Original Research Article
Oct. 3, 2020
Etiological Evaluation of Headache Patients in a Tertiary Care Hospital
Dr. Md. Shah Alam, Dr. Md. Ahsanul Kabir, Dr. Abdullah Al Maruf, Dr. Nayan Kanti Das, Prof. M. A. Azhar
Sch J App Med Sci | 2212-2218
DOI : 10.36347/sjams.2020.v08i10.001
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Background: Headache is a very common complain amongst patients attending inpatient and outpatient departments of Medicine and Neuromedicine. In this study an attempt has been made to evaluate the etiological and clinical pattern of headache in our populations. The results of the study will help prompt and early diagnosis of headache patients. Methods: This study was conducted in the department of Medicine and Neuromedicine of SSMC and Mitford Hospital from 1st July, 2014 to 31stDecember, 2014. This is a prospective observational study. Sample size is 100. Qualitative purposive sampling has been done. Sample has been selected according to inclusion and exclusion criteria. Proper history taking, thorough physical examination and necessary investigation have been done to find out the etiology of headache. The data has been recorded in a structured format and analyzed by computer software SPSS. Result: In the study mean age of the respondents was 39.8±26.66 (at 95%CI). Male and female ratio was 0.72:1.This study revealed that out of 100 patients 60 patients had Tension type headache (TTH), 11 patients had migraine, 15 patients had Mixed cranial headache (MCH), 1 patient to Cluster headache (CH) and 13 patients had secondary headache. It was seen that most patients (87%) suffered from primary headache with TTH being the commonest diagnosis. Females were more affected than male in all groups except secondary headache. There was decline in primary headache with advancing age as the number of secondary headaches increased. Investigations were needed in a very small group of patients. Conclusion: It is very important to differentiate the different types of headache. Knowledge about etiological pattern of headache will help clinically in prioritizing the patients, in planning investigations, early diagnosis and prompt management and prevent complications of the patients.
Original Research Article
Oct. 7, 2020
Key Clinical and Morphological Patterns of Anaemia in Preschool Children in Rural Setting of Bangladesh: A Fact Finding Study
Md. Moniruzzaman Mollah, Ashik Mosaddik, Asgor Hossain, Rejaul Karim, Ahmed Ferdous, Parvez Hassan, Md. Shukur Ali
Sch J App Med Sci | 2219-2224
DOI : 10.36347/sjams.2020.v08i10.002
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Background: Anaemia and its association with low physical and cognitive development in under-five children remain as a common public health burden in developing countries including Bangladesh. Diagnosing anemia with its clinical and morphological pattern is important since it help in directing further investigation, identifying the etiology and most importantly helps in treatment. Aim of the study: The aim of the study was to find out key clinical and morphological pattern of anaemia among the under-five children in rural community of Bangladesh. Methods and Materials: A cross-sectional study were conducted at five remote northern districts of Bangladesh involving rural children aged 6 - <60 months. Five millilitre (ml) venous blood was drawn using a sterile syringe and was analyzed with an ‘Automated Hematology Analyzer’ for complete hemogram. The degree of anaemia was classified into three categories on the basis of hemoglobin level. Chi-squared test and independent sample t test were the main statistical model to identify significant variables. A p-value <0.05 was considered as significant. Results: Overall prevalence of anaemia (N = 258) was 61.23% with mild, moderate and severe anaemia of 28.29%, 28.68% and 4.26% respectively. Of all anaemic children nearly 7% has been suffering from severe anaemia. The prevalence of anaemia was the highest (72%) in age group 6-24 months, which was followed by 63% in >24-36 months and 44.3% in >36-60 months categories. Morphologically, the most common type of anemia is microcytic anemia (80%) followed by normocytic anaemia (19%) in rural settings. Majority of microcytic anaemic children (63%) belongs to 6-24 month age group and normocytic anemia are commonly prevailed (50%) in >36-60 month and (43%) in 6-24 month aged group. Sex has no statistically significant influence on morphological pattern of anaemia (X2= .075). Conclusion: Clinically moderate anemia or mild anaemia is very common in preschool children particularly ......
Original Research Article
Oct. 6, 2020
Effect of Doxycycline on Proteinuria in Diabetic Nephropathy
Dr. Sushanta Kumar Barman, Dr. Md. Nizamuddin chowdhury, Dr. Mohammad Ehasun Uddin Khan, Dr. A.S.M Tanim Anwar, Dr. Monika Roy, Dr Muhammad Anamul Hoque, Dr. Md. Ruhul Amin
Sch J App Med Sci | 2225-2230
DOI : 10.36347/sjams.2020.v08i10.003
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Objective: In this study our main goal is to assess antiproteinuric effects of Doxycycline in patients with diabetic nephropathy. Method: This is a prospective interventional study and conducted at the Department of Nephrology in DMCH.The study included 60 clinically proven adult patients of DN. All patients were on optimal doses of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) for 2 months before the study. The patients were divided into two groups named control (group I, n = 30) and intervention group (group II, n = 30). Control group patients were maintained on optimal doses of ACEIs or ARBs, whereas intervention group patients received Doxycycline (100 mg/day) for a period of 3 months in addition to ACEIs or ARBs. Data were collected at month 0 and at month 1 at month 3. Results: The study result revealed that before intervention, the mean basal levels of 24 hours proteinuria was 2.2 ± 1.3g/day for Group I and 2.7 ± 1.42 g/day for Group II. P value is not significant in both group at baseline (p=0.2). Adequate glycemic control was achieved with insulin, oral hypoglycemic agents or both in all the patients. It reduced to 2.0 ± 1.2g/day for Group I and 2.5± 1.3g/day for Group II, at the end of 1 month. At the end of 3 months, a significant decline of proteinuria was observed in both the groups. In Group I it had a mean of 1.95 ± 1.2g/day, whereas it was 1.25± 0.78g/day in Group II. A statistically significant difference existed between the control and intervention groups (p < 0.05), at 3 months. Conclusion: Doxycycline has significantly reduces proteinuria in diabetic nephropathy patients.
Original Research Article
Oct. 6, 2020
Characterization of Breast Masses in Mammography using First Order Statistic
Umaima S. E. Ali, Eman M. Algorashi, Mohamed E. M. Gar-Elnabi
Sch J App Med Sci | 2231-2235
DOI : 10.36347/sjams.2020.v08i10.004
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This study concern to characterize the breast masses in mammography were defining the breast tissues to tumor, gland, fat and connective tissue, at cancer diagnostic medical center and carried out using Interactive Data Language [IDL] program as platform for the generated codes. The texture analysis technique used to find the gray level variation in mammography images. Analyzing the image with Interactive Data Language IDL software to measure the grey level variation of mammography images. The result of the classification showed that the breast areas were classified well from the rest of the tissues although it has characteristics mostly similar to surrounding tissue. Several texture features are introduced from first order statistics and the classification score matrix generated by linear discriminate analysis and the classification accuracy of breast tissues classified to Tumor 96.8%, gland 57.9%, fat 98.9, While the connective tissue showed a classification accuracy 98.5%. The overall classification accuracy of breast area 94.0%. These relationships are stored in a Texture Dictionary that can be later used to automatically annotate new mammography images with the appropriate breast area names.
Spontaneous Anterior Dislocation of the Lens in Homocystinuria
Karim Amhoud, Karmoune S, El Marzouqi B, Belaydi W, Lalaoui A, Abdallah E, Boulanouar A, Berraho A
Sch J App Med Sci | 2236-2238
DOI : 10.36347/sjams.2020.v08i10.005
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Purpose: To report an unusual case of a spontaneously dislocated crystalline lens into the anterior chamber associated with Homocystinuria. Methods: A 44-year-old woman with no occular trauma history presented with a spontaneously dislocated crystalline lens into the anterior chamber accompanied by corneal touch and increased intraocular pressure. The crystalline lens was extracted by phakoemulsification followed by a retro-pupillary iris claw. Results: Surgery was successful with improved visual acuity stabilized eye pressure and clarification of the cornea. Conclusion: Homocystinuria is a rare etiology of spontaneous anterior dislocation of the lens that requires multidisciplinary management.
Fallopian Tube Leiomyoma – A Rare Entity
Dr. Sujata. S. Kumbhar, Dr. Abhijit Phalke, Dr. Sonam Billawaria, Dr. Shefali Mishra
Sch J App Med Sci | 2239-2241
DOI : 10.36347/sjams.2020.v08i10.006
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Background: Leiomyomas are the most common benign tumors of the female genital tract and most frequently they arise from the smooth muscles cells of the uterus. Fallopian tube leiomyomas are extremely rare and arise from the myosalpinx or the cells of the blood vessels supplying the fallopian tubes. Case Report: A 53- year was admitted with colicky pain abdomen with recurrent uterine bleeding and cervical polyp on per vaginal examination. USG reported uterus being bulky and enlarged with complete loss of endo-myometrial differentiation – features likely suggestive of adenomyosis. With clinical diagnosis of cervical polyp and adenomyosis of uterus patient underwent panhysterectomy. Specimen of panhysterectomy and separately sent cervical fibroid were received for histopathology examination in our department of pathology in Krishna Institute of Medical Sciences, Karad. Discussion: Leiomyomas are the most common benign tumors of the female genital tract and most commonly arise from the uterus. The incidence of fallopian tube myomas are extremely rare(5) and it is difficult to evaluate their frequency of occurrence. Fallopian tube myomas arise from the mesosalpinx or the smooth muscle cells of the blood vessels supplying the tube. They are rarely diagnosed pre-operatively. Powerful USG could be helpful in diagnosing this condition, but laparoscopy can be used for definite diagnosis and management. Conclusion: Asymptomatic fallopian tube leiomyoma being chance findings are very rare and symptomatic fallopian tube leiomyoma as in this case are still rarer. This condition should be kept in mind as a differential diagnosis of any adnexal mass.
Original Research Article
Oct. 7, 2020
Feto Maternal Outcome of Teenage Pregnancy
Dr. Binoy Krishna Golder, Dr. Most. Zakia Sultana, Dr. Mahbubur Rahman, Dr. Begum Shamsun Nahar Shirin
Sch J App Med Sci | 2242-2245
DOI : 10.36347/sjams.2020.v08i10.007
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Objectives: In this study our main aim is to evaluate feto maternal outcome of teenage pregnancy. Methods: This Cross-sectional study was done attertiary medical college and hospital, Dhaka 1 year from August 2018 to July 2019. 100 Teenage pregnant ladies between 18 to 20 years were taken up as a case group for the study. 108 control group pregnant women of 21 to 35 years age, without any preexisting co-morbidities and history of previous caesarean section. Results: In the study, 23% had vaginal deliveries whereas 77% cases had caesaren deliveries. Failed induction was common in case and control group, 14.5% and 9.25%. Also, in case group 12.8% neonates were suffered from fetal distress, where as in control group it was 9.2%. Conclusion: From our study we can say that, in order to improve the teenage health periodic information, education, community activities, ANC camps to be held at primary health care centers. Further study is needed for better outcome.
Original Research Article
Oct. 10, 2020
A Study of Predisposing factors for Fungal Sepsis and Causative Organisms
Sharma A, Mathur P, Agarwal A, Gupta M
Sch J App Med Sci | 2246-2250
DOI : 10.36347/sjams.2020.v08i10.008
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Neonatal sepsis is the most common cause of neonatal mortality and morbidity. Studies have recorded an incidence of neonatal sepsis, varying between 11 and 24.5 per 1000 live births. It is responsible for about 30-50% of the neonatal deaths. Depending on the onset of symptoms, it can be classified into early onset sepsis within 72 h of life and late onset sepsis usually after 72 h of life. It has been one of the major diagnostic problems for physicians due to non-specific symptoms and the absence of a reliable Para clinical marker. Fungal blood stream infection (BSI) is an important cause of neonatal sepsis and sepsis related mortality. According to our study, the common risk factors for Fungal BSI include prematurity, low birth weight, central vascular catheterization, use of broad spectrum antibiotics, prolonged hospital stay, birth canal infections or discharges and male newborns. Neonatal fungal sepsis occurs in immunologically immature or very ill patients because of individual susceptibility and due to health care related infection. Early signs of sepsis are non-specific and may commonly presents with respiratory distress, feed refusal, apnoea and bulging fontanelle etc. A heart rate above 160 can also be an indicator of sepsis, this tachycardia can present even 24 hours before the onset of other signs. Culturing for microorganisms from a sample of CSF, blood or urine, is the gold standard test for definitive diagnosis of neonatal sepsis. Widespread infection despite negative culture is common. It is often difficult to establish the diagnosis of fungal sepsis because there are no easy, reliable and rapid tests. In addition to fluid resuscitation and supportive care, Amphotericin B continues to be the mainstay of therapy for systemic fungal infections. Recently Indian liposomal Amphotericin B derived from neutral lipids (L-Amp-LRC-1) has shown effective response at lower dose with less toxicity and inexpensive drug for the treatment of neonatal candidiasis.
Original Research Article
Oct. 11, 2020
Laboratory Findings of Typhoid Fever in Children: Study in a Tertiary Care Hospital
Dr. Amal Kanti Banik, Dr. Khokan Chandra Mazumder, Dr. Mrinal Kanti Mondol, Dr. Goury Prava Dhar, Dr. Mohammad Shafiqul Alam Chowdhury
Sch J App Med Sci | 2251-2255
DOI : 10.36347/sjams.2020.v08i10.009
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A case-control type of study was conducted over a period of 6 (Six) months following approval in the Department of Paediatrics, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh during the period from October 2012 to April 2013. Our aim was to assess laboratory findings of typhoid fever in children in Bangladesh. The sample size for this study was 240 (120 cases and 120 controls). Out of 120 participants in each group 79.2% cases and 68.3% controls respondents were mother of the children. In both groups, most of the study participants were from younger age group ≤ 5 years; 63.3% of cases and 80.8% of control. Mean ± SD of age were (5.1042 ± 3.11575) for cases and (3.5951 ± 2.50218) for controls Age distribution of the children was statistically significant where p -value was 0.0001 for t-test and 0.01151045 for chi-square (p<0.05). There was no positive association of different blood group but when each group was individually considered, blood group ‘B’ indicated there may be some positive association (RR = 1.4505, OR = 1.8713 and χ2 = 4.66, p = 0.030873). Only 3.3% children in case group and 4.2% in control group had Rh negative blood group. Widal test result was positive in 83.3% of cases; the remaining 16.7% were found to be Widal negative. The difference was statistically significant (χ2 = 18.22, p =0.0001. Blood culture was done in only 50 (41.7%) participant from the case group; out of them negative culture was obtained in 4 individuals, the difference was statistically significant (χ2 = 52.585, p = 0. (P < 0.05). Typhoid fever has a strong relation with socio-economic conditions and blood phenotypes.
Original Research Article
Oct. 11, 2020
Neonatal Sepsis - A Study of Predisposing Factors and Causative Organisms
Sharma A, Mathur P, Sharma J N, Gupta M, Agarwal A
Sch J App Med Sci | 2256-2259
DOI : 10.36347/sjams.2020.v08i10.010
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Neonatal sepsis is the most common cause of neonatal mortality and morbidity. Studies have recorded an incidence of neonatal sepsis, varying between 11 and 24.5 per 1000 live births. It is responsible for about 30-50% of the neonatal deaths. Depending on the onset of symptoms, it can be classified into early onset sepsis within 72 h of life and late onset sepsis usually after 72 h of life. It has been one of the major diagnostic problems for physicians due to non-specific symptoms and the absence of a reliable Para clinical marker. The common risk factors for neonatal sepsis include an Apgar score 6 at 5 minutes, prolonged rupture of membranes, placental inflammation, and clinical amnionitis (maternal fever, fetal tachycardia, and amniotic or gastric fluid leukocytes or bacteria), prematurity and very low birth weight, central vascular catheterization, parenteral nutrition, use of broad spectrum antibiotics, H2 blockers and corticosteroids, endotracheal intubation, and prolonged hospital stay. Early signs of sepsis are non-specific and may present with episodes of fever, respiratory distress, diarrhea, low blood sugar level, decreased movements, decreased suckling, seizures, bradycardia, swollen belly area, vomiting, jaundice or rash. A heart rate above 160 can also be an indicator of sepsis, this tachycardia can present up to 24 hours before the onset of other signs. Culturing for microorganisms from a sample of CSF, blood or urine, is the gold standard test for definitive diagnosis of neonatal sepsis. Widespread infection despite negative culture is common. In addition to fluid resuscitation and supportive care, a common antibiotic regimen in infants with suspected sepsis is beta-lactam antibiotic in combination with an aminoglycoside or a third generation cephalosporin and organism specific antibiotics. Granulocyte-macrophage colony stimulating factor is sometimes used in neonatal sepsis to correct neutropenia if present but it has no effect on reducing sepsis.
Original Research Article
Oct. 13, 2020
The Efficiency of Misoprostol versus Manual Vacuum Aspiration for the Treatment of Incomplete Abortion
Dr. Nasima Begum, Dr. Rokeya Begum, Dr. Khan Mashrequl Alam
Sch J App Med Sci | 2260-2265
DOI : 10.36347/sjams.2020.v08i10.011
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Objective: In this our main goal is to assess the efficiency of misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion. Method: This hospital based randomized controlled trial study was conducted in in-patient patient Department of Obstetrics and Gynaecology, Chittagong Medical College and Hospital from October 2007 to September 2008. A total of 128 women between the ages of 15 to 40 years with diagnosis of first trimester uncomplicated spontaneous incomplete abortion was included in this study. Among them 64 patients were randomized in group ‘A’ as case who were treated with Misoprostol and 64 patients were in group ‘B’ as control who were treated with Manual Vacuum Aspiration. Results: During the study, where the mean gestational size of uterus was 9.52 weeks at the time of initial examination. The mean size of uterus in misoprostol group was 9.07(SD ±1.93) and that of MVA group was 9.87 (SD± 1.35). More women in case group had no child of viable age on the other hand increased number of women in control group had at least one viable birth. 36 (60%) out of 60 women in misoprostol group 26 (41.93%) out of 62 reported pain and 36 (58.07%) out of 62 women in MVA and 24 (40%) patients in misoprostol arm said bleeding as the worst feature. Thirty six percent women in misoprostol group and 16% women in MVA group reported that the adverse effects were easily tolerable. Thirty percent women in Misoprostol arm and 29.03 % women in MVA arm were satisfied with their respective treatment. But only 3.23% patients in MVA arm while 53.30% women in Misoprostol arm were very satisfied with their allocated treatment. Fifty (83.3%) patients out of 60 in Misoprostol arm and 18 (29.03) out of 62 women in control group said that they would choose the method again if they face such a problem in future. When they were asked whether they would recommend it to their friends 93.3% patients in Misoprostol group and only 12.5% in MVA group said that they.........
Original Research Article
Oct. 15, 2020
Clinicohematological Profile of Anemia in Children – A Retrospective Descriptive Study
Dr. Pramila Ramawat, Dr. Nilesh Jain
Sch J App Med Sci | 2266-2270
DOI : 10.36347/sjams.2020.v08i10.012
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Aim: To study clinical spectrum and hematological profile of anemia and its association to age, gender and nutritional status in children aged 1 month to 14 years admitted in tertiary care hospital of Central India. Material and Methods: A retrospective descriptive study conducted by collecting data from hospital record system about children aged 1 month to 14 years admitted between Augusts to December 2019. Data analyzed for demography, clinical profile including anemia type, severity, etiology and effects, hospital stay and outcome. Result: In our study boys were outnumbered girls in hospitalization. Most common cause was nutritional anemia based on etiology. Infection and malnutrition were found in significant numbers of patients. Bicytopenia and pancytopenia were also noticed in patients. Conclusion: Nutritional anemia is most common cause of anemia in childhood especially in developing countries which can be prevented by proper nutritional support in growing age. Parents and caregiver need awareness regarding effect and causes of anemia and how to prevent it.
Original Research Article
Oct. 15, 2020
Early Detection of Multivessel Disease and Prevention of Short and Long Term Complications
Dr. Mohammad Aminul Islam, Dr. AHK Chowdhury, Dr. AKM Mujibur Rahman, Dr. Md. Khalequzzaman
Sch J App Med Sci | 2271-2277
DOI : 10.36347/sjams.2020.v08i10.013
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Objective: In this study our main goal is to early detection of multivessel disease and prevention of short and long term complications. Methods: This was prospective and observational study conducted at National Institute of Cardiovascular Diseases, Shere-e-Bangla Nagar, Dhaka, Bangladesh from February 2012 to December 2012. We examined enlisted eighty four (n=84) consecutive patients with acute inferior myocardial infarction within 12 hours of onset of chest pain and underwent thrombolysis in coronary care unit. Consequently patients were classified in two groups on the basis of admission electrocardiogram. Group A patients with acute inferior myocardial infarction associated significant (≥ 0.1 mV) precordial ST segment depression in leads V1-V6 (n=44, 52.38%); whereas group B had no remarkable precordial ST segment change (n=40, 47.62%). Thereafter Echocardiography was recorded within 3rd day and catheterization with coronary angiography was done within 4 weeks of infarction. Result: Angiographic result was in patients with precordial ST depression had more prevalence to double vessel (77.3% vs. 22.5%) and triple vessels disease found to be higher in group A (15.9% vs. 2.5%). Though anterior descending artery involvement was higher than left circumflex, but independent left anterior descending lesion could not implicated. Conclusion: In overall outcome, patients with ST segment depression in acute inferior myocardial infarction liked with more wideness of ischemic area of infracted zone and more prevalence to multi vessel lesion (double or triple vessel) and index of worse prediction. In conclusion, the current study may give significant clinical benefit to prediction of coronary artery involve from admission ECG, concurrently
Original Research Article
Oct. 17, 2020
Clinical Profile, Pattern of Presentation and Short Term Outcome of Cyanotic Congenital Heart Disease in Neonates
Dr. Dilruba Ibrahim Dipti, Dr. Md. Abu Sayeed, Dr. Abu Sayeed Munsi
Sch J App Med Sci | 2278-2285
DOI : 10.36347/sjams.2020.v08i10.014
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Background: Cyanotic heart disease refers to a group of many different heart defects that are present at birth (congenital) that results in a low blood oxygen level, many of which are life threatening in neonatal period necessitating early diagnosis and prompt treatment. Thus, by early intervention for critical cyanotic congenital heart diseases in neonatal period or early infancy, children can survive beyond the pediatric age. Aim of the study: To determine the clinical profile and pattern of presentation and short term outcome of cyanotic congenital heart disease in neonates. Methods and Materials: An observational type of cross-sectional study was conducted in the Department of Pediatric Cardiology of Dhaka Shishu hospital between the study period of July to December 2019 where total 74 newborn with cyanosis were recruited from outpatient and inpatient departments .Cyanotic congenital heart disease was diagnosed with the help of clinical examination and investigations finding and associated risk factor and treatment and short term outcome was documented. Results: Among the 74 neonates 58 (78%) were male and 16(22%) were female and male : female ratio was 3.6 :1. Age of presentation of majority of patient (n=36) was 16-28 days whereas only 3 patient presented in between 0-2 days. The neonates mainly had Transposition of Great Arteries (TGA) (n=22), Tetralogy of Fallot (TOF) (n=12),Tricuspid Atresia(n=7), DORV(n=7), Total Anomalous Pulmonary Venous Return(n=5), Hypoplastic Left Heart Syndrome(n=3). The median age of presentation of common cyanotic congenital heart defects like TGA, TOF, Tricuspid Atresia, DORV are 12-15 days. Median age of presentation for TAPVC was highest that is 23 days and Ebstein anomaly was lowest that is 8 days. In this study all of the study neonates (n=74) had cyanosis. Out of 74 patient 69(93%) had tacyhpnea, 61(82%) had tachycardia, 38(51%) had murmur, 26(35%) had hepatomegaly. Crepitation, rhonchi and oedema were found respectively.....
Original Research Article
Oct. 17, 2020
Evaluation of Post-operative Outcome in Patients with Trochanter Fracture of Femur in Treating with Proximal Femoral Nail and Dynamic Hip Screw
Debdulal Debnath, S. M Jihadul Islam, Nazmul Huda
Sch J App Med Sci | 2286-2291
DOI : 10.36347/sjams.2020.v08i10.015
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Background: We have very few data regarding the socio-demographic and clinical status of patients with Trochanter Fracture of Femur. Trochanter fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. Fracture of the proximal part of the femur are an important cause of morbidity and mortality in all age groups, especially the elderly. Proximal femoral nail and dynamic hip screw system are two widely used methods in treating trochanter fracture of femur. The aim of this study was to evaluate post-operative findings of the patients with Trochanter Fracture of Femur in Treating with Proximal Femoral Nail and Dynamic Hip Screw. Methods: The present prospective comparative study has been done in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh during the period from July 2015 to June 2017. During this period obeying inclusion and exclusion criteria 30 patients of unstable intertrochanteric fractures of femur were finalized as the study people. Among them 14 cases were treated with PFN and 16 with DHS. All statistical analysis of different variables was analyzed according to standard statistical method by Fisher’s Exact Test and Student t-Test and done by using SSPS method in computer. Result: In this study 63.3% of the subjects were 65 or above 65 years and 10% below 50 years of age. Sixty percent (60%) were male whereas 40% were female. House-wife comprised the main bulk (40%) as occupation. Other occupants were service holders (13.3%), businessman (13.3%), farmer (10%) and day-laborer (3.3%). The rest 20% were involved with other informal jobs. Causes of injury revealed that 26.7% trochanter fractures were caused by RTA and 36.7% by fall from height and 36.7% by accident at home. Two-third (66.7%) of the injuries had right-sided involvement. More than half (53.3%) of subjects were operated within 7 days of the incident. Conclusion: In this study, the highest cases of Trochanter......
Original Research Article
Oct. 17, 2020
Impact of Diabetes on Ischemic and Hemorrhagic Stroke
Khushboo Rathore, Dr. Raghuveer Choudhary, Dr. Kamla Choudhary, Dr. Kumari Nirja, Dr. Bhawna Shekhawat
Sch J App Med Sci | 2292-2296
DOI : 10.36347/sjams.2020.v08i10.016
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Stroke is the major cause of mortality and morbidity both in the developed and developing countries worldwide. We examined the impact of diabetes among ischemic and hemorrhagic stroke patients. Data from 100 consecutive patients with ischemic (72%) and hemorrhagic (28%) stroke were analyzed. Patients were classified into four categories ischemic and diabetic, ischemic and non-diabetic, hemorrhagic and diabetic, hemorrhagic and non-diabetic. Diabetes is an important risk factor associated with stroke. In the present study, only 21% of studied subjects were diabetic. While the majority that is 79% were non-diabetic. There was difference in sex wise distribution of diabetic status. Proportion of females having diabetes was more i.e., 22.22% (10/45) than males 20% (11/55). Systolic blood pressure shows higher significant difference between diabetic and non diabetic patients in both ischemic and hemorrhagic strokes (p <0.001). Diabetes mellitus have significantly more traditional risk factors in stroke patients. There is a difference between male and female relative frequencies of age and diabetes mellitus.
Original Research Article
Oct. 17, 2020
Role of Non-Invasive Methods to Predict the Presence of Gastro-Esophageal Varices among the Patients Present With Chronic Liver Disease
Md. Mamunur Rashid, Sultana Jasmin
Sch J App Med Sci | 2297-2308
DOI : 10.36347/sjams.2020.v08i10.017
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Background: Liver disease particularly chronic liver disease is one of the major public health problem, accounting for significant morbidity and mortality worldwide. Among the different complications, gastro-esophageal variceal bleeding is the deadliest complications of advanced liver disease and have been described in 50% of patients with liver cirrhosis. Moreover, the presence of gastroesophageal varices (GEV) has important implications for the prognosis and the severity of the disease. An estimate suggest that mortality due to variceal bleeding is around 20%. Objective: The objective of this study was to determine the role of non-invasive methods to predict the presence of gastroesophageal varices among patients with chronic liver disease. Methods: It was a hospital based cross-sectional study and conducted at the Department of Gastroenterology and department of Medicine in Dhaka Medical College Hospital, for six month period. Written informed consent was taken from the subject and ethical issues was ensured. Total 146 CLD individual was selected according to inclusion and exclusion criteria. Each patient was interviewed individually by the principal investigator. All these was registered, documented and analyzed in the statistical program Statistical Package for Social Science (SPSS) version 22.0. The data was systematically described and summarized and presented through descriptive statistics. In all cases significance level will be set at p<.05. Findings were expressed by graph and chart whichever is relevant. Thus the study was assessed the usefulness of non-invasive methods to predict the presence of Gastro-esophageal varices among the patients who present with chronic liver disease. Results: The mean age of the CLD patients was 44.62±13.87 years, minimum age 20 and maximum 78 years. Majority of the patients were male 78.8% and female 21.2%. Male: Female ratio was 3.7:1. In present study clinical presentation of CLD patients were showed 82.2% patients.......
Original Research Article
Oct. 17, 2020
Awareness about Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) among Paramedical Personnel in a Tertiary Care Hospital in Ranga Reddy District, Telangana
V. Sai Aishwarya, Dr. Sushma Katkuri
Sch J App Med Sci | 2309-2312
DOI : 10.36347/sjams.2020.v08i10.018
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Background: HIV continues to be a major global public health issue, having claimed almost 33 million lives so far. However, with increasing access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives. There were an estimated 38.0 million people living with HIV at the end of 2019. Aims & Objectives: To assess the knowledge of HIV/AIDS among para medical staff. Materials & Methods: The study was a hospital based cross-sectional study which was conducted in Malla Reddy Hospital, Suraram, Hyderabad. A total number of 109subjects (nurses and lab technicians) were included in the study. All the participants were given a questionnaire and the filled questionnaires were collected on site. Results: Out of 109 participants, majority of the study participants had good awareness about different modes of transmission of HIV. About 77% said it is through sexual route, 79.81% said it could be due to blood borne, 86% said from mother to child transmission and 87.15% said it is due to needle stick injury. Only 26% were aware that vaccine against HIV/AIDS is in the developmental stages. Conclusion: Transmission of blood borne infections through needle stick injury is a harsh reality involving health care personnel. There is an urgent need to teach basic knowledge about HIV infection and service availability.
Giant Fibroids: Diagnosis and Management Modality: About Two Cases and Literature Review
Benayada Mariyam, Ch’michi Nadia, Essabbagh Youssef, Echchikhi Meriam, Bennani Aicha, Lakhdar Amina, Zeraidi Najia, Kharbach Aicha, Baidada Aziz
Sch J App Med Sci | 2313-2317
DOI : 10.36347/sjams.2020.v08i10.019
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Uterine fibroids are benign pathologies, very common in women of childbearing age. They are the first cause of hysterectomy in women before menopause. Giant forms are rare. It raises diagnostic difficulties with other rare uterine tumors such as leiomyosarcoma. Magnetic resonance imaging specifies the organ of origin, the volume and the main relationships of the fibromyoma with adjacent structures. Medical treatment and embolization facilitates surgical treatment. We report here two cases of women with giant fibroma who underwent hysterectomy at the SOUISSI maternity hospital in Rabat.
Original Research Article
Oct. 19, 2020
CT Scan Findings of 400 COVID-19 Patients in Kuwait Bangladesh Friendship Government Hospital
Dr. Soheli Parvin, Dr. Syed Shamsul Arephen, Dr. Shahryar Nabi Shakil, Dr. S. M. Rokonuzzaman, Dr. Faisal Mohammed Pasha, Dr. R. N. Sarker, Dr. Tariqul Islam
Sch J App Med Sci | 2318-2325
DOI : 10.36347/sjams.2020.v08i10.020
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Background: The COVID-19 pandemic is an ongoing pandemic of coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). Bangladesh faces significant challenges in combating COVID-19 as it is a densely populated country with limited resources. The aim of this study is to evaluate the radiological findings of COVID-19 with the hope that this information will help to mitigate the disease. Methods: This retrospective study has been carried out among the patients of COVID-19 pneumonia tested by RT-PCR aged between 18-80 years. The data are collected from biochemical and radiological investigations with the help of biochemical instruments for obtaining blood samples and CT scan. Quality of data is strictly maintained and ethical issues are properly maintained in all the steps of this study. Results: 400 patients admitted to hospital between March 15, 2020, and August 25, 2020, were included in this study. The cohort included 277(69.3%) men and 123 (30.8%) women, and the mean age was 44•9 years (SD 15.2). In the CT chest findings, 342 (85.5%) patients had abnormal findings and the remaining 58 (14.5%) were normal. Among the abnormal CT findings, 270 (67.5%) had ground-glass opacity and 250 (62.5%) were present with ground glass opacity with crazy paving. The predominant pattern of abnormality observed in 312 (78.0%) patients was bilateral. Conclusion: This study provides essential information regarding CT chest of COVID-19 patients for prompt diagnosis in hopes to alleviate the ongoing pandemic.
Original Research Article
Oct. 19, 2020
Characterization of Infertility using Ultrasonography
Manal Z. A. Zeinalabdeen, Mohamed E. M. Gar-Elnabi
Sch J App Med Sci | 2326-2330
DOI : 10.36347/sjams.2020.v08i10.021
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The aim of this study to characterize the fertility in women using ultrasound through the uterine blood flow indices and uterus dimension. The sample consisted of 100 women; 50 of them were infertile and the other 50 were fertile women taken as control group. The result of this study showed that there is a significant difference between the fertile and infertile women in case of the uterus length and size, the uterus width and blood flow indices showed inconclusive result. The relationship of blood flow indices to uterine dimension showed a significant linear association between the uterus length and PI and PSV for the infertile women. While it shows similar relationship with the uterus length and area, and PI and PSV (multiple regression). These relationships were reverse in case of the fertile and infertile. For the infertile group there is an inverse linear relationship between the PI and uterus length and direct linear relationship between the PSV and uterus length. In case of fertile group there is a direct linear relationship between the PI and the uterus length (and uterus size) and inverse linear relationship between the PSV and uterus length and uterus size.
Original Research Article
Oct. 21, 2020
An Assessment of Primary Immunization and Factors Affecting Coverage – A Study on Hospitalised Children in Meghalaya
Jaideep V. Patel, Santanu Deb, Palash R. Gogoi, Prasenjit Paul, Sabrina Yesmin, Lima Sangla, Pramod Paharia
Sch J App Med Sci | 2331-2336
DOI : 10.36347/sjams.2020.v08i10.022
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Introduction: The need of the vaccines is felt the most in India, which accounts for 20% of the world’s child population, and responsible for 24% of all under-five deaths globally. There are pockets of low immunization coverage areas even after putting so many efforts by Government of India for full immunization coverage which means there are many barriers to achieve the desired results. The present study focuses on finding prevalence of fully immunized, partially immunized or un-immunization status as well as those barriers so that a way out to full immunization coverage can be obtained. Aim: To find out the primary immunization coverage status and factors associated with incomplete immunization in first year of life in hospitalized children between 1 to 5 years of age. Materials and Methods: This is a hospital-based cross-sectional study involving 92 children admitted in tertiary care teaching hospital of Meghalaya, India for the calendar year 2019. An interviewer-administered structured questionnaire constructed from a review of available literature on immunization coverage and influencing factors in immunization coverage was used to obtain the required data. Results: 92 cases were enrolled in the study. Out of total cases, 63(68.5%) were fully immunized, 18(19.6%) were partially immunized and 11(12%) were unimmunized. 27(29.3%). Females were 27(29.3%) and males 65(70.6%) (p = 0.04). Full primary immunization status was highest (70.6%) when distance of nearest health centre was closer to residence (10km) (p = 0.64), when maternal age was between 20-35 years, with class 1 socioeconomic status (Revised BG Prasad) (79.2%) (p = 0.049), with Urban residents(77.8%) (p = 0.8), with joint family (73.1%) (p = 0.04). Reason for drop out from full primary immunization was highest due to lack of knowledge of immunization schedule (27.6%) followed by lack of awareness (24.1%) and forgotten date (7.2%). Conclusion: Fully immunized cases were more and has increased with .......
Original Research Article
Oct. 21, 2020
Effect of Thumb Spica Splint in de Quervain’s Disease
Fahad Islam, Md. Imam Shahriar, A. B. M Zafar Sadeque, Md. Mahfuzur Rahman, Mohammad Ilias
Sch J App Med Sci | 2337-2342
DOI : 10.36347/sjams.2020.v08i10.023
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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 consist 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. The medication included non-steroidal Anti-inflammatory Drugs (NSAIDs) and analgesic, an injection of a steroid mixed with xylocaine into tendon sheaths. Objective: Main goal of this study is to evaluate the effect of Thumb spica splint in the management of de Quervain disease. Methods: This randomized clinical trial was performed in the Department of Physical Medicine and Rehabilitation, Chittagong Medical College Hospital, over a period of six months. Study population were the patients of de Quervain’s disease attending the out- patient department of Physical Medicine and Rehabilitation during the study period. Meticulous history taking, clinical examination and relevant investigations were done. Samples was selected by consecutive sampling from the population who are eligible as per inclusion and exclusion criteria from a definite date till desired sample size is reached and eligible participants were allocated into two groups, 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, non-steroidal anti-inflammatory agents (NSAIDs), ultrasound therapy (UST), along with Thumb spica splint. Control group received previous management except Thumb spica splint. Here Tynor brand Thumb spica splint was advised to use to all patient in experimental group, same analgesic drugs Tab. Naproxen 250mg two times daily after meal was given to all....
Tragic Outcome in Pregnancy
Dr. Tahmina Begum, Dr. MD. Nazrul Islam, Dr. Ferdousi Begum, Dr. Mahbubur Rahman
Sch J App Med Sci | 2343-2346
DOI : 10.36347/sjams.2020.v08i10.024
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In this study our main goal is to the objective of this study is to understand the incidence, socio epidemiological and etiological factors of intrauterine fetal death. This reparative study was conducted in the gynae and obstetric department of Mymensingh Medical College Hospital and Holy Family Red Crescent Medical College Hospital of Dhaka City from November 2018 to October 2019. A total 1736 pregnancy were studied. Out of them 48 we intrauterine fetal death (IUFD). Early identifying of underlying risk factors & diagnosis and timely intervention in the form of medical or surgical treatment will definitely help in reducing the morbidity and mortality of intrauterine fetal demise.
Original Research Article
Oct. 21, 2020
The Comparison of Glomerular Filtration Rate (GFR) Estimation by Cystatin C with Creatinine-Based Methods in Relation to Isotope-Based Method (99m-Tc DTPA Plasma Clearance) as Gold Standard in Patients with Chronic Kidney Disease
Dr. Shah Newaz Dewan, Dr. Masud Iqbal, Dr. M.Mahibur Rahman, Dr. Md. Abdullahel Kafee, Dr. Hasina Momtaz
Sch J App Med Sci | 2347-2351
DOI : 10.36347/sjams.2020.v08i10.025
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Objective: In this study our main goal is to evaluate the comparison of glomerular filtration rate (GFR) estimation by cystatin C with creatinine-based methods in relation to isotope-based method (99m-Tc DTPA plasma clearance) as gold standard in patients with chronic kidney disease. Method: This cross-sectional study was carried out in the outpatient department of nephrology, Sir Salimullah Medical College and Mitford hospital; Bangabandhu Sheikh Mujib Medical University and National institute of nuclear medicine and allied sciences (NINMAS), BSMMU, Dhaka from June 2016 to May 2017.A total of 120 Chronic kidney disease patients attending outpatient departments in above institutions were included in the study. Results: During the study, in all CKD patients the mean value of MDRD (36±14), CG (31±14) and CKD-EPI (31±15) which were significantly different (p<0.001) from the mean value of m-GFR method (40±14). Whereas significant difference was not observed (p=0.571) between the value of e-GFR-Hoek’s (39±16) and m-GFR (40±14).Significant correlation was found between m-GFR with MDRD (r=0.724, p<0.001), CG (r=0.697, p<0.001), CKD-EPI (r=0.721, p<0.001), e-GFR Hoek’s (r=0.748, p<0.001). It was observed that e-GFR Hoek’s (r=0.748, p<0.001) were more correlated with m-GFR than all other methods. cystatin C based method [e-GFR Hoek’s (AUC=0.965, Sensitivity 97 %, Specificity 76 %, p <0.0001)] had a significantly higher diagnostic accuracy than creatinine based methods [MDRD (AUC=0.914, Sensitivity 100 %, Specificity 23%, p <0.0001), CG (AUC=0.907, Sensitivity 99 %, Specificity 30 %, p <0.0001) and CKD-EPI (AUC=0.908, Sensitivity 98 %, Specificity 30 %, p <0.0001)]. Conclusion: From our study we can conclude that, serum cystatin C based estimated GFR showed better correlation with measured GFR in patients with CKD. Its diagnostic accuracy and agreement was found high with measured GFR than creatinine. Thus, cystatin C would be a good alternative marker for estimation of .....
Original Research Article
Oct. 23, 2020
Assesment of Lipid Profile Status in Hypothyroid Patients Attending Tertiary Care Center
Renuka P, Umamaheshwari V, Subarathi, Deepa P
Sch J App Med Sci | 2352-2354
DOI : 10.36347/sjams.2020.v08i10.026
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One of the major complication of hypothyroidism is atherosclerosis and cardio vascular disease. In worldwide, atherosclerosis is one of the leading cause of death and disability. Thyroid hormone increases LPL enzyme activity, LDL receptor gene expression, HMG CoA reductase activity and increases cholesterol excretion. In hypothyroidism hypercholesterolemia leads to production of reactive oxygen species that oxidises LDL which favours formation of atheromatous plaque which is responsible for foam cell formation [1]. Treatment with thyroxine decreases cholesterol level by upregulation of LDL receptors and increases its excretion through bile. This study group included 30 recently diagnosed hypothyroid individuals, 30 treated hypothyroid patients and 30 apparently healthy controls with age and sex matched. Thyroid profile and Lipid profile were measured in fasting blood samples. Total cholesterol, triglycerides and LDL-cholesterol were increased in recently diagnosed hypothyroidism compared to treated hypothyroidism and controls with the p value of <0.001. By this study we confirmed that altered lipid profile in hypothyroidism, one of the treatable cause for atherosclerosis. During treatment with thyroxine, hypothyroid patients should monitored for lipid profile, which may used as screening test to identify cardiovascular risk.
Original Research Article
Oct. 26, 2020
Role of Glycated Hemoglobin on Islets Cell Autoantibody Mediated Insulin Resistance in Type 2 Diabetic Patients
Dr. Saimun Nahar Rumana, Dr. Mohammad Moniruzzaman, Dr. Arif Mahmud Jewel, Dr. Md. Qumruzzaman
Sch J App Med Sci | 2355-2360
DOI : 10.36347/sjams.2020.v08i10.027
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Background: Latent autoimmune diabetes in adults often presents with a clinical phenotype indistinguishable from that of classic Type-2 Diabetes Mellitus (T2DM). Presence of auto antibodies, at diagnosis the secretion function of islets of beta-cell progressively worsens with disease duration which effects on the glycemic control and treatment failure. Among the auto antibodies Islet Cell Autoantibody (ICA) play important role in beta cell destruction leading to diabetes. Objective: The objective of the study was to find out the relationship between ICA and changes in the Glycosylated Hemoglobin (HbA1c) levels in newly diagnosed T2DM. Materials & Methods: A total number of 173 T2DM adult subjects of both sexes was selected and tested for presence of ICA autoantibody. ICA was measured by Enzyme Linked Immunosorbent Assay (ELISA) method and HbA1c measured by Immunoassay technique. Results: The participants divided into two groups according to presence and absence of ICA antibody. Among ICA positive cases, maximum patients were male within 41-50 years. No significant difference between ICA positive and negative patients in respect of age and gender. 12.7% (22 positive cases out of 173) of T2DM patients had been found to be ICA positive which was statistically significant (p<0.001). In ICA positive patients mean BMI (kg/m2) was 24.56±3.96 and in among 151 ICA negative cases mean BMI (kg/m2) was 24.90±4.07 which was not statistically significant. Mean of Fasting Blood Sugar(FBS)12.77±3.35 at the time of diagnosis among ICA positive patients is statistically significant (p<0.001). At diagnosis, the difference of mean HbA1c is higher in ICA positive patients than in ICA negative patients in newly diagnosed T2DM patient which was statistically significant (p<0.001). Conclusion: HbA1c levels were associated with ICA positive type 2 diabetic patients which indicate HbA1c has a potential diagnostic role to detect beta cell destruction leading to insulin resistance.
Original Research Article
Oct. 26, 2020
Characterization of the Pituitary Gland Shape with MR Imaging
Shayma Hamed, Ayad CE, Alaa Ibrahim, Nisreen Hassan, Nmariq Abdbalrhman, Kawthar Moh. Sharif Abdulrhman, Amna Mohamed Ahmed
Sch J App Med Sci | 2361-2365
DOI : 10.36347/sjams.2020.v08i10.028
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Magnetic Resonance Imaging (MRI) is the standard tool for the imaging of pituitary gland. The aim of the study was to characterize the shape of the pituitary gland in relation to age and sex. Methodology: A cross sectional prospective analytical study of the pituitary glands of Sudanese people, the data was collected from 301 Sudanese subjects (123 males’ percent 40.9% and 178 females’ percent 59.1%) who underwent MRI examination for brain. Results the females gender are the big frequency distribution than males among study sample. The convex shape appear in females more than males in the age group 20-29 years old the concave shape appear in age group between 40-49 and 50-60, the flat appear in age group 20-29, partial empty in age group 30-39, the only one empty case appear in female in age group 40-49.Concolusion the pituitary gland can be accurately determined by using MRI and should be correlated with the patient’s age and sex for further correlation.
Original Research Article
Oct. 26, 2020
Cytomorphological Patterns of Lymphadenopathy: A 5 Years Retrospective Study in a Tertiary Care Centre
Dr. Sujata Ganguli, Dr. Anjan Kumar Das
Sch J App Med Sci | 2366-2370
DOI : 10.36347/sjams.2020.v08i10.029
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Background: Lymphadenopathy is a common presenting feature in various non-neoplastic and neoplastic lesions. Fine needle aspiration cytology is a simple, quick, inexpensive and minimally invasive technique that can be used as a outpatient procedure to diagnose lymphadenopathies. This study was undertaken to assess the various causes of lymphadenopathy through FNAC, to see the distribution of lesions with respect to age, location and gender, and to assess the accuracy of lymph node FNAC in various non-neoplastic and neoplastic conditions. Methods: This was a retrospective study where total 2496 cases of lymph node FNAC were studied from august 2011 to July 2016 in the Department of Pathology of Calcutta National Medical College, Kolkata. The cytomorphologic features seen in the aspirates were analysed. Results: In this study, 2496 cases of lymphadenopathy were analysed. The age of the patients ranged from 3 months to 80 years. The male to female ratio was 1.12:1. Maximum number of cases were found to be in the age group of 11 to 20 years (24.2%). The most common lesion encountered was granulomatous lymphadenitis followed by reactive hyperplasia. Histopathology examination was done in 79 cases, out which only 3 cases showed discordance. Conclusion: FNAC is a safe, rapid and cost effective method in establishing the diagnosis in majority of cases of lymphadenopathy. It is therefore an important diagnostic procedure and prevents the patient from undergoing unnecessary surgery.
Safety Checklists in Biomedical Laboratories
Dr. K. N. Dave, Mr. R.S. Patil
Sch J App Med Sci | 2371-2374
DOI : 10.36347/sjams.2020.v08i10.030
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The various laboratory safety guidelines are based on the revised federal ‘Occupational Safety and Health Act (OSHA), USA and numerous safety standards suggested by the Joint Commission on Accreditation of Healthcare Organization (JCAHO), USA and the College of American Pathologists (CAP), USA. People working in clinical Laboratories are exposed to potential hazards. Risks can be minimized by taking various safety measures in the form of safety checklist. Establishing proper precaution in various areas of laboratories, one can maintain proper safety standards under differ heading.
Original Research Article
Oct. 26, 2020
A Comparative Study of Intra Articular Platelet Rich Plasma and Steroid Injection in Patients with Osteoarthritis Knee
Badrunnesa Ahmed, Md. Shafiqul Alam, Mohammad Tariqul Islam, Syed Mozaffar Ahmed, Taslim Uddin, Md. Jahidul Islam, Moshiur Rahman Khasru
Sch J App Med Sci | 2375-23781
DOI : 10.36347/sjams.2020.v08i10.031
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Introduction: Osteoarthritis (OA) knee is the most prevalent degenerative joint disease in the relatively elderly population. It is a leading cause of pain and disability in most countries worldwide. Aim of the study: To determine the effects of PRP in patients with OA knee. Material & Methods: A total 60 patients with OA knee were selected irrespective of sexes seeking treatment in the department of Physical Medicine and Rehabilitation, BSMMU, Dhaka and also referred from various outpatient departments of BSMMU and also general practitioners outside the hospital. The diagnosis of OA knee was confirmed by history, clinical examination, laboratory and radiological findings. They were divided into two group from radiological grading (Kellgren-Lawrence grade-I-III).In group-A patients were given intraarticur steroid, exercise and ADL instructions and group-B were treated with Intraarticur PRP, exercise and ADL instruction. All the patient availed 6 follow up at two week interval and two injection were given at 1st and 7th week. In every follow up patients were assessed by Visual analogue scale (VAS) and WOMAC score. All data were analyzed statistically by using the SPSS (version-21) for windows. Both paired and unpaired Student’s ‘t’ test and Chi-squired test was done as required, to see the level of significance. The results were expressed as mean standard deviation (SD) and p<0.05 was considered as the level of significance. Results: In both groups, majority of the participants had osteoarthritis in right knee joint. There is no statistical significance regarding knee involvement between two groups as the p-value is not significant. Table-4 showed the radiological grading of two groups. In both the groups most of the patients were enrolled in grade –II (>50%) .There is no statistical significance between the two groups. In comparison between two groups, it was found that there was no significant difference in improvement up to Wl to W9 scores, but difference of.....
Original Research Article
Oct. 26, 2020
Physicochemical and Phytochemical Standardization of Siddha Herbal Drug Formulation- Parangichakkai Chooranam
S. Kalaivani, M. Meenakshi Sundaram, R. Meenakumari
Sch J App Med Sci | 2382-2388
DOI : 10.36347/sjams.2020.v08i10.032
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The Siddha system of medicine is capable of treating all types of skin diseases. This trial medicine Parangichakkai chooranam is the sasthric preparation. The aim of the present study is investigating the phytochemical and physiochemical analysis of the trial drug Parangichakkai chooranam. Phytochemical analysis, heavy metal analysis and physiochemical parameters such as ash values, extract values, loss of drying were determined as protocol. The physiochemical parameters such as the total as value was found to be 14.3± 1.054, insoluble ash value 0.066±0.041, loss of drying 11.5±0.9 and water-soluble extract 5.213±0.9, alcohol soluble extract found to be 13.8±2.553. the phytochemical analysis of different extracts gave positive test for Alkaloids, flavonoids, steroids, coumarin, phenol, tannin, protein, sugar. The heavy metal analysis showed the presence of heavy metal mercury at 0.027ppm, which may be less than the recommended limit. The results obtained indicate that the drug is of standard quality and can be used as reference standard.
Standardization of Siddha herbal drug formulation-Adathoda Rasayanam for the Management of Soolikanam (Childhood asthma)
P. Jayapriya, K. Suresh, M. Meenakshi Sundaram, R. Meena Kumari
Sch J App Med Sci | 2389-2395
DOI : 10.36347/sjams.2020.v08i10.033
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Siddha system of medicine is one of the oldest and well documented Indian traditional system of medicine which has its origin in Southern part of India and Srilanka. Siddha system of medicine is capable of treating all types of diseases even some emergency cares. This trial medicine Adathodai Rasayanam is the sasthric preparation. The aim of the present study is to investigate the phytochemical and phytochemical analysis of the trial drug Adathodai Rasayanam. Preliminary phytochemical analysis, HPTLC analysis and physicochemical analysis such as ash values, extract values and loss on drying were determined. Phytochemical analysis gave positive test for alkaloids, steroids, triterpenoids, phenol, tannin saponin and sugar. The HPTLC finger printing analysis of Adathodai Rasayanam has shown two prominent peaks which indicates the presence of two versatile phytocomponents. Physicochemical parameters such as the total ash value was found to be 0.3167 ± 0.105, acid insoluble ash was found to be 0.1067 ± 0.05033 and Loss on drying at 105 °C was found to be 6.5 ± 2.666. The water soluble extractive and alcohol soluble extractive was found to be 19.4 ± 5.051 and 12.07 ± 1.102.
Original Research Article
Oct. 27, 2020
Effect of Rectal Prolapse Surgery on Patients’ Gastrointestinal Quality of Life
Kiliç Erol, Uğur Mustafa
Sch J App Med Sci | 2396-2401
DOI : 10.36347/sjams.2020.v08i10.034
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Rectal prolapse (RP) is a clinical condition causing reduced quality of life and is commonly treated via transabdominal and transanal approaches. The retrospective study included RP patients that were operatively treated via open or laparoscopic approach in our clinic between January 2016 and January 2020. In both groups, Gastrointestinal Quality of Life Index (GIQLI) was administered at postoperative week 1 and month 6 to assess patients’ health-related quality of life. The GIQLI scores at week 1 were significantly higher in the laparoscopic group (p<0.001), while no significant difference was found at month 6 (p>0.001). Both open and laparoscopic approaches led to a significant improvement in patients’ quality of life and this improvement occurred at an earlier time in the laparoscopic group compared to the open group.
Original Research Article
Oct. 29, 2020
Long Term Effect of VATS Sympathectomy for the Management of Primary Hyperhidrosis, Our Experience at King Hussein Medical Center
Ala Mohammad Qayet, Mutaz Fawaz Haddadin, Qasim Mohammad Al-Qaisi, Rami Ahmad Al-Qatameen, , Amany Abdullah Al-Mashagebah, Hani Abdelraheem Al-Hadidi, Jamal Elayan Al-Ayidi
Sch J App Med Sci | 2402-2404
DOI : 10.36347/sjams.2020.v08i10.035
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Background: Video assisted thoracoscopic (VATS) sympathectomy is the golden standard surgical procedure for primary hyperhidrosis (HH) nowadays. As any procedure there are immediate and long term effect of the procedure. Objective: in this study we want to review our patients and explore the short and long term effect of VATS sympathectomy. Methods: we want to review patients file and data whom had underwent VATS sympathectomy from 2017 till 2019 and their follow ups for one year. We want to investigate both immediate and long term effect and complications regarding pain, recurrence, and compensatory hyperhidrosis. Results: 210 patients was enrolled in the study. 113 males (53.8%) and 97 females (46.1%). Mean age was 22 years with age range from 14 to 32 years. All patient (100%) had resolution of their symptoms post operation. 10 patients (4.7%) had compensatory HH and only one patient (0.4%) had severe compensatory HH. No long term complication was recorded. No mortalities. Conclusion: T3-T4 VATS sympathectomy is a safe and effective method of controlling HH and has an acceptable rate of compensatory HH.
Original Research Article
Oct. 29, 2020
Spectrum of Oral Cavity Lesions Observed in 50 Cases – A Two Year Study
S. Srikanth, J. Rajitha
Sch J App Med Sci | 2405-2408
DOI : 10.36347/sjams.2020.v08i10.036
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Background: Oral cavity lesions are usually asymptomatic. Oral cancer is the most common type of cancer among males in India. Proper management of patients begins with an accurate diagnosis and histopathology is considered as the gold standard. Although the oral cavity lesions constitute only a small minority of pathological conditions, they are of great significance, as they have a potential to jeopardize the health and longevity of the patient. An adequate incision biopsy taken from an area representative of the lesion can provide over 98% diagnostic accuracy as to whether the lesion is malignant or not, when routine pathological techniques are used. Most oropharyngeal cancers in India present in advanced stages of malignancy. Materials & Methods: The present study is a prospective study done for a period of two years. All the oral cavity lesions are included in our study. Proper clinical history, radiological details if necessary and clinical examination were done in our study. Results: Out of the total 50 cases in our study, Squamous cell carcinoma was the most common lesion, contributing upto 14 cases. Male to female ratio was 4:1 and age group between 41-50 years contributed highest number of cases. Conclusion: Awareness should be created among people about the early approach to hospital, maintenance of oral hygiene by cultivating good oral habits, and periodic oral check-ups. Effective oral health programs for spread of knowledge and awareness, prevention, early diagnosis and management, and follow up of oral cancer must be implemented.
Original Research Article
Oct. 29, 2020
Review in Different Morphology of Pituitary Gland Using Magnetic Resonances Imaging
Shayma Hamed, Ayad CE, Alaa Ibrahim, Nisreen Hassan, Amna Mohamed Ahmed, Nmariq Abdbalrhman, Kawthar Moh. Sharif Abdulrhman
Sch J App Med Sci | 2409-2412
DOI : 10.36347/sjams.2020.v08i10.037
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Magnetic resonance (MR) occurs in the magnetic system that contains both magnetic moments and angular momentum [1]. Various radiological modalities that had been used to study gland such as computed tomography but MRI has proved to be an accurate diagnostic modality for the assessment of pituitary gland. Normal pituitary gland shows variation in size and shape, transient changes in the shape or signal intensity of the pituitary gland appears at different stages of life [2]. The gland tends to be rounded in shape at birth and becomes more flattened with age. This review study aimed to summarize the author’s articles about the shapes of normal pituitary gland when they are using the magnetic resonance imaging as imaging modalities. Authors discussed and illustrated the various shapes of gland are convex, concave most common in females and the flat shape are common in males.
Original Research Article
Oct. 29, 2020
The Effect of Regular Hemodialysis on the Nutritional Status of Children with End-stage Renal Disease
Amal Alshukri, Safia Elramli, Hana M Elbakoush Lecture, Ali Atiea Elmabsout
Sch J App Med Sci | 2413-2418
DOI : 10.36347/sjams.2020.v08i10.038
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Background: Children with end-stage renal disease (ESRD) have rates of mortality estimated to be 30-times higher than expected for age compared with those of healthy children. Physical manifestations of under-nutrition, such as body mass index (BMI) have been associated with increased risk of mortality. Traditional measures, such as height, weight and serum albumin concentration, may not be accurate indicators to assess the nutritional status of children receiving maintenance hemodialysis. Meeting the special nutritional needs of these children often requires nutritional supplementation, by either the enteral or the parenteral route. Recently, in children receiving maintenance hemodialysis that is malnourished, intradialytic parenteral nutrition (IDPN) has been utilized as a means to provide additional protein and calories. Objectives: The present study was carried out to identify the malnutrition in children receiving maintenance hemodialysis, with special focus on outcome. Method: This was A cross-sectional observational study was conducted in the Department of Pediatrics of a Pediatric hospital of Benghazi from January 2019 to June 2019. 81 children aged from five to eighteen years on regular hemodialysis. Outcome measures: Measurements included questionnaire that elicited information on social demographic characteristics, Patient’s medical history, and duration of hemodialysis. Anthropometry, biochemical parameters were measured. Anthropometric measurements were expressed as z - scores. Data were analyzed using descriptive statistics. The Chi-Square test was applied to examine the study data. Results: Data shows that 49. 4% of children had BMI between 5th percentile up to the 85th percentile were considered normal weight, while, 30. 9% of children had BMI less than the 5th percentile, were categorized as underweight. With regard to biochemical parameters, children had significantly higher serum phosphate, creatinine, and Blood urea nitrogen. However, study......
Original Research Article
Oct. 30, 2020
The Successful Use of Marsupialization of Maxillary Cysts and Benign Tumors Combined With Orthodontic Treatment
Afef Slim, Hajer Hentati, Inès Dallel, Mounir Omami, Adel Bouguezzi, Abdellatif Chokri, Jamil Selmi
Sch J App Med Sci | 2419-2425
DOI : 10.36347/sjams.2020.v08i10.039
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Introduction: We aimed through a systematic review of the literature to evaluate the effectiveness of marsupialization or decompression for cysts and benign cystic tumors of the jaw and to provide more information on the contribution of orthodontics to this conservative treatment. Articles and Methods: An electronic search on PubMed/MEDLINE and Cochrane Library databases was conducted using MeSH terms. The relevant articles published in English were identified after a review of their titles, abstracts and full reading of the papers. Results: Forty-six articles were included and analyzed. In this study, 1089 patients were included, with a total of 1101 lesions. Only 10 published articles dealt with the combined use of marsupialization of cystic lesions of the jaw and orthodontic treatment. Conclusion: Marsupialization or decompression could be performed as a single surgical procedure or combined with other treatment modalities for many cystic lesions of the jaws. It has been accepted and used as a conservative surgical option. Furthermore, combined orthodontic-surgical technique can be useful to promote the eruption of cyst-associated teeth. The long-term follow-up confirmed the treatment effectiveness.
Original Research Article
Oct. 30, 2020
A Comparative Study of Community Acquired Acute Kidney Injury with Hospital Acquired Acute Kidney Injury – A Hospital Based Study from North-East India
T. Brojen Singh, Stephen L. Daimei, Pranab Kumar Medhi, Prabin Kumar Majhi, N. Sharatkumar Singh
Sch J App Med Sci | 2426-2430
DOI : 10.36347/sjams.2020.v08i10.040
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Acute kidney injury (AKI) which is defined as an abrupt decline in renal function in a short period of time may be hospital-acquired AKI (HAAKI) or community-acquired AKI (CAAKI). This prospective study was conducted from October 2017 to September 2019 to compare the various clinical profile of patients with CAAKI and HAAKI. Patients with CAAKI and HAAKI aged 18 years and above were included in the study and patients with pre-existing renal disease, acute-on-chronic kidney disease and renal dysfunction in pregnancy were excluded. CAAKI was defined as those patients who were admitted with AKI whereas HAAKI as those who developed AKI after 48 hours of hospitalisation. Incidence of CAAKI and HAAKI was 1.07% and 0.44% respectively. There was no significant difference in the mean age and gender among the groups. Among the primary disease at admission, trauma and wound related diseases were significantly higher in HAAKI (<0.001) whereas neurological diseases was higher in CAAKI (<0.01). Sepsis (27.7%) and drug induced AKI (31.8%) was the most common cause of AKI in CAAKI and HAAKI respectively. In both the groups maximum number of the patients were in RIFLE–I category and more than 50% of the case was due to acute tubular necrosis (p< 0.7). HAAKI patients required renal replacement therapy (RRT) more frequently (p<0.01), needed longer hospital stay and had higher mortality (31.8%) (p< 0.002) in comparison with CAAKI. Our data suggests that CAAKI and HAAKI are a common cause of AKI. Development of HAAKI has a worse prognosis in disease outcome.
Original Research Article
Oct. 30, 2020
“Clinical Profile of Children with Birth Asphyxia: A Retrospective Study in Khulna Medical College, Hospital”
Dr. Nityananda Baruri, Dr. Shams Ibne Maksud, Md. Muhammad Syeeful Ameen
Sch J App Med Sci | 2431-2435
DOI : 10.36347/sjams.2020.v08i10.041
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Introduction: Birth asphyxia is defined by the World Health Organization "the failure to initiate and sustain breathing at birth." The WHO has estimated that 4 million babies die during the neonatal period every year and 99% of these deaths occur in low-income and middle income countries. Three major causes account for over three quarters of these deaths, serious infection (28%) complication of preterm birth (26%) and birth asphyxia (23%). This estimation implies that birth asphyxia is the cause of around one million neonatal deaths each year. One of the present challenges is the lack of a gold standard for accurately defining birth asphyxia. Because of same reason the incidence of birth asphyxia is difficult to quantify in Khulna Medical College, Khulna, Bangladesh. Aim of the Study: The aim of this study was to find out the clinical outcome of birth asphyxia, identify the common obstetric and neonatal risk factors, and study the cause of death. Material & Methods: Between Jan 2019 and Dec 2019, there were 114 live births asphyxiated neonates whose were clinically diagnosed and admitted in the department of pediatrics at Khulna Medical College Hospital, Khulna, Bangladesh in the mentioned hospital were finalized as the study population. Clinical information was collected retrospectively from maternal records (maternal age, gravida, type of delivery, presence of Thick meconium stain, induced or spontaneous labour, and pregnancy complications). The KMC records provided additional information about new born infant (birth asphyxia, stages of birth asphyxia, birth weight, sex and subsequent mortality). Results: The outcome of treatment in babies with birth asphyxia showing in Recovery rate in group one (HIE I) was 18(15.79%) , in group two (HIE II) was 77(97.40) and in group three (HIE III) was 7(6.14%) and Death ratio was in group one (HIE I) was 2(1.75%), in group two (HIE II) was 3(2.63%) and in group three (HIE III) was 7(6.14%). In the morbidity and mortality...
