KYAMC Journal

Xeroderma Pigmentosum in a Child: An Early Ocular Manifestation

Tue, 16 Jan 2024 00:00:00 +0000

A 17 month old boy of first degree consanguineous parents came with the history of poor vision and photophobia. He also had multiple hyper pigmented skin lesions all over the body since 8 months of age. The skin lesions were generalized, hyper pigmented, non-tender, not itchy but photosensitive. Initially the skin lesion was treated by local physicians but when the lesion was spreading, and subsequently when he had developed visual problem, then visited to pediatrician. There was no history of similar type of skin disorder in his family. His developmental millstone was age appropriate. His eyes were sensitive to sunlight and exposure to light causes redness along with poor vision. There was large corneal diameter, conjunctival xerosis, intense photophobia and poor vision in both eyes. Skin survey revealed hyper pigmented macules. Hair and nail apparatus were normal. There was no mucosal or dental involvement, no ulceration or growth elsewhere. Hearing was normal. By a multidisciplinary team this case diagnosed as Xeroderma Pigmentosum clinically. This case managed by proper counselling, advised to protection from sun light and follow up. We like to share our experience of diagnosing and treating this rare case in child with early ocular manifestation.

KYAMC Journal Volume: 14, No: 03, October 2023: 175-177.

Viral Hepatitis: HBV-HCV co-infection

Tue, 16 Jan 2024 00:00:00 +0000

Co-infection with HBV and HCV is a complex clinical existence which estimated prevalence is reported 0.7% to 16% worldwide. HCV superinfection is very common due to viral replication in HCV is more dominant over HBV. Most of the clinical studies reported that disease progression is faster in HBV and HCV co-infected patients in compare to those with mono-infection. Therefore, early diagnosis and proper treatment is important for withholding the disease progression. Here a case of 45 years old male with fever, anorexia, vomiting and mucus mixed stool. HBsAg and anti-HCV are positive. USG of whole abdomen suggesting chronic liver disease with chronic kidney disease. Endoscopy of upper GIT revealed grade III esophageal varices. There are no established guidelines for treatment of HBV-HCV co-infection. Only symptomatic treatment was given.

KYAMC Journal Volume: 14, No: 03, October 2023: 178-180.

Inter-Sphincteric Resection of Rectum for Ulcerated S-100 Negative Large Granular Cell Tumour

Tue, 16 Jan 2024 00:00:00 +0000

Non-neural granular cell tumor was first described in 1991 as an unusual primitive, polypoid variant of the conventional GCT (granular cell tumor). To date, this neoplasm remains as a rare entity and the cell of origin is uncertain. While the histological features are similar to the conventional (traditional) GCTs, it represents a distinct entity, as it is negative for S-100 and lacks true nerve sheath differentiation. We report here a case of a 49-year-old male patient with S-100 negative, vimentin positive large benign, ulcerated, bleeding non-neural GCT in the lower rectum. We confirmed the diagnosis histopathologically and immunohistochemically. We treated it by ISRR (Inter-Sphincteric Resection of Rectum) and primary colo-anal anastomosis. We find no other report of non-neural GCT located in the rectum in surgical literature. This is probably the first case of non-neural GCT identified in the rectum. This case report is presented here to document a non-neural GCT located in the rectum for the first time ever reported, and also to highlight the optimum best surgical approach, as we deemed here for this large ulcerated bleeding tumor in the rectum. This rectal non-neural GCT posed here as an unusual differential diagnosis from such more common neoplastic bleeding lesions in the rectum as carcinoma rectum, hemorrhoid, rectal polyp, etc. Here we like to discuss our experience, reviewing in brief the available literature implicating the biological behavior, histopathological and immunohistochemical features, differential diagnosis and therapeutic considerations of neural and non-neural GCTs.

KYAMC Journal Volume: 14, No: 03, October 2023: 181-187.

Electrophysiological Evaluation of Common Peroneal Nerve in Chronic Cigarette Smokers.

Tue, 16 Jan 2024 00:00:00 +0000

Background: Researchers have identified multiple negative health effects of smoking on the respiratory and cardiovascular systems. It was recently reported that substances in cigarette smoke also have pathological effects on peripheral nerves, which causes neuronal impairment. The common peroneal nerve conduction study is an essential electrodiagnostic test of the lower limb for the detection of peripheral motor nerve dysfunction.
Objectives: To assess the potential influence of smoking on the electrophysiological status of common peroneal nerve in young male chronic cigarette smokers.
Materials and Methods: This case-control study was conducted in the Department of Physiology, Sir Salimullah Medical College, Dhaka, from July 2017 to June 2018, including thirty male cigarette smokers aged 25 to 40 years. For comparison, another thirty age and BMI-matched healthy male non-smoker subjects were selected in the control group. The electrophysiological parameters (distal latency, amplitude, and motor nerve conduction velocity) of the left common peroneal nerve were evaluated by standard methods in the Department of Neurology, Dhaka Medical College Hospital. For the statistical analysis, an independent t-test was performed.
Result: In this study, the mean distal latency of the common peroneal nerve was slightly prolonged, while the mean amplitude was slightly reduced in smokers. However, these changes were not statistically significant. However, the motor nerve conduction velocity was significantly (p ˂ 0.05) slower in cigarette smokers compared to non-smokers.
Conclusion: Chronic cigarette smoking causes significant impairment of common peroneal motor nerve conduction, while it does not affect the amplitude in young individuals.

KYAMC Journal Volume: 14, No: 03, October 2023: 111-115.

Profile of Poisoning cases Attending in the Emergency Department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH), Enayetpur, Sirajganj.

Tue, 16 Jan 2024 00:00:00 +0000

Background: Poisoning is a significant global public health problem. In many countries acute poisoning is one of the common scenarios in the emergency department of any general hospitals globally but it’s pattern may vary in different parts of the world and even may be different regional variation in the same country.
Objective: In this study our main goal is to evaluate the Profile of Poisoning cases attending in the Emergency Department of Khwaja Yunus Ali Medical College & Hospital (KYAMCH), Enayetpur, Sirajganj.
Materials and Methods: This cross-sectional study was carried out at the emergency department of Khwaja Yunus Ali Medical college and hospital (KYAMCH), Enayetpur, Sirajganj from January’21 to December’21. Total 80 poisoning cases were collected by using a pre-designed format from Emergency register book/ records, for the study, were those who had undergone exposure to poison either by household or agricultural pesticides, stings bite or snake bite, industrial toxins or toxic plants, drug or miscellaneous products.
Results: During this study, the majority were belonging to 16-30 years age group (65%), (55%) were Female and (75%) were Muslims, most of the cases were Suicidal (70%) and no Homicidal case was recorded. Besides that, (20%) poisoning cases were due to Barbiturate, followed by (12.5%) were Organo-phosphorous compound poisoning as well as copper sulphate poisoning. (35%) victim came to hospital within 2 hours to 6 hours and (73.75%) cases were shifted to General bed, followed by (11.25%) cases were Admitted in ICU and (31.25%) cases were found during spring.
Conclusion: From our study, we can say that suicidal cases and Barbiturate poisoning were commonly seen. Besides that, young and middle-aged female people are mostly vulnerable to poisonous cases.

KYAMC Journal Volume: 14, No: 03, October 2023: 116-119.

Prevalence, Risk Factors and Perceived Effects of Workplace Violence on Nurses.

Tue, 16 Jan 2024 00:00:00 +0000

Background: Workplace violence (WPV) in healthcare settings is a significant global occupational and mental health concern, which is a major stressor for nurses, particularly in middle-income and low-income countries. It has serious negative consequences for the physical and mental well-being of healthcare workers and threatens the workplace environment for providing healthcare services.
Objective: To determine the prevalence, risk factors, and perceived effects of workplace violence on nurses in a purposively selected medical college hospital situated in Dhaka, Bangladesh.
Materials and Methods: A hospital-based cross-sectional study was initiated to determine the prevalence, risk factors, and perceived effects of workplace violence among the 220 nurses working in the Shaheed Suhrawardy Medical College Hospital.
Results: Most of the nurses (50.5%) faced violence in their workplace, or outside of the workplace or both. Among them 45.9% faced violence in their workplace alone, 38.8% faced violence in both places and 15.3% faced violence on the way to their workplace in terms of violence outside the workplace alone. Regarding the type of WPV and violence outside the workplace (VOW), the majority of the nurses experienced psychological violence (93.6% and 81.7%, respectively). Nurses' age, marital status, work experiences, and workplace distance from residence all had a statistically significant (p<0.05) relationship with their experience of violence. The sex of the nurses and the distance of their workplace from their residence were similarly statistically significant (p<0.05) about the place of occurrence of the incident. In addition, Nurses' age and marital status were statistically related (p<0.05) to different types of workplace violence.
Conclusion: Workplace violence has a negative impact on both the health and productivity of nurses. Workplace regulations and protocols focusing on safety in the workplace, reporting and surveillance, and education for all employees and management on how to avoid and handle violence are required. The hospital administration has also prioritized initiatives to minimize violence.

KYAMC Journal Volume: 14, No: 03, October 2023: 120-129.

Comparison of Different Diagnostic Methods of Helicobacter Pylori Infection in Children

Tue, 16 Jan 2024 00:00:00 +0000

Background: Helicobacter Pylori Infection (HPI) is usually acquired during childhood, without specific treatment this infection rarely resolves spontaneously. Therefore, correct diagnosis is necessary for the effective eradication and there is no single test can be regarded as the gold standard for the identification of H. pylori.
Objective: To compare the sensitivity, specificity, and accuracy of the stool antigen test, serologic test, rapid urease test, and histology for the diagnosis of H. pylori infection.
Materials and Methods: This cross-sectional descriptive study was conducted at the Department of Pediatric Gastroenterology & Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2019 to October 2021 on 54 children aged less than 18 years suspected to be H. pylori infection, who attended the outpatient as well as admitted. In a typical data sheet, a complete clinical history, exam results, and investigation reports were documented. Results were expressed as sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy.
Results: The gastro-duodenal biopsy and Rapid Urease Test (RUT) (100%) have the highest sensitivity, followed by serology (95%), and Saturation (SAT) (70%). Highest specificity was found in gastro-duodenal biopsy 88.2% followed by RUT 67.6% & SAT 41.2% and only 32.4% by serology. The gastro-duodenal biopsy had the highest diagnosis accuracy (92.6%), followed by RUT (79.6%), serology (55.6%) and SAT (51.9%).
Conclusion: In the study, the gastro-duodenal biopsy and rapid urease test both showed high sensitivity, specificity, and negative predictive value; as a result, the combination of these tests constituted the best alternative for making the diagnosis. Because of their high sensitivity, serological tests may be useful non-invasive screening methods.

KYAMC Journal Volume: 14, No: 03, October 2023: 130-137.

Correlation of Prostate Volume, Uroflowmetry Variables and BMI in Patients Having Clinical Benign Prostatic Hyperplasia.

Tue, 16 Jan 2024 00:00:00 +0000

Background: Benign Prostatic Hyperplasia (BPH) causing urinary obstruction is a common entity in a man over 40 years old. Enlarge prostate causes compression of the prostatic part of the urethra leading to bladder outflow obstruction, causes LUTs (lower urinary tract symptoms) of BPH and decreases quality of life.
Objectives: To find out the correlation of prostate volume, and BMI with Uroflowmetry variables, of patients having BPH symptoms.
Materials and Methods: A total of 44 patients having BPH symptoms, ages ranging from 48 to 85 years, who underwent transabdominal ultrasound and uroflowmetry in a standing position, were included in this study. The patients were divided into 4 age groups and 4 grades of prostate size for comparison. Height in cm and weight in Kg were recorded for BMI calculation.
Results: Among the patients, the mean age was 66.25, with a mean prostate size of 39.73 g, with a Qmax of 14.45 ml/sec, Qave 5.96 ml/sec, mean voided volume 327.14 ml and PVR 57.91 ml with mean flow time 61 sec.In age group l, there were 3 patients, ages ranged 40 to 50 years. In age group ll, there were 11 patients, age range 51 to 60 years. In age group lll, there were 17 patients, ages ranged 61 to 70 years. In age group lV, there were 13 patients, age range 71 to 84 years. In grade l of prostate size (prostate <30 g), there were 13 patients. In grade ll prostate size (prostate 30-<50 g ), there were 25 patients. In grade lll, prostate size (50- <85 g), there were 4 patients. In grade lV (prostate size is >85 g), there were 2 patients. No significant difference was found among 4 age groups and 4 grades of prostate volume. However, there was a weak correlation between prostate size and uroflowmetry variables without a significant difference.
Conclusion: There was a correlation between prostate volume and different uroflowmetry variables of age-related groups and grades of the prostate but the correlation was weak.

KYAMC Journal Volume: 14, No: 03, October 2023: 138-144.

Impact of Closure of Medical Colleges due to COVID 19: The Scenario of Online Classes and Learning Outcome in Undergraduate Medical Students.

Tue, 16 Jan 2024 00:00:00 +0000

Background: During Coronavirus disease (COVID 19) pandemic all educational institutions including the medical colleges in Bangladesh were closed for more than ten months. In this period all classes for undergraduate medical students like lectures and practical classes were taken by online platform. For this reason, the scenario of online classes and learning outcome need to be assessed among undergraduate medical students during COVID 19 pandemic.
Objective: To find out the scenario of online classes and learning outcome in undergraduate medical students during the COVID-19 pandemic.
Materials and Methods: An observational study, among different years of MBBS medical students exposed to both online and offline classes during COVID pandemic from 2020 -2021. This study was carried out by the Department of Pharmacology and Therapeutics, at Khwaja Yunus Ali Medical College (KYAMC). A total number of 237 medical students from different years were included randomly in this study. Among them 99 male and 138 female medical students participated. To collect data, a questionnaire form was supplied to the participants to fill up. This form contained some demographic criteria, health issues during online classes, internet connectivity issues, problem faced by students, opinion to encourage online classes in future and causal factors of lack of interest. In addition, we also made a comparison between marks obtained in case of online and offline written examinations (SAQ) and oral examinations (SOE).
Results: The result showed that anxiety and depression were developed in 53.59% and 44.30% of medical students respectively due to COVID-19. Eyesight problem was developed in 66.66% of medical students due to online classes. 50% of students reported the communication gap between patients and students during practical classes. 52.74% of medical students did not recommend such types of online classes in the future. The comparison between online and offline examinations showed that the results of offline exams were better than online.
Conclusion: During COVID pandemic we used online classes as an alternative teaching-learning process. But we found poor
performance in their exams. The students also did not suggest online classes in the future.

KYAMC Journal Volume: 14, No: 03, October 2023: 145-150.

Quality of Work Life among Nurses Working in Secondary Level Hospitals in Bangladesh

Md Golam Abbas, Ummay Thamima — Tue, 16 Jan 2024 00:00:00 +0000

Background: Nurses play a crucial role in the healthcare delivery system. The phrase "quality of work life" (QWL) describes the range of elements that affect how successfully nurses can balance their personal and professional lives.
Objective: To assess the level of quality of work life among nurses working in secondary-level hospitals in Bangladesh.
Materials and Methods: To assess the quality of the work-life balance, a cross-sectional study including 232 nurses working in secondary-level hospitals was carried out from January to December 2022. The WALTON QWL scale was used to construct the questionnaire.
Results: The QWL score average was 126.0±9.3. About two-thirds of the nurses (71.1%) among them reported moderate QWL. The nurses' QWL was statistically significant when considering their recent night shifts, their capacity to eat at the proper times, their ability to spend time with friends and family, their conflicts with coworkers, and their conflicts with doctors (p˂0.05). The majority of nurses who worked night shifts in the past month (75.1%) reported having moderate QWL, which included being able to take breaks during work hours (66.7%), experiencing sudden changes in the shift schedule (68.2%), not being able to eat at the right time (79.6%), not having many opportunities to spend time with family and friends (81.85), and having conflicts with coworkers (84.1%) and doctors (87.5%).
Conclusion: The study revealed that most of the nurses experienced moderate levels of QWL. The prevalence of QWL among nurses may have affected patient care, satisfaction with care, increased medical errors, and decreased overall hospital job efficiency. Enhancing nurses' QWL will help to raise the standard of nursing care given to patients at all levels and, as a result, increase their productivity.

KYAMC Journal Volume: 14, No: 03, October 2023: 151-157.

Clinicodemographic Pattern of Death in Road Traffic Accidents at Tangail Medical College.

Tue, 16 Jan 2024 00:00:00 +0000

Background: Rapid motorization bought a boon along with the curse of road traffic accidents toll. Injuries and death due to RTA are one of the major public health problems across the globe, especially in developing countries, due to lack of comprehensive legislative measures. RTA are responsible for the greatest number of injuries and fatalities worldwide by killing around 1.2 million people each year and injuring another 50 million. It will have an immeasurable impact on the families affected by RTA.
Objective: To evaluate the situation of RTA in Tangail and to find out the pattern of injuries present in the dead bodies in RTA.
Materials and Methods: This is a retrospective study based on autopsy reports conducted to find out the pattern of death due to road traffic accidents in Sheikh Hasina Medical College and Hospital, Tangail during the period from 1st January 2020 to 31st December 2020. After reviewing all postmortem reports 53 cases were found due to RTA, including railway accidents during this study period.
Results: A total of 391 postmortem were conducted during the study period from January 2020 to December 2020 and out of which 53 cases were RTA. Female deaths were only 12( 22.64%) and the majority of the deaths were male 41( 77.36%). The highest percentage of deaths were found in the age group 21-30 year 21( 39.62%), followed by 31-40 (18.87%), 41-50 years( 16.98%). According to the types of vehicles, buses and lorries were responsible for the deaths. Regarding the types of victim distribution, pedestrians 28 (52.83(%) were the highest percentage and vehicle occupants were 15(28.30%). Among total cases, head injury (41.51%) was the highest percentage responsible for deaths, followed by fracture of the skull bone ( 41.51%), fracture of the long bone ( 16.98%), chest injuries( 22.64%) and pelvis fracture (5.66%.)
Conclusion: Strict enforcement of traffic law, using seatbelts, maintaining the fitness of vehicles, driving licenses, improving public awareness, etc., can reduce this economic burden and protect vulnerable groups of people in our country.

KYAMC Journal Volume: 14, No: 03, October 2023: 158-160.

Clinico Pathological Study of Solitary Thyroid Nodule - A Prospective Study of 50 Cases.

Md Asaduzzaman, Md Moshiur Rahman, Mohammad Abdus Salam, Mahmudul Hasan Suzan — Tue, 16 Jan 2024 00:00:00 +0000

Background: A common Presentation of thyroid disorder is solitary nodule. A discrete swelling in an impalpable gland is termed as solitary nodule of thyroid. The majority of solitary thyroid nodule are benign. The incidence of malignancy is more common in female with mean age 35 years. Timely intervention in nodular lesion of thyroid can significantly reduce morbidity and mortality.
Objectives: The objective of this study was to evaluate the clinicopathological aspects of solitary thyroid nodule.
Materials and Methods: This study was conducted in the department of otolaryngology and general surgery of Shaheed Monsur Ali Medical College and Hospital in 50 patients with Solitary Thyroid Nodule from July 2016 to July 2019. All the patients those who were diagnosed solitary thyroid nodule underwent thyroid surgery after through clinical evaluation, USG and FNAC. The histopathological reports were evaluated and correlated with clinical diagnosis and discussed.
Results: Out of 50 patients’ majority were female only 8 were male patients. Peak incidence observed in the age group 30 to 40 years. Most of the patients presented with a swelling in front of neck 100% followed by pain 8%, dysphagia 4% and change of voice 4%. Swelling is located in the right lobe 70% followed by left lobe 26%. On FNAC examination they were presented with colloid nodular goitre 66%, follicular neoplasm 14%, thyroiditis 8%, papillary carcinoma 4% & cystic lesions 8%. But final histopathological report showed highest 30 (60%) cases was nodular goiter then follicular adenoma 10 (20%) and 6 (12%) were malignant.
Conclusion: From this study we considered that STN is present most commonly in female. Most of them are benign, but remarkable proportion 12% of solitary thyroid nodule were malignant, so careful assessment of thyroid nodule is important for early diagnosis and treatment.

KYAMC Journal Volume: 14, No: 03, October 2023: 161-164.

Effects of Perceived Parenting on Adolescent Psychological Well-being.

Tue, 16 Jan 2024 00:00:00 +0000

Background: Parenting has become increasingly important in the contemporary world, with an emphasis on many aspects and forms of parenting. It has a direct impact on the child's physical as well as psychological well-being and development.
Objective: To determine the effects of perceived parenting on psychological well-being of late adolescents at Police Lines School and College, Rangpur, Bangladesh.
Materials and Methods: A cross-sectional study was directed to determine the effects of perceived parenting on the psychological well-being of late adolescents at Police Lines School and College, Rangpur, Bangladesh. The semi-structured questionnaire was constructed to measure the psychological well-being of adolescents by ‘Ryff Scales of Psychological Well-Being’.
Results: The mean age of the participants was 17.7±0.6 years and about two-thirds of them were from the age group ≥18 years (61.1%). Regarding the psychological well-being of adolescents, the mean scores of autonomy were 3.6±0.7, environmental mastery was 4.1±0.9, personal growth was 4.6±0.6, a positive relationship was 4.1±0.8, purpose in life was 4.5±1.0 and self-acceptance was 4.1±0.8. Most of the adolescents slightly agree on autonomy (49.1%), environmental mastery (43.4%), positive relationship (51.4%), self-acceptance (50.9%) and average agrees on personal growth (55.7%), purpose in life (40.6%). The mean of PWB scores was 4.2±0.5. Two-thirds of the participants (67.1%) slightly agreed about the psychological well-being of the adolescents and only 6.3% slightly disagreed. The level of psychological well-being of adolescents was statistically significant with autonomy, environmental mastery, personal growth, positive relationship, purpose in life, and self-acceptance (p<0.05).
Conclusion: The study found that the more intense the perceived parenting, the lower the psychological well-being. Parenting awareness and counseling programs can support parents in improving their parenting style.

KYAMC Journal Volume: 14, No: 03, October 2023: 165-171.

Dengue Vaccine: Challenges and Limitations

Tue, 16 Jan 2024 00:00:00 +0000

Dengue is a common mosquito-transmitted viral infectious disease. Due to global warming and other climate changes, the dengue virus vector Aedes aegypti mosquito is breeding rapidly and spreading the dengue worldwide. As a result, every year, millions of people are infected by the dengue virus and tolls thousands of lives across the world. World Health Organization (WHO) has given a terrible message that dengue can become as an epidemic. Therefore, the invention of an effective dengue vaccine is a way to build the body’s immunity to fight against the disease. Efforts to develop a vaccine against dengue have been ongoing for decades. Currently, Dengvaxia is approved for use by individuals to prevent dengue with some limitations. Another vaccine, Qdenga is also shown to be effective against verities of dengue virus serotypes but this vaccine is not approved by the USA Food and Drug Administration (FDA) yet. Neither Dengvaxia nor Qdenga has approved in Bangladesh and other low and middle-economic countries due to its conservative approach, controversy and lack of WHO guidelines on dengue vaccine.

KYAMC Journal Volume: 14, No: 03, October 2023: 172-174.

Brief History of Safe Surgery

ABM Moniruddin — Tue, 16 Jan 2024 00:00:00 +0000

Abstract not available

KYAMC Journal Volume: 14, No: 03, October 2023:109-110.