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Factors associated with low back pain in adult: a study in a tertiary care hospital of Bangladesh
Get PDFBackground: Low back pain (LBP) is a very common health problem in humans that may cause disability and can affect work performance and well-being. It can be acute, subacute, or chronic in condition. Although several risk factors of LBP have already been identified like occupational posture, age, depressive moods, body height, or obesity we have not enough research-based data regarding this issue.
Aim of the study: The aim of this study was to evaluate the risk factors associated with low back pain in adults.
Methods: This cross-sectional observational study was conducted in the Department of Physical Medicine & Rehabilitation, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh during the period from July 2019 to December 2020. In total 57 confirmed LBP patients were enrolled as the case group patients and 30 healthy people were included as the control group participants in this study. All the clinical data regarding LBP were collected by using a predesigned questioner. Data were processed analyzed and disseminated by MS Office and SPSS programs as per need.
Results: In analyzing the risk factors of low back pain among the participants we observed, 47% of case group participants were used to remain in a sitting position for 0-1 hours per day whereas it was found among 67% in the control group. Moreover, in the case group, 14% of participants used to remain in a sitting position for more than 6 hours per day which was only 7% in the control group. Besides age (p=0.004) among several possible risk factors, in this study, we found a significant correlation of low back pain in the duration of sitting position between the case and control groups, where the p-value was 0.006.
Conclusion: Continuation of a long time sitting position is a harmful thing for the human musculoskeletal system. Now a day the lifestyle factors should be assessed with more attention for detecting the basic etiology of low back pain
Review article on Thalassemia
Get PDFThalassemia is a hereditary blood disorder which is passed down through families in which the body makes an abnormal form of hemoglobin. This disorder results in the destruction of red blood cell in large number, which leads to anemia. It is caused by mutation in the DNA of cells that make hemoglobin. Thalassemia should be prevented by premarital screening and prenatal diagnosis which is helpful in decreasing prevalence and future incidence of thalassemia.The most important problem in thalassemia patients are iron overload, cardiac arrhythmia, hepatitis, osteoporosis and endocrine disorder however there are typical signs and symptoms of anemia. People with thalassemia can get treatment as indicated by the degree of seriousness of their condition. Blood transfusion is the common treatment for thalassemia. This review presents the types, diagnosis, prevalence, complications and treatment of thalassemia
Surgical outcome of optical penetrating keratoplasty in a rural tertiary care hospital
Get PDFIntroduction: Optical Penetrating Keratoplasty (OPKP) is the gold standard surgical treatment for full-thickness corneal lesions and it is a well-established effective and safe technique. We conducted this study to verify the surgical outcome of OPKP at our rural hospital.
Aims and Objectives: To study the surgical outcome of OPKP in relation to corneal graft Clarity, Best Corrected Visual Acuity (BCVA), and Post-Operative Complications (POC)
Material and Methodology: In this prospective longitudinal hospital-based study we obtained postoperative data from patient’s records operated for OPKP from August 2018 to October 2019 after taking permission from IEC and patient’s consent. We included 22 patients who completed a minimum one-year follow-up.
Results: Out of 22 OPKPs, 50.00% were males. 18.18% of patients were in the 41-50 yrs age group. 1) Graft clarity was seen in 59.09%. 2) BCVA > 6/18was observed in 9.09% pts. 3) POC – Graft failure was seen in 18.18%. Epithelial defect, Raised IOP, Uveitis, Cataract and Corneal vascularization were other problems.
Conclusion: Though graft failure is a major complication, OPKP gives good BCVA and faster visual rehabilitation
Climate change: A potential risk factor for cancer?
Get PDFCancer, mainly known for abnormal growth and altered cellular function is now the second prominent reason of death in the world. There are so many factors responsible for this disease and one of the major factors in climate change. The deviations of weather patterns that are definitely a result of human activities over long periods of time generally referred to as climate change. The consequences include increasing temperature, melting of ice, rising sea levels, increasing wind speed, changes in rainfall patterns, etc. Due to all these concerns, the most important resource for a healthy life– Air, Water, and Food are gets disturbed and as a result, causes several health-related problems. Previous researches related to this field also demonstrated that climate change played a critical role in cancer risk and cancer surveillance. It increases the number of carcinogens and also blocks patients’ access to cancer hospitality. Here in this article, you will get to know about the impacts of climate changes on health. Why this can be potential risk factors for cancer by focusing mainly on lung and skin cancer and about some well-known limitations that we need have to resolve in the near future. In this concern, several steps have been implicated globally but more preparedness and attentiveness are reasonable
A comparative study between single dose Ceftriaxone as a prophylaxis versus conventional dose antibiotic in major gynaecological surgery in Dhaka Medical College Hospital, Dhaka, Bangladesh
Get PDFIntroduction: Wound site infections are a major source of postoperative illness accounting for approximately a quarter of all nosocomial infections. The centers for Disease Control and prevention term for infections associated with surgical procedures were changed from surgical wound infection to surgical site infection. Objective: To establish the use of single-dose prophylactic injectable antibiotics as well as to compare the rate of wound infection among the gynae post-operative patients treated by only single-dose prophylactic versus conventional dose of antibiotics. Materials and Methods: This was a prospective study, carried out at Dhaka Medical College Hospital, Dhaka, Bangladesh during the period of July 2005 to May 2006. During this study period, 100 cases were taken for the study. The patients were divided into two groups. Group A: Fifty patients received 2 gm ceftriaxone i/v as prophylaxis 1 hour before the incision. Group B: Fifty patients received conventional therapy i.e. Ciprofloxacin and Metronidazole for 7 days. The data were matched for ages, weight, socio-economic condition, anemia, and for surgical procedure and technique. Incidence of infection and length of hospital stay were determined for each patient. Results: This study was done to establish the efficacy of single-dose injection Ceftriaxone prophylaxis in the prevention of surgical site infection. One hundred cases were randomly selected from the admitted patients for major gynecological surgery. The variables taken for analysis are age, weight, Hb%, duration of operation, wound infection, length of hospital stay, and the risk factors for infection. At the time of randomization, the above-mentioned characteristics of the cases in very both groups revealed little significant difference. With this aspect, it can be sketched that this comparative study was done in almost similar types of cases in two groups and the result was not affected by those minor variations. It was shown that about 52% of the patients were in 35-44 years in group-A and 58% were in the same age in Group-B. Fifty of them received 2g prophylactic Ceftriaxone. Another Fifty received the conventional therapy i.e. Ciprofloxacin & Metronidazole for 7 days. Wound infection was observed in 5 patients (10%) in Group-A and 6 patients (12%) in Group-B. There was no significant difference was observed in both groups. Patients with wound infection in both groups were treated according to the procedure described in the protocol. The study finding showed only a loading dose of 2g prophylactic injection Ceftriaxone if given as per protocol is as effective as the multi-drug regimen. But the prophylactic single-dose group was more beneficial due to their good compliance fewer side effects, cost-effectivity, and decrease the probability of drug resistance. Conclusion: At the discussion, the most recent studies about the prevention of SSI and prophylactic antibiotic were analyzed. It was seen that the whole world is very much concerned about the prevention of surgical site infection as well as antibiotic resistance. As both of them cause an adverse effect on the patient and cost more. It can be concluded that infection prevention is highly dependent on Antibiotic prophylaxis Administration of antibiotics depends
Clinical and laboratory profile of patients with disorders of sex development: Experience from two tertiary care hospitals in Bangladesh
Get PDFDisorders of sex development (DSD) are relatively rare conditions where gender assignment remains uncertain, presented with ambiguous genitalia in newborns, and atypical sex development in adolescents. Management remains a challenge for all professionals involved and largely depends on the participatory factors responsible for the causation of the disorders.
Patients and Methods: All patients with the complaint of atypical features of sex development, attending the pediatric endocrine unit of two tertiary level hospitals in Dhaka city, in a period of 24 months from May 2017 to May 2019 were incorporated in this study and their clinical, hormonal and cytogenetic findings have been documented.
Results: Among 77 DSD patients under this study, there were 43 (55.84%) 46, XX DSD cases, 30 (38.96%) 46, XY DSD cases, and 4 (5.19%) sex chromosome DSD cases. The age of presentation ranged from 0 days to 19 years with a mean of 2.29±4.2 years. Only 16.9% of the cases presented in their neonatal period. Almost all (98.7%) patients featured genital ambiguity. Congenital Adrenal Hyperplasia (CAH) had been found in all of the 46, XX DSD cases and in 1 sex chromosome DSD case. Among the patients with 46, XY DSD, 5 patients had PAIS (Partial Androgen Insensitivity Syndrome), 5 patients had CAIS (Complete Androgen Insensitivity Syndrome), 3 patients had 5αRD (5α Reductase Deficiency) and 5 patients had GD (Gonadal Dysgenesis). The gender of rearing was male in 25 (32.5%) cases and female in 52 (67.5%) cases. During the study period, 12 (15.58%) patients had undergone surgical intervention, 35 (45.54%) patients had been referred for surgery, 36(46.8%) patients were under hormonal therapy, and for 2 (2.6%) patient’s operation had been planned.
Conclusions: As according to the finding of this study, AIS was the most common etiological findings among 46, XY DSD cases, and CAH was exclusively present among all 46, XX DSD cases
Five-year spatiotemporal distribution of malaria in hotspot and Ivermectin mass-drug administration zone of Amhara Regional State, Ethiopia
Get PDFObjectives: Evaluate the Spatiotemporal distribution of malaria in the hotspot and Ivermectin mass-drug administration Zone of Amhara Regional State, Ethiopia. Study Design: A descriptive prevalence study design was used.
Methods: - A 25 study sources were incorporated in the survey. Purposive sampling techniques were utilized. Data were obtained by the standard format of systematic evaluation of four surveillance units from January to August 2020 through observation, document review, and interviewing surveillance officers and focal persons using a semi-structured Survey. The statistical analysis, tabular, and graphical output are generated using the open-source statistical program R.
Results: - Average report fullness and aptness were 97.9% and 96% respectively. The average annual malaria incidence rate was a decline in terms of place and time, from the year 2015 to 2019 with an average reduction rate of 5.5% and the average annual parasitic incidence rate was 52 (22-199). In 2019/2020, 43,131 malaria cases were reported in the zone. The study identifies no program-specific supportive supervision of public health emergency management and no routine data analysis and was not used for decision making.
Conclusion: This result revealed that the malaria incidence rate showed a remarkable decline. However, the annual parasitic incidence rate remains constant. This indicates that ivermectin did not affect malaria elimination. Hence, the districts and sub-city health offices should conduct regular surveillance data analysis, perform supportive supervision, avail budgets and further laboratory investigations should be done to investigate the effect of ivermectin on the parasites under laboratory conditions
Pulmonary arterial hypertension in patients of healed pulmonary Tuberculosis and its association with quality of life
Get PDFBackground: pulmonary tuberculosis leads to pulmonary impairment after tuberculosis leads to pulmonary impairment (obstructive, restrictive, and mixed) which changed the quality of life of these patients.
Objective: To study Pulmonary arterial hypertension in patients of healed pulmonary tuberculosis and its association with quality of life.
Material and Methods: Sputum for AFB under NTEP, X-ray chest PA view, ECG, 2d-echocardiography, six-minute walk test, Saint George\u27s Respiratory Questionnaire.
Results: Symptoms score, Activity score, Impact score, total score were compared among cases those developed PAH and those who not developed and interpretation was p-value of .018, .0349, .0969, .0369 respectively.
Conclusion: Pulmonary impairment after tuberculosis is a major health-related problem. We should not focus only on managing active cases of pulmonary tuberculosis but should consider pulmonary impairment after tuberculosis that means post tubercular lungs need a relook. These patients should undergo proper and early screening, diagnosis, and correct recognition of the pattern of pulmonary impairment (obstructive, restrictive, and mixed) which will provide proper guidance for comprehensive management of these patients and thereby improving quality of life
Knowledge about the risk factors and sign-symptoms of cardiovascular diseases among the patient\u27s attendants at a specialized hospital in Bangladesh
Get PDFBackground: Now a day, cardiovascular disease (CVD) is a very common disease in Bangladesh. Hypertension is the most widely prevalent, largely preventable risk factor for CVD accounting for half of the deaths due to ischaemic heart disease and stroke. Therefore, due to CVD and CKD, uncontrolled hypertension has huge implications for the disease burden. In today’s world, awareness among people about the risk factors, signs symptoms, and prevention of CVD is considered as one of the most potent components in saving people from huge mortalities and morbidities of CVD. Aim of the study: The present study aimed to assess the knowledge about the risk factors and sign symptoms of cardiovascular diseases among the patient\u27s attendants in the NICVD (National Institute of Cardiovascular Disease) Dhaka, Bangladesh. Methods: This was a cross-sectional study. The study was conducted at a National Institute of Cardiovascular Disease (NICVD) in Dhaka, Bangladesh in collaboration with the Department of Public Health, Northern University, Dhaka, Bangladesh during the period from September 2017 to December 2017. Properly written consent was taken from all the participants before starting data collection. A pre-designed questioner was used to collect data. All the results were calculated with the help of a computer by using the SPSS 22.0 version. Data were presented according to the variable of the study and shown in percentage. Results: In this study maximum, 83.2% of respondents knew the risk factor of CVD but 16.8% had not. Among the total participants, the major risk factor of CVD hypertension was defined by 80%, smoking by 73%, alcoholism by 53%, DM by 50%, high fat diet by 52%, and family history of diabetes by 34% of respondents. The maximum, 79.2% respondents had the idea of the sign-symptoms of CVD whereas 20.9% had not. As sign/symptoms maximum, 94% of respondents defined chest pain as the major whereas 48% defined shortness of breathing, 39% defined sweating, 36% defined vomiting and 12% defined swelling as the sign/symptoms of CVD. This study revealed that 55.4% of respondents had knowledge regarding the prevention of CVD but 26.7% had not. Conclusion: The knowledge about the risk factors and significant symptoms of cardiovascular diseases (CVD) among the patient\u27s attendants in Bangladesh may not be considered satisfactory. So, there are many scopes to do more works on awareness development about CVD among the general population in Bangladesh
Gestalt diagnosis of children with dysmorphism - Necessity for establishing genetic diagnostic approach
Get PDFBackground: The overall prevalence of intellectual disability is approximately 2-3% in the general population and can be caused by genetic and environmental factors. Genetic factors include chromosomal anomalies, single-gene disorder, deregulation of imprinted genes, and multiple malformation syndromes without an identified genetic basis and idiopathic. In Bangladesh, the genetic diagnosis of dysmorphic patients has not yet been well established. Therefore, gestalt diagnosis has a crucial role in establishing the differential diagnosis, management, counseling, and genetic diagnostic approach.
Aim of the study: The aim of the present study was to assess the effectiveness and necessity of gestalt diagnosis on the suspected genetic syndrome with intellectual disability and comorbidities.
Methods: This prospective study was conducted at Dhaka Shishu Hospital during the period from December 2017 to May 2018. The study included 21 children with intellectual and developmental disabilities (IDD) who attended OPD and Mental Health Clinic of Dhaka Shishu Hospital, Dhaka, Bangladesh. Elaborate history taking, physical examination, and psychological assessment were done. The dysmorphic features were analyzed and correlated with syndromic diagnosis using OMIM search. Parents were counseled about the preferred genetic diagnostic tests to confirm the syndromic diagnosis. Prognosis of the index children and chance of recurrence in the next pregnancy was discussed when a particular syndrome was suspected. Informed written consent was taken from parents of every patient to use the photograph and data for diagnostic and academic purposes.
Results: Among total participants, 40% had severe cognitive delay 35% had a moderate delay, 25% had a mild cognitive delay, 70% had behavior problems and 55% had ASD and/or ADHD features. The seizure was present in 35% of patients. Among other comorbidities; speech and language delay was in 65%, motor delay was in 50%, vision impairment was in 10%, hearing impairment was 15 %. Suspected cases were, Noonan syndrome: 4, Angelman syndrome: 3, Fragile X syndrome: 2, Kabuki syndrome: 2, Sotos syndrome: 2. Genetic diagnosis could be established in only 2 patients with suspected fragile X syndrome.
Conclusion: The study emphasizes the necessity to approach gestalt diagnosis in syndromic children with IDD along with locally available low-cost genetic diagnostic facility thereby increasing the possibility of providing appropriate management and/or genetic counseling