bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between Anticipatory Socialization Experiences and First-Year Veterinary Students' Career Interests
Authors: Kedrowicz April A. , Fish Richard E. , Hammond Sarah
Published: January 2015

The purpose of this project was to explore first-year veterinary students' anticipatory socialization—life, education, and social experiences that assist in preparation for professional occupations—and determine what relationship exists between those experiences and career interests. Seventy-three first-year veterinary students enrolled in the Careers in Veterinary Medicine course completed the Veterinary Careers survey. Results show that students' anticipatory vocational socialization experiences are significantly related to their stated career interests. The career interests with the highest percentage of students expressing “a great deal of interest” included specialty private practice (37%), research and teaching in an academic setting (33%), and international veterinary medicine (31%). The career interests with the highest percentage of students expressing “no interest at all” included the military (50%), equine private practice (42%), and the pharmaceutical industry (41%). Less than half of the students (42%) stated that they reconsidered their career path after the first semester of veterinary school, but the majority (87%) developed a better understanding of how to pursue a nontraditional career path should they choose to do so.
A Specter Is Haunting Germany--the French Specter of Milieu
Authors: Feuerhahn Wolf
Published: January 2015

Gilles Deleuze, Felix Guattari, and Isabelle Stengers fought against a state-controlled form of science and saw “nomadic science/concepts” as a way to escape from it. The transnational history of the term milieu marks a good opportunity to contribute to another theory of nomadic vocabularies. Traveling from France to Germany, the word milieu came to be identified as a French theory. Milieu was seen as an expression of determinism, of the connection between the rise of the natural sciences and the rise of socialism, and it deterred the majority of German academics. Umwelt was thus coined as an “antimilieu” expression. This article defends a “transnational historical semantic” against the Koselleckian history of concepts and its a priori distinctions between words and concepts. Instead of taking its nature for granted, a transnational historical semantic investigation should analyze the terminological and national status given to the objects of investigation by the term's users.
From Organisms to World Society
Authors: Bauer Julian
Published: January 2015

This article proposes to analyze the idea of organism and other closely related ideas (function, differentiation, etc.) using a combination of semantic fields analysis from conceptual history and the notion of boundary objects from the sociology of scientific knowledge. By tackling a wide range of source material, the article charts the nomadic existence of organism and opens up new vistas for an integrated history of the natural and human sciences. First, the boundaries are less clear-cut between disciplines like biology and sociology than previously believed. Second, a long and transdisciplinary tradition of talking about organismic and societal systems in highly functionalist terms comes into view. Third, the approach shows that conceptions of a world society in Niklas Luhmann's variant are not semantic innovations of the late twentieth century. Rather, their history can be traced back to organicist sociology and its forgotten pioneers, especially Albert Schäffle or Guillaume de Greef, during the last decades of the nineteenth century.
Clones as Epistemic Objects
Authors: Halft Stefan
Published: January 2015

The creation of life has always spurred literary and cinematic productivity. Due to scientific progress in the fields of microbiology and genetics, countless novels and films today reflect the idea of human cloning more than other ideas. While the clone is often seen as the epitome of the posthuman, contemporary texts and films tend to modify the concept and (re)humanize the clone. It can be said that fictional literature and films play a pivotal role in the construction, modification, and circulation of concepts. Based on a cognitive linguistic concept of concept, the clone will be analyzed as an epistemic object. Focusing on conceptual processes of the configuration of knowledge, this article will show how the process of conceptualization works in literary texts and films and describe the techniques by which categories and concepts are constantly modified. Thus, it will be argued that literature and film play an active part in shaping a society's stock of knowledge.
Reviews
Authors: Årsheim Helge , Hochner Nicole , Rosenblatt Helena , Mačkinis Vilius , Friis Søren , Iacob Bogdan C. , Imbriano Gennaro
Published: January 2015

Brent Nongbri, Before Religion: A History of a Modern Concept (New Haven:
Yale University Press, 2013), 288 pp.

Christopher H. Johnson, Bernhard Jussen, David Warren Sabean, and
Simon Teuscher, eds., Blood and Kinship: Matter for Metaphor from Ancient
Rome to Present (New York and Oxford: Berghahn Books, 2013), 362 pp.

Quentin Skinner and Martin van Gelderen, eds., Freedom and the
Construction of Europe, 2 vols. (Cambridge: Cambridge University Press,
2013), 878 pp.

Anna Grzes´kowiak-Krwawicz, Queen Liberty: The Concept of Freedom in the
Polish-Lithuanian Commonwealth (Leiden and Boston: Brill, 2012), 135 pp.

Conor Gearty, Liberty and Security (Cambridge and Malden, MA: Polity
Press, 2013), 146 pp.

Balázs Trencsényi, The Politics of “National Character”: A Study in Interwar
East European Thought (London: Routledge, 2012), 227 pp.

Janet Roitman, Anti-Crisis (Durham, NC, and London: Duke University
Press, 2014), 157 pp.
Julius Caesar Arantius (Giulio Cesare Aranzi, 1530–1589) and the hippocampus of the human brain: history behind the discovery
Authors: Bir Shyamal C. , Ambekar Sudheer , Kukreja Sunil , Nanda Anil
Published: January 2015

Julius Caesar Arantius is one of the pioneer anatomists and surgeons of the 16th century who discovered the different anatomical structures of the human body. One of his prominent discoveries is the hippocampus. At that time, Arantius originated the term hippocampus, from the Greek word for seahorse (hippos [“horse”] and kampos [“sea monster”]). Arantius published his description of the hippocampus in 1587, in the first chapter of his work titled De Humano Foetu Liber. Numerous nomenclatures of this structure, including “white silkworm,” “Ammon's horn,” and “ram's horn” were proposed by different scholars at that time. However, the term hippocampus has become the most widely used in the literature.
Fatal rupture of a brain arteriovenous malformation flow-related aneurysm during microcatheter removal: a rare complication
Authors: Gabrieli Joseph , Clarençon Frédéric , Di Maria Federico , Fahed Robert , Boch Anne-Laure , Degos Vincent , Chiras Jacques , Sourour Nader-Antoine
Published: January 2015

Intracranial aneurysms are relatively frequently encountered in patients with brain arteriovenous malformations (BAVMs). They may be located on the circle of Willis, on arterial feeders, or even inside the nidus. Because BAVM-associated aneurysms represent a risk factor of bleeding, the question of the timing and modality of their management remains a matter of debate in unruptured BAVMs. The authors present a case of fatal periprocedural rupture of a flow-related aneurysm (FRA) during the removal of the microcatheter after injection of a liquid embolic agent. A 40-year-old man was treated at the authors' institution for the management of a Spetzler-Martin Grade III left unruptured frontal BAVM, revealed by seizures and a focal neurological deficit attributed to flow steal phenomenon. After a multidisciplinary meeting, endovascular treatment was considered to reduce the flow of the BAVM. A proximal FRA located on the feeding internal carotid artery (ICA) was purposely left untreated because it did not meet the criteria of the authors' institution for preventative treatment (i.e., small size [2.5 mm]). During embolization, at the time of microcatheter retrieval, and after glue injection, the aneurysm unexpectedly ruptured. The aneurysm's rupture was attributed to the stress (torsion/flexion) on the ICA caused by the microcatheter removal. Despite the attempts to manage the bleeding, the patient eventually died of the acute increase of intracranial pressure related to the massive subarachnoid hemorrhage. This case highlights a previously unreported mechanism of FRA rupture during BAVM embolization: the stress transmitted to the parent artery during the removal of the microcatheter.
Neurosurgical decision making: personal and professional preferences
Authors: Tanweer Omar , Wilson Taylor A. , Kalhorn Stephen P. , Golfinos John G. , Huang Paul P. , Kondziolka Douglas
Published: January 2015

OBJECT

Physicians are often solicited by patients or colleagues for clinical recommendations they would make for themselves if faced by a clinical situation. The act of making a recommendation can alter the clinical course being taken. The authors sought to understand this dynamic across different neurosurgical scenarios by examining how neurosurgeons value the procedures that they offer.

METHODS

The authors conducted an online survey using the Congress of Neurological Surgeons listserv in May 2013. Respondents were randomized to answer either as the surgeon or as the patient. Questions encompassed an array of distinct neurosurgical scenarios. Data on practice parameters and experience levels were also collected.

RESULTS

Of the 534 survey responses, 279 responded as the “neurosurgeon” and 255 as the “patient.” For both vestibular schwannoma and arteriovenous malformation management, more respondents chose resection for their patient but radiosurgery for themselves (p = 0.002 and p = 0.001, respectively). Aneurysm coiling was chosen more often than clipping, but those whose practice was ≥ 30% open cerebrovascular neurosurgery were less likely to choose coiling. Overall, neurosurgeons who focus predominantly on tumors were more aggressive in managing the glioma, vestibular schwannoma, arteriovenous malformation, and trauma. Neurosurgeons more than 10 years out of residency were less likely to recommend surgery for management of spinal pain, aneurysm, arteriovenous malformation, and trauma scenarios.

CONCLUSIONS

In the majority of cases, altering the role of the surgeon did not change the decision to pursue treatment. In certain clinical scenarios, however, neurosurgeons chose treatment options for themselves that were different from what they would have chosen for (or recommended to) their patients. For the management of vestibular schwannomas, arteriovenous malformations, intracranial aneurysms, and hypertensive hemorrhages, responses favored less invasive interventions when the surgeon was the patient. These findings are likely a result of cognitive biases, previous training, experience, areas of expertise, and personal values.
Impact of resident participation on morbidity and mortality in neurosurgical procedures: an analysis of 16,098 patients
Authors: Bydon Mohamad , Abt Nicholas B. , De la Garza-Ramos Rafael , Macki Mohamed , Witham Timothy F. , Gokaslan Ziya L. , Bydon Ali , Huang Judy
Published: January 2015

OBJECT

The authors sought to determine the impact of resident participation on overall 30-day morbidity and mortality following neurosurgical procedures.

METHODS

The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who had undergone neurosurgical procedures between 2006 and 2012. The operating surgeon(s), whether an attending only or attending plus resident, was assessed for his or her influence on morbidity and mortality. Multivariate logistic regression, was used to estimate odds ratios for 30-day postoperative morbidity and mortality outcomes for the attending-only compared with the attending plus resident cohorts (attending group and attending+resident group, respectively).

RESULTS

The study population consisted of 16,098 patients who had undergone elective or emergent neurosurgical procedures. The mean patient age was 56.8 ± 15.0 years, and 49.8% of patients were women. Overall, 15.8% of all patients had at least one postoperative complication. The attending+resident group demonstrated a complication rate of 20.12%, while patients with an attending-only surgeon had a statistically significantly lower complication rate at 11.70% (p < 0.001). In the total population, 263 patients (1.63%) died within 30 days of surgery. Stratified by operating surgeon status, 162 patients (2.07%) in the attending+resident group died versus 101 (1.22%) in the attending group, which was statistically significant (p < 0.001). Regression analyses compared patients who had resident participation to those with only attending surgeons, the referent group. Following adjustment for preoperative patient characteristics and comorbidities, multivariate regression analysis demonstrated that patients with resident participation in their surgery had the same odds of 30-day morbidity (OR = 1.05, 95% CI 0.94–1.17) and mortality (OR = 0.92, 95% CI 0.66–1.28) as their attendingonly counterparts.

CONCLUSIONS

Cases with resident participation had higher rates of mortality and morbidity; however, these cases also involved patients with more comorbidities initially. On multivariate analysis, resident participation was not an independent risk factor for postoperative 30-day morbidity or mortality following elective or emergent neurosurgical procedures.
Progressive restoration of spinal sagittal balance after surgical correction of lumbosacral spondylolisthesis before skeletal maturity
Authors: Thomas Diala , Bachy Manon , Courvoisier Aurélien , Dubory Arnaud , Bouloussa Houssam , Vialle Raphaël
Published: January 2015

OBJECT

Spinopelvic alignment is crucial in assessing an energy-efficient posture in both normal and disease states, such as high-displacement developmental spondylolisthesis (HDDS). The overall effect in patients with HDDS who have undergone local surgical correction of lumbosacral imbalance for the global correction of spinal balance remains unclear. This paper reports the progressive spontaneous improvement of global sagittal balance following surgical correction of lumbosacral imbalance in patients with HDDS.

METHODS

The records of 15 patients with HDDS who underwent surgery between 2005 and 2010 were reviewed. The treatment consisted of L4–sacrum reduction and fusion via a posterior approach, resulting in complete correction of lumbosacral kyphosis. Preoperative, 6-month postoperative, and final follow-up postoperative angular measurements were taken from full-spine lateral radiographs obtained with the patient in a standard standing position. Radiographic measurements included pelvic incidence, sacral slope, lumbar lordosis, and thoracic kyphosis. The degree of lumbosacral kyphosis was evaluated by the lumbosacral angle. Because of the small number of patients, nonparametric tests were considered for data analysis.

RESULTS

Preoperative lumbosacral kyphosis and L-5 anterior slip were corrected by instrumentation. Transient neurological complications were noted in 5 patients. Statistical analysis showed a significant increase of thoracic kyphosis on 6-month postoperative and final follow-up radiographs (p < 0.001). A statistically significant decrease of lumbar lordosis was noted between preoperative and 6-month control radiographs (p < 0.001) and between preoperative and final follow-up radiographs (p < 0.001).

CONCLUSIONS

Based on the authors' observations, this technique resulted in an effective reduction of L-5 anterior slip and significant reduction of lumbosacral kyphosis (from 69.8° to 105.13°). Due to complete reduction of lumbosacral kyphosis and anterior trunk displacement associated with L-5 anterior slipping, lumbar lordosis progressively decreased and thoracic kyphosis progressively increased postoperatively. Adjusting the sagittal trunk balance produced not only pelvic anteversion, but also reciprocal adjustment of lumbar lordosis and thoracic kyphosis, creating a satisfactory level of compensated global sagittal balance.
Outcomes following surgical intervention for impending and gross instability caused by multiple myeloma in the spinal column
Authors: Zadnik Patricia L. , Goodwin C. Rory , Karami Kristophe J. , Mehta Ankit I. , Amin Anubhav G. , Groves Mari L. , Wolinsky Jean-Paul , Witham Timothy F. , Bydon Ali , Gokaslan Ziya L. , Sciubba Daniel M.
Published: January 2015

OBJECT

Multiple myeloma is the most common primary tumor of the spine and is the most common primary malignant tumor of bone. Although spinal myeloma is classically a radiosensitive lesion, clinical or radiographic signs of instability merit surgical intervention. The authors present the epidemiology, surgical indications, and outcome data of a series of consecutive cases involving 31 surgically treated patients with diagnoses of multiple myeloma and plasmacytoma of the spine (the largest such series reported to date).

METHODS

Surgical instability was the criterion for operative intervention in this patient cohort. The Spinal Instability Neoplastic Score (SINS) was used to make this assessment of instability. The cases were analyzed using location of the lesion, spinal levels involved, Frankel score, adjuvant therapy, functional outcome, and patient survival.

RESULTS

All patients undergoing surgical intervention were determined to have indeterminate or gross spinal column instability according to SINS criteria. The median survival was 78.9 months. No significant difference in survival was seen for patients with higher SINS scores or for older patients (> 55 years). There was a statistically significant difference in survival benefit observed for patients receiving chemotherapy and radiation versus radiation alone as an adjuvant to surgery (p = 0.02).

CONCLUSIONS

In this 10-year analysis, the authors report outcomes of surgical intervention for patients with indeterminate or gross spinal instability due to multiple myeloma and plasmacytoma of the spine with improved neurological function following surgery and low rates of instrumentation failure.
Impact of Urinary Tract Infection on Steroid Response in Idiopathic Nephrotic Syndrome in Children
Authors: Barua Tanuka , Sultana Razia , Datta Pradip Kumar , Sharma Jhulan Das , Rezaul Karim Md , Ahmad Mainuddin
Published: January 2015

Context: UTI is one of the most common infection in nephrotic syndrome and may be a cause of delayed steroid response. Objective:To observe the impact of urinary tract infection on steroid response in idiopathic nephrotic syndrome children aged 2-6 years.Study design: Quasi experimental study Study period & place: Pediatric ward of Chittagong Medical College Hospital, Chittagong from 01.01.2009 to 31.12.2009. Participants: 52 Nephrotic syndrome children aged 2-6 years with typical clinical features Group A: Nephrotic syndrome with UTI, Group B: Nephrotic syndrome without UTI. Methods: Heat coagulation test, urine for R/M/E and C/S was done in every patient. Steroid was given according to standard regimen. Date of starting of steroid was recorded. Antibiotic was given in group A cases according to C/S report. Patients were followed for clinical and urinary remission. Group A and B were compared for remission time achieved by statistical method.Results: A male preponderance was noted about 57.7% against female about 42.3%. Generalized swelling of body & scanty micturation found in cent percent study group. Ascitis was found in 23.08%. Scrotal/labial swelling 7.69%.UTI developed in 30.8% of patients of NS. Male female ratio is 1:1. Infection delayed the remission of proteinuria. Mean remission time of NS without UTI patients was 7.39 days and with UTI patients was 9.31 days. In statistical analysis, mean remission time in group A =9.31+2.24 days(mean + SD), in group B=7.39+2.51 days(mean + SD), P value = <0.05, statistically significant.Conclusion: UTI in nephrotic syndrome causes delayed remission of proteinuria and may be asymptomatic.It should be screened in every nephrotic syndrome children routinely.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21046
Complications of Tonsillectomy, Adenoidectomy and Adenotonsillectomy in Chittagong Medical College Hospital
Authors: Chowdhury Abdul Qayum , Mojumder Dhanenjoy , Deb Nath Jishu
Published: January 2015

It is a prospective study is done with materials of 100 cases of Tonsillectomy patient giving Proper attention to age, sex, Indication of operation, Clinical Presentation, Duration of Operation, Post operative complications. Altogether 100 Patients of whom 54 were male and 46 female, collected for a period of 6 months from 16th July 2001 to 15th January 2002 with  maximum age group 48% were of 20+years and a sex ratio of Male: female 1.17:1 were included in the series the commonest indication is Recurrent tonsillitis was 83%. Among them clinical presentation, Patients presented with recurrent pain in throat (85%), History of Fever in 62% and difficulty in swallowing in 46%. Regarding duration of operation 40% Patients were operation within 30 to 39 minutes, 31% patients were operated within 40 to 49 minutes. In this Series, Complications that encountered after operation were hemorrhages both reactionary and secondary 1% and 2% respectively, operative local trauma in 4% cases and local infection in tonsillar bed in 6% cases. In this Series one patient needed second time general anaesthesia.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21047
Study on Clinical Presentation of Breast Carcinoma of 50 Cases
Authors: Mira Pervin Mosammat , Deb Nath Haradhan , Mejbahul Bahar Mohd. , Alam Ashraful , Bhowmik Juthi
Published: January 2015

Background: Breast cancer results from uncontrolled proliferation of malignant cells resulting appearance of a lump or a mass in the breast. Although many epidemiological risk factors have been identified, the cause of any individual breast cancer is most often unknowable. A womens reaction to any suspected disease of breast may include fear of disfigurement, loss of sexual attractiveness and death. Social and religious factors, unawareness of fatality of the disease, fear of infertility hinder early diagnosis & treatment. Early diagnosis is the key to increased survival.Objective: To find out clinical presentation for breast cancer.Study design: It is a prospective study of 50 carcinoma breast patients who palpable breast lump. It was conducted during the six months period. Data were collected pre-designed data collection sheet. Data were analysis statistical package for social science (SPSS) program.Result: Most of the malignant lesions are above the age of 40 years and peak incidence are between 41-50 years and most of patients under this study were in advanced stage-III (54%) and stage-IV (22%). Patients were presented as nipple discharge (20%), pain in the breast (26%), ulceration over the lump (14%), paeud orange (10%) skin fixation over the lump (18%), fixation to the chest wall (14%) nipple retraction (22%). Among the 50 patients there was only one male ca-breast patient (2%). Among the histopathological types infiltrating duct cell carcinoma (NST) were 41 (82%), ductal carcinoma in situ 6 (12%), lobular carcinoma invasive 2 (4%), lobular carcinoma in situ 1 (2%) and carcinoma involved in different quadrants were upper & outer 21 (42%), lower outer 5 (10%), upper and inner 12 (24%), lower and inner 4 (8%), central 7 (14%) and breast as a whole involvement was 1 (2%). About the involvement of carcinoma breast, left breast involvement were 52%, right breast 46% and bilateral involvement was 2%. Conclusion: This prospective study shows an alarming high incidence of carcinoma breast with palpable breast lump. The diversity of clinical presentation of breast lumps in different age group were observed is our hospital practice. This study gives an idea about the incidence of various types of lesions of breast in different age groups in our country.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21048
Frequency of Temporomandibular Joint Ankylosis in Various Age Groups with Reference to Etiology
Authors: Ali Hossain Mohammad , Shah Syed Adnan Ali , Biswas Rajat Sanker Roy
Published: January 2015

Introduction: Temporomandibular joint ankylosis is a gradually developing condition manifested by mandibular hypomobility. Limitation of mouth opening can be caused by bony or fibrous ankylosis of the temporomandibular joint as sequel to trauma, infection, and autoimmune diseases. The purpose of this study was to determine the frequency of temporomandibular joint ankylosis in various age groups and to see the etiology of temporomandibular joint ankylosis.Materials & methods: This descriptive study study was carried out at the department of Oral and Maxillofacial surgery, deMontmorency College of Dentistry / Punjab Dental Hospital, Lahore from September 2004 to August 2005 prospectively. A total 60 patients of various ages having TMJ ankylosis were included. Patients presented with TMJ ankylosis were assessed with detailed history and physical examination. Basic investigations including conventional radiographs and orthopentomogram were undertaken for every patient. Results: Females predominate with 35 (58.30%). Age ranged from 4 to 36 years and 11-20 years (60%) group predominating. In unilateral cases, left side involvement was more common in both males and females. TMJ ankylosis was post traumatic in 47(78.3%) cases followed by infection 7(11.7%) while birth trauma 2(3.3%) was rare. RTA was seen to the most frequent etiological factor followed by the fall.Conclusions: Temporomandibular joint ankylosis is a preventive entity if posttraumatic rehabilitation is instituted early and properly.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21056
Relationship of Various Prognostic Factors with Outcome of Treatment of Chronic Duodenal Ulcer Perforation Patients
Authors: Khan Sakhawat Mahmud , Alam Meer Mahbubul , Akhter Shahin , Alam Didarul
Published: January 2015

Background: In acute abdominal conditions, chronic duodenal ulcer  perforation is a very common surgical emergency that overwhelm the surgical ward throughout the year. Especially in the tropics and more in our country, peptic ulcer disease causes a major health problem. Objectives: To assess the usefulness of the prognostic factors in terms of morbidity and mortality in the treatment of perforated duodenal ulcer patient. Methods: This was a prospective study during the period from January 2003 to December 2003 in M.A.G. Osmani Medical College Hospital, Sylhet. The study included 100 cases of perforated chronic duodenal ulcer. Patients were randomly collected from all surgical units of SOMCH, Sylhet. Operation was done by simple closure with omental graft in all cases. Data analyzed by appropriate statistical method (Mean, SD & l2 test). Results: Highly significant relationship was found between increased age (>50 years) of patients with perforated duodenal ulcer and mortality (p<0.001). Lethality rate was higher in patients operated after 24 hours of onset of symptom in relation to patients operated within 24 hours of onset of symptom, (p<0.05). Different postoperative complications were prevalent in patients operated after 24 hours of onset of symptom, on the other hand complication rate was low in patients operated within 24 hours (p<0.001). There was also longer hospital stay in lately operated patients (more above median) than patients operated within 24 hrs (p<0.001). Mortality was higher in cases of purulent peritoneal fluid, where as it was nil in case of billous and serosanguinous fluid (p<0.001). More complications were developed in patients with purulent peritoneal fluid in comparison to billous and serosanguinous nature (p<0.001). There was more mortality in patients with preoperative shock in comparison with no features of shock (p<0.001). More complications were noted in patients with preoperative shock than in patients with no features of shock (p<0.01). Conclusion: Delayed operation, preoperative shock, more age and gross peritoneal sepsis bear a direct relationship with outcome of treatment chronic duodenal ulcer perforation patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21060
Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome
Authors: Das Rinku , Jafrin Rummana , Biswas Banita , Nahar Nazmun , Biswas Rajat Sanker Roy
Published: January 2015

Introduction: Uterine leiomyoma is remarkably common, however only a subset of women have their fibroids clinically detected, symptomatic, or warrant surgical treatment. Mode of treatment depends on age of the patients, number, size and site of the myoma and also fertility status of the patients. Materials & methods: To evaluate the sociodemographic, clinical characteristics, management outcome and its determinants in BSMMU, Dhaka, Bangladesh, the study was carried out. 50 patients of diagnosed leiomyoma admitted in the BSMMU, Dhaka was selected for the study. Clinical profile, type of surgery and postoperative follow up findings were noted. Data was analyzed by computer based software SPSS  18.Results: The common complaints among the 50 patients were progressive menorrhagia (70%), abdominal swelling (50%), infertility (24%), weight in pelvis (38%), weakness/dizziness or syncopal attack after menstrual period (26%) and recurrent miscarriages (12%). The average uterine size at presentation was 15±9.7 weeks. The majority (70%) of the women presented with multiple leiomyomata. The commonest anatomical position of the myomas were multiple positions and intramural(80%). Total abdominal hysterectomy with or without bilateral sulphingo ophorectomy according to age was the commonest surgical procedure performed in thirty two (64%) cases. Myomectomy was done in 12(24%) cases and laparoscopic assisted vaginal hysterectomy was done in also 6(12%) of patients.  Postoperative complications occurred in 24%(12) of the women. The most common complications were postoperative pyrexia 12%, blood loss  warranting transfusion 8%, wound infection 10% and prolonged hospital stay 6%.Conclusion: Uterine fibroid is common in our environment and most of the patients had regular menstrual cycle with progressive menorragia. Its removal is commonly associated with post-operative pyrexia, blood loss, and anemia and wound infection. Preoperative correction of anemia appropriate use of antibiotics and strict hemostasis and asepsis can reduce these complications.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21061
Comparison of Atherogenic Index of Plasma (AIP) Between Postmenopausal Women with Central Obesity and Postmenopausal Nonobese Women
Authors: Khanam Monowara , Khan Md Aminul Haque , Rahman Md Rewanur , Parvin Rukhsana , Akhter Selima , Ferdousi Shahnila
Published: January 2015

Background: Following menopause there are changes in values of lipid profile parameters. Abdominal obesity has also been linked to significant metabolic abnormalities including changes in lipid parameter values. Atherogenic index of plasma (AIP) calculated as log (TG/HDL-C) has been used as some practitioners as a significant predictor of atherosclerosis. So, we designed this study to observe the pattern of lipid profile parameters and to find out AIP in postmenopausal central obese women and to compare these between postmenopausal women with central obesity and postmenopausal nonobese women. Objectives: To assess the lipid profile status and AIP of postmenopausal women with central obesity and to compare these parameters with that of postmenopausal nonobese women.Materials & Methods: This cross sectional study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Sixty six postmenopausal women with central obesity and age matched 56 nonobese postmenopausal women were included in the study. Central obesity was defined having waist hip ratio more than 0.8 and BMI <25.0. All statistical analyses were done by SPSS 18.0. p values <0.05 were considered significant.Results: Statistically no significant difference was observed between the central obese women and nonobese women in lipid profile parameters. But AIP was found significantly higher in postmenopausal central obese women.Conclusion: Central obese postmenopausal women may be at higher risk of cardiovascular events compared with postmenopausal nonobese women in spite of no difference in lipid profile parameters as their AIP values are significantly different.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21064
Diet Intake Pattern and Nutritional Status of Rural Population in Bangladesh
Authors: Monoarul Haque Md , Amirul Hassan Md , Islam Khaleda , Bhuiyan Md Rijwan , Shahi Md Shah Jalalur Rahman , Lipi Rukhsana Parvin
Published: January 2015

Objective: The aim of this study is to explore the diet intake pattern and nutritional status of rural population in Bangladesh.Methods: A population based crosssectional study was conducted in three rural villages of Mohespur Upazilla, Jhenaidah district, Bangladesh. Total 200 samples were collected purposively to conduct this study. Data were collected through personal face to face interview by structured and semi-structured questionnaire from the respondents.Results: The mean (± SD) age of the respondents was 35±16.6 years where 64% were male. The monthly dietary intake pattern of the respondents shows that majority of the respondents take pulses, fish, meat, egg, milk and fruits 1 to 2 time per month. Majority (94.5%) of the respondents take cereals 2 to 3 times per day. In case of nutritional status, majorities (47%) have normal nutritional status where 30% are overweight, 15% are obese and 8% are suffering from underweight. Study also shows that there is no relation between gender and nutritional status of the respondents.Conclusion: Finally, this study indicates that the overall dietary intake pattern of rural population in Bangladesh is poor. Further study should be needed in a large scale to explore the real scenario of dietary pattern and nutritional status of rural population in Bangladesh.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21065
Level of Serum Uric Acid Along with Other Demographic Parameters in Patients with Acute Coronary Syndrome : A Study of 55 Cases from Chittagong
Authors: Murad Hasan , Dey Rajiv , Chowdhury Md Atiquel Islam , Hedayet Ullah Hridi , Abdur Rouf Md
Published: January 2015

The association between serum uric acid and ischemic heart disease remains controversial and it has been difficult to identify the specific role of elevated serum uric acid because of its association with established cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia and obesity. Our objective was to study the association of serum uric acid level with confirmed cases of Acute Coronary Syndrome i.e. Unstable Angina, Acute Myocardial Infarction(AMI). The study was conducted in Chittagong Medical College (CMC) & University of Science and Technology(USTC) and nearby diagnostic centre. The study was based on Patients with Acute Coronary Syndrome proved by ECG and/or raised serum Troponin I. The aim of the study was to determine the relationship between serum uric acid and Unstable angina or myocardial infacrtion. There were 35% males & 5% females. The mean age of respondent was 50 years and age ranges from 35 to 70 years. In this study 50 cases of diagnosed myocardial infarction were selected and subsequently investigated with ECG, Radiological and Echocardiographic investigations. Increased serum uric acid levels are a common finding in patients with high blood pressure, insulin resistance, obesity and Cardiovascular disease. The clinical findings, chest X-ray and ECG findings of patients with risk factors for myocardial infarction were extensively studied and the findings are consistent with findings stated in textbooks.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21070
Cervical Ectopic Pregnancy: A Puzzling Event
Authors: Begum Shahana , Ferdous Afroza , Sultana Munawar , Begum Rowshan Ara
Published: January 2015

Cervical ectopic pregnancy is the implantation of the conceptus within the cervix below the level of internal os1. Such pregnancy typically aborts within the first trimester, if it is implanted closer to the uterine cavity called cervico isthmic pregnancy it may continue longer2. Cervical pregnancy accounts for less than 1% of all ectopic pregnancies, with an estimated incidence of 1 in 2500 to 1 in 18000. Though the pregnancy in this area is uncommon but possibly life threatening condition due to risk of severe hemorrhage and may need hysterectomy2,3. Early detection and conservative approach of treatment limit the morbidity and preserve fertility. A 37 year old lady para 4+0 diagnosed as a case of cervical ectopic pregnancy with intractable bleeding and save the patient by emergency hysterectomy to control hemorrhage. The case is reported here for its relative rarity.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21072
Potts Disease with Psoas Abscess in a Diabetic Patient: A Conservative Approach
Authors: Moin Uddin Mohammad , Sultana Nusrat , Rehan Rezwan , Khan Aminuddin A.
Published: January 2015

Potts disease, also known as tubercular spondylitis, is a well known condition in developing countries. Here we report a case of Potts disease with bilateral psoas abscesses in a 51 years diabetic male with poor glycaemic control. Diagnosis is done on the basis of history, physical examination, plain radiology & MRI imaging and history of exposure to a tuberculosis case. He was treated conservatively and responded well to anti-tubercular chemotherapy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21073
Treacher Collins Syndrome : A Case Report
Authors: Morshed Tarannum , Paul Fonindro Nath , Sarker R N , Haque Shahara , Sultana Sadia
Published: January 2015

Treacher Collins syndrome (TCS) or Franceschetti syndrome is an autosomal dominant disorder of craniofacial development with variable expressivity. It is named after Edward Treacher Collins (1862-1932), the English surgeon and ophthalmologist, who described the essential components of the condition in 1900. Incidence of this syndrome is approximately 1 in 50,000 live births and it affects both genders equally. The typical physical features include downward slanting eyes, micrognathia (a small lower jaw), Conducting hearing loss, under developed zygoma, drooping part of lateral lower eyelids, and malformed or absent ears. This article describes clinical and radiological features of TCS in a 07 yr old female child who had reported to the department of Dentistry and Radiology with the complaint of forwardly placed upper anterior teeth and hearing loss. Also pathogenesis, prenatal diagnosis, differential diagnosis, management and preventive aspects are discussed.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21074
A Clinical Study of Ectopic Pregnancies in a Tertiary Care Hospital of Chittagong, Bangladesh
Authors: Yeasmin Most. Sabina , Uddin M Jalal , Hasan Enamul
Published: January 2015

Background: Motherhood, an eternal, universal and inherent dream which every woman has. This dream may not always be pleasant and it can involve nightmares. One of this is ectopic pregnancy: A pregnancy which can be life threatening. Aims : 1. To know the age group, parity, gestational age and the risk factors with re-spect to the ectopic pregnancy. 2. To know the clinical presentation of the ectopic pregnancy. 3. To know the treatment and morbidity and mortality associated with ectopic pregnancy.Materials & methods : A total of 47 admitted patients who were di-agnosed as ectopic pregnancy cases were retrospective analyzed between the periods from January 2013 to June 2014 at Chattagram Maa-O-Shishu Hospital Medical College, Agrabad, Chittagong. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultrasonogram and at surgery and morbidity associated with ectopic pregnancy were noted.Results: The incidence of the ectopic pregnancy in the pres-ent study was 7.4/1000 deliveries. A majority of the cases were multigravidas and majority of the cases gestational age were six to ten weeks. In most of the cases, there were no identifiable risk factors. The commonest risk factors present were history of MR (12.7 %)and abortion (10.6), history of tubal surgery (2.2%), infertility (2.2%) and pelvic inflammatory diseases (4.2%).The commonest symptoms were abdominal pain (89.3%), amenorrhea (78.7%) and abnormal vaginal bleeding (63.5%); and commonest signs were abdominal tenderness (70.5%), cervical excitation (52.6%) and adnexal tenderness (50.4%). Almost half (45%) were in a state of shock at admission. Ultrasound, a urine pregnancy test and serum B-hCG were the investigative modalities which were used. Surgery by open method in the form of salpingectomy (92.3%), salpingo-oophorectomy (5.5%) and salpingostomy (2.1%) were the mainstay of management. Morbidity included anemia (50.9%), blood transfusion (78%) and wound infection (2.1%). No maternal mortality noted.Conclusion: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.20993
Single Stage Lateral Based Flap Urethroplasty and Two Stage Urethroplasty in Proximal Penile Hypospadias with Chordee : A Prospective Case Control Study
Authors: Biswas Ipsita , Chakraborty Abhi Kumar , Noor-ul Ferdous Kazi Md. , Sultana Hafiza
Published: January 2015

Aims: Hypospadias is one of the commonest congenital abnormalities of the male genitalia. Proximal penile hypospadias is the challenging condition to correct. Lateral based flap (LB) procedure combines meatal  based flap and pedicle flap technique into one procedure without the need for an intervening anastomosis. In this study we compared Lateral based flap (LB) procedure with conventional two stage urethroplasty for proximal penile hypospadias with chordee. The aim of this study was to find out the outcome of lateral based flap urethroplasty in treating proximal penile hypospadias with chordee over two stage procedure.Study Design: In this prospective study that carried out from 1st January 2012 to 30th June 2013, patients with proximal penile hypospadias from 6 months to 144 months (12yrs) of age attending at Dhaka Shishu (Children) Hospital out patient department were primarily enrolled for this study. Patients were grouped into A and B on the basis of repair by Lateral based flap single stage urethroplasty and by two stage techniques respectively. Results were evaluated after 6 months of urethroplasty and onward.Results: Total 24 Patients, ages ranged from 7 months to 10 years (mean 3.97 years) of proximal penile hypospadias (12patients in each group) were included. For Lateral based flap (LB) procedure (Group-A), mean time required for urethroplasty was 3.23 hours. On the other hand, for control group (Group-B) mean total time required was 3.99 hours (for orthoplasty 1.67 hours and for urethroplasty 2.32 hours). Urethrocutaneous fistula developed in 16.6% (2 patients) and glanular dehiscence in 8.3% (1 patient) in each group. In addition 25% (3 patients) in control group developed meatal stenosis. Satisfactory results were observed more than 83% of group-A patients and 58.3% of group B patients.Conclusions: The study reflects that lateral based flap (LB) procedure technique may offer the patients with proximal and severe forms of hypospadias, a good chance of a single stage operation with high success rate.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21018
Health and Nutritional Status of Aged People
Authors: Haque Md Monoarul , Uddin A K M Majbah , Abu Naser Mohammed , Khan Md Zahid Hasan , Roy Suman Kumar , Arafat Yasin
Published: January 2015

Background: There is inadequate evidence based information to assist health policy makers in preparing for appropriate health, nutrition and social support guideline for the elderly in Bangladesh. Objective: The present study is an attempt to assess the health and nutritional status of elderly people in selected hospital in Dhaka.Methods: It was a cross sectional descriptive study. The subjects were selected purposively. The study was conducted among 50 elderly attending Bangabandhu Sheikh Mujib Medical University. Anthropometric data such as height and weight of the study subjects were collected by using standard techniques. Nutritional status was measured according to WHO guideline.Result: Most of the subjects belong to 60-64 yrs age group. Overall nutritional status as well as health status was not good and satisfactory. Most of them were suffering from malnutrition and arthritis as well as diabetes was very common. Partial reduced of appetite was seen among respondents. Dietary pattern was not good. Conclusion: Health and nutritional status of aged people in this study was not satisfactory.Recommendation: Intervention programs related to health and nutritional status may be arranged.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21019
Complimentary Feeding Practices in Under-2 Children
Authors: Paul Shanjoy Kumar , Islam Quazi Rakibul , Roy Sunirmal , Rudra Pranab Kumar
Published: January 2015

Background: Complimentary feeding (CF) practices are quiet frustating in our country. Innaproprite foods in first two years of life have detrimental impact on health and growth of children. The aim of the study was to see the present pattern of CF practices, to identify wrong practices and to  develop awareness among medical professionals so that they may encourage appropriate practices more vigorously for reducing child mortality and morbidity.Methods: A cross-sectional study was conducted from October, 2011 to December, 2011 in the Pediatric department (indoor and outdoor) of Sir Salimullah Medical College Mitford Hospital, Dhaka and in a private chamber of a district town of Bangladesh. Four hundred motherchild pairs were selected by non-random convenience sampling method. 6-24 months old children and children under six months (if was on complimentary feeding) were included. Data was collected from the mothers/caregivers of the children in a pretested semi-structured data collection sheet and analyzed by SPSS version 12. Appropriate statistical tests were done. Statistical significance was considered if p value was <0.05. Results: Early initiation was very high (49.25%). Most common first complimentary food was rice gruel with milk (26.56%). Most common current main complimentary food (25.52%) and most common main complimentary food fed in last 24 hours (26.82%) was also rice gruel with milk. Amount of complimentary food per feed was inappropriate in most cases. Frequency of CF was not appropriate in many cases. Fast foods and commercial cereal  were given to 54.8% & 33.33% children respectively. Only 1% mothers/caregivers had sound knowledge about CF. Positive support from family regarding practicing appropriate CF was found in 24.75% cases. Feeding practices were mostly influenced by relatives (25%).Conclusion: CF practices are still not ideal in our country. So, all possible interventions should be applied to improve it and thus to improve child survival.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21020