Abstrcat not availableFaridpur Med. Coll. J. 2014;9(1): 1-2
:Aspirin is the widely used cheap antiplatelet agent globally. Since marketing it was unbeaten for use in coronary diseases and ischemic stroke patients. Unfortunately for the last two decades the term ''Aspirin resistance'' (AR) has been evolved due to it's failure to protect the aspirin users against major cardiovascular events. Although the PlA1/A2 polymorphism in the GPIIIa platelet receptor along with other factors have been identified as responsible for this resistance, the term has not yet been defined. There is no consensus about ideal platelet function test. So it is more appropriate to say "treatment failure" to aspirin therapy rather using the term AR. Although Clopidogrel is being used alone or in combination with aspirin to overcome AR,platelet receptor (p2y12) inhibitors both Prasugrel and Ticagrelor are more potent than Clopidogrel in Acute Coronary Syndrome (ACS). Worldwide Prasugrel and Ticagrelor have been included in different guidelines to use in ACS.
Abstract:Annually about two million deaths occur globally due to tuberculosis (TB). Bangladesh ranks the sixth position among 22 highest burden TB countries in the world and also one of the 27 high multidrug resistant tuberculosis (MDR-TB) burden countries where about 70,000 people die every year due to TB. Among six key components of Stop TB Strategy (STS) Plan, the first one includes increase case notification of all forms of TB and improve diagnosis of new smear negative, extrapulmonary cases and TB in children by 2016. As TB can affect any organ in human body, the TB cases are managed by any discipline in medical community. Unfortunately diagnostic accuracy is not satisfactory and is not only due to uniform unavailability of the latest diagnostic facilities but also due to inadequate knowledge of the professionals about currently available modern laboratory techniques to diagnose TB. Light-emitting diode (LED) microscopy with fluorescence (auramine-rhodamine staining) should be preferred than conventional microscopy with Zeihl-neelsen (acid fast) staining to identify TB bacilli. Mantoux test (MT) indicates only infection by TB bacilli, does not necessarily the active disease. It may be positive in latent TB and in BCG (Bacillus Calmette-Guerin) vaccinated cases. Antibodies from Lymphocyte Secretion or Antibodies in Lymphocyte Supernatant (ALS) assay can detect active TB cases within three days of sample collection. The test is very useful to diagnose TB in children where sputum collection is difficult. Interferon gamma release assay (IGRA) tests are not advocated in low and middle-income countries, typically those with a high TB and/or HIV burden. Anti TB IgG/IgM/IgA tests should be avoided because these are being misinterpreted by someone as active TB cases. Adenosine Deaminase Assay (ADA) is a reliable test to diagnose tuberculous pleural effusion together with other evidences. ADA in pleural fluid <40 IU/L is considered negative for TB. The more the ADA level, the more possibility to be tuberculous effusion. Level >100 IU/L is highly specific for TB origin. Gene Xpert MTB/RIF, an Xpert test for mycobacterium tuberculosis (MTB) and Rifampicin (RIF) resistance, is used for rapid identification for TB bacilli, specially when MDR-TB is suspected, in human immunodeficiency virus ( HIV) infected cases and highly suspected sputum negative cases ( as a follow on test ) where microscopy frequently failed due to low bacterial load. The test exhibits high sensitivity and specificity for detecting pulmonary TB.
Dengue fever and dengue hemorrhagic fever emerged as major health problem in South East Asia and Bangladesh as well. The purpose of this study is to determine the use of ultrasound as an important adjunct to clinical and laboratory profile in diagnosing dengue fever and in predicting the severity of the disease. Sixty serologically diagnosed dengue fever patients between August and October 2019 referred for ultrasound scanning of the abdomen and thorax were selected for the study and the findings were analyzed. Out of the 60 patients, 19 (31.67%) had hepatomegaly, thick walled gall bladder, ascites with bilateral pleural effusion; 15 (25%) had hepatomegaly, thick walled gall bladder, ascites and only right sided pleural effusion; 6 (10%) had hepatomegaly and right sided pleural effusion; 5 (8.35%) had hepatomegaly and ascites; 3 (5%) had thick walled gall bladder; 1 (1.66%) patient had left sided pleural effusion and hepatomegaly; 1 (1.66%) patient had only hepatosplenomegaly; 1 (1.66%) had ascites with pericardial effusion and no abnormal sonographic findings was found in 9 individuals (15%). Ultrasound findings should strongly favor the diagnosis of dengue fever in patients presenting with fever and associated symptoms, particularly during an endemic. A simple ultrasound examination will effectively expedite the diagnosis and justifies initiation of specific treatment for dengue fever pending serological confirmation. Ultrasound also helps substantially in estimating the severity of the disease. Faridpur Med. Coll. J. Jul 2019;14(2): 90-92
Not Available Faridpur Med. Coll. J. Jan 2020;15(1): 1-2
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