Bangladesh Journal of Veterinary Medicine最新文献

{"title":"Cardiovascular assessment in Noncardiovascular surgery: what evidences say?","authors":"A. Maskey","doi":"10.3329/bjm.v34i20.66097","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66097","url":null,"abstract":"Annually more than 300 million patients (about 5% of the world population) undergo major surgery worldwide. Nearly 85% of major operations are noncardiac surgical procedures. Proper preoperative evaluation is important to reduce cardiovascular morbidity and mortality in patients undergoing noncardiac surgery. Cardiac risk is determined by two main factors: patient-related risk and surgical risk. Timing of surgery (Immediate, Urgent, time-sensitive, elective), type of surgical approach ( laparoscopy, vascular and endovascular procedure, open surgeries) , risk of surgery ( Low, intermediate, high surgical risk) determine surgical risk. Patient-related risk is assessed by patient’s age, the presence of cardiovascular risk factors (e.g. smoking, hypertension, diabetes, dyslipidaemia,) or established cardiovascular disease, and comorbidities (heart failure, arrhythmia etc.).In emergency surgery preoperative evaluation is limited as saving life is more important. In elective surgery patient related risk factors, comorbidity, associated cardiovascular diseases, timing and risk of surgery , functional capacity determine further preoperative evaluation with necessary investigations like ECG, Echo, laboratory investigations, biomarkers, stress test, coronary angiogram etc.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 179","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87240014","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":"Clinical Presentation of Heart Failure Patients Admitted in Colonel Maleque Medical College, Manikganj","authors":"Md. Toufiqur Rahman, RA Ahmed, Rumi Alam, M. A. Hossain, Md Sarowar Hossain, M. A. Hossain, Mohammad Nasimul Goni, Md Sajjadur Rahman, Mohammad Faridul Hoque, Manobendra Sarker","doi":"10.3329/bjm.v34i20.66180","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66180","url":null,"abstract":"Background: Heart failure is a complex syndrome that arises from abnormalities in the structure and/or function of the heart, whether inherited or acquired. This increase in prevalence and incidence is due to a variety of factors, including the aging of the population, improved survival rates from other cardiovascular diseases, and changes in lifestyle and risk factors such as obesity and diabetes. Heart failure patients have various presentations and different etiologies. This study aimed to see the different clinical presentations of hospitalized heart failure patients.\u0000Methods: This study was done to see Clinical Presentation of Heart Failure Patients admitted in Colonel Maleque Medical College, Manikganj and Maikganj Sadar Hospital. Total 3650 patients were enrolled for this study during the period of April 2018 to March 2023.\u0000Results: Most of the patients (60%) were of 51-70 years age group. 70 % (2555) patients were male. 99 % patients presented with SOB, 95 % patients had basal creps, 70% had orthopnoea, 49% had Paroxysmal Nocturnal Dyspoea (PND), 40% had leg edema and 25% had raised JVP. Average heart rate was 84 beats/min, average systolic B.P. was 128 mm Hg and average diastolic B.P. was 76 mm Hg. 49% population had hypertension, 39% patients had diabetes and 28% had concomitant respiratory illness. Average EF was 37 %. Ischemic Cardiomyopathy was the commonest (40%) cause of heart failure, acute coronary syndrome was the second leading (30%) cause, valvular heart disease and hypertension is the third common cause.\u0000Conclusion: Most of the heart failure patients are elderly age group. Most of the patients presented with shortness of breath and bilateral basal creps. Most patients had co-morbid other illness that influences the natural course of heart failure patients. Most common causes are ischemic cardiomyopathy, a sequel of ischemic insult of the heart.\u0000J Medicine 2023; Vol. 34, No. 2(1) Supplement: 219","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86749474","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":"Naphthalene Poisoning in a Young Glucose 6 Phosphate Dehydrogenase Deficient Patient","authors":"A. Begum","doi":"10.3329/bjm.v34i20.66179","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66179","url":null,"abstract":"Naphthalene poisoning is a rare form of toxicity that may occur after ingestion, inhalation, or dermal exposure to naphthalene-containing compounds. It is a volatile polycyclic hydrocarbon used as a household deodorizer and moth repellent.Ingestional naphthalene poisoning can leadto methaemo-globulinaemia and intravascular haemolysis with diagnostic and therapeutic challenge. Associated G6PD deficiency may make it more complicated. A 20-year-old man presented with low-grade fever, lethargy and dark urine for 4 days.His vitals showed normal temperature, tachycardia with normal blood pressure and low oxygen saturation(76%) despite having high flow oxygen (15L/min).On repeated queries, he gave a history of ingesting a few naphthalene balls after a heated conversation with his friends. Laboratory workup showed features of haemolysis, methaemoglobinaemia, haemoglobinuria and low glucose 6 phosphate dehydrogenase level. The patient was treated conservatively with intravenous fluid, packed red blood cells transfusion, N acetylcysteine andascorbic acid with full recovery.\u0000J Medicine 2023; Vol. 34, No. 2(1) Supplement: 218","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91245288","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":"Precision Medicine: An Emerging Approach for Patient Care","authors":"M Amir Hossain","doi":"10.3329/bjm.v34i20.66150","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66150","url":null,"abstract":"The philosophy behind contemporary healthcare is that one size fits all. Unfortunately, the outcomes of a standardized treatment regimen are not always uniform. That’s where the concept of precision medicine comes in. According to the Precision Medicine Initiative, precision medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.” This approach allow doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people and is in contrast to a one-size-fits-all approach, in which disease treatment and prevention strategies are developed for the average person, with less consideration for the differences between individuals. Although the term “precision medicine” is relatively new, the concept has been a part of healthcare for many years. For example, a person who needs a blood transfusion is not given blood from a randomly selected donor; instead, the donor’s blood type is matched to the recipient to reduce the risk of complications. The adoption of precision medicine will grow because its benefits to healthcare providers and patients are numerous. The highlighting ones are to shift the emphasis in medicine from reaction to prevention, predict susceptibility to disease, improve disease detection, preempt disease progression, customize disease-prevention strategies, prescribe more effective drugs, avoid prescribing drugs with predictable side effects and so on.The goal of precision medicine is to target the right treatments to the right patients at the right time. The short-term goals involve expanding precision medicine in the area of cancer research. Researchers at the National Cancer Institute (NCI) hope to use an increased knowledge of the genetics and biology of cancer to find new, more effective treatments for various forms of this disease. The long-term goals of the Precision Medicine Initiative focus on bringing precision medicine to all areas of health and healthcare on a large scale. Insufficient technologies, limited knowledge, and gaps in research are major obstacles to adding precision medicine to routine clinical care. Advances in precision medicine have already led to powerful new discoveries and FDA-approved treatments that are tailored to specific characteristics of individuals. Patients with a variety of cancers routinely undergo molecular testing as part of patient care, enabling physicians to select treatments that improve chances of survival and reduce exposure to adverse effects. Precision medicine will timely enable clinicians to integrate healthcare data with targeted assays and tests to identify and assess disease biomarkers and risks, determine actionable genetic variants in patients, obtain the entire picture of the metabolome, and map metabolites to disease pathways. Implementof precision medicine as a holistic approach, req","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135140816","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":"Approach to multidrug resistant bacterial infections","authors":"A. Basher","doi":"10.3329/bjm.v34i20.66143","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66143","url":null,"abstract":"Several bacterial pathogens have evolved into multidrug resistant (MDR) forms both in developed and developing countries at an expanding rate. The World Health Organization has identified antimicrobial resistance as one of the three most important problems facing human health. It was estimated that 4·95 million deaths were associated with bacterial AMR globally in 2019.1 Three infectious syndromes dominated the global burdens attributable to AMR: lower respiratory and thorax infections, bloodstream infections, and intra-abdominal infections. Some of the most important MDR pathogens that currently cause infection in hospital and in the community are the so-called “ESKAPE” pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and Enterobacter species), emphasizing their capacity to “escape” the effects of routine antibiotics. Most of the MDR studies were heterogeneous in terms of study design, patient population, site of infection, choice of antibiotic treatment, duration of followup period, and the outcome definitions, making it difficult to compare the different treatments and combinations of antibiotics used. Current recommendations in Europe and USA are based on systematic reviews that suggest different methods to prevent and control MDR infections, but provide little data on new and alternative antibiotic treatment options and therefore provide little firm guidance on specific treatment choices and algorithms. Attempts are ongoing to overcome antibacterial resistance by using new agents and combinations of new plus old agents. For example, both old (clavulanic acid, tazobactam) and new (avibactam, vaborbactam, relebactam) BLIs are being used in treatment algorithm for critically ill patients in the ICU according to MDR pathogen. There were still controversies regarding microbiological success for single agent compared with combinations of multiple agents. Many bacteria have the ability to produce biofilms, comprising organized congregations of bacteria adhering to each other making complex condition where antibiotic failed to wipe out bacteria despite of retaining in vitro susceptibility. It is also not always possible to conduct randomized controlled studies involving the required number of patients in a timely manner. So a requirement with the increasing choice of highly effective antimicrobial drugs, with dosages based on pharmacokinetic analysis of drug disposition, selection of the appropriate drug based on clinical microbiological data and pharmacodynamic indices. Rational antimicrobial therapy is more applicable today than in the history of antimicrobial therapy. Exploring newer modalities such as phage therapy and lytic antibiotics as well as obtaining a deeper understanding of the pathways involved in MDR mechanisms in order to engineer targeted drugs. Besides, rapid and comprehensive diagnostics are the key factor for the future management of antimicrobial resis","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77576971","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":"Kidney Disease – Bangladesh Perspective","authors":"M. R. Alam","doi":"10.3329/bjm.v34i20.66098","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66098","url":null,"abstract":"In Bangladesh, most patients with Chronic Kidney Disease (CKD) are diagnosed in the advanced stages of the disease, which leads to a high demand for kidney transplantation and dialysis services.Several studies suggest prevalence rate of CKD 6–18%; of them 11% were in stage III–V.Every year 35,000-40,000 new cases of kidney failure.Every year >20,000 chronic kidney failure patients die as they cannot afford dialysis or kidney transplant.73% treatment cost is out of pocket in Bangladesh.The cost of hemodialysis per session varies from 400- 4500 BDT (USD 4-45) depending on institute.Even the ultra-poor patients who take dialysis at the rate of BDT 500 (USD 5) per session have to spend a minimum of BDT 20,000 (USD 200) per month only for the treatment cost. 40% patients discontinue dialysis after 3-4 months due to financial constraint. The existing facilities can hardly accommodate 9000–10,000 new patients, which means RRT isnot available for 70–75% of ESRD patients.Annually dialysis is done on >18,000 kidney patients across the country.80% of the total kidney-related deaths are caused due to insolvency to continue treatment.Currently >90% of dialysis patients are receiving Hemodialysis.Initiatives are taken to make CAPD more accessible, but high cost of PD fluid & lack of trained personnel remains as major barriers. Challenges are there in providing Nephrocare.There is insufficient number and uneven distribution of trained medical & allied health professionals, lack of proper referral system & follow-up & lack of laboratory facility in many areas, particularly in rural setup.Absence of insurance coverage for kidney dialysis & transplant treatment.Absence of patient support group & their participation in policy making process. To overcome the challenges we have to ensure affordable & equitable access to kidney care for people living with CKD through Public & Public Private Partnerships. Protection from out-of-pocket healthcare expenditure through universal health coverage to provide insurance coverage for CKD patients and Subsidized treatment for dialysis & kidney transplant.Expansion of Fellowship program to develop more Nephrologists & training facility/ centers to develop more allied health professionals.Facilitating research for kidney disease with technical and financial support.Improve screening to ensure timely diagnosis and prevent CKD related complications.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 179-180","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90940145","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":"Treatment of Tuberculosis in special situations","authors":"M. D. Hossain, A. Mahmud, Md Ali Hossain, Mohammad Abdus Shakur Khan, K. Bennoor, Md Ferdous Wahid","doi":"10.3329/bjm.v34i20.66145","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66145","url":null,"abstract":"Treatment of Tuberculosis in special situations implies overcoming special challenges in patients with diabetes, pregnant women, people aged over 65 years, and those with chronic kidney or liver disease.Rifampicin is a potent hepatic enzyme inducer, may lower plasma levels of sulphonyl urea and can increase the hypoglycemic effect of metformin. Since insulin is not metabolized, no pharmacokinetic interactions with anti-TB drugs occur. Gastrointestinal upset and hepatitis are reported as the most frequent adverse events in older people. In patients >80 years,pyrazinamide may be omitted. In TB patients with chronic kidney disease (CKD), an inappropriate dosage of anti-TB drugs can result in unsuccessful treatment or side effects. Current guidelines for first-line anti-TB drugs therefore recommend that dosages of ethambutol (EMB) and pyrazinamide (PZA) be adjusted according to patient renal function and body weight, although no change in dosage is necessary for patients with mild renal insufficiency . However, it remains unknown how the renal function-based dosage adjustments recommended by the guidelines affect efficacy outcomes for TB patients with CKD. In chronic liver disease (CLD) patients, The Child–Turcotte–Pugh (CTP) score can be used as a guide for designing appropriate regimens. In stable CLD (CTP d”7), a treatment regimen including isoniazid, rifampicin, and ethambutol is recommended, a 2-month intensive phase with the three drugs, followed by isoniazid and rifampicin continuation phase for 7 months partially liver-sparing regimen consisting of Ethambutol, Rifampicin, and a quinolone for 9 months is advisable in case of more severe CLD (CTP 8–10).If CLD is very advanced (CTP £11), a total liver-sparing regimen consisting of Ethambutol and a quinolone (Levofloxacin or Moxifloxacin) for 12 months.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 196-197","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90971410","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":"Evaluation of the Efficacy and Tolerability of a Fixed Dose Combination of Amlodipine And Indapamide in Patients Older Than 55 Years","authors":"Q. Islam, K. Haque, Kaniz Moula, H. Ahasan, Md. Ismail Patwary, K. A. Azad, Mujibur Rahman, Md Zakir Hossain, M. Miah, A. Azad","doi":"10.3329/bjm.v34i20.66148","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66148","url":null,"abstract":"Background: There is very limited real-life data on hypertension management in Bangladeshi population. Considering this fact, this study evaluated the effectiveness of treatment with an indapamide/amlodipine single-pill combination (SPC) in Bangladeshi patients over the age of 55 years, in an OPD setting with uncontrolledsystolic hypertension in real-life clinical practice.\u0000Methods: This was a 3-month, multicenter, observational, open-label study conducted in 3 divisional cities of Bangladesh among patients with grade I or II hypertensions who were either uncontrolled on previous antihypertensive treatment or treatment-naïve. The effectiveness of indapamide/amlodipine SPC was assessed by the change in office systolic blood pressure (SBP) and the rate of target SBP (< 140 mmHg)achievement at 2 weeks, 1 month and 3 months, in four age groups: 55–59 years, 60–69 years, 70–79 years, and80 years or older.\u0000Results: The COMBINE study recruited 213 patients, of whom 185 took indapamide/amlodipine 1.5/5 mg SPC forafull three-month course of therapy.Mean age was 62.4±7.4 years, 76 men [41.1%] and 109 women [58.9%]. The absolute decrease of SBP during 3 months of taking indapamide/amlodipine single-pill combination (SPC) was 27.7 mm Hg, DBP - 10.2 mm Hg.After 3 months of treatment significant SBPdecreases from baseline were observed in each age group:”29.9 mmHg (from 156.7 to 126.8),”25.1 mmHg (from 152.7 to 127.6),”26.1 mmHg (from 152.8 to 126.7),and “ 24.5 mmHg (from 151.8 to 127.3)in the 55–59, 60–69, 70–79, and 80 years and older age groups, respectively.\u0000Conclusion: This COMBINE study results showed that indapamide/amlodipine SPC was associated with significant and rapid reductions in BP even in a different age range of Bangladeshi patients in routine clinical practice. This study result is consistent with already achieved data of this SPC globally.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 200","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86735706","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":"Unnecessary Prescription of Proton Pump Inhibitors (PPI): An Analysis of Inpatient Discharge Practices","authors":"Akhlak Ahamed","doi":"10.3329/bjm.v34i20.66152","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66152","url":null,"abstract":"Background: Proton pump inhibitors (PPI) have reportedly been used in inappropriate clinical settings, often leading to an increased risk of adverse effects, drug interactions, and costs.\u0000Aim: The aim of this study was to evaluate the appropriateness of PPI prescription on discharge of patients in medicine ward of a tertiary care hospital in Bangladesh.\u0000Methods: A cross-sectional study was done for 3 months in the department of medicine in a tertiary care hospital to evaluate the indications of PPI use, appropriateness of PPI use and types of PPI prescribed. A total of 107 patients who were prescribed PPI on discharge were enrolled after written informed consent and data were collected in a structured questionnaire.\u0000Results: Among the 107 patients discharged, 64 were males and 43 were females. The mean age was 51.3 ±17.6(SD) years.Among the study population, 49 were appropriately prescribed PPI and 58 were inappropriately prescribed PPI. Regarding indications, 53.1% received PPI for prevention of anti-platelet induced gastric erosion and 18.9% were prescribed PPI for no apparent reason. Age (p=0.199) and gender (p=0.605) was not significantly associated with the appropriate prescription of PPI.Of the various preparations of PPI prescribed, esomeprazole was prescribed in most of the discharged patients (56%).\u0000Conclusion: This study demonstrates the existence of an overprescription ofPPI. PPI prescription needs to be improved, thereby reducingdrug interactions, adverse effects and unnecessary economical expenses.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 202","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78582511","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":"Russell’s Viper Bite and Its Immediate Outcome In Bangladesh","authors":"A. S. M. M. Rahman, M. Haque, Mk Rahman, M. Amin, M. Faiz","doi":"10.3329/bjm.v34i20.66154","DOIUrl":"https://doi.org/10.3329/bjm.v34i20.66154","url":null,"abstract":"Background: Russell’s viper (Daboia russelii) is found in Asia, throughout Indian subcontinent, much of South East Asia, Southern China and Taiwan. Russell’s viper was seemed to be rare in Bangladesh. Anecdotes suggest that Russell’s viper (Daboia russelii) was an important cause of mortality in the 1920s, but no case of envenoming by this species has since been reported in Bangladesh. Russell’s viper bite has been reported and it is the one of the common snake bite at Rajshahi region which has great morbidity and mortality as well.\u0000Methods: This is a prospective observational study was conducted in the Medicine department of Rajshahi Medical College Hospital. We treated total 171 patients from 2013 to December 2022. Russell’s viper envenomation confirmed either by brought dead or live snake specimen, photograph, bedside 20MWBCT and other symptoms.\u0000Results: In the management of RV bite patient in the Rajshahi Medical College Hospital, we found that most of the patients are delayed in getting hospitalization after bite due to visit to traditional healer. In our study 96% were male, and 4% were female, mostly farmer and 90% bite site in the lower limb during work in the paddy field. The clinical presentation was pain and local swelling (100%), blood oozing from local site (77%), bruising (44%), haematuria (25%), hypotension (30%), oliguria and few with DIC. In lab findings, coagulopathy (24%), raised CPK (60%), 67% Patients had AKI (raised creatinine and RBC in urine), among them 50% needed dialysis. Few patients also develop multiorgan failure. All patients received polyvalent Anti-venomsupplied by GOB (Incepta Bangladesh Ltd.) which works against cobra, krait, Russell’s viper bite. Despite maximum available support at RMCH, around 30% patient died.\u0000Conclusion: It’s high mortality indicates that this polyvalent antivenom might not be working properly. We may need to increase the initial dose or we need to provide monovalent antivenom specific to RV in Bangladesh and early treatment at Upazila Health Complex to reduce the rate of death due to Russell’s viper bite.\u0000Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 204","PeriodicalId":8721,"journal":{"name":"Bangladesh Journal of Veterinary Medicine","volume":"1 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":"77728083","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}