Journal of medicine最新文献

{"title":"Clinical Presentation of Ischaemic and Haemorrhagic Stroke and Its Relation to Lipid Profile","authors":"Rahatun Nayeem, Masroor-ur-Rahman, Saiyeedur Rahman","doi":"10.3329/jom.v25i1.70522","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70522","url":null,"abstract":"Introduction: Stroke is a major health hazard in both developed and developing countries. Dyslipidaemia is one of the important risk factors for stroke. The purpose of the present study was to identify clinical presentations of both ischaemic and haemorrhagic stroke, and to find out correlation between stroke and lipid profile.\u0000Methods: The observational study was conducted in the Department of Medicine at Sher-e-Bangla Medical College Hospital, Barishal from April to September 2013 for a period of 6 months. All the stroke patients over 20 years of age of both sexes were selected as study population. After admission at the hospital, history was taken from the patients or the attendants. The clinical presentation was recorded in a pre designed data collection sheet. Fasting lipid profile was measured in every stroke patient.\u0000Results: Total 100 stroke patients were enrolled for this study, of them 36 were haemorrhagic and 64 were ischaemic stroke patients. The mean ± SD of age were 63.945 ± 8.84 and 62.26 ± 14.40 in haemorrhagic and ischaemic stroke patients respectively (p>0.05). Among both haemorrhagic and ischaemic stroke patients maximum 61.1% and 60.9% used to have sedentary work. Impaired level of consciousness was more common among the haemorrhagic stroke patients (91.7%) than ischaemic stroke patients (57.8%) group and the association is statistically significant (p=0.001). Limb weakness was the commonest presentation in both haemorrhagic (91.7%) and ischaemic (87.5%) stroke patients. The mean ± SD of total cholesterol was 173.47 ± 61.96 and 178.22 ± 54.79 in haemorrhagic stroke and ischaemic stroke patients respectively (p<0.05).\u0000Conclusion: Older age, male sex, sedentary work and dyslipidaemia were susceptible to be affected in stroke. Among lipoproteins, elevated total cholesterols, triglycerides and LDL showed strong correlation with both ischaemic and haemorrhagic strokes.\u0000J MEDICINE 2024; 25: 24-28","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"46 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386977","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":"Fundamentals in Clinical Neurology- 1st Edition by Aminur Rahman","authors":"Rubina Yasmin","doi":"10.3329/jom.v25i1.70531","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70531","url":null,"abstract":"Abstract not available\u0000J MEDICINE 2024; 25: 102","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"33 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387115","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":"CT severity Radiological phenotypes (CTS) assessment in COVID-19 pneumonia as ‘inconsistent predictor of disease severity’: A large tertiary care center study in India","authors":"Shital Patil, U. Dhumal, L. Kasture, G. Gondhali","doi":"10.3329/jom.v25i1.70528","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70528","url":null,"abstract":"Introduction: Radiological phenotypes are radiological patterns or observable characteristics of COVID-19 pneumonia. Various phenotypic classifications have been reported in literature. CT severity radiological phenotypes are widely used and universally accepted radiological phenotypic methods. Robust data is available regarding role of HRCT in COVID-19 pneumonia and we have evaluated role of CT severity in assessing natural course of COVID-19 illness during its evolution sand follow-up.\u0000Methods: Prospective, Observational study, included 3000 COVID-19 RT-PCR confirmed cases with lung involvement documented and radiological severity phenotypes categorized on HRCT thorax as mild, moderate and severe as per lung segment involvement bilaterally (scoring tool 0-25 score, mild 1-7, moderate 8-15 and severe 16-25). Radiological CT severity phenotypes were   evaluated in correlation with interventions such as oxygen support and oxygen plus ventilatory support requirement during hospitalization. Age, gender, Comorbidity, laboratory parameters and use of BIPAP/NIV in COVID-19 cases and outcome as with or without lung fibrosis were key observations. Final radiological outcome documented in follow up CT thorax imaging done at six months of discharge from hospital. Statistical analysis is done by using Chi square test. \u0000Results: In study of 3000 cases, ‘mild, moderate and severe’ radiological CT severity phenotypes were documented as 13.33%, 48.33% & 38.34 % respectively. CT severity has documented significant association with duration of illness at entry point [p<0.00001] Duration of illness (<7 days, 7-14 days and >14 days) plays a crucial role in predicting radiological CT severity phenotypes. CT severity has documented significant association with laboratory parameters at entry point (d-dimer, CRP, IL-6) [p<0.00001] and interventions required in indoor unit. [p<0.00001] Post COVID-19 lung fibrosis or sequelae has significant association with radiological CT severity phenotypes. [p<0.00001] Covariates such as age, gender, diabetes mellitus, IHD, Hypertension, COPD, Obesity has significant association with radiological CT severity phenotypes. [p<0.00001]\u0000Conclusion: Radiological CT severity phenotypic differentiation has documented very crucial role in initial assessment and during triaging of these cases in indoor and outdoor setting. Although CT severity is best predictor of severity it has showed ‘inconstancy’ in predicting disease severity, targeting interventions and predicting early and long-term outcomes in COVID-19 pneumonia.\u0000J MEDICINE 2024; 25: 46-57","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"44 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385056","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":"Nutritional Status and Quality of Life among Geriatric Patients in a Tertiary Care Hospital","authors":"Suzana Malek Tinu, R. Parveen, Monjurul Haque, Rubina Yasmin","doi":"10.3329/jom.v25i1.70523","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70523","url":null,"abstract":"Background: Wellbeing of the elderly population in terms of their health and nutritional status are often ignored and unidentified in the community. This study aimed at assessing the nutritional status of the geriatric patients and their quality of life (QOL) attending OPD of Mugda Medical College Hospital.                            \u0000Method: This survey was conducted in the OPD of Mugda Medical College Hospital from June to December 2022 through a cross-sectional analytical method. The study tools were the Mini-Nutritional Assessment tool and WHOQOL-BREF questionnaires which were used to observe the level of nutrition and quality of life among geriatric population respectively.                                                                                         \u0000Result: Of all the respondents, about half (46%) were at risk for malnutrition and about 28% were malnourished while 26% respondents’ level of nutrition was normal. About 62% respondents had poor QOL, whereas, 31% had fair QOL and only 7% had good QOL. Also, nutritional status and quality of life of the elderly had significant relationship.                                                                                   \u0000Conclusion: The impact of poor nutrition on the quality of life and physical ability of geriatric population is remarkably worthy of attention. The ageing process is challenging and raises public health concerns. Reduction of the observed prevalence of malnutrition and thereby upgrading the quality of life of elderly population should be more focused on and proper attention to this issue is crucial in the community as well as national level.\u0000J MEDICINE 2024; 25: 29-34","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"31 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386711","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":"Electrophysiological variations of Guillain-Barre syndrome in Bangladesh- Hospital based study","authors":"Shinjini Sarker, Sakhawat Hossain, Nawsabah Noor, Anjuman Ara Begum, Md Khairuzzaman, Pijous Biswas","doi":"10.3329/jom.v25i1.70520","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70520","url":null,"abstract":"Introduction: Guillain-Barre syndrome (GBS) is an immune mediated disorder of peripheral nerves which usually presents by rapidly evolving ascending weakness & mild sensory loss and hypo- or areflexia. Electrodiagnostic study (EDS) is the basis for classification of different subtypes of the disease. EDS also has a crucial role in diagnosis, ruling out of some differential diagnosis like myopathic and motor neuron disorders and confirming the neuropathic nature of GBS. The benefit of immunotherapy is greatest when introduced early. In addition, electrophysiological characteristic can predict the prognosis of patients with GBS. This study was conducted to determine the predominant subtype and electrophysiological pattern of GBS in the context of Bangladesh.\u0000Objectives: Objective of this study was to compare the electrophysiological variations among different electrophysiological subtypes of GBS.\u0000Methods: It is an observational cross sectional study conducted in Department of Medicine and Neurology, Sir Salimullah Medical College & Mitford Hospital and National Institute of Neuroscience (NINS), Dhaka, over a period of one year & four months. Total 30 patients were selected by purposive sampling technique. Demographic data were collected from the patients and recorded in structured case report form. Clinical examination and relevant investigations were done meticulously. Collected questionnaire were checked to identify any error in data. Data was analyzed with SPSS version 21 software.\u0000Result: In this study, maximum numbers of patients 53% were between 21-30 years of age group with mean value 27.47±8.1 years. Male to female ratio was 1.7:1. Frequency of Guillain-Barre syndrome is predominance at middle age group. Commonest presentation was limb weakness (parapledgia or quadripledgia) in 60% patients, paresthesias & numbness (40%), pain (100%) and deviation of mouth (63%) of GBS patients. Cerebrospinal fluid shows a mild pleocytosis (5 to 50 cells/µl) in majority of cases was found in 76%  of patients. Whereas elevated CSF Protein (>45 mg/dl) was seen in all GBS patient. Increased distal motor latency (DML) was found in 93% patients, whereas 7% patients had normal DML. In the case of the lower limbs, increased distal motor latency was predominant. Decreased amplitude of sensory nerve action potential (SNAP) was seen in 83% patients while 16% patients had normal. Slowing of motor conduction velocities, decreased amplitude as well as increase in distal motor latencies were observed, being more pronounced in the lower limbs. F-wave was completely absent in 20.0% patients while 20% patients showed decreased conduction velocity with prolonged latency. Sensory nerve action potential revealed that decreased  sensory  conduction  velocity  (SCV)  was  seen  in  26%,  absent  SCV  in  10%  and  normal  SCV  in  63% patients. Present study demonstrated that Acute inflammatory demyelinating polyneuropathy (AIDP) was the commonest type of Guillain-Barré syndrome","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"4 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139384479","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":"Metabolic dysfunctions in polycystic ovary syndrome","authors":"Mehrin Rahman, Fahim T Rahman, Md. Uzzwal Mallik, Joysree Saha, Md Mujibur Rahman, K. A. Azad","doi":"10.3329/jom.v25i1.70703","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70703","url":null,"abstract":"Polycystic Ovary Syndrome (PCOS) is a condition that involves various metabolic dysfunctions such as insulin resistance (IR), hyperandrogenemia, obesity, dyslipidemia, and steroid hormone irregularities. Although the exact cause of PCOS is still unknown, it is known to cause several hormonal disturbances, including hyperandrogenemia, IR, and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamic-pituitary-ovarian (HPO) axis, and ovarian tissue insulin resistance results in impaired metabolic signaling. This causes hyperandrogenemia, which is one of the primary causes of the symptoms of PCOS. Androgens may also lead to IR by modifying muscle tissue composition and functionality and increasing levels of free fatty acids, perpetuating the IR-hyperinsulinemia-hyperandrogenemia cycle. Obesity exacerbates hormonal imbalances, and in combination with dyslipidemia, amplifies cardiovascular and cerebrovascular risks. This review discusses the complex risk factors of PCOS, including genetic, epigenetic, and environmental factors. It also discusses the interconnected etiologies of metabolic dysfunctions of PCOS, its effective management, and metabolic consequences such as cardiovascular and cerebrovascular diseases.\u0000J MEDICINE 2024; 25: 68-77","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385874","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":"Arsenic intoxication causing Megaloblastic Anaemia- lesson learnt","authors":"I. Reza, Nawsabah Noor, Mahbub Mayukh Rishad, Mohammad Zahiruddin, H. Ahasan","doi":"10.3329/jom.v25i1.70534","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70534","url":null,"abstract":"Megaloblastic anaemia is a common hematological abnormality encountered in clinical practice. We here report a case of 40-year-old male who presented to us with feature of anaemia and typical dermatological manifestation of arsenic intoxication. Complete blood count of patient showed pancytopenia with no circulating atypical cells. Bone marrow examination performed and showed megaloblastic change. Arsenic level in the hair was done and came out very high a. A very few case reports of arsenic causing megablastic anaemia were done in past. Aim of this case report is to create awareness among the physician.\u0000J MEDICINE 2024; 25: 90-93","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"54 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386047","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 unusual hemorrhage as a complication of dengue fever in a tertiary hospital in Dhaka","authors":"Tahmid Bhuiyan, Aditi Das, Abdur Rahim, Mohammad Rafiqul Islam","doi":"10.3329/jom.v25i1.70537","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70537","url":null,"abstract":"Common bleeding complications of dengue hemorrhagic fever are epistaxis, gum bleeding, gastrointestinal bleeding, menorrhagia, hematuria.1  Major hemorrhage like intracranial hemorrhage have been documented but rare.  We present here a case of a 24 year old man with complaints of high grade intermittent fever for 5 days, upper abdominal discomfort for 3 days and swelling of right upper limb for same duration.  Laboratory investigations revealed a positive dengue serology, thrombocytopenia and elevated transaminases.  USG of the hand revealed a hematoma involving the right upper arm.  The patient was managed conservatively with elevation and immobilization of the upper limb and recovered gradually.\u0000J MEDICINE 2024; 25: 100-101","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"23 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387053","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":"Cutaneous Leishmaniasis in Bangladeshi Adult Male: A Case Report","authors":"Farjana Sultana, Md. Ahasanul Haque, Rafiya Afroz, Abdur Rahim, Mohammad Rafiqul Islam","doi":"10.3329/jom.v25i1.70536","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70536","url":null,"abstract":"Abstract not available\u0000J MEDICINE 2024; 25: 98-99","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"57 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139384907","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 Young Adult with Crohn’s Arthritis Necessitating Upper Gastrointestinal Tract Surgery - A Case Report","authors":"Tasmina Chowdhury, Israt Urmee, K. A. Azad","doi":"10.3329/jom.v25i1.70532","DOIUrl":"https://doi.org/10.3329/jom.v25i1.70532","url":null,"abstract":"Upper gastrointestinal tract predominant Crohn’s Disease (CD) remains an uncommon clinical entity, manifesting limited or vague symptomatology, thus delaying clinical suspicion and subsequent diagnostic evaluation. For that reason, it has not been widely described and there is a lack of clear recommendations for diagnosis or management. Standard Inflammatory Bowel Disease (IBD) evaluation including serologic testing, imaging, and endoscopy may initially not be fruitful. Furthermore, endoscopic evaluation may be inconclusive even in patients with long standing-disease. We describe a 30-year-old male who suffered long with persistent iron-deficiency anemia (IDA) and occasional melaena along with predominant axial arthropathy. Extensive in-patient testing including multiple endoscopic evaluation with standard biopsy were unfruitful. Ultimately, long standing recurrent gastric and duodenal ulcer, suggestive colonoscopy finding, and positive fecal calprotectin in a patient along with spondyloarthropathy drove us toward the diagnosis of Crohn’s disease. We started steroid, PPI, sulfasalazine and the patient is on follow up.\u0000J MEDICINE 2024; 25: 83-86","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":"56 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385649","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}