Annals of International Medical and Dental Research
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Editor-in-Chief: Dr Rohit Varshney
ISSN (Print): 2395-2814 ISSN (Online): 2395-2822
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://aimdrjournal.com/Default.aspx
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Item Exploring the Correlation Between Fibrinogen-to-Albumin Ratio and Contrast-Induced Nephropathy in the Study Population(Society for Health Care & Research Development, 2024-01) Mridha, Sohel; Rashid, Md. Mamunur; Kundu, Samir; Momen, Abdul; Afroza, Nahid; Masum, Mahmudul Hasan; Alam, IftekharBackground: Contrast-Induced Nephropathy (CIN) presents a significant risk in non-ST elevation acute coronary syndrome (NSTE-ACS) patients undergoing percutaneous coronary intervention (PCI). This study investigates the association between the Fibrinogen-to-Albumin Ratio (FAR) and CIN in such patients. Material & Methods: This cross-sectional study was conducted at the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, from June 2019 to May 2020. 200 NSTE-ACS patients undergoing PCI were categorized into two groups based on FAR: Group I (FAR ? 0.106, n=100) and Group II (FAR < 0.106, n=100). Clinical parameters, including pulse rate, blood pressure, and biochemical markers, were analyzed. The incidence of CIN and the role of FAR as a predictive marker were statistically evaluated. Results: Baseline clinical parameters showed no significant differences between the groups, with pulse rates averaging 88.8�.4 bpm in Group I and 87.7�.4 bpm in Group II (p=0.62). Troponin I levels were higher in Group I (42.1�.6 ng/dl) compared to Group II (35.5�.6 ng/dl, p=0.07). Group I also exhibited higher hemoglobin levels (12.5�5 gm/dl vs. 12.0�5 gm/dl in Group II, p=0.02). The incidence of CIN was significantly higher in Group I at 12%, compared to 2% in Group II. FAR was identified as a significant predictor of CIN, with an odds ratio of 11.45 (p=0.006). Conclusions: The study establishes FAR as a significant independent predictor of CIN in NSTE-ACS patients undergoing PCI. These findings suggest that FAR can be an effective biomarker for assessing CIN risk, potentially guiding more tailored patient management strategies in this high-risk group.Item Incidence of Shoulder Pain After Covid Vaccination- an Observational Study(Society for Health Care & Research Development, 2024-01) Sultana, Ayesha; Das, Rajat Shuvra; Hoque, A.K.M. Faizul; Hannan, Mohammad Abdul; Hassan, Mehdi; Karmakar, Chandra Shekhar; Jahan, A B M Sarwar; Siddique, Muhammed Sharif Uddin; Habibullah, AKMBackground: COVID-19 vaccines are key to restoring normalcy after the global pandemic. However, improper injection techniques due to lack of clear instructions and inexperienced personnel can lead to issues like shoulder injury related to vaccine administration (SIRVA), causing shoulder pain and limited mobility. Ensuring correct administration is crucial for vaccine efficacy and patient well-being. The aim of this study was to determine the incidence of shoulder pain following COVID-19 vaccination on public health. Material & Methods: This was an observational study and was conducted in the Department of � Anaesthesia, Analgesia and Intensive care medicine of Bangabandhu Sheikh Mujib Medical University (BSSMU, Dhaka, Bangladesh during the period from February 2023 to January 2024. The study included 120 patients, male and female, focusing on Shoulder Injury Related to Vaccine Administration (SIRVA) after COVID-19 vaccination. Physician-evaluated cases were analyzed to minimize diagnostic errors, using a checklist for data extraction. Results: Patients (29.2% aged 63-72 years) predominantly received Pfizer and Moderna vaccines (80%). Common symptoms were bursitis (36%) and adhesive capsulitis (44%). Onset varied, with 35.2% reporting immediate symptoms, 40.8% within 24 hours. Pain was predominant (92%). X-ray (63.2%) and MRI (36.8%) used for diagnosis. Treatment included oral steroids (56%), physical therapy (16%), and NSAIDs (24%). Conclusions: The significance of accurate vaccine administration to avoid complications like SIRVA. Clear guidelines and trained personnel are essential for the success of the COVID-19 vaccination campaign, ensuring both efficacy and the well-being of individuals.Item Early Complications of Internal Versus External Pancreatic Duct stent in Patients with Pancreaticoduodenectomy(Society for Health Care & Research Development, 2024-09) Talukder, Tuhin; Islam, Kazi Mazharul; Elahi, Mohammad Mahbub; Awal, Mohammad Abdul; Azam, ANM Nure; Rayhan, Golam Mahmud; Hakim, H A NazmulBackground: Pancreaticoduodenectomy (PD) is a complex surgical procedure with significant postoperative complications, including pancreatic fistula, delayed gastric emptying, and intra-abdominal infections. This study aims to compare the early postoperative complications of internal versus external pancreatic duct stents in patients undergoing PD. Material & Methods: This prospective observational study was conducted at Dhaka Medical College Hospital from January 1, 2023, to December 27, 2023. A total of 40 patients scheduled for PD were divided into two groups: 20 managed with internal stents and 20 with external stents. Data on demographic characteristics, per-operative factors, and postoperative complications were collected and analyzed. Results: The study population had a mean age of 56.78 years, with males constituting 65%. The most common histopathological diagnosis was periampullary carcinoma (50%). In the internal stenting group, 10% had a soft pancreas, 65% had a firm pancreas, and 25% had a hard pancreas. In the external stenting group, 40% had a soft pancreas, 50% had a firm pancreas, and 10% had a hard pancreas. Wound infections occurred in 10% of the internal stenting group and 15% of the external stenting group. Intra-abdominal collections were found in 5% of the internal stenting group and 10% of the external stenting group. GI bleeding was absent in the internal stenting group but occurred in 5% of the external stenting group. Intra-abdominal bleeding was absent in the internal stenting group but present in 10% of the external stenting group. Delayed gastric emptying was noted in 5% of participants in both groups. Grade A pancreatic fistula was observed in 10% of the internal stenting group and 15% of the external stenting group. Grade B and C pancreatic fistulas were only present in the external stenting group, at rates of 10% and 5%, respectively. Conclusions: Internal pancreatic duct stents are associated with lower incidences of wound infections, intra-abdominal collections, and severe pancreatic fistulas compared to external stents. These findings suggest that internal stents may offer better postoperative outcomes, although stent selection should be individualized based on patient-specific factors. Further research is warranted to confirm these results and guide clinical practice.Item Major and Minor Complications of Laparoscopic Surgery following Colorectal Cancer Treatment(Society for Health Care & Research Development, 2024-09) Salam, Abdus; Haque, Ekramul; Mallick, Mithun Kumar; Siddiq, Erfan; Rahman, Mizanur; Masum, Mahmudul Hasan; Islam, Muhammed Najibul; Rahman, Mohammed AshrafurBackground: Laparoscopic surgery has become a preferred minimally invasive option for colorectal cancer treatment due to its numerous advantages over traditional open surgery. This study aimed to evaluate the short-term outcomes of laparoscopic surgery for colorectal cancer at the National Institute for Cancer Research and Hospital (NICR&H) in Dhaka, Bangladesh. Material & Methods: This was a prospective observational study conducted from September 2018 to October 2019 in the Department of Surgical Oncology at NICR&H. The study included 39 patients diagnosed with colorectal cancer who underwent laparoscopic surgery. Data were collected prospectively from medical records, including demographic information, clinical characteristics, surgical details, and short-term postoperative outcomes. Statistical analysis was performed using SPSS for Windows, with categorical data expressed as numbers and percentages and continuous data as means and standard deviations. Results: The study comprised 23 males (58.97%) and 16 females (41.03%). Most participants had primary education (51.28%) and were housewives (41.03%). A family history of cancer was reported by 25.64% of participants. The most common chief complaint was per-rectal bleeding (48.72%). Colonoscopy findings included ulcer proliferative lesions in 64.10% of patients. The most frequent minor complication was urinary tract infection (30.77%), while surgery conversion (12.82%) was the most common major complication. Other major complications included hemorrhage, respiratory distress, internal hemorrhage, intra-abdominal abscess, acute renal failure, and postoperative mortality, each occurring in 2.56% of patients. Conclusions: Laparoscopic surgery for colorectal cancer in Bangladesh demonstrates significant benefits, including reduced postoperative pain and quicker recovery times, despite certain minor and major complications. These findings support the broader adoption of laparoscopic techniques in similar healthcare settings to improve patient outcomes.Item Prevalence of Behavioral and Emotional Disorders Among Rural and Urban School Going Children and Adolescents(Society for Health Care & Research Development, 2024-09) Ali, Mohammad; Islam, Md Rahanul; Ali, Sk SadekBackground: The mental health of children and adolescents is a critical concern, with significant implications for long-term outcomes. This study aims to assess the prevalence of behavioral and emotional disorders among school-going children and adolescents in rural and urban areas of Meherpur District, Bangladesh, and to explore the socio-economic factors contributing to these disparities. Material & Methods: This cross-sectional, descriptive, and analytical study was conducted among 435 school-going children and adolescents in rural and urban areas of Meherpur District, using purposive sampling. Data were collected through questionnaires and the Development and Well-being Assessment (DAWBA), with diagnoses generated according to ICD-10 criteria. Results: The study found that the prevalence of psychiatric disorders was slightly higher in rural participants (15.89%) compared to urban participants (14.03%), though the difference was not statistically significant. Major depressive disorder was the most common emotional disorder, affecting 3.74% of rural participants and 2.26% of urban participants. Hyperkinetic disorder was more prevalent in urban participants (2.71%) compared to rural participants (1.87%). Parental education, particularly maternal education, and occupational status were significantly associated with the prevalence of psychiatric disorders, with rural areas showing higher rates of illiteracy and agricultural occupation among parents. Conclusions: The findings suggest that while there are slight differences in the prevalence of psychiatric disorders between rural and urban populations, the socio-economic disparities, particularly in parental education and occupation, play a critical role in influencing these outcomes. Targeted interventions addressing these factors are essential for improving the mental health of children and adolescents in both rural and urban settings.Item The Effectiveness of Bilateral Pectoralis Nerve Block in Cardiac Surgery Patients for Managing Postoperative Pain(Society for Health Care & Research Development, 2024-01) Das, Rajat Shuvra; Hoque, A.K.M. Faizul; Sultana, Ayesha; Hannan, Mohammad Abdul; Hassan, Mehdi; Karmakar, Chandra Shekhar; Jahan, A B M Sarwar; Siddique, Muhammed Sharif Uddin; Habibullah, AKMBackground: Effective pain management following cardiac surgery contributes to enhanced recovery and increased mobility. But the coagulation status of the cardiac surgery patients makes neuraxial blocks risky. An alternative to neuraxial blocks for post operative pain management after adult cardiac surgeries is the Pectoralis Nerve (Pecs) block. This innovative technique offers a safe and minimally invasive approach for post operative pain management after adult cardiac surgeries. The objective of the study was to investigate the effectiveness of bilateral pectoralis nerve block in cardiac surgery with regards to enhanced recovery and postoperative pain management. Material & Methods: This was a quasi-experimental study and was conducted in the Department of Anaesthesia, Analgesia and Intensive care medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh during the period from January 2023 to June 2023. This study involved 40 adult cardiac surgery patients (25-65 years) undergoing coronary artery bypass grafting and valve repair or replacement surgeries via midline sternotomy. They were divided into two groups: Group A received conventional analgesia with intravenous paracetamol 01 gm TDS with continuous intravevous infusion of 1 microgram per kg body weight of fentanyl, and Group B received ultrasound guided bilateral Pectoral Nerve (PEC) block with volume of 0.2 ml per kg body weight of 0.25% bupivacaine with 5 mg of dexamethasone for each interfacial plane . Extubation criteria were used, and data were collected through a questionnaire for visual analogue score and vital parameters such as heart rate , blood pressure, respiratory rate , duration on invasive ventilation at 0 hour, 02 hour, 04 hour, 08 hour and 12 hour post operatively. Results: In total 40 patients from both the groups completed the study. The study found no significant differences in vital parameters between Group A and Group B. Group B showed significantly lower pain scores upto 12 hours post-extubation. Respiratory rate was significantly lower in Group B at six assessment times. No significant differences were observed in hemodynamic variables. Group B had a shorter ICU stay compared to Group A, but no significant difference in hospital stays or duration of ventilator use between the groups. Conclusions: The Pectoral Nerve (Pecs) block is an effective and less invasive and safe procedure for managing postoperative pain and enhancing recovery in adult cardiac surgeries such as CABG, valve repair or replacement surgeries with a medial sternotomy.Item Linseed Oil in preventing Peri-ileostomy Skin Excoriation in Children(Society for Health Care & Research Development, 2024-09) Chowdhury, Mozammel Haque; Islam, Mohammed Kabirul; Islam, Md. FaridulBackground: Peri-ileostomy skin excoriation is an inevitable complication following Ileostomy specially in children. To prevent such excoriation Zinc oxide paste and several other conventional modalities has been used with some demerits. So in search of an alternative, Linseed oil has been proposed to prevent peri-ileostomy skin excoriation as it contains an omega-3 ? Linolenic acid having anti-inflammatory, anti-allergic, skin soothing, healing and revitalizing properties. The aim of the study is to compare the effectiveness of Linseed oil and Zinc oxide paste in preventing periileostomy skin excoriation. Material & Methods: This was a prospective comparative interventional study conducted in 76 children (ranging from 1 day to 18 years) admitted at Dhaka Shishu (Children) Hospital requiring Ileostomy care from March 2017 to September 2019. Out of 76 children, 38 were purposively selected and randomly allocated in each of Group A (Linseed oil Group) and Group B (Zinc oxide Group). Patients were followed up for 1 month after operation. During this period, 5 children were lost from followup in Group A and 4 in Group B. So we studied with 67 patients among which 33 enrolled in Group A and 34 in Group B. SPSS version 25 statistical software was used to analyze. Results: Age, sex, weight, primary diagnoses and types of operation showed no significant statistical differences between two groups. Area of excoriation was absent in 22 (66.7%) patients in Group A and 8 (23.5%) patients in Group B. No patient in Group A had > 3 cm excoriation while in Group B 8 (23.5%) patients had > 3 cm excoriation which was statistically significant (p < 0.001). 1st degree excoriation was significantly more in group B 24 (70.6%) than Group A 10 (30.3%) (p -value = 0.001). Conclusions: Linseed oil is more effective than Zinc oxide in preventing peri-ileostomy skin excoriation. It is locally available, easy to use and potential to minimize the peri-ileostomy skin excoriation.Item Peritoneal Cytology in the Staging Process of Gastric Carcinoma(Society for Health Care & Research Development, 2024-09) Biswas, Girin Chandra; Shoaib, Tanvir Hasan; Prova, Mahnaz Tabassum; Rahman, Sonia; Rahman, Mofizur; Das, ShubhankarBackground: Peritoneal carcinomatosis is one of the patterns of recurrence in patients with gastric cancer. The prognosis of patients with advanced gastric cancer invading the gastric serosa because of the high incidence of peritoneal recurrence. Recurrence with this pattern is most likely caused by the presence of free cancer cells in the abdominal cavity exfoliated from the serosal surfaces of the primary gastric tumor. The study aimed to assess peritoneal cytology in the staging process of gastric cancer. Material & Methods: This Cross-sectional observational study was carried out in the Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh for twenty-one months, starting from July 2017 to March 2019 following approval of the protocol. 42 study patients were selected based on the inclusion and exclusion criteria. The patients were diagnosed clinically, radiologically, and histopathologically. A structured case record form was used to interview and collect data. The outcome of gastric carcinoma was measured by doing peritoneal cytology. All the data were compiled and sorted properly and analyzed statistically using Statistical Package for Social Science (SPSS-22). The results were expressed as percentages and mean � SD and presented as tables and charts. Results: In the present study, the mean (盨D) age of the subjects was 66.19 (�.38). The majority (33.3%) were aged 56-65 years. Among the study subjects, 64.3% were males and 35.7% were females. 52.4%, 40.5%, and 7.1%) study subjects had BMI 18.5-24.9 kg/m2, 25-30 kg/m2 and >30 kg/m2. In this study, out of 42 patients, 61.9% were smokers and 83.3% were taking betel leaf in their habit. Here, the majority (69%) of study subjects came from the middle class. In the present study, proximal and distal stomachs were involved in study subjects. The mean � SD tumor size was 6.20 � 1.86cm. The majority of study subjects had Type 3 and Type 4 tumors and T4a and N2 stage. In this study, total gastrectomy and lower radical gastrectomy were done in the majority of the patients. The time of index surgery was 1-1.5 hours in the majority of the subjects. In the present study, 64.3% of subjects had cytology positive, 31% had cytology negative and only 4.8% of subjects had suspected cytology. Negative cytology was significantly higher in T1, T2, N0, and N1 stages and positively cytology was significantly higher in T3, T4a, and N2 stages. Conclusions: After analyzing the results of the present study, it can be concluded that the majority of subjects had cytology positive, and positive cytology was significantly higher in the T3, T4a, and N2 stages. Negative cytology was significantly higher in T1, T2, N0, and N1 stage.Item Assessment of the Diagnostic Accuracy of EUS-FNAC for Evaluating Intra-Abdominal Lesions(Society for Health Care & Research Development, 2024-01) Rahman, Fazlur; Ferdous, Zannatul; Alam, AHM Towhidul; Khan, Manir HossainBackground: The abdominal cavities can develop a wide range of reactive, inflammatory, and neoplastic lesions. Determining prognosis and choosing the best method of treatment require accurate diagnosis. EUS-FNA is now routinely done in many endoscopic centers. This study conducted to assess the diagnostic accuracy of EUS-FNAC for evaluating intra-abdominal lesions. The aim of this study was to evaluate the diagnostic accuracy of EUS-FNAC for evaluating intra-abdominal lesions. Material & Methods: The observational analytical study was carried out from January 2016 to February 2017 over a period of 12 months in the general surgery unit in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. About twenty-five patients with intra-abdominal lesions were included in this study; the other patients were excluded based on exclusion criteria. The results were given with the use of tables showing mean values, ranges, frequencies, and percentages. Results: Out of 25 cases, the maximum number of patients 7 (28.00%) were in the age group >60 years. The mean age was 50.04, within the range of 14� years. The male-female ratio was 2.13:1. Most patients have symptoms of abdominal pain 19 (76.00%). The majority of patients presented without abdominal lump (80.00%). Most of the intra-abdominal lesions detected by EUS were in the pancreas 16 (64.00%), followed by intra-abdominal lymphadenopathy 5 (20.00%). Most of the needle passes (17 or 68.00%) were 3-4 passes. Majority of the patients were malignant 18 (72.00%). The EUS-FNAC technique has a high validity (88%) for diagnosing of intra-abdominal lesions, with a perfect specificity (100%) and positive predictive value (100%). Conclusions: In surgical practise, intra-abdominal lesions will always remain an enigma. EUS-FNAC is a more recent, safe, and less invasive diagnostic tool for deeply seated intra-abdominal lesions.. The accuracy of EUS-FNAC is really excellent in our study. Therefore, EUS-FNAC can be used as a valuable tool for pathologic examination of intra-abdominal lesions.Item Observation of Early Outcome and Complications among Gastric Cancer Surgery Patients(Society for Health Care & Research Development, 2024-09) Shoaib, Tanvir Hasan; Biswas, Girin Chandra; Parveen, Lt Col Shahajadi Shanjida; Prova, Mahnaz Tabassum; Haque, Md Ekramul; Fatema, Kaselia; Rahman, Sonia; Hossen, Md. NahidBackground Gastric cancer remains a significant public health challenge in Bangladesh, with a high prevalence of habitual risk factors and late-stage diagnoses. This study aims to evaluate the early outcomes and postoperative complications among gastric cancer surgery patients in a resource-limited setting. Material & Methods: This prospective, cross-sectional observational study was conducted from July 2017 to March 2019 at the Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Dhaka. Forty patients with biopsy-proven operable gastric carcinoma were selected using purposive nonrandomized sampling. Data were collected through clinical evaluations, structured interviews, and case record forms, focusing on demographic characteristics, habitual risk factors, tumor-related features, types of surgery, duration of surgery, hospital stay, and postoperative complications. Statistical analyses were performed using SPSS-22. Results: The mean age of participants was 65.16 � 10.28 years, with a male predominance (70%). Smoking (70%) and beetle leaf consumption (90%) were prevalent habitual risk factors. Distal stomach cancer was more common (65%), with a mean tumor size of 5.00 � 2.00 cm. Lower radical gastrectomy was performed in 65% of cases. Most surgeries (60%) were completed within 1 to 1.5 hours. Hospital stay durations varied, with 45% staying 11-15 days. Postoperative complications were noted in 52.50% of patients, including wound infections (20%) and urinary tract infections (15%). Conclusions: This study highlights the critical need for improved early detection, risk factor mitigation, and postoperative care in gastric cancer management within Bangladesh. These findings provide a foundation for future research and clinical strategies aimed at enhancing patient outcomes in similar resource-limited settings.Item Hospital Readmission Rates and Associated Factors in Pediatric Pneumonia Cases(Society for Health Care & Research Development, 2024-09) Awyal, AbdulBackground: Pediatric pneumonia remains a leading cause of hospitalization and morbidity among children, particularly in resource-limited settings. Understanding the factors associated with hospital readmission is crucial for improving patient outcomes and optimizing healthcare resources. Material & Methods: This retrospective cohort study analyzed data from 250 pediatric patients diagnosed with pneumonia and admitted to 250 Beded General Hospital, Nilphamari, Bangladesh over a two-year period from January 2022 to December 2023. Patients aged 0-18 years with a confirmed diagnosis of pneumonia were included, while those with chronic lung diseases, immunodeficiencies, or incomplete medical records were excluded. Data were collected from electronic medical records, focusing on patient demographics, clinical characteristics, treatment details, and readmission status within 30 days post-discharge. Descriptive statistics and chi-square tests were employed, along with logistic regression analysis to identify predictors of readmission. Results: The study found that 30% of the patients were aged 2-5 years, with a male predominance of 56%. Asthma was the most common comorbidity, affecting 24% of the cohort, while 60% had no comorbidities. The severity of pneumonia was evenly split between mild and moderate cases (40% each), with severe cases constituting 20%. Treatment modalities were equally divided between oral and IV antibiotics (40% each), with 20% receiving combined therapy. The 30-day readmission rate was 16%, indicating a significant proportion of patients required subsequent hospitalization. Conclusions: The findings highlight key factors influencing hospital readmission rates in pediatric pneumonia, emphasizing the need for targeted interventions and improved post-discharge care to reduce readmission rates and associated healthcare burdens.Item Prevention and Management of Endometriosis in Adolescent Girls(Society for Health Care & Research Development, 2024-09) Begum, FerdewsiBackground: Endometriosis is a chronic gynecological condition characterized by the presence of endometrial-like tissue outside the uterus, leading to symptoms such as pelvic pain, dysmenorrhea, and infertility. This study aims to investigate the prevention and management strategies for endometriosis in adolescent girls, focusing on both medical and surgical interventions, as well as the effectiveness of preventive measures. Material & Methods: This study is designed as a prospective cohort study at the Department of Obstetrics & Gynaecology in Mymensingh Medical College, Mymensingh, Bangladesh from July 2020 to July 2022. The study enrolled 88 adolescent girls aged 12-18 years who have been diagnosed with endometriosis through laparoscopy or imaging. Data were analyzed by SPSS (Statistical Package for Social Sciences) version 22.0. Statistical analysis involved descriptive statistics for baseline characteristics, comparative analysis between intervention groups using t-tests and chi-square tests, and longitudinal analysis using mixed-effects models, with statistical significance set at p<0.05. Results: In this study, progestins demonstrated a 65% response rate but were associated with weight gain. GnRH agonists showed an 80% response rate with side effects such as hot flashes, while aromatase inhibitors had a 70% response rate and were linked to joint pain. Surgical outcomes indicated that laparoscopy provided 90% pain relief with a 10% complication rate and 15% recurrence, whereas laparotomy resulted in 85% pain relief, 15% complications, and 20% recurrence. Quality of life measures showed significant improvements, with pain scores decreasing from 8.5 to 3.2, activity limitations reducing from 70% to 30%, and psychological well-being increasing from 50% to 80% after treatment. Conclusions: Effective prevention and management of endometriosis in adolescent girls involve early detection, appropriate medical treatments, and preventive measures. Key strategies include using combined oral contraceptives (COCs) and lifestyle modifications to reduce symptoms, supported by education programs to improve awareness. Progestins, GnRH agonists, and aromatase inhibitors are effective treatments, with laparoscopy being a successful surgical option.Item Assessment of Knowledge and Preventative Practices about COVID-19 Among OPD Patients(Society for Health Care & Research Development, 2024-09) Khanam, Tahmina IsratBackground: The COVID-19 pandemic has significantly impacted public health globally. Understanding the knowledge and preventative practices among patients is crucial for controlling the spread of the virus. This study aimed to assess the knowledge and preventative practices regarding COVID-19 among outpatient department (OPD) patients at Combined Military Hospital (CMH), Dhaka Cantonment. Material & Methods: This descriptive cross-sectional study included 71 participants from the OPD of CMH, Dhaka. Data were collected through face-toface interviews using a semi-structured questionnaire. The study assessed demographic characteristics, comorbidities, knowledge, and preventative practices. Data analysis was performed using SPSS version 23.0. Results: The majority of participants were aged 28-37 years (45.07%), with a mean age of 35.18 years. Females constituted 59.15% of the sample. Most participants were married (87.32%), and the predominant religion was Islam (91.55%). Educational levels varied, with 42.25% having completed SSC. Occupationally, 49.30% were housewives. Urban residents made up 76.06% of the sample. Common comorbidities included hypertension (15.49%) and diabetes mellitus (15.49%). High compliance was noted for wearing face masks (97.2%) and using hand sanitizer (91.5%). However, only 46.5% practiced social distancing, and 23.9% maintained good respiratory hygiene. Knowledge gaps were identified, with only 59.2% knowing common COVID-19 symptoms. Conclusions: The study highlights significant gaps in knowledge and adherence to preventative practices among OPD patients at CMH, Dhaka. Targeted educational interventions are needed to improve compliance with critical preventative measures. Addressing these gaps is essential for enhancing public health strategies and controlling the spread of COVID-19.Item The Role of Local Infiltration of 0.25% Bupivacaine at the Port Sites in Patients with Laparoscopic Cholecystectomy to Control Early Post-Operative Pain(Society for Health Care & Research Development, 2024-09) Kamal, Faysal; Siddique, Ibrahim; Mamun, Iftakhar Al; Adnan, Tazin Ahmed; Hasan, Rashidul; Hossain, ArifBackground: Pain management constitutes a vital aspect of surgical procedures, with analgesics commonly employed for this purpose. However, the use of analgesics can be associated with certain complications. This study aimed to assess the role of local infiltration of 0.25% bupivacaine at the port sites in patients with laparoscopic cholecystectomy to control early post-operative pain. Material & Methods: This cross-sectional study was carried out in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2022 to September 2022. As the study subjects, a total of 40 adult patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease enrolled purposively. Data were analyzed by using SPSS version 23.0 were applied. Results: In this study, group 1 had a mean NRS pain score of 2.55�6 at 6 hours and 4.1�21 at 12 hours, with the first analgesic given after 13.85�57 hours and a repeat dose after 22�29 hours. Group 2, however, had higher pain scores: 6.8�15 at 6 hours, and 7.95�6 at 12 hours, with the first analgesic administered after 2.75�72 hours, and a repeat dose after 9.5�15 hours. In group 1, 30.0% of patients required a single analgesic dose in the first 12 hours, with 75.0% needing a total of 2 doses. Only 5% required analgesics within the first 6 hours. In contrast, in group 2, nearly 90% needed analgesics within the first 12 hours, with all patients requiring analgesics within the first 6 hours. This difference was statistically significant (p<0.05). Conclusions: Local administration of 0.25% bupivacaine at the port sites following laparoscopic cholecystectomy appears to be more effective than conventional analgesics in reducing postoperative port site pain. Additionally, it reduces the dose and frequency of conventional analgesic consumption.Item Association of Sexual Dysfunctions and Substance Use Related Factors among Married Couples(Society for Health Care & Research Development, 2024-07) Islam, S. M. Zikrul; Mosharof, Bipasha; Islam, Md. Rafiqul; Chowdhury, Ahmed Riad; Rahman, Taslima; Uddin, Md. Jasim; Emam, Rahat; Alam, ShafiulBackground: Sexual dysfunction is a significant health issue that can be exacerbated by substance use, affecting both individual well-being and marital relationships. This study aims to explore the association between substance use and sexual dysfunction among married couples in Sylhet, Bangladesh, and to identify the sociodemographic factors that influence this relationship. Material & Methods: This cross-sectional study was conducted at the Addiction Clinic, Outpatient and Inpatient Department of Psychiatry, Sylhet MAG Osmani Medical College Hospital, from September 2020 to August 2022. A total of 49 married patients with substance use disorders were selected through purposive sampling. Data were collected using a pre-designed structured questionnaire, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and the Bangla version of the Arizona Sexual Experience Scale (ASEX). Statistical analysis was performed using SPSS version 25, with Chi-square tests to assess the significance of associations. Results: The study found that 37% of participants reported sexual dysfunction. Among these, 61.11% had low sexual desire, 50.00% had arousal problems, 66.67% had difficulty in vaginal lubrication, 55.56% had difficulty reaching orgasm, and 83.33% had problems with orgasmic satisfaction. Duration of substance use was significantly associated with sexual dysfunction (p=0.002), with 66.67% of participants using substances for more than 10 years experiencing dysfunction. The type of substance used also showed a significant association (p=0.01), with higher prevalence among poly substance users (66.67%). Age, gender, and education level were significantly associated with sexual dysfunction, while occupation, monthly income, habitat, and family history of psychiatric illness were not. Conclusions: The study underscores the complex interplay between substance use and sexual dysfunction, influenced by various sociodemographic factors. These findings highlight the need for integrated treatment approaches that address both substance use and sexual health. Targeted interventions and public health policies are essential to improve the sexual health and overall well-being of individuals with substance use disorders.Item Pattern of Differentiated Thyroid Carcinoma and Their Management Plan(Society for Health Care & Research Development, 2024-07) Shahrear, Md. Khaled; Haque, Muhammad Mahmudul; Iqbal, Ashik; Nafis, Ali Azim Muhammad; Khatun, RomenaBackground: Carcinoma of the thyroid gland is an uncommon cancer, 0.6% and 1.6% of all cases of malignant neoplasms in men and women respectively. But is the most common malignancy in the endocrine system. This study aimed to analyze the pattern of differentiated thyroid carcinoma and its management plan. Material & Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology, Rajshahi Medical College Hospital, Rajshahi, and Department of Otolaryngology Bangabandhu Sheikh Mujib Medical University (BSMMU), from July 2011 to Jun 2012. A total of 40 patients were selected as study subjects by simple random sampling technique. A descriptive analysis of data was carried out by using a statistical package for social science (SPSS) 22.0 for Windows. Results: The highest number of cases were found in the 3rd and 5th decade of life in papillary and follicular carcinoma respectively. The male-to-female ratio was 1:2.5 in papillary, and 1:5 in follicular carcinoma, with a majority (55.0%) from rural areas. Most of the cases (35, 87.5%) suffered from papillary carcinoma, followed by (5,12.5%) follicular carcinoma. The commonest symptom for seeking medical admission was swelling in the neck (Lymph node swelling included), which was present in 39(97.5%) cases. Symptoms of distant metastasis and dyspnoea were present in 3(7.5%) and 1(2.5%) case respectively. Through FNAC 38 (95.0%) cases were diagnosed or suspected preoperatively. Conclusions: The majority of the patients present in the 3rd and 5th decade of life in papillary and follicular carcinoma respectively, with a female preponderance. Moreover, papillary carcinoma is more common than follicular carcinoma, which commonly presents with unilateral tumors. Concerning the symptoms, swelling of the neck (including lymph node swelling) is the most common feature. It can be emphasized that nodal metastasis needs total thyroidectomy, and neck dissection with radio-iodine ablation. Distant metastasis needs total thyroidectomy, surgical resection of the metastatic mass, radio-iodine ablation (if the radioiodine scan is positive), and/or radiotherapy with thyroxine.Item Efficacy of Vaginal Misoprostol and Intracervical Catheterization in Labour Induction for Vaginal Delivery in Eclampsia Patients(Society for Health Care & Research Development, 2024-01) Rahman, Nazneen; Farhin, Kazi Khadeza; Sultana, Rahima; Rahman, Shahinur; Khatun, Sharifa; Khatun, Mahfuza; Khatun, Tahmina; Khatun, AsmaBackground: Eclampsia, a severe complication of pregnancy characterized by seizures, remains a significant cause of maternal and neonatal morbidity and mortality. Effective and safe labor induction methods are crucial for managing eclampsia, particularly in resource-limited settings. This study compares the efficacy and safety of vaginal misoprostol and intracervical Foley抯 catheterization for labor induction in eclamptic patients. The aim of the present study was to compare the vaginal misoprostol and intracervical catheterization to induce labor in eclamptic patients. Material & Methods: This prospective randomized clinical trial was conducted at the Eclampsia unit of Dhaka Medical College & Hospital, Bangladesh. Sixty antepartum eclamptic patients were enrolled with 30 receiving vaginal Misoprostol (25礸 every 6 hours for 24 hours) and 30 undergoing intracervical Foley抯 catheterization. The study assessed induction-delivery interval, mode of delivery and maternal and neonatal complications. Baseline characteristics including age, socioeconomic status, gravidity, gestational age and Bishop抯 Score were recorded. Results: The induction to active labor interval averaged 9.13 � 3.45 hours for the Misoprostol group and 10.27 � 3.26 hours for the Catheterization group (p=0.197). Active labor to delivery times were 6.48 � 4.20 hours and 5.67 � 5.79 hours respectively (p=0.566). Total induction to delivery times were comparable at 15.48 � 5.02 hours for Misoprostol and 15.92 � 6.12 hours for Catheterization (p=0.771). Vaginal delivery was achieved in 76.67% of the Misoprostol group and 83.33% of the Catheterization group. Complication rates including tachysystole (10% vs. 6.67%), uterine hyperstimulation (3.33% vs. 0%) and maternal fever (6.67% vs. 3.33%), were similar in both groups. Neonatal outcomes such as mortality (36.67% vs. 30%) and NICU admissions (36.67% vs. 30%) showed no significant differences. Conclusion: Both vaginal misoprostol and intracervical Foley抯 catheterization are equally effective and safe for labor induction in eclampsia with comparable induction times, delivery outcomes and complication rates. These findings are significant for resource-limited settings, guiding clinical decisions in labor induction for eclamptic patients.Item Awareness and Knowledge of Dentists of Kashmir Regarding Separated Instrument Management : A Questionnaire Based Cross-Sectional Study(Society for Health Care & Research Development, 2024-09) Shafia; Din, Junaid Mohi UA modified online questionnaire comprising of demographics, knowledge and practice based questions was prepared and distributed online amongst 215 dentists irrespective of their specialty. A stipulated time of two weeks was given to receive response. The data collected was segregated and analyzed using MS excel for descriptive analysis. The response rate of 76% was achieved as 163 responses were received out of 215 participants. The survey respondents comprised of 32.5% percent of graduates, 35.5% endodontists and rest post-graduates of other specialties. Around 78.5% respondents experienced instrument separation during cleaning and shaping while 12.5 % during initial negotiation. Regarding the level of fracture inside the canal almost 71.5% observed separation in apical third of canal in mesial roots (65.6%) of mandibular molars. Most of the clinicians preferred bypassing technique (59.9%) as first line of treatment. 21.9% respondents preferred to leave the separated instrument in canal without further treatment & 8.8% clinicians opted for retrieval of separated instrument. 9.4% referred to endodontist for further treatment. Most of the respondents were aware about the basic technique and about the role of magnification in management of separated instrument although more information and training is needed to get aquanted with latest techniques and equipments for the treatment of separated instrumentItem Pattern and Risk Factor Analysis of Oral and Maxillofacial Trauma- A Hospital Based Study(Society for Health Care & Research Development, 2024-09) Lone, Parveen Akhtar; Kumar, Jasbinder; Lalmuanpuia, C.Background: The purpose of the study is to discuss the epidemiology and pattern of oral and maxillofacial trauma and various risk factors related to them. Material & Methods: This retrospective study was conducted in the department of Oral and maxillofacial surgery, Indira Gandhi Govt. Dental College, Jammu between 1st January to 31st December 2023 for a period of one year. Standardized data was gathered related the following information: Gender, age, etiology of injury, anatomic site of trauma , presence and location of associated injuries, treatment pattern and complications. Following categories of injury cause were considered- RTA, Fall from height, Personal violence, Animal attack injury. Results: During the one year period of study, 600 patients presented with oral and maxillofacial fractures. Road traffic Accident was the most common cause of injury comprises 487 (81.2%) injuries. The next common cause was assault n=61 (10.2%) followed by fall from height n=45 (7.5%). The most common site of maxillofacial fracture was mandible n= 373(62.2%). The next common site of maxillofacial trauma was Zygomatic arch n=94(15.7%). The next common site of maxillofacial fracture was Maxilla n=60(10%) followed by dentoalveolar 49(8.2%). Conclusions: Road traffic accident remain the highest cause of injury. Precaution and preventive measures need to be reinforced, considering the quality of life, disability and cost of rehabilitation.Item Gender-Based Disparities in Glycemic Control: Insights from Diabetes Mellitus Populations(Society for Health Care & Research Development, 2024-07) Eva, Israt Zerin; Ferdous, Chandina; Qureshi, Nazmul Kabir; Afrooz, FarhanaBackground: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia due to either inadequate insulin secretion, insulin action, or both. Disparities in glycemic control among different demographic groups, particularly between genders, have been observed and warrant further investigation. This study aims to assess the gender-based disparities in glycemic control among a population of individuals with diabetes mellitus. Material & Methods: This study was a cross-sectional design to assess genderbased disparities in glycemic control among individuals with diabetes mellitus, conducted from November 2022 to October 2023 at National Healthcare Network (NHN), Uttara, Dhaka, Bangladesh. Data were collected from patient medical records and structured interviews, focusing on the primary outcome measure of glycemic control as assessed by the most recent HbA1c levels. Chi-square tests examined associations between gender and categorical variables like FBG levels and HbA1C. Pearson correlation coefficients were calculated to assess the strength of linear relationships between gender and glycemic control measures, with statistical significance set at p < 0.05. Results: Among the 108 participants, males (n=30) showed a relatively balanced distribution with 53.3% (n=16) having fasting blood glucose levels within the range of 4.4-7.2 mmol/L and 46.7% (n=14) having levels above 7.2 mmol/L. In contrast, females (n=78) exhibited a marked disparity, with only 18.0% (n=14) having within the range of 4.4-7.2 mmol/L and a significant 82.1% (n=64) presenting with above 7.2 mmol/L. Among the 108 participants, males (n=30) had 36.67% (n=11) with HbA1C levels below 7% and 63.3% (n=19) with levels at or above 7%. In contrast, females (n=78) had a lower percentage with controlled HbA1C levels, with only 21.80% (n=17) below 7% and a substantial 78.2% (n=61) at or above 7%. Conclusions: Based on the findings of this study, it is recommended to develop and implement gender-specific intervention programs aimed at improving glycemic control among females with diabetes, focusing on education, lifestyle modification, and adherence to medication