<h4>Introduction :</h4>
<p>
Sleep medicine is a medical superspeciality devoted to the diagnosis a...
<h4>Introduction :</h4>
<p>
Sleep medicine is a medical superspeciality devoted to the diagnosis and therapy of sleep disturbances and disorders. From the middle of the 20th century, research has provided increasing knowledge and answered many questions about sleep-awake functioning.
</p>
<p>
Disorders and disturbances of sleep are widespread and can have significant consequences for affected individuals, as well as economic and other consequences for society. Sleep deprivation has also been a significant factor in many dramatic accidents. The first sleep clinics in the United States were established in the 1970s.
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<h4>The International Classification of Sleep Disorders (ICSD) :</h4>
<p>
The concept of sleep medicine belongs to the second half of the 20th century. Due to rapidly increasing knowledge about sleep, including the growth of the research field of chronobiology from around 1960 and the discoveries of REM sleep (1952?53) and sleep apnea (first described in medical literature in 1965), the medical importance of sleep was recognized.
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<p>
The World Federation of Sleep Research & Sleep Medicine Societies (WFSRSMS) was founded in 1987. The European Sleep Research Society (ESRS) is a member of the WFSRSMS.
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<p>
The Assembly of National Sleep Societies (ANSS), which includes both medical and scientific organizations from 26 countries as of 2007, is a formal body of the ESRS. The American Academy of Sleep Medicine (AASM), founded in 1978, administered the certification process and sleep medicine examination for doctors.
</p>
<h4>Background :</h4>
<p>
Diabetic foot infections (DFIs) represent a major global health challeng...
<h4>Background :</h4>
<p>
Diabetic foot infections (DFIs) represent a major global health challenge, frequently leading to hospitalization, lower extremity amputation, and significant mortality. The choice of empirical antibiotic therapy is complicated by the polymicrobial nature of DFIs and the rising prevalence of multidrug-resistant organisms, particularly methicillin-resistant Staphylococcus aureus (MRSA).
</p>
<p>
This study aimed to compare the clinical and microbiological efficacy of Linezolid, a potent anti-Gram-positive agent, with Amoxicillin-Clavulanic Acid, a broad-spectrum antibiotic, in treating moderate to severe DFIs.
</p>
<h4>Methods :</h4>
<p>
In a prospective, open-label, randomized controlled trial conducted from 2021 to 2023, 300 patients with moderate to severe DFIs were enrolled. Participants were randomized to receive either Linezolid (600 mg IV/PO q12h) or Amoxicillin-Clavulanic Acid (1.2 g IV q8h or 625 mg PO q8h) for 7?14 days.
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<p>
The primary outcome was clinical cure rate at the test-of-cure visit (14 days after treatment completion). Secondary outcomes included microbiological eradication, incidence of adverse events, and duration of hospital stay.
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<h4>Results :</h4>
<p>
Linezolid demonstrated a significantly higher clinical cure rate compared to Amoxicillin-Clavulanic Acid (85.3% vs. 73.3%, p=0.01). Microbiological eradication was also superior in the Linezolid group (80.0% vs. 66.7%, p=0.02).
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<p>
Subgroup analysis revealed Linezolid?s pronounced efficacy against MRSA (90% vs. 25%, p<0.001), whereas Amoxicillin-Clavulanic Acid was more effective against Gram-negative pathogens (82% vs. 48%, p=0.003).
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<p>
The overall incidence of adverse events was comparable between groups (22% for Linezolid vs. 18% for Amoxicillin-Clavulanic Acid, p=0.40).
</p>
<h4>Conclusion :</h4>
<p>
Linezolid is a superior therapeutic option for DFIs where Gram-positive bacteria, especially MRSA, are suspected or confirmed. Amoxicillin-Clavulanic Acid remains a valuable agent for polymicrobial infections with significant Gram-negative involvement.
</p>
<p>
Tailoring empirical antibiotic therapy based on local antimicrobial resistance patterns and individual patient risk factors is crucial for optimizing outcomes in DFI management.
</p>
<h4>Background :</h4>
<p>
Thyroid swelling is a common problem in Bangladesh. Early and systematic...
<h4>Background :</h4>
<p>
Thyroid swelling is a common problem in Bangladesh. Early and systematic evaluation of a nodular thyroid swelling is necessary as it is a frequent presentation of thyroid neoplasia. USG Guided Fine Needle Aspiration Cytology (FNAC) is one of the diagnostic tools for early evaluation of thyroid nodules.
</p>
<p>
USG Guided FNAC is considered a cost-effective, simple, minimally invasive and easily repeatable procedure for preoperative screening in the diagnosis of most thyroid lesions. The objective of this study is to determine the sensitivity and specificity of USG Guided Fine Needle Aspiration Cytology (FNAC) and compare its efficacy with histopathology in diagnosis of thyroid swellings.
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<h4>Objective :</h4>
<p>
To evaluate the sensitivity and specificity of USG Guided Fine Needle Aspiration Cytology (FNAC) and histopathology for the diagnosis of thyroid swelling.
</p>
<h4>Method :</h4>
<p>
This observational prospective study was performed in the Department of Otolaryngology & Head Neck Surgery, Dhaka Medical College Hospital, Dhaka over 6 months duration from January 2019 to June 2019.
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<p>
A total of 50 patients with thyroid swelling were selected after taking informed written consent and fulfilling the inclusion criteria. Smears were taken by standard procedure and stained with Papanicolaou stain and Haematoxylin and Eosin stain.
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<p>
The smears were classified into categories like benign, indeterminate, malignant and unsatisfactory. Sensitivity, specificity, positive and negative predictive value and accuracy of USG Guided FNAC were calculated and compared with already available data. Appropriate statistical analysis was done to compare final histopathological findings with initial USG Guided FNAC findings.
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<h4>Result :</h4>
<p>
During the study period a total of 73 patients were found eligible for USG Guided FNAC. Most of the patients (52%) were from the 20?39 years age group. Among them 67.12% were female and the rest (32.87%) were male. In this government hospital, 75.34% were from low income group.
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<p>
According to the findings of USG Guided FNAC, nearly half (43.83%) of the patients had multinodular goiter, followed by colloid goiter (16.43%). Only 18 (24.66%) patients had carcinoma.
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<p>
From histopathological diagnosis, 55 patients had benign lesions and 18 patients had carcinoma. The efficacy of USG Guided FNAC as a diagnostic tool of solitary thyroid nodule showed sensitivity, specificity, PPV, NPV, PLR and NLR of 94.73%, 100%, 100%, 98.18%, 0 and 0.052 respectively.
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<h4>Conclusion :</h4>
<p>
This study revealed that this minimally invasive procedure, USG Guided FNAC, had the highest level of specificity, which was 100%. The hypothesis of the study was that USG Guided FNAC is the most useful preoperative diagnostic tool in thyroid swelling diagnosis.
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<p>
In this study, sensitivity of USG Guided FNAC was found to be 94.73%. Thus, it can be suggested that in maximum cases the diagnosis is accurate.
</p>
<h4>Keywords :</h4>
<p>
Swelling, USG Guided FNAC, Histopathology, Benign, Malignant.
</p>
<h4>Introduction :</h4>
<p>
Paraquat is a N,N<sup>2</sup>-dimethyl-4,4<sup>2</sup>-bipyridinium di...
<h4>Introduction :</h4>
<p>
Paraquat is a N,N<sup>2</sup>-dimethyl-4,4<sup>2</sup>-bipyridinium dichloride (systematic name), an organic compound with the chemical formula [(C<sub>6</sub>H<sub>7</sub>N)<sub>2</sub>]Cl<sub>2</sub>. It is classified as a viologen, a family of redox-active heterocycles of similar structure. It is widely used in our country and is a highly toxic compound.
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<p>
It was first discovered in 1950 and used in agriculture by 1962. It is rapidly absorbed by aerial plants and immediately inactivated in contact with the clay in the soil, leaving minimal residue. Being cheap and effective, paraquat is unregulatedly used in third world countries as herbicide.
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<p>
Paraquat is commercially available in Bangladesh as a bio-pesticide in 2 formulations - 20% paraquat and 20% paraquat plus 41% glyphosate combination. As paraquat is widely available in rural Bangladesh for its agricultural use, it has grown to be the major medium of self-harm over the years.<sup>1</sup>
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<p>
Paraquat poisoning can manifest as acute and chronic toxicity. The acute effects can result in both local and systemic manifestations. Local effects include ulceration of the skin, lips, tongue, pharynx, and esophagus. Systemic effects involve multiple organ failure, including liver insufficiency, acute kidney injury, respiratory failure, and convulsions.<sup>2</sup>
</p>
<h4>Background :</h4>
<p>
Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children...
<h4>Background :</h4>
<p>
Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children with an improved outcome at present. Because of its increased cure rate (almost 80%), more emphasis has been placed on reducing the toxicities of therapy, improving quality of life (QoL) during treatment and minimizing the long-term effect of therapy. So, the study was aimed at understanding QoL during different phases of chemotherapy.
</p>
<h4>Methods :</h4>
<p>
This cross-sectional study was conducted from 1st April, 2011 to 30th September, 2011 in the Department of Pediatric Hematology and Oncology, Bangladesh Medical University, Shahbag, Dhaka. Total 42 children of 2?16 years with ALL were included in this study. QoL scores were collected using the Pediatric Quality of Life Inventory? (PedsQL?) 4.0 Generic Scale and the Pediatric Quality of Life Inventory (PedsQL?) 3.0 Cancer Module proxy report. Medical and demographic data were collected from medical records and interviewing guardians. Data were processed and analyzed using SPSS (version 17.0).
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<h4>Results :</h4>
<p>
PedsQL overall was 62.03 (range 58.28?64.69), physical score 67.22 (range 53.13?71.88), psychological score consisting of emotion, social and school score was 60.00 (range 56.67?60.00), emotional score 72.50 (range 70.00?80.00), social score 100 (range 90.00?100.00) and school score 2.5 (0.0?20.0).
</p>
<p>
Social score was best but school score was worst. No predictor was found that significantly worsened QoL. Scores were similar in different phases of treatment.
</p>
<h4>Conclusion :</h4>
<p>
QoL in children with ALL has been described and there are no predictors of worse QoL. QoL was also similar in different phases of treatment. School summary score was worst, so special attention should be provided to improve the schooling of children.
</p>
<h4>Introduction :</h4>
<p>
Young women are primarily affected by lupus nephritis, which is linked...
<h4>Introduction :</h4>
<p>
Young women are primarily affected by lupus nephritis, which is linked to systemic lupus erythematosus and can seriously harm the kidneys if left untreated. Urine neutrophil gelatinase-associated lipocalin (NGAL) has become a viable non-invasive biomarker due to the invasiveness of renal biopsy. NGAL levels provide crucial information about kidney damage and the efficacy of therapy by indicating the severity of the disease and the response to treatment.
</p>
<h4>Materials & Methods :</h4>
<p>
A prospective observational study was conducted at BSMMU, Dhaka, between March 2023 and August 2024. Fifty-two adults with biopsy-proven lupus nephritis were enrolled. Clinical characteristics, urinary NGAL levels, biochemical parameters, and renal histopathology were recorded at baseline and reassessed after six months of therapy.
</p>
<h4>Results :</h4>
<p>
The study predominantly involved young females (92.3%), with 69.2% under the age of 30 and 67.3% having a normal weight. A majority were married (80.8%) and resided in urban areas (57.7%). Histologically, 57.7% of participants had class IV lupus nephritis.
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<p>
All patients were treated with Hydroxychloroquine, while 61.5% also received Cyclophosphamide plus Corticosteroids, 23.1% received MMF plus Corticosteroids, and 15.4% were treated with only Corticosteroids.
</p>
<p>
A complete response was achieved by 67.3% of the patients. Urinary NGAL levels, a marker of renal inflammation, were highest in patients with class IV lupus nephritis, both at baseline (2.14 ? 1.01 ng/mL) and at 6 months (1.20 ? 0.59 ng/mL), with a significant correlation to disease severity (p < 0.05).
</p>
<p>
Patients with proliferative lupus nephritis had higher urinary NGAL, elevated serum creatinine, and lower serum albumin levels compared to those with non-proliferative lupus nephritis. Those who experienced a complete response exhibited lower NGAL levels at both baseline (1.39 ? 0.48 ng/mL) and 6 months (0.80 ? 0.25 ng/mL).
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<h4>Conclusion :</h4>
<p>
The study highlights the potential of urine NGAL as a valuable biomarker for evaluating disease severity and treatment outcomes in lupus nephritis, suggesting that it could enhance clinical management and inform therapeutic decisions. However, further large-scale, multi-center studies are required to validate its use in routine clinical practice.
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