Background: Snake bite is an important but under recognised public health issue in Bangladesh. It is one of the important cause of mortality in our country specially in this southern part of Bangladesh. Objective: This study was carried out to evaluate the common type of snake bite in local area with their clinical presentation and outcome of admitted patients in hospital. Methods: Patients of snake bite diagnosed by history and clinical examination were consecutively selected for the study after fulfillment of inclusion criteria in the inpatient department of medicine ward, Khulna Medical College Hospital from July 2017 to June 2018. Data were collected and analysed afterwards. Results: Among 54 snake bite patients 27 (50%) were female and 27 (50%) were male. Twenty nine (53.7%) were venomous snake bite and 25 (46.3%) were non venomous. The common victims were farmers 14 (25.9%) and housewife 19 (36.2%). The bites were commonly encountered during walking (30%) in rural area. Bite also occured during sleeping (20%). The majority of the snake bite was observed during the month of June & July. Total 95% patient applied multiple tight tourniquet in the affected limb. A common local practice was to receive prehospital treatment from 'Ohzas'. Among 29 poisonous cases, drooping of the upper eyelid was present in 29 (100%) patients, External Opthalmoplegia and broken neck sign were present in 19 (66.6%) patients. Among the venomous snake bite cases 25 (93%) patients recovered completely after getting antivenom. Conclusion: Neurological manifestation (Ptosis, Opthalmoplegia, Broken neck sign) are very common in venomous snake bite. Early detection and application of antivenom is needed for better outcome. Treatment of venomous snake bite with Polyvalent serum is successful and safe. Bang Med J Khulna 2020: 53 : 23-26
Introduction: Diabetes mellitus (DM) is a common metabolic disorder and is significant for its ability to adverse effect of various organs. Skin manifestations in this condition are due to metabolic derangements, chronic complications and infections, which are commonly observed after developing clinical diabetes mellitus, but may also precede the disease. Aim: The aim of this study was to understand dermatological manifestations in diabetes mellitus relation with demographic parameters. Materials and Methods: It was a hospital based cross sectional study carried out among 80 randomly selected diabetic patients with/without skin lesions. Patients were then asked for their willingness to participate in the study. Skin examination was carried out and skin lesions were identified. All data was recorded in the pre-designed, pre-tested, and semi-structured questionnaire developed for the study. Data was analyzed using SPSS version 26. Frequencies and percentages were calculated for the necessary data. Result: : Mean age of the subjects was 51.0±13.2 years, minimum age 25 and maximum 80 years. It was observed that, out of 80 patients, 52 (65.0%) were aged between 41–60 years. 52 (65%) were female and 28(35%) were male patients. 46(57.5%) were housewives and 16(20.0%) were service holders, 10(12.5%) were farmers and other 8(10%). 41(51.2%) from middle class, 38(47.5%) from lower class and 1(1.3%) were from upper class. 61.2% patients came from rural area and 38.8% patients from urban area. The mean duration of diabetes mellitus was 6.6±5.1 years, 42.5% patients duration had 5-10 years followed by 36.3% below 5 years and 21.3% patients had DM more than 10 years. Out of 80 patients, a total of 39(48.8%) DM patients had skin manifestations and 41(51.2%) had no skin manifestations. Among 39 DM patients with skin disease, 19(48.7%) having a single, while 8(25.5%) had two and 13(30.8%) patients had three or more skin lesions. 22(56.4%) patients found diabetic dermopathy, diabetic foot ulcer 12(30.8%), fungal infections 9(23.1%), bullous lesions 7(17.9%), diabetic foot gangrene 5(12.8%), lypodystrophy 5(12.8%), pruritus 5(12.8%), xerosis 5(12.8%) cases, scleredema 3(7.7%), ichthyosis 2(5.1%) and bacterial infections 2(5.1%). Age, sex, educational level, socioeconomic status, residence found no significant association (p>0.05), but duration of diabetes mellitus was significantly associated with the presence of dermatological manifestations (p=0.001). Conclusion: The spectrum of skin manifestations due to DM in this study population is similar to that in other parts of the world. Diabetic dermopathy, Pruritus and fungal infections are the most common cutaneous manifestations in DM patients. The presence of skin manifestations can highlighten the suspicion for DM enabling early diagnosis and management and thereby can be helpful for preventing complications. Medicine Today 2022 Vol.34(2): 145-149
Introduction: Cardiovascular disease (CVD) is the leading cause of death in the world, accounting for 30% of deaths globally. CVD is a group of conditions affecting the functions of the heart, blood vessels or both. The major cardiovascular diseases include coronary heart disease (CHD), stroke, hypertension, heart failure and peripheral vascular diseases. Distribution of CHD and stroke is different in different regions of the world, especially western high-income, Asian and other countries. The Asian prevalence also not homogenous. Estimated number of deaths due to CVD worldwide will projected to 23.4 million, comprising 35% of all deaths in 2030. Significant increase in prevalence of coronary heart diseases (CHD) have been observed in the Asia including Bangladesh, but stroke in some regions of the world. Objectives: (1) Identification of cases and risk factors in different geographical area (2) Reduction of morbidity and mortality by proper treatment and management of modifiable risk factors. Materials and Methods: This observational study was done through using evidence from the published study articles of CVD in national and international journals, electronic databases such as MEDLINE, EMBESE and PUBMED. We also manually checked references of relevant publications of stroke and CHD. Study period: Jan2019-Dec2019. Results: Approximately 940 million people in the high income countries, where CHD is the dominant form of CVD which is 2–5 times higher than stroke. In the USA, Canada, Australia, New Zealand, Italy, France and Spain CVD death rates are very low. The highest death CHD rate is in Finland, Ireland, Scotland, Norway, Sweden of the European countries. In Eastern Europe and most of the Asia, the rate of coronary arterial diseases are rapidly increasing. Japan the Asian high income country the death ratio of stroke and CHD is 3:1.The East Asia and the pacific including China CVD is the major cause of death, where stroke dominating. People in South Asia including India and Bangladesh the coronary diseases are increasing alarmingly, where CVD death increase 30%over the preceding decade and the dominant form is CHD. In the central Asia, specially Uzbekistan, Kazakhstan, Tajikistan both CHD and stroke are very high. In Latin America death from CHD (35%) higher than stroke (29%). In the Middle East and North Africa, CHD responsible for 17% and stroke 7%of all death. Conclusion: Asian countries have disproportionately high morbidity and mortality from stroke with increasing tendency to CHD, but CHD in Western countries which may be due to complex interaction of genetic and environmental factors, smoking, hypertension and metabolic abnormalities. Death rate is higher in male sex from both CHD and stroke worldwide. Medicine Today 2022 Vol.34(1): 27-35
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