ABSTRACT
Objective: Tuberculosis [TB] is a major public health problem in Bangladesh since long. The present incidence and prevalence rates of all forms of TB are 227 and 404/100,000 population respectively. The aim of this study was to find out the clinical characteristics of involved cervical lymph nodes, demographic characteristics of the patients and response to treatment of Cervical Tuberculous Lymphadenitis [CTL] cases
Methods: A prospective study was performed in Shaheed Shamsuddin Ahmed Hospital, Sylhet, Bangladesh from June 2012 to June 2014. Total 65 patients having CTL attending outpatient department of the hospital were enrolled
Results: Age of the patients ranged from 5 to 60 years with a mean of 25.6 years. Two third [67.7%] of the patients were female. Male: Female ratio was 1:2.1. More than half of the patients came from rural areas [53.8%] and from low socio-economic conditions [58.5%]. Most of the patients presented with unilateral [87.7%], multiple [82.3%], matted [68.6%] lymph nodes, <3cm diameter [54%], commonly in right side [57.9%]. Abscess was found in 21.5% cases. Discharging sinus was found in 9.2% cases. Most commonly involved lymph node group was level V [59.4%] followed by level II [42.2%]. Systemic features were found in 63.07% patients. Associated lung lesion was found in 3.1% cases. FNAC was found positive for tuberculosis in 83.9% cases. Most of the patients [78.46%] were cured with six months anti-tubercular chemotherapy
Conclusions: Early diagnosis and treatment is critical in reducing the overall prevalence. It is essential to have awareness regarding common presentations of cervical tuberculous lymphadenitis among the general population as well as healthcare professionals working in the resource poor primary and secondary level hospitals
ABSTRACT
Objective: To evaluate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis [NEC] in preterm very low birth weight [VLBW] infants
Study Design: A randomized double blind controlled trial
Place and Duration of Study: The Paediatrics Department of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet Bangladesh, from July 2012 to June 2015
Methodology: Preterm [28 - 33 weeks gestation] VLBW [birth weight 1000 - 1499 g] neonates were enrolled. The study group was fed with probiotics once daily with breast milk from first feeding, and the control group with only breast milk without the addition of probiotics. Both the groups received other standard care. The primary outcome was the development of NEC [stage II and III], categorized by modified Bell's classification
Results: In 108 neonates, development of NEC was significantly lower in the study group than that of control group [1 [1.9%] vs. 6 [11.5%]; p=0.044]. Age of achievement of full oral feeding was significantly earlier in the study group than that in the control group [14.88 +/-3.15 and 18.80 +/-4.32 days; p < 0.001]. Duration of hospital stay was significantly short in the study group compared to the control group [15.82 +/-2.94 days vs. 19.57 +/-4.26 days; p < 0.001]
Conclusion: Probiotic supplementation reduces the frequency of necrotising enterocolitis in preterm neonates with very low birth weight. It is also associated with faster achievement of full oral feeding and short duration of hospital stay
ABSTRACT
Hereditary multiple exostoses [HME] is an autosomal dominant skeletal disorder characterized by the presence of multiple osseous prominences. It can occur sporadically or within families [22 - 56%]. Two genes, EXT1 and EXT2 located respectively at 8q24 and 11p11-p12, have been isolated to cause HME. It can cause gross deformity of limbs and growth disturbance which is quite a common complication. Malignant transformation to chondrosarcoma can also occur. Neurological presentations are rare and usually happened due to direct compression of a peripheral nerve or nerve root or less often the spinal cord. This case is possibly the first case of HME described from Bangladesh, presented with dorsal cord compression. Decompression was done and the complaints of myelopathy were improved
ABSTRACT
Naphthalene, a widely used industrial and household chemical, has rarely been an agent of poisoning worldwide. Severe haemolysis from naphthalene poisoning is rare and can be a challenge to clinicians. We report a 22-year-old female, who accidentally ingested naphthalene mixed coconut oil and got admitted with recurrent vomiting, headache and passage of dark urine. Severe intravascular haemolysis with hypotension and neutrophilic leukocytosis was detected. She was treated with red blood cell transfusions, intravenous saline infusion and ascorbic acid
ABSTRACT
This prospective cross-sectional study was conducted to find out the health seeking behavior of stroke patients and their associates as well as to identify the barriers of service intervention. The study was done at Occupational Therapy Department of Centre for the Rehabilitation of the Paralyzed [CRP], Dhaka, Bangladesh. A purposive sampling technique and pre-tested structured questionnaire were used for data collection. Face-to-face interviews were taken from 133 respondents obtaining informed consent. Majority [74.4%] of the patients took treatment from medical graduates and rest from village doctors [10.5%] and traditional healers [15.0%]. 51.1% patients knew about stroke from hospital whereas 14.3% from Kobiraj/Homeopath and 14.3% from their own experiences. Majority [85.7%] patients knew about the importance of initial treatment and 50.4% respondents had knowledge of better treatment facilities whereas 49.6% didn't. Participants view to seek treatment after stroke was significantly high [p < 0.001] despite barriers. The barriers were lack of money [52.6%], difficulties in transportation [31.6%] and lack of interest and family support [15.8%]. The result might be useful for policy makers to take further initiatives for better management of stroke patients and to improve the quality of their life
ABSTRACT
Most of the medical practitioner's are under the impression that Stevens Johnson Syndrome [SJS] is art uncommon life threatening drug reaction. In fact it is not as rare a disorder as we are led to believe. Stevens Johnson Foundation claims that they come to know of 15 new cases a week and that is only people with internet access. In Bangladesh the real burden is never estimated as information on monitoring and reporting of adverse drug reactions are not available. Stevens Johnson Syndrome is an immune complex mediated idiosyncratic systemic hypersensitivity reaction that may be triggered by medications, viral, bacterial, fungal infection and malignancies. Recent reports link SJS to the use of drugs rather then other etiologies. Here we report a case of SJS with fatal outcome which is probably the first case encountered in Bangladesh induced by Azithromycin