Clinical and Infective Outcome of Parasitologicaly Confirmed Kala-Azar Patients Treated with Sodium Antimony Gluconate

1970 ◽  
Vol 11 (1) ◽  
pp. 12-16
Author(s):  
Quazi Tarikul Islam ◽  
Ahasan Habib ◽  
Azizul Haque Azad ◽  
HAM Nazmul Ahasan ◽  
Md Mahmudur Rahman Siddiqui ◽  
...  

A total of fifty consecutive cases of Kala-azar admitted in the medicine units of Rajshahi Medical College Hospital during the period from February 2006 to October 2006 were included in this study. The number of the patients clearly indicates that the burden of Kala-azar in this region is significant and expanding. Male to female ratio was 1.9:1. Fever (96%) and splenomegaly (100%) were the predominant features. Hepatomegaly was found in 82% of the cases. Other clinical manifestations were Hyperpigmentation (76%), weight loss (62%), pallor (60%), jaundice (10%), oedema (10%), cough (6%) and lymphadenopathy (4%). Fever of 75% cases subsided within one week of starting treatment. Weight of 89.6% cases increased after completion of treatment. After completion of treatment spleen size regressed in 95.8% cases and no LD (Leishmania donovani) body was seen in 46 (92%) patients splenic / bone marrow aspiration after completion of treatment. 2 (4%) patients remain LD body positive after completion of treatment and 2 (4%) patients died during treatment. Still sodium antimony gluconate (SAG) is very effective in the clinical and parasitologicaly confirmed Kala-azar patients. A combination of sand fly control, early detection and treatment of the patients is the best approach for controlling Kala-azar. Keyword: Kala-azar, Sodium Stibogluconate, LD (Leishmania donovani) body, splenic or bone marrow aspiration. DOI:10.3329/jom.v11i1.4261 J Medicine 2010: 11: 12-16

2019 ◽  
Vol 6 (1) ◽  
pp. 12-15
Author(s):  
Ishrat Sharmin ◽  
AKM Quamruzzaman ◽  
Rezina Parveen ◽  
M Abdulah Yusuf ◽  
Rashida Akter Khanam

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar. Objectives: The aim of the present study was to compare KAtex, Bone marrow aspiration and DAT to diagnose VL. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the Department of Parasitology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala-azar (VL) cases of different age and sex attending IEDCR, Dhaka from different Kala-azar endemic areas of Bangladesh were selected for this study. Patients having fever for more than 2 weeks, with or without splenomegaly, having history of loss of body weight following onset of fever were clinically suspected as Kala-azar cases. Microscopy and culture was performed in bone marrow (BM). KAtex was performed with urine sample. Agglutination of sensitized latex indicated presence of Leishmania donovani antigen in urine and thereby visceral leishmaniasis. No agglutination indicates absence of antigen in urine. DAT was done with serums of all cases. Result: Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60(46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex and DAT. Among 60 BM negative cases, 15 were positive by KAtex and 23 were positive by DAT. The sensitivity of KAtex was 100.0% and specificity was 75.0%. The sensitivity of DAT was 100.0% and specificity is 61.6%. Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL in comparison with DAT. Bangladesh Journal of Infectious Diseases, June 2019;6(1):12-15


2020 ◽  
Vol 32 (1) ◽  
pp. 58-61
Author(s):  
Md Rezaul Karim Chowdhury ◽  
Md Haroon Ur Rashid ◽  
Amina Begum ◽  
Shamimur Rahman ◽  
Md Momenuzzaman Khan

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


2021 ◽  
Vol 8 ◽  
Author(s):  
Jianchun Xiao ◽  
Zixuan Zhao ◽  
Binglu Li ◽  
Taiping Zhang

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.


1970 ◽  
Vol 12 (2) ◽  
pp. 188-190
Author(s):  
Ratan Das Gupta ◽  
Aparna Das ◽  
Titu Miah ◽  
Mohammad Ashik Imran Khan ◽  
Muntasir Hasnain ◽  
...  

Kala Azar is a parasitic disease cause by Leishmania Donovani, transmitted by sand fly phlebotomus. Lymphadenopathy is not a common presentation in Indian Kala azar. We present an adult male from endemic zone of kalaazar presented with epitrochlear lymphadenopathy and hepato-splenomegaly and diagnosed by presence LD in lymphnode biopsy. Keyword: Kala Azar, Lymphadenopathy, Leishmania Donovani (LD) body, Bangladesh DOI: http://dx.doi.org/10.3329/jom.v12i2.8429 JOM 2011; 12(2): 188-190


2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Bai ◽  
Lixia Zhang ◽  
Jiuliang Zhao ◽  
Shangzhu Zhang ◽  
Jiaxin Zhou ◽  
...  

Objectives: This study aimed to describe the main characteristics of Chinese patients with cryoglobulinemia, especially the characteristics of patients with different causes of cryoglobulinemia.Methods: Eighty inpatients diagnosed with cryoglobulinemia from different wards in Peking Union Medical College Hospital were included in this study. Demographic, clinical, biological, and renal pathological data were collected. We analyzed the characteristics of 61 patients with different causes of cryoglobulinemia.Results: Most patients (36/80, 45%) were diagnosed between 40 and 60 years of age. The male: female ratio was 1:1.5. Mixed (II + III) cryoglobulinemia accounted for the majority (43.8%) of cases. Renal involvement (87.5%), cutaneous involvement (57.5%), and fever (27.5%) were the most common clinical manifestations, while other manifestations included serositis and pulmonary and gastrointestinal involvement. The most common renal histopathological pattern was membranoproliferative glomerulonephritis (25/42, 59.5%). The secondary causes of cryoglobulinemia included infectious diseases (26/61, 32.5%), such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and connective tissue diseases (22/61, 27.5%), such as lupus and hematologic tumors (13/61, 16.3%). Patients with hematologic tumors were diagnosed at an older age (P = 0.044) and mostly had type I cryoglobulinemia (P < 0.001). No significant difference in clinical or biological manifestations was found among patients with different causes of cryoglobulinemia.Conclusions: This is the largest cohort of Chinese patients with cryoglobulinemia. We found that renal involvement and HBV infection might be more common in Chinese patients with cryoglobulinemia.


2018 ◽  
Vol 4 (2) ◽  
pp. 45-47
Author(s):  
Ishrat Sharmin ◽  
AKM Quamruzzaman ◽  
Rezina Parveen ◽  
Rashida Akter Khanam ◽  
Md Abdullah Yusuf

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar.Objectives: The aim of the present study was to validate the KAtex method to diagnose VL.Methodology: This was a cross-sectional study carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the department of Parasitology at Institute of Epidemiology, Disease control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala- azar (VL) cases of different age and sex attending IEDCR from different Kala-azar endemic areas of Bangladesh were selected for this study. Microscopy and culture was performed with Bone marrow (BM). KAtex was performed with urine sample. Urine samples taken from cases were pretreated to inactivate heat labile materials which might cause a false positive reaction. Antigen which is detected by KAtex is heat stable carbohydrate antigen. Latex sensitized with antibodies raised against Leishmania donovani antigen was mixed with the urine sample on a glass slide. No agglutination indicates absence of antigen in urine.Result: Cases were 130. Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60 (46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex. Among 60 BM negative cases, 15 were positive by KAtex. The sensitivity of KAtex is 100% and specificity is 75%. Highest percentage (52.86%) of bone marrow positive cases were below 10 years of age group.Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL.Bangladesh Journal of Infectious Diseases, December 2017;4(2):45-47


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4090-4090
Author(s):  
Goksel Leblebisatan ◽  
Ilgen Sasmaz ◽  
Bulent Antmen ◽  
Yurdanur Kilinc ◽  
Umit Sizmaz Celik ◽  
...  

Abstract Objective: Platelet transfusion is used for the treatment of acute hemorrhages in diseases other than immunological events, which lead to severe thrombocytopenia. Besides the diseases in which production of platelets is completely terminated in the bone marrow and the platelet requirement is increased, immune thrombocytopenia and alloimmunization may also result in not being able to achieve the desired platelet levels with platelet transfusion, and life threatening hemorrhages. rFVIIa which is used for the management of life threatening hemorrhages in hemophiliac patients with inhibitors and in cases of acquired coagulopathies has also been used successfully in patients with thrombocytopenia. Here we present a case with a diagnosis of kala-azar, where nasal hemorrhage couldn’t be managed with conventional methods and required continuous replacement, and finally treated successfully by using rFVIIa. Case: At admittance to hospital, hepatosplenomegaly and pancytopenia were detected in the fifteen year old male patient. He was diagnosed with kala-azar upon the detection of Leishmania donovani amastigote form in the examination for bone marrow aspiration. Treatment with sodium stibogluconate was initiated (60 mg/kg). Replacements were performed in the patient due to thrombocytopenia and anemia, who developed nasal hemorrhage during follow-up and had anterior nasal cushion placed. The patient was supplemented with fresh frozen plasma, vitamin K and fibrinogen for his acquired coagulopathy. Since coagulopathy wasn’t corrected and nasal hemorrhage continued actively, 5-minute infusions of rFVIIa were administered to the patient at a dose of 4.8 mg (120 microgram/dl) three times every two hours. His hemorrhage was stopped by rFVIIa treatment. Conclusion: Our case demonstrated that use of rFVIIa for the management of hemorrhage in thrombocytopenic patients is also feasible in cases other than coagulopathy and that it may be an option for patients with hemorrhages that can not be managed with intensive platelet and plasma transfusions. This result shows that rFVIIa can be used effectively in other diseases other than hematological disorders that cause hemorrhage due to coagulopathy and thrombocytopenia.


2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Irfan Khurshid ◽  
Samina Naeem ◽  
Faiza Bashir ◽  
Ayyaz Lone ◽  
Noman Aslam ◽  
...  

Thirty patients of Retinoblastoma presenting in the Haematology Department of King Edward Medical College, Lahore were included in the study to find out the bone marrow involvement. The patients underwent bone marrow aspiration and peripheral blood examination was also done. The aspirates were screened for the presence of tumor cells. Of the patients studied 21(70%) were males while 9(30%) were females giving a male to female ratio of 2.8:1. Maximum number of patients were in the 2-3years age group. Twenty seven patients had unilateral Retinoblastomas while three patients had bilateral disease at presentation. The bone marrow of three patients showed presence of tumor cells.


2020 ◽  
Vol 26 (1) ◽  
pp. 11-17
Author(s):  
Md Kamruzzaman ◽  
Kazi Nurjahan ◽  
AS Gazi Sharifuddin ◽  
SK Ballav

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


Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 509
Author(s):  
Lydia Kossiva ◽  
Athanasios Thirios ◽  
Eleni Panagouli ◽  
Alexandros Panos ◽  
Stavroula Lampidi ◽  
...  

Since the beginning of the COVID-19 pandemic, there have been numerous reports and reviews on the complications caused by the disease, analyzing the acute and chronic consequences. The main symptoms of SARS-CoV-2 are dry cough, fever, and fatigue. COVID-19 appears to affect all systems, including renal, cardiovascular, circulatory, and respiratory systems, causing chronic obstructive pulmonary disease. We report on a 14-year-old male adolescent, who presented with thrombocytopenia (platelet count 92 × 109 /L) and leukopenia (white blood count 4.2 × 103 /μL) that was observed two months ago. Ten days before the first blood test, a viral infection with nasal congestion and runny nose was reported, without other accompanying symptoms. Viral antibodies screening revealed positivity for all the three specific COVID-19 antibodies. Further haematological evaluation with bone marrow aspiration revealed non-specific dysplastic features of the red cell and megakaryocyte progenitors. Although haematological alterations due to COVID-19 infection are available from adult patients’ reports, the effect of COVID-19 infection in the pediatric population is underestimated and this is the first case with such haematological involvement. Noteworthy, in the current case, the impact of the COVID-19 infection was not related to the severity of the disease, as the symptoms were mild. In similar cases, bone marrow aspiration would not be performed as a part of routine work-up. Thus, it is important when evaluating pediatric patients with COVID-19 infection to search and report those alterations in order to better understand the impact and the spectrum of clinical manifestations of the specific viral infection in children and adolescents.


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