Northern International Medical College Journal

Breastfeeding during the COVID-19 pandemic

2024-05-26T05:09:20+00:00

Abstract not available

Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 563-565

Public Health Evaluation:Avoidance of Breast Cancer Screening in Immigrant Canadians

2024-05-26T05:14:20+00:00

Breast cancer is one of the leading causes of death in Canadian women.¹This cancer can be detected early through screening and allow for higher chances of survival. However, the Canadian Cancer Statistics Advisory Committee found that it is still being diagnosed at late stages, even with organized screening programs implemented in Canadian provinces.1 In Ontario, mammography is recommended every two years for women ages 50-69 years where they receive a medical referral letter invitation, but women are still found to present in clinics with no history of screening or advanced cancer.² In 2017, 26500 breast cancer cases were found and in that 5000 women did not survive, with a majority of these women being immigrant. Canada is a multicultural country where more than 20% of the populations are immigrants, but yet more immigrant women die from breast cancer than non-immigrant women.^3,4 However, screening participation rates remain lower in immigrants than non-immigrants,⁵ possibly being fatal. It’s important to know the causes of screening avoidance. Thus, the purpose of this literature review is to investigate the avoidance of breast cancer screening of immigrant women in Canada.

Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 566-567

A rare case of Ellis-van Creveld syndrome with primary immunodeficiency with recurrent and persistent pneumonia

2024-05-26T06:14:48+00:00

Abstract not available

Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 594-597

Knowledge and Attitude towards Thalassaemia among Secondary School Teachers in Dhaka City

2024-05-26T05:31:37+00:00

Background : Thalassaemia is an important child health issue in Bangladesh and prevention is the key strategy to combat this problem. Teachers can play a significant role in preventing this disease provided they have a good knowledge about the disease.

Objective : The Knowledge and practice on thalassaemia among school teachers are unknown. The present study was, therefore, conducted among secondary school teachers of Dhaka City to assess their knowledge and attitude about thalassaemia.

Materials & Methods : This cross-sectional study was carried out in 8 secondary schools in Dhaka from January 2018 to June 2018. Out of 24 Govt. Secondary schools of Dhaka city, 8 schools were selected using random table. Four hundred school teachers from the 8 government schools were then selected using systematic sampling method. A semi structured questionnaire was used to evaluate knowledge of the respondents about thalassaemia. The test statistics used to analyze the data were descriptive statistics. The questionnaire also assessed preventive strategy and difference in attitude towards thalassaemia.

Result : The majority of the secondary school teachers are informed about thalassaemia, but their knowledge is inadequate regarding occurrence, nature and prognosis of thalassaemia. Among the respondents 6% had a good level of knowledge, 20% had average and 74% had poor level of knowledge. Regarding views on prevention, 16.5% thought the necessity of prenatal diagnosis of the carrier couples and 24.4% agreed that thalassaemia carriers should not marry each other. About 32.5% of the respondents were in agreement that premarital screening is essential for the prevention of thalassaemia to next generation.

Conclusion : Most of the secondary school teachers have poor knowledge in general aspects and preventive measures of thalassaemia. Majority of the teachers did not have positive attitude towards premarital screening for thalassaemia carrier, however majority of them showed positive attitude towards creation of an academically friendly environment for the thalassaemic patients.

Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 568-573

Nutritional status and dietary habit of COVID-19 patients: A study in a tertiary hospital

2024-05-26T05:36:09+00:00

Background: Nutritional status has impact on body immune function that is important for controlling disease process and prognosis of the newly emerging Coronavirus Disease 2019 (COVID-19). As no vaccine or specific antiviral treatment is not available for COVID-19, therefore, improvement of nutritional status is important. Adequate and appropriate diet is required for maintaining good nutritional status. There is very few research carried out to evaluate the influence of nutritional status and dietary habit of patients with COVID-19.

Objective: To study the nutritional status and dietary habit of COVID-19 patients admitted in a tertiary hospital of Dhaka, Bangladesh and its impact on the severity of the disease COVID-19.

Methodology: A cross-sectional study was performed on 384 patients in the Corona unit of Holy Family Red Crescent Hospital during 17th May to 31st December’ 2020. Patients were selected conveniently according to inclusion criteria. COVID-19 patients were categorized as Mild, Moderate and Severe cases according to National Institute of health and latest Public Health Information from Centers for Disease Control (CDC). Direct interviewing of the selected patients with pretested structured questionnaire, data were collected on socio demographic characteristics, nutritional status following Body Mass Index (BMI) grading, daily consumption of different food items in the last 3 months and dietary habits in the last 3 months of these three categories of patients. Written consent of the patient and ethical clearance was obtained prior to data collection. All statistical analyses were performed by using the SPSS software version 21.

Result: A total of 384 patients interviewed. Age distribution was Mean ±SD, 42.85±13.82. Male/Female ratio 1.33. Most of them were graduates, 33.1% and 42.9% were Govt. service holders. Monthly family income was Tk 35000 (taka thirty-five thousand) and above in 39.6% cases. Regarding source of infection in these patients, 40.3% and 35.2% from traveling abroad and shopping respectively. Urban dwellers were75% and 25% from rural area. Nutritional status of COVID-19 patients was calculated according to BMI grading. Among all Underweight COVID-19 patients- 90% were Moderate cases. Among all Normal nutritional status COVID- 19 patients we found 37.5%, 41.7% and 20.8% were in mild cases, moderate cases, and severe cases respectively. Regarding Overweight COVID-19 patients we found 46.7% and 32.7% in moderate and in severe cases. Obese 1 were 48.1% in moderate cases and 32.1% in severe cases of COVID-19 patients. On the other hand, all (100%) obese 2 patients were moderate cases. BMI found statistically significant p – 0.002. Regarding food items protein showed statistically significant (p- 0.04). In severe cases having good sun exposure was found in only 19.5% cases. Regarding dietary habit of COVID-19 patients, most of the variables were found statistically significant i,e skipping of their meal (p-0.016), number of meal ( p-0.040), quality of food( p-0.014), taking food according to daily requirement ( p - 0.021) and eating extra salt with food(p-0.029).

Conclusion: Considering the result, it can be concluded that COVID-19 patients were mostly middle aged from urban areas with average economic status. Source of infection was from traveling abroad and shopping. Nutritional status of most of Moderate and Severe COVID-19 cases were under weight, obese 1 and obese 2. Concerning diet and dietary habit, protein, skipping of meal, number of meals, variety of food, eating food according to daily requirement and eating extra salt with food significantly associated with the severity of COVID-19. This was a single centered study with a small sample size. A multicenter, larger sample size study recommended for confirming our data and to get an actual view of the nutritional status and dietary habit of COVID19 patients.

Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 574-580

Role of Biochemical Parameters for The Detection of Osteopenia of Prematurity

2024-05-26T05:47:52+00:00

Background: Complications from preterm birth are the leading causes of death among children under 5 years of age, responsible for approximately 1 million deaths in 2015. Three-quarters of these deaths could be prevented with current, cost-effective interventions. Premature infants, particularly those born at <28 weeks of gestation, are at significant risk for reduced bone mineral content (BMC) and subsequent bone disease, variably termed metabolic bone disease (MBD), osteomalacia, osteopenia, or neonatal rickets. Risk of fracture and growth failure increase in the presence of osteopenia in these infants. Early detection of Osteopenia of Prematurity (OOP) may prevent unwanted deaths.

Objectives: To identify biochemical markers of osteopenia in the neonatal period for early detection before the appearance of radiological evidence of osteopenia.

Methods: This prospective observational study was carried out at Dhaka Shishu Hospital (DSH) from July, 2016 to June, 2018. Babies admitted in the Neonatal Intensive Care and Special Care Baby Unit with gestational age <34 weeks and birth weight <2200 gm were included in the study. Purposive sampling technique was used to collect the study data. Blood sample for baseline biochemical markers were collected in 1st week of life, then subsequently at 2 weeks interval up to corrected term age. Wrist radiography was done for to detect radiological osteopenia at 6th week post-natal age and at corrected term age. Then the biochemical parameters are compared with radiological osteopenia.

Result: This study included 84 preterm new born below 34 weeks of gestation and a birth weight below 2200 grams. Radiological evidence of osteopenia of prematurity was found in 34 (40.5%) babies of which 29 (85.3%) were below 32 week and 5 (14.7%) were at or above 32 weeks. Osteopenic infants had significantly (p<0.001) lower birth weight (1318.82 ± 264.23 gm) compared to non-osteopenic infants (1701.40 ± 431.11 gm). Our study showed that the optimal cutoff point for Alkaline phosphatase (ALP) was 352.50 U/L at 3rd week of life, at which sensitivity and specificity were found 82.4% and 80.0% respectively. Serum inorganic phosphate values for the diagnosis of osteopenia was 4.67 mg/dl at 5th week of age. At this level, sensitivity was found to be 68.0%, whereas specificity was 60.0%. Serum calcium of the infants did not show any significant difference when they were enrolled in the study and in the first follow up. But serum calcium level was significantly lower in osteopenic infants compared to nonosteopenic infants in 2nd and 3rd follow up (p<0.05).

Conclusion: High alkaline phosphatase level at 3rd week of life and low serum inorganic phosphate at 5th week of life can be used as a predictor of osteopenia of prematurity.

Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 581-587

Electrolyte imbalance in hospitalized children with infections - a tertiary care Experience

2024-05-26T06:00:53+00:00

Background: Electrolyte imbalances are a common finding in hospitalized children, especially those with infections. Infections interfere with the body's normal fluid and electrolytes balance as well as various factors also contribute to electrolyte imbalances. Sometimes medicine used in the treatment of infections contributes in electrolyte abnormalities. Usually, the types of electrolyte abnormalities found among the hospital admitted children with infections are Hyponatremia, Hypernatremia, Hypokalemia, Hyperkalemia, Hypocalcemia etc.

Objective: To find out the types of electrolyte imbalance in hospitalized children with infection.

Methodology: This is a hospital based cross sectional study conducted from 1st April 2019 to 31st March 2020 at Ad-Din Women’s Medical College Hospital. A total of 120 children who met the inclusion criteria were enrolled for the study. Children aged 1 to 12 years, who were admitted into Pediatric ward with clinical diagnosis of septicemia with septic shock or with different bacterial infections were included in this study. Children with non-infectious diseases, Syndromic children, with prolonged medications like diuretics, steroids, chronic diseases, kidney diseases, protein energy malnutrition were excluded from this study. During admission, all suspected cases of infections were advised to do sepsis screening and serum electrolytes (serum sodium (Na+), serum potassium (K+), sometimes serum calcium (C-). At the time of admission, who were not investigated for electrolytes; they were also advised for electrolytes (several times) during his/her hospital stay particularly who were on intravenous fluid for more than 3 days without any enteral feed. Data were collected by clinical interview, physical examination and lab investigations report using a pretested structured questionnaire. All data was entered in a master chart in Microsoft Excel sheet and was analyzed in SPSS 21.0 software.

Result: Total 120 children were enrolled in this study, age ranges from 1 month to 12 years. Male 68(56.66%) and female 52(43.33%) with male female ratio 1.3 :1. Infants from 1 month to 1 year 68(56.66%), from 1 year to 5 year 38(32.66%) and 5years up to 12 years 14 (11.66%). Children had the following clinical presentations -fever in 52(43.33%) cases , reluctant to take feed 32(26.66%) vomiting 52 (43.33%), lethargy 23(19%), loose motion 60(50%), abdominal pain 14(11.66%), cough and respiratory distress 20(16.66%),tetany/convulsion 21(17.5%), unconsciousness 10(8.33%). History of taking in appropriately prepared ORS 17(14.66%) and concentrated ORS were present in 11(9.1%) cases. Clinical diagnosis was septicemia with or without septic shock, with blood culture positive10(8.3%), diarrhea/invasive diarrhea 58(48.33%), enteric fever 10(8.3%), pneumonia 6(5%),UTI/ Urosepsis 4(3.33%), Meningitis/ meningoencephalitis 8(6.66%), TBM 2(1.6%), dengue fever 6(5%), probable bacterial infections 8(6.66%) Among 120 cases serum Na <135mmol/l were in 34(28.33%) cases, from 135 to 145mmol/l were in 38(31.66%) but they had isolated hypokalemia. Mild hypernatremia were in 18(15%), moderate hypernatremia was in 24(20%) and severe hypernatremia were in 6(5%). Hypokalemia found in 70(58.33%)cases, Hyperkalemia present in 8(6.66%) and normal potassium were in 42(35%) cases, but they had isolated Hypernatremia or Hyponatremia. Chloride levels between 99 to 106mmol/l were in 40(33.33%) cases,<99mmol/l were in 30(25%) cases and >105mmmol/l were in 50(41.66%) cases.

Conclusion : Electrolyte imbalances are common in children with different types of infections specially in diarrhea with severe dehydration. Specific symptoms of electrolyte abnormality often merged with the underlying disease. A high index of suspicion is very important for identification of electrolyte imbalance.

Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 588-593