[Show abstract][Hide abstract] ABSTRACT: An intervention study was carried out in the department of paediatrics of Mymensingh Medical College Hospital, Mymensingh to compare the clinical efficacy of Azithromycin in the treatment of childhood typhoid fever with that of cefixime for a period of one year from January 2011 to December 2011. A total of 60 cases of typhoid fever were enrolled in to a randomized clinical trial and was divided into two groups. The inclusion criteria of the cases were: Documented fever for more than 4 days plus two or more of the following clinical features: toxic physical appearance, intestinal complaints, coated tongue, ceacal gurgling, hepatomegaly and splenomegaly, diarrhoea and constipation plus positive Widal test and/or blood culture positivity. Patients who had complication like GIT heamorrhage; intestinal perforaion and/or shock were excluded from the study. Data were collected in a structured questionnaire. Azithromycin was given at a dose of 10mg/kg/day for a period of 07 days Cefixime was given at a dose of 20mg/kg/day in two divided dose for 14 days. The mean time of defervesence was 4.05+1.14 days with azithromycin and 3.41+0.95 with cefixime respectively. The minimum defervesence time was 02 days and maximum defervesence time was 07 days. Clinical cure rate was 87% in azithromycin group and 93% in cefixime group. No serious adverse effect was noted related to azithromycin and cefixime therapy except nausea, vomiting, diarrhoea and jaundice. It was found that azithromycin is almost as effective as cefixime in the treatment of typhoid fever.
Mymensingh Medical Journal 07/2014; 23(3):441-448.
[Show abstract][Hide abstract] ABSTRACT: This study was done to determine the effects and outcome of inhaled budesonide in addition to standard management of asthma exacerbations in pediatric age groups. A randomized, double-blind, placebo controlled trial was done in a tertiary care urban hospital. Sixty six children aged 5 to 15 years with moderate to severe asthma exacerbations were eligible. All patients received a single dose of prednisolone 1mg/kg orally as first dose of systemic corticosteroids and then salbutamol (0.15mg/kg) and ipratropium bromide (500mcg) was nebulized every 20 minutes for 3 doses and then hourly for 2 hours as a part of standard treatment of asthma exacerbations. The intervention was 2mg (4mL) of budesonide or 4mL of normal saline which was nebulized immediately after the 1st dose of nebulized salbutamol and ipratropium bromide. The baseline characteristics of the budesonide group (n=33) and placebo group (n=33) were similar, but at 1 hour, 2 hour and 3 hour PEFR, respiratory rate, pulse rate, SaO2 and asthma score were significantly improved in the budesonide group compared to placebo group (p<0.01). The positive immediate effect of nebulized budesonide added to standard treatment of asthma exacerbations is an encouraging finding for further investigations of its routine use in the treatment of asthma exacerbations in children.
Mymensingh Medical Journal 07/2014; 23(3):418-425.
[Show abstract][Hide abstract] ABSTRACT: This prospective study was conducted in rheumatology clinic under the department of medicine of Bangabandhu Sheikh Mujib Medical University from December 2004 to December 2005 to asses the efficacy, safety and compliance of subcutaneous methotrexate (MTX) in active rheumatoid arthritis (RA) patients. A total of 92 active rheumatoid arthritis patients according to American College of Rheumatology (ACR) criteria were recruited for the trial for six months. Among them 46 cases belonged to injectable MTX group and 46 cases belonged to oral MTX group. Mean±SD age of patients was 45.54±12.42 vs. 44.63±13.99 years in subcutaneous group and oral group respectively. In the subcutaneous group 41 were female and 5 male; in the oral group 34 were female and 12 male. Mean duration of the disease was 49.74 months in subcutaneous group and 49 months in oral group. RA test was positive in 35 cases in both groups whereas Rose Waaler test was positive in 19 patients in subcutaneous group and 14 patients in oral group. At 24 week, response rate of ACR 20 was significantly higher in subcutaneous MTX than oral MTX group (93% vs. 80%, p=0.02). Similarly ACR 50 response was significantly higher in subcutaneous MTX than in oral group (89% vs. 72%, p=0.03). ACR 70 response was not significantly higher in SCMTX group then oral group (11% vs. 9 %, p=0.72). Adverse effects were relatively less in subcutaneous MTX and most common side effects were nausea (37% vs. 63%), vomiting (11% vs. 30%), dyspepsia (29% vs. 48%), dizziness (4l% vs. 52%) and alopecia (72% vs. 85%). The results of the study demonstrated that subcutaneous MTX was significantly more effective than oral MTX at the same dosage in active Rheumatoid arthritis patients with no increase in side effects.
[Show abstract][Hide abstract] ABSTRACT: This cross sectional descriptive study was to measure the thyroid angle and to establish the difference between sexes of different age groups in Bangladeshi cadaver. A total 60 human larynges were collected by purposive sampling from October 2008 to March 2009. Among them 45(male 23 and female 22) were collected from Bangladeshi cadavers (9 to 60 years) at the autopsy laboratory of Department of Forensic Medicine and 15 (male 6 and female 9) from stillborn infants of viable age (28 to 40 weeks of gestation) from Gynaecology and Obstetrics Department of Mymensingh Medical College, Mymensingh. The thyroid angle was measured and significant differences of the dimensions between different age and sex groups were observed. In the present study observed findings was compared with those of other researchers. The mean±SD thyroid angle was found as 65.00±11.65 degree in age Group A (28 to 40 weeks of gestation), 73.69±6.56 degree in age Group B (9 to 16 years) and 77.76±7.76 degree in age Group C (17 to 60 years). The mean thyroid angle was higher in female (83.1667±5.78220 degree) than that in male (73.9412±7.09460 degree) and statistically moderately significant in Group C, where t = 3.853 and p = 0.001. In statistical analysis, differences between age and sex groups were calculated by using Students (unpaired) 't' test. The present study revealed that the value was significantly greater in adult female than male and the value increased with age.
[Show abstract][Hide abstract] ABSTRACT: The school age is a dynamic period of growth and development. During this period physical, mental, social development of child takes place. The purpose of the study is to observe the nutritional status among the school aged children and to compare the urban and rural children. It is a descriptive cross sectional study. Data were collected from 600 children of primary school in Mymensingh district for a period of one year from October 2009 to September 2010. Among the primary school children in Mymensingh, Bangladesh 15.1% were wasted, 22.1% were stunted, 2.3% were both stunted and wasted and 60.4% children were within normal limit. Malnutrition was more in rural area in comparison with urban area. In rural area severely underweight, moderately underweight children were 62.1%, 65.6%, and corresponding result in urban area were 37.9%, 34.4% respectively. In rural area severely stunted, moderately stunted children were 100%, 58.6%, and in urban area they were 0%, 41.4% respectively. Again severely wasted and moderately wasted, children were 62.5%, 59.5% in rural area and 37.5%, 40.5% in urban area respectively. Malnutrition among girls were more then the boys.
Mymensingh Medical Journal 04/2013; 22(2):267-274.
[Show abstract][Hide abstract] ABSTRACT: Tuberculosis (TB) is a major public health problem in most developing countries. The present study was carried out among 100 clinically suspected pulmonary TB patients. One hundred sputum specimens were collected one from each of the suspects attending DOT'S corner of Mymensingh Medical College Hospital, Mymensingh, Bangladesh. The aim of the study was to evaluate the sensitivity and specificity of a polymerase chain reaction (PCR) based method detecting IS6110 sequence present in all Mycobacterium tuberculosis strains using sputum samples in comparison to culture on Lowenstein-Jensen mediums. The PCR was done using primers mtb1 & mtb2 which commonly target an insertion sequence of the organism (IS6110). Out of 100 samples, 18 (18%) showed PCR positive, whereas culture in Lowenstein-Jensen media were positive in 19(19%). In PCR 1 was false negative but none was false positive. In present study, sensitivity and specificity of PCR found 94.74% and 100% respectively. Analyzing the findings of the present study, it can be concluded that the PCR technique is a rapid and alternative method of culture on Lowenstein-Jensen medium for the diagnosis of pulmonary tuberculosis. In the present study, only presence or absence of M. tuberculosis was determined.
Mymensingh Medical Journal 07/2012; 21(3):399-403.
[Show abstract][Hide abstract] ABSTRACT: Chlamydia trachomatis is an obligate intracellular gram-negative bacterium which is the most prevalent cause of bacterial sexually transmitted infections (STI). The present study was carried to diagnose genital Chlamydia trachomatis infection among women of reproductive age, attending Mymensingh Medical College Hospital, during July 2009 to June 2010 by Immunochromatographic test (ICT) and Polymerase chain reaction (PCR). A total of 70 females were included in this study. Out of 70 cases 56 were symptomatic and 14 asymptomatic. Endocervical swabs were collected from each of the cases and examined by Immunochromatographic test (ICT) for antigen detection and Polymerase chain reaction (PCR) for detection of endogenous plasmid-based nucleic acid. A total 29(41.4%) of the cases were found positive for C. trachomatis either by ICT or PCR. Of the 56 symptomatic cases, 19(33.9%) were found ICT positive and 17(30.4%) were PCR positive. Among 14 asymptomatic females, 2(14.3%) were ICT positive and none were PCR positive. Though PCR is highly sensitive but a total of twelve cases were found ICT positive but PCR negative. It may be due to presence of plasmid deficient strain of C trachomatis which could be amplified by ompA based (Chromosomal gene) multiplex PCR.
[Show abstract][Hide abstract] ABSTRACT: The present study was carried to diagnose genital Chlamydia trachomatis infection among women of reproductive age, attending Mymensingh Medical College Hospital, during July 2009 to June 2010 by Polymerase chain reaction (PCR). A total of 70 females were investigated including 56 symptomatic and 14 asymptomatic cases. Endocervical swabs were collected and dipped in 500μl Tris buffer. Polymerase chain reaction (PCR) amplification was done for detection of endogenous plasmid-based nucleic acid. A total 17 out of 56 of the symptomatic cases (30.4%) were positive for C. trachomatis and none were found positive among the 14 asymptomatic cases. These findings suggest high prevalence of C. trachomatis infection among this group of population.