Mymensingh medical journal : MMJ最新文献

Coronary artery disease (CAD) is a leading cause of morbidity and mortality globally, with varying presentations including chronic coronary syndrome (CCS) and myocardial infarction (MI). The extent of vessel involvement plays a key role in prognosis and therapeutic decision-making. This retrospective observational study aimed to evaluate the prevalence of vessel disease (VD) patterns among patients with CCS and MI and to analyze associated risk factors at a tertiary care center. This study was conducted in Coronary Care Unit (CCU) and Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Bangladesh, from November 2023 to December 2024. A total of 88 patients admitted with a diagnosis of chronic coronary syndrome (CCS) and myocardial infarction (MI) to the Department of Cardiology were included in the study. The mean age of patients was 51.91±11.27 years, with a male predominance (69.32%). Hypertension and Diabetes mellitus were the most common comorbid conditions. Overall, SVD was observed in 46.59% of patients, 3VD in 29.55% and DVD in 23.86%. Among CCS patients, 39.29% had SVD, 28.57% had DVD and 32.14% had 3VD. MI patients showed a higher prevalence of SVD (45%) and 3VD (35%). In Chronic Coronary Syndrome (CCS) hypertension is the most common risk factor (53.57%) affecting the Coronary artery Disease and also provoke Myocardial infarction (51.67%). Smoking was more frequent in CCS patients (57.14%), while DM was slightly more common in the MI group (46.67%). This study found that SVD was the most prevalent vessel disease pattern in both CCS and MI patients, while 3VD was more frequently observed among MI patients, highlighting the severity of coronary involvement. Risk factors such as HTN, DM and smoking were prominent across both groups, emphasizing the need for early risk factor modification in CAD management.

Percutaneous nephrolithotomy (PCNL) is a minimally invasive and often safe and well-tolerated procedure. Studies with the standardized evaluation of complications of PCNL comparing single-tract and multi-tract PCNL are scarce. This study was conducted on this knowledge gap. An observational follow-up study among purposively selected 50 patients diagnosed with renal calculi undergoing PCNL was conducted in the Department of Urology, Dhaka Medical College Hospital, Bangladesh from April 2021 to December 2021. All complications were documented and classified according to the modified Clavien system. Twenty eight (28) subjects underwent single-tract and 22 underwent multi-tract PCNL; all were male and the mean ages were similar in the two groups (44.35±11.4 vs. 44.1±16.2 years). Right-side stones were more frequent (71.4%) in the single-tract group and left-side stones were more frequent (59.1%) in the multi-tract group. Stone size was larger in the multi-tract group than in the single-tract group (5.0±0.5 vs. 3.3±0.4 cm, p=0.012). Although grade I complications (54.5% vs. 32.1%, p=0.111) and grade II complications (100.0% vs. 64.3%, p=0.007) were more frequent in the multi-tract group than in the single-tract group, the single-tract group had a higher frequency of grade III (53.6% vs. 45.5%, p=0.569) and grade IV (21.4% vs. 9.1%, p=0.238); there were no grade V complications in either group. As a whole, complications were more frequent in the multi-tract than in the single-tract group (100.0% vs. 71.4%, p=0.024) and most were of lower grades (grade I and grade II) which were possible to manage conservatively. Grade III and grade IV complications were most frequently observed in the single-tract PCNL that required further intervention or management in the intensive care unit. Multi-tract PCNL is associated with higher lower-grade complications that can be managed conservatively. In contrast, higher-grade complications that need intervention or intensive care unit management are more frequent in single-tract PCNL. So, multi-tract PCNL is effective with acceptable morbidity in selected cases of large renal stones.

The fibula also known as the calf bone is a slender long bone and located lateral to the tibia. The fibula can be recognized by its head placed proximally, twisted shaft and lateral malleolus placed distally. The aim of this study was to measure the maximum length of the fibula in Bangladeshi people. This study was taken from 300 (right 152 and left 148) samples were selected through the purposive sampling technique for this cross-sectional descriptive study which was carried out in the Department of Anatomy, Mymensingh Medical College, Bangladesh from January 2023 to December 2023. Any damaged, unossified, fractured fibula was excluded. Data were tabulated and statistically analyzed using Microsoft Excel and SPSS software. The mean ± SD of maximum length of fibula was 34.32±2.05 cm on right side and 34.40±2.26 cm on left side. The several osteometric parameters from the adult human fibula can be accurately determined a person's natural height, his nutritional condition, his individuality and gender and also helps in different ankle fracture management.

Menopause is a natural process which is characterized by the permanent stoppage of menstrual period. It happens in women due to decrease of estrogen level at the ages of 45-55 years. The efficiency of life is disturbed because of imbalance of estrogen hormone such as irritability, night sweats, vaginal dryness, hot flushes, depression, sleep disturbance, headache etc. This cross-sectional analytical type study was done to evaluate the changes of blood pressure and serum total cholesterol levels in postmenopausal women in comparison to reproductive women and it was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2023 to December 2023. Among 200 healthy women, one hundred (100) female subjects were taken as control group (Group I) age ranges from 25-45 years and one hundred (100) female subjects were taken as study group (Group II) age ranges from 45-65 years. By indirect auscultatory method with an aneroid sphygmomanometer blood pressure was calculated and by enzymatic colorimetric method the serum total cholesterol level of the individual was measured. Output were expressed as mean±SD and by using unpaired students' 't' test, statistical significance of difference among the group was calculated. The mean ±SD of systolic blood pressure of Group I and Group II were 117.30±7.26 mm of Hg and 130.95±10.89 mm of Hg respectively and diastolic blood pressure of Group I and Group II were 76.65±5.03 mm of Hg and 85.20±6.43 mm of Hg respectively. In the study group the mean±SD of Blood Pressure is notably increased in comparison with control group. The mean±SD of serum total cholesterol level of Group I and Group II were 182.30±38.25 mg/dl and 217.63±55.53 mg/dl respectively. In the study group the mean±SD of serum total cholesterol level was markedly increased in comparison with control group. Postmenopausal women with higher Blood Pressure and serum total cholesterol level caused by lower level of female sex hormone specially estrogen hormone increased the change of cardiovascular disease, stroke, chronic renal failure, type-2 diabetes mellitus, insulin resistance and metabolic syndrome. So assessment of this parameter is important for early detection and prevention of complication related to higher Blood Pressure and serum total cholesterol level for leading a healthy life.

As a mode of delivery, the caesarean section (CS) is a life-saving measure for many cases, but it also may result in short- and long-term hazardous consequences and scar dehiscence is one of them. Identification of the patients prone to scar dehiscence followed by predictive measures could reduce the associated morbidity and mortality. Scar tenderness was discussed as a predictive sign of scar dehiscence but still, there is a lack of enough evidence. This study aimed to observe the frequency of scar dehiscence among patients undergoing CS presenting with scar tenderness. This study was an observational study and was conducted in the Department of Gynecology and Obstetrics, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January 2018 to June 2018. A total of 50 full-term pregnant women selected for lower segment CS (LSCS), presenting with scar tenderness from previous CS were enrolled. A semi-structured questionnaire was used during data collection. Statistical analyses were done with SPSS V-25.0. All ethical measures were done in accordance with the current Declaration of Helsinki. The average age of the studied mothers was 28 years. Per-operatively, scar complications were found in 46.0% of the cases (26.0% scar thinning, 16.0% scar dehiscence and 4.0% scar rupture). A short inter-delivery interval and a less equipped center as a previous location of CS were associated with scar complications (p<0.05). Postoperative maternal complications were observed in 12.0% of the patients which were, including wound infections, blood transfusion reactions and psychiatric disturbances. The frequency of IUD (intrauterine death) was 2.0% and 10.0% of the neonates needed NICU (Neonatal intensive care unit) admission. About one sixth of the scar tenderness patients had scar dehiscence with considerable amount of other complications. Extensive evaluation before any procedures is therefore suggested for all patients.

Aim of the study was to assess the tolerance and efficacy of rituximab in patients with different autoimmune diseases in a Bangladeshi population. This is an observational study or an open label clinical trial and was conducted in the department of Rheumatology of BSMMU, Dhaka, Bangladesh from September 2008 to September 2010. Total 20 patients were enrolled and three were lost to follow up. Among them, eleven were suffering from Rheumatoid arthritis (RA), three from Systemic lupus erythematosus (SLE) and three from Primary Sjogren's syndrome (PSS). All were unresponsive to first line recommended drugs available in Bangladesh. They were treated with Rituximab and were followed up to 24 weeks from the administration of Rituximab. Among the twenty patients eleven RA patients, three SLE patients and three PSS patients were completed the follow up. They were followed up for 6 months. Five (5) patients had suffered from adverse events and one of them died of pneumonia. All Rituximab treated RA patient achieved ACR 20 response (100.0%), one SLE patient achieved complete remission (SLEDAI 0-2) and another two achieved partial remission. Among the patients of PSS two achieved partial remission and another one achieved 45.1% improvement from the baseline. Treatment of different connective tissue diseases is sometimes very challenging. Use of Rituximab to treat various refractory autoimmune diseases showed good tolerance and short-term clinical efficacy in Bangladesh.

Vitamin A (retinol) is an essential, fat soluble nutrient stored in body organs, mainly the liver. Vitamin A is an essential nutrient for maintaining eye health and vision, growth, immune function and survival. Vitamin A deficiency is one of the most serious health problems in developing countries. This study was carried out to assess the knowledge on vitamin A and household consumption frequency of vitamin A-rich foods in some selected villages Chandina, Cumilla, Bangladesh. This cross-sectional study was conducted among 480 adult populations residing in some selected villages in Chandina, Cumilla, Bangladesh using a self-administered questionnaire from October 2021 to December 2021. Data were analyzed using computer software like Microsoft Word, Microsoft Excel. The study revealed that most of the respondents were in more than 45 years age groups (42.0%) and majority of them were female 291(60.62%) with Muslim predominant 440(91.67%). In concern of education more than 40.0% of them were completed secondary level 161(33.54%) and maximum of them were housewife 261(54.38%). More than 40.0% respondent's monthly family income was BDT 10,000-20,000(41.88%). About 66.88% participants had knowledge on vitamin A and maximum of them got this inform from health assistant 178(55.45%). According to vitamin A capsule given to your children, most the respondents told that they have given to their children (90.03%). According to their specific knowledge about vitamin A, most the respondents told about vitamin A maintains only eye health 171(53.27%), then followed by vitamin A deficiency only causes night blindness 95(29.60%), vitamin A helps in immunity 24(7.48%), vitamin A helps in digestion 13(4.05%), vitamin A maintains only skin health 11(3.43%) and vitamin A makes us healthy 7(2.18%). Regarding household consumption of vitamin A-rich foods, most of the respondents told that they eat green leafy vegetables less than 2 kg/week, carrot less than 2 kg/week, sweet potato less than 2 kg/week, pumpkin less than 2 kg/week, tomato 2-3 kg/week, papaya/coloured fruits less than 2 kg/week, liver less than 1 kg/week, small fish 1-2 kg/week, whole milk 1-2 L/week, egg 1-2 dozen/week. For cooking most of the respondents used vitamin A fortified soybean oil regularly 244(76.01%). In general the knowledge of study population regarding the importance of vitamin A was quiet satisfactory but frequency of consumption vitamin A-rich foods was still poorer in rural areas.

Polycystic ovarian syndrome (PCOS) is a multifactorial endocrine disorder often accompanied by metabolic and hepatic abnormalities, particularly in obese women. This study aimed to investigate the association between alanine aminotransferase (ALT) and thyroid hormone levels in obese women with PCOS in a Bangladeshi setting. This study was a cross-sectional study; conducted among 50 obese PCOS-diagnosed women, at the Outpatient Department of Obs and Gynae, Bangladesh Medical University, Bangladesh from July 2023 and June 2024 Clinical, biochemical and ultrasonographic evaluations were performed. Serum ALT, thyroid-stimulating hormone (TSH) and free thyroxine (fT₄) levels were measured. Statistical analyses included correlation and logistic regression to identify predictors of elevated ALT (>40 U/L). Among the study population, subclinical hypothyroidism was observed in 38.0% and overt hypothyroidism in 14.0% of participants. Elevated ALT was present in 36.0% of cases. ALT levels were significantly higher in hypothyroid patients (p=0.01). Positive correlation was found between ALT and TSH (r?=?0.41, p<0.01), while ALT and fT₄ showed a negative correlation (r?=?-0.35, p<0.05). Logistic regression confirmed hypothyroidism (OR: 2.60, p=0.028), higher TSH (OR: 1.22, p=0.022) and lower fT₄ (OR: 1.29, p=0.041) as significant predictors of ALT elevation. Thyroid dysfunction, particularly hypothyroidism, is strongly associated with hepatic enzyme elevation in obese women with PCOS. Routine thyroid and liver function assessment should be considered in PCOS management to prevent progression to metabolic and hepatic complications.

Spinal arachnoid cyst is an uncommon medical condition. Recurrence of arachnoid cysts is also an unfamiliar phenomenon. The recurrence and the postoperative complications had lengthened the craving for the patient's ambulation. However, appropriate surgical decisions and adequate surgical management with modern equipment have made the management unparalleled. Here, we explain a boy's journey from a bedridden condition due to a dorsal arachnoid cyst to the playground. Not only the disease entity but also the management and journey of the patient made this case uncommon. Finally prompt response with complete cyst removal and dural augmentation with a hydrated amniotic membrane enabled the boy to return to the playground again from a prolonged bed ridden state.