Background: Diabetic polyneuropathy (DPN) has a significant positive correlation with poor glycemic control (HbA1c ≥7%). The clinical, biochemical and electrophysiological parameters of DPN in Bangladeshi citizens have not yet been explored elaborately Objective: The purpose of the study was to detect and categorize status of glycemic control of Bangladeshi people and to analyze its impact on clinical severity of DPN using Toronto Clinical Scoring System (TCSS) and electrophysiological severity by modified Michigan diabetic neuropathy score (MDNS). Methodology: This observational study was carried out on diabetic patients having probable DPN by purposive sampling, attending Neurology OPD of Dhaka Medical College Hospital, Dhaka, Bangladesh and Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorder (BIRDEM) Hospital, Dhaka, Bangladesh from July 2014 to June 2016. Clinical parameters were recorded and DPN was graded as “no neuropathy”, “mild”, “moderate” and “severe” neuropathy by the Toronto Clinical Scoring System (TCSS). A standard nerve conduction study was performed on each patient and electrophysiological grading according to modified Michigan diabetic neuropathy score (MDNS) was done. Diabetic status of patients was classified into “controlled” (HbA1c <7.0%) and “uncontrolled” (HbA1c ≥7.0%) groups and HbA1c level and the clinical & electrophysiological severity scores were compared and were analyzed. Results: Mean age of the patients was 57.2±9.37 years. 51.0% cases were males and 49% cases were females. The mean HbA1c in the study population was 7.6±0.94% and 56.0% patients had HbA1c≥ 7% .Motor nerve conduction studies revealed that both CMAP amplitudes and MNCV in the ulnar, peroneal and tibial nerves were reduced significantly in patients of uncontrolled (HbA1c≥7%) DM (p<0.001). Sensory nerve conduction studies revealed significant reduction in SNAP amplitudes of median and ulnar sensory and sural nerves in the uncontrolled group (p<0.001). Electrophysiologically, 65.43% patients had mixed sensory-motor neuropathy (p<0.00001). Clinically severe DPN patients were higher (45.2%) within the uncontrolled (HbA1C ≥7%) group (p<0.00001). Similarly, severity in electrophysiological grading was more in patients with uncontrolled DM (48.8%) (p<0.00001). Conclusions: Neuropathic severity, either clinically or electrophysiologically, was associated with higher values of HbA1c. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 177-184

Background: Accurate detection of astrocytomas is very difficult. Objective: The purpose of the present study was to evaluate the usefulness of Magnetic Resonance Imaging (MRI) in detection of intracranial astrocytoma. Methodology: This cross sectional study was carried out in the Department of Radiology and Imaging with the collaboration of Department of Neurosurgery and Department of Pathology at Sir Salimullah Medical College (SSMC & MH), Dhaka from January 2013 to December 2013 for a period of one (1) year. Prior to the commencement of this study, the research protocol was approved by the ethical committee (Local Ethical committee) of SSMC. All the patients presented with clinically diagnosed cases of intracranial astrocytoma who were attended in the OPD and IPD were included as study population. The sampling technique was purposive, non-random sampling method. MRI was performed in all cases. The postoperative resected tissues were examined histopathological in the respective department. Then the collected reports were compared with findings of MRI. Results: The sample size of the present study was 48 astrocytoma patients. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI for the diagnosis of astrocytoma are 92.0%, 80.0%, 96.0%, 67.0% and 90.3% respectively. Conclusion: In conclusion MRI has a high diagnostic validity for the detection of astrocytoma. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):202-205

Background: Non-adherence to medication increases patient’s risk of morbidity, mortality and economic wastage of scare medical resources. This study was conducted to assess the role of doctor-patient communication and duration of consultation, as tools to improve adherence to hypertension treatment. Methods: Data of this cross-sectional study were collected by face to face interview and document review at Combined Military Hospital (CMH), Dhaka among 253 conveniently recruited hypertensive patients attending outpatient department during July 2016 to June 2017. Mean-age of the respondents was 49.2 (±10.4) years, mostly married male (54.9% male, 95.3% married). Mean consultation duration experienced by the respondents was 5.3 (± 1.3) minutes. Among the participants, 63.64% experienced effective communication, 66% were adherent and 34% were non-adherent to medication. Among the respondents with effective communication, 92.5% were adherent to medication. On the contrary, among the respondents with ineffective communication, 80.4% were non-adherent. Results: Duration of consultation had significant association with adherence to hypertension treatment (p<0.001). Association between communication and adherence to medication was highly significant (p<0.001). Binary logistic regression revealed that respondents were 3.23 times more adherent to medication with favorable response to the item- ‘Doctor gave me as much information as I wanted’ (p = 0.041); and 10.24 times with favorable response to the item- ‘Doctor checked to be sure that I understood everything’(p=0.006). Patients’ faithfulness in carrying out prescription and proscriptions correctly, depends on the adequacy and accuracy of patient’s knowledge of what they were supposed to do and on their motivation. Conclusion: Thus, it is necessary to formulate interventions to scale up communication skill of the physicians, and devise effective ways to educate patients on medication of chronic diseases. Further studies on characteristics of consultation to make it motivating and more effective may be conducted. Bangladesh Med Res Counc Bull 2018; 44: 145-151

Background: Tension-type headache is frequently reported by the patients. Objective: The purpose of the present study was to see the status of thyroid hormones among chronic tension type headache patients. Methodology: This study was conducted in the Department of Neurology at Dhaka Medical College, Dhaka, Bangladesh. The study subjects consisted of patients presented with primary headache disorders. Result: Among the patients 21.0% had chronic sub-type of TTH. Out of 42 chronic tension-type headache patients 12 had subclinical and another 12 had overt hypothyroidism. Statistically significant difference was seen among different sub-types of headache in relation to thyroid status. Conclusion: Hypothyroidism is found to be a co morbidity or precipitating factors to be development of chronic type of tension-type headache. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):189-192

Background Despite the wide acceptability of fasting lipid profiles in practice, emerging evidence suggests that random lipid profiles might be a convenient alternative for lipid measurement. The objective of the present study was to compare the fasting and random lipid profile among subjects with type 2 diabetes mellitus (T2DM). Methods The present cross-sectional study included 1543 subjects with T2DM visiting several endocrinology outpatient clinics throughout Bangladesh from January to December 2021. The fasting lipid profile was measured in the morning following 8–10 h of overnight fasting, and the random lipid profile was measured at any time of the day, irrespective of the last meal. The values of fasting and random lipids were compared using the Wilcoxon signed-rank test and Spearman rank correlation coefficients. Results In this study, a good level of correlation was observed between fasting and random lipid levels [r = 0.793, p < 0.001 for triglyceride (TG); r = 0.873, p < 0.001 for low-density lipoprotein cholesterol (LDL-C); r = 0.609, p < 0.001 for high-density lipoprotein cholesterol (HDL-C); and r = 0.780, p < 0.001 for total cholesterol (TC)]. In addition, TG and TC levels increased by 14% and 0.51%, respectively, in the random state compared to the fasting state (p- <0.05), while LDL-C levels decreased by 0.71% (p-value 0.42). No change was noticed in the HDL-C level. The difference between fasting and random lipid profiles was similar irrespective of patients’ age, sex, BMI, glucose-lowering drug(s), and lipid-lowering therapy. Conclusions Random lipid profile correlates significantly with fasting lipid profile with little difference. Hence, it might be a reliable alternative for fasting lipid profile in patients with T2DM.