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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

Dengue is a common arboviral infection in South-East Asia. It has various atypical manifestations; acute pancreatitis is one of them. Though the exact pathogenesis is not known, many mechanisms have been postulated. We present a case of a 32-year-old lady who presented with fever, upper abdominal pain and vomiting. She was subsequently diagnosed to have acute pancreatitis (AP) due to dengue fever (DF). She was treated conservatively for dengue fever and recovered completely. In DHF abdominal pain is an alarming feature. Though less common, AP should be kept in mind as a cause of acute abdominal pain in dengue.

Background: Hemodialysis is one of the treatment of end stage renal disease. Disturbance in calcium and phosphate metabolism are observed in these patients. One of the most common cutaneous manifestations in patients on hemodialysis is pruritus. The aim of this study is to evaluate the association between pruritus with serum calcium and phosphate levels in these patients. Methods: This analytic, descriptive, cross-sectional study was performed in 2014 over 191 patients of maintenance haemodialysis. Information related to the patients age, gender, residence, pruritus, duration and frequency of dialysis, was extracted from questionnaires. Serum levels of calcium, phosphate and albumin were measured & data were analyzed. Results: 68% of the patients had pruritus, of whom 48.2% had serum calcium levels below the normal range. The Mean ± SD of serum calcium, phosphate, Ca-PO4 product, and duration of dialysis were 8.77±1.22 mg/dl, 3.82±1.18 mg/dl, 34.17±12.69, and 18.01±11.94 months respectively in patients with pruritus and 9.24±1.15 mg/dl, 3.40±1.36 mg/dl, 35.75±13.02, and 17.84±16.01 months respectively in patients without pruritus. Our study showed that most patients with pruritus had serum calcium levels in the below normal range. Conclusion: Good control of serum calcium levels may have a role in reducing uraemic pruritus. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 127-133

Stroke is defined as focal or global neurological deficit of non-traumatic vascular origin which lasts 24 hours or more if the patient survives. Many researchers showed that risk of aspiration after stroke has been related to brain stem lesions. Moreover, assessing the risk of aspiration pneumonia in supratentorial ischaemic stroke has been established in a few recent studies. Aims of study was to see the association of lesion location and of risk of aspiration pneumonia in supratentorial ischaemic stroke. The study was done by random sampling from hospital-based stroke patients. Out of these patients we collected data from 100 acute hemispheric infarct patients who got admitted in Dhaka Medical College Hospital from July 2013 to December 2013. Subcortical infarcts were associated with higher proportion of risk of aspiration on day 1 with relative risk 2.63 which was statistically significant (95 percent CI 1.43 - 4.86, pvalue 0.001). Extended risk of aspiration on day 7 was also found more in these patients (relative risk 8.29, 95 percent CI 1.96 - 35.09, p-value 0.0004). Moreover, risk of aspiration was found in 32 percent patients, of which 14 percent was proved to have extended risk at day 7. Subcortical infarction is associated with higher risk of aspiration pneumonia in supratentorial ischaemic stroke. Faridpur Med. Coll. J. Jul 2019;14(2): 79-81

Objective: To determine the pattern of neurologic disorder in the specialized neurology out patient at tertiary care level.Methods: This observational study was carried out in specialized neurology outpatient clinic of Dhaka Medical College Hospital from July 2015 to July 2016, which included 8892 patients. Data were collected through a predesigned questionnaire from the hospital database kept at the clinic.Result: A total of 8892 patients were seen in neurology OPD in one year. About one third of the patients presented at 21-30 years of age. There was a male dominance (53%) with a male to female ratio of 1.12:1. Most of the patients had hypertension (3201, 36%) followed by diabetes and ischemic heart disease (1956, 22%; 1423, 16%) as co-morbid condition. Majority had Headache (4090, 46%) followed by vertigo (1067, 12%); vomiting (711, 8%) and neck and/ back pain (702, 8%) as presenting symptom at onset. Majority of the patients (46%) were diagnosed as headache disorder (Tension type headache in 33.5%, Migraine 7.5% and mixed headache in 5%) followed by ischemic stroke (896, 10%); polyneuropathy (446, 5%); vestibular disorder (441, 5%); movement disorder (267, 3%) and anxiety/depression (254, 3%). About 15% (1346) patient were undiagnosed at initial visit.Conclusion: Neurological diseases are not uncommon even at middle aged patients. Headache, vertigo, neck/back pain are common presenting symptom. Headache disorders and stroke are the commonest neurologic diagnosis at OPD.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 53-57

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity in low- and middle-income countries (LMICs) including Bangladesh. But no systematic review has been carried out in Bangladesh, which portraits the burden of COPD and its risk factors. Therefore, this systematic review was conducted to find out the prevalence and risk factors of COPD in Bangladesh. We searched PubMed, Google Scholar, Popline, and Banglajol from January 1, 1972 to April 30, 2017. We included studies that reported the prevalence and/or risk factors of COPD among Bangladeshi people. Two researchers independently searched and screened all the articles and extracted data from nine eligible studies. The whole process was verified by another researcher. Quality assessment was performed using a checklist adopted from published articles on quality assessment guidelines of observational studies. Discrepancies were resolved by consensus. Data analysis was done thematically. The pooled COPD prevalence among Bangladeshi adult was 12.5% (95% CI, 10.9-14.1) using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria and 11.9% (95% CI, 11.4-13.6) using the lower limit of the normality (LLN) criteria. The prevalence was higher among males, low socio-economic group, rural residents, and biomass fuel users. Tobacco consumption, exposure to biomass fuel, old age, and history of asthma were identified as major risk factors of COPD. COPD prevalence is high in Bangladesh. It is a timely need for the policy-makers and public health professionals to take pertinent steps for prevention and control of COPD in Bangladesh.

Background: Heavy metals may produce various symptoms among the exposed, of which polyneuropathy is a matter of real concern. Our aim was to determine the pattern and association between polyneuropathy and blood lead level. Methods: This case control study was done in the department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka in collaboration with Bangladesh Atomic Energy Centre from July 2001 to June 2002. The lead concentration in the blood was detected by Xray fluorescence (XRF) technique. Nerve conduction study and CSF examination were done among the cases. Result: Data were collected from 92 respondents, of whom cases and controls were equal in number with a male to female ratio of 8.17:1. Mean age of the cases and controls were 30.87 +14.53 years and 30.91+ 12.03 years respectively. Among the cases, 55% had sub acute type of polyneuropathy, followed by acute and chronic type of polyneuropathy among 30% and 15% respondants respectively. The mean CSF protein level was 112.00 + 65.04 gm/L. The mean CSF protein was higher in acute polyneuropathy than in subacute and chronic cases (p

Objective: To measure the changes in electro encephalogram (EEG) along with its sensitivity and specificity with clinical seizure among epilepsy patients referred to an electrophysiology lab in a tertiary care hospital of Bangladesh. Methods: This retrospective chart review was carried out in the electrophysiology laboratory of Dhaka Medical College Hospital from January 2011 to December 2013, which included 1154 patients. EEG was obtained through scalp electrodes following international 10/20 system. Information regarding patients was collected from the laboratory register with the help of a checklist. The EEG findings and clinical seizure events were then compared. Result: Among the 1154 patients, age varied from birth to 75 years. The mean age at presentation was 17±11.4 years and most of the patients were less than 10 years old (44.4%). The male predominated in our study (59.2%). Clinically diagnosed seizure was present in 970 patients (84.1%), among which Generalized tonic clonic seizure (GTCS) was the most common clinical type of seizure, followed by secondary generalized seizure in 19.4% (n=224) and focal seizure in 2% (n=30) patients and 6.8% (n=79) patients had pseudoseizure. Among the abnormal EEG (59%), generalized epileptiform discharge was found in 29%, whereas focal and secondary generalized discharge was found in 30%. The most common site of origin of epileptiform discharge was temporal lobe (28.3%). The overall sensitivity of EEG was 66% (ranged from 62% to 68% with a confidence interval (CI) at 95%) and specificity was 79% (72- 84% at 95% CI). The positive predictive value was 58% (55-61% at 95% CI) and negative predictive value was 41% (38-44% at 95% CI). Conclusion: Our study brings out the fact that EEG has a reasonable sensitivity and specificity as a diagnostic test and the superiority being the higher specificity of EEG. J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 215-222

Background: The purpose of this study was to determine the morbidity pattern and health seeking behaviour among the rural elderly population. Methods: This cross sectional study was conducted in six villages of Telihati union of Gazipur District from February to June 2013. Purposive sampling technique was used to collected data from 249 respondents, aged 60 years and above. Results: The mean age of the respondents was 64.2 (SD±5.6) years. About 70.3% of the respondents were male, majority (47%) respondents were illiterate, 33.3% earned less then ten thousand taka per month. About half (58.2%) of the elderly were still working, among the currently not working respondents majority (49%) were totally dependent. and only 52.6% respondents belonged to joint family. Almost all (98.8%) the respondents had some health problems; among these eye problems (81.7%), musculo-skeletal disorders (66.3%), gastrointestinal disorders (52.4%) and sleeping problems (50.4%) were predominant. Females suffered more from eye problems, musculoskeletal disorder, gastrointestinal disorder and sleeping problems. On the other hand, males suffered more from respiratory and genitorurinary problems. About 61% have a Government hospital or Community clinic nearby their residence, 70 % were satisfied with available health care facilities and 72% was satisfied with treating doctors even then a greater part (35%) was irregular for check-up. Majority (73.5%) was regular about taking treatment, among the irregulars majority (77.3%) was for un-affordability of medicine. Only 53% of the elderly knew names of some old age diseases. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21522 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 129-135

To detect the changes in electro encephalogram (EEG) and correlate the findings with clinical seizure events among epilepsy patients. This retrospective chart review was carried out in the electrophysiology laboratory of Dhaka Medical College Hospital from January 2011 to December 2013, which included 1154 patients. EEG was obtained through scalp electrodes following international 10/20 system. Information regarding patients was collected from the laboratory register with the help of a checklist. The EEG findings and clinical seizure events were then compared. Among the 1154 patients, age varied from birth to 75 years. The mean age at presentation was 17±11.4 years and most of the patients were less than 10 years old (44.4%). The male (59.2%) female ratio was 3:2 in our study. Clinically diagnosed seizure was present in 970 patients (84.1%), among which Generalized tonic clonic seizure (GTCS) was the most common clinical type of seizure, followed by secondary generalized seizure in 19.4% (n=224) and focal seizure in 2% (n=30) patients and 6.8% (n=79) patients had pseudoseizure. Among the abnormal EEG (59%), generalized epileptiform discharge was found in 29%, whereas focal and secondary generalized discharge was found in 30%. The most common site of origin of epileptiform discharge was temporal lobe (28.3%). There was a negative correlation between EEG and history of seizure events (pearson correlation significance 0.33). Our study brings out the fact that EEG has a negative correlation with clinical seizure events. CBMJ 2014 July: Vol. 03 No. 02 P: 03-08

Introduction : Hepatitis B virus is encountered sporadically throughout the year in Bangladesh. Bangladeshi physicians are also in a great risk for this blood-borne virus. To find out the seroprevalence of HBV and vaccination rate among the physicians, was the aim of this study. Methods : The study was an observational study and was conducted in the department of Medicine of Dhaka Medical College Hospital, Dhaka between April and September, 2012. Eighty physicians of department of Medicine were searched for hepatitis B virus with the help of a structured questionnaire. Physicians, who were found not vaccinated, were also investigated for HbsAg positivity by ELISA method. Results: Eighty five percent physicians were found vaccinated. Remaining 15% (12/80) physicians were investigated for HbsAg positivity but all were found negative. Vaccinated physicians who checked antibody titre (35.3%), were found well immunized. Fifty percent physicians experienced needle stick injury 2-5 times in their lifetime and 20% physicians did not use protective equipments during any invasive procedure. Conclusion: HBV remains a major cause of morbidity and mortality in Bangladesh. Hence, our physicians who were not vaccinated and also found HbsAg negative, should complete their vaccination schedule as early as possible. DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15540 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 11-15

This cross sectional study was done from January 2009 to June 2010 in Microbiology department of Dhaka Medical College, Dhaka on different laboratory methods for diagnosis of intestinal protozoal infections and their distribution among selected study population. Of the 375 stool samples evaluated, 103 (27.5%) samples were positive for the intestinal protozoa. The prevalence of G. intestinalis was highest (25.78%) followed by E. histolytica/dispar (8.98%). Other protozoa found were, E. coli (1.56%), B. hominis (1.95%), C. mesnilli (1.17%) and C. parvum (0. 78%). lron-hematoxyline stain showed highest sensitivity for detection of protozoa. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18510 Bangladesh Medical Journal 2011 Vol.40(2): 47-49

This prospective study was conducted in Dhaka Medical College Hospital during July 2006 to June 2007. 100 patients were included in the study among which forty seven received benzylpenicillin and fifty three was treated with ceftriaxone. The result of this study showed that mortality was similar in both groups but ceftriaxone had better outcome regarding duration of clinical features and hospital-stay. Key words: pyogenic meningitis; benzylpenicillin; ceftriaxone. DOI: 10.3329/jdmc.v17i2.6583J Dhaka Med Coll. 2008; 17(2) : 59-61

A middle aged lady presented with recurrent jaundice with normal SGPT, serum alkaline phosphatase, serum albumin and prothrombin time. Haemolysis was excluded by normal haemoglobin, peripheral blood film and reticulocyte count and finally she was diagnosed to have Gilbert's syndrome. Key words: Gilbert's Syndrome; Hyperbilirubinaemia. DOI: 10.3329/jdmc.v19i1.6257 J Dhaka Med Coll. 2010; 19(1) : 67-68.