Community Based Medical Journal 2022-06-16T05:24:16+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> “COVID-19” Fact Sheet 2022-06-14T04:44:01+00:00 M Karim Khan <p>Abstract not available</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 1-3</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Malnutrition in Elderly Population: Screening Tools and Management 2022-06-15T08:55:57+00:00 Shaorin Tanira Merina Tanzil Sadia Nusrat Alamgir Raihana Amin Md Abdul Muqueet SM Farhad Sazib <p>Malnutrition is a common, potentially serious, and frequently under-diagnosed condition among elderly people. Age-related physiologic changes in combination with organic and psychological disease processes contribute to the development of malnutrition in older adults. Profound malnutrition and serious illnesses often present concurrently, and each can accelerate the progression of the other. Early detection and careful interventions are very important to prevent further deterioration. However, Prompt diagnosis relies on physicians‟ clinical suspicion and available screening tools. We consider that systematic screening and early treatment of malnutrition are integral parts of global geriatric care. Hence, this paper aims to review the prevalence and aetiology of malnutrition among ageing population with a special focus on some of the commonly used screening tools in clinical practice. Some of the non-pharmacologic and pharmacologic interventions are also highlighted that are used to manage malnutrition in elderly patients.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 61-68</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Genetic Basis of Congenital Anomalies of Kidney and Urinary Tract 2022-06-15T09:14:35+00:00 Abu Sadat Mohammad Nurunnabi Mahmud Javed Hasan Amir Mohammad Kaiser Arif Mohammad Shuchana Chakma <p>Congenital anomalies of kidney and urinary tract (CAKUT) is a group of abnormalities affecting the kidneys or other structures of the urinary tract that include ureters, urinary bladder and urethra. CAKUT include renal agenesis or hypodysplasia, multicystic dysplastic kidney, ureteropelvic junction obstruction, duplication of the pelvis, ureter, and/or kidney, congenital megaureter, ureterovesical junction obstruction, vesicoureteral reflux and posterior urethral valves. Those results from abnormal development of the urinary system and is present from birth (congenital), although the abnormality may not become apparent until later in life. The clinical spectrum of CAKUT has significant impact on long-term patient survival. We observed that the causes of CAKUT are complex, usually combination of genetic and environmental factors contribute to the developmental abnormalities of kidney and urinary tract in foetus. The genetic factors involved in most cases of CAKUT are unknown; however, syndromic CAKUT is caused by changes in the genes associated with the particular syndrome. Variations in the same genes can also underlie some cases of isolated CAKUT. This review paper aims to discuss genetic basis of CAKUT, i.e., identifying different genes involved in syndromic and non-syndromic CAKUT. Modern genetic testing facilities can provide a precise diagnosis that can help individualize clinical care by screening for specific complications, facilitate medical decision making, and provide better genetic counseling.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 69-74</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Death by Lightning: Effective Public Health Strategies Needed 2022-06-15T08:43:59+00:00 Abu Sadat Mohammad Nurunnabi Md Mozaharul Islam Mohammad Tipu Sultan Kursiya Sanwar Ishrak Fatema Tofa <p>Lightning is one of the leading causes of weather-related fatalities. A man, approximately 30 years old, was brought to the morgue of Kishoreganj District Hospital, Bangladesh, in July 2021, known to be lightning strike victim. During postmortem examination, various types of skin burns were found in the body, at an entry site on and near the head, and at an inferiorly located exit site. The skin injuries consisted of superficial burns, charring, and singed hair; however, there was no deep burn. „Lichtenberg figures‟ were found. Internal findings at autopsy were nonspecific. Epidemiologically, the total number of global annual lightning fatalities range from 6,000 to 24,000 per year. In recent years, Bangladesh experiences a high rate of lightning deaths. We feel that the number of deaths by lightning should be seen as a call to action. Hence, deaths by lightning should be regarded as a public health problem in the country and necessary measures must be taken. Our case study aims to draw the attention of the physicians and public health department on injuries and deaths due to lightning strike. It is also important for forensic professionals to be familiar with the nature of injuries caused by lightning and lightning strike deaths.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 52-55</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal A Young Bangladeshi Boy with Primary Ciliary Dyskinesia (Kartagener’s Syndrome): A Rare Case 2022-06-15T08:47:51+00:00 Muhammad Abdul Bari Mahmud Javed Hasan Sultan Ahmed <p>Kartagener’s syndrome, an autosomal recessive inherited disorder, is a subgroup of primary ciliary dyskinesias (PCD). This genetic disorder manifests from early life which distinguishes it from acquired mucociliary disorders. Kartagener’s syndrome presents as a classical triad of situs inversus, sinusitis and bronchiectasis occurring majorly due to impaired ciliary motility. A 16 year-old boy from Fulbaria, Mymensingh with left sided consolidation for 1 month and recurrent episodes of nasal congestion and lower respiratory tract infection (LRTI) since his childhood. Clinical and imaging findings revealed left sided consolidation, chronic sinusitis, bronchiectasis, dextrocardia, and situs inversus. He was treated with orally administered antibiotics, bronchodilators, mucolytics, and chest physiotherapy. He was symptomatically better with the above therapy, and started on a long-term low-dose prophylactic antibiotic. As there is no easy, reliable non-invasive diagnostic test for Kartagener’s syndrome and the correct diagnosis is often delayed by years, it may cause chronic respiratory problems with reduced quality of life. Genetic counseling and fertility issues should be addressed once Kartagener’s syndrome is diagnosed.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 56-60</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal The Analgesic Effect of Dexamethasone and Magnesium Sulphate (MgSO4) as an adjuvant to 0.25% Bupivacaine in ultrasound guided Pectoral Nerve Block (PEC Block) for unilateral Modified Radical Mastectomy: A Comparative Study 2022-06-14T04:59:19+00:00 Mohammad Mahabubuzzaman MD Humayun Kabir Md Saiful Islam Lipon Kanti Bhowmick Md Zubyeer Ali Sheikh Dabasis Kumar <p><strong>Background: </strong>Postoperative pain following unilateral modified radical mastectomy (MRM) has been managed with Pectoral nerve block (PEC block). Several initiatives are ongoing to get the effective and safe way of prolongation analgesic effect postoperatively. Therefore, many types of adjuvants are adding to the local anaesthetic agents to prolong their analgesic effect. In this study either dexamethasone or magnesium sulphate (MgSO<sub>4</sub>) has added as an adjuvant to 0.25% bupivacaine in pectoral plane block (PEC block) for unilateral modified radical mastectomy. Here we observed which of the adjuvant would prolong the analgesic effect of 0.25% bupivacaine.</p> <p><strong>Methods: </strong>This randomized controlled trial was conducted at the Department of Anaesthesia, Analgesia, Palliative and Intensive Care Medicine, Dhaka Medical College following approval of the ethical committee. These patients were selected from the department of General Surgery, Dhaka Medical College during preanaesthetic checkup periods. Total 50 patients were scheduled for modified radical mastectomy and divided into Group A and Group B (each group contain 25 patients). The patients of the both groups were given pectoral plane block under ultrasound guide with 0.25% bupivacaine. The patients of Group A received magnasium sulphate 150 mg and Group B received dexamethasone 10 mg as an adjuvant to 0.25% bupivacaine. Pectoral nerve block was performed before induction of general anaesthesia and onset of sensory block was assessed among the both groups. All patients were observed peri-operatively and data were recorded into the data collection form. Finally, data was analyzed by SPSS version 22.</p> <p><strong>Observation and Results: </strong>Socio-demographic profile were similar among the both groups (p&gt;0.05). No significant difference was noted in terms of ASA score and BMI (p&gt;0.05). Mean duration of the analgesia (min) and time requirement of rescue analgesic therapy were significantly higher in dexamethasone group (p&lt;0.05) than MgSO<sub>4</sub> group. Post-operative requirement of pethidine (72.5±8.5vs 55.2±5.4 mg; p&lt;.045) was also higher in MgSO<sub>4</sub> group. Side effects profile like nausea and vomiting also significantly small in dexamethasone (4%) group than people received MgSO<sub>4</sub> group (20%) (p&lt;0.05).</p> <p><strong>Conclusion: </strong>Use of dexamethasone in comparison to MgSO<sub>4</sub> as an adjuvant to bupivacaine could prolong analgesia in postoperative period for pectoral plane block in unilateral modified radical mastectomy.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 4-13</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Correlation of Handedness with Hand Shape Index in Right Hander and Left Hander Medical Students of Bangladesh 2022-06-14T05:12:20+00:00 Md Shamsur Rahman Zubaida Gulshan Ara Anjuman Ara Rehana Parveen Zeenatul Momena Irin Parven Taslima Begum <p>This cross-sectional, analytical type of study was performed in Department of Anatomy, Dhaka Medical College, Bangladesh, from July 2016 to June 2017 on 52 right hander male and 52 right hander female, 40 left hander male and 34 left hander female Bangladeshi medical students. Convenient purposive sampling technique was adopted. History of any injury of upper limb was excluded to construct standard measurement. Handedness of each medical student was determined by the Edinburgh handedness inventory. Hand breadth and hand length was measured with the help of vernier caliper. Paired and unpaired student‟s „t‟ test and Pearson‟s correlation coefficient test were done for statistical analyses. Handedness score showed nonsignificant positive correlation with right hand shape index (r = +0.087, P&gt;0.05) and left-hand shape index (r = +0.008, P&gt;0.05) in right hander males. Handedness score showed non-significant negative correlation with right hand shape index (r = -0.017, P&gt;0.05) and left-hand shape index (r = -0.003, P&gt;0.05) in right hander females. Handedness score showed non-significant negative correlation with right hand shape index (r= - 0.210, P&gt;0.05) and left-hand shape index (r = -0.247, P&gt;0.05) in left hander males. Handedness score showed non-significant positive correlation with right hand shape index (r= +0.051, P&gt;0.05) and left-hand shape index (r = +0.213, P&gt;0.05) in left hander females. To summarize, handedness score showed nonsignificant positive correlation with right hand shape index and left-hand shape index in right hander males and left hander females. However, handedness score showed non-significant negative correlation with right hand shape index and left-hand shape index in right hander females and left hander males.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 14-20</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Assessment of Renal and Liver Function Tests Before and After Induction of Chemotherapy in Newly Diagnosed Acute Lymphoblastic Leukemia in Children 2022-06-14T06:17:26+00:00 Sayla Chowdhury Afiqul Islam Mahbuba Sultana Mir Iftekhar Mostafiz <p>A prospective study was done in the Department of Paediatric Hematology &amp; Oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between January and June of 2012, to observe the renal and liver function status in children suffering from acute lymphoblastic leukemia (ALL) before and after induction of chemotherapy. A total of 30 diagnosed patients of acute lymphoblastic leukemia were enrolled in the study. Renal and liver function tests were done before and after induction of chemotherapy. All the patients of the study were within 2-11 years range. Mean age was 5.12±2.53 years. Maximum 43.3% patients were within 3-6 years of age followed by 33.3% up to 3 years of age,13.3% within 6-9 year of age range and 10% above 9-year age range. 73.3% were male and 26.7% were female. Among the liver functions tests, mean bilirubin level of the patients before induction of chemotherapy was 2.31±4.71 mg/dl and after induction of chemotherapy was 1.12±2.15 mg/dl (P=0.122). Mean SGPT levels were 35.33±15.82 IU/L and 75±57.12 IU/l respectively (P=0.001). Mean total protein levels were 67.05±6.99 gm/dl and 64.47±7.51 gm/dl respectively (P=0.06). All the patients were HBsAg negative. Among the renal function tests, mean blood urea level of the respondents before induction was 28.89±7.95 mg/dl and after induction was 30.67±9.39 mg/dl (P=0.429). Mean serum uric acid levels were 4.63±1.18 mg/dl and 5.12±0.44 mg/dl respectively (P=0.044). Mean serum creatinine levels were 0.74±0.27 mg/dl and 0.67±0.22 mg/dl respectively (P=0.168). Mean GFR was 99.77±37.38 ml/1.732/min. before induction of chemotherapy and 108.57±37.29 ml/1.732/min. following chemotherapy (P=0.177). Kidney and liver functions may be affected in ALL in children. Recognition of hepatic and renal impairment at the onset of illness helps judicious chemotherapy in management of ALL.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 21-26</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Health Problems of Under-five Children in a Rural Area of Mymensingh District, Bangladesh 2022-06-14T06:20:31+00:00 Md Tufael Hossain Sultana Sobnam Dipu <p>A cross-sectional, descriptive study was conducted to determine health problems of under-five children in a selected rural area of Mymensingh District in Bangladesh. This study was done on the background that the document about community prevalence of health problems of under-five children is scarce though it has public health importance. This was a community-based cross-sectional descriptive study conducted among 144 children belonging from birth to 5 years residing in Churkhai village of Bhavokhali union, Mymensingh Sadar Upazila in between November and December of 2019, as a part of Residential Field Site Training of 3rd year students of Community Based Medical College, Bangladesh (CBMC,B). A purposive sampling technique was adopted. A pre-designed, pre-tested questionnaire has been used to collect required information by face-to-face interviewing mothers of under-five children. The data were entered and analyzed by SPSS version 20.0. Respondent mothers ranged from 16 years to 45 years, mean age 25.47±5.332 years. Majority of mothers were literate (75.69%), housewife (91.67%), belonged to middle class (69.44%). Out of total 144 children ranging from birth to 59 months, mean age 29.83±19.54 months, male: female ratio was 97.26:100. Majority of children (50.69%) were healthy. Nutritional status was assessed by history taking (history of birth weight) weight, height measurement and clinical examination. Prevalence of low birth weight was 15.28%. Prevalence of under-nutrition was 16.67% and over-nutrition was 1.39%. On clinical examination, prevalence of anemia was found 4.17%. The leading health problem was nutritional 22.22%, followed by respiratory illness 12.50%, diarrhoea 7.64%, skin disease 4.17%, dental caries 0.69%, conjunctivitis 0.69%, acute suppurative otitis media 0.69%, accidental injury 0.69%. Most of the family had safe water supply (98.61%), sanitary latrines (85.42%), semi-pucca house (50%) and suffer air pollution 69.44%. The nutritional profile was quite similar, but disease situation was better than the results of other studies in Bangladesh and in other developing countries.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 27-32</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Parental Awareness about Use of Mask and Hand Hygiene Practice of Their Children during COVID-19 Pandemic 2022-06-14T06:48:09+00:00 Rukhsana Parvin Jesmin Akter Shahabuddin Mahmud Mohammad Monirul Islam Khan Md Golam Mowla Md Al Amin Mridha <p>A descriptive, cross-sectional study was carried out in the Department of Pediatrics, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh, between January and August of 2021, to assess the awareness of parents regarding wearing mask and hand washing behavior of their children to prevent COVID-19 infection. A total of 378 parents whose children were admitted in the hospital (aged 2 years to 12 years) due to several diseases other than COVID-19, participated in this study. There was a face-to-face interview for each participant. Data were collected through semi-structured questionnaire. The majority of the participants (66.4%) were male and their income was within BDT.10000-20000 per month. Among the fathers, majority belonged to the age group of &gt;30 years. Regarding their educational background most of them (45.2%) completed education up to secondary level and most of them were service holders (33.9%). Among the mothers, the majority belonged to the age group of 20-30 years and mostly completed their education up to primary level (40.9%) and 75.6% of them were housewives. 83.3% of participants knew that COVID-19 is a contagious disease and 85.2% knew the mode of transmission. A total 72.8% of respondent believed that hand washing can prevent COVID-19, in which 40.5% follow the six steps of hand washing. Only 12% of their children wash hands for at least 20 seconds. 60.8% participants thought that face mask can prevent COVID-19, but only 45.2% participants used to wear face mask. Among them, 73% used to wear surgical face mask. About 33.6% answered that they always reused their face masks. About 59.3% participants noted that their children sometimes wear face mask and 57.1% of their children felt suffocation and discomfort while using face mask. Our study suggests that most of the parents have sufficient knowledge regarding COVID-19 including its mode of transmission and appropriate preventive measures. We also found a positive relationship of maternal education with a consolidated knowledge and awareness as well as practices of hand washing and mask wearing behavior among their children.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 33-40</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Prevalence of Refractive Errors among Primary School Children in the Southern Region of Bangladesh 2022-06-14T06:54:24+00:00 Syeed Mehbub Ul Kadir Mahar Ali Md Shirajul Islam Rukhsana Parvin ASM Quadir Mostafa Jahir Raihani AKM Rafiqul Islam Saifuddin Ahmmed <p>Refractive errors are considered as avoidable conditions which may lead to visual disabilities in children. A cross-sectional study was conducted between January and May of 2021 in a tertiary level specialized eye hospital in the southern region of Bangladesh to assess the refractive errors among primary (elementary) school children. Our study population was all the primary school children attending the outpatient department of the hospital. However, we used convenient sampling in the study. A total of 252 primary school-going children were examined – 148(58.7%) boys and 104(41.3%) girls. Among them, the minimum age was seven years, and the maximum age was 12 years. The mean age of the children was 9.67 years. Among the refractive errors, myopia was the highest prevalent condition (103 children, 50%), followed by astigmatism (77 children, 37.4%), and hyperopia (26 children, 12.6%). Among astigmatism, myopic astigmatism was 58(75.3%), while mixed astigmatism was observed in 13(17%) children and hyperopic astigmatism was found in 6(7.8%) children. The amblyopia was noted in 17 children (6.7%). The visual acuity was improved after corrections of the refractive errors.</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 41-45</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal Knowledge of Diet and Dietary Pattern in Pregnant Women Attending Antenatal Clinic in Community Based Medical College, Bangladesh 2022-06-14T07:00:30+00:00 Fakir Sameul Alam Maksuda Begum Md Tufael Hossain <p>A cross-sectional, descriptive study was conducted in Community Based Medical College, Bangladesh (CBMC,B) Hospital during August and September 2018 to identify knowledge, attitude and practice regarding diet among pregnant women attending antenatal checkup. This study was done as a part of Residential Field Site Training by 3rd year MBBS students under Community Medicine curriculum. Data were collected on a predesigned questionnaire by direct interviewing a total of 116 pregnant women. Data analysis was done by SPSS version 20.0. Age distribution of respondents ranged from 18 years to 35 years; mean age 24.45±4.69 years. Most of the respondents 99(85.34%) belonged to age group 18 years to 29 years. Most of them were Muslim 99(85.34%), literate 93(80.17%), and housewives 96(82.76%), belonged to middle class family 65(56.03%). 46(39.66%) were found at risk, based on risk assessment. Knowledge regarding diet and nutrition was found in optimum level. Majority 55(47.41%) had excellent score, while 49(42.24%) had good score and 12(10.34%) were not up to the mark. Attitude of family members regarding care of pregnant woman was positive in most cases, 113(97.41%). Majority 55(47.41%) had excellent dietary practice, 23(19.83%) were good and 38(32.76%) were bad. Barriers of implementation of good dietary practice include lack of knowledge 12(10.34%), poverty 17(14.66%) and lack of cooperation from husband and in-laws 9(7.76%).</p> <p>CBMJ 2022 January: vol. 11 no. 01 P: 46-51</p> 2022-06-16T00:00:00+00:00 Copyright (c) 2022 Community Based Medical Journal