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Assessment of temporomandibular disorder using Fonseca questionnaire and its classification based on DC/TMD criteria in tertiary hospital in Nepal.
Full text linkBackground and objective: Temporomandibular disorders (TMD) is an orofacial disorder, associated with temporomandibular joint (TMJ) pain, masticatory muscles fatigueness, restricted mouth opening and clicking. The Fonseca anamnestic index (FAI) is questionnaire for evaluating severity and characteristics of TMD. The Diagnostic criteria for temporomandibular disorders (DC/TMD) is used for diagnosis of TMD. The study assessed the severity, clinical characteristic and patterns of TMDs in Eastern Nepal population.
Methods: A cross sectional study was done in Department of Oral Medicine and Radiology using census sampling. Eighty patients having TMD was interviewed using Fonseca\u27s questionnaire, on pain TMJ pain, head, chewing, parafunctional habits etc. The clinical examination was done using DC/TMD examination form. The TMD was classified as pain disorder and TMJ disorder of right and left side. Statistical analysis was performed using SPSS version 11.5.
Results: FAI revealed TMD to be higher in female than male with odds ratio of 1.74. The mean age of the patient was 31.03 (±13.31). The duration from onset to diagnosis was 5.72 (±9.54) months. The Fonseca’s questionnaire showed 51.3% had moderate TMD followed by mild and severe. DCTMD criteria location of pain was most commonly in the TMJ region 47(58.8%) of cases followed by 7.5% in temporalis, masseter and other muscle and 1 (1.3%) had pain in sternocleidomastoid.
Conclusions: The TMDs showed moderate severity with Anamnestic Index. Myalgia was the most common pain disorder and disc displacement with reduction in right and left TMJ disorder
Evaluation of the prevalence of different types of hepatitis viruses in a tertiary care hospital
Full text linkBackground: Bangladesh is not exempt from the global viral hepatitis pandemic. Hepatotropic viruses comprise the majority of those that cause viral hepatitis. Hepatitis B virus (HBV), with hepatitis C virus (HCV), hepatitis A virus (HAV), and hepatitis E virus, is one of the most important hepatotropic viruses (HEV). The objective of the current study was to determine if individuals who were clinically thought to have the aforementioned diseases were also seropositive for HBV, HCV, HEV, and HAV.
Aim of the study: This study\u27s objective was to determine the prevalence, typical causes, mode of transmission, and risk factors associated with acute viral hepatitis.
Methods: This descriptive cross-sectional study was carried out between March 2012 and September 2012, in the department of Medicine, Shaheed Ziaur Rahman Medical College hospital in Bogura. In total 100 cases of acute viral hepatitis, patients were included in this study. These cases were included and excluded based on the inclusion and exclusion criteria. Information was acquired using a questionnaire after receiving written, informed consent, and applicable research was done. The information was then looked over.
Results: The study comprised 100 cases of acute viral hepatitis in total. In this study, acute viral hepatitis is most frequently caused by the hepatitis E virus (52%), with a peak incidence in people between the ages of 32 and 41. Hepatitis A virus (32%), which is most prevalent in people between the ages of 12 and 21 (54.55%), is the second most common cause. At a ratio of 7.33:1, males were more frequently impacted than females. The workforce was made up of 43%-day workers, 20% employees, 15% business owners, 10% students, and 12% others.
Conclusion: An increase in new instances of hepatitis B, C, and D was observed in Bangladesh, according to a study of their prevalence. These findings show that individuals in high-risk groups require the development of efficient preventative interventions and screening procedures. To determine the significance of diverse acute hepatitis causative agents in Bangladesh, more research is required
Preparation and characterization of binary blends of NR and oxidized NR with PVAc
Full text linkBackground: Studies had been performed on blends of natural rubber (NR) and poly vinyl acetate (PVAc). The two polymers had been characterized based totally on their physicochemical properties and used in paint production. Results received confirmed that viscometric measurement and density of the polymers did now not fluctuate much. Five paints of distinctive compositions labeled; Paint 1 (100% PVAc), Paint 2 (100% NR), Paint 3 (75% NR: 25% PVAc), Paint 4 (50% PVAc: 50% NR), and Paint 5 (25% NR: 75% PVAc) the usage of popular emulsion paint formula and approach of manufacturing have been employed. NR and PVAc are well-matched as binders in emulsion paint production. Therefore, NR/PVAc blends may want to be used as a binder in the coating industry as a choice to PVAc binder-based emulsion paint.
Objectives: This study aims to assess the Preparation and characterization of binary blends of NR and oxidized NR with PVAc.
Methods: This is an observational study. The study used to be carried out with the samples in the Department of Applied Chemistry and Chemical Engineering, Islamic University, Kushtia-7003, Bangladesh. The duration of the period from Data was entered in MS Excel and Statistical analysis was done using SPSS trial version.
Results: This study shows that the according to Constituent, Cellulose was 43.4822%, Alpha-Cellulose was 34.8427% and Cellulose was 8.6395%. And according to Source, Rice Straw was 32.15% %, Sugarcane was 41-43%, Rye Straw was 31.8-42.64%, Corn Stalks were 29.80% and Wheat Straw was 34-40%.
Conclusion: The residences of opacity, wash ability resistance, and putting contact drying time of emulsion paint with modified NRL binder and modified NRL combination with PVAc can be multiplied using in addition editing natural rubber latex (NRL) molecules. Modifications are needed to rise the adhesion of natural rubber latex (NRL). The adhesive characteristics of natural rubber latex (NRL) can match the characteristics of general adhesives such as PVAc.
 
The validity of plain lumber vertebral X-Rays in diagnosing osteoporosis in elderly-An age-based approach
Full text linkBackground: The diagnosis of osteoporosis relies on the quantitative assessment of BMD, which is currently considered the best predictor of osteoporotic fractures. Early diagnosis is the key for appropriate osteoporosis management. Although common, osteoporosis can be clinically silent, and without prevention and screening, the costs of osteoporotic fracture–related morbidity and mortality will burden healthcare systems, especially in developing countries.
Objective: To assessed the validity of plain radiography in diagnosing osteoporosis in elderly women.
Methods: A retrospective, cross-sectional, observational hospital-based study conducted at the Department of Ortho-Surgery, Patuakhali Medical College Hospital, Patuakhali, Bangladesh from June 2019 to July 2022. One hundred Seventy (170) female patients between the ages of 40 to 83 years were referred to the orthopedic department in PKMCH. These women were found to have features of osteopenia in lumber vertebrae plain radiography. The participants then categorized into two groups. Group A (n=101) are those who are younger than 65 years and group B (n=69) are those who are 65 years and older. The two groups underwent a quantitative ultrasound bone densitometry. Correlations between plain radiography parameters and QUS were calculated. Osteoporosis was diagnosed by QUS T-score ≤ –2.5 at the lumber vertebra.
Results: Total 170 patients were included. The mean age of the participants was 63.5±6 years old with the minimum age was 40 years and the maximum age was 83 years. The most common population aged more than 63 years old, group A who are less than 65 years of age were 101 participants (59.4%), while those 65 years and old were 69 (40.6%). The participants in both groups have showed features of osteopenia in their plain lumbar vertebral X-rays. By QUS; in group A: 2 patients (1.9%) were found to have a normal bone mineral density (T score = >-1 SD), 47 patients (46.5%) were osteopenic (T score between -1 and -2.5 SD), while 52 patients (51.4%) were osteoporotic (T score = <-2.5 SD), in group B: 3 patients (4.3%) were found to have a normal bone mineral density (T score =>-1 SD), 3 patients (4.3%) were osteopenic (T score between -1 and -2.5 SD), while 63 patients (91.3%) were osteoporotic (T score =<-2.5 SD). Also when we performed Fisher’s Exact test we found a significant difference in the validity of X rays as compared to QUS bone densitometry between the two groups, in Group A. The difference between X-ray and quantitative ultrasound bone densitometry was significant (p = 0.000000006 at p > 0.05), and was not significant in Group B (p = 0.491 at p >0.05).
Conclusion: Plain radiography can provide reliable method for diagnosis of osteoporosis in women with a higher risk for fragility fractures (≥65 years) especially in primary healthcare and sittings with limited resources.
 
Efficacy and Safety of Omega 3 Fatty Acid in the Treatment of Telogen Effluvium in Middle Aged Women
Full text linkBackground: Omega-3 fatty acids (omega-3 FA) are constituents of the membranes of all cells in the body and are precursors of locally produced hormones, eicosanoids, which are important in the prevention and treatment of various diseases, especially in women. Telogen effluvium (TE) is one of the most common causes of diffuse non scarring hair loss. In its acute form, it generates a lot of anxiety in the patient, which can be significantly allayed with a confident diagnosis. Objectives: The aim of this study is to assess the Efficacy and safety level of omega 3 fatty acid in the treatment of telogen effluvium in middle aged women. Methods: This is an observational study. This study was carried out on 120 female patients attended in the Department of Dermatology, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. The duration of the study period from January 2021 to December 2021. The period from Data was entered in MS Excel and Statistical analysis was done using SPSS-24. Results: A total of 120 patients, were evaluated prospectively. The baseline characteristics of women (Control) age, BMI, Telogen hair were 45.3±14.3, 19.8±2.5, 21.1±3.4. And (with supplement age, BMI, telogen hair were 47.6±10.2, 20.9±2.3, 20±4.1) Conclusion: Telogen effluvium, which commonly impacts women, begins suddenly with or without a recognizable initiating factor. It may be distinguished from traditional acute telogen effluvium by using its long fluctuating course
Transcatheter Cardiac Intervention in Neonates: Experience From a Tertiary Care Centre in Bangladesh
Full text linkBackground: Critical congenital heart disease (cCHD) is the most common reason requiring surgery or catheter- based intervention in the neonatal period. Transcatheter interventions in neonates present unique challenges in Bangladesh due to limited resources, unavailability of hardware, cost of procedure, low birth weight, sepsis, and delayed diagnosis. Careful technique, proper planning & safety measures reduces the incidence of complications. Methods: This retrospective study was conducted in the cardiac centre of Bangladesh Shishu Hospital & Institute between June 2014 to June 2022.Total 322 sick neonates required cardiac interventions during the study period. Clinical parameters, SPO2, echocardiographic data, cathlab data & outcome were recorded. Statistical analysis was done by using SPSS version 24.Results: Among 322 patients balloon atrial septostomy was done in 143(44%) patients mostly for DTGA PFO/small secundum ASD ± small PDA. 113 (35%) patients underwent PDA stenting for duct dependent pulmonary circulation. For severe stenosis with or without ventricular dysfunction 14 patients underwent balloon aortic valvuloplasty, 17 patients for balloon pulmonary valvuloplasty and 31 patients for coarctoplasty. There was significant reduction of mean gradient across the stenosis (p<0.05). Three patients with membranous pulmonary atresia with intact IVS underwent pulmonary valve perforation using CTO guide wire & one neonate with TOF with severe cyanosis underwent RVOT stenting successfully. Mean age for BAS patients was 14 days ± 10 days and mean weight 2.6 ± 0.72 Kg. Mean age for PDA stenting patients was 16 days ± 12 days and mean weight 2.5± 0.69 Kg.
 
Comparison Between the Efficacies of Amlodipine and Cilnidipine in Treating Hypertensive Patients
Full text linkBackground: Controlling systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertension (HTN) patients is one of the main challenges. Amlodipine is one of the calcium channel blockers (CCBs) with a remarkable pharmacokinetic and pharmacodynamic profile. But we have not enough research-based information regarding the effectiveness of amlodipine and cilnidipine in treating hypertension patients. Aim of the study: The objective of this study was to assess the effectiveness of amlodipine and cilnidipine in treating hypertensive patients.
Methods: This study was conducted at the Upazila Health Complex in Shahrasti, Chandpur, Bangladesh, from January 2021 to December 2021. In the study, 200 patients of either sex between the ages of 18 and 60 years were involved. The total number of participants were divided into two equal groups. There were 100 patients in each of the groups. As the part of the hypertension treatment protocol, patients in the first group, received oral amlodipine 5–10 mg/day whereas in other group, patients received oral cilnidipine 10–20 mg/day. During the checkup, the mean systolic and diastolic blood pressure values were noted and evaluated. SPSS 22.0 was used to analyze the data. Results: After 8 weeks of treatment, the cilnidipine group’s SBP gradually decreased from 146.2±12.60 to 130.04±5.023 and its DBP gradually decreased from 94.21±6.86 to 84.34±1.79. On the other hand, in the amlodipine group, a gradual decline of SBP from 151.46±11.21 to 131.62±3.91 and DBP from 95.5±5.80 to 83±2.55 was observed. The results of the paired t-test statistical analysis were statistically significant, where the P value was found as 0.00001. Conclusion: Considering the findings of this current study we can conclude that, both amlodipine and cilnidipine have significant role in controlling blood pressure. But cilnidipine shows some superiority over amlodipine in lowering systolic blood pressure which is equally effective in lowering diastolic blood pressure.
 
Efficacy Of Helicobacter Pylori Eradication In Helicobacter Pylori Positive Functional Dyspepsia Patients-A Double-Blind, Randomized, Placebo-Controlled Trial
Full text linkMultiple etiopathogenesis have been proposed for functional dyspepsia. But no conclusive mechanisms have been established yet. Many studies reported that H. pylori produce dyspeptic symptoms without any macroscopic lesion in the gastroduodenal mucosa. Some studies also reported that eradication of H. pylori relieves the symptoms of functional dyspepsia. The main objective of this double blind randomized placebo controlled clinical trial was to see the response of H. pylori eradication in the management of ‘H. pylori positive functional dyspepsia’. We conducted the study on H. pylori positive functional dyspepsia patients visiting the gastroenterology OPD and see the effects of H. pylori eradication on their symptom resolution. Consecutive 59 H. pylori positive functional dyspepsia patients were randomly assigned to receive either Anti H. pylori therapy (Levofoxacin, Amoxicillin and Omeprazole) or placebo for 14 days. H. pylori status was assessed by 13C urea breath test for inclusion into the study and 2 months later for eradication status along with symptom resolution. 23 patients receiving Anti H. pylori therapy and 17 receiving placebo were available for analysis. Two months after completion of therapy 56.5% patients resolved their symptoms who received Anti H. pylori therapy. On the other hand, 47.1% patients who received placebo relieved their dyspeptic symptoms. Dyspeptic symptom resolution was also not statistically significant when comparison made between H. pylori eradicated and non- eradicated subjects irrespective of their treatment regimen (p=0.102). So in this study we found that there is no relationship between H.pylori eradication and resolution of dyspeptic symptoms in patients with functional dyspepsia.
 
Prospective Study of Radiological Healing and Functional Outcome After Open Reduction and Internal Fixation of Danis-Weber Type-C Closed Ankle Fracture
Full text linkBackground: Ankle fractures are one of the most widespread lower limb fractures in adult, account for 9% of all fractures; one fourth constitutes bimalleolar fractures. As they remain a significant source of morbidity for both the young and the elderly, so proper fixation of fracture is required for a healthy outcome. Objective: To assess radiological healing and functional activities of treatment of Danis-Weber type-closed ankle fracture. Methods: A prospective observational study was carried out in Monno Medical College and Hospital, Manikganj, from June 2022 to December 2022. A total of 28 patients with Danis-Weber type-C ankle fracture were taken in this study. All the patients were initially managed by analgesic and short leg posterior slab. After admission, all were treated by ORIF with small DCP for fibula fracture and ORIF by two 4mm cannulated cancellous screws for medial malleolus fracture. Operations were done within 4 days to 14 days. The average follows up was 24 weeks. The outcome was assessed by the AOFAS score. Results: Out of 28 patients 14(50%) were 18 to 30 years of age, 7 (25%) were 31 to 40 years old, 5 (18 %) were 41 to 50 years old and 2 (7.1%) were 51-60 years old. The mean age was 34.68+10.79 years. Majority 20 (71%) of the patients were male and the rest 8 (29%) were female. 18 (64.3%) patients presented with right sided ankle fracture and 10 (35.7) with left sided fractures. Vast majority, 19 (68%) of injuries, were caused by RTA, 7 (25%) were twisting fall, 1 (3.6%) was fall from height and another 1(3.6%) was due to physical assault. 7(25%) patients surgery was done within 1st week, 21(75%) patients done in 2nd week from the occurrence of injury. Among 16(57.1%) patients had radiological evidence of healing at 12 weeks, 10(35.7%) had healing evidence at 14 weeks and in 2(7.1%) patients it was at 16 weeks. Mean duration of appearing radiological healing was 13.34±1.56 weeks range 12-16 weeks. 27(96.4%) patients had no limitation on daily activities, but had limitation on recreational activities. Our 11(39.3%) patients stayed 3 weeks and 16(57.1%) patients stayed 2 weeks. Mean duration of hospital stay was 14+2.68 days with minimum of 7 days and maximum of 17 days. In this study, out of 28 patients, final outcome was satisfactory (Excellent 13 and Good 11) in 24 (85.7%) cases and Unsatisfactory (fair 4 and poor 0) in 4 (14.3%) cases according to American Orthopedic Foot and Ankle Score. Conclusions: The study shows that proper operative treatment of Danis-Weber type C ankle fracture by the selected implant leads to excellent to good radiological and functional results with uncomplicated recovery in the majority of the cases. Appropriate patient counselling is necessary to prepare patient ready for the expected functional outcome.
 
Comparison of MACE between High and Low TIMI Risk
Full text linkIntroduction: Patients with ST-segment elevation myocardial infarction (STEMI) have increased risk for death and adverse cardiac events. Of great concern is the risk of cardiac arrest that accounts for the majority of early deaths and other major adverse cardiac events. Significant hospital resources are dedicated to these high risk patients.
Objective: To see the correlation of MACE between High and Low TIMI Risk.
Methodology: This cross-sectional prospective study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from July 2017 to June 2018. Fifty patients with definite diagnosis of acute STEMI, received streptokinase, aged above 18 years and both sex were included. Prior myocardial infarction, coronary revascularization procedures either CABG or angioplasty or coronary stenting; co-morbidities such as renal failure, heart failure, cardiomyopathy, valvular heart disease and congenital heart disease were excluded. On admission TIMI was recorded. In hospital MACE were also recorded.
Results: The mean age of patients was 52.64 (SD 11.88) years and majority of the patients were male (84%) with male to female ratio was 5.25:1. The mean TIMI risk score for STEMI 4.50 (SD 2.38). In hospital major adverse cardiac events (MACE) occurred in 19 (38.0%) cases. TIMI risk score for STEMI was significantly higher in patients with MACE compared to without MACE (16.95, SD 1.78 versus 3.00, SD 1.10; p<0.001) respectively.
Conclusion: In hospital major adverse cardiac events (MACE) occurred in 19 (38.0%) cases. TIMI risk score for STEMI was significantly higher in patients with MACE compared to patients without MACE (16.95, SD 1.78 versus 3.00, SD 1.10; p<0.001) respectively. From the study we conclude that TIMI risk score (5 or above) is a reliable tool in predicting in- hospital major adverse cardiac events in ST-segment elevation myocardial infarction