Delta Medical College Journal 2019-03-19T06:23:26+00:00 Prof. Dr. Md. Rezwanur Rahman Open Journal Systems <p>An official organ of Delta Medical College. Full text articles available.</p><p><a href="" rel="license"><img style="border-width: 0;" src="" alt="Creative Commons Licence" /></a><br />Articles in the Delta Medical College Journal are Open Access articles published under a <a href="" rel="license">Creative Commons Attribution 4.0 International License</a> CC BY License.</p><p>Deltal Medical College Journal is included on <a title="DOAJ" href="" target="_blank">DOAJ</a>.</p> Laboratory Medicine - Current 2019-03-19T06:23:04+00:00 Md Rezwanur Rahman <p><em>Abstract not available</em></p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 1-3</p> 2019-03-19T05:33:43+00:00 ##submission.copyrightStatement## Evaluation of the Patient Profile and Current Pattern of Care with Docetaxel Based Adjuvant Regimen in Operable Breast Cancer 2019-03-19T06:23:05+00:00 MA Hai Parveen Shahida Akhter Quamruzzaman Chowdhury Parvin Akhter Banu Mofazzel Hossain Kumkum Pervin <p><strong>Background: </strong>Early stage breast cancer can often be cured with surgery alone though there are chances of recurrent disease and decrease in survival. Adjuvant poly-chemotherapy with docetaxel-based regimens can improve both disease-free and overall survival in patients with operable breast cancer.</p> <p><strong>Objective: </strong>This study was designed to evaluate the patient profile and current pattern of care with docetaxel based adjuvant regimen in operable breast cancer patients including the treatment outcome from clinical practice.</p> <p><strong>Materials and method: </strong>This prospective, observational, non-comparative study planned to enroll newly diagnosed operable breast cancer patients with high risk of recurrence after surgery. Selection of docetaxel-based treatment strategy and dosage of therapy was at the discretion of individual oncologists as per routine clinical practice. Patient data were recorded during inclusion, each cycle of therapy, and follow-up at 1 year (+/- 1 month) after inclusion.</p> <p><strong>Results: </strong>Between August 2008 and July 2011 a total of 85 patients with median age of 53 years (23-73 years) were enrolled and 53 (62.4%) patients were postmenopausal. Ductal carcinoma, the most common cancer type,was found in 73 (85.9%) patients. Receptor status was positive for estrogen, progesterone or Her2/neu/erbB2 in 65.9%, 47.1% and 5.8% patients, respectively. Mastectomy either partial or total was performed in 76 (89.4%) patients for the current disease. An average of 8 (range: 2-15) lymph nodes (LN) mostly in axilla were excised in 56 patients and average of 4 (range: 1-11) LN nodes were positive. Sentinel LNs were negative, excised in 4 patients. The mean tumor size was 5.5 cm and most (82.4%) patients were diagnosed at Stage II disease including some at Stage I and III (7.1%, 10.6%). Docetaxel (Taxotere®) was combined with cyclophosphamide alone or in addition with doxorubicin, epirubicin, 5 FU and trastuzumab either in combination or sequential regimen. Taxotere in combination with adriamycin and cyclophosphamide was planned for 63.5% patients. Trastuzumab as sequential therapy could be afforded by 1 patient only. Data regarding radiotherapy or hormone therapy was not recorded. At the end of four cycles, 83.5% of patients were found disease free and 5.9% had loco regional relapse. At 1 year 71 (93.4%) patients were alive, 63 (88.7%) were relapse-free and 8 (11.2%) had loco regional relapse. Nausea, vomiting, diarrhea, alopecia, anemia and neutropenia were most commonly reported adverse events classified as Grade 1 or Grade 2. Grade 3 neutropenia was reported in 5 patients and 2 patients reported grade 4 neutropenia. Grade 3 diarrhea was reported in 1 patient.</p> <p><strong>Conclusion: </strong>Docetaxel as adjuvant chemotherapy offered one year survival in 93.4% (71/76) of the patients and 88.7% (63/71 patients) were disease-free. The safety profile of docetaxel based regimens was expected and manageable.</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 4-10</p> 2019-03-19T05:33:51+00:00 ##submission.copyrightStatement## Effect of Vitamin E on Serum Urea Level on Gentamicin Induced Nephrotoxicity in Long Evans Rats 2019-03-19T06:23:13+00:00 Md Shameem Ahmed Mohammad Ashraf Ahmed Md Rezwanur Rahman - Ashrafuzzaman Mushtari Jahan Md Abdul Matin Aysha Yasmin Marjina Khatun Farhana Afroz Kuazi Dil Afroz <p><strong>Background: </strong>The kidneys have an important role in eliminating the final products of metabolic activities, excreting the drugs and chemicals. A variety of frequently used drugs have been demonstrated to produce nephrotoxic effects.</p> <p><strong>Objective: </strong>This study was carried out to observe the effect of vitamin E on gentamicin-induced nephrotoxicity by assessing serum urea level in Long Evans rats.</p> <p><strong>Materials and method: </strong>The experimental study was carried out on 40 healthy Long Evans rats of both sex with the weight ranges from 172-255 gm and the age ranges from 7 to 10 weeks. The rats were divided into four groups - Group A (normal control) received normal saline, group B, C and D received gentamicin for 6 days, rats of group C received vitamin E capsule for total 9 days with gentamicin whereas group D received vitamin E capsule for total 10 days with gentamicin. Serum urea level was measured at the end of the experiment.</p> <p><strong>Results: </strong>The (mean±SD) serum urea levels in group A, B, C and D were 4.79±0.32, 12.41±1.22, 7.56±1.11 and 7.15±1.09 mmol/L respectively. The differences between groups were highly significant (p&lt;0.001) for group A &amp; B, A &amp; C, A &amp; D, B &amp; C, B &amp; D whereas the difference between C &amp; D (p&gt;0.01) was not significant. Serum urea level of the normal saline control group (group A) was within the normal limit (4.79 mmol/L). Serum urea level in gentamicin treated rats (group B) was more in comparison to gentamicin and vitamin E treated rats (group C &amp; D) and pretreatment with longer duration group (group D) showed lower serum urea value than shorter one (group C) though the groups showed no significant difference.</p> <p><strong>Conclusion: </strong>Vitamin E treatment showed some protective effect against gentamicin-induced nephrotoxicity. The results also indicated that effectiveness of vitamin E depends on duration of pretreatment that means the pretreatment duration must be increased to a suitable period for better protection against gentamicin-induced nephrotoxicity.</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 11-15</p> 2019-03-19T05:34:02+00:00 ##submission.copyrightStatement## Outcome of Mode of Delivery in Nulliparous and Multiparous Women Presenting with Early and Late Cervical Dilatation 2019-03-19T06:23:16+00:00 Ferdous Ara Shuchi Salma Lovereen Mst Nazumnnaher Mina <p><strong>Background: </strong>Knowledge of the patterns of normal and abnormal labour, and of women’s behavior, is fundamental to the formulation of mode of delivery. It is observed that women admitted to hospital early have a higher frequency of obstetric interventions in labour than those admitted later.</p> <p><strong>Objective: </strong>To study the outcome of spontaneous onset of labour in nulliparous and multiparous patients.</p> <p><strong>Materials and method: </strong>During the study period of 1st July 2008 to 31st Dec 2008, 568 pregnant women admitted in Kumudini Women’s Medical College were included in this study. Mothers were observed since admission with spontaneous onset of labour and followed up till they were released from the hospital. Labour outcome was measured and mode of delivery was compared among nulliparous and multiparous women.</p> <p><strong>Results: </strong>Among the nulliparous women, normal vaginal delivery occurred in 71 (23%) patients presented with early cervical dilatation (0-3 cm) and in 142 (46%) patients presented with late cervical dilatation (&gt;4 cm). In nulliparous women caesarean section were needed in 60 (45.8%) patients in early cervical dilatation group and in 35 (19.8%) patients in late cervical dilatation group. In multiparous women, normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation and in 133 (51%) patients presented with late cervical dilatation whereas cesarean section were done in 35 (34.7%) patients and in 25 (15.8%) patients in the two groups respectively. Duration of labour between nulliparous and multiparous was significantly different (8 hours vs. 6 hours). Indication of caesarean section were, 61 (40%) patients due to prolong labour, 48 (34%) due to foetal distress and 44 (26%) due to cephalopelvic disproportion.</p> <p><strong>Conclusion: </strong>Normal vaginal delivery occurred more and duration of labour was shorter in patients admitted with advanced labour (cervical dilatation &gt;4cm).</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 16-20</p> 2019-03-19T05:34:09+00:00 ##submission.copyrightStatement## Association of Chest Radiograph with Community Acquired Pneumonia among the Children Admitted in Dhaka Shishu Hospital 2019-03-19T06:23:18+00:00 Akhand Tanzih Sultana Mamun Miah Kazi Zahidul Hoque Jostna Ara Begum - Kamruzzaman - Nazia <p><strong>Background: </strong>Community-acquired pneumonia (CAP) is an infectious disease and common reason for hospitalization of children throughout the world. There are few published data about radiological findings and their relationship with community-acquired pneumonia (CAP) severity.</p> <p><strong>Objective: </strong>This study was conducted to evaluate radiological findings in children with community acquired pneumonia (CAP) of different severity.</p> <p><strong>Materials and method: </strong>A prospective study was conducted in the department of Paediatric Respiratory Medicine (Pulmonology) in Dhaka Shishu Hospital from November 2016 and April 2017. A total number of 35 children of 1 month to 10 years, who were admitted with cough or respiratory difficulty and radiological pneumonia were included in this study.</p> <p><strong>Results: </strong>Majority of the study participants 18 (51.43%) were infants with a male preponderance. The most common symptom was cough (94.29%) followed by fever (82.86%) and respiratory distress (42.86%). Crepitation (54.29%), tachypnoea (42.86%) and chest indrawing (28.57%) were the most common signs. Out of total 35 children 17 (48.57%) cases had pneumonia and 18 (51.43%) cases had severe pneumonia. Among chest X-rays, severe pneumonia had greatest frequency of primary end point consolidation (PEP) on right side (n=10, 55.55%), right infiltrates (n=5, 27.78%), bilateral infiltrates (n=2, 11.11%) followed by right sided pleural effusion (n=3, 16.67%) and pneumothorax (n=2, 11.11%). There was no association found between CAP severity and presence of radiological findings of pneumonia.</p> <p><strong>Conclusion: </strong>This study shows that severe CAP may not always be associated with positive radiological findings. This finding may be taken into consideration during the diagnosis and management of CAP.</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 21-25</p> 2019-03-19T05:35:02+00:00 ##submission.copyrightStatement## Situation of Working Slum Children in Dhaka City 2019-03-19T06:23:21+00:00 Shayela Farah Mohoshina Karim Sharmina Afrin <p><strong>Background: </strong>Rapid urbanisation in the 20th century has been accompanied by the development of slums. Nearly one-third of the world’s population and more than 60% of urban population in the least developed countries live in slums, including hundreds of millions of children. Slums are areas of broad social and health disadvantage to children and their families due to extreme poverty, overcrowding, poor water and sanitation, substandard housing, limited access to basic health and education services.</p> <p><strong>Objective: </strong>To assess the demographic and nutritional situation of working slum children in Dhaka city.</p> <p><strong>Materials and method: </strong>This descriptive cross sectional study was conducted at Moghbazar slum situated in Dhaka city from July to December, 2015.</p> <p><strong>Results: </strong>Out of 200 slum children, 57 (28.5%) were in the age group of 12-14 years, among them 110 (55.0%) were male. Regarding educational background, more than fifty percent never attended any kind of school. Forty five percent respondents lived with their parents. About 26% of the slum children were engaged in beggary, 23% were van/rickshaw puller, 22% were tokai, and 10% were cooli. Near about 75% respondents did medium type of work and 80% did 5-8 hour work per day and most of their income was 500-800 Tk. per month. One third respondents were severe under nourished, 50 (25%) were normal and 30 (15%) respondents were obese.</p> <p><strong>Conclusion: </strong>Increasing numbers of slums constitute a major challenge to development. Therefore, health related programmes should focus to improve the overall wellbeing of the working slum children.</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 26-30</p> 2019-03-19T06:20:43+00:00 ##submission.copyrightStatement## Substance Abuse among Bipolar Mood Disorder Patients 2019-03-19T06:23:24+00:00 Mohammad Harunur Rashid Ahsan Uddin Ahmed Muhammad Zillur Rahman Khan <p><strong>Background: </strong>Substance abuse is a major comorbidity among patients with bipolar mood disorder (BMD). In a major portion of patients with BMD substance abuse remains undiagnosed and untreated in Bangladesh.</p> <p><strong>Objective: </strong>This descriptive cross sectional study was conducted from November, 2014 to May, 2015 to determine proportion of substance abuse among patients with BMD.</p> <p><strong>Materials and method: </strong>A total of 151 patients with bipolar mood disorder were selected purposefully from both the inpatient and outpatient department of National Institute of Mental Health (NIMH), Dhaka, Bangladesh. Both male and female were included and informed written consent was taken from each respondent. During data collection, a structured questionnaire designed by the researchers containing socio-demographic and other variables was used.</p> <p><strong>Results: </strong>Among the respondents 23.8% was found to abuse substance.</p> <p><strong>Conclusion: </strong>So during the treatment of BMD the physicians should always search for substance abuse among the patients and treat them accordingly to achieve a fruitful outcome.</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 31-34</p> 2019-03-19T06:20:51+00:00 ##submission.copyrightStatement## Diabetic Peripheral Neuropathy: Epidemiology, Physiopathology, Diagnosis and Treatment 2019-03-19T06:23:08+00:00 Nazma Akter <p>Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes. It affects over 90% of the diabetic patients. It is widely accepted that the toxic effects of hyperglycemia play an important role in the development of this complication, but several other hypotheses have been postulated. It is typically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. DPN is often misdiagnosed and inadequately treated. Clinical recognition of DPN is imperative for allowing timely symptom management to reduce the morbidity associated with this condition. The management of diabetic neuropathic pain consists basically in excluding other causes of painful peripheral neuropathy, improving glycemic control as a prophylactic therapy and using medications to alleviate pain. First line drugs for pain relief include anticonvulsants, such as pregabalin and gabapentin and antidepressants, especially those that act to inhibit the reuptake of serotonin and noradrenaline. In addition, there is experimental and clinical evidence that opioids can be helpful in pain control, mainly if associated with first line drugs. Other agents, including for topical application, such as capsaicin cream and lidocaine patches, have also been proposed to be useful as adjuvant in the control of diabetic neuropathic pain, but the clinical evidence is insufficient to support their use. The purpose of this review is to examine proposed mechanisms of DPN, summarize current treatment regimen. A better understanding of the mechanisms underlying diabetic neuropathic pain will contribute to the search of new therapies.</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 35-48</p> 2019-03-19T06:20:55+00:00 ##submission.copyrightStatement## Large Foreign Body in Nose in Adult for a Long Time: A Rare Case 2019-03-19T06:23:09+00:00 KM Reza Ul Haq Refat Tabassum Shoriful Islam Asif Imran Siddiqui Mohammad Arman Zahed Basunia Russel Ahmed Khan Lodi Mithun Kumar Paul Md Amirul Islam <p>Otolaryngologists frequently encounter nasal foreign bodies, particularly among children and mentally retarded patients. Many unusual foreign bodies in the nose have been reported like nuts, plastic toy parts, beads and even button batteries. Several symptoms may be present in the case of a nasal foreign body which includes nasal discharge, epistaxis, infection, halitosis, foul breath or body odour and chronic sinusitis. We present a case of 19 years old girl with left sided nasal blockage, foul smell from left nostril and mouth with occasional nasal bleeding for last 13 years. She was treated conservatively but was not improved. On anterior rhinoscopy some blackish material covered with exudates was revealed which was very foul smelling and bleeds on touch. After nasoendoscopy we suspected that it would be an old foreign body which had already formed rhinolith. The large foreign body was fixed with floor, lateral and medial wall (nasal septum) and was removed by 0˚nasoendoscope and also through oral cavity under general anaesthesia.</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 49-52</p> 2019-03-19T06:21:01+00:00 ##submission.copyrightStatement## Reviewers in this issue Vol.7(1) 2019-03-19T06:23:11+00:00 Md Rezwanur Rahman <p>Abstract not available</p> <p><em>Delta Med Col J. </em>Jan 2019 7(1): 53</p> 2019-03-19T06:21:30+00:00 ##submission.copyrightStatement##