而变化，有助于搬运物品，在运动时使上肢远离骨盆。携带角度值的变化已被观察到与年龄、性别和一些选定的人体测量参数有关。本研究旨在评估孟加拉正常青少年的搬运角度与年龄、性别和手优势的关系。材料与方法:本研究在吉大港医学院解剖学系进行横断面观察性研究，将100名男性和100名女性青少年(10-19岁)分为两组(A组:10-15岁，B组:16-19岁)，均为右手优势。记录的数据采用SPSS version 25进行分析。统计分析采用非配对学生t检验。如果P值在95%置信水平上<0.05，则认为P值显著。结果:在16 ~ 19岁年龄组和女性中，双侧携带角显著高于男性(p<0.001)，优势手携带角显著高于女性(p<0.001)。结论:了解正常承载角值对肘关节骨折的处理、全肘关节假体的设计及骨残体性别鉴别具有重要的医学意义。Jcmcta 2022;33 (1): 29-33
{"title":"Variation of Carrying Angle of Elbow in Relation to Age, Sex and Dominant Arm in Adolescent Bangladeshi Population","authors":"Urmila Chowdhury, M. Ashrafuzzaman, Baishakhi Bhowmik, M. M. Hossain, Raju Chowdhury, Sarah Fatima Sumaiya","doi":"10.3329/jcmcta.v33i1.67056","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67056","url":null,"abstract":"Background: Elbow carrying angle changes with skeletal growth and maturity, helps in carrying objects and keeps upper limb away from pelvis during movement. Variation of carrying angle value has been observed in relation to age, gender, and some selected anthropometric parameters. Present study was aimed to evaluate the carrying angle in normal adolescents of Bangladesh in relation to age, gender, and hand dominance. \u0000Materials and methods: This cross-sectional observational study was conducted in the Department of Anatomy, Chittagong Medical College, Chattogram, upon 100 male and 100 female adolescents (10-19 years) by dividing them into two groups (Group A: 10-15 years, Group B: 16-19 years) and all were right hand dominant. Recorded data were analyzed by using SPSS version 25. For statistical analysis unpaired student’s ‘t’ test was done. p value was considered significant if it was <0.05 at 95% level of confidence. \u0000Results: Carrying angle of both sides was significantly higher in age group 16 to 19 years and in female (p<0.001) also significant greater value found in dominant hand (p<0.001). \u0000Conclusion: Knowledge of normal carrying angle value is important for management of elbow fracture, designing of total elbow prosthesis, and differentiation of sex in skeletal remain in medicolegal purpose. \u0000JCMCTA 2022 ; 33 (1) : 29-33","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"158 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79727244","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67265
I. Perveen, M. Saha, Md Quamrul Hasan
Background: Word-wide there is decreasing prevalence of Helicobacter pylori (H. Pylori) infection. As we are lacking in consistent data regarding H. Pylori infection in our polpulation, we aimed to find out prevalence of H.pylori infection in patients with dyspepsia in Nort-East part of Bangladesh. Material and methods: Clinical variables, stool antigen test result and endoscopic findings of consecutive patients with dyspepsia were recorded in a semi-structured questionnaire. Statistical analysis was done with SPSS programme 17.0(). Significance level was set at 0.05 or less. Results: A toal of 790 patients (male 549, female 241) were included in the study with higher mean age among female patients (41.46 VS. 39.19, p.008) than male patients. Three most common dyspetic symptoms were abdominel pain (n=365, 46.2%), bloating (n=280, 35.4%) and vomiting (n=163, 20.6%). A total of 217(39.5%) male and 87(36.0%) female were positive for stool antigen test (n=308, 38.5%) for H. pylori. No significant association was found between Helicobacter pylori infection and presence of individual dyspeptic symptom, number of dyspeptic symptoms (OR 1.385, p .103), age (OR .998, p .668), sex (OR 1.157, p .362), rural/urban residence (OR 1.126, p .503) or socioeconomic condition (OR .965, p .09). Around 81% (293/360) subjects had upper GI lesion (Gastritis/gastric ulcer, duoudenitis/duodenalulcer, oesophagitis/ulcer) in endoscopy and stool antigent positivity in paietnts with duodenal and gastric lesions (37% VS. 36.6%) were comparable. Conclusion: H. pylori infection rate among patients with dyspepsia is is in favour of declining prevalence of H.pylori infection in comparison to previous sudies. Majority of patients with dyspepsia had upperGI lesion in endoscopy. No sigficant differece was noted in H. pyori prevalence rate anong gastric or duodenal lesion or among PPI takers or non-takers. JCMCTA 2022 ; 33 (1) : 97-102
背景:世界范围内幽门螺杆菌(h.p ylori)感染的流行率正在下降。由于我们缺乏关于我国人群中幽门螺杆菌感染的一致数据，我们的目的是找出孟加拉国东北部消化不良患者中幽门螺杆菌感染的患病率。材料与方法:采用半结构化问卷，记录连续消化不良患者的临床变量、粪便抗原检测结果及内镜检查结果。采用SPSS 17.0软件进行统计分析。显著性水平设为0.05或更小。结果:共纳入790例患者(男549例，女241例)，女性患者的平均年龄高于男性患者(41.46 VS. 39.19, p.008)。三种最常见的消化不良症状为腹痛(365例，46.2%)、腹胀(280例，35.4%)和呕吐(163例，20.6%)。男性217例(39.5%)，女性87例(36.0%)，粪便抗原检测幽门螺杆菌阳性(308例，38.5%)。幽门螺杆菌感染与个体消化不良症状的存在、消化不良症状的数量(OR 1.385, p .103)、年龄(OR 0.998, p .668)、性别(OR 1.157, p .362)、城乡居住(OR 1.126, p .503)或社会经济状况(OR 0.965, p .09)之间没有显著关联。大约81%(293/360)的受试者在内镜检查中有上消化道病变(胃炎/胃溃疡、十二指肠炎/十二指肠溃疡、食管炎/溃疡)，十二指肠和胃病变患者的粪便抗原阳性(37%对36.6%)具有可比性。结论:与以往研究相比，消化不良患者幽门螺杆菌感染率的下降有利于幽门螺杆菌感染率的下降。大多数消化不良患者在内镜检查中出现上消化道病变。胃或十二指肠病变、服用或未服用PPI者的胃十二指肠幽门螺杆菌患病率无显著差异。Jcmcta 2022;33 (1): 97-102
{"title":"Is There Decreasing Prevalence of Helicobacter Pylori Infection in Patients with Dyspepsia?","authors":"I. Perveen, M. Saha, Md Quamrul Hasan","doi":"10.3329/jcmcta.v33i1.67265","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67265","url":null,"abstract":"Background: Word-wide there is decreasing prevalence of Helicobacter pylori (H. Pylori) infection. As we are lacking in consistent data regarding H. Pylori infection in our polpulation, we aimed to find out prevalence of H.pylori infection in patients with dyspepsia in Nort-East part of Bangladesh. \u0000Material and methods: Clinical variables, stool antigen test result and endoscopic findings of consecutive patients with dyspepsia were recorded in a semi-structured questionnaire. Statistical analysis was done with SPSS programme 17.0(). Significance level was set at 0.05 or less. \u0000Results: A toal of 790 patients (male 549, female 241) were included in the study with higher mean age among female patients (41.46 VS. 39.19, p.008) than male patients. Three most common dyspetic symptoms were abdominel pain (n=365, 46.2%), bloating (n=280, 35.4%) and vomiting (n=163, 20.6%). A total of 217(39.5%) male and 87(36.0%) female were positive for stool antigen test (n=308, 38.5%) for H. pylori. No significant association was found between Helicobacter pylori infection and presence of individual dyspeptic symptom, number of dyspeptic symptoms (OR 1.385, p .103), age (OR .998, p .668), sex (OR 1.157, p .362), rural/urban residence (OR 1.126, p .503) or socioeconomic condition (OR .965, p .09). Around 81% (293/360) subjects had upper GI lesion (Gastritis/gastric ulcer, duoudenitis/duodenalulcer, oesophagitis/ulcer) in endoscopy and stool antigent positivity in paietnts with duodenal and gastric lesions (37% VS. 36.6%) were comparable. \u0000Conclusion: H. pylori infection rate among patients with dyspepsia is is in favour of declining prevalence of H.pylori infection in comparison to previous sudies. Majority of patients with dyspepsia had upperGI lesion in endoscopy. No sigficant differece was noted in H. pyori prevalence rate anong gastric or duodenal lesion or among PPI takers or non-takers. \u0000JCMCTA 2022 ; 33 (1) : 97-102","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78077680","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67286
Afroza Akther Mazumder, S. Begum, N. Yousuf
Background: Use of vaginal pessary as a conservative therapy for pelvic organ prolapse is very common and upto 77% of clinicians uses ring pessary for 1 line management of prolapse. Aim to treat prolapse by conservative approach is to alleviate the symptoms of prolapse and avert or delay the need for surgery. Aim of this study was to find out improvements of symptoms related to pelvic organ prolapse and satisfaction rate after 3 months of using vaginal pessary. Materials and methods: A prospective observational study was conducted from January 2019 –to June 2019 in the Department of Gynaecology and Obstetrics of Bangabandu Memorial Hospital, Chattogram. Total 31 patients were included with symptomatic Pelvic Organ Prolapse (POP) willing to use pessary. Primary outcome were improvement of symptoms and their satisfaction from baseline to 3 months. Results: Age of the respondents were between 25-80 years with a mean of 50 ( +-12) years, maximum respondents were postmenopausal 54.8% .Out of 31 respondents 27(87.1%) continue pessary use upto 3 months and their after, 2(6.5%) cases spontaneous expulsion took place, 2(6.5%) discontinue the use. Compare with base line findings significant improvement in patients symptoms were observed at 3 months. Nearly all symptoms related to pelvic organ prolapse resolved from baseline to to 3 months: buldge (92.3% to 7.7% , p < 0.001), dragging pain in lower abdomen (100% to 14.8% , p<0.001). Urinary symptoms voiding difficulty improved in 88% ( p<0.001), urinary urgency improved in 81.8% (p<0.001), urge and stress incontinence improved in 100% (p<0.001). Incomplete empting of bowel improved in 100%(p<0.001). During follow up 4(12.9%) women complain of vaginal discharge. At 3months 88.9% women were satisfied with pessary and 3(11.1%) were dissatisfied. Conclusion: This study showed that treatment with use of ring pessary in women with pelvic organ prolapse had significant improvements in the symptoms with high satisfaction rate. JCMCTA 2022 ; 33 (1) : 118-123
{"title":"Use of Silicon Vaginal Pessary for Treatment of Pelvic Organ Prolapse","authors":"Afroza Akther Mazumder, S. Begum, N. Yousuf","doi":"10.3329/jcmcta.v33i1.67286","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67286","url":null,"abstract":"Background: Use of vaginal pessary as a conservative therapy for pelvic organ prolapse is very common and upto 77% of clinicians uses ring pessary for 1 line management of prolapse. Aim to treat prolapse by conservative approach is to alleviate the symptoms of prolapse and avert or delay the need for surgery. Aim of this study was to find out improvements of symptoms related to pelvic organ prolapse and satisfaction rate after 3 months of using vaginal pessary. \u0000Materials and methods: A prospective observational study was conducted from January 2019 –to June 2019 in the Department of Gynaecology and Obstetrics of Bangabandu Memorial Hospital, Chattogram. Total 31 patients were included with symptomatic Pelvic Organ Prolapse (POP) willing to use pessary. Primary outcome were improvement of symptoms and their satisfaction from baseline to 3 months. \u0000Results: Age of the respondents were between 25-80 years with a mean of 50 ( +-12) years, maximum respondents were postmenopausal 54.8% .Out of 31 respondents 27(87.1%) continue pessary use upto 3 months and their after, 2(6.5%) cases spontaneous expulsion took place, 2(6.5%) discontinue the use. Compare with base line findings significant improvement in patients symptoms were observed at 3 months. Nearly all symptoms related to pelvic organ prolapse resolved from baseline to to 3 months: buldge (92.3% to 7.7% , p < 0.001), dragging pain in lower abdomen (100% to 14.8% , p<0.001). Urinary symptoms voiding difficulty improved in 88% ( p<0.001), urinary urgency improved in 81.8% (p<0.001), urge and stress incontinence improved in 100% (p<0.001). Incomplete empting of bowel improved in 100%(p<0.001). During follow up 4(12.9%) women complain of vaginal discharge. At 3months 88.9% women were satisfied with pessary and 3(11.1%) were dissatisfied. \u0000Conclusion: This study showed that treatment with use of ring pessary in women with pelvic organ prolapse had significant improvements in the symptoms with high satisfaction rate. \u0000JCMCTA 2022 ; 33 (1) : 118-123","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80392681","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 : 2022-06-30DOI: 10.3329/jcmcta.v33i1.67285
Shantonu Kumar Saha, H. M. Hira, Jabed Jahangir, Ajoy Deb, Mamun Mustafa, S. Ghosh
Background: Fracture neck of femur has always presented a great challenge to orthopedic surgeons due to its nature of going into non-union and osteonecrosis of femoral head even with the best fixation method and adequate reduction. Treatment of fracture neck of femur varies according to patient’s age and fracture pattern. Purpose of this study was to compare the outcome of DHS with side plate and de-rotation screw with multiple cannulated hip screws in fracture neck of femur in adult. Materials and methods: This quasi-experimental study was carried out in the Department of Orthopedic Surgery, Chittagong Medical College Hospital from July 2017 to June 2019. Sixty patients age limit between 18 to 55 years, with (AO/OTA 31-B) fracture was taken by purposive sampling technique as per set criteria and were treated either by DHS with side plate and de-rotation screw or by cannulated hip screws. Harris Hip Score was used for evaluation of functional outcome of surgery. Results: In this study, out of 60 patients, male (83%) were more than female (17%), maximum age incidence was found in 26-36 years age group (30%), left side involvement was 51.7% and right side was 48.3%. Over 60% incidence was due to RTA. Functional outcome was 68% excellent and 24% good in DHS with de-rotation screw group and 55.6% good and 25.9% excellent in cannulated hip screw group according to Harris Hip Score. Only 6.7% had soft tissue infection, 13.3% had deep seated infection and delayed union, 10% had non-union and hip stiffness and 6.7% had AVN in DHS with de- rotation screw group and 10% had soft tissue infection, 6.7% had deep seated infection and delayed union, 13.33% had non-union and hip stiffness and 10% had AVN in cannulated hip screw group. Mean ± SD radiological union time in DHS with de-rotation screw group was 12.5 ± 1.225 weeks and in cannulated hip screw group was 13.61 ± 1.559 weeks. Conclusion: The functional outcome of fixation by DHS with de-rotation screw was better than fixation by cannulated hip screw for femoral neck fracture in adults. JCMCTA 2022 ; 33 (1) : 112-117
{"title":"Femoral Neck Fracture Treated with Dynamic Hip Screw System with De-rotation Screw Versus Cannulated Hip Screws","authors":"Shantonu Kumar Saha, H. M. Hira, Jabed Jahangir, Ajoy Deb, Mamun Mustafa, S. Ghosh","doi":"10.3329/jcmcta.v33i1.67285","DOIUrl":"https://doi.org/10.3329/jcmcta.v33i1.67285","url":null,"abstract":"Background: Fracture neck of femur has always presented a great challenge to orthopedic surgeons due to its nature of going into non-union and osteonecrosis of femoral head even with the best fixation method and adequate reduction. Treatment of fracture neck of femur varies according to patient’s age and fracture pattern. Purpose of this study was to compare the outcome of DHS with side plate and de-rotation screw with multiple cannulated hip screws in fracture neck of femur in adult. \u0000Materials and methods: This quasi-experimental study was carried out in the Department of Orthopedic Surgery, Chittagong Medical College Hospital from July 2017 to June 2019. Sixty patients age limit between 18 to 55 years, with (AO/OTA 31-B) fracture was taken by purposive sampling technique as per set criteria and were treated either by DHS with side plate and de-rotation screw or by cannulated hip screws. Harris Hip Score was used for evaluation of functional outcome of surgery. \u0000Results: In this study, out of 60 patients, male (83%) were more than female (17%), maximum age incidence was found in 26-36 years age group (30%), left side involvement was 51.7% and right side was 48.3%. Over 60% incidence was due to RTA. Functional outcome was 68% excellent and 24% good in DHS with de-rotation screw group and 55.6% good and 25.9% excellent in cannulated hip screw group according to Harris Hip Score. Only 6.7% had soft tissue infection, 13.3% had deep seated infection and delayed union, 10% had non-union and hip stiffness and 6.7% had AVN in DHS with de- rotation screw group and 10% had soft tissue infection, 6.7% had deep seated infection and delayed union, 13.33% had non-union and hip stiffness and 10% had AVN in cannulated hip screw group. Mean ± SD radiological union time in DHS with de-rotation screw group was 12.5 ± 1.225 weeks and in cannulated hip screw group was 13.61 ± 1.559 weeks. \u0000Conclusion: The functional outcome of fixation by DHS with de-rotation screw was better than fixation by cannulated hip screw for femoral neck fracture in adults. \u0000JCMCTA 2022 ; 33 (1) : 112-117","PeriodicalId":93458,"journal":{"name":"Journal of Chittagong Medical College Teachers' Association","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89417319","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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