Background: Psoriatic Arthritis (PsA) is a complex seronegative inflammatory arthritis associated with psoriasis, characterized by a wide range of clinical manifestations. This study aimed to explore the prevalence of PsA in arthritic patients along with associated demographic and clinical characteristics in a tertiary care setting in Bangladesh. Methods: This cross-sectional study was conducted at the Rheumatology Clinic of Dhaka Medical College Hospital over a period of 6 months from March 2018 to August 2018. A total of 600 arthritis patients underwent screening for PsA, with subsequent evaluations of confirmed cases based on the CASPAR criteria. Demographic and clinical characteristics were documented through face-to-face interviews and physical examination. For data collection, a pre-structured questionnaire was used. Disease activity was assessed using the DAPSA score. The study was conducted according to the ‘Declaration of Helsinki’. The statistical analysis was done with SPSS v-21. Results: The prevalence of PsA in arthritis patients was 5%. Age distribution of PsA showed a majority in between 30-39 years age group with a mean of 36.33±11.86 (SD). Slight female predominance was reported with a percentage of 53.3%. Almost three-fourths of study patients presented with a current diagnosis of psoriasis while the rest had a personal history or family history. A higher incidence (67.7%) of plaque psoriasis was observed followed by sebopsoriasis (20%) and for the rest of the patients, the type of psoriasis was unknown. The disease mostly involved multiple joints (90%), with ankle and metacarpal joints being the most commonly affected at 43.3% and 33.3%, respectively. Disease activity was high in the majority of the patients according to the DAPSA score, representing 53.34% of the patients, with the remainder exhibiting moderate to low disease activity. Conclusion: The study revealed a significant incidence of PsA among the arthritic population which indicates a pressing need for further extensive research on PsA across diverse populations. J MEDICINE 2024; 25: 35-40
{"title":"Prevalence of Psoriatic Arthritis among Patients with Arthritis: Insights from a Tertiary Rheumatology Clinic in Bangladesh","authors":"Sayeef Hossain Khan Mark, Rasif Hossain Khan, Shaima Rahman Mishu, Warda Mozammel, Md Mujibur Rahman","doi":"10.3329/jom.v25i1.70524","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70524","url":null,"abstract":"Background: Psoriatic Arthritis (PsA) is a complex seronegative inflammatory arthritis associated with psoriasis, characterized by a wide range of clinical manifestations. This study aimed to explore the prevalence of PsA in arthritic patients along with associated demographic and clinical characteristics in a tertiary care setting in Bangladesh.\u0000Methods: This cross-sectional study was conducted at the Rheumatology Clinic of Dhaka Medical College Hospital over a period of 6 months from March 2018 to August 2018. A total of 600 arthritis patients underwent screening for PsA, with subsequent evaluations of confirmed cases based on the CASPAR criteria. Demographic and clinical characteristics were documented through face-to-face interviews and physical examination. For data collection, a pre-structured questionnaire was used. Disease activity was assessed using the DAPSA score. The study was conducted according to the ‘Declaration of Helsinki’. The statistical analysis was done with SPSS v-21.\u0000Results: The prevalence of PsA in arthritis patients was 5%. Age distribution of PsA showed a majority in between 30-39 years age group with a mean of 36.33±11.86 (SD). Slight female predominance was reported with a percentage of 53.3%. Almost three-fourths of study patients presented with a current diagnosis of psoriasis while the rest had a personal history or family history. A higher incidence (67.7%) of plaque psoriasis was observed followed by sebopsoriasis (20%) and for the rest of the patients, the type of psoriasis was unknown. The disease mostly involved multiple joints (90%), with ankle and metacarpal joints being the most commonly affected at 43.3% and 33.3%, respectively. Disease activity was high in the majority of the patients according to the DAPSA score, representing 53.34% of the patients, with the remainder exhibiting moderate to low disease activity.\u0000Conclusion: The study revealed a significant incidence of PsA among the arthritic population which indicates a pressing need for further extensive research on PsA across diverse populations.\u0000J MEDICINE 2024; 25: 35-40","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"36 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386395","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}
Background: Chronic liver disease (CLD) in the clinical context is a disease process of the liver that involves a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. Liver diseases are frequently associated with hematological abnormalities. Bleeding and defective blood coagulation contributes to the anemia in CLD patients. Other mechanisms of anemia include aplastic anemia secondary to previous hepatitis, or side effects of treatment of hepatitis with chemotherapeutic agent. Other different factors, such as malabsorption, malnutrition or direct toxic effect also contribute to hematological abnormalities. The examination of complete blood count is common, economically cheap and readily available laboratory procedure. Red cell indices are valuable in the evaluation of morphologic characteristic of anaemias or hematological abnormalities in CLD patients. Objectives: To assess the red cell indices in chronic liver disease patients. Materials & method: This descriptive type of cross-sectional study was conducted in Department of Medicine, Dhaka Medical College Hospital, Dhaka, among 75 cases of Chronic liver disease patients. Samples were selected by purposive sampling technique. Detail demographic data were collected from the patients and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Results was presented by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc. Result: Maximum number of patients, 37(49.3%) were between 31-40 years of age with mean age of the patient was 37.58 ± 8.23 years. Out of 75 cases 58(77.0%) patients were male and 17(23.0%) were female. Male-female ratio was 3.34:1. Majority of patients belonged to Child Pugh score B. Prevalence of anaemia was 54(72%) in CLD patients. Microcytic anaemia was predominant and Normocytic anaemia was second most common. Hb concentration & MCV decreases with the severity of Child Pugh score. Abnormalities of red cell indices were positively associated with severity of CLD. Conclusion: Present study concluded that chronic liver diseases are associated with hematological abnormalities. Patients with severe hepatocellular disease develop defects of blood coagulation as a consequence of endothelial dysfunction, thrombocytopenia, deficiencies of coagulation factors and various associated disorders. In overall patients, Child Pugh class C cases had significant low hemoglobin in comparison to rest of group. Assessing the severity and type of anaemia by red cell indices is a useful tool for proper treatment, prognosis in patients of CLD for reducing the mortality and morbidity. J MEDICINE 2024; 25: 41-45
{"title":"Study on Red Cell Indices in Chronic Liver Disease in Tertiary Level Hospital","authors":"Rafiya Afroz, S. Deb, Ahmedul Kabir","doi":"10.3329/jom.v25i1.70525","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70525","url":null,"abstract":"Background: Chronic liver disease (CLD) in the clinical context is a disease process of the liver that involves a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. Liver diseases are frequently associated with hematological abnormalities. Bleeding and defective blood coagulation contributes to the anemia in CLD patients. Other mechanisms of anemia include aplastic anemia secondary to previous hepatitis, or side effects of treatment of hepatitis with chemotherapeutic agent. Other different factors, such as malabsorption, malnutrition or direct toxic effect also contribute to hematological abnormalities. The examination of complete blood count is common, economically cheap and readily available laboratory procedure. Red cell indices are valuable in the evaluation of morphologic characteristic of anaemias or hematological abnormalities in CLD patients.\u0000Objectives: To assess the red cell indices in chronic liver disease patients.\u0000Materials & method: This descriptive type of cross-sectional study was conducted in Department of Medicine, Dhaka Medical College Hospital, Dhaka, among 75 cases of Chronic liver disease patients. Samples were selected by purposive sampling technique. Detail demographic data were collected from the patients and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Results was presented by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc.\u0000Result: Maximum number of patients, 37(49.3%) were between 31-40 years of age with mean age of the patient was 37.58 ± 8.23 years. Out of 75 cases 58(77.0%) patients were male and 17(23.0%) were female. Male-female ratio was 3.34:1. Majority of patients belonged to Child Pugh score B. Prevalence of anaemia was 54(72%) in CLD patients. Microcytic anaemia was predominant and Normocytic anaemia was second most common. Hb concentration & MCV decreases with the severity of Child Pugh score. Abnormalities of red cell indices were positively associated with severity of CLD.\u0000Conclusion: Present study concluded that chronic liver diseases are associated with hematological abnormalities. Patients with severe hepatocellular disease develop defects of blood coagulation as a consequence of endothelial dysfunction, thrombocytopenia, deficiencies of coagulation factors and various associated disorders. In overall patients, Child Pugh class C cases had significant low hemoglobin in comparison to rest of group. Assessing the severity and type of anaemia by red cell indices is a useful tool for proper treatment, prognosis in patients of CLD for reducing the mortality and morbidity.\u0000J MEDICINE 2024; 25: 41-45","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"61 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386728","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":"The Dengue Outbreak of 2023: A Wake-Up Call for Healthcare Professionals and Policymakers for Effective Prevention and Control Strategies","authors":"Quazi Tarikul Islam","doi":"10.3329/jom.v25i1.70358","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70358","url":null,"abstract":"Abstract not available\u0000J MEDICINE 2024; 25: 1-3","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"57 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139384706","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}
Hypereosinophilia is a rare collection of syndromes of various etiologies that can present incidentally or in some cases, in a life-threatening manner. This is a unique case of a 38-year-old male who presented with acute encephalopathy following a cerebrovascular event and was later found to have elevated eosinophil counts. It is crucial to have high clinical suspicion to diagnose this rare disease when a patient presents with multi-organ dysfunction with no clear etiology, especially when involving a presentation of acute onset in a relatively young patient. J MEDICINE 2024; 25: 94-97
{"title":"Rare Case of Primary Hypereosinophilic Syndrome","authors":"A. Bs, Farzana Hoque","doi":"10.3329/jom.v25i1.70535","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70535","url":null,"abstract":"Hypereosinophilia is a rare collection of syndromes of various etiologies that can present incidentally or in some cases, in a life-threatening manner. This is a unique case of a 38-year-old male who presented with acute encephalopathy following a cerebrovascular event and was later found to have elevated eosinophil counts. It is crucial to have high clinical suspicion to diagnose this rare disease when a patient presents with multi-organ dysfunction with no clear etiology, especially when involving a presentation of acute onset in a relatively young patient.\u0000J MEDICINE 2024; 25: 94-97","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"25 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385225","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}
Pericardial effusion presentation is a large spectrum that can vary from asymptomatic to cardiac tamponade. It is a relatively common syndrome and has a diverse set of etiologies including infections, malignancy, radiation/iatrogenic, pericardial injury, metabolic disturbances, endocrine disease, connective tissue disease, autoimmune disorders, trauma, or idiopathic. Pericardial drainage is recommended in most large pericardial effusions or those causing cardiac tamponade. Pericardial fluid can be either purulent, serous, serosanguinous, or hemorrhagic. In the case of hemorrhagic effusion, the common etiologies include malignancy, iatrogenic, and tuberculosis (in endemic regions). Large hemorrhagic pericardial effusions resulting from idiopathic (presumed viral) pericarditis are rare but possible. We present an interesting case of a woman with a large hemorrhagic pericardial effusion presenting as subacute cardiac tamponade caused by idiopathic pericarditis in the setting of known malignancy. This report aims to increase awareness about pericarditis as a potential cause of significant hemorrhagic pericardial effusions, rather than solely attributing them to malignancy. J MEDICINE 2024; 25: 87-89
{"title":"Idiopathic Pericarditis Leading to Hemorrhagic Pericardial Effusion- A Case Report and Review","authors":"F. Bs, Farzana Hoque","doi":"10.3329/jom.v25i1.70533","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70533","url":null,"abstract":"Pericardial effusion presentation is a large spectrum that can vary from asymptomatic to cardiac tamponade. It is a relatively common syndrome and has a diverse set of etiologies including infections, malignancy, radiation/iatrogenic, pericardial injury, metabolic disturbances, endocrine disease, connective tissue disease, autoimmune disorders, trauma, or idiopathic. Pericardial drainage is recommended in most large pericardial effusions or those causing cardiac tamponade. Pericardial fluid can be either purulent, serous, serosanguinous, or hemorrhagic. In the case of hemorrhagic effusion, the common etiologies include malignancy, iatrogenic, and tuberculosis (in endemic regions). Large hemorrhagic pericardial effusions resulting from idiopathic (presumed viral) pericarditis are rare but possible. We present an interesting case of a woman with a large hemorrhagic pericardial effusion presenting as subacute cardiac tamponade caused by idiopathic pericarditis in the setting of known malignancy. This report aims to increase awareness about pericarditis as a potential cause of significant hemorrhagic pericardial effusions, rather than solely attributing them to malignancy.\u0000J MEDICINE 2024; 25: 87-89","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385683","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}
Background: Non-alcoholic fatty liver disease (NAFLD) encompasses the simple steatosis to more progressive steatosis with associated hepatitis, fibrosis and cirrhosis. Though accurate diagnosis of simple fatty liver (SFL) and non-alcoholic steatohepatitis (NASH) can be made by liver biopsy, it is not feasible to be done in all NAFLD patients. Relationship of C-reactive protein (CRP) with NAFLD was well documented in many populations, but comprehensive data is lacking in Bangladeshi people. Method: This case-control study was conducted at the Medicine, Gastroenterology and Hepatology departments in Dhaka Medical College Hospital from March to August 2018 involving 30 patients with NAFLD as case and apparently healthy 30 individuals as control. Abdominal ultrasound to detect fatty liver and serum CRP level estimation by nephelometry were performed for each subject to compare between two groups. Result: Majority of the NAFLD cases and healthy controls were female (70% and 60% respectively). Mean age was 47.53±9.69 year in NAFLD group and 46.03±8.44 year in healthy controls. NAFLD cases had significantly higher mean serum CRP concentration (6.27±1.80) mg/dl than that of healthy controls (3.94±2.16) mg/dl (p<0.001). Overweight/obesity and dyslipidaemia were found as significant risk factors for NAFLD compared to the healthy control group (p<0.05). Conclusion: NAFLD cases had significantly higher CRP than the control group. But, to find out the association of increasing CRP level with the severity of NAFLD and to establish it as a diagnostic tool, further extensive studies are recommended. J MEDICINE 2024; 25: 5-10
{"title":"Comparison of Serum C-Reactive Protein (CRP) Level Between Non-Alcoholic Fatty Liver Disease (NAFLD) Cases and Healthy Adults: A Cross-sectional Analytical Study.","authors":"Md Mohi Uddin, Mahbuba Shabnam, Md Khairul Islam, Farhana Afrooz, G. Banik","doi":"10.3329/jom.v25i1.70519","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70519","url":null,"abstract":"Background: Non-alcoholic fatty liver disease (NAFLD) encompasses the simple steatosis to more progressive steatosis with associated hepatitis, fibrosis and cirrhosis. Though accurate diagnosis of simple fatty liver (SFL) and non-alcoholic steatohepatitis (NASH) can be made by liver biopsy, it is not feasible to be done in all NAFLD patients. Relationship of C-reactive protein (CRP) with NAFLD was well documented in many populations, but comprehensive data is lacking in Bangladeshi people.\u0000Method: This case-control study was conducted at the Medicine, Gastroenterology and Hepatology departments in Dhaka Medical College Hospital from March to August 2018 involving 30 patients with NAFLD as case and apparently healthy 30 individuals as control. Abdominal ultrasound to detect fatty liver and serum CRP level estimation by nephelometry were performed for each subject to compare between two groups.\u0000Result: Majority of the NAFLD cases and healthy controls were female (70% and 60% respectively). Mean age was 47.53±9.69 year in NAFLD group and 46.03±8.44 year in healthy controls. NAFLD cases had significantly higher mean serum CRP concentration (6.27±1.80) mg/dl than that of healthy controls (3.94±2.16) mg/dl (p<0.001). Overweight/obesity and dyslipidaemia were found as significant risk factors for NAFLD compared to the healthy control group (p<0.05).\u0000Conclusion: NAFLD cases had significantly higher CRP than the control group. But, to find out the association of increasing CRP level with the severity of NAFLD and to establish it as a diagnostic tool, further extensive studies are recommended.\u0000J MEDICINE 2024; 25: 5-10","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"57 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386843","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}
Background: Chronic liver disease is a major burden with increased rates of morbidity & mortality worldwide. The role of endoscopy in liver disease is both diagnostic and interventional and a key to achieving a better outcome for the disease. Multiple presentations of CLD can be found at endoscopic evaluation. This study aimed at evaluation of the pattern of presentation of the endoscopic features of the admitted patients in Dhaka Medical College Hospital. Materials & Methods: This cross-sectional study was conducted over 100 adult patients of Chronic Liver Disease in Dhaka Medical College Hospital, from 1st of July 2019 to 31st of December 2019. After getting written informed consent, a detailed history, clinical examination, relevant investigations and upper GI endoscopy was carried out in each patient. All the methods in the present study were carried out following the ethical guidelines of the 1975 Declaration of Helsinki. Data were recorded in separated case record form and analyzed by IBM SPSS version 26. Results: Our study found that majority (43%) of the patients were aged between 41 to 50 years; 69% were male & 31% female. Mostly Hepatitis B virus infection was the etiology. The commonest (38%) endoscopic finding being the presence of both esophageal & gastric varices along with Grade III varices encompassing the largest entity (63.4%). Conclusion: More than half of the patients with gastro-esophageal varies has Grade III varices putting them in higher risk of morbidity and mortality. J MEDICINE 2023; 24(2): 135-138
{"title":"Endoscopic Features of Chronic Liver Disease Patients Admitted in a Tertiary Care Hospital in Bangladesh- A Cross Sectional Study","authors":"A. Siddiqua, Mahbub Mayukh Rishad, Nawsabah Noor, Ishrat Binte, Aparna Das, Nazmul Ahasan","doi":"10.3329/jom.v24i2.67277","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67277","url":null,"abstract":"Background: Chronic liver disease is a major burden with increased rates of morbidity & mortality worldwide. The role of endoscopy in liver disease is both diagnostic and interventional and a key to achieving a better outcome for the disease. Multiple presentations of CLD can be found at endoscopic evaluation. This study aimed at evaluation of the pattern of presentation of the endoscopic features of the admitted patients in Dhaka Medical College Hospital.\u0000Materials & Methods: This cross-sectional study was conducted over 100 adult patients of Chronic Liver Disease in Dhaka Medical College Hospital, from 1st of July 2019 to 31st of December 2019. After getting written informed consent, a detailed history, clinical examination, relevant investigations and upper GI endoscopy was carried out in each patient. All the methods in the present study were carried out following the ethical guidelines of the 1975 Declaration of Helsinki. Data were recorded in separated case record form and analyzed by IBM SPSS version 26.\u0000Results: Our study found that majority (43%) of the patients were aged between 41 to 50 years; 69% were male & 31% female. Mostly Hepatitis B virus infection was the etiology. The commonest (38%) endoscopic finding being the presence of both esophageal & gastric varices along with Grade III varices encompassing the largest entity (63.4%).\u0000Conclusion: More than half of the patients with gastro-esophageal varies has Grade III varices putting them in higher risk of morbidity and mortality.\u0000J MEDICINE 2023; 24(2): 135-138","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43011797","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}
Backgrounds: Interleukin 4 (IL 4) is a cytokine associated with the cause of several allergic diseases such as asthma due to their function in the differentiation of T helper type 2 lymphocytes and induction of the IgE isotype switch. Object: The study aims to determine the association IL-4 level with total serum IgE levels and asthma severity. Methods: A cross-section study was performed. Eighty-seven subjects were recruited from Karbala Teaching Hospital for Children in the period extending from January 25 to May 24, 2022, including children with asthma, were subjected to measure IL 4 level using Elabscience ELISA kit and measured total IgE level using AccuBind IgE ELISA kit. Results: Eighty-seven subjects of asthmatic children in which the mean age was 7.833 ± 3.652. There are 65.52% and 34.48% of asthmatic children (male and female, respectively). Total serum IgE was 398.889 ± 227.156 IU/ml, while the IL-4 level was 5.18 ± 8.224. There was a significant difference in IL 4 levels depending on asthma severity (P= 0.037). IL-4 levels in severe persistent asthma were higher than IL-4 levels in mild and moderate persistent asthma. Further, there was a highly significant difference in IL 4 levels depending on asthma controlled (P= 0.004). IL-4 levels in not well-controlled asthma were higher than IL-4 levels in well and partial controlled asthma. In addition, there was no significant correlation between IL-4 levels and total serum IgE levels (P=0.436). Conclusion: IL 4 has an important role in predicting asthma severity and asthma control in children. These findings have important implications for the treatment of IgE-mediated asthma. Despite this, IL 4 levels have no significant correlation with total serum IgE levels. J MEDICINE 2023; 24(2): 89-95
{"title":"Association of Interleukin-4 in Immunoglobulin-E Mediated Asthma: A Cross Sectional Study","authors":"R. Hameed, Haidar Najim Abood, H. Al-Hasnawy","doi":"10.3329/jom.v24i2.67270","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67270","url":null,"abstract":"Backgrounds: Interleukin 4 (IL 4) is a cytokine associated with the cause of several allergic diseases such as asthma due to their function in the differentiation of T helper type 2 lymphocytes and induction of the IgE isotype switch.\u0000Object: The study aims to determine the association IL-4 level with total serum IgE levels and asthma severity. Methods: A cross-section study was performed. Eighty-seven subjects were recruited from Karbala Teaching Hospital for Children in the period extending from January 25 to May 24, 2022, including children with asthma, were subjected to measure IL 4 level using Elabscience ELISA kit and measured total IgE level using AccuBind IgE ELISA kit.\u0000Results: Eighty-seven subjects of asthmatic children in which the mean age was 7.833 ± 3.652. There are 65.52% and 34.48% of asthmatic children (male and female, respectively). Total serum IgE was 398.889 ± 227.156 IU/ml, while the IL-4 level was 5.18 ± 8.224. There was a significant difference in IL 4 levels depending on asthma severity (P= 0.037). IL-4 levels in severe persistent asthma were higher than IL-4 levels in mild and moderate persistent asthma. Further, there was a highly significant difference in IL 4 levels depending on asthma controlled (P= 0.004). IL-4 levels in not well-controlled asthma were higher than IL-4 levels in well and partial controlled asthma. In addition, there was no significant correlation between IL-4 levels and total serum IgE levels (P=0.436).\u0000Conclusion: IL 4 has an important role in predicting asthma severity and asthma control in children. These findings have important implications for the treatment of IgE-mediated asthma. Despite this, IL 4 levels have no significant correlation with total serum IgE levels.\u0000J MEDICINE 2023; 24(2): 89-95","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42154721","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}
Nur mohammad Rakib, Mahbub Mayukh Rishad, SM Kawser Zafor Prince, Miftahul Jannat, Tazbiha Rahman Khan, Talha Islam Zinan, Tanvir Jeshan, Md. Alamgir Kabir
Background: Inherited Haemoglobin (Hb) disorders are the most frequent genetic hereditary disorders with an increasing global health burden, especially in low- and middle-income countries. This disorder is mostly caused by a point mutation on a globin gene resulting mostly in single amino acid substitutions and consequently defective globin chain production or reduced production of normal haemoglobin. Despite the limited study of this country regarding this issue, the number of individuals suffering from inherited Hb disorders is not negligible. Thus, the study was designed to evaluate the types of inherited haemoglobin disorders among the patients attending the haematology outdoor of Dhaka Medical College Hospital (DMCH). Methods: This hospital-based cross-sectional study was conducted at the Department of Haematology in DMCH, for a period of 6 months (June 2022 to November 2022. People attending the Haematology outpatient department and diagnosed with a case of inherited Hb disorder were approached for inclusion. Written informed consent was taken from each subject. Ethical issues were ensured properly. For the study, a total of 100 patients were interviewed for less than 30 minutes of duration in each case. Relevant investigations such as, Hemoglobin (Hb), Red Cell Count (RCC), MCV, MCH, MCHC, RDW, Reticulocyte, Serum ferritin were done in the Haematology lab of DMCH, and data were collected in a semi-structured questionnaire. Collected Data were analyzed by SPSS 21. Results: Out of 100 inherited Hb disorder subjects, the majority (60 or 60%) were from the age group of 14 to 24 years. The mean age of patients was 38.78 ± 6.09 with range 15-51 years. The male-female ratio was 1:1. The majority (58%) came from rural areas and 42% came from urban areas. Mean value of Hb was 10.54; subsequently, MCV (63.25), MCH (22.18), S ferritin (140.43). The majority of patients had their onset of clinical presentation of illness for 5 years. Among total subjects, two-thirds of the patients (66 or 66%) had Hb E Disease followed by 14% Beta thalassaemia trait, 14% Hb E trait, and 6% b thalassaemia major. No association was noted between the type of thalassaemia with age & sex of the subjects. Conclusion: Irrespective of age and sex variations, Hb E disease is the most frequent inherited haemoglobin disorder among the patient attending the haematology outdoor of a tertiary care hospital. J MEDICINE 2023; 24(2): 96-105
{"title":"Types of Inherited Hemoglobin Disorders Among the Patients Attending Hematology Outdoor of a Tertiary Care Hospital in Bangladesh","authors":"Nur mohammad Rakib, Mahbub Mayukh Rishad, SM Kawser Zafor Prince, Miftahul Jannat, Tazbiha Rahman Khan, Talha Islam Zinan, Tanvir Jeshan, Md. Alamgir Kabir","doi":"10.3329/jom.v24i2.67271","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67271","url":null,"abstract":"Background: Inherited Haemoglobin (Hb) disorders are the most frequent genetic hereditary disorders with an increasing global health burden, especially in low- and middle-income countries. This disorder is mostly caused by a point mutation on a globin gene resulting mostly in single amino acid substitutions and consequently defective globin chain production or reduced production of normal haemoglobin. Despite the limited study of this country regarding this issue, the number of individuals suffering from inherited Hb disorders is not negligible. Thus, the study was designed to evaluate the types of inherited haemoglobin disorders among the patients attending the haematology outdoor of Dhaka Medical College Hospital (DMCH).\u0000Methods: This hospital-based cross-sectional study was conducted at the Department of Haematology in DMCH, for a period of 6 months (June 2022 to November 2022. People attending the Haematology outpatient department and diagnosed with a case of inherited Hb disorder were approached for inclusion. Written informed consent was taken from each subject. Ethical issues were ensured properly. For the study, a total of 100 patients were interviewed for less than 30 minutes of duration in each case. Relevant investigations such as, Hemoglobin (Hb), Red Cell Count (RCC), MCV, MCH, MCHC, RDW, Reticulocyte, Serum ferritin were done in the Haematology lab of DMCH, and data were collected in a semi-structured questionnaire. Collected Data were analyzed by SPSS 21.\u0000Results: Out of 100 inherited Hb disorder subjects, the majority (60 or 60%) were from the age group of 14 to 24 years. The mean age of patients was 38.78 ± 6.09 with range 15-51 years. The male-female ratio was 1:1. The majority (58%) came from rural areas and 42% came from urban areas. Mean value of Hb was 10.54; subsequently, MCV (63.25), MCH (22.18), S ferritin (140.43). The majority of patients had their onset of clinical presentation of illness for 5 years. Among total subjects, two-thirds of the patients (66 or 66%) had Hb E Disease followed by 14% Beta thalassaemia trait, 14% Hb E trait, and 6% b thalassaemia major. No association was noted between the type of thalassaemia with age & sex of the subjects.\u0000Conclusion: Irrespective of age and sex variations, Hb E disease is the most frequent inherited haemoglobin disorder among the patient attending the haematology outdoor of a tertiary care hospital.\u0000J MEDICINE 2023; 24(2): 96-105","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45980009","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}
Background: Radiological phenotypes are radiological patterns or observable characteristics of COVID- 19 pneumonia. Methods: Prospective observational study, included 3000 COVID-19 RT-PCR confirmed cases with lung involvement documented and categorized on HRCT thorax at entry point as mild, moderate and severe as per lung segment involvement bilaterally and follow up CT thorax imaging at six months post discharge from hospital. Radiological phenotypes were categorized as ‘Evolved’ and ‘Evolving’ as per radiological features and analysed with inflammatory markers and interventions required in indoor setting including ventilatory support. Age, gender, Comorbidity, laboratory parameters and use of BIPAP/NIV in COVID-19 cases and outcome as with or without lung fibrosis were key observations. Statistical analysis is done by using Chi square test. Results: In study of 3000 COVID-19 RT PCR confirmed pneumonia, ‘Evolved’ and ‘Evolving’ radiological phenotype patterns were observed in 36.66% and 63.33% respectively. Duration of illness, laboratory parameters at entry point (CRP, IL-6, ferritin, LDH, D-dimer) & interventions required in indoor unit has significant association with Radiological phenotypes [p<0.00001] HRCT severity score at entry point & Post COVID-19 lung fibrosis or sequelae has significant association with radiological phenotypes. [p<0.00001] Conclusions: Radiological phenotypes have documented very crucial role in initial assessment of COVID- 19 pneumonia. Evolved and Evolving differentiation have documented important step in management of these cases in indoor and outdoor setting. J MEDICINE 2023; 24(2): 71-81
{"title":"Radiological Patterns Integration with Duration of Illness in COVID-19 Pneumonia as ‘Evolved’ and ‘Evolving’ Radiological Phenotypes: A Single Center Experience","authors":"S. Patil, Neel Tandel, L. Kasture, G. Gondhali","doi":"10.3329/jom.v24i2.67268","DOIUrl":"https://doi.org/10.3329/jom.v24i2.67268","url":null,"abstract":"Background: Radiological phenotypes are radiological patterns or observable characteristics of COVID- 19 pneumonia.\u0000Methods: Prospective observational study, included 3000 COVID-19 RT-PCR confirmed cases with lung involvement documented and categorized on HRCT thorax at entry point as mild, moderate and severe as per lung segment involvement bilaterally and follow up CT thorax imaging at six months post discharge from hospital. Radiological phenotypes were categorized as ‘Evolved’ and ‘Evolving’ as per radiological features and analysed with inflammatory markers and interventions required in indoor setting including ventilatory support. Age, gender, Comorbidity, laboratory parameters and use of BIPAP/NIV in COVID-19 cases and outcome as with or without lung fibrosis were key observations. Statistical analysis is done by using Chi square test.\u0000Results: In study of 3000 COVID-19 RT PCR confirmed pneumonia, ‘Evolved’ and ‘Evolving’ radiological phenotype patterns were observed in 36.66% and 63.33% respectively. Duration of illness, laboratory parameters at entry point (CRP, IL-6, ferritin, LDH, D-dimer) & interventions required in indoor unit has significant association with Radiological phenotypes [p<0.00001] HRCT severity score at entry point & Post COVID-19 lung fibrosis or sequelae has significant association with radiological phenotypes. [p<0.00001]\u0000Conclusions: Radiological phenotypes have documented very crucial role in initial assessment of COVID- 19 pneumonia. Evolved and Evolving differentiation have documented important step in management of these cases in indoor and outdoor setting.\u0000J MEDICINE 2023; 24(2): 71-81","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44319565","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：