Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59
Rickettsial diseases are a group of infections caused by the obligate intracellular bacteria Rickettsia. Rickettsial infections are common in southern Europe. The disease is usually characterized by the classical triad of fever, eschar and rash. Complications including neurological involvement are rarely described. We report an unusual case of meningitis in a 55 years old man presenting with high grade fever for 8 days associated with persistent headache. The patient was suspected to have enteric fever and treated with injection ceftriaxone. Forty-eight hours after admission, the presence of continued high grade fever, conjunctival congestion, headache, cough, low platelet and increased WBC count, and elevated transaminase raised the possibility of a different aetiology. Finally, Rickettsial meningitis was confirmed due to history of field visit, presence of eschar, neck rigidity, raised titre of WF OX-K antigen and the cerebrospinal fluid analysis revealed increased cellularity, hypoglycorrhachia, and hyper proteinorrhachia (106 mg/dL). Patient was treated with capsule doxycycline and other supportive therapy and became afebrile within 48 hours. This uncommon clinical scenario should be taken into account in the management of patients with high grade fever on admission. Delta Med Col J. Jul 2019 7(2): 100-103
Intra uterine fetal death occur in 1% of pregnancy. The patient goes into labour in most of the cases, spontaneously. Retained dead fetus may cause disseminated intravascular coagulation sometimes resulting death of a mother. Objective: The aim was to find out the reults after using intravaginal Misoprostol in Intrauterine fetal death in last trimester of pregnancy. Study design: This was a cross sectional observational study prospective in nature on 160 cases of intra uterine fetal death patients in indoor of department of Gynae and Obstertrics of Sir Salimullah medical college Hospital, Dhaka from 02/01/13 to 01/07/13, for a period of 6 months. Result: 60% of the patients were primi gravida. Mean age of the patients was 22.12±4.3 years 44% were in 33 to 36 weeks of pregnancy when induction was done. 41 (82%) patients having Bishops score d” 6 reqired 21±8.25 hours where as 09 (18%) patients having Bishops score e” 6 needed 10±1,1 hours to complete the delivery. There were no reports of maternal mortality. All the patients delivered per vaginally except one (2%) who needed ceasearean section due to development of chorioamnionitis. Conclusion: Intravaginal misoprostol can aid in vaginal delivery safely. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 90-93
Meningitis is a global health problem as mortality is high and a large proportion of survivors suffered from significant morbidity. The physicians are facing this challenge of emergency identification of this clinical syndrome, establishing its etiology and its prompt treatment not only to ensure survival but also to prevent long term sequelae in these patients. Poor outcomes caused by bacterial meningitis due to delays in diagnosis and treatment. In Bangladesh, the epidemiological study regarding meningitis in adults is rare. Rapid & easily available as well as specific test or means are also not in our hand. The aim of this study was to evaluate the aetiology of patient with meningitis in tertiary care hospital of Bangladesh.The main objective was to evaluate the aetiology of meningitis of patients admitted in medical wards of a tertiary care hospital. The study was a descriptive type of observational study. The study was carried out in the Department of Medicine, Dhaka Medical College Hospital, a tertiary level hospital of Bangladesh from first July 2013 to thirty first December 2013. A total 50 patients were enrolled with Meningitis, diagnosed on clinical, biochemical, other investigational background , fulfilling the inclusion and exclusion criteria. Patients having feature of meningitis was enrolled in the study after getting informed written consent from patient or attendant. Detail demographic data were collected from the informant was recorded in structured case report form. Clinical examination and relevant investigation with CSF study were done. Routine follow up of the patient was done. Data analysis was conducted with SPSS software. Among the 50 patient the mostly affected groups were below 40 years of age comprising 66%. The mean(±SD) age was 33.04 ±18 years. There was an overall male preponderance with a male to female ratio 1.63:1 (N=31 vs N=19). The highest number of patients were presented with fever (100%), headache (98%) and altered mental status (88%). Among all 50 cases of meningitis 27(54%) were diagnosed as pyogenic, 9 (18%) were tuberculous meningitis and 14(28%) were viral . Out of 27 pyogenic meningitis cases 19 (70.37%) developed convulsion, out of 9 tuberculous meningitis 3 (33.33%) developed convulsion and 11 (78.57%) out of 14 viral cases had convulsion, that is convulsion was more common in viral cases. Sixteen male patients (51.61%) and 11 female patients (57.89%) had pyogenic meningitis, 5 male patients (16.12%) and 4 female patients (21.05%) had tuberculous meningitis. On the other hand, 10 (32.25%) male and 4 (21.05%) female had viral meningitis. P value was 0.369, So the male and female difference was not statistically significant. Diagnosis was made on the basis of clinical findings and CSF study. Pyogenic were more common than viral cases and tubercular meningitis. Meningitis is foremost causes of morbidity and mortality. It is recommended that provision of proper health care support, Proper and rapid detection and others investigation facilities reduce the disability. In the interim, this study provides data that can inform public health strategies directed at assessing and reducing meningitis severity and meningitis events. Bangladesh Med J. 2017 May; 46 (2): 26-31
Human immunodeficiency Virus (HIV) seropositive individual is at risk of developing disease of cardiovascular system (CVD). There are scarce of research work regarding this field in Bangladesh. Considering scarcity, this study was conducted at anti-retroviral therapy (ART) center of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh to find out the frequency of the CVD and their common risk factors in HIV seropositive patients from March 2017 to September 2019. Different CVD risk factors were assessed in this study. The demographic data were assessed and World Health Organization STEPS questionnaire were used to collect demographic data. The 10-year CVD risk was calculated by using the Framingham coronary risk score (FRS). Mean age of study population was 38, SD= 9.8. Among them sixty-five (65%) were men and thirty-five (35%) were women. About one third were overweight followed by 5% were obese. High cholesterolemia, high triglyceridemia, high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) were found in 23%, 58%, 14%. and 63% of the HIV patent, respectively. Hypertension was present in 19% and diabetes in 15% of the patients. In Framingham risk score, 19% of the participants had intermediate to high risk of cardiovascular disease within 10 years. The cardiovascular risk factors were common in HIV patients attending ART center of BSMMU, where base line 10-years CVD risk was low. People living with HIV appear to be an imminent risk to develop CVD. Bangladesh Med J. 2021 May; 50(2) : 40-44
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