ABSTRACT
Background: The rising incidence of resistant fungal infections poses significant therapeutic challenges. This study aimed to compare the efficacy and safety of terbinafine monotherapy versus combination therapy with terbinafine and voriconazole in patients with resistant fungal infections. Methods: A total of 90 participants were enrolled from June 2022 to May 2024 at Colonel Maleque Medical College, Manikgonj, Bangladesh. Participants were randomly assigned to receive either terbinafine (6 mg/kg, maximum 500 mg/day) alone or in combination with voriconazole (200 mg/day). Outcomes assessed included mycological cure rates, clinical improvement, relapse rates, and adverse events over a 1-year follow-up period. Results: At 6 weeks, the mycological cure rate was 44% for the monotherapy group versus 78% for the combination group (p=0.001). At 1 year, the rates were 29% and 67%, respectively (p=0.001). Complete clinical improvement was observed in 29% of monotherapy patients compared to 62% in the combination group (p=0.002). Adverse events were more common in the combination group (44% vs. 22%, p=0.03), including higher rates of liver enzyme elevation and visual disturbances. Relapse rates at 1 year were lower in the combination group (27% vs. 44%, p=0.05). Conclusion: Combination therapy with terbinafine and voriconazole significantly improves mycological cure rates and clinical outcomes in resistant fungal infections compared to monotherapy, despite an increased incidence of adverse events.

ABSTRACT
Background: The pattern of child illness speacially neonatal illness varies depending on the location and period. examining the trend of newborn admissions. Being a low- and middle-income nation (LMIC), Bangladesh, understanding hospital admission patterns and post-care outcomes is crucial for a child's survival. In addition, Bangladesh has difficulty keeping up with and achieving the Sustainable Development Goal (SDG) in terms of newborn deaths and child mortality. Objective: This study's goal was to learn more about hospitalised patients' admission trends and treatment outcomes. Methods and Materials: The present retrospective study was carried out within the Department of Pediatrics at Prime Medical College Hospital in Rangpur, Bangladesh, spanning from January 2016 to November 2016. This study included a cohort of 1053 who were admitted at Prime Medical College Hospital. The cohort consisted of both inborn and outborn neonates throughout the specified period. Results: The most prevalent complications observed were perinatal asphyxia with hypoxic-ischemic encephalopathy (HIE) accounting for 24.8% (n=109), preterm low-birth-weight newborns comprising 34.2% (n=150), and neonatal septicemia representing 16.6% (n=73). The prevalence rates of Meconium Aspiration Syndrome and Neonatal Jaundice were found to be 3.4% and 5.7%, respectively. The leading cause of death were perinatal asphyxia accompanied with hypoxic-ischemic encephalopathy 19, which accounts for 50% of the total death, followed by preterm low birth 39.5%.The causes children admission in the hospital and highest cause of the admission is Respiratory system 30% (n=614) and Gastrointestinal (GI) tract 22.5% (n=614) and major cause of the child death 41.7% (n=12) and Nutritional disorder 25%. Though 97% of the patients have shown improvement in their health conditions and were subsequently discharged, while 1.95% unfortunately succumbed to mortality. Conclusion: The leading causes of neonatal ....

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Background: Hypertension is a significant non-communicable disease across the world which contributes to the worldwide disease burden. With the trend of graying population, this is a global pandemic. Objective: This study was aimed to assess the associated risk factors of hypertension in the elderly population in urban community of Dhaka city. Method: A total of 256 elderly people aged above 60 years with either pre-hypertension or hypertension were enrolled in this community-based cross-sectional study. The study period was January to July 2024. Results: It was found that, age, gender, being overweight, stress levels, red meat consumption and family history of hypertension were statistically significant with development of hypertension in the elderly. There was 3.5 times greater risk of development of hypertension in the elderly those who were overweight and had higher stress levels. It was also found that, those who not currently smoking, took normal amount of salt and consumed sufficient fruits and vegetables, were also vulnerable to hypertension. Diabetes mellitus was the commonest comorbidity in hypertensive elderly. Conclusion: Hypertension should be addressed with importance by the stakeholders, policy makers and the government in order to promote health awareness in the communities. Risk factors should be evaluated and prospective, larger-scale studies are recommended.

ABSTRACT
The burden of substance abuse is an enormous public health issue. Globally, 1 in every 17 people 15-64 years uses at least one drug. Cannabis as the most used drug. In Kenya, 1 in every 6 people between 15 and 65 years are currently using at least one drug. The aim of this study was to determining the burden of alcohol and drug abuse in Kenya, and suggest ways of reducing the burden. A scoping review of literature was conducted through the Google Scholar according to the criteria and methodology by Arksey and O’Malley (2005). 96 studies fully met the inclusion criteria. The study concluded that Kenya faces a heavy burden of alcohol and drug abuse that causes enormous physical, mental, biological, social, spiritual, psychological, emotional, economic, intellectual, developmental and environmental sufferings, robing individuals of social and economic opportunities, imposing an enormous burden on families and the society, and negatively affecting the country’s development efforts. Recommendations for addressing alcohol and drug abuse include: enhancing awareness regarding alcohol and drug use-related harms and its consequences; advocating for healthy, balanced lifestyles; normalizing self-love, self-care and seeking help; resisting peer pressure; building resilience; fostering strong interpersonal relationships; scaling up positive parenting and strengthening families; addressing stressful situations; developing life skills; enforcement of strong measures to regulate access to alcohol and drugs; early identification and reduction of alcohol and drug use; avoiding stigmatization and discrimination; using multi-dimensional family therapy strategies; scaling up broad-based, positive, holistic, innovative, affordable and evidence-based prevention, treatment, recovery and rehabilitation approaches/interventions; including gender-responsive, trauma-informed and anti-oppressive approaches in alcohol and drug addiction treatment as well as gender-based violence interventions;

ABSTRACT
The Region of Tombouctou is considered as one of landlocked regions in Mali, unstable war zone. The frequency of mandibular fracture becomes more than usual in the last years with lack of oral and maxillofacial team; limited complementary exams; and limited surgical tools. In purpose to reduce; to fix fracture line; and to restore function of maxillofacial areas, we decided to practice direct interdental wiring as alternative method for the treatment of limited displacement of mandibular fractures. Direct interdental wiring in Intermaxillary fixation for closed reduction in the mandibular fracture is rarely used today.

ABSTRACT
Introduction: Conjunctival autografting which is the mainstay in the management of pterygium. The conjunctival graft is most commonly harvested superiorly. However, superior bulbar conjunctiva may not be available for harvesting a graft in all cases and it would affect the outcome. This study aims at the efficacy of the inferior bulbar conjunctival grafting without using any suture or glue. Methods: This was a prospective observational study conducted in the Department of Ophthalmology, Pabna Medical College Hospital, Pabna, Bangladesh during the period from January 2019 to December 2020. In our study, we included 100 eyes of 98 patients with primary pterygium who underwent surgical procedures in Pabna Medical College Hospital. Results: A total of 100 cases were included in this case series. Patient’s age ranged from 18 to 83 years (mean 48.08±12.76 years). Total graft dehiscence occurred in 2 eyes (2%), graft retraction in 10 eyes (10%), and recurrence was seen in 1 eye (1%). At 3 months postoperatively, the gain in uncorrected visual acuity ranged from 2-3 lines in the Snellen chart in 9 eyes, symblepharon does not occur in any patient and no other complication was noted. Conclusion: Our study shows that this simple technique for pterygium surgery may prevent the potential risk of bad outcomes of future filtration surgery and overcome the conditions when superior bulbar conjunctiva may not be available for harvesting a graft.

ABSTRACT
Background: Percutaneous sclerotherapy is a minimally invasive treatment for cystic lesions and has emerged as a preferred alternative to traditional surgical methods due to its faster recovery times and lower complication rates. A sclerosing agent is instilled into the lesion causing cyst wall inflammation and lesion shrinkage. It has a significant role in managing cystic lesions, with better health outcomes. Objectives: To evaluate the indications, outcomes, efficacy, and complications of percutaneous sclerotherapy in the management of cystic lesions. Methodology: The study was a prospective cross-sectional study involving patients with cystic lesions referred for percutaneous sclerotherapy. Data was collected, analyzed, and presented in percentages, graphs, tables. Technical and clinical success rates were calculated. Efficacy was analyzed using chi-square test. Results: 27 patients with cystic lesions were treated. Most were females (77.8%), and males (22.2%), with a male-to-female ratio of 1:3.5. The commonest indication was pain (26.1%), followed by pressure symptoms (22.7%) and abnormal swelling (20.5%). Most lesions were located in the liver (25.9%), followed by the kidney (18.5%). Majority had significant improvement in clinical symptoms and size reduction with p-values < 0.05. The technical success rate was 100% and the clinical success rate was 96.3%. Minor complications were encountered including mild pain (7.4%), catheter blockage, cyst abscess formation, catheter insertion site infection, and inflammatory cyst septations (each 3.7%). Conclusion: Percutaneous sclerotherapy is a safe, efficacious treatment of cystic lesions with a high technical and clinical success rate. It should be considered as a first line of treatment for cystic lesions.