Nutrient foramen is an opening, which gives passage to the blood vessels of medullary cavity. In lower limb, the lower end of femur and upper end of tibia are the growing ends. The knowledge of nutrient foramen and nutrient artery is of utmost important in surgical procedures like bone grafting, fracture fixation etc. Damage to nutrient artery causes avascular necrosis of bone.

Introduction: Dehiscence is a partial or total separation of previously approximated wound edges, due to a failure of proper wound healing. Wound dehiscence primarily occurs after a surgery relating to an open wound. It is sometimes called wound breakdown, wound disruption, or wound separation. It can be influenced by various preoperative and postoperative factors. Various preoperative and postoperative variables might impact it, and these factors can also influence the patient's result following surgery. Aim of the Study: The aim of the study was to observe the risk factors and operative findings of abdominal wound dehiscence cases in emergency laparotomy. Methods: This prospective clinical study was conducted at the Department of Surgery, MAG Osmani Medical College, Sylhet, Bangladesh. The study duration was 8 months, from July 2008 to February 2009. A total of 460 participants were selected from those undergoing emergency laparotomy in the study place for this study. A consecutive selection method was followed for the selection of the participants. The participants were divided into two groups depending on whether wound dehiscence was developed or not. Result: All the baseline characteristics (age, body mass index, and smoking habit) of patients except sex were significantly associated with wound dehiscence. The history of receiving steroid and cytotoxic drug were higher in patients with wound dehiscence than that in patients without wound dehiscence. However, the history of receiving the immunosuppressive drug was almost identical between the groups. The patients who did not take hygienic measures or take bath before an operation or change clothing had a higher incidence of wound dehiscence. The risk factors tuberculosis, diabetes mellitus, jaundice, bronchial asthma, anemia, edema, and dehydration were found significantly higher in wound dehiscent patients compared to those without wound dehiscence. The mean duration of operation, prolene suture used for closure, midline incision, mass closure technique and drain given had significant influence on development of wound dehiscence. presence of ascitic fluid, pus and contaminated fecal material demonstrated their significant presence in patients who develop wound dehiscence than those who did not develop wound dehiscence. Postoperative conditions like abdominal distention, coughing and wound infection tend to be associated with wound dehiscence more frequently than their counterpart. Conclusion: The current study recommends evaluating patient-related risk factors before to surgery and quickly addressing them. A skilled surgeon should do surgery on high-risk patients. The study contends that the development of wound dehiscence is significantly influenced by baseline traits like age and BMI. The degree of patient cleanliness before surgery greatly influences the likelihood of wound dehiscence. According to the study, other factors that may affect the occurrence of postoperative abdominal wound dehiscence include surgical procedures, skin preparation, the length of the procedure, and the type of wound closure. Coughing, vomiting, and subsequent infection are additional postoperative side effects that increase the risk of wound dehiscence.

Background: More disability and incapacity to work and a poorer quality of life in spondyloarthritis (SpA) in the presence of enthesitis is associated with higher disease activity. Objective: To find out the co-relation between disease activity and quality of life among patients with peripheral spondyloarthropathy. Methodology: From March 2021 to February 2022, the Department of Physical Medicine and Rehabilitation at BSMMU, Dhaka, performed a cross-sectional research. A total of 105 individuals diagnosed with pSpA who were included in the trial were chosen on purpose. Excluded from the research were patients with concomitant systemic inflammatory rheumatic diseases such as RA, SSc, lupus, and Dermatomyositis. The validated Bengali version of The Ankylosing Spondylitis Disease Activity Score (ASDAS), including C-reactive protein (ASDAS-CRP), was used to measure disease activity, while the validated Bengali version of the Short Form Health Survey (SF) 12v2 was used to evaluate health-related quality of life. Results: The participants' mean age was 38.8(±9.8) years, and 68(64.8%) were male. The mean duration of sickness was 4.3(±3.3) years, with 55.4% of cases lasting less than 3 years. The mean ASDAS-CRP was 3.9(±0.08), with 69(65.7%) individuals having a very high Disease Activity Score. 100% of the individuals in the research experienced arthritis and inflammatory back pain. The majority of research subjects had the HLA B27 gene (N=101, or 96.2%), and 99(94.3%) had enthesitis. Physical Component Summary (PCS) and Mental Component Summary (MCS) mean scores were 34(±7.8) and 41(±7.7), respectively. A slight negative association existed between age and PCS scores on the SF-12 (r=-0.233, p=0.017). There was a negative connection between illness duration and PCS (r=-0.339, p=0.001) and MCS (r=-0.290, p=0.003) SF-12 scores. Again, there was a moderate negative connection between ASDAS-CRP and the PCS and MCS scores of the SF-12 (r=-0.406, p=0.001) and the MCS scores of the SF-12 (r=-0.461, p0.001). Conclusion: The Disease Activity Score of the majority of individuals with peripheral spondyloarthritis was very high. The psychological health of these patients was superior to their physical health. Both physical and mental health components were negatively linked with illness duration. There was a moderate inverse connection between ASDAS-CRP and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the SF-12.

Background: The majority of perinatal research on COVID-19 currently focuses on the pregnancy consequences of SARS-CoV-2-infected women, including as cesarean sections, fetal distress, premature delivery, and even maternal mortality. However, it is currently uncertain how the COVID-19 pandemic would negatively affect premature membrane rupture. Aim of the Study: The aim of this study was to assess the impact of Covid 19 on preterm rupture of membrane. Methods: This cross-sectional study was conducted in department of obstetrics and gynaecology, Care Medical College Hospital, Dhaka, Bangladesh from 2021 to 2022. Total 100 pregnant women were included in this study. Where group A represented Covid 19 affected (n=50) and group B represented Not affected by Covid 19 (n=50). Result: In this study, mean age was 30.9 years (SD±8.5 years) in group A and 29.3 years (SD±7.5 years) in group B. Mean gestational age was 37.55 weeks (SD±2.42 weeks) in group A and 36.10 weeks (SD±3.08 weeks) in group B. Both groups had history of preterm delivery (2%), 8% of group A and 4% of group B had history of postpartum hemorrhage, and 22% of group A and 2% of group B had other family members affected. The commonest mode of delivery in both groups; 74% and 62% in group A and group B respectively. 16% in group A and 8% in group B had premature rupture of membranes and 4% in group A and 2% in group B had preterm premature rupture of membranes. Table V shows the neonatal outcome. Neonatal Covid 19 positive was 4% in group A. 18% of group A and 10% of group B were admitted in NICU. Neonatal mortality was 4% in group A and 2% in group B. Conclusion: Preterm births are more likely to occur in pregnant COVID-19 patients and the disease has an impact on NICU admissions. Premature rupture of membranes at term and preterm are more frequent in patients with COVID-19.

Background: Post tubal ligation syndrome has been a topic of debate and the association of Dysfunctional uterine bleeding (DUB) has been identified as a long-term complication. In refractory cases, hysterectomy can be considered a treatment option for managing the post-ligation syndrome due to prolonged menstrual complaints. But very few studies summarize the fact in our country's context. Considering of epidemiological data, the study was designed to assess the incidence of hysterectomy for DUB with post-tubal ligation. Methods: The hospital-based cross-sectional type of descriptive study was conducted in the inpatient Department of Gynae & Obst in Rajshahi Medical College Hospital (RMCH), From January 2019 to July 2019. Women suffering from DUB and having a history of post tubal ligation were included in the study. After selecting the patients, informed written consent was taken from the subjects. All patients were subjected to a detailed history, clinical examination, and relevant investigation. In necessary cases, hysterectomy was done as a treatment option. Data were collected using a semi-structured questionnaire designed for the study by the researcher. Data analysis and presentation were made by statistical software SPSS 23. Results: Total 100 patients with DUB were included in this study. The mean age was 40.9±6.28 SD (years), range: 25-54 years. The majority of patients (52%) belonged to the age group (41 – 50 years). About 59% came from rural areas. The mean parity was 3.43±1.34. The incidence of hysterectomy among DUB patients with a previous history of tubal ligation was 25%. The mean duration of tubal ligation was 13.4±6.3 years. The usual presentation per vaginal bleeding pattern at presentation was menorrhagia (47%), followed in second and third by metrorrhagia (20%) and postmenopausal bleeding (17%). Besides, 78% of patients also complained of tiredness, and 12% complained of pelvic pain. And Mean duration of symptoms was 13.44 months. Conclusion: About one-fourth of the tubal ligation patients underwent a hysterectomy in their subsequent life, and usually presented with menorrhagia. However, further studies are needed to finalize the incidence rate.

Land is essential for every human activity on earth as it is the source of all material wealth. In order to regulate the ownership, use and development of land and land resources, nations over the world have instituted land ownership systems aimed at consistent balancing of the interests of the government, the land owning class and the landless class. This paper examines the parallel nature of statutory and customary land ownership in Cameroon, how it has evolved over the years until 1974 when a single land law, otherwise known as the 1974 Land Ordinance, which were established to harmonize and regulate land ownership in the country. The paper further contends that the present land ownership system in Cameroon as found in the ordinance is advocating inclinations with excessive state control of land ownership, use and development. In connection with our above objectives, we adopted an in-depth content analysis, which is based on primary and secondary sources of data collection imperative to the study. The paper concludes that such land system cannot effectively support the indigenes and development initiatives as it creates too much bureaucracy in land transactions, land registration and land titling. It recommends an urgent balance between the statutory and customary land ownership to facilitate access to land with ease for various purposes.

Herbal remedies used traditionally to cure different types of human disease. The research in herbal drugs, to discover single compound used a lead for developing new therapeutically active products. Cleome viscosa Linn. (wild or dog mustard), belongs to family(Capparaceae). Cleome viscosa well known plant for their antimicrobial, anti-diarrheal, hepatoprotective, analgesic and anti-fibrolytic potential. In living beings, infection caused by helminths (helminthiasis) is a severe problem to health that results in hardship and stunted growth. In the developing world, helminthiasis (in human intestine) is the most common infectious disease. The seed contained salicylic acid and Lupeol. This study has been carried out to evaluate anthelmintic potential of Cleome viscose seed by molecular docking via drug-tubulin interaction. The molecular docking result revealed that salicylic acid and Lupeol showed encouraging docking score. The docking score found to be -1.98 and -3.82 kcal mol–1 respectively.

Introduction: PEFR is considered as the simplest index of pulmonary function. Ventilatory function tests like PEFR provide a better understanding of the changes in the lungs from a diagnostic viewpoint. It is effort dependent and reflects mainly the calibre of the bronchi and larger bronchioles, which are subjected to reflex bronchoconstriction. Objective: To study the variations in the PEFR with various factors with respect to age, body mass index, blood pressure and heart rate among males and females patients. Methods: This was a cross-sectional study conducted at Department of Medicine, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to December 2020 among young male and female subjects. The subjects with no history of cardio, availability & capacity to cooperate adequately, non- smokers; and no history of any drug intake which could affect the lung functioning were included in the study. PEFR was measured with the subject comfortably seated during the same time of the day for all subjects. It was determined in litres/minute with the help of “The Peak”, Individualised Peak flow meter from Multispiro Inc. Results: Out of the total subjects 121 subjects, 45.4% were ≤18 years followed by 19-20 (42.1%) and >20 (12.3%). There were 37.1% males and 62.8% females. PEFR was found to be significantly (p=0.0001) higher among males compared to females in all the age groups. PEFR increased with increasing age in both male and female subjects. PEFR was found to be significantly (p<0.0) higher among males compared to females in the entire body mass index (BMI) category. PEFR increased with increasing BMI in both male and female subjects. Conclusion: PEFR is higher among male than female subject. Also, PEFR was higher in males than females in all the age groups and BMI status. The effects of various factors like age, height, weight, BSA and BMI on the PEFR values have also been discussed in this study. PEFR increases with increase in age and BMI in both male and female subjects.

Introduction: Vitamin D (VitD) insufficiency is present in over half of population worldwide. Over a billion people worldwide are vitamin D deficient or insufficient. It has been long known that VitD insufficiency contributes to development of osteopenia and osteoporosis. Objective: To assess the serum vitamin D and TSH status in postmenopausal women who have undergone routine blood investigations. Methods: We performed a retrospective review of data of 61 patients in postmenopausal age group (45-75yrs) during their routine blood investigation for the first time at Dept. of Obstetrics and Gynaecology, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to March 2021. The data was collected from medical record section and appropriate statistical analysis was done using percentage and frequency. Results: Out of 61 patients Vitamin D was insufficient (10-30 ng/mL) in 34.4% and deficient (<10 ng/mL) in 18.0%, and remaining normal. In 4.9%, TSH was low (less than 0.3 mIU/L) and in 18.0% TSH was high (more than 4.5 mIU/L), while the remaining 77.0 had normal TSH levels (0.3-4.5 mIU/L). 54.5%(n-11) patients with high TSH, had vitamin D deficiency and 18% patients with high TSH had insufficient vitamin D. 100% (n-3) of patients with low TSH had normal vitamin D. 22 patients had normal TSH and normal vitamin D. Conclusion: Prospective longitudinal studies with larger subject numbers and more comprehensive measurement of thyroid function along with examining the indicators of innate immunity may shed light into the underlying pathophysiology and mechanisms involved in the interaction between thyroid function and VitD metabolism. High TSH levels was associated with low vitamin D levels, low TSH levels was associated with normal serum vitamin D level. Hence association was linear between TSH and vitamin D in post-menopausal women.

Class II division 2 malocclusion is an obvious category of Class II malocclusion with typical characteristics like retroclined maxillary incisors and severe deep over bite, caused by both skeletal and dentoalveolar factors. In fact, diagnosing class II division 2 maloclusion is quite simple; neverthless the treatment process and prognosis are complex and delicate. This case report illustrates a combined orthodontic-orthognathic surgical treatment of a 19-year-old female with permanent dentition, sagittal skeletal Class II pattern, hypodivergent facial type and both class II molar and canine relationship with class II division 2 incisor relationship. The treatment plan was divided into 3 consecutive phases: the dentoalveolar decompensation, which lasted 13 months, the surgery of mandibular advancement and the finishing stage. The treatment had successfully improved the smile arc, the masticatory functions, and the dental occlusion of the patient.

Oils derived from oil-bearing seeds or certain fruit pieces are known as plant oils or vegetable oils. Using the Soxhlet extraction technique and n-hexane as the solvent, Thevetia peruviana seed oil was extracted from the seed flour. Its physicochemical parameters were determined using standard analytical methods. The hydroxylation process was done through the vigorous stirring of the oil and formic acid with the slow addition of peroxide. The hydroxylated oil was analyzed for functional groups present using Fourier Transform Infrared Spectrometer. The results of the physiochemical parameters showed that Thevetia peruviana oil has acid value (3.88 mg KOH/g), iodine value (93.5 Wij’s), peroxide value (30.0 meq/kg), kinetic viscosity (1.6cp) and saponification value (121.76 mgKOH/g) while the hydroxylated oil has acid value (0.77 mg KOH/g), iodine value (81.40 Wij’s), peroxide value (7.85 meq/kg), kinetic viscosity (7.43cp) and saponification value (162.05 mgKOH/g). The FTIR results showed that both non-hydroxylated and hydroxylated plant oils had the following functional groups OH, CH, C=C, CH2, and C=O. The results showed that the bands were shortened in the hydroxylated oil spectrum except (OH) which became broad indicating the formation of the hydroxyl group by the consumption of the C=C band in the unhydrolyzed oil. The hydroxylation of plant oils using Thevetia peruviana shows the potential of the plant oil to be used as a precursor for the production of industrial intermediates which can replace the dependence on petroleum products.

Background: Acute kidney injury (AKI, previously known as acute renal failure) is a frequent complication that affects a substantial number of hospitalized patients annually. However, the relationship between severity of AKI and in-hospital outcomes in the setting of acute Acute ST-Elevation Myocardial Infarction (STEMI) has not been well- documented. Chronic kidney disease is a strong predictor of in-hospital mortality in the acute myocardial infarction setting. Objective: To evaluate the Outcome of admitted patients of acute ST elevation myocardial infarction with renal function. Methods: The Prospective observational study was carried out at the Cardiology Department, Bangabandhu Sheikh Mujib Medical College and Hospital, Faridpur, Bangladesh from July 2020 to June 2021. 100 patients of STEMI diagnosed by clinical, biochemical and ECG criteria were included in the study. After getting serum creatinine level from them, eGFR was calculated and patients having <60ml/min were selected for the further studies. Results: In the STEMI patients, the ratio of male patients 76% and females’ patients (35%) was 3.34:1 with mean ± SD of age was 52.84 ±8.40 year. Among the 101 patients, chart indicating the outcome of the study patients where cardiogenic shock was found in 10.8% patients, heart failure was found in 24.7%, arrhythmias were found in 69.3% and death occurred in 5.9% of cases. Table 5 showing Stratification of patients by in relation with eGFR where different pattern and frequency of outcome was observed in relation with level of eGFR described. After calculating levels of eGFR, all the outcomes showed statistically significant (P < 0.05) except cardiogenic shock which didn’t show significance (P > 0.05. Conclusion: In concluded, that those who have renal impairment previously or develop after acute STEMI have inverse outcomes. As renal impairment is associated with an increased risk of coronary artery disease and stroke, the cardiovascular disease may develop early in the course of renal dysfunction.

Reportedly, SARS-CoV-2 infection impairs glucose homeostasis and metabolism. Moreover, hyperglycaemia has emerged as an important risk factor for COVID-19 mortality. A cross-sectional study involving hospitalized patients in Sidi-Bel-Abbes with COVID-19 critical infection regardless of diabetes status was conducted. Data was collected from COVID-19 Registry, including age, sex, and blood sugar level at admission. Out of 800 patients admitted for SARS-CoV-2 with, 332 patients (206 males, 126 females) exhibited hyperglycaemia, which equates to a prevalence of 41,5%. Patients had a median age of 64 years and a median blood sugar of 1,59. Admission hyperglycaemia was not statically associated with age and sex. Blood glucose status is paramount for ensuring safe and effective treatment of inpatients COVID-19. Additional studies are forthcoming to address the study's limitations and to better understand the impact of hyperglycaemia on COVID-19 patients.

Introduction: The current global pandemic due to SARS-CoV-2 has resulted in a large literature on associated comorbidities, including diabetes. COVID 19 infection in a diabetic child can be complicated by severe ketoacidosis. The aim of this study is to determine the effect of COVID-19 infection on a diabetic child. Observations: The first case involved a 12-year-old Congolese child from a diabetic mother who was hospitalized for febrile respiratory distress and a consciousness disorder. Biological examinations showed the first diabetic ketoacidosis. Chest radiography showed radiological images suggestive of COVID-19 involvement, which was confirmed by a PCR and a thoracic CT. The evolution was marked by the appearance of a left pleurisy of medium abundance, which regressed after treatment. Second, a 16-month-old infant with no prior history was admitted to the hospital for febrile dehydration with impaired consciousness. Biological tests were consistent with diabetic ketoacidosis. Multiplex PCRs were performed showing infection with SARS-CoV-2 and other viruses (adenovirus, rhinovirus and enterovirus). Chest radiography was normal. The evolution was favorable under treatment with insulin therapy, rehydration, and antibiotic therapy. Conclusion: After discussing the role of decompensation or the triggering of diabetes in children with SARS-CoV-2 infection, the authors insist on the polymorphism of the clinical presentation and the need to perform a PCR in a diabetic child with ketoacidosis.

Transfer Pump Selection for Oyama Hotel. The calculation and selection of the transfer pump has been carried out in the clean water installation of the Oyama hotel building. Transfer pump is required to move (lift) clean water from the ground water tank to the roof tank. The pump selection method is based on calculation of pump capacity and head. Pump capacity calculation is based on water demand during peak hours. Pump head calculation is based on static head and friction loss in the piping. From the results of the calculations, the capacity is 20m3/hour and the pump head is 9 bars.