Background: The current study aims to assess the impact of structured patient education on cardiovascular complications in post-covid patients with type-2 diabetes mellitus and dyslipidaemia. Objectives: To assess the prevalence of cardiovascular risk among type-2 diabetes mellitus with dyslipidaemia in post-covid patients. to analyse the cardiovascular risk correlated with diabetes and lipid profile. to assess the impact of patient education on cardiovascular risk complications. Method: A total of 300 patients were screened and of them, 205 were enrolled in the study based on the inclusion and exclusion criteria. Patient education was given to selected patients using structured patient leaflets and oral education after baseline. They are followed up after 2 months. Cardiovascular risk was assessed by ASCVD and Framingham risk assessment score. Results: The study analysed that there was a high prevalence in males, the age group 51-70 years, non-alcoholic, and non-smokers. At the baseline, most patients were at high risk. On comparing the baseline with the review, a 49.3% difference was seen in the high-risk category. Conclusion: The study revealed that age, gender, low density lipoprotein, total cholesterol, and random blood sugar were the important cardiovascular risk factors. The implementation of pharmacist care in collaboration with physicians and nurses may reduce cardiovascular risk complications and help in better medication management.

Aquasomes are considered an excellent and efficient carrier system for the transport of drugs or biochemically active long chain macromolecules such as proteins and peptides, various hormones, antigens, enzymes, and genes in the recently burgeoning field of nanobiotechnology research. These are three-layer self-collecting structures composed of an oligomeric film covering a strong stage nanocrystalline centre to which biochemically dynamic particles adhere to, independent of changes in the environment and which self-assembles through non-covalent or ionic connections. Aquasomes are circular particles, 60–300 nm in size, that are used to deliver antigens and medications. The structural stability is provided by the solid core, while the active drug molecules are stabilized and protected from dehydration by the polyhydroxy oligomer covering. The most common way to distribute aquasome formulations is parenterally, however recent research indicates that there may be additional, oral, ways as well. A combination of targeted molecular shielding and prolonged release mechanism is used by aquasome to deliver their bioactive chemicals. The present paper offers an overview of the aquasome as a potentially useful medication delivery technique. It covers every facet of aquasome, such as their structure, the processes for preparing them, ways to characterize them, and medical uses as a drug delivery system.

Introduction: Despite the availability of numerous treatment options, managing unstable proximal humeral fractures remains a significant surgical challenge. Utilizing a PHILOS plate is an effective surgical technique for addressing these fractures. This approach provides stability and support to the fracture site, promoting proper healing and potentially improving patient outcomes. Aim of the study: The aim of this study was to assess the functional outcome of PHILOS plate fixation in proximal humerus fractures. Methods: This prospective study was conducted in the the Department of Orthopedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka, Bangladesh during the period from January 2009 to December 2010. A total of 80 patients aged over 18 years were included in the study. Patients with open, pathological and ipsilateral distal fractures in the same limb were excluded from the study. Result: The youngest and the oldest one were 23 and 78 years respectively. Majority of the patients were male and business was their main occupation. Fifty patients (62.5%) presented with 3-part fractures, ten (12.5%) with four-part fractures and twenty (25%) with fracture dislocation. The interval between injury and plate fixation was 18 days and minimum and maximum interval was 2 and 78 days respectively. Majority (92.5%) of the injury was caused by high-velocity accident. Evaluation of the outcome at 6 months showed that 62.5 percent of patients had good outcome, 25 percent patients had fair outcome. Conclusion: PHILOS plate fixation for proximal humeral fractures provides stable fixation and good functional outcomes, particularly in elderly patients.

Background: Fractional exhaled nitric oxide (FeNO) has emerged as a potential tool for managing asthma in children, but its precise role remains under investigation. Objectives: This systematic review aims to comprehensively evaluate the current research on FeNO's utility in managing pediatric asthma. Methods: We conducted a systematic search of electronic databases like PubMed, MEDLINE, Science Direct, and Scopus. Two independent reviewers screened and extracted data from eligible studies. Results: Sixteen studies including 4612 participants in total and more than half of them 2558 (55.5%) were males—were included in our data. Intermediate FeNO levels had a higher yearly hospitalization rate than those with low or high FeNO levels. FeNO can be a predictive marker as one study found that FeNO levels of more than 35 ppb have the highest risk of developing respiratory disease in the future. Regarding the benefits of FeNO-guided therapy, the use of FENO in conjunction with GINA guidelines for ICS titration can help reduce daily ICS doses and treatment costs. FeNO was found reliable as an asthma biomarker only in children with concomitant aeroallergen sensitivity. Conclusion: The evidence for the effectiveness of FeNO-guided asthma care in children is critical. The effect of FeNO-guided treatment on pharmaceutical use is unclear. Any benefits in illness control must be balanced against the risk of increased drug use, particularly ICS, as higher rates were frequently observed in children with FeNO-guided monitoring. There is an obvious need for larger, longer-term research to address these problems before making firm recommendations for routine therapeutic use.

Background: The journey of pregnancy and childbirth embodies a critical period in a woman's life, impacting both maternal and child well-being. Understanding maternal status during and after labor beyond 28 weeks of gestation holds significant clinical relevance, given its implications for obstetric management and outcomes. Objective: This study aimed to assess maternal status during and after labor beyond 28 weeks of gestation at a tertiary hospital. Methods: A cross-sectional descriptive observational study was conducted at Mymensingh Medical College Hospital from March 2019 to August 2019. The study included pregnant women with fetal malpresentation from 28 to 42 weeks of gestation admitted to the labor and antenatal ward. A total of 50 participants were purposively sampled. Data were collected using a structured questionnaire and analyzed using SPSS version 16. Ethical approval was obtained, and informed consent was obtained from all participants. Results: The study revealed a diverse age distribution among mothers, with the majority falling within the 26-30 age bracket (40.0%). Parity distribution showed a significant proportion of mothers with four or more children (40.0%). Prolonged labor emerged as the most common complication (6.0%), followed by obstructed labor (4.0%). Maximum vaginal deliveries occurred at 28-31 weeks of gestation, while cesarean sections were predominant at or above 36 weeks. Cesarean section exhibited the highest survival frequency (100%), followed by vaginal delivery (90%) and assisted breech delivery (80%). Postpartum hemorrhage was the most common maternal morbidity (6.0%). Conclusion: In conclusion, our study sheds light on maternal demographics, labor complications, delivery modes, and perinatal outcomes at a tertiary hospital. The age distribution revealed diversity, with most mothers aged 26-30. Many were multiparous, underscoring the importance of obstetric history. Prolonged labor was predominant, emphasizing the need for vigilant monitoring. Cesarean sections were common after 36 weeks, ensuring higher survival rates. Despite benefits, postpartum hemorrhage posed a significant concern. This highlights the necessity for comprehensive obstetric care to improve maternal and neonatal outcomes. Further research is imperative to refine maternal-fetal care in tertiary settings.

Introduction: Head trauma is a major public health problem and a major cause of morbidity and mortality, particularly in young adults. Objective: To clarify the interest of computed tomography in the management of cranioencephalic trauma in the radiology and medical imaging department of the CHU GT. Methods: This was a retro and prospective study of 5 months ranging respectively from January to March 2010 on 103 cases, from August to November 2010 on 12 cases and concerned 115 patients who came for a CT scan in a context of traumatic brain injury. Results: The average age was 26.6 years with extremes from 4 years to 65 years. The sex ratio was 4.7%. Road accidents accounted for 80.9% of cases. All patients with computed tomography abnormalities, fractures of the vault represented 74.1% of cases, the base with 17.2% and in 8.5% of cases the fracture concerned both the vault and the base. The linear fracture interested the arch in 39.6% of cases. Pericerebral lesions were dominated by meningeal hemorrhage and extradural hematoma with 63.2% and 22.8% of cases. Hemorrhagic edema accounted for 81.7% of intracerebral lesions and in 12% of cases, intracerebral lesions were associated. Based on these data 48.3% of patients were operated on in neurosurgery. The mortality rate was 7.8%. Conclusion: CT remains the examination of choice in the management of craniocerebral trauma.

Introduction: The pharmacy-led discharge medication delivery to bedside (Med-to-bed) service in a tertiary care Johns Hopkins Aramco Healthcare (JHAH) hospital aims to optimize medication management during patient transitions from admission to discharge, especially for those with chronic conditions. The service entails the direct delivery of discharge medications to patients at the pharmacy following their discharge from inpatient wards, accompanied by comprehensive medication counseling. The pharmacy-led Med-to-Bed service aims to reduce patient wait times and improve overall clinical outcomes. Methods: This article highlights common challenges in medication reconciliation and post-discharge prescription fulfillment, highlighting the need for standardized protocols and improved hospital adherence to ensure seamless care transitions. It also discusses future considerations for optimizing the Med-to-Bed service, including proposed pharmacy renovations, installing a dedicated robotic dispensing system, and providing private spaces for patient counseling during medication pickup. Additionally, the proposal suggests deploying more pharmacy staff to address delayed discharge orders and making systemic enhancements to the EHR system to streamline prescription pickup. Result: The successful implementation of the proposed pharmacy-led Med-to-Bed service demonstrates the efficacy of interdisciplinary collaboration among nurses, physicians, and pharmacists. Through this collaborative approach, the Med-to-Bed service has shown tangible improvements in operational efficiency and patient outcomes, underscoring its potential to transform healthcare delivery models. Conclusion: Overall, this proposed model provides valuable insights into the transformative impact of integrated care initiatives like the Med-to-bed service in tackling complex medication management and enhancing quality patient care in hospitals.

Background: Invasive fungal infections (IFIs) represent a major challenge in intensive care units (ICUs) globally, contributing significantly to morbidity and mortality among critically ill patients. It is crucial to comprehend the dynamics of these infections in Bangladesh, considering its unique healthcare environment and tropical climate, to enhance management and prevention strategies effectively. Materials and Methods: The study was designed as a retrospective cohort study. Data was collected from fungal surveillance database of non-covid ICU of Dhaka Medical college for a period ranging from July 2022 to April 2024. The study enrolled 205 patients based on specific criteria. It aimed to identify the prevalence & resistance pattern of invasive fungal species. Statistical Package for Social Science (SPSS) version 25.0 was used for data analysis. Results: In the study of 205 ICU patients, demographic analysis revealed a predominance of males (65.37%) and an age distribution skewed towards those aged 30-60 years (46.34%). Common comorbidities included diabetes (20.00%), hypertension (24.88%), chronic kidney disease (10.24%), and COPD (14.63%). Invasive procedures, such as central venous lines (44.88%), were prevalent, alongside notable rates of fungal infection (8.29%), primarily involving Candida species. Resistance patterns among fungal-positive blood samples showed significant resistance to Amphotericin B, Caspofungin, and Voriconazole (50% each), while Fluconazole and Flucytosine exhibited no resistance. Species analysis identified Candida albicans, Candida tropicalis, and Candida auris with varying mortality rates (100%, 80%, and 66.67%, respectively). Conclusion: High mortality rates associated with Candida species underscore the urgent need for effective antifungal strategies tailored to local resistance patterns. Continued surveillance and improvements in infection prevention and control measures are essential to mitigate the impact of emerging resistant pathogens like Candida auris in healthcare settings.

Introduction: Acute pancreatitis is an acute inflammatory condition of the pancreas involving varying degrees of regional tissues and distant organ systems. This study aims to investigate the clinical presentations and risk factors associated with acute pancreatitis to enhance understanding and guide more effective management strategies. Aim of the study: The aim of this study was to evaluate the clinical presentation and risk factors associated with acute pancreatitis. Methods: This retrospective study was conducted at Holy Family Red Crescent Medical College Hospital, Dhaka, from July 1, 2021, to December 31, 2023, spanning 2.6 years. The study included 42 consecutive patients diagnosed with acute pancreatitis. Data were collected by reviewing patient records for demographic details, clinical presentations, etiological factors, complications, and outcomes. Statistical analyses were conducted using SPSS version 23, with categorical variables expressed as numbers and percentages. Result: The majority of the 42 patients included in the study were within the age group of 20-39 years, 24 (57.14%) patients The most common clinical presentation was abdominal pain, reported by 40 (95.24%) patients. Biliary causes, including gallstones and common bile duct stones, were identified as the predominant etiology in 27 (64.29%) patients. Complications included necrotizing pancreatitis in 4 (9.52%) patients. Regarding outcomes, 27 (64.29%) patients recovered and were discharged. Conclusion: Effective management, emphasizing early diagnosis and treatment, is crucial for reducing the morbidity and mortality associated with acute pancreatitis.

Myocardial infarction resulting from coronary embolism is a rare type of acute coronary syndrome, often going unnoticed. Distinguishing it from acute coronary syndromes arising from atherosclerosis is important, as it significantly influences the treatment approach. It is frequently associated with conditions that increase the risk of thromboembolism, such as infective endocarditis, atrial fibrillation, mitral valve disease, neoplasia and cardiac surgeries. We would like to present a case of coronary embolism involving a 42-year-old male with a history of rheumatic valve disease and atrial fibrillation who was admitted for acute chest pain. The diagnosis was confirmed through coronary angiography.

Objectives: To assess the effectiveness of different types of physical activities (e.g., weight-bearing exercises, resistance training, aerobic exercises) in preventing osteoporosis in postmenopausal women. Methods: A comprehensive computerized search of pertinent databases was conducted in order to find studies that satisfied the inclusion requirements. To find pertinent information, a thorough search of PubMed, SCOPUS, Science Direct, and Web of Science was conducted. Results: Our data included seven trials with 30,728 women. Each study included a different exercise program, such as walking impulse, general regular exercise, aerobic exercise, and multipurpose exercise. Frequent regular exercise for a longer duration (>1 h) had considerably stronger preventative benefits for postmenopausal osteoporosis. The multifunctional exercise regimen described here had a positive impact on specific musculoskeletal, BMD, body composition, and cardiometabolic endpoints. After a meal, 45 minutes of suprathreshold speed-enhanced accelerated walking on level ground can prevent or mitigate postmenopausal osteoporosis in stationary women. Hormone replacement therapy and aerobic exercise can raise vertebral bone mineral density. Conclusion: For postmenopausal women, physical activity is a crucial non-pharmacological intervention in preventing osteoporosis. Personalized exercise prescriptions are necessary, nevertheless, as evidenced by the variation in the efficacy of various exercise regimens. Subsequent studies have to persist in refining our comprehension of the ideal workout plans for averting osteoporosis and tackling the obstacles associated with consistency and durability.

Background: Obstructive sleep apnea (OSA) is a prevalent and potentially serious condition in children, with significant implications for health and development. Limited data exists on the prevalence and management of OSA in Saudi Arabian children. Objective: To study the prevalence and management of OSA in children residing in Saudi Arabia. Methods: An extensive search of PubMed, Web of Science, Scopus, and Science Direct was performed to locate relevant material. Rayyan QRCI was used to select the eligible articles. Results: Our data includes eight articles with 2619 children, 1254 (47.8%) of whom were males. The prevalence of OSA in Saudi children ranged from 6.6% in school children to 50% in children with SCD, with a total prevalence of 208 (9.9%). Adenotonsillectomy (AT) successfully and effectively managed OSA and lifestyle modifications improved the outcomes of AT. Anti-inflammatory therapy with a combination of nasal steroids and anti-leukotriene significantly lowers the adenectomy rate. Some orthodontic evaluation and orofacial morphology were significantly associated with a higher incidence of OSA. Conclusion: The prevalence of OSA in Saudi children is generally low but rising among children with SCD. AT and lifestyle modifications can reduce the severity and symptoms of sleep apnea in Saudi children with OSA. Anti-inflammatory and steroid therapy was reported to decrease the rate of implementing AT. Certain craniofacial traits were more common, but not consistently, in a subset of juvenile OSA patients. Effective care necessitates a comprehensive approach that includes early detection, surgical and non-surgical procedures, and addressing underlying risk factors like obesity and allergies. By addressing current hurdles and utilizing future research, Saudi Arabia's healthcare system may enhance the quality of life for children with OSA.

Cirrhosis is characterised by the formation of regenerative nodules in liver parenchyma surrounded by fibrous septa due to chronic liver injury. It occurs due to necrosis of liver cells followed by fibrosis and nodule formation. Cirrhosis is the final stage of chronic liver disease and has many causes including viral hepatitis, excessive alcohol intake and non alcoholic steatohepatitis. Liver cirrhosis effects the quality of life and patient survival. Cirrhotic patients are in need of early diagnosis and careful follow up to prevent further complications.This review article covers the clinical aspects of cirrhosis and its management strategies.

Background: Diabetes mellitus poses a significant global health challenge, with Type 2 Diabetes Mellitus (T2DM) being particularly prevalent and on the rise, especially in low and middle-income countries. Liver enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyl transferase (GGT), are vital indicators of liver health and metabolism, often showing elevated levels in individuals with diabetes. Despite the public health importance of this relationship, comprehensive research, especially in Bangladesh, remains limited. This study aimed to address this gap by evaluating liver enzyme levels and their correlation with T2DM. Objective: The objective of this study was to assess the frequency of elevated liver enzymes and their association with T2DM. Method: A cross-sectional study was conducted in a tertiary hospital in Dhaka from May to August 2023. The study included 192 participants with T2DM and an equal number of control participants without diabetes. Liver enzymes (AST, ALT, and GGT) were measured, and statistical analysis was performed using independent t-tests. Results: The study found that persons with Type 2 Diabetes Mellitus (T2DM) had significantly higher levels of Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) compared to the control group (p < 0.001). Nevertheless, there was no substantial disparity in GGT levels seen between the two groups (p = 0.065). Individuals with T2DM had a considerably higher mean fasting blood glucose level compared to controls (p < 0.001). The liver function test results of the participants with type 2 diabetes mellitus (T2DM) were substantially higher compared to the control group. The serum alanine aminotransferase (ALT) level was 46.06 ± 22.38 IU/L and the serum aspartate aminotransferase (AST) level was 42.94 ± 19.08 IU/L, with a p-value of less than 0.001. However, there was no significant association between the gamma-glutamyl transferase (GGT) level in both study groups, with a p-value of 0.065. Conclusion: Elevated levels of AST and ALT are common in individuals with T2DM, indicating potential liver dysfunction. Liver enzyme testing may serve as a valuable tool in the assessment and management of diabetes-related complications.

Background: In developing countries like Bangladesh, posterior urethral valves (PUV) are typically diagnosed postnatally, whereas in developed countries, they are often identified prenatally. Early diagnosis, complete fulguration, and regular follow-up are crucial to prevent renal impairment in PUV patients. Objective: This study aimed to evaluate the outcomes of endoscopic fulguration in PUV patients in a Bangladeshi medical setting. Method: Conducted at the Department of Urology, Dhaka Medical College & Hospital, this observational study spanned from July 2018 to June 2019. Thirty-five patients meeting inclusion and exclusion criteria were initially included, with five dropping out during follow-up. Endoscopic valve ablation was performed on all patients, followed by catheterization for 14 days. Post-procedure, patients were discharged within 48-72 hours with oral antibiotics and behavioral therapy advice. Follow-up visits over six months included assessments of height, weight, urine analysis, serum creatinine, kidney ultrasonography, and eGFR. Voiding cystourethrograms were performed at one- and six-months post-fulguration. Result: Most patients presented at ages 11-20 months (36.7%) and 21-30 months (26.67%). Poor urine stream and dribbling were the most common symptoms, seen in 83.33% and 76.67% of patients, respectively. Repeated fever was noted in 63.33% of patients, while 43.33% exhibited failure to thrive. VUR was present in 46.7% of patients; 42.86% had unilateral VUR and 57.14% had bilateral VUR. Following six months of fulguration, complete resolution of reflux occurred in 40% of right-side and 50% of left-side renal units. Decreased reflux grade was noted in 20% of right-side and 16.67% of left-side units, while persistence was seen in 40% and 33.33% respectively. Significant improvements in eGFR and serum creatinine levels were observed (p<0.001). Hydroureteronephrosis decreased from 22 to 8 cases, though this was not statistically significant (p=0.06). Conclusion: Endoscopic fulguration significantly improves renal function in PUV patients. About half of VUR cases resolved completely within six months post-procedure.

Background: Androgenetic alopecia (AGA) is a common form of hair loss affecting both men and women, characterized by progressive thinning of hair, particularly in the scalp's vertex and frontal areas. Treatments such as minoxidil and platelet-rich plasma (PRP) have been developed to manage AGA, each with distinct mechanisms and efficacy profiles. Objective: This study aimed to compare the efficacy of Minoxidil, Dermaroller, and PRP in treating AGA, evaluating their impact on hair growth and patient satisfaction. Methodology: This prospective comparative parallel-group interventional study was conducted on the outpatient department of Dermatology, tertiary hospital, between December 2022 and May 2023. Where male participants aged 18-45 years with grade II, III, or IV AGA were enrolled. Ninety patients were randomly assigned to three groups: Group A received 5% minoxidil twice daily; Group B received the same minoxidil regimen with monthly dermaroller treatment; Group C received 5% minoxidil along with monthly PRP injections. Participants were assessed at baseline, 3 months, and 5 months using photographic documentation and dermoscopy to measure hair growth improvements. Results: The mean age of participants was 29.90 ± 5.50 years, with a balanced gender distribution (1:1 male to female ratio) and a significant family history of AGA (70%). PRP with minoxidil demonstrated superior efficacy compared to minoxidil alone or minoxidil with dermaroller, showing significant improvements in hair counts at both 3 months (p=0.01) and 5 months (p<0.001). Dermaroller with minoxidil also showed improvements, though not statistically significant compared to minoxidil alone. Secondary efficacy analysis revealed significant shifts towards hair growth enhancement in the PRP + minoxidil group. Conclusion: PRP combined with minoxidil represents a promising and effective treatment option for AGA, offering superior outcomes compared to minoxidil alone or minoxidil with dermaroller. This combination therapy enhances hair growth through its regenerative effects on hair follicles, making it a valuable option for patients seeking non-surgical interventions with high satisfaction rates.

Objectives: To provide an updated synthesis of the evidence on the management of pulmonary hypertension (PH) in pediatric patients. Methods: We performed a thorough search of electronic databases such as PubMed, Science Direct, Cochrane Library, and Scopus. Two independent reviewers evaluated and retrieved information from qualifying papers. Results: Our data consists of eight studies with 2003 children, 930 (46.3%) of whom were female. Prostacyclin agonists were found to significantly improve hemodynamic parameters and reduced BNP levels, which implies that they have promising clinical efficacy and a good tolerance profile. No major side effects were noted except for headaches and gastrointestinal symptoms. Systemic glucocorticoids, inhaled NO, endothelin receptor antagonists, and PDE showed tolerability and clinical improvements in pediatric PH. Side effects such as acute kidney damage, renal failure, and methemoglobinemia were noted with the inhaled NO. Conclusion: Pediatric PH is still a difficult condition with high morbidity and mortality. All of the reported pharmacological interventions demonstrated good clinical outcomes and almost no adverse effects. Healthcare practitioners can improve the care of children with PH and eventually improve their quality of life and long-term survival by incorporating new research into clinical practice.