Showing papers by "Khulna Medical College published in 2011"
[...]
TL;DR: The incidence of the disease has decreased in developed countries as a result of vaccination and improved industrial hygiene, and administration of anti-protective antigen (PA) antibody in combination with ciprofloxacin produced 90%-100% survival.
Abstract: Anthrax is a zoonotic disease caused by Bacillus anthracis. It is potentially fatal and highly contagious disease. Herbivores are the natural host. Human acquire the disease incidentally by contact with infected animal or animal products. In the 18th century an epidemic destroyed approximately half of the sheep in Europe. In 1900 human inhalational anthrax occured sporadically in the United States. In 1979 an outbreak of human anthrax occured in Sverdlovsk of Soviet Union. Anthrax continued to represent a world wide presence. The incidence of the disease has decreased in developed countries as a result of vaccination and improved industrial hygiene. Human anthrax clinically presents in three forms, i.e. cutaneous, gastrointestinal and inhalational. About 95% of human anthrax is cutaneous and 5% is inhalational. Gastrointestinal anthrax is very rare (less than 1%). Inhalational form is used as a biological warefare agent. Penicillin, ciprofloxacin (and other quinolones), doxicyclin, ampicillin, imipenem, clindamycin, clarithromycin, vancomycin, chloramphenicol, rifampicin are effective antimicrobials. Antimicrobial therapy for 60 days is recommended. Human anthrax vaccine is available. Administration of anti-protective antigen (PA) antibody in combination with ciprofloxacin produced 90%-100% survival. The combination of CPG-adjuvanted anthrax vaccine adsorbed (AVA) plus dalbavancin significantly improved survival.
56 citations
TL;DR: Incidence of unknown poisoning, sedatives, snake-bite and corrosives were found to be gradually decreased over the study years, and male were found mostly affected in majority type of poisoning except Copper-sulphate, kerosene, puffer fish, paracetamol and other drugs category.
Abstract: This retrospective study was carried out in the Medicine Department of Khulna Medical College, the biggest tertiary hospital in the southern part of Bangladesh to observe the trends of poisoning in southern part of Bangladesh over four years including age and sex variation, mode of poisoning, type of poison used and outcome of poisoning. The hospital medical records of all patients, aged 10 years and above with history of acute poisoning from January, 2003 to December, 2006 were enrolled. Patients were categorized into four age group including Group (Gr.) I, Gr. II, Gr. III & Gr. IV having age range of 10-20, 21-30, 31-40 & >40 respectively. Underlying causes of poisoning were also observed totally and individually in different mode with male, female ratio and the percentage. Death cases according to mode of poisoning with demographic alignment were also observed. Statistical analysis were done using epi-info version 3.5.1 and measures were presented as proportion and percentage. Among 1903 cases, 1012 (53.1%) were male and 891 (46.8%) female with a ratio of 1.4: 1. The year wise total number of cases were progressively decreased from 627 (2003) to 353 (2006). Most commonly found toxic agent was Organo-Phosphate compound (526; 27.64%) with a very little sexual variation & this trend remained same in all study years. Poisoning with unknown substance was the second leading cause (16.03%) followed by Copper-sulphate (14.03%), Sedative (13.35%), Snakebite (12.93%) etc. Incidence of unknown poisoning, sedatives, snake-bite and corrosives were found to be gradually decreased over the study years. Male were found mostly affected in majority type of poisoning except Copper-sulphate, kerosene, puffer fish, paracetamol and other drugs category. Age group II (710; 37.3%) was the most vulnerable group with male (57.89%) preponderance followed by group I (643; 33.7%), III (329; 17.2%) and IV (221; 11.6%) respectively. Highest 1308 (68.7%) cases were suicidal in mode followed by 304 (15.9%) accidental and 291 (15.2%) homicidal. Out of 1903, 140 (7.3%) patients died. Death rate was highest in OPC poisoning (52.1%) followed by unknown substance (13.5%), snakebite and copper-sulphate (11.4%) etc. In an agro-based country like Bangladesh, it’s very difficult to reduce the poisoning cases and mortality. Prospectively designed multi-centered studies are needed to reflect the epidemiological properties of poisonings throughout Bangladesh, and would be very valuable for the determination of preventive measures. DOI: http://dx.doi.org/10.3329/bmrcb.v37i2.8436 BMRCB 2011; 37(2): 61-65
23 citations
TL;DR: Perforated peptic ulcer is prevalent even after the wide use of H2 receptor antagonists and strict case selection for surgical and non-surgical treatment has reduced mortality.
Abstract: Objective To determine disease characteristics, check the treatment status and compare outcome with other series. Design and setting A retrospective study in a single unit of the Department of Surgery of Khulna Medical College Hospital, south west Bangladesh. Patients and methods After diagnosis by clinical and radiological examination, 491 patients were treated during the period July 1992 to November 2002. Two options of treatment were carried out: simple closure and peritoneal lavage in 364 cases, and 127 patients managed by non-surgical methods. Main outcome measures mortality and morbidities. Results Male:female ratio was 445:46, average age 43 years. Mortality in the surgical group was 6.8% and in the non-surgical group 0.02%. Conclusion Perforated peptic ulcer is prevalent even after the wide use of H2 receptor antagonists. Strict case selection for surgical and non-surgical treatment has reduced mortality. These results support the case for non-operative treatment and for conservative surgery.
10 citations
TL;DR: The seroprevalence of antibody to Treponema pallidum among pregnant women and its association with age, sexual behavior and socioeconomic status was investigated.
Abstract: AIM: The aim of this study was to investigate the seroprevalence of antibody to Treponema pallidum among pregnant women and its association with age sexual behavior and socioeconomic status. MATERIALS AND METHODS: In this cross-sectional study 1266 sera were collected from pregnant women attending Bangabandhu Sheikh Mujib Medical University and Rajshahi Khulna and Chittagong Medical College Hospitals between February 2007 and April 2008. From each hospital samples were collected from about a quarter of the total recruited pregnant women. Sera were tested to identify the antibody to T. pallidum using Treponema pallidum hemagglutination at the Virology Department of Bangabandhu Sheikh Mujib Medical University. Logistic regression was used to explore potential risk factors for syphilis. RESULTS: Among 1250 sera tested (16 sera were discarded due to hemolysis) 37 (2.96%) were positive for T. pallidum antibody. Higher seropositivity was associated with couples with no formal education low socioeconomic status (P = 0.006) marriage at or before 18 years of age (P = 0.002) multiple marriages of the husband (P = 0.031) and sexual activity for more than 10 years (P = 0.007). Among these factors low education level of women early age of marriage and multiple marriages of the husband showed individual effects on high seropositivity to T. pallidum. CONCLUSIONS: The high seroprevalence of syphilis among pregnant women attending the antenatal clinics of these hospitals indicates the need for the incorporation of screening for syphilis in routine antenatal screening in Bangladesh. Improvement of education level in the female population prevention of early marriage and preventing polygamy of husbands may play an important role in prevention of syphilis among women. (c) 2011 The Authors. Journal of Obstetrics and Gynaecology Research (c) 2011 Japan Society of Obstetrics and Gynecology.
6 citations
TL;DR: Intestinal parasitic infestation is mostly found in rural children, which has the relation with the poor sanitation, low standard of living, less parental income and education, and early weaning.
Abstract: Objective To compare intestinal parasitoses between urban and rural children in developing countries and its related factors. Methods Children of 1-6 years old in the urban and rural areas who had not taken antihelmenthic drugs in the last 6 months were randomly selected. Various factors were taken as variables in a preformed questionnaire. Results Among the total 52 children, 24 were in urban and 28 were in rural group. Male/female ratio of the rural group was 1:1 and that of the urban group was 1.4:1. Average income was 12 000 taka and 4 000 taka per month in urban and rural areas, respectively. None of the rural group used sanitary latrine, whereas every one in urban group used sanitary latrine. Majority (71%) of the mothers in rural group were below the primary level of education. Majority (75%) of fathers were educated above higher secondary level in urban group. In the rural group 18 (64%) fathers had not received any education. Enterobius vermicularis was observed only in 1 (4%) stool samples of urban children but in rural group it was found in 7 (25%) of the stool samples. Enterobius vermicularis was the main parasite isolated from both groups. Exclusive breast feeding practice of less than 6 months was observed in 20 (83%) children of urban group but in rural group that of less than one year was found in 22 (78%) children. Conclusions Intestinal parasitic infestation is mostly found in rural children. Urban children almost have no intestinal parasitoses. It has the relation with the poor sanitation, low standard of living, less parental income and education, and early weaning. Unnecessary universal deworming of the urban and rural children in developing countries should be discouraged in order to use the money economically and effectively. It can be carried out in rural children and their living standard should be improved.
5 citations
TL;DR: Influenza mostly affected under-five children and young adult in southern part of Bangladesh and the peak season here was late summer and rainy season.
4 citations
TL;DR: This hospital based cross sectional descriptive study was performed to find out the prognostic factors of acute pancreatitis from the available clinical, biochemical, haematological and radiological data.
Abstract: This hospital based cross sectional descriptive study was performed to find out the prognostic factors of acute pancreatitis from the available clinical, biochemical, haematological and radiological data. A total of 50 cases were studied. Peak incidence was in the fourth decade. Among the known aetiological factors 18% were due to gallstone disease, 10% alcoholism, 4% pancreatobiliary ascariasis, but 60% were idiopathic. In this study 82% patients were had mild and 18% had severe acute pancreatitis. Overall mortality rate was 6%, mortality was significantly higher (33.33%) in severe acute pancreatitis (33.3% vs 0%). A higher mortality was associated with concomitant medical or surgical diseases, leucocytosis. Other factors associated with a higher mortality were high blood glucose, serum creatinine level and a lower serum albumin and calcium level. This study highlights the need of further study with more detailed recording of relevant data from primary care hospital to find out the clinical pattern of complications and prognostic factors in our country. Keyword: Acute Pancreatitis; Prognosis; Mortality DOI: 10.3329/jom.v12i1.6927 J Medicine 2011; 12 : 21-25
2 citations
TL;DR: Fenugreek showed a tendency of acting against the increased in amount of connective tissue in thymic section in Streptozotocin-induced diabetes mellitus, and further investigations are recommended for establishing fenUGreek as a safe, useful effective agent to minimize the increment in amountof connective tissues inThymus improving the diabetic condition by acting as antidiabetogenic agent.
Abstract: Context: Diabetes mellitus causes a marked increased in amount of connective tissue in thymus. Fenugreek has the hypoglycaemic effect. The study was carried out to find out whether Trigonella foenumgraecum (fenugreek seeds/methi seeds) has got any preventive role against the increment in amount of connective tissue in thymic section in diabetes mellitus. Study type: an experimental study on Long Evans rats which were divided into three equal groups depending on their different sorts of dietary feeding and drug treatment. Setting: Anatomy department of the then IPGMR (Institute of Post Graduate Medicine and Research) at present BSMMU (Bangabandhu Sheikh Mujib Medical University) and BIRDEM (Bangladesh Institute of Research and Rehabilitation in diabetes, Endocrine & Metabolic Disorders). Subjects: Fifty eight healthy young Long Evans rats of either sex weighing 72 to 174gm aged between 50 to 60 days were used in this study. Main outcome measures: variation in amount of connective tissue in thymic sections in different groups of rats. Result: in the nondiabetic control group the increased in amount of connective tissue in thymic section is lower than in diabetic control group. On the other hand, the increased in amount of connective tissue in thymic section in the fenugreek-treated diabetic rats is also lower than the amount of connective tissue in thymic section in diabetic control group but it is more or less similar to the amount of connective tissue in thymic section in nondiabetic control group. Conclusion: Fenugreek showed a tendency of acting against the increased in amount of connective tissue in thymic section in Streptozotocin-induced diabetes mellitus. However, further investigations are recommended for establishing fenugreek as a safe, useful effective agent to minimize the increment in amount of connective tissue in thymic section improving the diabetic condition by acting as antidiabetogenic agent. Key words: Diabetes mellitus; Connective tissue; Fenugreek; Thymus DOI: http://dx.doi.org/ 10.3329/bja.v9i1.8149 Bangladesh Journal of Anatomy January 2011, Vol. 9 No. 1 pp 49-52
1 citations
TL;DR: In this study FNAB technique of related gland masses considered as an efficient, safe, cost-effective, rapid and convenient method of diagnostic investigation.
Abstract: Six hundred forty eight cases of Fine Needle Aspiration (FNA) biopsies from glandular masses of thyroid and salivary glands were performed from February 1997 to December 2000 in the private chamber of the authors. Both FNAB and histopathological diagnosis of 517 cases were correlated in order to establish the efficiency, sensitivity and specificity of FNAB technique. Remaining 131 cases having inflammatory lesions were under clinical observation without surgical intervention. Total diagnostic efficiency was 97.87% and the sensitivity, specificity, positive predictive value and negative predictive value were 97.16%, 98.24%, 96.61%, 98.53% respectively. In this study FNAB technique of related gland masses considered as an efficient, safe, cost-effective, rapid and convenient method of diagnostic investigation. TAJ 2002; 15(1): 17-2
1 citations
TL;DR: Biological agents that specifically inhibit the effects of tumour necrosis factor-alpha (TNF-a) or interleukin-1 (IL-1) represent a major advancement in the treatment of RA and are highly specific and better tolerated.
Abstract: Rheumatoid arthritis (RA) is the commonest joint disease with considerable morbidity and mortality. Conventional disease modifying antirheumatic drugs like methotrexate form the cornerstone of therapy. These drugs have several limitations in terms of slow onset of action, adverse effects and modest remission rates. Several cytokines are involved in the pathogenesis of RA. Biological agents that specifically inhibit the effects of tumour necrosis factor-alpha (TNF-a) or interleukin-1 (IL-1) represent a major advancement in the treatment of RA. By targeting mediators that are directly involved in the pathogenesis of RA, these agents slow the radiological progression of bone and cartilage damage in joints, prevent or delay the onset of disability. These are highly specific and better tolerated. The use of these biological agents needs careful monitoring for side effects, including the development of infection. Additional anti-cytokine agents for the treatment of RA are under further development. Key words: Rheumatoid arthritis; biological agents; inflammatory cytokine. DOI: 10.3329/jbsp.v29i1.7168 J Bangladesh Coll Phys Surg 2011; 29:27-31
1 citations
TL;DR: The aim of this case report is to create awareness among the clinicians regarding this uncommon disease presented with ascites and irregular masses in the abdomen.
Abstract: Pseudomyxoma peritonei (PMP) is an uncommon condition characterized by abundant extracellular mucinous material in the peritoneal cavity and tumoural implants on the peritoneal and epiploic surfaces. Aim of this case report is to create awareness among the clinicians regarding this uncommon disease presented with ascites and irregular masses in the abdomen. PMP is a rare disease, may be benign or malignant, presented with ascites and irregular masses in the abdomen which is infrequently encountered in our clinical practice. Key words: Pseudomyxoma peritonei; mucinous carcinomatosis; hyperthermic chemotherapy; gelatinous material; irregular masses DOI: 10.3329/fmcj.v6i1.7415 Faridpur Med. Coll. J. 2011;6(1): 61-63
TL;DR: Whether thyroid surgery can be safely performed without the routine use of drains is determined and there is no evidence to suggest theoutine use of surgical drains following uncomplicated thyroid surgery.
Abstract: Use of surgical drains after thyroid surgery is standard surgical practice to prevent lifethreatening complications, arising from post-operative haematoma. There is increasing evidence to suggest that this is an outdated practice. This study determines whether thyroid surgery can be safely performed without the routine use of drains. This cross sectional study was done for two years and one hundred thyroidectomies were performed. No drains were inserted in any patient. Complications of thyroid surgery in this series were seroma formation (5%) cases and minor haematoma was only 1%. Re-exploration for bleeding was not encountered in any cases in this series. There is no evidence to suggest the routine use of surgical drains following uncomplicated thyroid surgery. Key words: Thyroid Surgery; Drain DOI: http://dx.doi.org/10.3329/bjo.v17i2.8852 BJO 2011; 17(2): 121-124
TL;DR: Karela showed a tendency of acting against hyperglycemic effects of Streptozotocin-induced diabetes mellitus and further investigations are recommended for establishing karela as a safe, useful effective anti-hyperglycemic agent as well as antidiabetogenic agent.
Abstract: Context: Scientific studies revealed the hypoglycaemic properties of momordica charantia. The present study was carried out to find out microscopically whether Momordica charantia (karela) has got any impact lowering of FBG (Fasting Blood Glucose) level in diabetes mellitus. Study type: an experiemental study. Setting: Anatomy department of the then IPGMR (Institute of Post Graduate Medicine and Research) at present BSMMU (Bangabandhu Sheikh Mujib Medical University) and BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine & Metabolic Disorders). Subjects: Sixty five healthy young Long Evans rats of male sex weighing 150 to 280gm aged between 10 to 12 weeks were used in this study. Methods: The rats were divided into four equal groups depending on their different sorts of dietry feeding and drug treatment. Main outcome measures: variation of differential FBG level in different groups of rat. Result: Mean 'initial' and 'final' (on day 7 and day 51 from Streptozotocin/vehicle injection) fasting blood glucose (FBG) level in the control group (Group-A) was 7.872 ± 0.60 and 8.55 ± 0.82 respectively. Therefore the mean (FBG) increased by about 13% (P = 0.022*) which is higher than that of the initial value. In untreated diabetic group the mean initial (FBG) level was 25.95 ± 8.90 and the mean final was 24.02 ± 4.08. So here, the (FBG) level decreased by about 13% (P = 0.557). On the other hand, in the insulintreated diabetic rats the mean initial (FBG) level was 24.35 ± 6.81 and the mean final was 8.38 ± 5.02, which is lower (P = 0.000*) & in the karela–treated diabetic rats, the initial (FBG) level was 23.03 ± 5.70 and the mean final was 5.65 ± 1.29 which is lower* (P = 0.000*). The value in the insulin-treated diabetic rats & in the karela-treated diabetic rats were significantly lower than that of the untreated diabetic rats (P = 0.007) & (P= 0.005) respectively. But there was no significant difference between the insulin-treated diabetic rats & the karela-treated diabetic rats (P = 0.605) in this regard. Conclusion: Karela showed a tendency of acting against hyperglycemic effects of Streptozotocin-induced diabetes mellitus. However, further investigations are recommended for establishing karela as a safe, useful effective anti- hyperglycemic agent as well as antidiabetogenic agent. Key words: Diabetes mellitus; Hyperglycemia; Momordica charantia (karela) DOI: http://dx.doi.org/ 10.3329/bja.v9i1.8148 Bangladesh Journal of Anatomy January 2011, Vol. 9 No. 1 pp 45-48