Comilla Medical College

Background: Eclampsia remains a major cause of maternal and perinatal morbidity and mortality worldwide. Despite declining incidence in developed countries due to improved antenatal care (ANC) and obstetric management, it continues to pose a significant public health challenge in developing countries like Bangladesh because of inadequate ANC, poor socioeconomic conditions, and limited access to healthcare services. Objectives: This study aimed to evaluate the maternal and fetal outcomes of eclamptic patients and to analyze their clinical profile and etiological background. Methods: This hospital-based cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Comilla Medical College Hospital (CoMCH) from January to December 2012. A total of 140 patients diagnosed with eclampsia were included. Sociodemographic characteristics, ANC status, clinical presentation, and maternal and perinatal outcomes were analyzed. Results: Most patients were aged 21–25 years (42.85%), housewives (>73%), primigravida (67%), and from low socioeconomic backgrounds (41.43%); only 17% received regular antenatal care. Antepartum eclampsia was the commonest presentation (61%), followed by intrapartum (27%) and postpartum eclampsia (10%). At admission, >65% had systolic blood pressure ≥160 mmHg and 70% had diastolic blood pressure ≥110 mmHg; moderate proteinuria was present in 38%. Six maternal deaths occurred. Among 142 neonates, 127 (89%) were live births, with 25 (17.6%) neonatal deaths and 15 (11%) stillbirths. Conclusion: Eclampsia remains a significant contributor to maternal and perinatal morbidity and mortality in Bangladesh. Early initiation of anticonvulsant therapy and timely delivery are critical to improving fetomaternal outcomes. J Com Med Col Teachers’ Asso July 2026; 30(2): 82-87

Abstract Brexpiprazole 2–4 mg daily is a novel dopamine D2 partial agonist approved for schizophrenia and improves effectiveness and tolerance by balancing D2, 5‐HT1A, and 5‐HT2A effects. This review assesses current evidence on its efficacy and safety within this dose range. PubMed, ScienceDirect, and The Cochrane Library were searched for trials published between 2011 and 2025 using specific keywords. Eligibility criteria included schizophrenia patients diagnosed using DSM‐IV, DSM‐IV‐TR, DSM‐5, or ICD‐10, with intervention being 2–4 mg of brexpiprazole. Positive and Negative Syndrome Scale (PANSS) score and Clinical Global Impression ‐ Severity scale (CGI‐S) were the primary efficacy endpoints, and treatment‐related adverse events were used to assess efficacy. Subgroup analysis was planned between the two dosage groups. The quality of randomized controlled trials (RCTs) was evaluated using the ROB2 tool, and the protocol registration was completed in PROSPERO. Among 464 retrieved articles, five trials with 2182 participants were found to be eligible. Brexpiprazole significantly improved total PANSS scores (mean difference [MD] −5.76; 95% confidence interval [CI] −7.69 to −3.83; p < 0.00001), positive subscale scores, negative subscale scores, and CGI‐S scores (MD −1.35; 95% CI −1.87 to −0.84; p < 0.00001). The treatment‐emergent adverse events were similar to placebo, and the risk of discontinuation was less with brexpiprazole (risk ratio 0.58; 95% CI 0.430.77; p = 0.0002). The most usual extrapyramidal symptom was akathisia. Brexpiprazole 2–4 mg showed significant improvements in PANSS and CGI‐S scores, with a lower risk of treatment discontinuation. These findings support its efficacy and tolerability in managing schizophrenia.

Abstract Introduction The ability to have children is connected with self-image, self-respect, and sexuality. Infertilitycan result in either sexual dysfunction or marital distress or both in male and female. Physicians often ignore the dyadic relation of the couple and their sexual intimacy while treating infertility. Objective The purpose of the present study was to examine the proportion of sexual dysfunction and their marital adjustment issues in individuals sufferring from infertility and compare differrent aspects of adjustment issues. Methods Patients were recruited randomly from the departments of infertility in two tertiary care hospitals named Bangladesh Medical University (BMU) and Bangladesh Institute of Rehabilitation of Diabetic and Endocrine metabolism (BIRDEM) in Dhaka city in Bangladesh. Only diagnosed patients seeking treatment were recruited. The study period was from October 2024 till June 2025. IRB was approved from BMU (IRB number: BSMMU/2024/5584). Either male or female patients with diagnosed infertility were randomly selected from these two institutes. Validated instruments like FSFI-6 was used to see female sexual dysfunction and IIEF-6 to see Erectile Dysfunction (ED) of any form and PEDT to see premature ejaculation (PE). Revised Dyadic Adjustment Scale (R-DAS) was applied to see the marital adjustment and satisfaction. Results Total 658 patients (male=320, female=338) were recruited.The mean age of male and female who came for infertility treatment were 33.77 and 28.57 respectively. In men, (n = 320) ED (Any degree) was found in 108 (33.7%) patients. Among the respondents, Mild ED was found in 77 (24.1%), Mild to moderate ED in 26 (8.1%) and Moderate ED in 05 (1.6%) patients. Premature ejaculation (Any degree) 60 (18.7), Probable PE was found in 18 (5.6%), PE 42 (13.1). Among the women, (n = 338) Sexual dysfunction was found in 47 (13.90%) patients. The prevalence of sexual dysfunction was substantial in this sub fertile cohort, affecting nearly one in four individuals (24.2%) overall. Men were disproportionately affected, with ED and PE is present in 33.7% and 18.7% of male partners respectively. These findings highlight that male sexual health concerns are a predominant comorbidity within the infertile population. R-DAS was used to see the marital adjustment and all three R-DAS constructs-Consensus, Satisfaction, and Cohesion-showed significant associations with sexual functioning outcomes. A score of 47 or less indicates marital dissatisfaction. Marital dissatisfaction was found in 17.2% male and 34% female. Higher Consensus and Satisfaction scores were positively correlated with better erectile (IIEF-6) and female sexual functioning (FSFI-6) and negatively correlated with premature ejaculation (PEDT) scores, indicating that greater marital agreement and satisfaction are linked to healthier sexual functioning. Cohesion showed a weaker but significant positive correlation with FSFI-6. Marital distress was significantly more prevalent among infertile women than men (34.0% vs. 17.2%, <0.001). High prevalence of distress was observed in men with mild-to-moderate ED (34.6%). And PE (p = 0.012). Conclusions Physicians dealing infertility should frequently address marital adjustment and sexual dysfunction among couples. Disclosure No

Gastric trichobezoar, though rare in children under 3 years, should be considered in cases of chronic vomiting, malnutrition, and unexplained gastric masses, particularly with clinical clues of irregular alopecia and history of hair ingestion. Abdominal CT is diagnostic, demonstrating a heterogeneous intragastric mass; surgical removal via gastrotomy is definitive treatment, with recurrence rates approaching 20% if underlying causes are unaddressed. Childhood pica and trichophagia are frequently associated with neglect, psychosocial stress, malnutrition, and micronutrient deficiencies, requiring comprehensive multidisciplinary intervention including surgery, nutritional rehabilitation, family psychological support, and child protection services evaluation. Early recognition and holistic management are essential to prevent life‐threatening complications such as obstruction, perforation, and severe malnutrition.

Background: Dementia is characterized by progressive decline in memory, thinking, reasoning, behavior, and personality. Several pharmacological agents including cholinesterase inhibitors such as donepezil, rivastigmine, and galantamine are used to alleviate symptoms. Objective: This study aimed to observe treatment responses among dementia patients using MMSE scores. Methodology: This observational study was conducted in the Department of Neurology, Comilla Medical College Hospital, Bangladesh, over 1.5 years from July 2021 to December 2022. A total of 75 patients were selected according to predefined criteria. Cognitive improvement was evaluated using MMSE scores before and after treatment. Data were analyzed using SPSS version 25, including multiple logistic regressions. Results: Among 75 participants, 48 (61.2%) showed improvement, while 29(38.6%) did not. Most patients were aged 66 to 75 years (34.7%). Females constituted 58.7% of the sample. Nearly half (46.7%) were illiterate. The most common symptoms were forgetfulness (100.0%), insomnia (93.3%), and restlessness (78.7%). Hypertension (48.0%), diabetes mellitus (17.3%), and stroke (34.7%) were the major comorbidities. Baseline MMSE scores showed mild to moderate impairment in 74.0% of patients. CT scans commonly revealed cortical atrophy (33.3%). Alzheimer’s disease was diagnosed in 57.3% of patients, and multi-infarct dementia in 42.7%. Rivastigmine was the most frequently prescribed medication (95% of cases). After treatment, 60.0% achieved a normal MMSE score. Overall, 61.3% of patients demonstrated clinical improvement. Conclusion: Alzheimer’s disease was the most common type of dementia in this study. Rivastigmine therapy showed satisfactory levels of improvement in cognitive function. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):72-79