Anthrax is a zoonotic disease caused by Bacillus anthracis. It is potentially fatal and highly contagious disease. Herbivores are the natural host. Human acquire the disease incidentally by contact with infected animal or animal products. In the 18th century an epidemic destroyed approximately half of the sheep in Europe. In 1900 human inhalational anthrax occured sporadically in the United States. In 1979 an outbreak of human anthrax occured in Sverdlovsk of Soviet Union. Anthrax continued to represent a world wide presence. The incidence of the disease has decreased in developed countries as a result of vaccination and improved industrial hygiene. Human anthrax clinically presents in three forms, i.e. cutaneous, gastrointestinal and inhalational. About 95% of human anthrax is cutaneous and 5% is inhalational. Gastrointestinal anthrax is very rare (less than 1%). Inhalational form is used as a biological warefare agent. Penicillin, ciprofloxacin (and other quinolones), doxicyclin, ampicillin, imipenem, clindamycin, clarithromycin, vancomycin, chloramphenicol, rifampicin are effective antimicrobials. Antimicrobial therapy for 60 days is recommended. Human anthrax vaccine is available. Administration of anti-protective antigen (PA) antibody in combination with ciprofloxacin produced 90%-100% survival. The combination of CPG-adjuvanted anthrax vaccine adsorbed (AVA) plus dalbavancin significantly improved survival.
This retrospective study was carried out in the Medicine Department of Khulna Medical College, the biggest tertiary hospital in the southern part of Bangladesh to observe the trends of poisoning in southern part of Bangladesh over four years including age and sex variation, mode of poisoning, type of poison used and outcome of poisoning. The hospital medical records of all patients, aged 10 years and above with history of acute poisoning from January, 2003 to December, 2006 were enrolled. Patients were categorized into four age group including Group (Gr.) I, Gr. II, Gr. III & Gr. IV having age range of 10-20, 21-30, 31-40 & >40 respectively. Underlying causes of poisoning were also observed totally and individually in different mode with male, female ratio and the percentage. Death cases according to mode of poisoning with demographic alignment were also observed. Statistical analysis were done using epi-info version 3.5.1 and measures were presented as proportion and percentage. Among 1903 cases, 1012 (53.1%) were male and 891 (46.8%) female with a ratio of 1.4: 1. The year wise total number of cases were progressively decreased from 627 (2003) to 353 (2006). Most commonly found toxic agent was Organo-Phosphate compound (526; 27.64%) with a very little sexual variation & this trend remained same in all study years. Poisoning with unknown substance was the second leading cause (16.03%) followed by Copper-sulphate (14.03%), Sedative (13.35%), Snakebite (12.93%) etc. Incidence of unknown poisoning, sedatives, snake-bite and corrosives were found to be gradually decreased over the study years. Male were found mostly affected in majority type of poisoning except Copper-sulphate, kerosene, puffer fish, paracetamol and other drugs category. Age group II (710; 37.3%) was the most vulnerable group with male (57.89%) preponderance followed by group I (643; 33.7%), III (329; 17.2%) and IV (221; 11.6%) respectively. Highest 1308 (68.7%) cases were suicidal in mode followed by 304 (15.9%) accidental and 291 (15.2%) homicidal. Out of 1903, 140 (7.3%) patients died. Death rate was highest in OPC poisoning (52.1%) followed by unknown substance (13.5%), snakebite and copper-sulphate (11.4%) etc. In an agro-based country like Bangladesh, it’s very difficult to reduce the poisoning cases and mortality. Prospectively designed multi-centered studies are needed to reflect the epidemiological properties of poisonings throughout Bangladesh, and would be very valuable for the determination of preventive measures. DOI: http://dx.doi.org/10.3329/bmrcb.v37i2.8436 BMRCB 2011; 37(2): 61-65
Haemophilia has been recognized a clinical entity since Biblical times when there was repeated history of death from circumcisional bleeding in male siblings. Recent advances in protein chemistry and recombinant DNA technology have produced a comprehensive account both of normal coagulation and of the molecular genetics of some type of haemophilia. Haemophilia is a hereditary coagulation disorders usually of male associated with serious bleeding which is transmitted by healthy women. It is caused by a reduction in the amount or activity of factor VIII. This protein serves as a cofactor for factor IX in the activation factor X in the coagulation cascade. Haemophilia A & Haemophilia B exhibit a wide range of clinical severity that correlate well the level of factor VIII activity. Those with less than 1% of normal activity develop severe disease; levels between 2% and 5% of normal are associated with moderate disease; and patient with 6% to 50% of activity developed mild disease. The variable degrees of factor VIII deficiency are largely explained by heterogenecity in the causative mutation. Several genetic lesions - deletions, nonsense mutations that create loop codons, splicing errors have been documented. Most severe deficiencies result from an unusual inversions involving X chromosomes that completely abolishes the synthesis of factor VIII. Haemophilia is inherited as X-linked recessive trait, and thus occurs in male and both homozygous and heterozygous female. Approximately 30% of patients have no family history; their disorder is presumably caused by new mutation. In this review article we want to highlight the recent aspects of haemophilia including the occurrence of haemophilia in female, genetic causes of coagulation factor deficiency, carrier detection and antenatal diagnosis, upto date diagnostic tools of this hereditary coagulation disorder as well as management of haemophiliac patients in special situation like circumcision, road traffic accident, minor and major surgery. (J Bangladesh Coll Phys Surg 2007; 25 : 29-37)
Influenza mostly affected under-five children and young adult. The peak season here was late summer and rainy season.
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