This cross-sectional type of descriptive study was conducted in three villages of Puthia Upazila under Rajshahi district to find out the prevalence of Generalized Anxiety Disorder (GAD) and its effect on their daily living. A total of 876 adult people of aged 18 years and above, were selected purposively. Data were collected by face to face interview with the help of a semi-structured questionnaire which contained Hamilton’s 7-point anxiety scale. Out of 876 respondents, 80% had GAD, where mild, moderate and severe GAD being 42.5%, 31.8% and 5.7% respectively. GAD was found to be more frequently associated in the 3rd and 5th decades of life, which constituted 27% and 12.9% respectively (p < 0.001). Having GAD, females have more ability to cope with daily living than males, though GAD was not found to be associated with sex (p >0.05). Illiterate and primary level educated respondents were more often associated with GAD (40.4 and 25% respectively) than the SSC and higher level educated people (p < 0.001). Businessmen were found to be significantly associated with GAD (29.7%) than the other occupations (p < 0.001). Poor people tend to be associated with GAD significantly more than the middle class and the rich (p < 0.01). Widow(er) and married and living together were likely to have GAD than the single or divorced or separated (p < 0.001). Activities of daily living gradually becoming more difficult when intensity of anxiety status increased which is statistically significant (p<0.001).The association between sex and problem facing in everyday life shows that over 40% of the females did not have any difficulty in dealing with problem situation as compared to only 25.8% of the males, while nearly half (48.6%) of males had quite difficulty in dealing with a problem as compared to 37.3% in females (p < 0.001). The present study concluded that majority rural adult people (4 in every five) suffer from generalized anxiety disorder (GAD). The ability of coping with a problem is higher in females than the males. This study might be the basis for further in depth study in this regard.TAJ 2014; 27(1): 14-23

To evaluate the thyroid hormone levels in pre-eclampsia and normal pregnancy, a study was undertaken among 54 women of age ranged from 18 to 35 years without present or past history of thyroid diseases. Among the study subjects, 32 women were patients of pre-eclampsia, 12 women were in their normal third trimester pregnancy and 10 women were married but nonpregnant (without having hormonal contraceptives at least for 6 months). We have measured serum levels of total and free thyroxine (TT 4 & FT 4 ) and total and free triiodothyronine (TT 3 & FT 3 ) by using RIA. The mean serum TT 4 and TT 3 in normal pregnancy were significantly higher compared to that of non-pregnant women when mean FT 4 and FT 3 were similar in both normal pregnancy and non-pregnant women. In pre-eclampsia, mean serum TT 4 and TT 3 were significantly higher than that of non-pregnant women but compared to that of normal pregnancy, TT 4 was clearly higher but not significant when TT 3 was significantly lower. The mean serum FT 4 was significantly higher in pre-eclampsia compared to non-pregnant women and not significantly higher compared to normal pregnancy. The mean serum FT 3 was similar in both non-pregnant and normal pregnancy but significantly lower in pre-eclampsia compared to normal pregnancy. In pregnancy i.e. in both normal pregnancy and pregnancy with preeclampsia, the increased serum thyroid hormone levels might result from increased stimulatory effect of placental hormones (hCG), 1,2 increased metabolic demands in pregnancy 3 and mental stress in pregnancy as mentioned by other investigators. Decreased TT 3 and FT 3 associated with higher TT 4 in pre-eclampsia might be due to reduced conversion of T 4 to T 3 in the liver and kidneys.

Desmoid tumours (DTs) are locally aggressive, benign tumours of fibroblastic origin. Up to 15% of DTs are associated with familial adenomatous polyposis. Mesenteric DTs in this cohort are associated with a worse prognosis due to secondary obstruction or abscess formation. Although degeneration into an abscess is rare, the management options remain unclear. Video S1 demonstrates our experience with laparoscopic drainage of a mesenteric desmoid abscess. The patient was a 29-year-old woman with known familial adenomatous polyposis and a mesenteric DT, who presented to our unit with a 3-day history of abdominal pain and fever. CT scan on admission demonstrated abscess formation within the known mesenteric DT. Despite 1 week of conservative management, there was no clinical or biochemical improvement in the patient's condition. Following a multidisciplinary team discussion, surgical drainage via a laparoscopic approach was utilized for source control. The video demonstrates careful mobilization and dissection of adherent small bowel from the desmoid abscess, and the subsequent creation of a safe area through which the abscess could be drained. Following drainage, intra-abdominal drains were left in situ until an interval scan was performed. This demonstrated complete resolution of the collection and the drains were subsequently removed. At 6 weeks' follow-up, the patient has required no further interventions or admissions. In units with significant expertise in minimally invasive surgery, laparoscopic drainage of a mesenteric desmoid abscess is a safe and feasible intervention in patients presenting with sepsis refractory to medical management.

Image guided FNAB of pulmonary lesions are widely applied now a days. Most of the lesions which are located nearer to the chest wall can be well visualized by ultrasonography. Whereas smaller lesions, deeply located ones, mediastinal or juxtra-hilar lesions may not be visualized sonographically. In those cases CT-guidance becomes beneficial. We report 127 FNABs done during a 2 year period. In considering the poor economic ability of the patient USG-guidance was preferred provided the lesion could be well visualized. Ultrasound guided method was successfully performed in majority of cases except a few where CT-guidance was necessary. After first aspiration an immediate cytological assessment was done by a quick staining method and in case of inadequacy of the specimen a second pass was made within an hour. Different pathological spectrum of diseases was diagnosed cytologically and was compared with their final diagnosis. Negligible immediate or late complications were noticed. Image guided FNAB of intra-thoracic masses can therefore be made with minimum complication, can allow the physician to decide the mode of treatment in a shortest possible time and in most of the cases an ultrasound guidance is sufficient enough to meet the poor economic status of people in this subcontinent. doi: 10.3329/taj.v20i2.3070 TAJ 2007; 20(2): 110-115