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Obituary news January-2023 讣告新闻 2023 年 1 月
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.74104
K. Halim
Abstract not available Bangladesh Med J. 2023 Jan; 52(1): 39
摘要不详 孟加拉国医学杂志》,2023 年 1 月;52(1):39
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引用次数: 0
Diagnosis and Prognosis of Neonatal Septic Arthritis from it’s Early Clinical Characteristics: Experience from a Tertiary Care Hospital 从新生儿化脓性关节炎的早期临床特征诊断和预后:一家三级医院的经验
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.71043
R. M. Chowdhury, Krishna Priya Das, Md Abdul Mannan, S. Moni, Shahanara Akter
Neonatal septic arthritis (NSA) is an unusual illness, but fatal clinical condition and must be diagnosed and treated properly in order to save the neonate's joints and life. High rate of morbidity and mortality may result from NSA if left untreated. Majority of NSA cases in developing countries present themselves late at the health care facilities, making the diagnosis difficult and sometimes overlooked by health care providers. Although septic arthritis has already been investigated but cases of NSA from developing countries are under reported. The goal of the study was to better understand the clinical and microbiological characteristics of neonates with septic arthritis as well as their prognosis of treatment.  This prospective observational study was conducted in Neonatal Intensive Care Unit (NICU) of Department of Neonatology and Out Patient Department (OPD) of Orthopaedics, Banga bandhu Sheikh Mujib Medical University (BSMMU). Total 30 neonate presented with acute septic arthritis were included in this study. Data were collected by reviewing record from NICU and   disease course, investigation profiles, treatment record of neonates were noted as recorded during the time of hospital stay or attending in OPD. For the assessment of prognosis clinical and radiological findings of all cases were followed-up for 12 months of age. Collected data of neonates with septic arthritis from record review were processed and analyzed by Statistical Package for the Social Sciences (SPSS) and result of analyzed, finally data were presented as in tables and graphs. This study finds that  nearly two-third (63%) of the neonates were male and knee joint was most frequently involved, accounting more than two-third ( 67%) of all single joint involvements. All of the cases were anemic and had high C-reactive protein (CRP) level.  Joint aspirate samples culture showed that the most prevalent (41%) organism was Klebsiella, followed by Acenotobacter and Seratia. Gram-negative bacteria predominated (91%). Most of the patient (76%) had favorable prognosis after treatment. Clinical evaluation and start of intravenous antibiotics should be given priority in suspected cases. Prompt surgical intervention and consistent follow-up in a tertiary hospital are necessary for the best results.Bangladesh Med J. 2023 Jan; 52(1): 18-23
新生儿化脓性关节炎(NSA)是一种不常见的疾病,但却是一种致命的临床症状,必须得到正确的诊断和治疗,才能挽救新生儿的关节和生命。如果不及时治疗,新生儿缺血性关节炎可能会导致很高的发病率和死亡率。在发展中国家,大多数 NSA 病例在医疗机构就诊时间较晚,因此诊断困难,有时甚至会被医疗服务提供者忽视。虽然已经对化脓性关节炎进行了调查,但发展中国家的非传染性关节炎病例却鲜有报道。这项研究的目的是更好地了解患有化脓性关节炎的新生儿的临床和微生物学特征,以及他们的治疗预后。 这项前瞻性观察研究在班加-班杜-谢赫-穆吉布医科大学(BSMMU)新生儿科新生儿重症监护室(NICU)和骨科门诊部(OPD)进行。本研究共纳入 30 名患有急性化脓性关节炎的新生儿。研究人员通过查看新生儿重症监护室的记录收集数据,并记录了新生儿住院期间或在手术室就诊时的病程、检查资料和治疗记录。为了评估预后,对所有病例的临床和放射学结果进行了为期 12 个月的随访。通过社会科学统计软件包(SPSS)对从记录审查中收集到的患有化脓性关节炎的新生儿数据进行处理和分析,并将分析结果以表格和图表的形式呈现。研究发现,近三分之二(63%)的新生儿为男性,膝关节最常受累,占所有单关节受累病例的三分之二以上(67%)。所有病例均贫血,C反应蛋白(CRP)水平较高。 关节吸出物样本培养显示,最常见(41%)的细菌是克雷伯氏菌,其次是醋硝杆菌和沙雷氏菌。革兰氏阴性菌占多数(91%)。大多数患者(76%)在治疗后预后良好。对疑似病例应优先进行临床评估并开始静脉注射抗生素。为了达到最佳效果,有必要在三级医院进行及时的手术干预和持续的随访:18-23
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引用次数: 0
Clinicobiochemical Parameters of Cytomegalovirus IgM and IgG positive Biliary Atresia and their Relation with Serological Titer in Infants. 巨细胞病毒 IgM 和 IgG 阳性胆道闭锁的临床生化指标及其与婴儿血清滴度的关系
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.71044
Sharmin Akter, K. Halim, Wahiduzzaman Mazumder, Rubayat Alam, K. Nahid, Md Rukunuzzaman
Cytomegalovirus (CMV) associated Biliary atresia (BA) is one of the clinical classification of Biliary atresia (BA). There is a hypothesis that CMV IgM positive BA is a clinically different entity and prognosis is poor. The aim of this study was to evaluate the clinical and biochemical parameters of CMV IgM and CMV IgG positive BA in one to six month old infants and their relation with serological titer. This cross-sectional study was carried out from January 2019 to June 2022 in the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. A total of 48 infants were included in this study as study subject who were diagnosed as biliary atresia with positive CMV IgM & CMV IgG. After taking written informed consents data were taken from parents or legal guardians by using a structured questionnaire. Data were analyzed by statistical package for social sciences (SPSS), version- 23.  Majority of the cases (58.3%) were in 2-4 month of age group, 70.8% were male and male-female ratio was almost 2.5:1. Regarding birth history most of the infants (95.8%) were term baby and  two-third (66.7%) of them was appropriate for gestational age (AGA). This study observed the onset of jaundice among the infants, here 60.4% of them detected jaundice jaundice within 7 days, 22.9% within 7-14 days and 16.7% after 14 days. About three fourth (73%) of infants presented with intermittent pale stool and more than one-fourth (27%) had persistent pales tool. One fourth 12(25%) patient had features of coagulopathy. The mean of total bilirubin, direct bilirubin, alanine transaminase (ALT) and gamma-glutamyl transpeptidase (GGT ) were 11.89±4.0, 8.27±3.42, 162.67±103.09 and 669.46±543.57 respectively; The mean of the titers of  CMV IgM and CMV IgG were 50.84±33.09 and  82.40±53.79  respectively. The prolong international normalised ratio (INR ) was in 30.8% of infants and mean INR was 2.44±2.54. Study finds that CMV IgM titer level was correlated with total bilirubin (r=-0.256; p<.05) and direct bilirubin (r=-0.365; p<.05); where CMV IgG titer level was correlated with age (r=-0.362; p<.05) and INR (r=0.271; p<.05). It may be concluded as increase in age would increase titer of IgG and increase in titer of IgG is associated with increase coagulopathy. Elevated levels of CMV IgM titer correlated with bilirubin level or cholestasis.Bangladesh Med J. 2023 Jan; 52(1): 12-17
巨细胞病毒(CMV)相关性胆道闭锁(BA)是胆道闭锁(BA)的临床分类之一。有一种假说认为,CMV IgM 阳性的胆道闭锁在临床上是一种不同的疾病,且预后较差。本研究旨在评估一至六个月大婴儿 CMV IgM 和 CMV IgG 阳性 BA 的临床和生化指标及其与血清学滴度的关系。这项横断面研究于2019年1月至2022年6月在达卡班加班杜谢赫-穆吉布医科大学(BSMMU)小儿胃肠病学和营养学系进行。本研究共纳入 48 名被诊断为胆道闭锁且 CMV IgM 和 CMV IgG 阳性的婴儿作为研究对象。在获得家长或法定监护人的书面知情同意后,采用结构化问卷调查的方式收集数据。数据采用社会科学统计软件包(SPSS)23 版进行分析。 大多数病例(58.3%)为 2-4 个月大的婴儿,70.8% 为男性,男女比例接近 2.5:1。在出生史方面,大多数婴儿(95.8%)为足月儿,其中三分之二(66.7%)的婴儿符合胎龄(AGA)。本研究观察了婴儿的黄疸发病时间,其中 60.4% 的婴儿在 7 天内发现黄疸,22.9% 的婴儿在 7-14 天内发现黄疸,16.7% 的婴儿在 14 天后发现黄疸。约四分之三(73%)的婴儿出现间歇性苍白大便,超过四分之一(27%)的婴儿出现持续性苍白大便。四分之一(12%)的患者有凝血功能障碍。总胆红素、直接胆红素、丙氨酸转氨酶(ALT)和γ-谷氨酰转肽酶(GGT)的平均值分别为(11.89±4.0)、(8.27±3.42)、(162.67±103.09)和(669.46±543.57);CMV IgM 和 CMV IgG 的平均滴度分别为(50.84±33.09)和(82.40±53.79)。30.8%的婴儿国际正常化比率(INR)延长,INR平均值为(2.44±2.54)。研究发现,CMV IgM 滴度水平与总胆红素(r=-0.256;p<.05)和直接胆红素(r=-0.365;p<.05)相关;而 CMV IgG 滴度水平与年龄(r=-0.362;p<.05)和 INR(r=0.271;p<.05)相关。由此可以得出结论,年龄的增长会增加 IgG 的滴度,而 IgG 滴度的增加与凝血功能障碍的增加有关。CMV IgM 滴度升高与胆红素水平或胆汁淤积有关:12-17
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引用次数: 0
Maternal Atrioventricular Nodal Re-entrant Tachycardia During Pregnancy: Case Report 妊娠期母体房室结再向性心动过速:病例报告
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.71042
Priyanka Podder, Joysree Saha
During pregnancy, the physiological changes predispose a woman for the development of new-onset or recurrent arrhythmia. Atrioventricular nodal re-entrant tachycardia (AVNRT) is a common supraventricular tachycardia (SVT) in reproductive age of woman. Although often it is benign in nature but concerning. Electrical cardioversion is safe during pregnancy. Electrophysiological study (EPS) and Radiofrequency ablation (RFA) can be performed in selected patients. Hereby, we report a case of a woman in her second trimester of pregnancy presented with diagnosed case of AVNRT. She was monitored by multidisciplinary team. Electrocardiogram (ECG) and Echocardiogram reveals normal changes. EPS and RFA was done one year back at the time of diagnosis. At her 37 weeks of pregnancy, she developed scar tenderness. Emergency caesarean section was done in presence of cardiologist. Maternal and perinatal outcome were good.Bangladesh Med J. 2023 Jan; 52(1): 35-38
在怀孕期间,由于生理变化,妇女容易患上新发或复发性心律失常。房室结再发性心动过速(AVNRT)是育龄妇女常见的室上性心动过速(SVT)。虽然它通常是良性的,但却令人担忧。电复律在怀孕期间是安全的。电生理研究(EPS)和射频消融术(RFA)可在选定的患者中进行。在此,我们报告了一例确诊为房室传导阻滞(AVNRT)的妊娠中期妇女病例。她接受了多学科团队的监护。心电图(ECG)和超声心动图显示正常变化。一年前确诊时曾做过 EPS 和 RFA。怀孕 37 周时,她出现了疤痕触痛。在心脏病专家在场的情况下,她进行了紧急剖腹产。孟加拉国医学杂志》,2023 年 1 月;52(1):35-38
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引用次数: 0
Drug Abuse of Professional Drivers: Experience from Referral Dope Test 职业司机的药物滥用问题:转介兴奋剂检测的经验
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.71039
Kaniz Fatema, K. Halim, Sohela Rahman, Sharmin Hamid, Keya Sarke, Arifa Akram, Ashiqur Rahman
In Bangladesh, drug abuse is one of the dangerous problems among drivers that hamper road safety and make government worry. In that context, this cross-sectional study was conducted in National Institute of Laboratory Medicine and Referral Center (NILMRC) and aims to determine the proportion of drug abuser among professional drivers in Bangladesh. This study also addressed to recognize the various types of abused drugs, the pattern and the trend of drug abusers during study period. Data were collected from online data server of NILMRC during the period of July to December 2022. Bangladesh Road Transport Authority (BRTA) customarily refers urine samples of drivers to NILMRC for dope test. Dope tests were performed in immunochromatographic test (ICT) device and semi-auto analyzer. Dope results and demographic data of drivers were well-kept-up in online server for electronic transfer and use of data. Commonly abused drugs in Bangladesh such as, cannabinoids, amphetamines, opiates, benzodiazepines and alcohol were assessed. A total of 70866 drivers had been tested for six months of study period among them 2720 (3.81%) were found dope test positive. Considering monthly trends from July to December 2022 the highest incidence were found in December where 473 (4.58%) of 10323 drivers were dope test positive; however in November 639 (4.56%) of 14,017, in September 682 (4.07%) of 16757, in October 551(3.62%) of 15221, in August 320 (3.42%) of 9348, then less incidence were found in July 55 (1.05%) of 5200 drivers had been tested positive. There was an increase number of test positive cases were detected during the period from July to December.  The highest number drug abuser that is more than two-third (70%) of drivers were found among young adult age group (25-44) years. The five types of abused drugs were tested; among those the highest proportion (91.5%) of abused drug was Cannabinoids, then Benzodiazepines was 5.5%, Amphetamine was 1.3%, Opiates was 1% and Alcohol was 0.8%. No female drivers were found test positive. Cannabinoids was the most common drug of abuse among drivers referred by BRTA, Bangladesh. During this study, there was challenge to different kind illegal means. If the illegal means could be resolute then the data of positive finding would be higher than this finding. So implementation online registration, proper identification by finger print or retinal scanning and providing online reports may minimize the illegal means.Bangladesh Med J. 2023 Jan; 52(1): 1-5
在孟加拉国,药物滥用是妨碍道路安全和令政府担忧的驾驶员危险问题之一。有鉴于此,本横断面研究在孟加拉国国立实验医学研究所和转诊中心(NILMRC)进行,旨在确定孟加拉国职业司机中药物滥用者的比例。本研究还探讨了各种类型的滥用药物、滥用药物者在研究期间的模式和趋势。数据收集于 2022 年 7 月至 12 月期间的 NILMRC 在线数据服务器。孟加拉国道路运输管理局(BRTA)通常会将司机的尿液样本交由 NILMRC 进行兴奋剂检测。兴奋剂检测通过免疫层析检测(ICT)设备和半自动分析仪进行。兴奋剂检测结果和驾驶员的人口统计数据均保存在在线服务器中,以便以电子方式传输和使用数据。评估了孟加拉国常见的滥用药物,如大麻类、苯丙胺类、鸦片类、苯二氮卓类和酒精。在为期六个月的研究期间,共有 70866 名司机接受了检测,其中 2720 人(3.81%)被发现兴奋剂检测呈阳性。从 2022 年 7 月至 12 月的月度趋势来看,12 月的兴奋剂检测呈阳性率最高,10323 名司机中有 473 人(4.58%)在 12 月的检测中呈阳性;然而,14017 名司机中有 639 人(4.56%)在 11 月的检测中呈阳性;16757 名司机中有 682 人(4.07%)在 9 月的检测中呈阳性;15221 名司机中有 551 人(3.62%)在 10 月的检测中呈阳性;9348 名司机中有 320 人(3.42%)在 8 月的检测中呈阳性;7 月的检测呈阳性率较低,5200 名司机中有 55 人(1.05%)在 7 月的检测中呈阳性。在 7 月至 12 月期间,检测呈阳性的人数有所增加。 吸毒人数最多的年龄组是25-44岁的青壮年,超过三分之二(70%)。在测试的五种滥用药物中,大麻类药物所占比例最高(91.5%),其次是苯二氮卓类药物(5.5%)、苯丙胺类药物(1.3%)、鸦片类药物(1%)和酒精(0.8%)。没有发现女司机检测呈阳性。大麻类药物是孟加拉国 BRTA 转介的司机中最常见的滥用药物。在本次研究中,不同种类的非法手段受到了挑战。如果能坚决杜绝非法手段,那么阳性结果的数据将高于此次发现的数据。因此,实施在线注册、通过指纹或视网膜扫描进行正确识别以及提供在线报告可最大限度地减少非法手段:1-5
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引用次数: 0
Pattern of Eosinophil and Neutrophil/ Lymphocyte Ratio in Different Stages of Chronic Kidney Disease. 慢性肾病不同阶段的嗜酸性粒细胞和中性粒细胞/淋巴细胞比率模式
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.71049
D. A. Ali, I. Ali, Uooja Devi, A. Arif, Nida Fatima, Fariha Aslam
Various expensive interventions are used to diagnosis the different stages of chronic kidney disease (CKD). This research is aimed to determine the pattern of eosinophil and neutrophil/ lymphocyte ratio in different stages of CKD. Data was collected in January 2023 from the patients of CKD and from their files of reports. Permission was taken from the patients. The individuals were from civil hospital Karachi and they were the patients of CKD. Sample size was 200. There was irregular pattern of eosinophil and neutrophil/lymphocyte ratio in different stages of CKD. The eosinophil count and neutrophil/ lymphocyte ratio were higher in higher stages of CKD. The eosinophil and neutrophil/ lymphocyte ratio were higher in higher stages of CKD and the pattern was irregular. Study finds that eosinophil and neutrophil/ lymphocyte ratio were higher and the pattern was irregular in higher stages of CKD.Bangladesh Med J. 2023 Jan; 52(1): 24-29
各种昂贵的干预措施被用于诊断慢性肾脏病(CKD)的不同阶段。本研究旨在确定慢性肾脏病不同阶段的嗜酸性粒细胞和中性粒细胞/淋巴细胞比率模式。研究人员于 2023 年 1 月从慢性肾脏病患者及其报告档案中收集数据。已征得患者的同意。样本来自卡拉奇市立医院,均为慢性肾脏病患者。样本量为 200 人。在慢性肾脏病的不同阶段,嗜酸性粒细胞和中性粒细胞/淋巴细胞比值呈不规则模式。嗜酸性粒细胞计数和中性粒细胞/淋巴细胞比率在慢性肾功能衰竭的较高阶段较高。嗜酸性粒细胞和中性粒细胞/淋巴细胞比值在慢性肾功能衰竭的较高分期中较高,且形态不规则。研究发现,嗜酸性粒细胞和中性粒细胞/淋巴细胞比率在慢性肾功能衰竭的较高阶段较高,且形态不规则:24-29
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引用次数: 0
Genetic Characterization of Aspergillus flavus and Saccharomyces cerevisae in Tracheobronchial Phlegm of HIV-infected Patients on Antiretroviral Therapy in Jalingo, Nigeria 尼日利亚贾林戈接受抗逆转录病毒疗法的艾滋病病毒感染者气管支气管痰中黄曲霉菌和酿酒酵母菌的遗传特征
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.71045
N. C. Awujo, Fyinbu Dennis Ishaku, Chrinius Hammuel
Fungal infections are among the diverse respiratory tract pathogens and account for a proportion of community acquired and nosocomial pneumonias thereby generating concerns particularly in immunocompromised patients. This study aims to genomically extract and sequence fungal DNA using the Basic Local Alignment Search Tool (BLAST) technology for their definitive and confirmatory identification thereby easing off the obstacles in their diagnosis due to similar appearance in their colony and morphology and ultimately determining their infection rates in persons receiving antiretoviral therapy against HIV. Sputa of 100 HIV infected out-patients of a Medical Centre in Jalingo, on anti-retroviral therapy were cultured on Sabouraud Dextrose Agar to isolate fungi species and assess their prevalence and distribution. Fungal colonies characterized culturally and biochemically as Aspergillus flavus and Aspergillus niger were subjected to the BLAST, and the similarities with the biological sequences in the National Center for Biotechnology Information (NCBI) database queried. There were observational variances in the colonial and microscopic appearances of A. flavus and A. niger on Sabouraud Dextrose Agar (SDA) plates and the microscope respectively. The similarities between the queried and biological sequences in the NCBI database, was almost all (99.7%) thus confirming their identity as Aspergillus flavus and Saccharomyces cerevisiae. The overall prevalence of fungi infection was 79.0%. More males (80.0%) than females (78.3%) were infected. In both sexes, fungi were most (92.9%) frequently isolated in patients that were between 30 and 39 years and least (64.7%) in those between 15 and 29 years. There was no established pattern (sex- and age- relatedness) of non-concomitant A. flavus and S. cerevisiae in fifty-seven male and female patients in six age categories even though A. flavus occurred more (48.1%) than S. cerevisae (24.1%) and the prevalence was higher (61.4%) in females than in males (38.6%). The high prevalence of these fungi in the study population, with or without symptoms of cough or fungal disease, mandates an early screening of such infected persons so as to reduce further complications and improve treatment.Bangladesh Med J. 2023 Jan; 52(1): 6-11
真菌感染是多种呼吸道病原体中的一种,在社区获得性和非社区性肺炎中占一定比例,因此引起了人们的关注,尤其是免疫力低下的患者。本研究旨在利用基本局部比对搜索工具(BLAST)技术对真菌 DNA 进行基因组学提取和测序,以便对其进行明确和确证鉴定,从而消除因菌落和形态相似而造成的诊断障碍,并最终确定其在接受抗逆转录病毒治疗的艾滋病患者中的感染率。将贾林戈一家医疗中心 100 名接受抗逆转录病毒治疗的艾滋病毒感染门诊患者的痰培养在沙保律葡萄糖琼脂上,以分离真菌种类并评估其流行率和分布情况。对培养和生化鉴定为黄曲霉和黑曲霉的真菌菌落进行了 BLAST 分析,并查询了它们与美国国家生物技术信息中心(NCBI)数据库中生物序列的相似性。黄曲霉和黑曲霉分别在沙保鲁葡萄糖琼脂(SDA)平板和显微镜下观察到的菌落和显微表现存在差异。查询到的序列与 NCBI 数据库中的生物序列几乎全部相似(99.7%),因此证实了它们是黄曲霉和酿酒酵母。真菌感染的总体流行率为 79.0%。男性感染率(80.0%)高于女性(78.3%)。在男女患者中,30 至 39 岁的患者最常分离到真菌(92.9%),而 15 至 29 岁的患者分离到的真菌最少(64.7%)。尽管黄曲霉菌的感染率(48.1%)高于蜡样芽孢杆菌(24.1%),而且女性的感染率(61.4%)高于男性(38.6%),但在六个年龄段的57名男性和女性患者中,黄曲霉菌和蜡样芽孢杆菌的非并发模式(性别和年龄相关性)并不存在。无论是否有咳嗽或真菌病症状,这些真菌在研究人群中的高流行率都要求对此类感染者进行早期筛查,以减少进一步的并发症并改善治疗:6-11
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引用次数: 0
Thyroid Collision Tumour: Concurrence of Two Thyroid Malignancy 甲状腺碰撞瘤两种甲状腺恶性肿瘤并发
Pub Date : 2024-06-13 DOI: 10.3329/bmj.v52i1.71062
Muhamad Hud Muhamad Zin, Firdaus Hayati, Shahrun Niza Abdullah Suhaim, S. N. Abdullah Suhaimi, R. Muhammad, Muhammad Afiq Bin Mohamad, Suria Hayati Md Pauzi, N. Isa, Mohamed Izzad Ishak
Thyroid carcinoma is the most common endocrine malignancy. However, it is exceptionally uncommon for two different thyroid malignancies to co-exist within the same thyroid gland. Herein, we present two cases where two different thyroid malignancies present as collision tumours of the thyroid gland. The hypothesis, epidemiology and management are discussed here. Case presentation: Case 1 was a 60 year-old woman presented with an accidental finding of left neck swelling. Ultrasound neck identified multinodular goitre with a suspicious left thyroid nodule. Ultrasound-guided fine-needle aspiration cytology of left thyroid nodule confirms papillary thyroid carcinoma. She underwent total thyroidectomy with central compartment neck dissection. However, histopathology reports a presence of medullary thyroid carcinoma and papillary microcarcinoma in the left thyroid gland. Case 2 was a 59 years old woman presented with left vocal cord paralysis with rapidly enlarging of a long-standing left thyroid swelling. Computed tomography identified bilateral thyroid swelling with left mass causing compression to the trachea and oesophagus. The patient subsequently underwent a total thyroidectomy bilateral central and left selective neck node dissections and left primary non-selective nerve re-innervation. A collision tumour with components of both Hurthle cell carcinoma and papillary microcarcinoma has been shown in histopathology. Collision tumours of the thyroid pose a diagnostic as well as a therapeutic challenge. They should be treated in a multidisciplinary team environment, and the care should be unique to the patient. The treatment should usually be directed by the most aggressive neoplasm.Bangladesh Med J. 2023 Jan; 52(1): 30-34
甲状腺癌是最常见的内分泌恶性肿瘤。然而,两种不同的甲状腺恶性肿瘤同时存在于同一甲状腺内的情况却极为罕见。在本文中,我们介绍了两例两种不同的甲状腺恶性肿瘤以甲状腺碰撞瘤的形式出现的病例。本文将对其假说、流行病学和处理方法进行讨论。病例介绍:病例 1 是一名 60 岁的女性,因意外发现左颈部肿胀而就诊。颈部超声检查发现多结节性甲状腺肿,左侧甲状腺结节可疑。超声引导下左甲状腺结节细针穿刺细胞学检查证实为甲状腺乳头状癌。她接受了全甲状腺切除术,并进行了中央区颈部清扫术。然而,组织病理学报告显示左侧甲状腺存在甲状腺髓样癌和乳头状微癌。病例 2 是一名 59 岁的女性,因长期左侧甲状腺肿物迅速增大而出现左侧声带麻痹。计算机断层扫描发现双侧甲状腺肿大,左侧肿块压迫气管和食道。患者随后接受了甲状腺全切除术、双侧中央和左侧选择性颈结节切除术以及左侧原发性非选择性神经再支配术。组织病理学显示,碰撞瘤同时具有赫氏细胞癌和乳头状微癌的成分。甲状腺碰撞瘤给诊断和治疗都带来了挑战。应在多学科团队的环境中对其进行治疗,并根据患者的具体情况采取独特的治疗方法。孟加拉国医学杂志》,2023年1月;52(1):30-34
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引用次数: 0
Vaccination and Pandemic Control in Bangladesh: Post Vaccination COVID-19 Positive Cases among Health Care Providers 孟加拉国的疫苗接种和大流行病控制:卫生保健提供者接种后的 COVID-19 阳性病例
Pub Date : 2024-01-02 DOI: 10.3329/bmj.v51i3.70211
K. Halim, Suchisree Saha, Sayda Tanjina Parvin, Sharmin Afroz, Sajib Roy, Tasnim Sanwar, Md Mahmudul Hasan Mitul, Nusrat Ahmed, Afsana Zerin Shakila, Puspita Saha, Khadija Islam Tisha, Anaya Nur Mou, Humayoun Kabir, Rezwana Tabassum, Nadiya Pasha, Akeba Munmun, Shaikh Shafiq ur Rahman, Shammi Akter, Most Sultana Afroz
Vaccination was started on a trial basis in Bangladesh from 27th January, 2021 and started mass vaccination from 7th February, 2021.  Since starting of mass vaccination it was noticed that, the health care providers (HCPs) who received two doses of Astra-Zeneca were then reported of being infected. This cross-sectional study was conducted during the period of July to December 2021 and data were collected from July to August 2021. The main objective was to measure the proportion of post vaccinated Corona Virus Disease-19 (COVID-19) positive cases among healthcare providers working in different healthcare facilities in Bangladesh and aimed to collect available evidence to characterize these infections and correlations with different co-morbidities. This study was carried out among 450 vaccinated HCPs who received 2 doses of vaccine at various health care facilities (HCFs) from 32 districts of Bangladesh. Data were collected from HCPs (Doctors, Nurses, Lab technician) who willing to participate irrespective of age and sex. Among the HCPs nearly three-fourth (71.6%) was doctors, 21.3% nurses and 7.1% were lab technologists. Here, most of the (88.0%) respondents were in age group 21 to 40 years and other 22.0% was in age group 41 to 59 years. The number of Male-female respondents was equal  and 77.8% of the respondents was Muslim followed by Hinduism (20.2%), Buddhist and Christian 2.0%. Study finds that 27.6% of the respondents was post vaccination COVID-19 positive (PVC-19+) (according to their rt-PCR test result). Less than one-fifth (18.7%) of the respondents had pre-existing co-morbidities among them 8.2% was suffering from hypertension (HTN), 6.0% asthma, 4% Diabetes Mellitus (DM), 2.0% Obesity, 1.1% ischemic heart disease (IHD) and 1.1% was others co-morbidities. Among the PVC-19+ cases most of them (84.6%) were in age group 21-40 years, male-female ratio was 1:0.9 and 81.5% was Muslim. More than three-fourth (77.4%) of positive cases were doctors, 17.7% nurses and 4.8% was lab technicians; among the PVC-19+ cases 87.9% was symptomatic. Three-fourth (75%) of the positive cases had fever, 51.6% had lost of smell and taste, 49.2% showed fatigue/ or malaise, 48.4% dry cough, 43.5% headache, 26.6% runny nose, 25.8% felt muscle pain, 19.4% sore throat, 18.5% shortness of breathing, 14.5% experienced joint pain, 9.7% had productive cough and 32.3% complained for other symptoms and signs. Majority of the PVC+19+ cases (57.26%) developed complications; among them 71.8% had tiredness/ fatigue, 31% difficulty in thinking/ concentrating, 21.1% headache, 19.7% cough, 15.5% dizziness, 14.1% loss of smell or taste, 12.7% joint or muscle pain, 12.7% fast-beating or pounding heart, 11.3% shortness of breathing, 8.5% chest pain and 29.9%  developed other complications. Pre-existing co-morbidity was found in 66.94% of positive cases, among those 41.5% HTN, 36.6% asthma, 14.6% DM, 14.6% obesity, 4.9% IHD and 9.8% had others co-morbidity. Chi-square test for indep
孟加拉国于 2021 年 1 月 27 日开始试行疫苗接种,并于 2021 年 2 月 7 日开始大规模疫苗接种。 自大规模疫苗接种开始以来,人们发现,接种了两剂阿斯利康疫苗的医护人员(HCPs)随后被报告受到感染。这项横断面研究在 2021 年 7 月至 12 月期间进行,数据收集时间为 2021 年 7 月至 8 月。主要目的是测量在孟加拉国不同医疗机构工作的医疗服务提供者中接种科罗娜病毒病-19(COVID-19)后阳性病例的比例,并旨在收集现有证据,以确定这些感染的特征以及与不同并发症的相关性。这项研究是在孟加拉国 32 个县的不同医疗机构 (HCF) 中接种了两剂疫苗的 450 名医疗保健提供者中进行的。数据收集对象是愿意参与研究的卫生保健人员(医生、护士、实验室技术人员),不分年龄和性别。在这些保健人员中,近四分之三(71.6%)是医生,21.3%是护士,7.1%是实验室技术人员。大多数受访者(88.0%)的年龄在 21 至 40 岁之间,另有 22.0%的受访者的年龄在 41 至 59 岁之间。男女受访者人数相当,77.8%的受访者信奉伊斯兰教,其次是印度教(20.2%)、佛教和基督教(2.0%)。研究发现,27.6% 的受访者接种 COVID-19 后呈阳性(PVC-19+)(根据 rt-PCR 检测结果)。不到五分之一(18.7%)的受访者在接种疫苗前患有并发症,其中 8.2% 患有高血压 (HTN),6.0% 患有哮喘,4% 患有糖尿病 (DM),2.0% 患有肥胖症,1.1% 患有缺血性心脏病 (IHD),1.1% 患有其他并发症。在 PVC-19+ 病例中,大多数人(84.6%)的年龄在 21-40 岁之间,男女比例为 1:0.9,81.5% 为穆斯林。超过四分之三(77.4%)的阳性病例为医生,17.7%为护士,4.8%为实验室技术人员;PVC-19+病例中,87.9%有症状。四分之三(75%)的阳性病例有发热症状,51.6%失去嗅觉和味觉,49.2%表现为疲劳/或乏力,48.4%干咳,43.5%头痛,26.6%流鼻涕,25.8%感到肌肉疼痛,19.4%喉咙痛,18.5%呼吸急促,14.5%关节疼痛,9.7%咳嗽有痰,32.3%有其他症状和体征。大多数 PVC+19+ 病例(57.26%)出现了并发症,其中 71.8%的人感到疲倦/疲劳,31%的人难以思考/集中注意力,21.1%的人头痛,19.7%的人咳嗽,15.5%的人头晕,14.1%的人嗅觉或味觉丧失,12.7%的人关节或肌肉疼痛,12.7%的人心跳过快或怦怦直跳,11.3%的人呼吸急促,8.5%的人胸痛,29.9%的人出现了其他并发症。66.94%的阳性病例在发病前已患有其他并发症,其中41.5%患有高血压、36.6%患有哮喘、14.6%患有糖尿病、14.6%患有肥胖症、4.9%患有高血压、9.8%患有其他并发症。对 PVC-19+ 病例的相关性进行了α = 0.05 的独立性卡方检验,结果显示,高血压(P = 0.009)和哮喘(P = 0.001)与 PVC-19+ 病例的相关性具有统计学意义。高血压和哮喘的医护人员即使在完全接种疫苗后也更有可能出现 COVID-19 阳性。医护人员是感染 COVID-19 的高危人群,他们可能会在家中或在护理病人或与其他工作人员交流时受到感染。孟加拉国医学杂志》,2022 年 9 月;51(3):1-9
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引用次数: 0
Outcome of Early Active and Late Mobilization following Flexor Tendon Repair in Zone ΙΙ of Hand 手部ΙΙ区屈肌腱修复术后早期主动活动和后期活动的结果
Pub Date : 2024-01-02 DOI: 10.3329/bmj.v51i3.70141
Krishna Priya Das, R. M. Chowdhury, Mamunur Rashid, MD Moniruzzaman, Sk Murad Ahmed, Ali Noor Polas, N. K. Datta
The functional outcome of flexor tendon injury after repair depends on multiple factors. Postoperative rehabilitation protocol plays an important role after a good repair for better functional outcomes. The aim of this study is to compare the outcome between early active mobilizations versus late mobilizations after flexor tendon repair in zone-II of hand. This Quasi-experimental (Nonrandomized control trial) was conducted from July 2018 to June 2021. Total 30 patients of flexor tendon injury in Zone-II of hand presented within 3 weeks were divided into two equal groups according to envelope technique, late mobilization (No intervention group) group- A and early active mobilization (Intervention group) group-B. All the flexor tendons were repaired with polypropylene 4/0 double strand score sutures and 6/0 epitendinous continuous sutures. In group-A mobilization started after 3 weeks and in group–B, intervention was given by active mobilization which was started at the day of operation. Buck Gramcko functional criteria and Louisville system were used for assessment of final result after 6 months of surgery. Male was predominant, M: F ratio was 3.3:1. Mean age of the respondent was 32.53±9.86 years. Dominant (Right) hand involvement was 70%. Student and service holder were the common involved group. Nearly three fourth (73%) of them had sharp cutting injury. More than half (53.10%) of the injuries were found in ring and little fingers followed by index (20.30%), middle (20.30%) and thumb (6.30%). Mean time interval between injury and operation was 11 days. Adhesion formation was the commonest complication that was 40% in group A and 20% in group B. More satisfactory outcome (87.50%) was found in group- B (Intervention group), that is patients who received early active mobilization; where the level of satisfactory outcome was less (62.50%) in group-A (Non-intervention group), that is patients who received late mobilization (p-value was significant <0.05). Early active mobilization following repair of flexor tendon in zone II of hand ensures better functional outcome with minimum complication compared to late mobilization.Bangladesh Med J. 2022 Sept; 51(3): 28-36
屈肌腱损伤修复后的功能效果取决于多种因素。为了获得更好的功能结果,术后康复方案在良好的修复后发挥着重要作用。本研究旨在比较手部二区屈肌腱修复术后早期主动活动与晚期活动的效果。这项准实验(非随机对照试验)于2018年7月至2021年6月进行。共有 30 名在 3 周内就诊的手部 Zone-II 区屈肌腱损伤患者,根据包膜技术分为两个相同的组,即晚期动员(无干预组)- A 组和早期主动动员(干预组)- B 组。所有屈肌腱均采用聚丙烯 4/0 双股缝合线和 6/0 表腱连续缝合线进行修复。A 组在 3 周后开始活动,B 组在手术当天就开始积极活动。巴克-格拉姆科功能标准和路易斯维尔系统用于评估手术 6 个月后的最终结果。受试者以男性为主,男女比例为 3.3:1。平均年龄为(32.53±9.86)岁。右手占 70%。学生和服务人员是常见的参与群体。近四分之三(73%)的受访者有锐器割伤。一半以上(53.10%)的损伤发生在无名指和小指,其次是食指(20.30%)、中指(20.30%)和拇指(6.30%)。受伤与手术之间的平均时间间隔为 11 天。B组(干预组)(即接受早期积极活动的患者)的满意度较高(87.50%),而A组(非干预组)(即接受后期活动的患者)的满意度较低(62.50%)(P值显著小于0.05)。孟加拉医学杂志》,2022 年 9 月;51(3):28-36
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引用次数: 0
期刊
Bangladesh Medical Journal
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