Medicine Today 2019-07-04T11:04:14+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 (BMDC).</p> Prediction of Perineal Tear During Childbirth by the Assessment of Striae Gravidarum Score 2019-07-04T10:58:51+00:00 Mahbuba Akhter Banu SF Nargis Mohammad Mizanoor Rahman Md Mohim Ibn Sina Murshida Pervin Mamata Manjari <p><strong>Introduction: </strong>Perineal tear (PT) is the most frequently occurring injury during vaginal birth. Striae gravidarum (SG) is a reflecting marker of connective tissue elasticity. This study aimed to assess SG score and to predict the likelihood of PT during childbirth.</p> <p><strong>Materials &amp; Methods: </strong>This was a cross-sectional study done at Sir Salimullah Medical College &amp; Mitford Hospital. Initially, all pregnant women admitted for vaginal delivery were enrolled but who subsequently needed lower segment caesarean section were excluded. Finally, 189 patients who gave vaginal birth were included. SG score was assessed using the Atwal numerical scoring system. The association was examined between PT as the outcome measure, defined by tears or lacerations and the total striae score (TSS) obtained at abdomen, hips, buttocks and breasts.</p> <p><strong>Results: </strong>More than half of study patients developed PT. Majority belonged to moderate striae group. Significant correlation was found between PT and TSS. Moderate and severe striae had significantly increased prevalence of PT as compared to mild striae (43.4% vs. 11.6%). Patients who were given episiotomy in moderate and severe striae group had less PT. Weight gain during pregnancy and TSS were significantly associated with a higher incidence of PT.</p> <p><strong>Conclusion: </strong>A woman’s SG score in general is a useful clinical predictor of the risk for PT during childbirth. Selective episiotomy in patients with moderate and severe striae can reduce the incidence of PT. SG score can be used as a simple and noninvasive tool by all categories of health personnel to better define women at risk for PT.</p> <p>Medicine Today 2019 Vol.31(2): 64-67</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Outcome of Patients Having Acute Myocardial Infarction with and without Streptokinase 2019-07-04T10:58:56+00:00 Faruque Uddin AK Fazlul Hoque <p><strong>Introduction: </strong>Acute myocardial infarction is the leading cause of death. Streptokinase is the most commonly used thrombolytic agent. This study was conducted to compare in-hospital outcome of patients with acute myocardial infarction receiving streptokinase with those not receiving it.</p> <p><strong>Materials &amp; Methods: </strong>This descriptive observational study was conducted at Coronary Care Unit, North East Medical College Hospital from 1st July August 2016 to 30th June 2018. 340 patients having acute MI were in- cluded in the study. Two groups were formed: sk group receiving streptokinase and non-sk group not receiving. In-hospital mortality was the primary end point while mechanical and electrical complications were the secondary end points.</p> <p><strong>Results: </strong>Among 340 patients, 255(75%) were males and 85(25%) females. Out of those 218 received strep-tokinase, while 122 did not. Mean age of sk group was 53.15±10.30 years and non-sk group 60.5±16 ears. Mean time of arrival to the hospital after symptom onset was 10.41±9.97 hours. SK group patients reached in 5.9±4.76 hours while non-sk group in 19.4±10.5 hours. In-hospital mortality in sk and non-sk group was 19(8.7%) and 25(20.5%) respectively, p=0.002. Complication rate was significantly higher in the non-sk group, 54.09% vs 34.86%, p=0.04.</p> <p><strong>Conclusion: </strong>Patients of acute myocardial infarction receiving streptokinase have significantly lesser in-hospital mortality and complications as compared to patients not receiving it.</p> <p>Medicine Today 2019 Vol.31(2): 68-71</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Frequency of Lympnode Metastasis in Supraglottic Ca Larynx 2019-07-04T10:58:57+00:00 Mohammad Rokan Uddin Bhuiyan Mohammad Idris Ali Balayet Hossain Siddiquee Fatema Johora Mohammad Kamal Hossain <p><strong>Introduction: </strong>To observe the association between the level of lymph node metastasis and the T- stage and to evaluate the N- stage in supraglottic carcinoma of larynx.</p> <p><strong>Materials and Methods: </strong>A prospective cross-sectional study was carried out on 80 consecutive cases of supraglottic carcinoma larynx in three tertiary level hospital in Dhaka during July'2009 to March 2011.</p> <p><strong>Results: </strong>The highest number of patients were in the age group 5th and 6th decades. Male to female ratio was 9:1. Topographically 70 cases (87.5%) had lesions involving epiglottis, 5 cases (6.25%) in aryepiglottic fold and 5 cases (6.25%) had lesions at false cord. Majority cases were histopathologically confirmed squamous cell carcinoma (95%) and among them 46 cases (57.5%) had well differentiated. Cervical metastatic lymph nodes were found 40% (32 cases) where level-II was most common. This was most frequent in early supraglottic(T1&amp;T2) carcinoma of larynx (86.25%), P=0.008. A positive correlation was found between the T stage of primary tumours and frequency of cervical lymphadenopathy. Lymph node metastasis were 4.77% in T1, 37.50% in T2, 71.43% in T3 and 91.67% in T4. In early stage lymph node involved 93.75% in Level- II, 6.25% in Level- III &amp; in advanced stage 100% in Level - II, 62.5% in Level - III and 25.0% in Level - IV. Distribution of study cases (31.25%) in stage-II, 25% in stage-I, 22.50% in stage-Ill and 21.25% were in stage-IV.</p> <p><strong>Conclusion: </strong>Result of this study may help the clinician for planning of treatment of this malignant diseases as well awareness.</p> <p>Medicine Today 2019 Vol.31(2): 72-75</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Injury Pattern in Fatal Cases of Stab Wound 2019-07-04T10:58:58+00:00 Misbah Ul Hoq Chowdury Ali Md. Shariful Alam Rubel Md Samir Uddin Kanta Deb Chowdhury Rifat Jahan <p><strong>Introduction: </strong>Stabbing is the most common method of homicide as like as other parts of the world. Precise examination of stab wound along with the type of other wounds considering their site, shape, number and orientation of the wounds in relation to each other etc. provide a number of clues which may be of paramount importance in reconstruction and interpretation of the whole events.</p> <p><strong>Materials and Methods: </strong>This is a retrospective study carried out in Forensic Medicine Department of Sylhet M.A.G. Osmani Medical College, Sylhet from July 2010 to June 2011 and in the year of July 2017 to June 2018 to observe different patterns of injuries in fatal cases of stab wound. 20 autopsies were included in this study using random sampling.</p> <p><strong>Results: </strong>Male(90%) are more victimized than female. The pattern of injury that found to be most common is the penetrating wound of the chest injuring either lung or heart. Second most common injury pattern is the penetrating wound of the chest or abdomen injuring eitherstomach or liver.Another pattern is widely scattered multiple stab wounds both on front and back of the body and the fourth pattern is stab wound of the lower limb causing division of a major blood vessel.</p> <p><strong>Conclusion: </strong>The stab wound is deeper than it is long or wide. This means depth is the greatest dimension in case of Stab wound and that is where the danger lies as it is evident in this study.</p> <p>Medicine Today 2019 Vol.31(2): 76-79</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Free Fibular Flap in Mandibular Defect Reconstruction in Perspective of a Tertiary Care Hospital of Bangladesh 2019-07-04T10:59:00+00:00 Mohammad Iqbal Kabir Muhammad Mizanur Rahaman Md Atiqul Islam Rabby Shamim Hasan Md Abdur Rob Golam Mohiuddin Chowdhury Ismat Ara Haider <p><strong>Introduction:</strong>The principal objectives of reconstruction after mandible resection are to restore physiological articulation, chewing, swallowing functions and esthetics of the patient. Metal plate and bone graft are usually used to achieve this purpose.From the point of view of bone resorption and augmented exposure to infection, free vascularized fibular flap (FFF), comprising alive bone, have shown a lower infection rate and high rate of success.</p> <p><strong>Materials and Methods: </strong>The study population of this clinical report included undertaking mandibular reconstruction by transplantation of a free vascularized fibular flap at the Department of Oral and Maxillofacial Surgery at the Dhaka Dental College between May 2014 to November 2014. The factors consider for studying were as following- age, sex, primary disease , period of reconstruction, mandibular defect classification, mandible resection range, height of reconstructed mandibular bone, number of locations of mandible osteotomy, vascular anastomosis and complication.</p> <p><strong>Results: </strong>Primary disease comprised one was ameloblastoma, one was recurrent ameloblastoma, and another was post-surgical facial deformity. According to the CAT classification body was the most commonly observed defect. All mandibular bones were left as single barrel. There were 2 cases of primary reconstruction and 1 of secondary reconstruction. Free fibular flap ranges from 12-18 cm. No postoperative complications were seen in any case.</p> <p><strong>Conclusion: </strong>Vascularized fibular flap is good choice in wide-range faults hard to fill with an iliac block graft. Further studies including greater samples of patients undertaking fibular bone transplantation are needed to comparatively investigate its merits in more detail.</p> <p>Medicine Today 2019 Vol.31(2): 80-84</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## A Clinicopathological Study of Solitary Thyroid Nodule 2019-07-04T10:59:01+00:00 GHM Shahidul Haque Md Jakir Hossain Sabrina Haque Md Anisur Rahman <p><strong>Introduction:</strong>Common presentation of thyroid disorders is solitary nodule. A discrete swelling in an otherwise impalpable gland is termed as solitary nodule of thyroid. The majority of solitary thyroid nodules are benign. The incidence of malignancy is 10-20%, being more common in females with a mean age of 35 years.The object of the study was to identify the incidence of malignancy in solitary nodule thyroid which emphasizes on the early diagnosis and adequate treatment.</p> <p><strong>Materials and Methods: </strong>The study was carried out in the department of ENT and Head-Neck Surgery of Rangpur Medical College Hospital, Rangpur and Shaheed Ziaur Rahman Medical College Hospital, Boruga in 50 patients with solitary thyroid nodule from July 2013 to June 2015.</p> <p><strong>Results: </strong>The solitary thyroid nodules were seen in 1.76% of surgical admissions. The mean age of the incidence of solitary thyroid nodule is 35 years. The incidence of malignancy in solitary thyroid nodule is 18.51%. The solitary thyroid nodules were frequent in females than males in the ratio of 6.71:1.</p> <p><strong>Conclusion: </strong>It is concluded from the present study that a remarkable proportion 10% of solitary thyroid nodules was malignant with females preponderance which emphasizes on the early diagnosis and adequate treatment.</p> <p>Medicine Today 2019 Vol.31(2): 85-88</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Role of Common Addictive Habits on Hypovitaminosis D among Bangladeshi People 2019-07-04T10:59:03+00:00 AHM Habibur Rahman Md Emdadul Haque Lubna Naznin Nasir Uddin Ahmed <p><strong>Introduction: </strong>Hypovitaminosis D is a silent but very devastating health issue throughout the world. Some common addictive habits in our country play important role on the issue. The objective of this study was to determine the role of common addictive habits on hypovitaminosis D among the clients attending specialized hospitals.</p> <p><strong>Materials and Methods: </strong>This cross-sectional study was conducted among 264 respondents attended Armed Forces Institute of Pathology (AFIP), Dhaka Cantonment for estimation of 25(OH) D within the period of July 2017 to June 2018. Data were collected by face-to-face interview, reviewing with Vitamin D level of the participants from laboratory with the help of a semi-structured questionnaire and checklist respectively. Data were checked, and analyzed with the help of SPSS version 23.</p> <p><strong>Results: </strong>Among the respondents, majority (68.56%) were female. The mean ±SD age of the respondents was 48.23 ± 14.05 years. The mean± SD level of 25(OH)D was 50.01± 29.93 nmol/L. Among the males, it was 50.86±28.61 nmo/L and 49.60±26.19 nmol/L among the female. The proportion hypovitaminosis D was 84.84% and a mare difference was found among male and female respondents (84.5% and 85.5% respectively. Smokers (43.88±13.01 nmol/L) were found with lower level of vitamin D than non-smokers (50.88±28.08 nmol/L) (p&lt;0.05).The respondents having habit of chewing betel nut showed lowerlevel of 25 (OH) D than those does not practice that (51.63±18.07 Vs 46.12±13.01 mmol/L).</p> <p><strong>Conclusion: </strong>The proportion of hypovitaminosis D was too high. Effective measure to be taken at all level to overcome the nutritional disorder<strong>.</strong></p> <p>Medicine Today 2019 Vol.31(2): 89-92</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Relation of Hypothyroidism on BMI and Dyslipidemia 2019-07-04T10:59:04+00:00 Nasir Uddin Ahmed Md Anwarul Kabir Abdur Razzak Shaheda Akter <p><strong>Introduction: </strong>Hypothyroidism is a common medical disorder in the general population especially in women. Over-weight, obesity and dyslipidemia are major public health problem in both developed and developing countries. The present study is an effort to determine the association between hypothyroidism with body mass index (BMI) and dyslipidemia.</p> <p><strong>Materials and Methods: </strong>This is a cross sectional descriptive type of observational study of 100 cases of primary hypothyroidism in the age group 15-75 years of both sexes from February 2018 to January 2019 in CMH, Momenshahi. BMI was measured by weight in kg/ height in m2 and lipid profiles were analyzed by semi-automated biochemistry analyzer. Data was analyzed by X-cel.</p> <p><strong>Results: </strong>Among 100 cases mean BMI were 28.51±4.52, 75 cases (75%) obese, 16 (16%) over-weight, 8 (8%) normal. Mean serum cholesterol, Triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) are195.1±44.57, 164.49±83.87, 40±3.91 and 122±41 mg/dl respectively.</p> <p><strong>Conclusion: </strong>Here data statistically showed primary hypothyroidism is significantly correlated with high BMI and serum cholesterol, TG, LDL levels were also significantly correlated to this disorder. But HDL is not correlated with primary hypothyroidism.</p> <p>Medicine Today 2019 Vol.31(2): 93-97</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Determination of the Prevalence of the Common Dermatological Conditions in Elderly Population Attending a Tertiary Care Hospital 2019-07-04T10:59:05+00:00 Md Saidur Rahman Md Abdul Mannan Md Anower Hossain Md Tozammel Hoque AKM Ahsan Habib <p><strong>Introduction: </strong>Skin disorders are common in elderly people. Systemic diseases promote the development of dermatological conditions. Various systemic diseases contribute to the presence of cutaneous disorders, indicating the possibility that a skin abnormality may sometimes be the first and only symptom of a much more serious medical problem. The aim of the study to determine the frequency of skin diseases in elderly patients.</p> <p><strong>Materials &amp; Methods: </strong>This was a cross-sectional study and non-probability convenient sampling technique was used. Patients were recruited from attending the Dermatology Out-patient Department of SZMCH during the study from January’2018 to July’2018. Patients included in the study having skin diseases aged between 60-80 years, including all those who were diabetic and hypertensive because diabetes and hypertension are the most common comorbid conditions among these elderly patients. Patients were included having skin diseases including pruritus, dermatitis, xerosis, eczema, psoriasis, scabies, bacterial infection, and fungal infections.</p> <p><strong>Results: </strong>More than half (53.0%) patients belonged to age 71-80 years. Three fourth (75.0%) patients had pruritus followed by 37(37.0%) had dermatitis, 24(24.0%) had xerosis, 23(23.0%) had eczema and 12(12.0%) had bacterial infections. Pruritis, dermatitis, eczema and bacterial infections were statistically significant (p&lt;0.05) among three groups.</p> <p><strong>Conclusion</strong>: More than half of the patients belonged to age more than 70 years of age. Most common (three fourth) skin patients had pruritis, followed by more common skin patients were found dermatitis, xerosis, eczema and bacterial infection. Pruritis, dermatitis, eczema and bacterial infections were statistically significant in different age groups.</p> <p>Medicine Today 2019 Vol.31(2): 98-101</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Lifestyle Pattern and Knowledge about Diabetes Mellitus 2019-07-04T10:59:07+00:00 Kartick Chanda Shaha Shima Akhter Khatun Nafisa Mustafa Farzana Ahmed Mohammed Asaduzzaman Khan <p><strong>Introduction:</strong>The aim of the present study was to assess the pattern of lifestyle and knowledge about diabetes mellitus among type 2 diabetic patients at two tertiary level hospitals in Mymensingh</p> <p><strong>Materials and Methods: </strong>A descriptive, cross sectional study was conducted from July 2015 to December 2015 among 300 patients attending at Medicine outpatient department of the Community Based Medical College Hospital and Endocrine outpatient department of the Mymensingh Medical College Hospital after obtaining requisite consent from the patients. Data were collected through the interviewing of the patients. The collected data were entered into the computer and analyzed by using SPSS version 20.1. The study was approved by the institutional ethical committee.</p> <p><strong>Results: </strong>In a pool of 300 type 2 diabetics, Most of the patients (57.3%) belonged to the middle age group 41-60 years. More than half of the respondents were female (n=223, 74.3%). 97% patients were found to have knowledge about timing of dose regimen. Majority of patient’s (35.7%) knowledge about hypoglycemia was poor. The rate of adherence to diet was 51%. The rate of adherence to exercise was 68.3%.</p> <p><strong>Conclusion: </strong>Majority of type 2 DM patients displayed optimal level of diabetes knowledge. There was a high rate of non adherence to diet and exercise recommendations by patients suffering from type 2 diabetes mellitus. So continuous patient education and awareness program are required.</p> <p>Medicine Today 2019 Vol.31(2): 102-104</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Knowledge about Anemia among Pregnant Women in Tertiary Hospital 2019-07-04T10:59:08+00:00 Fahmida Sultana Gulshan Ara Tania Akbar Rayhana Sultana <p><strong>Introduction: </strong>To evaluate knowledge about anemia among pregnant women visiting in OPD for antenatal care.</p> <p><strong>Materials and Methods: </strong>A cross sectional study was conducted in tertiary hospital Dhaka, from outdoor patient department of gynecology and obstetrics, to assess the knowledge about anemia among pregnant women and also to find out the percentage and type of anemia. A total 396 pregnant women were interviewed and information were collected by pre designed data collection sheet using various parameters. Interviews conducted by direct questionnaire, blood samples were collected at same setting.</p> <p><strong>Results: </strong>The mean age was 25.92±5.05, highest number 39.65% were age group 21-25 years, 28.79% were age group -30 years, 15.91% were age group 31-35 years, 11.36% were found age group &lt;20 years. Regarding antenatal visit during pregnancy, 25.8% pregnant women visited in 1st trimester, 46.7% pregnant women visited in second trimester, and 27.5% in 3rd trimester. Also 11.11% patients had anemia in first trimester, 39.39% anemic in 2nd trimester, 14.39% pregnant women anemic in third trimester and 35.10% had normal findings. And 67% pregnant woman’s had knowledge about ANC 32% had no knowledge.</p> <p><strong>Conclusion: </strong>In this cross sectional study it was found that poor knowledge about anemia and less iron intake is the main cause for anemia during pregnancy.</p> <p>Medicine Today 2019 Vol.31(2): 105-110</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Depression among Nurses in Pabna Mental Hospital, Pabna 2019-07-04T10:59:09+00:00 Md Fajlul Kabir Bhuiyan Md Masud Rana Sarker Chowdhury Rakibuzzaman Nahreen Rahman <p><strong>Introduction: </strong>Every day, nurses experience a great deal of stress. They face problems at work, people relying on them for their care, and also tons of responsibilities piling up at home. Psychological stress is common in hospital ward and associated with depression. Only few studies are done concerning mental health of Nurses in Bangladesh. The study was carried out with a view to find out the prevalence of depression among nurses at Mental Hospital, Pabna, Bangladesh.</p> <p><strong>Materials &amp; Methods: </strong>A cross sectional, questionnaire-based survey was carried out among the 125 nurses of Mental Hospital, Pabna. The studywas conducted between January to February 2019. The depression levels were assessed using Zung depression scale. Nurses were asked to complete the questionnaire and then the depression levels calculated.</p> <p><strong>Result: </strong>The overall prevalence of depression among the nurses was 4.13 percent. The prevalence of depression was 4.5 percent among female nurses versus 2.94 percent in male nurses.</p> <p><strong>Conclusion: </strong>The prevalence of depression is seen especially innurses. So, attempts should be made to alleviate the stressors.</p> <p>Medicine Today 2019 Vol.31(2): 111-113</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Outcome of Laparoscopic Deroofing of Renal Cyst- Our Experience 2019-07-04T10:59:11+00:00 Md Nazmul Haque Md Muazzam Hossan Md Mofiz Uddin <p><strong>Introduction: </strong>To evaluate the outcome of laparoscopic deroofing of renal cyst for the management of symptomatic renal cyst.</p> <p><strong>Materials &amp; Methods: </strong>This study was performed on 32 patients having symptomatic renal cyst at the Department of Urology, Shahid Sheik Abu Naser Specialized Hospital, Khulna and two other private hospitals in Khulna from January 2015 to December 2017. Patients having cyst size less than 5cm, previous abdominal surgery and sepsis were excluded from this study. Transperitoneal approach was adopted in all cases. All patients were diagnosed by ultrasonography and computed tomography to determine the Bosniak classification of the cyst. Pain and cyst recurrence were assessed during the follow-up.</p> <p><strong>Results: </strong>Thirty-two patients (mean age=52.9±12 years) with large renal cyst (mean size=35±13) were included. All procedures were completed successfully, with no major intraoperative complications. The mean (range) operative duration was 56 (35–125) min, affected by the site and number of cysts unroofed. All patients were symptom-free except one, who had a recurrent large cyst, anteriorly located, and who underwent open cyst deroofing.</p> <p><strong>Conclusion: </strong>Laparoscopic deroofing of symptomatic renal cysts should be the standard of care, especially after failed percutaneous aspiration, with reduced postoperative pain, short hospital stay and cost effective. It is feasible with conventional laparoscopic instruments and gives a better cosmetic outcome.</p> <p>Medicine Today 2019 Vol.31(2): 114-116</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## Study on TT Vaccination Status of Female Students of Khulna 2019-07-04T10:59:12+00:00 Farhana Ferdaus Susmita Nargis Heera Lal Roy Ehsanul Islam Md Tazul Islam Mahmuda Sultana <p><strong>Introduction: </strong>The purpose of giving the TT vaccine to women of childbearing age and to pregnant women is to protect them from tetanus and to protect their newborn infants against neonatal tetanus.</p> <p><strong>Materials and Methods: </strong>A descriptive cross-sectional study was done on January, 2017 to find out the TTvaccination status of students of Khulna Government Pioneer Girls College, Khulna. During scheduled time period. Data were collected from 100 respondents selected by purposive type of convenient sampling by face to face interview using a prepared mixed type of questionnaire.</p> <p><strong>Results: </strong>Among total respondent’s majority 36(36%) were belonged to 17-19 years of age group. People of our country nowadays more aware of TT vaccination as 97 (97%) of our total respondents had knowledge about TT vaccination. Achievement in TT vaccination coverage has been impressive throughout the country in recent years. It has also been reflected in our study, we had 84(84%) coverage and 55 (42%) of our respondents had completed their vaccination (5doses). Establishment and improvement of infrastructure of government health organizations 70(83.33%) of our study population received vaccination in government organization. Acceptance of TT vaccination has increased to a satisfactory level. In our study TT vaccination coverage was maximum (85.51%) in upper class and only (71.43%) in lower class respondents.</p> <p><strong>Conclusion: </strong>Despite high knowledge, completion of recommended doses of TT vaccine was not guaranteed due to stock-outs coupled with detrimental cultural and religious beliefs.That is why large scale study is needed to find out TT coverage among women of reproductive age group (15-49 years) of Bangladesh which can ensure the real scenario as well as factors related to this.</p> <p>Medicine Today 2019 Vol.31(2): 117-119</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## A Short Review on Anti-diabetics for Uncontrolled Type 2 Diabetes Mellitus 2019-07-04T10:58:53+00:00 Hussain Ahmad Md Abu Nayeem Chowdhury <p><strong>Introduction: </strong>This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade. Materials and Methods: This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included.</p> <p><strong>Materials &amp; Methods: </strong>Screening and diagnosis is still based on World Health Organization (WHO) and American Diabetes Association (ADA) criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers is still the recommended first line medication. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine.</p> <p><strong>Discussion: </strong>Screening and diagnosis is still based on World Health Organization (WHO) and American Diabetes Association (ADA) criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers is still the recommended first line medication. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine.</p> <p><strong>Conclusion: </strong>Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient.</p> <p>Medicine Today 2019 Vol.31(2): 120-127</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement## A Case Study of Achalasia of Cardia 2019-07-04T10:58:54+00:00 Md Rafiqul Islam Kazi Moinur Rahman Md Showkat Ali SM Golam Azam <p><strong>Introduction: </strong>Achalasia is a benign idiopathic disorder caused by progressive neuronal degeneration in the mesenteric plexus of Auerbach, which causing non-relaxing, hypertensive lower esophageal sphincter (LES) and aperistalsis of the esophageal body. This functional damage is irreversible and the treatment of esophageal achalasia is mainly palliative.</p> <p><strong>Case Report: </strong>Our patient is a 55 years old lady presents with progressive dysphagia, regurgitation, chest pain and weight loss. After clinical examination and relevant investigations, she was diagnosed as a case of achalasia of cardia of oesophagus.</p> <p><strong>Discussion: </strong>She was prepared for Heller’s myotomy with antireflux procedure. Operative procedure was done under general anaesthesia.</p> <p><strong>Conclusion: </strong>Postoperative recovery was good. The patient is asymptomatic, general condition improved and found healthy on follow up after one year.</p> <p>Medicine Today 2019 Vol.31(2): 128-130</p> 2019-06-26T00:00:00+00:00 ##submission.copyrightStatement##