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Ahmed A, Hossain L, Banik G, Sayeed A, Sajib MRUZ, Hasan MM, Hoque DE, Hasan ASM, Raghuyamshi V, Zaman S, Akter E, Nusrat N, Rahman F, Raza S, Hasan MR, Uddin J, Sarkar S, Adnan SD, Rahman A, Ameen S, Jabeen S, El Arifeen S, Rahman AE. Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control: a multi-centre study in Bangladesh. J Hosp Infect 2024; 145:22-33. [PMID: 38157940 DOI: 10.1016/j.jhin.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh. AIM Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh. METHODS We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities. RESULTS The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level. CONCLUSION The integrated intervention package improved IPCAF score in all facilities.
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Affiliation(s)
- A Ahmed
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - L Hossain
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - G Banik
- Health and Nutrition Sector, Save the Children, Dhaka, Bangladesh
| | - A Sayeed
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R U-Z Sajib
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois Urbana-Champaign, USA
| | - M M Hasan
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | | | | | - E Akter
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - N Nusrat
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | - F Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Raza
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R Hasan
- Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh
| | - J Uddin
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - S Sarkar
- Hospital Service Management, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S D Adnan
- Hospital and Clinics, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - A Rahman
- Communicable Disease Control, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S Ameen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Jabeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S El Arifeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A E Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Biswas D, Nag S, Khan AU, Ahamed F, Karim MR, Hasan MR, Haque AK. Hypoalbuminaemia as a Marker of Severity of Patients of Community Acquired Pneumonia. Mymensingh Med J 2023; 32:968-974. [PMID: 37777888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Community-acquired pneumonia (CAP) is a common presentation with an acute infection of the pulmonary parenchyma occurring in the community level. Despite the availability of potent antibiotics, it remains as a serious illness with significant morbidity and mortality in both developed and developing countries. This study was undertaken to determine the relation between serum Albumin and severity of CAP. This was a cross sectional descriptive study which was carried out in the Department of Medicine of Mymensingh Medical College Hospital (MMCH), Bangladesh from July 2019 to December 2019. The sample size was 67. Purposive sampling technique was employed. Patients of community acquired pneumonia (CAP), aged ≥14 years of both sex with recently developed radiological pulmonary shadowing with compatible clinical symptoms and signs were included. Patients who were chronically immunosuppressed, with chronic starvation, advanced liver disease or chronic kidney disease with or without receiving haemodialysis were excluded. Data analysis was done by SPSS software for Windows (version 23.0). The mean age 65.7±15.3 years, majority 13(19.4%) patients had chronic lung disease, 12(17.9%) had diabetes mellitus, 9(13.4%) had heart failure, 6(9.0%) had cerebrovascular disease, 6(9.0%) had neoplastic disease and 5(7.5%) had chronic renal failure. Majority 22(32.8%) patients had CURB-65 score 3, out of which 12(54.5%) had albumin level <20g/l, 9(40.9%) had albumin level 20.0-24.9g/l and 1(4.5%) had albumin level 25-29g/l. 17(25.4%) had score 4-5 out of which 10(58.8%) had albumin level <20g/l and 7(41.2%) had albumin level 20.0-24.9g/l, 15(22.4%) had score 2 and 13(19.4%) had score 0-1. Negative significant correction (r=-0.782; p=0.001) was found between CURB-65 score and albumin level. Significant number of patients with severe CAP show low serum albumin level at admission which is statistically significant when compared with CURB-65 score. Thus hypoalbuminaemia may be a good marker of severity of patients with CAP.
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Affiliation(s)
- D Biswas
- Dr Debashish Biswas, Indoor Medical Officer, Department of Medicine, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh
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Saeed T, Al-Muyeed A, Yadav AK, Miah MJ, Hasan MR, Zaman T, Hasan M, Ahmed T. Influence of aeration, plants, electrodes, and pollutant loads on treatment performance of constructed wetlands: A comprehensive study with septage. Sci Total Environ 2023:164558. [PMID: 37270017 DOI: 10.1016/j.scitotenv.2023.164558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/03/2023] [Accepted: 05/28/2023] [Indexed: 06/05/2023]
Abstract
This study reports the performance of non-aerated and aerated unplanted, planted, microbial fuel cell planted wetlands for stabilizing septage and treating the drained wastewater. The wetland systems of this study were dosed with septage for a relatively shorter period, i.e., 20 weeks, followed by 60 days of sludge drying period. The sludge loading rates across the constructed wetlands ranged between 259 and 624 kg total solids (TS)/m2 per year. Organic matter, nitrogen, and phosphorus concentration of the residual sludge ranged between 8512 and 66,374 mg/kg, 12,950 and 14,050 mg/kg, 4979 and 9129 mg/kg, respectively. The presence of plants, electrode, and aeration improved sludge dewatering and decreased the organic matter and nutrient concentration of the residual sludge. The heavy metals (Cd, Cr, Cu, Fe, Pb, Mn, Ni, and Zn) concentration of the residual sludge fulfilled the guidelines for agricultural reuse in Bangladesh. Chemical oxygen demand (COD), ammoniacal nitrogen (NH4-N), total nitrogen (TN), total phosphorus (TP), and coliform removal percentages from the drained wastewater ranged between 91 and 93 %, 88 and 98 %, 90 and 99 %, 92 and 100 %, and 75 and 90 %, respectively. NH4-N removal from the drained wastewater depended upon aeration. The sludge treatment wetlands achieved metals removal percentages (from the drained wastewater) ranging between 90 and 99 %. Physicochemical and microbial routes in accumulated sludge, rhizosphere, and media contributed to pollutants removal. Input load and organic removal increment (from the drained wastewater) were positively correlated; nutrient removal showed a contradictory trend. The non-aerated and aerated microbial fuel cell planted wetlands produced maximum power densities ranging between 66 and 3417 mW/m3. Because of the shorter experimental duration, this study revealed preliminary but new information on the macro and micro pollutants removal pathways in septage sludge wetlands (with and without electrode) that could be utilized to design pilot or full-scale systems.
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Affiliation(s)
- Tanveer Saeed
- Department of Civil Engineering, University of Asia Pacific, Dhaka 1205, Bangladesh.
| | - Abdullah Al-Muyeed
- CWIS-FSM Support Cell, Department of Public Health Engineering, Government of the People's Republic of Bangladesh, Dhaka 1000, Bangladesh
| | - Asheesh Kumar Yadav
- Department of Chemical and Environmental Technology, Rey Juan Carlos University, Mostoles 28933, Madrid, Spain
| | - Md Jihad Miah
- Department of Civil Engineering, University of Asia Pacific, Dhaka 1205, Bangladesh
| | - Md Rashedul Hasan
- Department of Civil Engineering, University of Asia Pacific, Dhaka 1205, Bangladesh
| | - Takrim Zaman
- Department of Civil Engineering, University of Asia Pacific, Dhaka 1205, Bangladesh
| | - Mehedi Hasan
- ITN-BUET Centre for Water Supply and Waste Management, Bangladesh University of Engineering and Technology, Dhaka 1000, Bangladesh
| | - Tanvir Ahmed
- ITN-BUET Centre for Water Supply and Waste Management, Bangladesh University of Engineering and Technology, Dhaka 1000, Bangladesh
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Dasgupta S, Samad A, Howlader SS, Choudhury DI, Hossain A, Khan MS, Hasan MR, Talukder QI, Rahman MK. Complete Heparin Reversal by Protamine during Off-Pump Coronary Artery Bypass Surgery (OPCAB): A Necessity or Myth? Mymensingh Med J 2023; 32:421-429. [PMID: 37002753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
In our country majority of the coronary artery bypass surgery (CABG) are done off-pump and was reported having excellent clinical outcome along with cost efficiency by various investigators. Heparin is commonly used as most effective anticoagulant, and protamine sulfate is now generally used to reverse the anticoagulant action of heparin. While under dosing of protamine may result in incomplete heparin reversal and prolonged anticoagulation, protamine overdosing is associated with impaired clot formation exerted by the intrinsic anti-coagulation properties of protamine itself, moreover protamine administration is associated with mild to severe cardiovascular and pulmonary complications. Apart from traditional full neutralization of heparin now-a-days, half dose protamine was also introduced showing good outcome regarding lower activated clotting time (ACT), overall, less surgical bleeding with less transfusion. This comparative study was designed to detect differences between traditional and decreased protamine dosing in Off-Pump Coronary Artery Bypass (OPCAB) surgery. Four hundred (400) patients who underwent Off-Pump Coronary Artery Bypass Surgery (OPCAB) surgery at our institution over a period of 12 months were analyzed and were divided into two groups. Group A- received 0.5mg of protamine per 100 unit of heparin; Group B-received 1.0mg of protamine per 100 unit of heparin. ACT, blood loss, hemoglobin and platelet count units of blood and blood product transfusion requirements, clinical outcome and hospital stay were assessed in each patient. This study showed that 0.5mg of protamine per 100 unit of heparin was always able to reverse the anticoagulant effect of heparin with no significant difference in hemodynamic parameters, amount of blood loss and requirements of blood transfusion in between the groups. A standard protamine dosing formula (protamine-heparin at ratio of 1:1) adequate for on-pump cardiac surgical procedures significantly overestimates protamine requirements for OPCAB. Patients treated with decreased protamine do not appear to have adverse outcomes in terms of post-operative bleeding.
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Affiliation(s)
- S Dasgupta
- Dr Saikat Das Gupta, Associate Consultant, Department of Cardiac Surgery, Square Hospitals Ltd, Dhaka, Bangladesh; E-mail:
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Jahan N, Khan MNI, Hasan MR, Bashar MS, Islam A, Alam MK, Hakim MA, Khandaker JI. Correlation among the structural, electric and magnetic properties of Al 3+ substituted Ni-Zn-Co ferrites. RSC Adv 2022; 12:15167-15179. [PMID: 35693236 PMCID: PMC9116189 DOI: 10.1039/d1ra09354a] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/11/2022] [Indexed: 11/21/2022] Open
Abstract
This study explored the structural, electrical, and magnetic properties of diamagnetic aluminium (Al3+) substituted nickel-zinc-cobalt (Ni–Zn–Co) mixed spinel ferrites, though the research on this area is in the infancy stage. Single-phase cubic spinel structures with the Fd3̄m space group of the synthesized Ni0.4Zn0.35Co0.25Fe(2−x)AlxO4 (0 ≤ x ≤ 0.12) ferrite samples were confirmed by X-ray diffraction (XRD) analysis. The average particle size ranged from 0.67 to 0.39 μm. Selected area electron diffraction (SAED) patterns were indexed according to the space group Fd3m, representing the particle's crystallinity. The optical band gaps ranged from 4.784 eV to 4.766 eV. Frequency-dependent dielectric constants and ac conductivity measurement suggested that the prepared ferrites were highly resistive. Relaxation times were reduced to a low value from 45.45 μs to 1.54 μs with the composition x. The Curie temperatures (Tc) were 615–623 K for all samples. Real part permeabilities (μ/) were relatively stable up to an extended frequency range of 106 Hz with relative quality factors (RQF) of around 103. Tuning of the properties indicates that the fabricated ferrites may be promising for high-frequency electronic devices. This study explored the structural, electrical, and magnetic properties of diamagnetic aluminium (Al3+) substituted nickel–zinc–cobalt (Ni–Zn–Co) mixed spinel ferrites, though the research on this area is in the infancy stage.![]()
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Affiliation(s)
- Nusrat Jahan
- Department of Physics, Jahangirnagar University Savar Dhaka 1342 Bangladesh .,Department of Physics, American International University Bangladesh (AIUB) Dhaka 1229 Bangladesh
| | - M N I Khan
- Materials Science Division, Atomic Energy Centre Dhaka 1000 Bangladesh
| | - M R Hasan
- Materials Science Division, Atomic Energy Centre Dhaka 1000 Bangladesh
| | - M S Bashar
- Sustainable Energy Technology, Institute of Fuel Research & Development, BCSIR, Ministry of Science & Technology Bangladesh
| | - A Islam
- Department of Physics, Magura Govt. Mahila College Magura Bangladesh
| | - M K Alam
- Department of Physics, Materials Science Lab, Bangladesh University of Engineering & Technology Dhaka 1000 Bangladesh
| | - M A Hakim
- Department of Glass and Ceramic Engineering, Bangladesh University of Engineering and Technology (BUET) Dhaka 1000 Bangladesh
| | - J I Khandaker
- Department of Physics, Jahangirnagar University Savar Dhaka 1342 Bangladesh
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Akhter T, Nessa A, Hasan MR, Sharmin A, Yeasmin F, Afroz L, Rukunuzzaman M, Naznen F, Sharmin T. Study on Body Mass Index and Serum Calcium Level in Postmenopausal Women. Mymensingh Med J 2022; 31:367-371. [PMID: 35383752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Menopause is one of the natural parts of women's life when menstrual cycle stops due to lack of estrogen, which occurs in middle age. Various health problems occur in this period which hampers quality of life. This study was done to evaluate the changes of body mass index and serum calcium level in post-menopausal women in comparison to reproductive women. This cross-sectional analytical type of study was done in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2021 to December 2021. A total number of 140 female subjects age ranged from 25-65 years were included in this study. Among them 70 (seventy) postmenopausal woman (45-65 years) were taken as study group (Group II) and 70 (seventy) reproductive women (25-45 years) were taken as control group (Group I). Body mass index was measured by Anthropometric measurements such as height and weight taken in meter and kilogram respectively and Serum calcium level was measured by colorimetric method with O-Cresolftalein-complexone (OCC). Data were expressed as mean (±SD) and statistical significance of difference among the group was calculated by unpaired Student's 't' test. The mean±SD of BMI of Group I and Group II were 23.05±4.43 kg/m² and 29.01±3.12 kg/m² respectively. The mean±SD of body mass index is significantly higher in study group in comparison with control group. Serum calcium of Group I and Group II were 10.95±0.77 mg/dl and 7.99±0.55 mg/dl respectively. The mean±SD of serum calcium level was significantly lower in study group in comparison with control group. Post-menopausal women with low serum calcium level have a chance of development of osteoporosis. So, assessment of this parameter is important for early detection and prevention of complication related to low serum calcium level for leading a sound life.
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Affiliation(s)
- T Akhter
- Dr Tania Akhter, M Phil (Physiology) Final Part, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Haque AN, Uzzaman KS, Hasan MM, Hasan KR, Hasan MR, Hussain M, Saha MK, Islam MS, Rahman MM, Roy MK, Kamruzzaman M, Minto MR, Alam MT, Hossain MZ, Islam MN, Islam MS. Outcome of Danis-Weber Type-B ankle fracture treated by Pre-contoured Distal Fibular Locking Plate. Mymensingh Med J 2021; 30:644-650. [PMID: 34226450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Danis-Weber type-B ankle fracture is one of the most common injuries in young and active individual. This fracture offers a considerable challenge to orthopedic surgeon. Though there are several options for treating such type of fracture, ORIF by Pre-contoured Distal Fibular Locking Plate is the preferred option in the recent years. This descriptive type of observational study was performed from July 2017 to June 2019 in NITOR. Thirty (30) patients, 22 male and 8 female with an average age of 39 years with Danis-Weber type-B ankle fracture underwent ORIF by Pre-contoured Distal Fibular Locking Plate for fractured fibula and ORIF by 4.0mm cannulated cancellous screw for fractured medial malleolus. All the patients were initially managed by analgesic and short leg posterior slab. Average follow up was 24 weeks. Final outcome was assessed by AOFAS score. The main cause of injury was RTA (56.67%). Mean operation time was 1.2 hours. Mean duration of Hospital stay was 16.43±1.73 days. Superficial infection was in 3.33% and skin necrosis in 3.33% patient. Mean duration of radiological healing was 12.73±0.39 weeks. At final follow up, mean dorsi flexion was 10.93°±0.357° and plantar flexion was 50.93°±0.357°. Ninety percent (90%) patient had no difficulties in walking on any surface; 96.67% patient had stable ankle hind foot; 86.67% patient had good. Ten percent (10%) had fair and 3.33% patient had poor alignment of foot. The mean score in this study was 88.67±2.31. Satisfactory outcome was observed in 86.67% patients and 13.33% had unsatisfactory results. On the basis of results in the present study, it can be concluded that treatment of Danis-Weber type-B ankle fracture by Pre-contoured Distal Fibular Locking Plate is an effective and reliable method.
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Affiliation(s)
- A N Haque
- Dr AKM Nazmul Haque, Junior Consultant (Orthopedics), Department of Orthopedics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
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Ali MH, Kabir MA, Islam MS, Rahim CM, Hasan MK, Islam MK, Hasan MR, Alam MS. Study on Precipitating Factor of Chronic Hepatic Encephalopathy. Mymensingh Med J 2020; 29:800-806. [PMID: 33116080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Hepatic encephalopathy (HE) is a neuro-psychiatric manifestation of chronic liver disease causing significant morbidity and mortality worldwide. Though the exact mechanism is unknown but it is well accepted that various precipitating factors are involved in hepatic encephalopathy. Aim of the study was explore the precipitating factors of chronic hepatic encephalopathy. This cross sectional descriptive study was conducted in the Department of Medicine and Department of Hepatology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period from April 2016 to October 2016. One hundred patients with hepatic encephalopathy fulfilling the inclusion and exclusion criteria were enrolled. Inclusion criteria were designed for all diagnosed cases of hepatic encephalopathy associated with cirrhosis of liver aged 18 years or above irrespective of sex. Patients with acute fulminant hepatitis and non-cirrhotic hepatic encephalopathy were excluded. The result of the study was mean age of hepatic encephalopathy was 52.81±8.15 years and 94.0% patients were above 40 years. Male (66.0%) were predominant over female (34.0%). HBsAg and Anti HCV were positive in 49.0% and 11.0% patients respectively. Stage of hepatic encephalopathy was stage-I in 8.0%, stage-II in 37.0%, stage-III in 39.0% and stage-IV in 16.0% patients. Changes of biochemical parameters were low haemoglobin level (70.0%), raised total count of leukocyte (25.0%), low platelet count (68.0%), low serum albumin (98.0%) raised prothrombin time (60.0%), low serum sodium (34.0%) and low serum potassium (63.0%). The recoded precipitating factors were gastrointestinal bleeding (14.0%), constipation (37.0%), hyponatremia (34.0%), hypokalemia (28.0%) infections (20.0%), use of diruretics (8.0%), use of sedatives (4.0%) and excess intake of protein (6.0%). While precipitating factor was absent in 11.0% of cases. In conclusion there are different factors which play a key role in precipitating hepatic encephalopathy but electrolytes imbalance, constipation, infections, Upper GI bleed, diuretics are the most common precipitating factors.
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Affiliation(s)
- M H Ali
- Dr Md Haidar Ali, Registrar, Department of Medical Oncology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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Sharmin T, Mirza TT, Hasan MR, Sarker K, Shamsi S, Shikha SS, Panna LK. Clinical Study on Rupture Uterus in Mymensingh Medical College Hospital. Mymensingh Med J 2019; 28:520-526. [PMID: 31391421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Uterine rupture is a devastating situation, has claimed innumerable lives of both the mother and the fetus. Even today, it is one of the common obstetric complications and a significant cause of maternal and fetal death. Several factors are responsible for this including-inadequate antenatal and intra partum care, poor communications and inadequate logistic support, above all, illiteracy and lack of knowledge of the people. To evaluate the patients with rupture uterus A cross sectional descriptive study was carried out in the department of Obstetrics & Gynaecology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2012 to June 2013. Total 100 cases of rupture uterus were included in this study within this period. Data were processed and analyzed by Computer software SPSS-16 version (Statistical Package for Social Science) & cases were selected purposively. Incidence of rupture uterus was 1.43%, common age group was 20-30 years, majority (67%) came from rural areas, multi-gravid patients were mainly affected (98%). Most of the patients (68%) had no antenatal check-up and 46% were handled by untrained Dai at home during labour pain and 56% exposed to oxytocic drugs. Unscarred uterus was more common (61%) & common clinical presentation was hypo-volumic shock (64%). Subtotal hysterectomy (51%) had done as surgical procedure in 51% patients and average duration of hospital stay was 11±4 days. The common post operative complications were sepsis (20%), wound infection (13%), shock (10%) and urinary fistula (8%). Incidence of peri-natal mortality was 89% and maternal mortality 14%.This study suggests maternal and perinatal morbidity and mortality is high due to rupture uterus. So prevention and proper management is necessary to overcome this problem. This study will hopefully give us some guide to take the strategies in improving the care of rupture uterus.
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Affiliation(s)
- T Sharmin
- Dr Tahmina Sharmin, Registrar, Department Obs and Gynae, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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Khan AK, Quddus SR, Khan HK, Ali MS, Kamruzzaman M, Hasan MR, Hasan M, Moon RH. Complications Following General Anaesthesia in Paediatric Patients. Mymensingh Med J 2018; 27:429-436. [PMID: 29769515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Complications in paediatric anaesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with smell patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of cases malpractice claims. Both minor & major complication occurs most commonly in infants and children under three especially those with severe co-morbidities. Knowledge of risk profiles in paediatric anaesthesia is a starting point for the reduction of risk complication.
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Affiliation(s)
- A K Khan
- Dr Md Abul Kalam Azad Khan, Assistant Professor & Head, Department of Anaesthesiology, Community Based Medical College Bangladesh (CBMCB), Mymensingh, Bangladesh
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Sultana N, Noor P, Abdullah ATM, Hasan MR, Ahmed KM, Naser MN. Growth performance and nutrient composition of juvenile Nile tilapia (Oreochromis niloticus) fed Spirulina flakes, rice bran and mustard oil cake. Malays J Nutr 2012; 18:275-282. [PMID: 24575673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Tilapia (Oreochromis niloticus) is an important cultured fish that is widely distributed in Bangladesh. This study was conducted to improve the growth performance and nutrient contents of the fish using five different types of feeds. METHODS Tilapia fingerlings were fed two types of commercial fish feeds (Feed-1 and Feed-2), Spirulina flakes (Feed-3), Feed-2 mixed with Spirulina flakes (Feed-4) and manually mixed feed made from a mixture of mustard oil cake and rice bran (Feed-5). After 4 weeks of being fed with the diets, growth parameters and meat nutrient composition of the tilapia fingerlings were recorded. RESULTS Significant growth in length and weight was observed in juvenile tilapia fish fed with commercial Feed-1 only, while growth performance varied significantly among fingerlings fed other types of feeds. Body tissue calcium (92.8 mg/100 g), iron (1.29 mg/100 g) was higher in fishes fed with dry Spirulina flakes (Feed 3), while the highest amount of zinc (2.09 mg/100 g) was recorded in fishes fed Feed-5. Protein (13.32%) content was highest in fish fed Feed-2 mixed with Spirulina flakes (Feed-4). CONCLUSION Meat nutritional quality of tilapia can be improved by combining commercial feeds with Spirulina flakes, compared with feeding commercial feeds in isolation.
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Affiliation(s)
- N Sultana
- Zoology Section, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - P Noor
- Zoology Section, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - A T M Abdullah
- IFST, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - M R Hasan
- Zoology Section, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - K M Ahmed
- Zoology Section, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - M N Naser
- Department of Zoology, University ofDhaka, Dhaka, Bangladesh
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Rahman S, Siddiqui MA, Haque M, Majumder SK, Ali MS, Majid MA, Hasan MR. Caudal anesthesia in pediatric surgical practice. Mymensingh Med J 2006; 15:197-203. [PMID: 16878105 DOI: 10.3329/mmj.v15i2.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Prospective study was carried out on 100 patients since May 2005 in my private practice and in the department of pediatric surgery of MMCH. Under caudal anesthesia along with or without ketaminie induction and gas inhalation all the patients underwent different surgical procedure namely anorectal surgery (eg. anoplasty, rectal polyp), urogenital surgery (Circumcision, hypospadias, meatotomy), groin surgery (hernia, hydrocele) and foot & leg surgery. Calculated dose schedule of drugs used in anesthesia and volume were maintained. Time of giving anesthesia and time of starting analgesia were recorded. Per-operative and postoperative analgesia were evaluated. Every parent was explained regarding the merit of caudal anesthesia calculated and compared with that of general anesthesia. Application of caudal anesthesia with or without ketamine & diazepam induction can be used safely and cost effectively and may be put into protocol in many of the pediatric surgical practice both in institute and also in private practice.
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Affiliation(s)
- S Rahman
- Mymensingh Medical College, Mymensingh
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13
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Nasreen SA, Haque MM, Hasan MR. Pregnancy outcome in adolescent and adult - a case comparison study. Mymensingh Med J 2006; 15:15-21. [PMID: 16467756 DOI: 10.3329/mmj.v15i1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study outlined the consequences of adolescent pregnancy with comparison to adults in Mymensingh Medical College Hospital, Mymensingh. It was a case-comparison study. The study population was the mothers who admitted and delivered at the Obstetrics and Gynaecology ward of hospital during April-June 2003. Sample size was 220 mothers, out of which 110 were primigravidae adolescent mothers and 110 were adults. The study finding showed that adolescents were 2.105 times and 3.679 times more at risk than adults to suffer from anaemia and UTI during pregnancy. Among adolescents 74(67.3%) and in adults 39(35.5%) had obstetric complications during pregnancy and the adolescents were 3.742 times more at risk than the adults. PET and Eclampsia were more common in adolescent than adult mothers. 86(78.2%) adolescents and 36(32.7%) adult mothers had complications before delivery. Pre term labour, Premature rupture of membrane (PROM) and Intra-uterine foetal death (IUD) were more common in adolescents than adult mothers. Stillbirths were more in adolescent mothers 23(20.9%) and adults 11(10.0%). There was more low birth weight (LBW) newborns in adolescents 42(38.2%) than adults 18(16.4%). As a result the adolescents were 3.157 times more likely to give birth to low birth weight babies . The newborns of the adolescent mothers were nearly 2 times more at risk to develop asphyxia neonatorum (p< 0.030, odds ratio=1.806).
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Affiliation(s)
- S A Nasreen
- Community Medicine Department, Mymensingh Medical College
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14
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Rahman S, Majumdar SK, Ahmed M, Singha JL, Majid MA, Hasan MR. Repair of cleft lip on relatively older children with anthropometrical surgical outcome. Mymensingh Med J 2006; 15:89-95. [PMID: 16467771 DOI: 10.3329/mmj.v15i1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A prospective study was done on 54 patients aged over 6 months with cleft lip with or without cleft palate admitted in the department of pediatric surgery of Mymensingh Medical College Hospital during the period from Oct 2002 to Dec 2004. The anthropometrical surgical outcome was evaluated by measuring the length, diameter and thickness of hemilip and diameter of nostril both pre and postoperatively (according to schedule). Patients were categorized into three groups according to their age. Mean Corrective rate was evaluated and it was shown 95% in the 1(st) age group, 93% in 2(nd) age group and 95.55% in the 3(rd) group. Complication was evaluated in only 16.66% of patients. Regarding the out come scar, cupid's bow, notching, labial and nasal symmetry were taken in consideration. Beside these this study might play a comparative role with the results of correction of cleft lip in early age.
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Affiliation(s)
- S Rahman
- Dept. of Paediatric Surgery, Mymensingh Medical College
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