Tag: statistics

Mymensingh Med J. 2025 Apr;34(2):453-460.

ABSTRACT

Functional dyspepsia is one of the most common gastrointestinal disorders. Immune activation by eosinophils is thought to be one of the important mechanisms behind the pathogenesis of functional dyspepsia. The study aimed to evaluate the association of gastric eosinophilia with functional dyspepsia. This cross-sectional study was conducted in the Department of Gastroenterology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh from July 2019 to June 2020. Forty-six (46) adult patients with functional dyspepsia diagnosed by Rome-III criteria were enrolled. Forty patients not fulfilling the criteria of functional dyspepsia and also patients attending the department for endoscopy (evaluation of anemia, pre-ERCP screening, evaluation of chronic diarrhea, etc.) and having normal endoscopic features subsequently were taken as comparison group. After endoscopy, a biopsy was taken from the gastric body and antrum of each participant. Counting of eosinophil and histopathology was done by an expert senior histopathologist. It was expressed in per HPF. Statistical analysis was done by SPSS 22.0 and p<0.05 was set as statistically significant. Mean±SD age was 40.34±16.22 and 40.15±13.96 in functional dyspepsia patients and patients taken for comparison respectively. Females were slightly predominant with a female-male ratio of 1.2:1. Lower middle-class families were found to be the most vulnerable group suffering from functional dyspepsia. The mean eosinophil count of gastric body and antrum in functional dyspepsia patients was higher than that of the comparison group. The difference between the two groups was statistically significant (p<0.001). A statistically significant relation was found between gastric eosinophilia (p=0.015, 0.016) with functional dyspepsia (p<0.001). Eosinophil count of gastric mucosa was significantly higher in functional dyspepsia patients and had an association with it. However, further study with a large sample size could explain this precisely.

PMID:40160064

Mymensingh Med J. 2025 Apr;34(2):447-452.

ABSTRACT

Covid-19 infection can affect the multiple-organ system. Acute kidney injury (AKI) is one of the complications and is associated with poor outcomes. Of many potential risk factors for the development of AKI, raised inflammatory markers are postulated to be responsible. A retrospective cohort study was conducted on 135 patients who were admitted in the ward and intensive care unit (ICU) from June 2020 to September 2020 in Enam Medical College and Hospital, Savar, Dhaka, Bangladesh. Patients aged ≥18 years with positive RT-PCR Covid-19 were included. AKI was defined and staged according to KDIGO criteria. We evaluated the incidence of AKI, the demographic and laboratory markers associated with AKI in Covid-19 patients and the outcome. Univariate and multivariate analyses were performed. The incidence of AKI was 27.0% (36). Most of them were in stage 1(75.0%). The mean age of the cohort was 52.19±15.55 years and 68.0% were male (n=92). Of the comorbidities, diabetes mellitus was the commonest (46.0%). On progressive multivariate logistic regression, severe/critical Covid-19 (aOR 3.1, 95% CI: 1.09-8.93, p-value 0.033), requiring mechanical ventilation (aOR 2.7, 95% CI: 1.13-6.51, p-value 0.026) and raised D-dimer (aOR 3, 95% CI: 1.07-8.22, p-value 0.036) were identified as independent risk factors associated with AKI. A higher proportion of patients who developed AKI required ICU (50.0% versus 14.1%, p<0.0001) and were intubated (39% versus 13.0%, p=0.003). Overall, in-hospital mortality was 22(16.0%). In-hospital mortality was higher in patients with AKI (39 versus 8.0%, p<0.0001). Severe Covid-19, requiring mechanical ventilation and raised d-dimer are associated with AKI in Covid-19. Early identification of risk factors can reduce the incidence of AKI and death.

PMID:40160063

Mymensingh Med J. 2025 Apr;34(2):438-446.

ABSTRACT

Maternal Near Miss is a serious antagonistic event that leads to harm and morbidity in the mother, but from which she survives. Maternal mortality rate in Bangladesh has declined by 66.0% over last few decades, valued at a rate of 5.5% every year. Aim of the study was to determine the magnitude, pattern and predictors of Maternal Near Miss cases. This cross-sectional descriptive type of observational study was conducted at the Department of Obstetrics and Gynecology in Mymensingh Medical College Hospital, Bangladesh from January 2018 to December 2018. A total of 69 patients were included for the study. Patients were evaluated for cardiac arrest, jaundice, gasping, shock coagulation disorders, cerebrovascular accident and total paralysis. Serum lactate >5mmol/L, paO₂/ FiO₂ <200mm of Hg, pH <7.1 and statistical analysis was performed using computer- based software, statistical package for social science (SPSS) version 20.0. Maximum number was found 44.93% in the age groups 20-29 years, maximum were rural patients (84.05%), no formal education (55.07%) of couple were significantly higher in case of maternal near miss case. Rate of maternal near miss case among the admitted patients was 4.86%. Among the maternal near miss case pregnancy induced hypertension were most common (44.9%). Most of the patients of the maternal near miss case presented with excessive P/V bleeding (37.7%). Among the medical management most common interventions were infusion of MgSO₄ (31.9%). Regarding neonatal outcome, live birth was 47.82%. Common causes of maternal near miss case are pregnancy induced hypertension, obstetric hemorrhage, ruptured uterus and ruptured ectopic pregnancy, prolonged/obstructed labor, impending uterine rupture and infections.

PMID:40160062

Mymensingh Med J. 2025 Apr;34(2):408-411.

ABSTRACT

To assess the pattern of analgesics used for pain among the cancer patients attending outpatient department in a tertiary level hospital in Bangladesh. During the one year study period between July 2018 and June 2019, a cross sectional study was conducted in the Department of Pharmacology and Therapeutics with the collaboration of Department of Radiotherapy, Mymensingh Medical College Hospital, Mymensingh. A total of 323 patients were selected. Data were collected by interviewing the patients and their prescription. After completion of data collection, data analysis was done using SPSS version 24.0. Out of 323 patients, Step 1 analgesics (Paracetamol or other NSAIDs) were prescribed to 61.9% patients; 21.4% and 7.1% patients were treated with Step 2 (Tramadol) and Step 3 (Morphine) analgesics. Step 1 and 2 combined analgesics were prescribed to 9.6% patients. Among the adjuvant drugs, 22.9% prescribed drugs were antidepressants, corticosteroids (16.7%), anticonvulsants (14.9%), antispasmodics (9.6%), antianxiety (3.7%) and antipsychotics (2.2%). This study showed that using of WHO analgesic (pain relief) ladder; it is capable of controlling pain in more than 90.0% of patients.

PMID:40160058

Mymensingh Med J. 2025 Apr;34(2):395-399.

ABSTRACT

Elevated preoperative CA 15-3 level is directly related to tumor burden and independent prognostic factors for breast cancer. The importance of elevated CA 15-3 level is very significant in evaluating a case of breast tumor. To evaluate the correlation between elevated serum CA 15-3 level with axillary nodal involvement this cross-sectional study was done in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2019 to June 2019. In this study total 50 women of diagnosed carcinoma of the breast were enrolled according to the inclusion and exclusion criteria. Serum CA 15-3 was measured in the morning of operation and all patients underwent MRM by single surgeon and involvement of axillary lymph node on histology was recorded. Among the sample most of the patients were between 41-50 years of ages and ductal carcinoma was the most prevalent type. Axillary nodal involvement was 72.0% and average number of lymph node involved was 5.25±5.96. Serum CA15-3 levels was significantly higher in nodal involved patients than those without lymph node involvement, which was statistically significant (p<0.05). But higher number of patient with normal CA15-3 level are found to have lymph node metastasis, and this data was not statistically significant (p>0.05). So, elevated CA 15-3 level has significant positive predictive value but it has no significant negative predictive value for nodal involvement.

PMID:40160056

Mymensingh Med J. 2025 Apr;34(2):388-394.

ABSTRACT

The vermiform appendix is known to play a role in immune function due to its concentration of lymphoid tissue, specifically lymphoid follicles. These lymphoid follicles do not remain confined to the mucosa but push through the muscularis mucosa and invade the submucosa. By counting the number of lymphoid follicle with their location researchers can evaluate the immune status of the Bangladeshi population across different age and sex groups. This cross-sectional descriptive study was conducted at the Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh and specimen were collected from autopsy laboratory of the department of Forensic Medicine of Mymensingh Medical College, Bangladesh from October 2016 to March 2017. The collected specimen was categorized into four groups: Group A (up-to 20 years), Group B (21-40 years), Group C (41-60) years and Group D (above 60 years). For this study 10 specimens from each group (total 40) were collected. Then after several tissues processing permanent histological slides were made for microscopic examination. For estimation of the number of lymphoid follicle of the vermiform appendix in the entire stained sections were examined under microscope and the number of lymphoid follicle was counted (4x objective &10x eye piece) and their number was counted and noted. From these the mean number of lymphoid follicle per age group was calculated. After counting the total number of lymphoid follicles in a histological section, the number of lymphoid follicles was located in the lamina propria and extending into submucosa were noted. Then the percentage of lymphoid follicles extending into submucosa was calculated. The mean number of lymphoid follicle was 9.40±1.07, 9.10±0.74, 5.70±1.49 and 1.80±1.03 in Group A, B, C and D respectively. It was also observed that number of lymphoid follicle gradually decreased as age advanced. The mean difference of number of lymphoid follicle between Group A&B was statistically non significant at p = or >0.05 level and differences between Group B&C, C&D, A&C, B&D, A&D were statistically highly significant at p <0.001 level. The mean number of lymphoid follicle in male was higher (9.60±1.14 in Group A, 9.14±0.90 in Group B, 5.83±1.94 in Group C, 1.83±0.98 in Group D) than that of female (9.20±1.10 in Group A, 9.00±0.00 in Group B, 5.50±0.58 in Group C, 1.75±1.26 in Group D) but mean difference between sexes in different groups was statistically non significant at p = or > 0.05 level. In the present study, the correlation between number of lymphoid follicle and age of the individual were done. It was also observed that number of lymphoid follicle gradually decreases as age advances. There is negative correlation between age and the number of lymphoid follicle and this differences was statistically highly significant where, r = – 0.934, p value was 0.001. In this study the location of lymphoid follicle in the lamina propria was 84.0%, 86.8%, 91.2% and 94.4% in Group A, B, C and D respectively and lymphoid follicles were found to extend into submucosa was 16%, 13.2%, 8.8% and 5.6% in Group A, B, C and D respectively. Here we can see that in early age percentage of extension of lymphoid follicle from lamina propria to submucosa is more than in later age. It may be due to size of lymphoid follicle. Size of lymphoid follicle was more in early ages and less in later ages. Overall, the study noted a progressive decrease in the number of lymphoid follicles as age increased.

PMID:40160055

Mymensingh Med J. 2025 Apr;34(2):360-364.

ABSTRACT

One of the most catastrophic non-communicable diseases in the world is type 2 diabetes mellitus (DM). It results in financial loss, incapacity, and death. Fasting blood sugar is one of the diagnostic criteria for type 2 diabetes. Cholesterol is necessary for overall health but high cholesterol can be harmful leading to atherosclerotic disease. This study intended to determine the relationship between fasting plasma glucose and serum total cholesterol in patients with type 2 diabetes in the Mymensingh locality. This cross-sectional analytical study was carried out in the department of Physiology, Mymensingh Medical College, Bangladesh, from July 2023 to June 2024. A total 200 subjects age ranged from 30-65 years were selected and from them 100 were grouped as Control group, Group I (female without diabetes) and 100 were grouped as Study group, Group II (female with diabetes). The data were calculated and analyzed by using SPSS version 26. Laboratory analysis of fasting plasma glucose was done by GOD-POD method and serum total cholesterol by CHOD-POD method. Data were expressed in mean±SD and statistical significance of difference among the groups were calculated by unpaired Students ‘t’ test. Correlation of serum total cholesterol with fasting plasma glucose was done by Pearson’s correlation coefficient test. The mean value of fasting plasma glucose of control group and study group were 4.94±0.24 and 8.40±0.91 mmol/L respectively. The mean value of serum total cholesterol in control group and study group were 164.28±15.88 and 225.89±16.69 mg/dl respectively. In study group both values were significantly increased than control group. Fasting plasma glucose was positively correlated with serum total cholesterol. By this study we founded significant correlation of fasting serum glucose and serum total cholesterol in female with type 2 diabetes mellitus.

PMID:40160051

Mymensingh Med J. 2025 Apr;34(2):351-354.

ABSTRACT

Menopause, due to decrease level of estrogen in women between the ages of 45-55 years, is a natural process that is characterized by the complete stoppage of menstrual cycle is called menopause. Because of imbalance of hormone mainly estrogen the efficiency of life is disturbed as a result various postmenopausal syndromes such as irritability, night sweats, vaginal dryness, hot flushes, depression, sleep disturbance and headache can occur in this period. This study was done to evaluate the changes of Body mass index (BMI) and serum uric acid in postmenopausal women in comparison to reproductive women. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Bangladesh from January 2023 to December 2023. A total number of 200 healthy women were enrolled in this study. Among them, one hundred (100) female subjects were taken as control group (Group I) age ranges from 25-45 years and one hundred (100) female subjects were taken as study group (Group II) age ranges from 45-65 years. BMI was calculated by anthropometric measurement such as height and weight was taken in meter and kilogram respectively and serum uric acid is expressed in mg/dl. Output were expressed as mean±SD and by using unpaired students’ ‘t’ test, statistical significance of difference among the group was calculated. The mean±SD of BMI of Group I and Group II were 21.91±1.57 kg/m² and 26.92±2.06 kg/m² respectively. In the study group the mean±SD of BMI is notably increased in study group in comparison with control group. The mean±SD of serum uric acid of Group I and Group II were 4.18±1.33 mg/dl and 7.36±0.46 mg/dl respectively. In the study group the mean±SD of serum uric acid was notably increased in study group in comparison with control group. Postmenopausal women with higher BMI and serum uric acid caused by lower level of female sex hormone specially estrogen hormone increased the change of cardiovascular disease, stroke, chronic renal failure, type-2 diabetes mellitus, insulin resistance and metabolic syndrome. So, the assessment of this parameter is important for early detection and prevention of complication related to higher BMI and serum uric acid for leading a healthy life.

PMID:40160049

BMC Gastroenterol. 2025 Mar 29;25(1):206. doi: 10.1186/s12876-025-03798-y.

ABSTRACT

BACKGROUND AND AIM: Nonalcoholic fatty liver disease (NAFLD) with liver fibrosis is associated with liver-related mortality and cardiovascular disease. Estimated glucose disposal rate (eGDR), which is an insulin resistance-related index, is related to the mortality caused by NAFLD. This study aimed to investigate the predictive value of eGDR for liver fibrosis in patients with NAFLD.

METHODS: The data from the National Health and Nutrition Examination Survey 2017-2020.03 were analyzed in the present study. NAFLD was diagnosed using the controlled attenuation parameter (CAP) tests using FibroScan^® model 502 V2 Touch.

RESULTS: The data from 1585 individuals were analyzed, including 224 with significant fibrosis and 1361 with nonsignificant fibrosis. Individuals with significant fibrosis were older and had higher CAP values and lower eGDRs (both P < 0.01). A negative correlation was found between eGDR and stiffness degrees (odds ratio: 0.643, 95% confidence interval: 0.643-0.726, P < 0.001); the correlation was also significant after adjusting for age, sex, and ethics (P < 0.001). For participants with obesity and overweight, eGDR was negatively correlated with age, CAP, body mass index (BMI), waist circumference, C-reactive protein level, and white blood cell (WBC) count (all P < 0.05). The multivariate analysis revealed that age, eGDR, BMI, aspartate aminotransferase (AST), and WBC and platelet (PLT) counts (all P < 0.05) were independent risk factors for significant fibrosis. A model incorporating eGDR, BMI, age, AST, WBC, and PLT had an AUROC of 0.822, and was superior to conventional noninvasive scoring systems, including the AST-to-PLT ratio index, fibrosis-4 level, and gamma-glutamyl transpeptidase to platelet ratio for individuals with obesity (all P < 0.01).

CONCLUSION: Low eGDR was negatively correlated with liver fibrosis in individuals with NAFLD and obesity, and a model incorporating eGDR, BMI, age, AST, WBC, and PLT demonstrated strong predictive value for fibrosis evaluation.

PMID:40158190 | DOI:10.1186/s12876-025-03798-y

BMC Med Educ. 2025 Mar 29;25(1):458. doi: 10.1186/s12909-025-06978-2.

ABSTRACT

BACKGROUND: The Progress Test Medizin (PTM) is a formative test for medical students issued twice a year by the Charité-Universitätsmedizin Berlin. The PTM provides a numerical feedback based on a global view of the strengths and weaknesses of students. This feedback can benefit from more fine-grained information, pinpointing the topics where students need to improve, as well as advice on what they should learn in light of their results. The scale of the PTM, taken by more than 10,000 participants every academic semester, makes it necessary to automate this task.

METHODS: We have developed a seven-step approach based on large language models and statistical analysis to fulfil the purpose of this study. Firstly, a large language model (ChatGPT 4.0) identified keywords in the form of MeSH terms from all 200 questions of one PTM run. These keywords were checked against the list of medical terms included in the Medical Subject Headings (MeSH) thesaurus published by the National Library of Medicine (NLM). Meanwhile, answer patterns of PTM questions were also analysed to find empirical relationships between questions. With this information, we obtained series of questions related to specific MeSH terms and used them to develop a framework that allowed us to assess the performance of PTM participants and compose personalized feedback structured around a curated list of medical topics.

RESULTS: We used data from a past PTM to simulate the generation of personalized feedback for 1,401 test participants, thereby producing specific information about their knowledge regarding a number of topics ranging from 34 to 243. Substantial knowledge gaps were found in 14.67% to 21.76% of rated learning topics, depending on the benchmarking set considered.

CONCLUSION: We designed and tested a method to generate student feedback covering up to 243 medical topics defined by MeSH terms. The feedback generated with data from students in later stages of their studies was more detailed, as they tend to face more questions matching their knowledge level.

PMID:40158187 | DOI:10.1186/s12909-025-06978-2