Peginterferon α-2a and ribavirin combination therapy achieves a sustained virological response (SVR) in patients with chronic hepatitis C. Little is know about long-term durability of hepatitis C virusRibonucleic acid (HCV-RNA) negativity in patient treated with pegylated interferon and ribavirin therapy. Aim of this study was to evaluate the durability of virologic response in patients with SVR to anti-viral therapy treated at our centre. A total of 52 patients with chronic hepatitis C virus infection who had obtained SVR after Peginterferon α-2a and ribavirin combination therapy were followed up to 5 years with annual HCV-RNA testing. During this follow up period, 4 of 52 patients with initial SVR developed late relapse of hepatitis C virus infection. Relapse was more common in patients who has cirrhosis (3/6 [50%]) vs (1/46 [2.17%]) without cirrhosis. In conclusion, SVR is durable in most patients, but some patients do have late relapse; long term follow up may be particularly important in a subset of patients with hepatitis C virus infection who have liver cirrhosis.
In the treatment of common bile duct stones and palliative decompression of malignant strictures, endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard. However, there are still concerns about procedure-related complications and patient discomfort. The aim of the study is to evaluate the pattern of post ERCP complications. This prospective observational study was conducted at the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February to October 2017. A total of one hundred patients who were eligible for ERCP were included in this study but five patients were excluded due to cannulation failure. Clinical examination , biochemical, and radiological investigation were performed before and after ERCP to assess the complication that occurred. The majority of patients in this study were at and below the age of 50 years, with a mean age of 49.74 ± 14.07 years and the age range was between 18 to 80 years. Majority of the subjects were male (54.7%), and male to female ratio was 1.21:1. The highest number of patients were diagnosed as choledocholithiasis (58.9%) followed by proximal cholangiocarcinoma (13.7%), Ca-gallbladder with biliary infiltration (8.4%), Distal cholangiocarcinoma (6.3%), Chronic calcific pancreatitis and Periampullary carcinoma each (3.2%), Suspected SOD & Chronic pancreatitis each (2.1%) and Worm in CBD and benign biliary stricture each (1.1%). In this study, the overall post-ERCP complication was 12.6%, with pancreatitis accounting for 9.4%, bleeding accounting for 2.1%, and cholangitis accounting for 2.1%. From the study, it can be concluded that pancreatitis is the most frequent Post-ERCP complication. Bangladesh Med J. 2021 May; 50(2) : 35-39
Objective: To determine etiological pattern of patients presenting with upper gastrointestinal bleeding in a tertiary care hospital of Bangladesh.Methods: This study was a prospective observational study, carried out in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to June 2013. Fifty adult patients presenting with haematemesis and/or melaena admitted into gastroenterology inpatient unit from outpatient department or patients referred from other inpatient units of Department of Medicine of BSMMU were included in the study. Endoscopic examination was performed within 24 to 48 hours of presentation. Lower GI endoscopy was done in selected cases.Results: The study patients were predominantly young or of early middle age with mean age being 34.45 ± 16.5 yrs. A male preponderance was observed with male to female ratio being 7.3:1 (44 male and 6 female). 62% of the patients presented with both haematemesis and melaena, 26% with melaena only and 12% with haematemesis alone. Endoscopy of upper gastrointestinal tract demonstrated duodenal ulcer to be predominant finding (50%), followed by gastro-esophageal erosions (20%), gastric ulcer (12%), esophageal varices (10%), gastric adenocarcinoma (4%) and stomal ulcer (4%).Conclusions: Endoscopy revealed that duodenal ulcer was the most common cause of upper gastrointestinal bleeding followed by oesophageal erosion, gastric ulcer, esophageal varices and stomal ulcer. Peptic ulcer disease still remains as the major cause of acute upper gastrointestinal haemorrhage, though cases of oesophageal erosion were also significant.Bangladesh Crit Care J September 2015; 3 (2): 60-62
Probiotic formulation is useful in reducing symptoms of irritable bowel syndrome. To assess effectiveness of multistrain probiotics with standard treatment than standard treatment alone. This was a randomized control trial conducted in the Department of Gastroenterology, BSMMU, from July 2015 to June 2016. Patients with diagnosed case of IBS using Rome III criteria, absence of red flag sign like anemia, fever, weight loss, per rectal bleeding, nocturnal frequency, family history of IBD, cancer and age 18-55 years, no probiotics used in prior 3 months were included in the study. Patients were divided into group A (Standard treatment) and group B (Probiotics with standard treatment). Symptom severity scores especially for abdominal pain, global symptom severity were assessed at baseline, at one month interval during treatment for two months and one month post treatment. Mean age of the patients was 31.64 ± 9.72 years and 32.17 ± 10.03 years with no statistical significant difference with male female ratio of 4.2:1 and 3.06:1 in group A and group B respectively. Severity of abdominal pain, frequency of pain in every 10 days, severity of abdominal distension, satisfaction with bowel syndrome, frequency of open bowels per day gradually reduced in both groups but was higher in group B than group A (P<0.05). Passing mucus with motion was gradually reduced in both groups but the decrement was higher in group A than group B (p<0.05). Multistrain probiotics with standard treatment is more effective in reducing IBS symptoms than standard treatment alone. JCMCTA 2016 ; 27 (2) : 31- 38
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