Medico Research Chronicles
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Case Report — Guttate psoriasiform eruptions in a 10 year old child
No full textA 10‑year‑old boy presented with a 4–5 year history of widespread papular, guttate psoriasiform eruptions with severe scalp involvement and persistent pruritus. Prior allopathic topical and antifungal therapies produced limited benefit. Treated under individualized classical homeopathy along with dermatologic supportive measures, the case showed gradual clinical improvement over 18 months with reduction in erythema, scaling and pruritus and stabilization of new lesion formation. We present history, totality, repertorisation, remedy selection, follow‑ups and outcome measures
Karyotype Analysis among Selected Bangladeshi Azoospermic Male Infertile Patients
Full text linkBackground: Male infertility is a global health concern, with genetic factors playing a crucial role in its etiology. Azoospermia, the absence of sperm in ejaculate, is often associated with chromosomal abnormalities. Karyotyping is a key diagnostic tool for identifying chromosomal alterations linked to male infertility. This study aimed to evaluate the karyotypic profiles of Bangladeshi azoospermic male infertile patients, highlighting the prevalence and clinical implications of chromosomal abnormalities.
Methods: This cross-sectional descriptive study was conducted at the Genomic Research Laboratory, Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 2022 to February 2023. Sixty-four azoospermic male patients aged 21–60 years were recruited through purposive sampling. Karyotyping was performed using the Giemsa banding (G-banding) technique following ISCN (2009) guidelines. Hormonal profiling and ultrasonographic assessments were conducted to evaluate testicular and endocrine abnormalities. Data analysis was performed using IBM SPSS Statistics (version 25).
Results: Among the 64 patients, 6.25% had Klinefelter syndrome (47,XXY), while 93.75% exhibited a normal karyotype (46,XY). Hormonal analysis showed that 6.3% of patients had abnormal testosterone, FSH, and LH levels, while 3.1% had abnormal prolactin and TSH levels. Ultrasonography revealed testicular abnormalities in 12.5% of patients, including bilateral small testes (6.25%) and epididymal cysts (3.1%). Antichlamydia antibodies were detected in 15.63% of patients, suggesting past or ongoing infections.Conclusion: This study underscores the importance of karyotyping in azoospermic males, detecting Klinefelter syndrome in 6.25% of cases, aligning with global prevalence rates. Given that 93.75% had a normal karyotype, further genetic screening, including Y-chromosome microdeletion analysis and whole-genome sequencing, is recommended. Integrating karyotyping, molecular diagnostics, and genetic counseling into infertility management can improve clinical decision-making and reproductive outcomes
Precision Anesthesia: Nalbuphine-Levobupivacaine vs. Fentanyl-Levobupivacaine in Spinal Blocks
Full text linkBackground: Intrathecal adjuvants enhance the efficacy of local anesthetics in spinal anesthesia. This study compared nalbuphine and fentanyl as adjuvants to hyperbaric levobupivacaine for lower abdominal surgeries.
Methods: In this prospective, randomized, double-blind study, 100 ASA I-II patients undergoing lower abdominal surgeries were allocated into two groups: Group LN (n=50) received 15 mg of 0.5% hyperbaric levobupivacaine with 0.8 mg nalbuphine intrathecally, and Group LF (n=50) received 15 mg of 0.5% hyperbaric levobupivacaine with 25 μg fentanyl intrathecally. Onset and duration of sensory and motor blockade, hemodynamic parameters, postoperative analgesia using Visual Analog Scale (VAS), and adverse effects were assessed.
Results: The onset of sensory block (2.795±0.599 min in Group LN vs. 2.625±0.562 min in Group LF; p=0.921) and time to complete motor block (10.38±1.081 min vs. 10.59±1.004 min; p=0.766) were comparable between groups. The duration of sensory block (282.29±23.09 min vs. 306.88±29.06 min; p=0.0001) and motor block (178.46±7.59 min vs. 242.96±39.17 min; p=0.0001) were significantly longer in Group LF. VAS scores were significantly lower in Group LN at 1.5, 2, 2.5, and 3.5 hours postoperatively (p<0.05). Hemodynamic parameters remained largely stable in both groups. The incidence of adverse effects was comparable, with pruritus observed exclusively in Group LF (4%).
Conclusion: Fentanyl provided prolonged sensory and motor blockade, while nalbuphine offered better early postoperative analgesia with faster motor recovery and absence of pruritus. Both adjuvants maintained hemodynamic stability with minimal adverse effects, suggesting their selection should be tailored to specific surgical requirements and desired recovery profiles
Efficacy of the Posterior Urethral Incision Technique (PUIT) in Urethrocutaneous Fistula Repair Following Hypospadias Surgery
Full text linkBackground: Urethrocutaneous fistula (UCF) is the most common complication following hypospadias repair, often requiring secondary surgical intervention. Despite advancements in surgical techniques, recurrence remains a significant challenge. The Posterior Urethral Incision Technique (PUIT) has been proposed as an alternative approach to improve UCF repair outcomes. This study evaluates the efficacy of PUIT in reducing UCF recurrence following hypospadias surgery. Methods: This prospective interventional study was conducted in the Pediatric Surgery Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh, from January 2017 to April 2018. A total of 30 patients aged 1–12 years with single UCF at least 6 months post-urethroplasty were included. PUIT was performed in all cases, and outcomes were assessed based on fistula closure rates and recurrence. Data were analyzed using SPSS version 26, with a significance level of p < 0.05. Results: The most common site of UCF was the coronal region (40%), followed by distal penile (33.3%), mid-penile (13.3%), and proximal penile (13.3%) sites. The overall success rate of PUIT was 83.3%, with 5 patients (16.7%) experiencing recurrence. Recurrence was highest in coronal fistulas (40%), with a statistically significant association between fistula location and recurrence (p < 0.001). Conclusion: PUIT is an effective technique for UCF repair, achieving a high success rate and low recurrence rate. It improves tissue approximation and reduces suture line tension, making it a reliable approach for fistula closure. Further studies with larger sample sizes and longer follow-up periods are recommended to validate its long-term efficacy
Surgical Management of Non-malignant Cases by Tracheostomy in a Tertiary Care Hospital
Full text linkBackground: Tracheostomy is a commonly performed surgical procedure that involves creating an opening through the neck into the trachea to establish an airway. It can be performed for both malignant and non-malignant conditions. In non-malignant cases, tracheostomy is typically indicated in scenarios where long-term airway management is necessary, and it is often performed in tertiary care hospitals, where specialized expertise is available. Objectives: The aim of the study was to evaluate the surgical management of non-malignant cases by tracheostomy in a tertiary care hospital. Methods: This cross-sectional study was carried out in the Department of ENT, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during June 2022 to May 2023. A total of 100 patients participated in the study. Statistical analyses of the results were obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: In this study, according to the age distribution, 10% of the patients were aged 15 to 24 years. Furthermore, 38% were between the ages of 35 and 44, with 12% between the ages of 55 and 64. And the majority 57% of the patients were male, while 43% were female. According to the socioeconomic position of the study population, 27% come from low class, 42% from middle class, and 31% from high class families. Conclusion: The surgical management of non-malignant cases requiring tracheostomy in tertiary care hospitals is highly specialized and ensures optimal outcomes through a multidisciplinary approach
Verilich hair serum in reducing hair shedding: A Case Report series
Full text linkBackground: Hair shedding disorders, including Telogen Effluvium (TE) and Female Pattern Hair Loss (FPHL), are common dermatological concerns with limited effective treatment options. This case series evaluates the efficacy of Verilich hair serum in reducing hair shedding among female patients diagnosed with these conditions.
Methods: A clinical study was conducted on 20 female patients (aged 18–60) experiencing hair loss exceeding 80 strands per day. Patients underwent baseline assessments, including trichoscopic imaging, hair pull tests, and laboratory evaluations (thyroid profile, vitamin D, ferritin levels). Diagnoses were categorized based on hair diameter diversity, with TE defined by diversity <10% and FPHL by diversity >10%. Enrolled participants applied 1ml of Verilich serum twice daily for one month. Efficacy was measured by comparing pre- and post-treatment daily hair loss counts, with a ≥40% reduction considered a positive response.
Results: After one month of Verilich serum application, 75% of patients exhibited a significant reduction in hair shedding (≥40% reduction in daily hair count). Among TE patients, those with acute TE showed a higher response rate than those with chronic TE (CTE). Patients with FPHL also experienced substantial improvements in hair fall reduction. No adverse effects were reported during the study.
Conclusion: Verilich hair serum demonstrated significant efficacy in reducing hair shedding in both TE and FPHL patients. The formulation, containing anti-inflammatory, antioxidant, vasodilatory, and hair growth-promoting ingredients, effectively reduced active shedding and improved overall hair health. These findings support its potential as a safe and well-tolerated treatment for diffuse hair loss disorders
A Case Study on the Psychosomatic Roots of Chronic Psoriasis
Full text linkPsoriasis is a chronic, immune-mediated skin disorder marked by well-demarcated erythematous plaques with silvery-white scales. This case paper presents the journey of a 41-year-old female patient who had been suffering from psoriasis since adolescence, a notable correlation with periods of emotional stress, a constitutional homeopathic approach was employed at Dr Batra’s. Over the treatment course, patient experienced not only physical healing but also emotional well-being and restored self-esteem. This paper underscores the importance of individualized homeopathy in managing chronic autoimmune conditions like psoriasis where suppression and recurrence are common challenges
Managing Post-COVID Diffuse Hair Thinning through homeopathy at Dr Batra’s
Full text linkHair thinning is a progressive condition characterized by reduced hair volume and density, often caused by a combination of genetic, hormonal, environmental, and post-infectious factors. In the homeopathic system of medicine, hair thinning is understood through an individualized, holistic lens that takes into account genetic predisposition, mental and emotional states, past illnesses, and miasmatic background. This paper presents a case of a young male who developed hair thinning following a COVID-19 infection. The case highlights the patient’s positive clinical response to individualized homeopathic care and integrative therapy, emphasizing the efficacy of a non-invasive approach in addressing chronic hair conditions at Dr Batra’s
Young Sudden Cardiac Death in Athletes – Genetics, screening controversies, and prevention
Full text linkBackground and Objectives: Sudden cardiac death (SCD) in young athletes remains a devastating event with significant prevention potential through genetic understanding and screening strategies. This systematic review synthesizes current evidence on genetic factors, screening controversies, and prevention approaches for SCD in athletes under 35 years.
Methods: We conducted a comprehensive systematic review following PRISMA guidelines, searching PubMed, Embase, Cochrane Library, and Web of Science from 2000-2025. Studies examining genetic causes, screening methods, and prevention strategies for athletic SCD were included. Random-effects meta-analysis was performed where appropriate, with quality assessment using Newcastle-Ottawa Scale.
Results: Of 3,847 identified records, 127 studies involving 47,892 athletes from 34 countries were included. Pathogenic variants were identified in 56.5% of SCD cases, with sarcomere protein variants (33.7%) being most common, showing strongest association with structural heart disease (OR 4.7, 95% CI: 3.2-6.9). Comprehensive screening protocols detected conditions in 16.1 per 1000 athletes versus 3.8 per 1000 with basic screening. European programs demonstrated superior detection rates (16.8‰) but higher false-positive rates (8.7%) compared to American approaches (4.2‰ detection, 2.1% false-positive). Meta-analysis of ECG-inclusive screening showed pooled sensitivity of 73.4% (95% CI: 65.2-80.8%). Intervention strategies reduced SCD risk by 85% (HR 0.15, 95% CI: 0.09-0.25), with 5-year event-free survival of 98% versus 87% in controls.
Conclusions: Genetic factors contribute substantially to athletic SCD, with population-specific variations requiring tailored approaches. Comprehensive screening significantly improves detection rates despite increased false-positives. Evidence-based interventions dramatically reduce SCD risk, supporting implementation of systematic screening and risk-stratified management protocols
Immunotherapy & Myocarditis – Balancing cancer immunotherapy with cardiotoxicity risks
No full textBackground: Immune checkpoint inhibitor-associated myocarditis represents a rare but potentially fatal complication that significantly impacts both cardiovascular and oncological outcomes. The balance between cancer treatment efficacy and cardiotoxicity risk remains a critical clinical challenge.
Methods: We conducted a retrospective cohort study of 2,634 cancer patients receiving immune checkpoint inhibitor therapy between January 2018 and December 2023. Myocarditis was diagnosed based on clinical presentation, biomarker elevation, and imaging findings. Primary endpoints included myocarditis incidence and risk factor identification. Secondary endpoints encompassed cardiovascular outcomes, treatment response, and impact on cancer progression.
Results: Twenty-six patients developed myocarditis (incidence 0.99%, 95% CI: 0.65-1.44%). Median time to onset was 42 days (IQR: 21-78). Cases were classified as mild (30.8%), moderate (46.2%), or severe (23.1%). Peak troponin levels correlated strongly with severity (mild: 2.4 ng/mL vs. severe: 45.2 ng/mL, p<0.001). Complete resolution occurred in 69.2% of patients, with response rates inversely related to severity. In-hospital mortality was 11.5%, rising to 50% in severe cases. Myocarditis development significantly impacted oncological outcomes, with shorter median progression-free survival (4.2 vs. 8.9 months, HR 1.68, p=0.012) and overall survival (11.8 vs. 18.2 months, HR 1.54, p=0.044) compared to unaffected patients. No independent risk factors were identified in multivariable analysis.
Conclusions: Immune checkpoint inhibitor-associated myocarditis occurs in approximately 1% of patients, with severe cases carrying substantial mortality risk. Early detection through biomarker monitoring and prompt treatment with corticosteroids can improve outcomes. However, permanent immunotherapy discontinuation significantly compromises cancer treatment outcomes, emphasizing the need for multidisciplinary cardio-oncology care and improved risk stratification strategies