Introduction: Since the first detection of corona virus disease (COVID-19) cases in Dhaka, Bangladesh on 8 March, 2020, numbers are rising alarmingly. Clinical data on COVID-19 in Bangladesh is lacking. We report early findings on demographic profile, clinical presentations and short-term clinical outcomes of confirmed COVID-19 patients admitted in a large teaching hospital in Dhaka, Bangladesh with preliminary analyses of their association with mortality. Materials and Methods: In this retrospective cross-sectional study, we included reverse transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 patients aged ≥ 15 years, who were admitted in Dhaka Medical College Hospital (DMCH) between May 2 and 15, 2020, the first two weeks when DMCH started admitting COVID-19 patients. Data were collected between May 25 and 29, 2020 from patients or their attendants through telephone interview by a structured questionnaire, after having appropriate consent, irrespective of outcome. One hundred and eight consecutive patients met inclusion criteria through convenient sampling from ward registrar, 102 patients could be reached over phone and data from two patients were discarded in the data cleaning process. The statistical analysis was done by the Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Among the total participants (n=100), mean age was 41.7±16.3 years, 63% were male and 60% patients had positive contact history. Appearance of symptom to hospital admission time was a median of 6 days (range 1 to 21 days) and mean hospital stay was 7.77 ± 5.62 days. Predominant presenting symptoms were fever (69%), cough (54%), breathlessness (41%), fatigue (40%), anorexia (26%) and diarrhea (19%). Hypertension (21%), diabetes mellitus (16%), heart diseases including ischemic heart disease (IHD) (8%) and renal diseases including chronic kidney disease (CKD) (8%) were frequent comorbidities. Ten out of hundred patients died. Older age (p= 0.001), male sex (p= 0.007), smoking (p= 0.001), breathlessness (p=0.001) and presence of comorbidities (p= < 0.05) were significantly associated with mortality. Conclusion: Frequent positive contact history and significant association of breathlessness, smoking and comorbidities with mortality in our study reinforces that abiding by the prevention and containment process, smoking cessation, ensuring proper oxygen therapy and addressing comorbidities adequately are very important measures to mitigate COVID-19 in Bangladesh like the rest of the world. J Bangladesh Coll Phys Surg 2020; 38(0): 29-36

IntroductionChikungunya is an arthropod-borne virus endemic to Africa, Southeast Asia and India that causes acute febrile polyarthralgia and arthritis. In this short case series, we discuss six Bangladeshi patients with chikungunya fever. Though Bangladesh is in endemic zone, it is not common here, hence it demands attention for proper diagnosis and management.Case presentationThe six cases of chikungunya we report occurred in native Bangladeshi women with ages ranging from 20 to 50 years and all having a middle class family background. Three women had severe incapacitating arthralgia as well as a maculo-papular rash and a high fever. The other three had a high grade fever and arthralgia only, but no rash. They were tested for chikungunya immunoglobulin M antibody and found to be positive in all cases. They were treated symptomatically with non-steroidal anti-inflammatory drugs and found responsive in most cases.ConclusionFrom this case series, it is evident that chikungunya is not that uncommon in Bangladesh. But the concomitant presence of other arthropod-borne infections with similar courses of illness makes most physicians less aware of this infection. An awareness and clinical knowledge are necessary to diagnose chikungunya infection properly.

Background: Alcohol is one of the most important causes of liver disease. In Bangladesh, alcoholism is not a usual practice among the general population as there are social and religious barriers against it. But in the Hill tracts, there is no social stigma in taking alcohol. Relatively little is known about this aspect in Bangladesh. This small-scale study was done to identify the spectrum of liver disease among tribal people. Material and Methods: A descriptive, observational clinical study was conducted for a period of six months (1st July, 2007 to 31st December, 2007) on a series of 50 tribal alcoholic people, collected from General Hospital and the tribal community of Rangamati Hill District. Subjects were included from both the urban and rural area of different socioeconomic classes. History, meticulous clinical examination and investigations were done to detect the pattern of alcohol induced liver injury. Results: Among the 50 cases, 47 patients were male and 3 were female cases. Both regular and irregular drinkers were included. The common symptoms of liver disease among tribal alcoholics were yellow coloration of sclera (24%), nausea & vomiting (20%) and weight loss (14%). The common findings were jaundice (24%), anemia (20%), ascites (10%), edema (10%) and hepatosplenomegaly (20%). Liver function tests revealed only 17 patients had mild to severe form of hepatocellular damage. Hyperbilirubinemia was found in 34% participants. AST/ALT ratio more than 2 was found in 32% subjects. Ultrasonography was done in 46 out of 50 subjects: 29 cases reported as normal (63.04%), fatty liver in 5 (10.87%), acute hepatitis in 5 (10.87%) and chronic liver disease in 7 (15.22%) cases. Liver biopsy was possible in 4 suspected cases (clinically and biochemically) of alcoholic liver cirrhosis and histology supported the clinical diagnosis in these cases. So, alcohol induced liver damage was noticed only in 17 cases. Nearly two-thirds of the participants were free from any form of liver disease. Conclusion: Despite the presence of risk factors for developing alcoholic liver disease, the prevalence was found to be low among the tribal alcoholic participants in this study. Keyword: Alcoholic liver disease; alcoholic fatty liver; alcoholic hepatitis; alcoholic liver cirrhosis; tribal population; Bangladesh DOI: 10.3329/jom.v12i1.6925J Medicine 2011; 12 : 7-11

No abstract

Melioidosis is not widely recognized in Bangladesh which is evident from the paucity of published reports on melioidosis from this region. Here, we summarize the clinical presentation, laboratory results, prevention and control policies and make important recommendations for patient management. A 35-years-old diabetic male forest officer from Gazipur Sadar located north-west of Dhaka city got admitted to Shaheed Suhrawardy Medical College Hospital, Dhaka with history of recurrent fever for last 1 year. Initially the fever was high grade (upto 105 0 F), intermittent nature and lasted for a few days to week. About five months back, the patient developed a parietal abscess over the left lumber region and was treated surgically accordingly. The patient then gradually recovered and remained afebrile for about one month. Fever again recurred, high grade, quotidian in nature and has been persistent for the last 3 months. The patient had also developed marked loss of appetite, altered bowel habit with occasional vomiting and lost about 15kg of his body weight. The patient noticed profuse watery diarrhea for last 2 days and got himself admitted. On examination, the patient was found wasted, conscious but slow mentation, dehydrated and moderately anaemic. His pulse was 116/min, blood pressure 80/60 mm Hg, respiration 24/min and oral temperature was 103 0 F but no palpable lymph nodes. The patient had moderate hepato-splenomegaly with left sided pleural effusion and bilateral depressed ankle jerks. Burkholderia pseudomallei was isolated and identified by blood and urine culture as well as with serological test. We should be more alert among the diabetic patients who are presented with fever with high ESR and neutrophilic leucocytosis, even if radiography or cytopathology is indicative of tuberculosis. [Bangladesh J Infect Dis 2015;2(1):23-26]