ABSTRACT
Background: Migraine headache is a common neurologicalepisodic condition originating from the central nervous systemthat can significantly impair the lives of otherwise normallyfunctioning people. Pharmacologic options for migraineprophylaxis include beta blockers, calcium channel blockers,antidepressants and anticonvulsants; all of which have varyingdegrees of adverse effects that may significantly limit their usein this disease.Objectives: To observe whether low dose Topiramate is moreeffective compared to Propranolol in migraine prophylaxis.Methods: This clinical trial was carried out in the Out PatientDepartment (OPD) & Headache Clinic, Department ofNeurology, Bangabandhu Sheikh Mujib Medical University,Dhaka. A total of 120 patients around the age range of 18 to 50years diagnosed as migraine (with aura or without aura)according to ICHD-3 criteria, were recruited as the studypopulation. By simple random sampling procedure, using odd& even number, 60 patients were administered by Tab.Topiramate 50 mg/ day named as group-I and rest 60 patientswere administered by Tab. Propranolol 80 mg /day named asgroup-II. Out of them in total 96 patients had completed thestudy due to drop out of 13 patients in group-I & 11 patients ingroup-II in different steps of follow up. Finally 47 patientsremain in group-I and 49 patients in group-II. During trial, threefollow up visits were taken for both group, 1st follow up after 4weeks of baseline information (Before starting prophylacticmedication), 2nd follow up after 4 weeks of treatment, 3rdfollow up after 8 weeks of treatment. Efficacy of treatment wasmeasured by headache frequency, duration and Severity ofheadache as measured by the VAS.Results: The mean (SD) age of group-I (topiramate) andgroup-II (propranolol) group were found 29.72 (9.58) yearsand 30.96 (10.11) years respectively. Female sex was foundpredominant in both groups. At final follow up, there wasstatistically significant difference in mean (SD) value offrequency of migraine attack between topiramate andpropranolol group [4.72 (2.80) vs. 3.48 (2.20); p=0.024].Propranolol appeared statistically significant than topiramate[TPM 5.53 (2.98) vs. PRO 4.36 (1.55); p=0.047]. RegardingSeverity of headache, better results also were observed in thepropranolol group than topiramate (p < 0.05). Both drugsappeared significant in efficacy measurement (p < 0.001).Patient drop out was more in the topiramate group than thepropranolol group (21.68 % vs. 18.34%). Furthermore, in thetopiramate group, patients complained of more adverse effectsthan propranolol group (23.4% vs. 14.3%), which wasstatistically significant.Conclusion: The present study suggests that low doseTopiramate and Propranolol are effective for migraineprophylaxis in reduction of frequency, Severity and duration ofmigraine headache individually and propranolol appears moreeffective compared to that of topiramate.
ABSTRACT
Back ground: Construction industry is one of the stable growing industries world over, including Bangladesh. In Dhaka city there are many construction sites, where workers are exposed to hazardous condition, specially the female workers. Throughout the world, over 90% of construction workers are male. In some developing countries, the proportion of women is higher. In Bangladesh their number is increasing day by day. Objective: To explore the health problems among the women building construction workers Methods: This cross-sectional study was carried out among 134 female construction workers. Data was collected through face to face interview by using prefixed questionnaire. The study was conducted from September 2011 to December 2012 in the Department of Community medicine, Dhaka National Medical College, Dhaka. The subjects were selected from different building construction sites of old Dhaka city. Results: It was observed that among 134 respondents, majority 96(71.6%) of the women construction worker were brick breaker and 38(28.3%) were weight carrier. Their mean age was 38.29±6.9 years. Most workers 110 (82.1%) had different types of skin problem. The proportion of skin problems was found to be high among the weight carrier and the difference was statistically highly significant (pOE .001). 89(66.5%) respondents had urinary tract infection, 66(49.3%) had constipation and 24(17.9%) complaint uterine prolapse. Among the total respondents 68(58.2%) complain of backache. The workers who complain of backache, 52(54.1%) were brick breaker and 16(42.1%) were weight carrier. 79 (58.9%) respondents used personal protective equipments, among them 61(77.2%) used self made hand gloves and 38(48.1%) used folded towel to carry weight. Besides of the total respondents 117(87.3%) complain of different types of respiratory problem. Conclusion: The study concludes that different types of skin diseases are present among female construction workers that might be attributable to exposure to hot humid working environment. Besides pain full micturation, uterine prolapse, low backache and respiratory problem were found among them which might need special attention.