Abstract not available J MEDICINE 2024; 25: 103-106
摘要不详 J MEDICINE 2024; 25: 103-106
{"title":"Diabetes and Fasting in Ramadan","authors":"K. Uddin","doi":"10.3329/jom.v25i2.74664","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74664","url":null,"abstract":"Abstract not available\u0000J MEDICINE 2024; 25: 103-106","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"10 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644080","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}
Gazala Afreen Khan, Negin Mohammad Hossein Rahimi, Mariam Gaeth, Baraah Abdulhakim, Farah Nagy, Reem Bassam
The MTHFR gene (Methylenetetrahydrofolate reductase), responsible for encoding the MTHFR enzyme, is vital for the body’s methylation processes, which are crucial for DNA synthesis, repair, and overall metabolic functions. Previous studies have shown that mutations in the MTHFR gene are associated with various diseases, including neural tube defects, male infertility, type II diabetes mellitus, cardiovascular diseases, and certain cancers. Additionally, abnormal methylation of the MTHFR gene can suppress other important genes such as methionine synthase, thymidylate synthase, choline kinase, and folate receptor genes. This suppression can result in a deficiency of the MTHFR enzyme, essential for proper cellular function, especially when a 677CT (C to T) transition occurs, leading to reduced enzyme activity. Despite the known implications of MTHFR gene mutations, no studies have probed these mutations in the female Arab population. To fill this gap, a pilot study was conducted to determine the prevalence of the MTHFR C677T gene mutation among 45 healthy Arab individuals in the United Arab Emirates. The study used the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method to detect the mutation. The study found that the mutated T allele had a 6% occurrence rate in the female Arab population. The genotype frequencies were 86.6% for the CC genotype, 13.3% for the CT genotype, and 0% for the TT genotype, indicating a relatively low prevalence of the MTHFR C677T polymorphism in Arab women. These findings provide preliminary data that can form the basis for further research on MTHFR gene mutations in this population, potentially enhancing the understanding and management of related health conditions. J MEDICINE 2024; 25: 141-148
{"title":"Genotype and Allele Frequency of Methylenetetrahydrofolate Reductase 677CTmutation in Female Arabs residing in the United Arab Emirates","authors":"Gazala Afreen Khan, Negin Mohammad Hossein Rahimi, Mariam Gaeth, Baraah Abdulhakim, Farah Nagy, Reem Bassam","doi":"10.3329/jom.v25i2.74372","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74372","url":null,"abstract":"The MTHFR gene (Methylenetetrahydrofolate reductase), responsible for encoding the MTHFR enzyme, is vital for the body’s methylation processes, which are crucial for DNA synthesis, repair, and overall metabolic functions. Previous studies have shown that mutations in the MTHFR gene are associated with various diseases, including neural tube defects, male infertility, type II diabetes mellitus, cardiovascular diseases, and certain cancers. Additionally, abnormal methylation of the MTHFR gene can suppress other important genes such as methionine synthase, thymidylate synthase, choline kinase, and folate receptor genes. This suppression can result in a deficiency of the MTHFR enzyme, essential for proper cellular function, especially when a 677CT (C to T) transition occurs, leading to reduced enzyme activity. Despite the known implications of MTHFR gene mutations, no studies have probed these mutations in the female Arab population. To fill this gap, a pilot study was conducted to determine the prevalence of the MTHFR C677T gene mutation among 45 healthy Arab individuals in the United Arab Emirates. The study used the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method to detect the mutation. The study found that the mutated T allele had a 6% occurrence rate in the female Arab population. The genotype frequencies were 86.6% for the CC genotype, 13.3% for the CT genotype, and 0% for the TT genotype, indicating a relatively low prevalence of the MTHFR C677T polymorphism in Arab women. These findings provide preliminary data that can form the basis for further research on MTHFR gene mutations in this population, potentially enhancing the understanding and management of related health conditions.\u0000J MEDICINE 2024; 25: 141-148","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"39 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141643474","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. J. B. Sayeed, Md Moniruzzaman, Md Mujibur Rahman
Embolic stroke due to atrial fibrillation is often underdiagnosed and has high morbidity and mortality among ischemic stroke. So it is of paramount importance to start anticoagulants as early as possible to prevent further ischemic stroke. However, early initiation of anticoagulants has created much debate, major & minor bleeding related to it are a major concern, and resumption of anticoagulants after intracranial hemorrhage is still a gray zone. Here, we described a narrative review to shed some light on the major concerns such as the optimal time to start an anticoagulant, the best agent to administer, the resumption of anticoagulant after a hemorrhagic stroke, and anticoagulant therapy in chronic rheumatic heart disease (CRHD) based on the recently published article. J MEDICINE 2024; 25: 155-158
{"title":"Anticoagulant in Acute Ischemic Stroke with Atrial Fibrillation: A Narrative Review","authors":"S. J. B. Sayeed, Md Moniruzzaman, Md Mujibur Rahman","doi":"10.3329/jom.v25i2.74657","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74657","url":null,"abstract":"Embolic stroke due to atrial fibrillation is often underdiagnosed and has high morbidity and mortality among ischemic stroke. So it is of paramount importance to start anticoagulants as early as possible to prevent further ischemic stroke. However, early initiation of anticoagulants has created much debate, major & minor bleeding related to it are a major concern, and resumption of anticoagulants after intracranial hemorrhage is still a gray zone. Here, we described a narrative review to shed some light on the major concerns such as the optimal time to start an anticoagulant, the best agent to administer, the resumption of anticoagulant after a hemorrhagic stroke, and anticoagulant therapy in chronic rheumatic heart disease (CRHD) based on the recently published article.\u0000J MEDICINE 2024; 25: 155-158","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"9 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141642521","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}
Sungkono, Firdian Makrufardi, Annisa Fairuz Nur Azizah, Firdiawan Ekaputra
Background: The sudden shift to remote learning, prompted by global health restrictions, compelled educators to devise innovative pedagogical strategies that transcend traditional boundaries. This transition underscored the pivotal role of technology in bridging gaps and enhancing learning experiences. As a result, technology ceased to be a mere supplement and instead became an essential conduit for effective medical education delivery. Methods: A systematic review was performed by searching relevant studies until June 2023 using the PubMed, MEDLINE, and EMBASE databases. The sudden shift to remote learning, prompted by global health restrictions, compelled educators to devise innovative pedagogical strategies that transcend traditional boundaries. This transition underscored the pivotal role of technology in bridging gaps and enhancing learning experiences. As a result, technology ceased to be a mere supplement and instead became an essential conduit for effective medical education delivery. Results: The systematic review of the literature found 47 studies that satisfied the inclusion criteria, addressing different facets of technology’s influence on medical education during the post-COVID-19 pandemic period. The analysis reveals a dynamic landscape where challenges catalyzed advancements. Educational institutions swiftly adapted to the new normal by embracing technology-driven solutions. Virtual patient interactions, augmented reality modules, and AI-driven personalized learning emerged as effective tools. These innovations not only addressed immediate challenges but also laid the groundwork for a more flexible and inclusive medical education ecosystem. Conclusions: The challenges experienced throughout the COVID-19 pandemic have significantly influenced the transformation of medical education in the post-pandemic era. By analyzing challenges and proposing innovative solutions, the crucial significance of technology is underscored, emphasizing the necessity for a comprehensive and adaptable approach to shape the trajectory of future medical education. J MEDICINE 2024; 25: 166-172
{"title":"Exploring challenges, innovations, and technological integration in medical education after COVID-19 pandemic: An In-depth analysis","authors":"Sungkono, Firdian Makrufardi, Annisa Fairuz Nur Azizah, Firdiawan Ekaputra","doi":"10.3329/jom.v25i2.74377","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74377","url":null,"abstract":"Background: The sudden shift to remote learning, prompted by global health restrictions, compelled educators to devise innovative pedagogical strategies that transcend traditional boundaries. This transition underscored the pivotal role of technology in bridging gaps and enhancing learning experiences. As a result, technology ceased to be a mere supplement and instead became an essential conduit for effective medical education delivery. Methods: A systematic review was performed by searching relevant studies until June 2023 using the PubMed, MEDLINE, and EMBASE databases. The sudden shift to remote learning, prompted by global health restrictions, compelled educators to devise innovative pedagogical strategies that transcend traditional boundaries. This transition underscored the pivotal role of technology in bridging gaps and enhancing learning experiences. As a result, technology ceased to be a mere supplement and instead became an essential conduit for effective medical education delivery. Results: The systematic review of the literature found 47 studies that satisfied the inclusion criteria, addressing different facets of technology’s influence on medical education during the post-COVID-19 pandemic period. The analysis reveals a dynamic landscape where challenges catalyzed advancements. Educational institutions swiftly adapted to the new normal by embracing technology-driven solutions. Virtual patient interactions, augmented reality modules, and AI-driven personalized learning emerged as effective tools. These innovations not only addressed immediate challenges but also laid the groundwork for a more flexible and inclusive medical education ecosystem. Conclusions: The challenges experienced throughout the COVID-19 pandemic have significantly influenced the transformation of medical education in the post-pandemic era. By analyzing challenges and proposing innovative solutions, the crucial significance of technology is underscored, emphasizing the necessity for a comprehensive and adaptable approach to shape the trajectory of future medical education.\u0000J MEDICINE 2024; 25: 166-172","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"1 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141640741","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}
Miftahul Jannat, M. Rishad, Nawsabah Noor, S. M. K. Z. Prince, Tazbiha Rahman Khan, Najeeb Mahiyuddin, Md Abdul Jalil Ansari
Background: Type 2 diabetes is a common metabolic disorder causing high blood sugar due to insulin resistance and relative insulin deficiency. It poses a significant global health burden, especially in low and middle-income countries. This study explores how well-controlled blood sugar (HbA1c) affects the types and patterns of complications in hospitalized patients with type 2 diabetes. Methods: Conducted over six months at a tertiary care hospital, this cross-sectional study included 200 men and women with T2DM. Data were collected through evaluations and documented. Macrovascular complications were identified using specific criteria: elevated cardiac troponin I for myocardial infarction, neurological deficits with imaging for stroke, and foot ulcers or amputation history for peripheral vascular disease. Results: Macrovascular complications were found in 33% of patients, with myocardial infarction being the most common (48.5%), followed by stroke (37.9%) and peripheral vascular disease (13.6%). Patients with complications had significantly higher HbA1c and blood glucose levels. Conclusion: A significant proportion of hospitalized T2DM patients have macrovascular complications, associated with higher HbA1c levels. These findings emphasize the importance of good glycemic control to prevent such complications. J MEDICINE 2024; 25: 136-140
{"title":"Pattern of Macrovascular Complications and its relationship with HbA1c in Hospitalized Patients with Type 2 Diabetes Mellitus","authors":"Miftahul Jannat, M. Rishad, Nawsabah Noor, S. M. K. Z. Prince, Tazbiha Rahman Khan, Najeeb Mahiyuddin, Md Abdul Jalil Ansari","doi":"10.3329/jom.v25i2.74310","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74310","url":null,"abstract":"Background: Type 2 diabetes is a common metabolic disorder causing high blood sugar due to insulin resistance and relative insulin deficiency. It poses a significant global health burden, especially in low and middle-income countries. This study explores how well-controlled blood sugar (HbA1c) affects the types and patterns of complications in hospitalized patients with type 2 diabetes. Methods: Conducted over six months at a tertiary care hospital, this cross-sectional study included 200 men and women with T2DM. Data were collected through evaluations and documented. Macrovascular complications were identified using specific criteria: elevated cardiac troponin I for myocardial infarction, neurological deficits with imaging for stroke, and foot ulcers or amputation history for peripheral vascular disease. Results: Macrovascular complications were found in 33% of patients, with myocardial infarction being the most common (48.5%), followed by stroke (37.9%) and peripheral vascular disease (13.6%). Patients with complications had significantly higher HbA1c and blood glucose levels. Conclusion: A significant proportion of hospitalized T2DM patients have macrovascular complications, associated with higher HbA1c levels. These findings emphasize the importance of good glycemic control to prevent such complications.\u0000J MEDICINE 2024; 25: 136-140","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641446","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}
Abstract not available J MEDICINE 2024; 25: 193-194
摘要不详 J MEDICINE 2024; 25: 193-194
{"title":"Obituary Vol. 25(2) Professor (Dr.) Md. Ridwanur Rahman","authors":"Editor in Cheif","doi":"10.3329/jom.v25i2.74971","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74971","url":null,"abstract":"Abstract not available\u0000J MEDICINE 2024; 25: 193-194","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"4 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141640195","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}
Tasmina Chowdhury, Md Mahmudul Hasan, I. Urmee, Khan Abul Kalam Azad, Md Shafiqul Islam
Ossification of the posterior longitudinal ligament (OPLL) is a rare but potentially devastating clinical entity of degenerative myelopathy. Highest reported prevalence of OPLL is in East Asian countries. The cervical spine is more commonly affected followed by thoracic and lumbar spine. The clinical manifestations range from asymptomatic to myelopathy or myeloradiculopathy. Although rare, thoracic OPLL is more severe than cervical OPLL and usually requires operative intervention. CT scan is the investigation of choice to determine the extent and thickness of the ossification. Treatment ranges from observation in patients with minimal symptoms to Surgical decompression followed by stabilization for patients with myelopathy. Here we discuss a middle-aged lady who presenting with a slowly progressive spastic paraplegia with bladder dysfunction, without sensory involvement. She was being treated conservatively as a case of spondylotic degenerative disease, but showed no improvement. Finally proper evaluation of her radiologic finding and clinical correlation revealed the diagnosis of OPLL. She underwent laminoplasty with decompressive surgery. The outcome was proved to be curative. J MEDICINE 2024; 25: 179-183
{"title":"Spastic Paraparesis in a Middle Aged Female Unmasked a Rare Cause of Myelopathy: Ossification of the Posterior Longitudinal Ligament (OPLL) - A Case Report","authors":"Tasmina Chowdhury, Md Mahmudul Hasan, I. Urmee, Khan Abul Kalam Azad, Md Shafiqul Islam","doi":"10.3329/jom.v25i2.74386","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74386","url":null,"abstract":"Ossification of the posterior longitudinal ligament (OPLL) is a rare but potentially devastating clinical entity of degenerative myelopathy. Highest reported prevalence of OPLL is in East Asian countries. The cervical spine is more commonly affected followed by thoracic and lumbar spine. The clinical manifestations range from asymptomatic to myelopathy or myeloradiculopathy. Although rare, thoracic OPLL is more severe than cervical OPLL and usually requires operative intervention. CT scan is the investigation of choice to determine the extent and thickness of the ossification. Treatment ranges from observation in patients with minimal symptoms to Surgical decompression followed by stabilization for patients with myelopathy. Here we discuss a middle-aged lady who presenting with a slowly progressive spastic paraplegia with bladder dysfunction, without sensory involvement. She was being treated conservatively as a case of spondylotic degenerative disease, but showed no improvement. Finally proper evaluation of her radiologic finding and clinical correlation revealed the diagnosis of OPLL. She underwent laminoplasty with decompressive surgery. The outcome was proved to be curative.\u0000J MEDICINE 2024; 25: 179-183","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141642340","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}
Md Abdul Quader, Anowar Ahmed Miajee, Nripen Kumar Kundu, Md Shamsuzzaman Shaheen
Acquired Hemophilia A (AHA) is a rare bleeding disorder. This results from autoantibodies to factor VIII (FVIII) that neutralizes the ability of factor VIII. This causes potentially severe bleeding episodes that carries a high risk of morbidity and mortality. Acquired Hemophilia usually occurs over 60 years of age or in postpartum period and associated with other autoimmune conditions. The diagnosis should be suspected when patients with new onset of bleeding without prior personal or family history of bleeding. The hallmark of this condition is mucocutaneous bleeding leading to ecchymosis, malena, hematoma, hematuria and spontaneous oozing from wounds. Management should uphold both hemostatic therapies to minimize bleeding and immune modulation strategies to re-establish immune tolerance to factor VIII. Here we present an older male case of such Acquired Hemophilia A without history of previous anticoagulant therapy as well as family history or personal history of bleeding episodes. The patient has got hemiarthroplasty with prosthesis with bone cementing due to fracture neck of femur. After 10th post-operative day he was diagnosed with clot retention in catheter in-situ and oozing from wound site after 12th post-operative day. His laboratory reports showed prolongation of Prothrombin Time (PT) and Activated Partial Prothrombin Time (APTT). His factor VIII was very low level and factor VIII inhibitor showed the time depended inhibitor presence. Thus diagnosed as Acquired Hemophilia A (AHA), the rare case in Bangladesh. He was managed with medications that resulted in normalization of factor VIII level. J MEDICINE 2024; 25: 173-175
获得性血友病 A（AHA）是一种罕见的出血性疾病。这是由于因子 VIII (FVIII) 的自身抗体中和了因子 VIII 的能力。这可能导致严重的出血发作，具有很高的发病率和死亡率。获得性血友病通常发生在 60 岁以上或产后，并伴有其他自身免疫性疾病。如果患者新近出现出血症状，且之前没有个人或家族出血史，则应怀疑诊断为后天性血友病。这种疾病的特征是粘膜出血，导致瘀斑、恶露、血肿、血尿和伤口自发渗出。治疗时应同时采用止血疗法和免疫调节策略，前者可最大限度地减少出血，后者则可重建对第八因子的免疫耐受。在此，我们介绍一例年龄较大的男性获得性血友病 A 患者，既往无抗凝剂治疗史，也无出血发作的家族史或个人史。患者因股骨颈骨折接受了半关节置换术，植入了骨水泥假体。术后第 10 天，他被诊断为原位导管内血块滞留，术后第 12 天伤口出现渗血。他的化验报告显示凝血酶原时间（PT）和活化部分凝血酶原时间（APTT）延长。他的第八因子水平很低，第八因子抑制剂显示存在时间依赖性抑制剂。因此，他被诊断为获得性血友病 A（AHA），这在孟加拉国非常罕见。通过药物治疗，他的第八因子水平恢复正常。
{"title":"Acquired Hemophilia A (AHA): A Rare Bleeding Disorder In a Tertiary Care Hospital In Dhaka, Bangladesh","authors":"Md Abdul Quader, Anowar Ahmed Miajee, Nripen Kumar Kundu, Md Shamsuzzaman Shaheen","doi":"10.3329/jom.v25i2.74380","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74380","url":null,"abstract":"Acquired Hemophilia A (AHA) is a rare bleeding disorder. This results from autoantibodies to factor VIII (FVIII) that neutralizes the ability of factor VIII. This causes potentially severe bleeding episodes that carries a high risk of morbidity and mortality. Acquired Hemophilia usually occurs over 60 years of age or in postpartum period and associated with other autoimmune conditions. The diagnosis should be suspected when patients with new onset of bleeding without prior personal or family history of bleeding. The hallmark of this condition is mucocutaneous bleeding leading to ecchymosis, malena, hematoma, hematuria and spontaneous oozing from wounds. Management should uphold both hemostatic therapies to minimize bleeding and immune modulation strategies to re-establish immune tolerance to factor VIII. Here we present an older male case of such Acquired Hemophilia A without history of previous anticoagulant therapy as well as family history or personal history of bleeding episodes. The patient has got hemiarthroplasty with prosthesis with bone cementing due to fracture neck of femur. After 10th post-operative day he was diagnosed with clot retention in catheter in-situ and oozing from wound site after 12th post-operative day. His laboratory reports showed prolongation of Prothrombin Time (PT) and Activated Partial Prothrombin Time (APTT). His factor VIII was very low level and factor VIII inhibitor showed the time depended inhibitor presence. Thus diagnosed as Acquired Hemophilia A (AHA), the rare case in Bangladesh. He was managed with medications that resulted in normalization of factor VIII level.\u0000J MEDICINE 2024; 25: 173-175","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"9 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141640415","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}
Rayeed Anan Surontee, Mohammad Mahfuzul Hoque, Tahsina Tasneem, Md Fariduzzaman, Md Mehedi Hasan, Md Shafiqul Bari
Leptospirosis and scrub typhus are common zoontic illnesses in tropical countries. Leptospira, a spirochaete, can cause leptospirosis when a patient comes in contact with contaminated water. Following a period of bacteraemic illness, leptospirosis may progress to a more severe form. Weil’s disease is a severe form of leptospirosis characterised by jaundice, haemorrhage and acute kidney injury. Scrub typhus, a rickettsial disease, common in South-East Asia is caused by Orientia tsutsugamushi occurs due to bite of Trombicula mite. An eschar forms at the site of the bite. Here we present a case of a 60-year-old gentleman, hailing from Savar who was diagnosed as a case of coinfection of scrub typhus and leptospirosis. Patient presented with an eschar, high grade fever and features of Weil’s disease. He didn’t initially respond to Ceftriaxone and then Doxycycline was added after which he became afebrile. J MEDICINE 2024; 25: 187-190
{"title":"Coinfection of Leptospirosis with Scrub Typhus: A Case Report","authors":"Rayeed Anan Surontee, Mohammad Mahfuzul Hoque, Tahsina Tasneem, Md Fariduzzaman, Md Mehedi Hasan, Md Shafiqul Bari","doi":"10.3329/jom.v25i2.74660","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74660","url":null,"abstract":"Leptospirosis and scrub typhus are common zoontic illnesses in tropical countries. Leptospira, a spirochaete, can cause leptospirosis when a patient comes in contact with contaminated water. Following a period of bacteraemic illness, leptospirosis may progress to a more severe form. Weil’s disease is a severe form of leptospirosis characterised by jaundice, haemorrhage and acute kidney injury. Scrub typhus, a rickettsial disease, common in South-East Asia is caused by Orientia tsutsugamushi occurs due to bite of Trombicula mite. An eschar forms at the site of the bite. Here we present a case of a 60-year-old gentleman, hailing from Savar who was diagnosed as a case of coinfection of scrub typhus and leptospirosis. Patient presented with an eschar, high grade fever and features of Weil’s disease. He didn’t initially respond to Ceftriaxone and then Doxycycline was added after which he became afebrile.\u0000J MEDICINE 2024; 25: 187-190","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"3 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641731","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}
Mohammad Rafiqul Islam, Latif Raiyan Rahman, N. Murch
Bangladesh has an ageing population, with increased multi-morbidity and polypharmacy. Acute care is becoming more complex, with increased admission numbers and little alternative to hospital attendance and admission. Alternative models of care are discussed, that include new ways of working and use of novel training techniques including technology such as point of care testing including ultrasound. The use of ambulatory care is also proposed, with rapid access and even virtual outpatient clinics. The development of specialist acute generalists can enable other clinicians to develop more specialised skills including managing separate gastrointestinal bleeding rotas and heart attack or stroke units. Standardised care at the front door can reduce variability in practice and promote excellence in acute care for all patients. The potential pros and cons of developing an acute (internal) medicine model in Bangladesh are discussed. J MEDICINE 2024; 25: 159-165
{"title":"Acute Medicine – Needs and Challenges: The Bangladesh Perspective","authors":"Mohammad Rafiqul Islam, Latif Raiyan Rahman, N. Murch","doi":"10.3329/jom.v25i2.74296","DOIUrl":"https://doi.org/10.3329/jom.v25i2.74296","url":null,"abstract":"Bangladesh has an ageing population, with increased multi-morbidity and polypharmacy. Acute care is becoming more complex, with increased admission numbers and little alternative to hospital attendance and admission. Alternative models of care are discussed, that include new ways of working and use of novel training techniques including technology such as point of care testing including ultrasound. The use of ambulatory care is also proposed, with rapid access and even virtual outpatient clinics. The development of specialist acute generalists can enable other clinicians to develop more specialised skills including managing separate gastrointestinal bleeding rotas and heart attack or stroke units. Standardised care at the front door can reduce variability in practice and promote excellence in acute care for all patients. The potential pros and cons of developing an acute (internal) medicine model in Bangladesh are discussed.\u0000J MEDICINE 2024; 25: 159-165","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"2 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141640661","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}
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