Epidemiological indicators and clinical profile of leprosy cases in Dhaka

Objective: To evaluate epidemiological indicators and clinical profile of leprosy patients in Dhaka City

Methods: In this cross-sectional observational study 722 new leprosy patients registered in six different clinics of The Leprosy Mission International - Bangladesh, Dhaka program over two and half year [January 2011 to June 2013] were included. Demographic details and clinical characteristics during diagnosis were recorded

Results: Out of 722 patients, 390 [54%] were males and 332 [46%] were females. Proportion of cases under 15 year age was 8.7%. Borderline tuberculoid was the most common form of the disease [81.0%] followed by tuberculoid [9.3%], lepromatous [4.3%], borderline lepromatous [3.5%], borderline [1.8%] and pure neural [0.1%]. Proportion of multibacillary leprosy was 22.4%. Most of the patients had duration of symptoms from 6 months to 1 year [53.0%]. 12% of patients had history of contact with leprosy patients. Type 1 reaction was more prevalent than type 2 [7.6% and 2.9%, respectively]. Proportion of cases with grade 2 disability was 5.9%. Most common presentation was with hypopigmented macule with obvious margin, marked anesthesia and mild infiltration. Ulnar nerve was the most common nerve to be involved [15.8%]

Conclusion: Leprosy cases are being frequently diagnosed in Dhaka city. Epidemiological indicators reflect that there may be ongoing disease transmission and relative delay in diagnosis despite a strong surveillance program

Tinea pedis: a clinical dilemma in Bangladeshi population

Tinea pedis is an important public health problem because of the increase in immunosuppressive states. Large scale studies in Asia are scarce, and the baseline incidence of tinea pedis is not firmly established. To find out the clinical types of tiena pedis amont the Bangladeshi population. 200 clinically suspected cases of tinea pedis were included in this study. In all cases, samples were collected for KOH microscopy and culture. Clinical pattern and associated relevant factors were noted according to a predetermined protocol. Papulosquamous tinea pedis was the most common clinical pattern in 80 [40%] followed by interteriginous type in 70 [35%] patients. Hyperkeratotic pattern was found less commonly in 45 [22.5%] patients followed by bullous pattern in 5 [2.5%] patients. The incidence of papulosquamous type of tinea pedis is relatively higher among the Bangladeshi population than other countries

Some tribal medicinal plants of Ghagra union of Rangamati district and their uses

Chakma is the largest tribal community in the Ghagra union of Rangamati District. Majority of them still depend on medicinal plants for the treatment of different ailments. A study was carried out in that area to document their knowledge about medicinal plants. 52 species under 38 families have been recorded which are used for the treatment of 43 diseases. Botanical name, tribal name, parts used and doses are mentioned

Efficacy of topical tacrolimus in atopic dermatitis

Mainstay treatments for atopic dermatitis include cutaneous hydration, antihistamines and topical glucocorticoids. To avoid side effects associated with long term and higher potency topical corticosteroids, further topical immunosuppressive agents should be tried. Topical tacrolimus has been extensively studied and shows promise in treatment of inflammatory skin diseases such as atopic dermatitis. To determine the safety and efficacy of tacrolimus in atopic dermatitis. In this randomized, case-control study, out of 60 patients with atopic dermatitis [age ranging 2 to 45 years], 30 [case] were treated with tacrolimus [0.03%] ointment twice daily and 30 [control] were treated with vaseline twice daily for up to 3 weeks. Evaluation included per cent body durface area [%BSA] affected, individual signs of atopic dermatitis, the Severity Score of Atopic dermatitis [SCORAD], and the patient's assessment of pruritus. The outcome variables like erythema, edema/papulation, oozing/crusting, excoriation, pruritus, body surface area involved and SCORAD in the case group improved significantly compared to those in the control group [p< 0.001, <0.001, <0.001, <0.005, <0.001, <0.001 and <0.001, respectively]. After 3 weeks of tacrolimus, all variables except lichenification score responded significantly. Significantly higher number complained of burning sensation in cases [20%] as compared to none in the control group. Topical 0.03% tacrolimus is more effective than the vehicle alone

Comparative efficacy of griseofulvin and fluconazole in the treatment of tinea capitis

Tinea capitis is caused by different species of dermatophytes particularly Microsporum and Trichophyton .Children are affected predominantly. Many systemic drugs e.g.griseofulvin, fluconazole, itraconazole, terbinafine, ketoconazoe etc are available for the treatment of tinea capitis. To compare the efficacy of griseofulvin and fluconazole in the treatment of tinea capitis. A total of 50 patients of age group 2-15 years were selected for the study.The cases were diagnosed clinically and confirmed by Wood 's lamp examination, KOH microscopy and culture.The patients were divided into two equal groups. Group A was given griseofulvin and group B was given fluconazole for a period of two months. Topical adjuvant therapy econazole nitrate was given in both groups. The patients were followed up at 2 weekly interval for clinical response and Wood 's lamp examination and finally KOH microscopy and culture. In group A clinical response was 84%and mycological response was 68%whereas in group B clinical response was 68%and mycological response was 56%. The present study showed that griseofulvin is more effective in the treatment of noninflammatory type of tinea capitis than fluconazole

Ethno-medical uses of some medicinally active plants for treating diabetes in Chittagong Hill Tracts, Bangladesh

Traditional medicinal knowledge on 14 plant species in the Chittagong Hill Tracts known to have properties in the treatment of diabetes is documented. These plants are being used in the Chitthgong Hill Tracts by the 13 tribal communities in traditional medicine for hundreds of years with reputation as efficacious remedies although there may not be sufficient data for sustaining their efficacy. Short diagnostic descriptions, systematic position and tribal names of the plants are described. Plant preparation, dose and period of use are directly translated from Chakma and Marma pharmacopoeia in collaboration with tribal professional practitioners and bilingual tribal guides of Khagrachari Hill district. Chittagong Hill Tracts

Role of splenectomy in splenic disorder

To study the haemoglobinopathies with their subsequent splenomegalic and hypersplenic symptoms and to assess the postoperative complications of splenectomy. There were 50 patients with splenic pathology operated upon in the Salmaniya Medical Centre. The symptomatology of splenomegaly and hypersplenism were evaluated in addition to the surgical indications for splenectomy; specific reference was made to splenic weight, its relation to morbidity and mortality and especially the occurrence of post-splenectomy sepsis. Haemoglobinopathies with their consequent splenomegalic and hypersplenic symptoms are a common indication for splenectomy in this part of the Arabian Gulf. Several studies have cautioned about post-splenectomy complications. The aim of this study was to assess these complications with specific reference to post-splenectomy sepsis and also to verify any relation between such complications and splenic size. Splenectomy was performed for splenomegaly and hypersplenism in 19 [38%] of the 50 patients; 17 [34%] had splenectomy because of splenic trauma and the remaining 14 [28%] because of lymphomas and/or adjuvant to other surgical procedures. The spleen weight was 840 g [range 185-2200 g]. The largest and heaviest spleens were found in patients with splenomegaly, and hypersplenism with sickle-cell disease. The mortality rate was 4% and postoperative complications were observed in 16%. There was no relation between the complication and splenic size. Our results show that these patients benefited from splenectomy, in terms of life-saving, haematological improvement and relief of discomfort and pain. These results were achieved with an acceptable mortality and morbidity

Effect of soil conditioners on nodulation and seed yield of faba bean grown in newly reclaimed area

In a field trial, sandy soil from Salhia project [Entisols, Quartzipsamments], soil taxonomy [1975], was treated with bitumen, polyacrylamide, urea-formaldehyde and uresol at rates of 50, 20, 75 and 40 g/m2 respectively. The germination faba bean seedlings after 15 days increased in the following order: Bit >PAM >Ur >UF >Cont. While, at 30 days, it changed to UF >Bit >Ur >PAM >Cont. The application of soil conditioners to sandy soil induced significant increase in the nodulation, dry matter and N-content of faba bean plants [after 75 days]. The yield of seeds increased by 20, 18, 15 and 11% as a result of treating the soil with UF, Bit, PAM and Ur respectively. Nitrogen balance revealed higher gain of N due to soil conditioner treatments. Bitumen emulsion exerts the most beneficial effect on symbiotic N fixation than other conditioners containing nitrogen