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Sexual and Reproductive Health Services during the COVID-19 Pandemic: Lessons Learned from Nepal
Get PDFThe COVID-19 pandemic, one of the worst public health crises of the century, has created severe health challenges. Since the announcement of nationwide lockdown in Nepal on March 24th, 2020, and yet another lockdown announced after the onslaught of the second wave, [1] it has had major detrimental effects on sexual and reproductive health (SRH) of women in Nepal. Although health systems and service providers have adapted to the crisis and have continued to provide SRH services, there is a lot to be learned and improve from this pandemic
Serum magnesium level in patients with acute myocardial infarction and its relation with arrhythmia
Get PDFIntroduction: Magnesium (Mg) is the second most common intracellular cation after potassium (K). Mg is a cofactor in many enzyme systems in human cells and it has a predominant role in normal myocardial physiology. The role of magnesium in cardiovascular disease has received widespread attention. Magnesium has been implicated in the complications like arrhythmias in acute myocardial infarction. Objective: To know the serum magnesium level in patients with acute myocardial infarction and its relation with arrhythmia. Methods: A descriptive cross-sectional study was conducted in the Department of Cardiology, Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur, Bangladesh from January 2020 to June 2020. 50 patients with acute myocardial infarction were admitted. Data were collected from patients of any age and both sexes with acute myocardial infarction as determined by clinical features, ECG evidence and biochemical report. A blood sample for estimation of serum magnesium level was collected as early as possible within 24 hours of admission and the 5th day of admission. After admission to CCU, every patient was under continuous cardiac monitoring to see and record any arrhythmia within 5 days’ onset of symptoms. Results: A total of 50 patients with acute myocardial infarction were included during the study period. The male to female ratio in the study group was 3.17:1 and the maximum incidence of acute myocardial infarction was seen in the 5th and 6th decade. The most common presenting symptom was chest pain which was present in all patients and was associated with sweat in 60% of patients and breathlessness in 64% of patients and palpitation in 50%. In the study, the most common risk factor found was smoking (70%) followed by diabetes (36%) and hypertension (30%). Anterior wall MI was found to be the most common type of MI (42%). Arrhythmia developed in (52%) patients and in the majority (57.7%) with anterior wall MI. In the study group mean serum magnesium level in 50 patients on day-1 is 1.86±0.39 and on Day-5 is 2.26±0.5. The mean serum magnesium level in 26 patients with arrhythmia was 1.65±0.26 on day-1 and 1.98±0.25 on day-5. In the study group, the mean serum magnesium level in 24 patients without arrhythmia was 2.05±0.41 on day-1 and 2.48±0.52 on day-5. The difference between the magnesium level in patients with arrhythmia and without arrhythmia is statically significant on both days- 1 and day-5 (p<0.001). PVC was the most common type (42.5%) of arrhythmia. Conclusion: serum magnesium levels are significantly low in patients who develop arrhythmia in acute myocardial infarction
Clinical and USG findings of patients presented with breast pain
Get PDFIntroduction: Breast pain also known as mastalgia is the dull ache in the breast, the cause is multifactorial. It can affect any age group. Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women aged 20-59 years worldwide. In India, breast cancer has ranked number one cancer among females, with an age-adjusted incidence as high as 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. Objective: To find out the Clinical and USG Findings of Patients Presented with Breast Pain. Settings and Design: Prospective cross-sectional descriptive study. Materials and Methods: Patients with complaints of breast pain in the age group 15 to 60 years with clinically no palpable mass attending to the Dept. of Clinical Oncology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh between January 2020 to December 2020 were included in the study. Detailed history with particular reference to age, duration of symptoms, Size, menstruation, marital status, parity, lactation, nipple discharge, and tenderness are recorded. Pain intensity was evaluated as mild, moderate, and severe. Ultrasound of the breast including the axilla was done for all cases and findings were recorded to correlate with clinical features. Results: Out of 90 patients studied, the majority were in the age group (21-30) years, (43%) followed by (31-40 years) (40%) respectively. 57(63%) were married and 33(43%) were single. 21 patients had 1 child, 18 had 2 children with 6 of them having no children. Out of 90 patients, only 3 attained menopause, the rest of them have their monthly cycles. 51 patients had cyclical breast pain and 39 had noncyclical breast pain, 39 had pain on the right breast, 36 on the left side, and bilateral in 15 patients. The pain was mild in 15 patients, moderate in 27 patients, and severe in 6 patients. Various USG findings of the affected breast were a normal study in 48 patients followed by duct ectasia and heterogeneous echogenicity fibroadenomas, small cystic lesion, and enlarged axillary lymph nodes, etc. Conclusion: The study results show that the majority of patients with breast pain without clinically palpable lumps had normal USG studies. But it also detects other early changes in the breast tissue. It can be used as a baseline investigation for any breast pain without palpable lumps
Depression among elderly living in old age homes and its association with other factors
Get PDFWith a progressively ageing population worldwide, treatment and identification of depression in older adults become increasingly important, particularly as older people have distinct presentations and needs than younger ones Depression with the elderly constitutes a serious public health problem that attracts worldwide interest. The goal of this particular study is actually estimating the prevalence of depression and its associated aspects among community-dwelling aged. It\u27s a cross-sectional analysis in which 203 aging adult individuals residing in old age homes of Delhi, India was selected arbitrarily. The job interview was completed using the socio-demographic tool, Geriatric Depression Scale (GDS), ICD 10 DCR, Duke interpersonal assistance scale, UCLA loneliness scale, as well as Barthel index was used. This particular study offers an astonishing signal for overall health professionals as well as wellness policy developers in India for the demand of a much better recognition of depressive symptoms in elderly
Study of clinical, radiological, and histopathological features of bone lesions- A two-year study
Get PDFBackground: A pathological bone lesion can present in any form of inflammatory to neoplastic conditions and they pose a definite diagnostic challenge. The aim of the present research was to study the incidence, age of presentation, and site of bone lesions, overview the clinical, imaging, and pathologic findings, and also compare radiological and histological findings. Methods: This study was conducted in 30 cases of bone lesions, who presented to a tertiary care hospital from May 2010 to September 2012. Clinical examination was done initially, followed by radiological imaging (X-ray, CT & MRI). Based on imaging, the decision of biopsy was taken for final diagnosis. Histopathological examination was done on Hematoxylin and Eosin stained slides. Results: Out of 30 cases, 14(46.66%) cases were benign, 14(46.66%) were malignant tumors and 2(6.66%) were non-neoplastic lesions. Osteochondroma (35.71%) was the most common benign bone tumor and multiple myeloma (28.57%) was the commonest malignant tumor while non-neoplastic lesions were avascular necrosis of hip & chronic osteomyelitis. The primary bone tumors occurred mostly in 0-50 years, while half cases of multiple myeloma and metastatic tumors were seen 1-2 decades higher. 85.71% of benign tumors occurred in males while malignant tumors showed equal sex incidence. All non-neoplastic cases occurred in males. The femur was most commonly involved long bone while the pelvis was the most commonly involved flat bone. Radiological diagnosis was consistent with histopathological diagnosis in 80% of cases. Conclusion: Age, sex, and site are important clinical parameters. Radiology and imaging investigation is an essential step in the diagnosis, prior to histopathological study. Clinical, imaging and histopathology thus remains the key for diagnosing bone lesions; especially so in bone tumors
The Utilization of Sexual and Reproductive Health Services among young people: A cross-sectional study in Greece: Reproductive Health Services and young people
No full textPurpose: To explore young people’s experiences of public or private services received for their sexual and reproductive healthcare.
Materials and Methods: A cross-sectional study was carried out involving 358 students from vocational post-secondary education during the academic year 2018-2019, using a questionnaire based on the directions of the Youth Friendly Sexual and Reproductive Health Services (SRHS) proposed by the International Planned Parenthood Federation (IPPF).
Results: Out of 358 students, only 35(9.78%) visited public health services, while 85 (23.74%) visited both public and private services. Gynaecologists, in private sectors, were visited by 127 students of whom 34.6% and 33,1% were between the ages of 18-20 and 21-30 years, respectively. 111 students (31.01%) did not use any service. A slight difference between the staff friendliness and the services received between the public and private sectors was observed. Similarly, a marginal lead was apparent in the private sector with regards to availability of appointments, emergencies and privacy. In the public sector, fewer participants were informed of the abortion services available.
Conclusions: The satisfaction rate was quite high regarding healthcare consultation, in both sectors. However, counseling on contraceptive methods, information on the prevention of sexually transmitted infections, and other aspects of sexual and reproductive health were not satisfactorily covered. Finally, participants wished for more counseling and a greater focus on personal concerns
The at-home delivery of treatment for benign prostate enlargement and chronic prostatitis enabled by Dr Allen’s Device is a valuable healthcare innovation during a pandemic
Get PDFIntroduction: The Coronavirus (COVID-19) outbreak has demonstrated the need for a novel delivery of treatment for benign prostate enlargement (BPE) and chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS). Their standard treatments with medications and surgeries require extensive contact between patients and healthcare professionals that worsens a pandemic. This study aims to determine whether therapeutic Dr Allen’s Device (DATD) and Thermobalancing therapy (TT) can be used as an effective self-management tool and at-home treatment for chronic prostate diseases.
Methods: This is a retrospective cohort study of 45 men with CP/CPPS and 124 men with BPE who were observed before and after applying TT with DATD at home for 6 months in 2 clinical controlled trials. The dynamics of clinical characteristics and parameters, such as pain, urinary symptoms, quality of life (QoL), and prostate volume (PV) were compared to the control groups without DATD.
Results: DATD reduced pain scores from 10.3 to 3.5 (P<0.001) in men with CP/CPPS. In men with BPE, DATD reduced PV from 45mL to 31mL (P<0.001) and urinary symptoms from 14.3 to 4.9 (P<0.001). DADT significantly improved QoL in both treatment groups. In the control groups, no positive changes were observed.
Conclusions: The use of DATD with TT relieves chronic pelvic pain and reduces an abnormal prostate size in patients with CP/CPPS and BPE, improving their QoL and wellbeing. Thus, DATD is an effective at-home self-management tool and provides a novel delivery of treatment for non-cancerous prostatic diseases, especially important during a pandemic
Outcome measures of laparoscopic versus open appendicectomy with uncomplicated acute appendicitis
Get PDFBackground: Acute appendicitis is the sudden and severe inflammation of the appendix. It can cause pain in the abdomen, and this pain may occur quickly and worsen within hours.
Aim of the study: To find out the Outcome Measures of Laparoscopic Versus Open Appendicectomy with Uncomplicated Acute Appendicitis.
Methods: This is a prospective type of observational study conducted in the Department of Surgery, Bangladesh Medical College Hospital, Dhaka, Bangladesh. The study period was from 1st July 2018 to 30 June 2020. 100 cases irrespective of sex were selected through random sampling who fit the selected criteria
Result: Among 50 cases of open appendicectomy, 33 cases (66%) were male and 17 cases (34%) were female. Among 50 cases of laparoscopic appendicectomy, 34 cases (68%) were male and 16 cases (32%) were female (p-value: 0.83). Open cases needed 67.50±9.20 minutes\u27 duration of anesthesia and laparoscopic cases 83.82±13.05 minutes (p-value: <0.001). Duration of surgery in group A (open cases) was (mean±SD) 44.54±11.75 minutes and in the group, B was (mean±SD) 68.28±15.24 minutes (p value<0.001). Per operative, hazards were observed in 2% of patients with laparoscopic appendicectomy (p-value: 0.31). Meantime required taking narcotic analgesic after surgery in Group A was 29.06±10.46 hours and in Group B 21.36±11.93 hours (p-value: 0.001)
Conclusion: After observing the outcome of both the procedure it can easily be concluded that laparoscopic appendicectomy is superior over the open procedure in terms of duration of anesthesia, duration of surgery, post-operative pain and discomfort, tolerance to a normal diet, hospital stay, return to post-operative indoor and outdoor activities, wound infection and cosmesis. So laparoscopic appendicectomy is the safer procedure by expert surgeons. Analyzing more recent studies, it can be suggested that laparoscopy is becoming the first-choice method for the management of acute appendicitis
Axillary lymph node status according to location, size, number and grading among breast cancer patients in tertiary care hospitals, Bangladesh
Get PDFBackground: There are a good number of tumor-related features available to predict the prognosis of breast cancer and its stage of severity. Axillary lymph node status according to the location, size, number, and grading among breast cancer patients have a potential prognostic value in the course of breast cancer treatment, mortality, and morbidity. We have very limited researched-based information regarding these issues.
Aim of the study: The aim of this study was to assess the axillary LN status according to location and grade of tumor also size and number of axillary LN among breast cancer patients.
Methods: This was axillary LN status according to the location of a prospective observational study conducted in the Department of Surgery & Oncology, Dhaka Medical College Hospital, BSMMU, and NICRH Dhaka, Bangladesh during the period from January 2015 to December 2016. In total 100 patients of several age groups with breast cancer, patients attended, diagnosed, and treated in the mentioned hospital were selected as the study subjects. Proper clinical examination and ultrasonography for the assessment of axillary lymph node status were done for every participant. All data were processed, analyzed, and disseminated by MS Office and SPSS program as per need.
Results: In location analysis, we observed, most of the tumors were located in the upper outer quadrant (57%) followed by 22.0%, 17.0%, and 4.0% were located in the upper inner quadrant, lower outer quadrant, and in other locations respectively. Most of the tumors were of Grade II (67%) followed by 21.0% and 12.0% were of grade I and grade III respectively. Maximum 52.5% patients of this study had a lymph node with the size of 1-2 cm followed by 25.0% and 22.5% patients had lymph nodes with the size of >2cm and 9. Both clinical examination and USG showed positive results in increasing the number of lymph nodes.
Conclusion: In analyzing the location, size, number, and grading of axillary lymph node among breast cancer patients by using clinical examination and USG findings, we found statistically significant correlations in the size and number of the lymph node. So, we can conclude that the location & grade of tumor and number & size of axillary lymph node among breast cancer patients are the most potent indicators of severity and status of breast cancer
Personalizing complete dentures!! A myth or reality?
Get PDFComplete edentulousness is a physical disability as detailed by the “World Health Organizationâ€. The ubiquity of tooth loss in the Indian populace is 91.2% in the above 65 years, age group. Edentulous patients agonize from compromised function, appearance, and a decreased quality of life. Thus, making a denture can be functional and comfortable, however, it can be repulsive in the eyes of the wearer. Therefore, the characterization of complete dentures has become an emerging trend in prosthodontics to achieve superior aesthetics in edentulous patients. Several methods have been advocated in an attempt to customize the artificial teeth and dentures bases according to the patients’ needs. Tinting the denture bases to reproduce the color and shade of the natural oral tissues is being commonly done in dental laboratories. This paper presentation features a method of matching the shade of the gingiva to as near as normal using pigments/stains and incorporating the same shade using the usual staining methods. This method can help to enhance the aesthetics of the complete denture wearer successfully