Background: Lung cancer is currently the leading cause of death from neoplastic diseases worldwide. During the preceding decades, it was the most commonly occurring malignant disease, both in terms of impact and mortality. Fiberoptic bronchoscopy is the most important diagnostic tool for lung cancer. Early tissue diagnosis and proper staging remains the key to the management of the lung cancer patient. Endobronchial forceps biopsy has high diagnostic yield from the visible lesions. The aim of the study was to evaluate diagnostic yield of endobronchial biopsy. Methods: A Cross Sectional Retrospective study of all patients with provisional diagnosis of lung cancer based on computed tomography (CT) scan of chest undergoing fiberoptic bronchoscopy was done at Department of Respiratory Medicine, Ibn Sina Diagnostic & Consultation Center, Chattogram, Bangladesh from July 2022 to June 2023. All fiberoptic bronchoscopy was done in endoscopy suite under local anesthesia. Patients were explained about the procedure thoroughly. Endobronchial biopsy was the main procedure performed. Results: A total of 120 patients underwent bronchoscopy for suspected lung cancer. The mean age of the patients was 58 years with range of 18 to 75 years. Among them 93 (77.5%) were male and 27 (22.5%) were female. Majority of the patients, 108 (90%) were smoker with a mean pack year of 42. The lesion was present more in right side (N=65) than the left side (N=55). Majority of the lesion was present in lobar bronchus followed by main bronchus. Bronchoscopy was normal in 10 patients (8.3%). 12 patients had lesion in multiple locations. The diagnostic yield of endobronchial biopsy was 75%. The diagnostic yield for central tumor was 81.6% which was statistically significant (p<0.001) compared to peripheral tumor and extrinsic compression. Conclusion: Endobronchial biopsy provides good diagnostic yield especially in central tumors. Fiberoptic bronchoscopy is a safe procedure.

Introduction: Diabetes is one of the leading health related catastrophes the world has ever witnessed. It affects millions of people all over the world. The reduced corneal sensitivity favors the occurrence of dry eye syndrome (DES) by reducing the blink rate, by decreasing the reflex-induced lacrimal secretion and increasing evaporative tear loss. It affects millions of people all over the world. Objective: Assessment of incidence of dry eyes in type 2 diabetic patients. Methods: A prospective study was carried out to assess the presence of dry eyes and to investigate the relationship of retinopathy with dry eyes. After applying inclusion and exclusion criteria 50 diabetic patients who attended the out-patient department of the Department of Ophthalmology, Ad-din Akij Medical College, Khulna, Bangladesh from July to December 2023. After applying inclusion and exclusion criteria 50 diabetic patients who attended the out-patient department of the Department of Ophthalmology, were selected. Results: Out of 50 Diabetic patients, 29 had dry eyes. Mild form of dry eyes was most common (20%). Majority of the patients were between the ages of 40-60 years. There was no significant association of age, sex and duration of diabetes with incidence of dry eyes. Mild form of dry eyes was most common (20%). There was no significant association of age, sex and duration of diabetes with incidence of dry eyes. Abnormal tear break up time was abnormal in 32%. Abnormal Fluorescein staining was seen in 20% study subjects. Moderate non-proliferative diabetic retinopathy was significantly more common in diabetic patients with dry eyes. Conclusion: Examination of dry eyes should be an integral part of the assessment of diabetic eye disease so as to improve the patients comfort and to prevent or minimize further structural damage to the ocular surface.

Background: Silent brain infarction (SBI) poses a significant yet often undetected risk in chronic kidney disease (CKD) patients, predisposing them to symptomatic stroke, dementia, and neurological mortality. Despite its implications, the association between SBI and CKD remains elusive, necessitating further exploration to elucidate potential predictive factors. Objective: This cross-sectional study investigated the relationship between SBI and metabolic abnormalities prevalent in CKD stages 3-5 (non-dialytic) patients. Methods: Conducted at the Department of Nephrology, Dhaka Medical College Hospital, Dhaka, from September 2018 to March 2020, the study enrolled 115 participants. Group I comprised 85 CKD stage 3-5 (non-dialytic) patients without neurological symptoms, while Group II comprised 30 healthy controls. Glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Diseases equation. Magnetic resonance imaging (MRI) was performed on all subjects. Statistical analysis utilized SPSS-26. Results: The rate of Silent Brain Infarction is 52.9% in CKD patients. SBI was found in 45(52.9%) patients in group I and 4(13.3%) in group II. The differences were statistically significant (p<0.05). Glomerulonephritis (45.9%) was the leading cause of CKD among the study patients. Most of the patients with Hypertensive Nephrosclerosis (76.9%) had SBI, which indirectly showed its strong association. As the CKD stages progressed, the SBI rate also increased (stage-3:8.9%; stage-4:35.6%; stage-5ND:55.6%). In a multivariate logistic regression analysis, CKD had an independent relationship with SBI along with serum phosphate level and serum parathyroid hormone level (CKD had Odds ratio (OR)=1.847 (95.0% CI 0.064 to 53.319), serum PO4 had OR=0.958 (95.0% CI 0.885 to 1.038) and serum PTH had OR=0.996 (95.0% CI 0.993 to 1.000). Spearman rank correlation coefficient test showed a positive correlation between the occurrence of SBI and serum PO4 level (r=0.416; p=0.001) and serum PTH level (r= 0.405; p=0.001) separately. Conclusions: The high prevalence of SBI in CKD stage 3-5 (non-dialytic) patients underscores its clinical significance. Serum phosphate and parathyroid hormone levels positively correlate with SBI occurrence, highlighting their potential as predictive markers. Understanding these associations can inform risk stratification and guide targeted interventions in CKD management.

The sentinel lymph node is the first lymph node to drain the tumour territory. Sentinel lymph node biopsy was first introduced in the management of melanoma patients in 1992 by Morton et al., Since then, its use has expanded to and become the standard of care in other cancer types. Lymphoscintigraphy is the standard technique for locating this node, and the surgical technique for removing it requires training. Anatomopathology uses standard histology and immunohistochemistry techniques. The aim of this examination is to look for micrometastases, which indicate lymph node invasion. If the sentinel lymph node is healthy, lymph node dissection is unnecessary.

Background: Guillain Barre Syndrome (GBS) is an acute, inflammatory, immune-mediated disorder of the peripheral nervous system triggered usually by a bacterial or viral infection or other antecedent events. GBS has become the leading cause of acute flaccid paralysis with a worldwide distribution. The incidence of GBS is variable across the world with overall incidence of 0.81-1.89/100000/year and incidence increases with age. Aim of the Study: This observational study was carried out to observe the pattern of clinical presentation, electrophysiological profile, and in-hospital outcome of Guillain-Barre Syndrome (GBS). Methods: A total number of 40 GBS patients at the department of Internal medicine, Neurology and Intensive care unit (ICU) of Sylhet M.A.G Osmani Medical College Hospital, Sylhet were enrolled during the period of February 2020 to March 2021. All patients were studied in detail including history, clinical examination and investigation. Results: The age of the patients ranged from 16 to 46 years with the mean age of 30.10 ± 13.44 years. Most of the cases occurred in autumn (60.0%) and antecedent event was present in 27.5% cases. In 40% patient’s initial symptom was bipedal edema who eventually went on to develop limb weakness/paralysis after various interval. Limb weakness was initial symptoms in 50% patients where Ascending paralysis was noted in the most of the cases (90%) and rest all 4 limbs. About 30% of the cases had objective sensory disturbance in the form distortion of pain (12%) and light touch (20%). Out of 40 patients 3 were treated with IVIg and 4 patients were managed in ICU. At discharge good or favorable outcome (GBS score < 3) was in 72.5% of the study population and poor or unfavorable outcome (GBS score ≥ 3) was in 27.5%. In hospital mortality was 10% in our study. A high GBS disability score at admission, ICU admission and mechanical ventilation were the factors that significantly associated with poor in-hospital outcome in GBS (p value <0.001 and <0.004 respectively). Conclusion: A good number of patients had pedal edema as initial symptom and all in-hospital outcome was favorable.

Introduction: Surgical site infection (SSI) is defined as an infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure. Most common cause of post-operative morbidity is surgical site infection (SSI) in planned cases accounting nearly 65% to 80% of all cases in our population. This study was conducted to know the need for antibiotic prophylaxis in clean, clean-contaminated surgical wounds and whether prophylactic antibiotic is itself sufficient to minimize surgical site infection. Methods: This was a prospective study was carried out at Dept. of Surgery, Enam Medical College Hospital, Savar, Bangladesh from July 2022 to June 2023. During this period, 150 cases were selected for our study. The cases were grouped in to two categories; Group A and Group B of 75 cases each. Group A comprises patients who received a pre-operative single dose of ceftriaxone a broad spectrum cephalosporin. Group B received no such prophylactic antibiotic. All were subjected to surgeries done under meticulous surgical technique. Results: Were divided equally into two groups, Group A included 75 cases who received single prophylactic dose of 1 gm of cefotriaxone given intravenously half an hour before surgery and Group B included 75 cases who did not receive any such antibiotic prior to surgery. The incidence of age varied from 5 to 60 years but maximum number of patients belonged to 21 to 30 years age group. Six patients in group B were infected; one belonged to 41-50 years age group three belonged to the 51-60 years age group and other two in the 61-70 years age group. Group A had 50 clean surgical cases and 20 clean contaminated cases, out of which none of them were infected. In group B out of 50 clean cases, 2 cases were infected and out of 30 clean contaminated cases 10 were infected. Our study showed that there is no need for prophylactic antibiotics in cases of clean surgeries. We recommend antibiotic prophylaxis in clean contaminated cases. The incidence of surgical site infection depends on various factors like old age (27.1%), anaemia (30.5%), Diabetes mellitus (25.4%) and prolonged duration of surgery more than 2 hours (14.2%). Conclusions: From this study we can conclude that, in cases of clean surgeries there is no need for prophylactic antibiotics, as there is no statistical significance, whereas in clean contaminated cases antibiotic prophylaxis is recommended as it reduces SSI statistically significant.

Antibiotic resistance is a serious problem that is growing rapidly around the world due to the overuse and misuse of antibiotics. This issue threatens global health, and it is critical to assess awareness to confront the spread of antibiotic resistance. Undergraduate education can influence practices, so it is important to determine students' knowledge, attitudes, and behaviour. The study investigated the knowledge, attitudes, behaviour, and use of antibiotic resistance among female hostel students in a Nigerian university. The survey revealed that while most respondents were familiar with "antibiotic resistance," only 40.7% expressed confidence in their understanding of the concept. The study identified a correlation between the student's year of study and their knowledge of antibiotic resistance, indicating that students in higher study levels possessed greater knowledge than those in lower levels (chi-square = p < 0.10). The study also found that Streptococcus spp was the most common gram-positive bacteria isolated, while Escherichia coli was the most common gram-negative bacteria isolated. Ciprofloxacin was the most effective for Escherichia coli, while Ampiclox had high resistance for gram-positive isolates, and Augmentin had high resistance for gram-negative isolates. Educational systems should consider including awareness campaigns on antibiotic resistance as part of community service courses. This would help to educate students and the public about the potential impact of antibiotic resistance on antibiotic usage. Additionally, educators should develop a general course covering important health issues to benefit all students.