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Medical Quiz-2 Vol. 34(3) 2023 医学测验-2卷34(3)2023
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68445
Muhammad Abdur Rahim
Abstract not available Bangladesh J Medicine 2023; 34(3): 261
[摘要]孟加拉J医学2023;34 (3): 261
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引用次数: 0
Accuracy of transient elastography in Identifying fibrosis among patients with Chronic hepatitis b: a cross-sectional Observational study 瞬变弹性成像识别慢性乙型肝炎纤维化的准确性:一项横断面观察性研究
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68423
Rajib Saha Rony, Ahmed Hossain, Md Daharul Islam, Md Fazal Karim, Aminur Rahman, Sudipta Saha Jui
Background: Hepatitis B virus (HBV) infection is a significant global public health problem, affecting millions of people worldwide. Liver biopsy is the gold standard for assessing fibrosis but is invasive and carries post-procedural risks. Noninvasive tests to evaluate liver fibrosis are needed, and transient elastography is one such method. This cross-sectional observational study aimed to assess the accuracy of transient elastography in identifying fibrosis among patients with chronic hepatitis B. Methods: The study was conducted at the Department of Medicine and Hepatology, Sir Salimullah Medical College Mitford Hospital, Dhaka. The study subjects were patients diagnosed with chronic hepatitis B infection, both outpatient and inpatient cases. Data were collected from 25 patients using convenient and purposive sampling techniques. Demographic data, clinical examination, and relevant investigations were recorded in a structured case report form. Data were processed, registered, edited, computerized, and analyzed. Results: The study included 25 patients with a mean age of 26.8±6.5 years, predominantly male (80%). All patients were HBsAg positive, 12.0% were HBeAg positive, and 56.0% were antiHBe positive. The mean HBV DNA PCR was 1516293.4±7475976.3 IU/ml. The mean ALT level was 45.4±13.8 U/L. The mean liver stiffness measurement (LSM) was 7.5±2.3 kPa, with 64.0% of patients showing fibrosis stage F0-F1. The mean periportal +/- bridging necrosis was 2.92±1.58, intralobular degeneration and focal were 1.16±0.55, portal inflammation was 2.52±0.87, histological activity index was 6.6±2.2, and fibrosis score was 1.44±1.04. Positive correlations were observed between LSM and histological activity index (r=0.239; p=0.251) and between LSM and fibrosis score (r=0.107; p=0.612). Conclusion: Our study demonstrates that transient elastography provides a non-invasive, easy, and cost-effective method for identifying fibrosis in chronic hepatitis B patients, serving as a potential alternative to liver biopsy. Bangladesh J Medicine 2023; 34(3): 199-205
背景:乙型肝炎病毒(HBV)感染是一个重大的全球公共卫生问题,影响着全世界数百万人。肝活检是评估纤维化的金标准,但它是侵入性的,并有术后风险。评估肝纤维化需要无创试验,瞬态弹性成像就是其中一种方法。这项横断面观察性研究旨在评估瞬时弹性成像识别慢性乙型肝炎患者纤维化的准确性。方法:该研究在达卡萨里穆拉爵士医学院米特福德医院医学和肝病学系进行。研究对象是诊断为慢性乙型肝炎感染的患者,包括门诊和住院病例。采用方便、有目的的抽样技术收集25例患者的数据。人口统计资料、临床检查和相关调查记录在结构化的病例报告表格中。数据经过处理、登记、编辑、计算机化和分析。结果:研究纳入25例患者,平均年龄26.8±6.5岁,以男性为主(80%)。所有患者HBsAg阳性,HBeAg阳性12.0%,抗hbe阳性56.0%。HBV DNA PCR平均为1516293.4±7475976.3 IU/ml。ALT平均为45.4±13.8 U/L。肝硬度测量平均值(LSM)为7.5±2.3 kPa, 64.0%的患者表现为F0-F1期纤维化。门静脉周围+/-桥性坏死平均为2.92±1.58,小叶内变性和局灶性坏死平均为1.16±0.55,门静脉炎症平均为2.52±0.87,组织学活性指数为6.6±2.2,纤维化评分为1.44±1.04。LSM与组织学活性指数呈正相关(r=0.239;p=0.251), LSM与纤维化评分之间(r=0.107;p = 0.612)。结论:我们的研究表明,瞬时弹性成像提供了一种无创、简单、经济的方法来识别慢性乙型肝炎患者的纤维化,可作为肝活检的潜在替代方法。孟加拉国J医学2023;34 (3): 199 - 205
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引用次数: 0
Sepsis, an Unusual Presentation of Typhoid Fever - A Case Report 败血症,伤寒的一种不寻常的表现- 1例报告
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68437
Ishrat Binte Reza, MA Zahiruddin, H. Ahasan, Quazi Tarikul Islam
Typhoid fever is an infection caused by Salmonella typhi. The common complications are intestinal perforation and typhoid encephalopathy. Cases of typhoid fever with sepsis and/or disseminated intravascular coagulation (DIC) are rarely reported. A 20 yr old male presented with grade fever, vomiting, diarrhoea.His Dengue NS1 was negative, procalcitonin was high,coagulation profile was altered and developed subclinical DIC along with septicemia within a short period of time which is very rare. Sepsis and DIC are rare complications of typhoid fever. Typhoid fever can be presented with profound bleeding manifestation other than gastrointestinal bleeding, since it is a common symptom of typhoid fever. Further research should be conducted to postulate association between typhoid fever and DIC. Here we reported an unusual case of sepsis which a caused by case of typhoid fever.Bangladesh J Medicine 2023; 34(3): 252-254
伤寒是一种由伤寒沙门氏菌引起的传染病。常见的并发症是肠穿孔和伤寒脑病。伤寒合并败血症和/或弥散性血管内凝血(DIC)的病例很少报道。一名20岁男性表现为发烧、呕吐、腹泻。他的登革NS1阴性,降钙素原高,凝血谱改变,在短时间内发展亚临床DIC并败血症,这是非常罕见的。脓毒症和DIC是伤寒的罕见并发症。伤寒是伤寒的常见症状,除消化道出血外,还可出现深度出血表现。伤寒与DIC之间的关系有待进一步研究。在这里,我们报告了一个不寻常的败血症的情况下,引起的情况下,伤寒。孟加拉国J医学2023;34 (3): 252 - 254
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引用次数: 0
Study of Left Ventricular Dysfunction In Type 2 Diabetes Mellitus Patients Without Known Co-Morbidities 无已知合并症的2型糖尿病患者左心室功能障碍的研究
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68429
Mohammed Nazim Uddin, Md Daharul Islam, Mohammad Sarwar Alam, Md Ataur Rahman, Shazedur Rahman, Khorshed Minhajul Alam Mondle, S. M. M. Hasan, Ahmed Hossain
Background: Subclinical left ventricular dysfunction in type 2 diabetes mellitus (DM) patients may precede the development of symptomatic heart failure. Detecting this dysfunction early could potentially prevent its progression. However, there is a scarcity of studies on this topic in Bangladesh. Therefore, this study aimed to explore the left ventricular function status in type 2 DM patients without any known co-morbid conditions in a tertiary care hospital.Methods: A cross-sectional study was conducted at the Department of Internal Medicine in Sir Salimullah Medical College & Mitford Hospital over a one-year period. A total of 100 patients with a diagnosis of type 2 DM, meeting the inclusion-exclusion criteria, were enrolled. Written informed consent was obtained from each participant, followed by the collection of socio-demographic data, detailed clinical history, and routine investigations. Echocardiograms were performed on all participants to assess the presence of systolic and diastolic dysfunction using various modes. Data analysis was conducted using the statistical software SPSS 23.0.Results: The mean age of the study patients was 47.23±9.13 (SD) years, with the majority in the age group of 40-49 years (43%). Female patients accounted for 58% of the sample, while male patients comprised 42%. The frequency of left ventricular diastolic dysfunction (LVDD) was 65%. The presence of LVDD was associated with longer duration of diabetes mellitus, higher HbA1C levels, older age, and increased BMI (p<.05).Conclusion: The majority of type 2 diabetic patients in this study exhibited left ventricular diastolic dysfunction, with a prevalence of 65%. Further larger-scale studies are recommended to validate these findings.Bangladesh J Medicine 2023; 34(3): 229-234
背景:2型糖尿病(DM)患者的亚临床左心室功能障碍可能先于症状性心力衰竭的发展。早期发现这种功能障碍可能会阻止其发展。然而,在孟加拉国,关于这一主题的研究很少。因此,本研究旨在探讨三级医院无已知合并症的2型糖尿病患者的左心室功能状态。方法:在萨里穆拉爵士医学院和米特福德医院内科进行了为期一年的横断面研究。共纳入100例诊断为2型糖尿病,符合纳入-排除标准的患者。每位参与者获得书面知情同意,随后收集社会人口统计数据、详细的临床病史和常规调查。超声心动图对所有参与者使用各种模式评估收缩和舒张功能障碍的存在。数据分析采用SPSS 23.0统计软件。结果:研究患者平均年龄为47.23±9.13 (SD)岁,以40 ~ 49岁年龄组居多(43%)。女性患者占样本的58%,而男性患者占42%。左室舒张功能不全(LVDD)发生率为65%。LVDD的存在与糖尿病持续时间较长、HbA1C水平较高、年龄较大和BMI升高相关(p< 0.05)。结论:本研究中大多数2型糖尿病患者表现为左室舒张功能不全,患病率为65%。建议进一步进行更大规模的研究来验证这些发现。孟加拉国J医学2023;34 (3): 229 - 234
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引用次数: 0
Measuring and Comparing Cortical Surface Area of Paracentral Lobule in a Tertiary care Hospital, Bangladesh 测量和比较孟加拉三级医院中央旁小叶皮质表面积
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68432
Mahfuza Chowdhury, Monira Khatun, Aminur Rahman, Tunajjina Kawsar, Rezowana Naznin, Ferdausi Rab
Background: The paracentral lobule is the area on medial surface of the cerebral cortex which extends from precentral sulcus to postcentral sulcus. Any trauma, tumor, or cerebral ischemia cause lesions of motor and sensory cortex of paracentral lobule. The result of this study is very important to the radiologists and neurosurgeons for diagnosis of above mentioned diseases and the practice of safe neurosurgery. This study was carried out to observe the cortical surface area of paracentral lobule in adult male and female Bangladeshi population,may help for future research.Methods: This cross- sectional study was conducted in the Department of Anatomy, Dhaka Medical College, Dhaka, during the period of January 2017 to December 2017. Total 70 adult Bangladeshi male &female people were selected, among them 35 male and 35 female, age ranging from 20-65 years. CT scan image of brain in mid sagittal view was used for this study. Data were analyzed by Unpaired Student’s ‘t’ tests.Results: The surface area of motor cortex of right and left paracentral lobule was significantly higher (p<0.01) in male.Surface area of sensory cortex of both paracentral lobule was significantly higher (p<0.05) in male than female.Conclusion: The present study reveals significant difference in morphological measurements of right and left paracentral lobule between male and female of adult Bangladeshi population.Bangladesh J Medicine 2023; 34(3): 235-238
背景:中央旁小叶是位于大脑皮层内侧表面的区域,从中央前沟延伸到中央后沟。任何外伤、肿瘤或脑缺血均可引起中央旁小叶运动和感觉皮层的损伤。本研究结果对放射科医生和神经外科医生对上述疾病的诊断和安全开展神经外科手术具有重要的指导意义。本研究对孟加拉成年男女的中央旁小叶皮层表面积进行了观察,为今后的研究提供参考。方法:本横断面研究于2017年1月至2017年12月在达卡医学院解剖学系进行。共选取孟加拉国成年男女70人,其中男性35人,女性35人,年龄在20-65岁之间。本研究采用脑正中矢状位CT扫描图像。数据采用Unpaired Student ' st检验进行分析。结果:男性右、左中央旁小叶运动皮质表面积明显增高(p<0.01)。男性双侧中央旁小叶感觉皮质表面积显著高于女性(p<0.05)。结论:本研究揭示了孟加拉成年人群男女左右中央旁小叶的形态学测量存在显著差异。孟加拉国J医学2023;34 (3): 235 - 238
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引用次数: 0
Disseminated herpes zoster in an Immunocompetent patient on long-term Clozapine: case report 长期服用氯氮平的免疫功能正常患者的播散性带状疱疹病例报告
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68435
Nikhil Das, Farzana Hoque
Disseminated herpes zoster is characterized by more than 20 herpetic lesions distributed across other body parts outside the affected dermatome. Disseminated herpes zoster occurs more frequently in immunocompromised patients and only a handful of case reports highlighted itsoccurrence in immunocompetent individuals. Clozapine use has been linked to decreased immune functioning, but no conclusive evidence to categorize clozapine as an immunosuppressive drug has been published. Here we report a case of a 65-year-old immunocompetent man on long-term clozapine who presented with vesicular lesions in a non-dermatomal distribution and was diagnosed to have disseminated zoster.Bangladesh J Medicine 2023; 34(3): 241-244
播散性带状疱疹的特征是分布在受感染皮肤以外的其他身体部位的20多种疱疹性病变。播散性带状疱疹更常发生在免疫功能低下的患者中,只有少数病例报告强调其发生在免疫功能正常的个体中。氯氮平的使用与免疫功能下降有关,但没有确凿的证据将氯氮平归类为免疫抑制药物。在这里,我们报告一个65岁的免疫功能正常的男性长期服用氯氮平,他表现为非皮肤分布的水疱性病变,并被诊断为播散性带状疱疹。孟加拉国J医学2023;34 (3): 241 - 244
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引用次数: 0
Paradoxical reactions in the form of Optochiasmatic arachnoiditis and stroke in An immunocompetent girl with tuberculous Meningitis- a case report 1例免疫功能正常的女孩结核性脑膜炎的视交叉蛛网膜炎和脑卒中的矛盾反应
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68433
Md Alamgir Hossain, Aminur Rahman, A. Agarwalla, Muhammad Jamil Ahmed, Abul Hasnat Md Russel, Shahjada Mohammad Dastegir Khan, Mohammad Moshiur Rahman, Biplab Paul, Pallab Kanti Saha, Z. Ali
The paradoxical response is characterized by clinical or radiologic worsening of pre-existing lesions or the appearance of new lesions following initiation of treatment for tuberculosis (TB). The paradoxical response has raised questions about the accuracy of the diagnosis, the potential for treatment failure, and the presence of an underlying disease, making it an important topic of care for clinicians. In this case report, we present the paradox reaction of a 14 year old girl diagnosed and treated for TB meningitis. This healthy immune girl is successfully treated with steroids, and we discuss the importance of treating the paradox of tuberculosis progression despite the use of effective anti-TB drugs.Bangladesh J Medicine 2023; 34(3): 245-251
这种矛盾的反应的特点是,在开始治疗结核病(TB)后,已有病变的临床或放射学恶化或出现新的病变。这种矛盾的反应引发了对诊断准确性、治疗失败的可能性和潜在疾病存在的质疑,使其成为临床医生护理的一个重要话题。在这个病例报告中,我们提出了一个14岁女孩诊断和治疗结核性脑膜炎的矛盾反应。这名健康的免疫女孩成功地接受了类固醇治疗,我们讨论了治疗结核病进展悖论的重要性,尽管使用了有效的抗结核药物。孟加拉国J医学2023;34 (3): 245 - 251
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引用次数: 0
Answer to Medical Quiz - 1 Vol. 34(3) 2023 医学测验- 1卷34(3)2023的答案
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68446
Aminur Rahman
Abstract not available Bangladesh J Medicine 2023; 34(3): 262
[摘要]孟加拉J医学2023;34 (3): 262
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引用次数: 0
Typhoid Dengue Co-infection: 2 Case Reports 伤寒登革热合并感染:2例报告
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68434
Quazi Tarikul Islam, Ishrat Binte Reza, Asif Ahmed
Dengue and typhoid fever are different entities with overlapping signs and symptoms. The resemblance of symptoms makes clinical diagnosis and treatment difficult. Both are major health problems mainly during monsoon. If they are not diagnosed timely and treated, outcome can be fatal. We report 2 cases of dengue virus co-infection with typhoid fever during this outbreak of dengue. The aim of this report was to create awareness about this co-infectionBangladesh J Medicine 2023; 34(3): 239-240
登革热和伤寒是不同的实体,具有重叠的体征和症状。症状的相似性给临床诊断和治疗带来困难。两者都是主要的健康问题,主要在季风期间。如果不能及时诊断和治疗,结果可能是致命的。在这次登革热暴发期间,我们报告了2例登革热病毒合并感染伤寒病例。本报告的目的是提高对这种合并感染的认识(bangladesh J Medicine 2023);34 (3): 239 - 240
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引用次数: 0
Scars of Experience: Unleashing Hope 经验的伤痕:释放希望
Pub Date : 2023-09-03 DOI: 10.3329/bjm.v34i3.68443
Chowdhury H Ahsan
Abstract not availableBangladesh J Medicine 2023; 34(3): 257-259
孟加拉J Medicine; 2023;34 (3): 257 - 259
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引用次数: 0
期刊
Bangladesh Journal of Veterinary Medicine
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