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Non-Compliant Class III Malocclusion – A Novel Treatment Approach
Full text linkDental cross bites are said to be an orthodontic emergency. Correction of these at the earliest is required to prevent full-fledged development of the malocclusions. Therefore, arises the need of interceptive orthodontics. 1 Unfavorable growth traits are present in Class III malocclusion patients. One might anticipate their malocclusion to get worse over time if no treatment is given during their development spurts. It has been observed that complete dental Class III adjustments can be performed with relatively early orthodontic intervention, and that this normalization will hold over further growth. Young patients\u27 increasing antero-posterior (AP) disparity has been addressed with a variety of interceptive orthodontic treatments and appliances. The ability to develop a more balanced craniofacial relationship in Class III patients can be easily aided by early therapy. This article describes a novel method of addressing Class III malocclusion in the mixed dentition phase with a fixed penta-helix appliance to achieve transverse expansion of maxilla as well as correct anterior dental crossbite.
 
Comparative Study Between Subcuticular Suture and Skin Staples for Skin Closure in Elective Surgery in A Tertiary Care Hospital in Bangladesh
Full text linkBackground: With the development of accelerated rehabilitation and the pressure placed on surgeons to reduce length of hospital stay, the method of skin closure has become increasingly important. The ideal surgical wound would be as strong as normal tissue; the moment it is closed. It is widely accepted that both sutures and staples can achieve the basic goals of wound closure. Both methods endeavor to re-approximate the skin by creating a watertight, tension-free, non-inverted opposition of the edges that promotes rapid healing and a cosmetically acceptable scar.
Objective: The aim of the study was to see the comparison between subcuticular suture and skin staples for skin closure in elective surgery.
Methods: This prospective type of comparative study was carried out at the department of Surgery, Mugda Medical College and Hospital, Bangladesh, from July 2019 to June 2020. A total of 380 patients were included in this study, divided in two groups based on the technique of wound closure: (i) subcuticular suture and (ii) skin staples group. Data was collected by face-to-face interview using a prepared structured questionnaires & checklist and analyzed on SPSS 22.
Results: Operation time in group I was less than operation time for the same aged group II at 73.55<80.26, which makes suture more efficient. Even the standard deviation error is more prominent in the staple group at 15.53 minutes compared to the suture group at13.65 minutes. The P value is significant at 5% significant level for the Suture group in case of operation time. Comparisons of independent post-operative parameters between two groups of study population. It was observed that majority patients in the poor alignment variable belonged to ‘No’ parameter. The poor alignment of scar variable is significant at 1% significant level. The suture group had lower people belonging in the poor alignment of scar than that of the staple group at 20%<41.58. It can be observed that group II has almost double the samples that have poor alignment of scar than that of the group I. Other post-operative observations, such as the presence of hypertrophic scar and keloid are not significant.
Conclusion: The study suggests that subcuticular suture is comparatively better than skin staples according to BNS score and prospective observation.
 
Empagliflozin, Linagliptin, and Metformin in a triple fixed-dose combination for individuals with type 2 diabetes
Full text linkAs per the International Diabetes Federation (IDF), the percentage of patients with type 2 diabetes mellitus (T2DM) is increasing globally. Tight glycemic control is a crucial aspect of the management of T2DM due to the progressive nature of the disease. Evidence advises that aggressive glycemic control is beneficial not only for the short-term but also for the long-term well-being of patients. Due to the progressive nature of T2DM, first-line therapy often fails to provide effective glycemic control, necessitating the addition of add-on therapy. Hence, FDCs can play a crucial role in achieving glycemic targets effectively. Also, patients who are unable to tolerate metformin or who experience side effects of metformin monotherapy receive fixed-dose combinations (FDCs) of various other oral antidiabetic agents (OAD) including sodium-glucose co-transporter-2 (SGLT-2) inhibitors, dipeptidyl peptidase (DPP-4) inhibitors, thiazolidinediones (TZDs), sulfonylureas (SUs), glucagon-like peptide-1 (GLP-1) antagonist, and basal insulin. The addition of the third agent can also be considered to enhance treatment efficacy
Telmisartan\u27s effect on blood pressure in type 2 diabetes patients with and without complications
Full text linkIn people with type 2 diabetes, cardiovascular disease (CVD) is the leading cause of morbidity. Hypertension (HTN) frequently coexists with diabetes, increasing the risk of end-organ damage significantly. Blockers of the RAAS, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), have become a mainstay in the treatment of patients with diabetes plus hypertension. Telmisartan is the only ARB indicated for the treatment of atherothrombotic CVD (history of coronary heart disease, stroke, or peripheral arterial disease) or types 2 diabetes mellitus (T2DM) with confirmed target organ damage, therefore, reduction in the cardiovascular risk and morbidity. Trials of telmisartan have also been shown to reduce the progression of renal disease in individuals with diabetes and varying degrees of nephropathy, an effect that appears to be at least partly independent of a reduction in blood pressure. The present review article is intended to give comprehensive information about the effect of telmisartan on blood pressure in type 2 diabetes patients with and without complications
Efficacy of zinc therapy in verruca vulgaris-A study in Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh
Full text linkIntroduction: Verruca vulgaris, caused by human papilloma virus (HPV), is a common skin condition world-wide which may be transmitted through breaks in the skin or autoinoculation into adjacent skin. The most common treatment for warts is physical destruction of the lesion. Treatment on numerous lesions using physical destruction, such as electrocautery, curettage, and cryotherapy is avoided by some patients due to pain, discomfort, recurrence and prolonged healing time. Objective: To assess the efficacy of zinc therapy in verruca vulgaris in our Dermatology outpatient department. Methods: This study was designed as a none randomized quasi experimental study including all patients above 15 years of age, who visited Skin & VD outpatient Department of Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to June 2022. 60 patients included in our study. Patients with mucosal warts or taking other drugs for warts or for any systemic disease for last two months to study or suffering with systemic illnesses or pregnancy and lactating were excluded for the study photographs were taken at baseline and at the outcome assessment. All patients were clinically examined thoroughly to rule out any systemic disease. Digital photographs were taken at baseline and at the outcome All data including demographic profile, clinical, response of treatment and side effects was recorded in an All patients were given Oral Zinc sulphate 10mg/kg/body weight (maximum of 600mg) daily for 3 months. Baseline investigations were carried out to rule out any systemic disease. Results: Total 60 patients were studied in this study. Mean years of presentation was 36 years. Commonest age group of presentation was seen between 15 and 25 years, 32(53.3%) patients (Table-1). Thirty (60%) patients were females. For the profession, 21(36%) patients were students. The difference between three months’ treatment of verruca vulgaris, 16.6% had 1 month, 20.0% and 63.3% had 2, 3 months respectively. Commonest site of presentation was seen over face in 20(33.3%) patients, followed by upper limbs 16(26.6%), scalp 8 (13.3%), soles 8 (13.3%), lower limbs 6 (10%), palms one (1.6%) and trunk 1 (1.6%). Mostly lesions were papules in 23 (38.3%) followed by papule and plaques in 18(30%), plaques in 12(20%) and combinations of nodules, papules and plaques in 7(11.6%). In about 27(45%) patients, lesions were firm, smooth in 25(41.6%) with regular margin in 32(53.3%). During follow-up of one month no improvement was seen in 13(21.6%), 25% improvement was seen in 36(60%), 50% improvement in 8 (13.3%) and 75% improvement in 3 (5%) patients. Side effects like nausea and mild abdominal pain was seen in 9 (10%) patients (See Table 2). Follow-up in two months showed 25% improvement in 30(50%), 50% improvement in 17(28.3%) and 75% improvement in 7(11.6%). Dropout rate was 1.66%. Side effect was seen in 1 (1.66%) patient who had gastrointestinal upset. Follow-up in three month showed 25% improvement in 15(25%), 50% improvement in 21(35%), 75% improvement in 16(26.6%) and 100% improvement in 4(6.66%) patients. This improvement over 3 months was statistically significant (p< 0.05). 
Evaluation of mechanical bowel preparation in elective colorectal surgery in a single center study.
Full text linkBackground: Mechanical bowel preparation (MBP) is mechanically carried out earlier than colon and rectal surgery, aimed at decreasing the danger of postoperative infectious complications. However, in instances of penetrating colon trauma, fundamental colonic anastomosis has proven to be protected even though the bowel is not prepared. Mechanical bowel preparation is not necessary in elective colorectal surgery. Objectives: The aim of this study is to assess the Evaluation of Mechanical Bowel Preparation in Elective Colorectal Surgery in a single-center study. Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of Surgery Rajshahi Medical College Rajshahi Hospital, Bangladesh. In Bangladesh for the duration of the period from June 2013 to May 2014. Results: This study shows that the according to age of 80 patients aged 20-above 51 years where 4(10%) were 20-30 years, 10(25%) were 31-41 years, 10(25%) were 41-50 years, 16(40%) were 51 and above years in Group A, and 6(15%) were 20-30 years, 6(15%) were 31-40 years, 13(32.5%) were 41-50 years and 15(37.5%) were 51 and above years in Group B. And 28(70%) were males and 12(30%) were females in group A. And 27(67.5%) were males and 13(32.5%) were females in group B. Conclusions: Mechanical bowel preparation earlier than elective colon and rectal surgical treatment cannot stop problems like anastomotic leakage, wound infection, intra-abdominal sepsis, abdominal abscess, and more abdominal complications. The colorectal surgical method can be executed safely barring mechanical bowel preparation
Complications after the operation of arthroscopic partial meniscectomy; A single center study
Full text linkBackground: Arthroscopic partial meniscectomy is one of the most frequent orthopedic strategies in the world. The knee is one of the most frequently injured joint because of its anatomical position and structure, its exposure to external forces and the functional demands. Evidence from clinical trials has raised questions about the effectiveness of this method in some patient groups. Regarding the practical overuse issue, we wanted to demonstrate the real risk of complication after arthroscopic partial meniscectomy. Objectives: The aim of this study is to assess the Complications after the operation of Arthroscopic partial meniscectomy in a single center. Methods This is a prospective interventional study. The study used to be carried out in the admitted patients in the department of Orthopedic, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR) Sher-E-Bangla Nagar, Dhaka, Bangladesh in the period from January 2013 to December 2014. Results: This study shows excellent post-operative results in 80% of patients, good in 12%, and fair in the remaining 08% of patients. Total 25 patients aged 16 to 40 years were, according to gender 80% were male, and 20% were female. This study found the complications of Infection, Swelling, Stiffness, and Instability were 0(0%), 1(04%), 0(0%), and 0(0%) respectively. Conclusions: The effectiveness of arthroscopic partial meniscectomy, an appreciation of relative risks is crucial for patients and clinicians. The estimated prevalence of complications after arthroscopic knee surgery varies widely. Our data provide a basis for decision-making and consent
Common risk factors of non-adherence antihypertensive medication and its determinants among patients
Full text linkBackground: Adherence to pharmacological treatment for hypertension is considered a key factor in guaranteeing successful therapy outcomes. Non-adherence to antihypertensive therapy can be determined by demographic, drug related, disease related and setting related factors. Objective: To assess the common risk factors of non-adherence antihypertensive medication and its determinants among patients. Methods: A prospective cross-sectional study was conducted at Cardiology Dept. Islami Bank Community Hospital Faridpur and 250 Bedded General Hospital, Gopalgonj, Bangladesh July to December 2021. A total of 120 patients were interviewed with a structured standard questionnaire and patient medication charts were reviewed. The questionnaire contained of demographic questions and characteristics of hypertension and its therapy. The data collected were cleaned, entered and analyzed using Statistical Package for Social Science (SPSS) version 19 for windows with 95% confidence interval and P value <0.05. Results: Total 120 study participants were interviewed of which 74 (61.7%) were female and 46 (38.3%) were males. The mean age of respondents was 54.7±12.7 years. Forty-five (37.5%) of the participants were at the age of above 60 years and 81 (67.5%) were illiterate. A large proportion of the subjects, 85 (70.8%), were married and 40 (33.3%) of the total study population were unemployed while 30 (25%) were housewives. Around one fourth (25%) of the study participants were found to be non-adherent to their treatment. Family support on adherence (AOR = 0.170, 95%CI = 0.030-0.905), spot blood pressure (AOR = 0.052, 95%, CI =0.003-0.242), place of patient residence (AOR=0.184, 95%CI =0.024-0.597) and hypertension related complications (AOR= 21.737, 95%CI =1.568-418.428) were found significantly and strongly associated with treatment non-adherence. Conclusions: In conclusion, this study were completely non-adherent and only around half of them were adherent to their medications. The absences of family support, being at the prehypertension class of blood pressure, hypertensive heart disease were shown to decrease adherence to antihypertensive medications. Therefore, health care professionals should be adequately trained and resourced to offer proper counseling to hypertensive patients on their medication and disease conditions
Management of hypertension: Comparison of Telmisartan with other antihypertensive drugs
Full text linkAngiotensin II type 1 receptor antagonists (ARBs) are highly effective antihypertensive drugs used clinically for the management of hypertension, prevention of heart failure, and protecting diabetic nephropathy. Hypertension is the most prevalent lifestyle disease affecting the cardiovascular system and a major risk factor for stroke. The ARBs are very effective in decreasing elevated blood pressure (BP) to a normal level. Additionally, they do not have side effects like cough and angioedema, as shown by other classes of antihypertensive drugs like angiotensin-converting enzyme inhibitors. This feature makes ARBs the most preferred therapeutic strategy for hypertension. Telmisartan is an ARB, approved by the Food and Drug Administration for the treatment of hypertension in 1998, and is proven to provide efficient and lasting BP control when compared to other agents. This review highlights several clinical trials carried out to compare the efficacy, safety, and tolerability of telmisartan with other antihypertensive agents
Procedural sedation in ERCP with propofol-ketorolac, propofol-dezocine and propofol -fentanyl: A comparative study
Full text linkBackground: The comparative outcomes of ketorolac, dezocine, and fentanyl had been evaluated in 150 healthy patients undergoing endoscopic methods in accordance to a randomized, double-blind protocol. Patients obtained ketorolac or dezocine or fentanyl 5min before procedure. The optimal dose of intravenous ketorolac triomethamine (ketorolac), a non-steroidal anti-inflammatory drug has no longer been decided in children. There are only restrained published data on the use of intravenous ketorolac for pediatric analgesia. Objectives: The aim of this study is to assess the patients with Procedural Sedation in ERCP with Propofol-Ketorolac, Propofol-Dezocine, and Propofol so that such patients can be diagnosed and treated early. Methods: This is an observational study. The study was carried out in the Department of Anaesthesiology, Dhaka Medical College Hospital in Bangladesh for the duration of one year (the period from June 2021 to May 2022). Results: This study shows that the according to the age of 150 Patients aged 18 to 50 years where, 25(16.16%) were 18-30 years, 82(54.67%) were 31-40 years and 43(28.67%) were 41-50 years. According to Propofol-Ketorolac the Intraoperative data of Propofol Dosages, Supplement fentanyl, Operating time, and Anesthesia time were 460±205, 25±39, 55±30 and 62±30 respectively, based on Propofol-Dezocine the Intraoperative data of Propofol Dosages, Supplement fentanyl, Operating time and Anesthesia time were 440±165, 24±35, 56±28 and 65±23 respectively and according to Propofol – Fentanyl the Intraoperative data of Propofol Dosages, Supplement fentanyl, Operating time and Anesthesia time were 473 ± 220, 20 ± 26, 53 ± 38 and 61 ± 37 respectively. Conclusions: Ketorolac appears to examine favorably with fentanyl when administered at some stage in Endoscopic procedures. In distinction to ketorolac, the use of dezocine resulted in an accelerated incidence of postoperative nausea and vomiting, contributing to a prolongation of the discharge time