Smoking enhances age related brain atrophy--a quantitative study with computed tomography.

This is a prospective study done on Bangladeshi people during the period from January 1999 to December 2002. Cases were collected from the department of Medicine in Sir Salimullah Medical College, Dhaka; Sher-e-Bangla Medical College, Barisal and Bangabandhu Sheikh Mujib Medical University, Dhaka. We examined the chronic effect of smoking on brain atrophy quantitatively with Computed Tomography (CT). Study was performed on 219 smokers and same numbers of non-smokers from 40 to 70 years old with neither neurological nor focal abnormality in brain CT. Brain atrophy index (BAI) which was a quantitative marker of brain atrophy reported previously, was calculated from each brain CT. Smokers showed a significant increase in BAI compared to non-smokers in groups 50-54 years (p<0.01), 55-59 years (p<0.01), 60-64 years (p<0.05) and 65-70 years (p<0.05). It was suggested that age-related brain atrophy was increased by chronic smoking through advanced atherosclerosis.

Depression after stroke-analysis of 297 stroke patients.

Stroke is commonly followed by some form of psychiatric disturbance. Association and severity of depression at the 3rd and 12th months after stroke in patients and controls were compared. Two registers of stroke patients were maintained over 2 years period in two different centers--one in Barisal Town and other in Mitford Hospital, Dhaka. A total of 297 first-ever strokes were registered. These patients were called back at the 3rd and 12th month interview and assessment. Beck's Depression Inventory (BDI), with 10 as the cut off point for depression, was applied to 161 of 212 survivors at the 3rd month and to 156 of 195 survivors at the 12th month. At the 3rd month, 41% of patients and 18% of controls were depressed (P<.001) and the difference was maintained at the 12th month 42% versus 19% (P<.05). Univariate risk factors for depression at the 3rd month were female sex, severe prognostic score at the onset of stroke, age more than 70 years, family history of stroke and living alone after stroke. Depression was common among stroke survivors at the 3rd months and its rate did not decrease at 1 year follow-up. Depression could be decreased if post-stroke rehabilitation services are improved. After the development of depression earlier diagnosis and management help a lot to the patients and care givers.

Analysis of psychiatric morbidity of outpatient children in Mitford Hospital, Dhaka.

The objective of this study was to describe the pattern of psychiatric morbidity among 97 child patients who, for the first time attended the psychiatric outpatient department of Sir Salimullah Medical College & Mitford Hospital, Dhaka, in the year 1994. Dissociative disorder (Hysteria) comprised the largest group (21.65%), followed by epilepsy (19.59%). Majority of the cases were within 7-10 years age group with mean age 9.74 (+/- 2.39) years. Male outnumbered female patients and 53.61% cases came from rural background. The findings of the study indicate the need for establishment of child psychiatric treatment centres in different parts of the country including rural areas.