Graves’ disease is by far the most common cause of hyperthyroidism in children [1]. In this specific population, the hyperthyroidism is willingly biochemically overt and clinically severe [2]. Childhood hyperthyroidism may also cause accelerated growth and bone maturation, and eventually deterioration in academic performance, hence the need for a good screening and a better management. children with GD require prompt treatment, for the most of cases it’s initially medical. But once this fails or is not possible, a definitive treatment should be considered [3]. For the antithyroid drugs use, we currently consider no difference in biochemical control between DT and BR [2,4], unlike previous approaches which argue in favor of the use of bloc-replace method in children [5-6]. However, for a curative treatment, total thyroidectomy is the preferred option for GD patients younger than 10 years [3]. We report the case of a girl who was 2 and a half years old in the moment of diagnose, and whom we followed for Graves' disease for 1 and a half years. Ethical considerations: In accordance with the regulations in force, informed consent, written and verbal, was provided to the parents of the child before the publication of this work.

The use of musculoskeletal ultrasound to assess sports-related injuries has been increasing worldwide. This case report focuses on an unusual form of synovitis of the talocrural joint in a 33-year-old male amateur weightlifter who presented to our sports medicine clinic with acute non-traumatic left ankle pain lasting for 2 days. He reported a recent change in his squatting technique and had no significant medical history other than a recent viral upper respiratory illness. Weight-bearing ankle X-rays were inconclusive, however, ultrasound evaluation revealed effusion in the talocrural joint upon assessment of the ankle’s anterior joint capsule. Additionally, the ultrasound examination helped rule out other common soft tissue ankle pathologies that can affect athletes. The athlete's symptoms resolved by day 5 with conservative measures, including weight bearing as tolerated, nonsteroidal anti-inflammatory drugs, and lymphatic drainage techniques. This report demonstrates the utility of musculoskeletal ultrasound in diagnosing an uncommon cause of ankle pain in athletes.

Background and Objectives: A high prevalence of thyroid disorder is found worldwide and it is a serious public health problem. A community‑based investigations showed that; overall occurrence of thyroid disease was 20.43%, highest incidence of diffuse goiter (7.35%), followed by sub-clinical hypothyroidism (6.59%), hypothyroidism (4.97%), hyperthyroidism (0.86%) and sub-clinical hyperthyroidism (0.65%) in Khulna, Bangladesh. Antithyroid autoantibodies are one of the most important causes of thyroiditis resulting hypothyroidism. The aim of this study was to investigate the prevalence of antithyroid antibody to hypothyroid patients in Khulna region. Methods: This cross‑sectional study was done on Hypothyroid patients of Khulna Medical College Hospital and Institute of Nuclear Medicine and Allied Science (INMAS), Khulna, from July 2023 to December 2023. After having informed written consent of adult sixty hypothyroid patients, was interviewed and examined the blood sample for relevant information; data recorded in a preformed, semi-structured data collection sheet (Patient particulars form) and analyzed. Results: About 20 percent had positive family history of hypothyroidism, 27 percent patient was associated with other autoimmune diseases and about 80 percent was associated with anti-thyroid antibody. Out of the sixty hypothyroid patients about fifty percent was obese, eighty percent was female of 30-60 years age group. Ninety percent of them belongs to poor socioeconomic conditions and came from rural area of Khulna district. Conclusions: Most of the patients were rural female of low socioeconomic back ground of reproductive age groups. There was very significant association of anti-thyroid antibody with these patients. They also associated with chronic autoimmune diseases and poverty.

Background: Even though most communities in developing countries understand the importance of disease prevention, they do not know how to do so. Beneficial programmes, like Health Fairs, even when relatively free, are often scorned. Understanding the importance of hypertension prevention in rural communities in developing nations is under-utilized. This study aimed to get the Awolowo community to come to terms with the benefits of an impactful Health Fair and generate convincing health information. It addressed how to motivate, generate interest and participate. Thus bridging knowledge gap and experience regarding disease prevention and medical screening. Methodology: This was a prospective study conducted over three days during a health fair at Awolowo town, Osun State, South-western Nigeria. A total of 178 Participants (18 years and above) were divided into three groups. Each group went through eight (8) different stations of specialized Health screening format. Blood pressure, Body mass index (BMI), and demographics were collected. Regression analyses was carried out on IBM SPSS (version 21) to examine the relationship between demographic features and blood pressure. Results: Our study found a high prevalence of pre-hypertension (41.6%) among participants. The study highlighted the rising rates of overweight (22.5%) and obesity (14%) in the population. Also, about 33% had hypertension, while increasing age was identified as a significant factor in its prevalence. The data demonstrates a strong correlation between obesity/overweight and hypertension. Conclusion: The specialized Health screening format and seminars/workshops served as motivation and interest generation. This should be adopted for similar studies. This study emphasizes the need for community interventions to address the growing prevalence of hypertension and obesity in Awolowo town and environ. Early diagnosis, heightened awareness, and lifestyle modifications are crucial approaches to mitigate health risks related to these conditions and enhance the overall health and well-being of the community.

Introduction: Bladder pain syndrome (BPS) is a chronic condition characterized by pelvic pain and urinary urgency/frequency. While the exact cause of BPS is unknown, various treatment options exist. This study aimed to evaluate bladder hydrodistension's short- and long-term efficacy in BPS patients. Methods: A retrospective analysis of four female BPS patients treated with bladder hydrodistension over 10 years was conducted. Symptoms, cystoscopy findings, and treatment outcomes were reviewed. Results: The average patient age was 40 years. All patients reported pain, with an average of 13 daytime and 3 nighttime urinary voids per day. Hydrodistension improved symptoms in 75% of patients, reducing daytime frequency and nocturia. Cystoscopy after hydrodistension revealed Hunner's ulcers in one patient and petechiae in three. One patient required a second hydrodistension. Transient worsening of symptoms and hematuria occurred in one patient each. Discussion: Bladder hydrodistension appears to be a safe and effective treatment for BPS, improving symptoms in most patients in our study. The findings are consistent with previous reports suggesting. Our study adds to the growing body of evidence supporting hydrodistension as a valuable tool in managing BPS. Conclusion: Bladder hydrodistension is a simple and minimally invasive technique that has proven its efficacy with a low complication rate. Our findings support the existing literature on the benefits of hydrodistension for BPS.

Background: Sepsis remains a significant health concern, particularly in resource-limited regions like Bangladesh. Despite available diagnostic methods, identifying bacterial infections in septic patients proves challenging, prompting the exploration of biomarkers. Procalcitonin (PCT) has emerged as a promising biomarker for bloodstream infections like sepsis. Objective: This study aims to evaluate the utility of measuring serum PCT levels in diagnosing and assessing the severity of sepsis, with a focus on enhancing early treatment in intensive care units (ICUs). Method: A prospective study was conducted on 50 patients admitted to the Combined Military Hospital, Dhaka ICU, exhibiting clinical manifestations of sepsis between April and September 2015. Patients of all ages and genders were included, while those with recent major surgery, trauma, or burn history were excluded. Detailed clinical assessments and laboratory investigations were performed, with data recorded on a standardized proforma. Result: Of the 50 patients evaluated, 64% were male, and 36% were female, with a mean age of 56.11±10.89 years. Sepsis was more prevalent in patients aged >50 years (60%) and in males (64%). Respiratory tract infection (RTI) was the most common source of sepsis (40% of cases), with Klebsiella pneumonia being the predominant organism. Higher Sequential Organ Failure Assessment (SOFA) scores correlated significantly with elevated serum PCT concentrations. Serum PCT demonstrated a significant difference between non-septic and septic groups (p-value <0.001), exhibiting sensitivity and specificity of 91% and 83.3%, respectively. Conclusion: Serum PCT emerges as a promising marker for sepsis in critically ill patients, enhancing diagnostic certainty and informing patient management. Its addition to routine work-ups could improve outcomes and patient care in ICUs.

Erectile dysfunction (ED) is a prevalent condition affecting adult men globally, characterized by the inability to achieve or maintain an erection sufficient for sexual intercourse. Neurological causes, including multiple sclerosis, Parkinson's disease, ischemic stroke, congenital spinal abnormalities, and spinal cord injuries, disrupt neural pathways essential for erectile function. Additionally, chronic conditions such as diabetes mellitus, hypertension, hyperlipidemia, and cardiovascular diseases, along with lifestyle factors like smoking and alcohol consumption, exacerbate ED by compromising vascular health. Psychological stressors further complicate the etiology of ED. Pelvic surgeries, cavernous nerve injuries, and certain medications, including antihypertensives and antidepressants, contribute to ED progression. Effective management requires addressing these neurological, vascular, hormonal, and psychological factors, necessitating a multidisciplinary approach involving specialists such as neurologists, urologists, endocrinologists, and mental health professionals. This review highlights the complex interplay between neurological disorders, systemic conditions, and lifestyle factors in the pathophysiology of ED, emphasizing the need for tailored treatment strategies targeting the underlying contributors to improve patient outcomes.

Background: Pressure injuries rank among the top five most frequent causes of patient injury worldwide. Usually, these ulcers develop in the body's bony regions where there is a higher chance of pressure and tissue deformation. Pressure injuries are still a common and severely incapacitating ailment, even with advances in medical understanding and the development of efficient therapies and preventative measures. They result in large socioeconomic consequences since they place a heavy load on the healthcare system and the affected individuals. Objectives: To assess the occurrence rate, identify correlated risk factors, and analyze additional indicators related to pressure injuries diagnosed within the care units of King Saud Medical City throughout the study period. Methodology: A descriptive cross-sectional study was undertaken at King Saud Medical City in Riyadh during the months of August and September 2023. The study focused on patients with newly identified pre-existing pressure injury lesions. Demographic information and associated risk factors were recorded in the study's data extraction sheet after obtaining participants' consent to engage in the research. The study commenced following approval from the institutional review board of king Saud medical city research and Innovation center, Riyadh. The gathered data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 26. Descriptive statistics, bivariate and multivariate logistic regression were computed to assess the statistical association, using odds ratio. Significance of statistical association was assured and tested using 95% confidence interval and P-Value of < 0.05 is considered statistically significant. Results: A total of 250 patients with pressure ulcers were identified during the study period. Most of the study participants were male, and the mean age of the participants was 59.2 years. The prevalence of pressure injuries in the hospital units included in the study was 18.8%. The sacral region was the most affected site, with 121 patients (48%) having pressure injuries in that area, while 83 patients (33%) had pressure injuries in the gluteal area. The most frequently associated comorbidities were hypertension, present in 140 patients (56%), and diabetes mellitus, present in 123 patients (49.2%). Conclusion: The prevalence of pressure ulcers was high among admitted patients at King Saud Medical City, Riyadh. Primary prevention health promotion programs should be implemented to prevent the occurrence of pressure injuries in our healthcare facilities and the community at large.

Background: Respiratory tract infections, especially pneumonia and tuberculosis, remain significant public health problems in Bangladesh. This information alone is critical to manage local pathogen distributions, antibiotic susceptibility, and response plans. Objectives: To evaluate the frequency of bacterial pathogens in sputum samples, test their antibacterial sensitivity, and relate them to various demographic factors among patients in Sylhet, Bangladesh. Methods: This cross-sectional study was carried out in the Chest Disease Clinic, Sylhet from January to June 2024.Sputum samples were taken from 120 patients diagnosed with lower respiratory tract infections. Colony and bacterial identification was done microbiologically, and antibiotic susceptibility was determined by using the Kirby-Bauer disk diffusion method. Results: The cocci were the most prevalent, with gram-positive bacteria constituting 75% of all isolates: Staphylococcus aureus 29. Co-amoxiclav had the highest sensitivity of 23 percent, while the highest resistance was recorded for linezolid at 50 percent. Tobacco use was described in 79. Overall, there was a significant association between TB-positive status and the isolation of Klebsiella pneumoniae (p = 0.032). Most participants were of lower SES, and this was observed in 59.32% of the study’s participants. Conclusions: This research found that gram-positive organisms are the most frequent cause of respiratory infections in Sylhet, with S. aureus being the most dominant isolate. The high tobacco use and the link to S. aureus colonization indicate that interventions could and should be targeted. Concerning antibiotic susceptibility patterns, the need to exercise reasonable use of antibiotics and constant monitoring of antimicrobial resistance cannot be overemphasized. These findings may help the local clinicians, help set up empirical antibacterial therapy, and facilitate the design of some targeted health interventions.

Prostate cancer is a major public health issue in men in their advancing years. Huggins and colleagues demonstrated the relationship between testicular androgen (testosterone) and prostate cancer growth. Since then, a lot more had been done in this area of study. Recently, low serum level of testosterone had been linked to aggressive prostate cancer (Pca). We set out to investigate the relationship between low serum testosterone and parameters related to Pca aggressiveness. Materials and Methods: We retrospectively studied fifty-one (51) men diagnosed with Pca who also met the inclusion criteria. Case-notes of these men were retrieved and relevant information for the study were extracted and entered into a spread-sheet and analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: The mean age and standard deviation for all men was 68.51±7.179 years ranging from 52 to 88 years. Men with low serum testosterone were older. Mean prostate specific antigen (PSA) and Gleason score (GS) were 45.90±30.95 ng/ml and 8.04 ±1.038 respectively; both indicating features of aggressive Pca. Mean serum testosterone was 3.741±1.938 and this correlated inversely with serum PSA and GS. Conclusion: Serum testosterone correlated inversely with notable parameters of aggressive Pca.