Uric acid has been proven to be a negative prognostic indicator in patients with acute myocardial infarction and heart failure. So the aim of the present study is to evaluate the uric acid as a predictor of outcome after acute myocardial infarction. A total of 120 patients presenting with acute myocardial infarction were included in the study where case were the AMI with heart failure and arrhythmia and control were the only Ami patients. Patients were evaluated in relation with clinical features, risk factors, complications, heart failure with Killip Class and serum uric acid level. Sociodemographic profiles of the study populations were matched in case and control group. Regarding different biochemical variables of case and control where serum uric acid was found significantly higher among the case group than the control (p<0.05). Among different risk factors of MI where hypertension, smocking, DM and sedentary lifestyle were found common in both case and control group showing the different signs of the case and control where all were more or less common among both groups. Serum uric acid level and arrhythmia class among the case group. Regarding prognostic evaluation of uric acid after MI where complete recovery, arrhythmia, recurrent MI, hospital stay and death was significantly found associated with risk stratification. Serum uric levels are raised during an episode of myocardial infarction and more so when the patient is in heart failure. There is a positive correlation between rising serum uric acid levels with higher Killip Class at the time of admission. Thus uric acid can be used as a prognostic indicator in patients presenting with myocardial infarction more so if they are in heart failure. JCMCTA 2016 ; 27 (2) : 63- 66
Introduction: Tuberculosis (TB) is highly prevalent in Bangladesh. The affection of the central nervous system(CNS) is one of the most dangerous manifestations of extrapulmonary tuberculosis. This may take the form of either tubercular meningitis (TBM), tuberculoma, or spinal arachnoiditis. CNS tuberculosis (CNS-TB) carries high morbidity and mortality among all forms of TB. The diagnosis is difficult and often delayed due to the varied and non-specific presentation. Aside from clinical indicators, cerebrospinal fluid (CSF) diagnostic indicators include mononuclear pleocytosis, low sugar levels, and high protein concentrations. It is possible to confirm Mycobacterium tuberculosis in CSF using staining, culture methods, and molecular analysis, but it is difficult. Advanced radiological imaging techniques can often be very helpful in making presumptive diagnoses, but they do not always yield confirm diagnoses. Aim: In our case series, we aimed to highlight the spectrum of presentation of CNS tuberculosis, diagnostic challenges, and initial response to anti-TB drugs. Material and Methods: We report a case series of six patients with CNS tuberculosis admitted to the neurology department between 2022 and 2023. Four of them were prospectively reviewed and two retrospectively. Data on presentation, diagnostic workup, and treatment were analyzed. Result: We presented six cases of CNS TB from 2022 to 2023. Four cases among six had only TBM, two cases had concomitant intracranial tuberculoma and two cases had tuberculosis in the extracranial site. The most common presentation were fever, altered consciousness level, and constitutional symptoms. CSF study was done and revealed increased total protein in all six cases, lymphocytic pleocytosis in 66.67% of cases, a low sugar level in 50% of cases, and raised ADA level in 66.67% of cases. MTB was detected in a polymerase chain reaction (PCR) in one case and was none positive for AFB stain and culture. MRI with contrast showed meningeal enhancement in all six cases, hydrocephalus in 66.67% of cases, and infarction and tuberculoma in 33.33 % of cases. Brain biopsy for histopathological confirmation was not done. All of them had an anti-tubercular therapy and reported good clinical responses at 21-day-follow up. Conclusion: CNS TB should be diagnosed primarily based on compatible clinical features, morphological findings on brain MRI, and CSF findings. In Bangladesh, CNS TB should always be considered an important differential diagnosis in patients with prolonged fever and headache, as well as altered consciousness level, and treatment should be initiated immediately on the basis of strong clinical suspicion, rather than waiting for laboratory confirmation.
Background: BCR-ABL translocation is the most common genetic abnormality associated with adult Acute Lymphoblastic Leukaemia (ALL) with poor outcome. Objective: The aim of the study was to determine the association of myeloid aberrant antigens and the presence of BCR-ABL gene rearrangements in acute lymphoblastic leukaemia (ALL) patients in our context. Method: A total of 38 ALL patients were included in this cross-sectional study from August 2018 to July 2019 according to selection criteria. BCR-ABL was detected by Real Time-Polymerase Chain Reaction (RT-PCR). Results: The median age at diagnosis was 27.5 years with male (76.3%) predominance. Aberrant myeloid markers, e.g.CD13 was present in 9(64.3%) patients who were BCR-ABL positive which was statistically significant (p:<0.05). Conclusion: Early suspicion about BCR-ABL positivity can be made in ALL patients who show aberrant myeloid expression.
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