Oral Prednisolone Treatment of Sudden Sensory Neural Hearing Loss: 16 A Three Year Retrospective Analysis

Sudden Sensory Neural Hearing Loss (SSNHL) is a serious medical condition and requires prompt medical attention. The study was done to estimate the effect of different protocols of oral Prednisolone plus high dose vitamin B-complex and vitamin BI, 132. Be in patients with unilateral SSNHL who have failed to respond to treatment. A retrospective study was done from January 2015 to January 2018 at the outdoor patient department of Holy Family Red Crescent Medical College Hospital, Dhaka among 75 randomly selected patients with a mean age of 46.32 years (range 25-69 years). with the preselected criteria. Each of the patient received one of the four standard oral Prednisolone dosing protocols along with high dose of vitamin B-complex and BI, 132, Be orally 20mg four times for a total dose of 80mg daily for one week, Group A, n=18; orally 20 mg three times, for a total dose of 60mg daily for one week Group B, n=18; orally 20mg two times for a total dose of 40mg daily for one week Group C, n=18; orally 10mg three times for a total dose of 30mg daily for one week. Group a n=18. All the doses were then tapered for next 5 days. Patient characteristics and pharmacological effects were compared among the 4 groups. The mean age, average duration of symptoms from onset to treatment, and degree of hearing loss were analyzed by means oft-test Treatment effects were analyzed by means of Chi-square test. P<0.05 was considered significant. Improvement of hearing was assessed by pure tone audiogram. The total effective rate was 88.89% 83.33%, 77.78% 66.67% for each treatment protocol, respectively, with no significant statistical difference between them (p00.05). The results suggest that a total dose of 80 mg is the most appropriate protocol. Prednisolone significantly improves the prognosis of SSNHL. Further multicenter studies are needed to determine the more standard treatment protocol.

Factors Affecting the Burden on Family Caregivers of ESRD Patients

Patients of chronic kidney disease on hemodialysis face varieties of challenges and comorbid conditions need regular assistance from family caregiver. Caregivers of end stage renal disease (ESRD) have to bear loads of patient's daily activities, cares, medication, carrying to hospital, managing their psycho-social and financial demands which impose additional stress and burden among them. The study was conducted to evaluate the effect of care giving of patients with ESRD and to analyze the factors associated with it This cross sectional, observational and descriptive type of study was conducted in the Department of Nephrology and Psychiatry of Holy Family Red Crescent Medical College during the period of July 2018 to June 2019. Fifty family caregivers of age more than 18 years providing care or assistance to a relative with ESRD on dialysis were included. The burden of the care giver was assessed by a verified and culturally adopted Bangla-version of 22 factor Zarit Burden Interview (ZBI-B) scale. Difference of burden was not statistically significant considering its sex, marital status, place of residence, education level, religion, relation with patient, living in same house with patient or duration of the care giving of the patients (p>0.05). In JO% cases care givers had little or no burden, 26% mild to moderate, 22% moderate and 2% severe burden. So, in Bangladesh caregiving to ESRD patients imposes no or little burden on majority offamdy caregivers.

The Effect of Self-Medication with NSAIDs on GIT in Orthopaedic Patients

Self-medication is a gradually increasing entity in a healthcare system. It leads patients towards greater independence in taking decisions about management of minor illnesses. It ensures access to medication and limits delayed diagnosis, worsening of disease evolution, the cost burden of drugs in comparison to prescribed drug. The aim of the study was to evaluate the prevalence of the use of NSAIDs as in the form of analgesics for self-medication with their associated risks especially GIT symptoms. This cross-sectional study was done at Holy Family Red Crescent Medical College Hospital, Dhaka, July 2018 to December 2018 for 6 months among the patients who registered to visit Orthopaedic OPD for their musridoskeletal problems. A pretested and validated questionnaire was used to collect data. There were 97% response rate recorded. The study included 571 randomly selected patient aged between 20 to75 years, of which 55.3% were from urban areas versus 44.7% from rural areas, females being dominant (69.32%). The drugs which was surveyed, were used by 84.8% of the study population, in most cases the administration being made without prior professional advice. Of the 331 participants prom urban areas, 89% used the self-medication, compared with 58.31% in rural areas. Paracetamol (46.34%), followed by Ketorolac (24.47%) and Diclofenac (22.7%) are among the most widely used analgesics, both in urban and rural areas. The most frequent symptoms that required self-medication were: low back pain (urban and rural are), neck pain (predominantly urban) and knee joint pain (predominantly rural areas). Misuse of analgesics and anti-inflammatory drugs, both in urban and rural areas is a burning issue. The growing economy improvised urban and rural people to avail the medications without knowing the risks. Close monitoring, a multilevel venture between all concerned -patients, physicians and pharmacists to provide the supervised education and appropriate information on safe self-medication for the accomplishment of national goals, are suggested plan of action. It will maximize the benefit and minimize the risks.

Nutritional Status of School Age Children Attending OPD of Selected Hospitals

School-age is the vital growing phase of a child. Primary school age is a progressive period of physical growth and mental development of the child. Health issues because of poor nutrition in elementary schoolage children are among the foremost common causes of a low level of school enrolment, high absenteeism, early dropout and unsatisfactory classroom performance. Growth monitoring is a global tool to evaluate nutritional status, health and development of individual children, and the overall nutritional status and health ofpopulations. To find out the nutritional status of schoolage children and to signify nutritional deficiencies, a cross-sectional study was undertaken among the 222 registered school age childrenat the OPD of two selected urban and rural hospitalof Bangladesh — Holy Family Red Crescent Medical College Hospital, Dhaka and Dhamrai Upaxilla Health Complex, Savar, Dhaka. The data was collected from the parents or attendant accompanying them by non-probability purposive sampling method through semi-structured questionnaire by face to face interview. The children between 5 to 15 years were recruitedaccording to inclusion and exclusion criteria. The age group of 8-10 years constituted the highest portion (31.5%) of the respondents. The mean ± SD age of the childrenwas 9.8 ± 7.27 years. Most of the childrenwere Muslims (94.6%). About 62% of them were boys and 38% were girls. Most of the children's mothers completed theirprimary education (37.4%). The percentage of the illiterate father was 17.12% Majority of the mothers were labourers (41.32%) and most of the fathers were farmers (31.08%). Most of the respondents had monthly family income Tk 10000-30000 (43%).44% had low birth weight and about 89% of them were vaccinated following a regular schedule The mean weight of childrenwas 22.63 ±4.65 kg and height were 120.92 ± 6.54cm. According to BM1 classification, there were 58% normal, 35% undernourished and 7 % obese/overweight. The health and nutrition status of children is one of the crucial elements in the assessment of the quality of life of the people To prevent nutritional problems and their consequences early diagnosis is necessary. So, it is important to raise awareness regarding the special nutritional needs of the school-age children and regularly monitor and assess the nutritional status of them.

Pattern of Homicidal Death among the Post-Mortem Cases in a Metropolitan City of Bangladesh

Homicide means killing one human being by another humafilt is a global problem and has significant consequence for both social and economic security of the people as well as national development This study warmed to describe patterns of the homicidal behavior in a major metropolitan area. Dhaka city and the relationships among socio-demographic characteristics. This was a cross-sectional study during the period of July 2017 to June 2018 in the Department of Forensic Medicine, Dhaka Medical College. A total number of 935 cases wereautopsied during the period,of which 319 cases were included in the study as homicidaldeath. All the inquest reports and the challan were read through along with post-mortem reports during the study period. The data were collected during the autopsy as well as from the registration books (Govt. records.) in the department of Forensic Medicine, Dhaka Medical College.Out of 319 homicidal death, 227cases were above the age of 30 years (71.15 % of the total cases),233 cases were male (73.04 %) and 86 were female (26.95 %) whereas considering religion, the majority were Muslim 287 in number (89.20%) and the rest were other religion. According to the types of wound 198 cases were stab and eta-throat, 81 cases were strangulation, 32cases were firearm injury & the 08 cases were suffocated The majority of deceased resulting from stab and cut-throat injuries and those were above 30 years of age group. The most of homicidal death occurred among the young age group which is very alarming to the society and for the nation. So, we should be aware enough to prevent such cases.

Socio-economic Status Associated with Normotensive and Pre-eclamptic Women in Bangladesh

Pre-eclampsia is a disorder of 2nd half of pregnancy, which is characterized by a combination of hypertension, proteinuria and edema; secondary to decreased placental perfusion. It is commonly associated with reduced weight, diameter and volume of placenta, along with other microscopic changes. This was a comparative study, of 220 pregnant women, selected with inclusion and exclusion criteria from 3 different medical colleges - Dhaka Medical College and Hospital, Sir Salimullah Medical College and Milford Hospital and Holy Family Red Crescent Medical College and Hospital. The objective of this study is to see the association of sods economic status of selected normotensive and pre-eclamptic women in Bangladesh. Those 220 cases were then divided into 2 groups - a study group, consisting of 110 pre-eclamptic women and a control group consisting of 110 normotensive pregnant women. The sample size was determined using the standard formula. The study was then explained to each individual subject and informed consent was taken. Standard pretested questionnaire was used to collect necessary information regarding their age, residential status, educational background, occupation, age of marriage, monthly income, dietary information and nutritional status. All interviews were conducted in the hospital. Dietary information was collected by 7 days food frequency questionnaire and food score was determined. Anthropometric and biochemical tests were carried out. Urinary protein was evaluated by the Heat Coagulation test. It was found that majority of the pre-eclamptic women were in the age group of 18-24 (56.36%) years, semi-urban (70.90%), housewives (56.36%), and 45.45% of the women could write. Almost half of the pre- eclamptic group (49.09%) had a monthly income of 25,000 to 29,999 taka.

Dengue 2019 — A change in perspective of clinical presentations and laboratory finding

Dengue is known primarily to be a disease of the monsoon season, and following that a post monsoon disease. Fever along with rash, ntyalgia and headaches were wry typical of the disease. However, since 2014, these trends have been changing in Bangladesh, with eases being reported in the premonsoon season. This cross sectional observational study was rried out from Januaty 2019 to July 2019 at Holy Family Red Crescent Medical College Hospital.ca 100 hundred patients who were serologically positive either by Dengue NS1 antigen or by Dengue 1gM antibody were conveniently taken in the study and their features and investigations (laboratory and ultrasonography) were noted. These findings were also compared with 100 dengue patients who were studied in 2013 in the same institute. Changes in the presenting features were noted; while fever was found to be present 100% in both years, aches and pains were prominently less in 2019 as compared to 2013 (headache, retro orbital pain, backache 23% vs 90%; 3% vs 45%; I% vs 48% respectively). Rashes and itching were also found to be less in 2019 as compared to 2013 (4% vs 16%; I% vs 30% respectively). On the other hand, gastrointestinal symptoms like nausea and vomiting were more in 2019 (51% vs 30% respectively). Similarly, on imaging, there appeared to be more evidence of plasma leakage as seen with (mites, pleural effusion and thickened gallbladder compared to 2013; leucopenia was noted to be less in 2019 (45% vs 60%), but thrombocytopenia < 50,000/L was more in 2019 (49% vs 25%). Although the patients reflect a small section of society, it is quite evident that there is a shift in the pattern of dengue presentation, both in their features and imaging.

Wound Infection in Orthopaedic Surgery: A Cross Sectional Study at Tertiary Care Teaching Hospital in Dhaka

Infections after operative procedures caused by multiple organisms appears with pain, fever; poor wound healing, antibiotic prolongation, need in-patient longer stays and increased expenses. It increases both morbidity and mortality. A cross-sectional descriptive study was conductedat Orthopaedics ward in Holy Family Red Crescent Medical College, a tertiary care teaching hospitalin Dhaka, Bangladesh for 3-month period to identify the frequently causative bacteria of wound infections and days of appearances of such infections. Tota1135 samples from patients with mean age of 35.77*I4.38 were analyzed. Patient history and clinical findings were collected in a data collection form during the study. Fifty-sixptis samples or wound swabs were collected from infected operated area and culture and biochemical tests for aerobic bacteria were done. Total of 21 from 36 samples were growth positive cultures (58.33%) and 15 were growth negative (41.66%). Most frequent organismcausing post-operative wound infection (POW!) was Pseudomonas aeruginosa,29.57% of positive isolatesandtheir post-operative days of appearances was mostly 6-10 days with82.7% frequencies. Surgical site infection is an unsettled ongoing problem which, although, cannot be completely rusticated.However, adequatepreventivestrategies against the most commonly isolated organism and proper care of wounds may reducethe occurrences of such infection.

Preventive Role of Zingiber Officinale against Hyperglycemia in Alloxan Induced Diabetic Rats

The experimental animal study was undertaken to investigate the preventive role ginger juice against hyperglycemia in alloxan induced diabetic rats.Male wistar rats,(130-150)gm wt fed on standard diet and water ad libitum, were divided into 3 groups(n=6) in each group: Group-L non-diabetic control group, Group-II, diabetic control & Group-III, normal rats pretreated with ginger before they were made diabetics. Diabetes was induced by inj. alloxan 150mg/kg body wt.,tp (Group-IL on 2nd day & Group-Ill, on the 9th day).Rats having blood glucose level of more than 7mmol/L on day 5(72 hours after alloxan inj) were considered diabetic & selected for experiment. Rats of Group-Ill received Zingiber officinale (ginger juice) (4m1/kg.body,wt orally) for 7 days (day 2-day8) through Pyles tube before alloxan induction & 3days after the induction. On day 12, animals were sacrificed under light ether anaesthesia, blood was collected by cardiac puncture for blood glucose estimation. Pretreatment with Zingiber officinale (ginger) juice significantly (p<0.01) reduced alloxan induced hyperglycemia.Zingiber officinale (ginger) is one of the most widely used spices and is reputed to have medicinal properties against diabetes mellitus. This study suggests that pretreatment with Zingiber officinale(ginger) prevents the development of hyperglycemia in alloxan induced diabetic rats.

Hyperemesis Graviderum: An observational study and outcome at a tertiary teaching hospital in Dhaka city

Hyperemesis graviderum is a complication of pregnancy that can lead to severe maternal nutritional deprivation. About 0.14% -1.3% of pregnant women sufferedfrom hyperemesis graviderum. Women with hyperemesis grmidanan causing loss of greater than 5% of their pre-pregnancy weight. And has been linked to fetal growth restriction, wernickes encephalopathy resulting in fetal death in 40% of cases . Ilyperemesis graviderzaninterfire there working life, it is important to know the outcome of hyperemesis graviderum on fetus and mother. A tertiary level hospital based prospective study was conducted on woman suffering from Hyperemesis graviderum and attended in OPD and 1F'D of Holy Family Red Crescent Medical College Hospital, Bangladesh to asses the adverse outcome of Hyperemesis Graviderum on .mother and baby and identifies its determinants. The mean age of the study group was 26.2513.25 years. Regarding parity, 54.0% patients were found primipara and 46.0% patients found multipara. The majority of the subjects (66%) were normal weight, 18% patients had overweight by BM1 (body mass index) 12% patients were underweight and 4% patients were obese. Distribution of the study subjects according to educational status, it was found that 32% were primary, 44% patients were high school, 12% patients were SSC, 8% patients were HSC and 4% patients were graduate and above. Out of 50 cases, 64% were housewife, 18% patients were service, 4% patients were business and 10% patients were student. Majority of patients (70%) had positive family history of hyperemsisgravidenn. Study showed 46% respondent started vomiting within 6-10 gestational weeks, 30% started vomiting more than 10 gestational weeks and 24% started vomiting within 1-5 gestational weeks. Maximum subjects (78%) needed home treatment and 22% patients were hospitalization. Most of the patients (68.0%) hemoglobin level 6- 10mg/d 1 . Maximum were rhesus positive blood group. Most of the patients 98% had normal serum creatinine level, 86% patients had normal serum electrolytes, 94% patients had normal urine R/M/E, 78% patients had normal RS'S level, 100% patients of hyperemesis gravidunn patients ultrasonography reports in pregnancy was normal. Among 50 patients, 4% patients had abortion history, 2% cases had IUD, 44% patients had IUGR and 10% patients had AGA in pre-term pregnancy. Out of 23 term pregnancy, 24% cases had 1UGR and 22% cases had AGA. Two percent neonatal death after delivery. hyperemesis Graviderum is related to maternal age, parity, education level, body mass index, occupation of the patients, education level, family history of hyperemesis graviderum and adverse outcome on mother and baby.