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A Case Report of Rickettsial Meningitis 立克次体脑膜炎1例报告
Pub Date : 2020-02-23 DOI: 10.3329/dmcj.v7i2.45568
Sadia Islam, S. Rahman, T. Samdani
Rickettsial diseases are a group of infections caused by the obligate intracellular bacteria Rickettsia. Rickettsial infections are common in southern Europe. The disease is usually characterized by the classical triad of fever, eschar and rash. Complications including neurological involvement are rarely described. We report an unusual case of meningitis in a 55 years old man presenting with high grade fever for 8 days associated with persistent headache. The patient was suspected to have enteric fever and treated with injection ceftriaxone. Forty-eight hours after admission, the presence of continued high grade fever, conjunctival congestion, headache, cough, low platelet and increased WBC count, and elevated transaminase raised the possibility of a different aetiology. Finally, Rickettsial meningitis was confirmed due to history of field visit, presence of eschar, neck rigidity, raised titre of WF OX-K antigen and the cerebrospinal fluid analysis revealed increased cellularity, hypoglycorrhachia, and hyper proteinorrhachia (106 mg/dL). Patient was treated with capsule doxycycline and other supportive therapy and became afebrile within 48 hours. This uncommon clinical scenario should be taken into account in the management of patients with high grade fever on admission.
立克次体病是由专性细胞内细菌立克次体引起的一组感染。立克次体感染在南欧很常见。这种疾病通常以发烧、焦痂和皮疹的典型三联征为特征。包括神经系统受累在内的并发症很少被描述。我们报告一个不寻常的病例脑膜炎在一个55岁的男子呈现高热8天,并伴有持续性头痛。患者怀疑有肠热,并给予注射头孢曲松治疗。入院48小时后,出现持续高热、结膜充血、头痛、咳嗽、血小板低、白细胞计数增加和转氨酶升高,提示可能存在其他病因。最后,立克次体脑膜炎的确诊是由于现场就诊史、结痂、颈部僵硬、WF OX-K抗原滴度升高以及脑脊液分析显示细胞增多、低糖血症和高蛋白血症(106 mg/dL)。患者给予强力霉素胶囊及其他支持治疗,48小时内退热。这种不常见的临床情况应考虑到患者入院时高热的管理。
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引用次数: 0
From the Desk of Editor-in-Chief Vol.7(2) 来自主编办公桌第7卷(2)
Pub Date : 2020-02-19 DOI: 10.3329/dmcj.v7i2.45539
S. Karim
Abstract not available Delta Med Col J. Jul 2019 7(2): 50
摘要不可用Delta Med Col J.Jul 2019 7(2):50
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引用次数: 0
Gastroprotective Effect of Azadirachta indica Leaves (Neem) Extract on Aspirin Induced Gastric Ulcer in Rats 印楝叶提取物对阿司匹林致大鼠胃溃疡的保护作用
Pub Date : 2020-02-19 DOI: 10.3329/dmcj.v7i2.45542
S. Farzana, S. Saha, N. Sultana, I. Khan
Background: Gastric ulcer is one of the common diseases worldwide. Different parts of Azadirachta indica (Neem) tree has different uses in medicine for its beneficial properties and its leaves are also known to have anti ulcerant effect. Objective: This study was conducted to find out the protective role of Azadirachta indica (Neem) extract in the development of gastric ulcer. Materials and method: The study comprised of 30 Albino rats: Group-A, Group-B, Group-C, Group-D and Group-E having 6 rats in each group. The experiment was divided into 2 parts: Experiment-1 and Experiment-2. Experiment-1 comprised of Group-A and Group-B where Group-A served as control and was provided with normal saline (2 ml/kg body wt). In group-B rats ulcer was produced by administration of aqueous suspension of Aspirin (200 mg/kg body wt). All the rats were sacrificed after 4 hours to confirm gastric ulcer by histopathology. In Experiment-2, rats of Group-C served as disease control group and provided with normal saline (2ml/kg body wt). Group-D was provided with alcoholic extract of Azadirachtaindica leaves (150mg/kg body wt) and Group-E was provided with Ranitidine suspension (20mg/kg). After 8 days of treatment, animals were fasted for 24 hours. Then aqueous suspension of Aspirin (200 mg/kg body wt) was administered and after 4 hours all rats were sacrificed. Gross and microscopic examinations were performed to evaluate the results. Results: Histologically Aspirin treated rats showed ulcerated mucosa. Pretreatment with Neem extract showed protection against Aspirin induced gastric mucosal damage which was statistically highly significant (p<0.001). Conclusion: The study suggests that pretreatment with Azadirachta indica (Neem) leaves extract may be useful in prevention of Aspirin induced gastric ulcer.
背景:胃溃疡是世界范围内常见的疾病之一。印楝树的不同部位因其有益的特性而在医学上有不同的用途,其叶子也具有抗溃疡作用。目的:探讨印楝提取物对胃溃疡的保护作用。材料和方法:本研究由30只白化大鼠组成:A组、B组、C组、D组和E组,每组6只。实验分为两部分:实验一和实验二。实验-1由A组和B组组成,其中A组作为对照并提供生理盐水(2ml/kg体重)。在B组大鼠中,通过施用阿司匹林水悬浮液(200mg/kg体重)产生溃疡。4小时后处死所有大鼠,通过组织病理学证实胃溃疡。实验2以C组大鼠为疾病对照组,给予生理盐水2ml/kg体重。D组给予印楝叶醇提取物(150mg/kg体重),E组给予雷尼替丁混悬液(20mg/kg体重)。治疗8天后,动物禁食24小时。然后给予阿司匹林(200mg/kg体重)的水悬浮液,4小时后处死所有大鼠。进行了大体和显微镜检查以评估结果。结果:阿司匹林治疗大鼠的组织学表现为黏膜溃疡。印楝提取物预处理对阿司匹林诱导的胃粘膜损伤具有保护作用,具有统计学意义(p<0.001)。结论:印楝叶提取物预处理可能有助于预防阿司匹林诱发的胃溃疡。
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引用次数: 2
Changing Pattern of Shingles (Herpes Zoster) in Hill Tracts: A Study among Tribal Community of Bangladesh 山区带状疱疹(Herpes Zoster)的变化模式:孟加拉国部落社区的研究
Pub Date : 2020-02-19 DOI: 10.3329/dmcj.v7i2.45541
Ahmed Tanjimul Islam
Background: Herpes zoster infection (shingles) is a common painful disease in Bangladesh. Changing pattern of the disease presentation can cause delayed diagnosis, inappropriate treatment, prolongation of the disease with debilitating symptoms and post herpetic neuralgia. Objective: The study was done to evaluate the different changing clinical and dermatome pattern of shingles among tribal community in Hill tracts of Bangladesh. Materials and method: This descriptive hospital based study was carried out among 74 shingles patients using simple, direct, standardized questionnaire with history, clinical and dermatological examination from July 2015 to July 2016 in Rangamati General Hospital, Rangamati, Bangladesh. Results: August to October was the vulnerable period for Shingles (75.7%) with highest number of cases found in September (32.4%). Rural area (70.2%) is vulnerable than urban area. Lumbar region (39.1%) is the commonest dermatome involved during examination. Itching was the commonest complaint (41.9%) for physician consultation and 15% cases suffered reactivation within six months in the same dermatome region. Conclusion: As changing and different pattern of manifestations are common in shingles in Hill Tracts, these are to be considered by local and consultant physicians in the total management to decrease delayed complications and reactivation.
背景:带状疱疹感染(带状疱疹)是孟加拉国一种常见的疼痛性疾病。疾病表现模式的改变可导致诊断延误、治疗不当、病程延长,伴有衰弱症状和疱疹后神经痛。目的:研究孟加拉国山区部落社区带状疱疹的临床和皮肤形态变化。材料与方法:本研究以描述性医院为基础,采用简单、直接、标准化的调查问卷,对孟加拉国Rangamati综合医院2015年7月至2016年7月的74例带状疱疹患者进行病史、临床和皮肤病学检查。结果:8 ~ 10月为带状疱疹易感期(75.7%),9月发病最多(32.4%);农村地区(70.2%)比城市地区脆弱。腰椎(39.1%)是检查中最常见的受累皮肤区。瘙痒是医生咨询中最常见的主诉(41.9%),15%的病例在6个月内在同一皮肤区再次激活。结论:山区带状疱疹的临床表现多种多样,值得当地医师和会诊医师在全面治疗中加以考虑,以减少迟发性并发症和复发。
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引用次数: 0
Materials Used for Suicidal Hanging Recorded during Autopsy from Sir Salimullah Medical College Morgue 萨里穆拉爵士医学院太平间尸检记录的自杀上吊材料
Pub Date : 2020-02-19 DOI: 10.3329/dmcj.v7i2.45543
S. R. Sumon, Kishoara Binte Quader, M. T. Asha, F. A. Mollika, M. S. A. Rashid, B. H. Khan, F. Ahmed
Background: Suicide is one of the commonest causes of death worldwide and has a great public health effect. The cause of suicide is found to be multi-factorial in which biological, psychological, social and environmental factors act together. The choice of method depends on the accessibility and availability of the means on the spot at the time of act. Objective: To find out the choice of ligature material used by the victims, type of hanging in relation to the point of suspension and other related factors. Materials and method: This retrospective observational study summarizes the post mortem examinations on 187 cases of suicide by hanging during January 2012 to December 2013 in the Department of Forensic Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. Ligature material used by the victim was noted from the available forensic reports. Results: The current study is done to find out the commonly used material in cases of hanging. Male (63%) outnumbered females (37%) in committing suicide by hanging. Most commonly used ligature material was rope (28%) followed by ‘orna’/’dupatta’ (22%). The nature of ligature material was soft in 68% cases while hard material was used in 5% cases. The position of knot was observed on left side of neck in 63% cases followed by right side in 21% cases. The commonly used ligature was a rope with guider, and ceiling fan and tree branches as the point of suspension. Conclusion: Rope is frequently used for domestic purposes and thus it is also the most commonly used ligature material. Social, cultural and economic values must be strengthened to reduce incidence of suicide.
背景:自杀是世界范围内最常见的死亡原因之一,对公众健康有着巨大的影响。自杀的原因是多因素的,其中生物、心理、社会和环境因素共同作用。方法的选择取决于行为发生时现场手段的可及性和可用性。目的:了解被害人使用的绳系材料的选择、悬挂方式与悬吊点的关系等相关因素。材料和方法:本回顾性观察性研究总结了2012年1月至2013年12月期间孟加拉国达卡萨里穆拉爵士医学院法医学系和米特福德医院187例上吊自杀的尸检结果。从现有的法医报告中发现了受害者使用的勒绳材料。结果:本研究旨在找出吊案常用材料。选择上吊自杀的男性(63%)多于女性(37%)。最常用的捆扎材料是绳索(28%),其次是“orna”/“dupatta”(22%)。结扎材料的性质为软的占68%,硬的占5%。结位在颈部左侧占63%,右侧占21%。常用的绳索是带引线的绳子,吊扇和树枝作为悬吊点。结论:绳索在家庭中使用较多,是最常用的结扎材料。必须加强社会、文化和经济价值,以减少自杀的发生率。
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引用次数: 0
Dengue – What to Do? 登革热——该怎么办?
Pub Date : 2020-02-19 DOI: 10.3329/dmcj.v7i2.45540
Rezwanur Rahman
Abstract not available Delta Med Col J. Jul 2019 7(2): 54-55
摘要不可用Delta Med Col J.Jul 2019 7(2):54-55
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引用次数: 1
Outcome of Mode of Delivery in Nulliparous and Multiparous Women Presenting with Early and Late Cervical Dilatation 早、晚宫颈扩张的无产和多产妇女分娩方式的结局
Pub Date : 2019-03-19 DOI: 10.3329/DMCJ.V7I1.40616
Ferdous Ara Shuchi, S. Lovereen, Mst Nazmunnaher Mina
Background: Knowledge of the patterns of normal and abnormal labour, and of women’s behavior, is fundamental to the formulation of mode of delivery. It is observed that women admitted to hospital early have a higher frequency of obstetric interventions in labour than those admitted later. Objective: To study the outcome of spontaneous onset of labour in nulliparous and multiparous patients. Materials and method: During the study period of 1st July 2008 to 31st Dec 2008, 568 pregnant women admitted in Kumudini Women’s Medical College were included in this study. Mothers were observed since admission with spontaneous onset of labour and followed up till they were released from the hospital. Labour outcome was measured and mode of delivery was compared among nulliparous and multiparous women. Results: Among the nulliparous women, normal vaginal delivery occurred in 71 (23%) patients presented with early cervical dilatation (0-3 cm) and in 142 (46%) patients presented with late cervical dilatation (>4 cm). In nulliparous women caesarean section were needed in 60 (45.8%) patients in early cervical dilatation group and in 35 (19.8%) patients in late cervical dilatation group. In multiparous women, normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation and in 133 (51%) patients presented with late cervical dilatation whereas cesarean section were done in 35 (34.7%) patients and in 25 (15.8%) patients in the two groups respectively. Duration of labour between nulliparous and multiparous was significantly different (8 hours vs. 6 hours). Indication of caesarean section were, 61 (40%) patients due to prolong labour, 48 (34%) due to foetal distress and 44 (26%) due to cephalopelvic disproportion. Conclusion: Normal vaginal delivery occurred more and duration of labour was shorter in patients admitted with advanced labour (cervical dilatation >4cm). Delta Med Col J. Jan 2019 7(1): 16-20
背景:了解正常和异常分娩的模式,以及妇女的行为,是制定分娩方式的基础。据观察,较早入院的妇女在分娩时接受产科干预的频率高于较晚入院的妇女。目的:探讨无产和多产患者自然产的结局。材料和方法:研究于2008年7月1日至2008年12月31日期间,在Kumudini女子医学院住院的568名孕妇被纳入本研究。母亲自入院以来一直观察自然分娩,并随访至出院。测量分娩结果,比较无产和多产妇女的分娩方式。结果:在未产妇女中,71例(23%)宫颈扩张早期(0 ~ 3cm), 142例(46%)宫颈扩张晚期(0 ~ 4cm),阴道正常分娩。宫颈扩张早期组和宫颈扩张晚期组分别有60例(45.8%)和35例(19.8%)需要剖宫产。在多次分娩的妇女中,66例(25%)患者宫颈扩张早期,133例(51%)患者宫颈扩张晚期阴道分娩正常,而两组分别有35例(34.7%)和25例(15.8%)患者行剖宫产。无产和多产的产程有显著差异(8小时vs. 6小时)。剖宫产指征:延长产程61例(40%),胎儿窘迫48例(34%),头骨盆比例失调44例(26%)。结论:产程晚期(宫颈扩张4cm)患者阴道正常分娩较多,产程较短。中华医学会医学杂志,2019 7(1):16-20
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引用次数: 2
Substance Abuse among Bipolar Mood Disorder Patients 双相情感障碍患者的药物滥用
Pub Date : 2019-03-19 DOI: 10.3329/DMCJ.V7I1.40618
M. Rashid, Ahsan Ahmed, Muhammad Zillur Rahman Khan
Background: Substance abuse is a major comorbidity among patients with bipolar mood disorder (BMD). In a major portion of patients with BMD substance abuse remains undiagnosed and untreated in Bangladesh. Objective: This descriptive cross sectional study was conducted from November, 2014 to May, 2015 to determine proportion of substance abuse among patients with BMD. Materials and method: A total of 151 patients with bipolar mood disorder were selected purposefully from both the inpatient and outpatient department of National Institute of Mental Health (NIMH), Dhaka, Bangladesh. Both male and female were included and informed written consent was taken from each respondent. During data collection, a structured questionnaire designed by the researchers containing socio-demographic and other variables was used. Results: Among the respondents 23.8% was found to abuse substance. Conclusion: So during the treatment of BMD the physicians should always search for substance abuse among the patients and treat them accordingly to achieve a fruitful outcome. Delta Med Col J. Jan 2019 7(1): 31-34
背景:药物滥用是双相情感障碍(BMD)患者的主要合并症。在孟加拉国,很大一部分骨密度障碍患者药物滥用仍未得到诊断和治疗。目的:本研究于2014年11月至2015年5月进行描述性横断面研究,以确定BMD患者药物滥用的比例。材料和方法:有目的地从孟加拉国达卡国家精神卫生研究所(NIMH)的住院部和门诊部共选择151例双相情感障碍患者。包括男性和女性,并从每个受访者那里获得知情的书面同意。在数据收集过程中,使用了由研究人员设计的包含社会人口统计学和其他变量的结构化问卷。结果:23.8%的被调查者存在药物滥用现象。结论:在骨密度治疗过程中,医师应及时发现患者的药物滥用情况,并进行相应的治疗,以取得良好的效果。中华医学杂志,2019,7(1):31-34
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引用次数: 0
Reviewers in this issue Vol.7(1) 本期审稿人第7卷(1)
Pub Date : 2019-03-19 DOI: 10.3329/DMCJ.V7I1.40621
Rezwanur Rahman
Abstract not available Delta Med Col J. Jan 2019 7(1): 53
摘要不可用Delta Med Col J.2019年1月7(1):53
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引用次数: 0
Association of Chest Radiograph with Community Acquired Pneumonia among the Children Admitted in Dhaka Shishu Hospital 达卡石树医院住院儿童胸部X线片与社区获得性肺炎的相关性
Pub Date : 2019-03-19 DOI: 10.3329/DMCJ.V7I1.40615
Akhand Tanzih Sultana, M. Miah, K. Hoque, J. Begum, Kamruzzaman, Nazia
Background: Community-acquired pneumonia (CAP) is an infectious disease and common reason for hospitalization of children throughout the world. There are few published data about radiological findings and their relationship with community-acquired pneumonia (CAP) severity. Objective: This study was conducted to evaluate radiological findings in children with community acquired pneumonia (CAP) of different severity. Materials and method: A prospective study was conducted in the department of Paediatric Respiratory Medicine (Pulmonology) in Dhaka Shishu Hospital from November 2016 and April 2017. A total number of 35 children of 1 month to 10 years, who were admitted with cough or respiratory difficulty and radiological pneumonia were included in this study. Results: Majority of the study participants 18 (51.43%) were infants with a male preponderance. The most common symptom was cough (94.29%) followed by fever (82.86%) and respiratory distress (42.86%). Crepitation (54.29%), tachypnoea (42.86%) and chest indrawing (28.57%) were the most common signs. Out of total 35 children 17 (48.57%) cases had pneumonia and 18 (51.43%) cases had severe pneumonia. Among chest X-rays, severe pneumonia had greatest frequency of primary end point consolidation (PEP) on right side (n=10, 55.55%), right infiltrates (n=5, 27.78%), bilateral infiltrates (n=2, 11.11%) followed by right sided pleural effusion (n=3, 16.67%) and pneumothorax (n=2, 11.11%). There was no association found between CAP severity and presence of radiological findings of pneumonia. Conclusion: This study shows that severe CAP may not always be associated with positive radiological findings. This finding may be taken into consideration during the diagnosis and management of CAP. Delta Med Col J. Jan 2019 7(1): 21-25
背景:社区获得性肺炎是一种传染性疾病,也是世界各地儿童住院的常见原因。关于放射学发现及其与社区获得性肺炎(CAP)严重程度的关系,很少有公开的数据。目的:本研究旨在评估不同严重程度的社区获得性肺炎(CAP)患儿的放射学表现。材料和方法:一项前瞻性研究于2016年11月至2017年4月在达卡石树医院儿科呼吸医学(肺病)进行。本研究共纳入35名1个月至10岁的儿童,他们因咳嗽或呼吸困难和放射性肺炎入院。结果:18名研究参与者中的大多数(51.43%)是男性占优势的婴儿。最常见的症状是咳嗽(94.29%),其次是发烧(82.86%)和呼吸窘迫(42.86%)。最常见的体征是心悸(54.29%)、呼吸急促(42.86%)和胸闷(28.57%)。在总共35名儿童中,17例(48.57%)患有肺炎,18例(51.43%)患有严重肺炎。在胸部X光片中,严重肺炎的主要终点巩固(PEP)发生率最高的是右侧(n=10,55.55%)、右侧浸润(n=5,27.78%)、双侧浸润(n=2,11.11%),其次是右侧胸腔积液(n=3,16.67%)和胸腔积液(n=2,11.111%)。CAP严重程度与肺炎的放射学表现之间没有关联。结论:本研究表明,严重的CAP可能并不总是与阳性放射学表现相关。这一发现可以在CAP的诊断和管理过程中加以考虑。德尔塔医学杂志2019年1月7(1):21-25
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引用次数: 0
期刊
Delta Medical College Journal
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