Eastern Medical College Journal

Peripartum Cardiomyopathy: A Review

Shabera Arzoo, Musammat Shamima Akter, Maher Akther, Fatematul Jannat — Thu, 23 Nov 2023 00:00:00 +0000

Peripartum cardiomyopathy (PPCM) is a rare, idiopathic, and often dilated cardiomyopathy that is marked by systolic dysfunction that presents in late pregnancy or the early postpartum period. A workshop convened by the US National Heart, Lung, and Blood Institute (NHLBI) in the 1990s defined PPCM as heart failure that develops in the last month of pregnancy or up to five months postpartum with left ventricular systolic dysfunction. Prior to the availability of echocardiography, diagnosis was based only on clinical findings. Recently, the inclusion of echocardiography has made diagnosis of PPCM easier and more accurate. Etiopathogenesis is still poorly understood, but recent evidence supports inflammation, viral infection, and autoimmunity as the leading causative hypotheses.

Eastern Med Coll J. July 2023; 8 (2):68-74

Lack of Attention in Health Management

Musleh Uddin Ahmed — Thu, 23 Nov 2023 00:00:00 +0000

Abstract not available

Eastern Med Coll J. July 2023; 8 (2): viii

Repair of Post-Infarction Ventricular Septal Rupture and Ventricular Aneurysm: A Case Report

Thu, 23 Nov 2023 00:00:00 +0000

Ventricular septal rupture is one of the fatal complications of acute myocardial infarction. With the advancement of medical management and availability of emergency cardiac care, the incidence of post infarct ventricular septal rupture has reduced considerably. We report a case, unique in being a late presentation of post infarct ventricular septal rupture with left ventricular aneurysm. The Ventricular septal rupture was repaired using a PTFE patch, followed by reinforced linear closure of aneurysm by a glutaraldehyde treated pericardial felt and revascularization using reversed saphenous vein graft to left anterior descending artery. The patient survived surgery with an uneventful postoperative course.

Eastern Med Coll J. July 2023; 8 (2):75-77

Levels of Patient Satisfaction Regarding Healthcare Services in Upazila Health Complexes

Thu, 23 Nov 2023 00:00:00 +0000

Background: Patient satisfaction always influences a person to estimate the quality of their healthcare experiences and maintains a continuous relationship with the physicians. The scope of healthcare services varies from country to country.

Methodology: A hospital-based cross-sectional study was conducted to assess the levels of patient satisfaction regarding healthcare services among the 202 patients in the purposively selected Upazilla Health Complexes (UHCs) located in Dhaka, Bangladesh.

Results: The mean age of the service receivers was 38.88±12.48 years, more than half (56.9%) were homemakers and had no formal education (32.7%), and they came from lower-income families (83.7%). Two-thirds (65.8%) of the patients have received services from OPD. Above half of the patients (59.0%) were satisfied with the services of the UHCs. The satisfaction with doctors was statistically significant with patient occupation and family income; satisfaction with nurse’s services was significant with patient’s education, occupation, and family income; satisfaction with paramedic services was significant with patient’s age and family income. Satisfaction about treatment, cleanliness, environment, and health services of the UHCs were significant with education. Satisfaction with investigation services was significant with education and family income. The patient’s occupation was also significant with the levels of patient satisfaction.

Conclusion: To improve the patient satisfaction proper attention should be given to the cleanliness of the UHCs and informing people about all the services of the UHCs.

Eastern Med Coll J. July 2023; 8 (2): 31-38

Increased Body Mass Index & Waist Circumference are Associated with Female Infertility: A Cross-Sectional Study

Thu, 23 Nov 2023 00:00:00 +0000

Background: The prevalence of obesity and overweight are increasing and has become an epidemic worldwide. Obesity has detrimental influences on all systems, including reproductive health. Obesity can lead to menstrual disturbance, anovulation, miscarriage, pregnancy complications and subfecundity and infertility. This study aimed to investigate the effects of body mass index (BMI) and waist circumference (WC) on infertility in women of childbearing age.

Methodology: This was a hospital based cross-sectional observational study comprising hundred (100) infertile women aging 18-35 years in Outpatient Department of Obstetrics & Gynaecology and Endocrinology in Chittagong Medical College Hospital and Department of Biochemistry, Chittagong Medical College, Chattogram. Samples were taken by non-probability consecutive sampling. Important variables in this study were age, BMI, waist circumference and Blood Pressure.

Results: Most of the infertile women were 21-30 years. In the study, among the infertile women increased BMI was found in 50% cases and increased waist circumference was found in 76% cases.

Conclusion: Overweight and obese patients should be informed about the importance of pre-pregnancy weight reduction and should be encouraged to lose weight before the treatment to reduce the poor obstetrical outcomes due to obesity.

Eastern Med Coll J. July 2023; 8 (2):39-42

Comparison Between Simple Closure and Subcutaneous Negative Pressure Drain Closure in Laparotomy Wound of Gastrointestinal Perforation

Thu, 23 Nov 2023 00:00:00 +0000

Background: surgical site infection (SSI) is an infection that occurs after surgery in the part of the body where the surgery took place. SSI is very common in patients of perforation peritonitis if the wound is primarily closed in the setting of gross abdominal contamination. Even after thorough peritoneal irrigation with normal saline, the incidence of wound infection is high. If the wound infection is controlled, then many complications related to it could be prevented.

Aim of the study: The aim of this study was to compare simple closure and subcutaneous negative pressure drain closure in laparotomy wounds of gastrointestinal perforation regarding the features, incidences, management, and outcomes.

Methodology: This clinical trial study was conducted at the surgical units of Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from July 2014 to June 2015. A total of 108 cases were selected by inclusion criteria. All the patients were divided in two groups; group A-where negative suction drain was not used and Group B-where a negative suction drain was used in the subcutaneous space at the time of closure of the abdomen after perforation and thorough peritoneal toilet. As per the inclusion criteria of this study patients undergoing emergency laparotomy due to gastrointestinal perforation, aged up to 60 years old, non-diabetic, non-anemic, normal renal function, non-jaundiced and normal nutritional status were included. The outcome compared in the form of wound infection, hospital stay, second surgery and morbidity.

Results: In this study, the average rate of SSI was found 55.76% (29/52) in group A and 30.36% (17/56) in group B. Average hospital stay for group A and group B were 19 days and 12 days respectively. Second surgery was needed in 4 cases in group A and for 8 cases in group B. The second surgery was done in the form of secondary suturing of wound or wound dehiscence and burst abdomen repair. Mortality in group A was 8 and in group B it was 4; but it was not related to SSI because all death occurred within 3 days after surgery mainly due delay presentation and to poor general condition pre-operatively. Overall morbidity was less with negative pressure closure compared to simple closure and it highly affects the morbidity and somehow mortality also.

Conclusion: The application of a subcutaneous negative pressure drain may be effective in preventing superficial surgical site infection and may reduce hospital stay, treatment cost, morbidity, and mortality. There is more chance of wound infection in such laparotomy wound because of highly contamination of the peritoneal fluid with fecal material. Such wound constantly leads to serous discharge and bacterial colonization. But negative pressure closure removes that collection and avoids wound infection, and it helps in reducing hospital stay and morbidity.

Eastern Med Coll J. July 2023; 8 (2):43-47

Evaluation of Fecal Occult Blood Test for Screening of Colorectal Carcinoma

Thu, 23 Nov 2023 00:00:00 +0000

Background:Colorectal carcinoma is one of the most common and leading causes of cancer-related death in the United States. Fecal occult blood test used as a screening test followed by sigmoidoscopy or colonoscopy to early detection of colorectal carcinoma.

Objective: To assess the fecal occult blood by fecal occult blood test of the patients who fulfill the criteria as a screening for colorectal carcinoma and evaluation of those patients who are positive for fecal occult blood test for early detection of colorectal carcinoma by fiber optic full colonoscopy.

Materials and Methods:This hospital based observational study was carried out in Dhaka Medical College Hospital, Dhaka, Bangladesh for a period of 6 month from July 2009 to December 2009. A total of 50 cases were selected by convenient sampling fulfilling the inclusion and exclusion criteria. Those who had positive fecal occult blood test were further advised for fiber optic full colonoscopy and biopsies were taken where necessary as a screening for colorectal carcinoma.Reported results and relevant data were recorded in the data sheet and then analyzed by standard statistical method.

Results: Total number of cases was 50. Adequate samples were obtained in 46 (92%) cases, among the adequate samples 18 (36%) were malignant and 28 (56%) were benign or nonmalignant lesions. Among the benign lesions, nonspecific colitis (13;26%) was the most common followed by rectal polyp (1;2%), proctocolitis (1;2%) and Normal tissue (1:2%). Adenocarcinoma (18;36%) was the most common type of colorectal carcinoma. In male, colorectal carcinoma (15;30%) was the more common than female (3;6%).

Conclusion: Guaiac based FOBT is a simple and less expensive test for identification of occult blood in stool. It is easily done with minimum cost and suitable test as a screening for early diagnosis of colorectal cancer. FOBT positive patient’s fiber optic colonoscopy is a wonderful investigation for further diagnosing the colonic lesion.

Eastern Med Coll J. July 2023; 8 (2):48-53

Occupational Health Problems and Healthcare Seeking Behaviour among Power-loom Workers

Thu, 23 Nov 2023 00:00:00 +0000

Background: Power-looms sector plays a significant role in the economic growth of Bangladesh. Occupational health problem is a burning issue for developing and developed countries whose economies are dependent on labour-intensive industrial sectors, such as the power-loom sector.

Materials &Methods: A cross-sectional study was conducted to assess the occupational health problems and health care seeking behaviour among 332 power-loom workers working in Sirajganj district, Bangladesh through face-to-face interviews by a pretested semi-structured questionnaire.

Results: The mean age of the power-loom workers was 31.7±10.4 years and a considerable number of participants (28.9%) had no formal education. Most workers (85.5%) were full-time power-loom workers, which is relevant to factors connected to health concerns and healthcare seeking behaviours. The mean working hours were 12.4±3.1 hours, working days were 6.0±0.3 days and 47.9% of the respondents reported feeling stressed while at work. Most of the power-loom workers (91.9%) were dependent on allopathic treatment. Many of the workers (78.3%) believed that their government did not provide a hospital and that NGOs only operated in a limited capacity (16.3%). It was stated that there was no maternity leave or allowance for the 100% female workforce. Presence of emergency measures was available opined by the half of the workers (49.1%). Lower back pain, neck discomfort, and upper back pain were the three most common musculoskeletal conditions, and they were substantially correlated with worker age and working hours.

Conclusion: The study concludes that power-loom workers are prone to develop musculoskeletal problems and strategies need to be developed to limit the problem and to promote their health.

Eastern Med Coll J. July 2023; 8 (2):54-60

Quality of Life and Its Accompanying Factors among Adult Female Patients with Chronic Bronchial Asthma

Thu, 23 Nov 2023 00:00:00 +0000

Background: Asthma is a well-known chronic respiratory disease and a common global health problem. In Bangladesh, more than 100 million people are suffering from cough and shortness of breath. Patients with a known diagnosis of asthma are an important determinant of reduced quality of life.

Objectives: To determine the quality of life and its accompanying factors among adult female patients with chronic bronchial asthma.

Materials and methods: This cross-sectional study was conducted at the National Institute of Diseases of the Chest and Hospital, Dhaka from January to December 2021. Total eighty-five diagnosed adult female bronchial asthma patients were included in this study. Data were collected by face-to-face interviews with a semi-structured questionnaire using the Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Test (ACT) scale. The checklist was used for collecting data by reviewing medical records.

Results: Among all the patients, the mean (±SD) age was 39.74±8.98 years and the highest frequency 48 (56.5%) patient’s age were in the 31-45 years group. In this study, the mean AQLQ score was 3.55 so, it indicated a moderate degree of impairment of quality of life and the most affected domain was environmental stimuli. Among all patients, 52 (61.2%) had partially controlled asthma. The study finding showed that the level of impairment of quality of life decreased with the increase of age (p=0.001). Uncontrolled asthma was associated with a lower quality of life (p=0.001). The low educational level 25 (29.4%), residing in rural areas 26 (30.6%) and having comorbidity 44 (51.8%) adversely affected the level of AQLQ.

Conclusion: Now a day’s chronic bronchial asthma is a major public health issue, and it affects the quality of life. So, the current study may contribute to the prevention of worsening the level of impairment of quality of life in bronchial asthma patients.

Eastern Med Coll J. July 2023; 8 (2):61-67