Global research consistently identifies significant disparities in the diagnosis of Autism Spectrum Disorder (ASD), strongly associated with family socioeconomic status and geographic location. However, such data from low-resource settings like Bangladesh is critically lacking. This case-control study aimed to characterize the socioeconomic and geographic profiles of children clinically diagnosed with ASD at a major tertiary centre in Bangladesh. The study was conducted at Department of Pediatrics, Mymensingh Medical College & Hospital, Bangladesh; Institute of Pediatric Neurodisorder and Autism (IPNA), BMU; Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh from June 2021 to May 2022, enrolling 25 children with ASD and 25 typically developing controls aged 3-16 years. Data on key demographic indicators, including parental education, family income, place of birth and residence characteristics, were collected through parental interviews. Statistical analyses revealed profound disparities. Children with ASD were significantly more likely to come from families with higher parental education (Fathers: 80.0% vs. 16.0%; Mothers: 76.0% vs. 12.0%), higher monthly family income (92.0% vs. 44.0%) and an urban birthplace (80.0% vs. 32.0%). Furthermore, residence near a high-traffic road was a strongly associated environmental factor (92.0% vs. 44.0%). These findings highlight significant inequities in the pathway to an ASD diagnosis in Bangladesh, which are likely driven by differential access to specialized healthcare, varying levels of parental awareness and the urban concentration of diagnostic services rather than causal risk factors. The results underscore an urgent public health imperative: to develop and implement equitable strategies that enhance ASD awareness, decentralize diagnostic capabilities and ensure that all children in Bangladesh, irrespective of their socioeconomic background or place of residence, have an equal opportunity for timely identification and support.
Abdominal obesity, measured by waist-to-hip ratio, is an independent, potent risk factor for Ischemic Stroke. Risk of stroke can be minimized through primordial prevention. The study was conducted to assess the high waist hip ratio as a risk factor for Ischemic Stroke. A case control study was conducted with IRB approval in the department of Medicine and Neurology, Mymensingh Medical College Hospital for a period of six months with 100 admitted Ischaemic Stroke cases selected purposively following inclusion and exclusion criteria with equal number of age-sex matched pair controls from patients' relatives, hospital staffs and admitted patients other than Ischaemic Stroke. Waist-hip ratio was calculated by dividing the waist circumference with the hip circumference. Socio-demographic, clinical, biochemical and haematological data were collected as well. Informed written consent was obtained from the participants or their guardians/attendants for interview, physical measurements and taking blood samples for biochemical examinations. Data were collected by principal investigator using case record form and interview schedule. All the relevant ethical issues and measures for data quality were taken into consideration. Data were analyzed by using SPSS version-17.0, and presented in tables and figures. Mean age of the cases and controls was 63.4±2.0 years with a male-female ratio of 3:2. Of cases, 35(35.0%) were house-wives and 32(32.0%) were Farmers, while of controls, 40(40.0%) were house-wives and 23(23.0%) were farmers. Left hemisphere 58(58.0%), and cerebral cortex 48(48.0%) were commonly involved areas of the brain. Hemiplegia (57.0%) and hemi-paresis (31.0%) were commonplace with exacerbated ankle jerk (60.0%) and extension planter response (55.0%). As many as 12(12.0%) cases and 16(16.0%) controls were diabetic (p>0.05) with 7(7.0%) cases and 1(1.0%) control had past history of Ischemic Heart Disease (p<0.05). 59(59.0%) cases and 33(33.0%) controls had Systolic Hypertension (p<0.001), while 48(48.0%) cases and 21(21.0%) controls had Diastolic Hypertension (p<0.0001). Seventy-five (75.0%) cases and 30(30.0%) controls had high waist-hip ratio (p<0.001). At least 39(39.0%) cases and 37(37.0%) controls had high total cholesterol level (p>0.05), whereas 52(52.0%) cases and 30(30.0%) controls had low HDL cholesterol level (p<0.0001), 54(54.0%) cases and 46(46.0%) controls had high LDL cholesterol level (p>0.05) and 63(63.0%) cases and 37(37.0%) controls had high triglyceride level (p>0.05). Waist-hip ratio is high among cases with high statistical significance. A significant number of cases and controls are with total cholesterol and high LDL, low HDL and high TG levels.
This descriptive type of cross sectional study was conducted to assess the post-partum family planning practices among 678 mothers who delivered in the last 12 months in selected areas of Gazipur district. The study was conducted from 17th September 2022 to 30th November 2022 and the data were collected through face to face interview from the villages of Sataish, Gutia and Rajabari of Gazipur district. A pre-tested, semi-structured, questionnaire was used to collect data for knowing their socio-demographic characteristics and practice of family planning methods. Out of 678 respondents, maximum (41.45%) mother were in the age group of 21-25 years. Almost all (96.00%) were Muslim. In terms of education 42.63% mothers were primary passed. Participants were mainly house wives (80.24%) and two-third (65.00%) mothers belong to nuclear family. Maximum mothers (42.92%) belongs to lower socio-economic class (10001-20000 taka). In the present study, the prevalence of postpartum family planning method use was (69.00%), among them more than half (59.00%) mothers used within 6 months after delivery. Almost half (49.00%) of the couple took decision combinedly and among user, most (41.79%) of them used combined oral pill. Majority (87.00%) of the mothers heard about family planning methods and half (51.87%) of the respondents got information from the health personnel. Two-third (66.99%) of the mothers received family planning counselling and (43.72%) received counselling during postnatal period. In this study, maximum (83.80%) mothers does not have any side effects after family planning methods use. Only (16.20%) had side effects, among them (32.85%) felt generalized weakness. Mothers (31.00%) who did not use family planning methods, among them (36.84%) had fear of side effects and very few (12.92%) reported that no sexual contact after delivery. Since family planning methods are not only for limiting births and the well-being of women, but also for the well-being of each family in society, improving the country's economy and maintaining the earth's ecological balance. As a result, family planning programs should be multidisciplinary in nature. It should include educating both husband and wife and other family members, enabling women to make decisions, raising literacy rates and developing the country's health system so that misconceptions about contraception can be corrected as needed by health workers and allied personnel.
Femoral neck fractures are common fractures and constitute a major health problem especially in elderly. Primary total hip arthroplasty has advantages with little or no comorbidities because it gives good functional outcomes. The study was aimed to assess the outcome of primary total hip arthroplasty in displaced fracture neck of femur in elderly patients. This quasi-experimental study was conducted at National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, from March 2021 to September 2023 among 30 patients with displaced fracture neck of femur, aged 60 years or more. All the cases underwent primary total hip arthroplasty by lateral Hardinge approach and were evaluated by clinical features, imaging by X-ray and Harris Hip Score (HHS). Six months follow up was done with clinical and functional assessment. The mean age was 62.5±2.58 years with a male predominance (53.0%). The main cause of injury was fall on ground (77.0%) and most cases there were left side involvement (57.0%). The mean interval between injury and surgery was 18.5±6.85 days. Complications were 2(7.0%) superficial wound infection and 2(7.0%) abductor weakness. In the last follow up after operation, 84.0% cases had no pain and 16.0% cases have complained slight pain. The mean flexion of hip at last follow up was 101.84°±7.25°. Mean abduction and adduction was 30.0°±0.0° and 25.67°±5.04° respectively. Internal rotation and external rotation at last follow up was 20.0°±0.0° and 20.0°±0.0° respectively. The mean HHS at 1st, 2nd and 3rd follow up was 68.64±5.94, 80.47±7.42 and 86.6±5.97 respectively and the increasement was statistically significant at each possible combination (p value <0.001 at each comparison). Finally, out of 30 cases, 16(53.0%) were excellent, 11(37.0%) were good, 2(7.0%) were fair and the rest 1(3.0%) was poor. Based on results of this study, it can be concluded that treatment of displaced femoral neck fracture in elderly patients with primary total hip arthroplasty is a satisfactory method.
Collecting data is essential to analyse demographic and clinical trends, measure the effectiveness of ptosis correction caused by lesions and determine the possibility of the progression of the disease. From 2015 to 2020, a prospective observational study was conducted in tertiary eye care in Bangladesh. The study included all patients who received surgical correction for mechanical ptosis caused by neurofibromatosis. The primary treatment approach was to remove the lesion through excision or debulking, followed by ptosis correction, either FBS (Frontalis Brow Suspension) or LPS (Levator Palpebrae superioris) reattachment. The results were assessed based on the extent of lesion reduction, the correction of ptosis and the likelihood of recurrence. The grading system ranged from a low score (poor) to an average score (fair) to a satisfactory score. A thorough examination was conducted on 48 cases, with an average age of 19.21. It was discovered that 29.0% of the cases presented mild ptosis accompanied by s-shaped PN (Palpebral neurofibromatosis). About 31.0% of individuals experience moderate ptosis, defined by OPN (Orbits-palpebral neurofibromatosis). In 40.0% of severe ptosis cases, OPN and TOPN (Temporo-orbital-palpebral neurofibromatosis) are present. The average MRD1 (Margin-reflex distance 1) measurement before surgery was -0.819 mm for patients who had ptosis surgery with LPS resection (75.0% of cases). In comparison, patients who had undergone FBS had an average preoperative MRD1 of -0.929 mm (25.0% of cases). Following a six-month surgical procedure, the average MRD1 measurements were +1.208 mm for LPS resection cases and +0.750 mm for FBS cases. The outcome was better in LPS resection than in FBS. Progression of the disease is common in severe cases of plexiform neurofibromatosis among young individuals. An optimal surgical solution for achieving satisfactory results and enhanced appearance demands a careful evaluation of the affected area, followed by removing the lesion through excision or debulking surgery and correcting any ptosis in a single procedure. This approach can undoubtedly provide exceptional cosmetic results.
Excessive electronic media use in early childhood is a potential risk factor for autism spectrum disorder (ASD), though evidence is inconclusive. This study examines screen exposure's relationship with ASD incidence and severity in Bangladeshi children. A hospital-based case-control study at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from July 1 2022 to June 30 2023, enrolled 260 participants (130 with ASD per DSM-5 criteria and 130 age-matched controls). Data were collected via structured caregiver interviews on children's screen exposure (including any exposure in the first year, initial exposure age, daily duration, hours during the first year and maternal screen use). ASD severity was assessed using the Autism Diagnostic Observation Schedule (ADOS). Group differences were evaluated using t-tests and χ² tests and correlations between exposure variables and severity were examined using Pearson's coefficients. Eighty percent of ASD cases were exposed to screens in their first year, compared with 46.2% of controls (p<0.001). Mean daily screen time was 6.26±2.37 hours for cases and 1.72±1.29 hours for controls (p<0.001). Children with ASD began exposure earlier (13.68±8.21 vs. 18.09±5.42 months, p<0.001). Screen duration and infant hours showed significant positive correlations with ADOS severity scores (r ≈ 0.30, p<0.001), while age at first exposure correlated negatively (r = - 0.31, p<0.001). Early, prolonged screen exposure was significantly associated with ASD diagnosis and symptom severity. Though causality is not established, these findings emphasize delaying screen introduction and promoting interactive play during early development.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with well-recognized female predominance; however, disease expression and severity may differ by gender. Data on gender-based differences in SLE from Bangladesh remain limited. This study aimed to compare sociodemographic characteristics, clinical manifestations, immunological profiles and disease activity indicators between male and female patients with SLE. This cross-sectional study was conducted at the Lupus Clinic, Department of Rheumatology, Bangladesh Medical University (BMU), Dhaka, Bangladesh, from December 2019 to January 2021. A total of 140 patients who fulfilled the classification criteria for SLE were enrolled, including 130 females and 10 males. Demographic data, clinical features, immunological and serological parameters, Safety of Estrogens in Systemic Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI) were analyzed and compared by gender. The female-to-male ratio was approximately 13:1. Male patients presented at younger ages (p=0.002) and had earlier disease onset than females (p=0.011). Lupus nephritis was significantly more frequent among male patients (p=0.037). Anti-dsDNA levels were higher in male patients, though not statistically significant; complement (C3) levels were significantly lower in male patients (p=0.014). Male patients had significantly higher disease activity (SELENA-SLEDAI) scores than females (p=0.044), whereas cumulative organ damage was comparable. Despite lower prevalence, male SLE patients exhibited more severe disease manifestations and higher activity. These findings underscore the importance of heightened clinical vigilance and gender-sensitive management strategies in SLE.
Anemia is a common complication of chronic kidney disease (CKD), particularly in patients with stage 5 disease and is associated with increased morbidity and mortality. This retrospective cohort study compared the effectiveness and short-term safety of Roxadustat versus erythropoietin (EPO) for the management of anemia among patients with CKD stage 5. Medical records of 198 adult patients were reviewed, including 99 patients treated with Roxadustat and 99 matched patients treated with EPO, matched 1:1 by age, sex and baseline hemoglobin level. Changes in hemoglobin, hematocrit, iron profile and adverse events over a three-month period were analyzed. Baseline hemoglobin levels were comparable between the Roxadustat and EPO groups (8.62±0.74 vs. 8.59±0.71 g/dL; p=0.756). At three months, mean hemoglobin increased significantly in both groups; however, the mean hemoglobin increase was greater in the Roxadustat group (2.21±0.34 g/dL) compared with the EPO group (2.04±0.37 g/dL; p=0.001). Absolute hemoglobin levels at three months did not differ significantly between groups (10.82±0.85 vs. 10.61±0.76 g/dL; p=0.071). Hematocrit at three months was slightly higher in the Roxadustat group (32.4±2.51% vs. 29.92±2.42%; p<0.001). Roxadustat-treated patients demonstrated favorable iron utilization, with higher transferrin saturation (26.0±6.2% vs. 24.0±6.1%; p<0.029) and serum ferritin levels (551±118.3 vs. 591±136 ng/mL; p=0.033) compared with the EPO group. A higher proportion of patients in the Roxadustat group achieved a hemoglobin level ≥10 g/dL (74.8% vs. 64.6%), although this difference was not statistically significant (p=0.122). The incidence of adverse events, including hypertension, electrolyte abnormalities, infections, headache, edema, thrombosis, seizure etc were comparable between the two groups (p>0.05 for all). In conclusion, Roxadustat was associated with increase in mean hemoglobin and more favorable iron metabolism parameters compared with erythropoietin, while demonstrating a similar short-term safety profile. These findings suggest that Roxadustat may represent a viable alternative to conventional erythropoiesis-stimulating agent therapy for the management of anemia in patients with CKD.
Hypovitaminosis D is a global public health concern and is known to be prevalent worldwide including in tropical countries. Data on its prevalence and determinants are scarce in Bangladesh. The objective of this study was to determine the vitamin D status and its dietary and lifestyle determinants among adult people attending selected clinical laboratories. It was a descriptive cross-sectional study conducted among 221 people undergoing laboratory investigation for serum 25- hydroxy vitamin D in selected two laboratories during the period of January 2022 to March 2022 (three months). The association between vitamin D status & individual specific variables was statistically analyzed. Out of 221 respondents, 156(70.59%) were female and 65(29.41%) were male, with a mean age of 45.32±17.41 years. Regarding serum vitamin D level, only 12.2% of respondents had a sufficient level of vitamin D and hypovitaminosis D was prevalent among 87.8% of respondents with 49.3% deficiency and 38.5% insufficiency. Vitamin D deficiency was found more among females (55.80%) compared to males (33.80%). This study reveals no milk intake (p=0.015) and traveling by car and motorbike (p=0.042) was significantly associated with hypovitaminosis D. No significant associations of vitamin D deficiency and insufficiency were detected with sea fish/oily fish consumption, vitamin D supplementation, covering clothes of females, use of sunscreen, physical exercise and smoking habit of the respondents. The study findings recommend encouraging people to take vitamin D-containing foods to prevent hypovitaminosis D and related consequences.
Right bundle-branch block (RBBB) during acute ST elevation. Known about how RBBB influences the prognosis of acute STEMI in the background of changing demography. The main objective of the study was to determine the prognostic significance of RBBB in acute STEMI patients. This prospective observational study was performed in the National Institute of Cardiovascular Diseases (NICVD), Dhaka from August 2015 to September 2016. Total 216 patients with acute STEMI were included in this study who presented within 12 hours of chest pain. All patients received thrombolysis. In Group I, 108 patients were included with RBBB and another 108 patients without RBBB were included in Group II. Mean age of Group I and Group II were 54.31±10.35 and 51.34±8.98 respectively. Male female ratio was 4.4 and 3.5 in Group I and Group II respectively. In patients with Group I and Group II in-hospital mortality was 20.4% versus 7.5% (p=0.006). The following complications were more frequently associated with Group I acute heart failure (Killip class II) 27.8% versus 13% (p.007), cardiogenic shock 16.7% versus 7.5% (p=.03), ventricular tachycardia 14.8% versus 6.5% (p=0.04), third-degree atrioventricular block 11.1% versus 4.6% (p<0.05), use of temporary pacemaker was in 9.3% versus 2.85% (p<0.05). Logistic regression analysis showed RBBB was independent factor associated with in-hospital mortality (RR 1.96, p=0.002). Acute STEMI patients with RBBB had higher in-hospital mortality compared with acute STEMI patients without RBBB. Complications such as acute heart failure, cardiogenic shock, ventricular tachycardia, third-degree atrioventricular block and use of temporary pacemaker were more common in RBBB of acute STEMI patients. RBBB in acute anterior STEMI was an independent predictor for in-hospital mortality in the multivariate analysis of this study.
Herniation of bladder into inguinoscrotal region is relatively rare and incidence rate is 1 to 3%. Patient presents with typical complains and complication. To prevent complications early diagnosis with imaging is necessary. Diagnosis can be made by Intravenous pyelography, Retrograde urethrography (RGU), Micturating cystourethrography (MCU), pelvic Ultrasound (USG), Computed tomography (CT) and magnetic resonance imaging (MRI). In this case report, 52 years old male patient presented with huge inguino-scrotal swelling, dysuria and manual compression leading to ease on voiding resulting shrinkage of scrotal swelling and was diagnosed as scrotal cystocele by RGU, MCU in conjugation with USG and CT.
This study evaluated the in vitro antibacterial activity of aqueous extracts of guava (Psidium guajava) leaves against two pathogenic bacteria: Gram positive Staphylococcus aureus and Gram negative Escherichia coli. The interventional study was conducted from July 2021 to June 2022 in the Department of Pharmacology and Therapeutics in collaboration with the Department of Microbiology, Mymensingh Medical College, Bangladesh. Antibacterial activity of the aqueous guava leaf extract (AGLE) was assessed at various concentrations using disc diffusion and broth dilution methods. Gentamicin was used as a standard antibiotic control in the broth dilution test and its activity was compared with that of AGLE. The extract was initially tested at eight concentrations (25, 50, 100, 200, 400, 600, 800 and 1000 μg/mL), followed by additional selected concentrations to more precisely define the sensitivity range and determine the minimum inhibitory level. Concentrations of 800 μg/mL and above produced clear inhibitory effects against both S. aureus and E. coli. The minimum inhibitory concentration (MIC) of AGLE for both organisms was 800 μg/mL. In contrast, the MIC of gentamicin was 1.5 μg/mL for S. aureus and 1 μg/mL for E. coli, indicating a substantially stronger antibacterial effect of gentamicin compared to AGLE under the same experimental conditions. Overall, the findings demonstrate that aqueous guava leaf extract possesses measurable antibacterial activity against S. aureus and E. coli, although its potency is lower than that of Gentamicin and suggest that guava leaves may serve as a potential complementary source of antimicrobial agents' in future antimicrobial drug research and development.
Diabetes mellitus is a syndrome of impaired carbohydrate, fat and protein metabolism caused by either lack of insulin secretion or decreased sensitivity of the tissues to insulin. The cross sectional study was performed in the department of Biochemistry, Mymensingh Medical College from July 2021 to June 2022 with the approval of the institutional review board (IRB) of Mymensingh Medical College. Total 100 subjects were included in this study. Out of them, 50 were selected as Group I and 50 as Group II. Group I noted as known case of Type 2 diabetes mellitus patients (diagnosed according to history and fasting serum glucose level ≥7.0 mmol/L and 2 hours after breakfast serum glucose level ≥11.1 mmol/L) age ranging from 35-65 years; where as Group II apparently healthy people of same age group. Serum Calcium was determined by colorimetric method with cresolphthalein. Pre assessed data were recorded in a collection sheet. Statistical analysis was done by using SPSS (Statistical Package for Social Science) version 26.0 windows package. Unpaired t' test was done between Group I and Group II. The difference in mean BMI was not significant (p>0.05). The mean ±SD values of serum calcium were 9.65±0.40 mg/dl and 11.02±0.70 mg/dl in Group I and Group II respectively. Serum calcium was decreased markedly in patients with Type 2 diabetes mellitus. So, early evaluation of Serum calcium (Ca) may reduce the complications of type 2 diabetes mellitus.
Neutropenic enteropathy (NEP) is one of the important causes of death due to infectious complication during induciton phase of chemotherapy in children with Acute Lymphoblastic Leukemia (ALL). So the objective of this study was to identify the risk factors of NEP. This prospective study was conducted in the Department of Pediatric Hematology & Oncology, Bangladesh Medical University (BMU), Bangladesh from November 2018 to January 2021. Total 98 ALL children were included in this study, among them 36 children developed NEP and 62 children did not develop NEP. Detailed history, clinical examination, hematological examination, laboratory examination, plain X-ray abdomen, abdominal ultrasonogram were performed in all cases. Majority of children with ALL were within the age of 1-10 years (70.0%) and females (63.3%). Children receiving regimen B were more common in children with NEP (80.6%) which was statistically significant (p=0.004). Hypokalemia (13.9%), hyponatremia combined with hypokalemia (44.4%) and hypoalbuminemia (41.2%) was significantly higher in children with NEP (p<0.05). Ultra sonogram findings revealed increased BWT (13.9%) and distended bowel loop (58.3%) was significantly higher in children with NEP (p<0.05). Regarding risk factors of neutropenic enteropathy mucositis, prolonged neutropenia (>7 days), septicemia and use of daunorubicin were found to be significantly different between children with NEP and children without NEP (p<0.05). Multivariate analysis demonstrated, prolonged neutropenia [OR (95% CI) = 44.5(2.82-701.6); p=0.007] and septicemia [OR (95% CI)=44.1(1.46-1334.1); p=0.029] were found to be significant risk factors for development of NEP. NEP is a life-threatening condition especially during the induction phase of chemotherapy, often leading to tragic outcomes, including death, which is often exacerbated by prolonged and profound neutropenia and septicaemia.
An electrophysiological test is routinely done to confirm Amyotrophic Lateral Sclerosis (ALS) and rule out differentials. Distal Motor Latency (DML) is a simple electrophysiological measure that is always done in a primary setting. It can be used as an excellent prognostic marker for ALS so that we can know ALS better and formulate precise management plans. This longitudinal study was conducted in the Neurology Department of Bangladesh Medical University (BMU), Dhaka, Bangladesh from April 2022 to October 2023. In this study a total of 34 subjects, 17 ALS patients with normal DML and 17 ALS patients with prolonged DML, were enrolled. Severity was assessed by the ALS functional rating scale-revised (ALSFRS-R). The study's endpoints were determined as death during this 6-month follow-up or reaching an advanced stage (ALSFRS-R <20). Then, an electrophysiological test was used to measure DML in all four commonly tested nerves. ALSFRS-R was significantly reduced (p<0.025) at 6 months in ALS patients with prolonged DML than normal DML. It was found that having a higher odd (p<0.012, OR=20.718), prolonged DML had a significant impact on the outcome of ALS patients than that of normal DML. In multivariate analysis, lower ALSFRS-R at diagnosis (B= -0.124, p<0.001, HR=0.883) and prolonged DML (B=1.412, p<0.031, HR=4.104) were associated with poor outcomes. ALS patients with prolonged DML also had a poorer prognosis than patients with normal DML (log-rank test, p<0.045). In this study, patients with prolonged DML had a significant functional decline, rapid disease progression and poor prognosis than patients with normal DML. So, prolonged DML can be used as a robust prognostic marker for patients with ALS.
In the past, the primary method for repairing cerebrospinal leaks was through craniotomy with intradural repair. However, in recent times, the popularity of transnasal repair via endoscopic sinus surgery has increased. This shift is mainly due to its lower morbidity and higher success rates. Nevertheless, the rise in iatrogenic CSF leaks has occurred as more surgeons adopt endoscopic sinus surgery. Therefore, caution must be exercised by endoscopic sinus surgeons when utilizing this technique. The objective of our study is to present a novel approach to endoscopic repair of CSF leaks. Herein, we present and discuss a case involving a 55-year-old woman with idiopathic CSF rhinorrhea accompanied by meningoencephalocele. Our technique involved the introduction of a specifically secured vicryl sutured fat plug into the intradural space, followed by applying traction on the suture to effectively seal the defect. This mechanism operates similarly to how a bath plug seals a bathtub. Importantly, our patient did not experience any intra- or post-operative complications. Furthermore, we did not utilize a lumbar drain or intra-thecal fluoresce in during the procedure.
Acute haemorrhagic strokes are most common in people with hypertension, which causes high morbidity and mortality in Bangladesh. In this study, we investigated that whether serum potassium level is associated with risk of haemorrhagic strokes in hypertensive patients or not. We conducted a cross-sectional descriptive study that was carried out in the Department of Medicine and Neurology of Mymensingh Medical College Hospital, Mymensingh from December 2019 to May 2020. Total 100 patients (Mean age: 59.5±15 years, 58% male and 42% female) of hypertension with acute haemorrhagic stroke were enrolled in this study considering inclusion (both sex, CT scan proven stroke) and exclusion criteria (patients with congestive cardiac failure, conn's syndrome and kidney diseases). Our results showed that significant number of patients (34.0%) had potassium imbalance, with hypokalaemia (k+ <3.5) present in 31.0% study patients and hyperkalaemia (k+ >5) found in 3.0% patients. The present study also revealed that majority of patients having potassium imbalance had lower ICH score. From these findings we can conclude that hypokalemia may be responsible for subsequent increase in hemorrahagic stroke incidents in hypertensive patients. However, association between severity of acute hemorrahagic stroke and potassium imbalance was found not significant.
Rape is one of the silent savagely violent sexual offences in Bangladesh. Without being affected by strong laws against it, the ill rape continues to uprising. Growing trend of the cruel sexual offence (rape) represents a major psychological sexual disorder and public health problem and headway of the country. But sometimes silence is thus symbolic of powerlessness in our society. For that reason, not be surprising that rape survivors often on a regular basis silent about their experiences and lifestyle. The goal of this study was to improve condition the pattern of all charged victims in the rural area of Bangladesh with the aim of create public awareness about the brutal crime. Here the retrospective study was conducted on 294 sexually alleged rape victims' report forms and reported from Faridpur Medical College, Bangladesh during the period of 2019 to 2021 for medical examination. Within the study subject maximum number (70.0%) of alleged rape cases were below the age of 20 years. Here More than two-thirds (75.15%) of the assailants were known to there victims, greater portion of the incidents (52.04%) occurred in the victims' houses and near places. This study also revealed that minimum number of victims (12.24%) reported within 24 hours for medical examination. Almost one fourth of the rape victims were gang raped and there were no positive finding in favour of sexual intercourse was found in about three fourth (72.40%) of cases. We need to raise public awareness about this rape which would be effective to report in right time with preserve the evidence of the crime and modern method like DNA analysis may be help to identify the assailant. Now we can expect women to break the silence about the exhausted experience used to support the lack of capacity.
Acute kidney injury (AKI) during the postpartum period remains a significant cause of maternal morbidity and mortality, particularly in low-resource settings. Despite advances in obstetric care, little is known about the short-term renal outcomes following postpartum AKI. The aim of the study was to assess the short-term outcomes of renal function in postpartum acute kidney injury patients. This prospective observational study was conducted at Mymensingh Medical College Hospital in Bangladesh between March 2020 and April 2021. The study enrolled 153 postpartum acute kidney injury (AKI) patients from the Departments of Nephrology and Obstetrics & Gynaecology using purposive sampling. Data on patient demographics, etiology and presentation were collected. Statistical analysis was performed using SPSS version 22.0, with a significance threshold of p<0.05 for all tests. After three months, 77.8% fully recovered, 4.6% developed chronic kidney disease and 2.0% needed dialysis. Sadly, 15.7% didn't survive, highlighting postpartum acute kidney injury's severity. Mortality rates didn't significantly differ between vaginal delivery (14.9%0) and cesarean section (16.0%) groups (p=0.488). Both groups saw positive outcomes, with 75.5% of vaginal delivery and 79.2% of cesarean section patients achieving full recovery. Serum creatinine dropped from 4.13±1.51 to 1.53±1.83 mg/dl after 3 months, indicating treatment success. Blood urea also significantly decreased from 128.51±39.59 to 101.65±55.57 mg/dl during this period. Most postpartum acute kidney injury patients show promising recovery, but some still grapple with persistent kidney issues. Tragically, mortality rates underscore the severity of this condition. Importantly, survival rates don't significantly differ between vaginal delivery and cesarean section patients, emphasizing timely interventions. Improved serum creatinine and reduced blood urea levels highlight treatment effectiveness.
