Effect of Ramadan Fasting on Serum Lipid Profile of Bangladeshi Female Volunteers.

The study was conducted to evaluate the effects of fasting for a period of one month during Ramadan on the lipid profile of Bangladeshi female volunteers who fasted during the Arabic month of Ramadan, when there occurs a change, both in the pattern and timing of dietary intake. Findings of the study showed that Ramadan fast significantly reduced serum Total cholesterol (TC) (p=0.030) and Low density lipoprotein (LDL-C) (p=0.011). A statistically nonsignificant elevation of triglyceride (TG)) was observed (p=0.598). High density lipoprotein cholesterol (HDL-C) also found to be raised significantly at the end of fasting (p = 0.037). Findings of the study revealed that fasting during the month of Ramadan changes lipid profile pattern in an aniatherogenic direction and may be beneficial to health.

Correlations of Serum Magnesium and Potassium in Acute Myocardial Infarction, Chronic Ischemic Heart Disease and Normal Healthy Volunteers of Bangladesh.

Magnesium (Mg) and potassium (K) are the major intracellular cations whose presence in the serum are low, but minor changes of those may show a remarkable change in the various body functions specially in the heart. The study was designed to find out the correlation between serum Mg and K in acute myocardial infarction (AMI), chronic ischemic heart disease (CIHD) and normal healthy volunteers. It was carried out over a period of 18 months in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) and Atomic Energy Center, Dhaka. A total of 101 subjects were included in which 32 subjects were AMI, 34 CIHD and 35 normal healthy volunteers. Serum glucose and serum creatinine were estimated to exclude diabetes and renal dystrophies. Estimation of serum CK-MB and ECG tracing were done as diagnostic tools of AMI and to categories the subjects into various groups. Serum Mg was estimated by Atomic absorption spectrophotometer and serum K by Ion sensitive electrode. The present study shows that there is a strong positive correlation of serum Mg and K in AMI, CIHD and healthy control subjects (r = 0.566, p<0.01 level). So it is suggested to estimate and supplement both Mg and K in IHD patients for their better management.

Persistence of low serum iron and high total iron binding capacity in pregnant women.

A cross sectional descriptive type of study was done in 98 women of reproductive age. Among them 25 were in control group of non pregnant women and 73 were pregnant women of 1st, 2nd and 3rd trimester of pregnancy with and without iron supplementation. The period of study was July 2004 to June 2005. The main objective of our study was to compare serum iron and total iron binding capacity in pregnant and non pregnant women. In present study serum iron was significantly increased in 2nd and 3rd trimester of pregnancy that was supplemented with iron when compared with the same category of women who were not supplemented with iron. On the other hand serum total iron binding capacity (TIBC) was significantly increased in 3rd trimester of pregnancy that was not supplemented with iron when compared with the same category of women who were supplemented with iron. It is evident that the significantly low serum iron and high TIBC in pregnant women is due in part to dietary iron deficiency. Therefore, iron therapy in pregnancy is helpful to maintain the serum iron and TIBC nearer to that of non pregnant normal women.

Serum HDL-cholesterol in women using low dose oral contraceptives.

This study was done to appraise the effects of low-dose oral contraceptives (OCs) containing 30microgm ethinyl estradiol and 150microgm levonorgestrel on lipid metabolism by a lipid variable-serum HDL-cholesterol (HDL-C). HDL-C has been identified as a lipoprotein that protects against atherosclerosis and its levels are inversely proportional to the risk for developing ischemic coronary disease and venous thromboembolic disorders. Ninety young women within reproductive age group were picked for this study. Sixty women using low-dose oral contraceptives served as experimental group and thirty age matched hormonal contraceptive non users were selected for control group. Experimental group was again subdivided into OCs users for last one-year group, three-year group and five-year group. The result showed that there was no significant difference on serum HDL-cholesterol levels between users & non-users women. It is concluded that low-dose oral contraceptives regimens did not significantly affect the lipid metabolism. It can be safely used as contraceptive & non-contraceptive purposes. The value of studied parameter for serial longer duration of OCs uses needs to be assessed.

Studies on serum lipid profile in hypertensive patient.

The study was carried out to appraise the serum total cholesterol, triglyceride, HDL-C and LDL-C values in hypertensive patients for providing information to the health-policy planners and also to the clinical practitioners about the importance of routine monitoring of lipid profile in hypertensive patients for prevention of coronary heart disease and other consequences to combat morbidity and mortality and to reinforce the need to consider these parameters in daily clinical practice. It was a cross-sectional study. The study was conducted at Department of Physiology and Biochemistry of Mymensingh Medical College, Medicine Unit of Mymensingh Medical College Hospital and in the community of Sadar, Mymensingh District. The period of the study was January 2005 to December 2005. A total number of seventy subjects were included in this study. Out of them 40 (forty) were hypertensive patients and 30 (thirty) were normotensive & healthy controls. Most of the hypertensive patients (65%) were taking treatment irregularly. Serum total cholesterol, serum triglyceride and serum LDL cholesterol were greater in hypertensive than those of normotensive .The differences of mean of serum total cholesterol, serum LDL cholesterol in between two groups were statistically significant and in case of serum triglyceride it was statistically highly significant. Serum HDL cholesterol was less in hypertensive than those of normotensive. The differences of mean of serum HDL cholesterol in between two groups were statistically highly significant. Among 40 hypertensives the number of "Getting treatment- regular" & "Getting treatment-irregular" was 14 (35%) & 26 (65%) respectively and the values are not statistically significant. Similarly in patients "suffering less than 5 years" and "suffering 5 years & above" the differences are also not statistically significant. Conclusion: The observations of this study has revealed that most of the hypertensive patients are taking treatment irregularly and there was significant alteration of serum cholesterol, triglyceride, HDL-C and LDL-C in hypertensive patients. Therefore, for routine monitoring of hypertensive patients to prevent the coronary heart disease (CHD) and other consequences, the reinforcement of the investigations of these parameters may be recommended in daily clinical practice.

Effects of long term iodized table salt consumption on serum T3, T4 and TSH in an iodine deficient area of Bangladesh.

The effect of iodized and non-iodized table salt in goiter hyper-endemic area on the thyroid gland and its hormones T3, T4 and Thyroid Stimulating Hormone (TSH) were studied in two hundred subjects from the Center for Nuclear Medicine and Ultrasound, Mymensingh. Iodized and non-iodized salt users were called study and control groups respectively. The mean concentration of T3 were 2.38 nmol/L and 2.22 nmol/L & T4 concentration were 128.67 and 123.72 nmol/L in the study and control group respectively. The mean TSH concentration was 1.52 mIU/L and 1.62 mIU/L in study and control group. The data indicated that continuous and long term use of iodized salt increased both T3, T4 and decreased TSH in such a limit which was not statistically deferent at P< 0.05 level as compared to the control group. There was no significant change in occurrence of (hypo and hyper thyroidism or iodinated salt induced thyrotoxicosis) adverse effect, following iodine supplementation. The study shows that, mandatory mass iodination of table salt consumption in a hyper-endemic iodine deficient area is safe and does not cause any side effect. We suggest close regular monitoring of T3, T4, and TSH and further evaluation by specifically designed studies for any probable link between iodine induced hypo or hyperthyroidism and mass iodination of table salt consumption.

Studies on Serum Creatinine and Creatinine Clearance in Hypertensive Patients.

Objectives: To assess the serum creatinine and creatinine clearance values in hypertensive patients for providing information to the health-policy planners, clinical practitioners about the importance of routine monitoring of serum creatinine and creatinine clearance in hypertensive patients for prevention of ESRD and other consequences to combat morbidity and mortality and to reinforce the need to consider these parameters in daily clinical practice. Study design: It was a cross-sectional study. Setting: The study was conducted at Department of Physiology and Biochemistry of Mymensingh Medical College, Medicine Unit of Mymensingh Medical College Hospital. Study period: The period of the study was January 2005 to December 2005. Participants: A total number of seventy subjects were included in this study. Out of 70 subjects, 40 (forty) were hypertensive patients and 30 (thirty) were normotensive & healthy controls. Intervention: The subjects were selected on the basis of history and clinical examination. Convenient sampling technique was applied. During visit the available hypertensive patients and controls (normotensive & healthy) those who were present were selected. Having received their written consent they were interviewed & examined by prepared personal data sheet and sample of blood (after overnight fasting) was drawn for biochemical examination. Main outcome measure: Mean values of serum creatinine and creatinine clearance. Result: Serum creatinine was greater in hypertensive than those of normotensive. Creatinine clearance was less in hypertensive than those of normotensive. Serum creatinine & creatinine clearance in between males hypertensive & control shows that CrCl were statistically significant but not the serum creatinine. In females of hypertensive & control shows no differences in case of SCr & CrCl. Among 40 hypertensive the number of “Getting treatment - regular” & “ Getting treatment-irregular” was 14 (35%) & 26 (65%) respectively. Similarly in patients “suffering less than 5 yrs” and “suffering 5 yrs & above” the differences are also not statistically significant. Conclusion: The observations of this study revealed that most of the hypertensive patients were taking treatment irregularly and there was significant alteration of biochemical parameters in hypertensive patients. Therefore, for routine monitoring of hypertensive patients to prevent the end stage renal disease (ESRD) and other consequences, the reinforcement of the investigations of these parameters may be recommended in daily clinical practice.

Studies on Serum Total Cholesterol, in Second and Third Trimester of Pregnancy.

Study was carried out in the department of physiology, Mymensingh Medical College, Mymensingh, Bangladesh during the period of July 2006 to June 2007 to investigate the effect of pregnancy on serum total cholesterol. The serum concentrations of total cholesterol was measured in 100 cases of 2nd and 3rd trimester of pregnancy and in a control group of 100 cases of non pregnant women which was matched on reproductive age. Data were analyzed by computer with SPSS program using unpaired student‘t’ test. The results showed that the pregnant women had significantly higher concentrations of serum total cholesterol. Higher concentration of total cholesterol was more common in pregnant than control and reaching maximum at 3rd trimester of pregnancy. This may be a purely physiological response to pregnancy or it may be indication of pathology in some women. These results deserve a follow up study to investigate whether the hypercholesterolemia persists after parturition.

Pregnancy associated complications of mothers with gestational diabetes mellitus.

This study was conducted in Mymensingh Medical College and Hospital, Mymensingh. It lasted for one year commencing in July 2003, and was designed to find out and compare the outcomes of gestational diabetes mellitus (GDM) with a view to reducing the complications. Forty cases of GDM with single pregnancy were selected as experimental group, while forty other cases of pregnant women without GDM constituted the control group. Questionnaire and observation chart were the research instrument in this study. Statistical analyses were done manually. It was found that the GDM mothers had a higher risk of complications like pre-eclampsia, hypertension, urinary tract infection and cesarean delivery. On the basis of these findings, however, appropriate measures for prevention, treatment and management of GDM may be adopted for better pregnancy outcomes.

Glycemic status in women using combined oral contraceptive pill.

This study was undertaken to determine the effects of low-dose combined oral contraceptives(OCs) containing 30 gm Ethinyl estradiol with 150 microg Levonorgestrel on carbohydrate metabolism by a glycaemic variable -- fasting blood glucose level. It is now known that impairment of carbohydrate metabolism is a potential risk factor for cardiovascular disease and other metabolic disorder. Sixty women age between 15-35 years using OCs served as experimental group and thirty age matched hormonal contraceptive non users were selected for control group. Experimental group was again subdivided into OCP (Oral contraceptive pill) users for last one year group, three year group and five year group. The result showed that there were no significant differences on blood glucose level between users and non-users women. It is concluded that the cyclic administration of monophasic low dose OCs did not altered blood glucose levels and there by have no additional adverse impact on women health reaffirming the ongoing oral contraceptive pill distribution program.

Is serum C-reactive protein really a sensitive stress marker in Bangladeshi people.

The present study was done to determine the serum C-reactive protein (CRP) concentration in normal subjects and patients suffering from infection, psychiatric disorders and of surgery. A total number of 55 subjects within 18-55 years age were selected from Mymensingh Medical College Hospital during the period from July 2003 to June 2004. Normal subjects as control were 13 and 42 comprised the group experimental. According to different types of stress the experimental group was further divided in to four subgroups: infection, psychiatric, pre and post surgery. Serum CRP concentration was measured by Immunoturbidimetric method from each subject. Statistical analyses were done by using Student's ' t' test. Statistically significant rise of serum CRP was observed in infection, psychiatric disorders and post surgery group in comparison to control group (P< 0.001). The study indicated that subjects with infection, psychiatric disorder and post surgery stage were in stressful conditions that resulted increased synthesis of CRP by liver cells due to Hypothalamopituitaryadrenal (HPA) axis hyperactivity and immune mediated inflammation.

Infant outcomes of gestational diabetes mellitus.

This study was carried out in Mymensingh Medical College and Hospital, Mymensingh. The work, which lasted for one year commencing in July 2003, was designed to find out and compare the infant outcomes of gestational diabetes mellitus (GDM) with a view to reducing the complications. Forty cases of GDM with single pregnancy were selected as experimental group, while forty other cases of pregnant women without GDM constituted the control group. Questionnaire and observation charts were the research instruments. Statistical analyses were done manually. It was retrieved that the offspring of GDM mothers had a higher risk of macrosomia, neonatal jaundice and respiratory complications. The perinatal mortality rate was also more in GDM cases. However, befitting measures for prevention, treatment and management of GDM may be taken up to ameliorate the situation.

Studies on clinical pattern of glomerulonephritis.

A prospective study of primary glomerulonephritis covering two and half years period was done at Dhaka Medical College Hospital & IPGMR, Dhaka from June 90 to July 92. A total of 100 cases were included in this study. All of the patients were of 13 years and above, clinically diagnosed, and by laboratory investigations, the diagnoses were established. In this study, we have tried to find out age incidence, sex ratio, possible aetiological factors, common clinical presentation, biochemical parameters and histological typing of primary glomerulonephritis.

Factors affecting the early discharge of the indoor psychotic patients - a sociodemographic survey in a specialized institution.

This is descriptive type of cross-sectional study carried out among 100-discharged patient in a specialized psychiatric hospital. Socio-demographic study revealed that among 100 cases 97% were admitted with schizophrenia, 35% with bipolar affective disorder, 10% with psychotic depression, 5% with brief psychotic disorder, 2% with schizoaffective disorder, 1% with schizophreniform disorder. Their mean hospital stay was 19 days with highest mean hospital stay in schizoaffective disorder (32 days). Mean age of the patient was 26.5 years and highest no. of patients (52%) were in 20-25 years age group. Male female ratio of the patient was 3.761: 1. Occupational distribution of the cases family history of psychiatric illness in 1st degree and 2nd degree relatives was present and mean duration of illness was 73.4 months. Statistically significant independent variables that have impact on length of hospital stay (Dependent patient (p<0.007); electro convulsive therapy (p<0.005); family history of psychiatric illness (p< 0.046), Treatment with typical antipsychotic drugs (p <0.033); treatment with atypical antipsychotic drugs (p <0.000), Rx with combination of typical and atypical antipsychotic drugs (p<0.012); treatment with depot preparation (p<0.011); Treatment with combination of oral antipsychotic drugs (p<0.003) and patient hailing from rural area (p<0.026).

Turner syndrome: a case of gonadal dysgenesis.

An eighteen years old girl came from Ishargang, Mymensingh complaining of short stature, absence of development of breast, lack of menstruation and other secondary sex characters. She was found in infantile appearance with a height of 123 cm, body weight of 28 kg. She had short, broad, webbed neck, cuvitus valgus, absence of development of breast, axillary and public hairs with infantile external genitalia. Hormonal profile revealed high level of LH and FSH, low level of estrogens. Ultrasonography revealed uterine hypoplasia and ill defined gonadal streaks, Karyotype showed typical 45, X0 pattern. She was diagnosed as a case of gonadal dysgenesis due to Turner syndrome.