Background: The COVID-19 pandemic has imposed psychological distress and fear across the globe; however, factors associated with those issues or the ways people cope may vary by country or context. This study aimed to investigate the factors associated with psychological distress, fear, and coping strategies for people living in Bangladesh during the COVID-19 pandemic.Methods: A cross-sectional study conducted in August-September 2020 using online platforms in Bangladesh. People residing in Bangladesh, aged ≥18 years, who were proficient in English and able to respond to online questionnaire. The Kessler Psychological Distress Scale was used to assess the psychological stress. Level of fear was assessed using the Fear of COVID-19 Scale, and strategies to cope were assessed using the Brief Resilient Coping Scale.Results: Of the 962 participants, half of them were aged between 30 and 59 years. Being born in Bangladesh, having graduate education, perceived distress due to employment change, effect of COVID-19 on financial situation, having multiple comorbidities, and visiting a healthcare provider in the last 4 weeks were associated with higher levels of both psychological distress and fear of COVID-19. Furthermore, higher psychological distress was associated with being a female (AOR 1.81, 95% CI 1.33–2.47, p < 0.001), being a frontline worker (AOR 1.50, 95% CI 1.04–2.15, p < 0.05), having pre-existing psychiatric problems (AOR 4.03, 95% CI 1.19–13.7, p < 0.05), being a smoker (AOR 2.02, 95% CI 1.32–3.09, p < 0.01), providing care to a known/suspected COVID-19 patient (AOR 1.96, 95% CI 1.40–2.72, p < 0.001), having a recent overseas travel history and being in self-quarantine (AOR 4.59, 95% CI 1.23–17.2, p < 0.05), self-isolation without COVID-19 (AOR 2.63, 95% CI 1.68–4.13, p < 0.001) or being COVID-19 positive (AOR 2.53, 95% CI 1.19–5.34, p < 0.05), and having high levels of fear of COVID-19 (AOR 3.27, 95% CI 2.29–4.66, p < 0.001). A higher level of fear was associated with moderate to high levels of psychological distress (AOR 3.29, 95% CI 2.31–4.69, p < 0.001). People with pre-existing mental health problems were less likely to be resilient (AOR 0.25, 95% CI 0.11–0.54, p < 0.01), whereas those with having an income were more likely to be resilient (AOR 1.46, 95% CI 1.02–2.11, p < 0.05).Conclusion: Effective interventions to support the vulnerable groups including improved access to mental health services are of utmost importance during the pandemic.

Background: Ischaemic priapism is one of rare presentation of Chronic myeloid leukaemia due hyper viscosity and it needs urgent urological intervention. Objective: To evaluate the need of urological intervention in Priapism with Chronic Myeloid Leukaemia (CML). Methodology: This is a retrospective study from January 2014 to July 2019 in the department of Urology, DMCH. Among 126 patients 6 were diagnosed as Priapism with CML. Records of these patients were evaluated and analyzed. Results: Among 126 patients 6 patients were diagnosed as priapism with CML Mean age of the patient was 46.7 years, 2 of them were farmer and 2 had history of taking herbal drugs immediate before sexual intercourse and developed Priapism. Five patients were newly diagnosed as CML after admission in Urology ward. Of these six cases five were managed with minimal invasive procedure such as intermittent pseudo-ephedrine injection and wide bore needle corporal aspiration with pseudo-ephedrine irrigation as emergency management, only one needed surgery that was proximal shunt. After emergency management all patients were sent to hematologist for definite management of CML. Conclusion: Priapism with CML is a medical emergency which need immediate minimal intervention with concomitant haematological management.

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL) in the world, and accounts for 30%–40% of all adult NHLs. It is clinically, morphologically and genetically a heterogeneous group of tumors composed of large B cells. This study aimed to determine the clinical features, treatment options, the response rate in a specialized cancer care centre. Methods: This retrospective study included all DLBCL patients registered in the department of Haematology of National Institute of Cancer Research and Hospital (NICR&H), Bangladesh between July 2016 to June 2019. Results: A total of 151cases were included in this study. The mean age was 47 years with a standard deviation (SD) of 15 years. Males (66.2%) were more in the occurrence of DLBCL. We divided the cases into three different entities of DLBCL and non-germinal centre B (non-GCB) variety was the prevalent (46.4%) one. Several types of first-line chemotherapy were used in management and the overall response rate (ORR) was 76.6% and 9.2% of death. The response was found to be significant with B symptoms, stage, and international prognostic index (IPI) score. But no significant difference was observed in outcome among different types of DLBCL after treatment. Conclusion: This retrospective study will help to ascertain the co relation of DLBCL outcome with clinicopathological profile. (edited) J MEDICINE JAN 2021; 22 (1) : 3-6

Background: Patients with active cancer are considered to be a high-risk group during the COVID- 19 pandemic. Reports of studies on the impact of COVID-19 infection on cancer patients in Bangladesh are sparse. This study was conducted to describe the clinical presentation and assess the outcome of COVID-19 infected cancer patients. Methods: In this prospective study, we enrolled 43 patients with active cancer from different cancer hospitals in Dhaka, Bangladesh who were tested positive for RTPCR of COVID-19. The study period was from August to October 2020 (three months) following ethical approval and informed written consent was ensured. The data were collected in a structured questionnaire form by interviewing the patients/relatives and from medical records of inpatient and outpatient departments and analyzed by SPSS version 25. Results: The mean age of the 43 study participants was 49.2 (±13.6) years with a male predominance (60.5%). The common primary malignancies were leukaemia (27.9%), carcinoma of the colon (18.6%), and carcinoma of the breast (14%). Diabetes (30.2%) and hypertension (27.9%) were the common co-morbidities. The most frequently found symptoms were fever and cough 67.4% each. Severe and critical illness were found in 27.9% and 2.3% cases respectively. 35 (81%) patients survived from COVID-19 and death was observed in 8 (19%) patients.There was no significant association of age, gender, primary malignancy type, and major co-morbidities with the outcome. Severe and critical illness were found to be significantly associated with higher mortality. Conclusions: COVID-19 related mortality is higher in cancer patients than in the general population. Mortality depends on the severity of COVID-19 in these patients, associated with severe & critical cases. Bangladesh J Medicine July 2021; 32(2) : 90-94

Background: Acute promyelocytic leukaemia (APL) is curable with carefully selected treatment protocol. Reduction of early fatal haemorrhage in initial phase of induction with cost effective combination of chemotherapeutic agents is considered to be the main challenge for successful outcome in APL. Objective: The study was conducted to see the effectiveness of the use of all-trans retinoic acid (ATRA) followed by single agent Arsenic tri oxide (ATO) in the induction phase of the management of APL. Methodology: This is an observational study and was conducted from October 2012 to September 2013, in department of Haematology and BMT of Dhaka Medical College Hospital, Dhaka, Bangladesh. Total 17 patients with PML/RARA positive APL were enrolled and all patients were treated with sequential use of ATRA in a dose of 45mg/m2 for initial 2-3 weeks up to differentiation and then ATO in a dose of 0.15mg/kg daily was used in induction up to 60 days after taking informed written consent. Outcome was drawn after consolidation of therapy. Results: The morphologic complete remission rate was 88.2%. Remission failure was in observed in 2 cases (11.8%) that died at day 12 and day 51 due to differentiation syndrome and arrhythmia respectively. No death observed within first 10 days of treatment initiation. Complications observed during management were weight gain (11, 64.7%), hyper leucocytosis (10, 58.8%), ATRA syndrome (9, 52.9%), headache (6, 35.3%), tachycardia (5, 29.4%), hypomagnesaemia (3, 17.7%) and supra ventricular tachycardia (1, 5.8%).  Conclusion: Initial use of ATRA up to differentiation of promyelocytes before use of single agent ATO induction and consolidation can be a cost-effective alternative against newly diagnosed APL in reduction of early haemorrhagic death.