Research Article
Etiology of Leg Edema: A Tertiary Care Hospital Experience
Dr. Sobroto Kumar Roy, Dr. Anisur Rahman Bhuiyan, Dr. Rajee Mahmud Talukder, Dr. Mahabubur Rahman, Dr. Shahriar Kabir Khan
Middle East Research Journal of Medical Sciences; 194-198.
DOI: https://doi.org/10.36348/merjms.2024.v04i06.006
Background: Leg edema can be a benign inconvenience or a symptom of severe health issues involving the cardiac, vascular, respiratory, renal, hepatic, or hematologic systems. Types of leg edema include venous edema, lymphedema, lipedema, inflammatory edema, pulmonary hypertension-induced edema, hormonal imbalance-related edema, drug-induced edema, idiopathic edema, and dependent edema. Aim of the study: This study aims to investigate the various causes and underlying factors contributing to leg edema and explore the different etiologies of leg edema. Methods: This observational study was conducted at Department of Medicine, Sheikh Sayera Khatun Medical College Hospital, Gopalgonj, Bangladesh, from January 2024 to June 2024, using purposive sampling to select 270 patients with leg edema. Inclusion criteria encompassed individuals aged 18 and older with unilateral or bilateral leg edema, while exclusion criteria included incomplete medical records and specific conditions. Data were gathered through structured forms, clinical assessments, and patient interviews, covering demographics, medical history, and edema characteristics. Ethical approval was obtained, and informed consent was provided. Data analysis was conducted using SPSS. Result: The majority (35.19%) are over 70 years old, with a mean age of 55.4 years. Females represent 61.85% of the population. Most participants are overweight (mean BMI = 28.5 kg/m²). A significant number (71.85%) have hypertension, and 64.07% report mobility issues, with 60% being wheelchair-bound. Leg edema is common, with 30.37% experiencing it for over 6 years. Venous insufficiency is the leading cause (71.11%), followed by congestive heart failure (18.15%) and nephrotic syndrome (12.96%). Other factors include NSAIDs, obesity, and hypoalbuminemia. Conclusion: Leg edema is primarily caused by venous insufficiency, congestive heart failure, and nephrotic syndrome. Our study found venous insufficiency as the most common etiology, with hypertension, diabetes, obesity, and immobility contributing to its development. Accurate diagnosis and management are crucial for improving patient outcomes.
Review Article
Etiology, Diagnosis, and Clinical Management of Vulvodynia (Vulvar Pain)
Ramazan Bayirli
Middle East Research Journal of Medical Sciences; 199-206.
DOI: https://doi.org/10.36348/merjms.2024.v04i06.007
Vulvodynia is a chronic condition characterized by pain and discomfort in the vulvar vestibule, the area surrounding the vaginal opening. The etiology and pathophysiology of vulvodynia are complex and multifactorial. Current evidence points to a combination of peripheral inflammation, neural sensitization, hormonal dysregulation, and psychosocial factors. It typically manifests as sharp, burning pain or discomfort localized to the vestibule. An individualized, multimodal approach is vital in the treatment of vulvodynia. Conservative therapy is often the first line of treatment, with pharmacological and surgical options considered when these are insufficient. Emerging therapeutic approaches include platelet-rich plasma and low-level laser therapies. The heterogeneity of vulvodynia and the lack of a standardized diagnostic approach present significant challenges in clinical practice and research. Future studies should focus on elucidating the underlying pathophysiology of vulvodynia, emphasizing identifying biomarkers that may facilitate early diagnosis and targeted treatments. Advances in understanding the roles of central sensitization, neuroinflammation, and genetic predispositions may pave the way for more personalized and effective treatments. Vulvodynia significantly affects women's physical, emotional, and sexual health. Although progress has been made in understanding the potential underlying mechanisms, many gaps remain in its effective management. A multidisciplinary approach that includes medical, physical, and psychological therapies offers the best outcomes for patients. However, further research is necessary to develop more effective, individualized treatments and to improve the overall quality of care for women suffering from this condition.
Research Article
Incidence of and Risk Factors for the Failed Induction of Labour-A Prospective Observational Study
Mst. Aleya Khatun, Naireen Sultana, Zahirun Nessa, Rifat Sultana, Jebun Nessa
Middle East Research Journal of Medical Sciences; 207-210.
DOI: https://doi.org/10.36348/merjms.2024.v04i06.008
Introduction: Induction of labor (IOL) is an artificial stimulation of uterine contraction at 28 or more weeks of gestation but before spontaneous onset of labor to achieve vaginal delivery and it is a common practice in current obstetrics. IOL is a life-saving obstetrical intervention indicated only when the benefits of discontinuing the pregnancy outweigh the risks of continuation. Objective: To study the incidence of and risk factors for the failed induction of labour. Methodology: This is a prospective observational study conducted at Dept. of Obst & Gynae, Shaheed Tazuddin Ahmad Medical College & Hospital, Gazipur, Bangladesh from January to June 2022. Total 120 woman who were induced with dinoprostone gel and who ended up with caesarian section were included in the study. Factors which might be responsible for the failed labor induction were assessed. Women who were taken up for caesarian section for fetal distress were excluded from the study. Results: Total 120 women with failed labour induction were included in the study, and we found that majority of the women were primiparous (75%), in the age group of 25 to 29 years (60.8%), and we found that most common indication of doing IOL is post-dated pregnancy (30%). Unfavorable cervix with bishop’s less than 5 was found in majority of the cases (28.3%). Other factors were gestational hypertension (19.1%), IUGR (10%), prolonged PROM (8.3%), gestational diabetes mellitus (8.3%), Rh negative pregnancy (3.3%). Conclusion: Induction of labour is an important obstetric procedure. There is a need to develop a protocol for the same. The success of induction of labour is determined by many maternal and fetal factors, which must all be taken into account to avoid unnecessary cesarean sections.
Research Article
Treatment of Subtrochanteric Femoral Fractures Using an Intramedullary Proximal Femoral Nail Versus Treatment of Subtrochanteric Femoral Fractures Using a Proximal Femoral Nail with A Trochanteric Support Plate
Abu Md. Mofakhkharul Islam, Sohel Mahmud Khan, Md. Ibrahim Miah, A. K. Al Miraj
Middle East Research Journal of Medical Sciences; 211-215.
DOI: https://doi.org/10.36348/merjms.2024.v04i06.009
Background: Sub trochanteric femur fracture is proximal femur fracture that occur within 5cm of lesser trochanter. 1 In the last few years with increased of knowledge of biomechanical and fracture biology management of sub trochanteric femur fracture have evolved to the next level. Comparison of sub trochanteric femur fracture treatment with intramedullary proximal femur nail vs intramedullary proximal femur nail augmented with trochanteric support plate. Methods: We retrospectively reviewed the clinical operative study was conducted at the department of orthopaedics on June 2006 to July 2007 BSMMU. Operative study was approved by the institutional ethics committee. Two groups were divided from 50 patients to 25 in each and first were treated with PFN and the other with a combination of PFN plus trochanteric support plate. Results: Total 60 patient were included in study 30 patients were treated with PFN and rest were treated with PFN with long trochanteric support plate. Patient were distributed in all age groups, the overall age of PFN group was 35 year and the average age of PFN with plate group was 37years. The PFN group had 20 male and 10 female and while the second group has 25 male and 5 female. At the end of 6 months all except 2 patients from group 1 mobilized unassisted while all the patient from group 2 got mobilized unassisted. Based on harries hip score. Conclusion: Intramedullary fixation with intra medullary proximal femur nail plus trochanteric support plate.is feasible for the treatment of subtrochanteric femur fracture. Intraoperative reduction and surgical skill are important for the clinical outcome and the patients.
Research Article
Seasonal Diseases Occurring in Brazil
Marco Vinícios de Oliveira Santana, Carlos Henrique Marchiori, Klebert de Paula Malheiros
Middle East Research Journal of Medical Sciences; 216-230.
DOI: https://doi.org/10.36348/merjms.2024.v04i06.010
The term seasonal refers to the periodicity of certain events. Anything that occurs within a time interval with a beginning, middle, and end and a certain frequency is considered seasonal. In other words, the word refers to that which is temporary and relative to each year's season. In this sense, seasonal diseases are those typically triggered or worsened at a specific time of the year. Differences in temperature and fluctuations in relative humidity favor the development of certain dysfunctions and complicate their healing process, also due to the habits that people maintain due to climate change or the chronological distributions of certain diseases in terms of maximum and minimum records always occur in the same period, whether year, month, week, or day. In these distributions, the variation is characterized by a certain seasonality related to the property according to which the phenomenon always repeats itself in the same season. The objective of this manuscript is to report seasonal diseases occurring in Brazil. To produce this article, a bibliographic survey was carried out in original articles, reviews, and meta-analyses obtained from the PubMed database between the years 1985 to 2024. As a search strategy, the terms used were “seasonal”, “diseases”, “autumn”, “spring”, “summer”, and “winter” terms “or” and “and”. The exclusion criteria adopted were the time limit from 1980 to 2024, no relation to the search strategies, abstracts without a pharmacological aspect of the system of endocannabinoids, and duplicate articles. Finally, they were accessed in full for the construction of this work, totaling 39 scientific works for its development.
Research Article
Study of Mansonellosis and Oropouche Fever: Vectors, Life Cycle, Transmission, Pathogenesis, and Diagnosis
Marco Vinícios de Oliveira Santana, Carlos Henrique Marchiori, Klebert de Paula Malheiros
Middle East Research Journal of Medical Sciences; 231-244.
DOI: https://doi.org/10.36348/merjms.2024.v04i06.011
Culicoides bites cause discomfort to humans due to an allergic reaction resulting from the proteins in their salivary glands, but they also cause great pain, especially when present in large numbers. They can cause reactions such as allergic dermatitis, papules, and pustules, and even more serious reactions such as eczema, scaling, and scarring with abnormal pigmentation of the human skin, in addition to being vectors of diseases. The objective of this manuscript is to describe mansonellosis and Oropouche fever, as well as their vector, life cycle, transmission, pathogenesis, and diagnosis. Data were collected using a quantitative and descriptive approach, through books and the following databases: SciVerse Scopus, Scientific Electronic Library Online (SciELO), and the Academic Search Tool (Scholar Google). The search was developed using the subject descriptor mosquito, diseases, hosts, transmission, diagnosis, and treatment mentioned in journals, through a review of the literature on the subject. In the initial search, the titles and abstracts of the articles were considered for the broad selection of works of probable interest, with the abstracts being highlighted. The time frame used was between 1972 and 2024, with a preference for searches of recent publications, and those that did not meet the established criteria were excluded.
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