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Objective: Invasive deep fungal infections have become a major cause of morbidity and mortality over the pastthree decades. Organ transplantation, the use of aggressive chemotherapy and the availability and widespreaduse of immunosuppressive treatments for many medical ailments have resulted in large populations ofpatients who are at risk of fungal infections. We report our experience to increase awareness of the clinicalspectrum of disseminated fungal infection and its similarity to other infections and malignancy.Materials and Methods: Case reports from different medical institution for last 6 months were searched throughcase registry and recent scientific presentation and publications.Results: Recently a case of Histoplasmosis was reported in Dhaka Medical College Hospital (DMCH) wherea 57 years old male presented with low grade fever for 3 months, backache followed by progressiveweakness of both lower limbs , there was spastic paraplegia with sensory loss upto the level of D10. An openbiopsy from paravertebral soft tissue showed histopathological features consistent with histoplasmosis. Otherdeep fungal infections e.g. pulmonary blastomycoses, mucormycoses and pulmonary aspergilloma were alsoreported in DMCH and Bangabandhu Shiekh Mujib Medical University (BSMMU) and RMCH.Conclusion: As these fungal infections are not commonly encountered in our country and most of the disseminationhas similar clinical features of chronic inflammatory process and malignancy, we need a high index of suspicion todiagnose with different diagnostic approach. Bangladesh may be experiencing increase load of disseminated fungalinfections and awareness is now very important to explore its underlying aetiology.Keywords: Endemic mycoses; histoplasmosis; blastomycosis; mucormycosis; aspergilloma; BangladeshDOI: 10.3329/jom.v11i2.5466J MEDICINE 2010; 11 : 170-175

Histoplasmosis is a deep fungal infection caused by Histoplasma capsulatum. It presents commonly with transient pulmonary infection but disseminated form can involve any system in the body. Adrenal gland is affected frequently in histoplasmosis but bilateral involvement is unusual. Adrenal histoplasmosis is also common in immunocompromised host. We report a case of bilateral adrenal histoplasmosis in an immunocompetent patient without any features of adrenal insufficiency. Histoplasmosis was diagnosed by fine needle aspiration cytology (FNAC) from adrenal gland. Patient was treated with itraconazole with good response and is currently under follow-up.

Background: Proton pump inhibitors (PPIs) are one of the most frequently prescribed classes of drugs in the world in the treatment of peptic ulcer, dyspepsia and gastro-oesophageal reflux. Objectives: To determine demographic, clinical response and practice characteristics of PPIs among the patients attending the out-patient department of a tertiary care hospital. Materials and Methods: In this prospective observational study 100 patients attending the out-patient department and taking oral proton pump inhibitors (PPI) for different symptoms and duration were included. Patient’s socio-demographic characteristics, PPI-related information (duration, frequency of use, doses and classes of PPIs) and symptomatic responses after taking PPI were noted. Drugs or diseases that influenced the intake of PPI were also recorded. Investigations done before or during PPI use and their findings were also noted. Results: Omeprazole (43%) and esomeprazole (35%) were the most frequently prescribed PPIs. Most of the patients (52%) were on PPI therapy for 1−3 months. Majority of the patients (72%) had taken PPIs on daily basis and 19% patients had taken irregularly or occasionally. Dosing frequency of PPIs prescribed were twice daily in most of the patients (77%). Sixty seven percent (67%) patients had taken PPI prescribed by doctors and 33% patients had taken PPI prescribed by non-doctors. Common indications for prescribing PPIs were heart burn (54%), upper abdominal pain/discomfort (38%) and bloating (33%). Symptoms reappeared after stopping the PPI in most of the patients (40%) and 35% patients had satisfactory relief of symptoms with PPI. Conclusions: Omeprazole and esomeprazole are the most frequently prescribed PPIs. Majority of the patients had taken PPIs on daily basis. In around one-third of the patients PPIs were prescribed by non-doctors. Common indications for prescribing PPIs were heart burn, upper abdominal pain/discomfort and bloating. Symptomatic responses varied after taking PPI and symptoms reappeared after stopping the PPI in most of the patients. J Enam Med Col 2020; 10(1): 10-16

Objectives: Different teaching aids are advocated in the medical colleges for delivery of lectures such as power point presentation, blackboard, transparency sheet, overhead projectors, extempore and lecture sheets .The aim of our study was to compare the more acceptable teaching methods between the students of Dhaka Medical College and Enam Medical College. Materials and Methods: Total one hundred students were selected from fourth year in each medical college. They were asked to fill in a fourteen item questionnaire about their perception of five lecture delivery methods. Questionnaire was properly explained. The results were analyzed separately to find out any differences between preferences of teaching methods in both medical colleges. Results: In DMC 50% students preferred traditional blackboard method ,25% PowerPoint presentations, 5% both blackboard and PowerPoint, 16% extempore and 4% lecture sheet .On the other hand, in EMC, 53% mentioned PowerPoint presentation as most acceptable, 38% blackboard, 5% combined blackboard and PowerPoint and 4% extempore. Some important comments were recorded which could be valuable for the medical teachers. Conclusion: The study showed that students of DMC clearly prefer traditional blackboard method rather than other teaching aids, whereas students of EMC prefer PowerPoint presentation. The study does not bring out any evidence based superiority of any lecture delivery method. It appears that any teaching aid can be appropriate and effective if the teachers are properly trained. This highlights the need for formal training in teaching technologies for good presentation and thus motivate the students. DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13612 Bangladesh J Medicine 2010; 21: 60-64

Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 60-62 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16124

Background: Following menopause there are changes in values of lipid profile parameters. Abdominal obesity has also been linked to significant metabolic abnormalities including changes in lipid parameter values. Atherogenic index of plasma (AIP) calculated as log (TG/HDL-C) has been used as some practitioners as a significant predictor of atherosclerosis. So, we designed this study to observe the pattern of lipid profile parameters and to find out AIP in postmenopausal central obese women and to compare these between postmenopausal women with central obesity and postmenopausal nonobese women. Objectives: To assess the lipid profile status and AIP of postmenopausal women with central obesity and to compare these parameters with that of postmenopausal nonobese women. Materials & Methods: This cross sectional study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Sixty six postmenopausal women with central obesity and age matched 56 nonobese postmenopausal women were included in the study. Central obesity was defined having waist hip ratio more than 0.8 and BMI <25.0. All statistical analyses were done by SPSS 18.0. p values <0.05 were considered significant. Results: Statistically no significant difference was observed between the central obese women and nonobese women in lipid profile parameters. But AIP was found significantly higher in postmenopausal central obese women. Conclusion: Central obese postmenopausal women may be at higher risk of cardiovascular events compared with postmenopausal nonobese women in spite of no difference in lipid profile parameters as their AIP values are significantly different.

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