Introduction: The aim of this study was to identify the factors arising from (i) personal perception of the vaccine or (ii) the mother's social environment and entourage that are associated with vaccination dropout in children aged 12 to 23 months. Materials and Methods: A cross-sectional observational study was conducted from 25 October 2022 to 18 February 2023 among mothers of 336 children aged 12 to 23 months in Kisangani. A pre-tested and administered questionnaire was used to collect data based on three-stage cluster sampling. Analyses were performed on STATA 13 using stepwise logistic regression with a threshold of 0.05. Results : After adjustment by multivariate logistic regression, the following factors were significantly associated with discontinuation of BCG vaccination in children aged 12 to 23 months: mother's religion (ORa=2.1 [95% CI : 1.1 - 4.4]), ignorance of vaccination schedule (ORa= 3 [95% CI :1.4 - 6.7]), not being informed by vaccinators to allay fears (ORa= 2.5 [95% CI :1.2 - 5.4]) and refusal to vaccinate one's child if the incidence of the disease decreases (ORa= 2.9 [95% CI :1.3 - 6.5]). Conclusion: In Kisangani, mothers' access to information and knowledge about routine vaccination were limited, with low BCG vaccination coverage. There is a need to increase awareness among mothers and carers in order to improve their knowledge of routine immunisation.

Objective: To find out the association between atherogenic index and thyroid status in hypothyroid patients. Method: This case control study was conducted in the Biochemistry Department of National Institute of Kidney Diseases and Urology during the period of 2018 and 2019. 100 subjects aged between 20-50 were selected by purposive sampling from the patients and attendants attending to the outpatient department of NIKDU. Among them 55 subjects were diagnosed case of hypothyroidism with TSH >4ng/dl and FT4<0.9 ng/dl and 45 subjects were age and gender matched healthy euthyroid controls. Here student unpaired t-test, Chi-square test and Pearson’s correlation test were used to determine the association of atherogenic index and hypothyroidism. SPSS version 23 was used for the level of significance and p value <0.05 was considered statistically significant. Result: A total 100 subjects were included in the study without subjects with hypertension, diabetes mellitus and renal failure. All the variables were compared between the two groups. Out of 55 cases, 20 were males and 35 were females. Out of 45 control subjects, 12 were males and 35 were females. There was no statistically significant difference in case and control group in term of gender and Chi-square test was done to measure the level of significance. Among case and control, highest percentage were in the range of 20-30 years with 43.6% and 55.5% respectively. The mean age of case group was higher than the control group, but the difference was not statistically significant (p<0.05). Mean AIP level was 0.75±0.27 in case group and 0.35±0.20 in control group and was statistically significance difference (<0.05) between the two groups. Conclusions: From this study, it may be concluded that high atherogenic index is associated with Hypothyroidism. Hypothyroid patient with increased AIP is prone to develop cardiovascular diseases. So, to decrease the incidence of cardiovascular diseases in hypothyroid individuals, regular monitoring of serum lipid profile should be done by clinician.

Background: Dyslipidemia, characterized by abnormal lipid profiles, is a significant risk factor for cardiovascular disease and has been increasingly implicated in the progression of chronic kidney disease (CKD). Dyslipidemia contributes to endothelial dysfunction, oxidative stress, and inflammation, potentially exacerbating renal impairment. However, the association between dyslipidemia and key renal risk factors—estimated glomerular filtration rate (eGFR), proteinuria, anemia, and C-reactive protein (CRP)—in renal transplant recipients remains inadequately explored. Objective: To assess the association between dyslipidemia and renal risk factors, including eGFR, proteinuria, anemia, and CRP, in renal transplant recipients. Methodology: A cross-sectional observational study was conducted at Sir Salimullah Medical College & Mitford Hospital, the CKD and Urology Hospital (CKD&U), and the Kidney Foundation Hospital and Research Institute, Bangladesh, over 13 months (May 2019–June 2020). A total of 105 renal transplant recipients were included through purposive sampling. Demographic, clinical, and laboratory data were collected, including fasting lipid profiles, serum creatinine, fasting blood glucose, urinary albumin-to-creatinine ratio (ACR), CRP, and eGFR (calculated using the MDRD equation). Statistical analysis was performed using SPSS v16, applying Chi-square tests to evaluate associations between dyslipidemia and renal risk factors. Results: Among renal transplant recipients, 61.9% had elevated triglycerides, 53.3% had high LDL, 33.3% had elevated total cholesterol, and 61.0% had low HDL. The mean triglyceride level was 214.38 ± 128.33 mg/dL, and the mean LDL was 100.41 ± 36.31 mg/dL. Dyslipidemia was significantly associated with reduced eGFR (p=0.04), indicating a decline in renal graft function. Lower ApoA1 levels were significantly linked to elevated CRP (p=0.01) and reduced eGFR (p=0.043), while higher ApoB levels were also associated with reduced eGFR (p=0.038). Hypertriglyceridemia was significantly correlated with anemia (p=0.05). However, no significant associations were observed between lipid markers and proteinuria, hypertension, or diabetes. Conclusion: Dyslipidemia, particularly elevated triglycerides and low HDL levels, is significantly associated with reduced renal function and systemic inflammation in renal transplant recipients. Specific lipid markers, such as ApoA1 and ApoB, may play a critical role in predicting renal dysfunction and inflammatory status. Early detection and management of dyslipidemia may be crucial in preserving renal function and improving long-term transplant outcomes.

Background: The COVID-19 pandemic necessitated exploration of convalescent plasma (CP) therapy. This phase-II RCT evaluated CP's efficacy in 30 severe COVID-19 patients (June 2020–July 2021), comparing standard care (n=30) with CP-added therapy (n=30). Despite historical success in viral outbreaks, evidence remained conflicting. We assessed 28-day mortality, clinical improvement, and safety, addressing gaps in donor antibody variability and timing. Objective: To determine therapeutic Role of Convalescent Plasma (CP) therapy in the treatment of severe COVID-19. Methods and Procedure: It was a Randomized Controlled phase-II Trial which was carried out at COVID-19 unit and ICU Bangabandhu Sheikh Mujib Medical University, Dhaka from 01June 2020 to 31July 2021. Plasma was collected and supplied in the department of Transfusion Medicine of BSMMU and transfused in patient at ICU, BSMMU. After proper evaluation 30 healthy donors required amount of convalescent plasma of COVID-19 was collected by continuous flow cell separator. The collected convalescent plasma was transfused to; 30 (INTERVENTION ARM) severe ill patients receiving standard treatment protocol admitted in ICU, BSMMU, Dhaka. Then the improvement of these patients was observed and another 30(control) patients receiving standard treatment protocol only and comparison was made. Before administration of the plasma it was screened for RCT-PCR for covid-19. HBsAg, Anti-HCV, HIV and other infections. Results: The study included 60 COVID-19 patients (30 control, 30 intervention) with comparable baseline characteristics (mean age 51-53 years; 40% vs. 56.6% males). The intervention group showed significantly higher baseline D-dimer (4.3 vs. 0.5 µg/mL, p<0.001) and ferritin (1045 vs. 631 ng/mL, p=0.049). Both groups had similar 28-day mortality (26.6%, RR=1.00, p=0.95), hospitalization duration (10 vs. 9 days), and discharge rates (63.3%). Clinical parameters improved over time, with mortality declining from 7.1% (Week-I) to 4.5% (Week-IV). Conclusion: In conclusion, this phase-II randomized controlled trial demonstrated that convalescent plasma (CP) therapy did not significantly improve 28-day mortality or other clinical outcomes in severe COVID-19 patients compared to standard care alone.

Massive localized lymphedema (MLL) is a rare condition typically observed in morbidly obese individuals, characterized by the formation of large, pedunculated masses, often located at the root of the thigh. We present the case of a 39-year-old obese female (BMI = 60.5 kg/m²) with a one-year history of a progressively enlarging, painless mass at the root of the left thigh. Clinical examination revealed a pedunculated mass with overlying skin changes consistent with an "orange-peel" appearance. Imaging studies, including ultrasound and magnetic resonance imaging (MRI), demonstrated a large, fatty mass with internal fibrillary structures and no involvement of adjacent fasciae or muscles. The MRI findings, including hypointense T1 and hyperintense T2 signals with mild gadolinium enhancement, were consistent with massive localized lymphedema. This case highlights the diagnostic challenges of MLL, which can mimic other soft tissue tumors such as liposarcoma or angiosarcoma. The importance of thorough imaging and clinical correlation is emphasized, particularly in distinguishing MLL from malignant conditions. Early recognition and accurate diagnosis are crucial to guide appropriate management and avoid unnecessary interventions.

Zika is a disease transmitted to humans by mosquitoes in Africa, Asia, and America, it’s caused by Zika virus (ZIKV) which is a RNA virus, ZIKV is classified within the family Flaviviridae, genus Flavivirus. The monitoring and diagnosis of the viruses early with specific molecular techniques will reduce the severity of viruses. This study aimed to detect the prevalence and molecular detection of ZIKV, and relation of age, sex, locality and other biomarkers to ZIKAV in Kassala State, Eastern Sudan. This was a cross-sectional study conducted in Kassala Teaching Hospital, Kassala State in Eastern Sudan, 286 samples for ZIKV analyzed using Real Time Polymerase chain reaction (RT-PCR), patients data were collected from questionnaire, from the Health Research Ethics Committee of the Ministry of Health and Social Development Kassala State ethical approval was achieved, and informed consent was obtained from participants or their guardians, statistical significance was determined using chi-square with significant set at P < 0.05. Out of 286 participants, 9 patients were positive for ZIKV, ZIKV positive was determined using RT-PCR, 2(22.2%) were males and 7(77.8%) were females, there was no a statistically significant association between gender and infection (χ² = 3.1, P = 0.1). The symptoms of positive patients were fever 9(100%) headache 9(100%), joint pain 9 (100%), back pain 9(100%), loss of appetite 9(100%), sweating 9(100%), chill 9(100%), vomiting 6(2.1%), skin rash 3(33.3%) and bleeding 0 (0%) and Poly arthralgia 8(88.9%). There were no a statistically significant differences between these symptoms and ZIKV positive patients. The haematological parameters in this study showed normal and abnormal, the most abnormal was low (thrombocytopenia, leucopenia, low RBCs), there was no a statistically significant differences with ZIKV infection ((χ² = 0.66, P = 0.717), (χ² = 0.43, P = 0.803), (χ² = 0.191, P = 0.909)) respectively. The study concluded no statistically significant differences were found among the symptoms of ZIKV-positive patients. Patients not used mosquito net, from family with same signs and past infection were a statistically significant differences with ZIKV infection ((X2 = 4.1, P = .008), (X2 = 8.1, P = .011), (X2 = 9.4, P = .014)) respectively There were no a statistically significant differences between thrombocytopenia, leucopenia and low RBCs concerning ZIKV infection ((χ² = 0.66, P = 0.717), (χ² = 0.43, P = 0.803), (χ² = 0.191, P = 0.909)) respectively.

Renal cell carcinoma (RCC), the most common form of kidney cancer, is often diagnosed incidentally through routine imaging or unexplained laboratory abnormalities. We report the case of a 62-year-old male with a medical history of type 2 diabetes mellitus, hypertension, dyslipidemia, and previously treated hepatitis C, who presented with an asymptomatic, mildly elevated alanine aminotransferase (ALT) level discovered during routine follow-up. Despite normal values for other liver enzymes, an abdominal ultrasound performed to investigate the abnormal ALT revealed a well-defined lesion in the left kidney. Further imaging with contrast-enhanced CT confirmed the presence of a renal mass, and histopathological evaluation following partial nephrectomy diagnosed clear cell RCC. This case illustrates the potential of minor ALT elevations as early indicators of extrahepatic malignancies such as RCC. It emphasizes the importance of thorough evaluation for persistent, unexplained ALT abnormalities, particularly in patients with metabolic risk factors or past hepatic conditions. Increasing evidence suggests a possible pathophysiological link between RCC and liver enzyme alterations, including cytokine release and hepatic congestion. Future studies are warranted to investigate the predictive value of ALT as a biomarker for RCC and the role of inflammatory mediators such as IL-6 in RCC-associated liver function changes.

Introduction: Abdominal aortic aneurysm (AAA) is a frequent vascular pathology, especially in elderly males. Horseshoe kidney (HSK), the most common renal fusion anomaly, presents a surgical challenge when associated with AAA. We report a case of successful open repair of a juxtarenal AAA in a patient with HSK. Case Presentation: A 68-year-old male with hypertension, diabetes, and active smoking was diagnosed with a 60 mm juxtarenal AAA and horseshoe kidney during routine imaging. The patient underwent elective open repair via a retroperitoneal approach. A bifurcated aorto-bi-iliac graft was placed. The right renal artery was reimplanted, and an inferior polar artery was revascularized using a saphenous vein graft. Discussion: HSK complicates AAA surgery due to anomalous renal vasculature and anteriorly located isthmus. Open repair allows precise revascularization and direct access to the aorta. Renal preservation strategies are crucial to reduce postoperative complications. Conclusion: Open surgical repair remains a reliable option in AAA with HSK when renal revascularization is necessary. Thorough preoperative planning and tailored reconstruction are key to achieving optimal outcomes.

Waldenström macroglobulinemia (WM) is a rare, indolent lymphoproliferative disorder characterized by the accumulation of abnormal lymphoplasmacytic cells in the bone marrow. These cells produce excessive amounts of monoclonal immunoglobulin M (IgM) protein, leading to symptoms such as fatigue, bleeding problems, and increased susceptibility to infections. In recent years, biclonal gammopathy, defined as the presence of two distinct monoclonal proteins in a patient’s blood or urine, has been increasingly recognized in some WM patients. For instance, Nakazaki et al., (2010) reported cases of WM with coexisting non-IgM gammopathy, specifically IgG.

Introduction: The aim of this study was to determine the epidemiological, clinical, therapeutic and evolutionary profile of malnutrition in children aged 0-59 months in the Kabondo health zone from 1 July to 31 August 2024. Materials and Methods: This was a descriptive cross-sectional study of 93 malnourished children aged 0-59 months in the Kabondo health zone. Due to the lack of a reliable sampling list, this study used non-probability convenience sampling. Indirect observation was used for data collection. Descriptive analysis based on tables, calculation of percentages and the arithmetic mean for quantitative variables enabled us to compare our results with previous work. Results: Malnourished children aged over 24 months were more represented, with a sex ratio of 1.4 in favour of boys. Anorexia, weight loss and asthenia were the main clinical signs observed, with marasmus as the type of malnutrition. Therapeutic aspects were dominated by Plumpynut as well as vitamin A, antibiotic therapy, Mebendazole and paracetamol. The average hospital stay was 13 days, with ¾ of cases discharged cured and without treatment failure, but with a death rate of 5.4%. Conclusion: These results shed light on the epidemiological, clinical, therapeutic and evolutionary profile of malnutrition in children aged 0-59 months in the Kabondo health zone.