SLE is one of the most common autoimmune disorders of women of childbearing age.It often manifests with various constitutional symptoms as well as combination of major organ involvement and outcome varies in different studies with current treatment. The present study is to see the patterns of organ involvement and outcomes at least after 6 months with standard treatment. This retrospective study was conducted in lupus clinic of two largest tertiary care hospitals in Dhaka city of Bangladesh over 2010 to 2019. It included 277 patients of SLE, diagnosed on the basis of ACR lupus diagnostic criteria and ACR lupus nephritis guideline and had received standard treatment. Outcomes were assessed by SLEDAI. The most common clinical manifestations were fever (71.8%), joint pain (71.4%), oral ulceration (54.8%), alopecia (36.4%), butterfly rash (28.5%), photosensitivity (32.1%) and Raynaud’s phenomenon (16.6%). Commonly involved major organ-systems were renal (41.5%), CNS (16.6%), pulmonary (7.2%), cardiac (3.2%) and hematological (12.2%). Renal biopsy was done in 91cases and the histology showed majority (37.3%) in class-IV. With standard treatment, a significant reduction of mean serum creatinine, proteinuria and SLEDAI was observed at least after 6 months. A total 35(12.63%) flares and 6 (2.17%) deaths occurred during the course of treatment. Renal and CNS are the most commonly involved major organ systems next to skin and joints. The overall outcome is favorable with standard treatment. J MEDICINE JUL 2020; 21 (2) : 89-92
Background: The health care workers’(HCWs) are working 24/7 in managing devastating pandemicCorona virus disease19(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) as front liner which leads them to be at highest risk for contacting infection. In Bangladesh, beinga lower middle-income country and densely populated, the burden is much more on HCWs. Methods: We did a cross-sectional study with an aim to identify the prevalence, risk factors, and outcomesof SARS-CoV-2 infection among the HCWs in a COVID-19 dedicated tertiary care hospital. Statisticalanalysis was done in SPSS version-26. Multivariate regression analysis was done to evaluate risk factorsresponsible for COVID-19 infection and the severity of the COVID-19 disease. We expressed odds ratiowith 95% CI, and considered the p-value of <0.05 as significant in the two-tailed test. Results: A total of 864 HCWs had participated with mean age of 34.16 ± 6.77 and 426 (49.31%) males.Among them 143 (16.55%) were tested RT-PCR positive for SARS-COV-2. Bronchial asthma/COPD andHypertension were the most common co-morbidities with 23 (16.08%) for each. About 102 (71.33%) ofthe RT-PCR positive HCWs became symptomatic. Fever, cough and myalgia were the most commonsymptoms 84(82.35%), 67(65.69%) and 52(50.98%) respectively.Multivariate regression analysis revealed hypertension, gout, and working in the COVID-19 confirmedward had a significant odds ratio for getting infected with SARS-CoV-2 [95% CI, p-value 1.91 (1.08 - 3.41),0.027; 5.85 (1.33 - 25.74), 0.020; and 1.83 (1.10 - 3.03), 0.019].Bronchial asthma/COPD and gout found to be risk factors for moderate to severe COVID-19 disease[95% CI, p-value 3.04 (1.01 - 9.21), 0.049 and 23.38 (3.42 - 159.72), 0.001]. Hospitalization rate was12(85.7%), and 3(100%) and median hospital stays were 11 (5.5 - 15), and 20 (7 - 30) days for moderate andsevere diseases respectively. Outcome was uneventful without any ICU admission and death. Conclusion: HCWs working in the COVID-19 confirmed ward are at increased risk of infection withSARS-COV-2. Some co-morbidities like hypertension and gout are important risk factors for contactingSARS-COV-2 infection. Bronchial asthma/COPD and gout favors disease severity. J MEDICINE 2022; 23: 5-12
Background: Acute pancreatitis (AP) is a significant cause of acute abdominal pain, morbidity andhospitalization. Knowing the details of the clinico-pathological presentation and outcome of the diseasemay aid the better understanding of the disease.Objective: The study was designed to assess the clinico-pathological profile and to estimate immediatehospital outcome of acute pancreatitis patients admitted into a tertiary care hospital. Materials and Methods: This hospital based cross-sectional type of observational study was conductedat Dhaka Medical College Hospital (DMCH), for one-year period (June 2018-May 2019).Total 106established cases of acute pancreatitis were included in this study. Data was analyzed by the SPSS 22Windows version and graph & chart were expressed by using SPSS 22 and MS Excel. The Result waspresented with tables and charts. Results: Among 106 patients, mean age of the patients was 42.5 ±11.3 SD (years), with male predominance(male: female-1.2:1). All of the patients complained abdominal pain (100%) while anorexia (48.1%), 43.4%had vomiting and 31.1% had fever. Regarding clinical signs, abdominal distension (45.3%), paralytic ileus(34.9%) and dehydration (43.4%) were found to be the major clinical signs. The common location of painwas in epigastric region (73.6%) with radiation to back in 20.8% patients. Pain was severe agonizing innature in 76.4% cases. Of all, gall stone disease (17.0%) was the most prevalent cause. According toAPACHE-II score, 74.5% patients had mild pancreatitis (APACHE-II <8) while according to Glasgowcriteria, 66.0% had mild disease (Glasgow score <3). Mean APACHE-II score was 7.07±2.50 and Glasgowscore was 2.90±2.33. Mean hospital stays were 8.9±3.6 days and NPO (nothing per oral) 4.9±1.9 days.Among the patients, 77.4% patients were alive and mortality rate was 22.6%. Conclusion: Although, a larger portion of the patients had no identifiable cause but gall stone was themost common etiology. Pain commonly located in epigastric region with radiation to back. Of all thecases, more than sixty percent of the patients had mild pancreatitis estimated by APACHE II score andGlasgow score. Mean hospital stays were about 9 days and nothing per oral was about 5 days. Overallmortality rate was 22.6%. J MEDICINE 2022; 23: 24-29
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