A Ferdousi, M A Islam, M Begum, M R Debnath, S P Shapla, T Saha, R Biswas, F Ferdouse, M A Rahman
{"title":"Diagnostic Value of Ultrasonography in Determination of Knee Joint Pathologies with Comparison to MRI.","authors":"A Ferdousi, M A Islam, M Begum, M R Debnath, S P Shapla, T Saha, R Biswas, F Ferdouse, M A Rahman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Knee pain is a common musculoskeletal symptom in the general population and results in significant disability, reducing the quality of life and inducing financial burden to the health care system. This cross-sectional, descriptive type of observational study was conducted with a total 52 patients having symptomatic knee joint disease in the Department of Radiology and Imaging, Mymensingh Medical College Hospital, Bangladesh from April 2019 to September 2020. This study was performed to find out the effectiveness of ultrasonography as a modality of investigation in the determination of knee joint pathologies with comparison to MRI, considering MRI as the gold standard. The majority of the patients 13(25.0%) were in the age group of 15-25 years with mean age was 39.88±15.308 years. In detecting synovial effusion, bursal collection, baker's cyst, tendinopathy and tumor pathologies ultrasound had 100.0% sensitivity, specificity and accuracy for each whether bursitis has 100.0%, 96.4% and 98.07% respectively. MCL tear had 100.0%, 97.8%, 98.07%. LCL tear detection showed 100.0%, 97.8%, 98.07%. PCL tear had 66.7%, 95.9%, 94.2%. ACL tear had 50.0%, 97.6%, 88.4% sensitivity, specificity and accuracy. Meniscal tear showed 66.7%, 97.8%, 88.4% sensitivity and accuracy. In all cases difference was statistically significant with a p value <0.0001 which strongly supported against null hypothesis. From this study, it is concluded that high-resolution USG showed high sensitivity, specificity and accuracy compared to MRI in detecting common knee abnormalities, and could be considered as the first-line imaging modality in the evaluation of knee pain.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Ullah, M M Billah, S K Saha, G K Paul, M A K Akanda, A A S Majumder
{"title":"Comparison of Atherosclerotic Cardiovascular Disease Risk Scoring Systems in Bangladeshi Population.","authors":"M Ullah, M M Billah, S K Saha, G K Paul, M A K Akanda, A A S Majumder","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Risk stratification is an important initial step for primary prevention of atherosclerotic cardiovascular diseases. There are a number of scoring systems for this purpose worldwide. We tried to evaluate two most updated scoring systems. To assess which one is the better for Bangladeshi population residing in Bangladesh. This cross-sectional study was conducted in a secondary and a tertiary care hospital in Bangladesh from January 2019 to June 2019. Total 274 patients were included in the study. They were evaluated using ASCVD scoring system and QRISK3 scoring system for the risk of atherosclerotic cardiovascular event (myocardial infarction and/or stroke) in next 10 years. Average age of the patients was 57.1±12.8 years and 192 of them were male and 92 of them were female. Half (50.4%) of the patients were smoker, half (51.1%) of them were hypertensive, 45.6% of them were diabetic, 29.6% of them had family history of premature atherosclerotic cardiovascular diseases and 27.0% of them were overweight or obese. According to ASCVD scoring 36.5% patients were at high risk, 32.5% at intermediate risk, 16.4% at low risk of cardiovascular events in next 10 years and risk evaluation was not possible in 14.6% patients. According to QRISK3 scoring method 55.5% are at high risk, 20.8% at intermediate risk, 16.0% at low risk of cardiovascular events and evaluation was not possible in 7.7% patients. Predictive value of QRISK3 scoring system is better to detect more patients who are at high risk for atherosclerotic cardiovascular events in next 10 years. QRISK3 can also evaluate the patients at a younger age. At present QRISK3 is better system to evaluate cardiovascular risk in Bangladeshi population. We need further study to evaluate its role in the form of clinical efficacy and cost effectiveness.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R K Shams, M Khan, A Islam, M C Das, U Chowdhury, D Das
{"title":"A Rare Case of Partially Ossified Sacrospinous Ligament Causing Sciatic Nerve Compression.","authors":"R K Shams, M Khan, A Islam, M C Das, U Chowdhury, D Das","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ossification of sacrospinous ligament induces a great risk for maintaining the stability of the pelvis. The sacrospinous ligament, along with the sacrotuberous ligament, plays a distinct role in the sacroiliac joint and pubic symphysis stability. The ossification may cause compression of neurovascular structure traversing through the greater and lesser sciatic foramen. Here we report a case of unilateral heterogenous ossification of the left sacrospinous ligament causing sciatic nerve compression and sciatic pain. A 22-year-old Bangladeshi woman, mother of one child, presented with complaints of pain in the lower back, left buttock and back of the upper thigh. Clinical examination and investigations revealed a diagnosis of the partially ossified sacrospinous ligament with sciatic nerve compression. Total excision of heterotrophic calcification and partial excision of left sacrospinous ligament through posterior approach by a left paramedian incision over the lower back was performed under general anaesthesia. On outpatient follow-up visits at 2 weeks and 6 weeks post-surgery, complete disappearance of pain was observed, and the patient was able to return to regular productive life activity. In this report, we presented a rare case of ossified sacrospinous ligament causing sciatic nerve compression with unknown etiology. The surgical approach performed, total excision of heterotrophic calcification and partial excision of left sacrospinous ligament through the posterior approach helped to preserve the pelvic stability with a good clinical outcome.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S M A Haque, T Mehataz, F Afros, R Ara, M Ahmed, S H Siddik
{"title":"Morphometric Study of Angle of Inclination of the Human Humerus.","authors":"S M A Haque, T Mehataz, F Afros, R Ara, M Ahmed, S H Siddik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The angle of inclination of the humerus is the angle between the long axis of the shaft and the central axis of the head of the humerus in the frontal plane. It is about 130° to 150°. Orthopedic surgeons performing reconstruction of the shoulder during prosthetic replacement should consider the size and placement of the head of the humerus. Prosthetic systems with a wide range of modular head sizes, eccentric tapers, and adjustable inclination angles and versions help orthopedic surgeons better to adapt prosthesis to a patient's bone anatomy. The present study aimed to establish the morphometry of the angle of inclination of the humerus in the Bangladeshi population and to correlate with the previous studies. The present prospective study was carried out with 100 (43 right-sided + 57 left-sided) dried humeri of unknown sex and age. In the present study, the mean±SD angle of inclination of the right humeri was 128.89±3.987 degree and the left humeri were 129.19±3.335 degree. In this article, we review the effects of this anatomical parameter on prosthetic design.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation of Fasting Serum Glucose and Serum Total Cholesterol in Sedentary Male.","authors":"F Yeasmin, A Nessa, A Sharmin, S S Suchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sedentary behavior has significant deleterious effects on human health. Sedentary behaviors associated with cardiovascular and metabolic disorders by decreasing lipoprotein lipase activities, impaired lipid and carbohydrate metabolism. This cross sectional study was done to see the association between fasting serum glucose and serum total cholesterol in sedentary male. This study was conducted in the Department of Physiology, Mymensingh Medical College, Bangladesh from Octy 2021 to June 2022. A total number of 100 subjects were included in this study. Among them, fifty (50) sedentary males were taken as study group (Group II) and fifty (50) active males were taken as control group (Group I). Age of both control and study group ranged from 25-60 years. Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired students' 't' test & Pearson's correlation coefficient test. Both of these biochemical parameters showed statistically significant difference in study group. The mean±SD of fasting serum glucose of control group (Group I) and study group (Group II) were 4.45±0.51 mmol/L and 5.91±0.60 mmol/L; and the mean±SD of serum total cholesterol level of control group (Group I) and study group (Group II) were 176.14±27.16 mg/dl and 252.58±18.97 mg/dl respectively. Fasting serum glucose and serum total cholesterol shows positive correlation in study group in comparison to control group. From this finding it can be concluded that there was significant correlation of fasting serum glucose and serum total cholesterol in sedentary males.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M F K Chowdhury, C K Ghosh, M S A Miah, M A Uddin, M Rassell, M H Rashid, A K Pal, K Mahabub-Uz-Zaman, K P Saha, M A R Miah
{"title":"Clinical Significance of Faecal Calprotectin in Differentiating Inflammatory Bowel Disease from Irritable Bowel Syndrome.","authors":"M F K Chowdhury, C K Ghosh, M S A Miah, M A Uddin, M Rassell, M H Rashid, A K Pal, K Mahabub-Uz-Zaman, K P Saha, M A R Miah","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory disorder of the gastrointestinal tract with relapsing and remitting course. Recurrent abdominal pain and discomfort in association with abnormal defecation in the absence of structural abnormality of the gut is the key feature of irritable bowel syndrome (IBS). Faecal biomarker may be used a precise tool in the differentiation of IBD and IBS. The aim of this study was to measure faecal calprotectin (FC) in patients with IBD and IBS and compare between them. This was a cross-sectional study done in the department of Gastroenterology, BSMMU, Bangladesh from May 2017 to August 2018. IBD patients were diagnosed on the basis of compatible history, clinical examination, laboratory, radiological and endoscopic findings. IBS patients were selected by using the Rome IV criteria. Quantitative faecal calprotectin ELISA (BUHLMANN Quantum Blue) test was done and compared between IBD and IBS patients. In this study, ninety (90) patients were enrolled, 45 patients with IBD and 45 patients with IBS. Mean age of the IBD patients was 32.24±9.76 years and IBS patients was 33.80±9.70 years. There were 28(62.2%) male and 17(37.8%) female patients with IBD and 30(66.7%) male and 15(33.3%) female patients with IBS. We found faecal calprotectin (FC) level was 445.68±237.35μg/gm in IBD patients and 39.16±17.31μg/gm in IBS patients. There was a significant difference of faecal calprotectin level between IBD and IBS patients (p-value <0.001). The sensitivity and specificity of faecal calprotectin to differentiate IBD from IBS was 91.1% and 86.7% respectively. The test accuracy was 88.9%. Area under ROC was 0.959 (95% CI, 0.909 to 1.0). This study showed that faecal calprotectin appears to be clinically useful, non-invasive, rapid and reliable marker to differentiate IBD from IBS.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patients' Satisfaction on Services of Out Patient Department of Secondary Level Public Hospitals in the Northern Region of Bangladesh.","authors":"D Roy, M F Al Fidah, R Reza","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The recent achievement in health sector of Bangladesh has got much recognition. To monitor the performance of its health services, the Government has implemented a new health management system. However, this health service delivery system is inadequate against huge expectancy and discrimination in center to periphery. The study was aimed to investigate the patients' satisfaction status on out patient department (OPD) services of secondary level public hospitals in the northern region of Bangladesh and the factors associated with it. This descriptive cross-sectional study was conducted among the OPD patients of Lalmonirhat 100 Bedded Hospital, Lalmonirhat and General Hospital, Kurigram, Bangladesh. The study was conducted from January 2018 to December 2018 among 400 respondents who were interviewed and data were collected using a partially structured questionnaire by the authors. A large number of respondents (38.3%) were in the age group of 18 to 30 years with the mean age beings 40.09 (range: 18-81 years). Majority of the respondents (52.5%) were female. Housewife was found to be the profession of 35.0% of the respondents and 66.8% of them were married. The average monthly household income of the respondents was Tk. 9648.75±6653.70. Majority (70.5%) of the respondents commented that happiness of care was satisfactory. Most of the respondents (62.5%) agreed that they will recommend this institution to others and 62.3% of the respondents were satisfied with the treatment. Among the respondents, 58.1% agreed that hospital was clean and tidy. A large portion (83.6%) of the respondents was not satisfied with the drinking water facilities. Marital status and monthly income of the respondents showed a statistically significant (p<0.05) relationship with the happiness of care they received. This study showed that majority (70.75%) of the patients were satisfied with the services provided by the out Patient Department of Lalmonirhat 100 Bedded Hospital, Lalmonirhat and General Hospital, Kurigram, Bangladesh except availability of drinking water facilities.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Gupta, S Chouhan, V Arya, R Singh, R Shrivastava, N Ravi
{"title":"A Cross-Sectional Study of the Normative Data of the Side-To-Side Soleus Hoffmann Reflex from the Calf Muscle in Healthy Individuals in the Lying Down Position.","authors":"A Gupta, S Chouhan, V Arya, R Singh, R Shrivastava, N Ravi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The goal of this study was to find out from the calf muscle, the normal H-reflex is in a group of healthy adults. This study is conducted for the period of one year in 2020-2021, in the department of Physiology AIIMS Bhopal, 119 adult male healthy volunteers who were asymptomatic from peripheral neuropathy and had a mean age of 30.40±6.78 were evaluated, to compare the normative tibial H reflex to their stature, body mass index, core body temperature, and limb length. The parameters considered were M- Latency, H-Latency, M-Amplitude, H- Amplitude and H/M Ratio in their left and right legs, respectively. A total of 111 participants (93.3%) were in the age group of 40 years or younger, with the mean age (in years) being 30.40±6.78. Only eight (8) participants (6.7%) belonged to the over-40 age group. The average weight (Kg), height (cm), and limb length (cm) were 173.11 cm, 10.48 cm, and 94.28 cm respectively. The mean ±SD latencies of the H reflex were 30.93±4.42 and 31.01±5.21 milliseconds in the right and left legs, respectively. Leg length and H reflex latency had a significant correlation (r = 0.55, p=0.05). There was no discernible correlation between age and the H reflex latency. The right and left H reflex latencies should vary by no more than 1.8 ms to be deemed normal. This research examined tibia H-reflex side-to-side latency variability and amplitude. Neurologic function may be assessed using the H-reflex. Due of its sensitivity to external circumstances, the H-reflex must be elicited carefully. The H-reflex may reveal neuronal function following damage if assessed appropriately.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K R Majumder, M I Siddique, D Maitra, M Rassell, M Pervin
{"title":"Reduction Mammaplasty: Experience in Context of Bangladesh.","authors":"K R Majumder, M I Siddique, D Maitra, M Rassell, M Pervin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are many women in Bangladesh who suffer from chronic shoulder pain, back and neck pain, nerve pain, and other difficulties due to large breasts but most of them are not keen to get rid of their problems. Most women in this country are afraid from surgery and they are not even aware about their body shape and images. Recently, very few of them are coming to the door of surgeons with enlarged breast difficulties. A study was conducted on reduction mammaplasty regarding experience in the context of our country. Few of the patients were motivated among many who have problems of the huge breast and perform reduction mammaplasty. The paper addresses the experience of reduction mammaplasty. The study among 8 patients was performed in, Anower Khan Modern Medical College and Hospital and Care Medical College and Hospital during the period of Octy 2018 to January 2021. The patients underwent reduction mammaplasty over a 2.5 years period were identified and reviewed for patients satisfaction rate, religious issues, shyness, Family restrictions, socio economic condition, lack of awareness, risk factor, symptom relief, limitation and complication rate. Rate of complications was from 6.5% to 22% for reduction mammaplasty, whereas reported patient satisfaction rates range from 85.0% to 95.0%. In the study, reported rates of symptom improvement range from 80.8% to 94.6%, religious issues about 90.0% to 95.0%, Shyness 80.0% to 87.5%, family restrictions 80% to 87.5%, socio economic condition (High Class n=5, Upper Middle Class n=3), risk factor 70.0% to 80.0%, but in regard to psychological well-being there are tremendous outcomes. Reduction mammaplasty has had excellent patient satisfaction levels. However, a very few complications may occur even in the most suitable candidate. Skilled and experienced surgeons, enriched healthcare infrastructures, meticulous pre-operative planning, gentle tissue handling and anticipatory post-operative care will reduce the incidence of adverse results.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Noor, M A Taher, M T Rahman, M Roy, Z Mostafa, M T Chowdhury
{"title":"Duplex Color Doppler Evaluation of Intrarenal Resistive Index in Type 2 Diabetic Patients Having Diabetic Nephropathy.","authors":"R Noor, M A Taher, M T Rahman, M Roy, Z Mostafa, M T Chowdhury","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diabetic nephropathy (DN) is considered the most frequent cause of end-stage renal disease (ESRD). For early diagnosis and follow up of renal function in patient with established DN, Duplex Doppler Sonography can be used as noninvasive tool. The aim and objective of the study was to determine whether resistive index could remain higher in type 2 diabetic patients having nephropathy in comparison with that of non-diabetic controls. This case-control study was done in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) from 1st Octy 2014 to 30th June 2015. Total 65 diabetic nephropathy patients were taken as study group and 65 healthy subjects were included as healthy control subjects. Duplex Color Doppler sonography of interlobar artery was carried out in both groups for the measurement of Peak systolic velocity, end diastolic velocity and arterial Resistive Index (RI). The RI of interlobar artery of left kidney in control group was 0.58±0.08 (mean±SD) and the mean RI of interlobar artery of left kidney in diabetic nephropathy patients was 0.74±0.53 (mean±SD). The difference of RI of interlobar artery of left kidney in the two groups was statistically significant and the RI of right kidney of control and that of case groups were 0.60±0.09 and 0.76±0.031 (mean±SD) respectively. In between control and case groups the RI of right kidney was statistically significant (p = <0.5). So, resistive index of interlobar artery was increased in type 2 diabetic nephropathy patients in comparison to control group. Study findings reveal that resistive index remains significantly higher in patients with diabetic nephropathy than control group. For this reason, RI can be used for early diagnosis of diabetic nephropathy by Duplex Doppler ultrasonography.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}