North East University

IntroductionHypertension is a leading contributor to maternal and cardiometabolic morbidity in Bangladesh. We developed and interpreted machine-learning (ML) models to predict hypertension and rank associated factors among married women with the goal of informing targeted screening and policy in low-resource settings.MethodsWe analyzed 4,253 married women from the nationally representative BDHS 2017–18 survey (hypertension prevalence: 23.1%). Twelve ML algorithms were trained under six class-balancing strategies with hyperparameters tuned via random search. Validation used a hold-out test set (80/20) and repeated stratified k-fold cross-validation; bootstrap confidence intervals were estimated for the selected model. Model performance was compared with parametric and non-parametric tests. To interpret results, SHAP was used to rank the top 20 predictors and visualize feature effects. Models quantify associations rather than causation.ResultsThe Extra Trees classifier with SMOTE+ENN achieved the best discrimination (F1 = 0.94; AUC-PR = 0.95; ROC-AUC = 0.95). Compared with the original imbalanced training, minority-class detection improved substantially (Extra Trees F1 increased from 0.08 to 0.94; recall from 0.04 to 0.95) while accuracy and ROC-AUC remained relatively stable across samplers. Statistical testing favored SMOTE+ENN for recall, F1, G-mean and AUC-PR. SHAP identified age, parity, recent births, contraceptive use, spousal education and BMI as key predictors. Younger age (<35 years) and normal/underweight status were protective, while parity ≥2–3, husbands’ age ≥ 40 years and overweight/obesity increased risk.ConclusionsAn interpretable ensemble model built primarily on sociodemographic and behavioral variables supplemented by limited biometric markers (BMI, glucose) can accurately flag hypertensive risk among married women in Bangladesh. Findings support programmatic integration of risk scores into eRegistries, routine blood pressure checks in family planning and postpartum visits, husband-focused education/SMS interventions and prioritization of high-parity households in high-risk regions. External validation on BDHS-2022 is planned to assess generalizability.

Background Bacterial keratitis is a potentially fatal corneal infection worldwide. Its deleterious effects include sudden and rapid destruction of the cornea. The exact cause is still unknown to health authorities and ophthalmologists. Various studies have suggested different theories. Some studies have suggested that the spectrum of bacterial corneal pathogens is largely influenced by local microbial flora, geography, and climatic factors. Aims and Objectives The aim of this study is to determine the bacteriological patterns and predisposing factors of bacterial keratitis in outpatient settings.Methods A total of 45 male and female patients with bacterial keratitis were evaluated from January 2015 to December 2016 at the Department of Ophthalmology, MAG Osmani Medical College Hospital, Sylhet, a divisional city of Bangladesh. The study recorded the patients' socio-demographic information, pre-existing factors, and clinical presentation. Bacterial cultures were performed from corneal swabs in the laboratory.Results The age range of most patients was between 41 and 60 years (55.6%). The mean age of bacterial keratitis was 47.60 ± 17.14 (range, 18–71) years. The study showed that the male to female ratio was 1.25:1, which was close to 1. The study also showed that common predisposing factors were 62.2% trauma and 31.1% chronic dacryocystitis. The highest 57.8% Gram-positive bacteria predominated, and the lowest 42.2% Gram-negative bacteria. Out of the total isolates, 37.8% were Staphylococcus epidermidis, 26.7% Pseudomonas aeruginosa, 20.0% Staphylococcus aureus, 8.9% Escherichia coli, and 6.7% Klebsiella species.Conclusion The study concluded that trauma is the most important predisposing factor in bacterial keratitis. Gram-positive bacteria are the main isolates and common bacteria are Staphylococcus epidermidis, Pseudomonas aeruginosa and Staphylococcus aureus. This study suggests a new dynamic alternative approach to the upcoming eye care pathway to promote global eye protection related to advanced sensor technology and national health policies, which is aligned with the Sustainable Development Goals 2030.

Probiotic&amp;lt;i&amp;gt; Lactobacillus &amp;lt;/i&amp;gt;reuteri has been shown to be useful for a number of gastrointestinal disorders. Its ability to secrete antimicrobial compounds, prevent pathogenic microorganisms from colonizing the host, and alter the composition of the commensal microbiota in the host are all major contributors to its therapeutic advantages. Not only that, but L. reuteri treatment strengthens the host&amp;apos;s defenses against infection and pro-inflammatory cytokine production while enhancing the growth and functionality of regulatory T cells. Numerous pediatric illnesses, particularly those pertaining to the intestinal health of infants, have been found to be well managed by L. reuteri, according to systematic reviews and meta-analyses. According to current research on L. reuteri, it may be useful in the management and avoidance of a number of common clinical disorders, including functional constipation, infantile colic, regurgitation, and diarrhea. Probiotic treatment for pediatric illnesses has had favorable benefits on bowel regularity in individuals with chronic constipation and has been found to successfully reduce screaming and/or fussing time in newborns with colic. Additionally, it quickens the emptying of the stomach and lessens distension. Several research have even come to the conclusion that this probiotic strain reduces the frequency of regurgitation. The potential of this probiotic strain for application in the treatment of several gastrointestinal disorders is evident from all of these findings. Therefore, this study aims to encapsulate and condense the advantages of this probiotic strain in clinical settings, with a particular emphasis on how it supports babies&amp;apos; and toddlers&amp;apos; immune systems and gut health.

Infertility is a significant global health issue, with a negative impact on people's wellbeing and human rights. Despite the longstanding association between obesity and infertility, there remains uncertainty, about the precise mechanisms underpinning this association and best management strategies. In this article, we aimed to address these uncertainties by reviewing the recent literatures. We found that, obese women undergo perturbations of the ‘hypothalamic pituitary ovarian axis’, and frequently suffer of menstrual dysfunction leading to anovulation and infertility. Besides the hormone disorders and subfertility that are common in the polycystic ovary syndrome (PCOS), in obesity the adipocytes act as endocrine organ. The adipose tissue indeed, releases a number of bioactive molecules, namely adipokines that variably interact with multiple molecular pathways of insulin resistance, inflammation, hypertension, cardiovascular risk, coagulation, and oocyte differentiation and maturation. Medicine Today 2025, Vol.37 (1): 144-148

Background: Sexual dysfunction (SD) is common in women with Major Depressive Disorder (MDD), yet its psychosocial and clinical determinants in low-resource settings remain insufficiently characterised. Objective: To quantify prevalence and domains of SD, and evaluate associations with depression severity, socio-demographic, behavioural, and clinical variables among reproductive-age Bangladeshi women with MDD. Methods: A cross-sectional study was performed at Sylhet MAG Osmani Medical College Hospital (Sept 2018–Aug 2020). Sixty-eight married women (18–45 yr) meeting DSM-5 MDD criteria were enrolled. Depression severity was assessed using the Bangla DASS-21; sexual function by the Female Sexual Function Index (FSFI). Variables included age, BMI, parity, illness duration, income, education, marital satisfaction, social support, antidepressant dose, physical activity, and comorbid anxiety. Analyses applied descriptive statistics, Chi-square, t-tests, Pearson/Spearman correlations, and multiple linear regression (significance p&lt;0.05). Results: Mean age was 32.6 ± 6.1 yr; BMI 24.8 ± 3.9 kg/m²; median illness duration 18 mo (IQR 12–30). Overall SD prevalence was 72.1%. Domain frequencies: desire 64.7%, arousal 58.8%, lubrication 52.9%, orgasm 50.0%, satisfaction 48.5%, pain 33.8%. FSFI total (22.4 ± 5.3) inversely correlated with depression severity (r = –0.62, p&lt;0.001). Higher BMI predicted reduced lubrication (β = –0.29, p=0.015). Parity ≥2 associated with lower orgasm scores (mean 3.2 ± 1.1 vs 4.0 ± 1.2; t=2.41, p=0.019). Illness duration &gt;24 mo linked to poorer desire (χ²=6.72, p=0.01). Social support (MOS-SSS) correlated positively with satisfaction (r=0.44, p=0.002). Regular physical activity was protective (FSFI mean 25.6 ± 4.8 vs 20.9 ± 5.2; p=0.001). Comorbid anxiety increased pain scores (β=0.31, p=0.012). Antidepressant dose (fluoxetine-equivalent) predicted orgasmic dysfunction (β=–0.34, p=0.006). Final regression (age, BMI, support, activity, anxiety, income, antidepressant dose) explained 52% of FSFI variance (adjusted R²=0.52). Conclusion: SD affects most women with MDD and is significantly shaped by depression severity, BMI, parity, treatment dose, social support, and lifestyle factors. Multidimensional screening and interventions are recommended.

Abstract BackgroundOnline education gained its popularity in the education system during the COVID-19 pandemic lockdown. The online platform, including social media, was institutionalized globally for the purpose of tutoring to keep the education process ongoing under feasible circumstances. However, the post-pandemic continuation of online education and prolonged usage of electronic devices imposed a greater risk of health issues related to sensory impairment. Our study aimed to determine the impact of online education on students’ hearing status and its associated factors.MethodsA cross-sectional study was conducted among 1030 students of 11th grade and above who were undergoing online education in Dhaka and Chattogram. Data were collected through the online administration of a structured questionnaire containing questions on sociodemographic status, family history of diseases, personal history of comorbidities, information related to screentime exposure, and SSQ-12 (Speech, Spatial, and Qualities of Hearing -12) scale. Descriptive statistics, Pearson’s chi-square test, two independent sample t-tests, and multiple linear regression analysis were employed to obtain the results.ResultThe mean SSQ score of the study participants was 7.74±1.37. In bivariate analysis, gender, family income, family history of diseases (e.g., obesity, headache, hearing problem), personal history of diseases (e.g., obesity, insomnia), device type (mobile/tablet, computer), average daily screen time with sound, and break pattern during online learning were significantly (p&lt;0.05 for all) associated with hearing status. In multivariate analysis, being female (coefficient -0.293, p=0.001), using mobile/tablet (coefficient -0.836, p=0.001), and continuous screen use (coefficient -0.348, p=0.003) were significantly associated with poor hearing status.ConclusionThis current study indicates the detrimental effect of online education on the hearing of young students in Bangladesh. Future studies should explore the long-term hearing effects of online education and guide the policy makers towards necessary preventive approaches.

Flibanserin, approved for the treatment of hypoactive sexual desire disorder (HSDD) in females, has demonstrated diverse therapeutic and adverse effect (AE) prospects in the extant randomized controlled trials (RCTs). This meta-analysis aimed to characterize the outcomes of flibanserin use in these patients comprehensively. RCTs involving women with HSDD receiving flibanserin in the intervention arm and placebo in the control arm were sought after throughout the electronic databases. The primary outcomes were the changes from baseline in satisfying sexual events (SSE) per month and sexual desire score per month measured using an electronic diary (eDiary). From 478 initially screened articles, data from 8 RCTs involving 7906 women with HSDD were analyzed. In premenopausal women, flibanserin 100 mg was superior to placebo in improving the number of SSE per month (mean difference, MD 0.69, 95% CI [0.39, 0.99]), eDiary sexual desire score (MD 1.71, 95% CI [0.43, 2.98]), Female Sexual Function Index (FSFI) desire domain (FSFI-d) score (MD 0.30, 95% CI [0.29, 0.31]), FSFI total score (MD 2.51, 95% CI [1.47, 3.55]), Female Sexual Distress Scale-Revised (FSDS-R) Item 13 score (MD -0.30, 95% CI [-0.31, -0.29]), and FSDS-R total score (MD -3.30, 95% CI [-3.37, -3.23]). Compared to placebo, a higher number of premenopausal women using flibanserin 100 mg achieved improvements in the Patient's Global Impression of Improvement score (OR 1.93, 95% CI [1.58, 2.36], P < .00001) and responded positively at Patient Benefit Evaluation (PBE) (odds ratio, OR 1.76, 95% CI [1.34, 2.31], P < .0001). Postmenopausal women receiving flibanserin 100 mg also benefited in terms of the number of SSE per month, FSFI-d and total scores, FSDS-R Item 13 and total scores, and PBE response. Although flibanserin use was associated with higher risks of dizziness, fatigue, nausea, somnolence, and insomnia, these adverse events were mild in nature; the serious AEs and severe AEs were comparable between the flibanserin and placebo groups. While flibanserin has demonstrated efficacy in the treatment of HSDD in both pre- and postmenopausal women, its therapeutic advantages may be overshadowed by the higher likelihood of AEs.

Background: In Bangladesh, ovarian malignancy is quite common. Given the growing emphasis on improving female health, the prevention, early detection &amp; and early treatment of female cancer will undoubtedly become more important at present &amp; and in the future. Objective: To evaluate the clinical and laparotomy findings of ovarian tumor. Method: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology in a Tertiary Medical College and Hospital from July 2021 to December 2022. 50 consecutive patients who attended the outpatient and who were admitted to this Hospital during this period, were taken as the study population. Results: During this study, out of 50 cases 32 (64%) complained of vague abdominal discomfort and occasional pain in the lower abdomen and 23 (46%) complained of a lump in the lower abdomen. Anemia was present clinically in 45 (90%) Mass was present in the abdomen of 44 (88%) patients. There were unilateral neoplasm in 43 (86%) cases and (14%) cases were bilateral. In 7 (14%) cases, neoplasms were solid, in 7 (14%) cases adhesions to the surrounding structures, partly cystic partly solid were 7 (14%) cases, clear peritoneal fluid in 5 (10%) cases and peritoneal seedling in 3 (6%) cases. Conclusion: Incidence of hospital admission of ovarian neoplasm in this study was 5.8%. Regarding nature of the neoplasm, 86 percent were found benign and 14 percent malignant. The mean age of the patients having neoplasm 35.5 years. As ovarian neoplasm is a silent killer disease, if we can provide some information through mass media, it may be of some help in early diagnosis of ovarian neoplasm and thereby could help our youthful victims.

Introduction: For the management of renal stones, Percutaneous nephrolithotomy (PCNL) has undergone significant changes in the last few years in the quest for improving efficacy and reducing morbidity. Minimally-invasive modalities of PCNL, such as mini- PCNL, ultra-mini PCNL, and micro-PCNL, have evolved with advancements in optics and technology. However, with these newer advancements, the migration of small fragments produced with laser lithotripsy remains a concern, which may result in incomplete stone clearance. A new technique of PCNL is termed “Superperc” that utilizes suction to remove all the fragments and maintain a one-way flow. Methods: This study involved 35 consecutive patients who underwent PCNL with the Superperc technique from March 2020 to December 2020. Surgery was performed using a pediatric ureteroscope used as a nephroscope and a specially designed sheath with a suction attachment. The Superperc uses a 10/12 F tract size, a specially designed Superperc sheath (Shah Sheath) with a suction mechanism, and a pediatric ureteroscope 4.5/6. Results: The age range is 20-65 years, with 23 males and 12 females. Stone size was 1- 3 cm, and operative time was 30-90 min. Upper calyceal punctures 7cases , 19 had middle, 6 lower calyceal and 3 had two punctures. DJ stent was placed in 7 patients, whereas 28 patients had a ureteric catheter for 24 hours. Only three patients required a nephrostomy tube. No blood transfusion. Postoperatively one patient had a mild fever, and one had transient hematuria. Complete stone clearance as per nephroscopy &amp;fluoroscopy. The hospital stay was 24-72 h. Conclusion: Superperc is a new technique of minimally-invasive PCNL and can be successfully done with minimal modification in the armamentarium, with the potential advantage of good stone clearance. Bangladesh J. Urol. 2022; 25(2): 71-75