bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome-scale clustered regularly interspaced short palindromic repeats screen identifies nucleotide metabolism as an actionable therapeutic vulnerability in diffuse large B-cell lymphoma
Authors: Davies Nicholas , Francis Tegan , Oldreive Ceri , Azam Maria , Wilson Jordan , Byrd Philip J. , Burley Megan , Sharma-Oates Archana , Keane Peter , Alatawi Sael , Higgs Martin R. , Rudzki Zbigniew , Ibrahim Maha , Perry Tracey , Agathaggelou Angelo , Hewitt Anne-Marie , Smith Edward , Bonifer Constanze , O’Connor Mark , Forment Josep V. , Murray Paul G. , Fennell Eanna , Kelly Gemma , Chang Catherine , Stewart Grant S. , Stankovic Tatjana , Kwok Marwan , Taylor Alexander Malcolm
Published: June 2024

Diffuse large B-cell lymphoma (DLBCL) is the most common malignancy that develops in patients with ataxia-telangiectasia, a cancer-predisposing inherited syndrome characterized by inactivating germline ATM mutations. ATM is also frequently mutated in sporadic DLBCL. To investigate lymphomagenic mechanisms and lymphoma-specific dependencies underlying defective ATM, we applied ribonucleic acid (RNA)-seq and genome-scale loss-offunction clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 screens to systematically interrogate B-cell lymphomas arising in a novel murine model (Atm-/-nu-/-) with constitutional Atm loss, thymic aplasia but residual T-cell populations. Atm-/-nu-/-lymphomas, which phenotypically resemble either activated B-cell-like or germinal center Bcell-like DLBCL, harbor a complex karyotype, and are characterized by MYC pathway activation. In Atm-/-nu-/-lymphomas, we discovered nucleotide biosynthesis as a MYCdependent cellular vulnerability that can be targeted through the synergistic nucleotidedepleting actions of mycophenolate mofetil (MMF) and the WEE1 inhibitor, adavosertib (AZD1775). The latter is mediated through a synthetically lethal interaction between RRM2 suppression and MYC dysregulation that results in replication stress overload in Atm-/-nu-/-lymphoma cells. Validation in cell line models of human DLBCL confirmed the broad applicability of nucleotide depletion as a therapeutic strategy for MYC-driven DLBCL independent of ATM mutation status. Our findings extend current understanding of lymphomagenic mechanisms underpinning ATM loss and highlight nucleotide metabolism as a targetable therapeutic vulnerability in MYC-driven DLBCL.
Management of HepatitisB - How far are We from the Holy Grail?
Authors: Mahtab Mamun Al , Fazle Akbar Sheikh Mohammad
Published: June 2024

Background: Although there are several antivirals available against hepatitis-B, they have several limitations including infinite duration of administration, viral resistance, adverse events and failure of prevention of liver disease progression in all cases. Therefore the quest for a new antiviral against heptatitis-B continues. Methods: Phase-1, 2 & 3 clinical trials of a novel therapeutic vaccine for hepatitis-B called NASVAC were conducted in treatment naive chronic hepatitis-B patients in Bangladesh. Subsequently the patients were followed up off treatment for upto 3 years. Results: Results show that NASVAC treated patients achieved better virologic control compared to those treated with pegylatedinterferon. NASVAC was not only found to be safe, it also induced immune modulation and most importantly unlike those patients who were treated with pegylatedinterferon, there was no progression of liver disease in NASVAC treated patients. NASVAC has subsequently been registered in five different countries and its recipe has been approved by the Drug Control Committee of Bangladesh Government. Conclusion: NASVAC appears to be an effective therapeutic agent for chronic hepatitis-B, free from adverse events and of finite duration that prevents liver disease progression.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 155
Serum adipocyte fatty acid binding protein (AFABP) level in different trimesters of gestational diabetes mellitus
Authors: Ferdousi Tahmina , Jahan Sharmin , Hasanat Ma
Published: June 2024

Background: Adipocyte fatty acid binding proteins (AFABP) are inflammatory adipocytokines released from adipose tissue. It is thought that it is related to insulin indices and pathogenesis of gestational diabetes mellitus (GDM). Their level may change during pregnancy with the increase of gestational age. This study aimed to determine the level of serum AFABP in mothers with GDM and normal glucose tolerance (NGT) in all trimesters to see whether they vary among different trimesters as well as between GDM and NGT. Methods: This cross-sectional study included 81 pregnant women with GDM (25, 25 & 31 in 1st, 2nd and 3rd trimesters respectively) and almost an equal number of NGT after challenging by three sample 75gm oral glucose tolerance test (OGTT) following WHO- 2013 criteria in the Endocrinology department of BSMMU. AFABP and insulin were measured from serum samples obtained in fasting state during OGTT. Glucose was measured by glucose oxidase, insulin concentration by chemiluminescent immunoassay, and AFABP by sandwich ELISA. Equations of homeostatic model assessment (HOMA) were used to calculate insulin indices. Results: AFABP [0.61(0.42, 1.52) vs. 0.80(0.43, 1.70), median; p=0.235] was statistically similar in GDM and NGT group. Similarly, AFABP showed no significant difference in all trimesters [0.54 (0.37, 0.89) vs. 0.79 (0.46, 1.78), p=1.34; 0.56(0.38, 1.70) vs. 0.76(0.34, 1.47), p=0.903; 0.65(0.46, 2.13) vs. 0.84(0.44, 2.48), p= 0.763 in 1st, 2nd and 3rd trimester respectively] in GDM than NGT. Moreover, AFABP showed no significant within-group difference (p=NS for all) among three trimesters of pregnancy in the GDM and NGT groups. AFABP was not significantly correlated with age, gestational age, BMI, glucose values and insulin indices in GDM or NGT (p= NS for all). By binary logistic regression, AFABP [OR (95%CI; 1.084(0.834-1.408), p=0.547] was not an independent predictor for GDM when adjusted for important demographic (age, gestational weeks, multigravida), clinical (BMI), and biochemical (HOMA-IR) covariates. Among the covariates, multigravida (p=0.019) and HOMA-IR (p <0.001) were observed to be independent predictors of GDM. Conclusion: It was concluded that AFABP is not statistically different in GDM and NGT or among the three trimesters of the two groups.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 160
Association of multimorbidity and disease clusters with neuroimaging and cognitive markers of brain health in 43,160 individuals.
Authors: Al Abid Shehab Uddin , Calvin Catherine M , Qureshi Danial , Veldsman Michele , Kuÿma El¿bieta , Littlejohns Thomas J
Published: June 2024

Background: Recent research has found that living with two or more chronic conditions, termed multimorbidity, is associated with an increased risk of developing dementia. In the current study, we investigated whether multimorbidity is associated with a range of dementia-related neuroimaging and cognitive markers of brain health that typically manifest prior to a clinical diagnosis of dementia. Methods: We included 43,160 participants aged 45-83 years free from neurological conditions, including dementia, who attended the UK Biobank imaging assessment from 2014-onwards. Multimorbidity was defined as the presence of ³2 long-term conditions from a standardised criteria of 39 conditions. Latent class analyses were used to identify disease clusters. Neuroimaging outcomes were measured using magnetic resonance imaging (MRI), and cognition was assessed by seven tests measuring different cognitive domains. Linear regression models, adjusted for socio-demographic and neuroimaging confounders, were used to test the association between multimorbidity and disease clusters with neuroimaging and cognitive outcomes. Results: Multimorbidity was present among 14,339 (33.2%) participants. In fully-adjusted models, presence of multimorbidity was associated with several measures of poorer brain health. This included lower volumes of grey matter (b: -0.03 standard deviation (SD); 95% confidence interval (CI): -0.04, -0.02), total brain (b: -0.01 [-0.02, -0.01]), left hippocampus (b: -0.03 [-0.05, -0.01]), increased white matter hyperintensity volume (v: 0.09 [0.07, 0.10]), poorer executive function (b: 0.04 [0.02, 0.06]), verbal declarative memory (b: -0.03 [-0.05, -0.01]), and processing speed (b: -0.07 [-0.10, -0.05]). A strong dose-response relationship was observed with the increasing number of multimorbid conditions and the aforementioned outcomes. Strength of associations varied across disease clusters, with a cluster predominantly driven by cardio-metabolic conditions showing the strongest associations with brain health outcomes. Clusters driven by ‘respiratory’, ‘mental health’ and ‘miscellaneous’ conditions were inconsistently associated with neuroimaging and cognitive outcomes. Conclusion: Multimorbidity, primarily cardio-metabolic multimorbidity, was associated with poorer brain health. These findings provide insights into the potential pathways underlying previously observed associations between multimorbidity and dementia risk.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 162
Keto Diet: Where Do We Stand Today?
Authors: M Saifuddin
Published: June 2024

Ketogenic diet seems like the latest weight-loss craze, but it’s been around for nearly a century. Developed in 1920s, this ultra-low-carb, high-fat diet was originally used to treat seizures in people with epilepsy but grab attention and popular among young generation and Diabetic patients for rapid weight reduction and hope to get numerous health benefits against Diabetes, Cancer, certain neurological disorders including Alzheimer's disease. Diabetic patients are following the diet as some people claim that reversal to non-Diabetic state and controlling Diabetes without any medication is also possible with this diet. Ketogenic diet involves drastically reducing carbohydrate intake and replacing it with fat aiming to force the body into metabolizing fat instead of carbohydrates. Burning fat seems like an ideal way to lose weight and reduce appetite. The classic Ketogenic diet is not a balanced diet and has numerous risks. Ketogenic diet is high in saturated fat with link to atherosclerosis and heart disease. There is risk of Diabetic ketoacidosis due to discontinuation of Anti Diabetic medication or patients on SGLT2 inhibitor. Other potential risks include nutrient deficiency, deterioration of existing liver disease, renal problems due to protein overload and increased risk of osteoporosis. Available research on the Ketogenic diet for weight loss is still limited with a small number of participants for a limited period and without control groups. So long term outcome of Ketogenic diet is uncertain as very low carb diet is difficult to sustain with numerous risk and possibility of weight gain after giving up of Ketogenic diet.
Bangladesh J Medicine, 2024; Vol. 35, No. 2, Supplementation: 148-149
Renal Involvement in Vasculitis: An Evidence-Based Approach
Authors: Chowdhury Md Nizamuddin
Published: June 2024

Vasculitis represents a heterogeneous group of disorders characterized by inflammation of blood vessels, affecting various organ systems, including the kidneys. Renal involvement in vasculitis poses significant diagnostic and therapeutic challenges due to its diverse clinical manifestations and potential for severe morbidity and mortality. This abstract aims to provide an evidence-based overview of renal involvement in vasculitis, emphasizing a comprehensive approach to diagnosis and management. Epidemiological studies have demonstrated that renal involvement occurs in a significant proportion of patients with systemic vasculitis, including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilicgranulomatosis with polyangiitis (EGPA). The spectrum of renal manifestations ranges from asymptomatic urinary abnormalities to rapidly progressive glomerulonephritis and chronic kidney disease. Diagnosis of renal vasculitis requires a systematic evaluation, including clinical assessment, laboratory investigations, imaging studies, and renal biopsy. Biomarkers such as anti-neutrophil cytoplasmic antibodies (ANCA) and complement levels aid in the diagnosis and classification of ANCA-associated vasculitis. Imaging modalities such as renal ultrasound, computed tomography (CT), and magnetic resonance angiography (MRA) provide valuable information regarding renal vasculature involvement. Renal biopsy remains the gold standard for establishing the diagnosis, determining the histopathological pattern, and guiding treatment decisions. Histological findings typically include necrotizing crescentic glomerulonephritis, pauci-immune glomerulonephritis, or immune-complex-mediated glomerulonephritis, depending on the underlying vasculitic process. Management strategies for renal vasculitis involve a multidisciplinary approach, incorporating immunosuppressive therapy, supportive care, and treatment of comorbidities. Induction therapy often consists of high-dose glucocorticoids combined with immunosuppressive agents such as cyclophosphamide or rituximab, tailored to the specific vasculitic subtype and disease severity. Maintenance therapy aims to achieve disease remission while minimizing treatment-related toxicity. Recent advances in targeted therapies, including novel biologics and small molecule inhibitors, offer promising alternatives for refractory or relapsing disease. However, optimizing treatment regimens requires careful consideration of efficacy, safety, and individual patient factors. In conclusion, renal involvement in vasculitis represents a complex interplay between immunological dysregulation, vascular inflammation, and end-organ damage. An evidence-based approach encompassing early recognition, accurate diagnosis, and tailored therapy is essential to improve outcomes and mitigate long-term renal complications in affected individuals.
Bangladesh J Medicine, 2024; Vol. 35, No. 2, Supplementation: 133-134
Drug-coated Balloon : A Superb Alternative To Coronary Stents
Authors: Singha Chayan Kumar
Published: June 2024

The evolution of interventional cardiology has witnessed a paradigm shift in the management of coronary arterydisease (CAD). Among the arsenal of interventions, coronary stents have been a cornerstone, providing mechanicalsupport and reducing restenosis rates. However, concerns persist regarding stent-related complications such asin-stent restenosis, late stent thrombosis & hazards of bleeding due to use of long dual antiplatelet (DAPT). Inrecent years, the emergence of drug-coated balloon (DCB) has introduced a promising alternative approach forthe treatment of CAD. DCB offer a unique mechanism of action, delivering antiproliferative drugs directly to thevessel wall without leaving a permanent implant. This characteristic eliminates concerns related to stent thrombosisand the need for long-term DAPT. Furthermore, DCB preserve vessel anatomy and vasomotion, potentially enablingfuture revascu- larization options. Clinical trials and real-world data have demonstrated the efficacy of DCB invarious coronary lesions, including small vessels and in-stent restenosis. This abstract provides an overview ofthe advantages of DCB over traditional coronary stents and highlights key clinical evidence supporting their use.Additionally, it discusses the economic implications and patient-centered outcomes associated with DCB therapy.Despite these advantages, challenges such as device delivery and optimal drug formulations remain areas ofongoing research and development. In conclusion, DCB represent a superb alternative to coronary stents inselected patients with CAD, offering comparable efficacy while mitigating stent & antiplatelet related complications.As technology continues to advance, further refinements in DCB design and drug delivery systems hold thepotential to revolutionize the landscape of coronary intervention, providing safer and more effective treatmentoptions for patients with CAD.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 151
Multiple myeloma: Evidence based management.
Authors: Saleh Abu Jafor Md
Published: June 2024

Multiple myeloma is a neoplasm of plasma cell which comprises 10% of all hematological malignancies. First case myeloma described in 18441 but medical treatment was commenced from 1960 with melphalan and prednisolone. In 1999 thalidomide was discovered and after three years huge change occurred with development of Bortezomib and Lenalidomide. Most common symptom is pain and progressively complicates with anemia, renal impairment, hypercalcemia which are better known as CRAB.Current treatment is triplet combination with VTD, VCD or RVD as standard of care2. The golden drug “melphalan” which was discovered in 1958, now used in conditioning purpose for autologous stem cell transplant. Another milestone is the discovery of anti-CD38 monoclonal antibody called Daratumumab which is approved in November 2015 to use as 4th agent with any of the above triplets or as single agent for selected patients.After relapse of 3rd or 4th line treatment including autologous stem cell transplant, where apparently no hope for further therapeutic option, chimeric antigen receptor T cell (CAR-T) therapy showed excellent remission rate above 60% and got US FDA approval in March 20212. In Bangladesh we are practicing with 3 or 4 drug induction followed by autologous stem cell transplantation, and then oral maintenance. Almost 150 autologous stem cell transplant has been done in Dhaka and Chattogram. Hope in future we will be able to start CAR-T therapy in our country.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 148
Alopecia: Updated management
Authors: Mia Mohammad Tariquzzaman
Published: June 2024

Hair is of high aesthetic value in human. Loss of hair is called alopecia. It is a common and complex concern causes frustration, negetive emotion and lack of confidence. Normal daily hair loss is about 100 to 150.Causes of Alopecia are Non Scarring alopecia, pattern alopecia /Androgenetic Alopecia, Unpattern alopecia - Alopecia areata, Telogen effluvium, anagen effluvium, Traction alopecia due to hair style, hair shaft damage by hot air dryers and by hair Straightening and Other causes:- Alopecia syphilitica, diabetesmellitus, hypothyroidism,anaemia, seborrheic dermatitis, psoriasis. Scarring alopecia are Lichen planopilaris, pseudopelade, DLE, Folliculitis decalvans, infections. Diagnostic approach to hair loss : step-1 - History of the hair problem , step-2 - obtain a through medical history, step-3 - Examination of scalp and hair and step - 4- Diagnostic tests are Hair pull test, Dermoscopy,scalp biopsy. Lab tests-CBC, Ferritin, TIBC,TSH,Testosteron and step-5: Treatment: - according to the cause of hair loss.Medical treatment. Topical and intralesional steroid, topical Minoxidil, tacrolimus, finasteride, spironolactone. Updated medical treatment: Tofacitinib. Updated procedural treatment( Procedure): - PRP therapy, Microneedling, Low level Laser therapy (LLLT), stem cell therapy, Hair transplant.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation:137
Hand-Held Ultrasound (HHU) as a Diagnostic and therapeutic tool in bedside clinical medicine
Authors: Rahim Abdur , Islam Md Rafiqul , Taha Abtahir Rahim , Bhuiyan Tahmid
Published: June 2024

Ultrasound is a sound wave that can be generated with a transducer via piezoelectric crystals and received to produce 2D images on a screen.  The evolution of ultrasound device from traditional cart based to hand held devices has massively increased its use in the bedside clinical setting which is called point of care ultrasound (PoCUS).  Its application is extensive ranging from lung ultrasound which can rapidly determine an effusion, edema or consolidation to determining the hemodynamic and cardiac parameters in critically ill patients.  This can be done by checking the Inferior vena cava (IVC) diameter and left ventricular ejection fraction.  Besides this, with high frequency probes, vascular integrity and difficult vascular access can be easily established.  Rapid assessment of trauma patients and surgical abdomen can also be established with ease.  In short, now is the time for physicians to take hand held USG devices as routine tool for clinical examination as it will increase diagnostic accuracy and improve care in medicine.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 150-151
Rabies: Is it Possible to Treat?
Authors: Basher Ariful
Published: June 2024

Rabies is one of the oldest and deadliest diseases in the world and causes a significant number of deaths. Over 95% of all human deaths from rabies occur in Asia and Africa. Bangladesh is endemic to rabies. Since the National Rabies Elimination Program was successfully implemented in 2010, Bangladesh has achieved considerable strides in preventing human mortality from rabies. Rabies post-exposure prophylaxis (PEP) is widely used and very effective. However, occasional incidences of rabies in individuals who have initiated or completed PEP have been documented. In this observational cohort study, total 45 clinically diagnosed rabies patients, irrespective of age and gender, from 33 different districts of Bangladesh were studied. A detailed clinico-demographic profile, including post-exposure prophylaxis received before the development of rabies, was recorded. RT-PCR for rabies was done on the saliva samples of all patients. An MRI, EEG, and CSF viral panel were also done for patients who were RT-PCR negative. From January 2022 to June 2023, 45 clinically diagnosed rabies cases were admitted to IDH. Two of them were PCR-positive. The median age of the patients was 11 years (IQR 5–40 years). 37 (82.2%) were males. Dogs were the most commonly accused animal (86.5%). The median time from exposure to the development of rabies symptoms was 37 days (IQR 22–60 days, range 07–240 days). The median duration of illness was 5 days (IQR: 3–7 days). All of the patients had severe exposure. Only 5(11%) patients received complete WHO-recommended post-exposure prophylaxis (PEP). 20 (45%) patients received only the rabies vaccine (incomplete PEP) without a wound wash or RIG. All the patients received supportive management. In addition to that, three patients were given intrathecal RIG at 40 U/kg/dose for two doses seven days apart. Out of three patients, two survived for more than two months. One patient is still alive after six months with significant morbidity. There is no cure for rabies; however, appropriate animal bite management by trained medical personnel with WHO-recommended PEP is the only way to achieve the goal of a rabies-free world.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 140
Early Cancer Detection: Screening Method
Authors: Hussain Syed Md Akram
Published: June 2024

Early detection of cancer is pivotal in improving patient outcomes and reducing mortality rates. Screening methods play a crucial role in identifying cancer at its nascent stages, facilitating timely interventions and treatment. This abstract focuses on various screening methods employed for early cancer detection, highlighting recent advancements and updates in the field. One of the most widely utilized screening methods is imaging-based screening, including mammography for breast cancer, colonoscopy for colorectal cancer, and low-dose computed tomography (LDCT) for lung cancer. These techniques enable the visualization of abnormal growths or lesions, aiding in the early diagnosis of cancer. In addition to imaging, biomarker-based screening has gained prominence in recent years. Biomarkers such as circulating tumor DNA (ctDNA), microRNAs, and protein markers offer non-invasive methods for detecting cancer-related changes in the body. These biomarkers not only enhance early detection but also contribute to monitoring treatment response and disease progression. Furthermore, advances in technology have led to the development of novel screening approaches, including liquid biopsy and artificial intelligence (AI)-assisted diagnostics. Liquid biopsy allows for the analysis of tumor-derived materials circulating in bodily fluids, offering a minimally invasive alternative to traditional tissue biopsies. AI-driven algorithms aid in the interpretation of screening results, improving accuracy and efficiency in cancer detection. Despite these advancements, challenges persist in achieving widespread adoption and accessibility of screening methods, including cost barriers and disparities in healthcare access. Efforts to address these challenges, coupled with ongoing research and innovation, hold promise for further improving early cancer detection and ultimately reducing the global burden of cancer-related morbidity and mortality.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 146
Obscure Gastrintestinal Bleeding
Authors: Shrestha Ramila
Published: June 2024

Obscure Gastrintestinal Bleeding is one of the most challenging disorders faced in gastrointestinal practice.Obscure gastrointestinal bleeding is defined as bleeding from the gastrointestinal tract that persists or recurs after a negative initial evaluation using gastroscopy, colonoscopy and radiological imaging.The underlying etiology can be found on initial evaluation in 10–20% of cases. Recurrent or persistent bleeding occurs in approximately half of OGIB patients (5%). OGIB is be classified as overt or occult bleeding. Overt OGIB is clinically  bleeding that recurs or persists after a negative  initial endoscopy, colonoscopy and radiological evaluation. Where as occult OGIB is defined as iron deficiency anaemia with or without a positive fecal occult blood test.The main reason for a negative initial evaluation because of intermittent  bleeding, The patient may present  anaemia, dehydration .The common etiologies of OGIB are carcinoid,GIST,adenocarcinoma,lymphoma,ampullary adenoma. Clinical presentation include ,nature of bleeding(eg.hemetemesis,hematochezia or melaena) ,bleeding diathesis,medication use,comorbidities (eg.valvular heart disease,vasculitis).High miss rate include for lesions in initial endoscopic evaluation with standard esophagogastroduodeoscopy(EGD) and colonoscopy. The mainstay in the management of these patients has ,traditionally the use of invasive procedures such as intra-operative enteroscopy.The introduction of video-capsule endoscopy (CE),Balloon-assisted enteroscopy (BAE).The introduction of video capsule endoscopy,balloon-assisted enteroscopy,spiral enteroscopt and computed tomography entergraphy(CTE) have largely replaced invasive surgical procedures, that can change in the approach to diagnosis and management of OGIB.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 142
Revisiting the management of heart failure with reduced ejection fraction
Authors: Majumder Abdullah Al Shafi
Published: June 2024

Management of HFrEF include: life style changes : diet. weight management, exercise , pharmacotherapy : “ Fantastic four -  RAAS inhibitors, Beta-blockers, SGLT 2 inhibitors, MRAs”; diuretics – symptom relief; Ivabridine ; Digoxin in selected patients; Vericiguat, Omicamtiv, Device therapy : CRT; ICD, Interventional : MV repair, Coronary angioplasty and Surgical – CABG; Repair or replacement of diseased valves, LV aneurysmectomy etc. Adjunct therapy in HFrEF are correction of iron deficiency: Inj ferric carboxymaltose, management of thyroid dysfunction and management of any associated risk factors. Periodic follow-up : clinical assessment, LV  dimension & systolic function by echocardiography; NT-pro BNP level ; Renal function & S electrolytes.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 135
Validation of Bengali Version of Functional Digestive Disorders Quality of Life Questionnaire
Authors: Rahman Md Mahmudur , Aftab Hafeza
Published: June 2024

Background: Irritable bowel syndrome and Functional dyspepsia are predominant functional bowel disorders with a substantial negative impact on quality of life. Functional digestive disorders quality of life questionnaire (FDDQL) is one of the most commonly used self-administered questionnaires developed to measure health related quality of life in patients with functional bowel disorders. It has been validated in many countries, still there is no Bengali version FDDQL. This study aimed to develop a culturally adapted Bengali version of the English FDDQL and to test its reliability and validity. Methods: The English version of the FDDQL was translated into Bengali and adapted in the local socio-cultural context, following the standard recommendations by Beaton et al. published in 2000. Content validity of the adapted Bengali version was assessed by the item-level & scale level content validity indices (I-CVI & S-CVI) and Modified kappa (k*). For convergent validity, correlation between FDDQL and general health related quality of life SF-36 was assessed by Pearson’s correlation coefficients. Internal consistency was assessed using Cronbach’s alpha coefficient. The Bengali translated questionnaire was tested upon 120 patients. Results: Translation and cross-cultural adaptation procedure revealed no major deviation with the content or language. I-CVI was  ³0.75, Modified kappa (k*) was  ³0.67 and S-CVI was 0.91. FDDQL showed strong positive correlation (Pearson’s correlation coefficients >0.74) with SF-36. The scale demonstrated excellent internal consistency (Crohnbach’s alpha=0.86) and test-retest reliability (ICC=0.93). Conclusion: This adapted Bengali version of FDDQL is a practicable, reliable and valid instrument, and can be used for the assessment of health related quality of life in patients with functional bowel disorders.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 169-170
Primary Tubercular Chorioretinitis Without a Pulmonary Focus: A case of Ocular Tuberculosis
Authors: Khalil Ibrahim
Published: June 2024

Tuberculosis is a global health problem. Around 2 billion people could have TB, with 10.6 million falling ill each year. TB remains deadly despite being preventable and treatable, claiming over 3,500 lives daily and totaling 1.3 million deaths annually. Additionally, approximately 30% of TB cases are missed by healthcare screenings and diagnostics, leading to poor health outcomes and further TB spread in communities. Untreated individuals can infect 10 to 15 others per year, with 10% developing active TB in their lifetimes. TB is an infectious disease that can affect various organs in the body, including the eye. Establishing the diagnosis of ocular TB is a clinical challenge, as most tubercular infections affect the pulmonary system first, and primary infection of the eye is extremely rare, with an incidence of about 1% to 2% .Ocular tuberculosis (TB) can affect various eye structures and may manifest independently of systemic TB. Typically, it arises from hematogenous dissemination from a primary focus; however, in exceptional instances, it may originate as a primary infection after epithelial injury. Diagnosing TB in an extrapulmonary site presents a significant clinical challenge. We present the case of a 25-year-old male who presented with a deteriorating loss of central vision in his right eye. A thorough neurologic examination and serological tests, the tuberculin skin test, a X-ray of the chest, ocular fundus photography, and optical coherence tomography were performed. Based on the clinical features and the outcome of appropriate tests, a presumptive diagnosis of ocular TB was made and later confirmed after initiating antitubercular therapy, which resulted in a marked improvement in the patient’s vision a week later. This case is an illustration of the rare nature and unusual presentation of extrapulmonary TB in the form of tubercular chorioretinitis, diagnosed in a resource-limited setting. Tubercular chorioretinitis, characterized by inflammation of the choroid and retina due to TB infection, presents a diagnostic challenge, especially in resource-limited environments where access to advanced diagnostic tools may be restricted. Therefore, this case highlights the importance of considering TB as a potential cause of ocular manifestations, even in settings where TB prevalence might not be high, and underscores the need for increased awareness and diagnostic capacity for extrapulmonary TB in resource-limited areas. This case exemplifies the infrequent occurrence and atypical manifestation, presenting a learning opportunity for future clinicians.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 172
Gitelman Syndrome: Three Cases of a Rare Genetic Disorder in a Tertiary Care Hospital
Authors: Taha Abtahir Rahim , Shahbaz Hossain , Abdur Rahim , Islam Rafiqul
Published: June 2024

Gitelman syndrome is a salt-losing tubulopathy caused by mutation of genes encoding sodium chloride (NCCT) and magnesium transporters in the thiazide-sensitive segments of the distal nephron. It is characterized by renal potassium wasting, hypokalemia, metabolic alkalosis, hypocalciuria and hypomagnesemia. Here we present three cases those we encountered in Shaheed Suhrawardy Medical College Hospital.A 20-year-old male who was a soldier of Border Guard Bangladesh presented to us with muscle cramps and tingling & numbness for last 05 days. On examination, we found normotension with positive trousseau’s sign. Investigation revealed hypokalemia with hypomag-nesemia. 24 hours urinary electrolytes were indicating urinary loss. As ABG revealed metabolic alkalosis and urinary calcium creatinine ratio was <0.15, we sealed our diagnosis to Gitelman syndrome.A 34- year-old normotensive school teacher who experienced hypokalemia four years ago and was on potassium supplement on demand came to us with sudden onset, rapidly progressive quadriplegia for last 05 days. This time symptom didn’t resolve after taking potassium supplement. On Examination, we found flaccid quadriplegia with diminished jerks. Investigation revealed hypokalemia with hypomagnesemia. On further digging, we found diminished 24 hours urinary calcium as well as metabolic alkalosis on ABG.The final one that we encountered was a 40-year-old female normotensive housewife who presented with generalized weakness as well as tingling & numbness for last 10 days. Physical examination was inconclusive but Investigations revealed hypokalemia, hypomag-nesemia&Metabolic alkalosis. Hypocalciuria was evident from both 24 hours urinary calcium & urinary calcium creatinine ratio.In all occasions, all other possible differentials were excluded. We opted for genetic mutation study as well as family screening but in vain. In a nutshell, any electrolyte imbalance shouldn’t be only managed by supplementation rather finding out the route of loss & arterial blood gas analysis may be a key to the ultimate diagnosis.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 172-173
Hypertriglyceridemia-induced Acute Pancreatitis Treated with Insulin Therapy: A Case series
Authors: Nizhu Lutfun Nahar , Anam Ahmed Mursel
Published: June 2024

Hypertriglyceridemia is a condition where high levels of triglycerides in the blood can cause recurrent episodes of acute pancreatitis. The risk of acute pancreatitis becomes significant when serum triglyceride levels exceed 1000 mg/dL. Although the severity of hypertriglyceridemia-induced acute pancreatitis may be related to higher HTG levels in the early stages, the overall clinical outcomes are similar to other causes. The initial management of HTG-AP differs from routine recommendations and poses additional diagnostic and therapeutic challenges. This retrospective case series describes our experience with hypertriglyceridemia-induced acute pancreatitis at our acute medicine department and emphasizes the role of insulin therapy in its management.
Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 180
Studies on the inhibition of honey bee cholinesterase by carbamates
Authors: Dale D. , Mehrotra K.N.
Published: June 2024

The kinetic constants for the inhibition (I50, Ka, K2c, -Ki, K3, and Ka' values) of honey bee cholinesterase by furadan and its two analogues were determined and evaluated. Furadan proved to be a potent inhibitor of honey bee enzyme. All the three carbamates showed a high affinity for honey-bee ChE. The affinity constants ranged from 0.22 to 2 .6 8 x 1 0 -- M. There was little variation among the carbamylation constants, indicating a minor role for the carbamylation step in the inhibition process. The significant variation in the bimolecular reaction constants of the three carbamates could be attributed to the variations in the affinity constants rather than to the carbamylation constants. In most cases, the average apparent affinity constants were comparable with the Ka values and increased progressively with the concentration of inhibitor.
Effect of the chemosterilants Apholate and Metepa on the ovaries of the Red cotton bug, Dysdercus Cingulatus Fabr. (Insecta, Heteroptera, Pyrrhocoridae)
Authors: Jalaja M. , Prabhu V.K.K.
Published: June 2024

Studies on the histology and histochemistry of the ovaries in normal Dysdercus cingulatus and effects of the chemosterilants apholate and metepa on the ovaries of this animal are presented. Single injection of 10µg metepa or 5µg apholate per newly moulted adult female does not apparently interfere with oocyte growth or vitellogenesis. But the eggs laid after both these treatments do not hatch. Oocyte development is however inhibited after treatment of newly moulted adult females with 12.5µg metepa or 7.5µg apholate. Histological and histochemical studies of the ovary after this treatment indicate disintegration of germarium and follicular epithelium as well as reduction in size of oocytes and their resorption. Prefollicular tissue almost completely disappears and multiple oocytes are present in follicles after treatment with apholate. Histochemical studies reveal no yolk granules of protein, carbohydrate, or lipid after treatment with both the sterilants. Treatment with apholate by contact method at 0 .22 mg/ sq cm of surface of contact, inhibits oocyte growth after ptevitellogenesis, ultimately resulting in irreversible atrophy of the ovarian tubes.
Histological and histochemical studies on the male accessory glands of culicine mosquitoes
Authors: Adlakha Vimala , Bhargava S. , Pillai M.K.K.
Published: June 2024

The paper deals with studies on the development, histology and histochemistry of the male accessory glands of Aedes aegyptii and Culex pipiens fatigans. The paired accessory glands in both the species grow rapidly from pupal stage till they mature in two-day old adults. The glands have an outer layer of muscles and an inner layer of simple columnar secretory cells. In Culex the gland has a central lumen in pupal stage while it is partly filled with cells in Aedes. The secretory cells are similar morphologically hut secretory activity is more in the posterior part of the glands than in the anterior part in both the species. The secretory granules in Aedes are small and are present in the lumen of the gland within polygonal cells whereas in Culex they are large and are not in bound form. Histochemical. Study suggests that the secretion is predominantly proteins, rich in SH-containing aminoacids. Further histochemical evidences indicate the presence of glycogen in the secretions of Aedes and Culex, and mucopolysaccharide in Culex only. The relevance of these findings is discussed.
Biology of Riptortus pedestris F. (Coreidae, Hemiptera), a pest of Cowpea
Authors: Visalakshi A. , Jacob Abraham , Nair M.R.G.K.
Published: June 2024

Studies on the biology of Riptortu.s pedestris F. ((Coreidae, Hemiptera) infesting pods of Cowpea have shown that the adults mate 2 to 3 days after emergence and egg 12 to 13 days thence. A female lays about 115 eggs, during an oviposition period of 30 days. The duration of the egg and nymph are about 4 and 16 days respectively. The Adult lives for 45 to 47 days. The nymphs and adults damage pea pods by sucking juice out of the fully formed seeds, which as a result Shrivel up and become discoloured. Tender pods when attacked fail to develop fully.
On Odontella (Clavontella) macronychia (Prabhoo) – a soil Collembola from Kerala
Authors: Prabhoo N. R.
Published: June 2024

The Subspecies Odontella Trispina Macronychia(Prabhoo) 1971 has been elevated to the species rank and named Odontella Trispina Macronychia based on the study of additional material. A complete description of the species is given.
PENERAPAN MEDIA AUDIO VISUAL UNTUK MENINGKATKAN MINAT DAN HASIL BELAJAR SISWA MTs HASYIM ASYARI AMBON PADA MATERI POKOK ENERGI DALAM KEHIDUPAN
Authors: Hamida Wa Ode , Natsir Nur Alim , Hardiansyah Muhammad Rizal , Mursalin Enggal
Published: June 2024

Penelitian ini bertujuan untuk meningkatkan minat dan hasil belajar siswa MTs Hasyim Asy’ari Ambon pada materi pokok energi dalam sistem kehidupan dengan menggunakan media audio visual sebagain media pembelajaran. Penelitian ini adalah classroom action research (PTK). Temuan menunjukkan minat dan hasil belajar siswa meningkat setelah menggunakan media audio visual. Peningkatan ini terlihat dari hasil observasi, angket, dan  tes formatif siklus I. Artinya, minat belajar siswa siklus I berdasarkan hasil observasi, secara klasikal 54,2%, dan berdasarkan angket sexara klasikal 54,8% untuk hasil tes formatif siklus I secara klasikal sebesar 54,2%, sedangkan hasil observasi, angket dan tes formatif siklus II adalah 84% untuk observasi minat belajar, 86,2% untuk angket  minat serta 88,5% hasil tes formatif. Berdasarkan analisis tersebut disimpulkan bahwa penerapan media audio visual dapat meningkatkan minat dan hasil belajar siswa MTs Hasyim Asy’ari Ambon pada materi pokok energi dalam sistem kehidupan.Kata Kunci: Minat dan hasil belajar siswa, media audio  visual
PENERAPAN PROBLEM BASED LEARNING (PBL) DALAM MENINGKATKAN HASIL BELAJAR KOGNITIF SISWA PADA MATERI SISTEM PENCERNAAN PADA MANUSIA
Authors: Souwakil Hadia , Jamdin Zamrin , Marda Nurwafiah
Published: June 2024

Penelitian ini bertujuan untuk mengetahui apakah model pembelajar Problem Based Learning (PBL)  dapat meningkatkan hasil belajar kognitif siswa kelas VIII pada materi sistem pencernaan pada manusia di MTs. Nurul Ikhlas Ambon, tipe penelitian ini adalah Penelitian Tindakan Kelas  dilakukan sebanyak 2 siklus, subjek penelitian ini adalah siswa kelas VIII MTs Nurul Ikhlas Ambon yang berjumlah 20 orang siswa. instrumen yang digunakan dalam penelitian ini adalah instrument tes, soal tes sebanyak 20 soal, penelitin ini dilaksanakan dari tanggal 16 november 2022 samapi dengan 16 desember 2022. Hasil penelitian menunjukan  bahwa hasil belajar siswa pada pra siklus siswa yang tuntas 2 orang siswa dengan presentase ketuntasan 10% sedangkan yang tidak tuntas sebanyak 18 siswa dengan presentase ketuntasan 90%, sedangkan  pada tahap siklus I siswa yang tuntas sebanyak 8 orang siswa dengan presentase ketuntasan 40% dan tidak tuntas sebanyak 12 orang siswa dengan presentase ketuntasan 60%, sedangkan pada siklus II siswa yang tidak tuntas sebanyak 3 orang siswa dengan presentase ketuntasan 15% dan siswa yang tuntas sebanyak 17 orang siswa dengan presentase ketuntasan 85%. Dengan demikian dapat disimpulkan bahwa penerapan model pembelajaran Problem Based Learning (PBL) dapat meningkatkan hasil belajar siswa.
Pengaruh Model Problem Based Learning (PBL) terhadap Kemampuan Berpikir Kreatif Peserta Didik Pada Pembelajaran Biologi
Authors: Rizal Resti , Alberida Heffi
Published: June 2024

Pendidikan pada era global saat ini harus dilihat dan berorientasi pada pengembangan kompetensi abad ke-21. Model pembelajaran berbasis masalah adalah model pembelajaran yang melibatkan peserta didik dalam memecahkan masalah dan menawarkan kesempatan kepada peserta didik untuk mempelajari hal yang secara lebih luas fokus pada mendidik peserta didik untuk aktif dan bertanggung jawab di seluruh bidang. Jadi, dalam suatu pembelajaran tidak hanya dituntut untuk peserta didik aktif, tetapi juga kreatif dalam menyelesaikan segala permasalahan yang diberikan oleh guru maupun permasalahan yang ditemukan oleh peserta didik sendiri. Berpikir kreatif merupakan sebuah keterampilan dan kemampuan terhadap peserta didik untuk memahami suatu masalah dan menemukan solusi dalam menyelesaikan masalah dengan menggunakan strategi atau metode yang berbeda. Model pembelajaran berbasis masalah dapat digunakan untuk meningkatkan berpikir kreatif dalam pembelajaran biologi. Tinjauan artikel literatur yang terkait dengan topik periode tujuh tahun (2016-2022) digunakan untuk penelitian. Dapat disimpulkan bahwa penerapan model problem based learning dapat digunakan sebagai upaya untuk meningkatkan berpikir kreatif siswa dalam pembelajaran biologi, karena dari 20 hasil penelitian menunjukkan bahwa penerapan model problem based learning dalam pembelajaran biologi dapat meningkatkan berpikir kreatif.
INFLUENCE OF CHARACTER EDUCATION ON POLITICAL LEADERSHIP IN ISLAM
Authors: Karimullah Suud Sarim
Published: June 2024

This study highlights the significant impact of character education in the Islamic context on political leadership development. This study bases its analysis on literature studies carried out in an integrative and comprehensive manner by examining and combining various relevant literature sources. The results show that character education in Islam is based on strong moral and ethical principles, including honesty, integrity, justice, and social responsibility. Political leadership in Islam puts forward the principles of justice, accountability, and concern for the general welfare. Character education is crucial in forming leaders with high morality and ethics. In addition, the influence of character education on political leadership is critical in shaping responsible, just, inclusive, and moral leaders who tend to lead sustainable leadership, maintain peace, and promote justice. In this regard, the influence of character education on political leadership in Islam is critical to creating leaders who can maintain peace, resolve conflicts, and participate in moral international diplomacy. Character education also makes leaders who can communicate honestly, maintain morality and ethics, and lead with integrity.
EFEKTIVITAS MODEL COLABORATIVE PROBLEM SOLVING (CPS) DALAM MENINGKATKAN SELF CONCEPT SAINS MAHASISWA CALON GURU SEKOLAH DASAR
Authors: M. Talakua M. , Takaria J.
Published: June 2024

Abstract: This study aims to determine the effectiveness of collaborative problem solving models in improving self-concept science student teachers at one LPTK SD State in the city of Ambon in Maluku. This study used a quasi-experimental with nonequivalent protest- posttest control group design, where the group will study measured self-concept science students using CPS models. The study population was a student at one LPTK PGSD in Maluku province, while the study sample were students PGSD VII semester of 2015/2016 academic year course on the development of elementary science education amounted to 30 students. Type of data analyzed in the study is quantitative data includes; Pretest-posttest self-concept and self-concept, and N-gain that has been converted using the MSI, and analyzed using descriptive statistics and inferential statistics. The results that the model of collaborative problem solving is very effective in improving self-concept science student teachers SD on one LPTK State in the city of Ambon, Maluku, both the results of Pre-SC and Post-SC obtained from the gain normalized or against each indicator self concept.
Key words: model collaborative, problem solving, self concept sains