Background: Salivary gland lesions encompass various non-neoplastic and neoplastic conditions with overlapping clinical presentations, posing diagnostic challenges. Fine Needle Aspiration Cytology (FNAC) serves as a minimally invasive, cost-effective technique for the preliminary assessment of such lesions. Still, its accuracy must be validated against histopathological examination, the gold standard for definitive diagnosis. Objective: This study aimed to evaluate the cytomorphological patterns of salivary gland lesions diagnosed through FNAC and to correlate these findings with corresponding histopathological results. Methods: A retrospective cross-sectional study was conducted at the Department of Histopathology and Cytopathology, Armed Forces Institute of Pathology, Dhaka Cantonment, from January 2014 to September 2015. A total of 55 cases with both FNAC and histopathological reports were analyzed. Data were statistically evaluated using SPSS version 11.0. Results: Among the 55 cases, submandibular gland lesions were most common (45.45%), followed by parotid (38.18%) and minor salivary glands (16.36%). FNAC identified 23 non-neoplastic (41.82%) and 32 neoplastic lesions (58.18%), including 19 benign and 13 malignant tumors. Histopathology confirmed 22 non-neoplastic and 33 neoplastic cases. Pleomorphic adenoma was the most frequent benign tumor, and mucoepidermoid carcinoma was the most common malignancy. Concordance between FNAC and histology was observed in 72.7% (40/55) of cases. FNAC demonstrated 92.9% sensitivity, 97.6% specificity, and high overall diagnostic accuracy. Conclusion: FNAC is a valuable first-line diagnostic tool in evaluating salivary gland lesions, with high sensitivity and specificity. However, certain limitations—particularly in distinguishing low-grade malignancies and some benign lesions—underscore the importance of histopathological confirmation in inconclusive or suspicious cases.

Background: Location of placement of the graft either dorsally, dorsolaterally or ventrally for the treatment of long segment anterior urethral stricture has become an issue with different series reporting different outcomes. Regarding dorsolateral and dorsal onlay technique, there are various published articles worldwide. In Bangladesh, there are limited study regarding the issue though there are lots of patients suffering from urethral stricture disease. Objective: Objective of the study is to compare the outcomes of these two techniques. Method: Present Quasi experimental study was conducted in the department of Urology, Rangpur Medical College Hospital & KMMCH, Rangpur, Bangladesh, during the period of October 2022 to September 2024. Total 50 patients with long segment (>2 cm) anterior urethral stricture were included in present study. Among them 25 patients underwent dorsolateral (group-A) and another 25 patients underwent dorsal onlay (group-B) urethroplasty. Patients were followed up for 06 months. Result: Mean ± SD age of group-A and Group-B were 43.72 ± 7.64 and 44.08 ± 7.56 years respectively (p >0.05). Mean ± SD of length of stricture of group-A and Group-B were 4.25±1.28 and 4.22±1.31 cm respectively (p >0.05). In Group-A and Group-B preoperative mean Peak urine flow rate on uroflowmetry (Qmax) were 6.68±1.35 and 7.00±1.46 ml/sec respectively (p >0.05). Mean post-operative Qmax were 20.00±3.20 & 20.52±4.38 ml/sec in Group-A, and 19.39±3.13 & 19.19±4.93 ml/sec in Group-B, on 1st and 2nd follow up respectively (p >0.05). There was statistically significant difference of mean Qmax in the same group before and after BMG urethroplasty. Success was defined as peak urine flow rate on uroflowmetry ≥15ml/sec with no stricture diagnosed on RGU & VCUG and urethroscopy, and no need of any post-operative urethral intervention. Re-stricture developed in 2 (8.0%) cases in Group-A and 4 (16.0%) cases in Group-B which needed urethral intervention. Success rate was 23(92%) cases and 21(84%) cases in group A and group B respectively (p >0.05). 02(8.0%) cases in Group-A and 03(12%) cases in Group-B had wound infection, 1(4.0%) case in Group-A and 3 (12%) cases in Group-B had chordee. Urethrocutenous fistula developed in 1 (4.0%) case in Group-A and 3 (12.0%) cases in Group-B; results between the two groups were not statistically significant. Conclusion: Outcome of dorsolateral buccal mucosal graft urethroplasty was comparable with dorsal onlay urethroplasty in present study. Well controlled randomized study with adequate sample size and follow up may reveal more divergent outcomes.

The ancient sages provided extensive information about the causes of ailments and even detailed the possibility of hereditary transmission channels and methods for curing them. Ayurveda is a natural medicine system that was developed in India over 5,000 years ago and uses herbs and other materials to treat health issues. Examining the contributions of ancient Indian medical scientists Sushruta, Charaka, and Patanjali is the study's main goal. Method: The study is descriptive in nature and is mostly based on information gathered from books and other secondary sources like journals, Hindu scriptures, and online search engines like e-libraries, e-books, e-articles, and different website-based information, reference materials, wikipedia, Buddhist writings, medical related ancient books, stories of Greek travelers to India, ancient scriptures, etc. Results: Indian medical knowledge travelled over the world and was retained in certain regions where it was used in a modified form while maintaining its originality. In conclusion, Sushruta, Charaka, and Patanjali had a major influence on India's medical systems in antiquity. Their important findings and innovative theories still have an impact on how we advance medical procedures.

Background: Proximal femur fractures, particularly intertrochanteric fractures, are common causes of morbidity among elderly patients. Surgical fixation using either a Dynamic Hip Screw (DHS) or a Trochanteric Plate (TP) is the standard of care, although evidence comparing their functional outcomes remains inconclusive. This study aimed to compare the clinical, radiological, and functional outcomes of proximal femur fracture fixation using DHS and TP. Methods: This comparative observational study was conducted at the Department of Orthopedics, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh, from January 2023 to December 2024. A total of 30 patients were equally divided into the DHS (n=15) and TP (n=15) groups. Patient demographics, intraoperative variables, complications, radiological union, and functional outcomes were assessed. Harris Hip Score (HHS) was used to evaluate function at 6 months postoperatively. Data were analyzed using SPSS v25.0, and p<0.05 was considered statistically significant. Results: The mean operative time was significantly shorter in the TP group (58 ± 12 min) than in the DHS group (65 ± 15 min, p<0.001). Radiological union at 12 weeks was slightly higher in the TP group (86.6% vs. 73.3%, p=0.37). Mean HHS was comparable (TP: 90.2 ± 7.5 vs. DHS: 87.5 ± 8.2, p=0.35). The complication rates were low and not significantly different between the groups. Conclusion: Both DHS and TP fixation methods are effective in treating proximal femur fractures. TP fixation may offer minor advantages in terms of operative time and early union, but the functional outcomes at six months are similar.

Background: The medical devices sector in India plays a crucial role in the country's healthcare system, ranging from simple bandages to complex devices like CT scans. Materiovigilance is a system for monitoring adverse events related to medical devices. The program empowers healthcare professionals to report adverse events, ensuring patient safety and improving the overall quality of healthcare through systematic surveillance and data analysis. Objective: To assess knowledge, attitude and practice of healthcare professionals toward materiovigilance and evaluate the impact of an educational intervention on these aspects. Methods: A cross-sectional prospective questionnaire study was conducted for a period of six months at a tertiary care teaching hospital with a sample size of 307 healthcare professionals. Healthcare professionals from Medical, Nursing, Pharmacy, Dental and Physiotherapy were included in the study. Base line data was collected by administering questionnaire. Educational intervention was provided to the same study participants and post interventional data was also collected. Chi-square test was used to test the significance of impact of educational intervention. Results: The collected data showed that 94.46% (290) were under the age group of 18-28. Before the intervention, only 36.16% (141) were aware of the term materiovigilance which increased to 100% (307) after the intervention. Before the intervention, 65.47% (201) did not know where the NCC of MvPi is located and 16.94% (52) gave the wrong answer, whereas after the intervention 88.6% (272) participants gave the right answer. Conclusion: Our study identified a significant knowledge gap in materiovigilance among healthcare professionals before the educational intervention. After the intervention, participants demonstrated a substantial increase in their knowledge and awareness of medical device-related adverse events (MDAEs).

The integration of pharmacy, laboratory and nursing practices has become increasingly vital in enhancing therapeutic outcomes within the healthcare system. As the landscape of healthcare evolves, both professions have expanded their roles beyond traditional boundaries, focusing on patient-centered care and collaborative practices. Interprofessional collaboration between pharmacists and nurses is fundamental in addressing the complexities of patient care. By working together, these professionals can develop integrated care plans that consider all aspects of a patient's health, leading to improved outcomes and enhanced patient satisfaction. Ongoing education and training for both pharmacists and nurses are essential to keep pace with emerging trends and innovations. As the healthcare landscape continues to evolve, the collaborative efforts of pharmacy, laboratory and nursing will be crucial in ensuring that patients receive comprehensive, high-quality care, ultimately enhancing therapeutic outcomes and improving overall health.

Background: Glucagon-like peptide-1 (GLP-1) receptor agonists have emerged as an effective treatment for type 2 diabetes, offering glycemic control and additional health benefits, including weight loss. Despite their increasing clinical importance, public awareness regarding these medications and their potential risks and benefits remains unclear, particularly in Madinah, Saudi Arabia. This study aimed to assess awareness levels toward GLP-1 anti-diabetic medications among adults in Madinah. Methods: A cross-sectional study was conducted in Madinah City, Saudi Arabia using a semi-structured survey that included knowledge about obesity and GLP-1 medications, and perceptions regarding their use, efficacy, and safety. Participants were categorized based on their awareness levels (poor, moderate, or high). Statistical analysis was performed to examine the association between participants' characteristics and awareness levels, with significance determined at p < 0.05. Results: This study included 260 participants, with nearly half holding a bachelor's degree (n=129, 49.6%). Approximately a quarter had prior knowledge of obesity medications (n=64, 24.6%), with the internet being the most common source. Most respondents (75.4%) believed that not everyone could use anti-obesity medications, and 66.5% recognized that a specific BMI is required for their use, with 28.1% selecting body mass index (BMI) ≥ 30 as the threshold. A majority (74.6%) acknowledged that these medications work through multiple mechanisms, and 84.2% believed they could reduce 3–8 kg annually. Side effects were widely recognized (82.7%), with 73.1% associating them with pancreatitis and 61.9% with thyroid tumors. Additionally, 73.5% considered these medications ineffective without diet and exercise. When asked about personal use if recommended by a doctor, responses varied, with 23.5% willing, 23.1% unwilling, and 53.5% uncertainty. Awareness levels were not significantly associated with education (P=0.552), though those with a bachelor's degree showed the highest awareness. Prior knowledge of obesity medications showed a borderline association with awareness levels (P=0.061). Conclusion: Awareness regarding GLP-1 anti-diabetic medications in Madinah is moderate, with knowledge gaps concerning their safety and appropriate usage. Targeted educational initiatives are needed to improve public understanding and ensure informed decision-making, particularly addressing misconceptions about risks and benefits. This is crucial for optimizing therapeutic outcomes and minimizing potential misuse.

Background: Blood group antigens play a critical role in transfusion medicine, affecting the safety and effectiveness of blood transfusions. Among these blood groups, the Kidd blood group system, which includes Jka, Jkb, and Jk3 antigens, is particularly significant due to its implications in delayed hemolytic transfusion reactions and its genetic variability across different populations. Objectives: This study compared the prevalence of Kidd blood group phenotypes among Saudi and non-Saudi blood donors in the regional blood bank in Riyadh, Saudi Arabia. The goals were to understand the distribution of these antigens and assess the level of genetic integration between the two groups. Methods: A cross-sectional study was conducted with 311 blood donors, comprising 155 Saudis and 156 non-Saudis. The phenotypes analyzed included Jk(a+b+), Jk(a-b+), Jk(a+b-), and Jk(a-b-). Data were collected from the regional blood bank in Riyadh, and statistical analysis was performed using Chi-square tests to compare phenotype distributions between the groups. Results: The study found that the most prevalent phenotype was Jk(a+b-), occurring in 47.74% of Saudis and 44.23% of non-Saudis. The least common phenotype was Jk(a-b-), observed in just over 1% of non-Saudis and less than 1% of Saudis. The prevalence rates for Jk(a+b+) and Jk(a-b+) were similar between the two groups, suggesting a high level of genetic integration. No significant differences were found in the distribution of these phenotypes between Saudi and non-Saudi donors, indicating substantial genetic similarity and intermingling. Conclusions: The results suggest that the regional blood bank in Riyadh has a homogenized population concerning Kidd blood group antigens, facilitating the development of donor databases that include comprehensive antigen profiles. These databases can enhance the precision of blood matching and reduce the risk of transfusion reactions. This study highlights the importance of genetic diversity in developing personalized medicine strategies and adapting transfusion protocols to local and regional antigen profiles.

Background: The most prevalent consequence of Diabetes Mellitus (DM) is Peripheral Neuropathy (PN), which is frequently undiagnosed and untreated and consequently leading to physical and emotional damage to an individual. Therefore, this study was designed to explore the proportion of peripheral neuropathy among diabetic patients in tertiary care setting. Methods: This cross-sectional observational study among 403 participants was conducted at the out-patient department of Dhaka Medical College Hospital, Sir Salimullah Medical College, BIRDEM Hospital for one year of period. Data collection was conducted with a pre tested semi structured questionnaire and were analyzed using the statistical software SPSS 26. Results: Mean age of the respondents was 50.92±10.56 (SD) years with a majority in age group 60-69years (29%). Male and female was observed as equally 51.9% male and 48.1% male. The majority of patients (60.5%) have been living with diabetes for 2-5 years. Significant proportion of the patients (64%) have uncontrolled diabetes, while only 36% have achieved control over their condition. Overall, 48.4% respondents had peripheral neuropathy among diabetic respondents. Among the respondents with peripheral neuropathy, 97(24.1%) respondents had mild NSS, 69(17.1%) had moderate NSS and 29(7.2%) had severe NSS. BMI (25.75±2.65 and 24.81±2.98 kg/m2), HbA1C (8.48±0.78 and 7.98±1.13 %) and triglyceride level (318.79±46.28 vs. 282.52±76.45 mg/dl) were significantly higher among peripheral neuropathy respondents compared to non-neuropathy respondents. Conclusion: The findings have important clinical implications Lifestyle modifications, such as weight management and diet control, may also be essential in preventing or managing peripheral neuropathy. Early detection of intervention to manage pain should be a priority.

Nowadays, the majority of seizure patients have lost confidence in themselves and are worried about their self-image, so they attempt to conceal their illness from others. Once a decision to treat epilepsy has been made, it is necessary to have a thorough knowledge of the choice of drug, toxic effects, mode of action with each antiepileptic drug. However, by determining the serum concentration and manipulating it within the therapeutic range it should be possible to find a regimen that adequately controls seizures without introducing unnecessary toxic effects. Since valproic acid is also a first-line treatment for epilepsy, it is now the most effective medication used. Over time, these medications are taken regularly.

Background: Family physicians in primary healthcare (PHC) settings frequently encounter emergency cases of varying severity. Managing such cases effectively requires structured protocols, proper training, and adequate equipment. This study aimed to identify the barriers faced by primary care physicians (PCPs) in managing emergency cases in Al Ahsa, Saudi Arabia. Methods: A cross-sectional study was conducted among PCPs working under the Ministry of Health (MOH) and National Guard Health Affairs (NGHA) in Al Ahsa. Data were collected using a self-administered electronic questionnaire distributed via official email and social media platforms. The instrument included sections on socio-demographic characteristics, a 10-item competency scale, a 12-item satisfaction scale, and the frequency of emergency cases encountered over the past 12 months. Results: Of the 414 respondents, 81.1% were female and 83.5% were aged between 25 and 34 years. Attendance at BLS, ACLS, and ATLS courses within the last 1–2 years was reported by 45.8%, 58.5%, and 50.4% of participants, respectively. Low competency levels were reported by 15.6% of physicians, and 18.9% expressed dissatisfaction in handling emergency cases. Higher competency and satisfaction scores were significantly associated with younger age, female gender, Saudi nationality, and possession of a bachelor’s degree. A positive correlation was observed between competency and satisfaction scores. Conclusion: The findings reveal moderate levels of competency and satisfaction among PCPs in managing emergency cases. Notably, older, male, and non-Saudi physicians demonstrated lower levels in both domains. Targeted training and continuous professional development are essential to enhance emergency preparedness in PHC settings.

Background: Laparoscopic cholecystectomy (LC) is traditionally performed under general anesthesia (GA), which ensures airway protection and optimal surgical conditions. However, GA is associated with notable drawbacks including hemodynamic fluctuations, delayed recovery, and increased postoperative discomfort. Thoracic segmental spinal anesthesia (TSSA) has emerged as a potential alternative, offering improved intraoperative stability and postoperative outcomes. Objective: To compare the intraoperative hemodynamic responses, perioperative complications, postoperative pain, and recovery profile between thoracic segmental spinal anesthesia and general anesthesia in patients undergoing elective laparoscopic cholecystectomy. Materials And Methods: This prospective, comparative observational study was conducted in the Ad-Din Akij Medical College Hospital, Khulna, during over 18 months from January’2023 to June 2024 and included 90 ASA I–II patients aged 25–55 years undergoing elective LC. Patients were randomized into two equal groups: Group a (TSSA) received 1.75 ml of 0.5% isobaric levobupivacaine with 25 µg fentanyl intrathecally at T9–T10; Group B (GA) received standard general anesthesia. Intraoperative heart rate and mean arterial pressure (MAP) were recorded at regular intervals. Postoperative outcomes included VAS pain scores, time to first analgesic, time to ambulation, and incidence of complications. Results: Baseline demographics were comparable between groups. Group A demonstrated significantly lower intraoperative heart rates and higher MAP values from 5 minutes after incision to the end of surgery (p<0.01). Postoperative VAS scores were significantly lower in Group A at 1, 3, and 6 hours (p<0.05). Time to first analgesic was longer (3.4±1.1 vs. 2.2±0.9 hours) and time to ambulation shorter (3.3±1.0 vs. 5.1±1.4 hours) in Group A (p=0.001). Perioperative complications were similar and not statistically significant between groups. Conclusion: TSSA is a safe and effective alternative to GA for laparoscopic cholecystectomy, offering superior intraoperative hemodynamic stability, better early postoperative analgesia, and faster recovery without increasing perioperative complications.

Background: Tapentadol having both mu-opioid receptor agonist and norepinephrine reuptake inhibitor characteristics has better GI profile and analgesic efficacy in acute and chronic including neuropathic pains. Post operative pain using tapentadol nasal spray with quicker recovery helps in minimizing the amount of time required for patient to be on bed rest, reduced hospital day, hospital expenditure and overall patient satisfaction. Objectives: We conducted this study to compare the efficacy of Tapentadol Nasal Spray and Diclofenac IV in the Post operative patients of Laparoscopic Cholecystectomy by using VAS (Visual Analogue Scale), to compare tapentadol and diclofenac in terms of safety of administration and to study the cost effectiveness. Methods: Using randomized, prospective study design, half of post-operative cases were prescribed tapentadol nasal spray and were assigned Group A. The second half of the postoperative cases received intravenous diclofenac and were assigned Group B. Scheduled dose of tapentadol nasal spray was 22.5 mg in each nostril and for intravenous diclofenac dose was 75 mg. Results: It was observed that the mean pain score in the subjects of the tapentadol nasal spray group was comparatively lower than intravenous diclofenac group by VAS (p<0.05). Conclusion: Tapentadol nasal spray at 22.5 mg in each nostril was found to be effective in managing the post operative pain with minimal side effects.

Antimicrobial resistance (AMR) represents a profound and escalating global health crisis, threatening to dismantle the foundations of modern medicine. In response, healthcare systems worldwide have implemented antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, improve patient outcomes, and curb the emergence of resistant pathogens. This review article explores the central thesis that the efficacy and success of contemporary ASPs in tertiary care settings are not merely enhanced by but are fundamentally dependent on the synergistic and deeply integrated collaboration of pharmacists, laboratory specialists, and nurses. We dissect the unique and indispensable contributions of each profession: the pharmacist's expertise in medication optimization, prospective audits, and formulary management; the laboratory specialist's foundational role in rapid diagnostics, susceptibility testing, and data-driven guidance; and the nurse's critical frontline position in timely administration, clinical monitoring, and patient education. By examining the intricate workflows and communication pathways that bind these roles, we present a model for an ideal "stewardship handshake," illustrating how their combined efforts lead to targeted, effective, and safe antimicrobial therapy. Furthermore, this review addresses the significant barriers to effective interprofessional collaboration—such as communication silos, hierarchical structures, and workflow inefficiencies—and proposes evidence-based solutions to overcome them. We also delineate key performance indicators for measuring the collective impact of this collaborative model. Finally, we look toward the future, considering the integration of emerging technologies like artificial intelligence and telehealth into stewardship, and conclude with a call to action for healthcare institutions to recognize, foster, and invest in these interprofessional teams as the primary defense in preserving the viability of antimicrobials for generations to come.

Background: The management of ureteral calculi is constantly evolving, and advances in technology, new medications and the application of pharmacotherapy continue to alter our approach to ureterolithiasis. The optimal clinical management of patient with ureterlithiasis requires knowledge of the diagnostic procedures, the rational treatment of acute stone colic, stone expulsive treatment and the modern principles of stone removal. The aim of this study was to explore the clinical characteristics and management of ureterolithiasis. Methods: This cross-sectional descriptive study was conducted in the Department of Surgery and Urology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from December 2013 to May 2014. Fifty eight patients with ureterolithiasis fulfilling the inclusion and exclusion criteria were selected. Results: The mean age of the patients was 36.0 ± 13.2 years, with the majority aged 31–40 years. All patients presented with abdominal pain, and 84.2% reported radiation of pain to the groin or genitalia. Other symptoms included nausea/vomiting (39.6%), hematuria (36.2%), and burning micturition (27.6%). Most stones (89.7%) measured between 1–2 cm. Treatments included ESWL (36.2%), ICPL (22.4%), open ureterolithotomy (31.0%), and expectant management (10.3%). Postoperative urinary tract infection occurred in 17.2% of cases; wound infection occurred in 11.1% of open surgery cases. Overall stone clearance was 86.2%, with the highest clearance in open ureterolithotomy (100%). Conclusion: With the availability of better facilities like Extracorporeal Shockwave Lithotripsy, the requirement for open surgery and interventional procedures may decrease.

Background: Chronic hepatitis B (CHB) is a significant global health burden, Patients with CHB are at increased risk of developing cirrhosis, liver failure and hepatocellular carcinoma (HCC). Even in asymptomatic state, there may be much progression of necroinflammation and fibrosis in liver in many patients specially in patients with elevated HBV DNA with normal alanine aminotransferase. Liver biopsy is the gold standard for fibrosis evaluation but has limitations, necessitating non-invasive alternatives like transient elastography in CHB patients with elevated DNA and normal ALT. Objective: This study aims to assess the correlation between TE and liver biopsy findings in CHB patients with elevated HBV DNA and normal ALT, evaluating TE's diagnostic accuracy in detecting significant fibrosis. Methodology: A cross-sectional study was conducted at the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from June 2019 to February 2020. Forty CHB patients (HBsAg positive >6 months, ALT <40 IU/L, HBV DNA >2,000 IU/mL) underwent TE and percutaneous liver biopsy. Fibrosis stages were evaluated using the METAVIR scoring system. TE findings were correlated with histological fibrosis using Pearson's correlation test, with statistical analysis performed via SPSS version 23. Results: The mean age of patients was 30.20 ± 8.3 years, with a male predominance (75%). TE classified 77.5% of patients as having F0-F1 fibrosis and 22.5% as F2 fibrosis. Histological analysis identified 57.5% with F0-F1 fibrosis and 42.5% with significant fibrosis (F2-F4). TE and biopsy findings showed a positive correlation (p<0.001). The receiver-operating characteristic (ROC) curve for TE demonstrated an area under the curve (AUC) of 0.774, with a cut-off value of 5.9 kPa yielding a sensitivity of 70% and specificity of 91% for detecting significant fibrosis. Conclusion: TE shows a strong correlation with liver biopsy findings in CHB patients with elevated HBV DNA and normal ALT, demonstrating its potential as a reliable, non-invasive alternative for fibrosis assessment. Utilizing TE in clinical settings could enhance early detection and management of liver fibrosis, reducing the need for invasive biopsies.

Background: Prolonged hypertension is believed to affect brain structure due to chronic vascular stress. Objective: To assess the correlation between hypertension duration and changes in brain volumes using 3D MRI. Methods: This cross-sectional study involved 100 hypertensive individuals aged 30–60 years. Brain volumes (gray and white matter) were measured using 3D MRI. Pearson correlation analysis was used to evaluate associations with hypertension duration. Results: Strong negative correlations were found between hypertension duration and both gray and white matter volumes (r = -0.49 to -0.56, p < 0.001). Conclusion: Longer duration of hypertension is associated with reduced brain volume, reinforcing the need for early detection and sustained management of blood pressure.

Laboratory diagnostics are indispensable to modern healthcare, yet the integrity of test results can be compromised by medication-related interference (MRI), a significant and underappreciated threat to patient safety. Erroneous laboratory data stemming from MRI can precipitate a cascade of clinical errors, including misdiagnosis, delayed or inappropriate treatment, and unnecessary additional testing. This review offers a practical, evidence-based guide for the key professionals’ integral to the laboratory testing process: nursing technicians, clinical pharmacists, and laboratory specialists. We systematically explore the foundational mechanisms of interference, classifying them into physiological (in vivo) effects, where a drug's pharmacodynamic or toxic action genuinely alters analyte levels, and analytical (in vitro) effects, where a drug or its metabolite directly disrupts the assay methodology. The review examines the vulnerabilities of common analytical platforms—spectrophotometry, immunoassays, enzymatic methods, and chromatography—to such interferences. A substantial compendium details clinically significant MRIs caused by major drug classes, with a particular focus on the profound and dangerous impact of high-dose biotin supplementation on immunoassays. The central aim of this guide is to delineate the distinct yet synergistic roles of the multidisciplinary team. It highlights the nursing technician's pivotal role in the pre-analytical phase, the clinical pharmacist's expertise in proactive drug identification and management, and the laboratory specialist's critical function in result validation and interference investigation. By elucidating the complexities of MRI and championing a framework for robust interprofessional collaboration, this guide seeks to arm healthcare teams with the knowledge and strategies required to protect the integrity of laboratory data, thereby enhancing clinical decision-making and safeguarding patient safety.

Background: Differentiating benign from malignant adrenal tumors is critical for determining appropriate clinical management. Although histopathology is the definitive diagnostic tool, contrast-enhanced computed tomography (CT) offers valuable non-invasive insights. Specific morphologic features- such as size, shape, margins, and enhancement patterns- can help predict malignancy. Establishing reliable CT-based criteria enhances diagnostic confidence and aids in selecting patients who may benefit from surgery or further evaluation. Objective: To evaluate the diagnostic value of CT morphologic features and tumor size in distinguishing benign from malignant adrenal tumors. Methods: This cross-sectional study was conducted at the Department of Radiology and Imaging, Bangladesh Medical University (BMU), Dhaka, over a two-year period and included 30 patients with clinically or radiologically suspected adrenal masses. All patients underwent contrast-enhanced CT (CECT) using a standardized adrenal protocol, including unenhanced, portal venous, and delayed phases. Tumor characteristics such as size, shape, margins, enhancement pattern, internal architecture, necrosis, calcification, and attenuation were assessed. CT findings were interpreted by radiologists blinded to histopathological results. Final diagnoses were confirmed by histopathological examination of biopsy or surgical specimens. CT features and lesion size were then correlated with histopathological outcomes to evaluate their significance. Results: Among the 30 patients evaluated, the mean age was 40.9 ± 17.8 years, with a male-to-female ratio of 1.3:1. CT revealed left-sided adrenal masses in 40%, right-sided in 33.3%, and bilateral involvement in 26.7%. Most lesions (63.3%) were <4 cm, and 53.3% appeared hypodense on pre-contrast imaging. Post-contrast, 50% of lesions showed homogeneous enhancement, while 46.7% showed heterogeneous enhancement. Hemorrhage and necrosis were noted in 23.3% of cases, and invasion into adjacent structures was observed in 6.7%, both exclusively in malignant lesions. Hypodensity was predominantly seen in benign lesions (46.6%), whereas hemorrhage, necrosis, and invasion were exclusive to malignancies. Among lesions <4 cm, 94.7% were benign; among those ≥4 cm, 54.5% were malignant. The odds of a lesion ≥4 cm being malignant were 21 times higher (OR: 21; 95% CI: 2.1–223.6; p = 0.002). Malignant tumors had a significantly larger mean diameter (8.05 ± 5.06 cm) than benign tumors (3.90 ± 2.14 cm; p = 0.003). Adrenal adenoma was the most common lesion (50%), followed by hyperplasia (13.3%) and adrenocortical carcinoma (10%). Conclusion: CT morphologic features, particularly lesion size, enhancement pattern, and structural alterations such as necrosis or invasion, are valuable indicators for distinguishing benign from malignant adrenal tumors. Lesions ≥4 cm and those showing heterogeneous enhancement or invasive characteristics were significantly associated with malignancy.

Clinical laboratory professionals and diabetes educators play pivotal roles in improving diagnostic accuracy and patient outcomes in diabetes management. Laboratory professionals are responsible for conducting precise and reliable laboratory tests, such as fasting blood glucose, HbA1c, and oral glucose tolerance tests, which are crucial for diagnosing diabetes and assessing glycemic control. Their expertise ensures that test results are accurate, timely, and interpret correctly to aid clinicians in making informed treatment decisions. Additionally, they maintain strict quality control measures and stay updated with advancements in diagnostic technologies to minimize errors and improve the overall quality of laboratory data used in diabetes care, Diabetes educators complement this by empowering patients through education about disease management, medication adherence, lifestyle modifications, and self-monitoring techniques. They help interpret test results and translate complex medical information into understandable advice, enhancing patient compliance and engagement. This collaborative approach between laboratory professionals and educators ensures that diabetes is managed effectively, reducing the risk of complications and enhancing patient outcomes. Together, they create a comprehensive support system that promotes accurate diagnosis, personalized treatment plans, and sustained disease control.

Background: Thyroid dysfunction is common in critically ill neonates and has been repeatedly implicated in gastrointestinal dysmotility and sub optimal growth. Yet, the magnitude and nature of its relationship with feeding difficulties in the neonatal intensive care unit (NICU) remain uncertain. Objectives: We synthesized contemporary evidence on the prevalence of thyroid disorders among NICU patients, quantified the frequency of concomitant feeding difficulties, and explored mechanistic links and therapeutic implications. Methods: A systematic search of PubMed, Web of Science, Scopus and ScienceDirect was performed from inception to 1 March 2025. Very low birth weight and term neonates admitted to NICU settings were eligible. Two reviewers independently screened records, extracted data and assessed risk of bias with the Joanna Briggs Institute tool. Results: From 812 unique records, 10 studies met inclusion criteria (4 cohort, 3 case control, 1 prospective crossover trial, 2 case reports; cumulative N = 2 387 neonates). Congenital or acquired hypothyroidism predominated; one series reported delayed thyrotropin elevation and another synthesized thyroid dysfunction secondary to maternal Graves’ disease. Across studies, hypothyroid infants required significantly longer periods nil per os, tolerated lower enteral volumes and had more frequent gastric residuals than euthyroid peers. Initiation of L thyroxine—typically 5 15 µg kg⁻¹ day⁻¹—consistently accelerated achievement of full feeds and resolved abdominal distension. Quality appraisal rated eight studies moderate and two high. Conclusion: The best available evidence indicates that untreated thyroid hypofunction is an under recognized, reversible contributor to feeding intolerance in the NICU. Routine thyroid re evaluation in hard to feed infants and prompt thyroxine replacement when indicated may shorten parenteral nutrition dependency and hospital stay. Robust multicenter trials are warranted to define optimal screening intervals and dosing strategies.

Background: Oral diseases remain a significant global health burden. The traditional restorative approach to dental care, focused on repairing disease outcomes, is increasingly recognized as insufficient for managing these chronic, multifactorial conditions. This highlights a critical need for a more preventive and holistic paradigm. Objective: This review aims to synthesize the current evidence on key dietary and pharmacological adjuncts that supplement and enhance standard mechanical dental care. Furthermore, it seeks to critically analyze the essential role of interprofessional collaboration (IPC) in the effective implementation of these adjuncts to optimize patient outcomes and facilitate a shift towards comprehensive, patient-centered oral healthcare. Methods: A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Scopus, and Web of Science, for articles published up to June 2025. The review prioritized systematic reviews, meta-analyses, randomized controlled trials, and authoritative position papers. Findings: The evidence strongly supports the efficacy of various pharmacological adjuncts, including topical fluorides for remineralization, chlorhexidine for short-term microbial control, and sub-antimicrobial dose doxycycline for host modulation in periodontitis. Dietary adjuncts, such as polyphenols, probiotics, and dietary nitrates, show promising potential in modulating the oral microbiome and host response. The synergistic potential of these adjuncts is most effectively realized when managed by a cohesive interprofessional team. This collaborative model, involving dentists, physicians, pharmacists, and dietitians, allows for comprehensive management of interconnected factors such as systemic disease, polypharmacy, and complex nutritional needs. Conclusion: The integration of evidence-based dietary and pharmacological adjuncts through a structured interprofessional collaborative model is fundamental to advancing modern dental care.

To analyse the drug prescription pattern for secondary prevention of stroke, medication adherence, knowledge and awareness about the disease, and direct medical costs involved in the treatment of stroke. A Prospective observational study was carried out for 6 months in the inpatient department. The inclusion criteria of the present study are patients of either sex aged ≥ 18 years, patients who were diagnosed as stroke patients and admitted to the intensive care unit of the hospital. About 120 prescriptions in total were examined during the 6-month trial. Men aged 64 showed a higher prevalence of this (53.33%). 120 individuals were included in the study, 115 (95.5%) of whom had ischemic stroke, while 5 (5%) had a haemorrhagic stroke. Hypertension, dyslipidemia, and diabetes mellitus were the three main co-morbidities found; these conditions were present in 82 (68.0%), 80 (66.6%), and 73 (60.8%%) individuals, respectively. The majority of the patients in this study on pharmacological prescriptions for stroke were being treated with statin and antiplatelet medications. 109 (90.8%) of the 120 patients received statin (Atorvastatin) medication. This study found that clopidogrel, prescribed to 102 (84.8%) and 19 (15.8%) patients, was the most widely used antiplatelet. In our facility, the sole anticoagulant utilized for stroke victims was heparin.

Nasopharyngeal carcinoma (NPC) is the most frequent malignancy arising in the nasopharynx. While cervical lymph node metastases are common at diagnosis, rare cases may occur without nodal involvement. We report the case of a 48-year-old man presenting with headache, epistaxis, and nocturnal snoring. Clinical examination revealed no palpable cervical lymphadenopathy. Imaging showed nasopharyngeal thickening with lysis of the sphenoidal floor and intracranial extension. Histological evaluation confirmed a high-grade undifferentiated infiltrating carcinoma of type UCNT. The patient responded well to chemotherapy.

To study the prescribing pattern of drugs used in Diabetes mellitus with cardiovascular diseases in a tertiary care hospital. A prospective observational study was done in the General Medicine department of Almas Hospital for 6 months to analyze the prescribing pattern of drugs used in Diabetes mellitus with cardiovascular diseases. 154 patient prescription patterns were studied, out of which 56.5% were males and 43.5% were females. Most of the patients were in the age group of 41-64. Hypertension was the most commonly found co-morbid condition. Glimepiride+metformin were mostly prescribed during a hospital stay. Metformin was the commonly prescribed oral hypoglycemic agent. It was found that the majority of drugs were prescribed from the recent NLEM of India by the practitioners which indicates the implementation and adoption of national drug policy by the hospitals and cardiologists

Introduction: In gynecology and ultrasonography, adnexal masses are a major health concern. Ultrasonography and International Ovarian Tumor Analysis (IOTA) criteria are crucial for diagnosing and identifying malignant grades, and an accurate distinction by non-invasive techniques is necessary for proper care. Methods: From January to May 2025, 400 patients who presented with adnexal masses at the Saudi Hospital for Obstetrics and Gynecology in Khartoum, Sudan, participated in a descriptive cross-sectional study. Adnexal lesions were assessed using transvaginal and abdominal ultrasonography, with the IOTA Simple Rules (SR) employed for classification. To evaluate associations with ultrasound results and final diagnoses, information on patient demographics, age, symptoms, and medical history was examined. Result: The age categories of 26–40 and 41–55 were the most impacted. The majority of patients experienced symptoms, with pain accounting for about 43.3% of cases. According to the IOTA SR criteria, ultrasonography identified 22% of masses as malignant and 68.8% as benign. Ultrasound characteristics, such as uneven shape, ascites, papillary projections, and vascularity, were found to be significantly associated with malignancy. Malignant lesions were also significantly associated with older age and a history of breast cancer. According to statistical analyses, ovarian cancer can be accurately predicted by certain ultrasonographic features using IOTA Simple Rules. In conclusion, ultrasonography is a reliable and efficient method for assessing and categorizing adnexal masses when used following IOTA guidelines. Combining the patient's age, medical history, and ultrasound characteristics improves diagnostic precision, enables prompt and effective treatment, and lowers the risk of surgery.

Introduction: The worrying increase in multi-resistant Gram-negative bacilli (GNB) infections and the glaring lack of therapeutic alternatives has allowed colistin to regain a place in the antibiotic arsenal, often as a last resort. This study aimed to evaluate a method for testing sensitivity to colistin that is simple, inexpensive, and accessible: disk diffusion, compared to the gold standard method of liquid microdilution. Materials and methods: A comparative study was conducted on 124 strains of Gram-negative bacilli. Each strain was tested by agar diffusion (50 µg colistin disk) and broth microdilution (Sensititre® plate). Results: Our results showed that the diffusion method does not meet the performance criteria established by the CLSI, with a particularly high major error rate (45.8%) and a categorical agreement of 83.1%. Conclusion: Disk diffusion cannot be considered a reliable method for testing colistin susceptibility in the laboratory.

Cancer is still one of the top causes of deaths in the world, taking almost 10 million human lives in 2020. While great strides are being made in the management of this disease, traditional tumour treatments still grapple with immense systemic toxicity, drug resistance, and the failure of drugs to precisely target complex tumour environments. Nanotechnology may overcome these issues, and a nanostructure robot for targeting drug delivery nanobots is increasingly considered one of the groundbreaking approaches in oncology. The present review covers the development, mechanisms, and applications of nanobots in cancer therapy, focusing on their potential to improve treatment efficacy with reduced adverse effects. Smart, stimuli-responsive nanobots can release their content based on tumour-specific factors like pH or temperature, enhancing therapy precision. Applications range from immunotherapy and gene therapy to overcoming obstacles in the form of the blood-brain barrier, demonstrating the versatility of nanobots in the treatment of aggressive cancers. More recently, AI and organ-on-a-chip models are combined to further perfect the design of nanobots and forecast the results of therapeutics, moving toward personalized treatments of cancer. Challenges are yet incomplete: biocompatibility, immunogenicity, and scalability remain relevant, besides regulatory and ethical concerns. Overcoming such limitations requires both interdisciplinary collaboration and technical development. The present review underlines the transformative potential of nanobots in the field of drug targeting and cancer therapy, a position whereby nanobots are a cornerstone of next-generation precision medicine. Nanobots overcome current limitations, hence promising safer, more effective, and personalized solutions for cancer treatment.

Objectives: To investigate the existing literature on the pharmacokinetics (PK) and pharmacodynamic (PD) of anesthetic agents in obese children. Methods: A total of 419 pertinent publications were found after a comprehensive search across four databases. 26 full-text publications were examined after duplicates were eliminated using Rayyan QCRI and relevance was checked; five studies finally satisfied the requirements for inclusion. Results: We included five studies with a total of 10,570 children and less than half of them 4741 (44.8%) were females. Research on the PK of propofol in obese adolescents identified total body weight (TBW) as a key determinant of drug clearance, emphasizing the limitations of relying solely on clinical factors for dosing. Additionally, a study on fentanyl highlighted the importance of TBW for loading doses and LBW/ lean body weight (LBW) for maintenance dosing, while cautioning against the heightened susceptibility of severely obese patients to fentanyl's respiratory side effects, necessitating careful PD considerations. Conclusion: Anesthesia management in obese children requires addressing unique physiological and pharmacological challenges. This review emphasizes the importance of TBW in dosing strategies and the integration of LBW and IBW for maintenance regimens to minimize risks. While offering valuable insights, further research is needed to validate these findings and establish standardized protocols, ultimately enhancing safety and efficacy in anesthetic care for obese pediatric patients.

Introduction: Determining whether an ovarian tumor is benign or malignant before surgery can change the treatment plan and aid in early identification. Transvaginal ultrasonography, in particular, is a useful technique for ovarian tumor detection. Early diagnosis is crucial since the majority of ovarian cancers are epithelial ovarian cancers (EOC), which grow quickly. Treatment can be more successful if a gynecologic oncologist is consulted right away to diagnose the type of tumor. Methods: A descriptive cross-sectional study was conducted among 400 patients presenting with adnexal masses at the Saudi Hospital for Obstetrics and Gynecology in Khartoum, Sudan, from January to May 2025. Transvaginal and abdominal ultrasonography were utilized to evaluate adnexal lesions. Data on patient demographics, symptoms, and medical history were analyzed to assess correlations with ultrasound findings and final diagnoses. Results: The study found that the most affected age group by ovarian tumors was those in 26-40 years, which constituted 42% and 41-55 years represented 28.25%. Approximately 43.3% of patients were asymptomatic, more than half were symptomatic, with pain being the most prevalent symptom. Ultrasonography classified 68.8% of masses as benign and 22% as malignant. Significant associations were found between ultrasound features, such as irregular contour, ascites, papillary projections, and vascularity, and the presence of malignancy. Older age and a history of breast cancer were also significantly associated with malignant lesions. Statistical analyses demonstrated that specific ultrasonographic features effectively predict ovarian malignancy. Conclusion: Ultrasonography is an efficient and dependable method for identifying, assessing, and categorizing ovarian cancers. Combining the patient's age, medical history, and ultrasound characteristics improves diagnostic precision, enables prompt and effective treatment, and lowers the risk of surgery.

Genital tuberculosis is a rare but significant cause of infertility and chronic pelvic disease, particularly in countries with a high tuberculosis burden. It is often underdiagnosed due to its asymptomatic or non-specific clinical presentation. We report the case of a 38-year-old woman with a history of treated peritoneal tuberculosis, in whom ovarian tuberculosis was revealed by bilateral pyosalpinx.

Chryseobacterium indologenes is a rare but emerging opportunistic Gram-negative pathogen, primarily isolated from hospital environments and associated with severe infections in immunocompromised or critically ill patients. We report the case of a 2-year-old girl with a history of recurrent bronchopulmonary infections and recent cardiac surgery for a subaortic membrane, who developed sepsis postoperatively.