Descriptive Type Of Observational Study Research Articles

Men’s perception and participation in maternal and child health care in the field practice area of a teaching hospital: A cross-sectional study from rural Bengal

ABSTRACT Introduction: Participation of men in maternal and child health (MCH) is crucial for the reduction of infant and maternal mortality. MCH care services have been focused on providing information and services to women, but males’ behaviour and decisions affect the health of the child and mother. Objectives: The objectives of the study were to assess the perception and participation of males in MCH care as well as, to identify the association of their perception and participation with socio-demographic characteristics and to find out the correlation between perception and participation regarding MCH care. Materials and Methods: A descriptive type of observational study with a cross-sectional design was conducted among 125 male residents from selected subcentres in Budge Budge II block of South 24 Parganas. Data were collected by face-to-face interviews using a predesigned, pretested, structured schedule. Multivariable binary logistic regression was done to identify the association between dependent and independent variables (P < 0.05). The correlation between perception and participation was assessed by Spearman’s rho. Results: The mean age of the participants was 34.3 (±5.6) years with most (59.2%) between the ages of 31–40 years of age. About 24% were unaware of pregnancy registration time, and 30.4% did not know the number of minimum antenatal check-ups. In total, 20% of study participants did not accompany their partner to the Antenatal Care (ANC) clinic, 6.4% did not accompany them during delivery, and almost 33.6% did not accompany their child to the immunization session. No variables were found to be significantly associated with the dependent variables. A statistically significant positive correlation was found between perception and participation (ρ = 0.3). Conclusion: Men’s perception and participation in MCH care services were found to be reasonably good though they can be improved. Awareness raises about the importance of men’s role in supporting their partner’s health during pregnancy and postpartum, as well as the overall well-being of their children through public health campaigns, community events, and targeted educational programs.

Recurrent Urinary Tract Infection- Etiology, Risk Factors and Outcome in a Tertiary Care Hospital of Bangladesh

Background: Urinary tract infections (UTIs) are one of the major causes of morbidity and comorbidities in patients with underlying conditions, and it accounts for the majority of the reasons for hospital visit globally. The high prevalence of recurrent UTIs represents a modifiable determinant for both societal and personal burdens, hence the importance of disease prophylaxis. Consultations for UTIs represent between 1% and 6% of all medical visits (~7 million visits and ~US$1.6 billion annually). They are associated with a significant burden of morbidity and mortality in the elderly, among whom UTIs are most prevalent. Methods: This cross-sectional descriptive type of observational study was conducted in the Department of Nephrology in Anwer Khan Modern Medical College Hospital, Dhaka, Bangladesh from January 2023, to December 2023. A total no of 93 patients were included in the study. Inpatients, age range 21-85 years, presenting or highly suspicious of having UTIs and the occurrence of ≥2 symptomatic episodes within 6 months or ≥3symptomatic episodes within 12 months were recruited in the study. Any patient who was terminally ill, who fails to give urine samples, with a history of antibiotic administration in the last two weeks and any female who was in their menstruation period were excluded from the study. Results: Among them 79 were female and 14 were male. Female to male ratio was 5.64:1. Mean age of the patients was 58.61±17.51 (Mean±SD). Most of the patients were of 61-70 years age group 23/93 (24.73%) and after that41-50 years 19/93 (20.43%). 92.47% (86/93) were married and 7.53% (7/93) were unmarried. Most of the patients were of Diabetes mellitus (DM) 57/93 (61.29%). After that Hypertension, Chronic Kidney Disease (CKD) and CKD + DM about 51/93 (54.84%), 39/93 (41.94%) and 36/93 (38.71%) respectively. 54/79 (68.35%) were of menopause and 24/79 (30.38%) women had regular menstrual cycle. 1/79 (1.27%) was pregnant.Escherichia coli(E coli) was the most prevalent uropathogens with 47/93 (50.54%) followed by Klebsiella pneumoniae 12/93 (12.90%), Pseudomonas aeruginosa 10/93 (10.75%), Streptococcus pyogenes 8/93 (8.60%), Staphylococcus aureus 6/43 (6.45%), Enterococcus faecalis 5/93 (5.38%) and others 5/93 (5.38%). 77.42% were of relapse and 22.52% were of reinfection. The Mean±SD of HbA1c was 7.83±2.15% and that of Serum creatinine and Hemoglobin were 2.17±1.18 mg/dl and 9.82±2.60gm%. On routine examination of urine, 39/93 (41.94%) patient had trace albumin present in urine and 57/93 (61.29%) had reducing sugar. 71/93 (76.34%) had1-2 pus cell in urine and 22/93 (23.66%) presented with plenty of pus cell with 19/93 (20.43%) had 0-4 RBC’s (Red blood cell). Factors associated with recurrent UTI were Age >50 years (56.99%), Female gender (84.95%), Married (92.47%), Menopause (58.06%), Diabetes mellitus (61.29%), Indwelling catheter >6 days (25.81%) and Genitourinary abnormalities (15.05%). Conclusion: This study has demonstrated that hospitalization, married individuals, duration of catheter, diabetes mellitus, genitourinary tract abnormalities, female gender and menopause are the most important factors associated with UTIs. Appropriate measures may help to reduce UTIs due to these associated factors. We recommend routine UTIs screening of patients of the following category: hospitalized, genitourinary tract abnormalities, indwelling catheter, diabetic, female gender, menopause and married individuals. If these routine checks are put in place, prevention of UTI can be realized at lower cost. Bangladesh J Medicine 2024; 35: 173-179

Outcomes of Fetal Malpresentation Beyond 28 Weeks of Gestation at a Tertiary-Level Hospital

Background: The term malpresentation encompasses any fetal presentation other than vertex, including breech, face, brow, shoulder, and compound presentations. Both fetal and maternal factors contribute to the occurrence of malpresentation. Objective: To determine the outcomes of fetal malpresentation beyond 28 weeks of gestation at a tertiary-level hospital. Material and Methods: It was a cross sectional descriptive type of observational study carried out in the Department of Obstetrics & Gynaecolgy, Mymensingh Medical College Hospital, Mymensingh during the period of March 2019 to August 2019.Structured questionnaire including history and physical examination of pregnant women were included in data collection sheet-and analysis was done by computer software SPSS version 20. Results: This study shows majority of the women 20(40%) were in the age group of 26-30 years. The average age was 29.9 years. The common fetal malpresentation was breech presentation 35(70%) followed by5(10%) was brow presentation, 5(10%) was shoulder presentation and 3(6%) was compound presentation and maximum seen in multiparity 20(40%) Regarding mode of delivery, 15(30%) delivered vaginally and 35(70%) had to do caesarean section. 13(26%) women suffered from complication during labour. Most common fetal morbidity were birth asphyxia 10(20%) and perinatal mortality was 2(4%). Conclusion: It was observed that major fetal morbidities were low birth weight, birth asphyxia and perinatal infection. Majority patients were delivered by caesarean section. Identification of the cases that require caesarean section, and allowing appropriate and safe trial of labour and vaginal delivery (if no contraindication) require clinical experience and technical skill. The obstetricians should acquire and maintain such knowledge through clinical exposure and attending obstetric emergency skill courses.

Perceived Barriers of Managing Teaching–Learning during COVID-19 Pandemic: A Descriptive Observational Study among Medical Educators in West Bengal

Introduction: The COVID-19 pandemic led to a paradigm shift in the landscape of medical education, necessitating a transition from traditional pedagogical methods to digital learning platforms. This study aims to find out the barriers faced by medical educators in West Bengal during the pandemic. Materials and Methods: This descriptive type of observational study with a cross-sectional design was conducted between December 2022 and February 2023 with a reference period of March 2020 to December 2020. The study population was the medical educators working during the reference period in the various departments of Government Medical Colleges in West Bengal. One hundred and twenty medical educators were selected using simple random sampling and responses were collected through a predesigned and pretested Google Forms. Collected data were checked for consistency and analyzed in GNU PSPP (v 1.4.2). Quantitative data were expressed as mean (±standard deviation) or median (±interquartile range), and qualitative data were expressed in frequency and percentage. Results: Out of the 120 sample population, 100 responded within the stipulated 7 days with a response rate of 83%. Most of the respondents had opined that they did not have a dedicated e-classroom facility for online education (87, 87%) and web camera (63, 63%). The majority had a prevailing teacher-centric approach to education including a lack of incorporating student feedback in deciding mode of communication. Conclusion: The study identifies the deficiency of logistical support and identifies the importance of capacity building of medical educators for tiding over similar situations in future.

Satisfaction among caregivers of beneficiaries with the services provided at the well-baby clinic of a tertiary care hospital, Kolkata

Background: Well-baby clinics (WBC) are health facilities for providing primary care, including immunization services to infants and children. Caregivers’ satisfaction is a vital indicator of the quality of healthcare services provided. Aims and Objectives: This study aims to assess the caregivers’ satisfaction with the services provided at the WBC of a tertiary care hospital in Kolkata, West Bengal and to identify the associated sociodemographic factors. Materials and Methods: A descriptive-type of observational study with a cross-sectional design, was conducted from June to July 2022, using a predesigned pretested and structured schedule, among 106 caregivers of beneficiaries attending WBC. Satisfaction was assessed using 24 items answered on a 5-point Likert scale, ranging from “highly satisfied” to “highly dissatisfied.” Data were tabulated in MS Excel 2021 and analyzed using statistical package for the social sciences v25.0. Bivariate Logistic Regression was performed to examine the association of sociodemographic factors with caregivers’ satisfaction. Results: High satisfaction with the services was observed among 52.8% participants. Least number of caregivers were satisfied with the vaccination services. Caregivers’ gender, mothers’ education and beneficiaries’ gender were found to be statistically significant with their satisfaction. Furthermore, the female caregivers had lower odds of statistically significant high satisfaction than the males. Conclusion: Almost half of the caregivers were less satisfied with the services offered at the WBC, while the least number of caregivers were satisfied with the vaccination services. Extensive research is needed to identify the factors contributing to the satisfaction of caregivers with the services, mainly vaccination.

Knowledge, attitude and practice regarding breast and cervical cancer among women of reproductive age residing in a rural area of West Bengal, India

Background and objectives: Developing screening programmes to lower breast and cervical cancer morbidity and mortality requires a better knowledge of psychological, socioeconomic, and environmental variables that may affect screening behaviours. This study was conducted to assess the knowledge, attitude and practices regarding breast and cervical cancer among women of reproductive age group in a village in West Bengal, India. Materials and methods: A descriptive type of observational study was conducted in village Muchisa of Budge-Budge II block, West Bengal among 300 women from January to June 2022 using a pre-designed, pre-tested, structured schedule by face-to-face interview method. Data were analyzed using SPSS version 25.0 using suitable descriptive and inferential statistics. Results: The mean age of the study participants was 31.6 ± 7.4 years. Out of 300 women, 41.7% and 41.3% had adequate knowledge on breast and cervical cancer respectively. Regarding attitude, 57.3% and 75.3% had highly favourable attitude on breast and cervical cancer respectively. Only 38 (12.7%) had performed breast self-examination at least once whereas only 5.3% had undergone Pap smear test at least once before the survey. Socio-demographic and economic factors of the respondents were significantly (p<0.05) associated with knowledge on breast cancer while none of these factors were found to have statistically significant association with knowledge on cervical cancer. Conclusion: Most of the study population did not have adequate knowledge of breast and cervical cancer, their risk factors and symptoms. Their attitude was positive but practice related to screening was very unsatisfactory. IMC J Med Sci. 2023; 17(2):011. DOI: https://doi.org/10.55010/imcjms.17.021 *Correspondence: Vineeta Shukla, Senior Resident, Department of Community Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, India; Email: vineeta1992@gmail.com

LIFESTYLE-RELATED PREDICTORS OF TESTOSTERONE DEFICIENCY AMONG MALE PATIENTS WITH CHRONIC SPINAL CORD INJURY

Objectives: In the current study, the author evaluated the prevalence of low testosterone and its independent predictors among male patients with chronic spinal cord injury (SCI). Design: This descriptive type of observational study was conducted in the department of PMR at SMS Medical College. Methods: In this cross-sectional study, 120 patients with chronic SCI were recruited, serum testosterone levels were assessed, and testosterone levels below 300 ng/dL were considered low. The following eight suspected independent predictors for low testosterone levels were assessed: age, body mass index (BMI), nicotine users, total lipid profile, level of injury, American Spinal Injury Association (ASIA) impairment scale, leisure-time physical activity (LTPA) score (h/week) via LTPA questionnaire, and aging male’s symptom (AMS) score via AMS questionnaire. Results: The mean age of the patients was 33.2±7.8 years. Patients with low testosterone exhibited a significant association with dorsal SCI (70.9%), motor complete (ASIA A and B) SCI (76.4%), nicotine use (65.5%), a higher triglyceride (TG) level (168.5 mg/dL), a higher total lipid level (712.9 mg/dL), and a higher AMS score (35.7). Patients with low testosterone were found to be engaged in lower (9.4 h/week) LTPA. A significant negative correlation of total testosterone levels was observed with TG (r=−0.184, p=0.044), total lipid (r=−0.570, p<0.001), BMI (r=−0.504, p<0.001), and AMS scores (r=−0.549, p<0.001). Whereas there was a significant positive correlation observed between total testosterone and LTPA (r=0.380, p<0.001). Conclusion: The prevalence of low testosterone is found at 45.8%, and BMI, LPTA, AMS, and total lipids are identified as independent predictors of low testosterone.

The Socio-Demographic Factors and Causes of Substance Abuse Relapse: 36 Cases

Background: Relapse is frequent among substance abusers all across the world, and Bangladesh is no exception. Drug-related issues are gradually becoming a hot topic in Bangladesh, from a social, economic, and medical standpoint. The present study aimed to find out sociodemographic factors associated with relapse amongst substance abuser. Material & Methods: This descriptive type of observational study conducted in the Combined Military Hospital and other Government/Private Hospital/Institute especially Central Drug Addict Treatment Center, Dhaka with a total sample size of 36 participants. Detailed information was obtained in each case according to protocol through complete history from patients or their accompanying attendants using a data collection sheet which was read out to them in Bangla. All the information was recorded in the pre fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS-23. Results: The study found that yaba was the most commonly abused drug among 36 participants, with 27.78% reporting abuse. 27.78% of participants had a psychiatric illness, with the majority being male (97.22%) and Muslim (88.89%). The largest group of participants were aged 31-40 (47.22%) and most were unemployed (83.33%) and married (94.44%). Peer pressure and family problems were the most commonly reported causes of relapse (91.67% and 83.33%, respectively). Other factors such as unemployment, depression, and failure in life also contributed to relapse. Conclusion: Yaba was the most prevalent substance of abuse and the majority of participants were male, had a psychiatric illness, and were unemployed. Peer pressure and family problems were the main causes of relapse.

Maternal and Neonatal Outcome of Patients Having Placenta Previa Lying Over The Uterine Scar

Background: Placenta previa (PP) is defined as placenta implantation in the lower uterine segment with or without overlying the endocervical os. It is a significant cause of severe fetal and maternal morbidity and mortality. Objective: To evaluate the maternal and neonatal outcome of placenta previa lying over the uterine scar due to previous one or two caesarean sections. Material and Methods: This descriptive type of observational study was done in the Department of Obstetrics & Gynaecology, Enam Medical College & Hospital, Savar, Dhaka, from December 2020 to June 2021. All relevant data were collected prospectively in a prescribed form (questionnaire). Data were processed and analysed with the help of the computer program SPSS (Statistical Package for Social Sciences) windows version 25. Results: This study shows the most familiar age group was 26-30 years, which included 46%, and 38% belonged to the 31-35 age group. The average age was 29.93 years. Maximum (54%) number of cases were admitted during the gestational period of 35-38 weeks. It was observed that maternal outcome was profuse intraoperative blood loss (100%), post-partum haemorrhage (26%), transfusion requirement (100%), and post-partum anaemia (28%). In addition, the outcome was fetal distress (36%) and lower Apgar scores at 1 min (24%). Conclusion: This study shows women with placenta previa lying over the uterine scar were more likely to have poorer maternal and neonatal outcomes. To counsel their patients appropriately, healthcare providers should be aware of possible complications of placenta previa lying over the uterine scar. J Dhaka Med Coll. 2022; 31(1) : 56-60

Frequency of Metabolic Syndrome and Lipid Profile Analysis among Patient with Type 2 Diabetes: A Single Center Study

Background: Diabetes mellitus is associated with various metabolic disorders, which leads to the progression of the disease and its complications. Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macro vascular complications in diabetes mellitus (DM) patients. Lipid profile is the indicators of dyslipidemia. Aim of the Study: The aim of this study was to accumulate the frequency of metabolic syndrome and lipid profile among patient with type 2 diabetes. Methods: This hospital based descriptive type of observational study was conducted in the Department of Medicine, North Bengal Medical College and Hospital, Sirajgonj, Bangladesh during the period from January 2022 to December 2022. In total 97 diagnosed patients with type 2 diabetes mellitus were enrolled in this study as the study subjects. Proper written consents were taken from all the participants before data collection. All demographic as well as clinical data were recorded. Data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The highest number (37%) of our participants was from 41-50 years’ age group and the female participants were dominating in number. Majority of the patients (63%) were obese: ≥30. In this current study, the frequency of metabolic syndrome was found as 71%. The mean± SD total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol of the respondents were found as 179.88±42.81, 179.88±42.81, 109.74±46.69 and 44.75±7.68 mg/dL respectively. Among the majority of our patients (72%) normal (≥40 mg/dL) HDL level was found. Conclusion: The higher frequency of metabolic syndrome among type 2 diabetes patients demands more attention from health professionals as well as the policy makers. There may not have any significant correlation of metabolic syndrome or type 2 diabetes with lipid profile but aged people may be prone to those diseases.

Reckoning the Status of HER2/neu Protein and Oncogene in Breast Cancer Specimens: Comparison of IHC Assay with FISH Assay at a Tertiary Care Centre, West India

Introduction: Breast carcinoma is the most prevalent malignant neoplasm among women with more than one million new cases per year. The benefit of humanised anti-Human Epidermal growth factor Receptor 2 (HER2)/neu monoclonal antibody trastuzumab (Herceptin) in HER2/neu-positive breast cancers has been well documented. Immunohistochemistry (IHC) for protein overexpression and Fluorescence In Situ Hybridisation (FISH) for detecting HER2/neu gene amplification is widely used. Some laboratories use IHC as primary test with FISH for subset of cases while using FISH as primary investigation followed by IHC if needed is done by others. Aim: To evaluate IHC assay in breast carcinoma cases for HER2/neu as screening test before FISH. Materials and Methods: A cross-sectional descriptive type of observational study was conducted in the Department of Pathology and Multi-Disciplinary Research Unit, SMS Medical College and attached hospitals Jaipur, India, between April 2020 and December 2021. A total 122 samples of invasive breast carcinoma were included in study for IHC and FISH analysis. On paraffin embedded breast tumour tissue sections, IHC was performed using mouse monoclonal antibody targeting the intracellular domain of HER2/neu protein and FISH was implemented by dual colour probes targeting the HER2/neu gene on chromosome 17. Cases were classified according to HER2/neu status on IHC interpretation and FISH interpretation as per American Society of Clinical Oncology/ the College of American Pathologists (ASCO/CAP) HER2/neu-2018 testing guidelines. Chi-square test, kappa coefficient and Z-test were applied for statistical analysis. The p-value<0.05 was considered significant. Results: Of the 122 patients of Invasive Duct Carcinoma (IDC), the mean age was 50.3±12.7 years with a age range of 25-70 years. HER2/neu IHC score 3+ (over expression) was seen in 19 (15.6%) cases while 2+ (equivocal) result was obtained in 84 (68.8%) cases and 19 (15.6%) cases showed negative (1+/0) HER2/neu expression. Out of 19 IHC positive cases, all cases were amplified by FISH and all 19 IHC negative cases, were non amplified by FISH. There were 84 IHC equivocal cases of which 37 (44%) cases were amplified, 45 (53.6%) non amplified and 2 (2.4%) cases were equivocal when analysed by FISH. Also, 11 (9%) cases were found Centromere Enumeration Probe (CEP) amplified in the study, they were negative or equivocal on IHC and none was IHC positive. Conclusion: The study concluded that combined FISH and IHC methodologies could optimise information on HER2/neu status in breast cancer patients. Also, testing algorithm is emphasised where laboratories may use IHC as a screening method and FISH can be used as accurate and specific method in IHC (2+) equivocal cases. Thus, patients with HER2/neu status positive of IHC (3+) or FISH (gene amplified) can be proposed to be treated with herceptin (trastuzumab).

A STUDY ON ROLE OF ULTRASOUND IN ANTENATAL FETAL WEIGHT ASSESEMENT AND CORRELATION WITH POSTNATAL WEIGHT

Background: The assessment of fetal growth is a critical component of prenatal care, enabling identication of fetuses at risk of perinatal morbidities and mortality. The fetal weight determination using ultrasound is one of the best indicators of fetal growth, however its accuracy is still questionable as it is affected by multiple anthropometric and genetic factors. Very little information is available regarding the effectiveness of the currently used western population-based models in calculation of fetal weight in Indian scenario. Our study aimed to evaluate the accuracy of Aim: prenatal ultrasound in calculation of estimated fetal weight in third trimester using pre-natal ultrasound at a tertiary care center in Rajasthan, India. Materials and Methods: Descriptive type of observational study was done at a tertiary care hospital in Rajasthan. 73 pregnant females were evaluated with estimated fetal weight (EFW) calculation using Hadlock 2 (AC, BPD, FL) formula and compared with actual birth weight. Results: Positive correlation existed between EFW and ABW with spearman's rho coefcient=0.615, p value <0.001. This difference in weight by ultrasound and actual weight was found to be statistically signicant (t=3.094, Df=144, p value<0.002). Our study was one of the very Conclusion: few studies which demonstrated that statistically signicant differences existed between the estimated fetal weight on USG and the actual birth weight on the basis of the currently used fetal weight estimation formulas which are based on foreign populations. High percentage error was noted in the calculation of fetal weight which may be due to a lot of factors like- fetal head position in pelvis , machine quality, maternal obesity, maternal restlessness during scan, excess fetal movements, subjective variations etc.

Pattern of Chest X-rays findings and clinical correlation with the severity in COVID-19 (RT-PCR positive) infected patients admitted in a COVID-19 dedicated hospital in Bangladesh

Objective: This study aims to analyze Chest X-ray findings in COVID 19(RT-PCR positive) patients, correlate between clinical and radiological findings and short-term outcomes of the patients with the view to enhance clinicians’ understanding of CXR findings in COVID 19 patients. Methods: This descriptive type of observational study included 277 reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed COVID-19 patients who were undergone CXRs, based on the clinician’s decision. Data were collected from May to September 2020 of Maternal and Child Health Training Institute (MCHTI)- a COVID-19 dedicated hospital, Lalkuthi, Mirpur-1, Dhaka and analyzed statistically through SPSS,Version 25. Each chest X-Ray is then scored using the Brixia score, a semi-quantitative scoring system rating lung involvement from 0 to 18 by a radiologist. The scores are then analyzed and compared with the characteristics of the patients, clinical presentation, and short-term outcome (in-hospital & after discharge) to correlate the severity and post covid-19 complications of COVID-19 infected patients. Results: A total of 277 RT-PCR-positive patients were performed chest x-ray P/A view, among them 58.12%(161) were male and 41.88%(116) were female. Age variation was from 6 to 95 years and the mean age was 42.48±15.53(S.D).Most of the patients(94.94%)were symptomatic and the majority(97.9%) of symptomatic patients had comorbidities(p-value 0.02).Among the x-ray performed patients(n=277), 39.35% (109) patients had positive findings suggestive of covid-19 infection. Comorbidities and sex had significant relation on positive x-ray findings(p-value 0.0001 and 0.001);males (70.6%) had more positive findings than females(29.4%).Positive x-ray findings were more common among the age group 41 to 60 years (p-value 0.0001 and Cramer’s V 0.59).Most of the patients (94.49%) had bilateral lungs involvement and consolidations were the commonest x-ray findings (43.1%).Clinical severity was assessed by symptoms and Spo2 level (<91%) and 20.2% were clinically severe (M-23.6%, F-15.5%). Age, comorbidities, and higher Brixia score (>8) had a significant relation to clinical severity (p-value 0.0001,0.0001&0.0001) and sex also influences clinical severity though statistically not significant (p-value 0.2).There was a significant relationship between positive X-Ray findings and decreased Spo2 level (p-value 0.0001, Cramer’s V 0.47).Regarding in-hospital outcome; 94.9% were recovered and 2.75%were death (only male)and following discharge; 42.60% (119) had post covid-19 complications and 0.72% (02) were dead. Comorbidities and age had an effect on short-term outcomes after hospital discharge though not statistically significant (p-value 0.16 and 0.16). The most common respiratory complications were SOB on exertion (23) and the most common non-respiratory complication was post covid fatigue syndrome (42). Comparison between Brixia score and post covid complications; more the Brixia score, the more the chance of post covid complications though statistically not significant (p-value 0.44). Conclusion: This study reveals bilateral lungs involvement and multifocal consolidations are the most common patterns of X-ray findings and clinical severity is associated with a higher Brixia score, male sex, increasing age, and presence of comorbidities. Bangladesh J Medicine 2022; 33: 280-292

Case control study on the association between vitamin d deficiency and diabetes mellitus type 2 at tertiary care hospital, Jaipur

Introduction: Diabetes mellitus refers to a group of common metabolic disorders. Recently, emerging evidence has suggested a role for suboptimal vitamin D status in the etiology of T2DM. This study aimed to determine the association between Vitamin -D deficiency and type 2 Diabetes Mellitus in patients of tertiary care centre, Jaipur. Method and material: This was a hospital based descriptive type of observational study done in Department of Medicine, of a tertiary care hospital in Jaipur, Rajasthan. This study included 100 cases and 100 control. Result: There were 55% males and 45% female among study participants. Out of 200 participants, 160 (80%) subjects are vit D deficient in which 84 (42%) are cases and 76 (38%) are controls, means cases are more deficient for vit D in comparision to controls. Conclusion: Though vitamin D deficiency is prevalent in T2DM and non-diabetic control subjects, its relationship in glycation control or insulin resistance in T2DM subjects could not be confirmed in our study population. This is potentially an important finding for public health, demonstrating that improvement in vitamin D status is one of the factors responsible for better health of the individuals.

Associations of Body Mass Index with Molecular Sub Types, Clinical and Pathological Characteristics of Breast Cancer in Bangladeshi Women

Obesity is a major health hazard not only for developed countries but also for Bangladesh and it is an established risk factor of breast cancer. In our country there is a scarcity of studies on the associations of BMI and different features of breast tumour. This study was aimed to evaluate the associations of BMI with molecular sub-types, clinical and pathological characteristics of breast cancer in Bangladeshi women. This cross sectional descriptive type of observational study was conducted in National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka from September, 2019 to August, 2020. A total of 90 patients with breast cancer were selected purposively according to inclusion and exclusion criteria. An informed consent was sought from the patient to take part is this study. Detail history taking thorough physical examination was done along with relevant investigations. Data were collected by semi structured questionnaire and analysis was done with the help of Statistical Package for Social Science (SPSS), version 21.0. Mean age of the respondents was 41.17 years with a standard deviation of ±8.79 and a range of 24-65 years. Of all, ninety percent patients were housewives and 52.2% belonged to upper middle socio-economic class. About 66.7% patients were pre-menopausal and 33.3% were post-menopausal. The mean BMI of respondents was 25.89(±4.67) kg/m2 and among them 51.1% were obese, 23.3% were overweight and 20.0% had normal weight. No association between BMI and vii molecular subtypes of breast cancer were noted (p>0.05). No association between BMI and hormone receptor status of breast cancer was found. Association with tumor size, axillary lymph nodes, tumor grade and lymphovascular space invasion were also not significant (p>0.05). No association between BMI and molecular subtypes, clinical and pathological features of breast cancer were noted both in pre and post-menopausal groups. This study found no association between BMI and different features of tumor, which could be attributed to small sample size, absence of control and a single centered study. However, further extensive study is recommended.

A Study of Molecular Subtypes of Carcinoma Breast by Immunohistochemistry at Tertiary Care Center, Jaipur

Introduction: Breast cancer is one of the most common malignant tumors and one of the leading causes of cancer related death amongst females worldwide. The clinical significance of molecular classification of carcinoma breast remains to be established. Molecular subtyping using immunohistochemistry can provide additional prognostic and predictive information. Aim and objectives: To identify morphological variants of carcinoma breast and to determine various proportions of molecular subtypes of carcinoma breast by immunohistochemistry. Materials and Methods: A descriptive type of observational study was done at SMS Medical College, Jaipur. 65 Modified Radical Mastectomy specimens received in the department were included in the study. The surgical specimens were then evaluated histopathologically and immunohistochemically for ER, PR, HER2/neu, and Ki67 markers. Results: Out of 65 breast carcinoma cases the most common histological type encountered in our study was Invasive ductal carcinoma of no special type (NST) (83.09%) followed by medullary carcinoma (4.63%) and invasive lobular carcinoma (3.09%) and a single case each of tubular, cribriform, metaplastic, lymphoepithelioma like carcinoma, carcinoma with apocrine differentiation and oncocytic carcinoma. The cases were further classified into molecular subtypes using protein expression patterns in IHC. The proportion of tumors found were Luminal A (32.31%), Luminal B (18.46%), HER2/neu overexpressed (13.84%), and Triple-negative (35.39%). Conclusion: The most common molecular subtype found in our study was Triple negative. The use of IHC markers in the clinical setting could determine the prognosis and benefit the patients with targeted therapies.

Prevalence of Elevated Troponin- I among Hospitalized Patients with COVID- 19.

Background: Corona Virus Disease 2019 (COVID-19) pandemic caused millions of pneumonia related death since December 2019. Cardiac troponin-I elevation is associated with adverse outcomes in cardiovascular and non-cardiovascular disease. There is a lack of data regarding the role of troponin-I on the assessment and COVID-19 stage classification and stratification. Objective: The study was aimed to estimate prevalence of troponin-I among hospitalized patients with COVID-19. Methods: This cross sectional descriptive type of observational study was carried out at COVID-19 isolation unit of Sylhet Women’s Medical College Hospital during the period of six months from April 2021 to September 2021. Data were collected from purposively selected 204 patients with COVID-19 from patient files and EMR. Data were analyzed by using SPSS version 21.0. Results: The study results revealed that mean age of the patients with COVID-19 was 57.97 years with a standard deviation of 15.78 years. Majority of them (121, 59.3%) were female and the remaining (83, 40.7%) were male. Proportion of comorbidities were estimated and found that each 115 (56.4%) patients were hypertensive and diabetic. Thirty five (16.2%) had ischemic heart disease; 3 (1.5%) had congestive cardiac failure and 2 (1.0%) had asthma. Only 1 (0.5%) patent has atrial fibrillation. Minimum level of troponin-I was 0.01 ng/ml and the maximum level was 21.70 ng/ml with a range of 21.69 ng/ml. Mean troponin-I of patients with COVID-19 was 0.38±1.78 ng/ml. Estimated prevalence of elevated troponin-I was 39.1%. Level of troponin-I in patients of different age group was compared and Chi-square test showed no significant difference (p>0.05). Elevation of troponin-I in both sex was compared and again Chi-square test showed no significant difference (p>0.05). Elevation of troponin-I was significantly higher on those who were detected by RT-PCR than those who were detected by rapid antigen test (p=0.048).Conclusion: Though the pattern of elevation of troponin-I was found similar in younger and older patients and in males and females, a significant number of patients with COVID-19 (65/204, 39.1%) had elevated troponin-I which should be addressed to evaluate and manage patients with COVID-19 more efficiently.

Health Perspective of Local and United Nation Personnel Reported in Bangladesh Level-II Hospital in Liberia

Introduction: Liberia is one of civil war-ravaged country, where peace process started by United Nation (UN) in 2003. Bangladesh is also included in peacekeeper’s mission including medical services and sent a Level-II Hospital named Banmed 10 which started works in Liberia in June 2013 and provide medical support to UN personnel as well as local people and civil military cooperation (CIMIC). Pictures of health problems of these personnel are drawn in this study. Objectives: To find out the disease pattern of natives and multinational UN personnel as well as local people visiting Level- II Hospital, Banmed-10. Materials and Methods: It was a descriptive type of observational study conducted among 6906 patients from 18 Jun 2013 to 31 March 2014. Data were collected from the outdoor/indoor medical records and documents. Relevant data are sorted out and entered in computer for necessary calculation. Results are arranged in appropriate tables showing percent or proportion. Results: Common diseases are found in UN personnel and Liberians such as Fever (Nos), Malaria, RTI, Diarrhoea, Backache, Arthritics, Hernia and others. Fever (Nos) most common 83.7% among the locals and 65.3% among the UN personnel. Malaria 16.3% among the locals and 11.3% among the UN personnel. Some special cases were also found like Lassa and Ebola. Conclusion: Bangladesh level-II Hospital has been providing medical support to UNMIL personnel as well as to local people as they are highly dependent on it due to heavy destruction of their medical facilities during civil war. Bangladesh earns commendable reputation by their high professionalism, quality service and dedication to the responsibility. JAFMC Bangladesh. Vol 17, No 2 (December) 2021: 52-56

Morphometric study of tibial condylar area in Rajasthan population

Background: Indians are the part of Asian-pacific population and they have a smaller build and stature in comparison of western population. The prosthesis for knee replacement surgeries which are presently being used are best suited for the western population therefore leading to implant size incompatibility with the resected bony surfaces. Aim of the study: To perform morphometric study of tibial condylar area in Rajasthan population. Materials and methods: The present study was conducted in the Department of Anatomy, S.M.S. Medical College, Jaipur. The study period was from approval of plan till 15th December 2019. The study is a descriptive type of observational study. 120 dry tibiae (60 right sided and 60 left sided) were required as sample size. The ethical clearance for the study was approved from the ethical committee of the hospital. Results: The mean AP diameter of the total tibial condyle was 45.28±2.93 mm on the right side and 44.68±4.29 mm on the left side and the total mean AP diameter of total tibial condyle was 44.98±3.67 mm. The difference in the mean AP diameter values between right and left side was found to be statistically not significant.

Anatomical morphometry of superior articular surface of proximal end of dried human tibiae in Rajasthan population

Background: The geometric mismatch between patient anatomy and implant components responsible for failure of knee replacement surgeries. Aim of the study: To study anatomical morphometry of superior articular surface of proximal end of dried human tibiae in Rajasthan population. Materials and methods: The present study was conducted in the Department of Anatomy, S.M.S. Medical College, Jaipur. The study period was from approval of plan till 15th December 2019. The study is a descriptive type of observational study. 120 dry tibiae (60 right sided and 60 left sided) were required as sample size. Results: The difference in the mean AP diameter of medial condyle between right and left side was found to be statistically non-significant. The difference in the mean transverse diameter of the medial condyle values between right and left side was found to be statistically non-significant. The difference in the mean AP diameter of the lateral condyle between right and left side was found to be statistically non-significant. The difference in the mean transverse diameter of the lateral condyle between right and left side was found to be statistically non-significant.