Background: Poor oral health can lead to hospital-acquired pneumonia, a serious condition that can prolong patient care and increase the risk of mortality. The bacteria found in the oral cavity of patients with periodontal disease can be particularly harmful if inhaled into the lungs. Patients who are on mechanical ventilation are at an increased risk of developing aspiration pneumonia. Objective: to investigate the effect of oral care on ventilation associated pneumonia (VAP) and various types of such care. Methods: This review article is performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature exploration was done in PubMed, Embase, and Web of Science databases for articles published between 2011 and 2023. The search words were "Mechanical ventilation, intubation, pneumonia, dental care, oral care and ICU ". Results: A total of 21 studies were included, the studies were randomized controlled trials (RCTs) or quasi-RCTs and observational studies. Twice-daily oral care with tooth brushing using purified water can significantly reduce the incidence of VAP. Oral care with chlorhexidine and brushing, as well as enhanced oral care, can also be effective in reducing the incidence of VAP. Improved education and implementation of oral care protocols with 0.12% chlorhexidine solution can significantly reduce the incidence of VAP. Conclusions: The review concludes that good oral hygiene, especially twice-daily oral care with tooth brushing using purified water, can significantly reduce the incidence of VAP in mechanically ventilated patients.

Introduction: Suicide remains a significant public health concern globally, with its prevalence reflecting complex interactions among various factors such as age, gender, socio-economic status, and profession. This study aimed to assess the patterns of suicide attempts, focusing on age, gender, socio-economic status, and profession. Methods: This descriptive cross-sectional study was carried out at Department of psychiatry, Sheikh Hasina Medical college, Jamalpur, Bangladesh during the period from January 2018 to December 2018. All patients with suicide attempts admitted in the different wards of Community-Based Medical College, Mymensingh, and fulfilling the inclusion and exclusion criteria were selected as a sample for the study. A total of 90 patients were selected as study subjects by purposive sampling technique. Data analysis was done by SPSS (Statistical Package for Social Sciences) version 20. Result: The study revealed that the majority of suicide attempts occurred in the 21-30 years age group (52%), with middle-class individuals contributing the highest number (47.8%) of attempts. Unmarried individuals, particularly females, had the most attempts (58%), while students accounted for the largest percentage of suicide attempts by profession (38%), primarily in the 11-21 years age group. Rural residents had more attempts (70%) compared to urban residents (30%), and individuals from joint families (66%) were more likely to attempt suicide than those from nuclear families (34%). Conclusion: Young adults (21-30 years) and adolescents (11-21 years) are the most vulnerable age groups, with suicide attempts being notably higher among unmarried individuals and those from middle socio-economic backgrounds. Females exhibit a higher rate of attempts than males, especially among the unmarried. Professionally, students and unemployed individuals are particularly at risk.

Background: Non-arteritic anterior ischemic optic neuropathy is the most common acute optic neuropathy in patients older than 50 years. Risk factors for NAION are structural crowding of disc, diabetes, systemic hypertension, hyperlipidaemia, smoking. Patients present with sudden monocular vision loss, dyschromatopsia, visual field defect, disc edema diffuse or segmental. Objectives: To evaluate risk of non arteritic anterior ischemic optic neuropathy after routine treatment. Method: This Longitudinal observational study was carried out from January 2016 to June 2016 at Department of Neuro-Ophthalmology, National Institute of Ophthalmology & Hospital, Sher -E-Bangla Nagar, Dhaka among Sixty cases. Detailed information were obtained in each cases according to protocol. A complete history was taken from the patient. Relevant investigation reports were collected. Selected patients were undergone detailed ophthalmological and systemic evaluation. They were treated at NIO&H with following measure like proper counseling, controlling of risk factors like diabetes, hypertension, hyperlipidaemia and were advised to take tablet vitamin B1, B6 & B12. They were followed up at 1st week, 4th week & 8th week. In each visit visual acuity, color vision, field of vision, RAPD & optic disc changes were recorded in a pre- designed data collection sheet. All the information’s were recorded according to fixed protocol. Results: Among the 60 cases, mean age was 55.67 (±4.89) years, minimum age was 51 and maximum age 69 years. Majority 32(53.3%) were male and 28(46.67%) were female. Associated risk factor like diabetes, hypertension, hyperlipidaemia and sleep apnea which were 53.3%, 36.67%, 30% and 13.3% respectively. Different disc changes of the study population were segmental disc swelling 36(60%) and diffuse disc swelling 24(40%) respectively. Regarding distant visual acuity patients were grouped into 6/6 to 6/12 group, 6/18-6/36 group, 6/60- 1/60 group and counting finger to hand movement group. At presentation most of the patient belongs to 6/6- 6/12 group which was 26(43.33%) followed by 6/18-6/36 group, it was 18(30%), 10(16.67%) were included in (6/60-1/60) group and the rest 06(10%) were included in counting finger to hand movement group. At final visit on 8th week 20(35.7%) patients remain in 6/6-6/12 group and also 6/18-6/36 group includes 20(35.7%) patients, 10(16.67%) were included in (6/60-1/60) group and the rest 06(10%) were included in counting finger to hand movement group. RAPD present in pretreatment 52(86.7%) and in post treatment were 46(82.14%). (p>0.05) that was not statistically significant. Color vision dyschromatopsia in pretreatment 46(76.7%) and in post treatment were 37(60%). In post treatment 06(10.71%) were normal color vision. (p<0.5) that was statistically significant. ocular involvement 52(86.67%) were 1st eye and 08(13.3%) were 2nd eye. Comparison of pre-treatment and post treatment visual field were Arcuate scotoma 12(20%) vs 09(16.07%), Inferior Altitudinal field defect 32(53.33%) vs 31(57.14%), Superior Altitudinal field defect 02(3.3%) vs 02(3.57%) respectively. Conclusion: In study no significant change found on visual acuity, colour vision and field of vision after treatment of non-arteritic anterior ischemic optic neuropathy.

Metabolic syndrome (MetS) is defined by a set of components including hyperglycemia, dyslipidemia, hypertension, and central obesity. Despite the well-established association between MetS and chronic kidney disease (CKD) whose prevalence is on the increase, significant gap remains in our understanding of the relationship between kidney dysfunction and individual components of MetS, particularly in Nigeria. The objectives were to determine the prevalence of kidney dysfunction among adults with MetS and to examine the relationship of key components of MetS with kidney dysfunction using a cross-sectional study of randomly selected hospital outpatients with MetS. Kidney function was assessed using estimated glomerular filtration rate (eGFR). Descriptive and inferential statistical analyses were performed and statistical significance was set at p < .05. The mean age of the 75 study participants with MetS was 53.33 ± 13.94 years. Females constituted 65.3% and males, 34.7%. The prevalence of kidney dysfunction (eGFR < 60 mL/min/1.73 m²) was 36.0%, with no significant difference between genders. The key components of MetS that significantly correlated with kidney function were blood pressure, serum high density lipoprotein-cholesterol, and triglyceride. The same components independently predicted kidney function. To conclude, the study highlights the considerable burden of kidney dysfunction among adults with metabolic syndrome in Nigeria. Hypertension and dyslipidemia were the components of metabolic syndrome significantly associated with kidney dysfunction. Screening, early detection and targeted interventions including lifestyle modification and appropriate drug management are crucial to mitigate the impact of metabolic syndrome on kidney health, to improve health outcomes and to reduce CKD burden.

Diplopia is a frequent symptom in ophthalmology and has many causes. It may be binocular or monocular, the latter reflecting ocular damage. The study of the interaction between diplopia and the workstation is often neglected in therapeutic management; however, diplopia at work can have consequences for the health and safety of the worker concerned and therefore for clinical and socio-professional prognosis. We report a case of monocular diplopia due caused by a nuclear cataract in a radiologist. The purpose is to illustrate and explain the interaction between diplopia and work and the repercussions on fitness for work. This case underscores the need for effective, multidisciplinary medical and occupational strategies to manage diplopia in the workplace.

Background: Acute watery diarrhea (AWD), which has a sudden onset and is associated with a risk of severe dehydration, is primarily spread through unsafe water, poor sanitation, and inadequate hygiene. Socioeconomic factors, like low parental education and poverty, further increase risks. WHO-recommended interventions, including oral rehydration therapy, zinc supplementation, and rotavirus vaccinations, have reduced diarrhea-related deaths globally. Aim of the study: This study aims to explore the socio-demographic, environmental, and behavioral factors associated with childhood watery diarrhea, particularly in high-risk regions. Methods: This prospective observational study was conducted at the Department of Pediatric, 250 Bedded General Hospital, Khulna, Bangladesh, with 210 children aged 0–60 months presenting acute watery diarrhea, enrolled over one year July 2023 to June 2024. Eligible children met specific inclusion criteria, while exclusion was applied to cases of chronic diarrhea or unrelated pre-existing conditions. Data confidentiality was maintained, with ethical approval granted. The analysis involved descriptive statistics in SPSS (version 26) for comprehensive result interpretation. Result: The study included 210 children under five, with a mean age of 14.51±5.34 months; most were aged 7-12 months (38.10%), and 54.29% were male. Caregivers were predominantly aged 28.39±4.11 years, with 73.81% having completed primary education. Key findings included high MMR vaccination rates (62.38%), significant exclusive breastfeeding for six months (58.57%), and recent diarrhea reports among 20.95% of caregivers. In terms of WASH practices, 60.48% used piped water, 57.62% stored drinking water separately, and 95.71% had toilet facilities. Notably, 67.14% used water only for handwashing, and 45.24% washed hands with soap post-toilet use. Conclusion: Safe water, sanitation, and handwashing practices are essential to reducing acute watery diarrhea in children under five. Children in households with untreated water and inconsistent caregiver handwashing face higher risks. Targeted public health initiatives to improve water treatment and hygiene could greatly reduce diarrhea incidence and improve child health outcomes.

Background: Psoriasis, a chronic inflammatory skin disorder, poses substantial challenges to affected individuals, with plaque psoriasis being the most prevalent form. Despite advancements in treatment, including biologic drugs and oral small molecules, there remains a need for effective, accessible, and safe therapies for moderate-to-severe psoriasis. Deucravacitinib, a novel oral small molecule targeting Tyrosine Kinase 2 (TYK2), emerges as a promising option in psoriasis management. Objective: This study aims to evaluate the efficacy and safety of deucravacitinib in the treatment of psoriasis. Method: A comprehensive literature search was conducted across multiple databases, including PubMed, clinicaltrials.gov, Cochrane Skin, and Embase, up to February 16, 2023. Manuscripts were selected and analyzed following PRISMA guidelines. Relevant keywords such as "psoriasis," "oral small molecules," "deucravacitinib," "efficacy," and "safety" were used. Various types of manuscripts, including reviews, meta-analyses, clinical trials, and real-life experiences, were considered. Abstracts and full texts of selected articles were reviewed, and references were cross-checked. Results: A total of four completed trials and six ongoing studies were included in the review. Completed studies demonstrated the efficacy of deucravacitinib, with significant improvements in Psoriasis Area and Severity Index (PASI) scores compared to placebo and apremilast. Notably, deucravacitinib showed superiority in achieving PASI 75, 90, and 100 responses. Safety profiles were generally favorable, with common adverse events including nasopharyngitis, headache, diarrhea, and nausea. Conclusion: Deucravacitinib emerges as an innovative and valuable option for psoriasis management, offering promising efficacy and safety outcomes in clinical trials. While further research is warranted to validate its efficacy and compare it with existing therapies, deucravacitinib holds potential as a significant addition to the psoriasis treatment armamentarium.

Background: Diabetes mellitus is a chronic disorder of energy metabolism caused by lack or decrease in the effectiveness of insulin, and is characterised by an abnormally elevated blood glucose concentrations and the development of macrovascular, microvascular and/or neuropathic complications. Diabetic neuropathy (DN) is one of the most debilitating outcomes of diabetes mellitus, and may cause pain, decreased mobility as well as amputation. Diabetes can damage the peripheral nervous system (PNS), through the induction of de-myelination in neurones, precipitated by chronic hyperglycaemia-induced oxidative stress, and causing a condition that involves the upper and lower limbs. Objective: The study discussed the risk factors for insulin resistance and pre-diabetes, type II diabetes mellitus and vascular complications, cellular and molecular basis of DN, physiopathological mechanisms, and the pharmacological treatment of DN. Method: The study examined journal articles and standard textbooks, as it relates to diabetes mellitus and its complications. Search for articles on DN was carried out in the literature. These were identified and reviewed for selection using chemical abstracts service, pubmed, google scholar, crossreference, web of science, pubmed central free article, and scopus. The key words used for search were: diabetic neuropathy; diabetic peripheral neuropathy; peripheral neuropathy; microvascular complications of diabetes mellitus; and neuromuscular complications of diabetes mellitus. Result & Discussion: Two hundred and fifty (250) articles and other works were identified, while ninety-seven (97) articles and non-journal materials were extracted and reviewed, taking into account the criteria for selection. Studies done in the last 4.5 decades were included, while works written on other languages, outside English were excluded. Findings indicate that DN is a complex disorder that affects the peripheral and/or cranial nerves, which is caused by unattended or poorly attended, long-term increase in blood glucose concentrations. It relatively manifests early, affecting a significant proportion of the micro-blood vessels in the middle-aged and elderly diabetic patients. DN causes numbness, loss of sensation, and sometimes pain in the feet, legs, arms or hands. Hyperglycaemia causes the activation and inhibition of several molecular pathways that are crucial for homeostasis in neuronal and neuroglial cells. Conclusion: DN is the commonest complication of diabetes mellitus. It has no known definitive therapy. Treatment is essentially symptomatic with huge economic and psychological burden, hence the rationale for a cost effective and targeted therapies. Achieving euglycaemia using anti-diabetic regimens (i.e., insulin and oral hypoglycaemic agents), foot care, changes in feeding habits and lifestyle modification are critical to holistically address the problem.