Background: Hypoxic ischemic encephalopathy (HIE) is a type of neonatal encephalopathy caused by systemic hypoxemia and/or reduced cerebral blood flow resulting from an acute peripartum or intrapartum asphyxia event. It is a condition that can cause significant mortality and long-term morbidity. Coagulopathy is one of the many consequences of compromised oxygen after perinatal asphyxia. International normalized ratio (INR) > 1.5, activated partial thromboplastin time (aPTT) > 50 seconds, prothrombin time (PT) >20s are used to evaluate coagulopathy in hypoxic ischemic encephalopathy neonates. A hematological system abnormality (20% each) is associated with perinatal asphyxia. Objective: To assess hematological and Coagulation function in hypoxic ischemic encephalopathy neonates. Materials and Methods: This cross-sectional type of descriptive study was conducted in the Department of Pediatrics at Rajshahi Medical College Hospital, Rajshahi over a period of 2years from July 2021 to June 2023. The study was conducted after obtaining ethical clearance from the Institutional Review Board (IRB) of Rajshahi Medical College and consent from the guardian of patients. Based on predefined eligibility criteria, a total number of 70 neonates with HIE stage II and III were included in this study. Data were collected and analyzed by using the ‘Statistical Package for Social Sciences (SPSS) software, 24-version). A chi-square test was used to see the relationship of organ dysfunctions between stage II and stage III hypoxic ischemic encephalopathy neonates. Results: Out of 70 hypoxic ischemic encephalopathy neonates, 55.70% neonates had stage-II and 44.30% had stage-III hypoxic ischemic encephalopathy. Mean age of the neonates was 10.81±8.08 hours, about 68.60% were male and 31.40% were female. Most of the neonates 71.43% had pulmonary dysfunction, 57.10% had cardiovascular dysfunction. Conclusion: Awareness of hypoxic-ischemic encephalopathy risk factors can help parents and medical personnel to prevent and prepare for possible complications.
Background: Serious morbidity and mortality are linked to infections in pediatric intensive care units (PICUs). The patterns of antibiotic resistance and the bacteriological profile differ significantly between environments. The purpose of this study was to evaluate the bacterial profile and patterns of antibiotic sensitivity in patients with blood cultures who were admitted to Chattogram Maa Shishu O General Hospital's PICU. Materials and Methods: 2384 blood culture samples taken from PICU patients between January and December 2023 were examined in this prospective observational study. Standard microbiological methods were used to identify positive cultures, and the BD BACTEC FX40 system was used to test for antibiotic susceptibility. Results: 96 (4.02%) of the total cultures were positive. The majority of patients were male (68.8%) and younger than 12 months (81.3%). Meningoencephalitis, pneumonia, and recurrent pneumonia were the most frequent primary diagnoses. Pseudomonas (59.4%) and Acinetobacter (27.1%) were the most common isolates, accounting for the majority of gram-negative bacteria (98.9%). These organisms were more susceptible to ciprofloxacin, meropenem, amikacin, and levofloxacin, but they exhibited high resistance to penicillin and cephalosporins. There was only one gram-positive isolate identified, Staphylococcus aureus, and it was amikacin, vancomycin, and linezolid sensitive. Conclusion: Improved infection control and antibiotic stewardship are critically needed in PICU settings due to the high incidence of multidrug-resistant gram-negative infections.
Background: In children suffering from thalassemia, the most common endocrine complication is primary hypothyroidism. However, thyroid dysfunction in transfusion-dependant Hb-E-β thalassemia children still remain underfocused. Therefore, the aim of the study was assessment of thyroid function in Hb E β thalassemia children. Methods: The present study was a descriptive cross-sectional study and conducted at department of Paediatrics in Rajshahi Medical College Hospital, for six months period following approval of the protocol. Total 72 children (age:4-12 years) with Hb E β thalassemia were included in the study. Informed written consent was obtained from parents of the subject and ethical issues were ensured. Thyroid function (T4, TSH) was assessed. Data were collected by face-to-face interview by the researcher with an aid of a semi-structured questionnaire. SPSS 20 was used for data analysis. Results: Mean age of the 72 study population was 7.55±2.46 (SD) year. Majority of the respondents were female 57% (41.04). Mean value of Serum ferritin was 3703±111 µg/l. Among all, 4.8% (3.45) respondents had hypothyroidism and 95.2% (68.54) respondents had normal thyroid status. Moreover, increased ferritin level was associated with hypothyroidism (p<0.05). Conclusion: About one in every twenty children with Hb E β thalassemia was suffering from hypothyroidism. However, further population-based study is required to get the exact prevalence.
Background: Illegal induced abortion remains a major, under-recognised contributor to maternal morbidity and mortality in low-resource settings such as Bangladesh. Objective: To evaluate the sociodemographic pattern, clinical presentation, complications, and management outcomes of illegal induced abortion at a tertiary referral hospital. Methods: This prospective observational study enrolled 100 women admitted with illegal induced abortion to the Department of Obstetrics and Gynaecology, Rajshahi Medical College Hospital, over six months, using purposive sampling and a pre-formed case record form. Categorical variables were expressed as frequencies and percentages; associations were tested using SPSS v26.0, with p<0.05 considered significant. Results: Most patients (68%) were aged 20–30 years and 88% were housewives; 45% belonged to poor socioeconomic strata and 25% were illiterate. Menstrual regulation (MR) accounted for 58% of induction methods, and 34% of procedures were performed by nurses without medical qualification, 26% self-administered, and 24% by traditional dais — none by registered doctors. Abdominal pain (92%) and per-vaginal bleeding (88%) were the predominant presenting complaints. Shock/septicaemia (24%) and pelvic peritonitis (22%) were the leading complications. Evacuation and curettage (44%) was the commonest surgical intervention. Outcome was favourable in 98% of cases (60% cured, 38% improved), with a case fatality of 2%. Conclusion: Illegal induced abortion in this cohort was strongly associated with poverty, low education, and unskilled providers, underscoring the urgent need for safe, accessible reproductive health services.
Background: Routine urinalysis remains a cornerstone investigation for screening and diagnosing urinary, renal, and systemic disorders, yet manual microscopy is labour-intensive and operator-dependent, prompting laboratories to evaluate fully automated platforms. Objective: To compare the diagnostic performance and inter-method agreement of an automated urine analyzer against manual microscopy as the reference standard for routine urinalysis in a tertiary-care setting. Methods: A cross-sectional analytical study was conducted at Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from 1 January to 30 June 2023. Mid-stream urine samples from 144 consecutive patients were analysed in parallel by an automated urine sediment analyzer and standard manual light microscopy of centrifuged sediment. Physicochemical and microscopic parameters were compared, and diagnostic indices, Cohen’s kappa (κ), and Bland–Altman statistics were computed in SPSS v26.0. Results: Of 144 patients, 76 (52.8%) were male and 68 (47.2%) were female; mean age was 41.3 ± 16.7 years. Suspected urinary tract infection (UTI) was the leading indication (62; 43.1%). Concordance between automated analysis and manual microscopy was almost perfect for white blood cells (WBC) (κ = 0.86, 95% CI 0.79–0.92) and red blood cells (RBC) (κ = 0.81, 0.74–0.88), substantial for bacteria (κ = 0.79) and crystals (κ = 0.71), and moderate for casts (κ = 0.58, 0.46–0.70; p = 0.041). Sensitivity and specificity for the automated platform were 94.4% and 90.8% for WBC, 89.5% and 92.1% for RBC, and 88.6% and 93.1% for bacteria, with overall accuracy ≥ 87.3% across all sediment elements (areas under ROC curves 0.78–0.95). Bland–Altman analysis demonstrated a small mean bias of +0.33 cells/HPF (limits of agreement −5.55 to +6.22) for RBC, and Pearson correlation for WBC counts was r = 0.94 (p < 0.001). Physicochemical parameters showed ≥ 92.3% agreement. Conclusion: Automated urinalysis offers excellent agreement with manual microscopy for cellular elements and physicochemical parameters, supporting its role as an efficient front-line screening tool, with manual confirmation reserved for casts and atypical sediments.
Background: Among complete blood counts, hemoglobin, hematocrit and mean corpuscular volume are commonly used in diagnostic medicine to evaluate normal and abnormal hematological status. As complete blood count depends on lifestyle, dietary habits, ethnicity and environment, country-wise normal level of complete blood count can help in judgmental decision and aid interpretation and accurate diagnosis of diseases. Methods: The study was conducted in the Department of Physiology in collaboration with Department of Pathology at Rajshahi Medical College, Rajshahi over a period of 1 year from January 2025 to December 2025. Based on predefined eligibility criteria, a total of 475 apparently healthy adults of both gender in Rajshahi City were included in this study. Data were analyzed by SPSS software, version-26 and p value less than 0.05 was statistically significant for all tests. Results: Regarding age distribution out of 475 respondents, 201 (42.30%) were within the age group of 20-29 years. The normal levels of Hb, hematocrit and MCV were 9.30-15.90 gm/dl, 31.40-48.50% and 70.70-96.31 fl, respectively. Hemoglobin, hematocrit and mean corpuscular volume were significantly higher in less than forty years than forty years or more aged respondents. Conclusions: Normal level of hemoglobin, hematocrit and mean corpuscular volume are important to diagnose diseases, screen blood donors and assess overall health.
Background: Alcium channel blockers are widely prescribed for the management of hypertension; however, adverse effects such as pedal edema and albuminuria may compromise treatment adherence and long-term outcomes. Cilnidipine, a newer dual L/N-type calcium channel blocker, has been reported to produce fewer vascular adverse effects compared with amlodipine. This study aimed to compare the safety profile and clinical complications associated with amlodipine and cilnidipine in hypertensive patients. Methods: This open-label randomized controlled study was conducted at the Department of Pharmacology and Therapeutics, Rajshahi Medical College, Bangladesh, from January to December 2021. Sixty patients with mild-to-moderate hypertension were randomly allocated into two equal groups. Group A received amlodipine (5–10 mg/day), while Group B received cilnidipine (10–20 mg/day) for three months. Demographic and clinical data were collected using a semi-structured questionnaire. The primary outcomes were the occurrence of pedal edema and albuminuria. Statistical analyses were performed using SPSS version 24, with p<0.05 considered statistically significant. Results: The baseline demographic characteristics were comparable between the two groups. Pedal edema occurred significantly more frequently in the amlodipine group than in the cilnidipine group (20.0% vs. 3.3%; p=0.041). Albuminuria was also more common among patients receiving amlodipine (23.3% vs. 6.7%), although the difference did not reach statistical significance (p=0.073). Conclusion: Cilnidipine demonstrated a more favorable safety profile than amlodipine, particularly regarding the lower incidence of pedal edema. These findings suggest that cilnidipine may be a better-tolerated alternative for the management of hypertension.
Background: Complex Schatzker type IV-VI tibial plateau fractures present severe articular comminution, metaphyseal-diaphyseal dissociation, and soft-tissue compromise that complicate conventional internal fixation strategies. Objective: This prospective study evaluated the functional, radiological, and complication outcomes of complex tibial plateau fractures managed by Ilizarov circular external fixation. Methods: A prospective observational study enrolled 112 patients with Schatzker type IV, V, or VI tibial plateau fractures treated by Ilizarov external fixation at Islami Bank Medical College Hospital, Nawdapara, and Rajshahi Medical College Hospital between January 2022 and December 2025, with outcomes analyzed using SPSS v26.0. Results: The cohort comprised 57 females (50.9%) and 55 males (49.1%), mean age 40.5±13.4 years; 52 fractures (46.4%) were open. Schatzker type V predominated (47, 42.0%). Mean operative time was 125.2±32.1 minutes and hospital stay 7.6±3.0 days. Radiological union was achieved in all 112 patients (100%) at 17.7±3.7 weeks, independent of Schatzker subtype (p=0.954). Mean Rasmussen functional and radiological scores were 26.1±2.7 and 16.3±1.4; mean KOOS was 83.9±8.3, and knee range of motion 114.6±14.6°. Final outcome was excellent in 54 (48.2%), good in 57 (50.9%), and fair in 1 (0.9%) patient. Overall complications occurred in 6 patients (5.4%), with no nonunion, malunion, or deep infection recorded (all subgroup comparisons, p>0.05). Conclusion: Ilizarov external fixation achieves universal union, favourable functional recovery, and low complication burden in complex tibial plateau fractures, representing a reliable, resource-appropriate reconstructive strategy for high-energy periarticular injury.
Background: Timely, coordinated rehabilitation after stroke is widely advocated, yet comparative evidence on early multidisciplinary versus conventional models in South Asian tertiary settings remains limited. Objective: This study evaluated whether an early multidisciplinary rehabilitation model improves functional recovery and quality of life compared with conventional stroke rehabilitation. Methods: A prospective comparative cohort of 168 stroke survivors (18–65 years) was enrolled at the Department of Physical Medicine & Rehabilitation, Rajshahi Medical College Hospital, between January 2024 and December 2025, allocated to early multidisciplinary rehabilitation (n=79) or conventional rehabilitation (n=89). Functional outcomes were assessed using the Barthel Index, Functional Independence Measure (FIM), modified Rankin Scale (mRS), and a quality-of-life instrument. Results: Both groups were well matched at baseline (all p>0.05). Post-intervention functional gains were substantial in both arms, with mean Barthel Index improvement of 28.5±4.5 in the early multidisciplinary group versus 27.7±4.7 in the conventional group (p=0.267), and comparable FIM and mRS change (p=0.424 and p=0.832, respectively). Quality-of-life improvement was numerically greater in the conventional group (30.4±6.2 versus 28.2±5.8, p=0.018). Independent of allocated group, shorter time to rehabilitation initiation was associated with greater mRS improvement (r=0.195, p=0.011; adjusted β=0.037, p=0.012). Overall complications occurred in 6 of 168 patients (3.6%), all mild and confined to the conventional arm. Conclusion: Structured rehabilitation delivered promptly after stroke onset, rather than programme labelling alone, appears to be the principal driver of functional recovery in this cohort.
Background: Urinary stone disease is among the most prevalent urological disorders, and routine ureteric stenting after ureteroscopic lithotripsy remains contentious because its attendant morbidity may outweigh the presumed benefits in uncomplicated procedures. Objective: To compare postoperative morbidity and convalescence between ureteric stenting and stentless management following uncomplicated ureteroscopic lithotripsy for lower ureteric calculi in a resource-constrained tertiary setting. Methods: This quasi-experimental study enrolled 80 adults with lower ureteric stones undergoing uncomplicated pneumatic ureteroscopic lithotripsy at a tertiary hospital in Dhaka (August 2022–July 2023). Alternate assignment allocated participants to stenting (Group A, n=40) or no stenting (Group B, n=40). Flank pain and dysuria (visual analogue scale), urgency, frequency, suprapubic pain, haematuria and analgesia requirement were recorded at 24 hours, two weeks and four weeks and analysed in SPSS v26.0. Results: The groups were comparable in age (41±12.9 vs 40±13.1 years), male predominance (77.5% vs 82.5%), body-mass index (26.1±3.1 vs 26.5±3.1 kg/m²) and stone size (7.3±1.0 vs 7.2±1.1 mm; all p>0.05). Operative time was longer with stenting (29.4±8.4 vs 19.6±3.3 min; p<0.001). At every visit Group A reported higher flank-pain and dysuria scores (24-hour flank pain 4.2±0.6 vs 1.6±0.7; dysuria 5.0±0.8 vs 1.5±0.5; both p<0.001). Urgency (92.5% vs 17.5%), frequency (90% vs 17.5%), suprapubic pain (70% vs 7.5%), haematuria (60% vs 2.5%) and analgesia requirement (65% vs 15%) at 24 hours were all significantly greater with stenting (p<0.001). The stone-free rate was 100% in both groups. Conclusion: Omitting the ureteric stent after uncomplicated ureteroscopic lithotripsy shortens operative time and markedly reduces irritative urinary symptoms, pain and analgesia requirement without compromising stone clearance, supporting selective stentless management.
Background: Menstruation is a universal experience of female that is not well understood or discussed in our nation. The aim of this study was to observe the stress and anxiety level of the respondents due to coordinated sequential hormonal changes that occurs during menstruation. Methods: Between January 1, 2023 to April 30, 2023, 120 healthy female medical students with a regular menstrual cycle (28±7 days) participated in this cross-sectional study at Varendra University's Department of Public Health in Rajshahi. Stress and anxiety level of the students were assessed and their relationship with bleeding rate were determined. Descriptive statistics and Chi-square tests were applied on the collected data. Results: Out of 120 respondents, the average age was 21.43±2.23 years, the age at menarche was 11.76±1.28 years and the BMI was 25.53±3.94 kg/m2. Twenty (16.7%) of the students reported having vaginal irritation as one of their symptoms during the previous six months. There were not statistically significant relationship of bleeding rate with exercise (p=0.063), sports (p=0.055) and stress level (p=0.208). But there were statistically significant relationship of bleeding rate with BMI (p < 0.001) and anxiety level (p=0.001). Conclusions: Maintaining normal BMI is very necessary for regular menstrual bleeding.
Background: Human feet are complex structure, roughly triangular or fan-shaped foundations designed for balance with a wider forefoot and narrower heel characterized by longitudinal and transverse arches that act as shock absorbers. Natural foot shapes vary and are frequently broader at the toes. Methods: The purpose of the study was to assess and compare the foot shape between adult Santhal and Bangalee population in Northern Region of Bangladesh. This was a cross-sectional type of comparative study conducted for a period of 1 year from January 2023 to December 2023 in the Department of Anatomy, Rajshahi Medical College, Rajshahi. This study was performed on 220 Santhal and Bangalee respondents who were selected by purposive sampling technique and semi-structured questionnaire was used to collect data from them. Data were analyzed via SPSS software. Statistical significance was evaluated as appropriate probability level p < 0.05 for all tests. Results: There was statistically highly significant difference of right foot shape (p < 0.001) but statistically nonsignificant difference of left foot shape (p > 0.05) between the Santhal and Bangalee respondents. Conclusion: Foot shape differs among ethnic groups. This study showed that the right foot shape varied between Santhal and Bangalee. Standard shaped right foot was found more in Santhal and slender shaped in Bangalee.
Background: Undescended testis (UDT) is the most prevalent congenital urological anomaly in male neonates. Orchiopexy is the standard surgical treatment for palpable inguinal UDT. Whether placement of a testicular fixation suture within the subdartos pouch is necessary or potentially harmful remains a matter of ongoing debate. Objective: To compare operative variables, short-term postoperative complications, long-term anatomical outcomes, and guardian satisfaction between orchiopexy performed with and without a testicular fixation suture. Methods: A prospective observational comparative study was carried out from 2022 to 2025 across two tertiary centers in Bangladesh. The study involved 42 children aged from 6 months to 14 years with palpable inguinal UDT, who were randomly assigned to two groups: Group A (orchiopexy with a 3/0 Vicryl testicular fixation suture, n=21) and Group B (orchiopexy without fixation suture, n=21). The study compared operative duration, early complications at two weeks, ultrasound findings at six months, and guardian satisfaction levels using Chi-square or Fisher's exact test (SPSS v25), considering p<0.05 as statistically significant. Results: Operative duration was notably longer in Group A, with 61.9% exceeding 60 minutes, compared to none in Group B (p<0.001). Early postoperative complications occurred more frequently in Group A (66.7% vs. 19.0%; p=0.004). Long-term six-month outcomes were generally similar (p=1.000), although testicular atrophy was more common in Group A (23.8% vs. 4.8%), and testicular reascension was observed only in Group B (14.3%). No cases of torsion were reported in either group. Guardian satisfaction levels were high and similar between the two groups (p=0.488). Conclusion: Sutureless orchiopexy using a well-fashioned subdartos pouch significantly reduces operative time and early morbidity while achieving comparable long-term anatomical outcomes. These findings support sutureless orchiopexy as a safe and effective approach for palpable inguinal UDT in children.
Background: Health-seeking behavior is a critical determinant of health outcomes, particularly in low-resource settings like Bangladesh. Understanding why and how general people access hospital care can inform targeted interventions to reduce delays and improve service utilization. However, empirical data from secondary-level public hospitals remain limited. Objective: To assess the health care-seeking behaviors among the general population attending a district-level hospital in Bangladesh. Methods: A prospective cohort study was conducted at Naogaon General Hospital from January 2023 to April 2023. A total of 347 participants were selected using purposive sampling. Data were collected through face-to-face interviews using a semi-structured questionnaire. Analysis was performed using SPSS version 23.0, employing descriptive statistics to summarize demographic characteristics, illness types, time to consultation, and reasons for hospital choice. Results: Among 347 participants, 62.0% delayed care-seeking for ≥3 days, and only 27.7% completed treatment. Acute febrile illness (37.5%) was the commonest complaint. Affordability (57.6%) and proximity (45.0%) drove hospital choice, while long waiting time (52.4%) and drug unavailability (33.1%) were major barriers. Older age and low income were significantly associated with delayed care-seeking (p<0.001 and p=0.002, respectively). Conclusion: While Naogaon General Hospital is preferred for its affordability and accessibility, delayed care-seeking and incomplete treatment adherence are prevalent. Interventions to reduce waiting times, ensure drug supply, and promote early consultation are urgently needed.
Background: Benign prostatic hyperplasia (BPH) is a common health problem in aging males, characterized by increased prostate tissue mass leading to urinary outflow obstruction and significant morbidity. Plasma markers of oxidative stress are elevated in men with BPH. This study aimed to assess oxidative stress by measuring serum malondialdehyde (MDA) levels in BPH patients before and after tamsulosin treatment. Methods: This quasi-experimental study was conducted on 60 newly diagnosed BPH patients from January 2019 to December 2019 in the Department of Pharmacology in collaboration with the Department of Urology, Rajshahi Medical College Hospital, Rajshahi, Bangladesh. MDA levels were measured using the thiobarbituric acid-reactive substance (TBARS) assay before and after three months of tamsulosin therapy (0.4 mg daily). Data were analyzed using paired t-test, with p < 0.05 considered statistically significant. Results: The mean age of participants was 61.60 ± 6.38 years. The mean plasma MDA level before tamsulosin treatment was 3.65 ± 1.82 µmol/L, which reduced significantly to 3.26 ± 1.64 µmol/L after three months of therapy (mean difference: 0.39 µmol/L, 95% CI: 0.16–0.62, p = 0.001). Overall, 70.0% of patients showed a decrease in MDA levels following treatment. Conclusion: Tamsulosin therapy significantly reduces serum MDA levels in patients with benign prostatic hyperplasia, indicating a reduction in oxidative stress. These findings suggest that tamsulosin may have beneficial antioxidant effects beyond its established symptomatic relief.
Background: The mesiobuccal (MB) root of the maxillary first molar is known for its anatomical complexity, which often complicates endodontic treatment. Knowledge of population-specific variations assists clinicians in planning effective therapy. Objective: To evaluate the root canal morphology, accessory canals, intercanal communications, and apical foramina of the MB root of maxillary first molars in the Rajshahi population using the clearing technique. Materials and Methods: A total of 385 extracted maxillary first molars were processed with the clearing technique. Canal configurations were classified according to Vertucci’s system. Accessory canals, intercanal communications, and number of apical foramina were recorded. Descriptive statistics and Chi-square tests were performed. Results: Vertucci types were: I (30.64%), II (31.42%), III (4.41%), IV (17.66%), V (3.89%), VI (7.53%), VII (3.37%), VIII (1.03%). Accessory canals were detected in the coronal (3.11%), middle (8.50%), and apical (55.58%) thirds. Intercanal communication was present in 36.10% of roots. Single, double, and triple apical foramina were observed in 66.49%, 32.46%, and 1.03% of samples, respectively. Chi-square analysis showed a significant association between complex Vertucci types and accessory canals (p < 0.05) and intercanal communications (p < 0.05). Conclusion: The MB root of the maxillary first molar in the Rajshahi population demonstrates significant anatomical variability. Clinicians should employ meticulous canal exploration, advanced irrigation, and careful obturation techniques to improve endodontic success.
Background: Elevated C-reactive protein and diminished serum albumin independently predict adverse prognosis after ischaemic stroke, and their composite, the CRP/albumin ratio, may capture inflammatory burden more precisely than either marker in isolation. Objective: This study evaluated the relation between admission C-reactive protein/albumin ratio (CAR) and in-hospital outcome among ischaemic stroke patients admitted to the intensive care unit. Methods: A prospective observational study enrolled 65 purposively sampled ischaemic stroke patients admitted to a tertiary-care intensive care unit. Admission CRP and albumin were measured within 24 hours, CAR was calculated for each patient, and its relation to survival status, mechanical ventilation, and renal replacement therapy requirement was analysed using SPSS version 26.0. Results: Of 65 patients, 35 (53.8%) survived and 30 (46.2%) died in hospital. Non-survivors exhibited significantly higher CRP and CAR mean ranks than survivors (CRP 46.80 vs 21.17; CAR 47.33 vs 20.71; both p<0.001) and required invasive mechanical ventilation more frequently (83.3% vs 34.3%, p<0.001). Univariate regression identified CAR as the strongest predictor of non-survival (OR 6.43, 95% CI 2.83–14.62, p<0.001), an association that persisted after adjustment for age, gender, residence, Glasgow Coma Scale score, and oxygen saturation (adjusted OR range 6.18–8.06, all p<0.05). CAR correlated strongly with CRP (rs=0.98, p<0.001) and inversely with Glasgow Coma Scale score (rs=−0.52, p<0.001). Receiver-operating characteristic analysis identified a cut-off CAR of ≥1.94 predicting mortality with 80% sensitivity, 91% specificity, and an area under the curve of 0.91 (95% CI 0.84–0.98, p<0.001). Conclusion: Admission CRP/albumin ratio is independently and robustly associated with in-hospital mortality in ischaemic stroke patients, supporting its use as an early, low-cost prognostic biomarker in critical care.
Background: Inguinal hernia is one of the most common surgical conditions, and both open and laparoscopic mesh repair are widely practiced. Although open repair remains common in many hospitals, laparoscopic repair may offer advantages in terms of postoperative pain, recovery, and patient satisfaction. Methods: This hospital-based comparative study included 100 patients who underwent inguinal hernia repair. Patients were equally divided into two groups: 50 underwent laparoscopic repair and 50 underwent open repair. Baseline characteristics, clinical profile, operative outcomes, postoperative pain, analgesic requirement, early recovery, complications, chronic groin pain, return to normal activity and work, patient satisfaction, and recurrence were compared between the two groups. Results: The laparoscopic group had significantly lower postoperative pain scores at 6 hours, 24 hours, 48 hours, discharge, and follow-up visits compared with the open group. Analgesic requirement was lower in the laparoscopic group. Time to oral feeding, time to mobilization, postoperative hospital stays, return to normal activity, and return to work were also significantly shorter after laparoscopic repair. Postoperative complications, including wound infection, hematoma, scrotal swelling, urinary retention, postoperative fever, and mesh infection, were more frequent in the open repair group. Chronic groin pain at 3 months was lower in the laparoscopic group. Patient satisfaction was higher after laparoscopic repair. Recurrence was rare and did not differ significantly between the two groups. Conclusion: Laparoscopic inguinal hernia repair was associated with lower postoperative pain, reduced analgesic requirement, faster recovery, fewer early complications, lower chronic groin pain, and higher patient satisfaction compared with open repair. However, baseline differences between groups should be considered when interpreting the findings.
Background: Abnormal uterine bleeding affects women across reproductive and postmenopausal life stages and may signal a spectrum extending from benign endometrial change to malignancy. Objective: This study evaluated the correlation between clinical presentation and histopathological findings in women with abnormal uterine bleeding. Methods: A cross-sectional analytical study was conducted in the Department of Gynecology and Obstetrics, Rajshahi Medical College Hospital, from July 2025 to June 2026, enrolling 156 women aged 18–65 years with abnormal uterine bleeding. Clinical variables, endometrial thickness, and histopathological diagnoses were extracted from case records and analysed using SPSS v26.0, with p<0.05 taken as significant. Results: Mean age was 40.6 ± 14.6 years and mean haemoglobin was 11.1 ± 2.1 g/dL, with anaemia (haemoglobin <12 g/dL) in 93/156 participants (59.6%). Polymenorrhoea (21.8%) and intermenstrual bleeding (21.2%) were the leading presentations. Histopathology showed endometrial hyperplasia without atypia in 39/156 (25.0%) and endometrial carcinoma in 33/156 (21.2%) specimens, with 84/156 (53.8%) classified as benign. Age group was strongly associated with histopathological category (χ²=94.08, df=18, p<0.001), and carcinoma cases were significantly older than non-malignant cases (47.3 ± 16.9 versus 38.8 ± 13.4 years; t=3.06, p=0.0026). Endometrial thickness, haemoglobin, and body mass index did not differ significantly across histopathological categories (all p>0.05). Hysteroscopy (26.9%) was the commonest management modality, and procedure-related complications occurred in 7/156 participants (4.5%). Conclusion: Age-stratified clinicohistopathological correlation reveals a substantial premalignant and malignant burden among women with abnormal uterine bleeding, supporting routine, age-directed endometrial sampling in this population.
Background: Breast pain, a common and often distressing symptom, affects a significant number of women, influencing their quality of life and requiring comprehensive evaluation. This condition, known as mastalgia, can have various underlying causes, including hormonal imbalances, particularly elevated prolactin levels. This study aimed to evaluate the association between hyperprolactinemia and breast pain (mastalgia), a frequently overlooked symptom of the condition. Methods: This cross-sectional study was conducted at a private hospital from 1/7/24 to 31/12/25 on 60 participants to evaluate breast pain as a symptom of hyperprolactinemia. Statistical analyses were conducted to determine the association between breast pain and serum prolactin levels, as well as treatment response and pain severity. Data were expressed in terms of frequency, percentages, and mean values, with p-values calculated to assess statistical significance. All analyses were performed using the statistical software SPSS version 26. Result: The study included 60 patients with a mean age of 35.6 years and a BMI of 24.5. A significant proportion had irregular menstrual cycles (30%) and a history of hyperprolactinemia (50%), with 66.7% experiencing breast pain, often sharp (30%) and lasting an average of 8.5 weeks. Elevated serum prolactin levels (mean 29.6 ng/mL) were associated with breast pain (P = 0.014). Imaging findings showed 33.3% of patients with abnormal breast ultrasound/mammography and 41.7% with pituitary abnormalities. Treatment for hyperprolactinemia was provided to 63.3%, with 33.3% achieving complete pain resolution. Pain severity was inversely correlated with treatment response. Conclusion: This study highlights the significant role of prolactin in the pathophysiology of breast pain in patients with hyperprolactinemia. Elevated prolactin levels are associated with a higher frequency and intensity of breast pain, as well as with abnormal imaging findings, particularly those related to pituitary function. Dopamine agonists remain an effective treatment for alleviating symptoms, including breast pain, with a clear dose-dependent response observed in this cohort.
