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1.
Mymensingh Med J ; 30(4): 913-920, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605456

RESUMO

Peripheral neuropathy caused by diabetes mellitus (DM) and vitamin B12 deficiency may produce overlapping clinical pictures. Metformin use is a known cause of B12 deficiency in patients with type 2 DM (T2DM). This cross-sectional comparative study was conducted at two specialized endocrine outpatient clinics in Mymensingh and Cumilla cities of Bangladesh over one year from July 2019 to June 2020. Non-pregnant adults (≥18 years of age) receiving drug treatment for T2DM for at least six months were included in this study. The study subjects were divided into two groups: those with ongoing treatment with metformin and those who never received metformin in their lifetime. Out of 99 subjects evaluated, 66 (66.7%) were in the metformin group, and 33 (33.3%) were in the non-metformin group. Subjects in the metformin group had significantly lower B12 levels compared to the non-metformin group [448.5 (343.0-570.9) vs. 549.0 (487.5-847.0) pg/mL, median (IQR), p<0.001]. None of the study subjects in the non-metformin group were either borderline deficient or deficient of B12 compared to five borderline deficient and three deficient subjects in the metformin group. Among the study subjects, 88.9% had peripheral neuropathy (PN) (43.4% mild, 21.2% moderate and 24.2% severe PN); the two groups had similar frequencies of PN. Though median serum B12 levels were lower in mild [483.0 (411.2-620.0) pg/mL], moderate [492.0 (366.5-680.0) pg/mL] and severe PN [524.5 (363.5-654.2) pg/mL] groups compared to absent PN group [540.0 (340.0-685.0) pg/mL]; the difference in B12 levels across the four groups was not statistically significant. B12 levels had weak negative correlation (r = -0.061, p = 0.624) with gram-years of metformin use. Periodic screening for serum vitamin B12 levels should be done to identify metformin-induced B12 deficiency in T2DM, especially those with PN.


Assuntos
Diabetes Mellitus Tipo 2 , Metformina , Adulto , Bangladesh/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Lactente , Metformina/uso terapêutico , Vitamina B 12
2.
Mymensingh Med J ; 30(4): 980-985, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605466

RESUMO

Autism spectrum disorder (ASD), being one of the fastest-growing disabilities in children, is an omnipresent, immutable neurodevelopmental disorder characterized by impaired socialization, impaired verbal and non-verbal communication, restricted interests, and repetitive behaviour patterns. A descriptive cross-sectional study was conducted from 30 October to 30 November 2019 among the MBBS students of 21 medical colleges in Bangladesh to assess their knowledge of autism. The 'Knowledge about Childhood Autism among Health Workers (KCAHW)' questionnaire containing 19 item questions divided into four domains was used. The total median score in the KCAHW questionnaire is 13 out of 19. The final total of respondents numbered 483. There were 215 (44.51%) male and 268 (55.49%) female students. Among 21 medical colleges, 10 are situated in the Dhaka district and 11 outside Dhaka; 14 medical colleges were public, and seven were private. The study shows that students' knowledge of autism spectrum disorder (ASD) is not up to the mark. While assessing the knowledge in each domain, Domain 4 (knowledge regarding nature, comorbidities, and onset) shows that only 32.6% of students of 4th phase and 21.5% of other phases have scored more than the median value, revealing that medical students were not familiar with nature, comorbidities, and the onset of ASD. It can be reliably diagnosed before two years of age, but the practical scenario is a different picturesque. Thus, medical students should have bona fide knowledge to diagnose this progressively prevailing disorder at the earliest possible time. We hope this study's aftermath will significantly impact the integrity and diversity of autism spectrum disorder.


Assuntos
Transtorno do Espectro Autista , Estudantes de Medicina , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Bangladesh/epidemiologia , Criança , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Masculino
3.
Mymensingh Med J ; 30(4): 1073-1078, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605479

RESUMO

Dengue is endemic in more than a hundred countries throughout the tropics. The classic presentation of dengue fever has expanded its horizon by involving different organ systems, and these system-specific presentations pose a diagnostic dilemma. The objective of this prospective observational study was to evaluate the sociodemographic, and clinical profile of expanded dengue syndrome (EDS) patients admitted to a tertiary hospital in Dhaka, Bangladesh. Data were collected from all admitted patients from April 2019 to September 2019 and diagnosed with dengue. The patients with dengue having EDS were followed up till discharge. Of 4200 dengue cases admitted during this period, 108 patients (2.57%) were diagnosed with EDS. Among the EDS cases, 94% were from Dhaka city, and 6% were outside Dhaka city; 66% of the patients were male. Gastrointestinal (GI) manifestations were the most common (87%) type of EDS, and among the GI presentations, acute acalculous cholecystitis (38.3%), acute pancreatitis (30.85%), acute hepatitis (21.27%) were the most frequent. Among the EDS cases, 5.55% had a central nervous system (CNS), 4.6% cardiovascular (CVS), and 1.88% had renal complications; 0.93% presented with myositis. The majority (90.74%) of the patients recovered with conservative management, 10 (9.26%) died. This study shows that expanded dengue syndrome (EDS) is not uncommon in Bangladesh's dengue viral infection. A high degree of clinical suspicion is the key to early diagnosis and treatment.


Assuntos
Dengue , Pancreatite , Doença Aguda , Bangladesh/epidemiologia , Dengue/diagnóstico , Dengue/epidemiologia , Dengue/terapia , Humanos , Laboratórios , Masculino , Estudos Prospectivos , Centros de Atenção Terciária
4.
Mymensingh Med J ; 30(3): 710-717, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34226460

RESUMO

Growth in children is influenced by multiple factors, including endocrine diseases like diabetes mellitus (DM). Data on growth parameters in children with type 1 DM (T1DM) are scarce in Bangladesh. This cross-sectional study, aimed to evaluate the anthropometric parameters of children with T1DM, was conducted at the Changing Diabetes in Children (CDiC), Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders General Hospital-2 (BIRDEM-2), Dhaka, Bangladesh from May 2018 to April 2019. Data on anthropometric parameters (standing height, weight, body mass index [BMI]) were collected in 2 groups, Group A: 82 children with T1DM and Group B: 82 age-sex matched otherwise healthy children having no DM. The age range of the study subjects was 2-9 years; there were 43 males and 39 females in each group. Height for age Z scores (HAZ) and percentile distribution, weight for age Z (WAZ) scores and percentile distribution, body mass index (BMI), body mass for age Z scores (BAZ) and percentile distribution were calculated using the reference values suggested by Indian Association of Pediatrics. Metabolic control was evaluated by measuring glycosylated hemoglobin (HbA1c). With slight male predominance (52.44%), the mean age of Group A and Group B was 14.27±3.77 years. The percentile distribution of height for age revealed significantly higher number of stunted subjects in Group A compared to Group B, both in male and female (p<0.05). The percentile distribution of weight showed higher number of underweight subjects in Group A than in Group B, both in males and females though the difference was statistically significant (p<0.05) only in males. Incase of males, the frequency of underweight respondents (according to weight for age Z scores) was significantly higher in Group A than in Group B. The mean of height in Group A (1.48±0.2 meter) was lower than in Group B (1.57±0.16 meter) and the mean weight in Group A (47.16±15.34kg) was also lower than Group B (49.82±14.77kg), though, these differences were not statistically significant (p>0.05). The HAZ and WAZ scores were lower in Group A than in Group B both in male and female subjects, though only in male respondents the difference of WAZ was statistically significant (p<0.05). The mean difference of HbA1c level was statistically significant in between the groups both incase of weight for age distribution and body mass for age distribution (p<0.05). This study concludes that children and adolescent with T1DM were shorter and lighter compared to their non-diabetic, otherwise healthy peers.


Assuntos
Diabetes Mellitus Tipo 1 , Adolescente , Bangladesh/epidemiologia , Estatura , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Estudos Transversais , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Humanos , Masculino
5.
Mymensingh Med J ; 30(3): 874-880, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34226483

RESUMO

Recently, mucormycosis, extremely rare fungal infections are emerging as a matter of concern in COVID-19. The saprophytic fungi of Mucorales species cause the disease, Mucormycosis, only in immunocompromised hosts. Clinical presentation of mucormycosis is related to the underlying conditions; rhino-cerebral disease is the most common form, especially in patients with diabetes mellitus; pulmonary, cutaneous, or gastrointestinal infections can also occur. Severe COVID-19 itself is a life-threatening disease and various factors, including diabetes, especially when complicated by ketoacidosis, previous respiratory pathology, immunosuppressive therapy, nosocomial infection sources and systemic immune alterations of COVID-19 itself predispose to mucormycosis. No specific biomarkers are available to diagnose mucormycosis; imaging of the involved area and histopathological examination of the biopsied tissue are most important in diagnosis. The underlying medical conditions must be corrected; these include good glycemic control, tapering of steroids, and reducing or stopping immunosuppressive medications. Systemic antifungal therapy with liposomal Amphotericin B is the medical treatment of choice though drug resistance is not uncommon. Surgical debridement of devitalized tissue is often required. Severe COVID-19 patients with secondary co-infections require longer hospitalization and had higher risks of death. The mortality rate is almost 50% despite timely adequate treatment. The judicious use of systemic glucocorticoids and immunosuppressive agents for treating severe disease and hyperglycemia control seems vital for preventing and managing mucormycosis.


Assuntos
COVID-19 , Mucormicose , Antifúngicos/uso terapêutico , Desbridamento , Humanos , Mucormicose/diagnóstico , Mucormicose/epidemiologia , Mucormicose/terapia , Pandemias , SARS-CoV-2
6.
Mymensingh Med J ; 30(2): 260-261, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33830100

RESUMO

No Abstract.


Assuntos
Glândula Tireoide , Bangladesh/epidemiologia , Humanos
8.
Mymensingh Med J ; 29(4): 807-814, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33116081

RESUMO

Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes mellitus (DM). DR remains a leading cause of blindness, currently accounting for 4.8% of the world's 37 million blindness cases. DR is one of the critical preventable causes of blindness. In Bangladesh, the number of studies reporting the prevalence and risk factors of DR in type 2 DM (T2DM) is limited. We conducted this cross-sectional study in a tertiary hospital in Bangladesh from March 2017 to August 2019 among 200 patients with T2DM for the presence and severity of DR by using color fundus photography in a dilated pupil. The diagnosis and grading of DR were made using the Early Treatment of Diabetic Retinopathy Study (ETDRS) Chart. Out of 200 subjects with T2DM, 35.5% had DR; the frequencies of NPDR and PDR were 19.0% and 16.5%, respectively. The mean age, diabetes duration, FPG, HbA1c, TG, TC, LDL-C, and serum creatinine were statistically higher, and eGFR was lower in the study subjects with DR than those without DR; BMI and HDL-C were indifferent in the two groups. The frequencies of males, subjects having monthly income of 10,000 Bangladeshi Taka (BDT) or more, smokers, hypertensives, and subjects having uncontrolled diabetes (HbA1c ≥7%), were higher in the DR group than the no DR group. Higher age (≥50 years), higher monthly income (≥10,000 BDT), urban residence, smoking, uncontrolled diabetes, and high LDL-C (≥100mg/dL) were found to be independent risk factors of DR in the study subjects. A large-scale nationwide study is needed to find out the actual prevalence of DR in Bangladesh.


Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Bangladesh/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/etiologia , Humanos , Masculino , Prevalência , Fatores de Risco
9.
Mymensingh Med J ; 29(4): 838-846, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33116085

RESUMO

Urinary tract infection (UTI) is commonly encountered in both community and hospital settings and is often associated with significant morbidity. The inappropriate administration of antibiotics to treat UTI increases the development of antimicrobial resistance to antibiotics. This cross-sectional study was conducted at the gynecology outpatient department (OPD) of Mymensingh Medical College Hospital, Bangladesh, from January 2018 to November 2019 to determine the frequency of causative micro-organisms of UTIs and their antibiotic resistance pattern. Four hundred eight women presenting with the symptoms of UTI referred with a diagnosis of UTI based on a urine routine examination, culture, and sensitivity reports to the OPD were included in the study. Antibiotic sensitivity testing was done in the microbiology department of the hospital following the Kirby-Bauer disc diffusion method. E. coli was the most common (48.5%) organism isolated, followed by Proteus (21.6%), Klebsiella (15.0%), Enterococcus spp. (4.7%), S. aureus (3.9%), Acinetobacter spp. (3.9%), and Pseudomonas (2.5%). The distribution of the causative organisms in various age groups of the patients was similar. Overall, most (>80%) of the organisms were resistant to Erythromycin (93%), Ampicillin (92%), Amoxycillin (90%), and Cefuroxime (84%); the highest sensitivity was found for Meropenem (85%), Amikacin (81%), Gentamycin (79%), and Nitrofurantoin (71%). The highest sensitivity of E. coli was found for Meropenem (90%), Amikacin (83%), Gentamycin (83%), and Nitrofurantoin (76%). E. coli were resistant to Ampicillin (100%), Amoxycillin (100%), and Erythromycin (100%), Cephalexin (85%), and Cefuroxime (85%). Proteus was highly sensitive to Meropenem (90%) and Gentamycin (82%), whereas highly resistant to most of the antibiotics. Klebsiella was found sensitive to Amikacin (90%), Gentamycin (77%), Meropenem (74%), and Ciprofloxacin (74%) and resistant to Ampicillin (100%), Erythromycin (87%), Cefixime (80%), and Cefuroxime (76%). The results of this study showed that resistance is likely to be against the most commonly used antibiotics. Most of the uropathogens showed sensitivity to injectable antibiotics, namely Meropenem, Gentamycin, and Amikacin.


Assuntos
Anti-Infecciosos , Ginecologia , Infecções Urinárias , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bangladesh/epidemiologia , Estudos Transversais , Escherichia coli , Feminino , Humanos , Testes de Sensibilidade Microbiana , Pacientes Ambulatoriais , Staphylococcus aureus , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia
10.
J Family Med Prim Care ; 9(7): 3444-3449, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33102311

RESUMO

Background: Both obesity and vitamin D deficiency are pandemics and both have influences on cardiovascular parameters. The reported prevalence of vitamin D deficiency in obesity is high. Data relating to vitamin D status in obese is currently lacking in Bangladesh. Objective: To discover the vitamin D status in Bangladeshi overweight and obese adults. Subjects and Methods: This cross-sectional study, conducted in a specialized endocrine center of Bangladesh, evaluated 500 consecutive overweight or obese subjects, diagnosed according to body mass index (BMI) categories applicable to the south Asian population. Serum 25(OH)D was measured by using the enzyme-linked fluorescent assay (ELFA) method, and the cutoffs described by the Endocrine Society were used to define vitamin D status. Results: The mean age of the study subjects was 45.85 (±11.41) years; most (59.6%) of them were in the age group 40-59 years; almost three-fourth (72.4%) were females; an almost equal number of them came from urban (33.8%), semi-urban (29.6%), and rural (36.6%) areas; three-fourth (74.2%) were homemaker. Their mean BMI was 29.54 (±3.11) kg/m2; the frequencies of overweight, class I obesity, class II obesity, and class III obesity were 27.6%, 57.4%, 12.2%, and 2.8%, respectively. The mean serum 25(OH)D level was 25.25 (±11.97) ng/mL. 27.4% were sufficient, and 33.4% were insufficient for vitamin D, whereas 39.2% had vitamin D deficiency. The 25(OH)D level did not differ across different age groups, gender, residence, education status, occupation, and income status. The 25(OH)D levels were also indifferent in overweight, obese class I, obese class II, and obese class III subjects. None of the demographic, anthropometric, and biochemical variables (except low-density lipoprotein cholesterol) correlated with 25(OH)D levels. Conclusions: The prevalence of vitamin D deficiency in overweight and obese Bangladeshi adults is very high.

11.
Mymensingh Med J ; 29(3): 539-544, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32844791

RESUMO

Due to high genetic susceptibility and rapidly urbanizing lifestyle, the prevalence of diabetes mellitus (DM) is rapidly increasing in Bangladesh especially in the younger population. This cross-sectional study was conducted from 14 to 25 November 2019 among the undergraduate students of a government medical college of Bangladesh to find out the frequency of dysglycemia and associated risk factors in them. A total of 364 students were included in the study. Relevant medical history was taken; clinical examinations and anthropometric measurements were done. Capillary blood glucose (CBG) was measured in fasting state. Out of 364 participants, 7(1.92%) had DM and 26(7.14%) were pre-diabetic. Two-fifth (19.5%) was hypertensive or pre-hypertensive. Almost half of them were either overweight (36%) or obese (13.5%) and 39% had abdominal obesity. Subjects with dysglycemia and normoglycemia did not differ in age, gender, smoking status, diastolic blood pressure (BP), body mass index (BMI), waist circumference, and presence of abdominal obesity and other diseases. A higher number of subjects in the dysglycemia group had first degree relative with type 2 DM (T2DM). Systolic BP was also higher in this group. T2DM in the first-degree relative was found to be a significant predictor of dysglycemia in the study subjects. Adoption of a healthy lifestyle with the aim of reduction of these modifiable cardiovascular risk factors is of utmost importance to ensure a healthy future generation.


Assuntos
Obesidade , Estudantes , Bangladesh , Índice de Massa Corporal , Estudos Transversais , Humanos , Prevalência , Fatores de Risco
12.
Mymensingh Med J ; 29(2): 234-240, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32506072

RESUMO

Polycystic ovary syndrome (PCOS) is associated with various metabolic risks imparting a higher risk for cardiovascular diseases (CVD) in affected women. Urinary albumin excretion (UAE) is a marker of endothelial leakiness and reflects early endothelial damage; thus is used as an important cardiovascular (CV) risk marker. UAE as a CV risk marker in PCOS patients is less well established. This cross-sectional study was done in a tertiary hospital of Bangladesh from January to December 2018 and 95 consecutive adult PCOS patients were screened for UAE. Clinical and anthropometric data were collected, and oral glucose tolerance test (OGTT), fasting lipid profile, serum creatinine, urine routine examination, total testosterone, prolactin, and TSH were measured. The urine albumin-to-creatinine ratio (UACR) was measured in a random single-voided urine sample. UACR cutoff ≥30mg/g was used to define albuminuria. The mean age of the subjects was 22.5±5.0 years; 72.6% were overweight/ obese; 68.4% had abdominal obesity; 94.7% had dyslipidemia and 40% of them had metabolic syndrome. Albuminuria was observed in 21.1% of the subjects. A higher frequency of metabolic syndrome was observed in albuminuric subjects than non-albuminuric ones (45% vs. 38.7%), though the difference was not statistically significant (p=0.617). Albuminuric subjects had higher plasma glucose (PG) value at 2 hours of OGTT and a higher frequency of acne. Other clinical, biochemical and hormonal parameters were similar in the two groups. PG 2 hours after OGTT and serum triglyceride (TG) showed positive correlations and LDL cholesterol showed a negative correlation with UACR. Our study emphasizes the need for screening PCOS women for UACR which may be helpful in identifying those subjects with future high risk of CVD.


Assuntos
Síndrome Metabólica , Síndrome do Ovário Policístico , Adulto , Albuminúria , Bangladesh , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos
13.
Mymensingh Med J ; 29(1): 66-72, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915338

RESUMO

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.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Disfunção Erétil/epidemiologia , Adulto , Distribuição por Idade , Bangladesh/epidemiologia , Glicemia/análise , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Disfunção Erétil/etiologia , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Testosterona/sangue
14.
Mymensingh Med J ; 29(1): 142-148, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915350

RESUMO

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.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus/epidemiologia , Empregados do Governo/estatística & dados numéricos , Hipertensão/epidemiologia , Obesidade/epidemiologia , Adulto , Bangladesh/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Distribuição por Sexo , População Suburbana/estatística & dados numéricos , População Urbana/estatística & dados numéricos
15.
Mymensingh Med J ; 29(1): 156-161, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915352

RESUMO

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.


Assuntos
Anticorpos/sangue , Autoanticorpos/sangue , Hipotireoidismo/diagnóstico , Hipotireoidismo/imunologia , Adulto , Autoantígenos , Bangladesh/epidemiologia , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Hipotireoidismo/epidemiologia , Iodeto Peroxidase , Proteínas de Ligação ao Ferro , Prevalência , Tireoglobulina/sangue , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
16.
Mymensingh Med J ; 28(3): 547-552, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31391425

RESUMO

Metabolic syndrome (Met-S) and vitamin D deficiency (VDD) are common in polycystic ovary syndrome (PCOS) and hypovitaminosis D in PCOS was found to be associated with Met-S and its components. This cross-sectional study evaluated 110 newly diagnosed women with PCOS randomly recruited from the Endocrinology outpatient department of Mymensingh Medical College Hospital, Bangladesh from January to December 2018 to assess vitamin D status and to explore the relationship of vitamin D status with Met-S and its components. Met-S was diagnosed by using the International Diabetes Federation (IDF) criteria applicable for South Asian women. Serum 25(OH)D was measured by using chemiluminescence immunoassay (CLIA) method and vitamin D status was determined as per The Endocrine Society cut points. Out of 110 PCOS women studied, 44(40%) had Met-S and 72 (65.5%) had vitamin D deficiency. Subjects with Met-S had higher body mass index (BMI), waist circumference (WC), systolic blood pressure (BP), diastolic BP, fasting plasma glucose (FPG), plasma glucose 2 hour after oral glucose tolerance test (PG 2H-OGTT), triglyceride (TG), total and LDL-cholesterol. The mean vitamin D level was lower in Met-S subjects than those without (17.25±5.71 vs. 20.09±7.02, p=0.027). The frequency of VDD was also higher in Met-S group (75% vs. 59.1%, p=0.227). Vitamin D level showed significant positive correlations with PG 2H-OGTT, TG, total and LDL-cholesterol. Age, BMI, WC, systolic BP, diastolic BP, Ferriman Galway score, FPG, HDL cholesterol, testosterone, prolactin, and TSH had no correlations with vitamin D level. Vitamin D may be associated with Met-S in PCOS as Met-S subjects had lower vitamin D level and higher frequency of vitamin D deficiency, and also correlated with some components of Met-S.


Assuntos
Síndrome Metabólica , Síndrome do Ovário Policístico , Deficiência de Vitamina D , Bangladesh , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Síndrome Metabólica/complicações , Síndrome do Ovário Policístico/complicações , Vitamina D , Deficiência de Vitamina D/complicações
17.
Mymensingh Med J ; 28(1): 23-30, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30755546

RESUMO

Depression is a common comorbidity of type 2 diabetes mellitus (T2DM) which adversely affects diabetes management and outcome. Identifying and treating comorbid depression may improve diabetes care. This cross-sectional study was conducted in several tertiary hospitals throughout Bangladesh from July 2017 to April 2018. Nine hundred (900) adult patients with T2DM aging ≥25 years having diabetes for at least 6 months and equal numbers of non-diabetic otherwise healthy controls were recruited from the outpatient departments of these centers. Depression was assessed in all consenting patients and controls by administering the Bangla (local language) version of the PRIME-MD Patient Health Questionnaire (PHQ-9); participants obtaining a score of 5 or more were labeled to have depression. Depression was present in 60.3% of T2DM patients and in 29.4% of controls. Statistically significant difference was found in age, marital status, occupation, body mass index (BMI), waist circumference, systolic blood pressure (BP), diastolic BP and PHQ-9 score between diabetic and non-diabetic subjects (<0.001). T2DM subjects had 4.71-fold higher odds of depression in comparison to the controls (95% CI: 3.76-5.90; p<0.001). Age ≥50 years, unmarried status, years of schooling ≤10 years, underweight, abdominal obesity, and hypertension appeared to be the significant predictors of depression in the study subjects. In T2DM subjects, diabetes in the family members, the presence of other comorbidities, diabetic complications, diabetes duration >5 years, insulin use, using insulin syringe for injection, albuminuria and CKD were the important predictors of depression. Our study found higher prevalence and risk of depression in T2DM patients than their non-diabetic counterparts. T2DM patients should be screened for depression in order to achieve and maintain the treatment goals.


Assuntos
Depressão/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Adulto , Bangladesh/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
18.
Mymensingh Med J ; 28(1): 137-143, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30755562

RESUMO

Erectile dysfunction (ED) is a common complication of diabetes mellitus. But it is frequently under diagnosed and may result in poor quality of life. Previous studies have shown a high frequency of ED in diabetic men. The aim of this cross-sectional study was to determine the frequency of ED and explore its risk factors in type 2 diabetic (T2DM) men in Bangladesh. During August 2013 to July 2014, 508 diabetic men aged 30-69 years were interviewed at the outpatient and inpatient departments of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM), Dhaka, Bangladesh. Recent biochemical data (within last 6 months) were collected from the patient's diabetes guide book and hospital records. Erectile function (EF) was assessed using the validated Bengali version of the International Index of Erectile Function-15 (IIEF-15) questionnaire. Out of 508 type 2 diabetic men, ED was found in 306(60.2%) patients. The frequency of ED was increased with age from 35.5% in men aged 28-39 years to 100% in those aged 60 years and above (p<0.001). Increasing age was also associated with an increase in the severity of ED (5.5% severe ED in 28-39 years age group vs. 77.4% in 60-69 years group, p=0.000). Duration of diabetes was also associated with the increase in both frequency and severity of ED (20.2% ED and 2.4% severe ED in diabetes duration 0-5 years vs. 100% ED and 100% severe ED in diabetes duration >20 years, p=0.000). The frequency of ED in patients with good and poor glycemic control was 3.5% and 71.6% respectively (p=0.000); frequency of severe ED was also higher in uncontrolled diabetic males (0% vs. 28.4% in controlled vs. uncontrolled DM, p=0.000). The characteristics found to be significantly associated with erectile dysfunction were: patient's age, housebound bedridden status, sedentary work, diabetes duration, HbA1c level, microvascular complications, IHD, and diuretic drugs use. Moderate physical activity was found to be inversely related to the frequency of erectile dysfunction. The frequency of ED is very high among Bangladeshi T2DM male and the frequency and severity of ED may be reduced by improving glycemic status.


Assuntos
Complicações do Diabetes/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Disfunção Erétil/complicações , Adulto , Distribuição por Idade , Idoso , Bangladesh/epidemiologia , Estudos Transversais , Disfunção Erétil/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Fatores de Risco
19.
Mymensingh Med J ; 27(4): 685-692, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30487481

RESUMO

Stroke is leading cause of death world wide, after coronary artery disease and cancer. A high proportion of patients suffering from an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a preexisting diagnosis of diabetes. An observational comparative study was carried out at the Department of Neurology and Medicine, Mymensingh Medical College, Mymensingh, Bangladesh from July 2011 to June 2013 among purposively selected ninety-three patients with a view to assess the outcome of stress hyperglycemia on acute stroke. Data were collected through interview, physical examinations & laboratory investigations by using case record form. Statistical analysis was performed using SPSS (Statistical package for social science) version 17. The mean age of this study was 59.04±15.01 years in the hyperglycemic group and 62.06±13.81 years in the normoglycemic group. The male female ratio in the Hyperglycemic and normoglycemic group was 2.12:1 and 2.44:1 respectively. Smoker was 48.8% in the hyperglycemic group and 52% in the normoglycemic group. 70% of the Hyperglycemic group and 66% of the normoglycemic were found hypertensive. Mean±SD blood glucose level was found 11.86±0.58mmol/L in the Hyperglycemic group and 6.50±1.55mmol/L in the normoglycemic group. Mean HbAlc were 6.14±0.56 in hyperglycemic group and 5.29±0.54 in normoglycemic group. Stroke severity score were 21.79±11.85 in Hyperglycemic and 28.64±9.53 in normoglycemic group on admission. Functional outcome was measured on discharge & at the end of 4th weeks of every patient by Glasgo Outcome Scale (GOS). The study also suggests that stress hyperglycemia is an important risk factor of poor stroke outcome.


Assuntos
Diabetes Mellitus , Hiperglicemia , Acidente Vascular Cerebral , Adulto , Idoso , Bangladesh , Glicemia , Feminino , Humanos , Hiperglicemia/complicações , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Acidente Vascular Cerebral/complicações
20.
Mymensingh Med J ; 27(4): 730-736, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30487487

RESUMO

Vitamin D deficiency is common in patients with polycystic ovarian syndrome (PCOS) and found to have multiple impacts on the disease process. Vitamin D status of women with or without PCOS in Bangladesh is largely unknown. This cross-sectional study was conducted in a tertiary level hospital of Bangladesh from January 2018 to April 2018 to address this lacuna. Sixty (60) newly diagnosed PCOS patients and 50 healthy controls aging ≥18 years were investigated for serum 25-hydroxy vitamin D [25(OH)D] level, fasting plasma glucose and fasting lipid profile in addition to their clinical and anthropometric profiles. None of the PCOS and the controls had sufficient 25(OH)D. Twenty five percent (25%) of PCOS patients were insufficient, 68.33% were deficient and 6.67% of were severely deficient of vitamin D; whereas in the control group the frequency was 12%, 50% and 38% respectively. PCOS patients had higher 25(OH)D than controls (17.53±4.6 vs. 13.79±6.1ng/mL, p<0.001). Although PCOS group had higher frequency of metabolic syndrome than control group (40% vs. 20%), 25(OH)D levels were similar in subjects with or without metabolic syndrome in both PCOS (16.82±4.74 vs. 17.99±4.49ng/mL, mean±SD, p=0.098) and control groups (14.06±5.94 vs. 13.73±6.20ng/mL, mean±SD, p=0.339). 25(OH)D level correlated with none of the clinical, anthropometric, metabolic and hormonal parameters in PCOS patients. Vitamin D deficiency is highly prevalent in Bangladeshi PCOS patients and healthy women of reproductive age.


Assuntos
Síndrome do Ovário Policístico , Deficiência de Vitamina D , Bangladesh , Estudos Transversais , Feminino , Humanos , Síndrome do Ovário Policístico/complicações , Centros de Atenção Terciária , Vitamina D/sangue , Deficiência de Vitamina D/complicações
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