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Nevin Manimala Statistics

Role of Vitamin B12 Deficiency and Hyperhomocysteinemia in Diabetic Retinopathy

Mymensingh Med J. 2023 Apr;32(2):459-462.

ABSTRACT

Diabetic retinopathy (DR) is one of the most important causes of preventable visual impairment among patients of working age and leading cause of blindness. Deficiency of vitamin B12 and folate has been associated with increased serum homocysteine (Hcy) levels. This study was done to find out the role of vitamin B12 and Hyperhomocysteine (HHcy) in Diabetic retinopathy. The present study is a hospital-based case-control study conducted during over a period of 12 months from January 2019 to December 2019 study conducted in the Department of Ophthalmology at BIRDEM General Hospital, Dhaka, Bangladesh consisting of 100 Type 2 DM patients either with or without retinopathy (DR, n=50 and DNR, n=50, respectively). Subjects with Type 2 DM with and without retinopathy were recruited from patients attending in the department of Ophthalmology at BIRDEM General Hospital, Dhaka and were matched for duration of diabetes. Diabetes subjects on nutritional supplements for the last 6 months and those with a history of nephropathy (based standard renal function tests) and complications other than DR were excluded. Homocysteine (Hcy) levels were inversely related (p<0.05) with Diabetes patients with retinopathy. Vitamin B12 also significant correlated with Diabetes patients with retinopathy. A statistically significant negative linear relationship was found between serum homocysteine and vitamin B12 levels (Pearson r = -0.918, p=0.001) Diabetes patients with retinopathy. Vitamin B12 significantly correlated with diabetes retinopathy and homocysteine levels were inversely related with diabetes patients with retinopathy.

PMID:37002758

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Effect of Duration of Hemostatic Compression on Radial Artery Occlusion after Transradial Percutaneous Coronary Intervention

Mymensingh Med J. 2023 Apr;32(2):386-392.

ABSTRACT

Radial artery occlusion (RAO) is now a major concern in transradial approach (TRA). RAO limits future radial artery use for further TRA, for as a conduit during CABG, for invasive hemodynamic monitoring and for creation of arteriovenous fistula for hemodialysis in Chronic Kidney Disease (CKD) patients through same vascular approach. The effect of duration of hemostatic compression of RAO is unknown in Bangladesh. This prospective observational study was conducted in the department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh (NICVD) from September 2018 to August 2019, to evaluate the effect of duration of hemostatic compression on the incidence of radial artery occlusion (RAO) after transradial percutaneous coronary intervention. A total of 140 patients underwent percutaneous coronary intervention (PCI) through TRA. RAO was defined as an absence of antegrade flow or monophasic flow or invert flow on Duplex study. In this study 70 patients (Group I) received 2 hours hemostatic compression after transradial PCI. Another 70 patients (Group II) received 6 hours hemostatic compression after transradial PCI. Radial arterial blood flow assessed at early (24 hours) and late (30 days) by color duplex study after the procedure in both groups. Early radial artery occlusion occurred in 4.3% of patients in Group I and 12.8% of patients in Group II, (p=0.04). Late radial artery occlusion occurred in 2.8% of patients in Group I and 11.4% of patients in Group II, the difference was statistically significant (p=0.04). From multivariate logistic regression analysis duration of hemostatic compression time 6 hours (p=0.01), post-procedural nitroglycerine use (p=0.03) and procedure time (p=0.03) were predictors of RAO. Shorter duration of hemostatic compression is associated with a lower incidence of early and late radial artery occlusion after transradial intervention.

PMID:37002749

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Study of Body Mass Index, Blood Pressure, Serum Sodium in Newly Diagnosed Hypertensive Patients

Mymensingh Med J. 2023 Apr;32(2):355-360.

ABSTRACT

Hypertension ‘The sustained elevation of systemic arterial pressure’ is a significant risk factor for heart disease, stroke and other cardiovascular diseases and an estimated 970 million people worldwide suffer from the disease resulting in significant morbidity, mortality and financial burden globally. It is the leading modifiable risk factor for morbidity and mortality worldwide. Worldwide an estimated 1.28 billion adults aged 30-79 years have hypertension, the majority (two-thirds) living with low and middle income countries. One of the global targets for non-communicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.Sodium plays an important role in blood pressure regulation with a reduced sodium intake being associated with a reduction in systolic and diastolic blood pressure. This study was done to evaluate the differences in body mass index (BMI) and serum sodium in hypertensive and normotensive subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh between the periods from January 2022 to December 2022. A total number of 140 male subjects, age ranged from (30-59) years were included in this study. Among them, seventy (70) hypertensive subjects were taken as study group (Group II) and seventy (70) age matched normotensive subjects were taken as control group (Group I). The results were calculated and analyzed by using Statistical Package for Social Science (SPSS) version 26.0. Anthropometric measurements like height and weight taken in meter and kilogram respectively. Systolic and diastolic blood pressure was performed by aneroid sphygmomanometer (ALPK2, Japan), laboratory analysis of serum sodium by colorimetric method. In this study we found that body mass index in control group 23.59±1.29 kg/m² and study group 26.81±2.31kg/m²; blood pressure (systolic pressure in control group 113.21±6.76 mm Hg and in study group 149.14±5.03 mm Hg, diastolic pressure in control group 75.57±4.55 mm Hg and in study group 100.21±5.28 mm Hg) and serum sodium in control group 138.84±2.12 & in study group was 147.94±1.41 which were significant in study group in comparison with control group. In study group parameters were significantly increased in comparison to control male group. Therefore, by this study we recommended that routine estimation of these parameters is important for prevention of complication related to hypertension for leading a healthy life.

PMID:37002745

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Comparison of Wet Mount Microscopy and Giemsa Staining to PCR in the Diagnosis of Vaginal Trichomoniasis in a Tertiary Level Hospital of Bangladesh

Mymensingh Med J. 2023 Apr;32(2):348-354.

ABSTRACT

Trichomonas vaginalis (T vaginalis) is the most prevalent non-viral sexually transmitted infection of the reproductive age group, which may lead to various complications, if left untreated. This study aimed to diagnose Trichomonas vaginalis infection by different diagnostic procedures and to evaluate the efficacy of different diagnostic procedures. This cross-sectional descriptive study was conducted among 102 women with vaginal discharge at the Department of Obstetrics & Gynecology at Mymensingh Medical College Hospital (MMCH) from July 2019 to December 2020. Three ectocervical swabs were collected from each patient. Saline wet mount microscopy, giemsa staining and PCR were performed for each patient. Data were collected using a structured questionnaire and analyzed using Excel 2007, statistical package for social sciences (SPSS) version 26.0. The PCR assay detected Trichomonas vaginalis positivity in 6(5.9%) of 102 patients, followed by Giemsa staining 4.9% and Wet mount examination 2.9%. Wet mount microscopy showed less sensitivity 33.33%, but high specificity 98.95%, 66.67% positive predictive value, 95.96% negative predictive value and accuracy 95.09%. The sensitivity, specificity, PPV, NPV and accuracy of Giemsa staining were 66.67%, 98.96%, 80.0%, 97.94% and 97.06% respectively. Statistical significance was observed when both WMM and Giemsa staining were compared to gold standard test PCR. In resource limited settings, a wet mount is a good option for diagnosis of T vaginalis infection as giemsa staining requires heavy T vaginalis infection to be positive. But wherever facilities are available, PCR should be performed.

PMID:37002744

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Urosepsis and Bacteriuria in Patients Undergoing TRUS-Guided Prostate Biopsy

Mymensingh Med J. 2023 Apr;32(2):330-337.

ABSTRACT

A prostate gland biopsy is a test to remove small sample of prostate tissue to be examined under a microscope. A biopsy may be done when a blood test shows a high level of prostate-specific antigen (PSA) or after a digital rectal examination finds an abnormal prostate or a lump. Transrectal ultrasound (TRUS) guided biopsy is a commonly performed procedure for the detection of prostate cancer. It is associated with serious complication like urosepsis. Although the incidence of post-TRUS urosepsis is low, when it occurs it is typically serious and leads to hospitalization. Antibiotics are used prior, during and after the procedure to prevent infections as a result of TRUS biopsy. Ciprofloxacin is being used as antibiotic of choice for a long time. Antibiotic prophylaxis may prevent such complications. This cross-sectional descriptive type of observational study was taken place in Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2010 to December 2011 among purposively selected 70 patients with an aim to determine the urosepsis and bacteriuria after TRUS guided prostate biopsy. Patients attending the Urology OPD in DMCH having of LUTS and other non-specific symptoms were evaluated by history, physical examination including digital rectal examination (DRE) and necessary investigations like serum PSA to identify the potential candidates. Patients with abnormal DRE findings and increased PSA level were included in this study and those who had any painful anal and rectal condition, bleeding diathesis, anticoagulant therapy and any known allergy to lidocaine, previously undergone prostrate biopsy and those who refused to give the informed consent were excluded from this study. Data were collected on variables of interest using a structured case record form. Data were processed and analyzed using Statistical package for social science (SPSS), version 17.0. Frequency of bacteriuria and urosepsis was measured according to urine and blood culture report. Sensitivity pattern was also seen. According to this study, the frequency of bacteriuria and urosepsis was 17.1% and 5.7% respectively. Most common uropathogen was E coli both in urine and blood culture. Organisms (100.0%) were found resistant to ciprofloxacin and amoxicillin. Most of the pathogens were sensitive to tobramycin, gentamycin and cefipime. A potentially dangerous ciprofloxacin resistant organism (ESBL producing E. coli) was found positive in 25.0% of culture positive patients.

PMID:37002742

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Study on Body Mass Index and Fasting Serum Glucose in Patient with Chronic Kidney Disease

Mymensingh Med J. 2023 Apr;32(2):313-319.

ABSTRACT

The BMI and fasting serum glucose was estimated in chronic kidney diseased patient to observe low body mass and the frequency of high in fasting serum glucose level in chronic kidney diseased patient (CKD). BMI fluctuations may indicate other serious comorbid conditions. Wasting is prevalent among patients with chronic kidney disease. It is to be distinguished from chronic inflammation and malnutrition, which is defined as the consequence of insufficient food intake. Diabetes is the most common cause of kidney disease. The chronic hyperglycemia of diabetes mellitus is associated with long-term damage, dysfunction and failure of kidneys, blood vessels, nerves, heart. This cross sectional study was carried out in the department of Physiology of Mymensingh Medical College, Mymensingh from July 2014 to June 2015. In this study total 200 subjects were selected with age ranged from 25 to 60 years and divided into 100 healthy persons as control group and 100 CKD patients as study group. Both control and study group were further divided into 50 male and 50 female. Unpaired student’s t test was used for Statistical data analysis. The mean±SE BMI of control group male and study group male were 25.04±0.13 and 23.87±0.41 kg/m² respectively. In study group male, mean±SE BMI was decreased. Result was statistically significant (p<0.05). The mean±SE BMI of control group female and study group female were 24.13±0.43 and 22.90±0.27 kg/m² respectively. In study group female, mean±SE BMI was decreased and result was significant (p<0.05). BMI was decreased in study group than in control group. The results were statistically significant. Fasting serum glucose was evaluated by the Enzymatic, colorimetric, GOD-PAP method. The results showed that the mean±SE fasting serum glucose of control group male & study group male were 5.31±0.17mmol/L and 7.56±0.37mmol/L respectively. In study group male, mean±SE FSG was increased. Result was statistically highly significant (p<0.0001). The mean±SE FSG of control group female & study group female were 5.11±0.11mmol/L and 7.37±0.33mmol/L respectively. In study group female, mean±SE FSG was increased & result was highly significant (p<0.0001). According to the above result, FSG was increased in study group than in control group. The results were statistically significant. Fasting serum glucose levels increased significantly in chronic kidney disease patients than the normal healthy persons. The increasing frequency of blood glucose level in CKD may predispose the patients to diabetes and increasing the other complications.

PMID:37002740

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Serum Albumin and C-reactive protein in Hospital Admitted Patients with Chronic Kidney Disease

Mymensingh Med J. 2023 Apr;32(2):307-312.

ABSTRACT

Adequate knowledge about the causes of chronic kidney disease and their potential prevention can improve poor clinical outcome in chronic kidney disease (CKD) patients. The study was designed to evaluate the serum albumin and C-reactive protein (CRP) levels in hospitalized patients with Chronic Kidney Disease. This cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, Bangladesh with the collaboration of the Department of Nephrology, Mymensingh Medical College Hospital, Mymensingh, from January 2021 to December 2021. The subjects were selected on the basis of inclusion and exclusion criteria by purposive and convenient sampling method. A total of 110 subjects were included in this study. Among them, 55 were diagnosed CKD patients denoted as Group I and 55 were normal healthy individuals denoted as Group II. In this study, serum albumin and CRP levels were measured. All values were expressed as Mean±SD. All statistical analysis was done by using SPSS (statistical package for social science) windows package version 21.0. Statistical significance of difference between Group I and Group II were evaluated by using student’s unpaired ‘t’-test and the significance was defined as p<0.05. Correlation was done by using Pearson’s correlation coefficient test. Mean age of Group I was 52.65±4.93 and Group II was 51.15±6.32 (p=0.165). The mean±SD of BMI was 24.46±1.84 for Group I and 24.50±1.05 for Group II (p=0.886). The mean±SD values of serum albumin were 3.62±0.26g/dl and 4.16±0.69g/dl in Group I and Group II respectively. We found highly significant (p<0.001) decrease in serum albumin. The mean±SD values of CRP were 24.00±16.73mg/L and <6.0±0.00mg/L in Group I and Group II respectively. So, we found significant (p<0.05) increase in CRP levels. There was negative correlation between serum albumin and CRP. Analyzing the findings of this study, significant decrease in serum albumin and significant increase in CRP levels were observed in CKD patients.

PMID:37002739

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Relationship of Serum Creatinine Level in Heart Failure Patients in Bangladesh

Mymensingh Med J. 2023 Apr;32(2):293-295.

ABSTRACT

Heart failure means that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stuff. In collaboration with department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh this cross-sectional study from January to December 2018 was performed in the department of Biochemistry in Mymensingh Medical College, Mymensingh, Bangladesh. The aim of this study was to explore the relationship of serum creatinine in patients with heart failure (HF) for management purpose. In this study 120 subjects were included, where 60 patients of diagnosed HF acts as case group and 60 individuals were normal healthy acts as control group. Serum creatinine was determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 21. Among the study groups the mean serum creatinine levels were 2.20±0.87mg/dl and 0.92±0.26mg/dl in case and control group respectively. Analysis showed that the mean serum creatinine level was highly significantly (p<0.001) increased in HF patients in comparison to that of control group.

PMID:37002736

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Assessment of Serum Total Cholesterol in Adult Male Hypertensive Bangladeshi People

Mymensingh Med J. 2023 Apr;32(2):290-292.

ABSTRACT

Hypertension is a most common health problem worldwide and its incidence seems to be increasing on global scale. The objective of the study was to assess the relationship of serum Total Cholesterol with hypertensive patients in order to compare this parameter with normotensive subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2017 to June 2018. A total number of 120 male subjects, age ranged from 30-65 years was included in this study. Among them, sixty (60) hypertensive subjects were taken as study group (Group II) and sixty (60) age matched normotensive male subjects were taken as control group (Group I). Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired students’ ‘t’ test. In this study we found that serum total cholesterol was significant in study group (229.62±17.49mg/dl) in comparison with control group (166.32±18.04mg/dl). Therefore, by this study we recommended that routine estimation of these parameters is important for prevention of complication related to hypertension for leading a healthy life.

PMID:37002735

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Nevin Manimala Statistics

Patient Satisfaction and Oral Health-Related Quality of Life for Four Implant-Assisted Mandibular Overdentures Fabricated with CAD/CAM Milled Poly Methyl Methacrylate, CAD/CAM Milled Poly Ether Ether Keton, or Conventional Poly Methyl Methacrylate. A Cross-Over Clinical Trial

J Oral Rehabil. 2023 Apr 1. doi: 10.1111/joor.13455. Online ahead of print.

ABSTRACT

BACKGROUND: New materials for overdenture base construction were evolved. Thus, more clinical trials are needed to validate these materials.

AIM: This study was aimed to compare the difference between CAD/CAM milled Poly methyl methacrylate (PMMA), Poly Ether Ether Keton (PEEK), and conventional mandibular implant assisted overdentures regarding patient satisfaction and oral health-related quality of life (OHRQL).

METHODS: This randomized, crossover, clinical study included 18 completely edentulous subjects rehabilitated with three mandibular implant-assisted overdentures with three different denture base materials opposing a maxillary single denture. These materials were: CAD/CAM milled PMMA, CAD/CAM milled PEEK, and conventional PMMA. Every participant first received each mandibular overdenture in a random manner. After six months of each overdenture use, patient satisfaction and oral health-related quality of life were assessed using Visual Analog Scale (VAS) and Oral Health Impact Profile (OHIP-EDENT-19) respectively, then cross-over to other groups was done. The same was repeated to the last group. Comparison of VAS and OHIP-EDENT-19 between groups were done using Kruskal Wallis test followed by Bonferroni test.

RESULT: Regarding all the VAS items, there were statistically significant higher scores for CAD/CAM Milled PMMA, and PEEK than conventional PMMA base except for speech, esthetic, smell. Regarding OHIP-EDENT-19, many items revealed statistically lower problems scores for CAD/CAM milled PMMA, and CAD/CAM milled PEEK than conventional PMMA base except psychological discomfort, psychological disability and social disability.

CONCLUSION: Within the limit of this study, CAD/CAM milled PMMA, and CAD/CAM milled PEEK were recommended as implant-assisted overdenture bases as it revealed higher patient satisfaction and better oral health-related quality of life in comparison to conventional PMMA implant- assisted overdenture.

PMID:37002714 | DOI:10.1111/joor.13455