How Did Mortality Rates from Covid-19 Differ between Vaccinated and Unvaccinated People in a Tertiary Level Hospital of Bangladesh?

This study aims to find out the difference in mortality rates between vaccinated & non-vaccinated Covid-19 positive patients who were admitted in a tertiary centre (Ward and Intensive care unit) of Bangladesh. Retrospective analysis of data over 6 weeks in February 2022- March 2022, 100 confirmed Covid-19 positive patients were included- 50 patients from ICU and 50 patients from ward irrespective of age, gender, vaccination status and co-morbidities. Seventy five percent (75.0%) of all confirmed Covid-19 positive patients were vaccinated. Mortality among vaccinated people was less compared to non-vaccinated population 41.3% vs. 52%. Interestingly it was found pregnancy was the most significant risk factor in childbearing age female group- 86.7% of patients (pregnant and peripartum) required Intensive care admission and mortality was 40.0% although none of them had any recorded co-morbidities. Again, mortality among vaccinated was significantly less (35.7%) compared to 100.0% mortality among unvaccinated. Mortality rate among patient admitted in intensive care was significantly high compared to patients treated in ward- 72.0% vs. 16.0%. In ICU 83.0% of patients who died were vaccinated (90.0% had 2 doses and 10.0% had 3 doses). On the other hand, 87.5% who died in ward were unvaccinated. Among the survivors from intensive care units- 93.0% were vaccinated compared to 7.0% unvaccinated. Pre-existing co-morbidities increased mortality (59.0%) compared to 40.9% mortality in patients without any previous medical conditions. We found vaccination against Covid-19 reduces the rate of death irrespective of co-morbidities or severity of disease. Recovery rate was significantly increased in vaccinated patients requiring intensive care support. Pregnancy was found to be the most important risk factor for Intensive care admission and mortality in otherwise healthy childbearing age females and mortality was significantly high (100.0% though limited data availability) in unvaccinated. These results require further revalidation on larger population.

Demographic Characteristics of Patients with Breast Cancer in Bangladesh: A Single-Centre Study.

We performed this study to investigate the socio-demographic factors of breast cancer patients of Bangladesh. This cross-sectional study was conducted in the Department of General Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2018 to September 2019 for a period of one (1) year. All consecutive cases of breast carcinoma admitted in hospital and attended at outpatient department during the study period were selected as study population. Total 50 patients were selected. The mean age of the study patients was 51.1. Maximum number (70.0% cases) of breast cancer was belonged in 4th to 5th decade aged group. 70.0% breast cancer patients were housewives. The most of the breast carcinoma was reported in the urban people which were 78.0% cases. The percentage of educated study population was 80.0%. On religious background, 86.0% cases of breast cancer patients were Muslim. Most of breast cancer patients were sporadic in origin 94.0% cases, had no family history of breast cancer. Breast cancer was mostly distributed in pre-menopausal aged group with 82.0% cases. Ninety percent (90.0%) of the study population was come from middle class socio-economic group. In western countries, incidence of breast cancer is more in elderly aged menopause women with high socio-economic class. In this study the breast carcinoma was most prevalent among educated urban Muslim pre-menopausal housewives of age group 4th to 5th decade and most of them belonged to middle socio-economic class. The socio-demographic factors of breast cancer patients in Bangladesh are disparate from western countries in age standard, social class group and menstrual status.

Quality of Life of Bangladeshi Doctors in the COVID-19 era: Are We Taking Good Care of Our Carers?

The Coronavirus pandemic has been affecting our healthcare professionals physically as well as psychologically since March 2020. Whilst various measures have been taken to protect their physical health, their mental wellbeing has not been brought into attention. We aimed to assess the well-being of Bangladeshi doctors and identify the high-risk group using a core-10 validated form. We performed an observational cross-sectional survey among Bangladeshi healthcare professionals. One hundred one (101) doctors filled out the core-10 form. We collected data over a 1-month-period during the first peak of COVID-19. According to our data, majority of the participants (49%) felt anxious or nervous at some point. Thirty one percent (31%) felt hopeless, unhappy even panic attacks but most significant finding was that 21% participants had at least once thought about ending their lives. This is a matter of concern and the workplaces should identify the vulnerable professionals so that they can be supported better mentally and socially. More than half of the participants (55%) were found to have moderate to severe depression in the first peak of COVID 19 pandemic. This is not over yet; more waves are coming. Therefore, it is really important that we address this issue before it is too late and ensure regular counselling, better childcare for working parents, safety measures to protect their families and financial security. Otherwise, we might exhaust our carers to a level where even they cannot help us survive this global challenge.

Electronic properties of TaAs2topological semimetal investigated by transport and ARPES.

We have performed electron transport and angle-resolved photo-emission spectroscopy (ARPES) measurements on single crystals of transition metal dipnictide TaAs2cleaved along the (2¯01) surface which has the lowest cleavage energy. A Fourier transform of the Shubnikov-de Haas oscillations shows four different peaks whose angular dependence was studied with respect to the angle between magnetic field and the [2¯01] direction. The results indicate elliptical shape of the Fermi surface cross-sections. Additionally, a mobility spectrum analysis was carried out, which also reveals at least four types of carriers contributing to the conductance (two kinds of electrons and two kinds of holes). ARPES spectra were taken on freshly cleaved (2¯01) surface and it was found that bulk states pockets at constant energy surface are elliptical, which confirms the magnetotransport angle dependent studies. First-principles calculations support the interpretation of the experimental results. The theoretical calculations better reproduce the ARPES data if the theoretical Fermi level (FL) is increased, which is due to a small n-doping of the samples. This shifts the FL closer to the Dirac point, allowing investigating the physics of the Dirac and Weyl points, making this compound a platform for the investigation of the Dirac and Weyl points in three-dimensional materials.

Prevalence of ESBL Encoding Genes in Acinetobacter baumannii Strains Isolated from Various Samples of a Tertiary Care Hospital in Mymensingh.

The aim of this study was to find the prevalence of ESBL genes among A. baumannii isolates. In this cross sectional study, 49 Acinetobacter spp. were isolated from various clinical samples from March 2019 to February 2020 conducted in the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Clinical samples including endotracheal aspirates, wound swab/pus, urine and blood. A total of 380 samples were analyzed. Growth was obtained in 34.21% of the samples yielding 130 organisms. Out of 130 organisms, 49(37.69%) were Acinetobacter spp. Among 49 Acinetobacter spp, 39(79.59%) were Acinetobacter baumannii which was identified by PCR targeting OXA-51 like gene. Amplification of the ESBL encoding genes, namely CTX-M, TEM, SHV done by molecular technique PCR. The most antibacterial resistance was against ceftriaxone (79.48%) and lower resistance only showed in colistin (12.82%). All the isolates were sensitive to tigecycline. The distribution of ESBLs genes such as TEM 20(51.28%), CTX-M 16(41.02%) and SHV 0(0%). The high resistance to most of the antibiotics among the studied strains and also a high prevalence of TEM gene in A. baumannii strains found in our study gives alarming sign towards the treatment complexity of these strains.

Relationship of BMI and Fasting Serum Glucose with Hypertension.

Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risks of cardiovascular and kidney disease. It is recognized as a major contributor to the disease burden globally. Aim of the study was to evaluate body mass index and fasting serum glucose level in male hypertensive patients in order to compare these parameters with male normotensive subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Bangladesh from July 2018 to June 2019. Total 200 male subjects, age range was from 30-65 years were included in this study. Among them, 100 hypertensive subjects were taken as study group (Group II) and 100 ages matched normotensive male subjects were taken as control group (Group I). Quantitative data were expressed as mean (±SD) and statistical significance of difference among the group was calculated by unpaired student's 't' test. In this study we found that body mass index was significantly (p<0.001) increased in study group (29.52±2.46) in comparison with control group (22.91±1.04). Fasting serum glucose level was also significantly (p<0.001) increased in study group (6.35±0.47) in comparison with control group (4.52±0.50). Based on the study carried out it is concluded that there is definite relationship of body mass index and fasting serum glucose level with hypertension. Therefore, basic measurement of weight and height to determine the body mass index and fasting serum glucose level as routine assessment during hospital visitation with appropriate lifestyle modification would help in controlling hypertension as well as its devastating consequences.

Frequency and Risk Factors of Diabetic Retinopathy among Patients with Type 2 Diabetes Mellitus: A Single-Center Study from Bangladesh.

Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes mellitus (DM). DR remains a leading cause of blindness, currently accounting for 4.8% of the world's 37 million blindness cases. DR is one of the critical preventable causes of blindness. In Bangladesh, the number of studies reporting the prevalence and risk factors of DR in type 2 DM (T2DM) is limited. We conducted this cross-sectional study in a tertiary hospital in Bangladesh from March 2017 to August 2019 among 200 patients with T2DM for the presence and severity of DR by using color fundus photography in a dilated pupil. The diagnosis and grading of DR were made using the Early Treatment of Diabetic Retinopathy Study (ETDRS) Chart. Out of 200 subjects with T2DM, 35.5% had DR; the frequencies of NPDR and PDR were 19.0% and 16.5%, respectively. The mean age, diabetes duration, FPG, HbA1c, TG, TC, LDL-C, and serum creatinine were statistically higher, and eGFR was lower in the study subjects with DR than those without DR; BMI and HDL-C were indifferent in the two groups. The frequencies of males, subjects having monthly income of 10,000 Bangladeshi Taka (BDT) or more, smokers, hypertensives, and subjects having uncontrolled diabetes (HbA1c ≥7%), were higher in the DR group than the no DR group. Higher age (≥50 years), higher monthly income (≥10,000 BDT), urban residence, smoking, uncontrolled diabetes, and high LDL-C (≥100mg/dL) were found to be independent risk factors of DR in the study subjects. A large-scale nationwide study is needed to find out the actual prevalence of DR in Bangladesh.

Evaluation of Serum Uric Acid and Serum Creatinine in Male Hypertensive Patients.

Hypertension is a major public health problem of adult population across the globe that significantly increases the risk of heart attack, stroke, kidney failure and blindness. It is one of the leading cause of premature death worldwide. Aim of the study was to evaluate serum uric acid and serum creatinine in male hypertensive patients in order to compare these parameters with male normotensive subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2018 to June 2019. A total number of 200 male subjects, age ranged from 30-65 years was included in this study. Among them, hundred (100) hypertensive subjects were taken as study group (Group II) and hundred (100) ages matched normotensive male subjects were taken as control group (Group I). Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired student's 't' test. In this study we found that serum uric acid and serum creatinine was significantly increased in study group in comparison with control group. Based on the study carried out it is concluded that there is definite relationship of serum uric acid and serum creatinine with hypertension. Therefore, serum uric acid and serum creatinine should be measured in all hypertensive subjects for prevention of devastating consequences of hypertension and thus can combat morbidity and mortality.

Evaluation of Serum Zinc Status and Glycated Hemoglobin in Patients with Type-2 Diabetes Mellitus.

Type-2 diabetes is the most common type of diabetes, accounting for about 90% of all diabetes. This study was done to assess the Serum Zinc status and Glycated Hemoglobin in type-2 diabetic patients in order to compare this parameter with healthy subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2018 to June 2019. A total number of 140 subjects, age was ranged from 35-65 years were included in this study. Among them, seventy (70) type-2 diabetic patients were taken as study group (Group II) and seventy (70) age matched healthy subjects were taken as control group (Group I). Group I again subdivided into control group male (Group IA) and control group female (Group IB). Group II also subdivided into study group male (Group IIA) and study group female (Group IIB). Data were expressed as mean±SE and statistical significance of difference among the group was calculated by unpaired students' 't' test. Therefore, by this study we recommended that routine estimation of this parameter is important for prevention of complication related to diabetes for leading a healthy life.

Body Mass Index in Adult Asthmatic Patients.

Asthma is a chronic inflammatory disorder of the airways, in which many cells and cellular elements play a role. Asthma is one of the most common diseases globally and currently affects 300 million people. Asthma and obesity have an enormous impact on public health. Since the 1990s, various studies have shown a correlation between an increase in body mass index (BMI) and asthma prevalence. This descriptive type of cross sectional study was done to find the levels of BMI in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty male and 50 female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. BMI were calculated by weight in kg divided by height in square meter (m²). For statistical analysis unpaired Student's 't' test was used. Mean BMI were significantly increased in both study group in comparison to control group and the result was statistically significant (p<0.001). From this study, it may be concluded that increase body mass index that is overweight or obesity can increase the prevalence and incidence of asthma. Obesity, by means of inflammatory mechanism or changes in lifestyle can trigger asthmatics symptoms in susceptible individuals.

Wurtzite (Ga,Mn)As nanowire shells with ferromagnetic properties.

(Ga,Mn)As having a wurtzite crystal structure was coherently grown by molecular beam epitaxy on the {1100} side facets of wurtzite (Ga,In)As nanowires and further encapsulated by (Ga,Al)As and low temperature GaAs. For the first time, a truly long-range ferromagnetic magnetic order is observed in non-planar (Ga,Mn)As, which is attributed to a more effective hole confinement in the shell containing Mn by the proper selection/choice of both the core and outer shell materials.

Relationship of Hemoglobin Concentration in Adult Asthmatic Patients.

Asthma is a chronic inflammatory disorder of the airways, in which many cells and cellular elements play a role. Asthma is one of the most common diseases globally and currently affects 300 million people. The epidemic rise in anemia, asthma, and related allergic disease is a common major public health problem worldwide. Asthma and anemia associated with acute infections occur both in children and adults. This descriptive type of cross sectional study was done to find out the levels of hemoglobin concentration in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and 50 (fifty) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. Hemoglobin concentration was estimated by Cyanmethemoglobin method. For statistical analysis unpaired student's 't' test was used. Mean hemoglobin concentration was significantly decreased in study group in comparison to control group and the result was statistically significant (p<0.001). The study findings showed a high prevalence of anemia among asthmatic patients than non asthmatic healthy persons.

A Giant Intra Abdominal Mass Mimicking Renal Cell Carcinoma: A Rare Presentation of Renal Angiomyolipoma.

Angiomyolipoma (AML) is a benign tumor commonly found in kidney than extra renal sites. Most of the small renal angiomyolipomas are diagnosed incidentally on ultrasound and other imaging studies. Some renal AMLs present clinically when become very big, giant renal angiomyolipoma. Although almost all cases are benign, a relatively rare variant of epitheloid angiomyolipoma has got malignant potential and can even metastasize. Ultrasonography, CT and MRI scan are usually used for diagnosis of angiomyolipoma with high level of accuracy; even though some lesions may be confused as renal cell carcinoma on imaging studies. Here, a 48 year old man presented with a large intra-abdominal mass preoperatively diagnosed as a case of right renal cell carcinoma and radical nephrectomy was performed. Histopathology revealed epitheloid angiomyolipoma (EAML).

Primary adrenal leiomyosarcoma in an adult female.

Primary leiomyosarcoma of the adrenal gland is a rare tumour and we describe such a case in a 35 year old female who had dull pain in the left flank for 6 months. There was no weight loss or fever only mild tenderness was in the left subcostal region. She was normotensive and there was no evidence of virilization. CT scan revealed left adrenal mass, after adrenalectomy it was 8.5×7.5×6.2cm³ in size. There was no evidence of local extension or metastasis. Histopathology confirmed adrenal leiomyosarcome.

Prevalence of colour blindness among the first year medical & dental students of Mymensingh Medical College, Bangladesh.

The purpose of this study was to detect the etiology, type and prevalence of colour blindness & to create awareness among the blind personnel. A survey of colour blindness among 239 ( male-87 & female-152) Medical and Dental first year students during their medical checkup before admission into Mymensingh Medical College in the session of 2012-2013 was done. Among them 8(male-7, female-1) were colour blind and prevalence was 3.35 % with a marked male predominance (male 8.04%, female 0.66 %). In view of the potential difficulties faced by such personnel in clinical works, detection during medical admission allowed appropriate counseling regarding subject selection for their future carrier.

Ventral free oral mucous membrane graft for bulbar urethral stricture.

The use of oral mucous membrane graft onlay urethroplasty represents the most widespread method of bulbar urethral stricture repair. We investigated the short term result of oral mucous membrane graft placed on the ventral surface for management of bulbar urethral stricture. Patients with Bulbar urethral stricture of any length, infection free urinary tract and informed consent for oral mucosa harvesting and urethroplasty were selected for study. We enrolled 108 cases of bulbar urethral stricture patients from January 2004 to July 2009. The mean ± SD preoperative maximum flow rate of 5.2 ± 2.6 ml/sec and mean ± SD PVR 87 ± 58.3 ml were treated by substitution urethroplasty with oral mucous membrane by a single surgical team in a private hospital. Causes of stricture were trauma 26(24.1%), infection 58(53.7%), catheter induced 8(7.4%), post TURP 11(10.2%) and unknown 5(4.6%). Oral mucous membrane was harvested from the cheek or from the inner side of lower lip. Defect of the urethra displayed by longitudinal ventral urethrotomy and the graft was sutured over the edges of the incised urethral mucosa over a 14 Fr latex Foley's catheter. Spongiosum tissue was closed over the graft. Pericatheter urethrogram was performed in all cases to check for the anastomotic leakage and the Catheter was removed after 2 weeks of the procedure. After removal of catheter uroflowmetry & ultrasound scan of bladder were performed to estimate the maximum flow rate and post voidal residue. The patient was followed-up every 3 months with uroflowmetry & ultrasonography. The median (range) age of the patients was 32(21-72) years. Mean follow up period was 36 months (range 12-54). Mean ± SD stricture length was 3.7 ± 2.6 cm. The overall success rate was 91.7%. Mean ± SD flow rate was 23 ± 4.2 ml/sec, mean ± SD post void residue was 25 ± 15.5 ml and patient quality of life (QOL) was excellent in almost all patients. Overall complications were seen in 9(8.3%) cases. Of which, restricture occurred in 6 patients; periurethral fistulae seen in 2 cases and per urethral bleeding in 1 patient. No significant complications were observed at the donor site. Oral numbness and mild discomfort complained by 67.6% patients which were managed by reassurance only. In our experience ventral placement of oral mucous membrane graft along with spongioplasty is a very easy procedure with very encouraging short term result.

Morning glory syndrome.

A 20 years young boy came from Sherpur was admitted in the Department of Ophthalmology, Mymensingh Medical College Hospital, Mymensingh on 10th December 2011 with the complaints of dimness of vision of right eye since childhood. His best corrected visual acuity right eye was 6/60 and left eye was 6/6. He has no strabismus or nystagmus. Fundus examination showed right eye - large disc with funnel shaped excavation surrounded by chorioretinal disturbance, white tuft of glial tissue on central part of disc, blood vessels emerge from rim of excavation in radial pattern. By clinical examination the patient was diagnosed as morning glory syndrome.

Goldenhar syndrome.

A female child of 10 months age from Netrokona, Bangladesh was admitted in the department of ophthalmology, Mymensingh Medical College Hospital, Mymensingh on 20.01.12 with the complaints of swelling on both her eyes and swelling of area in front of both ears. The child is mentally alert. Her fixation reflex is central, steady and maintained. On examination whitish growth on limbus, hard in consistency, non mobile, non tender, fixed with underlying structure both eyes. There are pre auricular skin tags. There is no cardiac abnormality and ENT consultation done reveals normal except pre-auricular ear tags. X ray of mandible and maxilla shows hypoplasia of maxilla and mandible. Clinical examination and investigations confirmed the diagnosis as Goldenhar syndrome.

Graphene coating makes carbon nanotube aerogels superelastic and resistant to fatigue.

Lightweight materials that are both highly compressible and resilient under large cyclic strains can be used in a variety of applications. Carbon nanotubes offer a combination of elasticity, mechanical resilience and low density, and these properties have been exploited in nanotube-based foams and aerogels. However, all nanotube-based foams and aerogels developed so far undergo structural collapse or significant plastic deformation with a reduction in compressive strength when they are subjected to cyclic strain. Here, we show that an inelastic aerogel made of single-walled carbon nanotubes can be transformed into a superelastic material by coating it with between one and five layers of graphene nanoplates. The graphene-coated aerogel exhibits no change in mechanical properties after more than 1 × 10(6) compressive cycles, and its original shape can be recovered quickly after compression release. Moreover, the coating does not affect the structural integrity of the nanotubes or the compressibility and porosity of the nanotube network. The coating also increases Young's modulus and energy storage modulus by a factor of ∼6, and the loss modulus by a factor of ∼3. We attribute the superelasticity and complete fatigue resistance to the graphene coating strengthening the existing crosslinking points or 'nodes' in the aerogel.

Usher syndrome.

A young girl of 10 years age came from Nalitabari, Sherpur was admitted in the department of Ophthalmology, Mymensingh Medical College Hospital, Mymensingh on the 5th January 2011 with the complaints of dimness of vision of both eyes, night blindness and profound deafness since birth. She had parental history of consanguineous marriage. Best corrected visual acuity of this patient was recorded 6/60 both the eyes with nystagmus. Fundus examination showed waxy pallor optic disc, arteriolar attenuation and bony spicule pigmentation both eyes. By history and clinical examination the patient was diagnosed as Usher syndrome.