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Nevin Manimala Statistics

Evaluation of Prognostic Findings in Newborns with Hypoxic Ischemic Encephalopathy: 5-Year Experience

Ther Hypothermia Temp Manag. 2025 Mar 31. doi: 10.1089/ther.2025.0011. Online ahead of print.

ABSTRACT

Hypoxic-ischemic encephalopathy (HIE) is a constellation of neurological signs as a result of hypoxia, hypercapnia, metabolic acidosis, and cerebral ischemia before birth. The aim was to evaluate risk factors, clinical and laboratory findings, and morbidity and mortality in neonates diagnosed with HIE who underwent therapeutic hypothermia (TH). Between January 2015 and December 2020, neonates diagnosed with HIE were evaluated in the neonatal intensive care unit. Risk factors, sociodemographic characteristics, degree of encephalopathy, clinical and laboratory findings, results of amplitude-integrated electroencephalography (aEEG), electroencephalography (EEG), magnetic resonance imaging (MRI) including diffusion weighted imaging (DWI) and cranial ultrasound (cUS), and mortality were retrospectively recorded. Of the 81 cases, we followed up with a diagnosis of HIE. When the patients were divided into groups and evaluated according to the Sarnat & Sarnat staging system, it was observed that 22 (27.2%) of the patients had mild HIE, 49 (60.5%) of the patients had moderate HIE, and 10 (12.3%) of the patients had severe HIE. The aEEG, EEG, DWI, and renal pathology of patients with seizures were statistically significantly higher than those of patients without seizures (p = 0.004, p = 0.002, p = 0.014, p = 0.025). MRI was performed in 66 patients within the first 7 days of life, and diffusional restriction was found in 22 of them. We found that DWI is superior to cUS in determining the severity of hypoxic injury and that renal involvement may be associated with poor neurodevelopmental outcomes. Due to the abnormal prognostic findings detected in infants with mild HIE, the existence of a standard definition of mild HIE that will determine the efficacy and reliability of therapeutic hypothermia will enable at risk infants to benefit from neuroprotective strategies.

PMID:40160108 | DOI:10.1089/ther.2025.0011

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The use of palliative care by people of Islamic faith and their preferences and decisions at the end of life: A scoping review

Palliat Support Care. 2025 Mar 31;23:e84. doi: 10.1017/S1478951525000148.

ABSTRACT

OBJECTIVES: The use of palliative care (PC) services from people of Islamic faith is seen limited. There are a fundamental lack of PC services appropriate to the target group and a lack of knowledge and acceptance. The transition from curative to PC is often perceived as problematic. Factors influencing PC use and end-of-life (EOL) decisions and preferences among people of Islamic faith are largely unclear.

METHODS: A scoping review was carried out using the methodology of the Joanna Briggs Institute. Studies of any design, published in English, German, or Arabic, and published by the end of August 2022, were eligible for inclusion. The systematic literature search was conducted in MEDLINE via PubMed, CINAHL, Cochrane Library, and Web of Science. Study statements were analyzed with a clear distinction between PC as EOL care and other EOL decisions, such as euthanasia, withdrawal, or withholding of one or more life-sustaining treatments or medications.

RESULTS: Sixty studies published between 1998 and 2022 were included. Only a few studies made statements about EOL care. The majority of studies focused on forms of euthanasia and indicated negative attitudes toward euthanasia, assisted suicide, and some other EOL decisions. Reasons for rejection include theological arguments, ethical and moral considerations, and others. Reasons for acceptance were principles of good death and dying, medical justifications, and others. The following barriers to the use of PC were identified laws and policies, lack of necessary resources, cultural norms and values, structure of the health-care system, communication and interaction between patients, relatives, and health-care staff, and others.

SIGNIFICANCE OF RESULTS: This review identifies the preferences for and difficulties in making EOL decisions and identifies barriers to specific PC for the Muslim population. Findings suggest how these barriers might be overcome.

PMID:40160101 | DOI:10.1017/S1478951525000148

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Unraveling the anoikis-cancer nexus: a bibliometric analysis of research trends and mechanisms

Future Sci OA. 2025 Dec;11(1):2484159. doi: 10.1080/20565623.2025.2484159. Epub 2025 Mar 31.

ABSTRACT

BACKGROUND: Cancer, influenced by genetics and the environment, involves anoikis, a cell death mechanism upon extracellular matrix detachment crucial for metastasis. Understanding this relationship is key for therapy. We analyze cancer and anoikis trends using bibliometrics.

METHODS: A search was conducted from Web of Science Core, PubMed, Scopus and non-English databases such as the CNKI (inception- 21 December 2024). Data analysis employed Microsoft Excel, VOSviewer, CiteSpace, R software, and the online platform (https://bibliometric.com/).

RESULTS: 2510 publications were retrieved, with a significant increase in the last decade. China led, the University of Texas system was productive, and the Oncogene Journal was popular. Breast, and colorectal cancers were frequently studied. Among them, representative tumor-related mechanisms were identified, commonalities such as (EMT, ECM, autophagy) and respective specific mechanisms were summarized.

CONCLUSION: This bibliometric analysis highlights rapid advances in anoikis research in cancer, emphasizing EMT and FAK pathways’ translational potential, guiding targeted therapies, and improving cancer treatment outcomes.

PMID:40160087 | DOI:10.1080/20565623.2025.2484159

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Association of High Sensitivity C-reactive protein (hs-CRP) Levels with Microalbuminuria in Type 2 Diabetic Patients

Mymensingh Med J. 2025 Apr;34(2):554-561.

ABSTRACT

High sensitivity C-reactive protein (hs-CRP) is a well-characterized marker of low grade systemic inflammation. Microalbuminuria is an established marker of vascular endothelial damage. There are evidences that nephropathy in type 2 diabetics develops due to sustained chronic low grade inflammation and vascular endothelial dysfunction. The objective of the study was to find out the association of serum high sensitivity C-reactive protein (hs-CRP) levels with microalbuminuria in type 2 diabetic patients. This cross-sectional observational study was carried out in outpatient departments of Nephrology and Endocrinology of Mymensingh Medical College Hospital, Mymensingh. One hundred (100) type 2 diabetic patients in the age group 30 to 70 years with at least one year duration were included in the study. FBS, Serum creatinine, Serum hs-CRP level and Albumin-creatinine ratio (ACR) were measured in these subjects. It was observed that higher level of hs-CRP found in subjects with microalbuminuria. Majority (93.2%) were with microalbuminuria >50mg/gm with hs-CRP >3mg/L. There is statistically significant association between microalbuminuria and hs-CRP (p<0.001). The Pearson correlation test also showed positive correlation between hs-CRP level and microalbuminuria (r=0.876; p<0.001). There were also statistically significant (p<0.05) relationship between microalbuminuria and FBS, HbA1c as well as serum creatinine. This study concludes that microalbuminuria accompanied by elevated hs-CRP in Type 2 diabetic patient suggesting activation of inflammatory pathways. The importance of early detection, monitoring of inflammatory marker hs-CRP and ACR as predictors of diabetic nephropathy can help in modulating diabetes and its complications.

PMID:40160077

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Does Vitamin D₃ Supplementation Improve Cardiac Autonomic Nerve Function in Vitamin D₃ Deficient Asthma COPD Overlap (ACO) Patients? A Randomized Clinical Trial

Mymensingh Med J. 2025 Apr;34(2):530-537.

ABSTRACT

Cardiac autonomic nerve dysfunction has been found associated with chronic obstructive pulmonary disease (COPD) patients as well as vitamin D₃ deficient patients. Heart rate variability (HRV), one of the markers of cardiac autonomic nerve function which is reduced in Asthma COPD overlap (ACO) patients. Sympathovagal balanced was improved in healthy subjects after administration of vitamin D₃. This randomized clinical trial aimed to observe the therapeutic effect of vitamin D₃ supplementation on non linear measures of HRV in 60 male vitamin D₃ deficient (<30 – 10 ng/ml) ACO patients. Patients were given orally either vitamin D₃ capsule or placebo per week for 6 months and serum vitamin D₃ level and non linear measures of HRV were assessed before and after intervention. HRV was measured by power lab 8/35, AD instruments and vitamin D₃ was assessed by chemiluminescent micro-particle immunoassay (CMA) method by auto analyzer. For statistical analysis paired sample ‘t’ test and independent sample ‘t’ test were done. Before intervention vitamin D₃ level and non linear parameters of HRV were similar in all patients but both these outcome measures significantly increased in vitamin D₃ treated but not in placebo treated patients after 6 months. In conclusion, vitamin D₃ supplementation is effective to improve HRV in vitamin D₃ deficient ACO patients.

PMID:40160074

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Prevalence and Predisposing Factors Heralding Retinopathy of Prematurity in Premature and Very Low Birth Weight Babies at a Tertiary Level Hospital of Bangladesh

Mymensingh Med J. 2025 Apr;34(2):519-529.

ABSTRACT

Several studies are being conducted worldwide to find out the prevalence of Retinopathy of prematurity (ROP) and any associated risk factors amongst preterm infants with very low birth weight (VLBW), birth weight ≤1500gm and Extreme low birth weight (ELBW) birth weight ≤1200gm. At the SCABU (Special Care Baby Unit) of Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh a prospective observational study was conducted from October 2016 to March 2017. Newborns with a gestational age of 35 weeks or less at birth and a birth weight of 1500 gm or less admitted at SCABU in BIRDEM General Hospital were the study subjects. The percentage of newborns with ROP were 30.0% (27) amongst screened infants (n=90), where 81.5% (22) were among VLBW and 18.5% (5) were among ELBW infants. Out of them 22.2% (6) had stage I, 37% (10) at stage II, 29.6% (8) at stage III and 11.1% (3) infants had Aggressive Posterior ROP (APROP). It was also found that other than the common causes of developing ROP, frequent blood transfusion and use of mechanical ventilator may be potential risk factors for developing ROP. Comparable rate of ROP was found between the SCABU of BIRDEM to the other Neonatal care units in Bangladesh. Factors other than prematurity and oxygen supplementation were found to play a role in the development of ROP i.e. blood transfusion and mechanical ventilation. Hence ROP screening should be a part of the routine service for premature babies and the threshold for screening should be lowered.

PMID:40160073

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Forensic Profiling of Deaths due to Suffocation

Mymensingh Med J. 2025 Apr;34(2):509-512.

ABSTRACT

Though the cases of suffocation are not frequently encountered, its frequency is increasing gradually. Objective of the study was to determine the cause, variety and manner of death in case of suffocation. This is a cross-sectional variety of descriptive study and was performed in the Department of Forensic Medicine at Dhaka Medical College, Dhaka, Bangladesh from January 2018 to December 2019. A proforma was drawn up in which different data were tabulated and analyzed. Thirty four (34) cases of suffocation were found of the total 2199 medicolegal autopsies. The age group of 31-40 years i.e. in 17 cases (50.0%) was mainly affected. Twenty one (21) male victims (61.76%) outnumbered the females. Among all suffocation cases smothering was on top i.e. in 18 cases (52.94%). Causes of death in suffocation were principally smothering by pillows in 11 cases (32.35%). Homicidal cases were determined in 22 cases (64.70%). This study reflects the dimensions of death due to suffocation.

PMID:40160071

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Association of Serum Gamma Glutamyl Transferase with Gestational Diabetes Mellitus

Mymensingh Med J. 2025 Apr;34(2):502-508.

ABSTRACT

Gestational diabetes mellitus (GDM) is the most common metabolic disorder resulting in adverse consequences on both maternal and fetal outcome. Oxidative stress plays an important role in the pathophysiology of gestational diabetes mellitus by inducing insulin resistance in the peripheral tissue and impairing insulin secretion from pancreatic β-cell. Serum gamma glutamyl transferase (GGT) plays an important role in oxidative stress and recently it has been recognized as a marker of oxidative stress. GGT can be used as an indicator of the GDM. High level of GGT is a new risk factor for GDM, which is cheap, rapid and easily available parameter for monitoring the GDM patients. This case control study was carried out in the Department of Obstetrics and Gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from May 2019 to February 2020. A total of 76 pregnant women were enrolled in this study, out of which 38 women with GDM was considered as Group A and rest 38 women with normal pregnancy was considered as Group B. Gamma glutamyl transferase concentration was measured in all the study subjects. Statistical analysis of the results was obtained by using Microsoft Excel and Statistical Packages for Social Sciences (SPSS-22.0). The mean GGT was 25.0±7.46U/L with ranged from 13-41U/L in Group A and 12.95±3.23U/L with range from 7-19U/L in Group B. The difference was statistically significant between two groups. A positive significant Pearson’s correlation was found between FBS and GGT in Group A. There was also positive significant Pearson’s correlation found between 2 hours ABF with GGT in Group A. In Group A serum GGT level >16U/L had 4.42 times significantly increased to develop GDM. GGT was higher in GDM group than normal pregnancy. Monitoring GGT levels in pregnancy may help to identify women with increased risk of developing GDM.

PMID:40160070

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Factors for Quitting Tobacco Consumption among the Male Bangladeshi Garments Workers: A Cross Sectional Study

Mymensingh Med J. 2025 Apr;34(2):469-475.

ABSTRACT

Despite enormous adverse effects, tobacco consumption is increasing with very little success of cessation programs. This is very important to have update knowledge regarding the factors attributed to the failed attempts for quitting tobacco consumption. The study was intended to find out the factors associated with quitting tobacco consumption among the male Bangladeshi garments workers. A descriptive cross-sectional study was carried out among 451 randomly selected workers of four purposively selected garments at Gazipur and Savar, Dhaka. After permission from the garments authorities and informed verbal consent from the selected respondents, data were collected by principal investigator using pre-tested interview schedule through face-to-face interview with privacy. After completion of each interview, questionnaire was cross-checked for completeness, consistency and discrepancy. Participants had freedom to withdraw from the study at any time without explaining any reason and data confidentiality was ensured strictly. The procedure did not have physical, mental and social risks. All other ethical issues and measures for data quality were taken into due consideration. Data were analyzed using computer software SPSS version 25.0 and presented in tables and diagrams. Nearly half 206(45.7%) of the workers were in age group 26 to 33 years with a mean of 28.85±8.03 years. Religion of 387(85.8%) respondents was Islam, while 278(61.6%) had completed secondary education. More than three-fifths 282(62.5%) of the workers were married with a mean family size of 4.24±1.44. As many as 379(84.0%) workers had monthly income less than 15000 Taka with a mean of 13212.86±1573.08 Taka. An overwhelming number 411(91.1%) of respondents started tobacco consumption within the age of 13 to 19 years with mean age of initiation of 16.18±2.67 years. Of 451 workers, 446(98.9%) made an effort to quit tobacco. Of them, for 286(64.1%) workers personal health problem was the influencing factor for quitting attempt. As many as 380(85.2%) workers preferred to quit tobacco consumption through reducing the consumption. Nearly three-fifths 264(59.3%) of workers were failed to quit due to bodily addiction. More than four-fifths 375(83.1%) workers affirmed that they could be able to quit tobacco. Nearly three-fourths 326(72.3%) workers did not consult doctor because they believed that they could do it by themselves. Over two-fifths 181(40.6%) of workers attempted for 4 to 10 times for quitting, while majority 213(47.8%) had maximum duration of abstinence for less than 1 week. It can be concluded that workers initiate smoking as teenagers. Personal health problems influence the workers in quitting tobacco. Moreover, they believed that they themselves are enough to do it without consultation with the physicians. A considerable number of workers had planned for quitting as well as attempted to do so more than once. However, all of them failed to do so due to bodily addiction.

PMID:40160066

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Health-seeking Behavior and Diagnostic Delay of Systemic Lupus Erythematosus in Patients of Bangladesh: A Hospital-Based Cross-Sectional Study

Mymensingh Med J. 2025 Apr;34(2):461-468.

ABSTRACT

Patients with systemic lupus erythematosus (SLE) often ignore the initial symptoms of the disease and delay in seeking medical care, which ultimately prolongs the diagnostic delay. The objective of the present study was to explore the health-seeking behavior and the factors associated with diagnostic delay in SLE patients. This cross-sectional study was conducted among 85 patients suffering from SLE who attended the Lupus Clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2012 to June 2013. Socio-demographic and disease-related data were collected by face-to-face interviews. Diagnostic delay was defined as the period of time from onset of initial symptoms of SLE and confirmation of diagnosis. Factors associated with diagnostic delay were determined by appropriate statistical test. Almost 75.0% of the patients visited qualified physicians and their average interval of seeking medical care after the onset of SLE symptoms was 1.4±2.6 months. The average interval between the onset of initial symptoms and the diagnosis of SLE was 12.3 (SD 13.9) months. It was longer in female patients (13.2 months versus 7.3 months in male). Early medical contact and visiting qualified physicians also shortened the diagnostic delay of SLE. Patients presenting with joint pain and fever had a longer diagnostic delay than those who presented with oral ulcers, malar rash and lupus nephritis. Patients’ health-seeking behavior, such as delayed medical care seeking, as well as presenting with nonspecific symptoms, such as fever and joint pain, which mimic other diseases, increases the diagnostic delay in SLE patients. These symptoms should be considered for the evaluation of immunological evidence of SLE.

PMID:40160065