Original Research Article
Sept. 4, 2020
IgA Nephropathies in Children: Epidemiological, Clinical, Histological and Evolutionary Profile: About 31 Cases
Dr. Khairoun Chaimae, Pr. Ait ouamar Hassan, Dr. Najat Oulahyan, Pr. Bentahila Abdelali
Sch J App Med Sci | 1969-1981
DOI : 10.36347/sjams.2020.v08i09.001
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IgA nephropathy is one of the most common primary glomerulonephritis in children. It is characterized by the presence in the PBR of mesangial deposits of type A immunoglobulins. We report the clinical, biological, histopathological, therapeutic presentation and the evolution, through a retrospective study comprising 31 cases collected in the pediatric IV department of the children's hospital in Rabat from 2007 to 2017. 31 cases have nephropathy in IgA, predominantly male. The average age of our patients at diagnosis was 10 years. Berger's disease was confirmed in 64% of cases, rheumatoid purpura in 30% of cases and 02 cases of secondary IgA nephropathy. Nephrotic proteinuria was present in 80% of cases, associated with hematuria (65%). Hypertension was present in 48% of patients while 32% of cases presented with acute renal failure. Lesions observed by light microscopy were according to the Oxford classification: M1 (61%), E1 (38%), S1 (41%), T1 + T2 (22%), C1 (22%). All the patients were put on corticosteroid therapy, associated with the immunosuppressant in 02 cases. The outcome was favorable for 93% of the patients and two patients progressed to CRF.
Acute Radial Nerve Palsy Due to the Puncture Trauma of the Arm: A Case Report
Ghannam Abdelaziz, Fekhaoui Mohammed Reda, Moncef Boufettal, Bassir Reda Allah, Kharmaz Mohammed, Lamrani Moulay Omar, Berrada Mohammed Saleh
Sch J App Med Sci | 1982-1984
DOI : 10.36347/sjams.2020.v08i09.002
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Traumatic injury to peripheral nerves are common. In the upper limb, the radial nerve is the most commonly injured, followed by the ulnar and median nerves. The advent of microsurgery has revolutionized the management of these lesions, unfortunately functional outcomes remain mediocre. We report an atypical case of a 32-year-old man with a puncture wound of the left arm caused by a glass injury. Surgical exploration found a total section of the radial nerve repaired by direct suturing. Radial nerve injury may be due to physical open or closed trauma, infection or a tumoral compression. It’s exceptionally during penetrating wounds because of his deep location. All Radial nerve palsies associated with open wounds should be explored surgically and primary nerve repair provides excellent results ranging between 78 and 90 percent. Initial clinical evaluation is important and all penetrating trauma need a surgical exploration: a puncture wound can be enough to damage a nerve, tendon, artery.
Original Research Article
Sept. 9, 2020
Anthropometric Measurement of Hand Length, Hand Breadth and Length of Middle Finger and Their Correlation with Stature in J&K Population
Dr. Mudasir Ahmad Khan, Prof (Dr.) Sunanda Raina
Sch J App Med Sci | 1985-1993
DOI : 10.36347/sjams.2020.v08i09.003
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Introduction: Stature is considered as one of the important parameters for personal identification. So, stature reconstruction is important as it provides forensic anthropological estimation of the height of a person in the living state which plays a vital role in the identification of individual remains. Aim: The aim of the present study was to investigate the association of hand length, hand breadth and length of middle finger with height and to show if height could be predicted using these measurements. Methodology: The present study was conducted on a sample of 200 medical students (100 males and 100 females) within the age group of 18-25 years from Government Medical College, Jammu and Indira Gandhi Dental College, Jammu. Results: It was observed that in males the length parameters show greater correlation than the breadth parameters and the highest correlation is shown by the Right Hand Length in males and Left Hand Length in females and lowest correlation is shown by Left Hand Breadth in males and Right Hand Breadth in females. Linear as well as multiple regression equations were also derived from each parameter studied to determine stature from them separately. Conclusion: It is concluded that dimensions of hand provides good reliability in estimation of stature. The highest correlation coefficient between stature and right hand length in males and left hand length in case of females, with lowest standard error of estimate, indicates that comparatively hand length provides highest reliability and accuracy in estimating stature in both males and females. By deriving the population specific linear and multiple regression equations, we can determine the height of a person reliably from the dimensions of hand, provided that the person belongs to the Jammu and Kashmir region.
Chornic Back Pain Secondary to Brucella Spondylitis
Dr. Mohamad Al Farouh, Dr. Sulaiman Madad
Sch J App Med Sci | 1994-1997
DOI : 10.36347/sjams.2020.v08i09.004
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Common zoonosis and the bacterial genus Brucella it causes a systemic, infectious disease called Brucellosis it is a big health problem in many places such as Latin America the Mediterranean sea region, and Middle East. It may involve tissues and multiple organs. Involvement of Osteoarticular is a complication of brucellosis most frequent, in which is difficult since in a clinical presentation the diagnosis of brucellar spondylitis. In this article we study a case of spondylitis cussed by a brucella in a 24-year old female.
Original Research Article
Sept. 9, 2020
Efficacy of Ultrasonography Guided PRP on Chronic Insertional Tendinitis of Achilles tendon
Abdul Haque, Sheik Md. Abdullah Rafi
Sch J App Med Sci | 1998-2002
DOI : 10.36347/sjams.2020.v08i09.005
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Background: Chronic insertional tendinitis of Achilles tendon is a common condition that can be challenging to treat. There are many modalities used as treatment ranging from physiotherapy, injections, shockwave therapy to surgical intervention. Platelet Rich Plasma (PRP) has increased in popularity recently as a treatment option for Achilles Tendinopathy. It contains growth factors that might accelerate healing and speed up the recovery of this condition. Aim of the study: The aim of this study was to evaluate the efficacy of ultrasonography guided PRP on chronic insertional tendinitis of Achilles tendon. Methods: This prospective observational study was conducted in Cumilla Trauma Center, Cumilla, Bangladesh during the period from January 2018 to July 2019. In total 52 patients with chronic insertional tendinitis of Achilles tendon selected and completed the full tenure of ultrasonography guided PRP treatment procedure were finalized as the study people. The study was approved by the ethical committee of the mentioned institute. Proper written consents were taken from all the participants. All the data were collected through a pre designed questioner and the findings were displayed in MS Excel tables and necessary figures. Result: In this study, the pre-test the mean VAS (Visual Analogic Score) of the participants was 7.6. After 10 weeks of applying PRP it was found 1.8 and after 24 weeks it was found 1.3. So this treatment method ensures very satisfactory mean VAS scores of the participants. In this study when we analyzed the levels of patient’s satisfaction we found, 59.62% (n=31) participants were satisfied whereas 36.54% (n=19) were moderately satisfied. Besides these, in this study we found only 2 participants who were not satisfied at all. Conclusion: Platelet-rich plasma US-guided injection is a safe procedure with no complications. Ultrasound is helpful to manage the follow-up, demonstrating the remodeling of.......
Original Research Article
Sept. 9, 2020
Impact of Maternal Severe Vitamin D Deficiency on Fetal Outcome
Dr. Rugea Mahmud Mahmmed, Prof. Dr. Namah AL-Sadik EL-Houni, Dr. Mohamed Masood Alferjani
Sch J App Med Sci | 2003-2007
DOI : 10.36347/sjams.2020.v08i09.006
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Vitamin D is known to play an important role in bone metabolism and immune system regulation. Objective: to evaluate the impact of maternal vitamin D level on Baby hematological & anthropometric measurements. Patients and methods: prospective cross sectional study was conducted on 22 women with their babies who delivered vaginally at AL- Jamhoria hospital labour room with gestational age ˃ 37 week. The verbal consent was taken with Full out the questions Form. Maternal venous blood for biochemical (vitamin D, PTH, s. Ca+, s. Po4, s. Alk. Ph) & baby venous blood for biochemical (vit. D, s.Ca+, s. PO4, s. Alk. Ph) and anthropometric measurements (B. weight, Length, Head circumference) were taken immediately after birth by same person. Results and Conclusion: 22 women with their babies, aged between 19- 42 year with mean (31.5± 5.83) where 5 (22.7 %) 0f them received vitamin D injection during pregnancy. Mean maternal vitamin D & parathyroid hormone levels were (3.29± 1.36 & 53.2± 2.2) respectively, the mean maternal calcium, phosphate & Alkaline phosphatase were {(8.5± 0.42), (3.66± 0.46), (77.5± 2.2)} respectively. The mean baby vitamin D level is 3.75± 2.04 where10 (45.5%) of babies had features of vitamin D. The mean baby calcium, phosphate, Alkaline phosphatase were {(9.20± 0.56), (5.20± 0.7), (93.5± 3.20)} respectively. The mean baby birth weight, Length, Head circumference were {(3.35± 0.45), (49.95± 1.17), (34.79± 1.08)} respectively. The significant correlation were exists between Maternal vitamin D & baby vitamin D & between Maternal parathyroid hormone & Baby Alkaline phosphatase.
Original Research Article
Sept. 9, 2020
Outcome of Tithanium Elastic Nails in Pediatric Femoral Fractures
Abdul Haque, Seik Md. Abdullah Rafi
Sch J App Med Sci | 2008-2012
DOI : 10.36347/sjams.2020.v08i09.007
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Background: Femoral fractures are common fractures in paediatric age group. There are various methods to treat such cases. Titanium elastic nailing is one of them and an established and reliable method for treating these types of fractures. Ideal treatment of fractures in the age group of 5 to 14 years is still a matter of debate as no consensus has been achieved till now. Aim of the study: The aim of this study was to evaluate the outcome of using titanium elastic nails (TEN) in pediatric femoral fractures. Methods: This observational prospective study was conducted in Cumilla Trauma Center, Cumilla, Bangladesh during the period from January 2018 to July 2019. A group of 50 children with femoral fractures selected to treat with titanium elastic nailing were finalized as the study population. All the information along with the outcomes of the participants were collected assessed and disseminated by several tables and charts of MS Office program. Results: In 20%, 14%, 4% and 2% cases we found superficial infection, mal-union, deep infection and nail breakage as complication respectively. As the final outcome of this study we found, the results were excellent in 34 patients (68%) successful in 12 (24%) and poor in 4 patient (8%) as per the scoring criteria for TEN by Flynn et al. Entry site irritation occurred in 3 patients limb lengthening (<1.5cm) was found in 3 cases both clinically and radiologically, which was clinically insignificant nail removal at 5th month, due to wound breakdown at entry sets in one case. Results were better for children in less than 10 years of age. Conclusion: Titanium elastic nailing is the method of choice for the simple pediatrics femoral fractures, as it is minimally invasive and shows good functional and cosmetic results. Surgical technique of this procedure is simple and reproducible. It allows short hospital stay and quick recovery from pain and it is cast-free.
Original Research Article
Sept. 9, 2020
Profile of Malignancies among Elderly Patients: A Study in the National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh
Md. Mostafa Kamal, Md. Johirul Islam, Md. Habibullah Talukder, Nausheen Laila, Md. Nafis Fuad
Sch J App Med Sci | 2013-2017
DOI : 10.36347/sjams.2020.v08i09.008
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Background: Global burden of cancer is increasing day by day. As a consequence of growing, and ageing population, an important part of this increase is predicted to concern developing countries like Bangladesh. We have very limited data regarding this issue. Aim of the study: The aim of this study was to find out the profile of geriatric cancers in National Institute of Cancer Research and Hospital, (NICRH), Dhaka, Bangladesh during 2012 to 2014. Methodology: It was a retrospective study using hospital based cancer registry records from January 2012 to December 2014. All geriatric patients with cancer, aged ≥ 65 years diagnosed by means of histological or cytological examination during that period, were included in the study. Results: Out of total 5294 patients, 78.30% (n=4145) were male and 21.70% (n=1149) were female. We found the highest number of patients from 65-74 years’ age group which was 73.88%. Then 21.10%, 4.14% and 0.89% were from 75-84, 85-94 and ≥95 years’ age groups respectively. About 44.94% (n=2379) of the patients were from Dhaka division and around 29.74% patients (n=1045) were from Chattogram division. Least number of patients came from Rangpur (2.13%, n=113) and Sylhet (2.72%, n=144) divisions. In total 38.21% (n=1584) male 2.35% (n=27) female patients were current smokers. In male patients lung (In male: 36.36% & in female: 25.76%) was the leading site of cancer in each year followed by oesophageal cancer (In male: 7.12% & in female: (11.31%). But separately there was found a noticeable association of breast in female patients and it was 13.49% in female group. Conclusion: In male the pattern is almost identical with that of the adult cancers. In female notable deviation was noted from usual adult female cancer as most of the years lung cancer led the tally.
Original Research Article
Sept. 12, 2020
A Study of Awareness about Breast Cancer and Breast Self-Examination in Nursing Students
Kale Kalpana M, Aswar Nandkeshav R
Sch J App Med Sci | 2018-2023
DOI : 10.36347/sjams.2020.v08i09.009
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Introduction: Breast cancer is the leading cause of cancer death worldwide which makes it an important health issue in women. Nurses being the front-line health care workers can play an important role in imparting education about BSE in women as early detection is essential to breast cancer survival. Hence the present study was undertaken with an objective to assess the knowledge and practice of nursing students regarding breast cancer and BSE which will help to fulfil the gap in knowledge, if there any, by imparting BSE training to them. Material and methods: Study design: descriptive, cross-sectional workplace-based study. Study place: all six nursing schools in Akola city. Period of study: June to July 2018. Study subjects: All 180, 2nd and 3rd year female nursing students of all six nursing schools in a city. Data collection: Pretested semi structure questionnaire was used to collect information about personal characteristics of nurses, about causes, risk factors, screening methods and treatment available and knowledge about breast self-examination. Ethical approval: Obtained from Institutional Ethics Committee and also permission was obtained from the principals of the concerned nursing schools. Results: out of 180 nursing students. 167 participated in the study. All participants have heard about breast cancer. Approximately 87.4%, 82.6% and 82.6% participants knew about various risk factors, various screening methods and different methods of treatment respectively. BSE was known to only 57.5% participants. Only 6.6 % knew about proper method of BSE while only 17.4% knew about frequency of BSE. Only 5.3 % practiced BSE. Conclusion: Though the knowledge of respondents about breast cancer is adequate, it requires reinforcing about the subject throughout their study. Their knowledge about BSE is very poor. Nurses should adopt such preventive screening procedure and act as role models for the patients and for the community.
Factors Affecting Ventriculo-Peritoneal Shunt Failure in Children: A Comprehensive Review
Dr. N.V.S. Sunil Kumar, Dr. Prakash Rao Gollapudi, Dr. K Srinivas
Sch J App Med Sci | 2024-2028
DOI : 10.36347/sjams.2020.v08i09.010
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Ventriculoperitoneal shunt (VPS) placement is one of the most commonly performed neurosurgical procedures and is necessary to treat most forms of hydrocephalus in children. These may be more common in developing countries due to poor economic conditions and a dearth of available resources. The shunt malfunction in paediatric patients may be caused by number of reasons, including obstruction, infection, pseudocyst formation and bowel perforation. This paper highlights the various factors affecting the successful outcome of VPS in children.
Original Research Article
Sept. 13, 2020
Prevalence of Helicobacter pylori among Peptic Ulcer Patients Attending National Hospital Abuja
Talabi EO, Ajobiewe HF, Ajobiewe JO, Ogundeji AA, Umeji LC, Ajobiewe DC
Sch J App Med Sci | 2029-2032
DOI : 10.36347/sjams.2020.v08i09.011
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Transmission of Helicobacter pylori is largely by the fecal-oral routes and considered as one of the major causes of peptic ulcer disease. Lack of proper sanitation, safe drinking water, and of basic hygiene, as well as poor diets and overcrowding, all play roles in determining the overall prevalence of the infection amongst patients attending National Hospital, Abuja. With their consent a total of 100 fecal samples were collected from patients and they were required to fill the questionnaire. Each fecal sample was tested using a Helicobacter pylori Ag rapid test cassette. Out of the 100 patients screened, 16 were found positive with the prevalence of 16%. The male patients showed a higher prevalence with 20.5% in contrast to the female prevalence of 13.6%. This data shows that the relatively low prevalence of this infection is as a result of the good living conditions and feeding habits of the patients.
Original Research Article
Sept. 17, 2020
Midazolam Premedication with Sevoflurane on Quality and Cost of Anaesthesia in Paediatric Day Case Surgery
Md. Arif Uddin, Md. Shafiqul Islam, Md. Abdur Rahim, Kazi Mahzabin Arin, AKM Akhtaruzzaman
Sch J App Med Sci | 2033-2038
DOI : 10.36347/sjams.2020.v08i09.012
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Objective: The Objective of the study was to evaluate the quality and cost-effectiveness of inhalation anaesthesia by sevoflurane using midazolam as premedication compared to using sevoflurane alone in paediatric patients. Method: This double blinded randomized clinical trial was conducted among 120 patients aged 1-7 years undergoing routine elective paediatric day case surgery of under 60 minutes of duration at the Department of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU, Dhaka during the period of May 2018 to september 2018. Results: During the study, the patients were randomly allocated into two equal groups–Group A (60 patients) and Group B (60 patients). The children of the experimental group (Group B) received orange juice containing 0.5mg/kg of oral midazolam. Perioperative blood pressure and heart rate were measured by standard monitors and recorded periodically. Induction of both groups was done by inhalation of 4% sevoflurane with fresh gas flow. Recovery profile of patients was measured by Modified Ramsay Sedation Score to observe any emergence of anaesthesia. Mean age of group A and group B patients were 3.76±1.21 and 4.06±1.32 SD (years) respectively, with male predominance (male 92.5% vs female 7.5%). In terms of parent separation characteristics group B were more comfortable (76.7% vs 11.7%) than group A and this finding was significant (p<0.001). Haemodynamic stability of patients were significantly higher in sevoflurane + midazolam group (group B) than group A (p<0.001), sevoflurane consumption rate and the cost of anaesthetic agent were observed between two groups and reduced consumption rate observed in group B and significantly reduced cost of sevoflurane observed in group B (p<0.001). Midazolam premedication with sevoflurane used in Paediatric day surgery may improve the quality of anaesthesia as they had lower incidence of difficult parent separation, makes the patients hemodynamically more stable and lower the incidence.......
Strabismus Revealing Ciliary Body Medulloepithelioma: A Case Report and Literature Review
Widad Belaydi, E. H. Abdallah, B. Marzouqi, A.Lalaoui, K. Amhoud, M.A. Filali, A. Berraho
Sch J App Med Sci | 2039-2042
DOI : 10.36347/sjams.2020.v08i09.013
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Ciliary body medulloepithelioma is rare congenital tumor. It develops from the non-pigmented ciliary body epithelium. It occurs mainly in the first decade of life. The clinical examination of the ciliary body is difficult that leads to a significant delay in diagnosis, until enlargement of the tumor, which produces secondary effects. The exact diagnosis is only made on histopathologic examination that found elements to differentiate between medulloepithelioma teratoid and non-teratoid, benign or malignant ones. Enucleation is the preferred method of treatment for advanced intraocular mass. Ciliary body medulloepithelioma have an excellent prognosis. The authors propose to describe a case of this rare tumor revealed by strabismus.
Original Research Article
Sept. 17, 2020
Sociodemographic Status of Propofol and Dexmedetomidine as an Agent of Conscious Sedation in Patients Undergoing Tympanoplasty
Md. Abdur Rahim, Mir Mohammad Rifat Chowdhury, Rahnuma Tasnim, Md. Arif Uddin, Md. Abdul Karim, AKM Akhtaruzzaman, Iqbal Hossain Chowdhury, S. M. Rashidul Hasan
Sch J App Med Sci | 2043-2051
DOI : 10.36347/sjams.2020.v08i09.014
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Objective: In this study our main goal is to assess sociodemographic characteristics of propofol and dexmedetomidine as an agent of conscious sedation in patients undergoing tympanoplasty. Method: This Randomised prospective clinical trial study was carried out with the patients who underwent tympanoplasty conducted at ENT operation theatre in BSMMU, Dhaka according to inclusion & exclusion criteria from February 2016 to February 2018. ASA I-II patients aged (18-45) years undergoing tympanoplasty were enrolled. Patients were randomized as Group I and Group II by computer-gerenated randomization where there was 30 patients in each group (n=30). Results: Both groups were almost similar in respect to age, weight, height, BMI. Mean age of the patient group-I was 30.93 ± 7.11 and 29.03 ± 7.36 in group-II and among them maximum age was 50 years and minimum age was 19 years in group-I and 44,14 years in group-II. Mean weight of the patient group-I was 58.43 ± 6.88 and 57.50± 5.52 group-II and among them maximum weight was 72 kg and minimum weight was 45 kg in group-I and 67,49 years in group-II. Mean height of the patient group-I was 1.60 ±0.06 and 1.59 ± 0.06 group-II and among them maximum height was 1.73 and minimum height was 1.49 in group-I and 1.79,1.49 meter in group-II.Mean BMI of the patient group-I was 22.72 ± 2.60 and 22.52 ± 2.18 group-II. Demographic data between the two groups were not statistically significant. During the study, a computer-generated randomization table was used to allocate the patients into 2 equal groups, 30 in each where Group I received dexmedetomidine and Group II received propofol. Observations were made during perioperative period for conscious sedation effectiveness on haemodynamics SBP, MAP, DBP, HR, SpO2 on different time intervals, surgical field bleeding status, patient satisfaction, surgeon satisfaction, intraoperative rescue sedation, intraoperative rescue analgesics, postoperative rescue analgesics, time to achieve...........
Recent Developments in Management of Attention Deficit Hyperactivity Disorder in Children
Rabindran, Darshini Madanagopal, Shasidaran
Sch J App Med Sci | 2052-2057
DOI : 10.36347/sjams.2020.v08i09.015
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Attention Deficit Hyperactivity Disorder (ADHD) is a common neuro-psychiatric disorder. Its symptomatology includes inattention, easy distractibility, hyperactivity, and impulsivity. Ideal approach to ADHD management comprises a combination of pharmacological and behavioral interventions. Pharmacological interventions include use of Stimulants like methylphenidate (MPH), dextroamphetamine or Nonstimulants. Pemoline, Atomoxetine, Clonidine, Guanfacine, Modafinil are other pharmacological agents used in ADHD. Newer drugs include Reboxetine and Venlafaxine. Theophylline and antidepressants like tricyclic antidepressants, desipramine and imipramine are also being tried. Apart from medications, there are many Non-Pharmacological methods which include Behavioural Therapy, Psycho-education, Exercise and Diet therapy. Behavioural interventions consist of techniques like Environmental modification, Parent training intervention, Cognitive Behaviour therapy and Cognitive training. Psycho-education includes Education of parents and family members about ADHD, Group education and direct clinical consultation. Diet management, Exercise, Omega fatty acid and nutritional supplements or Neurofeedback are being tried in the management of ADHD. External Trigeminal Nerve Stimulation (ETNS) is a new medical device to treat children with ADHD. ETNS generates low-level electrical stimulation and sends signals to areas of the brain related to attention, emotion and behaviour. The New Forest Parenting Package (NFPP) is a type of psychosocial intervention in the management of ADHD among children. It combines behavioural intervention with parent- child interaction. Alternative therapy in management of ADHD includes Electroencephalography, Biofeedback Training, Megavitamin Therapy, Herbal Treatments, Body and Craniosacral Manipulation, Sensory Integrative Training and Specific Supplements. Overall the use of integrative treatment model rather a single treatment modality is recommended........
Original Research Article
Sept. 17, 2020
Evaluation of Shape and Size of Sella Turcica Using Computerized Tomography in Saudi Populations
Hanan Elnour, Afrah Al-Otaibi, Maryam AL-Otaibi, Nourhan Arab, Rahaf AL- Thobaiti, Roaa Murad, Sara AL-Otaibi
Sch J App Med Sci | 2058-2063
DOI : 10.36347/sjams.2020.v08i09.016
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This study design to measure the size and shape of normal Sella turcica, were samples chosen among individuals from adult Saudi populations aged 19-99 years. A total of 210 samples (125 males and 85females), and the data collected in period from August 2019 to February 2020. Anteroposterior dimension, length and depth of Sella turcica were measured in each case and find out three unique shapes; the circle shape represents 40.5% with 85 patients, the ovoid shape 42.4% with 89 patients while the flat shape 17.1% with 36 patients, measurements obtained from measuring of Sella turcica, were the mean ± standard deviation for age was 47.59 ± 20.289 years, length, Width, AP and volume of Sella turcica was 8.07 ± 2.06mm, 7.408±1.64 mm, 10.11±2.08mm and 339.52±203.69mm respectively. The mean length of sella turcica for male and female was 8.010 and 8.165 mm, the Width for male was 7.215 mm and for female 7.692 mm, AP diameter for male 10.050 and for female 10.193mm, the volume of sella turcica for male was 329.139 and for female 354.781mm, so there is no difference between male and females. There is linear correlation between age of study group and the measured parameters from 19- 99 years. Analysis of variance test show that there was no significant difference between the Sella measurements, for length and patients age, where the p-value was 0.285 and for Width, AP and volume the p.value was 0.222, 0.128 and 0.067 respectively. CT can be used to assess the Sella turcica, and further studies on how the dimensions of the Sella turcica are interrelated with pathological conditions should be conducted with the use of advanced imaging methods. Sella turcica dimensions of the Saudi population obtained by CT in this study can be used in estimating pituitary gland size and in determining any pathology in the seller and parasailer regions.
Original Research Article
Sept. 17, 2020
Neurofibromatosis Type 1 and Pregnancy: About A Case and Review of the Literature
M. Benayada, N. Chmichi, A. Bennani, A. Lakhdar, N. Zeraidi, A. Kharbach
Sch J App Med Sci | 2064-2067
DOI : 10.36347/sjams.2020.v08i09.017
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A pregnancy is classified as high risk when the life of the mother or the fetus becomes fragile due to its association with certain diseases. Many health problems can be experienced in women before pregnancy, during and after pregnancy. Some health problems can also start in early adolescence with very mild clinical signs, but during pregnancy due to hormonal changes that may occur, lead to an intensification of the disease. We report the management of a 28-year-old woman with neurofibromatosis 1 (NF1). This study highlights the various complications related to Nf1 and its impact on pregnancy.
Original Research Article
Sept. 17, 2020
Trends in Antibiotic Resistance Patterns among Salmonella Enterica Species – A Six Year Study from Tertiary Care Centre
Ashish William, Aroma Oberoi, Divya D'souza, Arpit Oberoi
Sch J App Med Sci | 2068-2072
DOI : 10.36347/sjams.2020.v08i09.018
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Background: Typhoid remains a global public health problem with a higher burden in low- and middle-income countries (LMICs) due to poverty, limited access to safe water and unhygienic practices. The prevalence of Multidrug-resistant strains has been responsible for outbreaks in India. In recent years, there has been an increase in fluoroquinolones resistance because of which ciprofloxacin is no longer the empirical choice of treatment in our country. Objectives: The aim of the study is to know the prevalence of enteric fever associated with Salmonella enterica and determine its antimicrobial susceptibility in a tertiary care hospital. Methods: This is a retrospective study conducted in the Department of Microbiology, CMC and Hospital, Ludhiana for 6 years. All the culture positive enteric fever cases were included in the study. Antimicrobial susceptibility was done as per corresponding CLSI guidelines. Results: A total of 918 strains of Salmonella species- Salmonella typhi 802 (87.36%) and Salmonella paratyphi A 116 (12.63%) were isolated from the blood cultures. Antimicrobial susceptibility for chloramphenicol, ampicillin and co trimoxazole was found to be 94%, 97%, 100% for S. Typhi and 94.63%, 96.64% and 100% for S. Paratyphi A, respectively. There is a continuous increase in Ciprofloxacin minimum inhibitory concentration values over the time. Majority of Salmonella isolates were nalidixic acid resistant. Although the rate of MDR Salmonella strains was nil, their reduced susceptibility to fluoroquinolones has restricted their routine empirical use. Conclusions: Enteric fever continues to cause significant morbidity due to delayed diagnosis, inadequate treatment and worsening drug resistance in India and beyond. There has been a reported decline in MDR with a parallel increase in decreased ciprofloxacin susceptibility among S. Typhi. Third generation cephalosporins are the safest choice for empirical use as ampicillin, chloramphenicol or cotrimoxazole are ........
Original Research Article
Sept. 17, 2020
Effectiveness of Metoclopramide Combined with Dexamethasone and Granisetron alone in Preventing Post-operative Nausea and Vomiting in High Risk Patients Undergoing Laparoscopic Cholecystectomy
Rahnuma Tasnim, Debasish Banik, Md. Abdur Rahim, Shamima Akter, Sahin Sultana Chowdhury, Dilip Kumar Bhowmik
Sch J App Med Sci | 2073-2079
DOI : 10.36347/sjams.2020.v08i09.019
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Objective: In this study our main goal is to comparison of the effectiveness of metoclopramide combined with dexamethasone and granisetron alone in preventing post-operative nausea and vomiting in high risk patients undergoing laparoscopic cholecystectomy. Method: It is a cross sectional observational study on 120 patients who underwent laparoscopic cholecystectomy. The study period was July, 2017 to June, 2018. The study was conducted in the department of Anesthesia, Analgesia and Intensive care medicine of BSMMU. All the patients were chosen by purposive sampling. The study population was divided into two groups by simple lottery method. Group A patients got Granisetron (1mg iv single dose) and Group B patients got Metoclopramide and Dexamethason (Inj. Metoclopramide (10mg) and Inj. Dexamethasone (8mg)) just before induction. The observations were plotted into tabular and figure form. The categorical variable was analyzed by chi square test and the quantitative variables were analyzed by unpaired student’s t test. Results: The mean age of Group A and B patients were 33.73±6.97 and 34.62±7.16 years respectively. The sex ratio showed 21:39 and 15:45 in case of Male: Female respectively.out of 60 patients in each group PONV was reported in 20 (33.33%) and 16(26.67%) patients in Group A and Group B respectively. No PONV was reported in 40 (66.67%) and 44 (73.33%) patients in Group A and B respectively. 40(66.67%) and 44(73.33%) in Group A and B respectively showed no nausea and vomiting. 8(13.33%) and 7(11.67%) patients showed score 1 (nausea) in Group A and B respectively. On the contrary, 7(11.67%) and 5(8.33%) patients in Group-A and B respectively were categorized PONV score 2 (who experienced both nausea and vomiting. Only 5(8.33%) and 4(6.67%) patients experienced repeated vomiting ≥2 times who were categorized as PONV score 3.(p= 0.872). Among rescue antiemetic drug, analgesic drug use and postoperative hospital stay nothing but the hospital stay showed ......
Original Research Article
Sept. 19, 2020
Prevalence of Depression among Medical Undergraduates of Medical College Srinagar JK
Dr. Rifat Jan, Nighat Nabi
Sch J App Med Sci | 2080-2084
DOI : 10.36347/sjams.2020.v08i09.020
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Background: Depression among medical students is an important health issue at the global level. Academic pressure, though established, is an unavoidable cause of depression in medical students. It is associated with anxiety and psychological stress. Medical education across the globe is perceived as being inherently stressful. Studies on psychological problems such as stress, depression and anxiety among medical students have found that these disorders are under diagnosed and under treated. In this background the present study was undertaken with the objectives to assess the magnitude of depression and its associated factors among medical students. Methods: Medical undergraduates of Govt. Medical College Srinagar were enrolled for the study conducted between October 2018 to December 2018. A predesigned, pretested scale was used to assess their depression levels Results: The overall prevalence of depression was found to be 47.5%. Among those with depression, 49.5% had mild depression and 21% had borderline depression. Moreover, 26.31% had moderate depression and 3.15% was found with severe depression. 41.05% (39) of the depressed were males and 58.9% (56) were females. According to cut-off scores, 105 students (52.5%) scored as normal (1-10), 47 (23.5%) as mild (11-16), 20 (10%) as borderline (17-20), 25 (12.5%) as moderate (21-30), and 03 (1.5%) as severe (31-40) depression. The prevalence of depression was comparatively less among 2nd year and 3rd year medical students (35.38% and 30.22%, respectively) (χ2=34.76, P=0.001). Conclusion: Emphasize should be laid on the importance of screening for depression of medical students on a regular basis for early detection and rendering appropriate intervention like group counseling, stress management training etc. to protect the future professionals.
Sensory Processing Dysfunction in Children with Autism Spectrum Disorder
Rabindran, Darshini Madanagopal, Shasidaran
Sch J App Med Sci | 2085-2089
DOI : 10.36347/sjams.2020.v08i09.021
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Autistic Spectrum Disorder (ASD) is characterised by difficulties in social communication and interaction. As per latest DSM 5 update variations in sensory responses were included in diagnostic spectrum of ASD. Hyper/hypo reactivity to sensory input explains the abnormal patterns of behaviours, activities or interests seen in children with ASD. Autistic children have a dysfunctional sensory system known as Sensory Integration Disorder, Sensory Integration Dysfunction or Sensory Processing Disorder (SPD). In SPD, there is difficulty in processing information from the 5 classic senses, the sense of movement, and/or the positional sense. There are 2 classification systems for SPD. According to Miller’s Classification, there are three kinds of SPD namely Sensory Modulation Disorder (SMD), Sensory Based Motor Disorder and Sensory Discrimination Disorder. There are three subtypes in SMD namely Over-Responsiveness, Under-Responsiveness and Sensory -Craving. According to Schaaf’s Classification, there are five kinds of SPD namely Poor Sensory Perception, Somato Dyspraxia, Visuo Dyspraxia, Vestibular & Bilateral Integration and Sensory Reactivity. Under Sensory Reactivity there is Hyperactivity and Hypoactivity. The symptomatology of sensory dysfunction varies based on the primary senses which are predominantly involved. They may present with tactile, vestibular, proprioceptive, visual input, auditory input, taste input or smell input dysfunction. There are plenty of assessment tools for SPD diagnosis. The prominent tools include Sensory Profile, Sensory Integration and Praxis Test, Sensory Processing Measure and Evaluation in Ayres Sensory Integration. Awareness regarding the SPD in children with ASD will help to understand the disorder better ultimately leading to proper management.
Strategies for Prevention of Deafness in India
Rabindran, Shasidaran
Sch J App Med Sci | 2090-2094
DOI : 10.36347/sjams.2020.v08i09.022
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Deafness is complete inability to hear whereas Hearing impairment is complete or partial inability to hear. There are 4 grades of hearing loss based on hearing threshold of the better ear. In India, nearly 6.3% of the population have hearing impairment and the prevalence of childhood-onset deafness is 2%. The etiological factors leading to deafness are manifold. There is a rise in hearing loss secondary to noise exposure. Severe infections, meningitis, some medications cause hearing impairment. Maternal TORCH infection and chronic ear infection also contribute to hearing loss. It is estimated that nearly 50% of hearing loss are preventable. The 3 strategies are Primary prevention, Secondary Prevention and Tertiary prevention. Primary preventive strategies of deafness include education, hearing conservation programmes and legislation. Immunization of mothers against rubella, Immunization of children against H. influenza, S. pneumonia, measles and mumps can reduce childhood deafness. WHO advises that children should limit exposure to loud sounds? Improved maternal and child health practices would prevent hearing loss. Newborn and infant hearing screening should be mandatory. Awareness against excessive noise exposure should be created. Secondary preventive strategies of deafness include environmental modification. For children admitted to special schools or rehabilitation centres an audiological evaluation should be done prior to admission.There should be regular School-based hearing screening. Tertiary preventive strategies of deafness include hearing aids and rehabilitation. Rehabilitation measures should be provided for those who have developed hearing loss. Early detection and prompt management is the key to address the problem of deafness in India.
Original Research Article
Sept. 19, 2020
Preoperative Level of Serum CA- 125 in Patient with Ovarian Cancer
Dr. Jannatul Ferdous, Dr. Goury Prava Dhar, Dr. Mahbubur Rahman, Dr. Mohammad Mostafizur Rahman
Sch J App Med Sci | 2095-2100
DOI : 10.36347/sjams.2020.v08i09.023
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Introduction: Ovarian cancer is an alarming health problem in Bangladesh. The annual morality rate per 1, 00,000 people from ovarian cancer in Bangladesh has raised by 40.3% since 1990, an average of 1.8% per year. Globcan predicts changes in the reported incidence of ovarian cancer from 2912 in year 2012 to 3132 to 2015. Recurrent high- grade ovarian cancer is usually associated with short term survival. Disease stage at diagnosis is a strong prognostic variable for predicting patient outcome in ovarian cancer. Aim of the study: to investigate the histological characteristics and stage of ovarian cancer and to correlate with preoperative level of serum CA -125. Material & Methods: This cross sectional study was carried out at the Department of Obstetrics and Gynaecology in Ashiyan Medical College Hospital, Barua Khilkhet, and Dhaka, Bangladesh during the period from August 2018 to July 2019. A total of 100 patients were selected using purposive sampling technique for this study. Data were collected and documented on a preformed and pretested structured questionnaire. Clinical examination and relevant investigation were done and recorded accordingly. Data were processed and analyzed with the help of computer software SPSS 22. Results: Mean age of the study subjects was 45.7 ± 15.2 years with a range of 13-75 years. Table II shows education status of the study subjects. It was observed that half of the study subjects had education up to primary level, 26% had studied up to secondary level, 19% up to higher secondary level and only 5% were graduate. Mean BMI was 23.3± 3.0 kg/m2, mean age of marriage was 16.1± 2.8years and mean CA-125 level was 547.02± 478.74. Maximum study subjects had stage III (44.0%) followed by stage II (24.0%), stage I (21. 0%) and stage IV (11.0%). Also, most of the study subjects had serous tumors (70.0%) followed by mucinous tumors (11.0%), endometrioid adenocarcinoma (8.0%), clear cell tumors (4.0%), malignant tertoma (5.0%), ...............
Original Research Article
Sept. 19, 2020
An Assessment of the Morbidity and Mortality in Eclampsia: A Study in a Tertiary Care Hospital
Dr. Jannatul Ferdous, Dr. Goury Prava Dhar, Dr. Mahbubur Rahman, Dr. Mohammad Mostafizur Rahman
Sch J App Med Sci | 2101-2105
DOI : 10.36347/sjams.2020.v08i09.024
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Introduction: A perinatal condition in eclampsia is a major concern of infant injury and death in developing countries like Bangladesh. Eclampsia is the commonest cause of convulsions in pregnancy next being epilepsy. So proper initiatives against eclampsia can save many lives by decreasing the total mortality as well as the morbidity of child and mother. Aim of the study: The aim of our study was to assess the perinatal mortality and morbidity which are related to eclampsia. Methods: This was a cross sectional observational study carried out in the Department of Obstetrics and Gynaecology in 250 Bedded General Hospital, Ashiyan Medical College Hospital, Barua Khilkhet, Dhaka, Bangladesh during the period from June 2016 and July 2017. Proper written consent form all the participants were obtained and the ethical committee of the hospital had approved the study before starting the intervention. In total 178 pregnant women with eclampsia were finalized as the study population. Result: In our study we found in total 148 live births from total 178 mothers which were 83.15% against total study population. Among all the babies 139 were survived which was 93.91% among total live births. Death after birth was 9 in number which was 6.08% among total live births. Early neonatal death was 13 in number which was 7.3% against total mothers. Stillbirths were 16 in number which was 9% against total mothers. In perinatal complication analysis we found 42 babies with jaundice which was 28.38% among live births. Babies with septicemia were 28 (18.92%), with respiratory distress 25 (16.89%), with neonatal convulsion were 7 (4.73%) and with no complication were 46 (31.08%). Conclusion: In the conclusion, we can say that stillbirth is the main component of perinatal death and prematurity is an important cause of perinatal loss in eclampsia. So, early referral of eclampsia patients, early resuscitative measures and good neonatal care can improve perinatal outcome.
Etiology, Pathophysiology and Diagnosis of Learning Disability
Rabindran, Darshini Madanagopal
Sch J App Med Sci | 2106-2112
DOI : 10.36347/sjams.2020.v08i09.025
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Learning Disability is a type of neurodevelopmental disorder which affects nearly 5% of school-aged children globally. It affects acquisition, organization, retention, comprehension or use of both verbal and nonverbal information. Children with LD have average or above-average IQ. There are many types of LD. Classification of LD is based on (a) Information processing and (b) By function impairment. LD can be classified into four stages input, integration, storage and output based on information processing. By function impaired there are Dyslexia, Dysgraphia, Dyscalculia, Auditory and Visual Processing Disorder, Nonverbal LD, Dyspraxia and Dysphasia. LD is neurobiological in origin. Both Herditary and environmental factors contribute to its pathophysiology. Some possible risk factors include maternal illness, fetal exposure to alcohol, and use of toxic drugs during pregnancy, complicated pregnancy or delivery and neonatal problems. There are 5 models through which the etiology of LD can be explained namely Difference Model, Deficit Model, Delay Model, Disruption Model and Personal-Historical Model. These models are not mutually exclusive. Neurphysiological and Neuroanatomical studies of brain of dyslexic persons have shown malformations predominantly on the left cerebral cortex. Corticostriatal system disorder is proposed in pathogenesis of LD. Evaluation of a child with LD needs a multidisciplinary approach. Diagnostic evaluation of LD is a sequential process involving Speech and language, cognitive, educational, medical, and psychologic evaluations along with clinical assessment of LD criteria. NIMHANS has developed an index to assess children with LD. Understanding etiology and pathogenesis will help in early identification and early intervention.
Neuro Developmental Therapy - An Overview
Rabindran, Darshini Madanagopal, Shasidaran
Sch J App Med Sci | 2113-2116
DOI : 10.36347/sjams.2020.v08i09.026
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Neuro Developmental Therapy (NDT) also known as Bobath concept is an effective approach for neuro-motor disturbances in Cerebral palsy. It aims for normal motor development and prevention of contractures. There are many Handling techniques which concentrate on the sensory stimuli and thereby decrease spasticity, abnormal reflexes and movements. Basic principles of Bobath concept are 1) CNS lesion is the cause of tightness or weakness in muscle in CP, 2) Children with CP have postural and movement disorders, 3) CNS lesion induced atypical movement has potential to recover. NDT primarily considers that normal postural reflex mechanism is fundamental for motor performance. It is an interactive problem-solving approach which can be applied to CNS damage for recovery irrespective of severity or age. NDT incorporates the principle of neuroplasticity. The techniques used include therapeutic handling, facilitation and activation of key control points. Key elements in NDT are Alignment, Handling and Placing. Bobath Concept is a goal-orientated and task-specific approach. It targets for organisation of the internal (proprioceptive) and external (exteroceptive) environment of CNS for efficient functioning .NDT-based therapy helps in regaining functional movements that are based on postural control and alignment. Recently NDT has been tried in various other disorders like Stroke, Injury to brain or spinal cord, Brain tumour, Dementia, Multiple sclerosis, Parkinson’s disease, Amyotrophic lateral sclerosis and Infection-related encephalitis .Early diagnosis and early intervention before establishment of abnormal movement pattern can be helpful for the CP children to lead an independent and meaningful functional life.
Original Research Article
Sept. 20, 2020
Computational Analysis of Pyocyanin (Phz Gene) From Pseudomonas
Saranya Rathan, Geethalakshmi Sundararaman
Sch J App Med Sci | 2120-2126
DOI : 10.36347/sjams.2020.v08i09.028
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Pyocyanin is a biologically active phenazine produced by Pseudomonas aeruginosa. Pyocyanin is a blue redox-active secondary metabolite and a member of the large family of the tricyclic compounds. “Phenazines” Because of its solubility in chloroform it can be easily isolated. Pyocyanin or 1-hydroxy-5-methylphenazine is considered as a resonance hybrid of the mesomeric forms of N-methyl-1-hydroxyphenazine is capable of undergoing a two-electron reduction to a colourless product, leukopyocyanin. It is believed to bestow P. aeruginosa with a competitive growth benefit in colonized tissue and is also thought to be a virulence factor in diseases such as cystic fibrosis and AIDS where patients are commonly infected by pathogenic Pseudomonads due to their immunocompromised state. Pyocyanin is also a chemically stimulating compound due to its unusual oxidation-reduction activity. Phenazine-1-carboxylic acid, the predecessor to the bioactive phenazines, is produced from chorismic acid by enzymes determined in a seven-gene cistron in Pseudomonas aeruginosa. Phenzine-1-carboxylic acid is whispered to be converted to pyocyanin by the sequential actions of the putative. S-adenosylmethionine dependent N-methyltransferase PhzM and the putative flavin-dependent hydroxylase PhzS. Here we report the Predicted 3D Structure of PHZ S.
Original Research Article
Sept. 20, 2020
The Pattern of Presentation and Incidence of Tuberculosis in Patients on Chronic Hemodialysis
Pavan M
Sch J App Med Sci | 2127-2131
DOI : 10.36347/sjams.2020.v08i09.029
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Objective: The incidence of tuberculosis (TB) among dialysis population is much higher than general population. Immunosuppression induced by end-stage renal disease (ESRD) modified the clinical presentation of TB, resulting in atypical signs and symptoms, and a more frequent extrapulmonary presentation. This study was undertaken to determine the pattern of presentation and incidence of TB in ESRD patients. Methods: This was a prospective observational study done using 200 ESRD patients who are on chronic maintenance hemodialysis (HD) at Adichunchanagiri Institute of Medical Sciences, BG nagara, India. TB was diagnosed using clinical, radiological, biochemical, microbiological, and histological findings. Results: The incidence of TB was found to be 12%. It was found to be commoner in females, commonest in the age group 40–34 years. Pleural effusion was the commonest type of TB found (50%). The incidence of extrapulmonary TB was 87.5%. There was a high incidence of TB during the early years of initiation of HD. Patients with TB had a statistically significant low BMI compared to non-TB patients (18.42 kg/m2 Vs. 22.63 kg/m2. P<0.001). TB had a significant impact on mortality among HD patients. Conclusion: Patients with ESRD, on chronic maintenance HD are at increased risk for pulmonary and extra pulmonary tuberculosis and should be diagnosed with high index of suspicion. The TB infected patients generally presented worse mortality rates than the non-TB infected patients.
Original Research Article
Sept. 20, 2020
Intra-Operative & Post-Operative Complications in Pediatric Anesthesia: A Study in Cumilla Medical College, Cumilla, Bangladesh
Md. Delwar Hossain, Md. Atower Rahman, Md. Kamrul Hossain, Mohammad Shakhawat Hossain
Sch J App Med Sci | 2132-2136
DOI : 10.36347/sjams.2020.v08i09.030
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Introduction: Pediatric patients differ in their drug requirements because of their smaller body size, differences in body composition and handling capacity of drugs. Usually dosages are based on body weight, because it correlates so intimately with body water compartments. Objective: To find out the Intra-Operative & Post-Operative Complications in Pediatric Anesthesia. Materials & Methods: The present study was conducted in the Department of Anaesthesiology & ICU, Cumilla Medical College, Cumilla, Bangladesh during from January 2017 to December 2017. It included 250 pediatric patients of both gender. Parents were informed regarding the study and written consent was obtained. Ethical clearance was taken from institutional ethical committee. General information such as name, age, sex, ASA status, technique of anesthesia and complications were recorded. Results: The present study was conducted to identify anesthesia-related complications in pediatric patients. The present study was conducted on 250 pediatric patients of both genders. Factors such as conscious state, colour, respiration, pulse and blood pressure were also assessed. Age group 1 month- 1 year had 22 males and 33 females. 1-5 years had 45 males and 50 females, 5-10 years had 15 males and 20 females and 10-14 years had 40 males and 25 females. The difference was non- significant (P-0.5). Patients had ASA I (180), ASA 2 (50), ASA 3 (15), ASA 4 (3) and ASA 5 (2) status. The difference was significant (P-0.05). Type of anesthesia was general anesthesia (200), general anesthesia with caudal block (27), subarachnoid block (5) and general anesthesia with local anesthesia (18). The difference was significant (P-0.01). Common intra- operative complications were bradycardia (5), tachycardia (4), hypotension (4), hypertension (3), cardiac arrest (2), brochospasm (1), hypoventilation (2), pain (3) and prolonged unconsciousness (1). The difference was significant (P-0.01). Post- operative complications were..........
Etiology, Epidemiological Aspects and Preventive Strategies of Neural Tube Defects
Rabindran, Shasidaran
Sch J App Med Sci | 2137-2142
DOI : 10.36347/sjams.2020.v08i09.031
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Neural tube defect (NTD) is a defect in neurulation process of embryogenesis occuring during early human development. Failure of normal closure of neural tube causes NDT. Type and severity varies based on location of defect. NDT occurs predominantly at rostral and caudal ends. Folate is essential for DNA and RNA synthesis and for one carbon group transfer in methylation and nucleic acid synthesis. In folate deficiency, there is failure of post-translational methylation of the cytoskeleton leading to NTD. Some of the contributing factors for NTD include maternal illness, Low socio-economic status, Drugs, Food contamination and maternal Smoking. Folic acid supplementation reduces the prevalence of NTD by 70%. Multiple genes are associated with folate insensitive NTD. NTD can be classified based on the site of defect into Cranial and Spinal malformations and based on the presence or absence of exposed neural tissue into open or closed types. Some of the common factors to be considered in analysing NTD include Multiple Gestation, Dietary Factors, Sex, and Maternal obesity, Illness, Age, Socioeconomic Status, Parity, Occupational Exposure and Previous Pregnancy Wastage. Most popular strategy for prevention of NTD is folic acid supplementation for women of childbearing age. Other strategies for prevention of NTD include folate-rich diet, multivitamin supplementation, 6S- 5-MTHF, food fortification, combination of oral contraceptives and folate. With recent advances in genetics and diagnostic tools, genetic and syndromic causes of NTD can be prevented utilizing preimplantation genetic diagnosis or early detection by chorionic villous sampling and high resolution early antenatal ultrasound scan.
Conjunctival Melanoma at the Site of Previous Ocular Injury
Widad Belaydi, E. Abdallah, K. Amhoud, A.Lalaoui, B. Marzouqi, K. Amhoud, S. Karmoun, F. Kettani, A. Berraho.
Sch J App Med Sci | 2143-2145
DOI : 10.36347/sjams.2020.v08i09.032
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Conjunctival melanoma is relatively rare aggressive malignant tumor. Its incidence in the white population is estimated at 0.2 to 0.8 per million. Its management consists on surgical excision, cryotherapy, and eventually radiotherapy or local chemotherapy. UV rays are largely incriminated in the pathogenesis of melanoma, while the role of trauma is still a subject of controversy; this hypothesis of trauma is reinforced by the presence of melanomas in areas with low exposure to sunlight. We report a case of conjunctival melanoma evolving at the site of previous ocular trauma.
Original Research Article
Sept. 25, 2020
Comparison of Analgesic Effects of UST with NSAIDs and without NSAIDs in Patients with De Quervain’s Disease
A.B.M Zafar Sadeque, Mohammad Ilias, Fahad Islam, Md. Imam Shahriar, Md. Mahfuzur Rahman
Sch J App Med Sci | 2146-2151
DOI : 10.36347/sjams.2020.v08i09.033
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1. Background: De Quervain's disease has been described as an entrapment of the extensor pollicis brevis and abductor pollicis longus tendons in the first dorsal compartment of the wrist is a common cause of wrist and hand pain Treatment of the disease consists of pharmacological & non-pharmacological. The non-pharmacological includes immobilization, therapeutic heat and cold, electrical nerve stimulator, thumb stabilizer splint, postural correction at work and the adjustment of tools and equipment. This randomized clinical trial was performed to find out the effects of UST with NSAIDs and without NSAIDs in the patients of De Quervain’s disease. Methods: This randomized clinical trial was performed in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, over a period of six months. Group A-experimental or interventional group and group B-control group by randomization with the help of lottery. Experimental group was managed by activities of daily living (ADLs) instructions, ultrasound therapy (UST) with non-steroidal anti-inflammatory agents (NSAIDs gel), along with thumb spica splint. Control group B received previous management except non-steroidal anti-inflammatory agents (NSAIDs gel). All patients received therapeutic ultrasound in a same dosage (1 watt/ cm2/min) for 8 minutes. An evaluation was made at initial visit and two weeks interval for 6 weeks. So, there were three follow up visits and these evaluations were performed by the same investigator. In each visit, measurement of pain intensity and disability level were performed by using visual analogue scale (VAS), Tenderness Index and Patient rated wrist evaluation (PRWE) respectively. All results were recorded systematically. A post intervention result was compared with baseline result by SPSS-20. Results: Out of 60 total patients 60(100%) had Finkelstein test positive. Significant difference between Group A and Group B was found...........
Piaget's Theory and Stages of Cognitive Development- An Overview
Rabindran, Darshini Madanagopal
Sch J App Med Sci | 2152-2157
DOI : 10.36347/sjams.2020.v08i09.034
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Cognitive development is the capability of knowing, comprehending or understanding. Piaget studied about how children develop ability to think logically and scientifically. According to Piaget assimilation and accommodation are important for effective learning. Piaget made some assumptions that children build their knowledge based on experiences, they learn without influence from others, and by nature, they are motivated to learn. Piaget stated that development of cognition occurred through distinct stages which happen in the same order. Piaget’s stages include Sensorimotor stage (birth to 2 years), Preoperational stage (2 to 7 years), Concrete operational stage (7 to 11 years) and Formal operational stage (11 years and beyond). Cognitive development at sensorimotor stage is characterised by goal directed behaviour, object permanence, mental representation, cause and effect relationship and coordinated space. Sensorimotor stage is further subdivided into six substages. Every substage is associated with newer skill development. Cognitive development at preoperational stage is characterised by Transductive reasoning, Animism, Artificialism, Egocentrism, Symbolic Functioning, Centration, Irreversibility, Curiosity and Seriation. Key behaviours during preoperational stage include imitation, symbolic play, drawing, mental imagery and verbal evocation of events. Cognitive development at concrete operational stage is characterised by Logical thinking, Decentration, Reversibility, Cause and Effect relationship, Classification, Transitivity and Elimination of Egocentrism. Cognitive development at formal operational stage is characterised by Abstract thinking, Deductive reasoning, Problem solving, Hypothetical thinking, Adolescent Ego-centrism, Imaginary Audience and Personal fable. Basic components of piaget's cognitive theory include Stages, Schemas and Adaptations. Intellectual development is not a quantitative process, but a qualitative change.
Original Research Article
Sept. 26, 2020
Clinical Presentation and Complications of Chronic Calcific Pancreatitis
Mohammad Saief Uddin, Md Zabiul Islam, Md Mahfuzur Rahman Khan, Mostafa Mamoon Warid, Md Zulfiqur R Khan
Sch J App Med Sci | 2158-2164
DOI : 10.36347/sjams.2020.v08i09.035
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Background: Chronic pancreatitis is an inflammatory disease in which progressive and irreversible structural changes to the pancreas result in a permanent impairment of both the exocrine and endocrine functions. The treatment of chronic pancreatitis depends on 4 factors: the cause of the pancreatitis, the portion of the pancreas involved the presence or absence of symptoms, and the size of the pancreatic duct. The treatment procedure of chronic pancreatitis mostly depends upon the complications and features of the disease. Aim of the study: The aim of this study was to assess clinical profile and complications of chronic pancreatitis in hospitalized patients. Methods: This prospective observational study was conducted in Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh during the period from January 2017 to December 2017.Thirty (30) patients of pancreatic calculi were studied in this study. All the data were collected by a pre-designed questioner, analyzed by SPSS version 20 and findings were displayed by several tables and figures of MS Office program. Result: Present study shows that out of 30 patients 2 patients (6.67) developed wound infection in the post-operative period, 2 patients (6.67%) developed urinary tract infection one patient (3.33%) developed pancreatic fistula, one patient (3.33%) developed sub-acute intestinal obstruction, one patient (3.33%) developed jaundice. All are treated conservatively. No patient died in the post-operative period in hospital. All the patients of this series presented with abdominal pain (100%). Weight loss presented by 10 (33.33%) patient, Steatorrhoea by 9 (30%) patient, abdominal lump by 4 (13.33%) patient, 14 patients (46.67%) were diabetic and all patient have vague complain of anorexia, nausea & vomiting. Conclusion: In this study, complications were found in very few numbers. Both wound infections and respiratory tract ......
Original Research Article
Sept. 26, 2020
Study of Chronic Calcific Pancreatitis: 30 Cases
Mohammad Saief Uddin, Mohammad Abul Kalam Azad, Sarwar Ahmed Sobhan, Md Asaduzzaman Nur, Md Zulfiqur R Khan
Sch J App Med Sci | 2165-2172
DOI : 10.36347/sjams.2020.v08i09.036
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Background: The clinical course of chronic pancreatitis is still unpredictable, which relates to the lack of the availability of a clinical classification. Chronic calcific pancreatitis is a special form of chronic pancreatitis that tends to calcify or is associated with pancreatic lithiasis. Information regarding the presentations, physical findings, diagnostic findings and complications are very important for deciding about the treatment approach for calcific pancreatitis. Aim of the study: The aim of this study was to collect information regarding the presentations, physical findings, diagnostic findings complications the patients with chronic calcific pancreatitis. Methods: This prospective observational study was conducted in the Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh during the period from January 2017 to December 2017. Thirty (30) patients of pancreatic calculi were studied in this study. All the data were collected by a pre-designed questioner, analyzed by SPSS version 20 and findings were displayed by several tables and figures of MS Office program. Result: In total 27 participants were male and 3 were female. So the male-female ratio was 9:1. All the patients of this series presented with abdominal pain (100%). Weight loss presented in 10 (33.33%), Steatorrhoea in 9 (30%), abdominal lump in 4 (13.33%) & diabetes in (46.67%) patients. Jaundice was present in 3 cases (10%). Palpable lump in the epigastric region in 5 cases (16.67%) and tenderness in epigastric region in 10 patients (33.33%). Oedema was presented by 4 patients (13.33%), Ascites presented by 7 patient (23.33), Palpable liver was in 1 patient (3.33%) and palpable gall bladder in 2 patient (6.67%). As complication 30 patients 2 patients (6.67) developed wound infection in the post-operative period, 2 patients (6.67%) developed respiratory tract infection one patient (3.33%) developed.........
Filarial Hydrocele as Cause of Temporary Impotence in an Alleged Accused of Sexual Assault-A Case Report
Dr. Bhavish Prakash, Dr. Sachin Sonvane, Dr. Rajesh Sukhadeve, Dr. Manoj B Parchake
Sch J App Med Sci | 2173-2176
DOI : 10.36347/sjams.2020.v08i09.037
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Impotence is the inability to perform, or permit the performance of, the act of sexual intercourse, whereas sterility is the inability to impregnate/get impregnated. Hydrocele is an accumulation of fluid in the tunica vaginalis layer in the scrotum that causes it to swell. Alleged accused of sexual assault 52 year old brought for examination in hospital. On examination, giant hydrocele was noted and later confirmed by urologist and further investigation. This case report highlights the importance of detailed examination and how to frame opinion in such cases and sample collection.
Original Research Article
Sept. 28, 2020
Evaluation Regarding Sites and Types of Adhesion in Previous Cesarean Sections: A study in a Tertiary Care Hospital
Dr. Sabina Parveen, Dr. Md. Mahmudur Rahman, Dr. Begum Shamsun Naher Sherin, Dr. Mahbuba Akhter
Sch J App Med Sci | 2177-2180
DOI : 10.36347/sjams.2020.v08i09.038
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Introduction: During present decades caesarean section surgery has become one of the most common obstetric operations worldwide. Adhesions developed after cesarean sections (CS) vary according to the number of repeat section. We have very few data regarding adhesion locally. Aim of the study: The aim of this study was to evaluate the adhesion in previous cesarean sections regarding the sites and types of adhesion. Methods: This is a prospective observatory study conducted in the department of Obstetrics and Gynaecology in US-Bangla Medical College Hospital, Dhaka, Bangladesh during the period from January 2019 to December 2019. The study was approved by the ethical committee of the mention hospital. The proper written consents were obtained from all the participants before starting the main intervention. In total 60 patients with adhesion in previous cesarean sections were selected as the total study population of this study. Results: The most common type of adhesions was uterovesical found in all cases (100%). Omental adhesions with the anterior uterine wall came next in 56 cases (93.33%). Case of uterosigmoid was 18.33% and the case with the uterus intestinal was 11.67% in this study. Besides all these findings in analyzing the sites of adhesions we found the highest 70% cases of avascular. Then both fine and thin were 38.33% separately. On the other hand the frequencies of dense, thick, and vascular and distort anatomy were 58.33%, 45%, 28.33% and 21.67% respectively. Conclusion: A high percentage of cesarean deliveries result in adhesive disease, which delays repeat cesarean delivery of the fetus. The potential for adhesive disease should be included in counseling regarding primary elective cesarean births. The findings may be helpful in the treatment arena and in farther studies.
Original Research Article
Sept. 28, 2020
Surgical Management of Tibial Shaft Fracture of Adult Patients with Closed Antegraded Interlocking Intramedullary Nail
Md. Tariqul Islam, Md. Nazibullah, Anam Ahmed Ripon
Sch J App Med Sci | 2181-2186
DOI : 10.36347/sjams.2020.v08i09.039
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Background: Tibial shaft fracture is relatively common fracture in all age groups followed by direct or indirect violence. Intramedullary interlocking nail is commonly used for treating fractures shaft of the tibia. We have very few data regarding this issue. Aim of the Study: The aim of this study was to assess the efficacy of interlocking intramedullary nail for the management of tibial shaft fractures of adult patients. Material and methods: This was a retrospective study and it was carried out during the period from January 2017 to January 2020 in TMSS Medical College & RCH, Bogura and Natore Trauma Centre & Hospital, Natore, Bangladesh. The study was approved by the ethical committees of both the mentioned institute. Before starting the main intervention the proper written consents were taken from all the participants. In total of 38 adult patients of above 18 years age from both sexes with closed fracture shaft of tibia were included as the study population. All data were collected, analyzed and disseminated by MS Office program. Results: The average duration of operation for each patient was 48.553 ± 6.46 mins. The length of the incision among 48 patients recorded from 3~5cm and the average length of the incision was 3.658 ± 0.56 cm. The average blood loss in the operation was 34.211 ± 4.73 ml. The postoperative hospital stay was recorded from 7~14 day and the average hospital stay of those patient was 9.911 ± 1.98 days. The number of X-ray exposure during the whole follow-up recorded from 11~17.5 seconds and average X-ray exposure time was 13.5 second. All the patients were able to walk properly at our last follow-up. Average weight bearing time was 5.763 ± 1.49 weeks. In final outcome analysis of this study we found satisfactory result in 32 patients which was 84% and unsatisfactory in 6 patients which was 16% of the total study people. Conclusion: Intramedullary interlocking nail is an excellent method for closed, type1, 2 and 3A open fractures of tibia...
Original Research Article
Sept. 28, 2020
A Comparison between Anti-Thyroid Antibody Positive Euthyroid and Anti-Thyroid Antibody Negative Euthyroid in Pregnancy: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh
Md. Jahangir Alam, Md. Fariduddin, M. A. Hasanat, Murshed Ahamed Khan, M. A. Shehab
Sch J App Med Sci | 2187-2193
DOI : 10.36347/sjams.2020.v08i09.040
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Introduction: Thyroid disorders in pregnancy are receiving attention from many scientific corners. Over the past several years it has been proved that maternal thyroid disorders influence the outcome of mother and fetus during and also after pregnancy. Material & Methods: This observational and longitudinal study encompassed 300 pregnant mothers who were recruited on consecutive basis in their first trimester from the department of Obstetrics and Gynecology. BSMMU and antenatal clinic of a maternity hospital after fulfillment of inclusion criteria. Assay for anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies as well as free thyroxin (FT4) and thyroid stimulating hormone (TSH) were done by automated chemiluminescent method. Study subjects were categorized into normal and disorder groups on the basis of American thyroid association (ATA) defined criteria and all pregnant women were followed throughout the pregnancy till delivery, to note any adverse feto-maternal outcome. Results: Mean maternal age (±SD) was 25.68±4.50 years. Median gestational age on recruitment in the first trimester was 11.0 weeks. Most of the mothers were housewife (74.0%) followed by service holder (19.3%) and students (6.7%). About one third mother (29%) had history of previous abortion; 37% were primigravida and 46% were nulliparous indicating abortion or miscarriage in some mothers. Out of 300 pregnant mothers more than 200 were negative for both antibodies, 28 were positive for both antibodies, while 50 were positive for only anti-TPO and 12 were positive for only anti-TG (p<0.001, by McNemar’s test). These frequencies for euthyroid (n=19): 6,8, 4 and 1 (p=0.375), for hypothyroid (n=7): 2,0,4 and 1 (p=0.375), for SCH (n=102): 69, 10, 18 and 5 (p=0.011) and for subclinical hyper (n=9): 5,2,2 and 0(p=0.500) respectively. When antibody status was considered combined 90 subjects were positive and 210 were negative. Frequencies of positive and negative antithyroid......
Original Research Article
Sept. 30, 2020
Clinico-Etiological Profile of Neonatal Seizures in Term Neonates: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh
Mohammad Moniruzzaman Bhuiyan, Nadira Dilruba Hoque, Mahfuza Nasrin, Md. Ibrahim Khalil, Nasrin Akhter
Sch J App Med Sci | 2194-2197
DOI : 10.36347/sjams.2020.v08i09.041
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Background: Neonatal seizures or neonatal convulsions are epileptic fits occurring from birth to the end of the neonatal period. Neonatal seizures are a common neurological problem with a frequency of 1.5-14/1000 neonates. Neonatal seizure is common in this part of the South Asia and there was paucity of data from this area. Objective: Identification of etiology will help in management there by reducing morbidity and mortality. Materials and Methods: This prospective study was done in NICU Pediatrics Dept. of Tertiary Care Hospital, Dhaka, Bangladesh from Jan 2018 to Jan 2019. Term neonates with clinically identifiable seizure were included in the present study. Preterm neonates, babies with neonatal tetanus, and babies with obvious congenital malformation were excluded. Results: Out of 84 studied neonates, 46 were males and 38 were females. 29 neonates had seizures within first 24 hours and 22 neonates had seizures on day 2. Perinatal asphyxia was seen in 28 neonates and septicemia was seen in 21 neonates. Conclusion: Perinatal asphyxia was the most common cause for neonatal seizures in term neonates, followed by septicemia and metabolic disturbances.
Syncope and Influenza: A Case of Bradycardia
Dr. Mohamad Al Farouh, Dr. Irfan Shaikh
Sch J App Med Sci | 2198-2199
DOI : 10.36347/sjams.2020.v08i09.042
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Influenza is one of the commonest viral infections. It is usually self-limiting but serious complications have been reported. As the first line of contact for patients is usually the primary care physicians it is important to recognize any complications early. This case highlights how influenza patients presenting with syncope, we should consider cardiac complication as a differential.
Original Research Article
Sept. 30, 2020
Routine ANC can Save Thousands of Maternal Lives: A Study in Medical College Hospital
Tasnuva Akter, Farhat Hossain, Ismat Jahan
Sch J App Med Sci | 2200-2204
DOI : 10.36347/sjams.2020.v08i09.043
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Introduction: Antenatal care (ANC) is a routinely checkup service provided to a women during her pregnancy. Mainly, it aims to ensure the health of both the mother and the fetus and to reduce maternal mortality rate. It is evidenced that, ANC is one of the four pillars of Safe Motherhood Initiative; moreover, circulation of it begins from 18th century and was developed in the 19th century. Providing necessary information and advices to maintain maternal health, safe childbirth, postnatal recovery to a pregnant women and her family is the target of ANC. Aim of the study: This study aims to observe that routine ANC (Antenatal Care) can save thousands of maternal lives. Material & Methods: We carried out an observatory study in the department of Obstetrics and Gynaecology, SSMC & Mitford Hospital, Dhaka, Bangladesh during the period from July 2015 to June 2017. Our aim was to observe the association of maternal mortality with routine ANC. A total number of 48 cases were enrolled in this study using purposive sampling technique. Data were collected in a pre-designed data collection sheet from the records of maternal death cases of Mitford Hospital after taking permission from the authority. Necessary data were collected from admission register, case files and death certificates using a structured questionnaire. Results: Out of 48 patients, the mean age was 25.42 ± 3.89 years. Most of the patients (45.83%) belonged to lower middle class and only 6.25% were from upper class family. 33.33% patients had hypertension, 22.92% patients arrived in hospital with delay and both unsafe abortion and cardiac diseases were in 10.42% patients which were all statistically significant (p=<0.05). Among the 48 study patients 40.0% had caesarean section, 20.0% vaginal delivery and maternal deaths occurred as undelivered in 11.0%. 46.0% of deaths occurred within 24 hours of hospital admission and 42.0% patients died after 48 hours. Conclusion: ANC was observed only in 6.25% of ...........
Original Research Article
Sept. 30, 2020
Uses of Monotherapy and Combination of Antihypertensive Drugs for Hypertensive Patients with Type-2 Diabetes
Dr. Md. Ahsan Habib, Dr. Md. Aminul Hasan, Dr. Md. Rashadul Kabir, Dr. Md. Monwar Hossain
Sch J App Med Sci | 2205-2211
DOI : 10.36347/sjams.2020.v08i09.044
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Background: Now a day association of diabetes in hypertensive patients is a very common issue. In fact, people with both diabetes and hypertension have approximately twice the risk of cardiovascular disease as nondiabetic people with hypertension. Besides monotherapy combinations of antihypertensive drugs are essential for many cases of hypertensive patients with type-2 diabetes. We have not enough data regarding the uses of monotherapy and combination of antihypertensive drugs for hypertensive patients with type-2 diabetes. Aim of the study: The aim of this study was to assess the uses of monotherapy and combination of antihypertensive drugs for hypertensive patients with type-2 diabetes. Methods: This was an observational cross sectional study and it was conducted in Dhaka Medical College Hospital and BIRDEM Hospital during the period from July2016 to June 2017. In total 140 diagnosed hypertensive patients with type 2diabetes mellitus attending to the Endocrine Departments of Dhaka Medical College Hospital and BIRDEM Hospital completed the full tenure of the study were finalized as the study population. After data analysis, results were find out according to the objectives, study result were presented in the form of tables, charts and description of the key findings according to need. The collected data were also be entered and analyzed using statistical software SPSS version 16. Result: In total 66 (47.1%) patients of this study taken monotherapy and 74 (52.9%) patients taken combination drugs. In this study, 73%, 23% and 4% patients taken double, triple and quadruple combination of antihypertensive drugs respectively. As monotherapy, ARBs, CCBs, ACEIs, Beta Blockers, and diuretics were used in 35%, 23%, 20%, 16% and 6% patients respectively. In DMCH, ARB + Diuretics (8) and ARB +CCB (8) were most commonly used combinations. On the other hand, in BIRDEM, ARB + Diuretics (13) were most commonly used combinations and then B. Blocker + CCB (11) were most commonly...
