Background: Non Alcoholic Fatty Liver Disease (NAFLD) is the most common chronic liver disease worldwide. It is frequently associated with obesity, type 2 Diabetes Mellitus (DM) dyslipidemia and Hypertension (HTN). NAFLD patients may have higher level of serum Alanine Aminotransferase (ALT) serum Aspartate Aminotransferase (AST) or both. The aim of our study was to assess the profile of hepatic enzymes, specially serum ALT and AST in patients with USG-diagnosed NAFLD with regards to presence or absence of DM and HTN. Materials and methods: This cross sectional observational study was conducted in the Department of Physiology, Chittagong Medical College (CMC) during the period of January 2016 to December 2016. Total seventy five subjects, having fatty liver disease on ultrasonography, done by Radiologist of CMCH and fulfilling the inclusion and exclusion criteria were included in the study. Anthropometric measurments and clinical examinations were done. Serum ALT and serum AST level, Fasting Blood Glucose (FBS) and 2 Hrs Post Prandial Blood Glucose (2HPPBS) were estimated according to standard guideline. Data analysis was done by computer based software SPSS windows version 20. Data were expressed in mean ± SD. Students “t” test and chi-square test were done. Results: Liver enzyme ALT and AST were found elevated in 68% and 44% of the NAFLD patients respectively. Mean (± SD) ALT and AST were also higher than normal. Both ALT and AST were significantly higher in older patients with type II diabetes mellitus and hypertension. Only ALT elevation was significantly associated with systolic blood pressure. Conclusion: This study revealed that hepatic enzymes, ALT and AST elevate in NAFLD patients and also highlighted the importance of Type 2 Diabetes mellitus, hypertension to assess everyones risk for NAFLD. So, these enzymes should also be evaluated in NAFLD patients. JCMCTA 2025 ; 36 (2) : 41-45
Background: Cataracts are a leading cause of visual impairment globally, with higher prevalence and higher risks of complications with variable visual recovery among diabetic patients. The aim of the study is to compare the visual outcomes and postoperative complications of cataract surgery in diabetic versus nondiabetic patients attending Chittagong Medical College Hospital (CMCH). Materials and methods: This prospective comparative study was conducted from January to December 2022 and included two groups: 104 diabetic and 105 nondiabeticpatients.Visual acuity and complications were assessed preoperatively and at 1 week, 1 month and 3 months postoperatively. Data were analyzed using SPSS v25. Results: The diabetic group (n=104) had a significantly lower mean age (56.7±5.7 years) than the non-diabetic group (n=105) (60.4±6.3 years) (p<0.001). Diabetic patients had slightly poorer BCVA at 1 week (0.74 LogMAR) 1 month (0.49 LogMAR) and 3 months (0.30 LogMAR) compared to non-diabetics (0.68, 0.45, 0.27 LogMAR, respectively) though the overall visual gain was evident in both. Intraoperative complications (e.g. posterior capsular rent, vitreous loss) and postoperative complications (e.g. anterior chamber reaction, corneal edema, posterior capsular opacity, cystoid macular edema) were numerically higher in diabetics, but none reached statistical significance. Conclusion: Diabetic patients can achieve similar visual outcomes after cataract surgery, with slightly higher complication rates, but modern surgical techniques remain safe and effective. JCMCTA 2025 ; 36 (2) : 65-70
Background: Congenital Cyanotic Heart diseases refer to a bundle of different heart defects that present at birth. The result is low blood oxygen level. Cyanosis refers to bluish coloration of skin and mucus membrane. The purpose of the study to disseminate our knowledge and experience of clinical characteristics, presentation and treatment of the issue for readers as future reference. Case Presentation: In this case presentation, the anesthetic management of a 2year old baby on 28th September 2024, in Chittagong Medical College Hospital, who was diagnosed with an untreated Tetralogy of Fallot (TOF) complication a brain abscess, is described. Given the intricate relationship between the child's cardiac and neurological conditions, the patient's presentation of a brain abscess necessitated cautious evaluation of anesthesia. Conclusion: Specialized anesthetic techniques are vital for maintain hemodynamic stability, preventing additional hypoxemia and achieving successful operation. JCMCTA 2025 ; 36 (2) : 168-172
Background: As people age, the prevalence of hypertension significantly rises. There is little data on the prevalence of hypertension and its contributing variables among the hospitalized elderly Bangladeshis, particularly in tertiary care settings. the purpose of the study was aimed to investigate the burden of hypertension and contributing causes in older persons admitted to a Bangladeshi teaching hospital for tertiary care. Materials and methods: This was a descriptive cross sectional study conducted during the period from July 2022 to June 2023. The study included 150 in patients who were admitted and at least 60 years old. Using an organized case record form, information was gathered through interviews, medical records, and examinations of demographic, socioeconomic, lifestyle, family history, comorbidity, anti-hypertensive drug use and blood pressure management data.Separate bivariate and multivariate logistic regression analyses were conducted to identify the factors associated with hypertension and results were expressed as Odds Ratios (ORs) with 95% CI. Results: The mean age of the patients was 64.6 ±4.6 years. Overall, prevalence of hypertension was 47.3% (41.3% old cases and 6% newly diagnosed) among them 45 (63.3%) were male. Out of 62 known hypertensive, majority (95.2%) was not taking their anti-hypertensive drugs regularly and optimal blood pressure was not achieved in 64.5% of them. Factors including being of male (OR:2.839, 95% CI:1.053, 7.654) no formal education (OR:2.217, 95% CI:1.059, 4.64) being obese by BMI criteria (OR:3.904,95% CI: 1.565, 9.559) and having a family history of hypertension (OR:8.297, 95% CI: 1.841, 17.162) were found to be significantly associated with hypertension. Conclusion: To sum up, about 50% of the elderly patients hospitalized in the medicine wards of a tertiary-level hospital had hypertension, which necessitates immediate steps to address this issue. JCMCTA 2025 ; 36 (2) : 71-76
Background: Diabetes is a prevalent metabolic disorder linked to increased cardiovascular morbidity and mortality, which cannot be solely attributed to hyperglycemia or conventional cardiovascular risk factors like smoking or hypercholesterolemia. Intensive glycemic control using insulin to achieve near-normal glycemia does not significantly reduce macrovascular complications when compared to conventional glycemic control. The triglyceride glucose index is a significant indicator of the progression from prediabetes to type 2 diabetes mellitus. This study explored the correlation between triglyceride glucose index and HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) in prediabetes group and type 2 diabetes mellitus group. Materials and methods: This Cross-sectional analytical study was carried out in the Department of Biochemistry at Institute of Applied Health Sciences. After conducting non-probability purposive sampling methods 25 prediabetes and 25 type diabetes patients was selected. Fasting blood glucose, fating lipid profile and fasting insulin was measured. The triglyceride Glucose Index (TyG) and HOMA-IR (Homeostatic model assessment)-IR were calculated by following formula :- Triglyceride Glucose Index (TyG) = Ln [Fasting Triglycerides (mg/dL) × Fasting Glucose (mg/dL)]/2. HOMA-IR = Fasting Insulin (µIU/ml) × Fasting Glucose (mmol/l)/22.51. Results: There is a significant mean difference in BMI, Fasting insulin, fasting blood glucose, triglyceride, HDLC, triglyceride index and HOMA-IR between prediabetes and type 2 diabetes group.There is a significant positive correlation of TyG with HOMA-IR in prediabetes group and type 2 diabetes mellitus group. ROC curve Test the TyG value to predict type 2 diabetes mellitus. TyG index exhibits higher AUC 0.94 with CI (0.88-1.00). Conclusion: The study shows significant differences in key metabolic markers between prediabetes and type 2 diabetes mellitus, with a strong positive correlation between TyG index and insulin resistance in both groups. JCMCTA 2025 ; 36 (2) : 107-111
Background: One of the components of the modern life style is the intensive use of air conditioner for thermal comfort. With modernization, use of electric machines along with AC is rising day by day. Increased inhalation of cold dry air of air conditioner ultimately may cause alteration of pulmonary functions. The objective of this study was to assess the effect of air conditioner on pulmonary function tests. Materials and methods: This quasi experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, during January 2019 to December 2019 in collaboration with Continental Group Private Limited (Abu Baqar Ciddique) Chattogram and EPV (Energypac Power Venture) Chittagong Limited, Patiya, Chattogram. 35 apparently healthy adult males between the ages 20-45 years, working in air conditioned environment were taken as case. 35 healthy age and sex matched subjects, working in non air conditioned environment were taken as control. This study was done to measure pulmonary function test parameters among healthy Air Conditioner (AC) users and they were compared with non users of AC to see the effects of Air Conditioner (AC) on lung functions. Lung function test parameters like PEFR, MMF, FEF 25% , FEF and FEF , were measured by digital spirometer. Unpaired Student’s t test and Chi-square test were done by using SPSS-25 for statistical analysis. Results: The mean value of PEFR, MMF, FEF 75% and FEF were significantly (p<0.05) lowered in AC users comparing with control. The mean value of FEF 50% were (p>0.05) lowered in AC users comparing with control. Conclusion: The result of this study suggest that pulmonary function is significantly decreased after usage of air conditioner. Therfore public awareness for proper maintenance of AC, periodic analysis of pulmonary functions, limited use of AC and regular respiratory exercise can be recommended for preserving respiratory efficiency. JCMCTA 2025 ; 36 (2) : 112-117
Background: Coronavirus Disease 2019 (COVID-19) affects children mildly most of the cases. The study was done among the children of COVID-19 confirmed healthcare workers to see antibody response against COVID-19. Materials and methods: This cross-sectional study was conducted by the Children of COVID-19 confirmed Health Care Workers (HCWs) of Chittagong Medical College (CMC). After enrolling the HCWs, who were RTPCR positive within the last 14 days to 6 months, blood samples of their children were collected and tested for COVID-19 antibody. To determine the association of different characteristics, Fisher’s exact and Mann Whitney by U test were done. Results: Total 100 Children were tested for two variants of SARS-CoV-2 Antibody, UK and African variant. SARS-CoV-2 antibodies were detected in 41% of children for both variants. The Mean Antibody titer against UK and African variants was found 83.00±11.39% and 72.30±20.68% respectively. Symptomatic children showed significantly (p-0.00) higher SARS-CoV-2 seropositivity and asymptomatic children were also capable of developing response against SARS-CoV-2. Conclusion: Antibody titers were significantly higher in symptomatic children, approximately half of children with positive antibody tests for SARS-CoV-2 reported no symptoms. JCMCTA 2025 ; 36 (2) : 118-124
Background: Suicide is the act of deliberately killing oneself. Risk factors for suicide include mental disorder, especially depression and neurological disorders, cancer and HIV infection. Suicide remains a significant global health issue, with hanging being one of the most prevalent methods worldwide. Understanding the factors contributing to hanging suicides is crucial for effective prevention efforts. This study aimed to evaluate the factors associated with the use of highly lethal methods for suicide attempts, with a focus on hanging suicides. Materials and methods: A retrospective observational study was conducted at Chittagong Medical College, analyzing 72 cases of hanging suicides. Data on sociodemographic characteristics, psychosocial factors and environmental factors were collected from autopsy reports and medicolegal records. Descriptive statistics, bivariate analysis, and regression analysis were used to analyze the data. Results: Among the study participants, 69.4% were male, with a mean age of 34.2 years. Marital status analysis revealed that 52.8% were married. Unemployment was prevalent among 61.1% of cases. Environmental factors showed that 80.6% of cases occurred indoors, with an equal distribution between day time and night time incidents. Bivariate analysis indicated a significant correlation between marital status and hanging (p < 0.05) and a strong association between unemployment and hanging (p < 0.001). Regression analysis identified unemployment status as a significant predictor of hanging suicides (OR = 2.5, p < 0.01). Conclusion: This study highlights the importance of considering psychosocial and environmental factors in understanding hanging suicides. Targeted interventions addressing unemployment and marital status may help reduce the incidence of hanging suicides and improve suicide prevention efforts. JCMCTA 2025 ; 36 (2) : 141-144
Background: A Malaria surveillance system is essential to achieve "Malaria-free Bangladesh" by 2030. Though the system encountered challenges, including poor data quality, this study evaluated it in Khagrachari and rated its main attributes. Materials and methods: An observational study was conducted consisting of survey, secondary data analysis, record review and mixed methods of data collection. The surveillance system was examined using the "2001 United States Centers for Disease Control's updated guidelines for Evaluating Public Health Surveillance Systems". A total of 1407 patients' data was collected from previous records (2018-2022). Purposively chosen, 22 stakeholders participated in the study, and 128 case investigation forms were assessed. Results: 15(68.18%) out of 22 respondents had 12-year experience on surveillance and 17(77.27%) had formal training. 19(86.36%) respondents reported case definitions were easy-to-use, and 14(63.64%) participants claimed data tools could accommodate changes. 731(51.95%) cases were detected through Passive Case Detection (PCD) and nearly one-fourth (26.15%) cases by Government Organizations. The results of 'Timeliness' against the number of cases investigated within day one was 64.84%. Trends of cases showed significant decline ( 2 trend = 683.03, p = 0.0001). Conclusion: The system is effective as it meets most of its objectives. JCMCTA 2025 ; 36 (2) : 99-106
Background: Renal impairment is common in Coronavirus Disease-2019 (COVID-19) and the impact of renal impairment on patient outcomes may differ due to geographical area, differences in healthcare systems or hospital capacities. This study investigated the factors associated with in-hospital and 90 days outcomes in COVID-19 patients who needed hemodialysis for their renal impairment in a public tertiary hospital in Bangladesh. Materials and methods: This prospective observational study was conducted in Chittagong Medical College Hospital (CMCH) Chattogram, Bangladesh. Consecutive COVID-19 patients (Both confirmed and suspected) with renal impairment and subjected to hemodialysis were included. The demographic characteristics, clinical course and laboratory parameters were recorded. Outcome measures were in-hospital and 90 days mortality. Results: 315 patients were included in the study and 301 patients completed the 90 days follow up. The in-hospital mortality rate was 29.8% and 90 days mortality rate was 31.2%. Age was significantly higher in patients who died in hospital (47.5±14.3 vs 51.6±16.3 years, p=0.028) and died within 90 days (44.5±14.0 vs 50.9±3.2 years, p=0.002) of admission than who survived. Mortality in patients with End Stage Renal Disease (ESRD) on Maintenance Hemodialysis (MHD) were less than AKI and CKD patients (p=0.007) regarding in-hospital outcome. Total WBC count was also higher in expired patients both in-hospital (p=0.023) and 90 days (p=0.031) than survived patients. Median blood urea (188.0 vs 210.0 mg/dL) SGPT (31.0 vs 36.0 U/L) and D-dimer (2.6 vs 4.6 ug/mL) were significantly higher and Lymphocyte count was significantly lower in expired group than survived group regarding in-hospital mortality (p<0.05). There was no significant difference of serum creatinine, CRP, serum ferritin between expired and survived groups. Conclusions: This study showed that patients with COVID-19 who required hemodialysis were higher mortality rate both in-hospital and 90 days follow up. Older age, leukocytosis, lymphopenia, uremia, increased SGPT and D-dimer were predictors of in-hospital mortality. ESRD on MHD had good outcome. Older age and leukocytosis were predictors of 90 days mortality. JCMCTA 2025 ; 36 (2) : 85-91
Background: Hepatitis B Virus (HBV) remains a major global health concern, particularly in regions with limited screening. Antibodies to the Hepatitis B core antigen (antiHBc) indicate past or ongoing infection and help identify potential carriers. This study aims to assess the seroprevalence of anti-HBc among HBsAg-negative blood donors in Chattogram. Materials and methods: This cross-sectional observational study included 100 voluntary blood donors who were screened for anti-HBc (IgM and IgG) and anti- HBs using Electrochemiluminescence Immunoassay (ECLIA) and Chemiluminescent Microparticle Immunoassay (CMIA) respectively. Results: The results revealed that 21% of the HBsAgnegative donors were positive for anti-HBc, indicating previous or ongoing hepatitis B virus (HBV) infection. Notably, 76.2% of the anti-HBc-positive individuals were negative for anti-HBs, suggesting a potential risk of HBV reactivation or occult infection. Homemakers had the highest anti-HBc positivity rate (25%) while students had the lowest (15.8%). Blood transfusion recipients (33.3%) and those with a history of surgery (30.8%) showed higher anti-HBc positivity rates compared to other risk factors. Unvaccinated individuals exhibited a higher anti-HBc positivity rate (26.3%) than vaccinated individuals (14.0.Prior blood donors accounted for 76.2% of all antiHBc-positive cases. Conclusion: These findings highlight the hidden burden of past HBV exposure among asymptomatic blood donors and emphasize the need for enhanced vaccination coverage, safe transfusion practices and the potential inclusion of anti-HBc testing in blood donor screening protocols to reduce the risk of occult HBV infections in endemic areas. JCMCTA 2025 ; 36 (2) : 7-12
Background: In Bangladesh, Urinary Tract Infection (UTI) is the most common bacterial infection, and misuse of antibiotics is causing Antimicrobial Resistance (AMR) rapidly increasing. The purpose of this study is to identify the antibiotic resistance pattern of bacterial uropathogens in patients with multidrug resistance rates at a tertiary hospital in Chandanaish Upazilla, Chattogram. Materials and methods: An institution-based crosssectional study was done in the clinical laboratory for the diagnosis of patients attending BGC Trust Medical College and Hospital. The data of urine samples and their antibiotic sensitivity patterns were obtained from the laboratory register book. Secondary data were collected and entered into the SPSS version 22 computer software package for univariate and bivariate analysis. Results: Out of 891 registered patient data sets, 886 results were taken and investigated. About 27% (239) people had a urinary tract infection, and the maximum count of the isolates, 81.6% (195) were from females. The highest prevalence was obtained among the age groups of 19–30 years (36.8%). Escherichia coli was the most prevalent organism, 64.9% (155). All the isolatesshowed the maximum resistance to cefuroxime and cefradin, ranging from 85-100%. The antibiotic resistant rate and multi-drug resistant rate were 97.9% and 65.81%, respectively. E. coli showed the highest drug resistance and multi-drug resistance 65.9% and 64.3%. Conclusion: The study highlights a high prevalence of antibiotic resistance and multidrug resistance in bacterial uropathogens, notably Escherichia coli. Resistance to critical antibiotics like cefuroxime and cefradine underscores the need for enhanced antibiotic stewardship and control measures to combat Antimicrobial Resistance (AMR). JCMCTA 2025 ; 36 (2) : 92-98
Background: Hypertension is a major risk factor for Chronic Kidney Disease (CKD) often causing subclinical renal damage long before overt symptoms appear. Microalbuminuria, as reflected by the Urinary Albuminto-Creatinine Ratio (UACR) and a decline in estimated Glomerular Filtration Rate (eGFR) are key indicators of early renal impairment. Evaluating these parameters in non-diabetic hypertensive individuals can aid in timely identification of renal involvement. This study aimed to assess the UACR and eGFR in non-diabetic hypertensive patients compared to normotensive individuals attending a tertiary care hospital in Chattogram, Bangladesh. Materials and methods: This hospital-based crosssectional comparative study was conducted at Chittagong Medical College Hospital during the period from January to December 2023. A total of 136 participants were enrolled using purposive sampling and divided into two equal groups: hypertensive (n=68) and normotensive (n=68). Key variables were measured include UACR, eGFR, systolic and diastolic blood pressures, Body Mass Index (BMI) serum creatinine and lipid profile. Results: The prevalence of microalbuminuria was significantly higher in the hypertensive group compared to the normotensive group (33.8% vs. 7.4%, p<0.001). Hypertensive participants had higher mean age, BMI, systolic and diastolic blood pressures compared to normotensive counterparts (p<0.001 for all). The mean eGFR was significantly lower in hypertensive individuals (85.64 ± 14.15 vs. 94.28 ± 14.09 mL/min/1.73 m², p=0.001) while the mean UACR was significantly higher (49.15 ± 10.56 vs. 10.08 ± 1.16 mg/g, p<0.001). Multivariate linear regression identified SBP (b=0.619, p<0.001) as the only independent predictor of UACR levels. No variable independently predicted eGFR in the regression model. A graded relationship was observed between hypertension severity and microalbuminuria, with the highest prevalence noted in stage 2 hypertension (50%). Conclusion: Microalbuminuria is significantly more prevalent among hypertensive patients and is strongly associated with early organ damage. Early detection through routine screening in hypertensive individuals is recommended to prevent long-term complications. JCMCTA 2025 ; 36 (2) : 145-150
Background: TPM1 (Alpha Tropomyosin Protein) gene mutations were investigated in concentric HCM (Hypertrophic Cardiomyopathy) patients from tertiary hospitals, focusing on exons 5, 7, and 8—regions harboring a third of known pathogenic variants. HCM is an autosomal dominant disorder with diverse presentations, associated with mutations in genes like MYH7, MyBPC3, TNNT2 and TPM1. Located on chromosome 15q22.2, TPM1 encodes a crucial contractile protein in myocytes; its mutations may disrupt actintropomyosin interaction, leading to atypical hypertrophy patterns. The study aimed to identify such mutations in concentric HCM patients within our population. Material and methods: In this cross-sectional study, ten adult patients diagnosed with concentric HCM (90% male, 10% female, average age 44) were included. Genomic DNA was isolated from peripheral blood samples, and the targeted region of the TPM1 gene (2078 bp fragment encompassing exons 5, 7 and 8) was amplified using PCR and sequenced by Sanger sequencing. Results: Data analysis using Geneious® R11 and BLAST tool by NCBI revealed no pathogenic variants in the TPM1 gene within the studied region in any of the ten patients. Conclusion: The absence of mutations in this study may be due to the small targeted region, focus on exonic variants, or low prevalence of TPM1 mutations in the Bangladeshi population. As TPM1 mutations account for only 5% of HCM cases globally, further research using whole-genome sequencing (NGS) is recommended to address these limitations. JCMCTA 2025 ; 36 (2) : 131-136
Background: Learning strategies are systematic steps that students use to achieve specific learning objectives. Use of effective learning strategies enables the students to efficiently manage large amount of information pertaining to preclinical subjects in medical schooland ensures better academic outcome. This study aims to explore the relationship between learning strategy and academic scores of preclinical medical students in Bangladesh. Materials and methods: This was a cross sectional study conducted during the period from January to December 2024. Data were collected from 192 1 st and 2 year students of two medical colleges through a questionnaire. The 50 items of the questionnaire were divided in nine subscales. SPSS was used for analysis.Unpaired t-test and ANOVA were used to compare means. Pearson’s correlation coefficients were calculated between each subscale score and academic performance. Results: Female students, students who study for longer hours and those living in hostel displayed significantly higher scores. In terms of correlation, critical thinking showed moderate but significant correlation (r=0.42, p=0.00) while metacognitive self regulation (r=0.22, p=0.03) time and study management (r=0.31, p=0.00) revealed small though significant correlations with the academic score. Conclusion: The results of the study will enable the educators to guide the students on efficient learning practices to ensure better academic outcome. JCMCTA 2025 ; 36 (2) : 59-64
Background: Gastric cancer remains one of the most common types of cancer and a major cause of cancerrelated deaths. It ranks as the fifth most frequently diagnosed cancer and the fourth leading cause of mortality worldwide. The Tumor Microenvironment (TME) consists of tumor cells, extracellular matrix, immune cells, cytokines, and other components. Among these, immune cells- particularly T lymphocytes- plays a crucial role as regulatory factors in TME. In particular, T lymphocytes, especially CD8+ Cytotoxic T Cells (CTLs) are recognized as key anti-tumor immune cells. The aim of the study was to evaluate the expression of CD8+ tumor infiltrating lymphocytes in gastric adenocarcinoma and their association with histological grade and pathological stage. Materials and methods: This cross-sectional observational study was conducted in the Department of Pathology, Sir Salimullah Medical College, Dhaka from March 2022 to February 2024. A total of 50 gastrectomy samples with a histologically confirmed diagnosis of gastric adenocarcinoma were included in this study. The expression of CD8+ in TILs were evaluated in formalin-fixed and paraffin embedded specimens by immunohistochemistry. The CD8+ TILs were categorized as positive and negative expressions. Histopathological results were analyzed and statistical analysis was done using Statistical Package for Social Science (version 26.0). Results: In this study showed that among 50 cases, 68% (n=34) were male and 32% (n=16) were female. The major tumor type, poorly differentiated type of adenocarcinoma reported was 38%. CD8+ intra tumoral and stromal TIL expression was positive in 33 (66%) and 35 (61%) cases respectively. A significant association was found between intra tumoral CD8+ TILs and histological tumor grade (p value=0.037) pathological stage (pvalue = 0.005) but no significant association was seen with nodal status (p value =0.759). Similarly, a significant association was observed between the stromal CD8+ TILs with histologic grades (p value= 0.012) and pathological stage (p value = 0.035) but not with nodal status (p value = 0.434). Conclusion: As part of tumor microenvironment CD8+ TIL influence the progression and differentiation of gastric adenocarcinoma. These expression levels can be utilized as indicators of biological behavior and prognosis as well as in therapeutic purpose of gastric adenocarcinoma. JCMCTA 2025 ; 36 (2) : 46-52
Background: Colorectal cancer, a leading global malignancy, often involves dysregulation of apoptosis. Bcl-2, an anti-apoptotic protein inhibiting programmed cell death, is overexpressed in early colorectal carcinogenesis, suggesting a key role in tumor initiation. This study aimed to assess Bcl-2 expression in histologically diagnosed colorectal adenocarcinoma and its association with histopathological grade, stage, and other parameters. Materials and methods: A cross-sectional study of 49 surgically resected colorectal adenocarcinoma specimens was conducted from March 2021 to December 2022 at the Department of Pathology, Chittagong Medical College. Tissue sections underwent Hematoxylin and Eosin (H&E) staining and Bcl-2 immunostaining. Clinical and pathological data were recorded and statistically analyzed. Results: Overall, 85.7% (42/49) of colorectal adenocarcinoma patients showed positive Bcl-2 expression, predominantly moderate (38.8%) and strong (30.6%) staining, while only 14.3% were negative.Bcl-2 positivity was associated with female sex (p=0.029) conventional histopathological type (p=0.001) tumor grade (93.0% and 33.3% in low-grade and high-grade tumors, respectively, p=0.001) and nodal status (p=0.004). Low-grade carcinomas predominantly exhibited moderateto-strong Bcl-2 positivity, while high-grade carcinomas were mostly negative, showing a significant inverse correlation between Bcl-2 expression intensity and tumor grade (p=0.001). No significant associations were found with age, tumor location or depth of invasion. Conclusion: This study demonstrates that reduced or absent Bcl-2 expression in colorectal adenocarcinoma is significantly associated with higher tumor grade and aggressive behavior. These findings suggest Bcl-2 expression profiling holds promise as a prognostic marker and could represent a therapeutic target to promote apoptosis and inhibit early neoplastic growth in colorectal adenocarcinoma. JCMCTA 2025 ; 36 (2): 53-58
Background: Epistaxis is one of the common complaints in the emergency department. Anterior Nasal Packing (ANP) a frequently performed procedure in the management of epistaxis has many complications. The topical application of Tranexamic Acid (TXA) was found beneficial for the treatment ofanterior epistaxis. Objective of this study was to evaluate the role of topical tranexamic acid over anterior nasal pack in epistaxis management. Materials and methods: The study was a randomized controlled trial to compare the effect of topical TXA with ANP for treatment of anterior epistaxis conducted in the Department of Otolaryngology-Head and Neck Surgery of Chittagong Medical College Hospital (CMCH) Chattogram for a period of two years from February 2020 to January 2022. All adult patients admitted with epistaxis was the study population. A total of 220 patients (110 in each group) aged from 18 years and above with both genders were included as per selection criteria. Patients were followed up to control of epistaxis, then at 24 hours and finally from 24 hours up to 1 week from procedure. Fourteen patients were lost during follow up, eight from TXA group and six from ANP group. So, a total of 206 patients, 102 from TXA and 104 from ANP group were analyzed. Results: The mean age was 43.36±13.54 years inTXA group and 45.07±12.27 years in ANP group and was not statistically significant, p= 0.261. Number of male and female were 61 and 41 in TXA group andin ANP group were 52 and 52 (p=0.716). Mean bleeding arrest time in TXA group were 7.74± 3.28 minutes and in ANP group 9.28± 3.69 minutes (p value 0.004). Rebleeding within 24 hours was found in 6 patients in TXA group and 16 patients in ANP group (p value 0.045and risk coefficient 1.213). Overall treatment failure in TXA group was 11 and in ANP group was 30 (p value 0.0018). Mean length of hospital stay in TXA group was 24.71±2.84 hours and in ANP group was 27.92±8.92 hours (p value 0.000). Nasal Obstruction Symptom Evaluation (NOSE) score in TXA group was 24.95±4.9 and in ANP group was 66.92±5.96 (p value 0.000). Visual Analogue Scale (VAS) score in TXA group was 3.74±0.9 and in ANP group was 6.21±1.08 (p value 0.000). Conclusion: Topical TXA may be considered an effective treatment option for the management of anterior nasal epistaxis with less chance of re-bleeding, less discomfort and less duration of hospital stay. JCMCTA 2025; 36 (2) : 156-160
Background: Hemorrhagic Stroke (HS) is a devastating subtype of stroke with high mortality. The Intracerebral Hemorrhage Score (ICH Score) is a globally accepted prognostic tool for predicting 30-day mortality. To determine correlation between ICH Score and 30-day mortality in patients with HS at Neurosurgery Department of a tertiary hospital in Bangladesh. Materials and methods: A prospective observational study was conducted over 18 months, enrolling 288 adults with HS. The ICH Score was calculated at the time of admission. Patients were followed-up at 30-day by Glasgow Outcome Scale (GOS). Spearman’s correlation analysis was performed to determine correlation between ICH score and 30-day mortality. Results: The patients mean age was 59.6 years and 27 (9.5%) underwent surgical intervention. 30-day mortality rate was 42.25%. Strong positive correlation of ICH score was found with 30-day mortality (rho=0.984) and negative correlation was found with GOS score at 30-day (rho= 0.583). Mortality escalated with higher scores: 2.9% (Score 0), 27.1% (Score 1), 33.7% (Score 2), 72.9% (Score 3), 89.5% (Score 4) and 100% (Scores 5). Conclusions: The ICH score had positive correlation with 30-day mortality and acceptable in predicting 30-day mortality in HS. JCMCTA 2025 ; 36 (2) : 19-24
Background: Electric burn and machinery avulsion injury at scalp is very common in developing country like us. Early coverage by local flap may reduce extra cranial and also intracranial complication. To see long term functional and cosmetic outcome of local transposition/rotation scalpflap. Materials and methods: It is a prospective observational study to find out long term effect of local transposition flap over scalp/Calvarial wound.18 patients of scalp wound were included in this study with 14 male and remaining 4 were female for last 3 years (July 2022 to June 2025). Average age limit 32 years (7 years to 59 years). Patient of scalp wound actually caused by high voltage electric burn, tumour excision, bullet injury, machinery avulsion injury and road traffic accident. Five patients need intensive care unit and neurosurgical treatment for head injury. Results: All 18 patients under gone local transposition/ rotation flap for scalp wound. Only three of 18 flapshave marginal necrosis which gradually healed by dressing. Long term follows up shows complete functional and cosmetic recovery. Follow up X-ray skull shows good healing at bone and no evidence of osteomyelitis. All doner site of scalp flap covered with split thickness skin graft which remain hairless at long term follow up. Conclusion: Local subgaleal transposition/rotation scalp flap is the good option for scalp defect for variety of wound. Early coverage can prevent life threatened complication like brain abscess, CSF leakage and osteomyelitis. JCMCTA 2025 ; 36 (2) : 151-155
