IMC Journal of Medical Science最新文献

{"title":"Repeated episodes of seizures in an infant following accidental administration of tramadol suppository: a case report","authors":"Israt Zahan Ima, Md Abdul Baki, J. Nahar","doi":"10.55010/imcjms.17.010","DOIUrl":"https://doi.org/10.55010/imcjms.17.010","url":null,"abstract":"Tramadol has become a popular analgesic in last few years. Number of studies has reported tramadol poisoning in children. Here, we report a case of tramadol poisoning in a one and half month old infant who presented with repeated seizures and apnea following accidental administration of tramadol suppository.\u0000\u0000IMC J Med Sci. 2023; 17(1): 010. DOI: https://doi.org/10.55010/imcjms.17.010\u0000\u0000*Correspondence: Israt Zahan Ima, Department of Pediatrics, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), 1/A Ibrahim Sarani, Segunbagicha, Dhaka, Bangladesh. Email: imaisratzahan@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"195 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74485854","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":"Antibody response to receptor-binding domain of SARS-CoV-2 spike protein following vaccination and natural infection with SARS-CoV-2","authors":"F. Rahman, Sraboni Mazumder, S. Farook, P. Deb, S. Saha, F. Akter, Md. Shariful Alam Jilani, J. Haq","doi":"10.55010/imcjms.17.009","DOIUrl":"https://doi.org/10.55010/imcjms.17.009","url":null,"abstract":"Background and objectives: Antibody to SARS-CoV-2 develops both after natural infection with SARS-CoV-2 and vaccination. This study was undertaken to determine the antibody response to SARS-CoV-2 among population after natural SARS-CoV-2 infection and vaccination.\u0000\u0000Material and methods: The study was carried out on adults aged 18 years and above. Study population consisted of four groups. Group-1 (control): healthy and history of no prior SARS-CoV-2 infection and vaccination, Group-2: had past SARS-CoV-2 infection and no vaccination, Group-3: received two doses of recombinant adenoviral vector vaccine ChAdOx1 (Oxford–AstraZeneca) without past SARS-CoV-2 infection, and Group-4: had past SARS-CoV-2 infection and received 2 doses of ChAdOx1 vaccination.\u0000\u0000Blood was collected 1 and 7 months after the second dose of vaccination from Group-3 and 4 individuals. Single blood sample was collected from participants of Gr-1 and 2 at the time of enrolment. Immunoglobulin G (IgG) antibodies to receptor-binding domain (RBD) of SARS-CoV-2 spike protein S1 (anti-RBDS1 IgG) was determined in serum by ELISA method.\u0000\u0000Results: Total 176 participants aged 18 years and above were enrolled. Anti-RBDS1 IgG positivity rates were 51.9%, 66.7%, 96.8% and 100% in individuals of Group-1, 2, 3 and 4 respectively. Gr-4 had significantly (p < 0.05) mean higher anti-RBDS1 IgG antibody level (120.8 ± 31.9 DU/ml) compared to other groups 1 month after 2nd dose of vaccination. No significant differences in antibody response were found among the individuals of four groups across gender and comorbidities. Seven months after the 2nd dose of vaccines, the antibody concentration declined in 85.3% (112.1 ± 30.4 DU/ml to 75.9 ± 48.7 DU/ml) and 81.5% (127.3 ± 20.4 DU/ml to 92.5 ± 43.6 DU/ml) individuals of Group-3 and Group-4 respectively. Decline of antibody was 40.6% and 34.7% in 7 months, but all remained positive except 1 in Group-3. Fever (34.4%) and headache (24.8%) were the most common adverse effects noted after vaccination.\u0000\u0000Conclusion: The study revealed that ChAdOx1 nCoV-19 vaccine induces high concentration of persisting anti-RBDS1 IgG antibody after 2nd dose and previous infection with SARS-CoV-2 acts as immune priming. Therefore, antibody screening test prior to booster dose could be a good option to maximize coverage of vaccination.\u0000\u0000IMC J Med Sci. 2023; 17(1): 009. DOI: https://doi.org/10.55010/imcjms.17.009\u0000\u0000*Correspondence: J. Ashraful Haq, Department of Microbiology, Ibrahim Medical College, 1/A Ibrahim Sarani, Segunbagicha, Dhaka, Bangladesh. Email: jahaq54@yahoo.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85181792","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":"Fosfomycin susceptibility among Escherichia coli causing urinary tract infection in a tertiary care centre in Western Maharashtra","authors":"Yash Lohariwal, N. Das, Shahzad Mirza, N. Gandham, Rajashri Patil, Sahjid Mukhida, Heer Shah, Sameena Khan","doi":"10.55010/imcjms.17.008","DOIUrl":"https://doi.org/10.55010/imcjms.17.008","url":null,"abstract":"Background and objective: Urinary tract infection(UTI) is one of the most common bacterial infections encountered in clinical practice. UTIs caused by extended-spectrum beta-lactamase (ESBL) AmpC and metallo-beta-lactamase (MBL) producing Escherichia coli (E. coli) are difficult to treat. Fosfomycin is an old antibiotic that has excellent bactericidal activity against a wide range of bacteria. This study aimed to determine the fosfomycin susceptibility of E. coli causing UTI in a tertiary care hospital in Western Maharashtra, India.\u0000\u0000Material and methods: The study was conducted at a tertiary care center in Pune, a city of Western Maharashtra, India. Urine samples from UTI cases yielding significant (> 1x 105 cfu/ml) growth of E. coli were included in study. E. coli isolates were tested for susceptibility to fosfomycin and a panel of antimicrobial agents by Kirby Bauer disc diffusion method. All the isolates were tested for production of ESBL, AmpC and MBL.\u0000\u0000Result: A total of 88 E. coli were isolated of which, 47 (53.40%) and 41 (46.59%) were from male and female patients respectively. Of the total E. coli isolates, 58 (65.9%) were from in-patient cases. Multi-drug resistance was found in 69 (78.40%) isolates and remaining 19 (21.6%) were resistant to different antimicrobials tested. All (100%) the MDR and non-MDR isolates were sensitive to fosfomycin. Highest resistance was present against nalidixic acid (93.8%) while resistance was least against nitrofurantoin (15.91%), piperacillin/tazobactam (17.1%) and meropenem (18.18%). Of the total, 35 (50.72%) isolates were both AmpC and ESBL producers while 11 (15.94%) and 8 (11.59%) were only AmpC and ESBL producers respectively. MBL was positive in 15 (21.73%) of E. coli isolates. All those isolates tested sensitive to fosfomycin.\u0000\u0000Conclusion: The study revealed that fosfomycin had excellent activity against MDR E. coli causing UTI in our area.\u0000\u0000IMC J Med Sci. 2023; 17(1): 008. DOI: https://doi.org/10.55010/imcjms.17.008\u0000\u0000*Correspondence: Dr. Sameena Khan, Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India. E-mail: sameenak27@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"131 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76692169","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":"Effect of smoking on vital hemodynamic parameters and lipid profile of young smokers","authors":"BHUPENDRA KUMAR JAIN, Ashwin Songara, U. Chandrakantham, J. Nagwanshi","doi":"10.55010/imcjms.17.007","DOIUrl":"https://doi.org/10.55010/imcjms.17.007","url":null,"abstract":"Background and objectives: Tobacco use is associated with cardiovascular, respiratory and peripheral vascular diseases. The short term effects of tobacco smoking on vital hemodynamic parameters and lipid profile of young smoker with increased quantity of smoking is still debatable. The objective of this study was to evaluate the effect of smoking on vital hemodynamic parameters and lipid profile of young smokers.\u0000\u0000Materials and methods: The current study was an observational cross sectional study conducted in a tertiary care hospital over a period of 18 months and included smokers and non-smokers. Data on vital hemodynamic parameters like blood pressure, heart rate, oxygen saturation (SPO2) and lipid profile were collected. Chi-square and analysis of variance (ANOVA) tests were used to analyze the data.\u0000\u0000Results: A total of 80 smokers and 80 non-smokers were enrolled in the study. Blood pressure, heart rate and mean SpO2 were significantly (p<0.001) lower in non-smokers compared to smokers. Breath holding time (BHT) and single breath count (SBC) were higher in non-smokers. Mean values of total cholesterol (T-chol), low density lipoprotein (LDL) and triglyceride (TG) were significantly (p<0.001) higher in smokers than non-smokers, while high density lipoprotein (HDL) was significantly low in smokers. SBP, T -chol and TG significantly (p<0.05) increased as the quantity of smoking increased.\u0000\u0000Conclusion: Smoking is associated with derangement of vital hemodynamic parameters and lipid profile across the age. Anti-smoking campaign should be organized to discourage both personal smoking and smoking in public places.\u0000\u0000IMC J Med Sci. 2023. 17(1): 007. DOI : https://doi.org/10.55010/imcjms.17.007\u0000\u0000*Correspondence: Bhupendra Kumar Jain, Department of Pulmonary Medicine, School of Chhindwara Institute Of Medical Sciences, Jabalpur Medical University, Chhindwara, Madhya Pradesh, India. Email: drbhupendrakjain@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85337883","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":"Assessment of anemia among rural children in Kaduna State, Nigeria by determining hemoglobin and serum ferritin levels","authors":"Andrew Nuhu Yasmin, Dr. Obazee, Micheal Olugbamila Dada, A. Oyewande, B. Alabi, A. Faith, I. Conteh, F. Sanni, O. Abiodun, O. Bartholomew, Tolu Adaran, Z. Gwa, O. Afelumo, Innocent Okwose","doi":"10.55010/imcjms.17.006","DOIUrl":"https://doi.org/10.55010/imcjms.17.006","url":null,"abstract":"Background and objective: Children in the developing world are vulnerable to iron deficiency (ID) and iron deficiency anemia (IDA) because they grow fast and consume diets low in iron. Thus, this study assessed anemia in children aged 6 - 12 years in rural Nigeria, using hematological indices and serum ferritin as diagnostic tools.\u0000\u0000Materials and methods: This cross-sectional study was carried out in two primary schools in Kumin Masara Kataf village in Kaduna state, Nigeria. School children aged 6 - 12 years were enrolled. Personal information and laboratory data were collected. Hemoglobin and serum ferritin concentration was estimated to determine anemia and iron status. Data analysis was done using IBM-SPSS Inc., Chicago, IL, USA, version-25.0.\u0000\u0000Results: A total of 191 school-age children aged 6 - 12 years were enrolled in the study. The overall serum ferritin was 16.51±5.20 mg/L, but the children aged 6 - 9 years had significantly (p<0.05) higher serum ferritin (17.23±5.57 mg/L), compared to children aged 10-12 years (15.62±4.62). The mean hemoglobin concentration and serum ferritin were significantly (p<0.05) more elevated among males (11.17±2.53g/dl and 19.01±5.06 mg/L, respectively) than females (10.18±2.46 g/dl and 14.03±4.02 mg/L respectively).The overall rate of anemia was 51.3%, while IDA was 70.4% (69/98). Iron deficiency was present in 47.3% (44/93) children. Also, anemia was significantly (p<0.001) more prevalent among females (66.7%), than males (35.8%), and a higher proportion of females (87.5%) than males (26.2%) were iron deficient (p<0.05), but more males (44.1%) had IDA, p<0.05.\u0000\u0000Conclusion: This study found a high prevalence of IDA and ID among rural school children in Nigeria. It is recommended that healthcare providers focus more on preventing IDA right before childhood.\u0000\u0000IMC J Med Sci. 2023. 17(1): 006. DOI: https://doi.org/10.55010/imcjms.17.006\u0000\u0000*Correspondence: Andrew Nuhu Yashim, Haematology and Blood Transfusion Department, National Hospital, Abuja, Nigeria. Email: yashimnuhuandrew@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82021387","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":"Correlation of serum magnesium with HbA1c in patients with diabetes mellitus","authors":"F. Ahmed, N. Sultana, T. Akter","doi":"10.55010/imcjms.17.005","DOIUrl":"https://doi.org/10.55010/imcjms.17.005","url":null,"abstract":"Background and objectives: Diabetes mellitus (DM) is a leading cause of death and disability world wide. Magnesium acts as a cofactor in glucose metabolism and its decreased level causes insulin resistance and many complications in diabetic patients. The present study evaluated the correlation of serum magnesium with HbA1c in DM patients.\u0000\u0000Materials and methods: This cross sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2016 to June 2017. A total number of 100 individuals with and without diabetes mellitus were included in the study. HbA1c was measured by high performance liquid chromatography and estimation of serum magnesium was done by automatic biochemistry analyzer.\u0000\u0000Results: Out of 100 enrolled participants, 50 were diagnosed patients of DM (Group-A) and 50 were age and sex matched apparently healthy individuals (Group-B). The mean age of Group-A and B individuals was 50.5 ± 6.0 and 50.4 ± 5.1 years respectively. Group-A had significantly (p < 0.001) lower serum magnesium concentration compared to Group-B (1.5 ± 0.6 mg/dl vs 2.3 ± 0.5 mg/dl). Serum magnesium levels showed significant negative correlations with HbA1c (r = -0.511, p < 0.001).\u0000\u0000Conclusion: DM patients showed significant negative correlation of serum magnesium with HbA1c level. Routine screening for serum magnesium status would be helpful for the better management of diabetic cases.\u0000\u0000IMC J Med Sci. 2023. 17(1): 005. DOI: https://doi.org/10.55010/imcjms.17.005\u0000\u0000*Correspondence: Farzana Ahmed, Department of Biochemistry, Ibrahim Medical College, 1/A Ibrahim Sarani, Shegunbagicha, Dhaka, Bangladesh. Email: tanvy1108@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"134 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79460178","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":"Grade of liver siderosis in beta-thalassaemia major patients receiving different amount of blood transfusion","authors":"S. Basak, K. Das","doi":"10.55010/imcjms.17.004","DOIUrl":"https://doi.org/10.55010/imcjms.17.004","url":null,"abstract":"Background and objectives: A progressive accumulation of body iron easily occurs as a result of long-term transfusions in patients with anaemia of genetic disorders such as thalassaemia. Iron deposit in liver biopsy sections was studied in beta-thalassaemia major patients to assess the grade of liver siderosis and to correlate the grade with amount of blood transfused.\u0000\u0000Materials and methods: Beta-thalassaemia major patients having splenomegaly and selected for splenectomy were enrolled. Liver biopsy was taken from every patient during the splenectomy. Liver tissue was sectioned and stained with Perls’ prussian blue method for the presence of iron deposition. The degree of iron deposition was expressed as grades of siderosis from 0 to 4.\u0000\u0000Results: A total of 30 beta-thalassemia patients were enrolled in the study. Out of 30 patients, 7 were males (23.3%) and 23 females (76.7%). The mean age of patients was 15.2 ± 1.4 years. The mean serum iron and ferritin levels of the study cases were above the normal range. Blood received by all patients was 51.5 ± 11.6 units (range 31 to 88 units). Out of 30 patients, grade 1, 2, 3 and 4 liver siderosis was present in 1, 3, 9 and 17 patients respectively. Serum ferritin level of patients with grade 4 siderosis was significantly higher (p = 0.03) compared to grade 3 cases. Pearson’s correlation coefficient test revealed significant positive correlation between grades of liver siderosis and amount of blood transfusion received (0.626, p < 0.01).\u0000\u0000Conclusion: Grade of liver siderosis is associated with increased units of blood transfusion and is a good indicator for transfusional iron overload in beta-thalassaemia major patients.\u0000\u0000IMC J Med Sci. 2023. 17(1): 004. DOI: https://doi.org/10.55010/imcjms.17.004\u0000\u0000*Correspondence: Dr. Souvik Basak, Department of General Surgery, Medical College, Kolkata, West Bengal, India. Email: sb009cmc@gmail.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81971033","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":"Histopathologic and clinical features of diabetic nephropathy alone and with concomitant nondiabetic renal diseases","authors":"S. M. Islam, Shamoli Yasmin, Ishtyiaque Ahmed, W. Haque","doi":"10.55010/imcjms.17.003","DOIUrl":"https://doi.org/10.55010/imcjms.17.003","url":null,"abstract":"Background and objective: Diabetic nephropathy (DN) is a major complication of diabetes mellitus (DM) and one of the leading causes of end-stage kidney disease. The aim of the present study was to evaluate the histomorphological and clinical profiles of DN and associated non-diabetic renal dieases (NDRD) in diabetic patients.\u0000\u0000Materials and methods: The study was carried out at the Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Dhaka, from July 2019 to December 2020. Renal biopsy samples from known diabetic patients were included in the study. The formalin-fixed tissues were stained with haematoxylene & eosin (H&E), Periodic acid Schiff (PAS), Masson Trichrome (MT) and Jones Methanamine Silver (JMS) stains. Tissues were stained for IgG, IgA, IgM, C3, C1q, kappa and lambda for direct immunofluorescence (DIF) study. DN was histologically classified according to Tervaert classification system. Interstitial fibrosis and tubular atrophy (IFTA) as well as arteriolar hyalinization scoring was also done. Clinical information was retrieved from the patient’s information sheet.\u0000\u0000Results: Total 46 biopsy samples from DN cases were included in the study. The mean age of the cases was 46.76+10.63 years, including 36 males and 10 females. The most common clinical presentation was nephritic range proteinuria (n=32, 69.56%). Among all, 27 (58.69%) patients had haematuria. The mean serum creatinine level was 4.28+2.61 mg/dl, and 80.43% had serum creatinine levels >1.5 mg/dl. Histopathologic examinatiom revealed type III DN in 26 (56.5%) and type IV DN in 11 (23.9%) cases. IFTA score 1 (<25%) was seen in 20 (43.5%), score 2 (25-50%) in 19 (41.3%) and score 3 (>50%) in 7 (15.2%). Vascular hyalinization score-2 in 25 (54.3%), score-1 in 14 (30.4%) and score-0 in 7 (15.2%). DN class II, III and IV were associated with high urinary total protein (UTP) and serum creatinine levels. Among the histologic changes, percentage of glomerular sclerosis, the mean IFTA score and vascular hyalinization score were found to be highest in class IV DN, and all were significantly associated with histologic glomerular DN classes (p= <0.05). Of the total cases, 21 (45.65%) were found with nondiabetic renal diseases (NDRD), the most common feature was focal segmental glomerulosclerosis (FSGS) (26.57%), followed by IgA nephropathy and post-infectious glomerulonephritis (PIGN). Among 46 cases, one post-transplant biopsy was included, which revealed class II DN along with features of calcineurin inhibitor toxicity.\u0000\u0000Conclusion: Tervaert’s histologic classification of our cases revealed class III DN lesions as the predominant one, and the classes had a significant association with age of the patient, serum creatinine level, mean IFTA, arteriolar hyalinization and NDRD. Among the NDRD, FSGS was the most common pathology.\u0000\u0000IMC J Med Sci. 2023; 17(1): 003. DOI: https://doi.org/10.55010/imcjms.17.003\u0000\u0000*Correspondence: Sk Md Jaynul Islam, Department of Histopathology, A","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82101086","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":"Do obesity, hypertension and dyslipidemia pose significant risks for coronary artery disease among Bangladeshi diabetics?","authors":"A. Banu, F. Hoque, Khan Ahsan, M. Sayeed","doi":"10.55010/imcjms.17.002","DOIUrl":"https://doi.org/10.55010/imcjms.17.002","url":null,"abstract":"Background and objectives: For decades the global population has been experiencing diabetic epidemic. The risks related to obesity, diabetes mellitus (DM) and coronary artery diseases (CAD) are well known. This study aimed to assess the prevalence of coronary artery disease (CAD) and its related risks in Bangladeshi diabetics.\u0000\u0000Materials and methods: The study was conducted at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), a largest referral center for diabetes in Bangladesh. Socio-demographic and clinical history including biochemical investigation report were collected from the BIRDEM registry. The eligible criteria of study participants were: age 30 – 60 year, having DM, non-smoker, free from retinopathy, nephropathy and neuropathy. The prevalence of CAD, systolic hypertension (SHTN) and diastolic hypertension (DHTN) in the registered diabetic patients were estimated. Additionally, the study addressed the risk and predictors of CAD among those with DM.\u0000\u0000Investigations included – anthropometry, blood pressure, blood glucose, serum lipids and electrocardiogram (ECG). CAD was diagnosed on: (a) history of angina plus positive ECG - either on rest or on stress, post-myocardial infarction (MI) with Q-wave MI or non-Q-MI or echocardiographic evidences. Lipids namely triglycerides (TG), total cholesterol (T-Chol), high density lipoproteins (HDL) and low-density lipoproteins (LDL) were estimated by Hitachi-704 auto-analyzer using enzymatic method.\u0000\u0000Results: A total of 693 (M /W =295/398) participants volunteered. The prevalence of CAD, SHTN, DHTN and mean arterial hypertension (MAH) were 18.6%, 23.2%, 13.6% and 17.7%, respectively. Their mean (±SD) values of age, body mass index (BMI - kg/m2), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and mean arterial pressure (MAP) were 47 (8.6) years, 24.6 (3.5), 0.98(0.05), 0.56(0.06) and 101(11.3) mmHg, respectively. The mean (±SD) of FBG (mmol/L), T-Chol, TG and HDL (mg/dl) were 10.2 ± 4.0, 206 ± 44, 218 ± 86 and 47.5 ± 9.3 respectively. The women had significantly higher BMI (p<0.001), WHtR (p<0.001), SBP (<0.001), MAP (p<0.001), T-Chol (p<0.001) and TG (p=0.043) than men. The risk variables were categorized into quartiles and Chi-sq trend determined whether the increasing prevalence of CAD were significant. Higher quartile of age was found consistently significant (p<0.001). Of the obesity indices, only higher quartile of WHtR was significant (p< 0.05). For BP measures, higher MAP quartiles showed the trend significant (p<0.001). Likewise, for lipids, higher quartiles of TG (p<0.001) and lower quartile of HDL (p<0.001) were significant.\u0000\u0000Finally, logistic regression estimated the risk related to CAD. The highest age-quintile (>55y: 95% CI: 1.09 - 43.7) and highest TG-quintile (281mg/dl: 95% CI: 1.45-59.7) were proved to be significant predictor of CAD and HDL highest quintile (>54mg/dl) was proved to be significant protecting factor for ","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76766804","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":"Better cardioprotection in atrial septal defect patients treated with cardiopulmonary bypass beating heart technique without the application of aortic cross clamp","authors":"F. Ganai, A. M. Dar, G. Lone, D. Afroze","doi":"10.55010/imcjms.17.001","DOIUrl":"https://doi.org/10.55010/imcjms.17.001","url":null,"abstract":"Background and objectives: Creatine phosphokinase-myocardial band fraction (CPK-MB) and cardiac troponin I (cTnI) are cardiac specific biochemical markers which are raised in myocardial ischemia. The aim of this study was to determine cardiac injury by comparing the levels of cardiac enzymes CPK-MB and cTnI in atrial septal defect (ASD) patients whose operative repair was done under cardiopulmonary bypass (CPB) using beating heart technique with and without the application of aortic cross clamp.\u0000\u0000Materials and Methods: This study was carried out in the Department of Cardiothoracic and Vascular Surgery in a Tertiary Care Hospital over a period of 2 years. A total of 60 atrial septal defect (ASD) patients were operated and repair of the defect was done under the CPB using beating heart technique. Aortic cross clamp was applied in 22 patients (Group-A) while 38 patients were operated without cross clamp (Group-B) during the procedure. Blood samples were collected 24 hours prior and 12 hours post procedure for the estimation of CPK MB and cTnI levels.\u0000\u0000Results: Mean age of the atrial septal defect patients was 23.83±10.97 years and 60% and 40% of the patients were females and children (age < 18 years) respectively. Serum CPK-MB and cTnI l levels were in the normal range in all the patients before surgery and increased significantly post procedure. Twelve hours after surgery, the mean CPK-MB and cTnI levels were significantly low in Group-B patients compared to Group-A patients (CPK-MB: 56.39±23.55 U/L vs. 34.38±15.97U/L , p= 0.0004; cTnI: 9.37±4.97 ng/ml vs. 5.92±4.17ng/ml, p = 0.009).\u0000\u0000Conclusion: Post surgery CPK-MB and cTnI levels were significantly higher in ASD patients who underwent CPB surgery with aortic cross clamp compared to those in whom aortic cross clamp was not applied. Therefore, application of aortic cross clamp during the procedure induces greater levels of ischemic injury to the heart.\u0000\u0000IMC J Med Sci. 2023; 17(1): 001. DOI: https://doi.org/10.55010/imcjms.17.001\u0000\u0000*Correspondence: Feroze Mohammad Ganai, Department of CVTS, Superspeciality Hospital, Shireen Bagh, Srinagar, Jammu and Kashmir, India. Email address: ferose999@yahoo.com","PeriodicalId":55816,"journal":{"name":"IMC Journal of Medical Science","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73532425","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}