Browsing by Author "Hossain, MA"
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Item Differences in vacuum suction drainage pressure following mastectomy and its impact on the clinical outcome of breast cancer patients(Medip Academy, 2024-01) Bari, ML; Mahmud, R; Hossain, MA; Sharmin, I; Nusrat, T; Ahmed, SU.Background: Vacuum suction drainage is an obligatory practice for long past following mastectomy for breast cancer. But recent studies are showing that the pressure of the vacuum suction drain is of value in determining the volume of seroma formation and thereby the drain indwelling time, duration of hospital stays and patient morbidity. Half vacuum suction may be of greater value in this regard comparing full vacuum suction drainage. Objectives were to assess and compare the clinical outcome of half versus full vacuum suction drainage following modified radical mastectomy for breast cancer. Methods: Forty patients of histologically proven breast cancer had been chosen purposively and systematically randomized in two equal groups. Group A with half vacuum suction (device was squeezed up to half of its vertical length) and group B with full vacuum suction (device was squeezed to its maximum). The outcome measured were postoperative drainage, drain indwelling time and post-surgery length of hospital stay. Results: Patients having half vacuum suction had a significantly reduced mean total drainage volume (364.25±128.52 ml versus 822.00±251.30 ml), drain indwelling time (5.50±1.32 days versus 9.05±1.90 days) and post-surgery hospital stay (7.15±2.58 days versus 10.25±2.55 days) in comparison to the full vacuum suction group. No significant difference found in regards to postoperative pain and other wound related complications. Conclusions: We concluded that half vacuum suction drain ensures a lower drain collection and were removed earlier and hence reduced the hospital stay significantly than full vacuum suction drains.Item Effectiveness of pre-operative routine MRCP in patients scheduled for laparoscopic cholecystectomy(Medip Academy, 2024-08) Siddique, TB; Hossain, MA; Haque, MR; Mollah, MSR; Islam, MS.Background: Cholelithiasis is one of the most common surgical diseases worldwide. Laparoscopic cholecystectomy is the gold standard treatment for cholelithiasis, and has become the most common performed gastro intestinal operation. The prevalence is higher in women (7.7%) than in men (3.3%). We aimed to investigate the effectiveness of pre-routine magnetic resonance cholangiopancreatography (MRCP) before performing scheduled Laparoscopic cholecystectomy. Methods: This was a prospective observational study conducted in the Department of General Surgery, Dhaka Central International Medical College, and selected single private Hospital from Dhaka, Bangladesh during the period from January 2021 to January 2023. In our study, we included 90 female patients presented with acute or chronic calculus cholecystitis. All patients were diagnosed with multiple gall stones diseases on USG abdomen after initial clinical evaluation were included in this study. Result: In our study, we found the mean age was 34.97�48 years. Among 90 patients USG showed multiple stones in 85(94.44%) patients whereas, MRCP showed stones only in 24 (26.67%) patients. Among patients with normal CBD, MRCP found 25.33 % and USG found 93.33% with stones. There were 3 patients with more than 5 mg/dl. bilirubin who was diagnosed with stones in both findings. Among the patients with 148-220 ALP levels, both USG and MRCP found 90.48% of patients with stones. We found 1 true negative case and 20 true positive cases of multiple stones (with a p value of 0.017). Conclusion: We found that MRCP helps increase the safety of perioperative management in some cases. Preoperative ultrasonography has a low diagnostic accuracy rate when it comes to patients who also have gallstones and CBD stones. So, individuals with gallstones are advised to undergo a normal preoperative MRCP examination.Item Huge multinodular goiter with retrosternal extension: trans-cervical approach in a 39-year-old patient(Medip Academy, 2024-11) Jewel, AM; Rumana, SN; Rahman, M; Hossain, MA; Rahman, T; Razzak, MA; Reza, MM.Large multinodular goiters (MNG) with retrosternal extension present significant surgical challenges, particularly in resource-limited settings like Bangladesh. This case report describes the successful management of a huge MNG in a 39-year-old female using a trans-cervical approach, highlighting the importance of preoperative imaging, postoperative complications, and the healthcare challenges specific to developing countries. A 39-year-old female presented with a large anterior neck mass that had progressively enlarged over several years. Ultrasound and computed tomography (CT) confirmed the presence of a MNG with retrosternal extension. Fine needle aspiration (FNA) cytology revealed a benign follicular nodule. Preoperative biochemical findings showed subclinical hyperthyroidism and hypocalcemia. The patient underwent total thyroidectomy via a trans-cervical approach without the need for sternotomy. Postoperatively, the patient experienced transient hypocalcemia, which was managed with calcium and vitamin D supplementation, and mild transient hoarseness, likely due to recurrent laryngeal nerve (RLN) manipulation. The histopathological examination confirmed a benign MNG. The case demonstrates the feasibility and success of the trans-cervical approach in managing large retrosternal goiters, (RSG) minimizing postoperative morbidity while avoiding sternotomy. Preoperative imaging played a crucial role in surgical planning, and the management of transient complications was effective. This case also highlights the need for improved healthcare infrastructure and public health measures in regions like Bangladesh, where iodine deficiency remains prevalent.Item Impact of dietary habit on the mental wellbeing of adolescents: a Bangladeshi perspective(Medip Academy, 2024-10) Rahman, MM; Alam, MR; Naser, AZM; Parves, MM; Tanveer, SKM; Hossain, MA; Ahmed, E; Akter, T.Background: Adolescent mental health is a critical public health issue, significantly influenced by dietary habits. This study aims to explore the relationship between dietary patterns and mental well-being among adolescents in Dhaka, Bangladesh. Methods: This cross-sectional observational study was conducted with 600 students from Grades 9 and 10 across multiple schools in Dhaka. Data were collected using a structured questionnaire covering demographic information, dietary habits, and mental health assessed using the generalized anxiety disorder 7-item (GAD-7) scale. Result: The majority of participants were aged 15 years (37.83%) and 16 years (28.33%), with 61.33% being female. BMI classification revealed that 28.83% were underweight, 54.67% had a normal BMI, and 16.50% were overweight or obese. Dietary analysis showed that 56.17% had a mixed diet, 48.33% consumed fruits weekly, and 59.83% consumed vegetables regularly. Significant correlations were found between dietary habits and anxiety levels, with positive correlations between fruit and vegetable intake (r=0.143, p<0.001) and negative correlations between skipping breakfast and fruit intake (r=-0.172, p<0.001). Conclusion: This study highlights the significant impact of dietary habits on the mental well-being of adolescents in Dhaka. Regular consumption of fruits and vegetables is associated with lower anxiety levels, while poor dietary practices, such as skipping breakfast and high fast-food intake, are linked to higher anxiety. These findings underscore the need for targeted nutritional education and mental health interventions to improve adolescent health outcomes.Item Impact of Kangaroo mother care plus massage therapy on growth of preterm low birth weight infants at discharge(Medip Academy, 2024-12) Akter, S; Perveen, J; Ferdousi, F; Yasmin, F; Hossain, MA; Afreen, S; Dey, SK.Background: To assess the impact of kangaroo mother care plus massage therapy on growth of preterm low birth weight infants at discharge. Methods: This randomized controlled trial was conducted in Department of Neonatology in Bangabandhu Sheikh Mujib Medical University over a period of 15 months from March 2022 to June 2023. Total 122 newborns were admitted in neonatal intensive care unit (NICU) of BSMMU during the study period with birth weight 800g to <2000g and gestational age 28 weeks to <34 weeks were enrolled in the study after getting informed written consent from parents or caregiver. Infants with major congenital anomalies were excluded from this study. All data were analyzed by statistical package for social sciences (SPSS) version 25 (IBM, USA). Results: Total 122 newborns were admitted in neonatal intensive care unit (NICU) of BSMMU during the study period with birth weight 800g to <2000 g. Among them, 80 infants fulfilled inclusion criteria. Growth was significantly better in KMC plus massage therapy group. Mean weight gain per kg per day in KMC plus massage therapy group was 13.34�.20 g and it was nearly half in KMC group 6.18�.84 g only (p-value-0.01). Increase in length was 0.95�62 cm in KMC plus massage therapy group vs KMC group 0.66�49 cm (p-value-0.04). Increase in OFC was 0.59�29 cm in KMC plus massage therapy group vs KMC group 0.42�33 cm at discharge (p-value-0.03). Hospital stay in KMC group was 6.36�52 days, alternatively it was more 8.33�39 days in KMC plus massage therapy group. The dissimilarity was statistically significant (p-value-0.01) Study implication: Massage therapy potentiates benefits of kangaroo mother care in respect to better growth, so massage can be added along with KMC for better outcome. Conclusions: Massage therapy added to KMC is more effective than KMC alone in improving growth, although it did not affect the hospital stay.Item The impact of pre-operative uric acid levels on post-operative renal outcomes in off-pump coronary artery bypass grafting patients(Medip Academy, 2024-08) Hossain, MA; Nishat, FT; Rahman, CMM; Shanta, TN; Saquib, MMN; Maruf, MAB; Yadav, SK.Background: Elevated pre-operative uric acid levels significantly impact post-operative renal outcomes in off-pump CABG patients, increasing the risk of acute kidney injury, as evidenced by higher serum creatinine and reduced urine output. Methods: This cross-sectional study was conducted in Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh from January 2021 to December 2022. Total 160 patients undergoing off pump CABG were divided into two groups, group A and group B, each containing 80 patients. In group A, uric acid level was <7 mg/dl for male and <6 mg/dl for female and in group B, it was >7 mg/dl and >6 mg/dL for female. Results: The demographic characteristics, pre-operative serum UA levels and serum creatinine levels between the two groups was not statistically significant. Group A had shorter operative times (mean 265.21�.33 minutes) compared to Group B (mean 327.04�.32 minutes), with more patients in Group-B undergoing longer surgeries (>360 minutes). Group-B also had more grafts (mean 4.4 vs 3.6), higher serum creatinine (1.91 vs 1.17 mg/dl), bilirubin (0.8 vs 0.7 mg/dl), and lower urine output (mean 47.52 vs 95.37 ml/hour), all statistically significant (p<0.001). Conclusions: This study concludes that there is significant impact of pre-operative uric acid levels on post-operative renal outcomes in off-pump CABG patients.Item Impact of screen time on the mental health of adolescents in Bangladesh(Medip Academy, 2024-09) Parves, MM; Kamrul, M. Tanveer S; Hossain, MA; Naser, AZM; Rahman, MM; Alam, MR; Akter, T; Ahmed, E.Background: The rapid increase in screen time among adolescents has raised concerns about its potential impact on mental health. This study aims to examine the relationship between screen time, sleep duration, and anxiety levels among school-going adolescents in Dhaka, Bangladesh. Methods: A cross-sectional observational study was conducted with 568 students from multiple schools in Dhaka, Bangladesh, specifically targeting Grades 9 and 10. Statistical analyses were performed using SPSS version 25, with Chi-square tests and ANOVA used to determine significance, set at p<0.05. Results: The study included 568 participants, with 60.2% female and 82.0% in Grade 10. The majority (54.9%) had a normal BMI, while 32.2% were underweight. Most participants (62.9%) reported getting 7-8 hours of sleep per day, with a mean sleep duration of 7.13 hours (SD=1.25). The mean screen time was 4.02 hours (SD=1.63), with 68.0% reporting 2-4 hours of screen use per day. Anxiety levels varied, with 54.2% reporting no anxiety symptoms, 35.9% mild anxiety, 7.0% moderate anxiety, and 2.8% severe anxiety. ANOVA results showed a significant association between screen time and anxiety levels (p=0.043), with severe anxiety corresponding to the highest mean screen time (5.01 hours). Conclusions: The study found significant associations between screen time, sleep duration, and anxiety levels among adolescents. These findings underscore the need for interventions promoting balanced screen use and adequate sleep to improve adolescent mental health. Further research is recommended to explore long-term effects and develop targeted interventions.Item Location of venous reflux in our duplex test of patients with primary chronic venous insufficiency and comparison with that of the literature(Medip Academy, 2024-12) Chowdhury, MR; Hossain, MA; Choudhury, NA; Al-Miraj, AK; Sarker, NMA.Background: Chronic venous insufficiency (CVI) significantly impacts patients’ quality of life and poses economic burdens on healthcare systems. Accurate assessment of venous reflux is crucial for effective management. This study aimed to identify the sites of deep, superficial, and perforator venous reflux, including junctional incompetencies between superficial and deep veins in patients with primary CVI. Methods: A prospective observational study was conducted from July 1, 2022 to June 30, 2024, utilizing non-invasive Duplex ultrasonography on patients in our clinical practice. Data were collected without patient identification, and informed consent was obtained prior to procedures. Reflux was defined as venous flow reversal lasting over 0.5 seconds. Results: A total of 50 limbs from patients aged 20 to 77 years (mean age 43) were examined, with a male-to-female ratio of 52:48. Reflux was detected in the external iliac (41 limbs), common femoral (39 limbs), superficial femoral (21 limbs), popliteal (26 limbs), posterior tibial (7 limbs) and perforator veins (21 limbs). Sapheno-femoral junction incompetency was observed in 28 cases, with 6 cases indicating early-stage reflux. Dilatation of the great saphenous vein was noted in 33 cases, while 14 cases exhibited short saphenous vein dilatation. Conclusions: The detection of venous reflux reveals significant insights for diagnosing and managing CVI. This study highlights areas for improvement in Duplex examination techniques, advocating for enhanced training for healthcare professionals to elevate diagnostic standards, ultimately benefiting patient outcomes and reducing societal burdens associated with CVI.Item Outcomes and complications of open mesh inguinal hernia repair in a district-level hospital in Bangladesh(Medip Academy, 2024-08) Mostafa, ABM; Hossain, MA; Mohsin, NA; Bose, GK; Karim, SMR.Background: An inguinal hernia occurs when tissue protrudes through a weak spot in the abdominal muscles near the groin. Open mesh inguinal hernia repair aims to reinforce the abdominal wall with a mesh implant, reducing the risk of recurrence. This study aimed to assess the outcomes and complications of open mesh inguinal hernia repair. Methods: This cross-sectional study was conducted at the Department of Surgery, Moulvibazar 250 bed District Sadar Hospital from January, 2022 to July, 2023. As the study subjects, a total of 83 cases who had mesh repair for inguinal hernia were enrolled by using a purposive sampling technique. Data were analyzed using MS Office tools. Results: In this study, inguinal hernia recurrence was observed in 3 cases (3.6%), with 2 cases (2.4%) requiring reoperation. Intraoperatively, 96.4% (n=80) experienced no complications, while 1.2% (n=1) each suffered from injury to the spermatic cord and neurovascular structures. Postoperatively, over 10% of participants reported complications, including numbness (18.1%), hematoma (16.9%), scrotal swelling (15.7%), and seroma (13.3%). Conclusions: Recurrence and reoperation rates in open mesh inguinal hernia repair are relatively low. However, physicians should remain vigilant regarding potential postoperative complications such as numbness, hematoma, scrotal swelling, and seroma in patients undergoing this procedure.Item Prospects of Solar Pump for Irrigation and Household Applications for Climate Resilience in the Coastal Region of Bangladesh(Ms. M. B. Mondal, 2024-03) Hossain, MA; Hoque, MA; Kamar, SSA; Rahman, MA; Karim, NN; Islam, MS; Ashraf, T; Jahan, N; Kader, MA.Bangladesh is a climate vulnerable and agricultural country. Coastal region of Bangladesh is severely affected by climate change. To mitigate climate, change a solar pump of flow rate 180 liter per minute was designed and tested in farmers’ fields of Kalapara and Galachipa Upazila (sub-district) of Patuakhali district, Barguna Sadar and Amtali Upazila of Barguna district and Char Fasson and Lalmohon Upazila of Bhola district in the coastal region of Bangladesh for irrigating in high value crops like tomato and brinjal using pond/canal water. One solar pump was installed in each Upazila of off-grid area in 2018 and experiments were conducted during 2018-2021. Each solar pump was operated with 1300 Wp photovoltaic panels and the panels were also used for supplying electricity to home appliances and home water supply when the irrigation time was over. In farmers’ fields, water saving irrigation methods such as drip irrigation and alternate furrow irrigation were conducted. The water savings from drip and alternate furrow irrigation methods over famers’ practice (every furrow irrigation) for tomato were 48.79% and 30.39% and those for brinjal were 47% and 35%, respectively. The benefit cost ratio of the demonstrated solar PV system was found to be 1.62 which was higher than low lift diesel pump (1.30). A small solar pump of 0.8 kW reduced 1.76 ton of carbon emission per year than a similar diesel engine operated pump. The farmers in the project areas are using the solar panels for irrigation, lightings, operating fans, supplying drinking water, sanitation and other purposes. Therefore, solar pump is an environment friendly and climate resilient technology with multiple benefits for small holder farmers in the coastal region of Bangladesh.