Background: The objective of the study was to report the epidemiological characteristics of symptomatic laboratory confirmed COVID-19 patients seeking care from Dhaka Medical College Hospital (DMCH). Methods: This observational study was conducted in department of Medicine, DMCH for the period of 2 months following ethical approval. Total 100 RT-PCR confirmed COVID-19 patients were included and interviewed. Informed written consent was ensured before participation. Collected data were entered in a predesigned case record form and subsequently analyzed by SPSS-20. Results: Average age of presentation was 37.20±10.02(SD) years with male predominance (77%). Urban presence was in 90%. Thirty-two percent of the patients had comorbidities, with diabetes (16%) and hypertension (19%) being the most frequently observed.The most commonly observed symptoms was fever (65%), followed by cough (58%), breathlessness (42%), Dysgeusia (40%) and fatigue (33%). Mean duration of illness was 8.74±4.8 (SD) days. Overall mortality was 9%. All patients were managed according to the national guidelines and only 7% required ICU support. Conclusion: Patients were mostly middle-aged and male. Typical presentations were fever, cough, breathlessness and dysgeusia. Overall mortality was 9% among the admitted patients and requirement of ICU was 7%. Further study with large sample size is recommended to get a more precise picture. J MEDICINE JUL 2020; 21 (2) : 69-75

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

Background: Myocardial infarction is one of the leading causes of morbidity and mortality worldwide. Oxidative stress plays a vital role in the pathogenesis of atherosclerosis leading to myocardial infarction and Glutathione S-transferases (GSTs) act as detoxifying enzymes to reduce oxidative stress. The aim of the present study was to investigate the associations of the GST (T1 & M1) gene polymorphism with the susceptibility of myocardial infarction in the Bangladeshi population. Methods: A case-control study on 100 cardiac patients with MI and 150 control subjects was conducted. The genotyping of GST (T1 & M1) gene was done using conventional Polymerase Chain Reaction. Results: The percentage of GSTM1 genotypes was significantly (p< 0.01) lower in patients compared to control subjects while the GSTT1 genotypes were not significantly different between the study subjects. The individual with GSTM1 null allele was at 2.5-fold increased risk {odds ratio (OR)= 2.5; 95 % confidence interval (95 % CI)= 1.4 to 4.3; p< 0.01} of experiencing MI while individual with either GSTM1 or GSTT1 genotypes was at lower risk. In the case of GST M1 and GST T1 combined genotype, patients having both null genotypes for GST M1 and GST T1 gene showed significantly (p< 0.01) higher risk of experiencing MI when compared to control subjects (OR= 3.5; 95% CI= 1.7-7.2; p< 0.001). Conclusions: Thus our recent study suggested that GSTM1 alone and GSTM1 and T1 in combination augments the risk of MI in Bangladeshi population.

Background: Bone marrow aspiration is assessed for cytology and trephine biopsy provides overall cellularity, detection of focal lesion and infiltration. Bone marrow study plays a crucial role in identifying cause of aplastic anaemia in clinical practice. This study was carried out to see the etiological and clinical spectrum of pancytopenia based on bone marrow examination. Materials and Methods: This descriptive study was conducted in the Department of Medicine, Dhaka medical college Hospital, Dhaka, Bangladesh over a 2-year period (August 2016 to July 2018). A total 80 cases of pancytopenia were included in the study. Patients were diagnosed by hemoglobin less than 10 gm/ dL, total leukocyte count less than 4000/Cumm and platelet count less than 150000/cumm. Results: Maximum number of cases were seen in age group of 16-30 years (31.25%) and male to female ratio is 1.1:1. The commonest presenting complaint was fever in 40% (32/80) of the cases. Pallor was present in all the patients, Splenomegaly was seen in 20% (16/80) and hepatomegaly in 12.5% of the cases (10/80). Petechial hemorrhages were present in 5% (4/80). The commonest cause of pancytopenia was megaloblastic anemia (35%) and followed by aplastic anemia (32.5%). Conclusion: Pancytopenia is a common clinical problem encountered in clinical practice and the major differential diagnostic considerations of pancytopenia are aplastic anemia, megaloblastic anemia and hematological malignancies. J MEDICINE JUL 2019; 20 (2) : 68-71

Abstract Abstract Backgr Backgr Backgr Backgr Background: ound: ound: ound: ound: Hypertriglyceridemia fosters the development of atherosclerosis via several mechanisms and lead to ischemic stroke (IS) through its contribution to thrombogenicity. The association of hypertriglyceridemia with ischemic stroke was evaluated in this study. Methods:Methods: Methods: Methods: Methods: This was a case control study conducted in the Department of Medicine, Dhaka Medical College Hospital and data was collected in a questionnaire from January to June'2013. Patients presented with ischemic stroke, confirmed by CT scan of Head/ MRI of brain from 1 day to 6 months and other than ischemic stroke patients were considered as case and control respectively. Results:Results: Results: Results: Results: The mean age was found 61.0±8.3 years in case group and 60.5±8.1 years in control group. Male were predominant in both groups which was 80 (80.0%) in case group and 84 (84.0%) in control group. More than two third (68.0%) in cases and one fourth (25.0%) in controls patients had hypertension. 12 (12.0%) in cases and 2 (2.0%) in controls patients had heart disease. Normal triglycerides was found 52 (52.0%) in cases and 72 (72.0%) in control. The mean TG was found 179.9±62.8 mg/dl in cases and 148.0±51.9 mg/dl in controls. Desirable cholesterol was found 16 (16.0%) in cases and 25 (25.0%) in controls. The mean cholesterol was found 238.0±4.0 mg/dl in cases and 213.0±42.0 in controls. Optimal LDL was found 12 (12.0%) and 18 (18.0%) in case and control group respectively. Mean LDL was found 167.0±35.2 mg/dl in cases and 141.0±36.1 mg/dl in controls. Low HDL was found 64 (64.0%) in cases and 26 (26.0%) in controls. Mean HDL was found 41.2±10.6 mg/dl in case group and 49.0±8.6 mg/dl in control group.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a distinct clinicopathologic entity characterized histologically by a spectrum ranging from simple steatosis to steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma (HCC).Objective: To determine the incidenceand identify the risk factors of NAFLD in non-obese patients.Methods: It was a cross sectional study done in Department of gastroenterology, Nuclear Medicine and ultrasound, Radiology and Imaging, Virology, Biochemistry, BSMMU, Dhaka from March 2012 to June 2014. The patients more or equal to 18 years, non-obese were included. In this study total 190 patients were enrolled.Results: Among them 38 patients were with fatty liver and 152 patients without fatty liver on the basis of ultrasonogram. Where 141 were male and 49 were female with mean age was 49.24 + 9.05 years. Among total, 18.9% had diabetes mellitus, 28.4% had dislipidaemia 24.4% had history of hypertension. Total 18.9% patients having history of diabetes mellitus, normal vs fatty liver disease (20% vs 42.1%, p <0.001) and history of dyslipidemia (10.5% vs 100% , p <0.001), Haemoglobin percentage was 12.16 + 1.32 gm/dL, urine routine microscopic examination glucose present in 9.5% patients. SGPT 56.34 + 16.09 IU/L, SGOT 41.62 + 5.94 IU/L, alkaline phosphatase 99.31+ 19.76 IU/L. We found 6.3% patients were HBsAg positive and no patient was Anti HCV positive.Conclusion: Sedentary life style, Metabolic syndrome, DM, dyslipidameia, are risk factors of NAFLD in non obese person. Elevated liver enzymes are consequences of NAFLD. Though this study has some limitations, it will give some information about emerging liver disease without viral hepatitis.J MEDICINE July 2015; 16 (2) : 89-92

Introduction: Inadequate glycemic control among patients with type 2 diabetes constitutes a major public health problem and risk factor for the development of diabetes related complications. Hypertension is a common co-morbid condition of diabetes. Hypertension as a factor for poor glycemic control in diabetes patients has not been properly evaluated in Bangladesh. The aim of the study was to assess status of glycemic control among patients with Type 2 DM depending on the level of blood pressure in a tertiary care hospital. Method: This cross sectional study was carried out among 200 adult patients of either gender with type 2 diabetes mellitus, in the Department of Medicine and endocrinology, Dhaka Medical College Hospital from January to June 2015. Results: The mean age of the respondents were 56.85(±10.84) years, ranging from 35 to 77 years. Among 200 patients, 129 (64.5%) were hypertensive and 71 (35.5%) were normotensive with a mean duration of hypertension was 10.03 (±3.39) years. The mean HbA1c for all diabetic, hypertensive and normotensive patients were 7.41% (±1.35), 7.63% (±1.30) and 7.02% (±1.37) respectively. The mean HbA1c was significantly higher in hypertensive than normotensive group (p=0.002). The mean HbA1c was also significantly higher in patients with duration of hypertension (p=0.03) for more than 10 years and in patients who used beta blocker (p=0.005) and diuretics (p=0.02) as hypertensive medication. Among the patients with normal BMI and on dietary modification, those who were hypertensive had significantly higher (p=0.00008) mean HbA1c (7.12(±0.99)) than those were normotensive (5.01(±0.01)). Conclusion: The glycemic control in type 2 DM is found to be poor among the hypertensive patients. There is a complex association of multiple factors like age, gender, duration of hypertension and medications strongly influence the glycemic control of type 2 diabetics with hypertension. J MEDICINE JAN 2021; 22 (1) : 12-17

Introduction: Modern management of bronchial asthma requires prolonged medications to prevent symptoms and airflow limitations. An important issue in proper management of bronchial asthma is adherence to treatment. Objective: To see the non-adherence rate to inhalational medication in bronchial asthma patient as well as to see the factors responsible for non-adherence. Materials and Method: It was a cross sectional study conducted from 1st September 2017 to 31st March 2018 in Medicine unit of Sir Salimullah Medical College and Hospital (SSMCH). Result: Among the 136 respondents 70% were male and 30% were female. Non adherent rate was 93.7% for male and 100% for female. High cost of medicine, poor counseling, lack of family support, lack of immediate efficacy, forgetfulness, knowledge on how to use device are the main factors for non-adherence. Conclusion: The rate of non-adherence is very high amongst the participants. Therefore promoting optimal medication adherences through education, proper counseling is essential to optimize the benefits of treatment J MEDICINE JAN 2020; 21 (1) : 41-45