Journal of Bangladesh College of Physicians & Surgeons最新文献

{"title":"Procalcitonin as a Sepsis Marker in Patients of Critical Care Unit","authors":"R. Jasmine, S. Giti, A. Khan, N. Jubaida, L. Naznin","doi":"10.3329/jbcps.v41i3.66899","DOIUrl":"https://doi.org/10.3329/jbcps.v41i3.66899","url":null,"abstract":"Introduction: The aim of this study was to observe the diagnostic role of procalcitonin to evaluate sepsis and assess the level of inflammation for the patients of Critical Care Unit of different departments.\u0000Methods: This cross sectional, prospective and observational study was conducted at Armed Forces Institute of Pathology on the patients at Critical Care Unit of Paediatric, Surgery, Gynae and Medicine department in a tertiary care hospital (Combined Military Hospital, Dhaka) from June, 2020 to May, 2021. Total 106 patients were enrolled in this study. As the study was conducted during corona pandemic, RT-PCR test for Corona virus disease 2019 (COVID-19) along with serum procalcitonin and bacterial culture and sensitivity tests for different samples were prescribed for all 106 patients.\u0000Result: Out of 106 patients, 30.2% (32) patients were found positive and 69.69% (74) were found negative for COVID- 19 and 14.15% (15) patients had clinical documentation of bacterial co-infection, confirmed by blood, respiratory, or urine culture. After PCT test, 20.75 % (22) samples were found with severe sepsis or septic shock, 7.54% (08) samples were found with systemic infection, 18.06% (20) samples were with possible systemic infection, 31.13 % (33) samples were with local infections and 21.69% (23) were found within normal ranges of PCT.\u0000Conclusion: This study supports the importance of the diagnostic role of PCT to assess the level of sepsis as well as presence of co-infection which suggests that PCT level is a good biomarker for early diagnosis, assessment and treatment of patients in CCU.\u0000J Bangladesh Coll Phys Surg 2023; 41: 198-204","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45716254","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":"VATS (Video Assisted Thoracoscopic Surgery) Pleural Biopsy in the Diagnosis of Unexplained Pleural Effusion","authors":"Sheikh Md Zakirullah Rasha, A. Kibria, K. S. Islam, Md. Mofizur Rahman Mia, Manabendra Biswas, Mosharraf Hossain, A. Rahim, Dashab Hannan, A. Haque","doi":"10.3329/jbcps.v41i2.64505","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64505","url":null,"abstract":"Introduction:An unexplained pleural effusion is a difficult diagnostic dilemma that needs further histological study for a definitive etiological diagnosis. Video assisted thoracoscopic (VATS) pleural biopsy is a minimally invasive procedure that could resolve this problem. The study is conducted to determine the efficacy of VATS pleural biopsy in the diagnosis of unexplained pleural effusion.\u0000Methods: This  cross-sectional  study  was  to  investigate our experience  of VATS pleural biopsy for unexplained pleural effusion which  was  conducted  at  our center.   All   patients   who   underwent   VATS pleural biopsy for unexplained pleural effusion   during   the   period of January 2019 to December 2019 were included in the study. Epidemiological, clinical, radiological & histopathological data of the patients were collected and analyzed\u0000Results: The overall diagnostic yield of VATS pleural biopsy in our study was 95%. Malignancy was the most common histological diagnosis for unexplained pleural effusion followed by tuberculosis. In patients with malignant effusion, metastatic adenocarcinoma was commonly observed finding followed by metastatic squamous cell carcinoma. Minor complications related to the procedure were noticed with no mortality.\u0000Conclusion: VATS pleural biopsy has high definitive diagnostic accuracy in the evaluation of unexplained pleural effusions.\u0000J Bangladesh Coll Phys Surg 2023; 41: 141-149","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45023523","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":"Primary Umbilical Endometriosis: A Rare Entity","authors":"Moumita Roy","doi":"10.3329/jbcps.v41i2.64508","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64508","url":null,"abstract":"Primary umbilical endometriosis is a rare benign gynaecological disorder caused by ectopic endometrial tissue in the umbilicus. The disease typically manifests as a painful umbilical nodule associated with cyclic bleeding or discharge during menstruation. Here, a 46-year-old woman with low parity and without previous history of abdominal surgery has been reported who presented with cyclical per-umbilical bleeding and pain in the umbilical region during menstruation without any palpable umbilical nodule. The patient responded well to initial medical management, but symptoms recurred on discontinuation of the medication. Though clinically, there was no palpable nodule, and ultrasonography revealed a hypoechoic lesion in the lower umbilical region suggestive of endometrial deposition. On resuming medical management, her symptoms abated.\u0000J Bangladesh Coll Phys Surg 2023; 41: 173-176","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46402054","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":"Common Invasive Fungal Infection in Bangladesh and Available Management","authors":"H. Ahasan, Nawsabah Noor","doi":"10.3329/jbcps.v41i2.65105","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.65105","url":null,"abstract":"Invasive fungal diseases are an important cause of mortality in immunocompromised patients and in patients with chronic illnesses. Multiple studies in Bangladesh have documented the frequency of fungal infections in our country and results varied. However, better understanding of the invasive fungal infection includes learning about the epidemiology, clinical features, and diagnostic method which is integral part of improving outcomes. In this review, we discuss the common invasive fungal infection that are prevalent in our country along with the clinical pictures, diagnosis, and treatment. It is hoped that this article will highlight the burden of fungal infections on public health and promote effective diagnosis and therapy.\u0000J Bangladesh Coll Phys Surg 2023; 41: 164-169","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44637717","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":"Value of Alarm Features in Dyspepsia for Predicting Significant Organic Lesions in Endoscopy","authors":"I. Perveen, M. Saha, Md Badius Salam","doi":"10.3329/jbcps.v41i2.64504","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64504","url":null,"abstract":"Background: For a long older age and the presence of alarm features are regarded as indications for prompt endoscopy in patients with dyspepsia. We aimed to find out the value of alarm features in diagnosing serious organic upper gastrointestinal lesions in patients with dyspepsia.\u0000Material & methods: In this observational study clinical variables and endoscopic findings of consecutive patients with dyspepsia were recorded in a semi-structured questionnaire. Univariate and multivariate logistic regression was done stepwise to identify predictors for endoscopic findings. A simplified predictor model was built with the age and the presence of any predictor alarm feature to find out the diagnostic accuracy of this model for the significant endoscopic lesion.\u0000Results: Among 304 patients (M=134, F=170) one or more alarm features were present in 193 cases (63.5%). Significant organic lesions were found in 84(27.6%) cases. Age ≥ 45 years (OR 2.608), abdominal lump (OR 4.489) and family history of upper gastrointestinal cancer (OR 3.880) were found as independent predictors of major endoscopic findings. Using a simplified predictor model of age ≥ 45 years or the presence of any predictive alarm feature, sensitivity, specificity, positive predictive value, and negative predictive value were 32.4 %, 82.5 %, 79.8% and 36.4% respectively for a significant endoscopic lesion. For upper gastrointestinal cancers, these values were 6%, 100.0%, 100.0% and 47.3% respectively.\u0000Conclusion: The predictive value of the age and the presence of alarm features alone are not optimal for significant endoscopic findings in patients with dyspepsia. A newer and more accurate predictive model is a time demand for organic UGI lesions, especially for malignancies.\u0000J Bangladesh Coll Phys Surg 2023; 41: 132-140","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44804343","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":"Efficacy of Daclatasvir and Half Dose Sofosbuvir in the Treatment of Hepatitis –C Virus Infection in Patients of Maintanance Hemodialysis-3 Years Trial in A Tertiary Renal Center","authors":"M. Jabin, M. Mostafi, A. Kaiser, Mohammad Raidul Kader Samir, T.C. Linkon-, Saad Bin Alamgir, H. Ghosh, S.M. Juthi","doi":"10.3329/jbcps.v41i2.64539","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64539","url":null,"abstract":"Background: Hepatitis C virus (HCV) infection in end-stage renal disease (ESRD) heralds a bad outcome. Directly acting antiviral (DAA) drugs sofosbuvir along with daclatasvir are very effective in the management of HCV infection. Sofosbuvir is excreted mainly through the kidneys. There is sparse data worldwide on the use of sofosbuvir based drug regimens in ESRD patients having chronic hepatitis C (CHC) virus infection.This study was designed to evaluate the efficacy of half dose sofosbuvir in the management of HCV infection in ESRD patients on maintenance hemodialysis (MHD).\u0000Methods: This clinical trial was conducted among 125 ESRD patients on MHD at Gonoshasthaya dialysis center, Dhanmondi, Dhaka from July 2019 to June 2022. Total 125 HCV positive patient with ESRD on MHD were included in this study; all the patients underwent HCV-RNA PCR test. Patients with detectable HCV RNA were observed for six months without antiviral drugs to identify the occurrence of spontaneous clearance of virus. Patients who had detectable HCV-RNA after six months were treated with sofosbuvir(200 mg) and daclatasvir (60 mg), irrespective of genotype. The drugs were given daily for 12 weeks. All the patients were on regular follow up at two weeks interval. Blood counts, liver function, creatinine phosphokinase and serum amylase values were evaluated periodically; virological response was assessed by HCV-RNA after 12 weeks of antiviral treatment.\u0000Results: During the observation period, 29 (23.2%) patients had spontaneous virus clearance with an undetectable HCV-RNA.  In the remaining 96 patients, the median HCV-RNA level was 2.76×104 (1.56 ×103– 1.89×106)I IU. Twelve weeks after the treatment, 91 (94.8%) patients achieved sustained virological response (SVR) with undetectable HCV-RNA. All patients tolerated the DAAs well and none of the patients reported any serious adverse events. No patient discontinued antiviral therapy due to side effects. Patients who attained SVR with DAA, after 6 months we repeated HCV-RNA in 30 patients, in majority of them (28, 93.3%), HCV-RNA were undetected but in 2 (6.7%) patients,HCV-RNA were detected again.\u0000Conclusion: Daclatasvir along with half-dose sofosbuvir are safe and effective in the treatment of CHC patients with ESRD on MHD. Half dose sofosbuvir regimen can reduce the cost of treatment of HCV in ESRD patients in developing countries like Bangladesh, where cost is a significant barrier to HCV treatment.\u0000J Bangladesh Coll Phys Surg 2023; 41: 102-107","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47100050","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":"Association of Post-Partum Depression (PPD) with Anaemia and Vitamin D Deficiency","authors":"S. Nasreen, N. Mahjabeen, S. Shahreen","doi":"10.3329/jbcps.v41i2.64684","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64684","url":null,"abstract":"Background: Postpartum depression (PPD) affects about 15% of mothers. It is a serious disorder that may affect physical and mental health of new mothers and newborns. Mothers suffering from anemia and vitamin D deficiency may be at increased risk of developing PPD.\u0000Aim: Our study aimed to detect the association of anaemia and Vit D deficiency with postpartum depression & also to look at association of other maternal and perinatal complications.\u0000Materials & methods: In this cross sectional observational study, pregnant women having anemia (Hb% <11gm/dl), were grouped as A (n=141), pregnant women having low Vit D were grouped as B (n=28), and pregnant women with normal Hb% and normal Vit D were grouped as grouped C (n=58). A & B were taken as cases and group C was taken as control in the study.  Depression was evaluated by using Edinburg postnatal depression rating scale, P <0.05 was taken as statistically significant. Also secondary outcome like PPH, wound infection, Apgar score, preterm birth neonatal admission were noted down.\u0000Results: Depression was found significantly higher in both A= 60.3% and B =14.2%, than group C =0% (p<0.0001). Postpartum hemorrhage (PPH) and wound infection were found higher for group A (58% & 13%), Group B (28 &3%) respectively than control group C (5 &2%). Interestingly all women with VitD deficiency had postpartal haemorrhage (PPH). Regarding neonatal outcome, APGAR score was low in A (38%) and B (10.7%) in compare to control group C (0%). NICU Admission was seen higher in A=26% & B=10.7% than for C=0%. Incidence of Preterm birth (PTB) for A =25% & B= 2% were significantly higher than group C= 0%. No stillbirth was found in any group.\u0000Conclusion: Prevention, identification and treatment of anaemia and Vitamin D deficiency in pregnant women seem necessary, as they are strongly associated with postpartum depression and other complications.\u0000J Bangladesh Coll Phys Surg 2023; 41: 114-119","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45395380","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":"Management of Oral Leukoplakia: A Review","authors":"Sm Anwar Sadat, Fariha Tajin, N. J. Nishi, Naimul Islam","doi":"10.3329/jbcps.v41i2.64506","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64506","url":null,"abstract":"Oral leukoplakia is a widely known white oral mucosal lesion which is encountered by dental practitioners specially by oral and maxillofacial surgeons in daily practice. The objective of this article is to update the reader on the concept of treatment algorithm for the management of leukoplakia. Articles were searched through PubMed, Google Scholar and the Cochrane Library (2017 to 2021), confining search to English language with the key words e.g., leukoplakia, white patch, precancerous lesion, premalignant lesion and oral potentially malignant disorders. After initial collection of abstracts of 78 articles, finally 24 papers have been selected for writing up the paper updating on clinico-pathologic characters, diagnosis, evaluation, risk of malignant transformation, management and prognosis of oral leukoplakia. Oral leukoplakia is a common oral potentially malignant disorder. Early diagnosis and screening for oral cancer can potentially subside the mortality and morbidity of disease. Incisional biopsy is mandatory for diagnosis, treatment planning and for checking the prognosis of the lesion. There are no universal modalities on the most appropriate treatment, and despite the treatment disease can recur and undergo malignant transformation in patients. For high-risk lesions, complete excision is recommended and clinician should closely follow up these patients for life. For low-risk lesions and successfully treated cases, routine check-up is recommended by dental practitioners. Health education, counselling the individual, and behavioral therapies are most essential methods of prevention at a primary level by every health care provider.\u0000J Bangladesh Coll Phys Surg 2023; 41: 156-163","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43901117","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":"Laparoscopic Intra Peritoneal Onlay Mesh Plus (IPOM Plus) repair of Ventral Hernias – Experience in a Tertiary Hospital","authors":"","doi":"10.3329/jbcps.v41i2.64567","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64567","url":null,"abstract":"Introduction: Laparoscopic Ventral Hernia Repair (LVHR) was first described by Karl Leblanc in 1992 and has increasingly been gaining popularity in this present era of minimal access surgery. Laparoscopic Intraperitoneal Onlay Mesh (IPOM) repair with its modification intraoperative Onlay Mesh Plus (IPOM Plus) repair is now being well-accepted option for the treatment of ventral hernias.\u0000Objective: To assess the safety and efficacy of the laparoscopic IPOM plus modality in the management of ventral hernias.\u0000Methods: This is a descriptive observational study, carried out on 22 patients who underwent Laparoscopic ventral hernia repair by IPOM Plus technique between January 2017 to December 2018 at CMH Dhaka. Patients who had ventral hernia with a defect size> 2 cm but < 10 cm were included in this study.  Primary subcutaneous transfascial suture closure of all ventral hernias with defect size >2 cm were done using prolene 1-0.Optimized composite mesh (ParietexTM) and Polymesh composite partially absorbable mesh were used as prosthesis anchored with four corner sutures and fixed with  non absorbable tacking device. Follow up period was one year.\u0000Results:  A total of 22 patients underwent Laparoscopic IPOM Plus repair of ventral hernias. Intraoperative and postoperative complications were negligible. No seroma, bulging of mesh, intestinal obstruction, mesh infection and recurrence observed in one year follow up time. But one patient developed de novo spigelian hernia on the right side outside the mesh system after one year. One patient (4.5%) developed post operative persisting pain requiring analgesic at 2 months.\u0000Conclusion:: Laparoscopic IPOM plus repair of ventral hernia is a safe, effective and well accepted modality.\u0000J Bangladesh Coll Phys Surg 2023; 41: 150-155","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47098665","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":"JBCPS in 2021-2022: How The Editorial Board Worked, What Is Done and The Aspirations!","authors":"M. Mostafi, M. A. Rahim, Tanveer Ahmed","doi":"10.3329/jbcps.v41i2.64836","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64836","url":null,"abstract":"Abstract not available\u0000J Bangladesh Coll Phys Surg 2023; 41: 98-99","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42225056","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}