Mymensingh medical journal : MMJ最新文献

Hirsutism is a very common psychologically distressing medical condition. Laser is the commonly used method for the treatment of hirsutism. This study aims to observe the outcome and side effects of Nd:YAG Laser (Neodymium-doped Yttrium Aluminium Garnet laser) in hirsutism. This study was performed at the the department of Dermatology and Venereology, Dhaka Medical College Hospital, Bangladesh from June 2022 to December 2022 in which thirty-eight (38) female patients with facial hirsutism, aged 18-42 years were included and evaluated for the outcome and side effects of Nd:YAG laser with a spot size of 10 mm, fluence range of 18-25 (J/cm²) with pulse duration 25-40 ms for our skin photo type. Starting fluence of 18 (J/cm²) was increased by 10% at each laser session. Results showed that 31(81.6%) patients had excellent response followed by fair 4(10.5%) and 3(5.3%) good with poor 1(2.6%) at the end of 6 session. Short-term erythema was seen in 31.6% of patients, perifollicular oedema in 50.0% and post-inflammatory hyper-pigmentation in 3.0% of patients. The study showed that long pulsed (1064 nm) Nd:YAG laser is a very safe and effective means of hair reduction.

In recent years, there has been increased interest to find the association between gestational diabetes mellitus (GDM) and serum vitamin D status. Pregnant women all over the world have a substantial frequency of vitamin D insufficiency. There is much significant evidence that low vitamin D levels may be modifiable risk factors for GDM. The aim of the present study was to evaluate serum vitamin D status and observe its association with GDM. This cross-sectional study was conducted in the department of Biochemistry and Molecular Biology of BIRDEM General Hospital, Dhaka, Bangladesh from July 2016 to June 2017. Total 200 pregnant women (all aged between 20-40 years) were select from the outpatient department (OPD) of Gynaecology and Obstetrics BIRDEM General Hospital-2, Dhaka, Bangladesh. Among them 100 GDM patients were taken as cases and 100 normoglycemic pregnant women were taken as controls. Serum vitamins D, fasting blood glucose, 2 hours postprandial blood glucose were estimated in all pregnant women by standard laboratory methods. The mean vitamin D level was significantly lower in GDM patients compared to controls (22.36±11.05 vs. 37.1±15.4; p<0.001). Serum vitamin D levels were considerably lower in GDM patients than those of pregnant normoglycemic women.

Rectocele is a frequent cause of obstructed defecation and pelvic floor symptoms, yet Local data on presentation patterns and care pathways are limited. This study was aimed to evaluate patient characteristics, diagnosis spectrum and correlate symptoms with diagnosis and management in our hospital. It is a Retrospective observational study at Colchester General Hospital, ESNEFT. The study duration is 5 years, from January 2019 to December 2023. All patients who attended the Surgical outpatient clinic with features of obstructive defaecation symptoms and had a confirmed imaging diagnosis of rectocele in proctogram were included in this study. Among 132 patients with obstructive defecation syndrome (ODS), the majority were female 130(98.0%), with a mean age of 57.0±14.7 years, predominantly aged 50-64 years. Nearly half 62(47.0%), were diagnosed with rectocele combined with intussusception, 37(28.0%) with isolated rectocele and 33(25.0%) with rectocele with other pelvic floor disorders. The most frequent presenting symptoms were faecal incontinence 57(43.2%) and chronic constipation 55(41.7%) with others including incomplete evacuation, vaginal lump, rectal lump, passive faecal leakage during defaecation and prolapse. Chronic constipation and faecal incontinence remain the common symptoms at presentation in patients with rectocele. Conservative management, chiefly physiotherapy, was initiated in 121(91.7%) of patients, while surgical intervention was 5(3.78%). Most patients 118(89.4%) did not require further follow-up and 4(3.0%) showed excellent symptom improvement. Faecal incontinence and constipation dominate the symptom profile in our cohort. Most Patients had rectocele coexist with other pelvic floor pathologies, highlighting the need for Multidisciplinary assessment and conservative management remains the mainstay of treatment.

Tonsillectomy is one of the most commonly performed surgeries in Otolaryngology practice. Despite improvements in anesthetic and surgical techniques, post-tonsillectomy morbidities especially pain continue to be a significant clinical concern. This prospective, double blind, Randomized Controlled Trial (RCT) was conducted at Department of ENT and Head-Neck surgery, Dhaka Medical College Hospital, Bangladesh from January 2021 to June 2022. Total 100 patients were enrolled through non-probability purposive sampling and according to the selection criteria, who were admitted for elective tonsillectomy. They were randomly allocated into two groups of 50 persons each- 'Intra-operative local infiltration of Bupivacaine' (B) and 'Normal saline' (N) group according to intervention applied on them. A significantly lower score on Wong-Baker Faces Pain rating scale (WBS) was found in group 'B' comparing with group 'N' at 4, 6 and 8 hours interval after the surgery. Group 'B' patients started their oral intake significantly sooner than group 'N' patients. On analysis Pre-incisional peritonsillar infiltration of 0.5% Bupivacaine hydrochloride is a safe and effective method to reduce early post-tonsillectomy pain. This intervention is also effective for earlier start of oral feeding and to decrease in the incidence of post-operative morbidities.

Adenotonsillectomy is the most commonly performed surgery in children; in most cases, recurrent upper respiratory tract infections (URTIs) are the indication of surgery. This study aimed to investigate the effectiveness of adenotonsillectomy in children with URTIs in a tertiary level hospital in Bangladesh. This prospective observational study was done in the Department of Otolaryngology-Head and Neck Surgery of Chittagong Medical College Hospital (CMCH), Chattogram, Bangladesh from February 2023 to march 2024. Eighty (82) children with a diagnosis of recurrent URTIs who had adenotonsillectomy were analyzed regarding fever, throat pain, and cough. Data were recorded from each patient before surgery and 2 weeks, 1 month and 3 months after surgery. Pain was assessed by Visual Analogue Scale (VAS) and cough severity was assessed by Cough Symptoms Score (CSS). The age ranged between 4.0-14.0 years with a mean age of 8.2±2.4 years and 61.0% were female. At 3 months, pain intensity reduced in 42(51.2%) patients from baseline and remains unchanged in 40(48.8%) patients. Before surgery, 17.4% of the patients reported frequent daytime coughing which did not interfere with daytime activities. Two weeks, one month and 3 months after surgery, 4.9%, 4.9% and 7.3% of the patients reported frequent daytime coughing, respectively. Before surgery, most (64.6%) of the patients reported having night-time cough on waking only. Two (2) weeks, 1 month and 3 months after surgery, 29.3%, 20.7% and 35.4% of the patients reported night-time cough on waking only, respectively. Preoperative mean±SD temperature was 38.4±0.4°C. At 2 weeks, 1 month and 3 months after surgery, temperature reduced to 38.1±0.3°C, 37.9±0.4°C and 37.7±0.6°C, respectively (p<0.001). Adenotonsillectomy is effective in reduction of throat pain, cough severity and fever. One in every two children with recurrent URTIs reported symptomatic improvement following adenotonsillectomy.

Reconstruction of heel defects is challenging due to its unique anatomical character. Here, weight-bearing and protective sensations are both of equal importance for a defect to be reconstructed. The medial plantar artery (MPA) flap provides a durable, glabrous and sensate reconstructive option that closely resembles the native heel pad. This is a retrospective observational study where data were collected for operations done between January 2021 and December 2024 in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital (MMCH), Bangladesh. Fifteen (15) patients who underwent heel reconstruction with MPA flaps were evaluated for demographic data, etiology, flap survival, sensory recovery and postoperative outcomes. A total of 15 patients were operated on during this period, among them 11 were male and 4 were female. The mean age at surgery was 54.66 years (range 43-68 years). The etiologies identified were trauma (n=5), malignancy (n=4), neuropathic ulcer (n=2), infection (n=2) and unstable scar (n=2). Comorbidities included diabetes (n=5), hypertension (n=7) and ischemic heart disease (n=1). The mean surgical duration was 130 minutes and the average hospital stay after surgery was 7.06 days. There were no complete flap losses or any other donor site complications except one case of partial/distal flap necrosis, which was managed conservatively. All patients achieved protective sensation and were able to bear weight during the follow-up period. The MPA flap is a reliable and effective option for heel reconstruction, offering favorable functional outcomes with minimal donor site morbidity. It remains an ideal choice for covering moderate-sized defects in the plantar heel region.

Regular exposure to stressful situations makes police professionals more susceptible to mental health disorders. Despite the vital role in upholding law and order, the frequency of psychological problems among police professionals in Bangladesh is under-explored. This study aimed to assess the mental health status of the police professionals working at different level across Bangladesh by measuring the level of depression, anxiety and stress. A nationwide cross-sectional survey was carried out between January 2022 and December 2022, with 413 police professionals from all eight divisions and 27 districts of Bangladesh, who were purposively chosen to participate. Data were collected through a semi-structured questionnaire including the Depression, Anxiety and Stress Scale (DASS-21), personal and professional information. Descriptive statistics and bivariate analyses were conducted in SPSS version 26.0. According to DASS-21 score the results showed that 40.0% police personnel had 'normal' level of depression; 29.3% had 'normal' level of anxiety and 65.6% had 'normal' level of depression. While significant number of police personnel had severe to extremely severe symptoms of depression (29.6%), anxiety (48.7%) and stress (18.4%). Unintentional joining to the police force was associated with much greater levels of stress, anxiety and depression than joining by own choice or parental choice. Overall, the study showed that Bangladeshi police professionals have a significant mental health burden, with higher prevalence rates than other countries. That seems to be worsened by organizational stresses, stigma and a lack of welfare support, highlighting the necessity for structural changes, routine screening and counseling interventions.

Empyema evolves through exudative, fibrinopurulent and organized phases throughout 3 to 6 weeks. Clinical symptoms, a chest skiagram followed by thoracentesis, are enough for diagnosis. Most patients improved with systemic antibiotics, thoracentesis and chest tube drainage. The present case represents a four-year-old girl who had a fever, cough, chest pain and breathing difficulty for two weeks. Right-sided empyema was diagnosed after admission to our facility, which had not responded to appropriate antibiotics and closed chest tube drainage. Re-evaluation of the patient indicates a possible case of encysted empyema. Thoracotomy and decortication were done in collaboration with Thoracic Surgery Department, Chittagong Medical College Hospital, Bangladesh. Her recovery was excellent, with supervised post-operative care in the Pediatric Intensive Care Unit in the same facility. Radiographic loculation is one of the predictors of failure to conservative management. Choosing the correct treatment option based on the stages of empyema is vital, which can reduce morbidity and mortality. In addition, Patients got standard management at a reduced cost as full investigation, including contrast-enhanced computed tomogram (CECT), specialized surgical procedure and intensive care facilities were provided by a government hospital.

Preeclampsia (PE) is a common obstetrical disorder. It is a major cause of morbidity and mortality of mother as well as fetus. Its complex pathophysiology still remains unclear. Serum ferritin is an important marker of status of iron. Iron plays role as a catalyzer of oxidative stress as well as lipid peroxidation in the pathophysiology of preeclampsia. This study was conducted with an aim to explore the relation between serum ferritin and preeclampsia. This cross sectional comparative research was carried out in the Department of Obstetrics and Gynecology of Mymensingh Medical College Hospital, Bangladesh from March 2021 to September 2022. A total of 62 singleton pregnant women with preeclampsia were selected as case and 62 singleton normotensive pregnant women were selected as control in their third trimester after meeting the inclusion criteria. Venous blood sample was withdrawn from each participant that was centrifuged to separate the serum and that was used to measure serum ferritin level. Serum ferritin was measured by chemiluminescent immunometric assay. All data were collected using a structured questionnaire and analyzed by using window based computer software devised with Statistical Packages for Social Sciences (SPSS, 22.0). Mean serum ferritin level among case and control was 136.40±117.13ng/ml and 65.38±43.77ng/ml respectively which was statistically significant (p=0.001; Odds ratio 10.47; 95% Confidence interval = 3.11-38.8). Patients with preeclampsia had higher serum ferritin level in contrast with normal pregnant women. Raised serum ferritin might have influence in the pathogenesis of preeclampsia.

The objective of this study was to evaluate the efficacy of Exposure and response prevention (ERP) therapy in combination with Selective Serotonin Reuptake Inhibitors (SSRIs) in adolescents with Obsessive-Compulsive Disorder (OCD). This parallel arm interventional study was conducted among 40 adolescents with OCD in the Outpatient Clinic of the Department of Psychiatry of Bangladesh Medical University (BMU) Hospital, Dhaka, Bangladesh from May 2018 to September 2020. The participants were randomly selected either for SSRI in combination with ERP therapy (n=21) or SSRI only (n=19). The change in severity of OCD symptoms measured by Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and rate of response (≥25.0% reduction in OCD severity from baseline) and remission (final CY-BOCS score ≤12) were considered as the outcome measures. Combination of ERP therapy with SSRIs resulted in more reduction of OCD symptom severity in adolescents compared to SSRI only therapy (reduction in CY-BOCS score was 43.8% and 28.2% respectively at week 12, p-value <0.001). Besides, rate of 60 response at week 6 and rate of remission at week 12 were higher in adolescents who received ERP therapy in combination with SSRIs (response rate 85.7% vs. 26.3%, p-value <0.001 and remission rate 42.9% vs. 28.6%, p-value 0.001). Combination of ERP therapy and SSRI had a better efficacy compared to SSRI only in symptom reduction in adolescents with OCD.