Ibrahim Medical College Journal最新文献

{"title":"Detection of OXA-181/OXA-48 carbapenemase producing Enterobacteriaceae in Bangladesh","authors":"R. Khatun, S. Shamsuzzaman","doi":"10.3329/IMCJ.V9I2.28853","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I2.28853","url":null,"abstract":"Carbapenem resistant Enterobacteriaceae (CRE) is becoming a major public health concern globally. Detection of carbapenem hydrolyzing enzyme carbapenemase in Enterobacteriaceae is important to institute appropriate therapy and to initiate preventive measures. This study was designed to determine the presence of carbapenemase producers among the CRE isolated from patients at Dhaka Medical College Hospital, Bangladesh. Twenty-nine CRE strains detected by disk diffusion technique were included in the study. Minimum inhibitory concentration of imipenem and tigecycline was determined by agar dilution method. Carbapenemase production was phenotypically detected by Modified Hodge test while MBL producers were detected by combined disk and double disk synergy tests. Genes encoding bla NDM-1, bla OXA-181, bla OXA-48, bla KPC, bla CTX-M-15, bla OXA-1-group were identified by polymerase chain reaction (PCR). Out of 29 CRE, nineteen (65.6%) were positive for carbapenemase by any of the three phenotypic tests namely MHT, CD or DD tests. Those 19 isolates were also positive either for bla NDM-1 or bla OXA-181/ bla OXA-48 by PCR. Of the 19 PCR positive isolates, the rate of positivity for bla NDM- 1, bla OXA-181/ bla OXA-48 and bla NDM-1+ bla OXA-181/ bla OXA-48 was 73.7% (14/19), 57.9% (11/19) and 31.6% (6/19) respectively. Both bla OXA-181 and bla OXA-48 co-existed. All the carbapenemase producing organisms harboured bla CTX-M-15 except one C. freundii strain. The rate of resistance to different classes of antibiotics ranged from 63.2% to 100% except colistin and tigecycline. Organisms positive for OXA-181/OXA-48 had a low level of resistance to carbapenem (MIC 1 - 4 i g/ml) while with NDM-1 had high level resistance to imipenem (MICs 16 - ≥ 32 i g/ ml). Out of 19 carbapenemase positive isolates, 12 (63.16%) were extensively drug-resistant (XDR) and were only sensitive to tigecycline and colistin. The result of this study showed the presence of bla OXA-181/ bla OXA-48, bla NDM-1 positive strains in Bangladesh and colistin and tigecycline were the most effective drugs against carbapenemase producing Enterobacteriaceae (CPE). Epidemiological monitoring of carbapenemase producing organisms in Bangladesh is important to prevent their dissemination. Ibrahim Med. Coll. J. 2015; 9(2): 45-51","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121269030","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}

{"title":"Use of antibiotics in selected tertiary and primary level health care centers of Bangladesh","authors":"A. Ahmed, S. Jilani, O. Chowdhury, K. Islam, Akram Hossian, J. Alam, Ab Siddique, L. Barai, F. Rahman, J. Haq","doi":"10.3329/IMCJ.V9I2.28852","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I2.28852","url":null,"abstract":"A cross sectional study was conducted in inpatient department of seven primary level hospitals care centers (PLHCs) and six tertiary level hospitals (TLHs) of the country. Total 2058 hospitalized patients were interviewed over a six month period from October 2012. Most of the patients (85.9% in TLH and 100% in PLH) were prescribed with antibiotics at the time of admission. Only 6.4% patients of TLHs treated with antibiotic had culture proven infection and rest of the patient of TLH and all the patients of PLH were treated with antibiotic empirically. Top prescribed antibiotic was ceftriaxone (39.64% in TLH, 59.64% in PLH). Parenteral route of antibiotic administration was preferred for both at TLHs and PLHCs (63.3% and 76.9%). The results of the present study indicated that antibiotics were widely and inappropriately used without following standard guidelines or based on any rationality. This is an alarming situation, and needs to be addressed by the relevant authority to save the people from growing antibiotic resistance. Ibrahim Med. Coll. J. 2015; 9(2): 42-44","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123820517","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}

{"title":"Non-fatal drowning in under-five rural children of Bangladesh","authors":"Syed Abul Hassan Md Abdullah, M. Flora","doi":"10.3329/IMCJ.V9I2.28851","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I2.28851","url":null,"abstract":"Drowning has been identified as a major cause of death in children in both developed and developing countries. Non-fatal drowning is several times higher than the fatal drowning. To describe the socio-demographic and environmental attributes of non-fatal drowning in rural children this community based descriptive study was conducted on 122 children having non-fatal drowning events within one year of study period. This study was undertaken in Raigonj sub-district of Sirajgonj district in Bangladesh. Mothers of those children were interviewed using a structured questionnaire. Out of all participants 56.6% children were 2-4 years of age and male-female ratio was almost equal. Of the total respondent mothers 55% were illiterate and 41.8% were below the age of 25 years. Seasonal variation was observed in non-fatal drowning. Rainy season (50.8%) appeared as the most risky period followed by summer (29.5%). Higher incidence occurred (53.3%) between 10 am to 2 pm of the day. Although most of the drowning occurred outside the home, 9% drowning occurred in water container (like drum, tub) within the home. Pond (50.5%) was found as the most common place among open water source. During the occurrence, 23% child was not accompanied by parents or any caregivers. At the time of drowning, 47.5% mothers were engaged with usual household work and were not present at the place of occurrence whereas 13% mothers were present around the place of occurance. Before drowning, 45.1% victim was either playing, bathing or swimming in the water. Only 10.7% needed resuscitation, 25% were taken to health centre and reached the health centre within an hour, about a fifth (22.6%) of them were admitted. Restriction in dangerous water activities, strengthening supervision of children might decrease the incidence of drowning while quick and effective medical response might prevent its fatal consequences. Ibrahim Med. Coll. J. 2015; 9(2): 37-41","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120931270","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}

{"title":"Jejunal inflammatory fibroid polyp: a rare cause of intussusception","authors":"R. H. Talukder, Noor A Alam, Zahid Iqbal Jamal Uddin, Nilufar Shabnam","doi":"10.3329/IMCJ.V9I2.28856","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I2.28856","url":null,"abstract":"Inflammatory fibroid polyp is a benign and non-neoplastic condition of the gastro-intestinal tract, commonly affecting the gastric antrum, though it can affect any part of the gastro-intestinal tract. It is a submucosal, sessile, polypoid mass composed of myofbroblast like mesenchymal cells, numerous small blood vessels and marked inflammatory cell infiltrate mainly eosinophils. It commonly presents with intestinal obstruction or intussusception. We present here a case of recurrent episodes of small intestinal sub-acute obstruction due to intermittent intussusception associated with inflammatory ubroid polyp of jejunum. Ibrahim Med. Coll. J. 2015; 9(2): 58-60","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131276558","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}

{"title":"Disseminated melioidosis involving skin and joint: a case report","authors":"S. Afroze, M. A. Rahim, L. Barai, K. Uddin","doi":"10.3329/IMCJ.V9I2.28855","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I2.28855","url":null,"abstract":"Melioidosis is an infectious disease that can cause serious morbidity and may result in death if not treated early. Its causative organism, Burkholderia pseudomallei is present in soil and water. Here, we report a case of disseminated melioidosis involving skin and joint in a farmer residing in an area where the organism has been found in the soil. Ibrahim Med. Coll. J. 2015; 9(2): 55-57","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132762094","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}

{"title":"Effects of aqueous and ethanolic extracts of Aegle marmelos (BAEL) leaves on chronic inflammation in rats","authors":"S. Rahman, E. O. Eva, Rezaul Quader, Muqbula Tasrin, I. Khan","doi":"10.3329/IMCJ.V9I2.28854","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I2.28854","url":null,"abstract":"Aegle Marmelos Linn (Rutaceae) is used as ethno medicine against various human ailments. Several curde extracts from various parts (Leaves, flower, stem, root etc) of the plant A. marmelos Linn have shown variable anti-inflammatory effects in acute and chronic inflammation in animal models. The anti-inflammatory effects of A marmelos linn may be of special advantage compared to conventional anti-inflammatory drugs. The present study has therefore been undertaken with the objective to evaluate the anti inflammatory effect of aqueous and ethanolic extracts of A. marmelos leaves, compared to a standard anti-inflammatory drug (indomethacin) in chronic inflammatory conditions. The anti-inflammatory effect was studied in rats using cotton pellet implantation, where granuloma formation was used as an index of chronic inflammation. Aqueous and ethanolic extracts of A. marmelos leaves were given orally for 7 days daily at doses of 100 mg/kg body weight. The percent inhibition of granuloma formation following treatment with aqueous and ethanolic extracts of A. marmelos leaves, and indomethacin compared to control were 16.5%, 25.72%, and 39.37% respectively. The differences were statistically significant (p<0.05 in case of aqueous and ethanolic extracts and p<0.001 in case of indomethacin). The results suggest that in case of chronic inflammation, both aqueous and ethanolic extracts of A. marmelos have significant anti- inflammatory effect. The ethanolic extracts compared to aqueous extract produced greater anti- inflammatory effects. Ibrahim Med. Coll. J. 2015; 9(2): 52-54","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127559462","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}

{"title":"Child abuse in Bangladesh","authors":"F. Islam, Gulshan Akhter","doi":"10.3329/IMCJ.V9I1.27635","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I1.27635","url":null,"abstract":"In Bangladesh, a large number of children are deprived of their basic human rights due to unacceptable health, nutrition, education as well as social conditions. In addition, children are exposed to severe forms of sexual, physical and mental abuses at home, in the work place, in institutions and other public places. The nature and extent of violence against children irrespective of age, sex and class has been increasing day by day. These include physical torture, rape, homicide and sometimes heinous attacks with acid. Children are also victims of child labor and trafficking, both of which are treated as the most severe form of child exploitation and child abuse in the world today. This review article is aimed to focus on the present situation of various forms of child abuses in our country. Data collection is based on secondary sources of information from Dhaka Medical College Hospital, One Stop Crisis Center (OCC),UNICEF, Ministry of Home Affairs, Ministry of Women and Children Affairs, several Dhaka based organizations and news paper clipping. Ibrahim Med. Coll. J. 2015; 9(1): 18-21","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133746533","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}

{"title":"Prevalence of hypertension in people living in coastal areas of Bangladesh","authors":"M. Sayeed, Ahsab Rahman, Md. Hazrat Ali, Subrina Afrin, M. M. Rhaman, M. M. H. Chowdhury, A. Banu","doi":"10.3329/IMCJ.V9I1.27634","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I1.27634","url":null,"abstract":"The prevalence of hypertension was reported higher in the coastal areas in different populations of the world. There was no study on the prevalence of hypertension among the coastal people in Bangladesh. This study addressed the prevalence and risk of hypertension among people living in the coastal areas of Bangladesh. Total 32 different coastal communities were selected purposively in the six coastal districts (Barisal, Borguna, Vola, Pirojpur, Potuakhali and Jhalukathi) of Bangladesh. All people over 18 years were considered eligible. Social, clinical and family histories were taken. Height, weight, waist- and hip-girths were measured including systolic and diastolic blood pressure (SBP and DBP). Fasting blood glucose and lipids were also estimated. The accepted cut offs for systolic hypertension (sHTN) was ≥135mmHg and diastolic hypertension (dHTN) was ≥85 mmHg. Overall, 7058 (m / f = 2631 / 4427) people volunteered to participate in the study. The crude prevalence of sHTN was 17.8% [95% CI, 17.39 – 18.21] and dHTN was 19.0% [95% CI 18.08 – 19.92]. Compared to female, the male participants had higher prevalence of both sHTN (16.4 v. 20.2 %, p<0.001) and dHTN (17.4 v. 21.5%, p<0.001). The prevalence rates of sHTN were 14.6, 18.5 and 24.6% in the poor, the middle and in the rich class, respectively (p<0.001). Similar trend was observed with dHTN. Both types of HTN increased with increasing age (p<0.001), BMI (p<0.001), WHR (p<0.001) and WHtR (p<0.001). Logistic regression analyses proved that the participants of higher social class, of advancing age and with higher obesity had excess risk of hypertension. Positive family history of HTN, DM and stroke had also increased risk for HTN. We found higher prevalence of HTN in Bangladeshi coastal population compared to people living in other areas of Bangladesh. Family history of DM, HTN and stroke were significantly related to sHTN and dHTN. Increasing age, higher obesity and higher social class had excess risk for developing HTN. Further study may be undertaken to address other unexplored risks like physical inactivity, unhealthy diet or psychosocial stress affecting the coastal people. Salt content of water and food consumed by these people should also be investigated. Ibrahim Med. Coll. J. 2015; 9(1): 11-17","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123317053","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}

{"title":"Atypical central serous chorioretinopathy treated with intravitreal injection of bivacizumab - a case report","authors":"M. Goswami","doi":"10.3329/IMCJ.V9I1.27639","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I1.27639","url":null,"abstract":"Central serous chorioretinopathy (CSCR) is common in adult male having sudden dimness of vision in one eye and typical pattern of leakage in fundus fluorescein angiography. Treatment of typical central serous chorioretinopathy is conservative and / or focal laser photocoagulation. But atypical central serous chorioretinopathy is uncommon having different patterns of clinical presentation and features in fundous fluorescein angiography. Treatment option of atypical central serous chorioretinopathy is not yet established. Here, we present a case of atypical central serous chorioretinopathy successfully treated with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF, Bivacizumab). Ibrahim Med. Coll. J. 2015; 9(1): 34-36","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125431342","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}

{"title":"Molecular detection of atypical microorganisms in patients with ventilator associated pneumonia","authors":"S. Akter, R. Khatun, S. Shamsuzzaman","doi":"10.3329/IMCJ.V9I1.27636","DOIUrl":"https://doi.org/10.3329/IMCJ.V9I1.27636","url":null,"abstract":"Ventilator-associated pneumonia (VAP) is one of the major causes of morbidity and mortality among the critically ill patients of intensive care units (ICU). The present cross sectional study was conducted to isolate and identify bacterial causes of VAP among the patients admitted in intensive care unit (ICU) of Dhaka Medical College Hospital. The study was conducted between July, 2013 to June 2014. A total of 65 endotracheal aspirate (ETA) and blood samples were collected from patients with clinically suspected ventilator associated peumonia(VAP). Samples were collected from patients on mechanical ventilation for more than 48 hours. ETA and blood samples were cultured aerobically. Multiplex PCR was performed with ETA to detect Mycoplasma pneumoniae , Legionella pneumophila and Chlamydia pneumoniae . Among the atypical bacteria, M. pneumoniae were detected in 5 (7.69%), L. pneumophila in 4 (6.15%) cases by multiplex PCR in ETA from VAP cases. No C. pneumoniae was detected. The study revealed that in VAP cases atypical bacteria should be considered as a possible bacterial agents. Ibrahim Med. Coll. J. 2015; 9(1): 22-25","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121427930","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}