Ibrahim Medical College Journal最新文献

{"title":"AN AUDIT OF INTENSIVE CARE SERVICES IN BANGLADESH","authors":"M. Faruq, A. Ahsan, K. Fatema, F. Ahmed, Afreen Sultana, Rashed Chowdhury","doi":"10.3329/IMCJ.V4I1.5929","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5929","url":null,"abstract":"This study was conducted to survey the facilities, bed strength, functional characteristics, manpower, operational practices and distribution of intensive care units in Bangladesh. Direct interview of consultants in charge of different Intensive Care Units (ICUs) in the city of Dhaka was conducted by a structured questionnaire. All Adult Intensive Care Units (ICUs) and Coronary Care Units (CCUs) with ventilator support in the city of Dhaka belonging to government and private sectors were included. Our survey showed that 90% of all Intensive Care Units in Bangladesh were located in the city of Dhaka. There were 40 Intensive Care Units in the city of Dhaka, of which 33 were ICUs and 7 CCUs with ventilator support (also considered as ICU). Only 4 (10%) ICUs were located in government hospitals. Rest of the ICUs was in private hospitals / clinics. Total number of ICU beds was 424 and total numbers of beds in these hospitals were 8824. So 4.8% of total hospital beds were provisioned for critical care. Among these only 240 beds (60%) had ventilator support. 27(68%) of the 40 ICUs were multidisciplinary, 7(18%) CCUs, 5(12%) cardiac surgery and 1(2%) neurology. 64% ICUs were run by anesthesiologists. 85% facilities were open units as opposed to 15% closed units. Nurse: bed ratio of 1:1 was seen in 15(42%) facilities. On duty doctor: patient ratio was variable and highest was 1:4 in 9 ICUs (27 %). ICUs in Bangladesh are mainly situated in the city of Dhaka and mostly in the private sector. The standards and management strategies vary greatly. Ibrahim Med. Coll. J. 2010; 4(1): 13-16 Key words: Intensive Care Unit; Bangladesh; audit. DOI: 10.3329/imcj.v4i1.5929","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125392611","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":"Blood Pressure Levels among the Students of a Selected School","authors":"Abdullah Al-Shafi Mazumder, M. Flora, Md. Shahidullah, Rokeya Khanam, Md. Abdur Rashid, Md. Hasan Iqbal","doi":"10.3329/IMCJ.V4I1.5928","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5928","url":null,"abstract":"In Bangladesh, limited data are available on paediatric hypertension as well as their normal values. This study was done to assess the level of blood pressure in this population group. A total of 1118 students from class I to X of a selected school were measured twice for systolic and diastolic BP within five minutes interval following a standard protocol. The phase V diastolic blood pressure was recorded. The average of two readings was taken. Age was obtained from the school records. The mean age was 10.53 (± 0.09) years and 46.9% of the recruited students were females. The mean (±SE) and median of systolic and diastolic blood pressure were 97.89 (±0.39) and 97.50 mm Hg and 57.58 (±0.39) and 60.00 mm Hg, respectively. Boys had a significantly higher systolic (99.34 ± 0.56 mm Hg) and diastolic (62.59 ± 0.41 mm Hg) blood pressure than the girls (96.78 ± 0.50 mm Hg systolic BP and 51.54 ± 0.55 mm Hg diastolic BP; P<0.001). Systolic blood pressure was found to be positively correlated with age, height and weight and diastolic blood pressure was correlated with height and weight. Although this study gave us an insight into the paediatric BP situation in a particular school, a community based study with representative sample is recommended to develop a reference data on paediatric blood pressure for our country. Ibrahim Med. Coll. J. 2010; 4(1): 9-12 DOI: 10.3329/imcj.v4i1.5928","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122548385","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":"SOCIO-ECONOMIC FACTORS AND KNOWLEDGE INFLUENCING NEWBORN CARE PRACTICES: EXPERIENCE AT DHAKA SHISHU HOSPITAL","authors":"H. Begum, Mohammad Faizul Haque Khan","doi":"10.3329/IMCJ.V4I1.5930","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5930","url":null,"abstract":"Reducing maternal and neonatal mortality remains a big challenge for a developing country like Bangladesh. Mothers’ knowledge in neonatal care plays an important role in bringing down the mortality as well as morbidity. This study was conducted in Dhaka Shishu Hospital during the period of December 2007 to February 2008 and was based on primary data collected on socioeconomic status, knowledge and practice of mothers of neonates attending the hospital. A total of 400 mothers were interviewed. More than fifty percent mothers had an appropriate knowledge on feeding neonates, hand washing before handling neonates, care of eye, care of umbilicus and they were practicing as well. Where as less than fifty percent mothers had appropriate knowledge on keeping neonates warm, cutting hair, bathing, vaccination, oil massage and their practice rate also commensurate well with their knowledge level. Majority of the mothers were in the age group of 21-25 years, having completed primary education or passed SSC exam. They were house wives living in an urban area, with a monthly family income of 3000-7000 taka. Statistically significant association was found between socio demographic variables and knowledge and practices on neonatal care of the mothers. Ibrahim Med. Coll. J. 2010; 4(1): 17-20 Key words: Socio-economic factors; knowledge and practices; neonatal care DOI: 10.3329/imcj.v4i1.5930","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115341657","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":"Relationship of Microalbuminuria with different Clinical and Biochemical Parameters in Newly Detected Diabetes Mellitus Cases","authors":"I. Prasad, Z. Latif, T. Ahmed, F. Pathan, S. Ashrafuzzaman, Firoz Amin","doi":"10.3329/IMCJ.V4I1.5931","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5931","url":null,"abstract":"This study was conducted to assess the presence of microalbuminuria in newly detected diabetes mellitus (DM) cases in a small group of Bangladeshi population attending BIRDEM out patient department and to find out the relationship (if any) of microalbuminuria with different clinical and biochemical parameters. Out of 110 DM cases, 10 (9.1%) were found to have microalbuminuria. Blood pressure, both systolic (r=0.190) and diastolic (r = 0.30) had significant positive correlation with urinary albumin. There was no association of microalbuminuria with waist circumference, waist to hip ratio, serum triglycerides, HDL cholesterol, fasting blood glucose, age, sex, weight, height or BMI. This suggests that all newly detected diabetes mellitus should be screened for raised blood pressure and if found positive be given the same importance as blood glucose. They should be treated meticulously to revert or prevent microalbuminuria and thus prevent complications. Ibrahim Med. Coll. J. 2010; 4(1): 21-25 DOI: 10.3329/imcj.v4i1.5931","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125325424","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":"Religious and Spiritual Beliefs and Practices in Medicine: An Evaluation in a Tertiary Care Hospital in Malaysia","authors":"R. Yousuf, A. Fauzi, S. Akter, S. Azarisman, O. Marzuki","doi":"10.3329/IMCJ.V4I1.5927","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5927","url":null,"abstract":"In recent years there has been growing awareness regarding the role of religion and spirituality (R/S) in the practice of clinical medicine. Despite hundreds of articles in professional journals on the subject, little is known about physician beliefs regarding the influence of religion on health. We aim to assess the beliefs and observations of physicians regarding the role of R/S and patient’s health and whether they address such issues in their clinical practice. Concomitantly, we aim to assess the beliefs of our patients and whether they like to address such issues. Questionnaire was based on a cross sectional survey among hospitalized patients and their treating physicians. Nearly all patients and physicians reported a high prevalence of religiosity. Patients also acknowledged that their R/S was respected by the staff, and that physicians inquired R/S about half of the time. R/S was described as beneficial as it enabled patients to cope better with their illness and gave them a positive state of mind. Religion is important to many patients and physicians, but half of the physicians ignore it in their clinical practice. Physicians need to be attentive to patients R/S issues and address them in specific clinical situations. Ibrahim Med. Coll. J. 2010; 4(1): 4-8 Key words: Religion; spirituality; medicine; health; beliefs DOI: 10.3329/imcj.v4i1.5927","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129704458","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":"An Anomalous Left Anterior Descending Artery","authors":"M. M. Haq, M. Mansur, Syed Dawood Md Taimur","doi":"10.3329/IMCJ.V4I1.5934","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5934","url":null,"abstract":"Coronary artery fistulas can go undetected as they tend to remain clinically silent. Larger fistulas can end up with sudden death, ischemia, endocarditis or CCF. However, these are detected incidentally during non-invasive or invasive diagnostic testing for unrelated symptoms. This report describes such a case in a 56 year old male while undergoing a coronary angiogram following an anteroseptal infarction three weeks prior to the procedure. The fistula arose from the proximal left LAD and was seen in all views. It is important for cardiologists to remember about the possibility of such uncommon possibilities. Ibrahim Med. Coll. J. 2010; 4(1): 34-36 Indexing words: Cardiac anomalies; angiogram; fistula.","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114134950","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":"Melioidosis in Bangladesh - A Disease Yet to be Explored!","authors":"S. Jilani, J. Haq","doi":"10.3329/IMCJ.V4I1.5925","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5925","url":null,"abstract":"Melioidosis is a disease of public health importance in Thailand, Vietnam, Malaysia, Laos, Myanmar and northern Australia where it is associated with high case-fatality rates. In endemic areas, seroepidemiological surveys have showed that the infection is fairly common in childhood as 80% of children had antibodies by the age of four years.2 In infected individuals the organism may remain dormant inside the phagocytic cells for months, years or decades.3 The factors that provoke reactivation of this latent, dormant “time bomb” are stress and alteration of immune status. Diabetes mellitus, chronic renal failure, cirrhosis of liver, AIDS, hematological malignancies seem to predispose the activation of the disease in an otherwise dormant latent infection. The manifestations are highly diverse ranging from acute pulmonary infection, septicemia, acute or chronic suppurative infections involving almost all organ systems to meningitis.4 Fulminant sepsis is much more common and is associated with high mortality.","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133067278","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":"Cutaneous Metastatic Adenocarcinoma","authors":"Mazharulla Khan, N. Islam, Noor A-Alam, T. Maitra, S. Z. Hossain, Tamanna Narmeen","doi":"10.3329/IMCJ.V4I1.5933","DOIUrl":"https://doi.org/10.3329/IMCJ.V4I1.5933","url":null,"abstract":"A 51 year old man presented with multiple painless skin nodules throughout his body for 3 weeks. He complained of cramping pain in his calf muscles and thighs for 3 months, occasional fever with chills for 2 months and lost about 10kgs in these 3 months. Initially he was diagnosed as a case of viral myositis. His CPK and LDH were raised, febrile antigens and widal test were negative, CA 19-9 was very high (5018 u/ml). Biopsy of skin nodules showed features of metastatic adenocarcinoma. Ibrahim Med. Coll. J. 2010; 4(1): 31-33 Key word: Cutaneous metastasis; adenocarcinoma DOI: 10.3329/imcj.v4i1.5933","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114615031","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":"A Bacteriological Study of Diabetic Foot Infection in an Urban Tertiary Care Hospital in Dhaka City","authors":"S. Paul, L. Barai, Ashrafa Jahan, J. Haq","doi":"10.3329/IMCJ.V3I2.4216","DOIUrl":"https://doi.org/10.3329/IMCJ.V3I2.4216","url":null,"abstract":"Identification of organisms and effective antibiotic therapy is an important component of treatment of diabetic foot infections. This study was undertaken to determine the organisms associated with diabetic foot infection (DFI) and their antibiotic sensitivity pattern. A total of 75 patients having type 2 diabetes mellitus with Wagner's grade 1-5 foot ulcers attending BIRDEM hospital were included in the study. Specimens were processed for aerobic culture. The bacteriological isolation and antimicrobial sensitivity tests of the isolates were done by standard microbiological methods. Gram negative bacilli were tested for extended spectrum â lactamase (ESBL) production by double disc diffusion method. Culture was positive in 92% of the cases which yielded 135 pathogens. Of the positive culture, 75.3% had multiple organisms. Polymicrobial infection was more in higher grade of foot ulcers. Gram negative organisms were most frequently isolated (80%) bacteria. Pseudomonas (48%) and Proteus sp.(33%) was the most common Gram negative organisms isolated. Staphylococcus aureus was the most commonly isolated gram positive organism (21.3%). ESBL production was noted in 31.5% Gram negative bacilli and methicillin resistance was noted in 43.8% of Staphylococcus aureus . Most of the Gram negative bacilli were resistant to various classes of antibiotics. Imepenem was the most effective agent against Gram negative organisms, while vancomycin was for staphylococcus. The present study has shown that infection with multidrug resistant Gram negative bacilli is the most common cause of DFI in BIRDEM hospital. Ibrahim Med. Coll. J. 2009; 3(2): 50-54 DOI: 10.3329/imcj.v3i2.4216","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131472430","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":"Ultrasound Differentiation of Benign and Malignant Cervical Lymph Nodes","authors":"Mizanur Rahman, A. Sadeque, E. Omar, Sonjoy Kumar Khakta","doi":"10.3329/IMCJ.V3I2.4161","DOIUrl":"https://doi.org/10.3329/IMCJ.V3I2.4161","url":null,"abstract":"This study was conducted to see whether the size (measured by maximal short axis diameter), shape (expressed in terms of ratio dividing long axis diameter of the node by short axis diameter or L/S ratio), marginal clarity (regular or irregular margin), internal echo-pattern (homogeneous hypoechoic or heterogeneous) and hilar echogenicity (presence or absence of echo-genicity in hilum) are good criteria for differentiating benign from malignant cervical lymph nodes using high frequency (high resolution) ultrasound probe. The study was carried out from January 1998 to December 1998, among patients with enlarged cervical lymph nodes who were scanned with a high frequency (5.0 MHz) curvilinear probe. Chi-Square test was done to see the statistical correlation between two groups of nodes. A p value of <0.05 was taken as significant. Out of 65 nodes studied, 26 (100%) enlarged cervical nodes with short axis diameter more than 1 cm were all malignant. In contrast 31 (79.5%) of 39 enlarged nodes with short axis diameter less than 1cm were benign and rest were malignant (p<0.001). Of 34 enlarged nodes with L/S ratio <2, 30 (88.2%) nodes were found malignant and 4 (11.8%) were benign. Among the rest 31 enlarged nodes, 27 (87.1%) with L/S ratio ≥ 2 were benign while 4 (12.9%) were malignant (p <0.001). Among the 39 nodes with regular margin 28 (71.8%) were found benign, where as among 26 nodes with irregular margin 23 (88.5%) were malignant (p <0.001). When the internal echopattern was taken in account, 32 nodes had homogeneous hypoechoic echo of which 28 (87.5%) were benign and among 33 nodes with heterogeneous echopattern 30 (90.9%) were malignant (p <0.001). Among the 43 enlarged nodes with presence of hilar echogenicity 31(72.1%) were found benign and 22 (100%) nodes with no hilar echogenicity were all malignant (p <0.001). Such findings suggest that real time high resolution ultrasound might assist in differentiation of benign and malignant enlarged cervical lymph nodes. Ibrahim Med. Coll. J. 2009; 3(2): 40-44 Indexing words: Ultrasound, cervical lymph nodes, benign, malignant. DOI: 10.3329/imcj.v3i2.4161","PeriodicalId":226732,"journal":{"name":"Ibrahim Medical College Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134194138","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}