Comparison of efficacy of duloxetine with amitriptyline in terms of reduction in frequency of pain in the patients of diabetic neuropathy.

Objectives: To compare the efficacy of Duloxetine with Amitriptyline in Terms of Reduction in Frequency of Pain in The Management of Patients of Diabetic Neuropathy. Study Design: Randomized Control Trial. Setting: Medical OPD of ABWA Medical College Hospital Faisalabad. Period: Six Months from 01-01-2019 to 30-06-2019. Material & Methods: A total of 200 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5 years history of diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5% were included. Two groups were formed Group A was given 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose. After 3 weeks, an additional three weeks supply of medication was dispensed and patient were scheduled to return at week 6 for the final evaluation that recorded by me in terms of reduction in pain score and also assessed for 50% reduction in pain score from base line that was labeled as reduced. Results: 62%(n=62) in Group-A and 35%(n=35) in Group-B were treated effectively, which shows a significant difference between the two groups. Conclusion: The duloxetine was more effective than amitriptyline in terms of reduction of pain in diabetic neuropathy.

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DIABETIC NEUROPATHY;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.08.991 ◽

2017 ◽

Vol 24 (08) ◽

pp. 1181-1184

Author(s):

Mehr Imran ◽

Muhammad Umair Fiaz ◽

Muhammad Arslan ◽

Ayesha Khalid

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Neuropathy ◽

Pain Score ◽

Random Number ◽

Base Line ◽

Significant Difference ◽

Group A ◽

Random Number Table ◽

Group B ◽

Study Setting

Objectives: To compare the efficacy of duloxetine with amitriptyline for reductionin the frequency of pain management in patients with diabetic neuropathy. Study Design: It isa Comparative, Randomized and Prospective study. Setting: Medical Unit-4, DHQ, Hospital,Faisalabad. Study Duration: 5 months, October, 2016 to February 2017. Methods: A total of100 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5years historyof diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5%were included while those with co-existing other causes of peripheral neuropathy (porphyria,chronic renal failure, amyloidosis, leprosy, hypothyroidism), pregnant and lactating womenand use of Duloxetine or amitriptyline in previous three months were excluded from the study.Randomization was done by computer generated random number table, to allocate patientsto either group A (Duloxetine group) or group B (Amitriptyline group). Patients were instructedto take study medication in the morning, with a glass of water for up to 6 weeks. Group A wasgiven 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose.Baseline pain was recorded on VAS. Diary card was provided to all patients at the baseline visit.Each morning during the 1st 3 weeks, patients would be instructed to record the severity of thesymptoms in term of reduction in pain score recorded by visual analogue scale. After 3 weeks,an additional three weeks supply of medication was dispensed and patients were scheduled toreturn at week 6 for the final evaluation that was recorded by me in terms of reduction in painscore and also assessed for 50% reduction in pain score from base line that was labeled asreduced. Patients were followed up by keeping telephonic contacts of patients. Results: In ourstudy, out of 200 cases (100 in each group) 21%(n=21) in Group-A and 17%(n=17) in Group-Bwere between 20-40 years of age while 79%(n=79) in Group-A and 83%(n=83) in Group-Bwere between 41-65 years of age, mean+SD was calculated as 47.08+11.43 and 48.37+10.83respectively, 56%(n=56) in Group-A and 49%(n=49) in Group-B were male while 44%(n=44)in Group-a and 51%(n=51) in Group-B were females, comparison of efficacy in both groupswas done which shows that 62%(n=62) in Group-A and 35%(n=35) in Group-B were treatedeffectively, which shows a significant difference between the two groups. Conclusion: It isconcluded that the efficacy of duloxetine as compared to the amitriptyline in terms of reductionin frequency of pain in the management of patients of diabetic neuropathy is significantly higher.

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Intranasal Splint in Nasal Septal Surgery: Is It Necessary?

Medicine Today ◽

10.3329/medtoday.v32i2.48835 ◽

2020 ◽

Vol 32 (2) ◽

pp. 126-129

Author(s):

Jahangir Alam Mazumder ◽

Md Golam Mustafa ◽

AHM Delwar ◽

Shazibur Rashid ◽

Md Mostafizur Rahaman ◽

...

Keyword(s):

Complete Healing ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Septal Surgery ◽

Significant Difference ◽

Group A ◽

Medicine Today ◽

Group B ◽

Male To Female

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified. Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities. Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%). Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation. Medicine Today 2020 Vol.32(2): 126-129

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Modified Hasson technique versus Veress technique: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20194060 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3246

Author(s):

Robinson George ◽

Mebin Mathew ◽

Veerabhadra Radhakrishna ◽

Ashna Rahman ◽

Aswini Thenamangalath

Keyword(s):

Port Site ◽

Port Placement ◽

College Hospital ◽

Medical College ◽

Significant Difference ◽

Duration Of Surgery ◽

Group A ◽

Group B ◽

Needle Entry ◽

Better Than

Background: There are two techniques of port placement for laparoscopy, Veress and Hasson. Both have their own advantages of disadvantages. Plenty of new modifications of these techniques have been tried to reduce the risks. We modified Hasson’s technique and evaluated whether the technique is better than the standard Veress technique.Methods: A retrospective analysis was carried out in the Department of General Surgery, Al Azhar Medical College Hospital, India from January 2013 to December 2018.Results: There were 156 patients in group A who underwent laparoscopy by Modified Hasson technique. The Veress technique was used in 149 patients who belonged to group B. There was no difference between the two groups in terms of age and indications for the surgery. The entry time (the time to place the first port) for group A was significantly lesser than that of group B (2.08±0.65 min vs. 4.59±0.53 min; p=0.000). There were a total of two complications in group A which was significantly lesser than that of group B (14; p=0.002). There was no significant difference between the two groups in terms of extraperitoneal port placement, intraperitoneal injury, failure to enter the abdomen, port site seroma, port site infection, port site hematoma, and mortality. But, port site hematoma was significantly lesser in group A compared to group B (0 vs. 5; p=0.027).Conclusions: Modified Hasson’s entry was found to be much better than Veress needle entry due to its simplicity for beginners in laparoscopy, lesser time of achieving pneumoperitoneum and lesser duration of surgery in our study.

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Efficacy of Transcutaneous Electrical Nerve Stimulation for Management of Osteoarthritis of Knee Joint: A Randomized Control Trial

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v3i2.36768 ◽

2018 ◽

Vol 3 (2) ◽

pp. 75-79

Author(s):

Khurshid Mahmood ◽

Ariful Islam ◽

Aparajeya Bivab Bikash Baral ◽

Prasanta Kumar Chakraborty

Keyword(s):

Knee Joint ◽

Therapeutic Exercise ◽

Physical Medicine ◽

College Hospital ◽

Electrical Nerve Stimulation ◽

Medical College ◽

Significant Difference ◽

Group A ◽

Randomized Control ◽

Group B

Background: Management of osteoarthritis of knee joint is very important.Objective: The purpose of the present study was to observe the efficacy of transcutaneous electrical nerve stimulation (TENS) in the treatment of osteoarthritis (OA) of the knee.Methodology: This study was designed as randomized control trial which was conducted in the Department of Physical Medicine at Dhaka Medical College Hospital, Dhaka Bangladesh from July 2007 to December 2007 for a period of six (06) months. Patients presented with osteoarthritis at the age group of more than 30 years to 60 years with both sexes who were attended in Physical Medicine and Rehabilitation department in the Dhaka Medical College Hospital, Dhaka were selected as study population. The study populations were included by purposive sampling method after fulfilling the inclusion and exclusion criteria and were divided into two groups designated as intervention group (group A) and control group (group B). Group A was treated with TENS, therapeutic exercise, NSAID and ADL. Group B was treated with therapeutic exercise, NSAID and ADL.Results: A total of 60 patients with osteoarthritis (OA) of the knee joint were included in the study group. The mean age of both sexes were 46.67±7.04 years and male (46.83±7.73) patients were higher than female (46.56±6.41). There was significant difference in improvement of pain between two groups after treatment for two week (p=0.002); however, finally it was found that there was no significant difference in improvement of pain between two groups after treatment for 6(six) weeks. There was no significant difference in improvement of range of movement (ROM) between two groups after treatment for six weeks (p=0.946). There was no significant difference in improvement of walking speed between two groups after treatment for six weeks (p=0.611).Conclusion: In conclusion significant decrease of pain with increase of ROM and walking speed is found in all patients group with OA knee regardless of the treatment program.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 75-79

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Effect of Quadriceps Strengthening Exercise on Reduction of Pain in Knee Osteoarthritis

Bangladesh Medical Journal ◽

10.3329/bmj.v41i3.18953 ◽

2014 ◽

Vol 41 (3) ◽

pp. 19-22

Author(s):

CM Walid ◽

MH Islam ◽

AZM M Rahman ◽

MT Islam ◽

MK Hassan ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Pain Score ◽

Global Assessment ◽

Quadriceps Muscle ◽

College Hospital ◽

Female Ratio ◽

Strengthening Exercise ◽

Reduction Of Pain ◽

Group A ◽

Group B

Osleoarthritis is the leading cause of musculoskeletal pain and disability. Nonsteroidal anti-inflammatory drugs and physical modalities like Quadriceps muscle strengthening exercise can be used to treat such cases. This Randomized clinical trial study was done in the department of Physical Medicine and Rehabilitation, Sylhet M.A.G Osmani Medical College Hospital Sylhet, lo evaluate the role of quadriceps strengthening exercise in knee osteoarthritis during 1st April 2009 to 3lst October 2009. Sixty patients with knee osteoarthritis were selected according to inclusion and exclusion criteria. They were divided in, group A and group B randomly. Group- A was treated with NSAID (Aceclofenac 100 mg 12hrly) and group-B with NSAID and quadriceps strengthening exercise 10 repetition 3 times daily. Each patient was followed try every week for four weeks. The mean age was 61.067 ± 8.320 years and male female ratio was 1.4:1. Marked improvement was observed in both the groups assessed by pain score (p<0.001), physicians global assessment (p<0.001) and patients global assessment (p<0 001); and was continued throughout the treatment period of 4 weeks; with significantly marked in group A than group B beginning at 1st week of treatment [pain score (p<0.001), physicians global assessment (p<0.040) and patients global assessment (p<0.034)] and was continued at the 4th week of treatment [pain score (p<0.001), physicians global assessment (p<0.001) and patients global assessment (p<0.001)]. The overall difference between the groups from baseline to end point of treatment is significant with group A (exercise plus NSAIDs) experienced a faster pain relief than that of group B (Only NSAID) (p:<0.001). So from the present study, it may be concluded that quadriceps strengthening exercise is useful in reduction of pain in knee osteoarthritis and may be an adjuvant therapy in knee osteoarthritis. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18953 Bangladesh Medical Journal 2012 Vol.41(3): 19-22

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Role of Ultrasound In The Management of De'Quervain's Disease

Medicine Today ◽

10.3329/medtoday.v24i1.14112 ◽

2013 ◽

Vol 24 (1) ◽

pp. 31-35

Author(s):

Muhammad Kamrul Hassan ◽

M Habibur Rahman ◽

Fauzia Sobhan ◽

Farzana Khan Shoma ◽

Chowdhury Mohammad Walid

Keyword(s):

Pain Score ◽

Post Treatment ◽

Ultrasound Therapy ◽

College Hospital ◽

Medical College ◽

Vas Score ◽

Number Of Patients ◽

Group A ◽

Medicine Today ◽

Group B

This prospective type of experimental study was carried out to determine the improvement of symptoms by ultrasound therapy in management of de'Quervain's disease. It was done in the department of physical medicine and rehabilitation in Dhaka medical college hospital during the period of 30th January 2008 to 30th July 2008.The diagnosis of de'Quervain's disease confirmed by history and clinical examination(Finkelstein test). 50 patients were selected and randomly divided into two groups. Group-A patients were treated with thumb splint,NSAIDS and ADL. Group-B patients were treated with thumb splint, NSAIDS, ADL and ultrasound therapy. Each patients was assessed by pain score, visual analogue scale(VAS), grading of tenderness and swelling. Mean age was 41.02 years. Female and male ratio was 7.5:1. Most patients occupation was housewife 40(80%) and had a precipitating factor as wringing of cloths 31(62%). History of recurrence was found in 7(14%). Most of the patients developed pain gradually 72%(36). Post treatment VAS score improved significantly in group B(p<0.05), in groupB 96%(24) and in group A 52%(13) patients had VAS score 0 to 4. Post treatment significantly (p<0.01) higher number of patients were in swelling score. So in group B(84%) compared to group A (44%), After treatment pain score showed significant improvement (p<0.01) in group B patients (72%) compared to group A(24%). In group A, 16%(4) and in group B 32%(8) patient were completely cured(No pain,no tenderness and no swelling). DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14112 Medicine TODAY Vol.24(1) 2012 pp.31-35

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Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49882 ◽

2020 ◽

Vol 21 (2) ◽

pp. 105-110

Author(s):

Md Shawkat Alam ◽

Sudip Das Gupta ◽

Hadi Zia Uddin Ahmed ◽

Md Saruar Alam ◽

Sharif Muhammod Wasimuddin

Keyword(s):

Comparative Study ◽

Acute Urinary Retention ◽

Bladder Capacity ◽

Inclusion Criteria ◽

College Hospital ◽

Medical College ◽

High Incidence ◽

Group A ◽

Group B ◽

Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

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Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

10.53350/pjmhs211551134 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1134-1135

Author(s):

M. A. Chhutto ◽

A. H. Mugheri ◽

A. H. Phulpoto ◽

I. A. Ansari ◽

A. Shaikh ◽

...

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Adverse Outcomes ◽

Chronic Liver ◽

P Value ◽

College Hospital ◽

Medical College ◽

Group A ◽

Group B ◽

Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

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Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.6309 ◽

2021 ◽

Vol 28 (03) ◽

pp. 277-281

Author(s):

Bushra Shaikh ◽

Imamuddin Baloch ◽

Azhar Ali Shah ◽

Abdul Sami Mirani ◽

Parkash Lal Lund ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Wound Infection ◽

Port Site ◽

Site Infection ◽

College Hospital ◽

Medical College ◽

Duration Of Surgery ◽

Group A ◽

Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

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Surgery for primary intracerebral haemorrhage: is it safe and effective?

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v38i3.14328 ◽

2013 ◽

Vol 38 (3) ◽

pp. 74-78

Author(s):

MMH Talukder ◽

KMT Islam ◽

M Hossain ◽

MU Jahan ◽

F Mahmood ◽

...

Keyword(s):

Intracerebral Haemorrhage ◽

Glasgow Outcome Scale ◽

Control Group ◽

Intracerebral Haematoma ◽

College Hospital ◽

Conservative Group ◽

Best Medical Treatment ◽

Significant Difference ◽

Group A ◽

Group B

This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College Hospital from January 2006 to October 2007. All patients with primary intracerebral haematoma with Glasgow Coma Scale (GCS) 5-15 (on admission) and heamatoma volume 30 cc or above admitted at Neurosurgery department managed conservatively or surgically were included in this study. Total 60 patients were selected, of them 30 patients managed conservatively and 30 patients managed surgically. Conservatively managed patients regarded as control group (Group-A) and surgically managed patients regarded as experimental group (Group-B). Patients or attendants refused to operate were included in the conservative group. All the selected patients were evaluated on the basis of detailed history, clinical examination (general and neurological examination) and CT scan findings. Outcome was evaluated in term of Glasgow Outcome Scale (GOS). Best medical treatment was given for conservative group and operations were done for surgical group and followed up after surgery till discharge by observing GCS and GOS at discharge. Number of death were 15 (50%) patients in group- A and 13 (43%) patients in group-B. There was no significant difference in mortality rate between two groups but outcome was relatively better in group-B. According to Glasgow Outcome Scale, dependency in group-A and group-B was 26.6% and 23.4% respectively. So dependency were more in group-A. But there was no significant difference statistically. Seven (23.4%) patients were independent in group-A but 10(43.3%) patients were independent in group-B. However in relative terms of outcome of group-B was better than that of group-A. In our study we found no statistically significant difference in outcome between medical and surgical management of primary intracerebral haemorrhage. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14328 Bangladesh Med Res Counc Bull 2012; 38(3): 74-78 (December)

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