Socio-demographic and Clinical Characteristics of Patient with Thyroid Cancer

Background: Thyroid cancer is the most common malignant disease in endocrine system. It is an emerging public health issue associated with burden on the family, community and the nation. The aim of this study is to determine the socio-demographic and clinical characteristics of patient with thyroid cancer attending in tertiary hospital. Methods: This cross sectional study was conducted among 246 thyroid cancer patients in two tertiary hospitals of Dhaka city from 01 July 2018 to 30 June 2019. The subjects were selected purposively following specific selection criteria and maintaining ethical issues. Data were collected by face to face interview using a semi-structured questionnaire and checklist. Data were analyzed by the statistical package for the social science (SPSS) version 23. Results: This study revealed that majority (74.4%) of respondents was female, married (72%), housewife (61.4%), rural respondent (41.1%) and had primary education (69%). Mean (± SD) age of the respondent was 37.85(±12.20) years (Range 14-70 years) and mean (± SD) monthly family income was Tk. 17681(±10602). Out of 246 cases, 204 (82.9%) was papillary and 42 (17.1%) was follicular carcinoma. Various clinical presentations included visible neck swelling in 225 (91.5%), swollen lymph node in 103 (41.9%), pain 90 (36.6%), Difficulties in swallowing 87 (35.4%), Hoarseness of voice in 141 (57.3%), cough along with swelling 47(19.1%), Difficulties in breathing due to swelling in 13(5.3%) of the patients. Conclusion: Incidence of thyroid cancer has increased worldwide specially in female patients in 3rd and 4th decades of life. As thyroid cancer is a growing public health problem in Bangladesh, proper screening and early diagnostic facilities at all level should be available to measure its actual burden in the country. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 54-58

Serum Ferritin Status of Patients with Type 2 DM Attending OPD of BIRDEM General Hospital

Background: In recent times much is talked about of serum ferritin, an acute phase reactant a marker of iron stores in the body and its association with diabetes mellitus. Studies implicate that increased body iron stores and subclinical hemochromatosis has been associated with the development of glucose intolerance, type 2 diabetes and its micro as well as macrovascular complications. Material & Methods: This study was carried out to examine and to observe for any relationship between serum ferritin with Type 2 diabetes mellitus. Our study populations were included 163. Among them 81 type 2 diabetes patients as a case (M=49,F=32, mean 44.68 age in years)and 82 normal healthy individual as a control ( M=35, F=47 , mean 34.71 in years). Results: Majority were healthy outpatients who had come for regular checkup and were matched with controls. Serum ferritin and FBS were estimated and other investigations. Results showed that although Serum ferritin was in the normal range value it was increased in type 2 diabetes patients than in controls and was statistically significant, we did get a positive correlation with duration of diabetes. It can be concluded that there were positive associations between serum ferritin and FBG, age, sex among study groups. Conclusion: In conclusion our study shows that there is significant correlation between increased serum ferritin in diabetes compared to individuals with normal blood sugars in this part and hyper ferritinemia may be one of the causes for development of insulin resistance before overt diabetes. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 7-10

Promotion of vaginal birth in Bangladesh

not available Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 3-6

Risk Factors of Coronary Heart Disease among Civil Employees of a Tertiary Level Hospital

Background: Cardiovascular risk factors are the most inimical and deleterious elements to develop coronary heart disease (CHD). To identify the factors contributing to develop CHD is therefore of paramount importance. It needs endless attention to address the riddle. This effort is to candle the light on sociodemographic & other factors of CHD. Methods & Materials: This cross-sectional study was conducted in CMH Dhaka from September to December 2011 on 287 respondents. Data were collected by interview using semi-structured questionnaire. Data were checked, edited, coded, categorized, cleaned and analyzed using (SPSS version 20). Results: The study disclosed that respondent's mean age was 39.40+9.42 years, 67.2% were male and 32.8% were female. It was founded that 34.14% were smoker. The prevalence rate of HTN and DM were 14.3% and 4.5% respectably. The mean BMI was 24.55 with 58.5% had normal weight and 41.5% were overweight, 18.8% had positive family history of suffering from CHD. among the respondents 88.5% has got at least one risk factor, 60% has got 5-10 risk factors, 13.6% got 6-10 risk factors, 14.3% got>10 risk factors. Age was significantly associated with smoking (p<.049), educational status (p<.001) and blood pressure (p<.001). Physical exercise was associated with BMI (p<.001) and blood pressure (p<.001). Risk factors had highly significant association with age (p<.001). Conclusion: All these findings suggest that a substantial evidence of risk factors of coronary heart diseases were prevailing among the study population. Proper care through positive motivation, avoidance of risk behaviour, intervention of clinical conditions can resist risk factors of coronary heart disease thus coronary heart disease can be prevented. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 22-28

Errata vol. 11(1)

not available Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P vi

From the Desk of the Editor in Chief vol. 11(1)

not available Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 86

Out Come of Expectant Management and Induction of Labour with Premature Rupture of Membrane in Term Pregnancy

Introduction: Overall, at least 50% of mothers with PROM near term deliver within 48 hours. The latency period is in general inversely related to the gestational age at the time of PROM. At term, labor is desirable since infections become more likely with more prolong intervals between rupture and delivery. Neonatal complications and perinatal mortality and morbidity also associated with PROM. Material and methods: This randomized clinical trial study was carried out in the Department of Obstetrics and Gynecology Sir Salimuilah Medical College and Mitford Hospital Dhaka, during the period of January 2008 to September 2008. A total of 100 patients with term pregnancy had single fetus and cephalic presentation with PROM were enrolled in this study. After taking informed consent she was randomized in one of the two either groups according to the results of lottery. Fifty in Group I- Termination of the pregnancy (intervention group) by induction of labour and another 50 were in Group II- Expectant management for spontaneous delivery (expectant group). Randomization was 1:1 for intervention and expectant management. Proper history including demographic, past obstetric and medical history was taken, maternal temperature and Fetal heart rate was recorded. Antibiotics were given to all PROM women. The women of intervention group were induced by following ways -Women with riped cervix with oxytocin infusion and with unripe cervix, first underwent ripening by misoprostol followed by oxytocin infusion. Data was collected by standard questionnaire; results were compiled and relevant statistical calculation was done using computer-based software (SPSS). Results: The mean age was 20-24 years were predominant in both groups. Low income patients were more common in both groups. Primigravida were predominant in both groups. The mean gestation age was almost similar in both groups, no significant (p>0.05) difference was found between two groups. Majority (80%) patients had time interval 1 to 12 hours between rupture membrane and onset of labour pain in group I. On the other hand 80% patients in group II had 12 to 24 hours time interval for onset of labour pain after rupture membrane.Normal vaginal delivery was higher in group I, whereas caesarean section (LSCS) was higher group II. No statistically significant (p>0.05) difference was found between two groups.Duration of time interval between on set of labour pain to delivery was <12 hours in group I 88.0% patients and 96.0% in group II respectively. No statistically significant (p>0.05) difference was found between two groups.Hundred percent cases was live birth in both groups. Neonatal infection and death were significantly (p<0.05) higher in group II. Puerperal sepsis was significantly (p<0.05) higher in group II.The mean duration of hospital stay was 4.1±2.2 and 5.1±3.7 days in group I and group II respectively but this was not significant (p>0.05). Conclusion: In the present study there was no statistical difference in the mode of delivery and time interval between onset of labour pain and delivery in two groups though maternal complications, neonatal infection and perinatal death was higher where expectant management was followed. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 59-65

Fertility Control Behavior among the Clay Modeler Women in Rural Area

Background: Fertility control behavior of women in different cultural practices greatly influences the demographic pattern of a country. The high fertility rate is associated with maternal and infant mortality rate. The aim of this study was to find out the fertility control behavior of the clay modeler women in rural area. Material and Methods: This descriptive type cross sectional study was carried out among 1360 respondents by purposive sampling technique from19th to 21st January, 2019 in different villages of Dhamrai Upazila, Dhaka. Data were collected by duly pretested a semi-structured questionnaire through face to face interview. Data were analyzed manually and by using computer. Results: Then study revealed that majority of the respondents 79% were Muslims by religion and about 76% respondents were found within the age 25-44 years with mean age 34.8±8.6 years. About 32% & 35% respondents were found primary & secondary level of education respectively. Moreover, 16% respondents monthly income were less than TK 2000 and 37% respondents had 2-3 number of children. About 79% respondents were using the fertility control measures only. Among the users 67% respondents were using Oral pills, 10% & 8% were using IUCD and Injections respectively. Adherence factors for contraceptive use were husband's support 85%; support of family members 90% and availability of contraceptive materials were found 97%. On the other hand, non-adherence factors for contraceptive use were religious barrier 91%; fear of complications 97% and insultations 85%. In this study, Overall perceptions on fertility control measures and time interval for birth spacing found positive. Conclusion: Intensified efforts should be made towards creating public awareness and strengthening perception regarding fertility control behavior to overcome those non-adherence factors for contraceptive uses. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 29-34

Renal Tuberculosis Presented as Emphysematous Pyelonephritis: A Case Report

Emphysematous pyelonephritis(EPN) is an acute necrotic infection of the kidney which is characterized by presence gas in the renal parenchyma. Uncontrolled diabetes mellitus and obstruction of the urinary tract are the main predisposing factors and Mycobacterium tuberculosis is a rare causative pathogen. One of the major health problem faced particularly by the developing world since ages is that of tuberculosis (TB). Genitourinary tuberculosis (GUTB) is the second most common extra-pulmonary TB, with kidney being the most frequent site of infection. We herein report a case of a patient with uncontrolled diabetes mellitus who was admitted through emergency department with symptoms of pyelonephritis. Imaging revealed the gas in the renal parenchyma establishing the diagnosis and as we found sterile pyurea we searched for Mycobacterium tuberculosis. GUTB was diagnosed and was treated successfully with anti TB drugs. EPN is a medical emergency and once diagnosed, attention must be paid to avoid high mortality rates. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 73-77

Extensive Genital Warts in Man Hampering Conjugal Life: A Case Report

Genital warts, commonly known as condyloma acuminata, caused by the proliferation of squamous epithelial cells in the presence of sexually transmission of human papilloma Virus (HPV) infection. In human, HPV infection results in simple condyloma acuminatum, giant condyloma or Buschke-LÖwenstein tumour, and seldom penile carcinoma. There are several modalities of treatment options available for genital warts- medical and surgical, alone or in combination. Sometimes extensive genital warts represent a district entity resulting from HPV infection and require surgical management. We present the case of a 42-year-old male; rickshaw puller had multiple professional female sexual partners, who presented with extensive genital warts in penoscrotal region. Lesions were treated due to failure of medical management, by wide electrosurgical excision and rotation scrotal skin flaps Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 82-85