Mymensingh medical journal : MMJ最新文献

Covid-19 is a major public health concern globally and also in Bangladesh. The highly transmissible Covid-19 has plagued the worldwide population with a continuous upward thrust of the death toll, which might be related to insufficient knowledge, attitude and practice (KAP) score, and public awareness. The study was carried out with the objective to assess the level of knowledge, attitude and practice regarding Covid-19 among the adult people of a selected sub-urban community. It was a descriptive type of observational study that was carried out at Keraniganj Upazilla, Dhaka, Bangladesh from August 2022 to October 2022. Data were collected by face to face interview with a semi-structured questionnaire. Total 618 adult persons were included in the study. Total 15 questions were asked to assess the knowledge, attitude and practice of Covid-19. It is found that, majority 423(68.4%) of the respondents have the correct knowledge about the causative agent, 479(77.5%) of the respondents have the correct knowledge about the mode of transmission, 466(75.4%) of the respondents have the correct knowledge about the source, 528(85.4%) of the respondents have the correct knowledge about the symptoms of the disease 564(91.3%) of the respondents have the correct knowledge about preventive measures. Regarding attitude, majority 297(48.1%) of the respondents feel that Covid-19 is a very dangerous disease, 341(55.2%) respondents believe that vaccines are very useful, 351(56.8%) respondents believe that mask is very useful, 336(54.4%) respondents believe that distancing and isolation is very useful and 553(89.5%) respondents have the positive attitude about treatment seeking. Regarding practice, it is revealed that, only 25(4.0%) of the respondents are not vaccinated against Covid-19; 268(43.4%) respondents have taken 3 doses, 286(46.3%) respondents have taken 2 doses and 39(6.3%) respondents have taken 1 dose of vaccine. It is also found that, 321(51.9%) respondents use face mask irregularly, 364(58.9%) respondents wash hands regularly and 328(53.1%) respondents maintain distance sometimes. The findings of the study indicate that knowledge regarding Covid-19 is very poor among the community people. Considering the findings of the study it is recommended that more emphasis should be given on awareness building programs to attain positive attitude and proper practice related to Covid-19.

Lingual foramina are present on the inner surface of the anterior portion of body of mandible. These foramina provide passages of neurovascular structures to the mandible. The aim of the study was to identify these foramina if present, as well as their different positions in the anterior mandibular regions. This cross-sectional descriptive study was done on 150 fully ossified dry human mandibles in the department of Anatomy, Mymensingh Medical College, Bangladesh from July 2019 to June 2020. A non-random purposive sampling technique was adopted. Study was carried out by observations only. Lingual foramina were classified into midline position behind the symphysis menti and lateral position to symphysis. Again, in midline, they were grouped into three groups in relation with the position of genial tubercle (mental spine) as supraspinous, interspinous and infraspinous positions. Lingual foramina were present in all samples. In 96.0% samples, foramina were located in midline and rest 4.0% having lateral foramina. In midline position, they were grouped in relation with the mental spine. Among 144 samples, 79.86% foramens were found above the spine (supraspinous), 4.86% foramens found in between the spine (interspinous) and 15.27% foramens found below the spine (infraspinous). Study of these mandibular foramina helps to lower the per and post operative complications such as hemorrhage and hematoma formation in operations like implant placement, autogenous bone graft etc.

Trimetazidine increase glutathione peroxidase and limits membrane damage caused by reactive oxygen species (ROS). It also has cytoprotective effect and limits the production of trimethylamine N-Oxide (TMAO) and provides the renoprotective effect. This study was designed to evaluate the renoprotective effect of trimetazidine (TMZ) in an experimental model of streptozotocin (STZ induced diabetic nephropathy in rats. For this experimental study sixty-six rats (66) were divided into eight groups. Group I (C1) and group II (C2) were normal healthy rat groups and sacrificed on 22nd day. Three groups of rats were induced diabetic nephropathy by streptozotocin (STZ) single intraperitonial administration at a dose of 50mg/kg body weight. Biochemical indices like serum blood sugar and the status of oxidative stress was assessed by renal cortical glutathione (GSH) levels. In streptozotocin treated groups, renal glutathione was significantly (p<0.01) lower when compared to control. In TMZ treated group, whereas renal glutathione was significantly (p<0.01) higher when compared with STZ induced nephropathy groups of rats. It may be assumed from this study that trimetazidine has nephroprotective effects because of its special antioxidant effects, which can delay the onset, severity and progression of nephropathy induced by streptozotocin in rats. Therefore, trimetazidine may be extensively studied in human with diabetic nephropathy for confirmation of its nephro-protective effects.

Nearly every sector in the world was impacted by Covid-19, including the higher education and medical education systems. Distance learning is a recent development in Bangladeshi medical education. It is still unknown how online learning affects academic performance. This study aimed at assessing the association between online teaching and academic performance of medical students during Covid-19 pandemic. This cross-sectional descriptive type of observational study was carried out at Dhaka National Medical College and Shaheed Suhrawardy Medical College in the city of Dhaka and involved 202 4th-year medical students of both sexes. Purposive sampling was used to take samples. With the aid of a semi-structured questionnaire and a checklist, data were gathered via in-person interviews and record reviews, respectively. The study's results were displayed in tables and graphs as percentages, frequencies, and frequency distributions for categorical variables, along with means and standard deviations for continuous variables. Fisher's Exact test and the Chi square test were both used to evaluate associations between categorical variables. Among 202 students, with mean ±SD age of 23.04±0.969 years, 54.00% were female. Majority (78.70%) of students resided in urban areas that had monthly family income between TK.15000-TK.50000. For online classes, 76.20% students used smart phones for Zoom platform (85.60%) with 4G service (74.3%). Students had difficulty in interacting with teachers (55.4%), had illness (42.60%), among which vast majority (59.30%) complained of headaches. A major portion of the students (56.9%) felt that studies were hampered by the pandemic and thus suffered from mental pressure (63.9%) resulting in 75.0-79.0% class attendance (54.50%). Item score was 6.0-6.9 out of 10 in 60.9% students and 94.10% passed the second professional examination. Mass online learning is a fresh idea made possible by the pandemic. Given that medical education is heavily practice-based, it is important to investigate how online teaching affects students' academic performance.

Fractures of the shaft of the femur are among the most common fractures encountered in orthopaedic practice. The goal in treating a femoral shaft fracture is to promote union, mobilize the patient and restore the function of the limb. The aim of the study was to evaluate the effectiveness of primary dynamization with intramedullary interlocking nail for the treatment of femoral shaft fracture (AO type 32-A3). This prospective study was conducted in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh from July 2017 to June 2019. Fifty (50) patients with closed transverse fracture shaft femur (AO type 32-A3) were selected purposively as study participants. Patients with open fracture, pathological fracture, bilateral fracture and fracture at the lower third or neck of the femur were excluded from the study. All patients were treated with primary dynamization with intramedullary interlocking nail and followed up for one year. Final outcome was assessed using Thoresen criteria. The mean ±SD age of the patients was 32.5±11.8 years where most of the patients (92.0%, n=46) were male. The mean ±SD duration of injury of the patients was 13.9±4.7 days and 6 patients (12.0%) had associated injuries. Forty four (44) patients completed the one year follow up. According to the Thoresen criteria, majority of the patients (59.1%, n=26) had excellent outcome and near about one fifth of the patients (22.7%, n=10) had good outcome. Others had moderate (15.9%, n=7) and poor outcome (2.3%, n=1). Excellent outcome was significantly more among patients without associated injury (p=0.036). Primary dynamization with intramedullary interlocking nail is effective for the management of transverse fracture shaft of femur (AO type 32-A3).

This study analyzed data from the 2017-18 Bangladesh Demographic and Health Survey to examine the association between cooking fuel type and hypertension among women aged 30-49 years. From an initial sample of 20,127 women aged 15-49 years, a final analytical sample of 1,126 women aged 30-49 years was derived based on self-reported hypertension diagnoses and complete data availability. Among these women, 221(19.6%) reported being diagnosed with high blood pressure by a medical professional. The majority (81.2%) used unclean cooking fuels and 81.6% were not diagnosed with hypertension. Bivariate chi-square analysis showed no significant association between type of cooking fuel and hypertension (p=0.79). Univariate logistic regression similarly indicated no significant relationship (OR=0.95, 95% CI: 0.66-1.38). Multivariable logistic regression adjusting for age, BMI, education, occupation, residence, wealth and media exposure showed a marginal 5.0% higher likelihood of hypertension among women using unclean fuels compared to those using clean fuels. Additionally, rural residence, agricultural occupation and higher education were associated with a reduced risk of hypertension. Although the study did not find a statistically significant link between cooking fuel type and hypertension, socioeconomic and demographic factors played a more prominent role. These findings highlight the need for integrated public health strategies that address multiple determinants of hypertension risk among Bangladeshi women.

Glaucoma is chronic progressive irreversible optic neuropathy characterized by significant visual field (VF) loss. So, early diagnosis and proper treatment can preserve the useful vision in lifetime. The objective of the study was to determine the importance of ganglion cell complex (GCC) analysis as a parameter for diagnosis of glaucoma. This case control study was conducted in the Department of Ophthalmology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Bangladesh over a period of one year from July 2017 to June 2018. Twenty five (25) Type-2 Diabetes control subjects and 50 subjects with Type-2 diabetes were divided into two groups, 25 diabetic with pre perimetric and 25 diabetic with perimetric glaucoma. In this study, there was no significant difference in age (50.92±5.53 years vs. 52.44±4.75 years vs. 52.64±7.80 years), gender. Regarding Optical coherence tomography (OCT) Retinal Nerve Fiber Layer (RNFL) of right eyes of the study subjects, superior and inferior RNFL were significantly thinner in both pre-perimetric right eye (109.18±8.95 and 111.21±10.53) and perimetric right eye (90.28±8.94 and 91.51±7.87) comparing normal eyes (129.12±2.68 and 132.17±3.22). Superior and inferior RNFL were significantly lower in both pre-perimetric (110.13±11.53 and 113.75±9.61) and perimetric (95.93±15.08 and 93.29±12.68) left eyes comparing normal left eyes (129.71±5.50 and 132.57±5.22). Regarding OCT GCC layer of right eyes of the study subjects, superior and inferior GCC layer were significantly lower in both pre-perimetric (87.66±3.81 and 89.70±4.98) and perimetric (77.48±6.97 and 79.21±6.06) right eyes comparing normal eyes (104.53±2.73 and 106.88±3.29). Regarding OCT GCC layer of left eyes of the study subjects, superior and inferior GCC layer were significantly lower in both pre-perimetric (84.88±3.82 and 87.21±3.77) and perimetric (81.08±9.51 and 80.01±10.02) left eyes comparing normal eyes (102.64±2.29 and 105.20±1.27). GCC parameter is useful tool for diagnosis of Glaucoma. It has same ability to discriminate eyes with glaucoma and non glaucomatous eyes compared to RNFL. In glaucoma, GCC layer is significantly thin which correlates strongly with glaucomatous damage. According to our result GCC layer analysis is important investigation to diagnosis of Glaucoma.

The self-directed learning (SDL) ability of medical stu-dents is the crux of life-long learning for sounder patient care. The purpose of the study was to assess the readiness for SDL of phase I undergraduate medical students, evaluate the influence of sociodemographic factors on their readiness and appraise the perceptions of students and faculties about the structured SDL sessions. This study was a cross-sectional mixed method study. The self-directed learning readiness assessment of students was done with Abridged Fisher's SDL readiness scale. The influence of sociodemographic factors on self-directed learning readiness was analyzed with multiple linear regression taking p<0.05. Students' feedback evaluation by Satisfaction index of Likert scale question responses and thematic analysis of answers from open-ended questions were performed. The mean value of SDL readiness score of phase I MBBS students derived in this study was 111.56±17.44; 63.0% of students had self-directed learning readiness scores above average, 33.0% average and only 4.0% below average. Among the sociodemographic factors, only student's self-confidence was significantly related to the self-directed learning readiness score (Beta = 0.272, p=0.003). Students expressed their satisfaction with the SDL sessions promoting vital skills for life-long learning. The study revealed that the phase I MBBS students had optimum SDL readiness. Sociodemographic factors do contribute in influencing SDL readiness (SDLR). SDL sessions nurture vital skills for lifelong learning. Students willingly engage in SDL if facilitated by faculties in a structured fashion. SDLR assessments in postgraduate medical education can unveil how medical training metamorphoses health professionals into lifelong learners.

Nephrotic syndrome is a common renal disorder in the pediatric age group and the incidence of relapse in nephrotic syndrome is about 60.0-90.0%. Infection is an important contributing factor for the relapse of nephrotic syndrome. It may result progressive CKD. The objective of this study was to find out the pattern of Respiratory tract infections in nephrotic syndrome children presented with relapse. Children of both sexes, age range 1-12 years with relapse cases of nephrotic syndrome was admitted into the Department of Pediatrics, Dr M R Khan Shishu Hospital & ICH, Bangladesh included in this study until the desired number of 35 children were fulfilled. This cross sectional observational study was conducted into the Department of Pediatrics, Dr M R Khan Shish Hospital & ICH, Dhaka, Bangladesh from February 2020 to August 2020. The patient was enrolled according to inclusion and exclusion criteria. Data was collected through a structured questionnaire. Data were analyzed using computer-based programmed statistical package for social science (SPSS) for windows version 23.0. A total of 23 cases suffering from Nephrotic syndrome with relapse were studied. This study shows the mean age of children with infection was 5.91±3.17 years. Maximum (56.1%) were male children and 43.9% were female children. It was observed that (65.71%) of the subjects had one or more respiratory tract infections. The most common presentations of nephrotic syndrome patients during admission were swelling (100%), fever (82.60%) and cough (69.56%). Pneumonia was the commonest infection in this study (52.17%), then bronchiolitis (17.39%), tonsillitis (13.04%), pharyngitis (8.69%) and (4.34%) were otitis media and sinusitis. Streptococcus was isolated in 1(4.34%) patient and Covid-19 in 3(13.04%) patients. These results indicate major infections remain a crucial complication of nephrotic syndrome in children, especially during relapses. The relationship between infection and relapse showed a higher rate of relapse in pneumonia, bronchiolitis &tonsillitis. This study will give proper guidance to physicians to counsel and treat the patients accordingly.