immunoproliferative small intestinal disease is considered as a rare condition and has endemicity inMediterranean countries and often associated with campylobacter jejuni infection. This conditionvaries in severity from benign to frankly malignant. Prolonged remission can be obtained with longterm antibiotic therapy but chemotherapy is required for those who have aggressive disease. Bangladeshidata on IPSID is sparse. Here our patient 21 years old male presented with chronic diarrhoea, occasionalvomiting, severe weakness and significant unintentional weight loss. He had cachectic body built,bipedal edema, easy bruising, glossitis with angular stomatitis. His upper GI endoscopy showed multiplenodular lesion in the duodenum. Biopsy was taken from nodular lesion and sent for histopathology,geneXpert and culture. Histopathology revealed IPSID. He was treated with tetracycline and improvedclinically. J MEDICINE 2022; 23: 84-86

Bangladesh Journal of Medicine, Vol 23 No 2, 2012, Page 67-75 DOI: http://dx.doi.org/10.3329/bjmed.v23i2.14989

The death toll of the coronavirus disease 2019 (COVID-19) has been considerable. Several risk factors have been linked to mortality due to COVID-19 in hospitals. This study aimed to describe the clinical characteristics of patients who either died from COVID-19 at Dhaka Medical College Hospital in Bangladesh. In this retrospective study, we reviewed the hospital records of patients who died or recovered and tested positive for COVID-19 from May 3 to August 31, 2020. All patients who died during the study period were included in the analysis. A comparison group of patients who survived COVID-19 at the same hospital during the same period was systematically sampled. All available information was retrieved from the records, including demographic, clinical, and laboratory variables. Of the 3115 patients with confirmed COVID-19 during the study period, 282 died. The mean age of patients who died was higher than that of those who survived (56.7 vs 52.6 years). Approximately three-fourths of deceased patients were male. History of smoking (risk ratio 2.3; 95% confidence interval: 1.6–3.4), comorbidities (risk ratio: 1.5; 95% confidence interal:1.1–2.1), chronic kidney disease (risk ratio: 3.2; 95% confidence interval: 1.7–6.25), and ischemic heart disease (risk ratio:1.8; 95% confidence interval: 1.1–2.9) were higher among the deceased than among those who survived. Mean C-reactive protein and D-dimer levels [mean (interquartile range), 34 (21–56) vs. 24 (12–48); and D-dimer [1.43 (1–2.4) vs. 0.8 (0.44–1.55)] were higher among those who died than among those who recovered. Older age, male sex, rural residence, history of smoking, and chronic kidney disease were found to be important predictors of mortality. Early hospitalization should be considered for patients with COVID-19 who are older, male, and have chronic kidney disease. Rapid referral to tertiary care facilities is necessary for high-risk patients in rural settings J MEDICINE 2023; 24: 28-36

Background: The health care workers’(HCWs) are working 24/7 in managing devastating pandemicCorona virus disease19(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) as front liner which leads them to be at highest risk for contacting infection. In Bangladesh, beinga lower middle-income country and densely populated, the burden is much more on HCWs. Methods: We did a cross-sectional study with an aim to identify the prevalence, risk factors, and outcomesof SARS-CoV-2 infection among the HCWs in a COVID-19 dedicated tertiary care hospital. Statisticalanalysis was done in SPSS version-26. Multivariate regression analysis was done to evaluate risk factorsresponsible for COVID-19 infection and the severity of the COVID-19 disease. We expressed odds ratiowith 95% CI, and considered the p-value of <0.05 as significant in the two-tailed test. Results: A total of 864 HCWs had participated with mean age of 34.16 ± 6.77 and 426 (49.31%) males.Among them 143 (16.55%) were tested RT-PCR positive for SARS-COV-2. Bronchial asthma/COPD andHypertension were the most common co-morbidities with 23 (16.08%) for each. About 102 (71.33%) ofthe RT-PCR positive HCWs became symptomatic. Fever, cough and myalgia were the most commonsymptoms 84(82.35%), 67(65.69%) and 52(50.98%) respectively.Multivariate regression analysis revealed hypertension, gout, and working in the COVID-19 confirmedward had a significant odds ratio for getting infected with SARS-CoV-2 [95% CI, p-value 1.91 (1.08 - 3.41),0.027; 5.85 (1.33 - 25.74), 0.020; and 1.83 (1.10 - 3.03), 0.019].Bronchial asthma/COPD and gout found to be risk factors for moderate to severe COVID-19 disease[95% CI, p-value 3.04 (1.01 - 9.21), 0.049 and 23.38 (3.42 - 159.72), 0.001]. Hospitalization rate was12(85.7%), and 3(100%) and median hospital stays were 11 (5.5 - 15), and 20 (7 - 30) days for moderate andsevere diseases respectively. Outcome was uneventful without any ICU admission and death. Conclusion: HCWs working in the COVID-19 confirmed ward are at increased risk of infection withSARS-COV-2. Some co-morbidities like hypertension and gout are important risk factors for contactingSARS-COV-2 infection. Bronchial asthma/COPD and gout favors disease severity. J MEDICINE 2022; 23: 5-12

Background: Acute pancreatitis (AP) is a significant cause of acute abdominal pain, morbidity andhospitalization. Knowing the details of the clinico-pathological presentation and outcome of the diseasemay aid the better understanding of the disease.Objective: The study was designed to assess the clinico-pathological profile and to estimate immediatehospital outcome of acute pancreatitis patients admitted into a tertiary care hospital. Materials and Methods: This hospital based cross-sectional type of observational study was conductedat Dhaka Medical College Hospital (DMCH), for one-year period (June 2018-May 2019).Total 106established cases of acute pancreatitis were included in this study. Data was analyzed by the SPSS 22Windows version and graph & chart were expressed by using SPSS 22 and MS Excel. The Result waspresented with tables and charts. Results: Among 106 patients, mean age of the patients was 42.5 ±11.3 SD (years), with male predominance(male: female-1.2:1). All of the patients complained abdominal pain (100%) while anorexia (48.1%), 43.4%had vomiting and 31.1% had fever. Regarding clinical signs, abdominal distension (45.3%), paralytic ileus(34.9%) and dehydration (43.4%) were found to be the major clinical signs. The common location of painwas in epigastric region (73.6%) with radiation to back in 20.8% patients. Pain was severe agonizing innature in 76.4% cases. Of all, gall stone disease (17.0%) was the most prevalent cause. According toAPACHE-II score, 74.5% patients had mild pancreatitis (APACHE-II <8) while according to Glasgowcriteria, 66.0% had mild disease (Glasgow score <3). Mean APACHE-II score was 7.07±2.50 and Glasgowscore was 2.90±2.33. Mean hospital stays were 8.9±3.6 days and NPO (nothing per oral) 4.9±1.9 days.Among the patients, 77.4% patients were alive and mortality rate was 22.6%. Conclusion: Although, a larger portion of the patients had no identifiable cause but gall stone was themost common etiology. Pain commonly located in epigastric region with radiation to back. Of all thecases, more than sixty percent of the patients had mild pancreatitis estimated by APACHE II score andGlasgow score. Mean hospital stays were about 9 days and nothing per oral was about 5 days. Overallmortality rate was 22.6%. J MEDICINE 2022; 23: 24-29