Dyspnea reproducibility in a rural Bangladesh population

Background and Aims: Dyspnea may signal serious disease with increased morbidity/mortality. Dyspnea screening would only be valid if reproducible. The study aim was to determine the reliability (reproducibility) of assessing dyspnea through a simple questionnaire among a rural population. Methods: Participants were recruited from a Health Effects of Arsenic Longitudinal Study in Araihazar, Bangladesh. Dyspnea assessment used a questionnaire among 129 participants at two time points: at baseline and after 2 weeks to 9 months by trained physicians. All subjects were asked about the presence/absence of dyspnea in the last 6 months. At the second interview, a physician (blinded to questionnaire) conducted a clinical heart/lung examination and obtained a pulse oximeter reading. Results: Dyspnea prevalence by baseline questionnaire was 2.4%. Overall dyspnea reliability was 94% (121 out of 129). If the initial response was ‘yes’ for the presence of dyspnea, reliability was 91% (49 out of 54). For an initial response of ‘no’ for the presence of dyspnea, reliability was 96% (72 out of 75). The pulmonary examination and pulse oximeter readings were significantly more likely to be abnormal in those with dyspnea (P < 0.01). Conclusions: The reliability of a simple question on dyspnea is very high when obtained by physicians. Although validity was not the primary outcome, the increased likelihood of an abnormal chest examination or low pulse oximeter saturation for those reporting ‘yes’ to the dyspnea question suggests more significant underlying cardiopulmonary disease in those reporting recent dyspnea. Please cite this paper as: Pesola GR, Parvez F, Jasmin S, Hasan AKM R and Ahsan H. Dyspnea reproducibility in a rural Bangladesh population. The Clinical Respiratory Journal 2009; 3: 222–228.     

Changes of placental diameter thickness and cotyledon in eclampsia

The study was done to see the changes of placental diameter, thickness and number of cotyledons in eclapmsia. A total 45 placenta, 25 from eclamptic mother and 20 from normal pregnant mother were collected from Gynaecology and Obstetric department of Mymensingh Medical College and Hospital (MMCH). Study was done in Anatomy department of Mymensingh Medical College (MMC). Macroscopic study of the formol saline fixed placentas revealed that, compared to the controls there was trend of less placental diameter in eclamptic group(p=0.0004). Cotyledon number was found to be significantly less in eclampsia (p=0.0001). However there was no significant difference in placental thickness in eclamptic placenta than that of normal group. Statistical significance of difference between two groups was calculated by using Students "t" test. A difference between the two groups was considered to be significant when p<0.005. The morphological changes in placenta are possibly due to reduced uteroplacental blood flow in eclampsia.     

Evaluation of stentangioplasty in university cardiac center

In this ongoing prospective study conducted in University Cardiac Center, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2004 to January 2006. Fifty (50) patients (mean age 56+/-7.2 years) underwent stentangioplasty were evaluated. The study group of 50 patients consisted of 42 (84%) men and 08 (16%) women. The aim of this study was to evaluate in-hospital success, failure and complications during the procedures. About risk factors 19(38%) had hypertension, 13(26%) were smoker, 11(22%) suffered from diabetes mellitus, 05(10%) had family history of ischaemic heart disease. Average left ventricular ejection fraction was 54+/-7. Target vessel percutaneous coronary angioplasty (PTCA) were done in 61 vessel, intracoronary stent implanted in 58 vessels, direct stenting were done in 35 cases, failed PTCA were in 03(6%) cases and two had dissection. The native vessels had a mean reference diameter of 2.91 mm and their luminal diameter increased significantly after percutaneous coronary intervention (PCI). All the patients were discharged by one to three days of the procedure with improvement of their clinical condition. In conclusion, intracoronary stent deployment in coronary artery stenosis following balloon angioplasty is a valid and beneficial strategy with good in-hospital results.     

Comparison of efficacy between Tamsulosin and Finasteride on symptomatic Benign Prostatic Hyperplasia

This prospective study was done to compare the efficacy of Tamsulosin and Finasteride for the medical treatment of symptomatic Benign Prostatic Hyperplasia (BPH) at the surgery and urology outpatient department of Mymensingh Medical College Hospital during the period from January 2003 to December 2004. Closely matched 70 patients in the age range of 50-80 years presented with lower urinary tract symptoms and clinically diagnosed as BPH were selected in the present study. Among them, 36 patients (Group I) and 34 patients (Group II) were treated with Tamsulosin (0.4 mg once daily) and Finasteride (5 mg once daily) for a duration of 06 months respectively. The efficacy of two drugs was compared on the basis of IPSS and Qmax. The base-line parameters of both groups were statistically insignificant. A significant improvement of IPSS and Qmax was found after 06 months of treatment in both groups (P<0.001). A significant improvement of IPSS Qmax was found in both groups (p<0.001) during follow-up at 1st, 2nd, 4th and 6th month. It was also observed that Tamsulosin improved the IPSS and Qmax more quickly than Finasteride.     

Adenosine deaminase, nitric oxide, superoxide dismutase, and xanthine oxidase in patients with major depression: impact of antidepressant treatment

BACKGROUND: There has been much evidence in recent years that free oxygen radicals and nitric oxide (NO) may play an important role in the pathophysiology of neuropsychiatric disorders. In this study, we aimed to investigate whether NO, xanthine oxidase (XO), superoxide dismutase (SOD), and adenosine deaminase (ADA) levels are associated with major depression (MD) and to evaluate the impact of antidepressant treatments on NO, SOD, ADA and XO levels in MD. METHODS: Thirty-six patients who were diagnosed as MD according to DSM-IV criteria and 20 healthy controls were included. The serum levels of NO, XO, SOD, and ADA were measured by spectrophotometric methods both in patients and controls. Patients were treated with antidepressant drugs for 8 weeks. All patients were assessed by Hamilton Depression Rating Scale (HDRS) both before and after antidepressant treatment. RESULTS: ADA and XO levels of the patients were significantly higher than the controls. SOD level of the patients was significantly lower than the controls. Although NO levels of the patients were higher than the controls, the difference was not statistically significant. There was no correlation between HDRS and the parameters studied (SOD, ADA, XO, and NO) of the patients. After 8 weeks of antidepressant treatment, ADA and SOD activities were increased, whereas NO and, XO levels decreased significantly. CONCLUSIONS: ADA, XO, and SOD activity may have a pathophysiological role in MD and may predict prognosis of MD. Activity of these enzymes may be used to monitor effects of the antidepressant treatment.     

Predictors of timing of pregnancy discovery

Objective

Earlier pregnancy discovery is important in the context of prenatal and abortion care. We evaluated characteristics associated with later pregnancy discovery among women seeking abortion care.