Background: This study aimed to examine the differences in epidemiologic and disease aspects among patients with coronavirus disease-19 (COVID-19). Methods: The authors reviewed the hospital records between April 2020 and September 2021 and followed up on the patients for post-COVID complications. Findings: Older adult patients were predominantly affected during the third wave, and middle-aged patients were predominantly affected during the first and second waves. Men were predominantly admitted, considering the three waves, although more women were admitted in the second wave. Cough was more common in the second and third waves than in the first wave 522 (59.7%). Respiratory distress was the most common in the third wave, 251(67.1%), and least common in the first wave, 403 (46.1%). Anosmia was more common in the third wave 116 (31.2%). In the third wave, patients presenting in a critical state 23 (6.2%) and with severe disease 152 (40.8%) were more common. The hospital admission median (IQR) was longer in the first wave, 12 (8–20), than in other waves. More patients were admitted in the first wave (52%) than in the other waves, and patients received more oxygen in the third wave (75%) than in the other waves. Death occurred more commonly in the first wave (51%) than in the other waves. The positivity rate was higher in the third wave (22.8%) than in the other waves. In the third wave, the positivity rate was higher in women (24.3%) than in men. Post-COVID cough increased in the second wave, and fatigue was higher in the third wave than in the other waves. Tiredness and memory loss were greater during the second wave than in other waves. Conclusion: The authors found differences in the presentation, outcomes, and hospital epidemiologic trend of COVID-19 among the three waves.

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may cause severe life-threatening diseases called acute respiratory distress syndrome (ARDS) owing to cytokine storms. The mortality rate of COVID-19-related ARDS is as high as 40% to 50%. However, effective treatment for the extensive release of acute inflammatory mediators induced by hyperactive and inappropriate immune responses is very limited. Many anti-inflammatory drugs with variable efficacies have been investigated. Colchicine inhibits interleukin 1 beta (IL-1β) and its subsequent inflammatory cascade by primarily blocking pyrin and nucleotide-binding domain leucine-rich repeat and pyrin domain containing receptor 3 (NLRP3) activation. Therefore, this cheap, widely available, oral drug might provide an added benefit in combating the cytokine storm in COVID-19. Here, we sought to determine whether adding colchicine to other standards of care could be beneficial for moderate COVID-19 pneumonia in terms of the requirement for advanced respiratory support and mortality. Methods and findings This blinded placebo-controlled drug trial was conducted at the Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 300 patients with moderate COVID-19 based on a positive RT-PCR result were enrolled based on strict selection criteria from June 2020 to November 2020. Patients were randomly assigned to either treatment group in a 1:1 ratio. Patients were administered 1.2 mg of colchicine on day 1 followed by daily treatment with 0.6 mg of colchicine for 13 days or placebo along with the standard of care. The primary outcome was the time to clinical deterioration from randomization to two or more points on a seven-category ordinal scale within the 14 days post-randomization. Clinical outcomes were also recorded on day 28. The primary endpoint was met by 9 (6.2%) patients in the placebo group and 4 (2.7%) patients in the colchicine group (P = 0.171), which corresponds to a hazard ratio (95% CI) of 0.44 (0.13–1.43). Additional analysis of the outcomes on day 28 revealed significantly lower clinical deterioration (defined as a decrease by two or more points) in the colchicine group, with a hazard ratio [95%CI] of 0.29 [0.098–0.917], (P = 0.035). Despite a 56% reduction in the need for mechanical ventilation and death with colchicine treatment on day 14, the reduction was not statistically significant. On day 28, colchicine significantly reduced clinical deterioration measured as the need for mechanical ventilation and all-cause mortality. Conclusion Colchicine was not found to have a significant beneficial effect on reducing mortality and the need for mechanical ventilation. However, a delayed beneficial effect was observed. Therefore, further studies should be conducted to evaluate the late benefits of colchicine. Clinical trial registration Clinical trial registration no: ClinicalTrials.gov Identifier: NCT04527562 https://www.google.com/search?client=firefox-b-d&q=NCT04527562.

<p class="abstract"><strong>Background:</strong> Inflammation is playing a major role in the pathophysiology of severe COVID-19 disease. The main causes of mortality are cytokine syndrome and immune thromboembolism. Colchicine is an anti-inflammatory drug but its action is mediated by completely different pathophysiologic routes than that of corticosteroids and non-steroidal anti-inflammatory agents. Colchicine inhibits neutrophil chemotaxis, inhibits inflammasome signaling and reduces interleukin-1β, reduces neutrophil-platelet interaction and aggregation. Colchicine is a readily available, cheap drug, has been used safely for many years. Specific targeted anti-inflammatory drugs like tocilizuma and anakinra are costly. A previous study suggested a significant clinical benefit from colchicine in patients hospitalized with COVID-19. But they did not compare with placebo. So, we have designed this study.</p><p class="abstract"><strong>Methods:</strong> This is a prospective, double-blind, randomized, placebo-controlled clinical trial. The study will be conducted at Dhaka medical college hospital, Bangladesh. Real time-polymerase chain reaction (RT-PCR) positive COVID-19 patients with moderate symptoms will be included in this study. Participants will be randomized into two groups at 1:1 ratio. Patients of one group will be treated with standard treatment along with colchicine for 14 days. The patients in other group will be treated with standard treatment along with placebo for the same duration. The primary outcome of the study will be time to develop clinical deterioration, defined as the time from randomization to a deterioration of two points (from the status at randomization) on a seven-category ordinal scale.</p><p class="abstract"><strong>Conclusions: </strong>Enrolment of participants has begun at the study site. A total of 300 participants will be enrolled.</p><p class="abstract"><strong>Trial Registration:</strong> ClinicalTrials.gov identifier: NCT04527562.</p>

Amegakaryocytic thrombocytopenia is a rare variety of bone marrow aplasia characterized by thrombocytopenia in association with markedly diminished bone marrow megakaryocytes. It can occur as a component of aplastic anaemia or as an isolated form. Here we report a case of a teenage girl presented with bleeding per vagina and generalized weakness which is diagnosed as a case of amegakaryocytic thrombocytopenia by bone marrow examination. It will evolve into aplastic anaemia with the course of the disease.DOI: http://dx.doi.org/10.3329/jom.v14i2.19690 J Medicine 2013, 14(2): 207-209

Dengue fever first identified as ‘Dhaka Fever’ in 1964 & became endemic around 2000. The most recent spreading of dengue in 2019 was also notable for change in the presenting features of the patients attributed by some to the fact that causative virus might be of different serotype. Our study aims to assess the current pattern of presentation of dengue virus infection, done in inpatient of Department of Medicine of Dhaka Medical College Hospital Dhaka. This was a crosssectional, observational, descriptive study conducted between 1st August and 30th September 2019. A total 70 subjects, age >12 years were included in this study. Among them 55 were male & 15 were female, with a mean age of 28.33(±12.15) years. Comorbidities noticed in few cases such as DM (2, 2.90%), HTN (3, 4.35%), IHD (1,1.45%), CKD & COPD (1,1.45%). The most common presentation were fever (64, 91.43%), headache (62, 88.57%) anorexia (59, 85.51%), generalised pain (51, 73.91%), nausea (49, 71.01%). Examination findings at admission were temperature was high but not very high, pulse were normal, both systolic & diastolic pressure were somewhat normal, among the warning signs, severe abdominal pain (27.54%), persistent vomiting (21.74%), lethargy /restlessness /sudden behavioural change (21.74%) were most common. The common haematological parameters & routine investigation values were not deviated from expected range. As dengue is likely to continue to constitute a serious public health problem in Bangladesh, this study may help the practitioners to understand the changing pattern & to manage patients accordingly. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 199-207