College of Medical Sciences

The growing demand for sustainable construction materials has led to increased research on alternative binders that reduce environmental impact. This study investigates the development and performance of one-part alkali-activated concrete (OPAA) incorporating pulverized rice husk ash (PRHA), ground granulated blast furnace slag (GGBFS), and high-chloride contaminated recycled coarse and fine aggregates (RCA, RFA). Using anhydrous sodium metasilicate (ASMS) as the activator, the research focuses on optimizing mechanical and durability properties through statistical analysis of variance (ANOVA). Experimental results demonstrate compressive strengths ranging from 52 to 67 MPa, flexural strengths between 4.13 and 5.25 MPa, and split tensile strengths of 3.19 MPa. The modulus of elasticity (MOE) achieved values between 30.91 and 31.83 GPa, with water absorption rates varying from 0.57% to 2.97%. Durability assessments, including sorptivity, high-temperature resistance, and microstructural analysis using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD), confirmed the formation of dense C─ A─ S─ H and N─ A─ S─ H gels, contributing to enhanced mechanical strength and durability. Additionally, thermal stability tests demonstrated that OPAA concrete retains significant compressive strength even after exposure to 600°C, making it suitable for fire-resistant applications. Overall, this study provides a scalable and sustainable solution for reducing the carbon footprint of the construction industry while enhancing material performance. The findings support the adoption of alkali-activated concrete as a viable alternative to ordinary portland cement (OPC)-based concrete, contributing to the advancement of green building practices and sustainable infrastructure development. From a sustainability perspective, the study highlights the significant reduction in embodied energy (EE) and embodied carbon dioxide emissions (ECO2e) compared to OPC.

Background: Low-grade squamous intraepithelial lesions (LSIL) are commonly associated with persistent human papillomavirus infection and are frequently managed through conservative surveillance due to their potential for spontaneous regression. Emerging evidence suggests that disruption of the cervicovaginal microbiome, particularly depletion of Lactobacillus species, may contribute to lesion persistence. Microbiome-modulating therapies have therefore gained attention as low-risk adjuncts in cervical disease prevention. Objective: To determine whether topical cervical application of Lactobacillus probiotics increases regression rates of LSIL to normal cytology. Methods: A randomized controlled trial was conducted over 12 months in tertiary care gynecology clinics in the Lahore region of Pakistan. Women aged 21–45 years with cytologically confirmed LSIL were randomized to receive either topical cervical Lactobacillus probiotic therapy alongside standard surveillance or standard care alone. Cervical cytology was assessed at baseline, six months, and twelve months. The primary outcome was regression to normal cytology at 12 months. Data were analyzed using parametric statistical tests, with significance set at p < 0.05. Results: At 12 months, regression to normal cytology was observed in 71.9% of women in the probiotic group compared with 50.5% in the control group, representing a statistically significant difference. Persistence of LSIL was lower in the intervention group, while progression to higher-grade lesions was infrequent in both groups. Probiotic therapy was well tolerated, with no serious adverse events reported. Conclusion: Topical cervical Lactobacillus probiotic therapy significantly enhanced LSIL regression and reduced lesion persistence without added safety concerns. These findings support microbiome modulation as a practical and non-invasive adjunct to conservative LSIL management and cervical cancer prevention strategies. Keywords: Cervical Intraepithelial Neoplasia; Lactobacillus; Papillomavirus Infections; Probiotics; Randomized Controlled Trial; Uterine Cervical Dysplasia; Vaginal Microbiome

Abstract Background The optimal dietary strategy to enhance endurance training adaptations remains contentious. This study compared the effects of low-glycemic index (Low-GI), high-glycemic index (High-GI), and ketogenic (Low CHO High Fat - LCHF) diets on body composition, metabolic health, and VO₂ max in endurance athletes. Methods Fifty-seven male endurance athletes (age: 27.5 ± 4.9 years) were randomly assigned to a Low-GI (n = 19), High-GI (n = 19), or LCHF (n = 19) diet for 12 weeks. All participants followed a standardized endurance running program. Body composition, VO₂ max (via direct gas analysis during a Bruce Protocol test), and fasting blood parameters were assessed pre- and post-intervention. Results Significant main effects of time were observed for all groups, showing improvements in body composition and VO₂ max (p < 0.001). A significant time × group interaction was found for macronutrient intake, rate of perceived exertion (RPE), and weekly mileage (p < 0.001). The High-GI group showed no change in RPE and a decrease in mileage. The Low-GI and LCHF groups reported lower RPE and increased mileage. The LCHF group exhibited a significant increase in LDL cholesterol. Conclusion A structured training program improved fitness and body composition regardless of diet. However, diet type significantly influenced training behavior. The High-GI diet was associated with worse subjective outcomes, while Low-GI and LCHF diets were better tolerated. The LCHF diet's impact on LDL cholesterol warrants caution.

Diabetic striatopathy (DS) is a rare complication of uncontrolled diabetes mellitus (DM), primarily affecting elderly patients and characterized by choreiform movements with basal ganglia imaging abnormalities. It has a good prognosis and completely resolves with optimal glucose control meeting individualized glycemic goals with a basal-bolus insulin regimen and sometimes adjunctive anti-chorea medications.

Tonsillectomy is one of the most commonly performed surgical procedures on children. Indications for tonsillectomy include recurrent tonsillitis, obstructive sleep apnea, and peritonsillar abscess, among others. Bipolar diathermy and coblation surgeries are the most common used surgeries. Bipolar Diathermy efficiently manages postoperative hemorrhage but often results in increased postoperative pain due to higher thermal tissue destruction. In contrast, coblation is a procedure that offers a lower output of heat and results in lesser pain and shorter healing times. The present study compares the above two procedures to evaluate the postoperative outcomes regarding pain, healing, and safety of pediatric tonsillectomy patients. This was a prospective, randomized, experimental study on 120 pediatric patients ranging from 5 to 14 years who experienced recurrent or chronic tonsillitis or obstructive symptoms, amongst them sleep apnea. Both groups were operated on with extracapsular tonsillectomy under general anaesthesia, with standardized preoperative management and uniform anaesthetic protocols. The aforementioned parameters of pain, hemorrhage, and healing process were similarly followed up for postoperative evaluations at one, two, three, and 4 weeks. Mean scores of pain were very highly significantly lower in patients of Group A at visits than in patients of Group B. Patients of Group A received scores for visit for the first week at 9.45 ± 0.58 versus 9.82 ± 0.22 (p = 0.001) and scores for visit in the fourth week at 0.35 ± 0.40 versus 1.92 ± 1.78 (p = 0.001). Group A compared with group B had early healing time and fewer cases of bleeding complications. Time to pain resolution was shorter in Group A with a mean of 15.5 ± 2.0 days compared with a mean of 24.8 ± 3.4 days in Group B, (p = 0.001). The study results show that in pediatric patients, coblation-assisted tonsillectomy proved to have advantageous benefits over bipolar diathermy tonsillectomy. Coblation provided less postoperative pain and quick healing, with an overall shorter pain duration and fewer bleeding complications.

Nitrogen dioxide (NO2) exposure is a known risk factor for respiratory, cardiovascular, and neurological diseases and has also been linked to systemic hematological alterations, including an increased risk of anemia. However, the effects of NO2 exposure on the immune and hematopoietic function, which play a crucial role in the pathogenesis of these disorders, remain unclear. In this study, mice were exposed to environmentally relevant concentrations of NO2 (2.5 ppm, 5 h/day) for 28 days to investigate systemic immune and hematopoietic effects across the lung, spleen, and bone marrow (BM). NO2 exposure triggered experimental anemia, with approximately 10% decreases in red blood cell (RBC) count and hemoglobin (HGB) concentration. Further investigation revealed a heightened sensitivity of the BM to NO2 exposure. Notably, NO2-induced hematopoietic and immune dysregulation was specific to the BM, with minimal effects observed in the peripheral lung or spleen. Flow cytometry analysis indicated disrupted erythropoiesis, characterized by an expansion of precolony-forming unit-erythroid (preCFU-E) precursors and a differentiation block at the orthochromatic erythroblast (ortho-EB) stage. Granulopoiesis in the BM was also altered, with a 31% decrease in mature neutrophils (NEs), potentially due to developmental defects at the metamyelocyte (MM) stage. In addition, upstream hematopoietic progenitors, including common myeloid progenitors (CMPs) and common lymphoid progenitors (CLPs), were significantly expanded, potentially reflecting myeloid-lineage compensation for RBC and NE deficits and broader hematopoietic stress. This study reveals that NO2 exposure can lead to both erythroid and granulocytic hematopoietic abnormalities in the BM, providing novel mechanistic insights into the potential health risks associated with NO2.

Background: Respiratory distress complicating pediatric dengue fever cases underscores the significance of timely diagnosis and treatment, especially in endemic settings like Bangladesh. Coinfections with respiratory pathogens add to the complexity of management and treatment. This study aims to shed light on the coinfection and clinical implications of coinfections in pediatric dengue patients. Case Presentation: We present a case report of two children with dengue fever who were diagnosed with coinfections, including Salmonella, Acinetobacter species, and Staphylococcus hominis. These patients exhibited severe clinical manifestations (Persistent fever, respiratory distress), and positive dengue serology results. Diagnostic workup revealed coinfections, highlighting the need to consider alternative pathogens in dengue patients. Conclusion: Coinfections in dengue patients present unique challenges due to overlapping clinical features and the potential for delayed or missed diagnoses. The endemic nature of salmonella and dengue in Bangladesh increases the likelihood of co-occurrence. Understanding these associations is crucial for accurate diagnosis and timely intervention. Journal of Brahmanbaria Med. Coll. Volume 07 Issue 01 Jan 2025 ; 40-45