Clinical Outcome of Neonatal Septicemia in Bangladesh

Objective: In this study our main goal is to evaluate clinicaloutcome of neonatal septicemia in Bangladesh.Methods: This cross-sectional study is conducted at Neonatalunit of the department of paediatrics, Sir Salimullah MedicalCollege and Mitford Hospital, Dhaka, From July 2005 to June2006. Among 90 clinically diagnosed septicemic neonates, 30were blood culture positive.Results: During the study, where low birth weight (60%),prematurity (53%), prolonged rupture of membrane wasdocumented in 17% of cases. 70% delivery occurred by normalvaginal route, among them 50% occurred at home and 20%occurred at hospital. 30% were delivered by LUCS. 13% caseshad H/O fever in last trimester. Lethargic and reluctant to feed,83% had respiratory distress. Jaundice was present in 60%cases, fever was present in 40% cases. Other presentationswere apnea, convulsion, abdominal distension, sclerema,vomiting, hypothermia and diarrhoea.Conclusion: From our result, we can conclude that, thepattern of organisms are changing and high incidence ofmultidrug resistance remains a major challenge to manageneonatal septicemia.

Current Status of Dyslipidemia in Patients of Acute Myocardial Infarction And their Treatment Outcome in Bangladesh

Background: Dyslipidemia is one of the modifiable risk factorsof acute myocardial infarction which is caused by presence ofabnormal amount of lipid in blood.Objective: In this study our main goal is to evaluate the statusof dyslipidemia in patients of acute myocardial infarction andtheir treatment outcome in Bangladesh.Method: This cross-sectional prospective observational type ofstudy was conducted among 200 purposively selected patientsof acute myocardial infarction attended in CardiologyDepartment of NICVD, for treatment to see their pattern ofdyslipidemia and treatment outcome during January 2011 toDecember 2011. Study subjects were selected from admittedpatient at emergency department and at in-patient departmentof the Cardiology Department with acute coronary syndrome.Fasting lipid profile in next morning of admission was done andassessed. Dyslipidemia was considered according to ATP IIIguideline with Serum Total cholesterol > 200 mg/dl, TG>150mg/dl, LDL >100 mg/dl, HDL. Collected information waschecked repeatedly. Information was collected by theresearchers.Results: During the study, male patients were 58% higher thanfemale and most of them belongs to 51-60 years age group(40%).77% patients had dyslipidaemia and after treatment 57%patients got discharged.Conclusion: We can conclude that hypertriglyceridemia andhypercholesterolemia are the most prevalent dyslipidemia inpatients of acute myocardial infarction in Bangladesh. Furtherresearch, in particular longitudinal studies, is needed for betteroutcome.

The Association of Cardiac Troponin I Level on Admission with the Angiographic Severity of Coronary Artery Disease in Acute STEMI Patients

Objective: In this study our main goal is to find out theassociation of cardiac troponin I level on admission with theangiographic severity of coronary artery disease in acuteSTEMI patients.Method: This cross-sectional observational study was done inthe NICVD, Dhaka from October 2010 to September 2011. Atotal of 100 consecutive patients were included. Studypopulations were sub-divided into two groups on the basis ofcTn I level. In group I cTn I level ≥20ng/ml and in group II cTnI level <20ng/ml. 50 patients were included in group I and 50patients were included in group II.Results: Most of the patients presented with more than 4hours chest pain which was 68% vs. 60% patients in group Iand group II respectively. Where mean heart rate was higher ingroup I than group II (83.08.4 vs. 78.210.6). It wasstatistically significant (p=0.01) in student-test. Vessel score 2and 3 together formed the main bulk of the patients (68%) ingroup I, while vessel score 0 and 1 were frequently common ingroup II (80%). In group I there was no patient with vesselscore 0, in group II 12(24%) patients had vessel score 0 (5patients had normal coronaries and 7 patients had insignificantlesions, p-value from Chi square test).Conclusion: From our study we can say that, estimation ofserum cardiac troponin I might facilitate the triage of patientswith acute myocardial infarction by clinicians and moreaggressive approach to promote myocardial reperfusion mightbe warranted in the patients with high cardiac troponin I level.

A Comparative Analysis between Short Wave Diathermy and Infrared Radiation’s Effects on the Patients with Chronic Low Back Pain \r\nDue to Lumbar Spondylosis\r\n

Introduction: Low back pain is a symptom and not a disease.The low back pain is considered to incorporate dorsal painfound any place between the 12 thoracic vertebra and lowerbuttock up to gluteal folds or anus. Lumbar spondylosis is atypical reason for chronic low back pain and chronic disability.Objective: The main purpose of this research is to give acomparative analysis between short wave diathermy andinfrared radiation for treating lower back pain caused byspondylosis.Method: This was an observational study. A randomizedclinical trial study was conducted on Department of PhysicalMedicine and Rehabilitation, BSMMU, Shahbagh, Dhaka on153 patients who came to hospital with lower back pain andsuffered from spondylosis. The study duration was from 1stMarch 2010 to 15 September, 2010.Results: Out of 153 patients, irrespective of sex, it was foundthat most of the patients (50.98%) belong to 40-49 years agegroup followed by: 50-59 years (27.45%), 30-39 years(11.11%) and 60-70 years (10.46%) age group. in 72.2%patients prolonged sitting exacerbate the lower back pain.Prolonged standing was also found as another aggravatingfactor of pain among the study patients (17.6%). Prolongedwalking (5.9%) and leaning forward (3.3%) came next in theorder of aggravating factors for lower back pain. The study alsoshowed the performance difference between SWD and IRR onthe patients.Conclusion: Considering the information gathered from thisstudy, it can be concluded that all the tested therapies seemedto improve the patients with chronic low back pain. But IRR andSWD showed no significant difference in improvement for thepatients with chronic LBP due to lumbar spondylosis.

Study to Determine the Definite Percentage of the Different Analgesic Drugs and Analgesic Techniques Used At the Postoperative Ward for Pain Management in Sir Salimullah Medical College Hospital, Mitford, Dhaka

Background: The rationale of determining the percentage ofanalgesics used in postoperative period is to determine the realutilization of opioid sparing effect of nonsteroidal antiinflammatory drugs and the concept of multimodal analgesia.Objectives: To determine the cost of opioids consumptionbecause the opioids are expensive.Methods: Total 541 patients were selected to find out thetypes of analgesics are being used in the postoperative eperiod irrespective of the types of operation and anaesthesia,premedication by analgesics and intraoperative analgesicsused or not. Patients were divided into several age groups.Results: In the existing prospective cross sectional study it isviewed that combination of intramuscular injection of pethidineand nonsteroidal anti-inflammatory drugs (either in suppositoryform or intravenous or intramuscular route) have the highestpercentage in postoperative pain relief.

An Observation of Risk Factors Associated with Patients with Ischemic Stroke.

Background: Objective: our study was to observe the risk factors in different age group of patients with ischemic stroke. Methods: A total of 120 patients of ischemic stroke were considered on the basis of detail clinical history, laboratory findings and CT Scan/MRI. Results: Data was analyzed by using MS-Office software. Conclusion: Major risk factors associated with ischemic stroke was hypertension, smoking, alcohol consumption, diabetes mellitus, dyslipidemia and obesity.

Development and In-Vitro Evaluation of Vinpocetine Loaded Bi-Layer Tablet Using Different Polymers.

The present study has investigated various ways to formulate a bi-layer tablet dosage form containing an immediate release and a sustained release portion of a neuroprotective compound named vinpocetine. The bi-layer matrix tablet was prepared by simple compression of the SR granules and IR granules of vinpocetine. The sustained release effect of vinpocetine was achieved with polymers methocel K15M CR, kollidon SR and carbomer 934P. Physical properties of powders, granules and the finished tablets were evaluated. The drug release study of the tablets was studied for 2 hours in 0.1N HCl followed by 8 hours in pH 6.8 phosphate buffer as media using United States Pharmacopoea (USP) XXII paddle type dissolution apparatus. The effect of above mentioned polymers on vinpocetine release profile was investigated. The MDT values of all the formulations were calculated and correlated with the rate retardation capacity of drug release of the polymers used. The release rate of vinpocetine immediate release layer was found to be influenced little by kollidon CL and direct compressible grade lactose. The release rate, extent and mechanisms of sustained release layers were found to be governed by the nature and the extent of the polymer used in the formulation. Kinetic modeling of dissolution profiles reveled that vinpocetine release mechanism ranges from the anomalous / non – fickian transport to super case II transport in the given situations. These studies indicated that the proper balance between a matrix forming agent and a channeling agent can produce a drug dissolution profile similar to a theoretical dissolution profile will overcome the disadvantages of conventional tablets of vinpocetine.