Medical Journals Research Articles

Comment on: Psychiatric outcomes among survivors of COVID-19

We read with interest the article titled “Six-month psychiatric outcomes among survivors of COVID-19” published in Cukurova Medical Journal by Poyraz et al.. This study showed that anxiety, depression and sleep disorders improved over time, but symptoms continued in severe disease. COVID-19 can affect all organs in the body. Therefore, these processes can be prevented with early diagnosis and treatment. Smoking can couse chronic diseases. Additionally, smoking is one of the most important triggers of anxiety and depression. No information about smoking was found in the study. Obesity can couse sleep disorders. Were the patients body mass indexes checked?

Retraction Note: Complications of Abdominal Wall Hernia Repair Using Mesh: A Single Cohort Study

The Original Article was published on 10 February 2023The article mentioned above, which was published online on 10th of October, 2023, in Barw Medical Journal (Complications of Abdominal Wall Hernia Repair Using Mesh: A Single Cohort Study), has been retracted as a result of an agreement between the journal's Editor in Chief, Professor Kawkab Shishani, and Barw Publisher. The publisher learned from a third party that several articles had similar formats and structures. Also, there was a conflict between the authors; not all authors approved the last version of the manuscript. These all lead to the decision to retract it. The authors did not respond to the notification of retraction. Afflicted by these nations originate from the activities of multinational corporations or the global demand for certain goods. There is a moral imperative for developed countries and international organizations to assist in the fight against environmental pollution and its health repercussions. In conclusion, environmental pollution is not merely an economic or ecological issue; it is a profound public health crisis with cancer at its forefront. As developing countries continue their journey toward growth and development, ensuring a balance between progress and environmental stewardship is crucial. Failure to address this balance will not only undermine health outcomes but also threaten the sustainable future of these nations. The time to act is now, with concerted efforts from local, national, and global stakeholders to mitigate the risks and safeguard the well-being of current and future generations.

Demographic, epidemiological and clinical characteristics of Ukrainian war refugees with HIV infection in the Slovak Republic

BackgroundThe Slovak Republic, an Eastern European country, borders Ukraine, which has one of the highest rates of HIV/AIDS in Europe. This study aims to inform readers about the demographic characteristics of Ukrainian war refugees with HIV/AIDS seeking temporary protection status in Slovakia due to the Russian invasion of February 24, 2022. It focuses on their epidemiology, immunological profiles, co-infections, and treatment. DesignMulticenter, retrospective study between March 1, 2022, and March 31, 2023. MethodsData were collected from all Ukrainian patients with refugee status living with HIV or newly diagnosed, who presented to any of the five HIV/AIDS centers in Slovakia. Information was obtained through medical interviews, physical examinations, laboratory tests and medical reports from the Ukrainian Ministry of Health. ResultsFrom March 1, 2022, to March 31, 2023, 141 Ukrainian refugees were included, mostly women (56.7 %, n = 80), with a median age of 41 years. The median CD4+ count was 680 cells/mL; 69.2 % (n = 97) had a viral load below 40 copies/mL. On arrival, 87.8 % (n = 123) were on ART, 90.2 % (n = 111) on dolutegravir. Coinfections included hepatitis C (31 %, n = 41), hepatitis B (12.5 %, n = 17), and tuberculosis (11.3 %, n = 16). Three died from AIDS complications. ConclusionThe study provides a detailed overview of the epidemiological, demographic, immunological, co-infection, and treatment characteristics of Ukrainian PLWHA displaced by the war to the Slovak republic. With the conflict ongoing, it is necessary to be prepared for more refugees in the coming months.

Enhancing Clinical Accuracy of Medical Chatbots with Large Language Models.

The rapid advancement of large language models (LLMs) has opened up new possibilities for transforming healthcare practices, patient interactions, and medical report generation. This paper explores the application of LLMs in developing medical chatbots and virtual assistants that prioritize clinical accuracy. We propose a novel multi-turn dialogue model, including adjusting the position of layer normalization to improve training stability and convergence, employing a contextual sliding window reply prediction task to capture fine-grained local context, and developing a local critical information distillation mechanism to extract and emphasize the most relevant information. These components are integrated into a multi-turn dialogue model that generates coherent and clinically accurate responses. Experiments on the MIMIC-III and n2c2 datasets demonstrate the superiority of the proposed model over state-of-the-art baselines, achieving significant improvements in perplexity, BLEU-2, recall at K scores, medical entity recognition, and response coherence. The proposed model represents a significant step in developing reliable and contextually relevant multi-turn medical dialogue systems that can assist patients and healthcare professionals.

Email invitations to publish: Academically sound (such as SAFP) versus potentially predatory journals

Background: Researchers increasingly receive invitations by email to publish. We analysed email publication invitations received by staff members of the Department of Biostatistics, University of the Free State (UFS), comparing emails relating to accredited and non-accredited journals.Methods: This cross-sectional study included all publication invitations received via UFS email accounts by staff members from May 2023 to July 2023. The researchers independently completed the data form, then checked and resolved any discrepancies.Results: Of the 93 distinct emails received from 88 journals, only 15 (16%) were received from a journal appearing on the Department of Higher Education and Training (DHET) accredited journal lists. These included South African Family Practice (SAFP) and the African Journal of Primary Health Care and Family Medicine (PHCFM). Emails from non-accredited journals were significantly (p 0.01) less likely to refer to a journal with a health sciences-related title (37% vs. 86%), indicate the publisher (36% vs. 93%), provide a link to the journal website (59% vs. 100%), state a full physical address (24% vs. 80%), refer to author instructions (21% vs. 47%) or request the recipient to share the email with colleagues (5% vs. 47%). Emails from non-accredited journals were significantly (p 0.01) more likely to contain grammatical errors (63% vs. 0%) and flattering remarks regarding the recipient or his or her research work (49% vs. 0%), and to indicate the journal’s International Standard Serial Number (ISSN) (67% vs. 13%).Conclusion: Clear differences were found between email invitations from accredited versus non-accredited journals.Contribution: The findings provide insight into warning signals in email publication invitations.

Beyond the discomfort: understanding and managing sexual pain in women, a comprehensive case-based discussion.

Sexual pain has a profound impact on individuals, regardless of their sexual orientation or gender identity, and affects women more often than men. It adversely affects both sexual function and interpersonal relationships. Despite its prevalence, sexual pain in women often remains unaddressed and untreated. Various underlying causes contribute to sexual pain, sometimes involving multiple factors. We explore treatment options and offer clinical insights into the evaluation and management of 4 common conditions which cause sexual pain in women. In this article, we use the term "women" to indicate cisgender women. Our aim is to highlight the most common clinical scenarios of sexual pain and provide comprehensive discussions on each, to improve patient care and outcomes in the management of sexual pain. We conducted a comprehensive review of literature and clinical cases to explore the various causes and management strategies for sexual pain in women. We systematically searched databases such as PubMed, Google Scholar, and relevant medical journals. We included peer-reviewed articles, case studies, and clinical trials published between 2000 and 2023. Additionally, we analyzed real-life cases from our clinical practice at our academic institution. Our review identified various factors contributing to sexual pain in women, ranging from hormonal imbalances to neuroproliferative and inflammatory conditions affecting the genitourinary system. Each case should be approached individually to offer optimal management strategies accordingly. The management of sexual pain in women requires a comprehensive approach that addresses the multifactorial nature of the condition. Patient education and counseling play a crucial role in the management of sexual pain, empowering individuals to advocate for their own health and well-being. The collaboration between healthcare providers and patients can improve our understanding and management of this complex condition.

ADHD in Black Youth: A Content Analysis of Empirical Research from 1972 to 2023

Objective: The purpose of this content analysis study was to characterize patterns of research on Black youth with ADHD. Method: Relevant articles were identified through searching psychology and medical databases and cross-referencing citations in previously published review articles. The 204 empirical articles included in this study (1) were conducted in the United States, (2) had a predominantly child or adolescent sample, (3) had more than 80% Black youth/families in the study sample and/or conducted separate analyses for Black youth/families, and (4) examined ADHD symptoms or diagnoses. Articles were categorized into five primary content areas: Assessment, Treatment, Perceptions, Prevalence, and Associated Correlates. Journal characteristics, sample characteristics, and methodological characteristics are presented across these content areas. Results: Findings show a relatively low representation of Black youth with ADHD in the literature, with most studies using race comparative approaches and secondary data analyses, and many being published in medical journals. Conclusion: Based on these results, changes are recommended both at the individual study and broader systems levels (e.g., funding agencies). More research, funding, and publications centering Black youth with ADHD are vital to understanding and correcting long-standing health disparities for this community.

Trends in Enterococcus faecium Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure

Enterococcal bacteremia (EB) is on the rise both in Sweden and globally. While Enterococcus faecalis (E. faecalis) is susceptible to ampicillin and piperacillin/tazobactam (pip/taz), Enterococcus faecium (E. faecium) is not. Historically, most enterococcal infections have been caused by E. faecalis, but the epidemiology is changing with increasing recognition of enterococci as nosocomial pathogens and the emergence of resistance to commonly used antimicrobial agents. The use of pip/taz has increased dramatically in Sweden, but it is unknown if this has affected the relative incidence of E. faecalis/E. faecium bacteremia. Here, we investigate whether the number and proportion of E. faecium bacteremia (EfmB) cases have increased. Additionally, risk factors associated with EfmB with a focus on prior antibiotic exposure are analyzed. Medical journals of 360 patients with EB admitted to Sahlgrenska University Hospital are reviewed. The proportion of EfmB cases increased from 41% in 2015 to 51% in 2021. Hospital-acquired infection, previous exposure to pip/taz, and carbapenems are identified as independent risk factors for EfmB. There are considerable patient-related differences between the EfmB and EfsB groups, but there is no difference in mortality rates. In conclusion, the increasing proportion of EfmB cases is concerning and is seen parallel to the expanding use of pip/taz, one possible contributing factor. Our findings suggest that a cautious approach to antibiotic use is essential to prevent the spread of antibiotic-resistant bacteria.

Comparing Confirmed Sodium Nitrite Suicide Deaths With Poison Center Surveillance Estimates

Sodium nitrite is a curing agent increasingly used for self-harm and suicide, and multiple locales have reported increasing cases. However, approaches to forensic investigation of these cases are not standardized, and current modes of surveillance in the United States may be inadequate. To define a potential standard approach for identifying sodium nitrite deaths based on forensic confirmation, and compare findings based on this standard to poison center surveillance. This retrospective case series of sodium nitrite exposures and deaths was conducted in 2 urban medical examiner jurisdictions in New York State from 2000 to 2022. The population-based sample included individuals from (1) medical examiner reports of decedents where the cause of death was sodium nitrite and (2) poison center reports of intentional exposures to sodium nitrite. Sodium nitrite as either cause of death (medical examiner reports) or intentional exposure (poison center reports). Medical examiner determination of sodium nitrite deaths was considered the criterion standard and relied largely on confirmatory blood nitrite testing. Poison center records were assessed for intentional exposures to sodium nitrite. In this case series of 36 decendents, median (range) age was 28 (20-57) years; 23 (63.8%) were male; 6 (16.7%) were African-American, 5 (13.9%) were Chinese, 13 (36.1%) were White, and 4 (11.1%) had unknown race; and 6 (16.7%) were Hispanic. No deaths were found from 2000 to 2018, and yearly increases in deaths from 2019 to 2022; these deaths were largely missed by local poison center surveillance. Most cases (83.3% [n = 30]) had postmortem blood nitrite concentrations available, and multiple decedents had evidence of suicide kit recommendations from internet sources. In this case series of decedents in 2 New York medical examiner jurisdictions, sodium nitrite deaths increased yearly, and the medical examiners were able to obtain confirmatory nitrite concentrations in most cases. These findings suggest that poison center surveillance underestimates confirmed deaths from sodium nitrite; public health authorities should rely on multiple data sources when analyzing this problem, and forensic analyses should be standardized.

Potential of multimodal large language models for data mining of medical images and free-text reports

Medical images and radiology reports are essential for physicians to diagnose medical conditions. However, the vast diversity and cross-source heterogeneity inherent in these data have posed significant challenges to the generalizability of current data-mining methods for clinical decision-making. Recently, multimodal large language models (MLLMs), especially Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models, have revolutionized numerous domains, significantly impacting the medical field. In this study, we conducted a detailed evaluation of the performance of the Gemini series models (including Gemini-1.0-Pro-Vision, Gemini-1.5-Pro, and Gemini-1.5-Flash) and GPT series models (including GPT-4o, GPT-4-Turbo, and GPT-3.5-Turbo) across 14 medical datasets, covering 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy) and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Moreover, we also validated the performance of the Claude-3-Opus, Yi-Large, Yi-Large-Turbo, and LLaMA 3 models to gain a comprehensive understanding of the MLLM models in the medical field. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

Medical Toxicology vs. Emergency Medicine and Internal Medicine — Are We Really Full of Case Reports?

IntroductionCase reports are perceived as having diminished value relative to other study designs. It has been said that medical toxicology (MT) is based largely upon case report literature and thought to be unique in this regard. We sought to quantify recent MT publication of case reports compared with top periodicals from emergency medicine (EM) and internal medicine (IM) journals.MethodsA retrospective review examined 5 years of articles in 6 U.S.-based medical journals–MT (Journal of Medical Toxicology, Clinical Toxicology), EM (Annals of Emergency Medicine, Journal of Emergency Medicine), and IM (JAMA Internal Medicine, New England Journal of Medicine) was performed using on-line resources. Every article in each issue was categorized into Case report vs. Research and Analysis articles vs. Excluded. “Case report” was defined as one (or ≤ 5) individual patients, one patient’s data, etc. Total articles per issue were reported after removing Excluded items.ResultsBetween 2018 and 2022, these 6 periodicals published 522 issues; with 2644 case reports; and 8246 total included articles. Comparison of MT case reports vs. EM revealed a significant difference and odds (Odds Ratio = 1.7, (95% CI: [1.49, 2.03], p < 0.001); MT compared with IM was not significantly different (Odds Ratio = 1.1, (95% CI: [0.96, 1.30], p = 0.150). The percent of case reports increased in the IM and EM journals compared with a relative decrease in the MT journals. Cumulative case report precents were consistently greater in EM and IM than in MT.Conclusion In the past 5 years, MT journals published fewer and had a declining trend of case reports compared with leading EM and IM journals. Future research is needed to determine the effect on MT practice resulting from the diminished body of case report literature.

Comparative analysis of factors and barriers intervening in research participation among romanian and international medical graduates from one romanian medical faculty across three generations

Abstract Objectives This study focuses on the factors that encouraged engagement in research activities, as well as the barriers that restricted their involvement, until the final year of study at Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Faculty of Medicine. The main objectives of this study are to investigate potential disparities in research culture and student engagement in various research opportunities between Romanian and international medical graduates, as well as to conduct an examination of the observed patterns across various graduating years (2021–2023). Materials and methods A cross-sectional investigation was conducted among graduate students of the Faculty of Medicine at the Iuliu Hațieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania. From 2021 to 2023, all graduate students from the Romanian and international programs of the faculty were asked to participate in the study by filling out an anonymous online questionnaire. The final sample included 572 participants, of whom 392 were students from the Romanian section and 180 were students from international programs. Results Motivation and personal interest drive research engagement, according to over half of graduates. For over one-third of graduates, institutional elements like financial support and education also play a major role, as does the desire to enhance their curriculum vitae. More than 25% of graduates value community influence, 70% of graduates attended medical congresses, 12–15% presented papers at medical conferences, 23% wrote medical articles, 10–15% published at least one scientific paper in medical journals, and 20% participated in medical school research projects. Comparative analysis showed that Romanian students start research earlier, attend more medical conferences, present posters, collect data for studies, and are more interested in publishing graduation thesis data in scientific journals. To encourage international students to participate in research, the study found that colleagues’ examples were more important, and both time and funds were key barriers. The research also shows that 2022 and 2023 graduates will organize more scientific conferences. According to the study, 2022 graduates began their research earlier than others. Conclusions To increase student engagement in research activities, medical schools should prioritize the promotion of positive factors, minimize common barriers, offer customized support and resources, encourage collaborative research activities, and facilitate cross-cultural learning.

Sex and Women in the Archive and New Imaginaries of Female Same-Sex Relations in the Late Nineteenth Century

The article aims to contribute to queer histories of marginalised people and those who have left behind limited traces. It analyses medical sources informing about female same-sex relations among poor and marginalised women in Copenhagen, Denmark, during the late nineteenth century. The medical sources repeatedly mention how women in prostitution engaged in sexual and romantic relations with one other. The article provides examples of how female same-sex relations were described as passionate and dramatic, as well as violent, and proposes an expanded notion of female same-sex relations to accommodate “grim” stories of intimate partner violence and death. Furthermore, the medical reports associated women’s relations with carnal sex, . Finally, the article suggests that it might not have been the gender of a woman’s same-sex partner but rather the woman’s sexual activity, that caused condemnation. As the medical sources are confined to inform about women’s encounters with power authorities, such as doctors and police, I employ “imaginary scenarios” (Hartman 2021) to be able to represent the same-sex relations in a more profound way.

Hope of the of Parents of Primary School Children on Career in a Rural Community of Raozan Upazila, Chattogram

Background: Parents always think about the career of their children. They try to guide the children in such way so that they can lead an independent life in future. The social status, educational background, family environment, ambition etc. forms the basis of thinking of the parents for their children. This study was conducted to find out the pattern of hope ot the parents of Primary School Children on career in a rural community of Raozan Upazila, Chattogram District of Bangladesh. Materials and methods: This descriptive type of cross sectional study was conducted during the period February to October 2021. 100 respondents were selected by purposive type of non-probability technique. Face to face interviews were performed for information collection after getting consent. A pre tested mixed type of questionnaire was used. Results: 38% of the parents belonged to age group 31 to 35 years. Mean age of the parents was 25 years. Among them, 15% were of low socio- economic status and only 10% were of upper class. 45% of the parents had ambition that their child would be a doctor, 10% desired for teacher, 5% engineer and 7% as Islamic scholar. 93% parents had choosen Bangla medium school for their children. 65% parents had kept private tutor at home as mentor for their children and same percentage of parents expressed financial problems to provide education for their children, Conclusion: Socio-economic and literacy status of the families as well as monthly income were closely associated with future planning and ambition of the children. IAHS Medical Journal Volume 06(2), December, 2023; 9-12

Imipenem Susceptibility Pattern of Bacterial Isolates on Pregnant Women with Urinary Tract Infection in a Tertiary Hospital

Background: Urinary Tract Infection (UTI) in pregnancy, including Asymptomatic Bacteriuria (ASB) is associated with maternal morbidity and adverse pregnancy outcomes, like preterm birth and low birth weight. In spite of an association of ASB with adverse pregnancy results, screening and treatment is not done with much strength in our country. The antibiotic susceptibility patterns differ from region to region and in different global locations and are found to vary from time to time. This study was done to evaluate the susceptibility pattern of bacterial isolates against Imipenem causing UTI in pregnant women. Materials and methods: This observational study was conducted at the Department of Clinical Pathology, Bangabandhu Memorial Hospital, Chattogram During the period from January to June 2021. Urine sample from a total of 104 pregnant women was enrolled in this study. Isolation and identification of bacteria was done by conventional culture method and Imepenem susceptibility test, by Kirby-Bauer disc diffusion method. Results: Among the study samples, 31(29.8%) showed positive culture result and taken as confirmed UTI. E. coli (45.10%) was the predominant isolated bacteria followed by Klebsiella spp. (25.80%). 90% bacterial isolates were found sensitive to Imipenem and rest 10% were resistant. 93% E. coli showed sensitivity to Imipenem, whereas Klebsiella spp. showed 87.5% and Staphylococcus aureus showed 75% sensitivity to Imipenem. Both Enterococcus spp. and Pseudomonas spp. showed 100% sensitivity to Imipenem. Conclusion: Bacterial resistance against Imipenem is increasing day by day. So it should be kept as a reserve drug for severe life threatening condition. IAHS Medical Journal Vol 6(2), December 2023; 40-43

Vitamin D Status among Patients Visiting an Urban Tertiary Care Hospital, Dhaka

Background: Majority of the Bangladeshi population lives in an areas receiving ample sunshine throughout the year. Despite this fact multiple studies have shown wide prevalence of vitamin D deficiency in our country in all ages and both sexes. Adequate vitamin D status has an important clinical advantage for maintaining various activities as well as preventing diseases. In this lab based retrospective study, it was determined the prevailing condition of vitamin D deficiency among adult patients visiting MH Samorita Hospital and Medical College outdoor. The present study aimed to focus on assessing Vitamin D status of adult patients visited a tertiary care hospital of Dhaka city. Materials and methods: This was a retrospective study. A total of 72 cases were chosen by random sampling with records of vitamin D status, age and sex from July to December, 2022.The results were statistically analyzed with Statistical Packages for Social Science (SPSS-24). Results: Out of total subject (n=72) none of them showed toxic serum concentration of vitamin, 12.5 % had sufficient, 23.6% had insufficient and 63.9% had deficient levels of vitamin D. Gender wise comparison of vitamin D status showed male patients, 28.3% were deficient in vitamin D, 47.1% were insufficient, and a substantial 77.8% had sufficient levels. In contrast, a much higher proportion of female patients were deficient (71.7%) or insufficient (52.9%) in vitamin D, with only 22.2% having sufficient levels. According to age wise distribution, the highest percentage of vitamin D deficiency (58.7%) was observed in the youngest age group (18-30 years), while the proportion decreased in older age groups (30.4% for 31-50 years and 10.9% for 51-65 years). Conclusion: Vitamin D is an important vitamin which impacts many systems of the body .This study indicates that 63.9 % of subjects are vitamin D deficient which is very much alarming. So, it becomes paramount to further scrutinize the associated factors apart from age and gender. To this end, further studies are needed. IAHS Medical Journal Volume 6(2) December 2023; 68-72

The Effect of Intrathecal Anesthesia during Emergency Caesarean Section for Severe Preeclampsia and Eclampsia Patients in a Tertiary Care Hospital

Background: Severe preeclampsia and eclampsia are common in Bangladesh and are one of the leading cause of perinatal morbidity and mortality. The aim of the study is to observe the effect and hazards of intrathecal anesthesia for the mangement of caesarean section for severe pre-eclampsia and eclampsia patients. Management of these patients is very much important for the strenuous obstetrician and anesthesiologist both. Materials and Methods: This retrospective observational study was conducted in the Department of Anesthesiology and ICU of the IAHS (Institute of Applied Health Sciences) Chattogram from January 2022 to December 2022. Total 50 ASA grade 1 or 11, aged between 18-40 years, need urgent LSCS of 1-2 hours duration cases were selected purposively for intrathecal anesthesia. Patients with known cardiovascular and pulmonary diseases, fetal distress, severe maternal distress, uncontrolled DM, presence of any contraindication, patient’s refusal for SAB, septicemia, BP&gt;170/120 mmhg, altered coagulation profile, APH, IUD were excluded from this study. Results: Among the study subjects, 30(59.68%) cases were primigravida patients- out of which five had severe pre eclampsia and 25 had eclampsia. Intraoperative shivering was observed in 18(29.03%) cases, postoperative shivering was observed in 16(25.80%) cases. Acute renal failure was found in 3(6%) cases, HELLP syndrome 10%, DIC 8%, abruption placentae 14%, pulmonary edema 4%, septicemia 16%, PPH 12% and postpartum eclampsia 22% cases. Apgar score &lt;7 at 5 minutes in severe PET was observed in 04(6.45%) cases and eclampsia in 07 (14.51%) cases. Among them 10(20.96%) were eclamptic and 02(4.83%) had PET. p value was found 0.000 which is very highly significant. Conclusion: The outcome results of intrathecal anesthesia is better than general anesthesia. IAHS Medical Journal Volume 6(2) December 2023; 58-63

Socio-Demographic and Clinical Profile of Admitted Patients for Psychiatric Illness in a Tertiary Care Military Hospital in Bangladesh

Background: Mental health problems are becoming a public health issue in all countries around the world. It’s often ignored and unnoticed by patients, their relatives and society as well. Treatments for all these disorders are as available as efficacious. The purpose of this study was to assess the socio-demographic and clinical profile of admitted patients for psychiatric illness in a tertiary care military hospital. Materials and methods: This hospital based retrospective study was performed by analyzing the medical records of admitted psychiatric patients, carried out in the Department of Psychiatry at Combined Military Hospital (CMH), Chattogram from 01 July 2022 to 31 December 2022. For this purpose, 41admitted patients in psychiatry ward of CMH Chattogram were enrolled in the study. Psychiatric diagnoses of the patients were assigned by the consultant psychiatrist as per International Classification of Diseases (ICD) 10th Revision diagnostic criteria. Statistical analyses were carried out by using the Statistical Package for Social Sciences (SPSS)-version 16. The quantitative observations were indicated by frequencies and percentages. Ethical issues were maintained all through the study. Results: The results showed that more than half of (56.09%) patients were in 19-35 years of age with male preponderance (63.41%) and most of the cases reported from urban area (58.53%). The most common psychiatric morbidity among the patients were major depressive disorder (26.82%) followed by Anxiety disorder (17.07%) and Obsessive- compulsive disorders (17.07%). In this study majority of patients stayed 15-28 days (80.48%) on an average of 21.5 days. Conclusion: Neurotic cases were predominant in psychiatric admission. Results of this study may help in the planning for better mental health service integrated with primary healthcare system of our country. Findings of this study will also act as an eye-opener for psychiatrists regarding a wide range of psychiatric diagnoses as well future research in psychiatric fraternity. IAHS Medical Journal Vol 6(2), December 2023; 19-23

Morbidity Patterns and Health Seeking Behaviour of 50+ Elderly People in the Rural Community at Fateyabad in Chattogram

Background: Bangladesh is a nation with 9.3% geriatric population who are above 60 years of age and it is expected to rise to 22% in 2050. Health related problems of the elderly need comprehensive geriatric care. This study aimed to explore the morbidity pattern and its associated factors among the elderly population in a rural area of the Chattogram district of Bangladesh. Materials and methods: A cross-sectional study was conducted at Fateyabad in Hathazari, Chattogram, during the period from April to October 2023 which included 260 respondents aged 50 years and above. Data were collected by face-to-face interview by using a pretested mixed type questionnaire. Data were compiled and analysis were done by using scientific calculator and computer. Results: HTN and Diabetes Mellitus were the most common morbidities among elderly population which was 151 (58%) and 92 (35%) respectively. Female respondents were 143 (55%) and male were 117 (45%). Majority of the elderly population belonged to age group 50-59 which was 160 (61%) years and lion share of the respondents were housewife 134 (51%). The rates of seeking healthcare services was higher among elderly population with primary and secondary education, those living with spouses and children, those residing in extended families with seven or more members and older men and women with diabetes and cardiac diseases. Conclusion: On the basis of the findings, it is suggested that the traditional extended family structure should be sustained, wherein older people are treated with care and respect, thereby promoting health of the aged in rural Bangladesh. Furthermore, family relationships should be strengthened, because older individuals, require emotional and familial support to their end stage of life. IAHS Medical Journal Volume 6(2) December 2023; 64-67

Serum Electrolytes and Calcium Levels in Neonates Receiving Phototherapy for Neonatal Jaundice

Background: Neonatal Jaundice (NJ) is one of the most common causes of neonatal admission. Phototherapy is an important treatment modality for NJ. However, this treatment modality may itself result in changes of different biochemical parameters. The study aimed to evaluate the changes in serum electrolytes (Sodium, potassium and chloride) and calcium in neonates receiving phototherapy for NJ. Materials and methods: One hundred and two term neonates admitted to the Special Care Newborn Unit, Chattogram Medical College Hospital for the management of NJ by phototherapy were enrolled in this prospective observational study. Serum bilirubin, sodium, potassium, chloride and calcium were measured before and after 48 hours of phototherapy and compared. Results: The mean gestational age and mean age of admission of the neonates were 38.6±0.6 weeks and 6.42 ± .67 day respectively. The mean sodium, potassium and calcium level before therapy was respectively, 138.4±1.8 mmol/L, 4.1±0.3 mmol/L and 8.8±0.3 mg/dl. There was significant decrease in the level of mean sodium (136.4±1.6 mmol/L), potassium (3.8 ± 0.3 mmol/L) and calcium (8.4±0.4 mg/dL) after phototherapy. All neonates had normal level of serum calcium, sodium, potassium and chloride before phototherapy. After 48 hours of phototherapy, 46 (45.1%) of them had abnormal values with the incidence hypocalcaemia, hyponatraemia and hypokalemia respectively in 21.6%, 25.5% and 10.8% of the neonates. Conclusion: Neonates undergoing phototherapy are at risk of developing hyponatraemia, hypokalaemia and hypocalcaemia. Closed monitoring is essential to observe the changes in sodium, potassium and calcium and should be managed accordingly. IAHS Medical Journal Volume 6(2) December 2023; 83-86