Category: Statistics

Mymensingh Med J. 2022 Jul;31(3):656-665.

ABSTRACT

Congenital anomalies are one of the four leading causes of neonatal mortality in Bangladesh. The risk factors which are predictive of congenital anomaly in babies vary from country to country. In a developing country like Bangladesh many possible factors are present which should be identified & frequency needs to be assessed to understand the burden. The aim of this study was to determine the patterns and related maternal factors of fetal congenital anomaly. This cross-sectional type of comparative study was conducted at Department of Obstetrics & Gynecology in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2019 to August 2020. All the births occurring in the labor room were recorded. All newborn babies born with congenital anomalies were identified & included in this study. The rate of congenital anomalies was estimated and common types of congenital anomalies were noted. This study was conducted involving all women who had babies with congenital anomalies and the same number whose babies had no congenital anomalies. A structured questionnaire was used during data collection. Data was analyzed by Chi square test, bivariate analysis & multivariate logistic regression using statistical package for social sciences (SPSS) version 26.0. During the study period, 11479 deliveries were conducted. Among them 87 cases with congenital anomalies were identified. Frequency of congenital anomaly was 0.8%. Central nervous system was the predominant system involved (49.4%). Regarding risk assessment, Maternal age >30 years (OR 2.96, 95% CI 1.10-7.93, p value 0.032), consanguinity (OR 7.73, 95% CI 1.79-33.39, p value 0.006), first degree relative with history of congenital anomaly (OR 35.52, 95% CI 4.31-292.86, p value 0.001) and no intake of folic acid (OR 15.99, 95% CI 5.28-48.52, p value <0.001), passive smoking (OR 6.45, 95% CI 1.66-25.09, p value 0.007) were independent risk factors for congenital anomalies.

PMID:35780347

Mymensingh Med J. 2022 Jul;31(3):642-648.

ABSTRACT

Colorectal carcinoma (CRC) is one of the major public health problems. Vascular endothelial growth factor (VEGF) is an effective angiogenic factor and plays a pivotal role in the development, progression and metastasis of CRC. It also could further help in selecting patients of high risk of disease progression for adjuvant therapy. Therefore, this study was undertaken to reveal the importance of angiogenic factor (VEGF) as an adjunctive tool with histologic parameters of CRC. Total 45 cases were included in this cross-sectional observational study, performed in the department of Pathology, Mymensingh Medical College, Mymensingh and Immunohistochemistry was done in the department of Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2019 to February 2021. All the cases were evaluated for VEGF immunohistochemical expression. Majority of cases were low grade adenocarcinoma (86.9%) and most common stage was stage III (48.9%). Among 45 cases collectively 13 (4-negative + 9-weak positive) cases were low for VEGF expression and 32 (22-moderate positive + 10-strong positive) cases were high for VEGF expression. Statistically significant association was found with VEGF expression and increasing tumor stage as well as with lymph node metastasis (p<0.05). VEGF had positive significant correlation with stage (r=0.322; p=0.031) of tumor. However, no correlation with VEGF expression and grade (r=0.219; p=0.149) and other clinicopathological parameters of tumor was seen.

PMID:35780345

Mymensingh Med J. 2022 Jul;31(3):634-641.

ABSTRACT

Breast cancer is the most common diagnosed cancer in female over the world. It is the most important cause of ‘cancer death’ among female. For diagnosis of breast masses the Fine needle aspiration cytology (FNAC) is applied as the primary tool. Though it is an easy, rapid and comparatively minimally invasive and inexpensive procedure for quick diagnosis, it is largely a subjective tool. Computer-assisted image morphometry provides a new influential method for high-precision measurement of nuclear features and can help to differentiate between benign and malignant breast aspirates. Therefore, the aim of study was to evaluate computer assisted semi-automatic nuclear morphometry on cytology of breast lesions to differentiate benign and malignant lesions of breast. Total 70 cases were included in this cross sectional study, performed in the department of Pathology, Mymensingh Medical College, Mymensingh, Bangladesh from March 2019 to February 2021. Morphometric analysis was done on images captured from FNAC slides of the selected cases. Image J Morphometric Software was used for image analysis. Statistical analysis was done by using SPSS 26.0 version. On analysis of morphometry, four nuclear size parameters, two nuclear shape parameters and one nuclear chromasia parameter were measured. The cut-off values with sensitivity and specificity between benign and malignant category for mean nuclear area were 61.54μm², 91.0%, 97.0%, for mean maximum feret diameter 10.89μm, 94.0%, 95.0%, for mean minimum feret diameter 7.71μm, 94.0%, 97.0% and for mean nuclear perimeter 33.32μm, 94.0%, 95.0% respectively. So, in this observation, morphometry is adjunctive tools which may overcome the limitations of inter observer agreement, improve diagnostic accuracy and avoid unnecessary repeat Fine Needle Aspiration (FNA) in breast aspirates.

PMID:35780344

Mymensingh Med J. 2022 Jul;31(3):592-599.

ABSTRACT

Coronary artery disease is the leading cause of death and disability globally. The presentation of Non-ST segment elevation myocardial infarction (NSTEMI) is heterogeneous, with different risk levels in terms of death, infarction and recurrence of infarction. Current evidence suggests that plasma glucose level or hyperglycemia is a mediator of worse prognosis of MI. The objective of the study was to correlate on admission plasma glucose level in non-diabetic patient with in-hospital outcome of patients after first attack of NSTEMI. This prospective analytical study was conducted among purposively selected 280 patients with NSTEMI admitted in coronary care unit of Mymensingh Medical College Hospital during the period of June 2016 to May 2017. Data were collected from the informant by face to face interview, clinical examination and investigations using a pretested semi-structured case record form. Data were analyzed by SPSS. Patients were categorized into two groups; Group A: NSTEMI with admission plasma glucose level below 7.8mmol/l, (n=150, Male-110, Female-40). Group B: NSTEMI with admission plasma glucose level ≥7.8mmol/l, (n=130, Male-95, Female-35). Group B (n=130) is divided into two subgroups. Subgroup-I: NSTEMI with Hyperglycemia (7.8-9.3mmol/l), n = 67 (male 44, female 23), Subgroup-II: NSTEMI with Hyperglycemia (≥9.4mmol/l), n = 63 (male 51, female 12). All Patients were non diabetic excluded by HbA₁c. The mean left ventricular ejection fraction (LVEF) of Group B, Subgroup-II was significantly less than that of Subgroup-I (p<0.05). Correlation between LVEF levels and on admission plasma glucose level showed statistically significant moderate negative correlation, suggesting that the higher was the level of on admission plasma glucose level; the lower was the LV ejection fraction level in first attack of NSTEMI patients. Correlation coefficient between Troponin-I and plasma glucose level on admission of the study population (r=0.030) suggesting that the higher was the level of admission plasma glucose level the higher was the Troponin-I level in first attack of NSTEMI patients. The more was the plasma glucose level, less was LVEF, more was the heart failure and prolonged hospital stay. The study showed a strong predictor of adverse in-hospital outcome in the various levels of plasma glucose and NSTEMI. There was association between the concentration of the plasma glucose and the extent, severity of disease in the means of mean LVEF, the rate of heart failure and duration of hospital stay. The importance of this finding is even clear that RBS is a standard, valuable diagnostic tool for evaluation of severity and prediction of outcome of patients with NSTEMI.

PMID:35780338

Mymensingh Med J. 2022 Jul;31(3):600-605.

ABSTRACT

The serum Alanine Transaminase (ALT) activity has been regarded as a reliable and sensitive marker of liver disease. In the context of obesity ALT may also be a good indicator of overall health. Obesity has been reported as a risk factor associated with elevation of ALT, which is a surrogate marker of Non-alcoholic fatty liver disease (NAFLD). Elevated ALT may correlate with the severity of NAFLD in obese female. This study was done to evaluate the changes of serum ALT in obese female age ranged 30-60 years in comparison to normal healthy female of same age. At the same time we can know the relationship between body mass index and serum ALT concentration in obese female. This analytical cross-sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2020 to December 2020. A total number of 100 female subjects were included in this study. Among them fifty (50) normal healthy female were taken as control group (Group I) and fifty (50) obese female were taken as study group (Group II). The level of serum ALT was determined by Ultra violet (UV) method. Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired Student’s ‘t’ test. Pearson’s correlation coefficient test was done to find the correlation of serum ALT with BMI by using SPSS (version 21.0). During interpretation of results, p values of <0.001 were considered as statistically highly significant. In this study, serum level of ALT was significantly higher (p<0.001) in obese female compared to those of healthy control female. In addition, there is a positive correlation of serum ALT with BMI. From the results of the present study, it can be concluded that, elevated ALT was significantly associated with high BMI as well as with other feature of NAFLD.

PMID:35780339

Mymensingh Med J. 2022 Jul;31(3):581-585.

ABSTRACT

The most common cause of premature death in developing countries like Bangladesh is ischaemic heart disease. Cardiac troponin-I (cTnI) is 100 percent tissue specific for the myocardium which has been shown to be a very sensitive and specific biomarker for acute myocardial infarction. As acute myocardial infarction is a stressful condition so, plasma glucose level may also increase in this condition which is stress hyperglycemia and also plasma glucose level may be used for prediction of outcome as it is a cheap and easy available test. The aim of the study is to investigate the impact of the elevation of troponin-I level with plasma glucose level of non-diabetic patients in ST-elevation myocardial infarction. This study which was comparative type of analytical and cross- sectional study carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2021 to December 2021. Data was collected from Cardiology Department of Mymensingh Medical College Hospital, Mymensingh. A total number of 70 subjects participated in this study and were grouped as normoglycemic ST elevation myocardial infarction- Control group (Group I) and non-diabetic hyperglycemic ST elevation myocardial infarction- Study group (Group II). The results were calculated and analyzed by using SPSS. Serum troponin-I was measured by Fluorescence Immunoassay (FIA) and plasma glucose estimated by GOD-PAP method. Data were expressed in mean±SD and statistical significance of difference among the groups were calculated by unpaired Student’s ‘t’ test. The correlation between different parameter was done by Pearson’s correlation coefficient test. In this study, the result suggests that there is significant positive association between serum troponin-I and plasma glucose level in study group (hyperglycemic non-diabetic STEMI) in comparison to control group (normoglycemic STEMI). So, by this study we recommend that routine estimation of these parameters is important for prevention of complications related to acute myocardial infarction.

PMID:35780336

J Inj Violence Res. 2022 Jul 3;14(3). doi: 10.5249/jivr.v14i3.1693. Online ahead of print.

ABSTRACT

BACKGROUND: Intimate partner violence (IPV) is the most common type of domestic violence often used by men against their wives. Due to the destructive and widespread social and health consequences of IPV, the present study aimed to investigate the prevalence and related factors of IPV among married women in Garmsar, Iran.

METHODS: Using multi-stage clusters sampling method, this cross-sectional study included 400 married women in Garmsar, Iran. The data collection process was conducted during October and December 2019 using a researcher-made questionnaire. The content validity of the questionnaire was confirmed using content validity ratio (CVR) and content validity index (CVI) indicators (0.85 and 0.88, respectively). Also, the reliability was confirmed by examining the internal consistency and obtaining a score of 0.93 for Cronbach’s alpha. Descriptive and analytical statistics were performed using t-test, analysis of variance (ANOVA), and Tukey’s post-hoc test.

RESULTS: Most participants were in the age range of 20-40 years (mean age: 34.9 years). The overall exposure of women to IPV was 56.11%. In addition, the most prevalent types of IPV included legal (24%), social (24%), financial (22%), verbal (16%), physical (13%), emotional (12%), and sexual (11%). The effective factors on the prevalence of IPV included number of children, education level, occupation, and age (P less than 0.05).

CONCLUSIONS: We witnessed that women living in Garmsar faced different types of IPV and their overall exposure to this phenomenon was higher than the national and global average. To resolve the problem, the following measurements are recommended: a careful investigation of the reasons for the spread of IPV, implementing interventions based on reliable evidence, and serious cooperation of the experts and relevant governmental and non-governmental institutions, particularly citizens.

PMID:35780333 | DOI:10.5249/jivr.v14i3.1693

Perspect Psychiatr Care. 2022 Jul 3. doi: 10.1111/ppc.13136. Online ahead of print.

ABSTRACT

PURPOSE: This study examines the influence of socioeconomic factors on the prevalence of depression and anxiety and on the number of years lived with disability (YLD) of depression and anxiety.

DESIGN AND METHODS: This is an exploratory study. The study analyzed data from 160 member countries of the World Health Organization (WHO).

FINDINGS: Except for alcohol consumption and unemployment rate, Gini coefficient, age dependency, rural population, and population aged 65 and above have statistically significant effects on both depression and anxiety prevalence. Also, Gini coefficient and rural population have significant effects on YLD of depression and anxiety.

PRACTICE IMPLICATIONS: The study results will allow psychiatrists, psychologists, and other mental health professionals to focus on policy reforms that address the social determinants of mental health.

PMID:35780329 | DOI:10.1111/ppc.13136

Dis Esophagus. 2022 Jul 3:doac044. doi: 10.1093/dote/doac044. Online ahead of print.

ABSTRACT

Minimally invasive Ivor-Lewis Esophagectomy (MIE) is widely accepted as a surgical treatment of resectable esophageal cancer. Aim of this paper is to describe the surgical details of our standardized MIE technique and its safety. We also evaluate the esophageal mobilization in semiprone compared to the left lateral position. A retrospective analysis of 141 consecutive patients who underwent Ivor-Lewis esophagectomy for cancer, from February 2016 to September 2021, was conducted. All the procedures were performed by totally thoraco-laparoscopic with an intrathoracic end-to-side circular stapled anastomosis. Thoracic phase was performed in left lateral position (LLP-group, n=47) followed by a semiprone position (SP-group, n=94). The intraoperative and postoperative outcomes were prospectively collected and analyzed. The procedure was completed without intraoperative complication in 94.68% of cases in SP-group and in 93.62% of cases in LLP-group (P=0.99). The total operative time and thoracic operative time were significantly shorter in SP-group (P=0.0096; P=0.009). No statistically significant differences were detected in postoperative outcomes between the groups, except for anastomotic strictures (higher in LLP-group, P=0.02) and intensive care unit stay (longer in LLP-group, P=00.1). No reoperation was needed in any cases. Surgical radicality was comparable; the median of harvested lymph nodes was significantly higher in SP-group (P<0.0001). The present semiprone technique of thoraco-laparoscopic Ivor-Lewis esophagectomy is safe and feasible but may also provide some advantages in terms of lymph nodes harvested and total operation time.

PMID:35780319 | DOI:10.1093/dote/doac044

Med Phys. 2022 Jul 2. doi: 10.1002/mp.15844. Online ahead of print.

ABSTRACT

PURPOSE: To provide ultra-high dose rate pencil beam scanning proton dosimetry comparison of clinically used plane-parallel ion chambers, PTW Advanced Markus and IBA PPC05, with a proton graphite calorimeter in support of first in-human proton FLASH clinical trial.

METHODS: Absolute dose measurement intercomparison of the plane-parallel plate ion chambers and the proton graphite calorimeter was performed at 5 cm water equivalent depth using rectangular 250 MeV single layer treatment plans designed for the first in-human FLASH clinical trial. The dose rate for each field was designed to remain above 60 Gy/s. The ion recombination effects of the plane-parallel plate ion chambers at various bias voltages were also investigated in the range of dose rates between 5 – 60 Gy/s. Two independent model-based extrapolation methods were used to calculate the ion recombination correction factors k_s to compare with the two-voltage technique from most widely used clinical protocols.

RESULTS: The mean measured dose to water with the proton graphite calorimeter across all the pre-defined fields is 7.702 ± 0.037 Gy. The average ratio over the pre-defined fields of the PTW Advanced Markus chamber dose to the calorimeter reference dose is 1.002 ± 0.007 while the IBA PPC05 chamber shows ∼3% higher reading of 1.033 ± 0.007. The relative difference in the k_s values determined from between the linear and quadratic extrapolation methods and the two-voltage technique for the PTW Advanced Markus chamber are not statistically significant and the trends of dose rate dependence are similar. The IBA PPC05 shows a flat response in terms of ion recombination effects based on the k_s values calculated using the two-voltage technique. Differences in k_s values for the PPC05 between the two-voltage technique and other model-based extrapolation methods are not statistically significant at FLASH dose rates. Some of the k_s values for the PPC05 that were extrapolated from the three-voltage linear method and the semi-empirical model were reported less than unity possibly due to the charge multiplication effect, which was negligible compared to the volume recombination effect in FLASH dose rates.

CONCLUSIONS: The absolute dose measurements of both PTW Advanced Markus and IBA PPC05 chambers are in a good agreement with the NPL graphite calorimeter reference dose considering overall uncertainties. Both ion chambers also demonstrate good reproducibility as well as stability as refence dosimeters in ultra-high dose rate pencil beam scanning proton radiotherapy. The dose rate dependency of the ion recombination effects of both ion chambers in cyclotron generated PBS proton beams is acceptable and therefore, both chambers are suitable to use in clinical practice for the range of dose rates between 5 – 60 Gy/s. This article is protected by copyright. All rights reserved.

PMID:35780318 | DOI:10.1002/mp.15844