Mymensingh medical journal : MMJ最新文献

{"title":"Potentiality of Undergraduate Medical Education System of Bangladesh to Produce Global Standard Healthcare Professionals.","authors":"M K Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Not Available.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911368","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":"Comparison of Bupivacaine plus Dexmedetomidine versus Bupivacaine plus Fentanyl for Caudal Block in Pediatric Infraumbilical Surgery.","authors":"M K K Khan, M H O Rashid, N A S Rubel, M K B Khan, I Z Sarna, M Sonaullah","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Different additives have been used to improve the duration and quality of analgesia of the local anaesthetic used in the single-dose caudal block technique, such as opioids, epinephrine, clonidine, neostigmine, etc. Dexmedetomidine is a potent and a highly selective α2-adrenergic agonist having a sympatholytic, sedative, and analgesic effect and has been described as a safe and effective additive in many anaesthetic and analgesic techniques. Another agent is Fentanyl, a lipophilic opioid, is added frequently to local anaesthetics which least likely to cause respiratory depression when given extradurally, because of its high lipid solubility. It improves and prolongs the analgesia following the addition with bupivacaine for lower abdominal or infraumbilical procedures. The study was aimed to compare the efficacy of bupivacaine with dexmedetomidine versus bupivacaine with fentanyl for caudal block in pediatric infraumbilical surgery. This experimental study was carried out in Mymensingh Medical College Hospital, Bangladesh from 12 May 2019 to 11 November 2019. Total 60 patients, classified by American Society of Anesthesiologists (ASA) physical status category I-II, listed for infraumbilical surgery under caudal block were randomized by card method in two groups of 30 patients each. Anaesthetics were given by using a standardized protocol for induction, maintenance and recovery. Group BD (n=30) patients was given 1 μg/kg dexmedetomidine with 0.5 ml/kg bupivacaine 0.25% and Group BF (n=30) was given 1 μg/kg fentanyl with 0.5 ml/kg bupivacaine 0.25% for caudal epidural analgesia. Mean age of the patients were 6.1±1.7 years and 6.3±1.2 years in BD and BF group respectively. No significant differences were found between groups with respect to age (p=0.721). Male and female ratio was 1.12:1. In group BD 19(63.3%) patients had ASA I and 11(36.7%) ASA II. In group BF 22(73.4%) of patients had ASA I and 8(26.6%) had ASA II. Baseline heart rate was 95.2 and 98.4 beat/min in group BD and BF respectively. After 15 minute heart rate was found 94.4 beat/min in group BD and 90.9 beat/min in group BF. After 30 minute heart rate was 88.7 beat/min in group BD and 85.2 beat/min in group BF. This study showed statistical comparison of postoperative mean RASS scale and CHEOPS at different time interval between three groups. The corresponding mean differences in various groups were comparable and statistically significant (p<0.05). In group BD score was better than BF and the difference of group BD vs. group BF was significant except at base line, 90 min, 120 min (p>0.05). Dexmedetomidine as an adjuvant to bupivacaine is better than fentanyl in infraumbilical surgery has longer sedation and longer postoperative analgesia. Dexmedetomidine potentiates the action of local anaesthetics without increasing the incidence of side-effects compared to fentanyl.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911309","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":"Analysis of Liver Function Tests in Dengue Infected Patients.","authors":"S Khanduker, M Mojumder, R Ahmed, A Aharama, A Khanduker, F M Monika","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dengue is a mosquito-borne infection that in recent years has become a vital disease of international public health concern. Dengue virus infections and illness when symptomatic, that patients tend to present with a significantly wide variety manifestation. The aim of the study was to gauge liver dysfunction in patients with dengue infections. To judge the impact of dengue virus infection on liver function by measuring various liver function tests in blood samples of serologically diagnosed dengue patients. This study was undertaken as an observational cross-sectional study in the period of June 2019 to October 2020. Records of 120 serologically confirmed cases of dengue infection with available biochemical liver function tests, admitted to Bangladesh Medical College Hospital, were analyzed. Patients were classified as classical dengue fever (DF) - 64.1%, dengue haemorrhagic fever (DHF) - 24.1% and dengue shock syndrome (DSS) - 11.6%. The mean age was 36.61±14.55 years. Normal values of alanine aminotransferase (ALT) had 27.0% of patients and 73.0% had values above normal. With regard to AST 12.0% patients had normal values and 88.0% of patients had values above normal. Deranged alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin and total bilirubin was present in 72.0%, 86.0%, 57.0%, 27.0% patients respectively. The mean±SE of ALT, AST, albumin and total bilirubin were 240.38±892.60 U/L, 364.43±1948.03 U/L, 33.30±4.17 gm/L and 1.26±1.14 mg/dl respectively. The mean value of AST was significantly more than ALT. The degree of rise of ALT and AST was significantly more in DHF and DSS, as compared to DF. Mean serum ALT, AST and bilirubin values were significantly higher in patients with haemorrhage as compared to those without haemorrhage and in non-survivors. Serum albumin concentration was significantly lower in DSS than DHF or DF patients. Hepatic dysfunction was quite common altogether types of dengue infection, with AST rising significantly more than ALT. While preferentially high AST may function an early indicator of dengue infection, high ALT and bilirubin and reduce albumin may act as poor prognostic markers.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"166-173"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910427","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":"Flegel's Disease A Very Rare Skin Disease: A Case Report of Mother and Daughter in a Family.","authors":"M M Mahmud, M S I Bhuiyan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Flegel's disease (FD) or hyperkeratosis lenticularis perstans (HLP) is an extremely exceptional skin disease typified by hyper-keratotic papules usually found on the lower extremities. Only the histopathological study is the confirmatory test for diagnosis this disease. The treatment of Flegel's disease is not yet settled as a standard one. Here we report two (2) cases of Flegel's disease in a family one was a 36-year-old woman, a housewife, presented with multiple mildly pruritic hyperkeratotic erythematous plaques and papules on both legs with hyperpigmented border and surrounding skin for 16 years and another one was A 20-year-old woman, daughter of case 1, student of a private university, presented with multiple moderately pruritic, hyperkeratotic, hyperpigmented discrete papules on her both middle part of legs for 6 years that was inherited as autosomal dominant manner were presented in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 2021. A very few numbers of familial FD were reported globally.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"276-279"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911330","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":"Insomnia and Associated Social Factors among Medical Support Staff during the Covid-19 Pandemic.","authors":"F Ahmed, J Ara, M Nurunnabi, F Akter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The pandemic Covid-19 not only caused great public health problems but also caused enormous distress, especially for medical staff. The cross-sectional study aimed to investigate the prevalence rate of insomnia and to confirm the social factors among medical support staff in hospitals during the Covid-19 pandemic from 1st July 2020 to December 31st 2020. This study was conducted at Dhaka Medical College and Hospital (DMCH), Kurmitola General Hospital (KGH), Kuwait Bangladesh Friendship Government Hospital and Mugda Medical College and Hospital located at Dhaka and Tungipara UHC from Tungipara, Gopalganj, Bangladesh. Medical support staff in the Dhaka division was recruited. The face-to-face interview was conducted, obtained demographic data and asked self-design questions related to the Covid-19 pandemic and insomnia. Chi-square analysis was done to examine the associations between socio-demographic factors and insomnia symptoms. There were a total of 289 participants in our study. Participants 53(19.4%) had insomnia symptoms according to the Insomnia Severity Index (ISI) (total score ≥8). The chi-square test revealed that insomnia symptoms were associated with uncertainty in effective disease control (p=0.000, OR = 3.377, 95% CI = 1.842 - 6.189), worry about getting infected (p=0.001, OR = 2.748, 95% CI = 1.457 - 5.181). This study found that nearly one-fifth of the medical support staff suffered insomnia symptoms during the Covid-19 pandemic. The related factors included uncertainty in effective disease control and worry about getting infected.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"234-242"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911338","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":"Wernicke's encephalopathy, Central Pontine Myelinolysis and Supraventricular Tachycardia in a Case of Hyperemesis Gravidarum.","authors":"M R Huq, H Kabir, M I Chowdhury, S A Sultana, R Khatun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Wernicke's encephalopathy is a potentially lethal complication of thiamine deficiency which mainly occurs in chronic alcoholic patients. It may occur in other conditions like hyperemesis gravidarum too. Pregnancy may also be complicated with other neurological and cardiac complications. Here we present a rare case of hyperemesis gravidarum in a primigravida patient with twin pregnancy having Wernicke's encephalopathy, central pontine myelinolysis and recurrent supraventricular tachycardia. This 20-year-old lady had all the classic features of Wernicke's encephalopathy like confusion, nystagmus, ophthalmoplegia and ataxia. Empirical treatment was given with parenteral thiamine. MRI of the brain was suggestive of Wernicke's encephalopathy. She had transient dysphagia. MRI of the brain also revealed central pontine myelinolysis, which was the most likely cause of this dysphagia. With treatment, her condition improved significantly, supraventricular tachycardia was also corrected. This case warrants careful monitoring and treatment of hyperemesis gravidarum patients to prevent such complications.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"280-284"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911400","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":"Understanding Abnormal Uterine Bleeding: Navigating with PALM-COEIN Classification.","authors":"S Nahar, S Aosaf, S Parveen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Not Available.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911392","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":"Variation of Neck Length on Anterior and Posterior Aspect of Femur in Bangladeshi People.","authors":"R A Shanto, R Ara, M S Latif, M T H Russel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The regional variation of the femur bone is influenced by sex, stature geographical area and heredity, as the environment plays an important role in the developmental process. This cross-sectional descriptive purposive study was done on 150 (64 right and 86 left) fully ossified dry human femur of Bangladeshi people to find out the variation of neck length on anterior and posterior aspect. Sample was collected in the Department of Anatomy, Mymensingh Medical College, Bangladesh from January 2019 to December 2019. Fractured, damaged and remodeled bones were excluded from the study. Neck length was measured with the help of digital Vernier slide calipers. The mean±SD neck length on anterior aspect of femur on right and left side was, 30.81±3.74 mm and 29.99±3.91 mm respectively. The mean±SD neck length on posterior aspect of femur on right and left side was 35.90±4.07 mm and 35.97±4.17 mm respectively. The knowledge of variations in the parameters of dry femora will help the orthopedicians and also assist prosthetists to design a suitable prosthesis. These data also provide information about neck length of femur of Bangladeshi people and to compare these data to those from various other races thus it could contribute to demographic studies of fracture neck femur, osteoarthritis, hip joint ailments probability and management in Bangladeshi population.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"200-205"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911397","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":"Acute Aortic Dissection Masquerading as Acute Coronary Syndrome: Is Echocardiogram Mandatory before Primary Percutaneous Coronary Intervention?","authors":"M A H Khandaker, J S Kumar, P Panduranga","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 58-year-old hypertensive man was admitted with severe central chest pain and palpitation. His electrocardiogram (ECG) showed fast atrial fibrillation with features suggestive of left main coronary artery occlusion. He was taken to the Cath-lab but surprisingly, coronary angiogram (CAG) showed no stenosis. Meanwhile, other labs showed high D-dimer and lactate. Hence, bedside Transthoracic echocardiography (TTE) was carried out and showed dissecting flap in the ascending aorta. Immediately, a CT (Computed Tomography) was arranged and it revealed Stanford Type-A Aortic Dissection (AD). Then urgently, he was taken for surgery but unfortunately, he died after long surgical procedure. Here, the misleading factors were that his presentation and ECG changes were so typical of acute coronary syndrome (ACS) that heading us to think about coronary artery disease (CAD). Therefore, the intriguing question: is a bedside echocardiography before shifting to Cath-lab could have given the clue for early detection of AD.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"295-299"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911410","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":"Early Postoperative Outcome of Continuous Heparin Infusion versus Intermittent Intravenous Heparin after Initial Bolus Dose during Off-Pump Coronary Artery Bypass Surgery: An Eminent Time worthy Study.","authors":"K S S Rushel, S K Shimul, M K Alamgir, M Moniruzzaman, S Choudhoury","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Heparin is an anticoagulant used invariably in all cardiac surgery. Heparin dosing and its reversal were determined by monitoring activated clotting time (ACT). Intermittent heparin dosing after initial bolus dose is widely practiced to maintain ACT level 200-300 seconds in Off-pump coronary artery bypass surgery (OPCAB). Fluctuation of ACT level from this range may cause adverse postoperative outcome. This study was aimed to compare early postoperative outcome between intermittent heparin dose and continuous heparin infusion after initial bolus dose during OPCAB. This comparative cross-sectional study was carried out in National Institute of Cardiovascular Diseases (NICVD), Bangladesh from January 2019 to December 2020. Total 110 patients were enrolled by purposive sampling and divided into 2 groups: Group A where 55 patients received intermittent heparin after initial bolus dose and Group B where 55 patients received continuous heparin infusion after initial bolus dose. Data were analyzed by statistical package for social science (SPSS) version 26.0 and p value <0.05 was considered significant. Baseline ACT level of Group A and Group B was not significant (p=0.800). After bolus dose of Heparin, ACT level of Group A and Group B was not significant (p=0.068). Mean maintenance ACT was 326.34±22.774 seconds in Group A and 258.67±12.285 seconds in Group B patient, which was significant (p<0.001). Peroperatively 29.0% from Group A and 11.0% from Group B developed arrhythmia. Platelet count significantly reduced in Group A (p<0.001). Postoperative mean Troponin I level in Group A was 5.78±1.15 and Group B was 5.32±1.05ng/dl, which is significant (p=0.030). Postoperative blood loss was significantly higher in Group A than Group B (986.36±398.31 vs. 852.73±241.22, p=0.036). There was significantly better reduction of arrhythmia and ischemia in postoperative and on discharge ECG finding in Group B patients (p=0.002). On discharge echocardiography 31.0% from Group A and 13.0% from Group B had regional wall motion abnormality, which is significant (p=0.018). But there was no significant difference in LVEF% (52.65±5.99 vs. 53.85±5.77, p=0.287). Early postoperative outcome of continuous heparin infusion is better than intermittent intravenous heparin after initial bolus dose during Off-pump coronary artery bypass surgery. So, during OPCAB use of continuous heparin infusion after bolus dose is eminent time worthy.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 1","pages":"123-128"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911315","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}