scholarly journals A Clinical and Laboratory Profile of Multiple Myeloma

2018 ◽  
Vol 8 (3) ◽  
pp. 159-164
Author(s):  
Md Rezaul Karim Chowdhury
Keyword(s):  
Multiple Myeloma ◽  
Bone Pain ◽  
Radiological Finding ◽  
Clinical History ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Female Ratio ◽  
Medical College ◽  
The Common ◽  
Real Picture

Background: Myeloma, the most common malignant disease of bone, is incurable and occurring with increasing frequency in elderly population. Typical clinical features are weakness, fatigability, bone pain, anemia, renal insufficiency and hypercalcemia. Incidental discovery on comprehensive laboratory panels is common. Serum or urine protein electrophoresis or immunofixation and bone marrow aspirate analysis help the diagnosis of multiple myeloma.Objective: The aim of this study was to define and evaluate the clinico-laboratory features of newly diagnosed adult multiple myeloma (MM) patients in the context of Bangladesh.Materials and Methods: This study was carried out in two centers, from October 2005 to January 2010 in Bangabandhu Sheikh Mujib Medical University (BSMMU) and July 2012 to June 2017 in Enam Medical College and Hospital (EMCH). Thirty two diagnosed valid cases of multiple myeloma were included in this study. Clinical history, physical and relevant laboratory findings were carefully recorded and analyzed.Results: In this study among 32 patients, 29 were males and 3 were females with mean age 51.94 ± 10.09 years. The common complaints were bone pain, weakness and fatigue. The common clinical findings were bone tenderness, pallor and high ESR (ESR of all the study patients was more than 100 mm in 1st hour). Hemoglobin level was <8.5 gm/dL in 13 patients, serum creatinine ≥2 mg/dL in seven patients, serum albumin <30 mg/L in 14 patients and serum β2 microglobulin >5.5 mg/L in 15 patients. Three patients were hypercalcemic. Lytic lesions were the most common radiological finding in the study.Conclusion: This study showed that multiple myeloma is a disease of the middle and elderly aged population with male preponderance, with high male female ratio. Multivenued studies are needed to view the real picture of multiple myeloma in the context of Bangladesh.J Enam Med Col 2018; 8(3): 159-164

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 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 &lt;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.

INCIDENCE OF MALIGNANT KIDNEY TUMOURS IN PAEDIATRIC AGE GROUP

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Ahana Gupta ◽  
Ankita Gupta ◽  
Neelu Gupta
Keyword(s):  
Clinical History ◽  
Malignant Tumour ◽  
Age Group ◽  
Medical College ◽  
Paediatric Age ◽  
The Common ◽  
Patient’S History ◽  
Symptoms And Signs ◽  
Insight Into ◽  
Gross Examination

Background: Cancer is essentially a disease of adults, yet it is one of the common killers in childhood. In western countries cancer is next only to trauma as a cause of mortality in children under 20 years of age In India. Methods: The material for present study is obtained from S. P. Medical College, Bikaner and referred cases for a period of five years from 2011-2014. The clinical history regarding duration of the disease, mode of presentation, symptoms and signs are recorded from the case papers, request forms, patient’s history, clinical data along with relevant details obtained from available hospital and departmental records. The histopathology slides and paraffin blocks are reviewed. Gross examination is done carefully noting the size, shape, extent and configuration, nodularity, consistency (solid, cystic or mixed). A minimum of 4-5 bits are selected from the representative areas of tumor. The tissue for routine microscopy is preserved and fixed in 10% neutral buffered formalin for 24 hours and processed in automatic tissue processor (Histokinette) and embedded in paraffin. The sections 3-5 μ thick, are cut and stained by haematoxylin and eosin in all cases and special stains like PAS, MTS, and RT done where ever feasible Results: The incidence of malignant tumour in our study was 6.66% found. Conclusion: The present study provides a fair insight into the histological patterns of lesion in paediatric age group. Most common incidence was that of wilms tumour in paediatric age group followed by renal cell carcinoma. Imaging and histologic characterization are crucial to avoid any delay in management. Keywords: Malignant, Wilms, Histopatological tumour.

scholarly journals RARE-38. CNS LYMPHOMA INVOLVING HYPOTHALAMIC-PITUITARY AXIS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi229-vi229
Author(s):  
Dong-Won Shin ◽  
Hee Jun Yoo ◽  
Jeong Hoon Kim
Keyword(s):  
B Cell Lymphoma ◽  
Visual Disturbance ◽  
Clinical Findings ◽  
Endoscopic Biopsy ◽  
Cns Lymphoma ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Female Ratio ◽  
Perilesional Edema ◽  
Hypothalamic Pituitary Axis

Abstract BACKGROUND It is rare for CNS lymphoma which involves the hypothalamic-pituitary axis. It could result in misdiagnoses such as pituitary adenoma, craniopharyngioma, or glioma. We report clinical findings of eight cases of either primary or secondary lymphoma involving the hypothalamic-pituitary axis(H-P axis). METHODS We retrospectively reviewed 488 patients who were diagnosed as CNS lymphoma from 2000 to 2017 in our institute. There were eight patients (8/488, 1.6%) who had H-P axis involvement in radiographic findings while six patients received chemotherapy. We analyzed patient characteristics, pathologies, clinical features, laboratory findings, imaging, and treatment outcome. RESULTS The mean age was 48-year-old (range 18~80) and male to female ratio was 5:3. We performed endonasal TSA for four patients, endoscopic biopsy for two patients, and stereotactic biopsy for two patients. There were six patients of diffuse large B-cell lymphoma and two patients of MALT lymphoma. Seven patients were PCNSL and one patient was metastasized lymphoma. All patients had hormone imbalance whereas three patients had visual disturbance and one patient had diabetes insipidus. Initial serum LDH was 337±167IU/L(range 169~567 except one patient). MRI finding was different from the usual pattern which was low SI in T1 and high SI with perilesional edema in T2, on the other hands, our patients group revealed that five patients(62.5%) had iso SI in both T1 and T2, and only two patients(25%) showed perilesional edema in T2. Median OS and PFS of six patients who received chemotherapy were 34.8 months(range 0.9~93.7) and 33.0 months(range 0.9~93.4), respectively. Two patients(25%) died in 26 days and 51 days after diagnosis because of pneumonia and cardiac arrest, respectively. And one patient lost to follow up after diagnosis. CONCLUSION CNS lymphoma involving H-P axis is rare, however, we need to understand its unique characteristic.

scholarly journals Etiological causes of exudative pleural effusion in patients treated in a teaching hospital

Mediscope ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 30-33
Author(s):  
PK Chowdhury ◽  
S Ahmed ◽  
P Biswas ◽  
DK Ghosh ◽  
SMT Alam ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Lupus Erythematosus ◽  
Clinical History ◽  
Complete Recovery ◽  
College Hospital ◽  
Adequate Treatment ◽  
Medical College ◽  
Fluid Analysis ◽  
The Common ◽  
Exudative Pleural Effusion

The aim of this study was to find out the common etiological causes of exudative pleural effusion in patients before starting treatment. Fifty patients, diagnosed with pleural effusion on admission were randomly selected from Medicine and Paediatric wards of Khulna Medical College Hospital during the period from March 2016 to November 2016. Etiological diagnosis was established by sequential clinical history and findings on physical examination, laboratory tests, chest radiograph, CT scan of the chest and pleural fluid analysis. Patients who remained undiagnosed were subjected to fibro-optic bronchoscopy, thoracoscopic pleural biopsy, and histopathology. Among the patients having pleural effusion, there were tuberculosis, pneumonia, malignancy and systemic lupus erythematosus in 27 (54%), 11 (22%), 7 (14%) and 1 (2%), respectively. Despite all investigations, 4 (8%) were remained undiagnosed etiologically. Most of the pleural effusion cases were diagnosed as tuberculosis. Early and adequate treatment resulted in complete recovery of the patients.Mediscope Vol. 4, No. 1: Jan 2017, Page 30-33

scholarly journals Metastatic Pulmonary Calcification in Multiple Myeloma in a 45-Year-Old Man

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Salim R. Surani ◽  
Sara Surani ◽  
Amina Khimani ◽  
Joseph Varon
Keyword(s):  
Multiple Myeloma ◽  
Treatment Options ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Metastatic Calcification ◽  
Pulmonary Calcification ◽  
High Prevalence ◽  
Pulmonary Parenchyma ◽  
Hispanic Male ◽  
Metastatic Pulmonary Calcification

Metastatic calcification has been associated with multiple-myeloma-induced hypercalcemia. Despite of a relatively high prevalence of metastatic pulmonary calcification in patients with multiple myeloma, only a few cases have been clinically and radiologically detected. A 45-year-old Hispanic male presented to the Emergency Department with complaint of worsening weakness and myalgia. Laboratory findings revealed renal insufficiency and hypercalcemia. CT scan of chest revealed calcified pleural and pulmonary nodule. Technetium (Tc) 99 bone scan revealed diffuse activity in the pulmonary parenchyma consistent with metastatic pulmonary calcification. Metastatic pulmonary calcification, despite its high prevalence, remains undetected. This is, in part, due to its radiographic characteristic properties that evade detection by routine imaging studies. We present a case of a metastatic pulmonary calcification in a patient diagnosed with multiple myeloma and chronic kidney disease, as well as a brief literature review including clinical findings and treatment options.

scholarly journals Corneal ulcer: an epidemiological, microbiological and clinical study of cases attending Assam medical college and hospital, Dibrugarh, India

2020 ◽  
Vol 8 (3) ◽  
pp. 1076
Author(s):  
Mamoni Baruah ◽  
Rajiv Kumar Das ◽  
Vijaya Agarwalla ◽  
Pranami Basyach
Keyword(s):  
Corneal Ulcer ◽  
Geographical Area ◽  
Treatment Protocol ◽  
Predisposing Factor ◽  
Female Ratio ◽  
Medical College ◽  
Corneal Ulcers ◽  
The Common ◽  
Etiological Agents ◽  
Male To Female

Background: Corneal ulcer is one of the important ophthalmic conditions causing significant morbidity especially in the developing countries. This study was carried out to evaluate the common etiological agents, predisposing factors, age, gender and occupational distribution and to study the clinical features and management of all corneal ulcers.Methods: A total of 50 cases of corneal ulcers who attended the Ophthalmology outpatient department (OPD) of Assam medical college and hospital, Assam, India, over a 6 months period were included in the study. A detailed history was taken and examination done as per the proforma. Microscopy and culture were performed on all corneal specimens obtained.Results: Corneal ulcers were common in 3rd to 5th decades of life with Male to Female ratio of 1.3:1. Majority of patients were farmers or hired agricultural workers. Ocular trauma was the major predisposing factor in majority of cases (32%). Out of 50 cases, 31 (62%) were culture positive. 19 were bacterial isolates and 12 were fungal isolates. All patients were treated according to standard treatment protocol and majority (95.5%) patients responded well to treatment.Conclusions: This study has revealed that suppurative corneal ulcers are caused by both bacterial and fungal agents with bacterial preponderance in this geographical area. Early and accurate diagnosis and intensive treatment is the need of hour for saving the eye and preventing the catastrophe of lifelong blindness.

Clinico-epidemiologic characteristics of the 2019 dengue outbreak in Bangladesh

2020 ◽  
Author(s):  
Mohammad Jahid Hasan ◽  
Tamanna Tabassum ◽  
Mohiuddin Sharif ◽  
Mohammad Abdullah Saeed Khan ◽  
Akhi Roy Bipasha ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Clinical Findings ◽  
Immunoglobulin M ◽  
Laboratory Findings ◽  
Case Record ◽  
Medical College ◽  
Dengue Outbreak ◽  
Clinical Presentations ◽  
Pain Symptoms

Abstract Background Dengue fever shows a broad range of clinical presentations worldwide. Here we report on our clinical findings during the 2019 dengue outbreak in one of the largest tertiary care hospitals in Dhaka, the capital of Bangladesh. Methods A total of 747 suspected dengue cases (553 confirmed and 194 probable) were interviewed with a pro forma case record form. Statistical analyses were conducted using SPSS 20.0. Ethical clearance was obtained from the Dhaka Medical College. Results The mean age of the dengue cases was 27 y and approximately two-thirds were male. Positive tests for NS1 and anti-dengue immunoglobulin M antibody were present in 91.9% and 59.4% of the cases, respectively. Thrombocytopenia was present in 69% of cases and fever was present in 99.1% of cases. Gastrointestinal (GI) features, including anorexia and/or vomiting (69.4%), abdominal pain (39.8%) and diarrhoea (25.6%), were more prevalent than typical rash and pain symptoms. Hypotension was present in approximately one-quarter of patients (25.4%). Probable and confirmed dengue cases have shown similar clinical characteristics and laboratory findings. Conclusions The 2019 outbreak of dengue fever in Bangladesh was characterized by increased presentation with GI features. Recognition of this trend would permit early diagnosis and proper management of patients.

scholarly journals Study on Diagnostic Evaluation of Pancytopenic Patients

2020 ◽  
Vol 32 (1) ◽  
pp. 58-61
Author(s):  
Md Rezaul Karim Chowdhury ◽  
Md Haroon Ur Rashid ◽  
Amina Begum ◽  
Shamimur Rahman ◽  
Md Momenuzzaman Khan
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Clinical Findings ◽  
Medical College Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Presenting Symptoms ◽  
Erythroid Hyperplasia ◽  
Medicine Today

Introduction: Pancytopenia is a common hematological problem with an extensive differential diagnosis and is a challenging problem to the treating physician. Bone marrow aspiration and biopsy is an important diagnostic test for patient management. The objective of this study is to find out the incidence various causes of pancytopenia in patients attending to the Enam medical college hospital in savar. Materials and Methods: This prospective observational study was done in the department of haematology, Enam Medical College Hospital (EMCH) from July 2012 to June 2019. Results: In our study out of 66 patients, 36 (54.55%) were male, 30 (45.45%) were female and male to female ratio were 1.2:1.Generalized weakness 47 (71.21%) and fever 23 (34.85%) were the most common presenting symptoms followed by bleeding 17 (25.76%), weight loss 6 (12.12%), bodyache 6 (9.09%). Most common clinical findings were anemia 57 (86.36%) and bone tenderness 22 (33.33%). Other physical findings were purpura/brusing 13 (19.70%), splenomegaly 10 (15.15%), lymphadenopathy 4 (6.06%) and hepatomegaly 3 (4.55%). Hematological malignancy 29 (43.94%) and hypoplastic marrow 26 (39.39%) were the most common bone marrow finding of pancytopenic patients followed by megaloblastic anaemia 4 (6.06%), leishmaniasias 5 (7.58), and erythroid hyperplasia 2 (3.03%). Acute myeloid leukaemia was the common haematological malignancy 16 (24.24%), others were acute lymphoblastic leukaemia 5 (7.58%). Myelodysplastic syndrome 3 (4.55%), multiple myeloma 4 (6.06%), chronic myelogenous leukaemia in blastic crisis 1 (1.52%). Conclusion: So we concluded that complete workup is essential for all cases of pancytopenia to find out the treatable cases and to reduce the motality and morbidity in serious diseases. Medicine Today 2020 Vol.32(1): 58-61

Qualitative platelet defect and thrombohaemorrhagic complications in a patient with polycythaemia vera

2003 ◽  
Vol 23 (03) ◽  
pp. 138-143 ◽  
Author(s):  
D. Friess ◽  
B. Lämmle ◽  
L. Alberio
Keyword(s):  
Antiplatelet Agents ◽  
Clinical History ◽  
Myeloproliferative Disorders ◽  
Clinical Findings ◽  
Clear Correlation ◽  
Polycythaemia Vera ◽  
Laboratory Findings ◽  
Pathophysiological Mechanisms ◽  
Cytoreductive Treatment ◽  
History Of

SummaryWe describe a 67-year-old patient with polycythaemia vera and pathological functional platelet studies. He not only suffered a transient ischaemic attack despite taking of antiplatelet agents, but also showed bleeding diathesis with cerebral bleeding and spontaneous suffusions. Platelet function studies and clinical findings improved after phlebotomy and cytoreductive treatment with hydroxyurea.Thrombosis and haemorrhage account predominantly for morbidity and mortality in patients with polycythaemia vera. The pathophysiological mechanisms to explain thrombosis and bleeding in patients with myeloproliferative disorders including polycythaemia vera were intensively studied. However, up to now no clear correlation of laboratory findings in relation to clinical history of thrombosis and bleeding was demonstrated. In this report the most important pathophysiological mechanisms and therapy with antiplatelet agents are discussed.

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