Journal of Dhaka Medical College最新文献

{"title":"Role of HRCT Imaging in Diagnosis And Prognosis of Novel Corona (Covid-19) Pneumonia, Radiologists Experience in Dhaka Medical College Hospital Correlated with Rt-PCR.","authors":"S. Haque, N. Chowdhury, S. Nabi, H. Ara, Mahmud Mahfuza, Shams Shamsunnahar, Nahid Sajida, Mohammed Noor, I. Islam","doi":"10.3329/JDMC.V29I2.51184","DOIUrl":"https://doi.org/10.3329/JDMC.V29I2.51184","url":null,"abstract":"Background: High resolution computed tomography scan can be used as a effective modality for corona virus disease 2019(COVID -19) being a useful alternative to RT-PCR specially in hospitalized and RT-PCR negative patients. Purpose: To evaluate the efficacy of high resolution CT scan in diagnosis and prognosis of COVID 19 and to see the sensitivity specificity, accuracy, positive and negative predictive value. We also aimed to compare HRCT findings with RT-PCR in COVID 19 patients to find out the severity, prognosis and staging of COVID-19 corona virus disease. Materials and Method: This cross sectional prospective observational study was carried out in department of Radiology and imaging, Dhaka Medical College Hospital Dhaka ,Bangladesh in collaboration with department of Virology and COVID unit, Dhaka Medical college Hospital , Bangladesh Observations and Results : Total 200 patients were evaluated with HRCT findings and correlated with RT-PCR as gold standard. . Sensitivity was about 96% for chest CT, specificity 66% , PPV 97% accuracy 90% and NPV 62%. Conclusion: HRCT scan of chest is a useful modality for COVID -19 patients for the purpose of diagnosis and response to treatment. It is an important indicator for future prognosis . HRCT can be an important alternative of RT-PCR in symptomatic patients when RT-PCR is negative where facilities are available . It is important for the radiologists and clinicians to be familiar with different manifestations on CT . It will help in management planning for these patients .","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131969128","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":"A Comparison of Using Crystalloid Preloading and Co-Loading in Caesarean Section Operation Under Spinal Anaesthesia and Its Association with Spinal Anaesthesia Induced Hypotension and Heart Rate Variability","authors":"Taneem Mohammad, M. Mozaffor, S. Akter, M. Obaidullah, M. A. Miah, S. Rahman, Sm Ahsanul Habib, Sharmina Siddique, S. Alam, Shafinaz Mehzabin","doi":"10.3329/JDMC.V29I1.51164","DOIUrl":"https://doi.org/10.3329/JDMC.V29I1.51164","url":null,"abstract":"Context: There is lack of evidence on comparison of crystalloid pre-loading and co-loading in parturients undergoing cesarean section operation under spinal anesthesia in Bangladesh. Hence, the present study was designed to compare the efficacy of crystalloid pre-loading and co-loading in preventing spinal anesthesia induced hypotension and heart rate variability during caesarean delivery. Methods: This single blinded randomized controlled clinical trial was conducted in the Department of Anaesthesia, Analgesia & Intensive Care, Dhaka Medical College Hospital, Dhaka, Bangladesh, from January 2013 to December 2014. A total of 90 patients were selected 45 patients of group I received co-loading with Ringer’s lactate solution, while another 45 patients of group II received a pre-loading with the same fluid. Blood pressure and heart rate were recorded in both the groups with 3-minute intervals from the beginning of the subarachnoid block for the first 20 minutes, and then with 5-minute intervals up to one hour. Ephedrine was used as the primary rescue drug to treat hypotension. When ephedrine failed to treat hypotension, adrenaline was administered as a potent vasopressor. Results: The incidence of hypotension was 17 (37.8%) in group I (co-loading group) and 27 (60%) in group II (pre-loading group), which was significantly higher in group II (p<0.05). Comparatively higher heart rate was observed in group II, but not statistically significant. Ephedrine was required in 17 cases (37.8%) in group I and 27 cases (60%) in group II. Mean ephedrine required was 9.2±3.6 mg in group I and 11.5±4.3 mg in group II. The difference was statistically significant (p<0.05). Adrenaline was administered in 1 case (2.2%) in group I and in 2 cases (4.4%) in group II, which was not statistically significant (p>0.05). Conclusion: Severity of hypotension and increased ephedrine requirement were evident in patients who received crystalloid pre-loading (group II), which means crystalloid co-loading (group I) was more capable to prevent spinal anaesthesia induced hypotension.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125565195","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":"Anti-oxidant Vitamin (Vit C, Vit E) Levels of Selected Normotensive and Pre-eclamptic Women in Bangladesh","authors":"N. A. Khan, K. Islam, N. Nahid, M. Hoque, Shaifullah, Rafiquzzaman, P. K. Datta, G. Morshed, A. Masum, P. Chowdhury","doi":"10.3329/JDMC.V29I1.51172","DOIUrl":"https://doi.org/10.3329/JDMC.V29I1.51172","url":null,"abstract":"Pre -eclampsia is a disorder of 2nd half of pregnancy, which is characterized by a combination of hypertension, proteinuria and edema, secondary to decreased placental perfusion. Clinical studies suggest that antioxidant vitamins, such as Vit C and Vit. E can stabilize reactive free radicals, which are produced due to placental hypo perfusion, thereby preventing the development of pre-eclampsia. Pre-eclampsia remain a major cause of infant and maternal mortality and morbidity. In developing countries, pre-eclampsia causes an estimated 50,000 maternal deaths per year. Only a small number of studies have however, been conducted in Bangladesh. Objective: To compare the serum levels of antioxidants in selected pre-eclamptic and normotensive pregnant women. Methods: 220 pregnant women were selected with inclusion and exclusion criteria from 3 different medical colleges and divided into 2 groups – A study group, consisting of 110 pre-eclamptic women and a control group consisting of 110 normotensive pregnant women. Dietary information was collected by 7 days food frequency questionnaire and food score was determined. Anthropometric and biochemical tests were performed. Biochemical analysis such as serum vitamin C levels were measured by spectrophotometric method, and serum vitamin E levels were measured by HPLC (High Performance Liquid Chromatography) method. Results: The mean serum levels of Vit. C and Vit E were found to be significantly lower in the study group, compared to the control group. Anthropometric study revealed that the babies born to pre-eclamptic mothers had lower birth weight than those born to normotensive mothers. Conclusion: Therefore, low antioxidant levels do play a key role in the development of preeclampsia in pregnant women. DOI: https://doi.org/10.3329/jdmc.v29i1.51172 J Dhaka Med Coll. 2020; 29(1) : 53-58 1. Dr. Nahid Ahmed Khan, Associate Professor, Dept. of Anatomy, Holy Family Red Crescent Medical College. 2. Prof. Khaleda Islam, Professor, Institute of Nutrition and food Science, University of Dhaka. 3. Dr. Nuzaira Nahid, Honorary Medical Officer, working in BMCH 4. Dr. Mohammad Mahfuzul Hoque, Assistant Professor of Medicine, Dhaka Medical College, Dhaka 5. Dr. Md. Shaifullah, Assistant Professor of Medicine, Dhaka Medical College, Dhaka 6. Dr. Md. Rafiquzzaman, Indoor Medical Officer, Dhaka Medical College 7. Dr. Ponkaj Kanti Datta, Assistant Professor of Medicine, Dhaka Medical College, Dhaka 8. Dr. Md. Golam Morshed, Junior Consultant, Department of Medicine, OSD, DGHS, Dhaka 9. Dr. Abdullah Al Masum, Department of Internal Medicine, BSMMU, Dhaka 10.Dr. Partho Protim Chowdhury, Assistant Professor of Medicine, Dhak Medical College, Dhaka Correspondence: Dr. Nahid Ahmed Khan, Associate Professor, Dept. of Anatomy, Holy Family Red Crescent Medical College, E-mail: nahidmelia@gmail.com Mobile No: 01914222818 Received: 10-01-2020 Revision: 19-01-2020 Accepted: 21-03-2020 Introduction: Pre-eclampsia is a multi system disor","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115819151","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":"Estrogen Receptor Positive Secretory Breast Carcinoma in a Bangladeshi Elderly Woman Diagnosed by Core Needle Biopsy","authors":"Nafisa Abedin, Kazi Nabila Bushrah, Muhit Reza Md Muktadir, B. P. Dey","doi":"10.3329/JDMC.V28I2.51161","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51161","url":null,"abstract":"Secretory carcinoma is an extremely rare subtype of low grade invasive breast carcinoma and occurs infrequently in adults showing belligerent clinical course than in children. Surprisingly, it is the only epithelial carcinoma of breast representing characteristic balanced translocation.This paper reports a case of secretory breast carcinoma in an elderly post-menopausal woman in Bangladesh which is diagnosed by core needle biopsy. The majority of the case reports claimed this tumor to be a triple negative breast carcinoma, whereas our case report reveals a slightly different status in immunohistochemical context. A 78-years old, post-menopausal female presented with the chief complaints of painless, slowly enlarging lump in her left breast over nine months. Breast examination revealed a 2x1.5cm, well-delineated, firm, non-tender and mobile mass in the lower-outer quadrant of the left breast. Microscopically, the tumor was composed of cells containing PAS positive, diastase resistant and mucicarmine positive intra and extra-cellular secretory material and Alcian blue positive secretion was found extracellularly. The tumor cells showed strongly positive immunohistochemical reactivity for cytokeratin, EMA, E-cadherin and vimentin and focal positive reaction for S-100 protein and estrogen receptor but negative for both progesterone receptor and human epidermal growth factor receptor. Ki-67 proliferative index was about 4%. Hence, the diagnosis of secretory breast carcinoma (SBC) was made. The patient underwent modified radical mastectomy with axillary clearance without any axillary lymphnode involvement in an external center. The patient has not received any radio or chemotherapy. The patient was under continuous follow-up for 3-months.Unfortunately, owing to the nation-wide lockdown for dreadful COVID-19 pandemic, the patient couldn’t arrive at the hospital for further follow-up evaluation. Immunohistochemical (IHC) analysis has been proven to be an alternative potential method as gene analysis. Immunoprofiling of secretory breast carcinomas may play the pivotal role for selecting therapeutic strategies and predicting prognostic outcome of the disease process. Comprehending the immunohistochemical expression would make scope for applying targeted therapy in SBC patients in future.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124133714","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":"Versatility of Latissimus Dorsi Free Flap-a Prospective Study","authors":"A. F. M. A. Islam, Mohammad Rabiul Karim Khan, S. Sumi, Mohammad Hedayet Ali Khan, A. Kalam","doi":"10.3329/JDMC.V28I2.51149","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51149","url":null,"abstract":"Introduction: Free flaps offer a great variable of available tissues to cover larger, multifocal or multistructural defects. The choice among different free flap is dependent upon their recipient site requirement. Reconstruction with latissimus dorsi flap is now versatile tool in coverage. It can resurface large wound with reliable vascularity, consistent anatomy ,long pedicle length, opportunity for tailoring of flap. It has less donor site morbidity and has very little post-operative","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127124365","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":"Aetiological Pattern of Gastrointestinal Perforations: A Prospective Observational Study","authors":"P. K. Das, Chowdhury Md Mushfiqur Rahman, A. Rahman, Nayeem Dewan, Mahmudul Islam, K. Saha, A. Mamun","doi":"10.3329/JDMC.V29I2.51183","DOIUrl":"https://doi.org/10.3329/JDMC.V29I2.51183","url":null,"abstract":"Introduction: Peritonitis secondary to gastrointestinal perforation is one of the commonest surgical emergencies encountered all over the world. This study was done to highlight the spectrum of perforation peritonitis encountered in surgery unit of Dhaka Medical College Hospital. Method: It was observational prospective of 100 cases of perforation peritonitis treated in our hospital. All cases of perforative peritonitis whether spontaneous, infective or neoplastic pathology were included in this study. Results: The maximum numbers of patients were in age group between 31 to 40 years (39 %) with mean age 35 years. Male female ratio was 9:1. The most common aetiology of perforation peritonitis was peptic ulcer disease (73%) followed by enteric fever (12%), appendicitis (10%), tuberculosis (3%) and malignancy (2%). The most common sites of perforation were in descending order of frequency first part of the duodenum (65%), terminal ileum (12%), appendix (10%), gastric antrum (9%), jejunum (3%) and rectum (1%). Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (96%), muscle guard and rigidity (100%) were the common signs. Approximately 15-20% presented late with features of shock. Mortality rate was 2% and was significantly high in patients coming hospital late. Conclusion: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever have highest morbidity. Early recognition and timely appropriate intervention is very important in reducing morbidity and mortality. DOI: https://doi.org/10.3329/jdmc.v29i2.51183 J Dhaka Med Coll. 2020; 29(2) : 106109 Introduction Gastrointestinal perforation is a complete penetration of the wall of the stomach, small intestine or large bowel resulting in flowing of contents into the abdominal cavity causing peritonitis. The spectrum of aetiology of perforation peritonitis is different in different countries. In our country, presentation to hospital varies depending on access availability, awareness and economy. Late cases present with generalized peritonitis with purulent or fecal contamination and varying degree of septicaemia. It is important to know all the pattern in which a perforation peritonitis could present and the different aetiologies that lead to perforation peritonitis and the most common among them so that the decision for appropriate management of such a case can be taken at the earliest and the associated morbidity and mortality can be decreased. Our objective was to study the aetiology and pattern of presentation of different gastrointestinal perforations based on clinical findings, radiological report, operative findings and histopathology report. Methods This was a prospective study conducted in the department of surgery Dhaka Medical College Hospital. A total number of 100 cases were studied. Inclusion criteria • All cases presenting with signs and symptoms of p","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132046568","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":"Study of Liver Function Test in Cirrhotic Patient","authors":"N. Uddin, Nur-Wa-Bushra Jahan, K. Sultan, Rumana Nushrat, Julfiker Ali, H. Kabir, P. Biswas, Elias Bhuiyan, K. Murshed, S. Sultana","doi":"10.3329/JDMC.V28I2.51156","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51156","url":null,"abstract":"Aim: The study was carried out to see the Serum Bilirubin, ALT, AST and Alkaline Phosphatase as liver function in liver cirrhotic patient. \u0000Method: The study was carried out among 50 well-compensated patients of cirrhosis of liver irrespective of their age, sex, residence & income group. Patient was randomly selected while they were hospitalized in Dhaka Medical College Hospital, Sir Salimullah Medical College & Mitford Hospital and Bangabandhu Sheikh Mujib Medical University. \u0000Result: Serum Bilirubin, AST, ALT and Alkaline Phosphatase level were done in 50 (fifty) cirrhotic patient out of whom 38 were male and 12 were female. Mild to severe level of serum bilirubin were documented in 50% patients. Two-fold and fourfold rise of ALT were formed in 48% and 10% cirrhotic patient respectively. Similar pattern of rise of AST also shown in 50% cirrhotic patient. Alkaline Phosphatase value was normal in 92% patient and of 08% two-fold rise of Alkaline Phosphatase Alkaline Phosphatase. \u0000J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 190-191","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131460442","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":"Challenges in Treatment Strategies for Management of Neonatal Sepsis","authors":"T. Amin, A. N. Nur, Imran Mahmud","doi":"10.3329/JDMC.V29I1.51166","DOIUrl":"https://doi.org/10.3329/JDMC.V29I1.51166","url":null,"abstract":"Background: Neonatal sepsis is an important cause of morbidity and mortality in newborns. The symptoms and signs of neonatal sepsis are often non-specific and similar to other common neonatal diseases, investigation results are also non-specific and low sensitivity of blood culture also causes diagnostic dilemma and often empirical antibiotic treatment is given. This is why, there is challenges in making the diagnosis and treating neonatal sepsis. Objectives: To find the etiology, sensitivity and specificity of clinical features and investigations and optimal and effective treatment for neonatal sepsis. Materials and methods: The study was a prospective study done in the neonatal ward of a tertiary hospital in Bangladesh; total 100 neonates diagnosed as neonatal sepsis, were enrolled in this study. All study subjects were fully evaluated clinically, thoroughly investigated and properly treated as per protocol. Results: The sensitivity and specificity of clinical features and investigations were statistically significant (i.e. p <0.05) and etiologic agents were isolated by urine culture and sensitivity to antibiotics were shown and outcome measure e.g. mortality was 22% (OR 3.54; 95% CI 2.046.13; P <0.05). Conclusion: There are challenges in making diagnosis and treating neonatal sepsis, yet sincere approach to diagnosis and rational and appropriate use of antibiotics along with necessary adjuvant therapy can mitigate the challenges. DOI: https://doi.org/10.3329/jdmc.v29i1.51166 J Dhaka Med Coll. 2020; 29(1) : 23-28 1. Dr. Tahsinul Amin, Associate Professor, Dept. of Neonatology, Sher-e-Bangla Medical College, Barishal. 2. Dr. Ayesha Najma Nur, Consultant (Obstetrics and Gynecology), CWCH, Dhaka. 3. Dr. Imran Mahmud, Registrar, Department of Medicine, Dhaka Medical College, Dhaka Correspondence: Dr. Tahsinul Amin. Associate Professor, Dept. of Neonatology, Sher-e-Bangla Medical College, Barishal. E-mail :tahsinul_amin@yahoo.com. Mobile: 01715734232 Received: 05-12-2019 Revision: 15-01-2020 Accepted: 21-03-2020 Introduction Globally bacterial infection (sepsis, meningitis, pneumonia etc.) is a leading cause of 2.9 million neonatal deaths every year.1 Strategies to reduce preventable infection-related neonatal deaths by 2030 to meet the WHO Sustainable Development Goal (SDG) is a global health priority. Neonates are especially vulnerable to sepsis due to perinatal exposure to infective agents, compromised immune system and maternal and neonatal risk factors.1 In recent years neonatal mortality has decreased at much lower rates, and currently represents 40% of all childhood mortality.2 Three-fourths of these deaths occur in the first week of life.3 Neonatal sepsis is the third leading cause of neonatal mortality, only behind to prematurity and perinatal asphyxia.4 is responsible for 13% of all neonatal mortality, and 42% of deaths in the first week of life.5,6 In developing countries, clinically diagnosed sepsis is present in 49–170 per 1000 live bir","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131658388","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":"Pattern of Presentation and Organ Involvement in Dengue Fever at Dhaka Medical College Hospital","authors":"M. Rahman, P. Hasan, Tanjina Farheen, K. Islam, H. Rashid, M. Haque, I. Faruq, J. Chowdhury, P. K. Datta","doi":"10.3329/JDMC.V28I2.51158","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51158","url":null,"abstract":"Dengue fever first identified as ‘Dhaka Fever’ in 1964 & became endemic around 2000. The most recent spreading of dengue in 2019 was also notable for change in the presenting features of the patients attributed by some to the fact that causative virus might be of different serotype. Our study aims to assess the current pattern of presentation of dengue virus infection, done in inpatient of Department of Medicine of Dhaka Medical College Hospital Dhaka. This was a crosssectional, observational, descriptive study conducted between 1 August and 30 September 2019. A total 70 subjects, age >12 years were included in this study. Among them 55 were male & 15 were female, with a mean age of 28.33(±12.15) years. Comorbidities noticed in few cases such as DM (2, 2.90%), HTN (3, 4.35%), IHD (1,1.45%), CKD & COPD (1,1.45%). The most common presentation were fever (64, 91.43%), headache (62, 88.57%) anorexia (59, 85.51%), generalised pain (51, 73.91%), nausea (49, 71.01%). Examination findings at admission were temperature was high but not very high, pulse were normal, both systolic & diastolic pressure were somewhat normal, among the warning signs, severe abdominal pain (27.54%), persistent vomiting (21.74%), lethargy /restlessness /sudden behavioural change (21.74%) were most common. The common haematological parameters & routine investigation values were not deviated from expected range. As dengue is likely to continue to constitute a serious public health problem in Bangladesh, this study may help the practitioners to understand the changing pattern & to manage patients accordingly.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130408910","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":"Life–Threatening Hyperkalemia Presenting with Cardiac Arrest during Combined Therapy with Angiotensin – Converting Enzyme Inhibitor and Spironolactone: a Case Report","authors":"Shudipan Chakraborty, M. Khayer, Mahbubor Rahman","doi":"10.3329/JDMC.V28I2.51160","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51160","url":null,"abstract":"Abstarct A 56-year-old man with history of previous coronary artery bypass graft (CABG) surgery and prior history of mild renal impairment was brought to the emergency department at mid night in gasping state. On presentation his pulse and blood pressure (BP) were non recordable. Cardiopulmonary resuscitation (CPR) was started immediately and he was intubated in the emergency room. Within few minutes his pulse became perceptible but BP still remained non recordable. His bed side 12 leads electrocardiogram (ECG) revealed sine wave configuration,suggestive of severe hyperkalemia with heart rate 30-35 beats per minute (bpm).Urgently he was transferred to cardiac catheterization laboratory for temporary pacemaker insertion (TPI). After putting TPI he regained consciousness and BP raised to normal. His blood gas analysis showed severe hyperkalemia (Serum potassium level-9.4 mmol/L). In coronary care unit (CCU) he was commenced on standard treatment of hyperkalemia and his electrolyte imbalance normalized within 24 hours. His cardiac rhythm reverted back to sinus within 24 hours of admission and he was extubated next day and discharged from the hospital after 5 days in a relatively stable state.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115655259","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}