Central Medical College Journal

From the Desk of Editor in Chief

2023-05-24T09:50:00+00:00

Abstract not available

Central Medical College Journal Vol 6 No 1 January 2022 Page: 2

Proper Timing And Quality Sleep Maintain Healthy Life

2023-05-24T09:51:00+00:00

Abstract not available

Central Medical College Journal Vol 6 No 1 January 2022 Page: 3

Instructions for Authors

2023-05-24T09:57:11+00:00

Abstract not available

Central Medical College Journal Vol 6 No 1 January 2022 Page: 4-6

Prevalence of Iron Deficiency Anaemia in Ischaemic Stroke

2023-05-25T03:47:26+00:00

Background: Iron Deficiency Anaemia has been proposed as a risk factor for developing ischemic stroke. In long-term follow-up studies, and it is also known to increase the risk of death. Very little is known about the prevalence of Iron Deficiency Anaemia (IDA) in Bangladeshi stroke patients. We aimed to determine the prevalence of IDA among admitted patients of acute ischemic stroke in a tertiary care hospital in Bangladesh.

Materials and methods: In this cross-sectional study, 75 patients with acute ischemic stroke were selected purposively from the Neurology & Medicine Department of Comilla medical college hospital from February 2021 to May 2021. Traditional risk factors for stroke, stroke type and severity at admission were recorded for each patient. Anaemia is defined as haemoglobin <12gm/dl in women & <13gm/dl in men. IDA was defined as serum ferritin level <20 μgm/L in males and <40 μgm/L in females.

Results: Mean age was 65.8 (±11.4) years. Sixty percent of patients were male. Hypertension was the most prevalent risk factor present in 73.3% of the cases, followed by diabetes mellitus (49.3%), smoking (28.0%), ischaemic heart disease (25.3%), and dyslipidemia (21.3%). Small vessel strokes were the most common, accounting for 48% of all the patients, followed by large vessels getting affected in 38.7% of the cases. Prevalence IDA was 24%. (95% confidence interval: 14.9%-35.3%). However, the proportion of IDA among patients with severe stroke was 84.6% compared to 11.3% in non-severe strokes (p=0.001).

Conclusion: Prevalence of IDA in acute ischemic stroke is significant and it is associated with severe stroke in our hospital.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 7-13

Association of Vitamin-D Receptor Gene Single Nucleotide Polymorphism (FokI) with COPD

2023-05-25T03:51:24+00:00

Background: Vitamin D receptor gene (VDR) polymorphism and its association with various diseases have been previously investigated. But the association of vitamin D receptor gene polymorphism with COPD has not been investigated yet.

Objective: To assess the association between vitamin D receptor gene polymorphism (FokI) and COPD.

Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from March 2019 to February 2020. For this study, 15 (fifteen) pulmonologists diagnosed COPD patients with age 40 to 80 years (post-bronchodilator FEV1/FVC<0.70 and FEV1<80% predicted) and 15 (fifteen) apparently healthy age-matched individuals (for comparison), were selected. The single nucleotide polymorphism of vitamin D receptor gene (FokI) of all subjects was assessed by PCR-RFLPs. Data were expressed as mean ± SD and percentage. Statistical analysis was done by independent sample ‘t’ test and chi-square test. In the interpretation of the results, ≤0.05 level of probability (p) was accepted as significant.

Results: The frequency distribution of FokI genotype was 13.33% (FF), 73.34% (Ff), 13.33% (ff) and 13.33% (FF), 80% (Ff), 6.66% (ff) COPD patients and healthy subjects, respectively. Associations of FokI [FF (OR 1,95% CI 0.12-8.21, p=1.00); Ff (OR 0.68,95% CI 0.12-3.78, p=0.66); ff (OR 2.15,95% CI 0.17-26.67, p=0.54)] VDRSNP with COPD was statistically non-significant. Conclusion: The present study reveals that the FokI of VDR SNP is not associated with COPD.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 14-21

Contraceptive Practices and Awareness of Emergency Contraceptive Pills among Rural Women of Reproductive Age

2023-05-25T03:57:07+00:00

Background: Regular contraceptive use and emergency contraception are tools to prevent population explosion. Objective: To assess the contraceptive practices and awareness of emergency contraceptive pills among rural women of reproductive age. Methods: The cross sectional study is conducted over 3months (December 2021 to February 2022) among 345 women of reproductive age (15-49 years) who living with their husbands in selected rural residence at Mostafapur village under Sadar Upazilla in Cumilla district. Women who were pregnant, had a child younger than 2 years, or had any physical & psychological disorder were excluded. Participants are selected by convenience sampling technique, data are collected by face to face interview with a semi-structured questionnaire to assess socio-demographic characteristics, contraceptive practices and awareness of emergency contraceptive pills. Data are analysed by SPSS software. Results: In this study, majority (48.7%) of the participants are in the age group 25-34 years. Most of them are housewives (92.2%) and 33.0%has secondary education. The mean (±SD) monthly family income of the participants is 25463.77 (±15971.158) tk and 58.3% of the participants has 1-2 children. About the current practice of contraceptive method, 52.2% of the participants practice and OCP is the widely used method (58.3%), 44.40% take decision by both husband and wife. About reasons for using contraceptives, majority (38.3%) of them use due to spacing of birth and 27.2% cases do not use due to husband disapproval. Regarding awareness of ECPs, 55.9% of them aware of and Norpill is the widely heard method (20.7%). 27.4% of the participants’ source of information is frommedia: TV/Radio. About correct time of taking ECPs, 33.60%of them have no knowledge. Regarding conditions where ECPs are to be taken, majority 39.7% of them have no knowledge. About benefits of taking ECPs, majority (79.30%) of them know it can prevent pregnancy. Conclusion Contraceptive practices and awareness of ECPs are not satisfactory among rural women. So national wide campaign program should be conducted to improve this field.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 22-27

Iatrogenic Fistula after Gynecological Operation in a Tertiary level Hospital

2023-05-25T04:06:51+00:00

Background: Genitourinary fistula constitute a social calamity for the women in the developing countries.The most common cause being obstructed labor, as my study is on fistula due to iatrogenic cause, the most common cause is gynecological surgery. This study has been designed to find out the general information about iatrogenic genitourinary fistula and its outcome.

Method: A cross-sectional descriptive study was done on 42 women suffering from urogenital fistula admitted in fistula corner in the department of Obs. & Gynae, Rajshahi Medical College Hospital from March to September 2015. A detailed history was taken to find out the casual factor. All the result had noted in pre-designed history sheet. The data has analyzed by SPSS version II and percentage were calculated.

Results: Among 42 of total genitourinary fistula 19 cases of iatrogenic fistula were isolated after proper searching of detailed history. Among the 19 patients 11 (57.90%) patients developed fistula following total abdominal hysterectomy, 4 (21.05%) following laparotomy, 03 (15.79%) following vaginal hysterectomy with anterior colporrhaphy, and 1 (5.26%) patient developed fistula following repair of complete perineal tear. Among 11 patients with total abdominal hysterectomy, 06 were suffering from pelvic inflammatory diseases, 03 patients with fibroid uterus and of the rest 02 patients 01 with endometriosis and 01 patient with dysfunctional uterine bleeding. It was found in majority of the cases (68%) fistula developed within10 days. Among the iatrogenic genitourinary fistulas vesicovaginal type was found to be the most common (84.21%) in this study.

Conclusion: The etiology of urogenital fistula is preventable. By utilizing basic principal of surgery, all types of urinary fistula can be repair.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 28-33

Pattern of suicide in Bangladesh: A retrospective study

2023-05-25T04:23:43+00:00

Background: The most important global cause of mortality is suicide.Global suicide rates have increased 60% in the last 45 years. Unnatural death is one of the indications of social and mental health in a society.It is often neglected by researcher, health professionals, health policy makers and the medical profession.Unnatural death by suicide relates to multiple factors eg. low socio-economic condition, dowry system, lack of education, failure of love, poverty etc. Shooting, hanging and stabbing are a hard way of committing suicide and typically a male choice.Poisoning and drowning are soft way of committing suicide and typically a female choice. This article was aimed to find out the pattern and demography of suicidal death.

Materials and method: To find out the pattern of suicidal death, a retrospective data was collected from the records of Forensic Medicine Department in Sir Salimullah Medical College, Dhaka for the period of 1 year from January 2021 to December 2021.

Objective: The objective of this study was to find out pattern and demography of suicidal death, its distribution according to age, sex, common method used by victims and in this way try to identify the causative factors and develop the preventive measures that are essential to reduce suicidal death.

Results: The commonest methods of committing suicide were found hanging which was 60.3%, followed by poisoning 26%, burn 1.34%. Most of the victims (25%) were from the age group 1-15 years. Out of 328 cases 170 (52%) were male and 158 (48%) were female. Among them 196 (59.8%) were married and 132 (40.2%) were unmarried. Most common poison was Organo Phosphorus Compound (OPC).

Conclusion: To reduce the number of suicide a well designed and comprehensive program is needed which will identify the causative factors and which might help in prevention of suicide.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 34-38

Pyogenic granuloma: Clinicopathological and treatment scenario in Rajshahi Medical College Hospital

2023-05-25T04:27:58+00:00

Background: Oral pyogenic granuloma is a soft-tissue lesion of the oral mucosa. This lesion has a tendency to recur after surgical excision.

Materials and Methods: A total of 35 patients underwent surgical excision of pyogenic granuloma in the period from January 2019 to June 2022. Two surgical techniques were used to remove pyogenic granuloma: simple excision with root planing and modified excision with deep curettage.

Results: Females (54%) were slightly more predominant than males (46%). The upper and lower jaws were almost equally affected by the lesion with more predilection toward the posterior region. The size of the lesion ranged from 0.5 to 3 cm in diameter with slow-growing rate. Rural residents were more affected (57%) than urban people. The lesion appears clinically as a small red mass with sessile base, and these clinical features were similar in pregnant and nonpregnant women. The recurrence rate was 14.8% and seen only in patients treated by simple excision. Histopathological feature was consistent with inflammatory hyperplastic lesion, and there was no radiographic evidence of bone resorption associated with the lesion.

Conclusion: Modified excision with deep curettage prevents the recurrence of the lesion after 1-year follow-up.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 39-43

Effectiveness of topical tacrolimus treatment in vitiligo patients

2023-05-25T04:40:05+00:00

Background: Vitiligo is an acquired, pigmentary skin disorder that is disfiguring and difficult to treat. Phototherapy and the application of topical corticosteroids are most commonly prescribed. However, these therapies are often not effective and the use of corticosteroids on the face may lead to cutaneous atrophy, telangiectasia, and ocular complications.

Objective: To evaluate the effectiveness of topical tacrolimus treatment in vitiligo patients.

Materials and methods: This prospective, randomized control trial study was conducted among the patients who sought health care in the Dermatology and Venereology out patient department of KYAMC, Enayetpur, Sirajgonj from August 2021 to July 2022. The study was conducted with a view to evaluate the efficacy of topical tacrolimus in vitiligo and to see the adverse effects of topical tacrolimus in the treatment of vitiligo.

Results: This study shows 70 patients were enrolled them 32 were male and 38 were female. The mean age was 28.52±10.98 years. Monthly evaluations were performed. Maximum 61 patients (87.1%) achieved varying levels of repigmentation. 28 patients (40.0%) had reported up to 50% repigmentation. Sign and symptoms of erythema (8.6%) and burning (7.1%) were minimal.

Conclusion: This study revealed that tacrolimus ointment may be an effective and safe option for the treatment of vitiligo. The ease of topical self-administration with minimal side effects makes this novel immunomodulatory agent a promising addition to the therapeutic armamentarium for vitiligo.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 44-48

Management of ST Elevation Myocardial Infarction in a 17 years Girl in A Tertiary Care Hospital

2023-05-25T04:40:44+00:00

Background: Worldwide, myocardial infarction (MI) is an important cause of death. Number of AMI among young adult is increasing day by day in Bangladesh. Acute MI occurs most commonly at an older age. However, the incidence of acute MI in adolescents is increasing. This is partly due to an increase in cardiovascular risk factors (e.g. smoking, unhealthy diet), which might lead to premature atherosclerosis. However, several non-atherosclerotic causes of MI in adolescents are also described in the literature, such as vascular spasm due to the use of cocaine, amphetamine etc. We may assume that acute MI is not considered to be the most likely cause of chest pain in adolescents. Therefore, the risk of a dramatic outcome in this patient category may be significant. Myocardial infarction (MI) in the young (age < 45 years) is a significant problem; however, there is a scarcity of data on premature coronary heart disease and MI in the adolescent patients. MI in adolescents (age between 10–19 years) is extremely rare.Premature AMI, particularly in the setting of obstructive CAD and/or female sex, is an aggressive disease with high rates of recurrence and mortality, attributed largely to suboptimal control of modifiable risk factors.1 Collet et al2 reported that 1 in 3 patients with premature (≤45 years of age) CAD, of whom the majority experienced AMI, had at least 1 recurrent event over a follow-up period of 20 years. Strong independent predictors for recurrent events were persistent smoking, diabetes, hypertension. We present a case of the 17-year-old girl with extensive ST-segment elevated anterior wall myocardial infarction and found to have complete thrombotic occlusion of proximal left anterior descending coronary artery.

Central Medical College Journal Vol 6 No 1 January 2022 Page: 49-53