Thesis 2018
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Item A survey on skin disease and its impact on Quality of life(East West University, 2/10/2018) Khatun, Most. HajeraSkin disease is one of the common human illnesses It is a multidimensional concept that encompasses psychological, social and financial consequences of the skin disease on the patients, their families and on society. Chronic and incurable skin diseases, such as allergy, psoriasis, fungal infection and eczema, are associated with significant morbidity in the form of physical discomfort and impairment of patients' quality of life. The aim of the study was to explore the level of awareness of risk factors related to skin disease and its impact on quality of life (QoL) in different Govt hospital patients in Bangladesh. A pre-structured questionnaire was used to collect data from 181 patients from skin departments in four hospitals of different cities of Bangladesh. In this study purposive sampling technique was followed. The study represents the distribution of the patients according to their age where highest no. of patient (72.92%) were in the age group of 19-45 years followed by <18 year age group (16.02%). The majority (67.95%) of the patients belonged to middle socioeconomic class with monthly income within Tk.10,000-40,000 BDT and observed that major portion (35.91%) of the patients completed their primary education. On the other hand, 16.57% patients studied up to H.S.C and 13.81% patients were Graduate. Majority (63.54%) of the patients were male and 36.46% of the patients were female and maximum (48.07%) patients identified bad hygiene as the risk factors of skin infection followed by wearing tight cloth (27.07%), lack of sleep (17.67%), drinking less water (10.49%) etc. During the study it was seen that 43.65% of patients had oily skin and 35.91% of patient had dry skin. On the other hand, only 11.60% had normal skin. The prevalence of skin disease among adults was found to be 72.92% with allergy, psoriasis & fungal infection being the most common. Among the population 71.27% of the patients were mostly suffered by skin disease during the summer season. Awareness of skin disease is under-researched in Bangladesh, and a deep understanding remains to be achieved. Thus, there is a need for further studies on community health education and treatment individualization for skin disease.Item A Study on Lipid Profile Pattern of patients with Diabetes Mellitus and relationship with Blood Pressure, Serum Creatinine level and HbA1c(East West University, 2/6/2018) Sultana, ShahriaThis study reviews the relationship between dyslipidemia, chronic kidney disease, and cardiovascular diseases in patients with diabetes. Diabetes mellitus is associated with complications in the cardiovascular and renal system, and is increasing in prevalence worldwide. Modification of the multifactorial risk factors, in particular dyslipidemia, has been suggested to reduce the rates of diabetes-related complications. Dyslipidemia in diabetes is a condition that includes hypertriglyceridemia, low high-density lipoprotein levels, and increased small and dense low-density lipoprotein particles. This condition is associated with higher cardiovascular risk and mortality in diabetic patients. Current treatment guidelines focus on lowering the low-density lipoprotein cholesterol level; multiple trials have confirmed the cardiovascular benefits of treatment with statins. Chronic kidney disease also contributes to dyslipidemia, and dyslipidemia in turn is related to the occurrence and progression of diabetic nephropathy.Item In vitro Efficacy of Metronidazole and Secnidazole combination against clinical isolates of E. histolytica(East West University, 2/4/2018) Mim, Sabrina AkhterEntamoeba histolytica is the etiological agent of amoebic dysentery and amoebic liver abscess (ALA). Worldwide, 40–50 million symptomatic cases of amoebiasis occur annually and 70,000 to 100,000 deaths are due to this infection. In amoebiasis Metronidazole, a 5-nitroimidazole drug is the drug of choice for intestinal disease caused by Entamoeba histolytica. However, the random use of Metronidazole can result in increased minimum inhibitory concentration (MIC) against Entamoeba species. As a result treatment failure may occur when treated with antiamoebic drug. Therefore, the aim of the study is to determine the efficacy of combination of Metronidazole & Secnidazole against clinical isolates of E.histolytica. The clinical isolates of E. histolytica were treated individually with Metronidazole & Secnidazole at different concentrations (2.56, 1.28, 0.64, 0.32, 0.16, 0.08 μg/ml). Drug sensitivity assay of the samples was carried out by using microtiter plates containing 100μl of parasite suspension (1×106 parasites/ml). Plates were incubated at 37ºC. After 4 hours the viable parasites were observed under microscope using haemocytometer. Viable counts of the E. histolytica treated with different concentration of drugs were compared with the control. The viable parasites in Control were 7.7X105 cell/ml and 5.7X105 cell/ml for testing the Metronidazole and Secnidazole respectively. Viable cell counts of E. histolytica were 3X105, 3.5X105 & 4X105 cell/ml when different concentrations of Metronidazole (2.56, 1.28 & 0.64 μg/ml) were used. Viable cell counts of E. histolytica were 2.5X105, 3.9X105 & 4.6X105 cell/ml when different concentrations of Secnidazole (2.56, 1.28 & 0.64 μg/ml) were used. Cell inhibition was maximum at the highest concentration of individual treatment (Metronidazole and Secnidazole). The parasite inhibition was occurred in a dose dependent manner. Cell inhibition of parasite was 3X105 cell/ml when treated with 2.56 μg/ml of combination drug (Metronidazole+Secnidazole). The results indicate that both Metronidazole & Secnidazole showed adequate efficacy individually against E. histolytica. However, Combination (Metronidazole+Secnidazole) of these drugs didn‟t show any synergestic effect against E. histolytica.Item A Study on Types of Skin Diseases and its Impact on Quality of Life of Patients Coming to Private Hospitals in Dhaka city(East West University, 2/9/2018) Shaheen, AliyaThe skin is the largest organ in the body and it performs many vital functions such as protection against external physical, chemical, and biologic assailants. While skin diseases are very common among the populations in many developing countries, they have not been regarded as a significant problem that could benefit from public health measures. The aim of the study was to assess the level of awareness and knowledge about skin diseases and to observe their effect on quality of life. A total number of 148 patients of different private hospitals in Dhaka city were surveyed with a questionnaire in order to assess the awareness and knowledge regarding skin disease. Informed consent was obtained from the eligible participants before interview and participants who agreed to join the study provided the required information for the studies. Among them majority (62.2%) patients were female and highest number of patients were in the age group of 19 to 30 years. Greater part of patients had allergy (21.62%), psoriasis (16.89%) and acne (15.54%). Summer season had the maximum effect on skin and 53.38% participant had the influence of environment outside home. About 53% participants were aware about the risk factors for skin diseases. While 50% knew that bad hygiene have higher chances of contributing towards contracting skin infection, whereas 32.85% of them were aware that lack of sleep as a risk factor for infection. Among the participants 91.21% took medicines and steroids (74.07%) were the most common drugs taken by the patients. After hearing conversation, it was revealed that many patients were not satisfied with their treatment as they have to visit several times for the treatment but were still did not have any positive effect. Skin infections caused physical symptoms like itchiness, soreness and painful wounds which affect quality of life of 69.51% patients. From the result it was seen that the knowledge of the skin conditions were was not at satisfactory level among the specific settings of the patients of our country. Such awareness and knowledge could lead to better understanding and acceptance of the importance of the early detection and treatment of skin diseases.Item Effect of Metronidazole and Secnidazole against Clinical Isolates of E. Bangladeshi Collected from Mirpur Area, Dhaka City, Bangladesh(East West University, 1/23/2018) Islam, Md. ArifulInfectious diseases continue the major cause of morbidity and mortality worldwide including Bangladesh. Entamoeba histolytica is the etiological agent of amoebic dysentery and amoebic liver abscess (ALA). Worldwide, 40–50 million symptomatic cases of amoebiasis occur annually and 70,000 to 100,000 deaths are due to this infection. In amoebiasis Metronidazole, a 5-nitroimidazole drug is the drug of choice for intestinal disease caused by Entamoeba histolytica. In 2010-2011 a new species of Entamoeba named E. bangladeshi has been identified, which was positive for Entamoeba organism but negative for E.histolytica, E. disparand E. moshkovskii by PCR. It was found in the feces of children living in Mirpur, Dhaka, Bangladesh. Till now no studies have been carried out to determine the Sensitivity of Metronidazole and Secnidazole against this new species. Therefore, the objective of the study is to determine the sensitivity of Metronidazole and Secnidazole against clinical isolates of E. bangladeshi. The clinical isolates of E. Bangladeshi were treated with Metronidazole and Secnidazole at different concentrations (2.56, 1.28, 0.64, 0.32, 0.16, 0.08, and 0.04 μg/ml). Drug sensitivity assay of the samples was carried out by using microtiter plates containing 100 μg/ml of parasite. Plates were incubated at 370C. After 4 hours incubation, the viable parasites in Control were 6.3X106 and7.05X106 for testing the Metronidazole and Secnidazole respectively. Viable cell counts of E. Bangladeshi were 3.2X106, 4.5X106 when different concentrations of Metronidazole (2.56 and 1.28 μg/ml) were used. Viable cells counts of E. Bangladeshi were 3.15X106 and 3.65X106 when different concentrations of Secnidazole (2.56 and 1.28 μg/ml) were used. Inhibition of parasite occurred in a dose dependent manner when treated with metronidazole and secnidazole. Cell inhibition was maximum at the highest concentration of individual treatment (Metronidazole and Secnidazole). The results indicate that, Entamoeba isolates in Bangladesh do not seem to be resistant to the commonly used antiamoebic drugs. Metronidazole drug may be a useful treatment to inhibit the growth of E. bangladeshi. Further study is needed to explore different drugs at different concentrations and time intervals to determine the in vitro sensitivity against E. bangladeshi.