Medicine Today

The Mystery of Tomato Flu in India

Taniqsha Bambani , Ashfaque Hossain — Sun, 19 Nov 2023 00:00:00 +0000

Introduction: While the globe fights against monkeypox and the coronavirus, a new virus known as "Tomato flu" threatens. This virus's recognized target is children. In May 2022, the virus was found for the first time in Kerala, India. Due to its principal symptom, tomato-shaped blisters all over the body, the ailment was given the term "Tomato Flu." Recent reports described it as type of hand, foot and mouth disease (HFMD). It is easily diagnosed by a history and physical examination. It is an infectious condition, but there are still a lot of unanswered questions. To shed light on this topic, we decided to collect and summarize the information on this novel viral pathogen.

Materials and Methods: To accomplish this, we undertook a thorough literature assessment of the Tomato Flu research that has already been done. We analyzed data from various sources such as medical journals, government reports and news articles to gain a better understanding of this emerging disease. In addition, we conducted interviews with healthcare professionals who have treated patients with Tomato Flu to gain insights into their experiences.

Results: Survey of literature showed that Tomato Flu is a self-limiting disease. Children under the age of 5 and immunocompromised individuals are more susceptible to this disease. There is no diagnostic test for the disease, differential diagnosis involves typical symptoms and the absence of other known viral agents. There is no treatment, supportive care brings relief.

Conclusion: Overall, this review provides a better understanding of Tomato Flu and its potential impact on public health. By shedding light on this emerging virus, we hope to contribute to ongoing efforts to prevent and treat of this infectious disease.

Medicine Today 2023 Vol.35(2): 129-133

Aesthetic Management of an Unerupted Maxillary Central Incisor with a Closed Eruption Surgical Technique: A Case Report

Md Kamrul Hasan, Rokeya Rahman Tani, Mohsin Munir Khan Nabil, Samira Rahman — Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Treatment of impacted teeth requires a combination of orthodontics and surgery.

Case report: Reported case is of a 12-year-old-girl with an unerupted maxillary central incisor obstructed by an odomtome.

Discussion: Surgical exposure was done and traction with closed eruption technique was used.

Result: The tooth was aligned in the dental arch with accepted aesthetic and functional satisfaction of the patient.

Medicine Today 2023 Vol.35(2): 134-136

Preterm Labour Pain & Its Outcome in 50 pts attending at a Tertiary Care Hospital-ICMH

Mahe Jabeen, Jebunnesa, Mossammat Dilruba Akter, Anjuman Ara, Md Shabab Azmaeen — Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Preterm labor is the leading cause of neonatal morbidity all over the world. Over the past two decades despite major preventive efforts, the incidence of preterm birth has remained constant at about 5-10% of live births. The etiology is often multifactorial and poorly understood. Currently preterm labour is one of the most challenging problems confronting the obstetricians and perinatologists. With this background the present study was done to find out perinatal outcome in women presenting with preterm labour.

Aims To study the fetal and maternal outcome in preterm labor cases.

Materials and Methods: It was Prospective, single centered, observational study. A total of 50 women with preterm labor in the study period i.e. from June 2019 to May 2020 were included for the study sample. This study carried out at the department of Obstetrics and Gynecology, Institute of Child and Mother Health (ICMH), Matuail, Dhaka, Bangladesh. The data were collected personally through a structural questionnaire.

Results: Out of 50 subjects, majority of mothers 32(64%) were in age group of 21-30 years followed by 12(24%) in age group of 20 years. Majority 26(52%) of study subjects were primigravida followed by 24(48%) multigravida. Majority 32(64%) of study subjects were in lower class followed by 15 (30%) cases in middle class, 3(6.0%) cases in affluent class. Maximum 31 (62%) cases were unbooked cases and rest 19 (38%) cases were booked. Out of 50 babies who were <2500 grams, maximum 29 (58.0%) were low birth weight followed by 11(22%) being VLBW babies. 5 cases were >2.5 kgs, which are not LBW babies according to WHO Classification of low birth weight. Majority 17 (47.2%) stayed for 1-10 days followed by 9 (25.0%) babies for 11-20 days. Also 7 (19.4%) babies stayed for 21-30 days.

Conclusions: Preterm infants are at high risk of overall morbidity and mortality. Clinical suspicion, early detection and correction of risk factors, institutional delivery and good neonatal care back up facilities can improve the outcome of preterm labour and decrease the maternal complications as well.

Medicine Today 2023 Vol.35 (2): 73-77

Prevalence of Caries with its Distribution by Age & Gender in Institutional Clinical Patients

Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Consequence of dental caries is loose of healthy tooth structure which impacts negatively on aesthetics, function, self-esteem and quality of life of the patients. Different age groups and populations exhibit distinct caries prevalence rates, observations of which could provide a useful descriptive measure of caries susceptibility in tooth surfaces.

Materials and Methods: In this study, patients attending the Department of Conservative Dentistry & Endodontics of Dhaka Dental College & Hospital, located in Mirpur-14 and Department of Conservative Dentistry & Endodontics of Sapporo Dental College & Hospital, located in Abdullahpur (North Dhaka City), Bangladesh, were examined between 2017 and 2019. The location of dental caries on the teeth surfaces was recorded as following surface: Occlusal , Mesio-occlusal, Disto-occlusal, Proximal and Cervical for statistical evaluation and comparison. Furthermore, the age and gender of the patients were recorded on the chart for each caries tooth.

Result: Female had higher incidence 86 (57%) of caries than males 64 (43%). Caries distribution was common in the maxillary jaw (53.38%) than in the mandibular jaw (46.62%). Among our study patient occlusoal surface caries was most commonly observed (43.4%). Then, the proximal surface caries was seen in 28.3% cases. Overall 71.7% prevalence of caries was in occlusal and proximal area. Where, prevalence of proximal and cervical surface caries was higher in maxillary tooth (18.9% and 4.82%) than mandibular tooth (9.3% and 2.6%) respectively.

Conclusion: Female are more prevalent to dental caries than male. Occlusoal surface caries is most commonly observed, then, the proximal surface caries are commonly seen. Occlusal surface caries is more common in mandibular tooth than maxillary. Where, proximal and cervical surface caries was higher in maxillary tooth.

Medicine Today 2023 Vol.35(2): 78-82

Effects of Carbamazepine and Sodium Valproate on Serum Cholesterol in Epileptic Patients

Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Epilepsy is a common, chronic and non-communicable disorder of the brain. Carbamazepine, increasing serum cholesterol level, causes adverse cardiovascular and cerebrovascular events. Sodium valproate causes weight gain, hyperinsulinemia and insulin resistance leading to metabolic syndrome. These all causes increased morbidity and mortality of epileptic patients in later life.

Objective: to find out the effects of carbamazepine and sodium valproate on serum cholesterol in epileptic patients.

Materials and Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College during the period of July 2017 to June 2018. A total of sixty diagnosed epileptic patients were selected, of them, thirty patients were taking carbamazepine and thirty on sodium valproate. Data were analyzed with the help of SPSS version 22.0. Unpaired Student’s t-test and Mann-Whitney U test were done to see the level of significance (p<0.05). For correlation, Pearson’s correlation coefficient test was done.

Result: Mean ± SD of serum total cholesterol in carbamazepine and sodium valproate patients were 218.73 ± 29.70 mg/dl and 190.14 ± 17.10 mg/dl respectively (p<0.001).

Conclusion: This study reveals that hypercholesterolemia is related to carbamazepine medications.

Medicine Today 2023 Vol.35(2): 83-86

Effectiveness of an Educational Booklet for the Management of Patients with Chronic Low Back Pain

Sun, 19 Nov 2023 00:00:00 +0000

Introduction: The aim of the present study was to assess the effectiveness of provision of an educational booklet for the management of patients with chronic low back pain.

Material and Methods: A Randomized controlled clinical trial was conducted from January 2018 to June 2018 among 80 patients attending at Physical Medicine and Rehabilitation outpatient department of the Shaheed Suhrawardy Medical College and Hospital after obtaining requisite consent from the patients. 80 Patients were divided into two groups (Group A and Group B). Group A contains Patients educational booklet group + exercises + analgesics (Case group). Group B contains Physicians advice only group + exercises + analgesics (control group). Data were collected through interviewing and examining of the patients. The collected data were entered into the computer and analyzed by using SPSS (version 20.1) to assess the effectiveness of provision of an educational booklet for the management of patients with chronic low back pain. The study was approved by the institutional ethical committee.

Results: In a pool of 80 patients, the range of age was 18-55 years in case group and control group. There was no significant difference found in age between case and control group (p value is 0.383). Among the patients of case group 28 (70.0%) were male and 12 (30.0%) were female. Among the patients of control group 17 (42.5%) were male and 23 (57.5%) were female. Visual analogue score (VAS) score of group A patient was 5.4±1.0 and group B was 5.7±1.1 (p=0.143). At the first follow up the mean VAS score of group A was 4.5±1.0 and group B was 4.8±0.9 (p=0.111). At the second follow up the mean VAS score of group A was 3.1±0.9 and group B was 3.5±0.8 (p=0.077). And at the final (third) follow up the mean VAS score of group A was1.9±0.8 and group B was 2.4±0.6 (p=0.002).

Conclusion: There was significant improvement of pain of case group than control group. At the end of study we can tell that, educational booklet is effective for the management of patients with chronic low back pain.

Medicine Today 2023 Vol.35(2): 87-90

Complications of Nd Yag Laser Capsulotomy

Md Abdul Matin, Mahbubur Rahman Shaheen, Zakia Farhana, Sajed Abdul Khaleque — Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Aim and objective is to study the intra and post laser complications of Nd yag laser posterior capsulotomy and to find out the incidence of complications.

Materials and Methods: This study was conducted in the department of ophthalmology, Ad-Din Women Medical College 2, Bara moghbazar, Dhaka from July 2018 to June 2022. Our study included 206 patients of 220 eyes with significant PCO. Before laser capsulotomy all patients were assess by routine slit lamp examination, IOP measurement and posterior segment examination done for every patient for exclusion of gross posterior segment pathology. Nd yag laser capsulotomy was carried out under topical anesthesia. These patients were assessed for post laser visual acuity and complications in 1^st POD after 7 day and 1 month. Every patients with post laser routine medications and as per need of other related eye problems.

Result: Total 220 eyes of 208 patients included in our study ,including 93 male (44.71%) and 115 female (55.29%).Range of age were 21yrs to 87 years. Laser capsulotomy were done one eye in 208 patients and both eyes in 14 patients. Range of energy used in our study from 1 to 4.5 mJ. Complications were noted after yag laser capsulotomy In 29 eyes (13.76%) though after taking maximum precaution for avoiding complications including pre laser slit lamp examination, assessment of IOP, proper dilatation of pupil, power setting were minimum as per as possible.

Conclusion: The Nd yag laser capsulotomy is an effective, safe procedure for the treatment of opaque posterior capsule which is unique and magical approach for improvement of vision and restoration of effective life style. Every procedure have some adverse effect, Nd yag laser capsulotomy also have some complications .but benefit are tremendous if we can go in proper way.

Medicine Today 2023 Vol.35(2): 91-94

Pattern of Childhood Malignancy in a Tertiary Care Hospital

Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Cancer is a leading cause of death for children and adolescent worldwide. The cure rates in low middle-income countries are dismal (20%) in comparison to high income countries (80%). This study attempts to provide spectrum of pediatric malignancies from a tertiary care hospital in Bangladesh.

Aim: Aim of this study is to evaluate the pattern of Childhood malignancy in a tertiary care hospital like Dhaka Medical College Hospital(DMCH).

Materials and Methods: It is a prospective observational study was done in DMCH, over a period of 1 year (March 2014 to February 2015). After fulfilling the inclusion criteria, total 200 children aged 0-15 years were enrolled in this study. For classification of pediatric malignancies the International Classification of Childhood Cancer (ICCC), was followed.

Results: Patients were stratified in 4 groups according to the age; 0-3 years, 3-6 years, 6-9 years and 9-12 years. Most of the patients fell in 6–9-year group (29%), followed by 3–6-year group (25%). Majority of cases, 61% were male. The male to female ratio was 1.55:1. Among200 cases, Leukemia (49%) was the most common malignancy followed by lymphoma, CNS Tumor, Neuroblastoma, Retinoblastoma, Wilms tumor and Malignant bone tumors. Acute lymphoblastic leukemia (ALL) comprises majority (98/200) of leukemia.

Conclusion: This study gauges the trend of pediatric malignancies in Bangladesh, which is important in the planning and evaluation of health strategies. In Bangladesh, where there is dearth of high-quality data as we lack a dedicated pediatric cancer registry, such epidemiological studies play a significant part for this small but distinguished group of patients.

Medicine Today 2023 Vol.35(2): 95-98

The Effect of Atorvastatin Plus Ezetimibe Therapy Versus Atorvastatin Monotherapy on Clinical Outcome in Acute ST-Segment Elevation Myocardial Infaction(STEMI)

Sun, 19 Nov 2023 00:00:00 +0000

Introduction: An acute ST-elevation myocardial infarction (STEMI) is an event in which transmural myocardial ischemia results in myocardial injury or necrosis. The current 2018 clinical definition of myocardial infarction (MI) requires the confirmation of the myocardial ischemic injury with abnormal cardiac biomarkers. Acute coronary syndrome is the leading cause of death in the world and this is a consequence of unstable plaque due to dyslipidemia, reviewing with elevated LDL cholesterol. Reduction in LDL-c repeated clinical outcomes in patients with the acute coronary syndrome.

Objective: To assess the effect of atorvastatin plus ezetimibe therapy versus atorvastatin monotherapy on clinical outcome in acute ST-Segment Elevation Myocardial Infaction(STEMI).

Materials and Methods: A cross-sectional study was performed at dept. of Cardiology, Parkview Medical College, Sylhet, Bangladesh from June to December 2022. A total of 50 patients were evaluated in the study, including 42 patients with acute coronary syndrome with LDL-c levels≥70mg/dL at Can Tho Central General Hospital, we divided randomly into 2 groups: group A: control LDL-c by atorvastatin 40mg and ezetimibe 10mg; group B: control LDL-c by atorvastatin 40mg monotherapy. Then we compared the effect of control LDL-c between two groups after 10 follow-up days.

Results: 50 patients with acute coronary syndrome: 60.0% male and 40.0% female, the average age was 66.03 ± 12.06 years, 82.0% LDL- c levels ≥7 mg/dL. After 10 days of treatment, the target LDL-c concentration in the group treated with atorvastatin 40mg+ ezetimibe 10mg was 48.1%, in the group treated with atorvastatin 40mg was 29.9% (p<0.05).

Conclusions: LDL-c ratio reaches the target in the treatment group by atorvastatin 40mg + ezetimibe 10mg was 48.1% in the treatment group with atorvastatin 40 mg was 29.9% (p<0.05). From the results of our study, we recommend the combination therapy of atorvastatin and ezetimibe control LDL-c in patients with acute coronary syndrome better than atorvastatin monotherapy, thus physicians to treat patients with the acute coronary syndrome should combine early atorvastatin with ezetimibe since hospitalization.

Medicine Today 2023 Vol. 35(2): 99-104

Disease Characteristics of Chronic Venous Disease in Referral Hospital in Bangladesh

Sun, 19 Nov 2023 00:00:00 +0000

Introduction:Chronic venous disease (CVD) is widespread, underdiagnosed, and can progress to chronic venous insufficiency and venous ulcer, which can require extensive treatment. This condition negatively impacts patient quality of life and place substantial burdens on healthcare resources. In Bangladesh this problem is increasing with very poor awareness.

Materials and Methods: The prospective observational study was carried out in department of vascular surgery of National Institute of Cardiovascular disease. We randomly choose 180 patients with chonic venous disease (CVD) and evaluate their characteristics and prevalence of several types. Data collection started from May 2021 for next 6 months.

Results: : The patients of this survey were aged between 24 to 70 years and the Mean±SD age was 43.6±12.2. 78.3% of total study population were male, 33.3% were businessman and 10% were housewife. 66.6% patients were having low socio-economic condition. C2 varicose veins were highly prevalent among the study population (35%) & lowest prevalence of C4b lipodermatosclerosis or atrophie blanche (11.7%) we have seen in the study. (31- 40) & (51-60) these two age group were more prone to have CVD, 28.33% (n51) & 26.67% (n48) (p <0.001*) respectively. Male were predominantly more prevalent to having CVD, 78.33% (n141), (p <0.001).

Conclusion: Patients having CVD, invariably presented with the complains of heaviness of leg and unexplained leg swelling and Varicose vein were highly prevalent irrespective of sex. Advanced stages are more common in male patients. In every age group were having different stages of CVD. More awareness can help patients to get proper management and relief from chronic venous disease.

Medicine Today 2023 Vol.35(2): 105-108

Pattern, Severity and Outcome of Injuries Sustained in Road Traffic Accidents: A Tertiary Care Hospital-Based Study

Sun, 19 Nov 2023 00:00:00 +0000

Introduction:Road Expansion and motorization, in the country has been accompanied by a rise in road accidents leading to road traffic injuries (RTIs). Today RTIs are one of the leading causes of deaths, disabilities, and hospitalizations with severe socioeconomic costs across the world. The aim of the study is to determine the pattern, severity and outcome of injuries amongst road traffic accident victims.

Materials & Methods: An observational study was carried out at casualty department of Cumilla Medical College Hospital, from April 2020 to September 2020. Total 192 patients following RTIs were included in this study. After history taking, clinical examination and collection of investigation reports, data was analyzed by using SPSS-23.

Results: Out of 192 patients, 33.3% of the patients belonged to age group 21-30 years, 71.4% were male. More than two third (67.2%) patients accident took place in high way and 62 (32.8%) in other areas. According to pattern of victims 111(57.8%) patients was found in pedestrian of victims, 48(25.0%) in driver and 33(17.2%) in passenger. In injury severity score, 98(51.0%) patients were found minor injuries followed by 57(29.7%) moderate, 22(11.5%) serious and 15(7.8%) severe injuries. Ninety (46.9%) patients were found transfer for definitive care followed by 52(27.1%) discharge after Rx, 30(15.6%) wound infection, 18(9.4%) referred to higher center and 2(1.0%) death.

Conclusion: The present study shows that fatal accidents mainly affected the young adults in productive age groups and pedestrians. Highways were most commonly affected location. Most of the accidents caused by motorized vehicles.

Medicine Today 2023 Vol.35(2): 109-113

Functional Outcome of Distal Tibial Fractures Fixed with Distal Tibial Locking Plate using MIPPO Technique

Nripen Kumar Kundu, Anwar Ahmed Miajee , Sathi Dastider — Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Because of the extensive list of potential consequences, treating extra-articular distal tibia fractures is a daunting task for an orthopedic surgeon. This study was designed to evaluate the clinical and functional outcomes of minimally invasive plating for the treatment of distal tibial fractures.

Materials and Methods: This prospective study was conducted at the Department of Orthopedic Surgery, Popular Medical College and Hospital, Dhaka during June 2021 to May 2022. A total of 20 patients with distal tibial fracture were selected for surgery and treated with minimally invasive plating. Afterwards, the patients' clinical and radiological outcomes were recorded. The ankle-hindfoot score developed by the American Orthopedic Foot and Ankle Society (AOFAS) was used to assess the functional outcomes.

Results: In 15 of the 20 cases, radiological union took place between 18 and 22 weeks (mean 20.5 weeks); however, in 5 cases, union was delayed and required almost 26 weeks to establish. Four of the 20 cases experienced a superficial infection, while the remaining patients showed no further complications. According to the AOFAS score, our research showed that, out of 20 patients, 9 had excellent outcomes, 8 had good results, and 3 had acceptable results.

Conclusion: Treatment of distal tibia fractures with locking plates by MIPPO technique is an effective method of therapy to achieve union and excellent functional results since it aids in the early restoration of ankle movement while reducing ankle stiffness.

Medicine Today 2023 Vol.35(2): 114-117

Corneal Clarity after Phacoemulsification: Nuclear Management by Stop and Chop Method

Md Golam Rosul, Md Abdus Salam Siddique, Sayed Saleh Khan, Husna Harun — Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Restoration of effective vision is the principal aim of all modalities of cataract surgery including phacoemulsification. In this method, nuclear part of the cataractous lens is emulsified by ultrasonic power. Energy level of ultrasonic power and turbulence of fluid in the anterior chamber play an important role in corneal endothelial cell loss which inturn influences post-operative corneal clarity. Endothelial cell loss can be minimized by modification of nuclear management method. The common nuclear division techniques of phacoemulsification are stop and chop, divide and conquer and phaco chop.

Purpose: To show post-operative corneal clarity after phacoemulsification by stop and chop technique of nuclear divisions.

Materials and Methods: This prospective observational study was conducted at selected outdoor patients from January, 2023 to June, 2023 over 33 patients of age related cataract selected for phacoemulsification surgery. Patients were selected based on specific selection criteria. Selected patient underwent detail, ocular and systemic examinations as well as relevant investigations which included assessment of corneal endothelial cell count and central corneal thickness. Phacoemulsification were done in all patients by a single expert surgeon where technique of nuclear management by stop and chop were chosen randomly. Patients were followed up on 1 week, 4 weak and 12 weak after surgery. Corneal endothelial cell count and central corneal thickness were assessed in each visit. All the relevant data were presented by appropriate tables.

Results: The mean age of the study subjects were 60.96 with standard deviation 1.75 years out of which 14 were males and 17 were females. Pre-operative value of mean endothelial cell count was 2620+_-70.20/mm². Mean value of endothelial count was 2420+-68.90/ mm²,2345+-66.64/ mm², 2310+-66.04/ mm²respectively after 1 week , 4 weeks and 12 weeks after surgery. Mean value of central corneal thickness was 545+-40.50 micrometer, 535+-40.02 micrometer, 532+-39.85 micrometer respectively after 1 week, 4 weeks and 12 weeks after surgery.

Conclusion: Quantitative assessment of endothelial cell count and central corneal thickness shows that at end of the study there was no significant difference in mean endothelial cell count and mean central corneal thickness .

Medicine Today 2023 Vol.35(2): 118-120

Comparative Study on Serum Calcium in Pre-Eclampsia and Non Pregnant Women

Heera Lal Roy, Susmita Nargis — Sun, 19 Nov 2023 00:00:00 +0000

Introduction: There are many Hypertensive disorders in pregnancy like preeclampsia, eclampsia etc. Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Some studies have implicated that low serum calcium levels may have a role in pre-eclampsia but other studies failed to find relation between low levels of these trace elements and pre-eclampsia.

Objectives:To evaluate serum calcium in pre-eclampsia & non pregnant women.

Materials and Methods: This cross sectional study was carried out in among 31 pre-eclampsia patients, aged 20 to 40 years, and gestational age ranges from 20 to40 weeks and 31 age matched normotensive non-pregnant women having no proteinuria. Serum calcium was measured by Colorimetric method.

Results:The mean serum calcium level was 5.91 (±2.12) mg/dl in pre–eclampsia and was 5.72 (±2.46) mg/dl in normal women.

Conclusion The mean serum calcium level did not differ significantly between the subjects of pre–eclampsia and normal women (t=0; p<.05). The means of both data sets are equal so we can conclude that there is no significant difference between them.

Medicine Today 2023 Vol.35(2): 121-123

Evaluation of the Factors Affecting of Epistaxis: A Study in a Tertiary Care Hospital, Dhaka.

Sun, 19 Nov 2023 00:00:00 +0000

Introduction: Epistaxis refers to the occurrence of bleeding from the nose or nasal cavity. It is widely recognized as one of the most common emergencies encountered in medical settings, particularly in the ear, nose, and throat departments, as well as in accident and emergency departments across the globe. The management of epistaxis depends on the severity of the bleeding and may involve various interventions, including conservative measures like nasal packing, cauterization techniques, or, in more severe cases, surgical interventions.

Objective: The primary goal of this study was to investigate the various causes of epistaxis.

Materials and Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology and Head-Neck Surgery (ENT) in City Medical College & Hospital from May 2021 to April 2023. The study involved 220 patients who presented with epistaxis complaints at the ENT Outpatient Department or Emergency unit of hospital. Diagnosis of the cases was based on their medical history, clinical examination, radiological and laboratory investigations.

Result: 220 patients were studied during the period. The mean age ± standard deviation was determined to be 36.67 ± 18.06 years. The age range spanned from 1 to 85 years. Patients less than 25 years old were 124 (56.36%) and more than 25 years old were 96 (43.74%). Males (139) predominated in both indoor and outdoor patients with a male-to-female ratio of 1.7:1. The nasal cavity most involved was left 103 (47%) compared to right 85 (38.6%). Bilateral involvement was seen in 32 (14.4%) cases. Higher incidence was also noticed during winters 93 (42.1%), followed by summer 63 (28.7%), then autumn 38 (17.2%), and least in spring 26 (11.9%). The circadian rhythm was also noted where we found epistaxis to be more during night 82 (37.6%), followed by evening 78 (35.3%), and finally morning 60 (27.1%). Previous history of hypertension (HTN) is seen in 26.3% of cases (58). The history of taking medications with hemorrhagic risk currently or stopped within the last 10 days was 3.5% (8). We also found a relationship between the age group (<25 years, > 25 years) and the type of treatment.

Conclusion: Epistaxis, or nosebleeds, can be caused by various factors such as trauma, inflammation, tumors, blood disorders, cardiovascular issues, and foreign bodies. Younger individuals are more prone to traumatic causes, while older individuals may experience more severe nosebleeds. Hypertension is a significant contributor, emphasizing the importance of blood pressure management. Understanding these diverse causes is crucial for effective treatment and prevention of potential complications.

Medicine Today 2023 Vol.35(2): 124-128