ABSTRACT
Background: Ca-125 is a large molecular-weight glycoprotein synthesized by different cells originating from the coelomic epithelium. Although classically it has been used to monitor the course of ovarian epithelial cancer, there are other established circumstances associated with high serum Ca -125 levels and pulmonary tuberculosis is one of them. Diagnosing pulmonary tuberculosis, which is not bacteriologically positive often very challenging. Because many procedures are available for such cases but they are of limited use because some of them are lengthy or expensive or need sophisticated equipment, highly skilled personnel, etc. Serum CA-125 is a rapid, relatively inexpensive investigation. Objective: The present study aimed to assess the role of CA-125 in distinguishing pulmonary TB from bacterial pneumonia. Methods: This analytical cross-sectional study was conducted in the Department of Medicine, Dhaka Medical College Hospital for the period of March 2018 to September 2020.100 pulmonary tuberculosis patients were taken in group I, and 100 bacterial pneumonia patients were taken in group II according to selection criteria. Informed written consent was taken from each of the participants. All were subjected to detail clinical and demographic history along with thorough physical examination. Relevant investigations were done including serum CA-125. All final data were collected in the semi-structured and pretested case record form. After data collection, data were checked for errors, and analysis was done. Results: In this study, the mean CA-125 value was 62.29 (SD±31.51) IU/mL in group I(pulmonary tuberculosis). In group II (bacterial pneumonia) mean value was 22.95(±8.25) IU/mL. The mean value of CA-125 was significantly higher (p-value <0.001) in group I patients compared to group II. About 59.0% of patients in group I had a high level of serum CA-125 which had a significant difference from group II (p<0.001). ROC analysis of CA-125 in the diagnosis of patients with active pulmonary tuberculosis showed a cut-off value of ?31.7 IU/mL had sensitivity, specificity, PPV, NPV, PLR, NLR, and accuracy of 72%, 87%, 84.7%, 75.7%, 5.54%, 0.321%, and 79.5% respectively. Conclusion: This study’s findings stated that serum CA-125 may be a useful marker in distinguishing PTB from bacterial pneumonia. Therefore, further study with a more generalized study population is recommended.
ABSTRACT
Objective: To assess the efficacy of tacrolimus and clobetasol propionate in the treatment of alopecia areata
Methods A clinical trial was carried out in the department of Dermatology and Venereology, Dhaka Medical College Hospital, Dhaka, Bangladesh from May 2013 to April 2014. Total sixty patients were enrolled and divided into group A and group B. Thirty of group A patients were treated with topical tacrolimus and thirty of group B patients were treated with topical clobetasol propionate
Results: In group A, the duration of illness ranged from 2 months to 36 months and in group B, from 1 month to 24 months. Among the patients of group A and B, 25 [83.3%] and 27 [90%] patients improved, respectively. After 16th week of treatment, slight response in 6 [20%] and 4 [13.3%] and moderate response in 18 [59.4%] and 22 [63.2%] and marked response in 1 [3.3%] and 1 [3.3%] was seen in group A and group B, respectively. No significant difference was observed [p value = 0.648]
Conclusion: Both the drugs, clobetasol propionate and tacrolimus when used individually, were found to be equally effective in the treatment of alopecia areata and tacrolimus ointment 0.1% can be used as an alternate therapeutic modality