Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66149
Marium Waheed
Background: Neonatal period is the most vulnerable time for the occurrence of seizures. There are various etiological factors of neonatal seizures and increasing evidence suggests that neonatal seizures are associated with adverse neurodevelopment outcomes. The aim of the study is to determine of causes of neonatal seizures with outcome during management and long-term post-natal outcome. Methods: This prospective study conducted in Rangpur Mother and Children Hospital from 1st July to 2017 to 30th June 2022. Term newborn babies admitted in NICU with convulsion were the samples. A prepared and pretested “Protocol” containing Part-A and Part-B was used - Part-A in neonatal intensive care unit and Part-B in the attached Disability Research Center. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 200-201
{"title":"Neonatal Seizures and Neurodevelopmental Outcome","authors":"Marium Waheed","doi":"10.3329/bjm.v34i20.66149","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66149","url":null,"abstract":"Background: Neonatal period is the most vulnerable time for the occurrence of seizures. There are various etiological factors of neonatal seizures and increasing evidence suggests that neonatal seizures are associated with adverse neurodevelopment outcomes. The aim of the study is to determine of causes of neonatal seizures with outcome during management and long-term post-natal outcome.\u0000Methods: This prospective study conducted in Rangpur Mother and Children Hospital from 1st July to 2017 to 30th June 2022. Term newborn babies admitted in NICU with convulsion were the samples. A prepared and pretested “Protocol” containing Part-A and Part-B was used - Part-A in neonatal intensive care unit and Part-B in the attached Disability Research Center.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 200-201","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78398820","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66160
M. Matin
Background: COVID-19 is a worldwide pandemic causing huge burden on healthcare facilities. Most of the cases were asymptomatic and few were symptomatic. We still comprehensively did not know the exact estimated COVID-19 (symptomatic & asymptomatic) population. We had needed to identify the asymptomatic population of COVID-19 through the immune response of IgG antibody titer against spike protein of SARS CoV-2. The aim of the study is to determine the seroconversion in hospitalized COVID-19 patients and seroprevalence among healthcare workers and control community group against SARS CoV-2 infection. Methods: This observational study was carried out in COVID-19 unit of Bangabandhu Sheikh Mujib Medical University (BSMMU). Information about sociodemographic status, comorbidities, results of antibody response (IgG titer) and other relevant information was collected using a pre-designed data collection sheet. In this study, total 211 participants included and total 343 samples was taken for IgG titer measurement by ELISA method. The data was analyzed by SPSS version 25 and Graph pad prism version 8. Statistical analysis was done by using Chi-square test, Student’s t-test or Mann-Whitney U test. Statistical significance was defined as p value d”0.05. Results: Among COVID-19 patients 58.6% (34) were male and 41.4% (24) were female, median (IQR) age was 45.5 (33 to 57) and median (IQR) Body Mass Index (BMI) was 25.4 (23.39 to 27.42). Among the Healthcare workers 54.9% (84) were male and 45.1% (69) were female, median (IQR) age was 30 (25 to 33) and median (IQR) Body Mass Index (BMI) was 24 (21.53 to 25.71). The antibody titer persisted for more than 3 months in all hospitalized patients and no one was seronegative during the study period. The overall seroprevalence of healthcare workers were 54.9% and Doctors- 38%, Nurses-53.84% & Support staff- 72.54%. Anti-spike IgG titer was significantly higher in severe diseases but had no significant change with age, sex, body mass index, or diabetic status. Conclusion: This study shows persistence of antibody titers after 3 months in recovered COVID-19 patients. The results demonstrate high seroprevalence among the healthcare workers and control community group. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 207
背景:COVID-19是一种全球性的大流行，给医疗机构带来了巨大的负担。大多数病例无症状，少数有症状。我们仍然全面不知道COVID-19(有症状和无症状)人口的确切估计。我们需要通过SARS CoV-2刺突蛋白IgG抗体滴度的免疫应答来确定COVID-19无症状人群。本研究的目的是确定住院COVID-19患者的血清转化情况以及医护人员和对照社区人群对SARS - CoV-2感染的血清阳性率。方法:本观察性研究在Bangabandhu Sheikh Mujib医科大学(BSMMU) COVID-19科室进行。使用预先设计的数据收集表收集社会人口状况、合并症、抗体反应结果(IgG滴度)和其他相关信息。本研究共纳入211名被试，共抽取343份样本，采用ELISA法检测IgG滴度。采用SPSS version 25和Graph pad prism version 8对数据进行分析。统计分析采用卡方检验、学生t检验或Mann-Whitney U检验。统计学意义定义为p值为0.05。结果:新冠肺炎患者中男性34例(58.6%)，女性24例(41.4%)，IQR中位年龄45.5 (33 ~ 57)，BMI中位(IQR) 25.4(23.39 ~ 27.42)。其中男性84人(54.9%)，女性69人(45.1%)，年龄中位数(IQR)为30岁(25 ~ 33岁)，体质指数(BMI)中位数(IQR)为24(21.53 ~ 25.71)。所有住院患者抗体滴度持续3个月以上，研究期间无血清阴性。卫生保健工作者总体血清阳性率为54.9%，医生为38%，护士为53.84%，支持人员为72.54%。抗刺突IgG滴度在严重疾病中显著升高，但与年龄、性别、体重指数或糖尿病状态无显著变化。结论:本研究显示COVID-19康复患者抗体滴度在3个月后持续存在。结果表明，在卫生保健工作者和对照社区群体中，血清阳性率较高。孟加拉国J医学2023;第34卷，第2(1)号补编:207
{"title":"Humoral immune response against SARS COV-2 infection in hospitalized COVID-19 patients and healthcare workers","authors":"M. Matin","doi":"10.3329/bjm.v34i20.66160","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66160","url":null,"abstract":"Background: COVID-19 is a worldwide pandemic causing huge burden on healthcare facilities. Most of the cases were asymptomatic and few were symptomatic. We still comprehensively did not know the exact estimated COVID-19 (symptomatic & asymptomatic) population. We had needed to identify the asymptomatic population of COVID-19 through the immune response of IgG antibody titer against spike protein of SARS CoV-2. The aim of the study is to determine the seroconversion in hospitalized COVID-19 patients and seroprevalence among healthcare workers and control community group against SARS CoV-2 infection.\u0000Methods: This observational study was carried out in COVID-19 unit of Bangabandhu Sheikh Mujib Medical University (BSMMU). Information about sociodemographic status, comorbidities, results of antibody response (IgG titer) and other relevant information was collected using a pre-designed data collection sheet. In this study, total 211 participants included and total 343 samples was taken for IgG titer measurement by ELISA method. The data was analyzed by SPSS version 25 and Graph pad prism version 8. Statistical analysis was done by using Chi-square test, Student’s t-test or Mann-Whitney U test. Statistical significance was defined as p value d”0.05.\u0000Results: Among COVID-19 patients 58.6% (34) were male and 41.4% (24) were female, median (IQR) age was 45.5 (33 to 57) and median (IQR) Body Mass Index (BMI) was 25.4 (23.39 to 27.42). Among the Healthcare workers 54.9% (84) were male and 45.1% (69) were female, median (IQR) age was 30 (25 to 33) and median (IQR) Body Mass Index (BMI) was 24 (21.53 to 25.71). The antibody titer persisted for more than 3 months in all hospitalized patients and no one was seronegative during the study period. The overall seroprevalence of healthcare workers were 54.9% and Doctors- 38%, Nurses-53.84% & Support staff- 72.54%. Anti-spike IgG titer was significantly higher in severe diseases but had no significant change with age, sex, body mass index, or diabetic status.\u0000Conclusion: This study shows persistence of antibody titers after 3 months in recovered COVID-19 patients. The results demonstrate high seroprevalence among the healthcare workers and control community group.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 207 ","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74446704","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66186
MH Parvaz, S. Yesmin, I. Khalil, MR Rahman, AA Uddin
Disseminated Tuberculosis is a potentially lethal disease if not diagnosed and treated early. A high index of clinical suspicion and early diagnosis and timely institution of anti TB treatmen is life saving.Patient’s sociodemographic, clinical, labarotory investigations and treatment outcome were recorded in a case record form Here we report a case of 42 year old male, known case of diabetes mellitus, presented with the complaints of fever and headache for 1 month, dropping of both eyelids, diplopia and painful red eyes for 7 days. There was no sign of meningeal irritation. Neurological examination revealed proptosis and 3rd, 4th, 6th cranial nerve palsy as evident by bilateral ptosis, diplopia, restricted ocular movement in all direction. Fundoscopy showed choroid tubercle on left eye. CSF study suggestive of tubercular meningitis. CXR showed pleural effusion and pleural fluid study suggestive of tuberculous pleural effusion. We diagnosed him as disseminated tuberculosis (tubercular meningitis, ocular TB, pleural TB). After starting anti tubercular regimen and steroid, patient’s condition got improved. Disseminated tuberculosis usually presents with constitutional symptoms rather than respiratory features. Tubercular meningitis not always present with features of meningism. Choroid tubercle is pathognomic for tubercular meningitis. Early diagnosis and treatment can reduce the mortality, morbidity and complications of disseminated TB. J Medicine 2023; Vol. 34, No. 2(1) Supplement: 224
{"title":"Multiple Cranial Nerve Palsy & Choroid Tuberculoma in a Patient with Disseminated TB: A Clinic Biochemical Study","authors":"MH Parvaz, S. Yesmin, I. Khalil, MR Rahman, AA Uddin","doi":"10.3329/bjm.v34i20.66186","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66186","url":null,"abstract":"Disseminated Tuberculosis is a potentially lethal disease if not diagnosed and treated early. A high index of clinical suspicion and early diagnosis and timely institution of anti TB treatmen is life saving.Patient’s sociodemographic, clinical, labarotory investigations and treatment outcome were recorded in a case record form Here we report a case of 42 year old male, known case of diabetes mellitus, presented with the complaints of fever and headache for 1 month, dropping of both eyelids, diplopia and painful red eyes for 7 days. There was no sign of meningeal irritation. Neurological examination revealed proptosis and 3rd, 4th, 6th cranial nerve palsy as evident by bilateral ptosis, diplopia, restricted ocular movement in all direction. Fundoscopy showed choroid tubercle on left eye. CSF study suggestive of tubercular meningitis. CXR showed pleural effusion and pleural fluid study suggestive of tuberculous pleural effusion. We diagnosed him as disseminated tuberculosis (tubercular meningitis, ocular TB, pleural TB). After starting anti tubercular regimen and steroid, patient’s condition got improved. Disseminated tuberculosis usually presents with constitutional symptoms rather than respiratory features. Tubercular meningitis not always present with features of meningism. Choroid tubercle is pathognomic for tubercular meningitis. Early diagnosis and treatment can reduce the mortality, morbidity and complications of disseminated TB.\u0000J Medicine 2023; Vol. 34, No. 2(1) Supplement: 224","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83059029","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66122
S. Syed
Medically unexplained somatic complaints (MUSC) are a common phenomenon in primary care settings, and they pose a challenge to clinicians in terms of diagnosis and management. MUSC refers to the presence of physical symptoms that are not attributed to any known medical or organic cause. These symptoms can significantly affect patients’ quality of life and impose a substantial burden on healthcare systems. In real-life clinical practice, managing MUSC requires a multifaceted approach that includes a thorough clinical evaluation, psychoeducation, and collaborative care. The management of MUSC should start with establishing a good rapport with the patient and understanding their concerns and beliefs about their symptoms. Clinicians should also rule out any underlying medical conditions that may contribute to the symptoms. Once medical causes are excluded, the focus should shift to addressing the psychosocial factors that may be contributing to the symptoms. This can include educating patients about the nature of MUSC and the role of stress and anxiety in exacerbating their symptoms. Collaborative care involving primary care clinicians, mental health professionals, and other specialists is an effective approach for managing MUSC. It is essential to tailor the treatment to the individual needs of the patient and to ensure that they are engaged and motivated to participate in their care. In conclusion, managing MUSC in real-life clinical practice requires a collaborative, patient-centered approach that addresses the physical, psychological, and social factors contributing to the symptoms. Clinicians should adopt a biopsychosocial model of care and that maximizes patient engagement and improves their quality of life. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 184
{"title":"Medically unexplained somatic complaints: management in real life","authors":"S. Syed","doi":"10.3329/bjm.v34i20.66122","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66122","url":null,"abstract":"Medically unexplained somatic complaints (MUSC) are a common phenomenon in primary care settings, and they pose a challenge to clinicians in terms of diagnosis and management. MUSC refers to the presence of physical symptoms that are not attributed to any known medical or organic cause. These symptoms can significantly affect patients’ quality of life and impose a substantial burden on healthcare systems. In real-life clinical practice, managing MUSC requires a multifaceted approach that includes a thorough clinical evaluation, psychoeducation, and collaborative care. The management of MUSC should start with establishing a good rapport with the patient and understanding their concerns and beliefs about their symptoms. Clinicians should also rule out any underlying medical conditions that may contribute to the symptoms. Once medical causes are excluded, the focus should shift to addressing the psychosocial factors that may be contributing to the symptoms. This can include educating patients about the nature of MUSC and the role of stress and anxiety in exacerbating their symptoms. Collaborative care involving primary care clinicians, mental health professionals, and other specialists is an effective approach for managing MUSC. It is essential to tailor the treatment to the individual needs of the patient and to ensure that they are engaged and motivated to participate in their care. In conclusion, managing MUSC in real-life clinical practice requires a collaborative, patient-centered approach that addresses the physical, psychological, and social factors contributing to the symptoms. Clinicians should adopt a biopsychosocial model of care and that maximizes patient engagement and improves their quality of life.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 184","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77747774","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66144
C. K. Ghosh
Differentiating Crohn’s disease (CD) and Intestinal tuberculosis (TB) is a diagnostic dilemma for most of the Clinicians in the developing world where ITB is endemic and CD incidence is increasing. These two granulomatus diseases are remarkably similar in their clinical, endoscopic, radiologic and pathologic features. The only exclusive features are caseation necrosis on biopsy, positive smear for acid-fast bacillus (AFB) and / or AFB culture, and necrotic lymph node on cross-sectional imaging in ITB. These exclusive features are limited by poor sensitivity ( pauci bacillary disease ) and nonspecific diagnostic criteria for CD.However, ITB is potentially curable whereas CD is incurable disease. But rate of misdiagnosis of CD and ITB range between 50% and 70% worldwide. An incorrect diagnosis and treatment may increase complications, morbidity and mortality. A high index of suspicion and critical analysis of clinical, endoscopic, histologic, microbiologic, radiologic and serologic features are required for differentiation between CD and ITB. However, therapeutic anti-tubercular therapy (ATT) trial is still required in a significant proportion of patients to establish the diagnosis. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 196
{"title":"Crohn’s Disease and intestinal tuberculosis: allusion and illusion","authors":"C. K. Ghosh","doi":"10.3329/bjm.v34i20.66144","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66144","url":null,"abstract":"Differentiating Crohn’s disease (CD) and Intestinal tuberculosis (TB) is a diagnostic dilemma for most of the Clinicians in the developing world where ITB is endemic and CD incidence is increasing. These two granulomatus diseases are remarkably similar in their clinical, endoscopic, radiologic and pathologic features. The only exclusive features are caseation necrosis on biopsy, positive smear for acid-fast bacillus (AFB) and / or AFB culture, and necrotic lymph node on cross-sectional imaging in ITB. These exclusive features are limited by poor sensitivity ( pauci bacillary disease ) and nonspecific diagnostic criteria for CD.However, ITB is potentially curable whereas CD is incurable disease. But rate of misdiagnosis of CD and ITB range between 50% and 70% worldwide. An incorrect diagnosis and treatment may increase complications, morbidity and mortality. A high index of suspicion and critical analysis of clinical, endoscopic, histologic, microbiologic, radiologic and serologic features are required for differentiation between CD and ITB. However, therapeutic anti-tubercular therapy (ATT) trial is still required in a significant proportion of patients to establish the diagnosis.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 196","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74715739","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66138
Z. Khan
Superficial dermatophytosisis currently caused by dermatophytes belonging to three genera, namely Trichophyton, Microspurum and Epidermophyton. In recent years, superficialmycosis have becomeincreasingly resistant to current antifungal treatment. Multiple incidences of chronic infections, reinfections and treatment failure have been reported. The epidemiological shift from T, rubrumtoT. mentagrophytes/ T. interdigitalis are the dominant pathogen in recent tenea patients. Limitation of available approved antifungals for dermatophytosis treatment and difficulties or unavailability of culture and sensitivity test for fungus also contribute to difficulties in treatment outcome.The change in the clinical scenario with increasing frequency of treatment failure gives rise to innumerate treatment options based on individual experience from case by case. We focus on treatmentschedule given in standard textbooks and the current modifications that have evolved to treat the dermatophytosis. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 193
{"title":"Difficulties in Treating Dermatophytes: A Way To Overcome","authors":"Z. Khan","doi":"10.3329/bjm.v34i20.66138","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66138","url":null,"abstract":"Superficial dermatophytosisis currently caused by dermatophytes belonging to three genera, namely Trichophyton, Microspurum and Epidermophyton. In recent years, superficialmycosis have becomeincreasingly resistant to current antifungal treatment. Multiple incidences of chronic infections, reinfections and treatment failure have been reported. The epidemiological shift from T, rubrumtoT. mentagrophytes/ T. interdigitalis are the dominant pathogen in recent tenea patients. Limitation of available approved antifungals for dermatophytosis treatment and difficulties or unavailability of culture and sensitivity test for fungus also contribute to difficulties in treatment outcome.The change in the clinical scenario with increasing frequency of treatment failure gives rise to innumerate treatment options based on individual experience from case by case. We focus on treatmentschedule given in standard textbooks and the current modifications that have evolved to treat the dermatophytosis.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 193","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86283624","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66165
A. Kabir
Conventional autologous and allogenic hematopoietic stem cell transplants (HSCT) are lifesaving or life extending medical procedures but associated with significant risk for non-infectious and infectious complications. The center for international blood and marrow transplant research estimates that worldwide about 100000 transplants are performed yearly. The frequency of transplantation is varied widely from country to country, with a close association of transplant rates with gross national income (GNI) per-capita. Appropriate indication for transplant is mandatory for these rigorous procedures. Hematological malignancies, bone marrow failure syndromes, inherited immune deficiencies, hemoglobinopathies and inherited metabolic disorders are usual indications for BMT. Sources of hematopoietic stem cells are crucial. Patient evaluation includes psychosocial and systems evaluation. Foundation for the Accreditation of cellular therapy (FACT) is required. General guidelines for patient eligibility are chemo sensitive, adequate performance status, adequate nonhematopoietic organ function, ability to provide informed consent and adequately matched available donor or adequate collection of autologous stem cells. Exclusion criteria include chemo refractory, life expectancy severely limited by other illness, inability to tolerate preparative regimen and pregnancy. Relative contraindications are major medical comorbidities, major psychiatric illness and lack of insurance/financial resources. Comorbidities are cardiac arrhythmia, EF d” 50%, body mass index e” 35 kg/m2, serum creatinine > 2 mg/dl and EFV1 d” 65%. Allogeneic donor evaluation is also vital and includes HLA typing for HLA-A, -B, -DRBI; screening of transmissible diseases, laboratories, consents and notifications. J Medicine 2023; Vol. 34, No. 2(1) Supplement: 212
{"title":"Pre-transplant Medical Evaluation: A Multidisciplinary Approach","authors":"A. Kabir","doi":"10.3329/bjm.v34i20.66165","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66165","url":null,"abstract":"Conventional autologous and allogenic hematopoietic stem cell transplants (HSCT) are lifesaving or life extending medical procedures but associated with significant risk for non-infectious and infectious complications. The center for international blood and marrow transplant research estimates that worldwide about 100000 transplants are performed yearly. The frequency of transplantation is varied widely from country to country, with a close association of transplant rates with gross national income (GNI) per-capita. Appropriate indication for transplant is mandatory for these rigorous procedures. Hematological malignancies, bone marrow failure syndromes, inherited immune deficiencies, hemoglobinopathies and inherited metabolic disorders are usual indications for BMT. Sources of hematopoietic stem cells are crucial. Patient evaluation includes psychosocial and systems evaluation. Foundation for the Accreditation of cellular therapy (FACT) is required. General guidelines for patient eligibility are chemo sensitive, adequate performance status, adequate nonhematopoietic organ function, ability to provide informed consent and adequately matched available donor or adequate collection of autologous stem cells. Exclusion criteria include chemo refractory, life expectancy severely limited by other illness, inability to tolerate preparative regimen and pregnancy. Relative contraindications are major medical comorbidities, major psychiatric illness and lack of insurance/financial resources. Comorbidities are cardiac arrhythmia, EF d” 50%, body mass index e” 35 kg/m2, serum creatinine > 2 mg/dl and EFV1 d” 65%. Allogeneic donor evaluation is also vital and includes HLA typing for HLA-A, -B, -DRBI; screening of transmissible diseases, laboratories, consents and notifications.\u0000J Medicine 2023; Vol. 34, No. 2(1) Supplement: 212 ","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90729177","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66185
T. Ferdousi, Hurjahan Banu, N. Sultana, Hafsa Mahrukh, Kishore Kumar Shil, M. Hasanat
Background: Turner’ssyndrome (TS) is the most common cause of short stature and delayed puberty of female sex. Approximately half of the patients have its classic form of 45 XO, one fourth of patients are different mosaic forms and the remaining cases are structural abnormalities on X chromosome, among them most common structural abnormality is isochromosomeXq. These variant Turner’s can present with delayed menarche, amenorrhoea and infertility rather than classic manifestations of TS.Here we describetwo uncommon variants of TS, one is structural abnormality on X chromosome as 46X, iso(Xq) and another one is mosaic variety of TS including Isochromosome X as form of 45XO/46X, iso(Xq).Both of them presented with short stature and secondary amenorrhea without classic manifestations of TS. In TS with or without mosaicism, the frequency of isochromosome is reportedto be about 15-18%. Due to lack of classical manifestations of TS, diagnosis may be delayed and/or missed. So, female of short stature with secondary amenorrhoea should be searched for rare variants of TS by chromosomal analysis. J Medicine 2023; Vol. 34, No. 2(1) Supplement: 223
{"title":"Two Rare Variants of Turner Syndrome with Isochromosome Structural Abnormalities","authors":"T. Ferdousi, Hurjahan Banu, N. Sultana, Hafsa Mahrukh, Kishore Kumar Shil, M. Hasanat","doi":"10.3329/bjm.v34i20.66185","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66185","url":null,"abstract":"Background: Turner’ssyndrome (TS) is the most common cause of short stature and delayed puberty of female sex. Approximately half of the patients have its classic form of 45 XO, one fourth of patients are different mosaic forms and the remaining cases are structural abnormalities on X chromosome, among them most common structural abnormality is isochromosomeXq. These variant Turner’s can present with delayed menarche, amenorrhoea and infertility rather than classic manifestations of TS.Here we describetwo uncommon variants of TS, one is structural abnormality on X chromosome as 46X, iso(Xq) and another one is mosaic variety of TS including Isochromosome X as form of 45XO/46X, iso(Xq).Both of them presented with short stature and secondary amenorrhea without classic manifestations of TS. In TS with or without mosaicism, the frequency of isochromosome is reportedto be about 15-18%. Due to lack of classical manifestations of TS, diagnosis may be delayed and/or missed. So, female of short stature with secondary amenorrhoea should be searched for rare variants of TS by chromosomal analysis.\u0000J Medicine 2023; Vol. 34, No. 2(1) Supplement: 223","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91357255","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}
Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66118
M. Khalequzzaman
ST-Segment Elevation Myocardial (STEMI) is a lifethreatening condition that requires emergent, complex, well-coordinated treatment. Although the primary goal of treatment is simple to describe, reperfusion as quickly as possible- the management process is complicated and is affected by multiple factors including location, patient and practitioners’ characteristics. Indeed, treatment of acute STEMI has progressed considerably over the past 100 years, from the early stages of bed rest and development of thrombolytics and myocardial reperfusion, to today’s current strategy with a variety of mechanical and pharmacologic modalities. But the debate continues regarding optimal antithrombotic/anticoagulant and interventional strategies employed. Given the scientific and technological advantages, treatment strategies can be catered to better suit the patient and their presentation. Fibrinolytic therapy did save the lives compared to placebo, but at best restored Thrombolysis in Myocardial Infarction (TIMI) 3 Flow in 55-70% cases with increased incidence of recurrent ischaemia and infarction and intracranial haemorrhage. From Primary Angioplasty in Myocardial Infarction (PAMI) to 23 RCTs of Thrombolysis in Myocardial Infarction (TIMI) Vs Lysis showed that there is significant reduction in death (7.0% Vs 9.3%), Re-infarction (2.5% Vs 6.8%), haemorrhagic stroke (0.1% Vs 1.0%) and total stroke (1.0%) in Percutaneous Coronary Intervention (PCI) group. STEMI success has plateaued because of suboptimal salvage of myocardium and high rates of non-culprit lesion related events and reperfusion injury. Promising approaches should be further explored like hypothermia, stem cell and super-saturated oxygen therapy and PiCSO to enhance myocardial recovery and reduce infarct size. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 182
st段抬高心肌(STEMI)是一种危及生命的疾病，需要紧急、复杂、协调的治疗。虽然治疗的首要目标很简单，即尽快再灌注，但治疗过程复杂，受位置、患者和医生特点等多种因素的影响。事实上，在过去的100年里，急性STEMI的治疗已经取得了相当大的进展，从早期的卧床休息和溶栓和心肌再灌注的发展，到今天的各种机械和药物模式的当前策略。但是关于最佳抗血栓/抗凝和介入治疗策略的争论仍在继续。鉴于科学和技术的优势，治疗策略可以更好地适应患者和他们的表现。与安慰剂相比，纤溶治疗确实挽救了生命，但在55-70%的复发性缺血、梗死和颅内出血发生率增加的病例中，纤溶治疗最多只能恢复心肌梗死(TIMI) 3 Flow中的溶栓。从心肌梗死初始血管成形术(PAMI)到心肌梗死溶栓(TIMI)与溶栓的23项随机对照试验显示，经皮冠状动脉介入治疗(PCI)组的死亡率(7.0% Vs 9.3%)、再梗死(2.5% Vs 6.8%)、出血性卒中(0.1% Vs 1.0%)和总卒中(1.0%)显著降低。STEMI的成功已经趋于平稳，因为心肌修复不理想，非罪魁祸首病变相关事件和再灌注损伤的发生率很高。低温、干细胞和过饱和氧治疗以及PiCSO等有希望的方法可以促进心肌恢复，缩小梗死面积。孟加拉国J医学2023;第34卷，第2(1)号补编:182
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Pub Date : 2023-05-24DOI: 10.3329/bjm.v34i20.66163
M. Hasan, N. Sultana, Indira Roy, Amrit Rijal, M. Hasanat
Background: Adipokines and inflammatory cytokines may have an important impact on rising trend of diabetes in young across the globe. To see the association of serum adiponectin, leptin, resistin, tumor necrosis factor-alpha (TNF-á) and C-reactive protein (CRP) with obesity and abnormal glucose tolerance (AGT, includes both prediabetes and diabetes) in young Bangladeshi. Methods: This case-control study included 40 young participants with AGT [age 26 years (IQR 24-29); 60.0% female] and 40 with normal glucose tolerance [NGT; age 25 years (IQR 22-28); 44.0% female] encompassed following the oral glucose tolerance test (OGTT) and HbA1c. Insulin resistance (IR) was calculated by homeostasis model assessment (HOMA). The measurement of serum adiponectin, leptin, resistin and TNF-á was done by ELISA whereas CRP by Chemiluminescent tests. Results: Level of TNF-á, leptin, and adiponectin as well as frequency of raised resistin and CRP were statistically similar between AGT and NGT (p=NS for all). TNF-á, leptin and CRP were positively correlated while adiponectin and resistin were negatively correlated with measures of obesity. No adipokines or inflammatory cytokines had any significant correlation to glycemic measures, except negative correlation in AGT with leptin and CRP. Fasting insulin and IR had a positive correlation with leptin and CRP, negative correlation with adiponectin and resistin while no significant correlations with TNF-á. None of the cytokines or inflammatory markers were independent predictors of AGT in youth. Conclusion: The serum levels of cytokines do not differ significantly between AGT and NGT subgroups of young subjects and none of the cytokines was observed to be independent predictor over AGT in young. J Medicine 2023; Vol. 34, No. 2(1) Supplement: 209-210
{"title":"Impact of Adipokines and Inflammatory Cytokines On Abnormal Glucose Tolerance in Young","authors":"M. Hasan, N. Sultana, Indira Roy, Amrit Rijal, M. Hasanat","doi":"10.3329/bjm.v34i20.66163","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66163","url":null,"abstract":"Background: Adipokines and inflammatory cytokines may have an important impact on rising trend of diabetes in young across the globe. To see the association of serum adiponectin, leptin, resistin, tumor necrosis factor-alpha (TNF-á) and C-reactive protein (CRP) with obesity and abnormal glucose tolerance (AGT, includes both prediabetes and diabetes) in young Bangladeshi.\u0000Methods: This case-control study included 40 young participants with AGT [age 26 years (IQR 24-29); 60.0% female] and 40 with normal glucose tolerance [NGT; age 25 years (IQR 22-28); 44.0% female] encompassed following the oral glucose tolerance test (OGTT) and HbA1c. Insulin resistance (IR) was calculated by homeostasis model assessment (HOMA). The measurement of serum adiponectin, leptin, resistin and TNF-á was done by ELISA whereas CRP by Chemiluminescent tests.\u0000Results: Level of TNF-á, leptin, and adiponectin as well as frequency of raised resistin and CRP were statistically similar between AGT and NGT (p=NS for all). TNF-á, leptin and CRP were positively correlated while adiponectin and resistin were negatively correlated with measures of obesity. No adipokines or inflammatory cytokines had any significant correlation to glycemic measures, except negative correlation in AGT with leptin and CRP. Fasting insulin and IR had a positive correlation with leptin and CRP, negative correlation with adiponectin and resistin while no significant correlations with TNF-á. None of the cytokines or inflammatory markers were independent predictors of AGT in youth.\u0000Conclusion: The serum levels of cytokines do not differ significantly between AGT and NGT subgroups of young subjects and none of the cytokines was observed to be independent predictor over AGT in young.\u0000J Medicine 2023; Vol. 34, No. 2(1) Supplement: 209-210 ","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"57 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83700747","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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