The Insight
type: channel
description: The Insight is the official journal of Gopalganj Medical College, Gopalganj, Bangladesh and accepts articles for publication from home and abroad. This is a quarterly peer-reviewed journal and aims to publish work of the highest quality from all branches of medical science. The aim of the publication is to promote research and serves as a media for the dissemination of scientific information and recent knowledge among the readers. e-ISSN: 2789-6897 ISSN: 2663-9491
publisher: Gopalganj Medical College
language: en
publication name: The Insight
issn: 2663-9491
items: Association of Body Mass Index and Serum Lipid Profile Among the School Children
items: Anatomical Site Distribution of Histopathologically Confirmed Intestinal Tuberculosis in Surgically Managed Patients
items: Histopathological Patterns of Renal Injury in Gentamicin-Exposed Wistar Rats Following Turmeric Essential Oil and Losartan Treatment
items: Factors Associated with Delayed Presentation Among Patients with First-Episode Psychosis in Bangladesh
items: Clinical Outcome of Ilizarov External Fixation in Gustilo-Anderson Type III Open Tibial Fractures
items: Diagnostic Accuracy of Ultrasonography Compared with Magnetic Resonance Imaging for Rotator Cuff Pathologies of the Shoulder: A Cross-Sectional Study
items: Correlation between Physical Activity Level and Disease Activity in Axial Spondyloarthritis
items: Seasonal Variance in the Incidence Rate of Epistaxis: An Observational Study
items: Prevalence of Cardiometabolic Risk Factors and Estimated 10-Year ASCVD Risk among Rural Older Adults in Bangladesh
items: Clinical Spectrum and Presenting Features of Presumptive Tuberculous Meningitis in Children
items: Association of Sociodemographic Factors with Severity of Substance Use Risk among Bangladeshi Adolescents
items: Predictors of Worsening Renal Function in Patients Hospitalized with Acute Heart Failure
items: Post-Vaccination Immune Status Against the Hepatitis B Virus Amongst Doctors Working in a Tertiary Care Hospital
items: Thyroid Function Status in Women of Reproductive Age with Abnormal Uterine Bleeding
items: Predictors of Malignancy in Patients Presenting with Breast Lumps: A Multivariable Analysis from a Tertiary Surgical Center
items: Socio-Demographic and Lifestyle Predictors of Triple-Negative Breast Cancer in Bangladeshi Women
items: Comparison of Clinical Outcomes Between Hypertensive and Non-Hypertensive Intracerebral Hemorrhage
items: Clinical Patterns and Management Challenges of Endometriosis in Women of Reproductive Age
items: Educational Preparedness and Perceived Challenges for the Development of Forensic Odontology in Bangladesh: Perspectives of Medical and Dental Graduates and Undergraduates
items: Effects of Nephrotic Syndrome in Children
items: Accelerated Versus Standard Ponseti Method for Idiopathic Congenital Clubfoot: Impact on Treatment Duration, Healthcare Visits, and Clinical Outcomes
items: Diagnostic Accuracy of FNAC Compared with Histopathology in Patients with Palpable Breast Masses Attending a Tertiary Care Hospital
items: Thyroid Dysfunction and Autoantibody Positivity in Relation to Clinical Severity of Psoriasis
items: Association between Immunohistochemical markers and MRI features in patients with glioblastoma multiforme underwent surgery
items: Clinicopathological Characteristics of Diffuse Gliomas According to IDH1 Mutation Status
items: Outcome of severe head injury in Relation to basal cisterns on initial CT scan
items: Comparison of Accuracy of Ventricular Catheter Tip Placement by Conventional Free-Hand Method and Electromagnetic Neuronavigation Guided Ventriculoperitoneal Shunt Surgery
items: Association of Tumor Size and Margin in Preoperative MRI with Histological Grade Among Intracranial Meningioma Patients
items: Clinical and Functional Outcome of llizarov External Fixation in the Management of Infected Tibial Nonunion
items: Outcome Comparison Between Titanium Elastic Nailing and Hip Spica Casting in Pediatric Femoral Shaft Fractures

Association of Body Mass Index and Serum Lipid Profile Among the School Children
type: item
description: Background: Childhood obesity is an increasing global health concern and is expected to impose a substantial burden on individuals and healthcare systems. Obesity is a complex condition influenced by multiple genetic, environmental, and lifestyle factors and is associated with abnormal lipid profiles in children, increasing the risk of future cardiovascular disease. The aim of this study was to evaluate the association between high body mass index (BMI) and dyslipidemia among school children. Methods & Materials: This cross-sectional study was conducted from January to December 2019 in the Department of Biochemistry, Dhaka Medical College, Dhaka. School children aged 12-17 years were purposively selected based on history, physical examination, and relevant investigations. BMI and BMI percentile were assessed, and fasting serum lipid profile (TC, TG, LDL-C, and HDL-C) was measured using enzymatic methods. Written informed consent was obtained from participants and their parents. Data were collected using a pre-designed data sheet and analyzed with SPSS version 22.0. Statistical significance was set at p < 0.05. Results: Mean ± SD age of the study subjects was 13.5 ± 1.4. Among 12- to 17-year-olds, 3% were obese, 16.4% were overweight and 26.9% were underweight. The prevalence of hypercholesterolaemia, hypertriglyceridaemia, high level of low-density lipoprotein cholesterol (LDL-C) and low level of high-density lipoprotein cholesterol (HDL-C), were: 8.2%, 21.6%, 6.7% and 31.3% respectively. Increased level of serum level of TC, TG, LDL-C were found significant correlation with BMI and HDL-C showed a significant negative correlation with increased BMI. Conclusion: This study revealed overweight and obesity is common among the study subjects and those with higher BMI tend to have abnormal lipid profile.
subject: Original Article
  topic: section
subject: Body Mass Index
  topic: keywords
subject: Serum Lipid Profile
  topic: keywords
subject: School Children
  topic: keywords
creator: Mohammad Ruhul Manzur
creator: Shahnila Ferdousi
creator: Mizanur Rahman
creator: Nazmus Sadat
creator: Mezbah Uddin
creator: Fahmida Hoque
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-04
publication date: 2026-09-04
doi: 10.5281/zenodo.22307092

Anatomical Site Distribution of Histopathologically Confirmed Intestinal Tuberculosis in Surgically Managed Patients
type: item
description: Introduction: Intestinal tuberculosis is one of the common forms of extrapulmonary tuberculosis in endemic countries and frequently presents with nonspecific clinical features, making early diagnosis challenging. Knowledge of the common anatomical sites of involvement is important for accurate diagnosis, appropriate surgical planning, and effective patient management. The present study was undertaken to determine the anatomical site distribution of histopathologically confirmed intestinal tuberculosis in surgically managed patients. Methods & Materials: This descriptive cross-sectional observational study was conducted in the Department of Surgery of Uttara Adhunik Medical College Hospital (UAMCH) and Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from January 2015 to December 2015. Purposive sampling was employed, and 30 histopathologically confirmed intestinal tuberculosis patients were included in the study. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 20.0. Result: The mean age of the patients was 31.1 ± 9.7 years (range: 15-58 years), with the highest 40.0% belonging to the 21-30-year age group. Abdominal pain (83.3%), weight loss (76.7%), and fever, malaise, and anorexia (60.0%) were the most common presenting symptoms, while pallor (86.7%), distended abdomen (63.3%), and abdominal tenderness and palpable abdominal mass (56.7% each) were the predominant physical signs. The ileocaecal region was the most frequently involved anatomical site (56.7%), followed by the ileum (20.0%), whereas isolated involvement of the caecum (10.0%), colon (10.0%), and jejunum (3.3%) was relatively uncommon. Conclusion: The ileocaecal region was identified as the most commonly involved anatomical site, followed by the ileum, whereas isolated lesions of the caecum, colon, and jejunum were relatively infrequent. These findings reaffirm the characteristic predilection of intestinal tuberculosis for the ileocaecal region and highlight t…
subject: Original Article
  topic: section
subject: Intestinal Tuberculosis
  topic: keywords
subject: Anatomical Site
  topic: keywords
subject: Histopathology
  topic: keywords
creator: Jesmin Rahman
creator: Chaudary Nur-E-Tanzim
creator: Irin Rahman
creator: Tasnim Hossain
creator: Nazmun Nahar
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Histopathological Patterns of Renal Injury in Gentamicin-Exposed Wistar Rats Following Turmeric Essential Oil and Losartan Treatment
type: item
description: Introduction: Gentamicin-induced nephrotoxicity is characterized by proximal tubular degeneration, necrosis, inflammatory infiltration, vascular congestion, and interstitial changes. Turmeric-derived preparations and losartan have been investigated as potential modifiers of renal injury, although direct histopathological evidence concerning turmeric essential oil remains limited. Aim: To describe and compare renal histopathological patterns in gentamicin-exposed Wistar rats treated with turmeric essential oil or losartan. Methods & Materials: This experimental animal study was conducted at the Department of Pharmacology and Therapeutics, Sir Salimullah Medical College, Dhaka, Bangladesh, from July 2019 to June 2020. Twenty-five adult male Wistar rats were randomly allocated to five groups of five animals. Group A received normal saline. Group B received gentamicin 80 mg/kg/day intraperitoneally on days 8-14. Groups C and D received turmeric essential oil at 50 and 100 mg/kg/day orally, respectively, for 14 days, together with gentamicin on days 8-14. Group E received losartan 10 mg/kg/day orally for 14 days, together with gentamicin on days 8-14. Renal sections were stained with haematoxylin and eosin and assessed for inflammatory-cell infiltration, vascular congestion, proximal tubular injury, epithelial regeneration, and interstitial vacuolation using ordinal grades from 0 to 4. Results: The gentamicin-treated group showed inflammatory-cell infiltration grade 4, vascular congestion grade 3, proximal tubular injury grade 3, and interstitial vacuolation grade 2. Tubular necrosis and desquamation involved more than 50% of proximal tubules, and regeneration was absent. With turmeric essential oil at 50 mg/kg/day, inflammation was grade 2, while congestion, tubular injury, and vacuolation were grade 1. With turmeric essential oil at 100 mg/kg/day and losartan, all four injury domains were grade 1. Tubular epithelial regeneration was present in all three intervention gr…
subject: Original Article
  topic: section
subject: Gentamicin Nephrotoxicity
  topic: keywords
subject: Turmeric Essential Oil
  topic: keywords
subject: Losartan
  topic: keywords
subject: Renal Histopathology
  topic: keywords
subject: Wistar Rats
  topic: keywords
creator: M A Zabbar Pramanik
creator: Al Imran
creator: Afia Afrin
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Factors Associated with Delayed Presentation Among Patients with First-Episode Psychosis in Bangladesh
type: item
description: Introduction: First-episode psychosis is a critical stage in the course of psychotic disorders, and timely initiation of treatment is associated with better clinical and functional outcomes. In Bangladesh, evidence regarding the determinants of delayed presentation in first-episode psychosis remains limited. Therefore, this study aims to assess the factors associated with delayed presentation among patients with first-episode psychosis in Bangladesh. Methods & Materials: This observational analytical cross-sectional study was conducted among patients with first-episode psychosis attending the Department of Psychiatry in Combined Military Hospital, Dhaka, Bangladesh, from January 2022 to December 2022. A total of 104 patients fulfilling the diagnostic criteria for first-episode psychosis were included using purposive sampling. Data were analyzed using SPSS version 26.0. Results: 64 (61.5%) had delayed presentation to psychiatric services, with a median duration of untreated psychosis of 9 months (IQR 4-16 months). Most patients were 25-34 years old (44.2%), male (59.6%), from rural areas (63.5%), and had schizophrenia-spectrum disorders (71.2%). Traditional or religious healers were the most common first source of help (40.4%), while stigma (34.6%) and lack of awareness (28.8%) were the leading perceived barriers. Delayed presentation was significantly associated with rural residence (75.8% vs 36.8%, p=0.001), primary or lower education (76.5%, p=0.015), unemployment (73.1%, p=0.026), insidious onset of symptoms (85.0%, p<0.001), first consultation with traditional or religious healers (81.0%, p<0.001), and perceived stigma (83.3% vs 50.0%, p=0.002), whereas substance use showed no significant association (p=0.397). Conclusion: This study found that delayed presentation was frequent among patients with first-episode psychosis in Bangladesh, with almost two-thirds not receiving treatment within six months of symptom onset. Longer delays were significantly linked to ru…
subject: Original Article
  topic: section
subject: First-Episode Psychosis
  topic: keywords
subject: Factors
  topic: keywords
subject: Delayed Presentation
  topic: keywords
creator: Shah Mohammad Ashek Uddin Bhuiyan
creator: Mahbuba Akhter Jahan
creator: Md Kamurul Hassan
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Clinical Outcome of Ilizarov External Fixation in Gustilo-Anderson Type III Open Tibial Fractures
type: item
description: Background: Open tibial fractures, particularly Gustilo-Anderson type III lesions, present formidable challenges due to high infection and nonunion risks. The Ilizarov technique provides stable mechanical fixation while promoting osteogenesis, yet regional outcome data remain sparse. Objective: To assess the bone union rate and functional recovery following Ilizarov external fixation in these severe fractures. Methods & Materials: This prospective cohort study was performed at National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, from January 2023 to December 2025. A total of 47 purposively selected patients with type III open tibial fractures underwent Ilizarov frame application. Postoperative follow-up continued until union or for at least 12 months. Bone and functional outcomes were graded using the ASAMI scoring system. SPSS v23.0 was used for analysis. Results: Primary union occurred in 42 patients (89.4%), with a mean consolidation time of 4.8 months (range 3.2-7.5). ASAMI bone scores showed 31 excellent (66.0%) and 11 good (23.4%) outcomes. Functional outcomes were excellent in 28 (59.6%) and good in 13 (27.7%). Superficial pin-site infections developed in 9 cases (19.1%), and malunion in 5 (10.6%). Conclusion: The Ilizarov method demonstrates high efficacy for managing Gustilo-Anderson type III open tibial fractures, achieving robust bone healing and acceptable function with manageable complications in our cohort.
subject: Original Article
  topic: section
subject: Bone union
  topic: keywords
subject: Clinical outcome
  topic: keywords
subject: Gustilo-Anderson type
  topic: keywords
subject: Ilizarov external fixation
  topic: keywords
subject: Open tibial fractures
  topic: keywords
creator: Shahan Sazedur Rahman
creator: Mohammad Habibur Rahman
creator: Farjana Akter
creator: S M Tanveer Rahman
creator: Rizwan Jamil
creator: Abdul Matin
creator: Tanvir Ahmed Siddikee
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Diagnostic Accuracy of Ultrasonography Compared with Magnetic Resonance Imaging for Rotator Cuff Pathologies of the Shoulder: A Cross-Sectional Study
type: item
description: Background: Rotator cuff disorders are common causes of shoulder pain and functional impairment. Accurate imaging is important for identifying tendon abnormalities and guiding appropriate management. Ultrasonography (USG) is a readily available, non-invasive, and cost-effective imaging modality, whereas magnetic resonance imaging (MRI) provides comprehensive multiplanar assessment of soft-tissue structures. This study evaluated the diagnostic accuracy of USG compared with MRI for detecting rotator cuff pathologies of the shoulder. Methods & Materials: This cross-sectional study included 40 participants with clinically suspected shoulder musculotendinous pathology. We compared USG findings with MRI findings to detect rotator cuff abnormalities, particularly involving the supraspinatus, subscapularis, and infraspinatus tendons. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and Cohen's kappa agreement. Results: The mean age of participants was 50.1 ± 10.8 years, and 70.0% were male. USG demonstrated high diagnostic performance for supraspinatus abnormalities, with sensitivity ranging from 91.7% to 100.0%, specificity from 95.5% to 97.2%, and accuracy from 95.0% to 97.5%. For subscapularis lesions, sensitivity ranged from 92.9% to 100.0%, specificity from 96.2% to 100.0%, and accuracy from 95.0% to 100.0%. Infraspinatus lesions showed comparatively lower sensitivity, particularly for partial-thickness tears (66.7%) and tendinosis (75.0%), although specificity remained high. Conclusion: USG demonstrated high diagnostic accuracy and substantial-to-almost-perfect agreement with MRI for most rotator cuff pathologies. It may therefore serve as a useful first-line imaging modality, while MRI remains valuable for equivocal or complex lesions.
subject: Original Article
  topic: section
subject: Ultrasonography
  topic: keywords
subject: Magnetic Resonance Imaging
  topic: keywords
subject: Rotator Cuff
  topic: keywords
subject: Shoulder Pathology
  topic: keywords
subject: Diagnostic Accuracy
  topic: keywords
creator: Tania Kabir
creator: Yasna Kibria
creator: Shanta Islam Mou
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Correlation between Physical Activity Level and Disease Activity in Axial Spondyloarthritis
type: item
description: Background: Axial spondyloarthritis is a chronic inflammatory rheumatic disease associated with pain, stiffness, functional impairment, and reduced quality of life. Although physical activity is a key component of non-pharmacological management and has beneficial effects on disease outcomes, patients with axSpA are generally less physically active, and higher disease activity may be associated with lower physical activity participation. Objective: The aim of the study was to assess the correlation between physical activity level and disease activity among patients with axial spondyloarthritis. Methods & Materials: This cross-sectional observational study was conducted at the Department of Physical Medicine and Rehabilitation, Bangladesh Medical University (BMU), Dhaka, Bangladesh, from January 2025 to December 2025. Eighty patients with axial spondyloarthritis were enrolled. Disease activity, functional status, and physical activity level were assessed using BASDAI, BASFI, and IPAQ-SF, respectively. Data were analyzed using SPSS version 26.0, with p <0.05 considered statistically significant. Results: Among 80 patients with axial spondyloarthritis, moderate physical activity was the most common level (46.3%), while 60.0% had active disease. Mean BASDAI scores decreased significantly with increasing physical activity, from 5.6 ± 1.4 in the low-activity group to 3.6 ± 1.2 in the high-activity group (p < 0.001). Physical activity showed significant negative correlations with BASDAI (r = −0.52) and BASFI (r = −0.44), both p < 0.001. The mean BASDAI, BASFI, BASMI, and pain scores were 4.8 ± 1.6, 4.3 ± 1.5, 4.2 ± 1.4, and 5.3 ± 1.7, respectively, while the mean CRP and ESR levels were 11.8 ± 8.6 mg/L and 28.4 ± 17.2 mm/hr, respectively. Conclusion: Higher physical activity levels were significantly associated with lower disease activity and better functional status among patients with axial spondyloarthritis.
subject: Original Article
  topic: section
subject: Axial Spondyloarthritis
  topic: keywords
subject: Physical Activity
  topic: keywords
subject: Disease Activity.
  topic: keywords
creator: Nadia Rahman
creator: Imamur Rashid
creator: Nadim Kamal
creator: Abul Kalam Azad
creator: Mohammad Golam Nobi
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Seasonal Variance in the Incidence Rate of Epistaxis: An Observational Study
type: item
description: Background: Epistaxis is a common otorhinolaryngological emergency with variable etiological factors. Seasonal influences on its incidence remain underreported in tropical regions like Bangladesh, where climatic conditions fluctuate markedly. Objective: To determine the seasonal variance in the incidence rate of epistaxis among patients presenting to a tertiary care hospital in Bangladesh. Methods & Materials: A prospective observational study was conducted at Department of ENT, Mymensingh Medical College Hospital, Mymensingh, Bangladesh, from January 2024 to December 2025. A total of 143 patients with epistaxis were enrolled using purposive sampling. Data were analyzed using SPSS version 23.0. Seasonal categorization followed the standard Bangladeshi pattern: winter (December-February), summer (March-May), monsoon (June-September), and autumn (October-November). Incidence rates across seasons were compared. Results: Of 143 patients, the highest incidence of epistaxis occurred in winter (n=66, 46.2%), followed by summer (n=38, 26.6%), monsoon (n=22, 15.4%), and autumn (n=17, 11.9%), with a statistically significant seasonal difference (p<0.001). The bimodal age distribution showed peaks at 6-15 years (n=51, 35.7%) and 51-70 years (n=47, 32.9%). Anterior bleeding predominated (n=124, 86.7%). Male preponderance was observed (n=88, 61.5%). Conclusion: Epistaxis in Dhaka demonstrates significant winter predominance. The bimodal age distribution and anterior bleeding pattern align with global literature. These findings support seasonal resource allocation and preventive strategies during high-risk winter months.
subject: Original Article
  topic: section
subject: Anterior bleeding
  topic: keywords
subject: Epistaxis
  topic: keywords
subject: Incidence rate
  topic: keywords
subject: Seasonal variance
  topic: keywords
subject: Winter.
  topic: keywords
creator: Lobib Khan
creator: Faria Talukder
creator: Habibur Rahman
creator: Benazir Ahmed
creator: Sohel Rana
creator: Majharul Islam
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Prevalence of Cardiometabolic Risk Factors and Estimated 10-Year ASCVD Risk among Rural Older Adults in Bangladesh
type: item
description: Introduction: Cardiometabolic risk among older adults in rural Bangladesh is poorly characterised. Understanding the prevalence of cardiovascular risk factors and overall cardiovascular risk is important for targeted prevention. Objectives: To determine the prevalence of cardiometabolic risk factors and estimate the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among older adults living in rural Bangladesh. Methods & Materials: We conducted a community-based cross-sectional study among 405 adults aged 60-74 years from six rural villages in Dohar, Bangladesh, from February 2019 to March 2020. Sociodemographic, lifestyle, anthropometric, blood pressure, and biochemical data were collected. The 10-year ASCVD risk was estimated using the 2013 ACC/AHA Pooled Cohort Equations. Results: Dyslipidemia (60.7%), hypertension (37.5%), microalbuminuria (36.5%), diabetes mellitus (20.0%), and chronic kidney disease (9.6%) were common. Overall, 90.6% of participants had at least one cardiovascular risk factor or marker. A high estimated 10-year ASCVD risk (≥20%) was present in 22.5% of participants and was associated with male sex, age >65 years, current smoking, and unemployment or dependency. Conclusion: Cardiometabolic risk factors were highly prevalent among older adults in rural Bangladesh. Community-based cardiovascular risk assessment and targeted management of modifiable risk factors are needed. Interpret ASCVD risk estimates cautiously because the Pooled Cohort Equations have not been locally validated.
subject: Original Article
  topic: section
subject: Cardiometabolic Risk
  topic: keywords
subject: ASCVD Risk
  topic: keywords
subject: Older Adults
  topic: keywords
subject: Rural Bangladesh
  topic: keywords
subject: Cardiovascular Risk
  topic: keywords
creator: Shohael Mahmud Arafat¹
creator: Mehruba Alam Ananna⁹
creator: Mohammad Ferdous Ur Rahaman⁸
creator: Chowdhury Adnan Sami⁷
creator: Mohammad Abul Kalam Azad
creator: Mizanur Rahman Khan⁵
creator: Abed Hussain Khan⁴
creator: Mihir Kanti Adhikari³
creator: A K M Habibullah Bahar²
creator: Mohammad Azizul Karim¹⁰
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-09-03
publication date: 2026-09-03
doi: 10.5281/

Clinical Spectrum and Presenting Features of Presumptive Tuberculous Meningitis in Children
type: item
description: Introduction: Tuberculous meningitis (TBM) is a severe childhood tuberculosis that causes serious neurological problems and high death rates in low-resource settings. It is hard to diagnose early because symptoms are nonspecific and tests have low sensitivity with scarce CSF samples. Delays in diagnosis are common and lead to worse outcomes. Objective: This study aimed to describe the demographic, clinical, CSF, and imaging profiles and severity patterns in children with presumptive TBM. Methods & Materials: This descriptive cross-sectional study was carried out at Dhaka Medical College Hospital over one year, involving 96 children aged 1 month to 12 years with suspected TBM. The assessments encompassed clinical examination, GCS scoring, CSF cytology and biochemistry, brain MRI, and chest X-ray. Results: Children under 5 years made up 67.7%, with a mean age of 3.82 years, mostly male (1.5:1) and from rural areas (72.9%). Fever was universal (100%), followed by irritability (55.2%), altered consciousness (44.8%), and convulsions (42.7%). GCS indicated moderate (46.9%) and severe (17.7%) impairment. Severity was related to convulsions (p=0.042), altered consciousness (p=0.001), focal deficits (p=0.008), and neck rigidity (p=0.045). CSF showed lymphocytic dominance, high protein (87.8 mg/dl), and low glucose (51.2 mg/dl). MRI findings included basal enhancement (53.7%), infarcts (14.9%), and hydrocephalus (10.4%). Chest X-ray was normal in 71.9%. Contact history was noted in 17.7%. Only 30.2% were probable TBM, with 69.8% possible. Conclusion: Young males from rural families are at the highest risk. Persistent fever, altered consciousness, and seizures should alert clinicians in endemic areas. The prominence of TBM cases underscores the urgent need for better rapid diagnostics and targeted actions to cut mortality and prevent disabilities.
subject: Original Article
  topic: section
subject: Tuberculous meningitis
  topic: keywords
subject: Children
  topic: keywords
subject: Clinical presentation
  topic: keywords
subject: Cerebrospinal fluid
  topic: keywords
subject: Neuroimaging
  topic: keywords
subject: Glasgow Coma Scale
  topic: keywords
subject: Presumptive diagnosis
  topic: keywords
subject: Bangladesh.
  topic: keywords
creator: Arifur Rahman
creator: Sayeeda Anwar
creator: Naznin Akter
creator: Nanda Lal Das
creator: Shamim Ferdous Khan
creator: Hasan Moshiur Shawon
creator: Mainul Huq
creator: Ferdous Sharmin
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 749
ending page: 755
doi: 10.5281/zenodo.22116312

Association of Sociodemographic Factors with Severity of Substance Use Risk among Bangladeshi Adolescents
type: item
description: Background: Adolescent substance use is a growing public health concern, strongly influenced by sociodemographic and family-related factors, leading to varying degrees of risk severity. Aim of the study: To assess the association between sociodemographic factors and severity of substance use risk among Bangladeshi adolescents. Methods & Materials: This cross-sectional study was conducted over two years (October 2020-September 2022) in tertiary psychiatric and de-addiction centers in Bangladesh. A total of 140 adolescents aged 12-19 years were selected using purposive sampling. Data were collected through a structured questionnaire, and substance use risk was assessed using a CRAFFT-based categorization (low, moderate, high, very high). Statistical analysis was performed using chi-square test and multivariable logistic regression, with p<0.05 considered significant. Result: Most participants were male (93.6%), aged 17-19 years (50.0%). Low, moderate, high, and very high risk were 51.4%, 30.7%, 14.3%, and 3.6%, respectively. Significant associations were observed between substance use severity and age (p=0.018), gender (p=0.041), residence (p=0.027), education (p=0.033), family income (p=0.012), parental education (p<0.05), family conflict (p=0.001), and peer influence (44.3%). Multivariable analysis identified peer influence (AOR=3.12), family conflict (AOR=2.41), and low parental education (AOR=1.95) as key predictors. Conclusion: Sociodemographic and family-related factors significantly influence the severity of substance use risk among Bangladeshi adolescents. Peer influence, family conflict, and parental education emerged as the strongest determinants. Early identification of high-risk groups and targeted family- and school-based preventive interventions are essential to reduce adolescent substance use burden.
subject: Original Article
  topic: section
subject: Adolescents
  topic: keywords
subject: substance use risk
  topic: keywords
subject: sociodemographic factors
  topic: keywords
subject: Bangladesh
  topic: keywords
subject: peer influence
  topic: keywords
subject: family conflict.
  topic: keywords
creator: Fahad-Bin-Alauddin
creator: Rubaiya Khan
creator: Hafizur Rahman Chowdhury
creator: Ummea Sayeba Hassan
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 743
ending page: 748
doi: 10.5281/zenodo.22116290

Predictors of Worsening Renal Function in Patients Hospitalized with Acute Heart Failure
type: item
description: Background: Worsening renal function (WRF) is a frequent and clinically important complication among patients hospitalized with acute heart failure (AHF), leading to increased morbidity, prolonged hospitalization, and poor clinical outcomes. Early identification of patients at high risk of WRF may facilitate timely intervention and improve prognosis. Aim of the study: To identify the predictors of worsening renal function in patients hospitalized with acute heart failure and evaluate its association with in-hospital clinical outcomes. Methods & Materials: This prospective observational study was conducted in the Departments of Nephrology and Cardiology at Bangladesh Medical University, Dhaka, Bangladesh, from June 2023 to March 2025. A total of 58 adult patients admitted with acute heart failure and baseline serum creatinine <1.3 mg/dL were enrolled. Worsening renal function was defined as an increase in serum creatinine of ≥0.3 mg/dL within 48 hours or ≥1.5 times the baseline value within seven days. Demographic, clinical, laboratory, echocardiographic, and biomarker data, including urinary TIMP-2×IGFBP-7, were collected. Independent predictors of WRF were identified using multivariable logistic regression analysis. Result: Worsening renal function developed in 23 (39.7%) patients. Patients with WRF more frequently had diabetes mellitus (60.9% vs. 31.4%, p=0.027), previous heart failure admission (65.2% vs. 37.1%, p=0.034), NYHA class IV symptoms (69.6% vs. 51.4%, p=0.048), lower estimated glomerular filtration rate, lower serum albumin, higher inflammatory markers, elevated NT-proBNP, and markedly increased urinary TIMP-2×IGFBP-7 levels (all p<0.05). Hospital stay was significantly longer (9.2±3.1 vs. 6.4±2.3 days, p<0.001), and ICU admission was more frequent among patients with WRF (43.5% vs. 17.1%, p=0.030). Multivariable logistic regression identified diabetes mellitus (adjusted OR=2.74, p=0.048), previous heart failure admission (adjusted OR=2.96, p=0.044), s…
subject: Original Article
  topic: section
subject: Acute heart failure
  topic: keywords
subject: worsening renal function
  topic: keywords
subject: cardiorenal syndrome
  topic: keywords
subject: urinary TIMP-2×IGFBP-7
  topic: keywords
subject: NT-proBNP
  topic: keywords
subject: predictors
  topic: keywords
creator: H M Mohiuddin Alamgir
creator: K B M Hadiuzzaman
creator: Mohammad Kamrul Hasan
creator: Kabir Hossain
creator: Anjuman Ara Daisy
creator: Mamun Chowdhury Raju
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 736
ending page: 742
doi: 10.5281/zenodo.22116259

Post-Vaccination Immune Status Against the Hepatitis B Virus Amongst Doctors Working in a Tertiary Care Hospital
type: item
description: Background: Doctors face a high occupational risk of Hepatitis B. Vaccination provides protection, but the durability of this immunity is uncertain. This study assesses long-term vaccine-induced immunity in this vulnerable group. Objective: To assess the post-vaccination immune status against HBV among doctors in a tertiary care hospital and identify associated factors. Methods & Materials: This cross-sectional study was conducted at Sylhet MAG Osmani Medical College & Hospital from July to December 2018. Using simple random sampling, 75 doctors aged 23-59 years who were vaccinated against HBV ≥5 years prior were enrolled. Serum Anti-HBs antibody titers were measured using ELISA. Protective immunity was defined as an Anti-HBs titer ≥10 mIU/mL. Data were analyzed with SPSS v20; a p-value <0.05 was considered significant. Results: The mean age was 32.3±6.0 years; 64% were male. All 75 doctors received three vaccine doses. Time since vaccination exceeded five years for all: 36% at 6-10 years and 36% at 11-15 years. Protective Anti-HBs titers (≥10 mIU/mL) were found in 89.3% (64% >100 mIU/mL, 25.3% 10-100 mIU/mL), while 10.7% were non-protective (<10 mIU/mL). A significant association existed between titer and age (p = 0.032), but not with sex, BMI, time since vaccination, or booster history (p > 0.05). Conclusion: A decade after the primary series, most doctors maintain protective antibody levels, though 10.7% remain susceptible. These findings support the importance of post-vaccination testing and targeted booster strategies.
subject: Original Article
  topic: section
subject: Antibodies
  topic: keywords
subject: Body Mass Index
  topic: keywords
subject: Booster dose
  topic: keywords
subject: Doctors
  topic: keywords
subject: Hepatitis B vaccines
  topic: keywords
subject: Immunity.
  topic: keywords
creator: Masuk Al Marzan
creator: Jannatul Fardous
creator: Mirza Mohammed Mursalin
creator: Guljar Hossain
creator: Gobindra Karmaker
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 730
ending page: 735
doi: 10.5281/zenodo.22116246

Thyroid Function Status in Women of Reproductive Age with Abnormal Uterine Bleeding
type: item
description: Background: Abnormal uterine bleeding (AUB) is a prevalent gynecological concern among women of reproductive age, often linked to various underlying etiologies. Thyroid hormones are crucial for maintaining normal reproductive physiology. Thyroid dysfunction, which is highly prevalent in women, can significantly impact menstrual function, often leading to menstrual irregularities that may precede a formal diagnosis. Objective: To evaluate the thyroid function status in reproductive-aged women presenting with abnormal uterine bleeding. Methods & Materials: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology at Sylhet MAG Osmani Medical College Hospital, Sylhet. The study included women of reproductive age who presented with AUB. Participants were selected using a convenience sampling method based on predefined inclusion criteria. Data were collected through face-to-face interviews using a structured questionnaire after obtaining informed written consent. Statistical analysis was performed using SPSS version 22.0. Results: The mean age of the 81 participants was 37.19 years, with the majority (82.7%) aged between 30 and 40 years. Overall, thyroid dysfunction was identified in 30.8% of women with AUB. Specifically, 12.3% of patients had hyperthyroidism, while 18.5% had hypothyroidism. The study observed a higher prevalence of menstrual abnormalities among patients with thyroid disorders. Conclusion: Both hypothyroidism and hyperthyroidism are common findings in women presenting with AUB, with hypothyroidism being slightly more prevalent. Timely diagnosis and appropriate management of thyroid dysfunction in these patients can prevent unnecessary and ineffective diagnostic procedures and treatments.
subject: Original Article
  topic: section
subject: Abnormal uterine bleeding (AUB)
  topic: keywords
subject: Thyroid dysfunction
  topic: keywords
subject: Hypothyroidism
  topic: keywords
subject: Hyperthyroidism
  topic: keywords
subject: Menstrual abnormalities
  topic: keywords
subject: Reproductive-aged women
  topic: keywords
subject: Thyroid function tests
  topic: keywords
subject: Menstrual irregularity.
  topic: keywords
creator: Jannatul Fardous
creator: Masuk Al Marzan
creator: Nasreen Akhter
creator: Shahinara Islam
creator: Jannat Ara Rumana
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 724
ending page: 729
doi: 10.5281/zenodo.22116223

Predictors of Malignancy in Patients Presenting with Breast Lumps: A Multivariable Analysis from a Tertiary Surgical Center
type: item
description: Background: Breast cancer is the prevalent type of cancer among women globally and in Bangladesh. While the majority of breast lumps are non-cancerous, identifying malignant tumors can be difficult. Clinical and ultrasound characteristics can aid in predicting cancer, whereas histopathology offers a conclusive diagnosis. Data on independent factors predicting cancer in breast lump patients in Bangladesh is still scarce. This research sought to determine clinical and imaging factors independently linked to malignancy through multivariable analysis. Methods & Materials: An analytical observational study based in a hospital took place at Bangladesh Medical University from March 2025 to February 2026, involving 244 patients aged 18 years and older with noticeable breast lumps. Demographic, clinical, imaging, and histopathological information was gathered. Histopathological evaluation confirmed malignancy, and independent predictors were determined through multivariable logistic regression. Statistical significance was established at p<0.05. Results: Among 244 patients, 70 (28.7%) had malignant lesions, with invasive carcinoma NST being the predominant histological type. Multivariable analysis identified older age, positive family history, larger lump size, skin/nipple changes, and BI-RADS 4-5 as independent predictors of malignancy. BI-RADS 4-5 showed the strongest association (aOR 11.21, 95% CI: 4.72-26.62; p<0.001), followed by age >50 years (aOR 4.57) and lump size ≥5 cm (aOR 3.91). Conclusion: Older age, positive family history, larger breast lump size, skin/nipple changes, and BI-RADS 4-5 were independent predictors of malignancy. Integrating these clinical and imaging features may improve early identification and timely diagnosis of breast cancer among patients presenting with breast lumps.
subject: Original Article
  topic: section
subject: Breast Lumps
  topic: keywords
subject: Malignancy
  topic: keywords
subject: Predictors
  topic: keywords
subject: Breast cancer
  topic: keywords
creator: Aklima Parvin
creator: Sayem Al Monsur Faizi
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 719
ending page: 723
doi: 10.5281/zenodo.22115597

Socio-Demographic and Lifestyle Predictors of Triple-Negative Breast Cancer in Bangladeshi Women
type: item
description: Background (including objective): Triple-negative breast cancer (TNBC) is an aggressive molecular subtype of breast cancer with distinct epidemiology and high burden among South Asian women. Objective: To determine the association of socio-demographic factors, reproductive characteristics, and lifestyle patterns with TNBC. Methods & Materials: This cross-sectional study was conducted at Bangladesh Medical University from January to December 2023. A total of 116 female patients (58 TNBC; 58 non-TNBC) were enrolled through purposive sampling. Data on socio-demographic, reproductive, and lifestyle factors were collected using semi-structured questionnaires and clinical checklists. TNBC status was confirmed by immunohistochemistry. Statistical analyses were performed using SPSS v.26. Chi-square tests and multivariable logistic regression were used to identify predictors of TNBC (p < 0.05 considered significant). Results: TNBC-positive patients were younger than non-TNBC patients (39.79 ± 8.98 vs. 45.22 ± 11.22 years; p = 0.005) and more frequently resided in urban areas (43.86% vs. 22.41%; p = 0.015). Non-modifiable risk factors (early pregnancy, breastfeeding, early menarche, early menopause) and modifiable factors (OCP use, processed food consumption) were not significantly associated with TNBC. Moderate-intensity physical activity was more common in TNBC patients (96.6% vs. 82.8%). Multivariable logistic regression identified urban residence (OR = 2.704; 95% CI: 1.204-6.073; p = 0.016) and moderate-intensity physical activity (OR = 5.833; 95% CI: 1.218-27.937; p = 0.027) as independent predictors of TNBC. Conclusion: In this population, TNBC was more prevalent among younger, urban-residing women. Urban residence and lifestyle factors may play a role in TNBC pathogenesis.
subject: Original Article
  topic: section
subject: Triple-negative breast cancer
  topic: keywords
subject: Breast malignancy
  topic: keywords
subject: Socio-demographic factors
  topic: keywords
subject: Estrogen receptor
  topic: keywords
subject: Progesterone receptor.
  topic: keywords
creator: Azmira khatun
creator: Rasel Ahmad
creator: Mohammed Arafat Bin Hossain
creator: Azizur Rahman
creator: Mosammat Mira Pervin
creator: Krisna Rani Majumder
creator: S M Ear-E-Mahabub
creator: Ibrahim Siddique
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 714
ending page: 718
doi: 10.5281/zenodo.22115545

Comparison of Clinical Outcomes Between Hypertensive and Non-Hypertensive Intracerebral Hemorrhage
type: item
description: Background: Intracerebral hemorrhage (ICH) is associated with high mortality and disability. Hypertension is the leading cause of spontaneous ICH, while non-hypertensive ICH has diverse etiologies with distinct clinical features and outcomes. However, comparative data from Bangladesh are limited. This study aimed to compare the clinical outcomes of hypertensive and non-hypertensive ICH among Bangladeshi patients. Methods & Materials: This hospital-based comparative observational study included 120 patients with CT-confirmed spontaneous intracerebral hemorrhage (74 hypertensive and 46 non-hypertensive) admitted to a tertiary care hospital in Bangladesh between January and December 2025. Clinical and radiological data were collected prospectively, and functional outcome at discharge was assessed using the modified Rankin Scale (mRS). Statistical significance was set at P < 0.05. Results: Among 120 patients with spontaneous ICH, 74 (61.7%) had hypertensive ICH and 46 (38.3%) had non-hypertensive ICH. Non-hypertensive ICH was associated with significantly larger hematoma volume (36.9 ± 15.8 vs. 29.7 ± 13.4 mL; P = 0.011), more frequent lobar hemorrhage (50.0% vs. 17.6%; P < 0.001), and higher mRS score at discharge (4.2 ± 1.5 vs. 3.7 ± 1.4; P = 0.048). Hypertensive ICH predominantly involved deep brain regions (78.4% vs. 39.1%; P < 0.001). Although non-hypertensive ICH showed higher rates of surgery, ICU admission, complications, and in-hospital mortality, these differences were not statistically significant. Admission GCS ≤8 (AOR 2.89, 95% CI: 1.31-6.38; P = 0.009) and hematoma volume >30 mL (AOR 2.63, 95% CI: 1.22-5.66; P = 0.014) were independent predictors of poor functional outcome. Conclusion: Non-hypertensive ICH showed poorer functional outcomes, while low admission GCS and larger hematoma volume independently predicted poor prognosis, emphasizing early risk assessment and management.
subject: Original Article
  topic: section
subject: Hypertensive Intracerebral Hemorrhage
  topic: keywords
subject: Non-Hypertensive Intracerebral Hemorrhage
  topic: keywords
subject: Clinical Outcomes
  topic: keywords
subject: Ischemic heart disease
  topic: keywords
creator: Zahidul Islam
creator: Abul Bashar Md Mahbubul Haque
creator: Prosad Kumer Sarker
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 709
ending page: 713
doi: 10.5281/zenodo.22115498

Clinical Patterns and Management Challenges of Endometriosis in Women of Reproductive Age
type: item
description: Background: Endometriosis is a long-lasting condition where tissue similar to the endometrium develops outside the uterus, leading to pain, infertility, or no symptoms at all. It impacts 6-10% of women of reproductive age, has various contributing factors, and is primarily diagnosed through laparoscopy. Management involves both medical and surgical interventions; however, recurrence is frequent, and diagnosis is often postponed, particularly in resource-constrained environments such as Bangladesh. Methods & Materials: A cross-sectional study conducted at BIRDEM General Hospital-2 in Dhaka (July 2024-June 2025) involved 132 women (ages 18-45) diagnosed with endometriosis. Information regarding clinical, diagnostic, and treatment factors was gathered through questionnaires and records and examined using SPSS v25. The chi-square test was applied (p < 0.05). Ethical consent and informed approval were secured. Results: Of 132 women with endometriosis, the majority were aged 25-34 years (~46%) and experienced frequent symptoms such as dysmenorrhea (~84%), pelvic pain (~68%), and infertility (~35%). Stage II-III disease occurred most commonly (~66%), ultrasound was utilized in ~89%, and ~72% received medical therapy, whereas ~28% had surgery. Severe disease showed a significant association (p < 0.05) with age ≥30, rural living, low education levels, and infertility (OR ≈ 4.9), while advanced stages (III-IV) were connected to surgical procedures. Conclusion: Endometriosis was prevalent among women aged 25-34, primarily Stage II-III, presenting with pain and infertility, primarily managed through medical treatment; advanced stages and surgical intervention were associated with older age, living in rural areas, lower education levels, and infertility.
subject: Original Article
  topic: section
subject: Endometriosis
  topic: keywords
subject: Reproductive Age
  topic: keywords
subject: Clinical Patterns
  topic: keywords
subject: Management Challenges.
  topic: keywords
creator: Afroza Sultana
creator: Tanvir Ahmed
creator: Fatema Begum
creator: Soma Podder
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 704
ending page: 708
doi: 10.5281/zenodo.22115465

Educational Preparedness and Perceived Challenges for the Development of Forensic Odontology in Bangladesh: Perspectives of Medical and Dental Graduates and Undergraduates
type: item
description: Background: Forensic odontology uses dental expertise in legal cases, such as identifying individuals, estimating ages, analyzing bite marks, and providing expert witness accounts. In many countries, including Bangladesh, challenges such as insufficient resources, limited practical training, and inadequate educational exposure persist in medicolegal practice despite its significance. This research intended to evaluate educational readiness, experience, and perceived difficulties related to the advancement of forensic odontology among medical and dental students and alumni in Bangladesh. Methods & Materials: A cross-sectional study was carried out involving medical and dental students as well as graduate interns in Dhaka, Bangladesh. Data were gathered through a validated questionnaire evaluating knowledge of forensic odontology, educational readiness, attitudes, career outlooks, and perceived obstacles. Data analysis was conducted using SPSS version 29.0, employing Chi-square tests for group comparisons. Ethical approval was acquired, and all participants provided written informed consent. Results: Out of 402 participants, there was a strong understanding of forensic odontology, yet advanced knowledge and formal education were minimal. Merely 4.5% underwent formal training, with increased exposure noted among dental students and graduate interns (p<0.001). While 72.1% expressed interest in workshops, just 16.9% viewed it as a career choice. Insufficient infrastructure (87.8%) constituted the primary challenge, whereas dental students and graduate interns exhibited enhanced preparedness and career awareness (p<0.05). Conclusion: Although medical and dental students possess solid foundational knowledge in forensic odontology, their educational readiness is insufficient because of restricted formal instruction, practical experience, and career prospects. Enhancing curricula, offering organized training, and upgrading forensic infrastructure are crucial for the progress…
subject: Original Article
  topic: section
subject: Educational Preparedness
  topic: keywords
subject: Perceived Challenges
  topic: keywords
subject: Forensic Odontology
  topic: keywords
subject: Medical
  topic: keywords
subject: Dental
  topic: keywords
subject: Graduates
  topic: keywords
subject: Undergraduates.
  topic: keywords
creator: Iffat Kabir
creator: Muhosina Akhtar Boby
creator: Arifa Anamica
creator: Ruheela Islam
creator: Abubakar Abdullah
creator: Sarwar Zahan
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 698
ending page: 703
doi: 10.5281/zenodo.22115439

Effects of Nephrotic Syndrome in Children
type: item
description: Background: Chronic disorders, particularly nephrotic syndrome, are linked to psychological stress. In children with nephrotic syndrome, glucocorticoid medication can cause a variety of side effects, including behavioral issues. Aim of the study: The purpose of this study was to examine the effects of nephrotic syndrome in children. Methods & Materials: From June 2017 to May 2018, this prospective case control study was conducted at various institutes and medical college hospitals in Dhaka as well as Bogura. This study comprised 100 cases of nephrotic syndrome aged 4-17 years from a purposive sampling approach, as well as 100 age and gender matched control subjects. The behavior of children with nephrotic syndrome was assessed using SDQ grading. A data collecting sheet was created, and the Bengali version of the SDQ format was employed. Variables were measured using various methods. SDQ was compared to these variables, and data were analyzed using SPSS (version 22). Results: The case and control groups had mean ages of 7.86 ± 2.98 and 7.19 ± 2.77 years, respectively. There was no discernible difference in age between the cases and controls. The emotional symptoms scale, conduct difficulties scale, and peer relationship problem were significantly higher in cases than in controls, whereas the pro-social behavior scale was significantly lower. The total SDQ score did not differ significantly between kinds of nephrotic syndromes. However, the IFRNS had a greater SDQ level when compared to the other clinical variants. There was no association between SDQ score and father's or mother's occupation. There was no link between SDQ score and age, disease duration, or monthly household income in patients. Males made up the majority of both categories. Conclusion: This study discovered that children with nephrotic syndrome had much higher levels of emotional symptoms, conduct problems, and peer interaction issues than healthy children, whereas pro-social behavior was significant…
subject: Original Article
  topic: section
subject: Emotional symptoms
  topic: keywords
subject: psychological problems
  topic: keywords
subject: nephrotic syndrome
  topic: keywords
subject: SDQ
  topic: keywords
creator: Shaheed Hossain Sourav
creator: Anwar Hossain Khan
creator: Shanjoy Kumar Paul
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 694
ending page: 697
doi: 10.5281/zenodo.22115200

Accelerated Versus Standard Ponseti Method for Idiopathic Congenital Clubfoot: Impact on Treatment Duration, Healthcare Visits, and Clinical Outcomes
type: item
description: Background: Congenital idiopathic clubfoot is a common pediatric deformity affecting 1-2 per 1000 live births and can lead to long-term disability if untreated. The Ponseti method is the standard treatment, while the accelerated protocol uses more frequent cast changes to reduce treatment duration. However, evidence comparing these approaches remains limited in Bangladesh. This study aims to compare accelerated and standard Ponseti methods regarding correction outcomes, treatment efficiency, and healthcare burden. Methods & Materials: A prospective comparative study was conducted at NITOR, Dhaka, involving 30 infants with untreated idiopathic congenital clubfoot. Patients received either accelerated Ponseti (twice-weekly casts, n=15) or standard Ponseti (weekly casts, n=15) treatment following standard Ponseti principles. Outcomes assessed included number of casts required, treatment duration, healthcare visits, caregiver burden, and Pirani scores. Data were analyzed using SPSS version 25.0, with p<0.05 considered statistically significant. Results: Among 30 infants, baseline demographic and clinical characteristics, including age, sex, bilateral involvement, and Pirani score, were comparable between groups. The accelerated Ponseti group showed significantly shorter treatment duration (36.4 vs. 50.8 days), fewer hospital visits (7.1 vs. 9.8), and reduced caregiver work-loss days (7.8 vs. 10.6) (p<0.001). Final Pirani scores and overall clinical outcomes were comparable between groups, demonstrating effective deformity correction with reduced treatment burden and improved convenience using the accelerated method. Conclusion: The accelerated Ponseti method provides correction outcomes comparable to the standard Ponseti method while significantly reducing treatment duration, healthcare visits, and caregiver burden. It may serve as an effective and efficient alternative for managing idiopathic congenital clubfoot.
subject: Original Article
  topic: section
subject: Accelerated Ponseti Method
  topic: keywords
subject: Standard Ponseti Method
  topic: keywords
subject: Idiopathic Congenital Clubfoot
  topic: keywords
subject: Treatment Duration
  topic: keywords
subject: Clinical Outcomes
  topic: keywords
subject: Healthcare Visits.
  topic: keywords
creator: Mohammad Salim Miah
creator: Muag Bin Jabal
creator: Mohammad Shahin Akter
creator: Mizanur Rahman
creator: Abul Hasan
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 690
ending page: 693
doi: 10.5281/zenodo.22115038

Diagnostic Accuracy of FNAC Compared with Histopathology in Patients with Palpable Breast Masses Attending a Tertiary Care Hospital
type: item
description: Background: Breast masses are common, and accurate differentiation of benign and malignant lesions is essential. FNAC is a rapid, minimally invasive, and cost-effective diagnostic method, while histopathology remains the reference standard. However, recent Bangladeshi evidence on the diagnostic accuracy of FNAC is limited. This study aimed to evaluate the sensitivity, specificity, predictive values, and overall accuracy of FNAC compared with histopathology in diagnosing palpable breast masses. Methods & Materials: A hospital-based diagnostic accuracy study was conducted at Bangladesh Medical University, Dhaka, from January to December 2025, involving 94 patients with palpable breast masses. FNAC findings were compared with histopathology as the reference standard. Sensitivity, specificity, PPV, NPV, diagnostic accuracy, and Cohen's kappa were calculated using SPSS. Ethical approval and informed consent were obtained. Results: Among 94 patients, the mean age was 42.5 ± 11.6 years. Histopathology identified 39 (41.5%) malignant and 55 (58.5%) benign lesions, with fibroadenoma being the most common benign lesion and invasive ductal carcinoma/NST the predominant malignancy. FNAC correctly identified 34 malignant and 53 benign lesions, with 2 false-positive and 5 false-negative results. FNAC showed 87.2% sensitivity, 96.4% specificity, 94.4% PPV, 91.4% NPV, and 92.6% diagnostic accuracy. Agreement with histopathology was very good (κ=0.845, p<0.001). Conclusion: FNAC demonstrated high diagnostic accuracy, sensitivity, and specificity in differentiating benign from malignant palpable breast masses, with very good agreement with histopathology. It can therefore serve as a reliable, rapid, minimally invasive initial diagnostic tool, while histopathology remains essential for confirmation of difficult or suspicious lesions. Assistant Professor, Department of Surgery, Officer on Special Duty (OSD), Directorate General of Health Services (DGHS), Dhaka, Bangladesh draklima1981@…
subject: Original Article
  topic: section
subject: FNAC
  topic: keywords
subject: Histopathology
  topic: keywords
subject: Accuracy
  topic: keywords
subject: Palpable Breast Masses
  topic: keywords
subject: Sensitivity
  topic: keywords
subject: Specificity
  topic: keywords
creator: Aklima Parvin
creator: Sayem Al Monsur Faizi
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 685
ending page: 689
doi: 10.5281/zenodo.22113772

Thyroid Dysfunction and Autoantibody Positivity in Relation to Clinical Severity of Psoriasis
type: item
description: Background: Psoriasis is a chronic immune-mediated inflammatory disease, and other comorbidities that may be linked to psoriasis through the mechanisms of systemic autoimmune disorders. In patients with psoriasis, autoimmune thyroid disease has been observed more commonly, but the link between thyroid abnormalities and severity of psoriasis is not fully elucidated. Methods & Materials: A total of 63 patients with clinically and histopathologically diagnosed palmoplantar psoriasis (case) as well as apparently healthy age- and sex-matched controls were inducted into the study. Pasi and body surface area (BSA) were used to assess psoriasis severity. The laboratory examination consists of serum FT3, FT4, TSH, anti-TPO, anti-TG and TRAb. Results: The age of 35.8±16.7 years in DH and 35.4±16.9 in controls 78.0% of patients had chronic plaque psoriasis, and 73.0% had PASI >12, whereas 66.7% were reported with BSA involvement >10%. While most participants were euthyroid, thyroid function abnormalities were noted in 28 (44.4%) psoriasis patients. Patients of psoriasis with elevated anti-TPO antibodies (34.9%) and elevated anti-TG antibodies (46.0%). In patients with anti-TPO antibodies ≥5 IU/mL, 77.3% had PASI >12 and 81.8% had BSA >10%. Of these, 79.3% of those with anti-TG antibodies had PASI >12 and 75.9% had BSA >10%. Conclusion: In this study, the prevalence of thyroid dysfunction was high in patients with psoriasis and detection rates of thyroid autoantibodies were also elevated. Altered thyroid function was correlated with larger BSA involvement and relatively high serum levels of anti-TPO and anti-TG were mostly identified in patients with extensive and severe psoriasis.
subject: Original Article
  topic: section
subject: Psoriasis
  topic: keywords
subject: thyroid dysfunction
  topic: keywords
subject: thyroid autoimmunity
  topic: keywords
subject: anti-TPO antibody
  topic: keywords
subject: anti-thyroglobulin antibody
  topic: keywords
creator: Abir Hassan
creator: Kamrul Hassan Jaigirdar
creator: Towfiq Ahmad
creator: Tanzina Begum Chowdhury
creator: Marufa Shahrin
creator: Kamrul Hasan
creator: Farha Zaman
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 680
ending page: 684
doi: 10.5281/zenodo.22113723

Association between Immunohistochemical markers and MRI features in patients with glioblastoma multiforme underwent surgery
type: item
description: Background: Glioblastoma multiforme (GBM) is a common and fatal primary brain tumor. Magnetic resonance imaging (MRI) is an important tool used for diagnosing GBM. Tumor biology lights on nature and behavior of tumor which is a prime prognosticator of disease and treatment outcome and easily understood by immunohistochemical markers. If the association between Immunohistochemistry and MRI features could be established. Objectives: To investigate and find out association between immunohistochemical markers namely p53, Ki-67, MGMT and MRI features including Contrast tumor enhancement/T2 ratio, percentage of tumor necrosis/tumor volume, peritumoral edema. Materials & Methods: MRI features were taken as Contrast tumor enhancement/T2 ratio, percentage of tumor necrosis, peritumoral edema.Then associations were evaluated between p53, Ki-67, MGMT and Contrast tumor enhancement/T2 ratio, percentage of tumor necrosis/tumor volume, peritumoral edema in chi- square (χ2) test. Results: The results showed the mean age (±SD) of the population was 46.4+13.6. The age range started from minimum 13 years to maximum 70 years. Male: Female ratio was 1.75:1. Most common symptoms were headache, seizures and hemiparesis. The association between MRI features and immunomarkers in some extents were significant. The association between CTE/T2 ratio and p53 (p value 0.035), between percentage of tumor necrosis and Ki-67 (p value 0.018) and between tumor edema and MGMT (p value 0.010) were statistically significant. Conclusion: Imaging features of brain Glioblastoma such as CTE/T2, tumor necrosis percentage, degree of edema has a close association with tumor molecular pathology indicators such as the P53, Ki-67 and MGMT.
subject: Original Article
  topic: section
subject: Glioblastoma multiforme
  topic: keywords
subject: Magnetic resonance imaging
  topic: keywords
subject: Immunohistochemistry
  topic: keywords
subject: Ki-67
  topic: keywords
subject: MGMT
  topic: keywords
creator: Shimul Bhattacharjee
creator: Muzahidul Islam
creator: Mohd Moshiur Rahman
creator: Sheikh Mahmood Hasan
creator: Mohammad Nahid Hasan
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 673
ending page: 679
doi: 10.5281/zenodo.22113705

Clinicopathological Characteristics of Diffuse Gliomas According to IDH1 Mutation Status
type: item
description: Background: Diffuse gliomas are the most common primary malignant tumors of the central nervous system and exhibit marked clinical, histopathological, and molecular heterogeneity. Isocitrate dehydrogenase 1 (IDH1) mutation is a key molecular marker incorporated into the World Health Organization classification of diffuse gliomas because of its diagnostic and prognostic significance. Characterizing the clinicopathological features according to IDH1 mutation status may improve disease stratification and optimize patient management. Objective: To evaluate the clinicopathological characteristics of diffuse gliomas according to IDH1 mutation status. Materials & Methods: This cross-sectional analytical study included 110 consecutive patients with histopathologically confirmed diffuse glioma who underwent surgical resection at the Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh, between July 2020 and December 2021. IDH1 mutation status was determined by immunohistochemistry. Demographic characteristics, clinical presentation, histopathological subtype, WHO grade, and radiological findings were recorded using a structured data collection form. Statistical analyses were performed using SPSS version 26, and a p-value <0.05 was considered statistically significant. Results: The mean age of the participants was 40.75 ± 15.68 years, and 60.0% were male. Astrocytoma was the predominant histological subtype (88.2%), while WHO grade IV tumors constituted 49.1% of cases. IDH1 mutation was detected in 93 (84.5%) patients. Patients with IDH1-mutant gliomas were younger than those with IDH1-wild-type tumors (39.6 vs. 47.1 years). IDH1-mutant tumors were more frequently associated with frontal lobe involvement and favorable clinicopathological characteristics than IDH1-wild-type tumors. Conclusion: IDH1 mutation was highly prevalent among patients with diffuse glioma and was associated with distinct clinicopathological characteristics. Inc…
subject: Original Article
  topic: section
subject: Diffuse glioma
  topic: keywords
subject: IDH1 mutation
  topic: keywords
subject: Astrocytoma
  topic: keywords
subject: WHO grade
  topic: keywords
subject: Immunohistochemistry
  topic: keywords
creator: Sheikh Mahmood Hasan
creator: Mohammad Nahid Hasan
creator: Muzahidul Islam
creator: Mohd Moshiur Rahman
creator: Shimul Bhattacharjee
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 668
ending page: 672
doi: 10.5281/zenodo.22113680

Outcome of severe head injury in Relation to basal cisterns on initial CT scan
type: item
description: Background: Traumatic brain injury is a serious public health issue. This injury is the leading cause of death in younger people especially in developing country. Severe head injury defined as Glasgow coma scale scores of less than 9, have a higher mortality rate and poorer outcome. Young males are the main victims. The purpose of this study was to determine prognostic value of the compressed basal cisterns on initial CT scan. Materials & Methods: Among them 22 patients with compressed basal cisterns considered as Group A and 22 patients with normal basal cisterns considered as Group B. Sample was selected purposively according to selection criteria. A pre-structured data collection sheet was used for recording patient's demographic, clinical and radiological data. Results: Most of the patients belonged to age 21-40 years and majority of the study patients are male. Road traffic accident is the major cause of trauma. Three fourth of the study population's GCS score are in 3-5 group. The most common findings in intracranial haematoma are acute Subdural Haematoma. Unfavorable outcome is seen in patients with compressed basal cisterns in Group A by GOS score. Unfavorable outcome is higher with compressed basal cisterns group in group A. Conclusion: Based on the result of this study Basal cisterns on the initial CT scan is a strong predictor of outcome in severe head injury and compressed basal cisterns are strongly related to unfavorable outcome and death.
subject: Original Article
  topic: section
subject: Severe traumatic brain injury
  topic: keywords
subject: Basal cisterns
  topic: keywords
subject: Computed tomography
  topic: keywords
subject: Glasgow Outcome Scale
  topic: keywords
subject: Prognostic factors.
  topic: keywords
creator: Mohd Moshiur Rahman
creator: Muzahidul Islam
creator: Mohammad Nahid Hasan
creator: Shimul Bhattacharjee
creator: Sheikh Mahmood Hasan
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 661
ending page: 667
doi: 10.5281/zenodo.22113641

Comparison of Accuracy of Ventricular Catheter Tip Placement by Conventional Free-Hand Method and Electromagnetic Neuronavigation Guided Ventriculoperitoneal Shunt Surgery
type: item
description: Background: Ventriculoperitoneal (V-P) shunt surgery has a long history and is one of the most established neurosurgeries around the world. The purpose of V-P shunt surgery is to divert an accumulation of cerebrospinal fluid (CSF) from the cerebral ventricles to the abdominal cavity. Accurate placement of ventricular catheter is depended on both proper insertion trajectory and proper catheter tip positioning. Objective: To compare the proportion of optimal ventricular catheter tip placement by two different ventriculoperitoneal shunt procedures. Methods & Materials: This cross-sectional observational study was conducted in Department of Neurosurgery, National Institute of Neurosciences & Hospital, Dhaka. 60 participants with Hydrocephalus, diagnosed by CT scan of brain and who underwent ventriculoperitoneal shunt surgery, were studied. All participants were divided into 2 groups by random lottery system. Results: Total 60 participants were included in our study among them 0-1year of age group showed maximum participants of 66.67%. 10(16.67%) belong to 1-5 years' age group among them 6(20%) participants from Group B and 4(13.33%) participants from Group A. 8.33% belongs to 6-10 years age group among them 6.67%from Group B, 10% from Group A. Study shows the majority of study participants 40 (66.67%) were male where 20 (33.33%) were female. male female ratio was 2:1. Conclusions: Frameless navigation is a valuable tool to optimize the trajectory and final position of shunt catheter in the ventricle. Mechanical malfunction and infection are the most significant problems associated with shunts for the treatment of hydrocephalus.
subject: Original Article
  topic: section
subject: Hydrocephalus
  topic: keywords
subject: Ventriculoperitoneal Shunt
  topic: keywords
subject: Ventricular Catheter Placement
  topic: keywords
subject: Catheter Tip Positioning.
  topic: keywords
creator: Mohammad Nahid Hasan
creator: Sheikh Mahmood Hasan
creator: Muzahidul Islam
creator: Mohd Moshiur Rahman
creator: Shimul Bhattacharjee
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 656
ending page: 660
doi: 10.5281/zenodo.22113603

Association of Tumor Size and Margin in Preoperative MRI with Histological Grade Among Intracranial Meningioma Patients
type: item
description: Background: Meningiomas are the most common primary intracranial tumor, they are usually benign but may be atypical or sometimes anaplastic. In this study, we determined whether pre-operative magnetic resonance imaging (MRI) features could distinguish between benign and atypical meningioma. Objective: Objective of this study was to assess the relation of tumor size and margin in preoperative MRI of brain with postoperative histological grades in intracranial meningiomas. Methods & Materials: This cross-sectional type of experimental study started from January, 2020 to June, 2021 conducted at the department of neurosurgery of National Institute of Neurosciences and Hospital, Dhaka. Cases (n = 73) were selected consecutively as per selection criteria and undergone surgical excision of meningioma followed by histopathology. Quantitative data were presented as mean ±SD and qualitative data as frequency and percent. Results: Meningioma was most (24, 32.9%) common in 4th decade, mean age (± SD) =41.42 (± 12.078) years with age range from 18 to 75 years. The majority of the cases were female with male female ratio 1:3.3. Male are more susceptible for being WHO grade II and III meningioma. Association between tumor size and meningioma grade was not significant. Conclusion: This study shows that association of tumor size in preoperative MRI of brain with postoperative histological grade is not significant but that of marginal irregularity is significant. Preoperative assumption of tumor grades helps us in making surgical planning and counselling patient/party regarding possible outcomes as well as need of adjuvant therapy.
subject: Original Article
  topic: section
subject: Meningioma
  topic: keywords
subject: Magnetic Resonance Imaging
  topic: keywords
subject: Tumor Size
  topic: keywords
subject: Tumor Margin
  topic: keywords
subject: Histological Grade
  topic: keywords
creator: Muzahidul Islam
creator: Mohd Moshiur Rahman
creator: Mohammad Nahid Hasan
creator: Shimul Bhattacharjee
creator: Sheikh Mahmood Hasan
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-26
publication date: 2026-08-26
starting page: 649
ending page: 655
doi: 10.5281/zenodo.22113568

Clinical and Functional Outcome of llizarov External Fixation in the Management of Infected Tibial Nonunion
type: item
description: Background: Background: Infected tibial nonunion is a difficult complication characterized by persistent infection, bone loss, deformity, instability, and impaired limb function. Ilizarov external fixation offers simultaneous infection control, stable fixation, bone transport, deformity correction, and functional restoration. Aim of the study: The study aims to evaluate the clinical and functional outcomes of Ilizarov external fixation in the management of infected tibial nonunion. Methods & Materials: This descriptive observational study included 40 consecutive adults with infected tibial nonunion treated with Ilizarov external fixation at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh, from July 2024 to June 2025. All patients underwent debridement, with acute docking, corticotomy, bone transport, or bone grafting performed as required. Clinical and radiological follow-up assessed union, eradication of infection, ASAMI bone and functional outcomes, weight-bearing status, deformity, limb-length discrepancy, and complications. Data were analyzed using SPSS and summarized as mean ± SD, frequencies, and percentages. Results: Among 40 patients, the mean age was 39.6 ± 10.8 years; 82.5% were male, 67.5% sustained road traffic injuries, and 77.5% had open fractures. Bone defects were present in 72.5%, while Staphylococcus aureus was isolated in 45.0%. Following Ilizarov treatment, radiological union was achieved in 90.0%, eradication of infection in 87.5%, and overall treatment success in 85.0%. Excellent-to-good ASAMI bone and functional outcomes were observed in 82.5% and 77.5% of cases, respectively. Pin-tract infection was the most frequent complication, occurring in 37.5% of cases. Conclusion: Overall, Ilizarov external fixation achieved high rates of bone union, eradication of infection, and favorable functional recovery in infected tibial nonunion, with mostly manageable complications. The technique appears to be an…
subject: Original Article
  topic: section
subject: Infected tibial nonunion
  topic: keywords
subject: Ilizarov external fixation
  topic: keywords
subject: Bone union
  topic: keywords
subject: Infection eradication
  topic: keywords
subject: Functional outcome.
  topic: keywords
creator: S M Tanveer Rahman
creator: Mohd Mohidul Islam
creator: K M Shorfuddin
creator: Rizwan Jamil
creator: Shahan Sazedur Rahman
creator: Tajima Sultana
creator: Abdul Motin
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-23
publication date: 2026-08-23
starting page: 642
ending page: 648
doi: 10.5281/zenodo.22070621

Outcome Comparison Between Titanium Elastic Nailing and Hip Spica Casting in Pediatric Femoral Shaft Fractures
type: item
description: Background: Femoral shaft fractures are one of the most frequent fractures that require hospitalization in children, and the best treatment for school-age children is still a topic of debate between operative fixation using titanium elastic nailing (TEN) and conservative treatment using hip spica casting. This study aimed to compare the functional outcome results of TEN with hip spica casting in children with femoral shaft fractures. Methods & Materials: This comparative study was conducted at from Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh July 2025 to December 2025 and comprised 60 children with femoral shaft fractures, who were equally divided into two groups: TEN group (n=30) and hip spica casting group (n=30). Demographic, injury, treatment, radiological, and functional variables were recorded and compared between the two groups. Data were entered and analyzed on SPSS version 26. Results: Both groups showed similar outcomes at baseline. The time to partial and full weight-bearing, return to school, and radiological union was shorter in the TEN group than in the hip spica group, while the hospital stay was longer in the TEN group. The overall treatment-related complications (16.7% vs. 40%) and residual deformity were lower in the TEN group, and the final functional outcome and return to normal activity by 12 weeks were better with TEN. Conclusion: The results of this study indicate that titanium elastic nailing showed better outcomes than hip spica casting in children with femoral shaft fractures in terms of functional recovery and complication rate, and should be considered as the treatment of choice in the appropriate patient population in school-age children.
subject: Original Article
  topic: section
subject: Titanium elastic nailing
  topic: keywords
subject: Hip spica casting
  topic: keywords
subject: Pediatric femoral shaft fracture
  topic: keywords
subject: Functional outcome
  topic: keywords
creator: Mohd Mohidul Islam
creator: K M Shorfuddin
creator: Rizwan Jamil
creator: S M Tanveer Rahman
creator: Zakaria Bin Hamid
creator: Saiful Islam
creator: Nahidul Islam
rights: Copyright (c) 2026 The Insight https://creativecommons.org/licenses/by/4.0
date: 2026-08-23
publication date: 2026-08-23
starting page: 636
ending page: 641
doi: 10.5281/zenodo.22070593