Renal Involvement and HBV Infection Are Common in Chinese Patients With Cryoglobulinemia

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.

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

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v29i2.7952 ◽

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)

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Primary Retroperitoneal Ganglioneuroma: A Retrospective Cohort Study of 32 Patients

Frontiers in Surgery ◽

10.3389/fsurg.2021.642451 ◽

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.

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Acute Kidney Injury in Patients of Intensive Care Unit

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v8i1.31656 ◽

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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Intranasal Splint in Nasal Septal Surgery: Is It Necessary?

Medicine Today ◽

10.3329/medtoday.v32i2.48835 ◽

2020 ◽

Vol 32 (2) ◽

pp. 126-129

Author(s):

Jahangir Alam Mazumder ◽

Md Golam Mustafa ◽

AHM Delwar ◽

Shazibur Rashid ◽

Md Mostafizur Rahaman ◽

...

Keyword(s):

Complete Healing ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Septal Surgery ◽

Significant Difference ◽

Group A ◽

Medicine Today ◽

Group B ◽

Male To Female

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified. Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities. Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%). Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation. Medicine Today 2020 Vol.32(2): 126-129

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Renal Function Evaluation of Hypertensive Patients by Renogram in a Teaching Hospital

Faridpur Medical College Journal ◽

10.3329/fmcj.v11i1.30871 ◽

2016 ◽

Vol 11 (1) ◽

pp. 11-14

Author(s):

Jayanta Kumar Saha ◽

ARM Saifuddin Ekram ◽

Mohammed Shahadat Hossain ◽

ATM Ataur Rahman ◽

Prodip Kumar Biswas ◽

...

Keyword(s):

Renal Function ◽

Renal Involvement ◽

Public Health Problem ◽

Function Evaluation ◽

Major Public Health Problem ◽

College Hospital ◽

Cross Sectional ◽

Female Ratio ◽

Hypertensive Patients ◽

Medical College

Arterial Hypertension is the most common cardiovascular disease and is a major public health problem in both developed and developing countries. The aim of the study was to assess renal involvement in hypertensive patient by renogram, which is not detected by conventional biochemical test. This was a cross sectional observational study. Consecutive 30 hypertensive patients admitted in the medicine wards from March, 2006 to April, 2007 in Rajshahi Medical College Hospital, Bangladesh were taken as case. Informed consent was taken from all the study patients or from their attendants. Detail history was taken from each patient or from their attendants' then clinical examination and relevant investigations were done. Emphasis was laid to find out renal involvement in long standing hypertensive patients by renogram. After initial selection; laboratory investigations like Urine for R/M/E, Blood Sugar 2ABF, S. Creatinine, USG of KUB, ECG and Hb% were done for every patients. All patients included in this study renogram were done. Majority of the patient (40%) were between the age of 41-50 years and Male: Female ratio was 3:2. Most of the patient lead a moderately active life (66.67%). Serum Creatinine was raised in 23.33% patient whereas renal parenchymal insufficiency evidenced by renogram was found in 50% case. In this study, we found that a significant number of cases (26.67%) having renal parenchymal insufficiency were not detected by S. Creatinine level, but detected by renogram. Renogram is superior to conventional biochemical renal function test for early detection of hypertensive nephropathy.Faridpur Med. Coll. J. Jan 2016;11(1): 11-14

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

Journal of Medicine ◽

10.3329/jom.v11i1.4261 ◽

1970 ◽

Vol 11 (1) ◽

pp. 12-16

Author(s):

Quazi Tarikul Islam ◽

Ahasan Habib ◽

Azizul Haque Azad ◽

HAM Nazmul Ahasan ◽

Md Mahmudur Rahman Siddiqui ◽

...

Keyword(s):

Bone Marrow ◽

Leishmania Donovani ◽

Clinical Manifestations ◽

Bone Marrow Aspiration ◽

Sand Fly ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Kala Azar ◽

Sodium Antimony Gluconate

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

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Epidemiological Pattern of Renal Insufficiency among the Patients of Nephrology Unit of Dhaka Medical College Hospital, Dhaka, Bangladesh

Faridpur Medical College Journal ◽

10.3329/fmcj.v8i2.20391 ◽

2014 ◽

Vol 8 (2) ◽

pp. 80-84

Author(s):

Md Nazmul Haq ◽

Latifur Raaman ◽

Md Zohirul Islam Miah ◽

Easin Ali Gazi ◽

Shukti Catherine Baroi

Keyword(s):

Renal Insufficiency ◽

Medical College Hospital ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Throat Infection ◽

Ckd Stage ◽

Significant Difference ◽

History Of ◽

Epidemiological Pattern

A hospital based descriptive cross sectional study was conducted at Nephrology unit of Dhaka Medical College Hospital (DMCH) to see the association between epidemiological pattern of renal insufficiency with sociodemographic factors, kidney related factors and others factors. Sources of data include patient interviews, diagnosis cards and case records. Respondents were categorized to their CKD stage according to their estimated GFR on Modification of Diet in Renal Disease (MDRD). The sample comprised 150 patients suffering from CKD with male and female ratio being 1.5:1, mean age of the population was 47 years (SD ± 14.5), 47.3% of the respondents had history of streptococcal throat infection and 10% had previous kidney disease Renal Replacement Therapy (RRT) was the commonly advised therapy for CKD indicating very late diagnosis of CKD. Total 49.3% had smoking habit while 60.7% was on regular physical exercise and 49.3% took extra salt on their dietary habit, 52.7% were diabetic and 78.7% were hypertensive and 40% had both diabetes and hypertension. Total 76.6% were in stage-5 of CKD where 60.7% of them used NSAID with 54.0% within normal range of BMI. There is statistically significant difference with stage of renal insufficiency and history of streptococcal throat infection (p=0.00) and therapy advised for CKD (P-0.01). Worldwide, CKD is becoming a common disease in the general population. It requires early, accurate and improved detction and mangemnt of diabetes and hypertension, the major contributors to CKD. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20391 Faridpur Med. Coll. J. 2013;8(2): 80-84

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Utility of Tolonium Chloride Rinse in the Diagnosis of Oral Cancer

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v26i1.47947 ◽

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

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Evaluation of the Severity of Major Depression Using a Voice Index for Emotional Arousal

Sensors ◽

10.3390/s20185041 ◽

2020 ◽

Vol 20 (18) ◽

pp. 5041

Author(s):

Shuji Shinohara ◽

Hiroyuki Toda ◽

Mitsuteru Nakamura ◽

Yasuhiro Omiya ◽

Masakazu Higuchi ◽

...

Keyword(s):

Rating Scale ◽

Area Under The Curve ◽

Emotional Arousal ◽

Arousal Level ◽

National Defense ◽

College Hospital ◽

Medical College ◽

National Defense Medical College ◽

Significant Difference ◽

The Relationship

Recently, the relationship between emotional arousal and depression has been studied. Focusing on this relationship, we first developed an arousal level voice index (ALVI) to measure arousal levels using the Interactive Emotional Dyadic Motion Capture database. Then, we calculated ALVI from the voices of depressed patients from two hospitals (Ginza Taimei Clinic (H1) and National Defense Medical College hospital (H2)) and compared them with the severity of depression as measured by the Hamilton Rating Scale for Depression (HAM-D). Depending on the HAM-D score, the datasets were classified into a no depression (HAM-D < 8) and a depression group (HAM-D ≥ 8) for each hospital. A comparison of the mean ALVI between the groups was performed using the Wilcoxon rank-sum test and a significant difference at the level of 10% (p = 0.094) at H1 and 1% (p = 0.0038) at H2 was determined. The area under the curve (AUC) of the receiver operating characteristic was 0.66 when categorizing between the two groups for H1, and the AUC for H2 was 0.70. The relationship between arousal level and depression severity was indirectly suggested via the ALVI.

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Occupational Stress among Nurses in a Public Medical College Hospital

Delta Medical College Journal ◽

10.3329/dmcj.v6i2.38218 ◽

2018 ◽

Vol 6 (2) ◽

pp. 86-89

Author(s):

Shila Rani Das ◽

Chinmay Biswas ◽

Sharmina Afrin

Keyword(s):

Occupational Stress ◽

Family Income ◽

High Stress ◽

Clinical Work ◽

Medical College Hospital ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Work Related ◽

Significant Difference

Background: Now a days, there is increased demand and progress in the nursing profession. Along with these stress among the nurses has also increased.Objective: Purpose of the study was to assess the extent of perceived occupational stress and its association with work-related and non-work related causes among nurses.Materials and method: This Cross-sectional study was carried out among 197 nurses of Shaheed Suhrawardy Medical College hospital (ShSMCH), Dhaka, Bangladesh, from the period of 1st July 2015 to 30th June 2016. Sampling method was simple random sampling. Data was collected by face to face interview with the help of semi-structured questionnaire and finally all data were analyzed using SPSS software version 21.Results: It was found that 69% nurses were between the age of 21 to 39 years, 94.9% were female, 68% were married, 79.2% were Muslim, 84.3% had diploma, family income of 91.4% were equal to more than 40,000 Tk. and 95.5% used to do clinical work. Only 5.1% found to experience high stress. Statistically significant difference was found between sex, occupational stress and religion, educational status, and type of work (p < 0.05). Few nurses suffered from high stress but high level of stress were more in male, non Muslim, post graduate nurse and those who were engaged in administrative work.Conclusion: Nurse Managers should take appropriate actions to decrease stress helping their nurses to work efficiently and effectively.Delta Med Col J. Jan 2018 6(2): 86-89

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