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1.
Mymensingh Med J ; 30(4): 1124-1130, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605486

RESUMO

Female breast cancer can be diagnosed easily; but due to inappropriate health care utilization, health-seeking is lag behind. The objectives of the study were to find out the pattern of utilization of health care during breast cancer diagnosis and treatment and their health seeking time. We conducted this cross sectional study for one year; from July 2017 to June 2018 among 200 newly diagnose patients with breast cancer whose were selected randomly from National Institute of Cancer Research and Hospital, Dhaka, Bangladesh from the listed patients who attended at the outpatient department of chemotherapy day care center for treatment. Delay in reporting, wrong reporting, double reporting, delay in hospital admission, long queue for administrative work and delay to reach cancer specialist play a role in utilization of health care. Results showed that health care service delivery and utilization was found to be significant by (p<0.05) associated with the provider delay (p=0.010), total delay (p=0.017), delay to consult with cancer specialist (p<0.0001). By logistic regression it analyzed that utilization of health care there had 2 times more likely to cause provider delay (OR=2.5; 95% CI 1.087-5.762) p=0.03. Utilization of health care influenced stage of cancer with delay help seeking and diagnostic institution also. As low middle income country, like Bangladesh, delays in seeking consultation, late presentation and the availability of breast cancer management for all patients, represent major challenges.


Assuntos
Neoplasias da Mama , Bangladesh/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Estudos Transversais , Diagnóstico Tardio , Feminino , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Encaminhamento e Consulta
2.
Braz J Biol ; 83: e246727, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34468521

RESUMO

Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings' body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.


Assuntos
Cyprinidae , Linho , Probióticos , Ração Animal/análise , Animais , Dieta/veterinária
3.
Mymensingh Med J ; 30(3): 751-759, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34226465

RESUMO

Considering very limited information in the pattern of neonatal danger signs with associated risk factors in our perspective, the aim of the study was to understand the country-context pattern of neonatal danger signs and its related factors in a tertiary level hospital. This cross-sectional study was conducted among 259 mothers and their neonates in Dhaka Medical College Hospital, Dhaka, Bangladesh from 01 January 2015 to 31 December 2015. Data were collected by face to face interview from mother by pre-tested semi structure questionnaire which was adopted from WHO-UNICEF list of newborn danger signs. Measurement of weight was taken from hospital record. Observation of danger signs were done by following check list. Data analysis was done by SPSS 20.0. Of all, majority (41.6%) was in the age group of 20-24 years & was educated up to secondary level (42.47%). More than half of the participants (54.1%) had family income >10,000 BDT. Sixty percentage of mother took ANC visit <3 times during their pregnancy period. About 42.1% had ≥1 co-morbidities. Hospital was the predominate place of birth with 48.3% caesarean delivery. At least one neonatal danger sign was present in 20.1% while 39.4% had at least 2 danger signs. Rest of the child had ≥2 danger signs at a time. The distribution of danger signs were not feeding since birth or stop feeding 206(79.5%), severe chest in drawing 145(56.1%) respiratory rates 60 or more 126(48.6%), convulsion 72(27.8%), yellow soles 68(26.3%). Factors like 'fail to identify with an expert health assistant', trial of delivery at home, delivery at home, older neonatal age (8-28 days), presence of injury at birth, and cutting of umbilical cord by blade during delivery were associated with higher number of danger signs (p<0.05 in all cases). About 80% neonate in our setting had ≥1 sign and had association with fail to identify with an expert health assistant', trial of delivery at home, delivery at home, older neonatal age, presence of injury at birth, and cutting of umbilical cord by blade during delivery.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Mães , Adulto , Bangladesh/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Gravidez , Cuidado Pré-Natal , Centros de Atenção Terciária , Adulto Jovem
5.
Mymensingh Med J ; 26(4): 699-704, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29208854

RESUMO

Abortion is a global problem. Maternal mortality and morbidity is still high due to uncontrolled abortion mainly induced abortion which may turn to septic abortion. A total of 50 cases of septic abortion cases admitted in Dhaka Medical College Hospital were included in this study. This cross sectional study was designed to find out the clinical presentation and outcome of septic abortion from January 2010 to January 2011. Out of 50 cases of septic abortion admitted where 44(88%) were induced abortion. Majority of the cases were parous (2-3 parity 32%; 4-6 parity 38%; and 6+ parity 4%) and housewives 42(84%), living with their husbands 49(98%), hailing from urban, semi urban and urban slums. Nineteen (38%) having no education and 21(42%) had primary education. Most of the women 20(45.45%) wanted no more child, decided to terminate pregnancy not to overburden their families or due to disturbed marital relationship. The termination of pregnancy was carried out in first trimester 20(40%) and between (13-16) weeks it was 17(34%). Complications of septic abortion still remain a lethal threat to the life and health of women. The death rate was found 6(12%). And the leading causes of death were generalized peritonitis with septicaemia 3(50%), septicaemia with renal failure 2(33.30%), septic abortion with Disseminated Intravascular Coagulation 1(16.70%). Effective and widespread contraceptive use and continuing health and sex education remain pivotal if the incidence of septic abortion and their complications are to be reduced.


Assuntos
Aborto Induzido , Aborto Séptico , Mortalidade Materna , Aborto Séptico/diagnóstico , Bangladesh , Estudos Transversais , Feminino , Humanos , Gravidez
6.
Mymensingh Med J ; 26(4): 846-853, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29208874

RESUMO

Neonatal unit is more vulnerable and critical ward than any others. To assure breastfeeding in neonatal unit is one of the ways to reduce child morbidity and mortality. Baby friendly hospital initiative is the best method in hospital setting to assure breastfeeding. This cross-sectional descriptive study was conducted from July 2014 to December 2014 to find out the Status of Baby Friendly Hospital Initiative (BFHI) in neonatal unit of different public hospitals. The study area was consisting of several tertiary level hospitals in Dhaka city. Study was done in those hospital where declared as Baby Friendly Hospital Initiative. Total 137 data was collected from care givers (70) and healthcare providers (67). From hospital data it was found that all children discharged for last month were exclusively breastfed. Written breastfeeding policy was present in all hospitals but out of 67 staffs only 28(41.48%) staffs received training which was not fulfillment of the requirement of Global Criteria of UNICEF/WHO (BFHI External Assessment and Reassessment). In step 5 only 21(31.34%) staffs show or offered help for breastfeeding. In step 6 and 9 there were 100% fulfill the requirements, no teats and pacifier was found, no use of foods or drinks except medications. Nurses were co-operative but due to lack of training and motivation they were not fully aware about the importance of breastfeeding.


Assuntos
Aleitamento Materno , Promoção da Saúde , Hospitais , Bangladesh , Criança , Estudos Transversais , Humanos , Recém-Nascido
7.
Bone Joint J ; 97-B(10): 1309-15, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26430003

RESUMO

Despite being one of the most common orthopaedic operations, it is still not known how many arthroscopies of the knee must be performed during training in order to develop the skills required to become a Consultant. A total of 54 subjects were divided into five groups according to clinical experience: Novices (n = 10), Junior trainees (n = 10), Registrars (n = 18), Fellows (n = 10) and Consultants (n = 6). After viewing an instructional presentation, each subject performed a simple diagnostic arthroscopy of the knee on a simulator with visualisation and probing of ten anatomical landmarks. Performance was assessed using a validated global rating scale (GRS). Comparisons were made against clinical experience measured by the number of arthroscopies which had been undertaken, and ROC curve analysis was used to determine the number of procedures needed to perform at the level of the Consultants. There were marked differences between the groups. There was significant improvement in performance with increasing experience (p < 0.05). ROC curve analysis identified that approximately 170 procedures were required to achieve the level of skills of a Consultant. We suggest that this approach to identify what represents the level of surgical skills of a Consultant should be used more widely so that standards of training are maintained through the development of an evidenced-based curriculum.


Assuntos
Artroscopia/educação , Consultores , Medicina Baseada em Evidências , Articulação do Joelho , Ortopedia/educação , Artroscopia/normas , Humanos , Curva ROC
8.
Curr Rev Musculoskelet Med ; 7(2): 155-60, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24740158

RESUMO

Surgical training has followed the master-apprentice model for centuries but is currently undergoing a paradigm shift. The traditional model is inefficient with no guarantee of case mix, quality, or quantity. There is a growing focus on competency-based medical education in response to restrictions on doctors' working hours and the traditional mantra of "see one, do one, teach one" is being increasingly questioned. The medical profession is subject to more scrutiny than ever before and is facing mounting financial, clinical, and political pressures. Simulation may be a means of addressing these challenges. It provides a way for trainees to practice technical tasks in a protected environment without putting patients at risk and helps to shorten the learning curve. The evidence for simulation-based training in orthopedic surgery using synthetic models, cadavers, and virtual reality simulators is constantly developing, though further work is needed to ensure the transfer of skills to the operating theatre.

9.
Knee ; 21(1): 310-4, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23806768

RESUMO

BACKGROUND: Deciding whether to treat patients with bilateral arthritis with two-stage or bilateral single-stage arthroplasties is a cause of considerable debate in orthopaedic surgery. METHODS: A total of 394 cemented Unicompartmental Knee Arthroplasties (UKA) were performed in this unit between 2006 and 2010. A retrospective review identified 38 patients (76 knees) who underwent bilateral Single-Stage Sequential UKA, performed by a single surgeon. RESULTS: The mean BMI was 29.8 and the majority of patients were ASA grade 2. The mean duration of follow-up was 30 months. The mean total tourniquet time was 83 min. The mean post-operative haemoglobin was 11.8 and no patient required blood transfusion. The mean time to mobilisation was 18 h and the average length of stay was 3.5 days. This compares favourably with an institutional average length of stay of two days for a single UKA. There was a significant improvement in the mean pre- to post-operative OKS (from 14 to 34, p<0.0001). One patient required operative fixation of a tibial plateau fracture after sustaining a mechanical fall two months following surgery. There were no other major complications, including thrombo-embolic events or deep infections. Two patients required excision of a superficial suture granuloma. CONCLUSIONS: Bilateral Single-Stage Sequential UKAs provide significant improvement in patient function and can be performed safely with a low complication rate. Patients can benefit from a single hospital admission and anaesthetic whilst the shorter total in-patient stay reduces costs incurred by the hospital. LEVEL OF EVIDENCE: IV.


Assuntos
Artroplastia do Joelho/métodos , Idoso , Idoso de 80 Anos ou mais , Cimentos Ósseos , Feminino , Seguimentos , Hematócrito , Hemoglobinas/análise , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Osteoartrite do Joelho/cirurgia , Complicações Pós-Operatórias , Período Pós-Operatório , Estudos Retrospectivos , Torniquetes
10.
J Health Popul Nutr ; 32(4): 696-700, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25895203

RESUMO

Liver transplantation (LT) is the treatment of choice for patients with end-stage liver disease (ESLD). Chronic liver disease due to many causes is prevalent in a significant percentage of the Bangladeshi population. Until recently, liver transplantation facilities were not available, and ESLD patients were dying without treatment. Liver transplantation is a complex procedure that requires integrated and organized approach by a multidisciplinary team. The initiation of liver transplantation in Bangladesh has faced many difficulties. These difficulties have been encountered and overcome in phases. We have successfully performed the first two living-donor liver transplantations (LDLTs) in Bangladesh. The recipient of the first LDLT was a 42-year man with cryptogenic cirrhosis, and the second one was a male of 35 years, suffering from HBV cirrhosis. Both the recipients and donors are doing well and relishing the prospect of a normal life. These two successful liver transplantations are milestones in the development of liver transplantation services in Bangladesh.


Assuntos
Doença Hepática Terminal/cirurgia , Transplante de Fígado/métodos , Adulto , Bangladesh , Humanos , Imunossupressores/administração & dosagem , Masculino , Índice de Gravidade de Doença , Doadores de Tecidos , Resultado do Tratamento
11.
Bone Joint J ; 95-B(11): 1562-9, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24151280

RESUMO

Recent reports have suggested an increase in the number of anterior cruciate ligament (ACL) injuries in children, although their true incidence is unknown. The prognosis of the ACL-deficient knee in young active individuals is poor because of secondary meniscal tears, persistent instability and early-onset osteoarthritis. The aim of surgical reconstruction is to provide stability while avoiding physeal injury. Techniques of reconstruction include transphyseal, extraphyseal or partial physeal sparing procedures. In this paper we review the management of ACL tears in skeletally immature patients.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/métodos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Criança , Humanos , Ruptura , Resultado do Tratamento
13.
Arthritis ; 2012: 698709, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23082249

RESUMO

Aims. To examine all relevant literature on the economic costs of osteoarthritis in the UK, and to compare such costs globally. Methods. A search of MEDLINE was performed. The search was expanded beyond peer-reviewed journals into publications by the department of health, national orthopaedic associations, national authorities and registries, and arthritis charities. Results. No UK studies were identified in the literature search. 3 European, 6 North American, and 2 Asian studies were reviewed. Significant variation in direct and indirect costs were seen in these studies. Costs for topical and oral NSAIDs were estimated to be £19.2 million and £25.65 million, respectively. Cost of hip and knee replacements was estimated to exceed £850 million, arthroscopic surgery for osteoarthritis was estimated to be £1.34 million. Indirect costs from OA caused a loss of economic production over £3.2 billion, £43 million was spent on community services and £215 million on social services for osteoarthritis. Conclusions. While estimates of economic costs can be made using information from non-published data, there remains a lack of original research looking at the direct or indirect costs of osteoarthritis in the UK. Differing methodology in calculating costs from overseas studies makes direct comparison with the UK difficult.

14.
Cases J ; 3: 9, 2010 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-20150983

RESUMO

We describe a case of an ASNIS III 5.0 mm partially threaded cannulated screw unthreading itself as it was being inserted during fracture fixation of a humerus. The majority of complications associated with cannulated screws involve breaking of the screw, as opposed to unthreading. We believe that the self tapping design of the screw, in combination with the cannulated design, creates a potential area of weakness when used on hard bone.

15.
Bioresour Technol ; 100(20): 4551-8, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19467596

RESUMO

The ability of Ca-alginate immobilized Trichoderma harzianum has been explored for removal and recovery of uranium from aqueous streams. Ca-alginate as polymeric support was selected after screening different matrices. Immobilization of Trichoderma harzianum to Ca-alginate improved the stability as well as uranium biosorption capacity of biosorbent at 28+/-2 degrees C and 200 rpm. The suitability of packed bed column operations was illustrated by obtaining break through curves at different bed heights, flow rates and inlet uranium concentrations. The adsorption column containing 1.5 g dry weight of immobilized material has purified 8.5L of bacterial leach liquor (58 mg/LU) before break through occurred and the biosorbent became saturated after 25 L of influent. Sorbed uranium was recovered in 200 ml of 0.1N HCl resulting in 98.1-99.3% elution by 0.1N HCl, which regenerated the biosorbent facilitating the sorption-desorption cycles for better economic feasibility without any significant alteration in sorption capacity/elution efficiency.


Assuntos
Alginatos/metabolismo , Cálcio/metabolismo , Trichoderma/citologia , Trichoderma/metabolismo , Urânio/isolamento & purificação , Adsorção , Bactérias/metabolismo , Biodegradação Ambiental , Biomassa , Células Imobilizadas/citologia , Células Imobilizadas/ultraestrutura , Ácido Glucurônico/metabolismo , Ácidos Hexurônicos/metabolismo , Microesferas , Reologia , Soluções , Espectroscopia de Infravermelho com Transformada de Fourier , Trichoderma/ultraestrutura
16.
Indian J Pathol Microbiol ; 51(1): 39-41, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18417850

RESUMO

We present here a case of malignant hemangiopericytoma in a 40-year-old female who presented with a history of slowly growing mass in left gluteal region for about 1.5 years. She was evaluated and a mass of 10 x 7.5 x 5.5 cm 3 was found on computed tomography. The tumor was resected and was sent for histopathological evaluation. Grossly the tumor was encapsulated and on cut section it was nodular. Microscopy showed spindle cells forming cords and sheets separated by thin delicate stroma consisting largely of thin-walled vessels revealed by reticulin stain. Pleomorphism and mitotic figures were seen. It was diagnosed as a case of malignant hemangiopericytoma of gluteal region. The patient underwent radiotherapy and did apparently well. She is on regular follow-up because long-term follow-up is essential in all cases as recurrence can occur several years after treatment.


Assuntos
Nádegas/patologia , Hemangiopericitoma/diagnóstico , Adulto , Nádegas/diagnóstico por imagem , Feminino , Hemangiopericitoma/radioterapia , Hemangiopericitoma/cirurgia , Humanos , Tomografia Computadorizada por Raios X
17.
Indian J Pathol Microbiol ; 51(1): 72-3, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18417864

RESUMO

Leiomyoma is a benign tumor of smooth muscles. Leiomyoma originating from the scrotum is a rare entity. We report here a case of 50-year-old male who presented with a 4-cm lump in the left side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. The histopathology showed findings consistent with leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of solitary leiomyoma of scrotum was given. The patient was followed up regularly and is doing fine for last 4 months.


Assuntos
Leiomioma/diagnóstico , Escroto/patologia , Humanos , Leiomioma/cirurgia , Masculino , Pessoa de Meia-Idade
18.
J Biotechnol ; 121(3): 351-60, 2006 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-16242200

RESUMO

Glucose oxidase (GOD) was immobilized on cellulose acetate-polymethylmethacrylate (CA-PMMA) membrane. The immobilized GOD showed better performance as compared to the free enzyme in terms of thermal stability retaining 46% of the original activity at 70 degrees C where the original activity corresponded to that obtained at 20 degrees C. FT-IR and SEM were employed to study the membrane morphology and structure after treatment at 70 degrees C. The pH profile of the immobilized and the free enzyme was found to be similar. A 2.4-fold increase in Km value was observed after immobilization whereas Vmax value was lower for the immobilized GOD. Immobilized glucose oxidase showed improved operational stability by maintaining 33% of the initial activity after 35 cycles of repeated use and was found to retain 94% of activity after 1 month storage period. Improved resistance against urea denaturation was achieved and the immobilized glucose oxidase retained 50% of the activity without urea in the presence of 5M urea whereas free enzyme retained only 8% activity.


Assuntos
Celulose/análogos & derivados , Enzimas Imobilizadas/metabolismo , Glucose Oxidase/metabolismo , Polimetil Metacrilato/química , Técnicas Biossensoriais , Celulose/química , Celulose/ultraestrutura , Estabilidade Enzimática , Enzimas Imobilizadas/ultraestrutura , Glucose Oxidase/análise , Glucose Oxidase/ultraestrutura , Temperatura Alta , Concentração de Íons de Hidrogênio , Cinética , Membranas Artificiais , Microscopia Eletrônica de Varredura , Espectroscopia de Infravermelho com Transformada de Fourier , Ureia/farmacologia
19.
J Pharm Biomed Anal ; 37(2): 205-17, 2005 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-15708659

RESUMO

The interaction of drugs with DNA is among the most important aspects of biological studies in drug discovery and pharmaceutical development processes. In recent years there has been a growing interest in the electrochemical investigation of interaction between anticancer drugs and DNA. Observing the pre and post electrochemical signals of DNA or drug interaction provides good evidence for the interaction mechanism to be elucidated. Also this interaction could be used for the quantification of these drugs and for the determination of new drugs targeting DNA. Electrochemical approach can provide new insight into rational drug design and would lead to further understanding of the interaction mechanism between anticancer drugs and DNA.


Assuntos
Antineoplásicos/química , DNA/química , Eletroquímica , Ligantes , Estrutura Molecular
20.
Br J Surg ; 87(3): 362-73, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10718949

RESUMO

AIMS: Long-term survival after surgery for pancreatic cancer remains very low and it is particularly important that minimal surgery-related morbidity and mortality rates are achieved. It has been stated that centres performing small numbers of proximal pancreaticoduodenectomies are likely to have high morbidity and mortality rates. The results of pancreatic surgery in a district general hospital are reported. METHODS: This was a retrospective analysis of all pancreaticoduodenectomies over 4 years. RESULTS: Twenty-one selected patients underwent proximal pancreaticoduodenectomy and two patients total pancreatectomy over a 4-year period from 1995 to 1999. The operations were performed by two surgeons with a special interest in upper gastrointestinal surgery. The median age was 62 (38-83) years. There were 14 men and nine women. Fifteen patients had adenocarcinoma of the head of the pancreas, five had ampullary carcinoma, one duodenal carcinoma and there was one case of chronic pancreatitis. Six patients had pylorus-preserving pancreaticoduodenectomy (PPPD) and 15 had a standard Whipple procedure. The median stay in hospital was 20 (13-26) days. Two patients had a pancreatic leak, one of whom developed an intra-abdominal abscess which was treated successfully by percutaneous drainage. Six patients experienced delayed gastric emptying, two of whom had PPPD. Both the 30-day and in-hospital mortality rates were zero. The median number of lymph nodes dissected was 12 and in 11 patients no nodal metastasis was found. CONCLUSIONS: It is possible to perform pancreatic surgery in a district general hospital and achieve results that are comparable to those of specialist centres.

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