Annals of International Medical and Dental Research

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https://imsear.searo.who.int/handle/123456789/158082

Editor-in-Chief: Dr Rohit Varshney
ISSN (Print): 2395-2814 ISSN (Online): 2395-2822

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://aimdrjournal.com/Default.aspx

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Now showing 1 - 20 of 1947

Relationship between daily caregiving hours and quality of life among caregivers of patients with mental disorders
(Scholars Publisher, 2025-04) Dutta, Bijoy Kumar; Chowdhury, Md Hafizur Rahman; Khan, Rubaiya; Nath, Mukul Chandra; Haque, Md Shariful; Dhar, Pulin Bihari; Deb, Uttara
Background: Caregivers of patients with mental disorders experience significant burdens affecting their physical, psychological, social, and environmental well-being. While the relationship between caregiving burden and quality of life (QOL) is well established, the role of daily caregiving hours as a determinant of caregiver well-being remains unclear. This study aimed to examine the relationship between daily caregiving hours and QOL among caregivers of patients with mental disorders. Methods: This cross-sectional comparative study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, among 50 caregivers of patients with mental disorders. Caregivers were categorized based on their daily caregiving hours, and QOL was assessed using the World Health Organization QOL Scale, Brief Version. Statistical analyses, including independent t-tests, one-way analysis of variance, and Pearson’s correlation coefficient, were performed to determine the relationship between caregiving hours and QOL scores across four domains: Physical, Psychological, Social Relationships, and Environmental. Results: The majority of caregivers were middle-aged, married women (62% housewives) providing long-term care for young adults with schizophrenia or bipolar disorder. 42% of caregivers provided full-time (18–24 h) care, leading to lower physical health and environmental QOL scores. However, no statistically significant differences were found in QOL scores across caregiving durations (P > 0.05 in all domains), indicating that factors beyond caregiving hours, such as financial stress, social support, and emotional burden, may have a greater impact on caregiver well-being. Conclusion: Caregiving hours alone do not significantly impact caregiver QOL, emphasizing the need for comprehensive support systems addressing financial, emotional, and social burdens. Psychological distress and social isolation remain persistent challenges, regardless of caregiving duration. Holistic interventions, including mental health services, financial assistance, and structured caregiving networks, are necessary to improve caregiver well-being.
Bisphosphonate induced necrosis of jaws-the emerging challenging epidemic
(Scholars Publisher, 2025-02) Malik, Altaf Hussain; Vaishnov, Kalpesh; Majeed, Shabnum; Sheikh, Tafazul; Shah, Altaf H.
Background: The bisphosphonates are widely prescribed drugs to prevent bone resorption, however, are associated with the potential risk of osteonecrosis of jaws in patients receiving dental treatment. Methods: The study was designed to evaluate the chances of osteonecrosis in patients referred for management in whom dental treatment was carried out of negligence or lack of knowledge. Results: Out of 74 patients studied, 16 patients had developed osteonecrosis, particularly after dental extraction, and out of 16 patients, 12 patients were having underlying malignancy. Conclusion: Medication-induced necrosis of jaws is more in patients with underlying malignancy or other comorbidities compared to patients who are not suffering from malignancy, and dental treatment particularly extraction is a trigger in such patients for developing the debilitating condition.
Arthrocentesis for internal derangement – Two-needle technique
(Scholars Publisher, 2025-02) Malik, Altaf Hussain; Vaishnov, Kalpesh; Majeed, Shabnum
Background: The aim of this study is to investigate the efficacy of arthrocentesis with two needles and to compare it with arthrocentesis with one needle in the treatment of temporomandibular joint (TMJ) internal derangements. Methods: Fifty patients aged between 16 and 60 years comprised the study material in the department. The patient’s complaints were limited mouth opening and TMJ pain. The patients were randomly allocated into two groups, in one group two-needle technique was used, and in other groups single needle was used for arthrocentesis. The procedure was performed under all aseptic conditions. Clinical evaluation of the patients was done before the procedure, at 1 week, and 6 months after the procedure. Intensity of TMJ pain and maximal mouth opening were recorded at each follow-up visit. Results: There was a significant improvement in mouth opening and reduction in pain scores in the post-operative period with P value of (0.001); however, the addition of other needles did not improve the total outcome of the procedure. Conclusion: The two-needle technique does not improve the results compared to single needle technique.
Laparoscopic cholecystectomy in diabetes: Challenges and advances
(Scholars Publisher, 2025-04) Mostafa, A. B. M.; Al Mohsin, Nazmuddin; Rahman, Azizur; Karim, Shah Md Rezaul; Azad, Abul Kalam
Background: Laparoscopic cholecystectomy (LC) is the gold standard for treating symptomatic gallstone disease, offering advantages such as reduced post-operative pain, shorter hospital stays, and quicker recovery. However, managing diabetic patients presents unique challenges due to their increased risk of complications. This study aimed to assess the challenges and advances of LC in diabetes. Methods: This retrospective observational study was conducted to evaluate the challenges and advancements in LC among diabetic patients. A total of 100 patients were selected in several clinics of Moulvibazar, and the study took place at the Department of Surgery, in 250 Bed District General Hospital Moulvibazar, from May 2021 to June 2023. Statistical analysis was performed using SPSS. Result: This study on LC in diabetic patients revealed that good preoperative glycemic control (HbA1c <7%) significantly reduced complications, with 90% of well-controlled patients experiencing no post-operative issues compared to 60% of those with poor control. Middle-aged patients (50–59 years) and females were more commonly affected. Most surgeries (50%) were completed in under 90 min, with a low conversion-to-open rate (15%) and a majority (75%) experiencing no complications. Conclusion: LC in diabetic patients is both safe and effective, provided meticulous perioperative management is undertaken. This study highlights the critical role of glycemic control, with patients achieving HbA1c <7% experiencing significantly fewer complications and shorter recovery times. Despite challenges such as adhesions and inflammation, the low conversion-to-open-surgery rate (15%) reflects advancements in minimally invasive techniques. Most patients (75%) had no complications, and the low mortality rate (5%) underscores the procedure’s safety when supported by comprehensive care.
A study of bronchoscopic profile of respiratory patients in tertiary care hospital
(Scholars Publisher, 2025-02) Islam, Md Rezaul; Rahman, Md Masudur; Sani, Ahmad Zainuddin; Mahmud, Md Jakaria; Patwary, Md Hosna Sadat
Introduction: Bronchoscopy is the diagnostic inspection of the tracheobronchial tree. It is an alternative method to aid in the diagnosis of infection where non-invasive methods fail to cite the underlying etiology; especially in cases of pulmonary tuberculosis. Aim of the study: The aim of the current study is to assess bronchoscopic profile of respiratory patients in tertiary care hospital. Methods: This cross-sectional, hospital-based observational study was done in the Department of Respiratory Medicine and Internal Medicine Rajshahi Medical College Hospital to find out the bronchoscopic profile of respiratory patients. A total of 120 respondents fulfilling inclusion and exclusion criteria participated in the study. Result: Majority respondents belonged to age group 51–70 years (62.5%). Mean age was 52.49 ± 12.58 years. Majority of the respondents were Male (70.8%) and whereas were Female (29.2%). Majority of respondents were poor (50%). Majority of respondent’s religion was Islam (75%). Majority of respondents were resided in rural area (62.5%). Among total respondents, 54.2% were smoker. Most common chest X-ray findings were consolidation (25%). Among respondents in 17.5%, no abnormality detected. Most common bronchoscopic findings were the right main bronchus mass (20%). Most common complications of bronchoscopy were fever (10.8%), followed by nausea/vomiting (10%) and infection, whereas 50.8% of patients had no complication due to bronchoscopy. Among the respondents, acid-fast bacilli were found in 0.8%, not found in 21.7%, and not done in 77.5%. Most common histological findings in respondents were normal (60%). Conclusion: This study indicates that Bronchoscopy is a safe and useful tool for making the diagnosis of a variety of pulmonary diseases. Bronchial mass was the most common finding on bronchoscopy.
Renal development and functional outcomes: A comparative study of term low birth weight and normal birth weight infants
(Scholars Publisher, 2025-02) Iqbal, Mohammed Jafar; Islam, Mirza Md. Ziaul; Islam, Atiqul; Sen, Tanusree
Introduction: One of the biggest issues facing emerging nations is low birth weight (LBW). In our situation, the term LBW may be caused by maternal malnourishment, inadequate prenatal care, low socioeconomic position, repeated pregnancies with close spacing, and a lack of health knowledge. The proper renal development of LBW newborns resulting from intrauterine growth retardation is negatively impacted. Renal functional maturity can be predicted by examining the link between renal function and volume. The aim of this study was to compare the renal volume and functional status in the term LBW versus term normal birth weight (NBW) babies at 1 year. Materials and Methods: This case–control study was conducted at the Department of Pediatric Infectious Disease and Community Pediatrics at Bangladesh Shishu Hospital and Institute, Dhaka, from June 2009 to May 2010. Patients were selected according to inclusion and exclusion criteria. 100 children were recruited in this study at 1 year of age from that hospital. Among them 50 were born at term with NBW and the rest 50 were born at term with LBW. Data were collected by developing a structured questionnaire and a statistical analysis was carried out by using the Statistical Package for Social “IBM SPSS Statistics for Windows, version IBM SPSS Statistics for Windows, version XXII (IBM V.22). Result: It was observed that almost two-thirds (62.0%) of subjects belonged to age 12months in the term NBW and 28 (56.0%) in the term LBW. The mean age was 11.9 ± 0.6months in the term NBW and 12.2 ± 0.7months in the term LBW. More than half (58.0%) of subjects were male in the term NBW and 22(44.0%) in the term LBW. The majority (88.0%) of subjects came from urban areas in the term NBW and 37(74.0%) in the term LBW. The mean gestational age was 39.1 ± 0.8 weeks in the term NBW and 37.7 ± 0.8weeks in the term LBW. The mean SBP was 86.6 ± 8.0mmHg in the term NBW and 92.4 ± 7.9mmHg in the term LBW. The mean diastolic blood pressure was 49.2 ± 4.3mmHg in the term NBW and 52.2 ± 4.7 mmHg in the term LBW. The mean creatinine was 0.5 ± 0.13mg/dL in the term NBW and 0.53 ± 0.12 mg/dL in the term LBW. The mean spot urine protein creatinine ratio was 0.3 ± 0.06 in the term NBW and 0.4 ± 0.07 in the term LBW. The mean glomerular filtration rate (GFR) was 72.8 ± 19.1mL/min/1.73 m2 in the term NBW and 66.4 ± 16.7 mL/min/1.73 m2 in the term LBW. The mean kidney length was 5.5 ± 0.3 in the term NBW and 5.3 ± 0.3 in the term LBW. The mean breadth was 4.3± 0.2 in the term NBW and 4.0 ± 0.1 in the term LBW. The mean thickness was 2.2 ± 0.2 in the term NBW and 2.0 ± 0.3in the term LBW. The mean kidney volume was 27.4 ± 3.7 cm3 in the term NBW and 22.9 ± 3.6 cm3 in the term LBW. In the male group, the mean kidney volume was 28.1 ± 3.9 cm3 in the term NBW and 22.4 ± 2.7 cm3 in the term LBW. In the female group, the mean kidney volume was 26.5 ± 3.3 cm3 in the term NBW and 23.4 ± 4.2 cm3 in the term LBW. In the male group, the mean estimated GFR was 75.2 ± 17.9 mL/min/1.73 m2 in the term NBW and 67.1 ± 15.6mL/min/1.73 m2 in the term LBW. In the female group, the mean estimated GFR was 69.3 ± 20.6 mL/min/1.73 m2 in the term NBW and 65.8 ± 17.8 mL/min/1.73 m2 in the term LBW. Conclusion: This study demonstrates that blood pressure and spot urine protein creatinine ratio were significantly elevated in LBW babies. Kidney length (D1), breadth (D2), and thickness (D3) were smaller in LBW babies. LBW can potentially lead to adverse effects on kidney size and function in children.
Post-operative morbidity in patients undergoing surgery for proximal gastric cancer: A comprehensive assessment
(Scholars Publisher, 2025-02) Rahman, Sonia; Khan, Md. Hasib Uddin; Biswas, Girin Chandra; Shoaib, Tanvir Hasan; Prova, Mahnaz Tabassum; Sarkar, Md. Abdul Munim; Dey, Kallol
Introduction: Proximal gastric cancer, particularly esophagogastric junction cancer, poses a complex therapeutic challenge marked by high morbidity, mortality, and a generally bleak prognosis. This study is aimed to assess post-operative morbidity in patients undergoing surgery for proximal gastric cancer. Materials and Methods: This prospective observational study was conducted at the National Institute of Cancer Research and Hospital Department of Surgical Oncology. Patient selection followed pre-defined inclusion and exclusion criteria, leading to a study cohort of 50 eligible individuals. Data collection utilized a structured case record form, and the post-operative outcome was evaluated by examining complications and measuring hemoglobin and serum albumin levels. Statistical analysis employed the Statistical Package for Social Science (SPSS-24), incorporating the Paired Student’s t-test and Z proportion test where applicable. Results: In this study, a notable 52% of subjects experienced no complications. Throughout the study period, complications included wound infection (14%), wound disruption (4%), anastomotic leakage (4%), pneumonia (6%), peritonitis (4%), and duodenal stump leakage (6%). In addition, anastomotic stenosis (8%) and dumping syndrome (14%) were observed. Conclusion: Total radical gastrectomy featuring Roux-en-Y esophagojejunostomy for proximal gastric cancer showed good short-term outcomes with a few complications. The most common post-operative complications surgery-related were wound infections and anastomosis leakage.
Study of association of headache with hypertension in the patients attending at specialized clinic of a tertiary care hospital
(Scholars Publisher, 2025-04) Shyfullah, Md.; Jalil, Sharmina; Haque, Md. Ekramul; Khan, Md. Faisal Bin Selim; Irfan, Md. Ashraful Islam; Sadi, Md. Rokib; Irteeja, Md. Sakib; Afroj, Ami; Malik, Md. Ashadur Rahaman
Background: High blood pressure, or hypertension, is above-normal blood pressure. Blood pressure fluctuates during the day due to activity levels. Consistently elevated blood pressure can lead to a hypertension diagnosis. Research indicates a frequent link between hypertension and chronic daily headaches, including chronic migraines, although the cause remains unclear. The study examined the connection between headaches and hypertension. It involved headache patients from the Headache Clinic at Dhaka Medical College Hospital from July to December 2013. Methods: A total of 100 patients aged 18 years or above from both sexes, with the main complaint being headaches, were enrolled in this study. All questionnaires were checked very carefully to identify the error in collecting data. Data processing work consisted of registration of schedules, editing, coding, and computerization. Data were presented in graph, pie chart and tabulated form and finally analyzed on computer-based software SPSS Windows (16.0 version). Result: Almost all of the patients were aged 20–50 years, with a male-to-female ratio of 1:3, while 57% of the women were housewives. Most (84%) were married. Headache duration was 4.6 ± 3.3 years on average, and 64% lasted from 1 to 6 h (avg. 5.48 ± 3.31 h). The most common were constant headaches (63%). 3% was seen in radiation on the left side, while 9% on the neck, and 2% on the entire head. Nausea, vertigo, and photophobia were common symptoms. Precipitants were anxiety (39%), fatigue (24%), and sleep disturbance (21%). Relief measures were sleep (51%) and medication (50%). Hypertension was present in 21%, of which 14% were controlled and 7% were uncontrolled. No correlation was found between headache and hypertension duration. Fundus was normal in 97%, and 3% had cataracts. Conclusion: Headaches were more common in the 3rd decade and females were predominant. Stage I and Stage II hypertension were 14.0% and 7.0%, respectively. Non-migrainous was more frequent. This study data have revealed that headache and hypertension are not associated.
Comparative effect of tactile kinetic stimulation versus intermittent kangaroo mother care on body weight in Pre-term low birth weight infants
(Scholars Publisher, 2025-02) Belyat, Alam Iftekhar; Hoque, Md. Mahbubul; Dey, Sanjoy Kumer; Akhter, Nilufa; Hossain, Mohammad Monir
Background: Low birth weight (LBW) and pre-term birth remains significant contributors to neonatal morbidity and mortality, particularly in resource-constrained settings, such as Bangladesh. Kangaroo Mother Care (KMC) is a well-established intervention for improving growth and clinical stability in pre-term LBW infants. Tactile Kinetic Stimulation (TKS) is a lesser-known alternative involving systematic touch and motion. This study compared the effects of TKS and intermittent KMC on growth and clinical outcomes in pre-term LBW infants. Methods: A randomized controlled trial was conducted at Dhaka Shishu (Children) Hospital from January 2019 to December 2020. Forty pre-term LBW infants (gestational age 28–33 weeks, birth weight 1200–1800 g) were randomly assigned to Group A (TKS) or Group B (KMC). Group A received 15-min TKS sessions 4 times daily, while Group B received 2-h KMC sessions 4 times daily. Key outcomes included weight, length, occipito-frontal circumference (OFC), heart rate, temperature, time to achieve full feeding, and incidence of apnea. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Results: Baseline characteristics were comparable between the groups. The mean time to achieve full feeding was 5.63 ± 2.63 days in Group A and 5.50 ± 2.50 days in Group B (P = 0.48). Both groups showed progressive growth in weight, length, and OFC, with no significant differences at any time point. On the 21st day, the mean weight was 2080.94 ± 152.87 g in Group A versus 2038.57 ± 68.43 g in Group B (P = 0.21). Heart rate and temperature remained stable, with no significant differences. The incidence of apnea was low and comparable between groups (11% vs. 9%; P = 1.00). Conclusion: Both TKS and KMC were equally effective in promoting growth and maintaining clinical stability in pre-term LBW infants. TKS offers a viable alternative to KMC, particularly in settings with barriers to traditional KMC implementation. These findings highlight the potential of integrating either intervention into neonatal care strategies in resource-limited settings.
Vaginal versus oral misoprostol in the management of first trimester missed abortion among admitted patients in a tertiary level hospital
(Scholars Publisher, 2025-04) Abid, Taslima; Sultana, Surovi; Khatun, Nofisa; Kulsum, Umme; Rumpa, Farhana Yesmin
Background: Missed abortion is a common first-trimester pregnancy complication requiring effective medical management. Misoprostol, a prostaglandin E1 analog, is widely used through oral or vaginal administration. However, the comparative efficacy, required doses, expulsion time, and side-effect profile between these two routes remain subjects of ongoing research, particularly in low-resource settings like Bangladesh. Objective: The objective of the study was to compare the efficacy, required doses, time to expulsion, side effects, and cervical permeability between oral and vaginal misoprostol in the management of first-trimester missed abortion. Methods: This randomized controlled trial was conducted in a tertiary-level hospital in Bangladesh, involving 118 women diagnosed with first-trimester missed abortion. Participants were randomly assigned to receive either oral misoprostol (Group A, n = 59) or vaginal misoprostol (Group B, n = 59). Primary outcomes included complete expulsion rates, time to expulsion, number of doses required, and side effects. Statistical analysis was performed using Pearson’s Chi-square test for categorical data and independent t-tests for continuous variables, with significance set at P < 0.05. Results: Vaginal misoprostol demonstrated significantly higher complete expulsion rates (76.27% vs. 37.29%, P < 0.001), required fewer doses (mean: 1.69 vs. 2.41, P < 0.001), and had a shorter time to expulsion (7.69 ± 2.89 vs. 9.45 ± 1.40 h, P = 0.032) compared to oral misoprostol. Nausea and vomiting were more frequent with oral misoprostol, but other side effects were comparable. Cervical permeability among unsuccessful cases did not differ significantly between groups (P = 0.6985). Conclusion: Vaginal misoprostol is more effective than oral administration, offering higher expulsion rates, faster expulsion, and requiring fewer doses, with a similar safety profile. These findings support vaginal misoprostol as the preferred route for the medical management of first-trimester missed abortion. Future research should explore sublingual routes, adjunctive mifepristone therapy, and patient-centered factors to further optimize treatment strategies.
Early post-operative morbidity and complication rates in liver resection
(Scholars Publisher, 2025-04) Elahi, Mohammad Mahbub; Mehzabin, Shafinaz; Talukder, Md Tuhin; Islam, Kazi Mazharul; Awal, Mohammad Abdul; Azam, ANM Nure; Hakim, H A Nazmul
Background: Liver resection (LR) is a common surgical intervention for various hepatic conditions, including hepatocellular carcinoma, metastatic liver disease, and benign liver tumors. While this procedure can offer a potential cure for patients with localized disease, it is associated with significant early post-operative morbidity and complications that can impact patient outcomes. This study aims to evaluate the early post-operative morbidity and complication rates in patients undergoing LR. Methods: This prospective observational study was conducted among the indoor patients of the Hepatobiliary unit of the surgery department in Dhaka Medical College Hospital, from January 1st, 2023 to December 29th, 2023. All patients admitted to the hepatobiliary unit of the department of surgery, Dhaka Medical College Hospital were considered the study population. A total of 40 patients were selected as study subjects through a purposive sampling technique. Data were analyzed by the Statistical Package for the Social Sciences version 20.0. Result: In the early post-operative period following LR in 40 patients, the majority (40%) had blood loss of <400 mL, whereas 15% lost between 400–700 mL, and 7.5% had blood loss exceeding 700 mL. Postoperatively, 65% of patients experienced no complications, whereas 35% developed issues, including surgical site infections in 25% of cases and bile leaks or hemorrhage in 20%. Common interventions included delaying the abdominal drain in 30% of patients, extended hospital stays in 35%, and nutritional support in 25%. Fewer patients required reoperation or drain replacement (5% each). Conclusion: Results indicated that 65% of patients experienced no complications, whereas 35% faced various morbidities, primarily surgical site infections (25%), and bile leaks (10%). Interventions focused on delaying abdominal drains (30%) and nutritional support (25%). These findings highlight the importance of careful postoperative management to reduce complications, emphasizing the need for ongoing research to optimize patient outcomes following LR.
Pattern of deliberate self-poisoning cases: A study in a tertiary care hospital in Bangladesh
(Scholars Publisher, 2025-04) Mohaimen, Md. Shafi; Aktari, Farhana; Rikabdar, Moshiur Rahman; Mili, Nasrin Akter
Background: Deliberate self-poisoning (DSP) is a significant cause of morbidity and mortality, particularly in developing countries. Common substances used for self-harm include pesticides and medications, which are readily available in these settings. Understanding the patterns and risk factors associated with DSP is crucial for effective intervention and prevention strategies. This study aimed to identify the demographic patterns, of DSP cases at a tertiary care hospital in Bangladesh. Materials and Methods: This prospective observational study was conducted at the Department of Forensic Medicine, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh, from January 2021 to December 2023. A total of 113 DSP cases treated during the 24-month study period were identified from the emergency department register and enrolled purposively. Data were analyzed using Microsoft Office tools. Results: The study found that 39.8% of DSP cases were between 20 and 29 years old, with a slight majority of females (52%). Most participants were single (54%) and unemployed (30.1%). Regarding toxicology, 76.1% involved drugs, with family quarrels being the leading cause (44.2%). The majority (71.7%) had poisonings at home, with 45.1% requiring intensive care unit (ICU) admission. Most had a Glasgow Coma Scale >8 (89.4%), and 11.5% had prior suicide attempts. Conclusion: DSP is a major concern in Bangladesh, particularly among young adults and females. Family quarrels were the leading cause, with drug poisoning being the most common method. Most cases occurred at home, and a significant number required ICU admission.
Effects of thalidomide in transfusion-dependent beta-thalassemia patients
(Scholars Publisher, 2025-04) Hossain, Faria; Sharmeen, Olia; Alam, Md. Fakhrul; Shawon, Md. Hasan Moshiur; Rowan, Rowshan
Backgrounds: Beta thalassemia constitutes inherited disorders of hemoglobin (Hb) synthesis caused by decreased synthesis of ?-globin chains and relative overproduction of ?-globin chains, causing cell membrane damage, which plays a key role in ineffective erythropoiesis and peripheral hemolysis. Thalidomide, a fetal Hb inducer, shows significant effects in increasing Hb as well as transfusion requirements. This study aimed to evaluate the effects of thalidomide in transfusion-dependent beta-thalassemia patients. Methods: The prospective study was conducted at the Department of Pediatric Hematology and Oncology in collaboration with the Department of Hematology at Sir Salimullah Medical College Mitford Hospital over 1 year, from November 2022 to October 2023. A sample size of 54 with selection criteria included individuals with diagnosed cases of beta thalassemia who were transfusion-dependent. Thalidomide was given at 5 mg/kg/day to all age groups, along with aspirin at 3 mg/kg/day coverage, in addition to conventional therapy. Then, four monthly follow-ups were done for 1 year. Result: Thalidomide leads to an increase in mean Hb levels from 7.06 ± 0.99 g/dL to 9.33 ± 1.16 g/dL (P < 0.001) after 1 year of treatment. The mean number of blood transfusions reduced from 10.98 ± 1.41/year to 10.31 ± 1.36 (P < 0.001) after 1 year of treatment. Conclusion: The study revealed that thalidomide treatment led to a substantial increase in Hb levels as well as a notable decrease in transfusion frequency.
Comparison of side effects: “Vaginal versus oral misoprostol in the management of the first-trimester missed abortion”
(Scholars Publisher, 2025-02) Abid, Taslima; Sultana, Surovi; Khatun, Nofisa; Kulsum, Umme; Rumpa, Farhana Yesmin
Introduction: In recent years, the use of oral or vaginal misoprostol has grown in popularity. The therapeutic potential of misoprostol as an abortifacient has clearly been demonstrated in a randomized study. Misoprostol is active and safe both by oral and vaginal routes but the latter has been found to be better in many trials. Aim of the Study: Aim of the objective is to compare the efficacy and safety of vaginal misoprostol to oral misoprostol for the treatment of first-trimester missed abortion. Methods: The study was conducted in the Gynaecology and Obstetrics Department of Shaheed Ziaur Rahman Medical College Hospital in Bogra over a period of 6 months, from May 2015 to October 2015. The participants included women diagnosed with miscarriage, based on both their medical history and physical examinations, and referred from the outpatient department for admission. The diagnosis of missed miscarriage was confirmed by sonography. Only women who met the specified inclusion and exclusion criteria were enrolled, leading to a total sample size of 118 participants, divided into two groups of 59 each. Results: In both groups most of the respondents were in the “20–25 years” age group; out of the 59 respondents each in groups, 33.9% of Group A and 42.4% of Group B were in the age group. Mean ± standard deviation (SD) of age was calculated to be, (24.60 ± 3.049) for Group A and Group B (23.98 ± 2.387). Both groups had a similar type of distribution of the length of menstrual cycle. Out of the 118 respondents, only 11 (9.3%) had a previous miscarriage. 89.8% of Group A and 91.5% of Group B had not experienced abortion before. About two-fifths of the respondents in both groups (42.4% Group A and 37.3% Group B) were primigravidae. Among 2nd gravidae Group B (18) were double in count to Group A (9). Mean ± SD was calculated for Group A (1.81 ± 1.004) and Group B (1.78 ± 1.018). About 10.9 weeks was the average period of gestation for both groups. Both Group A and Group B had similar types of distribution. More than three-fourths of group B (45 [76.3%]) had successfully achieved complete expulsion of the conceptus; while in group A less than half of that (22 [37.3%]) had complete expulsion. Incomplete expulsion accounted to be 2½ times higher in Group A and “No expulsion” was 4 times as high as Group B. Conclusion: Per vaginal administration of Misoprostol in the posterior fornix is more effective than Oral Misoprostol. The former has a faster onset of action and better efficacy. Per vaginal Misoprostol has less side effects.
From Viral Illness to Autoimmune Crisis: Atypical Presentation of MOG-Positive ADEM in a Young Child following a Meta-pneumovirus Infection
(Society for Health Care & Research Development, 2024-11) Torne, Krupa
We report a case of a 3-year-old female who developed MOG-positive Acute Disseminated Encephalomyelitis (ADEM) following a Meta- pneumovirus infection. The patient presented with severe neurological symptoms, including acute encephalopathy, abducent nerve palsy, and rapid deterioration requiring intubation. Serum and cerebrospinal fluid (CSF) MOG antibodies were positive, and MRI revealed multifocal lesions in the brain and spinal cord. Treatment with high-dose steroids, intravenous immunoglobulin (IVIG), and plasmapheresis led to significant clinical improvement. This case underscores the diagnostic complexity of MOG-positive ADEM, particularly when associated with less commonly recognized viral infections like Meta-pneumovirus. The overlap of symptoms with viral encephalopathy emphasizes the need for a comprehensive diagnostic approach, including early MRI and MOG antibody testing, to differentiate from other CNS conditions. The involvement of Meta- pneumovirus, while not commonly reported as a trigger for ADEM, expands the spectrum of viral triggers and highlights the importance of considering a broad range of infectious agents in similar presentations. Early recognition and aggressive treatment were crucial for this patient’s recovery, illustrating the necessity of prompt intervention in MOG-positive ADEM, especially when extensive CNS involvement is observed.
Clinical and Surgical Management for Cerebral Astrocytoma
(Society for Health Care & Research Development, 2024-11) Awar, Omar Al; Zeki, Layal Abou; Haddad, Marwan; Nahle, Zeinab; Nehme, Patricia; Jabbour, Caroline Samaha
Cerebral astrocytoma is a primary brain tumor originating from astrocytes, the star- shaped glial cells that support and protect neurons. It represents a diverse group of tumors with varying degrees of malignancy, classified according to the World Health Organization (WHO) grading system into grades I through IV. Grade I astrocytomas, such as pilocytic astrocytomas, are generally well- circumscribed and less aggressive, while higher-grade tumors like anaplastic astrocytomas (Grade III) and glioblastoma multiforme (Grade IV) exhibit more aggressive behavior and poorer prognoses. Clinical presentation varies with tumor location and grade but commonly includes headaches, seizures, and focal neurological deficits. Diagnostic evaluation typically involves imaging techniques such as MRI and may be supplemented by biopsy for histological confirmation. Treatment strategies are tailored to the tumor grade and include surgical resection, radiation therapy, and chemotherapy. Despite advances in therapeutic approaches, the prognosis remains variable, with higher-grade tumors generally associated with reduced survival rates. Ongoing research focuses on improving early detection, understanding molecular mechanisms, and developing targeted therapies to enhance patient outcomes.
Comparison of Analgesic Efficacy of Piroxicam and Ketorolac in Impacted Mandibular Third Molar Surgery: A Prospective Randomized, Double Blind Clinical Study
(Society for Health Care & Research Development, 2024-11) Sharma, Shubham; Gupta, Amit; Nongmaithem, Jason; Awana, Kajal; Ghosh, Shayan; Dua, Piyush
Background: Postoperative pain following third molar extraction is said to be one of the most acute postsurgical painful conditions with patients require some form of analgesic to deal with it. This study examined the clinical efficacy of piroxicam and ketorolac in managing pain and swelling after lower third molar extraction. Material & Methods: This randomized controlled study was conducted among 24 patients requiring trans-alveolar mandibular molars extraction. GROUP A (12 patients) who were given a single dose of 20 mg piroxicam orally. GROUP B (12 patients) who were given 10 mg ketorolac QID orally. Pain and swelling was evaluated on 1st, 3rd, 7th, and 14th post-operative day. Results: The two study groups were comparable by age and gender. The mean (SD) pain score was lower in Group A (Piroxicam) as compared to Group B (Ketorolac) on Day 1 and 3 and it was found to be statistically significant (p<0.001). There was no significant difference in the mean (SD) pain score between the two groups by Day 7 and 14 of follow up. There was statistically significant reduction in swelling in Group A patients on Day 1, 3 and 7 as compared to Group B patients (p<0.001) but by Day 14 no statistically significant difference in swelling reduction was detected across the two groups. Conclusions: Both piroxicam and ketorolac were effective in reducing postoperative pain and swelling following removal of mandibular third molars with piroxicam showing better control in early postoperative days.
Exploring the Correlation Between Fibrinogen-to-Albumin Ratio and Contrast-Induced Nephropathy in the Study Population
(Society for Health Care & Research Development, 2024-01) Mridha, Sohel; Rashid, Md. Mamunur; Kundu, Samir; Momen, Abdul; Afroza, Nahid; Masum, Mahmudul Hasan; Alam, Iftekhar
Background: Contrast-Induced Nephropathy (CIN) presents a significant risk in non-ST elevation acute coronary syndrome (NSTE-ACS) patients undergoing percutaneous coronary intervention (PCI). This study investigates the association between the Fibrinogen-to-Albumin Ratio (FAR) and CIN in such patients. Material & Methods: This cross-sectional study was conducted at the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, from June 2019 to May 2020. 200 NSTE-ACS patients undergoing PCI were categorized into two groups based on FAR: Group I (FAR ? 0.106, n=100) and Group II (FAR < 0.106, n=100). Clinical parameters, including pulse rate, blood pressure, and biochemical markers, were analyzed. The incidence of CIN and the role of FAR as a predictive marker were statistically evaluated. Results: Baseline clinical parameters showed no significant differences between the groups, with pulse rates averaging 88.8�.4 bpm in Group I and 87.7�.4 bpm in Group II (p=0.62). Troponin I levels were higher in Group I (42.1�.6 ng/dl) compared to Group II (35.5�.6 ng/dl, p=0.07). Group I also exhibited higher hemoglobin levels (12.5�5 gm/dl vs. 12.0�5 gm/dl in Group II, p=0.02). The incidence of CIN was significantly higher in Group I at 12%, compared to 2% in Group II. FAR was identified as a significant predictor of CIN, with an odds ratio of 11.45 (p=0.006). Conclusions: The study establishes FAR as a significant independent predictor of CIN in NSTE-ACS patients undergoing PCI. These findings suggest that FAR can be an effective biomarker for assessing CIN risk, potentially guiding more tailored patient management strategies in this high-risk group.
Incidence of Shoulder Pain After Covid Vaccination- an Observational Study
(Society for Health Care & Research Development, 2024-01) Sultana, Ayesha; Das, Rajat Shuvra; Hoque, A.K.M. Faizul; Hannan, Mohammad Abdul; Hassan, Mehdi; Karmakar, Chandra Shekhar; Jahan, A B M Sarwar; Siddique, Muhammed Sharif Uddin; Habibullah, AKM
Background: COVID-19 vaccines are key to restoring normalcy after the global pandemic. However, improper injection techniques due to lack of clear instructions and inexperienced personnel can lead to issues like shoulder injury related to vaccine administration (SIRVA), causing shoulder pain and limited mobility. Ensuring correct administration is crucial for vaccine efficacy and patient well-being. The aim of this study was to determine the incidence of shoulder pain following COVID-19 vaccination on public health. Material & Methods: This was an observational study and was conducted in the Department of � Anaesthesia, Analgesia and Intensive care medicine of Bangabandhu Sheikh Mujib Medical University (BSSMU, Dhaka, Bangladesh during the period from February 2023 to January 2024. The study included 120 patients, male and female, focusing on Shoulder Injury Related to Vaccine Administration (SIRVA) after COVID-19 vaccination. Physician-evaluated cases were analyzed to minimize diagnostic errors, using a checklist for data extraction. Results: Patients (29.2% aged 63-72 years) predominantly received Pfizer and Moderna vaccines (80%). Common symptoms were bursitis (36%) and adhesive capsulitis (44%). Onset varied, with 35.2% reporting immediate symptoms, 40.8% within 24 hours. Pain was predominant (92%). X-ray (63.2%) and MRI (36.8%) used for diagnosis. Treatment included oral steroids (56%), physical therapy (16%), and NSAIDs (24%). Conclusions: The significance of accurate vaccine administration to avoid complications like SIRVA. Clear guidelines and trained personnel are essential for the success of the COVID-19 vaccination campaign, ensuring both efficacy and the well-being of individuals.
Early Complications of Internal Versus External Pancreatic Duct stent in Patients with Pancreaticoduodenectomy
(Society for Health Care & Research Development, 2024-09) Talukder, Tuhin; Islam, Kazi Mazharul; Elahi, Mohammad Mahbub; Awal, Mohammad Abdul; Azam, ANM Nure; Rayhan, Golam Mahmud; Hakim, H A Nazmul
Background: Pancreaticoduodenectomy (PD) is a complex surgical procedure with significant postoperative complications, including pancreatic fistula, delayed gastric emptying, and intra-abdominal infections. This study aims to compare the early postoperative complications of internal versus external pancreatic duct stents in patients undergoing PD. Material & Methods: This prospective observational study was conducted at Dhaka Medical College Hospital from January 1, 2023, to December 27, 2023. A total of 40 patients scheduled for PD were divided into two groups: 20 managed with internal stents and 20 with external stents. Data on demographic characteristics, per-operative factors, and postoperative complications were collected and analyzed. Results: The study population had a mean age of 56.78 years, with males constituting 65%. The most common histopathological diagnosis was periampullary carcinoma (50%). In the internal stenting group, 10% had a soft pancreas, 65% had a firm pancreas, and 25% had a hard pancreas. In the external stenting group, 40% had a soft pancreas, 50% had a firm pancreas, and 10% had a hard pancreas. Wound infections occurred in 10% of the internal stenting group and 15% of the external stenting group. Intra-abdominal collections were found in 5% of the internal stenting group and 10% of the external stenting group. GI bleeding was absent in the internal stenting group but occurred in 5% of the external stenting group. Intra-abdominal bleeding was absent in the internal stenting group but present in 10% of the external stenting group. Delayed gastric emptying was noted in 5% of participants in both groups. Grade A pancreatic fistula was observed in 10% of the internal stenting group and 15% of the external stenting group. Grade B and C pancreatic fistulas were only present in the external stenting group, at rates of 10% and 5%, respectively. Conclusions: Internal pancreatic duct stents are associated with lower incidences of wound infections, intra-abdominal collections, and severe pancreatic fistulas compared to external stents. These findings suggest that internal stents may offer better postoperative outcomes, although stent selection should be individualized based on patient-specific factors. Further research is warranted to confirm these results and guide clinical practice.

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