Bangladesh Journal of Medicine最新文献

{"title":"Tackling the Neurological Wilson Disease with Other Spectrum of Presentations: A Case Series","authors":"Benojeer Akter, M. Tonmoy, Mohammed Baieas Chowdhury, Gourabdey Sarker, Nandita Paul, Akhlak Ahmed","doi":"10.3329/bjm.v35i20.73435","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73435","url":null,"abstract":"Wilson’s disease (WD) is an inherited autosomal recessive, potentially treatable disorder of copper metabolism that produces neurologic, psychiatric, and liver manifestations, alone or in combination. It is caused by mutations in the ATP7B gene encoding a P-type ATPase. WD has a worldwide prevalence of ~1 in 30,000, with a mutation carrier frequency of 1 in 90. About half of WD patients (especially younger) present with liver abnormalities. The remainder present with neurologic disease (with or without underlying liver abnormalities), and a small proportion have hematologic or psychiatric problems at disease onset. Pathological copper accumulation causes a range of symptoms, most commonly hepatic and a wide spectrum of neurological symptoms including tremor, dystonia, chorea, parkinsonism, dysphagia, dysarthria, gait and posture disturbances. To reduce copper overload, medications are used that improve liver function and neurological symptoms. However, in some WD patients, treatment introduction leads to neurological deterioration, and in others, neurological symptoms persist with no improvement or improvement only after several years of treatment. Based on case and series reports, current recommendations and expert opinion, WD treatment is focused mainly on drugs leading to negative copper body metabolism (chelators or zinc salts) and copper-restricted diet. Treatment of WD neurological symptoms should follow general recommendations of symptomatic treatment. Patients should be always considered individually, especially in the case of severe, disabling neurological symptoms.Here we discuss 03 cases of WD with neurological and other manifestations treated accordingly, 02 patients responded to treatment while we lost another unfortunately.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 167","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"7 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141380390","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":"Alopecia: Updated management","authors":"Mohammad Tariquzzaman Mia","doi":"10.3329/bjm.v35i20.73384","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73384","url":null,"abstract":"Hair is of high aesthetic value in human. Loss of hair is called alopecia. It is a common and complex concern causes frustration, negetive emotion and lack of confidence. Normal daily hair loss is about 100 to 150.Causes of Alopecia are Non Scarring alopecia, pattern alopecia /Androgenetic Alopecia, Unpattern alopecia - Alopecia areata, Telogen effluvium, anagen effluvium, Traction alopecia due to hair style, hair shaft damage by hot air dryers and by hair Straightening and Other causes:- Alopecia syphilitica, diabetesmellitus, hypothyroidism,anaemia, seborrheic dermatitis, psoriasis. Scarring alopecia are Lichen planopilaris, pseudopelade, DLE, Folliculitis decalvans, infections. Diagnostic approach to hair loss : step-1 - History of the hair problem , step-2 - obtain a through medical history, step-3 - Examination of scalp and hair and step - 4- Diagnostic tests are Hair pull test, Dermoscopy,scalp biopsy. Lab tests-CBC, Ferritin, TIBC,TSH,Testosteron and step-5: Treatment: - according to the cause of hair loss.Medical treatment. Topical and intralesional steroid, topical Minoxidil, tacrolimus, finasteride, spironolactone. Updated medical treatment: Tofacitinib. Updated procedural treatment( Procedure): - PRP therapy, Microneedling, Low level Laser therapy (LLLT), stem cell therapy, Hair transplant.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation:137","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"8 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379736","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":"Fluid Management in Dengue -Insights from Bedside","authors":"Krishnatha Jayasekera","doi":"10.3329/bjm.v35i20.73382","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73382","url":null,"abstract":"Dengue fever, a prevalent tropical viral illness transmitted by mosquitoes, poses a substantial burden on healthcare systems in Southeast Asia. Despite the increase in case density annually there is a noticeable downward trend in mortality rates in Sri Lanka. The pathophysiological hallmark of severe dengue is plasma leakage, leading to potentially life-threatening complications such as shock and organ failure. Key aspects of clinical care include early recognition of warning signs, monitoring of clinical parameters, and tailoring fluid therapy to individual patient needs. Optimizing fluid management is essential for reducing morbidity and mortality associated with severe dengue infection. Key decisions on fluid management are individualized with intense monitoring of vital parameters. The amount and type of fluid administered to maintain adequate perfusion while preventing fluid overload are based on the bed side clinical and sonographic assessment. This case-based discussion provides an overview of current fluid management strategies in various clinical stages of dengue highlighting the common pitfalls that may arise during management of complicated dengue patients. It is of utmost importance that we acquire the insight into the judicious fluid management during critical phase of dengue to minimize morbidity and mortality. \u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 130-131","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381346","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":"Sexual dysfunction in irritable bowel syndrome","authors":"Farhana Sultana, S. Algin, H. Aftab","doi":"10.3329/bjm.v35i20.73437","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73437","url":null,"abstract":"Background: Irritable bowel syndrome (IBS) is a common functional bowel disorder. The prevalence of IBS is more inwomen. It is often associated with extra-intestinal symptoms like psychosomatic symptoms and sexual dysfunction. This study investigated the frequency of extra intestinal manifestation especiallypsychosomatic symptoms and sexual dysfunction of irritable bowel syndrome in women. Methods: This is a descriptive crosssectional study was conducted in the Department of Gastroenterology , Dhaka Medical College Hospital from April 2022 to March, 2023. Patients were included following Rome IV criteria for IBS and face to face interviewed. Psychosomatic Symptoms Questionnaire (PSQ-39), the Arizona SexualExperience Scale were used for psychosomatic and sexual status respectively. Results: One hundred twenty patients participated, mean age was 36.43±9.91years, Majority (40% ) had higher secondary level education, predominant occupation was housewife (82.5%) , most of them (55%) living in urban area. Mean duration of illness was 4.28±2.217 years, diarrhea predominant IBS-D (53%) was most common.Among them 65% had psychosomatic symptoms, 56.7 % reported sexual symptoms. According to ASEX criteria no sex drive was found in 27.5%, weak sex drive in 24.2%, sexual arousal never occurred in 26.7%, difficult in sex 28.3%, no vaginal lubrication in 17.5%, difficult in orgasm 29.2%, orgasm never experienced in 26.7%, difficult to reach orgasm in 28.3%, satisfaction of orgasm was never in 30%, unsatisfying orgasm in 26.7% of them.About 75.3% population had perception that IBS as their cause of sexual dysfunction, 8.2% had incompetent male partner, 9.4% had their partner in abroad and 7.1% patients had familial disharmony, 14.2% had history of abstinent. Conclusion: In addition to bowel problems sexual dysfunction is common extra intestinal complaints in IBS patients. Requires special attention during management of IBS in women\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 168.","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"11 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141378787","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":"Tale of a Comatose Female with Polyuria","authors":"Taha Abtahir, Islam Rifat, Rimi Sadia, Rahim Abdur, I. Rafiqul","doi":"10.3329/bjm.v35i20.73468","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73468","url":null,"abstract":"A 28-year-old non-diabetic, hypertensive house wife got admitted due to fall from standing followed by gradually developing irrelevant talking. After 5 days, she became disoriented followed by loss of consciousness. On query, attendant gave history of gradually increasing, intermittent, cramping lower abdominal pain for last 2 months. On examination, patient was comatose, body built below average, anemic, BP 70/40 mm (Hg), pulse- 60 beats/ min, GCS: E2V1M2= 5/15, Planter response bilaterally extensor, tenderness over the hypogastric region. Initially our impression was septic encephalopathy , so we followed 1 hour “Sepsis Bundle” sending blood culture, urine culture & serum procalcitonin & routine investigations. At the 1ST day following admission, patient’s urine output was 7000 ml in last 24 hours followed by 3 episodes of generalized tonic clonic seizure & urinary & fecal incontinence. In the meantime, investigations ensured sepsis as well as electrolyte imbalance. CSF study revealed CNS Tuberculosis. So, we started anti tubercular medication. At 5TH day following admission, Patient regained her consciousness. At 7TH day, patient passed 10 liter of urine in a day. We ensured strict intake output chart. 24 hours urinary electrolytes were indicating urinary loss. We opted for urine for beta-2-microglobulin and it came out positive. So, after long 23 days of recovery from polyuria, we discharged the patient with the final diagnosis of Disseminated Tuberculosis (CNS TB &Tubulo-interstitial Nephritis) with Electrolyte imbalance (Hyponatremia, Hypokalemia, Hypochloremia & Hypomagnesemia) and Scabies with Erosio Interdigitalis Blastomycetica with Xerosis.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 176","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141376913","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":"Drug-coated Balloon : A Superb Alternative To Coronary Stents","authors":"C. Singha","doi":"10.3329/bjm.v35i20.73364","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73364","url":null,"abstract":"The evolution of interventional cardiology has witnessed a paradigm shift in the management of coronary arterydisease (CAD). Among the arsenal of interventions, coronary stents have been a cornerstone, providing mechanicalsupport and reducing restenosis rates. However, concerns persist regarding stent-related complications such asin-stent restenosis, late stent thrombosis & hazards of bleeding due to use of long dual antiplatelet (DAPT). Inrecent years, the emergence of drug-coated balloon (DCB) has introduced a promising alternative approach forthe treatment of CAD. DCB offer a unique mechanism of action, delivering antiproliferative drugs directly to thevessel wall without leaving a permanent implant. This characteristic eliminates concerns related to stent thrombosisand the need for long-term DAPT. Furthermore, DCB preserve vessel anatomy and vasomotion, potentially enablingfuture revascu- larization options. Clinical trials and real-world data have demonstrated the efficacy of DCB invarious coronary lesions, including small vessels and in-stent restenosis. This abstract provides an overview ofthe advantages of DCB over traditional coronary stents and highlights key clinical evidence supporting their use.Additionally, it discusses the economic implications and patient-centered outcomes associated with DCB therapy.Despite these advantages, challenges such as device delivery and optimal drug formulations remain areas ofongoing research and development. In conclusion, DCB represent a superb alternative to coronary stents inselected patients with CAD, offering comparable efficacy while mitigating stent & antiplatelet related complications.As technology continues to advance, further refinements in DCB design and drug delivery systems hold thepotential to revolutionize the landscape of coronary intervention, providing safer and more effective treatmentoptions for patients with CAD.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 151","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"2 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141378716","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":"Review of Dengue Deaths in Bangladesh: An Interim Analysis of the 2023 Outbreak","authors":"Quazi Tarikul Islam, Sheikh Daud Adnan, Nazmul Islam Munna, H. Ahasan, R. Amin, Iffat Ara Shamsad, Rubina Yasmin, Mohammad Rafiqul Islam, Nawsabah Noor, Asimsaha","doi":"10.3329/bjm.v35i20.73273","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73273","url":null,"abstract":"Background: Dengue fever is one of the most prevalent mosquito-borne diseases and is categorized as a neglected tropical disease (NTD) by the World Health Organization (WHO). Last year, Bangladesh witnessed an unprecedented dengue outbreak, claiming a record-breaking 1705 lives and posing a significant public health concern. This presents the preliminary analysis of the demographics and clinical features associated with dengue-related fatalities in 2023. Methods: This study presents a retrospective analysis of 94 dengue death cases, which were collected from 15 different hospitals in Bangladesh between January 1, 2023, to December 31, 2023. The cases were classified based on the patient's age as children (age <15 years), adults (age between 15-59 years), and elderly (age >60 years). The study aimed to investigate the demographic and clinical characteristics of the patients and also explores adherence to national guidelines for IV fluid management. Results: The data reveals that among the patients, 11.8% were children, 65.6% were adults, and 22.6% were elderly. Furthermore, 52.7% of the patients were male, while 47.3% were female. Comorbidities such as diabetes mellitus and hypertension were prevalent among the patients. The median duration between disease onset and hospitalization was 3.0 (IQR: 2.0 - 5.0) days, and the median duration of hospital stay was 1.0 (IQR: 0.61 – 2.0) days. Expanded Dengue Syndrome (29.8%) was the most common diagnosis at admission, followed by Dengue Shock Syndrome (26.6%), Dengue Hemorrhagic Fever (DHF) (17.0%), and Dengue Fever (DF) (14.9%). The study also revealed that only 35.1% of the patients received IV fluid treatment according to the national guideline, 47.9% did not, and no relevant record was found for the remaining 17% of cases. The patient follow-up was according to the guideline for 12.8% of patients, while 38.3% were not, and 48.9% had no record. Moreover, it was found that patients who received IV fluid treatment according to the guideline survived significantly longer than those who did not, with a mean difference of 1.26 days (p<0.05). It was also found that the use of steroids (28%), antibiotics (39.8%), and drugs that are not recommended (33.3%) were prevalent among the patients. Conclusions: In conclusion, the findings of the interim analysis conducted during the 2023 dengue outbreak reveal that Dengue Shock Syndrome (DSS) was responsible for the largest proportion of fatalities (36%), followed by Expanded Dengue Syndrome (EDS) (23%) and sepsis. The study also highlights the significance of adhering to the National Guidelines for IV fluid management and its potential impact on patient survival.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 157","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379765","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 Adiposity indices with insulin resistance in women with polycystic ovary syndrome","authors":"Md Shahed Morshed, H. Banu, M. Hasanat","doi":"10.3329/bjm.v35i20.73267","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73267","url":null,"abstract":"Background: Insulin resistance is one of the cardinal features of polycystic ovary syndrome (PCOS) that different adiposity indices can predict. The aim of the study is tosee the association of different adiposity indices with insulin resistance and their utility as markers of insulin resistance. Methods: This cross-sectional study included newly diagnosed women with PCOS based on Rotterdam criteria by convenience sampling. After taking informed consent, related histories were taken, physical examinations (height and weight to calculate body mass index, BMI; waist circumference, WC; blood pressure; acantho-sisnigricans; and hirsutism by modified Ferriman-Gallwey score) were done, and fasting blood was drawn to measure glucose, lipids, insulin, total testosterone, luteinizing as well as follicle stimulating hormone were measured. Then an oral glucose tolerance test was done to measure glucose. Glucose was analyzed by glucose oxidase, lipid by peroxidase dehydrogenase, and all hormones by chemilu-minescence. Adiposity indices included visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride index (TyG), and its cross-product with BMI (TyG-BMI), and WC (TyG-WC). Insulin resistance was measured by the homeostasis model (HOMA-IR) and 2.6 was taken as the cut-off. Results: Among 632 women 437 (69.1%) had insulin resistance. All the indices were significantly higher in the insulin resistance group and correlated with HOMA-IR irrespective of the insulin resistance status (p <0.001). Among the five, the TyG-BMI had the highest area under the curve (AUC) of 0.731, then the TyG-WC (0.728), followed by LAP (0.704). VAI and TyG index were poor markers of insulin resistance. Conclusion: TyG-BMI, TyG-WC, and LAP were moderate markers of insulin resistance among women with PCOS.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 180","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"49 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377399","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":"Asthma COPD Overlap Syndrome","authors":"Ziaul Huq","doi":"10.3329/bjm.v35i20.73378","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73378","url":null,"abstract":"Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is a term to describe patients with both features of asthma and COPD, firstly proposed by a joint section of the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) in 2014, and revised to ACO (Asthma COPD Overlap) in GINA 2017. ACO is epidemiologically considered in 2% of the general population, 29.6% of asthmatic patients and 26.5% of COPD patients. Patients with ACO have a greater burden of symptoms, frequent exacerbations, poor quality of life, a more rapid decline in lung function and greater use of healthcare resources compared to patients with asthma or COPD alone, but global diagnostic criteria for ACO are inconclusive. Clinical definitions and classifications for ACOS vary widely, which impacts our understanding of prevalence, diagnosis and treatment of the condition. The diagnosis and differentiation of asthma from chronic obstructive pulmonary disease (COPD) in clinical practice is relatively straightforward in the majority of cases; however, some patients exhibit characteristics of both diseases. Where uncertainty exists regarding the correct diagnosis of asthma, COPD or both, this may represent a phenotype known as asthma-COPD overlap syndrome (ACOS)\u0000COPD is highly prevalent in the global population of older adults (40 years of age and older) and has been associated with smoking and exposure to environmental tobacco smoke or fumes. COPD is typically characterized by persistent airflow obstruction and chronic inflammation of the airways. Airway inflammation is also seen in asthma; however, there are distinct differences in the type of inflammatory cells seen in these two respiratory diseases. Biopsies reveal that inflammation in COPD is characterized predominantly by increases in CD8+ T-lymphocytes, neutrophils, and macrophages , although increases in eosinophils have been observed in sputum at the time of exacerbation . In contrast, inflammation in asthma is commonly characterized by increases in CD4+ T-lymphocytes and eosinophils. Asthma is also a chronic obstructive lung disease, but in mild and moderately severe asthma, airflow obstruction responds to treatment with inhaled corticosteroids and bronchodilators and is therefore not persistent and is reversible. \u0000Patients with ACO usually have the same asthma and COPD symptoms, including cough, sputum production, shortness of breath, and wheezing. However, exacerbation rates were 4 to 5 times higher in ACO patients compared with those with asthma or COPD alone. Also, it was found that patients with ACO have more emergency department visits and hospital admission.  The physical examination findings include wheezing and hyperinflation signs, the same as in chronic obstructive lung disease findings. However, findings can be normal, with periodic exacerbations in between.More research is needed to better characterize patients and to obtain a standardized ","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"10 S8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377769","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":"Endoscopic ultrasound: what is it and when should it be used?","authors":"B. C. Shil","doi":"10.3329/bjm.v35i20.73397","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73397","url":null,"abstract":"Flexible endoscopy was first developed in 1911 and ultrasound later arrived in 1956. In the 1980s, these modalities were merged to form the endoscopic ultrasound (EUS). EUS uses a special endoscope with a small ultrasound probe mounted on its tip called echoendoscope. Endoscopic ultrasound works similar to abdominal ultrasound, except the source of the sound waves is inside the body. Because the sound waves don’t need to pass through the skin and muscle to reach internal organs, EUS offers a better view of the GI tract and nearby organs than abdominal ultrasound. Thereby, EUS is a minimally invasive procedure that combines conventional endoscopic viewing of GI lumen with ultrasound imaging of gut wall in fine detail and surrounding structures and organs e.g mediastinum, lungs, liver, pancreas, gall bladder, biliary trees, vasculatures and lymph nodes. It is more precise in identifying small tumors and cysts that other imaging methods such as MRI and CT can miss.\u0000It has been shown to be very useful in evaluating submucosal tumors, extraluminal lesions pancreatobiliary diseases and staging of GI malignancies. There are two types of echoendoscopes for imaging: radial & linear. The radial EUS is used for diagnostic purpose. The linear echoendoscope is utilized for both diagnostic and therapeutic purpose like fine needle aspiration (FNA) or core biopsy (FNB) from GI lesions and in the treatment of a variety of clinical conditions. Therapeutic applications of EUS are rapidly expanding and facilitating, various interventions like celiac plexus block or neurolysis for pain control in pancreatic cancer and in chronic pancreatitis, drainage of pancreatic collection, necrotic tissues or pseudocyst, loculated ascites, liver abscess, pelvic abscess, EUS guided ERCP in failed conventional ERCP, TIPSS, ablation of tumors, application of chemotherapeutic or radioactive agents in different lesions and EUS guided gastroenterostomy etc.\u0000Still, EUS is very slow to be accepted within our country, it has now an established role in many arenas. It is a safe and cost-effective procedure which has a significant impact on the management of patients.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 143-144","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379980","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}