Mymensingh medical journal : MMJ最新文献

This study was aimed to find out the hospital based prevalence of paediatric ENT disorders in an ENT OPD of a peripheral military hospital of Bangladesh Armed Forces. This observational study was carried out at ENT out patient department of CMH Momenshahi, from 1st April 2017 to 31st March 2020. Irrespective of age and sex a total of 4612 children, between the ages of 0-14 years were included in this study. All types of ENT disorders were taken in to account. Data were obtained after ENT examination and necessary investigations. Total 4612 cases were studied. Male children (52.2%) were affected more and most of the children belongs the 6-10 years age group (44.4%).Throat related disorder (40.7%) were predominant followed by ear (34.8%). The most common ENT disorders were Chronic Tonsillitis (21.8%) followed by acute otitis media (16.1%) and pharyngitis (9.8%). Rate of Chronic otitis media (COM) was only 46(1%). ENT diseases are one of the major health problems among children. In addition to improved health education, socioeconomic status and better access to health care facilities; provision of early ENT specialist consultation may significantly reduce chronic or recurring symptoms and long term morbidities of common ENT disorders in children.

Type-2 diabetes mellitus is a global pandemic with immense social, health and financial consequences. The pathophysiology of type-2 diabetes is significantly influenced by overweight and obesity. Type-2 diabetes often goes hand-in-hand with high blood pressure. One way to check type-2 diabetes is by measuring fasting blood glucose. This cross-sectional analytical study looked at how blood pressure, body mass index (BMI) and fasting serum glucose relate to each other in women with type-2 diabetes in the Mymensingh locality. The research took place at the Physiology Department of Mymensingh Medical College, Bangladesh from Octy 2023 to June 2024. We included 200 participants: 100 apparently healthy women of 30-65 years without diabetes as the control group and 100 women with diabetes of same age group as the study group. The data was analyzed using SPSS software. Weight and height were measured anthropometrically in kilograms and meters, respectively. Blood pressure was checked with an aneroid sphygmomanometer for both systolic and diastolic values. To see if there were significant differences between groups, we used the unpaired Students 't' test and shared results as mean±SD. For relationships among fasting serum glucose, blood pressure and BMI, we used Pearson's correlation coefficient test. The average BMI for those in the control group was 24.19±1.22 kg/m². In contrast, the study group's average BMI was higher at 28.04±1.66 kg/m². The study group also had a greater average systolic blood pressure of 130.65±6.06 mm Hg compared to 115.30±5.07 mm Hg for controls. For diastolic blood pressure, values were also higher in the study group: 85.65±5.71 mm Hg compared to the control's 75.65±5.25 mm Hg. Fasting serum glucose levels showed a positive correlation with both BMI and blood pressure. We recommended from this study that routine evaluation of these parameters is important for preventing complications associated with type-2 diabetes mellitus.

Obesity is a major global health issue and WHO points out that 1 in 3 people globally is clinically obese. Obesity is a condition of having an excessive amount of body fat and is linked with several health disorders that include metabolic syndrome, cardiovascular diseases as well as liver diseases. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are usually used to assess liver function. It is established that obesity results in many cases of liver disorders known as steatosis or non-alcoholic fatty liver disease (NAFLD). It is the excessive deposit of fat within the liver cells that may result in inflammation, fibrosis and cirrhosis. Studies on obesity have established that obese subjects significantly tend to have higher liver enzymes like ALT and AST than non-obese adults. This study aims to compare these two liver enzymes between these two groups in the hopes of shedding light on how obesity impacts the liver and offers these biomarkers for NAFLD. The study was designed to assess the status of liver function in adult obese individuals by examining key markers, including serum Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), and to compare them with non-obese adults. The present cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, in collaboration with the Department of Endocrinology and Medicine, Mymensingh Medical College Hospital, from Octy 2023 to June 2024. The subjects were selected based on inclusion and exclusion criteria by purposive non-random sampling. A total of 200 participants took part in this study. Out of them, 100 were selected as case (obese adults) and another 100 non-obese adults were selected as control. In this study, serum ALT and AST levels were measured for analytical study. All the values were expressed as mean±SD. Statistical analysis was done using by using SPSS Windows package version 26.0. The statistical significance of the difference between the case and control was calculated using Student's unpaired 't'- test. Pearson's correlation is done to see the level of significance. After careful evaluation, the mean±SD values of serum ALT were 37.14±15.18 U/L and 21.92±5.10 U/L in case and control groups respectively, and mean±SD values of serum AST were 41.15±15.24 U/L and 25.01±6.65 U/L in case and control group respectively. This study revealed that mean serum ALT and AST levels were significantly increased in obese adults. There was a significant positive correlation found between BMI with serum ALT and AST levels. Analyzing the findings of this cross-sectional study, significant alterations in serum ALT and AST levels were observed among obese adults.

Umbilical granuloma may be defined as a small mass of granulation tissue which develops at the base of the umbilicus after separation of the cord. It consists of true granulation tissue with fibroblast and abundant capillaries. Treatment options are chemical cauterization, electro cauterization and sometimes need surgical excision. Aims of this study were to develop a simple and feasible method for the treatment of umbilical granuloma with table salt (NaCl). This was a multi-center prospective type of observational study and conducted from January 2023 to March 2024 in the department of Pediatrics Surgery, Mymensingh Medical College Hospital, Mymensingh and other Private Hospitals of Mymensingh, Bangladesh. Total 66 patients were included among them 59(89.09%) cured and 7(10.6%) patients need other options. No complications and recurrence was seen in 3 months follow up. Treatment of umbilical granuloma with table salt (NaCl) is a simple, effective, low cost and feasible method.

The exact cause of essential hypertension remains unclear. There is evidence to suggest that the development of essential hypertension is causally related to serum calcium levels. This study was designed to assess the status of serum calcium level in patients with essential hypertension and compared with healthy control. The research study was cross-sectional observational in nature. This study was done at the Department of Physiology in Sylhet MAG Osmani Medical College, Sylhet, Bangladesh. The duration of the research period was one year. All the known case of hypertension and newly diagnosed hypertensive patients were selected and compared with age-sex matched apparently healthy individual. Age below 18 years, pregnant women and patients taking supplementary calcium therapy were excluded from this study. Blood pressure was measured by auscultatory method; aneroid sphygmomanometer and standard stethoscope were used. Automated chemistry analyzer Vitrose-350, USA was used to estimate serum calcium level. Standard operating procedure strictly followed. There were 62 hypertensive (both known case of hypertension and newly diagnosed cases) were selected in hypertensive group (Group A) and 62 age-sex matched apparently healthy individuals were selected in normotensive group (Group B). The mean age of hypertensive and normotensive subjects was not statistically significant (p=0.814). There were 27(43.5%) male and 35(56.5%) female in hypertensive group, 32(51.8%) male and 30(48.4%) female in normotensive group. The distribution was statistically not significant (p=0.472). The mean value of the systolic blood pressure (SBP) was 146.45±5.82 mm Hg and the mean value of the diastolic blood pressure (DBP) was 92.90±7.66 mm Hg in hypertensive group. The mean value of the SBP was 112.74±6.88 mm Hg and the mean value of the DBP was 74.52±5.33 mm Hg of the normotensive group. The difference in mean blood pressure (BP) between the two groups was highly significant (p<0.001). The mean value of the serum calcium level was 8.59±0.55 mg/dl in hypertensive group and 9.12±0.93 mg/dl in normotensive group, which was statistically significant (p <0.001) between two groups. Serum calcium was significantly lower in hypertensive group than normotensive group. There was a negative correlation of the serum calcium level with both systolic and diastolic blood pressure.

Acute kidney injury (AKI) requiring dialysis (AKI-D) is an important health care burden and is associated with very high in-hospital mortality. Timely initiation of dialysis in AKI is fundamental to achieve treatment goals and to provide solute clearance and removal of excess fluid while awaiting the recovery of kidney function. The primary outcome of interest of the study was recovery of sufficient kidney function to discontinue haemodialysis therapy and complete recovery of renal function. This prospective observational study has been conducted in Mymensingh Medical College Hospital, Bangladesh from September 2019 to February 2021. All adult patients with AKI-D were included in the study. All patients were followed up till death or complete recovery or for a maximum period of six month. A total of 134 patients of AKI-D were included in the study with the mean age of 42.3±15.7 years. Male (54.5%) were slightly more than female with a male to female ratio of 1.2:1. Diabetes and hypertension were present in 16 (11.9%) and 47 (35.1%) patients respectively. The causes of AKI were sepsis (35.1%), urinary tract infection (34.3%), acute watery diarrhoea (9.7%), leptospirosis (11.2%), obstetric (10.4%), malignancy (8.2%), post renal obstruction (8.2%), drugs (7.5%), surgery (18.7%), rapidly progressive glomerulonephritis (6%), COVID 19 (5.2%), rhabdomyolysis (4.5%), intestinal obstruction (3.7%), acute gastroenteritis (2.2%), wasp bite (2.2%), insecticide poisoning (1.5%), star fruit toxicity (1.5%), haemolytic uremic syndrome (0.7%) and unknown (1.5%). Mean number of dialysis requirement was 5.9±8.6 and length of hospital stay was 15.4±10.5 days. Out of 134 patients, 95(70.9%) were discharged from hospital and 39(29.1%) died in hospital. Total death of patients during the study period were 49(36.6%) including home death of 10(7.5%) patients. Complete recovery of kidney function was achieved in 70(52.2%) patients and partial recoveries of kidney function who can survive without dialysis were observed in 12(9%) patients. Three (2.2%) patients remain on dialysis and 85(63.4%) patients survived during the study period. Survival rate was significantly higher in patients with ≤40 years (72.6%) and significantly lower in patients with malignancy (18.2%) and post renal obstruction (27.3%). Outcomes of patients with AKI-D remain poor. Advanced stage of AKI, older age, late presentation, malignancy, nutritional deficiency and delay at initiation of dialysis were associated with high mortality and reduced survival.

Traumatic brain injury (TBI) is a leading cause of death and disability globally as well as in Bangladesh; its incidences are growing with an increasing number of high-speed motor vehicles, more movement of the public and mechanization in industry. The aim of the study was to analyze the causes, risk factors and treatment outcomes of traumatic brain injuries in victims reported to emergency and casualty departments following intensive care with or without surgical intervention in a tertiary care hospital. This prospective type of observational study was conducted at the Neurosurgery ward of Rangpur Medical College Hospital, Bangladesh from March 2022 to February 2024. A total of 360 head injury patients with TBI were assessed with gender, age, cause, and type of trauma, Glasgow Coma Scale on admission, associated other injuries, time lapsed from trauma to hospitalization and care given. A total of 360 Cases (n=360) of TBI, male 273(n=273) and female 87(n=87) were included most common group was 16-30 years (45%) and Males (75.83%) victims were more than female (24.16%). Frequency percentage cause is RTA 190(52.7%) and intra-cranial injury (42.77%), Intra and extra-cranial injury 206(57.22%), pathophysiological cause (n=360), SDH 122(33.88%), EDH (28.33%), concussion (15.83%), cerebral contusion (14.16%), diffuse axonal injury (05%) and subarachnoid haemorrhage (2.77%). Traumatic brain injury was common among young adult males and RTA was the leading cause. Many factors influence the better outcome of TBI with reduced mortality and morbidity including the patient's age, the injury's severity, the time between TBI and the start of definitive treatment associated with other major injuries and facilities available for resuscitative care.

Risk stratification is an important initial step for primary prevention of atherosclerotic cardiovascular diseases. There are a number of scoring systems for this purpose worldwide. We tried to evaluate two most updated scoring systems. To assess which one is the better for Bangladeshi population residing in Bangladesh. This cross-sectional study was conducted in a secondary and a tertiary care hospital in Bangladesh from January 2019 to June 2019. Total 274 patients were included in the study. They were evaluated using ASCVD scoring system and QRISK3 scoring system for the risk of atherosclerotic cardiovascular event (myocardial infarction and/or stroke) in next 10 years. Average age of the patients was 57.1±12.8 years and 192 of them were male and 92 of them were female. Half (50.4%) of the patients were smoker, half (51.1%) of them were hypertensive, 45.6% of them were diabetic, 29.6% of them had family history of premature atherosclerotic cardiovascular diseases and 27.0% of them were overweight or obese. According to ASCVD scoring 36.5% patients were at high risk, 32.5% at intermediate risk, 16.4% at low risk of cardiovascular events in next 10 years and risk evaluation was not possible in 14.6% patients. According to QRISK3 scoring method 55.5% are at high risk, 20.8% at intermediate risk, 16.0% at low risk of cardiovascular events and evaluation was not possible in 7.7% patients. Predictive value of QRISK3 scoring system is better to detect more patients who are at high risk for atherosclerotic cardiovascular events in next 10 years. QRISK3 can also evaluate the patients at a younger age. At present QRISK3 is better system to evaluate cardiovascular risk in Bangladeshi population. We need further study to evaluate its role in the form of clinical efficacy and cost effectiveness.

The angle of inclination of the humerus is the angle between the long axis of the shaft and the central axis of the head of the humerus in the frontal plane. It is about 130° to 150°. Orthopedic surgeons performing reconstruction of the shoulder during prosthetic replacement should consider the size and placement of the head of the humerus. Prosthetic systems with a wide range of modular head sizes, eccentric tapers, and adjustable inclination angles and versions help orthopedic surgeons better to adapt prosthesis to a patient's bone anatomy. The present study aimed to establish the morphometry of the angle of inclination of the humerus in the Bangladeshi population and to correlate with the previous studies. The present prospective study was carried out with 100 (43 right-sided + 57 left-sided) dried humeri of unknown sex and age. In the present study, the mean±SD angle of inclination of the right humeri was 128.89±3.987 degree and the left humeri were 129.19±3.335 degree. In this article, we review the effects of this anatomical parameter on prosthetic design.

Knee pain is a common musculoskeletal symptom in the general population and results in significant disability, reducing the quality of life and inducing financial burden to the health care system. This cross-sectional, descriptive type of observational study was conducted with a total 52 patients having symptomatic knee joint disease in the Department of Radiology and Imaging, Mymensingh Medical College Hospital, Bangladesh from April 2019 to September 2020. This study was performed to find out the effectiveness of ultrasonography as a modality of investigation in the determination of knee joint pathologies with comparison to MRI, considering MRI as the gold standard. The majority of the patients 13(25.0%) were in the age group of 15-25 years with mean age was 39.88±15.308 years. In detecting synovial effusion, bursal collection, baker's cyst, tendinopathy and tumor pathologies ultrasound had 100.0% sensitivity, specificity and accuracy for each whether bursitis has 100.0%, 96.4% and 98.07% respectively. MCL tear had 100.0%, 97.8%, 98.07%. LCL tear detection showed 100.0%, 97.8%, 98.07%. PCL tear had 66.7%, 95.9%, 94.2%. ACL tear had 50.0%, 97.6%, 88.4% sensitivity, specificity and accuracy. Meniscal tear showed 66.7%, 97.8%, 88.4% sensitivity and accuracy. In all cases difference was statistically significant with a p value <0.0001 which strongly supported against null hypothesis. From this study, it is concluded that high-resolution USG showed high sensitivity, specificity and accuracy compared to MRI in detecting common knee abnormalities, and could be considered as the first-line imaging modality in the evaluation of knee pain.