Showing papers in "Bangladesh Journal of Medical Science in 2012"
TL;DR: The findings of this study suggested that, the cloth tape measurement was reliable at all the three different anatomical landmarks of the chest wall and could be used as an outcome measure for chest expansion in the management of cardiorespiratory conditions.
Abstract: Objective: The Objective of this study was to determine the intrarater reliability of chest expansion at three different anatomical landmarks using a cloth tape measure among healthy peoples. Materials and Methods: 120 healthy male and female volunteers were evaluated on two occasions in different days. The measures consisted of chest expansion measurement at axilla, fourth intercostals and xiphoid levels. The measurements were taken in the standing position with the arms hanging sideways at all the three different anatomical landmarks. The test-retest reliability of the measurements was determined by intraclass correlation coefficient (ICC) and standard error of measurements (SEMs). Results : An acceptable reliability was determined by ICC values greater than than 0.85 and SEMs less than 5%. The mean age of the subjects was 21.93 years. ICC of all measures ranged between 0.95 to 0.97 and SEMs were 1.9%, 1.8%, 1.5% at the axillary, fourth intercostals and xiphoid level respectively. Conclusions : The findings of this study suggested that, the cloth tape measurement was reliable at all the three different anatomical landmarks of the chest wall. Therefore, this measurement technique could be used as an outcome measure for chest expansion in the management of cardiorespiratory conditions. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12602 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12
16 citations
TL;DR: Antepartum oligohydramnios is associated with an increased risk of fetal heart rate abnormalities and in this population it is not predictive of adverse perinatal outcome as measured by low apgar score and NICU admission, yet this may be reflective of the aggressive antepartums and intrapartum management that these patients received.
Abstract: Objectives: The purpose of this study to assess the effect of oligohydramnios on perinatal outcome especially at third trimester of pregnancy. Methods: This prospective and observational study was conducted in a private specialized hospital at Dhaka city from January to December 2009. In this study 78 singleton pregnant females with gestational age from 28 - 42 weeks with less amniotic fluid index (AFI) were analyzed for perinatal outcome. Data were expressed as number (percentage). Proportion test was performed for comparison between two groups , P value <0.05 was taken as level of significance. Results: Women with oligohydramnios were significantly associated with an abnormal antepartum fetal heart rate (FHR), meconium stained fluid, Apgar score less than 7 or NICU admission. Also subjects with AFI of 5.0 cm or less had a higher rate of cesarean section for fetal distress. Conclusions: Antepartum oligohydramnios is associated with an increased risk of fetal heart rate abnormalities. Although in our population it is not predictive of adverse perinatal outcome as measured by low apgar score and NICU admission, yet this may be reflective of the aggressive antepartum and intrapartum management that these patients received. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9820 BJMS 2012; 11(1): 33-36
14 citations
TL;DR: FDA staining method has been proposed to be appropriate for the rapid diagnosis of drug resistant tuberculosis in developing countries including Bangladesh.
Abstract: Objective : Drug resistant tuberculosis has long been a common problem prevailing in developing countries including Bangladesh Present study focused on the rapid identification of live Mycobacterium tuberculosis among treatment failure cases Materials and Methods : Sputum samples from a total of 100 category-I and category-II treatment failure cases, assumed as multidrug resistant tuberculosis, were studied through fluorescein diacetate (FDA) staining under light emitting diode (LED) fluorescence microscope Considering culture method as gold standard, we also compared the results of FDA staining with that of auramine O staining Results : A total of 85% acid-fast bacilli were detected by FDA staining, 82% by auramine O staining and a total of 85% isolates were detected in Lowenstein-Jensen (LJ) culture The sensitivity of FDA staining (9647%) was estimated to be slightly higher than that of auramine O staining (9176%) Moreover,7647% cases were detected as multidrug resistant tuberculosis (MDR-TB) Conclusion : Taken together, FDA staining method has been proposed to be appropriate for the rapid diagnosis of drug resistant tuberculosis DOI: http://dxdoiorg/103329/bjmsv11i412605 Bangladesh Journal of Medical Science Vol 11 No 04 Oct’12
10 citations
TL;DR: It is shown that post operative nausea-vomiting, anastomotic leakage rate, re-exploration, wound infection and RTI rates are higher in group A than those of group B, and the incidence of UTI in post operative period is higher in Group B.
Abstract: Background: Traditionally, enteric feeds are withheld for a period of 48-72 hrs, sometimes even more following enteric anastomosis depending upon return of full peristaltic sounds. This results in a period of nonstimulation of gut –‘Gut Rest’, which was supposed to result in better anastomotic healing. But this same also deprives the intestinal mucosa of surface nutrients as well as prolongs parenteral fluid therapy, thereby depriving the patients of adequate nutrition. Along with it, prolonged parenteral therapy also keeps the patients bound to bed with its resultant complications like, prolonged hospital stay and increased cost of therapy. Objectives: To compare the benefits of early enteral feeding over conventional enteric feeding following enteric anastomosis with special regards to patients recovery and complications. Methods and materials : The selection of patients into group A (60) and group B (60) was done after having fulfilled inclusion and exclusion criteria. Informed consent was obtained. The patients of group A were fed via enteral route within 24 hrs of enteric anastomosis. The patients of group B were fed via enteral route after 48-72 hrs or appearance of full peristaltic sounds following enteric anastomosis. These patients were followed in post operative period for their drain output, any nausea, vomiting or significant abdominal distension, prolonged ileus, post operative duration of shospital stay, post operative infective complications (e.g. wound infection, UTI, RTI), and different haematological and biochemical examinations. Results : This study shows that post operative nausea-vomiting, anastomotic leakage rate, re-exploration, wound infection and RTI rates are higher in group A than those of group B. In this study, the incidence of UTI in post operative period is higher in group B. But the differences in above mentioned variables are not statistically significant. Whereas appearance of intestinal peristaltic sound is earlier in group A (42.8 ± 10.68 hours) compare to that of group B (52.6 ± 13.46 hours). Here, the difference is statistically significant (p value = 0.000022) The duration of post operative hospital stay is shorter in group A (8.45 ± 5.143 days) than that of group B (10.533 ± 4.952 days). The difference of duration post operative hospital stay is statistically significant (p value = 0.0257). Removal of nasogastric tube, resumption of oral feeding, and passage of first flatus and/or defecation were earlier in the group A than that of the group B; the differences were statistically significant. The post operative day-5 albumin level is better in group A (3.147 ± 0.4409 gm/dl) than that of group B (2.935 ± 0.3124 gm/dl). This difference is also statistically significant (p value = 0.0029). There are three mortalities in group Awhereas one mortality in group B. This difference in mortality in two groups is not statistically significant. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12597 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12
10 citations
TL;DR: The residence, education, employment status and parity have significant effects on the present duration of BF that is about 20 months which is below the India's national figure of 25 months and WHO recommended figure of 24 months.
Abstract: Objective: The purpose of present study is to investigate the differentials and determinants of duration breastfeeding (BF) according to various socio-economic and demographic factors. Methods: A cross sectional study of 1225 ever-married women of reproductive age with at least one live birth was conducted in four valley districts of Manipur under cluster sampling scheme. Survival analysis technique has been adopted through SPSS vs 16. Results: The median duration of BF is found to be 20.37 months. Among the six explanatory variables of interest, only two factors - place of residence (relative risk (RR) =1.35) and employment status RR = 1.88) have highly significant effect (P<0.01) on BF and only two factors educational level (RR=1.02) and parity (RR = 0.83) are found to be statistically significant (P<0.05) on BF. Conclusion: The residence, education, employment status and parity have significant effects on the present duration of BF that is about 20 months which is below the India's national figure of 25 months and WHO recommended figure of 24 months. Key words: Fertility; censored case; parity; life table; proportional hazard model DOI: http://dx.doi.org/10.3329/bjms.v10i4.9493 BJMS 2011; 10 (4): 235-239
9 citations
TL;DR: The data concluded that serum calcium level was lower during third trimester of the study subjects which may be explained by the fact of increased demand of the growing fetus and exposing the mother at risk of complications related to low serum calcium.
Abstract: Background and Objectives: Pregnancy is the physiological process in which progressive anatomical, physiological and biochemical changes occur. Secretion of different hormones during pregnancy is responsible for maternal adaptation to the increasing demand of the growing fetus. The present study was aimed to evaluate serum calcium and phosphate status in normal pregnant women in different trimesters. Materials and Methods: A total number of 140 subjects, age range 20-40 (yrs) were recruited in the study which includes 100 normal pregnant women termed as study group (Group B) and 40 healthy women without pregnant (Group A), served as Control. Group B subjects were subdivided into Group B1 (n=12), Group B2 (n=30) and Group B3 (n=58) on the basis of duration of pregnancy- 1st, 2nd and 3rd trimesters respectively. Calcium was measured by CPC (photometric method for Ca) and serum phosphate by colorimetric method. Statistical analysis was done using SPSS for Windows, Version 10. Unpaired Student's -'t' test performed to calculate statistical differences between groups. Results: Age (yrs) (mean±SD) and BMI of the pregnant women in different groups did not show statistical difference. Serum calcium (mean±SD) levels in the 1st (p=0.0001) and 2nd (p=0.02) trimester was significantly higher compared to the Controls. In 3rd the value was significantly lower (p=0.015) compared to the Controls and of 1st and 2nd trimesters (p=0.001). Serum phosphate (mean±SD) levels in three trimesters did not show statistical significant difference compared to the Controls and among the pregnancy groups. Conclusion: The data concluded that serum calcium level was lower during third trimester of the study subjects which may be explained by the fact of increased demand of the growing fetus and exposing the mother at risk of complications related to low serum calcium. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11732 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12
9 citations
TL;DR: This research presents a novel probabilistic approach that aims at determining the carrier and removal of canine coronavirus from the blood stream through a simple, straightforward and efficient method called “surgical autopsies”.
Abstract: Not available DOI: http://dx.doi.org/10.3329/bjms.v11i4.12594 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12
9 citations
TL;DR: Knowledge of breast feeding among primi gravida mothers attending ANC clinic was of fair in quality and statistical association was existed between age, education, religion, socio-economic status & occupation of respondents with their knowledge about breast feeding.
Abstract: Background : Breast feeding, the most natural way of infant feeding to satisfy nutritional, metabolic and psychological needs of the baby. Objectives : To assess the knowledge of breast feeding among primi- gravida mothers attending ante-natal clinic and to determine the association between socio-demographic variables with their knowledge. Materials and Methods : Hospital based cross sectional study was conducted at Ante-natal clinic of Krishna Hospital and Medical Research Center, Karad district Satara. Pre-tested structured proforma used to collect information from 590 married primi gravid mothers attending anti-natal clinic during study period by utilizing personal interview method. Statistical Analysis : socio-demographic frequency percentage distribution, knowledge scoreing and statistical association was analysed by using chi-square test. Results : Out of 590 primi gravida mothers,59.66% showed fair quality of knowledge about breast feeding. knowledge about rooming in, family support for breast feeding & burping after breast feeding was 97.7%, 95.4% , 93.5% however weaning, colostrums feed, hazards of bottle feeding and prelactal food was 84%, 82.7%,75.5% and 54% respectively. Statistical association was existed between age, education, religion, socio-economic status & occupation of respondents with their knowledge about breast feeding (?2=151.52, p < 0.0001*; ?2=211.27,p<0.0001*; ?2=133.91,p < 0.0001*; ?2=35.59,p < 0.0001* and ?2=131.04,p<0.0001*) respectively. Conclusion: knowledge of breast feeding among primi gravida mothers attending ANC clinic was of fair in quality. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12603 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12
9 citations
TL;DR: Febuxostat, at a daily dose was more effective than allopurinol at the commonly used fixed daily dose of 300 mg in lowering serum urate.
Abstract: Aim: To assesses the efficacy of a relatively new drug-Febuxostat in management of gout and its comparison with allopurinol Method: A comparative study of both Allopurinol and Febuxostat was done on 100 patients of gout Both were studied for efficacy side effects and for gout flare up Results: Primary efficacy end point (baseline values) - a serum urate concentration of less than 60mg per deciliter at the last three measurements was reached by 54 %( 27/50) of group A patients taking 80mgs of febuxostat and 25 %( 12/50) of group B patients taking allopurinol 300mgs per day (P<0001) Secondary efficacy end point(follow up values)- At first visit( after 2 weeks of onset of study), the proportions of subjects with serum urate concentration of less than 60mg/dl was significantly higher in the group A receiving febuxostat than the group B receiving allopurinol(P<0001)[Tableno-1] Conclusion: Febuxostat, at a daily dose was more effective than allopurinol at the commonly used fixed daily dose of 300 mg in lowering serum urate Results of side effects and gout flare up were similar in both groups Key words: Allopurinol; febuxostat; uric acid; gout DOI: http://dxdoiorg/103329/bjmsv10i47522 BJMS 2011; 10 (4): 257-259
8 citations
8 citations
TL;DR: This cross-sectional study aimed to record various primary dentition parameters in 700 Saudi children, 2-6 year-old, which was divided into 4 age groups and was randomly selected to observe the differences between the age groups.
Abstract: Background: Occlusal characteristics of the primary dentition vary among populations and ethnic groups. Materials and Methods: This cross-sectional study aimed to record various primary dentition parameters in 700 Saudi children, 2-6 year-old, was divided into 4 age groups and was randomly selected to observe the differences between the age groups. Results: 55.6% of the children had a 'flush terminal plane' molar relationship. The proportion of children with distalstep molar relationship was significantly lower 23 (3.2%). The degree of overbite was significantly less in the 5-year-olds than in the 3-year-olds. The majority of the children (80.7%) had spaced dentition. The prevalence of anterior cross bite was 0.7% and of open bite was 0.3%. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12608 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12
TL;DR: The present data suggest that in terms of bed occupancy rate the NITOR found to run in optimal capacity which, however, might be attributed to the relative high rate of ascendance and discharges on requests.
Abstract: Background and Aims: Providing a necessary care for a sick person outside home 'in hospes or hospital' dates back to nearly 300 century BC. In the present day hospital care facilities has been taken an institutional shape both in public and private sector. A hospital bed is both a scarce and expensive commodity in healthcare. Administrators running hospitals are in a dire need of objective measures and methods for efficient management of their limited financial resources. Bed utilization rates can be of immense help in realistic and effective decision making. The present study was undertaken to explore utilization of bed in a specialized tertiary care hospital in the Dhaka city. Methods: Hospital records of the year were reviewed- age, gender, disease profile, duration of hospital stay, outcome of treatment were recorded and bed occupancy rate was calculated. Data were presented as number, percentage and/ or mean SD, as appropriate. The dada were managed by Statistical Package for Social Science (SPSS) for Windows Version 10. Results: The results showed in the year 2001 total number of admissions were 13,305 of which 9953 (74.8%) were male and 3352 (25.2%) female. Average monthly admission was 1109. Maximum number of admissions (1304) was observed in the month of September of that year. Male admission rate was higher than female admission throughout the year. Among all the admission 27.2% were of road traffic accident cases. Among the admitted patients there was 57.3% discharge with advice, 1.9% death, 14.6% discharge on request bond, 12.7% discharge on request. Of all the admission there 12.5% found to be absconded. Bed occupancy rate was 79.75% and average length of stay in the hospital 18.47 days. Conclusions: The present data suggest that (i) in terms of bed occupancy rate the NITOR found to run in optimal capacity which, however, might be attributed to the relative high rate of ascendance and discharges on requests; (ii) average length of stay of patients appeared to be relatively longer and (iii) the management need to look into the issue and take appropriate measures to reduce patients unwanted long duration of stay and make the tertiary care hospital improve the quality of services. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9817 BJMS 2012; 11(1): 18-24
TL;DR: Attitudes of smokers were significantly different on most items of tobacco, but knowledge of tobacco problem in the undergraduate medical students was not sufficient, teaching about tobacco and related issues remains essential in the undergraduates medical course.
Abstract: Objective: To assess trends of smoking and the relation between smoking behavior of undergraduate medical students and their attitudes towards smoking and treatment of tobacco dependence. Methodology: Data was collected from the medical students of Rajshahi Islami Bank Medical College, Bangladesh. A total of 200 male students completed the anonymous questionnaire. Response rate was 80.0%. Results: Of the respondents 20% and 80% were regular smokers and non-smokers respectively. Only 32.50 % of the regular smokers smoke less than ten cigarettes, 30.0 % smoke ten to twenty cigarettes whereas, 37.50% smoke more than 20 cigarettes per day. 25% started smoking at nineteen years of age, 22.5% started before this age and 27.5% and 25.0 % started at twenty and twenty one years of ages respectively. 70% started smoking just for pleasure. Only 29.72% smoke light cigarettes whereas 33.78% and 36.48% smoke medium and heavy cigarettes respectively. Almost 75% smokers agreed with the fact that smoking is harmful to health and 45% realized that their cigarette smoke bother others and again 70% of smokers have attempted to quit smoking but failed and 42.5% still wanted to quit smoking. About 55% of smokers complained that they suffer from chronic cough, 60% were lacking concentration in their studies and 45% felt that they were short of memory. Conclusions: Attitudes of smokers were significantly different on most items of tobacco, but knowledge of tobacco problem in the undergraduate medical students was not sufficient. Teaching about tobacco and related issues remains essential in the undergraduate medical course. Key words: Smoking; hazardous; cigarette; students; medical rducation; vurriculum DOI: http://dx.doi.org/10.3329/bjms.v10i4.9501 BJMS 2011; 10 (4): 280-283
TL;DR: The findings have conclusively established that occupation-related prolonged physical activity induces thickening of the Achilles tendon.
Abstract: Background: The degree of physical activity may induce strain and stress on the Achilles tendon because of its role in the elastic mechanics of gait. Material &Methods: The study was carried out to determine the effect of occupation-related physical activity on the thickness of the Achilles tendon. The effect of occupation- related physical activity on the thickness of the Achilles tendon in three phases (ATT at Normal phase, ATT at Dorsiflexed phase and ATT at Plantarflexed phase) was assessed, by ultrasound, among four classes of occupations- Labourers/farmers, Dancers, Athletes and a less active class (control group). Results: Results show that the less active (control group) had the least value for ATT (normal) (3.31±0.50mm) being almost at par with those of the dancers. The athletes and labourers/farmers had significantly higher values than the control (P=0.000 and 0.007 respectively). Conclusion: Our findings have conclusively established that occupation-related prolonged physical activity induces thickening of the Achilles tendon. DOI: http://dx.doi.org/10.3329/bjms.v11i2.9666 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 103-111
TL;DR: A flap surgery followed by restoration with glass ionomer cement was carried out for the cessation of resorption process, finally a cast partial denture was delivered for prosthetic rehabilitation.
Abstract: Multiple idiopathic cervical resorption (MICR) is a disease of the tooth in which there is progressive cervical resorption of multiple teeth leading to exfoliation of crown. The etiological factors for such a resorption are various but the lack of definitive single etiological factor/disease process makes management of such processes extremely difficult. A flap surgery followed by restoration with glass ionomer cement was carried out for the cessation of resorption process, finally a cast partial denture was delivered for prosthetic rehabilitation. DOI: http://dx.doi.org/10.3329/bjms.v11i2.8680 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 151-153
TL;DR: Most of the important bacterial pathogens have developed resistance to the major antibacterial options and it is now a global healthcare threat.
Abstract: Presently for all clinicians & surgeons, one of the greatest concern and anxiety is the emergence of drug resistance to the pathogenic organisms. Since last 80 years of antimicrobial use-from the sulphonamides of the 1930s to the present carbapenems-resistance always emerges, even when it is least expected. Most of the important bacterial pathogens have developed resistance to the major antibacterial options and it is now a global healthcare threat. Clinical and economic impact of this is devastating, especially in developing countries like ours. Recent estimates in the European Union for the costs of selected multidrug resistant bacteria are 25,000 deaths per year and 1.5 million EUR 1 . In the USA $ 20-30,000 per patient excess hospital costs, excess social cost of 10-18 million and double the morbidity (attributable mortality 6.5%). In a recent survey of European Intensive Care Unit physicians, 82% considered multidrug resistance to be the major problem 3 . In developing countries including Bangladesh 70% of hospital acquired neon. Unit infections cannot be treated with WHO recommended drugs .
TL;DR: It is concluded that, the later the treatment is started the poorer the outcome will be.
Abstract: Objective: To evaluate growth and development of children with congenital hypothyroidism (CHT) attending Pediatric Endocrine OPD BIRDEM. Methodology: It is a cross sectional study which was conducted at Pediatric outpatient department BIRDEM in a study period of 1 year (May 2008 to April 2009). A total number of 80 children with CHT were included in the study. A data sheet was used for each subject containing all the information. History and thorough physical examination was carried out including anthropometry, and developmental assessment. Developmental assessment was done according to Denver developmental screening test using standard charts of developmental progress which is appropriate for child's age. TSH and FT4 were done by chemiluminescent method in multichannel auto analyzer. Other investigations included bone x ray. Result: Total 80 children with congenital hypothyroidism between 1 to 5 years of age fulfilling the inclusion criteria were studied. Majority of the study population (71.20%) were diagnosed outside BIRDEM and 28.80% at BIRDEM. In the study population, 73.70% children were diagnosed within 1st three month of age and considered as early treated group, 26.20% diagnosed between three to nine month of age and classified as late treated group. Majority (56.20%) of the study population were female, and 43.70% were male child. All children among study sample were from non goiter endemic zone. Only 3 (5.0%) children among early treated group had maternal history of thyroid disorder and H/O ingestion of anti thyroid drugs and none among late treated group. 11(18.6%) early treated group and 2 (9.5%) late treated group children had affected peer with similar disorder and there was no family history of endocrine disorder among either group of study sample. Among 59 early treated group of children only 5(8.4%) had coarse facies, 2(3.3%) had protruded tongue and bradycardia, 4(6.7%) children had dry rough skin, 1(1.6%) was hypotonic, 2(3.3%) had delayed relaxation of ankle jerk and none had wide open fontanel. Out of 21 late treated group of children, 12(57.1%) had coarse facies, 4(19%) had protruded tongue, 6(28.5%) had bradycardia, 15(71.4%) children had dry rough skin, 16(76.1%) was hypotonic, 12(57.1%) had wide open fontanel and delayed relaxation of ankle jerk. Among 59 early treated group of children 53(89.8%), 51(86.4%), 55(93%) had normal and 6(10.1%), 8(13.5%), 4(6.7%) had delayed gross motor, fine motor and cognition respectively. Whereas among 21 late treated group 9(42%), 6(28.5%), 7(33.3%) had normal and 12(57%), 15(71.4%), 14(66.6%) children had delay in gross motor, fine motor and cognition respectively. There was no visual impairment among either group of children in study sample. Among 59 early treated group of children 57(96.6%) had normal hearing and 47(82.6%) had normal speech. Whereas among 21 late treated group, hearing impairment was seen among 7(25.9%) and speech delay was noticed among 16(76.1%) children. Among early treated group only 2% children had delayed radiological bone age, whereas 6% children among late treated group had delayed bone age. Conclusion: Congenital Hypothyroidism (CHT) is a serious condition of newborn babies, which leads to permanent mental and physical retardation if not identified within first few weeks of life. It is concluded that, the later the treatment is started the poorer the outcome will be. DOI: http://dx.doi.org/10.3329/bjms.v10i4.9495 BJMS 2011; 10 (4): 245-251
TL;DR: There was lack of awareness regarding diverse treatment modalities and the teething myths and realities, and more educative programs should be initiated to make parents aware of teether myths and reality.
Abstract: Objective: The relationship of the first deciduous tooth eruption and the general health of an infant has always been a subject of curiosity. The enigma of teething although historical, continues to pervade contemporary child health care due to many unexplained teething myths. The treatment modalities used in teething have been diverse. The objective of this study was to evaluate the awareness, beliefs and knowledge of parents towards teething symptoms. Materials and method: Hundred parents were randomly selected from two kindergarten schools and were interviewed according to a structured questionnaire. Collected data was analyzed by a statistical software known as SPSS. Results: Results revealed that though parents knew about teething but there was lack of awareness regarding diverse treatment modalities and the teething myths and realities. Conclusions: More educative programs should be initiated to make parents aware of teething myths and realities. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9822 BJMS 2012; 11(1): 40-43
TL;DR: In this article, the authors conducted a community-based cross-sectional study to find out the reproductive health profile of rural married women of a selected rural community in Dhamrai Upazila of Dhaka district.
Abstract: Design: The study was a community based cross sectional study. Objective: The study was conducted to find out the reproductive health profile of rural married women of a selected rural community in Dhamrai Upazila of Dhaka district. Materials and Methods: The study was conducted among 204 married women of reproductive age included considering specific selection criteria. Data were collected by face-to-face interview using a semi-structured questionnaire. Maintaining quality control check data were processed and analyzed by using SPSS software. Results: The study revealed that majority of the women were either illiterate (34.1%) or had primary education (33.3%) with mean age of 31+8.65 years. Most of them (88.2%) were house wives and major segment (52.9%) had poor monthly family income (Tk.5000-10000). Among all, 63.7% were married within 11-17 years of age and 69.8% gave birth of first child during adolescence (16- 18 years). Major part (60.29%) of the women didn't use any contraceptive and only 38.55% utilized antenatal care. Average number of children was 2.73+1.52 and most of the delivery (81.6%) was conducted at home by untrained birth attendants (57.0%). Adverse pregnancy outcome included abortion, menstruation regulation, still birth, complications to new born and mothers. Reproductive health problems faced by the women included menstrual problem, physical assault, leucorrhea, mental torment, sexual annoyance, puerperal infection, pregnancy related complications, urinary tract infection & pelvic inflammatory disease. Most (81.43%) of the illiterate women didn't utilize ante-natal care while majority (60.0%) having higher secondary school certificate (HSC) had =3 ante-natal visits and this variation was statistically significant [?2(12)=26.35, p<0.05]. Majority (71.21%) of the illiterate women didn't use any contraceptive method while most of them having HSC used either condom or oral contraceptive and this discrepancy was statistically significant [?2(12)=27.86, p<0.05]. Majority (67.1%) of the illiterate women were delivered by untrained birth attendants whereas all women having HSC were delivered by doctor (40.0%), nurse (20.0%) and traditional birth attendant (40.0%), this difference was statistically significant [?2(12)=24.57, p<0.05]. Conclusion: Reproductive health profile was worse among the illiterate, less aware and low income rural women. The study recommends formulation and implementation of effective strategies to improve reproductive health status of the rural women. Key words: Married women; reproductive health; pregnancy profile; rural community. DOI: http://dx.doi.org/10.3329/bjms.v10i4.9496 BJMS 2011; 10 (4): 252-256
TL;DR: In this paper, the performance of visual inspection of acetic acid (VIA) in the detection of precancerous and early cancerous lesions of cervix was evaluated and the final diagnosis was based on histology.
Abstract: Aim: To evaluate the performance of visual inspection of acetic acid (VIA) in the detection of precancerous and early cancerous lesions of cervix. Materials and methods: Total 5593 eligible women who randomly came to the Gyenae out patient department (OPD) of RMCH (Rajshahi Medical College Hospital) were examined by VIA. Detection of well defined, opaque, acetowhite lesions close to the squamocolumner junction or in transitional zone or dense acetowhitening of ulceroproliferative growth on the cervix constituted a positive VIA. Those who had abnormal results in screening test & those who had clinically suspicious lesions were sent for colposcopic evaluation (n= 442) & directed biopsy were taken from colposcopically suspected areas (n=214). The final diagnosis was based on histology. Results: Out of 5593 patients, 442 (7.20%) were VIA positive. 442 patients were colposcopically evaluated .Among them, 228 (51.58%) were normal and 202(45.70%) had different stages of cervical intraepithelial lesions (CIN) and 12 ( 2.71 % ) had carcinoma of cervix. Out of 214 patients biopsied, 23.36 % patients had a final diagnosis of CIN lesions, 5 (2.33%) had carcinoma in-situ & 17 cases (7.94%) had invasive carcinoma. Besides to find out the predictable factors of cervical lesions data have been collected from VIA positive patients regarding age of first coitus and first delivery, history of extra marital exposure and STI, use of contraceptive methods and family history of cancer. Age of first coitus between 12 to 15 years and 16 to 20 years were observed among 203 (46 %) and 40 % (177) women respectively. More than half of the patients (62%) were experienced with their first delivery within the age 15-20 years which was below 15 years of 12 % (53) patients. Fifty four percent patients used OCP and barrier methods used were only 10 %. Family history of cancer was observed among 09 % women. 58% patients were belonged to lower middle class and upper group were only 9% (table 1) Conclusion: In our study detection of different grades of intraepithelial lesions (CIN-I, CIN-II, CIN-III, invasive carcinoma) of cervix by VIA was comparable to that of colposcopy. So VIA is suitable for detection of precursor lesions of cervical cancer in low resource settings and also for diagnosis, follow up treatment and epidemiological studies of cervical cancer. Key words: Visual inspection; VIA; cervical carcinoma; colposcopy; screening; epidemiological studies. DOI: http://dx.doi.org/10.3329/bjms.v10i4.9494 BJMS 2011; 10 (4): 240-244
TL;DR: This article reviews the literature on various management strategies described to prevent and control the gagging in dental patients and recommends a number of approaches to be considered.
Abstract: Gagging in dental patients can be disruptive to dental treatment and may be a barrier to a patient care, preventing the provision of treatment and the wearing of prostheses. Many management techniques have been described to control the gagging. This article reviews the literature on various management strategies described to prevent and control the gagging. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9816 BJMS 2012; 11(1): 12-17
TL;DR: This study aims to see the immediate outcome of the children with AGN, a significant cause of morbidity and mortality in developing countries, who are between 6 years to 12 years of age with male predominance and come from poor socioecononic status.
Abstract: Acute Glomerulonephritis (AGN) in children is common in our country and possesses a significant hospital load. AGN is principally a disease of children were poverty, overcrowding and poor hygiene are prevailing. It is a significant cause of morbidity and mortality in developing countries. Objective : To see the immediate outcome of the children with AGN. Materials and Mithods: Sixty two cases of AGN were enrolled in this study. All cases were collected from paediatric department of Sir Salimullah Medical College (SSMC) and Mitford Hospital, Dhaka during the period of September 2000 to November 2001. A thorough history were taken and chemical examination were carried out and the patient were observed during hospitalization and after discharge and recorded in a preformed questionnaire. Results: Total number of cases were sixty two. Eighty one percent were between 6 years to 12 years of age with male predominance. Most of then came from poor socioecononic status (81%). All patients had generalized edema. Eighty one percent had reduced micturation, 29% had gross haematuria, 13% ascitis, 3% anuria, 2% had epistaxis with convulsion and coma. Eighty four percent had hypertension, 50% had infected scabies. Urinary RBC was found in 93.55% cases and RBC cast in 70-96% cases, blood urea over 40 mg/dl in 30.64% patient and serum creatinine over 1.0 mg/dl in 9.88% patients. DOI: http://dx.doi.org/10.3329/bjms.v10i4.9499 BJMS 2011; 10 (4): 269-274
TL;DR: A 17 year-old Bangladeshi female presented with a severe Class II division 1 incisor relationship on a mild Skeletal II base and was commenced using fixed appliances and followed by extractions of upper first premolars.
Abstract: A 17 year-old Bangladeshi female presented with a severe Class II division 1 incisor relationship on a mild Skeletal II base Crowding was moderate in the upper arch The lower arch was well aligned Treatment was commenced using fixed appliances and followed by extractions of upper first premolars This case illustrates the versatility of the fixed appliances in the treatment of those cases exhibiting Class II division 1 malocclusion with crowding DOI: http://dxdoiorg/103329/bjmsv11i19827 BJMS 2012; 11(1): 63-65
TL;DR: In the context of changing medical education system, South East Asia is also adopting up to date medical curriculum for the medical students in these countries, likely to become a hub of 'educational tourist'.
Abstract: After the concept of evidence based medicine it became important all over the world to have more structured, clinical oriented curriculum. According to the United Nations, Asia is divided into five sub regions. Brunei, Cambodia, East Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam belong to South-eastern Asia. To cope with the rapid changes in medical education curriculum most of the medical school in Asia particularly south East Asian countries adopted took up curriculum to fit to the current need. Medical education in Malaysia and Singapore developed similarly as the two countries together formed a federation in the British Empire until independence in 1957. Currently, in medical education, a trend has emerged to utilize "trustable research findings" in place of "personal opinions" as a basis for educational management and decision-making. Several of Malaysia's medical schools partner with other European, American and Asian schools, and students sometimes earn the certification or accreditation to practice in those countries as well. In the context of changing medical education system, South East Asia is also adopting up to date medical curriculum for the medical students in these countries. As a result rapid changes in curriculum with special focus on research these schools likely to become a hub of 'educational tourist'. Keywords : Medical education; Malaysia; South East Asia. DOI: http://dx.doi.org/10.3329/bjms.v10i4.9491 BJMS 2011; 10 (4): 226-229
TL;DR: Combination therapy (GA 2, HQ 2% and KA 1%) has a few lightening effect on melasma, with no remarkable side effects.
Abstract: Background & Methodology: It was an opened clinical trial. The study was carried out from March 2009 to February 2011, in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, Bangladesh to evaluate the efficacy and side effects of the combination therapy of hydroquinone(HQ), kojic acid(KA) and glycolic acid(GA) for the treatment of melasma. Patients suffering from melasma were selected as study population. Within the period of data collection, thirty patients of melasma were assigned purposively. The efficacy was evaluated using Melasma Area and Severity Index (MASI) Score. The severity of melasma of each of the four regions (forehead, right malar region, left malar region and chin) are assessed based on three variables, percentage of the total area involved (A), darkness (D) and homogenicity (H). Results: The study showed that majority (30%) of the cases were between 20 to 25 years, majority (77%) of patients were female, (50%) patients were housewives, (50%) were in graduation level of education, (50%) of patients was found as upper class and negative family history was present in majority (80%) of cases. It was seen that highest (93%) number of patients were malar type and 7% were centro-facial type. The study showed the change in MASI Score after treatment with combination therapy (GA 2%, HQ 2% and KA 1%). After 12 weeks of treatment, the average MASI score was decreased by 24.20% indicating mild reduction of the severity of melasma and 18%, 18%, 9% and 55% patients developed side -effects like itching, burning sensation, scaling, and erythema respectively. Conclusion: Combination therapy (GA 2%, HQ 2% and KA 1%) has a few lightening effect on melasma, with no remarkable side effects. Further study should be conducted with large number of sample and longer follow up. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11720 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12
TL;DR: The study clearly shows the relationship between type2 diabetes and hyperlipidemia, which may influence the mechanism by which type2abetes is associated with increased CAD risk.
Abstract: Objectives: Serum lipid profile viz the level of total cholesterol (TC), Triglyceride (TG), HDL-cholesterol and LDL-cholesterol of type2 diabetic patients have been studied and compares them with levels of control subjects. Results: The mean value of the TG level for male diabetics was higher than that for the female diabetics and the mean values of TC, HDL-C and LDL-C were not found significantly different between male and female diabetics. Hyperlipidemia has a documented causative relation with CAD, but the major risk associated with diabetes may be due to the associated hyperlipidemia. The study revealed that dyslipidemia is very common in type2 diabetics and the most common abnormality observed was increased serum triglyceride levels (58%). The next common abnormality was decreased serum high-density lipoprotein cholesterol (HDL-C) levels and increased serum low-density lipoprotein cholesterol (LDL-C) levels. A high total serum cholesterol levels was found in 41% patients. 39% of the patients examined were overweight, and 7% were overtly obese. Conclusion: Thus, the study clearly shows the relationship between type2 diabetes and hyperlipidemia, which may influence the mechanism by which type2 diabetes is associated with increased CAD risk. DOI: http://dx.doi.org/10.3329/bjms.v11i2.11479 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 121-125
TL;DR: The comparative approach regarding the ethics of surrogacy from the Western secular and Islamic bioethical view reveals both commensurable and incommensurable relationship.
Abstract: The comparative approach regarding the ethics of surrogacy from the Western secular and Islamic bioethical view reveals both commensurable and incommensurable relationship. It is not either straight forward ‘commensurable’ or straight forward ‘incommensurable.’ Islamic bioethics is straight-forward in prohibiting reproductive cloning on its own features and also guess social chaos and anarchy. Western secular bioethics has both arguments and counter arguments both for and against this scientific innovation. Both are eager to highlight the welfare of the society as a whole but the approaches are not always the same. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12595 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12
TL;DR: Investigating the treatment of subtrochanteric femoral fractures in skeletally immature adolescents concluded that Rigid and close interlocking nailing between the age of 9-16 years offered excellent fracture stability allowing early mobilization (early weight bearing) and joint motion in comparisons to the other groups and between the ages of 6-8 years titanium elastic nail and bridging plate offered excellent result.
Abstract: Introduction: Subtrochateric femoral fracture is a major cause of morbidity and mortality in patients with lower extremity injuries. There have been no studies that have specifically looked at the management of subtrochanteric femoral fractures in skeletally immature adolescents. It was the purpose of this study to investigate the treatment of this injury in this unique patient population. Methods: This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2006 to November 2008. Thirty-four patients were recruited from Emergency and out patient department having closed subtrochanteric femoral fracture. All patients were operated under general or spinal anesthesia. All patients were followed for twelve months. Results: All children achieved union in a mean time of 10 weeks (range from 6 - 16 weeks) depending on the type of long bone. Full weight bearing was possible in a mean time of 8.8 weeks. Mean duration of hospital stay was 9.8 days. The mean follow-up period was 28 months (17-48 months). Complications were recorded in 4 (11.77%) patients and included: two entry site skin irritations, one protrusion of the wires through the skin and one delayed union. The results were excellent in 97.06% and good in 2.97% patients. Conclusions: We conclude that Rigid and close interlocking nailing between the age of 9-16 years offered excellent fracture stability allowing early mobilization (early weight bearing) and joint motion in comparisons to the other groups and between the age of 6-8 years titanium elastic nail and bridging plate offered excellent result. DOI: http://dx.doi.org/10.3329/bjms.v11i2.9664 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 91-97
TL;DR: It is suggested that body's internal production of antioxidant is not enough to neutralize all free radicals, so increased dietary intake of antioxidant lycopene in the form of tomato products is beneficial, which is easily available in developing country like India.
Abstract: Back ground: Lycopene, 40 carbon acyclic carotenoid containing 11 conjugated double bonds, is a phytochemical found in tomatoes and other red fruits. Oxygen derived free radicals are the most reactive species and as an antioxidant lycopene has a singlet oxygen quenching ability twice as high as that of ?-carotene and 10 times higher that of ?-tocoferol, lycopene participate in a host of chemical reactions to protect critical cellular biomolecules including lipid, proteins and DNA. Materials and Methods: The present study include 30 subjects having oxidative stress, age between 40-60 years, nonsmoker, with no history of chronic systemic illness and no medication were taken as patients.30 patients matched healthy subjects were taken as control. All subjects were selected from outpatient department of NSCB Medical College Jabalpur M.P. After estimation of base line antioxidant enzyme and vitamins, we supplement 180 gm of tomato (products like soup, paste. ketchup) contain 12 mg of lycopene to the patient group. After 60 days of lycopene supplementation oxidative stress biomarkers like SOD, GPX, GR, GSH, lipid peroxidation product MDA and other antioxidant vitamins A, vitamin C, vitamin E were estimated in patient's blood sample. Results: The main result of the study revealed that lipid per oxidation product MDA was found to be decreased significantly but after lycopene supplementation levels were improved. The results of SOD , GPX, GR, GSH,Vitamin A ,Vitamin E and Vitamin C were significantly increased after lycopene supplementation, it indicates the improved antioxidant profile after the supplementation of lycopene. Conclusion: There was a significant decrease in oxidative stress after the supplementation of lycopene therefore the study suggest that body's internal production of antioxidant is not enough to neutralize all free radicals, so increased dietary intake of antioxidant lycopene in the form of tomato products is beneficial, which is easily available in developing country like India. Key Words: Oxidative stress; Lycopene; MDA; GSH; SOD; Vitamin C; Vitamin E DOI: http://dx.doi.org/10.3329/bjms.v10i4.9500 BJMS 2011; 10 (4): 275-279
TL;DR: The results indicates that the increased mortality during 11-15 years of age can cause transfusional iron overload, which can cause increased morbidity and premature mortality in thalassemia patients.
Abstract: Objective: The aim of the present study is to surveying the mortality in thalassemic patients from Solapur District, Maharashtra State, India. Methods: Present observational survey study, one hundred twenty five clinically proved by their medical reports, cases of thalassemic children's with age 6 months to 18 Years, coming for to get blood transfusion from different parts of Solapur district. Results: The results indicates that the increased mortality during 11-15 years of age. As a result, transfusional iron overload can cause increased morbidity and premature mortality in thalassemia patients. This study will be helpful in further defining the morbidity and mortality in thalassemic patients. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11717 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12