Mymensingh Medical College & Hospital

Mymensingh, Bangladesh

Mymensingh Medical College & Hospital

Mymensingh, Bangladesh

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Ahsan M.M.,Mymensingh Medical College Hospital
Mymensingh medical journal : MMJ | Year: 2010

Kala-azar is one of the major public health problem in Bangladesh. But the diagnosis of the problem often is difficult, unusual and time consuming, a simple, noninvasive, easy to perform, reliable and rapid diagnostic test has been a long-felt need of the clinicians. Therefore, the present study was conducted to see the sensitivity and specificity of Latex Agglutination test (KAtex) to detect leishmanial antigen from urine of kala-azar cases. The study was carried out in the department of Paediatrics, Mymensingh Medical College and Hospital, Bangladesh during July to December, 2008. A total of 100 urine samples were collected of which 50 were confirmed kala-azar cases and 50 were age and sex matched controls. Out of 50 kala-azar cases 47 showed positive result of KAtex. The test was also positive in 01 out of 30 healthy controls. None of the febrile controls was positive by KAtex. The sensitivity, specificity, positive predictive value and negative predictive value of the test using presence of LD bodies in splenic and/or bone marrow aspirate as gold standard were 94%, 98%, 97.91% and 94.23% respectively. KAtex is simple, noninvasive, easy to perform, rapid and reliable test for diagnosing kala-azar in endemic area and useful for small, less equipped laboratories as well as for the laboratories with better facilities.


Imam M.A.,Mymensingh Medical College Hospital
Mymensingh medical journal : MMJ | Year: 2013

This descriptive, cross sectional, comparative and analytical study assessed the quality of life of major depressive patients and healthy controls. It was carried out in the department of psychiatry of Bangabandhu Sheikh Mujib Medical University (BSMMU) on patients of major depressive disorder according to structured clinical interview (SCID and diagnostic and statistical Manual) (DSM-IV) criteria. The study used world health organization quality of life scale (WHO QoL -BREF) Bangla version to assess QoL of major depressive patients. The study assessed eighty patients of major depressive disorder who were recruited purposively from the Department of Psychiatry, BSMMU who were above the age of 18 years irrespective of sex. Same number of age, sex matched hospital staff of different strata of the BSMMU were included in this study. The study shows that the all parameters of quality of life scales in patients (mean±SD) were Overall health (case 2.20±0.77 & control 3.79±0.52), Physical (case 2.77±0.383 & control 3.44±0.322), Psychological (case 2.53±0.353 & control 3.51±0.382), Social (case 2.88±0.65 & control 3.85±0.543), Environmental (case 2.87±0.533 & control 3.27±0.514) and overall quality of life (case 1.94±0.817 & control 3.71±0.556) which major depressive disorder were significantly reduced.


Haque M.F.,Mymensingh Medical College & Hospital
Mymensingh medical journal : MMJ | Year: 2011

Per-operative shivering following spinal anaesthesia is a common problem in the operation theatre. Adequate management of shivering during operation is one of the goals of anesthesiologists for the benefit of the patient. Because there are many unpleasant and harmful effects caused by shivering in many patients especially respiratory and cardiac disease patients. For this reason aggressive and optimal treatment of per-operative shivering is essential to reduce the morbidity of the patients. Our observations were that occurrence of shivering was more in younger patients than older patients, thin patients than obese patients, anxious patients than non-anxious patients and more frequent in patients who received vasoconstrictor drugs, administration of fluid at running rate just before or during operation, administration of cold local anaesthetic agents (by taking drug from the freeze) into subarachnoid space. And shivering was better managed by administration of nalbuphine HCl and surface skin warming (wrapping of the skin). There are many studies regarding the incidence, prevention & treatment of post-operative shivering but there is no study regarding the incidence & treatment of per-operative shivering by nalbuphine following spinal anaesthesia. This study was designed to compare the anti-shivering efficacy and side effects (Nausea, Vomiting, and Somnolence) of tramadol hydrochloride with that of nalbuphine hydrochloride in the treatment of per-operative shivering following spinal anaesthesia. This study was also done to observe the incidence of shivering during operation following spinal anesthesia.


Siddique M.A.,Mymensingh Medical College Hospital
Mymensingh medical journal : MMJ | Year: 2012

Due to difficult anatomical position nasopharyngeal carcinoma (NPC) is always challenging problems both from the diagnostic and therapeutic corner. A 24 years old lady came to our Department of Otolaryngology and Head-Neck Surgery with the complaints of epistaxis, right sided neck swelling, nasal obstruction and headache. On digital palpation Nasopharyngeal mass was found. We took biopsy from nasopharynx under indirect vision but report was not conclusive. Then we did CT scan, nasendoscopy. Nasendoscopy showed bilateral ethmoidal polyp with nasopharyngeal mass. We took biopsy from the nasopharyngeal mass and confirmed the diagnosis.


Islam M.R.,Mymensingh Medical College & Hospital
Mymensingh medical journal : MMJ | Year: 2011

This prospective study was done for to see the efficacy of preoperative use of granisetron plus dexamethasone (Group A) & granisetron (Group B) alone for the postoperative prevention of nausea & vomiting after tonsillectomy operation. One hundred patients undergoing tonsillectomy & adenoidectomy operation under general anaesthesia who were admitted in the Mymensingh Medical College Hospital during the period from July 2008 to June 2009 with American Society of Anaesthesiologists (ASA) grade I & II with age 3-40 years, body weight 10-60 kgs, were studied. Observation of this study was analyzed in the light of comparison between the two groups. All results were expressed as mean±SEM. Age in Group A 15.98±1.028 & Group B 17.18±0.961 years; Weight in Group A 38.40±1.492 & Group B 39.76±1.561 kgs and operational duration in Group A 52.60±0.786 & Group B 52.70±0.823 minutes. The studied groups were statistically matched for age, weight, duration of surgery. We observed that the effects of combination of granisetron & dexamthasone are more than granisetron alone in prevention of nausea & vomiting after tonsillectomy operation. The frequency of vomiting was 4% in combination & 16% in single therapy which is statically significant (p<0.05).


Miah A.H.,Mymensingh Medical College Hospital
Mymensingh medical journal : MMJ | Year: 2012

The present descriptive cross-sectional study was conducted in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh over a period of one year during November 2009 to October 2010. The study was conducted to describe the variations in types of stroke (ischemic stroke and hemorrhagic stroke) during summer and winter. An attempt was also made to observe the frequency of common risk factors of stroke by seasons. A total of 292 patients of any age irrespective of sex fulfilling the WHO criteria of acute stroke and confirmed by CT scan were selected from consecutive admission in the Department of Medicine, Mymensingh Medical College Hospital. Detail history and thorough clinical examinations were done. Routine and relevant investigations were carried out. The mean age of the patients was 59.9±14.3 years. A male preponderance was observed in the study. In summer 66% of patients and in winter 34% of patients were presented. Ischemic stroke was present in 54.1% patients and 45.9% patients had haemorrhagic stroke. The study found that the frequency of ischaemic stroke during summer (62.4%) was significantly greater than that during winter (37.8%). The frequency of haemorrhagic stroke during winter (62.2%) was significantly greater than that during summer (37.6%). Hypertension was the most important risk factor and other risk factors were smoking, diabetes mellitus, tobacco chewing, ischemic heart disease, dyslipidemia, oral contraceptive pill, alcohol consumption, atrial fibrillation and past history of stroke. Increasing age was also noted as a risk factor (60.7% >60 years). Most of the risk factors were homogenously distributed between two seasons and between ischemic and haemorrhagic group. Hypertension was significantly higher in haemorrhagic stroke patients compared to ischemic stroke patients.


Alam M.S.,Mymensingh Medical College Hospital
Mymensingh medical journal : MMJ | Year: 2013

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorder which is associated with considerable sufferings of patient and Peppermint oil is volatile oil, its active principle is menthol-contain a cyclic monoterpine which has anti-spasmotic properties due to its ability to block calcium channel of intestinal smooth muscles. This study observed the efficacy of peppermint oil for relieving the symptoms and changes of quality of life (QOL) in diarrhea predominant IBS. This was a prospective double blind randomized placebo-controlled study conducted in the Bangabandhu Sheikh Mujib Medical University during July 2008 to September 2009. Patients who fulfilled ROME II were initially selected but those had red flag signs or any organic disease was excluded from the study. Seventy four patients were enrolled in the study and randomly allocated to receive either peppermint oil or placebo three times daily for six weeks. Changes of symptoms were assessed three week interval during treatment and two weeks after the end of treatment. Data were analyzed by paired and unpaired 't' test. Finally sixty five patients completed the trial. It was observed that, at six weeks of therapy abdominal pain is markedly improved (mean±SD) 4.94±1.30 in peppermint oil group compared with 6.15±1.24 in placebo group and the difference was statistically highly significant (p>0.001). But two weeks after end of trials pain score again increased (6.09±1.93). Other symptoms and quality of life did not improve significantly. So the study result concludes that peppermint oil is effective in reliving only abdominal pain in diarrhea predominant IBS transiently.


Khan N.,Mymensingh Medical College Hospital
Mymensingh medical journal : MMJ | Year: 2011

The 18fluorine-fluorodeoxyglucose (18F-FDG), a glucose analog, has been widely used in tumor imaging. The tumoral uptake of 18F-FDG is based upon enhanced glycolysis. Following administration, 18F-FDG is phosphorylated and trapped intracellularly that forms the basis of PET imaging. An important mechanism to transport 18F-FDG into the tumor cell is based upon the action of glucose transporter proteins; furthermore, highly active hexokinase bound to tumor mitochondria helps to trap 18F-FDG into the cell. In addition, enhanced 18F-FDG uptake may be due to relative hypoxia in tumor masses, which activates the anaerobic glycolytic pathway. In spite of these processes, 18F-FDG uptake is relatively nonspecific since all living cells need glucose. Clinical application of 18F-FDG imaging is therefore recommended in carefully selected patients.


Saha N.,Mymensingh Medical College & Hospital
Mymensingh medical journal : MMJ | Year: 2010

This prospective comparative study was conducted in the department of Pediatric Surgery, Dhaka Shishu (children) Hospital during the period of June 2007 to September 2008 with the children of <12 years, diagnosed as acute Appendicitis. Patient selection was done by simple random technique by means of lottery. For open Appendectomy (OA) conventional method & for Laparoscopic Appendectomy (LA) 3 trocher technique was applied. Data was analyzed with the help of SPSS version 10. In this study 60 cases with acute Appendicitis including both gender were studied by two groups, group-A include 30 cases for laparoscopic and group-B include 30 cases for open appendectomy. Postoperative pain was assessed in both groups by using FLACC scale and compared at 1st 6-hours, 24 hours, 72 hours, 96 hours & at day 7. At 1st 6-hours, most of the children 24(80%) of group A had moderate pain whereas 17(56.7%) children of group B had severe pain (p<0.001). At 24 hours most of the patient 17(56.7%) of group A had mild pain compared to 27 (90%) patients of group B had moderate pain (p<0.0001). At 48 hours in group A most of the children 23(76.7%) had mild pain compared to moderate pain in 18(60%) children of group B (p<0.0001). Subsequently at 72 hours and at 96 hours most of the patients of LA group were free of pain compared to OA group. At final follow-up on day 7, 29(96.7%) children of group A had no pain compared to 26(86.7%) of group B. Regarding analgesics requirement both qualitative & quantitative requirements of analgesics were less in LA group than OA group. About post operative wound infection in group A only 1(3.3%) case had developed post operative wound infection whereas in group B 7(23.3 %) cases had. The mean (+/-SD) of post operative length of hospital stay was 52.00+/-11.62 (range 48-96) hours for group A and 76.00+/-12.74 (range 48-96) hours for group B children (p<0.001). Laparoscopic Appendectomy is more effective, preferable & superior procedure than that of open Appendectomy to reduce the post operative morbidity in children undergone appendectomy for acute appendicitis.


Nahar L.,Mymensingh Medical College Hospital
Mymensingh medical journal : MMJ | Year: 2013

A descriptive cross sectional study was carried out in Gynae and Obstetrics & Pathology department of Mymensingh Medical College Hospital (MMCH) to see the placental changes in normal pregnant & pregnancy induced hypertensive (PIH) mother. Total 80 placentas were collected, 40 from normal pregnant mothers having no hypertension and 40 from PIH group (one from gestational hypertension, 17 from pre-eclampsia and 22 from eclamptic mother). Macroscopic study of the placenta revealed placental weight, surface area and number of cotyledons were less in study group. Mean placental weight in study group was 419.50gm and in control group was 477.50gm (p<0.001). Mean surface area in study group & control group were 232.29cm2 and 304.80cm2 respectively (p<0.001). Mean number of cotyledons were 15.39 and 17.40 in study & control group respectively (p<0.001) and lower diameter of umbilical cord p<0.04667. But in the present study placental thickness was not significant p<0.539. In PIH group, macroscopic infractions were more marked. There was a single umbilical artery present in one patient in PIH group. In PIH group syncytial knots (95%), fibrinoid necrosis (80%), VSM formation, sclerosis, chorangiosis and calcification were more marked. Infarction was present in placenta of PIH 34(85%) and in control group 8(20%). Common placental changes were significant in this study. So, early intervention in PIH is rational to get the good perinatal morbidity and mortality.

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