Mymensingh medical journal : MMJ最新文献

This study explores the physiological effects of three pranayama techniques- Shitali, Sheetkari and Ujjayi - on Heart Rate Variability (HRV) and Electroencephalographic (EEG) patterns, with a focus on autonomic balance and brain wave activity. Twenty participants performed each pranayama for five minutes following a five-minute baseline rest period, with HRV and EEG data collected throughout. Heart rate variability (HRV) was quantified using the Neural Check HRV analyzer, whereas electroencephalography (EEG) was utilized to observe fluctuations in neural oscillatory patterns. Significant increases in HRV parameters, including Total Power, Low Frequency (LF) and Low Frequency to High Frequency Ratio (LF/HF ratio, were observed after all pranayama techniques, indicating enhanced autonomic regulation. Sheetali and Sheetkaripranayamas showed the most substantial increases in parasympathetic activity, as evidenced by Percentage of successive Normal-to-Normal intervals that differ by more than 50 milliseconds (pNN50%) and Root Mean Square of Successive Differences (RMSSD). EEG analysis revealed significant increases in Beta, Gamma and a decrease in Delta waves post-practice, reflecting heightened alertness, cognitive function and relaxation. Theta waves decreased, suggesting reduced deep meditative states. Shitali, Sheetkari and Ujjayi pranayamas significantly influence HRV and EEG patterns, enhancing autonomic balance, cognitive function and relaxation. These pranayamas can help reduce stress, support heart health and sharpen the mind. However, further research with larger sample sizes and control groups is necessary to validate these findings and explore long-term effects.

High-risk pregnancies may put women and their partners under a lot of emotional and physical strain. Several variables can enhance or decrease the dangers associated with a high-risk pregnancy, one of which is amniotic fluid, also known as liquor amnii. The aim of the study was to observe the risk factors of high-risk pregnancy cases among patients with and without meconium-stained liquor amnii. This cross-sectional comparative study was conducted at the Department of obstetrics and gynecology, Combined Military Hospital (CMH), Cantonment, Dhaka, Bangladesh. The study duration was 6 months, from February 2012 to July 2012. The study was conducted with a total of 86 women among those who were admitted to the high-risk antenatal ward of the study hospital. Total of 86 high-risk cases were taken for the study. Among them, 12(14.0%) were found with meconium-stained liquor (Group A) and 74(86.0%) cases were found without meconium-stained liquor (Group B). In Group A common risk factors were prolonged pregnancy (33.3%), then hypertensive disorder 25.0%. In Group B common risk factors were hypertensive disorder in 23.0% then diabetes in 18.9%. A cord around the neck was observed in 25.0% of cases in Group A in comparison to 8.1% in Group B. Participants with meconium-stained liquor amnii were shown to be at higher risk in all categories, according to the study. Severe high-risk pregnancy cases were more common in those with liquor amnii. Although the risk factor difference was greater in the group with meconium-stained liquid amnii, the difference was not statistically significant.

Silicosis is a preventable occupational lung disease that can present in chronic, accelerated or acute forms. While chronic silicosis is a known risk factor for spontaneous pneumothorax, this complication is rarely reported in acute silicosis and can be life-threatening. We report an autopsy of a 40-year-old male with acute silicosis who died following a recurrent right-sided spontaneous pneumothorax. He had worked in a glass manufacturing facility with intense silica dust exposure for one year and had a prior episode of pneumothorax due to suspected silicosis eight months before his death. Post-mortem examination revealed a right tension pneumothorax with complete collapse of the right lung, extensive fibrosis in both lungs and ruptured subpleural bullae. Histopathology confirmed acute silicosis with classic silicotic nodules. This case underscores that even acute silicosis can lead to fatal spontaneous pneumothorax, although such complications are more typically associated with chronic silicosis. It highlights the importance of early recognition of pneumothorax in silicosis patients and reinforces the need for stringent occupational dust control and health surveillance to prevent silicosis and its severe complications.

Botulinum Toxin injection is the mainstay of treatment of Adductor Spasmodic Dysphonia. However its outcomes, improvement, duration of effects and complications are matter of discussion. The aim & objective of this study was to see the outcomes of Botulinum Toxin injection in Adductor Spasmodic Dysphonia. This prospective, single arm, pre-port, interventional study was conducted in the Department of Otolaryngology-Head & Neck Surgery, Bangladesh Medical University (BMU), Dhaka, Bangladesh from January 2019 to June 2020 on 34 cases having Adductor Spasmodic Dysphonia. Cases were investigated by recording their Voice Handicap Index (VHI) scores at five time points: i) immediately prior to injection (baseline), ii) 1-3 days, iii) 2 weeks, iv) 8 weeks and (v) 12-week post-injection periods. In VHI, both individual (Functional, Physical and Emotional) subscale and total scores were considered. Comparison was done between pre-injection with post-injection VHI. All the information was recorded in a pre-tested questionnaire. In this study statistically significant improvement of VHI were found in 2-week post-injection time (Functional 13.74, Physical 20.03, Emotional 14.76, Total 48.53, p value <0.05) and 8-week post-injection time (Functional 8.24, Physical 12.47, Emotional 11.18, Total 31.89, p value <0.05). But no significant differences were found between pre injection VHI and VHI found in 1-3 days and 12-week post-injection period. Complications following this Botulinum Toxin injection were mild and subsided within 1-4 days. There was significant improvement of voice after Botulinum Toxin Injection in spasmodic dysphonia, although it needs repetition at about 12-week intervals.

Drowning is the process of experiencing respiratory impairment from submersion /immersion in liquid. Determining the cause of death in drowning cases is quite challenging which can be achieved with thorough investigation and complete autopsy done. After complete autopsy only the pathologist certifies a death best on drowning. In the field of Forensic Medicine are facing difficulties in estimation of time, cause and mode of death. Hence this study aimed to analyse the various aspect of drowning death whose Post Mortem were conducted in the Mortuary of Dhaka Medical College, Dhaka, Bangladesh in the year 2020. This study was a retrospective study which was conducted among 162 dead subjects. In this study all the dead bodies were recovered from different sources of submersion irrespective of age or sex and either the bodies were fresh or decomposed. Detailed history related to place of the incident, type of water, position of the body and other relevant findings were obtained from the records. The majority of the subjects with drowning were 118(72.83%) of the males following by 44(27.16%) of the female. The place of drowning was found to be in river 96(59.25%) and ditch 24 (14.81%) followed by lake 28(17.28%) and pond 14(8.64%). The magnitude of drowning is higher among males in and drowning has become an undervalued problem with inclusion of child population. Hence there is necessity for prevention among all the ages by the Government so that over all burden caused by drowning can be reduced.

Leprosy continues to cause long-term complications due to delayed treatment. Although Bangladesh achieved national elimination of leprosy in 1998, hundreds of new cases are still detected annually, with many patients developing disabilities. Effective management of complications remains a public health challenge. This study aimed to assess the current situation of managing long-term complications of leprosy in Bangladesh, identify challenges and explore opportunities for improving quality treatment through government and NGO hospitals. The cross-sectional study was conducted between November 2020 and October 2021 in five purposively selected divisions of Bangladesh. Participants included 20 government and NGO managers or physicians involved in leprosy care and 35 patients with complications receiving treatment at designated facilities. Data were collected on treatment practices, referral patterns and patient experiences. In 2019, 1933 complication cases were managed, of which 1,595 required admission and 256 referrals (13.0%). In 2020, 883 cases were treated, with 872 admissions and 96 referrals (10.9%). The leading indication for referral was reconstructive surgery (44.4%), followed by treatment at Upazila Health Complex (11.1%), reactions (16.7%), ulcers (16.7%) and squamous cell carcinoma of the foot (11.1%). Danish Bangladesh Leprosy Mission (DBLM) Hospital, Nilphamari, was the most cited referral center (46.7%). Regarding future integration, 30% of managers recommended specialized leprosy hospitals, while others suggested district or medical college hospitals, or enhanced government support to NGOs. Patient-reported barriers included difficulties reaching referral centers (31.4%), financial problems (22.9%) and issues with referral letters (20.0%). Only 25.7% reported no difficulties. Major surgeries, complicated ulcers and chronic osteomyelitis remain significant management challenges. Constraints include limited funding for NGOs, insufficient trained manpower and inadequate rehabilitation logistics. Strengthening district and medical college hospitals with skilled personnel and resources, alongside government support for NGO facilities, is essential to improve comprehensive leprosy complication management in Bangladesh and countries with low-resource settings.

The phrase "eyes are the window of the brain" reflects the intricate neuroanatomical and physiological connection between ocular structures and central nervous system (CNS) function. This review explores the vital role of the eyes in detecting neurological disorders, with emphasis on the optic nerve, retina, extraocular muscles and pupillary reflexes. Advances in neuro-ophthalmology have enhanced early detection of brain tumors, hydrocephalus, demyelinating diseases and raised intracranial pressure through ocular findings. This article synthesizes anatomical, clinical and imaging insights to underline the significance of ophthalmic evaluation in neurology and neurosurgery.

Hysterectomy is the most common gynaecological surgery done in females worldwide as it provides definitive cure to wide range of gynaecological diseases, both benign and malignant. The indications to perform this major surgery should always be justified and pathology should be proved. Histopathological examination is essential to justify the appropriateness of the hysterectomy. The cross sectional descriptive type of observational study was carried out to correlate preoperative indications of abdominal hysterectomy with histopathological findings. This study was conducted in the department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Bangladesh from January 2020 to December 2020. The study included 100 women undergoing planned abdominal hysterectomy after fulfilling the inclusion and exclusion criteria by purposive sampling. Detailed information was obtained in each case regarding the history, clinical presentation, mode of diagnosis and histopathological report. Data were then classified, edited, coded and entered into the computer for statistical analysis by using SPSS Version 26.0 and presented in graph, pie chart and tabulated form. A total of 100 elective total abdominal hysterectomies were performed. Menorrhagia was the leading symptom (33.0%) followed by abdominal pain (20.0%). Leiomyoma was the most common pre-operative diagnosis (41.0%) followed by adenomyosis (20.0%). The most common histopathological diagnosis was leiomyoma (34) followed by adenomyosis (20.0%). Clinical and histopathological correlation was 100.0% in cases of ovarian tumor, complex endometrial atypical hyperplasia, pelvic inflammatory disease (PID), endometrial polyp and chronic cervicitis. Only 40.0% of preoperatively diagnosed postmenopausal bleeding cases were correlated histopathologically while the rest were missed preoperatively which included endometrial polyp (40.0%) and adult granulosa cell tumor (20.0%).

Nutritional status of under-five children is a matter of concern worldwide and malnutrition is a one of the most important public health problems in Bangladesh. The slums are particularly at high risk of vulnerability to food insecurity and child malnutrition. The study was conducted to assess the nutritional status of children of slum areas of Mymensingh Municipality of Bangladesh. This descriptive cross sectional observational study was conducted in different slums of Municipality of Mymensingh district in Bangladesh from March 2017 to August 2018 among randomly selected 630 under five children. Data were collected by interviewing and measuring the weight, height, Mid-upper arm circumference (MUAC). WHO growth reference charts were used to calculate Weight for Age, Height or Length for Age and Weight for Height Z scores. Mean age of 630 children was 29.38±16.23 months, among them 49.7% were male and 50.3% were female. Two hundred and fifteen (34.1%) children were delivered at home, 33.2% delivered at clinic and 32.7% delivered at hospital. Around 14.2% of children had low birth weight. Colostrum was given in 94.1% children. Breast feeding was initiated within 1 hour of birth in 52.7%. Exclusive breast feeding was practiced in 60.6% and prolonged exclusive breast feeding was found in 18.1% of children. Around 63.5% continued breast feeding for 24 months. Complementary feeding was started before 6 months in 39.4%, within 6 to 8 months in 42.5% and late complementary feeding was practiced in 15.4% cases. Mean values for weight and height were found higher in males than females. Frequency of underweight, stunting and wasting was 28.9%, 29.7% and 12.3% respectively. Age group of 12-23 months showed the highest frequency of underweight (33.5%). Wasting (16.0%) and stunting (34.4%) was found more in age group 24-35 months. Frequency of underweight, stunting and wasting was found more in children having male sex, low family income, low birth weight, prelacteal feeding, no colostrum feeding, non-exclusive breast feeding, prolong exclusive breast feeding and early and late complementary feeding practices. Overall under-nutrition was found in 37.9% and 62.1% children were nutritionally normal as they had no underweight, stunting or wasting. Under nutrition is a common problem among slum children.

To describe the clinico-epidemiological characteristics of pediatric cystic fibrosis (CF) cases among Bangladeshi paediatric population was the objective of the study. This observational study included pediatric patients (up to 14 years of age) with a clinical diagnosis of CF. Data were collected within the period from April 2021 to October 2021. Informed assent was taken from the accompanying parent. Clinical and epidemiological characteristics were analyzed on the basis of demographic data, medical history, laboratory tests and outcome information. Collected data were analyzed statistical software, SPSS 26.0. A total of 50 patients (66.0% male) with a mean±SD age of 39.7±30.75 months were included. Twenty-eight patients (57.14%) had siblings with CF and 41.67% of parents had a history of consanguineous marriage. The majority of them were stunted (86.0%) and underweight (86.0%) and half of them had wasting (54.0%). Median disease duration was 12 months (range: 2-72). Cough (100.0%) and purulent sputum (100.0%) were the predominant respiratory symptoms, while failure to thrive (98.0%) and bulky offensive stools (86.0%) were prime gastrointestinal symptoms. Among the signs, malnutrition (94.0%), short stature (72.0%), digital clubbing (64.0%) and bronchiectasis (40.0%) were most frequent. Pulmonary hypertension (48.0%, n=24) was the most common comorbidity identified in the study participants. In hospital, mortality was 16.0% (n=8). Digital clubbing, bronchiectasis, pancreatic insufficiency and abnormal liver function tests were significantly higher in the patient who died. Children with cystic fibrosis most commonly present with under nutrition and respiratory symptoms. Failure to thrive was almost a global phenomenon. Pulmonary hypertension was the most common complication found in echocardiography.