Abstract

Background: Amyotrophic lateral sclerosis (ALS) disease which is also known as motor neuron disease (MND) or Lou Gehrig's disease, is causes the death of neurons controlling voluntary muscles. There may have association of serum uric acid, homocystine and ferritin with amyotrophic lateral sclerosis. But we have not enough data regarding these issues. The aim of this study was to evaluate the association of serum uric acid, homocystine and ferritin with amyotrophic lateral sclerosis.Methods: It was a case-control study conducted in the department of neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2010 to December 2011. Finalized 76 study people were divided into two equal groups containing 38 participants in each. In group I (case group) there were 38 patients with ALS and in group II (control group) there were 38 healthy people. The correlation of annual decline of ALS Functional Rating Scale-Revised (ALS-FRS) and forced vital capacity (FVC) were analyzed. Data were collected through pre-designed questioners and processed and analyzed by using SPSS version 11.5.Results: In this study the inverse correlation between serum uric acid and the annual decline of ALS-FRS in male, spearman rho correlation was -0.37 (p<0.01) and in female it was -0.78 (p<0.001). The inverse correlation between serum uric acid and the annual decline of FVC were in male, spearman rho correlation was -0.33 (p<0.05) and in female it was -0.39 (p<0.05). Inverse correlation between homocystine and the annual decline of ALS-FRS in male, spearman rho correlation was -0.42 (p<0.02) and in female, it was -0.64 (p<0.001). The inverse correlation between homocystine and the annual decline of FVC in male, spearman rho correlation was -0.41 (p<0.04) and in female, spearman rho correlation was -0.37 (p<0.05). The inverse correlation between serum ferritin and the annual decline of ALS-FRS in male, spearman rho correlation was 0.47 (p<0.01) and in female, spearman rho correlation was 0.76 (p<0.001). The inverse correlation between serum ferritin and the annual decline of FVC in male, spearman rho correlation was 0.49 (p<0.001) and in female, it was 0.71 (p<0.001).Conclusions: In most of the cases we found significant correlation of serum uric acid, serum homocystine and serum ferritin with amyotrophic lateral sclerosis (ALS). So all these components would be considered as some potential indicators or bio-markers of amyotrophic lateral sclerosis (ALS).

Background: Helicobacter pylori (HP) infection is an important cause of peptic ulcer disease (PUD) in the world. This study was aimed to know the trend of H.P. infection among the symptomatic subjects Method: This was a retrospective observational study conducted from January 2015 to July 2018 in three different hospitals in Dhaka city. Patient who presented with dyspepsia underwent 13C urea breath test. Positive cases were analyzed. Results: A total 1343 patients were taken for UBT where 308 (23%) patients were found positive. The mean age group was 41.21+13.6. Male were more infected (61%) than female (39%). Conclusion: Improving sanitary and hygienic condition of this region along with significantly increasing HP eradication therapy and PPI use by the symptomatic individuals might have contributed to the decreasing trend of infection Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 121-124

Introduction:Stroke is the second most common cause of death throughout the world and is the most common cause of severe adult physical disability 1 and third leading cause of death in Bangladesh. 2 The World Health Organization (WHO) ranks mortality due to stroke in Bangladesh as number 84 in the world. The reported prevalence of stroke in Bangladesh is 0.3%. The high number of disability-adjusted life years lost due to stroke (485 per 10,000 people) shows that stroke severely impacts Bangladesh's economy. 2 Recognized risk factors are hypertension, diabetes, smoking, heart disease, dyslipidaemia. So for primary prevention of stroke, risk factors identification is essential. 3 Hyperlipidaemia is manifested by elevation of the plasma concentrations of the various lipid and lipoprotein fractions (total cholesterol, LDL cholesterol, VLDL, triglycerides etc). Elevation of total and LDL cholesterol is associated particularly with atherosclerotic disease (like CHD, stroke etc) risk, but it is increasingly clear that moderately raised triglycerides or VLDL in the presence of low HDL-cholesterol may also be atherogenic. 4 There is a well-established inverse relation between serum concentrations of HDL cholesterol and the risk of coronary heart disease, 5 but it is not a welldocumented risk factor for stroke. Several case-control studies have noted an inverse relation between HDL cholesterol and risk of stroke or transient ischemic attack. 6,7,8 The Framingham Study, the Copenhagen Study and the Israeli Heart Disease Study have all demonstrated a trend toward higher risk of thromboembolic stroke with lower HDL cholesterol levels in men. 9,10,11 These data add to the evidence relating lipids to stroke and support HDL-C as an important modifiable stroke risk factor. 12 In conjunction with other risk factors, measurement of HDL cholesterol (commonly available from routine lipid screening) could become an increasingly useful tool for identifying elderly persons at high risk of stroke. Abstract:Stroke is an alarming health hazard all over the world as well as in Bangladesh and one of the leading causes of mortality and morbidity. There is a well-established inverse relation between serum concentrations of high density lipoprotein cholesterol (HDL-c) and the risk of coronary heart diseases but it is not a welldocumented risk factor for stroke. This study was done to evaluate of the HLD-c concentration among elderly ischaemic stroke patients. This cross sectional study was conducted

Background: Guillain-Barre Syndrome (GBS) is the most common cause of acute flaccid paralysis in the adult population. It is an acute post infectious immune mediated peripheral neuropathy with a marked variation in pathology, clinical presentation and prognosis. Objective: The aim of the study were to evaluate clinical profile, to assess autonomic involvement & electrophysiological findings in adult patients with GBS. Methods: An observational, cross sectional study was carried out in the Department of Neurology, BSMMU, Dhaka from March, 2015 to September, 2017. Total 43 patients of GBS fulfilling the inclusion criteria were recruited as the study population. Detailed clinical examination, CSF study & nerve conduction study were done. Disability status was measured by Hughes functional grading scale. For autonomic assessment 35 adult healthy control were also included for comparison. Then following tests of autonomic nervous system were performed in both patient and control group 1) resting heart rate and heart rate on changing posture (30: 15 ratio) 2) supine blood pressure and blood pressure on changing posture 3) heart rate response to valsalva maneuver 4) heart rate response to deep breathing and E: I ratio 5) sphincter disturbance by symptoms questionnaire. Results: The mean age of patients was 35±12 years (range18 to 65 years) with slight male predominance (58.1%). Major clinical presentation was weakness of all 4 limbs followed by sensory complaints (44.2%). 7% of the patient had breathing difficulty and dysphagia. Only 4.7 % had diplopia. Among the symptoms of autonomic dysfunction most common symptoms was constipation (30.2 %) followed by palpitation (14%), urinary retention (7%), lightheadedness and urinary incontinence (4.7%). Cranial nerve palsy was present in 34.9% of cases among them facial palsy was found commonly (27.9%), followed by bulbar palsy (7%) and ophthalmoplegia (4.7%). One patient (2.3%) had both facial palsy and ophthalmoplegia. AIDP, AMAN and AMSAN subtypes comprised 32.6%, 37.2% and 20.9% of cases respectively. Regarding autonomic dysfunction variation of heart rate by different maneuver like posture change, deep breathing and valsalva maneuver was found commonly. 30:15 ratio was abnormal in majority of the patients (82.4%) followed by abnormal max-min HR/min on deep breathing (58.1%) and abnormal valsalva ratio (37.2%). Other abnormalities were postural hypotension (38.2%), sinus tachycardia (25.6%), hypertension (16.3%), hypotension (4.7%), and sinus arrhythmia (4.7%). Bowel bladder dysfunction was another autonomic dysfunction among them constipation 30%, urinary retention 7% and urinary incontinence 4.7% of cases. Conclusion: GBS can be presented with variable presentation including autonomic dysfunction. In this study common clinical presentation was limb weakness & different patterns of autonomic dysfunction was found in patients with GBS. Common electrophysiological subtype was AMAN. So in addition to clinical & electrophysiological analysis autonomic evaluation is essential in every patients with GBS as autonomic dysfunction is one of important cause of mortality. Bangladesh Journal of Neuroscience 2019; Vol. 35 (2): 57-62