Mymensingh medical journal : MMJ最新文献

{"title":"A Six Year Old Boy with Lepromatous Leprosy: A Case Report Revealing an Unsolved Mystery.","authors":"S F Sobhan, M O Farook","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Leprosy is a chronic granulomatous disease resulting from infection with the unculturable pathogen Mycobacterium leprae. Lepromatous leprosy is the most severe form, typically seen in adults with poor immune response to the bacillus. It is exceptionally rare in young children, specially under 10 years of age due to disease's long incubation period and lower exposure. Early presentation in a child raises question about atypical transmission and host susceptibility. We report a case of a six-year-old boy from Purbadhola, Netrokona, Bangladesh with a four-year history of progressive, asymptomatic erythematous plaques on the left arm and right side of the face. Physical examination revealed well-defined, dry plaques without definitive sensory loss or nerve thickening. Initial differential diagnoses included lupus vulgaris, lepromatous leprosy, and sarcoidosis. Slit skin smear revealed a bacillary index of 1+, suggesting lepromatous leprosy and again we went for skin biopsy for histopathology for any additive diagnosis and it revealed tuberculoid leprosy. The patient was treated with WHO-recommended multibacillary multidrug therapy (rifampicin, dapsone, clofazimine) in collaboration with Damien Foundation. After 4 months, there was marked improvement, with near-complete resolution of skin lesions. This case highlights the diagnostic complexity in pediatric leprosy where clinical, histopathological, and bacteriological findings may not align. It underscores the importance of comprehensive evaluation and the role of slit skin smear in all suspected cases of leprosy especially in children. Early diagnosis and appropriate treatment are crucial to prevent long-term complications and transmission.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"959-964"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355284","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":"The Clinical Characteristics and Laboratory Findings of Early and Late Onset Pediatric Idiopathic Intracranial Hypertension: A Single-Centre Experience.","authors":"H A Khan, U K Sarker, D Saha, J Parvin, N Shams, A K M Rahman, M A Kaisar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The objection of the study was to evaluate the features of pediatric idiopathic intracranial hypertension (IIH) at different age groups. This prospective study was done in Pediatric Neurology Department, National Institute of Neurosciences and Hospital, Bangladesh from January 2018 to June 2020. Total 19 cases were enrolled who were clinically suspected and had normal CSF with opening pressure (OP) above 250 mm H2O. They were further categorized as Group I (early- onset pediatric IIH) and Group II (late-onset pediatric IIH) according their age of onset. All patients underwent thorough neurological and ophthalmological evaluations. Clinical and laboratory findings were analyzed by SPSS version 22.0. Mean age was 8.1±2.07 years in Group I and 11.77±0.44 years in Group II. Male were found predominant in Group I while female was more in Group II (p=0.255). Headache (100.0%), vision (70.0%), vomiting (60.0%) irritability (30.0%) and papilledema (90.0%) and sixth nerve palsy (80.0%) were common clinical presentation among Group I. Diffuse headache was more in Group II. Obesity was found significantly more in Group II than Group I (p=0.033). CSF analysis revealed normal cellular and biochemical profiles in all patients. Mean CSF opening pressure was higher in Group I (23.0±9.83 cmH2O) compared with Group II (20.66±4.33 cmH2O), although the difference was not statistically significant. A negative correlation was observed between age and CSF opening pressure. Brain MRI was normal in all cases. Routine laboratory investigations, including complete blood count, liver function tests, serum electrolytes and thyroid function tests, were unremarkable. There was a clear distinction between presentations of early onset and late onset pediatric IIH. Early onset IIH may present with higher CSF opening pressure and less association with obesity, whereas late-onset IIH shows a pattern more similar to adult IIH with increased obesity prevalence.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"795-800"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355304","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":"Risk Factors of Neutropenic Enteropathy during Induction Phase of Treatment of Childhood Acute Lymphoblastic Leukemia.","authors":"Y T Jahan, M A Karim, C Y Jamal, A T M Rahman, O S Baten, M L R Molla, M I Habib, S Khandokar, M S Zaman, S Islam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neutropenic enteropathy (NEP) is one of the important causes of death due to infectious complication during induciton phase of chemotherapy in children with Acute Lymphoblastic Leukemia (ALL). So the objective of this study was to identify the risk factors of NEP. This prospective study was conducted in the Department of Pediatric Hematology & Oncology, Bangladesh Medical University (BMU), Bangladesh from November 2018 to January 2021. Total 98 ALL children were included in this study, among them 36 children developed NEP and 62 children did not develop NEP. Detailed history, clinical examination, hematological examination, laboratory examination, plain X-ray abdomen, abdominal ultrasonogram were performed in all cases. Majority of children with ALL were within the age of 1-10 years (70.0%) and females (63.3%). Children receiving regimen B were more common in children with NEP (80.6%) which was statistically significant (p=0.004). Hypokalemia (13.9%), hyponatremia combined with hypokalemia (44.4%) and hypoalbuminemia (41.2%) was significantly higher in children with NEP (p<0.05). Ultra sonogram findings revealed increased BWT (13.9%) and distended bowel loop (58.3%) was significantly higher in children with NEP (p<0.05). Regarding risk factors of neutropenic enteropathy mucositis, prolonged neutropenia (>7 days), septicemia and use of daunorubicin were found to be significantly different between children with NEP and children without NEP (p<0.05). Multivariate analysis demonstrated, prolonged neutropenia [OR (95% CI) = 44.5(2.82-701.6); p=0.007] and septicemia [OR (95% CI)=44.1(1.46-1334.1); p=0.029] were found to be significant risk factors for development of NEP. NEP is a life-threatening condition especially during the induction phase of chemotherapy, often leading to tragic outcomes, including death, which is often exacerbated by prolonged and profound neutropenia and septicaemia.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"847-855"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355342","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 Iron Deficiency Anemia with Migraine: A Case-Control Study.","authors":"M R N Rahman, M Saiduzzaman, M S I Bhuya, M S Hossain, M H Mekhola, S Hossain, S Roy, M N Sadat, M Bhattacharjee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Migraine headache is a common primary headache disorder which is multifactorial in origin. On the other hand, iron deficiency anemia causes metabolic abnormalities in the brain which leads to a reduction in neuronal activities. The study was designed to determine the association between iron deficiency anemia and migraine. This was a case-control study which was conducted among patients attending at the outpatient department of Neurology of Mymensingh Medical College Hospital with migraine headache fulfilling the International Headache Society criteria and non-Migraine age and sex matched healthy individuals from November 2019 to April 2021. Total 155 migraine patients (case) and 155 non-migraine healthy individuals (control) were included in this study. After signing the informed written consent, the blood samples were collected for complete blood count and serum ferritin level. The study result showed that iron deficiency anemia was more common in migraine patients than non-migraine healthy individuals (p<0.001). In female patients, serum hemoglobin and ferritin level were significantly low in migraine (p<0.001 and p<0.001 respectably) but in male patients only serum ferritin level was significantly low (p=0.001). There is also an association between severity of migraine attack and iron deficiency anemia (p=0.042). The patients with severe headache had lower serum hemoglobin and ferritin level which were statistically significant (p=0.005 and p<0.01 respectably). The study observed an association between iron-deficiency anemia, serum hemoglobin and ferritin levels with migraine. Therefore, iron deficiency anemia may be investigated in migraine patients and iron supplements might be an effective treatment in patients with migraine.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"719-725"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354997","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":"Associated Coronary and Cardiac Anomalies among One to Eighteen Years Old Tetralogy of Fallot Patients.","authors":"U K M Ara, M Z Hussain, C M Ahmed, T Islam, R B Habib, M S S Ullah, T Karim, M S Alam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Precise pre-operative diagnosis of any coronary or cardiac anomalies in Tetralogy of fallot (TOF) patients can minimize intra-operative and postoperative complications. In such cases time appropriate alternative surgical approaches may be required to consider, thus the consequent morbidity and mortality can be reduced. The study attempted to observe the TOF patients to assess the pattern of associated coronary and cardiac anomalies among them. This cross sectional study was carried out in the departments of Paediatric Cardiology in three tertiary level hospitals in Dhaka, Bangladesh, from January 2018 to December 2018. Seventy two diagnosed cases of TOF, who went for cardiac catheterization in the respective hospitals, aged between one to eighteen years (1 to 18) were recruited. Cardiac catheterization and angiography was performed via femoral route following the standard protocol. Angiographic findings of cardiac catheterization of each patient was monitored and recorded. Data analysis was carried out using SPSS software, version 22.0. Among the TOF patients, associated coronary anomalies were present in 9 patients (12.5%) and associated cardiac anomalies were present in 52 patients (72.22%). Single associated cardiac anomaly was present in 47.22% patients and multiple associated cardiac anomalies were present in 25.0%. The presentations of coronary artery anomalies were as such right coronary artery arising from non-coronary sinus or from high up posteriorly or from LAD or from left coronary sinuses in 2.78% cases each and there was 1.39% cases of single coronary ostium from non-coronary sinus. The presentation of associated cardiac anomalies showed that, major aortopulmonary collateral artery (MAPCA) was the most common associated cardiac anomalies found in 65.27% of the TOF patients in this study. Atrial septal defect and right aortic arch was found in 22.2% and 11.10% of the TOF patients respectively. Patent ductus arteriosus and persistent left superior vena cava- each was present among 4.20% of the patients. Right pulmonary artery stenosis, supravalvular pulmonary stenosis, left pulmonary artery stenosis, aorto-pulmonary window, pulmonary atresia- each was present in 1.40% of the patients. Among the cardiac anomalies, the patent ductus arteriosus and persistent left superior vena cava was statistically significantly associated with coronary anomalies in this study (p<0.05). Anomalous coronary artery and associated cardiac lesions are common among the patients with TOF in Bangladesh. Coronary artery anomalies are significantly associated with other cardiac anomalies namely PDA and persistent left superior vena cava (PLSVC). Large scale multicenter study is further required, to understand the co-existence of coronary and cardiac anomalies among TOF patients to actualize more scrutinized diagnostic and surgical outline for better treatment outcome among these patients.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"932-938"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355017","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":"BATH-PLUG Technique in Case of Endoscopic Management of Cerebrospinal Fluid Rhinorrhea.","authors":"S A Shawrave, S J M Zoheb, G I Galib, R Z Tanni, M M R Shawon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the past, the primary method for repairing cerebrospinal leaks was through craniotomy with intradural repair. However, in recent times, the popularity of transnasal repair via endoscopic sinus surgery has increased. This shift is mainly due to its lower morbidity and higher success rates. Nevertheless, the rise in iatrogenic CSF leaks has occurred as more surgeons adopt endoscopic sinus surgery. Therefore, caution must be exercised by endoscopic sinus surgeons when utilizing this technique. The objective of our study is to present a novel approach to endoscopic repair of CSF leaks. Herein, we present and discuss a case involving a 55-year-old woman with idiopathic CSF rhinorrhea accompanied by meningoencephalocele. Our technique involved the introduction of a specifically secured vicryl sutured fat plug into the intradural space, followed by applying traction on the suture to effectively seal the defect. This mechanism operates similarly to how a bath plug seals a bathtub. Importantly, our patient did not experience any intra- or post-operative complications. Furthermore, we did not utilize a lumbar drain or intra-thecal fluoresce in during the procedure.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"965-969"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355152","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":"Treatment of Base of Condyle Fracture Using Minimal Access Surgery: Infinitesimal Peri-Angular Pterygomasseteric Transsectioning Approach (IPPTA): A Case Report.","authors":"M Iqbal, M U Azeez, F Ferdousi, A K M Kadir, S B Mostofa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The most common maxillofacial injury is a fractured mandible. The reduction and fixation of the condyle portion of the mandible are the most critical portions because they are connected to numerous significant anatomical landmarks. IPPTA is a minimally invasive method for treating the base of a condyle fracture and there are several other recognized ORIF techniques for treating different portions of condyle fractures. A 20-year-old male visited a clinic's outdoor department, complaining about an inability to close his mouth properly. He stated that he had a road traffic accident nine days prior. An orthopantomogram revealed a unilateral base of condyle fracture and left parasymphysis of the mandible. Apart from the fracture of the mandible, he did not have any additional injuries. We decided to use the intaroral vestibular technique for the parasymphysis fracture and the IPPTA for the base of the condyle fracture because the patient expressed a great deal of worry regarding the aesthetic aspect of the recovery period. A minimally invasive surgical procedure like IPPTA aids in overcoming postoperative recovery periods involving eating, swallowing and mastication, as well as the duration of maxillo-mandibular fixation.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"970-974"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355046","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":"Maternal Vitamin D Deficiency and Its Impact on Pregnancy Outcome: A Cross-sectional Study in Bangladesh.","authors":"J Saha, J Ara, S Akter, S F Shetu, S Siddique, I Prasad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Vitamin D deficiency during pregnancy is common, especially in low- and middle-income countries. The objective of the study was to determine the prevalence of vitamin D deficiency among pregnant women of Bangladesh and its association with adverse maternal and fetal outcomes. The cross-sectional study was conducted among 420 pregnant women admitted to the department of Obstetrics and Gynecology of Popular Medical College Hospital for delivery from July 2019 to June 2022. Data collection was done through face-to-face interview using a semi-structured case record form and laboratory tests. A logistic regression model was constructed to determine the association between maternal vitamin D status and pregnancy outcomes. Prevalence of vitamin D deficiency [serum 25(OH)D <30 nmol/L] among pregnant women was 11.7% and vitamin D insufficiency [serum 25(OH)D 30-75 nmol/L] was 77.6%. In logistic regression model, vitamin D deficiency was not significantly associated with gestational diabetes mellitus (aOR 2.32, 95% CI 0.54, 12.0), preeclampsia (aOR 2.94, 95% CI 0.75, 14.6), preterm labor (aOR 2.41, 95% CI 0.98, 6.25), low birth weight (aOR 2.04, 95% CI 0.81, 5.30), intrauterine growth retardation (aOR 2.55, 95% CI 0.51, 18.7) and low APGAR score (aOR 1.51, 95% CI 0.24, 12.0). A large proportion of the pregnant women had a suboptimal level of vitamin D. However, no significant association between vitamin D deficiency and pregnancy outcome was found in the study.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"908-916"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355182","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":"Gender-Based Differences in Clinical, Immunological and Disease Activity Profiles of Systemic Lupus Erythematosus Patients in Bangladesh.","authors":"S S Sunny, M I Islam, I H Bandhan, H Nakamura, S Dey, F B Rashid, M A K Azad, M N Islam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with well-recognized female predominance; however, disease expression and severity may differ by gender. Data on gender-based differences in SLE from Bangladesh remain limited. This study aimed to compare sociodemographic characteristics, clinical manifestations, immunological profiles and disease activity indicators between male and female patients with SLE. This cross-sectional study was conducted at the Lupus Clinic, Department of Rheumatology, Bangladesh Medical University (BMU), Dhaka, Bangladesh, from December 2019 to January 2021. A total of 140 patients who fulfilled the classification criteria for SLE were enrolled, including 130 females and 10 males. Demographic data, clinical features, immunological and serological parameters, Safety of Estrogens in Systemic Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI) were analyzed and compared by gender. The female-to-male ratio was approximately 13:1. Male patients presented at younger ages (p=0.002) and had earlier disease onset than females (p=0.011). Lupus nephritis was significantly more frequent among male patients (p=0.037). Anti-dsDNA levels were higher in male patients, though not statistically significant; complement (C3) levels were significantly lower in male patients (p=0.014). Male patients had significantly higher disease activity (SELENA-SLEDAI) scores than females (p=0.044), whereas cumulative organ damage was comparable. Despite lower prevalence, male SLE patients exhibited more severe disease manifestations and higher activity. These findings underscore the importance of heightened clinical vigilance and gender-sensitive management strategies in SLE.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"886-892"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355262","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":"Scrotal Cystocele with Right Inguinoscrotal Hernia: A Rare Case Report.","authors":"M N Islam, M H M Kamal, M A Kabir, P Siwakoti, J R Parajuli, B P Karki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Herniation of bladder into inguinoscrotal region is relatively rare and incidence rate is 1 to 3%. Patient presents with typical complains and complication. To prevent complications early diagnosis with imaging is necessary. Diagnosis can be made by Intravenous pyelography, Retrograde urethrography (RGU), Micturating cystourethrography (MCU), pelvic Ultrasound (USG), Computed tomography (CT) and magnetic resonance imaging (MRI). In this case report, 52 years old male patient presented with huge inguino-scrotal swelling, dysuria and manual compression leading to ease on voiding resulting shrinkage of scrotal swelling and was diagnosed as scrotal cystocele by RGU, MCU in conjugation with USG and CT.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"35 3","pages":"975-977"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355353","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}