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Mondol B.A.,Dhaka Medical College and Hospital
Mymensingh medical journal : MMJ | Year: 2010

Tuberculosis can involve any organ system of the body. Although rare tuberculosis of nervous system (NS) is not uncommon in our country. In the nervous system tubercle bacilli can cause tuberculous meningitis, abscess , tuberculoma in brain & spinal cord. Untreated Central Nervous System (CNS) tuberculosis is devastating. Early diagnosis & prompt treatment of NS is essential to avoid morbidity & mortality. Tubercle bacilli causes chronic caseating granulomatous lesion. Tubercular meningitis presents with fever, headache, neck stiffness & cranial nerve palsy. Tuberculoma may present with headache, seizure and focal deficit. In the spinal cord tuberculoma or tubercular abscess may result in para paresis or quadri-paresis. For diagnosis of nervous system tuberculosis CSF analysis and neuroimaging are important. CSF cell count, Gram staining, Culture and Polymerase Chain Reaction (PCR) are helpful for diagnosis. Imaging helps in the diagnosis of tuberculoma and tubercular abscess. Computed tomography (CT) guided Fine Needle Aspiration for Cytology (FNAC) helps to establish the histopathological diagnosis. Use of combination antitubercular drugs for long period (12-18 months) is necessary to treat nervous system tuberculosis. Source

Hussain M.A.,Bangladesh University of Engineering and Technology | Alam F.,Bangabandhu Sheikh Mujib Medical University | Rupa S.A.,Enam Medical College and Hospital | Awwal R.,Dhaka Medical College and Hospital | And 3 more authors.
Ultrasonics | Year: 2014

Elasticity imaging techniques with built-in or regularization-based smoothing feature for ensuring strain continuity are not intelligent enough to prevent distortion or lesion edge blurring while smoothing. This paper proposes a novel approach with built-in lesion edge preservation technique for high quality direct average strain imaging. An edge detection scheme, typically used in diffusion filtering is modified here for lesion edge detection. Based on the extracted edge information, lesion edges are preserved by modifying the strain determining cost function in the direct-average-strain-estimation (DASE) method. The proposed algorithm demonstrates approximately 3.42-4.25 dB improvement in terms of edge-mean-square-error (EMSE) than the other reported regularized or average strain estimation techniques in finite-element-modeling (FEM) simulation with almost no sacrifice in elastographic-signal-to-noise-ratio (SNRe) and elastographic-contrast-to-noise-ratio (CNRe) metrics. The efficacy of the proposed algorithm is also tested for the experimental phantom data and in vivo breast data. The results reveal that the proposed method can generate a high quality strain image delineating the lesion edge more clearly than the other reported strain estimation techniques that have been designed to ensure strain continuity. The computational cost, however, is little higher for the proposed method than the simpler DASE and considerably higher than that of the 2D analytic minimization (AM2D) method. © 2013 Elsevier B.V. All rights reserved. Source

Nahar Begum S.M.K.,Anwer Khan Modern Medical College | Chowdhury M.A.,Anwer Khan Modern Medical College | Mojumder A.S.,Anwer Khan Modern Medical College | Khan O.,Dhaka Medical College and Hospital
Journal of Medicine (Bangladesh) | Year: 2015

Pleomorphic adenoma, though essentially benign can undergo malignant transformation. This is the case report of a 72 year old male with a giant tumor of parotid gland measuring 20.0×18.0×16.5cm & weighing 7 kg. Pleomorphic adenoma can rarely transform into carcinoma ex pleomorphic adenoma over time as it enlarges; moreover, histologically, squamous cell carcinoma (SCC) is exceedingly rare. Patient developed the tumor for a period over 20 years & it caused withdrawal from social contact. The tumor gradually enlarged without any pain or other complication except for rapid growth & pain a year before. Postoperative facial function and local control of tumor was achieved. Despite Of having a cancer with significant extracapsular invasion, our patient did not present any metastatic focus. Besides morphological patterns, authors need to categorize invasive carcinoma ex pleomorphic adenoma according to its potentiality to metastasize. Various parameters which can predict malignant transformation in pleomorphic adenoma is also yet to be explored. © 2015 Bangladesh Society of Medicine. All rights reserved. Source

Fakir A.Y.,Dhaka Medical College and Hospital
Mymensingh medical journal : MMJ | Year: 2011

The study was done to determine the clinical, radiological and histopathological characteristics along with the management outcome of differentiated thyroid carcinoma. This Retrospective study included sixty patients with differentiated thyroid carcinoma presented to Department of Otolaryngology and Head-Neck Surgery at Dhaka Medical College Hospital and Apollo Hospitals Dhaka from June 2006 to December 2008. The data of each patient included age, sex, presenting symptoms and signs, provisional diagnosis, preoperative investigations, operation notes, histopathological examination and state at follow up. This study included 28 males and 32 females. The mean age was 42.7 years. Maximum patients presented at 4th decade. The commonest presentation was thyroid swelling followed by lateral neck swelling. Detailed clinical assessment before operative treatment has been done for all patients. Fifty five patients (91.66%) presented with single nodule. Distant metastasis was found in 2 cases. All patients underwent fine needle aspiration cytology which was conclusive in 38 patients (63.33%). All the sixty patients underwent surgical excision; either total thyroidectomy or completion thyroidectomy. Neck dissection was performed in 8 patients. All patients received postoperative radio-iodine. Fifty one cases were papillary carcinoma and 9 cases were follicular carcinoma. Except for one case with local recurrence the remaining cases were disease free on follow up (up to 10-40 months). One patient died with bone metastasis 2 years after operation. Of all thyroid cancers, majority cases are papillary cancer (85%). In contrast to other cancers, thyroid cancer is almost always curable. Most thyroid cancers grow slowly and are associated with a very favorable prognosis. Early diagnosis and treatment of the same is strongly advisable. Source

Rahman M.H.,Dhaka Medical College and Hospital | Ali L.,BIHS | Ali L.,Biomedical Research Group
Journal of Medicine (Bangladesh) | Year: 2015

Objective: To explore lipid abnormalities in normoglycemic first-degree diabetic relatives (FDRs) and prediabetic and diabetic subjects in the natural history of diabetes. Research design and methods: Thirty six impaired fasting glucose (IFG), 61 isolated impaired glucose tolerance (I-IGT), 64 combined IFG-IGT, 73 diabetic, and 32 FDRs along with 57 normoglycemic healthy controls without family history of diabetes in 1st degree relatives, were selected purposively following 2003 ADA cut-off values and 2006 WHO/IDF grouping. Anthropometry and blood pressure of the subjects were taken. Fasting and 2-h plasma glucose and HbA1C were measured. Fasting plasma triglyceride, total cholesterol and HDL cholesterol were measured by enzymatic colorimetric method. Results: Serum triglyceride was higher in IFG, I-IGT, IFG-IGT, diabetic and FDRs compared to Control [145 (59- 307), 128 (66-584), 166 (68-764), 161 (69-750) and 130 (81-281) vs. 108 (47-219) mg/dl, P<0.01, P<0.01, P<0.001, P<0.001 and P<0.05]. Total cholesterol was raised in IFG-IGT and diabetes compared to Control [185 (105-310), 185 (123-326) vs. 171 (101-235) mg/dl, P<0.05] and FDRs. But HDL did not differ among the groups. Prevalence of metabolic syndrome was higher in IFG, I-IGT, IFG-IGT and diabetes and FDRs than Control [55%, 38%, 57%, 58% and 36% vs. 15%, P<0.001, P<0.01, P<0.001, P<0.001 and P<0.05] and also in IFGIGT and diabetic compared to I-IGT and FDRs (P<0.05). Conclusions: Higher prevalence of metabolic syndrome and raised serum triglyceride is seen among diabetic, prediabetic and 1st degree diabetic-relatives. Total cholesterol and non-HDL cholesterol is raised only in IFG-IGT and diabetes, the more decompensated glycemic states. © 2015 Bangladesh Society of Medicine. All rights reserved. Source

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