Search

Background: Classification based on ascitic fluid protein has been challenged on several occasions in diverse clinical situations, including cirrhotic patients on extended diuretic treatment, cardiac ascites, 1/3 individuals with malignant ascites, spontaneous bacterial peritonitis, and even normal ascitic fluid. Objective: The study's objective was to observe the role of serum ascites albumin gradient (SAAG) in diagnosing Ascites. Methods: This cross-sectional observational study was conducted at the Department of Medicine, Sylhet M.A.G. Osmani Medical College Hospital, Bangladesh. with a total of 100 participants with ascites following the inclusion and exclusion criteria of the study. Result: The most prevalent cause of ascites was cirrhosis, observed in 56% of the participants. Among the 56 cirrhosis patients, mean ± S.D. values of AFTP, AFAlb, SAlb, and SAAG were 2.1±1.2, 0.8±0.6, 3.1±0.7, and 2.2±0.7 respective units accordingly. According to ascitic fluid albumin values, a statistically significant relation was observed between cirrhosis and tuberculosis (P<0.01) and cirrhosis vs malignancy (P<0.01) cases. According to serum ascitic albumin gradient values, a similar significant association was also found between cirrhosis vs tuberculosis (P<0.01) and cirrhosis vs malignancy (P<0.01) cases. Conclusion: SAAG is an essential laboratory tool for the correct aetiological diagnosis of ascites. [ABSTRACT FROM AUTHOR]

Background: Hypomagnesaemia has been associated with diminished respiratory muscle power, which maintains the work of breathing. However, the effect of magnesium on asthma has yet to be examined in our country. Therefore, assessing the serum magnesium level in acute severe asthma patients in a tertiary-level hospital was the study's objective. Methods: The study was a hospital-based descriptive cross-sectional study conducted at the Department of Medicine and Department of Respiratory Medicine in DMCH. Each patient performed serum magnesium ion (Mg2+) during admission with other necessary investigations. Results: Fifty-seven percent of participants had hypomagnesemia, and 43% of patients had normal magnesium levels. Mean serum magnesium was 1.57±0.22 mg/dl [range: 1.25-2.23 ng/dl]. Although a higher proportion of patients with severe attacks (64.8%) had hypomagnesemia than those who had moderate-severity attacks (47.8%), the difference is not statistically significant (p >0.05). About 23% of patients stayed at the hospital for >3 days; among them, 73.9% had hypomagnesemia. Hypomagnesaemia patients had higher odds of staying at the hospital for >3 days, but the relation is not statistically significant (OR 2.62, 95% CI 0.93 -7.36, p >0.05). Conclusion: Hypomagnesaemia is present in half of the patients with acute severe bronchial asthma and is not associated with the severity of the disease and duration of hospital stay. [ABSTRACT FROM AUTHOR]

Introduction: Uncontrolled Diabetes mellitus is a growing cause of disability and premature death. HbA1c is an indicator of glycemic control status over the previous three months. Therefore, to minimize the morbidity and mortality of diabetic patients, it would be necessary to identify the factors associated with poor glycemic control, which may not be similar to developed countries. Objective: To identify factors acting as a barrier to reasonable glycemic control of known diabetic patients in Bangladesh. Materials and methods: This is a hospital-based descriptive cross-sectional study among diabetic patients with poor glycemic control in the indoor and outdoor Medicine and Endocrinology departments of Dhaka medical college hospital, Dhaka, from July 2019 to December 2019 (6 months). For at least three months, patients who had uncontrolled Diabetes were selected by purposive and convenient sampling method. Results: One hundred and six patients with poor glycemic status were included in the analysis. Aged persons were at risk for poor glycemic control, especially age range of 50-69 years (65.0%) P-value was 0.004. Duration of Diabetes and educational status were significantly associated with poor glycemic control. P values were 0.001 and 0.003, respectively. Conclusion: Patient education plays a pivotal role in controlling glycemic control, favoring treatment success, reducing adverse drug events, and preventing further complications of Diabetes. [ABSTRACT FROM AUTHOR]

Importance: Hypokalemia is a neglected common manifestation in COVID-19 patients admitted in hospital though it has serious consequences. Coronavirus may cause hypokalemia through disruptions of rennin-angiotensin system, gastrointestinal loss or other unknown mechanisms. Objective: To investigate the prevalence of hypokalemia among patients with moderate to severe COVID-19 and its association with other clinical and laboratory parameters. Design, Setting, and Participants: This was cross sectional observational study conducted at Dhaka medical College Hospital of Bangladesh from June, 2020, to August 2020. Participants were included who were positive for rt-PCR for COVID-19 according to the national guideline. The patients were classified as having severe hypokalemia (plasma potassium <3 mmol/L), hypokalemia (plasma potassium 3-3.5 mmol/L), and normokalemia (plasma potassium >3.5 mmol/L). Results: Prevalence of hypokalemia among patients with COVID-19 was 20.2%, severe hypokalemia (2 patients [1.5%]) and hypokalemia (25 patients [18.7%]). One thirty four (134) patients with positive COVID-19 were included. The mean [SD] age of these 134 patients according to different potassium levels appear to be: 68 [2.83] years for severe hypokalemia, 51.93[11.68] years for hypokalemia and 50.73[14.7] years for normokalemia. Among them, 46 patients were females [34.32%]) and rest were males [65.68%]. Within the total sum of 134 patients, 107 were identified having normokalemia, [79.9%]. 25 patients [18. 7%] had hypokalemia and only two patients [1.5%] were found having normokalemia. Among 134 patients, three commonest symptoms were fever (132 patients [98.5%]), dry cough (123 patients (91.79%) and shortness of breath (122 patients [91.04%]), followed by less common symptoms like fatigue (89 patients [66.410%]), sore throat (60 patients [44.77%]), and diarrhea (44 patients, [32.83%]). Shortness of breath was associated with grades of hypokalemia (P=0.022). Only 26 patients (19.4%) manifested having vomiting/Nausea. The predominant comorbidities found among these 134 participants were Hypertension (68 patients [64.2%]), Diabetes (54 patients [52.9%]), Ischemic heart disease (37 patients [38.1%]) and Asthma (27 patients [31.0%]). The prevalence of comorbidities was not associated with Hypokalemia. Conclusions Prevalence of hypokalemia among patients with COVID-19 is high (20.2%) and appropriate treatment is highly required. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcome of optical internal urethrotomy (OIU) with or without intralesional triamcinolone acetonide injection for the treatment of short segment anterior urethral stricture. Methods: This prospective quasi experimental study was carried out in the department of Urology, DMCH, Dhaka from November 2015 to April 2017 on 50 patients with short segment of anterior urethral stricture. Cases were randomly allocated to group A (OIU without Triamcinolone) and group B (OIU with Triamcinolone). Each group consisted of 25 patients. Data were analyzed and compared by statistical tests. Results: There were no significant differences in the baseline characteristics of the patients. Recurrences of stricture urethra were higher among those without Triamcinolone than cases with Triamcinolone which was statistically significant (p=0.033) at 6 month and (p=0.016) at 9 months. Regarding mean time interval in month of development of recurrence of stricture was 6.1±1.66 months in Group A and 7.66±1.52 months in Group B which was statistically significant (p=0.001) Conclusion: OIU with intralesional triamcinolone is better than OIU alone. It significantly reduced and delayed the recurrence of anterior urethral stricture. [ABSTRACT FROM AUTHOR]

Dengue fever first identified as 'Dhaka Fever' in 1964 & became endemic around 2000. The most recent spreading of dengue in 2019 was also notable for change in the presenting features of the patients attributed by some to the fact that causative virus might be of different serotype. Our study aims to assess the current pattern of presentation of dengue virus infection, done in inpatient of Department of Medicine of Dhaka Medical College Hospital Dhaka. This was a crosssectional, observational, descriptive study conducted between 1st August and 30th September 2019. A total 70 subjects, age >12 years were included in this study. Among them 55 were male & 15 were female, with a mean age of 28.33(±12.15) years. Comorbidities noticed in few cases such as DM (2, 2.90%), HTN (3, 4.35%), IHD (1,1.45%), CKD & COPD (1,1.45%). The most common presentation were fever (64, 91.43%), headache (62, 88.57%) anorexia (59, 85.51%), generalised pain (51, 73.91%), nausea (49, 71.01%). Examination findings at admission were temperature was high but not very high, pulse were normal, both systolic & diastolic pressure were somewhat normal, among the warning signs, severe abdominal pain (27.54%), persistent vomiting (21.74%), lethargy/restlessness/sudden behavioural change (21.74%) were most common. The common haematological parameters & routine investigation values were not deviated from expected range. As dengue is likely to continue to constitute a serious public health problem in Bangladesh, this study may help the practitioners to understand the changing pattern & to manage patients accordingly. [ABSTRACT FROM AUTHOR]

Background: The one of the most common metabolic disorder that remains worldwide is Diabetes mellitus. Dietary intake of omega-3 fatty acid may confer a protective effect against diabetes, improves high density lipoprotein (HDL-C) and reduce low density lipoprotein cholesterol (LDL-C) levels. Objective: To observe the effect of supplementation of omega-3 fatty acid on HDL and LDL levels in type 2 DM. Methods: A prospective interventional study was conducted from January 2017 to December 2017. A total numbers of 52 diagnosed type 2 diabetic patients of both sexes were selected with age ranging from 40 to 50 years. Among them, 27 type 2 diabetic patients with supplementation of omega 3 fatty acid (2g/day) for 12 weeks was considered as study group. Another 25 type 2 diabetic patients without supplementation of omega 3 fatty acid were considered as control group for comparison. The study subjects were selected from Outpatient Department of Endocrinology, Dhaka Medical College Hospital, Dhaka and personal contact from Dhaka city on the basis of inclusion and exclusion criteria. The research work was carried out after obtaining ethical clearance from concerned departments, Research Review Committee and Ethical Review Committee of Dhaka medical college, Dhaka. The study parameters serum HDL was estimated by enzymatic colorimetric method in auto-analyzer and serum low density lipoprotein was calculated by using Friedwald formula in Department of Laboratory Medicine, Dhaka Medical College Hospital, Dhaka. The parameters were studied 2 times in study and control groups i.e. at the beginning of study (base line) and after 12 weeks of study period. Data were collected in pre-designed structured questionnaire from the researcher by herself. For statistical analysis, Paired Student's 't' test and Unpaired Student's 't' test were performed as applicable using SPSS for windows version 16.0. Results: In this study High density lipoprotein cholesterol that is good cholesterol increased and low density lipoprotein cholesterol was decreased in diabetic patients after supplementation with omega-3 fatty acid in comparison to that of their baseline value. Again, after 12 weeks, high density lipoprotein was higher and low density lipoprotein cholesterol was lower in diabetic patients after supplementation with omega-3 fatty acid in comparison to control group. Conclusion: After analyzing the results of the study, it can be concluded that omega-3 fatty acid can improve HDL and lowers LDL levels in diabetic patients may be helpful to minimize the complications of type-2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Ivermectin is a naturally-derived dihydro derivative of avermectin originating exclusively from a single microorganism isolated from Japanese soil displaying an exceptionally wide range of antiparasitic efficacy against internal and external parasites of human and domestic animals. At the outset introduced as veterinary drugs of commercial livestock and companion animals but it was quickly discovered to be ideal in tackling two of the world's most distressing and disfiguring diseases such as river blindness and elephantiasis which have besieged African countries for centuries. The kinetics of ivermectin is characterized in general terms by a slow absorption process, a broad distribution in the organism, low metabolism, and slow excretion. The pharmacokinetic parameters of ivermectin vary extensively and in accordance with many factors that can all influence the drug's plasma concentration. These factors, which include the animal species, route of administration, vehicle used in the commercial formulation, bodyweight, body condition, age, physiological status, and amount and type of nutrition, all of which contribute to differences in drug efficacy. Currently, ivermectin is one of the most important drugs for the control of endectoparasitic infection in human and veterinary medicine and was the joint focus of the 2015 Nobel Prize, some 3 decades after its remarkable discovery. Although best described for its activity on glutamate-gated chloride channels in parasites, understanding much of its therapeutic mechanism and wide array of novel targets remains to be elucidated. Today, ivermectin is continuing to surprise and excite scientists, with an extensive use and an enormous success as well as showing novel promise against a diverse range of human and animal diseases round the globe. [ABSTRACT FROM AUTHOR]