Bangladesh Medical Journal最新文献

{"title":"Obituary news January-2023","authors":"K. Halim","doi":"10.3329/bmj.v52i1.74104","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.74104","url":null,"abstract":"Abstract not available \u0000Bangladesh Med J. 2023 Jan; 52(1): 39","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141349524","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":"Diagnosis and Prognosis of Neonatal Septic Arthritis from it’s Early Clinical Characteristics: Experience from a Tertiary Care Hospital","authors":"R. M. Chowdhury, Krishna Priya Das, Md Abdul Mannan, S. Moni, Shahanara Akter","doi":"10.3329/bmj.v52i1.71043","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.71043","url":null,"abstract":"Neonatal septic arthritis (NSA) is an unusual illness, but fatal clinical condition and must be diagnosed and treated properly in order to save the neonate's joints and life. High rate of morbidity and mortality may result from NSA if left untreated. Majority of NSA cases in developing countries present themselves late at the health care facilities, making the diagnosis difficult and sometimes overlooked by health care providers. Although septic arthritis has already been investigated but cases of NSA from developing countries are under reported. The goal of the study was to better understand the clinical and microbiological characteristics of neonates with septic arthritis as well as their prognosis of treatment.  This prospective observational study was conducted in Neonatal Intensive Care Unit (NICU) of Department of Neonatology and Out Patient Department (OPD) of Orthopaedics, Banga bandhu Sheikh Mujib Medical University (BSMMU). Total 30 neonate presented with acute septic arthritis were included in this study. Data were collected by reviewing record from NICU and   disease course, investigation profiles, treatment record of neonates were noted as recorded during the time of hospital stay or attending in OPD. For the assessment of prognosis clinical and radiological findings of all cases were followed-up for 12 months of age. Collected data of neonates with septic arthritis from record review were processed and analyzed by Statistical Package for the Social Sciences (SPSS) and result of analyzed, finally data were presented as in tables and graphs. This study finds that  nearly two-third (63%) of the neonates were male and knee joint was most frequently involved, accounting more than two-third ( 67%) of all single joint involvements. All of the cases were anemic and had high C-reactive protein (CRP) level.  Joint aspirate samples culture showed that the most prevalent (41%) organism was Klebsiella, followed by Acenotobacter and Seratia. Gram-negative bacteria predominated (91%). Most of the patient (76%) had favorable prognosis after treatment. Clinical evaluation and start of intravenous antibiotics should be given priority in suspected cases. Prompt surgical intervention and consistent follow-up in a tertiary hospital are necessary for the best results.\u0000Bangladesh Med J. 2023 Jan; 52(1): 18-23","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141348707","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":"Clinicobiochemical Parameters of Cytomegalovirus IgM and IgG positive Biliary Atresia and their Relation with Serological Titer in Infants.","authors":"Sharmin Akter, K. Halim, Wahiduzzaman Mazumder, Rubayat Alam, K. Nahid, Md Rukunuzzaman","doi":"10.3329/bmj.v52i1.71044","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.71044","url":null,"abstract":"Cytomegalovirus (CMV) associated Biliary atresia (BA) is one of the clinical classification of Biliary atresia (BA). There is a hypothesis that CMV IgM positive BA is a clinically different entity and prognosis is poor. The aim of this study was to evaluate the clinical and biochemical parameters of CMV IgM and CMV IgG positive BA in one to six month old infants and their relation with serological titer. This cross-sectional study was carried out from January 2019 to June 2022 in the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. A total of 48 infants were included in this study as study subject who were diagnosed as biliary atresia with positive CMV IgM & CMV IgG. After taking written informed consents data were taken from parents or legal guardians by using a structured questionnaire. Data were analyzed by statistical package for social sciences (SPSS), version- 23.  Majority of the cases (58.3%) were in 2-4 month of age group, 70.8% were male and male-female ratio was almost 2.5:1. Regarding birth history most of the infants (95.8%) were term baby and  two-third (66.7%) of them was appropriate for gestational age (AGA). This study observed the onset of jaundice among the infants, here 60.4% of them detected jaundice jaundice within 7 days, 22.9% within 7-14 days and 16.7% after 14 days. About three fourth (73%) of infants presented with intermittent pale stool and more than one-fourth (27%) had persistent pales tool. One fourth 12(25%) patient had features of coagulopathy. The mean of total bilirubin, direct bilirubin, alanine transaminase (ALT) and gamma-glutamyl transpeptidase (GGT ) were 11.89±4.0, 8.27±3.42, 162.67±103.09 and 669.46±543.57 respectively; The mean of the titers of  CMV IgM and CMV IgG were 50.84±33.09 and  82.40±53.79  respectively. The prolong international normalised ratio (INR ) was in 30.8% of infants and mean INR was 2.44±2.54. Study finds that CMV IgM titer level was correlated with total bilirubin (r=-0.256; p<.05) and direct bilirubin (r=-0.365; p<.05); where CMV IgG titer level was correlated with age (r=-0.362; p<.05) and INR (r=0.271; p<.05). It may be concluded as increase in age would increase titer of IgG and increase in titer of IgG is associated with increase coagulopathy. Elevated levels of CMV IgM titer correlated with bilirubin level or cholestasis.\u0000Bangladesh Med J. 2023 Jan; 52(1): 12-17","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141348442","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":"Maternal Atrioventricular Nodal Re-entrant Tachycardia During Pregnancy: Case Report","authors":"Priyanka Podder, Joysree Saha","doi":"10.3329/bmj.v52i1.71042","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.71042","url":null,"abstract":"During pregnancy, the physiological changes predispose a woman for the development of new-onset or recurrent arrhythmia. Atrioventricular nodal re-entrant tachycardia (AVNRT) is a common supraventricular tachycardia (SVT) in reproductive age of woman. Although often it is benign in nature but concerning. Electrical cardioversion is safe during pregnancy. Electrophysiological study (EPS) and Radiofrequency ablation (RFA) can be performed in selected patients. Hereby, we report a case of a woman in her second trimester of pregnancy presented with diagnosed case of AVNRT. She was monitored by multidisciplinary team. Electrocardiogram (ECG) and Echocardiogram reveals normal changes. EPS and RFA was done one year back at the time of diagnosis. At her 37 weeks of pregnancy, she developed scar tenderness. Emergency caesarean section was done in presence of cardiologist. Maternal and perinatal outcome were good.\u0000Bangladesh Med J. 2023 Jan; 52(1): 35-38","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350177","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":"Drug Abuse of Professional Drivers: Experience from Referral Dope Test","authors":"Kaniz Fatema, K. Halim, Sohela Rahman, Sharmin Hamid, Keya Sarke, Arifa Akram, Ashiqur Rahman","doi":"10.3329/bmj.v52i1.71039","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.71039","url":null,"abstract":"In Bangladesh, drug abuse is one of the dangerous problems among drivers that hamper road safety and make government worry. In that context, this cross-sectional study was conducted in National Institute of Laboratory Medicine and Referral Center (NILMRC) and aims to determine the proportion of drug abuser among professional drivers in Bangladesh. This study also addressed to recognize the various types of abused drugs, the pattern and the trend of drug abusers during study period. Data were collected from online data server of NILMRC during the period of July to December 2022. Bangladesh Road Transport Authority (BRTA) customarily refers urine samples of drivers to NILMRC for dope test. Dope tests were performed in immunochromatographic test (ICT) device and semi-auto analyzer. Dope results and demographic data of drivers were well-kept-up in online server for electronic transfer and use of data. Commonly abused drugs in Bangladesh such as, cannabinoids, amphetamines, opiates, benzodiazepines and alcohol were assessed. A total of 70866 drivers had been tested for six months of study period among them 2720 (3.81%) were found dope test positive. Considering monthly trends from July to December 2022 the highest incidence were found in December where 473 (4.58%) of 10323 drivers were dope test positive; however in November 639 (4.56%) of 14,017, in September 682 (4.07%) of 16757, in October 551(3.62%) of 15221, in August 320 (3.42%) of 9348, then less incidence were found in July 55 (1.05%) of 5200 drivers had been tested positive. There was an increase number of test positive cases were detected during the period from July to December.  The highest number drug abuser that is more than two-third (70%) of drivers were found among young adult age group (25-44) years. The five types of abused drugs were tested; among those the highest proportion (91.5%) of abused drug was Cannabinoids, then Benzodiazepines was 5.5%, Amphetamine was 1.3%, Opiates was 1% and Alcohol was 0.8%. No female drivers were found test positive. Cannabinoids was the most common drug of abuse among drivers referred by BRTA, Bangladesh. During this study, there was challenge to different kind illegal means. If the illegal means could be resolute then the data of positive finding would be higher than this finding. So implementation online registration, proper identification by finger print or retinal scanning and providing online reports may minimize the illegal means.\u0000Bangladesh Med J. 2023 Jan; 52(1): 1-5","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346143","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":"Pattern of Eosinophil and Neutrophil/ Lymphocyte Ratio in Different Stages of Chronic Kidney Disease.","authors":"D. A. Ali, I. Ali, Uooja Devi, A. Arif, Nida Fatima, Fariha Aslam","doi":"10.3329/bmj.v52i1.71049","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.71049","url":null,"abstract":"Various expensive interventions are used to diagnosis the different stages of chronic kidney disease (CKD). This research is aimed to determine the pattern of eosinophil and neutrophil/ lymphocyte ratio in different stages of CKD. Data was collected in January 2023 from the patients of CKD and from their files of reports. Permission was taken from the patients. The individuals were from civil hospital Karachi and they were the patients of CKD. Sample size was 200. There was irregular pattern of eosinophil and neutrophil/lymphocyte ratio in different stages of CKD. The eosinophil count and neutrophil/ lymphocyte ratio were higher in higher stages of CKD. The eosinophil and neutrophil/ lymphocyte ratio were higher in higher stages of CKD and the pattern was irregular. Study finds that eosinophil and neutrophil/ lymphocyte ratio were higher and the pattern was irregular in higher stages of CKD.\u0000Bangladesh Med J. 2023 Jan; 52(1): 24-29","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141347497","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":"Genetic Characterization of Aspergillus flavus and Saccharomyces cerevisae in Tracheobronchial Phlegm of HIV-infected Patients on Antiretroviral Therapy in Jalingo, Nigeria","authors":"N. C. Awujo, Fyinbu Dennis Ishaku, Chrinius Hammuel","doi":"10.3329/bmj.v52i1.71045","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.71045","url":null,"abstract":"Fungal infections are among the diverse respiratory tract pathogens and account for a proportion of community acquired and nosocomial pneumonias thereby generating concerns particularly in immunocompromised patients. This study aims to genomically extract and sequence fungal DNA using the Basic Local Alignment Search Tool (BLAST) technology for their definitive and confirmatory identification thereby easing off the obstacles in their diagnosis due to similar appearance in their colony and morphology and ultimately determining their infection rates in persons receiving antiretoviral therapy against HIV. Sputa of 100 HIV infected out-patients of a Medical Centre in Jalingo, on anti-retroviral therapy were cultured on Sabouraud Dextrose Agar to isolate fungi species and assess their prevalence and distribution. Fungal colonies characterized culturally and biochemically as Aspergillus flavus and Aspergillus niger were subjected to the BLAST, and the similarities with the biological sequences in the National Center for Biotechnology Information (NCBI) database queried. There were observational variances in the colonial and microscopic appearances of A. flavus and A. niger on Sabouraud Dextrose Agar (SDA) plates and the microscope respectively. The similarities between the queried and biological sequences in the NCBI database, was almost all (99.7%) thus confirming their identity as Aspergillus flavus and Saccharomyces cerevisiae. The overall prevalence of fungi infection was 79.0%. More males (80.0%) than females (78.3%) were infected. In both sexes, fungi were most (92.9%) frequently isolated in patients that were between 30 and 39 years and least (64.7%) in those between 15 and 29 years. There was no established pattern (sex- and age- relatedness) of non-concomitant A. flavus and S. cerevisiae in fifty-seven male and female patients in six age categories even though A. flavus occurred more (48.1%) than S. cerevisae (24.1%) and the prevalence was higher (61.4%) in females than in males (38.6%). The high prevalence of these fungi in the study population, with or without symptoms of cough or fungal disease, mandates an early screening of such infected persons so as to reduce further complications and improve treatment.\u0000Bangladesh Med J. 2023 Jan; 52(1): 6-11","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141349811","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":"Thyroid Collision Tumour: Concurrence of Two Thyroid Malignancy","authors":"Muhamad Hud Muhamad Zin, Firdaus Hayati, Shahrun Niza Abdullah Suhaim, S. N. Abdullah Suhaimi, R. Muhammad, Muhammad Afiq Bin Mohamad, Suria Hayati Md Pauzi, N. Isa, Mohamed Izzad Ishak","doi":"10.3329/bmj.v52i1.71062","DOIUrl":"https://doi.org/10.3329/bmj.v52i1.71062","url":null,"abstract":"Thyroid carcinoma is the most common endocrine malignancy. However, it is exceptionally uncommon for two different thyroid malignancies to co-exist within the same thyroid gland. Herein, we present two cases where two different thyroid malignancies present as collision tumours of the thyroid gland. The hypothesis, epidemiology and management are discussed here. Case presentation: Case 1 was a 60 year-old woman presented with an accidental finding of left neck swelling. Ultrasound neck identified multinodular goitre with a suspicious left thyroid nodule. Ultrasound-guided fine-needle aspiration cytology of left thyroid nodule confirms papillary thyroid carcinoma. She underwent total thyroidectomy with central compartment neck dissection. However, histopathology reports a presence of medullary thyroid carcinoma and papillary microcarcinoma in the left thyroid gland. Case 2 was a 59 years old woman presented with left vocal cord paralysis with rapidly enlarging of a long-standing left thyroid swelling. Computed tomography identified bilateral thyroid swelling with left mass causing compression to the trachea and oesophagus. The patient subsequently underwent a total thyroidectomy bilateral central and left selective neck node dissections and left primary non-selective nerve re-innervation. A collision tumour with components of both Hurthle cell carcinoma and papillary microcarcinoma has been shown in histopathology. Collision tumours of the thyroid pose a diagnostic as well as a therapeutic challenge. They should be treated in a multidisciplinary team environment, and the care should be unique to the patient. The treatment should usually be directed by the most aggressive neoplasm.\u0000Bangladesh Med J. 2023 Jan; 52(1): 30-34","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141349103","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":"Vaccination and Pandemic Control in Bangladesh: Post Vaccination COVID-19 Positive Cases among Health Care Providers","authors":"K. Halim, Suchisree Saha, Sayda Tanjina Parvin, Sharmin Afroz, Sajib Roy, Tasnim Sanwar, Md Mahmudul Hasan Mitul, Nusrat Ahmed, Afsana Zerin Shakila, Puspita Saha, Khadija Islam Tisha, Anaya Nur Mou, Humayoun Kabir, Rezwana Tabassum, Nadiya Pasha, Akeba Munmun, Shaikh Shafiq ur Rahman, Shammi Akter, Most Sultana Afroz","doi":"10.3329/bmj.v51i3.70211","DOIUrl":"https://doi.org/10.3329/bmj.v51i3.70211","url":null,"abstract":"Vaccination was started on a trial basis in Bangladesh from 27th January, 2021 and started mass vaccination from 7th February, 2021.  Since starting of mass vaccination it was noticed that, the health care providers (HCPs) who received two doses of Astra-Zeneca were then reported of being infected. This cross-sectional study was conducted during the period of July to December 2021 and data were collected from July to August 2021. The main objective was to measure the proportion of post vaccinated Corona Virus Disease-19 (COVID-19) positive cases among healthcare providers working in different healthcare facilities in Bangladesh and aimed to collect available evidence to characterize these infections and correlations with different co-morbidities. This study was carried out among 450 vaccinated HCPs who received 2 doses of vaccine at various health care facilities (HCFs) from 32 districts of Bangladesh. Data were collected from HCPs (Doctors, Nurses, Lab technician) who willing to participate irrespective of age and sex. Among the HCPs nearly three-fourth (71.6%) was doctors, 21.3% nurses and 7.1% were lab technologists. Here, most of the (88.0%) respondents were in age group 21 to 40 years and other 22.0% was in age group 41 to 59 years. The number of Male-female respondents was equal  and 77.8% of the respondents was Muslim followed by Hinduism (20.2%), Buddhist and Christian 2.0%. Study finds that 27.6% of the respondents was post vaccination COVID-19 positive (PVC-19+) (according to their rt-PCR test result). Less than one-fifth (18.7%) of the respondents had pre-existing co-morbidities among them 8.2% was suffering from hypertension (HTN), 6.0% asthma, 4% Diabetes Mellitus (DM), 2.0% Obesity, 1.1% ischemic heart disease (IHD) and 1.1% was others co-morbidities. Among the PVC-19+ cases most of them (84.6%) were in age group 21-40 years, male-female ratio was 1:0.9 and 81.5% was Muslim. More than three-fourth (77.4%) of positive cases were doctors, 17.7% nurses and 4.8% was lab technicians; among the PVC-19+ cases 87.9% was symptomatic. Three-fourth (75%) of the positive cases had fever, 51.6% had lost of smell and taste, 49.2% showed fatigue/ or malaise, 48.4% dry cough, 43.5% headache, 26.6% runny nose, 25.8% felt muscle pain, 19.4% sore throat, 18.5% shortness of breathing, 14.5% experienced joint pain, 9.7% had productive cough and 32.3% complained for other symptoms and signs. Majority of the PVC+19+ cases (57.26%) developed complications; among them 71.8% had tiredness/ fatigue, 31% difficulty in thinking/ concentrating, 21.1% headache, 19.7% cough, 15.5% dizziness, 14.1% loss of smell or taste, 12.7% joint or muscle pain, 12.7% fast-beating or pounding heart, 11.3% shortness of breathing, 8.5% chest pain and 29.9%  developed other complications. Pre-existing co-morbidity was found in 66.94% of positive cases, among those 41.5% HTN, 36.6% asthma, 14.6% DM, 14.6% obesity, 4.9% IHD and 9.8% had others co-morbidity. Chi-square test for indep","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139390483","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":"Outcome of Early Active and Late Mobilization following Flexor Tendon Repair in Zone ΙΙ of Hand","authors":"Krishna Priya Das, R. M. Chowdhury, Mamunur Rashid, MD Moniruzzaman, Sk Murad Ahmed, Ali Noor Polas, N. K. Datta","doi":"10.3329/bmj.v51i3.70141","DOIUrl":"https://doi.org/10.3329/bmj.v51i3.70141","url":null,"abstract":"The functional outcome of flexor tendon injury after repair depends on multiple factors. Postoperative rehabilitation protocol plays an important role after a good repair for better functional outcomes. The aim of this study is to compare the outcome between early active mobilizations versus late mobilizations after flexor tendon repair in zone-II of hand. This Quasi-experimental (Nonrandomized control trial) was conducted from July 2018 to June 2021. Total 30 patients of flexor tendon injury in Zone-II of hand presented within 3 weeks were divided into two equal groups according to envelope technique, late mobilization (No intervention group) group- A and early active mobilization (Intervention group) group-B. All the flexor tendons were repaired with polypropylene 4/0 double strand score sutures and 6/0 epitendinous continuous sutures. In group-A mobilization started after 3 weeks and in group–B, intervention was given by active mobilization which was started at the day of operation. Buck Gramcko functional criteria and Louisville system were used for assessment of final result after 6 months of surgery. Male was predominant, M: F ratio was 3.3:1. Mean age of the respondent was 32.53±9.86 years. Dominant (Right) hand involvement was 70%. Student and service holder were the common involved group. Nearly three fourth (73%) of them had sharp cutting injury. More than half (53.10%) of the injuries were found in ring and little fingers followed by index (20.30%), middle (20.30%) and thumb (6.30%). Mean time interval between injury and operation was 11 days. Adhesion formation was the commonest complication that was 40% in group A and 20% in group B. More satisfactory outcome (87.50%) was found in group- B (Intervention group), that is patients who received early active mobilization; where the level of satisfactory outcome was less (62.50%) in group-A (Non-intervention group), that is patients who received late mobilization (p-value was significant <0.05). Early active mobilization following repair of flexor tendon in zone II of hand ensures better functional outcome with minimum complication compared to late mobilization.\u0000Bangladesh Med J. 2022 Sept; 51(3): 28-36","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139390541","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}