Abstract:Peripheral neuropathy is common in chronic renal failure patients and it '

Background and purpose: Stroke is a leading cause of mortality and morbidity in both developed as well as developing countries. The clinical presentation of stroke depending on the site and extent of lesions. For the management purpose it is important to know whether we are dealing with a bleed or an infarct. Methodology: Computed Tomography (CT scan) is available most of the tertiary level hospitals in Bangladesh. This study was carried out to compare clinical diagnosis of stroke with Computed tomography (CT) scan findings in ascertaining the type of stroke (hemorrhagic or ischemic). Materials and methods: This cross-sectional comparative study was conducted in the Department of Neurology, Rajshahi Medical College Hospital during the period of January 2010 to December 2010. Total 200 stroke patients were selected by purposive sampling technique on the basis of inclusion and exclusion criteria as the study sample. . CT brain scan was done for all the patients. The clinical diagnosis was compared with the results of CT scan and performance test was done. Results: Clinically 67 patients were diagnosed as hemorrhagic stroke and 133 patients were diagnosed as ischemic stroke. Out of these 67 hemorrhagic patients CT scan revealed that 56 patients had intracerebral hemorrhage, 5 had infarct, 4 had subarachnoid hemorrhage and 2 had space occupying lesions in the brain. Out of these 133 ischemic patients CT scan revealed that 119 patients had infarction, 6 had intracerebral hemorrhage and 8 had space occupying lesions in the brain. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of hemorrhagic stroke were 90.32%, 92.03%, 83.58%, 92.02% and 91.5% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of ischemic stroke were 95.96%, 81.58%, 89.47%, 92.53% and 90.5% respectively. Conclusion: The diagnosis of stroke in clinically with high accuracy, but perform a CT scan will help to confirm and differentiate to type stroke. Thus CT scan should be done in all cases stroke to specify the diagnosis. DOI: http://dx.doi.org/10.3329/bjn.v28i2.17179 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 96-101

Spinal tuberculosis (Pott’s disease) during pregnancy reported to be rare & can be associated  with destruction of the intervertebral disc & adjacent vertebrae that can lead to cord compression  & thereby paraplegia or quadriplegia. Delay in diagnosis is common & most cases are diagnosed  when paraplegia has already been occurred. This serious complication requires special attention  during pregnancy & delivery. Here we reported a case of term pregnancy with Pott’s paraplegia.  As the patient had complete motor & sensory loss from D7 level, (above the level of umbilicus  to the lower limbs) LUCS was done without anesthesia & a healthy female baby was delivered.  She did not require any analgesia post operatively DOI: http://dx.doi.org/10.3329/bjog.v25i1.13731 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 37-40

Spinal tuberculosis (Pott's disease) during pregnancy reported to be rare & can be associated with destruction of the intervertebral disc & adjacent vertebrae that can lead to cord compression & thereby paraplegia or quadriplegia. Delay in diagnosis is common & most cases are diagnosed when paraplegia has already been occurred. This serious complication requires special attention during pregnancy & delivery. Here we reported a case of term pregnancy with Pott's paraplegia. As the patient had complete motor & sensory loss from D7 level, (above the level of umbilicus to the lower limbs) LUCS was done without anesthesia & a healthy female baby was delivered. She did not require any analgesia post operatively.TAJ 2009; 22(1): 282-286

Mollaret's meningitis is defined as a benign recurrent aseptic meningitis characterized by three to ten episodes of fever and signs of meningeal irritation lasting between 2 to 5 days, associated with spontaneous recovery. Mollaret in 1944 described this rare form of self limiting aseptic recurrent benign meningitis. It is an extremely rare condition. Till 2002 approximately 50 cases of recurrent HSV meningitis have been described in the United States and in Europe. Here a report of a patient with recurrent meningitis, which resembles the criteria of Mollaret's Meningitis, is presented.   doi: 10.3329/taj.v17i1.3489 TAJ 2004; 17(1) : 41-46

Idiopathic Intracranial Hypertension is a disease of unknown aetiology common in obese females and presents with headache, papilledema, raised CSF opening pressure, no abnormalities in CSF examination and no abnormality on CT scan or MRI of the Brain. Sinovenous abnormalities are commonly detected in patients of IIH by different neuroimaging techniques. But the exact role of these sinovenous abnormalities in the causation of the disease or whether they are an effect of the disease is not yet known. Nor has a ‘gold standard’ investigation been established yet for detection of the sinovenous abnormalities. This study was done to detect the presence of sinovenous abnormalities in IIH patients by performing a Magnetic Resonance Venography of the brain. All 33 patients of IIH who presented to Rajshahi Medical College Hospital during the study period from June 2009 to May 2010 were included in the study. There were 30 females and 3 males having a F:M ratio of 10:1. 91% of the patients were between 20 and 35 years of age and most of them were married housewives. 63.64% patients had history of use of oral contraceptives. Unusually 51.52% of the patients had a BMI less than 25 indicating that they were not even overweight (BMI 25 to 30). Only 6% of the patients had BMI > 30 indicating that they were obese. Headache and papilloedema were present in all patients but visual difficulties were present only in 54.54% of the patients. Abnormalities in MRV of the brain were detected in 27.27% (9/33) of the patients and transverse sinus hypoplasia was the commonest finding (88.89% - 8/9 patients). There was no statistically significant difference in the findings of MRV abnormalities between the males and females or among the patients having BMI less or more than 25TAJ 2013; 26: 53-56

Parkinson's disease is a disease of motor manifestations but non-motor symptoms are also common in Parkinson's disease. Little emphasis is put on non-motor symptoms of PD and there is little data on the relationship of non-motor symptoms to different aspects of the patient and the disease. In this study the relationship of non-motor symptoms to age at onset, duration and stage of the disease, and dose and duration of levodopa use are studied.128 patients of PD were studied for non-motor symptoms. 111 patients had different types of sensory, autonomic or psychiatric symptoms. Sensory and autonomic symptoms were significantly more common in patients with early age of disease onset and more prolonged duration of the disease, but psychiatric symptoms had no relationship with these factors. In this study it was also found that the frequencies of non-motor symptoms were related to the stage of the disease, longer the duration of the disease more and more non-motor symptoms appear so that 100% patients in stage 5 of the disease had non-motor symptoms. Also sensory and autonomic symptoms were significantly more common in patients with longer duration and higher dose of levodopa use but psychiatric symptoms were significantly commoner in patients with prolonged duration of levodopa use but not to dose of levodopa used.

One of the most common and useful forms of medical intervention is anticoagulant therapy and it is the mainstay of treatment and prevention of thrombosis in different clinical settings, like atrial fibrillation (AF), acute coronary syndrome (ACS), acute venous thromboembolism (VTE), and in patients undergoing invasive cardiac procedures. More than 6 million patients in the United States receive long-term anticoagulation therapy for the prevention of thromboembolism due to AF, placement of a mechanical heart-valve prosthesis, or VTE.1 For more than 60 years, until 2009, warfarin and other vitamin K antagonists were the only class of oral anticoagulants (OAC) available. Although these drugs are highly effective in prevention of TE, their use is limited by a narrow therapeutic index that necessitates frequent monitoring and dose adjustments. This results in substantial risk and inconvenience, leading to inadequate anticoagulant prophylaxis. Recently some new OAC have been marketed which are effective, easier to use and has less side effects. Dabigatran is a new oral thrombin inhibitor and Rivaroxaban, Apixaban and Edoxaban are oral factor Xa inhibitors. This review outlines why these new OACs were essential and describes in detail about these new drugs. J Bangladesh Coll Phys Surg 2019; 37(3): 135-150