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1.
PLoS One ; 16(2): e0245885, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33561180

RESUMEN

BACKGROUND: During the catastrophic situation of the COVID-19 pandemic, the role of the health care workers (HCWs) is the most crucial, and their absenteeism, whether due to inability or unwillingness, becomes a major concern for the national health system. Hence, the present study aimed to determine the willingness and its associated factors to work during the COVID-19 pandemic among the physicians of Bangladesh. METHODS: This was a cross-sectional study conducted from April 21 to May 10, 2020, using an online survey among the Bangladeshi physicians living in the country. Both univariate and multivariable binary logistic regression models were used to determine the predictors of the willingness of the physicians to work during the COVID-19 pandemic. RESULTS: More than 69% physicians reported that they were willing to work during the COVID-19 pandemic, 8.9% reported that they were not willing, while 21.4% of participants were not sure about their willingness. Younger age, having experience of treating patients during previous pandemics, working in the emergency departments and high self-reported compliance to the recommended PPE were important predictors of being willing to work during COVID-19 pandemic. Concern for family and risk of transmitting the infection to family members were most commonly reported as major barriers of working during the pandemic (30%) followed by having comorbidities (25%), lack of adequate safety measures (25%), fear of being infected (12.2%), not involved in clinical practice (12.5%) etc. CONCLUSIONS: Though the majority of the physicians were willing to work during the COVID-19 pandemic, sufficient supply of PPE, support to maintain recommended quarantine and isolation policy after risky hospital duty along with adequate and effective training can increase their willingness to continue their sacred duty during this crucial pandemic.


Asunto(s)
Pandemias , Médicos/psicología , Adulto , Actitud del Personal de Salud , Bangladesh/epidemiología , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Equipo de Protección Personal , Riesgo , Encuestas y Cuestionarios , Trabajo
2.
J Environ Manage ; 283: 111974, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33550119

RESUMEN

The indirect, unplanned use of urban wastewater by peri-urban farmers in developing countries poses a severe risk to the environment and the farmers. Planned water reuse could contribute substantially to the irrigation water demand in peri-urban agriculture and minimize the risk. However, implementing such practice requires a thorough evaluation of stakeholder's perception and the scope within the existing organizational structures. This paper aims to assess the level of awareness, perception, and willingness of different stakeholders toward current practices and the prospect of urban water reuse in Khulna City - one of the most vulnerable cities located in the southwest of Bangladesh due to the consequences of rapid climate changes in the Bengal delta. Also, institutional arrangements and their functioning were analyzed to understand the current sectoral performance. One questionnaire with 385 respondents from the urban area, 32 in-depth interviews and one focus group discussion with farmers in the peri-urban area, and ten interviews with key informants from the government and non-government organization was conducted. Results indicate an overall positive attitude among major stakeholder groups toward planned water reuse for peri-urban agriculture. More than half of the citizens (53%) are willing to pay for the treatment of wastewater and majority of the farmers (66%) are willing to pay for the supply of better-quality irrigation water. However, the public sector responsible for wastewater collection and treatment requires adjustment in rules and regulations to implement planned water reuse. Interrelated factors such as lack of transparency and coordination, shifting responsibilities to other organizations, lack of required resources need to be addressed in the updated rules and regulations. Strategies to enforce current regulations and align all stakeholders are also crucial for collection and treatment of wastewater and its subsequent use for crop production.


Asunto(s)
Eliminación de Residuos Líquidos , Agua , Agricultura , Bangladesh , Ciudades , Percepción , Aguas Residuales , Abastecimiento de Agua
3.
Artículo en Inglés | MEDLINE | ID: mdl-33562427

RESUMEN

Background: Coronavirus disease (COVID-19) has affected people's lives globally. While important research has been conducted, much remains to be known. In Bangladesh, initial treatment (self-administered, hospitalized), persistent COVID-19 symptoms ("long COVID-19"), and whether COVID-19 leads to changes in mental state, such as depressive symptoms, of people are not known. This study aimed to examine treatment, persistent symptoms, and depression in people who had been infected with COVID-19 in Bangladesh. Methods: A cross-sectional survey was conducted on 1002 individuals infected with COVID-19 (60% male; mean age = 34.7 ± 13.9; age range = 18-81 years), with data taken over a one-month period (11 September 2020 to 13 October 2020). A self-reported online questionnaire was used to collect data on socio-demographics, lifestyle, COVID-19 symptoms (during and beyond COVID-19), medication (over-the-counter or doctor-prescribed), and depression (assessed using the Patient Health Questionnaire (PHQ-9)). Results: Twenty-four percent of participants self-medicated with over-the-counter medicine when they were first diagnosed with COVID-19. Self-medication was higher among female vs. male respondents (29.6% vs. 20.2%, respectively, p = 0.002). A minority (20%) reported that they experienced persistent COVID-like symptoms after recovering from COVID-19. The most reported persistent symptoms were diarrhea (12.7%) and fatigue (11.5%). Forty-eight percent of participants were categorized as having moderate to severe depression. Based on multivariate regression analysis, depression during COVID-19 was positively associated with lower family income, poor health status, sleep disturbance, lack of physical activity, hypertension, asthma/respiratory problems, fear of COVID-19 re-infection, and persistent COVID-19 symptoms. Conclusions: The findings suggest a need for appropriate interventions for COVID-19 patients to promote physical and mental wellbeing.


Asunto(s)
/psicología , Depresión/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bangladesh/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Automedicación , Encuestas y Cuestionarios , Adulto Joven
4.
Environ Pollut ; 271: 116333, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33535364

RESUMEN

There is growing interest in understanding the contribution of environmental toxicant exposure in early life to development of cardiometabolic diseases (CMD) in adulthood. We aimed to assess associations of early life exposure to arsenic and cadmium with biomarkers of CMD in children in rural Bangladesh. From a longitudinal mother-child cohort in Matlab, Bangladesh, we followed up 540 pairs. Exposure to arsenic (U-As) and cadmium (U-Cd) was assessed by concentrations in urine from mothers at gestational week 8 (GW8) and children at ages 4.5 and 9 years. Blood pressure and anthropometric indices were measured at 4.5 and 9 years. Metabolic markers (lipids, glucose, hemoglobin A1c, adipokines, estimated glomerular filtration rate (eGFR) were determined in plasma/blood of 9 years old children. In linear regression models, adjusted for child sex, age, height-for-age z score (HAZ), BMI-for-age z score (BAZ), socioeconomic status (SES) and maternal education, each doubling of maternal and early childhood U-Cd was associated with 0.73 and 0.82 mmHg increase in systolic blood pressure (SBP) respectively. Both early and concurrent childhood U-Cd was associated with diastolic (D)BP (ß = 0.80 at 4.5 years; ß = 0.75 at 9 years). Each doubling of U-Cd at 9 years was associated with decrements of 4.98 mg/dL of total cholesterol (TC), 1.75 mg/dL high-density lipoprotein (HDL), 3.85 mg/dL low-density lipoprotein (LDL), 0.43 mg/dL glucose and 4.29 units eGFR. Each doubling of maternal U-Cd was associated with a decrement of 1.23 mg/dL HDL. Both maternal and childhood U-As were associated with decrement in TC and HDL. Multiple comparisons were checked with family-wise error rate Bonferroni-type-approach. The negative associations of arsenic and cadmium with biomarkers of CMD in preadolescent children indicated influence of both metal(loid)s on fat and carbohydrate metabolism, while cadmium additionally influenced kidney function and BP. Thus, fewer outcomes were associated with U-As compared to U-Cd at preadolescence.


Asunto(s)
Arsénico , Enfermedades Cardiovasculares , Adulto , Bangladesh/epidemiología , Biomarcadores , Cadmio , Niño , Preescolar , Humanos , Estudios Longitudinales
5.
Environ Monit Assess ; 193(2): 104, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33521861

RESUMEN

Unplanned industrialization and improper management of wastes and gases into open surfaces are affecting the agricultural lands causing heavy metal pollution. This study monitored a suburban industrial zone located beside the Dhaka Export Processing Zone (DEPZ) at the Dhaka district in Bangladesh. We studied the heavy metal (Fe, Mn, Cr, Cu, Ni, Co, Zn, Pb, and Cd) concentration in the agricultural soils, plants, and in the atmospheric particulate matter (PM). The soils were found moderately contaminated with Fe, Cu, Ni, Co, and Zn and less contamination with Mn, Cr, Pb, and Cd. The enrichment factor (EF) and pollution load index (PLI) concluded a moderate level of soil pollution in this region. Besides, the plant samples showed an excess level of Cr and a similar level of Cu, Ni, Co, Zn, Pb, and Cd compared with the levels of industrial polluted sites of Bangladesh. The atmospheric PM analysis showed the presence of Fe, Mn, Cu, Ni, Zn, and Pb metals. The EF showed the anthropogenic origin of Mn and Ni in the atmospheric PM. The statistical correlation (r < 0.0001) of soil and plant heavy metals showed the possibility of transfer of metals from soil to plant which will cause the increase of pollution intensity. Overall, this agricultural region became an intermediate pollution zone. This study will help the decision-maker become conscious of heavy metal pollution in the suburban regions to monitor agricultural lands from anthropogenic pollution.


Asunto(s)
Metales Pesados , Contaminantes del Suelo , Bangladesh , Monitoreo del Ambiente , Contaminación Ambiental , Metales Pesados/análisis , Material Particulado , Medición de Riesgo , Suelo , Contaminantes del Suelo/análisis
6.
Trials ; 22(1): 2, 2021 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-33397432

RESUMEN

OBJECTIVE: General: To assess the virucidal efficacy of povidone iodine (PVP-I) on COVID-19 virus located in the nasopharynx Specific: i. To evaluate the efficacy of povidone iodine (PVP-I) to removeCOVID-19 virus located in the nasopharynx ii. To assess the adverse events of PVP-I TRIAL DESIGN: This is a single-center, open-label randomized clinical trial with a 7-arm parallel-group design. PARTICIPANTS: The study will be conducted at Dhaka Medical College Hospital, Dhaka, Bangladesh. INCLUSION CRITERIA: All RT-PCR-confirmed COVID-19 cases aged between 15-90 years with symptoms for the past 4 days will be screened. Those who give informed consent, are willing to participate, and accept being randomized to any assigned group will also be considered for final inclusion. EXCLUSION CRITERIA: Patients with known sensitivity to PVP-I aqueous antiseptic solution or any of its listed excipients or previously diagnosed thyroid disease or who had a history of chronic renal failure: stage ≥3 by estimated glomerular filtration rate (eGFR) Modification of Diet in Renal Disease (MDRD) or had acute renal failure (KDIGO ≥stage 2: creatinine ≥2 times from the baseline) or patients who required invasive or noninvasive ventilation or planned within the next 6 hours were considered for exclusion. Moreover, lactating or pregnant women will also be restricted to include here. INTERVENTION AND COMPARATOR: This RCT consist of seven arms: Arm-1 (intervention group): will receive povidone iodine (PVP-I) nasal irrigation (NI) at a concentration of 0.4% Arm-2 (intervention group): will receive PVP-I nasal irrigation at a concentration of 0.5% Arm-3 (intervention group): will receive PVP-I nasal irrigation at a concentration of 0.6%. Arm-4 (intervention group): will receive PVP-I nasal spray (NS) at a concentration of 0.5%. Arm-5 (intervention group): will receive PVP-I nasal spray at a concentration of 0.6%. Arm-6 (placebo comparator group): will receive distilled water through NI Arm-7 (Placebo comparator group): will receive distilled water through NS The intervention arms will be compared to the placebo comparator arms. Other supportive and routine care will be the same in both groups. MAIN OUTCOMES: The primary outcome is the proportion of cases that remain COVID-19 positive following the intervention. It will be assessed from 1 minutes to 15 minutes after the intervention. Any occurrence of adverse effects following the intervention will be documented as a secondary outcome. RANDOMIZATION: The assignment to the study (intervention) or control (comparator) group will be allocated in equal numbers through randomization using random number generation in Microsoft Excel by a statistician who is not involved in the trial. The allocation scheme will be made by an independent statistician using a sealed envelope. The participants will be allocated immediately after the eligibility assessment and consenting procedures. BLINDING (MASKING): This is an open-label clinical trial, and no blinding or masking will be performed. NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): A total of 189 confirmed cases of COVID-19 will be randomized into seven groups. In each arm, a total of 27 participants will be recruited. TRIAL STATUS: The current trial protocol is Version 1.5 from September 10, 2020. Recruitment began September 30, 2020 and is anticipated to be completed, including data analysis by February 28, 2021. TRIAL REGISTRATION: The trial protocol has been registered in the ClinicalTrials.gov on September 16, 2020. NCT Identifier number: NCT04549376 . FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting the dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol.


Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Nasofaringe/virología , Povidona Yodada/administración & dosificación , /efectos de los fármacos , Administración Intranasal , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bangladesh , /virología , Ensayos Clínicos Fase II como Asunto , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Persona de Mediana Edad , Lavado Nasal (Proceso) , Rociadores Nasales , Nasofaringe/efectos de los fármacos , Placebos/administración & dosificación , Placebos/efectos adversos , Povidona Yodada/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Adulto Joven
7.
Mymensingh Med J ; 30(1): 3-5, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397843

RESUMEN

COVID-19 pandemic brings significant number of post-acute and chronic disabilities requiring attention to Physical Medicine and Rehabilitation (PMR) services. Total Health and Rehabilitation sector in Bangladesh is overwhelmed; patient care and academic activities are seriously impacted by this pandemic. Rehabilitation team works and academic calendar is disrupted. Bangladesh PMR working to manage COVID-19 imposed rehabilitation challenges with adjustment and adaptations of the existing facilities. There is an urgent need to undertake additional measures promptly, including rehabilitation capacity building anticipating the potential challenge that would be faced by the hospitals in the estimated upsurge of COVID-19 cases and its complications thereafter. This topic highlights the activity log for COVID-19 preparedness and mitigation for rehabilitation services in Bangladesh with a message for other rehabilitation settings in the world.


Asunto(s)
Pandemias , Bangladesh/epidemiología , Humanos , Estudios Longitudinales , Centros de Rehabilitación
8.
Mymensingh Med J ; 30(1): 182-188, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397872

RESUMEN

The objective of the study was to investigate and quantify the severity of COVID-19 infection by high resolution computed tomography (CT) of chest and to determine its relationship with clinical parameters. This study also aimed to see CT changes with clinical recovery or progression of disease. This cross sectional study was performed from July 20 to August 20, 2020, where both chest HRCT and clinical features were included in laboratory confirmed COVID-19, 100 patients, attending the depertment of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. This study included clinical symptoms, comorbidities of patients, HRCT chest characteristics, CT severity score. After collection of all required data and careful medical chest review, the clinical data of laboratory confirmed patients was compiled and tabulated. In this study group out of 100 patients, most of the patients were in 5th & 6th dacades with a mean age of 53.7 years. In this study out of 100 patients 72% were male and 28% were female with an average sex ratio of male : female being 2.5:1. Prevalance of various clinical presentation in this study sample population distributed as fever in 76% cough in 77.4%, shortness of breath in 55%, sore throat in 17% were the most common clinical manifestations while a few patients (13.2%) also had other symptoms like headache, chest tightnes, anosmia and diarrhoea. Major comorbid conditions were diabets mellitus, hypertension, bronchial asthma and Chronic kidney disease (CKD). Patient with comorbid disease, especially if multiple had higher symptomatic presentation. Out of 100 patients 75.5% patient had co-morbidity where as 24.5% ptaients did not have any co-existing disease. According to HRCT imaging severity score the lung pathological changes were evaluated, when typical covid findings in 80%, intermediate in 10%, atypical in 2% and normal chest CT findings in 8% patients. Symptomatic presentation had found higher (85.21%) who had CT severity index >15/25 while sympotomatic presentation lesser (14.79%) who had CT severity index <15/25. CT severity index of 1-5 was seen in 20(21.73%) patients, 6-10 in 38(41.30%) patients, 11-15 in 22(23.91% patients, 16-20 in 10(10.86%) patients and 21-25 in 2(2.17%). As positive CT findings were more prominent in symptomatic and co-morbid patients HRCT chest in COVID-19 patient had a major diagnostic and prognostic importance. Clinical symptoms of patients directly correlated with CT severity score. Therefore, CT imaging was found to be useful in predicting clinical recovery of patient or progression of disease.


Asunto(s)
Tomografía Computarizada por Rayos X , Bangladesh , Estudios Transversales , Femenino , Humanos , Pulmón , Masculino , Persona de Mediana Edad
9.
Mymensingh Med J ; 30(1): 85-89, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397856

RESUMEN

Liver abscess is a serious, life threatening condition. A recent development in the management of liver abscesses, facilitated by advances in diagnostic and interventional radiology, has decreased mortality rates. The purpose of this study is to search for the clinical presentations and surgical outcomes of liver abscess in our country. The markers of the outcome are mortality, duration of hospital stay and complications such as wound infection, residual disease following surgery, biliary leakage, intra abdominal abscess formation. This observational cross sectional study was conducted in Mymensingh Medical College & Hospital (MMCH), Bangladesh for 12 months from 1st January 2017 to 31st December 2017. Total 25 patients presenting with the features of liver abscess were included in this study by convenient and purposive sampling according to the inclusion and exclusion criteria. Surgical principles of liver abscess management were applied and outcomes were observed. The patients were diagnosed on the basis of clinical feature, findings of abdominal ultrasound and occasionally by doing CT scan. Most of the patients (28%) were in the age group of 51-60 years. Regarding sex distribution majority of the patients (64%) was male. Most of patients presented with fever (92%), anorexia and vomiting (32%), upper abdominal pain (84%). Hepatomegaly and reactive pleural effusion are the important findings present in 9(36%) and 8(32%) patients respectively. Size of the liver abscess was more than 5cm in 72% patients. Among the patients right lobe was predominantly involved. It was found during laparotomy that 4 patients (16%) had spontaneous rupture of abscess into peritoneal cavity. One (4%) patient developed biliary leakage after surgical drainage. No intra abdominal abscess or residual diseases was observed after surgery. Among the patients 24% developed wound infection. The overall mortality rate was 12%. The median length of hospital stay was 8 days (range: 1-15 days). Outcome of surgical drainage of liver abscess in tertiary care hospital of our country shows satisfactory result. So, patients with large multiple liver abscess, septic shock, failures of percutaneous drainage should be treated by early open surgical intervention.


Asunto(s)
Absceso Hepático , Bangladesh/epidemiología , Estudios Transversales , Drenaje , Humanos , Absceso Hepático/diagnóstico , Absceso Hepático/cirugía , Masculino , Persona de Mediana Edad , Centros de Atención Terciaria
10.
Mymensingh Med J ; 30(1): 90-100, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397857

RESUMEN

An observational longitudinal study was conducted in the Department of Neonatology and Child Developmental Center, Mymensingh Medical College Hospital (MMCH), Bangladesh during the period of September 2016 to February 2018 to find out the neuro-developmental outcome of high risk neonates at the age of 6 months. Five hundred seventy six (576) high risk neonate who were admitted in the neonatology department in Mymensingh Medical College Hospital were selected as study population by Purposive sampling technique. After admission written informed consent from parents or guardians obtained and Data was collected in a pre-designed case record form. At 6th months of age total 400 baby were came to Child Development Centre and their motor, cognition and behavior development were assessed by Bayley Scale of Infant Development and severity of cognitive, motor and behavior impairment were graded. All data were compiled, tabulated and then analyzed by computer software SPSS version 20.00. Mean age was 7.2±3.3 days. Among studied newborns 18.1% were preterm and 81.9% were term. Most of the newborn were male (63.0%). Developmental delay was found in 81.5% and neuro-developmental outcome was found normal in only 18.5% newborns. Significant delayed motor performance was found in 52% newborns where 17% had mild delay. Significantly delayed mental performance was found in 57.0% and 28.52% had mildly delayed mental performance. Non-optimal behavior was found in 57.0% newborns and14% had questionable behavior. Very low birth weight, preterm very low birth weight, home delivery, perinatal asphyxia and neonatal seizure were found to have significant relation with developmental delay. Most of the high risk neonates develop developmental delay.


Asunto(s)
Asfixia Neonatal , Recién Nacido de muy Bajo Peso , Bangladesh/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Embarazo , Centros de Atención Terciaria
11.
Mymensingh Med J ; 30(1): 115-122, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397861

RESUMEN

Non-invasive tools are needed to rule out the presence of esophageal varices (EV) in patients with chronic liver disease. The aim of this study was to evaluate diagnostic accuracy of Liver stiffness-spleen size-to-platelet ratio (LSPS) for EV detection and identification of high risk EV in patients with CLD. A total of 70 patients with CLD irrespective of the etiology attending at OPD and admitted in Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD) of BIRDEM General Hospital, Dhaka, Bangladesh from January 2016 to October 2017 were enrolled in this observational cross-sectional study. All patients underwent routine laboratory tests, liver function tests, ultrasonography, liver stiffness (LS) measurement and esophagogastroduodenoscopy. Clinical value of LSPS was compared with platelet count, spleen size and LS for detection of esophageal varices. Diagnostic accuracy was assessed by the Area under the receiver operating characteristic (AUROC) curve. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using ROC curve. LSPS has better diagnostic accuracy for detection of EV in terms of AUROC, showing superiority over each factor alone. LSPS also detect high risk EV but accuracy was lower than detection of EV. The optimal cutoff values of LSPS for EV and high risk EV were 0.879 and 4.132 respectively, at which AUROC, negative predictive value, and accuracy were 0.910 [95% confidence interval (CI) 0.832-0.988], 90.9% and 90.0% and 0.695 (95% CI 0.520-0.870), 62.5% and 69.4% respectively. LSPS represents a useful, noninvasive method to detect EV and a high risk EV in patients with CLD. Clinicians should recommend those patients with CLD who show higher values of LSPS to undergo further endoscopic examination.


Asunto(s)
Várices Esofágicas y Gástricas , Hepatopatías , Bangladesh , Estudios Transversales , Várices Esofágicas y Gástricas/diagnóstico , Várices Esofágicas y Gástricas/etiología , Humanos , Hígado/patología , Cirrosis Hepática/patología , Valor Predictivo de las Pruebas , Curva ROC , Factores de Riesgo , Bazo/diagnóstico por imagen
12.
Mymensingh Med J ; 30(1): 171-175, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397870

RESUMEN

To establish the frequency, risk factors and its relation with the outcome of the management of Pharyngocutaneous fistula (PCF) was aimed. This is an observational, cross-sectional study which was conducted in the Department of Otolaryngology and Head-Neck surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh since 2006-2018. Duration of this study was 13 years (2006-2018). Total number of patients was 252. Total PCF developed in 49 participants. PCF developed more in irradiated patients with multiple co-morbidities. Number of PCF healed spontaneously was 40. There were 9 PCF which required surgical interventions and among them 3 recurred. High incidence of pharyngocutaneous fistula mostly due to advanced stage of disease, positive margin, various levels of surgical expertise and post irradiated patients with multiple co-morbidities.


Asunto(s)
Neoplasias Laríngeas , Laringectomía , Bangladesh/epidemiología , Estudios Transversales , Humanos , Recurrencia Local de Neoplasia , Complicaciones Posoperatorias , Estudios Retrospectivos
13.
Bull Environ Contam Toxicol ; 106(2): 243-249, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33452610

RESUMEN

The concept of the Nitrogen (N) cycle has been modified over the years based on certain new pathways, including comammox, anammox, and DNRA (dissimilatory nitrate reduction to ammonium). Comammox, nitrification, anammox, denitrification, DNRA, and nitrogen fixation pathways play key roles in the N cycle in paddy soils. Pesticides and chemical fertilizers' effects on the N cycle in paddy soils together with the possible manifestation of these newly discovery pathways are the focus of this review. Both chemical fertilizers and pesticides' overuse affect nitrifying archaea/bacteria and denitrifying and anammox bacteria, while heavy metals affect the nitrification rates in paddy soils. To add extra value to this study, we quantified the comammox amoA single copy gene from the Nitrospira strain 'Nitrospira inopinata'. This review will help researchers access the latest information on the N cycle, particularly in the light of the most recent discoveries.


Asunto(s)
Microbiota , Plaguicidas , Bangladesh , Desnitrificación , Fertilizantes/análisis , Nitrificación , Nitrógeno , Ciclo del Nitrógeno , Oxidación-Reducción , Suelo
14.
PLoS One ; 16(1): e0240385, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33439890

RESUMEN

BACKGROUND: With the proposed pathophysiologic mechanism of neurologic injury by SARS CoV-2, the frequency of stroke and henceforth the related hospital admissions were expected to rise. This paper investigated this presumption by comparing the frequency of admissions of stroke cases in Bangladesh before and during the pandemic. METHODS: This is a retrospective analysis of stroke admissions in a 100-bed stroke unit at the National Institute of Neurosciences and Hospital (NINS&H) which is considerably a large stroke unit. All the admitted cases from 1 January to 30 June 2020 were considered. Poisson regression models were used to determine whether statistically significant changes in admission rates can be found before and after 25 March since when there is a surge in COVID-19 infections. RESULTS: A total of 1394 stroke patients took admission in the stroke unit during the study period. Half of the patients were older than 60 years, whereas only 2.6% were 30 years old or younger. The male to female ratio is 1.06:1. From January to March 2020, the mean rate of admission was 302.3 cases per month, which dropped to 162.3 cases per month from April to June, with an overall reduction of 46.3% in acute stroke admission per month. In those two periods, reductions in average admission per month for ischemic stroke (IST), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and venous stroke (VS) were 45.5%, 37.2%, 71.4% and 39.0%, respectively. Based on weekly data, results of Poisson regressions confirm that the average number of admissions per week dropped significantly during the last three months of the sample period. Further, in the first three months, a total of 22 cases of hyperacute stroke management were done, whereas, in the last three months, there was an 86.4% reduction in the number of hyperacute stroke patients getting reperfusion treatment. Only 38 patients (2.7%) were later found to be RT-PCR SARS Cov-2 positive based on nasal swab testing. CONCLUSION: This study revealed a more than fifty percent reduction in acute stroke admission during the COVID-19 pandemic. Whether the reduction is related to the fear of getting infected by COVID-19 from hospitalization or the overall restriction on public movement or stay-home measures remains unknown.


Asunto(s)
/epidemiología , Hospitales/estadística & datos numéricos , Admisión del Paciente/estadística & datos numéricos , Accidente Cerebrovascular/terapia , Adulto , Bangladesh/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Retrospectivos
15.
Mymensingh Med J ; 30(1): 6-12, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397844

RESUMEN

Intentional artificial rupture of the amniotic membranes during labour, called amniotomy or 'breaking of the water's, is one of the most commonly performed procedures in modern obstetric and midwifery practice. The primary aim of amniotomy is to speed up uterine contractions and therefore shorten the length of labour. However there are concerns regarding unintended adverse effects on the woman and baby. A prospective observational study was conducted to determine the effectiveness and safety of routine procedure of amniotomy to shorten the duration of labour (prolonged or not) in Mymensingh Medical College & Hospital, Mymensingh, Bangladesh from July 2011 to December 2011. One hundred low-risk women with spontaneous onset of labour at term with singleton fetus in cephalic presentation and intact amniotic membranes and a cervical dilatation between 4 and 5cm were conventionally assigned to have amniotomy during the course of labour. Maternal demographics, duration of labour (prolonged or not), maternal and perinatal outcome were considered as major outcome. Majority (49.0%) of the patients belonged to 21-25 years age group and primigravida was predominant and most of them had middle socio-economic conditions. More the three-fourth (89.0%) of the patients had head engaged. Rh-positive and negative were found 96.0% and 4.0% respectively. The primigravidae required 10.07±2.17 hours in 1st stage of labour and had 1.51±0.5 hours duration of 2nd stage of labour. In case of multi-gravidae it was 6.07±2.06 hours in 1st stage of and 1±0.5 hours in 2nd stage of labour. There was a marked reduction of amniotomy-delivery interval time in this study, which was 3 hours 40 minutes and whereas mean cervical dilatation was 4cm during amniotomy. Almost three fourth (72.0%) cases delivered vaginally among which, with episiotomy in 49.0% and without episiotomy in 23.0%. Instrumental delivery was in 9.0% of which 4.0% by forceps, 5.0% by vaccum extraction and 14.0% underwent LUCS. Still birth was found 2.0%, asphyxiated 3.0% and prenatal death 1.0%. In terms of referral to neonatal care unit it was found that 7.0% were asphyxiated. Asphyxia and low APGAR score was 4.0%, low birth weight 9.0%, instrumental delivery was 5.0%, Rh incompatibility was 2.0%. Only 1.0% babies needed admission to neonatal care unit and were intubated. So, Amniotomy significantly reduced the duration of the first stage of labour without affecting the oxytocin requirement, the rate of caesarean section and newborn outcome.


Asunto(s)
Cesárea , Primer Periodo del Trabajo de Parto , Amniotomía , Bangladesh , Femenino , Humanos , Recién Nacido , Embarazo , Factores de Tiempo
16.
Mymensingh Med J ; 30(1): 13-20, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397845

RESUMEN

Rheumatic heart disease causes a substantial number of morbidity and mortality in Southeast Asia. In Bangladesh prevalence of Rheumatic Fever and Rheumatic heart disease is still high, 0.6 and 0.3 per thousand populations, respectively. Mitral valve mostly involved in the form of mitral stenosis in the rheumatic process. Treatment selections and its success largely depend upon the severity of disease especially the extent and distribution of calcification. Echocardiography has got the key role in determining the pattern, extent and severity of mitral stenosis. Two dimensional and Doppler echocardiography are conventionally used. With the increasing availability of 3D echocardiography, better cardiac imaging is possible now. The heart being a complex three-dimensional structure, the 3D evaluation would definitely offer better imaging for accurate assessment of the severity of mitral stenosis, especially details of commissural involvements. Many scoring systems are available for the assessment of the severity of rheumatic Mintral Stenosis (MS), mostly 2DE based; among them, Wilkins is mostly practiced. This cross-sectional observational study was conducted in University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from May 2012 to October 2012. Data were collected from 50 subjects who underwent transthoracic 2D and 3D Echocardiography for the assessment of rheumatic mitral stenosis especially detection of calcification also it's severity, extent, and distribution, furthermore the presence of commissural calcification. Precise measurement of Mitral valvular area is essential in the assessment of severity, which is found similar by both 2DE (0.98±0.24cm²) and 3DE (0.92±0.23cm²). But in identifying calcification and its extent especially commissural involvement is better detected by 3DE (p=0.002). This has paramount importance in therapeutic decision making of chronic rheumatic MS. To make a well-organized management plan and also for the confident prediction of complications, three-dimensional echocardiography has promising prospects in detecting commissural calcification and should be considered as an essential adjuvant to the conventional two-dimensional echocardiography.


Asunto(s)
Ecocardiografía Tridimensional , Estenosis de la Válvula Mitral , Cardiopatía Reumática , Bangladesh/epidemiología , Estudios Transversales , Humanos , Estenosis de la Válvula Mitral/diagnóstico por imagen , Estenosis de la Válvula Mitral/etiología , Cardiopatía Reumática/complicaciones , Cardiopatía Reumática/diagnóstico por imagen
17.
Mymensingh Med J ; 30(1): 21-27, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397846

RESUMEN

Patients with Diabetes Mellitus are at high risk of cardiovascular events because of abnormal lipid metabolism. Dyslipidemia is common in patients with Diabetes Mellitus (DM). However; in Bangladesh this issue is not yet properly addressed. The aim of this study is to determine the prevalence and patterns of dyslipidaemia in patients with DM in a divisional city Mymensingh. This cross-sectional study was conducted in randomly selected eligible patients from the indoor registry of the Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Bangladesh from April 2012 to March 2013. A well structured questionnaire and blood investigation for lipid profile and blood sugar were the tools of data collection from 120 randomly selected DM patients registered in the department of cardiology, MMCH. Out of 120 enrolled participants the prevalence of dyslipidemia in DM patients was 86.0%, prevalence of dyslipidemia in males was 88.0% while in females was 85.0% but the difference was not significant (p=0.42). Regarding age group, BMI and duration of DM, there is no significant association exists with dyslipidemia. About half of the studied DM patients have high serum total cholesterol level (50.83%), while 22.5% had low serum HDL-C levels and 35.0% had high serum LDC-C level, most of patients had serum triglyceride levels above normal range (67.5%) and so the common patterns of dyslipidemia in this study were serum triglyceride level followed by total cholesterol. High prevalence of dyslipidemia among diabetes mellitus in Mymensingh city were observed and so the common patterns of dyslipidemia is triglyceride followed by total cholesterol. This study emphasizes the importance of screening of lipid profile as these abnormalities may lead to development of cardiovascular diseases.


Asunto(s)
Cardiología , Diabetes Mellitus Tipo 2 , Dislipidemias , Bangladesh/epidemiología , Estudios Transversales , Dislipidemias/epidemiología , Femenino , Hospitales , Humanos , Masculino , Prevalencia
18.
Mymensingh Med J ; 30(1): 28-34, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397847

RESUMEN

The global burden of cancer is gradually rising. In our context we are also facing the same problem. Hematological malignancies (HMs) are important component of cancer. Early diagnosis and proper treatment at right time, a good number of HMs patients can be cured or lengthening the survival period. For this purpose a proper diagnostic criteria should be developed in our settings. This research work is carried out to find out the clinicopathological findings of HMs in our population. This was a cross-sectional descriptive type of observational study conducted in the Department of Medicine and Hematology of Mymensingh Medical College Hospital, Bangladesh from July 2016 to June 2017. Total 45 patients were purposively selected on the basis of inclusion and exclusion criteria with a view to observe the clinical and laboratory findings. Mean age of the patients was 44.5 years. Highest average age (70 years) was found in chronic lymphocytic leukaemia (CLL) and lowest (29 years) in acute lymphoblastic leukaemia (ALL). Majority of the respondents were male in all HMs except in non-Hodgkin's lymphoma (NHL) where male-female ratio was 0.3:7. Among male most of them were farmers or day laborers and most of the females were housewife. Almost all patients were exposed to single or multiple exposures like smoking, betel nut, betel leaf, tobacco leaf, fertilizer or pesticides. Acute myeloblastic leukaemia (AML) was the leading HMS with 31.11% representation followed by non-Hodgkin's lymphoma (NHL) 20%, Hodgkin's lymphoma (HL) 15.56%, acute lymphoblastic leukaemia (ALL) 11.11%, chronic myeloid leukaemia (CML) 11.11%, multiple myeloma (MM)6.67% and chronic lymphocytic leukaemia (CLL) 4.44%. Duration of symptoms was vary from 2 days to 5 years. In acute leukaemia duration was short (average 2 months). Common clinical findings were anaemia (95.5%), fever (80.0%), hepatosplenomegaly (42.2%), lymphadenopathy (40.0%), bony tenderness (22.2%) and bleeding manifestations (15.5%). Some uncommon findings were also reported like menorrhagia, facial nerve palsy, arthritis and disorientation. Common laboratory abnormalities were high ESR, anaemia, leukocytosis, thrombocytopenia and immature cell in PBF especially in acute leukaemia. Clinical suspicion along with history of positive exposure indicates strong possibilities of haematological malignancies. It should be kept in mind that haematological malignancies may also present with some isolated uncommon findings.


Asunto(s)
Neoplasias Hematológicas , Linfoma no Hodgkin , Adulto , Anciano , Bangladesh , Estudios Transversales , Femenino , Neoplasias Hematológicas/epidemiología , Hospitales , Humanos , Linfoma no Hodgkin/epidemiología , Masculino
19.
Mymensingh Med J ; 30(1): 35-42, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397848

RESUMEN

This cross sectional comparative study was conducted in the Nephrology and Medicine outdoor and in-patients department of Mymensingh Medical College Hospital, Bangladesh from April 2014 to March 2015. A total of 100 patients with CKD and 100 healthy subjects were included in the study. Data were collected by interview of the patients, clinical examination and laboratory investigations using a semi-structured case record form. Among all subjects, 50.0% had no CKD and 50.0% patients had CKD: Stage 3 CKD were 8.5%, CKD Stage 4 CKD were 21.0%, CKD Stage 5 CKD were 20.5%. Serum creatinine was 4.32±3.08mg/dl in patients with CKD and 1.00±0.22mg/dl was in healthy subjects. Mean±SD of CCR/ml/min was found 17.67±11.63ml/min in patients with CKD and 79.31±13.31ml/min was found in healthy subjects. On the other hand, Mean±SD CCCR/ml/m/1.73m² was found 19.79±12.85 ml/m/1.73m² in patient with CKD and healthy subjects had 83.83±13.33 ml/m/1.73m². Urinary creatinine was 45.59±15.63 & 57.66±11.45mg/dl respectively. CKD-EPI eGFR was 22.10±15.02 & 90.61±23.27ml/m/1.73m²; MDRD eGFR was 22.15±14.18 & 89.35±26.19 ml/m/1.73m² respectively. Difference between all the variables between CKD group and healthy group was found statistically significant (p<0.001). CKD-EPIeGFR and MDRDeGFR were increased both in CKD patients and healthy subjects in respect to CCR and CCCR. There was a strong positive correlation between CCCR (ml/m/1.73m2) and CKD-EPI (ml/m/1.73m²) among all patients (r=0.934 and p<0.001) and also a positive correlation of CCCR with MDRD among all patients (r=0.913 and p<0.001). A positive correlation of CCCR was found with CKD-EPIeGFR among CKD patients (r=0.848 and p<0.001). A positive correlation of CCCR was also found with MDRDeGFR among CKD patients (r=0.841, p<0.001). There are positive correlations between CCCR and CKD/EPI among healthy subjects (r=0.616 and p<0.05) and between CCCR with MDRD among healthy subjects (r=0.568 and p<0.05). Various formulae were used to calculate GFR on the basis of serum creatinine levels. The Overall correlation of population (healthy and CKD patients) between CCCR and CKD EPI and MDRD formula was (r=0.93 and 0.91) respectively, among CKD patients it was (r=0.848 and r=0.841) in healthy subjects it was (r=0.616 and r=0.568) respectively. CKD EPI eGFR and MDRD eGFR formula had fairly good correlation with conventional 24 hours creatinine clearance in both CKD patient and healthy subjects, there was even more strong correlation especially in CKD patients. The performance of CKD-EPI equation is better than MDRD equation to estimate the eGFR in both CKD patients and healthy subjects.


Asunto(s)
Insuficiencia Renal Crónica , Bangladesh , Creatinina , Estudios Transversales , Receptores ErbB , Tasa de Filtración Glomerular , Voluntarios Sanos , Humanos , Insuficiencia Renal Crónica/diagnóstico
20.
Mymensingh Med J ; 30(1): 43-47, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397849

RESUMEN

This cross sectional comparative study was done to investigate the association between low thyroid hormone level and migraine headache in adults patients. The study was conducted in Mymensingh Medical College Hospital, a tertiary level hospital of Bangladesh. Study period was from November 2017 to April 2018. The study subjects consisted of 50 patients with migraine headache as case, compared with 50 patients of headache other than migraine as control, seen in Neurology out patient department (OPD). Thyroid function test was performed by new automated immuno-chemiluminometric assay. Mean age was 29.80±9.87 years in migraine group and 34.18±11.82 years in non migraine group. Male female ratio was 1:2.3 and 1:1.7 in two groups. Level of TSH was significantly higher in migraine patients (3.52±2.53 vs. 2.25±2.13) than other headache patients (p=0.008). Thyroid disorder especially subclinical hypothyroidism was significantly higher (28% vs. 08%) in migraineurs than non migraineurs (p=0.032). No significant relationship was found between thyroid hormone level and headache characteristics of migraine patients (p>0.05). Migraine headache is associated with low thyroid hormone and thyroid disorder can be considered as comorbidity of migraine headache.


Asunto(s)
Trastornos Migrañosos , Adulto , Bangladesh/epidemiología , Estudios Transversales , Femenino , Cefalea , Humanos , Masculino , Trastornos Migrañosos/complicaciones , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/epidemiología , Hormonas Tiroideas , Adulto Joven
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