M Abdur Rahim Medical College, Dinajpur (MARMC) is a public medical school in Bangladesh, established in 1992. It is located in the Dinajpur District of Rangpur Division. It is affiliated with Rajshahi Medical University. It was renamed from Dinajpur Medical College and Hospital to M Abdur Rahim Medical College and Hospital after M. Abdur Rahim.
Abstract Background: Hypospadias is one of the common genitourinary anomalies, has been treated with a variety of operative procedures, but tubularized incised plate urethroplasty (TIPU) has proven to be the most effective because of its simplicity and positive outcomes. The postoperative complications are thought to be reduced by a flap during the TIPU. It is still up for debate whether utilizing a flap is risk-worthy given the hazards involved in doing so as well as the issue of single or double layer urethral closure. Objective: To compare the outcomes of TIPU by single layer urethral closure with flap and double layer urethral closure without flap in mid and distal hypospadias. Methods: This prospective comparative study was conducted in the Paediatric Surgery Department, Mymensingh Medical College Hospital, Bangladesh, from January, 2022 to June, 2023. Patients aged up to 12 years with mid and distal hypospadias, according to inclusion and exclusion criteria was included in this study. Patients were divided alternatively in Group A(single layer with flap) and Group B(double layer without flap). Data of follow up schedule was recorded at 2nd, 4th, 8th and 12th week from the day of surgery. Data were processed both manually and by computer using computer software Statistical package for social sciences (SPSS) version 29.0.1.0. Results: 47 patients were enrolled, 24 were in group A and 23 were in group B with a mean age 6.16 ± 3.345 years. Mid penile, Distal penile and coronal hypospadias were 21%, 75% and 4% respectively. Postoperative complications were 41.7% in group A and 39.1% in group B (ρ = 0.849) with urethrocutaneous fistula (UCF) rate 33.3% and 30.4% respectively, less in 4-8 years age group. There were statistically significant differences (ρ < 0.05) between two groups in terms of operative time (94.46 ± 6.661 vs. 75.26 ± 2.800 min) and cosmetic outcome. Conclusion: Flap does not seem to reduce overall complications of TIPU, rather has its own hazards. Double layer urethral closure without flap is beneficial considering operative time and cosmetic outcome. Researching with a multivariable comparison group throughout a broad study population could a concrete conclusion be drawn.
Heatstroke (HS) encompasses acute multi-organ dysfunction and increases susceptibility to subsequent heat-related conditions, making timely diagnosis and intervention critical. This systematic review aimed to identify risk factors and long-term health consequences, evaluate cooling methods for field interventions, and assess the accuracy of predictive technologies. A comprehensive search of five major databases (MEDLINE/PubMed, Embase, Web of Science, Scopus, and CINAHL) was conducted in May 2024 for peer-reviewed English studies published between January 2014 and May 2024. Eligibility criteria included populations diagnosed with classic or exertional heatstroke (EHS) and reports on clinical outcomes. Methodological quality was assessed using the JBI critical appraisal tools, and the certainty of the evidence was determined using the GRADE system. Results were synthesized narratively due to study heterogeneity. Out of 1346 identified records, 39 studies were included. Risk of Bias (RoB) assessment categorized 66.7
Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly that typically presents in any age with progressive aortic regurgitation. A 55-year-old Bangladeshi woman came with a 3 weeks history of progressive dyspnea, intermittent chest tightness, and palpitations. Trans-esophageal echocardiography confirmed a QAV with central leaflet malcoaptation and mild aortic root dilatation. Further assessment with cardiac computed tomography and magnetic resonance imaging enabled detailed anatomical characterization, severity assessment, and operative planning. Multimodality imaging is crucial for accurate diagnosis, risk stratification and surgical decision-making. This case highlights the value of comprehensive imaging and individualized surgical planning in achieving favorable outcomes in patients with QAV.
Background Breast cancer remains a major public health concern in low- and middle-income countries (LMIC's), including Bangladesh, where delayed healthcare-seeking contributes to late-stage diagnosis and poor outcomes. This study aimed to identify factors associated with delay in seeking medical care among breast cancer patients in Bangladesh. Methods A cross-sectional study was conducted at the Department of Radiotherapy, Rangpur Medical College Hospital, Bangladesh, from January to December 2024. A total of 206 newly diagnosed breast cancer patients aged ≥ 18 years were included. Data were collected using an interviewer-administered structured questionnaire covering socio-demographic characteristics, clinical features, presenting symptoms, healthcare-seeking behavior, and perceived causes of delay. Data were analyzed using IBM SPSS Statistics version 27. Descriptive statistics, Pearson's chi-square test, and binary logistic regression were performed. Crude odds ratios (CORs) and adjusted odds ratios (AORs) with 95% confidence intervals were reported. Results The mean age of participants was 46 ± 11.0 years, and most patients were female (202, 98.0%). A breast lump was the presenting symptom in all patients. A large proportion of patients presented with advanced-stage disease, particularly Stage III (42.2%) and Stage IV (18.0%). Delay in seeking medical care was observed in 123 patients. The most common reported cause of delay was the use of traditional treatment/homeopathy (77.2%), followed by misinterpretation of symptoms as non-serious (24.4%). Cancer stage was significantly associated with delay in seeking medical care (p < 0.001). In the adjusted analysis, Stage IV disease was significantly associated with higher odds of delay [AOR = 10.8, 95% confidence interval (CI): 1.28-119, p = 0.039]. The strongest predictor of delay was first consultation with a homeopathy practitioner (AOR = 51.7, 95% CI: 19.7-163, p < 0.001). Socio-demographic factors, including age, residence, education, income, occupation, and smokeless tobacco use, were not significantly associated with delay. Conclusion Delay in seeking medical care among breast cancer patients in Bangladesh was mainly associated with initial consultation with homeopathy practitioners and advanced cancer stage, rather than socio-demographic factors. Strengthening public awareness, promoting early symptom recognition, improving referral pathways, and discouraging reliance on non-formal care pathways may help reduce delays in breast cancer diagnosis and treatment.
