International Journal of Research in Medical Sciences
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Editor: Dr. Bhaven Kataria
ISSN: 2320-6071 Online : 2320-6012
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://www.msjonline.org/index.php >
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Item Existing challenges and histopathological review of borderline ovarian epithelial tumors(Medip Academy, 2024-10) Singh, R; Raman, E; Agarwal, P; Maurya, MK; Jaiswal, R; Gupta, S; Solanki, V; Agarwal, S; Singh, AK.Background: The borderline tumour seen in the ovary can be with or without stromal invasion. Diagnosis and application of the correct criteria are of utmost importance to avoid over or undertreatment of these. We analyzed the borderline tumors reported in 2 years with respect to clinical outcome based on the morphological diagnosis and points that needed reconsideration. Methods: Cases reported as borderline tumors in ovary were retrieved from records reviewed and follow up was recorded. Additionally, we performed a morphometric analysis to confirm the maximum size of the invasive front. Results: A total of 467 resected ovarian tumor specimens were received, of which 266 (266/467 *100=56.9%) were epithelial tumors; out of them 54.88% were benign, 4.88% were borderline and 40.22% were malignant. The mean age at the time of borderline diagnosis was 38.66 years. On follow-up two cases among them developed further disease. One was reported from our center and one from outside, both were mucinous-type tumors. On critical review we found that there was minimal nuclear atypia in both, there was no evidence of convincing stromal invasion except few irregular well formed glands were seen infiltrating the stroma in one case. Conclusions: A large multicenter, interdisciplinary collaboration and data-driven study is needed to reconfirm and reconsider the cut-off of 5mm especially in mucinous tumors.Item Venifixe: phytovanoactive topical infused oil for healing and preventing epidermal and venous ailments(Medip Academy, 2024-10) Apurba, G; Banerjee, SK; Venkatesh, VSG; Singal, DK; Ganguly, A.Background: This study investigates Venifixe�, a cost-effective phyto-vanoactive infused oil, as an alternative treatment for epidermal and venous ailments (EVA). Venifixe� combines venoactive phyto-complexes, hydrophilic botanical extracts, essential oils, carrier oils, and epidermal care components. The study strives to offer a non-invasive and potentially more effective alternative to conventional treatments, aiming to improve or prevent various EVAs and enhance patients' quality of life. Despite the array of existing treatments, there remains a need for formulations offering enhanced efficacy, reduced invasiveness, and broader applicability. Methods: Over twelve weeks, 250 participants (average age: 59.91�25 years), diagnosed with varicosities via ultrasonography, were included. Participants were divided into two groups: 142 received standard management (SM) for symptomatic EVA, and 108 received Venifixe� treatment. Both groups were assessed for EVA-related symptoms (pain, itchiness, restlessness, swelling/edema, heaviness, and leg cramps) and Venous Clinical Severity Score (VCSS) based on CEAP classification pre-and post-treatment. Results: At twelve weeks, the Venifixe� group demonstrated a VCSS ROC curve (AUC=0.905, 95% CI: 0.89-0.92, p<0.0001), with 93.68% sensitivity, 61.11% specificity, and 75.43% accuracy, indicating favorable treatment outcomes. Significant reductions in VCSS risk ratios and associated symptom prevalence (p<0.0001) led to an improved NHS gradation scale from level 3 to level 2 compared to the SM group. Conclusions: Venifixe�'s topical application provides a more effective phytotherapeutic approach for EVA compared to standard management, offering symptom relief and enhancing quality of life. These results, supported by ROC curves and NHS gradation improvements, warrant further clinical investigation.Item Magnitude of sympathovagal imbalance and its correlation with inflammatory response and oxidative stress in pregnant women at risk of pregnancy induced hypertension: a cross-sectional study(Medip Academy, 2024-10) Karpagam, VK; Pal, GK; Habeebullah, S; Velkumary, S; Soundaravally, R.Background: Pregnancy-induced hypertension (PIH) is a common complication of pregnancy but it抯 genesis isn抰 known. It is proposed to be due to an excessive inflammatory response in the mother secondary to placental or maternal factors. The study aimed to measure the magnitude of sympathovagal imbalance (SVI) and to evaluate the role that oxidative stress and the inflammatory response play in the development of sympathovagal imbalance in pregnant mothers with risk factors of pregnancy-induced hypertension. Methods: A cross-sectional study was carried out among pregnant women with at least one risk factor for PIH and age-matched pregnant women without risk factors for PIH as controls from March 2023 to February 2024 in a tertiary care hospital in Pondicherry. The intergroup differences in the mean between the two groups were compared using the Mann Whitney test and the Student's T-test. Results: Short-term heart rate variability was significantly higher among cases while time domain analysis didn抰 show significance. Total Cholesterol (TC), Triglycerides (TG), Very Low-Density Lipoprotein (VLDL) and Low-Density Lipoprotein (LDL) were significantly higher among the cases and High-Density Lipoprotein (HDL) was low in cases compared to controls. There is a strong correlation of Low Frequency to High Frequency (LF-HF) ratio with Tumor Necrosis Factor-alpha (TNF-?) and high sensitivity (hs-CRP) in patients with risk factors of PIH. Conclusions: Pregnant women at risk of pregnancy-induced hypertension showed increased inflammatory response, oxidative stress and dyslipidaemia. Hence, conducting sessions for stress management not only during pregnancy but also in the pre-pregnancy period can alleviate sympathetic dysfunction.Item Effect of a reverse diet kit on the regression of atherosclerosis plaque and its effect on the lipid profile in patients with coronary artery disease(Medip Academy, 2024-10) Sane, R; Mandole, R; Amin, G; Ghadigaonkar, P.Background: Prevalence of coronary artery disease (CAD) constitutes a major public health problem in developing countries. CAD also represents a major economic burden on health care systems and eventually creates a large gap in the quality of care associated with the disease. Methods: To study ayurveda based disease and symptoms modifying therapy (Dietary modification and panchakarma therapy) to reduce symptoms of CHF and IHD and focus on reduction of total atheroma volume (TAV); plaque burden by a scientifically designed kit (Reverse diet kit) by Madhavbaug using a pre and post-test experimental design for patients with CAD. Results: At the end of 90 days, a coronary CT angiogram revealed that TAV decreased significantly by 71.76 mm3 in post-intervention plaque volume compared with baseline in the three major epicardial branches of the coronary artery. Conclusions: The data provided relevant real-world evidence that the 慠everse Diet Kit� can modulate coronary artery plaque deposition by reducing lipid infiltration within the coronary plaque and may lead to disease reversal wherein panchakarma therapy enabled symptom management and helped improve cardiovascular outcomes in patients with CAD.Item Insulin resistance and metabolic syndrome in generalized anxiety disorder: a cross-sectional study(Medip Academy, 2024-10) Kalva, LT; Jannabhatla, VBK; Anusha, N; Tirupathe, S.Background: Generalized anxiety disorder (GAD) involves persistent and excessive anxiety affecting daily activities for at least six months, often accompanied by restlessness, fatigue, irritability, muscle tension, and sleep difficulties. Insulin resistance (IR) and metabolic syndrome (MetS) are linked to psychiatric disorders due to their impact on the central nervous system. This study aims to assess IR and MetS prevalence in GAD patients and explore their relationship with GAD severity. Methods: In a six-month cross-sectional study at a tertiary care center in southern India, 66 patients aged 18-60 diagnosed with GAD per DSM-5 criteria were included. Exclusion criteria were other psychiatric disorders, significant medical conditions, and specific medication use. GAD severity was assessed using the Hamilton anxiety rating scale (HAM-A). IR was calculated using the homeostatic model assessment of insulin resistance (HOMA-IR) formula, with a value of 2.5 or higher indicating significant IR. MetS was diagnosed based on the International Diabetes Federation's criteria. Results: Among the 66 participants (59.1% female, mean age 43.41 years), 39.4% had severe GAD. Significant IR was present in 39.4% of participants, while 34.8% met the criteria for MetS. No significant correlation was found between GAD severity and IR or MetS, although a sedentary lifestyle was notably higher in GAD patients (57.6%). Conclusions: The study highlights a high prevalence of IR and MetS among GAD patients, without a significant correlation with GAD severity. Routine metabolic screening and integrated management strategies are recommended for GAD patients to address both mental and metabolic health concerns.Item Inter-rater and intra-rater reliability of head-mount laser device on assessing cervical spine proprioception in patients with cervicogenic headache(Medip Academy, 2024-10) Prakash, J; Nagarani, R; Bhojan, K; Shalini, CR; Reddy, RC; Chittybabu, D; James, TT.Background: Relationship exist between the occurrence of cervicogenic headache (CGH) and head posture, due to a reduction in proprioception from the cervical spine. Active joint position sense of the cervical spine can be assessed using head-mount LASER device. This study evaluated the reliability of the head-mount LASER device in assessing cervical proprioception in adults with CGH. Methods: A total of 50 adults of both genders with a clinical diagnosis of CGH were recruited for the study. The assessment for cervical proprioception was done using the device using a pre-determined test protocol, by two different therapists. The tests were repeated on the next day as well. The accuracy of relocation of the LASER pointer from the pre-determined target spot were evaluated in centimeters, during both flexion and extension. Results: The study found good inter-rater reliability for flexion (ICC=0.888; 95% CI: 0.743 to 0.945) and extension (ICC=0.873; 95% CI: 0.754 to 0.931), and good to excellent intra-rater reliability for the device (ICC for flexion and extension being 0.952 and 0.951, respectively). Conclusions: This study concluded that head-mount LASER device can be used as a clinical tool in assessing cervical proprioception, and demonstrated good inter-rater and intra-rater reliability when used on patients with cervicogenic headache.Item Deciphering the distribution of ESKAPE pathogens in various clinical samples and its pattern of antimicrobial resistance: a study from a tertiary care center in Wayanad, Kerala(Medip Academy, 2024-10) Nandhana, DB; Murali, A; Deepthy, BJ.Background: ESKAPE includes 6 nosocomial pathogens which are capable of 慹scaping� the biocidal actions of antimicrobial agents. Antimicrobial resistance of ESKAPE pathogens in clinical samples is crucial for effective patient management and development of targeted treatment strategy. So, the present study was designed to investigate the distribution of ESKAPE pathogens across diverse clinical samples and to find out their prevalence in different clinical sample such as pus, sputum and urine. This provides an insight to their varied ecological niches within healthcare settings. Methods: This was a retrospective study done at Dr. Moopen抯 Medical College. A total of 6492 clinical samples were studied to isolate ESKAPE pathogens. Which included urine, sputum and pus samples. Results: A total of n=6,492 Individual bacteria isolates were recovered from clinical specimens such as sputum (1473), urine (3710) and pus (1309) out of which n=1181 were ESKAPE pathogen. The most frequent clinical sample were pus 580 (49.12%) followed by urine 265 (22.43%) and respiratory samples 336 (28.45%). The most predominant bacteria were found to be Staphylococcus aureus (31.39%) in pus whereas Klebsiella pneumoniae in urine (40.10%) and respiratory samples (40.48%). The average age of the involved patients was approximately 74.8�.67 years, and the range of ages in the dataset is in 1-97 years, with a gender distribution of 637 (58.28%) males and 470 (42.72%) females. Conclusions: Our findings reveal that pus serves as a significant reservoir for ESKAPE pathogens, with Staphylococcus aureus and Pseudomonas aeruginosa as predominant organisms.Item Association between platelet aggregation parameters and primary open angle glaucoma(Medip Academy, 2024-10) Agarwal, R; Singh, S; Dhawan, P; Narang, A; Gupta, P; Namrata; Khan, S.Background: The aim of the research was to study association between platelet aggregation parameters and primary open angle glaucoma. Methods: An analytical cross sectional study with comparison group was conducted on 120 patients (60 cases, 60 controls). All enrolled patients underwent a comprehensive ophthalmological examination which included visual acuity assessment and refractive error testing, slit lamp examination, intraocular pressure (IOP) measurement with Goldmann's applanation tonometer, Gonioscopy using Sussman 4 mirror gonioscope, optic nerve head examination by slit lamp and biomicroscopy using +90D lens, visual field analysis and mean deviation assessment using automated perimeter in both eyes, retinal nerve fiber layer (RNFL) analysis by optical coherence tomography (OCT), complete blood count (CBC) analysis for the study of platelet aggregation parameters, platelet count (PLT), platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume (MPV), and platelet large cell ratio (P-LCR). Results: Based on the direction of assessment, PCT was evaluated for prediction of glaucoma, a cut off of PCT <0.203 was found to be 83.3% sensitive and 53.3% specific. Severity of POAG did not show any significant association with any of the platelet aggregation parameters. Conclusions: In the present study, we did not find a significant association of different platelet parameters with severity of POAG either.Item Comparison of the efficacy of 3% hypertonic saline and 20% mannitol in reducing intracranial pressure in patients with traumatic brain injury(Medip Academy, 2024-10) Prakash, A; Kumar, V; Kumar, D; Ali, M; Ansari, MH.Background: Objective of the study was to compare the effects of 3% hypertonic saline (HTS) solution and 20% mannitol (MTL) solution on intracranial hypertension. Methods: The prospective study subjects consisted of 60 patients with traumatic brain injury admitted to the Department of Neurosurgery, RIMS, Ranchi between March 2020 to February 2023. The subjects fulfilling the inclusion criteria were selected and divided into two groups: group A (n=30): treated with 3% HTS, and group B (n=30): treated with 20% MTL. Results: All the findings were noted on Microsoft excel sheet and data were analyzed using the statistical package for the social sciences (SPSS) 21.0 package. Quantitative data were analyzed using student抯 t-test (paired and unpaired) and categorical data were analyzed by the test of proportion, Chi-square, and Fisher抯 exact test. Conclusions: Both 3% HTS and MTL can effectively reduce intracranial pressure, but 3% HTS has a more sustained effect on intracranial pressure and can effectively increase cerebral perfusion pressure.Item Safety and effectiveness of paravertebral block for simple mastectomy: a prospective study(Medip Academy, 2024-09) Hannan, MA; Arin, KM; Karmakar, CS; Tusher, SM; Das, RS; Sultana, A.Background: Paravertebral block (PVB) has emerged as an alternative to general anesthesia (GA) for various surgical procedures, offering potential advantages such as improved postoperative pain control and reduced systemic side effects. Simple mastectomy, a common surgical intervention for breast cancer treatment, involves the removal of breast tissue without axillary lymph node dissection. Methods: This prospective study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from 1st January 2022 to 30th June 2023. A total of 50 patients undergoing simple mastectomy were randomly assigned. Results: PVB significantly reduced postoperative VAS scores at 1 hour (2.3�1 vs. 4.7�3), 6 hours (2.1�9 vs. 4.4�2), 12 hours (1.9�8 vs. 3.8�0), and 24 hours (1.7�6 vs. 3.5�9) (all p<0.001). Opioid consumption was lower in the PVB group (4.8�1 mg vs. 12.4�2 mg, p<0.001). Incidence of PONV was reduced (16% vs. 48%, p=0.019), hospital stay was shorter (2.3�5 days vs. 3.1�7 days, p=0.001), and patient satisfaction was higher (4.6�5 vs. 3.8�7, p=0.003). No significant differences were observed in intraoperative hemodynamic parameters or adverse events. Conclusions: Paravertebral block provides superior pain management, reduces opioid use and PONV, shortens hospital stays, and improves patient satisfaction compared to GA in simple mastectomy, demonstrating its efficacy and safety in perioperative care.Item Model preparation-an effective teaching-learning tool in microbiology(Medip Academy, 2024-10) Tripathi, PC; Singh, H; Suryawanshi, RK.Background: Learning by doing has retention rate of 75%. Working model preparation helps in better understanding of concepts by the students and improves their confidence. They will have a prolonged retention of the topic and its concept thus developing a scientific approach and attitude. The aims were to study the perception of the students for model making, to create students understanding of three-dimensional view of microbiology and to motivate the students to learn microbiology in a better and easy way. Methods: The study was conducted at the department of microbiology, CIMS, Chhindwara. Study participants were second phase MBBS student抯 of 2019 batch. 20 Topics were allotted for model preparation. 100 students were divided in 5 different batches. Guidance for model preparation was provided by a mentor of the department. Cost-effective materials such as cardboard, thermocol, paper was used by the students. One week time was given to the students for model preparation. Fifteen days after submission of model a competition was held to motivate students. Results: Most of the students enjoyed the activity, found it useful, interesting, helpful in understanding the concept of the subject, helpful in building logical thinking and gained confidence about the subject. Conclusions: This activity helped the students to showcase their cognitive, psychomotor and communication skills. Constant motivation by teachers to the students shows that slow learners could try to perform well after looking at the other team members.Item A study to assess the knowledge regarding polycystic ovarian syndrome among the high school girls in a selected high school, Siliguri, West Bengal(Medip Academy, 2024-10) Sarkar, S; Sharma, S; Dutta, B; Roy, J; Mahanta, P; Das, P; Karmakar, P; Barman, R; Das, S; Barman, S; Dutta, S; Ghosh, S; Patowary, S; Sarkar, S; Basak, S; Dey, T.Background: Polycystic ovarian syndrome is a common reproductive and endocrine disorder found in 6-10% of the female population. The global prevalence of PCOS is estimated between 4% and 20%. The world Health Organization data suggest that approximately 116million women (3.45%) are affected by PCOS globally. The age standardized incidence rate of PCOS in women of reproductive age was 82.44 per 100000 in 2017, 1.45% higher than in 2007. Methods: There are many research designs, but among them we have chosen non-experimental research design for this study. Sample of this research study was 105 high school students of Little Angels� Senior Secondary School, Siliguri through consecutive sampling technique. The instrument used to assess level of knowledge among high school girls was self-structured questionnaire. Results: Findings revealed that among high school girls 7.62% had poor knowledge, 26.67% had average knowledge, 64.76% had good knowledge and 0.95% had excellent knowledge about polycystic ovarian syndrome. Conclusions: The study concluded that the selected variables namely age, religion, educational class, exercise has significant impact on the knowledge regarding polycystic ovarian syndrome among high school girls. The study can be replicated with a larger sample to the findings can be generalized to a larger population.Item Determining the effect of developmental 慔R nurturing connect� interventions on compassion and empathy in physicians and surgeons(Medip Academy, 2024-10) Solanki, D.Background: Empathy in healthcare, particularly therapeutic empathy, is vital for understanding and validating patients' emotions, leading to better patient care and outcomes. Despite its benefits, empathy often declines during medical training. While various training programs aim to enhance empathy are designed, there is a need for standardized methods and more qualitative research to address this. Therefore, in the current study, to enhance the combined concept of empathy and compassion, developmental interventions called "HR nurturing connects� (HRNC) were implemented. Methods: This two-arm, prospective, randomized study involving 28 doctors. 14 doctors in the intervention group underwent the HRNC training which focused on enhancing empathy and compassion through training modules and constructive feedback. Whereas the control group received no developmental intervention. Evaluation for parameters of empathy and compassion were evaluated by using the cumulative Bhaktivedanta抯 index of compassion and empathy in physicians and surgeons (BICEPS) score which involved assessments from doctors and 2 nurses, 2 ward clerks working with respective doctors at multiple time points. Results: The intervention significantly increased empathy and compassion (p<0.001) of the doctors randomized in intervention group, with BICEPS scores rising from 66.51�87 (baseline) to 84.12�43 (12 months). In contrast, the control group showed minimal changes, with scores increasing from 63.48�56 (baseline) to 69.5�87 (12 months). Conclusions: The 慔RNC� program has proven effective in enhancing empathy, compassion, kindness, and understanding in doctors, resulting in better patient outcomes, an improved workplace environment, and higher overall healthcare quality.Item Correlation between blood group and autoantibodies formation in multi-transfused thalassaemia patients(Medip Academy, 2024-10) Al-Mamun, ABM; Islam, MA; Fatema, K; Chakrabarty, T; Islam, K; Karim, TA.Background: Thalassemia is a prevalent genetic disorder of hemoglobin synthesis, characterized by reduced production or absence of one or more globin chains, requiring frequent blood transfusions that can lead to complications such as autoantibody formation. The purpose of this study was to assess the correlation between blood group and the formation of autoantibodies in thalassemia patients who have received multiple blood transfusions. Methods: This cross-sectional study at the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, conducted from October 2017 to September 2018, included 384 thalassemia patients who received at least 10 units of red cell concentrate. Participants were selected based on specific inclusion and exclusion criteria, with informed consent obtained. Data collection involved patient interviews, clinical examinations, and hematological tests. Statistical analysis using SPSS version 23.0 included Chi-square, Fisher抯 exact, and t-tests, with significance set at p<0.05. Results: Among 384 patients, the most common blood group was B+ (46.2%). Coombs' test results showed DCT positivity in 3.1% of 384 patients, ICT positivity in 7.5%, and both DCT and ICT in 4.2%. Most patients (92.3%) had their first transfusion after age 2, with 84.6% receiving transfusions every 2-4 weeks. Conclusions: In conclusion, B positive blood group thalassemia patients receiving frequent transfusions are at a higher risk of autoantibody formation, and Rhesus phenotype-matched blood with pre-storage leukodepletion is recommended to mitigate this risk.Item Co-morbidities of diabetes mellitus among admitted stroke patients in a tertiary hospital(Medip Academy, 2024-10) Islam, MS; Tanjum, T; Sarker, SS; Islam, MK; Saha, C; Dutta, R; Das, N; Dey, S.Background: Diabetes mellitus significantly impacts stroke risk and outcomes by influencing co-morbid factors and stroke patterns, guiding interventions to reduce diabetes rates and improve stroke outcomes. The aim of this study was to describe the distribution of co-morbidities of diabetes among hospitalized stroke patients. Methods: To describe the pattern of co-morbidities of diabetes among hospitalized stroke patients was a descriptive study. It was done in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital from January 2015-June 2015. A total of 110 patients were enrolled in the study. Result: Patients averaged 56.95 years old (SD�594), with the majority (50%) aged 51-60 years. Among the 110 patients, 72 were male, most of whom (97.2%) were smokers. Half of the males had controlled diabetes, while all females had uncontrolled diabetes. Ischemic stroke affected 75% of males and 97.4% of females. About 80% of males had hypertension, compared to 92% of females. Dyslipidaemia was known in 29% of males and 37% of females. Kidney disease prevalence was low in both groups. More than half of both males (55.6%) and females (55.3%) were obese. Peripheral neuropathy was noted in 47% of males and 65.8% of females. Non-alcoholic fatty liver disease affected 28% of males and 21% of females. Conclusion: It's crucial to implement targeted strategies for preventing and managing stroke in diabetic patients, emphasizing education and raising public awareness about diabetes and its complications.Item Assessment of cervicovaginal smear and HPV DNA co-test for cervical cancer screening: implications for diagnosis and follow-up strategies(Medip Academy, 2024-10) Shaheen, N; Afrin, SS; Ripon, MRK; Nahar, K; Khan, AA; Haque, S.Background: Cancer of the cervix, despite being a preventable disease, continues to be a significant public health problem in females. In recent years, much new development has taken place in the field of screening, diagnosis and management of cervical intraepithelial neoplasia. Methods: A total of 980 patients aged between 20 to 60 years were included in the study. All the patients have gone through Pap test, RT-PCR for HPV test and colposcopy biopsy. Then the sensitivity and specificity are calculated. Retrospectively selected Pap specimens with RT-PCR HPV testing results obtained from the Department of Pathology of Sheikh Fozilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur, Bangladesh from July 2022 to July 2024 followed by the result is correlated with Colposcopy guided biopsy. Results: We found 250 cases of human papilloma virus RT-PCR positive, 433 cases of Pap test positive result and 399 cases of positive colposcopy biopsy result. So, The HPV test was demonstrated to be more sensitive (75%) than specific (55%) and was more sensitive than colposcopy for detecting CIN changes (75% vs. 73%). Conclusion: HPV tests showed a higher sensitivity than colposcopy, but colposcopy results presented higher specificity. Combining HPV testing and colposcopy proved to be the most efficient method for detecting CIN lesions.Item Frequency of pulmonary hypertension in chronic kidney disease patients (stages 3, 4, 5) at a tertiary care hospital(Medip Academy, 2024-10) Islam, MZ; Akter, T; Rahman, AKMM.Background: Chronic kidney disease (CKD) is a challenging issue for health care providers and major burden for health care. Cardiovascular disease is a well-recognized and important source of mortality in a patient with chronic kidney disease. The aim of this study was to observe the frequency of pulmonary hypertension in chronic kidney disease patients at tertiary care hospital. Methods: This cross sectional observational study was conducted in the Department of Medicine, Combined Military Hospital, Dhaka Cantonment, Bangladesh over a period of six months from 17th November 2019 to 16th May 2020. Results: It was observed that majority, e.g., 28.0% patients belonged to age 41-50 years, mean age was found 41.4�7 years in Group-A and 42.1�5 years in Group-B. On evaluation of eGER, maximum patients (e.g., 61%) had <15 ml/min/1.73 m2, followed by 24.0% of patients had 15-29 ml/min/1.73 m2 and 15.0% case detected 30-59 ml/min/1.73 m2. Standard 2D, M mode echocardiographic was conducted in all patients. In this study, mPAP<25.0 mmHg was detected in 31 (62.0%) and 45 (90.0%) in group A and group B respectively. Overall prevalence of pulmonary hypertension was 24.0%. On comparison between groups, it is evident that frequency of pulmonary hypertension was predominant in patients with chronic kidney disease on maintenance haemodialysis than patients with chronic kidney disease without maintenance haemodialysis (38.0% vs. 10.0% respectively). Conclusions: Pulmonary hypertension (PH) is common in patients with chronic kidney disease and is an independent predictor of mortality.Item Posterior reversible encephalopathy syndrome: a study of risk factors, presenting complaints, and magnetic resonance imaging findings from a tertiary care hospital in Pakistan(Medip Academy, 2024-10) William, M; Anjum, S; Habib, M; Paudel, N; Anjum, AS.Background: Posterior reversible encephalopathy syndrome (PRES) primarily occurs in the background of high blood pressure and manifests as symmetrical vasogenic edema involving the parieto-occipital lobes. This study aims to determine the risk factors, presenting complaints, and various typical and atypical radiological patterns of PRES in a larger single-center population. Methods: This is a retrospective observational study of 81 patients with clinical and radiological diagnoses of PRES. Demographic data, concurrent medical illnesses, and presenting complaints were extracted from medical records. Areas of the brain involved and atypical imaging findings were studied on various MR imaging sequences. Results: The most common risk factor was eclampsia (64.20%), followed by renal diseases (16.05%). All but eight cases occurred in the background of hypertension. The most frequent presenting complaint was seizure (79.01%). The most common radiological manifestation was bilaterally symmetrical vasogenic edema, with the parietal lobe (92.59%) and the occipital lobe (83.95%) primarily affected. Restricted diffusion was present in 23.46%, hemorrhage in 8.64%, and post-Gadolinium contrast enhancement in 2.47% of patients. Conclusions: PRES has a diverse clinical and radiological presentation awareness about which among medical professionals is important for timely diagnosis and treatment.Item Impact of dietary habit on the mental wellbeing of adolescents: a Bangladeshi perspective(Medip Academy, 2024-10) Rahman, MM; Alam, MR; Naser, AZM; Parves, MM; Tanveer, SKM; Hossain, MA; Ahmed, E; Akter, T.Background: Adolescent mental health is a critical public health issue, significantly influenced by dietary habits. This study aims to explore the relationship between dietary patterns and mental well-being among adolescents in Dhaka, Bangladesh. Methods: This cross-sectional observational study was conducted with 600 students from Grades 9 and 10 across multiple schools in Dhaka. Data were collected using a structured questionnaire covering demographic information, dietary habits, and mental health assessed using the generalized anxiety disorder 7-item (GAD-7) scale. Result: The majority of participants were aged 15 years (37.83%) and 16 years (28.33%), with 61.33% being female. BMI classification revealed that 28.83% were underweight, 54.67% had a normal BMI, and 16.50% were overweight or obese. Dietary analysis showed that 56.17% had a mixed diet, 48.33% consumed fruits weekly, and 59.83% consumed vegetables regularly. Significant correlations were found between dietary habits and anxiety levels, with positive correlations between fruit and vegetable intake (r=0.143, p<0.001) and negative correlations between skipping breakfast and fruit intake (r=-0.172, p<0.001). Conclusion: This study highlights the significant impact of dietary habits on the mental well-being of adolescents in Dhaka. Regular consumption of fruits and vegetables is associated with lower anxiety levels, while poor dietary practices, such as skipping breakfast and high fast-food intake, are linked to higher anxiety. These findings underscore the need for targeted nutritional education and mental health interventions to improve adolescent health outcomes.Item In vitro and in vivo evaluation of antibiotic combination against colistin resistant Acinetobacter baumannii isolated from patients of a tertiary care hospital, Bangladesh(Medip Academy, 2024-10) Jahan, S; Shamsuzzaman, SM.Background: Emerging resistance to colistin in clinical Acinetobacter baumannii isolates is of growing concern as these-strain are simultaneously resistant to most antimicrobial agents. Colistin is considered as last resort for treating severe bacterial infections caused by gram negative multidrug resistant bacteria. Since current treatment option for these strains are extremely limited, different antimicrobial combinations were used to see their efficacy against colistin resistant A. baumannii both in vitro and in vivo. Methods: Cross-sectional study was done in the department of Microbiology, Dhaka Medical College, Bangladesh from July, 2017 to June, 2018. Antibiotic susceptibility was performed by disc-diffusion technique and MIC. Colistin resistance genes were detected by PCR. In vitro activity of colistin, tigecycline, imipenem, amikacin and their combinations were evaluated by agar dilution method. Rat septicemic models were made using the colistin resistant A. baumannii and effectiveness of antibiotic combinations were tested in rats. Results: Among 32 isolated A. baumannii 12.5% were colistin resistant. All colistin resistant A. baumannii were positive for lpxA, lpxC, pmrA, pmrB genes; 75% were positive for lpxD gene, 50% were positive for pmrC gene. The proportions of synergy observed in colistin-tigecycline, colistin-imipenem, colistin-amikacin and imipenem-amikacin were 75%, 50%, 50% and 25% respectively in vitro. The best in vivo result appeared in group treated with colistin-tigecycline combination where 100% bacterial clearance from rats was observed while colistin-imipenem combination showed 83.33% clearance. Conclusion: Colistin plus tigecycline or colistin plus imipenem may be alternative treatment option against colistin resistant A. baumannii infection.