The ongoing COVID-19 pandemic has been a scientific, medical and social challenge. Since clinical course of this disease is largely unpredictable and can develop rapidly causing severe complications, it is important to identify laboratory biomarkers which may help to classify patient’s severity during initial stage. Previous studies have suggested C - reactive protein (inflammatory) and D-dimer (biochemical) as an effective biomarker. The differential severity in patients across the world and our limited understanding in the progression of the disease calls for a multi-country analysis for biomarkers. Therefore, we have analyzed these biomarkers among 228 Bangladeshi COVID-19 patients. We show significant association of COVID-19 severity with these two biomarkers. Thus, we suggest using these biomarkers for Bangladeshi COVID-19 patients for disease monitoring. Such validated preventive measures may decrease the case fatality ratio substantially.

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Background: Stroke is defined as a sudden onset focal neurological deficit of vascular etiology and is a major cause of mortality and morbidity around the globe. The aim of this study was to find out the proportion of major risk factor or factors related in infarctive stroke cases. Methods: This hospital based descriptive cross sectional study was carried out in one hundred (100) ischemic stroke patients admitted in Medicine units associated with Neurology ward in Enam Medical College & Hospital, Savar, Dhaka, Bangladesh during the period from January 2015 to September 2017. Permission for the study was taken from the mentioned departments and authorities. Subjects were selected in all age groups and both male and female patients to whom duration of illness were less than 72 hours. Results: Among all, 61% were male and 39% were female and male female ratio 1.56:1. The maximum number of patients (36%) were in between 61-70 years of age. Majority of the patients (40%) came from middle class (TK. 7000-10,000/Month). A significant number of patients had high level of lipid profile e.g. Total cholesterol (>200 mg/dl) 73.33%, LDL (>150 mg/dl) 60%, TG (>150 mg/dl) 70%. In many cases multiple risk factors were present. It was observed that hypertension was the most common major risk factor for stroke. Among the 60% of the hypertensive patients only 45% were controlled with treatment and 33.33% were uncontrolled with treatment and 21.66% did not take any medicine or measures. About 47% were smoker. Diabetes mellitus was detected in 26% of patients which is lower than hypertension and hyperlipidaemia. About 25% of patient had history of previous stroke and 20% patient had family history of stroke. Only 6% was alcoholic. Among the female patients 5% received oral pills. Conclusion: Hypertension is one of the major risk factors for the stroke. For the management and prevention of hypertension like stroke, we are recommending the following measures like Hypertension screening programme for early detection, management and follow up and increase awareness regarding hypertension and its complication. It should be controlled by personal motivation, anti-smoking campaign, banding of the smoking propaganda in the TV, Radio, News paper, poster, banner, leaflet etc. Ensure punishment for smoking in open public places and public transports.

Key Clinical MessageHypomethylating agents may be useful in some but not all cases of myelodysplastic syndromes. In some versions of these conditions, this treatment may yield deleterious results.AbstractChronic myelomonocytic leukemia (CMML) is considered to be a heterogeneous group of hematopoietic neoplasms. Usually it shares the features of myeloproliferative neoplasms (MPN) and myelodysplastic syndromes (MDS) and is known as MDS/MPN. It occurs mostly in the elderly and has an inherent tendency to transform to acute myeloid leukemia. FDA has approved hypomethylating agents (HMAs) such as 5‐azacitidine (AZA) and decitabine (DEC) for the treatment of this disorder. The extent of response rate to AZA varies considerably among patients. Our report describes a patient with CMML who not only did not respond to a conventional dose of intravenous (IV) therapy with AZA, but showed marked progression of the disease with the leucocyte count rising exponentially while undergoing the aforesaid treatment. We believe this is the first such case reported in the currently extant literature.

The ongoing COVID-19 pandemic has been a scientific, medical and social challenge. Since clinical course of this disease is largely unpredictable and can develop rapidly causing severe complications, it is important to identify laboratory biomarkers which may help to classify patient’s severity during initial stage. Previous studies have suggested C - reactive protein (inflammatory) and D-dimer (biochemical) as an effective biomarker. The differential severity in patients across the world and our limited understanding in the progression of the disease calls for a multi-country analysis for biomarkers. Therefore, we have analyzed these biomarkers among 228 Bangladeshi COVID-19 patients. We show significant association of COVID-19 severity with these two biomarkers. Thus, we suggest using these biomarkers for Bangladeshi COVID-19 patients for disease monitoring. Such validated preventive measures may decrease the case fatality ratio substantially.