Community Based Medical Journal <p>The official journal of Community Based Medical College, Mymensingh, Bangladesh. Full text articles available.</p> en-US No part of the materials published in this journal may be reproduced, stored or transmitted without prior written permission of the editorial board. (Dr. Mahamud Javed Hasan) (Md Fahmid Uddin Khondoker) Sat, 02 Sep 2023 17:32:06 +0000 OJS 60 Informed Consent through Community Engagement in Collaborative Research in Developing Countries <p>Multinational nature of research activities has been growing increasingly through collaboration that involves a developing country and a developed country. However, several scandals have been reported to date in such research done by the western authorities in the name of collaboration, development, or health improvement in different developing countries especially revolving informed consent and protection of the participants. Those incidences tend to create distrust and may result in non-cooperative attitude among developing countries in further collaboration. This paper aims to discuss how much an informed consent is really informed and how community engagement can make it more meaningful and ethical by respecting the values of any society (i.e., participating developing country). Evidence suggests that there are essential interdependence and overlapping between consenting process and community engagement in that collaborative research. Community engagement is able to provide a meaningful insight that helps in formulation of context-specific consent process. It also helps to regulate and monitor consenting procedure, withdrawal from participation, and any relevant changes while research is ongoing. Moreover, as a sign of showing respect to the participating group in research, community engagement has been found instrumental in making research more acceptable and mutually beneficial.</p> <p>CBMJ 2023 July: Vol. 12 No. 02 P: 192-200</p> Abu Sadat Mohammad Nurunnabi, Sadia Akther Sony, Munira Begum, Saida Sharmin, Fariha Haseen, Md Kamran Ul Baset Copyright (c) 2023 Abu Sadat Mohammad Nurunnabi, Sadia Akther Sony, Munira Begum, Saida Sharmin, Fariha Haseen, Md Kamran Ul Baset Sat, 02 Sep 2023 00:00:00 +0000 An Evaluation of the Effectiveness of Calcium Hydroxide as A Root Canal Sealer Constituent <p>A descriptive, comparative study was conducted in the Department of Conservative Dentistry and Endodontics, Dhaka Dental College Hospital, Bangladesh, from December 2014 to November 2015, to evaluate the effectiveness of calcium hydroxide as a root canal sealer constituent. A total of 60 patients were selected by purposive sampling technique. Patients were divided into two equal groups of 30: group-I had zinc-oxide eugenol [ZOE] cement as a root canal sealer, while group-II had calcium hydroxideor sealapex [Ca(OH)<sub>2</sub>] cement as a root canal sealer. Total number of teeth treated by single-visit root canal therapy. Out of 60 patients, 37(61.7%) patients were male. In ZOE group, the highest incidence was in age group 21-30 years, where as in Ca(OH)<sub>2 </sub>group, it was in 11-20 years. The mean age of the patients was 27.62±6.20 years in ZOE group and 25.0±6.14 years in Ca(OH)<sub>2 </sub>group. 21(70.0%) mentioned trauma as an etiological factor followed by caries 4(13.33%) in ZOE group, while 18(60.0%) patients mentioned trauma followed by caries 6(20.0%) in Ca(OH)<sub>2 </sub>group. In ZOE group, the incidence of pain was 23(76.67%), and in Ca(OH)<sub>2 </sub>group, 22(73.33%) reported pain. Periapical radiolucency follow-up findings were significantly better at 3-month and 6-month follow-ups in the Ca(OH)<sub>2 </sub>group. The difference inthe final outcome of effectiveness in both ZOE and Ca(OH)<sub>2 </sub>group in the management of periradicular pathosis was statistically not significant (P&gt;0.05). The present study findings revealed that single-visit root canal therapy was equally effective in the management of endodontically involved teeth with periradicular pathosis. After 12 months, in follow-up with post-operative clinical and radiological evaluations, Ca(OH)<sub>2 </sub>sealer group showed better results than ZOE sealer group. However, in shorter follow-ups, Ca(OH)<sub>2 </sub>sealer group showed significantly better findings as compared to ZOE sealer groups. &nbsp;</p> <p>CBMJ 2023 July: vol. 12 no. 02 P: 141-149</p> Farzana Anar, Md Harun Ar Rashid, Khaled Mohammad Islam, Rashedur Rahman, Md Mukhlachur Rahman, Sultana Razia Khanam, Md Masuqur Rahman Copyright (c) 2023 Farzana Anar, MD Harun Ar Rashid, Khaled Mohammad Islam, Rashedur Rahman, MD Mukhlachur Rahman, Sultana Razia Khanam, MD Masuqur Rahman Sat, 02 Sep 2023 00:00:00 +0000 Comparison of Efficacy and Safety of Oral Use of Terbinafine and Itraconazole for the treatment of Tinea paedis: A Randomized Controlled Parallel Group Open Labeled Trial with Clinico-Mycological Correlation <p>Treatment of tinea paedis is very crucial with the different antifungal drugs. The purpose of the present study was to compare the efficacy and safety of oral use of terbinafine and itraconazole for the treatment of tinea paedis. This study was a double-blind, randomized, single-center clinical trial. The patients were randomly allocated to receive a daily dose of terbinafine 500 mg daily for 4 weeks (Group I) or 200 mg of itraconazole for 4 weeks daily (Group II). The primary efficacy criterion was mycological cure, defined as negative results on microscopy and culture at the end of follow-up and no requirement of second intervention treatment. Secondary efficacy criteria included clinical cure without second intervention treatment and mycological and clinical relapse rates. A total of 50 patients were included in this study, it was observed that majority patients were age belonged to 31-40 years in both groups. Regarding gender distribution of the study patients, it was observed that male were predominant in both groups, which was 20(80.0%) in group A and 19(76.0%) in group B. All hyperkeratotic patients were shown 100.0% cases of clinical response. However, interdigital lesion were recovered in 7(100.0%) cases in group A and 6(85.7%) cases in group B. In conclusion, tinea paedis is significantly improved by both drugs, without significant difference after 8 weeks follow-up.</p> <p>CBMJ 2023 July: vol. 12 no. 02 P: 150-156</p> Sharmin Begum Copyright (c) 2023 Sharmin Begum Sat, 02 Sep 2023 00:00:00 +0000 Short Term Outcomes of Laparoscopic Versus Open Appendicectomy in Patients with Acute Appendicitis <p>A prospective, observational study was carried out in the Department of Surgery of Sylhet MAG Osmani Medical College, Bangladesh, from May 2019 to May 2020, to compare the short-term outcomes of laparoscopic versus open appendectomy for acute appendicitis. A total of 120 patients who were diagnosed with acute appendicitis and underwent surgery were included in this study. The selected patients underwent appendectomy either by laparoscopic or using open method under general anesthesia. The patients were divided into two groups – 60 patients underwent laparoscopic appendectomy as group-I and the other 60 patients underwent open appendectomy as group-II. The mean age was 26.25±7.83 years in group-I and 22.88±6.92 years in group-II. The difference was statistically significant (P&lt;0.05). Male predominance was found: 40(66.67%) in group-I and 44(73.33%) in group-II. However, the difference was not statistically significant (P&gt;0.05). The mean operating time was 65.05±8.76 min in group-I and 40.08±4.82 min in group-II. The mean time resumption of diet was 7.3±0.9 hours in group-I and 25.4±4.5 hours in group-II. The mean postoperative pain was 1.32±0.47 in group-I and 3.27±0.69 in group-II. 1(1.7%) patient had wound infection in group-II; however, no patients in group-I developed wound infection. The mean duration of hospital stay was 2.20±0.40 days in group-I and 3.62±0.98 days in group-II. The majority (81.7%) of the patients had the best quality of the scar in group-I and 48(80%) in group-II. The mean quality of the scar was 4.82±0.39 in group-I and 2.90±0.44 in group-II. All those differences except wound infection were statistically significant (P&lt;0.001). This study demonstrated that laparoscopic appendectomy is as safe and effective as the open procedure. The overall benefit of laparoscopic appendectomy is more, as it results in less postoperative pain, shorter duration of hospital stays, better wound healing, as well as cosmetic outcome as compared to open procedure.</p> <p>CBMJ 2023 July: Vol. 12 No. 02 P: 157-163</p> Monika Parvin, Dewan Ali Hassan Chowdhury, Mohammad Ashik Anwar Bahar Copyright (c) 2023 Monika Parvin, Dewan Ali Hassan Chowdhury, Mohammad Ashik Anwar Bahar Sat, 02 Sep 2023 00:00:00 +0000 Comparison of Respiratory Symptoms among Under Five Children Living in Households Using Biomass Fuel and Fossil Fuel in An Urban Area of Bangladesh <p>A cross-sectional study was conducted at Uttarkhan Thana under Dhaka City Corporation, Bangladesh, between January and December of 2018, to compare respiratory symptoms in under five children living in households using biomass fuels and fossil fuels. The study community comprised of three areas named Vatulia, Munda and Pulartek of Ward No. 4 of Uttarkhan Thana. Total number of households were 1329. Population size in total was 5114, where 2548 were male and 2566 were female. Among them 200 households were chosen by simple random sampling technique – selected households had under five children and met the inclusion criteria (i.e., mother or caregiver of children under five years of age wanted to participate voluntarily. However, we excluded children having congenital anomalies and households using electricity for cooking purpose. A semi-structured questionnaire was used as data collection instrument. Questionnaire included socio-demographic characteristics such as age, sex, educational status, marital status, occupation, number of family members. Cooking related information, e.g., frequency of cooking, duration of cooking, type of fuel used, presence of children during cooking, sleeping in the kitchen and respiratory symptoms in children, e.g., nasal discharge, cough, breathing problems, chest tightness, wheezing, and sore throat were included in the data sheet. Besides, it contained information regarding location of the kitchen, area of the kitchen and presence of any ventilation facility and chimney. Nasal discharge (79.7% vs. 71.6%), cough (69.9% vs. 64.2%), and sore throat (9% vs. 6%) were more common in biomass fuel users’ children. In contrast, shortness of breath (22.4% vs. 18.8%) and wheezing (31.3% vs. 24.1%) were more common among fossil fuel users’ children. However, none of those differences were statistically significant (P&gt;0.05).</p> <p>CBMJ 2023 July: vol. 12 no. 02 P: 164-170</p> Nusrat Jahan, Tunazzina Shahrin, Irtifa Aziz Oishee, Syed Shafiq Tamal, Md Khalequzzaman Copyright (c) 2023 Nusrat Jahan, Tunazzina Shahrin, Irtifa Aziz Oishee, Syed Shafiq Tamal, Md Khalequzzaman Sat, 02 Sep 2023 00:00:00 +0000 Hypotensive Anaesthesia during Spine Surgery – A Comparison between Dexmedetomidine and Magnesium Sulphate <p>A good visualization of the surgical field can be achieved by controlled hypotension with various hypotensive agents. Both dexmedetomidine and Magnesium Sulphate (MgSO4) has powerful analgesic effect and can induce hypotension during surgery. This study is aimed to compare the efficacy of Dexmedetomidine with Magnesium Sulphate in controlled hypotension during spine surgery. This randomized, prospective study was carried out in anesthesiology department of Combined Military Hospital, Dhaka for six-months of period following ethical approval. Total 60 patients, scheduled for spine surgery under GA were included in this study and randomly divided into Group D (Dexmedetomidine, n=30) and Group M (Magnesium sulfate, n=30). Informed written consent was taken from each subject. In every 15 mins, heart rate, systolic &amp; diastolic blood pressure, mean arterial pressure (MAP) are assessed and the surgical field was assessed by the Boezaart surgical field bleeding score. Data were collected in separated case-record form and analyzed by the SPSS 24. Demographic characteristics were similar across the two groups in terms of age, sex, BMI, ASA grading, pre-operative systolic and diastolic blood pressure (p&gt;0.05). Group D had higher mean duration of controlled hypotension (102.50±33.44 vs 85.33±20.25 minutes, p=0.02) and lower mean time to achieve target MAP (34.50±22.68 vs 46.00±10.37 minutes, p=0.016) than Group M. MAP was significantly lower for Group D patients than the Group M patients with time (p&lt;0.05). Boezaart surgical field bleeding score was also significantly lower in Group D compared to Group M (p&lt;0.05). In this study Dexmedetomidine is found more effective than Magnesium Sulphate in achieving controlled hypotension during spine surgery. Better haemodynamic stability is also found in Group D in comparison to Group M.</p> <p>CBMJ 2023 July: vol. 12 no. 02 P: 171-182</p> Ahsanul Kabir, Abul Kalam Azad, A T M A Rustom, Suraya Akter, Md Hasan Mahmood, Rashed Ashraf, Muinul Islam Shah, Md Mujahidul Islam, Aziza Jahan Copyright (c) 2023 Ahsanul Kabir, Abul Kalam Azad, A T M A Rustom, Suraya Akter, Md Hasan Mahmood, Rashed Ashraf, Muinul Islam Shah, Md Mujahidul Islam, Aziza Jahan Sat, 02 Sep 2023 00:00:00 +0000 Morphometric Variation of Acromion Process in A Bangladeshi Population <p>A cross-sectional, descriptive study was done on 150 (70 right and 80 left) fully ossified dry human scapulae of Bangladeshi people to find out the variation in length and breadth of the acromion process. Sample collection was carried out in the Department of Anatomy, Mymensingh Medical College, Bangladesh, between January and December of 2019. Any kind of damaged or broken scapulae were excluded to maintain standard measurement. Length and breadth were measured with the help of digital Vernier slide calipers. The mean (±SD) length was 41.77±5.87 mm and 40.84±6.262 mm on right and left sided scapulae respectively and the mean (±SD) breadth was 22.19±3.08 mm on right sided scapulae and 22.1±2.69 mm on left sided scapulae. These data are important to compare Bangladeshi scapulae to those from various other races that could contribute to demographic studies of shoulder disease probability and management in Bangladeshi population.</p> <p>CBMJ 2023 July: Vol. 12 No. 02 P: 183-187</p> Md Safat Latif, Rafuja Afrin Shanto, Dilruba Afrose Mili, Shamima Islam, Shah Md Atiqul Haque, Tasnoma Siddiquee, Sabiha Tanzeem, Masuma Sultana Copyright (c) 2023 Md Safat Latif, Rafuja Afrin Shanto, Dilruba Afrose Mili, Shamima Islam, Shah Md Atiqul Haque, Tasnoma Siddiquee, Sabiha Tanzeem, Masuma Sultana Sat, 02 Sep 2023 00:00:00 +0000 Silent Lupus Nephritis: Unmasking the Subtle Burden of Renal Involvement in Systemic Lupus Erythematosus – A Case Report <p>Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by the involvement of multiple organs, including the kidneys. Lupus nephritis (LN) is a common and severe manifestation of SLE, often leading to renal dysfunction and disease progression. However, some cases of LN can present with minimal or no clinical symptoms, making early detection and intervention challenging. We present a case report of a 26-year-old lady from Bangladesh with "silent" LN, emphasizing the importance of vigilant monitoring and timely diagnosis. The patient initially presented Swelling of lower limbs but did not exhibit overt urinary symptoms or signs of renal dysfunction. Laboratory investigations revealed elevated antinuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA) antibodies, and reduced complement levels. Despite the absence of classical clinical features, a renal biopsy was performed due to persistent laboratory abnormalities, which confirmed the presence of LN. The patient's treatment regimen included high-dose corticosteroids and immunosuppressive agents, resulting in clinical improvement and normalization of laboratory parameters. Regular monitoring of renal function and disease activity was crucial in maintaining disease control and preventing further renal damage.</p> <p>CBMJ 2023 July: Vol. 12 No. 02 P: 188-191</p> Mahmud Javed Hasan Copyright (c) 2023 Mahmud Javed Hasan Sat, 02 Sep 2023 00:00:00 +0000 Awareness Regarding Crush Injury and Renal Complications <p>Abstract not available</p> <p>CBMJ 2023 July: Vol. 12 No. 02 P: 138-140</p> Mahmud Javed Hasan Copyright (c) 2023 Mahmud Javed Hasan Sat, 02 Sep 2023 00:00:00 +0000