Bangladesh Medical Journal最新文献

{"title":"Clinical Manifestation of Acute Myocardial Infarction in Elderly Patients","authors":"Md Liakat Hossain, Azm Ahsan Ullah, Mohammad Mizanur Rahman, Md Haidar Ali, Rashedul Hasan, Muhammad Nafees Hussain Amit, Kshitish Chandra Talukder","doi":"10.3329/bmj.v51i2.68355","DOIUrl":"https://doi.org/10.3329/bmj.v51i2.68355","url":null,"abstract":"Myocardial Infarction is one of the most common causes of mortality and morbidity among the elderly patients. Also, it is known for wide range of clinical presentations other than chest pain. Yet, a large number of patients may have atypical or no symptoms. As an indication of a cardiac problem, resulting in a delay in seeking medical care the absence of typical chest pain and the vagueness of symptoms might not be recognized. The absence of typical chest pain and the vagueness of symptoms might not be recognized. This cross sectional observational study was carried out among 50 patients >60 years of either sex with acute myocardial infarction in the Department of Medicine and CCU of Dhaka Medical College Hospital, Dhaka, from January 2018 to July 2018. Then consent was taken. History taking and physical examination were done in a predesigned data collection sheet. Then required investigation like ECG, cardiac enzymes and relevant laboratory investigations was done. After collecting all available information statistical analysis was done using SPSS for windows version 20. Result was expressed as frequency, percentage, mean (±SD), range, p-value. Among the 50 patients diagnosed as having AMI, 14 (28%) patients presented with atypical presentation to the hospital. Atypically presenting AMI Patients were mostly ae group 60-69 years (50%). Among all patients 29 (58%) were male and 21(42%) were female. 14 (28%) patients had no complaints of chest pain, out of which, dyspnea and epigastric pain (28.6%) are the commonest. Atypical presentation is found in 38.1% of female elderly patients and 20.7% of male patients (p=0.002). Commonest risk factor, found in this study was hypertension (66%) of the patients included in the study. Next common was Diabetes Mellitus (64%), hypercholesterolemia (56%) and smoking (28%). 13 Patients with Diabetes presented with atypical symptoms among atypical group (p=0.008). Most of the patients with atypical symptoms (78%) presented lately more than 12 hours compared to patients with typical symptom. Mortality rate was higher among the patient presented with atypical symptoms (42.3%) than among the patients presented with typical chest pain (27.7%). 28% patient with atypical chest pain was found to have inferior MI and mortality was highest among those with inferior MI and atypical symptoms. This study showed that even though chest pain was the most common presentation in elderly AMI patients, they were also found to have atypical presentations like dyspnea, vomiting, sweating and epigastric pain. This signifies the need of examining physicians to meticulously identify acute myocardial infarction in elderly for successful and immediate treatment. Accurate diagnosis of ACS could reduce hospital mortality and morbidity.\u0000Bangladesh Med J. 2022 May; 51(2): 13-20","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"52 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138593989","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":"Obituary news May-2022","authors":"K. Halim","doi":"10.3329/bmj.v51i2.70294","DOIUrl":"https://doi.org/10.3329/bmj.v51i2.70294","url":null,"abstract":"Abstract not available \u0000Bangladesh Med J. 2022 May; 51(2): 59","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"15 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138591429","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":"Outcome and Indication of Caesarean Section amongst Pregnant Women Experiencing Premature Rupture of Membranes","authors":"Sabikun Nahar, Sohana Sultana, Sabina Yeasmin","doi":"10.3329/bmj.v51i2.69256","DOIUrl":"https://doi.org/10.3329/bmj.v51i2.69256","url":null,"abstract":"Premature rupture of membranes (PROM) is characterized by the spontaneous rupture of chorioamniotic membranes more than one hour before the onset of labor. This condition typically arises spontaneously in most cases, affecting a significant portion of pregnancies. Notably, PROM can also occur in full-term pregnancies. This cross-sectional follow-up study was conducted among pregnant women had premature rupture of membranes and experiencing Caesarean Section (CS) in the department of Obstetrics and Gynaecology of Dhaka National Medical College Hospital (DNMCH), Dhaka, Bangladesh during the period of March to August 2011. The main aim of the study was to find out the indication and outcome of pregnant women with PROM and completed CS. A total of 90 data were collected purposively from all pregnant women more than 28 weeks of gestational age with PROM admitted in the Department of Obstetrics and Gynaecology, DNMCH, Dhaka for labour and underwent CS during study period. The data were collected using a semi-structured data sheet through direct questioning of the patients and physical examinations. Daily follow-ups were conducted until the patients were discharged, and data were also obtained from the clinical records of the patients. PROM patients encompassed all age groups, with ages ranging from 18 to 38 years. The overall educational level of the participants was low, with less than two-third (61.1%) belonging to the low socio-economic status. The average gestational age was 36.65 weeks, with 53.3% being primigravida, 45.6% being multigravida and grand multipara was 1 (1.11%). Only two had multiple pregnancies, and 11 respondents had experienced per vaginal bleeding. During previous gestations, 20 had a history of Caesarean section, 12 had experienced abortion, and 2 had previous cases of PROM. Nutritional deficits were found in 36.7% of patients, Pregnancy Induced Hypertension (PIH) in 35.6%, infections in 12.2%, and chronic hypertension in 5.6%. Four foetuses were in breech presentations, one had a single compound presentation, and two had a transverse or oblique lie. All the women were experiencing gushing of fluid per vagina, with one-fifth (20.0%) having meconium-stained and 12.2% blood-stained vaginal discharge. Attempts to prolong pregnancy were not very successful, with the longest duration being 75 hours. Caesarean sections had to be performed in all cases, with 34.4% within 24 hours and 41.2% within the next 24 hours. Elective caesarean sections following PROM were 28.9%. Indications for emergency caesarean section included a previous history of Caesarean section in 19 cases, foetal distress was found in 18 cases, failed induction in 7 cases, chorioamnionitis in 6 cases, foetal malpresentation was in 5 cases, and other reasons in 9 cases. More than one-third (35.56%) respondents had morbid condition to complicate the postpartum period. Among the complications, 21.11% suffered from wound infection; followed by puerperal sepsis 8.89% and po","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"15 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138592651","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":"Coronary Artery Perforation following Percutaneous Coronary Intervention in an Elderly Patient: A case report","authors":"Sumit Barua, Md. Kamrul Hasan, S. Raha, Md. Salahuddin Rahaman, Md Sorower Hossain","doi":"10.3329/bmj.v51i2.69240","DOIUrl":"https://doi.org/10.3329/bmj.v51i2.69240","url":null,"abstract":"Percutaneous coronary intervention (PCI) is widely used in the diagnosis and treatment of symptomatic coronary artery disease. However, much like any other procedure, it has its risks; one such rare but lethal complication is coronary artery perforation (CAP) which requires immediate intervention. Prompt recognition and appropriate treatment strategy are of utmost importance in reducing the mortality and morbidity. We herein report a case of Ellis Type III perforation of the left anterior descending coronary artery (LAD) during PCI who underwent emergency coronary artery bypass grafting (CABG) refractory to conventional coronary stent placement and balloon tamponade. The patient recovered well despite excessive initial postoperative bleeding and was discharged from the hospital.\u0000Bangladesh Med J. 2022 May; 51(2): 54-58","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138591008","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 Red Cell Distribution Width and Platelet Count Ratio to Predict the Severity and Outcome in Acute Pancreatitis","authors":"Tanmoy Saha, I. Mahbub, Md Tuhin Akhter, Md Shah Alam Miah, Abdullah Al Shah Newaz, Dilruba Akter, SM Ali Hasan, I. Datta, Md. Fazlul Karim Chowdhury","doi":"10.3329/bmj.v51i1.68521","DOIUrl":"https://doi.org/10.3329/bmj.v51i1.68521","url":null,"abstract":"Clinical course of acute pancreatitis (AP) varies widely, its clinical features exhibit very low sensitivity for the prediction of severity of disease which is associated with high morbidity and mortality. Several single or multi parameter scoring systems have been described to evaluate the severity of AP. But sometimes, it is not clinically practicable to use these scoring systems for evaluation. This study aimed to find out the Role of Red Cell Distribution Width and Platelet Count Ratio (RPR) to predict the Severity and Outcome in AP. This prospective longitudinal study was carried out from July 2019 to July 2020, at the in-patient department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders, BIRDEM General Hospital, Dhaka. Total 100 patients with AP were included for this study according to selection criteria. An informed written consent was taken from all the participants. Detail history was taken and thorough physical examination was done along with relevant laboratory investigations. Ranson's score, Modified Glasgow score, Bedside index of severity in acute pancreatitis (BISAP), red cell distribution width and platelet count ratio (RPR) were calculated. All data were recorded and analyzed by Statistical package for social sciences (SPSS) 23. In this study 44% patients were more than 60 years with a mean age of 51.34 (±15.45) year. More than two thirds patients were (67%) male. In mild acute pancreatitis  mean value of Ranson's score, BISAP score and modified Glasgow score was 0.79 (±0.14), 0.90 (±0.1) and 0.80 (±0.14) and 3.29 (±1.16), 1.77 (±0.46) ,2.74 (±0.69) in moderate to severe pancreatitis respectively with statistically difference were found in both severities (p<.05). The patients with mild pancreatitis and the patients with moderate to severe pancreatitis had significant difference (p<.05) between mean RDW (14.68±1.59% versus 15.51±3.27%), mean RPR (0.043±0.06 versus .062±.002) and platelet count (340.9±841.6 cells/mm3 Versus 236.4±825.4 cells/mm3). The ROC analysis of RPR in predicting severity of pancreatitis showed a cut-off value of ≥ 0.056 and diagnostic accuracy test showed sensitivity, specificity, PPV, NPV and accuracy as 63.6%, 82.2%, 81.4%, 64.9% and 72% respectively. Mean Ranson's score, BISAP score and Modified Glasgow score was 2.09 (±1.45), 1.34 (±0.39) and 1.83 (±1.08) in survived patients and 5.50 (±0.70), 4 and 3.50 (±0.70) in dead patients with significant difference between both groups (p<.05). Mean RDW (15.08±2.67% Vs 17.85±0.21%), mean platelet count (284.43±143×109/L Vs 236.4± 825.4×109/L) and mean RPR (0.053±0.02 Vs 0.094± 0.005) was also significant between survived and dead patients (p<.05). The ROC analysis of RPR in predicting outcome showed cut-off value of ≥ 0.06 and diagnostic accuracy test showed sensitivity, specificity, PPV, NPV and accuracy as 100%, 63.27%, 5.26%, 100% and 64% respectively. Red cell distribution width and platelet count ratio (RPR) can be used as a novel biomarker to pr","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90645863","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":"Vitamin D Status in Hypothyroid Patients","authors":"R. Bhowmic, Mohammad Kamrul Hasan, M. U. Bhuiyan, UzzalKanti Das, Md Shahriar Siddiki, Shah Mubdi Un Naafi, Md Faizul Islam Chowdhury","doi":"10.3329/bmj.v51i1.68501","DOIUrl":"https://doi.org/10.3329/bmj.v51i1.68501","url":null,"abstract":"Vitamin D deficiency is a global health problem. It is estimated that about 25-50% of patients commonly encounter vitamin D deficiency in clinical practice. Recent studies show hypothyroid patients suffer from significantly low vitamin D level. As vitamin D and thyroid hormone act through steroid receptors, one can affect the other’s action. Considering the scientific evidence, the study was aimed to assess the vitamin D level among the subjects with hypothyroidism. This hospital-based case-control study was conducted among 70 subjects including 35 cases and 35 controls at the Departments of Medicine and Endocrinology in Dhaka Medical College Hospital in 6 months duration following approval of this protocol. Data were collected by face to face interview, using a structured questionnaire and case record review. Hospital records including laboratory reports were also reviewed.  Thirty-five cases and thirty-five control samples were screened for vitamin D levels. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 23. Among the participants, 55 were female with a male-female ratio of 1: 3.67. The mean age was 44.6 ± 11.69 year. The highest number of patients were in between 41 to 55 year (41%). The majority of cases were from rural areas (67.0%). There was no significant differences in socio-demographic profiles between the cases and control groups (P >0.05). Hypovitaminosis D was found in 67% of cases. Among them 39.0% had mild insufficiency (20-29 ng/ml), 21.0% had moderate deficiency (10-19 ng/ml) and 7.0% had severe deficiency (< 10 ng/ml). The mean vitamin D level was 23.79 ± 8.1 ng/ml. Serum 25(OH)D level was markedly reduced in hypothyroid cases in comparison to the euthyroid control group [22.14 ± 8.02  and 26.22 ± 7.53 respectively ); P < 0.005]. Data showed hypothyroid patient is likely to develop Hypovitaminosis D 3.37 times higher compared to a euthyroid patient (OR=3.37; 95% CI:1.644-9.7440; P=0.02). Moreover, this lower level is not associated with the difference in age, sex and occupation (P< 0.005). Hypovitaminosis D is associated with hypothyroidism with no variation in respect to age, sex and occupation. The hypovitaminosis D is significantly associated with hypothyroi- dism in the study population.\u0000Bangladesh Med J. 2021 Sept; 51(1): 25-32","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83347091","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":"Comparison of Pulse Rate and Blood Pressure between Obese and Non-Obese Young Adults","authors":"Arfa Islam, S. Basak, Mobassarul Islam, I. A. Jerin, Suborna Dey, Rifath Nawrin Ovi, Syed Nadim Ahmed, Abdullah Al Shah Newaz","doi":"10.3329/bmj.v51i1.68421","DOIUrl":"https://doi.org/10.3329/bmj.v51i1.68421","url":null,"abstract":"Obesity has been reported to be associated with a number of cardiovascular diseases. Some researchers forecast that obesity may contribute to increase prevalence of high blood pressure in young adults. To compare pulse rate and blood pressure between young obese and non-obese subjects, this cross-sectional analytical study was done in the Department of Physiology, Sylhet MAG Osmani Medical College from January to December 2017. Fifty obese (BMI ≥27.5 kg/m2) and age-sex matched non-obese (BMI 18.5-22.9 kg/m2) young adult were selected. The age (35.56 ± 3.02 years versus 32.40 ± 4.20 years; p=0.116) and sex 26 (52.0%) male versus 31 (62.0%) male; p=0.313) were not differ between obese and non-obese subjects. The mean resting pulse rate (82.98 ± 3.50 beats /minute versus 72.64 ± 3.58 beats/minute; p<0.001), systolic blood pressure (130.20 ± 10.00 mm Hg versus 107.30 ± 10.60 mm Hg; p<0.001) and diastolic blood pressure (80.90 ± 7.19 mm Hg versus 67.90 ± 7.22 mm Hg; p<0.001) were higher in obese compared to non-obese participants. Obesity increases pulse rate and blood pressure in young adults.\u0000Bangladesh Med J. 2021 Sept; 51(1): 47-51","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77410576","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":"Effects of Short Wave Diathermy Therapy in Patients with Adhesive Capsulitis of Shoulder (ACS)","authors":"Asiful Haque, Md Ahsanul Hoque, A. Z. Sadeque, Hasan Habibur Rahman, Mohammad Ilias, Musa Muhammad Hojaifa, Aparajeya Bivab Bikash Baral, Mohammad Kamruzzaman Bhuiyan","doi":"10.3329/bmj.v51i1.68510","DOIUrl":"https://doi.org/10.3329/bmj.v51i1.68510","url":null,"abstract":"There are varieties of management option for Adhesive capsulitis of shoulder (ACS) also known as Periarthrosis and in general population commonly known as Frozen Shoulder. Short Wave Diathermy (SWD) is one of the important therapeutic option for frozen sholder. The aim of the study is to determine effectiveness of SWD in order to improve the pain and range of motion in Adhesive Capsulitis. A total 56 subjects were selected for this non-randomized controlled trial in the Department of Physical Medicine and Rehabilitation, Chattogram Medical College Hospital with adhesive capsulitis in a period of 6 months. The subject were divided into two intervention groups; group-A with conventional treatment plan with SWD and group-B with conventional treatment only. Tool used for assessment were Visual Analogue Scale (VAS) to measure pain with Tenderness Grading (TG) and Shoulder Pain and Disability Index Score (SPADI). The analysis was done to measure the difference of effectiveness of both interventions by independent t-test with SPSS-20. Among 56 patients regarding analysis of sex in both groups male and female were matched (p>0.05) and male - female ratio was 1.66: 1. Considering socioeconomic status, poor was 21.4%, middle class was 44.6% and rich was 33.9%. Among all patients 35.7% were housewives, 16.1% were service holder, farmers were 12.5%, businessmen were 16.2% and laborers were 3.6%. In total patients, 48.2% had right shoulder involvement, 50.0% had left side involvement and one patient had both sided disease. There were 92.7% patients who had localized pain and only 7.3% had radiation. Majority of the experienced pain in the evening was 56.4% and rest had pain at night  was 43.6%. About half of the patients in both groups had constant and intermittent type of pain 47.5% and 45.5% respectively other types were sharp and dull.  Significant difference between Group A and Group B was found at week 2, week 4 and week 6 follow-up (p<0.05) whereas initial follow-up was non-significant in VAS analysis (p>0.05). Significant difference between Group A and Group B was found at week 2, week 4 and week 6 follow-up (p<0.05) regarding change of tenderness  grading  in Group A, then Group B patients. Significant difference between Group A and Group B was found at week 2, week 4 and week 6 follow-up (p<0.05) regarding SPADI. When SWD is combined with conventional management of adhesive capsulitis it gives better reduction in pain and disability. Conventional treatment plan with SED is more effective in the management of pain and reduce disabilities in patients with ACS.\u0000Bangladesh Med J. 2021 Sept; 51(1): 1-7","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89596203","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":"Serum D-dimer Level in Patients with Acute Leukemia in a Tertiary Care Hospital","authors":"Mohammad Nafees Hussain Amit, Mohammad Mizanur Rahman, Md. Liakat Hossain, Md. Rashedul Hasan, Md. Haidar Ali, Kshitish Chandra Talukder, A.Z.M Ahsan Ullah, Mst Siddika Sultana","doi":"10.3329/bmj.v51i1.68503","DOIUrl":"https://doi.org/10.3329/bmj.v51i1.68503","url":null,"abstract":"D-dimer is a molecule, formed by the breakdown of excessive fibrin from the activation of coagulation system. Ample evidence suggests that increased activation of coagulation system in patients with acute leukemia (AL) leads to higher D-dimer levels. Considering shortage of evidence in our perspective, the study was designed to observe the D-dimer level in acute leukemia in different morphological types and phases among the patients admitted in a tertiary care hospital. This hospital based cross-sectional study was conducted at the Department of Medicine and Department of Hematology in Dhaka Medical College Hospital, for a period of 6 months following approval of this protocol. Patients with New case (NC) of AL, at complete remission (CR) and in patient’s wither lapsed (R) AL were included in the study. Purposive sampling methods were followed for sample selection. Written informed consents were taken from the all study subjects and ethical issues were ensured. Data were collected by interview using a structured questionnaire. All study population were subjected to details history taking, physical examination and relevant investigations of D-dimer level. Collected data were analyzed by the SPSS version 20.0. Among 50 patients, 58% were males and 42% were females. Mean age was 34±5.6 SD years and the height number of patients (40%) belonged to age group 21-30 years. Three fourth of the patient (76%) had diagnosed as AML and rest of them 24% had ALL. The most common subtype of Acute Myeloblastic Leukemia M3 (AML) was 47, 37% and most common subtype of ALL L2 was 50%. Most of the respondents were found as new case (80%) followed by in decreasing order complete remission case 14% and relapse case 6%. Overall, D-dimer level was 3.69 mg/dl (0.1mg/dl-40 mg/dl), and D-dimer level is slightly higher in AML group than ALL patient (4.26 vs 2.18mg/dl). Moreover, new cases have higher level of D-dimer (4.2 mg/dl) in comparison with complete remission (1.2 mg/dl) or relapse case (2.7 mg/dl). It was also found that APL patients has higher D-dimer level than other form of leukemia. D-dimer level in acute leukaemia patients 3.69 mg/dl. Higher value of AML was found in patients than ALL and increased D-dimer level is also evident in newer case particularly APL. D-dimer level rises in acute leukemia patients. However, further study is recommended with appropriate study design.\u0000Bangladesh Med J. 2021 Sept; 51(1): 8-17","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81410209","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":"Evaluation of Ophthalmoscopic Findings in Type 2 Diabetic Patients at a Tertiary Level Hospital","authors":"Md Tuhin Akhter, Md. Fazlul Karim Chowdhury, Tanmoy Saha, Md Shah Alam Miah, Md Mahmudunnaby, Abdullah Al Shah Newaz, Khandker Mahbub Uz Zaman, Susmita Islam, Md Khalequzzaman Linckon","doi":"10.3329/bmj.v51i1.68511","DOIUrl":"https://doi.org/10.3329/bmj.v51i1.68511","url":null,"abstract":"Diabetes mellitus (DM) is a global burden of disease. Long standing disease causes macrovascular and microvascular complications. Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and it remains a leading cause of blindness and visual impairment in the working-age population in both developing and developed world. Patients with diabetes often developed other ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and maculopathy. The study was carried out to evaluate the ophthalmoscopic changes in type-2 diabetes mellitus (T2DM) patients. This hospital based cross-sectional study was conducted in the department of Medicine, Shaheed Suhrawardy Medical College Hospital, Dhaka, from September 2018 to March 2019. Patients with T2DM attended at the department of medicine within the mentioned period were enrolled after fulfilling the selection criteria. Patients with dense, lentalopacities and other media opacities which prevented posterior segment examination were excluded from the study. Sample was selected by purposive sampling method. Detail demographic data were collected from the patients and recorded in structured case report form. Clinical examination and relevant investigations were done meticulously. Then pupil was dilated and ophthalmoscopic examination was done. Among the 50 diabetic patient’s male was 54%, middle aged (49-60 years) was 54% and sedentary workers was 84.0% with a positive family history of DM was 56.0%. Most of the patients were known hypertensive (64.0%) at the time of enrolment and almost all (94.0%) were taking antihypertensive drug. Retinal photography was performed in all patients and retinopathy was detected in 29 (58%) patients. Fundoscopic findings revealed that cotton-wool spots detected in 32.0% patients, Flame-shaped hemorrhages was 16.0% patients; Arteriovenous nipping was is 18.0% patients and opticdisc swelling (Papilloedema) in 26.0% patients. In this study 21 (42%) patients had normal fundoscopic findings. Retinopathy was more common in smoker (70.0%). Uncontrolled and long-standing diabetes and high HbA1c was major risk factors for the development of retinopathy (P < 0.001). In conclusion, diabetic retinopathy is more common in male smoker with uncontrolled and long-standing diabetic patients. T2DM is a major cause of blindness as it affects microvasculature of retina.\u0000Bangladesh Med J. 2021 Sept; 51(1): 33-40","PeriodicalId":8711,"journal":{"name":"Bangladesh Medical Journal","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81466640","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}