Pulse

Dominance of human Influenza H1N1pdm09 in flu like patients during early two months of 2020

Rummana Rahim — 2023-06-14

Introduction:Influenza is a worldwide respiratory infectious disease which affect all age groups and associated with significant number of morbidity and mortality each year. The circulating subtypes varies countrywide yearly, and it helps policy maker to get preparedness for early effective management of influenza epidemics.

Materials and methods Nasal swabs were collected from 463 patients in January and February 2020 presenting flu-like symptoms and Rapid Influenza Diagnostics Tests (RIDTs) were performed for influenza A & B screening as a routine test. Then influenza A subtyping was done by RT-PCR followed by gel electrophoresis of 27 influenza positive samples.

Result Among 463 cases, 106 (22.9%) were Influenza positive with huge (99.06%) dominance of Influenza A. Subtyping of randomly selected outpatient derived 27 Influenza A positive cases showed flourishing presence of seasonal Influenza A/H1N1pdm09 (21; 77.8%).

Conclusion This small study warrants further elaborate investigation to know circulating influenza A subtyping in the country which may assist health care providers in making treatment decisions and hence, appropriate patient management.

Pulse Volume 12-14 2020-2022 p.4-9

Is Helminthiasis a Precipitating Factor for Frequently Relapsing Nephrotic Syndrome?

Sabina Sultana — 2023-06-14

Nephrotic Syndrome (NS) is a common childhood illness. It is a disease of relapse and remission with major concern to manage the cases with relapse. Helminthiasis also a common problem in our subcontinent. So, it is very important to find out any relation with helminthiasis and relapse in children. In our study, 88 patients, clinically diagnosed as minimal change nephrotic syndrome, were studied to find out any relationship with helminthiasis and frequent relapse. 36 patients (40.9%) had no helminthic infection, 34 patients (38.6%) had helminthiasis and 18 patients (20.5%) had atopic disorders. 62 patients were successfully followed up for 6 months. Relapses occurred 47.8% (11/23) patients in non-helminthiasis group. 88.5% (23/26) in helminthiasis group and 84.6% (11/13) in atopic group, patients who completed follow up. Thirteen percent (3) patients in non-helminthiasis group, 50% (13) in helminthiasis group and 38.5% (5) in atopic group were found to be frequent relapser. The differences were statistically significant.

Pulse Volume 12-14 2020-2022 p.10-12

Prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis among patients suspected of sexually transmitted infections in Evercare Hospital Dhaka during 2015 to 2022

Nazmul Hasan — 2023-06-14

Background Sexually Transmitted Infections (STIs) are often diagnosed by clinical symptoms and signs due to lack of sensitive laboratory methods. Most of the time pathogens are not identified and antibiotics are used empirically. The purpose of our study is to find out the STI pathogens detected by sensitive multiplex PCR done routinely in a tertiary care hospital.

Materials and methods A total of 578 samples were tested from February 2015 to July 2022. Urine, prostatic secretion, urethral swab, high vaginal swab, semen, throat swabs were collected from symptomatic patients for the routine test. DNA was extracted and Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis were screened by using CE-IVD approved multiplex Real Time PCR kit.

Result Out of 578 cases, 76 (13.15%) were positive for at least one pathogen and 5 were co-infections. Out of 76 positive cases, Chlamydia trachomatis was found 41 (53.9%), Neisseria gonorrhoeae was 13 (17.1%), Mycoplasma genitalium was 12 (15.8%), and Trichomonas vaginalis 5 (6.6%) and co-infections with Neisseria gonorrhoeae and Chlamydia trachomatis was 5 (6.6%). Positivity rate was remarkably higher in male (77.6%) than female (22.4%) and predominant age group was 19-40 years.

Conclusion The predominant STIs pathogen found in our cohort is Chlamydia trachomatis followed by Neisseria gonorrhoeae. Multiplex PCR is a wide-ranging diagnostic method for the detection of multiple pathogens simultaneously which allows early and accurate diagnosis of STIs.

Pulse Volume 12-14 2020-2022 p.34-39

Assessment of Fitness for Air travel in Patients with Pulmonary Diseases

SM Abdullah Al Mamun — 2023-06-14

During air travel, increasing hypoxia with altitude ascent is a potentially serious problem for patients with hypoxemic chronic airway obstruction (CAO). Travel by air is the most popular way of transport nowadays & estimated that each year worldwide, more than 3 billion passengers travel by air & 736 million in the United States alone. For most passengers, even those with respiratory disease, air travel is safe and comfortable. Some patients with COPD &other Chronic Lung diseases may be at risk but, with screening, these patients can be identified and most of them can travel safely with supplemental oxygen. Some patients with chronic lung disease may have mild hypoxemia at sea level but during air travel in a hypobaric hypoxic environment, compensatory pulmonary mechanisms may be inadequate despite normal sea-level oxygen requirements. In addition, compensatory cardiovascular mechanisms may be less effective in some patients who are unable to increase cardiac output. Air travel also presents an increased risk of venous thromboembolism. It's estimated that, almost 1 medical emergency for every 600 flights. Respiratory symptoms accounted for 12% of all these in-air emergencies.

Pulse Volume 12-14 2020-2022 p.16-21

Antimicrobial Resistance and the next Pandemic

Borhan Uddin Ahmed — 2023-06-14

Abstract not available

Pulse Volume 12-14 2020-2022 p.3

Patient safety culture plays an essential role to ensure safe patient care and quality in healthcare services

Tahmina Rahman — 2023-06-14

Patient Safety is a global health priority. Every year, millions of patients suffer or die because of unsafe and poor- health care service. There are several factors which compromise patient safety and cause potential harm in health care settings. In developed countries, it is estimated that one in every 10 patients is harmed while receiving care in hospital. In developing countries, there is inadequate information on adverse event due to poor quality of health care service. Despite recent developments in Bangladesh, there is still great concern about the quality of care in healthcare sector. Evercare Hospital Dhaka is one of the leading private health care organizations in the country and committed towards patient safety from the very beginning. The purpose of this article is to discuss the importance of patient safety culture at healthcare service and how it is nurtured at Evercare hospital Dhaka by following the joint commission international standards.

Pulse Volume 12-14 2020-2022 p.53-61

Pulse Official Vol.12-14

Editor in Chief — 2023-06-14

Abstract not available

Pulse Volume 12-14 2020-2022 p.60-68

Papillary Tumor of Pineal Region: A Case Report

Ahmed Khaled — 2023-06-14

Pineal region tumors constitute about 0.4%-1% of intracranial tumors in adults. These tumors may arise from pineal gland itself or structures around it which are all termed as pineal region tumor. Papillary tumor of the pineal region is a non-parenchymal tumor of the pineal region. First described in 2003, it is an extremely rare tumor. We have presented a case of 27-year-old female patient presented as a pineal tumor. After successful excision, the tumor proved to be Papillary tumor of Pineal region (PTPR) both histomorphologically and immunohistochemical study.

Pulse Volume 12-14 2020-2022 p.13-15

Exosomes - A Potential Candidate to Combat Covid-19 and A Future Emerging Nanotechnology with Diverse Perspectives

Md Abu Quoreshi Khan — 2023-06-14

Corona virus causes severe contagious acute respiratory syndrome known as coronavirus disease 2019 (COVID-19). Several initiatives have been taken to tackle so far. One of them, being therapy based biological nano particles “Exosomes”. Administration of exosomes loaded with immunomodulatory cargo in combination with antiviral drugs will be a promising approach. This study deals with the exosomal isolation techniques of the Bruton Tyrosine Kinase (BTK) protein from cells. It represents initial trials to establish a method to isolate exosomes from human B cells.

Pulse Volume 12-14 2020-2022 p.22-25

Infective Endocarditis Associated with Multisystem Inflammatory Syndrome in Children (MIS-C): Two Case Studies

Tahera Nazrin — 2023-06-14

Infective endocarditis (IE) is the infection of endocardial surface of the heart. IE is the rare disease with significant complications which require early diagnosis and proper treatment for reducing morbidity and mortality.IE with vegetation on pulmonary valve, leaflets are uncommon. However, we have diagnosed one case with infective endocarditis associated with Multisystem Inflammatory Syndrome in Children (MIS-C) which is related with COVID-19. MIS-C is commonly associated with coronary artery aneurysm (CAA), myocarditis and heart failure. Our patient had IE and was subsequently affected with MIS-C due to COVID. The child had vegetation on pulmonary valve with flail pulmonary valve-leaflet with grade II pulmonary regurgitation and MIS-C related CAA. The second child was previously diagnosed as infective endocarditis and was treated in other hospital for intravenous antibiotic for four weeks. However, in our hospital he was diagnosed clinically, by laboratory investigations and by echocardiography as MIS-C with large vegetation, which was surgically removed, and biopsy revealed mycobacterium tuberculosis as causative organism.

Pulse Volume 12-14 2020-2022 p.26-31

An interesting case of Posterior Layering in the Urinary bladder on Fluorine- 18 Fluorodeoxyglucose (F18-FDG) PET-CT study

Sharmin Farhana — 2023-06-14

Contrast PET/CT may show layering within the UB, and several examples of have been reported in the literature. But without using contrast this is rare. Our case demonstrates the interesting posterior layering of F18-FDG in urinary bladder in a 78 years old male without the use of contrast.

Pulse Volume 12-14 2020-2022 p.32-33

Case series report of LINAC-based Stereotactic radiosurgery of Intracranial meningioma – an institutional experience

Taohida Yasmin — 2023-06-14

Stereotactic radiosurgery (SRS) has been widely used for the treatment of intracranial lesions. We have been doing SRS since March 2019. The unique ability of SRS to deliver higher focused dose to the smaller targets preferably in a single exposure in a convenient manner while sparing adjacent critical structures has made a more widely adopted treatment option. This case series is intended to show our institutional experience and procedural technique adapted for treating intracranial meningioma using SRS by Linear accelerators. We present five cases of intracranial meningioma. Four had Grade I meningioma and one patient with Grade III meningioma. One patient had radiological diagnosis only and treated with SRS. Two patients underwent gross total resection and SRS was prescribed on the event of recurrence. Rest two patients had recurrence/progression after subtotal resection and adjuvant radiation. The dose prescription ranged from 13 to 21Gy in one to three fractions which was determined by tumor volume, location, grade, proximity to critical structures, pre-existing neurologic impairment, previous treatment history, time to progression/relapse and the ideal balance of prescription dosage and expected problems. There were no acute side effects from any of the procedures. All five patients had improvement in clinical symptoms in the immediate post-SRS period. One patient who has two-year post-SRS revealed a significant regression in the size of the tumor. This case series summarizes the fact that SRS for intracranial meningioma is safe and effective treatment strategy when appropriate.

Pulse Volume 12-14 2020-2022 p.40-52