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Sociodemographic & clinical-pathological evaluation of non-alcoholic fatty liver disease among Bangladeshi population: A single center study
Get PDFBackground: Non-alcoholic fatty liver disease (NAFLD) is a term that refers to a variety of clinicopathological abnormalities in the liver that are a leading cause of hepatic dysfunction and mortality. Obesity, type 2 diabetes, and metabolic syndrome are all contributing to an expanding health problem that goes unreported. There is a scarcity of population-based data in a representative sample of the general population in Bangladesh. Aim of the study: The aims of the study were to evaluate the socio-demographic & clinical-pathological non-alcoholic fatty liver disease among the Bangladeshi population. Method: This cross-sectional study was conducted from July 2019 to December 2019 at Dhaka Medical College Hospital, Bangladesh. This study was purposefully conducted among 35 participants. Results: Among 35 participants, the mean age of the participants was 38.89±8.50 years. Maximum participants (80%) were female and housewives (68.6%). And 60% of participants’ socioeconomic status was a middle-class state. Maximum (48.6%) participants had diabetes mellitus (DM) and obesity (42.9%). The HBs Ag and Anti-HCV were negative among all participants. Their mean body weight was 72.74±8.74 and their mean body height was 61.37±2.67. Here, the odds ratio of the stiffness of liver CAP was 0.75 and the odds ratio of fibroscan of liver CAP was 1.00. Conclusion: NAFLD affects almost one-third of Bangladesh\u27s population. Non-alcoholic fatty liver disease is more common in people with a high BMI (overweight and obese), diabetics, and people in their forties and fifties. The scope of non-alcoholic fatty liver disease is enormous, and healthcare institutions must act quickly. As a result, a focused treatment strategy for non-alcoholic fatty liver disease should be developed
Combined Transconjunctival and Transcaruncular Approach for Repair of Large Orbital Floor and Medial Wall Fracture: A Case Report
Get PDFA variety of approaches have been documented in literature for accessing the orbital floor and medial wall fractures. Several transcutaneous approaches were used traditionally, to access these regions. However, significant postoperative complications associated with these approaches have been reported. The transconjunctival approach was introduced to overcome these complications. However, the medial wall of the orbit was found to be difficult to gain access to, due to the vital structures in this area. The Lynch incision was the conventional approach of choice for access to the medial wall of the orbit. However, since 1998 the transcaruncular approach kept gaining popularity. The combined transconjunctival and transcaruncular approach to gain access to these fractures has recently been re-evaluated. We present a case of a patient with orbital floor and medial wall fractures secondary to trauma where a combined transconjunctival and transcaruncular incision was used
Current mutation-targeted DMD treatments and their theoretical application in a sub-group of Albanian patients
Get PDFAlthough the molecular origins of Duchenne muscular dystrophy have been known for several years, there is still no curative treatment for the disease. Exon skipping is a mutation-specific approach; which exon to skip depends on the size and location of the mutation. As such, having a genetic diagnosis of the disease is important. The genetic diagnosis mentioned in this paper was made privately in a sub-group of DMD patients from our clinic. Nine out of fourteen patients (64%) have mutations that are targeted by therapies that are currently licensed or undergoing Phase III trials
Status of carotid artery atherosclerosis among the ischemic stroke patients
Get PDFBackground: Carotid artery atherosclerosis is a widespread pathological condition and one of the most significant risk factors for the development of ischemic stroke. The risk of ischemic stroke increases with the increase in the degree of carotid artery atherosclerosis. Aim of the study: This study aimed to assess the status of carotid artery atherosclerosis among ischemic stroke patients. Methods: This descriptive cross-sectional study was conducted in the Department of Neurology of Sir Salimullah Medical College & Mitford Hospital (MH), Dhaka, Bangladesh for one year. In total 70 ischemic stroke patients were selected as the study subjects according to the selection criteria. Written informed consents were taken from all the study subjects. Data were analyzed using statistical program SPSS 20.0. Results: Among stroke patients, 62.9% had carotid stenosis. Among stroke patients 34.3% had mild, 15.7% had moderate and 12.9% had severe carotid stenosis. The degree of stenosis of carotid arteries increased with increasing of age. Most common associated risk factor was DM (64.3%) followed by HTN (45.7%), smoking (37.5%), and dyslipidemia (30.0%). Obesity was observed in 13 (18.6%) cases, MI in 11 (15.7%) cases, CKD in 4 (5.7%) cases and electrolyte imbalance in 3 (4.3%) cases. Majority of the plaques were found in the carotid bulbs (32.3%), followed by common carotid artery (29.0%), internal carotid artery (22.6%), and common carotid artery bifurcation (12.9%) and external carotid artery (3.2%). The majority of the plaques were homogenous (59.7%) followed by heterogenous (17.7%), calcified (17.7%) and ulcerated (4.8%) plaques. Conclusion: Carotid artery stenosis is common in ischemic stroke patients. Diabetes mellitus, HTN and smoking are the most common risk factors in ischemic stroke patients. The majority of the plaques are found in carotid bulb and most of the plaques are usually homogenous
Thromboembolic events as a complication of Covid-19
Get PDFCoronavirus-2 (SARS-CoV2/ Severe Acute Respiratory Syndrome Corona Virus 2) infection has emerged as a global health crisis. The incidence of thromboembolic disease is very high in SARS- CoV2 disease and involves multiple organ systems ranging from cutaneous thrombosis to pulmonary embolism, stroke or coronary thrombosis sometimes with catastrophic outcomes. Evidence points towards a key role of thromboembolism, hypercoagulability and overproductionn of proinflammatory cytokines mimicking a “cytokine storm†which leads to multiorgan failur
Profile of infections in nephrotic syndrome patients of western rural Maharashtra.
Get PDFBackground: Infection is a major complication in children with Nephrotic syndrome. Patients with relapse will have increased susceptibility to bacterial infection because of urinary losses of immunoglobulins & properdin factor B, defective cell-mediated immunity, immunosuppressive therapy, malnutrition & edema, or ascites acting as potential culture medium.
Aims & Objectives: To study the spectrum of infections in nephrotic syndrome of childhood.
Material and Methods: A longitudinal observational study was conducted including the nephrotic syndrome cases after ethical approval from the institution at a tertiary care hospital from November 2020 to October 2021.
Results: The sex ratio of the study was 1.44:1 with a mean age of 4.2 years. The most common presenting feature in our study was decreased urine output with generalized edema and the most common type of infection was upper respiratory tract infections. Our study found that most common organism causing infection in NS was Escherichia coli (E. coli).
Conclusion: With high index of suspicion, early institution of appropriate antibiotics, aggressive management of infections together with use of steroids enables remission of NS and support better prognosis
A Clinical review. Point of care testing (POCT)-A boon to Emergency Department.
No full textPoint of care testing (POCT), otherwise referred to as near patient, bedside, or extra laboratory testing, is not new. These are the tests done in which results can be obtained in less than 30 minutes. The effect of point of care testing can be assessed in terms of the benefit to the diagnostic or treatment strategy and thus overall health outcome.5
It is almost axiomatic that providing a more rapid result saves time and therefore money. However, there will be no saving unless the result is acknowledged and action taken. The technology now exists to enable a wide range of diagnostic tests to be provided at the point of care. The need for such testing clearly exists and will increase as the practice of Emergency medicine changes and individuals take greater responsibility for the patient health. Rapid provision of results can facilitate better clinical decision making, improved patient adherence, and greater patient satisfaction, all of which lead to improved clinical outcomes and shortens the hospital stay there by reduces the economic burden
Unrecognized renal dysfunction in patients with acute stroke- Cross sectional study
Get PDFBackground and Objectives: Unrecognized renal insufficiency, defined as an estimated glomerular filtration rate <60 mL/min/l .73 m2 in the presence of normal serum creatinine levels, is a common comorbid condition among patients with various cardiovascular conditions. The current study was aimed to evaluate the prevalence and clinical significance of unrecognized renal dysfunction in patients admitted with acute stroke.
Patients & Methods: This cross sectional study consisted of patients with acute stroke admitted in medical ward at Stanley medical college. Estimated glomerular filtration is estimated using MDRD and CKD — EPI formula. Study group is divided into three groups (Normal renal function, Unrecognized and Recognized renal dysfunction) as per eGFR. The two primary outcomes such as severe disability at hospital discharge and in-hospital mortality are compared in each group.
Results: Of the 100 patients with stroke included in the study, 62% had a normal renal function, 31% had recognized renal insufficiency, and 7% had unrecognized renal insufficiency. Mortality rates are higher in patients with recognized and unrecognized renal insufficiency compared with patients with normal renal function (29% and 28.5% and 9.6%) respectively, P <0.04053). Similarly, severe disability rates at discharge are also higher in patients with recognized and unrecognized renal insufficiency compared with patients with normal renal function (72.27%, 80 %, and 32.14%) respectively.
Conclusion: Unrecognized renal insufficiency is common among patients with acute stroke and is associated with adverse short-term outcomes
Clinical profile of myopia in adult patients at a rural tertiary care hospital.
Get PDFIntroduction: Myopia, also known as short sight is that diopteric condition of eye in which, with accommodation at rest, incident parallel rays come to a focus anterior to the retina.[1] The person can see near objects more clearly than distant ones and are called “short-sightedâ€. The prevalence of simple myopia and high myopia (degenerative myopia) are increasing globally at an alarming rate, with significant increases in the risks for vision impairment from pathologic conditions associated with high myopia, including retinal damage, cataract and glaucoma. We conducted the study to find out the percentage of mild / moderate/severe myopia in adult patients at a rural tertiary care hospital.
Aims and Objectives:To study the clinical profile of Myopia in patients more than 20 years at a rural tertiary care hospital.
Materials and Methods: An Observational, Descriptive Cross-Sectional Hospital based study was conducted at a tertiary care hospital. A total of 100 patients with Myopia were screened and evaluated. We studied the myopic patients above 20 years attending to our hospital OPD. Family history and information about the risk factors was obtained by using pre structured proforma. Snellen’s chart was used to record the unaided visual acuity and best corrected visual acuity. Color vision was assessed by Ischihara pseudo isochromatic color plates. With the help of retinoscopy, refractive errors were determined. Spherical equivalent of refraction (SER) was calculated . Central corneal thickness was calculated by Pac Scan Pachymeter. Axial length was calculated by A Scan biometry. Dilated fundus examination was done by Direct and indirect ophthalmoscope. Results were analyzed using suitable statistical tests. Grading of myopia was done as Mild Myopia(<3D), Moderate Myopia (3-6 D), Severe Myopia (>6 D) and Pathological myopia with fundus changes.
Results: The mean age of the study population was 32.98 ± 15.77 years with 53% (53) males and 47% (47) females. The mean SE was -2.66 ± 3.02 D. 66% (66) patients had mild myopia, 23% (23) patients had moderate myopia,7% (7) patients had severe myopia while 4% (4) patients had pathological myopia with fundus changes.
Conclusion: Occurrence of mild myopia is most common followed by moderate, severe, and pathological myopia which is the least common type
Study of clinical profile and management of age-related macular degeneration at rural tertiary care hospital
Get PDFIntroduction: Age-related macular degeneration (ARMD) is the leading cause of irreversible blindness in elderly population after 5th decade. It is a degenerative disorder affecting macula, characterized by drusens and RPE changes. Choroidal neovascularization (CNV) and Pigment epithelial detachment (PED). Age, Gender, Smoking, Hypertension, Diabetes mellitus, Atherosclerosis, Obesity, Family history, Dietary habits are its known associated risk factors.
Aims/Objective: To Study Clinical profile, Risk factors and Management protocols in patients of Age Related Macular Degeneration at Rural Tertiary Care Hospital
Material and Methods: An observational, descriptive cross-sectional Hospital based study was conducted at a tertiary care hospital. Total 50 patients were evaluated through structured proforma. Patient’s personal history, medical history, family history, alcohol consumption, smoking, systemic illness history like Diabetes mellitus, hypertension, were studied. Dilated Fundoscopic Examination readings was taken from OPD Patient records. Direct ophthalmoscopy and Slit lamp biomicroscopy with 90D lens were conducted. Management protocols were noted like Medical management, optical management, Reference to higher center. All patients of ARMD Attending Rural Tertiary Care hospital and Patients willing to participate in the study were included. Patients below 40 years of age and Patient having optical media opacities, Myopia, Uveitis, Glaucoma, Cataract, Vitreo retinal diseases were excluded.
Results: Out of 50 study patients, 60% were Females. Most common age group observed was 61-70 years of age. Dry ARMD was seen in 70% patients, Wet ARMD was seen in 30 % patients. Visual acuity was more affected in Wet ARMD than Dry ARMD. Most common risk factors associated with ARMD were history of Hypertension in 70% patients, followed by Diabetes in 55%, Smoking in 57%, Alcohol consumption in 52% patients. Medical treatment was advised to 70% patients; Optical aids were given to 25% patients. 30% patients were referred to higher center; no surgical management was offered to any patients.
Conclusion: ARMD is more commonly seen in patients above 60 years of age and more in females. Dry ARMD seems to be more common than Wet ARMD, however visual disability is more in Wet ARMD