There have been very few reports in the literature of gout and pseudogout of the spine. We describe six patients who presented with acute sciatica attributable to spinal stenosis with cyst formation in the facet joints. Cytopathological studies confirmed the diagnosis of crystal arthropathy in each case. Specific formation of a synovial cyst was identified pre-operatively by MRI in five patients. In the sixth, the diagnosis was made incidentally during decompressive surgery. Surgical decompression alone was undertaken in four patients. In one with an associated degenerative spondylolisthesis, an additional intertransverse fusion was performed. Another patient had previously undergone a spinal fusion adjacent to the involved spinal segment, and spinal stabilisation was undertaken as well as a decompression. In addition to standard histological examination material was sent for examination under polarised light which revealed deposition of urate or calcium pyrophosphate dihydrate crystals in all cases. It is not possible to diagnose gout and pseudogout of the spine by standard examination of a fixed specimen. However, examining dry specimens under polarised light suggests that crystal arthropathy is a significant aetiological factor in the development of symptomatic spinal stenosis associated with cyst formation in a facet joint.
Background: Tuberculosis continues to be a health problem in many countries. There may be simultaneous multiple organ involvement. Diagnosis of one organ disease may lead to missing off diagnosis of other organ involvement.Objectives: The present study was done to analyze the association of cutaneous tuberculosis with pulmonary tuberculosis.Material and methods: Through purposive sampling a total of 23 patients of suspected cutaneous tuberculosis were primarily enrolled in this cross sectional study. History was taken and examinations were done to find out types of cutaneous lesions and to explore a pulmonary involvement. Investigations including CBC with ESR, Mantoux test and Skin biopsy were done for each and every patient. Those who had cutaneous tuberculosis on histopathology chest x-ray were done to detect pulmonary lesions. After investigations 2 patients were excluded due to absence of tubercular infection. Finally 21 patients were included in this study. Data were collected in a predesigned structured questionnaire.Results: Out of 21 patients 16 (76.19%) were male and 5(23.81%) were female with a male to female ratio of 3.2:1. Age range varies from 5-70 years with a mean of 29.76±18.2 years. MT was positive in 76.20% of patients. CXR showed 23.81% of the patients with cutaneous TB had simultaneous pulmonary involvement. The association is statistically significant (p<0.05).Conclusions: Patients with Cutaneous tuberculosis may have pulmonary involvement in a statistically significant number. In any patient with cutaneous TB, meticulous systemic examinations and relevant investigations have to be done to explore pulmonary involvement. DOI: 10.3329/bmrcb.v36i2.6988Bangladesh Med Res Counc Bull 2010; 36: 57-60
Introduction:Christmas disease (Hemophilia B, factor IX hemophilia) is a rare bleeding disorder due to deficiency of coagulation factor IX 1 . Most commonly factor IX is quantitatively reduced, but in one-third of cases an abnormally functioning molecule is immunologically present. Factor IX deficiency is one-seventh as common as factor VIII deficiency hemophilia but is otherwise clinically and genetically identical.Factor IX deficiency or dysfunction occurs in 1 in 100,000 male births 2 . Accurate laboratory diagnosis is critical, since it is indistinguishable clinically from factor VIII deficiency (hemophilia A) but requires different treatment. Case Report:A 25 years old college student hailing from Mymenshing got himself admitted in BSMMU hospital on 2 nd February, 2009 with complaints of pain and restricted movement of left hip joint for 10 days, recurrent swelling and pain in multiple joint for last 20 years and prolonged bleeding following minor trauma since childhood.On examination patient is mildly anaemic, non icteric, pulse-92/min, BP-110/70 mm of Hg, no edema or lymphadenopathy. On examination of musculoskeletal system, there was wasting of thigh and calf muscles, tone was normal, power was 4/5, movement was reduced in both knee & elbow joints, as well as left hip joint. Nervous system and other system examination reveled nothing abnormal. Christmas Disease (Hemophilia -B) - Abstract:We report a 25 years old man developed Haemarthrosis of left hip joint with a history of recurrent swelling and pain in multiple joints and prolonged bleeding following minor trauma since childhood. Subsequent investigations revealed Christmas disease (Haemophilia B). Hemophilia B is an X-linked bleeding disorder. This case emphasises the importance of considering a diagnosis of haemophilia in a man with unexplained bleeding, even in the absence of a positive family history.[ BSMMU J 2009; 2(2): 90-91]
The purpose of the present study was to find out the clinicopathological characteristics of Hepatocellular Carcinoma (HCC) patients. All the clinically suspected patients were recruited as per inclusion and exclusion criteria. The relevant socio-demographic characteristics, clinical findings as well as the physical examination were performed after talking written consent from all the study subjects. The ultrasonography was performed to all the patients. After that, the patients were sent to the department of pathology for histopathological examination. The descriptive cross-sectional study was carried out in the Department of Oncology of National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh from July 2014 to June 2015 for a period of 12 months. Total sample size was 52 in this study and age distribution of HCC was found from 25 years to 97 years to with the mean age 50.57 ± 12.09 years. Males were predominant (78.0%), male and female ratio was 3.72:1. The common presenting features of HCC were abdominal pain and swelling, fever and jaundice; viral marker was positive in 86.5% of patients (HBsAg-67.3%, Anti HCV-19.2%) with normal tumor marker alpha-fetoprotein (AFP) in 69% of the patients. Okuda staging shows 82.7% patients within stage I and Stage II and performance status, 38.5% patients were unable to carry out normal activity. Sonological findings revealed 69.2% patients had ≤2 cm tumor size, 88.4% had ascites lastly splenomegaly was present among 86.5% respondents.
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