Medicine Today 2024-05-08T06:55:40+00:00 Prof. N.A. Kamrul Ahsan FACS, MS Open Journal Systems <p>A professional medical journal recognised by the Bangladesh Medical and Dental Council (BM&amp;DC).</p> Clinicopathological Evaluation of Thyroid Dysfunction in Women with Abnormal Uterine Bleeding 2024-04-25T06:21:11+00:00 Jinat Fatema Tanzina Iveen Chowdhury Bidisha Chakma Kazi Farhana Begum Tripti Rani Das <p><strong>Introduction: </strong>Abnormal uterine bleeding describes any variation from normal bleeding patterns in nonpregnant, reproductive-aged women beyond menarche lasting for at least 6 months. Regular cyclic menstruation results the choreographed relationship between the endometrium and its regulating factors. Any type of disturbance between the regulatory mechanism of pituitary ovarian axis or pelvic diseases results in abnormal uterine bleeding. Thyroid hormones play a key role in the menstrual and reproductive function of women. It is recognized universally that menstrual disturbances may accompany clinical alterations in thyroid function. Objectives: To evaluate the thyroid dysfunction in patients with abnormal uterine bleeding. <strong>Materials and Methods: </strong>This cross sectional study was conducted in Department of obstetrics &amp; gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from April 2023 to December 2023. Women with abnormal uterine bleeding were included in the study. Sample was selected by purposive sampling. Sample size was 100. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously. Data was collected by using a semi-structured questionnaire. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Result was presented in the form of tables, pie chart, graphs, bar diagrams, histogram &amp; charts etc. <strong>Results: </strong>In this study, the maximum numbers of cases (43.0%) were between 26-35 years age group. Mean age was 29.57 ± 8.27 years. Large numbers of respondents came from urban area (58%). On evaluation of types &amp; causes of AUB, maximum patient belongs to AUB-L (leiomyoma) group (53%) followed by AUB-A (adenomyosis) (28%); AUB-P (polyp) (8%); AUB-O (ovulatory) (9%) and AUB-M (malignancy) (2%). Present study showed that prevalence of thyroid disorders is 26% in AUB patients. The prevalence of Hypothyroidism was 18% and Hyperthyroidism was 8%. Thyroid dysfunction is associated with menstrual abnormalities in females of all age groups. <strong>Conclusion:</strong> Abnormal uterine bleeding has a strong association with thyroid disorders. The most common type of disorder is subclinical hypothyroidism. Thus, all patient of AUB must be evaluated for thyroid dysfunction.</p> <p>Medicine Today 2023 Vol.36 (1): 1-6</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Association of Risk Factors with Female Pattern Hair Loss 2024-04-25T09:00:14+00:00 Tanjina Nasrin Md Abdul Wahab Lubna Khondker Ruhus Safa Noor <p><strong>Introduction:</strong> Female Pattern Hair Loss (FPHL) is one of the main causes of hair loss in adult women and has a major impact on individual’s quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal, and environmental factors<em>. </em>Objective: To evaluate etiological factors associated with female pattern hair loss<em>. </em><strong>Materials &amp; Methods:</strong> This was a hospital-based case control study, conducted in the Department of Dermatology &amp; Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March, 2021 to August, 2022. In this study, total 100 females aged 18 to 45 years were enrolled. Among them, 30 females had history of hair loss &gt;6 months, presented to outpatient department, BSMMU were included as case &amp; 70 healthy females who had no history of hair loss included as control according to inclusion &amp; exclusion criteria. Diagnosis of FPHL was made clinically &amp; Ludwig classifications were used to assess the degree of hair loss. Information on possible risk factors for FPHL was collected using a questionnaire interview. <strong>Result:</strong> The mean age of the patients with FPHL was 41.0±7.77 years with majority belongs to &gt;40 years of age group &amp; their mean duration of hair loss was 26.3±12.0 months. Among the patients of FPHL, 36.7% had history of inadequate intake of iron containing food, 66.7% had family history of alopecia, 36.7% had history of increased bleeding during their menstruation, 20.0% had multiple (&gt;3) childbirth &amp; 23.3% had hypertension. About 86.7% patients with FPHL had low serum ferritin (&lt;30ng/ml) with mean serum ferritin level was 20.25±16.07ng/ml and 66.7% patients of FPHL had low Hb (&lt;12 µg/l) with mean Hb was 11.47±1.52 µg/l. In the multivariate logistic regression analysis significant association found with FPHL were age (OR 2.013, 95% CI 0.672-3.714), family history of alopecia (OR1.231, 95% CI 0.162-1.991) and lower serum ferritin level (OR1.090, 95% CI 1.043-1.139). <strong>Conclusion:</strong> Age, family history of alopecia, lower serum ferritin may be implicated as risk factors for female pattern hair loss.</p> <p>Medicine Today 2023 Vol.36 (1): 7-11</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Assessment of High Serum Cystatin C as an Early Marker of Renal Impairment in Pre Eclampsia 2024-04-25T09:25:59+00:00 Tahsnin Ferdoues Nahreen Akhtar Mohammad Arbab Sarker Ummee Aziza Wahid Masuma Akter Mishkat Tabassum <p><strong>Introduction: </strong>Preeclampsia is the most common medical complication during pregnancy and one of the leading causes of maternal and perinatal morbidity and mortality in Bangladesh. Kidney has role in both adaptive physiology of normal pregnancy and in pathophysiology of preeclampsia. Among the new biomarkers, serum Cystatin C can reliably reflect the GFR in both healthy and hypertensive pregnant women. It is important to evaluate the diagnostic efficiency of Cystatin C as a marker of renal function in preeclampsia. <strong>Aim: </strong>To assess high serum Cystatin C level as an early marker of renal impairment in pre-eclamptic patients. <strong>Materials and Methods: </strong>From March, 2021 to February, 2022 (A total of 12 months) a cohort study was conducted among 66 pregnant women, aged 18 to 40 years with pre-eclampsia and normal serum creatinine (0.5-0.8mg/dl) at their 20-28 weeks of gestation attending the antenatal clinic and admitted in the Department of Feto maternal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, selected by non random purposive and convenient sampling. <strong>Results: </strong>Out of 66 respondents, final analysis was done with 62 patients. Among 62 study samples, 76% patients had “High Cystatin C” level that was greater than 0.84 and renal impairment developed in 15% pregnant women. Majority of the participants were in 25-30 age groups (46.8%). The mean serum creatinine level of the pregnant women increased throughout follow up and it was statistically significant (p&lt;0.05) in both cases. No significant difference was found between serum Cystatin C in renal impaired and normal renal function pre eclampsia patients at a cut off value of 0.84. ROC analysis of serum Cystatin C level for detection of renal impairment among Pre eclamptic patients found a cut-off value of ≥1.49 showed the highest Youden index of 0.721. The sensitivity, specificity, PPV, NPV and accuracy of serum Cystatin C were 77.78%, 94.34%, 70.00%, 96.15% and 91.94%. <strong>Conclusion: </strong>Higher Cystatin C level in pre-eclampsia reflected renal impairment at an early stage even before conventional marker like serum creatinine raise. The diagnostic efficiency of Cystatin C as a marker of renal function in pre eclampsia can be used to reduce maternal morbidity and mortality of Bangladesh.</p> <p>Medicine Today 2023 Vol.36 (1): 12-16</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Prevalence of Vitamin D Deficiency among Patients Attending Tertiary Level Hospitals in Bangladesh: Hospital-Based Cross-Sectional Study 2024-04-28T11:44:59+00:00 Md Mahabubul Islam Majumder Hafizur Rahman Mostaque Ahmed Mohammad Nazim Uddin Tarek Ahmed Ashrafur Rahaman Mahadi <p><strong>Introduction: </strong>Vitamin D (Vit D) is essential for calcium and phosphate homeostasis, critical for bone growth and remodeling. Its deficiency leads to conditions like osteomalacia and rickets, with adverse effects on osteoporosis, growth, and skeletal health. This study aimed to assess Vitamin D Deficiency prevalence among patients in Bangladeshi tertiary-level hospitals. <strong>Materials and Methods:</strong> A prospective cross-sectional study was conducted from January to December 2019 at Cumilla Medical College Hospital and Central Medical College Hospital. We enrolled 1250 patients meeting inclusion criteria and collected data via a pre-designed questionnaire. <strong>Results:</strong> Most participants (31.8%) were aged 31-40, with a mean age of 37.31±13.37. Male patients constituted 53.3%, and 46.7% were female. Rural residents accounted for 52.6%, while 25.8% lived in urban areas, and the rest abroad, mainly the Middle East. The majority (88.5%) belonged to middle-class families, and only 1.5% reported sufficient sun exposure. Strikingly, 54.2% were Vitamin D deficient, 40% had insufficient levels, and only 6.4% had adequate Vit D. <strong>Conclusion:</strong> This study highlights a significant prevalence of Vitamin D deficiency among patients in Bangladeshi tertiary hospitals. The data underscore the urgent need for healthcare authorities to address this public health concern. Policymakers and healthcare providers should be aware of the potential long-term health consequences of Vitamin D deficiency, emphasizing the importance of strategies to promote adequate Vit D levels in the population.</p> <p>Medicine Today 2023 Vol.36 (1): 17-22</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Pattern of Ocular Injuries in a District Hospital of Bangladesh 2024-04-28T12:12:22+00:00 Md Musharraf Hossain Md Mahmud ul Huda Sajed Abdul Khaleque <p><strong>Introduction: </strong>Ocular injuries are one of the leading causes of visual morbidity in our country. Our present study aims to evaluate the pattern of ocular injuries in a District Hospital. <strong>Materials and Methods: </strong>This was a prospective observational study, conducted by ophthalmology department of Sherpur District sadar hospital, Bangladesh. The study was done from January 2023 to June 2023. <strong>Results: </strong>The sample size was 100. All age’s group and both sexes were selected randomly in this study. The history of the patient regarding particulars of the patient, time of injury, place where it occurs, type of object, nature of injury and visual acuity at presentation was recorded. Most of the patients were 11-20 years age group (44 %). 82 % of the patients were male and 18 % were female. Patients were mostly from low socioeconomic group (65%). 35% patients attended hospital within 6 hours of injury. Type of the injury was accidental most commonly (88 %) and of them occupational was the majority (54 %), homicidal injuries were 12 %. Sharp objects causes 55 %, blunt trauma causes 35% of injuries. 65% of patients had open globe injury and 35 % had closed globe injuries. Most of the patients (62 %) had visual acuity 6/60 to PL at the time of admission. <strong>Conclusion: </strong>Our study reviled that young males of low socioeconomic group affected more and with sharp objects and are mainly occupational in nature.</p> <p>Medicine Today 2023 Vol.36 (1): 23-25</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Efficacy of Doxylamine and Pyridoxine during Pregnancy Induced Nausea and Vomiting 2024-04-29T02:59:46+00:00 Tinni Rani Paul Khan Md Muzammel Hossain Shukdeb Paul Amirun Nahar Estiak Ahmed Farah Diba Chowdhury <p><strong>Introduction: </strong>Nausea and vomiting in pregnancy (NVP) is the most common medical condition of pregnancy causes a significant clinical, psychological and economic burden. Therefore, it is very important to treat this condition appropriately and effectively. The combination of Doxylamine and Pyridoxine is recommended as first-line therapy for nausea and vomiting in pregnancy. <strong>Objectives: </strong>To observe the therapeutic efficacy of combined Doxylamine and Pyridoxine for treatment of nausea and vomiting in pregnancy. <strong>Materials and Methods: </strong>An observational study was conducted on patients with nausea and vomiting in pregnancy attended the Model Family planning clinic in the Department of Obstetrics and Gynaecology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from January 2019 to December 2019. A total 90 patients with clinically meaningful nausea vomiting (Pregnancy-Unique Quantification of Emesis [PUQE] score &gt; 6) were selected and given 2-4 tablets each containing combined Doxylamine succinate 10 mg and Pyridoxine hydrochloride 10 mg based on a pre-specified titration protocol response to symptoms by respective physician and PUQE score was recorded in all participants before initiation of treatment and at 8th day and 15th day of treatment. In course of follow up period 7 patients were dropped out and finally 83 patients were analyzed in this study. <strong>Result: </strong>The mean PUQE score was decreased from 10.27 ± 1.76 to 7.94 ± 1.75 at 8th day and to 5.35 ± 1.47 at 15th day of treatment was significant (p&lt;0.001). The percentage reduction of PUQE score was 23.14% at 8th day and 46.91% at 15th day of treatment. The difference was significant (p&lt;0.001). <strong>Conclusion: </strong>Combined Doxylamine-Pyridoxine is effective and well tolerated in the treatment of nausea and vomiting in pregnancy (NVP).</p> <p>Medicine Today 2023 Vol.36 (1): 26-30</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Morphological Parameters of Gallbladder are Correlated with Age 2024-04-29T03:44:14+00:00 Farjana Mansura Kazi Abdullah Al Mamun Abdullah Al Faisal Mahmuda Khatun Halima Akter Suchi <p><strong>Introduction: </strong>Gallbladder issues are prevalent globally, particularly in Bangladesh, and become more common with age. Diagnosis involves clinical assessment and confirmation through noninvasive and invasive methods. Understanding gallbladder features is crucial for effective investigation, diagnosis, and management. <strong>Objectives: </strong>To find out relation between morphological parameters of human gallbladder with age. <strong>Materials and Methods: </strong>This cross-sectional descriptive study was conducted in the Department of Anatomy in collaboration with the Department of Forensic Medicine, Sylhet MAG Osmani Medical College, Sylhet from January 2014 to December 2014. Fifty human postmortem gallbladders were selected. Dead bodies autopsied within 36 hours of death. Considerable signs of decomposition or decomposed dead body, presence of gross gallbladder disease and any history of poisoning cases were excluded. All the specimens were examined to detect the length, breadth, weight and thickness of the gallbladder; and length and diameter of cystic duct. <strong>Results: </strong>The study included cadavers ranging in age from 11 to 55 years, with a mean age of 35.02 ± 19.98 years. Of the total, 29 (58.0%) were male, and 21 (42.0%) were female. The length and thickness of the gallbladder increased significantly with age, as did the length and diameter of the cystic duct. But the weight and breadth also change with age, although not significantly. <strong>Conclusion: </strong>The length and thickness of the gallbladder; the length and diameter of the cystic duct were varied with age; but no variation in weight and breadth.</p> <p>Medicine Today 2023 Vol.36 (1): 31-35</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Pattern of Pesticide and Herbicide Poisoning Among People Admitted to Medicine Wards of a Tertiary Care Hospital 2024-04-29T04:35:27+00:00 Mohammad Abu Naser Siddique Imran Uddin Robel Ummay Fatema Khatun <p><strong>Introduction: </strong>Acute poisoning has become a major public health problem accounting for significant morbidity and mortality around the globe<sup>2</sup>. According to WHO data, an estimated 193,460 people died worldwide in 2012 from unintentional acute poisoning. 84% of these deaths occurred in resource-lacking low- and middle income countries<sup>3</sup>. The toxicity of accessible poisons and the scarcity of adequate medical facilities for poisoning management is responsible for a such a high mortality rate in this region<sup>4</sup>. Acute pesticide poisoning usually occurs during agricultural use either by accidental exposure or by suicidal attempt, rarely as homicidal<sup>2,5&amp;8</sup>. This study is designed to assess the patterns of pesticide &amp; herbicide poisoning among rural &amp; urban peoples admitted to medicine ward of a tertiary level hospital and to find out the sociodemographic characteristics of the respondents. So that the supply of these agents be properly regulated to prevent easy accessibility and misuse. <strong>Materials and Methods: </strong>It was a hospital based cross-sectional observational study conducted at indoor Department of Medicine, Chittagong Medical College Hospital for six months period from 01/01/2019 to 31/06/2019. Ethical clearance was taken from ethical review committee of Chittagong Medical College and informed consent was obtained from each participants. Hundred patients above 12 years of age with a relevant history and clinical signs and symptoms of any type of pesticides and herbicides poisoning who fulfilled the selection criteria were selected consecutively for the study. Data was collected using a pretested, multi-structured questionnaire which comprised of questions to identify demographic data, type and circumstances of poisoning. <strong>Results: </strong>Regarding motive of poisoning in our study 81% patient took pesticide &amp; herbicide poisoning for suicide and 19% admitted with accidental case. This result is consistent with the study where most common reason of pesticide &amp; herbicide poisoning was suicide (93.3%) <sup>20</sup>. A study performed at Rajshahi Medical College from January 1991 to December 1994 showed that out of those 405 cases of OPC poisoning 310 were suicidal (76.54%) and 95 were homicidal (23.45%) poisoning<sup>28</sup>. The present study revealed that factors responsible for the suicidal attempt were familial disharmony in 46% of cases, marital problems in 19%, financial problem in 16%, mental disorder in 3% and 11% due to other reasons. Shadequl-Islam et al. reported the motive of pesticide poisoning in their study that 45% of cases were due to familial disharmony, 15% unknown, 13.3% depression, 8.3% marital problems, 5% financial problems and 13.3% due to other reasons<sup>26</sup>. In most cases, the patient could access to the poison by self-purchasing from poison retailers. <strong>Conclusion: </strong>This study has indicated that young adults, males and socially underprivileged people are at a higher risk of pesticides and herbicides poisoning. This study showed pesticides &amp; herbicides poisoning is the most common modes of suicidal deaths. Pesticides are mostly misused purposefully as an easy means for committing suicide. Early diagnosis and treatment is mandatory in order to minimize mortality from these potentially lethal compounds. It is recommended that the supply of pesticides be properly regulated to prevent easy accessibility and misuse.</p> <p>Medicine Today 2023 Vol.36 (1): 36-40</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Bleeding Time and Clotting Time in Pre-eclampsia, Eclampsia and Normal Pregnancy 2024-04-29T05:56:05+00:00 Sharmin Sultana Sultana Md Anowarul Islam Rukhsana Afroz Fouzia Farid Mahmuda Sultana Shumi <p><strong>Introduction: </strong>The most important cause of maternal and perinatal morbidity and mortality are hypertensive disorder (Preeclampsia and eclampsia). In preeclampsia and eclampsia there is hypercoagulable state which acts as a risk factor for thromboembolism and DIC. <strong>Objective: </strong>This study was carried out to compare the coagulation indices in normal pregnancy, preeclampsia and eclampsia. <strong>Materials and Methods: </strong>This cross sectional study was conducted in Dhaka Medical College from January to December’ 2014. Total 150 women aged 18 – 40 years were selected for this study. Among them 50 normal pregnant, 50 preeclamptic and 50 eclamptic women were selected as study group and age matched 50 healthy nonpregnant women were considered as control group. Bleeding time was estimated by Duke’s method and clotting time was estimated by capillary tube method. <strong>Results: </strong>In this study bleeding time and clotting time were significantly higher in preeclamptic and eclamptic women than those of healthy nonpregnant women. <strong>Conclusion: </strong>From this study it can be concluded that bleeding time and clotting time are closely related with preeclampsia and eclampsia.</p> <p>Medicine Today 2023 Vol.36 (1): 41-44</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Comparative Study of Paramedian and Midline Incision in Laparotomy for Peritonitis due to Non-traumatic Gastro-intestinal Tract Perforation 2024-04-29T06:42:00+00:00 Md Zillur Rahman Md Aziz Ullah Sadia Rahman Soma Rahman <p><strong>Introduction: </strong>A prospective observational study was conducted to compare the paramedian incision with midline incision in gastro-intestinal tract perforation. <strong>Objectives: </strong>To identify better or superior incision which may reduce post operative mortality and morbidity after laparotomy. <strong>Materials and Methods: </strong>A prospective observational Hospital based study was conducted from January 2009 to June 2009 at department surgery of Shaheed Ziaur Medical College Hospital, Bogura. A total 100 patients of peritonitis due to non-traumatic gastro-intestinal tract perforation were taken for study. Sample were collected by Convenience (purposive) sampling method. Midline incision and Para median incisions were performed as per standard technique. The details of operations, post-operative complications and follow up to be recorded and analyzed. <strong>Results: </strong>Opening time and closing time in midline incision is significantly less than paramedian (P &lt;0.001). Incidence of wound infection and incidence of wound dehiscence in our study in midline group was less compared to paramedian group buy it is not significant. All forms of dehiscence ranging from superficial dehiscence to burst abdomen were included. Incidence of incisional hernia was significantly higher in midline incision (P&lt;0.05). Healing time was significantly lower in midline compared to Paramedian group (P&lt;0.05). <strong>Conclusion: </strong>It is concluded that midline incision is preferred compared to paramedian incision. Incidence of wound dehiscence and wound infection is less in midline incision.</p> <p>Medicine Today 2023 Vol.36 (1): 45-49</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Outcome of Myringoplasty with Temporal Fascia and With Sliced Tragal Cartilage Graft-A Comparative Study 2024-04-29T11:28:58+00:00 Samir Mohammad Tasrif S M Nafeez Imtiaz Md Murshedur Rahman S M Tariful Hasan Md Harun Ur Rashid Md Sha Sakender <p><strong>Introduction: </strong>Myringoplasty is the surgical procedure to repair tympanic membrane perforations and thereby improving hearing, providing a dry ear, and reducing susceptibility to infections. Although there are many kinds of techniques and graft materials used, no methods have proven indisputably superior to the other. Therefore, to find out the outcome of myringoplasty using temporal fascia and sliced tragal cartilage in chronic inactive mucosal otitis media was set as an objective of the study. <strong>Materials and Methods: </strong>This cross-sectional observational study was conducted at the department of Otolaryngology &amp; Head-Neck surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH) for six months from July 2018 to December 2018, after acceptance of the protocol and approval from IRB. Patients attending in the ShSMCH with complaints of chronic inactive mucosal otitis media were approached for inclusion of the study and final selection were done in according to the selection criteria. Ethical issues were ensured properly throughout the study period and inclusion was confirmed following signing written informed consent. All patients were randomly allocated into two groups where one group were received myringoplasty with temporalis fascia graft and another group received sliced tragal cartilage. Total 50 patients (25 patients in each group) were included, and they were subjected to details history taking, physical examination and necessary investigations. The researcher conducted all the interview and collected data were recorded into a case record form for each patient. Data analysis was done by SPSS 17. <strong>Results: </strong>Of total, 50 study population, mean age of the 32.30±10.93 SD (years) with 58% male and 42% females respectively. No significant age and gender difference is noted across the group (p&gt;0.05). Patients having temporal fascia graft had significantly higher proportion of graft uptake in comparison to patients having sliced tragal graft (p&lt;0.05). Both groups of the patient improve significantly in term of hearing after operation (p&lt;0.05 in each group) but comparison in between groups showed that the improvement was significantly higher in temporal fascia graft group (p&lt;0.001). <strong>Conclusion: </strong>Myringoplasty with temporal fascia graft could be a better option than sliced tragal cartilage graft in our population. However, further larger study with longer follow up is necessary to finalize the comment.</p> <p>Medicine Today 2023 Vol.36 (1): 50-54</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Clinical Assessment of Early Morning Blood Pressure in Patients with Hypertension 2024-04-29T11:28:50+00:00 Kazi Mohammad Abdul Awal Atia Afrose Most Monira Yesmin Saniut Chowdhuri Md Shohedul Alam Murshid Ur Rahman Ashek Mahmud Manju Md Fozlur Rahman Tania Begum <p>A significant population experiencing hypertension, blood pressure (BP) demonstrates a significant rise during the awakening hours, it is linked to heightened cardiovascular complications during this time of the day. Many medications used to manage high BP fail to effectively control BP in the early morning, especially when administered once daily in the morning. Key factors to consider when choosing an efficient antihypertensive medication include the agent's pharmacokinetics, formulation, and timing of dosing. Examples of antihypertensive drugs with proven efficacy in regulating early morning BP include medications with extended pharmacologic half-lives, like telmisartan (an angiotensin II receptor blocker), amlodipine (a calcium antagonist), and bisoprolol (a beta-blocker). Administering chronotherapeutic preparations at bedtime has also been shown to be effective in managing early morning BP. There is a correlation between elevated early morning BP and cardiovascular risk, future clinical studies should emphasize evaluating the performance of antihypertensive drugs during this critical period of heightened risk. (Prev Cardiol. 2007;10:210−214) © 2007 Le Jacq.</p> <p>Medicine Today 2023 Vol.36 (1): 55-61</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today Role of Sertaconazole in the Treatment of Dermatophytosis 2024-04-29T12:00:10+00:00 Lubna Khondker <p>Dermatophytosis is a major health burden worldwide and is now increasing day by day. Dermatophytosis is also becoming increasingly unresponsive to topical conventional antifungals now a day. Newer topical antifungals may be more effective in these patients. Sertaconazole is a new, broad spectrum, fungicidal and fungistatic imidazole with added antipruritic and anti-inflammatory activity that may be effective and beneficial in improving the quality of life for the patient with dermatophytoses. It is indicated in the European Union(EU) for the treatment of superficial skin mycoses such as dermatophytosis (including tinea corporis, tinea cruris, tinea manus, tinea barbae and tinea pedis), cutaneous candidiasis, pityriasis versicolor and seborrhoeic dermatitis of the scalp, and in the US for tinea pedis only. Sertaconazole has broad-spectrum antifungal activity against dermatophytes of the Trichophyton, Epidermophyton and Microsporum genera, and yeasts of the genera Candida and Cryptococcus; additionally, it is effective against opportunistic filamentous fungi and Gram-positive bacteria. Moreover, the antifungal activity of sertaconazole is maintained in clinical isolates of dermatophytes that show reduced susceptibility to other azoles. While the drug has good dermal penetration, this is not associated with systemic absorption. In clinical trials in patients with superficial mycoses, 2% sertaconazole cream applied twice daily was effective in the eradication of a range of dermatophytoses, and a significantly greater proportion of patients were cured compared with those receiving 2% miconazole cream twice-daily treatment. Both as a topical cream and suppository preparation, sertaconazole was generally well tolerated. Sertaconazole is a well-established antifungal agent, which is now available in a variety of formulations, and remains a useful treatment option particularly in patients with fungal infections resistant to other azoles.</p> <p>Medicine Today 2023 Vol.36 (1): 62-66</p> 2024-05-08T00:00:00+00:00 Copyright (c) 2024 Medicine Today