Community Based Medical Journal 2021-09-22T01:17:49+00:00 Dr. Mahamud Javed Hasan Open Journal Systems <p>The official journal of Community Based Medical College, Mymensingh, Bangladesh. Full text articles available.</p> Physical activity: the non- pharmacological preventive remedy for non-communicable diseases (NCDs) 2021-09-21T09:28:16+00:00 Mohammad Aminul Islam <p>Abstract not available</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 1-3</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal An Assessment of Serum Cholesterol level and BMI in Women: Study in Several Private Chambers in Mymensingh 2021-09-21T09:28:19+00:00 Nahid Bintay Ansary Arup Ratan Paul Md Mahamudur Rahman Maria Hussain Rubiat Naznin <p>The increased risk of cardiovascular disease associated with higher serum cholesterol levels in middle-aged persons has been established, but there have been few studies conducted regarding the issues in Mymensingh. For evaluation of serum cholesterol and BMI in women of Mymensingh, across-sectional studywas conducted in several private chambers in the districts of Mymensingh, Bangladesh during the period from January 2017 to December 2017. A total of 48 Female patients participated in the study. In the study, participants were aged between 18 to 29 years of age. The study suggested that the serum cholesterol was below 4.99 were 15(31.25%), 5.00 to 6.49 were 13(26.08%) and above 6.50 were 20 (41.67%), the Mean ± SD was 4.45 (0.76). The health status according to BMI showed that 12.50% (n=6) of the participants were underweight &lt;18.49, majority 50.00% (n=24) of the population were from normal weight range (18.5-24.9), 16.67% (n=8) of the participants were overweight and 20.83 %( n=10) of the participants were obese &gt;30. The Mean ± SD was 18.93± (3.68). Measurement of BMI and Serum Cholesterol levels can help doctors to treat patients properly for reducing the burden of death in our country.</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 4-9</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal A Case Control Study on Serum Level of Micronutrients in Decompensated Liver Cirrhosis Patients in Mymensingh, Bangladesh 2021-09-21T09:29:54+00:00 Md Shahadath Hossain Md Muzibar Rahman ASM Shahidullah Bina Sen Md Rafiqul Hoque Arup Ratan Paul Kamona Rani Saha <p>Liver cirrhosis is an end stage condition of liver disease and the leading cause of death for both men and women all over the world. It causes death due to acute or chronic gastrointestinal blood loss &amp; multi organ failure. The aim of the study is to evaluate the serum Copper, Zinc and Iron levels in patients with liver cirrhosis. A total 120 subjects were included in this study. Among them, 60 diagnosed decompensated liver cirrhosis patients denoted as case group (n=60) and 60 were normal healthy individuals denoted as control group (n=60), both the case and control groups were male because liver cirrhosis occurs rarely female in Bangladesh. The subjects were briefed and written consents were taken. Under all aseptic precaution 5 ml of venous blood was collected from median cubital vein, analysis was carried out in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, over a period of one year from July 2015 to June 2016. All statistical analysis was performed by SPSS windows package, version 20. Significance of the difference between two groups were evaluated by using student's unpaired 't' test. All the values were expressed as mean ± SD and P value 0.05 was taken as the level of significance. After careful evaluation, in the present study we found significant increase in the serum Copper levels and significant decreases in the serum Zinc and Iron levels in liver cirrhosis patients when compared with that of control group. It can be concluded that to overcome fatal consequences of decompensated liver cirrhosis patients we should avoid high Copper containing food provides Zinc and Iron supplementation as well as blood transfusion may be beneficial.</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 10-16</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal Severe acute pancreatitis- it's diagnosis and management- A study of 20 cases 2021-09-21T09:31:52+00:00 Mohammad Monir Hossain S M Shakwat Hossain Delowar Hossain <p><strong>Background</strong>: Severe acute pancreatitis is defined as pancreatitis in which there is persistent organ failure that does not resolve within 48 hours. Severe acute Pancreatitis is characterized by pancreatic necrosis, a severe systemic inflammatory response and often multiorgan failure. Severe acute pancreatitis is a serious and life threatening disease. Mortality varies from 20 to 50 percent.</p> <p><strong>Objective</strong>: The objectives of this study are to develop our knowledge about presentation and diagnosis of severe acute pancreatitis, and to develop a standard management protocol to rescue that patient suffering from severe acute pancreatitis.</p> <p><strong>Methods</strong>: This observational study was carried out in Combined Military Hospital (CMH) Dhaka, during the period of August 2014 - Feb 2015. A total 20 patients of severe acute pancreatitis were studied prospectively, evaluated and managed.</p> <p><strong>Results</strong>: In this study, out of 20 patients 12(60%) male and 08(40%) female. Male: Female = 3:2. The youngest patient of this series was 03 years and oldest was of 55 years. First categorization of severity of acute pancreatitis was done on the basis of Ranson score. Those patients whose score is 3 or more are categorized as severe. After categorization subsequent management was planned on the basis of laboratory and CT findings. Out of 20 patients all have raised WBC, serum Calcium level decrease in 16 patients, LDH raised in 16 patients, PaO2 decrease in 14 patients, Base deficitincreased in 12 patients, and blood urea nitrate raised in 14 patients. Contrast enhanced CT scan done in all patients and 12 patients were found with reduced enhancement in pancreas, peripancreatic edema and stranding of fatty tissue and remaining 8 patients have fluid collected in peri- and retro pancreatic space. Total 12 patients were given conservative treatment. Remaining 8 patients were operated whose CT findings were reduced enhancement in pancreas and these patients were suspected for infective pancreatic necrosis. In this study 3 patients were expired. Out of these three patients, 2 patients underwent operative intervention and 1 patient was given conservative treatment.</p> <p><strong>Conclusion</strong>: Severe acute pancreatitis is a life threatening condition. Its serious regional and systemic involvement causes multiple organ or system failure. Early diagnosis and effective treatment can significantly reduce the mortality and morbidity.</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 17-29</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal Changes in Serum Calcium, Albumin and Alkaline Phosphatase Levels of Postmenopausal Women 2021-09-21T09:41:24+00:00 Kamana Rani Saha Susmita Das Shahidul Islam AHM Hasan Rafika Afrose Md Abdur Razzaque Mia <p>A case-control cross-sectional study was carried out to observe the changes in serum calcium, albumin and alkaline phosphatase levels of postmenopausal women compared to their premenopausal counterparts. This is to enable us ascertain the relative risk of developing osteoporosis in postmenopausal women in Bangladesh. One hundred and eighteen (118) apparently healthy females (59 premenopausal=control and 59 postmenopausal=case) were selected for the study. The study was carried out in the Department of Biochemistry, Mymensingh Medical College in cooperation with the Department of Gynecology, Mymensingh Medical College Hospital and Community Based Medical College Hospital Bangladesh during the period from January to December 2009. Data were collected through clinical evaluation from pre-selected questionnaires. Fasting venous blood samples were taken for laboratory investigations. Serum calcium and albumin was determined using colorimetric method and enzymatic end point method was used to determine serum alkaline phosphatase levels. Statistical significance of difference between two groups were evaluated by using Student's unpaired 't' test with the help of SPSS software package. The results showed statistically significant decrease in serum calcium and albumin (p&lt;0.01) of menopausal women compared to reproductive age group. The postmenopausal women had significantly higher (p&lt;0.01) concentrations of serum alkaline phosphatase than the premenopausal women with regular menstruation. Therefore, it can be concluded that menopause leads to the increased risk of osteoporosis by decreasing serum calcium and albumin and by increasing alkaline phosphatase levels. The decreased serum calcium and increased alkaline phosphatase levels indicate that menopause is an independent risk factor for developing osteoporosis in women of Bangladesh.</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 30-35</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal Effect of Cigarette Smoking on Fasting Serum Glucose in Healthy Male Population 2021-09-21T09:44:09+00:00 Rubiat Naznin Sayeda Nazrina Shahanaz Parveen Nahid Bintay Ansary Shamima Nasrin Aklima Khanom Tanzina Taskia - Muktadira Maria Hussain <p>Acute effects of cigarette smoking include impaired insulin action that leads to abnormal glucose metabolism. Smoking is an independent risk factor for type 2 diabetes which is one of the global health crises and insulin resistance is one of the main risk factors for cardiovascular disease. This cross-sectional study was done to examine whether fasting serum glucose differs between cigarette smokers compared to non-smokers and to investigate the association of cigarette smoking with the development of impaired fasting glucose and type 2 diabetes. This study was done in the Physiology department of Mymensingh Medical College, an outpatient department of Mymensingh Medical College Hospital, for over a period of one year from July 2014 to June 2015. Fasting serum blood glucose was done by enzymetric colorometric GOD-PAP method in a total of 150 subjects, in which non-smokers were 50 and numbers of smokers were 100 with the duration of smoking 5 - 10 years and &gt;10 years. A questionnaire including data was completed in all cases. The data were checked, coded, and entered into an SPSS 11.5. Statistical significance of difference among the groups was calculated by Students unpaired t' test. P-value &lt;0.05 was considered as a level of significance. Fasting Serum Glucose level was increased gradually with the duration of smoking in smokers than the non-smokers. Results were statistically highly significant. Fasting Serum Glucose gradually increase with the duration of smoking and results were within the physiological limit in two study groups (Group-II A with 5-10 years duration of smoking and Group- II B with more than 10 years duration of smoking) but not statistically significant. This study showed cigarette smoking has deleterious effects on insulin metabolism causing an increase in serum glucose with duration of smoking period.</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 36-39</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal Therapeutic angiogenesis by stem cell: new hope for the ischemic limbs 2021-09-21T09:44:09+00:00 AKM Mohiuddin Raihan Anwar Peter Lewis BA Sadiq <p>Critical limb ischemia in an intractable condition associated with high level of amputation, leading to low quality of life increase morbidity and mortality. It is often not treated by standard therapeutic modalities. Neoangiogenesis has been proposed as a novel method of treatment of such patients. Vascular Endothelial Growth Factor (VEGF) and Cytokine Fibroblast growth Factor (FGF1) have been shown to elicit neoangiogesis. Stem cells are progenitor cells which can differentiate in vivo into different type of cells. Collateral vessel formation after stem cell therapy. A case of 50 years old male, diabetic, hypertensive with dry gangrene of tip of left ring finger was treated with stem cell therapy after proper counseling. He received the therapy in the form of SVF (Stromal Vascular Fraction) from adipose tissue by local injection in the territory of the affected vessels. Following monitoring parameters were reported, improved wound status, local temperature change, oxygen saturation change in the ischemic zone. Outcome of stem cell therapy in this case including the rest pain disappeared at 14 days and the finger becomes warmed by 5°C in 3 weeks. The gangrenous area healed in 3 months. Amputation was averted. Angiogenesis is a complex process leading to new blood vessels formation. Mesenchymal stem cells (MSCs) are a type of adult stem cell which has an immunomodulatory effect. Stem cell therapy has been used to improve limb Vascularity. Stem Cells are likely to be an important modality to treat critical limb ischemia.</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 40-46</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal Acute kidney injury associated with ingestion of star fruit: Acute oxalate nephropathy: a report of two cases 2021-09-21T09:46:04+00:00 Mahmud Javed Hasan Nitai Chandra Ray Shaikh Shariful Islam Shakil Azam Nahid Tumpa Shom Proloy Gosh Abu Torab Md Saifullah <p>There are few case reports regarding star fruit's nephrotoxicity and neurotoxicity in chronic kidney disease patients. Star fruit (Averrhoa carambola) is commonly consumed as a herbal remedy for various ailments in tropical countries. However, the dangers associated with consumption of star fruit are not commonly known. Although star fruit induced oxalate nephrotoxicity in those with existing renal impairment is well documented, reports on its effect on those with normal renal function are infrequent. We report two unique clinical presentation patterns of star fruit nephrotoxicity following consumption of the fruit. The first patient is a 52 year-old male diabetic patient who had normal renal function prior to developing acute kidney injury (AKI) after consuming large amount of star fruit juice at once for remedy of diabetes. The second patient, a 27 years old young male who developed acute kidney injury following star fruit ingestion in empty stomach. One case needed 4 sessions of hemodialysis another case recovered over 2 weeks without the need for haemodialysis. Consumption of star fruit, especially on an empty stomach or in a state of dehydration may precipitate acute kidney injury. A history of star fruit ingestion must be actively looked for in patients presenting with unexplained acute kidney injury. The use of star fruit as a therapy for diabetes should be discouraged.</p> <p>CBMJ 2019 July: Vol. 08 No. 02 P: 47-51</p> 2019-08-05T00:00:00+00:00 Copyright (c) 2019 Community Based Medical Journal