Rapid progression of chronic kidney disease (CKD) is seen in patients with hepatitis C virus (HCV) infection compared with uninfected patients. Despite the high efficacy of direct-acting antivirals (DAAVs), their cost represents a limiting factor to their use in developing countries. Aim. This study aimed to evaluate the efficacy of low dose Sofosbuvir along with Daclatasvir in the management of HCV infection in end-stage renal disease (ESRD) patients. Methods. A total of 82 HCV positive patients on ESRD were included in this study. The patients were observed for six months without antiviral drugs. Patients who remained seropositive were divided into two groups. The first group included 26 (37%) patients who were treated with half-dose Sofosbuvir 200 mg and Daclatasvir 60 mg and the second group consisted of 44 (63%) patients who have been treated with full-dose Sofosbuvir 400 mg and Velpatasvir 100 mg irrespective of HCV infection genotype for 12 weeks also. Results. 12 (14%) patients became seronegative spontaneously. All patients (100%) of both groups achieved sustained virological response with undetectable HCV RNA in 12 weeks of the treatment. There were nonsignificant gastrointestinal side effects in the full dose Sofosbuvir group. All patients tolerated the DAAs well. No patient discontinued antiviral therapy due to side effects Conclusion. In this study, the spontaneous seroconversion of HCV was 14%. Low-dose Sofosbuvir along with Daclatasvir was safe and as effective as full-dose Sofosbuvir and Velpatasvir in the treatment of HCV in ESRD patients. Low-dose Sofosbuvir regimen can be recommended for HCV infection treatment in ESRD patients.

not available J Bangladesh Coll Phys Surg 2019; 37(4): 165-166

No abstract

Background: Although menstrual abnormalities and associated hormonal dysregulations are very common in the reproductive age group of Chronic Kidney Disease (CKD) patients, this remains a neglected area. This field had been poorly explored in last ten years worldwide and a few research regarding this area in Bangladesh as well. Aim: To evaluate menstrual abnormalities occurring in CKD stage 5 (CKD5)patients undergoing twice-weekly and thriceweekly maintenance hemodialysis (HD) also in non-dialytic CKD5 patients and to provide more detail information on hormone profile (FSH, LH, Prolactin, Estradiol) of these patients. Materials and method: This obsevational study was conducted in the Department of Nephrology, DMCH, the sample population was also collected from BSMMU and NIKDU from April 2017 to March 2018. A total of 51 CKD stage 5 patients were enrolled in this study. Among them, 34 patients were dialytic (17 of them were taking twice weekly HD and 17 of them were taking thrice weekly HD) and 17 non-dialytic patients at reproductive age were evaluated. Detailed menstrual histories, thorough clinical examinations as well as investigations were done in all the patients. Serum FSH, LH, Estradiol, and Prolactin were evaluated using chemiluminescence immunoassay in the Department of Microbiology of BSMMU. Statistical analysis of the study was done by SPSS-24. The confidence interval was considered at 95% level. P-value <0.05 was considered statistically significant. Results: 100% of non-dialytic CKD5 women had menstrual disorders (72% of patients had secondary amenorrhea, 18% had oligomenorrhoea and 10% had menometrorrhagia). And 73.52% of patients in the HD group had menstrual disorders (29% patients had regular menstruation, 28.5% had secondary amenorrhea, 23.5% had oligomenorrhoea and 19% had menometrorrhagia). With continuation of HD amenorrhea disappeared in 43% of patients in the thrice-weekly HD group, also 22.22% patients in the twice-weekly HD group regained menstruation. Serum LH and prolactin levels were significantly higher in the non-HD group compared to the HD group (p<0.05). Estradiol levels were also higher in HD patients than the non-HD patients. LH and Prolactin levels were also higher in the twice-weekly HD group compared to the thrice-weekly HD group. In the secondary amenorrheic group, serum FSH, LH, Prolactin levels were significantly higher than the other groups having menstrual disorder (p<0.05). Conclusion: Menstrual abnormalities and associated hormonal dysregulations were significantly lower in thriceweekly HD patients compared to the twice-weekly HD patients and significantly lower in twice-weekly HD patients compared to the non-dialytic CKD5 patients. Besides, it is suggested that long-duration dialysis might improve menstrual disorders in such patients as prolactin, LH levels gradually decreased with longer duration of dialysis. J Bangladesh Coll Phys Surg 2022; 40: 45-51

The first case of COVID-19 in Bangladesh was declared in March 08, 2020 and since then we are fighting against this deadly pandemic under the prudent and dynamic leadership of Hon’ble Prime Minister Sheikh Hasina as Chief Advisor. The active, sincere and dedicated efforts of Prime Minister’s Office, Cabinet Division, Ministry of Health and Family Welfare and other different ministries have proved this COVID battle to be a winning game for our country. All the doctors, nurses and health workers played the pivotal role along with administration, police and all others. Among the frontline doctors, the fellows and members of all specialties of Bangladesh College of Physicians and Surgeons (BCPS) had a significant participation. They remain to be appraised. This review article probes to reveal the enormous contributions of all fellows and members of BCPS in various sectors of the COVID-19 battle in Bangladesh. This paper analyzed all activities of BCPS fellows and members by collecting data from the COVID-19 dedicated hospitals, Directorate General of Health Services, Bangladesh and directly from fellows of BCPS. A systematic search in the net was also performed using specific search words to extract relevant data and articles published on COVID-19 from Bangladesh. A non-probability sampling technique was used without any structured questionnaire. Data were directly included in MS excel spread sheet. Simple description analysis was performed and results were expressed in tables and charts. We found that fellows and members of BCPS took a significant leadership and provided supreme dedicated services in almost all fields of COVID-19 crisis; e.g. frontline patientcare, education and training, national policy making, research and publication and nationwide guidance and awareness build-up. Among the doctors of government COVID-19 dedicated hospitals in Dhaka, about 650 fellows participated in treating about 1.5 lacs admitted patients. First interim guideline on COVID-19 management in Bangladesh was published by fellows in executive committee of Bangladesh Society of Medicine. It was later transformed into national guideline by DGHS. Fellows were the leaders at national level. The National Technical Advisor Committee and Directorate General of Health Services of Bangladesh are the two main bodies who lead the war in the frontline and both are headed by fellows of BCPS. Journal of BCPS was the first in Bangladesh to publish COVID-19 supplement issue on July 31, 2020 with 12 original articles. So far 128 COVID related articles from BCPS fellows have been published in national and international journals. Fellows fought in the frontline in every sector, shoulder to shoulder with all doctors and health workers of Bangladesh. They have triumphed their beloved college, Bangladesh College of Physicians and Surgeons, to be one of the greatest centers of excellence for the medical education and patient care in Bangladesh. J Bangladesh Coll Phys Surg 2022; 40: 19-27