Introduction: Despite ongoing advances in the treatment of chronic kidney disease (CKD), the mortality rate, and level of health-related quality of life (HRQOL) for the CKD population remain significantly higher than for the general population. The importance of measuring end-stage renal failure (ESRF) patients' quality of life in relation to healthcare lies in not only providing absolute survival but also the quality of that survival. Due to cost constraints, the profile of chronic kidney disease patients and their treatment in Bangladesh is almost identical to that of India, with patients frequently requesting a reduction in the frequency of dialysis sessions, the use of less expensive dialyzers, dialyzer reuse, and the absence of erythropoietin therapy. Hence, augmenting the QOL may perhaps be a challenge and an observable fact of specific interest for renal healthcare teams. This study is intended to assess KDQOL among patients receiving hemodialysis for 8 hours, and 12 hours per week, patients receiving CAPD, and patients of CKD stage V who decline any form of renal replacement therapy, and remained on conservative treatment. The aim of the study was to assess the quality of life among patients of CKD Stage V. Methods: This cross-sectional study was carried out at the Department of Nephrology, Dhaka Medical College Hospital and BIRDEM general hospital. The patients who received consultation at the Outdoor Department of selected hospital from November 2010 to October 2011. The study assess the of Quality of Life, and Cost Effectiveness on different modalities of treatment among the patients of chronic kidney disease stage V, and also to find out the best modality of dialysis. A total number of 134 consecutive patients were enrolled in this study, out of which 42 patients who were advised to commence renal replacement therapy, and after counseling opted to remain in conservative treatment were considered as GROUP I, 39 patients who received hemodialysis 8 hours per week were considered as GROUP II, 30 patients who received hemodialysis 12 hours per week in one or more centers were considered as GROUP III, and 23 patients who received Continuous Peritoneal Dialysis at least 3 exchanges per day were considered as GROUP IV. Result: Mean age was almost similar in all four groups, and most of the patients were 5th decade, and above. Male was predominant in all four groups, and the male-female ratio was almost 2:1 in the whole study patients. Diabetic nephropathy and glomerulonephritis were more common etiology of CKD in all four groups. Monthly expenditure was significantly (p<0.05) higher in group IV, followed by group III, group II, and group I in all three follow-ups, however, monthly expenditure was almost similar between group III, and group IV (p>0.05) but the mean monthly expenditure was higher in group IV patients. Mean serum Creatinine was lowest in group IV followed by group III, group II, and group I in descending order. Serum albumin was low in all the groups but almost parallel in all follow-ups in group II, groups I, and group IV, whereas the lowest was in group II followed by group I and group IV, but declined in group III during the 2nd, and 3rd follow-up from 1st follow-up. Hemoglobin level consistently remained within the target range in group IV in all follow-ups but below the target range in group I followed by group II, and group III in ascending order. The physical component score increased significantly in Group III, and Group IV at consecutive follow-ups, however, it was higher in Group IV. Similarly, the mental component score was recorded highest in Group IV, followed by group III, group II, and group I. Regarding mortality, it was observed that more than half of the patients were expired in group I, one-third in group II, and 16.7% in group III, and only 8.7% in group IV during final follow-up. Conclusion: Patients receiving continuous ambulatory peritoneal dialysis achieved the best clinical parameters in terms of control of blood pressure, and volume overload. On the other hand, parameters were a lot away from the desired target in patients receiving hemodialysis for 8 hours per week, and they did not have significantly better parameters in comparison to those who were only on conservative treatment. The scenario of serum albumin, and serum creatinine, though complicated by the existence of malnutrition, were in best approximation to the desired level in these patients. According to the age-sex-matched risk categorization of the patients, it was found that the majority of patients on conservative treatment were in more than the average risk category.

Background: Stabilization of weather factors especially temperature, pressure and humidity in bunkers that housed the Linear accelerators is necessary for safety of equipment and their efficient function for our patients. Daily variation of such factors can lessen the performance of Linear accelerators resulting to an error in their output and wrong dosimetry. Sokoto centre being located in the North-Western region of Nigeria with three unique seasons (Dry hot, Harmattan winter and Wet raining seasons) require a study of this kind to ascertain the influence of those harsh environmental factors on bunker's internal air condition. Methods: Daily records of Linac bunker temperature and pressure were measured using Precision mercury-in-glass thermometer and Opus barometer (OPUS 10 THI) from January 2019 to December 2021. Similarly, the corresponding daily external environmental temperature and pressure for the study period were obtained from Nigerian Meteorological Agency. The values were grouped according to the months of year, mean values of temperature and pressure for each month of the year were generated and graphs and bar-charts were plotted for both bunker and external environment. Similarly, an overall mean score for both temperature and pressure of each month of the three years period were generated and graphs were plotted with those values for bunker and external environment. Results: The overall mean external temperature for the study period was 35.7°C, ± 3.82 as standard deviation (SD) and with a range of 26.0 – 43.6 °C, while for the overall mean bunker temperature it was 27.1°C ±1.7 SD and a range of 23.1 - 31°C. For the external environmental pressure, the overall mean value was 78.1hpa ± 1.5 as SD and a range of 68.1– 83.1hpa, while for the bunker it was 977.2 hpa ± 2.55 as SD and a range of 966.9 – 988.7 hpa. Using the pearsons correlation, it indicate that there is a significant association between environmental and bunker temperature (p-value=0.002). Conclusion: External environmental temperature showed a significant influence on bunker temperature despite the presence of chillers. But for environmental and bunker pressure, the relationship is complex and non-significant. Similarly, the seasons of the year also influenced bunker temperature.

Background: Hepatitis B Virus (HBV) is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is most commonly transmitted from mother to child during birth and delivery. Also, by contact with patient blood or other fluids during sex with an infected partner. The virus enters the cell body by sodium taurocholate cotransporting polypeptide receptor (NTCP), then it replicate and invade other healthy cells. Aim: the aim of this study is to design a drug that can block sodium taurocholate cotransporting polypeptide receptor (NTCP), Using bioinformatics tools and servers. Material and method: Using CHemSketch the drug molecule was drawn and determined and using OpenBabel software the molecule was transferred and designed into MOL 2 format to be applied in the SwissDock server. The target protein from the protein database bank using the PDB ID of NTCP receptor protein was retrieved and then inserted it into SwissDock. The result of docking was then subjected to SwissADME to check the pharmacological effect. Results: A novel drug that can inhibit and block sodium taurocholate cotransporting polypeptide receptor (NTCP) hence can treat the HBV. Conclusion: With these predicted pharmacokinetics and chemical properties of NTCP inhibitor, a new emerging drug to treat hepatitis B virus disease, which affects the majority of people around the world, especially in poor countries, can be developed, and this can be achieved with more research and laboratory procedures.

Diabetes mellitus has over the years become a public health issue. It is a complex disease which is characterized by chronic hyperglycemia. The present study was designed to determine some platelet indices in Type 2 Diabetic Mellitus (T2DM) patients compared to non-diabetic controls. A total of 240 subjects comprising 120 T2DM (60 males and 60 females) aged 20-55 years and 120 apparently healthy age and gender-matched controls were recruited for the study. Blood samples (5.0ml) were collected from each subject for the analysis of the parameters using Mindray 530 BC automated analyzer, Mindray, Japan. The data was analyzed using T-test and level of significance set at p < 0.05. The result revealed significant increase in the platelet indices involving the Mean Platelet Volume (MPV) (12.17 + 0.78 vs 7.80 + 1.18), Platelet Distribution Width (PDW) (14.41 + 1.5 vs 9.30 + 0.92) and plateleterit (PCT) (0.27 + 0.32 vs 0.17 + 0.00) between the T2DM patients and non-diabetic controls. This finding supports platelet activation in T2DM patients.

Introduction: Wound and mesh infections after inguinal hernia repair are very severe complications. Today it is an established fact to repair hernias with meshes in various ways to prevent or delay the recurrence of hernia, but knowledge regarding the incidence of mesh infection is rare. The aim of the study was to assess the incidence of mesh infection in Open Inguinal Hernia Repair. Methods: This retrospective study was conducted at the Department of Surgery, Sylhet M.A.G Osmani Medical College, Sylhet, Bangladesh during the period from January 2020 to December 2021. The study included 400 patients who underwent mesh repair for inguinal hernia repair during the 2 years period. Among the total 400 patients, 24 were diagnosed with mesh related infections. Mesh related infections influenced by type of mesh use; surgical techniques and underlying comorbidity were all recorded. Both medical and surgical management required for mesh infection were also recorded. Use of antimicrobial included coverage of staphylococcus. Laparoscopic hernia repair cases were excluded from the study. Result: The study found 24 mesh related infection in a total of 400 patients who underwent open inguinal hernia repair. The overall mesh related infection rate was 3%. The infection was established at a variable delay after mesh insertion, with 40% delayed onset after procedure and 60% diagnosed during the first post-operative month. Infection was cured in 6 patients after mesh removal. Conclusion: Mesh removal appears to be one of the appropriate treatments for this rare and serious complication. The most common pathogen was Staphylococcus aureus and E. Coli. The possibility of a mesh related infection remains active weeks or even years after initial hernia repair. If mesh infection develops it should be treated vigorously and mesh should be excised early if necessary.

Breast tumour could be benign or malignant in nature, thus early detection is of the essence for good management outcome. Associated morbidity and mortality in relation to breast cancer, in particular, are of great concern. Among the different challenges in the management of breast cancer, cytopenia is commonly reported, while, associated blood transfusion dependence has received little attention. This study, therefore, looked into the features of breast cancer patients particularly with regards to disease staging and average blood transfusion needs. This cross-sectional descriptive study enrolled 46 female patients accessing medical care for breast tumour in Southern Nigeria. Bio-data and information on clinical assessment were obtained from patients’ case files. Blood sample was collected from each enrolled subject for assessment of carcinoembryonic antigen level by immunochromatographic assay method. Breast tumour was observed to be prevalent among women of reproductive age with a peak at the age range of 36-45 years. Majority of the cases (82.6 %) turned out to be malignant, while 17.4% were benign conditions. Advanced stage 4 cases accounted for 47.4% of the studied group. Increasing prevalence of mortality during therapy was recorded alongside advancement in age as well as stage of the cancer. The carcinoembryonic antigen level varied significantly across the various breast cancer stages. Stage 4 breast cancer showed significantly elevated mean value compared to both stages 1 and 2. There is prevailing late detection of breast cancer in the Nigerian population contributing to high mortality rate and more demands on blood transfusion.

Diarrhea is one of the major causes of infant and young children morbidity and mortality globally. It is characterized by passing of more than 3 watery stools within 24hr which is accompanied by loss of body fluids and electrolytes leading dehydration and death if not treated. Therefore, this study was aimed in assessing knowledge and use of Oral Rehydration Therapy (ORT) in the management of childhood diarrhea among mothers. A cross sectional descriptive study was conducted among 103 mothers living in Kambaza metropolis using a questionnaire for quantitative data collection. The data were analyzed using Statistical Package for Social Sciences (SPSS), version 20 and p-value <0.05 was considered statistically significant. The results showed that a significant proportion of respondents were below the age of 36 years (25-35years) with the mean age of 30±0.327 years and most of them (92.2%) were married. 81.6% of the respondents heard knowledge about ORT and majority of them (82.5%) indicated they know to prepare ORS/SSS. The use of ORT in the management of childhood diarrhea was also found to be high (82.5%) among the mothers. A significant portion of the mothers (95.1%) indicated already made ORS sachet was more effective in treating diarrhea than home-made SSS. There is no significant relationship between maternal level education and use of ORT in the management child diarrhea (p=0.476). However, a significant relationship exit between maternal knowledge on ORT preparation and its usage for management of childhood diarrhea (p=0.037). This study recorded high knowledge and use of ORT for management of childhood diarrhea among mothers of under-five children. Therefore, it recommended that maternal knowledge on use of ORT and its preparation should be encourage.

Introduction: Bacteria that enter the bloodstream and mobile to the brain cord cause bacterial meningitis. The disease is less frequent in developed countries compared to developing countries. In Bangladesh, bacterial meningitis constitutes 25% and the case fatality rate was 14%. The mortality from meningitis is near 100% in untreated individuals and can still be up to 40% in children who received appropriate antibiotic therapy in developing countries. Aim of the Study: The study aims to investigate the specificity, sensitivity, and diagnostic accuracy of CSF-CRP in the diagnosis of Acute Bacterial Meningitis (ABM). Methods: An observational cross-sectional study was carried out in the Department of Pediatric Medicine, Dhaka Shishu Hospital (DSH), from 01 Jan-2017 to 30 Jun-2017. A total of 100 patients were enrolled in this study following the inclusive criteria. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. Result: Among the study population majority of patients (43, 43.0%) were 0-2 years old. One-third of bacterial meningitis (35,35.0%) occurs commonly at an early age (0-2 years). Out of fifty- seven cases (n=57) of bacterial meningitis, twenty-two cases were culture negative and thirty-five cases were culture positive. In the case of bacterial meningitis, in fifty-one cases (51,89.4%) out of fifty-seven, the CSF CRP test was truly positive, with mean±SD 21.7±10.9, false negative were only six cases (6, 10.5%). In aseptic meningitis thirty-nine cases (39,90.6%) out of forty-three cases, the CSF-CRP test was truly negative, and false positive were four cases (4,9.3%). The sensitivity of CSF CRP in differentiating bacterial meningitis from aseptic meningitis was 89.47%, specificity 90.69%, & diagnostic accuracy was 90%. Conclusion: Bacterial meningitis is fatal and more communal in children under one year of age to sixteen years of age. Increased consciousness and initial gratitude and apposite antibiotic treatment can decrease morbidity and mortality. Diagnostic accuracy can be applied as the initial test for the diagnosis of bacterial meningitis.