Jalalabad Ragib-Rabeya Medical College (JRRMC) (Bengali: জালালাবাদ রাগীব-রাবেয়া মেডিকেল কলেজ) is a private medical school in Bangladesh, established in 1995. It is located in the Pathantula area of Bimanbandar Thana, in Sylhet. It is affiliated with Shahjalal University of Science and Technology (SUST) under the School of Medical Sciences. The college is associated with 925-bed Jalalabad Ragib-Rabeya Medical College Hospital.
BACKGROUND:Cardiovascular disease remains the leading cause of mortality worldwide, with residual cardiovascular (CVS) risk remaining high despite pharmacological interventions. Cholesteryl ester transfer protein (CETP) inhibitors have shown promise in improving lipid profiles, but their comparative effectiveness in reducing CVS outcomes remains unclear. This network meta-analysis and network meta-regression aimed to evaluate the comparative effectiveness of CETP inhibitors (Evacetrapib, Anacetrapib, Dalcetrapib, and Torcetrapib) on CVS outcomes, including CVS mortality, all-cause mortality, major adverse cardiovascular events, myocardial infarction, need for revascularization, and stroke. METHODS:A Bayesian network meta-analysis was conducted, incorporating data from 10 randomized controlled trials with 84,134 patients diagnosed with cardiovascular disease or at high risk. We compared various CETP inhibitors for their effectiveness in reducing CVS events. Network meta-regression was used to assess the impact of covariates such as age, sex, and baseline lipid levels. RESULTS:Evacetrapib ranked highest for CVS mortality (relative risk [RR]: 0.92, 95% credible interval [CrI]: 0.39-1.87; Surface Under the Cumulative Ranking Curve [SUCRA]: 71.91%) and Anacetrapib for major adverse cardiovascular events (RR: 0.40, 95% CrI: 0.07-1.06; SUCRA: 84.25%). Dalcetrapib showed favorable effects on all-cause mortality (RR: 0.72, 95% CrI: 0.16-1.42; SUCRA: 67.51%) and stroke (RR: 0.75, 95% CrI: 0.41-1.26; SUCRA: 83.03%). Anacetrapib had the highest rank in reducing myocardial infarction (RR: 0.83, 95% CrI: 0.46-1.15; SUCRA: 86.06%). CONCLUSIONS:This analysis suggests that Evacetrapib and Anacetrapib are the most effective CETP inhibitors for improving CVS outcomes, with Dalcetrapib showing beneficial effects in certain outcomes. Further studies are needed to confirm these findings.
Abstract Background: Diabetic macular oedema (DMO) is a leading cause of visual impairment among patients with diabetic retinopathy. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, particularly Bevacizumab, is widely used to reduce macular oedema and improve visual outcomes. Objective: To evaluate the visual and anatomical outcomes following three monthly intravitreal injections of Bevacizumab in patients with diabetic macular oedema. Methods: This hospital-based cross-sectional study was conducted in the Department of Ophthalmology, Gopalganj Eye Hospital and Training Institute, from July 2022 to December 2023. A total of 102 patients (150 eyes) with type 2 diabetes mellitus and centre-involving DMO were included. Eligible eyes received three monthly intravitreal injections of Bevacizumab (1.25 mg/0.05 mL). Best corrected visual acuity (BCVA), central foveal thickness (CFT) measured by spectral domain optical coherence tomography, and intraocular pressure (IOP) were assessed at baseline and one month after the final injection. Results: The mean BCVA improved significantly from 0.82 ± 0.41 logMAR at baseline to 0.55±0.39 logMAR after treatment (p<0.001). The mean CFT decreased from 441.20 ± 148.60 μm to 358.62±142.41 μm (p<0.001). A total of 96.6% of treated eyes showed visual improvement, with 41.3% gaining two or more lines of vision. The most common complication was subconjunctival haemorrhage (21.3%), while serious adverse events such as retinal detachment and endophthalmitis were rare (2.7% each). Conclusion: Three monthly intravitreal Bevacizumab injections significantly improve both visual acuity and macular thickness in patients with diabetic macular oedema, with an acceptable safety profile.
Abstract Background: Proliferative diabetic retinopathy (PDR) is a vision-threatening complication of diabetes mellitus. Intravitreal Bevacizumab (Avastin), an anti-VEGF agent, is widely used to regress retinal neovascularization. Objective: To evaluate the effectiveness of intravitreal Bevacizumab injection among the patients with proliferative diabetic retinopathy. Methods: This comparative cross-sectional study was conducted at the Department of Ophthalmology, Sheikh Fazilatunnesa Mujib Eye Hospital & Training Institute from July 2022 to December 2023. A total of 112 PDR patients were equally divided into controlled (n=56) and uncontrolled (n=56) diabetes groups. All patients received intravitreal Bevacizumab (1.25 mg) and were followed up at 1 day, 2 weeks, and 1 month. Treatment response was assessed by fundus fluorescein angiography and categorized as complete, partial, or no regression. Results: The mean duration of diabetes mellitus was significantly higher among uncontrolled diabetic patients compared to controlled diabetic patients (15.4±4.36 vs. 10.8±3.98 years; p=0.001). IDDM was more common in both groups; however, the distribution of diabetes type was not significantly associated with glycemic control status (p=0.315). On the 1st post-procedure day, all patients in both groups showed no response to treatment. At the 2nd week follow-up, 96.4% of controlled diabetic patients achieved complete regression and 3.6% showed partial regression, whereas among uncontrolled diabetic patients, 32.1% achieved complete regression, 48.2% showed partial regression, and 19.6% showed no response (p=0.001). Similar findings were observed at the 4th week follow-up (p=0.001). Conclusion: Intravitreal Bevacizumab (Avastin) injection was found to be effective in the treatment of proliferative diabetic retinopathy, particularly among patients with well-controlled diabetes mellitus.
