IAHS Medical Journal

Desire of Women during Intrapartum Care

2023-06-17T08:23:01+00:00

Abstract not available

IAHS Medical Journal Vol 5(2), Dec 2022; 1

Aetiology and Risk Factor Analysis of Patients with Chronic Pancreatitis Admitted in a Tertiary Hospital

2023-06-10T05:44:24+00:00

Background: Chronic pancreatitis is defined as a continuing inflammatory disease of the pancreas characterized by irreversible morphologic changes that typically cause pain and/or permanent loss of both exocrine and endocrine function. Chronic pancreatitis can result from episodes of acute pancreatitis of any cause, most commonly in those with multiple relapsing episodes of acute pancreatitis. The objective of our study is to determine the aetiology and risk factor in chronic pancreatitis patients admitted in the hospital.

Materials and methods: A retrospective observational study was conducted in the Department of Medicine, Maa- Shishu-O-General Hospital, Chattogram from July 2020 to September 2022. Total 29 patients were selected, as presenting in Medicine Department with documented presentation. All data were taken meeting exclusion criteria and analysed.

Results: Mean age, weight, waist circumference and BMI is 35.6 year, 57 kg, 32 cm and 24.5 respectively. Almost 2/3 of the patients admitted from urban area and mostly belong to average socioeconomic groups and male are little bit more affected n=15, 51.7%. Maximum cases were non alcoholic n=18, 62.1%. and found raised Triglyceride n=10, 34.5%. Pancreatic calcification found in significant cases n=14, 48.3%.

Conclusion: Chronic pancreatitis is one of the common causes of recurrent abdominal pain. Malnutrition and hypertriglyceridimia is the commonest cause in our country and abdominal x-ray have dramatic role in diagnosis and prognosis also.

IAHS Medical Journal Vol 5(2), Dec 2022; 2-5

Evaluation of Vacuum Assisted Wound Closure and Conventional Wound Closure In Contaminated Major Surgical Wound

2023-06-10T06:18:37+00:00

Background: Surgical Site Infections (SSI) increase costs, hospital stay, morbidity, and mortality. Vacuum-Assisted Closures (VAC) system has been gaining popularity recently in managing wounds to reduce SSI. But the current guidelines do not recommend its routine use for surgical wounds. This study aimed to compare the effectiveness and safety of VAC with conventional wound closure techniques for preventing SSIs in the major contaminated surgical wound.

Methods and materials: Sixty patients with a contaminated surgical wound from the Department of Surgery and Department of Casualty of Chittagong Medical College Hospital were randomized in a 1:1 ratio to receive either VAC (Using Romovac device) or conventional wound closure. The primary endpoint was the rate of uncomplicated wound healing, defined as a Southampton wound score of <2 at 30 days postoperatively. Secondary outcomes include duration of hospital stay and other complications (Defined by the Clavien-Dindo Classification). The primary analysis was an intention-to-treat analysis performed with a Chi-square test.

Results: There were no significant differences in mean age, sex, body mass index, smoking history, wound class, indication for surgery and duration of surgery between the two groups. At 30 days postoperatively, 29 (96.3%) of 30 patients undergoing VAC had uncomplicated wound healing compared to 13 (43.6%) in the conventional closure group (p<0.001). Most patients (26/30, 86.6 %) in the VAC group experienced Clavien-Dindo grade I or II complications. In contrast, in the conventional closure group, 28 (93.3%) patients developed Clavien-Dindo Grade III or IV complications (p<0.001). The mean length of hospital stay was significantly shorter in the VAC group than in the conventional closure group (12.2±3.59 versus 29.07±10.36 days, p<0.001).

Conclusion: VAC resulted in favourable wound healing with less complication and shorter hospital stay than the conventional technique for the closure of the contaminated surgical wound.

IAHS Medical Journal Vol 5(2), Dec 2022; 6-10

Outcome of Early Versus Delayed Laparoscopic Cholecystectomy in Acute Calculus Cholecystitis

2023-06-10T06:44:43+00:00

Background: The timing of cholecystectomy for acute cholecystitis has been debated with most studies favoring early cholecystectomy. However, most surgeons in Bangladesh prefer to delay surgery in the acute phase. The study aimed to compare between early Laparoscopic Cholecystectomy (LC) with that of delayed laparoscopic cholecystectomy in the management of acute calculus cholecystitis.

Materials and methods: This quasi-experimental study included a total of 74 patients with a diagnosis of acute calculous cholecystitis as per Tokyo guideline from the Surgery Department, Chittagong Medical College Hospital, during August 2019 to July 2020. Thirty-seven patients underwent early cholecystectomy (Within 7 days of onset of symptoms) and 37 patients underwent elective or delayed cholecystectomy (After a gap of 6-8 weeks from the acute attack). Peroperative events, postoperative complications, length of hospital stay and days needed to return to full activity were compared between two groups.

Results: Both early and delayed groups were similar in-terms of their baseline demographic and clinical characteristics. Significantly higher number of patients in the early group had difficult Callot’s triangle dissection (59.4% vs. 27.1%, p<0.01) and lower number of patients had difficult gallbladder bed dissection (5.4% vs. 37.8%, p<0.001) than the delayed group. The proportion of the patients required conversion to open surgery was 10.8% and 6.1%, respectively in early and delayed group (p=0.691). Total hospital stay was shorter in the early surgery group than the delayed surgery group (6.05±0.52 vs. 12.03±1.46 days, p=0.001). Wound infection, duration of hospital stays following surgery, and days need to return to full activity after surgery was similar between two groups.

Conclusion: Early cholecystectomy is feasible and safe for acute cholecystitis and is better method of treatment because of its shorter hospital stay, which is a major economic benefit to both the patient and health care system.

IAHS Medical Journal Vol 5(2), Dec 2022; 11-14

Comparative Study of Short-Term Outcome between Laser Hemorrhoidoplasty and Milligan-Morgan Hemorrhoidectomy

2023-06-10T13:36:59+00:00

Background: Due to the fear of postoperative pain and complications associated with open Milligan-Morgan (MM) surgery, mildly symptomatic patients often hesitate and delay undergoing surgical treatment for internal haemorrhoids. Laser Hemorrhoidoplasty (LHP) has been gaining popularity recently in the management of hemorrhoid. This study aimed to evaluate the efficacy of the LHP compared with MM surgery in the management of internal haemorrhoids.

Materials and methods: This multi-center, open label, randomized controlled trial included 60 patietns with secondand third-degree internal haemorrhoids. The patients were randomized in a 1:1 ratio to receive either LHP (Group I) or conventional MM hemorrhoidectomy (Group II). Primary outcome parameter was postoperative pain assessed by Visual Anlougue Scale (VAS) at 24 hours, 7 days and 30 postoperative days.

Results: Both the groups were comparable in terms of the demographic characteristics. The mean operation time was significantly lower in group I than group II (19.13±3.42 vs. 28.67±4.54 minutes, p<0.001). The mean VAS score of pain at 24 hours and 7 days postoperative were significantly lower in group I than in group II (p<0.001 and p<0.004, respectively). At postoperative, 30 days the mean VAS scores were similar in both groups (p=0.722). The mean total days of consumed analgesic were significantly shorter in group I than in group II (7.94±5.79 vs. 11.01±2.96 days, p<0.001). The mean time to return to regular activity was significantly earlier in group I than in group II (8.76±3.58 vs. 13.6±3.47, p<0.001). Postoperative bleeding was less in group I than in group II (6.6% vs. 26.7%). The mean length of hospital stay, rate of complete resolution and need for medical treatment for residual symptom and repeated surgery were similar between two groups.

Conclusion: LHP was associated with reduction of postoperative pain, postoperative bleeding, and administered with analgesics. So, if available LHP is preferred to open hemorrhoidectomy.

IAHS Medical Journal Vol 5(2), Dec 2022; 15-19

Clonazepam Versus Diazepam as Sedative in Elective Caesarean Section Under Spinal Anaesthesia

2023-06-10T13:59:29+00:00

Background: Regional anaesthesia has become an important anaesthetic technique now a days. The use of spinal anaesthesia is often limited by the unwillingness of patients to remain awake during surgery. Pharmacologically induced tranquility improves acceptance of regional technique. This study compares Clonazepam and Diazepam in terms of onset and recovery of sedation, haemodynamic effects and adverse effects of both the drugs during elective caesarian section under spinal anaesthesia.

Materials and methods: This randomized clinical trial included 60 ASA (American Society of Anaesthesiologists) grade I patients between age 20-40 years undergoing elective Caesarean sections under spinal anaesthesia during the period of January 2022 to June 2022. Patients were randomly allocated to one of two groups: Clonazepam group (Group C, n=30), who received Clonazepam in a single dose of 0.015mg/kg and Diazepam group (Group D, n=30), who received Diazepam in a single dose of 0.15mg/kg.

Results: There was no significant difference of mean blood pressure and mean heart rate between the two groups (p>0.05). Time of onset and duration of sedation was comparable between the two groups (p value 0.759 and 0.652 respectively). Percentage of patient satisfaction was comparable between the two groups(80% vs 86.66%, p value 0.841). Incidence of pain in arm during drug administration was significantly more in Diazepam group (10% vs 100%, p<0.001).

Conclusion: Both Clonazepam and Diazepam have satisfactory haemodynamic stability and sedation characteristic in single dose technique during spinal anaesthesia for caesarean section.

IAHS Medical Journal Vol 5(2), Dec 2022; 20-24

Knowledge, Perception and Practices of Teledentistry among The Dentists during COVID-19 Pandemic

2023-06-11T12:11:54+00:00

Background: Virtual dentistry practices, when implemented correctly, reduce the burden on healthcare systems by preventing COVID-19 and asymptomatic carriers from infecting healthcare professionals and high-risk employees. This study was carried out to evaluate the perception and state of teledentistry practices among the dentists during COVID-19 pandemic.

Materials and methods: A descriptive cross-sectional study was conducted among 218 dentists through a semistructured questionnaire to evaluate the state of teledentistry practices among 6 dental colleges and hospitals in Dhaka City.

Results: Most of the dentists (87.2%) mentioned that teledentistry practice increased during COVID-19 pandemic and it has reduced the spread of infection. Majority recommended teledentistry is a good tool for oral hygiene instruction (72.5%) but couldn’t provide accurate diagnosis (73.9%). One fourth of the respondents (26.1%) prescribed medicine virtually and others prefer providing health education and counseling only. There are some barriers during practicing teledentistry such as poor audio or audio-video quality, expensive set-up, accurate diagnosis provision and difficulty to use software.

Conclusion: Teledentistry isn't intended to replace traditional methods of treatment that involve patient examination, but rather to provide a new way to practice healthcare. Dentists should be encouraged to practice virtual health education tool which may lower the cost burden, overcrowding and spread of COVID-19.

IAHS Medical Journal Vol 5(2), Dec 2022; 25-28

Prevention of Postoperative Nausea and Vomiting after Abdominal Surgery : Aprepitant/Dexamethasone Versus Mirtazapine/Dexamethasone

2023-06-11T12:18:42+00:00

Background: Patients having elective abdominal surgery under general anesthesia often have Postoperative Nausea and Vomiting (PONV). In this study the main goal is to evaluate the outcome of Aprepitant/Dexamethasone (A/D) combination vs Mirtazapine/Dexamethasone (M/D) combination vs Dexamethasone (D) alone for prevention of PONV in individuals after abdominal surgery.

Materials and methods: This cross sectional study was carried out at tertiary medical hospital from January 2021 to January 2022. Where a total of 150 patients scheduled for abdominal surgery were randomly allocated to receive 8 mg dexamethasone Intravenous Infusion (IVI) only in the D group or in addition to 80 mg aprepitant capsule in the A/D group or in addition to 30 mg mirtazapine tablet in the M/D group. In each 50 patients divided to each group. Assessment of PONV was carried out at 0–2 h (Early) and 2–24 h (Late). The primary outcome was the complete response 0-24 h after surgery. Collective PONV, postoperative pain, side effects and patient satisfaction score were considered as secondary outcomes.

Results: Majority of the study populations belonging to 41-50 years age group (65%) and 60% of them were male. In concordance to that, the intraoperative variables of duration of surgery and mean given intravascular fluid volume were comparable between groups. In the early postoperative period (0–2 h), there was a statistically significant difference between the A/D group and the D group in the number of vomiting episodes with comparable efficacy between the A/D and M/D groups. There were no statistically significant differences between the studied groups regarding nausea episodes, collective PONV, rescue antiemetic usage, and the number of patients exhibiting a complete response. Pain score at (0–2 h) was significantly higher in the D group in comparison to the A/D and M/D groups with comparable efficacy between the A/D and M/D groups (p < 0.001). The rescue analgesic doses were significantly higher in the D group compared to the A/D and M/D groups with statistically significant differences between the A/D and M/D groups (p < 0.001). in addition, more patients in the A/D and M/D groups were satisfied with the PONV prevention protocol compared to the D group.

Conclusion: The combination of aprepitant and dexamethasone, as well as mirtazapine and dexamethasone, has been proven to be more effective than dexamethasone alone in reducing postoperative nausea and vomiting in critically ill patients following abdominal surgery.

IAHS Medical Journal Vol 5(2), Dec 2022; 29-33

Evaluation of the Weightage on Dermatological Pharmacotherapy in Undergraduate Pharmacology Education of Bangladesh

2023-06-11T13:05:31+00:00

Background: The aim of pharmacology education is to make graduate competent enough to prescribe safely and effectively. So it is expected that pharmacology education would incorporate all the important aspects of prescribing. Skin diseases are associated with a considerable disease burden in Bangladesh and mostly treated in primary care settings by junior doctors.

Materials and methods: This descriptive cross-sectional study was conducted to analyze the undergraduate pharmacology curriculum and written question papers (SAQ) of MBBS curriculum of 07 different universities (Bangladesh University of Professionals, University of Dhaka, University of Chittagong, University of Rajshahi, Shahjalal University of Science and Technology, University of Science and Technology, Chittagong and Gono Bishwabidyalay) of Bangladesh in last 10 years (January 2010 to November 2019). The evaluation was conducted through searching certain key phrases.

Results: In Pharmacology & Therapeutics portion of the MBBS curricula, there was not a single hour to teach dermatological pharmacotherapy. Highest presence of dermatological pharmacotherapy related question was observed in Bangladesh University of Professionals (BUP) followed by University of Rajshahi (RU).And statistically significant difference (p<0.00001) was observed among seven universities.

Conclusion: Current study revealed negligible presence of dermatological pharmacotherapy in undergraduate pharmacology education of Bangladesh over 10 years period.

IAHS Medical Journal Vol 5(2), Dec 2022; 34-37

Pattern of Psychiatric Admissions in Private Psychiatric Hospitals in Chattogram

2023-06-11T13:53:53+00:00

Background: Globally, psychiatric disorders have become an alarming issue. Nowadays, it is highly recognized among the population of Bangladesh. Around 970 million people suffer from various psychiatric disorders and depression is the 4th leading cause of disability worldwide. They immensely contribute to the global burden of diseases. This study determines admission patterns among patients with psychiatric disorders in private psychiatric hospitals in Chattogram.

Materials and methods: Between July 2021 and June 2022, a cross-sectional study was conducted at Mononibash (A Specialized Psychiatric Hospital) and Chattogram Manoshik Hospital. Purpose sampling method was used and a total of 150 participants included those aged between 13 to 83 years. A semistructured questionnaire was imposed to obtain socio-demographic and other relevant clinical information from patients and attendants. The diagnosis was based on clinical interviews using the Standardized Diagnostic Statistical Method (DSM-V).

Results: Among 150 patients 94 (62.67%) were male and 56 (37.33%) were female. In the age group of 21 to 40 years (60%), psychiatric disorders were highly prevalent. The most common psychiatric disorders were Schizophrenia (53.33%), Bipolar affective disorder (24.67%), Brief psychotic disorder (10%), Major depressive disorder (4%), Personality disorder (3.33%), Conduct disorder (1.33%) and other related disorders (2%).

Conclusion: These results can help to improve diagnosis, treatment services, prevention of psychiatric disorders, and mental health promotion. Well-designed epidemiological and clinical research is needed to improve and ensure comprehensive healthcare delivery for psychiatric patients.

IAHS Medical Journal Vol 5(2), Dec 2022; 38-41

The Association between Dyslipidemia and Psoriasis in Bangladeshi People: A Cross-Sectional Study

2023-06-11T14:05:46+00:00

Background: Psoriasis-related inflammation is linked to dyslipidemia, a significant risk factor for cardiovascular disease. Recognizing the link between psoriasis and dyslipidemia may significantly impact the treatment. This research is to find the association between psoriasis and dyslipidemia among Bangladeshi people.

Materials and methods: A cross-sectional study was conducted in Delta Medical College and Hospital during the period of June 2021 and May 2022. 170 patients with psoriasis were selected aged between 30-50 years of both sexes. Lipid profile test was done for the study populations. After overnight fast, the patients were asked to return early morning and 3 cc of blood of them send to laboratories. Data were processed and analyzed with the help of the Microsoft Office Excel Software.

Results : Among 170 psoriasis patients, 52.94% were from the capital city Dhaka, and about 47% were from the rest of the country. From the Lipid Profile Test (Serum) test, 37% of individuals with psoriasis had dyslipidemia.

Conclusion : This research found that psoriasis patients were at increased risk for dyslipidemia. For this reason, it is crucial to regularly check blood lipid levels in all psoriatic patients to detect dyslipidemia and its potential consequences at an early stage.

IAHS Medical Journal Vol 5(2), Dec 2022; 42-45

Predicting Role of the Appendicitis Inflammatory Response Score in Diagnosis and Risk Stratification of Acute Appendicitis among Adult Patients

2023-06-11T14:36:41+00:00

Background: Appendicitis is a global disease. Understanding the global evolution of appendicitis in highly industrialized countries and in newly industrialized countries is necessary for planning healthcare resource utilization. Scoring systems have been designed to aid in the clinical assessment of patients with acute appendicitis. The recently introduced Appendicitis Inflammatory Response (AIR) score was designed to overcome these drawbacks. This simple clinical score can correctly classify the majority of patients with suspected appendicitis. To evaluate the AIR score on patients with suspicion of acute appendicitis and its risk stratification and assess the sensitivity and specificity of the AIR score.

Materials and methods: This descriptive of observational study was carried out in the Department of Surgery, Chittagong Medical College Hospital, Chattogram from 21st March to 20th September 2017. Total 100 cases of appendicitis patients were selected after careful history taking, thorough general and local examination and appropriate investigations fulfilling inclusion and exclusion criteria.

Results: The present study of 100 selected cases reveals that maximum number of patients (54.0%) were between 15-25 years age group, mean age of appendicitis was 24.5±8.9 years. The sensitivity and Specificity of the Appendicitis Inflammatory Response Score (AIR score) in diagnosis and risk stratification of acute appendicitis was 85.2% and 96.9% respectively. Similarly, the positive predictive value and accuracy rate for the same is 93.5 % and 93.0% respectively.

Conclusion: Through associating easily applicable clinical criteria and two simple laboratory tests AIR score help in diagnosis and risk stratification of suspected appendicitis and could guide decision-making to reduce admissions, optimize utility of diagnostic imaging and prevent negative explorations.

IAHS Medical Journal Vol 5(2), Dec 2022; 46-51

Risk Factors for Acute Ischaemic Stroke in Young Adults in Armed Forces Medical Institute of Dhaka

2023-06-11T15:45:45+00:00

Background: Stroke is a leading cause of death and disability in developing countries, afflicting individuals at a young age. The affection of economically productive group adds further to the overall disease burden. The contribution of established vascular risk factors to ischaemic stroke in young adults has not been evaluated systematically in CMH, Dhaka Cantonment. The purpose of the study is to detect the risk factors for acute Ischaemic stroke in adults.

Materials and methods: The case-control study was carried out in the department of Neurology and Medicine, CMH Dhaka during October 2019 to August 2020. Consecutive ischemic stroke patients who met the inclusion criteria and were hospitalized in the Department of Neurology and Medicine at CMH Dhaka were included in the study.

Results: The mean age of young patients with ischaemic stroke was 40.1 (SD± 6.6) years (Range 17-45 years). There were 40 (59.7%) male and 27 (40.3%) female with ratio of male to female was 1.5:1. Risk of acute ischaemic stroke was 2.7 times higher in smoker [36 (53.7%) vs 20 (29.9%) OR=2.7, 95% of 01=1.34-5.55, p<0.01] 2.4 times higher in diabetic [23 (34.3%) vs 12 (17.9%), OR=2.4, 95% of 01=1.07-5.35, p<0.05], 2.6 times higher in hypertensive patients [27 (40.3%) vs 14 (20.9%), OR=2.6, 95% of 01=1.19-5.49; p<0.05], 4.2 times higher in patients with atrial fibrillation [11 (16.4%) vs 3 (4.5%)]. The mean BMI of the respondents was 21.8 (SD± 3.3) Kg/M2 in stroke patients of young and was 22.3 (SD 2.9) Kg/M2 in control group (p>0.05).

Conclusion: Ischemic stroke in young patients has wider risk factors. Hypertension, diabetes mellitus, smoking and atrial fibrillation are the most common risk factors of acute ischemic stroke in young adults. Early identification of risk factors and proper prevention, treatment and life style modification may reduce the morbidity and mortality in young stroke patients.

IAHS Medical Journal Vol 5(2), Dec 2022; 52-57

Lens Thickness and Associated Factors among Age-Related Cataracts Patients in Chattogram, Bangladesh

2023-06-17T06:27:41+00:00

Background: Lens Thickness (LT) is one of the important parameters in ocular biometry. The observation of LT among cataract patients is of great importance from clinical and pathophysiological perspectives. The study aimed to investigate the relationship between the LT and lens density changes concerning age, types and densities of agerelated cataracts in a sample of the Bangladeshi population.

Materials and methods: It is a prospective observational case control study. A total of 2066 (n = 2066) participants were included in the study from an Eye Hospital in Chattogram, Bangladesh. All participants underwent standard vision testing. LT was evaluated using the immersion technique with A-scan ultrasound. The types and density of cataracts were identified with a slit-lamp attached to a video camera. Cataract was classified morphologically into cortical, nuclear, and posterior sub-capsular types. Nuclear cataract was observed under oblique illumination, and retro-illumination was used to assess cortical and posterior sub-capsular cataracts. The density of the lens nucleus was graded as Emery and Little classification.

Results: Ages of the study population ranged from 40-95 years, with a mean age of 62.76 ± 9.43 years. Of the participants, 937 (45.4%) were males and 1129 (54.6%) were females. The mean LT was 4.15±0.86mm. The LT was greater in older (³60 years) patients than in the younger (41-59 years) (4.21±0.85mm versus 4.01±0.86mm, p < 0.001). The mean LT in male and female patients were, respectively, 4.18±0.89mm and 4.12±0.84mm with any statistical significance (p<0.097). The mean LT was the highest in nuclear cataracts (4.79 ± 0.39mm), followed by cortical (3.9 ± 0.73mm) and posterior sub-capsular cataracts (4.16 ± 0.93mm). The relation between LT and the Grade of cataract was insignificant (p<0.078).

Conclusion: In this large Bangladeshi age-related cataractous population, we found that thicker lenses are associated with older age and nuclear cataracts.

IAHS Medical Journal Vol 5(2), Dec 2022; 58-61

Antenatal Care Practice and Reasons for Spontaneous Vaginal Delivery at Homein Rural Bangladesh : A Synopsis

2023-06-17T06:58:14+00:00

Background: In the last decade Bangladesh has made significant progress in reducing maternal and child mortality. Still, spontaneous vaginal delivery at home and neglected Antenatal Care (ANC) practice is evident among women of reproductive agein the rural communities.Home delivery assisted by skilled attendants has not reached the expectation. Present study was aimed to evaluate the status of antenatal care practice and the underlying causes of preference of for spontaneous vaginal delivery at home among the rural people.

Materials and methods: A descriptive cross-sectional study was conducted over a period of one year (January 2019 December 2019) in selected villages of Feni and Chattogram district. 312 respondents, who were married women in reproductive age (15 – 49 years) and had at least one delivery experience, were interviewed face-to-face by using of a pre-tested mixed questionnaire. Collected data were presented and analyzed by SPSS version-23 software.

Results: Majority 67.95% of the respondents attended hospital or clinic for ANC while 32.05% of them didn’t perform it. 68.60% respondents preferred spontaneous vaginal delivery at home and only 31.40% of them preferred institutional delivery. The respondents 51(23.83%) didn’t prefer institutional delivery due to financial matter.

Conclusion: Adequate coverage of ANC yet remains poor and women’s attending these services had faced significant gaps in the content of ANC in rural Bangladesh. To reduce maternal mortality, access to health facility for pregnant mothers and inclusion of skilled birth attendants, strengthening the health system is necessary to make birth safer for both mothers and newborns.

IAHS Medical Journal Vol 5(2), Dec 2022; 62-66

Thyroid Hormone Status of School Going Children in An Urban Area of Chattogram, Bangladesh

2023-06-17T07:10:25+00:00

Background: Thyroid gland is the endocrine organ that secretes hormones namely, Triiodothyronine (T3) and Thyroxine hormone (T4). T3 and T4 are released in relation to the message of tropic hormone TSH, by the anterior pituitary. Absences as well as excess of thyroid hormones have harmful impacts on the overall health condition like physical and mental impediment. Poor intelligence leading to poor academic performance is frequently observed in hypothyroid children. The study was aimed to estimate serum T3, T4 and TSH levels of a group of school going children in urban area of Chattogram, Bangladesh.

Materials and methods: This cross-sectional observational study was conducted among school going children (Age: 7-12 years) of Chattogram city between January, 2022 and June 2022. Chattogram based three schools were selected by convenient sampling. A total of 500 blood samples of children were collected and serum T3, T4 and TSH levels were measured. Estimation of T3 and T4 were done by Radioimmunoassay (RIA) and estimation of TSH was done by Immunoradiometric assay (IRMA) in the in Vitro laboratory.

Results: Among 500 children, the estimated mean ±SD serum T3 hormone level was2.46±0.79 (Range: 1.27-5.51) nmol/L, mean ±SD serum T4 hormone level was 141.99±32.77 (Range: 86.21-239.05) nmol/L and mean ±SD serum TSH hormone level was 1.58±1.04 (Range: 0.30-3.02) mIU/L.

Conclusion: Thyroid hormone status of the study group children was found within normal limits. However, regular screening of children is suggested to identify the subclinical and unreported clinical cases, so that theiroptimum growth and development are ensured.

IAHS Medical Journal Vol 5(2), Dec 2022; 67-69

Congenital Adrenal Hyperplasia: A Case Report

2023-06-17T08:16:05+00:00

Background: Congenital Adrenal Hyperplasia (CAH) in children varies in presentation and progression with several challenges in optimal management. Effective treatment is to achieve normal growth and development while avoiding adrenal crisis and hyperandrogenisation though achieving the balance between over treatment and undertreatment remains challenging.

Case Presentation: A 24 days old male child presented with repeated vomiting, severe weight loss and had decreased level of activity since 7 days of age. After total clinical, radiological, pathological evaluation it was diagnosed as congenital adrenal hyperplasia.

Conclusion: The approach to its diagnosis and management was a combined multidisciplinary effort of the Departments of Pediatrics, Endocrinology and Pathology.

IAHS Medical Journal Vol 5(2), Dec 2022; 70-73