Khulna Medical College

Non-alcoholic fatty liver disease (NAFLD) and type 2 Diabetes Mellitus are the major causes of significant mortality and morbidity. NAFLD and type 2 diabetes have common risk factors. SGLT-2 inhibitors are believed to have a beneficial effect on liver fat in patients with NAFLD and type 2 diabetes. However, there are limited data available on this aspect of empagliflozin use. Thus, we aimed to compare the impact of empagliflozin on liver fat reduction in type 2 diabetes and NAFLD. A comprehensive search of databases like PubMed, Google Scholar, and Cochrane Library was done. In the end, a detailed analysis was performed on a total of 6 finalized studies, all of which were randomized controlled trials. This comprehensive analysis consisted of a cohort of 589 Individuals. A total of six studies were included. Primary outcomes assessed were MRI-PDFF, AST, ALT, HOMA-IR and total bilirubin. Empagliflozin significantly reduced liver fat compared to placebo, with a pooled standardized mean difference (SMD) of −0.43 (95

Introduction: In the medical colleges, mental health of medical students is improperly affected by learning process which has unavoidably led to high incidence of depression, anxiety and stress among them. Information regarding related possible contributing factor of emotional status of recently admitted MBBS student can help necessary steps to prevent or treat any psychiatric morbidity like depression, anxiety and stress. Objectives: This study was conducted to assess the factors responsible for stress, anxiety and depression among Phase-I medical students of Khulna city. Methodology: This was a cross sectional descriptive study. Four hundred Phase-I medical students from a public and three private medical colleges of Khulna city were taken as sample. They were given structured questionnaire forms to fill up. In the first phase, the validated DASS-21, Bangla version screening tool was used to evaluate the prevalence of depression, anxiety and stress among the subjects. Demographic variables such as age, gender and socioeconomic conditions of the family were also noted. Results: Among the sample, 61.1% (244) were female and 38.9% (156) were male. 47.5% (190) of the participants were from the government medical college and 52.5% (210) were from the private medical colleges. The prevalence of depression, anxiety and stress were found 39.0% (156), 28.2% (113) and 32.0% (128) respectively in total participants. The prevalence of depression in male and female students were 39.1% (61) and 60.9% (95) respectively. The prevalence of anxiety in male and female students were 46.9% (46) and 53.1% (52) respectively. Similarly, the prevalence of stress found in male and female students were 39.8% (51) and 60.2% (77) respectively. Conclusion: The common causes of stress disorder were found out to be academic troubleshot as poor performance in examinations 46.7% (187), difficulty in understanding the lesson 51% (204), difficulties in memorizing 60% (240). Medicine Today 2026, Vol.38 (2): 276-281

Advances in childhood cancer treatment have markedly improved survival, but survivors remain at risk of late endocrine and reproductive complications. Chemotherapy, particularly alkylating agents, cranial or pelvic radiotherapy and hematopoietic stem-cell transplantation may impair the hypothalamic-pituitary-gonadal axis and directly damage the gonads. Survivors may develop precocious, delayed, or arrested puberty, hypogonadism, reduced ovarian reserve, impaired spermatogenesis, and infertility. Importantly, normal pubertal development does not always indicate preserved fertility. Early identification through treatment-exposure assessment, growth and pubertal monitoring, hormonal evaluation and appropriate fertility assessment is essential. Fertility-preservation strategies should ideally be discussed before cancer treatment and continued throughout survivorship. A structured, multidisciplinary approach can improve reproductive health and quality of life in childhood cancer. [J Assoc Clin Endocrinol Diabetol Bangladesh, 2026;5(Suppl 1): S13]

Abstract Background: Sleep apnea (SA), predominantly in its obstructive form (OSA), and hypertension (HTN) are 2 of the most prevalent chronic conditions worldwide, each independently associated with substantial cardiovascular morbidity and mortality. Mounting evidence supports a bidirectional, self-reinforcing pathophysiological relationship between these 2 disorders, yet this interplay remains underappreciated in routine clinical practice. Methods: We conducted a comprehensive narrative review of peer-reviewed literature published between 1990 and 2025. Databases searched included PubMed/MEDLINE, EMBASE, and the Cochrane Library using search terms encompassing obstructive sleep apnea, central sleep apnea, HTN, resistant HTN, blood pressure, sympathetic nervous system, intermittent hypoxia, continuous positive airway pressure, and related mechanistic and therapeutic terms. Landmark prospective cohort studies, randomized controlled trials, systematic reviews, meta-analyses, and high-quality mechanistic studies were included. Results: Obstructive SA affects 9–38% of the adult population and is independently associated with a 2.89-fold increased risk of incident HTN in prospective cohorts. Mechanistic pathways driving OSA-associated HTN include intermittent hypoxia-mediated sympathoexcitation, oxidative stress, endothelial dysfunction, renin–angiotensin–aldosterone system upregulation, systemic inflammation, and impaired baroreflex sensitivity. Conversely, HTN perpetuates OSA through nocturnal rostral fluid redistribution causing upper airway edema, aldosterone-mediated pharyngeal narrowing, and altered ventilatory control. Resistant HTN (RH) exhibits OSA prevalence rates of 64–83%. Continuous positive airway pressure therapy produces mean systolic blood pressure reductions of 2–3 mmHg, with substantially greater effects in RH, severe OSA, and patients with high nocturnal hypoxemic burden. Mineralocorticoid receptor antagonists show dual benefit in the RH–OSA–-aldosterone excess phenotype. Conclusions: Obstructive SA and HTN form a bidirectional, self-amplifying pathological cycle. Systematic OSA screening in hypertensive patients and blood pressure evaluation in patients with OSA are warranted. Integrated, multidisciplinary management targeting both conditions simultaneously offers the greatest potential for cardiovascular risk reduction.