Dr. Kh. Md. Faisal Alam, Shah Md. Ahsan Shahid
TAJ, Jul-Dec 2024; 37(2) 1-4
https://doi.org/10.62469/taj.v037i02.01
The global COVID-19 pandemic has drastically altered the landscape of healthcare, presenting unparalleled challenges to medical professionals and systems.1 At the heart of the effort to manage the crisis is the polymerase chain reaction (PCR) test, which has emerged as the gold standard for diagnosing COVID-19. PCR testing has been pivotal in identifying SARS-CoV-2, the virus responsible for the disease, owing to its high sensitivity and specificity. In Bangladesh, particularly in institutions like Rajshahi Medical College (RMC), PCR testing has been crucial in shaping the country's response to the pandemic. This editorial provides a critical analysis of PCR testing at RMC, considering its implementation, impact, challenges, and lessons learned. The PCR test operates on a principle of amplifying viral genetic material to detectable levels, even in individuals with low viral loads. This attribute made it the preferred diagnostic tool early in the pandemic. The global health community rapidly adopted PCR testing due to its ability to detect infections with high accuracy, thus enabling early isolation, contact tracing, and treatment decisions.
Md. Monowar Tarik, MT Rahaman, Md. Munzur Rahman, R Sharmin, MA Hannan
TAJ, Jul-Dec 2024; 37(2) 5-15
https://doi.org/10.62469/taj.v037i02.02
Background: Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy, caused by compression of the median nerve under the flexor retinaculum at the wrist. Objective: This study aims to evaluate the effectiveness of carpal tunnel release through a small transverse incision in alleviating symptoms in patients with CTS who did not respond to conservative treatments. Method: A prospective interventional study was conducted on 30 patients at Rajshahi Medical College Hospital from January 2019 to December 2022. Patients underwent open carpal tunnel release through a 1.5 cm transverse incision at the proximal palmar crease. Outcomes were measured through clinical assessments (Phalen's test, Tinel's sign) and post-operative follow-ups at 30 days. Results: Of the 30 patients treated, 24 (80%) were female, and 6 (20%) were male, with ages ranging from 30 to 60 years. The duration of symptoms was less than one year in 6 patients (20%), between one to two years in 17 patients (56.67%), and more than two years in 7 patients (23.33%). Satisfactory outcomes were observed in 29 patients (96.67%), with improvement in paresthesia, numbness, and pain. One patient (3.33%) had persistent symptoms post-surgery. No major complications, such as infection or motor nerve injury, were reported. Conclusions: Carpal tunnel release through a small transverse incision is a safe, low-cost, and effective treatment for CTS, offering rapid recovery with minimal complications.
Md. Munzur Rahman, Md. Monowar Tarik, Md. Obaidul Haque, Md. Sofikul Islam
TAJ, Jul-Dec 2024; 37(2) 16-26
https://doi.org/10.62469/taj.v037i02.03
Background: Total Hip Replacement (THR) significantly improves patient quality of life (QoL) and satisfaction. However, post-operative outcomes can vary depending on the surgical techniques employed. Objective: This study compares patient satisfaction and QoL post-THR between conventional and minimally invasive surgical techniques at Rajshahi Medical College Hospital, Bangladesh. Method: A prospective study was conducted from January 2021 to June 2023 at the Department of Orthopaedic Surgery, Rajshahi Medical College Hospital. A total of 48 patients who underwent THR (24 with conventional techniques, 24 with minimally invasive techniques) were assessed using validated patient satisfaction and QoL questionnaires. Post-operative pain, functional recovery, and complications were also evaluated. Results: Patients minimally invasive THR reported significantly higher satisfaction rates (92%) compared to those treated with conventional techniques (75%) (p = 0.02). QoL scores were also better in the minimally invasive group (85 vs. 72, p < 0.01). Functional recovery was faster, with 80% resuming daily activities within six weeks in the minimally invasive group, compared to 58% in the conventional group (p = 0.03). Post-operative pain was lower in the minimally invasive group (20% vs. 40%, p = 0.04). Complication rates were similar between both groups (8% vs. 10%, p = 0.74). Conclusion: Minimally invasive THR results in higher patient satisfaction, faster recovery, and improved QoL compared to conventional techniques, suggesting it as a preferable option for THR in Bangladesh.
Md. Tousifur Rahman, Ashim Kumar Ghosh
TAJ, Jul-Dec 2024; 37(2) 26-33
https://doi.org/10.62469/taj.v037i02.04
Background: Inoperable head and neck squamous cell carcinoma (HNSCC) poses a formidable challenge in oncology due to limited treatment options and unfavorable prognosis. Concurrent and sequential chemoradiotherapy have emerged as key therapeutic modalities, but their relative efficacy remains a topic of debate. Objective: This study aimed to compare the effectiveness of concurrent versus sequential chemoradiotherapy in the management of inoperable HNSCC, with a focus on treatment outcomes and toxicity profiles. Method: A retrospective analysis was conducted at Department of Radiotherapy, Rajshahi Medical College Hospital Bangladesh, over one year from June 1, 2019, to December 31, 2020. A total number of 96 patients diagnosed. Patients were divided into two groups based on the treatment approach received: concurrent chemoradiotherapy (n=48) and sequential chemoradiotherapy (n=48). Result: The study was found that concurrent chemoradiotherapy associated with significantly higher rates of locoregional control compared to sequential chemoradiotherapy (78% vs. 65%, p<0.05). Similarly, overall survival rates were superior in the concurrent therapy group, with a median survival of 24 months compared to 18 months in the sequential therapy group (p<0.05). However, concurrent chemoradiotherapy was also associated with a higher incidence of acute toxicities, including mucositis (60% vs. 45%, p<0.05) and dysphagia (55% vs. 40%, p<0.05), compared to sequential therapy. Conclusion: Concurrent chemoradiotherapy demonstrates superior locoregional control and overall survival outcomes compared to sequential chemoradiotherapy in the management of inoperable HNSCC.
Maurin Azad, Sabiha Y. Moni, Md. A. Haque, Rajesh K. Ghose, Nafisa Akkas, Md. H. Rahman, Md. M. Islam
TAJ, Jul-Dec 2024; 37(2) 34-40
https://doi.org/10.62469/taj.v037i02.05
Background: Acute coronary syndrome (ACS) is the leading cause of death in the world and it is a consequence of unstable plaque due to dyslipidemia, mainly elevated LDL cholesterol (LDL-C). Methods: This randomized controlled trial was conducted on 80 diagnosed ACS patients with hypercholesterolemia at the department of Pharmacology and Therapeutics in collaboration with the Department of Cardiology, Rajshahi Medical College and Hospital, Rajshahi. The study population was divided into 2 groups. In study group, 40 patients were treated with combination therapy of tablet Atorvastatin (10 mg) plus Ezetimibe (10 mg) and in control group, 40 patients were treated with tablet Atorvastatin (20 mg) alone for 12 weeks. Serum triglyceride, total cholesterol, HDL-C and LDL-C were measured initially at baseline and at the end of the 8th and 12th weeks of drug administration. Results: The reduction of serum total cholesterol and LDL-C from baseline to the 12th week of drug administration was greater in combination therapy group than the monotherapy group which were statistically highly significant (p < 0> 0.05 in both cases). The efficacy was greater in the combination therapy group than in the monotherapy group on considering the achievement rate of LDL-C less than 70 mg/dl and it was found statistically significant (p < 0.05). Conclusion: It might be stated that the combination therapy of Atorvastatin and Ezetimibe for reducing hypercholesterolemia is more beneficial than doubling the dose of Atorvastatin in the case of hypercholesterolemic patients with ACS.
Ashraf Uddin Khan, Niksar Akhter, Sharmeen Sajedeen
TAJ, Jul-Dec 2024; 37(2) 41-46
https://doi.org/10.62469/taj.v037i02.06
Background: Intra-cerebral hemorrhage (ICH) is focal bleeding from a brain blood vessel. It contributes to about 10-15% of the yearly global stroke count, roughly 2 million cases, with an occurrence rate of 10-30 per 100,000 individuals. Patient outcomes depend on clinical presentation and radiological criteria. Aim of the study: This study aimed to assess the clinical and radiological profile of intra-cerebral hemorrhage. Methods: This was a cross-sectional study that was conducted in the Radiology and Imaging Department, Sheikh Sayera Khatun Medical College Hospital, Bangladesh from January 2018 to December 2018. In total 320 diagnosed intra-cerebral hemorrhage (ICH) patients, by computed tomography scan, were enrolled in this study as the study subjects. A purposive sampling technique was used in sample selection. All data were processed, analyzed and disseminated by using MS Office. Results: Participants showed a male-female ratio of 2:1, with 38% aged 61-70. Radiologically, 46% had capsuloganglionic involvement, 22% thalamus, 8% thalamoganglionic, 8% frontal. Common symptoms: altered sensorium (40%), headache (34%), seizures (28%). Leading cause: hypertension (74%). Glasgow Coma Scale: 9-12 for 57%, 13-15 for 34%, <9 for 9%. Conclusion: Aged males are mainly prone to intra-cerebral hemorrhage. The capsuloganglionic region and thalamus are the most vulnerable parts for hemorrhage. Altered sensorium, headache and seizures are the most common symptoms in such cases.
Ruby Akter, Israt Sultana, Shamima A. Shimu, Nazmun N. Poly
TAJ, Jul-Dec 2024; 37(2) 47-53
https://doi.org/10.62469/taj.v037i02.07
Background: Among the chronic diseases, cervical cancer is still a public health problem. An inflammatory Pap smear may miss cervical precancerous changes due to low sensitivity and high false negativity of Pap smear. Methods: This was a cross-sectional type of descriptive study on 384 married non-pregnant patients aged ≥ 18 years presented with persistent inflammatory changes on Pap smear attending in the OPD of Obstetrics and Gynecology, Rajshahi medical college Hospital, Rajshahi over a period of 1 year from June 2020 to July 2021. Pre-designed, validated, semi-structured questionnaire and purposive sampling technique were used to gather information from the patients. Results: According to colposcopic grading, 46.60% of the women harbor CIN-1, 10.70% CIN-2, 2.60% CIN-3 and remaining 40.10% chronic cervicitis among the women with persistent inflammatory changes on Pap smear. Again, according to histological grading, 26.60% of the women had CIN-1, 4.70% CIN-2 and remaining 68.80% chronic cervicitis. Conclusions: Colposcopy is an excellent tool for evaluation of cervical carcinoma if operator is properly trained. Concomitant histology also increases the sensitivity and specificity of the test.
A K M Tanvirul Haque, Jamil Raihan, Akhter Uzzaman, Md. Anwarul Haque, Shahnuma Tarannum, Mithun Mahbub Khan
TAJ, Jul-Dec 2024; 37(2) 54-60
https://doi.org/10.62469/taj.v037i02.08
Background: Laparoscopic cholecystectomy is a commonly performed surgical procedure, and the choice of anesthesia, either spinal or general, remains a subject of debate. Objective: To assess and compare the outcomes of spinal anesthesia and general anesthesia for laparoscopic cholecystectomy, with postoperative pain management, recovery time, complications, and patient satisfaction between the two anesthesia techniques. Methods: This multicenter study was conducted at Rajshahi Medical College Hospital, Rajshahi, Bangladesh. A total of 106 patients undergoing laparoscopic cholecystectomy were enrolled in the study. They were divided into two groups: one receiving spinal anesthesia and the other receiving general anesthesia. Data was collected from June 2021 to December 2022. Surgical duration, intraoperative complications, postoperative pain levels, analgesic requirements, time to discharge, and patient satisfaction were evaluated. Statistical analysis was performed, and percentages were calculated to compare the outcomes. Results: The study revealed that 62% of patients who received spinal anesthesia had a shorter surgical duration compared to 48% in the general anesthesia group. Postoperative pain levels were lower in the spinal anesthesia group, with 75% of patients reporting minimal pain compared to 54% in the general anesthesia group. Analgesic requirements were also lower in the spinal anesthesia group (70% vs. 45%). The recovery time was shorter in the spinal anesthesia group, and 78% of these patients were discharged earlier. Furthermore, 80% of patients in the spinal anesthesia group expressed high satisfaction, while it was 65% in the general anesthesia group. Conclusions: Spinal anesthesia appears to offer advantages in terms of shorter surgical duration, reduced postoperative pain, lower analgesic requirements, faster recovery, and higher patient satisfaction compared to general anesthesia in laparoscopic cholecystectomy.
Md. Muzahidul Islam, Sabiha Yasmin Moni, Shariful Hasan Ripon, Md. Habibur Rahman, Shahi Sultana Rozi, Maurin Azad, Nusrat Jahan
TAJ, Jul-Dec 2024; 37(2) 61-68
https://doi.org/10.62469/taj.v037i02.09
Background: Painful peripheral neuropathy is a common consequence of long-term diabetes mellitus that impairs quality of life. Pregabalin (an anticonvulsant) and Duloxetine (a new SNRI) are frequently recommended for diabetic peripheral neuropathic pain. Methods: This randomized clinical trial on painful diabetic neuropathy patients was conducted in the Department of Pharmacology and Therapeutics at Rajshahi Medical College, Rajshahi, in collaboration with the Diabetic Association General Hospital (RADAS), Rajshahi, on 110 patients for one year, from July 2022 to June 2023 after obtaining consent from them. The study population was separated into two groups (Groups A and B) based on drug allocation. For 12 weeks, 55 patients in Group-A received Duloxetine 30 mg twice daily (study group), while 55 patients in Group-B received Pregabalin 75 mg twice daily (control group). The VAS score was assessed at baseline and again at the end of four, eight and twelve weeks of drug treatment. Results: The mean age of the patients in Duloxetine group was 50.25±7.42 years and Pregabalin group was 49.53±7.84 years. The effect of two drugs on painful diabetic neuropathy was almost equal and the reduction of VAS score between the two groups was statistically non-significant (p > 0.05). At the full course of treatment, Duloxetine is cost-effective in comparison to Pregabalin. Conclusions: In terms of efficacy, Duloxetine or Pregabalin may be used to treat painful diabetic peripheral neuropathy.
Arika Jannat, Sabiha Yasmin Moni, Md. Iqbal Hossain, Lotifa Hoque, Pervin Akter, Md. Murshid-Ur-Rahman, Md. Awlad Hossain
TAJ, Jul-Dec 2024; 37(2) 69-76
https://doi.org/10.62469/taj.v037i02.010
Background: Medicinal plants are widely used in many countries for different ailments due to cost effectiveness and less side effects. Vernonia amygdalina (V.amygdalina) (Bitter leaf) is one of the important medicinal plant which has many pharmacological properties. Methods: This quasi-experimental study was carried out in the Department of Pharmacology and Therapeutics, Rajshahi Medical College, Rajshahi from January 2021 to December 2021. This study was conducted in two steps: Firstly, preparation of aqueous extract of leaves of V. amygdalina. Secondly, assessment of its antioxidant effect through DPPH free radical scavenging activity. Results: The results of the study showed that the antioxidant activity of aqueous extract of leaves of V. amygdalina at the concentration of 0.0625 mg/ml, 0.125 mg/ml, 0.25mg/ml, 0.5mg/ml and 1 mg/ml were 34.9±1.14, 63.3±0.62, 76±0.83, 77.9±1.37 and 84.9±1.86 respectively. The aqueous extract of Vernonia amygdalina gave the highest inhibition of 84.9±1.86% at 1mg/ml and lowest inhibition of 34.9±1.14% at 0.0625 mg/ml. The antioxidant activity of standard ascorbic acid at the concentration of 0.0625 mg/ml, 0.125 mg/ml, 0.25mg/ml, 0.5mg/ml and 1 mg/ml were also being evaluated which were 80.1±1.68, 86.5±2.47, 91.6±0.65, 93.2±0.44 and 94.5±0.62 respectively. Ascorbic acid gave the highest inhibition of 94.5±0.62% at 1 mg/ml and lowest inhibition of 80.1±1.68% at 0.0625 mg/ml. Comparing the antioxidant effect of Bitter leaf & Ascorbic acid difference was found statistically significant (p<0.05). Conclusions: These results revealed that antioxidant activity of different concentration of aqueous extract were found but it was less when compared to standard antioxidant effect of ascorbic acid. Hence it is concluded that aqueous leaves extract of V. amygdalina showed antioxidant effect.
Md. Nasir Uddin, Ayub Ali Chowdhury, Masud Iqbal, Kazi Shahnoor Alam, Md. Babrul Alam, Swapan Kumar Saha, Muhammad Arif Anwar, Md.Hafizur Rahman, Golam Kibria, Israt Zarin Rahman, Jebunnesa Ani
TAJ, Jul-Dec 2024; 37(2) 77-86
https://doi.org/10.62469/taj.v037i02.011
Background: Accurate measurement of renal function is critical for diagnosing and stratifying kidney disease. Various methods to estimate glomerular filtration rate (GFR) have shown variable results depending on the studied population. Objective: This study aimed to evaluate the effectiveness of different GFR estimation methods in assessing renal function in a selected rural adult population. Method: A cross-sectional study was conducted from July 2019 to June 2020, including 222 participants based on specific inclusion and exclusion criteria. Detailed histories and relevant investigations were obtained from each participant. Estimated GFR (eGFR) was calculated using serum creatinine, cystatin C, and combined formulas. Data were recorded in separate case record forms and analyzed using SPSS 26.0 and MedCalc 13.0. Results: The mean (±SD) age of the study population was 41.12±12.72 years, with a majority aged 31-50 years (59.5%). There was a male predominance (53.6%). Mean eGFRs were as follows: MDRD 117.31±25.54 mL/min/1.73 m², Cockcroft-Gault 102.87±30.50 mL/min/1.73 m², CKD-EPI 119.52±20.48 mL/min/1.73 m², cystatin C-based 107.17±16.34 mL/min/1.73 m², and combined creatinine-cystatin C 105.48±20.87 mL/min/1.73 m². Renal function assessment by MDRD, Cockcroft-Gault, CKD-EPI, cystatin C, and combined equations showed significant agreement with each other. Conclusions: Different GFR estimation methods showed no clear superiority over each other. However, eGFR CKD-EPICr demonstrated perfect agreement with the MDRD equation, and eGFR CKD-EPICys showed substantial agreement with eGFR CKD-EPICr-Cys.
Md. Anwarul Haque, Mst. Mousumi Marjiara Begum, Md. Siddiqur Rahman, Hasibul Hasan
TAJ, Jul-Dec 2024; 37(2) 87-97
https://doi.org/10.62469/taj.v037i02.012
Background: Arteriovenous fistula (AVF) surgery is vital for hemodialysis in patients with end-stage renal disease (ESRD). Despite its advantages over other vascular access methods, AVF surgery is associated with several complications, impacting patient outcomes. Objective: This study aims to investigate the complications associated with AVF surgery in Bangladesh, focusing on patient outcomes and contributing factors. Method: A comprehensive study was conducted at Rajshahi Diabetic Association Hospital and Rajshahi Apollo Hospital, Rajshahi, Bangladesh, from January 2020 to December 2023. A total of 1,288 patients underwent AVF surgery of these, 1,224 fistulas were created using the radial arteries and 64 using the brachial artery. Data were collected on postoperative complications, including fistula maturation failure, infections, thrombosis, and Aneurysms. Results: A total of 1,288 patients underwent AVF surgery, with 61% male (786) and 39
Israt Sultana, Ruby Akter, Shamima A. Shimu, Nazmun N. Poly
TAJ, Jul-Dec 2024; 37(2) 98-105
https://doi.org/10.62469/taj.v037i02.013
Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in adolescents and women of reproductive age and AMH (Anti-Mullerian Hormone) is an important hormonal indicator of PCOS. Methods: This was a cross-sectional type of comparative study on 80 reproductive women attending in the OPD of Obstetrics and Gynecology, Rajshahi medical college Hospital, Rajshahi over a period of 1 year from July 2021 to June 2022. Among them 40 PCOS women were selected in group A and 40 age matched healthy women were also recruited in group B for comparison. History of oligomenorrhoea, hirsutism, BMI and serum AMH level were estimated using the auto analyzer machine. Results: Mean AMH of PCOS and healthy women were 9.89 ± 3.84 mg/dl and 1.36 ± 1.05 mg/dl, respectively. In the study, the common phenotype of PCOS was phenotype C (40%) but highest mean level of AMH was found in phenotype B which was 12.7 ± 6.6 ng/ml. AMH was nine times higher in women with PCOS than healthy women and it was statistically highly significant (p < 0.001). Maximum diagnostic potential for PCOS was at cut-off 2.55 ng/ml with sensitivity 90% and specificity 85%. Conclusions: As a diagnostic tool, AMH is highly sensitive and specific in case of PCOS.
Bedowra Begum, Shamima N. Rupa, A.S.M. Sayem, Shahin Mahmuda, Tahasina S. Tasu, Farjana Kabir, Monimul Islam
TAJ, Jul-Dec 2024; 37(2) 106-111
https://doi.org/10.62469/taj.v037i02.014
Background: The time a fetus develops inside a woman's uterus is known as pregnancy, and it typically lasts for 40 weeks. To maximize the benefits of pregnancy, good glycemic control must be maintained throughout. Methods: This cross-sectional type of comparative study was carried out in the Department of Physiology in Rajshahi Medical College, Rajshahi and data were collected from the Maternity and Child Welfare Centre (MCWC), Rajshahi over a period of 1 year from January 2019 to December 2019 among the pregnant and non-pregnant women to assess the hemoglobin A1c during the 3rd trimester of pregnancy. Prior to the commencement of the study approval was taken from the Ethical Review Committee (ERC). A semi-structured questionnaire and laboratory support were used to gather information from 120 women by convenient sampling technique. Results: The results showed that plasma HbA1c was 4.8 ± 0.4% in pregnant women and 5.6 ± 0.5% in non-pregnant women and it was statistically highly significant (p < 0.001). So, regular monitoring of HbA1c in pregnant women should be done to avoid adverse pregnancy outcomes. Conclusions: The study indicated that nondiabetic women with pregnancy had significantly lower HbA1c compared with non-pregnant women.
Md. Waliur Rahman, Md. Habibullah Sarkar, Shireen Jabeen Sume, A K M Tanvirul Haque
TAJ, Jul-Dec 2024; 37(2) 112-120
https://doi.org/10.62469/taj.v037i02.015
Background: Fibrocystic breast disease, also known as mammary dysplasia, is a non-cancerous condition that results in breast lumps, pain, and discomfort. Objective: This study aims to compare the effectiveness of Danazol alone versus Danazol combined with Evening Primrose Oil (EP) in treating fibrocystic breast disease. Method: A randomized controlled study was conducted on 200 outpatients at Chuadanga Sadar Hospital, Bangladesh, from January 2022 to December 2023. Patients were divided into two groups. Group A received Evening Primrose Oil 1000 mg twice daily combined with Danazol 100 mg twice daily for three months. Group B Danazol 100 mg twice daily alone for three months. Pain levels were compared using mean and standard deviation, and an independent sample T-test was employed. The efficacy of the treatments was further analyzed using the chi-square test. Results: The study included 200 patients with a mean age of 30.54 ± 4.53 years. The VAS pain score between the two groups showed a mean difference of 1.53±0.27. The results indicated significantly lower pain in the group using Danazol combined with EP capsules compared to Danazol alone (p = 0.001). The percentage of response in Group B was higher than in Group A. Conclusion: Danazol combined with Evening Primrose Oil is more effective in reducing pain in patients with fibrocystic breast disease compared to Danazol alone.
Md. Tamjid Ali, Quazi Tamanna Haque
TAJ, Jul-Dec 2024; 37(2) 121-130
https://doi.org/10.62469/taj.v037i02.016
Background: Osteoarthritis is a prevalent knee joint disorder causing cartilage degradation and subchondral bone changes, leading to pain, stiffness, and impaired movement. Inflammatory mediators play a crucial role in the pathogenesis of Knee OA causes cartilage degeneration. Method: A prospective study was conducted from January 2020 to December 2023, involving 132 patients diagnosed with age-related OA at the Department of Physical Medicine & Rehabilitation, Rajshahi Medical College Hospital. Blood samples were analyzed for inflammatory cytokines (TNF-α, IL-1β) and matrix metalloproteinases (MMP-3, MMP-13). Radiographic and clinical assessments were used to evaluate the activities of cartilage and bone changes. Results: In this study of 132 patients with age-related osteoarthritis (OA) Knee, 54% exhibited moderate to severe OA based on radiographic assessments, while 46% had mild OA. Elevated levels of Tumor Necrosis Factor-alpha (TNF-α) and Interleukin-1β (IL-1β) were found in 78% of the patients, with mean TNF-α levels at 56.3 ± 12.7 pg/mL and IL-1β at 48.9 ± 11.4 pg/mL in those with elevated mediators. These levels showed significant correlations with cartilage degradation and subchondral bone sclerosis (p < 0.01). Matrix Metalloproteinases (MMP-3 and MMP-13) were elevated in 65% of patients, with mean levels of 112.4 ± 25.3 ng/mL for MMP-3 and 89.2 ± 20.7 ng/mL for MMP-13, both correlating strongly with cartilage breakdown and subchondral bone changes (p < 0.01). Radiographic evaluations indicated severe cartilage degeneration in 54% of patients, correlating with high TNF-α and IL-1β levels, and subchondral bone sclerosis in 60% of patients, also associated with elevated inflammatory mediators. Conclusions: Inflammatory mediators, particularly TNF-α and IL-1β, are significantly associated with connective tissue degeneration in age-related OA.
Farhana Yasmin, Aparajita Roy, Muhammad Zubayer Alam, A. K. M. Shamsul Alam
TAJ, Jul-Dec 2024; 37(2) 131-138
https://doi.org/10.62469/taj.v037i02.017
Background & Objective: Depression is a prevalent issue among rural Bangladeshi women, exacerbated by socio-economic challenges, cultural norms, and limited access to mental health care. Despite the high risk, research on this population's mental health is limited. This community-based study aims to assess the prevalence of depression in rural Bangladeshi women and identify associated socio-economic and demographic factors using a structured questionnaire. The findings will help inform targeted interventions to improve mental health outcomes in this vulnerable group. Methods: This study, conducted from October to November 2023 in Puthia Upazila, assessed depression in 318 rural women aged 18-49 using DASS-21. Excluding pregnant and post-menopausal women, it employed descriptive statistics, chi-square tests, and binary logistic regression to identify socio-economic predictors of depression, offering insights for future mental health policies. Results: The study of 318 rural women in Bangladesh found that 17.3% (n=55) experienced depression. Key factors included age, with the highest rate of 34.1% in the 46-49 age group (Chi-square = 22.55, p < .000), and illiteracy, where 47.8% were depressed (Chi-square = 82.9, p < .000). Lower income (29.6%, Chi-square = 33.47, p < .000) and having three or more children (33.3%, Chi-square = 22.7, p < .000) also correlated with higher depression rates. Logistic regression identified women aged 36-45 as more likely to be depressed (OR = 4.2, p < .05), while primary education and having no children were protective factors. Conclusion: This study reveals high depression rates among rural Bangladeshi women, influenced by age, education, income, and family size. It highlights the need for targeted mental health interventions addressing these factors to improve well-being.
Md. Sirazum Munir, Md. Ahsanul Haque, Quazi Dilruba Parveen Munni, Sahanaj Parvin
TAJ, Jul-Dec 2024; 37(2) 139-145
https://doi.org/10.62469/taj.v037i02.018
Background: The emergence of multidrug resistant (MDR) Escherichia coli are particularly challenging for clinician. Development of an effective vaccine may overcome the problems associated with treatment failure and antibiotic resistance. Object: This study was designed to determine immune response against MDR E.coli using formaldehyde inactivated E.coli in mice model. Methods & Results: In this study, fifteen Swiss albino mice were used. Intradermal inoculation was implemented three times at 14 days interval with formaldehyde inactivated MDR E.coli. The mice were given intraperitoneal challenge with live E.coli and observed for 14 days. Tail blood was collected to assess antigen binding capacity of the serum antibody of immunized mice by ELISA. The survival rate was 100% among the mice of immunized group at 14 days of post challenge. In ELISA, OD values of serum immunoglobulin G of pre and post challenge immunized mice were significantly higher (p < .001). Conclusion: In this study, It was observed that formaldehyde inactivated MDR E.coli induced protective antibodies in mice model.
Farjana Kabir, Shamima Nazneen Rupa, Sayeeda Sultana Jolly, Bedowra Begum
TAJ, Jul-Dec 2024; 37(2) 146-151
https://doi.org/10.62469/taj.v037i02.019
Background: Thyroid is an endocrine gland which is located below the larynx. The principal hormones of thyroid gland are thyroxine (T4), and tri-iodothyronine (T3). The activity of the thyroid gland depends on the age as well as gender. However, with advancing age the concentration of these hormones decreases in apparently healthy male and female. The current study was carried out to investigate the impact of age and gender on the level of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) in apparently healthy individuals. Objective: This study was designed to observe the levels of FT3, FT4 and TSH among different age-sex groups of normal healthy population residing in Rajshahi City. Methods: This cross-sectional descriptive study was carried out in the department of physiology in collaboration with institute of nuclear medicine and Allied Sciences, Rajshahi. 120 apparently healthy persons in age group of 8-65 years were studied. Random blood sample was taken to measure the level of free T3, free T4, TSH by Radioimmunoassay (RIA) and Immunoradiometric assay (IRMA). Data were analyzed by ANOVA Test and independent t test. Result: Non-significant drop of FT4, TSH level and significant drop of FT3 level with advancing age. Moreover, mean FT3, and FT4 concentration is non-significantly higher in male in comparison to female. However mean TSH concentration is significantly higher in male in comparison to female. Conclusion: It can be concluded from the present study that non-significant drop of FT4, TSH level and significant drop of FT3 level with advancing age.
Mamuni Sultana, Bayzid Mostafa
TAJ, Jul-Dec 2024; 37(2) 152-160
https://doi.org/10.62469/taj.v037i02.020
Background: Cesarean section (C-section) is a common surgical procedure associated with risks of surgical site infections (SSIs) and delayed wound healing. Objective: This study aims to evaluate the role of serum albumin concentration in predicting SSIs and wound healing outcomes after C-sections. Method: A longitudinal analysis was conducted on 122 pregnant patients undergoing C-sections at the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, between January and December 2020. Preoperative serum albumin levels were measured, with hypoalbuminemia defined as < 3.5 g/dL. Patients were categorized into groups of hypoalbuminemic (Group I) and normal albuminemic (Group II). Postoperatively, patients were monitored for 60 days to identify SSIs and signs of delayed wound healing. Result: The mean preoperative serum albumin level was 2.57 ± 0.35 g/dL in Group I and 4.2 ± 0.4 g/dL in Group II, with a statistically significant difference (p < 0.05). In Group I, 9 out of 19 patients (47.4%) developed post-cesarean wound infections and delayed wound healing, compared to 7 out of 103 (6.8%) in Group II. The risk ratio for wound infections and delayed healing in hypoalbuminemic patients was 6.97 (95% CI: 3.00-16.20), indicating a significantly higher risk in Group I. The length of hospital stay was longer for Group I (10.2 ± 2.1 days) compared to Group II (7.5 ± 1.8 days). The readmission rate was higher in Group I, with 1.5% of patients requiring no readmission compared to Group II. 47.4% of Group I experienced complications, compared to 6.8% in Group II, highlighting a substantial disparity. Conclusions: Preoperative hypoalbuminemia is a significant predictor of SSIs and delayed wound healing in patients undergoing C-sections.
Nazifa Islam, Shah Md Badruddoza, Khadiza khanam, Anindita Sarkar, Tanshina Afrin
TAJ, Jul-Dec 2024; 37(2) 161-167
https://doi.org/10.62469/taj.v037i02.021
Background: Tubercular lymphadenitis (TBL) is the most common form of extra pulmonary tuberculosis. Currently the standard diagnostic tool for TBL is culture, which takes more than several weeks to yield results. Recently the use of nucleic acid amplification tests (NAATs), especially polymerase chain reaction (PCR) has gained acceptance for rapid diagnosis of tubercular lymphadenitis. This study is to evaluate the role of real time PCR in the diagnosis of tubercular lymphadenitis. Methods: This cross-sectional type of descriptive study was conducted in the Department of Pathology, Rajshahi Medical College and Department of Microbiology (BSMMU) over a period of two years from July 2017 to June 2019. Tissue biopsy from the lymph node was fixed with 10% formalin and was processed and stained with haematoxylin and eosin stain and was examined in Pathology Department of Rajshahi Medical College, Rajshahi and Real time PCR was done in Microbiology Department of BSMMU, Dhaka. Out of the 47 cases, 32 cases were histopathologically confirmed as tubercular lymphadenitis and the rest 15 cases were as chronic non-specific lymphadenitis which served as control in the study. Results: The Real time PCR had (46.87%) sensitivity, (100%) specificity. PPV was (100%) and NPV was (46.87%). The overall diagnostic accuracy of the test was (63.82%). Conclusion: The study concluded that role of Real time PCR was mildly sensitive and highly specific in the diagnosis of tubercular lymphadenitis.
Mst. Mahmuda Khatun, S.M. Asafudullah, Khadiza Khanam, Sadia Refat, Swapna Majumder
TAJ, Jul-Dec 2024; 37(2) 168-174
https://doi.org/10.62469/taj.v037i02.022
Background& Objective: Gastric cancer is known as one of the most common cancers and cause of death. Early and accurate diagnosis is an important tool for proper treatment response. Mutation of the p53 tumor suppressor gene is the most frequent genetic alteration observed in human cancers. The aim of this study was to evaluate the expression of p53 in gastric adenocarcinoma and its association with histological grade. Methods & Materials: This cross-sectional study was conducted in the Department of Pathology, Rajshahi Medical College, from September 2019 to August 2021. A total of 50 gastrectomy samples with a histologically confirmed diagnosis of gastric adenocarcinoma were included in this study. Expression of p53 was evaluated in formalin-fixed and paraffin embedded specimens by immunohistochemistry. Result: p53 expression was observed in all cases among which 31 (62%) patients showed low and 19 (38%) patients showed high p53 expression. Level of p53 expression was found significantly associated with histological grade. But, the p53 expression levels was not associated with the age of the patients with gastric adenocarcinoma (p>0.05). Conclusion: The expression of p53 involved in the progression and differentiation of gastric adenocarcinoma. These expression levels can be utilized as indicators of biological behavior and prognosis of gastric adenocarcinoma.
A. H. M. Anisuzzaman, Klaara Salmin Sattar, Amitabh Sarker, Md. Ruhid Hossain, Noor Mohammed, Abdullah Al Maruf, Md. Enamul Karim
TAJ, Jul-Dec 2024; 37(2) 175-182
https://doi.org/10.62469/taj.v037i02.023
Background: Ischemic stroke is a significant cause of morbidity and mortality worldwide, often leading to hospital admissions and imposing a substantial burden on healthcare systems. Method: The study was conducted at Dhaka Medical College Hospital from July to December 2010, enrolling 100 hospitalized patients diagnosed with acute ischemic stroke. Demographic data, clinical presentations, and risk factor profiles were collected using standardized forms and analyzed using descriptive statistics. Results: Ischemic stroke was found most commonly in the 51-60 age groups (49%) and then the 61-70 age groups (24%). Most of the patients were male. The male-female ratio is 1.56:1. Most patients were from rural areas (69%). 58% of patients with ischemic stroke presented with a Glasgow coma scale (GCS) 9-15 and 42% with GCS <9. Cranial nerve palsy 20% of cases. Plantar reflexes were extensor in 80% of cases mostly on the left side. The commonest presentation was hemiplegia or hemiparesis (90%). Headache was present in 40%, vomiting in 20%, and convulsion in 23% of cases. Among patients with ischemic stroke, hypertension was found in 76% of cases, followed by dyslipidemia (46%), smoking (37%), diabetes mellitus (25%), heart disease (23%), and family history of stroke (21%). 71% of patients were on irregular use of antihypertensive drugs. Cortical infarction was found in 58% of cases. Conclusion: The findings underscore the importance of recognizing the demographic and clinical characteristics of ischemic stroke patients for early intervention and prevention strategies. Addressing hypertension as a key modifiable risk factor could significantly reduce the burden of ischemic stroke.
Bidhan Krishna Sarker, Sangita Devi, Sonia Akter, Tasnova Islam Chy, Sharmin Jahan Khan, Md. Shahab Uddin
TAJ, Jul-Dec 2024; 37(2) 183-189
https://doi.org/10.62469/taj.v037i02.024
Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is a growing health concern globally, with varying prevalence and severity. This study aimed to investigate the demographic distribution, severity grading, associated risk factors, and biochemical profiles in patients with NAFLD. Methods: This cross-sectional study was conducted at Comilla Medical College and Hospital, involving 50 adult patients diagnosed with NAFLD. The study assessed demographic characteristics, NAFLD grading through ultrasound, and the association of risk factors and biochemical markers with NAFLD severity. Result: The study cohort had a higher representation of older adults (56% aged 55 years or older) and females (64%). The majority of participants (54%) were diagnosed with Grade 1 NAFLD, while Grades 2 and 3 were observed in 32% and 14% of participants, respectively. Significant associations were found between higher NAFLD grades and risk factors such as hypertension, BMI ≥ 23 kg/m^2, and a weight-to-height ratio >0.8. Elevated levels of total cholesterol, ALT, AST, and ALP were significantly associated with higher NAFLD grades, whereas HDL-C, LDL-C, and triglycerides levels did not show a significant correlation with disease severity. Conclusion: This study underscores the prevalence of NAFLD in older adults and females, with a higher occurrence of less severe disease forms. The progression of NAFLD severity is closely linked with specific risk factors and biochemical markers. These findings highlight the importance of considering demographic characteristics and individual risk profiles in the management and treatment of NAFLD.
Tanshina Afrin, Khadiza Khanom, Arefa Sultana, Md. Saifur Rahaman
TAJ, Jul-Dec 2024; 37(2) 190-197
https://doi.org/10.62469/taj.v037i02.025
Background: Salivary gland lesions encompass a range of benign and malignant tumors, inflammatory conditions, and developmental anomalies. Histopathological examination plays a critical role in accurate diagnosis and management. Objective: This study aimed to evaluate the histopathological spectrum of salivary gland lesions, focusing on their frequency, distribution, and associated clinical characteristics in a sample of patients. Methods: A prospective observational study was conducted at the Department of Pathology, Rajshahi Medical College, Rajshahi, from July 2022 to June 2023. A total of 52 cases of salivary gland lesions were enrolled through purposive sampling. Specimens were processed using standard histological techniques, including hematoxylin and eosin staining, followed by histopathological examination. Data were analyzed using MS Office tools. Results: The study included 63% male and 37
Swati Sarker, Gopa Sarker, Farhana Rahman, Shahin Mahmud, Md. Jawadul Haque
TAJ, Jul-Dec 2024; 37(2) 198-203
https://doi.org/10.62469/taj.v037i02.026
Background: One of the most prevalent endocrine problems in pregnant women is thyroid dysfunction which is linked to poor outcomes for both the mother and the fetus. It is obvious that overt hypothyroidism which is characterized by elevated TSH and low thyroid hormone levels in the mother, particularly in the early stages of pregnancy, may impact the development of the baby's brain or result in other pregnancy related complications. The aim of the study was to determine and compare the TSH status in pregnant and non-pregnant women in Rajshahi city. Methods: This cross-sectional comparative study was carried out in the Department of Physiology, Rajshahi Medical College, Rajshahi over a period of 1 year from July 2022 to June 2023 on 180 reproductive women aged 20-35 years in Rajshahi city. Data from 90 pregnant and 90 non-pregnant women were gathered using a pre-designed, validated and semi-structured questionnaire. Results: The mean ages of the pregnant and non-pregnant women were 25.26 ± 4.44 years and 27.66 ± 4.45 years, respectively. The mean TSH value in pregnant women was higher than non-pregnant women and it was statistically highly significant (p < 0.001). Trimester specific analysis showed that serum TSH level was increased in 3rd trimester than other trimester of pregnancy and it was statistically highly significant (p < 0.001). Conclusions: Therefore, it is imperative to check the TSH level regularly during pregnancy. Early identification of hypothyroidism may prevent difficulties and provide a good life for the unborn child and mother.
Aparajita Roy, Md. Jawadul Haque, Nahid Farzana Chowdhury, Md. Arifur Rahman, Md. Sarwar Jahan
TAJ, Jul-Dec 2024; 37(2) 204-211
https://doi.org/10.62469/taj.v037i02.027
Diabetes mellitus one of the main chronic illnesses that is now a global public health concern. Diabetes complications and mortality might arise from inadequate knowledge about diabetes self-care. The patient's level of knowledge on diabetes self-care has a direct correlation with diabetic complications. Methods: This was a cross-sectional descriptive study conducted from January to December 2022. The study focused on patients with type 2 diabetes at Rajshahi Medical College Hospital and Rajshahi Diabetic Association General Hospital. Data was collected from 210 respondents using a purposive sampling technique and a semi-structured questionnaire. Results: A total of 210 patients with diabetes, with a mean age of 51.44±8.26 years, were included. Among those 69.5% had good knowledge and 30.5% had poor knowledge regarding self-care among diabetes patients. Knowledge of diabetes self-care was found to be significantly correlated with residency (p<0.01), education level (p<0.001), and monthly income (p<0.01). Conclusions: Knowledge of self-care is essential for keeping diabetes under control. The government and mass media must work to raise public awareness about its importance for diabetes patients.
Md Mahinul Islam, Md Minhaz Uddin Rajib, Most. Masuda Afroz, Karina Rahman, Tania Ahmed
TAJ, Jul-Dec 2024; 37(2) 212-218
https://doi.org/10.62469/taj.v037i02.028
Background: Fistula-in-ano, a common surgical pathology, causes significant patient discomfort and disability, often receiving only temporary relief and casual attention in general medical practice. Fistula-in-ano is an abnormal communication between the anal canal or rectum and the perianal skin which is the chronic manifestation of the acute perianal process that forms an anal abscess. This study investigates the etiology of the perianal fistula. Method: The cross-sectional observational study was carried out in the Department of Rangpur Medical College Hospital, Rangpur, from July 2015 to December 2015. A total of 100 patients were selected as study subjects by simple random sampling technique. All data were collected using a pre-formed questionnaire. Collected data was classified, edited, coded, and entered into the computer for statistical analysis by using SPSS version 20. Collected data were analyzed using descriptive statistics. Results: Perianal fistulas predominantly affected males (86%), with a male-to-female ratio of 6.14:1. The most affected age group was 20-50 years, with no exemptions except for those below 10 years and over 80 years. A significant portion (76%) had a history of prolonged sitting at work. Most of the organisms were enteric in origin and constituted about 69.64%. Conclusion: This study reveals that perianal fistulas primarily affect individuals aged 20-50, with a higher incidence in males, in low socioeconomic group, and a significant portion is associated with prolonged sitting at work. Organisms isolated from a discharge of fistulas are mostly enteric origin and E. coli (50%) is the highest incidence.
Md Minhaz Uddin Rajib, Most. Masuda Afroz, Md Mahinul Islam, Karina Rahman, Tania Ahmed
TAJ, Jul-Dec 2024; 37(2) 219-226
https://doi.org/10.62469/taj.v037i02.029
Background: Breast cancer is the most common cancer among women worldwide, with early detection playing a crucial role in improving outcomes. Objective: This study aimed to evaluate the physical examination characteristics and the delay in seeking healthcare among breast cancer patients at Rangpur Medical College Hospital. Methods: A cross-sectional observational study was conducted from November 2015 to April 2016. A total of 62 patients diagnosed with breast cancer were included using simple random sampling. Data were analyzed using SPSS version 26.0. Results: The age distribution showed 43.54% (27 patients) between 51-60 years, and 21% (13 patients) between 41-50 years, with a mean age of 49.16. Hormonal contraceptive use was reported by 75.8% of patients, and 87% had a history of breastfeeding. A significant 67.74% had never heard of breast self-examination (SBE), and only 9.68% performed SBE. Physical examination revealed that 90.32% had breast lumps, 6.45% had wrinkled nipples, and 3.22% showed puckered skin. Regarding disease stage, 34% presented with stage II, 52% with stage III, and 14% with stage IV. Among stage II patients, 28% had delayed seeking medical attention for more than 3 months, while 81% of stage III patients and 89% of stage IV patients had a similar delay. The average delay in seeking medical care was 3.8 months. Conclusions: A considerable delay in seeking medical attention was observed, leading to advanced-stage breast cancer at presentation. The lack of knowledge regarding SBE emphasizes the need for public health campaigns to promote early detection and reduce delays in seeking care.
Most. Eleza Khanom, Md. Abdul Hye, Rahat Bin Habib, Md. Ruhul Amin, Md. Selim Khan
TAJ, Jul-Dec 2024; 37(2) 227-231
https://doi.org/10.62469/taj.v037i02.030
Background: Cervical cancer is a major health issue, particularly in developing countries like Bangladesh, where the incidence and mortality rates are higher compared to global averages. Early detection through screening is critical. Objective: This study aimed to determine the incidence of cervical intraepithelial neoplasia (CIN) among women aged 24-59 years attending a VIA screening camp at UHC, Tanore, Rajshahi, and assess the effectiveness of VIA screening. Method: A cross-sectional observational study was conducted in January 2020 at the Outpatient Department (OPD) of UHC, Tanore, Rajshahi. A total of 1,200 women aged 24-59 years participated in the screening program. Women were screened for cervical abnormalities using VIA (Visual Inspection with Acetic Acid). Demographic data were collected through a structured questionnaire, and women who tested positive for abnormalities were treated with thermocoagulation or referred for further management. Results: Out of 1,200 women, 18 tested positive for cervical abnormalities (1.5%), resulting in an incidence rate of 2.44 cases per 10,000 women per week. Of these, 13 women (72.2%) received thermocoagulation treatment, while 5 women (27.8%) with large lesions were referred for further evaluation. Additionally, 6 women (0.5%) had breast lumps and were referred for FNAC at Rajshahi Medical College Hospital (RMCH). The majority of women (58.67%) were aged over 35 years, and 95% were housewives. Conclusion: VIA screening is an effective, low-cost tool for early cervical cancer detection in low-resource settings. Regular screening and early treatment can significantly reduce cervical cancer prevalence in Bangladesh.
Soumen Sarkar, Md. Joynul Islam, A. T. M. Ashadullah, Md. Masum Ali, Md. Shamsuzzaman Mondle
TAJ, Jul-Dec 2024; 37(2) 232-240
https://doi.org/10.62469/taj.v037i02.031
Background: Lumbar disc herniation (LDH) is a prevalent cause of lower back and leg pain, affecting a significant portion of the adult population globally. Surgical interventions, namely Percutaneous Endoscopic Lumbar Discectomy (PELD) and Open Lumbar Microdiscectomy (OLM), are common therapeutic options. This study aims to compare the outcomes of these two techniques focusing on demographic factors, clinical assessments, and postoperative recovery metrics. Methods: This cross-sectional comparative study included 70 patients diagnosed with LDH, who were divided into two groups based on the surgical technique: PELD (Group I, n=33) and OLM (Group II, n=37). Preoperative and postoperative evaluations included Motor and Sensory Examinations, Straight Leg Raise tests, and Magnetic Resonance Imaging (MRI). Pain and disability were quantified using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Data analysis involved comparing improvements in VAS and ODI scores, duration of surgery, and the incidence of complications. Results: Both groups showed significant improvements in VAS and ODI scores post-surgery. Moreover, Group I (PELD) reported more pronounced pain reduction and quicker recovery (p<0.05). The average operative time was shorter for Group I, indicating a more efficient surgical process. Conclusion: PELD and OLM are both effective for treating LDH, but PELD may offer advantages in terms of pain reduction, recovery time, and preservation of neurological function. These findings support the need for individualized surgical planning based on patient-specific demographic and clinical characteristics to optimize outcomes.
Md. H. Rahman, Shadia S. Sultana, Md. M. Islam, Pervin Akter, Mehnaz Afrin, Maurin Azad, Tohorunnesa
TAJ, Jul-Dec 2024; 37(2) 241-246
https://doi.org/10.62469/taj.v037i02.032
Background: Globally, Type 2 diabetes mellitus (DM) is a leading cause of morbidity and mortality and oral antidiabetic medications are an essential part of the treatment plan. While long-term blood glucose management can be challenging by using monotherapy antidiabetic medications, combination therapy with various modes of action is frequently required. Methods: This quasi-experimental study was conducted in the Department of Pharmacology and Therapeutics, Rajshahi Medical College, Rajshahi in collaboration with Rajshahi Diabetic Association General Hospital (RADAS), Rajshahi on Type 2 DM patients who had inadequate glycemic control with Metformin and diet with lifestyle modification therapy. Based on predefined eligibility criteria, a total number of 42 Type 2 DM patients of both sexes were included in the study. Tablet Alogliptin 25mg as once-daily dose was added after breakfast to the ongoing treatment of tablet Metformin 1000mg for each patient and was followed up at the end of 4, 8 and 12 weeks of drug administration. Results: Most (92.90%) of the patients had diabetes ≥ 1-year duration. After administration of Alogliptin as add on therapy with Metformin, overall reduction of FBS, PPBS and HbA1c from baseline to 12 weeks of intervention was found statistically highly significant (p < 0.001 in each case). Conclusions: So, Alogliptin with metformin might be used as an 1st line oral antidiabetic drug in case of inadequately control Type 2 diabetes mellitus patients.
A B M Ali Hasan, Tahmina Rahman, Md Manir Hossain, Md. Abdul Matin, Krishna Karmaker, Md. Faridal Mamun, Akash Chakrabartti, Md. Rubel Mia
TAJ, Jul-Dec 2024; 37(2) 247-254
https://doi.org/10.62469/taj.v037i02.033
Background: Acute watery diarrhea remains a significant health concern for children under five, particularly in low-resource settings. This study investigates the association between maternal education, socioeconomic factors, and the management of acute watery diarrhea, including antibiotic usage, in this vulnerable age group. Methods: This cross-sectional study was conducted among < 5 children presenting with acute watery diarrhea at the paediatric ward of Kumudini Hospital. Data were collected prospectively on basic demographic characteristics, maternal education levels, and details regarding antibiotic use prior admission to paediatric ward, which were analyzed to determine patterns and influences on treatment approaches. Result: The study included 180 children, predominantly males (58.89%). Most families had monthly income more than 10,000 BDT. The primary education level for most mothers was secondary (58.89%). Antibiotics were prescribed in 139 cases, with 52.51% by registered doctors and 44.60% by non-registered practitioners. Antibiotics were most commonly administered within the first three days of illness (69.78%) and were generally used for less than seven days (66.18%). Children of illiterate mothers had the highest antibiotic use (52.51%), and a substantial reliance on non-registered practitioners for prescriptions was noted, especially among children whose mothers had primary education. Conclusion: The study highlights a significant impact of maternal education on the treatment of acute watery diarrhea in children under five.
Mohammad Nurul Amin, Ramanuj Bhattacharjee, Shahrin Fardose Lisa, Sunzida Akhter, Tanjib Mahmud, Md. Salim Moral
TAJ, Jul-Dec 2024; 37(2) 255-261
https://doi.org/10.62469/taj.v037i02.034
Background: Anesthesia choice significantly impacts postoperative outcomes, particularly concerning ICU admissions and recovery times. This study compares regional anesthesia (RA) and general anesthesia (GA) regarding their postoperative complications, aiming to evaluate differences in respiratory issues, infection rates, hemodynamic stability, and ICU duration. Objectives: To compare postoperative complications of regional vs. general anesthesia in ICU-admitted patients and evaluate related outcomes. Method and Materials: This comparative, retrospective, cross-sectional study analyzed data from 120 patients admitted to ICUs across private clinics in Sylhet from July 2022 to June 2024. Participants were categorized based on the type of anesthesia received—either regional or general. Data on demographics, anesthesia type, and postoperative complications were collected from medical records. Result: The study included 120 participants, predominantly aged 46-55, with a mean age of 45 years. Among them, 54.2% received regional anesthesia, while 45.8% underwent general anesthesia. Postoperative complications were most commonly respiratory (16.7%), followed by cardiovascular (12.5%). ICU stays varied, with 45.8% of patients staying for 1-2 days. Conclusion: This study demonstrates that the choice of anesthesia type significantly impacts postoperative outcomes, ICU stay duration, and complication rates among surgical patients.
Md. Ahsanul Haque, Md. Sirazum Munir, Quazi Dilruba Parveen Munni, Sahanaj Parvin
TAJ, Jul-Dec 2024; 37(2) 262-269
https://doi.org/10.62469/taj.v037i02.035
Background: Methicillin-resistant Staphylococcus aureus (MRSA) and Extended Spectrum Beta-Lactamase (ESBL) producing bacteria are significant public health threats, both globally and locally, due to their multidrug resistance, including resistance to third-generation cephalosporins and carbapenems. Objective: This study aimed to detect MRSA and ESBL-producing bacteria and analyze their antimicrobial resistance patterns in infected wound patients from the Rajshahi region. Materials and Methods: A cross-sectional descriptive study was conducted from July 2017 to June 2018, collecting wound swabs from surgical units at Rajshahi Medical College Hospital. Specimens were cultured on blood agar, nutrient agar, and MacConkey’s agar, and incubated at 37°C for 24 hours. Bacterial susceptibility was tested using the modified Kirby Bauer disk diffusion method on Mueller Hinton agar. MRSA was identified by Cefoxitin disk diffusion, and ESBL-producing bacteria were detected via the disk diffusion test. Results: Out of 250 samples, 213 (85.2%) yielded bacterial growth, identifying a total of 231 bacterial isolates. Among these, 136 (58.8%) were gram-negative, and 95 (41.2%) were gram-positive. Females were more predominant (146, 58.4%) compared to males (104, 41.6%), with a male-to-female ratio of 1:1.4. The most common isolate was S. aureus (71, 30.8%), followed by Pseudomonas aeruginosa (47, 20.3%). Of the S. aureus isolates, 53.5% were MRSA. Additionally, 41.3% of gram-negative isolates were ESBL producers, with high resistance to third-generation cephalosporins (65%) and carbapenems (40%). Conclusions: MRSA and ESBL-producing bacteria pose significant resistance challenges in wound infections in Rajshahi.
Md. A. Rahman, Prof. Dr. J. Haque, Farhana Yasmin, Kowsarunnahar, A.B.M.N. Intekhab, A. Zannat
TAJ, Jul-Dec 2024; 37(2) 270-278
https://doi.org/10.62469/taj.v037i02.036
Background: Almost fifty years of studying health systems has made patient -satisfaction a primary interest of researchers. It is thought to be a significant result of high-quality medical care. Patient input regarding the quality of medical services is crucial for healthcare organizations because it aids in the development of better service policies, better decision-making, meeting patient expectations, formulating management strategies, keeping an eye on service providers' performance, and other areas. Methods: This six-month cross-sectional descriptive study, which included male and female patients aged 18 and over, was conducted in the outpatient departments of Jalalabad Ragib Rabeya Medical College Hospital, Park View Medical College Hospital, and Women's Medical College Hospital in the Sylhet district. A pre-tested, validated, semi-structured questionnaire was utilized to collect data from 400 patients. Results: The mean satisfaction score was highest score in general satisfaction domain (4.32) and lowest in financial aspect (2.62) in this report. This study had 65.5% of male and 34.5% of females. 29% of the study patients were illiterate and remaining 71% were educated. The employed people were more satisfied (mean score= 3.84) than unemployed people (mean score= 3.69), married respondent were more satisfied than unmarried respondents for regarding receiving healthcare. Conclusions: This study showed that educational level, living place, marital status, age, sex, occupation were the important factors for satisfaction rate in outpatient departments of hospitals of Sylhet division.
Nishat Anam Borna, Shahela Jesmin, Rokeya Khatun, Khondokar Seheli Nasrin Lina
TAJ, Jul-Dec 2024; 37(2) 279-288
https://doi.org/10.62469/taj.v037i02.037
Background: Cervical incompetence poses significant challenges in obstetrics, often leading to preterm labor or pregnancy loss. Cervical cerclage is a surgical intervention aimed at reinforcing the cervix to prevent premature delivery. This study evaluates the fetomaternal outcomes of cervical cerclage in a tertiary hospital setting in Bangladesh. Objective: To assess the fetomaternal outcomes following cervical cerclage in patients with cervical incompetence at Rajshahi Medical College Hospital. Method: A cross-sectional descriptive study was conducted with a sample size of 21 patients, purposively selected from the Gynae ward of Rajshahi Medical College Hospital. Data were collected from January 1, 2017, to December 31, 2018. Cervical cerclage was performed using the McDonald purse string suture technique. Results: Out of the 21 patients who underwent cervical cerclage, 6 had undergone in vitro fertilization (IVF). The procedure resulted in a 70.58% term delivery rate, with 12 patients delivering via caesarean section. Preterm labor occurred in 23.52% of cases. The overall fetal salvage rate was 88.23%. Among the patients, 66.67% were aged 31-35 years, 71.42% were nulliparous, and 9.52% experienced bleeding complications. Notably, 66.67% had a history of mid-trimester losses, and 70.58
Shamima Nazneen Rupa, Bedowra Begum, Shahin Mahmuda, Farjana Kabir, Sayeeda Sultana Jolly
TAJ, Jul-Dec 2024; 37(2) 289-295
https://doi.org/10.62469/taj.v037i02.038
Background: Among all birth control methods, combined hormonal contraceptives are the most widely used. Previous studies have suggested that early oral contraceptive pills (OCPs) could be harmful to the liver. There was no research on how the more recent OCPs affected liver function, even though earlier OCPs had their dosage and content changed to reduce negative effects. Methods: This cross-sectional analytical study was carried out on 184 healthy women aged 20-45 years. Among them 92 women were OCP users and 92 women were OCP non-users. BMI matched non-OCP users’ women were recruited in the study for comparison of ALT and AST. Systematic sampling technique was applied to select each respondent. Having obtained ethical clearance from the Ethical Committee and informed consent from the respondents, data collection was commenced. Results: The results showed that the mean ALT level was higher in OCP users women (52.65±16.96 U/L) compared to non OCP users (36.17±20.26 U/L) and it was statistically significant (p < 0.05). The mean AST level was also higher in OCP users women (48.15±12.94 U/L) compared to non OCP users (37.14±15.42 U/L) and it was also statistically significant (p < 0.05). Conclusions: So, regular monitoring of liver function test should be done among OCP users women and adaptation of other suitable birth spacing method is necessary among them.
Sufia Khatun Sumi, Banita Mistry, Farzana Binta Rashid, Mohua Chandra, Ahmed Hossain, Azimul Haque, Narayan Saha
TAJ, Jul-Dec 2024; 37(2) 296-303
https://doi.org/10.62469/taj.v037i02.039
Background: Guillain-Barre Syndrome (GBS) is a rare neurological disorder affecting all age groups, characterized by the immune system mistakenly attacking peripheral nerves, causing weakness, numbness, and, in severe cases, paralysis. While the exact cause is often unknown, GBS is commonly preceded by infections like respiratory or gastrointestinal illnesses. Aim of the study: This study aimed to assess the demographic and clinical characteristics of children with Guillain-Barre syndrome. Methods and Materials: This observational study was carried out at the National Institute of Neurosciences and Hospital (NINS&H) in Dhaka, Bangladesh, spanning from September 2018 to August 2019. A total of 93 children diagnosed with childhood Guillain-Barre Syndrome (GBS) were included as the study subjects using a consecutive sampling technique. Data analysis was performed using MS Office tools. Results: Participants, with a mean age of 7.73 ± 3.80 years and a male-to-female ratio of 1.7:1, reported antecedent illnesses in 60 cases (64.5%). Electrophysiological abnormalities indicated 65.6% with acute motor axonal neuropathy (AMAN), 31.2% with acute inflammatory demyelinating polyradiculo-neuropathy (AIDP), and 3% with acute motor and sensory axonal neuropathy (AMSAN). Neurologically, 87.1% exhibited progressive weakness (quadriparesis), while 12.9% had paraparesis. Cranial nerve dysfunction, including 42% with bulbar involvement and 2.1% with facial palsy, was observed in 44.1% of cases. Conclusion: Guillain-Barré Syndrome (GBS) tends to affect younger male children more frequently.
Sangita Devi, Bidhan Krishna Sarker, Sharmila Chakroborty, Ummul Sifat Rizwana Rahman, Karuna Rani Karmakar
TAJ, Jul-Dec 2024; 37(2) 304-312
https://doi.org/10.62469/taj.v037i02.040
Background: Cervical cancer remains a significant public health challenge, especially in low to middle-income countries. Early detection through effective screening methods like colposcopy is crucial for timely intervention and management. Methods: This cross-sectional analytical study included 200 women attending a colposcopy center at Comilla Medical College Hospital. Participants were selected through random sampling, with inclusion criteria of women aged 20 to 60 years who were Visual Inspection with Acetic acid (VIA) positive. Result: The study primarily involved women aged 30-49 (80%), with 50% having primary education and 54
Zahir Al Imran, Khadiza Khanam, Arefa Sultana, Md. Zahid Hossain
TAJ, Jul-Dec 2024; 37(2) 313-319
https://doi.org/10.62469/taj.v037i02.041
Prostatic enlargement is a significant cause of morbidity in men, and distinguishing between prostatic adenocarcinoma and benign prostatic conditions remains challenging. Objective: This study aims to assess the role of neutral mucin in distinguishing prostatic adenocarcinoma from benign prostatic nodular hyperplasia. Methods: This cross-sectional study was conducted from March 2018 to February 2020 in the Department of Pathology at Rajshahi Medical College and Bangabandhu Sheikh Mujib Medical University (BSMMU). A total of 60 prostate tissue specimens, including 30 diagnosed cases of nodular hyperplasia and 30 of prostatic adenocarcinoma, were included. The specimens were processed with Hematoxylin and Eosin staining, followed by Periodic Acid Schiff (PAS) staining to detect neutral mucin. Positive or negative staining was recorded. Statistical analysis was performed using SPSS version 20. Results: Of the 30 prostatic adenocarcinoma cases, neutral mucin was detected in 6 (20%) cases and absent in 24 (80%). In contrast, among the 30 cases of nodular hyperplasia, neutral mucin was present in 27 (90%) cases and absent in 3 (10%). The sensitivity of PAS stain for detecting prostatic adenocarcinoma was 80%, and its specificity for nodular hyperplasia was 90%. The accuracy of PAS stain in distinguishing adenocarcinoma from benign nodular hyperplasia was 85%. Conclusions: The PAS stain is a reliable histochemical marker for differentiating prostatic adenocarcinoma from nodular hyperplasia
Abdul Hye, Be-Nazir Ahmmad, Rukhsana Parvin, Ruhul Amin, Eleza Khanom, Belal Hossain, Shahida Yeasmin, Lutfur Rahman
TAJ, Jul-Dec 2024; 37(2) 320-325
https://doi.org/10.62469/taj.v037i02.042
Background: Recording of blood pressure in children below 3 years of age is not carried out routinely. But measurement of blood pressure should be a routine part of clinical examination of children over 3 years of age. Routine measurement of blood pressure in infants, children and adolescents is needed for identification of affected children before the development of symptoms and will allow taking measure for prevention of complications due to hypertension. Objective: To determine the normal distribution of blood pressure in the pediatric population and relation with age, sex, weight, height & socioeconomic status of children. Methodology: This is a prospective cross-sectional study done from July 2017 to June 2018 with sample size of 532 school going children including both sexes. Between the age group of 5-15 year were included and grouped into three. Children with renal diseases and family history of hypertension were excluded. Result: This study showed that 0.9% of children had both SBP and DBP were above 95th percentile for age. For higher, middle and lower social class the prevalence was 1.7, 0.8 and 0.6 respectively. The prevalence is almost equal in both sexes. Conclusion: Measurements of blood pressure over a period of time in children should be done during the course of their continuous care and should not be ignored. Periodic health check-up with intervention is needed where there are established consistent and significant observations.
M Emdadul Haque, M Zahirul Haque, Abu Shahin Mohammed Mahbubur Rahman
TAJ, Jul-Dec 2024; 37(2) 326-333
https://doi.org/10.62469/taj.v037i02.043
Background: Harpic is a toilet cleansing agent. Due to its accessibility, Harpic poisoning is common among young people. We conducted this study to assess the poisoning of the toilet cleansing agent (Harpic) and its outcome among patients attending Rajshahi Medical College Hospital. Methodology: This observational study involved 50 patients who were exposed to Harpic poisoning in the medicine department of Rajshahi Medical College Hospital from January 2018 to December 2018. Results: Here, the female-to-male ratio was 3.55:1, and the mean age of the patients was 24.9 ± 6.3 years. Most (74%) were between 18 and 30 years old. Our patients were more from urban areas (76%) than rural areas (34%). 78% of the cases were either illiterate or below the SSC level. 88% of patients took Harpic for suicidal attempts. The average amount of Harpic ingestion was 21.6 ± 8.4 ml. In all cases, the tongue, throat, and abdomen felt painful and burning. 54% had endoscopic evidence of injury in different grades, including 20% had Grade II A injuries, 2% had Grade IIB lesions, and 32% had Grade III lesions. Around 84% of cases completely recovered, whereas the rest developed some complications. Only one case developed esophageal stricture. Fortunately, no death occurred. Conclusion: In this study, younger individuals often ingested Harpic as a means of suicide, with more cases among females living in urban areas. Grade III lesions were predominant on endoscopy, and about 85% were fully cured. The study’s limitations include a short follow-up period and a small sample size, suggesting the need for further research.
Md. Tafiqul Islam, Md. Mashiur Arefin, Md. Abdul Bari, Mst. Sufia Sultana, Md. Abdur Rahim
TAJ, Jul-Dec 2024; 37(2) 334-343
https://doi.org/10.62469/taj.v037i02.044
Background: Muscle-invasive bladder cancer (MIBC) presents significant treatment challenges. Neoadjuvant chemotherapy (NACT) has been posited as a means to improve surgical outcomes by downstaging tumors prior to radical cystectomy. Methods: This quasi-experimental study involved 60 patients with diagnosed MIBC, divided equally into a study group receiving NACT followed by radical cystectomy and a control group undergoing cystectomy alone. Data were collected on demographic characteristics, tumor staging pre- and post-NACT, intraoperative blood loss, surgical complications, and histopathological outcomes. Statistical analysis was conducted to compare the outcomes between the two groups. Result: The study demonstrated a significant increase in patients downstaged to N0 post-NACT (93.33% post-NACT vs. 83.33% pre-NACT, p=0.399) and a notable reduction in positive surgical margins in the NACT group compared to the control group (0% vs. 13.33%, p=0.038). Additionally, there was a significant decrease in intraoperative blood loss and difficulties related to resection, anastomosis, and stoma formation post-NACT (p=0.001). However, early and late post-operative complications did not show significant differences between the two groups. Conclusion: Neoadjuvant chemotherapy significantly enhances the likelihood of achieving negative surgical margins and complete tumor resection, and reduces intraoperative complications in patients undergoing radical cystectomy for muscle-invasive bladder cancer.
Nujhat Sharmin Urmi, Natia Rahnuma, Rukshana Khan, Rebeka Sultana Mishu, Nila Ahmed, Tahmina Sharmin
TAJ, Jul-Dec 2024; 37(2) 344-348
https://doi.org/10.62469/taj.v037i02.045
Background: The most dangerous complication and the most critical cause during pregnancy and childbirth is post-partum hemorrhage (PPH). Severe anemia, acute respiratory distress syndrome (ARDS), acute renal failure (ARF), coma, and cardiac arrest are all possible side effects. Aim of the study is to find out the etiology of post-partum haemorrhage following lower uterine caesarean section. Materials and Methods: The study was carried out in the Department of Obstetrics and Gynecology, Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet, as a cross-sectional study. This study comprised 75 patients who had a postpartum haemorrhage after a lower uterine caesarean operation. Patient with postpartum haemorrhage after CS was assessed using a complete history, clinical examination, and appropriate investigations. Clinical history, confirmed haemodynamic condition, and quantifying blood loss were used to make the diagnosis of postpartum haemorrhage. Results: Uterine atony was the most common cause of PPH in 44 (58.7%) patients, followed by 16 (21.3%) placental abruption, 11 (14.7%) abnormalities in placental implantation, 3 (4.0%) chronic late bleeding, and 1 (1.3%) uterine rupture. Primary PPH was observed in 46 individuals (61.3%) and secondary PPH in 29 patients (38.7%). The majority of patients (93.3%) were alive, with only 5 (6.7%) dying. Conclusion: The most prevalent cause of PPH was uterine atony, which was followed by placental abruption, anomalies in placental implantation, chronic late bleeding, and uterine rupture. Individuals were found to have the majority of main PPH.
Ariful Alam Suman, Prof. Md. Habibullah Sarkar, Mohd. Sultanul Abedin, Towhidul Hasan Nahid, Asim Sarkar
TAJ, Jul-Dec 2024; 37(2) 349-357
https://doi.org/10.62469/taj.v037i02.046
Background: Complex perianal fistula is very challenging to treat, often requires procedures like partial fistulotomy followed by the application of a seton to prevent fecal incontinence and recurrence. Objective: This study aimed to assess the clinical outcomes of employing a modified cutting seton following partial fistulotomy in respect to recurrence and incontinence, for treating complex perianal fistula in a tertiary hospital setting. Method: A longitudinal study was conducted involving (n=239) patients admitted to the Department of Surgery in Rajshahi Medical College Hospital over a 4-years period from May 2020 to April 2024. Purposive sampling was utilized, with patient data collected from histories, physical examinations, investigations, treatment sheets, and postoperative follow-up using semi-structured questionnaires. Results: The study comprised predominantly male patients (79.08%), with the majority falling within the 35-45 age group (54.39%). Notable findings included a significant proportion with a history of perianal abscess (24.69%), with many having sought treatment from non-medical sources (71.19%). Recurrence rates at 3, 6 and 12- months post-procedure was low (1.67%, 2.09% and 3.35% respectively), with minimal incidences of incontinence (7.11% at 3 months, 3.35% at 6 months and 1.26% at 12 months). Conclusion: The study reflects the outcomes of partial fistulotomy and application of modified cutting setons in the treatment of complex perianal fistula, demonstrating minimal side effects in the clinical context.
Fatima Jannat, Mohammad Abdul Quayyum, Munawar Sultana, Mohammad Shaha Alam, Mohammad Jahangir Kabir Bhuiyan, Osmanur Rashid
TAJ, Jul-Dec 2024; 37(2) 358-364
https://doi.org/10.62469/taj.v037i02.047
Background: Polycystic Ovary Syndrome (PCOS) is a prevalent hormonal disorder affecting women of reproductive age, characterized by irregular menstrual cycles, elevated androgen levels, and ovarian cyst formation. As the most common endocrine disorder in this demographic, understanding its risk factors is crucial. Methods: This case-control study was conducted in a district-level hospital at Cox's Bazar from January 2023 to December 2023. As study subjects, 60 women diagnosed with Polycystic Ovary Syndrome (PCOS), aged between 15 and 45 years, were included in the case group. Additionally, 60 age-matched healthy women were randomly selected for the control group. Data analysis was performed using SPSS Version 23.0. Results: In this study, in risk factor analysis, BMI (Body Mass Index; p=0.023), education level (p=0.013), regular tea drinking (0.030), marital status (p=0.034), gravidity (p=0.017), parity (p=0.003), family relationship (p<0.001), family history of PCOS (p=0.006), diabetes (p<0.001), family history of infertility (p=0.006), and mother's irregular menstruation (p=0.003) showed notable significance. Additionally, lack of physical exercise was significantly associated with the case group (p=0.030). Conclusion: Common risk factors for polycystic ovary syndrome (PCOS) among Bangladeshi women encompass various factors such as lower education levels, unmarried status, lower gravidity and parity, poor family relationships, insufficient physical exercise, family history of PCOS, diabetes, and infertility, along with a mother's irregular menstruation.
Bijoy Talukder, Be-Nazir Ahmmad, Rukhsana Parvin, Belal Hossain, Shameem, Ibrahim Hoshen, Syeda Nafisa Islam, Shahida Yeasmin, Prof. Dr. Belal Uddin
TAJ, Jul-Dec 2024; 37(2) 365-371
https://doi.org/10.62469/taj.v037i02.048
Background: Perinatal asphyxia is one of the leading causes of neonatal mortality and morbidity worldwide and the outcomes of hypoxic ischemic encephalopathy (HIE) are devastating and permanent, making it a major burden for the family and society. Objective: To assess cardiovascular and pulmonary function in hypoxic ischemic encephalopathy neonates. Materials and methods: This cross-sectional type of descriptive study was conducted in the Department of Pediatrics at Rajshahi Medical College Hospital, Rajshahi over a period of 2years from July 2021 to June 2023. The study was conducted after obtaining ethical clearance from the Institutional Review Board (IRB) of Rajshahi Medical College and consent from the guardian of patients. Based on predefined eligibility criteria, a total number of 70 neonates with HIE stage II and III were included in this study. Results: Out of 70 hypoxic ischemic encephalopathy neonates, 55.70% neonates had stage-II and 44.30% had stage-III hypoxic ischemic encephalopathy. Mean age of the neonates was 10.81±8.08 hours, about 68.60% were male and 31.40% were female. Most of the neonates 71.43% had pulmonary dysfunction, 57.10% had cardiovascular dysfunction. Conclusion: There was statistically significant cardiovascular and pulmonary dysfunction (p< 0.001) as well as significant difference between the stage II and stage III hypoxic ischemic encephalopathy neonates in terms of cardiovascular and pulmonary (p< 0.05) dysfunctions.
Romena Alam, M.A Khan, Salma Afrose, Zahirul Haque, Col (Dr.) Lutfunnahar khan
TAJ, Jul-Dec 2024; 37(2) 372-376
https://doi.org/10.62469/taj.v037i02.049
Liver diseases are frequently associated with hematological abnormality. Anaemia of diverse etiology occurs in 75% of patient with chronic liver disease. The present study aimed to find out the prevalence and type of anaemia among chronic liver disease patient. This cross-sectional type of observation study was conducted among 138 patients attended and admitted in DMCH and BSMMU. Haemoglobin level was determined by using automated haematology analyzer. Morphological type of anaemia was studied and anaemia is defined by WHO. A total number of 138 CLD patients are evaluated. The mean age ± SD of participants is 38.27 ± 16.20 with range of 10-80 years. The distribution of patients according to sex, male79.0% is predominant and female (21.0%). Mean haemoglobin (gm/dL) is found in 9.30 ±2.45. Haemoglobin is decreased among the CLD patients, moderate form of anaemia (39.2%) in majority of patients followed by mild form (27.5%) and severe form only (5.8%). Anaemia is prominent finding in this study, severity of anaemia is mild to moderate in majority cases and normochromic normocytic anaemia is predominant than other type of anaemia. Early recognition of these potentially treatable condition can help in achieving better outcome.
Abu Hena Mostafa Kamal, Wahida Khatun, Md. Golam Morshed, Md. Akkasur Rahman
TAJ, Jul-Dec 2024; 37(2) 377-380
https://doi.org/10.62469/taj.v037i02.050
This study presents a comprehensive evaluation of the efficacy of treatment protocol in managing Lambda-cyhalothrin (OPC) poisoning cases at ICU of Rajshahi Medical College Hospital. The research focused on the case of Fahmida, a 25-year-old female patient who was admitted with severe Lambda-cyhalothrin poisoning, experiencing life-threatening respiratory distress. The study examined the interventions and treatments administered, including airway management, gastric lavage, activated charcoal, Atropine, Pralidoxime, fluid resuscitation, continuous monitoring, and supportive cares. Fahmida's clinical progress was analyzed, emphasizing the critical role of timely and appropriate treatment. The outcome of this case demonstrates the effectiveness of the treatment protocol in ICU. Fahmida's condition improved significantly, leading to her successful weaning off the ventilator. She was discharged in stable condition. Furthermore, a calculation of the percentage improvement in Fahmida's condition has been provided, indicating the extent of recovery achieved during her ICU stay. This study also discussed its findings in the context of similar studies, highlighting the percentage of improvement in other cases with Lambda-cyhalothrin (OPC) poisoning who underwent comparable treatment protocols. Comparision of these percentages allow for a broader assessment of the treatment's efficacy and its potential implications for improving patient outcomes in pesticide poisoning cases.
Debprio Das, Shah Md. Ahsan Shahid, Shantona Rani Paul, Zamil Hussain, Rezaul Hamid MD Nure, Shuvashis Saha Shuvo
TAJ, Jul-Dec 2024; 37(2) 381-384
https://doi.org/10.62469/taj.v037i02.051
Dorsal mesentery agenesis is often associated with jejunal atresia and these patients present with symptoms in early neonatal life. However, very few reports were found on the agenesis of the dorsal mesentery without small bowel atresia. Here we report an 8-month-old child with mesenteric agenesis without bowel atresia presented as intestinal obstruction due to twisting of the gut along with internal herniation where a single marginal vessel was the key supply to the whole small bowel.
Afroza Nazneen, Md. Yusuf Ali
TAJ, Jul-Dec 2024; 37(2) 385-392
https://doi.org/10.62469/taj.v037i02.052
Background: Scalp defects, whether from trauma, burns, or congenital causes, present significant challenges for reconstructive surgery due to the inelasticity of the scalp tissue, complicating both functional and aesthetic restoration. Objective: This study aims to evaluate various methods of scalp defect reconstruction over a 10-year period at Rajshahi Medical College Hospital, Bangladesh, with a focus on patient demographics, defect characteristics, and surgical outcomes. Methods: A retrospective review of patients undergoing scalp reconstruction between 2013 and 2023 was conducted. Data on patient age, gender, etiology, defect location, size, depth, bone exposure, and reconstructive techniques used were analyzed. Various reconstructive methods such as local flaps, skin grafts, and tissue expanders were employed based on the defect characteristics. Surgical outcomes, including complications, healing rates, and aesthetic results, were evaluated over a follow-up period of 6 months to 2 years. Results: A total of 150 patients (120 male, 30 female) were included. The majority (80%) of defects were caused by trauma, followed by burns (15%) and congenital anomalies (5%). Local flaps were the most common reconstructive technique (65%), followed by skin grafts (25%) and tissue expansion (10%). Success rates for wound healing were 90%, with a complication rate of 10%, including infections and partial graft failure. Aesthetic outcomes were rated as good or excellent in 85% of patients, while 10% had moderate results, and 5% had poor cosmetic outcomes. Conclusion: Scalp reconstruction using local flaps offers the highest success rates and aesthetic outcomes. Early intervention and careful selection of techniques based on defect characteristics are critical for optimal results.