The Planet

Clinical and Electroencephalogram Patterns of Refractory Epilepsy in Children

2024-02-29T06:55:27+00:00

Introduction: Refractory epilepsy, impacting 10–20% of children with epilepsy, significantly affects the child's education, social interactions, cognitive function, and recreational activities. A thorough clinical assessment can unveil precise syndromic and etiological diagnoses. Recent strides in neuroimaging and electrophysiology have transformed the management, complementing clinical evaluation. Aim of the study: This study aimed to assess the clinical and electroencephalogram patterns of refractory epilepsy in children. Methods & materials: This prospective observational study was conducted at the Department of Pediatric Neurology, Combined Military Hospital, Dhaka, Bangladesh from July 2022 to June 2023. A total of 42 diagnosed cases of refractory epilepsy were selected as study subjects using a purposive sampling technique. Data collection was conducted using MS Office tools. Results: This study found that 50% of cases had syndromic epilepsy, 33% had symptomatic epilepsy, and 74% had onset within the first year. Episodes lasted minutes and occurred over 5 times annually. Regarding EEG findings, consistent with generalized epileptogenic activity was observed in the highest number of cases (28.58%). 14.29% of cases showed generalized tonic-clonic seizure. In the current study, diagnostic findings revealed that the highest number of cases (33.33%) had infantile spasms. Additionally, 16.67% and 9.52% of cases were identified with seizure disorder and refractory epilepsy with tuberous sclerosis, respectively. Conclusion: Among children with refractory epilepsy, syndromic epilepsy is most prevalent. To pinpoint distinctive features such as generalized tonic-clonic seizures, epileptogenic activity, infantile spasms, and epileptic encephalopathy, the electroencephalogram (EEG) emerges as a highly effective diagnostic tool.

Socioeconomic and Nutritional Status of Mother Affecting Neonatal Outcome — A Cross Sectional Study in Shaheed Suhrawardi Medical College and Hospital

2024-02-29T06:50:23+00:00

Introduction: Nutrition plays a major role in maternal and child health. During pregnancy, it is essential that the mother’s diet contains adequate nutrients and energy at each stage to allow proper fetal growth and to maintain her own health. Objective: To find out if the socioeconomic and nutritional status of mother had any effects on neonatal outcome. Methods & materials: A descriptive cross sectional study was carried out among 80 mothers fulfilling the inclusive criteria, were included in study admitted under the Department of Obstetrics & Gynaecology during the study period of January, 2018 to June, 2018. Results: Among 80 cases, 35 (43.75%) patients were in between 31-35 years. Average 1878.10±360.82 kcals were taken by mothers which was contributed by carbohydrates 192.08±41.89 gm, protein 45.11±12.87 gm and fat 42.11±12.22 gm. Average weight gaining by the mothers during their 1st, 2nd and 3rd trimester which was found to be 0.9 ± 0.8 kg, 4.1± 0.9 kg and 4.7±01.1 kg respectively. Maximum number (61,76.25%) of babies were born in between >37-41 wks. Fifty-nine babies had APGAR score >7 at 1min and 55 babies had APGAR score > 7 at 5 min. Conclusion: Maternal Hb level, BMI and parity were associated with neonatal outcome. Hence, in order to reduce the adverse pregnancy outcomes awareness should be created among pregnant women and women of child bearing age about the factors that can improve the nutritional status of the women prior to conception and during pregnancy.

Evaluation of the Visual Inspection with Acetic Acid (VIA) Positive Cases with Colposcopic Findings

2024-02-29T06:45:18+00:00

Introduction: Visual Inspection with Acetic Acid (VIA) is a crucial cervical cancer screening method that has proven to be an effective and accessible tool, particularly in resource-limited settings. Cervical cancer is a significant global health concern, with a disproportionately high burden in low- and middle-income countries. In the absence of widespread access to more sophisticated screening technologies, VIA has emerged as a valuable technique for early detection and management of cervical abnormalities. Objective: To determine the frequency CIN I, CIN II, CIN III in Visual Inspection with Acetic Acid (VIA) positive cases with the help of colposcopic examination. Methods and materials: The was prospective cross sectional descriptive study conducted among the Visual Inspection with Acetic Acid (VIA) positive cases who were attending at in Colposcopic Clinic of Department of Obstetrics and Gynecology, BSMMU, Dhaka, Bangladesh during 1st June 2010 to 30th August 2010. Results: The mean age was 35.8±9.9 years and majority (40.0%) subjects were found between 30-39 years age group. Most (72.0%) of the study patients were multipara and the mean age of 'last confinement was 7.8±6.8 years. Majority 38(38.0%) of the patient was normal, 25(25.0%) of the study patients had CIN I, CIN II in 13(13.0%), CIN III in 5(5.0%), 4(4.0%) had invasive carcinoma and 15(15.0%) unsatisfactory Colposcopy. Conclusions: Visual inspection with acetic acid (VIA) effective to screen women. It can be done by nurses or midwives with appropriate training. Although still under investigation, research results show that VIA is simple, accurate, cost-effective, and acceptable to most women.

Comparative Study between Open Vs Closed Intramedullary Interlocking Nail for Fracture Shaft of Femur

2024-02-29T06:38:19+00:00

Introduction: A fracture shaft of the femur refers to a break or crack that occurs along the long, cylindrical portion of the femur bone in the thigh. Surgical intervention is often necessary for displaced or unstable fractures. Two reduction methods, open and closed nailing are used for the fixation of femoral shaft fractures. Objective: To compare the clinical and functional outcomes associated with open and closed nailing techniques for femoral shaft fractures. Methods and materials: This quasi-experimental study was conducted in the Department of Orthopaedics, Sher-e-Bangla Medical College Hospital, Barisal and Private Hospitals of Barisal from January 2020 to December 2021 over a period of two years. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS), version 12. Results: Mean age was almost similar in both groups. In closed group it was 38.17 ± 10.91 years whereas in open group it was 36.90 ± 11.93 years. In the closed reduction group, RTA accounted for 66.7% of the fractures, followed by falls at 23.3% and physical assault at 10.0%. Similarly, in the open reduction group, RTA was the leading cause at 76.7%, followed by falls at 16.7% and physical assault at 6.7. Union was confirmed maximum in closed cases (93.3%) than open cases (86.7%) but the difference was not statistically significant. Conclusion: It can be concluded that compared to open interlocking nailing techniques, closed interlocking nailing has a number of benefits, including faster union, higher union rates, and a lower infection rate.

Serum Magnesium Level in Different Stages of Chronic Kidney Disease Patients in a Tertiary Care Hospital

2024-02-29T06:24:42+00:00

Introduction: Chronic Kidney Disease (CKD) is a growing global health concern with complex metabolic implications, including alterations in serum magnesium levels. This study aims to explore the relationship between serum magnesium levels and different stages of CKD, as well as the impact of the duration of illness on this relationship. Methods & materials: This cross-sectional study was conducted on 220 patients admitted to the Department of Nephrology and Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh. Data were collected on demographic variables, CKD stages, and biochemical parameters, including serum magnesium levels. The duration of illness was also recorded and analyzed. Result: The mean age of the study population was 52.89±10.42 years, with a male predominance (63.6%). A high prevalence of advanced CKD stages was observed, with 67.28% of participants in either Stage 4 or Stage 5. A significant negative correlation was found between serum magnesium levels and estimated Glomerular Filtration Rate (eGFR) (r=-0.735, p<0.01). Additionally, a positive association was identified between the duration of illness (12 to 36 months in 65.45% of participants) and advanced CKD stages. Conclusion: The study reveals a complex interplay between serum magnesium levels, eGFR, and the duration of illness in CKD patients. The high prevalence of advanced CKD stages and its association with longer duration of illness underscore the need for timely diagnosis and effective early intervention strategies. Monitoring serum magnesium levels could be instrumental in the comprehensive management of CKD patients.

Serum lactate and Procalcitonin as Biomarkers of Severe Sepsis

2024-02-29T06:19:22+00:00

Introduction: Septicemia is a medical emergency that requires early diagnosis and proper treatment. Due to indiscriminate use of antibiotics in our country, in many cases of septicemia blood culture remains negative this creates a diagnostic challenge. These in turn affect management. Serum lactate as well as serum procalcitonin markers can be good options in this regard. This study will help us to find out the role of serum lactate and serum procalcitonin level as a marker of bacterial sepsis and will help to use antibiotic properly. Objectives: The main aim of this study was to find out serum lactate and serum procalcitonin as a biomarker of severe sepsis. Methods & Materials: It is an observational cross-sectional study was carried out the Medicine inpatient department and intensive care unit of Dhaka Medical College Hospital, Dhaka during September 2015 to February 2016. A total number of 40 patients were enrolled in this study. Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: In this study, 52.5% of patients are between the ages of 51 – 65 years, with 25% falling between the ages of 36 – 50 years. The mean age was 49.67 ± 8.78 years. while, depending on gender, 32 (80%) were male while the remaining 8 (20%) were female. Among the 40 patients, 65% had diabetes mellitus as a co-morbidity. Other chronic diseases and immunosuppressive factors put the patients vulnerable to severe sepsis. The majority of the patients had a mix of disorders or risk factors. Conclusion: Serum procalcitonin (PCT) and lactate have been identified as two of the most promising indications of sepsis in critically sick patients. These markers can be used in conjunction with clinical signs and standard lab parameters that may indicate a severe infection at the time of ICU admission. serum PCT and lactate might be included to the routine work-up of critically sick patients who have a suspicion of sepsis, which could enhance patient treatment and enhancement diagnostic certainty.

Observation on the Impact of Different General Anesthesia Techniques on Post-Operative Outcomes in Patients Undergoing General Anesthesia

2024-02-29T06:14:58+00:00

Introduction: General anesthesia is a standard practice in surgical procedures, ensuring patient comfort and safety during surgery. However, the choice of anesthesia technique can vary, with options ranging from intravenous anesthesia, inhalation anesthesia, to total intravenous anesthesia (TIVA). Preoperative decision-making for patients requires a long-term perspective. Objective: This study aimed to compare the anesthetic effects of propofol, sevoflurane, and desflurane in a cohort of 300 patients undergoing a common surgical procedure. Methods & materials: Patient demographics revealed comparable sample sizes, with Group A (propofol) exhibiting a mean age of 45 ± 5, Group B (sevoflurane) 47 ± 6, and Group C (desflurane) 42 ± 4. Gender distribution was relatively balanced across the groups. Intraoperative parameters such as the duration of anesthesia, blood loss, and intraoperative fluids varied slightly among the three groups. Results: Group A demonstrated a lower incidence of nausea and vomiting compared to Groups B and C. Postoperative outcomes, including time to extubation, pain levels, and length of hospital stay, displayed subtle differences. Statistical analyses, employing one-way ANOVA for continuous variables and chi-square tests for categorical variables, were conducted. Additionally, complications, such as respiratory issues, cardiovascular complications, and surgical site infections, were assessed. Conclusion: The findings suggest that propofol has to be associated with a lower incidence of nausea and vomiting, warranting further investigation into its potential advantages in improving perioperative outcomes.

Exploring the Incidence and Contributing Factors of Skin Disorders — An Observational Study

2024-02-29T05:12:42+00:00

Introduction: Skin disorders are prevalent health concerns with a substantial impact on individuals' well-being and healthcare systems. This study explores the incidence and contributing factors of skin disorders, aiming to enhance our understanding of their prevalence and potential determinants. Methods & materials: A total of 172 cases were analyzed, considering environmental and lifestyle factors such as smoking status, alcohol consumption, sunlight exposure, sunscreen use, and exposure to chemicals or irritants at work. This observational study employs a cross-sectional design, capturing data from the study population. Results: The findings reveal that a significant proportion of individuals (12.21%) are present smokers. Exposure to sunlight varies, with nearly half reporting less than 1 hour of daily exposure, underscoring the need to explore the relationship between sunlight duration and skin health. Sunscreen use is infrequent, with 94.77% either never or rarely using it, highlighting a potential gap in protective measures against harmful UV rays. A high percentage (97.67%) report never or rarely being exposed to chemicals or irritants at work, indicating a relatively low occupational risk for skin disorders. Conclusion: This comprehensive analysis sheds light on the multifaceted nature of skin disorders, emphasizing the interconnectedness of lifestyle choices and environmental exposures with skin health. The insights derived from this study contribute to the development of targeted preventive measures and interventions to mitigate the incidence and impact of skin disorders in the population.

Expression of E-Cadherin and its Association with Histological Prognostic Parameters of Breast Carcinoma

2024-02-29T05:05:42+00:00

Introduction: Breast cancer stands as the foremost cause of morbidity and mortality among females globally, including Bangladesh. Metastasis development is a crucial prognostic factor in invasive breast cancer, often requiring systemic treatment. The aberrant expression of adhesion-related antigens on tumor cells strongly indicates the tumor's metastatic potential, leading to a poor prognosis for the patient. This study aimed to assess the expression of E-Cadherin and its association with histological prognostic parameters of breast carcinoma. Methods and materials: This cross-sectional study was conducted at the Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh from March 2020 to February 2022. A total of 41 patients diagnosed with invasive breast carcinoma of no specific type were included in the study using convenient sampling. SPSS Version 23.0 was used for data analysis. Results: In this study, most patients exhibited E-Cadherin negativity, significantly associated with histological grading, increased tumor size (p = 0.024), more metastasized lymph nodes (p = 0.032), and triple-negative breast cancer (p = 0.011). Loss of E-Cadherin expression in both core needle biopsy and mastectomy samples showed a significant association with higher tumor grade (p = 0.009 and 0.028, respectively). Conclusion: Assessing E-Cadherin expression may be crucial in evaluating tumor aggressiveness and planning treatment modalities.

Incidence and Risk Factors for Postoperative Nausea and Vomiting (PONV) in Patients Undergoing General Anesthesia

2024-02-29T05:00:13+00:00

Introduction: One of the most bothersome and persistent side effects of general anesthesia surgery for patients is postoperative nausea and vomiting, or PONV. This study aims to measure the Postoperative nausea and vomiting (PONV) with anesthetic, surgical, and patient-related variables. Methods and materials: This observational study was conducted in the 250-bed General Hospital and the Sheikh Hasina Medical College Hospital in Jamalpur, Bangladesh between March 2023 and May 2023. There were 265 female participants and 235 male participants in the 500-person sample. Using a systematic random sample technique, all patients over 18 undergoing surgery under general anesthesia were chosen from the daily operating room list. During the first 24 hours following surgery, PONV was predicted using the Koivuranta score. Result: It was discovered that 25.6% of the study population had PONV. A correlation was found between the occurrence of PONV, female gender, and non-smoking status. Patients with a history of PONV from previous surgeries, patients undergoing general anesthesia, and patients receiving opioids during the postoperative period were found to have a higher incidence of PONV. Conclusion: Even though the institutional procedure included the administration of antiemetics (single or dual), the prevalence of PONV remained high. Our understanding of more recent antiemetics and their incorporation into PONV care guidelines needs to be updated. More research is required to examine several additional potential risk variables that could influence the prevalence of PONV.