Bangladesh Journal of Medicine最新文献

{"title":"Management of HepatitisB - How far are We from the Holy Grail?","authors":"M. Mahtab, A. S. M. Fazle","doi":"10.3329/bjm.v35i20.73264","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73264","url":null,"abstract":"Background: Although there are several antivirals available against hepatitis-B, they have several limitations including infinite duration of administration, viral resistance, adverse events and failure of prevention of liver disease progression in all cases. Therefore the quest for a new antiviral against heptatitis-B continues. Methods: Phase-1, 2 & 3 clinical trials of a novel therapeutic vaccine for hepatitis-B called NASVAC were conducted in treatment naive chronic hepatitis-B patients in Bangladesh. Subsequently the patients were followed up off treatment for upto 3 years. Results: Results show that NASVAC treated patients achieved better virologic control compared to those treated with pegylatedinterferon. NASVAC was not only found to be safe, it also induced immune modulation and most importantly unlike those patients who were treated with pegylatedinterferon, there was no progression of liver disease in NASVAC treated patients. NASVAC has subsequently been registered in five different countries and its recipe has been approved by the Drug Control Committee of Bangladesh Government. Conclusion: NASVAC appears to be an effective therapeutic agent for chronic hepatitis-B, free from adverse events and of finite duration that prevents liver disease progression.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 155","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"6 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379654","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 Case of Milk Alkali Syndrome: The Forgotten Diagnosis of Generalized Weakness and Altered Consciousness","authors":"Md Sabbir Hossain, Md Abul Kalam Azad, Mohammad Ferdous Ur Rahaman, Kazi Ali Aftab, Imrul Basher Rahman, S. Monira","doi":"10.3329/bjm.v35i20.73464","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73464","url":null,"abstract":"This case reports outlines a 76-year-old male’s progression from papillary thyroid carcinoma diagnosis to the development of Calcium-Alkali Syndrome (CAS) following thyroidectomy. Initially presenting with thyroid mass, surgery was followed by generalized weakness and altered sensorium, investigations that revealed elevated calcium levels ,metabolic alkalosis and renal impairment . Diagnosis pointed to CAS, likely triggered by prescribed calcium and calcitriol post-surgery. Cessation of supplements and hydration resulted in resolution. While postthyroidectomy hypocalcemia is anticipated, CAS poses challenges, especially with increasing calcium supplement use. This emphasizes the need for vigilant monitoring of electrolyte imbalances, particularly in regions with limited follow-up practices. Clinicians should balance preventing hypocalcemia without risking hypercalcemia, stressing the importance of timely identification and tailored interventions to prevent CAS complications. This case underscores the significance of recognizing CAS as a potential postoperative complication, urging vigilant monitoring and tailored management in similar clinical settings.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 174","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381218","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":"Invasive Orbital Aspergillosis: Treatment Challenge.","authors":"Sanjida Aktar, Farjana Sultana, Haqueahsanul, Abdur Rahim, Mohammad Rafiqul Islam","doi":"10.3329/bjm.v35i20.73469","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73469","url":null,"abstract":"Orbital cellulitis is a serious infection that involves the muscle and fat located within the orbit. The causative organisms of orbital cellulitis are commonly bacterial but can also be polymicrobial, even fungal or mycobacteria. In immunocompromised patients with orbital cellulitis, mucormycosis and invasive aspergillosis should be considered as the cause of orbital cellulitis.A 55 years old, normotensive, non-diabetic lady came with swelling of left eye with purulent discharge, on October, 2022. She took consultation from an Ophthalmologist and had excision of the tissue mass. Her histological diagnosis was invasive orbital aspergillosis.  After 2 months, she again developed orbital swelling with severe purulent discharge and consulted with department of Maxillofacial surgery. They referred the patient to us for proper management.On query, patient gave history of completing COVID-19 vaccination 2nd dose and couldn’t receive 3rd dose due to this medical condition. She did not have any history of diagnosed COVID-19 infection.After complete clinical evaluation, we decided to arrange FESS (functional endoscopic sinus surgery) with surgical debridement. After surgery, we planned to start Inj. Amphotericin-B. Considering patient’s poor financial condition, we started Tab. Posaconazole. During hospital stay for 3 months, she suffered from orbital infection twice. Culture sensitivity reports revealed Pseudomonas (1st time) and E. coli (2nd time). We treated the patient with antibiotics accordingly. She took Tab. Posaconazole for 6 months and was cured completely. In conclusion, high suspicion of fungal infection should be kept in mind even in absence of any co-morbidity.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 177","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141378409","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":"Three cases of hypopituitarism with variable presentation","authors":"Moumita Hossain, Haque Ahasanul, Afrozrafiya, Bashar Fuad Bin, Rahim Abdur, I. Rafiqul","doi":"10.3329/bjm.v35i20.73472","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73472","url":null,"abstract":"Patients with hypopituitarism often experience a delay in diagnosis. Symptoms which maybe life threatening are nonspecific and often attributed to aging and/or related morbidities. We have diagnosed three patients with hypopituitarism. We treated them accordingly and they dramatically improved. Our first case 60 years old female came to us with sudden onset of vomiting for several times and generalized weakness. She is known case of diabetes mellitus, hypertension and IHD with HF (EF 40%). In routine investigation we found unusual hyponatremia and hyperkalemia. We did pituitary function test as well as other necessary investigation. We found hypopituitarism and pituitary microadenoma in MRI of brain with pituitary protocol.Our second case 43years old female presented to us with vomiting for four months for several times with features of anemia. We did routine investigation and found hypomagnesemia, hypocalcemia, hypokalemia and hypernatremia. In search of previous document, we found hyponatremia, hypokalemia and hypochloremia. For these she admitted into tertiary care hospital and treated as acute gastroenteritis. We did pituitary function along with other possibilities. We found hypopituitarism with multiple endocrine neoplasia. Imaging showed pituitary microadenoma involving left half of anterior pituitary.Our third case 68 years elderly female known to have hypertension and diabetes mellitus came to us with features of meningo-encephalitis. We searched for features of meningo-encephalitis in MRI of brain. We found empty Sella. Pituitary function tests revealed hypopituitarism. Lactational failure and pre mature amenorrhea was absent in all three cases. So, suspicion about hypopituitarism should be kept in mind though clear-cut features are absent to save lives of our patients.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation:178","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381348","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":"Role of 18F-FDG PET-CT in evaluation of Ca Lung patients – multicenter experience in Bangladesh.","authors":"Rawnak Afrin","doi":"10.3329/bjm.v35i20.73256","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73256","url":null,"abstract":"Background: Most patients with lung cancer are diagnosed with advanced disease stage, which is clinically aggressive and has high metastatic potential.FDG- PET is widely used in lung cancer staging at diagnosis, response evaluation after systemic treatment, re-staging after neo-adjuvant treatment and surveillance. To determine the diagnostic & prognostic value of 18 F-FDG PET/CT in lungcarcinoma patients. Methods: Total 450pathologically confirmed lung carcinoma patients(aged between 30 and 89 years with mean age of 61 years)without prior surgery and treatment were included, conducted in two centers for 5 years.Semi-quantitative estimation of FDG uptake was performed by calculating SUVmax value, corrected for dose administered and body weight.Results:This study showed male predominance, 75% patients were male, 25% were female. 58% patients had adenocarcinoma. Smoking was found to be an important contributing factor in male patients.70% patients had stage III& IV disease.Patients having stage III & IV revealed elevated CEA level than stage I & II. Patients having stage IV disease showed nodal, hepatic, cerebral and skeletal metastases.The SUV max value was higher in patients with squamous cell carcinoma. Treatment plan has changed in 70% of the patients after 18F-FDG whole body PET-CT scan. Conclusion: FDG-PET is a useful adjunct in NSCLC TNM staging. The usefulness of FDG-PET mainly lies in nodal staging and distant metastatic survey. The use of PET—CT for preoperative staging of NSCLC reduced both the total number of thoracotomies and the number of futile thoracotomies.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 156","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"5 2‐3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141376830","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 Dermatophytosis: Scenario of Bangladesh and Their Management","authors":"Md Uzira Azam Khan","doi":"10.3329/bjm.v35i20.73383","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73383","url":null,"abstract":"Dermatophytosis is one of the skin diseases caused by dermatophyte fungi. Dermatophytes cause tinea pedis, tinea corporis, tinea cruris, tinea capitis, tinea unguium, tinea manum etc. They mainly occur in tropical countries like Southeast Asia. The prevalence of dermatophytosis ranges 20%-25%.  Dermatophytosis typically presents as a well-demarcated, sharply circumscribed, mildly erythematous, pruritic scaly patch or plaque with a raised edge. The lesions may become widespread and invasive. It has significant negative social, psychological, and occupational health effects.  The diagnosis is often clinical but in some cases the diagnosis requires microscopic examination, culture and PCR assay for fungal DNA of skin scrapings. Currently, dermatologists are facing a devastating situation with cases of dermatophytosis presenting with unusually large and atypical lesions making diagnosis difficult and has created a real panic among them.  As enough research is not done in this area, hence it poses a therapeutic challenge to practitioners. American Academy of Dermatology guidelines on dermatophytosis were published two decades ago and the British Association of Dermatology focused only on tinea capitis and onychomycosis. Also, the treatment in the textbooks is not updated. Bangladesh has not yet produced any guideline on this issue. Indian Expert Forum Consensus Group recommended treatment for dermatophytosis recently. It recommended treatment as follows: (i) tineapedis: terbinafine (250 mg/day) in naïve cases for 2-4 weeks, or itraconazole (200 mg - 400 mg/day, in divided dose) in recalcitrant/ severe cases for >4 weeks; (ii) tineacruris and corporis: topical antifungal agents (azoles) in naïve cases. Extensive or recalcitrant infection require oral combination therapy: terbinafine (250 mg/day) and itraconazole (100 mg-200 mg/day) in naïve cases. In recalcitrant cases, itraconazole (200 mg-400 mg/day, in divided dose) along with topical therapy for 2–4 weeks in naïve cases, 4 weeks in recalcitrant cases: (iii) tinea incognito: abrupt withdrawal of steroids and oral itraconazole 200 mg-400 mg daily for 4-6 weeks or longer are suggested: (iv) Onychomycosis: Terbinafine 250 mg/day for 6 weeks in fingernail and 12-16 weeks in toenail infection. Itraconazole 200 mg per day for 12 weeks continuously, or alternatively as pulse therapy at a dose of 400 mg per/day for 1 week/month for 2 pulses for fingernail 3 pulses for toenail. Treatment should be continued for 2 weeks after clinical cure. Baseline LFTs and periodic follow-up should be done. With the current situation, Indian dermatologists use higher doses, longer duration and combination of oral antifungals for the management of recalcitrant cases. Griseofulvin and fluconazole are used in patients where terbinafine or itraconazole had failed.  Use of keratolytics (except folds and face), moisturizers, calcineurin inhibitors, desiccant powder and antihistamines have been suggested. Avoidance of tight-fittin","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"43 S204","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377867","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 multimorbidity and disease clusters with neuroimaging and cognitive markers of brain health in 43,160 individuals.","authors":"Shehab Uddin Al Abid, Catherine M Calvin, Danial Qureshi, Michele Veldsman, El¿bieta Kuÿma, Thomas J. Littlejohns","doi":"10.3329/bjm.v35i20.73270","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73270","url":null,"abstract":"Background: Recent research has found that living with two or more chronic conditions, termed multimorbidity, is associated with an increased risk of developing dementia. In the current study, we investigated whether multimorbidity is associated with a range of dementia-related neuroimaging and cognitive markers of brain health that typically manifest prior to a clinical diagnosis of dementia. Methods: We included 43,160 participants aged 45-83 years free from neurological conditions, including dementia, who attended the UK Biobank imaging assessment from 2014-onwards. Multimorbidity was defined as the presence of ³2 long-term conditions from a standardised criteria of 39 conditions. Latent class analyses were used to identify disease clusters. Neuroimaging outcomes were measured using magnetic resonance imaging (MRI), and cognition was assessed by seven tests measuring different cognitive domains. Linear regression models, adjusted for socio-demographic and neuroimaging confounders, were used to test the association between multimorbidity and disease clusters with neuroimaging and cognitive outcomes. Results: Multimorbidity was present among 14,339 (33.2%) participants. In fully-adjusted models, presence of multimorbidity was associated with several measures of poorer brain health. This included lower volumes of grey matter (b: -0.03 standard deviation (SD); 95% confidence interval (CI): -0.04, -0.02), total brain (b: -0.01 [-0.02, -0.01]), left hippocampus (b: -0.03 [-0.05, -0.01]), increased white matter hyperintensity volume (v: 0.09 [0.07, 0.10]), poorer executive function (b: 0.04 [0.02, 0.06]), verbal declarative memory (b: -0.03 [-0.05, -0.01]), and processing speed (b: -0.07 [-0.10, -0.05]). A strong dose-response relationship was observed with the increasing number of multimorbid conditions and the aforementioned outcomes. Strength of associations varied across disease clusters, with a cluster predominantly driven by cardio-metabolic conditions showing the strongest associations with brain health outcomes. Clusters driven by ‘respiratory’, ‘mental health’ and ‘miscellaneous’ conditions were inconsistently associated with neuroimaging and cognitive outcomes. Conclusion: Multimorbidity, primarily cardio-metabolic multimorbidity, was associated with poorer brain health. These findings provide insights into the potential pathways underlying previously observed associations between multimorbidity and dementia risk.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 162","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"92 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377282","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":"Renovuscular Hypertension: Management Difficulties","authors":"Md Babrul Alam","doi":"10.3329/bjm.v35i20.73503","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73503","url":null,"abstract":"Atherosclerotic renal artery stenosis (ARAS) is a major cause of renovascular hypertension and ischemic nephropathy, frequently leading to end-stage renal disease. Diagnostic evaluations for hemodynamically significant renal artery stenosis should target patients at moderate to high risk of renovascular disease. Key clinical indicators include severe or resistant hypertension, an acute rise in blood pressure from a previously stable level, youngonset hypertension without a family history, an unexplained and sustained increase in serum creatinine by more than 30% following the initiation of renin-angiotensin system inhibitors, moderate to severe hypertension in individuals with diffuse atherosclerosis, renal asymmetry, and recurrent episodes of flash pulmonary edema. Interventions for renal artery stenosis carry substantial risks, especially for patients with chronic kidney disease. ARAS is a progressive condition that can lead to worsening stenosis and eventual renal failure. The primary management strategy for renovascular hypertension should focus on treating the underlying cause. Medical management is the preferred initial approach for ARAS-induced renovascular hypertension, as numerous studies have shown no significant renal or cardiovascular benefits from invasive procedures. Patients should receive comprehensive medical therapy to control hypertension, routine chronic kidney disease care, and aggressive treatment for secondary cardiovascular prevention, including the use of aspirin, statins, smoking cessation, and glycemic control in diabetic patients. While medical therapy and risk factor reduction are crucial, revascularization may be warranted for certain patients based on the severity of hemodynamic impairment and the potential for kidney function recovery, typically through percutaneous transluminal renal angioplasty with stenting or, in selected cases, surgery.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 152-153","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"21 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379777","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":"Diffuse Parenchymal lung disease: An update, diagnosis & management","authors":"Mohammad Mohiuddin Ahmad","doi":"10.3329/bjm.v35i20.73381","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73381","url":null,"abstract":"Diffuse Parenchymal lung disease (DPLD) is an umbrella term for over 200 different diseases that display considerable variation in terms of clinical course, treatment and prognosis. Broadly, they can be subdivided into those with an identifiable cause and those without; the latter being referred to as idiopathic interstitial pneumonias. Clinical assessment aims to identify a possible cause; screening for features of systemic disease (eg connective tissue disease) or environmental triggers. Relevant exposures include pneumotoxic drugs, radiation therapy, occupational exposures (eg asbestosis) or implicated allergens (hypersensitivity pneumonitis). Distinguishing the various forms of pulmonary fibrosis is critical for determining correct management and for predicting prognosis. All DPLD is characterized by variable degrees of inflammation and fibrosis. In inflammation dominant disease, the histology is that of organizing pneumonia or non-specific interstitial pneumonia, while in fibrosis dominant disease, Usual interstitial pneumonia (UIP) is present– characterized by fibroblastic foci and only mild to moderate inflammation. These histological patterns are associated with specific radiological features, the recognition of which may abrogate the need for a formal biopsy and tissue diagnosis. With the discovery and approval of two new anti-fibrotic drugs (pirfenidone and nintedanib) heralding a new era in the disease. While these novel anti-fibrotic agents have been shown to slow the decline in forced vital capacity (FVC), they neither halt progression nor reverse existing fibrosis. These drugs only can be used in fibrosis predominant disease. In inflammation predominant cases can be treated by addressing the etiology. Pulmonary rehab is an important component of management.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 135","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"14 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141380159","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":"Movement disorder: Beyond medical treatment","authors":"Jalal Uddin Muhammad Rumi, Selim Shahi","doi":"10.3329/bjm.v35i20.73428","DOIUrl":"https://doi.org/10.3329/bjm.v35i20.73428","url":null,"abstract":"Medication, in conjunction with rehabilitative treatments such as physiotherapy, occupational therapy & even psychotherapy, is the prime therapy for movement disorders. As the condition advances, these techniques may fail or have unfavorable outcomes, necessitating surgery. In movement disorders such as essential tremor (ET), Parkinson’s disease (PD), and dystonia, surgery has become a well-established type of treatment. A variety of surgical treatments such as resection, ablation, stimulation, cell therapy, gene therapy, immunotherapy and others have been utilized to manage cases with movement disorder. Currently deep brain stimulation (DBS), with its inherent character of adjustability and reversibility including strong advocacy and marketing from industry, is most common surgical procedure for PD, ET and dystonia. Radiofrequency thalamotomy and other ablative procedures are also performed in selected patients. DBS has complicated electrical effects on individual neurons and neuronal networks, affects neurotransmitter concentrations and dynamics, and shapes the microenvironment, which includes astrocytes, microglia, and endothelial cells. DBS also affects neuroplasticity and may cause neurogenesis and neuroprotection (Jakobs et al. 2019).We have started DBS surgery on 2017, and as of today have done seven cases. Among them five are patient of advanced PD and two were suffering from generalized dystonia.We have done bilateral STN DBS in four PD patient and unilateral VIM thalamus DBS in another case. Bilateral GPI DBS was done in both cases of generalized dystonia.Our results in all our cases are very much encouraging. We like to share our experiences and outcome in the presentation.\u0000Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 152","PeriodicalId":516125,"journal":{"name":"Bangladesh Journal of Medicine","volume":"115 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377663","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}