bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-Related Quality of Life among Elderly Population of Bangladesh
Authors: Ahmmed FM Shamim , Rahman Md Saydur , Zafreen Farzana , Ara Rowshan , Islam Md Ziaul 
Published: June 2021

Introduction: Elderly population in Bangladesh is one of the largest in the world in term of absolute number and ageing is an emerging problem. Elderly are at risk from non-communicable diseases as well as mental problems and health-related quality of life (HRQoL) affects in urban and rural elderly.
Objective: To find out and compare HRQoL in urban and rural elderly population of Bangladesh.
Materials and Methods:A comparative cross-sectional study was carried out to compare HRQoL in urban and rural elderly. This was a two samples study; 130 each from urban and rural. Total 260 elderly were selected conveniently. Data were collected through face to face interview using a pre-tested semi structured questionnaire of SF-36 v2 HRQoL survey. This study was carried in urban elderly residing in Ward number 3, Race Course, Cumilla City Corporation and in rural elderly residing in Noapuskuni Village of Babutipara Union, Muradnager Upazila, Cumilla. This one-year study was conducted from 15 July 2017 to 14 June 2018.
Results: Majority of the elderly were Muslim (91.5%), female (53.5%), married (59.6%) and from joint family (91%). The mean ± SD age of elderly was 69.26±6.337 years and mean ± SD monthly family income was Tk. 16561.54±9192.076. SF- 36 v2 HRQoL scale; a licensed software-based survey tool was used measure the health-related quality of life of elderly. Most of the elderly were found with average physical component summary (PCS) (53.1%) and mental component summary (MCS) (50.8%) of HRQoL. Age had significant negative correlation with PCS (p<0.001) and MCS (p<0.001) in urban and rural elderly. Education level of urban and rural elderly had significant positive correlation with PCS (p<0.01) and MCS (p<0.01). Marital status of urban and rural elderly had significant negative correlation with PCS (p<0.001) and MCS (p<0.001) of HRQoL. Among the rural respondents, the mean ± SD of PCS of male was 43.79±5.766 and female was 41.14±6.860. The difference was statistically significant (p<0.05). Mean score of PCS of urban and rural respondents were 45.68±6.366 and 42.43±6.467 respectively. This difference was statistically significant (p<0.001). Mean scores of MCS of urban and rural respondents were 43.96±4.921 and 42.56±7.028 respectively. This difference was not statistically significant (p>0.05).
Conclusion: Most of the elderly had average level of health-related quality life. Rural female elderly had significantly lower physical health of HRQoL than that of rural male elderly. Physical dimension of HRQoL of rural elderly was significantly lower than that of urban elderly.
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 161-164
Socio-demographic Characteristics of Depressive Illness Patients Attending a Selected Military Hospital
Authors: Hamid Md Abdul , Rahman Md Mahbubur , Islam Md Rafiqul , Islam Sheikh Shahidul 
Published: June 2021

Introduction:Depressive illness is generally not perceived as an important public health problem and is not priority in health care delivery system in Bangladesh. It is the leading cause of disease-related disability in the country today. Gender differences in depression are likely to be result of certain risk factors.
Objectives: To find out gender difference in epidemiological and socio-demographic features associated with depressive illness.
Materials and Methods: This descriptive cross sectional study was carried out among 91 diagnosed depressive patients attending in the psychiatry department of CMH Dhaka from January to December 2014. The patients were interviewed through an interviewer-administered questionnaire. Data were analyzed by using SPSS version 20. Chi-square test was used to see the level of significance.
Results: In this study the mean age of the patients was 34.47±9.577 years. The study revealed that depressive illness appears to be more in female during child bearing and child rearing period of 16-39 years and male of 40-63 years were more sufferer than female which was significantly different (p<0.05). In this study 63.74% of patients were female and 36.26% were male with ratio of 1.757:1. It was observed that the association of depression with residence in urban area in female (72.1%) was significantly (p<0.05) higher than male (27.9%) in the same area. This study revealed that the association of depression with history of financial hardship in female was statistically significant (p<0.05) over their male counter-part.The study also revealed that strenuous job was significantly (p<0.05) associated with depression in female than male.
Conclusion: The overall finding of the study indicates that possibility of gender difference in certain epidemiological and sociodemographic features of depressive illness is significantly present. As depressive illness has significant impact on burden of disease and quality of life, this issue needs to be addressed.
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 178-180
Barodontalgia among Aircrew of Bangladesh Air Force
Authors: Rahman Md Masudur , Khan Mizanur Rahman , Ahsan Mohammad Ahmed , Alam Mohammad Khairul , Wahab Md Abdul 
Published: June 2021

subjected to atmospheric pressure changes and have an influence on flights. Barodontalgia is caused whenever the pulp is exposed to differential pressure gradient.
Objective: To see the barodontalgia among aircrew of Bangladesh Air Force.
Methodology: A cross-sectional study was carried out in Dental wing medical squadron BAF base Basher Dhaka. The study participants were recruited during one year among all the pilots and crewmembers attending departments specializing in medical follow-up at the study period from the Bangladesh Air Force.
Results: Among the 50 barodontalgia group, most 39(78%) of the respondents were found technical and military flying whereas 50 without barodontalgia group 38(76%) specifically in military flying. In barodontalgia, 62% respondents were found in moderate pain (4-6), 26% in mild pain (1-3) and 32% in severe pain (7-10). In barodontalgia, 50% respondents were descent of barodontalgia, 52% were altitude where barodontalgia was reported to appear during the flight was <4000 meters and 70% were flight speed was 500-1000 km/h. Most of the respondents were found specifically in commercial flights in patients with barodontalgia. Majority pain intensity was found moderately in barodontalgia
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 186-188
Study on Prolapsed Intervertebral Disc Cases Admitted in Military Hospitals
Authors: Ali ASM Zulfiquer , Zafreen Farzana , Wahab Md Abdul 
Published: June 2021

Introduction: Prolapsed intervertebral disc is a condition that can occur anywhere along the spine, but most often occurs in the lower back. It is sometimes called a bulging, protruding or ruptured disc. It is one of the most common causes of lower back pain as well as leg pain or sciatica.
Objective: To study the demographic characteristics of prolapsed lumbar intervertebral disc by age, gender, clinical presentation, levels of spinal column involvement, treatment options and post operative complications for lumbar disc prolapse.
Materials and Methods: This cross sectional study was conducted in Rangpur and Saidpur Combined Military Hospital from September2017 to December 2018. A Total of 223 Cases was studied and data were collected by semi-structured questionnaire by face to face interview and medical documents.
Results: Most commonly affected disc spaces were L5/S1(35.87%)followed by L4/L5 (33.18%) and L4/L5,L5/S1(14.28%). Males were mostly affected and commonest among 30-39 years’ age group (45.29%). Chi-square test is done and result is statistically significant (p<0.01). Most of the cases given conservative treatment 202(90.58%), surgical treatment given 21(9.41%). Mechanical backache wasthe most common (14.29%) post operative complications.
Conclusion: In this study prolapsed intervertebral disc was common in the lower lumbar region at the level of L4/L5 and L5/S1.
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 221-223
Congenital Cystic Adenomatoid Malformation of Lung in an Infant
Authors: Hossain SM Shahadat , Haque Khan Nazmul , Sultana Mahbuba 
Published: June 2021

Congenital Cystic Adenomatoid Malformation (CCAM) is considered a hamartomatous lesion of lung with excessive proliferation of bronchial structure without alveoli. We have treated a child of 12 months who presented with difficulty in breathing after birth and chest x-ray PA view shows increase lucency in the right upper zone suggestive of CCAM. Patient underwent right upper lobectomy under general anaesthesia and now she is fine.
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 235-236
Munchausen Syndrome Presenting with Bleeding per Nose, Ears, Eyes and Mouth1
Authors: Bhuiyan Shah Mohammad Ashek Uddin , Islam Md Azizul , Chowdhury Sohel Hasan , Hossain Md Azad 
Published: June 2021

In 1951, Richard Alan John Asher first reported Munchausen syndrome as a factitious disorder. The essential feature of this disorder is that patients feign physical symptoms to get admission in a hospital. These patients may feign symptoms of disorder of any organ system. Even experienced clinicians are deceived by these symptoms and histories presented by these patients. Usually they know which of the symptoms and diagnoses usually require hospital admission or medication. Because of rarity of this disease and lack of knowledge and awareness even among the physicians, often misdiagnosis occur which results in unnecessary use of medical tests and evaluations. For these reasons this is one of the toughest and challenging diagnoses in any medical set up. We present this rare case of a patient who presented to the department of emergency, ENT and Eye repeatedly with Bleeding per nose, ears, eyes and mouth for 8 months. The patient was successfully treated, initially with psychotropic then psychotherapy with no recurrence. This interesting and rare case is presented to create awareness amongst all specially to medical population about Munchausen syndrome so that they can be diagnosed easily and treated with efficiency as well as misdiagnosis and unnecessary use of medical resources can be avoided.
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 237-239
Still’s Disease–A Case of Diagnostic Dilemma
Authors: Razzak Md Abdur , Rahman Afsana , Rahman Quazi Audry Arafat 
Published: June 2021

Still’s disease is an auto-inflammatory multisystem disease characterized by high spiking fever, salmon-colored rash that comes and goes, arthritis and other varieties of systemic manifestations. The puzzling fever and leukocytosis and high serum level of procalcitonin mistakenly may lead to diagnosis of severe bacterial infection or sepsis. But use of broad-spectrum antibiotic fails to improve the condition. It may mimic other multisystem autoimmune rheumatic diseases, but autoantibodies are negative. It may resemble the malignancies like leukemia and lymphoma, but lymph node biopsy and bone marrow study does not support. We have reported a case of Still’s disease in a 14-year-old young boy. Initially he presented like a viral illness, but high fever persisted for more than 4 weeks associated with body ache and skin rash withoutany arthritis. He had cervical lymphadenopathy, mild hepatosplenomegaly, pleural and pericardial effusion. He had persistent leukocytosis, high serum procalcitonin and high serum ferritin but low serum iron. Bacterial infection and sepsis were excluded, hematologic malignancy was ruled out by lymph node biopsy and bone marrow examination. There was no conclusive evidence of tuberculosis. Still a therapeutic trial was given but failed to produce any benefit. After exclusion of all the possible differentials and basing on diagnostic criteria he was diagnosed as a case of Still’s disease. With the use of steroid and immunosuppressive agent his condition improved dramatically and now he is leading a normal life.
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 240-242
Case Report: Causative De novo Variants of KCNT2 for Developmental and Epileptic Encephalopathy
Authors: Gong Pan , Jiao Xianru , Yu Dan , Yang Zhixian 
Published: June 2021

Objective:KCNT2 gene mutations had been described to cause developmental and epileptic encephalopathies (DEEs). In this study, we presented the detailed clinical features and genetic analysis of two unrelated patients carrying two de novo variants in KCNT2 and reviewed eight different cases available in publications.Methods: Likely pathogenic variants were identified by whole exome sequencing; clinical data of the patients were retrospectively collected and analyzed.Results: Our two unrelated patients were diagnosed with Ohtahara syndrome followed by infantile spasms (IS) and possibly the epilepsy of infancy with migrating focal seizures (EIMFS), respectively. They both manifested dysmorphic features with hirsute arms, thick hair, prominent eyebrows, long and thick eyelashes, a broad nasal tip, and short and smooth philtrum. In the eight patients reported previously, two was diagnosed with IS carrying a ‘change-of-function' mutation and a gain-of-function mutation, respectively, two with EIMFS-like carrying a gain-of-function mutation and a loss-of-function mutation, respectively, one with EIMFS carrying a loss-of-function mutation, three with DEE without functional analysis. Among them, two patients with gain-of-function mutations both exhibited dysmorphic features and presented epilepsy phenotype, which was similar to our patients.Conclusion: Overall, the most common phenotypes associated with KCNT2 mutation were IS and EIMFS. Epilepsy phenotype associated with gain- and loss-of-function mutations could overlap. Additional KCNT2 cases will help to make genotype-phenotype correlations clearer.
Childbirth Experiences and Delivery Care During Times of War: Testimonies of Syrian Women and Doctors
Authors: Bashour Hyam , Kharouf Mayada , DeJong Jocelyn 
Published: June 2021

Background: Until the eruption of violence in 2011, Syria made good progress in improving maternal health indicators including reducing the maternal mortality ratio and increasing the level of skilled birth attendance. The war in Syria has been described as one of the worst humanitarian crises in recent times. Damascus Maternity Teaching Hospital is the largest maternity public hospital in the country that survived the war and continued to provide its services even during periods of pronounced instability. The main aim of this paper is to highlight the experience of childbirth and delivery care as described by women and doctors at times of severe violence affecting Damascus.Methods: This paper is based on secondary analysis of qualitative data collected between 2012 and 2014 for a WHO-funded implementation research project introducing clinical audits for maternal near-misses. This analysis specifically looked at the effects of violence on the childbirth experience and delivery care from the perspective of both women and physicians. A total of 13 in-depth interviews with women who had recently delivered and survived a complication and 13 in-depth interviews with consultant obstetricians were reviewed and analyzed, in addition to three focus group discussions with 31 junior care providers.Results: Three themes emerged concerning the experiences of women and doctors in these times of war. First, both women and doctors experienced difficulty reaching the hospital and accessing and providing the services, respectively; second, quality of care was challenged at that time as perceived by both women and doctors; and third, women and doctors expressed their psychological suffering in times of hardship and uncertainty and how this affected them.Conclusions: Efforts to safeguard the safety of delivery and prevent maternal mortality in Syria continued despite very violent and stressful conditions. Both women and providers developed strategies to navigate the challenges posed by conflict to the provision of delivery care. Lessons learned from the experiences of both women and doctors should be considered in any plans to improve maternal healthcare in a country like Syria that remains committed to achieving the Sustainable Development Goals in 2030 in the aftermath of nearly 10 years of war.
Is Fatty Liver Associated With Depression? A Meta-Analysis and Systematic Review on the Prevalence, Risk Factors, and Outcomes of Depression and Non-alcoholic Fatty Liver Disease
Authors: Xiao Jieling , Lim Lincoln Kai En , Ng Cheng Han , Tan Darren Jun Hao , Lim Wen Hui , Ho Cyrus S. H. , Tan Eunice Xiang Xuan , Sanyal Arun J. , Muthiah Mark D. 
Published: June 2021

Background and Aims: Both non-alcoholic fatty liver disease (NAFLD) and depression have a high global prevalence which is projected to increase further. While studies exploring the association have been done, there are conflicting data. This study aims to assess the prevalence and association between depression and NAFLD.Methods: Medline and Embase were searched from inception to March 3, 2020. Meta-analysis of proportions using the generalized linear mix model was conducted to analyze the pooled prevalence of depression in NAFLD patients. Risk factors for depression in NAFLD patients were evaluated in conventional pairwise meta-analysis.Results: Ten studies involving 2,041,752 NAFLD patients were included. Pooled prevalence of depression was 18.21% (CI: 11.12–28.38%) in patients with NAFLD and 40.68% (CI: 25.11–58.37%) in patients with non-alcoholic steatohepatitis (NASH). NAFLD resulted in significantly higher risk of development of depression (OR: 1.29, CI: 1.02–1.64, p = 0.03). NASH patients had a significantly higher risk of depression compared with NAFLD patients (RR: 2.83, CI: 2.41–3.32, p &lt; 0.001). Diabetes, body mass index (BMI), female sex, smoking, and history of pulmonary disease were significant risk factors for depression in NAFLD patients.Conclusion: This study demonstrated a high prevalence of depression in NAFLD patients and a significant association between both conditions. Furthermore, patients with NASH had a significantly higher risk of depression compared with those with NAFLD. Diabetes, BMI, history of lung disease or smoking, and female gender were significant risk factors. Further studies investigating the pathophysiological mechanism underlying depression and NAFLD are needed.
Irreversible Electroporation Treatment With Intraoperative Biliary Stenting for Unresectable Perihilar Cholangiocarcinoma: A Pilot Study
Authors: Yang Po-Chih , Chen Yan-Jun , Li Xiao-Yong , Hsiao Chih-Yang , Cheng Bing-Bing , Gao Yu , Zhou Bai-Zhong , Chen Sheng-Yang , Hu Shui-Quan , Zeng Quan , Huang Kai-Wen 
Published: June 2021

BackgroundTreating perihilar cholangiocarcinoma (PHCC) is particularly difficult due to the fact that it is usually in an advanced stage at the time of diagnosis. Irreversible electroporation treatment (IRE) involves the local administration of a high-voltage electric current to target lesions without causing damage to surrounding structures. This study investigated the safety and efficacy of using IRE in conjunction with intraoperative biliary stent placement in cases of unresectable PHCC.MethodsThis study enrolled 17 patients with unresectable Bismuth type III/IV PHCC who underwent IRE in conjunction with intraoperative biliary stent placement (laparotomic) in two medical centers in Asia between June 2015 and July 2018. Analysis focused on the perioperative clinical course, the efficacy of biliary decompression, and outcomes (survival).ResultsMean total serum bilirubin levels (mg/dL) on postoperative day (POD) 7, POD30, and POD90 were significantly lower than before IRE (respectively 3.46 vs 4.54, p=0.007; 1.21 vs 4.54, p&lt;0.001; 1.99 vs 4.54, p&lt;0.001). Mean serum carbohydrate antigen 19-9 (CA19-9, U/ml) levels were significantly higher on POD3 than before the operation (518.8 vs 372.4, p=0.001) and significantly lower on POD30 and POD90 (respectively 113.7 vs 372.4, p&lt;0.001; 63.9 vs 372.4, p&lt;0.001). No cases of Clavien-Dindo grade III/IV adverse events or mortality occurred within 90 days post-op. The median progression-free survival was 21.5 months, and the median overall survival was 27.9 months. All individuals who survived for at least one year did so without the need to carry percutaneous biliary drainage (PTBD) tubes.ConclusionsIt appears that IRE treatment in conjunction with intraoperative biliary stent placement is a safe and effective approach to treating unresectable PHCC. The decompression of biliary obstruction without the need for PTBD tubes is also expected to improve the quality of life of patients.
Parasagittal Approach of Epidural Steroid Injection as a Treatment for Chronic Low Back Pain: A Systematic Review and Meta-Analysis
Authors: Knezevic Nebojsa Nick , Paredes Stephania , Cantillo Santiago , Hamid Albara , Candido Kenneth D. 
Published: June 2021

Background: Epidural steroid injection (ESI) has proven benefits in controlling chronic low back pain and can be performed via the midline interlaminar (MIL) or transforaminal (TF) approach. A modified interlaminar approach, the parasagittal interlaminar (PIL), has surfaced as a more reliable, safe, and suitable approach to minimize complications related to MIL and TF.Objective: To conduct a systematic review and meta-analysis to assess and compare the effectiveness and safety of PIL with both MIL and TF approaches in adult patients with a history of chronic low back pain.Methods: A literature search was conducted using major electronic databases, such as PubMed, EMBASE, and Cochrane. Selected studies included patients with unilateral radicular symptoms, secondary to lumbar intervertebral disc hernias or degenerative lumbar disc disease, that, additionally, received ESIs via PIL or either MIL or TF under fluoroscopic guidance. Randomized and observational studies with pain relief score and/or functional disability assessment and at least a 2-week follow-up were included.Results: The search led to the initial identification of 174 studies. Following the screening, eight studies were included in the qualitative analysis and seven randomized controlled trials (RCTs) were included in the statistical analysis. PIL showed statistically significantly more pain relief and functional improvement than MIL at 1-, 3-, and 6-month post-procedure. Compared to TF, PIL showed statistically significantly more pain relief at 3- and 6-month after the procedure. Additionally, PIL showed benefits in terms of lower mean fluoroscopy time, less radiation exposure, zero adverse events in all the included studies, no cases of intravascular spread compared with the TF approach, and a higher anterior epidural spread (AES) of PIL compared with TF.Conclusions: Our systematic review and meta-analysis suggest that the PIL approach is an effective and safe alternative to the MIL and TF approaches in patients presenting with chronic low back pain when epidural injections are indicated, demonstrating a higher level of pain relief and a stronger improvement in functionality post-procedure.