Tag: pubmed

Mymensingh Med J. 2025 Apr;34(2):554-561.

ABSTRACT

High sensitivity C-reactive protein (hs-CRP) is a well-characterized marker of low grade systemic inflammation. Microalbuminuria is an established marker of vascular endothelial damage. There are evidences that nephropathy in type 2 diabetics develops due to sustained chronic low grade inflammation and vascular endothelial dysfunction. The objective of the study was to find out the association of serum high sensitivity C-reactive protein (hs-CRP) levels with microalbuminuria in type 2 diabetic patients. This cross-sectional observational study was carried out in outpatient departments of Nephrology and Endocrinology of Mymensingh Medical College Hospital, Mymensingh. One hundred (100) type 2 diabetic patients in the age group 30 to 70 years with at least one year duration were included in the study. FBS, Serum creatinine, Serum hs-CRP level and Albumin-creatinine ratio (ACR) were measured in these subjects. It was observed that higher level of hs-CRP found in subjects with microalbuminuria. Majority (93.2%) were with microalbuminuria >50mg/gm with hs-CRP >3mg/L. There is statistically significant association between microalbuminuria and hs-CRP (p<0.001). The Pearson correlation test also showed positive correlation between hs-CRP level and microalbuminuria (r=0.876; p<0.001). There were also statistically significant (p<0.05) relationship between microalbuminuria and FBS, HbA1c as well as serum creatinine. This study concludes that microalbuminuria accompanied by elevated hs-CRP in Type 2 diabetic patient suggesting activation of inflammatory pathways. The importance of early detection, monitoring of inflammatory marker hs-CRP and ACR as predictors of diabetic nephropathy can help in modulating diabetes and its complications.

PMID:40160077

Mymensingh Med J. 2025 Apr;34(2):530-537.

ABSTRACT

Cardiac autonomic nerve dysfunction has been found associated with chronic obstructive pulmonary disease (COPD) patients as well as vitamin D₃ deficient patients. Heart rate variability (HRV), one of the markers of cardiac autonomic nerve function which is reduced in Asthma COPD overlap (ACO) patients. Sympathovagal balanced was improved in healthy subjects after administration of vitamin D₃. This randomized clinical trial aimed to observe the therapeutic effect of vitamin D₃ supplementation on non linear measures of HRV in 60 male vitamin D₃ deficient (<30 – 10 ng/ml) ACO patients. Patients were given orally either vitamin D₃ capsule or placebo per week for 6 months and serum vitamin D₃ level and non linear measures of HRV were assessed before and after intervention. HRV was measured by power lab 8/35, AD instruments and vitamin D₃ was assessed by chemiluminescent micro-particle immunoassay (CMA) method by auto analyzer. For statistical analysis paired sample ‘t’ test and independent sample ‘t’ test were done. Before intervention vitamin D₃ level and non linear parameters of HRV were similar in all patients but both these outcome measures significantly increased in vitamin D₃ treated but not in placebo treated patients after 6 months. In conclusion, vitamin D₃ supplementation is effective to improve HRV in vitamin D₃ deficient ACO patients.

PMID:40160074

Mymensingh Med J. 2025 Apr;34(2):519-529.

ABSTRACT

Several studies are being conducted worldwide to find out the prevalence of Retinopathy of prematurity (ROP) and any associated risk factors amongst preterm infants with very low birth weight (VLBW), birth weight ≤1500gm and Extreme low birth weight (ELBW) birth weight ≤1200gm. At the SCABU (Special Care Baby Unit) of Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh a prospective observational study was conducted from October 2016 to March 2017. Newborns with a gestational age of 35 weeks or less at birth and a birth weight of 1500 gm or less admitted at SCABU in BIRDEM General Hospital were the study subjects. The percentage of newborns with ROP were 30.0% (27) amongst screened infants (n=90), where 81.5% (22) were among VLBW and 18.5% (5) were among ELBW infants. Out of them 22.2% (6) had stage I, 37% (10) at stage II, 29.6% (8) at stage III and 11.1% (3) infants had Aggressive Posterior ROP (APROP). It was also found that other than the common causes of developing ROP, frequent blood transfusion and use of mechanical ventilator may be potential risk factors for developing ROP. Comparable rate of ROP was found between the SCABU of BIRDEM to the other Neonatal care units in Bangladesh. Factors other than prematurity and oxygen supplementation were found to play a role in the development of ROP i.e. blood transfusion and mechanical ventilation. Hence ROP screening should be a part of the routine service for premature babies and the threshold for screening should be lowered.

PMID:40160073

Mymensingh Med J. 2025 Apr;34(2):509-512.

ABSTRACT

Though the cases of suffocation are not frequently encountered, its frequency is increasing gradually. Objective of the study was to determine the cause, variety and manner of death in case of suffocation. This is a cross-sectional variety of descriptive study and was performed in the Department of Forensic Medicine at Dhaka Medical College, Dhaka, Bangladesh from January 2018 to December 2019. A proforma was drawn up in which different data were tabulated and analyzed. Thirty four (34) cases of suffocation were found of the total 2199 medicolegal autopsies. The age group of 31-40 years i.e. in 17 cases (50.0%) was mainly affected. Twenty one (21) male victims (61.76%) outnumbered the females. Among all suffocation cases smothering was on top i.e. in 18 cases (52.94%). Causes of death in suffocation were principally smothering by pillows in 11 cases (32.35%). Homicidal cases were determined in 22 cases (64.70%). This study reflects the dimensions of death due to suffocation.

PMID:40160071

Mymensingh Med J. 2025 Apr;34(2):502-508.

ABSTRACT

Gestational diabetes mellitus (GDM) is the most common metabolic disorder resulting in adverse consequences on both maternal and fetal outcome. Oxidative stress plays an important role in the pathophysiology of gestational diabetes mellitus by inducing insulin resistance in the peripheral tissue and impairing insulin secretion from pancreatic β-cell. Serum gamma glutamyl transferase (GGT) plays an important role in oxidative stress and recently it has been recognized as a marker of oxidative stress. GGT can be used as an indicator of the GDM. High level of GGT is a new risk factor for GDM, which is cheap, rapid and easily available parameter for monitoring the GDM patients. This case control study was carried out in the Department of Obstetrics and Gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from May 2019 to February 2020. A total of 76 pregnant women were enrolled in this study, out of which 38 women with GDM was considered as Group A and rest 38 women with normal pregnancy was considered as Group B. Gamma glutamyl transferase concentration was measured in all the study subjects. Statistical analysis of the results was obtained by using Microsoft Excel and Statistical Packages for Social Sciences (SPSS-22.0). The mean GGT was 25.0±7.46U/L with ranged from 13-41U/L in Group A and 12.95±3.23U/L with range from 7-19U/L in Group B. The difference was statistically significant between two groups. A positive significant Pearson’s correlation was found between FBS and GGT in Group A. There was also positive significant Pearson’s correlation found between 2 hours ABF with GGT in Group A. In Group A serum GGT level >16U/L had 4.42 times significantly increased to develop GDM. GGT was higher in GDM group than normal pregnancy. Monitoring GGT levels in pregnancy may help to identify women with increased risk of developing GDM.

PMID:40160070

Mymensingh Med J. 2025 Apr;34(2):469-475.

ABSTRACT

Despite enormous adverse effects, tobacco consumption is increasing with very little success of cessation programs. This is very important to have update knowledge regarding the factors attributed to the failed attempts for quitting tobacco consumption. The study was intended to find out the factors associated with quitting tobacco consumption among the male Bangladeshi garments workers. A descriptive cross-sectional study was carried out among 451 randomly selected workers of four purposively selected garments at Gazipur and Savar, Dhaka. After permission from the garments authorities and informed verbal consent from the selected respondents, data were collected by principal investigator using pre-tested interview schedule through face-to-face interview with privacy. After completion of each interview, questionnaire was cross-checked for completeness, consistency and discrepancy. Participants had freedom to withdraw from the study at any time without explaining any reason and data confidentiality was ensured strictly. The procedure did not have physical, mental and social risks. All other ethical issues and measures for data quality were taken into due consideration. Data were analyzed using computer software SPSS version 25.0 and presented in tables and diagrams. Nearly half 206(45.7%) of the workers were in age group 26 to 33 years with a mean of 28.85±8.03 years. Religion of 387(85.8%) respondents was Islam, while 278(61.6%) had completed secondary education. More than three-fifths 282(62.5%) of the workers were married with a mean family size of 4.24±1.44. As many as 379(84.0%) workers had monthly income less than 15000 Taka with a mean of 13212.86±1573.08 Taka. An overwhelming number 411(91.1%) of respondents started tobacco consumption within the age of 13 to 19 years with mean age of initiation of 16.18±2.67 years. Of 451 workers, 446(98.9%) made an effort to quit tobacco. Of them, for 286(64.1%) workers personal health problem was the influencing factor for quitting attempt. As many as 380(85.2%) workers preferred to quit tobacco consumption through reducing the consumption. Nearly three-fifths 264(59.3%) of workers were failed to quit due to bodily addiction. More than four-fifths 375(83.1%) workers affirmed that they could be able to quit tobacco. Nearly three-fourths 326(72.3%) workers did not consult doctor because they believed that they could do it by themselves. Over two-fifths 181(40.6%) of workers attempted for 4 to 10 times for quitting, while majority 213(47.8%) had maximum duration of abstinence for less than 1 week. It can be concluded that workers initiate smoking as teenagers. Personal health problems influence the workers in quitting tobacco. Moreover, they believed that they themselves are enough to do it without consultation with the physicians. A considerable number of workers had planned for quitting as well as attempted to do so more than once. However, all of them failed to do so due to bodily addiction.

PMID:40160066

Mymensingh Med J. 2025 Apr;34(2):461-468.

ABSTRACT

Patients with systemic lupus erythematosus (SLE) often ignore the initial symptoms of the disease and delay in seeking medical care, which ultimately prolongs the diagnostic delay. The objective of the present study was to explore the health-seeking behavior and the factors associated with diagnostic delay in SLE patients. This cross-sectional study was conducted among 85 patients suffering from SLE who attended the Lupus Clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2012 to June 2013. Socio-demographic and disease-related data were collected by face-to-face interviews. Diagnostic delay was defined as the period of time from onset of initial symptoms of SLE and confirmation of diagnosis. Factors associated with diagnostic delay were determined by appropriate statistical test. Almost 75.0% of the patients visited qualified physicians and their average interval of seeking medical care after the onset of SLE symptoms was 1.4±2.6 months. The average interval between the onset of initial symptoms and the diagnosis of SLE was 12.3 (SD 13.9) months. It was longer in female patients (13.2 months versus 7.3 months in male). Early medical contact and visiting qualified physicians also shortened the diagnostic delay of SLE. Patients presenting with joint pain and fever had a longer diagnostic delay than those who presented with oral ulcers, malar rash and lupus nephritis. Patients’ health-seeking behavior, such as delayed medical care seeking, as well as presenting with nonspecific symptoms, such as fever and joint pain, which mimic other diseases, increases the diagnostic delay in SLE patients. These symptoms should be considered for the evaluation of immunological evidence of SLE.

PMID:40160065

Mymensingh Med J. 2025 Apr;34(2):453-460.

ABSTRACT

Functional dyspepsia is one of the most common gastrointestinal disorders. Immune activation by eosinophils is thought to be one of the important mechanisms behind the pathogenesis of functional dyspepsia. The study aimed to evaluate the association of gastric eosinophilia with functional dyspepsia. This cross-sectional study was conducted in the Department of Gastroenterology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh from July 2019 to June 2020. Forty-six (46) adult patients with functional dyspepsia diagnosed by Rome-III criteria were enrolled. Forty patients not fulfilling the criteria of functional dyspepsia and also patients attending the department for endoscopy (evaluation of anemia, pre-ERCP screening, evaluation of chronic diarrhea, etc.) and having normal endoscopic features subsequently were taken as comparison group. After endoscopy, a biopsy was taken from the gastric body and antrum of each participant. Counting of eosinophil and histopathology was done by an expert senior histopathologist. It was expressed in per HPF. Statistical analysis was done by SPSS 22.0 and p<0.05 was set as statistically significant. Mean±SD age was 40.34±16.22 and 40.15±13.96 in functional dyspepsia patients and patients taken for comparison respectively. Females were slightly predominant with a female-male ratio of 1.2:1. Lower middle-class families were found to be the most vulnerable group suffering from functional dyspepsia. The mean eosinophil count of gastric body and antrum in functional dyspepsia patients was higher than that of the comparison group. The difference between the two groups was statistically significant (p<0.001). A statistically significant relation was found between gastric eosinophilia (p=0.015, 0.016) with functional dyspepsia (p<0.001). Eosinophil count of gastric mucosa was significantly higher in functional dyspepsia patients and had an association with it. However, further study with a large sample size could explain this precisely.

PMID:40160064

Mymensingh Med J. 2025 Apr;34(2):447-452.

ABSTRACT

Covid-19 infection can affect the multiple-organ system. Acute kidney injury (AKI) is one of the complications and is associated with poor outcomes. Of many potential risk factors for the development of AKI, raised inflammatory markers are postulated to be responsible. A retrospective cohort study was conducted on 135 patients who were admitted in the ward and intensive care unit (ICU) from June 2020 to September 2020 in Enam Medical College and Hospital, Savar, Dhaka, Bangladesh. Patients aged ≥18 years with positive RT-PCR Covid-19 were included. AKI was defined and staged according to KDIGO criteria. We evaluated the incidence of AKI, the demographic and laboratory markers associated with AKI in Covid-19 patients and the outcome. Univariate and multivariate analyses were performed. The incidence of AKI was 27.0% (36). Most of them were in stage 1(75.0%). The mean age of the cohort was 52.19±15.55 years and 68.0% were male (n=92). Of the comorbidities, diabetes mellitus was the commonest (46.0%). On progressive multivariate logistic regression, severe/critical Covid-19 (aOR 3.1, 95% CI: 1.09-8.93, p-value 0.033), requiring mechanical ventilation (aOR 2.7, 95% CI: 1.13-6.51, p-value 0.026) and raised D-dimer (aOR 3, 95% CI: 1.07-8.22, p-value 0.036) were identified as independent risk factors associated with AKI. A higher proportion of patients who developed AKI required ICU (50.0% versus 14.1%, p<0.0001) and were intubated (39% versus 13.0%, p=0.003). Overall, in-hospital mortality was 22(16.0%). In-hospital mortality was higher in patients with AKI (39 versus 8.0%, p<0.0001). Severe Covid-19, requiring mechanical ventilation and raised d-dimer are associated with AKI in Covid-19. Early identification of risk factors can reduce the incidence of AKI and death.

PMID:40160063

Mymensingh Med J. 2025 Apr;34(2):438-446.

ABSTRACT

Maternal Near Miss is a serious antagonistic event that leads to harm and morbidity in the mother, but from which she survives. Maternal mortality rate in Bangladesh has declined by 66.0% over last few decades, valued at a rate of 5.5% every year. Aim of the study was to determine the magnitude, pattern and predictors of Maternal Near Miss cases. This cross-sectional descriptive type of observational study was conducted at the Department of Obstetrics and Gynecology in Mymensingh Medical College Hospital, Bangladesh from January 2018 to December 2018. A total of 69 patients were included for the study. Patients were evaluated for cardiac arrest, jaundice, gasping, shock coagulation disorders, cerebrovascular accident and total paralysis. Serum lactate >5mmol/L, paO₂/ FiO₂ <200mm of Hg, pH <7.1 and statistical analysis was performed using computer- based software, statistical package for social science (SPSS) version 20.0. Maximum number was found 44.93% in the age groups 20-29 years, maximum were rural patients (84.05%), no formal education (55.07%) of couple were significantly higher in case of maternal near miss case. Rate of maternal near miss case among the admitted patients was 4.86%. Among the maternal near miss case pregnancy induced hypertension were most common (44.9%). Most of the patients of the maternal near miss case presented with excessive P/V bleeding (37.7%). Among the medical management most common interventions were infusion of MgSO₄ (31.9%). Regarding neonatal outcome, live birth was 47.82%. Common causes of maternal near miss case are pregnancy induced hypertension, obstetric hemorrhage, ruptured uterus and ruptured ectopic pregnancy, prolonged/obstructed labor, impending uterine rupture and infections.

PMID:40160062