Journal of Bangladesh College of Physicians and Surgeons最新文献

{"title":"Dengue Fever in Pregnancy - Maternal and Fetal Outcome","authors":"Fatema Rahman, Dina Layla Hossain, Shikha Ganguly, F. N. Tawhida, Layla Khayrun Nahar","doi":"10.3329/jbcps.v41i40.69678","DOIUrl":"https://doi.org/10.3329/jbcps.v41i40.69678","url":null,"abstract":"Background and objectives: There has been a lot of concern related to dengue infection in pregnant women in recent years due to an increase in number of dengue infections worldwide. Dengue fever during pregnancy is associated with early pregnancy failure, preterm delivery, low birth weight babies, prematurity, and occasionally neonatal mortalities. The primary objective is to find out the maternal and fetal outcome of pregnancy affected by Dengue fever. Materials and Method: This is a prospective observational study, conducted over a period of 3 months from 1st July to 30th September 2023 in Dhaka Medical College Hospital, Dhaka, Bangladesh. Result: Out of the 44 pregnant patients admitted with suspected dengue infection, 56.8% were diagnosed serologically positive by NS1 and 43.2% by Dengue IgM . Fever was found in 100% patients and Thrombocytopenia was found in 45.9% patients, PPH in 13.6%. Regarding obstetric management 25% got conservative management ,27.2% delivered vaginally and 38.6% undergone LSCS. About 25% pt needed to shift ICU in antenatal and postnatal period.4.5% were maternal mortality in this study period. On the other hand 13.7% were still born and 13.7% of the babies required NICU admission due to prematurity and low birth weight. Conclusion: Dengue related complications are high in pregnancy. Timely and precise interventions in dengue infected pregnant women are needed for optimal outcome. Early detection and access to proper medical care in this specific group by multidisciplinary team can reduce complications and mortality. J Bangladesh Coll Phys Surg 2023; 41: 21-24","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139215037","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":"Dengue-Associated Posterior Reversible Encephalopathy Syndrome Occurring in a Woman with 32 Weeks Pregnancy: A Case Report from Bangladesh","authors":"Mohiuddin Ahmed","doi":"10.3329/jbcps.v41i40.69731","DOIUrl":"https://doi.org/10.3329/jbcps.v41i40.69731","url":null,"abstract":"Posterior reversible encephalopathy syndrome (PRES) is an increasingly well recognised reversible clinicoradiological condition. Dengue can cause various neurologic complications like encephalitis, myelitis, Guillain-Barré syndrome (GBS), and myositis, which are increasingly being recognized in addition to the more common manifestations of plasma leakage and coagulopathy. Posterior reversible encephalopathy syndrome (PRES) is rare in dengue, although the pathophysiology of endothelial dysfunction likely underlies both. Here we report a case of dengue-associated posterior reversible encephalopathy syndrome in a pregnant woman J Bangladesh Coll Phys Surg 2023; 41: 99-100","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139227903","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":"Dengue Uproar In Bangladesh: Look Back And Forward To Learn To Live With Dengue","authors":"E. Yunus","doi":"10.3329/jbcps.v41i40.69671","DOIUrl":"https://doi.org/10.3329/jbcps.v41i40.69671","url":null,"abstract":"Abstract not available.  J Bangladesh Coll Phys Surg 2023; 41:6-9","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139219040","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":"Expanded Dengue Syndrome with Multiorgan Involvement in a Woman with Twin Intrauterine Fetal Death - A Case Report","authors":"Taimoon Nahar Khanom","doi":"10.3329/jbcps.v41i40.69733","DOIUrl":"https://doi.org/10.3329/jbcps.v41i40.69733","url":null,"abstract":"Dengue is the most rapid mosquito-borne disease in the world.  As per the WHO guidelines for dengue fever, a list of atypical or unusual manifestations, also termed ‘Expanded Dengue Syndrome’ (EDS), is mentioned. Pregnancy increases the risk of expanded dengue syndrome. A 32-year-old woman with IUFD (twin) at 36 weeks gestation with H/O 1 C/S was reported with expanded dengue syndrome with multiorgan involvement. She was referred to a tertiary centre with H/O high fever, loose emotion, less fetal movement, and dengue NS 1 antigen positive. She was eventually diagnosed as having expanded dengue syndrome with multiorgan involvement with IUFD (twin) at 36 weeks. The decision of LSCS was taken by a multidisciplinary approach. She was managed with FFP, platelet apheresis, therapeutic plasma exchange, and I/V antibiotics, in addition to liver & neurological support in the ICU unit. This case emphasised the hazards of dengue infection in pregnant women, which needs special consideration. Early recognition with careful monitoring and multidisciplinary management are the key factors in a favourable outcome for a dengue patient. J Bangladesh Coll Phys Surg 2023; 41: 105-108","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139226327","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":"Predictors of Acute Kidney Injury in Hospitalized Dengue Patients: A Cross-sectional Study","authors":"Shaila Rahman, Amit Wazib, Rayhan Ahmed, Tamanna Bahar","doi":"10.3329/jbcps.v41i40.69680","DOIUrl":"https://doi.org/10.3329/jbcps.v41i40.69680","url":null,"abstract":"Background: Dengue is an endemic RNA viral infection in Bangladesh. It can affect different organ systems, acute kidney injury (AKI) is one of them. The study aimed to detect the prevalence and predictors of dengue-associated acute kidney injury (DAKI) and in-hospital outcome. Methods: This cross-sectional study was carried out from July to September 2023 at the peak of dengue outbreak in the Department of Medicine in Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh. A total of 203 confirmed cases of dengue aged > 12 years were finally included in the study. Results: The prevalence of DAKI was 7.9%. The mean age of DAKI cases was higher than the non-AKI cases (p-value 0.008). AKI was significantly associated with DHF (43.8% vs 17.6%), higher HCT, higher neutrophil count and lower lymphocytes. In multivariate analyses age more than 60 years, dengue haemorrhagic fever (DHF) and multiple organ dysfunction (MODS) were the independent predictors of DAKI. AKI itself was the independent predictor of hospital stay for more than three days (OR 4.67; 95% CI 1.29-16.92). There was no mortality in the study participants. All were discharged home with resolved AKI. Conclusion: Age more than 60 years, DHF and MODS are the independent risk factors of DAKI. Future studies are required to find out the risk factors for early diagnosis and prompt management. J Bangladesh Coll Phys Surg 2023; 41: 29-33","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"227 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139226845","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":"Determination of normative value of Psychometric hepatic encephalopathy score in Bangladeshi volunteers","authors":"Mrinmay Kumar Podder, Hafeza Aftab, Md Musab Khalil, Mohammad Iqbal Hossain, Md Imran Hossain, Parash Ullah, Md Fakruzzaman","doi":"10.3329/jbcps.v41i4.68883","DOIUrl":"https://doi.org/10.3329/jbcps.v41i4.68883","url":null,"abstract":"Background and Objectives: The psychometric hepatic encephalopathy score (PHES) is a composite score of five different neuropsychological tests. It is considered as gold standard test to diagnose Minimal Hepatic Encephalopathy(MHE). But one problem with PHES is that it needs normative value of its five components as they vary from population to population. So population based normative value should be derived before it is applied to that population. MHE is diagnosed when variation from this normal value occur, provided other criteria are fulfilled. The aim of this study is to find out the normative value of PHES test batteries. Methods: This cross sectional observational study among healthy volunteers took place in department of Gastroenterology, Dhaka medical college from May 2019 to April 2020. All participants in this study took part in the test according to international norm. Results: Among the 300 study population,age and years of education had significant impact on all tests score. Hence, multivariate equation adjusting age and years of education were derived. A scoring method was applied depending on deviation from predicted score for all tests. Finally, -5 PHES was determined as cut off value for normal and pathological. Conclusion: Age and education adjusted normative value of five components of PHES were constructed in Bangladeshi population. PHES cut off value was also determined. Now it is possible to calculate PHES among liver cirrhosis patients of Bangladesh. J Bangladesh Coll Phys Surg 2023; 41(4): 277-281","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136382041","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":"Comparing the Efficacy of Pamidronate and Thalidomide for the Treatment of Refractory Axial Spondyloarthritis: An Open Label Randomized Clinical Trial","authors":"Nadia Sultana, A F M Mahbubul Alam, Iftekhar Hussain Bandhan Bandhan, Md Masudul Hasaan, Md Golam Rabbani, Md Ekramul Kabir, Md Abu Shahin, Minhaj Rahim Choudhury, Syed Atiqul Haq, Mohammad Mostafa Zaman","doi":"10.3329/jbcps.v41i4.68930","DOIUrl":"https://doi.org/10.3329/jbcps.v41i4.68930","url":null,"abstract":"Introduction: Spondyloarthritis (SpA) is a chronic systemic inflammatory rheumatic disease affecting sacroiliac joints, spine and peripheral joints. Pamidronate and thalidomide are proven to be effective in refractory axial SpA in some studies. This study aimed at comparing the efficacy and safety of pamidronate and thalidomide in refractory axial spondyloarthritis (SpA). Methods: This open label randomized clinical trial was conducted on refractory SpA patients at the department of rheumatology of Bangabandhu Sheikh Mujib Medical University, Dhaka. Pamidronate 60mg intravenous monthly and thalidomide 200mg/day were given to pamidronate and thalidomide groups, respectively for 6 months. Both groups received non-steroidal anti-inflammatory drugs and therapeutic exercises. More than 20% improvements in Assessment of Spondyloarthritis International Society (ASAS-20) at 6 months were considered as primary outcome measure. Secondary outcome measures included Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), Bath ankylosing spondylitis meteorological index (BASMI), patient global assessment, physician global assessment, erythrocyte sedimentation rate (ESR), C-reactive protein, ASAS 40 etc. Results: Significant improvement in ASAS 20 was observed in both pamidronate (76.9%) and thalidomide (85.2%) groups (P=0.501). Among the secondary outcome ASAS 40 response rates were 46.2% and 51.9% in the pamidronate and thalidomide groups respectively. All other secondary outcome indicators such as BASDAI, BASFI, BASMI etc. within-group showed significant improvements in both groups (P<0.001). Between-group differences were nonsignificant (P>0.1) except for ESR (P=0.006). There were no serious adverse events in any group. Conclusions: Pamidronate and thalidomide were effective in refractory axial SpA and were well tolerated. However, there was no significant difference in the efficacy of the two drugs. J Bangladesh Coll Phys Surg 2023; 41(4): 269-276","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"30 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134909213","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":"COVID-19 presenting as Acute abdomen- a study of 3 cases","authors":"Shrebash Paul, Md Khairul Islam, Forhad Uddin Hasan Chowdhury, Fazle Rabbi Chowdhury","doi":"10.3329/jbcps.v41i4.68949","DOIUrl":"https://doi.org/10.3329/jbcps.v41i4.68949","url":null,"abstract":"COVID-19 is a multisystem disease and sometimes patient can present with life threatening extra-pulmonary manifestations. Amongst GI symptoms nausea, vomiting, abdominal pain and diarrhoea are common. Severe hepatobiliary manifestations like acute pancreatitis, acute hepatitis and cholecystitis are rare in SARS-CoV-2 infection. In this case series we described three cases presented with hepatobiliary manifestations. All of them had acute abdominal pain and finally proven to be the case of acute pancreatitis and acalculous cholecystitis in addition to classical COVID- 19 symptoms. Two of them had severe symptoms and required high volume of oxygen, while one case (acalculous cholecystitis) had mild symptom only. All of them recovered successfully. High degree of clinical suspicion is required while managing atypical presentation of COVID-19 cases. This is also vital to refer the cases to advance care hospitals in time to ensure multidisciplinary care. J Bangladesh Coll Phys Surg 2023; 41(4): 320-324","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"89 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134908374","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":"Limiting Antibiotic Use in Upper Respiratory Tract Infections","authors":"Md Ridwanur Rahman, Mohammad Lutful Ehsan Fatmi","doi":"10.3329/jbcps.v41i4.68981","DOIUrl":"https://doi.org/10.3329/jbcps.v41i4.68981","url":null,"abstract":"Abstract not available J Bangladesh Coll Phys Surg 2023; 41(4): 248-250","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"8 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134908840","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":"Successful Outcome of a Heterotopic Pregnancy: A Case Report","authors":"Hamida Begum, Muluken Tesfaye, Fatima Ashrafi","doi":"10.3329/jbcps.v41i4.68952","DOIUrl":"https://doi.org/10.3329/jbcps.v41i4.68952","url":null,"abstract":"Heterotopic pregnancy refers to the presence of simultaneous pregnancies at two different implantation sites. We present an unusual case of term heterotopic pregnancy, the ectopic pregnancy being abdominal implantation. The co-existence of spontaneous full term intra-uterine with advanced abdominal ectopic pregnancy and both viable babies without any residual effect or congenital anomalies is one of the rarest forms of heterotopic pregnancy. Other than Ultrasound, increased HCG, or alpha feto protein, sophisticated modern technology like MRI or CT’s Scan absolutely needed for proper diagnosis, placental localization and vascularization to prevent intra-operative catastrophies. J Bangladesh Coll Phys Surg 2023; 41(4): 338-341","PeriodicalId":105305,"journal":{"name":"Journal of Bangladesh College of Physicians and Surgeons","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134909046","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}