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- 검색키워드
- 저자 : ( Fazle Rabbi Chowdhury ) (검색결과 2 건)
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( Fazle Rabbi Chowdhury ),( Mohammed Zakiul Islam ),( Ralf Weige,Nazia Hassan ),( Ismail Patwary ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: In Bangladesh there are around 300,000 new cases of TB every year with 70,000 deaths. In spite of major national and global efforts obstacles to effective diagnosis and treatment still persist. This study sets out to assess factors like socio- economic and demographic characteristics, patients care seeking pattern, average cost etc.in north eastern part of Bangladesh. Methods: This cross sectional study was done by interviewing systematically selected patients in two urban and two semi-urban DOTS center from July 2012 to June 2013 using a structured questionnaire considering socio-economic status, care seeking pattern, money spent for diagnosis & treatment and quality of service etc. Sputum smear positive patients aged = 19 years receiving treatment for = four weeks were enrolled. Chi-square test was done to explore the level of signifi cance. Results: Out of 170 patient`s majority (76; 44.7%) was belonged to most economically productive age group (25-44 years). About one third (59; 34.7%) patients were the only earning member of the family and majority (131; 77.05%) of them was not working due to current illness (p = 0.005). Delay in diagnosis (117; 68.82%) was common ((p = 0.005) among semi-urban patients while they (121; 71.1%) also experienced signifi - cant (p = 0.005) delay (> 3 weeks) to reach the DOTS corner and spent more money (> 15 USD) to confi rm their diagnosis compared to urban counterpart (p = 0.005). 70% patients utilized private health care services initially and fear of government formalities (87; 73.1%) was the most common reason for that. Total 27.05% participants suspect about quality of drug. Conclusions: The linkage between TB and poor socio economic condition is well documented. Policy makers should implement “pro-poor bias” in their TB strategies. Regular monitoring is essential to overcome the barriers.
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( Mohamamd Robed Amin ),( Fazle Rabbi Chowdhury ),( Ariful Basher ),( Mohammad Abul Faiz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Adulterated methanol is highly toxic and leads to severe metabolic acidosis, blindness and mortality is very high if not treated with specifi c antdote. The time of ingestions and severity of illness is very short and comprehensive quick assessment and care is crucial for survivial of patient. The selective antidote Fomepizole is not available in Bangladesh and pure intravenous ethanol is also out of reach in health care facility. The oral ethanol has its legislative restriction. Methods: From November 2012 to January,2013, in sphere of 3 months medicine units of Dhaka Medical College Hospital (DMCH) experienced 8 cases of methanol poisoning with fatality. Results: Six patient presented in unconscious states within 3 to 7 hrs of consuming methanol while two patient presented within 48 hrs. All of them had gastrointestinal toxicity with variable episodes of vomiting. Three patients presented with visual impairment while only two out of eight had normal ophthalmoscopy. Respiratory distress was uniformly found in all patients before unstable profound shock. Blood ethanol level was not performed in any patient due to lack of available facility. Seven patients received only supportive measures ranging from steroids to sodium bi carbonate while one patient presented in severe toxicity and died quickly before any supportive measures. Antidote was not prescribed in any patient in the form of fomepizole or intravenous or oral ethanol. Conclusions: Methanol poisoning is a severe form of poisoning and currently the physicians are not adequately trained enough to deal with quick assessment and prompt treatment in Bangladesh. The judicious use of antidote even in the form of oral ethanol and folinic acid can save the precious life. A national guideline should be uniformly practiced by the physicians to combat the catastrophic methanol poisoning in Bangladesh.
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