Journal of medicine最新文献

{"title":"Exploring the Bone Mineral Density of Health Professionals of Medical College by Using Calcaneal Quantitative Ultrasound","authors":"Abu Muhammad Shamsu Uddin, H. Rahman, Shangkar Barua, Mohammed Nurul Alam, Umme Salma Amin, Md Farhad Hussain, Md Ayub Ali","doi":"10.3329/jom.v24i2.67276","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67276","url":null,"abstract":"Background: Osteoporosis, an important cause of fracture in Bangladesh is a highly unrecognized and unaddressed issue among health professionals. Osteoporosis means low bone mineral density (BMD) and screening is not done routinely to diagnose it. Moreover, the prevalence of low BMD among Health professionals in the country is not well known. To prevent osteoporosis-induced fracture it demands more attention to early detection, prevention, and treatment.\u0000Objectives: The present study was carried out to assess the bone mineral status of health professionals of Cox’s Bazar medical college and also to find out the correlation with age, sex, Vitamin D, calcium supplementation, and physical activity by using quantitative ultrasound (QUS) of the calcaneus. Materials and Method: This is a descriptive, cross-sectional study that has been done at Cox’s Bazar Medical College.\u0000Result: The total number of participants was 267 which were screened by using a calcaneal ultrasound heel bone densitometer. Among them 190 were female and 77 were male. The majority of the health professionals 237(88.76%) were below 45 years. Mostly, 194(72.66%) participants had normal BMD, 73(27.34%) participants were in osteopenia and none of them were osteoporotic. Among those above 45 years old study people, nearly half 14(46.67%) were osteopenic, and for ages below 45 years of health professionals, only 59(24.89%) were osteopenic. Out of 77 male participants, 15(19.48%) were osteopenic and out of 190 female participants, 58(30.53%) were osteopenic. Out of the total 267 study people, 81(30.34%) agreed to take calcium and vitamin-D supplementation with significant p-value = 0.003 whereas 32(39.51%) participants were in the osteopenic stage and 49(60.49%) had healthy bony status. The number of using Calcium and vitamin-D supplementation was high, which may be due to positive answers from particular participants like the elderly and health care supporting staff. In our study 120(44.94%) participants did exercise but mostly irregularly, and 147(55.06%) did not do exercise. Out of 120(44.94%) participants doing regular exercise 37(30.83%) were osteopenic and the rest of 83 (69.17%) health professionals were in normal BMD.\u0000Conclusion: Among the health care professionals, osteopenia is not uncommon and regular exercise practice and rational Calcium and vitamin-D supplementation may be preventive for osteoporosis.\u0000J MEDICINE 2023; 24(2): 131-134","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48521439","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":"Thyroiditis- A Challenging Case Report that Used PET-CT for Definitive Diagnosis in a Non-COVID Patient During COVID-19 Pandemicc","authors":"R. Sethuraman, I. Venkatraman, S. P","doi":"10.3329/jom.v24i2.67279","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67279","url":null,"abstract":"A whole-body PET scan coupled with contrast-enhanced CT was performed on a 45-year-old woman with persistent fever for 3 weeks. This was performed to make a definitive diagnosis in a few hours as an out-patient itself to avoid admission / frequent visits to the hospital during the COVID-19 pandemic for this non-COVID patient. Although step-wise investigations such as ultrasound, thyroid antibodies, and biopsy would be ideal and devoid of radiation, other co-existing causes for fever if any (malignancy, other non-infectious causes) might have been missed. Therefore, in addition to confirming the clinical diagnosis (Thyroiditis), whole-body PET-CT helped to rule out other causes of fever of 3-week duration. Therefore, we wish to highlight the unique approach that we adopted here due to the restrictions on admissions during the pandemic for this non-COVID patient.\u0000J MEDICINE 2023; 24(2): 152-154","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49474521","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":"Internal Medicine as a Specialty","authors":"Md. Abul Faiz","doi":"10.3329/jom.v24i2.67267","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67267","url":null,"abstract":"Abstract not available\u0000J MEDICINE 2023; 24(2): 69-70","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42828211","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 Consanguineous Marriages in UAE Nationals and the Risk of Genetic Diseases","authors":"G. Khan, Ghada Al Hammadi, Ayah Ziyada, Khulood Al Waeel, Lara Ayman, Eiman Shams Elddin Elgailani","doi":"10.3329/jom.v24i2.67269","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67269","url":null,"abstract":"Introduction: The occurrence of consanguineous marriages has been common in the Arab populations due to socio-cultural factors. Genetic diseases are rare in the overall population, but their frequency unusually increases as the prevalence of consanguineous marriages increases. The aim of our pilot study was to investigate the extent of consanguinity and its effects on non-communicable genetic diseases, in Emirati population.\u0000Methodology: This research was based on a socio-economic survey (SES) conducted by a group of students of Dubai Pharmacy College for Girls in the year 2018. Subjects for this preliminary study were selected by using convenience sampling method from urban regions of United Arab Emirates local households. A questionnaire was designed for this purpose and data was collected during household visits.\u0000Results: Our study showed that the incidence of consanguinity is relatively high with a rate of about 65% approximately and 33% of all these consanguineous marriages are of the first cousin and closer marriage type. Our results states that consanguineous marriages have a negative effect on reproductive health factors and in turn posing a risk for occurrence of noncommunicable genetic diseases, congenital malformations, and various chronic and complex multifactorial diseases in Emirati Arab population.\u0000Discussion: Genetic counselling and premarital counselling must be accentuated to reduce the risk of genetic syndromes in the population.\u0000J MEDICINE 2023; 24(2): 82-88","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47958187","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":"Autosomal Recessive Congenital Icthyosis with Cataract – A Case Report from Pakistan","authors":"N. Fatima, A. Arif, Sharmeen Nasir, Fariha Aslam","doi":"10.3329/jom.v24i2.67280","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67280","url":null,"abstract":"The ichthyoses are a diverse group of disorders with variable clinical presentations. There are syndromic and non-syndromic forms with multiple associated features. The association of autosomal recessive congenital icthyosis (ARCI) with cataract is a rare phenomenon and no such case has been reported in recent literature. We hereby report the case of a 5-year-old female patient, a product of consanguineous marriage, who presented to the pediatric department of Dr. Ruth K.M Pfau Civil Hospital Karachi, Pakistan, with the complaint of rough skin with scaling and peeling over the entire body since birth due to congenital icthyosis. Shefurther developed complaints of reduced vision which later was diagnosed as cataract. Her previous two siblings had similar illness and they expired. Widespread scaling is the defining feature of ichthyosis specifically when it comes to ARCI it manifests at birth and can later progress to any spectra of illness. A multidisciplinary approach is required for the management of such patient.\u0000J MEDICINE 2023; 24(2): 155-157","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46350664","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":"Implementation of Ecological Distribution of Venomous Snakes for Clinical Management of Snakebite in Bangladesh","authors":"Ibrahim Khalil Al Haidar, A. Ghose, M. Noman, Md. Mizanur Rahman, S. Rudra, Abdul Auawal, M. Islam, Md. Asir Uddin, Rabiul Alam Md Erfan Uddin, A. A. Sayeed, M. Amin, Md. Farid Ahsan, Md. Abul Faiz, Mohammad Abdul Wahed Chowdhury","doi":"10.3329/jom.v24i2.67278","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67278","url":null,"abstract":"Background: Snakebite envenoming is a global health problem, mostly in tropical and subtropical countries. Bangladesh is a subtropical country facing thousands of snakebite envenoming death every year. Knowledge of the distribution of venomous snakes is necessary to identify snakebite-prone areas, develop strategies for prevention and management, and reduce venom-induced mortalities and morbidities.\u0000Methods: An integrated effort of direct observations of snakes, qualitative analysis of museum specimen records, clinical records of snakebites, and scholarly literature records were used to understand the pattern of distribution of venomous snakes in Bangladesh.\u0000Results: We enlist 65 venomous snake species from Bangladesh and present detailed documentation on their distribution pattern. However, only nine species were considered medically relevant species because of their venom potentiality to kill humans and available clinical records of envenomation. The distribution pattern of those species divides the country into two major portions. A portion consists of northern, northwestern, and western parts of the country, which are habitats of Naja naja, Bungarus caeruleus, and B. lividus. Another portion comprised of the northeastern, southeastern, and southern parts of the country provides habitats for N. kaouthia, B. niger, and Trimeresurus erythrurus. However, Daboia. russelii had a different distribution pattern along the bank of the Padma and Meghna, and some coastal districts. Moreover, B. walli had a scattered distribution over the country. The knowledge of this ecological distribution of venomous snakes across the country bears a significant practical effect on clinical management of snakebite. Treating physicians can have a better understanding of possible offending snake species using this knowledge and the clinical syndromes produced by venoms.\u0000Conclusion: Pattern of distribution of medically relevant venomous snakes in Bangladesh approaches to initiate concise and specific bite management strategies for two distinct distributional regions of the country. Moreover, the distribution of D. russelii and B. walli demands specific strategies for bite management.\u0000J MEDICINE 2023; 24(2): 139-151","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44851716","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 Young Lady with Quadriparesis","authors":"A. Siddiqua, R. Quddus, Homayra Tahseen, Sharmin Akter","doi":"10.3329/jom.v24i2.67281","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67281","url":null,"abstract":"Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disease, causing multifocal CNS inflammation affecting the optic nerves & spinal cord. In the 20th century, ‘Devics disease’ was considered as a variant of Multiple sclerosis(MS) that spared the brain. However, the discovery of IgG-class antibodies that bind to the water channel aquaporin-4 (AQP4-IgG) in serum from patients with Devic’s disease, but not from those with typical MS, established NMO as a distinct entity with a chronic, relapsing course. Our patient, a 42-year-old woman has been suffering from vomiting for 2 months followed by inability to move all extremities for last 7 days. It was the very 1st episode of such type of illness. We are reporting this case to highlight the presentation of NMOSD, which is itself a rare disease, outcropped as ‘Area postrema syndrome’, an inaugural manifestation in this patient.\u0000J MEDICINE 2023; 24(2): 158-161","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41466363","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":"Development and Validation of a Machine Learning System for Analysis and Radiological Diagnosis of Digital Chest X-ray Images","authors":"M. Khanom, Aseef Iqbal, A. Hoque, F. Jeenia, Muslim Uddin","doi":"10.3329/jom.v24i2.67273","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67273","url":null,"abstract":"Introduction: Medicine is identified as one of the most promising field of application for Artificial Intelligence (AI). The current research presents development and validation of a machine learning system to diagnose chest x-ray images with higher accuracy.\u0000Methodology: It was a multi-cantered, experimental study conducted from 01 July, 2021 to 30 June, 2022. The experiment was a two-step process; in the first step, a machine learning system (MLS) was developed through training, testing and tuning a specialised computer hardware & software utilising 5600 chest X ray images from NIH (National Institute of Health) chest X ray dataset. In the second step, 500 unseen chest X ray images from study centres were allowed to be diagnosed by the machine learning system and results were compared with expert opinions.\u0000Result: After the system was developed, validation was done on 3 different variations of Deep Residual Network and tested for their accuracy in classifying the findings. Using ResNet50V2, an average accuracy of 84.37%% was achieved. With case-specific variation, highest accuracy was 94.84%, highest specificity was 97.23% and highest sensitivity was 88.25%.\u0000Conclusion: With utilisation of this machine learning system, a faster radiological diagnosis of huge number of X ray images will become possible using only a small computer. Dependency on manpower, logistic support as well as rate of human-made errors can be minimised. However, this machine is never meant to replace an expert human opinion and it can never think beyond the box.\u0000J MEDICINE 2023; 24(2): 112-118","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48341111","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":"Proton Pump Inhibitors Usage Among Discharged Patients in a Tertiary Care Hospital- An Observational Study","authors":"Akhlak Ahmed, Benojeer Akter, Md. Mahmudun Naby, Md Romanur Rahman, Syed Zakir Hossain","doi":"10.3329/jom.v24i2.67275","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67275","url":null,"abstract":"Background: Proton pump inhibitors (PPI) have reportedly been used in inappropriate clinical settings, often leading to an increased risk of adverse effects, drug interactions, and costs. Aim: The aim of this study was to evaluate the appropriateness of PPI prescription on discharge of patients in medicine ward of a tertiary care hospital in Bangladesh.\u0000Methods: A cross-sectional study was done for 3 months in the department of medicine in a tertiary care hospital to evaluate the indications of PPI use, appropriateness of PPI use and types of PPI prescribed. A total of 107 patients who were prescribed PPI on discharge were enrolled after written informed consent and data were collected in a structured questionnaire.\u0000Results: Among the 107 patients discharged, 64 were males and 43 were females. The mean age was 51.3 ±17.6 (SD) years.Among the study population, 49 were appropriately prescribed PPI and 58 were inappropriately prescribed PPI. Regarding indications, 53.1% received PPI for prevention of anti-platelet induced gastric erosion and 18.9% were prescribed PPI for no apparent reason. Age (p=0.199) and gender (p=0.605) was not significantly associated with the appropriate prescription of PPI.Of the various preparations of PPI prescribed, esomeprazole was prescribed in most of the discharged patients (56%).\u0000Conclusion: this study demonstrates the existence of an over-prescription of PPI. PPI prescription needs to be improved, thereby reducing drug interactions, adverse effects and unnecessary economical expenses.\u0000J MEDICINE 2023; 24(2): 125-130","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49589960","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":"Bronchoscopic Assessment of Radiologically Detected Lung Lesion","authors":"Monjurul Kader Chowdhury, Palas Biswas, P. Sarker, Md Saidur Rahman, Tanzina Begum Chowdhury, Md Masudur Rahman, Khan Abul Kalam Azad","doi":"10.3329/jom.v24i2.67272","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67272","url":null,"abstract":"Background: Radiologically detected lung lesions are very common in regular clinical practice. It is very important to diagnose radiologically detected lung lesions early. Flexible fiber-optic bronchoscopy is an excellent minimally invasive and safe investigation for early diagnosis of lung diseases.\u0000Methods: Data were collected using a semi-structured questionnaire from the patients who had lesion on chest x-ray that were not in the peripheral part and advised for bronchoscopy. Patients were followed up after getting their histopathology. Statistical analysis using SPSS16.0 was carried out thereafter.\u0000Results: Mean age of the respondents was 56.8 years with age ranging from 25 to 85 years. 82% of the patients were male. Male-female ratio was 4.5:1. Endobronchial growth was found in maximum 46% patients during bronchoscopy, followed by 22% showing inflammatory lesion. In 20% of the patients, bronchoscopy findings showed normal findings and 12% patients showed inconclusive results. In subsequent biopsy and histopathology, maximum 55.88% showed non-neoplastic lesion. Among the non-neoplastic lesions 26.47% showed non-specific inflammation.20.58% showed tuberculosis, 5.88% showed sarcoidosis and 2.94% showed aspergilloma. 35.29% cases showed neoplastic lesion, 2.94% showed inconclusive results, 2.94% showed normal results and 2.94% showed inadequate sample. 58.33% cases were squamous cell carcinoma, 25% cases were adenocarcinoma, 8.33% showed small cell carcinoma and 8.33% showed mixed cell type of carcinoma.\u0000Conclusion: Fiberoptic bronchoscopy can be successfully employed for the diagnosis of lung diseases, including malignancies and granulomatous lesions.It is extremely useful in finding specific etiologies of various lung diseases.\u0000J MEDICINE 2023; 24(2): 106-111","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48329784","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}