International Journal of Research in Medical Sciences
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Prevalence of heart failure in dengue patients with concurrent capillary leakage syndrome, unveiling ‘leakage-failure coexistence’
Get PDFBackground: Dengue fever, a mosquito-borne viral infection, has been a growing global health concern with significant morbidity and mortality. Among the myriad complications that Dengue can manifest, capillary leakage syndrome has emerged as a particularly severe and challenging aspect of the disease.
Aim of the study: The aim of this study was to assess the prevalence of heart failure in dengue patients with concurrent capillary leakage syndrome.
Methods: This cross-sectional observational study was conducted in Department of Medicine, Khwaja Yunus Ali Medical Hospital, Sirajgonj, Bangladesh, during the period from July 2022 to June 2024. Out of 400 cases of dengue fever patients, 50 patients diagnosed with dengue fever with heart failure with concurrent capillary leakage syndrome were included in this study.
Result: This study of total 400 participants (mean age 35.4±12.6 years) revealed male predominance (64%, p=0.036) and urban residency (76%, p=0.017). The average presentation delay was 6.2 days, with 30% reporting prior dengue (p=0.025). Laboratory findings showed elevated hematocrit (48.5%±5.2%, p=0.012), hypoalbuminemia (1.8±0.4 g/dl, p=0.001), and raised NT-proBNP (1500 pg/ml, p=0.007), indicating CLS and cardiac stress. Echocardiography identified reduced LVEF (28%), myocarditis (22%), and arrhythmias (16%) on ECG. Predictors of heart failure included NT-proBNP (OR 4.2, p=0.002) and hypoalbuminemia (OR 3.5, p=0.004). Heart failure was present in 5%, highlighting the burden of CLS and cardiac dysfunction, necessitating improved diagnostics and multidisciplinary interventions.
Conclusion: This study highlights the multifaceted complications of CLS and cardiac involvement in dengue patients
A comparative study between primary resection anastomosis versus Hartmann’s procedure with colostomy in patients of colonic mass presenting with acute intestinal obstruction
Get PDFBackground: Acute intestinal obstruction is a life-threatening condition, with colonic masses being a significant cause. The choice of surgical procedure primary resection and anastomosis (PRA) or the Hartmann procedure (HP) with colostomy-depends on multiple factors, including patient stability and the extent of obstruction. Both techniques have distinct advantages and associated risks, with ongoing debate about their comparative outcomes in emergency settings.
Methods: A prospective observational study was conducted over 18 months at the Department of Surgery, B. J. M. C. and S. G. H. Pune. Sixty patients with colonic masses presenting with acute intestinal obstruction were analysed. Patients were divided into two groups: those undergoing PRA and those undergoing HP. Data on perioperative parameters, postoperative complications, and outcomes were collected and statistically analysed using statistical package for the social sciences (SPSS) version 18.0.
Results: Among the 60 patients, PRA was associated with shorter hospital stays (mean 7.57 days) compared to HP (mean 12.33 days; p=0.000). Postoperative wound infections occurred in 25% of patients, with higher rates in the HP group (33.3%) than the PRA group (16.7%). Colostomy-related complications were exclusive to the HP group (23.3%). There was no significant difference in mortality between the two groups (6.7% each), but PRA patients experienced a higher rate of anastomotic leaks (6.7%).
Conclusions: PRA offers faster recovery and fewer long-term complications in select patients, while HP remains safer for those with severe contamination or hemodynamic instability. Individualized patient assessment is crucial for determining the optimal surgical approach
The critical role of bone density in implant dentistry: a review article
Get PDFBone density is a crucial factor for the success of dental implants. A strong, dense jawbone provides the necessary foundation for the implant to fuse with the surrounding bone, a biological process called osseointegration. This direct connection between the implant and the bone is what makes it stable and ensures it lasts a long time. Without adequate bone density, which can be compromised by systemic conditions like osteoporosis or localized bone loss, the implant lacks a solid anchor. This can lead to poor primary stability, delayed healing, and a significantly higher risk of failure. To precisely assess this critical parameter, dentists rely on a classification system, such as the Misch classification, which categorizes bone quality into four distinct types, from D1 (dense cortical bone) to D4 (very fine trabecular bone). This detailed evaluation is essential as it directly informs the surgical procedure, guiding the clinician in selecting the optimal implant design and placement technique to ensure a predictable and successful outcome
Genomic landscape of hepatitis C virus in India: a systematic review and meta-analysis
Get PDFIn India, the prevalence of hepatitis C virus (HCV) infection ranges from 0.5% to 1.5%, with most infected individuals being asymptomatic and without jaundice. HCV is responsible for approximately 25% of liver-related disorders, including hepatocellular carcinoma (HCC) and liver cirrhosis, and is increasingly recognized as a cause of chronic liver diseases. Populations at high risk for HCV transmission include intravenous drug users (IDUs), renal transplant recipients, dialysis patients, and those receiving blood products. HCV is categorized into seven genotypes, each with various sub-genotypes, playing a crucial role in epidemiology and outbreak investigations. An extensive literature search was conducted in Scopus, PubMed, and Web of Science from January 2003 to December 2023, using keywords such as ‘hepatitis C’ and ‘genotype’ along with MeSH terms for refinement. Out of 739 retrieved articles, 20 articles fulfilled the inclusion criteria for analysis, with the mean age of participants being 41±4. A statistically significant difference (p<0.001) was found between gender and sample size. Notably, genotype 3 was most prevalent (45%), while genotype 1 and 3 showed equal prevalence (26%) in the North-Eastern region. It is essential to implement and monitor government initiatives like NVHCP to enhance understanding and public health regarding HCV
Inhaled insulin in diabetes management: a review of efficacy, safety, and patient-centered outcomes
Get PDFInhaled insulin offers a non-invasive alternative to subcutaneous insulin for managing diabetes mellitus. Technosphere insulin (TI), marketed as Afrezza, delivers ultra-rapid-acting insulin via the pulmonary route, facilitating rapid absorption and improved post-prandial glucose (PPG) control. Clinical trials have demonstrated that TI achieves non-inferior glycaemic control compared to subcutaneous rapid-acting insulins in both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), with notable reductions in HbA1c and enhanced PPG outcomes. TI’s fast onset (peak concentration ~15 minutes) and short duration reduce late hypoglycaemia risk. Studies also report improved patient satisfaction due to greater ease of use and reduced injection burden, supporting better treatment adherence. The most common adverse effect is mild, transient cough; small reversible declines in pulmonary function (FEV1) have been observed, necessitating careful patient selection and monitoring. Inhaled insulin is contraindicated in individuals with chronic lung diseases or recent smoking history. Future research should explore its use in paediatric and pregnant populations and assess long-term safety, adherence, and cost-effectiveness. With expanding evidence from trials like INHALE-3, inhaled insulin represents a valuable addition to the diabetes treatment landscape, particularly for patients seeking flexible and patient-centred insulin therapy
The effect of social media on body image, self-esteem, and social appearance anxiety among young adults
Get PDFBackground: Social media usage is growing rapidly among young adults, influencing body image, self-esteem, and appearance-related anxiety. Aim was to assess the relationship of social media usage with body image, self-esteem, and social appearance anxiety among young adults.
Methods: A cross-sectional study was conducted among 404 college students at Santosh Medical College and Hospital during the M.Sc. Clinical Psychology program. Purposive sampling was used. Tools included the social media use scale, Rosenberg self-esteem scale, body image satisfaction rating scale, and social anxiety questionnaire for adults (SAQ-A30). Data were collected using standardized procedures. Descriptive statistics (mean, standard deviation) were used to assess participant characteristics. Chi-square tests were used to examine the association between social media use and psychological variables. Data were analyzed using SPSS version 23 and MS Excel.
Results: There was a highly significant association between social media usage and all three psychological variables: body image dissatisfaction (χ2=297.99, p<0.01), low self-esteem (χ2=46.57, p=0.027), and social appearance anxiety (χ2=293.43, p<0.01). Social media usage (χ2=302.14, p<0.01) was strongly linked to poorer mental health outcomes.
Conclusions: The study highlights the psychological risks of high social media engagement among young adults. It reveals a significant relationship between social media use and body image dissatisfaction, low self-esteem, and high social appearance anxiety. Media literacy, mental health awareness, and promoting healthy online behaviour are essential for mitigating these effects
Effect of stress among school teachers
Get PDFBackground: Teachers are increasingly experiencing occupational stress, which may affect their psychological functioning and general health. In recent years, this concern has grown particularly among private school teachers, who face continuous academic, emotional, and administrative pressures. Understanding the nature and extent of stress in this population is crucial for identifying associated mental health patterns and guiding relevant psychological assessment. Aim was to evaluate the level of stress among private school teachers and examine its correlation with general health, personality traits, depression, anxiety, and psychological well-being. It was a cross-sectional study conducted in private schools in Ghaziabad, India.
Methods: The study included 375 full-time school teachers selected through purposive sampling. Standardized psychological tools used were the general health questionnaire (GHQ-12), Eysenck personality questionnaire (EPQ), depression anxiety stress scale (DASS-42), and Ryff psychological wellbeing scale. Data analysis was performed using SPSS-23. Descriptive statistics (mean and standard deviation) and Pearson correlation coefficients were used to assess associations between general health, personality traits, psychological well-being, and psychopathologies.
Results: Over 75% of teachers exhibited extremely severe levels of depression, anxiety, and stress. Approximately 67.6% showed moderate to severe general health concerns. High psychoticism (60.8%) and neuroticism (39.7%) scores were observed, with neuroticism significantly correlated with depression (r=0.160), anxiety (r=0.142), and stress (r=0.193), all at p<0.01. Only 32.8% of participants demonstrated high levels of psychological well-being.
Conclusions: The study reveals a substantial presence of psychological distress among private school teachers and significant associations with specific personality dimensions. These findings underline the importance of continued psychological evaluation and consideration of personality patterns when addressing teacher well-being
Simultaneous coronary artery and bilateral carotid artery stenting in the same setting: first ever experience in Bangladesh
Get PDFThe coexistence of coronary artery disease (CAD) and carotid artery stenosis (CS) is relatively common, particularly among elderly patients. However, the optimal management of patients with simultaneous severe CAD and bilateral CS remains a subject of clinical debate, as multiple treatment strategies exist. We present the case of a 66-year-old male who was admitted to the National Institute of Cardiovascular Diseases (NICVD), Bangladesh, with recurrent syncopal episodes and exertional chest pain. Diagnostic evaluation with Digital Subtraction Angiography (DSA) and Coronary Angiography (CAG) revealed bilateral severe internal carotid artery stenosis along with significant stenosis of the right coronary artery (RCA). The patient was successfully treated with a one-stage percutaneous intervention involving right coronary artery stenting followed by bilateral internal carotid artery stenting. To the best of our knowledge, this is the first documented case of such a simultaneous triple-vessel intervention in Bangladesh
Graph-based learning for sleep microarchitecture: a hybrid graph autoencoder and graph attention network approach
Get PDFBackground: Sleep plays a vital role in cognitive function, memory consolidation, and overall neurological health. Analysis of sleep microarchitecture including features such as sleep spindles, K-complexes, slow waves, and EEG bandpower components provides critical insights into sleep disorders and genetic diseases. However, the complex interactions between sleep architecture and underlying genetic abnormalities remain underexplored. This study aims to investigate these interactions by leveraging advanced graph-based deep learning methods to uncover hidden relationships within EEG signals.
Methods: We developed a graph autoencoder (GAE) combined with a Graph attention network (GAT) to analyze polysomnography (PSG) data from the National Children's Hospital (NCH) dataset. EEG epochs were modelled as graph nodes, while edges were constructed based on bandpower similarity between epochs, enabling dynamic representation of sleep activity. The GAE learned latent embeddings that capture subtle patterns in sleep microarchitecture, and the GAT applied attention mechanisms to classify and interpret relationships between EEG events, sleep disorders, and genetic abnormalities. Three core analyses were conducted: (1) identifying differences in sleep microarchitecture across sleep disorders, (2) detecting EEG event changes associated with genetic disorders, and (3) exploring shared patterns linking sleep and genetic abnormalities.
Results: The model achieved classification accuracies of 92.4%, 91.2%, and 88.6% across the three tasks, respectively. The approach successfully identified distinct EEG event patterns in subjects with co-occurring sleep disorders.
Conclusions: This work presents a scalable, automated, and interpretable framework for analyzing the interplay between sleep microarchitecture, sleep disorders, and genetic disorders
Clinicopathological mimics of accessory breast tissue: a case series with cytological and histological correlation
Get PDFAxillary swellings in young women present a broad differential diagnosis, from benign developmental anomalies such as accessory breast tissue (ABT) to neoplastic lesions including fibroadenoma and phyllodes tumor. This case series reports eight patients with varied clinical and pathological findings. Six women aged 19–28 years presented with unilateral or bilateral axillary swellings, with initial clinical impressions ranging from lipoma and lymphadenopathy to soft tissue tumors. Fine needle aspiration cytology (FNAC) was performed in all cases, followed by surgical excision and histopathological confirmation in most. Diagnoses included ABT in four patients, lactating adenoma in one, bilateral lipomas in one, benign phyllodes tumor in one and fibroadenoma in one. FNAC aided in narrowing the differential diagnosis, but definitive identification relied on excision and histopathology. Recognition of ABT and its mimickers is important, as these lesions can undergo physiological and pathological changes similar to normal breast tissue and misdiagnosis may lead to unnecessary anxiety or inappropriate management. This series highlights the value of correlating clinical, cytological and histopathological findings to ensure accurate diagnosis and optimal treatment of axillary swellings in young women