The well-documented fact that chronic arsenic exposure can lead to skin lesions, atherosclerotic diseases and cancers. The findings of association between arsenic exposure and diabetes mellitus indicate additional risk to human health. The aim of this study was to observe the association of chronic arsenic exposure from drinking water and risk of development of type 2 diabetes mellitus. To this end, a cross-sectional study was conducted in Comilla district of Bangladesh where ground water is heavily contaminated with arsenic. The individuals unexposed to arsenic were recruited from the Jhenaidah district. People with arsenic-related skin lesions were defined as subjects exposed to arsenic. Diabetes was defined if fasting blood glucose (FBG)>6.1 mmol/L following World Health Organization (WHO) guidelines. The common odds ratio for diabetes mellitus among subjects exposed to arsenic was 3.5 (95% confidence interval 1.1-10.9). After adjustment for age, sex and BMI, the Mantel-Haenszel weighted prevalence ratio was 3.5 (95% CI: 1.1-11.1); 3.7 (95% CI: 1.1-11.8) and 4.4 (95% CI: 1.1-17.2) respectively. The indicated relationships were significant (P<0.05). The observations suggested, chronic arsenic exposure through drinking water may be a risk factor of type 2 diabetes mellitus. J Bangladesh Coll Phys Surg 2019; 37(1): 5-12
Background: The occurrence of COVID-19 infection in rheumatic patients and their evaluation are of global interest. The purpose of this study was to determine the clinicodemographiccharacteristics of COVID-19 infection among rheumatic patients. Methods: In this observational cross-sectional study, 167 consecutive patients of both genders from online consultancy were enrolled from 13th June to 12thOctober 2020 conducted in a tertiary level rheumatology consultation center, Modern One Stop Arthritis Care & Research Center®, Dhanmondi, Dhaka. The WHO case definition of COVID-19 and disease severity scoring tool were used for diagnosis and assessment of the patients.Suspected cases were interviewed in detail and investigated with RT-PCR for COVID-19, HRCT of the chest, X-ray chest P/A view, and other necessary tests. The prevalence of COVID-19 infection was expressed in percentage. Results: Out of 167 rheumatic subjects,64 and 103 were men and women respectively, witha mean age of 42.15±13.04 years. The prevalence of COVID-19 infection was 7.78% (13/167). RT-PCR was positive in 9 (69.23%) patients and the remaining weresuspected cases (RT-PCR was negative but positive clinical features and X-ray chest findings.All COVID-19 positive patients presented with fever (100%).Among COVID-19 cases,spondyloarthritis (SpA), osteoarthritis of knee(OA),psoriatic arthrtis (PsA), rheumatoid arthritis (RA) and systemic lupus erythematosus(SLE)were5 (38.46%), 3 (23.08%), 2 (15.38%), 2 (15.38%) and 1 (7.69%) respectively.DMARDs/biologics wereongoingin 3 (tofacitinib), 1 (etanercept), 1 (methotrexate), 1 (sulphasalazine), 1(hydroxychloroquine) and 1 (leflunomide) patients.The use of non-specific drugs for Covid-19 treatment were azithromycin, ivermectin, doxycycline, and hydroxychloroquin. Among these rheumatic patients, the elderly group of patients with the comorbidities like diabetes5 (38.46%), hypertension 5 (38.46%)and bronchial asthma 3 (23.08%)were infected with COVID-19. Conclusion: The prevalence of COVID-19 was 7.78% among the rheumatic patients. Fever was the universal presentation in this study. The commonest rheumatic diseases were SpA . Diabetes and hypertension werethe most common comorbidities in patients with rheumatic diseases with COVID-19 infection. J Bangladesh Coll Phys Surg 2023; 41: 205-211
A 40-year-old woman had been suffering from many symptoms of Behçet's disease (BD) since her childhood without being diagnosed. She had recurrent mouth ulcers and, from the age of 21, vulva ulcers followed by loss of vision due to central retinitis and later also ankle arthritis. At the age of 31, uveitis due to BD was diagnosed. The fact that BD is often not recognized in Bangladesh explains the marked delay in her diagnosis. The initial central retinitis responded well to oral glucocorticoids, azathioprine, and cyclosporine, but in the course of time she became refractory to these agents. Considering her financial constraints, low dose Infliximab (3mg/kg) was used and resulted in a remarkable but temporal improvement. She went into remission by using a regimen of 5 mg/kg with increased interval time. In this article, the treatment options for ocular involvement in BD patients are summarized. Conclusions: In countries like Bangladesh, the diagnosis of Behçet's disease can be delayed. The early cooperation of dermatologists and eye surgeons with rheumatologists is necessary. Most cases of resistant ocular BD today can be successfully treated with anti-TNF agents. Promising results are published with other biologics for refractory and multi-resistant cases.
Background: The purpose of this study was to assess the efficacy and safety of intraarticular Hylan G-F 20 and triamcinolone acetonide 80 mg (TA) in primary knee osteoarthritis (OA) refractory to standard care in a developing country. Methods: After injection of either Hylan or TA, patients were seen at 12 and 26 wk. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, pain, stiffness (100 mm visual analogue score), and European Quality of Life (EQ) score were measured as well as radiographic joint space change and joint severity grade. Results: The 26-week study was completed by 24 patients receiving Hylan (45 knees) and 21 receiving TA (38 knees). The primary outcome (improvement ≥40% of total WOMAC scores) at 12 wk in the Hylan group was 30 (66.7%) and in the TA group 5 (13.2%) (P<0.00) and at 26 wk, 35 (77.8%) and 10 (26.3%), respectively, (P<0.001). All secondary end points (pain, stiffness quality of life) improved significantly after 12 and 26 wk in both groups) but more in the Hylan group. The Kellgren-Lawrence radiographic grade improved more in the Hylan group than the TA group. The joint space improved at 12 wk in the Hylan and TA groups (0.4±0.8 and 0.1±0.5, respectively, P=0.044), and at 26 wk (0.6±1.1 and 0.0±0.5, respectively, P=0.003). No remarkable side effects were observed. Conclusions: In primary knee OA refractory to standard care, pain improved significantly more with Hylan G-F 20 than with TA after 12 and 26 wk as regards function and quality of life. Further studies are needed to assess longer time effects.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.