Infection remains an important cause of morbidity and mortality in neutropenic hosts after chemotherapy or due to bone marrow failure. In the face of worldwide changes in the incidence and spectrum of bacteraemia, we evaluated 47 febrile neutropenic patients in the haematology department of BSMMU during the period of October 2009 to October 2010. The overall rate of blood culture positivity was 17% (8/47) which is similar to most of the recent study in the western world, but the bacterial spectrum is different from that in developed world [1,2,3,4] JCMCTA 2013 ; 24 (1): 19-21
Beta thalassaemia is one of the most prevalent haemolytic disorders worldwide which poses serious economic burden to the society. Study on clinical and demographic pattern of this disorder will help the concern authorities to figure out the problem. This cross-sectional descriptive study was carried out to determine the socio-demographic and clinical characteristics as well as to find out the existence of other co-morbidities among the ?-thalassaemic patients (n-101). The study was carried out at the Department of Haematology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from June 2010 to January 2011. Data were collected from 3 tertiary care hospitals of Dhaka city. Almost all the patients were young, age ranged from 10 to 32 years with the mean age of 16. Male to female ratio was almost equal (52.5:47.5) and 80% of the respondents were Muslims. Forty-five (45%) percent of patients were illiterate and 37% respondents had primary education only. Almost 90% were unmarried and majority had a family of 6-8 members. Forty-seven percent (47%) of patients had monthly income 5000-7000 BDT and 56% of the respondents were unemployed. The major clinical features were pallor (72.3%), palpitation (60%), and breathlessness (52.5%). The haemoglobin (Hb) concentration ranged from 7gm/dl to 12gm/dl and 57% patients had an Hb concentration of 8 gm/dl. Sixty percent of the respondents had jaundice with majority had enlarged spleen (86%) and some had enlarged liver too (23%). Ninety percent (90%) respondents had co-morbidities among which arrhythmia is more prevalent (54%).
We report a case of a 45-year-old gentleman presenting with numbness of both legs and hands. He has anemia, spastic quadriplegia with exageraterd tendon jerks with lose of vibration and position sense. Investigations revealed combined deficiency anemia with low serum vitamin B12. His MRI of cervicel spine was normal. Endoscopically he had atrophic gastritis. Ultimately he was dignosed as a case of sub-acute combined degeneration of spinal cord due to pernicious anemia. Patient was treated with injection vitamin B12 and well responded. On his followup, he had significant clinical improvement. This is a reversible condition if early diagnosis can be made and vitamin B12 therapy promptly given. Delayed treatment can result in irreversible neurological impairment.DOI: http://dx.doi.org/10.3329/jom.v14i1.14585 J MEDICINE 2013; 14 : 85-87
Background: Blood culture is a part of management algorithm in febrile neutropenia. However, the incidence of positive result of blood culture is decreasing and the spectrum of the causative microbial is changing over time. Objective: The objective of this study was to see the incidence of bacteraemia and its association with the severity of neutropenia. Methodology: Based on naturally occurring blood stream infection, we evaluated 47 febrile neutropenic patients using blood culture to see the incidence of bacteraemia during the period between October 2009 and October 2010. Results: The overall rate of blood culture positivity was 17% (8/47). It was found to be significantly higher in 32% (8/25) (p = 0.014) of patients with very severe neutropenia, 26.9% (7/26) (p = 0.044) positivity was found when blood culture was done on the first day of febrile episode and 41.7% (5/12) (P = 0.008) in the absence of prophylactic antibiotic. Conclusion: Blood culture was found to be a valuable tool for the evaluation of bacteraemia and should be used in all cases of febrile neutropenia.
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