bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Methods for Estimating Gamma Distribution Parameters with Outliers Observation
Authors: Ali Taha , Saleh Dlshad , Mustafa Abdulqader Qais , Omer Ahmed Awaz
Published: February 2025

The purpose of our research is to work to maintain parameters for the Gamma Distribution within a better frame of precision in the context of other methods and dealing with outliers. Outliers are common and pose a threat to modelling because one little outlier scales a statistical model and brings about the estimations of parametric index validity. The objective of this study was to find useful applications for the detection and mitigating effect of outliers accomplished through the Hampel filter, the nonlinear fit of the Gamma distribution using the Median Rank Regression (MRR) method for the calculation of the shape parameter and scale parameters.
This study then generated simulated data drawn from various parameter values of the Gamma distribution modelled with outliers and ran through the proposed Hampel-MRR method. These results were compared with those produced by the MLE and classical MRR methods based on MSE performance measures. From this research, it was observed that the proposed method gives a more accurate and robust estimate of the parameters, especially with increasing sample sizes and varying parameter values.
Implications of this research are those of broader application for the improvement of reliability research. This is just what is needed in decomposing survivability time distribution aiming to predict system performance and maintenance interventions. Superb empowerment and clubbing the years of theory with real-time applications are big draws for this technique over its counterparts in the midpoint of the era of outliers.
Strategic Leadership and Their Impact on the Quality of Work Life: An Analytical Study in the Directorate of Intelligence and Counter-Terrorism
Authors: Abdul Karim Omar Abdul Rasool , Tala Asim Faiq Tala Asim Faiq
Published: February 2025

The present study investigates the linkage between strategic leadership practices and quality of work life (QWL) within the Intelligence and Counter-Terrorism Directorate. Data was drawn from 115 freshly acquired respondents from senior and middle management by means of a multi-item questionnaire. The analysis that follows - SPSS, AMOS and SMART PLS V.4 - shows that the Directorate's clear defining of strategic direction and decisive decision making largely affects QWL. The study deduces critical issues pertaining to strategic leadership towards the improvement of work conditions and job security and human capital development where all will lead to better performance by the organization. In summary, strategic leadership practices, including setting strategic direction, developing human capital, ethical practices, and balanced strategic control, significantly affect quality of work life. The Directorate is very much interested in a clear definition of direction with respect to the strategic direction resulting from its decisive and bold decision-making at several points of the organization and with its transparent task descriptions. The Directorate also shows increasing importance toward emphasizing ethical practices by backing its levels with some ethical standards and principles and proper use of scarce resources in tandem with the Directorate approach towards further showing interest in the constitutionality of how the work is arranged, dealing equally with workers, and providing job security based on efficiency and productivity. This study, therefore, emphasizes the relevance of strategic leadership with respect to the positive creation of an atmosphere within which to improve organizational performance through better quality of work life.
Analysis and Measurement of Investment in The Industrial Sector and Its Impact on Unemployment in Iraq for The Period (2004-2022)
Authors: Abdul Hussein Kadim Haitham , Saleh Lawrence Yahiya
Published: February 2025

The study scrutinizes the influence that industrial investment has on unemployment rates in Iraq during the years ranging from 2004 to 2022. Employing the ARDL econometric model, the study analyzes and interprets the net as well as foreign investments and their concomitant relationship with unemployment. The findings reveal a significant and direct qualitative relationship between investment in the industrial sector and unemployment, showing that increased investment in this sector will, indeed, decrease the unemployment level. This has managed to emphasize the importance of an industrial sector in the absorption of surplus labor and contributions to gross domestic product (GDP). Further, by establishing a local industry that meets national demand of goods and services, investment in the industrial sector will have an alternative to imports and be able to stabilize the economy while improving growth. The latter includes the standpoint that efficient public spending would, therefore, be maximized by the industrial sector in terms of economic development and employment. Also, the study will emphasize how a stable investment environment can thus be used to attract local and foreign investments by having political, economic, and social stability. The results also show that bureaucracy clearing, enhancement of physical infrastructure, and legal guarantees and incentives form an important list of things that encourage a conducive investment environment. Overall, the study gives an insight to contribute better understanding on how those strategic investments in the industrial sector can serve to reduce upfront unemployment and yet foster sustainable economic growth in Iraq. This study offers significant insights to many policy makers in terms of maximizing the effectiveness of public spending and investment in achieving long-term economic objectives.
In vitro study of size-dependent inhibition of human cytochrome P450 (P450) P450-1A2, P450-2A6, P450-2B6, P450-2C8, P450-2E1, P450-2J2, and P450-3A5 by zinc oxide nanoparticles (ZnONPs)
Authors: Chowdhury Lamia , Pung Yuh Fen , Pung Swee Yong , Ong Chin Eng , Kong Cin , Pan Yan
Published: February 2025

Zinc oxide nanoparticles (ZnONPs) are employed widely in various fields. However, these ZnONPs may potentially inhibit enzyme activities. Cytochrome P450 (P450-) isozymes, which play a crucial function in human bio-transforming drugs, can be inhibited by ZnONPs, leading to slower clearance of co-administrated drugs and elevated drug plasma concentrations. This study aimed to reveal the inhibitory effects of the ZnO nano-sized particles, (<50 nm ZnONP50), (<100nm ZnONP100), and bulk particles (ZnOBP) on human recombinant P450-1A2, P450-2A6, P450-2B6, P450-2C8, P450-2E1, P450-2J2, and P450-3A5 under a size-dependent context. Fluorescence enzymatic assays were carried out to quantify enzyme activities in vitro. The results indicated that ZnO particles inhibited the tested P450 isozymes with varying potencies.

ZnONP50 inhibited P450-2B6 and P450-2E1 with Ki values of 20.3 μg/mL and 16.6 μg/mL following a mixed mode; inhibited P450-2C8 with Ki value of 43.3 μg/mL competitively; inhibited P450-2J2 with Ki values of 8.2 μg/mL and 2. 5 μg/mL non-competitively. ZnONP100 inhibited P450-2B6 and P450-2E1 with Ki values of 6.7 μg/mL and 40.1 μg/mL following mixed mode; inhibited P450-2J2 with Ki value of 20.0 μg/mL following mixed or non-competitive mode; inhibited P450-3A5 with Ki value of 0.5 μg/mL non-competitively. ZnOBP competitively inhibited the enzymatic activity of P450-2E1 with Ki value of 28.3 μg/mL. The inhibition potency observed for P450-2B6, P450-2J2, and P450-2E1 depended on the size of the ZnO particle. In conclusion, the interactions between ZnONP products and co-administered drugs metabolized by these inhibited P450-isozymes should be further investigated using in vivo models. Additionally, in silico studies are recommended to characterize these interactions at the molecular level.
Multidimensional Index Model Development for Assessing Exacerbation Prognosis in COPD
Authors: Apriani Nuni , Widiyanti Anggriyana Tri , Ikbari Gissan Rafli , Hermawan Riki
Published: February 2025

Background: Acute exacerbations are a major cause of poor outcomes in patients with Chronic Obstructive Pulmonary Disease (COPD). However, attention to early recognition of acute exacerbation symptoms has been limited to FEV1 (Forced Expiratory Volume in 1 second). COPD is a complex disease that involves many dimensions, so early symptom recognition requires a more comprehensive multidimensional assessment. This study is a retrospective cohort study to develop a multidimensional index model in assessing the prognosis of exacerbations in COPD patients.
Objectives: This study aims to find a comprehensive index model in the early assessment of exacerbations to reduce mortality and morbidity in COPD patients.
Methods: This study is a retrospective cohort study by conducting non-interventional observations.  A total of 28 COPD patients based on GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria were included as respondents.
Results: The Cox Regression survival analysis for the quartiles showed a significant effect of this multidimensional index on predict exacerbation prognosis.
Conclusion: The BODEX + sPO2 provided an adequate match between predicted and observed exacerbation prognosis in COPD.
The Effect of Emotional Freedom Technique (EFT) on Blood Pressure Reduction in Hypertensive Patients in Pondok Ranggon, East Jakarta
Authors: Astuti Yuli , Safari Uum , Sutiawati Dewi Nur , Atika Fanisa Nur
Published: February 2025

Background: Hypertension is defined as an increase in blood pressure above 140 mmHg systolic and 90 mmHg diastolic. The prevalence of hypertension in the DKI Jakarta Province recorded 923,451 cases in 2021. Hypertension management often focuses primarily on pharmacological treatments, highlighting the need for non-pharmacological therapies without side effects, such as Emotional Freedom Technique (EFT) therapy.
Objectives: This study aims to examine the effect of EFT therapy on reducing blood pressure.
Methods: This study utilized a quasi-experimental design with a pretest-posttest control group approach. The study population consisted of 16 individuals, with 8 respondents in the hypertension group and 8 respondents in the control group.
Results: The analysis showed a p-value of 0.025 (p-value ≤ 0.05) for both systolic and diastolic blood pressure before and after the intervention, indicating that EFT therapy significantly affects blood pressure reduction.
Conclusion: Regular EFT therapy has been proven to effectively reduce blood pressure over seven days of intervention.
PENGARUH KUALITAS PELAYANAN, KETERJANGKAUAN BIAYA, KEAMANAN PASIEN, DAN LINGKUNGAN FISIK TERHADAP KEPUASAN PASIEN DI RUMAH SAKIT DR. M. HASSAN TOTO BOGOR TAHUN 2023
Authors: Nopayani Rika , Hardiana Hedy , Hendarwan Harimat
Published: February 2025

Rumah sakit perlu melakukan upaya terbaik untuk memasuki sektor kesehatan yang telah berkembang pesat dengan berbagai strategi. Kepuasan pasien dipengaruhi oleh beberapa faktor diantara nya kualitas pelayanan, biaya perawatan, keamanan pasien, dan lingkungan fisik. Salah satunya adalah di RS. Upaya untuk meningkatkan kepuasan pada RSAU dr. M.Hassan Toto sudah dilakukan berbagai macam, akan tetapi dari data kunjungan yang setiap tahun menurun.  Tujuan penelitian untuk mengetahui pengaruh kualitas pelayanan, keterjangkauan biaya, keamanan fisik, dan lingkungan pasien terhadap kepuasan pasien. Jenis penelitian ini menggunakan kuantitatif dengan metode survei. Populasi dalam penelitian ini adalah pasien rawat inap pada bulan desember yaitu sebanyak 442 orang. Teknik pengambilan sampel menggunakan jenis non-probability sampling yang menggunakan rumus Slovin. Analis data dengan uji statistik dengan RStudio. Hasil penelitian nilai customer satisfaction indeks sebesar 59,84, nilai ini termasuk dalam kategori "cukup puas", ini berarti bahwa secara keseluruhan, responden dalam penelitian ini memiliki tingkat kepuasan yang cukup terhadap atribut-atribut yang diteliti. Dan terdapat pengaruh kualitas pelayanan sebesar 0,2089036 menunjukan bahwa korelasinya yang lemah keterjangkauan biaya dengan besar nilai 0,9709661 lingkungan Fisik dengan nilai 0,9696457, dan keamanan pasien 0,9735532 terhadap kepuasan pasien dengan nilai p yang lebih kecil dari 0,05. Variabel yang paling berpengaruh terhadap kepuasan pasien adalah keamanan dan lingkungan fisik sesuai dengan nilai Rho yang paling mendekati nilai +1.
Comparison of health related quality of life between end-stage renal disease patients on haemodialysis and continuous ambulatory peritoneal dialysis
Authors: Chowdhury Tufayel Ahmed , Billah Md Mostarshid , Ananna Mehruba Alam , Rahim Muhammad Abdur , Iqbal Sarwar
Published: February 2025

Background: Patients with end-stage renal disease (ESRD) require dialysis for their survival. Haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) are two different modes of dialysis which can lead to multitude of stressful physical, mental and social problems. This study was done to evaluate the health related quality of life (HRQOL) of ESRD patients undergoing HD and CAPD. Methods: This cross-sectional analytical study was conducted in the Department of Nephrology, BIRDEM General Hospital, Dhaka during January 2019 to June 2020. A total of 66 ESRD patients undergoing HD or CAPD were taken after obtaining informed written consent. Information on socio-demographic characteristics, clinical features and laboratory investigations were assessed. HRQOL was assessed by using the validated Bengali version of Kidney Disease Quality of Life Short Form Tool (KDQOL-SF-36 version1.3). A semistructured questionnaire was used for data collection and analysis was done by Statistical Package for Social Science (SPSS) version 24.0. Results: Majority of ESRD patients underwent HD (54.5%). Age was significantly associated with dialysis treatment modality (HD vs CAPD: 55.6±11.9 vs 62.9±11.9 years, p<0.05). According to SF-36 and KDQOLSF 1.3 assessment, patient undergoing CAPD had a better QOL and mental health compared to HD. Among SF- 36 domain, physical functioning had a significant positive relation with haemoglobin level (r=0.320, p=0.009). Haemoglobin level was positively correlated with symptoms, effects of kidney disease and burden of kidney disease in KDQOL-SF 1.3 scores (p<0.05). Conclusion: CAPD patients demonstrated a better QOL compared to HD patients.
BIRDEM Med J 2025; 15(1): 9-15
Renal cell carcinoma: epidemiology, risk factors and clinicopathological profile
Authors: Hassan Muhammad Rafiqul , Sultana Razia , Khan Mohiur Rhaman , Arefin Mirza Shamsul , Chowdhury ATM Mowladad
Published: February 2025

Background: The incidence of renal cell carcinoma (RCC) is increasing worldwide. The aims of this study were to describe epidemiological data, risk factors, clinicopathological characteristics of RCC. Methods: This cross-sectional descriptive study was carried out at the department of Urology, BIRDEM General Hospital from Janaury 2013 to July 2023. All radiological characteristics and fine needle aspiration (FNA) positive RCC cases were included and othere renal tumor such as angiolipoma, renal cyst, renal tuberculosis were excluded. Results: A total 200 RCC patients were included in the study. The mean age at presentation was 52.28 years and male (74%) were predominant. Most of the patients (66%) were asymptomatic, smoking (62%) was the most common modifiable risk factor, 50% patients had hypertension. In 54% cases right kidney was involved. Raised erythrocyte sedimentation rate was the most common (60%) paraneoplastic feature. The most common histopathologic type of renal tumour was clear cell carcinoma (70%), followed by papillary (20%) and chromophobe (6%) carcinoma; 66% of the patients presented at Robsing Stage II and 20% cases diagnosed as stage III. Conclusion: It had been observed that RCC mostly occurred in young male patient at right kidney with fewer symptomatic detection. Tobacco smoking were the most common modifiable risk factor. Diagnosis were made at advance stage of the disease.
BIRDEM Med J 2025; 15(1): 16-21
Barriers of achieving and maintaining glycemic target among patients with type 2 diabetes mellitus on insulin therapy
Authors: Islam Mohammad Aminul , Dutta Mita , Tabassum Maliha , Islam Md Shafikul , Rezwana Israt , Sumyia Umme , Ghosh Parijat , Afsana Faria , Amin Md Feroz , Ashrafuzzaman SM
Published: February 2025

Background: Many obstacles exist that lead to failure of achievement of glycemic target in persons with diabetes mellitus (DM) prescribed with insulin. However, there is an inadequate amount of data to address these barriers and to make effective intervention. The aim of this study was to identify barriers of achieving and maintaining glycemic target among type 2 diabetic patients on insulin therapy. Methods: This cross-sectional study was carried out in the Department of Endocrinology, BIRDEM General Hospital from March 2020 to August 2022. Total 384 patients with type 2 DM on insulin therapy were recruited by convenient sampling. Face to face interview was taken from the patient by following the inclusion and exclusion criteria. Patients were examined for his/her injection site, injection technique; insulin vial and syringe were also checked for any mismatch. Biochemical reports were collected from patient records. Data analysis was done by SPSS version 25 considering level of significance at 0.05. Results: The mean age of the participants was 56 ± 10, (m±SD) years. Majority (73.9%) were obese. Hypertension (70.6%) was common among the patients. Few (10.7%) patients maintained physical exercise regularly. The mean duration of DM was 12.15± 5.39 years and they were taking insulin for a mean of 4.40± 2.64 years. Most of the patients took premixed insulin (38.3%) followed by split mixed (29.7%) and basal-bolus (21.1%) regimen. Most common cause of poor glycemic control was insulin omission (46.4%). Obesity, using premixed insulin, irregular physical exercise, irregular self-monitoring of blood glucose (SMBG), not following the diet chart, no education on target glucose and insulin dose adjustment were associated with HbA1c >10%, which indicates poor glycemic control. Conclusion: Overall, lack of knowledge about glycemic control and insulin dose adjustment, insulin omission, non-adherence to the diet, irregular physical exercise act as barriers to achieve optimum glycemic control.
BIRDEM Med J 2025; 15(1): 34-38
Aetiology of pleural effusion among patients with chronic kidney disease
Authors: Afroz Farhana , Hossain Mohammad Delwar
Published: February 2025

Background: Pleural effusion is common in patients with chronic kidney disease (CKD). Aetiology of pleural effusion is diverse like heart failure, tuberculosis (TB), pneumonia, uraemia etc. Proper diagnosis of the cause is necessary as treatment plan varies from case to case. This study was designed to evaluate the aetiology of pleural effusion in patients with CKD. Methods: This cross-sectional study was conducted in the Departments of Nephrology and Dialysis, Internal Medicine and Respiratory Medicine of BIRDEM General Hospital, Dhaka, from July to December, 2022. Sixtytwo patients, aged e_18 years with CKD stage 3 to 5 with pleural effusion were included in this study. Patients having bleeding disorder, recent myocardial infarction or patients unwilling for thoracocentesis were excluded. Patients were evaluated clinically and by aspiration of pleural fluid. Results: Of the 62 patients, 42 (67.7%) were male and 20 (32.3%) were female. The mean age was 52 years. Commonest symptom was dyspnea (47, 75%), cough (33, 53%), weight loss (23, 37%) anorexia (22, 35%), fever (16, 25%), pleuritic chest pain (15, 24%), bilateral basal crepitations (15, 24%), abdominal swelling (9, 14%), engorged neck veins (7, 11%). Diabetes mellitus (DM) (50, 80%) was the commonest comorbidity in our patients. A previous history of TB was present in 9 (14%) patients (most of whom completed treatment) and 7 patients had history of malignancy (including 2 on treatment). In our study, 38 (61%) patients were in CKD stage 4, 6 (9%) patients were on dialysis. In most cases (51, 81%), effusions were bilateral transudative. Fluid overload (32, 62%), heart failure (29, 56%) and nephrotic syndrome (11/21%) were common transudative effusion. Etiology of exudative pleural effusion were TB, uremia, empyema and hypothyroidism. Conclusion: Aetiologiy of pleural effusion in CKD are mostly fluid overload, heart failure, nephrotic syndrome, TB and empyema.
BIRDEM Med J 2025; 15(1): 39-43
Air Pollution: An Invisible Threat to Kidney Disease
Authors: Hasan Mahmud Javed
Published: February 2025

Abstract not available
CBMJ 2025 January: Vol. 14 No. 01 P: 1-3
Influence of Cigarette Smoking on Forced Expiratory Volume in the First Second (FEV1) among Male Smokers
Authors: Naznin Rubiat , Nazrina Sayeda , Hussain Maria , Naznen Farhana
Published: February 2025

Cigarette smoking is an intractable public health problem that carries threat to the health of entire population. Smoking is a known risk factor for chronic obstructive pulmonary disease, cardiovascular diseases and certain cancers specially lung cancer. This cross-sectional, comparative study was conducted in the outpatient department of Mymensingh Medical College Hospital, Bangladesh, from July 2014 to June 2015, to examine whether the forced expiratory volume in the first second (FEV1) differs between cigarette smokers and non-smokers and also estimate the effect of duration of cigarette smoking on lung function. FEV1 was recorded in total 150 subjects, in which non-smokers were 50 (as control, group I) and numbers of smokers were 100 with duration of smoking was 5-10 years (group IIA) and >10 years (group IIB). FEV1 was measured by using Spiromaster PC-10 Spirometer. A questionnaire including participants’ history and physical examination was completed. FEV1 decreased gradually with the duration of smoking in both study groups i.e., group IIA (5-10 years duration of smoking) and group IIB (>10 years duration of smoking) as compared to the control group (non-smokers, group I) (p<0.001). FEV1 was also found lower in group IIB (>10 years duration of smoking) as compared to group IIA (5-10 years duration of smoking) (p<0.05). Our study showed that cigarette smoking has a strong impact on airway obstruction that is reflected through a reduction in FEV1.  
CBMJ 2025 January: Vol. 14 No. 01 P:11-15
Biochemical and Serological Investigations in Incidentally Detected Asymptomatic HBsAg-Positive Subjects (IDAHS)
Authors: Murshed Khaled Mahbub , Kabir C M Shamim , Azad Md Abul Kalam , Ahmed Nazma , Masud Md Adnan Hasan
Published: February 2025

This cross-sectional, observational study was conducted among 50 incidentally detected asymptomatic HBsAg positive subjects (IDAHS) in the out-patient department (OPD) of the Department of Hepatology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh, between May and November of 2017. All demographic characters like age, sex, education level, occupation and socio-economic status as well as mode of detection and duration of HBsAg positivity and risk factors were documented in the data sheet. Serum bilirubin and alanine aminotransferase (ALT) were measured using auto analyzer in the biochemistry laboratory. Serum bilirubin ≤1.0 mg/dl and ALT levels ≤40 IU/L in males and ≤30 IU/L in females were set as normal. Serological tests were performed by using ELISA method, e.g., HBeAg and anti-HBeAg in the microbiology laboratory. The participants’ age ranged between 21 and 57 years with a mean of 30.2±9.3 years. We found that 23(46%) subjects were detected HBsAg positive during routine checkup followed by blood donation 11(22%), antenatal check-up 7(14%), going abroad 4(8%), family screening 3(6%) and before vaccination in 2(4%) subjects respectively. Among risk factors, 18(36%) had family history of HBsAg and only 1(2%) subject had unsafe sexual exposure. In total, 17(34%) were found having elevated ALT levels and only 1(2%) had abnormal bilirubin level. In total, 38(76%) subjects were HBeAg negative, while 35(70%) were Anti-HBe positive. Most IDAHS subjects were negative to HBeAg, however, they need to be followed up at regular intervals so that appropriate measures can be taken in time.  
CBMJ 2025 January: Vol. 14 No. 01 P: 16-21
Position of the Anterior Commissure in Relation to the Anterior Height of the Thyroid Cartilage: A Cadaver Based Study
Authors: Ara Anjuman , Rahman Md Shamsur , Mili Dilruba Afrose , Jannat Rumman Al
Published: February 2025

A cross-sectional, descriptive type study was done in the Department of Anatomy, Mymensingh Medical College, Bangladesh, between October 2008 and March 2009, to determine the position of the anterior commissure in relation to the anterior height of the thyroid cartilage in cadavers and observe gender difference, if any. A total of 29 postmortem human larynges (male 17 and female 12) were collected from dead bodies (aged between 17 to 60 years) from the mortuary of the Department of Forensic Medicine of the same institution. In the present study, the mean value of the ratio of the distances between the superior thyroid notch and anterior commissure and the midline height from thyroid notch to the inferior border of thyroid cartilage was found 0.23 in females and 0.26 in males. No statistical differences were observed between these two groups (p>0.05). It was also found that anterior commissure lies at the junction of upper one fourth and lower three fourth of the anterior height of thyroid cartilage.  
CBMJ 2025 January: Vol. 14 No. 01 P: 22-27
Common Causes of Donor Rejection in Blood Transfusion Services at Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
Authors: Nahar Kamrun , Binni Subrina Yesmin , Nine S M A Zulker , Shams Khanam Zahida
Published: February 2025

A cross-sectional, descriptive study was carried out in the Department of Transfusion Medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between April 2008 and March 2009, to determine common causes of donor rejection in blood transfusion services. From the register book of the department data was curated. A total of 16,619 donors were included in data analysis. Among them, a total of 765 were rejected donors: party donor and voluntary donor were 558(73%) and 207(27%) respectively. The majority of the rejected donors were in 18-30 years age group (68%), followed by 31-40 years age group (24.2%), 41-60 years age group (5.9%), 60-65 years age group (0.7%). In sex distribution, 603(78.8%) were males and 162(21.2%) were females; male-female ratio was 3.7:1. The majority of the study subjects belonged to the 18-30 years age group (68%), followed by 31-40 years age group (24.2%), 41-60 years age group, >60 years age group (0.7%). Most of the donors were students (40.8%); among females most of them were housewives. Party donor and voluntary donor rejection 558(73%) and 207(27%) respectively. Donor rejection was due to medical causes 443(57.9%), serological causes 207(27.1%) and non-medical causes 115(15.0%). Among medical causes, history of sensitive/contraindicated medication 98(12.8%), ongoing menstruation 37(4.8%), history of jaundice 26(3.4%) and asthma 21(2.7%) were common. Among non-medical causes, 100(13.1%) were rejected due to short interval from previous blood donation, while 10(1.3%) were rejected due to underage (<18) and 5(0.7%) for being over age (>65). Among physical findings, 101(13.2%) of were rejected due to underweight, 27(3.5%) due to high blood pressure, 17(2.2%) due to low blood pressure, 21(2.7%) for low hemoglobin levels and 13(1.7%) allergic skin conditions. Donor rejected for serological causes involved 188(24.6%) HBsAg positive and 19(2.5%) HCV positive cases.  
CBMJ 2025 January: Vol. 14 No. 01 P: 34-39
Impact of the COVID-19 Pandemic on Interventional Cardiology: A Retrospective Study
Authors: Hasan Md Hasibul , Kadir A N M Monowarul , Kabir Ahsanul
Published: February 2025

The recent COVID-19 outbreak has impacted the delivery of healthcare and interventional cardiology services worldwide. Several studies conducted in different countries have revealed that there was a significant reduction in performing percutaneous coronary intervention (PCI) procedures during the onset of the pandemic; however, the situation of such interventional practice n Bangladesh is not well documented. Hence, this study aims to investigate the changes in the volume of interventional cardiology services before and during the COVID-19 outbreak in a tertiary level healthcare facility of the country. This retrospective study based on record review involved 304 patients admitted into Mugda Medical College Hospital, Dhaka, Bangladesh, between April 2019 and April 2021. The patients were categorized as group A (pre-COVID; N=170) and group-B (COVID; N=134) patients. Data were obtained on patient demographics, risk factors, medical history, type of intervention, and readmission of the patient. The pandemic period had an increased number of patients aged ≥60 years (51.5% vs. 42.9%) and a significant shift in gender distribution (16.4% male vs. 78.2% pre-pandemic). The ST elevation myocardial infarction (STEMI) remains relatively stable between the two groups (60.0% vs. 59.7%; p>0.05). Rates remained stable (40.3% vs. 40.0%; p<0.001). Similarly, the number of non-ST elevation myocardial infarction (NSTEMI) cases also remains unchanged (40.0% vs. 40.3%; p>0.05). An increase in balloon angioplasty procedure was observed during the pandemic (49.41% vs. 62.69%; p<0.001). In contrast, there was a huge decrease in angioplasty with stent procedure (42.35% vs. 21.64%; p<0.001). Patient readmission rate slightly decreased (18.82% vs.16.42%; p>0.05). This study highlighted that the COVID-19 outbreak brought changes in the patient population and interventional procedures in interventional cardiology at Mugda Medical College Hospital, Dhaka, Bangladesh. These figures are rather stable in STEMI cases, contrary to the tendencies in other countries, whereas the transition to balloon angioplasty most likely tried to reduce the time of the procedure. Thus, they stress the imperativity of context-sensitive approaches to cardiovascular health management during epidemics and call for additional research on later consequences.  
CBMJ 2025 January: Vol. 14 No. 01 P: 40-45
Microbial Profile in Paediatric Patients with Wound Infection and Their Antibiotic Susceptibility Pattern
Authors: Dola Nigha Zannat
Published: February 2025

Wound infection is one of the major health problems that frequently occur among patients reporting or admitted in the hospital. This observational study was conducted in the Department of Microbiology at Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh, between November 2023 and May 2024, to observe the microbial profile in paediatric patients with wound infection and their antibiotic susceptibility pattern. A total of 372 wound swabs were collected and analyzed by using culture and antibiotic sensitivity tests. From total wound swab samples, culture positive samples were 281(75.54%). Among those, 52(18.5%) were Gram-positive and 229(81.5%) were Gram negative. Pseudomonas spp was the most commonly 83(36.24%) isolated organisms, followed by Escherechia coli 48(20.96%), Acinetobacter spp 33(14.41%), Klebsiella spp 24(10.48%) among Gram-negative bacteria. On the other hand, Staphylococcus spp 23(44%) was the most prevalent, followed by Staphylococcus aerues 18(35%) among Gram-positive isolates. 94% of the isolated Staphylococcus aerues were methicillin resistant Staphylococcus aerues (MRSA). Staphylococcus spp showed higher resistant pattern against azithromycin (91%), erythromycin (91%), linezolid (78%), ciprofloxacin (69%), moxifloxacin (65%), levofloxacin (52%) and gentamycin (52%). Most of the Gram-negative bacteria showed higher resistant against ampicillin followed by third and fourth generation cephalosporins, fluroquinolones. Periodic surveillance of microbial profile and appropriate antibiotic selection are necessary to prevent multidrug resistant bacteria in hospital patients. Moreover, infection prevention campaigns must be strengthened among hospital wards and premises.  
CBMJ 2025 January: Vol. 14 No. 01 P: 46-53
Morphometric Study of Maximum Antero-Posterior and Curved Antero-Posterior Diameter of the Head of the Dry Humerus Bone
Authors: Haque Shah Md Atiqul , Mehataz Tasnova , Afros Farzana , Ismatsara Mst , Ahmed Muntasir , Biswas Tithi Rani , Tanzeem Sabiha , Debnath Dhrubajit , Bose Sanjib Kumar , Pal Niloy Kumar
Published: February 2025

The humerus is a typical long bone of the upper limb; its head articulates with the glenoid cavity of the scapula to form the shoulder joint. The rounded head of the humerus is too weakly supported in the scapular glenoid cavity lined by the glenoid labrum; hence, it forms one of the most mobile and most unstable joints. Our study aims to determine the morphometry of the dry humeral head. This cross-sectional, descriptive study was carried out in the Department of Anatomy, Mymensingh Medical College, Bangladesh, from July 2021 to June 2022. We took 100 (right=43 and left=57) samples through the purposive sampling. Any damaged, unossified or fractured bones were excluded. The maximum anteroposterior diameter of the head of the humerus was measured by using digital slide calipers, while the curved anteroposterior diameter of the head was measured by using flexible measuring tape. The mean anteroposterior diameter of the head was found 38.665±3.206 mm at right side and 38.321±3.115 mm at left side. The mean curved anteroposterior diameter of the head was found 57.116±5.499 mm and 54.789±4.977 mm at right and left side respectively. Our findings are expected to be helpful for clinical anatomists, orthopedic surgeons, anthropologists, and radiologists for academic teaching and clinical decision making.
CBMJ 2025 January: Vol. 14 No. 01 P: 66-69
Prevalence of Pulmonary and Extrapulmonary Tuberculosis Among the Patients Attending Community Based Medical College, Bangladesh (CBMC,B) Hospital
Authors: Biswas Binoy Krishna , Khan Manjur Ul Karim , Biswas Suttam Kumar , Begum Maksuda , Ali Md Yunus
Published: February 2025

Tuberculosis (TB) is a chronic granulomatus bacterial infection affecting almost all organs of the body and classified as pulmonary TB (PTB) and extrapulmonary TB (EPTB). In our country, tuberculosis is still a havoc in community health. This retrospective study by reviewing case records was conducted in Community Based Medical College, Bangladesh (CBMC,B) Hospital, Mymensingh, Bangladesh, to estimate the prevalence of pulmonary and extrapulmonary tuberculosis among the patients attending the hospital between January 2022 and June 2024. Data  were collected from the patients’ records – a total of 67 patients admitted under Surgery, ETN and Medicine units of the hospital. 20(29.85%) of the patients were diagnosed with PTB, while 47(70.15%) had EPTB. Out of 67 patients, 29(43.28%) were male and 38(56.72%) were female; male-female ratio was 1:1.31. Based on occupations, housewives were the highest in numbers (45%), followed by students (18%), farmers (13%), service holders (12%), day labourers (10%) and drivers (2%). Pulmonary TB was more prevalent among the 51-60 years age group (25%), followed by the 71-80 age group (20%). Extrapulmonary TB was more prevalent among the 21-30 years age group (29.8%), followed by the 31-40 years age group (23.4%). A male predominance (65%) was observed compared to female (35%) in PTB; in contrast, a female predominance (66%) was observed compared to male (34%) in EPTB. Among EPTB patients, cervical lymph nodes TB was found in 22(46.8%), followed by breast TB 8(17%), axillary TB 7(14.9%) and abdominal TB 3(6.4%). Tubercular abscess was diagnosed in 7(14.9%) cases. More and more TB awareness campaigns in the community educating people on mode of transmission of TB and self-assessment along with early diagnosis and prompt treatment can improve the situation to a great extent.  
CBMJ 2025 January: Vol. 14 No. 01 P: 81-84
Comparison of Efficacy and Safety of Vildagliptin and Linagliptin in Patients of Type 2 Diabetes Mellitus with Chronic Kidney Disease
Authors: Ahmed Sultan , Hasan Mahmud Javed , Bari Md Abdul , Islam Md Aminul , Alam Md Rezaul , Jahan Ferdous , Hasan Rafiqul , Helal ASM Julfekar
Published: February 2025

Both vildagliptin and linagliptin are dipeptidyl peptidase-4 (DPP-4) inhibitors used to manage blood sugar levels in patients with type 2 diabetes mellitus (T2DM), including those with chronic kidney disease (CKD). This randomized comparative study was conducted in the Department of Medicine, Community Based Medical College, Bangladesh (CBMC,B) Hospital, Mymensingh Bangladesh, between January and December 2023, to compare the efficacy and safety of vildagliptin and linagliptin in patients of type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD). A total of 120 type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD) were enrolled and randomly divided into two groups. Group A (60 patients taking vildagliptin 50 mg) and Group B (60 patients taking linagliptin 5 mg). Both groups received respective medication along with metformin 500 mg and glimepiride 2 mg. Baseline demographic and diagnostic findings showed similar results between Group A and Group B. Both groups experienced significant improvements in FBG and PPG levels, along with a notable reduction in creatinine levels. LDL-C levels decreased in both groups, but the change was only statistically significant in Group B. Additionally, creatinine and AST levels significantly decreased in both groups. At follow-up, Group B had significantly lower PPG levels compared to Group A. Both vildagliptin and linagliptin are effective and safe for type 2 diabetes patients with chronic kidney disease. However, linagliptin shows some superiority over vildagliptin in controlling postprandial glucose levels.  
CBMJ 2025 January: Vol. 14 No. 01 P: 96-100
Morphometric Study of the Horizontal and Diagonal Length of the Human Mandible
Authors: Ahmed Muntasir , Akter Mahfuza , Haque Shah Md Atiqul , Jewel Abdul Alim
Published: February 2025

The body of the human mandible has upper and lower borders. The lower border is smooth and called the base of mandible. The ramus has four borders, among them the inferior border is continuous with the base and ends with posterior border of ramus making the angle of the mandible. The cross-sectional, descriptive study was conducted in the Department of Anatomy, Mymensingh Medical College, Bangladesh, between July 2019 to June 2020, to determine the horizontal length and diagonal length of the human mandible. This study was done on 150 fully ossified dry mandibles. A non-random purposive sampling technique was adopted. The diagonal length was measured at the base of mandible from a point on symphysis menti to the posterior most point at mandibular angle, while the horizontal length was measured from the anterior margin of chin to a center point on a projected straight line along the posterior border of two mandibular angle. The mean (±SD) horizontal length of mandible was found 70.87 (±6.2) mm. The mean (±SD) diagonal length of at the right side of the mandible was found 81.90 (±5.3) mm and on the left side, it was 79.72 (±5.1) mm. This study will help the dental and maxillofacial surgeons in their field of practice. Forensic anthropology and prosthesis manufacturer will also be benefited from the study.  
CBMJ 2025 January: Vol. 14 No. 01 P:118-121
Evaluation of Medication-Related Challenges in Hypertensive Patients: A Comprehensive Assessment at Community Based Medical College, Bangladesh (CBMC,B) Hospital
Authors: Sattar Shamima
Published: February 2025

A cross-sectional, observational study was carried out at Community Based Medical College, Bangladesh (CBMC,B) Hospital, Mymensingh, Bangladesh, between January and September of 2023, to assess the proportion and nature of drug therapy problems, the regimen management of hypertension, and the associated risks among hypertensive patients. A total of 120 hypertensive patients willingly participated and responded to a structured questionnaire. Patient data include demographic characteristics, medications, clinical parameters, lifestyle factors, and drug therapy issues. The study included an equal distribution of males and females, with most patients aged 49-58 years (29.2%). Telmisartan (62.5%) and amlodipine (50.0%) were the most commonly prescribed medications. Among drug therapy problems (DTPs), need for monitoring (35%) and potential drug interactions (31.67%) were found most significant. Diabetes mellitus (37.50%) and chronic kidney disease (25.83%) were main comorbidities. Stress (50%) and unhealthy diet (49.17%) emerged as leading risk factors, while polypharmacy (55%) and comorbidities (53.33%) in patients emerged as main clinical challenges. This study suggests that medication review processes need to be well structured, resources required for improving the patients’ knowledge about hypertension and its treatments are necessary for healthcare organizations in the country and monitoring activities ought to be conducted from time to time to review the management of hypertension.  
CBMJ 2025 January: Vol. 14 No. 01 P: 128-133
Epidemiological Profile Autoimmune Bullous Diseases: A Study Done in A Tertiary Care Hospital in Bangladesh
Authors: Islam Nahida , Shakil Mohammad Imdadul Hoque
Published: February 2025

A cross-sectional study was conducted in the Department of Dermatology and Venereology, Community Based Medical College, Bangladesh (CBMC,B), Mymensingh, Bangladesh, between March 2022 and  March 2024, to evaluate the epidemiology of autoimmune bullous diseases (AIBDs). A total of 89 patients diagnosed with autoimmune bullous diseases (AIBDs) were enrolled in this study using a purposive sampling method. All demographic and clinical information was documented. Most of our participants were aged 60 years or older (53.9%). A male predominance was observed (59.6%). The most prevalent type of AIBD was pemphigus vulgaris (59.6%). Hypertension (12.4%), diabetes mellitus (7.9%), hyperlipidemia (5.6%), osteoporosis (4.5%), coronary heart disease (3.4%) and hepatitis (3.4%) were observed as the main comorbidities. In nearly three-fourths of the cases (74%) only oral mucosal involvement was identified, while only nasal (2%), only genital (8%), and both oral and genital (16%) mucosal involvement were also observed. Overall, our data showed that the older male population is mainly prone to autoimmune bullous diseases (AIBDs) in Bangladesh.  
CBMJ 2025 January: Vol. 14 No. 01 P: 134-138
In Silico Design and Evaluation of a Novel Multi-Epitope Vaccine Against Treponema denticola (strain ATCC 35405): A Reverse Vaccinology Approach
Authors: Chowdhury Ashiqur Rahman Khan , Paul Aurpita Rani , Tamanna Nusrat Jahan , Ovi Mst Nafisa Omman , Momo Mehejabine Islam , Sarker Ruma , Moury Israt Jahan , Jahan Farjana , Rahman Evana , Shila Sabrina Akhter , Hasanat Hamja , Fahi Faria Hossain , Hossain M Mahboob
Published: February 2025

Treponema denticola is a gram-negative, drug resistant bacterium found in primary dentition infections and around teeth, causing inflammation and tissue homeostasis linked to periodontal diseases including early-onset periodontitis, necrotizing ulcerative gingivitis, and acute pericoronitis. In previous research, potential drug targets against the pathogen had been identified and characterized. However, as of now, there are no vaccines specifically available against T. denticola for human use. Hence, this study aims to design an immunoinformatic vaccine using a reverse vaccinology approach against this deadly pathogen. Human (HLA) allele specific potential T-cell and B-cell epitopes were shortlisted through a stringent procedure from a total of two antigenic proteins of T. denticola (namely, Acetate kinase AckA and Chromosomal replication initiator protein DnaA). The multi-epitope vaccine (MEV) was constructed using linkers with adjuvant human beta-defensin-3. The vaccine construct was verified, based on its antigenicity and physicochemical properties, and showed strong binding with the human receptor (TLR4). Molecular dynamics simulation confirmed the stable nature of the docked complex. The results of in silico immune simulation revealed that constructed vaccine activated B and T lymphocytes which induced high levels of antibodies and cytokines. Furthermore, in silico cloning analysis ensured efficient expression of desired gene in the microbial system. Thus, the vaccine construct developed in this study is capable of eliciting both innate and adaptive immunity and has all the potential for the development of a next-generation vaccine which may in turn effectively combat the periodontal pathogen T. denticola. Nevertheless, further in vitro and animal studies are warranted to strengthen our findings for its utility as a probable preventive measure.  
CBMJ 2025 January: Vol. 14 No. 01 P: 139-155
Scalability and Sustainability Issues of Mobile Learning in Health Professions Education
Authors: Nurunnabi Abu Sadat Mohammad , Rahman Ashiqur , Akter Nahida , Talukder Mohammad Abu Sayeed , Tapu Thanadar Tamjeeda , Rehana Jinnat , Nahar Niru Shamsun
Published: February 2025

Mobile learning has been used increasingly in the past decades in different health profession education, and advancement in technology have produced different forms of mobile learning development modalities such as simulations, virtual patients, online courses and many interactive contents. However, many of those efforts’ outcomes failed to live up to their promises; hence, those were not widely adopted and became unsustainable. A literature review has been done through a literature search conducted across three databases – Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE (Ovid) and Google scholar – for studies describing or evaluating different mobile learning platform as used for education and professional development of different health professions based on user experience, perceived barriers, facilitating factors to scale it up and make it sustainable. This paper tends to identify factors or actions which are considered to optimize the experience and satisfaction of different stakeholders, help scaling up and identify strategies for sustainability of mobile learning interventions for health professions education.  
CBMJ 2025 January: Vol. 14 No. 01 P: 186-191
Varietal Screening for Tolerance Against Leaf Roller of Mungbean Under Field Condition
Authors: Khan Mohammad Mohasin Hussain , Ullah Md Habib
Published: February 2025

An experiment was carried out in the farmer’s field at Sonakhali, Barguna sadar, Barguna of Bangladesh during January to April 2016 to evaluate different varieties of mungbean against leaf roller in order to find out tolerant/less susceptible varieties of mungbean. Results revealed that all varieties regarding leaf roller population the variety, local Mung, IPSA Mung-5, BU Mung-2 and BINA Mung-2 had highest population of leaf roller and were highly susceptible varieties to leaf roller. The varieties, BARI Mung-2, GK Mung-27, BU Mung-1 and IPSA Mung-12 had lowest population of leaf roller, which indicated that these varieties were least susceptible to leaf roller. Among all tested varieties, none showed complete resistance against leaf rollers but BARI Mung-5 and BARI Mung-6 showed comparatively better resistance against leaf roller. The highest population of leaf roller/m2 (7.0) plants in the field was observed in the 2nd week of March and then declined gradually up to the 4th week of March in 2016. BARI Mung- 6, BINA Mung-2, BU Mung- 1 and local Mung varieties had the highest percent leaf area damage by leaf roller while IPSA Mung-5, GK Mung-27, BARI Mung-5 and BU Mung-2 varieties had the lowest percent leaf area damage by leaf roller. There was a strong negative correlation between number of leaf roller and yield.
J. Asiat. Soc. Bangladesh, Sci. 50(1-2): 1-15, June-December 2024