ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
Review on Updated Management of Prurigo Nodularis (PN)
Md. Tauhidur Rahman, Sazia Afrin, Fatamatuz Zohura Antora, Jaheda Akter, Sadia Rubana Nila, Fatima Wahida
Page no 367-371 |
DOI: https://doi.org/10.36348/sjm.2024.v09i09.005
Background: Prurigo Nodularis (PN) presents as a challenging chronic dermatological condition characterized by intensely pruritic nodules on the skin, leading to significant morbidity. Despite its prevalence and impact on patients' quality of life, treatment options remain limited, necessitating evidence-based approaches to address this complex condition effectively. Objective: This study aims to provide an updated overview of evidence-based management strategies for PN, highlighting recent advancements in treatment modalities. Method: A systematic review of clinical studies on PN treatment was conducted by searching the PubMed and Scopus databases from January 1, 2001, to December 1, 2023. A total of 706 unique studies published in English were identified and screened for inclusion criteria. Only primary clinical studies investigating treatment strategies in PN patients were included, while case reports and series with fewer than five patients were excluded. Relevant publications were further supplemented by searching bibliographies for additional studies meeting the inclusion criteria. Results: The review identified significant advancements in evidence-based management strategies for PN, driven by a growing body of clinical research and therapeutic innovation. Pharmacological interventions targeting pruritus, inflammation, and lesion resolution have shown efficacy, including topical agents such as corticosteroids, emollients, Vitamin D3 analogues, tacrolimus creams, and systemic therapies like antihistamines, gabapentinoids, immunosuppressant and anti-inflammatory agents, JAK inhibitors, retinoids, and sometimes selective serotonin reuptake inhibitors (SSRIs). Additionally, emerging biological agents and non-pharmacological approaches, such as multidisciplinary interventions, have demonstrated promise in improving patient outcomes. Conclusion: Evidence-based management of PN represents a dynamic field with evolving treatment modalities. While challenges persist, including limited efficacy and safety concerns of certain treatments, recent developments in targeted therapies, systemic immunomodulators, and novel pharmacological approaches offer hope for improved patient care. Further research into genetic underpinnings and personalized therapies is warranted to address the heterogeneous nature of PN and enhance treatment efficacy and safety.
ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
Incidence of Cervical Intraepithelial Neoplasia in the Outpatient Department: A Study at Islami Bank Medical College Hospital, Rajshahi
Dr. Mst. Abeda Khatun, Dr. Nasrin Begum Doty, Dr. Nasrin, Dr. Wahida Farzana Chowdhury
Page no 449-455 |
DOI: https://doi.org/10.36348/sijog.2024.v07i09.009
Background: Cervical Intraepithelial Neoplasia (CIN) is a precancerous condition and a significant cause of cancer-related mortality among women in developing countries. In Bangladesh, its prevalence is rising due to low screening rates and late-stage diagnosis. Objective: This study aimed to determine the incidence of CIN among women attending the outpatient department of Islami Bank Medical College Hospital, Rajshahi, and to identify associated risk factors. Method: A prospective observational study was conducted in the Department of Obstetrics and Gynecology at Islami Bank Medical College Hospital, Rajshahi, Bangladesh, from January 2020 to December 2023. The study included 218 women aged 30-65 years. Screening for CIN was performed using visual inspection with acetic acid (VIA) and Pap smear/Liquid Based Cytology (LBC). Positive cases were confirmed using colposcopy. Statistical analysis was performed to determine the significance of risk factors, with a p-value <0.05 considered statistically significant. Results: Out of 218 women screened, 35 were diagnosed with CIN, yielding an incidence rate of 16.1% (95% CI: 11.5% - 21.8%). Of these, 20 cases (57.1%) were identified as CIN 1, 10 cases (28.6%) as CIN 2, and 5 cases (14.3%) as CIN 3. The incidence of CIN was significantly associated with early sexual exposure (p=0.03) and multiple sexual partners (p=0.02). The use of VIA and LBC demonstrated a combined sensitivity of 92% for CIN detection. Conclusions: The study highlights a significant incidence of CIN among the outpatient population in IBMC Rajshahi, emphasizing the need for enhanced screening and preventive strategies. Early detection of cervical cancer through VIA and LBC, followed by colposcopy, proves effective in managing CIN. Public health initiatives should focus on increasing awareness, health education, and accessibility to screening services to reduce cervical cancer incidence.
ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
A Study on Case Fatality of COVID-19 Patients with Ischemic Heart Disease in Selected Hospitals in Dhaka City
Dr. S. M. Aminul Islam, Dr. Khandaker Md Safiul Kabir, Dr. Md. Shahnur Islam
Page no 372-381 |
DOI: https://doi.org/10.36348/sjm.2024.v09i09.006
Objective: To identify the significant level of Case fatality of Covid-19 Patients with Ischemic Heart Disease in selected hospitals in Dhaka city. Method: This cross sectional study was carried out at NICVD/ Lab aid cardiac hospital/ Universal cardiac hospital from January 2023 to February 2023. Where a total of 384 adults (>18 ages) with Ischemic Heart Disease who admitted in hospital and tested positive for Covid- 19 were included as a sample population. After collecting data from sample population, data was checked and re-checked for completeness and correctness. The Collected data was analyze via statistical Software’s like STATA, SPSS etc. Results: during the study, majority were belonging to 51-60 years age group, 32.81%. followed by 27.60% were belong to 41-50 years age group and 23.18% belong to >61 years age group and majority were male, 80%.42.71% had normal weight whereas 28.13% were overweight & 24.74% were obese. 80.47% had chest pain, followed by 13.28% had dyspnea, 12.50% had cough, 10.68% had palpitation, 4.17% had vomiting. where 46.61% had STEMI, followed by 17.19% had NSTEMI, 19.27% had unstable angina, 25.78% had systemic hypertension, 21.88% had diabetes mellites, 6.77% had Heart valve disease, 4.43% had Arrhythmia. Plus, majority didn’t get their vaccination, 89.60%.49.48% had abnormal level of anxiety status whereas 55.73% had abnormal level of depression. Multivariable logistic regression found residence, age, profession, and income to be statistically significantly associated with anxiety after controlling for the other factors found to be significant at the univariate level. Plus, Chronic disease, STEMI, NSTEMI to be statistically significantly associated with anxiety after controlling for the other factors found to be significant at the univariate level. Cardiovascular Drug Therapy at Hospitalization of Covid-19 shows Medical therapy included ACE inhibitors (22.1% of the patients), ARBs (20.57%). mean length of hospital stay was 10.7±2.7 days, with an overall in-hospital mortality of 5.8% (515 of 8910 patients) in this population of patients with completed outcomes. Conclusion: Our findings indicate that health care providers, particularly cardiologists and nurses, should take extra care to detect and evaluate all heart disease patients for level of anxiety and depression in a clinical setting. There is a need to develop a quick screening approach in hospitals dealing with cardiovascular inpatients to identify those needing extra evaluation and care.
ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
Outcome of Empirical Antibiotic Prescription for the Treatment of Community Acquired Pneumonia
Dr. S. M. Aminul Islam, Dr. Khandaker Md Safiul Kabir, Dr. Md. Shahnur Islam
Page no 677-681 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i09.006
Background: The primary cause of illness and death in Bangladesh is community acquired pneumonia (CAP). Many hospitals in Bangladesh lack the resources to perform sputum cultures and sensitivity tests, making it difficult to identify the etiological agent of an infection. As a result, antibiotics are prescribed on a "empirical basis" rather than as part of a specific anti microbial treatment. The optimal antibiotic for treating CAP should be chosen using an empirical approach. Objective: The purpose of this study is to evaluate the effectiveness of various empirical antibiotic choices in the management of CAP. Methods: Eighty-two patients with CAP were included in this prospective observational research at a tertiary medical college hospital in Bangladesh. Inclusion and exclusion criteria were used to choose patients. Chest x-rays confirmed the diagnosis of CAP. The antibiotic was chosen based on clinical experience, which is an empirical method. The majority of patients received a combination antibiotic, whereas the remaining handful received monotherapy. The result served as an evaluation of the empiricism used in selecting the antibiotic. During the research, data were recorded in standardized formats. SPSS was used for the statistical analysis. Results: A total of 82 people were treated, and of them, 62 (or 76%) were men and 20 (or 24%) were women. The average age was 54.4% (9.6%). The round of antibiotics was supposed to last for a week. There were no unwanted medication reactions. No cases of lung abscess or parenchymal damage to the lungs occurred, and only one patient had paraneumonic effusion. Every single person made a full recovery. Conclusion: In many hospitals in Bangladesh, the choice of antibiotic for treating CAP is made on a "empirical" basis. Selecting an appropriate antibiotic requires better sputum culture and sensitivity testing in hospital labs.
ORIGINAL RESEARCH ARTICLE | Sept. 16, 2024
Workplace Humanization and Job Effectiveness of Business Education Graduates in Tertiary Institutions in Rivers State
Wagbara Chinyere Dorathy, Fortune Omasirichi Sam-Eleyi
Page no 544-551 |
DOI: https://doi.org/10.36348/jaep.2024.v08i09.004
This study examined workplace humanization and job effectiveness of business education graduates in tertiary institutions in Rivers State. Two (2) objectives, research questions and null hypotheses were stated, answered, formulated and tested to guide this study. Descriptive survey design was adopted in this study and the population consists of one thousand two hundred and eighty-three business education graduates in public tertiary institutions in Rivers State and the sample size of this study was two hundred and ninety-seven respondents drawn from the population with the use of Taro Yamen formular, hence simple random sampling techniques was adopted in this study. A self-developed questionnaire titled “Workplace Humanization and Job Effectiveness of Business Education Graduates Questionnaire (WoHuJEBEGQu) was used to obtain data for this study. In addition, the said instrument employed face and content validity, which was validated by experts in the study area and a reliability index coefficient of 0.81 was obtained using test-retest method of Pearson Product Moment Correlation Coefficient (PPMC). Mean and standard deviation was used to answer and analyzed the research questions while independent t-test statistical tool was used to test the null hypotheses at 0.05 level of significance. Findings of this study revealed that job security and equity in remuneration are the variables of workplace humanization that enhances job effectiveness of business education graduates in tertiary institutions in Rivers State to a high extent. In addition, there is no significant difference in the mean responses of male and female business education graduates on extent job security and equity in remuneration enhances job effectiveness in the aforementioned institutions in Rivers State. It was therefore recommended among others that management of institutions should display equal fairness in the areas of employees’ remuneration so that there will not be room for any marginalization.
Background: A deficiency is a public health issue for many children and adults. In wartime hardship, patients eat little meat, dark vegetables, and fruits, which can cause vitamin A deficiency and corneal dryness, erosion, ulceration, and perforation. The purpose of this study was to identify the characteristics and demographics of vitamin A insufficiency in Sudan during the 2023-2024 war. Methodology: This prospective descriptive study was carried out between June 15, 2024, and August 15, 2024, at Dr. Khalil's Ophthalmology Center in North Kordofan, Sudan. The study looked at 100 individuals who presented at the clinic complaining of deficient night vision (including full coverage during the notification period). Results: In this study, only six patients had corneal opacity, with 67% being males and 33% females. In terms of Bitto's spots, 12% are present, with males and females having 58% and 42%, respectively, and 46% having dry eyes. 52% were males and 48% were females in terms of retinal pigmentation. Only one female patient exhibited peripheral retinal pigmentation, which was due to retinitis pigmentosa; all patients had inadequate food intake; and no diarrhea was reported. Conclusion: In Sudan, the rise in vitamin deficiency can be attributed to the inadequate development of all health system programs. Additionally, the devastating war, which primarily affects young people, has forced most people to leave their homes and become either displaced or refugees. Consequently, 69% of the patients were 17 years old or younger.
ORIGINAL RESEARCH ARTICLE | Sept. 14, 2024
Prognosis of Anaemic Pregnant Women at the Gabriel Touré University Hospital in Bamako (Mali)
Sylla Cheickna, Sanogo Siaka Amara, Fané Seydou, Bocoum Amadou, Adiawiakoye Adane, Séma Kéita, Dembélé Sitapha, Dao Seydou, Z, Tégueté Ibrahima, Traoré Youssouf
Page no 430-440 |
DOI: https://doi.org/10.36348/sijog.2024.v07i09.007
The aim was to assess the prognosis of anaemic pregnant women at the Gabriel Toure University Hospital in Bamako (Mali). Materials and Methods: This was a cross-sectional, descriptive and analytical study. It covered a period of 6 months and involved 432 patients. Results: the frequency of anaemia associated with pregnancy was 28.7% or 432 cases of anaemia among 1505 pregnant women. The mean age was 25.99 years with extremes of 15 and 45 years. Among them, the majority were housewives and constituted 77.8% of the workforce compared to only 4.9% of civil servants. The etiological factors often associated were: gestationity (3.52 with extremes of 1 and 11); primiges (29.20%); parity (3.26 with extremes of 1 and 11). The mean birth interval was 24.4 months with extremes of minus 6 months and 158 months. In 78.7% of cases, patients were transfused. The prognosis was characterized by a maternal mortality rate of 4.4% and a neonatal mortality rate of 33.3%. The mean length of hospital stay was 5.21 days. Conclusion: Anaemia in pregnant women is a pathology that causes maternal and neonatal mortality. The unavailability of blood products worsens the prognosis.