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">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 src="data:image/jpeg;base64,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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> en-US <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> kholdun@hotmail.com (Dr Abu Kholdun Al-Mahmood) banglajol.info@gmail.com (Md Fahmid Uddin Khondoker) Thu, 10 Jan 2019 07:27:44 +0000 OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 Concept of Materiovigilance in Unani Medicine https://www.banglajol.info/index.php/BJMS/article/view/39539 <p>Abstract not available</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.5-6</p> Syed Ziaur Rahman ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39539 Sun, 30 Dec 2018 00:00:00 +0000 CRISPR Cas-9 genome editing and Islam: A religious perspective https://www.banglajol.info/index.php/BJMS/article/view/39540 <p><strong>Background: </strong>Certainly, the ultimate aim of Islamic law is to “protect human life” either through mitigation of hardship or recognition of public interests reckons biomedical innovations allowable where-if cling by ethical, moral and legal principles. Assertively, if–CRISPR Cas- 9 genome editing–methods based on the guided principles of Islamic law and jurisprudence, as “harm has to be redressed” can be justified keeping in view the human dignity, honor and prestige. Hence, newer technologies can be adopted because “necessity renders prohibited things as permissible” with certain caveats. Arguably those who consider it as an evil must think over that “in the presence of two evils, the one whose injury is greater is avoided by the commission of the lesser”.</p> <p><strong>Conclusion: </strong>Therefore if Cas-9 based method leaning towards evils, even then it can be acceptable in case where an atypical germ-line sequence can affect the next generation, which is indeed a great evil, and “the lesser of evils is preferred over the greater one” renders it permissible with a view it might enhance human health and living standard. Conversely, curing a minor disease if causing another equal infirmity or greater should be rendered forbidden as “harm cannot be removed by harm”, then, “a greater harm can be removed by a lesser one” germ-line editing/alteration in severe cases will be allowed on the basis of necessity.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.7-13</p> Fazli Dayan ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39540 Sun, 30 Dec 2018 00:00:00 +0000 Mathematical Epidemic Model of HIV/AIDS in Pakistan https://www.banglajol.info/index.php/BJMS/article/view/39541 <p>In Pakistan the effect population mobility, specifically labor migration and refugees is also thought to have been important in explaining the rapid spread of HIV/AIDS. One of the effects labor migration is likely to have had increased the prevalence of the overlap of sexual partnership. A nonlinear fractional differential equation model is discussed for transmission and control of HIV/AIDS in Pakistan. We shall also discuss the disease free equilibrium and stability behavior of the model</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.14-23</p> Syed Rizwan Ul Haq Tirmizi, Nasiruddin Khan, Syed Talha Tirmizi, Syeda Amara Tirmizi ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39541 Sun, 30 Dec 2018 00:00:00 +0000 Herbal Products and Conventional Drugs – an Uneasy Alliance https://www.banglajol.info/index.php/BJMS/article/view/39542 <p>This review examines the interaction between herbal remedies and conventional (orthodox) drugs. There has been a substantial increase in the consumption of herbal remedies in recent times for various reasons. They are often combined with one another, and are often used simultaneously with conventional drugs that are taken for a wide range of disorders, both acute and chronic. The probability of a real and substantial interaction between the therapeutic agents originating from different medical paradigms is likewise expanding. Whilst most of the herbdrug interactions are undoubtedly minor, benign, and harmless, there are reports of more serious interactions. Possible reasons for specific herb-drug interactions are examined, particularly from the pharmacokinetic and pharmacodynamic perspectives</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.24-29</p> John Glynn, Rashid Bhikha ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39542 Sun, 30 Dec 2018 00:00:00 +0000 Global Dental Arch Dimension Norms and Sexual Disparities: An overview https://www.banglajol.info/index.php/BJMS/article/view/39543 <p><strong>Background: </strong>The aim of the present study was to do an overview of the arch dimension for various populations. Also, to evaluate the various type of measurement methods and sexual disparities. Two reviewers independently performed the selection process and the quality of studies was assessed.</p> <p><strong>Method: </strong>Studies published form January 2000 until October 2015 were identified in electronic databases: Pubmed, Scopus, Science direct, Web of Science, Medpilot and Medline using keywords.Criteria used included: observational studies, Arch size measured, Permanent dentition, Arch dimension investigated via plaster and digital dental models, measurement via calipers and computers software’s.</p> <p><strong>Result: </strong>The forest plots showed the continuous trend for the greater arch dimension for male in relation to female. The current overview showed the arch dimension and its disparities for various populations.</p> <p><strong>Conclusion: </strong>The various methods to assess arch dimension should be carefully considered and well conducted as part of the clinical assessment of orthodontic treatment, since arch dimension could influence the diagnosis and treatment planning of orthodontist.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.30-35</p> Rafiqul Islam, Mohammad Khursheed Alam, Fazal Shahid, Mohd Fadhli Khamis ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39543 Sun, 30 Dec 2018 00:00:00 +0000 Nationality as a risk factor of tuberculosis resistance in two co-related countries https://www.banglajol.info/index.php/BJMS/article/view/39544 <p><strong>Background: </strong>Republic of Azerbaijan and Iran are two neighboring countries with high amount of travelling between them, different rates of TB and its resistance. These relationships could complicate the controlling of tuberculosis programs.</p> <p><strong>Objective: </strong>The study was conducted to determine the prevalence of tuberculosis (TB) resistance and its risk factors in the two geographically co-related regions.</p> <p><strong>Method: </strong>A total of 119Mycobacterium tuberculosis isolates from the patients of the target regions (Azerbaijan Rep. and Tabriz, Iran) were examined at the Central Tuberculosis Laboratory in Tabriz, Iran. The cultures and drug susceptibility tests was performed on Lowenstein-Jensen. All the isolates were categorized by MIRU-VNTR molecular method into clustered and un-clustered groups. The clustering as well as demographic data were analyzed to determine the risk factors contributing to TB resistance. The categorical data about the TB resistance were compared using a chi square test.</p> <p><strong>Results: </strong>27.8 percent of isolates were resistant at least to one of the 1st line of anti-tuberculosis drugs. The prevalence of any drug resistance and MDR were 64.6 and 17.9 percent respectively for Azari isolates, where the rate of resistance to rifampin and isoniazid was higher than streptomycin and ethambutol. The corresponding figures for the isolates from Tabriz were 16.9 and 3.3 percent respectively.</p> <p><strong>Conclusions: </strong>The results of this comparative and cross-sectional study showed statistically significant differences in TB resistance between the isolates from the patients of Azerbaijan Rep. and Iran. According to the results, the rate of resistance to RMP, INH, and MDR was higher in Azerbaijan; consequently, nationality could be regarded as a risk factor of MDR, resistance to RMP and INH but not to SM and ETB. Other studied parameters did not contribute to TB resistance.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.36-41</p> Ali Afaghi Gharamaleki, Seyyedreza Moaddab, Mojtaba Darbouy, Khalil Ansarin, Shahram Hanifian ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39544 Sun, 30 Dec 2018 00:00:00 +0000 Potential Immuno-modulatory activity of Probiotics containing Lactobacillusacidophilus and Lacobacilluscasei to increase the ratio of IFN γ/IL-4 in patients with Allergic Rhinitis https://www.banglajol.info/index.php/BJMS/article/view/39545 <p><strong>Aims</strong>: This study aimed to determine the effect of probiotic combination on ratio of IFN-γ: IL-4 levels in patients with allergic rhinitis.</p> <p><strong>Materials and methods</strong>: Single blind, randomized controlled trial.This study included 40 patients with severe allergic rhinitis according to WHO criteria. This study used 2 treatment groups with probiotics and placebo control group. IFN γ and IL-4 levels were evaluated using ELISA method. Data were analyzed using paired T test with 95% confidence intervals</p> <p><strong>Results and Discussion</strong><strong>: </strong>In the treatment group, the levels of IFN-γ increased significantly (p&lt;0.05).In contrast, IL-4 levels decreased significantly(p&lt;0.05). There was a significant difference between the IFN-γ ratio: IL-4 treatment and control group (p &lt;0.05).</p> <p><strong>Conclusion</strong>: The administration of combination of probiotics can improve the levels of IFN-γ/ IL-4 in patients with moderate to severe allergic rhinitis.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.42-45</p> Andriana Tjitria Widi Wardani, - Wiratno, Dina Fatmawati ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39545 Sun, 30 Dec 2018 00:00:00 +0000 Association between polymorphism of lys198asn endothelin-1 gene and endothelin-1 plasma level in javanese obesity population https://www.banglajol.info/index.php/BJMS/article/view/39546 <p><strong>Background: </strong>Endothelin-1 plays a role as a vasoconstrictor and also inhibits the expression of adiponectin in obesity. The Lys198Asn polymorphism of the endothelin-1 gene will increase the level of endothelin-1 plasma and increase the risk factor of obesity.</p> <p><strong>Objective: </strong>In this study, we investigated the relationship between Lys198Asn polymorphism of endothelin-1 gene and endothelin-1 plasma level among individuals with obesity in Javanese population.</p> <p><strong>Method: </strong>This study was conducted on 61 obese subjects and 65 control subjects. All subjects were measured for anthropometrics and endothelin-1 plasma level by ELISA (Enzyme-linked Immune Sorbent Assay). The polymorphism of Lys198Asn of ET-1 (Endothelin-1) was screened by using PCRRFLP (Polymerase Chain Reaction- Restriction Fragment Length Polymorphism<strong>).</strong></p> <p><strong>Results: </strong>TT genotype was a risk factor of obesity (OR 5.344 CI=95% 1.77-16.16) compared with GG genotype. Levels of endothelin-1 plasma were higher in obese subjects than that of control subjects (p=0.013), with TT genotype having the highest endothelin-1 plasma level (p&lt;0.001).</p> <p><strong>Conclusion: </strong>The Lys198Asn polymorphism of endothelin-1 gene plays a role in increasing endothelin-1 plasma levels and is risk factors of obesity.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.46-49</p> Dewi Karita, Ahmad Hamim Sadewa, Pramudji Hastuti ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39546 Sun, 30 Dec 2018 00:00:00 +0000 Sirtuin 1 (SIRT1) and activated caspase 3 expression on rat spinal cord in acute phase after Sciatic nerve injury https://www.banglajol.info/index.php/BJMS/article/view/39548 <p><strong>Background</strong>: Increase of SIRT1 expression inhibit the increase of activated Caspase 3 expression in acute phase of traumatic brain injury (TBI). However, the SIRT1 expression on rat spinal cord in acute phase after peripheral nerve injury was unknown.</p> <p><strong>Objective</strong>: To reveal SIRT1and activated Caspase 3 expression on rat spinal cord in acute phase after sciatic nerve injury and to reveal the correlation between SIRT1 and activated Caspase 3 expression after sciatic nerve injury.</p> <p><strong>Method</strong>: Thirty male Wistar rats aged 3 months were divided into sham operated and crush injury group. Termination was performing at days 3, 7 and 14. Lumbar spinal cord segments 4-5 (VTh12-VL1 high) embedded in paraffin blocks. Imunohistochemistry staining was performed using antibody of SIRT1 nuclear marker and activated Caspase 3. Observations were performed by two double blinded observers in 400x magnification. The data were analyzed using unpaired t-test and Pearson correlation. All data were processed using statistical analysis with confidence interval (CI) 95% and limit of significance (p-values)&lt;0.05.</p> <p><strong>Results</strong>: SIRT1 expression on the anterior horn was higher compared with control at days 7 and 14 (p&lt;0.05), but no differences were found on posterior horn at all termination days(p&gt;0.05). Activated Caspase 3 expression on the anterior horn was higher at all termination days(p&lt;0.05) and at day 7 on posterior horn (p&lt;0.05). Thereis a positive correlation between SIRT1 and activated Caspase 3 expression on anterior horn at day 7 (p&lt;0.05).</p> <p><strong>Conclusion</strong>: SIRT1 expression on the anterior horn was higher compared with the control at days 7 and 14. Activated Caspase 3 expression on the anterior horn was higher on all termination days and at day 7 on posterior horn. There is a positive correlation between SIRT1 and activated Caspase 3 expression on anterior horn on day 7.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.50-56&nbsp; </p> Dwi Nur Ahsani, Rina Susilowati, Yustina Andwi Ari Sumiwi ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39548 Sun, 30 Dec 2018 00:00:00 +0000 Factors related to self-care practice in asthmatic patients at rajshahi in Bangladesh https://www.banglajol.info/index.php/BJMS/article/view/39549 <p><strong>Background: </strong>This descriptive correlation study was aimed to examine factors related to selfcare practice in asthmatic patients at Rajshahi in Bangladesh.</p> <p><strong>Methods: </strong>A total of 126 asthmatic patients who met the inclusion criteria were selected by simple random sampling technique during March to April, 2014. The research instruments consisted of four parts: The Demographic Questionnaire, The Asthmatic Self-Care Practice Questionnaire, The Attitude of Asthmatic Questionnaire, and The Knowledge of Asthmatic Questionnaire. KR-20 for the reliability of Knowledge Questionnaire was yielded at 0.76 and the Cronbach’s alpha coefficient of Attitude and Self-Care Practice Questionnaire were 0.74 and 0.75 respectively. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.</p> <p><strong>Result: </strong>The results of the study illustrated that the total mean score of self-care practice in asthmatic patients was 49.63 (S.D = 9.5). The mean total score of attitude was 72.46 (S.D =9.27) and the total mean score of knowledge was 11.80 (S.D = 4.42). There was a moderate positive significant correlation between attitude and self-care practice (r =0.49, p &lt; 0.01). Additionally, there was a moderate positive significant correlation between knowledge and self-care practice (r = 0.30, p &lt; 0.01).</p> <p><strong>Conclusion: </strong>The findings suggested that nurses should conduct health education programs to increase knowledge and promote positive attitude about self-care practice in asthmatic patients.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.57-62</p> Kamruzzaman Mohammod, Wanlapa Kunsongkeit, Khemaradee Masingboon ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39549 Sun, 30 Dec 2018 00:00:00 +0000 Foetal outcome in pregnant women with anaemia https://www.banglajol.info/index.php/BJMS/article/view/39551 <p><strong>Objective</strong>: To find out the situation and causes of anaemia in pregnant women at MMIMSR during the study period with special reference to the severity of the disease and to find out foetal outcome in pregnant women with anaemia.</p> <p><strong>Methods</strong><strong>: </strong>The study was conducted in Department of Obstetrics and Gynaecology, MMIMSR, Mullana, Ambala(India). The study was carried out between the period of october 2012 to September 2014.A total of 200 cases of moderate and severe anaemia were included in the study on the basis of simple random sampling method and 200 cases of non anaemic subjects were included to serve as controls for the anaemic group, during the study period. Hb gm/dl was taken as criteria for deciding anaemia cases and also to classify them according to the severity. Cases were classified according to WHO criteria.</p> <p><strong>Results: </strong>Out of 200 cases of anaemia, 70% were moderately anaemic (Hb 7 – 9.9gm/dl) and 30% were severly anaemic (Hb &lt; 7gm/dl). Microcytic hypochromic type of anaemia (82.5%) was more prevalent suggesting nutritional inadequacies as cause of anaemia. Adverse foetal outcome in the form of preterm birth (17%), still birth (3.5%), low birth weight babies (27.5%), neonatal morbidity (23.3%) was more in the anaemic group than non anaemic controls</p> <p><strong>Conclusion</strong><strong>: </strong>Anaemia in pregnancy has adverse foetal outcome in the form of decreased birth weight, increased perinatal morbidity and mortality.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.63-72</p> Neerja Singal, Bal Krishan Taneja, Geetanjali Setia, Kiran Kumar Singal ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39551 Sun, 30 Dec 2018 00:00:00 +0000 Epidemiological characteristics of acute intestinal infection outbreaks in Ukraine Under the current conditions https://www.banglajol.info/index.php/BJMS/article/view/39552 <p><strong>Objective: </strong>determination of epidemiological peculiarities of acute intestinal infections outbreak incidence in Ukraine for the period 2014-2017.</p> <p><strong>Materials and methods</strong><strong>: </strong>Applying descriptive and analytical techniques of an epidemiological research method and statistical methods, using materials of the official statutory records of the Ministry of Health of Ukraine, the nature of acute intestinal infection outbreaks by etiology, transmission routes and affected cohort groups was investigated.</p> <p><strong>Result and discussion</strong><strong>: </strong>At the current stage AII outbreaks are registered every year and throughout Ukraine. Herewith, their specific gravity in total diarrheal infection incidence, excluding shigellosis and salmonellosis, is insignificant. Outbreak incidence levels in the industrial and tourist centres of Ukraine exceed similar rates in other regions by several times. Salmonelloses dominate in the nosological structure of outbreak incidence. The majority of outbreaks is transmitted by food. Most of diarrheal infection outbreaks are connected with catering facilities and children’s pre-school institutions, as well as with visiting festive occasions arranged at home. A rise in outbreak incidence is observed from May till September. Rotaviral enteritis outbreaks are more frequently registered in January through March.</p> <p><strong>Conclusion: </strong>The detected peculiarities of acute intestinal infection outbreak incidence shall be considered when developing regional programs of epidemiological surveillance over diarrheal infections.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.73-77</p> Nina Malysh, Mycola Chemych, Svitlana Doan, Roman Rodyna ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39552 Sun, 30 Dec 2018 00:00:00 +0000 Assessment of oxidative damage and lipid profile levels in tobacco chewers with Type 2 diabetes mellitus https://www.banglajol.info/index.php/BJMS/article/view/39554 <p><strong>Objectives: </strong>To assess oxidative damage and lipid profile levels in Type 2 diabetes mellitus patients with or without tobacco chewing habit.</p> <p><strong>Methods: </strong>Total of 141 newly diagnosed Type 2 diabetes mellitus patients with tobacco chewing habit from past &gt;18 years were included, 136 Type 2diabetes mellitus without any tobacco chewing habit, 140 normal healthy subjects without any tobacco chewing habit were included in the study. Blood sample was collected after 8-12 hours fasting from each subject to estimate glucose and cholesterol. The plasma was used for estimation of total antioxidant (TAA) activity, Vitamin C and thiobarbituric acid reacting substances (TBARS) by standard methods. Statistical analysis was done with SPSS version 16.</p> <p><strong>Results: </strong>The glucose, cholesterol and TBARS levels were found to be increased significantly (p&lt;0.001) in diabetic patients with tobacco chewing habit, as well as TAA, Vitamin C levels decreased significantly (p&lt;0.001) when compared with healthy individuals.</p> <p><strong>Conclusion: </strong>We observed increased oxidative stress and declined levels of antioxidants in newly diagnosed type 2 diabetes patients with tobacco chewing habit. It is known that hyperglycemia induces oxidative stress and further facilitate the progression of diabetic complications.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.78-82</p> T Nagamma, Nirjala Laxmi Madhikarmi, Singh PP ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39554 Sun, 30 Dec 2018 00:00:00 +0000 Acne and One‘s Self Confidence: Cross-sectional study on Malaysian Student population https://www.banglajol.info/index.php/BJMS/article/view/39555 <p><strong>Introduction</strong>: Self-confidence of an individual must be motivated by self without the inference of any internal or external consequences. Acne is a common skin defect among adolescents, and even in adults that can cause psychological weakness affecting one’s self-confidence level. The objective of this study is to investigate the effect of acne on the self-esteem of young adults of Malaysian student population.</p> <p><strong>Materials and Method</strong><strong>: </strong>A cross-sectional survey was done using a newly developed questionnaire having majorly close ended (in 2-point scale) questions. Total of 185 Malaysian MBBS students were randomly chosen, and only 171 valid responses from the victims of acne were analyzed.</p> <p><strong>Results: </strong>Among the students with acne problems, 88% of them opine that they lose their self-confidence due to the effect of acne. Out of this, 78% of them were preferred to associated with the people where as 22% of the students do not prefer to be involved with the individuals.</p> <p><strong>Conclusion: </strong>From the results, it was found that acne significantly reduces self-confidence of a majority of students whereas a small group of participants does believe that acne does not describe them. Students with acne problems are more self-conscious and perform poorly in social life. It is regardless of the clinical severity of their acne. In conclusion, acne influences students’ ability in public affairs.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.83-86</p> Abhinitha P, Ravina Suloshini Gengatharan, Sarah Zulkiflee, Purveena Ganisan, Sitharrthen Arumugam, Naveen Kumar ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39555 Sun, 30 Dec 2018 00:00:00 +0000 Clinical features of rheumatic heart disease in children and adults in Western Ukraine https://www.banglajol.info/index.php/BJMS/article/view/39556 <p><strong>Background: </strong>Rheumatic heart disease (RHD) is still a big problem affecting children and adults in many countries all over the world.</p> <p><strong>Objectives</strong><strong>: </strong>The aim of our study was to determine the clinical course of RHD in children and adults of Western Ukraine, to ascertain the reasons for development and progression of the disease, and outline prospects for its prevention.</p> <p><strong>Material and methods: </strong>The study included 32 children aged 11 to17 years and 35 adults aged 20 to 42 years with RHD. All patients underwent a standardized examination protocol, which consisted of detailed medical history, laboratory tests, ECG, Doppler echocardiography.</p> <p><strong>Results: </strong>The mean age in the children group was 15.8±1.5 years and in adults group - 35.4±7.3 years. Rural areas residents were the majority in both children and adults groups, 71.9% and 77.1% respectively. Recurrent acute rheumatic fever (ARF) was observed in 35.0% of children and in 54.3% adults with history of ARF. Long-term secondary prevention of streptococcal infections was satisfactory in 40.0% of child cases and in 31.6% of adult cases. The lack of compliance and poor health awareness among patients and their parents were most common reasons for inadequate prophylaxis. Subclinical RHD was diagnosed in 37.5% of child cases and in 45.7% of adult cases. Isolated mitral regurgitation (MR) was common in child cases (43.8%) while mitral stenosis (MS) (isolated or combined) was the most common in adult cases (88.6%). Clinical signs of heart failure were absent in half of child cases, but were present in all adult cases at functional class II and III (42.3% and 57.7% respectively). Atrial fibrillation occurred in 34.3% of adult cases.</p> <p><strong>Conclusion: </strong>MR is the predominant cardiac valvular lesion in children with RHD. Inadequate secondary prevention was identified as one of the main causes of development and progression of the disease, leading in adults to MS, combined valvular lesions, arrhythmic and infectious complications. Education of patients and their parents is very important for improving compliance with long-term prophylaxis. Special attention should be given to patients from rural areas and those with difficulties in adhering to antibiotic prevention regimes.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.87-93</p> Oksana Boyarchuk, Tetyana Hariyan, Tetyana Kovalchuk ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39556 Sun, 30 Dec 2018 00:00:00 +0000 Prevalence and Preventive Measures of Infertility in Male by Kruger’s Criteria, a Randomized Study in Private and Government Health Care Hospitals https://www.banglajol.info/index.php/BJMS/article/view/39557 <p><strong>Background</strong>: Every single couple out of 10 is in search of medical care because of infertility. Men older than 40 years and Women older than 30 years are at an increased risk of infertility. On the other hand, the estimation of male infertility is frequently underestimated or delayed. Symptomatic approaches steadily reducing the magnitude of couples classified as having idiopathic infertility. This is than perceived that no simple tests can conclude the probability of pregnancy in congregation in which the man is an infertile partner.</p> <p><strong>Method: </strong>Current study is design to figure out existence, problems, and causes, associated with infertility and treatment. In the view of the fact that the investigative consequences responsible for infertility in male. For this purpose survey has been conducted at different private and government health care hospital (n=33 patient of infertility) were selected for further studies.</p> <p><strong>Result: </strong>Results revealed that most of the patients are in the middle of their ages reported infertile. Primary infertility in infertile patients is 73% where as the presence of secondary infertility in the remaining respondent is 27%. Among all, 52% of the patients have co-morbid history of diabetes mellitus, 18% of them have issues about genitourinary trauma and infections, 30 patient have been identified problems related morphological count, 51% of them investigated abnormal volume of man semen. Evaluation of the study on infertility by Kruger’s strict morphology test over 75% of the men having insignificant infertility issues whereas 25% of them were observed significant infertility issues.</p> <p><strong>Conclusion: </strong>It is concluded that male infertility is independent on the age factor according to our survey based study whereas, excessive use of tobacco, alcohol, high fat food consumptions, obesity, heavy weight exercises, sedative life styles, contacts with chemical or toxins, stress or psychological disturbances might provoke issues of infertility.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.94-99</p> Somia Gul, Huda Ashraf, Owais Khawar, Madiha Moid ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39557 Sun, 30 Dec 2018 00:00:00 +0000 Effect of heavy metals on the readaptive processes in the urinary bladder https://www.banglajol.info/index.php/BJMS/article/view/39558 <p><strong>Introduction: </strong>Heavy metals (HM) are dangerous elements due to their toxicity and prevalence play an important role in the environmental pollution and hazards to health risk. Impact of HM at high concentrations may lead to the failures of urinary bladder (UB) structure and functions. The aim of our study was to determine the readaptive changes in the UB of the rats and effectiveness of vitamin E using after the long-term intake of the HMS mixtures.</p> <p><strong>Materials and Methods: W</strong>e used mature male laboratory rats which were divided into three series with special experimental conditions after the influence of HM. The detailed analysis of the UB state was performed by using morphometric, spectrophotometric, histological and electron microscopy methods.</p> <p><strong>Results: </strong>We had determined that the long-term intake of HM caused the significant increase of their accumulation in the tissue and morphometric changes of UB. Obtained results after the cancelation of the HM effect demonstrate smooth morphological restructuring of the UB wall with the reduction of difference of accumulation and morphometric indicators with control. The adjustment of vitamin E during there adaptation period showed better result recovery and optimization of all parameters, but they haven’t completely returned to normal state.</p> <p><strong>Conclusions: </strong>The influence of HMS mixture led to significant negative effect on the UB at all stages of research. However, under the conditions of readaptation the tendency towards a certain stabilization of all indicators was observed, but they didn’t completely pass to the end of the study. The vitamin E using has caused the acceleration and improved the development of readaptive change after HM exposure.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.100-106</p> Anatolii Romaniuk, Vladyslav Sikora, Yulia Lуndіna, Mykola Lуndіn, Natalia Hyriavenko, Volodymyr Sikora, Ludmila Karpenko, Artem Piddubnyi, Maryna Miroshnichenko ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39558 Sun, 30 Dec 2018 00:00:00 +0000 Protective Effect of Bixin Isolated from Bixa orellana L. Seeds on UVB-Induced Inflammation and Immunosuppression of the Skin https://www.banglajol.info/index.php/BJMS/article/view/39559 <p><strong>Background</strong>: DNA damage caused by excessive ultraviolet B (UVB) radiation on the skin triggers the response to inflammatory and immunosuppression. The bixin from Bixa orellana L. has been proven to be able to inhibit cyclo-oxygenase.</p> <p><strong>Objective: </strong>to verify whether the bixin lotion has the effect to offer protection against inflammation and immunosuppression due to acute UVB irradiation in shaved BALB /c mice.</p> <p><strong>Methods</strong>: Protection against inflammation and immunosuppression, respectively were studied in 4 groups of mice. Each group was treated respectively with topical application of base lotion as a control; bixin lotion doses of 0.5 mg; 2.5 mg and 125 mg, for 10 days prior to and during the UVB irradiation. The Inflammation was induced by UVB irradiation, 360 mJ/cm2 once a day for 3 consecutive days, whereas the immunosuppression was induced by UVB irradiation, 360 mJ/cm2 once a day for 5 consecutive days. The inflammatory response was measured as an increase in middorsal skinfold thickness at the peak response. The immune response was measured as the contact hypersensitivity (CHS) response to oxasolon sensitization.</p> <p><strong>Results</strong>: The results indicated that in concentration range used, bixin lotion significantly decreased the middorsal skinfold thickness at 72 hours after UVB radiation (p &lt;0.05) compared to the control, but there was no significant difference between couples of the dose of bixin. Bixin lotion was also capable to restore the suppression of CHS from 34.22% in the control group to 11.4%; 0.5% and 0% at doses of 0.5; 2.5 and 125 mg respectively (p &lt;0.05).</p> <p><strong>Conclusion: </strong>Bixin lotion has the potential to reduce the inflammatory edema reaction and the suppression of CHS of mice induced by UVB radiation.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.107-111</p> Atina Hussaana, - Suparmi, Hani Afnita Murti ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39559 Sun, 30 Dec 2018 00:00:00 +0000 Centella asiatica decrease bax expression In prefrontal cortex of rat models https://www.banglajol.info/index.php/BJMS/article/view/39560 <p><strong>Introduction</strong>: Centella asiatica is a herb, which has neuroprotective properties, thus, it can be used to prevent neural damage caused by stress and increased glucocorticoid level. Madecassoside, asiaticoside, asiatic acid, and madecassic acid that are contained inside Centellaasiatica extract have antioxidant and neuroprotective properties.</p> <p><strong>Method: </strong>This research is an experimental research using an animal model with post test-only control group design. We used samples from biologically stored product, in the form of 25 rat-brain tissue paraffin blocks. These brain tissues originated from 25 rat models that were divided into groups P1, P2, P3, P4, and P5. Group P1 was intervened with restrain stress.Group P2, P3, and P4 was intervened with restrain stress and ethanolic extract of Centella asiaticaat 150, 300, and 600 mg/kgBW/days, respectively. Group P5 was intervened with stress and fluoxetinat 10 mg/kgBW/days. On day 23, brain tissues were terminated, perfused, and extracted. Brain tissues were then made into paraffin blocks, turned into preparation pieces, histochemically stained, and cells that expressed caspace-bax were counted.</p> <p><strong>Results</strong>: There was a statistically significant difference of Bax expression between P1 group and P3, P4, and P5 (p=0,01). Bax expression in group P1 was significantly higher than P2, P3, P4, and P5. There was no statistically significant difference of Bax expression between group P1 and P2 (p=0,08).</p> <p><strong>Conclusion</strong>: Ethanolic extract of Centella asiatica was able to decrease Bax expression in prefrontal cortex of chronic restraint stress induced Spraque Dawley rat models.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.112-117</p> - Kuswati, Nanang Wiyono, Syaefudin Ali Akhmad ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39560 Sun, 30 Dec 2018 00:00:00 +0000 Toxicological Studies of popular eye cosmetic used world wide https://www.banglajol.info/index.php/BJMS/article/view/39561 <p><strong>Background and Objective: </strong>Present research work was designed and conducted to verify the safe use of kajal, a popular eye cosmetic, which is widely used to beautify eyes throughout the world especially in South Asia and Middle East region.</p> <p><strong>Material and Method</strong><strong>: </strong>The toxicological studies were conducted in experimental animals for a period of 90 days to clarify misleading thoughts associated with its long term use including lead toxicity. The study was carried out in Albino rats of Wister strain and New Zealand White rabbits. Hashmi kajal dibya (net weight 4.25g), an eye cosmetic manufactured by M/s A.Q. and company international Pakistan was used as source for study. The ingredients claimed by the manufacturer are zinc oxide, wax, cinnamonum camphora, processed carbon black and clarified butter.</p> <p><strong>Result: </strong>The elemental analysis resulted in presence of zinc 9.56%, lead 0.09% and total ash 41.01%, while sulfur, antimony, mercury and arsenic were not detected in the sample. The sub-chronic toxicological studies revealed that no toxicological effects were found in experimental animals. All the animals of test and control groups exhibited normal physiological activities and an increase in body weights. Lead and Zinc levels remained constant throughout the experimental period and no mortality was recorded. Furthermore, liver and kidney function tests were normal, indicating non-toxic effect of the kajal on vital organs.</p> <p><strong>Conclusion: </strong>So it can be assumed that this eye cosmetic is non-toxic and can be used safely in humans.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.118-123</p> Tehmina Sohail, Atiq Ur Rahman, Hina Imran, Zahra Yaqeen, Nudrat Fatima, Zakir Ur Rehman, Khula Shireen ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39561 Sun, 30 Dec 2018 00:00:00 +0000 Relatıonshıp between C-erb-B2 expressıon and other prognostıc factors in gastrıc cancer https://www.banglajol.info/index.php/BJMS/article/view/39562 <p><strong>Background: </strong>Gastric cancer-related deaths are among the leading causes of cancer-related deaths. Clinical trials with targeted agents continue in the treatment of stomach cancer, with randomized trials of chemotherapy to prolong survival in the treatment of metastatic gastric cancer. Metastatic stomach cancer treatment is also becoming increasingly personalized to the characteristics of the patient and tumor as it is in breast cancer.</p> <p><strong>Result: </strong>Trastuzumab has shown randomized trial (TOGA study) in c-erbB2 positive metastatic stomach and gastroesophageal junction adenocancer patients to prolong median survival.Immunohistochemically, the presence of cerbB2 positivity and scoring at the time of diagnosis or in the resection material suggests that patients, especially in the metastatic stage, is necessary. The grade (score) of Cebb2 positivity was more pronounced in adenocarcinomas especially located anatomically close to the gastroesophageal junction.</p> <p><strong>Conclusion</strong>: In our study, it was aimed to reveal the relationship between the demographic characteristics of patients who are candidates for treatment and the level of cerbB2 positivity and anatomic localization, especially in the metastatic stage if stomach and thyroid cancer are considered to be a common condition in our region.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.124-129</p> Havva Tugba Kiper Yılmaz, Selçuk Ergen, İdris Baydar, Ayşe Çarlıoğlu, Ali Kurt ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39562 Sun, 30 Dec 2018 00:00:00 +0000 The prevalence of skin and venereal diseases among the geriatric patients attending in a tertiary care Hospital in Dhaka, Bangladesh https://www.banglajol.info/index.php/BJMS/article/view/39563 <p><strong>Background: </strong>The prevalence of skin and venereal diseases among geriatric populations generally differ in different countries and within various regions of a country depending upon social, economic, racial &amp; environmental factor. The morbidity in elderly associated with skin and venereal diseases makes them an important public health problem. Very scanty literature was found on this geriatric problem in our country which is either disease based, community based or specified population group based.</p> <p><strong>Objective</strong><strong>: </strong>To assess the dermatological &amp; venereal complaints of the elderly attending a dermatology outpatient department in a tertiary care hospital.</p> <p><strong>Materials and Methods: </strong>We retrospectively analyzed a total of 1303 geriatric patients who were 60 years and above and came to the OPD of dermatology &amp; venereology department of Ibn Sina Medical College Hospital, Dhaka, Bangladesh, over a period of 3½ year from January, 2014 to June, 2017. Data were collected on special proforma and analyzed with appropriate method.</p> <p><strong>Results: </strong>Among 1303 patients 676 (51.88%) were male and 627 (48.12%) were female and most of the patients belonged to the age group 60-69 year (73.6%), mean age being 66.8 ± 7.06 year. The most commonly presented skin complaints were eczematous dermatitis (42.6%), fungal infection (19.14%), generalized pruritus (5.06%), seborrheic dermatitis (5.06%), urticaria (4.75%) and viral infections (4.29%) respectively. Tinea corporis (29.3%) was the most common of fungal infections and herpes zoster (82.14%) was the most frequent of viral infections.</p> <p><strong>Conclusion: </strong>Eczematous dermatitis was found to be the most common noninfectious disease and fungal infection was the most common infectious disease in all age groups and genders.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.130-135</p> Mohd Nurul Alam, Md Anwar Husain, Ayesha Siddiqua, Zahir Uddin Mohammad Babar, Md Rashidul Hasan ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39563 Sun, 30 Dec 2018 00:00:00 +0000 The Effects Comparisons of Sauropus androgynous, Moringa oleiefera alone and in combination on iron deficiency in anemia rats https://www.banglajol.info/index.php/BJMS/article/view/39564 <p><strong>Background: </strong>Leaves extract of Sauropus androgynous (Sa) or Moringaoleiefera(Mo) alone has been shown to increase hemoglobin level in iron deficiency anemia. The combination of the two extracts have been known to potentially have a synergistic effect on anemia. The objective of this study is to compare the anti-anemic effect of Sa, Mo alone and their combination on iron deficiency anemia in rats.</p> <p><strong>Methods</strong><strong>: </strong>Thirty female wistarstrain rats were randomly divided into 5 groups: normal, iron deficiency anemia, Sa, Mo and the combination of Sa and Mo. Beside the normal group, rats were fed Fe-deficient diet to induce iron-deficiency anemia. Level of hemoglobin, ferritin and plasma MDA were measured on day 8 (after induction of anemia) and day 29. Data were analyzed using One Way ANOVA followed by LSD post hoc test.</p> <p><strong>Result</strong><strong>: </strong>The rats fed with Fe-deficient diet for 7 days shown significantly had a lower plasma Hb and ferritin levels and higher plasma MDA levels compared to the normal group (p &lt;0.05) After the treatment, the rats given the extracts significantly had a higher mean of Hb and Ferritin and a lower mean of MDA level compared to anemic control. The mean Hb, ferritin and MDA level of the combination group were close to normal group.</p> <p><strong>Conclusion: </strong>The combination of the leaves extract of Sauropus androgynous or Moringaoleiefera is more effective against iron deficiency anemia compared to extract alone in rats.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.136-140</p> Ulfah Dian Indrayani, Hadi Sarosa, Atina Hussaana, Bagas Widiyanto ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39564 Sun, 30 Dec 2018 00:00:00 +0000 Awake fiberoptic intubation – A golden choice still? - Report of two Cases https://www.banglajol.info/index.php/BJMS/article/view/39565 <p>Abstract not available</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.141-144</p> MS Raghuraman, P Krishnaprasad, K Vinod, Pranjali Kurehkar, G Dilipkumar, N Gnanasekar ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39565 Thu, 10 Jan 2019 00:00:00 +0000 Morel-Lavallée lesion in a ‘non-traumatic’ thigh: a diagnostic challenge! https://www.banglajol.info/index.php/BJMS/article/view/39566 <p><strong>Background: </strong>Morel-Lavallée Lesion (MLL) or Morel-Lavallée Seroma (MLS) is a posttraumatic seroma that occurs following a closed degloving injury. It is very important for trauma surgeons to be aware of this relatively rarely reported entity as early diagnosis increases the likelihood of successful management.</p> <p><strong>Case report: </strong>We present a patient, wherein the patient had no history of trivial trauma and presented with a gradually growing swelling of left thigh, that was clinically and radiologically diagnosed as a soft tissue neoplasm, successfully managed by surgical excision and were reported to be a MLS. The clinical diagnostic dilemma was solved by the histopathologist!</p> <p><strong>Conclusion: </strong>A differential diagnosis of MLL should be kept in mind in patients presenting with soft tissue swellings.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.145-148</p> Devesh Sanjeev Ballal, Balaji Jayasankar, Gabriel Rodrigues, Ranjini Kudva ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39566 Thu, 10 Jan 2019 00:00:00 +0000 Approach for paediatric cervical lymphadenopathy: Tuberculosis versus lymphoma https://www.banglajol.info/index.php/BJMS/article/view/39567 <p>Constitutional symptoms are the most common clinical manifestation of the systemic disease. When there is the presence of cervical lymphadenopathy concurrently, systemic infection or malignancy has to be taken into consideration. At the paediatric or adolescent age group, tuberculosis and lymphoma are the common diseases that associated with these symptoms. We should consider patient’s age group, risk factors and the disease presentation for the diagnosis. With the guidance of the imaging studies, laboratory and histopathological studies, the precise final diagnosis is made.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.149-152</p> Chew Shiun Chuen, Norhafiza Mat Lazim, Lim Eng Haw, Nur Asyilla Che Jalil, Hilma Hazmi ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39567 Thu, 10 Jan 2019 00:00:00 +0000 Haemangiomatous polyp of uterine cervix: a rare cause of post-coital bleeding – a case report. https://www.banglajol.info/index.php/BJMS/article/view/39568 <p>Cavernous haemangioma of uterine cervix is a very rare lesion. It is clinically significant due to its presentation of pervaginal bleeding mimicking many other neoplastic lesions. Occasionally it may leads to massive haemorrhage complicating to hypovolemic shock. Here we are presenting a rare case of cavernous haemangiomatous polyp of endocervix presented with postcoital bleeding in a 32 years old lady. Surgical removal is curable and also has been proved to control post-coital bleeding successfully in our case.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.153-155</p> Subrata Pal, Kingshuk Bose, Srabani Chakrabarti, Mrinal Sikder ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39568 Thu, 10 Jan 2019 00:00:00 +0000 Recurrent primary leiomyosarcoma of the seminal vesicle treated with curative radiotherapy. https://www.banglajol.info/index.php/BJMS/article/view/39569 <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 scenario of locally recurrent seminal vesicle leiomyosarcoma.</p> <p>Bangladesh Journal of Medical Science Vol.18(1) 2019 p.156-158</p> Anna Santacaterina, Antonino Scimone, Silvana Parisi, Nicola Settineri, Angelo Platania, Grazia Acquaviva, Stefano Pergolizzi ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 https://www.banglajol.info/index.php/BJMS/article/view/39569 Thu, 10 Jan 2019 00:00:00 +0000