scholarly journals Clinical features and treatment efficacy for IgG4-related thyroiditis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xinxin Han ◽  
Panpan Zhang ◽  
Jieqiong Li ◽  
Zheng Liu ◽  
Hui Lu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Treatment Efficacy ◽  
High Rate ◽  
Thyroid Antibodies ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Igg4 Related Disease ◽  
Serum Igg4 ◽  
Average Patient

Abstract Purpose This study aimed to clarify the clinical features of and evaluate the treatment efficacy for IgG4-related thyroiditis. Methods Fourteen IgG4-related thyroiditis patients and 42 randomly matched IgG4-related disease (IgG4-RD) patients without thyroiditis in a prospective cohort at the Peking Union Medical College Hospital (PUMCH) were enrolled from 2011 to 2019. Patient demographics, clinical characteristics, laboratory parameters and treatment efficacy were analysed. Results The prevalence of IgG4-related thyroiditis in our cohort was 2.0%. The average patient age was 42.8 ± 14.9 years, and the male: female ratio was 1:1. Goiter (14, 100.0%), hard thyroid (14, 100.0%) and neck compression (5, 35.7%) were the most prevalent onset symptoms observed. IgG4-related thyroiditis was characterized by asymmetric diffuse thyroid enlargement on ultrasound. Thirteen (92.9%) patients had hypothyroidism, and all patients had significantly elevated circulating thyroid antibodies. Compared with patients without thyroiditis, patients with IgG4-related thyroiditis had less submandibular gland involvement and lacrimal gland involvement and lower serum IgG4 and T-IgE levels (P = 0.019, P = 0.022, P = 0.004, and P = 0.006, respectively) and more single-organ involvement (P = 0.011). After treatment, the symptoms were relieved, while the size of the thyroid gland did not change significantly, and levothyroxine as a supplemental therapy was still needed. Conclusions IgG4-related thyroiditis is a distinct subtype of IgG4-RD characterized by positive circulating thyroid antibodies and a high rate of hypothyroidism. Although compression symptoms could be relieved with treatment, the thyroid size did not change significantly, and the damage to thyroid function was often irreversible.

Utility of Tolonium Chloride Rinse in the Diagnosis of Oral Cancer

2020 ◽  
Vol 26 (1) ◽  
pp. 11-17
Author(s):  
Md Kamruzzaman ◽  
Kazi Nurjahan ◽  
AS Gazi Sharifuddin ◽  
SK Ballav
Keyword(s):  
Developing Countries ◽  
Oral Cancer ◽  
Prospective Study ◽  
Diagnostic Delay ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Biopsy Report ◽  
Patient Side ◽  
Tolonium Chloride

Background: Oral cancer burden in developing countries is huge. In Bangladesh and India incidence were 10.6% and 10.4% respectively on 2018. At the same time worldwide incident was only 2%. Majority patients present at advanced stage and their survival rate is poor. Diagnostic delay from patient side and health delivery system side is significantly longer and it is more in developing countries. Like other malignancy early diagnosis can save a lot of these patient. Methods: This prospective study was carried out in Khulna Medical College Hospital from July 2017 to July 2019. Patients who will meet the criteria for this prospective study and capable and willing to give informed consent were enrolled. 20 second rinse/gargle with 10ml of 1% Tolonium chloride solution was done. Biopsy were taken from stained lesion, biopsy report were compared with TC stained lesions. Results: Out of 1650 patients in our outdoor department for various problem and only 30 cases were selected for this study according to selection criteria. Of 30 patients, 18 (60%) were male and 12 (40%) were female. The male-to-female ratio was 3:2. It was found that the sensitivity of 1% Tolonium Chloride rinse for oral precancer and cancer detection was 83.33%, whereas the specificity was 84.21%. Conclusion: Tolonium chloride rinse is a good screening test for oral cancer diagnosis with sensitivity 83.33% and specificity 84.21%. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 11-17

scholarly journals Surgery at Cranio-vertebral (CV) Junction: Our Experience of 32 Cases

1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Type I ◽  
College Hospital ◽  
Chiari Malformation Type I ◽  
Female Ratio ◽  
Medical College ◽  
Neoplastic Lesion ◽  
Wide Range

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)

scholarly journals Predisposing Factors of Scabies among the Patients Attending Skin and Venereal Disease Outdoor of Dhaka Medical College Hospital

1970 ◽  
Vol 9 (2) ◽  
pp. 82-86
Author(s):  
Afzalur Rahman Mahmood ◽  
Zannatun Nur
Keyword(s):  
Standard Deviation ◽  
Venereal Disease ◽  
Family Members ◽  
Predisposing Factors ◽  
Medical College Hospital ◽  
College Hospital ◽  
Socioeconomic Condition ◽  
Female Ratio ◽  
Level Of Education ◽  
Medical College

This cross sectional type of descriptive study was carried out among the patients attending the Skin and Venereal Disease (VD) Out Patient Department (OPD) of Dhaka Medical College Hospital (DMCH) from August 2006 to November 2006 with a view to explore the current situation of scabies and its predisposing factors. In this regard 213 clinically diagnosed scabies contracted patients were interviewed randomly by using pre-tested questionnaire. Risk factors were assessed considering their dwelling places, types of families, number of family members, persons living in each room, using fomites of infected persons, socioeconomic condition, occupation, level of education, regular bathing and cloth washing habit along with age, sex distribution and clinical presentation of scabies. The mean age of the respondents was 13.16 years with a standard deviation (SD) of ±5.38 years and majority (36.15%) was in the age group of 1-5 years. Male, female ratio was 1.15:1. Major level of education was in the group of class I to V (38%). 50.73% had family members comprised of 4 to 6. Majority (38.50%) belonged to lower middle class (income 3001-6000 taka/month). Among the respondents maximum (54.93%) were infected by family members. 77.94% respondents used fomites of affected persons and 66% respondents shared beds of infected persons. Mean duration of illness was 42 days with standard deviation of ±4.47 days. Among the male, majority (82.63%) had lesion on lower abdomen and buttock. In contrary, 80.28% female had lesion on hand. 58.68% presented with papule. The study recommends that emphasis should be given on personal hygiene and life style of people as well as educating them about scabies. Key words: Scabies, Predisposing factors, Skin and VD outdoor DOI = 10.3329/jom.v9i2.1436    J MEDICINE 2008; 9 : 82-86

scholarly journals Primary Retroperitoneal Ganglioneuroma: A Retrospective Cohort Study of 32 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianchun Xiao ◽  
Zixuan Zhao ◽  
Binglu Li ◽  
Taiping Zhang
Keyword(s):  
Growth Pattern ◽  
Clinical Manifestations ◽  
Incomplete Resection ◽  
Radiological Imaging ◽  
College Hospital ◽  
Laboratory Findings ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
The Masses

Purpose: To investigate the clinical characteristics, diagnosis, differential diagnosis, therapy options, and outcomes of retroperitoneal ganglioneuroma.Methods: In this retrospective study, we collected and analyzed the clinical data of 32 patients diagnosed with retroperitoneal ganglioneuroma and admitted to Peking Union Medical College Hospital from October 2012 to August 2019.Results: Among our 32 cases with retroperitoneal ganglioneuroma, the male-to-female ratio was 1:3 and the mean age was 35. Only 25% of the cases presented with abdominal pain while more than 65% had no specific symptoms. The masses could be found through physical examination in only five patients. Most of the tumors are located near the renal area. They were usually single and displayed an embedded growth pattern with diameters <10 cm, clear borders, and soft texture. For radiological imaging, the majority of tumors demonstrated soft tissue density with mild-to-moderate enhancement on CT imaging and showed hypoecho with moderate blood flow signals in ultrasound. No significantly abnormal laboratory examinations were found in most patients. Of all the 32 patients, 2 chose surveillance after biopsy due to difficulties in operation, while others chose surgical resection. The mean follow-up time was 15.8 months among 26 patients. The tumor remained stable in the surveillance cases. Residual tumors were found in four cases receiving operations with no progress and discomfort. No recurrence was seen in all patients.Conclusions: The retroperitoneal ganglioneuroma is a benign tumor without specific clinical manifestations or significant laboratory findings. Typically, it is shown as low density with a clear border and an embedded growth pattern in radiological imaging. The overall prognosis is good. Surgery is an effective approach with possible severe complications. Incomplete resection or surveillance can be considered for some cases where complete resection is difficult to achieve.

scholarly journals Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female ◽  
Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

Laparoscopic Cholecystectomy for Acute Cholecystitis: Indication, Risk, and Outcome

2021 ◽  
Vol 8 (06) ◽  
pp. 5508-5513
Author(s):  
Dr. Shiladitya Shil ◽  
Dr. Ashutosh Deb Sarma ◽  
Dr. Md. Alomgir Islam ◽  
Dr. Md. Abdullah-Hel-Baki Abdul ◽  
Dr.Monira Begum
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prospective Observational Study ◽  
The Other ◽  
Surgical Indication ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
Good Treatment Option

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.

P0237COMPARISONS OF CLINICAL FEATURES IN GITELMAN SYNDROME PATIENTS WITH DIFFERENT URINARY CALCIUM EXCRETIONS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Lei Zhang ◽  
Bingbin Zhao ◽  
Xiaoyan Peng ◽  
Ying Wang ◽  
Limeng Chen
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Urinary Calcium ◽  
Gitelman Syndrome ◽  
Urinary Calcium Excretion ◽  
P Value ◽  
Calcium Excretion ◽  
College Hospital ◽  
Female Ratio ◽  
Gene Testing

Abstract Background and Aims Hypocalciuria is considered typical in Gitelman syndrome (GS). However, a few GS cases diagnosed by gene testing presented as normocalciuria have been reported in recent years. Our study is to observe the clinical features in GS patients with different urinary calcium excretions, and investigate the value of urinary calcium excretion in the clinical classification for GS. Method GS cases from the National Rare Diseases Registry System of China (NRSC) (2016-2018) with SLCl2A3 gene screened in Peking Union Medical College Hospital were collected. The features of urinary calcium excretion were analyzed, and the phenotypes of patients with hypocalciuria were compared to those with normocalciuria. Hydrochlorothiazide (HCT) test was performed and the maximal increasement of chloride excretion fraction (△FECl) was calculated to evaluate the extent of NCC dysfunction. Results A total of 83 genetically proven GS patients was included, with the mean age at diagnosis of 31.0±13.0 years, and the male/female ratio was 1.4:1. Among them, 53 (63.9%) patients had hypocalciuria. The ratio of urinary calcium/creatine was significantly lower in patients with hypocalciuria (0.08±0.06mmol/mmol) compared to those with normocalciuria (0.47±0.28mmol/mmol), with a P value of &lt;0.001. Age, gender, estimated glomerular filtration rate, blood pressure, alkalosis, and serum and urinary electrolytes including potassium, magnesium, natrium, chloride, and phosphorus were all comparable between patients with hypocalciuria and normocalciuria. Based on a standardized symptom questionnaire, fatigue (52.8% vs. 76.7%, P=0.03) and polyuria (9.4% vs. 30.0%, P=0.02) were less frequently reported in hypocalciuria patients, while all the other clinical symptoms were comparable. Sixteen patients in each group underwent HCT test, and the △FECl value was comparable between patients with hypocalciuria and normocalciuria (median, 0.54% vs. 0.83%, P=0.88), both of which indicated a blunt response to HCT (&lt;2.86% according to our previous study). Conclusion The results show that 63.9% of the GS patients in this study had hypocalciuria. There is no definite relationship between urinary calcium excretion, phenotype and the extent of NCC dysfunction.

scholarly journals Pattern of Sexually Transmitted Diseases (STDs) Among Patients Attending Out Patient Department of Dermatology of Dhaka Medical College Hospital, Dhaka, Bangladesh

1970 ◽  
Vol 19 (1) ◽  
pp. 7-10
Author(s):  
CM Ali ◽  
TK Sikdar ◽  
N Sultana ◽  
N Ahmed ◽  
AKMR Haque ◽  
...  
Keyword(s):  
Sexually Transmitted Diseases ◽  
Secondary Level ◽  
Educational Status ◽  
Medical College Hospital ◽  
College Hospital ◽  
Dermatology Department ◽  
Female Ratio ◽  
Male And Female ◽  
Sexually Transmitted ◽  
Medical College

The study was conducted among 568 patients of STDs out of 58560 male and female patients in the OPD of Dermatology Department of Dhaka Medical College Hospital (DMCH) during the period of March 2009 to February 2010 irrespective of sex and age >15 years with a view to assess the prevalence of sexually transmitted diseases. In this study prevalence of STDs such as gonorrhea, syphilis, non gonococcal urethritis, chancroid, genital herpes and genital warts were 29.58%, 12.68%, 41.58%,4.93%,8.45% and 2.82% respectively; male and female ratio were 3.73:1. The highest prevalence rate was found in age group of 25-34 years (42.25%). According to educational status of the respondents, 33.80% were up to secondary level and only 2.82% were master degree holder. Among occupation 36.62% were in service, and 15.49% were students. According to socioeconomic status 40.14% were poor and only 9.86% were from upper middle class. Key words: Sexually transmitted diseases; prevalence. DOI: 10.3329/jdmc.v19i1.6243 J Dhaka Med. Coll. 2010; 19(1) : 7-10.

Clinical features of the late onset myasthenia gravis in the Osaka Medical College Hospital

2017 ◽  
Vol 381 ◽  
pp. 1086-1087
Author(s):  
Y. Yoshimoto ◽  
A. Tsukahara ◽  
K. Unoda ◽  
K. Yamane ◽  
S. Ishida ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Features ◽  
Late Onset ◽  
Medical College Hospital ◽  
Osaka Medical College ◽  
College Hospital ◽  
Medical College

scholarly journals Acute Kidney Injury in Patients of Intensive Care Unit

2017 ◽  
Vol 8 (1) ◽  
pp. 38-44
Author(s):  
Nazneen Mahmood ◽  
Md Fazlur Rahman ◽  
Md Mostafizur Rahman ◽  
SM Hossain Shahid ◽  
Md Mahmudur Ahman Siddiqui
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Type I ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Failure Group ◽  
Medical College

Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44

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