https://www.banglajol.info/index.php/BJMS/issue/feed Bangladesh Journal of Medical Science 2019-04-18T13:22:01+00:00 Dr Abu Kholdun Al-Mahmood kholdun@hotmail.com Open Journal Systems <p>A journal sponsored by the Ibn Sina Trust. Full text articles available.<br />NLM ID=101563859</p><p>Bangladesh Journal of Medical Sciences is included on <a title="DOAJ" href="https://doaj.org/toc/2076-0299?source=%7B%22query%22%3A%7B%22filtered%22%3A%7B%22filter%22%3A%7B%22bool%22%3A%7B%22must%22%3A%5B%7B%22term%22%3A%7B%22index.issn.exact%22%3A%222076-0299%22%7D%7D%2C%7B%22term%22%3A%7B%22_type%22%3A%22article%22%7D%7D%5D%7D%7D%2C%22query%22%3A%7B%22match_all%22%3A%7B%7D%7D%7D%7D%2C%22from%22%3A0%2C%22size%22%3A100%7D" target="_blank">DOAJ</a>.</p><p><strong>Journal Metrics</strong><br /><a href="https://www.scopus.com/sourceid/19900192321" target="_blank">CiteScore Tracker 2017</a>: Updated on April 30, 2018</p><p><img 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" alt="" /></p><p><a href="https://www.researchgate.net/journal/2223-4721_Bangladesh_Journal_of_Medical_Science" target="_blank">ResearchGate Journal Impact</a> (2013): 0.62</p><p><a href="https://www.scimagojr.com/journalsearch.php?q=19900192321&amp;tip=sid" target="_blank">Scimago Journal Rank</a> (2017): 0.17</p><p><img src="data:image/png;base64,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" alt="" width="152" height="114" /></p> https://www.banglajol.info/index.php/BJMS/article/view/40680 Antibiotic Use, Antibiotic Resistance, and Anti Stewardship – A Global Public Consequences 2019-04-18T13:22:01+00:00 Mainul Haque runurono@gmail.com <p>Abstract not available</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.169-170</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40681 A Review on Opioid Dependence, Mechanism and Treatments Used: Option of Treatments: Modern versus Alternative Medicine 2019-04-18T13:21:59+00:00 Nor Zidah Ahmad nzidahahmad@gmail.com Khairi Che Mat nzidahahmad@gmail.com Nasir Mohamad nzidahahmad@gmail.com Rohayah Binti Husain nzidahahmad@gmail.com Nor Hidayah Abu Bakar nzidahahmad@gmail.com Nur Husna Zakaria nzidahahmad@gmail.com Siti Norhajah Hashim nzidahahmad@gmail.com Liyana Hazwani Mohd Adnan nzidahahmad@gmail.com Mohamad Halim Mohamad Shariff nzidahahmad@gmail.com <p>Opioid dependence is one of the severe social problems encountered by civilization nowadays. Prior to the illicit use of opioid, an abundance of research had been done in order to understand the molecular and cellular action of the opioid. In spite of that, the actual cellular mechanism remains controversial. Hence, this review is targeting on the mechanism of opioid dependence in a biochemical pathway and treatments available either via drug medication or the use of natural remedies to treat opioid dependence.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.171-177</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40682 Thrombophilia in Pregnancy and Puerperium 2019-04-18T13:21:56+00:00 Farhana Dewan dr_fdewan@yahoo.com Mariha Alam Chowdhury dr_fdewan@yahoo.com Khairun Nessa dr_fdewan@yahoo.com <p>Abstract not available</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.178-183</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40683 Explanation and elucidation of cancer in reference to Greco-Arabic literature 2019-04-18T13:21:53+00:00 Wasim Ahmad drwasimkulliyat@gmail.com Mohd Zulkifle drwasimkulliyat@gmail.com - Hamiduddin drwasimkulliyat@gmail.com Sadaf Afreen drwasimkulliyat@gmail.com Obaidur Rahman drwasimkulliyat@gmail.com <p>Muslim scholars made tremendous contribution in various fields of science and their benefaction of work exhibits in all branches of medicine. Cancer is discussed by then Muslim scholars like Ibn Sina, Razi , Ismail Jurjani ,Hunain b. Ishaque, Rabban Tabri, Ahmad b. Mohammad Tabri, , Ibn ul Quff, Ibn Zuhr etc. In their descriptions cancer means <em>Sartan </em>(crab) as it reflects the true character of disease, since it sticks to the part stubbornly like a <em>Sartan</em>. Galen states that <em>Sartan </em>is the result of an excess of black bile. It may be due to an excessive hotness and dryness of liver by which consumed foods transform into irritant morbid matter. Concurrently, the spleen becomes weak and is unable to absorb the <em>Sawda </em>(black bile). Muslim scholars classified and distinguished clearly among the varieties of cancer in relation to specific organs such as eye, stomach, bladder, penis, uterus, mouth, and nerve tumours. The need of the hour is to evaluate and analyse the disease along with its pathophysiology, predisposing factors, differential diagnosis, and varieties of therapeutic paradigms that include nutrition, drugs, <em>Ishal </em>(bowel cleansing), <em>Tanqia </em>(evacuation of morbid matter from the body), surgical and non surgical interventions i.e. leaching , <em>Amal kai </em>(cauterization). Since the cancer is spreading at an incredible rate in both developed and developing countries but no way of relief is ensured yet in any system of medicine. Greco-Arabic literature has rich potential to intervene in palliative way in such dreadful disease. Likewise, Ray born Razi asserted that when cancer is at the beginning, it can be kept stationary and can be prevented from ulceration. This systematic review highlights relevant Greco-Arabic literature on cancer.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.184-189</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40684 The role of zinc supplementation for diarrhoea in children: a critical review 2019-04-18T13:21:50+00:00 Wulandari Berliani Putri wulandari.berliani@gmail.com Syaefudin Ali Akhmad wulandari.berliani@gmail.com Sufi Desrini wulandari.berliani@gmail.com <p><strong>Background:</strong> Nearly 1.7 million children suffer from diarrhoea and around 760,000 die each year. The high prevalence of diarrhoea in the developing countries is closely related to lack of safe drinking water, inadequate sanitation and hygiene, and poor health and nutritional status. These environmental conditions facilitate the spread of infectious disease easily. The great morbidity and mortality of this preventable and treatable disease raise concern on how to save children from this fatal disease by improving management of diarrhoea. Several studies suggest that zinc deficiency contribute towards high morbidity and mortality in diarrhoea. Further, there is an area of uncertainty regarding how significant zinc supplementation will help to reduce the duration and severity of diarrhoea in children compared to the diarrhoea management without zinc?</p> <p><strong>Objective:</strong> To critically analyse the current evidences of zinc supplementation in diarrhoea.</p> <p><strong>Data Sources</strong>: Keywords searching through MEDLINE Ovid database and additional references from retrieved articles. Study Selection: Limited to randomized controlled trial(RCT) study design and systematic review studies which were conducted from 2006 to 2016. However, there is one prospective cohort study included as it is a follow-up of subjects who participated in the previous double-blind randomized placebo-controlled trial.</p> <p><strong>Data Synthesis:</strong> This review involves a summary of 10 articles that have been appraised on their relevance in evaluating the role of zinc in reducing severity and duration of diarrhoea in children. Further, the literature found is synthesised through method used in the studies and the effectiveness of zinc therapy</p> <p><strong>Conclusion</strong>: Zinc is relatively safe to be used and it can improve diarrhoea management especially in developing countries.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.190-195</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40685 Red cell indices and peripheral blood film findings of anti-Psychotic treatment and treatment naïve Psychiatic patients in a tertiary Hospital in Nigeria. 2019-04-18T13:21:48+00:00 AO Shittu drakeem06@yahoo.com AO Adewoye drakeem06@yahoo.com HO Olawumi drakeem06@yahoo.com <p><strong>Background</strong>: The overall burden of morbidity and mortality from psychiatric disorders is on the rise. Holistic approach in the care of this group of patients has become inevitable. There is need for collaboration between psychiatrists and other physicians, laboratory physicians inclusive. Study design: cross sectional descriptive case- control study.</p> <p><strong>Materials and method</strong>: A total of 198 patients including controls were recruited for this study. Patients with schizophrenia constituted majority of the respondents, 86.4% of antipsychotic-naïve patients and 90.9% of patients on antipsychotics. A comprehensive medical examination was carried out on every participant. On every sample, automated Full Blood Count was performed using Sysmex2000i and peripheral blood film was made and examined.</p> <p><strong>Result</strong>: 51.5% and 47% of anti-psychotropicnaïve patients and patients on anti-psychotic were 18-40 and 41-60 years respectively. Male (57.6%), predominated the anti-psychotic naïve group while female (51.5%) predominated the group on anti-psychotics. Schizophrenia was the diagnosis in the majority of patients, 86.4% and 91% respectively in anti-psychotic naïve and antipsychotic treatment groups. Other diagnoses were depressive illness, substance use disorder and dementia. Of all the subjects, one (1.5%) schizophrenic patients and two (3%) of controls had abnormal haemogram results. For the schizophrenic patient with abnormal results, haematocrit was 12g/dl, MCV of 75fl and MCH of 26pg, while the two controls with abnormal results had only haematocrit deranged with value of 12.3g/d. Neutrophil hypersegmentation was seen on the film of five antipsychotic-naïve patients (7.5%) diagnosed with Schizophrenia and one (1.5%) of the controls. Macrocytosis was only seen in three (4.5%) of the five antipsychotic-naïve patients that had neutrophil hypersegmentation.</p> <p><strong>Conclusion:</strong> No significant difference was noted in the Full Blood Counts among the two sets of patients and controls, although there were isolated cases of neutrohil hyperesegmentation and macrocytosis.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.196-205</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40686 Anthropometric Measurement of External Ear and Correlation with Age in North Regional People of Bangladesh 2019-04-18T13:21:45+00:00 Md Asadujjaman asadujjaman@ruet.ac.bd Md Harum Or Rashid asadujjaman@ruet.ac.bd Sohel Rana asadujjaman@ruet.ac.bd <p><strong>Objective</strong>: The purpose of this study was to build an external ear anthropometric database in North regional people of Bangladesh. This study also aimed to show the morphological variations between male and female as well as changes in ear anthropometry with age.</p> <p><strong>Materials and Methods</strong>: Ear dimensions of 313 people (150 male and 163 female), aged between 18-75 years, were measured pursuant to standard anthropometric measurement procedure. A total of five external ear dimensions- ear length, ear breadth, base of the auricle, lobe length and lobe breadth was measured. Pearson correlation coefficient was used to determine the relationship among various ear measurements, and linear regression analysis was used to estimate ear dimensions from the age of the people.</p> <p><strong>Result</strong>: All ear dimensions were found larger in male than in women. The result also revealed that, dimensions of ear parameters increase proportionally with the increase of age, except male left-lobe breadth and female lobe breadth in both sides.</p> <p><strong>Conclusion</strong>: Of course, this study of human ear morphology will serve as a quantitative database and play an enormous importance of anatomy and human factors engineering point of view.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.206-210</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40687 Cardiac Function in Uncomplicated Type 2 Diabetes Mellitus 2019-04-18T13:21:43+00:00 Bimal K Agrawal bkagrawal2001@yahoo.com Parul Jain bkagrawal2001@yahoo.com Saurabh Marwaha bkagrawal2001@yahoo.com Richa Goel bkagrawal2001@yahoo.com Himanshu D Kumar bkagrawal2001@yahoo.com - Jagdish bkagrawal2001@yahoo.com <p><strong>Objective</strong><em>: </em>Diabetic cardiomyopathy (DC) is a myocardial disease characterized by myocyte hypertrophy, interstitial fibrosis, protein glycosylation and intra-myocardial micro-angiopathy due to prolonged exposure of myocardial tissues to hyperglycemia in diabetes mellitus (DM) patients. Alteration in cardiac function can be non-invasively assessed via echocardiography. The early recognition of cardiac dysfunction can prevent the symptomatic heart failure in DM patients. The study aimed at evaluating cardiac function in uncomplicated type 2 diabetes mellitus.</p> <p><strong>Materials And Methods</strong><em>: </em>Sixty Type 2 DM patients without any feature of the coronary arterial disease (CAD), hypertension, nephropathy and respiratory illness were enrolled in the study and compared with the sixty age matched healthy controls. Echocardiographic assessment was done in all subjects to evaluate the cardiac function.</p> <p><strong>Results</strong><em>: </em>Diastolic dysfunction was more common in diabetic patients when compared with normal healthy population. Systolic dysfunction progresses with age of the diabetic patient.</p> <p><strong>Conclusion</strong><em>: </em>Echocardiography is a simple noninvasive cost effective test for detecting cardiac dysfunction in Type 2 DM patients and should be applied to detect early Left ventricular(LV) dysfunction so that corrective measures may be initiated early and cardiac functions may be preserved for long.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.211-215</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40688 Changes in smile morphometric indices following maxillary advancement and mandibular setback surgery in skeletal Class III patients 2019-04-18T13:21:40+00:00 Fahimeh Farzanegan h.shafaee@gmail.com Farzin Hearvi h.shafaee@gmail.com Mandana Karrari h.shafaee@gmail.com Hooman Shafaee h.shafaee@gmail.com Touraj Vaezi h.shafaee@gmail.com Roozbeh Rashed h.shafaee@gmail.com <p><strong>Objectives<em>: </em></strong>The aim of this study was to evaluate the changes in smile morphometric indices following maxillary advancement and mandibular setback surgery in patients with skeletal class III malocclusion.</p> <p><strong><em>Materials and Methods</em></strong><strong>: </strong>Smile morphometric indices were measured on frontal rest and smile photographs of 15 female patients with skeletal Class III malocclusions before and three months after maxillary advancement and mandibular setback surgery. Pre- and post-surgery measurements were compared.</p> <p><strong>Results<em>: </em></strong>The amount of left and right commissural height, philtrum height, and maximum upper incisor show at rest did not change significantly three months after surgery (p&gt;0.05). The amount of maximum upper and lower incisor show, interlabial gap, smile width and index, buccal corridor ratio, gingival display, and smile arc on the frontal smile photographs didn’t showstatistically significant difference before and after surgery (P&gt;0.05).</p> <p><strong>Conclusion: </strong>Orthognathic surgery in patients with skeletal Class III malocclusion had no significant effect on rest and smile parameters from the frontal view.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.216-221</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40689 Prevalence of Acute and Chronic Forms of Leukemia in Various Regions of Khyber Pakhtunkhwa, Pakistan: Needs Much More to be done! 2019-04-18T13:21:38+00:00 Shujaat Ahmad razmianbutterfly@gmail.com - Kifayatullah ullahkifayat0@gmail.com Kiramat Ali Shah qazikiramat3366@gmail.com Haya Hussain haya@sbbu.edu.pk Anwar Ul Haq anwar@sbbu.edu.pk Abid Ullah abid@sbbu.edu.pk Asaf Khan hafizsbbu@gmail.com Najm Ur Rahman najm@sbbu.edu.pk <p><strong><em>Background and objective: </em></strong>Leukemia is one of the fatal diseases and their morbidity and mortality rates increases day by day all over the world. This piece of research study was designed in order to find out the prevalence of different types of leukemia in Khyber Pakhtunkhwa, Pakistan during January 2015 to December 2016.</p> <p><strong><em>Material and Method: </em></strong>The retrospective research study was carried out at Institute of Radiotherapy and Nuclear Medicine (IRNUM) Peshawar. A data of 400 admitted patients of leukemia were evaluated.</p> <p><strong><em>Result: </em></strong>It was observed that acute leukemia (80%) was more prevalent than chronic leukemia (20%). Amongst types of leukemia, Acute Lymphocytic Leukemia (ALL) 49.5% (n=198) was more prevalent than Acute Myelogenous Leukemia (AML) 31.25% (n=125), Chronic Myelogenous Leukemia (CML) 10% (n=40) and Chronic Lymphocytic Leukemia (CLL) 9.25% (n=37) was less prevalent in this study. It was also found that leukemia was more prevalent in male patients 64.5% (n=258) as compared to females 35.5% (n=142) and male to female ratio was 1.8:1. Most of the patients were under the age of 20 years.</p> <p><strong><em>Conclusion: </em></strong>Acute leukemia was more prevalent than chronic leukemia during this study in this part of the country and needs to be address.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.222-227</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40690 Zn as the Factor of Alkaline Phosphatase in Periodontal Patients consuming Minangkabau food in West Sumatra, Indonesia 2019-04-18T13:21:36+00:00 Nila Kasuma nilakasuma@dent.unand.ac.id Utmi Arma nilakasuma@dent.unand.ac.id Linda Risalina nilakasuma@dent.unand.ac.id Indrawati Liputo nilakasuma@dent.unand.ac.id Fildzah Nurul Fajrin nilakasuma@dent.unand.ac.id <p><strong>Background</strong>: Periodontal disease is preceded by an inflammation in the gingiva surrounding the teeth called gingivitis. It is an untreated gingivitis causing hard tissue damage (alveolarbone). This inflammation increases the activity of ALP enzyme. Zinc is an Alkaline Phosphatase co-factor.</p> <p><strong>Aim:</strong> This study aims at proving the connection between Alkaline Phosphatase (ALP) and zinc within the food of the Minangkabau people in West Sumatra, Indonesia. 60 samples are involved in this study. ALP level is tested by using ELISA technique. Zinc level in Minangkabau food is measured by Food Frequency Questionnaire (FFQ). Data is analyzed by means of univariate to describe each variable , Kolmogorov Smirn of Test is used to see the normal distribution ( p &gt; 0.05).</p> <p><strong>Result</strong>: Pearson correlation is conducted to see the correlation between ALP level and zinc clevel in Minangkabau food. The study reveals that ALP activity is higher in mild periodontitis compared to mild gingivitis and healthy control. Zinc level is significantly lower in mild periodontitisthanin mild gingivitis and healthy control individuals. The relation between ALP and zinc level indicates strong correlation with positive direction (r = - 0,884).</p> <p><strong>Conclusion</strong>: Zn decreases ALP activity and shows that zinc complement has both preventive and curing effects in periodontitis patients.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.228-232</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40691 Pre-operative serum total bilirubin level as an indicator marker of perforated appendicitis. 2019-04-18T13:21:33+00:00 Nur Karyatee Kassim karyatee@usm.my Aniza M Jelani anizamj@usm.my T Salwani T Ismail tusti@usm.my Julia Omar juliakb@usm.my Hanim A Ibrahim afzankk@usm.my W Norlina W Azman dr_wannorlina@usm.my Noorazliyana Shafii noorazliyana@usm.my Najib Majdi Yaacob najibmy@usm.my <p><strong><em>Objectives</em></strong><strong>: </strong>Acute appendicitis is one of the most common surgical emergencies. Perforated appendicitis can result in increased morbidity and mortality. Thus, early identification of perforation can reduce the impact on patient and improve outcome. Apart from total white cell count (TWCC), serum total bilirubin (SB) has been shown to indicate perforation in appendicitis. The aim of this study was to assess the usefulness of serum total bilirubin (SB) as the preoperative indicator for perforated appendicitis.</p> <p><strong><em>Materials and Methods</em></strong><strong>: </strong>This was a retrospective study of all appendicectomies cases done in Hospital Universiti Sains Malaysia (HUSM) over a one-year period in 2014. Only patients with histopathologically confirmed appendicitis with available liver function tests and total white blood cell count preoperatively were included in the study. These appendicitis cases were further divided into perforated and non-perforated based on histopathological reports obtained.</p> <p><strong><em>Results: </em></strong>A total of 245 patients had appendicectomy done in 2014 between January to December 2014. Out of 110 from these 245 patients met the inclusion and exclusion criteria. SB was significantly higher (p&lt;0.001) in patients with perforated appendix compared to non-perforated.</p> <p><strong><em>Conclusion: </em></strong>In conclusion, this study showed that preoperative SB is a useful laboratory parameter for perforated appendicitis to improve clinical decision-making by the clinician.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.233-237</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40692 Neonatal arterial blood gases & immediate outcome following perinatal asphyxia. 2019-04-18T13:21:30+00:00 Md Abdul Mannan dr_amannan@yahoo.com Subir Dey dr_amannan@yahoo.com SM Rezaul Karim dr_amannan@yahoo.com Shahed Iqbal dr_amannan@yahoo.com Sabina Yasmin dr_amannan@yahoo.com Navila Ferdous dr_amannan@yahoo.com <p><strong><em>Background: </em></strong>Perinatal asphyxia (PNA) remains a significant cause of death and disability despite the important advances in perinatal care in the past decades<strong>. </strong>Early neonatal mortality within the first 24 hours contributes substantially to overall neonatal mortality rates. Estimates of the incidence of perinatal asphyxia vary, in resource-rich countries is about 1/1000 live births and in resource-poor countries is probably much more common, an incidence of 5–10/1000 live births and represents the second most common cause of neonatal death (24%) after preterm birth related complications (35%). About one quarter of all neonatal deaths globally are caused by PNA &amp; an equal number of serious neurological consequences ranging from cerebral palsy &amp; mental retardation to epilepsy.</p> <p><strong><em>Objective: </em></strong>To determine how well neonatal arterial blood pH and base deficit predict immediate outcome (survival to discharge) following perinatal asphyxia.</p> <p><strong><em>Methods: </em></strong>This was a prospective study conducted in the delivery room and adjacent neonatal area (NICU) of Ad-din Medical College Hospital (AMCH), over 6 months from 1st June and 30th November, 2017. Research assistants were trained to observe and record events related to labor and neonatal resuscitation. Patient information was obtained which included patient characteristics (gender, birth weight &amp; gestational age) and APGAR scores at and beyond 5 minutes. Within one hour of delivery all admitted neonates were subjected to an arterial blood gas (ABG) analysis by GEM Premier 3000 blood gas analyzer and pH and base deficit were noted. All the neonates were classified according to GA, BW and Gender. After proper cleaning the collected data were analyzed thoroughly. Descriptive analyses were performed; differences in outcome by GA, BW, Gender, APGAR scores and ABG (pH and base deficit) status were determined using analysis of variance. Analyses were performed using the Statistical Package for Social Sciences (SPSS) version (Chi-Square test).</p> <p><strong><em>Results</em></strong><strong>: </strong>A total 50 neonates were studied in this period of which 72% survived &amp; 28 % expired. Death was mostly observed in neonate who had very high level of base deficit (&gt; 20mmol/L) &amp; very low pH (pH &lt;7.0) in 1st hour postnatal ABG. Survival rate was higher, 94.7% in &gt;35 - &lt;37 weeks GA group in comparison of &gt;37 weeks (58%) of GA (p = 0.0050). The neonates with birth weight (BW ) &gt;2000 - &lt;2500 gm were observed 77.78% survival and 68.75% in neonates with BW &gt;2500gm (p = 0.494). In this study most of the neonates were male (70%) &amp; recovery rate was relatively better among baby boys (74.3%) than baby girls (66.67%) (p = 0.582). High APGAR score neonates had better rate of recovery than poor APGAR score neonates. The neonates with APGAR score 4-6 beyond 5 minutes were observed 88.33% survival &amp; the neonates with APGAR score 0-3 beyond 5minutes were 55% survival (p= 0.028). High pH value neonates in 1st hour ABG were found higher rate of survival in comparison to low pH value neonates. It was 83.33% in pH 7.10- &lt;7.20 neonates, 72.73% in pH 7.0- &lt;7.10 neonates and 33.33% in pH &lt;7.0 neonates respectively (p=0.0136). The neonates with high level of base deficit in 1st hour ABG showed lower rate of survival than low level of base deficit neonates. It was 12.5% in base deficit &gt; 20mmol/L neonates, 33.33% in base deficit &gt; 15 - 20mmol/L neonates &amp; 87.18% in base deficit &gt; 12 -15mmol/L neonates respectively (p=0.00003).</p> <p><strong><em>Conclusion: </em></strong>From this study it is concluded that initial pH and base deficit of 1st hour ABG of neonates along with APGAR score at or beyond 5 minutes is a good predictor of risk &amp; immediate outcome following perinatal asphyxia. A good percentage of neonates recover due to early diagnosis, meticulous nursing care and timely intervention.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.238-243</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40693 Features of leukocytes’ apoptosis and emoxypine succinate efficacy in case of combined trauma of the chest and both thighs in rats 2019-04-18T13:21:27+00:00 Inna Krynytska krynytska@tdmu.edu.ua Mariya Marushchak marushchak@tdmu.edu.ua Liudmyla Holovatiuk luda888m@rambler.ru Leonid Shkrobot shkrobot@tdmu.edu.ua Natalia Sokhor sokhor@tdmu.edu.ua Julia Stepas stepas2014@gmail.com <p><strong><em>Objective: </em></strong>This study aims to establish features of blood leukocytes’ apoptosis and substantiate the efficacy of emoxypine succinate applying in case of combined trauma of the chest and both thighs in rats.</p> <p><strong><em>Materials and Methods: </em></strong>Analysis of cell samples to determine reactive oxygen species was evaluated by the flow laser cytometry method, using 2.7-dichlorodihydrofluorescein diacetate (Sigma Aldrich, Germany). The number of leukocytes with low mitochondrial transmembrane potential was evaluated by the flow laser cytometry method, using a kit of reagents «MitoScreen» («BD Pharmingen», USA). The number of apoptotic leukocytes was evaluated by the flow laser cytometry method, using a kit of reagents “ANNEXIN V FITC” (“Beckman Coulter”, USA). Emoxypine succinate to animals was injected intraperitoneally 1 time per day during 14 days from the first day of experiment in the dosage of 40 mg/kg.</p> <p><strong><em>Results and Discussion</em></strong><strong>: </strong>It was established the progressive, statistically significant increasing of Annexin V- positive cells percentage from the first day of the combined trauma of the chest and both thighs in rats with the highest values within 7-14 days of observation. On 28 day of experiment the reduction of apoptotic white blood cells percentage by 7.7% than the findings on 14 day was observed, but it remained 33.3% higher than control. The analysis of data in case of emoxypine succinate applying indicates that production of reactive oxygen species by leukocytes began to decline after 3 days of experiment and continued to decrease with maximum of action on 7 day. On 28 day of experiment the production of reactive oxygen species by leukocytes has decreased by 39.8 %; the percentage of leukocytes with low transmembrane potential has decreased by 34.6 % vs rats without medical treatment. At the same time the dynamics of FITC Annexin V- positive leukocytes changes in case of combined trauma of the chest and both thighs in rats and emoxypine succinate applying on 28 day of experiment has decreased by 16.7 % vs rats without medical treatment.</p> <p><strong><em>Conclusion: </em></strong>One of important signaling pathways of apoptosis triggering in case of experimental combined trauma of the chest and both thighs is reactive oxygen species overproduction and disruption of the mitochondrial inner membrane due to the decreasing of transmembrane potential in 3-7 days of observation. Emoxypine succinate applying in post-traumatic period has a positive effect, characterized by decreasing of the production of reactive oxygen species, the percentage of leukocyte with low mitochondrial transmembrane potential and the percentage of FITC Annexin V- positive cells of leukocyte suspension. But the dynamics of FITC Annexin V- positive leukocytes changes leads us to believe that in the initiation and implementation of cell death in case of combined trauma apart mitochondrial, there are other mechanisms.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.244-251</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40694 Depression, Anxiety and Stress among Obese Patients with Chronic Illnesses: Prevalence and Associated Factors in North East Malaysia 2019-04-18T13:21:24+00:00 Raihan Hassan muizz_r@yahoo.com Maryam Mohd Zulkifli meccha1607@gmail.com Imran Ahmad profimran@usm.my Siti Suhaila MohdYusoff drsuhaila@usm.my <p><strong><em>Introduction</em></strong><strong>: </strong>Concomitant obesity and chronic medical illness is a significant health problem in Malaysia and worldwide. The comorbid psychological impact in obese patients is associated with a social stigma and low self-esteem. The aim of this study was to determine the prevalence and the factors associated with depression, anxiety and stress in obese patients with chronic medical illnesses attending an outpatient clinic.</p> <p><strong><em>Methods: </em></strong>This was a cross-sectional study among obese patients with chronic medical illnesses presenting at the Universiti Sains Malaysia Hospital outpatient clinic. A total of 274 patients were involved. The 21-item Depression, Anxiety and Stress Scale questionnaire was used, and the results were evaluated using single and multiple logistic regression analyses.</p> <p><strong><em>Results: </em></strong>The prevalences of depression, anxiety and stress among the obese patients with chronic medical illnesses were 13.9%, 23.4% and 10.9%, respectively. Younger age [p=0.003, adjusted odds ratio (AOR),1.0; 95%confidence interval (CI),0.91–0.98], unemployed employment(p=0.013, AOR,3.7;95% CI,1.32–10.09) and smoking (p=0.022, AOR,3.2; 95% CI,1.18–8.55) were associated with depression. No formal education (p=0.011, AOR,5.7; 95%CI,1.49–21.89), high body mass index (p=0.029, AOR,1.1;95% CI,1.01–1.13) and family history of psychiatric illness (p=0.018, AOR,5.1; 95% CI,1.33–19.56) were associated with anxiety. Stress was strongly associated with females (p=0.004, AOR,5.0; 95% CI,1.70–15.13) and smoking(p=0.002, AOR,6.5; 95% CI,2.03–20.7).</p> <p><strong><em>Conclusion: </em></strong>Interestingly, younger age group was associated with depression. Current smokers, no education, family history of psychiatric illness and female sex were significantly associated with anxiety and stress. This notifies new emerging knowledge on factors associated with obese patients that would empower the development of effective preventive strategies for it.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.252-259</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40695 Evaluation of Errors in Prescription Writing: A Cross-Sectional Study at Community Pharmacies and Tertiary Care Hospitals of Lahore, Pakistan 2019-04-18T13:21:21+00:00 Muhammad Farhan Ali Khan farhanali6879@gmail.com Muhammad Salman farhanali6879@gmail.com Nazeer Hussain Khan farhanali6879@gmail.com Talha Masood farhanali6879@gmail.com Muhammad Safdar farhanali6879@gmail.com - KhuzaimaIkhlaq farhanali6879@gmail.com Muhammad Umair Ansari farhanali6879@gmail.com Muhammad Shahid Latif farhanali6879@gmail.com Muhammad Saqlain farhanali6879@gmail.com Zia Ul Mustafa farhanali6879@gmail.com Noman Asif farhanali6879@gmail.com <p><strong><em>Background: </em></strong>Prescription errors often lead to mishaps around healthcare facility that often end up with adverse drug reactions and even some cases death Being in a healthcare facility the patient should have full confidence in the health care providers and not have to worry about minor mistakes leading to a possible lethal one.</p> <p><strong><em>Aim and objective</em></strong>: The aims and objectives of our study is to evaluate the prescription writing errors in different community pharmacies and tertiary care hospitals also to assess the knowledge of patients regarding their disease and treatment.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.260-266</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40696 Assessment on the awareness level about diarrhoea and its management among mothers attending outpatient department in a rural hospital of West Bengal, India 2019-04-18T13:21:19+00:00 Pampa Basu basu_pampa@yahoo.com Arupkumar Chakrabartty basu_pampa@yahoo.com Salil Bhattacharya basu_pampa@yahoo.com Krishnadas Bhattacharya basu_pampa@yahoo.com Urmila Dasgupta basu_pampa@yahoo.com Saikat Bhattacharya basu_pampa@yahoo.com Kazi Monjur Ali basu_pampa@yahoo.com <p><strong><em>Background</em></strong><strong>: </strong>Diarrhoea is one of the leading causes of under-five childhood morbidity and mortality in India, despite the availability of easy interventions through oral rehydration at the community level. The level of knowledge varies from country to country and within the country, further variations exist in state, district and sub district level based on difference in socio-demographic characteristics of the population. And based on these variations, different community needs different health education efforts in its extent and approaches. It was therefore relevant to explore the level of awareness about diarrhoea and its management among the mothers who were the first level of caregivers.</p> <p><strong><em>Objective: </em></strong>To assess the level of knowledge about diarrhoea and oral rehydration therapy among the mothers having their children of 6 months to 5 yrs with diarrhea</p> <p><strong><em>Materials and methods: </em></strong>It was a facility based cross-sectional descriptive epidemiological study conducted among 62 mothers having their children of 6 months to five years with diarrhoea. Mothers attended a rural hospital under the geographical area of Madhyamgram in North 24 Parganas district of West Bengal, India. Data was collected by face to face interview of the mothers in the outpatient department of the hospital using a pre-designed and pre-tested questionnaire. The analysis was done in Statistical Package for Social Sciences (SPSS), version 20.0 using bivariate and multivariate (multiple logistic regression model) to examine the statistical significance at 95% confidence interval.</p> <p><strong><em>Results: </em></strong>Mean knowledge score was 7.8 (Range 0-17). Lower knowledge score group (0-8) accounted to 36 persons (37.1%) and higher knowledge group (9-19) accounted to 26 persons (62.9%). Knowledge about alarming symptoms of the dehydration was significantly poor. At the individual level, literacy of women and their caste were strongly associated with the knowledge about diarrhoea and its management. At the household level, the way of the disposal of household garbage was also strongly associated.</p> <p><strong><em>Conclusion: </em></strong>Considering the poor knowledge of the mothers, the study recommends for extensive health education measures widely in the community with a special focus for the illiterate and socio-economically lower groups, and also for the families having the practice of open garbage disposal.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.267-273</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40697 Learner Perceptions Regarding the Lecture and the Small Group Discussion as Teaching/Learning Methods in Physiology” 2019-04-18T13:21:16+00:00 Preetha Paul drpreethapaul@yahoo.co.in Lalitha Subramanyam drpreethapaul@yahoo.co.in Geetha Raghunathan drpreethapaul@yahoo.co.in Balaji Arumugam drpreethapaul@yahoo.co.in <p><strong><em>Introduction: </em></strong>Physiology has traditionally been taught through lectures, but other methods are now being tried. One of these, the small group discussion (SGD), is considered to be more tuned to learners’ needs compared to the lecture.</p> <p><strong><em>Aim</em></strong><strong>: </strong>This study was undertaken to determine learner perceptions on the lecture and the SGD as teaching/learning methods in physiology.</p> <p><strong><em>Methods: </em></strong>Ninety-seven first MBBS students were taught Physiology in both lecture and SGD formats for a whole year. Feedback was then obtained from the students using a validated and structured questionnaire. Data was entered in Excel sheet and analyzed using SPSS software.</p> <p><strong><em>Results and Discussion</em></strong><strong>: </strong>Learners felt that both the lecture and the SGD helped them understand basic principles well (93.4 and 93.3%), contributed effectively to the learning process (84.6 and 90%) and fostered critical thinking skills (64.9 and 68.9%). For delivery of basic concepts, learners preferred the lecture for its systematic presentation. SGDs were perceived to promote active participation of learners (85.6%), encourage facilitator-learner interaction (87.8), and retain student interest better (62.2%).Overall, learning was better-stimulated by the SGD (73.4%) rather than the lecture (35.2%).</p> <p><strong><em>Conclusion</em></strong><strong>: </strong>In the teaching/learning of physiology, appropriate use of both the lecture and the SGD will serve to nurture and sustain learner interest effectively.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.274-278</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40698 Low total physical activity, high total sitting time and high sitting time on a work day are correlated with low fitness in male working adults: a cross sectional study 2019-04-18T13:21:14+00:00 Rakhmat Ari Wibowo rakhmatari@mail.ugm.ac.id Widya Wasityastuti rakhmatari@mail.ugm.ac.id Zaenal Muttaqien Sofro rakhmatari@mail.ugm.ac.id <p><strong><em>Background </em></strong><strong>: </strong>Low fitness is an emerging factor for cardiovascular diseases. Physical activity and sitting time are arising factors that influence fitness level. There are some debates on what domain of physical activity and sitting time that have more influences on fitness level. The aims of this study were to (1) explore each domain of physical activity &amp; sitting time and analyze their associations with low fitness in male working adults and (2) explore the differences between sitting time on a working day and a day-off.</p> <p><strong><em>Method </em></strong><strong>:</strong>In this cross-sectional study, a total of 31 healthy male staffs were recruited. Participants used International Physical Activity Questionnaire (IPAQ) long version to recall their physical activity and sitting time, and their fitness level was measured by a submaximal exercise test. Data were analyzed both by univariate and multivariate techniques. Multivariable logistic regressions were employed to calculate Odds Ratio (OR) of low fitness by each domain of physical activity and sitting time.</p> <p><strong><em>Result </em></strong><strong>: </strong>Data of 27 participants were considered for analysis. Total physical activity was inversely associated with low fitness [OR 0.961, 95% Confidence Interval (95% CI) 0.928 – 0.995]. Total sitting time and sitting time on a working day were positively associated with low fitness (total sitting time: OR 1.101, 95% CI 1.001-1.211; sitting time on a working day: OR 1.01, 95% CI 1.001-1.019). We also observed that sitting on a working day was significantly higher than sitting time on a day-off (p = 0.004).</p> <p><strong><em>Conclusion </em></strong>: The results support association of total physical activity, total sitting time and sitting time on a working day with fitness level. There were also difference between sitting time on a working day and a day-off.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.279-287</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40699 Awareness, knowledge and attitude toward secondary health care system: survey of physicians in Kosovo 2019-04-18T13:21:11+00:00 Albiona Rashiti premtim.rashiti@uni-pr.edu Leonora Svarça premtim.rashiti@uni-pr.edu Afërdita Kurti premtim.rashiti@uni-pr.edu Premtim Rashiti premtim.rashiti@uni-pr.edu <p><strong><em>Objective</em></strong><em>: </em>To assess knowledge, awareness and attitude among hospital physicians from Kosovo toward current situation of Health Care System (HCS) especially Secondary Health Care (SHC) in Kosovo.</p> <p><strong><em>Methods: </em></strong>In this cross-sectional study, anonymous questionnaire were delivered to three regional hospitals in Kosovo. The main outcome measures were physician’s awareness of the management of secondary health care institutions, awareness and use of new technology for improving health care in second level and their suggestions for further improvement.</p> <p><strong><em>Results: </em></strong>Results are divided into three main categories: I. Relevant information on the knowledge of the health care system, were respondents had valuable information and insight; II. Relevant information on suggested improvements, in which respondents gave their proposals regarding workplace and inter managerial relations and III. Relevant information on continues education possibilities for medical staff.</p> <p><strong><em>Conclusions</em></strong><em>: </em>In conclusion there is a need to prioritize proper cooperation between primary, secondary, and third level of health institutions, in terms of entire health management in order to increase the quality of health services delivery, in line with western standards.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.288-293</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40700 Study of Usage Rate for Various Complementary and Alternative Medicine among People Visited Non-Conventional Medical Centers in Shiraz, Iran, in 2016. 2019-04-18T13:21:09+00:00 Majid Movahed mmovahed@rose.shirazu.ac.ir Razieh Rayanpour mmovahed@rose.shirazu.ac.ir <p><strong><em>Introduction: </em></strong>The present research was aimed at studying the usage rate for the complementary and alternative medicine, at identifying its low-consumption and high-consumption methods, and at analyzing the relationship between demographic variables and the usage rate of this medicine among the people who visited the non-conventional medical centers in Shiraz, Iran.</p> <p><strong><em>Methods: </em></strong>This research is an analytical-cross-sectional study in which 800 people have been visited 6 non-conventional medical centers in July 2016; having gained their satisfaction, they were studied by method of complete enumeration. The data were collected using a researchermade questionnaire and analyzed through SPSS.</p> <p><strong>Result: </strong>In this study, 68% of visitors used the complementary and alternative medicine in medium rate. The high-consumption kind includes the Natural products, the Movement-based approaches and the Traditional treatments. The low-consumption kind includes the Energy-based treatments and whole medical system. The demographic variables such as age, gender, ethnicity, education, birth place and occupation were in relation with the usage rate of complementary and alternative medicine.</p> <p><strong><em>Conclusion: </em></strong>The healthy people have tended to use the complementary and alternative medicine as a part of their healthy lifestyle. The high-consumption strands had origin in the culture and tradition of a society and they are easily available. The low-consumption strands include the methods that the people were less familiar with them; these strands have limited accessibility and the higher costs.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.294-302</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40701 Factors Affecting Nurses’ Perceived Organizational Commitment: A Qualitative Study 2019-04-18T13:21:07+00:00 Faribah Sepahvand f_atashzadeh@sbmu.ac.ir Foorozan Atashzadeh Shoorideh f_atashzadeh@sbmu.ac.ir Soroor Parvizy f_atashzadeh@sbmu.ac.ir Mansoureh Zagheri Tafreshi f_atashzadeh@sbmu.ac.ir <p><strong><em>Objective: </em></strong>Nurses’ organizational commitment is one of the most important factors that facilitates their professional evolution and influences the method of care provision, quality of care, and patients’ satisfaction. The aim of this study was identified the factors that affect nurses’ perceived organizational commitment.</p> <p><strong><em>Material and Methods</em></strong><strong>: </strong>This qualitative study, conducted on 16 clinical nurses employed in Social Security Hospital of Khorramabad, Iran, during five months from May to September 2015, used deep semi-structured interviews. Purposive sampling method was used for the selection of nurses and the data were analyzed using conventional qualitative content analysis. Lincoln &amp; Guba’s criteria were used to secure data accuracy and stability.</p> <p><strong><em>Results: </em></strong>Sixteen subcategories, five categories, and three themes were distilled during content analysis process. The abstracted themes included “organizational factors”, “occupational challenges”, and “contributory management”.</p> <p><strong><em>Conclusion</em></strong><em>: </em>Our findings showed that numerous factors present in nurses’ profession and work environment may influence the rate of nurses’ interest and commitment in the hospital and the related organization. Hence, nurse managers can foster the promotion of nurses’ organizational commitment through creating the required suitable conditions.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.303-311</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40702 Exploration of Unani concept of blood purifying drugs and likely models for its screening 2019-04-18T13:21:04+00:00 Ansari Mushir nasreennium@gmail.com Nasreen Jahan nasreennium@gmail.com Ghulamuddin Sofi nasreennium@gmail.com <p><strong><em>Introduction</em></strong><em>: </em>In Unani system of medicine, blood is regarded as mixture of <em>akhlat </em>(humours) i.e. <em>dam </em>(Sanguine), <em>balgham </em>(phlegm), <em>safra </em>(yellow bile) and <em>sawda </em>(black bile). Normal blood consists of “<em>akhlate latifa </em>(plasma)” and “<em>kaseefa </em>(corpuscles)”. Normal blood is one in which all humours are in normal proportion in terms of quantity and quality and specific to each individual. It is normal in colour, free from bad odour and moderate in viscosity. Morbid blood develops due to impurities /disease in the blood which ultimately alter its quantity and quality. If we co relate these abnormalities with modern concept then all bleeding disorders and coagulopathy fall under “<em>Riqqate dam” </em>(low viscosity of blood); all the thromboembolic disorders; polycythaemia, leukaemia and anaemia fall under “<em>Ghilzate dam”</em>(hyperviscosity of blood), while septicaemia, bacterial diseases can be correlated with “<em>ufunat” </em>(infections).</p> <p><strong><em>Methods</em></strong><em>: </em>The classic and relevant books of Unani and conventional medicine were studied. The databases utilized for obtaining information, are scientific research publications from indexed journals available through Google Scholar, PubMed and Science Direct.</p> <p><strong><em>Results and Conclusion</em></strong>: Blood purifying drugs cause necessary changes and maintain the viscosity of the blood by their moderate heat; cold; dry and wet properties. These drugs are alterative and bring the quality and quantity of blood in equilibrium. Strengthen the defensive mechanism and eliminate toxins via sweat, urine, faeces etc. These drugs are digestive<em>, </em>tonic to stomach and liver and boost the immune system. In the line of the above conceptual framework few experimental models are being suggested i.e. effect of drugs on blood constituents, coagulation parameters, anemia, leukaemia, polycythaemia, thrombocytopenia and infections. This preliminary study may serve as a tool for the screening of blood purifier drugs in various blood disorders.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.312-321</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40703 Spontaneous cerebrospinal fluid rhinorrhoea and its association with body mass index (BMI) 2019-04-18T13:21:02+00:00 Tan Yee Wen drsalina_h@yahoo.com Balwant Singh Gendeh drsalina_h@yahoo.com Rohana Ali O’Connell Husain drsalina_h@yahoo.com Salina Husain drsalina_h@yahoo.com Kamalan Jeevaratnam drsalina_h@yahoo.com <p><strong><em>Objective: </em></strong>The purpose of this study is to review the correlation of spontaneous cerebrospinal fluid rhinorrhoea (CSFR) and Body Mass Index (BMI) and describe the demographics, the surgical techniques and outcomes.</p> <p><strong><em>Materials and methods</em></strong><strong>: </strong>We performed a retrospective review of clinical data of twenty patients diagnosed with spontaneous CSFR and treated at the Malaysian National University Medical Centre from 1997 to 2015.</p> <p><strong><em>Result and Discussion: </em></strong>A total of 20 patients were selected in this research (19 females,1male). The mean age was 45.5 years with nineteen females and one male patient. The mean BMI was 33.1kg/m2.Majority of patients with spontaneous leaks are females in their forties. The bath plug technique, onlay of middle turbinate grafts, nasoseptal flaps and mucoperiosteal grafts techniques were used and three patients reported recurrences.</p> <p><strong><em>Conclusion</em></strong><strong>: </strong>Spontaneous CSFR is more common in women in their 40s with BMI&gt;25. The most common sites of leaks are the cribriform plate followed by the sphenoid sinus. Spontaneous CSFR cases are strongly related with increased BMI.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.322-328</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40704 Prevalence of hepatitis B Virus in clinically suspected infectious hepatitis in Meerut, I 2019-04-18T13:21:00+00:00 Salman Khan salman186631@gmail.com Molly Madan MollyMadan@gmail.com Sunil Kumar Virmani salman186631@gmail.com <p><strong><em>Objective:</em></strong>-Hepatitis B is noteworthy medical issues that may include the late continuation of liver cirrhosis and hepatocellular carcinoma. The present study aimed to know the seroprevalence of hepatitis B Virus in Meerut with different clinical conditions.</p> <p><strong><em>Methods: </em></strong>The studyconducted on 4927 patients in Meerut, India, which was performed in central research center labortory of Microbiology at netaji subhash Chandra Bose Medical College and Hospital Between January 2013 to April 2017 The sera were separated and screened for HBsAg byimmune-chromatographic card test then HBsAg positive serum sampleswere tested again for HBsAg using ELISA kit<strong>. </strong>Positive samples for HBsAgwere tested for HBeAg ELISA kit<strong><em>.</em></strong></p> <p><strong><em>Results: </em></strong>In 245 positive cases 118 (48.16 %) were male and 127 (51.84%) were female. The seroprevalence rate of HBV was 4.97% in Meerut, India. Age group21–30 was the highest seroprevalence (7.46%) when compaired to other age group. Of the 245 HBsAg Positive case 55 (1.12%) were HBeAg positive. 20 were male, Highest HBeAg positive male were found in 21- 30age group. Out of 55 HBeAg cases, 35 were female and 92 female were negative for HBeAg, this was stastically significant (P&lt; 0.039) by using Z test.</p> <p><strong><em>Conclusions: </em></strong>The study uncovered that the seroprevalence of HBV was alarmingly higher in such a populace, which presumably mirrors a high foundation predominance of HBV contaminations ought to be mulled over and Implementation of group based preventive measures and enhanced procedures for safe blood supply may demonstrate valuable to diminish the seroprevalence</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.329-333</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40705 Study on vancomycin-resistant enterococci in faecal samples from non-hospitalized individuals at MMIMSR, Haryana, India 2019-04-18T13:20:57+00:00 Shyamsundar Bera drsoniaagar@gmail.com Sonia Mehta drsoniaagar@gmail.com Manisha Bhatt Dwivedi drsoniaagar@gmail.com Varsha A Singh drsoniaagar@gmail.com Rajdeep Paul drsoniaagar@gmail.com Sumi Nongrum drsoniaagar@gmail.com <p><strong><em>Background: </em></strong>Enterococci, formerly classified with fecal streptococci, have been recognized to be of fecal origin since the beginning of this century.</p> <p><strong><em>Method: </em></strong>This study was undertaken to determine the prevalence of stool colonization with vancomycin resistant Enterococcus (VRE) and also to evaluate the risk factors for colonization with vancomycin resistant Enterococcus among non- Hospitalized individuals at MMIMSR, Mullana.Test was performed for VRE isolates collected over a period of 6 months (Oct2015- March 2016). Faecal samples were collected by using sterile container from non- hospitalized individuals then to Cultures using Mac Conkey and Blood agar. After presumptive diagnosis as an enterococcus spp, 50 Enterococcal isolates were then again cultured on special VRE screen agar media to identify vancomycin resistant Enterococcus.</p> <p><strong><em>Result: </em></strong>The results were further supported by modified Kirby-bauer disk diffusion method with vancomycin (30μg) as per CLSI guideline. A total of 29 (58%) <em>Enterococcus faecalis </em>and 21 (42%) <em>Enterococcus faecium </em>were detected among the faecal isolates and 2 (4%) were VRE. According to CLSI guideline isolates showing diameter of zone of inhibition ≤16mm were considered among the VRE. Chronic diseases, previous hospital stay (more than 15 days) and repeatedly antibiotic consumption was found to be significant risk factor for non-hospitalized individuals.</p> <p><strong><em>Conclusion: </em></strong>There is need for programs to promote greater attention about antibiotics usage in the general population. Education of Health care workers with implementation and observation of hand-washing practices constitutes a very effective step in preventing the spread Prolonged use of vancomycin drug should not be recommended by the physician.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.334-339</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40706 Effect of Second hand Smoke on Arterial Stiffness among Healthy Women 2019-04-18T13:20:55+00:00 Suriyati Sariban suriyatisariban@yahoo.com Siti Suhaila Mohd Yusoff drsuhaila@usm.my Juwita Shaaban juwita@usm.my Norhayati Mohd Noor hayatikk@usm.my Harmy Mohamed Yusoff harmyusoff@unisza.edu.my <p><strong><em>Introduction</em></strong><em>: </em>Arterial stiffness is recognised as a significant cardiovascular risk factor and an independent predictor of all causes of cardiovascular death. Women are the largest population exposed to cigarette smoke either at work or from their partner. The objectives of this study are to compare the arterial stiffness (augmentation index and pulse wave velocity) between second hand smoke (SHS) and non second hand smoke (non-SHS).</p> <p><strong><em>Designs and method</em></strong>: Comparative cross-sectional study was conducted among 118 healthy female subjects (64 SHS and 54 non- SHS). The women were in the SHS group if their spouse is a smoker and they had an exposure to cigarette smoke for at least three years, minimum of15 minutes two days a week. Pulse wave analysis and pulse wave velocity was used to study the arterial stiffness. Pulse wave analysis reported as percentage of augmentation index. Pulse wave velocity equal to carotid femoral distance (meter) divided by time (second)</p> <p><strong><em>Results</em></strong><em>: </em>The mean augmentation index (AIx) for SHS groups was 17.9 (SD7.06) and for non SHS groups was 20.7(SD6.11). The mean of Pulse wave velocity was 8.94 (SD1.36) in SHS groups and 9.02 (SD8.68) in non SHS groups. ANOVA and ANCOVA shown significance difference in crude mean (<em>p </em>= 0.047) and estimated marginal mean (<em>p </em>= 0.028) of augmentation index between SHS and non - SHS after controlling for age and BMI. However, there was no significant difference in crude mean (<em>p </em>= 0.795) and estimated marginal mean (<em>p </em>= 0.716) pulse wave velocity between SHS and non - SHS after controlling for age and BMI.</p> <p><strong><em>Conclusion</em></strong><em>: </em>An increase in augmentation index amongst non SHS in this study most probably due to exposure to environmental tobacco at work compared to exposure to spouse’s smoke</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.340-346</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40707 Correlation between Digit Ratio and Incidence of Meningioma and its Clinical Profiles 2019-04-18T13:20:52+00:00 Surya Pratama Brilliantika thohar@gmail.com Muhammad Thohar Arifin thohar@gmail.com Hermawan Istiadi thohar@gmail.com Tri Indah Winarni thohar@gmail.com Hexanto Muhartomo thohar@gmail.com <p><strong>Background</strong>: Proliferation and progression of meningioma were influenced by the balance of estrogen and testosterone. Digit Ratio (DR) was a sign of prenatal exposure to estrogen and testosterone. This study intends to find the relationship between Digit Ratio and meningioma.</p> <p><strong>Aim</strong>: To determine the relationship between DR and incidence of Meningioma and its Clinical Profiles (age at the onset, sex, Body Mass Indec (BMI) and histopathology grading)</p> <p><strong>Methods</strong>: Analytical observational study was used with case-control design. Case group consisted of patients clinically and histopathologically diagnosed with meningioma (n=25). Patients who were not diagnosed with primary intracranial tumors were included in the control group (n=25). Matched group were conducted. Subjects of this study were patients of RSUP dr Kariadi in the period of January 2016-August 2017. This study was conducted by collecting data consisted of DR, age, sex, BMI, and grading histopathology. Tests used in this study are Chi-Square Test, Mann-Whitney Test and Fishers exact Test.</p> <p><strong>Results</strong>: Digit Ratio Mean for right, left and right-left difference were 1.0041; 1.0104 and 0.0357 while for the right and left DR cutoff value 0.993; 0.989. There is a relationship between right and left Digit Ratio and incidence of meningioma (p = 0,000) with OR (Odds Ratio) Right DR = 11.17(CI95% 2,864 – 43,464) and OR left DR = 16,00 (CI95% 4,002 – 63,975). There is a relationship between Right Digit Ratio andBMI case group (p = 0,022). There is no relationship of Digit Ratio and age at onset, gender and histopathology grading (p &lt;0.05).</p> <p><strong>Conclusion</strong>: DR is risk factor of Meningioma</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.347-352</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40709 Prevention of Chronic Non-Communicable Diseases in Russia: Analytical Review of General Institutional Issues 2019-04-18T13:20:50+00:00 Tatyana Maksikova tanya.maksikova@bk.ru Aleksey Kalyagin tanya.maksikova@bk.ru Dmitriy Piven tanya.maksikova@bk.ru Galina Sinkova tanya.maksikova@bk.ru <p><strong><em>Objective: </em></strong>The purpose of this research is to assess regulatory, organizational and methodological documents, as well as Russian and international recommendations, to use infromation from them to identify and systematize problems in prevention of chronic non-communicable diseases, and tooffer solutions.</p> <p><strong><em>Materials and Methods: </em></strong>Analysis encompasees the key Federal Laws of the Russian Federation; orders, records, and reports provided by various ministries and departments of the Russian Federation,as well as by the leading research institutes; guides, manuals, and federal recommendations; the latest Russian and foreign guidelines and recommendations on prevention of chronic non-communicable diseases.</p> <p><strong><em>Results and Discussion: </em></strong>Analysis was faced with a number of problems:poor correlation between changes in regulatory documents governing the prevention of chronic non-communicable diseases; incomplete allowance for international experience and guidelines on prevention of chronic non-communicable diseases, incomplete epidemiological data; poor coordination and uneven assignment of responsibilities in structures involved in prevention; shift in emphasis from population-oriented prevention and high-risk groups towards secondary prevention; below-satisfactory efficiency of tuberculosis screening in clinical examination.</p> <p><strong><em>Conclusions: </em></strong>Their resolutionmay significantly increase the effectiveness of measures intendedfor prevention of chronic non-communicable diseases and their risk factors from occurence in Russia.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.353-367</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40710 Profiling of the bacterial pathogens associated with hospital acquired infections in hospitals within makurdi metropolis, middle belt, nigeria. 2019-04-18T13:20:48+00:00 Emmanuel Olumuyiwa Onifade arethomps@gmail.com Innocent Okonkwo Ogbonna arethomps@gmail.com Joseph Ikwebe arethomps@gmail.com Stephen Olaide Aremu arethomps@gmail.com <p><strong>Background</strong>: Nosocomial bacteria are bacteria that cause diseases acquired from the hospital environments. Aim: This study looked into profile of bacterial pathogens associated with nosocomial infections in hospitals within Makurdi metropolis. Result: A total of 71 bacterial pathogens were encountered from 240 samples analysed from three hospitals in Makurdi metropolis. Of the 71 isolates, 46(64.8%) were Gram positive and 25(35.2%) were Gram negative. The Gram positive constituting S. aureus (50.70%) and staphylococcus spp (14.08%) while the Gram negative constituting E. coli (15.50%), klebsiella spp (7.04%) and P. aeruginosa (12.68%). Out of 21(29.58%) isolates cultured from hand swabs, the bacterial pathogens from hand swab at F M C was the highest 12(57.14%) followed by C H M 5(23.81%) while B M M C has the least profile of 4(19.05%). With regards to hospital air, the highest profile of nosocomial bacteria was also from F M C 8(61.54%), followed by B M M C 4(30.77%) while C H M had just only one isolate 1(7.69%). Of 21(29.58%) isolates from B M M C; 10(47.62%) S. aureus, 4(19.05%) Staphylococcus spp, 2(9.52%) P. aeruginosa and 5(23.81%) Escherichia coli were obtained. In C H M, out of 18(25.35%) bacterial pathogens evolved constituting 12(66.67%) S. aureus, 2(11.11%) Staphylococcus spp, 1(5.56%) P. aeruginosa and 3(16.67%) E. coli. Whereas, the profile of 32(45.07) isolates in Federal Medical Centre Makurdi constituting 14(43.75%) S. aureus, 4(12.50%) Staphylococcus spp, 6(18.75%) P. aeruginosa, 3(9.38%) E. coli and 5(15.63%) Klebsiella spp were obtained. The antibiotic susceptibility pattern to Staphylococcus spp reveals that the highest level of sensitivity were demonstrated by Cloxacillin and Ofloxacin with 50%, followed by Augumentin and Cefuroxime with 40%, Gentamicin (30%), Erythromycin (20%) and least sensitivity with Ceftriazone (10%) while Ceftazidime has the highest resistance recorded 0% sensitivity. E. coli has the highest sensitivity on Ceftazidime having 81.8% and Gentamicin 63.6%, Ofloxacin also displayed a high level of sensitivity to isolates tested with 63.6% sensitive, follow by Cefuroxime (45.5%).</p> <p><strong>Conclusion</strong>: This study showed that nosocomial bacterial pathogens particularly, S. aureus, P. aeruginosa, Staphylococcus spp and enteric bacteria, E. coli and Klebsiella spp are the predominant pathogens associated with infections acquired in hospital environment.So, information on resistance patterns of isolates encountered in this study will assist the clinicians in making improvement in management of nosocomial infections.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.368-378</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40711 The Correlation between Polymorphism of β Fibrinogen Gene -455 G/A and Serum Fibrinogen Level with The Severity of Coronary Artery Stenosis In Coronary Artery Disease Patient 2019-04-18T13:20:46+00:00 Taufik Indrajaya tfk_indrajaya@yahoo.com Yudhi Fadilah tfk_indrajaya@yahoo.com Mediarty Yuwono tfk_indrajaya@yahoo.com Ali Ghanie tfk_indrajaya@yahoo.com <p><strong><em>Background: </em></strong>Now a days coronary artery disease (CAD) becomes major cause of death. One among 7 deaths in America caused by CAD. CAD is an atherosclerosis process, which progresively develops into plaque that will lead to stenosis of coronary artery lumen. Several studies found that high serum fibrinogen level is an independent and significant to the severity of artery coronary stenosis. Serum fibrinogen level determined by genetic factor. Polymorphism of fibrinogen gene <em>β </em>-455 G/A seem plays an important role in plasma fibrinogen level. Although some studies showed a significant correlation between polymorphism and cardiovascular diseases, but some other studies report inversely.</p> <p><strong>Aim. </strong>To evaluate the correlation between the polymorphism of fibrinogen gene <em>β </em>-455 G/A and serum fibrinogen level with the severity of artery coronary stenosis.</p> <p><strong><em>Method: </em></strong>This is an analytic correlative study with prospective approach without comparison. Coronary angiography was performed in catheterization labor in the department of internal medicine, while DNA analysis and PCR done in the department of microbiology in General Hospital dr Muhammad Husin Palembang- Indonesioa, since July 2015 until Agustus 2016. Samples are CAD patient who undergo for coronary angiography and fulfield the criterias. The severity of stenosis in coronary artery determined by Gensini score. This study included 31 patient.</p> <p><strong><em>Results</em></strong><strong>. </strong>Among 31 CAD patients, this study found severe stenosis of coronary artery in 17 patients (53,1%), moderate in 5 patients (15,6%) and mild in 10 patients (31,2%). Genetic analysis showed that serum fibrinogen level was controlled by polymorphism of fibrinogen gene <em>β </em>-455 G/A, concecutively by genotipe AA in 15 patients (48,4%), genotipe GA in 12 patient (38,7%) and by genotipe GG in 4 patients (12,9%). <em>Chi Square </em>test showed a significant correlation between polymorphism gene fibrinogen <em>β </em>-455 G/A and serum fibrinogen level (p=0,039). <em>Spearman’s rho </em>test found no significant correlation between serum fibrinogen level and severity of coronary artery stenosis based on Gensini score (r=0,142; p=0,447). And also this study found no significant correlation between polymorphism gene fibrinogen <em>β </em>-455 G/A with the severity of stenosis in coronary artery (p=0,512).</p> <p><strong><em>Conclusion. </em></strong>Although this study succeded to prove that serum fibrinogen level was determined by polymorphism fibrinogen gene <em>β </em>-455 G/A, but there are no significant correlations between polymorphism fibrinogen gene <em>β </em>-455 G/A and serum fibrinogen level with severity of coronary artery stenosis in CAD patients. This study suggest to study other candidate gene to look for other cardiac risk beside this fibrinogen.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.379-384</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40712 Laser assisted orthodontic tooth movement in Saudi population: a randomized clinical trial. 2019-04-18T13:20:43+00:00 Mohammad Khursheed Alam mkalam@ju.edu.sa <p><strong><em>Objectives</em></strong><strong>: </strong>This study aimed to assess laser assisted orthodontic tooth movement (OTM) among subjects undergoing fixed orthodontic treatment (FOT) of four different treatment modalities (TM).</p> <p><strong><em>Materials and Methods</em></strong><strong>: </strong>Following consort flow diagram, a total of 32 subjects randomly allocated in to 4 different group based on TM. Group A (GA): 8 subjects, FOT with self-ligating bracket (SLB) + low laser irradiation (LLLI), Group A (GB): 8 subjects, FOT with self-ligating bracket + Non-LLLI, Group C (GC): 8 subjects, FOT with conventional bracket (CB) + low laser irradiation (LLLI), Group D (GD): 8 subjects, FOT with CB + Non-LLLI<em>.</em></p> <p><strong><em>Results: </em></strong>Clinical photographs and diagnostic CBCT has been taken. Clinical observation of OTM, baseline, 1-day and 28-day afterFOT in all TM groups has been assessed by single calibrated specialist. Among 4 TM groups, best OTM results observed in GA and the lesser OTM observed in GD.</p> <p><strong><em>Conclusion: </em></strong>Among all 4 TM groups,1-month after FOT GA revealed promising benefit in relation to OTM.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.385-390</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40713 The role of 4-pba on tnf-alpha related apoptosis on human vein endothelial cells 2019-04-18T13:20:41+00:00 Oski Illiandri oilliandri@ulm.ac.id <p>Tumor Necrotizing Factor-alpha (TNF-α) has been well-known as a potent pro-inflamatory cytokine involved in many degenerative disease. Oneof its primary target organ-damaged wasendothelial cellswhich willlead to its endoplasmic reticulum stress (ERS) and induced its apoptosis. Endothelial cell apoptosis will lead high implication in many disease pathomechanism ofmany degenerative disease. Some study report ERS inhibitor 4-Phenyl Butyric Acid (4-PBA) properties to inhibitinflammation processin endothelial cells.However, wether 4-PBA can decrease apoptosis level in inflamationof endothelial cells is still poorly understood</p> <p><strong><em>Objective</em></strong>. This study to answer whether 4-PBA can decrease apoptosis triggered by inflammatory reactions mediated by TNFα.</p> <p><strong><em>Methods</em></strong>: This study is an exploratory study laboratory in vitro using cell culture Human Umbilical Vein Endothelial Cells (HUVEC) apoptotic count cells with the design of post test only control group consisting of three treatment groups with doses of 4-PBA 1 nM / mL, 2 nM /mL, and 3 nM /m L.</p> <p><strong><em>Results</em></strong>. Administration4-PBA in cultured HUVEC derived endothelial cells significantly decrease apoptosis at any dose of PBA but no dose dependently (p &lt;0.05)</p> <p><strong><em>Conclusion</em></strong>: Based on the results that has been done, it can be concluded that 4-PBA can reduce levels of endothelial cells apoptosis which were exposed to proinflamatory cytokine TNF-α. Further research need to elucidated 4-PBA mechanism to inhibit endothelial apoptosis.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.391-394</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40714 Age-dependent cardioprotective action of meldonium on heart remodeling under the experimental hypoosmolar hyperhydration 2019-04-18T13:20:39+00:00 Yarmolenko Olga o.yarmolenko@med.sumdu.edu.ua Sikora Vitaliy v.sikora@med.sumdu.edu.ua Bumeister Valentyna v.bumeyster@med.sumdu.edu.ua Prykhodko Olga o.prykhodko@med.sumdu.edu.ua Demikhova Nadiia demyhova@med.sumdu.edu.ua Bumeister Lina v.bumeyster@med.sumdu.edu.ua <p><strong><em>Background: </em></strong>Chronic water overload leads to a remodeling of the internal organs, in particular the heart. The reaction of the organism to the influence of the damaging factors varies depending on age. Therefore, the complex treatment of diseases, which results in a positive water balance, requires the prescription of cardioprotectors.The aim of our study was the determination of morphological changes of the heart of rats of different age under the influence of hypoosomolar hyperhydration and an attempt to correct the detected changes by means of meldonium.</p> <p><strong><em>Material and Method:</em></strong>The experiment was conducted on 36 laboratory male rats of two age groups: young (3 months old), and old (22 months old).Modeling of severe degree ofhypoosmolarhyperhydration was by the introduction of 10 ml distilled water three times a day and synthetic analogue of antidiuretic hormone «Minirin» (Ferring) 2 times a day at a dose of 0.01 mg without meldonium (first experimental series) and with the parallel introduction of meldonium (second experimental series). We analyzed organometric and histomorphometric data to study the features ofthe heart remodeling.</p> <p><strong><em>Results: </em></strong>The organometric study indicated a uniform increase in the weight of the ventricles and a significant dilatation of the right ventricular cavity in young ratsof the first experimental series, and there was a predominant increase in the weight of the right ventricle and uniform dilatation of the cavities of both ventricles in old animals of the same series. The histomorphometric study has determined increasing in the diameter of cardiomyocytes and their nuclei in both age groups. We observed increasing in the relative amount of cardiomyocytes and vessels, and decreasing in relative amount of connective tissue in young rats. In contrast, there was decreasing in relative amount of cardiomyocytes and vessels, and increasing in the relative amount of connective tissue in old animals. The meldonium administration positively acts on the right ventricle, slowing its dilatation in young rats of the second experimental series and its hypertrophy in old rats. Moreover, the diameter of cardiomyocytes in both age groups is significantly increased, but meldonium stabilizes the diameter of the nuclei of cardiomyocytes. Also meldonium increases in the relative amount of vessels in 3-month age rats.</p> <p><strong><em>Conclusions: </em></strong>The use of meldonium to correct the morphofunctional state of myocardium in rats under the influence of severe degree of Hypoosmolar hyperhydration significantly reduces the damaging effect of water overload on the myocardium of young animals, and to a lesser extent, on the myocardium of animals of old age. The positive effect of meldonium on the heart of experimental rats is to enhance myocardial vascularization, slowing the growth of the weight of the chambers of the heart, and slowing the dilation of ventricular cavities.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.395-401</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40715 Thyroid status in the combination of atrial fibrillation with subclinical thyrotoxicosis 2019-04-18T13:20:36+00:00 Ruslan F Rakhmatullov rrakhmatullov@list.ru Artur F Rakhmatullov rrakhmatullov@list.ru Fagim K Rakhmatullov rrakhmatullov@list.ru Larisa F Burmistrova rrakhmatullov@list.ru Inessa J Moiseeva rrakhmatullov@list.ru <p><strong><em>Objective</em></strong>: To study the factors in the development of atrial fibrillation in patients with subclinical hyperthyroidism on the background of angina pectoris as a result of a comprehensive analysis of the electrocardiographic and echocardiographic indicators of the heart, thyroid volume, thyroid hormone levels and lipid profile.</p> <p><strong><em>Materials and Methods: </em></strong>The risk factors for atrial fibrillation (AF) were studied in patients with subclinical hyperthyroidism (SH) and angina pectoris. It was revealed that the starting factor for the occurrence of AF in patients with subclinical hyperthyroidism is a shift in the reference values of thyroid hormones. It was established that the total depression of the ST segment reflects the degree of coronary reserve in patients with AF on the background of SH.</p> <p><strong><em>Results and Discussion</em></strong>: It has been shown that in patients with subclinical hyperthyroidism, there is a normal level of total cholesterol and LDLP, a low level of triglycerides and atherogenicity, and a high level of HDLP. When combined with subclinical hyperthyroidism and paroxysmal AF, there is an increase in the level of total cholesterol, LDLP, TG, atherogenicity and decreased HDLP.</p> <p><strong><em>Conclusion</em></strong>: It has been proven that diastolic dysfunction of the left ventricle of the first type is formed on the background of SH.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.402-410</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40716 Overt acquired primary hypothyroidism in a ten-year-old girl with perinatally-acquired HIV infection on HAART: A rare association 2019-04-18T13:20:34+00:00 Alphonsus N Onyiriuka alpndiony@yahoo.com Olufemi K Olaniyi alpndiony@yahoo.com <p>Overt hypothyroidism is rare in human immunodeficiency virus (HIV)-infected children but can further compromise the child’s quality of life. We report a case of a 10-year-old girl with perinatally-acquired human immunodeficiency virus (HIV) infection who subsequently developed overt acquired primary hypothyroidism. She has been on highly active antiretroviral therapy (HAART) for 9 years but developed goitre 2 years before presentation. Her thyroid gland was diffusely enlarged, firm, freely movable and non-tender. She had no symptoms of hypo- or hyperthyroidism. Physical examination revealed periorbital puffiness. Although her height was 139cm (50th percentile), it was significantly below the target centile range (152.5- 169.5cm). Results of investigations showed very low free T4 and markedly elevated TSH level (31-fold increase above our laboratory reference value). Ultrasonography of the goitre showed multicystic nodules in both lobes. She was commenced on oral levo-thyroxine 100μg once daily.</p> <p><strong>Conclusion: </strong>Physicians need to pay more attention to thyroid function in HIV-infected children on HAART, particularly in the presence of linear growth abnormalities.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.411-415</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40717 Challenges in Managing A Patient With Central Post-Stroke Pain 2019-04-18T13:20:32+00:00 Mazatulfazura SF Salim fazurasf@upm.edu.my Muhammad Hafiz Hanafi drmdhafiz@usm.my Tan Yew Chin drtanyc@usm.my Nur Karyatee Kassim karyatee@usm.my Mazlina Mazlan mazlinamazlan@ummc.edu.my <p><strong>Objective:</strong> This is a case illustration of the challenges in managing a patient with central post stroke pain secondary to right thalamic bleed. We describe in detail the events of this case management and the challenges that we had encountered. Method: We report a case of a 68-yearold lady who had right thalamic bleed secondary to hypertensive crisis in 2015 and was further complicated with central post stroke pain over the hemiparetic side. In our report, we describe in detail the challenges in managing the patient to improve her function to achieve a better quality of life.</p> <p><strong>Conclusion</strong>: This article illustrates the importance of a multidisciplinary approach and knowledge of various methods in managing a patient with central post stroke pain.</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40718 Neuroendocrine Tumour of the Breast in a Young Lady: A Case Report 2019-04-18T13:20:29+00:00 Zainal Adwin Zainal Abidin firdaushayati@gmail.com Firdaus Hayati firdaushayati@gmail.com Nornazirah Azizan firdaushayati@gmail.com Jasmin Jaszle Saladina firdaushayati@gmail.com <p>Primary neuroendocrine tumours of the breast are rare. The WHO has classified them according to the tissue grading. The clinical presentation is similar to the usual infiltrating ductal carcinomas, however the histopathological assessment requires special staining to confirm the diagnosis of neuroendocrine tumour. We report a case of a primary neuroendocrine tumour of the breast in a 33-year-old lady who presented with a locally advanced breast tumour with multicentric disease.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.419-422</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40719 Ear Foreign Body in Paediatric Patients: Methods of Removal and When to Refer. 2019-04-18T13:20:27+00:00 Chew Shiun Chuen shiunchuen@gmail.com Nik Adilah Nik Othman shiunchuen@gmail.com <p>Paediatric patient with a foreign body in the ear may be present primarily to primary care physician or being referred to the otorhinolaryngology (ORL) clinic. The foreign bodies vary from organic to inorganic material with different sizes and shapes. Removal of foreign body in the ear canal requires adequate clinical experience as well as proper clinical instruments and cooperative clinical staff. Throughout the years, many clinical instruments and devices have been designed and proven to able to facilitate a smooth procedure with high success rates. However, an agitated child may be uncooperative and the increase in the number of attempts will result in injury of the ear canal or displacement of foreign body to the middle ear. Thus, clinical experience is essential and the doubtful cases are preferably to be performed under general anaesthesia to prevent complications.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.423-426</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40720 Recurrent primary leiomyosarcoma of the seminal vesicle treated with curative radiotherapy 2019-04-18T13:20:25+00:00 Anna Santacaterina stefano.pergolizzi@unime.it Antonino Scimone stefano.pergolizzi@unime.it Silvana Parisi stefano.pergolizzi@unime.it Nicola Settineri stefano.pergolizzi@unime.it Angelo Platania stefano.pergolizzi@unime.it Grazia Acquaviva stefano.pergolizzi@unime.it Stefano Pergolizzi stefano.pergolizzi@unime.it <p>A case of locally recurrent leiomyosarcoma of the left seminal vesicle, previously surgically resected, is described in a 65-year-old man. The patient underwent curative radiation therapy (61 Gy/33 fractions). Initially, he experienced a complete response after irradiation, but 15 months after treatment, progressive disease was recorded both in lung and bone, without evidence of local recurrence. The lack of efficient systemic therapies leads to a poor prognosis in this disease; clinical outcome in this patient seems to suggest the utility of radiotherapy in the very rare <em>scenario </em>of locally recurrent seminal vesicle leiomyosarcoma.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.427-429</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40721 Lupus Cofactor Effect of Mixing Study: Example of a Case Report and Revisit on Theoretical Aspects 2019-04-18T13:20:23+00:00 Wan Suriana Wan Ab Rahman suriana@usm.my Zefarina Zulkafli suriana@usm.my Mohd Nazri Hassan suriana@usm.my Wan Zaidah Abdullah suriana@usm.my <p><strong>Background:</strong> Lupus anticoagulants (LA) are in vitro inhibitors paradoxically associated with thrombosis and performing coagulation test on a mixture of test plasma and pooled normal plasma to evidence this property is a mainstay in LA detection.</p> <p><strong>Case report</strong>: We report a 20-year-old man who presented with one week history of fever, associated with productive cough, jaundice, and lethargy. He was a known case of systemic lupus erythemathosus for 10 years. Isolated activated partial thromboplastin time (APTT) were prolonged. Interestingly, the APTT mixing study was not corrected and showed more prolonged results than baseline APTT. LA study showed presence of a strong LA, which is related to the underlying autoimmune disease.</p> <p><strong>Discussion</strong>: This case focuses on the ‘rebound phenomenon’ in APTT mixing test, from a strong LA that gives a cofactor inhibitory effect to the entire test system after adding the normal plasma.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.430-433</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40722 Fatal Case of Chromobacterium violaceum Bacteraemia 2019-04-18T13:20:20+00:00 Nur Hafiza Muharam zakuan@usm.my Azura Hussin zakuan@usm.my Zakuan Zainy Deris zakuan@usm.my <p><em>Chromobacterium violaceum </em>is rarely associated with human infection in tropical and subtropical regions. We report a fulminant fatal case of bacteremia in a 52-year-old lady, with underlying diabetes mellitus, who was presented with a month history of back swelling associated with fever, lethargy and poor oral intake. <em>C. violaceum </em>was isolated from blood and identify by standard biochemical test.However the patient’s condition deteriorating rapidly and succumbed to death on the day of admission. In these regions, <em>C. violaceum </em>should be one of the differential causes of sepsis, especially if the patient presented with skin lesions and/or multiple organ abscesses with history of exposure to soil or stagnant water.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.434-436</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40723 Prosthetic rehabilitation of a microtia patient by adhesive retained auricular prosthesis: A dental technique. 2019-04-18T13:20:18+00:00 Md Minhaz Ul Islam Nizami dr.nafij@gmail.com Ahmed Mushfiqur Rahman dr.nafij@gmail.com Nafij Bin Jamayet dr.nafij@gmail.com Mohammad Khursheed Alam dr.nafij@gmail.com Zuryati Ab Ghani dr.nafij@gmail.com Adam Husein dr.nafij@gmail.com <p><strong><em>Introduction</em></strong><strong>: </strong>Auricular deformity can be emotionally traumatising and affects social behavior of an individual. In such cases, aesthetically acceptable prosthesis serves as a viable alternative technique to surgical reconstruction.</p> <p><strong><em>Case description</em></strong><strong>: </strong>Impression of the auricular defect was taken by light and regular body of poly vinyl siloxane impression material. Wax sculpting was challenging due to the bulgy remnant of the defected ear. The wax pattern was made very thin to accommodate and mask the remnant without compromising the aesthetic. Trial on the patientwas done for correction of the contours, angulation, height and width according to the normal contralateral ear. The intrinsic coloration of a Room Temperature Vulcanizing silicone was done and poured in a custom-made three-piece mold. Before the final issue of the auricular prosthesis, extrinsic coloration was done based on the surrounding area of the defect.</p> <p><strong><em>Discussion: </em></strong>Fabrication of adhesive retained prosthesis is challenging in patients with large deformed soft tissue who refuse to undergo surgical repair. A modified wax sculpting was done to overcome this challenge. Medical grade silicone was the choice of material because of its flexibility, biocompatibility and life like appearance.</p> <p><strong><em>Conclusion: </em></strong>Replacement of missing ear is a difficult and multi-step task in which extensive array of materials and techniques need to be employed. This fabrication technique is alternative to surgical repair with the utilization of available and economical materials.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.437-439</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement## https://www.banglajol.info/index.php/BJMS/article/view/40724 Tuberculous Spondylitis involving Sacrum- a rare location and presentation of Pott’s disease: Case report and review of the Literature 2019-04-18T13:20:15+00:00 Shahidul Islam Khan sikhan55@yahoo.com Nazmin Ahmed sikhan55@yahoo.com Asifur Rahman sikhan55@yahoo.com Abdullah Al Mahmud sikhan55@yahoo.com Rafiqul Islam sikhan55@yahoo.com Md Kamrul Ahsan sikhan55@yahoo.com <p><strong><em>Background: </em></strong>Spinal tuberculosis is a common form of extrapulmonary manifestation of tuberculosis. Among them tubercular involvement of the lumbosacral region or isolated involvement of sacram is very rare presentation.</p> <p><strong>Aim of the work</strong>: The aim of this case presentation is to describe two rare cases of Pott’s disease which clinically mimicked spinal tumor.</p> <p><strong><em>Case report: </em></strong>A 60-year-old hypertensive, diabetic male patient admitted with low back pain radiating to both lower limbs for 7 months along with low grade fever, generalized weakness and weight loss for the same duration. Clinically, patient had features of flaccid paraparesis, tenderness at the lumbosacral junction, restricted SLR on both sides. There was no features of autonomic dysfunction. MRI of lumbosacral spine showed infective spondylodiscitis at L4 to S1 level with collapse of L5 vertebrae along with paravertebral and epidural abscess. Diagnosis was confirmed by CT guided FNAC from the lesion. Next case was a 23-year-old male patient presented with back pain and walking difficulty for 5 months with some constitutional symptoms.MRI of the dorsal spine with whole spine screening showed multifocal skipped lesion involving whole spine with presence of huge presacral collection. Percutaneous transpedicular aspiration of the purulent material under C-Arm guidance was done and tuberculous infection confirmed by Gene Xpert.</p> <p><strong><em>Conclusion: </em></strong>Though sacral tuberculosis is rare presentation of Pott’s disease but it should be considered as one of the differential diagnosis in any lytic lesion involving the sacrum in perspective of our country.</p> <p>Bangladesh Journal of Medical Science Vol.18(2) 2019 p.440-445</p> 2019-03-25T00:00:00+00:00 ##submission.copyrightStatement##