Objective: To identify the common risk factors associated with carpal tunnel syndrome. Methodology:This case-control observational study was conducted in the department of neurology and medicine, DMCH from May 2010 to April 2011 for a duration of 1 year. The study included purposively selected 80 persons. Patients attending the outdoor and admitted in indoor of department of neurology and medicine, DMCH with a clinically suspected CTS and established by electrophysiological parameters selected as cases (group –I) . Healthy volunteers and subjects who were devoid of any features of CTS but having history with isolated injury to the lower limb nerve and isolated facial nerve palsy with normal electrophysiological parameters selected as control (group –II). Data were collected by interview of the patients, clinical examination and laboratory investigations using the research instrument. Result: The mean age was 42.7±9.8 years with range from 24 to 64 years and 41.1±9.1 years with range from 26 to 61 years in group-I and group-II respectively. The proportion of male and female patients was similar in both the study groups. Male Female ratio was 1: 7 in both groups. In this study it was observed that hypothyroidism was found 25.0% in group I and 5.0% in group II, which was significantly (p<0.05) higher in carpal tunnel syndrome patients. Diabetes mellitus was significantly higher in carpal tunnel syndrome patients, which was 22.5% in group I and 7.5% in group II. Rheumatoid arthritis was found 20.0% in group I and 5.0% in group II, which was significantly (p<0.05) higher in patients with carpal tunnel syndrome. Pregnancy was found 11.4% in group I and 2.9% in group II. CKD with hemodialysis was found 17.5% and 7.5% in group I and group II respectively. In pregnancy and CKD with hemodialysis difference was not statistically significant (p>0.05) among the two groups. Regarding obesity it was found in this present series that 42.5% and 17.5% patients were obese in group I and group II respectively. Obesity was significantly (p<0.05) higher in patients with carpal tunnel syndrome. In this study it was found in multivariate analysis that patients with hypothyroidism 1.28 times, DM 2.20 times, RA disease 3.84 times, obesity 5.9 times more likely to be associated with carpal tunnel syndrome but CKD with hemodialysis patients and pregnancy were not significantly associated in multivariate analysis. In this study it was also found that almost a half (47.5%) of the patients was housewives followed by garment workers (27.5%) and clerical workers (22.5%) in group I, which indicates that carpal tunnel syndrome was more common among housewives. Conclusion: A conclusion can be made from the above mentioned result that CTS is multifactorial. Obesity, diabetes mellitus, hypothyroidism and rheumatoid arthritis are commonly associated with carpal tunnel syndrome. Moreover female sex and age were also associated with CTS. This study also found that patients diagnosed as having work-related CTS have a high prevalence of concurrent medical conditions capable of causing CTS without respect to any particular occupation. Bangladesh Journal of Neuroscience 2013; Vol. 29 (2) : 70-78
Background: Eclampsia is a complex hypertensive disorder of pregnancy affecting multiple systems. Central nervous system is commonly affected and is a cause of significant morbidity and mortality in women. Various neurological complications are found in eclamptic patients. Aims and Objectives: The aim of this study was to explore the various CNS complications related to eclampsia. Materials and Methods: This retrospective observational study was carried out in the ‘Eclampsia ward’ of Department of Gynaecology and Obstetrics of Dhaka Medical College Hospital (DMCH), during the period of November, 2010 to October, 2011 in patients admitted with a history of eclampsia. Fifty(50) patients were included in this study. Data was collected by a semistructured questionnaire. The patients were interviewed and a complete clinical examination was performed by the investigator. It was reviewed by a consultant neurologist. Results & conclusion: The results revealed that patients had headache, comatose state, stroke, focal neurological deficit, post partum psychosis, aphasia and cortical blindness. Death occurred in 6.0% of patients. As eclampsia is the third major cause of pregnancy related maternal death in Bangladesh (16%), and no study has yet not been reported in this field, this study might help in formulating management plan; predict prognosis and functional recovery in the individual cases. Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 11-15
Objective: To evaluate the solitary & multiple site of extracranial and intracranial atherosclerotic arterial stenosis in patients of ischemic stroke with diabetes mellitus. Methodology: This retrospective observational study was conducted among the patients having ischemic stroke with diabetes mellitus who were admitted in Dhaka Medical College & Hospital (DMCH) out patient department during March 2010 to February 2011. A total of 30 patients with ischemic stroke and diabetes mellitus were included in the study. CT scan of brain was done to every patient to confirm the diagnosis. Digital subtraction angiography was performed for complete evaluation. Result: The mean (±SD) age was 57.9±9.2 years with a range from 43 to 80 years and male female ratio was 29:1. Among 21 patients with extracranial stenosis, either single, double and triple or more lesions were found in 53.3%, 85.7% and 87.5% of patients respectively. Again among 9 patients with intracranial stenosis, it was observed that 46.7% of patients had single lesion stenosis, 14.3% of patient had double lesion stenosis and 12.5% of patients had triple or more lesion stenosis. Double (85.7%) and triple (87.5%) lesions were significantly (p<0.05) higher in extracranial stenosis compared to intracranial stenosis (14.3% and 12.5% respectively). Most (78.9%) of the patients had >70% stenosis in extracranial arteries and 21.1% in intracranial arteries. Patients with >70% stenosis were significantly (p<0.05) higher in extracranial arteries. Conclusion: A conclusion can be made from the above mentioned result that occurrence of multiple site of lesions and more severe stenosis occurred more in extracranial group than in intracranial group of ischemic stroke patients among diabetic population of Bangladesh. Bangladesh Journal of Neuroscience 2013; Vol. 29 (1) : 1-4
Background: Guillain-Barré syndrome (GBS) is an acute autoimmune polyneuroradiculopathy characterized by flaccid paralysis which may lead to respiratory failure requiring intensive care. Objective: The purpose of the present study was to explore the relationship between the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and disease severity of GBS patients who are not known to have DM. Methodology: This cross-sectional study included adult GBS patients without having DM [age 35 (22-48) years, median (interqurtile range, IQR); 39 male 22 female] who were admitted to Neurology department, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from July 2018 to June 2019. Demographics, clinical data were noted and FPG, HbA1c were measured. Disease severity were assessed by the GBS disability scale ranging from 0 to 6 with increasing score reflecting increased disability. Results: Patients with more severe GBS (disability score ≥4, unable to walk) had higher frequency of elevated FPG >5.5 mmol/L (61.2%; 30/49) in comparison to those with less severe GBS (disability score ≤3, able to walk; FPG >5.5 mmol/L in 16.7%, 2/12; p=0.006). But distribution of HbA1c category was not different across the groups (disability score ≥4 vs. ≤3: HbA1c <5.7: 40% vs. 58%; 5.7-6.4: 50% vs. 25%; >6.4: 10% vs. 17%; p=0.296). Participants with elevated FPG were elder [elevated vs. normal FPG: 40 (28-54) vs. 25 (19-43) years; median (IQR), p=0.012] and had higher CSF glucose (p=0.002) than those with normal FPG, but there was no difference in respct of gender, MRC sum score, requirement of assisted ventilation, CSF protein, GBS subtypes and duration of hospital stay (p=not significant for all). Conclusions: Patients with severe GBS have higher frequency of elevated FPG but not HbA1c. An acute change in glucose metabolism may occur in GBS which needs further study. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 96-100
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