Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.
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
Back ground: Malignancy related pericardial effusion (PE) may represent a terminal event in patients with therapeutically unresponsive disease. Pericardial tamponade (PT) is a co morbid condition in many diagnosed malignant cases. Selection of patients with malignancies who are responsive to available treatment may achieve significant improvement in palliation. Early detection of pericardial tamponade and appropriate intervention (Pericardiocentesis) or Subxyphoid pericardiotomy may result long term survival benefit.Objective: Early detection and management of PE and tamponade in malignant cases.Methods: Color Doppler (C-D) echocardiography was done in 260 patients with underlying malignancies on chemo or radiotherapy from oncology department of Delta Medical college and hospital from May 2016 to December 2016. These cases were reviewed retrospectively for clinical features, diagnosis and therapy for their malignancy.Results: 81% have shortness of breath, sign of pulsus paradoxus and pericardial tamponade were found in 22% and 5% patients respectively. During echocardiography, pericardial effusion was found in 102 patients. 65% have mild pericardial effusion, whereas 27% have moderate and 8% have severe PE. Effusions with malignancy comprising of 40% adenocarcinomas of lung, 15% carcinoma (Ca) of pharynx, 10% Ca breast, 10% lymphoma, 10% is Carcinoma of unknown primary, 8% Ca esophagus and 7% others (Renal, Hepatic, ovary & cheek).University Heart Journal Vol. 12, No. 1, January 2016; 23-25
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