Military Hospital Research Articles

An assessment of the probability of patients experiencing bone pain for early prioritization to the rehabilitation clinic

Background: As a result of DEXA and risk factor-based evaluation, which rank patients according to their osteoporosis risk, risk assessment instruments such as the Osteoporosis Self-assessment Tool, Risk Assessment Instrument, and Simple Calculated Risk Estimation were created. Aims: In two phases, the precision of evaluation instruments will be assessed: pre-test, post-test, and pre-diagnostic DEXA will be utilised to determine the accuracy of the assessment tools and pre-test, respectively. Methods: From September to November 2021, this study examines osteoporosis patients at Prince Rashid bin Al-Hasan Military Hospital in Jordan. Bayes' theorem and osteoporosis screening methodologies are utilised to calculate the post-test probability of patients. Evaluation of AUROC and performance metrics will be conducted utilising a ROC curve. The term of the investigation is 2021-2021. Results: The gender distribution of the 206 patients examined in the study was 5.87:1. AUCs SEMs for the binary logistic regression models incorporating independent variables (OST, ORAI, and BAQ) varied in response to the probability of FRAX≥3% versus <3%. FRAX% exhibited the following sensitivity indices: 0.02, 75%, 41.36%, 66.36%, and 41.03%. The innovative quotient (BAQ), which represents the ratio of body weight to age, had respective pre-test probabilities of 0.789±0.033, 0.484±0.042, and 0.254±0.037. Conclusion: The research examined the probability of BLR_BAQ after the test was conducted using OST and ORAI references. Significant AUROCs were observed for all three osteoporosis instruments; however, the performance of the post-test probabilities for FRAX≥3% of the BLR_BAQ model was subpar, as evidenced by both the standards and ORAI inference.

To 110th anniversary of cardiac surgeon and researcher Igor N. Meshalkin

Igor N. Meshalkin (1913–1996) was Soviet cardiac surgeon, Dr. Sci. (Medicine). He was a graduate of the 2nd Moscow State Medical Institute (2nd MSMI, now the N.I. Pirogov Russian National Research Medical University). He was a participant in the Great Patriotic War. Igor N. Meshalkin began his professional career as a medical resident and an assistant of the clinic of faculty surgery in the 2nd MSMI since 1947; then as a medical resident of the Main Military Hospital of the Armed Forces of the USSR since 1951 and an assistant of the general surgery department of the pediatric faculty in the 2nd MSMI since 1954. In 1958–1963, he headed the Department of Acquired Heart Diseases in the Institute of Experimental Biology and Medicine (now the E.N. Meshalkin National Medical Research Center). In 1963–1977, Igor N. Meshalkin was the head of the department in the Central Clinical Hospital of the 4th Main Directorate of the USSR Ministry of Health. His research interests were focused on urgent abdominal surgery, thoracic surgery, mitral stenosis surgery. Igor N. Meshalkin was the author of 55 scientific works including two monographs. Received 8 November 2023. Accepted 14 November 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article. Acknowledgment: The authors would like to thank Marina, daughter of Igor N. Meshalkin, for providing personal documents and photographs.

Neonatal Hypoglycemia How common is Hypoglycemia in Newborns Weighing Less Than 2500 gms: A Hospital Based Study

Objective:To determine the frequency of hypoglycemia in neonates weighing less than 2500 grams in first 48 hours of life presented to CMH Abbottabad.
 Study Design: Cross Sectional Study.
  
 Setting: Department of Pediatrics, Combined Military Hospital, Abbottabad.
  
 Duration of Study: This study was conducted from 1st July 2020 to 1st January 2021
  
 Subjects and Methods:
  
 A total of 110 neonates of both genders with birth weight less than 2500 grams using consecutive non-probability sampling technique were included in the study. Capillary blood was  collected  by heel prick after proper aseptic measure for blood glucose estimation by Glucometer at 0, 1, 2, 3, 6 and every 6 hours till 48 hours of birth. All hypoglycemic neonates were managed with intravenous administration of 10%glucose.
 Results:
  
 Gestational age range in this study was from 34 to 42  weeks with mean gestational age of 38.663±1.55 weeks, mean birth weight 1622.818±409.23 grams and mean blood glucose level was 54.763±9.55 mg/dl. Total 80% neonates were male. Hypoglycemia was observed in 27.3% neonates. No significant difference was seen comparing frequency of hypoglycemia among pre-term and term neonates (p-value 0.52), male vs female neonates (p-value 1.00) and different modes of delivery. (p-value 0.6). While frequency of hypoglycemia was significantly high in extremely low birth neonates as compared to low and very low birth weight. (p-value <0.01).
  
  
 Conclusion:
  
 Our study concluded that frequency of hypoglycemia was 27.3% in newborns weighing less than 2500 grams in first 48 hours of life. Extremely low birth weight (less than 1000gms) is a significant determinant for hypoglycemia.
 Keywords:
  
  First 48 hours, frequency, low birth weight, hypoglycemia, new borns
  
  

Medication compliance and related factors among readmission people with type 2 diabetes at 108 Military central Hospital

Objectives: Survey on medication compliance rate and related factors in people with type 2 diabetes readmitted for inpatient treatment at 108 Central Military Hospital. Participants and methods: A cross-sectional descriptive study was conducted on 168 patients with Type 2 diabetes readmission from January 2021 to December 2022. The study assessed medication adherence using the MARS–5 questionnaire (Medication Adherence Report Scale 5). Results: The rate of medication compliance in patients was 21.8%, non-compliance accounted for 78.2%. Patients who occasionally forget to take medication account for the highest rate of 51.8%, arbitrarily reducing the dose to less than the prescribed dose accounted for 32.1%, rarely skipping doses, and stopping medicine for a period of time accounted for 35.7% and 50.2%, respectively. There was a relationship between age and current medication and medication compliance. The difference was statistically significant(p < 0.05). Conclusion: The medication compliance rate in diabetic patients readmitted to the hospital in the study was low, only 21.8%, of which patients forgot to take medication and arbitrarily reduced the dose and stopped using medication for a period of time accounting for the highest proportion. high rate. Strengthening health education on medication adherence during follow-up examinations for patients and caregivers is extremely necessary to reduce the risk of hospital readmission, maintain blood sugar at normal levels, and minimize diabetes complications.

Bogdan N. Kotiv — surgeon, professor, general of medicine (on the 60th anniversary of his birth)

March 14, 2024, marked the 60th anniversary of Bogdan N. Kotiv, the Deputy Head of the Military Medical Academy named after S.M. Kirov for clinical work, abnormal chief surgeon of the Academy, Honorary Doctor of the Russian Federation, Doctor of Medical Sciences, Professor, and Major General of the Medical Service. After graduating from the academy, B.N. Kotiv served in the Transcaucasian Military District as a leading surgeon in a separate medical battalion. In 1988, a young military surgeon participated in the provision of assistance to victims of the earthquake in the city of Spitak (Armenia) and received the first experience in providing medical care in military field conditions. In 1990, B.N. Kotiv entered the adjunct school at the Department of General Surgery, and in 1993, he successfully defended his dissertations for the degree of candidate of medical sciences. In 1998, the dissertation for the Doctor of Medical Sciences degree was brilliantly defended. In 2006, Bogdan N. Kotiv headed the Department of Hospital Surgery. When it was going through difficult times, a reorganization of the educational process occurred. Bogdan N. carefully preserved the traditions of teaching thoracic surgery and actively introduced the experience of modern complex surgical interventions into the educational process, including on the abdominal organs. The surgical school of the Department of Hospital Surgery rapidly took a leading position. In 2013, B.N. Kotiv was appointed the Deputy Head of the Academy for Academic and Scientific Work. Since 2021, Bogdan N. Kotiv has been the Deputy Head of the Academy for Clinical Work. He controlled and coordinated the clinical base of the academy, organized interactions with military hospitals throughout the country, and often went on business trips. At the beginning of a special military operation, a colossal responsibility fell on his shoulders. There was a need to quickly solve the permanently emerging problems of organizing the provision of medical care to the wounded in the conditions of the Academy clinics. With his direct participation, the clinical base was redesigned, its bed capacity was expanded, and new technologies for providing specialized medical care to the wounded, sick, and injured were introduced. For several generations of surgeons, Bogdan N. has been a wise mentor and role model. Under the leadership of Bogdan N. Kotiv, the range of scientific research conducted at the academy has significantly expanded. The fundamental directions of medicine for the study of the molecular and cellular foundations of combat lesions and cellular and tissue engineering technologies have received new development, and multidisciplinary scientific research is being conducted regarding the regenerative abilities of the liver.

Evaluating the performance of selected military hospitals in Tehran in response to Covid-19 pandemic: A cross-sectional study.

The rapid spread of coronavirus disease 2019 (Covid-19) led the need to admit a large number of infected people to hospitals in a short period of time, turning them into one of the most important responsive organizations. This study aims to evaluate the performance of selected military hospitals because they carried out a military operation in Tehran in response to the recent pandemic. This is a descriptive-analytical study. The statistical population of this study consisted of military hospitals responding to Covid-19 pandemic in Tehran. A checklist to evaluate the performance of hospitals in response to Covid-19 pandemic (six areas, 23 sub-areas and 152 items) was used as a data collection tool in this study. This tool had six domains, including risk management and planning, coordination and communication, infection prevention and control, diagnosis and treatment, education and training, and resource management. The overall performance of selected hospitals was 63%, which indicated a good performance. The domain of coordination and communication obtained the lowest score. The investigated hospitals had good performance because they had a desirable access to resources. Periodic self-assessment and accreditation is recommended to improve the performance of these hospitals.

Long-term real-life outcomes of the Clareon® hydrophobic intraocular lens: the Clarte study in 191 eyes

BackgroundTo describe and analyze the real-life refractive, functional and safety outcomes of the Clareon® intraocular lens (IOL) after 3 years.MethodsData was collected retrospectively for observational purposes between July 2017 and December 2019 in the ophthalmology department of Desgenettes military hospital in Lyon, France. Eyes that underwent cataract surgery with Claeron® implantation were consecutively included. Patients with a systemic or ocular condition that could affect the visual outcome were excluded. Postoperative corrected (CDVA) and uncorrected (UDVA) distance visual acuities as well as capsule and IOL transparency were assessed at 1 month and 3 years.ResultsA total of 326 eyes were analyzed at one month and 191 eyes were reassessed at the 3-year follow-up visit. At 3 years, the mean CDVA was 0.003 LogMAR (95% confidence interval [CI]: -0.003 to -0.01) and the mean UDVA was 0.075 (95% CI: 0.054 to 0.095). Three quarters of the patients had an UDVA ≥ 0.097 logMAR (20/25 Snellen equivalent) and 50% had an UDVA ≥ 0 (20/20). The absence of glistening was reported in 95.3% of cases and 4.7% [9] of patients experienced a clinically significant posterior capsular opacification (PCO) for which Nd:YAG treatment was required.ConclusionsThis real-life study reports high-performance and stable long-term refractive outcomes of the Clareon® IOL with good safety in terms of PCO and glistening.

The Accuracy of pHH3 in Meningioma Grading: A Single Institution Study

Introduction: In the latest WHO classification of central nervous system tumors, Mitotic Index (MI) counted on Phosphohistone-H3 stained slides (pHH3-MI) has been suggested as a valid proliferative marker in various tumors including in the evaluation of meningioma grading. We aim to report our own experience in assessing the efficiency of the anti-pHH3 antibody as a grading tool for meningiomas. Methods: A retrospective study was conducted on a series of 40 meningiomas diagnosed from March 2020 to April 2021 at the Pathology Department of the Military Hospital of Tunis. We attempted immunohistochemistry and compared MI assessed on both pHH3 and HE-stained slides. Results: According to the HE-MI and pHH3-MI, the 40 cases of meningiomas were respectively divided into 35 versus 29 grade 1 cases, four versus eight grade 2 cases, and one versus three grade 3 cases. A highly significant correlation was found between pHH3-MI and HE-MI (p < 0.001). A significantly higher sensitivity in the pHH3 counting method was reported in our study. Discussion: we found, in accordance with the literature, that pHH3-MI is more reliable and accurate in mitotic counting, therefore exhibiting a high sensitivity in tumor grading, reported by an upgrade within 22,5% of the cases. Conclusion: PHH3-MI count facilitated a rapid reliable grading of meningiomas. However, molecular characteristics that could have a potentially significant impact on tumor progression should be the subject of further research.

PATTERN OF CHRONIC LIVER DISEASE IN CHILDREN IN A TERTIARY CARE HOSPITAL

The study aimed to identify the different signs, symptoms, and causes of chronic liver disease in children. The study involved patients between the ages of 1 and 12 years who were suspected of having chronic liver disease, excluding those with acute liver disease, congenital anomalies, and liver transplant recipients. The study was conducted in the Department of Pediatrics at Pak Emirates Military Hospital in Rawalpindi from September 2023 to December 2023. The results of the study showed that the most common causes of chronic liver disease in the patients were progressive familial intrahepatic cholestasis, followed by glycogen storage diseases, Hepatitis C, Wilson's disease, and Hepatitis B. Jaundice, abdominal distension, peripheral swelling, ascites, hepatomegaly, and splenomegaly were the most common symptoms of chronic liver disease. Some patients also suffered from variceal bleeding and hepatic encephalopathy. In conclusion, the study found that chronic liver disease in children from Pakistan has a diverse range of causes and symptoms.

Significance of serum ferritin and De Ritis ratio in non-alcoholic fatty liver disease as diagnostic markers

Objective: To ascertain the significance of serum ferritin and De Ritis ratio as diagnostic markers in patients of non-alcoholic fatty liver disease with and without type 2 diabetes mellitus. Methods: The comparative cross-sectional study was conducted from February to October 2022 at the Radiology Department of Combined Military Hospital, Rawalpindi, Pakistan, and comprised individuals aged 30-65 who were divided into 3 groups. Healthy controls formed group I, non-alcoholic fatty liver disease patients without type 2 diabetes mellitus formed group II and non-alcoholic fatty liver disease patients with type 2 diabetes mellitus were in group III.  Blood 5ml was withdrawn and assessed for alkaline phosphatase, aspartate transaminase, alanine transaminase and ferritin. De Ritis ratio was calculated and subjected to intergroup comparison. Data was analysed using SPSS 22. Results: Of the 210 subjects, 110(52.4%) were males and 100(47.6%) were females, with 70(33.3%) in each of the three groups. Group I had 38(54.3%) females and 32(45.7%) males with mean age 37.50±4.513. In group II, there were 27(38.6%) females and 43(61.4%) males with mean age 45.86±9.646, while in group III there were 35(50%) females and 35(50%) males with mean age 54.01±9.243. Serum ferritin levels were significantly increased in patient groups II and III compared to control group I (p<0.05). De Ritis ratio was markedly raised in groups II and III compared to group I (p<0.05). Ferritin was significantly correlated to age, weight, height, fasting blood sugar, haemoglobin, alkaline phosphatase, aspartate aminotransferase, alanine transaminase and bilirubin (p<0.05). De Ritis ratio had a significant correlation with body mass index and fasting blood sugar (p<0.05). Conclusion: Serum ferritin and De Ritis ratio were found to be useful diagnostic indicators for non-alcoholic fatty liver disease, highlighting their importance in improving disease screening. Key Words: NAFLD, Non-alcoholic steatohepatitis, Ferritin, SGPT, SGOT.

Ocular Manifestations Revealing of Behçet's Disease: About 42 Cases

Introduction: Behçet's disease is a chronic, autoimmune, multisystem of unknown etiology, characterized by oral ulcers, genital ulcers, and eye lesions. Ophthalmological manifestations of Behcet's disease are numerous and are often indicative of the disease. Our job is to study these events in a group of patients in whom the ophthalmologic involvement was indicative of Behcet's disease. Materials and Methods: A retrospective study in the ophthalmology department at the military hospital of instruction Mohamed V in Rabat between January 2009 and December 2015. It involved 42 patients who initially consulted for eye symptoms and in that the diagnosis of Behçet's disease was selected based on the criteria of ISG. Results: The initial ocular demonstrations were non-granulomatous anterior uveitis in (15,06%) of which (10,9%) with hypopyon, intermediate uveitis (9.5%), ocular hyalite (12.32%), panuveitis in (41,1%), retinal vasculitis (16.43%), retinal vein occlusion (3.6%), papillary edema (1.8%). The criteria used for the diagnosis of Behcet's disease were essentially have oral ulceration, genital ulceration and pathergy test. Discussion: In 10% to 20% of cases, ocular involvement may be opening, remaining isolated for several years. The most frequently revealing clinical aspects of Behcet's disease are the anterior uveitis, and vasculitis panuveites. Conclusion: the ethnic and geographic origin of the patient, the young age and some clinical features of ocular lesions should remind ophthalmologists to Behcet's disease to inflammation of one of the ocular structures and encourages him to seek other diagnostic criteria in collaboration with other specialities

Telangiectasias, recurrent epistaxis and a strong family history—a case of Osler-Weber-Rendu Syndrome in Pakistan

Osler-Weber-Rendu syndrome or Hereditary Haemorrhagic Telangiectasia (HHT) is a rare condition, with very few reported cases, especially in Pakistan. As healthcare workers, we encounter multiple cases of recurrent epistaxis in the emergency as well as out-patient departments. However, patients are usually treated symptomatically without a thorough workup. HHT should be considered among the differentials for recurrent epistaxis, as a clinical diagnosis can be made with detailed family history and physical examination. Here is the case of a 58-year-old male who presented to the Gastroenterology OPD, Combined Military Hospital, Lahore, in November 2021, with complaints of generalised weakness and blood in stools. He had a history of recurrent epistaxis and telangiectasias, and further inquiry revealed a strong family history of similar symptoms. He was diagnosed as a case of Osler-Weber-Rendu Syndrome. Informed consent was taken from the patient prior to the writing of the manuscript.

Burn or trauma scoring: experience of the burn unit of the Queen Astrid Military Hospital during the terror attacks on 22 March 2016.

On 22 March 2016, the burn unit (BU) of Queen Astrid Military Hospital assessed a surge in severely injured victims from terror attacks at the national airport and Maalbeek subway station according to the damage control resuscitation (DCR) and damage control surgery (DCS) principles. This study delves into its approach to identify a suitable triage scoring system and to determine if a BU can serve as buffer capacity for mass casualty incidents (MCIs). The study reviewed retrospectively the origin of explosion, demographic data, sustained injuries, performed surgery, and length of stay of all admitted patients. Trauma scores (Injury Severity Score (ISS) and New Injury Severity Score (NISS)) and triage scores (Revised Trauma Score (RTS), New Trauma Score (NTS), and Trauma Score Injury Severity Score (TRISS)), were compared to burn mortality scores (Osler updated Baux Score and Tobiasen's Abbreviated Burn Severity Index (ABSI)). Of the 23 casualties admitted to the BU, the scores calculated on average 3.5 indications for a level 1 trauma center (ISS 4, NISS 6, RTS 0, T-NTS 4). Nevertheless, no deaths occurred during admission or the 1-year follow-up. MCIs create chaos and a high demand for care. Avoiding bottlenecks and adhering to the DCR/DCS principles are necessary to deliver the best care to the largest number of people. This study indicates that a BU can serve as buffer capacity for MCIs. Nevertheless, its integration into the medical resilience plan depends on accurate scoring, comprehensive care availability, and understanding of the DCR/DCS concept. NTS for triage seems the best fit for scoring polytrauma referrals to a BU during MCIs.

Outcomes and Measures of Children with Bilateral Cochlear Implants: A Single-center Experience in Bangladesh

Children dealing with hearing impairment encounter challenges associated with speech and language delays, significantly impacting their quality of life. Recent data from the World Health Organization indicate that 466 million people worldwide experience disabling hearing loss, with 34 million being children. Cochlear implantation (CI) is a novel approach for severe to profound sensorineural hearing loss. In pediatric CI, the main objective is to enable hearing-impaired children to perceive sound promptly, facilitating speech and language development. This study investigated the outcomes of bilateral pediatric cochlear implant (CI) users in Bangladesh, applying the Speech, Spatial, and Qualities of Hearing questionnaire and the Classification of Auditory Performance-II (CAP-II). Conducted at the Combined Military Hospital in Bangladesh, the study involved 10 children with bilateral cochlear implants. The results revealed commendable scores in speech understanding, spatial hearing, and qualities of hearing, underscoring the effectiveness of cochlear implant interventions. Deeply examining the implications is the topic of discussion of these findings, emphasizing the positive impact of early implantation and the adaptability of assessment tools in diverse cultural contexts.

Type 2 diabetes mellitus and recurrent Tuberculosis: A retrospective cohort in Peruvian military workers

BackgroundThe role played by type 2 diabetes mellitus (DM2) in the occurrence of recurrent tuberculosis is still uncertain. Military personnel are an occupational group with an increased risk for tuberculosis exposure due to their activities. Methods. We conducted a retrospective cohort to study the association between DM2 and recurrent TB in military workers who have been previously treated for tuberculosis at the Central Military Hospital in Lima, Peru, between 2016 and 2017. We evaluated the risk between DM2 and recurrent TB using Nelson-Aalen graphical analysis and Cox regression stratified by TB cured with hazard ratio (HR) calculation adjusted for confounders. Results. We evaluated 220 workers with a mean age of 23.2 ± 7.8 years (96.8 % male). DM2 and recurrent TB frequency were 11.8 % and 5.0 %, respectively. Those with DM (36.5 %) presented a greater proportion of recurrent TB than those without DM2 (10.5 %). The cumulative risk for recurrent TB increases faster among workers with DM2 (p = 0.025, LR chi-squared test). Cox regression stratified by type of cured TB did not show an association between DM2 and recurrent TB (HR: 3.67; 95 %CI: 1.00–13.46). Conclusion. The cumulative risk for recurrent TB increases faster in patients with DM than in those without DM2. DM2 is not associated with the time of apparition of recurrent TB in military workers.

Clinical Presentation, Echocardiographic Findings, Treatment Options Available for Ventricular Septal Defect in Children: A Study in a Tertiary Care Military Hospital

Introduction: Ventricular Septal Defect (VSD) is the most common congenital heart defects. Early diagnosis, appropriate treatment and transcatheter VSD closure with newer devices in favorable cases, decrease the need for surgical interventions and mortality. Objectives: To determine the clinical presentation, echocardiographic findings and the treatment options available for VSD in Paediatric Cardiology Department, Combined Military Hospital (CMH) Dhaka. Methods: It was a cross sectional observational study carried out in the department of Paediatric Cardiology, CMH Dhaka. Forty six isolated ventricular septal defect cases were diagnosed by echocardiography. Clinical features, echocardiographic findings and treatment options of all 46 cases were observed and recorded in pre formed data sheet and statistical analysis was done in statistical software SPSS version 25. Results: Among the 46 patients of VSD, majority 20(43.48%) were in age group 0-6 months. Most of them were male 24(52%). Common presenting features were dyspnea on exertion 23(50%), cough 30(65.20%), head sweating 23(50%), and feeding problem in 34(73.91%). VSD in 27(58.6%) patients were <5mm, 15(32.6%) were 5-10mm and 4(8.7%) had size >10mm. Most of the VSDs were perimembranous 31(67.39%). Among the 46 cases medical management was given to 20(43.5%), device closure was done in 10(21.7%) patients and surgical interventions done in 16(34.8 %) patients. Conclusion: Most of the VSD patients presented at an earlier age some of them were undergone device closure and some require surgical interventions that were not suitable for device closure. Patients those presented lately developed pulmonary hypertension. JAFMC Bangladesh. Vol 19, No 1 (June) 2023: 22-26

Semenology of Infertile Men Reported at a Tertiary Level Military Hospital of Bangladesh

Introduction: A very simple, cheap, easily available and non-invasive approach has made routine semen analysis the most important tool for diagnosis of male fertility. Objective: To determine I) the percentage of abnormality in semen parameters present in the husbands of infertile couples, II) the effect of occupation on abnormal parameters and iii) the effect of increasing age on semen quality. Methods: A cross sectional retrospective study was designed in a period of April 2019 to March 2020 on the basic semen analysis reports of the husbands of infertile couples reporting to the fertility clinic of a tertiary level military hospital of Bangladesh.  Results: Out of 851 couples only 372 were excluded from female cause. At least 44% husbands showed at least one abnormality in their semen parameters according to WHO 2010 criteria and out of them 3.8% were azospermic. Almost all abnormalities showed more severity in the patients reporting from non-military background. Significant differences were demonstrated in the mean values in semen parameters like volume, concentration and motility between different occupational groups. Mean values of sperm concentration between different age groups showed significant changes. Values of other parameters also showed gradual decrease with increase of age but differences were not significant. Conclusions: The present study showed that even 56% normozoospermic husbands can be partners of infertile couples. Occupation and age affect male fertility. JAFMC Bangladesh. Vol 19, No 1 (June) 2023: 66-71

Clinical and Biochemical Characteristics of Acute Pancreatitis Patients Attended in a Tertiary Hospital of Bangladesh

Introduction: Acute pancreatitis is a complex, life- threatening disease resulting from acute inflammation of the pancreas which causes considerable morbidity and mortality among the patients. Objectives: To find out the clinical and biochemical characteristics of acute pancreatitis patient attended at the Combined Military Hospital (CMH) Dhaka. Methods: This observational study was conducted at CMH Dhaka among 40 patients of acute pancreatitis admitted from 1st January 2013 to 30th June 2013. Data were collected through face-to-face interview using a pre-tested semi- structured questionnaire and review of the hospital records. Results: Highest number of the respondents (42.5%) belongs to the age group of 20-39 years. The mean age was 44.90 years (±13.46) years and 60.0% of them were male. More than half (57.5%) of the respondents had monthly income in the 20001 to 50000 Taka with average of 31,650(±15,255.60) Taka. All the patients presented with pain in the abdomen which was followed by nausea/ vomiting (82.5%), abdominal distention (72.5%). On examination, it was revealed that all the respondents had abdominal tenderness which was followed by muscle guard (10.0%), ascites (7.5%) and jaundice (5.0%). Almost half (47.50%) of the respondents developed acute pancreatitis due to stone in the gall bladder which was followed by idiopathic origin (30.0%). Eighty five percent of the patients had severe symptoms and rest (15%) had mild symptoms. All the respondents had elevated serum amylase level and 82.5% had elevated serum lipase level. Conclusion: Acute pancreatitis mostly affect young adult male. Most common clinical presentations are upper abdominal pain, nausea/vomiting and abdominal tenderness. Gallstone is the commonest cause of the condition. Serum amylase is the most important biochemical abnormality found in acute pancreatitis. JAFMC Bangladesh. Vol 19, No 1 (June) 2023: 38-41

Clinicopathological Study of Patients with Non-inflammatory Benign Breast Disease at Combined Military Hospital (CMH) Chattogram

Introduction: Breast lump is a very common problem among females attending surgical outpatient department. Its development and growth are under the control of various hormones and various physiological statuses like menstruation, pregnancy, lactation and menopause. Objectives: To evaluate the clinicopathological status of patients with non-inflammatory benign breast disease (NIBBD). Methods: This clinical study was conducted at the department of surgery, CMH Chattogram, this study was done during January 2018 to May 2019. Patient presented with breast lump, nipple discharge, sinus and mastalgia in whom histopathology revealed any type of non-malignant BBD were included in the study. Patient treated on outdoor patient basis were excluded and patient with malignant breast lesions or acute breast abscess requiring incision and drainage were excluded from the study. Results: Majority of the patients, 41(74.5%) had breast lump followed by 10(18.2%) had breast pain, 6(10.9%) had nipple discharge and 3(5.5%) had enlargement of breast. Most of the site was found unilaterally 54(98.2%). Majority of the patients, 27(49.1%) had fibroadenoma, 14(25.5%) had fibrocystic diseases, 10(18.2%) had fibroadenosis, 2(3.6%) had duct ectasia, 1(1.8%) had cystosarcoma Phyllodes and 1(1.8%) had Lipoma. Conclusion: Maximum age group was 3rd to 4th decade. Most of the patients clinically presented with lumps in the breast followed by pain, enlargement of breast, fever and nipple discharge. Mostly encountered breast lesion was fibroadenoma other common lesion were found fibrocystic diseases, fibroadenosis, duct ectasia, cystosarcomaphyllodes and Lipoma. JAFMC Bangladesh. Vol 19, No 1 (June) 2023: 27-30

Side Effects of COVID-19 Vaccination among the Pregnant Women: A Cross-Sectional Study in a Tertiary Hospital of Bangladesh

Introduction: Pregnancy is a very special time for a woman and her family, although being pregnant is a stressful condition for every woman. The COVID-19 pandemic has made that condition more stressful. Clinical trials prove that COVID-19 vaccines are safe for pregnant women and also for lactating mothers. So WHO has approved vaccines for both above-mentioned groups. Hence, Bangladesh Government has taken the decision to vaccinate every pregnant woman against COVID-19 infection. Objectives: To assess the side effects of COVID-19 vaccination on pregnant women in a tertiary care hospital in Bangladesh Army. Methods: This cross sectional single-centered observational study was conducted in Combined Military Hospital (CMH) Dhaka from August 2021 to November 2021. Total 50 pregnant nullipara and multipara women with double dose vaccination were included. Relevant data were recorded in a preformed data collection sheet and analyzed by SPSS version 20. Results: Mean age of the participants was 19.2±10.8 years. The most commonly observed symptoms were pain in injection site, fatigue, swelling in injection site and myalgia. The most prevalent affected age group were 25-35 years. Among 48 participants, 20(41.6%) had co-morbidites. Two participants were found to have COVID-19 infection (4%) after vaccination. Conclusion: Side effects profile obtained from pregnant women in this study were non-life threatening. A recognized vaccine programme can be a relieving factor for pregnant women from increased stress and anxiety caused by COVID-19. JAFMC Bangladesh. Vol 19, No 1 (June) 2023: 34-37