ABSTRACT
Background: Acute viral hepatitis (AVH) is a major health concern in developing countries like Bangladesh regarding morbidity as well as mortality. Usually, acute infections are caused by A, E, hepatitis viruses, and occasionally hepatitis B virus. Infection caused by the hepatitis C virus is usually asymptomatic. Prior knowledge of the demographic and clinical profile of acute viral hepatitis may be helpful for treatment professionals in the management of such patients. Aim of the study: The aim of this study was to assess the demographic and clinical profile of acute viral hepatitis patients in Bangladesh.Material & Methods:This prospective observational study was conducted in the Department of Gastroenterology, US-Bangla Medical College & Hospital during the period from March 2018 to February 2019, in Bangladesh. A total of 59 suspected patients with acute viral hepatitis were included as the study subjects for this study. Ethical approval of the study had been taken from the ethical committee of the mentioned hospital. A predesigned questionnaire was used in data collection. Collected data analyzed by using MS Office and SPSS version 23.0 programs as per need. A P-value, of <0.05 was considered significant.Results:Among 59 participants, the male-female ratio was 3.2:1 and the mean (±SD) age was 23.88±14.83 years. Analyzing hepatitis infection, we found hepatitis E was the highest in number 32(54.24%), followed by hepatitis E virus 20(33.9%), and hepatitis B virus 5(8.47%). In this study, we did not find any patients with hepatitis C virus, and 2 participants didn’t have any hepatotropic virus. The mean (±SD) Serum bilirubin (mg/dl) was 6.35±1.63, and the mean (±SD) serum alkaline phosphatase (IU/L), serum. creatinine (mg/dl), serum albumin (gm/dl) and plasma glucose random (mg/dl) were found 366.81±257.20, 6.97±14.96, 19.75±22.98 and 10.08±5.49 respectively. Considering dual viruses among the total of 5 patients along with hepatitis E & A viruses in this study, we found all were hepatitis B viruses. Among them, 3 with hepatitis E and the rest 2 were with hepatitis A virus consequently. Among them 3(60%) with hepatitis A and the rest 2(40%) with hepatitis E. In the issue of patients attended with clinical complaints, vomiting was the highest among hepatitis A patients 19(86.4%) followed by jaundice 8(36.4%) and fever8(36.4%). On the other hand, among hepatitis E patients’ jaundice was highest at 19(61.3%) followed by vomiting at 17(54.8%), and fever at 6(19.4%) respectively.Conclusions:The incidence of HEV is found as the most predominant among all the acute viral hepatitis patients and vomiting and jaundice were the most common presenting complaints.
ABSTRACT
Background:Allergic transfusion reactions (ALTR) are very common complication of blood transfusion. Advances in transfusion medicine have significantly decreased the incidence of ALTR; however, ALTR continue to be burdensome for transfusion dependent patients. It increases their existing sufferings. Allergic reaction is more common in platelet concentrate transfusion because stored platelet concentrate supernatants (PCSNs) accumulate striking levels of biological response modifiers (BRMs) during storage. Objective: To determine the risk factors of allergic reactions in platelate concentrate transfusion. Method: It is a case control study enrolled a total of 64 diagnosed case of aplastic anaemia receiving transfusion of platelet concentrate at Department of Transfusion Medicine, BSMMU, Dhaka, from May 2015 to April 2016. Among them 32 case of aplastic anaemia having allergic reaction due to transfusion of platelet concentrate was considered as group I (case) and rest 32 patients not developed allergic transfusion reaction due to transfusion of platelet concentrate was considered as group II (control). Patients age belong to 5 - 50 years and both sex and also patients getting transfusion of plate late concentrate were enrolled in this study. Statistical analysis: Statistical analyses were carried out by using the Statistical Package for Social Sciences version 20.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Chi-Square test, Odds ratio with 95% CI used to analyze the categorical variables, shown with cross tabulation. Student ttest used for continuous variables. Significant value of 'p' was decided to be at a level of 0.05 in two tailed tests. Result: The mean age was found 22.1±11.58 years in group I and 23.5±3.8 years in group II. Twenty four (75.0%) patients were male in group I and 17(53.1%) patients in group II. Almost twenty (62.5%) patients come from urban area in group I and 19(59.4%) in group II. In group I, thirty two (100.0%) patients had urticarialrash, 100.0% had itching, 37.5% had angioedema, 3.1% had cough, 3.1% had chest pain, 3.1% had respiratory distress, 3.1% had fever and 3.1% had vomiting. Almost twenty(62.5%) patients had tachycardia (>100 bpm) in group I and all patients had normal pulse in group II.Thirty two (100.0%) patients had normal blood pressure in both group. In group I, 31(96.9%) patients developed mild allergic reaction, 3.1% moderate allergic reaction. Majority (40.6%) patients belonged to age 16-30 years in present allergic transfusion reaction and 11(34.3%) in absent allergic transfusion reaction. Most (40.6%) of the patients was found blood group B in present allergic transfusion reaction and 11(34.4%) in absent allergic transfusion reaction. Multiple unit of PC transfusion increases 3.69 times risk to develop allergic transfusion reactions with 95% CI 0.99 to 14.44%.Platelet concentrate storage>3daysincreases 5.95timesrisktodevelopallergic transfusionreactionwith95%CI1.75to21.09%. Conclusion: Multiple unit (≥2) transfusion and Platelet concentrate storage >3 days were significantly (p<0.05) associated with allergic transfusion reactions but no significant association was found between allergic transfusion reactions with age and Blood group.
ABSTRACT
Background: Oral contraceptive pill (OCP) is related to development of hypercoagulability and the risk of thromboembolic effects in women. Objectives: To assess the coagulability status in women taking oral contraceptives by estimation of plasma fibrinogen level and total count of platelets. Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of January 2012 to December 2012 on sixty apparently healthy female subjects aged 25 to 45 years taking OCPs for 1 to 10 years. Thirty subjects were 1 to 5 years user group and another 30 subjects were >5 to 10 years user group. They were collected from family planning clinics of Dhaka city. In addition, age matched 30 apparently healthy women of OCP nonusers were also studied as control. For assessment of coagulability state, plasma fibrinogen and total counts of platelet levels were estimated by automated coagulation analyzer and automated hematology analyzer. Statistical analysis was done by unpaired Student’s t’ test. Results: The mean (±SE) total count of platelet level was significantly higher (P<0.001) in contraceptive user group and plasma fibrinogen level was higher in users but it was not significant. Conclusion: This study concludes that OCP users had more tendency of hypercoagulability and therefore these women are at higher risk of thromboembolic effects.
ABSTRACT
Cirrhosis is a consequence of chronic liver diseases. Zinc is a micronutrient that plays an important role in the function of liver. This cross-sectional study was carried out in the Department of Biochemistry, Dhaka Medical College, from July 2010 to June 2011 to observe the association of serum zinc level with liver cirrhosis. A total of 100 adults, both males and females with age range of 18-60 years, of which 50 were healthy subjects and 50 adult hospitalised cirrhotic patients were selected purposively for the study according to selection crieteria. Fasting serum zinc level was measured with atomic absorption spectrophotometer. Serum zinc level was found to be low in 72% patients. Mean ±SD of serum zinc levels (μg/L) were 610.32 ± 169.60 and 827.66 ± 267.32 in cases and controls respectively. In cirrhotic patients serum zinc level was significantly lower than that of healthy controls (P<0.001). Though, it is difficult to draw any definite conclusion from this study, because of reduced level serum of zinc found in cirrhotics, Zn may be supplemented to them with a hope of better treatment response.