Background: Depression is one of the leading causes of human disability worldwide. Among vulnerable groups, medical professionals are disproportionately effect by depression.Almost 1 in 4 medical students, especially female, suffers from depression worldwide. Ironically, 80% of these cases are reported from low and middle income countries.This can impact not only the health of the sufferer but also all of those who receives medical care from them.Methods: This cross sectional study was conducted in Ad-din Sakina Women’s Medical College, Jasore. One hundred seventy seven participants including students of different batches and Intern doctors were enrolled by convenience sampling in this study. A self administered form including nine item Patient Health Questionnaire (PHQ-9) was used to collect data from September 2024 to April 2025. SPSS was used to run the statistical analayis.Results: Overall 85.3% of participants were found to be in depressive spectrum with 10.7% falling into the category of severe depression. The highest mean PHQ-9 was found among fourth year students (14.48±5.17) and in the 24-26 year-old age group (11.66±5.9).The response “Feeling tired or having little energy” was reported mostly (34.5%) amidst the nearly everyday category followed by Feeling bad about yourself – or that you are a failure or have let yourself or your family down” (31.1%). 11.3% despondence had suicidalideation.Conclusion: The staggeringly high proportion of depressive symptoms should raise the alarm to take mental health of medical students and interns seriously. Every institute should have means to screen and diagnose depression and take actions accordingly to avoid the negative impacts of the condition including planned or completed suicide. J MEDICINE 2026; 27(1): 21-26

Takayasu’s arteritis is a rare, chronic form of large- and medium-vessel vasculitis, predominantly affecting the aorta and its primary branches. Histopathologically, it is characterized by mononuclear cell infiltration and granulomatous inflammation of the vascular media, resulting in progressive arterial wall thickening, stenosis, occlusion, or aneurysmal dilation. Involvement of the common carotid arteries is a notable but atypical manifestation, often contributing to diagnostic complexity. The disease can lead to serious complications, including stroke, ischemic heart disease, pulmonary hypertension, secondary systemic hypertension, and aneurysm formation. Diagnosis is primarily based on a combination of clinical presentation and angiographic findings. J MEDICINE 2026; 27(1): 55-57

Background: Early identification of patients requiring mechanical ventilation (MV), either invasive or non-invasive, is critical to reduce morbidity and mortality in community-acquired pneumonia (CAP). Cortisol,a primary stress hormone, may serve as a prognostic marker in CAP. Objective: To evaluate the association between admission serum cortisol levels and the need for MV in patients with CAP. Methods: This prospective study enrolled 92 adults with CAP admitted to Dhaka Medical College Hospital over 12 months. Serum cortisol was measured at 9:00 AM on the first available morning after admission using ELISA.All participants were categorized into high cortisol (>23 mcg/dL) and normal cortisol (< 23 mcg/dL) groups. The primary outcome was the requirement for MV. Logistic regression and receiver operating characteristic (ROC) analysis were applied to assess predictive value. Results: Patients with high cortisol had a significantly greater need for MV compared with those with normal levels (31.8% vs 4.2%, p = 0.001). High cortisol independently predicted MV (OR = 10.7, 95% CI: 2.28–50.6, p = 0.030). ROC analysis showed good discriminative ability for cortisol (AUC = 0.831), while CURB-65 (AUC = 0.972) and CRP (AUC = 0.947) performed better. Conclusion: Admission serum cortisol is independently associated with the need for MV in CAP patients and provides additional prognostic information beyond conventional severity scores. Incorporating cortisol measurement into early assessment may improve risk stratification and help guide timely escalation of care, especially in resource-limited settings.

Background: The neutrophil-to-lymphocyte ratio (NLR), a cheap blood parameter, has shown promise as a predictor of adverse outcomes in severe infections. However, its utility in predicting mortality among patients with severe CAP in Bangladesh remains underexplored. Objective: This study aimed to assess the predictive value of admission NLR for in-hospital mortality among patients with CAP admitted to a tertiary care hospital in Bangladesh. Methods: This prospective, observational study was conducted from July 2023 to June 2024 at Dhaka Medical College Hospital. One hundred eight patients aged 18 years or older with a clinical and radiological diagnosis of CAP were included. Exclusion criteria were hospital-acquired pneumonia, pulmonary tuberculosis, malignancy, immunosuppression, and HIV infection. Baseline demographic, clinical, and laboratory data were collected. NLR was calculated from routine complete blood counts, and a predefined cutoff of 7.12 was used for stratification. In-hospital mortality was the primary outcome. Logistic regression and ROC curve analyses were performed to evaluate the predictive performance of NLR. Results: The overall in-hospital mortality rate was 12.0%. Patients with an NLR ³7.12 had a significantly higher mortality risk (OR: 1.63; 95% CI: (1.07–3.82); p = 0.040). Multivariate analysis identified NLR as an independent predictor of mortality (adjusted OR: 1.34; 95% CI: 1.02–1.75; p = 0.033), along with chronic kidney disease (adjusted OR: 5.63; 95% CI: 1.15–27.60; p = 0.033) and cardiac failure (adjusted OR: 36.87; 95% CI: 5.57–244.22; p < 0.001). ROC analysis demonstrated excellent predictive performance for NLR, with an area under the curve (AUC) of 0.905. Conclusion: Elevated admission NLR is a significant independent predictor of in-hospital mortality in patients with CAP. Given its simplicity, cost-effectiveness, and widespread availability, NLR can be a valuable prognostic tool in resource-constrained settings, complementing traditional clinical scores like CURB-65. J MEDICINE 2025; 26(2): 110-116

Background: COVID-19 has led to lasting health impacts, including post-COVID syndrome, persistent symptoms beyond three months. SARS-CoV-2 affects various metabolic pathways, contributing to chronic sequelae.This study examines metabolic parameters among post-COVID patients in Bangladesh, focusing on clinical and laboratory findings. Methods: A cross-sectional study of 236 patients with post-COVID-19 syndrome was conducted at the Respiratory Medicine Department of Bangladesh Medical University, from August 2021 to July 2022. Clinical symptoms and physical measurements (height, weight, BMI) were recorded. Parameters assessed included WBC count, platelet count, serum ferritin, blood glucose, HbA1c, serum creatinine, serum electrolytes, and fasting serum lipid profile. Data were analyzed using SPSS 26 version, with t-tests, Chi-square, and Fisher’s exact tests. Results: The study revealed significant alterations in metabolic parameters post-COVID. Mean WBC count was 9,000 cells/mm (SD=2,500), while mean platelet count was 200,000 (SD=30,000). Mean serum ferritin levels were elevated to 550 ng/mL (SD=200). A significant increase in blood glucose was noted, with a mean of 140 mg/dL (p<0.05), while HbA1c reached 6.8% (p=0.03). Serum creatinine levels increased by 15% (p<0.01), indicating renal stress.A higher prevalence of dyslipidemia was observed, with 55% of patients showing elevated fasting serum LDL levels. Conclusion: The study identified significant metabolic abnormalities in post-COVID patients, including elevated blood glucose, HbA1c, serum ferritin, serum creatinine, and fasting serum LDL levels. These findings suggest increased risks of diabetes, systemic inflammation, renal dysfunction, and dyslipidemia. Routine metabolic screening and long-term follow-up are recommended to detect and manage post- COVID complications effectively. J MEDICINE 2025; 26(2): 124-130

Migrant women ventured overseas to work in domestic roles and came back to their home countries enduring different types of physical and psychological mistreatment. Among those who faced various forms of mistreatment during their migration, a significant number experienced mental health issues upon returning home. An example is a 28-year-old female migrant who was physically abused in Saudi Arabia and later developed psychosis after coming back home. This case study provides a detailed understanding of the observation process, highlighting that female migrants who return home encounter diverse forms of social harassment and stigma, such as social isolation, excessive anxiety, depression, fear, and loss of dignity. Consequently, the report recommends the expansion of mental health services and rehabilitation programs for female migrants upon their return. J MEDICINE 2025; 26: 59-62

Abstract not available J MEDICINE 2024; 25: 195

Abstract not available J MEDICINE 2024; 25: 193-194

Introduction: Chronic obstructive pulmonary disease (COPD) ranks as the fourth leading cause of global mortality, with anticipated increases in prevalence and mortality in the future. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) highlights the importance of considering COPD diagnosis in patients with relevant symptoms or risk factors, confirmed through spirometry. While COPD is preventable and treatable, it often presents with significant extra-pulmonary effects, particularly cardiac manifestations. Echocardiography offers a rapid, noninvasive method to assess these cardiac complications. Objective: This study aimed to investigate the clinical profiles and echocardiographic changes in COPD patients and their correlation with disease severity. Method: Conducted as an observational cross-sectional study, the research took place in the indoor departments of Medicine and Respiratory Medicine at Sir Salimullah Medical College & Mitford Hospital, Dhaka, between May 25th, 2017, and November 24th, 2017; enrolling 105 diagnosed COPD patients aged e”18 years. Data collection involved a structured questionnaire covering socio-demographic details, risk behavior, and respiratory complaints. Physical examinations, spirometry, and echocardiography were conducted for diagnosis, severity grading, and cardiac evaluation, respectively. Statistical analysis employed SPSS software (version-22), presenting results through frequency, percentage, tables, graphs, and figures. Result: The study population was predominantly male (88.6%) with a mean age of 64.1 years. Most patients (94.2%) were smokers with a mean pack-year history of 22.03. All patients presented with cough and shortness of breath, and 88.5% had wheezing. Spirometry revealed moderate COPD in 40% of patients, with a distribution across all severity grades. Echocardiography showed abnormalities in 52.4% of patients, with tricuspid regurgitation, pulmonary hypertension, and right ventricular dilatation being the most frequent findings. A significant correlation was observed between C OPD severity and the presence of these echocardiographic abnormalities. Conclusion: Clinical examination unveiled common respiratory findings, while echocardiography demonstrated diverse cardiac manifestations in COPD patients. A significant proportion of patients exhibited normal findings on X-ray and echocardiography. The study highlights the prevalence of moderate COPD severity and the association between very severe COPD and specific cardiac complications, emphasizing the importance of comprehensive assessment and management strategies for COPD patients. J MEDICINE 2024; 25: 115-120

This case reports outlines a 76-year-old male’s progression from papillary thyroid carcinoma diagnosis to the development of Calcium-Alkali Syndrome (CAS) following thyroidectomy. Initially presenting with thyroid mass, surgery was followed by generalized weakness and altered sensorium, investigations that revealed elevated calcium levels ,metabolic alkalosis and renal impairment . Diagnosis pointed to CAS, likely triggered by prescribed calcium and calcitriol post-surgery. Cessation of supplements and hydration resulted in resolution. While post-thyroidectomy hypocalcemia is anticipated, CAS poses challenges, especially with increasing calcium supplement use. This emphasizes the need for vigilant monitoring of electrolyte imbalances, particularly in regions with limited follow-up practices. Clinicians should balance preventing hypocalcemia without risking hypercalcemia, stressing the importance of timely identification and tailored interventions to prevent CAS complications. This case underscores the significance of recognizing CAS as a potential postoperative complication, urging vigilant monitoring and tailored management in similar clinical settings. J MEDICINE 2024; 25: 184-186