Ad-din Women's Medical College

ABSTRACT Background: Chronic urticaria (CU) is a common inflammatory skin disorder with an often unidentified etiology. Growing evidence suggests an autoimmune basis, particularly an association with thyroid dysfunction and thyroid autoimmunity. However, data from South Asian populations, including Bangladesh, remain limited. Objective: The objective of this study was to evaluate the association of thyroid dysfunction and thyroid autoimmunity among patients with CU and to explore associated demographic, clinical, and laboratory correlations. Methods: This cross-sectional study was conducted from January to June 2025 at a tertiary care hospital in Dhaka, Bangladesh. A total of 187 patients aged 5–60 years with CU of more than 6 weeks’ duration were enrolled. Demographic and clinical data were collected using a structured questionnaire. Laboratory investigations included thyroid function tests (thyroid-stimulating hormone [TSH], free T3, and free T4), thyroid autoantibodies (anti-thyroid peroxidase [anti-TPO], anti-thyroglobulin [anti-Tg], and TSH receptor antibody), serum immunoglobulin E (IgE), eosinophil count, and complete blood count. Statistical analysis was performed using SPSS version 23, with P < 0.05 considered statistically significant. Results: Abnormal thyroid function was observed in 51.33% of patients, with overt hypothyroidism being the most common abnormality (34.22%). Anti-TPO antibodies were positive in 67.01% and anti-Tg antibodies in 52.8% of the tested patients. Thyroid disorders and autoantibody positivity were significantly more common among females. Patients with thyroid disorders had higher eosinophil counts, and serum IgE levels were significantly elevated in anti-TPO-positive cases. Several clinical manifestations and comorbidities showed significant associations with thyroid disorders. Conclusion: CU is strongly associated with thyroid dysfunction and thyroid autoimmunity. Routine screening for thyroid abnormalities should be considered in patients with CU.

Background: Age-related cataract is the leading cause of reversible blindness worldwide. Phacoemulsification with intraocular lens (IOL) implantation is the standard surgical treatment, offering rapid visual recovery and minimal complications. Objective: To evaluate the visual outcomes following phacoemulsification with intraocular lens implantation in patients with age-related cataract. Methods: This descriptive observational study included 250 patients undergoing cataract surgery. Pre-operative assessment included visual acuity, slit lamp examination, intraocular pressure, and biometric measurements. All patients underwent small incision cataract surgery with posterior chamber IOL implantation using the SRK/T formula. Postoperative visual acuity was assessed on Day 1, Week 1, and Week 4–6. Data were analyzed using descriptive statistics, and comparison between pre- and postoperative outcomes was performed. Results: The mean age of patients was 64.8 ± 9.2 years, with a slight female predominance. Preoperatively, most patients had visual acuity between 6/36–6/60 (36.4%). On Day 1, good visual outcome (6/6–6/18) was achieved in 88.8% of cases, which remained 56.0% at Week 1 and 30.8% at Week 4–6 due to incomplete follow-up. No poor visual outcomes (<6/60) were observed. There was a statistically significant improvement in vision after surgery (p<0.001). Conclusion: Phacoemulsification with IOL implantation is a safe and effective procedure for age-related cataract, providing significant improvement in visual acuity with excellent early postoperative outcomes.

Background Family caregivers of patients with cancer in low-resource settings often experience substantial psychological and practical burdens in the absence of formal training and structured support. Caregiver preparedness may be a modifiable factor influencing psychological outcomes; however, evidence from Bangladesh remains limited. This study aimed to assess caregiver preparedness and its association with perceived stress among family caregivers of cancer patients in Bangladesh. Methods A hospital-based cross-sectional study was conducted among 202 adult family caregivers of cancer patients receiving chemotherapy and/or radiotherapy at two tertiary care hospitals in Bangladesh. Participants were selected by simple random sampling from daily patient registers. Data were collected through face-to-face interviews using a pretested semi-structured questionnaire. Caregiver preparedness was measured using the Preparedness for Caregiving Scale (PCS) and categorized as low, intermediate, and high. Perceived stress was assessed using the validated Perceived Stress Scale (PSS-10). Multivariable logistic regression was performed to identify factors associated with high stress. Results The mean caregiver preparedness score was 20.3 (SD ± 6.3), with 42.6% of caregivers demonstrating intermediate preparedness and 22.3% high preparedness. Overall, 40.6% of caregivers reported high perceived stress. A weak inverse trend was observed between caregiver preparedness and perceived stress (R 2 = 0.013), but the association was not statistically significant. In multivariable analysis, compared with highly prepared caregivers, those with low preparedness (AOR 4.33; 95% CI 1.42–13.16) and intermediate preparedness (AOR 3.96; 95% CI 1.44–10.87) had significantly higher odds of high stress. Additional factors significantly associated with higher stress included being a first-degree relative (AOR 11.28; 95% CI 1.39–91.24), caregiving duration of 12–24 months (AOR 2.39; 95% CI 1.20–4.74), lack of childcare support (AOR 1.90; 95% CI 1.01–3.56), and higher educational attainment. Conclusion Caregiver preparedness has emerged as a significant predictor of perceived stress among family caregivers of cancer patients in Bangladesh. Strengthening preparedness through structured training and psychosocial support interventions within oncology care is likely reduce caregiver stress in resource-limited settings.

Background:Bronchiolitis remains the commonest acute lower respiratory tract infection in younger children globally. Bronchiolitis is often misdiagnosed as World Health Organization (WHO)-classified pneumonia due to closely related clinical manifestations. Our primary objective was to assess the prevalence of viral bronchiolitis among WHO-classified pneumonia, and the secondary objective was to evaluate their management. Methods:This was a prospective observational study. Infants (aged <2 years) suffering from WHO-classified pneumonia attending the country's largest academic paediatric hospital 'Bangladesh Shishu Hospital and Institute', Dhaka, during July 2020 through June 2021 were enrolled (n = 60) following systematic sampling (every second child). We revalidated all infants meeting the inclusion criteria (cough, fast breathing and/or chest in-drawing) for bronchiolitis assessment using clinical, radiological, haematological, biochemical, and microbiological analyses. Nasopharyngeal aspirate (NPA) was subjected to polymerase chain reaction (PCR) assay for respiratory syncytial virus (RSV), influenza A, and influenza B viruses. Clinical features, treatment modalities, mode of discharge, and length of hospital stay (LOS) were subjected to differentiate bronchiolitis from WHO-classified pneumonia. Results:PCR of NPA of 60 WHO-classified pneumonia cases yielded RSV in 41 (68%) who had pertinent clinical symptoms and signs suggestive of bronchiolitis, attested by benign chest radiography (85%). Further, their mean (x̄) and standard deviation (SD) complete blood count (x̄ = 15,488; SD = 1874/cm) with x̄ = 36% (SD = 11) neutrophil) and C-reactive protein (x̄ = 4.49 (5.88) mg/L cut off reference value >5 mg/L) were indicative more as non-bacterial infections favouring RSV bronchiolitis. In contrast, all 19 non-RSV cases did not differ in clinical findings, as attested by haematological, microbiological and radiographical features, suggesting bronchiolitis-like illness, further supported by disease outcome, discharge pattern and LOS (x̄ = 4.7; SD = 2.29) days). Nevertheless, antibiotics were given in 95% of all 60 cases. Conclusions:There was a high proportion of bronchiolitis among WHO-classified pneumonia, and antimicrobials were prescribed to treat those cases. The findings need the attention of policymakers to address the overlap between WHO-classified pneumonia and bronchiolitis and minimise the potential overuse of antibiotics.

Background: Asthma is a major global health problem and one of the leading causes of childhood emergency visits. Management is often challenging because of comorbidities, poor adherence, improper inhaler technique, environmental factors, and severe therapy-resistant asthma.Objective: To determine the effects of vitamin D supplementation on asthma control and severity.Materials and Methods: This randomized clinical trial was conducted in the Department of Pediatric Respiratory Medicine at Bangladesh Shishu Hospital and Institute from January 2019 to December 2020 among children aged 6–15 years diagnosed with asthma. Eligible participants were randomly assigned into Group A and Group B with blinding. Group A received oral vitamin D3 (cholecalciferol) 400 IU daily for 4 months along with standard treatment, while Group B received standard treatment only. After 4 months, asthma severity, level of control, peak expiratory flow rate (PEFR), acute exacerbations, and emergency visits were assessed. A p-value <0.05 was considered significant.Results: Asthma control improved significantly in Group A; 33 patients achieved well-controlled asthma compared to 21 in Group B (P=0.029). Moderate persistent asthma decreased from 42 to 20 patients in Group A versus 35 to 31 in Group B (P=0.033). PEFR <80% decreased significantly in Group A (P=0.014). Acute exacerbations and emergency visits were also significantly lower in Group A (P=0.031 and P=0.001, respectively).Conclusion: Low-dose short-course vitamin D supplementation alongside standard therapy improved asthma control, reduced severity, decreased exacerbations, and lowered emergency hospital visits in children with asthma. KYAMC Journal Vol. 16, No. 04, January 2026: 169-176.