Background: Cholangiocarcinoma is a malignant tumor of the biliary epithelium with poor prognosis due to late presentation. Histopathology is the gold standard for diagnosis but is invasive and limited in assessing tumor extent. Triphasic multidetector computed tomography (MDCT) offers a non-invasive alternative for evaluation. Objective: To assess the diagnostic role of triphasic MDCT in characterizing cholangiocarcinoma and to correlate imaging findings with histopathology. Methods: This cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, from September 2022 to August 2024. A total of 33 patients with suspected cholangiocarcinoma underwent triphasic MDCT. Imaging findings regarding lesion characteristics, location, growth pattern, vascular invasion, lymph node involvement, and enhancement patterns were analyzed. Histopathology was used as the reference standard. Diagnostic performance was calculated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Results: The mean age was 65.6 ± 7.51 years, with 66.7% males. Most tumors were perihilar (63.64%) and periductal infiltrating (60.6%). Ill-defined margins (69.7%) and delayed enhancement (81.82%) were common findings. Vascular invasion and lymph node involvement were seen in 27.3% and 39.39% of cases, respectively. MDCT showed a sensitivity of 89.66%, specificity of 75%, accuracy of 87.88%, PPV of 96.3%, and NPV of 50%, with a significant correlation with histopathology (p = 0.01). Conclusion: Triphasic MDCT is a reliable, non-invasive modality with high diagnostic accuracy for cholangiocarcinoma and is valuable for tumor characterization and staging.

Wilms tumor is the most common primary malignant renal tumor of childhood. Treatment of Wilm’s tumor consists of surgery, chemotherapy and occasionally radiotherapy. Counseling of parents, regarding the treatment cost is one of the most important components of treatment. However, as there is no published article or data is available in Bangladesh regarding the actual treatment cost of the disease, it becomes very difficult for the paediatric oncologists and paediatricians to give exact idea to the parents about the treatment cost. This cross-sectional, observational study was aimed to ascertain the treatment cost of Wilms tumor in Bangladesh. The study was done in the Department of Paediatric Hematology & Oncology and Department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital and Department of Paediatric Surgery of Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh, between December 2010 and May 2011. Sixteen patients were enrolled from indoor and outpatient department of both the hospitals. Data was collected by interviewing parents and checking the order for chemotherapy. Investigation cost and medicine cost was calculated from money receipt of the hospital and medicine store respectively. Data was noted in the prepared questionnaire form and cost of treatment of individual patient was calculated. The treatment cost including operative, chemotherapy and radiotherapy cost was calculated in free bed and paying bed of both the hospitals. In free bed, treatment cost for stage–I was USD 427.26, while for stage II–IV was USD 529.35. In paying bed, treatment cost was USD 548.59 for stage–I, USD 653.24 for Stage II–IV, and USD 2802.71 for relapsed cases with intensive chemotherapy. In private hospitals, treatment cost was USD 756.35 and USD 858.44, for stage–I and Stage II–IV respectively. To conclude, treatment cost depended upon the staging, histology and whether the treatment was done in Government Hospital or private hospital. However, if a child with Wilms tumor presents at earlier stage, the treatment is quite affordable at around USD 425 in government tertiary level hospital in Bangladesh. International Journal of Human and Health Sciences Vol. 10 No. 02 Apr’26 Page: 99-102

Introduction: With the expectation of having better clinical outcome in the treatment of class v non-carious cervical lesions, nano filled resin modified glass ionomer cement (RMGIC) has been introduced in dentistry. This study aimed to evaluate the clinical performance of nano filled RMGIC in the management of class V non-carious cervical lesions. Materials and methods: It was a randomized clinical trial carried out at the Department of Conservative Dentistry and Endodontics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The patients had at least two non-carious cervical lesions on the buccal surface with approximal depth of 1-1.5 mm. Total 50 samples were included. Nano filled resin modified glass ionomer restoration was assessed by Modified Ryge’s Criteria by means of retention, color matching, marginal integrity and surface texture. Patients were recalled after 3, 6, and 12 months for follow up observation. Results: At 12 months follow up, the retention of 47(94%) nano filled RMGIC showed Alpha rating. Regarding color matching, nano filled RMGIC were more color stable observed. The marginal integrity of nano filled RMGIC was also better after six months interval. Further more polished enamel surface texture was achieved in 45 (90%) nano filled RMGIC at 12 months observation. Conclusion: The outcomes of using nano filled RMGIC in the restoration of cervical defects of teeth, prior to root coverage measures, were very encouraging regarding both clinical and patient-centered parameters such as retention, surface finish, and marginal integrity. For better understanding of the material, long term follow-ups are necessary. Update Dent. Coll. j: 2025; 15(2): 7-12

Background: The World Health Organization (WHO) created the International Classification of Functioning, Disability, and Health (ICF) in 1998 because disability information is important for health. A person's functioning in six important life domains—cognition, mobility, self-care, getting along, daily activities, and involvement in society—is captured by WHODAS 2.0 (WHODAS-2), which was developed to expand the breadth and applicability of the ICF. Due to factors including overcrowding, poverty, illiteracy, ignorance, and a lack of access to healthcare, disabilities are quite common. In order to facilitate future comparisons as well as validity testing, this research attempts to translate, culturally modify, and verify WHODAS 2.0 into Bangla. Methods: The research, carried out at Bangabandhu Sheikh Mujib Medical University in Dhaka, included 46 adult individuals with medical disorders and challenges in performing tasks. The original English WHODAS 2.0 was translated into Bangla for preliminary surveys. A pilot study was performed to evaluate the comprehensibility along with the accuracy of the pre-final version. Authorization to translate the English version was secured in accordance with Beaton et al.'s suggestion. The completed questionnaire's reliability and validity were evaluated in the second step. Results: The research included 40 patients, having a mean age of 36.25±12.18 years. The predominant demographic was male, with an average of 72.5%. The majority were uneducated, with just 17.5% possessing reading and writing skills. The majority of them were married, separated, widowed, or cohabiting. The majority were self-employed. The WHODAS 2.0 surveys have satisfactory internal consistency, with a Cronbach's alpha of 0.955 for all 38 questions. The authors advocate for an alpha greater than 0.7, which is the benchmark for all scales. The computed ICC is 0.975, situated between the range of 0.962-0.985. Conclusion: The Bangla version of WHODAS 2.0 demonstrates internal consistency, validity, responsiveness, and usability, exhibiting strong discriminative qualities for evaluating impairment in patients. J Shaheed Suhrawardy Med Coll 2024; 16(2): 69-78

Background: Pilonidal sinus disease is a common and debilitating condition that predominantly affects young adults, especially males, and is characterized by chronic inflammation of the natal cleft with a tendency for recurrence and significant morbidity despite various surgical treatment options. The purpose of the study is to evaluate the perioperative course and early postoperative outcomes of patients undergoing Limberg flap surgery for pilonidal sinus. Methods: This prospective observational study at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh (July 2019–August 2020) included 18 adult patients with primary pilonidal sinus who underwent Limberg flap repair, with perioperative outcomes, complications, and recovery assessed at follow-up, and data analyzed using SPSS® 24 under ethical approval and patient consent. Results: Among 18 patients undergoing Limberg flap surgery for pilonidal sinus, the mean age was 26.9 ± 5.2 years, with 88.9% male. Mean operative time was 88.8 ± 12.7 minutes, hospital stay 4.17 ± 0.7 days, and return to work 12.7 ± 1.8 days. Postoperative complications occurred in 5 patients (27.7%), mainly seroma and tip necrosis, with no recurrences up to 9 months; overweight strongly correlated with complications (r = 0.93, p < 0.001). Conclusion: Limberg flap surgery for pilonidal sinus is safe and effective, allowing early recovery with low complication rates, though overweight patients have higher risk of postoperative complications.

The world has been devastated by the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 2019 to 2023 which necessitated stratifying patients into mild, moderate, severe, and critical categories based on clinical presentation, oxygen saturation, radiological findings, and systemic inflammatory response syndrome (SIRS). This study aimed to quantify lung involvement using high-resolution computed tomography (HRCT) and correlate it with clinical severity and laboratory parameters. This observational cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July to September 2020. A total of 90 RT-PCR-confirmed COVID-19 patients were enrolled from outpatient and inpatient departments on the basis of clinical and laboratory parameters in accordance with Interim Guidance, 27th May, 2020 on the Management of COVID-19 from WHO. The major CT findings and CT severity score were described by using internationally standard nomenclature defined by the Fleischner Society glossary and peer-reviewed literature on viral pneumonia. CT severity scores were calculated and statistically correlated with clinical severity and laboratory markers including SpO2, neutrophil and lymphocyte percentages, CRP, and D-dimer. A receiver operating characteristic (ROC) analysis was performed to determine a cutoff CT severity score for identifying severe cases. The mean CT severity score was 11.66, with severe cases showing significantly higher scores than non-severe cases (13 vs. 8.87). HRCT scores had a moderate negative correlation with SpO2 and lymphocyte percentage, and a moderate positive correlation with neutrophil percentage, CRP, and D-dimer. A CT severity score ≥ 8.5 was identified as the threshold for severe disease on ROC analysis. Age, sex, smoking status, and comorbidities had no relation with the severity of COVID-19. HRCT severity score had moderate negative correlation with disease severity of COVID-19. HRCT severity score is also found to have moderate positive correlation with total neutrophil percentage, CRP, and D-dimer; and moderate negative correlation with total lymphocyte percentage. No correlation was also found between increasing CT severity score with the presence of comorbidities. HRCT severity scoring showed a moderate correlation with clinical severity and laboratory markers in COVID-19, supporting its utility in triage and prognostication. Integrating HRCT scoring into clinical evaluations may enhance decision-making and patient management strategies.

Background: While rheumatoid arthritis is the most commonly seen form of inflammatory arthritis world-wide, it is accompanied by chronic inflammation of the synovium, resulting in structural damage and disability. Methotrexate remains the primary first-line conventional synthetic csDMARD used for rheumatoid arthritis, also being advocated as a first-line treatment option for treat-to-target approaches owing to its established efficacy, especially in controlling the disease activity and halting structural development. Nonetheless, the achievement of remission or sustained LDA as a solo therapy, especially using methotrexate, is possible only for a limited proportion of patients, as evidenced by real-world data, where a wide variability is seen, especially according to baseline disease activity. Objectives: The aims of the present study were to find the rate of remission or LDA state after methotrexate monotherapy and to find the predictive factors of this rate in patients suffering from RA. Methodology: This uncontrolled open-labeled clinical trial was carried out in the Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from January to December 2019. The patients satisfying the American College of Rheumatology (ACR) criteria of RA published in 2010, who were unexposed to MTX, were started on subcutaneous injections of MTX, with a fixed weekly dose of up to 25 mg. Of a total of 105 patients, 91 patients completed the follow-up period of 6 months. The principal outcome measure was achievement of LDA or remission, based on Disease Activity Score-28 with C-reactive protein (DAS28-CRP). Secondary outcomes were Clinical Disease Activity Index (CDAI) response rates and achievement based on American College of Rheumatology 50% improvement criteria (ACR50). Results: 20.9% of patients met LDA and 18.7% met remission at 6 months of MTX monotherapy based on DAS28-CRP. In total, around 40% of patients met treat-to-target criteria for LDA or remission. Baseline activity level was significantly associated with achieving DAS28-CRP response (OR 0.09; 95% CI 0.02–0.46). There was also an association between HLA-DR4 SNP rs6457617 and CDAI response (p = 0.05). Conclusions: In this patient population, 40% of the patients attained LDA/remission state on methotrexate monotherapy. Baseline disease activity emerged as an important predictor of response, while genetic predictors such as HLA-DR4 SNPs could also affect response trajectory.

Background: Mandibular ameloblastoma is a locally aggressive odontogenic tumor which presents with various clinical and radiological manifestations. It is important to learn its clinicopathological appearance to manage it surgically in the best possible way and to get tumor free clear margin. Objectives: To assess the clinicopathological and radiological features of the mandibular ameloblastoma and compare the outcome of the surgical as well as postoperative results between various resection margin groups. Methods: This prospective experimental study included 30 patients with histopathologically confirmed mandibular ameloblastoma treated at the Department of Oral and Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University. Patients were allocated into three groups of ten based on radiological tumor extent and planned resection margins of 0.5 cm, 1.0 cm, and 1.5 cm, respectively. Clinical data, radiographic findings, operative details, and histopathological outcomes were systematically recorded. Tumor extension patterns, tumor length, follow-up duration, margin status, and postoperative complications were analyzed. Statistical evaluation was performed using SPSS Version 16.0, with significance set at p < 0.05. Results: The majority of patients were between 20 and 30 years of age (46.7%), with a male predominance (60%). Radiological evaluation showed that Group 3 exhibited the most extensive tumor spread, frequently involving the entire ramus. Mean tumor length did not differ significantly among groups (p = 0.105). Tumor-free margins were achieved in 28 cases, with margin involvement occurring only in Group 1. Segmental resection was the most common procedure. Postoperative complications included wound dehiscence (n=4), plate exposure (n=3), and plate fracture (n=2). No recurrence was observed during follow-up. Conclusion: Mandibular ameloblastoma reveals variable radiological extension patterns, with wider resection margins (≥1 cm) ensuring predictable tumor-free clearance. The overall post-operative consequences remained satisfactory, and no recurrence was detected during follow-up.

Background: Spinal anesthesia is commonly used for lower limb and perianal surgeries, offering effective intraoperative and early postoperative analgesia, though achieving optimal pain control remains a challenge due to the limited duration of standard local anesthetics and potential opioid-related side effects. This study aimed to compare the postoperative analgesic efficacy, safety, and patient satisfaction of intrathecal dexmedetomidine versus fentanyl in patients undergoing perianal surgery. Methods: This quasi-experimental study at the Departments of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, included 64 perianal surgery patients receiving intrathecal bupivacaine with either fentanyl or dexmedetomidine. Sensory and motor blocks, hemodynamics, pain, analgesia duration, adverse effects, and satisfaction were recorded and analyzed using SPSS 23.0 (p < 0.05). Results: In 64 patients (32 per group), demographics were comparable (mean age 45.3 ± 8.5 y, 75% male, 57.8% ASA I). Group B had longer sensory (292.1 vs 205.6 min) and motor blocks (162.5 vs 126.5 min) and prolonged analgesia (278.5 ± 16.2 vs 198.7 ± 25.2 min). VAS scores were lower in Group B at 2–6 h (p ≤ 0.033). Adverse effects were mild, with pruritus only in Group A, and patient satisfaction was high and similar between groups (4.58 ± 0.5 vs 4.53 ± 0.5). Conclusion: Intrathecal dexmedetomidine provides superior and prolonged postoperative analgesia with good safety and high patient satisfaction in perianal surgeries.

Background: Spinal anesthesia is widely regarded as the preferred method for lower abdominal surgeries due to its cost-effectiveness, safety, and ability to provide postoperative analgesia while preserving mental clarity and airway reflexes. This study aimed to compare the block characteristics and hemodynamic effects of intrathecal dexmedetomidine versus fentanyl when added to hyperbaric bupivacaine in patients undergoing saddle block for perianal surgeries. Methods: This quasi-experimental study at the Departments of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh (Oct 2021–Sep 2022), enrolled 64 perianal surgery patients assigned to bupivacaine–fentanyl or bupivacaine–dexmedetomidine groups, assessing block, hemodynamics, analgesia duration, and complications. Data were analyzed with SPSS 23.0 (t-test/Chi-square, p < 0.05). Results: Sixty-four patients received saddle block with bupivacaine 7.5 mg plus fentanyl 15 μg (Group A) or dexmedetomidine 5 μg (Group B). Baseline characteristics were comparable. Sensory (4.82 vs 4.65 min) and motor block onset (12.26 vs 11.58 min) were similar. Hemodynamics remained stable, with minor mid-interval decreases. Group B had longer sensory (292.1 min) and motor block (162.5 min) and prolonged analgesia (278.5 vs 198.7 min, p = 0.0001). Hypotension occurred in 2 patients in Group A; no cardiovascular collapse was noted. Conclusion: Intrathecal dexmedetomidine prolongs sensory and motor block and analgesia more than fentanyl while maintaining stable hemodynamics and minimal complications in saddle block.

Introduction: Cervical cancer is the second most common cancer in female with high morbidity and mortality. Worldwide, cervical cancer is the fourth most occurring malignancy and results in an estimated 530,000 new cases annually with 270,000 deaths. In many developed countries, health education, awareness programs and early detection and appropriate management achieve 80% reduction in mortality. Cervical cancer death is successfully prevented in developed countries by cervical cytology screening. Methods: This was a comparative cross sectional study conducted in Gynaecological Oncology Department of Bangabandhu Sheikh Mujib Medical University. Duration of the study was one year from July 2018 to June 2019. It was aimed to evaluate the performance status of Pap's smear as a screening test for cervical cancer. Sample size was Hundred and Pap's smear were collected at GOPD. Cytology of the sample were done by conventional method. All the patients underwent colposcopy and directed biopsy at the colposcopy clinic of Gynae Oncology. Result: The result shows maximum (44%) patients had first intercourse at 10-15 years of age. Maximum (72%) patients came from low socioeconomic condition. The specificity and positive predictive value of pap's test was found as 81% and 52.63% respectively. According to pap's report 19% patients were positive and according to colposcopy biopsy 59% patients were positive for cervical intraepithelial neoplasia. Conclusion: Cervical cancer screening for the early diagnosis of CIN, pap's smear is mandatory. VIA as a screenings test is not sufficient for the postmenopausal women. Medicine Today 2026, Vol.38 (1): 129-132

Introduction: Invasive fungal infections (IFI) are common nosocomial infections in immunosuppressed individuals. Method: It was a cross-sectional and observational study. A total of 77 peripheral venous blood samples were collected from clinically suspected IFI patients from the intensive care unit (ICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU). The study was conducted from December 2022 to August 2023. Result: A total of 77 critically ill patients with a high risk of invasive fungal infection (IFI) were classified based on blood culture into three groups: no fungemia (41 patients with proven bacterial sepsis), suspected fungemia (25 patients with negative blood culture), and definite fungemia group (11 patients with culture-proven fungemia). 10/54 presented Candida spp. and 1/54 presented Aspergillus spp. Hospitalization for more than 3 weeks, the use of a central device, persistent thrombocytopenia, and CRP levels were significantly higher in the definite fungemia group compared to the other two groups. In contrast, mechanical ventilation lasting more than 1 week was significantly higher in the definite fungemia group compared with the no fungemia group. IFI was more commonly seen in patients with autoimmune diseases (p = 0.002, odds ratio 10.13, 95% CI: 2.3-44). The majority of cases were from the age group of _60 years, predominantly male. Conclusion: Invasive fungal infection is grossly underreported in critical settings. Early suspicion, thorough investigation, and timely diagnosis may alleviate patients of significant mortality and morbidity. Medicine Today 2026, Vol.38 (1): 32-36

Anisometropic amblyopia is the most common cause of visual morbidity in childhood which is characterized by reduced spatial vision due to refractive error. This study was planned to determine the visual outcome after full refractive correction of anisometropic amblyopia among 5-15 years old children. The Cross sectional interventional study was conducted conducted in the Departments of Community Ophthalmology and Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from March 2017 to august 2019. Children (5-15 years) having myopic, hypermetropic & astigmatic refractive error between two eyes will be minimum 1.0 D difference after refraction and didn’t get any treatment for this problem yet were the study population. Total 52 untreated children were included in the study. 3 children did not attend the follow up visit. The mean age of the subjects of our study was 9.47 years, range of age was 5-15 years. 44 (89.8%) patients were bilateral & 5 (10.2%) were unilateral. After full correction of refractive error with spectacles alone improved anisometropic amblyopic eyes visual acuity an average of 2.3 lines in snellen’s chart. Visual acuity improved from baseline by 2 or more lines (95% CI) in 85% of the patients and by 3 or more lines in 49.3%. This improvement is statistically significant (P<0.0001). Additionally, amblyopia resolved in 7 of 49 (15%) patients with residual amblyopia who continued to be treated with spectacles even after completion of follow up plan. Improvement of visual acuity continued beyond the initial 12 weeks of spectacle wearing for 37 (75.5%) of the 49 patients completing the initial 12 week visit, after completing 24 weeks, it was 26 (53.1%). The mean VA of the right eyes at baseline was 0.45 Log MAR unit. In 2nd visit shows the mean of VA is 0.34 log MAR unit and in 3rd visit mean is 0.23 log MAR unit. Total improvement in right eye was 0.22 logMAR unit. The mean VA of the left eyes at baseline was 0.51 LogMAR unit. In 2nd visit shows the mean of VA is 0.37 logMAR unit and in 3rd visit VA mean is 0.30 logMAR unit. Total improvement in right eye was 0.21 logMAR unit. Average improvement in both eyes 0.215 logMAR unit. So, results shows that refractive correction is a powerful treatment modality for young children with anisometropic amblyopia. If we can detect them earlier then we should have given these children a better vision & prosperous life. J.Natl.Inst.Ophthalmol.2024;7(2): 20-27

Background: Post-operative complications following biliary tract surgery vary widely, and comprehensive data on their patterns, management, and outcomes remain limited, especially in resource-constrained settings. The aim of the study was to evaluate the types, clinical features, management strategies, and outcomes of complications following biliary tract surgery in 50 patients. Methods: This prospective study at the Department of Surgery, Dhaka Medical College Hospital (DMCH), and Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from January 2007 to February 2008 included 50 patients with complications following biliary tract surgery, excluding combined biliary, pancreatic, or stomach procedures. Patients underwent detailed history, examination, and investigations (USG, LFT, ERCP, MRCP). Minor complications were managed conservatively, major complications surgically (Roux-en-Y hepaticojejunostomy/ choledochojejunostomy), and retained stones endoscopically, with outcomes assessed on follow-up. Results: Among 50 patients, most were male (43, 86%) and aged 31-50 years (37, 74%). Minor bile leak (20%) and bile duct injuries (30%) were the most common complications, with jaundice (40%) as the main clinical feature. Laparoscopic cholecystectomy caused 80% of injuries. Most presented within 1 month (70%). Management included operative (40%), non-operative (34%), and endoscopic (10%) approaches, with Roux-en-Y hepaticojejunostomy being the most frequent procedure (60%). Follow-up showed recurrent cholangitis (14%) and restricture (4%). Conclusions: Biliary tract injuries, particularly after laparoscopic cholecystectomy, remain a serious concern, with timely recognition, careful surgical technique, and Roux-en-Y hepaticojejunostomy being key to management, while prevention and vigilant long-term follow-up are essential to optimize outcomes.

Background: Diabetes mellitus (DM) is a major global health concern, with men affected having a threefold higher risk of erectile dysfunction (ED) than non-diabetic men. The study aims to determine the association between serum lipid profile abnormalities and ED in adult patients with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study at the Departments of Dermatology and Venereology and Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh (March 2019–July 2020) included 382 married men with T2DM. Age, body mass index (BMI), diabetes duration, glycated haemoglobin (HbA1c), and lipid profile were recorded. ED was assessed using the Bengali IIEF-5 and classified as severe, moderate, mild, or no ED. Data were analyzed with statistical package for the social sciences (SPSS) v23.0 (t-test, Chi-square; p≤0.05). Results: Among 382 men with type 2 diabetes, 158 (41.4%) had ED. Those with ED were older (48.7 versus 44.3 years), had higher BMI (26.5 versus 25.9 kg/m²), higher HbA1c (8.21 versus 7.95), and longer diabetes duration (7.14 versus 5.95 years; all p ≤ 0.05). ED severity was severe 10.2%, moderate 13.4%, and mild 17.8%. Triglycerides were higher (225.1 versus 200.8 mg/dl, p<0.001) and LDL-C slightly lower (131.97 versus 136.02 mg/dl, p=0.025), with no differences in total cholesterol or HDL-C. Conclusion: Elevated triglycerides and slightly lower LDL-C are associated with erectile dysfunction in men with T2DM, highlighting the role of lipid abnormalities in its development.

Background: Rasmussen encephalitis (RE) is a chronic, progressive encephalitis affecting one hemisphere of the brain. Intractable focal seizures, progressive neurological & cognitive decline and hemispheric atrophy are common clinical and radiological presentations of the disease. Objective: To see the clinical spectrum & short-term treatment outcome of Rasmussen Encephalitis. Method: It was a prospective interventional study, conducted at Department of Pediatric Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2022 to July 2023. Total 15 patients with Rasmussen encephalitis were evaluated after IV Methylprednisolone therapy at the doses of 20-30 mg/kg/day. Results: Among 15 patients, 8 (53.3%) were aged 5–10 years and 7 (46.7%) were <5 years; males predominated (11, 73.3%). All presented with seizures, hemiparesis, neuroregression, and cognitive impairment. Dysarthria was observed in 10 (66.7%) and facial nerve palsy in 4 (26.7%). Focal seizures were most common (7, 46.7%), followed by generalized tonic–clonic seizures (3, 20%). EEG showed unihemispheric slowing in 12 (80%) and generalized slowing in 3 (20%). Neuroimaging revealed unihemispheric insular–perisylvian atrophy with basal ganglia involvement in all cases. Following IV methylprednisolone, seizure frequency improved in 13 (86.7%) and EEG improved in 8 (53.3%). Conclusion: All patients with Rasmussen encephalitis presented with seizure, hemiparesis, neuroregression & cognitive impairment. IV Pulse methylprednisolone therapy were effective where seizure frequency reduced more than three-fourth cases & electroencephalographical improvement occured more than half of the cases of all Rasmussen encephalitis.

Background: Splenectomy in children is an uncommon procedure. Data based on children, who underwent splenectomy in Bangladesh are scarely published. Incidence of early postoperative complications is highest from first to third days after surgery. So, the objective of our study to find out the early postoperative outcome of splenectomized children. Methods and Materials: Patients who underwent splenectomy from Jan' 2016 to Dec'2023 were reviewed retrospectively from the medical files in the Pediatric Surgery Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Datas were analysed by using the Statistical Package of Social Science of Software Program (SPSS) version 26. Results: In our study 55.7% were male patients. Age range was (4-18) years, mean age 11.02+3.92. Among them 63.9%(101) patients was within the age (> 5 to 12) years,. 27.8% (44) patients was (>12- 18) years, and 8.3% (13) patients was (1-5) years of age. Indication of the splenectomy was mostly (70.3%) Hb E- beta thalassemia.93.1% patients had history of repeated blood transfusion.Patients Hb level significantly(p<0.001)) increased after splenectomy. 66.5%(105) patients developed no complication after splenectomy and 33.5% (53) patients developed different types of early postoperative complications. Of them 37(23.3%) patients developed thrombocytosis, 8( 5.1%) patients developed portal vein thrombosis, 5(3.2%) patients intra-abdominal hemorrhage and death occurred only in 3(1.9%) of patients. Conclusion: Indications for splenectomy in our institution was mostly hematologic disorders patients. Complications after splenectomy were equivalent to other literatures. DOI: https://doi.org/10.52783/jchr.v16.i1.11937

Objective: This study aims to determine the efficacy of tofacitinib in the treatment of early diffuse cutaneous systemic sclerosis.Materials and methods: This open-label randomized controlled clinical trial was conducted at the Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka. The trial was registered at ClinicalTrials.gov (identifier: NCT06044844). Consecutive sampling was used in this study. Forty-six patients were randomized to groups A and B using block randomization, with 23 patients in each group. In group A, tofacitinib (5 mg) was administered twice daily. Group B received cyclophosphamide (500 mg/m² monthly). Primary efficacy was assessed by the change in the Modified Rodnan Skin Score (mRSS) from baseline after 24 weeks. Secondary efficacy was assessed by the change in the Disease Activity Score for 28 joints (DAS28) in response to changes in C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR). The Bangla version of the Health Assessment Questionnaire-Disability Index (B-HAQ) response from baseline to 24 weeks was analyzed. Oral prednisolone (≤10 mg/day), calcium channel blockers, and phosphodiesterase 5 inhibitors (sildenafil and tadalafil) were administered. Follow-up was performed at four, 12, and 24 weeks. History, physical examination, and relevant investigations were used to assess adverse effects. Changes in acute-phase reactants and composite measures within the groups from baseline to 24 weeks were also analyzed. Adverse effects were assessed through patient history, physical examination, and relevant investigations.Results: Per-protocol analysis showed a significantly greater reduction in mRSS in group A compared with group B at 12 weeks (7.0 ± 2.89 vs. 5.26 ± 2.42; p = 0.03) and 24 weeks (10.17 ± 2.92 vs. 8.0 ± 4.08; p = 0.04). DAS28-ESR and DAS28-CRP reductions were significant between the groups from baseline to weeks 12 and 24 (p < 0.05). The reduction in functional status (measured by B-HAQ) was 2.11 ± 4.91 and 0.96 ± 0.53 in groups A and B, respectively (p = 0.43). FVC change was 9.17 ± 8.33 in group A and 3.43 ± 8.1 in group B. Within the other core set of outcomes, composite measures were significantly improved in group A. Two patients (8.7%) in group A and six patients (17.4%) in group B developed nausea. Two patients (8.7%) in both groups developed respiratory tract infections and urinary tract infections. Taeniasis developed in three patients (13%) in group B. Two cyclophosphamide-treated patients (8.7%) developed hemorrhagic cystitis.Conclusions: Tofacitinib demonstrated significant efficacy in reducing skin thickness (mRSS) in early dcSSc, showing both numerical and statistical advantages over cyclophosphamide at 24 weeks, along with a more favorable safety profile. These findings support further evaluation of tofacitinib as a potential therapeutic option in this patient population.

A case-control study was carried out in the Department of Obstetrics &amp; Gynaecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between January 2013 and June 2014, to see the association of hypertension and C-reactive protein (CRP) levels in pre-eclampsia patients. A total of 78 patients were enrolled in the study. Patients were divided into three groups: group-I included of 26 pregnant women with mild pre-eclampsia, while group-II had 26 pregnant women with severe pre-eclampsia and group-III had 26 women with normal pregnancy. Group-I and group-II were together considered as ‘case’, while group-III was considered as ‘control’. We adopted a convenient sampling technique. For each patient, after a 10-minute of resting phase, blood pressure was measured following standard procedure. C-reactive protein (CRP) was measured from patients’ serum based on latex particle-enhanced nephelometric immunoassay using CardioPhase® High Sensitivity CRP kit. The mean systolic BP was found 155.0±13.7 mmHg in group-I+group-II (case group) (i.e., mild and severe pre-eclampsia), while 108.46±0.8 mmHg in group III (control group). Similarly, the mean diastolic BP was found 102.31±9.7 mmHg in group-I+group-II and 68.46±7.8 mmHg in group-III. The differences were statistically significant (p=0.001). The mean CRP level was found 23.82±21.8 mg/L in group-I+group-II (case group) and 4.42±0.9 mg/L in group-III (control group). The difference was statistically significant (p=0.001). A positive significant correlation was found between systolic blood pressure and CRP level, as of Pearson's correlation coefficient r=0.439 (p=0.025) and r=0.434 (p=0.027) in mild and severe pre-eclampsia respectively. Similarly, a positive significant correlation was found between diastolic blood pressure and CRP level, as of Pearson's correlation coefficient r=0.446 (p=0.022) and r=0.440 (p=0.024) in mild and severe pre-eclampsia respectively. CBMJ 2026 January: vol. 15 no. 01 P:50-55

A descriptive, cross-sectional study was conducted in the Department of Forensic Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from September 2023 to February 2025, to evaluate the knowledge, attitudes, and perceptions of undergraduate medical students regarding medico-legal autopsies, exploring the impact of forensic medicine education on their understanding and appreciation of autopsies in future medical practices. A total of 105 students from third to fifth year of the MBBS program were selected through convenient sampling. Before data collection consent was taken and confidentiality was strictly maintained. Data was collected through a semi-structured, pre-tested questionnaire. The mean age of participants was 22.26±1.12 years, with most in the 21–22 years age group (68.6%). Gender distribution was nearly balanced (51.4% male and 48.6% female). A significant portion of respondents (73.3%) demonstrated knowledge of the purpose of autopsies, while 88.6% recognized the necessity of postmortem examinations in all unnatural deaths (P&lt;0.001). 73.3% students know the aims of autopsy which is to determination of cause and circumstance of death. 35.2% students think that autopsy is indicated in suicidal death. 84.8% of students have an idea about the laboratory for chemical analysis but they have (69.5%) wrong idea about the preservatives of viscera which they think is formalin. 63.8% of students have knowledge that stomach, liver and kidney are preserved for chemical analysis (P&lt;0.001). 79% of students recognize that an inquest report is necessary before conductive medico-legal autopsy. 78.1% know the classification of postmortem and they (67.6%) also know that virtual autopsy new form of postmortem examination. Comfort with autopsy exposure was reported by 75.2% of students, 97% students do not think autopsy as a harassment to the victim’s family and 78% endorsed the inclusion of autopsies in the curriculum. 67.6% strongly agreed that autopsy helped in improving students anatomy. However, 80% expressed dissatisfaction with the limited number of autopsies observed (P&lt;0.001). Overall, undergraduate medical students exhibit positive attitudes and awareness towards medico-legal autopsies; however, some gaps in practical exposure/training and emotional preparedness were identified by them. CBMJ 2026 January: vol. 15 no. 01 P:224- 232