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: Knowledge and Utilization of Community Clinic Services among the Catchment Area of Nandigram, Bogura, Bangladesh
items: Distribution of Fingerprint Patterns among Bengali Postgraduate Medical Residents in Bangladesh
items: Measuring Variation of IVC Diameter in Bangladeshi Population in BIRDEM – A Prospective Observational Study
items: Comparative Clinical Outcomes of Patients with Low and Preserved Left Ventricular Ejection Fraction Undergoing Off-Pump Coronary Artery Bypass Surgery – A Single-Center Study
items: Relationship of Microalbuminuria with HbA1c and Other Renal Function Parameters in Type 2 Diabetic Post Menopausal Women
items: Efficacy of Core Decompression alone in Early-Stage Avascular Necrosis of the Femoral Head
items: Artificial Intelligence in Medical Science: Navigating Promise and Peril – an editorial
items: Temporal Onset and Duration of Pulmonary Haemorrhage – Impact on Survival Outcomes in Neonates
items: Prevalence and Patterns of Migraine among Adults Attending Tertiary Hospitals in Bangladesh
items: Burden of Chronic Suppurative Otitis Media and Hearing Loss among Primary and Secondary School Children – A Cross-Sectional Study
items: Pleural Fluid Cytology and Biochemical Profiles in Pediatric Pleural Effusion
items: Distinguishing Suicidal Hanging from Homicidal Ligature Strangulation – A Diagnostic Accuracy Study of Autopsy and Scene Findings
items: Pregnancy Outcome in Women with and without Diabetes Mellitus – A Comparative Study
items: Comparative Evaluation of Ketamine–Propofol versus Ketamine–Diazepam for Total Intravenous Anesthesia in ERAS-Guided Day Case Surgery
items: Association between Elevated HbA1c Levels and Risk of Trigger Finger in Diabetic Patients
items: Phacoemulsification In Eyes with High and Normal Axial Length – A Study of 100 Cases
items: Preoperative Risk Profile and Clinical Characteristics of Bangladeshi Patients Undergoing Isolated CABG
items: Role of Epidural Steroid Injection in Pain Reduction and Functional Recovery in Prolapsed Lumbar Intervertebral Disc (PLID)
items: Regional Anesthesia as a Primary Technique for COVID-19 Surgical Patients – Experience from a COVID Dedicated Hospital in Bangladesh
items: Impact of Body Mass Index on Acne Severity – Findings from a Hospital-Based Cross-Sectional Study (100 Cases)
items: Evaluation of Lower Tibial Metaphyseal Plate Osteosynthesis with or without Fixation of Lateral Malleolar Fracture – A Prospective Study
items: Prevalence of incidental findings in CT scan of paranasal sinuses
items: Assessment of Knowledge and Practices Regarding Shoulder Mobilizing Exercises Among Frozen Shoulder Patients
items: Exploring the Relationship between Dysmenorrhea and Mental Health Disorders in Young Women
items: Evaluation of Psychiatric Types of Morbidities among the Caregivers with Dementia
items: Vitamin D Deficiency among Children Visiting Outpatient Department in Bangladesh Shishu Hospital & Institute
items: Asymptomatic Cardiac Arrhythmias in Maintenance Hemodialysis – Frequency, Causes, and Patterns
items: Clinicopathological Profile of Pediatric Outpatients at Bangladesh Shishu Hospital & Institute – A Cross-Sectional Study
items: Functional Outcomes of Closed Tibial Shaft Fractures Treated with Suprapatellar Intramedullary Nailing – A Prospective Study
items: Comparative Outcomes between Off-Clamp and On-Clamp Nephron-Sparing Surgery – A Retrospective Analysis

Knowledge and Utilization of Community Clinic Services among the Catchment Area of Nandigram, Bogura, Bangladesh
type: item
description: Introduction: Bangladesh has made signiﬁcant progress in recent times in many of its social development indicators, particularly in rural health services. Clinic (CC) is also based on principles of Primary Health Care to serve the greatest interest to the largest population. Methods & Materials: This Cross-sectional type of descriptive study was conducted at Department of Community Medicine, Rajshahi Medical College Hospital from January 2020 to December 2020. People who were residing in ward no 6, 7, 9, vatra union, Nandigram Upazila, Bogura were the study population. Results: Majority of the respondents (94.0%) knew about overall the services given by community clinic. The relationship between age and knowledge about supplied contraceptives for women from community clinic was statistically significant. Relationship between Monthly income and knowledge about contraceptives supplied for women from community clinic was statistatically significant. Conclusion: In spite of some limitations in the provision of healthcare services, community clinics have emerged as a flagship program of the Government of Bangladesh. By providing adequate and appropriate logistics supports, PHC services can establish from Ccs.
subject: Original Article
  topic: section
subject: Community Clinic
  topic: keywords
subject: Knowledge
  topic: keywords
subject: Utilization of services
  topic: keywords
subject: Primary health care
  topic: keywords
creator: Tahsina Nasreen
creator: Sharif Md Osman
creator: Asma Ur Rizal
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 481
ending page: 486
doi: 10.5281/zenodo.17752867

Distribution of Fingerprint Patterns among Bengali Postgraduate Medical Residents in Bangladesh
type: item
description: Background: Fingerprints serve as unique, permanent, and reliable biometric identifiers that remain unchanged throughout life. Dermatoglyphic studies have gained increasing interest for their potential applications in forensic and anthropological sciences. However, such data are limited among Bangladeshi populations, especially in medical professionals. Objective: To determine the distribution of fingerprint patterns among Bangladeshi postgraduate medical residents and to assess the association with sex. Methods & Materials: This cross-sectional study was conducted at the Department of Forensic Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), from February 2024 to January 2025. A total of 115 postgraduate medical residents (1150) were included through convenient sampling. Fingerprints were collected using the rolling ink method and classified into arches, loops, and whorls. Data were analyzed using SPSS version 26. The Chi-square (χ²) test was applied to assess the association between fingerprint patterns and sex, with a significance level set at p < 0.05. Results: Loops were the most prevalent fingerprint pattern (62.5%), followed by whorls (29.1%) and arches (8.4%). Female participants exhibited a higher proportion of loop patterns than males, though the difference was not statistically significant (χ² = 1.409, p = 0.494). Finger-wise analysis showed loops were most frequent on middle and little fingers, while whorls predominated on ring digit. Conclusion: Loop patterns predominated among Bangladeshi postgraduate medical residents, with no significant sex-based differences. These findings provide baseline dermatoglyphic data for Bangladeshi adults and highlight the need for broader population-based research to explore potential genetic and biological influences.
subject: Original Article
  topic: section
subject: Fingerprint patterns
  topic: keywords
subject: Dermatoglyphics
  topic: keywords
subject: Sex association
  topic: keywords
subject: Bangladeshi medicalresidents
  topic: keywords
subject: Loops
  topic: keywords
subject: Whorls
  topic: keywords
subject: Arches
  topic: keywords
creator: Sarwar Zahan
creator: Milton Kumar Debnath
creator: Jahidur Rahman
creator: Shifat Jannat Sporshow
creator: Khalid Ibn Hasan
creator: Tamanna Hossain Simi
creator: Sonia Naznin Sunny
creator: Moriom Ferdousi
creator: Al-Razwan Akber
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 477
ending page: 480
doi: 10.5281/zenodo.17752766

Measuring Variation of IVC Diameter in Bangladeshi Population in BIRDEM – A Prospective Observational Study
type: item
description: ABSTRACT Background: Echocardiographic assessment of inferior vena cava (IVC) diameter and its respiratory variation helps to measure right atrial pressure (RAP). While IVC distends RAP rises. Phases of respiratory cycle has significant variation of inferior vena cava diameter in normal individual. There may be other factors that also influence IVC diameter. Aim: The present study aimed to see the size and dynamics of IVC, its respiratory variation and other factors influencing IVC diameter.. Methods & Materials: This prospective observational study was conducted at BIRDEM over six months in 2024, involving 1200 adult patients. Demographic data were recorded. BMI was calculated and categorized for analysis. Echocardiographic assessments of IVC maximum (IVC Max) and minimum (IVC Min) diameters, collapsibility index (CI), left ventricular ejection fraction (EF), and diastolic dysfunction (DD) were measured. Variation of IVC diameter with age, sex, BMI, EF, DD, and DM were assessed, with p < 0.05 considered significant. Results: The mean age of participants was 53.04 ± 10.95 years, and mean BMI was 26.00 ± 4.46 kg/m². Mean IVC Max and Min diameters were 18.44 ± 1.84 mm and 13.28 ± 2.00 mm, with a mean CI of 0.292 ± 0.115. IVC size correlated positively with age, male sex, and BMI (p < 0.01) but not with diabetes (p > 0.05). Larger IVC diameters and lower CI were observed in participants with reduced EF and advanced diastolic dysfunction (p < 0.001). Conclusion: IVC diameter and collapsibility index are significantly related to cardiac function and demographic factors, serving as useful non-invasive indicators of right atrial pressure and cardiac filling status.
subject: Original Article
  topic: section
subject: Inferior vena cava (IVC)
  topic: keywords
subject: echocardiography
  topic: keywords
subject: ejection fraction (EF)
  topic: keywords
subject: diastolicdysfunction (DD)
  topic: keywords
subject: diabetes mellitus (DM)
  topic: keywords
subject: Body mass index (BMI)
  topic: keywords
creator: Shabnam Jahan Hoque
creator: Rownak Jahan Tamanna
creator: Aparna Rahman
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 471
ending page: 476
doi: 10.5281/zenodo.17752703

Comparative Clinical Outcomes of Patients with Low and Preserved Left Ventricular Ejection Fraction Undergoing Off-Pump Coronary Artery Bypass Surgery – A Single-Center Study
type: item
description: Background: Left ventricular dysfunction is a major risk factor influencing outcomes after coronary artery bypass grafting (CABG). Off-pump CABG (OPCABG) has been proposed as a safer alternative for patients with reduced ejection fraction by avoiding cardiopulmonary bypass-related complications. This study aimed to compare intraoperative and early postoperative outcomes between patients with reduced and preserved left ventricular ejection fraction (LVEF). Methods & Materials: This comparative observational study was conducted in the Department of Cardiac surgery, United Hospital, Dhaka, Bangladesh, from July 2024 to December 2024. A total of 100 patients undergoing OPCABG were included: Group A (LVEF ≤35%, n=50) and Group B (LVEF >35%, n=50). Results: Patients with reduced LVEF were slightly older (61.8 ± 8.2 vs. 58.4 ± 7.9 years; p=0.041) and had more prior myocardial infarctions (64% vs. 44%; p=0.047). Group A received fewer grafts (2.7 ± 0.8 vs. 3.1 ± 0.7; p=0.008) and required longer operative time (220 ± 35 vs. 205 ± 30 min; p=0.03). The need for intra-aortic balloon pump (16% vs. 4%; p=0.046), prolonged inotropic support (42% vs. 20%; p=0.018), ICU stay (3.8 ± 1.6 vs. 2.9 ± 1.1 days; p=0.004), and hospital stay (9.2 ± 2.5 vs. 7.8 ± 2.0 days; p=0.006) were higher in Group A. LVEF improved significantly in both groups, with greater recovery in Group A (Δ% +8.4 ± 4.1 vs. +4.8 ± 3.9; p=0.002). Conclusion: OPCABG is safe and effective even in patients with severe left ventricular dysfunction, resulting in significant improvement in ventricular function and acceptable early morbidity and mortality rates.
subject: Original Article
  topic: section
subject: Off-pump coronary artery bypass grafting
  topic: keywords
subject: left ventricular ejection fraction
  topic: keywords
subject: myocardial dysfunction
  topic: keywords
subject: cardiac surgery outcomes
  topic: keywords
creator: Tania Nusrat Shanta
creator: Mirza Md Nazmus Saquib
creator: Syed Golam Azam
creator: Arif Ullah Bhuiyan
creator: Arif Ahmed Mohiuddin
creator: Shadequl
creator: C M Mosabber Rahman
creator: Musarat Jahan
creator: Nazneen Nawal
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 466
ending page: 470
doi: 10.5281/zenodo.17752600

Relationship of Microalbuminuria with HbA1c and Other Renal Function Parameters in Type 2 Diabetic Post Menopausal Women
type: item
description: Background: Type 2 diabetes mellitus (T2DM) is a growing global health concern, with Bangladesh projected to rank 8th in adult diabetes prevalence by 2030 [1–4]. Microalbuminuria, an early marker of diabetic nephropathy linked to poor glycemic control, predicts renal and cardiovascular complications [5,6]. This study aims to assess the correlation between microalbuminuria, glycemic control, and renal function parameters in postmenopausal women with T2DM. Aim of the study: The aim of the study was to evaluate the association between microalbuminuria, HbA1c levels, and renal function parameters in postmenopausal women with type 2 diabetes at DMCH. Methods & Materials: This cross-sectional study at the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh (July 2014–June 2015) included 100 postmenopausal women with type 2 diabetes from the endocrine outpatient department. Blood and urine samples were analyzed for glucose, HbA1c, albumin, creatinine, microalbuminuria, and ACR. Data were processed using SPSS v21; p<0.05 was considered significant. Results: Among 100 postmenopausal women with T2DM, 78% had microalbuminuria. All patients with diabetes >5 years and 94.4% with hypoalbuminemia were microalbuminuria positive. Significant correlations were found with ACR (r=0.997), HbA1c (r=0.75), FBS (r=0.717), S. creatinine (r=0.694), S. albumin (r=–0.750), and U. creatinine (r=–0.762) (p=0.001). Conclusion: Microalbuminuria is common in diabetic postmenopausal women in Bangladesh, and early screening can help prevent diabetic complications and chronic kidney disease.
subject: Original Article
  topic: section
subject: Microalbuminuria
  topic: keywords
subject: HbA1c
  topic: keywords
subject: Renal Function
  topic: keywords
subject: Type 2 Diabetes Mellitus
  topic: keywords
subject: Postmenopausal Women
  topic: keywords
creator: Aklima Mazhar
creator: Pijush Karmakar
creator: Alim Ur Rahman
creator: Salma Nasir
creator: Rydwana Munmun
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 461
ending page: 465
doi: 10.5281/zenodo.17752560

Efficacy of Core Decompression alone in Early-Stage Avascular Necrosis of the Femoral Head
type: item
description: Background: Avascular necrosis of the femoral head (AVNFH) is a progressive musculoskeletal disorder that can cause substantial disability due to collapse of the articular surface, primarily affecting young, active adults and posing significant socioeconomic challenges. The purpose of the study was to evaluate the efficacy of core decompression alone in patients with early-stage avascular necrosis of the femoral head. Methods & Materials: This prospective observational study at the Department of Orthopedics, Rangpur Medical College Hospital, Rangpur, and Sadar Hospital, Lalmonirhat, Bangladesh (July 2021–June 2025), included 30 patients with early-stage AVN (Ficat–Arlet I–II) undergoing core decompression. Demographics, HHS, radiological outcomes, and complications were recorded; data were analyzed using SPSS 26.0, with mean ± SD, frequencies (%), and paired t-tests for HHS changes (p < 0.05). Results: Among 30 patients (mean age 24.8 ± 4.0 years; 23 males), 14 had bilateral hip involvement. Etiology included steroid-induced AVN in 14, idiopathic in 10, and alcohol-related in 6 cases. Mean Harris Hip Score improved significantly from 58.4 preoperatively to 84.6 at 12 months (p < 0.001), with 22 patients achieving good-to-excellent outcomes. Radiologically, 24 hips remained stable or improved, while 6 progressed. Postoperative complications were minimal: mild pain in 8 patients, early femoral head collapse in 2, and no femoral neck fractures. Conclusion: Core decompression alone is a safe and effective treatment for early-stage avascular necrosis of the femoral head, providing significant functional improvement and radiological stability.
subject: Original Article
  topic: section
subject: Core Decompression
  topic: keywords
subject: Avascular Necrosis
  topic: keywords
subject: Femoral Head
  topic: keywords
creator: Aminur Rahman
creator: Hazrat Ali Miah
creator: Mainul Hasan
creator: Rezaul Karim
creator: Anisur Rahman
creator: Raihan Ali
creator: Farzana Khondoker
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 456
ending page: 460
doi: 10.5281/zenodo.17751833

Artificial Intelligence in Medical Science: Navigating Promise and Peril – an editorial
type: item
description: The accelerating integration of artificial intelligence (AI) into medical science marks a pivotal moment for global health systems. Once considered a speculative tool, AI is rapidly becoming an essential component of diagnostics, therapeutics, and health-care delivery. Yet its future role will be defined not by technological capability alone, but by our collective willingness to govern it responsibly, equitably, and transparently. In diagnosis, AI has demonstrated clear value. Deep-learning models can detect abnormalities in radiology and digital pathology with a consistency that often narrows inter-observer variation. Early evidence from prospective studies suggests that AI-assisted reporting can reduce time to diagnosis and support overburdened clinical services without compromising safety...
subject: Editorial
  topic: section
creator: H N Sarker
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-25
publication date: 2025-11-25
starting page: 455
ending page: 455
doi: 10.5281/zenodo.17714335

Temporal Onset and Duration of Pulmonary Haemorrhage – Impact on Survival Outcomes in Neonates
type: item
description: Introduction: Pulmonary haemorrhage is a catastrophic neonatal condition associated with extremely high mortality. The timing of onset and duration of bleeding play crucial roles in determining outcomes. The present study aimed to evaluate the impact of temporal onset and duration of pulmonary haemorrhage on survival outcomes in neonates. Methods & Materials: This prospective cohort study was conducted at Bangladesh Shishu Hospital & Institute, Dhaka, from July 2019 to June 2021. Seventy neonates (gestational age 28–42 weeks) who developed pulmonary haemorrhage during hospitalisation were enrolled. Demographic, clinical, and temporal data were recorded. Survival outcomes were compared between survivors (n=8) and non-survivors (n=62) using the unpaired Student’s t-test and Fisher’s Exact test. Statistical analysis was performed using SPSS version 22.0. Results: Mortality was 88.5%. Survivors had significantly earlier onset of haemorrhage (3.00 ± 1.69 days) compared with non-survivors (8.12 ± 7.07 days; p=0.046). Similarly, onset during hospitalisation was earlier (3.37 ± 1.18 days vs. 6.64 ± 3.44 days; p=0.007), and duration was markedly shorter in survivors (4.50 ± 0.53 h vs. 9.48 ± 0.56 h; p=0.001). Clinical appearance differed significantly (p=0.044), with dyspneic presentations dominating among survivors, whereas lethargy predominated in deaths. Conclusion: Temporal variables—particularly early onset and shorter duration—are strong survival predictors in neonatal pulmonary haemorrhage. Prompt recognition and early hemostatic intervention within the first few hours are crucial for improving prognosis and guiding clinical management.
subject: Original Article
  topic: section
subject: Neonatal Pulmonary Haemorrhage
  topic: keywords
subject: Temporal Onset
  topic: keywords
subject: Duration of Bleeding
  topic: keywords
subject: Survival Outcomes
  topic: keywords
subject: High Mortality
  topic: keywords
creator: Sumaiya Liza
creator: Nabila Islam
creator: Farhat Lamisa Kabir
creator: Nur Uz Zaman
creator: Tanvir Hossain Khan
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 451
ending page: 454
doi: 10.5281/zenodo.17586899

Prevalence and Patterns of Migraine among Adults Attending Tertiary Hospitals in Bangladesh
type: item
description: Introduction: Migraine is a disabling, recurrent primary headache disorder characterized by moderate-to-severe recurrent head pain associated with nausea, photophobia, and phonophobia. The research aims to quantify the prevalence and pattern of migraine among adults presenting at Bangladeshi tertiary hospitals. Methods & Materials: This was a cross-sectional observational study conducted among 58 adult patients who were seen in the Neurology Outpatient Departments of Neurology, Gopalganj Medical College, Gopalganj, Bangladesh between January 2024 and December 2024. Adults aged 18 years or more who met the ICHD-3 criteria for migraine and were willing to participate were included. Data were analyzed using SPSS version 26.0. Result: The female sex (74.1%) and age 26–35 years (41.3%) were predominant among the 58 patients. Migraine without aura was most frequent (72.4%), with 4–9 attacks per month and 4–12 hours' duration being most common. The most frequent precipitating factors were stress (69.0%), disturbance of sleep (65.5%), and exposure to noise (50.0%). Most frequent associated symptoms were nausea/vomiting (72.4%), photophobia (69.0%), and phonophobia (65.5%). Conclusion: This study establishes migraine as a prevalent neurological disorder in adults who are presenting to tertiary centres in Bangladesh, with extreme female predominance and highest prevalence in the age group of 26–35 years. Migraine without aura was present in most cases, and precipitating factors were stress, inadequate sleep, and sound exposure. In most patients, attacks lasted 4–12 hours, and were accompanied by nausea, photophobia, and phonophobia.
subject: Original Article
  topic: section
subject: Migraine
  topic: keywords
subject: Photophobia
  topic: keywords
subject: Phonophobia
  topic: keywords
creator: Mahabubur Rahman
creator: Mohammad Masudur Rahman
creator: Pallab Kanti Saha
creator: Paresh Chandra Halder
creator: Mohammad Azizul Karim
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 447
ending page: 450
doi: 10.5281/zenodo.17586873

Burden of Chronic Suppurative Otitis Media and Hearing Loss among Primary and Secondary School Children – A Cross-Sectional Study
type: item
description: Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear with perforation of the tympanic membrane and frequent or continuous discharge from the ear, typically resulting in hearing loss. The aim of this study is to ascertain the burden of hearing loss and chronic suppurative otitis media in children in primary and secondary schools. Methods & Materials: It was a cross-sectional survey conducted between January 2024 to December 2024 in 76 children who were 6-16 years of age, studying in primary and secondary schools, in North Bengal Medical College & Hospital to assess the burden of chronic suppurative otitis media (CSOM) and hearing loss following it. Data analysis was performed using SPSS version 26.0. Result: In the current study of 76 school children with a mean age of 10.8 ± 2.9 years, 35.5% of them had chronic suppurative otitis media (CSOM) with a majority being unilateral (81.5%) and tubotympanic type (77.8%). Duration of discharge from the ear was 2.4 ± 1.1 years. In 92.6% of the infected children, impaired hearing was described primarily as mild to moderate conductive impairment (85.2%), averaging 38.4 ± 9.2 dB in hearing threshold, indicating heavy disease burden and accompanying auditory deficit in this subgroup. Conclusion: This study sets a colossal burden of chronic suppurative otitis media (CSOM) and associated hearing loss in primary and secondary school children with a prevalence rate of 35.5% and hearing impairment observed in 92.6% of the cases.
subject: Original Article
  topic: section
subject: Chronic Suppurative Otitis Media
  topic: keywords
subject: Hearing Loss
  topic: keywords
subject: School Children
  topic: keywords
subject: Tubotympanic
  topic: keywords
creator: Kamrul Rasel Khan
creator: Shafiqul Islam
creator: Imadul Islam
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 443
ending page: 446
doi: 10.5281/zenodo.17586846

Pleural Fluid Cytology and Biochemical Profiles in Pediatric Pleural Effusion
type: item
description: Introduction: Pleural effusion, the accumulation of excess fluid in the pleural cavity, is a common cause of respiratory morbidity in children and can result from a variety of infectious and non-infectious conditions. In the pediatric population, parapneumonic effusion and tuberculous pleural effusion are among the most frequently encountered causes, each with distinct cytological and biochemical profiles. This study aims to evaluate the pleural fluid cytology and biochemical parameters in children with pleural effusion. Methods & Materials: This cross-sectional study was conducted at the Department of Pediatric Respiratory Medicine, Bangladesh Shishu Hospital and Institute, Dhaka, from July 2019 to January 2022. A total of 58 children from 1 to 18 years of age admitted with pleural effusion were selected as study subjects. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26.0. Result: Among the 47 study patients, parapneumonic effusion (63.8%) was the most common cause of pleural effusion, followed by tuberculous pleural effusion (36.2%). Pleural fluid analysis showed that TPE cases had significantly lower total cell counts and polymorph percentages, but higher lymphocyte percentages compared to non-TPE cases (P <0.001). Glucose levels were also significantly lower in TPE (P <0.001), while protein and LDH levels did not differ significantly between the groups. Conclusion: Analysis of pleural fluid cytology and biochemical profiles in pediatric pleural effusion revealed that tuberculous pleural effusion is characterized by significantly higher lymphocyte percentages and lower polymorphonuclear cell counts, along with reduced glucose levels and lower total cell counts, compared to non-tuberculous effusions.
subject: Original Article
  topic: section
subject: Pleural Effusion
  topic: keywords
subject: Pleural Fluid Cytology
  topic: keywords
subject: Biochemical Profiles
  topic: keywords
subject: Tuberculosis
  topic: keywords
creator: Nabila Islam
creator: Sumaiya Liza
creator: Tapan Chandra Roy
creator: Nur Uz Zaman
creator: Asif Mahmud
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 439
ending page: 442
doi: 10.5281/zenodo.17586838

Distinguishing Suicidal Hanging from Homicidal Ligature Strangulation – A Diagnostic Accuracy Study of Autopsy and Scene Findings
type: item
description: Introduction: Differentiating suicidal hanging from homicidal strangulation remains a critical challenge in forensic pathology due to overlapping scene findings, ligature patterns, and internal neck injuries. Accurate classification is essential for justice, mortality reporting, and public health surveillance. This study aimed to evaluate the diagnostic accuracy of autopsy, internal neck injury, and scene findings in distinguishing suicidal hanging from homicidal strangulation. Methods & Materials: This observational, cross-sectional autopsy-based forensic study analyzed 120 cases (95 suicidal and 25 homicidal) after excluding incomplete or decomposed cases. The study was conducted at the Department of Forensic Medicine at Dhaka Medical College from January 2022 to July 2022. The manner of death was determined through combined scene evidence, police inquest, and autopsy consensus. Data were collected using a structured pro forma, and statistical analysis was performed using SPSS (version 26.0). Results: Suicidal hangings were marked by oblique, non-continuous ligature marks above the thyroid cartilage, parchmentization, and no defense injuries, while homicidal cases showed horizontal marks, fractures, and signs of struggle. Sedatives were found only in homicides. The predictive model accurately distinguished suicides from homicides (AUC = 0.97, sensitivity = 97%, specificity = 92%). Conclusion: Careful assessment of the scene and autopsy findings can effectively differentiate suicidal hangings from homicidal strangulations. Oblique, non-continuous ligature marks above the thyroid cartilage and absence of defense injuries indicate suicide, while horizontal marks, internal trauma, and struggle signs suggest homicide.
subject: Original Article
  topic: section
subject: Suicidal hanging
  topic: keywords
subject: Homicidal strangulation
  topic: keywords
subject: Forensic pathology
  topic: keywords
subject: Ligature markanalysis
  topic: keywords
subject: Diagnostic Accuracy
  topic: keywords
creator: Monisha Datta
creator: Suvendu Kumar Banik
creator: Manoshi Datta
creator: Kazi Golam Mukhlesur Rahman
creator: Mamtaz Ara
creator: Mazharul Islam
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 432
ending page: 438
doi: 10.5281/zenodo.17586818

Pregnancy Outcome in Women with and without Diabetes Mellitus – A Comparative Study
type: item
description: Background: Diabetes during pregnancy, both gestational and pre-existing, is an increasing concern in South Asia, linked to higher risks of preeclampsia, cesarean delivery, macrosomia, and neonatal hypoglycemia. This study compared maternal and neonatal outcomes between diabetic and non-diabetic pregnancies in a tertiary hospital. Methods & Materials: This comparative cross-sectional study was carried out in the Department of Gynecology and Obstetrics, Gazi Medical College Hospital, Khulna, Bangladesh, from January to December 2024. A total of 320 pregnant women (160 with diabetes and 160 without) were enrolled to compare maternal and neonatal outcomes. Participants were ≥28 weeks gestation with singleton pregnancies. Data on demographics, antenatal complications, delivery, and neonatal outcomes were collected using a structured questionnaire. Gestational diabetes was diagnosed per IADPSG/WHO 2013 criteria, and analyses were performed using SPSS v26.0. Results: Among 320 pregnant women, most diabetics had gestational diabetes diagnosed at 26 weeks, with 70% achieving good glycemic control. Diabetic mothers showed higher rates of polyhydramnios, caesarean delivery, macrosomia, and shoulder dystocia. Their infants had greater birthweight, more hypoglycaemia, NICU admissions, and longer hospital stays. Adverse maternal (21.3% vs. 11.3%) and neonatal (36.3% vs. 21.3%) outcomes were significantly higher in diabetics. Diabetes, maternal age ≥35 years, and hypertension independently predicted poor outcomes. Conclusion: This study found that diabetes during pregnancy, whether gestational or pre-existing, significantly increases the risk of adverse maternal and neonatal outcomes, including hypertension, cesarean delivery, macrosomia, and neonatal hypoglycemia. Even with reasonable glycemic control, complications remained more common among diabetic mothers than non-diabetic ones.
subject: Original Article
  topic: section
subject: Gestational Diabetes Mellitus (GDM)
  topic: keywords
subject: Pregnancy Complications
  topic: keywords
subject: Maternal andNeonatal Outcomes
  topic: keywords
creator: Morsheda Yasmin Tamanna
creator: S M Ikbal Kabir
creator: Naznin Nahar
creator: Afsana Ferdous
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 424
ending page: 431
doi: 10.5281/zenodo.17586808

Comparative Evaluation of Ketamine–Propofol versus Ketamine–Diazepam for Total Intravenous Anesthesia in ERAS-Guided Day Case Surgery
type: item
description: Introduction: ERAS protocols in day-case surgeries reduce stress and promote faster recovery. TIVA is favored for its controllable depth and quick emergence. This study compares ketamine–propofol and ketamine–diazepam anesthesia regarding perioperative stability and recovery outcomes in ERAS-guided day-case surgeries. Methods & Materials: This one-year prospective comparative study (July 2024–June 2025) at Gazi Medical College, Khulna, included 60 adults undergoing ERAS-guided day-case surgery. Patients were randomized into two groups: Group A (Ketamine + Propofol) and Group B (Ketamine + Diazepam). Perioperative parameters, recovery, PONV, pain, complications, and hospital stay were analyzed using SPSS v26.0, with p < 0.05 considered significant. Results: Both groups were comparable in demographics, ASA status, types of surgery, and intraoperative parameters. Group A (ketamine–propofol) demonstrated significantly better hemodynamic stability, smoother recovery from anesthesia, and a lower incidence of PONV (p < 0.05). Recovery was faster in Group A, with earlier oral intake and ambulation, shorter PACU stay, and reduced hospital stay (all p <0.001). Intraoperative complications were also lower in Group A. Conclusion: The study concludes that the ketamine–propofol combination offers superior recovery outcomes compared to ketamine–diazepam for total intravenous anaesthesia in ERAS-guided day-case surgeries. It provides better postoperative analgesia, reduces PONV, and ensures smoother and faster recovery without compromising hemodynamic stability. This regimen aligns well with ERAS principles, making it a more effective choice for ambulatory anesthesia.
subject: Original Article
  topic: section
subject: Total Intravenous Anesthesia (TIVA)
  topic: keywords
subject: Enhanced Recovery after Surgery (ERAS)
  topic: keywords
subject: Day Case Surgery
  topic: keywords
creator: Gaitri Kashyapi
creator: Abhijit Mondol
creator: Saddam Hossain
creator: Murad Hossain
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 418
ending page: 423
doi: 10.5281/zenodo.17586786

Association between Elevated HbA1c Levels and Risk of Trigger Finger in Diabetic Patients
type: item
description: Background: Diabetes mellitus is a chronic metabolic disorder that not only causes vascular complications but is also associated with musculoskeletal manifestations such as trigger finger, which are often underrecognized. The purpose of the study was to assess the association between elevated HbA1c levels and the risk of developing trigger finger among diabetic patients. Aim of the study: The aim of the study was to assess the association between elevated HbA1c levels and the risk of developing trigger finger among diabetic patients. Methods & Materials: A cross-sectional study at the Medicine Outpatient Department of BIRDEM General Hospital, Dhaka, Bangladesh (Nov 2018–Apr 2019) included 354 type 2 diabetic patients with hand complaints, and demographic and clinical data were collected to assess associations with trigger finger using SPSS and chi-square tests (P < 0.05). Results: Among 354 diabetic patients, trigger finger affected 177 (50%). Age and sex were similar between groups, while diabetes duration >5 years was higher in trigger finger patients (114, 64.4% vs 91, 51.4%; P = 0.018). Hypertension was present in 122 (68.9%) trigger finger patients. HbA1c >6.5% was seen in 122 (68.9%) with trigger finger and 119 (67.2%) without (P = 0.733), showing no significant association. Conclusion: Trigger finger is the most common hand complication in diabetic patients, associated with longer diabetes duration but not with elevated HbA1c levels.
subject: Original Article
  topic: section
subject: HbA1c
  topic: keywords
subject: Trigger Finger
  topic: keywords
subject: Diabetes Mellitus
  topic: keywords
creator: A K M Asad-Ud Doza
creator: Sabbir Jashim Ahmed
creator: Tasnuva Tabassum
creator: Rihan Azad
creator: S M Sharfuddin
creator: Rakib AlImran
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 413
ending page: 417
doi: 10.5281/zenodo.17583306

Phacoemulsification In Eyes with High and Normal Axial Length – A Study of 100 Cases
type: item
description: Background: Axial length plays a critical role in cataract surgery outcomes. Patients with high axial length are often at increased risk of intraoperative complications and suboptimal visual recovery. This study aimed to evaluate the intraoperative complications of cataract surgery with phacoemulsification in eyes with high and normal axial length. Methods & Materials: A total of 100 cataract patients were divided into two groups: Group I (normal axial length, 21–24.5 mm) and Group II (high axial length, ≥26 mm), with 50 patients in each group. Data on age, gender, occupation, axial length, intraoperative complications, refractive error, and visual acuity on the first postoperative day and after six weeks were collected and analyzed. Results: The majority of patients were aged 61–80 years (55%) and male (66%). Group I had a mean axial length of 22.95 ± 0.90 mm, while Group II had a significantly longer mean of 27.76 ± 1.10 mm (p < 0.05). Intraoperative complications were more frequent in Group II (6.00%) compared to Group I (4.00%), with posterior capsule tear being significantly higher in the high axial length group (p = 0.03). Refractive status differed significantly between the groups, with Group II showing higher degrees of myopia (p < 0.05). Postoperative visual acuity was better in Group I at both the 1st POD and 6-week follow-up, with more patients achieving 6/6–6/9 vision compared to Group II. Conclusion: Patients with high axial length undergoing phacoemulsification are more prone to intraoperative complications and demonstrate poorer visual and refractive outcomes compared to those with normal axial length. Proper preoperative assessment and surgical precautions are essential to optimize outcomes in high axial length eyes.
subject: Original Article
  topic: section
subject: Phacoemulsification
  topic: keywords
subject: Axial length
  topic: keywords
subject: Cataract surgery
  topic: keywords
subject: Visual acuity
  topic: keywords
subject: Refractive status
  topic: keywords
creator: Fatema Ferdous Ara
creator: Fatema Tuj Johra
creator: aoroze Ferdous Romance
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 407
ending page: 412
doi: 10.5281/zenodo.17583284

Preoperative Risk Profile and Clinical Characteristics of Bangladeshi Patients Undergoing Isolated CABG
type: item
description: Background: Understanding the preoperative clinical profile of patients undergoing coronary artery bypass grafting (CABG) is essential for surgical planning and outcome prediction; however, population-specific data from Bangladesh are limited. Objective: This study aimed to describe the demographic, anthropometric, comorbidities, renal, and cardiac characteristics of Bangladeshi patients undergoing isolated CABG at a tertiary cardiac center. Methods & Materials: A comparative cross-sectional study was conducted at the National Heart Foundation Hospital and Research Institute in Dhaka between September 2020 and August 2022. Five hundred consecutive patients scheduled for isolated CABG were enrolled in this study. Data were collected from medical records and assessments using standardized forms. Descriptive statistics were performed using SPSS (version 26). Results: The mean age was 60.2 ± 7.5 years, with 81.8% male patients. Over half (51.6%) were overweight (BMI 23–27.5 kg/m²), and hypertension (63.6%) and diabetes (44.2%) were the most common comorbidities. Normal renal function (serum creatinine < 1.4 mg/dL) was found in 91.2% of patients, with a mean creatinine clearance of 85.9 ± 13.4 mL/min. Most patients were NYHA class III (62%), with 70.6% having had a recent myocardial infarction and 77.6% showing an ejection fraction of 31–50%. Elective CABG comprised 75.4% of cases, while 1% were emergent. Conclusion: Bangladeshi CABG patients typically present as middle-aged males with high rates of hypertension, diabetes, and moderate ventricular dysfunction. Recognizing these preoperative characteristics is crucial for optimizing care and tailoring risk models for regional populations.
subject: Original Article
  topic: section
subject: Coronary artery bypass grafting
  topic: keywords
subject: preoperative profile
  topic: keywords
subject: cardiovascular risk factors
  topic: keywords
creator: Zafar-Al Nimari
creator: Mohammad Azizul Islam
creator: Ahmad Pear Salahuddin
creator: Nahedul Morshed
creator: Nittyananda Pal
creator: Satyajit Sharma
creator: Anowarul Azim
creator: Oindril Saha
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 402
ending page: 406
doi: 10.5281/zenodo.17583236

Role of Epidural Steroid Injection in Pain Reduction and Functional Recovery in Prolapsed Lumbar Intervertebral Disc (PLID)
type: item
description: Introduction: Prolapsed lumbar intervertebral disc (PLID) is a leading cause of low back pain and radiculopathy, significantly influencing patients' quality of life. ESIs reduce inflammation and nerve root irritation, offering short-term pain relief and improved mobility. Methods & Materials: This one-year retrospective study (January 2022–December 2023) at Gazi and Khulna Medical Colleges, Bangladesh, included 50 adults (20–60 years) with MRI-confirmed lumbar disc prolapse unresponsive to ≥4 weeks of conservative therapy. Patients received interlaminar or transforaminal epidural steroid injections. Pain (VAS), disability (ODI), complications, and satisfaction were evaluated at baseline, 1 week, 1 month, and 3 months. Result: The study included 50 patients with a mean age of 41.6 years; 56% were male, and 60% had sedentary occupations. The most common disc prolapse level was L4-L5 (56%), and protrusion was the predominant type (44%). Interlaminar ESI was most frequently used (60%) with methylprednisolone (64%), and 60% received a single injection. Significant reductions in pain and disability were observed, with VAS scores dropping from 7.6 to 2.8 and ODI scores from 58.2% to 24.3% at 3 months (p<0.001). Complications were minimal and mild, and 76% of participants reported excellent or good satisfaction following the intervention. Conclusion: Epidural steroid injections (ESIs) effectively manage prolapsed lumbar intervertebral disc (PLID) by providing significant pain relief and functional improvement. This study showed marked reductions in VAS and ODI scores, with minimal complications and high patient satisfaction, supporting ESIs as a safe, effective, and non-surgical treatment option for PLID.
subject: Original Article
  topic: section
subject: Epidural Steroid Injection (EPI)
  topic: keywords
subject: Pain Reduction
  topic: keywords
subject: Functional Recovery
  topic: keywords
subject: Prolapsed Lumbar Intervertebral Disc (PLID)
  topic: keywords
creator: Saddam Hossain
creator: Murad Hossain
creator: Abhijit Mondol
creator: Gaitri Kashyapi
creator: S M Ikbal Kabir
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 396
ending page: 401
doi: 10.5281/zenodo.17582972

Regional Anesthesia as a Primary Technique for COVID-19 Surgical Patients – Experience from a COVID Dedicated Hospital in Bangladesh
type: item
description: Introduction: The COVID-19 pandemic has reshaped anesthetic practice, with general anesthesia (GA) carrying increased risks due to airway manipulation and aerosol generation. Regional anesthesia (RA) offers a safer alternative by reducing viral transmission, preserving respiratory function, and providing superior postoperative analgesia with fewer pulmonary complications. Methods & Materials: This retrospective observational study was conducted in the Department of Anesthesiology in Mugda Medical College and Hospital, Dhaka, Bangladesh, over one year, from March 2020 to April 2021, enrolling 80 adult surgical patients with confirmed or suspected COVID-19 and underwent elective or emergency procedures under regional anesthesia (spinal, epidural, combined spinal-epidural, or peripheral nerve blocks). Data were analyzed using SPSS v26.0, with results presented as mean ± SD for continuous variables and percentages for categorical variables. Results: Among 80 COVID-19 surgical patients, the mean age was 45.2 ± 12.8 years, with male predominance (65%) and most classified as ASA II (57.5%). RT-PCR positivity was 80%, and 65% were symptomatic; hypertension (30%) and diabetes (25%) were common comorbidities. Elective surgeries comprised 75%, predominantly general surgery (45%). Spinal anesthesia was most frequent (65%), with 95% block success and 5% conversion to general anesthesia. Intraoperative hypotension (25%) and bradycardia (10%) were noted, while desaturation was rare (5%). Conclusion: This study highlights regional anesthesia as a safe and effective primary technique for COVID-19 surgical patients, ensuring stable intraoperative conditions, superior analgesia, and minimal complications. Its use reduces postoperative morbidity and healthcare provider exposure, supporting its role as the preferred anesthetic approach in pandemic surgical care
subject: Original Article
  topic: section
subject: COVID-19
  topic: keywords
subject: Regional anesthesia
  topic: keywords
subject: General anesthesia
  topic: keywords
subject: Anesthetic techniques
  topic: keywords
creator: S M Ikbal Kabir
creator: Morsheda Yasmin Tamanna
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 390
ending page: 395
doi: 10.5281/zenodo.17582937

Impact of Body Mass Index on Acne Severity – Findings from a Hospital-Based Cross-Sectional Study (100 Cases)
type: item
description: Background: Acne vulgaris is a common chronic inflammatory disorder of the pilosebaceous unit, mainly affecting adolescents and young adults. Its pathogenesis involves hormonal, genetic, and microbial factors, with recent evidence suggesting a possible role of metabolic parameters like Body Mass Index (BMI). However, the association between BMI and acne severity remains inconsistent across studies. Objective: To evaluate the relationship between BMI and acne severity among patients attending the dermatology outpatient department of a tertiary care hospital. Methods & Materials: A hospital-based cross-sectional study was conducted on 100 clinically diagnosed acne vulgaris patients aged 15–35 years. Demographic and anthropometric data were recorded, and BMI was calculated as weight (kg)/height (m²) and categorized per WHO standards. Acne severity was assessed using the Global Acne Grading System (GAGS). Data were analyzed using SPSS version 26, applying chi-square and Pearson’s correlation tests. A p-value <0.05 was considered significant. Results: The mean age was 21.8 ± 3.4 years, with a female-to-male ratio of 1.38:1 and a mean BMI of 24.3 ± 3.7 kg/m². Moderate acne was most common (40%), followed by mild (29%), severe (22%), and very severe (9%). A significant positive association was found between higher BMI and greater acne severity (χ² = 12.87, p = 0.01), with a moderate positive correlation (r = 0.32, p = 0.01). Conclusion: Elevated BMI is significantly associated with increased acne severity, highlighting the potential role of weight management in acne control.
subject: Original Article
  topic: section
subject: Acne vulgaris
  topic: keywords
subject: Body Mass Index
  topic: keywords
subject: Acne severity
  topic: keywords
subject: Global Acne Grading System (GAGS)
  topic: keywords
subject: Obesity
  topic: keywords
subject: Cross-sectional study
  topic: keywords
subject: Dermatology
  topic: keywords
subject: Metabolic factors
  topic: keywords
creator: Jannatul Sharmin Joarder
creator: A S M Rowshon Alam
creator: Fahmida Zebin
creator: S M Hasinur Rahman
creator: Abdul Hasib Joarder
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 385
ending page: 389
doi: 10.5281/zenodo.17538494

Evaluation of Lower Tibial Metaphyseal Plate Osteosynthesis with or without Fixation of Lateral Malleolar Fracture – A Prospective Study
type: item
description: Background: Distal tibial metaphyseal fractures, with or without associated lateral malleolar fractures, are common injuries resulting from high-energy trauma. The role of fibular fixation in improving stability and outcomes remains debated. Objective: To evaluate the functional and radiological outcomes of plate osteosynthesis of distal tibial metaphyseal fractures with or without fibular fixation in 40 patients. Methods & Materials: A prospective study was conducted on 40 patients with distal tibial metaphyseal fractures, managed by plate osteosynthesis. Patients were divided into two groups: Group A (n=20) – tibial fixation only; Group B (n=20) – tibial fixation with fibular plating. Functional outcome was assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and radiological union was monitored over 12 months. Results: Mean union time in Group A was 19.2 weeks vs. 17.6 weeks in Group B. Malalignment (>5°) occurred in 4 patients (Group A: 3, Group B: 1). Mean AOFAS scores at final follow-up were 84.3 (Group A) vs. 88.6 (Group B). Complications included superficial infection (3 cases), delayed union (2 cases), and ankle stiffness (2 cases). Conclusion: Fibular fixation in addition to tibial plating provides better alignment and marginally faster union, with improved functional outcomes. However, differences were not statistically significant. Selective fibular fixation may be considered, especially in cases with instability or comminution.
subject: Original Article
  topic: section
subject: Distal Tibial Metaphyseal Fracture
  topic: keywords
subject: Osteosynthesis
  topic: keywords
subject: Fibular Fixation
  topic: keywords
subject: Ankle Stability
  topic: keywords
subject: Plate Fixation
  topic: keywords
creator: Abdul Kader
creator: Abu Zaker Hossain Sarker
creator: Sultan Mahmud
creator: Moktaruzzaman
creator: Sazzad Hossain
creator: Uday Kumar Sarkar
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 381
ending page: 384
doi: 10.5281/zenodo.17538467

Prevalence of incidental findings in CT scan of paranasal sinuses
type: item
description: Background: The use of computed tomography (CT) scans has become a common diagnostic tool for evaluating the paranasal sinuses (PNS), particularly in patients presenting with symptoms such as chronic sinusitis, nasal obstruction, or facial pain. CT imaging offers detailed visualization of sinus anatomy and pathology, often leading to accurate diagnosis and management. Incidental findings (IFs) are unintentional discoveries unrelated to the imaging purpose. Imaging exams on people with suspected intracranial diseases may detect IFs in the PNS. Objectives: The aim of the study was to evaluate the prevalence of incidental abnormalities on computed tomographic scans of the paranasal sinuses. Methods & Materials: This cross-sectional study was carried out in the Department of Radiology & Imaging, Uttara Adhunik Medical College & Hospital, Dhaka, Bangladesh during January 2023 to December 2023. A total of 120 patients were participated in the study. Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: The age distribution showed that (14.16%) patients were under 20 years old, (20.0%) were between 21 and 40 years old and 48 (40.0%) were over the age of 61. The majority of the patients were male (58.33%) and (41.66%) being female. According to employment status, (15.83%) of patients were housewives, (10%) were businessmen, (7.5%) were retired officers and (34.16%) were service members. According to socioeconomic level, (58.33%) of the patients come from middle-class families, (24.16%) from low-income families and (17.60%) from middle-class families. Conclusion: Incidental abnormalities on paranasal sinus CT scans are common, though most findings are minor and unlikely to require intervention. Awareness of these incidental findings is essential to avoid unnecessary follow-up and treatment, particularly when abnormalities do not correlate with symptoms. Further research is w…
subject: Original Article
  topic: section
subject: Computed tomography (CT)
  topic: keywords
subject: Paranasal sinuses (PNS)
  topic: keywords
subject: Incidental findings (IFs)
  topic: keywords
creator: Ziaul Haq Bhuiyan
creator: Farhan Matin
creator: Mir Afsary Wahed
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 376
ending page: 380
doi: 10.5281/zenodo.17538463

Assessment of Knowledge and Practices Regarding Shoulder Mobilizing Exercises Among Frozen Shoulder Patients
type: item
description: Background: Frozen shoulder (adhesive capsulitis) is a common musculoskeletal condition characterized by pain and restricted shoulder movement. Adequate knowledge and consistent practice of shoulder exercises are essential for improving pain and mobility. This study aimed to assess patients’ knowledge and practice regarding shoulder exercises and to examine their association with patient-reported improvement. Methods & Materials: A cross-sectional descriptive study was conducted among 140 patients diagnosed with frozen shoulder at the Department of Physical Medicine and Rehabilitation, BIRDEM General Hospital, Dhaka, Bangladesh, from January to June 2024. Data were collected using a semi-structured questionnaire assessing socio-demographics, knowledge, and practice of shoulder exercises. Knowledge and practice levels were categorized as good, moderate, or poor. exercise adherence was assessed both via self-report and observation. Associations between education, knowledge, practice, and patient-reported improvement were analyzed using Chi-square tests, with p < 0.05 considered statistically significant. Results: The majority of participants were middle-aged (45–54 years, 40%) and female (58.6%). Overall, 32.1% had good knowledge, 51.4% moderate, and 16.4% poor knowledge regarding shoulder exercises. Regarding practice, 25.0% demonstrated good practice, 47.9% moderate, and 27.1% poor practice. Higher education was significantly associated with better knowledge (p = 0.02) and practice (p = 0.01). Patient-reported improvement was significantly associated with both knowledge (p = 0.011) and practice (p = 0.001), with 62.2% of patients with good knowledge and 71.4% of patients with good practice reporting improvement in pain or mobility. Conclusions: Although most patients had moderate knowledge and practice, better knowledge and adherence were strongly associated with improvement in frozen shoulder symptoms. Strategies to enhance patient education, guided exercise sessio…
subject: Original Article
  topic: section
subject: Frozen shoulder
  topic: keywords
subject: Adhesive capsulitis
  topic: keywords
subject: Shoulder exercises
  topic: keywords
subject: Knowledge
  topic: keywords
subject: Practice
  topic: keywords
subject: Adherence
  topic: keywords
subject: Patient-reported improvement
  topic: keywords
creator: Nadia Siddiquee
creator: A K M Asad-Ud- Doza
creator: Sanzida Akter
creator: Mohammad Rabiul Hasan
creator: Abul Khair Ahmad Zaman
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 368
ending page: 375
doi: 10.5281/zenodo.17538458

Exploring the Relationship between Dysmenorrhea and Mental Health Disorders in Young Women
type: item
description: Background: Dysmenorrhea, or painful menstruation, is a common gynecological condition among young women that can significantly affect their physical and psychological health. Emerging evidence suggests a potential link between dysmenorrhea and mental health disorders, yet limited data exist in the Bangladeshi context. Objective: To explore the relationship between dysmenorrhea and symptoms of depression, anxiety, and stress among young women attending outdoor in 250 Beded Sadar Hospital, Sirajganj. Methods & Methods: A cross-sectional study was conducted among 224 female respondents aged 16–24 years using a structured questionnaire. Dysmenorrhea severity was assessed using a Visual Analog Scale (VAS), and mental health status was evaluated using the Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed using SPSS version 25 with descriptive statistics and chi-square tests to assess associations. Results: The prevalence of dysmenorrhea was 91.5%, with 45.9% reporting moderate and 33.7% reporting severe pain. Among participants with moderate-to-severe dysmenorrhea, 62.4% had symptoms of depression, 71.3% had anxiety, and 59.6% reported stress. Statistically significant associations were found between dysmenorrhea severity and all three mental health domains (p < 0.05). Conclusion: The study reveals a strong association between dysmenorrhea and mental health disorders among young women. These findings highlight the need for integrated health strategies focusing on both menstrual and psychological well-being. Early screening, mental health counseling, and improved menstrual health education are essential to reduce the burden of dysmenorrhea-related mental health issues.
subject: Original Article
  topic: section
subject: Dysmenorrhea
  topic: keywords
subject: Depression
  topic: keywords
subject: Anxiety
  topic: keywords
subject: Mental Health
  topic: keywords
subject: Young Women
  topic: keywords
subject: Bangladesh
  topic: keywords
creator: Mst Tahmina Akter
creator: Rukhsana Yasmin
creator: Mst Shohela Pervin
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 362
ending page: 367
doi: 10.5281/zenodo.17538451

Evaluation of Psychiatric Types of Morbidities among the Caregivers with Dementia
type: item
description: Background: Globally, an estimated 30 million people suffer from dementia, a number expected to quadruple every 20 years. Dementia patients often require high levels of care, predominantly provided by unpaid family caregivers. Without caregivers, patients face lower quality of life, earlier institutionalization, and increased societal and economic burden. Objective: To assess the evaluation and types of psychiatric morbidities among caregivers of patients with dementia. Methods & Materials: A cross-sectional observational study was conducted from July 2022 to June 2023 at the Psychiatry departments of National Institute of Neuro Sciences & Hospital (NINS) and National Institute of Mental Health (NIMH) & Hospital, Dhaka. A total of 107 caregivers were recruited using purposive sampling. Data were collected via face-to-face interviews with a semi-structured questionnaire. Psychiatric morbidity was assessed using DSM-5 criteria and confirmed clinically. Data were analyzed with SPSS v24 using descriptive statistics and Chi-square tests for associations. Results: Most caregivers were female (68.2%), aged 28–37 years (52.3%), with the majority being housewives (36.4%). Most had no prior experience in caregiving for patients with dementia (88.8%) and were not physically abused by the patient (86%). Overall, 75.7% of caregivers had psychiatric morbidity. The most common conditions were Major Depressive Disorder (54.3%), Obsessive-Compulsive Disorder (16%), Generalized Anxiety Disorder (9.9%), Panic Disorder with Agoraphobia (7.4%), and Panic Disorder without Agoraphobia (3.7%). Social Phobia, Somatoform Disorders, and Eating Disorders were less frequent. No significant association was found between socio-demographic characteristics and psychiatric morbidity. Conclusion: Caregivers of dementia patients experience a high prevalence of psychiatric morbidity, particularly depression and anxiety, highlighting the need for targeted mental health support and interventions.
subject: Original Article
  topic: section
subject: Prevalence
  topic: keywords
subject: Psychiatric Morbidities
  topic: keywords
subject: Caregiver
  topic: keywords
subject: Dementia
  topic: keywords
creator: Fatema Zohra
creator: Abdullah Al Sayeef
creator: Nilufer Akhter Jahan
creator: Rifat Binte Alam
creator: Sifat Sharmin
creator: Syed E Shaude
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 356
ending page: 361
doi: 10.5281/zenodo.17538441

Vitamin D Deficiency among Children Visiting Outpatient Department in Bangladesh Shishu Hospital & Institute
type: item
description: Background: Vitamin D plays a crucial role in bone mineralization, immune function, and overall growth. Deficiency is a widespread public health concern, particularly among children in South Asia, including Bangladesh. Limited sun exposure and dietary insufficiency are recognized contributors, but the prevalence and associated risk factors remain underreported in pediatric outpatient populations. Aim of the study: To determine the prevalence, risk factors, and clinical impact of vitamin D deficiency among children attending outpatient departments of Bangladesh Shishu Hospital & Institute. Methods & Martials: A cross-sectional study was conducted from From January 2024 to December 2024 on 210 pediatric patients (<18 years) using purposive sampling. Demographic, clinical, and lifestyle data were collected via structured questionnaires. Serum 25-hydroxyvitamin D [25(OH)D] was measured using chemiluminescent immunoassay and classified as deficient (<20 ng/mL), insufficient (20–29 ng/mL), or sufficient (≥30 ng/mL). Associations with age, sex, BMI, sunlight exposure, and season were analyzed using chi-square tests and multivariable logistic regression. Result: Vitamin D deficiency was observed in 59.5% of participants, and 26.2% had insufficient levels. Deficiency was most prevalent during winter and spring and was significantly associated with limited sunlight exposure (<2 hours/day). Age, sex, and BMI were not independent predictors of deficiency. Conclusion: Vitamin D deficiency is highly prevalent among children attending outpatient departments in Dhaka. Environmental and lifestyle factors, particularly inadequate sunlight exposure and seasonal variation, are key contributors. Routine screening, safe sun exposure, and dietary or supplemental interventions are recommended to prevent adverse musculoskeletal and immune outcomes.
subject: Original Article
  topic: section
subject: Vitamin D deficiency
  topic: keywords
subject: Pediatric
  topic: keywords
subject: Sunlight exposure
  topic: keywords
subject: Bangladesh
  topic: keywords
subject: 25-hydroxyvitamin D
  topic: keywords
creator: Luna Parveen
creator: Mahmudul Hoque Chowdhury
creator: Sumaiya Liza
creator: Delara Sultana
creator: Kinkar Ghosh
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 351
ending page: 355
doi: 10.5281/zenodo.17538432

Asymptomatic Cardiac Arrhythmias in Maintenance Hemodialysis – Frequency, Causes, and Patterns
type: item
description: Background: Cardiac arrhythmias are a major cause of morbidity and mortality in patients undergoing maintenance hemodialysis (MHD). Many arrhythmias remain asymptomatic and undetected, contributing to sudden cardiac death. Understanding their frequency, patterns, and predictors is crucial for improving patient outcomes. Aim of the study: To determine the frequency, types, and possible clinical and biochemical predictors of asymptomatic cardiac arrhythmias among patients receiving maintenance hemodialysis. Methods & Materials: This cross-sectional observational study was conducted at the Department of Nephrology, BSMMU, Dhaka, from April 2023 to September 2024. A total of 49 adult MHD patients meeting inclusion criteria underwent 24-hour Holter monitoring and echocardiographic evaluation. Demographic, clinical, and biochemical parameters were recorded and analyzed using SPSS (version 26). Logistic regression was applied to identify predictors of arrhythmia. Result: Asymptomatic arrhythmias were detected in 77.6% (PACs), 71.4% (PVCs), 59.2% (bradycardia), and 65.3% (tachycardia) of patients. Most events occurred during or immediately after dialysis. Lower post-dialysis magnesium (OR 0.007, 95% CI: 0.00–0.77, p=0.039) and potassium levels (OR 0.11, 95% CI: 0.01–0.84, p=0.033) were significant predictors for ventricular ectopy. Other factors, including age, diabetes, hypertension, and LVMI, were not independently associated. Conclusion: Asymptomatic cardiac arrhythmias are common in MHD patients, with electrolyte fluctuations—particularly reduced post-dialysis magnesium and potassium—serving as key contributors. Routine Holter monitoring and individualized dialysis prescriptions may help in early detection and prevention of fatal arrhythmias.
subject: Original Article
  topic: section
subject: Maintenance hemodialysis
  topic: keywords
subject: asymptomatic arrhythmia
  topic: keywords
subject: Holter monitoring
  topic: keywords
subject: magnesium
  topic: keywords
subject: ventricular ectopy
  topic: keywords
creator: Saiful Ahammad Sarker
creator: Omar Faroque
creator: Sharif Raihan Siddique
creator: S M Remin Rafi
creator: Mamun Chowdhury Raju
creator: Anjuman Ara Daisy
creator: Mohammad Kamrul Hasan
creator: Debabrata Ghosh
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 345
ending page: 350
doi: 10.5281/zenodo.17538429

Clinicopathological Profile of Pediatric Outpatients at Bangladesh Shishu Hospital & Institute – A Cross-Sectional Study
type: item
description: Background: Pediatric outpatient departments (OPDs) are critical for early diagnosis and management of childhood illnesses. Understanding the clinicopathological profile of pediatric outpatients is essential for guiding effective healthcare strategies and improving child health outcomes in resource-limited settings. Aim of the study: To analyze the clinicopathological profile of pediatric outpatients at Bangladesh Shishu Hospital & Institute, Dhaka, identifying prevalent diseases, clinical presentations, laboratory findings, nutritional status, and outcomes. Methods & Matrials: A hospital-based cross-sectional study was conducted over six months, enrolling 310 children below 15 years attending the pediatric OPD. Demographic data, clinical complaints, provisional diagnoses, laboratory findings, and nutritional status were recorded. Outcomes were categorized as conservative management, hospital admission, or specialist referral. Data were analyzed using SPSS version 26, with p≤0.05 considered statistically significant. Result: The mean age was 5.41 ± 3.97 years, with 55.5% males and 62.6% from urban areas. Fever (41.3%) and cough/cold (32.9%) were the most common complaints. Respiratory tract infections (36.1%) and gastrointestinal disorders (25.2%) predominated. Laboratory abnormalities were observed in hemoglobin (43.2%), WBC count (32.9%), and ESR (38.1%). Nutritional assessment revealed 41.3% of children were underweight, stunted, or wasted. Most children (69.0%) were managed conservatively, while 23.2% required admission. Conclusion: Respiratory and gastrointestinal illnesses remain the leading causes of pediatric outpatient visits, with a substantial burden of malnutrition and laboratory abnormalities. These findings emphasize the need for targeted preventive, diagnostic, and management strategies to optimize pediatric healthcare outcomes in Bangladesh.
subject: Original Article
  topic: section
subject: Pediatric outpatients
  topic: keywords
subject: Clinicopathological profile
  topic: keywords
subject: Dhaka Shishu Hospital
  topic: keywords
subject: Malnutrition
  topic: keywords
subject: Respiratory infections
  topic: keywords
creator: Luna Parveen
creator: Mahmudul Hoque Chowdhury
creator: Sumaiya Liza
creator: Delara Sultana
creator: Kinkar Ghosh
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 340
ending page: 344
doi: 10.5281/zenodo.17538425

Functional Outcomes of Closed Tibial Shaft Fractures Treated with Suprapatellar Intramedullary Nailing – A Prospective Study
type: item
description: Background: Tibial shaft fractures are among the most common long bone fractures with high incidence in young adults. Intramedullary nailing is the gold standard of fixation, and the suprapatellar approach has gained popularity due to technical advantages. Evidence on functional outcomes in closed fractures is still lacking, however. Objectives: The aim of this study was to assess the functional outcomes of closed tibial shaft fractures treated with suprapatellar intramedullary nailing. Methods & Materials: This prospective observational study was conducted in the Department of Orthopaedics, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Sher-E-Bangla Nagar, Dhaka, Bangladesh, for one year period from March 2022 to March 2023. Total 33 adult patients with closed tibial shaft fractures were enrolled. Results: In this study, mean age was 38.3 ± 11.6 years with male predominance (69.7%). Fractures of AO type 42A were most common (54.5%). The mean knee ROM at last follow-up was 130.3 ± 8.6°. The majority of patients (72.7%) had fair functional outcomes, 18.2% good, and 9.1% poor. The average VAS was 0.5, and anterior knee pain was complained of by only 15.2%. Lysholm scores improved significantly from 83.1 at 6 months to 93.8 at 12 months (p<0.001). Conclusion: Suprapatellar nailing for closed tibial shaft fractures produces good functional outcomes, few complications, and gradual improvement, justifying its use as a safe and effective method of fixation.
subject: Original Article
  topic: section
subject: Functional Outcomes of Closed Tibial Shaft Fractures Treated withSuprapatellar Intramedullary Nailing
  topic: keywords
creator: Kamruzzaman
creator: Golam Mahmud
creator: Mohtesham Ara
creator: Mohammad Nazmul Abedin
creator: Mahmudul Hasan
creator: Rakiz Khan
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-11-06
publication date: 2025-11-06
starting page: 335
ending page: 339
doi: 10.5281/zenodo.17538417

Comparative Outcomes between Off-Clamp and On-Clamp Nephron-Sparing Surgery – A Retrospective Analysis
type: item
description: Objective: To compare perioperative and functional outcomes between off-clamp and on-clamp techniques during nephron-sparing surgery (NSS). Methods & Materials: A retrospective study of 70 patients who underwent NSS for renal tumors between January 2020 and July 2025. Patients were divided into two groups: Off-Clamp NSS (Group A, n=34) and On-Clamp NSS (Group B, n=36). Data on operative time, estimated blood loss (EBL), warm ischemia time (WIT), complications, and renal functional outcomes (eGFR changes) were analyzed. Results: Group A showed significantly higher EBL (p=0.02) but better postoperative renal function preservation (mean eGFR drop: 5.6% vs 11.4%, p<0.001). Group B had shorter operative times and less intraoperative bleeding. No significant difference was observed in complication rates or oncologic margin positivity. Conclusion: Off-clamp NSS offers superior renal functional preservation compared to on-clamp NSS at the expense of higher blood loss. Patient selection remains crucial, and off-clamp NSS may be particularly beneficial in younger patients with baseline impaired renal function.
subject: Original Article
  topic: section
subject: Partial nephrectomy
  topic: keywords
subject: Off-clamp technique
  topic: keywords
subject: On-clamp technique
  topic: keywords
subject: Nephron-sparing surgery
  topic: keywords
subject: Warm ischemia
  topic: keywords
subject: Estimated blood loss
  topic: keywords
subject: Renal function preservation
  topic: keywords
subject: eGFR decline
  topic: keywords
subject: Positive surgical margin
  topic: keywords
subject: Perioperative outcomes
  topic: keywords
creator: Masud Rana
creator: N I Bhuiyan
creator: Abu Sayed
creator: M A Arafat
creator: Hasibul Islam
creator: Muntasir Chowdhury
rights: Copyright (c) 2025 The Insight https://creativecommons.org/licenses/by/4.0
date: 2025-10-17
publication date: 2025-10-17
starting page: 333
ending page: 334
doi: 10.5281/zenodo.17379087