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> Medico Edge Publications en-US Medico Research Chronicles 2394-3971 Various presentations of intracranial meningiomas <p>Meningiomas are the most common non-glial tumor of the central nervous system (CNS). There are a number of characteristic imaging features of meningiomas on magnetic resonance imaging (MRI) that allow an accurate diagnosis, however there are a number of atypical features that may be diagnostically challenging. Furthermore, a number of other neoplastic and non-neoplastic conditions may mimic meningiomas.</p> Rahul J Mehta Yogendra Sachdev Ganesh Vikhe Manohar Sachdev Copyright (c) 2022 Rahul J Mehta, Yogendra Sachdev, Ganesh Vikhe, Manohar Sachdev 2022-11-09 2022-11-09 9 6 337 349 10.26838/MEDRECH.2022.9.6.628 Prevalence and the outcome of peptic ulcer disease- A retrospective study <p><strong>Introduction: </strong>Peptic ulcer disease (PUD) occurs due to an imbalance between stomach acid-pepsin and mucosal defense mechanisms. It affects 4 million people worldwide annually. About 10%-20% of patients with PUD will have complications and 2%-14% of the ulcers will perforate causing an acute illness. <strong>Objective:</strong> To assess the prevalence and the outcome of peptic ulcer disease. <strong>Materials and Methods: A </strong>retrospective study was conducted at the Department of Gastroenterology, Army Medical College Jashore, Jashore Cantonment, Bangladesh from January to June 2022. In total, 120 patients who underwent emergency surgery for perforated peptic ulcer were included in this study. The clinical Data regarding age, gender, complaints, time elapsed between onset of symptoms and hospital admission, physical examination findings, co-morbid diseases, laboratory and imaging findings, operative methods, post-operative complications, length of hospital stay, morbidity and mortality were collected retrospectively. <strong>Results: </strong>Out of 87 (72.5%) patients were male and 33 (27.5%) were female patients and the mean age was 60 years. The mean time for presentation to the hospital was 32 hours. While 29 (24.4%) of the patients had shock at presentation, 49 of them (40.8%) were identified to have at least one comorbid disease. It was identified that perforation was most frequent in the pre-pyloric region (86 patients, 71.6%). The length of hospital stay was longer in patients who developed morbidities. In the post-operative period, 46 patients (38.3%) developed morbidity. The most frequent morbidity was wound infection. 33 (27.5%) patients died. The most frequent reason for mortality was sepsis. In our study age over 60 years, presence of co-morbidities late time at presentation of more than 24 hrs. from the onset of symptoms, shock at presentation were noted as independent risk factors influencing morbidity and mortality. <strong>Conclusion</strong>: In spite of the developments in peptic ulcer disease treatment, peptic ulcer perforation remains a serious surgical problem. Patients above the age of 60, with a time to presentation longer than 24 hours, presence of shock at the time of presentation and concomitant diseases, are patients at high risk for post-operative morbidity and mortality, close monitoring of which can help reducing mortality and morbidity. Early diagnosis, prompt resuscitation and urgent surgical intervention are essential to improve outcomes.</p> Md. Ahsanul Haque Raj Mohon Hira Sharna Moin Syed Didarul Haque Md. Jahangir Hossain Md. Jasim Uddin Alomgir Kabir Copyright (c) 2022 Md. Ahsanul Haque, Raj Mohon Hira, Sharna Moin, Syed Didarul Haque, Md. Jahangir Hossain, Md. Jasim Uddin6, Alomgir Kabir 2022-11-08 2022-11-08 9 6 370 377 10.26838/MEDRECH.2022.9.6.625 Profile of infections in nephrotic syndrome patients of western rural Maharashtra. <p><strong>B</strong><strong>ackground</strong>: Infection is a major complication in children with Nephrotic syndrome. Patients with relapse will have increased susceptibility to bacterial infection because of urinary losses of immunoglobulins &amp; properdin factor B, defective cell-mediated immunity, immunosuppressive therapy, malnutrition &amp; edema, or ascites acting as potential culture medium.</p> <p><strong>Aims &amp; Objectives:</strong> To study the spectrum of infections in nephrotic syndrome of childhood.</p> <p><strong>Material and Methods: </strong>A longitudinal observational study was conducted including the nephrotic syndrome cases after ethical approval from the institution at a tertiary care hospital from November 2020 to October 2021.</p> <p><strong>Results:</strong> The sex ratio of the study was 1.44:1 with a mean age of 4.2 years. The most common presenting feature in our study was decreased urine output with generalized edema and the most common type of infection was upper respiratory tract infections. Our study found that most common organism causing infection in NS was Escherichia coli (E. coli).</p> <p><strong>Conclusion</strong><strong>: </strong>With high index of suspicion, early institution of appropriate antibiotics, aggressive management of infections together with use of steroids enables remission of NS and support better prognosis.</p> Himanshu Raichandani Amit Kumar Pandey Rajib Chatterjee Jayashree Jadhav Copyright (c) 2022 Himanshu Raichandani, Amit Kumar Pandey, Rajib Chatterjee, Jayashree Jadhav 2022-11-02 2022-11-02 9 6 378 384 10.26838/MEDRECH.2022.9.6.631 A study of the prognostic value of red cell distribution width and neutrophil: lymphocyte ratio in adults with sepsis <p><strong>I</strong><strong>ntroduction</strong>: Sepsis continues to be a major cause of morbidity and mortality in Intensive Care Units (ICU) despite the better understanding of its pathophysiology in recent years. This may manifest as organ dysfunction such as hypotension, altered mental status, abnormal coagulation, increase in bilirubin levels, deranged renal function and increase in oxygen requirements. With this background, the current study of the relationship between RDW and neutrophil: lymphocyte ratio with severity of illness in patients admitted to medical ICUs with sepsis, has been undertaken.</p> <p><strong>Objectives: </strong>To study the prognostic value of red cell distribution width and neutrophil: lymphocyte ratio in sepsis.</p> <p><strong>Materials and Methods: </strong>This study was conducted on adult patients, who were admitted in ICUs of Tertiary care hospitals attached to Dr. VVP RMC, Loni, Maharashtra and whose haematological investigations were done within 24 hours of ICU admission. Patients with haematological disorders, immunocompromised patients, patients whose haematological investigations were not done within 24 hours of admission and who were not admitted in ICU were excluded from the study. The study was conducted for a two-year timespan, from September 2020 to September 2022. On admission, patients were stratified according to q-SOFA scoring<sup>10</sup>&nbsp;&nbsp; and SOFA score were calculated. Haematological investigations were done within 24 hours of admission. q-SOFA score and SOFA score were calculated at the fifth day of admission to ICU, to assess progress of the patient.</p> <p><strong>Results: </strong>Majority of the patients with sepsis were over 50 years of age. Hypertension, diabetes and obstructive airway diseases were the most common comorbidities present in the patients that were present in the study. Pulmonary infections were the most common source of infection in majority of sepsis cases, followed by tropical/ non- localised infections. RDW was found to be between 14.2 and 15.2 in majority of patients with sepsis in the study group. It was found that higher the RDW, higher the q-SOFA score and worse is the outcome at the end of 5 days. RDW at admission vs Outcomes assessed using ANOVA obtained a p value of p&lt;0.0001 (highly significant). Patients with worse outcomes had a high RDW at admission. NLR vs q-SOFA assessed using Kruskal Wallis and then checked using Mann Whitney U test showed a significant p value of 0.006. It was found in the study that as the q-SOFA score increases, median NLR increases.</p> <p><strong>Conclusion: </strong>The study implies that patients with sepsis having an RDW more than 15.050 may benefit from early interventions and more aggressive management. In low resource settings, the RDW, in the emergency department could afford the earliest opportunity to identify patients at risk of bacteremia and the administration of antimicrobials at the appropriate time.</p> Rohit K Patel K M Raul P. P. Anandulal Rushabh N. Lunawat Copyright (c) 2022 Dr. Rohit K Patel*, Dr. K M Raul, Dr. Anandulal P. P., Dr. Rushabh N. Lunawat 2022-11-12 2022-11-12 9 6 385 395 10.26838/MEDRECH.2022.9.6.636 Effect of glycaemic status in neonatal sepsis-A prospective observational study <p><strong>Introduction: </strong>Neonatal hypoglycemia is a common and readily treatable risk factor for neurologic impairment in children. Although associations between prolonged symptomatic neonatal hypoglycemia and brain injury are well established,&nbsp;the effect of milder hypoglycemia on neurologic development is uncertain.&nbsp;<strong>Objective:</strong> To determine the glycemic status among patients with neonatal sepsis and to evaluate their association with the mortality.&nbsp; <strong>Methods: </strong>It was a prospective observational study conducted at Department of Pediatrics, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from July 2021 to June 2022. Total 52 patients clinically diagnosed as neonatal sepsis were studied, a detailed history and thorough physical examination was done in each patient on admission. History included age of newborn, sex, gestational age, h/o prolonged rupture of membrane (PROM), intrapartum fever or fever 3 days before delivery, per vaginal foul smelling discharge, prolonged labor and features of sepsis. Physical examination included respiratory rate, heart rate, temperature, chest indrawing, grunting, cyanosis, convulsion, breath sound, added sound, weight, jaundice, bleeding manifestation, status of fontanelles, umbilicus and capillary refill time. Blood glucose level and mortality of neonates having hypoglycemia and hyperglycemia were analyzed.<strong> Results: </strong>Out of 52 patients clinically diagnosed as neonatal sepsis were studied. The mean age was found 10.2±8.4 days with range from 1 to 28 days and more than half (51.6%) patients belonged to age ≤7 days. More than two third (68.7%) patients were male and 31.3% were female. 42(80.77%) patients were found CRP positive and 10(19.23%) were negative CRP. 34.62% patients were blood culture positive and 65.38% patients were culture negative. Majority (71.43%) of CRP positive patients were found normoglycemic, 11.90% were found hypoglycemic and only 16.67% were found hyperglycemic. Among 18 culture positive patients 11(61.11%) were normoglycaemic, 3(16.67%) were hypoglycemic and 4(22.22%) were hyperglycemic. 57.1% of hyperglycemic and 40% of hypoglycemic patients were died whereas only 13.3% of normoglycemic patients were died. Out of 10 expired patients, 2 patients Hypoglycemia, 4 patients Normoglycemia and 4 patients Hyperglycemia. Mortality was high in Hypoglycemia patient (40.0%) in comparison with normoglycaemic patient (13.33%) and the difference was not statistically significant (p&gt;0.05) between two groups. Mortality was also high in hyperglycaemic patient (57.14%) in comparison with normoglycaemic patient (13.33%) and the difference was statistically significant (p&lt;0.05) between two groups. <strong>Conclusion: </strong>Alteration of glycemic status occurred in septic newborn. Our study showed mortality is higher among the septic newborn with hyperglycemia. The incidence of hypoglycemia was high as compared to hyperglycemia. Neonatal hypoglycemia and hyperglycemia was a significant factor in the overall mortality in neonatal sepsis.</p> Mrinal Kanti Das Suravi Sarkar Md. Fazlul Kader Dilruba Sultana Md. Yousuf Ali Md. Rustam Ali Alam Iftekhar Belayet Copyright (c) 2022 Mrinal Kanti Das, Suravi Sarkar, Md. Fazlul Kader, Dilruba Sultana, Md. Yousuf Ali, Md. Rustam Ali, Alam Iftekhar Belayet 2022-11-16 2022-11-16 9 6 396 402 10.26838/MEDRECH.2022.9.6.630 Role of Serum Lactate Dehydrogenase (LDH) and endometrial thickness in the detection of endometrial carcinoma in perimenopausal bleeding <p><strong>Introduction: </strong>Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal patient (other than the expected cyclic bleeding that occurs in patients taking combined (ie, estrogen-progestin), cyclic, postmenopausal hormone therapy. Perimenopausal bleeding (PMB) occurs in approximately 3% of women and it is the usual presenting symptom of endometrial carcinoma in approximately 93% of cases. <strong>Objective</strong>: To assess the role of serum lactate dehydrogenase (LDH) and endometrial thickness in the detection of endometrial carcinoma in perimenopausal bleeding. <strong>Methods</strong>: This prospective cross-sectional study was carried out at Obstetrics and Gynecology Department, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from January 2020 to June 2022. This study included 102 women with perimenopausal bleeding admitted to Obstetrics &amp; Gynecology Department at RMCH. All cases were subjected to full history, full clinical examination, transvaginal sonography, serum LDH, and Diagnostic endometrial biopsy was taken for histopathological examination.&nbsp; <strong>Result:</strong> In this study, endometrial thickness at 11.5mm cut-off value showed 80.6% sensitivity, 53.7% specificity, PPV 53.7%, NPV 80.5%and diagnostic accuracy 64.4%. It was found that TVS evaluation of endometrial thickness is not sensitive enough to detect cancer of the endometrium and therefore, could not replace the histological evaluation of the endometrial tissue in women with postmenopausal bleeding. LDH level cutoff value of 430 U/L could differentiate malignant from benign lesions with a sensitivity of 80.6%, specificity of 57.4%, PPV of 55.7% and NPV of 81.5% with a diagnostic accuracy of 66.7%. Thus, total serum LDH can be used as a good negative test using the cut-off level (430 U/L). A combination of evaluation of endometrial thickness by TVS (with a specificity of 53.7% and accuracy of 64.4%) and serum LDH (with a specificity of 57.4% and accuracy of 66.7%) increase the specificity to 72.2%. also, increase the accuracy to 67.7%. <strong>Conclusion:</strong> Measurement of serum LDH is considered another simple method to be combined with TVS if endometrial cancer is suspected. However, further studies are needed using LDH isoenzymes profile and TVS endometrial morphology.</p> Rawshan Akhtar Nahid Yusuf Anika Ahmed Nasim Panvej Saklayen Ferdous Copyright (c) 2022 Rawshan Akhtar, Nahid Yusuf, Anika Ahmed, Nasim Panvej, Saklayen Ferdous 2022-11-12 2022-11-12 9 6 407 415 10.26838/MEDRECH.2022.9.6.637 Prevalence and antimicrobial susceptibility pattern of pseudomonas aeruginosa isolated from clinical samples in Jashore Medical College Hospital. <p><strong>B</strong><strong>ackground</strong><strong>:</strong> Pseudomonas aeruginosa is one of the leading causes of hospital-acquired infections. Increased resistance in this organism continues to pose a significant threat to patient care because of limited therapeutic options. The main objective of this study was to find out the prevalence and current antimicrobial susceptibility pattern of P. aeruginosa isolates obtained from various clinical samples at a tertiary care hospital.</p> <p><strong>Methods:</strong> The study was conducted in the Bacteriology laboratory of the Department of Microbiology, Jashore Medical College Hospital, Jashore, Bangladesh.&nbsp; All clinical samples received from various departments from January 2021 to December 2021. The colonies which were grown on culture media were identified by different standard biochemical tests. Antimicrobial susceptibility testing was done using Kirby–the Bauer disc diffusion method and the results were interpreted according to the CLSI guidelines. Quality control of the test was done by standards ATCC strain of P. aeruginosa 27853.</p> <p><strong>Result: </strong>A total of 167 cultured organisms were recorded and analyzed in this study. Among 167 cultured organisms, there were 37 isolates identified as P. aeruginosa. Among the antibiotic sensitivity patterns of P. aeruginosa, we found that the most sensitive drug was colistin 35 (94.59%), followed by levofloxacin 31(83.78%), cefuroxime axetil 29(78.38%), gentamicin 26(70.27%), and each cefperazone+sulbactum &amp; netilmicin has a percentage of 24(64.86%) On the other hand, we found P.aeruginosa showed resistance towards Ofloxacin 24(64.86%), Piperacillin 23(62.16%), Ceftazidime 21(56.76%), Cefoprazone 20(54.05%), Cefipime 20(54.05%), Aztreonam 19(51.35%), Cefaprazone + sulbactum 16(43.24%) and Gentamycin 17(45.00%).</p> <p><strong>Conclusion:</strong> Most of the P. aeruginosa strains were isolated from sputum, urine, respiratory secretions and pus samples and were found to be MDR. Piperacillin-tazobactam was the most sensitive chemotherapeutic agent followed by Colistin and levofloxacin.</p> Seema Saha Debasish Dutta Goutam Kumar Ghosh Ripa Sinthia Biswas Surovi Era Suchi Copyright (c) 2022 Dr. Seema Saha, Dr. Debasish Dutta*, Dr. Goutam Kumar Ghosh, Dr Ripa Sinthia Biswas, Dr. Surovi Era Suchi 2022-11-16 2022-11-16 9 6 416 424 10.26838/MEDRECH.2022.9.6.638 Clinical profile of myopia in adult patients at a rural tertiary care hospital. <p><strong>Introduction</strong>: Myopia, also known as short sight is that diopteric condition of eye in which, with accommodation at rest, incident parallel rays come to a focus anterior to the retina.[1] The person can see near objects more clearly than distant ones and are called “short-sighted”. The prevalence of simple myopia and high myopia (degenerative myopia) are increasing globally at an alarming rate, with significant increases in the risks for vision impairment from pathologic conditions associated with high myopia, including retinal damage, cataract and glaucoma. We conducted the study to find out the percentage of mild / moderate/severe myopia in adult patients at a rural tertiary care hospital.</p> <p><strong>Aims and Objectives:</strong>To study the clinical profile of Myopia in patients more than 20 years at a rural tertiary care hospital.</p> <p><strong>Materials and Methods:</strong> An Observational, Descriptive Cross-Sectional Hospital based study was conducted at a tertiary care hospital. A total of 100 patients with Myopia were screened and evaluated. We studied the myopic patients above 20 years attending to our hospital OPD. Family history and information about the risk factors was obtained by using pre structured proforma. Snellen’s chart was used to record the unaided visual acuity and best corrected visual acuity. Color vision was assessed by Ischihara pseudo isochromatic color plates. With the help of retinoscopy, refractive errors were determined. Spherical equivalent of refraction (SER) was calculated . Central corneal thickness was calculated by Pac Scan Pachymeter. Axial length was calculated by A Scan biometry. Dilated fundus examination was done by Direct and indirect ophthalmoscope. Results were analyzed using suitable statistical tests. Grading of myopia was done as Mild Myopia(&lt;3D), Moderate Myopia (3-6 D), Severe Myopia (&gt;6 D) and Pathological myopia with fundus changes.</p> <p><strong>Results</strong>: The mean age of the study population was 32.98 ± 15.77 years with 53% (53) males and 47% (47) females. The mean SE was -2.66 ± 3.02 D. 66% (66) patients had mild myopia, 23% (23) patients had moderate myopia,7% (7) patients had severe myopia while 4% (4) patients had pathological myopia with fundus changes.</p> <p><strong>Conclusion:</strong> Occurrence of mild myopia is most common followed by moderate, severe, and pathological myopia which is the least common type.</p> Rohit Aphale Shubhangi Nigwekar Rucha Kacha Saurabh Kapase Copyright (c) 2022 Rohit Aphale, Shubhangi Nigwekar*, Rucha Kacha, Saurabh Kapase 2022-11-22 2022-11-22 9 6 428 434 10.26838/MEDRECH.2022.9.6.634 Study of clinical profile and management of age-related macular degeneration at rural tertiary care hospital <p><strong>I</strong><strong>ntroduction: </strong>Age-related macular degeneration (ARMD) is the leading cause of irreversible blindness in elderly population after 5th decade. It is a degenerative disorder affecting macula, characterized by drusens and RPE changes. Choroidal neovascularization (CNV) and Pigment epithelial detachment (PED). Age, Gender, Smoking, Hypertension, Diabetes mellitus, Atherosclerosis, Obesity, Family history, Dietary habits are its known associated risk factors.</p> <p><strong>Aims/Objective:</strong> To Study Clinical profile, Risk factors and Management protocols in patients of Age Related Macular Degeneration at Rural Tertiary Care Hospital</p> <p><strong>Material and Methods: </strong>An observational, descriptive cross-sectional Hospital based study was conducted at a tertiary care hospital. Total 50 patients were evaluated through structured proforma. Patient’s personal history, medical history, family history, alcohol consumption, smoking, systemic illness history like Diabetes mellitus, hypertension, were studied. Dilated Fundoscopic Examination readings was taken from OPD Patient records. Direct ophthalmoscopy and Slit lamp biomicroscopy with 90D lens were conducted. Management protocols were noted like Medical management, optical management, Reference to higher center. All patients of ARMD Attending Rural Tertiary Care hospital and Patients willing to participate in the study were included. Patients below 40 years of age and Patient having optical media opacities, Myopia, Uveitis, Glaucoma, Cataract, Vitreo retinal diseases were excluded.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <p><strong>Results: </strong>Out of 50 study patients, 60% were Females. Most common age group observed was 61-70 years of age. Dry ARMD was seen in 70% patients, Wet ARMD was seen in 30 % patients. Visual acuity was more affected in Wet ARMD than Dry ARMD. Most common risk factors associated with ARMD were history of Hypertension in 70% patients, followed by Diabetes in 55%, Smoking in 57%, Alcohol consumption in 52% patients. Medical treatment was advised to 70% patients; Optical aids were given to 25% patients. 30% patients were referred to higher center; no surgical management was offered to any patients.</p> <p><strong>Conclusion: </strong>ARMD is more commonly seen in patients above 60 years of age and more in females. Dry ARMD seems to be more common than Wet ARMD, however visual disability is more in Wet ARMD.</p> Rucha M Kacha Shubhangi Nigwekar Rohit Aphale Saurabh Kapase Copyright (c) 2022 Rucha M Kacha, Shubhangi Nigwekar*, Rohit Aphale, Saurabh Kapase 2022-11-23 2022-11-23 9 6 435 441 10.26838/MEDRECH.2022.9.6.635 Correlation of serum transaminases with dengue serology <p><strong>A</strong><strong>im:</strong> Clinical correlation of dengue serology with serum transaminases</p> <p><strong>Introduction:</strong> Dengue, caused by dengue virus, spread by AEDES genus mosquito, is one of the most significant arthropod borne disease. In severe and less severe forms dengue may affect liver enzymes. The goal of this research was to examine and compare dengue serology with serum transaminases.</p> <p><strong>Methodology</strong>: The study comprised of 109 cases for which informed consent was taken and the patients were monitored throughout their hospital stay. Dengue antibody detection was used to confirm dengue infection and serum transaminases were monitored.</p> <p><strong>Conclusion: </strong>All types of dengue infection frequently result in elevated transaminases values with SGOT rising much more thn SGPT. Patients with NS1 antibody + dengue, have significantly higher serum transaminases levels. Also, high SGOT and&nbsp; SGPT values may be a poor prognostic indication and an early sign of dengue infection.</p> Ranjeet S. Patil D. V. Sumesh Reddy V. Rasagna Abhijeet Mulay Dr. S. Varade Copyright (c) 2022 Dr. Ranjeet S. Patil, Dr. D. V. Sumesh Reddy, Dr. V. Rasagna, Dr. Abhijeet Mulay, Dr. S. Varade 2022-11-23 2022-11-23 9 6 442 452 10.26838/MEDRECH.2022.9.6.639 Role of multi-detector computed tomography in characterization of ovarian masses with cyto-histopathological correlation <p><strong>Background:</strong> Ovarian cancer continues to pose a major challenge to physicians and radiologists. Besides clinical examination, CA 125 levels, and ultrasonography, CT scan is also used as a diagnostic technique for ovarian carcinoma and is superior to US in assessment of the nature of ovarian masses. With the advent of MDCT, it has become possible to acquire several thin slices and image reconstruction in axial, coronal and sagittal planes contributing valuable information towards preoperative surgical and management planning. <strong>Objectives:</strong>&nbsp; To evaluate the diagnostic accuracy of MDCT&nbsp;to differentiate between benign and malignant ovarian masses and to compare the findings with cyto- histopathological results. <strong>Materials and methods: </strong>This study was conducted in the department of Radio diagnosis, Dr. Balasaheb Vikhe Patil rural medical college and Dr. Vitthalrao Vikhe Patil Pravara Rural hospital, Loni BK, 413736 during the period of April 2021 to June 2022.CT imaging findings of 50 patients with ovarian masses were compared with cyto-histopathological results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of MDCT were calculated. <strong>Results:</strong> 50 cases were evaluated by Computed Tomography; total 60 lesions were found (10 bilateral / 50 unilateral). Benign ovarian lesions were present in 28 patients whereas malignant ovarian lesions were present in 22 patients based on Computed Tomography. Cyto/histopathological correlation revealed benign lesions in 30 patients and malignant lesions in 20 patients. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of Computed Tomography was found to be 90.0%, 86.6%, 89%, 85% and 90.0%. <strong>Conclusion:</strong> MDCT imaging offers a safe, accurate and noninvasive modality to differentiate between benign and malignant ovarian masses.</p> Shubham Mahajan Yogendra Sachdev Ravindra Kawade Ganesh Vikhe Copyright (c) 2022 Dr. Shubham Mahajan, Dr. Yogendra Sachdev, Dr Ravindra Kawade, Dr. Ganesh Vikhe 2022-11-24 2022-11-24 9 6 453 458 10.26838/MEDRECH.2022.9.6.648 Role of MRI in evaluation of cervical cancer and it’s clinical & histopathological correlation <p><strong>B</strong><strong>ackground:</strong> Cervical cancer is one of the leading causes of mortality and morbidity in women. Clinical FIGO staging has been used traditionally but due to its ineffectiveness regarding tumor extent, stromal invasion, distant organ invasion and overstaging of tumors, it is not considered the gold standard for staging of tumor. Use of MRI is now being encouraged for the pre-treatment evaluation of carcinoma cervix. Histopathology remains the most commonly utilized diagnostic tool of cervical cancers. This study was planned with the aim to compare the diagnostic performance of MR Imaging, using histology as the gold standard, with regard to the presence, size and extent of invasive cervical cancers and the detection of metastatic lymph nodes and prognosticates disease outcome and treatment modality and thus reduce the morbidity and mortality associated with the disease. M<strong>aterials and methods: </strong>This study was conducted in the department of Radio diagnosis, Dr. Balasaheb Vikhe Patil Rural Medical College and Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital, Loni BK, 413736 during the period of June 2021 to June 2022. It was a retrospective study, 30 cases of clinically suspected or diagnosed as carcinoma cervix by biopsy and Pap smear, referred to the department of Radio diagnosis. Imaging was done with 3 Tesla Philips Ignesia.</p> <p><strong>Results:</strong> Among the study population, the mean age observed was 55.62 ± 15.0 years, with BMI 20.65 ± 3.29 kg/m2 and majority belonged to lower socio-economic status.&nbsp; The common risk factors associated with Carcinoma Cervix was multiparity (74%) and the most common presenting complaint was foul smelling vaginal discharge observed in 58% cases.&nbsp; 5 cases out of 30 that were diagnosed as IA on clinical examination and on MRi they were staged as IB, IIA and IIB on MRI. Rest of the cases were staged as shown in the table and the results were &nbsp;Statistically significant. (p value&lt;0.007304)</p> <p><strong>Conclusion:</strong> Carcinoma cervix is primarily staged clinically as per FIGO guidelines but MRI can modify treatment options and may provide clinically important prognostic information not available from current FIGO staging. MRI also has the potential to be used as diagnostic tool for cervical cancer as it correlates strongly with histopathology.</p> Uma Shankar B Yogendra Sachdev Ravindra Kawade Ganesh Vikhe Risham Mahajan Copyright (c) 2022 Dr. Uma Shankar B., Dr. Yogendra Sachdev, Dr. Ravindra Kawade, Dr. Ganesh Vikhe, Dr. Risham Mahajan* 2022-11-25 2022-11-25 9 6 459 465 10.26838/MEDRECH.2022.9.6.654 Efficacy of zinc therapy in verruca vulgaris-A study in Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh <p><strong>Introduction: </strong>Verruca vulgaris, caused by human papilloma virus (HPV), is a common skin condition world-wide which may be transmitted through breaks in the skin or autoinoculation into adjacent skin. The most common treatment for warts is physical destruction of the lesion. Treatment on numerous lesions using physical destruction, such as electrocautery, curettage, and cryotherapy is avoided by some patients due to pain, discomfort, recurrence and prolonged healing time. <strong>Objective:</strong> To assess the efficacy of zinc therapy in verruca vulgaris in our Dermatology outpatient department. <strong>Methods: </strong>This study was designed as a none randomized quasi experimental study including all patients above 15 years of age, who visited Skin &amp; VD outpatient Department of Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to June 2022. 60 patients included in our study. Patients with mucosal warts or taking other drugs for warts or for any systemic disease for last two months to study or suffering with systemic illnesses or pregnancy and lactating were excluded for the study photographs were taken at baseline and at the outcome assessment. All patients were clinically examined thoroughly to rule out any systemic disease. Digital photographs were taken at baseline and at the outcome All data including demographic profile, clinical, response of treatment and side effects was recorded in an All patients were given Oral Zinc sulphate 10mg/kg/body weight (maximum of 600mg) daily for 3 months. Baseline investigations were carried out to rule out any systemic disease. &nbsp;<strong>Results: </strong>&nbsp;Total 60 patients were studied in this study. Mean years of presentation was 36 years. Commonest age group of presentation was seen between 15 and 25 years, 32(53.3%) patients (Table-1). Thirty (60%) patients were females. For the profession, 21(36%) patients were students. The difference between three months’ treatment of verruca vulgaris, 16.6% had 1 month, 20.0% and 63.3% had 2, 3 months respectively. Commonest site of presentation was seen over face in 20(33.3%) patients, followed by upper limbs 16(26.6%), scalp 8 (13.3%), soles 8 (13.3%), lower limbs 6 (10%), palms one (1.6%) and trunk 1 (1.6%). Mostly lesions were papules in 23 (38.3%) followed by papule and plaques in 18(30%), plaques in 12(20%) and combinations of nodules, papules and plaques in 7(11.6%).&nbsp; In about 27(45%) patients, lesions were firm, smooth in 25(41.6%) with regular margin in 32(53.3%). During follow-up of one month no improvement was seen in 13(21.6%), 25% improvement was seen in 36(60%), 50% improvement in 8 (13.3%) and 75% improvement in 3 (5%) patients.&nbsp; Side effects like nausea and mild abdominal pain was seen in 9 (10%) patients (See Table 2).&nbsp; Follow-up in two months showed 25% improvement in 30(50%), 50% improvement in 17(28.3%) and 75% improvement in 7(11.6%). Dropout rate was 1.66%. Side effect was seen in 1 (1.66%) patient who had gastrointestinal upset.&nbsp; Follow-up in three month showed 25% improvement in 15(25%), 50% improvement in 21(35%), 75% improvement in 16(26.6%) and 100% improvement in 4(6.66%) patients. This improvement over 3 months was statistically significant (p&lt; 0.05).&nbsp;</p> Rozina Afroz Ayesha Akter Copyright (c) 2022 Rozina Afroz, Ayesha Akter 2022-11-24 2022-11-24 9 6 466 472 10.26838/MEDRECH.2022.9.6.640 Pattern of sinonasal tumours presented in Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh <p><strong>Introduction:</strong> Sinonasal tumors most commonly arise from the nasal cavity, followed by the maxillary and ethmoid sinus; sphenoid and frontal sinus tumors are both extremely rare entities. In the sinonasal complex, squamous cell carcinoma (SCC) is the most common histology, constituting 40 to 50% of all sinonasal malignancies.&nbsp; <strong>Objective:</strong> To assess the pattern of sinonasal tumors presented in Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. <strong>Methods:</strong> This is a retrospective study carried out in the Department of ENT &amp; Head-Neck Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to June 2022. It includes 52 cases of neoplastic sinonasal growths. All cases were thoroughly evaluated including history, head and neck examination including endoscopy, imaging and histopathological examinations. All the non-neoplastic cases were excluded from the study. Details of clinical presentation, examination, radiological and histopathological findings were recorded.&nbsp; <strong>Results:</strong> A total of 52 sinonasal tumors presented during the period. Out of which, 41 were benign and 12 were malignant tumors. Out of 41 benign tumors, inverted papilloma was the most common comprising&nbsp;&nbsp; 12 cases (22.6%) followed by squamous (epithelial) papilloma 11 cases (20.8%), hemangioma 10 cases (18.9%), osteoma and fibrous dysplasia each 2 cases (3.8%) and ossifying fibroma, pleomorphic adenoma and angiomyoma one case each (2%). Out of 12 malignant tumors, squamous cell carcinoma was the commonest malignancy observed in the study. They were four in number (7.5%), followed by basal cell carcinoma in three cases (5.7%) and malignant melanoma in two (3.8%). Adenocarcinoma, osteosarcoma and Rhabdomyosarcoma were each one in number (5.37%) (Table-1). Nasal blockage (94.3%), nasal discharge (66.04%), epistaxis (39.6%), hemifacial pain/pressure (34%) and facial fullness/external deformities, each (18.9%) were among the commonest presentation. <strong>Conclusion:</strong> The similarities of benign and malignant disorders at initial presentation may lead to a significant delay in the diagnosis of malignancy. Key indicators of malignancy such as cranial neuropathies and proptosis are uncommon at initial presentation and signify advanced disease. Neoplasms of the nasal cavity and paranasal sinuses are rare but require a high index of suspicion for diagnosis due to the overlapping presentation between benign and malignant ones.</p> Md. Shafiul Alam A. Q. M. Mahmudul Haque Md. Abdul Wahed Md. Khorshed Alam Copyright (c) 2022 Md. Shafiul Alam, A. Q. M. Mahmudul Haque, Md. Abdul Wahed, Md. Khorshed Alam 2022-11-23 2022-11-23 9 6 473 480 10.26838/MEDRECH.2022.9.6.641 Relation of serum prolactin level to systemic lupus erythematosus disease <p><strong>B</strong><strong>ackground: </strong>Systemic lupus erythematosus (SLE) is an autoimmune disease that involves multiple organ systems. Prolactin accelerates the breakdown of immune tolerance by promoting the survival, maturation and activation of autoreactive B and T cells, dendritic cells and macrophages and may play a role in the pathogenesis of autoimmune diseases, including systemic lupus erythematosus. Premature cardiovascular disease is the leading cause of morbidity in lupus which may be directly associated with altered lipid metabolism in systemic lupus erythematosus patient.</p> <p><strong>Objective: </strong>To find out the relation of serum prolactin and lipid profile with systemic lupus erythematosus patients.</p> <p><strong>Methodology: </strong>This cross sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from January 2017 to December 2017. In this study, fifty diagnosed patients of SLE (Group A) and fifty apparently healthy individuals (Group B) of both sexes were selected according to the selection criteria from Department of Medicine, Dhaka medical college hospital, Dhaka (Group A) and by personal contact (Group B). Baseline parameters (body mass index, blood pressure and fasting plasma glucose) of both groups were measured. Serum prolactin was estimated by enzyme immune assay.</p> <p><strong>Results: </strong>Out of 100 patients included in our study. Mean ± SD of serum prolactin level was significantly higher (p &lt;0.001) in SLE patients (37.95 ± 18.47) ng/ml when compared to healthy controls (14.82 ± 2.86) ng/ml. Distribution of serum prolactin status in SLE patients shows among 50 patients 37 (74%) has hyperprolactinemia and 13 patients have normal prolactin level. Among age (mean ± SD), gender distribution and duration of disease of study subjects among groups. There were no significant differences in terms of age and gender between SLE patients and healthy subjects show homogenecity of both groups. Shows serum prolactin of the study subjects in both groups. Serum prolactin level was significantly higher in SLE patients than healthy individual. Serum prolactin showed significant positive correlation with SLE (p&lt;0.001). &nbsp;In Group A thirty seven SLE patients had raised serum prolactin &amp; thirteen had normal prolactin level. The correlation of serum prolactin with SLE. There was significant positive correlation of serum prolactin.</p> <p><strong>Conclusion</strong>: From present study it can be concluded that systemic lupus erythematosus is related to increased serum prolactin level and with dyslipidemia.</p> Sabrina Alam Nasima Sultana Md. Mamun Ur Rashid Jannatut Tasmin Irin Sultana Tahmidul Islam Mst. Nadira Parvin Copyright (c) 2022 Sabrina Alam, Nasima Sultana, Md. Mamun Ur Rashid, Jannatut Tasmin, Irin Sultana, Tahmidul Islam, Mst. Nadira Parvin 2022-11-24 2022-11-24 9 6 481 488 10.26838/MEDRECH.2022.9.6.642 Outcome of medical induction of labour in post-dated pregnancy <p><strong>Introduction</strong>: Post maturity, post-term, Postdate, and prolonged pregnancy is accepted terms by WHO and the International Federation are of Gynecology and Obstetrics to describe pregnancy beyond dates (expected date of delivery). Prolongation of pregnancy complicates up to 10% of all pregnancies and carries increased risk to mother and foetus.&nbsp; <strong>Objective: </strong>To study of medical induction of labour in post-dated pregnancy. <strong>Methods: </strong>This prospective observational study was conducted in the Department of Obstetrics and Gynecology, 250 Bedded Sadar Hospital, Jhenaidah, Bangladesh from January to June 2022. Fifty (50) patients included in our study. Labour induction in post-dated pregnancy was performed only after appropriate assessment of the mother and foetus. The inclusion criteria were intact membrane, cephalic presentation, singleton pregnancies, low Bishop score in post-dated pregnancies. Absolute contraindications to induction of labour include contracted pelvis, placenta previa, unexplained vaginal bleeding, presentation other than head and previous caesarean section were excluded from the study. This study shows that the main method was oxytocin drip and second method was ARM+oxytocin in drip, some cases induced by using oral prostaglandin and very few cases induced by intra cervical prostaglandin. <strong>Results: </strong>Total 50 patients included in our study. Among than 32 patients were primigravida and 18 patients were multigravida. They were 18-38 years of age range. 20 patients (40%) were induced by only oxytocin drip and second method was ARM+oxytocin drip applied on 20 patients, some cases-7 patients (20%) were induced by using oral prostaglandin and very few cases-3 patients (10%) were induced by intra cervical prostaglandin. Only oxytocin drip and failure rate was 30%, combined ARM and oxytocin drip applied on 20 patient and failure rate was 20%. 1 patient were induced by using oral prostaglandin and failure rate was 14.2% and very few cases-3 patients were induced by intra cervical prostaglandin and failure rate was 0.0% Among spontaneous vaginal delivery was 70 %, 14% assisted vaginal delivery. Among them Forceps covers 6% and Ventouse covers 8%. <strong>&nbsp;</strong>12% Caesarean section was done for foetal distress, 4% for cervical distocia and 4% for hyper stimulation. Among them healthy baby was born 70%. 26% distress baby and 4% Still birth. <strong>Conclusion</strong>: The timely onset of labour is an important determinant of perinatal outcome. Confirmation of diagnosis of postdatism is very important. In management of postdatism a careful advice and proper monitoring can alleviate maternal anxiety and untoward complications. It is a routine practice in many centers of our country to terminate most of the post-dated pregnancy by caesarean section due to limitations of foetal monitoring system and oxytocin titration Induction of labour in the presence of a ripe cervix and favorable fetal presentation appears to carry little risk to mother or foetus.</p> Md. Alauddin Mst. Marfia khatun Sadia Sultana Mollika Farhana Sharmin Copyright (c) 2022 Md. Alauddin, Mst. Marfia khatun, Sadia Sultana Mollika, Farhana Sharmin 2022-11-25 2022-11-25 9 6 489 495 10.26838/MEDRECH.2022.9.6.643 Mitral annular calcification: A marker of severe coronary artery disease in patients under 60 years old <p><strong>Background:</strong> Mitral Annular calculation (MAC) is a fibrous, degenerative calcification of the mitral valve support ring. Mitral Annular calcification is a common condition. In other population-based study, the prevalence of MAC was reported as 13%. It is more common in women and people over 70 years old. Most previous pathological and clinical studies have proposed that MAC may be a form of atherosclerosis and suggested that coronary atherosclerosis and MAC have similar etiology. <strong>Methods:</strong> A Cross sectional Study was conducted at Sir Salimullah Medical College &amp; Mitford, Dhaka, Bangladesh. Patients of coronary artery disease with or without MAC who were selected for coronary angiography. Group–1: Patients with mitral annular calcification. Group–2: Patients without mitral annular calcification. <strong>Results:</strong> Total 79 patients was selected, mean age was 48.94±8.1 years. In MAC group male patients were 41(85.4%) &amp; female 7(14.6%). In no MAC group male patients were 19(61.2%) &amp; female 12(38.8%). Significant sex difference was observed among MAC &amp; no-MAC group (p=0.005). In this study, 66% of patients with MAC and 33% of patient without MAC had single vessel disease, 68% patients with MAC and 32 % without MAC had double vessel disease, 83% of&nbsp; patient with MAC and 17% patient without MAC had triple vessel disease, and 100% of patient with MAC had left mean coronary artery disease, and 12% of MAC and 88% of patient without MAC had no significant coronary artery disease. Among 2 left main patients, 100% had severe MAC. Among 15 patients of TVD none was mild, 2(20%) moderate and 13(54.1%) had severe MAC. Among 15 patient of DVD&nbsp;&nbsp; 2(13.3%) were mild, 5 (33.4%) moderate and 8(53.3%) had severe MAC. Among 14 patients of SVD 10(71.4%) were mild, 3(30%) moderate and 1(4.2%) had severe MAC. Among 2 patient of non-significant coronary artery disease, 2(14.3%) without CAD had mild MAC and none had moderate and severe MAC. Multivariate analysis shows MAC (p=0.007) as an independent predictor for coronary artery disease. <strong>Conclusions:</strong> This study finding suggest that&nbsp; in patient aged less than 60 years, mitral annular calcification associated with an increased prevalence&nbsp; of severe and extensive&nbsp; obstructive coronary artery disease. Mitral annular calcification may be an easily detected echocardiographic marker of the presence of obstructive coronary artery disease, especially when associated with angina symptoms.</p> Md. Babul Mia Md. Rezaul Karim Nur Hossain Md. Jahurul Haque Tariq Ahmed Chowdhury Sania Hoque Copyright (c) 2022 Md. Babul Mia, Md. Rezaul Karim, Nur Hossain, Md. Jahurul Haque, Tariq Ahmed Chowdhury, Sania Hoque 2022-11-25 2022-11-25 9 6 496 504 10.26838/MEDRECH.2022.9.6.644 Fracture of radial neck and proximal ulna with medial displacement of the radial shaft <p><strong>Introduction:</strong> Radial neck injuries are reasonably common, and when present as isolated injuries with minimal displacement or angulation, a good outcome is anticipated. Elbow injuries are common in children but radial neck fractures are relatively rare (5% to 10%) in paediatric elbow fractures. <strong>Objective: </strong>To assess the fracture of radial neck and proximal ulna with medial displacement of the radial shaft. <strong>Materials and Methods:</strong> This was a retrospective study conducted at Dept. of Ortho-Surgery, Sheikh Sayera Khatun Medical College Hospital, Gopalgonj, Bangladesh from January 2018 to December 2021. Medical records of ten patients who had displaced radial neck fractures treated at our Hospital.&nbsp; Ten patients who had displaced radial neck fractures (Judet type III and type IV) treated. Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up of four years (range: six months to seven years). Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up. <strong>Results:</strong> The mean age of the patients was 9.12±2.2 years (range: 4 to 14 years). Eight (80%) patients were males and two (20%) patients were females. The right side was the most commonly injured side (right at 68% and left at 32%). Six (60%) cases were of Judet type III and (40%) cases were of Judet type IV. The mean fracture angulation of the series was 56.5 degrees (range 33.2 degrees to 79.2 degrees). Four patients had isolated radial neck fractures and four patients had associated proximal ulna fractures and one patient had associated posterolateral elbow dislocation. Among two patients treated with percutaneous pin leverage and intramedullary nailing by the Metaizeau technique, one patient had an excellent outcome, and the other had a good outcome. Among four cases treated with open reduction and K-wire fixation, two patients had good outcomes, one patient had a fair outcome, and one patient had a poor outcome. <strong>Conclusion:</strong> The majority of moderately to severely displaced pediatric radial neck fractures which need intervention can be managed by the closed reduction technique of Metaizeau with or without pin leverage with excellent to good functional outcomes at short-term follow-up. Some cases need open reduction which also has good to fair outcomes.</p> Md. Humayun Kabir Badsha Mia Sadiqul Amin Niksar Akhter Sarifuzzaman Copyright (c) 2022 Md. Humayun Kabir, Badsha Mia, Sadiqul Amin, Niksar Akhter, Sarifuzzaman 2022-11-25 2022-11-25 9 6 505 516 10.26838/MEDRECH.2022.9.6.649 Evaluation of birth weight in comparison to other anthropometric parameters to detect low birth weight <p><strong>B</strong><strong>ackground: </strong>Birth weight is an important determinant of child survival and development. Low birth weight is a major health problem in developing countries. Identification of low-birth-weight babies in the community and their screening to ascertain required level of care is very important to achieve normal goals in child survival. A large proportion of deliveries take place at home and there is need to develop simple, inexpensive, non-invasive and practical methods to identify LBW newborns soon after birth. The study was aimed to evaluate the relative usefulness and validity of chest, arm and occipito-frontal circumferences and to correlate them with birth weight to identify LBW babies.&nbsp; <strong>Objectives: </strong>To evaluate birth weight in comparison to other anthropometric parameters for detection of low-birth-weight babies. <strong>Methodology: </strong>This was a cross-sectional descriptive study conducted among the low birth weight babies admitted in the Pediatric wards and the low birth weight babies born in the Obstetrics wards of Rajshahi Medical college hospital to evaluate birth weight in comparison to other anthropometric parameters to detect low birth weight by measuring birth weight (BW) at or just after birth, chest circumference (CC), mid-arm circumference (MAC), occipito-frontal circumference (OFC) and to find suitable surrogates for low birth weight by comparing different parameters. <strong>Results: </strong>350 LBW newborns were studied. Their mean CC, OFC and MAC were 30.05cm, 31.61cm and 9.68cm respectively. Mean BW was 1975gm. There was significant relationship between birth weight and gestational age (p =&lt;0.001), chest, mid-arm and occipito-frontal circumferences (p =&lt;0.001). There was a positive correlation of birth weight to anthropometric parameters like chest, mid-arm and occipito-frontal circumferences but the highest correlation coefficient was found with mid-arm circumference (BW-MAC: r = 0.90, BW-CC: r = 0.75 and BW-OFC: r = 0.83). &nbsp;Mid – arm and chest circumferences were very good anthropometric surrogates of LBW. But MAC was the best surrogate (r = 0-90) to detect LBW babies. <strong>Conclusion: </strong>Anthropometric values are simple, practicable, quick and reliable indicators for early detection of LBW newborns in a community. MAC in our perspective can effectively be used as a surrogate for LBW.</p> Md. Selim Khan Mst. Afroza Khatun M. H. Tarafder Rawshan Akhtar Nasim Parvej Anika Ahmed Saklayen Ferdous Copyright (c) 2022 Md. Selim Khan, Mst. Afroza Khatun, M. H. Tarafder, Rawshan Akhtar, Nasim Parvej, Anika Ahmed, Saklayen Ferdous 2022-11-25 2022-11-25 9 6 517 525 10.26838/MEDRECH.2022.9.6.650 Progression of left ventricular ejection fraction after acute myocardial infarction <p><strong>Introduction</strong>: A significant proportion of deaths in patients with chronic ischemic cardiomyopathy are due to heart failure or sudden cardiac death (SCD) [1].&nbsp;Numerous clinical trials have confirmed the benefit of implantable cardioverter-defibrillator (ICD) treatment in patients with reduced left ventricular (LV) function after an acute myocardial infarction (AMI). Objective: To measure and compare Left Ventricular Ejection Fraction (LVEF) after acute anterior wall and inferior wall myocardial Infarction and correlate LVEF with clinical findings in the patients.&nbsp; <strong>Methods</strong>: It was a prospective observational echocardiography based study which was carried out in the Dept. of Cardiology, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from March to October 2022. A total of 60 (sixty) patients of (anterior or inferior) Acute Myocardial infarction (AMI) were included in the study. Patients were divided in two groups on the basis of anterior myocardial wall MI (AWMI) or inferior myocardial wall MI (IWMI). Echocardiography was done on all cases and ejection fraction was calculated by applying Simpson’s Rule and patients were examined at the same time to see the presence of signs of left ventricular failure (LVF). (LVEF) was correlated with the findings of LVF in these patients.&nbsp; <strong>Results:</strong> Out of 30 patients of anterior wall MI, 18 (60%) were male and 12 (40%) were female. In inferior wall MI, 28 (93.3%) were male and 2 (6.7%) were female. In all 60 patients (76.7%) patients were male and (23.3%) were females. In anterior wall MI, (6.7%) were in 30 to 40 years of age, (33.3%) were in 41 to 50 years of age, (33.3) were in 51 to 60 years of age, (20.0%) were in 61 to 70 years of age, and (6.7%) were in 71 to 80 years of age. Minimum age was 39 years; maximum was 72 years, with mean of 54.57 and SD of 9.22. In patients with LVF mean ejection fraction (EF) was 37.13 with standard deviation (SD) of 8.4 %. In patients without failure the mean EF was 56.29% with SD of 3.75. In 30 patients of IWMI, mean EF was 54.93% with SD of 6.86. In 30 patients of AWMI it was 46.07% with SD of 11.72. In all 60 patients minimum EF was 30% and maximum was 60% with a mean of 50.50 with SD of 10.52. In AWMI, 53% patients had signs of left ventricular failure. In patients of IWMI, 13.3% had signs of LVF.&nbsp; <strong>Conclusions:</strong> AWMI causes more decrease in LVEF. LVF is more commonly associated with AWMI than IWMI. There is statistically significant difference in LVEF of patients with and without LVF.</p> Amir Hossain Md. Abdur Rashid Md. Durul Hoda Faruk Ahmed Md. Badiuzzaman Mohammad Refatul Islam Mohammad Abdullah Al Mamun Muhammad Anwar Saadat Copyright (c) 2022 Amir Hossain, Md. Abdur Rashid, Md. Durul Hoda, Faruk Ahmed, Md. Badiuzzaman, Mohammad Refatul Islam, Mohammad Abdullah Al Mamun, Muhammad Anwar Saadat 2022-11-28 2022-11-28 9 6 526 532 10.26838/MEDRECH.2022.9.6.656 Osteoporosis awareness among perimenopausal women-A cross-sectional study <p><strong>Introduction: </strong>Osteoporosis is a global public health problem currently affecting more than 200 million people worldwide. Osteoporosis is characterized by low bone mass and is associated with deterioration of bone microarchitecture. Osteoporosis causes the bones to be fragile and increases susceptibility to fracture even with trivial trauma.<strong> Objective:</strong> To assess the knowledge of pre-and post-menopausal women on osteoporosis. <strong>Methods:</strong> A cross sectional study was carried out at the Dept. Obstetrics and Gynaecology, Sheikh Sayera Khatun Medical College &amp; Hospital, Gopalganj, Bangladesh from November 2021 to June 2022. One hundred (100) patients included in our study. Fifty premenopausal women and fifty post-menopausal women were selected using purposive sampling. Baseline data was collected and the knowledge was assessed using the knowledge questionnaire respectively developed by the researcher. Fifty pre-menopausal women between the age of 25-45 years and fifty post-menopausal women between the ages of 46-65 years were selected using purposive sampling technique. <strong>&nbsp;Results:</strong> Majority of the pre-menopausal women 38 (76%) had average knowledge, 10 (20%) had poor knowledge and 2(4%) had good knowledge when compared to post-menopausal women 35 (70%) had average knowledge, 14(28%) had poor knowledge and 1(2%) had good knowledge regarding risk factors and prevention of osteoporosis. Both premenopausal 76% and postmenopausal 70% women demonstrated average knowledge of osteoporosis based on their awareness questionnaire score. Comparison of the knowledge level in pre and post-menopausal women showed the mean knowledge score of pre-menopausal women is 11.37±3.26 SD and mean knowledge score of post-menopausal women is 10.243±.24 SD The ‘p’ value was &gt;0.05 Hence, there was no difference in the knowledge level between the pre and post-menopausal women. <strong>Conclusions:</strong> Although half of the pre- and postmenopausal women reported having some awareness of OP, their level of knowledge was average, particularly with regard to the concept, risk factors associated, treatment with the condition and its complications. Having information or creating awareness regarding the risks of OP, screening for OP and a better understanding of the diet during the post-menopausal period of those at risk are important, as both may play a major role in influencing an individual's OP-preventing behaviors.</p> Sazeda Khatun Zenat Rehana Rina Shaha Md. Humayun Kabir Fariha Rezmin A. A. Shafaatullah Copyright (c) 2022 Sazeda Khatun, Zenat Rehana, Rina Shaha, Md. Humayun Kabir, Fariha Rezmin, A. A. Shafaatullah 2022-11-28 2022-11-28 9 6 533 540 10.26838/MEDRECH.2022.9.6.658 Thromboembolic events as a complication of Covid-19 <p>Coronavirus-2 (SARS-CoV2/ Severe Acute Respiratory Syndrome Corona Virus 2) infection has emerged as a global health crisis. The incidence of thromboembolic disease is very high in SARS- CoV2 disease and involves multiple organ systems ranging from cutaneous thrombosis to pulmonary embolism, stroke or coronary thrombosis sometimes with catastrophic outcomes. Evidence points towards a key role of thromboembolism, hypercoagulability and overproductionn of proinflammatory cytokines mimicking a “cytokine storm” which leads to multiorgan failure</p> Dhiraj Giri Yogendra Sachdev Ravindra Kawade Ganesh Vikhe Copyright (c) 2022 Dr. Dhiraj Giri, Dr. Yogendra Sachdev, Dr Ravindra Kawade, Dr. Ganesh Vikhe 2022-11-03 2022-11-03 9 6 350 369 10.26838/MEDRECH.2022.9.6.629 A case report Early recognition and Timely intervention saved a life-A case report. <p>A 56-year-old male patient was brought to our Emergency room with a history of unconsciousness after a minor accident in front of our hospital. On arrival the patient was unresponsive without pulse-was in cardiac arrest, a code blue was activated and CPR started immediately, cardiac rhythm showed shockable rhythm Ventricular fibrillation, the patient has managed as per ACLS protocols for shockable rhythm-ventricular fibrillation. After 12 minutes of hard work achieved ROSC, the airway was secured, ECG showed acute anterior wall ST elevation MI, the patient was shifted to Cath lab immediately coronary angiography showed complete LAD block stunts placed, shifted to ICU extubated on next evening and discharged from hospital with no neurological deficit on 4<sup>th</sup> day.</p> <p><strong>KEY WORDS</strong>: Unresponsive, CPR, cardiac arrest, Code Blue, Shockable rhythm, coronary angiography.</p> Mohammed Shabbir Pyarejan Copyright (c) 2022 Mohammed Shabbir Pyarejan 2022-11-21 2022-11-21 9 6 403 406 10.26838/MEDRECH.2022.9.6.633 A Case series of Neonatal Inflammatory Syndrome (MIS-N) with rare clinical manifestations <p>Multisystem inflammatory syndrome in neonates (MIS-N) is hypothesized to be caused either following transplacental transfer of SARS-CoV2 antibodies. MIS-N presents with a variety of clinical presentations and requires a high index of suspicion.</p> Param Harsh Ashwin Arora Copyright (c) 2022 PARAM HARSH, Ashwin Arora 2022-11-23 2022-11-23 9 6 425 427 10.26838/MEDRECH.2022.9.6.632