Bangladesh Journal of Medical Science https://www.banglajol.info/index.php/BJMS <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" rel="noopener">DOAJ</a>.</p> <p><strong>Journal Metrics</strong><br><a href="https://www.scopus.com/sourceid/19900192321" target="_blank" rel="noopener">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" rel="noopener">ResearchGate Journal Impact</a>&nbsp;(2013): 0.62</p> <p><a href="https://www.scimagojr.com/journalsearch.php?q=19900192321&amp;tip=sid" target="_blank" rel="noopener">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> Ibn Sina Medical College en-US Bangladesh Journal of Medical Science 2223-4721 <p>Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that:</p><ol type="1" start="1"><li>Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work.<br /><br /></li><li><a href="http://creativecommons.org/licenses/by/4.0/" rel="license"><img style="border-width: 0;" src="https://i.creativecommons.org/l/by/4.0/88x31.png" alt="Creative Commons Licence" /></a><br />Articles in Bangladesh Journal of Medical Science are licensed under a <a href="http://creativecommons.org/licenses/by/4.0/" rel="license">Creative Commons Attribution 4.0 International License</a> CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.</li><li>Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li><li>Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.</li></ol> Challenges of Publishing in High Impact Medical Journals from Lower- And Middle- Income Countries https://www.banglajol.info/index.php/BJMS/article/view/42868 <p>Abstract not available</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.671-674</p> Mainul Haque Zubair Kamal ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 671 674 10.3329/bjms.v18i4.42868 The Immunomodulatory, Nitric Oxide and Cytokine activity of SeptilinTM https://www.banglajol.info/index.php/BJMS/article/view/42869 <p><strong><em>Objective: </em></strong>Herbal immunomodulatory preparations are increasing in popularity. <em>In vitro, in vivo </em>and clinical trial studies are needed to ensure safety, quality and efficacy of these herbal medicines. Septilin<sup>TM</sup>, a proprietary herbal medicinal product has been reported to have immunomodulatory effects.</p> <p><strong><em>Methods: </em></strong>For this narrative review the author surveyed the primary literature on SeptilinTM and its ingredients with regards to immunomodulatory, nitric oxide (NO) and cytokine activity. Databases utilized included Pubmed, Science Direct and EBSCO, Google Scholar as well as a hand search through journals and bibliographies was included. English language restriction was observed. The following parameters had to be met for study inclusion: investigations on Septilin<sup>TM</sup> as a formulation (liquid or dried form) were accepted. Research on the isolated constituents of SeptilinTM (single herbs) was also accepted. The accepted model types included; <em>in vitro </em>and <em>in vivo</em>, animal and human models. The following were also required; method of preparation of the Septilin<sup>TM</sup>, concentration of the plant preparation and dose/exposure time. Only studies providing statistically significant results with regards to immunomodulatory, cytokine and nitric oxide activity were included.</p> <p><strong><em>Results: </em></strong>Septilin<sup>TM</sup> and its ingredients had effects on at least one cytokine. The most frequently studied cytokines were IL-1, IL-2, IL-4, IL-6, TNF, and IFN. Many studies also reported on NO activities. Septilin<sup>TM</sup> and its ingredients demonstrated modulation of several cytokines with varying results on NO activity. The bulk of studies conducted on Septilin<sup>TM</sup> and its ingredients were <em>in vitro, </em>the few <em>in vivo </em>studies were mainly conducted in rats or mice models with a few studies conducted on humans.</p> <p><strong><em>Conclusion: </em></strong>The <em>in vitro </em>and <em>in vivo </em>research demonstrates that SeptilinTM and its ingredients modulate the secretion of multiple cytokines and NO with varying effects on cytokine and NO secretion due to divergent research methodologies. The reported therapeutic success of these herbal products by natural medicine practitioners and clinicians may be due to their effects on cytokine and NO activity.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.675-688</p> Mujeeb Hoosen ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 675 688 10.3329/bjms.v18i4.42869 Anterior Loop of the Mental Nerve- Unlooping its Importance in Dentistry https://www.banglajol.info/index.php/BJMS/article/view/42870 <p>In any surgical procedure, proper consideration to anatomical structures along with their precise position is of utmost importance. One such anatomical region in anterior mandible is anterior loop of mental nerve. The dental procedure carried out in anterior mandible can lead to neurosensory disturbances if this loop is injured. The presence of anterior loop have been made using conventional imaging modalities like panoramic and periapical radiography, however, limitations of two-dimensional imaging results in either over- or underestimation of the actual size making its use restricted. Cone Beam Computed Tomography is a gold standard threedimensional imaging modality that allows generating multi-planar slices of an area of interest; its accuracy for analysis and linear measurements of craniofacial structures have been confirmed by several studies. This paper highlights the role of accurate and thorough assessment of the inter-foraminal region and anterior loop of the mental nerve prior to any surgical procedure especially in anterior mandible to avert any neurological complications.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.689-695</p> Rakhi Issrani Namdeo Prabhu Arunpriya Srinivasan Mohammad Khursheed Alam ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 689 695 10.3329/bjms.v18i4.42870 Prevalence of Urinary Tract Infection due to Urinary Catheterization in Obstetric and Gynaecological Operations https://www.banglajol.info/index.php/BJMS/article/view/42871 <p><strong><em>Background</em></strong>: Urinary catheterization is routinely done in major gynaecological and obstetric operations in our country. It has some advantages and disadvantages of its own. Among the advantages, it can significantly prevent retention of urine, help in measuring urinary output, avoid discomfort due to full bladder, prevent postpartum hemorrhage and reduce spinal headache due to reduced movements. On the other hand, it can be a constant source of urethral irritation leading to UTI and can cause urethral strictures. So, a quantitative research is necessary to determine the relationship between urinary catheterization and UTI, for establishing a guideline for judicious catheterization.</p> <p><strong><em>Methods: </em></strong>Between January 2010 and December 2011, data was collected for conducting an cross-sectional observational study on 49 subjects undergoing various gynaecological and obstetric operations. Precatheterization urine for routine and culture-sensitivity findings were recorded and compared with catheter tip culture and sensitivity after removal. Besides, other factors e.g. clinical history, comorbidity status, hemoglobin status, duration of catheterization, nature of operation etc was brought into consideration.</p> <p><strong><em>Results</em></strong><em>: </em>Patients having urinary catheters for more than 5 days, were found to be more than twice as likely to be developing UTI in various operations, than the patients having catheter for one day. Preoperative albuminuria was also found to be a likely predisposing factor, as the percentage of patients with UTI who had preoperative albuminuria was double compared to the preoperative albuminuria negative patients. The direct relationship between nature of operation and development of post-catheterization UTI was difficult to establish, because of the duration of catheterization acting as a confounding variable.</p> <p><strong><em>Conclusion</em></strong>: In most cases of LUCS and hysterectomy, catheter-associated complications can be overcome by avoiding catheterization altogether. This can be better achieved by encouraging the patient to void their bladder immediately before surgery. In long and complicated operations, catheterization cannot be avoided but the postoperative duration of catheterization can be reduced to avoid complications. Moreover, preoperative optimization of comorbid status, hemoglobin status, albuminuria etc can bring forth a favourable outcome in terms of catheterassociated complications.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.696-702</p> Jesmin Akter Ahmad Seraji Lutfun Nahar Shahriar Islam Khan Md Redwan Ahsanullah ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 696 702 10.3329/bjms.v18i4.42871 Polymorphism of DTNBP1 Gene P 1635 (Rs3213207) In Schizophrenic Javanese, Indonesia https://www.banglajol.info/index.php/BJMS/article/view/42872 <p><strong><em>Background</em></strong><strong>: </strong>Many putative genes were predicted as risk factors of schizophrenia. One of these genes is DTNBP1 gene. One of single nucleotide polymorphism (SNPs) of DTNBP1 gene is P1635 (rs3213207).</p> <p><strong><em>Objective: </em></strong>This study aimed to find out the association between DTNBP1 gene, P1635 (rs3213207), and risk of schizophrenia.</p> <p><strong><em>Methods</em></strong>: DNA was isolated from blood of 25 schizophrenia patients and 25 healthy controls. DNA was applied to restriction fragment length polymorphism polymerase chain reaction (RFLP PCR). PCR products were digested by BSr1 enzyme.</p> <p><strong><em>Results: </em></strong>The results show that there are 24 AA genotype (wild type) from 25 Javanese schizophrenia patients and 1 GG homozygote, while all 25 of controls are AA genotype (wild type). The p value of Fisher’s exact test is 0,500.</p> <p><strong><em>Conclusion</em></strong>: There is no significant differences of genotype distribution of SNP P 1635(rs3213207) between schizophrenia patients and healthy controls in Javanese population</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.703-705</p> EM Sutrisna Ratna Yuliani ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 703 705 10.3329/bjms.v18i4.42872 Effectivity of Bacterial Suspension Bacillus thuringiensis Var Israelensis in Killing Aedes aegypti L. Mosquito Larvae https://www.banglajol.info/index.php/BJMS/article/view/42873 <p><strong><em>Objective: </em></strong>Dengue hemorrhagic fever is a disease transmitted by the mosquito Aedes aegypti. Prevention of transmission of this disease one of which is the chemical control with temefos, but the use of sustainable temefos can cause insect resistance and environmental damage. Therefore we need an effective and safe alternative to larvicide, the suspension of Bacillus thuringiensis var israelensis.</p> <p><strong><em>Methods: </em></strong>This study used a type of true experimental research design with posttest only control group design. Samples used in this study are the third instar larvae of Aedes aegypti. Concentrations used in this study were a 0.01%; Of 0.02%; Of 0.03%; 0:04% and 0.05% by the number of 25 larvae per treatment and 3 times replication.</p> <p><strong><em>Results: </em></strong>Based on the Kruskal Walls obtained a value of 0.009&gt; 0.05 means there is a stock mortality of larvae using a suspension of the bacterium Bacillus thuringiensis, temefos and distilled. Test Mann Whitney showed that among the positive control (temefos a 0.01%) and negative control (distilled water) there are differences in the number of larvae mortality significantly, the positive control treatment with no significant difference, and between negative control and treatments armpits there are differences in the number of deaths larvae significant. The LC<sub>50</sub> value obtained was 0.010% and the LT<sub>50</sub> value obtained was 2,683 hours.</p> <p><strong><em>Conclusions: </em></strong>The suspension of bacteria Bacillus thuringiensis is effective in killing the larvae of Aedes aegypti with LC<sub>50</sub> values of 0.0105 and LT<sub>50</sub> values on the clock to 2.683.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.706-710</p> Tri Wahyuni Sukesi - Sulistyawati Eva Hendrawati Surahma Asti Mulasari ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 706 710 10.3329/bjms.v18i4.42873 Tocotrienol-Rich Fraction Modulates Genes Expression in Oxidative Stress-induced Caenorhabditis e legans https://www.banglajol.info/index.php/BJMS/article/view/42874 <p><strong><em>Objective</em></strong>: The study was done to determine the effect of Tocotrienol rich fraction (TRF) on the expression of RNAs in <em>C. elegans </em>under oxidative stress.</p> <p><strong><em>Methods: </em></strong>The nematodes were divided into 4 groups and treated accordingly: control; TRF; hydrogen peroxide (H202); TRF treatment before and after H202-induction (TRF+H202+TRF). Expressions of RNAs were analyzed with Affymetrix Genechip <em>C. elegans </em>Genome Array and Genespring GX11 software where differentially expressed genes were further analyzed using gene ontology (GO). Selected genes (unc-15, cit-1.2, ftn-1, rsks-1, unc-4 and daf-12) were analyzed with RT-qPCR to validate the results.</p> <p><strong><em>Results: </em></strong>TRF modulated the expression of 314 genes involved in determination of adult lifespan, regulation of growth and lipid modification. A total of 440 genes involved in RNA metabolic processes, transcription, growth and differentiation of muscle and nerve cells were differently expressed following H202 induction. TRF treatment before and after H202- induction resulted in 438 differentially expressed genes involved in RNA metabolic processes, transcription, response to xenobiotic stimulus and protein amino acid phosphorylation.</p> <p><strong><em>Conclusion</em></strong>: TRF modulates the expression of genes involved in the regulation of lifespan in <em>C. elegans</em>.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.711-721</p> Goon Jo Aan Noralisa Abdul Karim Mohd Shahril Aszrin Zainudin Suzana Makpol ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 711 721 10.3329/bjms.v18i4.42874 Assessment the relation between lifestyle with mental health and educational achievement in nursing students https://www.banglajol.info/index.php/BJMS/article/view/42875 <p><strong><em>Objective</em></strong><strong>: </strong>This study was aimed to assess the correlation between lifestyle with mental health and educational achievement ofnursing students.</p> <p><strong><em>Materials and Methods: </em></strong>This is a descriptivecorrelational study that all students in nursing college in 2015 were selected by the census sampling method. Data gathering tool were standard Walker’s lifestyle questionnaire and General Health Questionnaire-28 and data were analyzed by SPSS/21.</p> <p><strong><em>Results: </em></strong>The results reported that most subjects (61.01%) displayed moderate levels of lifestyle. In considering domains mental health37.28%, were depression and 34.74% anxiety. Based on the Pearson correlation coefficient test, there was a diverse correlation between lifestyle (p=0.004, r=-0.34) and educational achievement (p=0.001, r=-0.24) with mental health but there was a direct linear correlation between lifestyle and educational achievement<strong>.</strong></p> <p><strong><em>Conclusion: </em></strong>Regarding the role of lifestyle and mental health and to ensure the efficiency and dynamism of the people in the education and prevention of academic failure recommended that be scheduled byimprove methods of lifestyle to promote educational status and activate counseling centers andguidance on psychological issues the mental health.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.722-728</p> Mohammad Heidari Marzieh Borjian Borujeni Mansureh Ghodusi Borujeni Mansureh Ghodusi Borujeni Parvin Rezaei ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 722 728 10.3329/bjms.v18i4.42875 The Utility of Beta 2 Microglobulin (B2M) as an Initial Diagnostic Tool for Oral Squamous Cell Carcinoma (OSCC): Evidence from a Malaysian Scenario https://www.banglajol.info/index.php/BJMS/article/view/42876 <p><strong><em>Background: </em></strong>The delay in diagnosis of oral squamous cell carcinoma (OSCC) is a factor in rendering the poor prognosis, and recent research has explored the use of serum tumour markers such Beta 2 Microglobulin (B2M), to aid early diagnosis. However, despite a high incidence of OSCC in Southeast Asia, no studies on the clinical use of B2M in the region were found.</p> <p><strong><em>Objectives: </em></strong>To determine if serum B2M level can serve as an initial diagnostic tool to indicate if a biopsy is warranted, and if so, to propose a local B2M serum reference value to identify OSSC patients<strong>.</strong></p> <p><strong><em>Methodology: </em></strong>Twenty-one patients were seen at Hospital Universiti Sains Malaysia (HUSM) for a one-year period, between June 2016 and June 2017, and equal number of healthy controls participated in the study. Apart from patient history, venous blood of approximately 5ml volume was collected from each subject at the pre-treatment stage and analysed by an Abbot ARCHITECT c8000 analyser using the immunoturbidimetry method. The results were analysed using ROC analysis and the Mann Whitney test.</p> <p><strong><em>Results: </em></strong>Serum B2M levels showed a statistically significant increase (p&lt;0.001) in patients compared to controls. The test was shown to have 90.5% sensitivity and 90.5% specificity. It was found to be a sensitive and specific serum tumour marker at a cut off value of 1.57mg/l to differentiate cases from controls.</p> <p><strong><em>Conclusion: </em></strong>B2M is a sensitive and specific tumour marker to differentiate OSCC cases from controls. It is cost effective and minimally invasive, making it a potentially useful adjunct diagnostic tool in a high-risk patient pool.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.729-735</p> Maithrea Suresh Narayanan Nur Karyatee Kassim Tang Liszen Baharuddin Abdullah Julia Omar Suhaily Mohd Hairon Norhafiza Mat Lazim ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 729 735 10.3329/bjms.v18i4.42876 A Study of Social Support among Non-Depressed and Depressed Mothers after Childbirth in Jahrom, Iran. https://www.banglajol.info/index.php/BJMS/article/view/42877 <p>The purpose of this study was to evaluate the social support provided for non-depressed women and women with postpartum depression referring to health centers in Jahrom.</p> <p><strong><em>Method</em></strong><strong>: </strong>In order to achieve the mentioned goal, three health care centers randomly selected. 60 referring women who had the required criteria were selected by convenience sampling method and were divided into two groups of postpartum depression (30) and non-depressed (30) people. For evaluation of social support, the Phillips Social Support scale was used, and Edinburgh Postpartum Depression Questionnaire was used to evaluate postpartum depression. Data were analyzed by T-test.</p> <p><strong><em>Results: </em></strong>The results showed that there was a significant difference between the non-depressed and those with postpartum depression in terms of social support (P = 0.03). These findings are remarkable in that they can be used to prevent the progression of treatment for postpartum depression.</p> <p><strong><em>Conclusion: </em></strong>It is necessary to implement social and behavioral interventions in order to encourage and educate families, friends and kinship networks in order to provide socially desirable support for mothers, as well as cultural interventions in order to modify the morbidity of men to reduce postpartum depression.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.736-740</p> Marzieh Kargar Jahromi Fatemeh Mohseni Esmail Parsayee Manesh Sajad Pouryousef Farzad Poorgholami ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 736 740 10.3329/bjms.v18i4.42877 Association of interleukin-6 polymorphism (-634C/G) in the promoter region with diabetic nephropathy in type 2 diabetes mellitus https://www.banglajol.info/index.php/BJMS/article/view/42878 <p><strong><em>Background</em></strong><strong>:</strong>Long term microvascular complications of DM includes: nephropathy, retinopathy, and neuropathy. Increased level of IL-6 and its polymorphism have been associated with diabetic nephropathy.The present study was designed to determine serum level of IL-6 and C/G polymorphism at − 634 position in the promoter region of IL-6 gene in patients with type 2 diabetes mellitus (T2DM) with and without nephropathy.</p> <p><strong><em>Method: </em></strong>This comparative study was comprised of 164 subjects, divided into two groups of 82 subjects in each. The subjects who had diabetes for more than 5 years without nephropathy were labeled as group-I and the subjects who had diabetes for more than 5 years with nephropathy were labeled as group-II. IL-6 polymorphism was detected by RFLP and its level was determined by ELISA technique. Data was analyzed using SPSS 20.0.</p> <p><strong><em>Results: </em></strong>In group-I, 14 (17.1%) patients had CC, 47 (57.3%) had CG and 21 (25.6%) had GG polymorphism. In group-II, 9 (11%) patients had CC, 69 (84.1%) had CG and 4 (4.9%) had GG polymorphism. Pearson’s correlation test determined significant association of IL-6 polymorphism (CC,CG,GG) in both the groups (p <strong>&lt;</strong>0.001). In patients of CC polymorphism, median levels of IL-6 was high in group-I (4.2) as compared to group-II (3.2),whereas in patients of CG polymorphism, median levels of IL-6 was high in group-II (3.8) as compared to group I (3.7) while in GG polymorphism, median levels of IL-6 was same in both the groups. On comparison of IL-6 polymorphism and level of IL-6 there was no statistically significant difference between the two groups (p1=0.304, p2=0.425 respectively).</p> <p><strong><em>Conclusions: </em></strong>Statistically significant difference in the frequencies of allele (CC,CG,GG) between two groups is pointing towards the protective role of GG allele as it was predominant in T2DM patients without nephropathy.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.741-747</p> Rakshanda Talib Muhammad Kashif Romeeza Tahir Nadeem Ahmed Saba Khaliq Bushra Mubarik Afia Abbas Shah Jahan Nadeem Afzal ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 741 747 10.3329/bjms.v18i4.42878 Okra Infusion Water Improving Stress Oxidative and Inflammatory Markers on Hyperglycemic Rats https://www.banglajol.info/index.php/BJMS/article/view/42879 <p><strong><em>Objective: </em></strong>Okra has been known for its properties in improving diabetes markers. Most study used okra extract instead of its infusion water. Okra infusion water (OIW) contains polysaccharide and viscous fiber that delay gastric emptying, and help controlling glucose and HbA1C level. As the glucose low level, so does the inflammation and oxidative stress on hyperglycemic rats. This study aims to investigate the effect of OIW in improving glucose level, HbA1C, SOD and CRP levels.</p> <p><strong><em>Materials and methods: </em></strong>Posttest only control group design was applied to this experimental study using 15 male wistar rats divided randomly into 3 groups: Control, Streptozotocine (STZ), Streptozotocine+okra (OKRA). STZ, and OKRA groups induced with 65 mg/kg BW Streptozotocine and 110 mg/kg BW Nicotinamide on day 8. After the desirable glucose level achieved, OKRA were given 3.6 ml OIW on day 12-28. Data were analyzed using ANOVA in each variable.</p> <p><strong><em>Results: </em></strong>Fasting and Postprandial Glucose level of OKRA (137,40±3,57 mg/dL and 154.58±2.71 mg/dL), STZ (251,77±2,30 mg/dL and 270.18±3.03 mg/dL); HbA1C level of OKRA (7.93±0.25), STZ (21.29±0.65); SOD level of OKRA (55.292±3.77%), STZ (16.472±5.298%); CRP level of OKRA (1,540±0,059 mg/dL), STZ (2,230±0,093 mg/dL)</p> <p><strong><em>Conclusions: </em></strong>OIW able to improve glucose, HbA1C, SOD, and CRP level on hyperglycemic rats.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.748-752</p> N Tyagita KP Utami FH Zulkarnain SM Rossandini NP Pertiwi MA Rifki AH Safitri ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 748 752 10.3329/bjms.v18i4.42879 Diagnostic diversities of Clear Fluid encountered during Fine needle aspiration cytology with an analysis of various variables. https://www.banglajol.info/index.php/BJMS/article/view/42880 <p><strong><em>Background: </em></strong>Incidental finding of clear fluid during fine needle aspiration (FNA) is not rare in day to day practice of cytology. Though clear in appearance, cells obtained from it may yield a diverse diagnosis ranging from an inconclusive opinion to a malignant lesion. So, clear fluid is not non-significant always; lack of proper processing and examination may prove fatal to a patient.</p> <p><strong><em>Aim: </em></strong>To evaluate the diverse diagnosis of clear fluid.</p> <p><strong><em>Materials and methods</em></strong>: During a period of three years, hundred and seven cases which yielded clear fluid during FNAC from different parts of the body were studied. Direct and indirect smears (wherever applicable) was prepared, stained and examined microscopically.</p> <p><strong><em>Results</em></strong><em>: </em>Of these 107 cases of clear fluid, Male: Female ratio was 1: 1.6. Maximum cases - 55 (51.40%) was found in the age group 21 to 40 years. Trunk held the most number of lesions - 54 cases (50.46%). FNA results were interpreted as inconclusive in 19 cases (17.76%), benign in 84 cases (78.50%), suspicious in 01 case (0.93%) and malignant in 03 cases (2.80%). Epidermal cyst was the most common benign lesion - 16 cases (14.95%). Malignant lesions found were papillary carcinoma of thyroid, carcinoma of breast and metastatic squamous cell carcinoma – one case each.</p> <p><strong><em>Conclusion: </em></strong>Our study emphasizes on the importance of proper examination of clear fluid as it may prove helpful in an undiagnosed case of malignancy and it may also improvise the learning of young pathologists.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.753-755</p> RS Minz A Adhikari S Biswas RN Ray K Bose S Mondal ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 753 755 10.3329/bjms.v18i4.42880 Can ESR be a diagnostic marker for assessing the severityof malarial infection? A retrospective study https://www.banglajol.info/index.php/BJMS/article/view/42881 <p><strong><em>Objective: </em></strong>This study aimed to investigate the variation of ESR in malarial infection and find out the variation of ESR in related to the degree of parasitemia.</p> <p><strong><em>Material and Methods: </em></strong>A retrospective study with a duration of 6 months, on 385 randomly selected positive malaria cases. Their clinical record and lab records were analyzed for ESR level.</p> <p><strong><em>Result: </em></strong>The sample of 385 positive malaria cases has included both males and females, ages ranged from 15-60 years old. A total number of Plasmodium.<em>falciparum</em>was 60 (uncomplicated &amp; severe cases) and for Plasmodium<em>vivax </em>was 325. In P.<em>vivax </em>infection the raised values were seen in 174 cases (53.5%) and in P. <em>falciparum </em>infection it was seen in 36 cases (60%). The degree of parasitemia did not show any significant rise in ESR in case of malarial infection.</p> <p><strong><em>Conclusion: </em></strong>In our investigation, the degree of parasitemia did not show a significant rise in ESR except in the case of occasional parasitemia. We assume that the rise in ESR may be due to inflammatory process during infection or due to the presence of inclusion bodies</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.756-759</p> Asha Patil Vivek Raghavan Muduthan Gunavathi Kunder ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 756 759 10.3329/bjms.v18i4.42881 Facilities available in the medicine shops in Chittagong city corporation area: A cross- sectional study conducted in Bangladesh https://www.banglajol.info/index.php/BJMS/article/view/42882 <p><strong><em>Background: </em></strong>The aim of this was to inspect the facilities available in the medicine shops and their impacts on quality medicines and health services to be found in the Chittagong City Corporation of Bangladesh.</p> <p><strong><em>Method: </em></strong>This cross-sectional study was conducted from December 2015 to February 2016. A well-designed standard protocol developed by the project supervisor. Different information was collected from the medicine shops.</p> <p><strong><em>Results: </em></strong>Among the total 190 studied medicine shops, pharmacist and physician were available in 99 (52%) and 51 (27%) shops, respectively. A-grade pharmacist was available in four(04) shops. However, no air conditioner was found in 14 shops, while a refrigerator was not found in 15 shops but these shops were facing sun rays from the east side. In addition, four (04) and five (05) shops were not used the air conditioner and refrigerator, respectively but they were facing sun rays from the west side.</p> <p><strong><em>Conclusion</em></strong>: Facilities in the medicine shops in this city were good, however, we think the responsible person should be more aware to ensure proper retail pharmacy practices.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.760-763</p> Md Jakaria Mohammed Aktar Sayeed ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 760 763 10.3329/bjms.v18i4.42882 Single blinded in-vitro study comparing microleakage between CAD/CAM crowns milled out of feldspathic ceramic and resin nano ceramic, cemented with three resin cements https://www.banglajol.info/index.php/BJMS/article/view/42883 <p><strong><em>Background</em></strong>: Studies on microleakage of Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) crowns are abundant. However many of them are inconclusive, especially those using self adhesive cements<strong><em>.</em></strong></p> <p><strong><em>Aims: </em></strong>To compare the microleakage between CAD/CAM crowns milled out of feldspathic ceramic and resin nano ceramics, cemented with three resin cements.</p> <p><strong><em>Materials and Methods</em></strong><em>: </em>Crown preparation was made on 54 extracted human premolars. Impressions were captured optically using CEREC 3D machine intraoral camera, and crowns were milled from feldspathic ceramic (CEREC® Blocs PC, VITA) and resin nano ceramic (Lava™ Ultimate CAD/CAM Restorative, 3M ESPE) blocks. The crowns were then cemented with three cements (n = 9); RelyX™ U200 Self-Adhesive Resin Cement (3M ESPE); NX3 Nexus ® cement with two-step etch-and-rinse adhesive (Kerr Corporation) or three/multistep etch-and-rinse resin cement, Variolink® II/Syntac Classic (Ivoclar Vivadent). The specimens were kept in water for 24 hours, thermocycled, and then soaked in methylene blue dye for 24 hours, before being sectioned mesiodistally. Microleakage was assessed using a fivepoint scale using stereomicroscope. Statistical analysis of the data was carried out using ONEWay ANOVA.</p> <p><strong><em>Results: </em></strong>CEREC® Blocs PC crowns showed significantly less microleakage <em>(p&lt; 0.001) </em>compared to Lava™ Ultimate. RelyX™ U200 showed significantly lower microleakage <em>(p&lt; 0.001) </em>compared to other cements. Combination of Lava™ Ultimate crown cemented with RelyX™ U200 showed the least microleakage <em>(p&lt; 0.001</em><strong>)</strong>.</p> <p><strong><em>Conclusions: </em></strong>The microleakage scores were affected by the types of crown and cements.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.764-772</p> Asa Yazdani Fard Zuryati Ab Ghani Zaihan Ariffin Dasmawati Mohamad ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 764 772 10.3329/bjms.v18i4.42883 Psychiatric morbidity among the patients with acne Vulgaris in a tertiary care Hospital https://www.banglajol.info/index.php/BJMS/article/view/42884 <p><strong><em>Background: </em></strong>Acne vulgaris is a chronic inflammatory skin disorder which has a high prevalence among adolescence and young adults. Although acne does not cause direct physical impairment, it can produce a significant psychosocial burden. As the face is almost always the site of involvement of acne, its presence can alter one’s perception of body image. Increased levels of anxiety, anger, depression, and frustration are also observed in patients with acne. Acne affects social, vocational, and academic performance of teenagers &amp; young adult.</p> <p><strong><em>Objective: </em></strong>To identify socio-demographic profile and to evaluate the psychiatric morbidity in patients with acne vulgaris in a tertiary care hospital.</p> <p><strong><em>Materials and Methods</em></strong><strong>: </strong>This cross sectional study was conducted from June 2017 to December 2017 among the patients of acne vulgaris attending outpatient department of Dermatology in Ibn Sina Medical College Hospital, Dhaka. Purposive sampling technique was used. The sample size of the study was 181. Data were collected by using semi structured socio-demographic questionnaire and the SRQ to screen psychiatric symptoms. The Self Reporting Questionnaire (SRQ), is a psychiatric case finding instrument, was developed by World Health Organization (WHO) to screen for psychiatric disturbance especially among developing countries. The data obtained was collected, tabulated and subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS), for windows version 20.</p> <p><strong><em>Results</em></strong><em>: </em>Study was conducted on 181patients comprising 135(74.6%) were female &amp; 46(25.4%) were male. Age group between 16 to 22 years carried maximum incidence 100(55.2%). Among the patients Psychiatric morbidity was found in86(48%) of the study population. Psychiatric morbidity was found more in young and females patients. Among the types of psychiatric morbidity Anxiety disorders were 57(66.3%) &amp; Major Depressive Disorder(MDD) was 29(33.7%).Anxiety disorders were included social phobia (26.7%), generalized anxiety disorder (GAD) (18.6%), panic disorder (14%) and obsessive compulsive disorder (OCD)(7%).</p> <p><strong><em>Conclusion</em></strong><em>: </em>Patients with acne vulgaris in whom psychiatric morbidity is present, should be routinely evaluated and their psychiatric morbidity need to be treated adequately for maximize their health.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.773-778</p> Fahmida Ahmed Anwar Husain Meherunnessa Begum Mohd Nurul Alam Muhammad Ayaaz Ibrahim ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 773 778 10.3329/bjms.v18i4.42884 Bronchoscopy for Removal of Foreign Body in Lower Airway: A Retrospective Analysis https://www.banglajol.info/index.php/BJMS/article/view/42904 <p>Bronchoscopy is performed for diagnostic or therapeutic purpose. Therapeutic bronchoscopy is mainly done for removal of foreign body from lower airway. Both the condition and procedure itself are associated with high mortality and morbidity. The aim of the study was to audit data regarding demography, types and location of foreign body, onset of symptom, admission duration, clinical and investigation findings along with duration of ventilation. We also highlight on the complications pertaining to the condition in our series.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.779-782</p> <p>&nbsp;</p> Shankar Ramasundram Sharmini Kuppusamy Sivakumar Kumarsamy Valuyeetham Kamara Ambu Irfan Mohamad ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 779 782 10.3329/bjms.v18i4.42904 Susceptibility of Specific HLA DRB1*15 AlleleAmong Chronic Hepatitis B Infected Bangladeshi Patients https://www.banglajol.info/index.php/BJMS/article/view/42905 <p><strong><em>Background: </em></strong>The outcome of hepatitis B virus (HBV) infection may be influenced by host factors like Human Leukocyte Antigen (HLA).The expression of HLA genes in peripheral blood mononuclear cells (PBMCs) may reflect the molecular mechanism underlying different HBV infection outcomes.</p> <p><strong><em>Objective: </em></strong>The purpose of the present study was to explore whether HLA DRB1*15 allele confer susceptibility to chronic hepatitis B infected Bangladeshi patients.</p> <p><strong><em>Method: </em></strong>This cross sectional study was carried out in the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during July 2012 to June 2013 for a period of one year.Evaluation of HLA DRB1*15 allele distribution among 30 chronic hepatitis B infected (HBV) Bangladeshi patients compared them with 30 healthy individuals.HLA DRB1*15 allele distribution was detected by conventional PCR followed by agarose gel electrophoresis, using commercial low-resolution DRB1*15 allele polymerase chain reaction sequence specific priming kit.</p> <p><strong><em>Result: </em></strong>A total of 30 chronic hepatitis B infected (HBV) Bangladeshi patients were evaluated together with 30 healthy controls. The study revealed a significant increase of DRB1*15 allele (46.7% vs 20%; RR= 3.5; X2 = 7.2; P&lt;0.05) compared to healthy controls. This is the first report on HLA DRB1*15 allele associations among chronic hepatitis B (HBV) infected Bangladeshi patients.</p> <p><strong><em>Conclusion: </em></strong>The present study reveals that HLA DRB1*15 allele was more frequent in chronic hepatitis B infected Bangladeshi patients compared to healthy individuals. Thus, HLA DRB1*15 allele of HLA class II molecules significantly affect the outcome of hepatitis B infection.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.783-788</p> Rokshana Akhter - Afzalunnessa Shahina Tabassum Murad Hossen ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 783 788 10.3329/bjms.v18i4.42905 A study on evaluation of solitary nodular thyroid lesions by FNAC and its histopathological correlation https://www.banglajol.info/index.php/BJMS/article/view/42906 <p><strong><em>Background: </em></strong>Solitary nodular enlargement of thyroid is one of the common indications for surgical excision. Since most of the nodules are benign, symptomless, normal thyroid hormone profile, they do not require excision. This study was done to evaluate the utility of FNAC as a rapid diagnostic method in various thyroid lesions and guide the clinician for further treatment.</p> <p><strong><em>Objective: </em></strong>This main objective of the study to evaluate the cyto-histopathological findings, and the accuracy of fine needle aspiration cytology (FNAC) procedure in solitary nodular thyroid lesions.</p> <p><strong><em>Materials and Methods</em></strong><strong>: </strong>This prospective study comprises total 160 cases with thyroid lesions referred to cytopathology laboratory and gland morphology studied by ultrasonography (USG). Based on ultrasonography report Fine Needle Aspiration were done manually or guided and aspirated material fixed on fixative and stained to examine.</p> <p><strong><em>Results: </em></strong>Age incidence varied from 10-80 yrs. The commonest age group affected was 21-40 yrs. The ratio of male to female was 1:2.2. The duration of symptoms ranged from 10 days to 15 years. Maximum number of cases presented with midline swelling of the neck. On cytology 52 (32.5%) cases were diagnosed as colloid goiter, 46 (28.75%) as colloid goiter with cystic change, 16(10%) as thyroiditis - among them 6(3.75%) as granulomatous thyroiditis, 8(5%) as lymphocytic thyroiditis, 2(1.25%) as dequervain thyroiditis, 10 (6.25%) as follicular neoplasm, 2(1.25%) as hurthle cell adenoma, 5(3.3%) as papillary carcinoma, 2 (1.25%) as medullary carcinoma, 1(0.33%) anaplastic carcinoma and 1(0.33%) NHL as suspicious smear. Histopathological examination was possible in 60 cases. The overall sensitivity was 90.2%, specificity was 98.2% and accuracy was 97.1%.</p> <p><strong><em>Conclusion: </em></strong>FNAC is a rapid, efficient, cost-effective, relatively painless procedure and produces a early result with a high diagnostic accuracy. It has high rates of sensitivity and specificity to diagnose the solitary thyroid lesions and thereby it is an important diagnostic tool and further management of patients with thyroid lesions.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.789-795</p> Md Iqbal Karim Rosen Nachev Nikolay Fuklev Nazlima Nargis ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 789 795 10.3329/bjms.v18i4.42906 Abdominal tuberculosis in urgent surgery https://www.banglajol.info/index.php/BJMS/article/view/42907 <p><strong><em>Objective</em></strong>: This article presents retrospective analysis conducted on the basis of the General Surgery Clinic of the Irkutsk State Medical University (ISMU).</p> <p><strong><em>Materials and methods: </em></strong>165 cases of abdominal tuberculosis (AT) were detected and analyzed. The sample was made from the total number of patients who were treated in the surgical department for urgent reasons from 2009 to 2018.</p> <p><strong><em>Results and Discussion: </em></strong>Proportion of hospitalized AT cases from the total number increases every year and slightly decreases only after 2013. The largest number of hospitalizations in 2013 was 29 cases or 2.1%. General characteristics are as follows: 95% of patients were 30–35 years old, 93% used drugs, 80% were HIV positive, and 88.3% suffered abdominal pain. Tuberculosis of the gastrointestinal tract with ulcer perforation was more common (53.7%). 140 (84.5%) patients had history of operation. Overall mortality was 57.6%.</p> <p><strong><em>Conclusion</em></strong>: The main cause of mortality was generalized tuberculosis. The contribution of these cases to the overall mortality over the period taken was not possible to estimate.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.796-800</p> Vladimir A Beloborodov Elena A Kelchevskaya Aleksandr P Frolov Darizhab B Tsoktoev Igor Y Oleynikov Igor E Golub Mihail A Kozhevnikov ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 796 800 10.3329/bjms.v18i4.42907 Influence of marginal and segmental bony resection on the local control of oral Squamous cell carcinoma involving the mandible https://www.banglajol.info/index.php/BJMS/article/view/42908 <p><strong><em>Background and objective</em></strong>: Marginal or segmental resection of bone are often required for tumor removal in oral squamous cell carcinoma patients to secure adequate margin. The present study aims to evaluate the surgical outcome and post-operative complication of both group of patients and also assesses the local control of the disease in the oral cavity.</p> <p><strong><em>Methods</em></strong><em>: </em>In this prospective study, 32 patients who were treated with marginal or segmental jaw resection for oral squamous cell carcinoma of the lower part of oral cavity was undertaken within September 2008 to August 2013.There were 9 males and 23 females with a median age of 40.5 years. Twenty patients underwent marginal and 12 patients had segmental resection of the mandible. Distribution of the subject by age, sex, primary site of lesion, pathologic tumor stage, presence of mandibular invasion, pathologic cervical lymph node stage and feature of post- operative complications were analyzed prospectively.</p> <p><strong><em>Results</em></strong><em>: </em>According to this study, the mandible was involved in 83.3% of patient with segmental resection and 15% of patients with marginal resection. Buccal mucosa was mostly involved site in marginal group (60%) and retro molar trigon was highly involved site with segmental group (41.7%). In marginal group 30% cases was involved with stage1 and 70% was stage2; in segmental group 25% cases were stage2 and 67.7% were stage3. Statistically significant difference was exist in pathological cervical node stage(p&lt;0.05). Mandibular invasion was significantly more in segmental group (p&lt;0.05). Soft tissue surgical margins were positive in 4 patients (20%) in the marginal group and in 3 patients (25%) in the segmental group. Negative neck lymph node was found in 20 (63%) cases and positive neck node was found in 12 (37%) cases, of which four patients, including 2(15%) cases in the marginal group and 2(8.3%) cases in the segmental group was died. Trismus and mastication problems were found higher in segmental than marginal resection group.</p> <p><strong><em>Conclusion</em></strong><em>: </em>Marginal resection of mandible is effective for patient with oral squamous cell carcinoma in the early stage. Post-operative outcome and local control of disease in segmental group were slightly higher than marginal group. Positive surgical margin status and bone invasion was found as the most important predictor of local control of the diseases in patient with oral squamous cell carcinoma.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.801-807</p> Mohammad Deedarul Alam ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 801 807 10.3329/bjms.v18i4.42908 Patients’ Knowledge on Rheumatoid Arthritis presenting with Arthralgia in a Tertiary Care Teaching Hospital, Pakistan https://www.banglajol.info/index.php/BJMS/article/view/42909 <p><strong><em>Objectives: </em></strong>The main aim of this study was to determine the level of knowledge about rheumatoid arthritis disease among patients presenting with arthralgia in a tertiary care teaching hospital, Pakistan.</p> <p><strong><em>Materials and Methods: </em></strong>A cross-sectional study during the period of September 2015 - March 2016 in the Medical Out-Patient Department, Shaheed Mohtarma Benzir Bhutto Medical University Hospital, a tertiary care teaching hospital in Larkana, Pakistan. Patients above 40 years of age of either gender were included in the study. A non-probability purposive sampling technique was employed to include the participants in the study. A pre-designed questionnaire with open and close ended questions was used. The questionnaire in English language was also translated in local language to facilitate the participants. All the statistical analysis was conducted using Stata statistical software 14.</p> <p><strong><em>Results: </em></strong>A total number of 251 participants completed the questionnaires. 42 (56.6%) were from rural settings, while 233 (92.8%) were females. The overall mean age was 59 ± 8.69 years. There were 139 (55.4%) of the participants were ≥ 60 years of age. The average BMI was 23.1 ± 4.3. Moreover, 144 (57.4%) participants were found noneducated. The duration of the disease was less than 10 years in 154 (61.4%) of the participants. While, 157 (62.5%) participants were not knowing about factors which contribute to the onset of rheumatoid arthritis. We observed that, on the basis of responses to the relevant questions, only 4 (1.6%) participants were considered fully aware.</p> <p><strong><em>Conclusion: </em></strong>We observed lack of knowledge in majority of the participants presenting with arthralgia. The public awareness and education through different vertical programs as well as through social media in the country which can play very important role.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.808-813</p> Munawar Hussain Soomro Mansoor Magsi Muhammad Aslam Soomro Muhammad Akram Oussama Lahmar ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 808 813 10.3329/bjms.v18i4.42909 Situation Awareness of Cough etiquettes of Hospital Security personnel and Janitors https://www.banglajol.info/index.php/BJMS/article/view/42910 <p><strong><em>Background</em></strong><em>: </em>Nosocomial infection is a major problem in hospitals around the world. To minimize the risk of infection in hospitals and other healthcare facilities, cough etiquette has to be applied. Thus, good situation awareness and the understanding why cough etiquette is important are necessary. The purpose of this study was to find out the effective education on cough etiquette on hospital security personnel’s and janitors’ situation awareness on cough etiquette.</p> <p><strong><em>Methodology: </em></strong>This research study followed quasy experimental design with pretest and post test control group design<em>. </em>The sampling technique was purposive sampling involving 24 respondents for experimental group and 27 respondents for the control group. The analysis of the data employed Wilcoxon test and it employed Mann Whitney test to find out the difference of independent variable medians<em>. </em>Questionnaires were used to gather data collection.</p> <p><strong><em>Results</em></strong><em>: </em>The result of the analysis presented a mean of 97,7 on the post-test of control group and a mean of 116,3 on the post-test of treatment group. Wilcoxon and Mann Whitney tests resulted p = 0,001 (&lt; 0,05), which meant there were significant differences.</p> <p><strong><em>Conclusion</em></strong><strong>: </strong>Education on cough etiquette is effective to raise hospital security personnel and the janitors’ awareness on cough etiquette.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.814-817</p> - Kusbaryanto Ekorini Listiowati ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 814 817 10.3329/bjms.v18i4.42910 Naturally Occurring ‘enzyme only’ Anti-E antibody: A Rare Occurrence https://www.banglajol.info/index.php/BJMS/article/view/42911 <p>Naturally occurring anti-E, present without obvious antigenic stimulation is a rare occurrence of red cell antibody of the Rh blood group system. It is mentioned that such naturally occurring anti-E react only with enzyme modified E-positive red cells. This case report describes a rare case of naturally occurring anti-E in a patient with autoimmune haemolytic anaemia (AIHA).</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.818-819</p> Rabeya Yousuf Nor Fadzliana Abdullah Thalith Tang Yee Loong Chooi Fun Leong ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 818 819 10.3329/bjms.v18i4.42911 It was inhaled not swallowed-Neglected 5 month foreign body airway https://www.banglajol.info/index.php/BJMS/article/view/42912 <p>A delayed detection of foreign body airway implicated high morbidity. The longer duration of the foreign body in the lung can lead to a more sinister complication. A radiolucent foreign body, non organic foreign body and unwitnessed foreign body ingestion contribute significantly to the delay in the diagnosis of foreign body aspiration. We report a case of an undiagnosed radio opaque foreign body in the right bronchus for five months in a 8-year-old child, which the onset of foreign body ingestion was witnessed by parents. Eventually he presented with pneumonia and atelectasis.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.820-822</p> Senthilraj R Amarpreet S Periyathamby S Nik Hassan NFH ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 820 822 10.3329/bjms.v18i4.42912 Custom made ocular prosthesis for acquired eye defect:Adefinitive option of rehabilitation https://www.banglajol.info/index.php/BJMS/article/view/42913 <p><strong><em>Objective</em></strong><em>:</em>This case report describes the rehabilitation process of a case of acquired eye defect with patient specific or custom made ocular prosthesis for a patient who had her left eye surgically enucleated as a treatment step for retinoblastoma.</p> <p><strong><em>Method</em></strong><em>: </em>After primary evaluations, an intraorbital impression was taken while reproducing natural eye movements to ensure accuracy of the impression. The impression was cast and a transparent acrylic conformer was made from the mould in the cast. The conformer was adjusted as required and Iris position determined. The conformer was then used to cast the final custom ocular prosthesis. The patient was then instructed on its usage and maintenance.</p> <p><strong><em>Result: </em></strong>A custom made ocular prosthesis was provided to the patient and it was to her satisfaction.</p> <p><strong><em>Conclusion: </em></strong>Custom made ocular prosthesis is highly recommended in rehabilitation of facial defects of a co-operative patient as it does not have most of the limitations which a stock ocular prosthesis does.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.823-826</p> Taseef Hasan Farook Ahmed Mushfiqur Rahman Md Minhaz Ul Islam Nizami Mehedi Amin Nafij Bin Jamayet Mohammad Khursheed Alam ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 823 826 10.3329/bjms.v18i4.42913 A Very Rare Case Report of Sigmoid Adenocarcinoma with Involvement of the Bladder at the time of initial diagnosis https://www.banglajol.info/index.php/BJMS/article/view/42914 <p>In nephro-urologic field, extent of approach to causes of lower urinary tract complaints in fourth decade or more of life is challenging matter. Physicians must notice to alarm signs in diagnosis of patients to prevent misdiagnosis of important causes. in practice, combination of hematuria and constipation accompany weight loss are red flags. Bladder neoplasm is a malignant cause of above symptoms that sometime originate from neighboring organ. Bladder metastases are very rare in colorectal cancers (CRC). Symptoms of primary tumor may be precede or coincide with urinary symptoms. The present study describes an unusual case of symptomatic bladder involvement from sigmoid adenocarcinoma. A 68-year-old man with complaints of dysuria, frequency, microscopic-hematuria, nausea, vomiting, and abdominal pain was diagnosed as adenocarcinoma of sigmoid colon metastatic to the bladder. This case underlined the need to prompt and careful attention to patients with hematuria-dysuria in adult age.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.827-829</p> Babak Hadian Babak Khodadadi Nahid Rezaei Kourosh Ghanadi ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 827 829 10.3329/bjms.v18i4.42914 Lysosomes of Cancerous and Normal cells in Response to Low-energy/low-dose Medical Diagnostic X-rays https://www.banglajol.info/index.php/BJMS/article/view/42915 <p><strong><em>Background: </em></strong>Low-energy/low-dose ionizing radiation is increasingly being used in medical diagnosis, yet the effects of low-energy/low-dose medical diagnostic X-rays on biological systems remains a mystery. Thus, the aim of this present study is to determine the characteristics of lysosomes of cancerous and normal cells in response to low-energy/low-dose medical diagnostic X-rays.</p> <p><strong><em>Methods and materials</em></strong>: Three cell lines composed of peripheral blood mononuclear cells (PBMCs), adriamycin-sensitive erythroleukemia cells (K562), and adriamycin-resistant erythroleukemia cells (K562/<em>adr</em>), were all exposed to low-energy/low-dose medical diagnostic X-rays that operated at 50, 70, and 100 kV, and 100 mAs for obtaining radiation doses at 0.03, 0.07, and 0.10 mGy, respectively. Accumulation of acridine orange in the lysosomes of each cell line was determined using flow cytometry completed at 4 and 6 hours-post irradiation.</p> <p><strong><em>Results: </em></strong>The data showed an increase in fluorescence intensity of acridine orange in three irradiated cells line at 4 hours post-irradiation, but this intensity did not change at 6 hours post-irradiation when compared to that of corresponding non-irradiated cells<strong>.</strong></p> <p><strong><em>Conclusion: </em></strong>This finding suggests that changes in lysosomes might be a response to low-energy/low-dose medical diagnostic X-rays.</p> <p>Bangladesh Journal of Medical Science Vol.18(4) 2019 p.830-834</p> Montree Tungjai Nuttakan Tubthaing Suchart Kothan ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2019-08-30 2019-08-30 18 4 830 834 10.3329/bjms.v18i4.42915