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Khulna, Bangladesh

Alim A.,Khulna Medical College | Nurunnabi A.S.M.,Dhaka Medical College | Mahbub S.,Shahabuddin Medical College | Ara S.,Dhaka Medical College
Bangladesh Journal of Medical Science | Year: 2012

Context: The spleen is the largest single mass of lymphoid tissue in all vertebrates. Histological changes are evident in advancing age along with functional capability of the human spleen. A cross-sectional, descriptive type of study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2008, to see the age related microscopic changes in the human spleen. Methods: 30 human spleens were collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine of Dhaka Medical College, Dhaka. The samples were divided into three age-groups including group A (15-29 years), group B (30-49 years) & group C (50-69 years). Then 5 best prepared histological slides from each group were taken and examined under the light compound microscope to determine the thickness of capsule, diameter, number and percent amount of white pulp in the human spleen. Results: The thickness of the splenic capsule were found 84.60±7.97?m, 117.92±4.16?m, and 132.17±6.37?m in group A, B and C respectively. The diameter of the white pulp were found 0.32±0.01 mm, 0.32±0.01 mm and 0.31±0.01 mm, while the number of white pulp per sq. mm were 2.28±1.04, 2.38±0.93 and 2.04±0.76 in group A, B and C respectively. Moreover, the amounts of the white pulp were determined 23.09±1.38, 24.45±1.84 and 22.54±1.08 in group A, B and C respectively. The difference in thickness of the splenic capsule was statistically significant among the study groups (p<0.001). However, no difference was found in diameter, number and percentage of the white pulp of the spleen among those age groups. Conclusion: The thickness of the capsule of the spleen was found to increase with advancing age in humans. However, no age change was evident in diameter, number or amount of the white pulp.

Rasul C.H.,Khulna Medical College and Hospital | Muhammad F.,Khulna Medical College | Hossain M.J.,International Center for Diarrhoeal Disease Research | Ahmed K.U.,Khulna Medical College and Hospital | Rahman M.,Institute of Epidemiology
Malaysian Journal of Medical Sciences | Year: 2012

Background: Acute meningoencephalitis is an important cause of morbidity and mortality around the globe. The objective of this study was to examine the distribution of acute meningoencephalitis and its aetiological agents among children admitted to a tertiary hospital in southern Bangladesh. Methods: This prospective study was carried out in Khulna Medical College Hospital from 2007 to 2009. All of the admitted children between 1 month and 12 years of age were enrolled over a 2-year period if they met the inclusion criteria of having an acute onset of fever (≤ 14 days) and any of the following 3 signs: neck stiffness, convulsion, or altered mental status. Cerebrospinal fluid (CSF) was collected within hours and sent to the laboratory for cytological and biochemical analyses. CSF was examined by Gram staining and a latex agglutination test to detect common bacteria. Serum and CSF were also tested for Japanese encephalitis virus antibodies. Results: A total of 140 children were included in the study, which accounted for 2.5% of admissions between 2007 and 2009. The number of acute meningoencephalitis cases was relatively higher (37.9%) during the monsoon season. The CSF report revealed a pyogenic form in 24 (18.5%) and a viral form in 13 (10.0%) cases. Altered mental status was significantly less frequent (P < 0.001) in cases of pyogenic meningoencephalitis (62.5%) than in cases of non-pyogenic meningoencephalitis (93.4%). Bacterial causes were identified in 11 (8.5%) children; the causative agents included Streptococcus pneumoniae (n = 8), Neisseria meningitides (n = 2), and Haemophilus influenzae (n = 1). Three (2.3%) patients were positive for Japanese encephalitis virus. Conclusion: S. pneumoniae was themost common bacteria causing acutemeningoencephalitis among the study subjects, and Japanese encephalitis virus was present in few patients. © Penerbit Universiti Sains Malaysia, 2012.

Ashrafuzzaman M.D.,Khulna Medical College | Mustafa K.G.,Khulna Sadar Hospital
Current Rheumatology Reviews | Year: 2014

Aim: The aim of this review is to update the knowledge about the Kawasaki disease (KD) which includes the way of early detection and latest treatment plan for the disease. Method: A number of literatures were reviewed and latest information about the etiology, diagnosis, laboratory investigation, treatment and outcome of the disease was collected and depicted in the review article. Result: Kawasaki disease is a multisystem vasculitis mainly affecting medium sized blood vessels. It is the second most common cause of vasculitis after Henoch Scholein Purpura (HSP) in children. Etiology of the disease is still unknown. Auto-immunity with genetic influence is thought to associate with the disease. Many physicians are ignorant of the disease. The pediatrician must be aware of the disease and suspect this condition in less than 5 year old children presenting with more than 5 days fever. the number of methods on the basis of criteria is set for the diagnosis of the disease. Latest treatment plan is set up for the disease which reduces the morbidity and mortality to a great extent. Conclusion: Physicians must have consciousness and comprehensive knowledge for the early suspicion of this disease. Any child presenting with fever for more than 5 days should not be ignored and other criteria of KD have to be evaluated by the physician. Early diagnosis and updated treatment are imperative for the prevention of morbidity and mortality for the disease. © 2014 Bentham Science Publishers.

Islam M.N.,Khulna Medical College
Mymensingh medical journal : MMJ | Year: 2012

Hydatidosis is a parasitic zoonotic echinococcal infection that affects both humans and other mammals. These diseases are common worldwide but particularly common in sheep and cattle farming regions. Anaphylaxis mediated by IgE is a serious complication of surgery or trauma which necessitates more aware of its clinical features, diagnosis and management. It is important to make a preoperative diagnosis based on the typical image findings, so that particular precaution can be taken not to rupture the lesion. A woman presented with a right upper quadrant cutaneous abscess. USG reveals multiple cystic lesions in the liver arranged in cartwheel appearance, CT disclosed a cystic lesions having daughter cysts, marginal calcifications, marginal enhancement and contiguous abdominal wall abscess, which led to a diagnosis of complicated hepatic hydatid cysts with abdominal wall abscess formation. FNAC showed scolices surrounded by chronic inflammatory cells. Abdominal wall abscess may be a presentation of hydatid liver disease.

Chowdhury F.R.,Sylhet MAG Osmani Medical College | Rahman A.U.,Dhaka Medical College | Mohammed F.R.,Dhaka Medical College | Chowdhury A.,Khulna Medical College | And 2 more authors.
Bangladesh Medical Research Council Bulletin | Year: 2011

This retrospective study was carried out in the Medicine Department of Khulna Medical College, the biggest tertiary hospital in the southern part of Bangladesh to observe the trends of poisoning in southern part of Bangladesh over four years including age and sex variation, mode of poisoning, type of poison used and outcome of poisoning. The hospital medical records of all patients, aged 10 years and above with history of acute poisoning from January, 2003 to December, 2006 were enrolled. Patients were categorized into four age group including Group (Gr.) I, Gr. II, Gr. III & Gr. IV having age range of 10-20, 21-30, 31-40 & >40 respectively. Underlying causes of poisoning were also observed totally and individually in different mode with male, female ratio and the percentage. Death cases according to mode of poisoning with demographic alignment were also observed. Statistical analysis were done using epi-info version 3.5.1 and measures were presented as proportion and percentage. Among 1903 cases, 1012 (53.1%) were male and 891 (46.8%) female with a ratio of 1.4: 1. The year wise total number of cases were progressively decreased from 627 (2003) to 353 (2006). Most commonly found toxic agent was Organo-Phosphate compound (526; 27.64%) with a very little sexual variation & this trend remained same in all study years. Poisoning with unknown substance was the second leading cause (16.03%) followed by Copper-sulphate (14.03%), Sedative (13.35%), Snakebite (12.93%) etc. Incidence of unknown poisoning, sedatives, snake-bite and corrosives were found to be gradually decreased over the study years. Male were found mostly affected in majority type of poisoning except Copper-sulphate, kerosene, puffer fish, paracetamol and other drugs category. Age group II (710; 37.3%) was the most vulnerable group with male (57.89%) preponderance followed by group I (643; 33.7%), III (329; 17.2%) and IV (221; 11.6%) respectively. Highest 1308 (68.7%) cases were suicidal in mode followed by 304 (15.9%) accidental and 291 (15.2%) homicidal. Out of 1903, 140 (7.3%) patients died. Death rate was highest in OPC poisoning (52.1%) followed by unknown substance (13.5%), snakebite and copper-sulphate (11.4%) etc. In an agro-based country like Bangladesh, it's very difficult to reduce the poisoning cases and mortality. Prospectively designed multi-centered studies are needed to reflect the epidemiological properties of poisonings throughout Bangladesh, and would be very valuable for the determination of preventive measures.

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