Pub Date : 2022-12-08DOI: 10.3329/cmoshmcj.v21i2.63128
Shaheda S. Ahmed, Wazir Ahmed, M. J. Uddin, Feroza Aktar, S. Dutta, Ziaur Rahman, A. Hoque
Background: Neonatal screening program is very fruitful in saving our newborns from preventable neonatal diseases, thereby healthy grooming of future generations. Though newborn screening for a thyroid disorder is one of the greatest successes in preventive pediatrics but still has not practically worked out for all neonates in Bangladesh at the national level.The majority of newborns with a thyroid disorder have a normal appearance without detectable physical signs and are almost always missed. Screening at the proper time (Approximately 2-7 days after birth), rechecking of suspicious cases within a week, and initiation of treatment (Within 2 weeks of age) of thyroid disorders particularly Congenital Hypothyroidism (CH), can prevent the irreversible mental and physical impairments. Transient neonatal hyperthyroidism is the common form of neonatal hyperthyroidism. The purpose of the study was, Neonatal Screening (NS) to evaluate the rate of thyroid disorders among Preterm (Early preterm born before 34th week of gestation, late preterm born between 34th week and before 37th week of gestation), Term (Born within 37th to 42nd week of gestation) and Post-term (Born after 42nd week of gestation) newborns. Birth weight was alsomeasured to categorize the newborns according to their weight. Materials and methods: It was a cross-sectional, observational type of study. The place was the Neonatal Department of Chattogram Maa-O-Shishu Hospital Medical College, Chattogram. Blood samples were collected from eighty neonates aging 2 to 7 days and sent to the laboratory for estimation of TSH and FT4. Results: Total number of samples was 80. Out of them, preterm new-born were 19 and term new-born were 61, no post-term case was found. Both groups wereagain divided into normal birth weight (³2.5 kg) and low birth weight (< 2.5 kg). Hyperthyroidism (High or normal FT4 but low TSH) was observed in 23 term newborns (37.7%) and hypothyroidism (Low or normal FT4 but high TSH) in 11 term newborns (18.03%) and the rest were Euthyroid (TSH normal, FT4 normal/increased/decreased). In the case of preterm, there were more hypothyroid 03 (15.78%) than hyperthyroid 02(10.52%). Conclusion: Our study observed that, among the newborns, who were admitted to the hospital,around half of them (39 out of 80) had abnormal thyroid function. The newborns with abnormal thyroid status were informed to their parents for further evaluation by the Department of Endocrinology. It would be helpful to reach the final diagnosis and treat it accordingly. Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 44-47
{"title":"Screening of New-Borns for Thyroid Status Admitted in Neonatal Ward of a Tertiary Care Hospital","authors":"Shaheda S. Ahmed, Wazir Ahmed, M. J. Uddin, Feroza Aktar, S. Dutta, Ziaur Rahman, A. Hoque","doi":"10.3329/cmoshmcj.v21i2.63128","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63128","url":null,"abstract":"Background: Neonatal screening program is very fruitful in saving our newborns from preventable neonatal diseases, thereby healthy grooming of future generations. Though newborn screening for a thyroid disorder is one of the greatest successes in preventive pediatrics but still has not practically worked out for all neonates in Bangladesh at the national level.The majority of newborns with a thyroid disorder have a normal appearance without detectable physical signs and are almost always missed. Screening at the proper time (Approximately 2-7 days after birth), rechecking of suspicious cases within a week, and initiation of treatment (Within 2 weeks of age) of thyroid disorders particularly Congenital Hypothyroidism (CH), can prevent the irreversible mental and physical impairments. Transient neonatal hyperthyroidism is the common form of neonatal hyperthyroidism. The purpose of the study was, Neonatal Screening (NS) to evaluate the rate of thyroid disorders among Preterm (Early preterm born before 34th week of gestation, late preterm born between 34th week and before 37th week of gestation), Term (Born within 37th to 42nd week of gestation) and Post-term (Born after 42nd week of gestation) newborns. Birth weight was alsomeasured to categorize the newborns according to their weight. \u0000Materials and methods: It was a cross-sectional, observational type of study. The place was the Neonatal Department of Chattogram Maa-O-Shishu Hospital Medical College, Chattogram. Blood samples were collected from eighty neonates aging 2 to 7 days and sent to the laboratory for estimation of TSH and FT4. \u0000Results: Total number of samples was 80. Out of them, preterm new-born were 19 and term new-born were 61, no post-term case was found. Both groups wereagain divided into normal birth weight (³2.5 kg) and low birth weight (< 2.5 kg). Hyperthyroidism (High or normal FT4 but low TSH) was observed in 23 term newborns (37.7%) and hypothyroidism (Low or normal FT4 but high TSH) in 11 term newborns (18.03%) and the rest were Euthyroid (TSH normal, FT4 normal/increased/decreased). In the case of preterm, there were more hypothyroid 03 (15.78%) than hyperthyroid 02(10.52%). \u0000Conclusion: Our study observed that, among the newborns, who were admitted to the hospital,around half of them (39 out of 80) had abnormal thyroid function. The newborns with abnormal thyroid status were informed to their parents for further evaluation by the Department of Endocrinology. It would be helpful to reach the final diagnosis and treat it accordingly. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 44-47","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85839669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59763
H. Akter, Mursheda Khanam, Tanjina Hoq, R. Das, M. Chowdhury
Background: Clinical manifestations of children with COVID 19 differ widely from adult cases. They usually have milder disease. There are limited data on pediatric COVID patient from Bangladesh. This study was conducted to find out the demographic and clinical characteristics of COVID-19 in children and post-COVID complications in a specialized COVID hospital from south-east part of Bangladesh. Materials and methods: This retrospective study was conducted in Bangladesh Institute of Tropical and Infectious Diseases (BITID), Fouzderhat, Chattogram from April 2020 to September, 2020. Medical records of PCR-confirmed pediatric COVID- 19 cases were collected. Data regarding age, sex, residence, contact history, presenting features, hospitalization, comorbidities and post-COVID complication were noted. Statistical analysis was done by SPSS 20.0 version. Results: Out of total 2058 pediatric patients, 183 (8.9%) were PCR confirmed COVID- 19 cases. Male to female ratio was 1.3:1 and median age was 11 years (Age range 3 months to 17 years). 35% patients belonged to the age group 11 to 15 years. Family clustering was the main transmission route (81.3%) and parents were the most common source (77.8%). Most of the patients lived in the Chattogram metropolitan area (57.1%). Highest peak of infection were during the month of May and June. Many of them (38.9%) were asymptomatic. Among them 11-15 years age group were mostly asymptomatic (38.6%). Most common presentation was fever (85%) followed by cough (37.5%), runny nose (25%) and sore throat (19.3%). For 2-5 years age group, gastrointestinal symptoms were predominant (30%). Only 9 patients (6.3%) required hospitalization. The median time from onset to cure was 3 days (Ranging from 1 to 30 days). Total 8 patients (5.6%) developed post-covid complications. Those were extreme weakness (2.8%), anorexia (2.1%), chronic cough (1.4%), insomnia (0.7%) and headache (0.7%). 16-17 years patients mostly suffered from these complications. There was no mortality in this pool of pediatric patients. Conclusion: COVID 19 in pediatric patients is distinct from adults. There was slight male preponderance with 11-15 years age group being more susceptible. Most common source of infection were parents. Many patients had asymptomatic infection. Fever was the most common presenting feature followed by respiratory symptoms. Very few patients developed post-COVID complications which were mild and there was no mortality. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 61-65
{"title":"Demographic and Clinical Profile of COVID-19 and Post-COVID Complications in Children at a Specialized COVID Hospital","authors":"H. Akter, Mursheda Khanam, Tanjina Hoq, R. Das, M. Chowdhury","doi":"10.3329/cmoshmcj.v21i1.59763","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59763","url":null,"abstract":"Background: Clinical manifestations of children with COVID 19 differ widely from adult cases. They usually have milder disease. There are limited data on pediatric COVID patient from Bangladesh. This study was conducted to find out the demographic and clinical characteristics of COVID-19 in children and post-COVID complications in a specialized COVID hospital from south-east part of Bangladesh. \u0000Materials and methods: This retrospective study was conducted in Bangladesh Institute of Tropical and Infectious Diseases (BITID), Fouzderhat, Chattogram from April 2020 to September, 2020. Medical records of PCR-confirmed pediatric COVID- 19 cases were collected. Data regarding age, sex, residence, contact history, presenting features, hospitalization, comorbidities and post-COVID complication were noted. Statistical analysis was done by SPSS 20.0 version. \u0000Results: Out of total 2058 pediatric patients, 183 (8.9%) were PCR confirmed COVID- 19 cases. Male to female ratio was 1.3:1 and median age was 11 years (Age range 3 months to 17 years). 35% patients belonged to the age group 11 to 15 years. Family clustering was the main transmission route (81.3%) and parents were the most common source (77.8%). Most of the patients lived in the Chattogram metropolitan area (57.1%). Highest peak of infection were during the month of May and June. Many of them (38.9%) were asymptomatic. Among them 11-15 years age group were mostly asymptomatic (38.6%). Most common presentation was fever (85%) followed by cough (37.5%), runny nose (25%) and sore throat (19.3%). For 2-5 years age group, gastrointestinal symptoms were predominant (30%). Only 9 patients (6.3%) required hospitalization. The median time from onset to cure was 3 days (Ranging from 1 to 30 days). Total 8 patients (5.6%) developed post-covid complications. Those were extreme weakness (2.8%), anorexia (2.1%), chronic cough (1.4%), insomnia (0.7%) and headache (0.7%). 16-17 years patients mostly suffered from these complications. There was no mortality in this pool of pediatric patients. \u0000Conclusion: COVID 19 in pediatric patients is distinct from adults. There was slight male preponderance with 11-15 years age group being more susceptible. Most common source of infection were parents. Many patients had asymptomatic infection. Fever was the most common presenting feature followed by respiratory symptoms. Very few patients developed post-COVID complications which were mild and there was no mortality. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 61-65","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"314 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75846048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59758
M. Ali, Md Zakir Hossain, B. Bidhu, Amaresh Chandra Shaha, Md. Ashraful Haque, A. Alam, Umme Habiba, Md Ruhul Amin Sarkar
Background: Meningitis is an inflammatory condition involving the meninges of the brain and spinal cord. Acute meningitis is global burden of disease, has a high casefatality rate and survivors can have severe lifelong disability. It can have infectious causes, such as bacteria, mycobacteria, viruses, fungi, or parasites, or be associated with autoimmunity, cancer, or reactions to medication. Risk factors that predispose individuals to meningitis and epidemics include malnutrition, household overcrowding, HIV infection, absence of immunisation, indoor air pollution, and sickle cell disease. Bacterial meningitis can rapidly become fatal and lead to severe disability in those who survive. Purpose of this study was clinical study of acute meningitis in adults. Materials and methods: This cross sectional observational study was conducted in Department of medicine, Rangpur Medical College Hospital, among the 100 patients who presented with sign symptoms of meningitis. Detailed history, clinical examination and thorough investigations were done and the findings were recorded on a proforma. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: The mostly affected groups were 16-20 and 31-40 years. Mean age was 33.04 (±18.08 SD) years. There was an overall male preponderance with a male to female ratio 2.12:1. Fever headache, and vomiting was most common symptoms. Altered consciousness was present in 80% of cases, focal neurological deficit and rash were present in 10% cases. CSF findings are the hallmark of diagnosing various types of meningitis. Colour of CSF, glucose and protein concentration of CSF found in this study correlates with maximum authority. On evaluation of aetiology, 66% cases were due to bacteria and 24% and 10% cases were tuberculous and viral aetiology respectively. Outcome of pyogenic meningitis was good and mortality was 6%. Inspite of treatment 8 out of 24 (33%) tuberculous meningitis patient’s were died. One case of bacterial and one case of viral meningitis were missed during follow up. Conclusion: Meningitis is foremost causes of morbidity and mortality. It is recommended that provision of proper health care support, rapid detection and other investigation facilities reduce the disability. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 36-40
{"title":"A Clinical Study of Acute Meningitis in Adults in Rangpur Medical College Hospital","authors":"M. Ali, Md Zakir Hossain, B. Bidhu, Amaresh Chandra Shaha, Md. Ashraful Haque, A. Alam, Umme Habiba, Md Ruhul Amin Sarkar","doi":"10.3329/cmoshmcj.v21i1.59758","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59758","url":null,"abstract":"Background: Meningitis is an inflammatory condition involving the meninges of the brain and spinal cord. Acute meningitis is global burden of disease, has a high casefatality rate and survivors can have severe lifelong disability. It can have infectious causes, such as bacteria, mycobacteria, viruses, fungi, or parasites, or be associated with autoimmunity, cancer, or reactions to medication. Risk factors that predispose individuals to meningitis and epidemics include malnutrition, household overcrowding, HIV infection, absence of immunisation, indoor air pollution, and sickle cell disease. Bacterial meningitis can rapidly become fatal and lead to severe disability in those who survive. Purpose of this study was clinical study of acute meningitis in adults. \u0000Materials and methods: This cross sectional observational study was conducted in Department of medicine, Rangpur Medical College Hospital, among the 100 patients who presented with sign symptoms of meningitis. Detailed history, clinical examination and thorough investigations were done and the findings were recorded on a proforma. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. \u0000Results: The mostly affected groups were 16-20 and 31-40 years. Mean age was 33.04 (±18.08 SD) years. There was an overall male preponderance with a male to female ratio 2.12:1. Fever headache, and vomiting was most common symptoms. Altered consciousness was present in 80% of cases, focal neurological deficit and rash were present in 10% cases. CSF findings are the hallmark of diagnosing various types of meningitis. Colour of CSF, glucose and protein concentration of CSF found in this study correlates with maximum authority. On evaluation of aetiology, 66% cases were due to bacteria and 24% and 10% cases were tuberculous and viral aetiology respectively. Outcome of pyogenic meningitis was good and mortality was 6%. Inspite of treatment 8 out of 24 (33%) tuberculous meningitis patient’s were died. One case of bacterial and one case of viral meningitis were missed during follow up. \u0000Conclusion: Meningitis is foremost causes of morbidity and mortality. It is recommended that provision of proper health care support, rapid detection and other investigation facilities reduce the disability. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 36-40","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87575724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59761
Shamima Khanam, Tirtha Khastagir, Rahat Anjum, Mitasree Barua, M. Khatun, M. Z. Rahman
Background : Colorectal carcinoma (CRC) is the most frequently observed malignancy worldwide. The incidence of CRC is 3.5% in Bangladesh. Conflicting data exist about the prevalence of HER-2/neu over expression in colorectal cancer ranging from 0 to 83%. The aim of this study was to evaluate the expression of Her-2/neu protein in colorectal cancers. Materials and methods: This descriptive cross-sectional study was conducted in the Department of Pathology of Chittagong Medical College, Chittagong, Bangladesh from 1st January 2017 to 31st December 2017. A total of 52 cases with a histopathological diagnosis of colorectal cancers included in the study as sample size, HER2 status was evaluated by immunohistochemistry (IHC) in formalin fixed, paraffin embedded tissue.Positive expression was assigned a score from 0–3+.IHCs were analysed with grades of colon cancers. Results: The mean age in this study was 47.62years range from 12 to 85 years ,53.8% were female. Among 52 specimens 30 (57.7%) cases were from colon and all the cases were adenocarcinoma and rest of all (42.3%) were from rectum.33 (63.5%) cases were Grade-I, 8 (15.4%) were Grade-II, and 11 (21.2%) were Grade-III. Only 8 (15.4%) of 52 cases showed HER2 positive, 4 (50.0%) cases were from grade- Iand another 4 (50.0%) were grade- II tumours. HER2 overexpression were significantly associated with well differentiated CRC than poorly differentiated (p=0.044). Conclusion: HER2/neu protein expression was observed in colorectal cancer but HER-2/neu protein is less likely to be expressed in colon cancer cell lines among our patients. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 52-56
{"title":"Socio Demographic Profile and HER2 Status in Patients with Colorectal Carcinoma","authors":"Shamima Khanam, Tirtha Khastagir, Rahat Anjum, Mitasree Barua, M. Khatun, M. Z. Rahman","doi":"10.3329/cmoshmcj.v21i1.59761","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59761","url":null,"abstract":"Background : Colorectal carcinoma (CRC) is the most frequently observed malignancy worldwide. The incidence of CRC is 3.5% in Bangladesh. Conflicting data exist about the prevalence of HER-2/neu over expression in colorectal cancer ranging from 0 to 83%. The aim of this study was to evaluate the expression of Her-2/neu protein in colorectal cancers. \u0000Materials and methods: This descriptive cross-sectional study was conducted in the Department of Pathology of Chittagong Medical College, Chittagong, Bangladesh from 1st January 2017 to 31st December 2017. A total of 52 cases with a histopathological diagnosis of colorectal cancers included in the study as sample size, HER2 status was evaluated by immunohistochemistry (IHC) in formalin fixed, paraffin embedded tissue.Positive expression was assigned a score from 0–3+.IHCs were analysed with grades of colon cancers. \u0000Results: The mean age in this study was 47.62years range from 12 to 85 years ,53.8% were female. Among 52 specimens 30 (57.7%) cases were from colon and all the cases were adenocarcinoma and rest of all (42.3%) were from rectum.33 (63.5%) cases were Grade-I, 8 (15.4%) were Grade-II, and 11 (21.2%) were Grade-III. Only 8 (15.4%) of 52 cases showed HER2 positive, 4 (50.0%) cases were from grade- Iand another 4 (50.0%) were grade- II tumours. HER2 overexpression were significantly associated with well differentiated CRC than poorly differentiated (p=0.044). \u0000Conclusion: HER2/neu protein expression was observed in colorectal cancer but HER-2/neu protein is less likely to be expressed in colon cancer cell lines among our patients. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 52-56","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88373073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59765
Mazharul Islam, A. Azad, S. Kazmi, Sidrah Khan, S. Krishnan
Diabetic ketoacidosis and Hyperosmolar Hyperglycaemic State are both acute, lifethreatening metabolic complications occurring in patients with Type 1 and Type 2 Diabetes. The presence of both these conditions simultaneously in one patient is always a challenge to the clinicians. We report such a case of a 62-year-old gentleman known to have Type 2 diabetes, presented with multiple episodes of vomiting and collapse. On arrival to the Emergency Department, he was tachycardic and physical examination revealed upper abdominal tenderness. Blood tests revealed initial pH 6.96, HCO3 6.1mmol/L, Glucose high, blood ketones 5.8mmol/L, K 4.5mmol/L, and Lactate 1.7mmol/L. His calculated serum osmolality was 340mmol/Kg, serum amylase 532U/L and Troponin 88ng/ml. He was treated as per the DKA protocol of the trust and was transferred to the High Dependency Unit. In view of his raised serum osmolality, he was diagnosed as having mixed Diabetic Ketoacidosis and Hyperglycaemic Hyperosmolar State. A CT scan of the abdomen was done to find out the underlying etiology which suggested acute pancreatitis. Additionally, he was diagnosed as having Type 2 myocardial infarction (MI). Both the surgical and cardiology teams were involved in his care. Because of his having both DKA and HHS features the management, especially fluid resuscitation was tailored accordingly. Eventually, the patient recovered and was stepped down to the ward 3 days later. Our case emphasizes that prompt and correct diagnosis of diabetic emergencies can lead to successful outcomes in patients with multiple complications as well. Timely diagnosis, thorough clinical and biochemical evaluation, and effective management are essential for the resolution of DKA and HHS. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 70-72
糖尿病酮症酸中毒和高渗性高血糖状态都是发生在1型和2型糖尿病患者中的急性、危及生命的代谢并发症。一个病人同时出现这两种情况对临床医生来说总是一个挑战。我们报告这样一个62岁的绅士已知的2型糖尿病,表现为多次发作呕吐和崩溃。到达急诊科时,他心跳过速,体格检查发现上腹部有压痛。血液检查:初始pH 6.96, HCO3 6.1mmol/L,葡萄糖高,血酮5.8mmol/L, K 4.5mmol/L,乳酸1.7mmol/L。计算血清渗透压340mmol/Kg,血清淀粉酶532U/L,肌钙蛋白88ng/ml。他被按照信托的DKA协议对待,并被转移到高度依赖股。鉴于他的血清渗透压升高,他被诊断为糖尿病酮症酸中毒和高血糖性高渗透压状态。腹部CT扫描发现潜在的病因提示急性胰腺炎。此外,他被诊断为2型心肌梗死(MI)。外科和心脏病小组都参与了他的治疗。由于他同时具有DKA和HHS的特点,因此对其进行了相应的处理,特别是液体复苏。最终,患者康复,3天后被下放到病房。我们的病例强调,及时和正确的诊断糖尿病急症可以导致成功的结果,以及患者的多重并发症。及时诊断、全面的临床和生化评价、有效的管理是解决DKA和HHS的关键。上海医科大学医学院;月(1);2022年1月;页70 - 72
{"title":"Mixed Diabetic Emergencies with Acute Pancreatitis and Type 2 Myocardial Infarction: A Case Report","authors":"Mazharul Islam, A. Azad, S. Kazmi, Sidrah Khan, S. Krishnan","doi":"10.3329/cmoshmcj.v21i1.59765","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59765","url":null,"abstract":"Diabetic ketoacidosis and Hyperosmolar Hyperglycaemic State are both acute, lifethreatening metabolic complications occurring in patients with Type 1 and Type 2 Diabetes. The presence of both these conditions simultaneously in one patient is always a challenge to the clinicians. We report such a case of a 62-year-old gentleman known to have Type 2 diabetes, presented with multiple episodes of vomiting and collapse. On arrival to the Emergency Department, he was tachycardic and physical examination revealed upper abdominal tenderness. Blood tests revealed initial pH 6.96, HCO3 6.1mmol/L, Glucose high, blood ketones 5.8mmol/L, K 4.5mmol/L, and Lactate 1.7mmol/L. His calculated serum osmolality was 340mmol/Kg, serum amylase 532U/L and Troponin 88ng/ml. He was treated as per the DKA protocol of the trust and was transferred to the High Dependency Unit. In view of his raised serum osmolality, he was diagnosed as having mixed Diabetic Ketoacidosis and Hyperglycaemic Hyperosmolar State. A CT scan of the abdomen was done to find out the underlying etiology which suggested acute pancreatitis. Additionally, he was diagnosed as having Type 2 myocardial infarction (MI). Both the surgical and cardiology teams were involved in his care. Because of his having both DKA and HHS features the management, especially fluid resuscitation was tailored accordingly. Eventually, the patient recovered and was stepped down to the ward 3 days later. Our case emphasizes that prompt and correct diagnosis of diabetic emergencies can lead to successful outcomes in patients with multiple complications as well. Timely diagnosis, thorough clinical and biochemical evaluation, and effective management are essential for the resolution of DKA and HHS. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 70-72","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87351455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59752
T. Banu, T. Chowdhury, T. T. Aziz, Nowrin Tamanna, Arni Das, Nugayer Sharmeen, Sanchita Roy, Durdana Sadab, Sabbir Ahmed
Background: Adolescence is an important phase of life and adolescent girls have specific health related problems. The aim of the study was to address the health-related issues of urban school going adolescent girls from a lower-middle income country. Materials and methods: A cross-sectional study was performed among 1315 school high-school girls. Demographic and socioeconomic parameters were recorded and health related behaviours and problems analysed. Results: Age ranged from 10 to 17 years. Immunization and deworming rates were 98.17% and 57.41%, respectively and deworming significantly reduced in higher classes (p=0.00). Major physical complaints were eye problems (583, 44.33%), allergy to various substances (500, 38.02%), headache (435, 33.08%) and menstrual problems (334, 25.40%). Obesity and overweight were significantly more in higher classes and underweight in lower classes (p<0.01). Conclusion: Diverse and serious health related undiagnosed problems prevail among girls’ high school. Malnutrition, ocular problems, menstrual problems and headaches are major areas of concerns. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 19-25
{"title":"Health and Disease among Adolescent Urban School Girls in Bangladesh","authors":"T. Banu, T. Chowdhury, T. T. Aziz, Nowrin Tamanna, Arni Das, Nugayer Sharmeen, Sanchita Roy, Durdana Sadab, Sabbir Ahmed","doi":"10.3329/cmoshmcj.v21i1.59752","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59752","url":null,"abstract":"Background: Adolescence is an important phase of life and adolescent girls have specific health related problems. The aim of the study was to address the health-related issues of urban school going adolescent girls from a lower-middle income country. \u0000Materials and methods: A cross-sectional study was performed among 1315 school high-school girls. Demographic and socioeconomic parameters were recorded and health related behaviours and problems analysed. \u0000Results: Age ranged from 10 to 17 years. Immunization and deworming rates were 98.17% and 57.41%, respectively and deworming significantly reduced in higher classes (p=0.00). Major physical complaints were eye problems (583, 44.33%), allergy to various substances (500, 38.02%), headache (435, 33.08%) and menstrual problems (334, 25.40%). Obesity and overweight were significantly more in higher classes and underweight in lower classes (p<0.01). \u0000Conclusion: Diverse and serious health related undiagnosed problems prevail among girls’ high school. Malnutrition, ocular problems, menstrual problems and headaches are major areas of concerns. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 19-25","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79104825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59748
Md Jalal Uddin, Kawsar Sultana, Chinmoy Baidya, N. Akhter
Background : Infants are at increased risk of morbidity and mortality. So, it is necessary for clinicians to properly place judgement on if an infant requires hospital admission. However, there is a lack of data on which diseases frequently need hospitalization in infancy. Hence the aim of this study was to provide a comprehensive description of infants requiring admissions to healthcare facilities. Materials and methods : This was a cross-sectional study conducted at the outpatient department of a tertiary level hospital. Hundred infants between 1 month to 12 months of age, who were advised for hospitalization following a provisional diagnosis by an expert clinician were enrolled as study subjects. Their details were obtained from caregivers during their visit and the results were analyzed manually. Results : The mean age of infants was 5.4±3.7 months with 2-month-old being the most common age group. The male: female ratio was 1.6:1 while the ratio forurban vs rural settings was 2.2:1. The most common religion was Islam (87%) followed by Hinduism (12%) and then Buddhism (1%). The most common diagnosis of study subjects in descending order of frequency were acute respiratory infection (46%) acute watery diarrhea (34%) burn and scald injury (13%) congenital disorders (10%) and late onset neonatal sepsis (8%). Conclusion : Most common indicators requiring hospital admissions among infants are acute respiratory infection, acute watery diarrhea, burn and scald injury, congenital disorders and late onset neonatal sepsis. Further study needs to be done to look for seasonal variation and variation between neonates and other under-5 age group children. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 3-6
{"title":"Top Five Indications of Hospital Admission of Infants","authors":"Md Jalal Uddin, Kawsar Sultana, Chinmoy Baidya, N. Akhter","doi":"10.3329/cmoshmcj.v21i1.59748","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59748","url":null,"abstract":"Background : Infants are at increased risk of morbidity and mortality. So, it is necessary for clinicians to properly place judgement on if an infant requires hospital admission. However, there is a lack of data on which diseases frequently need hospitalization in infancy. Hence the aim of this study was to provide a comprehensive description of infants requiring admissions to healthcare facilities. \u0000Materials and methods : This was a cross-sectional study conducted at the outpatient department of a tertiary level hospital. Hundred infants between 1 month to 12 months of age, who were advised for hospitalization following a provisional diagnosis by an expert clinician were enrolled as study subjects. Their details were obtained from caregivers during their visit and the results were analyzed manually. \u0000Results : The mean age of infants was 5.4±3.7 months with 2-month-old being the most common age group. The male: female ratio was 1.6:1 while the ratio forurban vs rural settings was 2.2:1. The most common religion was Islam (87%) followed by Hinduism (12%) and then Buddhism (1%). The most common diagnosis of study subjects in descending order of frequency were acute respiratory infection (46%) acute watery diarrhea (34%) burn and scald injury (13%) congenital disorders (10%) and late onset neonatal sepsis (8%). \u0000Conclusion : Most common indicators requiring hospital admissions among infants are acute respiratory infection, acute watery diarrhea, burn and scald injury, congenital disorders and late onset neonatal sepsis. Further study needs to be done to look for seasonal variation and variation between neonates and other under-5 age group children. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 3-6","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87187608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59759
M. Parveen, M. Hannan, J. Ferdoush
Background: The objective of this study was to understand the factors which have positively and negatively affected delivery of medical education in Bangladesh during the COVID-19 epidemic and to apply this knowledge to improve preparedness in the event of future COVID spikes or other pandemics. Materials and methods: A 20-question survey was constructed and responses from over 300 medical students across Bangladesh were received and statistically examined by chi-squared, logistic regression and latent class analysis. Results: Quality of internet connection has the biggest impact on delivery of highquality online courses. General experience with online course delivery through number of courses attended and year in the program were also impactful. Latent class analysis indicated that two classes of students existed with regards to their answers (Yes/No/Undecided) as to whether they would attend class or sit professional exams if schools reopened. The characteristics of each class were diverse and enabled a glimpse into the psyche of the students. Conclusions: The results demonstrated a need for government to ensure every one has access to a good quality internet. Not only will it improve the perception of online medical courses, it will prevent students from unnecessary travelling increasing the risk of transmission. With experience in developing online curricula, the misconception that it is inferior to classroom equivalent may be reduced. More confidence in the quality of online classes may encourage more students that are apprehensive about the professional exams to regain their self-confidence and sit them and increase the pool of independently practicing physicians in Bangladesh. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 41-46
{"title":"Medical Education Amidst the COVID-19 Pandemic: A Takeaway from Perspectives of Medical Students of Bangladesh","authors":"M. Parveen, M. Hannan, J. Ferdoush","doi":"10.3329/cmoshmcj.v21i1.59759","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59759","url":null,"abstract":"Background: The objective of this study was to understand the factors which have positively and negatively affected delivery of medical education in Bangladesh during the COVID-19 epidemic and to apply this knowledge to improve preparedness in the event of future COVID spikes or other pandemics. \u0000Materials and methods: A 20-question survey was constructed and responses from over 300 medical students across Bangladesh were received and statistically examined by chi-squared, logistic regression and latent class analysis. \u0000Results: Quality of internet connection has the biggest impact on delivery of highquality online courses. General experience with online course delivery through number of courses attended and year in the program were also impactful. Latent class analysis indicated that two classes of students existed with regards to their answers (Yes/No/Undecided) as to whether they would attend class or sit professional exams if schools reopened. The characteristics of each class were diverse and enabled a glimpse into the psyche of the students. \u0000Conclusions: The results demonstrated a need for government to ensure every one has access to a good quality internet. Not only will it improve the perception of online medical courses, it will prevent students from unnecessary travelling increasing the risk of transmission. With experience in developing online curricula, the misconception that it is inferior to classroom equivalent may be reduced. More confidence in the quality of online classes may encourage more students that are apprehensive about the professional exams to regain their self-confidence and sit them and increase the pool of independently practicing physicians in Bangladesh. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 41-46","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91108416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59757
A. Ali
Background : The pattern of disease of a community is not always constant. It was observed that every decade produces its own pattern of disease. The pattern of disease depends on the socio-economic factors, as well as historical period, geographical location and other condition. To determine the pattern of disease of soldiers attending at MI room of CMH Ramu. Materials and methods: This descriptive cross-sectional study was conducted at Medical Inspection Room of Combined Military Hospital Ramu, Cox’s Bazar from July 2021 to November 2021. A total of 501 sick soldiers were selected through systematic random sampling for the study. Data were collected by face to face interview with structured questionnaire. Results: Mean age of the respondents was 29.32 ± 1.0 years.Mean age of the respondents was 29.32 ± 1.0 years. Majority of the respondents (53.1%) were in the age group of 20-29 years, followed by 37.1% respondents of 30-39 years. Most frequent acute complaints were fever and injury (100.0%), followed by RTI (97.6%) and musculoskeletal pain (95.7%). Most frequent complaints of chronic disease were hypertension and Diabetes mellitus (100.0%), followed by backache (55.6%), skin disease (11.4%) and eye disease (91.7%).The selected disease like fever, RTI, GI complain, skin disease were higher among the respondents living in the barrack (77.3%) than those who were living in family accommodation (22.7%). Conclusion: The findings of this study revealed that most frequent acute complaints was fever and injury (100.0%), followed by RTI (97.6%), musculoskeletal pain (95.7%). Most frequent complaints of chronic disease were Hypertension and Diabetes mellitus, followed by backache (55.6%), Skin disease (11.4%) and eye disease (91.7%). This study will provide a guideline for planning and implementation of intervention program and resource allocation. It will also provide a guideline for further studies. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 31-35
{"title":"Pattern of Diseases among Soldiers Attending Combined Military Hospital Ramu, Coxs Bazar","authors":"A. Ali","doi":"10.3329/cmoshmcj.v21i1.59757","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59757","url":null,"abstract":"Background : The pattern of disease of a community is not always constant. It was observed that every decade produces its own pattern of disease. The pattern of disease depends on the socio-economic factors, as well as historical period, geographical location and other condition. To determine the pattern of disease of soldiers attending at MI room of CMH Ramu. \u0000Materials and methods: This descriptive cross-sectional study was conducted at Medical Inspection Room of Combined Military Hospital Ramu, Cox’s Bazar from July 2021 to November 2021. A total of 501 sick soldiers were selected through systematic random sampling for the study. Data were collected by face to face interview with structured questionnaire. \u0000Results: Mean age of the respondents was 29.32 ± 1.0 years.Mean age of the respondents was 29.32 ± 1.0 years. Majority of the respondents (53.1%) were in the age group of 20-29 years, followed by 37.1% respondents of 30-39 years. Most frequent acute complaints were fever and injury (100.0%), followed by RTI (97.6%) and musculoskeletal pain (95.7%). Most frequent complaints of chronic disease were hypertension and Diabetes mellitus (100.0%), followed by backache (55.6%), skin disease (11.4%) and eye disease (91.7%).The selected disease like fever, RTI, GI complain, skin disease were higher among the respondents living in the barrack (77.3%) than those who were living in family accommodation (22.7%). \u0000Conclusion: The findings of this study revealed that most frequent acute complaints was fever and injury (100.0%), followed by RTI (97.6%), musculoskeletal pain (95.7%). Most frequent complaints of chronic disease were Hypertension and Diabetes mellitus, followed by backache (55.6%), Skin disease (11.4%) and eye disease (91.7%). This study will provide a guideline for planning and implementation of intervention program and resource allocation. It will also provide a guideline for further studies. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 31-35","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91191904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.3329/cmoshmcj.v21i1.59747
Rajat Sanker Roy Biswas, M. J. Uddin
Abstract not available Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 1-2
[摘要]上海医科大学医学院;月(1);2022年1月;1 - 2页
{"title":"Medical Research : A Neglected Issue in Bangladesh","authors":"Rajat Sanker Roy Biswas, M. J. Uddin","doi":"10.3329/cmoshmcj.v21i1.59747","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i1.59747","url":null,"abstract":"Abstract not available \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 1-2","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74906063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}