Mymensingh medical journal : MMJ最新文献

Ossification of sacrospinous ligament induces a great risk for maintaining the stability of the pelvis. The sacrospinous ligament, along with the sacrotuberous ligament, plays a distinct role in the sacroiliac joint and pubic symphysis stability. The ossification may cause compression of neurovascular structure traversing through the greater and lesser sciatic foramen. Here we report a case of unilateral heterogenous ossification of the left sacrospinous ligament causing sciatic nerve compression and sciatic pain. A 22-year-old Bangladeshi woman, mother of one child, presented with complaints of pain in the lower back, left buttock and back of the upper thigh. Clinical examination and investigations revealed a diagnosis of the partially ossified sacrospinous ligament with sciatic nerve compression. Total excision of heterotrophic calcification and partial excision of left sacrospinous ligament through posterior approach by a left paramedian incision over the lower back was performed under general anaesthesia. On outpatient follow-up visits at 2 weeks and 6 weeks post-surgery, complete disappearance of pain was observed, and the patient was able to return to regular productive life activity. In this report, we presented a rare case of ossified sacrospinous ligament causing sciatic nerve compression with unknown etiology. The surgical approach performed, total excision of heterotrophic calcification and partial excision of left sacrospinous ligament through the posterior approach helped to preserve the pelvic stability with a good clinical outcome.

Sedentary behavior has significant deleterious effects on human health. Sedentary behaviors associated with cardiovascular and metabolic disorders by decreasing lipoprotein lipase activities, impaired lipid and carbohydrate metabolism. This cross sectional study was done to see the association between fasting serum glucose and serum total cholesterol in sedentary male. This study was conducted in the Department of Physiology, Mymensingh Medical College, Bangladesh from Octy 2021 to June 2022. A total number of 100 subjects were included in this study. Among them, fifty (50) sedentary males were taken as study group (Group II) and fifty (50) active males were taken as control group (Group I). Age of both control and study group ranged from 25-60 years. Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired students' 't' test & Pearson's correlation coefficient test. Both of these biochemical parameters showed statistically significant difference in study group. The mean±SD of fasting serum glucose of control group (Group I) and study group (Group II) were 4.45±0.51 mmol/L and 5.91±0.60 mmol/L; and the mean±SD of serum total cholesterol level of control group (Group I) and study group (Group II) were 176.14±27.16 mg/dl and 252.58±18.97 mg/dl respectively. Fasting serum glucose and serum total cholesterol shows positive correlation in study group in comparison to control group. From this finding it can be concluded that there was significant correlation of fasting serum glucose and serum total cholesterol in sedentary males.

Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory disorder of the gastrointestinal tract with relapsing and remitting course. Recurrent abdominal pain and discomfort in association with abnormal defecation in the absence of structural abnormality of the gut is the key feature of irritable bowel syndrome (IBS). Faecal biomarker may be used a precise tool in the differentiation of IBD and IBS. The aim of this study was to measure faecal calprotectin (FC) in patients with IBD and IBS and compare between them. This was a cross-sectional study done in the department of Gastroenterology, BSMMU, Bangladesh from May 2017 to August 2018. IBD patients were diagnosed on the basis of compatible history, clinical examination, laboratory, radiological and endoscopic findings. IBS patients were selected by using the Rome IV criteria. Quantitative faecal calprotectin ELISA (BUHLMANN Quantum Blue) test was done and compared between IBD and IBS patients. In this study, ninety (90) patients were enrolled, 45 patients with IBD and 45 patients with IBS. Mean age of the IBD patients was 32.24±9.76 years and IBS patients was 33.80±9.70 years. There were 28(62.2%) male and 17(37.8%) female patients with IBD and 30(66.7%) male and 15(33.3%) female patients with IBS. We found faecal calprotectin (FC) level was 445.68±237.35μg/gm in IBD patients and 39.16±17.31μg/gm in IBS patients. There was a significant difference of faecal calprotectin level between IBD and IBS patients (p-value <0.001). The sensitivity and specificity of faecal calprotectin to differentiate IBD from IBS was 91.1% and 86.7% respectively. The test accuracy was 88.9%. Area under ROC was 0.959 (95% CI, 0.909 to 1.0). This study showed that faecal calprotectin appears to be clinically useful, non-invasive, rapid and reliable marker to differentiate IBD from IBS.

The recent achievement in health sector of Bangladesh has got much recognition. To monitor the performance of its health services, the Government has implemented a new health management system. However, this health service delivery system is inadequate against huge expectancy and discrimination in center to periphery. The study was aimed to investigate the patients' satisfaction status on out patient department (OPD) services of secondary level public hospitals in the northern region of Bangladesh and the factors associated with it. This descriptive cross-sectional study was conducted among the OPD patients of Lalmonirhat 100 Bedded Hospital, Lalmonirhat and General Hospital, Kurigram, Bangladesh. The study was conducted from January 2018 to December 2018 among 400 respondents who were interviewed and data were collected using a partially structured questionnaire by the authors. A large number of respondents (38.3%) were in the age group of 18 to 30 years with the mean age beings 40.09 (range: 18-81 years). Majority of the respondents (52.5%) were female. Housewife was found to be the profession of 35.0% of the respondents and 66.8% of them were married. The average monthly household income of the respondents was Tk. 9648.75±6653.70. Majority (70.5%) of the respondents commented that happiness of care was satisfactory. Most of the respondents (62.5%) agreed that they will recommend this institution to others and 62.3% of the respondents were satisfied with the treatment. Among the respondents, 58.1% agreed that hospital was clean and tidy. A large portion (83.6%) of the respondents was not satisfied with the drinking water facilities. Marital status and monthly income of the respondents showed a statistically significant (p<0.05) relationship with the happiness of care they received. This study showed that majority (70.75%) of the patients were satisfied with the services provided by the out Patient Department of Lalmonirhat 100 Bedded Hospital, Lalmonirhat and General Hospital, Kurigram, Bangladesh except availability of drinking water facilities.

The goal of this study was to find out from the calf muscle, the normal H-reflex is in a group of healthy adults. This study is conducted for the period of one year in 2020-2021, in the department of Physiology AIIMS Bhopal, 119 adult male healthy volunteers who were asymptomatic from peripheral neuropathy and had a mean age of 30.40±6.78 were evaluated, to compare the normative tibial H reflex to their stature, body mass index, core body temperature, and limb length. The parameters considered were M- Latency, H-Latency, M-Amplitude, H- Amplitude and H/M Ratio in their left and right legs, respectively. A total of 111 participants (93.3%) were in the age group of 40 years or younger, with the mean age (in years) being 30.40±6.78. Only eight (8) participants (6.7%) belonged to the over-40 age group. The average weight (Kg), height (cm), and limb length (cm) were 173.11 cm, 10.48 cm, and 94.28 cm respectively. The mean ±SD latencies of the H reflex were 30.93±4.42 and 31.01±5.21 milliseconds in the right and left legs, respectively. Leg length and H reflex latency had a significant correlation (r = 0.55, p=0.05). There was no discernible correlation between age and the H reflex latency. The right and left H reflex latencies should vary by no more than 1.8 ms to be deemed normal. This research examined tibia H-reflex side-to-side latency variability and amplitude. Neurologic function may be assessed using the H-reflex. Due of its sensitivity to external circumstances, the H-reflex must be elicited carefully. The H-reflex may reveal neuronal function following damage if assessed appropriately.

There are many women in Bangladesh who suffer from chronic shoulder pain, back and neck pain, nerve pain, and other difficulties due to large breasts but most of them are not keen to get rid of their problems. Most women in this country are afraid from surgery and they are not even aware about their body shape and images. Recently, very few of them are coming to the door of surgeons with enlarged breast difficulties. A study was conducted on reduction mammaplasty regarding experience in the context of our country. Few of the patients were motivated among many who have problems of the huge breast and perform reduction mammaplasty. The paper addresses the experience of reduction mammaplasty. The study among 8 patients was performed in, Anower Khan Modern Medical College and Hospital and Care Medical College and Hospital during the period of Octy 2018 to January 2021. The patients underwent reduction mammaplasty over a 2.5 years period were identified and reviewed for patients satisfaction rate, religious issues, shyness, Family restrictions, socio economic condition, lack of awareness, risk factor, symptom relief, limitation and complication rate. Rate of complications was from 6.5% to 22% for reduction mammaplasty, whereas reported patient satisfaction rates range from 85.0% to 95.0%. In the study, reported rates of symptom improvement range from 80.8% to 94.6%, religious issues about 90.0% to 95.0%, Shyness 80.0% to 87.5%, family restrictions 80% to 87.5%, socio economic condition (High Class n=5, Upper Middle Class n=3), risk factor 70.0% to 80.0%, but in regard to psychological well-being there are tremendous outcomes. Reduction mammaplasty has had excellent patient satisfaction levels. However, a very few complications may occur even in the most suitable candidate. Skilled and experienced surgeons, enriched healthcare infrastructures, meticulous pre-operative planning, gentle tissue handling and anticipatory post-operative care will reduce the incidence of adverse results.

Diabetic nephropathy (DN) is considered the most frequent cause of end-stage renal disease (ESRD). For early diagnosis and follow up of renal function in patient with established DN, Duplex Doppler Sonography can be used as noninvasive tool. The aim and objective of the study was to determine whether resistive index could remain higher in type 2 diabetic patients having nephropathy in comparison with that of non-diabetic controls. This case-control study was done in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) from 1st Octy 2014 to 30th June 2015. Total 65 diabetic nephropathy patients were taken as study group and 65 healthy subjects were included as healthy control subjects. Duplex Color Doppler sonography of interlobar artery was carried out in both groups for the measurement of Peak systolic velocity, end diastolic velocity and arterial Resistive Index (RI). The RI of interlobar artery of left kidney in control group was 0.58±0.08 (mean±SD) and the mean RI of interlobar artery of left kidney in diabetic nephropathy patients was 0.74±0.53 (mean±SD). The difference of RI of interlobar artery of left kidney in the two groups was statistically significant and the RI of right kidney of control and that of case groups were 0.60±0.09 and 0.76±0.031 (mean±SD) respectively. In between control and case groups the RI of right kidney was statistically significant (p = <0.5). So, resistive index of interlobar artery was increased in type 2 diabetic nephropathy patients in comparison to control group. Study findings reveal that resistive index remains significantly higher in patients with diabetic nephropathy than control group. For this reason, RI can be used for early diagnosis of diabetic nephropathy by Duplex Doppler ultrasonography.

Chest X-ray is an important diagnostic aid frequently used alongside microscopic smear of sputum for the confirmation of pulmonary tuberculosis (TB). However, there is a dearth of literature investigating the clinical and radiological pattern of sputum positive pulmonary TB among adults in Bangladesh. The current study explored these patterns in presentation. This descriptive cross-sectional study was conducted at outpatients in department of medicine of a tertiary care hospital. A total of 50 newly diagnosed adult cases of smear positive pulmonary TB attending at the Directly Observed Treatment Short-course (DOTS) corners were consecutively included. Informed written consent was taken before inclusion. Data were collected through face-to-face interview. Radiological presentation was explored using chest X-ray. Data were analyzed by SPSS version 26.0. The average age of patients was 41.0±17.12 years and majority were male (78.0%). The most prevalent respiratory symptom was cough (80.0%) followed by constitutional symptom like fever (70.0%) and weight loss (72.0%). Wasting was the predominant sign (60.0%). Radiologically both lungs were involved in 32.0%, left lung were involved in 30.0% cases and right lung were involved in 26.0% of cases. Twelve percent (12.0%) of patients had normal chest X-ray. Upper zone involvement was commonly observed in this study's patients (66.0%). The predominant pattern was consolidation (46.0%) followed by fibrosis (26.0%), nodular opacity (12.0%), collapse (10.0%), cavity (6.0%), pleural effusion (2.0%) and bronchiectasis (2.0%). Findings of this study would help familiarize and identify the common clinical and radiological presentations of sputum positive pulmonary TB patients in day-to-day practice.

Helicobacter pylori (H. pylori) is a major cause of peptic ulcer disease (PUD), which needs effective eradication of the organism to heal ulcers and prevent a recurrence. In recent years, increasing resistance of H. pylori to clarithromycin and amoxicillin have decreased peptic ulcer cure rate following treatment with standard triple therapy worldwide. The addition of probiotics with standard triple therapy has shown excellent efficacy in H. pylori eradication and has appeared to be an alternative treatment strategy. This study aimed to assess the efficacy of standard triple therapy plus probiotics for H. pylori eradication and ulcer healing compared to standard triple therapy alone. This double-blind, randomized placebo-controlled clinical trial included 158 with endoscopically proven H. pylori-positive PUD who were randomly allocated equally into two groups; Group A was treated with standard triple therapy plus probiotics, and Group B was treated with standard triple therapy plus placebo for 14 days. The outcome was evaluated at the end of treatment (14th day) (symptoms plus adverse events) and after 60 days of treatment completion (H. pylori eradication and ulcer healing). One hundred forty four (144) study subjects (73 in Group A and 71 in Group B) completed the study. Significantly higher H. pylori eradication rate (82.2%vs. 67.6%, p=0.043) and ulcer healing rate (92.3% vs. 60.0%, p=0.049) were observed in the standard triple therapy plus probiotic group than the standard triple therapy plus placebo group. Early relief of epigastric pain was also seen among patients getting probiotics than the placebo in addition to standard triple therapy (42.3% vs. 15.1%, p<0.001).The addition of probiotics significantly improves the H. pylori eradication rate and ulcer healing rate among the patients getting standard triple therapy. Further large-scale, multi-center studies are needed to recommend routine use of probiotics with standard triple therapy for H. pylori eradication.

Parental relationship with children is the most natural, unique and enduring bond in the world gifted by God. As child's first education begins at home, so the quality of parental relationship with children may have an impact on child's life as well as school performance. The objective of this study was to find out the association between parental relationship and school performance of children. This was a cross sectional study where class six to ten children aged between 11-17 years was participants. Seven secondary schools were selected in Rajshahi city of Bangladesh for data collection. The self-administered questionnaire was used to find out the quality of parental relationship by using the Inventory of Parent and Peer Attachment (IPPA) scale. To asses school performance face to face interview was conducted to the corresponding class teachers as well as exam result and attendance were also taken from official records. The study period was one year from January 2019 to December 2019. Out of total 385 children, 53.5% were girls and 46.5% were boys. The mean age of the children was 13.63±1.289 years. Good quality of relationship with mother was 96.1% and poor-quality relationship was 3.9%. As well as good quality of relationship with father was 93.5% and poor-quality relationship was 6.5%. This study founded boys seemed to establish better relationships with mother compared to girls. Findings also revealed a positive significant association between children's relationship with their mothers and school performance. There was no significant relationship present between all socio-demographic characteristics and parental relationship except gender and occupation of father. This study found statistically significant relationship between parental relationship and school performance of children. Therefore, awareness among parents about parental relationship should be considered as a part of betterment of school performance.