scholarly journals Response of systemic PUVA in vitiligo - experience with 25 cases in Combined Military Hospital, Dhaka

2015 ◽  
Vol 10 (1) ◽  
pp. 29-33
Author(s):  
ATM Rezaul Karim ◽  
Md Abdul Latif Khan ◽  
Md Sayeed Hasan ◽  
Moyassaque Ahmed ◽  
Shirajul Islam Khan ◽  
...  

Introduction: It is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. As a result, white patches appear in the skin in different parts of the body. Objective: The objective of this study is to see the efficacy of systemic PUVA in the treatment of vitiligo patient. Methods: This is an prospective longitudinal interventional study, carried out in the depigmented area was assessed according to the department of Dermatology and Venereology, Combined Military Hospital, Dhaka in between the duration of April 2010 to March 2011. Total 25 vitiligo patients based on inclusion criteria like patient with vitiligo affecting more than 5% body surface area, patient having ivory- white fluorescence on Wood’s lamp, patient who was above 15 years of age, patient who had given written consent, patient was not taken any previous treatment etc. Results: This study showed the therapeutic response of study group after 04 weeks of therapy, 05 (20%) patients responsed Fair, 15 (60%) patients responsed Poor and no responsed by 05 (20%) patients. Therapeutic response of study group after 08 weeks of therapy showed that 15 (60%) patients responsed Fair and 10 (40%) patients responsed Poor. It was observed after 12 weeks of therapy that 13 (52%) patients responsed Poor followed by 10 (40%) patients responsed Fair and 02 (08%) patients responsed well. 29 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Therapeutic response of study group after 16 weeks of therapy was 15 (60%) patients responsed Fair, followed by 06 (24%) patients responsed Poor and 04 (16%) patients responsed Good. It was showed that after 20 weeks of therapy 13 (52%) patients responsed Fair, followed by 08 (32%) patients responsed Good, 03 (12%) patients responsed Poor and 01 (04%) patients responsed Excellent. It was observed that after 24 weeks of therapy 12 (48%) patients responsed Good, followed by 08 (32%) patients responsed Fair, 03 (12%) patients responsed Poor and 02 (08%) patients responsed Excellent. Conclusion: Systemic PUVA for the repigmentation of vitiligo seems to be effective. Study needs large number of patients for longer period of duration for confirmation of results. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22900 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

2015 ◽  
Vol 10 (1) ◽  
pp. 93-98
Author(s):  
Md Mostafil Karim ◽  
Shahina Akhter ◽  
Mushtaq Ahmad

Introduction: The lymphoma’s are a group of malignant disease that originate from uninhibited growth of cellular elements normally found in lymphatic tissue. All forms of lymphoma have the potential to spread from their origin in a single node or chain of nodes to other nodes and eventually to disseminate to spleen, liver and bone marrow. Objective: To assess the response rate and to evaluate the toxicity and safety of CHOP regimen. Methods: In this study 50 cases were selected of all age irrespectively and both sexes diagnosed at Combined Military Hospital, Dhaka. A prescribed proforma was used for each patient. It included particulars of the patient, history, physical findings, laboratory investigations (biopsy, cytology, and bone marrow study), ultrasonography and CT-scan in appropriate cases. Results: In this study, starting from July 2009 to June 2010, 50 patients were included. Out of them, 30 patients (60.00%) achieved complete remission, 12 patients (24.00%) had partial remission. Overall responses were 84 percent and 8 patients (16.00%) were non-responder. Two patients (4%) of non-responder died during chemotherapy. Conclusion: In this study a significant number of patients achieved complete and partial remission. The response was rapid and most of the patients achieved complete or partial remission after receiving only 2-3 cycles of therapy. Considering the toxicities, the patients were well-tolerated to CHOP regimen. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22932 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014


Author(s):  
Paul B. Chapman

INTRODUCTION In recent years the expectation related to treating patients with metastatic melanoma has changed. Three years ago, a diagnosis of metastatic melanoma was bleak; only a small number of patients would benefit from standard treatment and the reason for treatment benefit was often unknown, leaving physicians with limited options to help their patients. Today, just 3 years later, there are proven therapies that allow physicians to expect to shrink tumors and extend the lives of their patients after diagnosis. In this article, Paul B. Chapman, MD, Memorial Sloan Kettering Cancer Center, summarizes the recent advances in the field of metastatic melanoma and looks ahead to topics such as focusing on specificity, shutting down the ERK pathway, intermittent dosing, discovering driver mutations, individualizing checkpoint inhibition, and identifying rejection antigens to identify what should occur next in order to continue to improve outcomes for a larger population of patients with metastatic melanoma. Dr. Chapman's paper reminds us of the exciting progress that has been made while focusing on the work that is left in the field. Dr. Chapman is a physician-scientist who specializes in diagnosing and treating melanoma that has metastasized to other parts of the body. Dr. Chapman led a clinical trial that paved the way, in part, to the approval of vemurafenib—a drug that targets a BRAF mutation that is present in approximately 50% of patients with metastatic melanoma. Dr. Chapman is one of five Memorial Sloan Kettering scientists to be appointed to a melanoma “Dream Team” that focuses on identifying potential therapies for metastatic melanoma patients who do not have the mutated form of the BRAF gene. Dr. Chapman is also a professor of medicine at the Weill Cornell Medical College and is the chair of the Melanoma Research Alliance Medical Advisory Board. In addition to the above, Dr. Chapman is a sought-after mentor for medical oncology fellows and has a current research interest in identifying novel means to more durably block signaling in the MAPK pathway in melanoma cells. Jedd Wolchok, MD, PhD, Scientific Program Committee Chair


2019 ◽  
Vol 14 (1) ◽  
pp. 41-45
Author(s):  
SM Nurul Irfan ◽  
Md Mahbubur Rahman ◽  
Sangita Mithun ◽  
SM Yasir Arafat ◽  
Farzana Zafreen

Introduction: Infertility is an increasingly prevalent condition which causes considerable psychological problems among infertile couples. Objective: To assess the psychological state of infertility in terms of depression, anxiety and stress among the infertile couples of Bangladesh. Materials and Methods: This cross-sectional study was conducted in the fertility centre of Combined Military Hospital, Dhaka from January to July 2018 among purposively selected 112 infertile couple. Data were collected by face to face interview through a pretested semi-structured Bangla questionnaire of Depression-Anxiety-Stress Scale and analyzed by computer software SPSS 19.0. Results: Among the 112 infertile couples, depression was found among 54.5%, anxiety among 53.6% and stress in 30.4% of females. Whereas among males depression was found in 38.4%, anxiety 26.8% and stress 21.4%. This study also revealed that couples with primary infertility had more depression, anxiety and stress than others. Conclusion: Females have been psychologically more affected than their husbands due to infertility. More than half of the females had depression and anxiety and about one third was affected by stress which was higher than their husbands. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 41-45


2016 ◽  
Vol 12 (2) ◽  
pp. 66-70
Author(s):  
Md Shameem Haidar ◽  
Md Abdur Razzak

Introduction: The seronegative arthritis is a heterogeneous group of inflammatory rheumatic diseases with predominant involvement of axial, peripheral joints and enthesitis. All of these have some distinct as well as some overlapping features, characteristic peripheral asymmetrical lower limb involvement and a negative rheumatoid factor. Involvement of joints is usually oligoarticular but rarely polyarthritis may be present. Diagnosis is usually made from clinical features rather than investigations. Objective: To evaluate the seronegative arthritis clinicopathologically by collecting and analyzing the relevant informations. Materials and Methods: A descriptive cross-sectional prospective study was conducted at Combined Military Hospital, Chittagong from November 2015 to October 2016. A total 74 patients of suspected seronegative arthritis were included. Detail socio-demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigations were done meticulously to confirm the aetiology of seronegative arthritis. Results: Maximum number of patients was in the 3rd to 4th decade (62.1%), mean age of the patient was 37.4±8.7 and 38.7±8.1 years in male and female respectively. Malefemale ratio was 2.65:1. Symmetrical sacroiliitis was found in 15(20.2%) patients, asymmetrical sacroiliitis in 36(48.6%) and in 23(31.2%) cases sacroiliac joint was not involved. Common aetiology for seronegative arthritis showed that, reactive arthritis recognized in majority of patients 29 (39.1%) and second most common cause was seronegative rheumatoid arthritis in 23(31%) patients. Conclusion: The Seronegative arthritis is a social, economical and health-care burden. Patients who develop 66 JAFMC Bangladesh. Vol 12, No 2 (December) 2016 arthritis have high disability, discomfort and loss of quality of life. Seronegative arthritis is an interesting group of related conditions with overlapping features and genetic and familial association. That may alert the primary care physician to attain possible diagnosis of spondyloarthritis and to consider a rheumatological opinion. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 66-70


2015 ◽  
Vol 10 (2) ◽  
pp. 39-43
Author(s):  
Azizun Nessa ◽  
Md Amzad H Fakir

Introduction: In military environment where musculoskeletal injury is more common, NSAIDs abuse and subsequent AKI carries a special risk. This study of NSAIDs induced AKI was carried out to highlight this issue.Objective: To find out the incidence, risk factors, diagnostic approach, clinical course, management and outcome of patients of Bangladesh Armed Forces.Methods: This longitudinal study was carried out in nephrology centre, combined military hospital (CMH) Dhaka from July 2010 to Jun 2013. Total 59 patients of NSAIDs induced AKI were included in this study. Any patient having pre existing renal pathology or chronic kidney disease was excluded from the study.Results: Total 59 patients were included in this study. Mean age of the patient was 36±7.12 yrs. Forty five patients (76.27%) took NSAIDs at their own and 14 patients (23.73%) were prescribed by physician. Fifty one patients (86.44%) took NSAIDs because of musculoskeletal pain. Dehydration due to physical exertion (30.50%), gastroenteritis (15.25%) and nil per os (NPO) (5.08%) were the common predisposing factors. Common symptoms were swelling of the body (40.67%), headache (32.20%), fatigue (27.11%) and vomiting (13.55%). Oedema was the most common sign (40.67%). Blood urea and serum creatinine were raised in all patients. Treatment includes drug withdrawl (100%), fluid resuscitation (86.44%), fluid restriction (61.01%), short course of steroid (13.55%) and haemodialysis (10.16%). Forty seven patients (79.66%) had complete recovery within two weeks of therapy whereas nine patients (15.25%) required more than two weeks to one month for complete recovery. Three patients (5.09%) developed chronic kidney disease (CKD).Conclusion: NSAIDs induced AKI carries a good prognosis with early diagnosis and proper management and it can be prevented by limiting the availability of over the counter drugs and creating awareness both in physicians and patients.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014


2016 ◽  
Vol 12 (2) ◽  
pp. 71-75
Author(s):  
Md Niamul Gani Chowdhury ◽  
Mohammad Enamul Hoque ◽  
Md Abdul Latif Khan ◽  
Md Shirajul Islam Khan

Introduction: The Severe Cutaneous Adverse Drug Reactions (SCADRs) are rare but life-threatening as these encompass drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and acute generalized exanthematous pustulosis (AGEP). Objective: To estimate the incidence of SCADRs and to find out the cause in Bangladesh. Materials and Methods: 50 patients with SCADRs were studied over a period of 1 year from January 2015 to December 2015 in the Department of Dermatology, Combined Military Hospital, Dhaka. Data were collected from the informant and recorded in structured Case Report Form. Quantitative data were expressed as mean and standard deviation and qualitative data as frequency and percentage. Results: Clinical diagnosis of the study subjects recognized 46.0% cases as SJS, 28(19.0%) as TEN, 16.0% as DRESS and 10.0% as AGEP. The maximum incidence (46%) was seen in the age group of 31-50 years; mean age of the patient was 37.42+5.3 years. Male and female ratio was 2.84:1. Anticonvulsant group of drugs could give rise to maximum incidence of SCADRs. Carbamazepine was responsible in 22.0% cases of SCADRs, followed by Phenytoin in 16.0% patients and Phenobarbital in 14.0% cases. Conclusion: SCADRs were seen mostly with the anticonvulsant drugs belonging to Carbamazepine and Phenytoin group. SCADRs deserve continuous monitoring to plan preventive strategies. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 71-75


2020 ◽  
Vol 14 (2) ◽  
pp. 200-202
Author(s):  
Feroz Ahmed Sohel ◽  
Sanzida Jahan ◽  
Saifullah Russel ◽  
Farzana Zafreen

Introduction: Abortion in Bangladesh is illegal under most situations, but menstrual regulation is often used as a substitute. Abortion can be legally performed by a physician in a hospital if it is necessary to save the life of the mother. A person, who performs an abortion under any other circumstances, including a woman who self-aborts, can be punished by a fine and imprisonment. Objective: To assess the socio-demographic profile of abortion cases attending a tertiary level hospital of Bangladesh. Materials and Methods: This cross-sectional descriptive type of study was carried out among 80 patients at the Gynae ward and out patient department of Dhaka Medical College Hospital from March 2012 to June 2012. The study population was women attending the selected hospital for an abortion or abortion-related complications. Results: Most of the respondents 35(43.8%) were below 25 years of age and all patients were housewives. The maximum number of patients 63(78.8%) had spontaneous abortion, low socio-economic status and majority were multigravidas. It was also found that patients with abortion were mostly in their second (43.8%) and third (21.3%) decade of life. Conclusion: In this study, the commonest reason for termination of pregnancy was unplanned pregnancy. Creating awareness and timely intervention might decrease the number of abortion cases. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 200-202


2016 ◽  
Vol 12 (2) ◽  
pp. 98-101
Author(s):  
Md Ershad Ul Quadir ◽  
Md Mahbubur Rahman ◽  
Md Tanvirul Islam ◽  
SM Shakhawat Hosssain

Introduction: Haemorrhoid is the frequent problem in clinical practice of general surgery. Haemorrhoids are dilatation and tortuosity of rectal veins affecting almost 4.5% of the population. Various operative and non operative therapeutic options are in practice to treat haemorrhoids, yet none has been proven cent percent effective. Sclerotherapy is a simple, safe and cost effective procedure that is widely practiced globally to treat haemorrhoids. Many sclerosants are being used with variable efficacies. Objective: To evaluate the outcome of injection Sclerotherapy in first degree and second degree haemorrhoids. Materials and Methods: Fifty patients of both gender having haemorrhoids who attended Outpatient Department (OPD) at BNS Patenga from September 2013 to August 2014 were included in this study. On the basis of history, patients were selected for Digital Rectal Examination (DRE) and proctoscopic examination to confirm the diagnosis. Sclerotherapy was repeated at interval of 6 weeks till symptomatic relief was achieved. Maximum 3 sittings of sclerotherapy were given. Patients were followed up at 3 months interval for 1 year. Results: This prospective study was conducted on 50 cases of first degree and second degree Haemorrhoids. The highest number of patients 21(42%) were in the age group of 21-30 years with majority 38(76%) being male. Male female ratio was 3.16: 1. All the patients presented with painless per-rectal bleeding. Satisfactory results were observed in 29(58%) patients of whom 20(40%) patients were having first degree haemorrhoids and 9(18%) patients were having second degree haemorrhoids. Sclerotherapy was more effective in first degree compared to second degree haemorrhoids patients. Conclusion: Injecting Sclerotherapy is a suitable office procedure for treatment of haemorrhoids. The method is easy, convenient, cheap, well accepted and comfortable for patient. More or less there are no complications and the result is also satisfactory. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 98-101


2020 ◽  
Vol 15 (1) ◽  
pp. 61-63
Author(s):  
Md Rezaur Rahman ◽  
Umar Rashed Munir ◽  
Farzana Zafreen ◽  
Md Abdul Wahab

Introduction: MRI investigation indicates sensitivity as well as specificity. The increasing clinical utility, coupled with the greater availability and capacity to per¬form, has resulted in a dramatic increase in their use over the past de¬cades. The expectation of the care seekers has also increased and it is a major concern whether this increase in MRI result has improved patient outcomes or not. Objective: The study was carried out with the aim to evaluate various aspects of satisfaction among the MRI performing patients at Combined Military Hospital, Dhaka. Materials and Methods: This descriptive cross sectional study was carried out on patient satisfaction of MRI services at CMH, Dhaka. A total of 186 patients performing investigation at MRI Department of CMH Dhaka since 01st May 2011 to 15th May 2011 were interviewed. Data were collected and analysed by face-to-face interview and reviewing medical record with the help of a questionnaire and checklist. Results: The waiting time of 8-12 weeks for MRI was maximum among 24.7% patients; followed by 17.7% for 2-4 weeks and 16.1% for 1-2 weeks. It also revealed that waiting time was higher (8-12 weeks) in Neurosurgery referred cases (33.3%), Orthopaedic (28.2%) followed by Neurology (14.3%) (p<0.05). The outdoor patients experienced more waiting time in comparison to indoor patients. Orthopaedic referred cases had the highest (53.8%) positive finding followed by Neurosurgery (15.1%) and Medicine (7.5%). A significant majority of the patients are satisfied (68.81%) or very satisfied (25.80%) with the MRI service. Conclusion: This study finding will help the hospital administrator not only in monitoring the investigation but also to take measures to improve the facilities of MRI department. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 61-63


2015 ◽  
Vol 9 (2) ◽  
pp. 43-48
Author(s):  
Nazmul Huda Khan ◽  
Mushtaq Ahmad ◽  
Farial Naima Rahman ◽  
Mohammad Ali ◽  
Mahbubur Rahman

Introduction: Armed Forces personnel suffer from various patterns of injuries during their military training activities which may lead to considerable mortality & morbidity. The high incidence of injuries places a substantial burden on the health care delivery system. Successful treatment outcome and modifications can reduce the operational, fiscal, and health impact of these problems. Objective: To find out the types, causes and morbidity pattern of common injuries received by the members of Bangladesh Armed Forces during their military activities. Methods: This is a descriptive retrospective study carried out to explore the injuries amongst Bangladesh Armed Forces personnel due to military duties. The study population (193) included all injured indoor cases treated in Combined Military Hospital (CMH) Dhaka during the period of January 2009 to December 2009. Data was collected by reviewing the case sheets of patients and analyzed with the help of SPSS Version 11.5. Results: Numbers of Injured subjects amongst the Army personnel were 132(68.4%) followed by 34(17.6%) in Navy and 27(14%) in Air Force. Among them 82(42.5%) belonged to fighting group, 50(25.9%) supporting and 61(31.6%) service group. Knee injury constituted the highest number of patients i.e. 43(22%), followed by 43 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 33(17%) Armand 25(13%) foot injuries. About one fourth, 53(27.5%) cases sustained injury in sports ground followed by 50(25.9%) in operation area and 28(14.5%) in training ground. Physical training events PT/Drill caused maximum injury 7(3.6%) followed by crossing 6ft wall 5(2.6%), horizontal rope 4(2.1%). Maximum duration of hospital stay among the cases were 1-2 weeks in 65(33.7%) followed by 3-4 weeks in 56(29%) and 1-3 months in 41(21.2%) cases. Eighty two (42.5%) injured cases suffered for 3 to 6 months followed by 43(24.4%) for 6 months to1 year. Out of all cases 72(37.3%) were recommended for medical category C, 2(1%) for category B, 11(5%) were Medically Boarded Out (MBO). Conclusion: The study revealed that musculoskeletal injuries especially in knee, foot, shoulder, forearm, ankle, lower leg and patella are prevalent in armed forces personnel. The high incidence of injuries places a substantial burden on the health care delivery system and leads to many lost training days. Careful study and analysis in this regard definitely will explore new dimension to prevent and combat this preventable health burden. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21825 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013


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