A professional medical journal recognized by the Bangladesh Medical and Dental Council (BM&DC).
Association of Serum Leptin Level with Preeclampsia
Introduction with Objective: The aim of the present study was to assess the association of serum leptin level with preeclampsia. Materials and Methods: This cross-sectional study was conducted from March 2022 to February 2023 in the department of Laboratory Medicine, Fetomaternal Medicine and Obstetrics and Gynaecology, BSMMU. A total 80 cases were selected as study population as per inclusion and exclusion criteria. They were grouped as preeclamtic (group I) and normal pregnant women of more than 20 weeks of gestation (group II). After taking written informed consent, 2.0 ml of random venous blood and 24 hours urine for protein were collected. Serum leptin level was estimated in Laboratory Medicine department and 24 hours urinary protein measured in Biochemistry and Molecular Biology department. After data collection and processing, all statistical analysis were done by SPSS software windows version 26. Result: The mean serum leptin level was found 28.3±12.52 ng/ml in group I and 14.24±5.10 ng/ml in group II. The difference was statistically significant (p 0.001) between two groups in unpaired t-test. Mean 24 hours urinary protein was 0.33±0.03 gm and 0.12±0.13 gm in group I and II respectively and the difference was statistically significant (p in unpaired t-test. There was positive linear relationship between 24 hours urinary protein and serum leptin level (r=+0.225, p>0.05) found in Pearson’s correlation co efficient test. In ROC curve analysis, cut off value of serum leptin was found 21 ng/ml with 80% sensitivity and 90% specificity. The area under curve (AUC) of serum leptin level was 0.904. In our study, 32 preeclampsia patients (80%) had serum leptin level was ≥21 ng/ml which considered positive This finding of the study revealed that increased serum leptin level was associated with preeclampsia. Conclusion: Serum leptin level was increased in preeclamptic study group compared to normal pregnancy. Serum leptin level may be used as a biomarker of preeclampsia to help the clinicians for diagnosis. Medicine Today 2025, Vol.37 (2): 160-163
Comparison of Non-albuminuric and Microalbuminuric Diabetic Patients
Introduction with Objective: The aim of the present study was to compare the Non-albuminuric and microalbuminuric Diabetic Patients. Materials and Methods: This comparative study was conducted in the Department of Laboratory Medicine, BSMMU, Shahbagh, Dhaka. The duration of the study was from June 2022 to February 2023. Diagnosed patients with diabetes mellitus who fulfill the inclusion and exclusion criteria were selected as the study population. After data collection and processing, all statistical analysis was done by SPSS software windows version 26. Result: Majority of microalbuminuric subjects (n=17, 37%) were 60-69 years. Male patients were suffering from more microalbuminuria. Mean (±SD) BMI of non-albuminuric and microalbuminuric subjects were 23.76±4.18 kg/m2 and 23.90±3.50 kg/m2 respectively. Mean(±SD) disease duration was 6.63±1.37 years in non-albuminuric and 7.41±1.73 years in microalbuminuric subjects. The difference of disease duration was statistically significant between non-albuminuric & microalbuminuric subjects (p<0.018). Mean value of HbA1c was 6.92±1.77 in non-albuminuric and 7.27±1.58 in microalbuminuric study subjects which was statistically not significant. Mean serum creatinine level in non-albuminuric and microalbuminuric subjects were 1.33±0.33 and 1.45±0.37 respectively and e-GFR level in non-albuminuric and microalbuminuric subjects were 57.4±21.3 and 55.8±24.1 respectively. Serum creatinine and e-GFR level between the non-albuminuric and microalbuminuric study subjects were statistically significant. Conclusion: Prevalence of microalbuminuria showed statistically significant association with age, duration of diabetes, serum creatinine and e-GFR level. Medicine Today 2025, Vol.37 (2): 164-166
Leveraging Social Media for COVID-19 Vaccine Uptake in Urban Dhaka: A Public Sector Management Perspective
Introduction: The COVID-19 pandemic posed unprecedented challenges for the public health system worldwide, affecting low and middle-income countries like Bangladesh severely. In Dhaka, dense urban settlements, widespread miscommunication, and fear of the vaccine hindered the success of early vaccination. Traditional media did not reach the poor, so the Directorate General of Health Services (DGHS) had to make use of social media tools to promote the use of vaccines. Materials and Methods: This qualitative study spans Dhaka, Bangladesh, from January 2021 to December 2022. It analyses secondary data sources, including government reports, peer-reviewed journals, and social media. The digitally engaged urban youth, middle-class homes, and digitally excluded groups like slum dwellers and the elderly population are some of the targeted populations. Discussion: Social networking sites, primarily Facebook, YouTube, and Twitter, were instrumental in disseminating culturally appropriate, geolocated vaccine messages. The "Tika Dibo" campaign raised awareness and pushed registration via the 'Surokkha' app, particularly among digitally literate youth. However, digital marginalization, limited monitoring of disinformation, and decentralized campaign management capped the overall effect. Strategic constraints included inadequate real-time feedback loops and no tailored communication for marginalized groups. Conclusion: Social media is a promising medium for low-cost and scalable public health outreach in urban LMIC settings. However, for optimal impact, online campaigns must be complemented by inclusive access strategies, timely monitoring of data, and better institutional coordination. Bangladesh’s experience offers important lessons for integrating social media into mainstream, long-term public health planning beyond emergency response contexts. Medicine Today 2025, Vol.37 (2): 167-170
Sonographic Measurements of Portal Vein Diameter of Healthy Adult in Sylhet, North East Part Bangladesh.
Introduction with Objective: Portal vein diameter is important in portal hypertension. So this study was designed to see portal vein diameter among healthy adult. Materials and Methods: Consecutive healthy (nondiabetic, normotensive without clinical, biochemical and sonological evidence of liver disease) were enrolled. Portal vein diameter in resting, inspiratory and expiratory phases were recorded. Average of data of resting, inspiratory and expiratory diameters were calculated. And average of all three diameters of each person were taken as mean portal vein diameter. Relation of portal vein diameters with age, sex, BMI and abdominal circumference were calculated using SPSS version 20. Result: Total 237 (male 135; 57.0% and female 102; 43.0%, age ranging from 18 years to 93 years, mean 38.19) were enrolled. The mean portal vein diameter was 8.81 mm ranging from 6.1 mm to 13 mm for both sexes. Portal vein diameter was significantly higher among males (mean 9.06 mm vs 8.47mm; P=0.003). Within females portal vein diameter varied significantly with BMI. Conclusion: The mean portal vein diameter in our study was 8.81 mm (ranging from 5 mm to 13 mm. So higher diameter may give suspicion for raied portal vein pressure. Medicine Today 2025, Vol.37 (2): 171-173
Correlation of TIMI Risk Score with Gensini Score in Angiographic Study in Patients with Non–ST-Elevation Myocardial Infarction
Introduction: Coronary artery disease (CAD) becomes a major cause of death. CAD is an atherosclerosis process, which progressively develops into plaque that will lead to stenosis of coronary artery lumen. Several studies found that Thrombolysis in Myocardial Infarction (TIMI) risk score is an significant marker of the severity of coronary artery disease. Objectives: To see the correlation between TIMI risk score and Gensini score in patient with Non-ST segment elevation myocardial infarction. Materials and Methods: This cross-sectional observational study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from 1st September 2018 to 31st August 2020. Total 73 patients with NSTEMI who underwent coronary angiography (CAG) were selected. Patients were divided in two groups: Group A = TIMI score ≤4 and Group B = TIMI score >4. Coronary angiography was performed by experienced interventional cardiologist to assess severity of CAD. Angiographic severity was assessed by Gensini score. Results: This study was conducted on total 73 patients. Age of the patients ranged from 21 to 70 years with the mean age of 51.08 ± 11.11 years. Among them 55 (75.3%) patients were male and 18 (24.7%) patients were female. Total 45(61.6%) patients were in group-A and 28 (38.4%) patients were in group-B. Mean TIMI risk score was 2.89 ± 1.05 in group-A and 5.71 ± 0.76 in group-B. Majorities of the patients in high TIMI risk score group had hypertension, diabetes, dyslipidaemia and history of smoking but most of them had no family history of CAD. Mean Gensini score was 20.47± 18.27 in group-A and 35.00 ± 25.04 in group-B, the difference was significant (p=0.006). There was a positive linear correlation between TIMI risk score and Gensini score (r=0.497; p= <0.001). Conclusion: This study demonsrated that TIMI risk score has positive correlation with Gensini Score in angiographic study in patients with NSTEMI. Medicine Today 2025, Vol.37 (2): 174-178
Clinicopathological Evaluation of Asymptomatic Bacteriuria in Diabetes Mellitus Patients
Introduction: Asymptomatic bacteriuria (ASB), or asymptomatic urinary infection, is isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs referable to urinary infection. Patients with diabetes mellitus (DM) have a high frequency of ASB and urinary tract infections (UTIs). High glucose concentration in the urine of DM patients may favour the growth of uropathogens. Early detection, strict glycemic control and proper treatment prevent the burden of asymptomaticbacteriuria. Objectives: To observe the frequency of asymptomatic bacteriuria and common isolates among diabetic patients. Materials & Methods: This cross-sectional study was conducted amongst diabetic patients from March 2016 to December 2016. Sample was selected by purposive sampling technique. Patients with DM were selected for study. Sample size was 72. Mid-stream urine samples collected into sterile container for urinalysis. Cultures with colony counts ≥ 105cfu/ ml were considered as significant bacteriuria. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously. Result: Mean age of patients was 56.04±18.08 yrs. Female patients were predominant, out of 72 cases 32(44%) were male and 40(56%) were female. Present study showed that ASB was present in 57(79.16%) patients and E. coli was the most common pathogen. Other isolates included Klebsiella pneumoniae 11(19.29%), Proteus sp. 6(10.52%) and Enterobacter sp. 5(8.77%). Conclusion: Asymptomatic bacteriuria is common in DM patients. The occurrence of ASB in the older population and females was significant in this study. ASB may lead to albuminuria and urinary tract infection, and may warrant treatment in diabetics. So it is recommend screening for detection and treatment of ASB in diabetic patients should be routinely. Medicine Today 2025, Vol.37 (2): 179-182
Socio-Demographic Characteristics of Musculoskeletal Pain and Patients' Perceptions of Physical Therapy
Introduction: Musculoskeletal pain is a major cause of disability, affecting joints, bones, muscles, and soft tissues, with prevalence increasing with age. Socio-demographic factors such as age, gender, occupation, and income influence patients' experiences and satisfaction with physical therapy. Understanding these perceptions is essential for improving treatment outcomes and patient satisfaction. Physical therapy, which includes modalities like thermotherapy and electrotherapy, aims to alleviate pain and enhance recovery. Objective: To find out the patients’ perception on physical therapy treatment of musculoskeletal conditions. Material and Methods: This cross-sectional study was conducted over a one-year period from February 1, 2018, to January 31, 2019, to assess patients' perceptions of physical therapy treatment for musculoskeletal conditions at the Department of PM&R, BSMMU, Dhaka. The study focused on patients with musculoskeletal pain who sought physical therapy, adhering to specific inclusion and exclusion criteria. Results: The study included 150 patients with a mean age of 40±14.02 years, most of whom were aged 41-50 years. Of the patients, 68% were male and 32% female. The majority lived in Dhaka (42.7%), with 30.7% from semi-urban areas and 26.7% from nearby villages. Marital status showed 80% married and 17.3%unmarried. Most patients received thermotherapy, with 71.3% completing therapies within 10 minutes. Satisfaction levels were generally positive, with 65.3% satisfied with exercise instructions and 66.0% with facilities. Conclusion: This study reveals that most participants were middle-aged males, primarily from the middle-class, with a notable number being housewives. While overall satisfaction with physical therapy services, facilities, and equipment was high, complete satisfaction was less common, particularly with exercise instructions and equipment. Although a few patients deemed the treatment cost unreasonable, the majority were pleased with the environment and privacy measures. Notably, nearly all patients expressed a willingness to continue therapy at the center, reflecting a general satisfaction with the services offered, despite some opportunities for enhancement. Medicine Today 2025, Vol.37 (2): 183-188
Socio-Demographic Characteristics of Breast Cancer Patients in Bangladesh: A Single Centre Study
Introduction: Breast cancer is a significant public health concern worldwide and has a significant impact on individuals, families, and society. While progress has been made in the diagnosis, treatment, and prevention of breast cancer, there is still much to be learned about the disease and its impact on patients. The objective of the study was to find out the socio-demographic characteristics of breast cancer among women in a selected cancer specialized hospital in Dhaka city. Materials and Methods: This cross-sectional Study was carried out among 108 patients attending at the department of Oncology at Delta Medical College Hospital; Dhaka for the treatment of breast cancer within the defined period from January 2022 to December 2022. All the data were compiled and sorted properly and the quantitative data was analyzed statistically by using Statistical Package for Social Science. Result: Majority of the breast cancer patients (32.41%) were within the age range of 50-59 and 40-49 years. The most common weight for the breast cancer patients was in the range of 40-50 kg with frequency of 43(39.81%). Most of the respondents have come from urban areas with a frequency of 63 (58.33%). Most of the breast cancer patients were housewives (n=61, 56.48%) followed by service holders (n= 30, 27.78%). Most of the patients (n=94, 87%) were married. Most of the women were Muslim (87%). Family history was positive for 61 patients (56.48%). Out of 108 patients, 63 of the respondents had diabetes (58.3%). Out of the 108 respondents having breast cancers, 61 (56.5%) reported not using contraceptive pills, whereas 47 (43.5%) used contraceptive pills. Only 22.22% breast cancer patients used hormone replacement therapy. Out of 108 breast cancer patients, having exposure to X-ray was with frequency 44 (40.74%) and having no X-ray exposure was with frequency 64 (59.26%). Most of the breast cancer patients (n=70, 64.81%) were prone to betel-nut chewing habit. The highest frequency was 58 (53.7%) who were having daily 2 cups of tea which was followed by 3 cups of tea 25 (23.15%). Most of the respondents (n= 67, 62.04%) were prone to taking added salt consumption. 48 (44.44%) of the respondents had red meat for more than one time in a week. For the breast cancer patients, having no alcohol consumption was the higher number (n=61, 56.48%), whereas the alcohol consumption number was 47 (43.52%). Conclusion: In our study breast carcinoma was more common within the age range of 50-59 and 40-49 years. Regular screening of this age group through mammography will helps to early detection of breast carcinoma. Medicine Today 2025, Vol.37 (2): 189-192
Comparative Analysis of Oral Cavity Carcinoma in Smokers vs. Non-Smokers
Introduction: Oral cavity carcinoma (OCC) is a significant health concern, with smoking being a major risk factor. It involves malignancies affecting intraoral structures like the tongue, lips, and gums. Tobacco smoke contains carcinogenic compounds that contribute to DNA damage and oncogenic transformations. This study compares OCC in smokers and non-smokers, focusing on prevalence, progression, and prognosis, to highlight the differences in clinical presentation, histopathology, and outcomes. Objectives: To compare clinical features, tumor sites, staging, histopathology, and treatment outcomes of oral cavity carcinoma in smokers and non-smokers. Method and Materials: This comparative cross-sectional study was conducted at BSMMU from July 2016 to June 2018, involving 120 patients diagnosed with oral cavity carcinoma. Participants were divided into two groups: smokers (60) and non-smokers (60). Data on clinical presentation, tumor staging, and treatment outcomes were collected. Statistical analysis was performed using SPSS, with descriptive and comparative methods to evaluate significant differences between groups. Results: The study included 120 participants with a mean age of 48.2 ± 12.3 years. Of these, 66.7% were male, and 50% were smokers. Smokers reported more pain (83.3%), ulceration (75%), and difficulty eating (58.3%) compared to non-smokers. The tongue was the most common tumor site in smokers (50%). Smokers showed higher rates of advanced-stage cancer, with 41.7% in Stage II. Squamous cell carcinoma was predominant in both groups. Non-smokers had better remission outcomes (66.7% vs. 50%). Conclusion: Smokers with oral cavity carcinoma exhibited more advanced stages, while non-smokers were more likely to present with early-stage cancer. Medicine Today 2025, Vol.37 (2): 193-197
Management of Inferior Turbinate Hypertrophy: A Comparative Study between Partial Inferior Turbinectomy (PIT) and Submucosal Diathermy (SMD)
Introduction: Symptomatic hypertrophy of the inferior turbinate is a common complaint in ENT outpatient departments. When medical management fails, surgical intervention becomes necessary. Among the various surgical options, partial inferior turbinectomy (PIT) and submucosal diathermy (SMD) are widely used for managing inferior turbinate hypertrophy. Objectives: To compare the clinical outcomes of PIT and SMD in a tertiary care setting. Materials and Methods: This prospective randomized comparative study was conducted at the Department of Otolaryngology and Head-Neck Surgery, Rajshahi Medical College Hospital, from December 2016 to November 2017. Sixty patients (aged 18–60 years) with bilateral inferior turbinate hypertrophy unresponsive to medical treatment were enrolled. After informed consent, they were randomly assigned to two groups: Group A (n=30) underwent PIT, and Group B (n=30) underwent SMD. Postoperative symptoms such as nasal obstruction, pain, bleeding, and crust formation were assessed at 2 days, 2 weeks, and 2 months. Data were analyzed using SPSS-23. Results: There were no significant differences in age, sex, socioeconomic status, or body weight (p>0.05) between groups. Group A showed significantly greater improvement in nasal obstruction at 2 weeks (80.0% vs 53.3%) and 2 months (86.7% vs 63.3%). Mild pain after 2 weeks was more prevalent in Group B (56.7% vs 23.3%). Postoperative bleeding was significantly less in Group B after 2 days (10.0% vs 33.3%), while crust formation was higher in Group A at 2 weeks (73.3% vs 43.3%). Conclusion: PIT was more effective in relieving nasal obstruction, whereas SMD had a better safety profile regarding postoperative bleeding and pain. Medicine Today 2025, Vol.37 (2): 198-203
Risk Factors for Breast Cancer among Patients in a Tertiary Care Hospital, Khulna, Bangladesh
Introduction: Breast cancer is the leading cause of cancer-related mortality among women worldwide. While the burden is rising in low- and middle-income countries, data on associated risk factors remain limited, particularly in Bangladesh. Aim of the study: This study aimed to identify and evaluate sociodemographic, anthropometric, lifestyle, and reproductive risk factors for breast cancer in Bangladeshi women attending tertiary care hospitals. Materials and Methods: Over one year, this prospective observational study investigated breast cancer risk factors among 85 women treated at the Department of Surgery, Khulna Medical College Hospital, Khulna, Bangladesh from June 2021 to July 2024. Ethical approval and informed consent were obtained. Participants met specific inclusion criteria, including histologically confirmed breast cancer and age ≥18, while those with other cancers, mental disorders, or chronic diseases were excluded. Data were collected via structured interviews and physical examinations, considering age, BMI, menarche, first live birth, family history, menopausal status, and prior breast surgery. SPSS 26.0 was used foranalysis, applying logistic regression to identify risk factor associations with statistical significance set at p<0.05. Result: Women aged >60 years had significantly lower odds of breast cancer (AOR: 0.40, 95% CI: 0.20–0.80, p=0.01) compared to those <39 years. Unemployment (AOR: 1.50, 95% CI: 1.00–2.30, p=0.05) and urban residence (AOR: 1.50, 95% CI: 1.00–2.30, p=0.05) were associated with higher risk. Overweight (BMI 25–29.9 kg/m²) and obesity (BMI ≥30 kg/m²) significantly increased the odds of breast cancer. Lifestyle factors, including diet, smoking, and alcohol intake, showed no significant associations, while physical activity demonstrated a potential protective effect. Conclusion: Sociodemographic and anthropometric factors, such as unemployment, urban residence, and higher BMI, were significantly associated with breast cancer risk in this population. Lifestyle and reproductive factors did not show strong associations. These findings highlight the need for targeted interventions to address modifiable risk factors and improve early detection strategies in Bangladesh. Medicine Today 2025, Vol.37 (2): 204-208
Management of Congenital Talipes Equino Varus by Ponseti Technique: Our Experience
Introduction: Clubfoot is a crippling ailment that can cause children to walk abnormally. The Ponseti treatment technique is utilized to treat children with congenital clubfoot. This study aims to determine the percentage of clubfoot children who benefit from the Ponseti approach and assess its efficacy. Objective: This research aims to assess the effectiveness of the Ponseti approach in the treatment of congenital Talipes Equino Varus (CTEV) in the neonatal age range. Materials and Methods: Between July 2022 and December 2022, a prospective observational study was conducted at the 250-bed municipal hospital in Gopalganj and the Sheikh Sayera Khatun Medical College hospital in Gopalganj. Every baby with CTEV was treated with Ponseti casting. Results: A total of 100 newborns and 155 CTEV feet were treated. There were thirty-four females and sixty-six males. There were sixty feet (38.71%) of non-rigid variety and ninety-five (61.29%) of stiff variation. 45 patients had unilateral involvement and 55 had bilateral involvement. The study group's mean pre-treatment Pirani score was 5.57. 150 feet (96.77%) of the 155 total feet were successfully managed. Conclusion: the Ponseti approach is a great, easy-to-use, minimally invasive method of treating CTEV deformity. Ideally, it can be performed as a day-case procedure without general anesthesia even in the neonatal period. Medicine Today 2025, Vol.37 (2): 209-213
Morphology and Treatment of Tibial Fracture in Adult Patients at Teaching and Referral Hospital
Introduction with Objective: Tibia fractures are the most common long bone fractures in adult. The aim of the present study was to assess the morphology and treatment of tibial fracture in adult patients at a tertiary hospital. Materials and Methods: This Prospective Study was carried out among 48 patients attending at the department of Orthopedics Surgery at Chittagong Medical College Hospital, Chittagong for the treatment tibial fracture within the defined period from May 2022 to April 2023. Total 4 patients were dropped out in the middle of follow up. So follow up was done among 44 patients. All the data were compiled and sorted properly and the quantitative data was analyzed statistically by using Statistical Package for Social Science. Result: Out of 48 patients, the mean ± SD age of the patients was 36.98 ± 8.240 years. Most of the patients (83.33%) were male. According to type of fracture, 45.8% patients had both 42A (1, 2, 3) and 42B (2, 3) type and 8.3% patients had 42C (3) type of fracture. Regarding location of fracture, 52.1% patients had proximal 1/3 of shaft fracture and 47.9% patients had middle 1/3 of shaft fracture of Tibia. Average mean ± SD duration of operation was 83.25 ±10.903 minutes (range: 60-110 minutes). Average mean ± SD fluoroscopy time was 110.48 ±10.078 seconds (range: 90-134 seconds). Average mean ± SD radiological union time was 3.44 ±0.841 months (range: 3-5 month). Average mean ±SD range of motion (ROM) was 110.00 ±2.753o (range: 105-115o) after 1 month, 120.66±5.048o (range: 113-128o) after 3 months, 124.11±4.260o (range: 118-130o) after 5 months and 128.11±3.294o (range: 123-133o) after 6 months. Average mean ±SD range of Lysholm knee score was 57.55 ±2.256 (range: 55-62) after 1 month, 67.00 ±3.941 (range: 60-73) after 3 months, 77.50 ±5.364 (range: 70-86) after 5 months and 86.64 ±5.545 (range: 72-95) after 6 months. After operation with itramedullary nail approach most of the patients (79.5%) functional outcome after six month was excellent. Conclusion: Treatment of tibial fracture was mainly surgical using locked intramedullary nail. Medicine Today 2025, Vol.37 (2): 214-217
Generalized Anxiety Disorder and Sleep Quality of Day Laborers during COVID-19 Pandemic
Introduction: Since December 2019, Coronavirus Disease (COVID-19) has had a significant impact on the world. It had severe economic repercussions in Bangladesh. The lockdown had interfered with the production, availability, and supply of enough food. As a result, food prices have increased, making it harder for low-income individuals, such as day laborers, to survive. Aims and objectives: The purpose of the study was to determine the level of generalized anxiety disorder (GAD) and evaluate the association between sleep quality and GAD among day laborers during the COVID-19 pandemic. Materials and Methods: This cross-sectional study was conducted among 227 construction workers, rickshaw pullers, van pullers, and other day laborers from the Faridpur district. Participants were conveniently selected and interviewed in person using a semi-structured questionnaire, with data collection taking place at their convenience from January to December 2020. Results: The majority of respondents reported minimal anxiety (75.3%), followed by mild anxiety (14.5%), moderate anxiety (9.7%), and severe anxiety (0.4%). most respondents had good sleep quality (74.4%), while 25.6% experienced poor sleep quality. A strong positive correlation was observed between GAD scores and sleep quality scores (p<0.05). A significant association was found between anxiety and sleep quality, with higher levels of anxiety linked to poorer sleep quality. Factors such as age, marital status, smoking, and years of work experience were significantly associated with sleep quality (p<0.05). Unmarried participants were more likely to report poor sleep, potentially due to fewer family-related responsibilities compared to their married counterparts. Conclusion: This study revealed that day laborers during the COVID-19 pandemic had a significant mental health charges. It should be widespread procedure to continuously monitor and assess the psychological effects of the day workers during this period. Medicine Today 2025, Vol.37 (2): 218-224
Clinical Profile and Etiology of Children Presenting with Prolonged Fever in a Tertiary Care Hospital
Introduction: Prolonged fever in children, defined as fever persisting for ≥10 days without an initially identifiable cause, is a common yet diagnostically challenging clinical presentation, especially in resource-limited settings. Aim of the study: To determine the common causes of prolonged fever and its clinical presentation and outcome which may guide to narrow the diagnostic approach. Materials and Methods: A prospective observational study was conducted on 86 children aged 1 year to 12 years admitted with prolonged fever. Detailed history, clinical examination, and a stepwise diagnostic protocol—including baseline and targeted investigations—were used to determine underlying causes. Result: The majority were aged between 5 to 10 years (43.02%), followed by 1–5 years (33.72%) and 10-12 years (23.25%). In terms of gender males are predominate (56.97%). The common identifiable causes were Rickettsial fever (31.40%), Leukemia& lymphoma (11.63%), Enteric Fever (10.46%) and Bronchopneumonia (10.46%). In 6.97% of cases, the cause of prolonged fever remained undiagnosed. The most common associated clinical features included chills or rigors (43.02%), Pallor (36.05%), hepatomegaly (26.74%), cough (23.25) and vomiting (20.93%). Categorization of the diseases showed infectious cause predominant (73.25%) then malignancy (13.95%) and connective tissue /autoimmune disease (5.81%). Most hospital stays ranged from 8 to 14 days (50.00%), during which 86.04% recovered, 11.62% were referred, and one death occurred. Conclusion: Infectious diseases remain the predominant cause of prolonged fever in children in low-resource settings. However, a notable proportion had non-infectious or undiagnosed etiologies, highlighting the need for a structured, multi-tiered diagnostic approach. Early recognition and context-specific management strategies are essential to improve outcomes. Medicine Today 2025, Vol.37 (2): 225-229
Physical Examination Findings of Painful Shoulder
Introduction with Objective: Shoulder pain and weakness are common complaints among patients, which can lead to disability and affect a person’s ability to perform daily activities. The aim of this study was to identify the physical examination findings of painful shoulder. Materials and Methods: This Prospective Observational Study was carried out among 101 patients attending at the Department of Physical Medicine and Rehabilitation, Dhaka Medical College and Hospital (DMCH), Dhaka within the defined period from July 2021 to December 2021. Ethical clearance was obtained from the Institutional Review Board (IRB) of Dhaka Medical College Hospital. Purposive sampling was done according to availability of the patients. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-20.1). Results: Majority of the patients (59.4%) were in 41-50 years age group where the mean age of the patients was 50.3 ± 7.9 years and 51 (50.5%) patients were male. Majority of the patients (59.4%) had shoulder pain on right shoulder. In case of active movement, the mean external rotation (in abduction) of the patients was 69.1 ± 17.5 and the mean forward flexion was 153.9 ± 17.2. On the other hand, in case of passive movement, the mean external rotation (in abduction) of the patients was 73.6 ± 15.2 and the mean forward flexion was 160.7 ± 13.7 On physical examination, 76 (75.2%) patients were Neer tests positive, 62 (61.4%) were Jobe’s test for supraspinatus positive and 37 (36.6%) were Yegarson’s test for the long head of the biceps brachii positive. Most of the patients (93.1%) were Patte’s test for infraspinatus negative. Conclusion: Appropriate physical examination of the shoulder is important for making an accurate diagnosis and distinguishing certain pathologies of the shoulder. Medicine Today 2025, Vol.37 (2): 230-232
The Outcome of Percutaneous Nephrolithotomy (PCNL) in the Management of Large Upper Ureteric Stone
Introduction with objective: Urolithiasis, a prevalent urologic condition affecting 10-15% of the population, poses significant challenges, particularly in impoverished nations where complications such as urosepsis and renal failure contribute to elevated morbidity rates. The surgical management of stone disease has evolved from traditional open procedures to include non-invasive and minimally invasive techniques, driven by factors such as stone location and size. Percutaneous nephrolithotomy (PCNL) introduced in 1955, revolutionized the approach to kidney stones, and its popularity has grown, especially for larger kidney stones and upper ureteric stones. The aim of this study was to observe and assess the outcomes of percutaneous nephrolithotomy in managing large upper ureteric stones. Materials and Methods: This prospective observational study was carried out among 35 patients attending at the department of Urology at Sir Salimullah Medical College Mitford Hospital, Dhaka for the treatment of upper ureteric stone within the defined period from January 2019 to December 2020. All the data were compiled and sorted properly and the quantitative data was analyzed statistically by using Statistical Package for Social Science. Result: The clinical features of patients who underwent PCNL were analyzed, revealing a mean stone size of 20.05 mm, an operative time of 90.17 minutes, and a postoperative hospital stay of 1.80 days. The distribution of stones on the right and left ureters was 51.40% and 48.60%, respectively, with a stone clearance rate of 97.1% and a 2.9% incidence of residual stones. The study further assessed postoperative complications, reporting per-operative complications in 28.6% of cases, including bleeding, pleural and renal pelvis injuries, and post-operative complications in 31.4%, such as fever, blood transfusion, and urinary leakage. Conclusion: Mean operative time, hospital stay was less. Comparative analysis revealed PCNL as a less morbid procedure, aligning with its established efficacy for stone clearance. The study contributes valuable insights into the clinical outcomes and complications associated with PCNL, offering considerations for its application in managing large upper ureteric stones. Medicine Today 2025, Vol.37 (2): 233-236
Effect of Ramadan Fasting on Cognitive Function of Physicians
Introduction: Effect of fasting on human cognition has been a topic of recent research. The results of those studies are contradictory at best. Moreover, fasting as a religious ritual for an entire holy month of Ramadan has many denominators that differs from other pattern of fasting. Data on cognitive functions of physicians during Ramadan is scarce. We had investigated the effect of Ramadan fasting on physicians who are actively engaged in treating patients. Materials and Methods: This was a cross-sectional study conducted on 53 doctors working in a teaching hospital. Basic and task specific data were collected 1 week before and during Ramadan. On each occasion, cognition of each participant was tested using Trail making Test (TMT) part A and B, Simple reaction time (SRT) and Stroop test. Independent and paired t-test and multiple regression analysis were used for statistical analysis of Data in SPSS with significance level set at 0.05 or lower. Result: Overall, Ramadan fasting had no significant impact on cognitive capabilities of the physicians. Female participants (67.9%) performed better in TMT A and B and increased age was related to poorer results in SRT, TMT A and B. Higher diastolic blood pressure was associated with higher TMT B score. Neither sleep nor the blood glucose had any significant impact on cognition during Ramadan. Conclusion: In our study we had found no impairment of cognitive functions of treating physicians from different age group and specialties due the religious fasting on the holy month of Ramadan. Medicine Today 2025, Vol.37 (2): 237-240
Time of Apyrexia after Azithromycin Therapy in Uncomplicated Childhood Typhoid Fever
Introduction with Objective: The aim of the present study was to assess the time of apyrexia after Azithromycin therapy in uncomplicated childhood Typhoid Fever. Materials and Methods: A cross sectional study was conducted in the Department of pediatrics, Dhaka National Medical College, Dhaka from July 2024 to October 2024. According to selection criteria one hundred subjects were selected with the age ranging from 1-12 years of either sex who was diagnosed as typhoid fever. Widal test positive was included for the study & specific antibiotic Azithromycin was started. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-20.1). Results: Most of the patients (n=51) belong to 6-8 years age group. Young male patients (52%) were more than the young female patients (48%). Majority of the patients (n=39) time of apyrexia after taking antibiotic was 4 days. Almost three fourth patients (75.0%) had nausea after taking antibiotic. Conclusion: Azithromycin is effective in the treatment of childhood typhoid fever. Majority of the patient’s time of apyrexia after taking antibiotic was 4 days. Medicine Today 2025, Vol.37 (2): 241-243
Incidence of Overweight in Plantar Fasciitis Patients
Introduction with Objective: Plantar fasciitis is a common condition causing heel and arch pain and has been related with degenerative changes in the plantar fascia resulting in tissue thickening. The aim of this study was to assess the incidence of overweight in plantar fasciitis patients. Materials and Methods: This cross-sectional study was conducted in the Department of Physical Medicine & Rehabilitation, Dhaka Medical College Hospital, Dhaka during February 2023 to March 2024. A total of 51 patients with plantar fasciitis were included in the study. Ethical clearance was obtained from the Ethical Review Committee of Dhaka Medical College Hospital. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-20.1). Results: The mean age of the patients was 46.6 ±4.3 years where majority of the patients (51.0%) were in 41-45 years age group and 27 (52.9%) patients were male. Among the 51 patients, 21 (41.2%) patients were homemakers whereas others were service holder (35.3%, n=18), businessmen (11.8%, n=6), and (11.8%, n=6) were involved in other professions. The mean BMI of the patients was 26.8 ±2.6 kg/m2 where 38 (74.5%) patients were overweight, while 5 (9.8%) were obese. Conclusion: Overweight is considered a significant risk factor for plantar fasciitis. Medicine Today 2025, Vol.37 (2): 244-246
Platelet Indices among Women with Pre-eclampsia attending at a Tertiary Care Hospital – A Case Control Study
Introduction: Pre-eclampsia (PE) is a pregnancy-specific hypertensive disorder characterized by endothelial dysfunction, increased systemic vascular resistance, platelet activation, and coagulation abnormalities. These changes can lead to serious complications for both mother and fetus. Platelets play a key role in vascular repair and primary hemostasis, and platelet indices—including plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR)—reflect changes in platelet morphology and activity. Alterations in these indices have been increasingly studied as potential early markers of pre-eclampsia. Typically, platelet count decreases while MPV and PDW increase, with more pronounced changes in PE than in normotensive pregnancies. These variations can appear 2–8 weeks before the clinical onset of PE. Aim: To compare platelet indices among women with pre-eclampsia and normotensive pregnant women to evaluate their potential as early indicators for the diagnosis of pre-eclampsia. Materials and Methods: This case-control study was conducted over 12 months (June 2023 to May 2024) in the Department of Gynecology & Obstetrics at the Institute of Child and Mother Health, following ethical approval. A total of 62 pregnant women were enrolled, including 31 women with pre-eclampsia (Group A) and 31 normotensive pregnant women (Group B) as controls. After informed consent, clinical data and laboratory values were collected using structured case-record forms and analyzed with SPSS version 26. Results: Most participants were aged 21–30 years (67.7% in cases vs. 58.1% in controls, p=0.632). Systolic and diastolic pressures were significantly higher in cases. Platelet indices showed significant differences: MPV (10.58 ± 1.48 vs. 8.42 ± 1.09 fl), PDW (12.84 ± 1.53 vs. 11.19 ± 1.38 fl), P-LCR (25.97 ± 4.00% vs. 22.19 ± 2.89%), and PCT (0.2485 ± 0.0360% vs. 0.2175 ± 0.0279%) were all elevated in pre-eclamptic women (p<0.05). Conclusion: Platelet indices- especially MPV, PDW, P-LCR, and PCT—were significantly elevated in women with pre-eclampsia compared to normotensive pregnant women. These markers may serve as early, cost-effective indicators for the prediction and monitoring of pre-eclampsia. Larger prospective studies are needed to validate these findings. Medicine Today 2025, Vol.37 (2): 247-251
Over-the-Counter Medication Use without Prescription Trends in Dhaka City: A Cross-Sectional Survey
Introduction: Self-medication with over-the-counter (OTC) drugs is rising in urban Bangladesh, raising concerns over misdiagnosis, side effects, and antibiotic resistance. Data on such practices among diverse adult populations in Dhaka City remain limited. Objectives: To estimate the prevalence of OTC medication, use without prescription, identify motivations, characterize ailments and drug categories, and examine demographic predictors. Methods: A cross-sectional survey was conducted from March to May 2025 among 400 adults in Dhaka using multistage cluster sampling. A semi-structured questionnaire captured demographic data, self-medication practices, types of ailments, drug classes, sources, motivations, and knowledge. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression. Results: Of 400 participants (mean age 26.5 ± 8.3 years; 52% female), 83.0% reported self-medication in the past three months. Major reasons included quick relief (40.0%), lack of time (27.5%), minor illness perception (21.3%), and high consultation cost (16.8%). Common ailments were fever/headache (24.8%), gastric issues (22.3%), and respiratory symptoms (14.0%). Frequently used OTC drugs included NSAIDs (33.0%), antacids (20.5%), antibiotics (17.5%), and antipyretics (13.0%). Pharmacies were the main source (78.3%), with influences from peers (45.1%) and old prescriptions (42.2%). Male gender, higher education, and student status were significant predictors (p < 0.05). Conclusions: OTC self-medication is highly prevalent in Dhaka, driven by convenience and accessibility. Misuse of NSAIDs and antibiotics signals urgent need for regulatory control, public education, and affordable healthcare options. Medicine Today 2025, Vol.37 (2): 252-257
Risk Factors & In-Hospital Outcome of Acute ST Segment Elevation Myocardial Infarction among Young (<40 Years) versus Older (>40 Years) Patients: A Comparative Study
Introduction: Acute coronary syndrome (ACS) is a global health issue that causes premature death, disability, and rising healthcare costs. Younger people are now experiencing acute myocardial infarction (AMI), which is usually seen in older adults. Unfortunately, public awareness of AMI, its risk factors, and complications is low. Youthful coronary artery disease (CAD) prevalence and outcomes are also unknown. This study compares risk factors and in-hospital outcomes of acute ST-segment elevation myocardial infarction (STEMI) in younger (≤40 years) and older (>40 years) patients. Material and Methods: An observational, hospital-based study was conducted at the Department of Medicine, Khulna Medical College Hospital. The study included 100 consecutive patients, with 50 patients aged 40 years or younger and 50 patients older than 40 years, all diagnosed with acute STEMI. Clinical characteristics, echocardiographic findings, and in-hospital outcomes were evaluated and compared between the two age groups. Data analysis was carried out using SPSS (Statistical Package for Social Science), with statistical significance determined at a p-value ≤0.05, applying the Chi-square test for analysis. Results: The majority of patients in both age groups were male (74% in the younger group vs. 80% in the older group). The younger cohort demonstrated a significantly higher prevalence of smoking (70% vs. 54%), a positive family history of ischemic heart disease (52% vs. 32%), dyslipidemia (48% vs. 36%), and a higher body mass index (BMI). Conversely, conditions such as hypertension (14% in the younger group vs. 80% in the older group), diabetes (20% vs. 46%), and a history of angina (16% vs. 28%) were more common among older participants. Notably, the left ventricular ejection fraction (LVEF) was significantly better in the younger group (p = 0.005). Complications such as heart failure (32% vs. 16%), arrhythmias (24% vs. 8%), cardiogenic shock (18% vs. 2%), post-MI angina (12% vs. 6%), and in-hospital mortality (14% vs. 6%) were more frequent in older patients, though these differences did not reach statistical significance. Conclusion: Young patients with AMI exhibit distinct risk profiles and generally have better in-hospital outcomes compared to their older counterparts. This study underscores the importance of early intervention and control of modifiable risk factors, such as smoking, poor diet, obesity, and dyslipidemia, to mitigate the incidence of AMI in younger populations. Medicine Today 2025, Vol.37 (2): 258-262
Microbial Infections in Patients Suffering from Burn Injuries: A Systematic Review
Polymicrobial infections are common in patients suffering from burn injuries. Hospitalized patients are at a heightened risk of contracting hospital-acquired infections and extended hospital stays raise the possibility of infection with resistant organisms. Pseudomonas aeruginosa, Proteus mirabilis, Acinetobacter baumannii, and Klebsiella pneumoniae are the most often found multidrug-resistant (MDR) Gram-negative bacteria in burn wound infections (BWIs). BWIs caused by Gram positive organism like Staphylococcus and Streptococcus are also prevalent. Fungi-like Candida species appear to occur also. Nonetheless, opportunistic pathogen infection is highly prevalent in burn victims. Variations in geographic location and infection control practices result in variations in the causal agents of BWIs. All things considered, increased serum cytokine levels, systemic immune response and immunosuppression are indicative of burn injuries. Therefore, prompt identification and intervention can quicken the healing of wounds and lower the chance of developing new infections at the site of injury. A multidisciplinary approach from infectious disease experts and burn surgeons is also required to effectively track antibiotic resistance in BWI pathogens, prevent the super-spread of MDR infections and enhance treatment results. Medicine Today 2025, Vol.37 (2): 263-268
The Capital Investment Structure of the Medicine Sector in Bangladesh
The capital investment structure of the medicine sector in Bangladesh plays a pivotal role in determining the industry's financial resilience, research capabilities, and global competitiveness. This study applies a mixed-methods research design to comprehensively analyze the capital composition, financing strategies, and investment challenges facing pharmaceutical companies operating in Bangladesh. Quantitative analysis is conducted on panel data of 10 leading firms from 2014 to 2023, focusing on debt-equity ratios, return on assets (ROA), return on equity (ROE), and long-term capital trends. Qualitative data from interviews with industry experts and financial officers provide insights into decision-making processes, risk management, and investor behavior. Findings reveal a significant preference for equity over debt, with many companies leveraging internal funding and public equity rather than bank loans or venture capital. Institutional barriers, high interest rates, and policy inconsistencies have discouraged debt financing and foreign direct investment (FDI). Additionally, regulatory constraints and a weak capital market infrastructure limit the expansion of investment opportunities in research and development (R&D). The study concludes with strategic recommendations including development of sector-specific credit instruments, enhancement of IPO mechanisms, incentivization of private equity and venture capital, and the creation of favorable regulatory frameworks. By aligning capital investment strategies with global best practices, Bangladesh’s medicine sector can achieve long-term financial sustainability and innovation-driven growth. Medicine Today 2025, Vol.37 (2): 269-273
Challenges and Strategies to Strengthen Diabetes Prevention Programmes in Bangladesh
Accelerated urbanization, changing lifestyle, and growing health inequality have all contributed towards Bangladesh's diabetes burden unfolding as a serious public health emergency. Structural, social, and policy-level impediments to the effective prevention and control of diabetes in the country are critically examined in this research. Despite the recognition of the threat of non-communicable disease (NCD) and of diabetes at the national programs and policy levels, implementation has been patchy and disproportionately concentrated in urban areas. Inequities are compounded by an un-integrated healthcare system, lack of funding, substandard primary care centers, and a severe shortage of trained staff. This paper highlights the intricacies of these barriers, various social determinants of health through to policy intransigence and digital divides, and the need for a multisectoral, equity-oriented, and integrated response. The potential of public-private partnerships, digital health innovations, and community interventions is examined in the context of Sustainable Development Goal 3 (SDG 3). Drawing from a close integration of policy briefs, epidemiological data, and the subject literature, this paper proffers strategic recommendations to augment the agenda for diabetes prevention in Bangladesh. It recommends scaling up primary prevention, capacity development, and reorientation of the health system towards chronic disease management to reduce morbidity, mortality, and socioeconomic consequences of diabetes. Medicine Today 2025, Vol.37 (2): 274-278
Unusual Presentation of Kala Azar: A Case Series from Rajshahi Medical College Hospital, Bangladesh
Kala Azar, or visceral leishmaniasis, often manifests with a typical triad of fever of long duration, wt loss, and splenomegaly. Unusual manifestations can sometimes make the diagnosis and management difficult. This case series was conducted in the Department of Hematology, Rajshahi Medical College Hospital, Rajshahi, Bangladesh. This case presented unusual occurrences of a typical disease, Kala Azar, which were encountered. The clinical challenges of diagnosis and management highlight different therapeutic interventions and responses. All 4 cases of Kala Azar, with unusual presentations, were retrospectively analyzed. Clinical examination, history, laboratory investigations, results, diagnosis, and treatment responses were retrieved, and in-depth analyses were conducted. Present 4 cases of unusual diseases. One patient had a fever and cough, and pancytopenia was not described as a common manifestation of Kala Azar. His initial blood tests described non-reactive malarial slides, whereas the final bone marrow report described pancytopenia due to Kala Azar. The patient improved with amphotericin-B courses. The presentation of Kala Azar was unusual in some cases, which is why its clinical evaluation must be kept in mind in endemic areas. Conducting a profound evaluation and early management is essential. Medicine Today 2025, Vol.37 (2): 279-284
Typhoid Conjugate Vaccine Introduction in Bangladesh: Implementation, and Health System Strengthening Strategies
Abstract not available Medicine Today 2025, Vol.37 (2): 158-159