Medical College for Women and Hospital

Vitamin D is widely known for its influence on the homeostasis of calcium and phosphate levels in the body and its involvement in maintaining musculoskeletal health. In its active form, 1,25-dihydroxy cholecalciferol, this vitamin has immunomodulatory effects on both the innate and adaptive immune systems. The active form of vitamin D plays a neuroprotective role in the central nervous system, highlighting its importance in maintaining brain health. Studies have noted the role of vitamin D in the formation of antioxidants, reduction of pro-inflammatory cytokines, lowering of oxidative stress, improvement of mitochondrial respiratory health, and slowing of the progression of neuronal damage. This vitamin may also influence development by facilitating the differentiation of cells, the expression of neurotrophic factors, the regulation of cytokines, the synthesis of neurotransmitters, intracellular calcium signaling, and the expression of genes involved in neuronal differentiation. An association has been noted between vitamin D deficiency and the risk of developing several neuronal diseases, including Parkinson's disease, headaches, multiple sclerosis, and Alzheimer's disease. The neuroprotective role of vitamin D suggests the potential benefit of vitamin supplementation in slowing the progression of such conditions and promoting brain health. It is essential to conduct further studies in the future to better understand the mechanisms by which vitamins affect brain health. It is also necessary to determine the potential benefits of vitamin D supplementation in patients with neurological diseases.

Background Renal stone disease constitutes a significant global urological burden, with percutaneous nephrolithotomy (PCNL) serving as the gold-standard treatment for large calculi. Mini-PCNL has emerged to reduce morbidity while preserving efficacy; however, comparative prospective evidence from South Asian settings, including Bangladesh, remains scarce. This study aimed to compare the clinical outcomes, including efficacy and morbidity, of mini-PCNL and standard PCNL in the management of renal stones. Methods A prospective comparative study was conducted at the Department of Urology, Chittagong Medical College Hospital, Chattogram, Bangladesh, and two private hospitals in the same region from May 2019 to April 2020. A total of 100 adult patients with renal calculi (1-3 cm) were recruited through nonprobability consecutive sampling and allocated equally into two groups on the basis of surgeon discretion and intraoperative judgment: standard PCNL (24-28 Fr, n = 50) and mini-PCNL (14-20 Fr, n = 50). Operative parameters, postoperative pain (visual analog scale (VAS) score), hemoglobin drop, hospital stay, stone-free rate, renal function, and complications were compared between the groups. Data were analyzed using independent t-tests and chi-square tests, with p < 0.05 considered statistically significant. Results Baseline characteristics, including age, sex, and stone size, were comparable between the groups. Mini-PCNL demonstrated a significantly shorter access time (4.28 ± 0.57 vs 7.87 ± 0.39 min, p < 0.001) and fluoroscopy time (3.75 ± 0.51 vs 5.83 ± 0.65 min, p < 0.001) but a longer operative time (94.53 ± 13.56 vs 78.60 ± 17.80 min, p < 0.001). Postoperative pain (VAS score: 5.52 ± 1.24 vs 7.04 ± 1.09, p < 0.001), hemoglobin drop (1.02 ± 0.32 vs 1.31 ± 0.79 g/dL, p = 0.018), and length of hospital stay (2.32 ± 0.46 vs 3.13 ± 0.72 days, p < 0.001) were significantly lower in the mini-PCNL group. Stone-free rates, renal function outcomes, and complication rates were comparable between the two techniques. Conclusions In this study, mini-PCNL was associated with lower perioperative morbidity, shorter hospital stay, and reduced fluoroscopy exposure compared with standard PCNL, while stone clearance was comparable between the two groups. However, operative time was longer with mini-PCNL. Given the nonrandomized allocation and potential for selection bias, these findings should be interpreted with caution. Larger randomized multicenter studies are needed to confirm these observations.

This narrative review examines the influence of helmet use on safety, comfort, cognition, and batting performance during cricket match play, with a view to proposing recommendations for design evolution and policy revision. The review involved an extensive exploration of leading databases, including Medline, SPORTDiscus, PubMed, and Scopus, covering the period from their inception to 30 December 2024. Findings confirm that helmets reduce head and facial injuries by attenuating impact forces, though visual obstruction and heat stress persist due to restricted airflow and faceguard design. Cognitive impacts vary: short-term use produces minimal effects on reaction time, whereas prolonged use may impair vigilance. Research on cardiovascular responses and repeated-sprint ability remains limited. The review concludes that helmets enhance safety but require better ventilation, fit, and adjustable faceguard gaps to balance protection and performance. Further studies on helmets' physiological and cognitive effects are needed to make cricket batting safer.

A bstract Background: Thyroid dysfunction includes both hypothyroidism and hyperthyroidism, conditions that influence metabolic and biochemical processes, including blood glucose regulation and its long-term control. Objectives: Therefore, the aim of this study was to estimate the prevalence of undiagnosed thyroid dysfunction (overt and subclinical hypothyroidism and hyperthyroidism) among selected professional groups in Dhaka, Bangladesh, and metabolic markers and explore gender differences in the prevalence of thyroid disorders. Materials and Methods: This is a cross-sectional study including 401 patients. Data collection was done from 2023 to 2024 in Dhaka, Bangladesh. A stratified random sampling was used for selecting sample size such as corporate, education, healthcare, and government. Results: Most participants were euthyroid (85.5%), followed by those with hypothyroidism (13.2%) and hyperthyroidism (1.2%). Significant differences in thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels appeared for hyperthyroid and hypothyroid groups ( P < 0.05), with the hypothyroid group showing higher TSH and lower levels of FT4. Blood sugar is weakly though significantly positively correlated with FT4 ( r = 0.113, P < 0.024), and there was a strong correlation of blood sugar and glycated hemoglobin A1c ( r = 0.849, P < 0.001). Gender differences were noted, with males having predominantly subclinical hypothyroidism and females having overt hypothyroidism. Conclusion: This study found that while most participants were euthyroid, a notable proportion had previously undiagnosed thyroid dysfunction, predominantly subclinical hypothyroidism, among professional groups in Dhaka. Gender-specific patterns were observed, with overt hypothyroidism more common in females and subclinical hypothyroidism more frequent in males.

A bstract Background: Effects of meal- and sleep-related factors on glucometabolic control among South-Asian people with type 2 diabetes mellitus (T2DM) were inadequately reported, especially in the context of sex. Objective: This study evaluated the sex-specific associations of meal- and sleep-related factors on glucometabolic control among people with T2DM. Materials and Methods: From February to December 2025, we enrolled 694 adults with T2DM across four hospitals. Data collection included meal- and sleep-related histories, physical measurements (height, weight, waist circumference, and blood pressure [BP]), and glucometabolic parameters (e.g., glycated hemoglobin, plasma glucose, fasting lipid profiles, and body indices). Findings were categorized and evaluated against established clinical recommendations to identify abnormal health values. Results: Obesity and dyslipidemia were more frequent in females compared with males. More than three daily meals were associated with higher odds for hypertriglyceridemia (odds ratio [OR] = 2.0) in males but lower odds for low high-density lipoprotein-cholesterol (OR = 0.4) in females. Bedtime after 11 pm was associated with higher odds for general (OR = 2.1) and central obesity (OR = 1.9) only in males. Dinner–bedtime interval up to 2 h was associated with higher odds for high total cholesterol (TC), both for males (OR = 2.4) and females (OR = 1.8), and uncontrolled systolic BP (OR = 1.7) in females. Sleep duration at night below 6 h was associated with higher odds for uncontrolled diastolic BP (OR = 2.8) and overall uncontrolled BP (OR = 2.5) in males, and higher odds for high TC (OR = 1.7) in females. Conclusion: Meal- and sleep-related factors may be associated with poor glucometabolic status with distinctive sex-specific association in people with T2DM.