Koch's Abdomen- Successful Management of Abdominal Cocoon with Jejunostomy and Second Line Antitubercular Drugs
Dr. Saurabh Tiwari, Dr. Shahaji Deshmukh, Dr. Vishesh Dikshit, Dr. Abhaya Gupta, Dr. Paras Kothari
Sch J App Med Sci | 1643-1645
DOI : 10.36347/sjams.2020.v08i07.001
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Abdominal tuberculosis (ATB) in children poses a diagnostic challenge because of its nonspecific clinical features, often delaying the diagnosis. The annual incidence of tuberculosis (TB) is nearly 10.1 million, including around 1 million children [1]. It is estimated that worldwide, 239 000 children younger than 15 years die from TB in a year [2]. TB being endemic in India accounts for about a quarter of the global TB cases, the highest in the world [3]. We hereby report a case of intestinal obstruction in a 6 month old child secondary to abdominal koch’s. The child underwent jejunostomy for severe bowel adhesions, frozen pelvis and cocoon formation. Histopathology of omentum and mesenteric lymphnodes confirmed it to be abdominal tuberculosis. With parenteral nutrition and injectable antitubercular drugs(second line) for 7 weeks before stoma closure and 2 weeks later patient could be managed successfully and discharged on oral ATT(Anti tubercular treatment).We could successfully manage abdominal tuberculosis with jejunostomy(high output fistula) with second line injectable ATT and total parenteral nutrition.
Does the Inadequate Health Resources Aggravate Covid-19 Pandemic?
Jayadevan CM
Sch J App Med Sci | 1646-1650
DOI : 10.36347/sjams.2020.v08i07.002
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Inadequate health resources to tackle affected patients can aggravate Covid-19 pandemic. There were 8.92 million Covid-19 cases, 0.47 million Covid-19 deaths and 4.74 million recovered Covid-19 cases in the world as on June 21, 2020. Using a sample data of 117 countries until June 17, 2020, this study verifies and finds the support for the hypothesis that those inadequate health resources worsens Covid-19 pandemic.
Original Research Article
July 4, 2020
The Ascitic Fluid Fibronectin Level to Differentiate Malignant From Nonmalignant Ascites
Dr. Mohammad Nurul Islam Khan, Dr. Nooruddin Ahmad, Dr. Md. Abdul Kader Zilani, Dr. Priobrata Karmakar, Dr. Sushanta Kumar Barman, Dr. Md. Mostofa Alam
Sch J App Med Sci | 1651-1655
DOI : 10.36347/sjams.2020.v08i07.003
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Objective: In this study our main goal is to evaluate the ascitic fluid fibronectin level to differentiate malignant from nonmalignant ascites. Method: This observational, cross sectional type study conducted in Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka from September 2014 to February 2017. During the study period of total 60 patients (30 patients with malignant ascites and 30 patients with nonmalignant ascites) were enrolled for the study. Results: Mean ascetic fluid fibronectin was found 0.50±0.15µg/ml in malignant ascites group and 0.22±0.07µg/ml in nonmalignant ascites group. Mean ascitic fluid fibronectin was found 0.64±0.11 µg/ml in positive for malignant cell group and 0.45±0.17 µg/ml in negative for malignant cell group. The mean difference was not statistically significant (p>0.05) between two groups. Sensitivity of cut off value of ascitic fluid fibronectin ≥0.22 µg/ml was 82.86%, specificity 96.0%, accuracy 88.33%, positive and negative predictive values were 96.67% and 80.0% respectively. Conclusion: The present study revealed on the usefulness of fibronectin in the differential diagnosis of ascites and these data and findings suggest that fibronectin may have potential value to differentiate malignant from nonmalignant ascites.
Original Research Article
July 4, 2020
Changes of HRQoL in Patients of Pulmonary TB at Different Phases of Category-1 Anti-tubercular Chemotherapy
Dr. Md. Nazmul Hasan, Dr. Mohammed Mostanshir Billah, Dr. Md. Abdur Rahim, Dr. Imtiaz Ahmed, Dr. Md. Tariq Hasan
Sch J App Med Sci | 1656-1660
DOI : 10.36347/sjams.2020.v08i07.004
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Background: Tuberculosis (TB) is the second common cause of death worldwide. Bangladesh is one of the high prevalent regions for tuberculosis. Tuberculosis significantly affects the quality of life of a patient. It not only affects the physical health but also alters the other domains like psychological aspect of health. Objective: In this study our main goal is to find out changes of HRQoL in patients of pulmonary TB at different phases of category-1 anti-tubercular treatment. Method: This cross-sectional study was conducted in Department of Internal Medicine, BSMMU, Dhaka from September, 2015 to September, 2016. About 61, respondents were included in the study. The HRQoL is assessed by SF-36 questionnaire which is already validated in Bengali beforehand. Results: Among 61patients, the average age of PTB patients mean (±SD) was (31±11.4) with a male preponderance. The improvement of HRQoL was significant (p<0.001) and continued till the end of treatment after six months. Comparison of the scores in patient before starting treatment and after the initial phase (first 2 months) of treatment shows significant improvement in all health domains (p<0.001). Also, there is a significant difference of HRQoL score between pulmonary tuberculosis patient at two months of treatment and completion of anti-tubercular chemotherapy (p<0.001). Conclusion: This study observed that HRQoL improves significantly with DOTS-based anti-tubercular treatment. Therefore, quality of life in addition to chemotherapy should be taken into account in case of tuberculosis treatment.
Original Research Article
July 8, 2020
Isolation and Identification of Bacteria from Petroleum Polluted Soil in Auta Balefi, Nasarawa State
Olukeye OO, Ajobiewe HF, Ajobiewe JO, Ogundeji AA, Umeji LC
Sch J App Med Sci | 1661-1666
DOI : 10.36347/sjams.2020.v08i07.005
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This research work is aimed at highlighting the proportional differences in the number of organisms isolated from the various Petroleum product pollution sites. Engine oil and diesel are both petroleum products used in daily activities. These activities may lead to the pollution of the soil due to accidental spills. The pollution sites chosen for the research (two mechanic workshops, a diesel dispensing site and a diesel generator surrounding) were grossly polluted and therefore ideal for the research. From the pollution sites, Pseudomonas spp. Bacillus spp. Micrococcus spp., Staphylococcus spp., Aerococcus spp. were identified after macroscopic, microscopic and biochemical characteristics were analysed. The ability of the organisms to grow on agar containing the pollutants suggested their ability to degrade engine oil and diesel oil by using them as a carbon source. These bacteria therefor have the potential to be used for the breakdown of pollutants in bioremediation. Statistical analysis showed that there was no significant proportion in the number of bacteria present in the different pollution sites (P > 0.05).
Original Research Article
July 8, 2020
Prevalence of Klebsiella pneumoniae Infection in Adults Attending National Hospital, Abuja, Nigeria
Yabwa KG, Ajobiewe HF, Ajobiewe JO, Ogundeji AA, Umeji LC
Sch J App Med Sci | 1667-1672
DOI : 10.36347/sjams.2020.v08i07.006
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This study was aimed at determining the prevalence of Klebsiella pneumoniae infection in adults attending National Hospital, Abuja. A semi structured questionnaire for socio-demographic information was administered after obtaining patients’ informed consent. A prevalence rate of 21.0% was recorded for this study, with the highest prevalence of 30.9% recorded among the female group, while the male group recorded the prevalence of 8.9%, (P>0.05). In terms of age, prevalence rates, increased with increase in age of adults (P<0.05). Prevalence of the Klebsiella pneumoniae infection varied with educational qualification of adults, with those who had no formal education recording the highest prevalence of infection (42.9%). There was also a significant association between educational qualification and prevalence of infection (P<0.05). Those who had knowledge of respiratory tract infections recorded lower prevalence of infection (14.0%) and this was significant (P<0.05). Those who had a form of respiratory infection however, recorded higher prevalence of the infection (25.9%) and risk factors of living in crowded areas were statistically not significant in this study (P>0.05). Those who had a history of Pneumonia had a higher prevalence of infection, but this was not significant (P>0.05). There was also a significant difference between prevalence of Klebsiella pneumoniae infection and exposure to cold (P<0.05). A relatively high prevalence of the infection was recorded in this study, which justifies the need for more awareness of klebsiella pneumoniae infection.
Original Research Article
July 8, 2020
Estimation of Stature from the Length of Index Finger (2DL) and Ring Finger (4DL) in Nepalese Adults
Abhishek Karn, Shivendra Jha, Amshu Pradhan, Bishal Joshi
Sch J App Med Sci | 1673-1678
DOI : 10.36347/sjams.2020.v08i07.007
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Establishing the identity of an individual in cases of mass disasters or when dismembered body parts are found is one of the significant Forensic investigations. Stature is a very important factor helping identity establishment in all cases of identification. With the aim to help cases of forensic identification, this study attempts to estimate the stature of an adult Nepalese from the length of index finger (2DL) and the ring finger (4DL). The study was carried out on a randomly selected cross sectional sample of 250 adult Nepalese students of third and fourth year MBBS and BDS studying in Universal College of Medical Sciences Teaching Hospital (UCMSTH), Bhairahawa, Nepal. Stature, left and right 2DL and 4DL were measured and statistically analyzed. Pearson’s correlation coefficient was computed and Simple Linear Regression equations were derived to estimate stature from left and right 2DL and 4DL. The mean stature (171.06 cm) of males exceeds the mean stature (160.67 cm) of females. The Pearson correlation was higher between left and right 2DL and stature in males (Left 2DL r = 0.7 and Right 2DL r = 0.64) whereas it was higher between left and right 4DL in females (Left 4DL r = 0.8 and Right 4DL r = 0.8). Linear regression equations were derived for estimating stature in males and females from their left and right 2DL and 4DL. Scatter diagrams were plotted to see the association between the variables. Stature and body parts ratio being a population specific trait, we formulated simple linear regression equations to ascertain stature from 2DL and 4DL in Nepalese population.
Bilateral Mediastinal Bronchogenic Cysts – A Case Report
Nanda Patil, Parneet Kaur, Supriya Karmakar, Snigdha Vartak
Sch J App Med Sci | 1679-1681
DOI : 10.36347/sjams.2020.v08i07.008
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Bronchogenic cyst is one of the broncho-pulmonary anomaly which is very rare. These cysts are mostly situated in the mediastinum near the carina and rarely within the lung parenchyma, pleura or diaphragm. Most are found incidentally and symptoms are related to compression of the trachea, bronchi or esophagus. We report a rare case of bilateral mediastinal bronchogenic cysts in a 19 weeks male abortus.
Original Research Article
July 9, 2020
“Functional Outcome of the Results of Locking Compression Plate for the Treatment of Non-United Humeral Shaft Fracture Augmented with Autogenouscancellous Bone Graft: A Study in Pabna Medical College Hospital, Pabna, Bangladesh”
Md. Masudur Rahman, Md. Mohiuddin Aslam
Sch J App Med Sci | 1682-1688
DOI : 10.36347/sjams.2020.v08i07.009
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Introduction: A fracture bone usually heals by the formation of new bone at the fracture site. Occasionally, only fibrous tissue is formed, when this happens both surgeon & patient are disappointed. The bone is a specialized form of connective tissue may account for its ability to heal by the formation of new bone. The humerus is a long bone connecting two important joints of upper limb- which has wide range of movement having very little bony stability in shoulder joint and distal elbow joint which is a uni axial hinge joint. Objective: To find out the Functional Outcome Of The Results Of Locking Compression Plate For The Treatment Of Non-United Humeral Shaft Fracture Augmented With Autogenouscancellous Bone Graft. Materials & Methods: This prospective study of "treatment of nonunion of humeral shaft fracture by locking plate and screws augmented with autogenouscancellous bone grafting" was carried out during the period of 1st December 2014 to 31th May 2016 at Pabna Medical College, Pabna, Bangladesh. Sample size will be calculated by using following statistics = 384. Purposive sampling (non-randomized) according to availability of the patients and strictly considering the inclusion and exclusion criteria. Data will be collected with a pre-tested structured questionnaire containing history, clinical examination, laboratory investigations, pre-operative, per-operative, postoperative follow up findings and complications. Observations and Results: This prospective study of treatment of nonunion of humeral shaft fracture by locking plate and screws augmented with autogenouscancellous bone grafting was carried out in 16 patients to find out the common cause of fracture, age and sex incidence and to propose a protocol for treating such cases. Sixteen patients were included in the study group and they were divided into 4-groups. The mean age was 38.19 with a standard deviation mean (±SD) 0.04 years. The age ranged from 28 to 60 years and the maximum number was ...........
Original Research Article
July 12, 2020
Side Effects of Sodium Valproate among Children with Epilepsy under 2 Years of Age
Farhana Afroj, Narayan Saha, Bithi Debnath, Md. Ahsanul Islam, Debabrata Roy, ASM Selim
Sch J App Med Sci | 1689-1695
DOI : 10.36347/sjams.2020.v08i07.010
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Introduction: Sodium valproate is proposed for addition to the Model List of Essential Medicines, for use in the management of epilepsy in children. This is an effective in treating many seizure types, like generalized tonic clonic seizure, myoclonic seizure, absence seizure, in other epilepsy syndrome like infantile spasm, Landau-Kleffner syndrome (LKS) etc. Aim of the study: The aim of this study was to observe the side effects caused by sodium valproate in children below 2 years of age. Methodology: This observational cross sectional study was conducted in the Paediatric Neurology patient, department of National Institute of Neurosciences and Hospital (NINS), Sher-e-Bangla Nagar, Dhaka, Bangladesh, during September 2015 to February 2016. Fifty children under 2 years of age with epilepsy were enrolled in this study. Enrollment was done as per inclusion criteria and after informed verbal consent from the mother or the attendant. Detail history was taken about demographic factors which include children’s age, age of onset of seizure, height, weight. Data were collected in a pre-designed questionnaire. The data was processed and analyzed by the application of SPSS version 17. Results: Out of total studied respondents the male patients were 54% and female were 46%. Maximum 46% patients were diagnosed with epilepsy between 6-12 months, Out of total studied patients the maximum 44% started sodium valproate ages between 7-12 months. Among the total studied patients 40% toke 26-30mg/kg/day sodium valproate as their treatment regime. Total 16% had anaemia among the studied patients, whereas for the rest 84% patients no other symptoms were found during their general examination. Among the total studied patients, the most dominating side effect of the patients was vomiting which resulted 1/5th (20%) of the all side effects. The side effects of both hair loss and loss of appetite shows the same result of 10% for each whereas, only 4% and 2% had abdominal pain and ............
Original Research Article
July 12, 2020
Health Factors Associated with Antenatal Care among Women in Rural Bangladesh
Fakhria Alam, Gulnar Begum, Md. Alauddin
Sch J App Med Sci | 1696-1700
DOI : 10.36347/sjams.2020.v08i07.011
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Introduction: One of the MDG5 tactical goals is to improve access to prenatal and postpartum programs that effectively reduce the morbidities associated with postpartum maternal health. Proper antenatal care is a very few of the pillars of Harmless Motherhood Initiatives, an international effort thrown by the World Health Organization (WHO) and other cooperating agencies in 1987 intended to lessen the quantity of deaths related to pregnancy and childbirth. Aim of the Study: the aim of this study is to identify the factors associated with antenatal care among women in rural area. Material & Methods: This is a cross sectional study conducted in the department of Obstetrics & Gynecology of 250 bedded General Hospital, Jamalpur, Bangladesh during the period from January 2018 to December 2018. A total number of 174 ever-married reproductive aged women with at least one child were selected for this study. In this study the method of direct interview was used for data collection. Attention was given to record factual and true statement made by the respondents. The fieldwork was commenced on from 1st November 2016 and was completed 10th February 2018. Results: Age range of the study participants were from 16 to below 40 years, where almost half of the respondents (44.82%) were aged 20-24 years, 10.91% were aged <=19 years and only 8.04% are aged <40 years. The socio-demographic characteristics of the study participants shows, majority (60.92%) were aged between 16-19 years at the time of their marriage, and 39.65% of the total participants were aged between 18-20 years at their first delivery; 72.41% have one child; 82.76% of the total participants were from rural area and the rest 17.24% were from urban area. Of the total patient 87.94% have currently used contraceptive and 74.13% have previously used contraceptive; majority (33.9%) had been on oral pill, 32.18% were using condoms, and 25.31% had no adopted methods; no. of antenatal visits shows that, 82.7% ...............
Original Research Article
July 14, 2020
The Sociodemographic Status of Biliary Tract Carcinoma Patients Getting Chemotherapy in a Day Care Center of Tertiary Care Hospital of Bangladesh
Dr. Md. Nazmul Hasan, Dr. Md. Tariq Hasan, Dr. Md. Abdullah – Al – Maruf, Dr. Mohammed Mostanshir Billah, Dr. Imtiaz Ahmed, Dr. Mohammad Jahan Shams, Dr. Md. Zillur Rahman Bhuiyan
Sch J App Med Sci | 1701-1705
DOI : 10.36347/sjams.2020.v08i07.012
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Back ground: Biliary tract cancers refer to as group of cancers that arise from epithelial lining of the gall bladder and bile ducts peri-hilar and extra hepatic biliary tree and peri-ampullary tumors. Though biliary tract cancer is a rare entity. Objective: In this study our main goal is to evaluate the sociodemographic status of biliary tract carcinoma patients. Method: This cross-sectional study was conducted in Department of Oncology Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and National Institute of Cancer Research and Hospital, Dhaka from January 2018 to June 2019. 78patients with advanced biliary tract carcinoma (Stage IV), attending the out-Patient department were selected as sample where 39 patients received - Oral Capecitabine plus injectable Cisplatin (Arm-A) and 39 patients received injection Gemcitabine plus Cisplatin (Arm-B). Purposive sampling was done and data were analyzed by SSPS 21. Results: In this study, the majority of the patients were in the 50 to 59 years age groups in both the arms, range from 37 -70 years. Most of the patients were in the group 2 in both the arms. It was 51.29% and 56.41% in arm A & B respectively. 53.85% and 43.59% patients from Arm A and B had the primary tumor in the Gall Bladder respectively. 35.89% and 43.58% patients from Arm A and B respectively had the primary tumor in the Cholangiocarcinoma (CCA). On the other hand, 10.26% and 12.83% patients from Arm A and B had the primary tumor in the Periampullary Carcinoma respectively. Most of the patients (66.66% in Arm A and 66.66% in Arm B) had liver metastasis. Conclusion: In conclusion we can say that, this study demonstrated that, biliary tract cancers are a highly aggressive human malignancy that is difficult to diagnose. Most of the cases site of metastasis increase gradually which compare from similar studies in the literature.
Original Research Article
July 14, 2020
Outcome of Syed’s Modified Pubo-Vaginal Fascial Rectus Sling Surgery in The Treatment of Female Urinary Incontinence - A Single Centre Experience
Dr. Syed Sajjad Nazir, Dr. Shahnawaz Rasool, Dr. Javid A Magray, Dr. Shabir A Mir, Dr. Fuad S Baqal, Dr. Omar S Akhter, Dr. Tanveer I Dar, Dr. Saleem Javid
Sch J App Med Sci | 1706-1711
DOI : 10.36347/sjams.2020.v08i07.013
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Objective: We Modified the technique of pubo-vaginal fascial rectus sling to make it minimally invasive, less expensive and reduce the incidence of post operative urinary dysfunction. Material and Methods: This study was conducted over a period of ten years on 147 patients who were operated from Jan 2003 to Jan 2013, and followed till Jan 2020. Female patients with age range from 25–65yrs, having SUI were included in the study. Apart from the standard operative procedure of PVS, we have developed a modification in which once the prolene threads are passed above from the vaginal wound, they are not tied together as per the standard procedure but a Hemolok clip (10mm) was used bilaterally to secure the thread over the rectus sheath. Results: Operation was performed in general as well as in regional block. Mean operative time was 45 min with average blood loss of 100 ml. Average Sling length was 10cm with a width of 2cms. Hemolok clips (10mm) were used at both ends over the rectus sheath after appropriate tension. Hospital stay was 2.4 days. Minor Complications occur in 17 pts (11.5%). Till Jan 2020, 131pts (89.11%) are voiding well & have no leakage or retention, while rest of the patients 16 (10.88%) are lost to follow up after 3 years. Conclusion: Syed’s Modified Pubovaginal fascial rectus sling is a highly successful strategy for the management of Female urinary incontinence with a low rate of postoperative voiding dysfunction with good long term functional & cosmetic results.
Clinical Approach to “I am Forgetting” in Older People
Dr. Anand P. Ambali, Dr. Pranay Kumar R. P
Sch J App Med Sci | 1712-1715
DOI : 10.36347/sjams.2020.v08i07.014
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The older people suddenly become aware about their memory when they fail to recognise their relatives or forget where they have placed common items like keys. But after few minutes or hours they remember, this is part of normal ageing. The older person when forgets and does not remember what he has forgotten is a more serious issue and these moments of forgetfulness are noticed by family members over period of time and they too ignore thinking it as part of ageing! The older people consult the physician saying my “memory is weak” or “I am forgetting”. This is a tricky situation for the clinician and family members. A detailed analysis is required only if red flag signs are present. A brief test like “Three item recall test” can be done and depending upon the result, the older people can be rest assured that their memory is good. Some older people hide their memory problems fearing that they will be diagnosed having serious disorders due to which they will be isolated. A psychological disorder like depression is the main cause for loss of memory which is pseudo loss and also mimics dementia, which needs to be remembered. All older person presenting with memory issues should be screened for depression using a suitable scale. The memory loss that occurs over period of time usually suggests organic and chronic disease. While sudden onset of memory loss is seen in a condition called Delirium which needs immediate hospitalisation and evaluation. An attempt is done by the authors here for the benefit of students of medicine, sociology and nursing in approaching an older person when they say “I am forgetting”.
Original Research Article
July 18, 2020
Evaluate the Effectiveness of Serum Magnesium Level in Patients with Newly Diagnosed Acute Leukemia
Dr. Md. Abdul Kader Zilani, Dr. Jannatul Ferdous, Dr. Mohammad Nurul Islam Khan, Dr. Masuda Begum, Dr. Sushanta Kumar Barman, Dr. Showrab Biswas
Sch J App Med Sci | 1716-1721
DOI : 10.36347/sjams.2020.v08i07.015
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Background: Acute leukaemia is a clonal malignant disorder affecting all age groups. It is characterized by the accumulation of immature blast cells in the bone marrow. This results in bone marrow failure, reflected by peripheral blood cytopenias and circulating blast cells. In most cases the etiology is not obvious, but internal and external factors associated with damage to DNA can predispose to acute leukaemia. Objective: In this study our main goal is to evaluate the effectiveness of serum magnesium level in patients with newly diagnosed acute leukemia. Method: This Observational cross-sectional study was done at Department of Haematology, BSMMU, Dhaka from September 2016 to August 2017. During the study period of total 85 patients were enrolled for the study. Results: Most of the patient’s age was found 36.17(±19.15) years, majority age group was found 10-40 years of age which was (62.4%). Regarding gender 55% were found male and 45% were found female and educational status 45(54.12%) were primary level, 21(24.71%) were SSC, 5(5.88%) were HSC and 07(8.24%). Majority (60%) of the patients were found married. Majority 59% of the patients came from poor class socioeconomic status followed by 40% were came from middle class socioeconomic status. Regarding occupational status 33(38.82%) were house wife, 10(11.76%) were day laborer, 12(14.12%) were farmer and 19(22.35%) was student. Regarding acute leukemia majority 60(70.6%) were found AML and 25(29.4%) ALL. Conclusion: From our result we can conclude that, significantly lower serum magnesium level was found in newly diagnosed acute leukemia patients. Among them significantly lower in ALL patients than AML patients. Half of the acute leukemia patients were found hypomagnesaemia.
Original Research Article
July 18, 2020
Epidemiology and Clinical Characteristics of Patients with Glaucoma in a Hospital Based Population in Central India
Dr. Sonalee Mittal, Dr. Dinesh Mittal
Sch J App Med Sci | 1722-1728
DOI : 10.36347/sjams.2020.v08i07.016
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Purpose: To assess Demographic and Clinical Characteristics of Glaucoma patients in 1345 patients seen at Drishti The Vision Eye Hospital between January 2018 to December 2019. Materials and Methods: Medical charts of patients with Primary Open‑Angle Glaucoma (POAG), Primary Angle Closure Glaucoma (PACG), and Secondary Glaucoma (SG) were reviewed. The main outcome measures of patients with Glaucoma included Basic Demographic Data (Age at Presentation, Gender, and Residence), Clinical Characteristics (Vision, Intraocular Pressure, Fundus Photographs and Visual Fields), and Previous History (Diabetes Mellitus, Injury, Hypertension, Cardiovascular Disease, Smoking, and use of Alcohol). Results: Data from 1345 Glaucoma patients were reviewed, of which POAG, PACG and SG patients accounted for 40% (538 patients) and 44% (592 patients) and16% (215 patients) respectively. Female Gender, Age, Cardiovascular Disease, and Hypertension were associated with PACG. POAG was related to Family History, Myopia and Age. There was Positive Correlation between SG and history of Injury and Diabetes Mellitus. In the Secondary Glaucoma Subgroup, 33 subjects had Aphakia,23 had Pseudophakia, 51 Corneo Iridic Scar, 27 had Uveitic Glaucoma, 33 eyes had Post Traumatic Glaucoma and 35 eyes had Neovascular Glaucoma,15 eyes Secondary to uncontrolled Diabetes Mellitus and 17 eyes Secondary to untreated Ischaemic CRVO and 8 eyes had long history of use of Steroids. Conclusion: PACG and POAG are almost prevalent equally in this part of country. We recommend Applanation Tonometry, Gonioscopy, Disc Evaluation, and Perimetry should be incorporated in the Detection Protocol for Glaucoma.
Original Research Article
July 20, 2020
Socio-Demographic Pattern of Patients Suffering from Extra Pulmonary Tuberculosis
Dr. Imtiaz Ahmed, Dr. Sadia Sabah, Dr. Mohammad Abdus Sattar Sarker, Dr. Mohammed Mostanshir Billah, Dr. Md. Tariq Hasan, Dr. ABM Abdullah
Sch J App Med Sci | 1729-1733
DOI : 10.36347/sjams.2020.v08i07.017
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Objective: In this study our main goal is to evaluate the demographic pattern of patients suffering from extra pulmonary tuberculosis. Method: This cross-sectional descriptive type study was carried out at Medicine departments of Sir Salimullah Medical College & Mitford Hospital, Dhaka from 19th December 2016 to 18th June 2017. A total 100 patients were included in the study where detailed history was taken then thorough clinical examinations. Results: More than fifty percent (56.0%) of the patients were in the age group 20-40 years and 30.0% of the patients were in age group 20 and below while only 14.0% of the patients were in the age group above 40 years. Also, male and female ratio of the patients was almost equal. Majority of the patient’s had the history of contact with TB patients. Majority of the patient’s had normal chest x-ray findings (60.0%) while 26.0% of the patient’s had homogenous opacity in chest x-ray findings and 2.0% and 4.0% of the patient’s had cavity lesion and fibrosis respectively, in chest x-ray findings. Conclusion: Our study concludes that majority of the tuberculosis patients are within the economically productive age group ranged between 20-40 years. Females are the majority of the patients with extra pulmonary tuberculosis. Based on this results TB control programme might usefully target young and female populations for early diagnosis to decrease tuberculosis morbidity and mortality.
Original Research Article
July 21, 2020
High Resolution Computed Tomography (HRCT) Assessment of Suspected COVID-19 Patients -----A Study of 51 Patients
Dr. Md Ubaidul Islam, Dr. Yeasir Ahmed Masum, Dr. Laila Rubaiat, Dr. Sudipta Gope, Dr. M.N. Rubaia Islam Bony, Dr. Justin Clump, Dr. Mousumi Anuradha Sangma
Sch J App Med Sci | 1734-1740
DOI : 10.36347/sjams.2020.v08i07.018
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Objective: To investigate High resolution computed tomography (HRCT) features of patients with suspected COVID 19 in Moulvibazar district, Bangladesh and to evaluate the diagnostic value of HRCT and reverse transcriptase polymerase chain reaction (RT PCR) for COVID 19 pneumonia. Methods: This retrospective study included all patients with COVID 19 pneumonia suspicion, who were examined by both HRCT and RT PCR at initial presentation. The sensitivities of both tests were then compared. For patients with a final confirmed diagnosis, clinical and laboratory data, in addition to HRCT imaging findings were evaluated. Results: Total of 21 cases was finally diagnosed with COVID-19 pneumonia among 51 suspected patients. Twenty patients had abnormal HRCT findings at presentation, and only one patient had a normal thoracic HRCT. Using RT-PCR, 19 cases showed positivity, with 2 cases initially missed. Amongst the missed cases, patients had a positive result in the second RT-PCR test (after 2 and 4 days) Therefore, sensitivity of HRCT examinations was 95.45 % at presentation, whereas first round RT-PCR sensitivity was 86.36 %. Conclusion: COVID 19 manifest with chest HRCT imaging abnormalities even in asymptomatic patients. RT PCR may produce initial false negative results. We suggest that patients with typical HRCT findings with negative RT PCR results should be isolated, and RT PCR should be repeated to avoid misdiagnosis.
Original Research Article
July 21, 2020
Distress and Glycemic Control in Patients with Diabetes Mellitus with Co-Morbid Depression
Dr. Malika Jindal, Dr. Geet Bagri, Dr. Navkiran S. Mahajan
Sch J App Med Sci | 1741-1745
DOI : 10.36347/sjams.2020.v08i07.019
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Background: Co-occurrence of Diabetes Mellitus and Depressive Disorder has become a major health concern in today’s world. Several studies have looked into correlation of Diabetes Distress and Depression with the glycemic control but there are very few longitudinal studies and findings are also inconsistent. Aim: To assess Diabetic Distress and Glycemic control in patients with Diabetes Mellitus. Material and methods: The clinical study was conducted on 100 patients. 50 patients with Diabetes Mellitus and Depression in case group and 50 patients with Diabetes Mellitus in control group were included. Diabetes Distress was assessed by 17-item Diabetes Distress Scale. Glycemic control was assessed by routine HbA1C investigations. Depressive Disorder was assessed by 21- item Hamilton rating scale for Depressive symptoms and severity. Patients were assessed at baseline and 6 months. Results: Poor glycemic control was associated with higher Diabetes Distress (especially emotional burden and regimen related Distress) among both the groups at baseline and 6 months (p-value<0.005). Improvement in the glycemic control in both the groups was associated with the reduction in Diabetes Distress (p-value=0.000). There was no significant difference between the Diabetes Distress score among the two groups. There was no significant relationship between the glycemic control with HAM-D score at baseline but there was improvement in HAM-D score with improvement in the glycemic control (p-value=0.016). Conclusions: Better glycemic control improves the Diabetes Distress as well as HAM-D score.
Original Research Article
July 21, 2020
A Study on Quality of Life and Cognitive Impairment in Hepatitis C Positive Patients Receiving Interferon Therapy
Dr. Karanjot Kaur, Dr. Anuj Sharma, Dr. Ranjive Mahajan
Sch J App Med Sci | 1746-1754
DOI : 10.36347/sjams.2020.v08i07.020
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Background: An association between hepatitis C virus infection and neuropsychiatric symptoms has been proposed for some years. These symptoms include affective & behavioral components that are sometimes not easily distinguished from each other. Chronic infection with hepatitis C virus (HCV) has a profound effect on health-related quality of life- with fatigue, depression and neurocognitive deficits among the most common complaints. Aim: To study of Quality of life and cognitive impairment in Hepatitis C positive patients receiving Interferon Therapy. Material and methods: The clinical study was conducted on 60 patients with chronic Hepatitis C infection. The patients were drawn from Gastroenterology Deptt. (OPD & indoor) and patients referred to Psychiatry Department for assessment. There were divided into two groups (A & B). Group A included cases who were hepatitis C +ve and were on Interferon therapy Group B included controls who were Hepatitis C +ve and not on Interferon therapy. Cognitive assessment and QOL was assessed by using socio demographic profile, cognitive functioning scale and quality of life questionnaire. Results: In hepatitis C patients on Peg- IFN therapy (Group A) , cognitive functioning was highly significantly impaired from baseline to 12 weeks as compared to patients not on Peg -IFN therapy (Group B) (P =0.001). Also , in Group A , there was highly significant worsening in physical as well as psychological component of QOL questionnaire from baseline to 12 weeks as compared to Group B ( P = 0.000). Conclusions: There is a significant impairment in cognitive functions and quality of life in Hepatitis C patients on Peg-interferon therapy.
Original Research Article
July 21, 2020
Role of Dexmedetomidine as Preemptive Analgesic on Postoperative Pain Following Open Abdominal Hysterectomy under General Anaesthesia: A Placebo Controlled Study
Dr. Syed Ariful Islam, Dr. Md. Saydur Rahman, Dr. MD. Imrul Islam, Dr. A. K. M. Faizul Hoque , Dr. Mohammad Shamsul Arefin, Dr. Md. Jobayer Hossain, Dr. Mohinee Begum, Prof. AKM Akhtaruzzaman, Prof. M
Sch J App Med Sci | 1755-1763
DOI : 10.36347/sjams.2020.v08i07.021
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Background: Abdominal hysterectomy is a common and major surgery associated with moderate to severe pain. Various short and long term complications may occur if the pain is treated inadequately. Different drugs and interventions are currently being practiced for adequate pain management. Among them, preemptive analgesia was adopted with the aim to reduce the dose of opioid by preventing central sensitization. Thereby, avoiding dose related side effects despite providing adequate analgesia. The dexmedetomidine, a highly potent 2 agonist with several perioperative beneficial properties, was investigated for its status as preemptive analgesic. Objective: The present study was designed to evaluate the role of preemptive dexmedetomidine on postoperative analgesia following open abdominal hysterectomy under general anaesthesia. Methods: Forty ASA I and II, aged more than 18 years patients, undergoing open abdominal hysterectomy were allocated into 2 equal groups (n=20 in each group) by a computer-generated randomization table. Group A and B received equal volumetric (0.25ml/kg) dexmedetomidine and normal saline respectively, 20 minutes prior to induction of general anaesthesia. VAS and PCA morphine consumption, heart rate, mean arterial pressure and capillary oxygen saturation was recorded at defined postoperative time points and adverse effects were noted. Results: The total amount of postoperative morphine requirement after 24 hours was 30.98±1.15 mg in group A and 32.15±2.16 mg in Group B (p value=0.039) which is significantly higher in group B. The group A had significantly lower VAS score in both the resting (P= 0.001, 0.001, 0.019, 0.010and 0.042) and movement state (P = 0.001, 0.006, 0.007, 0.029 and 0.035) for time points of 1st, 2nd, 6th, 12th and 24th hours post-operatively, compared to the group A. Furthermore, we observed, there was significant obtundation of HR and MAP, evoked by intubation and extubation in group A. Similar response was seen just...........
Original Research Article
July 21, 2020
An Evaluation of the Quality of Life in Patients with Knee Osteoarthritis: Adhunik Sadar Hospital, Chapinawabgonj, Bangladesh
Dr. Md. Abdus Sobhan, Dr. Mohammad Mostafizur Rahman
Sch J App Med Sci | 1764-1766
DOI : 10.36347/sjams.2020.v08i07.022
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Osteoarthritis (OA) is the most common form of arthritis. Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine. A cross-sectional descriptive study was conducted to evaluate quality of life in knee OA patients who came to treat in the dept of orthopaedics, Adhunik Sadar hospital, Chapainawabganj, Bangladesh during the period from January 2018 to December 2018. All the data were obtained from direct interview to the patients after getting informed written consent from them. A total of 51 patients were included. The majority of knee OA patients was women (64.7%), age more than 60 years (41.2%), and body mass index (BMI) 18.5-23.5 kg/m2, grade 2 of Kellgren-Lawrence grading system of knee OA (54.9%), and had no history of knee trauma (92.2%). Majority of patients did not experience any problem in 5 dimensions of EQ-5D-3L including mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Some problems mostly appeared in pain/discomfort (76.5%) and mobility (31.4%) dimensions. In this study most of patients did not experience problems in all dimensions. Hence, it showed a good Quality of life in knee OA patients. More attention, proper management, and modification of modifiable risk factors can give positive impact on knee OA patients.
Acute Esophageal Necrosis: About A New Clinical Case
S. Roudi, M. A. Lkousse, J. Rizkou, F.Aboutarik, A. AitErrami, S. Oubaha, Z. Samlani, K. Krati
Sch J App Med Sci | 1767-1769
DOI : 10.36347/sjams.2020.v08i07.023
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Acute esophageal necrosis is a rare condition. The diagnosis is easily made by an upper digestive endoscopy which shows a black esophagus appearance. The etiology is not clearly established but seems to be multifactorial. The treatment of acute necrotizing esophagitis is primarily medical. We report a case of acute necrotizing esophagitis revealed by upper gastrointestinal bleeding.
Original Research Article
July 24, 2020
“Relation between Per-Operative and Post-Operative Tranfusion of Fresh Frozen Plasma and Post-Operative Blood Loss in the Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass”
Md. Zanzibul Tareq, Abu Jafar Md. Tareq Morshed, Md. Mustafizur Rahman, Md. Rezwanul Hoque, Debasish Das, Md. Noor E Elahi Mozumder
Sch J App Med Sci | 1770-1778
DOI : 10.36347/sjams.2020.v08i07.024
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Introduction: Post-operative blood loss remains a major problem after cardiopulmonary bypass. The increased bleeding tendency after cardiac surgery using cardiopulmonary bypass is a complex result of multiple hemostatic defect including coagulation factor deficiency, inadequate neutralization of heparin, increased fibrinolytic activity & platelet deficiency in quantity & quality. In this study effect of Fresh Frozen plasma on post-operative blood loss was evaluated. Objective: To evaluate the relation between post-operative blood loss and transfusion of fresh frozen plasma of the patient undergoing cardiac surgery with cardiopulmonary bypass. Materials and Methods: This comparative cross sectional study was carried out at the department of cardiac surgery in BSMMU hospital. The study population was 60, with each group having 30 patients. Grouping of patients were done with respect to transfusion of fresh frozen plasma (group a patients who were received FFP and whole blood & group B: patients who were received whole blood only). Demographic, pre-operative and post-operative data were analyzed statistically to establish the hypothesis. There was significant difference in age, cross clamp time, total bypass time between two groups. Results: Total sixty (60) patients who underwent cardiac surgery with cardiopulmonary bypass were included in this study as per the inclusion and exclusion criteria. Patients were grouped into group A and B on the basis of per-operative & post-operative transfusion. Patient in group A received FFP & blood whereas patients in group B received whole blood only. Surgical procedure and ICU care were adopted on standard hospital protocol. Among the study population mean age in group A was 27.43±7.53 years and in group B was 32.37±7.54 years. The difference in age between two groups was statistically significant (p<0.05). There was no statistical significance of gender between the two study groups (p>0.05). The mean BMI in group A was...........
Multiple Intracranial Meningiomas - A Case Report
Nanda Patil, Purva Mayekar, Nitesh Nasre
Sch J App Med Sci | 1779-1781
DOI : 10.36347/sjams.2020.v08i07.025
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Meningiomas are benign tumors, accounting for 13- 20% of all primary central nervous systems tumors. Multiple meningiomas are rare and the term is used for more than one meningioma occurring in several intracranial locations without signs of neurofibromatosis. The prognosis of multiple intracranial meningiomas is similar to benign solitary meningioma. We present a rare case of multiple intracranial meningiomas in a 45 years old female patient.
Sister Marie-Joseph's Nodule in an Ovarian Adenocarcinoma: A Case Report
Aboutarik Fatima Ezzahra, Rizkou Jihane, Roudi Safae, Ait Errami Adil, Samlani Zouhour, Krati Khadija, Oubaha Sofia
Sch J App Med Sci | 1782-1784
DOI : 10.36347/sjams.2020.v08i07.026
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Sister Mary Joseph's nodule (SMJN) is a metastatic umbilical tumor. It is a very rare condition, with a poor prognosis; however, it can be the first sign of intra-abdominal cancer, most commonly an adenocarcinoma metastasis from a gastrointestinal or gynecologic primary malignancy. We report a case of umbilical skin metastasis (or Sister Marie-Joseph's nodule) revealing bilateral ovarian adenocarcinoma in a 61-year-old patient. And through this case we emphasize on the delayed diagnosis associated with this tumor.
Original Research Article
July 28, 2020
To Study the Pattern of Drug Resistance in Microbiologically Confirmed Cases of Tuberculosis and Risk Factors Associated with Drug Resistance
Dr. Naveen Pandhi, Dr. Ritu Dadra, Dr. Balbir Malhotra, Dr. P. Prasanth
Sch J App Med Sci | 1785-1788
DOI : 10.36347/sjams.2020.v08i07.027
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This is an observational prospective study, which included 200 microbiologically confirmed cases of tuberculosis (TB) which came to outpatient department or got admitted in the wards. Clinico-diagnostic profile of these cases was determined. The collected data were documented, compiled, tabulated and statistically analysed to reach a valid conclusion. Out of 200 microbiologically confirmed cases of TB, 25% of the cases were in the age group of 21-30 years, 147 (73.5%) were drug susceptible (DS) and 53 (26.5%) were drug resistant (DR). Amongst DR-TB cases, 21 (18.7%) were new and 32 (36.4%) were previously treated cases. Rifampicin mono-resistance was higher in both new (47.6%) and previously treated (37.5%) drug resistance cases. The majority of the patients with DR-TB had previous history of ATT i.e., (p value <0.5). Risk factors associated with DR-TB are female gender and previous history of Anti-tubercular therapy (ATT) (p value <.05).
Original Research Article
July 28, 2020
Perception and Behaviour Related to Non Communicable Diseases among Dhaka City Dwellers: A Qualitative Study
Colonel Md Rezaur Rahman, Lieutenant Colonel Md Abdul Wahab, Lieutenant Colonel Md Fakhrul Alam, Dr. Israt Jahan
Sch J App Med Sci | 1789-1793
DOI : 10.36347/sjams.2020.v08i07.028
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Bangladesh's growing burden of Non-Communicable Diseases (NCDs) is attributable to increasing urbanization and coinciding behavioral shifts together with a dietary shift. This study aims to examine the views and expectations of respondents in an urban slum population of Dhaka on NCDs and dietary improvements. A general understanding of the conduct related to NCDs among residents in the slum community has been employed with qualitative methods. Three men and three women, from diverse cultures, performed core informant interviews to emphasize on problems that were found in the interviews. Four major themes emerged: i) financial hardship influencing health ii) urbanized dietary habits iii) tobacco and sweetened tea as foundations of daily existence iv) A health-conscious action using local tools. One significant result was that the respondents viewed deprivation as one of the main triggers of NCDs, along with general economic development. A remarkable finding was that the poor were perceived to be one of the main causes by NCDs even with general economic improvement. This study explains how urban slum residents in Dhaka viewed their everyday activities in relation to NCD's and diet as shifting from rural to urbanized lifestyles. Our study has found that expectations and attitudes of NCDs are negative as well as encouragetive, and may lead to the optimal implementation of NCD preventive and health promotion services.
Original Research Article
July 29, 2020
“Types of Bile Duct Injury and their Management Outcome- A Cross-Sectional Descriptive Study”
Md. Atikur Rahman, Zulfiqur Rahman Khan, Bidhan C. Das, Malay Kumar Saha, Mohammad Nizamul Hossain Sowdagar
Sch J App Med Sci | 1794-1801
DOI : 10.36347/sjams.2020.v08i07.029
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Background: Bile duct injury is severe and potentially life threatening complication of cholecystectomy. It ruins the patient physically, mentally, socially and financially. The incidence of bile duct injury is alarming in our country. Management of such patients needs to be explained. Aims: To identify the types of bile duct injury and their subsequent management plan in our perspective. Methods: The study was carried out at Department of Hepatobiliary and Pancreatic surgery, BSMMU, BIRDEM, DMCH & other specialized hospital in Dhaka, Bangladesh. Patient with bile duct injury that occurred in local hospitals following cholecystectomy and subsequent admission in the department of Hepatobilliary and pancreatic surgery; BSMMU, BIRDEM and DMCH, Dhaka, Bangladesh during the period January 2014 to July 2018. A total of 70 patients diagnosed as bile duct injury were included in the study. Bile duct injury that occurs during liver or pancreases surgery or accident was excluded. Data were collected using a predesigned data collection sheet and analyzed using computer software SPSS (Statistical Package for Social Sciences) version 22. Results: Young and female patients suffer more 44(62.9%) than male. Occurrence was common during laparoscopic cholecystectomy 42(60%). Most of bile duct injury occur when cholecystectomy done on acute condition of gall bladder 59(84.3%). Most of bile duct injury patient came to specialized center after several week of injury with billiary stricture 54 (77.14%) with jaundice, some patients presented with abdominal pain 48(68.6%), abdominal distension 18(25.7), biliary peritonitis 16(22.9) and biliary fistula 14(20%). Patients with bile duct injury were evaluated by USG, liver function test, ERCP and MRCP. Maximum BDI patients were Bismath Type II 32(45.7%) and Bismath Type III 18(25.7%). Most of these patients were managed by Roux-eny hepaticojejunostomy 41(59%) alone, some patients were managed by ERCP stenting 4(5.7%) but when patients.........
