Delayed first passage of meconium and also prolongation of meconium passage creates great anxiety among parents. Some study showed that that first passage of meconium is delayed in preterm infants compared to term infants. The difference in duration of meconium passage in term and preterm infant has however never been assessed before. This cross sectional study was carried between July 2010 to December 2010 among 100 Newborn babies ranging from 28 to 42 weeks of gestation who were delivered in the Department of Obstetrics and Gynaecology or admitted in the Department of Neonatology of Dhaka Medical college Hospital were included in the study. Gestational age was determined from first day of last menstruation (when available) and also by using Expanded Ballard Scoring System. In case of any discrepancy of more than 2 weeks, the later was accepted. This study was carrying out to determine the time of first passage of meconium and duration of passage of meconium in term and preterm infants. Out of total 100 infants, 58 were male and 42 were female. The numbers of babies were 21, 28, 25 and 26 in group I, II, III and IV respectively. The mean age at which the babies passed first meconium were 23.5±3.5, 33.0±3.8, 25.7±4.2 and 17.3±4.6 hours in group I, II, III and IV respectively, which was<48 hours irrespective of gestational age. The mean gestational age of the babies who passed meconium for <4 days was 37.1±2.2 weeks. On the contrary, mean gestational age of the babies who passed meconium for>4 days was 32.6±4.3 weeks and this observation was statistically significant (p<0.001). First passage of meconium in all newborn was within 48 hours irrespective of gestational age. Duration of passage of meconium was significantly prolonged among babies with lower gestational age. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13677 AKMMC J 2013; 4(1): 6-9
Background: Cystatin C is being considered as a potential replacement for serum creatinine as a filtration marker. Objectives: This present study was conducted to determine the validity of Cystatin C as a renal function test and to compare the Cystatin C and serum creatinine level between the CKD cases and person not having CKD. Methodology: The present case control study was conducted in the department of Nephrology of Dhaka Medical College Hospital during the period of January 2009 to December 2009 with the aim to find out the serum Cystatin C as diagnostic markers of chronic kidney disease. In the present study total 100 respondents were included. Among them 50 were CKD patients and another 50 were without CKD. Results: It was an age and sex matched study. Out of 50 patients with CKD, 29 (58.0%) were in the stage IV followed by 15 (30.0%) were in the stage III and rest 6 (12.0%) were in the stage V. In CKD group 31 (62.0%) had glomerulonephritis, 18 (36.0%) had HTN, 11 (22.0%) had DM and 3 (6.0%) had obstructive uropathy. In without CKD group 9 (18.0%) had HTN, 6 (12.0%) had DM. Mean±SD of Serum Creatinine in CKD and without CKD groups were 5.73±2.69 and 0.85±0.11mg/dl respectively. Mean±SD of Serum Cystatin C in CKD and without CKD groups were 3.59±1.21 and 0.71±0.09 mg/dl respectively. In all patients sensitivity of Cystatin C to diagnose CKD was 100.0% and specificity also100.0%. Sensitivity of serum creatinine to diagnose CKD was 88.0% and specificity was 100.0%. Conclusions: Cystatin C proved more reliable than creatinine and was comparable to plasma creatinine and Cockcroft-Gault estimation. Serum Cystatin C had higher diagnostic accuracy with high sensitivity and specificity to detect renal function and is a reliable marker of renal function.
Introduction: Glomerular disease associated with wide variety of biochemical disturbance and pathophysiological alteration in human body. It is a leading cause of chronic kidney disease in developing countries. In Bangladesh prevalence of CKD and ESRD increasing mostly due to glomerulonephritis. Presentation of glomerular disease ranges from asymptomatic to life threatening acute complications-AKI and also CKD.The prevalence of glomerular disease is different in various regions of the world and varies depending on the race, age, geographical, etiological, cultural and economic characteristics. This study reflects pattern of glomerular disease and their clinicopathological and histological characteristics in Bangladeshi population. Methods: This study has been conducted at department of nephrology, Shaheed Suhrawardy Medical College hospital, Dhaka from January 2017 to June 2018. 206 patients of glomerular disease was included in the study with proteinuria >0.5gm/day or presence of RBC or RBC cast in urine and /or renal impairment. Selected patients were evaluated both clinical history, examination and investigations. After taking consent renal biopsy was performed and histopathology (light microscopy and DIF) done by expert pathologist. All data recorded in case report form (CRF). Data were analyzed by using SPSS software. Results: Total 206 patients included in the study with mean age 34.5AE14.13 years, female were more than male (61.5%). More than 50% patients were in less than 40 years. Most common presentation was edema (87.2%), others were hypertension, anemia, reduced urine, hematuria, shortness of breath, arthritis, skin rash, sore throat and renal failure. Histologically Mesangial Proliferative Glomerulonephritis was more common variety of Glomerulonephritis (34.3%). Others were Lupus Nephritis (15%), Membranoproliferative (12.1%), FSGS (11.6%), IgA nephritis (5.8%), MCD (5.3%), Membranous Nephropathy (3.9%) and IgM nephropathy (2.9%). FSGS and IgM glomerulonephritis male were more affected than female, in MesPGN, LN, MPGN and IgA glomerulonephritis female were more affected than male. Patient with FSGS, MPGN, MesPGN and LN were hypertensive. Common age of MCD was 10-20 years, in FSGS >50% presented in 21-40 years, membranous glomerulonephritis 21-40 years, membranoproliferative glomerulonephritis 21-50 years, mesangial proliferative glomerulonephritis 10-50 years, lupus nephritis 10-40 years age, IgA nephritis10-50 years, IgM 10-30 years of age respectively. Mean UTP 4.24AE3.17 gm/day. >50% of FSGS, MGN, MpGN, MesPGN and MCD patients had more than 3gm/day proteinuria. 50.49% glomerulonephritis was associated with increase serum creatinine. Mesangial proliferative, membranoproliferative glomerulonephritis, FSGS, Membranous Nephropathy, Lupus Nephritis and IgA nephropathy associated with renal impairment. Conclusions: Histological pattern of glomerulonephritis may vary from different geographical area. In our study Mesangial proliferative glomerulonephritis was most common variety of glomerular disease.FSG...
Background- Cardiovascular mortality is significantly higher in ESRD patient.There are various risk factors for development of cardiovascular diseases including traditional risk factors, factors unique to ESRD patients and emerging risk factors.It is believed that their combined actions are integrated in the progression of atherosclerosis and inflammation plays a central role. C-reactive protein is a valuable marker of inflammation. Determination of serum creactive protein levels may be a useful predictor of cardiovascular diseases in ESRD patients Objective-To find out relationship between c-reactive protein and cardiovascular diseases. Methods- This cross sectional study was carried out into department of Nephrology, Dhaka Medical College Hospital, Bangladesh following fulfillment of inclusion and exclusion criteria. For analytical purpose total study population were divided into two groups on the basis of creactive protein level. Patients having c-reactive protein £6 mg/L were considered as group A and >6 mg/L were considered as Group B. The differences between groups were analyzed by unpaired t-test, fisher’ exact test or chi-square (X2) test. Multivariable regression analysis was done to see the association between c-reactive protein and cardiovascular diseases. Results- Patients with raise c-reactive protein have significantly higher cardiovascular disease than that of normal c-reactive protein. Multivariable linear regression analysis after adjusting for age, sex, smoking and diabetes shows that subject with CRP £6 mg/L vs >6 mg/L had 1.51 (95% CI 1.02 to 2.19) times increase risk of having cardiovascular disease. Conclusion- Inflammatory process has a role in development of cardiovascular diseases in ESRD patient. J Shaheed Suhrawardy Med Coll 2020; 12(2): 95-99
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