Chittagong Medical College Hospital

About: Chittagong Medical College Hospital is a healthcare organization based out in Chittagong, Bangladesh. It is known for research contribution in the topics: Population & Malaria. The organization has 676 authors who have published 601 publications receiving 7040 citations.

Review the Evidence for Structured Education in Diabetes Management

Abstract: Structured Education is of detrimental importance for the management, counseling, and prevention of complications in diabetic patients. Different structured education programs exist that significantly improves the quality of life in diabetic patients as well as improves psychosocial outcomes by enhancing self-empowerment and self-motivation. Improvements have also been noted in bio-medical outcomes as a result of structured education most significantly in HbA1C, total cholesterol and frequency of hypoglycemia. In order to ensure patient satisfaction and improve outcomes related to complications, it is very important to identify and support patients whose psychosocial situations and reactions to the diagnosis may affect their ability to adjust or take adequate responsibility for self-care early in the course of the disease. In this review, we will discuss and highlight the evidence that support the benefits, limitations, and cost effectiveness of structured education in diabetes management

Effect of Topical Tacrolimus on Vitiligo in Children

Abstract: Background : Considering safe treatment modalities for children with vitiligo, search for newer therapeutic agents continues. Hence, new immunomodulatory agents such as calcineurinantagonists, frequently referred to as topical immunomodulators (TIMs) have recently been introduced as new promising tools to treat acquired hypopigmentary disorders. Tacrolimus is safe in treating children due to lack of skin atrophy and less data are available on effect of topical tacrolimus on vitiligo. Objective : To see the effect of topical tacrolimus on vitiligo in children. Materials and Methods : This prospective study was done in outpatient department of Dermatology and Venereology, Chittagong Medical College Hospital (CMCH), Bangladesh. Clinically diagnosed vitiligo patients of up to 12 years age visiting Skin & VD OPD, CMCH during study period were the study population (total 30). The study was carried out from November 2007 to April 2008. Results : A total of 30 patients, 13 (43.33%) males and 17 (56.66%) females with focal, segmental or generalized vitiligo were studied. Seventy percent of study subjects were from 7–12 years of age. Topical tacrolimus 0.03% ointment was administered twice daily for 12 weeks to each patient. Repigmentation was complete (>75%) in 43.33% cases (13/30), was moderate (50–75%) in 33.33% (10/30), mild (<50%) in 13.33% (4/30). Clinical adverse effects were noted in 6.67% (2/30) of cases where pruritus was in 3.33% (1/30) and burning in 3.33% (1/30). None of the reactions was severe, all were mild and well-tolerated and most occurred within the first month of initiation of treatment and resolved with continued use of drug and completely cured after the treatment completed. Nobody had to discontinue the therapy for side effects. Conclusion : In conclusion, tacrolimus ointment may be a rapidly efficacious and safe option for the treatment of vitiligo in children. The ease of topical self-administration with minimal side effects makes this novel immunomodulatory agent a promising addition to the therapeutic armamentarium for vitiligo in children. J Enam Med Col 2016; 6(1): 33-37

Report of a Rare Case of Sarcomatoid Renal Cell Carcinoma

Abstract: A 50 years old non-smoker female with the history of right flank pain and hematuria surgically treated with right sided radical nephrectomy. Macroscopically it showed a large growth located at the lower pole of the right kidney. Histologically the tumor was composed of exuberant sarcomatous elements predominantly malignant fibrous histiocytoma like pattern and diagnosed as sarcomatoid renal cell carcinoma. There was no scope for immunohistological analysis of that tumor in our setup. It is important to recognize the sarcomatoid component in the renal tumors because of its aggressive behavior and adverse prognosis. We report herein a case of sarcomatoid renal cell carcinoma histomorphogically. DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21039

Evaluation of Efficacy and Tolerability of Perindopril 8 mg in Bangladeshi Hypertensive Patients: Results from an Open-label, Observational, Multi-center Study (CONTROL)

Abstract: Background: The CONTROL (COversyl in Newly diagnosed stage-II & unconTROlled hypertensivepatients triaL) was performed with an objective to evaluate the blood pressure (BP) lowering efficacyand tolerability of Perindopril 8mg in newly diagnosed stage II patients and uncontrolledhypertensive patients among Bangladeshi population. Methods: This was an open-label, observational, multi-center study conducted in consultationcenters for out-patients located in different cities of Bangladesh. Adults, aged above 18 years withnewly diagnosed stage-II hypertension or uncontrolled hypertension, were recruited. Patients weretreated with Perindopril 4mg daily for first 1 week, afterwards uptitrated to Perindopril 8 mg dailyand continued treatment for 12 weeks. Patients were followed-up at week-1, week-4, week-8 andweek-12. Results: In total, 245 patients were enrolled. Among them, 88 were newly diagnosed stage-II (Group-I) and 157 were uncontrolled (Group-II) hypertensive patients. Male and female distribution was57% and 43% respectively. Mean age of patients was 54.5 ±11.7 years.After 12 weeks treatment, there was a significant reduction in BP from baseline (p<0.001) in overallpopulation as well as in Group I and in Group II. In overall population, the mean BP reduction was-31/-15 mmHg (from 163.7/96.8 mmHg to 132.4/81.7 mmHg. In Group I, the reduction was -33/-16mmHg (from 166.5/98.2 mmHg to 133.4/82.0 mmHg) and in Group II, -30/-14 mmHg (from 159.3/95.6 mmHg to 129.1/81.6 mmHg).10 patients (4.1%) had to discontinue the treatment due to adverse effects. Dry cough (2%) andhypotension (1.2%) were the main cause of discontinuation. Perindopril 8mg was well tolerated asindicated by the high proportion of physicians (81%) reporting ‘good’ to ‘excellent’ tolerability atweek 12. Conclusion: This study suggests that Perindopril 8mg is effective and safe in the treatment ofhypertension in Bangladeshi patients. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12272 Cardiovasc. j. 2012; 5(1): 44-50