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1.
J Korean Med Sci ; 37(1): e13, 2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34981683

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) is generally asymptomatic or mild in otherwise healthy children, however, severe cases may occur. In this study, we report the clinical characteristics of children classified as critical COVID-19 in Korea to provide further insights into risk factors and management in children. METHODS: This study was a retrospective case series of children < 18 years of age classified as critical COVID-19. Cases were identified by the Korea Disease Control and Prevention Agency surveillance system and medical records were reviewed. Critical COVID-19 was defined as cases with severe illness requiring noninvasive (high flow nasal cannula, continuous positive airway pressure, or bilevel positive airway pressure) or invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT), between January 20, 2020 and October 7, 2021. RESULTS: Among 39,146 cases diagnosed with COVID-19 in subjects < 18 years of age, eight cases (0.02%) were identified as critical COVID-19. The median age was 13 years (range 10 month-17 years) and male-to-female ratio was 1:1. Three children had underlying diseases; one child has asthma and major depressive disorder, one child had Lennox-Gastaut syndrome and one child had mental retardation and was newly diagnosed with type 2 diabetes mellitus with the diagnosis of COVID-19. Among the eight children, seven were obese (body mass index range [BMI] median 29.3, range 25.9-38.2, weight-for-length > 97% for infant) and one was overweight (BMI 21.3). All patients had fever, six patients had dyspnea or cough and other accompanied symptoms included sore throat, headache, lethargy and myalgia. Radiologic findings showed pneumonia within 1-8 days after symptom onset. Pneumonia progressed in these children for 2-6 days and was improved within 5-32 days after diagnosis. Among the eight critical cases, remdesivir was administered in six cases. Steroids were provided for all cases. Inotropics were administered in one case. Six cases were treated with noninvasive mechanical ventilator and three required mechanical ventilator. One case required ECMO due to acute respiratory distress syndrome. All cases were admitted to the intensive care unit and admission period ranged from 9-39 days. Among all critical COVID-19 cases < 18 years of age, there were no fatal cases. CONCLUSION: To develop appropriate policies for children in the COVID-19 pandemic, it is important to monitor and assess the clinical burden in this population.


Asunto(s)
COVID-19/epidemiología , SARS-CoV-2 , Adolescente , COVID-19/complicaciones , COVID-19/terapia , Niño , Preescolar , Cuidados Críticos , Femenino , Humanos , Lactante , Masculino , República de Corea/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
3.
BMC Health Serv Res ; 22(1): 31, 2022 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-34986832

RESUMEN

BACKGROUND: The need for youth-friendly sexual and reproductive health (SRH) services has been identified as a national policy priority in Jordan, but there remains limited data on service utilization among adolescents, especially those who are unmarried, and there is limited training for healthcare practitioners (HCPs) in providing SRH services to youth. The objectives of this study are to 1) describe the most common reasons for encounters that HCPs have with unmarried youth clients about SRH topics and 2) explore differences in SRH services provided to unmarried youth by provider in Jordan. METHODS: This cross-sectional study used a two-stage cluster-randomized sampling scheme to sample HCPs (doctors, nurses, and midwives) from health facilities in four governorates in Jordan. Data were collected on practitioner demographics, facility characteristics, and self-reports of having provided services related to nine common SRH concerns to unmarried girls or boys between the ages of 15-19 years. Chi-square tests were conducted to analyze the associations between provider and facility characteristics, client sex, and types of services rendered. RESULTS: In total, 578 providers participated in the study (110 male and 468 female). Practitioners most commonly reported seeing unmarried female youth for concerns related to puberty (38.5%) and family planning (18.51%) and unmarried male youth for concerns of puberty (22.49%) or condoms (11.59%). In total, 64.45, 64.61 and 71.19% of midwives, nurses, and doctors reported having provided any SRH service to an unmarried adolescent. While practitioners most often reported seeing clients of the same sex, male practitioners were more likely to report having seen a female client for STIs (9.09% vs. 4.27% p = 0.040), and providing general information about sexual activity (12.73% vs. 5.77% p = 0.011) than female providers. CONCLUSIONS: Our results suggest that a substantial proportion of HCPs have provided SRH services to unmarried youth - challenging existing perceptions of the SRH care-seeking practices of unmarried youth in this conservative context.


Asunto(s)
Servicios de Salud Reproductiva , Persona Soltera , Adolescente , Adulto , Estudios Transversales , Atención a la Salud , Femenino , Instituciones de Salud , Humanos , Jordania , Masculino , Salud Reproductiva , Conducta Sexual , Adulto Joven
4.
Environ Int ; 158: 107012, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34991268

RESUMEN

OBJECTIVE: The aim of this study was to explore the association between exposure to particulate matter with an aerodynamic diameter of 2.5 mm or less (PM2.5) and blood pressure (BP) levels in children and adolescents and to illustrate the impact of PM2.5 levels on BP growth curves in a cohort study. METHODS: A longitudinal study was designed and included 4303 children (7617 BP measurements) living in the selected areas, and evaluations were conducted in 2014-2015 (visit 1) and followed up in 2019 (visit 2). Two-stage stratified cluster sampling was used to include urban-rural areas. A mixed linear regression model and mixed logistic regression model were used to analyze the effect of PM2.5 exposure on BP and the incidence of prehypertension and hypertension in children. RESULTS: After adjusting for covariates, systolic blood pressure (SBP) (2.21 (95% CIs: 0. 81, 3.62), mmHg), diastolic blood pressure (DBP) (1.92 (95% CIs: 0.74, 3.11), mmHg), mean arterial pressure (MAP) (2.03 (95% CIs: 0.89, 3.17), mmHg) and heart rate (HR) (2.24 (95% CIs: 0.11, 4.37), beats/min) increased significantly in the fourth quartile of PM2.5 exposure levels compared with the first quartile (all P < 0.01). In addition, long-term exposure to PM2.5 was significantly positively correlated with SBP, DBP and MAP, and the effect was more notable in urban areas than that in rural areas. Moreover, the risk of prehypertension and hypertension incidence increased by 1.17 (95% CIs: 1.03, 1.33) fold with a one-quartile increase in PM2.5 exposure. The long-term effects of annual mean PM2.5 exposure on SBP, DBP and MAP were significant from pregnancy to 7, 3 and 4 years of age, respectively. CONCLUSION: Long-term exposure to PM2.5 was positively associated with growth curves of hemodynamics indexed from pregnancy to childhood and adolescence, and the effect was more significant in urban areas than in rural areas.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Hipertensión , Adolescente , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/análisis , Contaminación del Aire/estadística & datos numéricos , Presión Sanguínea , Niño , Estudios de Cohortes , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Humanos , Hipertensión/epidemiología , Estudios Longitudinales , Material Particulado/análisis , Embarazo , Estudios Prospectivos
5.
BMC Public Health ; 22(1): 42, 2022 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-34991525

RESUMEN

BACKGROUND: COVID-19 has developed into a worldwide pandemic which was accompanied by an «infodemic¼ consisting of much false and misleading information. To cope with these new challenges, health literacy plays an essential role. The aim of this paper is to present the findings of a trend study in Switzerland on corona-specific health literacy, the use of and trust in information sources during the COVID-19 pandemic, and their relationships. METHODS: Three online surveys each with approximately 1'020 individuals living in the German-speaking part of Switzerland (age ≥ 18 years) were conducted at different timepoints during the COVID-19 pandemic, namely spring, fall and winter 2020. For the assessment of corona-specific health literacy, a specifically developed instrument (HLS-COVID-Q22) was used. Descriptive, bivariate, and multivariate data analyses have been conducted. RESULTS: In general, a majority of the Swiss-German population reported sufficient corona-specific health literacy levels which increased during the pandemic: 54.6% participants in spring, 62.4% in fall and 63.3% in winter 2020 had sufficient corona-specific health literacy. Greatest difficulties concerned the appraisal of health information on the coronavirus. The most used information sources were television (used by 73.3% in spring, 70% in fall and 72.3% in winter) and the internet (used by 64.1, 64.8 and 66.5%). Although health professionals, health authorities and the info-hotline were rarely mentioned as sources for information on the coronavirus, respondents had greatest trust in them. On the other hand, social media were considered as the least trustworthy information sources. Respondents generally reporting more trust in the various information sources, tended to have higher corona-specific health literacy levels. CONCLUSIONS: Sufficient health literacy is an essential prerequisite for finding, understanding, appraising, and applying health recommendations, particularly in a situation where there is a rapid spread of a huge amount of information. The population should be supported in their capability in appraising the received information and in assessing the trustworthiness of different information sources.


Asunto(s)
COVID-19 , Alfabetización en Salud , Adolescente , Estudios Transversales , Humanos , Pandemias , SARS-CoV-2 , Encuestas y Cuestionarios , Confianza
6.
J Pediatr Orthop ; 42(2): e212-e217, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-34995263

RESUMEN

BACKGROUND: Pediatric musculoskeletal infection (MSKI) is a bacterial infection of the bone, joint, and/or muscle that can be difficult to diagnose. The Kocher and Caird algorithms were developed to distinguish septic arthritis (SA) from transient synovitis (TS) in the hip. These algorithms have been applied to all patients presenting with painful, swollen monoarticular joints regardless of suspicion for SA. The aim of this analysis was to assess the test performance of Kocher and Caird to distinguish MSKI among all pediatric patients presenting with monoarticular joint pain. A secondary aim was to validate the original algorithms. METHODS: We conducted a secondary analysis of a prospective cohort study evaluating the test performance of procalcitonin for suspected SA in a pediatric emergency department. Patients aged 0 to 16 years old who presented with a painful or swollen monoarticular joint were considered for enrollment. We compared the test performance of the traditional algorithms in an expanded population of MSKI versus alternate joint pain using sensitivity, specificity, and area under the curve (AUC). As a sensitivity analysis, missing data for predictors like temperature, erythrocyte sedimentation rate, C-reactive protein, and inability to bear weight were multiply imputed using the Stata program, mi impute, for changed equations. RESULTS: The Caird algorithm had better test performance compared to the Kocher in all populations. Both algorithms were most discriminative in comparing SA to TS in all joints (AUC: 0.84 Caird and 0.75 Kocher). However, the Caird criteria performed almost as well discriminating MSKI from other causes of monoarticular joint pain in all joints (AUC: 0.79; 95% confidence interval: 0.72, 0.85) and nonhip joints (AUC: 0.80; 95% confidence interval: 0.71, 0.88). CONCLUSION: Based on the findings of this study, it is clinically reasonable to apply the Caird algorithm to pediatric patients presenting with monoarticular joint pain of medium and large joints such as the knee, ankle, shoulder, elbow, and wrist, in addition to the hip. LEVEL OF EVIDENCE: Level III-retrospective study of novel applications of SA algorithms.


Asunto(s)
Artritis Infecciosa , Adolescente , Algoritmos , Artritis Infecciosa/diagnóstico , Sedimentación Sanguínea , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Estudios Prospectivos , Estudios Retrospectivos
7.
J Pediatr Orthop ; 42(2): 116-122, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-34995265

RESUMEN

BACKGROUND: The prevalence of back pain in the pediatric population is increasing, and the workup of these patients presents a clinical challenge. Many cases are selflimited, but failure to diagnose a pathology that requires clinical intervention can carry severe repercussions. Magnetic resonance imaging (MRI) carries a high cost to the patient and health care system, and may even require procedural sedation in the pediatric population. The aim of this study was to develop a scoring system based on pediatric patient factors to help determine when an MRI will change clinical management. METHODS: This is a retrospective cohort analysis of consecutive pediatric patients who presented to clinic with a chief complaint of back pain between 2010 and 2018 at single orthopaedic surgery practice. Comprehensive demographic and presentation variables were collected. A predictive model of factors that influence whether MRI results in a change in management was then generated using cross-validation least absolute shrinkage and selection operator logistic regression analysis. RESULTS: A total of 729 patients were included, with a mean age of 15.1 years (range: 3 to 20 y). Of these, 344 (47.2%) had an MRI. A predictive model was generated, with nocturnal symptoms (5 points), neurological deficit (10 points), age (0.7 points per year), lumbar pain (2 points), sudden onset of pain (3.25 points), and leg pain (3.75 points) identified as significant predictors. A combined score of greater than 9.5 points for a given patient is highly suggestive that an MRI will result in a change in clinical management (specificity: 0.93; positive predictive value: 0.92). CONCLUSIONS: A predictive model was generated to help determine when ordering an MRI may result in a change in clinical management for workup of back pain in the pediatric population. The main factors included the presence of a neurological deficit, nocturnal symptoms, sudden onset, leg pain, lumbar pain, and age. Care providers can use these findings to better determine if and when an MRI might be appropriate. LEVEL OF EVIDENCE: Level III-diagnostic study.


Asunto(s)
Dolor de Espalda , Dolor de la Región Lumbar , Adolescente , Dolor de Espalda/diagnóstico por imagen , Dolor de Espalda/etiología , Niño , Humanos , Vértebras Lumbares , Imagen por Resonancia Magnética , Valor Predictivo de las Pruebas , Estudios Retrospectivos
8.
BMJ Case Rep ; 15(1)2022 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-35027378

RESUMEN

Heminasal agenesis is an exceedingly rare congenital anomaly which is frequently associated with disorders of eye, lacrimal drainage system and face. At times, a proboscis may also be noted with this condition. Herein, we present a case of a 13-year-old boy who presented to us with heminasal agenesis with concomitant microphthalmos, leucomatous corneal opacity, blepharoptosis, dacryocystocoele and maxillary hypoplasia. The child underwent a modified transeptal external dacryocystorhinostomy with placement of a lacrimal stent. There was significant improvement of epiphora and discharged following surgery. Heminasal aplasia with dacryocystocoele is surgical challenge; however, a well thought out surgical approach can yield satisfactory outcomes.


Asunto(s)
Dacriocistorrinostomía , Anomalías del Ojo , Aparato Lagrimal , Obstrucción del Conducto Lagrimal , Conducto Nasolagrimal , Adolescente , Niño , Humanos , Masculino , Cavidad Nasal , Conducto Nasolagrimal/diagnóstico por imagen , Conducto Nasolagrimal/cirugía
9.
J Am Assoc Nurse Pract ; 34(1): 3-4, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34978541

RESUMEN

ABSTRACT: Firearm injuries are considered among the five leading causes of death for people ages 1-64 years. The issue is of concern for nurse practitioners (NPs) and NP educators as the need for gun violence-related health care increases. This essay focuses on several local and national efforts to address the short- and long-term consequences of gun violence.


Asunto(s)
Armas de Fuego , Violencia con Armas , Enfermeras Practicantes , Heridas por Arma de Fuego , Adolescente , Adulto , Niño , Preescolar , Violencia con Armas/prevención & control , Humanos , Lactante , Persona de Mediana Edad , Violencia/prevención & control , Heridas por Arma de Fuego/prevención & control , Adulto Joven
10.
Artículo en Chino | MEDLINE | ID: mdl-34979618

RESUMEN

Objective:To understand the sensitization characteristics of humulus pollen in patients with allergic rhinitis or allergic asthma in Beijing, and to explore the proportion of the population allergic to humulus pollen. Methods:Selected 8380 patients who were diagnosed with allergic rhinitis, allergic asthma, and allergic rhinitis combined with asthma in outpatient clinic from January 2017 to December 2019. SPT test was performed with humulus allergen reagent to compare the sensitization distribution of humulus pollen by age and disease, and analyze the sensitization characteristics of humulus pollen. Results:The total positive rate of humulus pollen SPT reached 49.59%.The positive rate of humulus pollen SPT was the highest in the age group of 10 to 14 years old, reaching 71.98%, compared with other age groups, there was a statistical difference (P<0.01); and the positive rate of SPT in patients under 10 years of age gradually increased with age, and the positive rate of SPT in patients over 50 years of age gradually decreased with age. Humulus pollen SPT positive patients ++++ and above accounted for 41.43%, which was significantly different from other groups (P<0.01). Single humulus was less allergenic, accounting for about 23.87%. Most of them were combined with multiple pollen allergies (76.13%), and often combined with chenopodiaceae pollen sensitization (92.81%). Conclusion:The SPT positive rate of humulus pollen in patients with allergic rhinitis or asthma in Beijing area is nearly 50%. The positive rate of SPT is the highest among patients aged 10-14, and most of them show strong positive reactions. It is suggested that humulus pollen is the main allergen of allergic rhinitis and asthma, and the sensitization of humulus pollen tends to be multiple allergens.


Asunto(s)
Humulus , Rinitis Alérgica Estacional , Rinitis Alérgica , Adolescente , Alérgenos , Niño , Humanos , Persona de Mediana Edad , Polen , Rinitis Alérgica Estacional/epidemiología , Pruebas Cutáneas
11.
Zhonghua Yan Ke Za Zhi ; 58(1): 41-45, 2022 Jan 11.
Artículo en Chino | MEDLINE | ID: mdl-34979792

RESUMEN

Objective: To investigate the cognitive effects of monocular blindness and related influencing factors. Methods: A cross-sectional study was conducted. The patients with monocular blindness (the age of onset <16 years) were enrolled from Beijing Tongren Eye Center, Beijing Tongren Hospital between January 2018 and June 2020. The Montreal cognitive assessment (MoCA) scale was applied to assess seven cognitive domains including visuospatial and executive function, naming, attention, etc. Based on MoCA scores, all the patients were classified into two groups: normal cognitive functions and cognitive impairment. Spearman's correlation was used to perform the single factor analysis of the influencing factors of cognitive functions. Multivariate linear regression analyses were applied to identify the independent influencing risk factors. Results: A total of 45 patients with monocular blindness were enrolled. There were 25 males and 20 females, with age at testing being (27±10) years.The incidence of cognitive impairment in 45 patients was 60.0% (27/45). The abnormal items ranking from a high to low rate were language (95.6%, 43 cases), delayed recall (75.6%, 34 cases), visuospatial and executive function (60.0%, 27 cases), abstract (44.4%, 20 cases), attention (35.6%, 16 cases), naming (20.0%, 9 cases), and orientation (0%). There were statistically significant differences (all P<0.05) in total score (21.9±3.3 vs. 27.4±1.4), visuospatial and executive function (3.2±1.7 vs. 4.6±0.7), naming (2.7±0.6 vs. 2.9±0.2), attention (5.3±1.0 vs. 5.8±0.4), language (1.1±0.8 vs. 1.8±0.8), abstract (1.1±0.8 vs. 1.8±0.5) and delayed recall (2.3±1.3 vs. 4.4±0.8) between two groups of patients with and without cognitive impairment. Spearman's correlation analysis showed visuospatial and executive functions, attention, abstract and MoCA total score were positively correlated with education years (correlation coefficients being 0.355, 0.424, 0.434 and 0.370, respectively; all P<0.05). Multiple linear regression showed that duration of blindness was correlated with naming (ß=-0.325), and years of education correlated with attention (ß=0.472), abstract ability (ß=0.441) and MoCA total score (ß=0.390) (all P<0.05). Conclusions: Monocular blindness may affect language, delayed memory and visuospatial executive functions. The duration of blindness is an independent risk factor, and higher education is a protective factor of the cognitive impairment.


Asunto(s)
Disfunción Cognitiva , Adolescente , Ceguera , Cognición , Estudios Transversales , Función Ejecutiva , Femenino , Humanos , Masculino
12.
Mymensingh Med J ; 31(1): 24-30, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999675

RESUMEN

Lymphadenopathy is a common problem encountered in day to day clinical practices in Bangladesh. It is an abnormal increase in size and/or altered consistency of lymph nodes. The condition generally is not a disease itself but a symptom of one of many possible underlying problems. So it is very much essential to achieve a correct diagnosis of patients presenting with lymphadenopathy. This cross sectional study carried out at the Department of Medicine, Mymensingh Medical College Hospital (MMCH), Mymensingh over a period of 6 months from January 2014 to June 2014. This study was carried out to evaluate the clinical presentations and to see the ultimate diagnosis by appropriate investigations of lymphadenopathy patients. It is a male predominance study. Metastatic carcinoma (Met. Ca) belonged to relatively higher age group, tuberculosis (TB) and acute leukaemias belonged to younger age group and lymphoma belonged to middle age group. Among 50 cases metastatic carcinoma comprises total 14(28%), lymphoma 13(26%), tuberculosis (TB) 12(24%), acute leukaemia 7(14%), non-specific (Non Sp.) 4(8%) cases. Among lymphoma non Hodgkin's lymphoma (NHL) was 10 (20%) then Hodgkin's disease (HD) was 3(6%) and among acute leukaemia acute lymphoblastic leukaemia (ALL) was 5(10%) and acute myeloblastic leukaemia (AML) was 2(4%) cases. Most of the patients belong to younger age groups, 32% cases were from 18-30 years. Most of the patients had generalized lymphadenopathy. Biopsy of lymph node was done in 60% cases. Fine needle aspiration cytology (FNAC) was done in 24% cases. Bone marrow study (BMD) was done in 14% cases include all cases of leukemia. Among 50 patients correct clinical diagnosis were found 100% cases of ALL and non-specific infection, 80% cases of metastatic carcinoma, 66.66% cases of AML and NHL, 62.5% cases of TB, 50% cases of HD. AML and ALL were diagnosed by bone marrow study. Over all 70% of clinical diagnosis were found correct in this study. In conclusion malignancy, lymphoma and tuberculosis were the most common cause of lymphadenopathy patients. Most of the cases were diagnosed by taking appropriate history and examination but FNAC, biopsy and bone marrow study were need for final diagnosis.


Asunto(s)
Ganglios Linfáticos , Linfadenopatía , Adolescente , Adulto , Biopsia con Aguja Fina , Estudios Transversales , Humanos , Linfadenopatía/diagnóstico , Masculino , Persona de Mediana Edad , Centros de Atención Terciaria , Adulto Joven
13.
Mymensingh Med J ; 31(1): 55-60, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999680

RESUMEN

The most common malignant neoplasm in Childhood is Leukemia which is about 41% of all malignancies. Incidence of CNS involvement is less than 5% in Acute Lymphoblastic Leukemia and 6-29% in Acute Myeloblastic Leukemia at Diagnosis. For Successful treatment of childhood leukemia it is mandatory, to give sufficient therapy directed to the CNS to treat sub clinical or overt CNS Leukemia. Without Central Nervous System- Directed therapy, relapses originating from the CNS in up to 75% cases. For this purpose it is crucial to find out the CNS involvement in acute leukemia at diagnosis. This study was conducted to find proportion and pattern of central nervous system involvement (central nervous system manifestation and/or cerebrospinal fluid findings) in acute leukemia at diagnosis in Bangladesh. A cross sectional study was conducted from May 2012 to November 2012 in the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Total 50 samples were included those having age <15 years newly diagnosed with acute leukemia by purposive sampling. Common age group 1-5 years (48%), 32 patients (64%) were male and 18 patients (36%) were female. Out of 32 male patients 4 patients presented with CNS manifestation and among 18 female patients 2 patients presented with CNS manifestation. There is no association between sex and CNS presentation (P value 0.89). 25 (50%) patients had total leukocyte count >11,000-1,00,000. Twelve (24%) patients had total leukocyte count <4,000. Eight (16%) patients had total leukocyte count 4,000-11,000, and rest 05(10%) patients had leukocyte count >1,00,000. Proportion of CNS manifestation was found 6/50 patients. Eight (8) patients were suffering from AML and 42 patients were suffering form ALL. Among 8 AML patients 1 (11.1%) patient had CNS manifestation and Among 42 ALL patients 5(11.1%) patients had CNS manifestation. Out of 6 patients with CNS manifestation, 2 (04%) patients presented with clinical manifestation, and 5(10%) had positive CSF findings. Pattern of CSF finding of 50 leukemic children CNS-1 90%, CNS-2 02%, CNS-3 08%, and no patients had traumatic lumber puncture with concomitant presence of blasts cells. There is significant association was found between hyper leukocytosis and CNS manifestation (p=0.138) but there is no statistically significant association between positive CSF findings and neurological findings (p=0.082). At conclusion, CNS manifestation is not uncommon (6/50 patients) was found in acute leukemia at diagnosis. So, every patient of acute leukemia should be examined carefully for CNS involvement along with CSF cytospin.


Asunto(s)
Leucemia Mieloide Aguda , Leucemia-Linfoma Linfoblástico de Células Precursoras , Adolescente , Bangladesh/epidemiología , Sistema Nervioso Central , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/epidemiología , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiología
14.
Mymensingh Med J ; 31(1): 80-87, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999684

RESUMEN

Glomerular disease is one of the most important causes of chronic kidney disease in developing countries like Bangladesh as well as the whole world. The pattern of glomerular disease varies in different countries and can have different clinical presentations. The aim of the study was to analyze the clinical profile and to determine the histological pattern of glomerular diseases in a large tertiary care hospital in Bangladesh. All kidney biopsies performed in Mymensingh Medical College Hospital, Bangladesh from October 2018 to March 2020 were prospectively analyzed in the study. A total of 101 patients with kidney biopsy were examined by clinical and laboratory findings and by light and immuno-fluorescence microscopy. The mean age was 30.0±14.6 years and 50(49.5%) were male and 51(50.5%) were female with a male to female ratio of 1:1. The clinical syndromes namely nephrotic syndrome, nephritic syndrome, nephrito-nephrotic presentation, RPGN like presentation, macroscopic haematuria and asymptomatic urine abnormality were present in 31.7%, 34.5%, 22.8%, 11.9%, 19.8% and 10.9% patients respectively. The most common histological varieties found in the study were mesangial proliferative glomerulonephritis (MesPGN) (18.8%) and focal segmental glomerulosclerosis (FSGS) (18.8%). Other histopathological pattern among the studied subjects revealed minimal change disease (MCD) in 5.9%, membranous nephropathy (MN) in 7.9%, membranoproliferative glomerulonephritis (MPGN) in 16.8%, IgA nephropathy in 5%, IgM nephropathy in 2%, IgG nephropathy in 2%, diffuse proliferative glomerulonephritis (DPGN) in 1%, focal proliferative glomerulo-nephritis (FPGN) in 3%, crescentic GN in 3%, lupus nephritis (LN) in 13.9%, amyloidosis in 1% and fibrillary glomerulopathy in 1% patient. The pattern of glomerular disease found in this study was similar to other studies performed in Bangladesh with a little variation. It may guide the future researchers to establish a national kidney biopsy registry in Bangladesh.


Asunto(s)
Insuficiencia Renal Crónica , Adolescente , Adulto , Bangladesh/epidemiología , Biopsia , Femenino , Humanos , Riñón , Masculino , Estudios Retrospectivos , Centros de Atención Terciaria , Adulto Joven
15.
Mymensingh Med J ; 31(1): 99-106, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999687

RESUMEN

Menstruation, an essential part of the reproductive cycle, is experienced by all adolescent girls. Poor menstrual hygiene is associated with serious ill-health and drop-out from school. An intervention study was carried out to evaluate the outcome of health education on menstrual hygiene practice among randomly selected 45 adolescent girls attending in a purposively selected Shomospur Girls' High School, Khoksha at Kushtia district in 2018. Data were collected before and after intervention by pre-tested, semi-structured interview schedule with a view to explore the practice during menstruation. Majority 23(51.11%) subjects were between 10 to 14 years of age with a mean of 14.42±1.03 years. Mean age at menarche was 12.38±1.15 years. During menstrual period, adolescent girls used to refrain from performing daily household chores (34), skip from attending school (26), stay alone (26) and avoid to mix with others (25). Over two-thirds 31(68.89%) girls forbade nutritious foods like fish, meat, egg and tamarinds. As many as 39(86.67%) girls used to clean their genitalia, and everybody used to have regular bath and washing hands after changing menstrual absorbent. Generally, most of the girls (39, 86.67%) accustomed to use the reusable absorbent. Nearly one third 15(33.33%) girls used to dry the reusable absorbent in room corner, while 5(11.11) in shaded area and 3(6.67%) in the toilet. A considerable number of girls (12) stored the reusable materials in room corner and under the bed. At least 27(60.00%) girls did not use to change menstrual absorbent at school. While after intervention, none of the girls hesitated to attend others and felt safe to perform daily household chores. Moreover, they were confident to attend school and need not to stay alone during menstruation. Cent percent girls practiced to have food containing iron, vitamin C, and drank plenty of water. Warm water with soap and/or detergent was used for cleaning sanitary cloths. An overwhelming number 42(93.33%) of girls used to dry reusable materials in sunlight with a statistically significant difference (p<0.05). Change of behaviour as to frequency of changing sanitary pad (p<0.05) and methods of disposal of sanitary materials was revealed. It can be concluded that imparting knowledge to adolescent girls is effective to keep away from harmful social behaviours, food intake practice and use of sanitary napkin, replace of menstrual absorbent at regular interval and cleaning and storage of reusable sanitary materials with their hygienic disposal.


Asunto(s)
Higiene , Menstruación , Adolescente , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Productos para la Higiene Menstrual , Instituciones Académicas
16.
Mymensingh Med J ; 31(1): 124-128, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999691

RESUMEN

The history of ascariasis is very old. It is endemic in various parts of Bangladesh. Hepatobiliary ascariasis is a well-known complication of the intestinal ascariasis. Although cosmopolitan, it predominantly affects people in Asia, Africa, and South America. This was a prospective observational study conducted from July to December 2014 to explore the short term outcome of therapeutic ERCP in the treatment of biliary ascariasis in a tertiary care hospital of Bangladesh. A total of 60 cases of biliary ascariasis were selected conveniently in this study. Data were collected by face-to-face interviews and observation with the help of data sheet. Data were checked for quality control and analyzed by computer using SPSS software. The mean±SD age of the patients was 30.96±7.66 years. All the patients were aged between 17 and 55 years and predominantly affect women in the 3rd and 4th decades. The most common presentation was upper abdominal pain in 47(83.32%) of the patients. Ultrasound was the diagnostic tool of choice, where biliary ascariasis was found in 40(66.7%) of patients. ERCP is reserved mainly for therapeutic purposes and found successful in 57(95%) of the patients.


Asunto(s)
Ascariasis , Enfermedades de las Vías Biliares , Adolescente , Adulto , Ascariasis/diagnóstico por imagen , Ascariasis/terapia , Bangladesh , Enfermedades de las Vías Biliares/diagnóstico por imagen , Enfermedades de las Vías Biliares/terapia , Colangiopancreatografia Retrógrada Endoscópica , Femenino , Humanos , Persona de Mediana Edad , Centros de Atención Terciaria , Adulto Joven
17.
Mymensingh Med J ; 31(1): 135-141, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999693

RESUMEN

Suicide is a major preventable public health problem globally however, under attended in Bangladesh. It happens because of multi-factorial involvement; nevertheless, past suicidal attempt is a significant predictor of future suicidal behavior. We aimed to assess the suicidal behaviors among the patients visiting for psychiatric care in a tertiary care hospital of Bangladesh. This cross-sectional study was conducted among the patients attending at department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, from March 2018 to February 2019. A total of 379 patients were interviewed with pre-tested semi structured questionnaire. Non probability purposive sampling was used to collect data. Data were entered into Statistical Package for the Social Sciences 16.0 software and analyzed Among the 379 respondents, 197(52%) were male, 52.5% were married. Mean±SD age of the respondents was 29.94±11.32 year ranging from 18 to 75 years. About 24% percent of the respondents had family history of mental illness, 4% had family history of completed suicides. Prevalence of life time suicidal ideation among the patients was found as 32.5%, one-year prevalence rate 26.4%, one month 17.2% and within last two days it was found as 11.3%. The rate of suicidal plan was 14.0%, preparation 10.0% and attempt was 7.4%. Mean±SD age of onset of suicidal ideation was 24.33±8.9 year ranging from 14 to 57 years. About one in three psychiatric patients had life time suicidal ideation. Third decade of life was found to be vulnerable for onset of suicidal thoughts.


Asunto(s)
Ideación Suicida , Suicidio , Adolescente , Adulto , Bangladesh/epidemiología , Estudios Transversales , Humanos , Masculino , Prevalencia , Factores de Riesgo , Centros de Atención Terciaria , Adulto Joven
18.
Mymensingh Med J ; 31(1): 161-164, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999697

RESUMEN

Helicobacter Pylori (H Pylori) that infects about 90% people of developing countries causes dyspepsia and upper gastrointestinal lesions. The aim of this study was to detect the trend of H Pylori active infection and to investigate the endoscopic findings of H Pylori infected dyspeptic patient of Bangladesh. In this prospective study, 360 dyspeptic patients (Male-251, Female-109) were recruited. Patients having alarm features, history of gastrectomy and malignancy were excluded from this study. Non-invasive fecal antigen test for H Pylori was done of all patients. All selected patients were sent for upper gastrointestinal endoscopy. Helicobacter Pylori fecal antigen was found positive in 134(37.2%) from 360 dyspeptic patients (age 14-80 years). Among 360 patients 303 (80.16%) had macroscopic endoscopic mucosal lesions. H Pylori infected 114 patients had endoscopic mucosal abnormality. H Pylori non-infected 189 patients also had mucosal lesion. Twenty patients (35.08%) had H Pylori infection among the 57 patients having endoscopic normal looking mucosa. This study revealed that active H Pylori infection rate is declining in Bangladesh. Risk of endoscopic mucosal lesion is more expected in H Pylori active infection.


Asunto(s)
Dispepsia , Infecciones por Helicobacter , Helicobacter pylori , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Dispepsia/epidemiología , Heces , Femenino , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto Joven
19.
Mymensingh Med J ; 31(1): 258-262, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999712

RESUMEN

The 2012 Junior Management of Really Sick Patients with Anorexia Nervosa (MaRSiPAN) guidelines recommends daily blood testing during the initial 5 days of children admitted for inpatient re-feeding. The aim of this study was to determine the clinical utility of this and whether blood tests could be minimised. Single centre retrospective study of children admitted for inpatient treatment of anorexia nervosa (January 2018 - August 2020) was done in a general paediatric ward. Weight, body mass index and re-feeding blood biochemistry were recorded. There were 37 patients, all females, aged between 11-17 years. Weight ranged from 21.4-61.75 Kg. Phosphate levels were 0.6-1.6 mmol/L; mean value 1.22 mmol/L. Over the 5 days of daily testing, mean and median values of all blood results remained within reference ranges. No biochemical indication of re-feeding syndrome was evident and resulted in no change of management. There is limited utility in daily blood testing for patients for the initial 5 days.


Asunto(s)
Anorexia Nerviosa , Adolescente , Anorexia Nerviosa/terapia , Índice de Masa Corporal , Niño , Femenino , Hospitalización , Humanos , Pacientes Internos , Estudios Retrospectivos
20.
Mymensingh Med J ; 31(1): 263-266, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999713

RESUMEN

Noonan syndrome is a genetic disorder of autosomal dominant inheritance that prevents normal development in various parts of the body. A spontaneous mutation without any family history may also result in the condition. Noonan syndrome can affect normal growth. Birth weight may be normal, but growth slows over time. The growth spurt usually seen during the teenage years may be delayed, and bone maturity also is delayed. In this case A 13 year's male admitted inpatient Department of Endocrinology, Mymensingh Medical College Hospital in April 2021 with not attaining appropriate height and delayed development of secondary sexual characteristics. His birth weight was normal; gestational and neonatal history was uneventful. He was diagnosed with severe pulmonary stenosis at four years and underwent cardiac surgery at his four and eleven years. He was noted to have growth failure from the age of 9 years onward. He had no family history of such type of disease. On examination, he was short statured, underweight, having an upper: lower segment ratio of 1.05 with an arm span of 126cm. He had craniosynostosis, high arched palate, the thick helix of ears (outer rim), small, upturned nose, depressed broad nose, deeply grooved philtrum, keratosis pilaris of the face and upper arm, slant eyes with proptosis, keloid scar over mid-chest, widely spaced nipple, shield chest, pectus excavatum and cubitus valgus. His sexual maturation score was A1, P1, B1. He had pulmonary stenosis with pulmonary hypertension. He had mild microcytic anemia with normal liver, renal, blood glucose, and calcium profile. His bone age was delayed (9 years), thyroid function was normal. The growth hormone dynamic test after clonidine stimulation was normal. His karyotype was 46XY. We have considered giving recombinant growth hormone therapy to accelerate his height.


Asunto(s)
Anomalías Múltiples , Enfermedad de Darier , Síndrome de Noonan , Adolescente , Niño , Cejas , Trastornos del Crecimiento , Humanos , Recién Nacido , Masculino , Síndrome de Noonan/diagnóstico , Síndrome de Noonan/genética
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