Bangabandhu Sheikh Mujib Medical University Journal

Sealing coronary perforation by hand-made covered stent: A case report

2023-09-13T04:23:07+00:00

Coronary artery perforation, a rare but deadly complication of percutaneous coronary intervention (PCI), can be managed by several modalities, including balloon inflation, heparin-reversing agent, thrombin injection, microcoils, fat embolization, covered-stent implantation, or surgery. We share our experience in emergency innovative management of coronary perforation during routine PCI. We faced an Ellis class III perforation of the right coronary artery during PCI. The balloon inflation technique failed to occlude the perforation, and no other facility was available to solve the problem immediately. The patient developed mild pericardial effusion but was hemodynamically stable. We made a covered stent by wrapping it with polyurethane (Tegaderm® skin dressing material) and deployed it. The perforation was sealed. The patient was discharged in stable condition and doing well at a 12-month follow-up examination. Hand-made covered stent may be a good bailout option to seal coronary perforation where premounted covered stents are not readily available.

Quality of life among adolescents with substance use disorders

2023-09-18T10:01:55+00:00

Background: Adolescents are vulnerable to substance use, which profoundly affects their function, feelings and quality of life (QoL). This study aimed to assess the physical health, psychological, social relationships, and environmental domains of QoL among adolescents with substance use disorders (SUDs).

Methods: A cross-sectional study was done from October 2020 to September 2021 among 44 adolescents selected purposively from Central Drug Addiction Treatment Center (CDC), Dhaka and Ashokti Punorbashon Nibash (APON), Manikganj. Clinical diagnosis was assigned using The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by psychiatrists. Then, they were interviewed with a questionnaire and a Bengali Version of the World Health Organization quality of life scale brief version (WHOQOL-BREF).

Results: Among the 44 adolescents with SUD, 18 (40.9%) rated their QoL as poor, 14 (31.8%) as very poor, 8 (18.2%) as neither poor nor good, and only 4 (9.1%) as good. Nearly half of them (47.7%) reported that they were dissatisfied, one third (29.5%) were very dissatisfied with their health. Among the four domains, the psychological domain (9.8±2.3) had the lowest mean score, followed by physical health (10.5±2.7), social relationships (10.6±2.6), and environmental domain (11.5±2.2) of the WHOQOL-BREF. Multiple drug users had poorer scores of their QoL than single drug user.

Conclusion: Our study demonstrated that all domains of QoL (physical, psychological, social, and environmental) are impaired in adolescents with SUDs.

Perception towards the effects of internet-based education on adolescents: A cross-sectional study

2023-09-13T15:32:53+00:00

Background: In the era of internet dependency on education, the study aimed to determine the perception of the effects of internet-based education (IBE) among adolescents.

Methods: This cross-sectional study included conveniently selected 140 adolescent students and 60 of their parents from a secondary school located in Sabujbag thana of Dhaka city. Data were collected through a questionnaire-based interview on adolescents’ IBE and its physical, psychological, and social effects.

Results: On average, adolescents and parents were 15 and 42 years old. Parents provided more negative input on physical health such as headache (88.3 vs 65.0%, P<0.01), sleep disruption (76.7 vs. 52.9%, P<0.01), and backache (90.0 vs 44.3%, P<0.01) compared to the adolescents. However, they had similar perceptions about physical activity. Parents showed more concern about the potential loss of motivation and self-discipline (73.3 vs 48.6%, P=0.002). Adolescents were more optimistic about community networking (92.9 vs. 81.7%). The opposite views were expressed by the parents that long screen time undermines societal values (66.7 vs. 15.7%, P<0.001).

Conclusion: Although there were differences between the perceptions of parents and adolescents, IBE was favoured in many instances such as painting/drawing skills, getting updated information, school performance, social skills, and community networking.

Expression of Ki-67 and E-cadherin in patients with non-small cell lung cancer attending a tertiary care hospital

2023-09-21T17:49:26+00:00

Background: E-cadherin and Ki-67 expressions may provide real-time insights into the tumor's status and can be utilized as targeted therapeutics for lung cancer. We aimed to explore the expression of Ki-67 and E-cadherin in non-small cell lung cancer (NSCLC) patients and to identify their association with clinicopathological features.

Methods: In this cross-sectional study, forty formalin-fixed paraffin-embedded (FFPE) NSCLC tissue blocks were identified from January to October 2022, based on hospital records from the Department of Pathology of National Institute of Diseases of the Chest and Hospital, Dhaka Medical College and Hospital. Samples were reevaluated for tissue quality, diagnosis, and exclusion-inclusion criteria. Finally, twenty-five samples were analyzed, and relevant clinicopathological data were collected from patients or authorized representatives. Ki-67 and E-cadherin expression were analyzed by immunohistochemistry and their relationships with each other.

Results: Ki-67 expression was positive in 40% of the NSCLC tissue, and E-cadherin was negative in 40% of the NSCLC tissue. No statistically significant relation was found between the expressions of Ki-67 and E-cadherin. No statistically significant association was found in Ki-67 and E-cadherin expressions with clinicopathological characteristics except E-cadherin with comorbidity.

Conclusion: Positive expression of Ki-67 and negative expression of E-cadherin was found in two-fifths of NSCLC tissues but not significant. Simultaneous estimated of Ki-67 and E-cadherin may contribute to the treatment planning and predict prognosis of the NSCLC patients.

Association of vitamin D level with systemic lupus erythematosus: A case - control study

2023-08-27T14:31:43+00:00

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune connective tissue disease. SLE patients are more prone to vitamin D deficiency because of their light sensitivity, renal involvement, and prolonged steroid use. This current study aimed to determine the relationship between vitamin D deficiency and SLE.

Methods: In this case-control study, 50 SLE patients (cases) and 50 healthy people (controls) were recruited. The reference value of vitamin D is as follows: normal ≥ 30 ng/ml, deficient ≤ 20 ng/ml, and insufficient 21–29 ng/ml.

Results: The mean (standard deviation) of vitamin D levels in SLE patients was 19.5 (5.3) ng/mL, which was significantly lower than those in healthy controls, 27.3 (10.0) ng/mL (P<0.001). The healthy controls had a higher proportion of people with normal vitamin D levels (≥ 30 ng/ml). We noticed a moderate negative correlation between vitamin D levels and fatigability, while a moderate positive correlation was seen with hemoglobin levels and the duration of sun exposure. However, in multiple logistic regression analysis, all the associations mentioned above disappeared.

Conclusion: Although vitamin deficiency was found to be associated with SLE, its relationship disappears when the confounding by other variables is considered in the analysis.

IndoCyanine Green fluorescence guided resections in hepatobiliary surgery

2023-08-27T09:37:29+00:00

Background: Fluorescence-guided surgery (FGS) has recently gained popularity as a promising technique for treating visceral, hepatobiliary, and pancreatic neoplasms. It involves using laser sources to illuminate injected substances that emit a fluorescence signal, guiding surgical procedures, and providing real-time visualization of otherwise undetectable structures. This review explores the advancements in hepatobiliary surgery using IndoCyanine Green (ICG) fluorescence guided resections.

Methods: The review examined the use of FGS in identifying subcapsular liver tumors, millimetric hepatocellular carcinoma, intrahepatic cholangiocarcinoma, liver metastases, and various benign liver neoplasms. In addition, fluorescence cholangiography using ICG injection was explored to improve liver surgery's accuracy and safety.

Results: The review found that ICG fluorescence-guided resections can potentially improve surgical outcomes by enhancing the accuracy and safety of procedures. The use of fluorescence cholangiography allows for the efficient identification of the bile ducts and helps surgeons avoid damaging critical structures during liver surgery.

Conclusion: ICG fluorescence-guided resections represent a promising method for improving surgical outcomes and patient safety for visceral and hepatobiliary Surgery. It is a quick, easy, inexpensive, and safe device that can be used for various surgical applications. As imaging systems continue to improve, fluorescence imaging can become a widely used intraoperative navigation tool for open, laparoscopic, and robotic surgery.