Journal of Rangpur Medical College

Surgical Management and Short-Term Outcome of Patients with Posterior Fossa Tumor in All Age Groups: Our Perspective

Sun, 05 May 2024 00:00:00 +0000

Background: Different types of brain tumor can occur in the region of posterior fossa. Ependymoma, medulloblastoma and pilocytic astrocytoma occur mostly in children and rarely in adults. Brain metastases in adults are the most common malignancies at this site. Other tumors that occur in the posterior fossa are meningioma, schwannoma, hemangioblastoma, brain stem glioma and epidermoid tumors. Posterior fossa tumor has different treatment approaches and prognosis. So, an accurate diagnosis, surgical approaches, complication analysis and outcome assessment are mandatory. Objective: To evaluate the clinical aspects, surgical approach, role of preoperative shunt, post-operative complications, and short-term outcome of patients with posterior fossa tumor in different age groups. Methods: This cross-sectional observational study included 36 patients with posterior fossa tumors that were admitted and operated in the Neurosurgery Department of Rangpur Medical College Hospital between the period of November 2018 and June 2022. In each patient clinically diagnosis was confirmed by MRI of Brain with contrast followed by histopathology. Results: Out of 36 patients, 23(63.9%) patients were male and 13(36.1%) were female. Mean age was 18.01±13.95 SD years (minimum 6 months and maximum 45 years), more common in pediatric age group (36.1% <10 years and 25% between 11-20 years). Common presentations were headache (91.6%), vomiting (83.3%) and ataxia (72.2%). Medulloblastoma (27.8%) and ependymoma (25%) were common histological types. Surgical outcome was excellent in 17 cases (47.2%), while poor in 5.6% and 19.4% patients died. There was no statistically significant association of surgical outcome with age (p=0.148) and sex (p=0.170). Suboccipital craniotomy was superior to other surgical procedures in terms of patient’s outcome (p=0.031). Ependymomas and Astrocytomas had better outcome (p=0.014). Conclusions: Surgical outcome is related to the operative approach and histology of the tumor in this study, but no significant association of patient’s outcome with age, sex and preoperative procedure.

J Rang Med Col. March 2024; Vol. 9, No. 1: 3-9

Clinical and Laboratory Predictors of Mortality in Pediatric Patients with Severe Dengue at Dhaka Shishu Hospital

Sun, 05 May 2024 00:00:00 +0000

Background: Dengue fever, particularly in its severe form, poses a significant health challenge in tropical regions like Bangladesh. Understanding the clinical and laboratory predictors of mortality in pediatric patients with severe dengue is crucial for improving management strategies and patient outcomes. Methods: This cross-sectional analytical study was conducted at the Department of Pediatrics, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh, from January 2019 to December 2020. It included 300 pediatric patients diagnosed with severe dengue. Results: Of the 300 participants, 286 (95.33%) survived, while 14 (4.67%) succumbed to the disease. Major bleeding, refractory shock, a significant rise in hematocrit, signs of pleural effusion, and ascites were significantly associated with mortality. Hematologically, a low platelet count (<15000/mm3) was a strong predictor of mortality. Elevated serum ferritin levels (>500 micrograms/L) were also significantly associated with increased mortality risk. Conclusions: The study highlights major bleeding, refractory shock, significant hemoconcentration, pleural effusion, ascites, low platelet count, and high serum ferritin levels as key predictors of mortality in pediatric patients with severe dengue. These findings underscore the need for comprehensive clinical monitoring and targeted management strategies to improve outcomes in pediatric dengue patients.

J Rang Med Col. March 2024; Vol. 9, No. 1:10-15

Pattern of Breast Cancer in Women at Child-bearing Age, its Risk Factors and Clinicopathological Evaluation in Tertiary Level Hospital

Md Rasedul Haque, Md Amzad Hossain — Sun, 05 May 2024 00:00:00 +0000

Background: Carcinoma breast is the leading cancer in female in Bangladesh, increasing significantly due to urbanization and adoption of western life style. Objective: This study aimed to systematically understand the pattern of breast cancer, its risk factors and clinicopathological evaluation in women at their childbearing age. Methods: A cross sectional observational study, data was collected from 50 patients of histopathologically confirmed breast cancer in the department of Surgery, Combined Military Hospital, Dhaka from 2022 to 2023. Results: The majority of the cases were 41-45(42%) years age with mean presentation was 43.55 (SD-/+9.63) years. Invasive ductal carcinoma was the most common subtype 86%, followed by ductal carcinoma in situ (8%). Of the cases 2% were nullipara and 46% had two children. Median age of at 1st birth was 21 years. A significant proportion (16%) had family history of breast cancer. 98% patients gave history of breast feeding. Conclusions: Breast cancer is increasingly occurring in younger age groups in Bangladesh, results suggested a mixture of different factors in women like age of menarche, age of first child birth, parity, history of breast feeding and family history poses higher risk for breast cancer.

J Rang Med Col. March 2024; Vol. 9, No. 1:16-21

Vitamin D and it’s Association with FokI VDR Polymorphism in Patients with Asthma-COPD Overlap

Sun, 05 May 2024 00:00:00 +0000

Background: Asthma-COPD overlap is a new phenotype in respiratory ailments. It has been shown that this group of patients might possess vitamin D3 deficiency. The association of vitamin D receptor (VDR) gene polymorphism with serum vitamin D status in ACO patients has not been investigated yet. Objective: To assess the association of VDR gene polymorphism (FokI) with serum vitamin D status in patients with Asthma-COPD overlap. Methods: This cross-sectional study was carried out in the Department of Physiology of Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2018 to July 2018 on 23 (twenty-three) patients (aged ≥40 years) with ACO. For comparison, 24 (twenty-four) apparently healthy age, smoking duration and BMI matched subjects were selected. For all participants single nucleotide polymorphism of VDR gene FokI (rs10735810) was done by DNA extraction, polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Vitamin D3 was measured by using automated analyzer: ARCHITECT Plus ci4100. The results were expressed as mean with standard error (mean±SEM) and frequency distribution. The data were statistically analyzed by Graphpad prism (Version 7) using independent sample ‘t’ test, two sample proportion test, Fisher exact test and ANOVA test. In the interpretation of results, ≤0.05 level of probability (p) was accepted as significant. Results: The mean±SEM of serum 25(OH)D were 16.37±0.78 and 18.46±1.01 ng/ml in control and study groups, respectively. The frequency distribution of FokI genotype was 86.95% (FF), 8.69% (Ff), 4.35% (ff) and 91.66% (FF), 4.17% (Ff), 4.17% (ff) in ACO patients and healthy subjects, respectively. When FoKI VDR SNP was analyzed with serum vitamin D status in patients with ACO, statistically no association was seen. Conclusions: FokI VDR SNP is not associated with serum vitamin D status in patients with ACO.

J Rang Med Col. March 2024; Vol. 9, No. 1: 22-27

Comparison of Maternal and Neonatal Complications in Women with and without Gestational Diabetes Mellitus

Sun, 05 May 2024 00:00:00 +0000

Background: Gestational Diabetes Mellitus (GDM) is a common pregnancy-related metabolic disorder associated with adverse maternal and neonatal outcomes. Gestational Diabetes Mellitus is characterized by glucose intolerance that develops during pregnancy. It affects approximately 7% of all pregnancies and has been linked to an increased risk of maternal and neonatal complications. Objective: The study was aimed to provide a comprehensive comparison of maternal and neonatal complications in women with and without GDM involving a thorough examination of medical records and clinical data to identify patterns and associations between GDM and various complications. Methods: A retrospective cohort study was conducted, including pregnant women with and without GDM who received prenatal care and underwent hospital delivery at the Department of Obstetrics and Gynecology, Enam Medical College and Hospital, Dhaka, Bangladesh from June 2022 to June 2023. Clinical data, including maternal age, gestational age at diagnosis, parity, and antenatal care were collected. Pregnancy outcomes, such as maternal complications, and live birth complications were also assessed. Result: A total of 60 pregnant women were included in the analysis, 30 were diagnosed with GDM and 30 without GDM. Analysis of pregnancy outcomes revealed a higher incidence of cesarean section deliveries in the GDM group (p<.05). Additionally, infants born to mothers with GDM had a higher risk of neonatal complications. Conclusions: Women diagnosed with GDM demonstrated distinct clinical characteristics and experienced a higher incidence of adverse pregnancy outcomes. These findings underscore the importance of effective management and close monitoring of pregnant women with GDM to optimize maternal and neonatal health.

J Rang Med Col. March 2024; Vol. 9, No. 1: 28-32

Clinical Association of Lupus Erythematosus with Patients of Vitiligo: A Case Control Study

Sun, 05 May 2024 00:00:00 +0000

Background: Vitiligo is an idiopathic acquired depigmentary skin/ mucous membrane disorder. Lupus erythematosus and vitiligo are diseases of autoimmune origin. A genetic explanation for the association between lupus erythematosus and vitiligo has recently been attempted. Objective: To find out the association of lupus Erythematosus in patients of vitiligo. Methods: This case control study was carried out in the department of Dermatology & Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of January 2023 to December 2023. A total of 180 patients with and without vitiligo from both genders and different ages for case and control groups were included in the study based on inclusion and exclusion criteria. Patients were divided into two groups, 90 patients with vitiligo as cases and 90 patients without vitiligo (healthy subjects) as controls. Wood’s lamp examination was performed for diagnosis of vitiligo. LE was diagnosed based on ACR criteria and laboratory test including Complete blood count, Urinalysis, ANA, anti-ds DNA, VDRL and Skin biopsy. Patients with lupus erythematosus and patients without lupus erythematosus were considered as group I and group II respectively. Results: In this study, the mean age was found 41.7±12.8 years in case group (Vitiligo) and 42.1±13.6 years in control group (Healthy subjects).More than half (51.1%) of the patients were female in case group and 41(45.6%) in control group. There was no significant difference was found regarding age, sex, anemia, leucopenia, thrombocytopenia, proteinuria, ANA and anti ds-DNA. Family history of vitiligo was significantly higher in vitiligo patients than healthy patients (26.7% vs 12.2%). The majority 45(50.0%) presented with generalize followed by 21(23.3) acrofacial, 13(14.4%) focal, 10(11.1%) segmental and 1(1.1%) mucosal of vitiligo. Lupus erythematosus was higher in vitiligo patients than healthy patients (4.4% vs 1.1%) but the difference was not statistically significant between the two groups (p=0.184). Conclusions: This study concluded that family history of vitiligo was significantly higher in vitiligo patients than healthy patients. Lupus erythematosus was higher in vitiligo patients than healthy patients, but not statistically significant.

J Rang Med Col. March 2024; Vol. 9, No. 1: 33-38

Evaluation of Morbidity and Mortality of Eclampsia at Brahmanbaria Medical College and Hospital

Saima Rahman, Nasima Begum, Ashik Mahmud — Sun, 05 May 2024 00:00:00 +0000

Background: Eclampsia is a severe and life-threatening complication of pregnancy, characterized by the onset of seizures in a woman with preeclampsia. This hypertensive disorder of pregnancy is associated with a range of maternal complications, presenting a significant challenge in obstetric care. Maternal complications of this nature can significantly affect both maternal and perinatal health, potentially leading to higher rates of mortality and morbidity. Objective: This study was aimed to evaluate the morbidity and mortality of eclampsia in Brahmanbaria Medical College and Hospital. Methods: This cross-sectional observational study was conducted at Brahmanbaria Medical College and Hospital, Brahmanbaria, Bangladesh, from January 2021 to December 2021. The study included 56 pregnant women with eclampsia purposively. Demographic and clinical information was recorded, and data analysis and dissemination were carried out using MS Office tools. Results: Regarding perinatal outcomes, 80% of cases resulted in live births, with a 57% survival rate. Among live births, 4% experienced post-birth mortality, and 11% faced early neonatal death. Among live births (n=45), a significant 69% experienced intrauterine growth restriction (IUGR). Maternal complications included abruptio placenta in 32% of cases, HELLP syndrome in 5%, and maternal death occurred in 5% of cases. Conclusions: Eclampsia assessment shows complex perinatal and maternal outcomes. Live births are common, but survival is challenging. High post-birth and neonatal mortality highlight newborn vulnerability. Intrauterine growth restriction (IUGR) worsens newborn health concerns. Maternal issues like abruptio-placenta, HELLP syndrome, and maternal death further complicate matters.

J Rang Med Col. March 2024; Vol. 9, No. 1: 39-43

Sociodemographic and Clinical Characteristics of Persons with Epilepsy Attending an Epilepsy Clinic of a Tertiary Hospital in Bangladesh

Sun, 05 May 2024 00:00:00 +0000

Background: Epilepsy is a common neurological disorder found in all societies. It is seen that the relative frequency of various clinically important characteristics is different in persons with epilepsy (PWE) living in different geographical areas. The purpose of this study was to describe the sociodemographic and clinical characteristics of a cohort of patients with epilepsy from an Epilepsy Clinic of a tertiary hospital in Bangladesh. Methods: This cross-sectional study was conducted in the Department of Neurology at Rangpur Medical College Hospital, Rangpur, Bangladesh, from July 2022 to June 2023. The patients were recruited from the epilepsy clinic. A structured questionnaire was designed to collect relevant information by interviewing the consecutive PWEs. Results: A total of 252 PWEs were recruited, of which 134(53.2%) were male. Most [200(79.4%)] of them were young (age group 0 to 29 years) and had generalized seizures 147(58.3%). The median age of the 1st seizure was 11 years (range 0.5-73.0), and the median duration of epilepsy was 5.0(0-35) years in the present study. EEG, CT scan, and MRI could be done in 200(79.4%), 128(50.8%), and 68(27%, respectively. Among them, 24.2%(61), 10.7%(27), and 11.1%(28) patients had different types of abnormalities on EEG, CT scan, and MRI, respectively. A family history of seizures was present in 20(7.9%) patients. Sixteen patients(6.3%) were not getting any AEDs, 63.1% and 30.6% were on single and multiple AEDs, respectively. Sixty-five (25.8%) patients reported stopping the drug without any medical consultation. Forgetfulness was the most reported (21, 33.8%) reason for stopping drugs, followed by the misconception that the disease was cured (14, 21.5%), lack of time to buy pills (12, 18.5%), and no money to buy (9, 13.8%). Seventy-seven reported having two or more continuous seizures despite taking AEDs regularly. Conclusions: Present study documented some treatment gap and non-adherence to medication in PWE. PWE should be adequately advised about the disease and the effects of drug non-compliance.

J Rang Med Col. March 2024; Vol. 9, No. 1: 44-49

Outcomes of Pregnancies in Women with Congenital Heart Disease: A Study in a Tertiary Care Hospital in Bangladesh

Hasina Akhter, Nahid Reaz Shapla, Kamrun Nahar — Sun, 05 May 2024 00:00:00 +0000

Background: Pregnancies in individuals with congenital heart disease (CHD) frequently pose complex challenges. The presence of CHD elevates the risks not only for the expectant mother but also for the well-being of the developing fetus. Additionally, careful monitoring and specialized medical care are crucial throughout the pregnancy to ensure the best possible outcomes for both. Objective: This study was aimed to assess the outcomes of pregnancies in women with congenital heart disease. Methods: This was a cross-sectional observational study that was conducted in the Combined Military Hospital (CMH), Dhaka, Bangladesh from January 2020 to December 2021. A total 30 pregnant women with congenital heart disease were enrolled through purposive sampling. All the demographic and clinical information was recorded. Data were processed, analyzed, and disseminated by using MS Office tools. Results: Among participants, Lower Segment Cesarean Section (LSCS) was the most common delivery (43.3%), followed by vaginal delivery (36.7%). Instrumental delivery, specifically through outlet forceps, was found in 6.7% of cases. Pregnancy termination occurred in 6.7% due to inevitable abortion and 3.3% for medical reasons, resulting in one maternal death (3.3%). Perinatal outcomes included 90% live births and 81.5% with Apgar scores ≥9. Neonatal Intensive Care Unit (NICU) admission was required for 33.3%, with a 3.3% perinatal death rate. Conclusions: In pregnant women with congenital heart diseases, common delivery modes are Lower Segment Cesarean Section (LSCS) and vaginal delivery. Termination and maternal fatality rates are low. Perinatal outcomes are generally positive, with most births resulting in live infants with Apgar scores ≥9 and high newborn survival rates, although some require Neonatal Intensive Care Unit (NICU) admission.

J Rang Med Col. March 2024; Vol. 9, No. 1: 50-54

Frequency of Hypocalcemia and Hypomagnesemia in Autistic Spectrum Disordered Children of Bangladesh

Shahana Parvin, Shorifa Shahzadi, Shelina Begum, Syeda Nusrat Mahruba — Sun, 05 May 2024 00:00:00 +0000

Background: Autistic spectrum disorder (ASD) in children is commonly associated with mitochondrial dysfunction and mineral deficiency. Studies have highlighted links between Ca2+ and Mg2+ deficiency and neuronal excitability, along with connections between iron deficiency and behavioral abnormalities in individuals with ASD. Objective: This study was aimed to assess the frequency of hypocalcemia and hypomagnesemia in autistic spectrum-disordered children of Bangladesh. Methods: This cross-sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2014 to January 2015. The study included 100 randomly selected male children, with 50 in a healthy control group (Group A) and 50 diagnosed with autistic spectrum disorder (Group B). Children with ASD were selected from the Parents Forum (DOHS, Mohakhali), while the control group was chosen from schools with typically developing children. Fasting serum levels of various components along with calcium and magnesium were measured, and statistical analysis was conducted using independent sample 't' tests and proportion (Z) tests, with a significance level set at p-value ˂0.05. Results: In this study, out of 50 autistic spectrum disorder cases, the frequencies of hypocalcemia and hypomagnesemia were 74% and 52%, respectively. A comparison with the control group revealed significantly higher frequencies of both hypomagnesemia and hypocalcemia in the ASD group, with p-values <0.001. Conclusions: Among most children with autism spectrum disorder in Bangladesh, hypocalcemia and hypomagnesemia are prevalent. These prevalences are significantly higher than those observed in healthy children.

J Rang Med Col. March 2024; Vol. 9, No. 1: 55-58

Comparison of Recovery Rate and Early Complications Between Primary Resection and Two-stage Operation in the Treatment of Acute Non- Complicated Sigmoid Volvulus

Sun, 05 May 2024 00:00:00 +0000

Background: This study compares recovery rates and early complications associated with primary resection and a two-stage operation in treating acute sigmoid volvulus, a gastrointestinal emergency requiring prompt intervention. Proper diagnosis and appropriate operative approaches are crucial for lifesaving treatment. Objectives: This study was aim to compair of recovery rate and early complecations between two operative procedures. Methods: The cross-sectional analytical study was conducted from May to October 2015in National Institute Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh, involved 50 patients with acute non-complicated sigmoid volvulus, randomly divided into two groups, with the outcome variable being the only difference between two groups. Results: Two stage operation patients experienced 24% stomal complications, while one stage operation patients did not experience any late complication. The mean time for one stage operation was longer, and one stage operation resulted in 200 ml blood loss compared to 156 ml in two stage operations. Conclusion: In consideration of anastomotic leakage, operative time, operative blood loss post-operative hospital stay, two stage operation was better than primary resection.

J Rang Med Col. March 2024; Vol. 9, No. 1: 59-64

Hospital Acquired Diarrhoea in Children: A Study in a Tertiary Care Hospital in Sylhet

Sun, 05 May 2024 00:00:00 +0000

Background: Children hospitalized for diseases other than diarrhoea can be infected with an enteric pathogen during their stay at hospital, which may complicate and prolongs the course of illness and hospital stay. Hospital acquired diarrhoea are defined as those occurring more than 72 hours after admission to hospital. Nosocomial diarrhoea second to nosocomial respiratory tract infections in causing morbidity among hospitalized children. Objectives: The study was designed to find the rate of hospital acquired diarrhoea, their risk factors and to observe the clinical features. Method: This cross-sectional observational study was conducted in the inpatient department of Pediatrics in Jalalabad Ragib-Rabeya Medical College, Sylhet over a period of 3 months between July to September 2018. A total number of 274 children aged from 1 month to 5 years were admitted in inpatient department other than diarrhoea were included in the study. During their hospital stay, all patients were followed up daily for development of diarrhoea. Results: Out of 274 children 80 patients developeddiarrhoea 72 hours after admission, the rate of occurrence of hospital acquired diarrhoea was 29.2%. Patients who developed hospital acquired diarrhoea, were initially admitted due to pneumonia accounted for about 65% followed by 12.5% due to malnutrition. Patients aged below two years and staying in hospital for longer duration developed diarrhoea more. Presence of any diarrhoeal patient in a bed close the patient’s bed (p=0.00001), hand washing by mother’s during handling baby (p=0.00001), hand washing by doctors (p=0.00001), and sharing the bathroom with diarrhoeal patient (p=0.000061), were statistically associated with the development of nosocomial diarrhoea. Diarrhoea was mostly watery in nature (80%) having pus (80%) and RBC (100%) on stool microscopy and patients suffered from milder dehydration (80%). Conclusions: Hospital acquired diarrhoea is common in admitted patients, which may complicate the disease course, prolonged the hospital stay.

J Rang Med Col. March 2024; Vol. 9, No. 1: 65-70

Association Between Sociodemographic Status and Physical Functioning of Obese School Going Children- A Cross Sectional Study

ABM Ariful Islam, Md Abu Zafar Al Murad, Fatema Tuj Johora — Sun, 05 May 2024 00:00:00 +0000

Background: Obesity is major non-communicable disease (NCD) all over the world affecting both children & adult. More than 30 million overweight children are living in developing countries & 10 million in developed countries. Childhood obesity leads to a significant reduction in health-related functioning. So, the negative effects of childhood obesity on quality of life (QoL) have to be determined to combat the problem. Objective: To determine the association between sociodemographic status and physical functioning of obese school going children. Methods: This was a cross sectional type of descriptive study conducted at different schools of Rajshahi city from June 2015 to September 2015. Four (4) schools were selected- a) Govt. Laboratory High School, Rajshahi b) Rajshahi Collegiate School c) River view Collectorate School, Rajshahi and d) Rajshahi University School. The study population were 5 to 15 years old obese school children. A total number of 221 children were interviewed. Results: The ages of the respondents were between 4 to 15 years, and the mean age was 7.83±3.058 years. Among the 221 respondents more than half (56.6%) were in 4-7 years of age group, another 24.0% belonged to the age group of 8- 11 years and only 19.5% were 12- 15 years age group. Weight of the respondents was from 20 to 65 kg and mean weight of the respondents was (41.64±10.75). Here, 36.2% weight was from 37-47 kg and 29.0% weight was from 26-36 kg. Another 23.1%, 7.7% and 4.1% weight was from 48-58 kg, 59-69 kg and 15-25 kg respectively. There was no significant relationship with respondent age and sex with physical functioning (p ≥ 0.05). There was a significant relationship with weight and physical functioning (p≤0.05). Conclusions: The sociodemographic status may influence the physical functioning of the obese school going children. Their lifestyle must be modified in this early life otherwise they will be affected by different non communicable disease

J Rang Med Col. March 2024; Vol. 9, No. 1: 71-76

Vitamin D status in Type 2 Diabetes Mellitus in a Tertiary Level Hospital

Sun, 05 May 2024 00:00:00 +0000

Background: There is increasing evidence of a relationship between vitamin D status and type 2 diabetes. Diabetes has also been found to be associated with 25(OH)D (vitamin D) deficiency and the role of vitamin D has recently emerged, especially in preventing cardiovascular diseases and cancer. and insulin resistance. Objective: This study aimed to compare vitamin D deficiency between healthy and Type 2 Diabetes Mellitus (T2DM) patients. Methods: This cross-sectional study was conducted from July 2021 to June 2022 in the Department of Physiology, Rangpur Medical College, Rangpur. For this study, a total number of 100 subjects were selected among them 50 non-diabetic healthy subjects were included as control and 50 Type 2 Diabetes Mellitus patients were included as cases. The subjects of control were selected from the surrounding community of Rangpur district and subjects of cases were selected from Diabetic Association and from Outdoor of Endocrinology Department, Rangpur Medical College and Hospital, Rangpur. For statistical analysis, an independent sample t-test was performed by computer-based software SPSS-23.0 version for windows. Results: The mean vitamin D level was lower in the diabetic patients than in non-diabetic participants (14.1±8.3 ng/ml and 37.3±11.3, p<0.001). Conclusions: Early screening for serum vitamin D level is recommended for T2DM patients. Hence, it is crucial to promptly address any deficiencies in vitamin D levels.

J Rang Med Col. March 2024; Vol. 9, No. 1: 77-81

Bruxism in Children

Obehi O Osadolor, Otakhoigbogie U, Aisosa J Osadolor — Sun, 05 May 2024 00:00:00 +0000

Background: Bruxism can occur in children living or residing in slums areas, rural areas, remote and urban communities. The prevalence of bruxism among children varies in the literature. Bruxism is associated with sound during teeth clenching or involuntary teeth grinding, and this can disturb parents, guardian and family members. It can be diagnosed with clinical history, clinical examinationand use of electromyography and polysomnography. Method: An electronic literature search in science direct and goggle was done in December 2023 using the Population, Concept and Context framework. Search terms and keywords were combined by Boolean operators. Two independent investigators screened titles and abstracts of publications on bruxism among children. Original (primary) research articles with accessible full text were included for review, while review articles, systematic reviews, thesis, dissertations and perspectives related to bruxism among children were among articles excluded during screening. Original (primary) research articles related to voluntary tooth clenching,other oral habits and bruxism/tooth grinding among children with special health care needs were also excludedduring screening. Results: Abstract and full texts were screened using inclusion criteria by two independent investigators. The identified study was carried out in Egypt, Ugandaand South Africa respectively. Conclusion: Bruxism can occur among children.Itcan affect the quality of life of childrenwith tooth sensitivity, tooth attrition with wear facets, and psychological concerns.More studies from diverse ethnic population and countriesin Africa countries will fill the gaps in knowledge and add to the existing literature.

J Rang Med Col. March 2024; Vol. 9, No. 1: 82-85

Pregnancy with Non-cirrhotic Portal Hypertension: A Case Report

Iffat Ara, Safura Khatun — Sun, 05 May 2024 00:00:00 +0000

Pregnancy with non cirrhotic portal hypertension is an uncommon condition. Due to physiological changes in pregnancy, the patients with portal hypertension may exaggerate and produce life threatening complicationslike variceal haemorrhage and increased incidents of adverse maternal and fetal outcomes. Pregnancy also predisposes the patient to develop hepatic decompensation. So, management of such cases requires a multi-disciplinary approach. In this case report,21-year-old primigravida presented with known case of non cirrhotic portal hypertension at her 33 weeks of pregnancy with huge splenomegaly and history of hematemesis.The pregnancy ran uneventfully, and she underwent elective LSCS at 38+ weeks and gave birth of a live female baby, weighing 3kg was delivered. Post operative recovery was uneventful. The patient was discharged on the 4th post operative day. We want to focus upon different aspects of pregnancy with portal hypertensionto prevent complications and manage the case.

J Rang Med Col. March 2024; Vol. 9, No. 1: 86-88

E- Health in Bangladesh: Are we Ready for the Commuter?

Shah Md Sarwer Jahan — Sun, 05 May 2024 00:00:00 +0000

Abstract not available

J Rang Med Col. March 2024; Vol. 9, No. 1:1-2