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1.
Mymensingh Med J ; 29(1): 5-15, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915329

RESUMEN

Acute post-streptococcal glomerulonephritis (APSGN) is the commonest cause of acute glomerulonephritis (AGN), which usually present with gross hematuria, mild edema, oliguria, hypertension and varying degree of renal insufficiency. It is more common among the population of school going age where poverty, overcrowding and poor hygienic conditions are prevailing. This cross sectional observational study was aimed to know the socio-demographic variables, clinical profile and immediate outcome of AGN in hospitalized children and was conducted in the Pediatric department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2014 to April 2015. A detailed history was taken from the parents in each case with a written questionnaire. A written consent was also taken from the guardian of the including patients and also permission was taken from the ethical committee of MMCH. Thorough clinical examination and available relevant investigations were done in all patients. Progresses of the patient were monitored by daily clinical examinations and also by investigations. Data were analyzed by statistical package for social science (SPSS) windows version 18. Results were verified by doing standard test for significance. Among total 60 cases male was 58.3% & female was 41.7%. The common age group of presentation was between 7-12 years (73%), peak age of incidence was 7-9 years. Most of them came from low socioeconomic status (83.3%), 63.3% from rural area with average 5-6 member's family size. Most of the parents were illiterate. History of (H/O) skin infection was present in 35(58.3%) patients, 15(25%) had H/O sore throat, 15% did not give any H/O infection before presentation. Average duration of gap between infection and appearance of clinical feature was 7-14 days in 73.40%and 15-21 days was in 45.7% in case of sore throat & skin infection respectively. Almost all (95%) patients presented with puffiness of face, others presented with scanty micturition, gross hematuria, respiratory distress, fever, convulsion and altered sensorium. Edema (75%), hypertension (88.3%), pallor (38%), tachypnea (25%), tachycardia (26.7%) were the important clinical findings. Microscopic hematuria was present among 96.66% patients; low complement level was found in 85% cases. There is significant association between low socioeconomic statuses with more hospital stay. Only one patient died due to heart failure and 98.3% patient had complete recovery. Results of this study conclude that most of the patients came from rural illiterate family with low socioeconomic background. Skin infection is the commonest cause of acute glomerulonephritis. Edema, scanty micturation, hematuria and hypertension are the common mode of presentation. Heart failure and hypertensive encephalopathy are the common complication of AGN. Immediate prognosis of AGN was excellent.


Asunto(s)
Glomerulonefritis/diagnóstico , Tiempo de Internación/estadística & datos numéricos , Enfermedad Aguda , Bangladesh/epidemiología , Niño , Estudios Transversales , Femenino , Glomerulonefritis/epidemiología , Humanos , Incidencia , Masculino , Pediatría , Población Rural , Factores Socioeconómicos
2.
Mymensingh Med J ; 29(1): 16-20, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915330

RESUMEN

Now a days depression is one of the leading cause of disabilities all over the world. Depression leads to a wide range of disorders and affects people of all communities. Medical students pass through a relatively high level of stress. Several studies revealed that anxiety and depression is significantly prevalent among medical students and often it persists even when they become physicians. The study was designed with an aim to estimate the prevalence of depression among the medical students of Bangladesh. The cross sectional descriptive type of observational study was conducted among randomly selected 399 Bangladeshi students of third year MBBS from six (6) randomly selected public medical colleges of Bangladesh from February 2017 to July 2017. Data were collected by a semi-structured self-administered questionnaire containing Beck's Depression Inventory. Data were entered and analyzed by SPSS version 20.0. Among 399 medical students, 45.6% were male and 54.4% were female. Regarding presence of depression among the medical students, 35.8% students had normal score. More than one fourth of the students (25.1%) had mild mood disturbance. Borderline clinical depression was found in 15.5% and moderate depression was found in 18.0% of the students. Severe depression was found in 5.3% students and one (0.3%) student was suffering from extreme depression. Overall 39.1% students were suffering from different levels of depression. Depression was prevalent more in female students (45.6%) than male students (31.3%). Suicidal tendency was present in 18.8% students. Among them 14.3% had thoughts of killing themselves but they would not carry them out; 3% would like to kill themselves and 1.5% would kill themselves if they had the chance. Suicidal tendency was also a bit higher in female students (19.3%) than male students (18.1%). A significant number (39.1%) of medical students of Bangladesh are suffering from depression and many of them (18.8%) have suicidal tendency which demands immediate attention of the authority. The findings of the study warrant a need for psychiatric counseling and support services for vulnerable students.


Asunto(s)
Depresión/epidemiología , Estudiantes de Medicina/psicología , Bangladesh/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Masculino , Encuestas y Cuestionarios
3.
Mymensingh Med J ; 29(1): 43-47, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915334

RESUMEN

Hypertension is a major public health challenge to population in socio-economic and epidemiological transition. It is a risk factor for cardiovascular mortality which accounts for 20-50 per cent of all deaths. Hypertension has been recognized among young adults more frequently in recent years. Data regarding hypertension in Bangladesh is often insufficient. The purpose of the study was to find out the risk factors of hypertension in young adults of Bangladesh. The study was conducted among 322 purposively selected young adults aged 20 to 49 years attending in the outpatient department of one public and five private hospitals of Mymensingh and Dhaka division of Bangladesh during the period of January 2018 to December 2018. More than half (54.4%) of the patients were at or below the age of 40 years. Mean age of the patients was 38.7±7.8 years and 58.7% were male. Maximum patients (87.6%) were married and with variable educational and occupational status. More than three fourth of the patients (76.7%) were from urban area whereas 14.3% from rural and 9.0% were from sub-urban area. Family history of hypertension was positive in 86.6% of patients. Blood pressure was categorized according to JNC 7. About half (49.4%) of the patients were stage I hypertensive; 22.4% were stage II hypertensive and 28.3% were pre-hypertensive. The major risk factor was tobacco smoking (46.0%), obesity (29.2%), dyslipidaemia (25.2%), high salt intake 21.8% and use of chewable tobacco (13.7%). Serum creatinine was found raised in 11.5%, cardiomegaly in 2.2% and concentric left ventricular hypertrophy in 18.6% of patients. In 38.5% patients hypertension was complicated affecting heart (27.0%) and kidney (11.5%). Common comorbidities were ischaemic heart diseases (20.5%) and diabetes mellitus (13.4%). Tobacco use, obesity, dyslipidaemia and high salt intake are the major modifiable risk factors found in hypertensive young adults. In addition to medication these factors should be addressed for prevention and effective control of hypertension.


Asunto(s)
Presión Sanguínea/fisiología , Diabetes Mellitus/epidemiología , Cardiopatías/epidemiología , Hipertensión/epidemiología , Adulto , Bangladesh/epidemiología , Comorbilidad , Femenino , Humanos , Hipertensión/diagnóstico , Isquemia/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Población Rural/estadística & datos numéricos , Clase Social , Población Urbana/estadística & datos numéricos , Adulto Joven
4.
Mymensingh Med J ; 29(1): 48-54, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915335

RESUMEN

One-fourth of all women suffer from breast disease in their lifetime. World Health Organization estimated that over 508,000 women died in 2011 due to breast cancer worldwide.For several years, fine needle aspiration cytology (FNAC) was the most practiced method for the pathological diagnosis of breast lump specially differentiation of benign from malignant. The advent of core needle or True-Cut biopsy (TCB) in the new millennium has resulted in many surgeons switching to TCB since it provides a sufficient amount of tissue for pathologists to make an accurate histological diagnosis.During the study period, patients present with clinically palpable breast lump admitted in different surgicalunits of MMCH, among them 100 patients selected purposively. Then a prospective comparative study was carried out in the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2017 to February 2018. Out of a total of 100 patients, who presented with suspicious breast lump, as clinically diagnosed 68 patients had benign breast lump and 32 patients had malignant breast lump. FNAC confirmed the diagnosis of breast carcinoma in 27 patients with sensitivity 89.65% and specificity 66.66%. True-cut biopsy confirmed the diagnosis of breast carcinoma in 29 patients with sensitivity 96.66% and specificity 100%. It also gave the definitive histological type and grade which correlated with the final histopathology report in 29 out of the 30 patientsTCB also provides adequate tissue for the evaluation of molecular markers which have extreme therapeutic value.


Asunto(s)
Biopsia con Aguja/métodos , Biopsia/métodos , Enfermedades de la Mama/patología , Neoplasias de la Mama/patología , Mama/patología , Carcinoma/patología , Adulto , Bangladesh/epidemiología , Biopsia con Aguja Fina , Neoplasias de la Mama/epidemiología , Carcinoma/epidemiología , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Sensibilidad y Especificidad
5.
Mymensingh Med J ; 29(1): 60-65, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915337

RESUMEN

In spite of the recommendation for rescue antenatal corticosteroids (ACS), the optimal time interval between primary and rescue courses has not been clearly demonstrated. The aim of this retrospective study was to determine the effects of the interval between a single ACS (Dexamethasone) course and delivery on the incidence of respiratory distress syndrome (RDS) in neonates at Mymensingh Medical College Hospital Center from 1st January 2017 to 30th June 2017. Injection Dexamethasone 2 doses (12.5mg IM 12 hourly for 2 doses) or 4 doses (6mg IM every 12 hours for 4 doses) use to arrest preterm labor as well as to prevent RDS delivered beyond 48 hours after ACS administration between 24 and 34 weeks gestation. The risk of RDS was compared between patients who delivered within seven days (Group I) and 7-14 days (Group II) after ACS administration. We included 140 and 60 patients in Group I and Group II respectively. After adjusting for confounders, the ACS delivery interval was significantly associated with RDS in Group II (adjusted odds ratio 12.8, 95% confidence interval 1.31-164.7). A longer ACS delivery interval is associated with a higher risk of RDS. Thus, the use of a rescue course could be expected to reduce the incidence of RDS in patients beyond seven days after ACS administration who remain at risk for preterm delivery within seven days, especially in cases of placenta previa and/or women bearing a male fetus.


Asunto(s)
Corticoesteroides/administración & dosificación , Dexametasona/administración & dosificación , Nacimiento Prematuro/prevención & control , Atención Prenatal/métodos , Síndrome de Dificultad Respiratoria del Recién Nacido/epidemiología , Corticoesteroides/efectos adversos , Bangladesh/epidemiología , Dexametasona/efectos adversos , Femenino , Humanos , Incidencia , Recién Nacido , Recien Nacido Prematuro , Masculino , Embarazo , Síndrome de Dificultad Respiratoria del Recién Nacido/prevención & control , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
6.
Mymensingh Med J ; 29(1): 66-72, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915338

RESUMEN

Various forms of sexual dysfunction occur in men with diabetes mellitus (DM) including disorders of libido, ejaculatory problems, and erectile dysfunction (ED). This cross sectional study was conducted in a tertiary hospital of Bangladesh from December 2017 to May 2018 to find out the frequency and risk factors of ED in subjects with type 2 DM (T2DM). One hundred fifty (150) consecutive male patients with T2DM attending the Endocrinology outpatient department (OPD) of the hospital during the study period were evaluated for the presence of ED by using the International Index of Erectile Function-5 (IIEF-5) questionnaire; their socio-demographic, anthropometric, and clinical data were also recorded. Glycemic status was assessed by measurement of fasting plasma glucose (FPG) and HbA1c. Morning serum testosterone was measured in all. Among 150 subjects 68(45.3%) had ED; ED was mild in 14.7%, mild to moderate in 18.0%, moderate in 6.0% whereas severe ED was present in 6.7% of the subjects. The subjects with ED had higher mean age, longer duration of DM, higher body mass index (BMI), higher HbA1c, higher FPG, higher serum creatinine, and lower serum testosterone level than those without ED. Study subjects in the higher age group and higher duration of DM had higher frequencies of ED. IIEF-5 score showed significant negative correlation with age, duration of DM, HbA1c, fasting plasma glucose, serum creatinine and significant positive correlation with serum testosterone. In logistic regression analysis, duration of DM and serum testosterone were found be independent predictors of ED. Frequency of ED among Bangladeshi type 2 diabetic males is high; duration of DM and serum testosterone are independent predictors of ED in them.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Disfunción Eréctil/epidemiología , Adulto , Distribución por Edad , Bangladesh/epidemiología , Glucemia/análisis , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Disfunción Eréctil/etiología , Hemoglobina A Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Prevalencia , Factores de Riesgo , Testosterona/sangre
7.
Mymensingh Med J ; 29(1): 97-103, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915343

RESUMEN

This study was aimed to compare the long-term outcomes and survival rate among mitral valve replacement using thoracotomy and standard median sternotomy in a single surgeon's practice. Total 250 patients were evaluated; Group I (n=65) patients had anterolateral thoracotomy and Group II (n=185) had standard median sternotomy for valve replacement. Mean age was 25.1±5 years in Group I and 41.8±10.5 years in Group II. Female was predominant in Group I. Total operative time and bypass time was statistically significant in Group I (235.5±25.8 minutes; 84.2±12.75 minutes) in contrast to Group II (203.8±15.5 minutes; 71.5±10.5 minutes). Incision scar was not visible in females in Group I but full incision scar was visible in Group II. Post-operative ICU stay duration was significant high in Group II. Though, wound infection incidence was 0% in Group I; however, 9.73% patient had wound infection in Group II. Only 1.62% patient developed unstable sternum in Group II. Most of the patients from both study group were in regular follow up and 1-year mortality rate was 4.62% and 5.94% in Group I and Group II respectively. Mitral valve replacement through a right anterolateral thoracotomy is easy and safe to perform; while getting maximum benefits for the patients. Besides satisfactory cosmetic outcome especially in female, this approach provides better exposure to mitral apparatus even in patients with small left atrium, cost effectiveness, less duration of hospital stays and absence of the risk for unstable sternum.


Asunto(s)
Enfermedades de las Válvulas Cardíacas/cirugía , Implantación de Prótesis de Válvulas Cardíacas/métodos , Esternotomía/métodos , Esternón/cirugía , Toracotomía/métodos , Adulto , Bangladesh/epidemiología , Procedimientos Quirúrgicos Cardíacos/métodos , Femenino , Enfermedades de las Válvulas Cardíacas/mortalidad , Implantación de Prótesis de Válvulas Cardíacas/mortalidad , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Válvula Mitral/cirugía , Tasa de Supervivencia , Resultado del Tratamiento , Adulto Joven
8.
Mymensingh Med J ; 29(1): 129-135, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915348

RESUMEN

Tetanus is a potentially preventable neurological infectious disorder with paucity of literature in Bangladesh. We aimed to see the demography and symptom profile of tetanus cases managed at the Infectious disease Hospital Sylhet. This hospital based cross-sectional descriptive study was conducted within the time period of January to December 2012 among 50 consecutive admitted patients in the Infectious Disease Hospital, Sylhet, Bangladesh who were diagnosed as a case of tetanus and fulfilling the inclusion criteria and exclusion criteria. Neonatal tetanus was considered as exclusion criteria and clinical diagnosis of tetanus was considered as the tetanus. Data were collected purposively with pretested predesigned questionnaire. Data were processed manually and analyzed with the help of SPSS Version 16.0. The mean±SD age was 33.00±16.8 years, ranging from 10 to 70 years. Among the 50 respondents, 72.0% were male, 50% from lower class, 34% were students and 30.0% had their educational status of primary level, 60.0% from rural social background. Trismus was found in 98.0% of the cases, rigidity in 96.0% cases, body ache in 94.0% cases, dysphagia in 92.0% cases, neck pain in 78.0% cases, dysarthria in 92.0% cases, reflex spasm in 66.0% cases, opisthotonus in 46.0% cases and urinary retention in 26.0% cases. In this study rural male people with lower socioeconomic status individuals were mostly affected with trismus, rigidity, body ache and dysphagia symptoms.


Asunto(s)
Trastornos de Deglución/etiología , Tétanos/diagnóstico , Trismo/etiología , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Anciano , Bangladesh/epidemiología , Niño , Estudios Transversales , Trastornos de Deglución/epidemiología , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Población Rural , Distribución por Sexo , Factores Socioeconómicos , Tétanos/complicaciones , Tétanos/epidemiología , Tétanos/terapia , Resultado del Tratamiento , Trismo/epidemiología , Adulto Joven
9.
Mymensingh Med J ; 29(1): 142-148, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915350

RESUMEN

Hypertension (HTN) is an important cause of cardiovascular mortality and the prevalence of hypertension is increasing particularly in middle- and low-income countries including Bangladesh. No data are available for the prevalence of hypertension among the government employees in Bangladesh. In this cross-sectional study, conducted from 30 October to 31 December 2016, 1219 government employees aging ≥18 years working in Rangpur city were evaluated for the presence of HTN and its risk factors. Socio-demographic and anthropometric data, data on the presence of various known risk factors of hypertension were collected. Hypertension was defined with systolic BP ≥140mmHg and/or diastolic BP ≥90mmHg or those getting treatment for hypertension. Statistical analysis was done by using SPSS version 23.0; odds of hypertension among subjects with risk factors were calculated and p ≤0.05 was considered to be statistically significant. The prevalence of hypertension was 38.3% among the study subjects. Significantly higher odds of having hypertension were observed in study subjects with the age groups of 35-49 (OR 2.12, 95% CI: 1.51-2.99, p<0.001) and ≥50 (OR: 4.96, 95% CI: 3.43-7.18, p<0.001) years than age group <35 years. Employees who were averagely satisfied and not satisfied for their jobs also had higher odds (OR: 1.38, 95% CI: 1.00-1.91, p=0.049 and OR: 1.48, 95% CI: 3.43-7.18, p=0.337) of having hypertension than fully satisfied ones. Having diabetes mellitus was found to increase the odds (OR 2.12, 95% CI: 1.51-2.99, p<0.001) of hypertension. Male gender, urban/suburban residence, not doing physical exercise, sedentary/light working habit, overweight/obesity also increased the odds of having hypertension though these were not statistically significant. There is a high burden of hypertension among the government employees in Rangpur city. Age, job satisfaction and diabetes were independent risk factors of hypertension.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus/epidemiología , Empleados de Gobierno/estadística & datos numéricos , Hipertensión/epidemiología , Obesidad/epidemiología , Adulto , Bangladesh/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Distribución por Sexo , Población Suburbana/estadística & datos numéricos , Población Urbana/estadística & datos numéricos
10.
Mymensingh Med J ; 29(1): 156-161, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915352

RESUMEN

Sub clinical hypothyroidism (SCH) is common in clinical practice. Autoimmunity is thought to be the most important cause of SCH. In this cross-sectional study, we investigated 120 SCH patients and 100 healthy controls attending the Endocrinology Outpatient Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from June 2014 to April 2015 for anti-thyroid antibodies (anti-TPO and anti-Tg). Measurement of serum TSH, FT4, anti-TPO, and anti-Tg antibodies were done by using the chemiluminescent sequential immunometric assay. SCH patients had a higher mean age; the frequencies of female subjects, those having family history of thyroid disease or other autoimmune diseases, and goiter were higher in SCH group than in the control group. Forty-five percent (45%) of SCH patients were positive for anti-thyroid antibodies (23.3% for both anti-TPO and anti-Tg, 16.7% for only anti-TPO, and 5% positive for only anti-Tg) in comparison to only 10% anti-thyroid antibody positive controls (none for both antibodies, 8% for only anti-TPO, and 2% positive for only anti-Tg). The SCH subjects in the lower age group, females and with a TSH >10µIU/mL had the higher frequency of thyroid autoimmunity. Female gender, high socioeconomic condition, the presence of other autoimmune diseases, the presence of goiter and TSH >10µIU/mL were associated with higher odds of anti-thyroid antibody positivity in the SCH group, though none were statistically significant. The frequency of anti-thyroid antibody was higher in SCH and was more prevalent among the females, younger patients and those having a goiter, other autoimmune diseases, and TSH >10µIU/mL.


Asunto(s)
Anticuerpos/sangre , Autoanticuerpos/sangre , Hipotiroidismo/diagnóstico , Hipotiroidismo/inmunología , Adulto , Autoantígenos , Bangladesh/epidemiología , Biomarcadores/sangre , Estudios Transversales , Femenino , Humanos , Hipotiroidismo/epidemiología , Yoduro Peroxidasa , Proteínas de Unión a Hierro , Prevalencia , Tiroglobulina/sangre , Tirotropina/sangre , Tiroxina/sangre , Triyodotironina/sangre
11.
Mymensingh Med J ; 29(1): 162-168, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915353

RESUMEN

Hypertension and diabetes co-exist frequently. Therefore, salt intake behavior, a risk factor of hypertension, in diabetic patients plays an important role in determining their cardiovascular outcome. The purpose of this study was to assess the knowledge and behaviors of health risks associated with a salt intake in adults with type 2 diabetes. This cross-sectional study was conducted among the type 2 diabetic in-patients of Bangladesh Institute of Health Sciences General Hospital, Dhaka, Bangladesh from October to December 2016. Data were collected from 131 respondents through interview using WHO STEPS module of salt with adaptation to local context like on amount of added salt while taking meal. Information on blood pressure, body mass index and relevant co-morbidities were also collected. About half of the respondents were women (56.5%). Mean age of the respondents was 54.3±14.4 years. More than six in 10 of them (62.6%) took added salt while taking meal; and 40.5% took processed foods with high salt. The mean amount of added salt intake among the users was 4.4±1.6gm per day having no significant difference between men and women. Though 47.3% of the respondents believed that lowering salt in meal is very important and 77.9% of them believed that excess salt or salty sauce can cause health problems. Salt intake behavior is poor in patients with type 2 diabetes even having regular contacts with doctors and other health professionals. Appropriate measures can be taken to increase awareness, change their attitude and behavior regarding salt consumption.


Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud/etnología , Cloruro de Sodio Dietético/efectos adversos , Adulto , Anciano , Bangladesh/epidemiología , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Conducta Alimentaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cloruro de Sodio Dietético/administración & dosificación
12.
Mymensingh Med J ; 29(1): 177-182, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915355

RESUMEN

Global population is ageing and Bangladesh has one of the fastest growing ageing populations in this region. Growth in the elderly population relative to other age groups challenges existing health services, family relationships and social security. Combined with this, depression has become a major mental health problem for elderly people especially for urban elderly for nuclear family norm in urban areas. The study was descriptive type of cross-sectional in nature and was conducted in Rangpur Medical College Hospital, Rangpur & Prime Medical College Hospital, Rangpur, Bangladesh. The objective of this study was to assess the lifestyle and level of depression in urban elderly. Depression was measured by questionnaire of geriatric depression scale among 254 respondents. 87.8% of the respondents were age between 60-70 years. Majorities (63%) of the respondents were male, 54% of the respondents lived in nuclear type family and the rest (46%) in joint type of family. Among respondents near half (47.2%) of the respondents found Mild depressive, around one third (32.7%) were severe depressive, and the rest (20.1%) were normal. There was significant association between occupational status of the respondents and depression (x² = 45.600, df=14, p=0.000). Farmers unemployed found severely depressive (52.1%) followed by day-labourer (50%) and businessmen (37.5%). There was significant association between financial self dependency and depression of the respondents (x²= 34.072, df=4, p=0.000). Severe depression (43.8%) was found among those who were not financially self dependent. There was also significant association between monthly income and depression of the respondents (x²= 67.327, df=8, p=0.000). The study also found that lower income group (

Asunto(s)
Estilo de Vida , Población Urbana/estadística & datos numéricos , Anciano , Bangladesh/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/etnología , Depresión/psicología , Evaluación Geriátrica , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Factores Socioeconómicos , Encuestas y Cuestionarios
13.
Mymensingh Med J ; 29(1): 187-194, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915357

RESUMEN

Coronary artery disease is the most common form of heart disease and single most important cause of premature death in developed countries. Off pump coronary artery bypass grafting surgery has recently became widespread internationally and has produced good clinical outcome even in left main coronary artery disease following off pump coronary artery bypass grafting surgery. A prospective observational study was conducted in the department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh from January 2015 to September 2016 after fulfillment of enrollment criteria, 428 patients were studied for the purpose of the study and they were grouped in two, significant left main coronary artery disease in group A and non left main coronary artery disease requiring surgery in group B. Comparison of risk factors between groups demonstrates that diabetes mellitus and smoking habit between two groups were almost identical. 69.2% of patient with significant left main coronary artery group were hypertensive and 25.2% were dyslipidaemic in comparison to non left main coronary artery disease group which were 50.9% and 6.5% respectively. Requirement of per operative inotropic support was significantly higher in left main coronary artery group. 33.6% of patient of left main coronary artery group required per operative inotropic support whereas non left main coronary artery group require 24.8%. Postoperative inotropic support, mechanical ventilation time, ICU stay, hospital stay and complication were similar in both these groups. So, we can say that off pump coronary artery bypass grafting surgery for significant left main coronary artery disease is as safe as non left main coronary artery disease.


Asunto(s)
Puente de Arteria Coronaria Off-Pump , Puente de Arteria Coronaria/métodos , Enfermedad de la Arteria Coronaria/cirugía , Enfermedad Coronaria/cirugía , Bangladesh/epidemiología , Enfermedad de la Arteria Coronaria/epidemiología , Dislipidemias/epidemiología , Humanos , Hipertensión/epidemiología , Periodo Posoperatorio , Estudios Prospectivos , Factores de Riesgo , Resultado del Tratamiento
14.
Mymensingh Med J ; 29(1): 195-201, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915358

RESUMEN

Gastric cancer (GC) is one of the most common tumors and remains the second leading cause of cancer mortality in the world. The incidence of gastric carcinoma is declining in the last few years in some areas like USA, UK, Canada etc, because of reduction in chronic H. pylori infection, smoking, decrease use of smoked and salted food. The gastric carcinoma still remains a burden for Bangladesh as the prevalence of H. Pylori has not substantially decreases. Among the gastric carcinomas, adenocarcinomas are the most common type. So the study was performed to observe the location and histomorphologic pattern of Gastric and gastrooesophageal junction (GEJ) adenocarcinoma. This descriptive cross sectional study was carried out at the Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh from January 2013 to December 2014. A total of 130 patients with primary gastric and GEJ adenocarcinomas were included in this study. All the cases were evaluated for routine histological examination. The age range of the patients was 17 to 80 years and male to female ratio was 2.25:1. Antrum is the most common (66.9%) site being affected, followed by GEJ (19.2%), body (13%) and fundus (0.76%). Tumors of the antrum and GEJ were found mostly in the late age. On macroscopic examination, the ulcerated tumor mass (69.2%) was most frequent then the others. Regarding histological examination, 84(64.6%) cases were intestinal type, 32(24.6%) diffuse and 14(10.8%) mixed type by Laurens classification. According to WHO classification, about half of the cases (49.2%) were tubular carcinoma and rest were others. Most of the intestinal type carcinoma (71.4%) was presented with moderately differentiated and 25.0% with well differentiated. Where as the diffuse type presented with poorly differentiated in 96.9% cases.


Asunto(s)
Adenocarcinoma/patología , Unión Esofagogástrica/patología , Neoplasias Gástricas/patología , Adenocarcinoma/clasificación , Adenocarcinoma/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bangladesh/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Gástricas/epidemiología , Adulto Joven
15.
Mymensingh Med J ; 29(1): 209-214, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915360

RESUMEN

Most of the mortalities among Diabetic Nephropathy patients are cardiovascular, if we identify the risk factor, measures can be taken to prevent it. Hence an objective was set to evaluate the association between carotid artery intima media thickness (CIMT) with eGFR in patients of CKD stage III, IV and V among patients with type 2 diabetes mellitus; also, correlation with age, BMI, lipid profile. This cross-sectional, observational study was performed in 70 patients in different stages of CKD in Diabetic Patients selected by Inclusion Criteria (Diabetic nephropathy patients with stages III, IV, V and exclusion Criteria (Acute kidney injury, History of carotid surgery, Patients of MI and stroke). This study was performed in Department of Nephrology, Dhaka Medical College in collaboration with the Department of Radiology and Imaging, laboratory of Department of Biochemistry and Department of Microbiology at Dhaka Medical College Hospital (By standard method in laboratory) from 1st January 2016 to 31st December 2016. eGFR was measured by MDRD formula and the CIMT was measured using an ultrasonographic examination. The mean CIMT was 0.9±0.21mm, and 62.9% of the subjects showed IMT thickening (≥1mm). The carotid IMT elevated significantly with the stage progression of CKD (Overall eGFR mean 28.8±14.5mL/min/1.73m² in CIMT<1mm with range from 6 to 54 and 9.1±9.0mL/min/1.73m² in CIMT ≥1mm with range from 3 to 32 (p=0.001). The eGFR was significantly lower in the patients with CIMT thickening than those without CIMT thickening. eGFR was also significantly associated with CKD stages (p=0.001), serum creatinine (p=0.001), BMI (r = -0.330, p=0.005), and negatively associated with age group, duration of hypertension, smoking. However, the CIMT was not significantly different among the patients at different stages of diabetic nephropathy (r = -0.172, p=156) and age group. It has been concluded that the mean CIMT was markedly high in patients with CKD compared to normal expected value. This study showed a relationship between the CIMT and the renal parameters as eGFR and the stages of diabetic nephropathy with a confirm association between the CIMT and diabetic macroangiopathy.


Asunto(s)
Arterias Carótidas/patología , Grosor Intima-Media Carotídeo , Diabetes Mellitus Tipo 2/fisiopatología , Diabetes Mellitus/patología , Riñón/fisiopatología , Insuficiencia Renal Crónica/fisiopatología , Bangladesh/epidemiología , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Tasa de Filtración Glomerular , Humanos , Insuficiencia Renal Crónica/epidemiología
17.
PLoS One ; 14(12): e0221691, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31887122

RESUMEN

BACKGROUND: Globally, low birthweight (LBW) infants (<2.5 kilograms) contribute up to 80% of neonatal mortality. In Bangladesh, approximately 62% of all births occur at home and therefore, weighing newborns immediately after birth is not feasible. Thus, estimates of birthweight in Bangladesh are mostly obtained based on maternal perception of the newborn's birth size. Little is known about how birthweight is perceived in rural communities, and whether families associate birthweight with newborn's health status. Our objective was to explore families' perceptions of newborn's birthweight, and preventive and care practices for a LBW newborn in rural Bangladesh. METHODS: We conducted a qualitative study in two rural settings of Bangladesh, including 32 in-depth interviews (11 with pregnant women, 12 with recently delivered women, 4 with husbands whose wives were pregnant or had a recent birth, 5 with mothers-in-law whose daughters-in-law were pregnant or had a recent birth), 2 focus group discussions with husbands and 4 key-informant interviews with community health workers. We used thematic analysis to analyse the data. RESULTS: Most participants did not consider birthweight a priority for assessing a newborn's health status, although there was a desire for a healthy newborn. Recognition of different categories of birthweight was subjective and often included several physical descriptors including birth size of the newborn. LBW was not considered as a criterion of a newborn's illness unless the newborn appeared unwell. Maternal poor nutrition, inadequate diet in pregnancy, anaemia, illness during pregnancy, short stature, twin births and influence of supernatural spirit were identified as the major causes of LBW. Women's preventive practices for LBW or small newborns were predominantly constrained by a lack of awareness of birthweight and fear of caesarean section. As an effort to avoid caesarean section during birth, several women tended to perform potentially harmful practices in order to give birth to a small size newborn; such as avoiding nutritious food and eating less in pregnancy. Common practices to treat a LBW or small newborn who appeared ill included breastfeeding, feeding animal milk, feeding sugary water, feeding formula, oil massage, keeping the small newborn warm and seeking care from formal and informal care providers including a spiritual leader. Maternal lack of decision-making power, financial constraint, home birth and superstition were the major challenges to caring for a LBW newborn. CONCLUSION: Birthweight was not well-understood in the rural community, which highlighted substantial challenges to the prevention and care practices of LBW newborns. Community-level health education is needed to promote awareness related to the recognition of birthweight in rural settings.


Asunto(s)
Parto Domiciliario/ética , Salud del Lactante/etnología , Salud del Lactante/tendencias , Adulto , Bangladesh/epidemiología , Peso al Nacer , Cesárea , Femenino , Parto Domiciliario/tendencias , Humanos , Renta , Lactante , Mortalidad Infantil , Recién Nacido de Bajo Peso/fisiología , Recién Nacido , Madres/psicología , Parto , Aceptación de la Atención de Salud/psicología , Embarazo , Población Rural , Factores Socioeconómicos
18.
J Glob Health ; 9(2): 020803, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31673347

RESUMEN

Background: Bangladesh had a large reduction in childhood deaths due to diarrhoeal disease in recent decades. This paper explores the preventive, promotive, curative and contextual drivers that helped Bangladesh achieve this exemplary success. Methods: Primary and secondary data collection approaches were used to document trends in reduction of Diarrhoea Specific Mortality Rate (DSMR) between 1980 and 2015, understand what policies and programmes played key roles, and estimate the contribution of specific interventions that were implemented during the period. Data acquisition involved relevant document reviews and in-depth interviews with key stake-holders. A systematic search of literature was undertaken to explore socio-economic, aetiological, behavioural, and nutritional drivers of diarrhoeal disease reduction in Bangladesh. Finally, we used LiST (Lives Saved Tool) to model the contributions of the relevant interventions during three time periods (1980-2015, 1980-2000 and 2000-2015), and to project the number of lives saved in 2030 (compared to 2015) if these interventions were implemented at near universal coverage (90%). Results: The factors which likely had the most impact on DSMR were the coordinated efforts of the Government of Bangladesh (GoB) with non-government organizations (NGOs) and the private sector that enabled swift implementation, at scale, of interventions like oral rehydration solution (ORS) and zinc, promotion of breastfeeding, handwashing and sanitary latrines (WASH), as well as improvements in female education and nutrition. Compared to 1980, we found ORS and reduction in stunting prevalence had the greatest impact on DSMR, saving roughly 70 000 lives combined in 2015. Until 2000, ORS had a higher contribution to DSMR reduction than reduction in stunting prevalence. This proportionate contribution was reversed during 2000-2015. At near universal coverage (90%) of combined direct diarrhoeal disease, nutrition and WASH interventions, we project that an additional 5356 deaths due to diarrhoea could be averted in 2030. Conclusion: Bangladesh's achievement in reduction of DSMR highlights the important role of an enabling policy environment that fostered coordinated efforts of the public and private sectors and NGOs for maximal impact. To maintain this momentum, evidence-based interventions should be scaled up at universal coverage.


Asunto(s)
Mortalidad del Niño/tendencias , Diarrea/prevención & control , Mortalidad Infantil/tendencias , Logro , Bangladesh/epidemiología , Preescolar , Diarrea/mortalidad , Humanos , Lactante , Recién Nacido , Evaluación de Programas y Proyectos de Salud
19.
Environ Health Prev Med ; 24(1): 65, 2019 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-31775610

RESUMEN

BACKGROUND: Little is known regarding the effect of exposure to biomass fuel smoke inhalation on respiratory symptoms in the Bangladeshi population which is a major health hazard in most of the developing countries. This study aims to explore the association between respiratory symptoms and biomass fuel smoke exposure among children under 5 years of age. METHODS: Data were extracted from the Bangladesh Urban Health Survey conducted in 2013. A total of 10,575 mothers with at least one surviving children were selected. Respiratory symptoms among children under 5 years of age were considered as the primary outcome. Sequential multiple logistic regression models were used to observe the association between respiratory symptoms and biomass fuel smoke exposure adjusting the effect of residential factors and mother and child characteristics. RESULTS: Around 40% of the mothers exclusively used biomass fuel irrespective of the kitchen location and 54% of them were habituated in indoor cooking. The prevalence of respiratory symptoms of under-five children among in-house and outdoor biomass fuel users was 23.0% and 21.9%, respectively. Results of fitted multiple logistic regression models showed that the odds of having respiratory symptoms among children under 5 years of age were increased due to in-house biomass fuel use [OR = 1.18; 95% CI, 1.04-1.36] compared with the non-biomass user. An increased risk of respiratory symptoms was also significantly associated with mother's birth complication [OR = 1.51; 95% CI, 1.36-1.67], non-government organization (NGO) membership of mothers [OR = 1.32; 95% CI, 1.16-1.51], age of the child (6-23m) [OR = 1.29; 95% CI, 1.10-1.52], and nutritional status (stunting) [OR = 1.18; 95% CI, 1.06-1.31]. CONCLUSION: This study found the use of in-house biomass fuel as a significant risk factor associated with respiratory symptoms of children under 5 years of age. More longitudinal studies should be designed to establish a causal relationship between HAP (household air pollution) and respiratory symptoms among children with more direct measures of HAP and clinical procedure.


Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Exposición por Inhalación/efectos adversos , Trastornos Respiratorios/epidemiología , Trastornos Respiratorios/etiología , Humo/efectos adversos , Contaminación del Aire Interior/efectos adversos , Bangladesh/epidemiología , Biomasa , Preescolar , Culinaria/métodos , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Recién Nacido , Masculino , Madres , Prevalencia , Factores de Riesgo , Salud Urbana
20.
BMC Public Health ; 19(1): 1567, 2019 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-31775703

RESUMEN

BACKGROUND: Bangladesh has one of the highest drowning mortality rates in the world. The use of unregulated water transportation may contribute to this burden, with 38% of all passenger traffic occurring by water. The present study aims to identify provider and end user perception on water transport related drowning risk, and barriers and facilitators for improving water safety practices. METHODS: A qualitative study was conducted in a riverine area of Bangladesh, the Barishal division. Data was collected through 18 in-depth interviews, two small group discussions and six observations in February-March 2016. Content analysis was conducted, guided by domains of Haddon's matrix for injury prevention. RESULTS: A range of unsafe behaviours, practices and conditions were identified at pre event, event and post event stages of water transport related drownings. It was also recognised it is not only the regulation of water transport but other factors such as occupational insecurities, poor access to rescue services and healthcare, migration and capacity for skill development among providers that contribute to unsafe water transport practices and drowning risk. CONCLUSION: There are some immediate measures that can be implemented, with some monitoring and accountability processes for water transport safety. However, there is need for robust data to quantify transport related drowning, making a case for prioritization and action by relevant stakeholder such as government and transport providers.


Asunto(s)
Ahogamiento/mortalidad , Navíos , Transportes/estadística & datos numéricos , Adolescente , Adulto , Anciano , Bangladesh/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Adulto Joven
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