European Journal of Cardiovascular Medicine

Background: Acute cholecystitis is one of the most common complications of gallstone disease. Laparoscopic cholecystectomy is the standard treatment. However, the optimal timing of surgery—early or delayed—remains a topic of discussion. Aim: To compare the clinical outcomes of early versus delayed laparoscopic cholecystectomy in patients with acute cholecystitis. Materials and Methods: This prospective comparative study was conducted in the Department of General Surgery at a tertiary care hospital over a period of one year. A total of 100 patients diagnosed with acute cholecystitis were included and divided into two groups: Group A (early laparoscopic cholecystectomy within 72 hours of symptom onset) and Group B (delayed laparoscopic cholecystectomy after 6–8 weeks of conservative management). Parameters assessed included operative time, conversion rate, postoperative complications, and duration of hospital stay. Results: Early laparoscopic cholecystectomy showed shorter overall hospital stay compared to delayed surgery. Operative time was slightly higher in the early group, but complication rates were comparable between the two groups. Conclusion: Early laparoscopic cholecystectomy is safe and effective for the management of acute cholecystitis and results in shorter total hospital stay without significant increase in complications.

Background: Hypertension is a leading modifiable risk factor for cardiovascular mortality, accounting for approximately 19.2% of global deaths in 2019. Its distribution across urban and rural geographies has historically differed, but rapid demographic and nutritional transitions are reshaping this landscape — particularly in low- and middle-income countries (LMICs). This review examines hypertension prevalence, risk factor profiles, and the awareness-treatment-control cascade across urban and rural populations. Methods: Evidence was synthesized from peer-reviewed population-based cross-sectional studies, systematic reviews, and meta-analyses published between 2013 and 2018. Primary sources include a landmark PLoS Medicine meta-analysis (Ranzani et al., 2018) of 299 surveys across 66 LMICs (n=19,770,946); the PURE multi-country study (n=142,042); and regional studies from India, Pakistan, Saudi Arabia, West Africa, and East Africa. Results: Pooled urban hypertension prevalence was 30.5% (95% CI: 28.9–32.0%) versus 27.9% (95% CI: 26.3–29.6%) in rural areas (urban-rural difference: 2.45%; 95% CI: 1.57–3.33%). This gap was largest in South Asia (7.50%) and sub-Saharan Africa (4.24%), and reversed in Europe and Central Asia (rural exceeding urban by 6.04%). Between 1990 and 2018, rural hypertension prevalence rose faster than urban. Urban risk factors included sedentary lifestyle, obesity, dietary sodium excess, and psychosocial stress; rural risk factors were dominated by poor healthcare access, low health literacy, undetected disease, and rising obesity. Awareness, treatment, and control were consistently lower in rural communities. Conclusions: While urban populations currently carry slightly higher hypertension prevalence in most LMICs, the rural burden is rising faster and is accompanied by a critical deficit in awareness, treatment, and control. Targeted rural screening programs, community health worker deployment, medication supply-chain improvements, and health literacy campaigns are urgently needed to avert a rural hypertension epidemic.

Background: Refractive error is a global health concern affecting a huge number of people and is associated with various ocular morbidities, overall prevalence of refractive errors was found to be 29%. A refractive error study in children (RESC) in India showed, hyperopia present in 7.7% of children &myopia in 7.4%. Correction of significant refractive errors in childhood helps in preventing amblyopia & strabismus. All the patients who attended the ophthalmic OPD at tertiary health care centre with visual defects were included in the study. The study is proposed to be conducted from November 2018 to May 2019. There was no significant shift in number of patients pre and post dilation in both eyes of patients of myopic astigmatism, with (p-value = 0.6478) and (p-value = 0.3862) for right and left eyes respectively, which are not significant. Materials and methods: Patients between 5 and 25 years with a visual acuity better than +0.3 logmar unit were included in this study. Noncycloplegic AR, cycloplegic AR and cycloplegic refraction were done for each patient. These results were compared. Result: In our study included 48.9% of males and 51.1% female patients, with maximum patients 30 (33.3%) in age group of 16-20years. Comparison of pre & post cycloplegic values of Auto-refractometer values in 23 & 24 right and left eyes of hypermetropia patients respectively, there was a significant increase in number of patient from dioptric range (+0.25 to +1.25) to (+2.75 to +3.75), which was 12 to 28 and 20 to 31 right and left eyes respectively, with (p- value= 0.0001) in right eye and (p-value = <0.001) in left eyes, which is significant. There was no significant shift in number of patients pre and post dilation in both eyes of patients of myopic astigmatism, with (p-value = 0.6484) and (p-value = 0.3868) for right and left eyes respectively, which are not significant. Conclusion: Retinoscopy is a reliable starting point for refraction; however, autorefraction values are important in order to accurately prescribe cylindrical correction

Background: Metabolic syndrome (MetS) including dysglycemia, obesity (especially central obesity), high blood pressure, low high-density lipoprotein cholesterol (HDL-C), and elevated triglyceride levels, is a complex of risk factors for type 2 diabetes and cardiovascular disease (CVD). MetS is a disease associated with multiple factors, and the main diagnostic indicators (components) include blood pressure, overweight and obesity, HDL-C, and fasting blood glucose. However, controversy exists about the impact of MetS on the prognosis of patients with CVD. Materials and methods: This are a prospective, cross sectional and observational study was conducted in the Shadan Institute of Medical Sciences Teaching Hospital and Research Center from June 2019 to November 2019 involving 470 students. The study was conducted using the criteria for metabolic syndrome defined by international diabetes federation. Data for height, weight, body mass index, waist circumference, fasting blood glucose, serum cholesterol, serum triglycerides (TG), high density lipoprotein (HDL), and low density lipoprotein were collected

Mucormycosis is a fatal fungal infection predominantly occurring in a diabetic and in immunocompromised patients. Infection is acquired by inhalation, ingestion or traumatic inoculation in a susceptible host. Impairment of host defence mechanisms affecting innate immune system facilitates invasive fungal infection. Skin and soft tissue mucormycosis, necrotizing fasciitis has been described in victims of road traffic accidents, natural disasters (Tsunami, tornado) who had dirt contaminated wounds. Clinical presentation of such patient is non-specific for mucormycosis and represents bacterial necrotizing skin and soft tissue infection. Early clinical suspicion and appropriate microbiological work up allow early diagnosis and appropriate antifungal therapy. With this case report we are describing mucormycosis involving anterior abdominal wall in a diabetic patients and challenges faced in the treatment.

In this paper we studied the effect of tuber extract of nutgrass (Cyperus rotundus l.) on fetal weight and length of white rat (Rattus novergicus) Sprague Dawley. Pregnant female rats (n=24) are grouped into four consisted of six rats each. Group-1 (control) only received distilled water. Group-2, 3 and 4 consecutively received tuber extract of nut grass at the dose of 22.5, 45, and 90 mg/kg body weight. Extract was given orally using gavage needle on day 6th for 13 days until day 18th of pregnancy. On day 18th of pregnancy, female rats were lapartomized under deep anaesthesia. All fetuses were taken to measure their body weight and length. The results showed that both fetal weight and fetal length of the rats were significantly decreasing with increasing doses of the extract. In conclusion, tuber extract of nut grass (Cyperus rotundus l.) has inhibitory effects against fetal growth of rats during pregnancy

One significant member of the Rubiaceae family and a frequently used herb in siddha treatment is Spermacoce hispida Linn. Phytochemical components found in plant extracts include saponins, tannins, phenolics, steroids, essential oils, flavonoids, and terpenoids. This plant's chemical components have been employed for its antidiabetic, antihypertensive, hepatoprotective, anti-inflammatory, antihyperlipidemic, analgesic, antifungal, anticancer, and antioxidant activities. In the current investigation pharmacognostic evaluation and antioxidant potential of Spermacoce hispida was carried out. The outcome of study showed that the methanolic extract of S.hispida had strong hydrogen donating ability with an IC50 value of 60.91 µg/ml, respectively and the value was found to be less than the standard vitamin C (IC50 value of 19.77 µg/ml).

Allergic rhinitis is the most common atopic disorder seen in the outpatient clinic. Montelukast, is a novel medication, is an antagonist to the leukotriene receptor. The aim of this work was to identify the improvement in the severity of symptoms of child with AR treated with Montelukast. A cross-sectional study was conducted among fifty-patients with a chronic cough and (sneezing, nasal congestion, rhinorrhea, and postnasal drip) at least eight weeks using Montelukast between the periods of January 2019 to March 2019. By using the symptom severity score for AR, that calculated. Data including (age, gender, associated disease, exacerbation factors, and classical therapy). The dose of 10-mg Montelukast once daily was prescribed. On follow-up, after four-weeks, compliance was ensured and then the symptom severity score was recorded again. Most of patients aged above 40 years. Males to females ratio was 1:1.5. Most of patients (40, 80%) lived in urban regions. There was a reduction of the symptoms associated with RA after treatment with Montelukast. Exacerbation factors was as following, dust was found in 80%, food 40%, exercise 64%, psychological 50%, and smoking 48%. SSS was declined after therapy significantly (P=0.05). Patients using showed improvement of symptoms, pain was relieved from 82%, exhaustion 80%, vomiting 92%, sleep disturbance in 80%, affecting daily life in 88%, and syncope 96%. In conclusion, the common symptoms of AR are improvement in response to Montelukast. The improvement in the symptom severity score was maximum in sneezing-nasal congestion- rhinorrhea and least in postnasal drip

Background: Left atrial enlargement (LAE) has been proven to be significantly related to stroke and cardiovascular diseases. Previous studies have shown a link between Left atrial enlargement (LAE) with the increase in the risk of stroke and cardiovascular diseases (CVD). Bangladeshi data is lacking on the exact prevalence of LAE. Aims and Objectives: To study the prevalence of LAE and its associated risk factors. Materials and Methods: Hundred patients having were studied in the Department of Vascular Surgery, Bangabandu Sheikh Mujib Medical University (BSMMU), and Dhaka, Bangladesh from January 2020 to December 2020. After a complete physical examination, echocardiogram was performed in all the patients. In present study LAE is defined if the LA diameter is more than 4.0 cm in men and 3.8 cm in women. We performed multivariable logistic regression analysis to identify risk factors for LAE. Results: Prevalence of LAE was 8%. The prevalence of LAE was higher in men (9.37%). On multivariable logistic regression analysis advancing age (OD;1.034), increased systolic blood pressure (SBP) (OR: 2.862), increased diastolic blood pressure (DBP) (OR: 1.32), abnormally high BMI (OR: 3.721), increased prevalence of diabetes (OR: 1.245), increased left ventricular myocardial index (LVMI) (OR: 1.023), and decreased left ventricular ejection fraction (LVEF), decreased heart rate (HR), and decreased estimated glomerular filtration rate (eGFR) were found to be the major risk factors of LAE. Conclusion: A significant number of patients had LAE. Among the risk factors advancing age, increased SBP, increased BMI, presence of diabetes mellitus, increased LVMI, decreased eGFR, decreased LVEF, and decreased HR were more common.