Male To Female Ratio Research Articles

Modelling incidence and mortality cancer parameters with respect to GLOBOCAN 2020Age standardized world estimates

In this paper, an empirical model with the critical number of incidences and deaths for female cancers as adjustable parameters has been developed using life expectancy data from GLOBOCAN world estimates on cancer types. The model was developed based on the cumulative risk and exponential correlation techniques such that the significance of the adjustable parameters ascertains the strength of this research in two ways. First, it indicates indicates the rapid increase in female cancer morbidity with increase in the number of male cancer cases, regardless of incidence or mortality. Second, it suggests that female cancer cases may approach a virtual limiting value as male cancer cases reach extremely high levels. This projection aligns with the global population trends, indicating a proportional increase in cancer cases each year. Additionally, the cumulative risk of cancer incidences of each sex has been modelled separately against the global cumulative risk of cancer incidences of both sexes which revealed regions that have passed their inflection point and those that are yet to reach the inflection point. There was a curvature change, which indicates an inflection point coinciding with the South-Eastern Region and indicating that for the regions beyond the inflection point, the increase of the cumulative risk of cancer incidences of females against that of males is more accentuated compared with the regions before the inflection point. However, when the cumulative risk of cancer mortality of each sex is modelled separately against the global cumulative risk of cancer mortality of both sexes shows a non-linear dependence and the increase is more accentuated for males than for females. This finding indicates that cumulative risk is influenced by factors beyond the male-female population ratio. This study advances cancer studies as it provides a nuanced understanding of gender-specific cancer trends, crucial for developing targeted cancer prevention and treatment strategies. By elucidating the dynamics of cancer incidences and mortalities across different regions and sexes, the findings can inform public health policies and resource allocation to combat cancer more effectively on a global scale.

Prognostic Factors in Patients Diagnosed with Gallbladder Cancer over a Period of 20 Years: A Cohort Study.

Gallbladder cancer (GBC) is an uncommon cancer. This study aimed to determine the outcomes of GBC in relation to geographic, demographic, and clinical factors in a Canadian province from 2000 to 2019. This population-based retrospective cohort study included all patients diagnosed with gallbladder cancer (GBC) in Saskatchewan, Canada, from 2000 to 2019. Cox proportional multivariate regression analysis was conducted to identify factors associated with poorer outcomes. In total, 331 patients with a median age of 74 years and male-female ratio of 1:2 were identified. Of these patients, 305 (92%) had a pathological diagnosis of GBC. Among patients with documented staging data, 64% had stage IV disease. A total of 217 (66%) patients were rural residents, and 149 (45%) were referred to a cancer center. The multivariate analysis for patients with stage I-III GBC showed that stage III disease [hazard ratio (HR), 2.63; 95% confidence interval (CI), 1.09-6.34)] and urban residence (HR, 2.20; 95% CI, 1.1-4.39) were correlated with inferior disease-free survival. For all patients, stage IV disease (HR, 3.02; 95% CI, 1.85-4.94), no referral to a cancer center (HR, 2.64; 95% CI, 1.51-4.62), lack of surgery (HR, 1.63; 95% CI, 1.03-2.57), a neutrophil-lymphocyte ratio of >3.2 (HR, 1.57; 1.05-2.36), and age of ≥70 years (HR, 1.51; 95% CI, 1.04-2.19) were correlated with inferior overall survival. In this real-world context, the majority of patients with GBC were diagnosed at a late stage and were not referred to a cancer center. For those with early-stage GBC, living in an urban area and having stage III disease were linked to worse outcomes. Across all stages of GBC, stage IV disease, older age, absence of surgery, lack of referral to a cancer center, and a high neutrophil-to-lymphocyte ratio were associated with poorer survival.

Extreme Body Condition Index Values in Small Mammals.

The body condition index (BCI) values in small mammals are important in understanding their survival and reproduction. The upper values could be related to the Chitty effect (presence of very heavy individuals), while the minimum ones are little known. In this study, we analyzed extremes of BCI in 12 small mammal species, snap-trapped in Lithuania between 1980 and 2023, with respect to species, animal age, sex, and participation in reproduction. The proportion of small mammals with extreme body condition indices was negligible (1.33% with a BCI < 2 and 0.52% with a BCI > 5) when considering the total number of individuals processed (n = 27,073). When compared to the expected proportions, insectivores and herbivores were overrepresented, while granivores and omnivores were underrepresented among underfit animals. The proportions of granivores and insectivores were higher, while those of omnivores and herbivores were lower than expected in overfit animals. In several species, the proportions of age groups in underfit and overfit individuals differed from that expected. The male-female ratio was not expressed, with the exception of Sorex araneus. The highest proportion of overfit and absence of underfit individuals was found in Micromys minutus. The observation that individuals with the highest body mass are not among those with the highest BCI contributes to the interpretation of the Chitty effect. For the first time in mid-latitudes, we report individuals of very high body mass in three shrew species.

Evaluation of Surgical Reconstruction of Old Tendo Achilles Injury by Bosworth Technique

Background: Chronic Achilles tendon rupture in the watershed hypovascular region (zone II) makes end-to-end repair less feasible. Bosworth's technique, involving gastrocnemius-soleus turndown, was studied to determine its efficacy and functional outcome in repairing chronic tendon in zone II. Objective: To evaluate surgical reconstruction of old Tendo Achilles injury by Bosworth technique. Methods: This prospective study was carried out in Dhaka Medical College Hospital (DMCH) form July 2006 to December 2007. 20 cases were selected as non-randomized purposive sampling technique who came to the out patients department of DMCH. All cases were diagnosed as old neglected Tendo Achilles injury and treated by surgical reconstruction by Bosworth technique. Two cases were lost from follow up and discarded from the study. Finally the study was done on 18 patients. Results: The mean age of the patients was 31.7 years and the lowest and highest cases were 17 and 47 years respectively. The male female ratio was 5:1. One-third (33.3%) patients were day labourer, 22.2% service holders, 16.7% house wives and the rest 27.8% students. Two-Third of the patients (67%) had involvement of left Tendo Achilles and the rest (33%) had right Tendo Achilles. Nearly 40% of patients’ injury was caused by the overhanging edge of the toilet Pan, 27.8% by traumatic rupture, 11.1% assaulted by sharp weapon, another 11.1% by sharp edge of a metallic plate, 5.6% accidentally by sharp cutting knife and 5.5% by broken glass. The mediun level of injury was 3.5 cm above from the insertion of Tendo Achilles, while the lowest and highest level were 2.5 and 6 cm. Minimum delay from injury to operation was 6 weeks and maximum 32 weeks. 5 patients (27.8%) gained normal range of ankle movement, 6 patients (33.3%) decreased by 5° of unaffected side, 4 (22.2%) by 10° and 3 (16.7%) by more than 10⁰. Mean power of planter flexion, mean calf width and mean score to stand on tip toe on injured side relative ........

Management and Outcomes for Peritoneal Dialysis Patients Diagnosed with Abdominal Hernias.

The success of peritoneal dialysis is highly dependent on the integrity of the abdominal wall. Therefore, routine examination and treatment of abdominal hernias can prevent peritoneal dialysis (PD) failure, discontinuation, and conversion to hemodialysis. In this present study, we present our examination protocol for patients proposed for PD and our attitude in treating parietal defects in patients on peritoneal dialysis. highlight whether PD is a risk factor for the occurrence of ventral hernias, the relationship between associated pathologies and the occurrence of hernias and the need for an HD switch in the postoperative period. Between January 2016 and December 2022, a group of 133 patients proposed for insertion of a PD catheter were evaluated according to the protocol established by our hospital. Routine examination for the diagnosis of abdominal hernias and repair before starting the DP is part of the procedure. We included patients with a 3 year minimum follow-up after insertion and evaluated the incidence of parietal defects that appeared during PD treatment. Nine patients were diagnosed and operated on for abdominal hernia before starting peritoneal dialysis and none of them had a recurrence of hernia during PD. Twelve patients were diagnosed with abdominal hernias during dialysis treatment (9% incidence) and the median length of time at which parietal defects occur during PD is 12.5 months [range 2-48]. Median BMI is 27.12 [range 22.3-31.24], with a female-male ratio of 2:1 Five patients were transferred to HD, three permanently and two patients temporarily. No patient abandoned PD treatment due to the presence of an abdominal parietal defect. Diagnosis of ventral hernias prior to the time of catheterization for PD leads to a decrease in the incidence of parietal defects during PD and is mandatory in patients who are candidates for PD. Open alloplastic surgical procedures are safe procedures with a low recurrence rate in PD patients. The postoperative continuation of PD is feasible but the decision is to be made by the multidisciplinary team and individualized for each patient.

Temporal dynamics of condition index and glochidia larval occurrence in freshwater mussel, Lamellidens corrianus (Lea, 1834) collected from a wetland of Mymensingh, Bangladesh

We report the temporal pattern of condition index (CI), and glochidia larval presence and discharge in freshwater mussel, Lamellidens corrianus, obtained from the Darikathal Beel at Trishal upazila of Mymensingh district in Bangladesh. Samples were drawn monthly over a year from July 2021 to June 2022. The mean shell length, shell height, shell breadth, tissue wet weight, and shell dry weight were 86.29±8.36 mm, 19.31±1.42 mm, 40.31±4.90 mm, 12.52±4.77 g, and 12.05±2.85 g, respectively. The male-female sex ratio was 1.00:2.00 with no sexually undifferentiated animals in the sample.

Long Term Health Problems and Associated Factors among COVID-19 Recovered Patients

A cross-sectional, descriptive study was conducted among 181 individuals recovered from COVID-19 infection and had been missing infection (negative rt-PCR test) or signs-symptoms for minimum three months. The study aims determine newly developed health problems in patients, which was conducted at Post-COVID Unit of Anwer Khan Modern Medical College Hospital, Dhaka, Bangladesh, between July 2021 and June 2022. Through convenient sampling, data were collected by face-to-face interview and history of signs/ symptoms during the infection were recorded from reviewing prescription and interview as well by using a semi-structured questionnaire. The mean age of the participants was 39.56±6.92 years and male-female ratio was 1.45:1. The mean monthly family income of the participants was 36,022.09±4130.56 BDT which represents lower middle to middle class family in terms of Bangladesh context. During COVID-19 infection most of the (97%) respondents had fever, and 87%, 79% of the patients had sore throat and cough respectively as common symptoms; in addition, more than one-third (34%) had diarrhea. Several constitutional symptoms also recorded during their course of illness like headache (74%) and malaise (54%). More than one-third (34%) of the respondents required admission in hospital. During the course of infection, 41%, 26% and 31% participants were suffered from mild, moderate and severe form of COVID-19 illness. Most of the respondents developed long term health problems following COVID infection and post-viral fatigue was the most prevalent (85%) among the post COVID individuals and this long-term health problem-post viral fatigue was found to be associated with monthly income and it was statistically significant (p&lt;0.05). Others long term health problems including shortness of breath (74%), loss of memory (38%), difficulty in concentration (41%), loss of hair (30%), fast beating or pounding heart (33%) were also noticed. Insomnia (56%), persistent cough (35%), loss of taste (32%) and change of bowel habit (28%) were other health problems revealed in this study. Association between loss of memory and gender (p&lt;0.0001), diabetes mellitus and severity of COVID-19 (p&lt;0.05), sore throat, cough and severity of COVID-19 (P&lt;0.05) were also found significant. diabetes mellitus (35%), hypertension (34%) and bronchial asthma (24%) were observed to be most common comorbidities. Shortness of breath – one of the post-COVID consequence was found significantly associated with diabetes mellitus and bronchial asthma (p&lt;0.05). Our study found that persistence of various signs and symptoms from COVID-19 infection and newly yield complications in individual who recovered from COVID-19 infection are collectively comprise long term health problems of post-COVID patients. This long-term health problem of post-COVID people is a major public health concern. Fatigue, dyspnea, difficulty to concentrate, memory loss, persistent cough, fast beating or pounding heart, loss of smell, loss of taste, insomnia are the most common long term health problems in COVID-19 recovered people. Long-term follow up may be recommended to understand future consequences of COVID-19 patients and well-being for the post-COVID people. CBMJ 2024 July: vol. 13 no. 02 P: 158-168

Comparison of Titanium versus Resorbable Intramedullary Nailing in Pediatric Forearm Fractures.

Pediatric forearm fractures, particularly involving the shaft or diaphysis, are common injuries typically resulting from accidental trauma during various activities. Traditional treatment involves closed reduction and casting; however, surgical intervention may be necessary in certain cases. The gold standard surgical approach utilizes elastic stable intramedullary nailing (ESIN), but a newer technique uses bioabsorbable intramedullary nails made of poly(lactic-co-glycolic acid) (PLGA). This study aims to compare the outcomes of these two surgical methods in pediatric diaphyseal forearm fractures. We retrospectively reviewed 86 patients who underwent operative treatment due to the diaphyseal fractures of the forearm in the Surgical Division, Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary between 2018 and September 2022. The mean age was 9.48 (ranging from 4 to 17). A total of 41 patients underwent surgery with PLGA implants (RESIN technique), while 45 patients were treated with titanium elastic nails (ESIN technique). Various factors including patient demographics, injury mechanisms, fracture characteristics, and complications were assessed. Both groups showed similar gender distribution, with a majority of fractures occurring in boys (the male-female ratio was 31:10 in the PLGA group, while in the titanium elastic nailing (TEN) group, this ratio was 29:16, with no statistical difference between the groups (p > 0.005). The average age of the patients treated with PLGA implants (8.439 years) was lower compared to those treated with titanium nails (10.422 years). A statistically significant difference was found regarding the average age of the two groups (p = 0.0085). Left-sided injuries were more prevalent in both groups (59% of the cases in the PLGA group and 69% in the TEN group, with no statistically significant difference, p = 0.716), and fractures typically involved both the radius and ulna. This represents 93% of the cases in the PLGA group and 80% in the TEN group. Regarding the involvement of bones, we also did not find a statistically significant difference (p = 0.123). The mechanisms of injury predominantly involved indirect force, such as falls (30 cases in the PLGA group and 27 cases in the TEN group), and no statistically significant difference was found (p = 0.139) regarding the mechanism of the injury. Complication rates were lower in the PLGA group (7%) compared to the titanium group (20%). The treatment of pediatric diaphyseal forearm fractures using PLGA implants appears to be a viable alternative to traditional titanium implants. Advantages include no need for secondary surgery and associated cost savings and reduced complication rate and stress associated with anesthesia and surgery. Prospective randomized trials are warranted to further validate these findings and explore long-term outcomes.

Validity of Serum Ammonia Level for Diagnosis of Severity of Hepatic Encephalopathy in Children

Hepatic encephalopathy is a broad spectrum neuropsychiatric abnormalities of liver dysfunction. Ammonia level may correlate with the severity of liver failure. The brain is very sensitive to the toxic effects of ammonia. As a result patient may manifests with irritability, slurring of speech, reversal of sleep-awake cycle, flapping tremor, confusion, stupor or even deep coma. This study was aimed to validate the ammonia level in children with liver failure for the assessment of its severity considering hepatic encephalopathy. This cross-sectional comparative study was conducted among 64 children aged 1-15 years of both sexes (study subjects) diagnosed as acute or acute on chronic liver failure in the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of November 2017 to September 2019. The subject were divided into two groups for the comparison of ammonia level to assess the severity in contrast to hepatic encephalopathy. In the first group 32 were liver failure with encephalopathy and in the second group 32 were liver failure without encephalopathy. Hepatic encephalopathy was diagnosed on the basis of West Haven Criteria. The analysis was done by the Receiver Operating Characteristic Curve with SPSS-20. Among the 64 patients female were 45% whereas male patients were 55%, male female ratio was 1.2: 1. Regarding etiology, Wilson disease was the most common cause and it was nearly two-third (65.6%) of children, cryptogenic cirrhosis was 10%, Hepatitis A was 9.4%, Autoimmune Hepatitis (AIH) was 3.10%, Hepatitis E, Hepatitis B, Hepatitis C, biliary atresia and lipid storage were 1.60% respectively. This study showed that, ammonia of ≥71 µmol/L is an indicator for presence of hepatic encephalopathy in children. The analysis by the Receiver Operating Characteristic Curve showed area under the curve (AUC) is 0.86 with upper bound 0.96 and lower bound is 0.77. It was observed that about half (48.4%) of the children had positive blood ammonia level (≥71.0 umol/L) and among the children of positive blood ammonia level most of them (80.65%) had hepatic encephalopathy and 19.35% had no encephalopathy. More than half (51.6%) children had negative (&lt;71.0 umol/L) blood ammonia level, among them 21.21% children had encephalopathy and 78.79% patients had no encephalopathy. Sensitivity of blood ammonia was found 78.1%, specificity 81.2%, positive predictive value 80.6%, negative predictive value 78.8% and accuracy 79.7%. In conclusion, high level of ammonia is found with higher grade of encephalopathy and hyperammonia is also found in liver failure without encephalopathy. Bangladesh Med J. 2023 May; 52(2): 1-5

Role of Laparoscopy in Evaluation of Various Blunt Abdominal Trauma

Introduction with Objective: The aim of the present study was to assess the role of laparoscopy in evaluation of various Blunt abdominal trauma (BTA) in tertiary care teaching hospital. Materials and Methods: A prospective observational study was conducted from 21st June 2016 to 21st December 2017 among 50 abdominal blunt trauma patients attending at Casualty Block, Dhaka Medical College Hospital, Dhaka, after obtaining requisite consent from the patients attendant. Data were collected through the assessment and investigation report of abdominal blunt trauma patients in the Casualty Department. The collected data were entered into the computer and analyzed by using SPSS (version 20.1) to assess the role of laparoscopy in evaluation of various blunt abdominal trauma. Results: Most of the patients were from 21-30 years (36%) of age group followed by 11-20 years (32%). The median age of this study population is 27 years. Of the study population, 84% (n=42) were male and 16% (n=8) were female. Male-female ratio was 84:16. In this study, 62% (n=31) of patients underwent only laparoscopy and 38% of patients (n=19%) underwent laparoscopy followed by laparotomy. Perforation of gas containing hollow viscus (94.73%) is responsible for conversion of laparoscopy into laparotomy in patients with blunt abdominal trauma. Among 50 patients 14 patients (28%) developed post operative complications. Rate of wound infection was higher laparoscopy followed by laparotomy (n=11). One patient developed post operative collection following laparoscopy. The accuracy rate is 100% in laparoscopic evaluation of BTA in this study. Conclusion: laparoscopy is a useful modality for evaluating and managing hemodynamically stable blunt abdominal trauma patients. Medicine Today 2024, Vol.36 (2): 95-98

Nutritional Status of Under-Five Children in the Climate Vulnerable Area of Bangladesh

Children, due to their physiological and metabolic vulnerabilities, are particularly sensitive to climate-related changes. Factors such as heat waves, extreme weather events, temperature variations, increased precipitation, and drought directly impact food and nutrition. This cross-sectional study was aimed to assess the nutritional status of under-5 children in a flood-prone district in northern Bangladesh. A total of 207 children aged 24-59 months were conveniently selected for the study. Data collection involved face-to-face interviews and observations using a semi-structured questionnaire. Data analysis was performed using SPSS version 16.0. Demographic information, educational background, immunization status, breastfeeding practices, health history, and dietary intake were considered for assessing nutritional status. More than half (55.6%) of the children was in age group 48-59 months, and the male-female ratio was 1.25:1. Most of the (70%) children belonged to nuclear families and more female children (53.6%) had completed their primary education than male (44%). All children were immunized, where three-fifth (60.4%) of the mothers acknowledged breastfeeding after birth, and three-fourth (75.4%) had completed exclusive breastfeeding. The majority were not ill in the month preceding the data collection. Dietary assessment revealed that most of the (94%) children consumed rice in the morning as breakfast, 97% at midday as lunch, and 94% at night as dinner. Among the children all of them had experienced flooding (100%) and significant proportion had experienced river bank erosion (97.6%). According to measurements, 81.2% were normal by MUAC, 62.8% by height for age Z scores, 71% by weight for age Z scores, and 83.1% by weight for height Z scores. The study identified higher proportions of underweight and severe wasted cases in male children, severe stunted cases with mothers having primary education, and severe wasted cases in extended families. Although certain trends were observed, the relationships between nutritional status and variables such as gender, maternal education, family type, and duration of residence were not statistically significant. Given the potential long-term impact of malnutrition, early intervention, and prioritization of nutritional considerations during the under-five age group are imperative. Bangladesh Med J. 2023 May; 52(2): 29-39

The role of immune-inflammatory markers in children with complicated and uncomplicated malaria in Enugu, Nigeria

BackgroundThere is currently insufficient data regarding immune parameters and relationship with severity of malaria infection in Enugu, Nigeria where the economic and social costs of the disease and its management are extremely high. This study was conducted to determine the relationship between malaria severity and some immune-inflammatory markers among malaria-infected children in Enugu, Nigeria.MethodsThe study adopted a case control design. Eligible children were categorized into three groups — complicated, uncomplicated and healthy children. Pro-inflammatory cytokines –interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α); and anti-inflammatory cytokine — interleukin-10 (IL-10) were assayed using enzyme-linked immunosorbent assay (ELISA) technique, while immune cell ratios — neutrophil lymphocyte ratio (NLR) and monocyte lymphocyte ratio (MLR) were calculated from full blood count results.ResultsThe overall mean age of the participants was 7.3 ± 3.4 (range: 6 months − 12 years) and the male-female ratio was 1:1. There was no significant difference between the ages of the three groups (P = 0.44). The Mean levels of IFN-γ, TNF-α, and NLR were higher in complicated than uncomplicated malaria (266.9 ± 66.3pg/ml vs. 62.5 ± 6.4pg/ml, p < 0.001; 140.3 ± 30.0pg/ml vs. 42.0 ± 9.0pg/ml, p < 0.001; and 32.9 ± 16.2pg/ml vs. 17.8 ± 6.0pg/ml, p < 0.001, respectively); and higher in uncomplicated malaria than healthy children (62.5 ± 6.4pg/ml vs. 40.6 ± 9.1pg/ml, p < 0.001; 42.0 ± 9.0pg/ml vs. 105.7 ± 32.1, p < 0.001; 17.8 ± 6.0pg/ml vs. 18.7 ± 6.2pg/ml, p < 0.001, respectively). On the other hand, the mean level of IL-10 is higher in uncomplicated than complicated malaria (105.73 ± 32.06pg/ml vs. 40.60 ± 9.11pg/ml, p < 0.001). There was a positive correlation between NLR and IFN-γ (r = 0.815; p = 0.003), as well as NLR and TNF-α (r = 0.745; p = 0.002).ConclusionComplicated malaria is associated with higher levels of pro-inflammatory cytokines while uncomplicated malaria is associated with higher levels of anti-inflammatory cytokines. NLR correlates positively with pro-inflammatory cytokines, and could be useful in evaluation for the severity of malaria infection.

Pattern of poisoning cases in Bir Hospital

Background: Poisoning is one of the major causes of hospitalization through emergency and is a major public health problem in the country. For starting preventive measures, information on nature and extent of poisoning is required. For some years, there has been no study on poisoning at Bir hospital. Objectives: To find out the patient profile, the common poisons and outcome of poisoning cases. Materials and Methods: A retrospective analysis of all acute poisoning cases admitted to the emergency department of Bir Hospital from January 2005 to June 2005 was done to study the pattern of acute poisoning. Data on age, sex, time elapsed after intake, circumstances of poisoning, name of the poisonous substance, actual use, chemical type, hospitalization days, severity and outcome were collected and analyzed. Results: The age of the patients varied from 16 to 65 years. The male female ratio was 1:1.3. More than three-fourth (76.8%) of the female patients were from 16 to 25 years age group. Similarly, 46.5% of the male patients were from 16 to 25 years age group. In more than 25 years of age, there was malepredominance in all the age group. The common insecticides used for poisoning were organophosphorus compounds mainly Methyl Parathion (Metacid) and Dichlorovos (Nuvan). Paracetamol alone or combination preparations with antihistamines were the most common analgesic used. Benzodiazepines were the most commonly used anxiolytics. Ninety-seven percent of caseswere intentional poisoning for suicidal attempt. Most of the cases (61.6%) had arrived hospital within 3 hours after exposure to the poison. The hospital stay of the admitted patients with poisoningranged from one to sixteen days. The mean hospital stay was 5.9 days. During the hospital stay, six (6.0%) cases were managed in Intensive Care Unit (ICU) service. In this study, only 3% cases had mortality. There were 5 cases of Aluminium Phosphide poisoning but surprisingly, none of them died from this highly toxic poison. Conclusion: Suicide among adolescents and young adults is a common public health problem. Patients with intentional poisoning must undergo psychiatric consultation during their stay in the hospital for the treatment poisoning. This will minimize the risk of next attempt of self harm. In addition, strict rules must be followed regarding sale of psychotropic medicines and pesticides. Effective clinical management of poisoning can minimize the mortality.

Clinical spectrum and risk factors of severe dengue among hospitalized patients - a cross-sectional study during the 2023 dengue epidemic in Bangladesh

Introduction: Dengue is a significant public health concern for Bangladesh with recurrent epidemics. This study aimed to investigate the clinical and biochemical presentations and identify risk factors for severe dengue among patients admitted to a tertiary care hospital during the 2023 epidemic in Bangladesh. Methods: This cross-sectional study was conducted at a tertiary care hospital in Bangladesh between July and September 2023. Data were collected from 176 adult patients with serologically confirmed dengue infection. Clinical and laboratory parameters were recorded, and severity of dengue was categorized according to WHO guidelines. Logistic regression was performed to identify predictors of severe dengue. Results: Of the 176 patients included, 113 had severe dengue and 63 had non-severe dengue. The mean age was 34.5 (SD 14.3) years, with a male-female ratio of 1:1.07. Conventional symptoms including fever, myalgia, headache, and retro-orbital pain were present in majority of patients, with warning signs present in twothirds of them. Laboratory findings showed leukocytopenia (53%), thrombocytopenia (25.6%), elevated hematocrit level (4.5%), elevated ALT, AST and ferritin level (36%, 24% and 50% respectively). Logistic regression identified persistent vomiting (aOR 3.22, 95% CI 1.41–8.04), clinical fluid accumulation (aOR 2.23, 95% CI 1.13–5.74), and elevated serum AST (aOR 3.13, 95% CI 1.30–7.79) as predictors of severe dengue. Conclusion: Most dengue cases presented with typical symptoms and warning signs, with associated laboratory abnormalities. Persistent vomiting, clinical fluid accumulation, and elevated serum AST levels upon admission could predict severe dengue. J MEDICINE 2024; 25: 121-128

TUSC3, p53 and p21 genetic association with development of oral submucous fibrosis and oral squamous cell carcinoma among addictive tobacco chewers of Pakistan

BackgroundThis study delves into the intricate landscape of oral cancer, a global concern with a high incidence in Asian countries. We focus on oral squamous cell carcinoma (OSCC), primarily driven by the consumption of betel nut and its derivatives. OSCC often arises from premalignant lesions like oral submucous fibrosis (OSF). In Pakistan, OSCC is prevalent among men due to various addictive substances, including smokeless tobacco and chewing materials. Mutations in tumor suppressor genes, such as TP53 and p21, play crucial roles in this malignancy’s development. We also explore the involvement of TUSC3 gene deletion in OSCC and OSF.MethodsIn this study we investigated demographics, TUSC3 gene expression, deletion analysis, and TP53 and p21 genetic alterations in OSCC and OSF patients (blood and tissue of 50 samples in each condition) who had tobacco derivates usage history. The association analysis was carried out mainly through PCR based genotyping.ResultsThe study’s patient cohort (OSCC and OSF) displayed a wide age range from 13 to 65 years (Mean = 32.96 years). Both conditions were more prevalent in males, with a male-female ratio of approximately 2.5:1. Chewing habits analysis revealed high frequencies of gutka use in both OSF and OSCC patients. TUSC3 expression analysis in OSCC cell lines indicated significant downregulation. Genotyping showed no TUSC3 deletion in OSF cases, but a deletion rate of over 22% in OSCC tissue samples. Analysis supported a significant association of TUSC3 deletion with OSCC development but not with OSF. Polymorphism in p53 exon 4 and p21 (rs1801270) were significantly associated with both OSCC and OSF, adding to their pathogenesis. Our findings further revealed a strong correlation between TUSC3 deletion and the excessive use of tobacco and related products, shedding light on the genetic underpinnings of OSCC development.ConclusionsNotably, our study provides a crucial insight into genetic aspects underlying OSCC and OSF in response of addictive consumption of areca nut, betel quid, and tobacco derivatives. A significant association between TUSC3 deletion and OSCC development, along with polymorphisms in TP53 and p21, underscores the importance of further research into the molecular mechanisms driving oral cancer progression for improved diagnosis and treatment outcomes.

Thrombus age does not differentiate between cardiogenic and atherosclerotic strokes

ObjectiveInterventional stroke therapy made thrombi available for histological analysis. Unfortunately, simple composition aspects such as erythrocyte versus fibrin/platelet rich did not allow a feasible allocation to thrombi’s cardiac or carotid...

Perception of Fresh Graduates and new Academic Faculty Regarding Specialty of “Health Professional Education” as a Career- A Multicentre Study in Pakistan

Objectives: To gain insight into emerging medical professionals’ awareness and willingness to choose health profession education as their career Study design: Quasi experimental trial. Place and duration of study: HIT Hospital Taxila in the period of 6 months. Methodology: A cross-sectional questionnaire-based study was conducted in 3 institutes Wah Medical College (Wah Cantt), UMDC (Lahore), Sardar Begum Dental College and Kabir Medical College (Peshawar) and allied hospitals. The participants were selected via convenience sampling. MBBS and BDS graduates were included in the study. Data was collected using a self-administered questionnaire using nominal YNDK scale used to evaluate the understanding regarding Health professional education. Data was collected and analyzed in SPSS version 23. Results: Eighty-five participants completed the questionnaire with equal male female ratio. The participants were well aware of the field and were well acquainted with MHPE.A significant number of participants agreed on making it part of undergraduate curriculum as 67% of them faced difficulties during their undergraduate studies. 91% encouraged Health professional education training at their institutes and 70% of them have Health professional education department. PBL and OSCE were known to 55.3% and 88.2% respondents respectively. Experience alone cannot make one a good teacher was expressed by 71.8% participants while 47.1% respondents command on subject is enough for being a good teacher. 65.9% participants stated that Health professional education is a demanding that involves active teaching not merely a managerial job. Conclusions: Our results highlight the need for more research into how medical professionals see health profession education. The ever-changing healthcare landscape requires educational programs that are in line with potential students’ knowledge base and objective to enhance health profession education that develops a skilled and driven healthcare workforce in Pakistan.

Perception of Fresh Graduates and new Academic Faculty Regarding Specialty of “Health Professional Education” as a Career- A Multicentre Study in Pakistan

Objectives: To gain insight into emerging medical professionals’ awareness and willingness to choose health profession education as their career Study design: Quasi experimental trial. Place and duration of study: HIT Hospital Taxila in the period of 6 months. Methodology: A cross-sectional questionnaire-based study was conducted in 3 institutes Wah Medical College (Wah Cantt), UMDC (Lahore), Sardar Begum Dental College and Kabir Medical College (Peshawar) and allied hospitals. The participants were selected via convenience sampling. MBBS and BDS graduates were included in the study. Data was collected using a self-administered questionnaire using nominal YNDK scale used to evaluate the understanding regarding Health professional education. Data was collected and analyzed in SPSS version 23. Results: Eighty-five participants completed the questionnaire with equal male female ratio. The participants were well aware of the field and were well acquainted with MHPE.A significant number of participants agreed on making it part of undergraduate curriculum as 67% of them faced difficulties during their undergraduate studies. 91% encouraged Health professional education training at their institutes and 70% of them have Health professional education department. PBL and OSCE were known to 55.3% and 88.2% respondents respectively. Experience alone cannot make one a good teacher was expressed by 71.8% participants while 47.1% respondents command on subject is enough for being a good teacher. 65.9% participants stated that Health professional education is a demanding that involves active teaching not merely a managerial job. Conclusions: Our results highlight the need for more research into how medical professionals see health profession education. The ever-changing healthcare landscape requires educational programs that are in line with potential students’ knowledge base and objective to enhance health profession education that develops a skilled and driven healthcare workforce in Pakistan.

Helicobacter Pylori: Beyond The Gut - Insights Into Its Association With Dermatological Conditions

Introduction: Helicobacter pylori (H. pylori) is a Gram-negative bacterium associated with gastrointestinal diseases and extra-gastrointestinal manifestations, including dermatological conditions. Understanding the precise mechanisms and clinical implications of the H. pylori skin disorder association is essential. Materials and methods: A cross-sectional observational study was conducted at a private dermatology center in Ahmedabad, Gujarat, from January 2021 to August 2023. Patients coming with various dermatological conditions and with suspected H. pylori infection underwent clinical examination, laboratory tests, and skin biopsy to confirm the diagnosis of disease. The statistical analysis assessed associations between demographics, dermatological conditions, and H. pylori antibody test results. Laboratory Investigation: H. pylori antibody levels were measured using serology by doing H.pylori IgG antibody level testing and cut-off values of &gt;0.90 were considered positive. Statistical Analysis: Data entry and analysis involved Microsoft Excel 360, calculating proportions, and percentages, and drawing appropriate inferences. Results: Of 1131 enrolled patients (male-female ratio 1:1.43), 22% tested positive for H. pylori, with higher positivity rates in patients aged &gt;60 years and 40-60 years. Analysis revealed varying proportions of H. pylori positivity across dermatological conditions, with alopecia areata and chronic urticaria showing the highest rates. Conclusions: While studies suggest H. pylori’s involvement in dermatological diseases, further research is needed to understand this relationship fully. Systematic investigations into the impact of eradication therapy are essential to inform clinical management strategies and guide future research directions.

P-119 Factors affecting male-to-female ratio at birth in IVF/ICSI cycles

Abstract Study question Are there any factors during an IVF cycle that can influence the ratio of male or female preimplantation embryos? Summary answer Semen preparation technique significantly influences the male-female ratio of newborns through IVF-ICSI with a greater proportion of boys with gradients and girls with swim up. What is known already Although some works have related the fertilization technique or the transfer of blastocysts with the male-female ratio in those born through assisted reproduction, there are limited studies that investigate the relationships of the various factors involved during an IVF/ICSI cycle with the ratio male-female at birth. Furthermore, the number of studies that looked at the effect of embryo morphokinetics in sex ratio at birth, produced contradictory results. Study design, size, duration Retrospective, multicenter study at seven reproductive units belonging to the same center in Spain. The study included 202 patients who underwent IVF/ICSI treatment between January 2022 and December 2022, ensuring that 100% implantation was obtained. All cycles were accomplished with time-lapse, and the transfers were performed at the blastocyst stage. The sex was confirmed at birth. Participants/materials, setting, methods Sex ratios of 223 live births were compared regarding to fertilization method (IVF or ICSI), age, culture medium, embryo morphokinetics (t2, t3, t4,t5,tM,tSB,tBc,cc2,s2), twinship, origin of oocytes and sperm, embryo quality and sperm preparation technique (swim-up vs gradients). The Student’s T test was used for metric variables and the χ2 test for dichotomous variables (p &amp;lt; 0.05). To assess if the rest of the metric variables influenced sex, the Kolmogorov-Smirnov test and the Pearson test were used. Main results and the role of chance 223 live births were obtained: 181 single births after the transfer of one blastocyst and 42 double births of the same sex after the transfer of two blastocysts. Among the 223 newborns included in the study, a statistically significant predominance (p &amp;lt; 0.05) of males was found: 58.3% (95%CI:51.8-64.8%) of boys (n:130) compared to 41.7% (95%CI:35.2-48.2%) of girls (n :93). The mean age of the patients was 38.3 years (SD: 4.87), with no significant differences found regarding the sex ratio, as well as with the fertilization technique (p = 0.937), culture medium (p = 0.096), twinning (p = 0.222), the origin of the oocytes (p:0.608), the origin of the semen (p:0.721) and embryo quality (P:0.186). A statistically significant relationship was found between the sex of the newborn and the semen preparation technique (62.1% of male with gradients versus 32.1% with swim up, p:0.003), which was confirmed using a multivariate binary logistic regression model (p:0.0200). Analyzing each of the parameters obtained from the time lapse with respect to the sex of the newborns in a univariate manner with Student’s T for independent samples no significant differences were found in the division times studied or in the times of the cell cycle and synchrony. Limitations, reasons for caution The main limitation is the necessity of a larger sample size and to further investigate the reasons for these results. Further studies with standardized culture conditions and well-justified inclusion criteria are needed to reach robust and reliable conclusion. Wider implications of the findings While the study needs for more extensive sample size for future research, is the first time to suggest that method of sperm preparation may have an impact on the sex ratio at birth. Understanding which factors within ART process can affect sex ratio remain important considerations. Trial registration number not applicable