Mymensingh medical journal : MMJ最新文献

Cardiac dysfunction in liver cirrhosis is a common but frequently overlooked condition. Along with many complications, liver cirrhosisis is well known to affect the heart, but the relationship between the cardiac dysfunction and severity of liver cirrhosis is poorly understood. Some studies reveal a significant relationship, while others do not. The purpose of this study is to determine the relationship between the severity of liver cirrhosis and left ventricular dysfunction. This cross-sectional study was carried out in a tertiary care hospital of Central India. Following informed consent, 135 patients with liver cirrhosis who met the inclusion criteria were included in the study. The Child-Pugh Score and MELD-Na (Model for End-Stage Liver Disease with Sodium) Score for each participant were computed. All patients underwent 2D echocardiography and the results were analysed. In this study, 75 patients (55.6%) had some degree of diastolic dysfunction, whereas 60 patients (44.4%) did not. Forty of the 75 had grade I diastolic dysfunction, 22 had grade II and 13 had grade III diastolic dysfunction. Patients with MELD-Na scores greater than 19 had a higher prevalence of diastolic dysfunction (75.5%) compared to those with MELD-Na scores of 19 or less (45.5%). Similarly, diastolic dysfunction was higher in patients with Child-Pugh Class C (70.3%) than in those with Child-Pugh Class A or B (42.2%). Diastolic dysfunction was found in 56.1% of alcoholic cirrhosis patients and 55.1% of non-alcoholic cirrhosis patients. In this study, we found that as liver cirrhosis advances, an increasing percentage of individuals develop diastolic dysfunction. However, the severity of diastolic dysfunction is unrelated to the cause of liver cirrhosis.

Early childhood caries (ECC) is encountered as a serious oral health issue, chiefly in deprived areas. ECC remains a global concern, troubling babies and pre-school-aged children across nations. The widespread nature of ECC is notable and it is reportedly found in approximately 85.0% of individuals from low socioeconomic backgrounds. Due to its origins and solutions that are developed within the family environment, ECC is often referred to as a family-centered disease. ECC is a condition that affects infants and toddlers, characterized by the presence of decayed, missing, or filled teeth in children up to 71 months old. Maxillary primary incisors are the initial teeth to be affected. Decalcification of enamel appears as a white area in the cervical third of the tooth. At the early stage, if not identified and treated accordingly, lesion progression occurs and the clinical crown is destroyed. A wide range of cariogenic microbes, fermentable carbohydrates and certain environmental factors are recognised as the primary threats in the initiation and progression of ECC. ECC is a commonly found childhood illness; fortunately, it is an avoidable condition. Inappropriate feeding practices, marginalised populations, ignorant parents and the absence of facilities for dental treatment are principal contributing factors to the high prevalence of ECC. This appraisal focuses on the risk factors and emphasizes approaches to managing ECC.

Gastric Carcinoma, often known as Gastric Cancer, is the second leading cause of cancer-related deaths globally. Gastric cancer symptoms are virtually non-existent and by the time they appear, the disease has most likely spread. There is an urgent need to develop techniques for detecting stomach cancer that do not rely exclusively on histological findings. The Ki-67 labeling index analysis can show the tumor's aggressiveness. The investigation was carried out to assess the utility of Ki-67 as a tool for detecting stomach cancer. The aim of the study was to observe the expression of the Ki-67 expression in histopathologically diagnosed Gastric Carcinoma Patients. This cross-sectional analytical study was carried out in the Department of Pathology, Sir Salimullah Medical College, Dhaka, Bangladesh from July 2017 to June 2019. A total of 60 adults who were histopathologically diagnosed patients with gastric carcinoma in gastric endoscopic biopsies and resected samples. More than one-third of the patients (38.3%) belonged to the age group of 61-70 years. The age of the participants ranged from 40 years to 82 years. Fifty five percent (55.0%) were male and 45.0% were female, 63.3% of the cancers were in the pylorus region, 33.3% were in the body and 3.3% were in the cardiac end. Eighty percent (80.0%) of the participants had intestinal type of cancer and 20.0% had diffuse type. The mean Ki-67 labeling Index was 46.69±12.57 in Intestinal variety of gastric carcinoma 49.47±10.74 in diffuse variety, with no statistical significance between them. Fifty percent (50.0%) of the cancers were moderately differentiated, 36.67% were poorly differentiated and 13.33% were well differentiated. The Association between histopathological grading of gastric carcinoma and Ki-67 was found to be statistically significant. The tumor's growth is very variable. The Ki-67 labeling index demonstrates the proliferative activity of tumor cells. Ki-67 showed significant associations with the diagnosis and prognosis of gastric cancer.

Dermatoglyphics is the analysis of fingerprints. The fingerprint is unchangeable and distinctive for each individual. Various dermatoglyphic studies were conducted earlier in several genetic and metabolic disorders. This cross sectional and observational study with some analytical components was conducted in the Department of Anatomy of Chittagong Medical College, Bangladesh to find out the relationship between digital dermatoglyphics and ABO groups from July 2017 to June 2018. A total of 200 (100 male and 100 female) MBBS Students of Chittagong Medical College, Bangladesh were selected as the study subjects by convenient purposive sampling technique. Finger prints were obtained by ink method and detailed analysis was done by using SPSS-20.0. Mean of Absolute Finger Ridge Count showed highest and lowest values in blood Group B and AB respectively in males and in blood Group B and O respectively in females. Highest and lowest values of mean Total Finger Ridge Count were found in blood Group A and AB in males, in blood Group B and O in females respectively. These findings were statistically significant. This study suggested a relationship of digital dermatoglyphics with blood groups in both genders.

This study aims to examine the impact of the Covid-19 pandemic on various aspects of the personal lives of students of Mymensingh Medical College. This study is descriptive cross-sectional observational study that has been carried out concentrating on the undergraduate and postgraduate students of Mymensingh Medical College, Bangladesh. The location was selected purposively and the "Raosoft sample size calculator" was used in order to determine the size of the sample. The acceptable margin of error for this study is 5.0% at a 95.0% confidence interval, 50.0% response distribution from the total number of 1655 medical students; the calculated minimum total sample size was 312- undergraduate students 218 and postgraduate students 94. Medical students were selected purposively based on inclusion and exclusion criteria. Reliability of the questionnaire has been ensured by measuring Cronbach's α coefficient (0.635) and validity has been established by KMO and Bartlett test. The data collection process started in January 2021 and concluded in December 2021. Correlation analysis indicates a statistically significant impact of the Covid-19 pandemic on the personal lives of the respondents by producing a p-value less than 0.05. The study suggests that most medical students have experienced an increased sense of loneliness and depression regardless of their demographic attributes. Physical health did not improve, although consumption of junk food decreased. On the other hand, students became more religious however, their sense of empathy did not change much and they were currently seized by session jam. The experience of online classes has not been perceived positively by the students.

Psoriasis is a chronic, immune-mediated systemic disease with skin manifestations and multisystem involvement, including effects on the reproductive system. Its pathogenesis involves genetic, environmental, and immunological factors. Cytokines (TNF-α, IL-1, IL-6, IFN-γ) released during inflammation inhibit Leydig and Sertoli cells of testes and affect aromatase activity, leading to testosterone and estradiol imbalance. The study was designed to evaluate serum testosterone and estradiol levels in male psoriasis patients and their association with disease severity. This cross-sectional analytical study was conducted in the Department of Biochemistry, Dhaka Medical College from July 2023 to June 2024 with 50 diagnosed male psoriatic patients (Group A) and 50 healthy controls (Group B) selected from Out-Patient-Department of Dhaka Medical College Hospital. The study subjects were matched according to age, sex and other socio-demographic factors. Subjects were assessed via history, examination, and biochemical tests. Disease severity was evaluated using Psoriasis Area and Severity Index (PASI) and erectile dysfunction via International Index of Erectile function (IIEF-5) questionnaire. Serum total testosterone and estradiol were measured by competitive fluorescence immunoassay. Mean ages were 33.04±6.02 years (Group A) and 29.64±5.71 years (Group B). In Group A, 44.0% had mild (PASI <10) and 56.0% had moderate-severe (PASI ≥10) psoriasis; 26% had a family history and 34% reported erectile dysfunction. Median testosterone was 1.9ng/ml in Group A vs. 6.4ng/ml in Group B (p=0.001) and estradiol was 7 pg/ml vs. 18.5 pg/ml (p=0.003). Moderate-severe psoriasis patients had lower testosterone (1.7ng/ml) and estradiol (4.6pg/ml) than mild cases (3.7ng/ml and 8.8pg/ml, respectively). PASI scores showed significant negative correlations with testosterone (rho = -0.809, p=0.001) and estradiol (rho = -0.715, p=0.001). Psoriasis severity was significantly associated with erectile dysfunction. Male psoriatic patients have significantly lower testosterone and estradiol levels than healthy controls, with severity negatively correlating with both hormones and associated with erectile dysfunction.

The brachial plexus is a complex network that transmits motor and sensory signals between the spinal cord and the upper limbs. Klumpke's palsy, a rare injury affecting the lower brachial plexus (C8-T1 roots), commonly occurs in newborns or adults after severe trauma and is characterized by a claw-hand deformity, sensory loss along the medial forearm and hand and weakness in the small muscles of the hand. Adult-onset Klumpke's palsy following minor trauma is exceptionally rare. We report a unique case of isolated right-sided Klumpke's palsy in a 31-year-old male after a trivial fall from bed. Nerve conduction studies confirmed the diagnosis, showing reduced compound muscle action potentials and absent F-wave responses in the right median and ulnar nerves, consistent with a postganglionic lesion in the lower brachial plexus. A previously healthy 31-year-old man presented with two months of pain, numbness and tingling in his right forearm and hand following a minor fall. He experienced difficulty grasping objects, weakness and claw hand deformity. Examination revealed reduced motor strength in wrist and finger muscles, decreased sensation in C8-T1 dermatomes and hypothenar atrophy, with preserved reflexes and intact cranial nerves. Electrophysiological tests showed absent CMAP in the right ulnar nerve and reduced CMAP in the right median nerve, with no F-waves detected, while sensory conduction was normal. The patient received conservative treatment through a multidisciplinary approach. Physiotherapy focused on range-of-motion exercises, strengthening unaffected muscles, using splints to reduce claw deformity, gabapentin for neuropathic pain and NSAIDs for inflammation and nerve conduction studies were scheduled every three months to monitor recovery. The patient reported prior upper arm compression from a tight bandage, which may have contributed. This case emphasizes the importance of considering lower brachial plexus injury after minor trauma and highlights the key role of electrophysiological diagnosis.

A 32-year-old man was admitted with acute abdomen for 4 days in the Central Hospital Ltd., Dhanmondi, Dhaka, Bangladesh, on 30 September 2019. From history, physical examination and investigation, he was diagnosed as a case of acute intestinal obstruction (Jejuna volvulus causing obstruction). After resuscitation emergency laparotomy was done and which revealed a left paraduodenal hernia with gangrenous jejunum. Resection of the gangrenous gut with end to end anastomosis (duodeno-jejunal) was done. Patient was shifted to ICU for emergency management and then general bed. Total hospital stay was 25 days.

Hypertension is prevalent in chronic kidney disease (CKD) patients and uncontrolled hypertension is a known risk factor for increased cardiovascular morbidity and for progression of CKD. So, accurate blood pressure measurement and its management should be the utmost necessity in CKD population. Left ventricular hypertrophy (LVH), which is thickening of the left ventricular wall, is a surrogate end point of cardiovascular morbidity in hypertensive patients. Goal of this study was to determine the predictive role of ambulatory blood pressure monitoring (ABPM) for LVH in comparison with that of casual blood pressure (CBP) measurement in children with CKD. This cross-sectional study was conducted in the Department of Pediatric Nephrology of Bangabandhu Sheikh Mujib Medical University from June 2020 to July 2021. A total of 68 diagnosed CKD patients, staged 3 to 5D, aged 5 to 18 years were enrolled for the study. CBP was obtained by an oscillometric device (Aneroid) in the office setting and ABPM performed for a 24-hour period with an oscillometric device (Welch Allyn ABPM 7100). Echocardiography was performed for all patients for assessing LVH by calculating the Left Ventricular Mass Index (LVMI). Then the association between ABPM parameters and LVH was determined. The correlation of LVMI with average systolic and diastolic blood pressure was tested for both ABPM and CBP measurements using Pearson's Correlation test. Comparison was made between abnormal ABPM parameter and casual hypertension in predicting LVH by Chi Square test. The mean age of the study subjects was 12.69±2.89 years with a male predominance (62.0%). Twenty-six (38.24%) patients were found hypertensive based on CBP measurement compared to forty (53.0%) patients using ABPM. Assessing that the ABPM would be a better method than CBP measurement, which overrates white coat hypertension (10.3%) but underestimates masked hypertension (20.5%). As a whole, LVH was found in twenty-nine (42.64%) patients. There was a significant association between ABPM parameters (SBP and DBP load, non-dipping, elevated BP index) and LVH. The positive predictive value of systolic and diastolic blood pressure load for predicting LVH were 72.4% and 78.3% respectively. When adjusted with multiple parameters, SBP and DBP loads were found significantly associated with LVH (adjusted odd ratio were 4.58, 5.32 respectively). There was a strong positive correlation between left ventricular mass index with systolic and diastolic blood pressure (by ABPM) (r=0.636, r=0.708 respectively) but weak positive correlation was found between LVMI and CBP. While comparing with CBP measurements, there was a significant association found in predicting LVH and ABPM parameters (DBP load and BP index). ABPM parameters like high diastolic BP load and elevated BP index can predict LVH more than casual BP measurement in children with CKD.