ObjectiveThe COVID-19 pandemic is still raging worldwide. While there is significant published evidence on the attributes of patients with COVID-19 from lower-income and middle-income countries, there is a dearth of original research published from Bangladesh, a low-income country in Southeast Asia. Based on a case series from a tertiary healthcare centre, this observational study has explored the epidemiology, clinical profile of patients with COVID-19 and short-term outcomes in Dhaka, Bangladesh.Design and settingA total of 422 COVID-19-confirmed patients (via reverse transcription–PCR test) were enrolled in this study (male=271, female=150, 1 unreported). We have compiled medical records of the patients and descriptively reported their demographic, socioeconomic and clinical features, treatment history, health outcomes, and postdischarge complications.ResultPatients were predominantly male (64%), between 35 and 49 years (28%), with at least one comorbidity (52%), and had COVID-19 symptoms for 1 week before hospitalisation (66%). A significantly higher proportion (p<0.05) of male patients had diabetes, hypertension and ischaemic heart disease, while female patients had asthma (p<0.05). The most common symptoms were fever (80%), cough (60%), dyspnoea (41%) and sore throat (21%). The majority of the patients received antibiotics (77%) and anticoagulant therapy (56%) and stayed in the hospital for an average of 12 days. Over 90% of patients were successfully weaned, while 3% died from COVID-19, and 41% reported complications after discharge.ConclusionThe diversity of clinical and epidemiological characteristics and health outcomes of patients with COVID-19 across age groups and gender is noteworthy. Our result will inform the clinicians and epidemiologists of Bangladesh of their COVID-19 mitigation effort.

Congenital Diaphragmatic Hernias (CDH) is a rare entity with incidence of 1:3000 live births. Late presentation is unusual and in most cases is diagnosed in adolescents or early childhood. Asymptomatic diaphragmatic hernia in the absence of trauma is very rare in adults. The finding of CDH in adults is mostly incidental. Left sided hernia i.e. Bochdalek hernia is more common. It is more commonly associated with other anomalies. The morbidity and mortality are mainly due to pulmonary hypoplasia. We report a case of CDH, posterolateral defect (Bochdalek type), with mild mediastinal shifting to right side in a young lady, who was asymptomatic throughout the life and referred to us for evaluation of incidental findings of chest X-ray abnormality who was suffering from cholelithiasis. The surgical approach for the resolution of this pathology is variable and it depends on the presence and severity of visceral complications.J Bangladesh Coll Phys Surg 2018; 36(4): 175-178

Objective: This study aims to analyze Chest X-ray findings in COVID 19(RT-PCR positive) patients, correlate between clinical and radiological findings and short-term outcomes of the patients with the view to enhance clinicians’ understanding of CXR findings in COVID 19 patients. Methods: This descriptive type of observational study included 277 reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed COVID-19 patients who were undergone CXRs, based on the clinician’s decision. Data were collected from May to September 2020 of Maternal and Child Health Training Institute (MCHTI)- a COVID-19 dedicated hospital, Lalkuthi, Mirpur-1, Dhaka and analyzed statistically through SPSS,Version 25. Each chest X-Ray is then scored using the Brixia score, a semi-quantitative scoring system rating lung involvement from 0 to 18 by a radiologist. The scores are then analyzed and compared with the characteristics of the patients, clinical presentation, and short-term outcome (in-hospital & after discharge) to correlate the severity and post covid-19 complications of COVID-19 infected patients. Results: A total of 277 RT-PCR-positive patients were performed chest x-ray P/A view, among them 58.12%(161) were male and 41.88%(116) were female. Age variation was from 6 to 95 years and the mean age was 42.48±15.53(S.D).Most of the patients(94.94%)were symptomatic and the majority(97.9%) of symptomatic patients had comorbidities(p-value 0.02).Among the x-ray performed patients(n=277), 39.35% (109) patients had positive findings suggestive of covid-19 infection. Comorbidities and sex had significant relation on positive x-ray findings(p-value 0.0001 and 0.001);males (70.6%) had more positive findings than females(29.4%).Positive x-ray findings were more common among the age group 41 to 60 years (p-value 0.0001 and Cramer’s V 0.59).Most of the patients (94.49%) had bilateral lungs involvement and consolidations were the commonest x-ray findings (43.1%).Clinical severity was assessed by symptoms and Spo2 level (<91%) and 20.2% were clinically severe (M-23.6%, F-15.5%). Age, comorbidities, and higher Brixia score (>8) had a significant relation to clinical severity (p-value 0.0001,0.0001&0.0001) and sex also influences clinical severity though statistically not significant (p-value 0.2).There was a significant relationship between positive X-Ray findings and decreased Spo2 level (p-value 0.0001, Cramer’s V 0.47).Regarding in-hospital outcome; 94.9% were recovered and 2.75%were death (only male)and following discharge; 42.60% (119) had post covid-19 complications and 0.72% (02) were dead. Comorbidities and age had an effect on short-term outcomes after hospital discharge though not statistically significant (p-value 0.16 and 0.16). The most common respiratory complications were SOB on exertion (23) and the most common non-respiratory complication was post covid fatigue syndrome (42). Comparison between Brixia score and post covid complications; more the Brixia score, the more the chance of post covid complications though statistically not significant (p-value 0.44). Conclusion: This study reveals bilateral lungs involvement and multifocal consolidations are the most common patterns of X-ray findings and clinical severity is associated with a higher Brixia score, male sex, increasing age, and presence of comorbidities. Bangladesh J Medicine 2022; 33: 280-292

Background: Salivary gland tumors (SGT) are uncommon tumors of diverse histopathology accounting for <2% of all neoplasms. Early diagnosis differentiates between benign and malignant SGT and less extensive surgical procedure can be performed. The objective is to study the spectrum of primary SGT with special emphasis on their distribution, treatment and outcome at a rural tertiary care centre.Methods: A prospective observational study was conducted on 30 consecutive primary SGT patients attending the Departments of Surgery and Otorhinolaryngology of North Bengal Medical College and Hospital over a period of one and half years. All patients were clinically evaluated, investigated, treated accordingly and followed up during the period of study. Data was collected and compiled in Excel sheet and analysed using GraphPad Software and GraphPad QuickCalcs 2018 (San Diego, CA). A p value <0.05 was considered statistically significant.Results: Maximum patients (83.3%) were in the age range of 31-60 years. The male to female ratio was 1:4 for benign tumours and 1:1 for malignant tumours. Malignant cases were 66.67%. Involvement of parotid gland was the commonest (43.3%) and mostly presented with swelling (73.3%). Pleomorphic salivary adenoma was the commonest benign tumor (33.3%) and mucoepidermoid carcinoma was the commonest malignant tumor (16.7%). Permanent facial palsy was observed in 2 (9.5%) and recurrence in 4 patients (19%).Conclusions: SGT are rare and present in various modes. Malignant cases were singularly more in this study.

Takayasu’s arteritis (TA) is a rare, idiopathic, chronic inflammatory disease with cell-mediated inflammation, involving mainly the aorta and its major branches. It leads to stenosis, occlusion or aneurysmal degeneration of large arteries. The clinical presentation is characterized by an acute phase with constitutional symptoms, followed, months or years later, by a chronic phase in which symptoms relate to fibrosis or occlusion of vessels. Conventional angiography, the gold standard method for initial diagnosis, appears to have been replaced with new imaging modalities such as magnetic resonance angiography (MRA) and 18Ffluorodeoxyglucose positron emission tomography (FDGPET) in recent years. These are also used for the assessment of disease activity. New tools for disease assessment such as Indian Takayasu’s Arteritis Score 2010 (ITAS2010) and color Doppler ultrasound (CDUS) aim to better characterize and quantify disease activity. Leflunomide, tumor necrosis factor (TNF)-± antagonists, and tocilizumab are new options for patients resistant to conventional therapies. Prognosis is possibly getting better, with lower mortality in recent years due to recent advancement in investigations and management. J Bangladesh Coll Phys Surg 2020; 38(1): 35-45