bluuebunny/crossref_metadata_2025 huggingface dataset:
Explanation and elucidation of cancer in reference to Greco-Arabic literature
Authors: Ahmad Wasim , Zulkifle Mohd , Hamiduddin - , Afreen Sadaf , Rahman Obaidur
Published: April 2019

Muslim scholars made tremendous contribution in various fields of science and their benefaction of work exhibits in all branches of medicine. Cancer is discussed by then Muslim scholars like Ibn Sina, Razi , Ismail Jurjani ,Hunain b. Ishaque, Rabban Tabri, Ahmad b. Mohammad Tabri, , Ibn ul Quff, Ibn Zuhr etc. In their descriptions cancer means Sartan (crab) as it reflects the true character of disease, since it sticks to the part stubbornly like a Sartan. Galen states that Sartan is the result of an excess of black bile. It may be due to an excessive hotness and dryness of liver by which consumed foods transform into irritant morbid matter. Concurrently, the spleen becomes weak and is unable to absorb the Sawda (black bile). Muslim scholars classified and distinguished clearly among the varieties of cancer in relation to specific organs such as eye, stomach, bladder, penis, uterus, mouth, and nerve tumours. The need of the hour is to evaluate and analyse the disease along with its pathophysiology, predisposing factors, differential diagnosis, and varieties of therapeutic paradigms that include nutrition, drugs, Ishal (bowel cleansing), Tanqia (evacuation of morbid matter from the body), surgical and non surgical interventions i.e. leaching , Amal kai (cauterization). Since the cancer is spreading at an incredible rate in both developed and developing countries but no way of relief is ensured yet in any system of medicine. Greco-Arabic literature has rich potential to intervene in palliative way in such dreadful disease. Likewise, Ray born Razi asserted that when cancer is at the beginning, it can be kept stationary and can be prevented from ulceration. This systematic review highlights relevant Greco-Arabic literature on cancer.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.184-189
Changes in smile morphometric indices following maxillary advancement and mandibular setback surgery in skeletal Class III patients
Authors: Farzanegan Fahimeh , Hearvi Farzin , Karrari Mandana , Shafaee Hooman , Vaezi Touraj , Rashed Roozbeh
Published: April 2019

Objectives: The aim of this study was to evaluate the changes in smile morphometric indices following maxillary advancement and mandibular setback surgery in patients with skeletal class III malocclusion.

Materials and Methods: Smile morphometric indices were measured on frontal rest and smile photographs of 15 female patients with skeletal Class III malocclusions before and three months after maxillary advancement and mandibular setback surgery. Pre- and post-surgery measurements were compared.

Results: The amount of left and right commissural height, philtrum height, and maximum upper incisor show at rest did not change significantly three months after surgery (p>0.05). The amount of maximum upper and lower incisor show, interlabial gap, smile width and index, buccal corridor ratio, gingival display, and smile arc on the frontal smile photographs didn’t showstatistically significant difference before and after surgery (P>0.05).

Conclusion: Orthognathic surgery in patients with skeletal Class III malocclusion had no significant effect on rest and smile parameters from the frontal view.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.216-221
Zn as the Factor of Alkaline Phosphatase in Periodontal Patients consuming Minangkabau food in West Sumatra, Indonesia
Authors: Kasuma Nila , Arma Utmi , Risalina Linda , Liputo Indrawati , Fajrin Fildzah Nurul
Published: April 2019

Background: Periodontal disease is preceded by an inflammation in the gingiva surrounding the teeth called gingivitis. It is an untreated gingivitis causing hard tissue damage (alveolarbone). This inflammation increases the activity of ALP enzyme. Zinc is an Alkaline Phosphatase co-factor.

Aim: This study aims at proving the connection between Alkaline Phosphatase (ALP) and zinc within the food of the Minangkabau people in West Sumatra, Indonesia. 60 samples are involved in this study. ALP level is tested by using ELISA technique. Zinc level in Minangkabau food is measured by Food Frequency Questionnaire (FFQ). Data is analyzed by means of univariate to describe each variable , Kolmogorov Smirn of Test is used to see the normal distribution ( p > 0.05).

Result: Pearson correlation is conducted to see the correlation between ALP level and zinc clevel in Minangkabau food. The study reveals that ALP activity is higher in mild periodontitis compared to mild gingivitis and healthy control. Zinc level is significantly lower in mild periodontitisthanin mild gingivitis and healthy control individuals. The relation between ALP and zinc level indicates strong correlation with positive direction (r = - 0,884).

Conclusion: Zn decreases ALP activity and shows that zinc complement has both preventive and curing effects in periodontitis patients.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.228-232
Pre-operative serum total bilirubin level as an indicator marker of perforated appendicitis.
Authors: Kassim Nur Karyatee , Jelani Aniza M , T Ismail T Salwani , Omar Julia , Ibrahim Hanim A , W Azman W Norlina , Shafii Noorazliyana , Yaacob Najib Majdi
Published: April 2019

Objectives: Acute appendicitis is one of the most common surgical emergencies. Perforated appendicitis can result in increased morbidity and mortality. Thus, early identification of perforation can reduce the impact on patient and improve outcome. Apart from total white cell count (TWCC), serum total bilirubin (SB) has been shown to indicate perforation in appendicitis. The aim of this study was to assess the usefulness of serum total bilirubin (SB) as the preoperative indicator for perforated appendicitis.

Materials and Methods: This was a retrospective study of all appendicectomies cases done in Hospital Universiti Sains Malaysia (HUSM) over a one-year period in 2014. Only patients with histopathologically confirmed appendicitis with available liver function tests and total white blood cell count preoperatively were included in the study. These appendicitis cases were further divided into perforated and non-perforated based on histopathological reports obtained.

Results: A total of 245 patients had appendicectomy done in 2014 between January to December 2014. Out of 110 from these 245 patients met the inclusion and exclusion criteria. SB was significantly higher (p<0.001) in patients with perforated appendix compared to non-perforated.

Conclusion: In conclusion, this study showed that preoperative SB is a useful laboratory parameter for perforated appendicitis to improve clinical decision-making by the clinician.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.233-237
Depression, Anxiety and Stress among Obese Patients with Chronic Illnesses: Prevalence and Associated Factors in North East Malaysia
Authors: Hassan Raihan , Mohd Zulkifli Maryam , Ahmad Imran , MohdYusoff Siti Suhaila
Published: April 2019

Introduction: Concomitant obesity and chronic medical illness is a significant health problem in Malaysia and worldwide. The comorbid psychological impact in obese patients is associated with a social stigma and low self-esteem. The aim of this study was to determine the prevalence and the factors associated with depression, anxiety and stress in obese patients with chronic medical illnesses attending an outpatient clinic.

Methods: This was a cross-sectional study among obese patients with chronic medical illnesses presenting at the Universiti Sains Malaysia Hospital outpatient clinic. A total of 274 patients were involved. The 21-item Depression, Anxiety and Stress Scale questionnaire was used, and the results were evaluated using single and multiple logistic regression analyses.

Results: The prevalences of depression, anxiety and stress among the obese patients with chronic medical illnesses were 13.9%, 23.4% and 10.9%, respectively. Younger age [p=0.003, adjusted odds ratio (AOR),1.0; 95%confidence interval (CI),0.91–0.98], unemployed employment(p=0.013, AOR,3.7;95% CI,1.32–10.09) and smoking (p=0.022, AOR,3.2; 95% CI,1.18–8.55) were associated with depression. No formal education (p=0.011, AOR,5.7; 95%CI,1.49–21.89), high body mass index (p=0.029, AOR,1.1;95% CI,1.01–1.13) and family history of psychiatric illness (p=0.018, AOR,5.1; 95% CI,1.33–19.56) were associated with anxiety. Stress was strongly associated with females (p=0.004, AOR,5.0; 95% CI,1.70–15.13) and smoking(p=0.002, AOR,6.5; 95% CI,2.03–20.7).

Conclusion: Interestingly, younger age group was associated with depression. Current smokers, no education, family history of psychiatric illness and female sex were significantly associated with anxiety and stress. This notifies new emerging knowledge on factors associated with obese patients that would empower the development of effective preventive strategies for it.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.252-259
Evaluation of Errors in Prescription Writing: A Cross-Sectional Study at Community Pharmacies and Tertiary Care Hospitals of Lahore, Pakistan
Authors: Khan Muhammad Farhan Ali , Salman Muhammad , Khan Nazeer Hussain , Masood Talha , Safdar Muhammad , KhuzaimaIkhlaq - , Ansari Muhammad Umair , Latif Muhammad Shahid , Saqlain Muhammad , Mustafa Zia Ul , Asif Noman
Published: April 2019

Background: Prescription errors often lead to mishaps around healthcare facility that often end up with adverse drug reactions and even some cases death Being in a healthcare facility the patient should have full confidence in the health care providers and not have to worry about minor mistakes leading to a possible lethal one.

Aim and objective: The aims and objectives of our study is to evaluate the prescription writing errors in different community pharmacies and tertiary care hospitals also to assess the knowledge of patients regarding their disease and treatment.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.260-266
Low total physical activity, high total sitting time and high sitting time on a work day are correlated with low fitness in male working adults: a cross sectional study
Authors: Wibowo Rakhmat Ari , Wasityastuti Widya , Sofro Zaenal Muttaqien
Published: April 2019

Background : Low fitness is an emerging factor for cardiovascular diseases. Physical activity and sitting time are arising factors that influence fitness level. There are some debates on what domain of physical activity and sitting time that have more influences on fitness level. The aims of this study were to (1) explore each domain of physical activity & sitting time and analyze their associations with low fitness in male working adults and (2) explore the differences between sitting time on a working day and a day-off.

Method :In this cross-sectional study, a total of 31 healthy male staffs were recruited. Participants used International Physical Activity Questionnaire (IPAQ) long version to recall their physical activity and sitting time, and their fitness level was measured by a submaximal exercise test. Data were analyzed both by univariate and multivariate techniques. Multivariable logistic regressions were employed to calculate Odds Ratio (OR) of low fitness by each domain of physical activity and sitting time.

Result : Data of 27 participants were considered for analysis. Total physical activity was inversely associated with low fitness [OR 0.961, 95% Confidence Interval (95% CI) 0.928 – 0.995]. Total sitting time and sitting time on a working day were positively associated with low fitness (total sitting time: OR 1.101, 95% CI 1.001-1.211; sitting time on a working day: OR 1.01, 95% CI 1.001-1.019). We also observed that sitting on a working day was significantly higher than sitting time on a day-off (p = 0.004).

Conclusion : The results support association of total physical activity, total sitting time and sitting time on a working day with fitness level. There were also difference between sitting time on a working day and a day-off.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.279-287
Awareness, knowledge and attitude toward secondary health care system: survey of physicians in Kosovo
Authors: Rashiti Albiona , Svarça Leonora , Kurti Afërdita , Rashiti Premtim
Published: April 2019

Objective: To assess knowledge, awareness and attitude among hospital physicians from Kosovo toward current situation of Health Care System (HCS) especially Secondary Health Care (SHC) in Kosovo.

Methods: In this cross-sectional study, anonymous questionnaire were delivered to three regional hospitals in Kosovo. The main outcome measures were physician’s awareness of the management of secondary health care institutions, awareness and use of new technology for improving health care in second level and their suggestions for further improvement.

Results: Results are divided into three main categories: I. Relevant information on the knowledge of the health care system, were respondents had valuable information and insight; II. Relevant information on suggested improvements, in which respondents gave their proposals regarding workplace and inter managerial relations and III. Relevant information on continues education possibilities for medical staff.

Conclusions: In conclusion there is a need to prioritize proper cooperation between primary, secondary, and third level of health institutions, in terms of entire health management in order to increase the quality of health services delivery, in line with western standards.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.288-293
Study of Usage Rate for Various Complementary and Alternative Medicine among People Visited Non-Conventional Medical Centers in Shiraz, Iran, in 2016.
Authors: Movahed Majid , Rayanpour Razieh
Published: April 2019

Introduction: The present research was aimed at studying the usage rate for the complementary and alternative medicine, at identifying its low-consumption and high-consumption methods, and at analyzing the relationship between demographic variables and the usage rate of this medicine among the people who visited the non-conventional medical centers in Shiraz, Iran.

Methods: This research is an analytical-cross-sectional study in which 800 people have been visited 6 non-conventional medical centers in July 2016; having gained their satisfaction, they were studied by method of complete enumeration. The data were collected using a researchermade questionnaire and analyzed through SPSS.

Result: In this study, 68% of visitors used the complementary and alternative medicine in medium rate. The high-consumption kind includes the Natural products, the Movement-based approaches and the Traditional treatments. The low-consumption kind includes the Energy-based treatments and whole medical system. The demographic variables such as age, gender, ethnicity, education, birth place and occupation were in relation with the usage rate of complementary and alternative medicine.

Conclusion: The healthy people have tended to use the complementary and alternative medicine as a part of their healthy lifestyle. The high-consumption strands had origin in the culture and tradition of a society and they are easily available. The low-consumption strands include the methods that the people were less familiar with them; these strands have limited accessibility and the higher costs.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.294-302
Exploration of Unani concept of blood purifying drugs and likely models for its screening
Authors: Mushir Ansari , Jahan Nasreen , Sofi Ghulamuddin
Published: April 2019

Introduction: In Unani system of medicine, blood is regarded as mixture of akhlat (humours) i.e. dam (Sanguine), balgham (phlegm), safra (yellow bile) and sawda (black bile). Normal blood consists of “akhlate latifa (plasma)” and “kaseefa (corpuscles)”. Normal blood is one in which all humours are in normal proportion in terms of quantity and quality and specific to each individual. It is normal in colour, free from bad odour and moderate in viscosity. Morbid blood develops due to impurities /disease in the blood which ultimately alter its quantity and quality. If we co relate these abnormalities with modern concept then all bleeding disorders and coagulopathy fall under “Riqqate dam” (low viscosity of blood); all the thromboembolic disorders; polycythaemia, leukaemia and anaemia fall under “Ghilzate dam”(hyperviscosity of blood), while septicaemia, bacterial diseases can be correlated with “ufunat” (infections).

Methods: The classic and relevant books of Unani and conventional medicine were studied. The databases utilized for obtaining information, are scientific research publications from indexed journals available through Google Scholar, PubMed and Science Direct.

Results and Conclusion: Blood purifying drugs cause necessary changes and maintain the viscosity of the blood by their moderate heat; cold; dry and wet properties. These drugs are alterative and bring the quality and quantity of blood in equilibrium. Strengthen the defensive mechanism and eliminate toxins via sweat, urine, faeces etc. These drugs are digestive, tonic to stomach and liver and boost the immune system. In the line of the above conceptual framework few experimental models are being suggested i.e. effect of drugs on blood constituents, coagulation parameters, anemia, leukaemia, polycythaemia, thrombocytopenia and infections. This preliminary study may serve as a tool for the screening of blood purifier drugs in various blood disorders.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.312-321
Spontaneous cerebrospinal fluid rhinorrhoea and its association with body mass index (BMI)
Authors: Wen Tan Yee , Gendeh Balwant Singh , Husain Rohana Ali O’Connell , Husain Salina , Jeevaratnam Kamalan
Published: April 2019

Objective: The purpose of this study is to review the correlation of spontaneous cerebrospinal fluid rhinorrhoea (CSFR) and Body Mass Index (BMI) and describe the demographics, the surgical techniques and outcomes.

Materials and methods: We performed a retrospective review of clinical data of twenty patients diagnosed with spontaneous CSFR and treated at the Malaysian National University Medical Centre from 1997 to 2015.

Result and Discussion: A total of 20 patients were selected in this research (19 females,1male). The mean age was 45.5 years with nineteen females and one male patient. The mean BMI was 33.1kg/m2.Majority of patients with spontaneous leaks are females in their forties. The bath plug technique, onlay of middle turbinate grafts, nasoseptal flaps and mucoperiosteal grafts techniques were used and three patients reported recurrences.

Conclusion: Spontaneous CSFR is more common in women in their 40s with BMI>25. The most common sites of leaks are the cribriform plate followed by the sphenoid sinus. Spontaneous CSFR cases are strongly related with increased BMI.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.322-328
Prevalence of hepatitis B Virus in clinically suspected infectious hepatitis in Meerut, I
Authors: Khan Salman , Madan Molly , Virmani Sunil Kumar
Published: April 2019

Objective:-Hepatitis B is noteworthy medical issues that may include the late continuation of liver cirrhosis and hepatocellular carcinoma. The present study aimed to know the seroprevalence of hepatitis B Virus in Meerut with different clinical conditions.

Methods: The studyconducted on 4927 patients in Meerut, India, which was performed in central research center labortory of Microbiology at netaji subhash Chandra Bose Medical College and Hospital Between January 2013 to April 2017 The sera were separated and screened for HBsAg byimmune-chromatographic card test then HBsAg positive serum sampleswere tested again for HBsAg using ELISA kit. Positive samples for HBsAgwere tested for HBeAg ELISA kit.

Results: In 245 positive cases 118 (48.16 %) were male and 127 (51.84%) were female. The seroprevalence rate of HBV was 4.97% in Meerut, India. Age group21–30 was the highest seroprevalence (7.46%) when compaired to other age group. Of the 245 HBsAg Positive case 55 (1.12%) were HBeAg positive. 20 were male, Highest HBeAg positive male were found in 21- 30age group. Out of 55 HBeAg cases, 35 were female and 92 female were negative for HBeAg, this was stastically significant (P< 0.039) by using Z test.

Conclusions: The study uncovered that the seroprevalence of HBV was alarmingly higher in such a populace, which presumably mirrors a high foundation predominance of HBV contaminations ought to be mulled over and Implementation of group based preventive measures and enhanced procedures for safe blood supply may demonstrate valuable to diminish the seroprevalence

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.329-333
Study on vancomycin-resistant enterococci in faecal samples from non-hospitalized individuals at MMIMSR, Haryana, India
Authors: Bera Shyamsundar , Mehta Sonia , Dwivedi Manisha Bhatt , Singh Varsha A , Paul Rajdeep , Nongrum Sumi
Published: April 2019

Background: Enterococci, formerly classified with fecal streptococci, have been recognized to be of fecal origin since the beginning of this century.

Method: This study was undertaken to determine the prevalence of stool colonization with vancomycin resistant Enterococcus (VRE) and also to evaluate the risk factors for colonization with vancomycin resistant Enterococcus among non- Hospitalized individuals at MMIMSR, Mullana.Test was performed for VRE isolates collected over a period of 6 months (Oct2015- March 2016). Faecal samples were collected by using sterile container from non- hospitalized individuals then to Cultures using Mac Conkey and Blood agar. After presumptive diagnosis as an enterococcus spp, 50 Enterococcal isolates were then again cultured on special VRE screen agar media to identify vancomycin resistant Enterococcus.

Result: The results were further supported by modified Kirby-bauer disk diffusion method with vancomycin (30μg) as per CLSI guideline. A total of 29 (58%) Enterococcus faecalis and 21 (42%) Enterococcus faecium were detected among the faecal isolates and 2 (4%) were VRE. According to CLSI guideline isolates showing diameter of zone of inhibition ≤16mm were considered among the VRE. Chronic diseases, previous hospital stay (more than 15 days) and repeatedly antibiotic consumption was found to be significant risk factor for non-hospitalized individuals.

Conclusion: There is need for programs to promote greater attention about antibiotics usage in the general population. Education of Health care workers with implementation and observation of hand-washing practices constitutes a very effective step in preventing the spread Prolonged use of vancomycin drug should not be recommended by the physician.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.334-339
Effect of Second hand Smoke on Arterial Stiffness among Healthy Women
Authors: Sariban Suriyati , Mohd Yusoff Siti Suhaila , Shaaban Juwita , Mohd Noor Norhayati , Mohamed Yusoff Harmy
Published: April 2019

Introduction: Arterial stiffness is recognised as a significant cardiovascular risk factor and an independent predictor of all causes of cardiovascular death. Women are the largest population exposed to cigarette smoke either at work or from their partner. The objectives of this study are to compare the arterial stiffness (augmentation index and pulse wave velocity) between second hand smoke (SHS) and non second hand smoke (non-SHS).

Designs and method: Comparative cross-sectional study was conducted among 118 healthy female subjects (64 SHS and 54 non- SHS). The women were in the SHS group if their spouse is a smoker and they had an exposure to cigarette smoke for at least three years, minimum of15 minutes two days a week. Pulse wave analysis and pulse wave velocity was used to study the arterial stiffness. Pulse wave analysis reported as percentage of augmentation index. Pulse wave velocity equal to carotid femoral distance (meter) divided by time (second)

Results: The mean augmentation index (AIx) for SHS groups was 17.9 (SD7.06) and for non SHS groups was 20.7(SD6.11). The mean of Pulse wave velocity was 8.94 (SD1.36) in SHS groups and 9.02 (SD8.68) in non SHS groups. ANOVA and ANCOVA shown significance difference in crude mean (p = 0.047) and estimated marginal mean (p = 0.028) of augmentation index between SHS and non - SHS after controlling for age and BMI. However, there was no significant difference in crude mean (p = 0.795) and estimated marginal mean (p = 0.716) pulse wave velocity between SHS and non - SHS after controlling for age and BMI.

Conclusion: An increase in augmentation index amongst non SHS in this study most probably due to exposure to environmental tobacco at work compared to exposure to spouse’s smoke

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.340-346
Prevention of Chronic Non-Communicable Diseases in Russia: Analytical Review of General Institutional Issues
Authors: Maksikova Tatyana , Kalyagin Aleksey , Piven Dmitriy , Sinkova Galina
Published: April 2019

Objective: The purpose of this research is to assess regulatory, organizational and methodological documents, as well as Russian and international recommendations, to use infromation from them to identify and systematize problems in prevention of chronic non-communicable diseases, and tooffer solutions.

Materials and Methods: Analysis encompasees the key Federal Laws of the Russian Federation; orders, records, and reports provided by various ministries and departments of the Russian Federation,as well as by the leading research institutes; guides, manuals, and federal recommendations; the latest Russian and foreign guidelines and recommendations on prevention of chronic non-communicable diseases.

Results and Discussion: Analysis was faced with a number of problems:poor correlation between changes in regulatory documents governing the prevention of chronic non-communicable diseases; incomplete allowance for international experience and guidelines on prevention of chronic non-communicable diseases, incomplete epidemiological data; poor coordination and uneven assignment of responsibilities in structures involved in prevention; shift in emphasis from population-oriented prevention and high-risk groups towards secondary prevention; below-satisfactory efficiency of tuberculosis screening in clinical examination.

Conclusions: Their resolutionmay significantly increase the effectiveness of measures intendedfor prevention of chronic non-communicable diseases and their risk factors from occurence in Russia.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.353-367
Profiling of the bacterial pathogens associated with hospital acquired infections in hospitals within makurdi metropolis, middle belt, nigeria.
Authors: Onifade Emmanuel Olumuyiwa , Ogbonna Innocent Okonkwo , Ikwebe Joseph , Aremu Stephen Olaide
Published: April 2019

Background: Nosocomial bacteria are bacteria that cause diseases acquired from the hospital environments. Aim: This study looked into profile of bacterial pathogens associated with nosocomial infections in hospitals within Makurdi metropolis. Result: A total of 71 bacterial pathogens were encountered from 240 samples analysed from three hospitals in Makurdi metropolis. Of the 71 isolates, 46(64.8%) were Gram positive and 25(35.2%) were Gram negative. The Gram positive constituting S. aureus (50.70%) and staphylococcus spp (14.08%) while the Gram negative constituting E. coli (15.50%), klebsiella spp (7.04%) and P. aeruginosa (12.68%). Out of 21(29.58%) isolates cultured from hand swabs, the bacterial pathogens from hand swab at F M C was the highest 12(57.14%) followed by C H M 5(23.81%) while B M M C has the least profile of 4(19.05%). With regards to hospital air, the highest profile of nosocomial bacteria was also from F M C 8(61.54%), followed by B M M C 4(30.77%) while C H M had just only one isolate 1(7.69%). Of 21(29.58%) isolates from B M M C; 10(47.62%) S. aureus, 4(19.05%) Staphylococcus spp, 2(9.52%) P. aeruginosa and 5(23.81%) Escherichia coli were obtained. In C H M, out of 18(25.35%) bacterial pathogens evolved constituting 12(66.67%) S. aureus, 2(11.11%) Staphylococcus spp, 1(5.56%) P. aeruginosa and 3(16.67%) E. coli. Whereas, the profile of 32(45.07) isolates in Federal Medical Centre Makurdi constituting 14(43.75%) S. aureus, 4(12.50%) Staphylococcus spp, 6(18.75%) P. aeruginosa, 3(9.38%) E. coli and 5(15.63%) Klebsiella spp were obtained. The antibiotic susceptibility pattern to Staphylococcus spp reveals that the highest level of sensitivity were demonstrated by Cloxacillin and Ofloxacin with 50%, followed by Augumentin and Cefuroxime with 40%, Gentamicin (30%), Erythromycin (20%) and least sensitivity with Ceftriazone (10%) while Ceftazidime has the highest resistance recorded 0% sensitivity. E. coli has the highest sensitivity on Ceftazidime having 81.8% and Gentamicin 63.6%, Ofloxacin also displayed a high level of sensitivity to isolates tested with 63.6% sensitive, follow by Cefuroxime (45.5%).

Conclusion: This study showed that nosocomial bacterial pathogens particularly, S. aureus, P. aeruginosa, Staphylococcus spp and enteric bacteria, E. coli and Klebsiella spp are the predominant pathogens associated with infections acquired in hospital environment.So, information on resistance patterns of isolates encountered in this study will assist the clinicians in making improvement in management of nosocomial infections.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.368-378
The Correlation between Polymorphism of β Fibrinogen Gene -455 G/A and Serum Fibrinogen Level with The Severity of Coronary Artery Stenosis In Coronary Artery Disease Patient
Authors: Indrajaya Taufik , Fadilah Yudhi , Yuwono Mediarty , Ghanie Ali
Published: April 2019

Background: Now a days coronary artery disease (CAD) becomes major cause of death. One among 7 deaths in America caused by CAD. CAD is an atherosclerosis process, which progresively develops into plaque that will lead to stenosis of coronary artery lumen. Several studies found that high serum fibrinogen level is an independent and significant to the severity of artery coronary stenosis. Serum fibrinogen level determined by genetic factor. Polymorphism of fibrinogen gene β -455 G/A seem plays an important role in plasma fibrinogen level. Although some studies showed a significant correlation between polymorphism and cardiovascular diseases, but some other studies report inversely.

Aim. To evaluate the correlation between the polymorphism of fibrinogen gene β -455 G/A and serum fibrinogen level with the severity of artery coronary stenosis.

Method: This is an analytic correlative study with prospective approach without comparison. Coronary angiography was performed in catheterization labor in the department of internal medicine, while DNA analysis and PCR done in the department of microbiology in General Hospital dr Muhammad Husin Palembang- Indonesioa, since July 2015 until Agustus 2016. Samples are CAD patient who undergo for coronary angiography and fulfield the criterias. The severity of stenosis in coronary artery determined by Gensini score. This study included 31 patient.

Results. Among 31 CAD patients, this study found severe stenosis of coronary artery in 17 patients (53,1%), moderate in 5 patients (15,6%) and mild in 10 patients (31,2%). Genetic analysis showed that serum fibrinogen level was controlled by polymorphism of fibrinogen gene β -455 G/A, concecutively by genotipe AA in 15 patients (48,4%), genotipe GA in 12 patient (38,7%) and by genotipe GG in 4 patients (12,9%). Chi Square test showed a significant correlation between polymorphism gene fibrinogen β -455 G/A and serum fibrinogen level (p=0,039). Spearman’s rho test found no significant correlation between serum fibrinogen level and severity of coronary artery stenosis based on Gensini score (r=0,142; p=0,447). And also this study found no significant correlation between polymorphism gene fibrinogen β -455 G/A with the severity of stenosis in coronary artery (p=0,512).

Conclusion. Although this study succeded to prove that serum fibrinogen level was determined by polymorphism fibrinogen gene β -455 G/A, but there are no significant correlations between polymorphism fibrinogen gene β -455 G/A and serum fibrinogen level with severity of coronary artery stenosis in CAD patients. This study suggest to study other candidate gene to look for other cardiac risk beside this fibrinogen.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.379-384
Laser assisted orthodontic tooth movement in Saudi population: a randomized clinical trial.
Authors: Alam Mohammad Khursheed
Published: April 2019

Objectives: This study aimed to assess laser assisted orthodontic tooth movement (OTM) among subjects undergoing fixed orthodontic treatment (FOT) of four different treatment modalities (TM).

Materials and Methods: Following consort flow diagram, a total of 32 subjects randomly allocated in to 4 different group based on TM. Group A (GA): 8 subjects, FOT with self-ligating bracket (SLB) + low laser irradiation (LLLI), Group A (GB): 8 subjects, FOT with self-ligating bracket + Non-LLLI, Group C (GC): 8 subjects, FOT with conventional bracket (CB) + low laser irradiation (LLLI), Group D (GD): 8 subjects, FOT with CB + Non-LLLI.

Results: Clinical photographs and diagnostic CBCT has been taken. Clinical observation of OTM, baseline, 1-day and 28-day afterFOT in all TM groups has been assessed by single calibrated specialist. Among 4 TM groups, best OTM results observed in GA and the lesser OTM observed in GD.

Conclusion: Among all 4 TM groups,1-month after FOT GA revealed promising benefit in relation to OTM.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.385-390
The role of 4-pba on tnf-alpha related apoptosis on human vein endothelial cells
Authors: Illiandri Oski
Published: April 2019

Tumor Necrotizing Factor-alpha (TNF-α) has been well-known as a potent pro-inflamatory cytokine involved in many degenerative disease. Oneof its primary target organ-damaged wasendothelial cellswhich willlead to its endoplasmic reticulum stress (ERS) and induced its apoptosis. Endothelial cell apoptosis will lead high implication in many disease pathomechanism ofmany degenerative disease. Some study report ERS inhibitor 4-Phenyl Butyric Acid (4-PBA) properties to inhibitinflammation processin endothelial cells.However, wether 4-PBA can decrease apoptosis level in inflamationof endothelial cells is still poorly understood

Objective. This study to answer whether 4-PBA can decrease apoptosis triggered by inflammatory reactions mediated by TNFα.

Methods: This study is an exploratory study laboratory in vitro using cell culture Human Umbilical Vein Endothelial Cells (HUVEC) apoptotic count cells with the design of post test only control group consisting of three treatment groups with doses of 4-PBA 1 nM / mL, 2 nM /mL, and 3 nM /m L.

Results. Administration4-PBA in cultured HUVEC derived endothelial cells significantly decrease apoptosis at any dose of PBA but no dose dependently (p <0.05)

Conclusion: Based on the results that has been done, it can be concluded that 4-PBA can reduce levels of endothelial cells apoptosis which were exposed to proinflamatory cytokine TNF-α. Further research need to elucidated 4-PBA mechanism to inhibit endothelial apoptosis.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.391-394
Overt acquired primary hypothyroidism in a ten-year-old girl with perinatally-acquired HIV infection on HAART: A rare association
Authors: Onyiriuka Alphonsus N , Olaniyi Olufemi K
Published: April 2019

Overt hypothyroidism is rare in human immunodeficiency virus (HIV)-infected children but can further compromise the child’s quality of life. We report a case of a 10-year-old girl with perinatally-acquired human immunodeficiency virus (HIV) infection who subsequently developed overt acquired primary hypothyroidism. She has been on highly active antiretroviral therapy (HAART) for 9 years but developed goitre 2 years before presentation. Her thyroid gland was diffusely enlarged, firm, freely movable and non-tender. She had no symptoms of hypo- or hyperthyroidism. Physical examination revealed periorbital puffiness. Although her height was 139cm (50th percentile), it was significantly below the target centile range (152.5- 169.5cm). Results of investigations showed very low free T4 and markedly elevated TSH level (31-fold increase above our laboratory reference value). Ultrasonography of the goitre showed multicystic nodules in both lobes. She was commenced on oral levo-thyroxine 100μg once daily.

Conclusion: Physicians need to pay more attention to thyroid function in HIV-infected children on HAART, particularly in the presence of linear growth abnormalities.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.411-415
Neuroendocrine Tumour of the Breast in a Young Lady: A Case Report
Authors: Abidin Zainal Adwin Zainal , Hayati Firdaus , Azizan Nornazirah , Saladina Jasmin Jaszle
Published: April 2019

Primary neuroendocrine tumours of the breast are rare. The WHO has classified them according to the tissue grading. The clinical presentation is similar to the usual infiltrating ductal carcinomas, however the histopathological assessment requires special staining to confirm the diagnosis of neuroendocrine tumour. We report a case of a primary neuroendocrine tumour of the breast in a 33-year-old lady who presented with a locally advanced breast tumour with multicentric disease.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.419-422
Ear Foreign Body in Paediatric Patients: Methods of Removal and When to Refer.
Authors: Chuen Chew Shiun , Othman Nik Adilah Nik
Published: April 2019

Paediatric patient with a foreign body in the ear may be present primarily to primary care physician or being referred to the otorhinolaryngology (ORL) clinic. The foreign bodies vary from organic to inorganic material with different sizes and shapes. Removal of foreign body in the ear canal requires adequate clinical experience as well as proper clinical instruments and cooperative clinical staff. Throughout the years, many clinical instruments and devices have been designed and proven to able to facilitate a smooth procedure with high success rates. However, an agitated child may be uncooperative and the increase in the number of attempts will result in injury of the ear canal or displacement of foreign body to the middle ear. Thus, clinical experience is essential and the doubtful cases are preferably to be performed under general anaesthesia to prevent complications.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.423-426
Recurrent primary leiomyosarcoma of the seminal vesicle treated with curative radiotherapy
Authors: Santacaterina Anna , Scimone Antonino , Parisi Silvana , Settineri Nicola , Platania Angelo , Acquaviva Grazia , Pergolizzi Stefano
Published: April 2019

A case of locally recurrent leiomyosarcoma of the left seminal vesicle, previously surgically resected, is described in a 65-year-old man. The patient underwent curative radiation therapy (61 Gy/33 fractions). Initially, he experienced a complete response after irradiation, but 15 months after treatment, progressive disease was recorded both in lung and bone, without evidence of local recurrence. The lack of efficient systemic therapies leads to a poor prognosis in this disease; clinical outcome in this patient seems to suggest the utility of radiotherapy in the very rare scenario of locally recurrent seminal vesicle leiomyosarcoma.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.427-429
Lupus Cofactor Effect of Mixing Study: Example of a Case Report and Revisit on Theoretical Aspects
Authors: Rahman Wan Suriana Wan Ab , Zulkafli Zefarina , Hassan Mohd Nazri , Abdullah Wan Zaidah
Published: April 2019

Background: Lupus anticoagulants (LA) are in vitro inhibitors paradoxically associated with thrombosis and performing coagulation test on a mixture of test plasma and pooled normal plasma to evidence this property is a mainstay in LA detection.

Case report: We report a 20-year-old man who presented with one week history of fever, associated with productive cough, jaundice, and lethargy. He was a known case of systemic lupus erythemathosus for 10 years. Isolated activated partial thromboplastin time (APTT) were prolonged. Interestingly, the APTT mixing study was not corrected and showed more prolonged results than baseline APTT. LA study showed presence of a strong LA, which is related to the underlying autoimmune disease.

Discussion: This case focuses on the ‘rebound phenomenon’ in APTT mixing test, from a strong LA that gives a cofactor inhibitory effect to the entire test system after adding the normal plasma.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.430-433
Fatal Case of Chromobacterium violaceum Bacteraemia
Authors: Muharam Nur Hafiza , Hussin Azura , Deris Zakuan Zainy
Published: April 2019

Chromobacterium violaceum is rarely associated with human infection in tropical and subtropical regions. We report a fulminant fatal case of bacteremia in a 52-year-old lady, with underlying diabetes mellitus, who was presented with a month history of back swelling associated with fever, lethargy and poor oral intake. C. violaceum was isolated from blood and identify by standard biochemical test.However the patient’s condition deteriorating rapidly and succumbed to death on the day of admission. In these regions, C. violaceum should be one of the differential causes of sepsis, especially if the patient presented with skin lesions and/or multiple organ abscesses with history of exposure to soil or stagnant water.

Bangladesh Journal of Medical Science Vol.18(2) 2019 p.434-436
Undervaluation of rheumatoid arthritis activity under interleukin-6 inhibitor therapy
Authors: Ionescu Rosana Bristena , Doran Cristina , Moscalu Denisa Elena
Published: April 2019

A 62-year-old female patient with advanced rheumatoid arthritis was admitted for assessment of disease activity. Patient was currently under treatment with Tocilizumab and Cyclosporine A (3mg/kg). Her history of hepatitis C and elevated transaminases (treated with Methotrexate) rendered her ineligible for this standard therapeutic option. Several other DMARDs (Azathioprine, Sulfasalazine, Hydroxychloroquine) and biological therapies (Etanercept, Certolizumab) had proven ineffective.

On admission, patient reported increased morning pain and stiffness of hand joints. Clinical examination revealed fourteen swollen joints with no tenderness at compression and typical signs of advanced rheumatoid arthritis: ulnar deviation of fingers, interosseous muscle atrophy, swan neck deformity, impaired prehension. Laboratory investigations showed normal CRP (1.83 mg/L) and slightly increased ESR (44 mm/h) values. DAS28-CRP=2.7 (low activity), DAS28-ESR=4.12 (moderate activity). Hand and wrist radiographs were characteristic of advanced stage disease: bone erosions, joint spaces narrowing, metacarpophalangeal subluxations, juxta-articular osteoporosis. Ultrasound of hand joints revealed signs of active disease with positive Doppler signal.

During hospitalisation the patient received pain relieving treatment (Dexamethasone, Lornoxicam). On discharge, Cyclosporine A dose was increased to 5mg/kg. The timeliness of a different biological treatment will be assessed after 3 months, in case of persistent disease activity.

The present case highlights the risk of disease activity undervaluation in patients undergoing biological therapy with interleukin-6 inhibitors if the standard DAS28-CRP score is used [1],[2],[3], due to their additional inhibitory effect on hepatic CRP production. It is advised that in such cases, articular ultrasound and DAS28-ESR score should be considered for a more accurate assessment.
Determining the relationship between non-performing loans, economic growth, and asset size: An application in Turkish Participation Banking Sector
Authors: APAN Mehmet , İSLAMOĞLU Mehmet
Published: April 2019

Participation Banks are an alternative financial
institution that contributes to the development and deepening of the financial
system in the Turkish Banking Sector. In this study, the relationship between participation banks,
non-performing loans, gross domestic product, and asset size in the period
2005: Q1-2018: Q2 was investigated by using the co-integration, Granger
causality tests and regression analysis methods. The results of the Granger
causality test show that there is a one-way causality relationship between
non-performing loans to gross domestic product and the gross domestic product
to asset size, but there is a double causality relationship between
non-performing loans and asset size. In the results of empirical analysis, a
statistically significant relationship was found between both gross domestic
product and asset size, and non-performing loans. In this context, it is
determined that there is a negative relationship between non-performing loans
and gross domestic product. On the other hand, it was determined that the asset
size of the participation banking sector increased and the non-performing loans
were affected in the same direction.
Is The Dutch Disease Valid for Turkey in terms of the Effects of Portfolio Investments and Export Revenues on the Manufacturing Industry?
Authors: KONAK Ali
Published: April 2019

The
Dutch disease which emerges as a result of suddenly finding a large amount of
commercially valuable mines, is an economical issue which has an effect on
various macroeconomic variables, notably on foreign exchange rate. Although in
theory, the Dutch disease is defined as a problem caused by foreign currency
which is acquired by the detection and exportation of valuable mines in the
long term, it is possible for other economic developments which provide inflow
of foreign currency to the country to have economical effects on the national
economy that are similar to the effects of the Dutch disease. In our study in
which we question the existence of the Dutch disease due to the inflow of
foreign currency through various channels, the effects of portfolio investments
and export revenues on manufacturing industry sector were analyzed in terms of
the hypothesis of the Dutch disease by using the quarterly data of
2005:Q1-2018:Q4, obtained from the Electronic Data Delivery System (EDDS) of
The Central Bank of the Republic of Turkey (CBRT) and by using Toda-Yamamoto
causality test. As a result of the analysis, there wasn’t a causal relationship
between manufacturing industry and portfolio investments and exports. For this
reason, it was concluded that the Dutch disease is out of the question for
Turkey’s economy.
The Analysis of the Effect of Real Interests on Income Distribution with ARDL Model Approach
Authors: KAMACI Ahmet , CEYHAN M.said , PEÇE Mehmet Akif
Published: April 2019

The
Gini coefficient which measures the unfair distribution of income is a value
between 0 and 1. As the index value approaches to 1, unfairness increases and
as it approaches to 0, income distribution becomes fairer. The aim of this
study is to examine the effect of real interest on income distribution in 5
developing countries which are close to each other in terms of real per capita
income with panel data analysis. In this context, since the data of 2000-2016
include cross sectional dependency, second generation panel root tests were
used. Since the series are stable on different levels, ARDL model was utilized.
Then, the coefficient between the variables were determined by using the PMG
estimator and causality analysis was conducted. According to the result of the
study, although there isn’t a short-term relationship between the variables,
there is a cointegrated relationship in long-term. Furthermore, according to
the PMG estimator, an increase of 1 unit, increases the Gini coefficient by
0.007. Since the conducted causality analysis was resulted in accordance with
the Gini coefficient from real interests, it verifies this result. Since the
increase in real interests increases the Gini coefficient, real interests
should be decreased for a more fair income distribution, according to the
result of this study.