Journal of Current and Advance Medical Research 2019-04-11T05:33:17+00:00 Dr. M. Abdullah Yusuf Open Journal Systems <p>Official journal of Bangladesh Doctors Society. Articles in the Journal of Current and Advance Medical Research are Open Access articles published under the Creative Commons CC BY-NC License (<a href=""></a>). This license permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.</p> <p>JCAMR is included in the <a title="NLM" href="" target="_blank" rel="noopener">NLM Catalog</a> ID:101673828</p> Role of Radiology in Image Guided Pain Management 2019-03-27T10:10:02+00:00 Tariqul Islam <p>Abstract not available</p> <p>Journal of Current and Advance Medical Research 2019;6(1):1</p> 2019-03-27T08:23:00+00:00 ##submission.copyrightStatement## Anti-Inflammatory Effect of Ethanolic Extract of Carica Papaya Leaves and Indomethacin in Cotton Pellet Induced Granuloma in Animal Model 2019-03-27T10:10:03+00:00 Afroza Sultana Rumana Afroz Onayza Yasmeen Muqbula Tasrin Aktar Md Abdullah Yusuf <p><strong>Background: </strong>Anti-inflammatory effect can be exerted by <em>Carica papaya</em>.</p> <p><strong>Objective: </strong>The purpose of the present study was to see the anti-inflammatory effect of ethanolic extract of <em>Carica papaya </em>leaves and indomethacin in carrageenan induced rat paw edema animal model.</p> <p><strong>Methodology: </strong>This was an animal study carried out in the Department of Pharmacology at Dhaka Medical College, Dhaka, Bangladesh during the period from July 2014 to June 2015 for a period of one (01) year. The leaves of <em>Carica Papaya </em>collected from Botanical garden, Mirpur, Dhaka, Bangladesh. The animals were divided into four groups. The animals were divided into four groups. In all the animals granuloma were induced by implantation of autoclaved cotton pellet on the 1st day and they treated as follows: Group I were served as control that was received normal saline. Group II were received ethanolic extract of <em>Carica Papaya </em>leaves. Group III were received ethanolic extract of <em>Carica Papaya </em>leaves. Group IV were received indomethacin. On the 15<sup>th</sup> day animals were anesthetized, implanted pellets were dissected out, dried at hit air oven and the final weights were measured.</p> <p><strong>Result: </strong>The experiment was carried out on 48 Long Evan Norwegian rats. Rats were divided in 4 groups of six animals each. The mean increase of weight of cotton pellet was 48.06±1.02, 24.48±0.36, 22.42±0.56 and 18.02±0.43 in group I, II, III and IV respectively. The inhibition of granuloma formation was 49.06%, 53.35% and 62.51% in group II, III and IV respectively.</p> <p><strong>Conclusion: </strong>In conclusion the ethanolic extract of <em>Carica Papaya </em>leaves has effects on cotton pellet induced granuloma formation in experimental rat.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):2-5</p> 2019-03-27T08:23:11+00:00 ##submission.copyrightStatement## Pattern of Tumour among Hepatocelluar Carcinoma Patients attended at a Tertiary Care Hospital in Dhaka City 2019-03-27T10:10:09+00:00 Md Akter Hossain Md Saiful Haque Md Ashikur Rahman Zinat Nasreen Mostaque Ahmed Bhuiya Abu Bakar Siddique <p><strong>Background: </strong>The pattern of hepatocelluar carcinoma may vary in different patients.</p> <p><strong>Objective: </strong>The purpose of the present study was to see the pattern of hepatocelluar carcinoma among the patients attended at a tertiary care hospital in Dhaka city.</p> <p><strong>Methodology: </strong>This cross-sectional study was carried out in the Department of Radiology and Imaging at Dhaka Medical College, Dhaka and Banghabandhu Sheikh Mujib Medical University, Dhaka from January 2007 to May 2008 for a period of around one and half year. All the patients presented with hepatocellular carcinoma at the age group of more than 20 years with both sexes were selected as study population. The patients were undergone CT-scan examination and the confirmation was performed by histopathological examination. The details of the pattern of tumor among the hepatocellular carcinoma patients were examined and were recorded.</p> <p><strong>Result: </strong>A total number of 50 patients were recruited in this study after fulfilling the inclusion and exclusion criteria. Mean age with SD of study population was 48.78 ±12.07. Within 25 cases of HCC as diagnosed by CT scan 13(52%) had solitary lesion 7(28%) had multiple lesions and remaining 5(20%) had diffuse lesions. The tumour size of 8 cm or more was the highest which was 10 in numbers. However, 4 to 8 cm was found in 7(28.0%) cases and 3 to 4 cm was detected in 3(12.0%) cases.</p> <p><strong>Conclusion: </strong>In conclusion most of the HCC is solitary lesion with more than 8 cm in size.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):6-9</p> 2019-03-27T08:23:19+00:00 ##submission.copyrightStatement## Relationship between Long Duration Use of Hormonal Contraceptive and Serum Lipid Profiles among the Women of Dhaka City 2019-03-27T10:10:11+00:00 Kashefa Khatun Shamsun Nahar Abida Sultana Shahnur Chisty Asma Rumanaz Shahid Iqbal Arselan <p><strong>Background: </strong>Long duration use of hormonal contraceptives can cause different metabolic effects.</p> <p><strong>Objective: </strong>The purpose for the present study was to see the relationship between long duration of use of hormonal contraceptives and serum lipid profiles.</p> <p><strong>Methodology: </strong>This cross-sectional study was carried out in the Department of Obstetrics &amp; Gynaecology in collaboration with the Biochemistry Department at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2004 to December 2005 for eighteen (18) months. Women of reproductive age group who had given the history of taking low-dose oral contraceptive pills (OCP) containing 30 meg ethinyloestradiol (EE) plus 150 meg levonorgestrel (LNG) were included as study population. The women were divided into group A which was consisted of women who were using OCP for up to 5 years and group B who were using OCP for more than 5 years. Blood was collected from each woman in fasting state and serum was sent for estimation of serum lipids profiles like serum triglycerides, total cholesterol, LDL and HDL.</p> <p><strong>Result: </strong>The women in group A was consisted of 20 women and the rest 20 women were in group B. Comparison of mean age between control and case groups showed no significant difference (31.75±4.85 vs 30.43±5.44 years). In women using OCP ≤5 years and &gt;5 years, the mean (±SD) cholesterol levels were 252.50±48.86 and 239.55±48.73 mg/dl (p&gt;0.10), triglyceride levels were 204.30±48.10 and 191.45±67.89 mg/dL (p&gt;0.10), HDL levels were 42.82±8.96 and 43.00±6.46 (p&gt;0.10) and LDL levels were 168.83±50.82 and 158.26±50.32 (p&gt;0.10) respectively.</p> <p><strong>Conclusion: </strong>The level of total cholesterol and triglycerides are not significantly varied with long duration (more than 5 years) of oral contraceptive pills use.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):10-13</p> 2019-03-27T08:23:28+00:00 ##submission.copyrightStatement## Technology Enhanced Learning in Undergraduate Pharmacology through Online Quizzes: A Pedagogical Approach and Medical Students’ Perspective 2019-04-11T05:33:17+00:00 Sujit Kumar Sarker Geethanjali Bhas Vijaya Marakala Mohammad Abdullah Yusuf <p><strong>Background: </strong>Technology enhanced learning in medical curriculum is expanding rapidly because of research showing the benefits for learners in terms of engagement, convenience, attainment and enjoyment.</p> <p><strong>Objectives</strong>: The purpose of the present study was to explore medical students’ perspective on technology enhanced learning in undergraduate pharmacology.</p> <p><strong>Methodology: </strong>This descriptive cross-sectional study was conducted in the Faculty of Medicine during 2016 for a period of three (3) months. Second year MBBS students who were studying in the International Medical School, Management &amp; Science University,Selangor, Malaysia with the age group of equal or more than 18 years of age with both sexes were selected as study population. Several online quizzes were conducted by Quizizz. Data were analysed after online quizzes using semi-structured questionnaire.</p> <p><strong>Results: </strong>A total number of 42 students were involved in this study. Among these 35(83.33%) surveyed students were strongly agreed with timing for answering the questions however, 39(92.86%) strongly agreed that quizzes stimulate interest in pharmacology and 28(66.67%) strongly agreed that quizzes improve knowledge and skill in pharmacology. Most of the students suggested to continue online quizzes.</p> <p><strong>Conclusion:</strong>Systematic analysis and stratification of students’ perceptions regarding technology enhanced learning initiatives such as online quizzes are essential in gaining insight for educational planning and interventions in pharmacology.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):14-17</p> 2019-03-27T08:23:37+00:00 ##submission.copyrightStatement## Myomectomy at the time of Cesarean Section: A Prospective Multicentre Study 2019-03-27T10:10:14+00:00 Nargis Akther Shereen Yousuf Rashida Khatun Nargis Fatema Khairun Nahar <p><strong>Background: </strong>Myomectomy can be performed during cesarean section.</p> <p><strong>Objective: </strong>The purpose of the present study was to assess the safety and efficacy of myomectomy during cesarean section.</p> <p><strong>Methodology: </strong>The study design was a prospective multi-centre study done in three tertiary care hospitals Dhaka Medical Collage, BSMMU &amp; private Hospital in Dhaka City. The subject were 65 pregnant women elective or emergency myomectomy during cesarean section. All cesarean section myomectomy were performed by consultants. Intra-operative and post-operative complications such as change in haematocrit, length of operation, blood loss were estimated. Length of hospital stay was also recorded.</p> <p><strong>Results: </strong>79 Fibroid of various sizes (2 to 6cm) were removed from 65 women. Fibroid were on the anterior uterine wall with most being sub serous and intra mural. Four patients had one unit of whole blood transfusion in post-operative period. No hysterectomy was done at the time of cesarean section. There was no significant change of haematocrit: incidence of post-operative fever and duration of operation. The mean duration of post-operative hospital study was 7.3±1.2 days, 5 patients subsequently became pregnant, were also underwent repeated cesarean section in the study period.</p> <p><strong>Conclusion: </strong>In selected cases myomectomy during cesarean section does not appear to result in an increased risk of intrapartum or short-term post-partum morbidity if performed by an experienced practitioner. Cesarean myomectomy is a safe surgical options with no significant complications.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):18-22</p> 2019-03-27T09:16:21+00:00 ##submission.copyrightStatement## Comparison of Effect of Silymarin and Ethanol Extract of Trigonella foenum-graecum on Gentamicin Induced Nephrotoxicity in Rats 2019-03-27T10:10:16+00:00 Syeda Rubayat Hilmi Zesmin Fauzia Dewan AKM Nurul Kabir Muhammad Moinul Islam <p><strong>Background: </strong>A variety of drugs and chemicals possess nephrotoxic potentials; therefore it is of keen interest to the researchers to obtain ways and means for alleviation of nephrotoxicity.</p> <p><strong>Objective: </strong>The present study was designed to compare the ameliorative effect of silymarin with ethanol extract of <em>Trigonella foenum-graecum </em>in an experimental model of gentamicin- induced nephrotoxic rats.</p> <p><strong>Methodology: </strong>This animal study was conducted by giving distilled water intraperitoneally to control group for seven days (1ml/rat/day) and was sacrificed on 8<sup>th</sup> day. To induce nephrotoxicity, gentamicin (GM) was administered (80 mg/kg/day for 7 days) intraperitoneally and sacrificed on 15th day. The ethanol extract of <em>T. foenum-graecum </em>was administered (500 mg/kg/day for 14 days) orally concomitantly with GM (7 days) and sacrificed on 15<sup>th</sup> day. To another group of rats, silymarin was administered (500 mg/kg/day for 14 days) orally concomitantly with gentamicin (7 days) and sacrificed on the 15<sup>th</sup> day. Biochemical indices like serum creatinine and serum urea levels were estimated to determine nephrotoxicity and amelioration of nephrotoxicity in all rat groups. To determine the status of oxidative stress and lipid peroxidation, the renal cortical glutathione (GSH) and renal cortical malondialdehyde (MDA) levels were estimated.</p> <p><strong>Results: </strong>Statistically significant amelioration was observed in all the biochemical parameters in <em>T. foenum-graecum </em>and silymarin treated groups.</p> <p><strong>Conclusion: </strong>The ameliorating effect of <em>T. foenum-graecum </em>is much more effective in comparison to that of silymarin in nephrotoxicity.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):23-27</p> 2019-03-27T09:16:31+00:00 ##submission.copyrightStatement## Self-Medication Practice among Medical Students of a Tertiary Teaching Hospital in Dhaka City 2019-03-27T10:10:18+00:00 Asma Khan Afroza Sultana Benzir Ahammad Shamsun Nahar Shafeya Khanam <p><strong>Background: </strong>Self-medication is a common practice worldwide and the irrational use of drugs is a cause of concern.</p> <p><strong>Objective: </strong>This present study was designed to assess the rate of self-medication among the medical students in a tertiary teaching hospital in Dhaka.</p> <p><strong>Methodology: </strong>This descriptive cross-sectional study was conducted in the Department of Pharmacology at Shaheed Suhrawardy Medical College, Dhaka, Bangladesh from October to December 2017 for a period of three (03) months. The participants were briefed about the nature of the study; the consent was taken and a pre‐tested semi‐structured questionnaire was administered to them. The information pertaining to the pattern of self‐medication, indications for self‐medication and drugs used for self‐medication was included in the questionnaire.</p> <p><strong>Result: </strong>A total of 303 students were included in this study. The rate of self-medication was 100.0%. A larger number of females were self-medicating (81.2%) than males (75.3%). The majority of the students self-medicated because of the illness being too trivial for consultation (43.2%) and previous experience of illness (43.2%). Fever (73.3%) and headache (65%) are the most common cause of self-medication. Antipyretics were most commonly self–medicated by the participants (98%). 45.5% 0f students told that self-medication is not an acceptable practice. 40% of the participants opined that self-medication was a part of self-care.</p> <p><strong>Conclusion: </strong>In conclusion self-medication is widely practiced among students of the institute</p> <p>Journal of Current and Advance Medical Research 2019;6(1):28-31</p> 2019-03-27T09:16:39+00:00 ##submission.copyrightStatement## Comparison of Knowledge of Women with Gestational Diabetes Mellitus and Healthy Pregnant Women Attending at Hospital in Bangladesh 2019-03-27T10:10:20+00:00 Nowshin Monir Zebunnesa Zeba Azizur Rahman <p><strong>Background: </strong>A very common medical condition during pregnancy is Gestational Diabetes Mellitus (GDM) which has become a global health concern, not only for its higher prevalence, but also because it can be a predisposing factor for type 2 DM and causes other increased health risk for both mother and their offspring in later life.</p> <p><strong>Objective: </strong>The objective of the study was to compare knowledge of GDM including source of knowledge, treatment, awareness about GDM and impact of GDM on the baby among mothers with GDM and healthy pregnant mothers.</p> <p><strong>Methodology: </strong>The study was a cross-sectional study conducted in Cumilla city from May to October 2016. Eighty-nine participants attending the outpatient department of two hospitals and one antenatal clinic in Cumilla city were selected. A structured questionnaire and in-depth interview method was used to obtain data.</p> <p><strong>Result: </strong>Significant difference has been found in knowledge between GDM patients and normal pregnant women regarding source of knowledge (p=0.01), treatment of GDM (p=0.000), risk factors of GDM (p=0.01), problems in managing GDM (p=0.003), nutrition maintenance (p=0.006) and physical exercise (p=0.000). No significant difference has been found in GDM awareness (p=0.83) and its impact on the baby (p=0.28) in two groups. Awareness of GDM is found to be associated with higher education (p=0.000), family history of DM (p=0.05), meal plan (p=0.03) and maintaining nutrition (p=0.01).</p> <p><strong>Conclusion: </strong>Knowledge about GDM is poor among pregnant women, especially among normal pregnant women.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):32-37</p> 2019-03-27T09:16:46+00:00 ##submission.copyrightStatement## Clinical Profiles and Types of Senile Cataract Patients: Experience of 30 Cases in Bangladesh 2019-03-27T10:10:21+00:00 Shamima Sultana AQM Omar Sharif Inamur Rahman Choudhury MM Ehsanul Haque Wahida Begum <p><strong>Background: </strong>Senile cataract can be expressed with different clinical presentation.</p> <p><strong>Objective: </strong>The purpose of the present study was to find out the clinical profiles of senile cataract patients.</p> <p><strong>Methodology: </strong>This cross-sectional study was conducted at National Institute of Ophthalmology, Dhaka, Bangladesh from January 1999 to December 2000 for a period of two (02) years. Patients with senile cataract were selected for study. The details clinical profiles of the study population were recorded like types, grades of cataract and visual acuity. Data were collected on pre-designed data collection sheet, compiled and appropriate statistical analysis was done using computer based software.</p> <p><strong>Result: </strong>A total number of 60 eyes of cataract patients were recruited for this study. The mean age with the standard deviation was 58.8±6.055 years. Majority of the patients were suffering from total cataract that is nuclear plus cortical plus posterior subcapsular variety which was 31(51.7%) eyes of cataract patients. Majority of the patients were grade III (amber) type of nuclear sclerosis which was 26(43.3%) eyes of cataract patients. Most of the patients were presented with PL which was 32(53.3%) eyes of cataract patients.</p> <p><strong>Conclusion: </strong>In conclusion majority of the patients are suffering from total cataract with grade III (amber) type of nuclear sclerosis.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):38-41</p> 2019-03-27T09:16:55+00:00 ##submission.copyrightStatement## Histopathological Study of Upper Gastrointestinal Tract Endoscopic Biopsies 2019-03-27T10:10:23+00:00 Mosammat Suchana Nazrin Nur E Jannatul Ferdous Madhusudan Saha Fahmi Iqbal Rabbi <p><strong>Background: </strong>Diseases of gastrointestinal tract are a major cause of morbidity and mortality<em>. </em><strong>Objective: </strong>This study was carried out to determine the spectrum of histopathological lesions of upper gastrointestinal tract.</p> <p><strong>Methodology: </strong>This retrospective study was conducted in the Department of Pathology at North East Medical College, Sylhet, Bangladesh during a 36 months period from January 2013 to December 2015. Endoscopies were performed using Olympus 150, forward viewing upper GI endoscope. The biopsy specimens received were fixed in 10.0% formalin and routinely processed in Haematoxyline &amp; Eosin stain.</p> <p><strong>Results: </strong>The present study included 135 endoscopic biopsies. The mean age with SD of the study population was 53.20±16.09 years. Among 53 cases of esophageal biopsies 8(15.08%) cases showed non-neoplastic lesions and 45(84.92%) cases were neoplastic of which 39(73.6%) cases and 6(11.32%) cases were squamous cell carcinoma and adenocarcinoma respectively. Among 6 cases of gastro esophageal junction biopsies 3(50%) cases showed non-neoplastic lesions and 3(50%) were neoplastic, of which 2(33.33%) were adenocarcinoma and 1(16.67%) were squamous cell carcinoma. Among 61 cases of stomach biopsies 34(55.74%) showed non-neoplastic lesions and 27(44.26%) were neoplastic, of which 1(1.64%) case was adenoma and 25(40.98%) were adenocarcinoma. Among 15 cases of duodenal biopsies 13(86.67%) cases showed non-neoplastic lesions and 2(13.33%) were neoplastic one of which was adenocarcinoma (6.67%). Among 135 cases endoscopist reported 82(60.74%) cases as neoplastic and 53(39.26%) as non-neoplastic, whereas histopathology revealed 77(57.03%) cases neoplastic and 58(42.97%) cases non-neoplastic.</p> <p><strong>Conclusion: </strong>Common site of upper GIT endoscopic biopsy is stomach which are mostly neoplastic lesion; however, most common malignancy is squamous cell carcinoma of the oesophagus.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):42-46</p> 2019-03-27T10:07:43+00:00 ##submission.copyrightStatement## Maternal and Socio-Demographic Factors Associated with Birth Weight of Newborns Delivered at a Teaching Hospital of Dhaka City 2019-03-27T10:10:24+00:00 Sadia Afrin Anisur Rahman Afsar Ahammed Shaila Afrin Md Khalequzzaman Sarker Ahmed Hossain <p><strong>Background: </strong>Birth weight is the most important predictor of newborn health and survival and is associated with higher risk of infant and childhood mortality.</p> <p><strong>Objective: </strong>The objective of this study was to assess the maternal and socio-demographic factors of low birth weight (LBW) newborns of mothers admitted at a teaching medical college hospital in Dhaka city of Bangladesh.</p> <p><strong>Methodology: </strong>This was a cross sectional study. Interview was taken by face to face interview and was focused to obtain the information about maternal weight at onset gestation, before delivery, educational, economical status of family, antenatal care visits, maternal exposure to hypertension and anaemia. Data had been collected from interview and medical records.</p> <p><strong>Results: </strong>This study revealed from multivariate liner regression analysis. In this model, birth weight had been considered as continuous variable and results had depicted the relationship of different maternal factors with birth weight. This study suggests that there were several factors which lead to LBW babies. The study shows ANC visits (p value 0.05), number of parity (p value .02) and hypertension (p value 0.02) had significant negative effect of on birth weight. Mothers who had taken less ANC visits, more chance of having LBW.Hypertensive mothers were at risk of having low birth weight babies than normotensive mothers. Number of parity was also found as a significant factor. Primi mothers were more prone to LBW.</p> <p><strong>Conclusion: </strong>This study suggests that less ANC visits, increase number of parity and hypertension have significant negative effect of on birth weight.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):47-52</p> 2019-03-27T10:07:50+00:00 ##submission.copyrightStatement## Status and Patients Satisfaction Attended at Emergency Department of a Tertiary Level Hospital in Dhaka City 2019-03-27T10:10:26+00:00 Khursheda Akhtar Md Mamun Or Rashid Khodeza Akhtar Ayesha Siddika Syeda Subrina Siddika <p><strong>Background: </strong>Emergency department is one of the most important parts of a hospital which is the point of major public health interest.</p> <p><strong>Objective: </strong>The purpose of the present study was to find out the existing facilities of emergency department, to assess the satisfaction of patients and health care providers on emergency services.</p> <p><strong>Method: </strong>This cross-sectional study was carried out at emergency department of Mugda Medical College, Dhaka, Bangladesh from January 2017 to June 2017 for a period of six (06) months. Research instruments were semi structured questionnaire. Existing facilities at emergency department were assessed by check list which was adopted from Table of Equipment (TOE) by Directorate General of Health Service (DGHS) and satisfaction level was categorized as good and bad. Face to face interview was taken from emergency patients and health care providers attending in emergency unit.</p> <p><strong>Result: </strong>A total of 75 samples of respondents were selected purposively. Most of the respondents (30.0%) were in 26 to 35 years age group. According to their education level, 24(48.0%) were illiterate. Most of the respondents (76.0%) were attended to emergency unit by walking; however 48(96.0%) respondents attended by health care providers immediately. Half of the patients (50.0%) buy drugs from local dispensary and investigation in hospital was also done by half of the patients. After reaching at emergency, maximum patients 25(50.0%) waited for 1 to 5 minutes for receiving medical attention and mean waiting time was 10.14 minutes. Overall satisfactory level at emergency unit was good 23(46.0%) and bad 27(54.0%) (p&lt;0.0001).</p> <p><strong>Conclusion: </strong>Numbers of potential barriers influence the patients’ satisfaction. Periodic patient satisfaction survey should be institutionalized to provide feedback for continuous quality improvement.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):53-58</p> 2019-03-27T10:08:00+00:00 ##submission.copyrightStatement## Genetics of Type 2 Diabetes: A Review 2019-03-27T10:10:05+00:00 Md Fakruddin <p>Diabetes Mellitus (DM), one of the most non-communicable diseases, is increasing day by day in an alarming way. More than 140 million people are suffering from diabetes throughout the world. It is not a single disease entity, but rather a group of metabolic disorders sharing the common underlying feature of hyperglycemia. Hyperglycemia in diabetes results from defects in insulin secretion, insulin action, or, most commonly, both. The chronic hyperglycemia and attendant metabolic deregulation may be associated with secondary damage in multiple organ systems, especially the kidneys, eyes, nerves, and blood vessels. The pathophysiology of diabetes is not fully elucidated. Insulin secretory dysfunction and insulin resistance or both is main candidate for this metabolic disorder, moreover various genetic and environmental factors may also involve in this process. Racial variations play also an important role as evidenced by various studies. However, the interrelationships between the molecular and metabolic mechanisms in these parameters contributing this life threatening disease still remain a mystery to the scientists.</p> <p>Journal of Current and Advance Medical Research 2019;6(1):59-63</p> 2019-03-27T10:08:09+00:00 ##submission.copyrightStatement## Isovaleric Acidemia in a 5 Years of Boy: A Case Report 2019-03-27T10:10:07+00:00 Nazmul Haque Narayan Saha Md Badrul Alam Quazi Deen Mohammad Sk Azimul Hoque Ariful Islam Yamin Shahriar Chowdhury Bithi Debnath <p>Isovaleric acidemia (IVA) is an autosomal recessive disease of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase (IVD). In this case report a five years old boy was admitted to National Institute of Neurosciences and Hospital, Dhaka Bangladesh with the history of fever, cough, vomiting, diarrhea, stupor and extreme sleepiness for 3 days. Second degree consanguinity was documented between the parents. Neurological examination revealed exaggerated reflexes and ankle clonus was present bilaterally. EEG and MRI of brain had normal results. Urine organic acid analysis by gas chromatography-mass spectrometry showed slight increment in concentration of 3 hydroxyisovaleric acid and an elevated concentration of isovalerylglycine. Tandem mass spectrometry of acylcarnitines in dried blood spots showed elevated C5-carnitine isovalerylcarnitine (10.3umol/l). Based on history, clinical examination and laboratory results, a diagnosis of isovaleric academia was ascertained. Patient was treated accordingly with rehydration fluid, correction of metabolic acidosis, antibiotic and supportive care</p> <p>Journal of Current and Advance Medical Research 2019;6(1):64-66</p> 2019-03-27T10:08:18+00:00 ##submission.copyrightStatement##