Mymensingh medical journal : MMJ最新文献

Musculoskeletal (MSK) conditions are a leading cause of disability, particularly in rural regions of developing nations where access to physiotherapy is limited. Telehealth offers a potential solution by delivering physical therapy remotely. However, its feasibility for conservative musculoskeletal management beyond post-surgical care remains underexplored in such settings. The study aimed to assess the feasibility and patient acceptance of telehealth physical therapy for musculoskeletal complaints in a rural region of a developing country. A cross-sectional, questionnaire-based study was conducted in a tertiary care institute serving a predominantly rural population. Patients with non-surgical musculoskeletal conditions who had access to smartphones and English literacy were included. Participants were guided to access prescribed physical therapy exercises via online video links and completed a structured questionnaire four weeks later to evaluate understanding, adherence and symptom relief. Among 257 participants (72.8% rural), 75.1% reported symptom relief and 68.9% preferred telehealth for future care. Over 90.0% successfully accessed and understood the exercises; however, barriers included lack of time (48.6%), difficulty understanding techniques (12.1%) and unavailability of local-language content (10.9%). No demographic factors significantly correlated with symptom relief. Telehealth physical therapy is a feasible and well-accepted modality for managing MSK complaints in rural populations of developing nations. Despite adherence and content-language challenges, it holds promise for improving rehabilitation access. Strategic implementation focusing on culturally appropriate content, digital literacy and hybrid care models could expand its effectiveness and scalability.

A-35-years old male was presented with recurrent ischemic stroke with left atrial myxoma. The two most common types of ischemic strokes are thrombotic and embolic. Cardiac myxoma is a source of emboli to the central nervous system. In absence of any history of cardiac problems cardiac investigations may not be performed in ischemic stroke and diagnosis of cardiac myxoma may be delayed as in the case reported here. Cardiac myxoma should be considered in any patient presenting with ischemic stroke and echocardiography should be performed to reach a definitive diagnosis.

Subtrochanteric femoral fractures account about 10.0% to 34.0% of all hip fractures with a high complication rate. Anatomically the fracture is proximal to adequately control with implants for femoral shaft and distal enough to control with implants used for intertrochanteric fractures. Inherent instability and forces of muscles giving the fracture a tendency to varus collapse. Due to high rate of implant failure; extramedullary and intramedullary implants are not suitable these fractures. Recently Proximal femoral nail (PFN) has been applied in treatment of subtrochanteric fractures. It has an excellent result in respect of union, fewer complications and early rehabilitation. The aim of this study was to assess the rate and time for union of fractures by PFN and determine perioperative parameters. This prospective study was conducted from August 2022 to July 2023 at Mymensingh Medical College Hospital through non randomized purposive sampling. Total 20 patients aged above 18 years irrespective of sex with closed subtrochanteric fracture were included but pathological fractures, multiple injuries were excluded from the study. Healing process and postoperative complications were recorded after clinical and radiological evaluation. Radiographic Union Score for Tibial (RUST) fracture of Whelan was used to evaluate Union status; by where radiographs (X-ray) based assessment of healing of the four cortices done. The entity cortical scores were added to give an entire score; 4 being the least amount demonstrating fracture are positively not healed and 12 being the highest score representing that the fracture is positively healed. Mean age of the patients was 44.65±12.30 years with range 25-70 years. Majority of patients were male (65.0%) and most of injury (80.0%) due to road traffic accident with most fractures was Seinsheimer type II (45.0%). Average operative time was 98.75±17.23 minutes. Follow up period was average 34.05±3.12 weeks (26-36 weeks) time to union was 13.40±3.80 weeks (10-26 weeks). According to RUST criteria; union rate 95.0% with delayed union 5.0% and no nonunion. There were two patients with superficial wound infection and no implant failure. This study concludes that PFN is a safe and reliable implant for the treatment of subtrochanteric femoral fractures.

Transfusion-transmissible infections (TTIs) like hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis pose significant public health challenges, particularly in developing nations. Blood transfusions can pose a significant risk for these infections if proper screening procedures are not followed. This study aims to determine the prevalence and trends of TTIs among blood donors at Mymensingh Medical College Hospital, Bangladesh. This retrospective and cross-sectional analysis was conducted on donor records from January 2023 to December 2024. Donor samples were screened for HBV, HCV, HIV and syphilis using Immunochromatography (ICT) methods. Demographic data, including age, sex and blood group, were also analyzed, along with monthly and yearly trends. Out of 116,689 donors, 669 (0.57%) were sero-positive for at least one infection. HBV was the most prevalent (0.49%), followed by syphilis (0.07%), HCV (0.02%) and HIV (0.01%). Most sero-positive donors were male (87.9%) and within the 26-35 years age group (69.6%). Blood group O had the highest proportion (47.4%) of sero-positive cases. HIV and syphilis prevalence increased slightly in 2024 compared to 2023. The highest monthly TTI cases recorded in the month of June. Although the overall TTI prevalence among blood donors was relatively low, HBV remains a significant concern. Continuous screening, awareness campaigns and improved public health interventions are necessary to reduce the risk of TTIs and ensure safe blood transfusion practices.

Trimetazidine (TMZ) has anti-ischemic effects by increasing glutathione peroxidase and membrane damage caused by reactive oxygen species (ROS) and also production of trimethylamine N-Oxide (TMAO) which causes cytoprotection and provides the renoprotective effect. This preclinical trial was conducted in Animal rat house of Pharmacology Department at BSMMU, Dhaka, Bangladesh from 1st March to 31st 2017 for 30 days, this experimental study sixty-six (66) rats were divided into eight groups. Group I and II received no medication. Three groups (IIIa, IVa and Va) of rats were induced diabetic nephropathy by streptozotocin (STZ). Parallel to these groups, three combined treatment groups (IIIb, IVb and Vb) treated by trimetazidine concomitant with STZ. IIIa and IIIb were sacrificed on 22nd day to detect incidence of nephropathy, groups IVa and IVb were sacrificed on 43rd day to detect onset of nephropathy and groups Va and Vb were sacrificed on 57th day to detect progression of nephropathy. Biochemical indices like the status of oxidative stress were assessed by serum creatinine levels. In streptozotocin treated groups, serum creatinine was significantly (p<0.01) higher when compared to control. In TMZ treated group, whereas serum creatinine was significantly (p<0.01) lower when compared with STZ induced nephropathy groups of rats. It may be assumed from the present study that trimetazidine has cytoprotective as well as prevent renal damaged because of its special antioxidant effects, which can delay the onset, severity and progression of nephropathy induced by STZ in rats by reducing serum creatinine level.

This study aimed to evaluate the relationship between body mass index (BMI) and the severity of dengue infection among hospitalized adult patients in Bangladesh. This observational study was carried out at Mymensingh Medical College Hospital in Bangladesh from June 2024 and September 2024. This study enrolled 389 laboratory-confirmed adult dengue patients. At admission, data on demographics, clinical features and lab results were collected and in-hospital outcomes noted. Patients were categorized into normal weight (BMI 18.5-23.0kg/m²) and overweight-obese (BMI ≥23.0 kg/m²) groups using Asian-specific BMI cutoffs. The 2009 'WHO' dengue case definition was used to classify disease severity. The study patients were observed with a median age of 28 years (Range: 18-80) and the majority were male (80.7%). Among the patients, 265 had normal weight and 124 were classified overweight-obese. Overweight-obese patients were comparatively older (median age: 31 vs. 26 years; p<0.001) and also were predominantly male. A higher prevalence of complications was observed in overweight-obese patients including ascites (32.3% vs. 21.1%; p=0.018), plasma leakage (31.5% vs. 20.8%; p=0.022), pleural effusion (24.2% vs. 14.3%; p=0.017) and persistent diarrhea (16.1% vs. 7.9%; p=0.014). Dengue severity distribution was 27.8% without warning signs, 66.8% with warning signs and 5.1% severe cases. The in-hospital mortality rate was 0.8%. BMI was not associated with dengue severity, hospital stay, or mortality (p>0.05). In this single-center study from Bangladesh, overweight and obese patients with dengue exhibited a higher frequency of complications; however, BMI was not significantly associated with dengue severity or in-hospital outcomes.

Ineffective performance of cardiopulmonary resuscitation (CPR) when needed will cause poor clinical outcomes. Hence more focus should be on the improvisation of CPR training. Various methods of teaching have been used in basic life support (BLS) training. This prospective, single-blinded, quasi-experimental study that evaluated an educational intervention at a tertiary teaching hospital from September 2022 to June 2023. In this study, we aimed to highlight the application of objective structured clinical examination (OSCE) to identify amateur BLS skills and the use of deliberate practice to master that skill. Structured BLS training was provided to 225 participants including nursing staff (n=158), paramedical staff (n=23) and medical students (n=44). A pre-validated OSCE checklist based on the American Heart Association (AHA) 2020 guidelines for cardiopulmonary resuscitation was included for skill-based assessment. The pre and post training OSCE scores of participants were compared. The OSCE was used to identify the skills that needed more practice and the aim was to practice until the score was 100.0% as per the OSCE checklist. A pre and post-test questionnaire with questions covering the theoretical aspects of BLS was administered to all participants. Out of 225 enrolled participants, 177 completed all stages of training. Post training OSCE scores statistically improved in all the participant with (n=79) or without prior (n=98) experience of CPR training. Most forgotten step while demonstrating the BLS was calling for help (33.0%). Immediately after training only 65.0% were able to demonstrate the BLS sequence as recommended by AHA (American Heart Association). Median number of OSCE practice sessions to achieve a 100.0% score was 2 (two) for those with prior training and 4 (four) for first-time trainees. Willingness to give CPR in future emergencies increased from 85.0% to 96.0% among participants after training. The OSCE scores pre and post training improved in both novices and previously trained participants. OSCE can be used as a training tool to check and improve knowledge of BLS.

Acute myeloid leukemia is the second most common type of leukemia in adults. The treatment of acute myeloid leukemia is very challenging. This observational study was conducted with total of 54 patients with de novo acute myeloid leukemia were identified at the department of Hematology in National Institute of Cancer Research and Hospital, Dhaka, Bangladesh from July 2016 to June 2022 who were treated with induction chemotherapy (3+7) consisting of daunorubicin and cytarabine and 3 cycles High dose intermittent ARA-Cas consolidation regimen. Patients who were refractory to induction therapy received re-induction therapy, if they achieved remission after re-induction then received consolidation therapy. Morphological complete remission was achieved in 70.4% of the patients and resistant disease was seen in 22.2% after induction therapy. Early mortality after induction therapy occurred in 7.4% cases. Thirty three percent (33.0%) of patients with complete remission after conventional therapy developed relapse with median follow up of 36 months. The median overall survival was 18 months. The overall survival of acute myeloid leukemia patients was 42.6% at 6 years. The event-free survival at a median of 36 months was 33.3%. With the view of scarcity of the indexed data in Bangladesh we have designed this study. In addition, this study result will help all hematologists.

Stroke is a global health problem. It is the leading cause of disability and the second leading cause of mortality worldwide. This observational study was carried out in the Department of Medicine and Department of Neurology, Mymensingh Medical College Hospital, Bangladesh a tertiary-level academic and treatment-based hospital in Bangladesh from 1st July 2013 to 31st December 2013, to find out the abnormalities of lipid profile of patients of ischemic stroke involving anterior circulation. Patients having a history of stroke were enrolled in the study after getting informed written consent from the patient or attendant. One hundred hospitalized adult patients with stroke were selected for the study based on inclusion and exclusion criteria. Fifty-one percent (51.0%) of patients were accustomed to leading a sedentary lifestyle. The majority of the patients hailed from urban areas of Bangladesh and seventy-eight percent had a habit of experiencing active lifestyle patterns. Among the risk factors, it was observed that hypertension was a major (72.0% cases) risk factor for stroke. Diabetes mellitus was detected in 15.0% of cases. The majority were Type-2 Diabetes mellitus. Forty percent (40.0%) of the patients were smokers in various forms. The majority of patients (52.0%) have normal serum cholesterol within normal limits (<200 mg/dl), but in more cases 48.0% above the normal limit (>200 mg/dl), 12.0% cases have raised Low Density Lipoprotein (LDL) Cholesterol (>190 mg/dl), only 6.0% cases have low (<100 mg/dl) High Density Lipoprotein (HDL) Cholesterol and 20.0% cases have raised serum triglyceride (TG) level (>200 mg/dl). So, we should think about known dietary habits, lifestyle and risk factors of stroke, proper control of which plays an important role in the primary prevention of the disease.

Bacterial infection is one of the biggest causes of morbidity and mortality worldwide. Pathogens have also gradually developed resistance to the miracle drug, antibiotics. That's why interest in searching for effective alternatives for the current antibiotics with different mode of action on microbes is increasing. In this regard, one of the reputed medicinal plants, Nigella sativa (Kalojira) was investigated for potential antibacterial effect against commonly encountered pathogens (Staphylococcus aureus and Escherichia coli). Both aqueous and ethanolic extract of Kalojira was found active against Staphylococcus aureus and Escherichia coli in disc diffusion method. Zone of inhibitions of aqueous extract at 100.0% (1000μg/ml) concentrations were 25mm against Staphylococcus aureus, 24mm against Escherichia coli. Zone of inhibitions of ethanolic extract were 32mm against Staphylococcus aureus and 32mm against Escherichia coli at 100.0% concentration. The broth dilution technique was performed to determine the MICs of Aqueous kalojira extract (AKE), EKE and Amikacin. The MICs of AKE were 500μg/ml and 600μg/ml against Staphylococcus aureus and Escherichia coli respectively. The MICs of EKE were 400μg/ml and 400μg/ml against aforesaid organism respectively. The MIC of Amikacin was 1.5μg/ml against Staphylococcus aureus and 1μg/ml against Escherichia coli. The MIC of Amikacin was lowest in comparison to MICs of AKE and EKE for the test organisms. The subculture study showed the same results with that of previous experiments.