Mymensingh Medical College (Bengali: ময়মনসিংহ মেডিকেল কলেজ), formerly Lytton Medical School, is a public medical college and hospital in Mymensingh, Bangladesh. The institute was established in 1924 during the British Raj under the former name. Brigadier General Fazlul kabir is the present director of the medical college hospital.
BACKGROUND:Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are widely used in managing type 2 diabetes (T2D). A significant number of these patients choose to observe religious fasting during Ramadan. Although existing guidelines recommend caution when administering SGLT2i during Ramadan due to potential adverse effects, there is limited data on their use in this patient population. AIM:To assess the safety and effectiveness of SGLT2i in patients with T2D who fast during Ramadan. METHODS:Relevant studies involving adults with T2D who received an SGLT2i in the intervention arm and other glucose-lowering drugs in the control arm were systematically searched through electronic databases. The primary outcome was the occurrence of adverse events in the two groups; additional outcomes included changes in glycemic and anthropometric parameters during the peri-Ramadan period. RevMan Web was used to conduct meta-analysis using random-effects models. Outcomes were presented as mean differences (MDs) or risk ratios (RRs) with 95%CI. RESULTS:Twelve studies involving 3625 subjects were included. The risks of postural dizziness (RR = 6.39, 95%CI: 1.58-25.80, P = 0.009, I 2 = 44%), hypotension/postural hypotension (RR = 4.43, 95%CI: 1.35-14.55, P = 0.01, I 2 = 31%), and sodium loss (MD = -1.00 mmol/L, 95%CI: -1.34 to -0.67, P < 0.00001, I 2 = 0%) were higher in the SGLT2i group compared to the non-SGLT2i group. The SGLT-2i group achieved larger reductions in systolic (MD = -2.41 mmHg, 95%CI: -4.52 to -0.30, P = 0.02, I 2 = 46%) and diastolic blood pressure (MD = -1.71 mmHg, 95%CI: -2.70 to -0.72, P = 0.0007, I 2 = 20%), and experienced a lower risk of symptomatic hypoglycemia (RR = 0.53, 95%CI: 0.29-0.97, P = 0.04, I 2 = 69%). The two groups exhibited comparable changes in glycated hemoglobin, body weight, and renal function. The risks of other specific adverse events, including dehydration, dizziness, volume depletion, symptomatic hyperglycemia, severe hypoglycemia, and genitourinary infections, were identical in the two groups. CONCLUSION:SGLT2i may be generally safe and effectively manage T2D during Ramadan; however, the results are less robust and should be interpreted with caution. Large multicenter randomized trials are necessary to confirm their safety, especially for at-risk groups, and to improve clinical decision-making.
Globally, undergraduate students exhibit a higher tendency towards tobacco and other substance use. Although there are almost 50,000 undergraduate medical students studying in Bangladesh currently, evidence regarding the prevalence of tobacco other substance use among them is very limited, let alone the predictors. This research aims to investigate the prevalence of tobacco or other substance use among medical students in Bangladesh and to investigate the factors associated with tobacco or other substance use. This cross-sectional study was conducted between May 2023 and August 2024 in sixteen medical colleges in Bangladesh. A total of 1,129 medical students were selected by convenience sampling, and data were collected using an online self-reported semi-structured questionnaire. Descriptive statistics, chi-square test, t-test, and multiple logistic regression model were used to report the study findings. The mean age of the students was 22.3 (± 2) years, with slightly higher female preponderance (52.3
OBJECTIVES:Metabolic dysfunction-associated steatotic liver disease (MASLD) is common and linked to cardiometabolic comorbidities, with few direct comparisons between glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors (SGLT2is). METHODS:This multicenter, retrospective, propensity score-matched cohort study utilized data from the TriNetX U.S. Collaborative Network. Adults with MASLD and at least one metabolic comorbidity were identified as new initiators of semaglutide (n = 128,332) or SGLT2is (n = 100,542), excluding alternative exposures and confounding liver etiologies. One-to-one propensity score matching on >50 covariates yielded balanced cohorts of 55,525 patients each. Time-to-event outcomes, including all-cause mortality, hospitalization, major adverse cardiovascular events, major adverse liver outcomes, major adverse kidney events, ascites, hepatic failure, and hepatic encephalopathy, were evaluated at 1-year and 5-year follow-ups using Kaplan-Meier analysis and Cox proportional hazards models. RESULTS:Semaglutide was linked to significant risk reductions compared to SGLT2is. At 1-year, hazard ratios (HRs) were 0.382 (95% CI 0.338-0.430) for all-cause mortality, 0.444 (95% CI 0.429-0.459) for all-cause hospitalization, 0.502 (95% CI 0.476-0.530) for major adverse cardiovascular events, and 0.361 (95% CI 0.316-0.412) for major adverse liver outcomes. At 5-years, the corresponding HRs were 0.494 (95% CI 0.459-0.531), 0.565 (95% CI 0.551-0.579), 0.584 (95% CI 0.560-0.609), and 0.494 (95% CI 0.452-0.540). Major adverse kidney events showed no difference at 1-year (HR 0.998), but a reduction at 5-years (HR 0.858; 95% CI 0.789-0.933). Individual liver events (ascites, hepatic failure) followed similar patterns. CONCLUSIONS:In this large real-world MASLD cohort, initiating semaglutide was linked to potential reductions in mortality, hospitalization, and adverse cardiometabolic, liver, and kidney outcomes compared to SGLT2is.
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.
Political unrest heightens women’s vulnerability to psychosocial distress and depression. The July 2024 revolution in Bangladesh caused major societal disruption, yet its mental health impact on women is poorly understood. This study assessed the prevalence and associated factors of depression among adult women during this period of unrest. A cross-sectional design was conducted among 687 adult women using a structured, validated questionnaire. Depression was assessed through a Patient Health Questionnaire-9 (PHQ-9) with seven self-reported health outcomes. A PHQ-9 score ≥ 10 is considered depression; otherwise, no depression. A binomial Logistic regression and a Pearson Chi-square test were used to identify factors associated with depression. Overall, 54.87
