Medico Research Chronicles <p style="text-align: justify;"><code></code>Medico Research Chronicles (Medrech) ISSN No. <a href="">2394-3971</a>, is an official journal of Medico Edge Publications. It is a peer-reviewed, open-access journal of medical and health sciences, published on bi-monthly intervals. It publishes various manuscripts on the diverse specialization of medical, health science, and clinical research.</p> <p>Indexed by the&nbsp;&nbsp;<a href=""><strong>United States'&nbsp;NLM Catalogue, NCBI</strong></a></p> <p><strong>Medico Research Chronicles has been positively evaluated by <a href=";lang=pl">Index Copernicus</a>, Poland for the year 2021 and assigned an IC Value of 84.43</strong></p> <p><strong>Academicians and Researchers interested in reviewing the article are requested to join us on Publons: <a title="Publons by Web of Science" href=""></a></strong></p> <p><strong><a href="">Click Here </a></strong>for the notification details.</p> <p>&nbsp;</p> en-US (Dr. Bindu Jain) (Dr. Vibhor Kumar Jain) Thu, 05 Jan 2023 00:00:00 +0530 OJS 60 Progression & prognosis of Covid-19 patients having diabetes mellitus <p><strong>B</strong><strong>ackground:&nbsp; </strong>Diabetes patients experience a variety of internal health issues, including immune deficiencies, inflammatory storms, hyperglycemia, coagulation risks, and elevated levels of ACE2 receptors. They also suffer from various illnesses like high blood pressure, cardiovascular disease, kidney problems, visual issues, and a host of others. None of these factors raise the chance of contracting SARS-CoV-2. However, once they are infected, the condition worsens to the point that the death rate is high.</p> <p><strong>Objective:</strong> This study aimed to examine the severity of symptoms between COVID-19 participants with and without diabetes.</p> <p><strong>Methods:</strong>&nbsp; A total of 347 patients with confirmed SARS CoV-2 were selected by a purposive sampling method for this retrospective, single-center study that took place from June 1, 2020, to August 31, 2020, at the Department of Medicine, TMSS Medical College, and Rafatullah Community Hospital, Bogura, Bangladesh. We investigated and compared their sociodemographic information, clinical traits, morbidities, lab results, and CT scan results. The study was approved by the ethical committee of the mentioned hospital. All of the patients tested positive for COVID 19. Patients with a COVID 19 negative result and those younger than 18 years old were, however, eliminated based on the study's exclusion criteria.</p> <p><strong>Results:</strong> Diabetes patients experienced worse hospital outcomes, including a death rate of 19.4% (p=0.002163), and longer hospital stays (p = 0.0001) compared to non-diabetic patients. Additionally, diabetic patients got more oxygen therapy (32 hours, p 0.05), injectable antiviral drugs (161, p 0.05), and low molecular weight heparin (105, p 0.05) than non-diabetics. These findings suggest that diabetes affects the prognosis of COVID 19.</p> <p><strong>Conclusion:</strong>&nbsp; Diabetes worsens the prognosis and is a risk factor for the Covid-19 symptoms' quick progression. Therefore, individuals with Covid-19 infection and diabetes should receive additional attention because they could deteriorate at any time.</p> <p>&nbsp;</p> <p>&nbsp;</p> Md. Mahbub Alam Siddiqui, Md. Rafiqul Islam, Md. Mir Sufian, Priyanka Podder, Md. Abu Masud Ansary, Shahed Ahmed, Nyeem Ahmad Nibir, Md. Rafiur Rahman Sahin Copyright (c) 2023 Dr. Md. Mahbub Alam Siddiqui, Dr. Md. Rafiqul Islam, Dr. Md. Mir Sufian, Dr. Priyanka Podder, Dr. Md. Abu Masud Ansary, Dr. Shahed Ahmed, Dr. Nyeem Ahmad Nibir, Dr. Md. Rafiur Rahman Sahin Wed, 04 Jan 2023 00:00:00 +0530 Evaluation of the prevalence of different types of hepatitis viruses in a tertiary care hospital <p><strong>B</strong><strong>ackground: </strong>Bangladesh is not exempt from the global viral hepatitis pandemic. Hepatotropic viruses comprise the majority of those that cause viral hepatitis. Hepatitis B virus (HBV), with hepatitis C virus (HCV), hepatitis A virus (HAV), and hepatitis E virus, is one of the most important hepatotropic viruses (HEV). The objective of the current study was to determine if individuals who were clinically thought to have the aforementioned diseases were also seropositive for HBV, HCV, HEV, and HAV.</p> <p><strong>Aim of the study:</strong> This study's objective was to determine the prevalence, typical causes, mode of transmission, and risk factors associated with acute viral hepatitis.</p> <p><strong>Methods:</strong>&nbsp; This descriptive cross-sectional study was carried out between March 2012 and September 2012, in the department of Medicine, Shaheed Ziaur Rahman Medical College hospital in Bogura. In total 100 cases of acute viral hepatitis, patients were included in this study. These cases were included and excluded based on the inclusion and exclusion criteria. Information was acquired using a questionnaire after receiving written, informed consent, and applicable research was done. The information was then looked over.</p> <p><strong>Results:</strong> The study comprised 100 cases of acute viral hepatitis in total. In this study, acute viral hepatitis is most frequently caused by the hepatitis E virus (52%), with a peak incidence in people between the ages of 32 and 41. Hepatitis A virus (32%), which is most prevalent in people between the ages of 12 and 21 (54.55%), is the second most common cause. At a ratio of 7.33:1, males were more frequently impacted than females. The workforce was made up of 43%-day workers, 20% employees, 15% business owners, 10% students, and 12% others.</p> <p><strong>Conclusion:</strong>&nbsp; An increase in new instances of hepatitis B, C, and D was observed in Bangladesh, according to a study of their prevalence. These findings show that individuals in high-risk groups require the development of efficient preventative interventions and screening procedures. To determine the significance of diverse acute hepatitis causative agents in Bangladesh, more research is required.</p> S. M. Arafat, Md. Maniruzzaman Asraf, K.M Monjurul Alom, Rozina Afroz, A.S.M Shahabur Alom, Md. Mehedi Hasan, Jobyer Ahmmed Copyright (c) 2023 Dr. S. M. Arafat, Dr. Md. Maniruzzaman Asraf, Dr. K.M Monjurul Alom, Dr. Rozina Afroz, Dr. A.S.M Shahabur Alom, Dr. Md. Mehedi Hasan, Dr. Md. Rashedul Haque, Dr. Jobyer Ahmmed Thu, 05 Jan 2023 00:00:00 +0530 Preparation and characterization of binary blends of NR and oxidized NR with PVAc <p><strong>Background: </strong>Studies had been performed on blends of natural rubber (NR) and poly vinyl acetate (PVAc). The two polymers had been characterized based totally on their physicochemical properties and used in paint production. Results received confirmed that viscometric measurement and density of the polymers did now not fluctuate much. Five paints of distinctive compositions labeled; Paint 1 (100% PVAc), Paint 2 (100% NR), Paint 3 (75% NR: 25% PVAc), Paint 4 (50% PVAc: 50% NR), and Paint 5 (25% NR: 75% PVAc) the usage of popular emulsion paint formula and approach of manufacturing have been employed. NR and PVAc are well-matched as binders in emulsion paint production. Therefore, NR/PVAc blends may want to be used as a binder in the coating industry as a choice to PVAc binder-based emulsion paint.</p> <p><strong>Objectives:</strong> This study aims to assess the Preparation and characterization of binary blends of NR and oxidized&nbsp;NR&nbsp;with&nbsp;PVAc.</p> <p><strong>Methods: </strong>This is an observational study. The study used to be carried out with the samples in the Department of Applied Chemistry and Chemical Engineering, Islamic University, Kushtia-7003, Bangladesh. The duration of the period from Data was entered in MS Excel and Statistical analysis was done using SPSS trial version.</p> <p><strong>Results: </strong>This study shows that the according to Constituent, Cellulose was 43.4822%, Alpha-Cellulose was 34.8427% and Cellulose was 8.6395%. And according to Source, Rice Straw was 32.15% %, Sugarcane was 41-43%, Rye Straw was 31.8-42.64%, Corn Stalks were 29.80% and Wheat Straw was 34-40%.</p> <p><strong>Conclusion: </strong>The residences of opacity, wash ability resistance, and putting contact drying time of emulsion paint with modified NRL binder and modified NRL combination with PVAc can be multiplied using in addition editing natural rubber latex (NRL) molecules. Modifications are needed to rise the adhesion of natural rubber latex (NRL). The adhesive characteristics of natural rubber latex (NRL) can match the characteristics of general adhesives such as PVAc.</p> <p>&nbsp;</p> MH Uddin, MM Haque Copyright (c) 2023 Uddin MH, Haque MM Thu, 05 Jan 2023 00:00:00 +0530 Efficacy Of Helicobacter Pylori Eradication In Helicobacter Pylori Positive Functional Dyspepsia Patients-A Double-Blind, Randomized, Placebo-Controlled Trial <p>Multiple etiopathogenesis have been proposed for functional dyspepsia. But no conclusive mechanisms have been established yet. Many studies reported that <em>H. pylori </em>produce dyspeptic symptoms without any macroscopic lesion in the gastroduodenal mucosa. Some studies also reported that eradication of H. pylori relieves the symptoms of functional dyspepsia. The main objective of this double blind randomized placebo controlled clinical trial was to see the response of <em>H. pylori </em>eradication in the management of ‘<em>H. pylori </em>positive functional dyspepsia’. We conducted the study on <em>H. pylori </em>positive functional dyspepsia patients visiting the gastroenterology OPD and see the effects of <em>H. pylori </em>eradication on their symptom resolution. Consecutive 59 <em>H. pylori </em>positive functional dyspepsia patients were randomly assigned to receive either Anti <em>H. pylori </em>therapy (Levofoxacin, Amoxicillin and Omeprazole) or placebo for 14 days. <em>H. pylori </em>status was assessed by <sup>13</sup>C urea breath test for inclusion into the study and 2 months later for eradication status along with symptom resolution. 23 patients receiving Anti <em>H. pylori </em>therapy and 17 receiving placebo were available for analysis. Two months after completion of therapy 56.5% patients resolved their symptoms who received Anti <em>H. pylori </em>therapy. On the other hand, 47.1% patients who received placebo relieved their dyspeptic symptoms. Dyspeptic symptom resolution was also not statistically significant when comparison made between <em>H. pylori </em>eradicated and non- eradicated subjects irrespective of their treatment regimen (p=0.102). So in this study we found that there is no relationship between <em>H.pylori </em>eradication and resolution of dyspeptic symptoms in patients with functional dyspepsia.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> Muhammad Sayedul Arefin, Shiplu Basak, Md. Abdul Mumit Sarkar, Md. Rehan Habib, Farid Ahmed, Shamima Sharmin Kanta, Md. Razibul Alam Copyright (c) 2023 Arefin MS, Basak S, Sarkar MAM, Habib MR, Ahmed F, Kanta SS, Alam MR Sat, 07 Jan 2023 00:00:00 +0530 Prevalence of LV diastolic dysfunction in people with type 2 diabetes mellitus with a normal systolic function <p><strong>B</strong><strong>ackground and Aims</strong>: To determine the incidence of LV diastolic dysfunction (LVDD) in type 2 diabetics having a normal LV systolic function. This observational study aimed to determine the prevalence of LVDD in a normotensive T2DM population with a preserved Left Ventricular Ejection Fraction (LVEF) and to impress the importance of initiating early therapy with agents like SGLT2 inhibitors.</p> <p><strong>Materials and Methods</strong>: Persons diagnosed with T2DM underwent standard TTE and assessment of their LVEF and grading of LV diastolic dysfunction. LVEF ≥ 50% was considered as normal. All the subjects underwent resting transthoracic 2-dimensional echocardiography and Doppler imaging, to assess left ventricular systolic and diastolic function. A total of 2,150 cases were assessed at the hospital, over 4 years.</p> <p><strong>Results:</strong> Of the 2,150 cases included 56% (1204) were males, and 44% (946) were females,</p> <p>&nbsp;72% (1548), [59% males and 41% females] had Grade I LV diastolic dysfunction.</p> <p><strong>Conclusion:</strong> This observational study concludes that there is a huge prevalence of LV diastolic dysfunction, in people with T2DM, which is an important risk factor for cardiac morbidity and mortality, which may lead to the development of overt heart failure and progression to coronary artery disease if not corrected early.</p> <p>&nbsp;</p> <p>&nbsp;</p> Sanjay Sud Copyright (c) 2023 Dr. Sanjay Sud Sat, 07 Jan 2023 00:00:00 +0530 Pattern of presentation in clinically diagnosed epileptic patients <p><strong>Background:</strong> Diagnosis of epilepsy is based mainly on clinical history and examination. EEG constitutes the single most valuable laboratory test in the evaluation of patients with epilepsy. It is a safe, non-invasive procedure for evaluation of electrophysiological state of patients with epilepsy. <strong>Objective:</strong> To find out the Pattern of presentation in clinically diagnosed epileptic patients. <strong>Methods:</strong> This cross-sectional study carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. A total of 152 epileptic patients attended in the Epilepsy Clinic of the Department of Neurology were enrolled for this study. Information on socio-demographic and seizure characteristics was obtained. The recordings from patients were obtained using the standard. <strong>Results:</strong> A total of 152 patients were recruited. Maximum patients (43.4%) were in age group 11-20 followed by 37 (24.3%), 27 (17.8%), 13 (8.6%) and 9 (5.9%) were in age groups 21-30 years, 1-10 years, 31-40 years and &gt;40 years respectively. Male (62.5%) were predominant than female (37.5%). Male female ratio was 1.67:1. Distribution of patients according to common presenting features. Out of 95 patients most common clinical features were generalized convulsion 63.2%, frothy mouth 61.8%, loss of consciousness 59.9% and tongue bite 57.2% in case of generalized seizure and in focal seizure most common was abnormal movement (20.4%). Most of the patients (50.7%) had GTCS followed by 19 (12.5%), 18 (11.8%), 13 (8.6%), 13 (8.6%) and 12 (7.9%) patients had focal seizure without impairment of consciousness, focal seizure with secondary generalization, absence seizure, focal seizure with impairment of consciousness and myoclonic seizure respectively. Among distribution of abnormal EEG findings in patients with generalized seizure. Of them 56 (87.5%) patients had generalized epileptic discharge and 8(12.5%) patients had typical absence seizure. <strong>Conclusion:</strong> Based on the above study it can be concluded that diagnosis of epilepsy is based on clinical history and examination. The most common clinical presentation of epileptic patients is generalized seizure, generalized convulsion and frothy mouth help to clinical diagnosis of epilepsy, assist in planning drug management and determining prognosis.</p> <p>&nbsp;</p> <p>&nbsp;</p> Sabbir Ahmed Dhali, Mohammad Shameem Al Mamun, Muhammad Mahbubur Rahman, Sonia Anjum, Reaz Mahmud, Mohammad Fakhrul Islam Copyright (c) 2023 Sabbir Ahmed Dhali, Mohammad Shameem Al Mamun, Muhammad Mahbubur Rahman, Sonia Anjum, Reaz Mahmud, Mohammad Fakhrul Islam Sat, 07 Jan 2023 00:00:00 +0530 Study of renal profile in children with congenital heart disease in western rural Maharashtra. <p><strong>I</strong><strong>ntroduction</strong>: The incidence of congenital heart disease (CHD) is 8-10 per 1000 in India and worldwide and due to recent advancements in diagnostic modalities, early diagnosis and management are possible leading to an increase in long-term survival. Renal involvement is one of the known complications of CHD, especially in cyanotic CHD.</p> <p><strong>Materials &amp; method</strong>: It was a prospective longitudinal study conducted at a tertiary care hospital, including 112 cases ranging from 1 month to 12 years of age with ECHO-proven CHD were studied for the renal profile. Investigations included urea, serum creatinine, serum electrolytes (Na, K, Ca), along with the Urine analysis for protein creatinine ratio. USG abdomen study for kidney size, bladder wall thickness, post-void residue, and pelvi-calceal dilatation was done.</p> <p><strong>Results</strong>: 83.9% of CHD were acyanotic and 16.1% were cyanotic CHD. The most common CHD was VSD (39.3%). Male predominance was noted with Male to Female ratio of 1.24:1.</p> <p>The most common presenting symptom of CHD in our study was poor weight gain (71.4%). Anemia was found in 42 out of the total CHD cases (37.5%). Serum creatinine was raised in 5 patients (4.5%) of CHD. Incidence of elevated creatinine was more common in cyanotic CHD (16.7%) than cyanotic CHD (2.1%) Blood Urea was found to be abnormal in 9.8% of CHD.</p> <p><strong>Conclusion</strong>: Children with CHD are prone to develop renal problems and therefore need monitoring of renal parameters. Serum creatinine levels are most deranged and hence should be checked serially as it is one of the easily available laboratory parameters.</p> <p>&nbsp;</p> <p>&nbsp;</p> Bhushan Deo, Saladi Naga Ratnam, Amit Kumar Pandey, Jayashree Jadhav Copyright (c) 2023 Bhushan Deo, Saladi Naga Ratnam, Amit Kumar Pandey, Jayashree Jadhav Thu, 19 Jan 2023 22:12:00 +0530 The validity of plain lumber vertebral X-Rays in diagnosing osteoporosis in elderly-An age-based approach <p><strong>Background: </strong>The diagnosis of osteoporosis relies on the quantitative assessment of BMD, which is currently considered the best predictor of osteoporotic fractures. Early diagnosis is the key for appropriate osteoporosis management. Although common, osteoporosis can be clinically silent, and without prevention and screening, the costs of osteoporotic fracture–related morbidity and mortality will burden healthcare systems, especially in developing countries.</p> <p><strong>Objective:</strong> To assessed the validity of plain radiography in diagnosing osteoporosis in elderly women.</p> <p><strong>Methods:</strong> A retrospective, cross-sectional, observational hospital-based study conducted at the Department of Ortho-Surgery, Patuakhali Medical College Hospital, Patuakhali, Bangladesh from June 2019 to July 2022. One hundred Seventy (170) female patients between the ages of 40 to 83 years were referred to the orthopedic department in PKMCH. These women were found to have features of osteopenia in lumber vertebrae plain radiography. The participants then categorized into two groups. Group A (n=101) are those who are younger than 65 years and group B (n=69) are those who are 65 years and older. The two groups underwent a quantitative ultrasound bone densitometry. Correlations between plain radiography parameters and QUS were calculated. Osteoporosis was diagnosed by QUS T-score ≤ –2.5 at the lumber vertebra.</p> <p><strong>Results:</strong> Total 170 patients were included. The mean age of the participants was 63.5±6 years old with the minimum age was 40 years and the maximum age was 83 years. The most common population aged more than 63 years old, group A who are less than 65 years of age were 101 participants (59.4%), while those 65 years and old were 69 (40.6%). The participants in both groups have showed features of osteopenia in their plain lumbar vertebral X-rays. By QUS; in group A: 2 patients (1.9%) were found to have a normal bone mineral density (T score = &gt;-1 SD), 47 patients (46.5%) were osteopenic (T score between -1 and -2.5 SD), while 52 patients (51.4%) were osteoporotic (T score = &lt;-2.5 SD), in group B: 3 patients (4.3%) were found to have a normal bone mineral density (T score =&gt;-1 SD), 3 patients (4.3%) were osteopenic (T score between -1 and -2.5 SD), while 63 patients (91.3%) were osteoporotic (T score =&lt;-2.5 SD). Also when we performed Fisher’s Exact test we found a significant difference in the validity of X rays as compared to QUS bone densitometry between the two groups, in Group A. The difference between X-ray and quantitative ultrasound bone densitometry was significant (p = 0.000000006 at p &gt; 0.05), and was not significant in Group B (p = 0.491 at p &gt;0.05).</p> <p><strong>Conclusion:</strong> Plain radiography can provide reliable method for diagnosis of osteoporosis in women with a higher risk for fragility fractures (≥65 years) especially in primary healthcare and sittings with limited resources.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> Md. Salim Matber, M. Muniruzzaman, Mohammad Golam Sagir, AKM Fakhrul Alam Copyright (c) 2023 Md. Salim Matber, M. Muniruzzaman, Mohammad Golam Sagir, AKM Fakhrul Alam Tue, 10 Jan 2023 00:00:00 +0530 Assessment of temporomandibular disorder using Fonseca questionnaire and its classification based on DC/TMD criteria in tertiary hospital in Nepal. <p><strong>B</strong><strong>ackground and objective: </strong>Temporomandibular disorders (TMD) is an orofacial disorder, associated with temporomandibular joint (TMJ) pain, masticatory muscles fatigueness, restricted mouth opening and clicking. The Fonseca anamnestic index (FAI) is questionnaire for evaluating severity and characteristics of TMD. The Diagnostic criteria for temporomandibular disorders (DC/TMD) is used for diagnosis of TMD. The study assessed the severity, clinical characteristic and patterns of TMDs in Eastern Nepal population.</p> <p><strong>Methods: </strong>A cross sectional study was done in Department of Oral Medicine and Radiology using census sampling. Eighty patients having TMD was interviewed using Fonseca's questionnaire, on pain TMJ pain, head, chewing, parafunctional habits etc. The clinical examination was done using DC/TMD examination form. The TMD was classified as pain disorder and TMJ disorder of right and left side. Statistical analysis was performed using SPSS version 11.5.</p> <p><strong>Results:</strong> FAI revealed TMD to be higher in female than male with odds ratio of 1.74. The mean age of the patient was 31.03 (±13.31).&nbsp; The duration from onset to diagnosis was 5.72 (±9.54) months. The Fonseca’s questionnaire showed 51.3% had moderate TMD followed by mild and severe. DCTMD criteria location of pain was most commonly in the TMJ region 47(58.8%) of cases followed by 7.5% in temporalis, masseter and other muscle and 1 (1.3%) had pain in sternocleidomastoid.</p> <p><strong>Conclusions: </strong>The TMDs showed moderate severity with Anamnestic Index. Myalgia was the most common pain disorder and disc displacement with reduction in right and left TMJ disorder.</p> Dr. Iccha Kumar Maharjan, Mehul Rajesh Jaisani Copyright (c) 2023 Dr. Iccha Kumar Maharjan, Dr. Mehul Rajesh Jaisani Fri, 13 Jan 2023 00:00:00 +0530 Expression of CD56 and HBME-1 in surgically excised thyroid nodules <p><strong>Introduction:</strong> Thyroid nodules represent a wide spectrum of neoplasms with different biological behaviors Majority of thyroid nodules are benign, but malignancy is found in approximately 5–15% of cases. Accurate diagnosis of these thyroid nodules is difficult, because of subtle and subjective histomorphological criteria. Immunohistochemistry method may play a complementary role to clarify diagnostic dilemma. CD56 is a neural cell adhesion molecule expressed on thyroid follicular cells. &nbsp;Down regulation of CD56 can shows correlation with tumour progression. Hector Battifora mesothelial epitope (HBME-1) is a membranous antigen located on follicular thyroid tumour cells and normal thyroid tissue is negative for HBME-1. <strong>Objective: </strong>To observe the expression of CD56 and HBME-1 in the diagnosis of surgically excised thyroid nodules. <strong>Methods:</strong> This cross sectional study was conducted in the Department of Pathology, Chittagong Medical College, Chattogram from March 2019 to February 2021. Immunohistochemistry was done at Armed Forces Institute of Pathology, Dhaka Cantonment. Sixty-three surgically resected thyroid nodules were evaluated to find out their histopathological type. Immunostaining was done by using primary antibody against CD56 (FLEX Monoclonal Mouse Anti-Human CD56 Clone 123C3 Ready to use (LINK). Denmark) and HBME-1 (Anti–Mesothelioma mouse monoclonal antibody HBME-1ab2383. Abcam, UK). Patient’s demographic data were collected and recorded in a predesigned data sheet. Statistical analysis was carried out as required. Ethical practice was ensured in every step of the study. <strong>Results: </strong>Among the 63 cases, mean age (±SD) of the patients was 39.47 ± 13.67 years and male to female ratio of 1:6.9. Thirty-four patients (76.3%) had multiple nodules. Among the 63 patients, 68.3% (43 cases) were histologically diagnosed as benign and 31 .7% (20 cases) as malignant thyroid nodules according 2017 WHO classification of thyroid tumours. Immunohistochemistry was performed using the markers CD56 and HBME-1 for all the 63cases.In present study weak to strong positive expression of CD56 was observed in 33(76.7%) cases out of 43 benign nodules whereas negative CD56 expression was observed in 20(100%) malignant cases. CD56 expression between benign and malignant lesion was statistically significant (p value, 0.002). HBME-1 was showed positive expression for 17(85%) out of 20 cases of malignant nodules and negative expression was observed in benign nodules. No statistically significant (p&gt;0.250) difference was found between HBME-1 expression and histopathological diagnosis. So this study has improved the better understanding of thyroid nodules by expression of these immunomarkers (CD56 and HBME1) and thus may help the patients for selecting appropriate management protocol. <strong>Conclusion: </strong>In this study, Positive HBME-1 staining is a strong indicator of malignancy, although negative staining does not rule it out. IHC with CD56 and HBME-1 is considered to be important ancillary test in the diagnosis of thyroid neoplasms, but it does not replace the conventional histopathological examination.</p> Naznin Nahar Momin, Pradip Bhattacharjee, Sadia Refat Wahid, Rumana Mahmud, Taniza Farnaz, Mohammad Zillur Rahman Copyright (c) 2023 Naznin Nahar Momin, Pradip Bhattacharjee, Sadia Refat Wahid, Rumana Mahmud, Taniza Farnaz , Mohammad Zillur Rahman Mon, 23 Jan 2023 00:00:00 +0530 The Efficacy of Serum Procalcitonin as A Reliable Marker for Diagnosis of Neonatal Sepsis <p><strong>Background:</strong> Newborn sepsis (NS) is a major cause of neonatal morbidity and mortality, and it has become a serious global public health issue. Because the clinical appearance of NS can be confounded with non-infectious conditions, the onset of sepsis might be fast, and the clinical process can swiftly subside. Early recognition and diagnosis of neonatal sepsis are difficult because of the variable and non-specific clinical presentation of this condition.&nbsp; <strong>Objective:</strong> To evaluate the efficacy of serum procalcitonin as a reliable marker in diagnosis of neonatal sepsis. <strong>Methods:</strong> This cross sectional analytical study was carried out in the Department of Pediatric, Mugda Medical College Hospital, Dhaka, Bangladesh from March to May 2020. Total 55 new-borns with suspected sepsis were included in the study. Specimens of blood were obtained from each neonate prior to commencement of antibiotic for sepsis work up. Serum CRP and procalcitonin levels were measured. Data analysis was performed by using SPSS for windows version 21. Chi-square test, Mann- Whitney U test and Validity test was done to measure the level of significance. Area under the ROC (Receiver operating characteristics) was evaluated. A p value ≤0.05 was considered level of significance. <strong>Results:</strong> Among total 55 new-borns included in this study, 27(49.09%) new-born were diagnosed as proven sepsis and 28(50.9%) new-born as clinical sepsis. A statistical significant difference was observed between the mean of birth weight in septic and suspected groups. The mean of gestational age (GA) in proved sepsis infants was 31.9 weeks that was lower than two other groups (<em>P</em>&lt; 0.05). The procalcitonin (PCT) was high in 58.2% (500-&lt;2000 pg/ml) new-born and remarkably high (2000-&lt;10000) in 36.4% new-born with sepsis. At a cut-off value &gt; 500pg/ml, the sensitivity of PCT in detecting sepsis was 46.4% its specificity 75%, positive predictive value was 67.9%, and negative predictive value was 60.7% whereas the sensitivity of CRP for predicting sepsis was 33.3%, specificity 77.8%, positive predictive value 62.9% and negative predictive value was 55.6%. The area under the ROC curve for procalcitonin (0.653) was significantly higher than CRP (0.571). <strong>Conclusion:</strong> In conclusion, the serum levels of PCT is a more reliable marker than the serum levels of CRP or the WBC counts in the early diagnosis of neonatal sepsis and in the evaluation of the response of the disease to the antibiotic therapy. The benefit of measuring serum PCT routinely in the diagnosis and follow-up of neonatal sepsis, is that it reduces the hospital costs.</p> <p>&nbsp;</p> <p>&nbsp;</p> Mohammad Sazzad Hossain Chowdhury, Md. Obaidul Islam, Md. Kabir Alam, Mohammad Naim Iqbal Mollah Copyright (c) 2023 Mohammad Sazzad Hossain Chowdhury, Md. Obaidul Islam, Md. Kabir Alam, Mohammad Naim Iqbal Mollah Thu, 02 Feb 2023 00:00:00 +0530 Maternal and Perinatal Outcome of Liver Function in Severe Pre Eclampsia and Eclampsia Patients <p><strong>Background:</strong> Preeclampsia and eclampsia are common pregnancy specific multi system disorder in Bangladesh and are major causes of maternal, foetal and neonatal mortality and morbidity. <strong>Objective:</strong> To determine the extent of hepatic involvement in severe preeclampsia &amp; eclampsia and its relation to fetomaternal outcome. <strong>Methods:</strong> It was a hospital based prospective study. This randomized clinical trial was conducted to evaluate liver function in severe preeclampsia and eclampsia on 100 patients with severe preeclampsia and eclampsia selected randomly who were admitted in department of obstetrics and gynaecology unit of Rangpur medical college and hospital through outpatient department and emergency during a time period of June 2015 to November 2015. Data was collected in preformed questionnaires after taking written informed consent from the patient or legal guardian after proper counseling.Then date was presented in graph and tabulated form and finally analyzed by SPSS version–16. <strong>Results:</strong> 100 patients were taken in this study–62 as eclampsia and 38 as severe preeclampsia. 0ut of 100 patients maximum (60%) were between 20-35 years of age, 62% patients were primigravida, 46% were more than 36 weeks of gestation, 53% patients were belonged to low socioeconomic status, 59% patients were primarily educated, 25% patients had no antenatal checkup and 42% were on irregular antenatal checkup. Most of the severe preeclamptic patients presented on admission with headache (65.78%) and epigastric pain (13.15%) and most of the eclamptic patient (51.61%) were conscious and 29.03% were unconscious. Maximum patients (56%) were delivered by LSCS. In severe preeclampsia group blood urea were raised in 73.68%, S. Creatinine were raised in 71.05% and S.Uric acid were raised in 65.78%. Liver function was abnormal in 21.05% patients among them S.bilirubin was raised in 15.7%, SGPT was raised in 21.05% patients SGOT was raised in 18.42% patients. LDH was raised in 13.15% patients. In eclamptic patients’ blood urea was raised in 72.58% patients, S. creatinine was raised in 66.12% patients; S. uric acid was raised in 61.29% patients. Liver function was abnormal in 22.58% patients, among them, S. bilirubin was raised in 29.03%, SGPT in 48.38%, SGOT was raised in 30.64% and LDH was raised in 45.16% patients. Maternal morbidity and mortality was more in patients with abnormal liver function. It maternal mortality was 12.5% in severe preeclamptic patients and 14.28% in eclamptic patients with abnormal liver function. Perinatal morbidity and mortality was also higher in patients with abnormal liver function. Perinatal mortality was 62.5% in severe preeclamptic patients and 42.85% in eclamptic patients with abnormal liver function. <strong>Conclusion:</strong> From this study it was found that abnormal liver function in patients with severe preeclampsia and eclampsia, affect both maternal and fetal outcome negatively. Therefore, prior information of liver function in such patients may help to reduce maternal and perinatal mortality and morbidities.</p> <p>&nbsp;</p> <p>&nbsp;</p> Mst. Mahmuda Begum, Shamima Begum, Most. Nasrin Sultana, Mst. Hasina Banu, Sohely Sultana Copyright (c) 2023 Mst. Mahmuda Begum, Shamima Begum, Most. Nasrin Sultana, Mst. Hasina Banu, Sohely Sultana Fri, 03 Feb 2023 00:00:00 +0530 Surgical Airway management in Critically ill Patients: A Review article <p><strong>Abstract: -</strong></p> <p>Tracheostomy is among the most frequently performed procedures in critically ill patients, being done in medical and surgical intensive care units (ICUs).<sup>1,<strong>2,3,4.</strong></sup>, there is little agreement on the indications, timing of tracheostomy in critically ill patients. The most common indication for tracheostomy in the ICU is need for prolonged mechanical ventilation.<strong><sup>7, 8.</sup></strong> Tracheostomy has several advantages over endotracheal intubation, Recent ACCP (American college of chest physicians) guidelines <sup>22 </sup>suggest that tracheostomy should be considered after an initial period of stabilization on the ventilator, when it becomes apparent that the patient will require prolonged ventilator assistance. Despite having been a known about the complications of prolong ETT insitu, the specifics of how, when, and why to perform a surgical airway are still debated. New methods of surgical airway management have to be evaluated against the gold standard, which will always be the open tracheostomy. Today we have to evaluate these new procedures not only by their efficacy but also by their cost effectiveness.</p> <p>&nbsp;</p> <p>&nbsp;</p> Mohammed Shabbir Pyarejan Copyright (c) 2023 Mohammed Shabbir Pyarejan Thu, 05 Jan 2023 19:42:46 +0530