Background: Androgenetic alopecia (AGA) also known as male pattern baldness is the most common hair loss disorder characterized by chronic, nonscarring disorder that is marked by a progressive reduction in the diameter, length, and pigmentation of the hair. This disorder is located primarily on the central scalp with various patterns of loss. Pathophysiological features include an alteration in the hair cycle via reduction of the anagen (growth) phase, inflammation, and follicular miniaturization. Therapies for AGA are limited and there is no cure. There is a high demand for hair restoration. Platelet-rich plasma (PRP), a treatment modality shown to promote wound healing, has also been explored as a treatment for AGA. Objectives: To observe the effectiveness of platelet-rich plasma for Androgenetic Alopecia. Materials & method: This prospective observational study was conducted among 30 subjects with androgenetic alopecia from July 2018 to June 2020 in a reputed private hospital in Dhaka. Five platelet-rich plasma (PRP) treatments, at intervals of 4 –5 weeks, and 2 follow-up examinations were performed. Blood (9 cc) from each AGA patient was collected in 10 cc syringe, and PRP was isolated using commercially available kit under sterilized conditions. Isolated PRP was injected in the bald areas of scalp of AGA patients. Treatment efficacy was assessed by changes in hair number and diameter. A secondary objective was to assess clinical improvement, which was evaluated by 5-point Likert scale. Then variables were analyzed and compared. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Comparison was done by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc. Result: It was found that majority of the patients i.e. 41(68.3%) were in the age group 20-40 years, mean age was found to 38.3±6.5 years. No significant difference in age and other demographic profile was observed between groups. The median (range) hair number per square centimetre at baseline was 38.0 (13-105) in the both groups. At the final follow-up visit, hair number is improved & it was found 53.0 (24-130) in the treated group and 41.0 (11-105) in the control group. Differences was statistically significant (p=0.017). Hair diameter (μm) at baseline was 65.0 (48-81) μm in the treated group and 66.0 (49-75) in the control group. At the final follow up visit, hair diameter also improved and it was 80.0 (58-94) μm in the treated group and 69.0 (51-85) μm in the control group. Differences was statistically significant (p=0.031). There were no treatment-related adverse effects. Conclusion: Present study concluded that PRP is an effective treatment option in androgenetic alopecia, provides better clinical outcome in terms of improve hair density, diameter and significant subject satisfaction. J Shaheed Suhrawardy Med Coll 2021; 13(2): 158-163
Background: COVID-19 is the pandemic disease causes severe acute respiratory infection. Tcell mediated responses are activated and responses are initiated by antigen presentation via DCs and macrophages. Immunologically SARS-CoV showed that virus infected lung epithelial cells produced IL-8 in addition to IL-6. A hyperinflammatory environment has been a hallmark of COVID 19 infection and is thought to be a key mediator of morbidity and mortality. C-reactive protein (CRP), an inflammatory marker, can be used in the diagnosis of COVID pneumonia. Purpose: To find out the role of CRP in COVID-19 Infection and comparison with Chest Computed Tomography. Materials and method: This cross sectional prospective study was conducted in Department of Medicine, Dhaka Medical College Hospital, among the 100 patients with symptomatic and positive RT-PCR for SARS-CoV-2. C-reactive protein (CRP) level was compared with HRCT findings. All the information collected in data collection sheet and analyzed using SPSS version-22. Result: Mean age of the patient was 45.2 ± 8.5 years. Fever and cough was commonest presentation, 79.0% and 36.0% of patients respectively. It showed, 27.0% cases were found to have raised CRP where 73.0% had normal level with mean value 14.1 mg/L. Chest HRCT imaging finding revealed, 44% patients had 26–50% lung involvement and 16 patients had 51–75% involvement. In maximum patients (57.0%), chest CT showed single or multiple GGO. HRCT score was significantly higher in patients with raised CRP, and a significant positive significant correlation (r=0.941; p=0.001) between the HRCT scores and CRP level. Conclusion: The rising CRP can aid in predicting COVID-19 pneumonia and significantly correlates with percentage of lung involvement on HRCT in COVID-19 pneumonia. J Dhaka Med Coll. 2021; 30(2) : 136-141
Background: Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy which imposes a heavy burden of maternal morbidity and mortality if its diagnosis and treatment are delayed. Objective: This prospective study intended to determine the frequency, etiology and outcomes of the patients of pregnancy related acute kidney injury (PRAKI) in different tertiary care hospitals in Bangladesh. Methods: This was a prospective study of patients with pregnancy related complications leading to acute kidney injury admitted in selected departments of different tertiary care hospitals in Bangladesh for a period of one year (October 2018 to September 2019). Patients were included in this study who were healthy previously and developed acute kidney injury (serum creatinine >70.72 mmol/l) due to pregnancy related complications. Recruited patients were monitored after 3 months with a view to exclude chronic kidney disease. Result: A total of 351 patients with pregnancy and puerperium were observed, of these patients studied, 34 (9.2%) had pregnancy-related AKI. In 32 patients who completed the study, the mean age was 27.2±6.2 years. There were more subjects belonging to the rural area (68.8%) and nineteen (59.4%) of patients were below primary level of education. Most of the study subjects from lower socioeconomic status (56.2%). Twenty-one (65.5%) patients were multigravida, and mean parity of the patients included in this study was 1.7±0.8. Nineteen (59.4%) patients did not receive any antenatal care. PRAKI occurred during the post-partum period in 53.2% of the cases, 21.9% in third trimester, and 24.9% in first and 2nd trimester. The most common cause of PRAKI in our study was sepsis, occurring in about 15 patients (46.9%). Most common presentation of PRAKI was oliguria (87.5%) and edema (84.3%). Mean hemoglobin level was 7.8 ±1.7 gm/dl and creatinine level was 573±407 μmol/l. A majority of the patients (81.25%) underwent hemodialysis, while others were treated with conservative management only. At the three-month follow-up, complete resolution of AKI was observed in 62.5% patients, progressed to CKD in 25% whereas mortality occurred in 12.5% patients. In univariate analysis, inappropriate antenatal care (p- 0.0018), low mean platelet count (p-0.00001), higher serum creatinine (p-0.00004), dialysis at presentation (p-0.0154), and septicemia (p-0.0487), have significant effect. Conclusion: Pregnancy related AKI is still a critical situation in developing countries and rare entity in developed countries. Maternal mortality has decreased but sepsis still accounts for majority of cases of PRAKI. Therefore, early diagnosis and treatment is the need of the hour. J Dhaka Med Coll. 2021; 29(1): 76-81
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