Tag: pubmed

Mymensingh Med J. 2022 Oct;31(4):1048-1056.

ABSTRACT

Avascular necrosis (AVN) of femoral head is an increasingly common cause of musculoskeletal disability. Most of the cases caused by steroid induced and traumatic but idiopathic cause are not also uncommon. Almost all the patients presented with pain at the hip, limping gait, restricted movement and difficulty in waking and squatting and becomes disabled. Core decompression and muscle pedicle bone graft at stage IIA, IIB and III provides painless and mobile life. Core decompression supplemented with bone graft to enhance mechanical support and augment healing. We have started a prospective study for the treatment of AVN of Femoral head at stage IIA, IIB and III by core decompression and Tensor fascia lata muscle pedicle bone graft in the department of Orthopaedic surgery Bangabandhu Seikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2009 to December 2019. Aim of the study was to assess the effectiveness of core decompression and tensor fascia lata muscle pedicle bone graft in the treatment of AVN of femoral head at stage IIA, IIB and III. A total 48 patients and 65 hips were operated. Out of 48 patients, male was 30(62.50%) and female was 18(37.5%). Male-Female ratio was 1.66:1. Age of the patients ranging from 20 years to 50 years, mean age 36±4.65 years. According to aetiology corticosteroid induced was 47/65 (72.31%), idiopathic was 8(12.31%), post traumatic was 4(6.15%), ITP was 2(3.08%), ALL was 2(3.08%), and alcohol induced was 2(3.08%) of femoral head involvement. According to Ficat and Arlet’s staging, stage IIA hip involvement was 28/65(43.08%), stage IIB was 32(49.23%) and stage III was 5(07.69%). All patients were treated with core decompression along with tensor fascia lata (TFL) muscle pedicle bone graft. All patients were followed clinically and radiologically at regular interval. Follow up period was 6 months to 10 years. Harris hip score (HHS) was used for evaluation of clinical outcome. Among the 65 hips, 24(36.92%) was excellent outcome (HHS >90), 30(46.15%) was good outcome (HHS: 80-90), 7(10.78%) was fair outcome (HHS: 70-79) and 4(6.15%) was poor outcome. For valid statistical analysis excellent and good results were grouped as satisfactory that was 54(83.07%) and fair and poor results were grouped as unsatisfactory that was11(16.93%), p value is <0.001 that is significant. It has been concluded that core decompression and TFL muscle pedicle bone graft is a pain relieving, head preserving procedure and improve hip function for the management of AVN of femoral head in stage IIA, IIB and III.

PMID:36189551

Mymensingh Med J. 2022 Oct;31(4):1020-1026.

ABSTRACT

Meningitis literally means inflammation of the meninges. It is mostly caused by bacteria, virus, fungus and protozoa and pyogenic meningitis constitutes a serious neurological disorder associated with significant morbidity and mortality in developing countries. This study was carried out to evaluate the clinical presentation and immediate outcome of pyogenic meningitis in children. This was a prospective observational study and conducted at department of Paeditrics in Cumilla Medical College Hospital, Cumilla, Bangladesh from July 2014 to June 2015. Total 50 children were diagnosed as pyogenic meningitis fulfilling the inclusion criteria was included in this study. Cases were enrolled purposively. Immediately after admission through history and clinical examination, complete blood count, random blood sugar, Cerebrospinal fluid (CSF) examination and blood culture was done in all patients. For statistical analysis chi-square test was done and significance of analysis was made when p value <0.05. This study includes patients aged between 2 months to 12 years and male female ratio was 1.5:1. Several risk factors like male sex (60.0%), age below one year (42.0%), Protein energy malnutrition (PEM) (30.0%), not exclusively breastfed (44.0%) were identified. Common presenting complaints were fever (100.0%), convulsion (96.0%), altered consciousness (42.0%) and vomiting (38.0%). Common physical signs were neck rigidity (56.0%), Kernig’s sign (26.0%) and bulged fontanelle (34.0%). CSF was hazy in 54.0%, clear in 38.0% and turbid in 08.0% cases, CSF protein was more than 100mg/dl in 90.0% of the cases and glucose was less than 40mg/dl in most of the cases (94.0%). Streptococcus Pneumoniae (49.0%) followed by Neisseria Meningitidis (38.0%) were the two most commonly isolated organism responsible for pyogenic meningitis. Mortality rate during hospital stay was 18.0% and complications developed in 18.0% of cases. To avoid maltreatment in our resource limited setting due to failure of identifying organism, this study might help to administer appropriate antibiotics against organism and to reduce morbidity and mortality in meningitis. This study revealed less mortality rate in our country than neighbors and severe malnutrition important risk factors for the burden of pyogenic meningitis. It requires large scale multicentre studies to establish the whole scenario of Bangladesh.

PMID:36189547

Mymensingh Med J. 2022 Oct;31(4):992-997.

ABSTRACT

In this study our main goal is to evaluate the role of ultrasonography (USG) for determination of placental maturity and fetal gestational age. This cross-sectional study was done at the Department of Radiology and Imaging (USG section) Mymensingh Medical College and Hospital, Mymensingh from July 2008 to June 2010, where 60 patients included in this study, who was attending in the department of Radiology & Imaging for transabdominal ultrasonography with early and late pregnancy related complaints. In this study among the 60 patients, the youngest one was eighteen years and oldest one was thirty-nine years old age. Thirty five percent (35.0%) patients were from 26-30 years age group. About 33 patients out of 60(55.0%) were house wives. Most of the patients were presented with amenorrhea (65.0%) 39 out of 60. Among 60 patients, 20 patients (33.3%) were in gestational age within 12-28 weeks, 20 patients (33.3%) were in gestational age within 29-36 weeks and 20 patients (33.3%) were within >36 weeks gestational age. Among them, 20 patients (33.3%) had grade III placenta, 20 patients (33.3%) had grade II placenta, 12 patients (20%) had grade I placenta and 08 patients (13.3%) had grade 0 placenta. Out of 60 patients, 18 patients (30.0%) were in high risk group and 70.0% were normal. Six (6) patients (10.0%) suffered from HTN, 3 patients had RH negative (5.0%) blood group, 3(5.0%) patients suffered from APH, 3 patients suffer from DM and 3 from IUGR. In this study showed hypertension and IUGR had strong correlation with accelerated placental maturation. Maternal DM and Rh sensitization were associated with delayed maturation of the placenta. This study concludes that, USG appears to be the best imaging modality for the evaluation of placenta and its grading. USG is relatively less expensive and it is good considering the diagnostic accuracy in pregnancy profile. It is noninvasive procedure without any radiation hazards and better visualization of the lesion in different section, but this study is not a complete reflection of overall incidence and statistics regarding the ailment in our country. For this a more extensive study over a longer period covering different section of society is very much needed for better outcome.

PMID:36189543

Mymensingh Med J. 2022 Oct;31(4):937-946.

ABSTRACT

Increase platelet count can accompany various cancers including lung cancer. This finding has recently been suggested to indicate poor prognosis. In patients with malignancies, thrombocytosis has previously been related disease stage, histological type and survival. In this study, the prevalence of thrombocytosis and the prognostic information provided by platelet count were analyzed in patients with stage IV Non-Small Cell Lung Cancer (NSCLC) with an aim to assess elevated platelet count as a prognostic factor in patients with stage IV NSCLC and to investigate whether there is relationship between thrombocytosis, other clinico-pathologic factors and median survival. This prospective observational study was conducted in National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh from September 2019 to August 2020. A total of 108 patients were enrolled purposively. Detail history taking, thorough physical examination was done along with relevant investigations. Data were collected by semi structured questionnaire and analysis was done with the help of Statistical Package for Social Science (SPSS), version 21.0. The mean age of the patients was found 56.4±12.2 years with range from 35 to 75 years. Majority (79.6%) patients were male, 52.8% patients came from low income and 36.1% were farmer. Majority (40.7%) were symptomatic; in bed >50.0% of day. Almost two third (59.3%) had <5.0% weight loss. Almost three fourth (69.4%) had squamous cell carcinoma. At the time of first assessment 75(69.4%) patients had normal and 33(30.6%) had elevated platelet count level. Age, sex and histological type were statistically not significant between normal and elevated platelet count level groups. But performance status, weight loss were statistically significant (p<0.05) between two groups. According to univariate analysis, age, performance status at presentation, weight loss more than 10.0% for 3 months and platelet count prior the start of treatment were all significant predictors for the overall survival. In multivariate analysis age, performance status at presentation and initial thrombocytosis were independent prognostic determinants for overall survival. Median survival time was significantly higher for the normal platelet count group and elevated platelet count group (7.5 months versus 5.5 months) respectively (95% CI, 5.5-7.5), p<0.001. The frequency of thrombocytosis in patients with stage-IV NSCLC at first presentation was 30.6% and median survival time in these patients was significantly shorter compared in patients without thrombocytosis. These results concluded that an elevated platelet count could be a useful prognostic factor for survival in patients with stage-IV NSCLC.

PMID:36189536

Mymensingh Med J. 2022 Oct;31(4):920-924.

ABSTRACT

Patients often present with chronic kidney disease (CKD) complicated with hypocalcaemia. Lower serum calcium is independently associated with chronic kidney disease. Aim of this study was to assess of serum calcium level in chronic kidney diseased patients in order to compare this parameter with healthy subjects. This analytical type of cross-sectional study was carried out in the Physiology department, Mymensingh Medical College, Mymensingh, Bangladesh from July 2018 to June 2019. A total number of 200 subjects, age range 30-70 year were included in this study. Among 200 subjects, 100 healthy were taken as control group (Group I) and 100 chronic kidney diseased patients were taken as study group (Group II). Control group (Group I) subdivided into male healthy subject (Group IA) and female healthy subject (Group IB). Also study group (Group II) subdivided into male chronic kidney diseased patient (Group IIA) and female chronic kidney diseased patient (Group IIB). The results were calculated and analyzed by using SPSS version-21. Expression of data as mean±SE and statistical significance of difference among the group was calculated by unpaired student’s ‘t’ test. In this study we found that mean±SE serum calcium of Group IA and Group IIA were 9.60±0.09mg/dl & 8.04±0.03mg/dl respectively. The mean±SE serum calcium of Group IB and Group IIB were 9.38±0.096mg/dl & 8.19±0.05mg/dl respectively. Serum calcium was significantly decreased in study groups in comparison with control groups (p<0.001). By this study we therefore recommended that routine estimation of this parameter is important for prevention of complication related to chronic kidney disease for leading a healthy life.

PMID:36189533

Mymensingh Med J. 2022 Oct;31(4):894-899.

ABSTRACT

Thalassemia is the most prevalent single gene defect in human beings worldwide. Repeated blood transfusions along with chelation therapy are mainstay of treatment in thalassemia patients. However these recurrent blood transfusions result in iron overload which along with chelation therapy causes deterioration of liver function. Aim of the study was to evaluate the liver function tests in β-thalassemia major patients. This cross sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from January 2017 to December 2017. In this study, 50 diagnosed patients of β Thalassemia major (Group A) and 50 apparently healthy children (Group B) of both sexes were selected from the department of Paediatrics, Dhaka medical college. The study parameters were serum ferritin, bilirubin, AST, ALT, ALP. The results were compared statistically between groups. Serum ferritin level (mean±SD) in thalassemic major patients in Group A (890±446.38 microgram/L) which is significantly higher above normal level. Serum bilirubin in Group A (3.27±2.62 mg/dl) and in Group B (0.48±0.24 mg/dl), Serum ALT in Group A (53.06±34.0 U/L) and in Group B (16.70±4.81 U/L), AST in Group A (84.56±33.54 U/L) and in Group B (11.60±2.72 U/L) and ALP levels in Group A (422.42±226.99 IU/L) and in Group B (221.86±80.54 IU/L). All the values were significantly higher (p<0.001) in β-thalassemia patient than that of normal children. This study concludes that liver function parameters are significantly higher in β thalassemia major patients. So routine evaluation of liver function tests may be advocated for thalassemic patients to predict early onset of hepatic dysfunction.

PMID:36189529

Mymensingh Med J. 2022 Oct;31(4):891-893.

ABSTRACT

Adolescence explained as a period of age between 10 to 19 years. This is a major contributing period to build up the health of girls. Ferritin is an intracellular protein that contains iron and releases it in a controlled fashion and it reflects body iron stores and systemic inflammation during adolescent period. It is considered the best single test for the diagnosis of iron deficiency anemia during adolescent because its concentration is directly proportional to total body iron stores in adolescent period. This study was done in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh to evaluate the changes of serum ferritin levels among iron deficient anemic adolescent girls in comparison to healthy adolescent girls in Bangladesh. This was a cross sectional, prospective, analytical type of study. This study ranged from 10-19 years of adolescent girls. Seventy (70) healthy adolescent girls, as control group (Group I). Seventy (70) iron deficiency anemic adolescent girls as study group (Group II). Serum ferritin was estimated by Micro-particle Enzyme Immunoassay Test Kit. Data were expressed as mean (±SD). Statistical significance of difference among the Group I and Group II were calculated by unpaired students ‘t’ test. The mean±SD level of serum ferritin among Group I and Group II were 26.22±4.03μg/L and 13.33±3.18μg/L respectively. Mean values ±SD of serum ferritin significantly lower in (Group II) in comparison with (Group I). Higher numbers of adolescent girls are still suffering from anemia along with low level of serum ferritin in Bangladesh. For combat this situation, immediate, sustainable and long term public health intervention and nutritional supplementation must be required.

PMID:36189528

Work. 2022 Sep 29. doi: 10.3233/WOR-220235. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic resulted in mandatory remote working for workers in many sectors, including education.

OBJECTIVE: This study aimed to investigate the physical characteristics of workspaces, computer use, and prevalence, associated factors, and reported impact of computer-related musculoskeletal symptoms (MSS) among university staff during the COVID-19 pandemic.

METHODS: A cross-sectional study of staff in a university in Ireland was conducted in March 2021. An anonymous online survey of computer use, work practices and 3-month prevalence and the reported impact of computer-related MSS (modified Nordic Musculoskeletal Questionnaire) was conducted. Data analysis involved descriptive statistics and factors associated with MSS were ascertained using chi-squared analysis.

RESULTS: The analysis included 1045 responses. The majority (63%) worked solely from home, used a laptop more frequently than a desktop computer, and worked a greater number of hours. Almost half (48%) did not have a dedicated home workspace. More respondents reported their university workspace (72%) was more comfortable than their home workspace (51.2% ; p < 0.0001). Prevalence of computer-related MSS was 83% : neck (62%), shoulder (57%), lower back (47%). Laptop-related MSS was reported more frequently (82%) than desktop-related MSS (65% ; p < 0.05). Computer-related MSS was associated with workspace, equipment at home, laptop use, female gender, and righthandedness (p < 0.05). A reduction in non-work-related activities (35%), work activities (18%) and seeking medical attention (24%) was reported.

CONCLUSION: The prevalence of computer-related MSS was high and associated with remote working. Further studies that aim to mitigate the risks of computer-related MSS in those working remotely or in hybrid models are required.

PMID:36189523 | DOI:10.3233/WOR-220235

Work. 2022 Sep 29. doi: 10.3233/WOR-220137. Online ahead of print.

ABSTRACT

BACKGROUND: Digital applications have been vital to ensuring business continuity during the COVID-19 pandemic. Indeed, digital transformation is considered key to shaping Europe’s future, including the opportunity for hybrid work. Consequently, a central issue is the experience and perception of workers and the effect on their mental well-being.

OBJECTIVE: Building on the assumption that the more ‘digitalized’ and ‘experienced with working from home (WFH),’ the more positive peoples’ perceptions are, this paper explores how workers in Italy and Denmark perceived WFH during the first COVID-19 lockdown from a psychosocial perspective and what lessons could be drawn for policy and industry.

METHODS: Ranking top and bottom respectively on the European Digital Economy and Society Index (DESI) and different pre-pandemic experiences of WFH, data about WFH perceptions and mental well-being were collected among Danes and Italians via a survey from March to May 2020. The data were analyzed using descriptive statistics, t-Tests, and ANOVA.

RESULTS: The combination of high rank and pre-experience of WFH did not result in a positive perception of WFH. Mental well-being of Danes were mostly affected and they experienced WFH to be more challenging than the Italians, where the key disadvantages were related to “Home office constraints” and the isolation that followed.

CONCLUSION: When digitalizing Europe and workplaces are likely to offer people the opportunity to have hybrid work, the results highlight how national conditions affect the prospects of the new ways of working including people’s mental well-being and where actions are most needed for policy and industry.

PMID:36189522 | DOI:10.3233/WOR-220137

Work. 2022 Sep 29. doi: 10.3233/WOR-211249. Online ahead of print.

ABSTRACT

BACKGROUND: Work injury can put older workers at higher risk of disability and early retirement. Rapid population ageing has raised questions about the ability of older workers to continue working, especially for those who have experienced work injury. Career development practices have been highlighted as a form of rehabilitation support to enable longer working lives of injured older workers.

OBJECTIVE: The purpose of this study was to explore whether career development practices contribute to higher expected retirement age for injured older workers (aged 45 and above).

METHOD: A total of 274 older Australian workers employed at large organisations completed a survey about their health, retirement intentions, work injury, and engagement with career development practices. Hierarchical multiple regression and two-way analysis of variances were used to analyse the data.

RESULTS: Work injury contributed to significantly lower expected retirement age for older workers. Work training and development predicted a significant amount of variance in expected retirement age of injured older workers, and enabled them to work to later retirement ages. There was no statistically significant difference in injured older workers’ expected retirement age for those who participated in career discussion with their managers and those who did not participate.

CONCLUSION: Lack of career development support can affect injured older workers’ ability to participate in employment. The findings highlight the importance for rehabilitation and human resource professionals to have a proactive and educative role in providing career development support to injured older workers.

PMID:36189521 | DOI:10.3233/WOR-211249