Maternal sociodemographic characteristics and risk factors of antepartum fetal death.

The objectives of this study were to assess the sociodemographic profile and to identify the risk factors of ante-partum fetal death which occurs after the age of viability of fetus. This prospective observational study was conducted in the Obstetrics department of Ad-din Women Medical College Hospital during the period of June, 2009 to July, 2010. A total of 14,015 pregnant patients were admitted in the study place after the age of viability, which was taken as 28 weeks of gestation for our facilities. Eighty-three (0.59%) of them were identified as intrauterine fetal death. Assessment of maternal sociodemographic characteristics and maternal-fetal risk factors were evaluated with a semi structured questionnaire pretested. Majority (81.92%, n=68) of the patients were below 30 years of age, 78.31% belonged to middle socioeconomic group. Almost 58% women had education below SSC level and 28.91% took regular antenatal checkup. About 61.45% patients were multigravida. Most (59.04%) ante-partum deaths were identified below 32 weeks of pregnancy. Out of 83 patients, maternal risk factors were identified in 41(49.59%) cases where fetal risk factors were found in 16(19.27%) cases; no risk factors could be determined in rests. Hypertension (48.78%), diabetes (21.95%), hyperpyrexia (17.3%), abruptio placentae (4.88%) and UTI (7.36%) were identified as maternal factors; and congenital anomaly (37.5%), Rh incompatibility (37.5%), multiple pregnancy (12.5%) and post-maturity (12.5%) were the fetal risk factors. Here, proximal biological risk factors are most important in ante-partum fetal deaths. More investigations and facilities are needed to explain the causes of antepartum deaths.

Metastasis in differentiated thyroid carcinoma.

Seventy patients of differentiated thyroid carcinoma (DTC) irrespective of age and sex were selected in ENT Department of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Rangpur Medical College Hospital who were admitted from March 2003 to March 2005. Female were more commonly affected (2.6:1) Papillary carcinoma was more common in 31-50 years of age and follicular carcinoma (ca) common in 41-50 years of age. Among the differentiated thyroid carcinoma papillary carcinoma found 77.15% and follicular ca. found 22.85%. Lymph node metastasis was more common in papillary (35%) than follicular carcinoma (12.5%). But distant metastasis was more common in follicular (12.5%) than papillary carcinoma (3.70). Maximum lymph node metastasis was found in level 3(55%), level 2(45%).

Neck swelling with renal stone.

Since the advent of screening of calcium and imaging techniques (CT and MRI), hyperparathyroidism has been detected with increasing frequency. Although in the past, most patients present with severe bone and renal diseases, a large number of patients are asymptomatic. Number of parathyroid glands and their ectopic locations in individuals are the problem of its management. Parathyroid adenoma or hyperplasia may be a part of Multiple Endocrine neoplasia type II. This is the story of a boy of 18 years who had got admitted in the department of Otolaryngology, Mymensingh Medical College Hospital with the complaints of a neck swelling, abdominal discomfort, inability to walk, frequency of micturation for almost same duration of 1 year. After search, hypercalcaemia, bilateral renal stone, raised parathormone level and enlarged one parathyroid gland in lower pole of left thyroid lobe was identified. Clinically it was diagnosed as parathyroid adenoma which was proved histologically after surgical excision. Many controversies still exist regarding the treatment policy of parathyroid adenoma.

The spectrum of acute Epstein-Barr virus infection in Saudi children.

Most of the primary infections caused by Epstein-Barr virus in children are asymptomatic. In symptomatic patients, clinical presentation is variable. We describe 33 patients admitted to Suleimania Children's Hospital, Riyadh from 1409 too 1411H (1988 to 1990G) with acute primary infection caused by Epstein-Barr virus. The clinical presentation was mostly with upper respiratory tract infection, fever, lymphadenopathy, and hepatosplenomegaly. Three patients had arthralgia and three had neurological manifestations. Only four patients had atypical lymphocytes > 10%. Elevated serum alanine and aspartate aminotransferase levels were found in about 54.55 of the patients.