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@#Introduction: Understand the progression of colorectal cancer from the beginning until the advance stages is difficult and challenging. However, this could be overcome with a good animal model. Methods: In this study, a modified approach had been used to develop colorectal cancer model. The model was developed and monitored from colitis formation until the late stage of colorectal cancer. The changes of neutrophil lymphocyte ratio (NLR), serum microRNAs and infiltrate neutrophil in different stages of colorectal cancer were assessed in this study. Results: Results showed that the progression of the disease is correlated with NLR as early as the formation of colitis (r=0.121, p<0.026). Meanwhile, the size of the tumor at each stage is also associated with the NLR value (r=0.185, p<0.0012). In the serum microRNAs study, it was found microRNAs expression in blood serum change in different stages of colorectal cancer. In the early stage of colitis formation, miR223 (> 3 fold expression, p < 0.0025) were abundantly found in the blood serum. Meanwhile in others stage mild (miRNA345 > 2.5 fold, p<0.0011), moderate (miRNA347 & miR512 > 3 fold, p<0.002) and severe (miR31 & miR145 > 2 fold, p<0.0001) microRNAs were also found expressed differently. The quantities of infiltrate neutrophil were varied in different stages of the disease. Conclusion: This study provides an insight into the immunity and molecular level of colorectal cancer and it allows a progressive monitoring on the changes in the molecular, cellular and histological level.
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Background: In march 2020, with the declaration of COVID-19 as a global pandemic, the schools, colleges, and universities of the highly contagious areas of the world were instantaneously closed to mitigate the deleterious effects of COVID-19. Moreover, as a result of social distancing, the most effective preventative strategy since the emergence of COVID-19, medical education has been profoundly disturbed. In light of the prevailing pandemic, an abrupt shifting of the educational system was made from face-to-face learning to online methodologies to provide uninterrupted education to the students of the affected countries. By and large, traditional education was replaced by various forms of e-learning. The aim of this study was to evaluate the perception of e-learning in undergraduate medical students at Medical Colleges during covid pandemic. Material & Methods: This was a cross-sectional questionnaire-based study and was conducted from December, 2020 to February, 2021 in the CARe Medical College, Dhaka, Bangladesh. In the present study we included 270 undergraduate medical students as our participants and students who were not willing to participate were excluded from our study. Results: In our study we found the mean age of the respondents was 23.05 ± 1.28 years and majority of our students were female (68%) compared to male (32%). Most of the students (67%) had moderate grade of IT skills. We found major advantage of e-learning was the ability to record classes 67% and the disadvantage was poor internet speed (68.9%). Among all students, 51.1% & 6.7% students were able to increase knowledge, 62.6% & 3% were able to increase clinical skill and 37.8% & 7.4% were able to increase social skill via conventional & e-learning methods respectively. Majority (88.1%) students preferred face-to face learning method and 11.9% preferred e-learning method. Conclusion: In our study, we evaluated the student’s perception of e-learning and its associated advantages and disadvantages in terms of learning outcomes. While comparing e-learning and face-to-face learning among undergraduate medical students,we found face-to-face learning was considered the most effective way of learning to increase knowledge, practical skills and social skills. Therefore, most of our students preferred the face-to-face learning method compared to e-learning.
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Background: Pregnancy with jaundice is considered a high-risk pregnancy. It is the most usual health complaint in pregnant women found more often in developing countries than in developed ones. Jaundice can be concurrent with 1st trimester due to pathological infection for instance viral hepatitis or gall stones or due to the drug administered during pregnancy. These patients may feel better if initial diagnosis and suitable management are provided. This present study intended to evaluate the clinical profile & complications of jaundice during pregnancy. Material & Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2012 to June 2012. A total (N=50) of pregnant women with symptoms of jaundice were enrolled in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 16.0. Descriptive inferential statistics were performed to determine the results of this study. Results: Among the study population (N=50), the majority of patients (34, 68.0%) age were between 20 to 24 years. The mean gestational age of patients was 35.3±3.2 weeks and twelve patients (12, 24.0%) underwent caesarean delivery. Based on clinical features, twenty-seven respondents (27, 54.0%) had mild jaundice, fourteen respondents (14, 28.0%) had moderate jaundice & about one-fifth of the patients (9, 18.0%) had severe jaundice. Fifteen pregnant (15, 30.0%) women had a fever, around two-fifth of the patients (19, 38.0%) had vomiting, pruritus in one patient (1, 2.0%), vaginal bleeding in twelve patients (12, 24.05), & more than half of the patients (27, 54.0%) had ruptured membrane. The causes of jaundice during pregnancy were viral hepatitis in forty-three patients (43, 86.0%). The majority of the patients (27,54.0%) had serum bilirubin less than 10mg, fourteen patients (14,28.0%) had 10 to 15mg of serum bilirubin & only one patient (1,2.0%) had serum bilirubin more than 20mg. SGOT & SGPT was found 100-500 IU/ml in twenty-three patients (23,46.0%) & 500-1000 IU/ml in ten patients (10,20.0%). Alkaline was raised in eighteen cases (18, 36.0%) Based on maternal complications, the majority of patients (31, 62.0%) had a postpartum haemorrhage, and ten patients (10, 20.0%) experienced encephalopathy. Thirty-eight babies (38, 76.0%) were born alive, intrauterine death was in seven cases (7, 14.0%), and stillborn in five cases (5, 10.0%). Conclusion: Hepatitis E was the most common cause of viral hepatitis in our study. Major complications were postpartum haemorrhage and encephalopathy. This study also prevailed, jaundice in pregnancy is related to an increase in maternal mortality and morbidity, obstetric complications, and perinatal complications.
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Background: Introduction: Intrahepatic cholestasis of pregnancy (ICP), is the most common liver disease specific to pregnancy. Previous studies of fetal effects have suggested that ICP is associated with a higher rate of adverse neonatal outcomes including preterm birth, neonatal respiratory distress syndrome (RDS), meconium-stained amniotic fluid, neonatal intensive care unit admission, and stillbirth. Material & Methods: This was a 4 year retrospective observational study including 43,344 female who delivered in our hospital out of which 1126 cases of ICP were identified, who were compared with 1136 age and parity matched controls. Results: : Previous history and family history of ICP was significant in the ICP group. Gestational diabetes and preterm labour were more frequent in the ICP group. Mean birth weight was lower in the ICP group, rate of small for gestational age foetuses was not significantly different. Cesearean section and post-partum haemorrhage was more frequent in the ICP group. Adverse neonatal outcomes i.e. respiratory distress syndrome (RDS) and need for NICU admission were more in the ICP group. Conclusion: ICP is associated with increased rate of preterm delivery, post-partum hemorrhage and increased neonatal morbidity. Management of patients with ICP should be individualized based on the severity of symptoms and associated medical complications.
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Background: To study the menstrual abnormalities among adolescent females attending a gynaecolocial outpatient department (OPD) in a tertiary care hospital. Material & Methods: It was a cross sectional study which was carried at outpatient department (OPD) of obstetrics and gynaecology, Government medical college Srinagar over a period of 6 months. A total of 90 adolescent females in the age group 10-19 years were included in the study. Along with the demographic profile, menstrual abnormalities were evaluated with the help of self-structured questionnaire. Results: The mean age of the study population was 15.6 ± 2.8 years. Majority of the adolescent females were in the age group of 16-19 years (44.4%), literate with formal education above 10th class (37.8%) and from rural background (56.7%).Dysmenorrhea was the most common menstrual morbidity in 64.4% of adolescent females followed by menorrhagia (26.7%). Pain abdomen was the most common premenstrual symptom encountered by 62.2% of females. Conclusion: Menstrual abnormalities are common in the adolescent females with dysmenorrhea being the commonest.
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@#Introduction: This study measured the outcome of the Optimal Health Program (OHP) among frontline healthcare workers during the COVID-19 pandemic. The OHP is a wellness-based self-management intervention focused on well-being to gain optimal health. OHP is originally from Australia and has been translated, culturally adapted and branded as the Program Kesihatan Optimum Sanubari (SANUBARI). The program was conducted as a psychosocial intervention and the outcomes measured were self-efficacy, coping styles and well-being. Methods: Eligible participants were nurses who actively managed COVID-19 inpatients in Hospital Kuala Lumpur and committed to complete the intervention. Those who did not provide consent or had comorbidity, unstable medical or psychiatry illnesses were excluded. 43 nurses were recruited through convenience sampling method and completed outcome measures from General Self-Efficacy Scale, Brief COPE and WHO-5 Well-being Index, before and 1-month after the intervention. The OHP was conducted via group-based, using OHP Sanubari workbook with 5 weekly sessions by trained facilitators and lasted for 60 to 90 minutes per session. Results: Significant improvement was observed 1-month post intervention for self-efficacy (t(42)=5.64, p <0.001) and well-being(t(42)=2.14, p<0.05); different approach coping strategies(acceptance, use of informational support, positive reframing, active coping, and planning) and avoidant coping strategies(distraction, venting, denial, and substance use). Whilst, humor coping reduced significantly 1-month post-intervention (t(42)=3.66, p<0.05). Conclusion: This study reports the positive outcome of OHP on the mental health status of healthcare workers during the pandemic. This program can be considered as a tool towards optimal health throughout their career.
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Type 2 diabetes mellitus (T2DM) is a multifactorial, polygenic, and metabolically complicated disease. A large number of genes are responsible for the biogenesis of T2DM and calpain10 (CAPN10) is one of them. The association of numerous CAPN10 genetic polymorphisms in the development of T2DM has been widely studied in different populations and noticed inconclusive results. The present study is an attempt to evaluate the plausible association of CAPN10 polymorphism SNP-19 (rs3842570) with T2DM and T2DM-related anthropometric and metabolic traits in the Noakhali region of Bangladesh. This case-control study included 202 T2DM patients and 75 healthy individuals from different places in Noakhali. A significant association (p 0.05). Additionally, SNP-19 genetic variants showed potential associations with the anthropometric and metabolic traits of T2DM patients in terms of body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, and triglycerides. Our approach identifies the 2R/3R genotype of SNP-19 as a significant risk factor for biogenesis of T2DM in the Noakhali population. Furthermore, a large-scale study could be instrumental to correlate this finding in overall Bangladeshi population.
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@#This study aimed to investigate the irrigation dynamics of the positive pressure side-vented (SV) needle, EndoVac (micropores) needle and modified apical negative pressure (mANP) open-ended needle using computational fluid dynamics (CFD). A simulation of a prepared root canal (conical frustum) of 15 mm length with an apical diameter of 0.40 mm following Protaper F4 apical preparation was created using three-dimensional (3D) CAD software. The 3D simulated needle of SV 30G needle, EndoVac with micropores needle and mANP, 30G flat open-ended needle were also created. The irrigation dynamics were evaluated through transient CFD simulations. In addition, the irrigation dynamics of mANP at 0.2 mm, 0.5 mm, and 1.0 mm short from the working length were also assessed. The EndoVac and mANP showed negative apical static pressure and streamline patterns able to reach the apical region, thus indicating negligible extrusion. Meanwhile, SV showed positive apical static pressure and almost nonexistent streamlines beyond the needle tip. The SV showed the highest wall shear stress (WSS) magnitude of 1030Pa whereas Endovac (161 Pa) and mANP1 (258 Pa). However, SV revealed lower average WSS (10 Pa) compared to mANP1 (13 Pa) and mANP2 (11 Pa). This is due to SV developed a localised maximum WSS opposite the open vent area only therefore, uneven distribution of WSS. The EndoVac system developed a localised maximum WSS in the pair of micropores furthest away from the apical. CFD analysis of the EndoVac, mANP and SV showed different technique approach, needle design and needle depths insertion affect the irrigation dynamics pattern and magnitude.
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ABSTRACT Objective: Sexual dysfunction among women with diabetes is a common but neglected health issue worldwide. The objective of the present study was to investigate the prevalence of sexual dysfunction and its associated factors among women with type 2 diabetes mellitus (T2DM). Subjects and methods: This cross-sectional comparative study comprises 150 women with diabetes and 100 healthy women without diabetes who visited the endocrinology outpatient department of Mymensingh Medical College Hospital (MMCH). The data were collected from July to December 2019. Sexual dysfunction was assessed by the 19-item Female Sexual Function Index (FSFI). Informed consent was obtained before participation. Collected data were analysed by SPSS 26. Results: More women with diabetes than control subjects reported sexual dysfunction (79% vs. 72%; p = 0.864). The global FSFI score was lower among the diabetes patients than among the healthy controls (20.8 ± 7.2 vs. 23.7 ± 4.8; p < 0.001). Patients with T2DM scored significantly lower in the domains of desire (p = 0.04), lubrication (p = 0.01), orgasm (p = 0.01), and satisfaction (p < 0.001), but not the domain of arousal (p = 0.09). A prolonged duration of diabetes was the primary contributor to orgasm problems (adjusted odds ratio, aOR 1.3, 95% CI 1.1-1.7) and painful intercourse (aOR 1.2, 95% CI 1.1-1.5). Conclusion: Sexual problems are frequent in women with diabetes. Inclusion of sexual health in comprehensive diabetes management is crucial to address this problem as well as to improve the quality of life of female diabetes patients.
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Background: Herpes Zoster is a more sporadic disease than a doe’s primary VZV infection. Herpes Zoster is typically transmitted person to person by direct contact. The lifetime risk of developing Herpes Zoster is between 25% and 30%, rising to 50% in those aged at least 80 years. The aim is to identify the side effects of oral valacyclovir and oral acyclovir in the treatment of herpes zoster.Material & Methods:This randomized clinical trial was conducted in the Department of Dermatology and Venereology, ShaheedSuhrawardy Medical College and Hospital, Dhaka, from April 2016 to September 2016. A total of 60 patients with herpes zoster were enrolled in the study. Group A Valacyclovir was 30 patients, and Group B Acyclovir was 30 patients.Results:In Group-A, it was observed that 6(20.00%) patients had nausea found to be the highest, 4(13.33%) patients had Headache, 3(10.00%) patients had vomiting, 2(6.67%) patients had Diarrhea,0(0.00%) patients had anorexia, 3(10.00%) patients had abdominal pain, and 1(3.33%) patients had dyspepsia found to be lowest in Group-A, and 8(26.67%) patients had nausea found to be highest, 5(16.67%) patients had Headache, 4(13.33%) patients had vomiting, 3(10.00%) patients had Diarrhea,1(3.33%) patients had anorexia, 5(16.67%) patients had abdominal pain, and 1(3.33%) patients had dyspepsia found to be lowest in Group-B of study patients as side effects.Conclusion:The rate of cessation of abnormal sensations, rash healing, and complications or adverse effects was not similar with both the treatments. There were no clinically significant differences in the nature and frequency but there were clinically significant differences in severity of adverse/side events between the two treatment groups. Thus, we conclude that in the management of herpes zoster, valacyclovir accelerates the resolution of pain and offers simpler dosing, and maintains a favorable safety profile than acyclovir.
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Background:Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities.The aimof the studywas tostudy the psychiatric comorbidities in patients with migraine.Methods:The study population comprised all the out patients who fulfilled the diagnostic criteria of migraine attending a tertiary care psychiatry hospital over a period of 6 months.A total of 90 cases of migraine seen over a period of 6 months were analysed to know the demographic characteristics, clinical pattern and psychiatric comorbidity.Results:Maximum patients were between 21-40 years of age group (41.1%), females (83.3%), married (74.4%) and housewives (52.2%). 64.5% of study population was literate with a formal education above 10thstandard. Migraine without aura was commonest sub-type (65.6%).Noise (75.6%) and sunlight (65.6%) was the most common precipitating factors. Anxiety disorders were the most common comorbid psychiatric disorders (40%), followed by major depressive disorder (24.4%). In 24.6% cases, no psychiatric comorbidity was present.Conclusions:Migraine is comorbid with several psychiatric disorders, including anxiety and depressive disorders. When migraine and a comorbid psychiatric disorder are present, it is important to take both disorders into account in formulating a treatment plan.
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Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under?five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health?care facilities. A community?based cross?sectional study was carried out among 380 under?five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under?five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru?Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.
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Background: Eclampsia is one of the major causes of maternal and perinatal mortality. Eclampsia is more common in developing countries compared to developed countries.This study aimed to assess the maternal outcome in eclamptic patients.Material & Methods:This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Gazi Medical College, Khulna, Bangladesh, during the period from September 2017 to February 2019.Results:The mean age of study people was 23.84 years (SD±5.03 years), among them 58% had postpartum eclampsia and 42% had antepartum eclampsia. Most of the study people (62%) did not take regular antenatal check-ups during pregnancy and 47% of study people had 1-4 convulsions before admission, and most of the study people (80%) had high blood pressure stage 2 (?140/?90 mmHg), Oedema was presented in 98% of study people, 44% of study people and 3gm/l(+++) albumin in the urine. In this study, 56 % had LUCS delivery and 44% had a vaginal delivery, 7% of study people had pulmonary oedema, 7% had renal failure, 2% had DIC, 7% had CVA, 9% had abruption placenta 16% had PPH, 31% needed admission in ICU. There was no maternal death, mean duration of hospital stay was 7 days (SD±3 days). For most of the study people (56%), BP on discharge was normal (?120/?80 mmHg) and for all study people, urine albumin was nil.Conclusions:Eclampsia was a major cause of maternal and fetal mortality and morbidity in Bangladesh. Race and age appear to be risk factors for eclampsia with Bangladeshi women and those at the extremes of reproductive age at greater risk. Antenatal care is important in reducing perinatal mortality and possibly maternal complications.
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Background: The ongoing pandemic COVID-19 is more serious for people with comorbidities and the elderly people. Comorbidities such as hypertension, diabetes, cardiovascular disease, and chronic liver disease affect the majority of COVID-19 patients. COVID-19 affected patients having comorbidities are often admitted to ICU for proper treatment. The aim of this study was to evaluate the impact of co-morbidities on Covid-19 Positive Cases Admitted to ICU. Material & Methods: This cross-sectional study was conducted in the Department of Anesthesia and ICU, Shaheed Sheikh Abu NaserSpecialized Hospital, Khulna, Bangladesh, during the period from June 2020 to July 2021. A total of 87 patients with covid-19 positive admitted to ICU were included in this study.Results:The majority of the study people were in the age group of 60-69. Most of the study people were male in with co-morbidities group (52.87%) and were female in without co-morbidities group (5.75%). Among 87 patients, 78 (89.6%) had different types of co-morbidities. More than half of the study people (64.37%) had diabetes. We found that the majority of the patients (77.30%) stayed in ICU for less than 15 days. 80.95% of patients with hypertension had to stay in ICU for less than 15 days. Among the patients with diabetes, 73.21% stayed in ICU for less than 15 days. About 8.97% of patients with diabetes were discharged from the hospital. 2.56% of patients with hypertension and diabetes were referred to another hospital. Among the death patients, 58.97% had diabetes and 43.59% had hypertension.Conclusions:Patients with comorbidities were more severely affected and had a higher mortality rate. Age, diabetes mellitus, and hypertension were the main factors affecting the survival of patients.
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Background: Oxygen saturation measures the quantity of haemoglobin in the blood that is saturated with oxygen. Hemoglobin is a component of red blood cells that binds oxygen and transports it to outlying tissues. Oxygen is commonly used throughout the world in neonatal units. Injudicious use of Oxygen may not maintain appropriate oxygen status rather can lead to hypoxemia or hyperoxemia, both of the conditions are injurious to neonatal health. Objective: To assess the oxygen saturation in neonate after birth.Methods:A cross-sectional study conducted in the Department of Neonatology BSMMU, Shahbag, Dhaka, Lab Aid Specialized Hospital, Dhaka, Bangladesh from October 2013 to March 2014. A total 317 patients were selected according to selection criteria. The parents were interviewed with a specific pre-designed and pre-tested questionnaire and some information were gathered by document review. All neonate both term and late preterm (?34weeks) who would not be anticipated for resuscitation was included.Results:A total 317 neonate were selected according to selection criteria. Among the study subjects more than half were male (57.1%). Rests were female (42.9%). Average gestational age of the study subjects was 37.47� 1.16 (SD) with the range of 34-40. On the other hand average birth weight was 2.88�46 (SD) with the minimum birth weight 2.0 kg and maximum weight 4.2 kg. Illustrates the median (IQR) heart rate from one to ten min for preterm versus term births. At one to three minutes and at five minutes after birth preterm infants had significantly lower SpO2 measurements. From six to 10 minutes after birth and four minutes after birth there was no significant difference between SpO2 measurements for mode of delivery. Paired sample t test showed that average SpO2 was less in 1 minute[88.42�8(SD)] than in 5 minute [94.25�5(SD)] and statistically this differences were highly significant (t=24.44, p=0.000). Pearson correlation showed high positive correlation (p=0.000) and correlation co-efficient r=0.479. Correlation was significant at the 0.01 level.Conclusion:It is 搉ormal� to have low oxygen saturation measurements in the first minutes after birth. It takes time for infants to reach oxygen saturation levels described as 搉ormal� in the later postnatal period. Oxygen saturation increased with time i.e., it was more in 5 minutes than in 1 minute and similarly more in 10 minutes than in 5 minutes. Conversely heart rate was found more in one minute than to five and ten minutes. Oxygen saturation was ? 90% within 3 to 4 minutes. Significant changes were found in Oxygen saturation by mode of delivery in three minutes & in heart rate by two minutes after birth. At one to ten minutes after birth preterm infants had lower SpO2 measurements.
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Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in China, in December 2019, and was declared a pandemic by WHO on March 11, 2020. The treatment is evolving and is mostly supportive in nature. Material and methods: This was a single-center retrospective study that included confirmed COVID-19 cases treated at our institute (a tertiary care hospital in Jammu and Kashmir, India), between March 2020 and December 2020. Patients with age more than 18 years were included in the study. Results: On evaluating the effect of various drug therapies used in management of COVID-19 patients of all severity, use of remdesivir and famotidine was associated with significantly higher odds of survival. In subgroup of patients with severe disease, use of systemic steroids was associated with significantly higher odds of survival in addition to remdesivir and famotidine. In patients with severe COVID-19 illness, likelihood of survival was significantly higher in those who received combination of systemic steroids plus remdesivir compared to steroids and remdesivir alone. Conclusion: Steroids were effective in severe COVID-19 illness and the combination of steroids and remdesivir was more effective in severe illness. There is a need to undertake more large scale prospective randomized trials to determine the most effective drug therapies to treat the sick patients and prevent worsening of mild cases.
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@#A delayed wound healing process can lead to detrimental complications in chronic wound patients such as tissue necrosis and systemic infections. Application of immunonutrition (IN) in experimental animal models and chronic wound patients has shown promising and improved wound healing processes. IN restores the supply of essential nutrients that are critical for cell growth and tissue repair in the wounded subjects. Several commonly found nutrients in IN formulations include polyunsaturated fatty acids (PUFAs), essential amino acids, trace elements such as zinc and vitamins. Recently, some studies suggested the use of traditionally used herbs like curcumin in IN recipes due to its efficient wound healing properties. The roles and functions of IN in wound healing encompass recruitment of white blood cells, platelets and fibroblasts into the wounded area during the coagulation and inflammation phases, enhancement of fibroblast proliferation, collagen synthesis and neovascularization in the proliferation phase; and lastly, regulation of tissue re-epithelization for wound closure and recovery. In this review, the roles and functions of individual nutrients were deliberately discussed alongside their mechanisms of action in wound healing. This aims to provide a more holistic insight into the potentials of those nutrients when used as part of IN for major wound patients. Despite its remarkable effects in wound healing, several criteria should be considered in an IN formulation: the type and severity of wounds, administration timing and mode of administration, and concoction of immune-boosting nutrients in order to ensure the optimal wound healing effects.
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Summary@#Flagellate erythema is characterized by “whiplike’’ linear streaks, usually following bleomycin chemotherapy or is associated with consumption of shiitake mushrooms, dermatomyositis, adult onset still disease as well as human immunodeficiency disease. Here, we describe a case of bleomycin-induced flagellate erythema in a patient with Hodgkin lymphoma.
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@#Introduction: The COVID-19 pandemic has forced revolutionary changes in the delivery of medical education and imposed much stress on medical students and academicians. This study aimed at evaluating the level of exposure to COVID-19, COVID-related functional difficulties and concerns experienced by medical students, approximately one year after COVID-19 became significant health and socio-economic issues in Malaysia. Methods: A cross-sectional study using self-administered online questionnaire, was conducted among the undergraduate medical students of a private university in Malaysia. Results: A total of 243 medical students participated. They reported low level of exposure to COVID-19 infection. Majority of them demonstrate moderate level of difficulties in learning (median score of 3, highest score = 4) and high levels of COVID-related concerns (median scores of 4 to 5, highest score = 5). Lowest household income category was a significant predictor of high level of functional difficulties (OR = 3.878, 95%CI: 1.651, 9.110); whilst female gender was a significant predictor of high level of COVID-related concerns (OR = 7.400, 95%CI: 1.920, 28.514). Conclusion: One year following the onset of COVID-19 pandemic in Malaysia, medical students still reported significant functional difficulties in learning and demonstrated high levels of COVID-related concern. Collaborative efforts to mitigate the problems need to be intensified with emphasis on the delivery of online medical education and special attention to female and lower socio-economic group students to prevent detrimental consequences to medical students and medical education. Multi-center and longitudinal studies are recommended.
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@#Introduction: Dengue fever is one of the world’s most severe mosquito-borne diseases, with high morbidity and mortality rate. Poor dengue prevention practices are one of the factors contributing to dengue outbreak. National Health and Morbidity Survey (NHMS) have collected lots of population data on the prevalence of various non-communicable and communicable diseases, including dengue. NHMS 2020 however, focus on communicable diseases i.e., Dengue, Malaria, HIV & Covid-19. Notwithstanding, data on Cognitive, Affective and Behaviour (CAB) domains are scarce. Thus, this study was aimed to develop and validate CAB questionnaire on dengue in Malaysia. Material and Methods: The questionnaire was developed by adapting and improvising similar previous questionnaires used during NHMS 2015, selected published questionnaires, expert panel and literature review. A sample of 200 respondents was used to evaluate the internal consistency of the final instrument. Results: 5 experts reviewed the content validity of the CAB questionnaire while 20 respondents tested its face validity. The Cronbach’s alpha coefficients scores were within the acceptable range from 0.661 to 0.677. Various adjustments were made by deleting items with low Cronbach alpha values in attempt to attain the highest possible alpha values, but further deduction could not be made due to the retention of several important domain-measurement items. Conclusions: The validity and reliability of the CAB-IHBR-Dengue-A-01 questionnaire were of ‘acceptable’ ranges and can be used to assess CAB. The questionnaire is a valid and reliable tool for assessing the CAB’s ability to influence dengue prevention among Malaysians.