PAHMC Journal

Background: Chronic kidney disease (CKD) represents a significant challenge to public health, often accompanied by significant psychological distress, including depression and anxiety. These psychological disorders can negatively influence patients’ quality of life (QoL) and adherence to treatment.

Objective: To determine the prevalence of depression and anxiety in individuals with CKD, examine related risk factors, and assess their effect on QoL.

Methods: A cross-sectional study was carried out at the Department of Nephrology in collaboration with the Department of Psychiatry at Community-Based Medical College, Bangladesh, between January 2023 and December 2024. A total of 83 CKD patients were recruited using purposive sampling, with data collected through validated scales for depression, anxiety, and QoL assessment.

Results: Among 83 CKD patients, depression prevalence was 38.6% and anxiety prevalence was 31.3%. Dialysis dependency (OR: 2.45 for depression, 2.12 for anxiety), low socioeconomic status, and comorbidities were significant risk factors. Depression correlated with reduced physical health (r=-0.52) and emotional well-being (r=-0.61), while anxiety showed similar negative correlations.

Conclusion: Depression and anxiety are common among individuals with CKD and substantially reduce their quality of life. Prompt screening and the incorporation of mental health interventions are crucial for alleviating psychological distress and enhancing patient outcomes.

Keywords: Chronic kidney disease, Depression, Anxiety, Quality of life, Risk factors

Background: Diabetic retinopathy (DR) is a major microvascular complication of diabetes mellitus and a leading cause of vision loss globally. The rate of progression of DR may differ between individuals diagnosed at a younger age (young-onset diabetes mellitus, YODM) and those diagnosed later in life (late-onset diabetes mellitus, LODM).

Objective: To compare the progression patterns of DR in YODM and LODM patients, evaluating differences in severity, risk factors, and clinical outcomes.

Methods: This retrospective cohort study analyzed medical records of 400 patients (200 YODM, 200 LODM) diagnosed with diabetes for at least five years at the Vitreo Retina Department of the National Institute of Ophthalmology & Hospital, Dhaka, in 2017 and 2018.

Results: 45.0% of YODM patients had progressed to proliferative DR compared to 27.0% of LODM patients (p<0.001). Diabetic macular edema was observed in 38.0% of YODM cases versus 22.0% in LODM cases. YODM patients exhibited higher mean HbA1c levels (8.9±1.3%) than LODM patients (7.8±1.1%, p=0.015). LODM patients had a higher prevalence of hypertension and dyslipidemia, but despite more comorbidities, DR severity was lower in LODM.

Conclusion: DR progresses more aggressively in YODM patients despite similar diabetes duration when compared to LODM patients, driven primarily by prolonged hyperglycemic exposure and poorer metabolic control.

Keywords: Diabetic Retinopathy, Young-Onset Diabetes, Late-Onset Diabetes, Disease Progression, Vision Loss, Hyperglycemia

Background: Appendicitis often necessitates emergency surgery, but diagnosis can be challenging without classic symptoms. Diagnosis is supported by ultrasound, complete blood count, CRP testing, and computed tomography, with ultrasound preferred due to its safety.

Objective: To analyze the utility of sonography in identifying severe acute appendicitis and to examine its relationship with patient age.

Methods: A cross-sectional study evaluated the role of ultrasonography in detecting acute and severe appendicitis at Community Medical College and Hospital, Mymensingh, Bangladesh, over one year (September 2023 to August 2024). It involved 150 patients, with 113 diagnosed with severe acute appendicitis, with histological confirmation in 100 of 113 cases.

Results: The 16-25 age group had the highest incidence of severe acute appendicitis (44% of cases). The majority of patients were male (60%). Ultrasound showed the appendix in 95% of cases, with a target sign in 95%, and 100% had sonographic McBurney’s tenderness. USG accuracy included a sensitivity of 94.24% and a specificity of 91.7%, with an overall diagnostic accuracy of 92.1%.

Conclusion: Ultrasonography is an effective, non-invasive, and cost-efficient tool for diagnosing acute appendicitis, helping reduce unnecessary surgeries and aiding timely decision-making. Younger males are more frequently affected by appendicitis.

Keywords: Diagnostic, Ultrasonography, Severe Acute Appendicitis, Correlation

Background: Surgical resection is the principal treatment for colorectal cancer, but it carries significant morbidity and mortality.

Methods: This cross-sectional study was carried out from January 2017 to August 2018, evaluating fifty-nine patients with colorectal adenocarcinoma against defined inclusion and exclusion criteria.

Results: Most complications occurred in the male group (33.9%) and in the >50 years age group. Forty-four percent of cases were in pathological stage pT2N0MX (Stage I). The most common complication (56%) was wound infection, and postoperative complications were more frequent in rectal cancer patients than in colonic cancer cases. Patients operated on by laparoscopy alone had less preoperative blood loss, shorter postoperative hospital stays, and lower complication rates (p<0.05).

Conclusion: The laparoscopic approach favorably influences postoperative outcomes following colorectal cancer surgery. Measures should be taken to reduce postoperative wound infection.

Keywords: Colorectal cancer, Postoperative complications, Wound infection, Laparoscopic surgery, Short-term outcome

Cortical blindness originating from the brain’s cortex is an uncommon yet severe pregnancy-related complication, often associated with preeclampsia or posterior reversible encephalopathy syndrome (PRES). We present the case of a first-time pregnant woman, aged 28, who experienced sudden bilateral visual loss postpartum. Neuroimaging revealed findings consistent with PRES. Timely diagnosis and management led to partial visual recovery. This report highlights the critical importance of prompt diagnosis and management for pregnancy-induced cortical blindness.

Keywords: Cortical blindness, Pregnancy, Preeclampsia, PRES, Posterior reversible encephalopathy syndrome, Visual loss

Inflammatory bowel disease (IBD) refers to a persistent inflammatory condition of the gut arising from interactions between the host’s physiology and intestinal microbes in those with a genetic predisposition. The development of IBD is multifactorial, and its worldwide prevalence is rising, prompting more individuals to consider dietary choices as both an explanatory factor and a therapeutic approach for their condition. This review systematically examines the disease’s pathogenesis and emphasizes current discoveries concerning host genetics, intestinal flora, the influence of diet, and environmental triggers. These areas may provide vital insights for discovering new predictive or prognostic markers and creating innovative treatments.

Keywords: Inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, Diet