Assessment of the Relationship between Non-motor features and Severity of Parkinson's Disease Patients in Bangladesh.

Parkinson's disease (PD) is second most common neurodegenerative disorder after Alzheimer's disease that may present with both motor and non-motor symptoms (NMSs). Many of the ignored NMSs may potentiate further deterioration of the patient's quality of life (QoL). But there is scarcity of data regarding NMSs of PD patients and their relationship with the disease severity in Bangladesh. This study was aimed to investigate the frequency of NMSs and assess their debatable impact on the severity of PD patients in Bangladesh. This cross-sectional type of observational study was conducted in neurology department of Dhaka Medical College Hospital, Bangladesh from January 2012 to June 2013 which recruited 60 eligible PD patients. The PD patients and disease severity was demonstrated by UK Parkinson's Disease Society Brain Bank criteria for idiopathic PD and the Hoehn and Yahr scale respectively. Whereas, NMSs were demonstrated by the self-structured questionnaire which had encountered 30 common symptoms of PD. The mean age of our study cohort was found 57.88±10.56 years with male female ration 2:1. According to the Hoehn and Yahr (H & Y) severity scale 38.3%, 38.3%, 20.1% and 3.3% patients had been suffering from stage ?, stage II, stage III and stage ?V Parkinson's disease respectively. Irrespective of the severity of the PD the frequency of NMSs was nocturia (66.7%), sadness or blues (65.0%), memory disturbance (61.7%), anxiety (58.3%), insomnia (56.7%), orthostatic hypotension (55.0%), erectile dysfunction (50.0%), urinary urgency (46.7%), anhedonia (45.0%), olfactory disturbance (38.3%), constipation (38.3%), hyper or hypo sexuality (31.7%) and restless leg syndrome (31.7%). However, after head-to-head NMSs analysis, daytime dribbling of saliva (p=0.024), urinary urgency (p=0.036), nocturia (p=0.001), weight loss (p=0.001), anhedonia (p=0.027), excessive daytime sleepiness (p=0.024), insomnia (p=0.007), vivid dream (p=0.024), REM behavior disorder (p=0.010), restless leg syndrome/ periodic leg movements (p=0.043) had significantly been reported higher among the stage II PD patients than that of stage I patients. Whereas fall (p=0.001), dysphagia or choking (p=0.002), constipation (p=0.003), fecal incontinence (p=0.033), excessive daytime sleepiness (p=0.033), anxiety (p=0.036) and anhedonia (p=0.044) were significantly more prevalent among the advanced stage (III) than stage (II) PD patients. Mean total NMS increased significantly with PD severity based on H and Y staging with a mean NMSQ-T (Non-Motor Symptoms Questionnaire Test) of 5.43 in stage 1, 9.22 in stage 2, 13.75 in stage 3 and 17.0 in stage 4 (p=0.0001). This study revealed that there was high frequency of NMSs among the PD patients and most common symptoms were nocturia, sadness, memory impairment, anxiety, insomnia, orthostatic hypotension, erectile dysfunction, anhedonia, urinary urgency and constipation. Finally, the more advanced disease as indicated by a higher H&Y stage was associated with significantly higher number of reported NMSs.

Pulmonary Rehabilitation: A Weapon to Fight against COVID-19.

No Abstract.

Socio-demographic Profile of COVID-19 Patients and Difficulties Faced by Them while Testing RT-PCR: A Multi-center Cross-sectional Study.

This study was aimed to find out the socio-demographic profiles as well as difficulties of Reverse transcription polymerase chain reaction (RT-PCR) testing faced by Coronavirus Disease 2019 (COVID-19) patients. This cross-sectional study was conducted from 10th August to 7th September 2020. Data were collected by telephone interview using a pre-designed questionnaire after taking verbal consent from the participants. Out of 281 COVID-19 patients, 279 were diagnosed by RT-PCR; 10.3% were asymptomatic. Off them 67.6%were males, 24% were hospital staffs. Majority (66.2%) were from the non-city corporation area. History of recent contact with known COVID-19 patients was present in 56.9% cases. Fever (78.3%) and cough (58%) were the most common symptoms. One third of the patients faced difficulty to test RT-PCR for COVID-19. Sixteen percent patients complained of difficulty of getting serial for testing, the maximum waiting time was one week before giving samples. Thirty patients (10.8%) had to wait longer than usual time after reaching the center before giving sample. Hospital staffs were unable to co-operate in 2.5% of the patients while difficulty of managing transport to the hospital for suspected COVID-19 patient was an issue in 2.2% of the patients. Though testing was more difficult in city corporation areas (p=0.028), delay of getting test result was less (p<0.001). Maximum delay of getting test result was 10 days. Finding out the difficulties of COVID-19 testing will help to point out the issues behind these and will help to take necessary steps to tackle this matter. Testing rate can be increased to contain this highly contagious virus in this densely populated country.

Neonatal COVID-19 Infection: Is Neonate Safe?

No Abstract.

Diabetes Mellitus and COVID-19: Unholy Association of Two Pandemics.

Not Available.

Frequency of Dysglycemia and Obesity among Undergraduate Students of a Medical College of Bangladesh.

Due to high genetic susceptibility and rapidly urbanizing lifestyle, the prevalence of diabetes mellitus (DM) is rapidly increasing in Bangladesh especially in the younger population. This cross-sectional study was conducted from 14 to 25 November 2019 among the undergraduate students of a government medical college of Bangladesh to find out the frequency of dysglycemia and associated risk factors in them. A total of 364 students were included in the study. Relevant medical history was taken; clinical examinations and anthropometric measurements were done. Capillary blood glucose (CBG) was measured in fasting state. Out of 364 participants, 7(1.92%) had DM and 26(7.14%) were pre-diabetic. Two-fifth (19.5%) was hypertensive or pre-hypertensive. Almost half of them were either overweight (36%) or obese (13.5%) and 39% had abdominal obesity. Subjects with dysglycemia and normoglycemia did not differ in age, gender, smoking status, diastolic blood pressure (BP), body mass index (BMI), waist circumference, and presence of abdominal obesity and other diseases. A higher number of subjects in the dysglycemia group had first degree relative with type 2 DM (T2DM). Systolic BP was also higher in this group. T2DM in the first-degree relative was found to be a significant predictor of dysglycemia in the study subjects. Adoption of a healthy lifestyle with the aim of reduction of these modifiable cardiovascular risk factors is of utmost importance to ensure a healthy future generation.

Ecology of bats and their role in emerging zoonotic diseases: a review.

The order Chiroptera is the second largest order of mammals and shows great physiological and ecological diversity. These animals play significant ecological roles as prey and predator as well as facilitating pollination, seed dispersal, arthropod reduction and nutrient distribution and reutilisation in nature. Bats act as hosts to a range of viral, bacterial, fungal and parasitic zoonoses. Human activities increase the likelihood of exposure to bats, thereby increasing the opportunity for infections to spill over. Continuing ecological processes, emergence and spillover of novel pathogens in naïve hosts, including humans, along with other complex natural phenomena require proper understanding that may help in predicting the next spillover. This review will discuss the ecology of bats and their role in the emergence of different zoonoses, particularly those of viral origin, in an organised manner to increase understanding of the factors that may play significant roles in spillover of these pathogens from bats to other animals, including humans.

L'ordre des Chiroptères, le deuxième des mammifères en nombre d'espèces, présente des caractéristiques physiologiques et écologiques très diverses. Ces animaux jouent un rôle écologique majeur à divers titres, en tant que proies et prédateurs, mais aussi parce qu'ils interviennent dans la pollinisation, la dispersion des semences, la réduction des populations d'arthropodes et la répartition et réutilisation des nutriments dans la nature. Les chauves-souris sont les hôtes d'un large éventail de virus, bactéries, champignons et parasites zoonotiques. Les activités humaines entraînent une probabilité accrue d'exposition aux chauves-souris, ce qui à son tour multiplie les situations à la faveur desquelles les maladies infectieuses peuvent se transmettre d'une espèce réservoir à des hôtes accidentels. Les processus écologiques continus, l'émergence d'agents pathogènes nouveaux et l'atteinte accidentelle d'une espèce réceptive mais habituellement non touchée, y compris l'homme, ainsi que d'autres phénomènes naturels complexes, doivent être correctement appréhendés afin de pouvoir prédire la prochaine occurrence de ce type de transmission inter-espèces. Les auteurs examinent l'écologie des chauves-souris et leur rôle dans l'émergence de plusieurs zoonoses, notamment d'origine virale, en les présentant sous forme raisonnée afin de mieux faire comprendre les facteurs susceptibles de jouer un rôle significatif dans la transmission de ces agents pathogènes des chauves-souris à d'autres espèces, y compris l'homme.

El orden de los quirópteros, que es el segundo más grande de los órdenes de mamíferos, presenta una gran diversidad fisiológica y ecológica. Estos animales cumplen importantes funciones ecológicas como presas y predadores, además de facilitar la polinización, la dispersión de semillas, la reducción de las poblaciones de artrópodos y la distribución y reutilización de nutrientes en el medio natural. Los murciélagos son hospedadores de una serie de zoonosis víricas, bacterianas, fúngicas y parasitarias. Las actividades humanas aumentan la probabilidad de exposición a murciélagos, acrecentando con ello las posibilidades de extensión secundaria de una infección. Los continuos procesos ecológicos, la aparición de nuevos patógenos y su extensión a hospedadores no expuestos previamente, incluidas las personas, junto con otros fenómenos naturales complejos, obligan a conocer cabalmente estos procesos para ayudar a predecir dónde puede darse la siguiente extensión secundaria. Los autores examinan la ecología de los murciélagos y la función que estos cumplen en el surgimiento de diferentes zoonosis, en especial las de origen vírico, de manera organizada para conocer mejor los factores que pueden influir sustancialmente en el paso de esos patógenos del murciélago a otros animales, en particular el ser humano.

Study on Endoscopic Retrograde Cholangiopancreatography.

Endoscopic retrograde cholangiopancreatography (ERCP) is a modern & universally established modality in the evaluation and treatment of suspected biliary and pancreatic disease. In Bangladesh, ERCP services are limited to few tertiary care centers mostly in the capital & large city. ERCP was 1st introduced in Mymensingh on 3rd April 2016 in a private hospital. Since then, Mymensingh Medical College Hospital (MMCH) provides ERCP services to a large volume of patients in collaboration with private center for diagnostic accuracy & therapeutic purpose. The aim of this study was to evaluate our experience in ERCP, to characterize & evaluate the aetiology, findings of ERCP & frequency of complications. This prospective type of study was carried out by the department of hepatology, MMCH from 3rd April 2016 to 10th July 2018 in collaboration with that private center where ERCP has been established. All patients undergoing ERCP during this period were included. Aetiology & findings were assessed at the time of ERCP & complications were assessed during procedure, index hospitalization & within 30 days after the procedure by telephone contact. A total of 301 consecutive ERCP were performed during the study period. Among them, 182(60.5%) were male & 119(39.5%) were female with an age range of 18-78 years. The most common indications for ERCP were: cholangiocarcinoma in 98(32.56%) & choledocholithiasis in 95(31.56%) followed by periampullary growth in 93(30.89%), suspected CBD stricture in 12(4%) & chronic pancreatitis in 2(0.66%). The most common findings were choledocholithiasis (32.56%), cholangiocarcinoma (32.56%), biliary obstruction due to periampullary growth (30.56%). Biliary fistula with distal bile duct stricture was found in (1.66%), bile duct stricture in (1.33%), chronic pancreatitis in (0.66%), and organic papillary stenosis with deformed bulb were discovered in (0.34%) case. All ERCPs were done for therapeutic purpose. Endoscopic sphincterotomy was the most common therapeutic procedure (87.04%) of which biliary stenting was done in (67.44%) & stone extraction in (33.71%). Stone extraction from biliary tree was successfully done in 94 cases (98.67%) but it was unsuccessful from biliary tree in 4 cases (1.33%) & also from pancreatic duct in a separate case. The most frequent complication was Post-ERCP pancreatitis in 9 patients (2.99%) followed by acute confusional state (1.33%). Post-ERCP cholangitis occurred in (0.99%) & death was reported in 2 cases (0.66%) due to anaesthetic hazard.

Acute Kidney Injury in Patients with Acute Viral Hepatitis: A Study in a Tertiary Care Hospital.

This cross sectional observational study was done in the Department of Medicine, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from May 2013 to April 2014 to find out the proportion of acute kidney injury among patients with acute viral hepatitis and to identify risk factors associated with development of acute kidney injury (AKI). A total of 100 patients with acute viral hepatitis were included purposively as study subjects. Among them 61 were male and 39 were female. They were divided into AKI group (n=6) and non-AKI group (n=94) on the basis of development of AKI. There was no significant difference in mean age (39.0±13.1 years vs. 32.2±10.8 years, p=0.335) and sex (67% vs. 61% & 33.0% vs. 39.0%) p=0.769) between AKI group and non-AKI group. There were 27% acute viral hepatitis A, 21% acute viral hepatitis B and 52% acute viral hepatitis E but no case of acute viral hepatitis C was found in this study. Acute kidney injury (AKI) developed in 6 of 27 patients with acute viral hepatitis A. This study showed that 22.2% patients with acute viral hepatitis A developed acute kidney injury but patients with acute viral hepatitis B (HBV) and hepatitis E (HEV) did not develop acute kidney injury. Majority of the patients with acute kidney injury were smokers and hypertensive with elevated mean arterial pressure (p=0.0001) at presentation and had higher total bilirubin (p=0.0001), alanine aminotranseferase values (p=0.040), prolonged prothrombin time (INR) {p=0.0001}, lower albumin (p=0.0001), lower haematocrit level (p=0.0001), high CRP concentration (p=0.0001), leucocytosis (p=0.0001) and thrombocytopenia (p=0.0001) at presentation than patients without acute kidney injury. It is evident from the study that acute kidney injury is not a rare complication in patients with acute viral hepatitis.

Significance of Age-Spleen-Platelet Ratio Index (ASPRI) to Exclude Cirrhosis in Patients with Chronic Hepatitis B.

Liver biopsy is an integral part of management of patients with Chronic Hepatitis B (CHB), which is helpful in confirming diagnosis, assessing grade of inflammation and stage of fibrosis and also in guiding treatment strategy. Although liver biopsy is relatively safe, morbidity occurs in 0.2-2% of patients. Hence various non-invasive markers, like AST-ALT Ratio (AAR), Age-Platelet Index (API), AST to Platelet Ratio Index (APRI), Fibroscan etc. have been developed worldwide to asses liver histology. Age-Spleen-Platelet Ratio Index (ASPRI) is new in this series. In this cross sectional study 51 (fifty one) patients with CHB, attending at Hepatology ward in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2006 to May 2006, were studied. They were divided into two groups: Group I patients with ASPRI<5 and Group II patients with ASPRI>5. Clinical, serological, biochemical, virological parameters were analyzed and following liver biopsy, correlation of liver fibrosis with ASPRI was evaluated. Among 51 patients of CHB, 30 patients Group I with ASPRI<5 (mean 3.4) had mean fibrosis 1.3 using Knodell scoring system; while mean age, spleen size and platelet count were 23.2 years, 8.6cm and 278?109/L accordingly. In Group II, 21 patients with ASPRI>5 (mean 5.8) had mean fibrosis 1.8; mean age was 30.6 years, spleen size 9.5cm and platelet count 195?109/L. Mean liver fibrosis was significantly increased in Group II patients. In Group I patients, liver fibrosis showed significant correlation with platelet count (p=0.03) and ASPRI (p= 0.011), while none was observed in Group II patients. Age-Spleen-Platelet Ratio Index ASPRI can be used as a good tool for diagnosis of liver fibrosis in chronic hepatitis B. However, further study with larger study population is required to assess its validity.

Sonographic Evaluation of Colonic Carcinoma in Comparison to Colonoscopy.

Colon cancer is one of the main causes of cancer death. Diagnosis requires the examination of the entire large bowel by means of radiological or endoscopic techniques. Though there is not a remarkable advancement in gastrointestinal (GI) tract evaluations, the modern radiological imaging methods emphasize the importance of ultrasonography (US) evaluations and stand US out as the scanning method in malignancies of the GI tract. The objective of this study is to investigate the role of ultrasonography in the diagnosis of cancers of the colon & it's accuracy in comparison to colonoscopy. This cross sectional analytical study included a total of 62 patients, including 38(61.29%) male and 24(38.71%) female patients who came at Mymensingh Medical College Hospital & Popular Diagnostic Center, Mymensingh from January 2013 to November 2015 & whose ultrasonography and endoscopic examinations were planned with suspicion of colon cancer. Considering the colonoscopic biopsy as a gold standard, the sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ultrasonography were evaluated manually. All patients underwent ultrasonography and colonoscopy and results were compared with histopathologic diagnosis. Malignancy was histopathologically identified in 37(59.68%) patients. The sensitivity of ultrasound to identify colon cancer was 86.48%, its specificity was 84%, positive predictive value and negative predictive value was 88.89% & 80.77% respectively. The sensitivity of endoscopic intervention was 100%, its specificity was 96% and positive predictive value was 93.7%. Likewise, a series of analytical and clinical parameters were evaluated, in an attempt to establish associated factors of a colon cancer by means of the statistical package SPSS 13.0 for Windows. Therefore, we believe that abdominal ultrasonography which is non-invasive, easily accessible, cost-efficient method may detect a colonic mass or wall thickening consistent with a colonic carcinoma with a high degree of accuracy.

Exceptional Multiple Foreign-Body Ingestion by a Patient with Schizophrenia.

Swallowing foreign body in adult is uncommon. This mostly occurs accidentally or in psychologically unsound patient. A 32-years-old male patient with abdominal pain admitted in surgery department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh with a history of swallowing various objects. After endoscopic confirmation and psychological evaluation he underwent laparotomy and 29 different objects were removed from his stomach by Gastrotomy. He was psychiatrically evaluated after recovery from operation and was found to be suffering from Schizophrenia with cannabis use. The aim of reporting this case can raise awareness at the patients complains should be taken seriously to prevent morbidity and even mortality.

Detection of dermatophytes in healthy companion dogs and cats in eastern India.

In recent times increasing occurrence of dermatophytosis, especially among the school children in eastern India was evidenced along with increased tendency of keeping companion animals such as dogs and cats. This study was undertaken to detect the occurrence of dermatophytes with antifungal susceptibility among the companion animals. A total of 1501 healthy companion animals comprising 1209 dogs and 292 cats belonged to individual owners in and around Kolkata (West Bengal, India) were examined for the evidence of dermatophytosis during 2011-2013. The collected samples were subjected to direct examination by standard KOH mount technique. The samples were inoculated into both Sabouraud dextrose agar (SDA) with 0.05% chloramphenicol and 0.5% cycloheximide and dermatophyte test medium (DTM). Each of the fungal isolate was identified based upon its colony characteristics and hyphal and conidial cells it produced. Antifungal susceptibility of the isolates was tested by broth micro dilution assay using fluconazole, ketoconazole, itraconazole, miconazole, griseofulvin and amphotericin-B antifungals. Among the 1209 samples from dogs and 292 samples from cats, 253 (20.93%) and 109 (37.33%) samples were positive for dermatophytes by direct examination. Three identified species of dermatophytes with predominant occurrence were Microsporum canis, Microsporum gypseum and Trichophyton mentagrophytes. Ketoconazole (0.06-0.5 µgm/ml), itraconazole (0.03-0.5 µgm/ml) and amphotericin-B (0.03-0.5 µgm/ml) showed lowest MIC values against M. canis, T. mentagrophytes and M. gypseum, respectively. This is the first systemic report of dermatophytes in healthy companion animals with large numbers of samples in India.

Non-alcoholic Fatty Liver Disease (NAFLD)--A Review.

Non-alcoholic fatty liver disease (NAFLD) is an emerging problem in Hepatology clinics. It is closely related to the increased frequency of overweight or obesity. It has recognised association with metabolic syndrome. Central obesity, diabetes mellitus, dyslipidemia are commonest risk factors. Association with hepatitis C genotype 3 is also recognised. NAFLD is an important cause of cyptogenic cirrhosis of liver. It affects all populations and all age groups. Most patients with NAFLD are asymptomatic or vague upper abdominal pain. Liver function tests are mostly normal or mild elevation of aminotranferases. Histological features almost identical to those of alcohol-induced liver damage and can range from mild steatosis to cirrhosis. Two hit hypothesis is prevailing theory for the development of NAFLD. Diagnosis is usually made by imaging tools like ultrasonogram which reveal a bright liver while liver biopsy is gold standard for diagnosis as well as differentiating simple fatty liver and non-alcoholic steatohepatitis (NASH). Prognosis is variable. Simple hepatic steatosis generally has a benign long-term prognosis. However, one to two third of NASH progress to fibrosis or cirrhosis and may have a similar prognosis as cirrhosis from other liver diseases. Treatment is mostly control of underlying disorders and dietary advice, exercise, insulin sensitizers, antioxidants, or cytoprotective agents. The prevalence of NAFLD is increasing. So it needs more research to address this problem.

Synthesis of LiNbO3 Nanoparticles by Citrate Gel Method.

We present investigations on the preparation of nearly stoichiometric lithium niobate (LiNbO3) nanoparticles using citrate gel method. Citric acid is used as a chelating agent and ethylene glycol is added for polyestarification between the chelates. In addition to the main lithium niobate phase, the secondary phase of lithium niobate, LiNb3O8, and an unreacted phase of Nb2O5 were also observed in the resultant product. The appearance of unwanted phases is a serious problem in citrate gel method. We have observed that the synthesis parameters such as molar ratio of citric acid to metal ions (R1), pH, molar ratio of ethylene glycol to citric acid (R2) and calcination temperature strongly influence the presence of the unwanted phases and these parameters are optimized to remove these phases. Evolution of the phase was investigated by powder XRD whereas TG/DTA was done to find out the crystallization temperature. It was observed that nearly stoichiometric and pure LiNbO3 nanoparticles can be obtained with the optimized parameters, R1 = 3, pH = 8, R2 ≥ 2 and calcination temperature = 700 degrees C. The stoichiometry of the synthesized LiNbO3 nanoparticles was investigated using Raman spectroscopy.

Primary extramedullary esophageal plasmacytoma - a case report.

Extramedullary plasmacytomas are very uncommon tumors, may occur commonly in the upper respiratory passages. These are rarely seen in the middle and lower gastrointestinal system and exceptional to originate in the esophagus. We present a novel case of a 65-year old man who presented with dysphagia and weight loss. After taking detailed clinical history and physical examination endoscopy was performed that showed an ulcero-proliferative lesion involving the lower third of esophagus. Histopathological examination revealed sheets of malignant plasma cells, some with prominent nucleoli. Immuno-histochemistry could not be done due to unavailability. A bone marrow biopsy was performed which was negative for involvement. This is a rare case of esophageal plasmacytoma diagnosed on endoscopy in a patient presenting with dysphagia.

Parotid gland metastasis - an unusual presentation of adenocarcinoma of lung.

Lung cancer is the most frequent malignant disease and the most common cause of cancer death in the world. Primary carcinoma of the lung was an uncommon cancer until the 1930s. Common cell types in bronchial carcinoma are squamous 35%, Adenocarcinoma 30%, Small-cell 20%, Large-cell 15%. We present a case of a bronchial neoplasm metastasis to the parotid gland. A 50 years old male patient presented with a 7×5cm painless parotid mass that was metastatic adenocarcinoma on histopathology. Then we thoroughly examined the patient and he was investigated accordingly. There was an abnormal shadow in the lung on chest x-ray, CT revealed a lung tumour on left side. Metastasis to the parotid gland from any distant primary site is quite unusual. We are going to present this case in the journal because of its rarity. Parotid gland metastasis from the lung is rare & if a careful examination is not performed primary focus may be overlooked, negatively affecting the lifetime survival rate & the prognosis of the patient.

Detection and characterization of zoonotic dermatophytes from dogs and cats in and around Kolkata.

AIM: The ringworms of pet dogs, cats, and stray animals (dogs, cats, and other animals) could be a potential source of zoonotic infections causing a serious public health problem in the busy city Kolkata. The pet owners are more susceptible to get this infection from their pets, because of the close contact with them as dermatophytosis is very much prevalent in those pets. So, this study was aimed to check the prevalence of dermatophytosis in dogs, cats, and in pet owners. MATERIALS AND METHODS: A total of 362 clinically suspected cases of dermatophytosis from dogs (123 in number), cats (202 in number), and human beings (37 in number) were collected and studied from in and around Kolkata to detect the presence of significant dermatophytes. Direct microscopy and cultural examination of the isolates were performed following standard methodology. Identification and characterization of the isolates were done by different biochemical tests. RESULTS: Samples (n=285) having significant dermatophytic fungal infections were found to be of highest number in cats (158, 55.5%) than in dogs (108, 37.8%) and humans (19, 6.7%), respectively. The incidence of Microsporum canis (60.0%) was the highest from affecting dogs, cats, and human beings in comparison to Microsporum gypseum (22.5%), Trichophyton mentagrophytes (15.8%) and Trichophyton rubrum (1.7%). Detection of T. rubrum was only from human cases in this study, whereas the presence of rest three were slightly higher in cats than that of the dogs and humans in this present study. The incidences were higher in young animals and in humans of the age group of 21-30 years, during the rainy season (from April to August) and also in in-contact human beings. CONCLUSION: M. canis was the most commonly pathogen among all causing dermatophytosis in animals and also in the pet owners. M. gypseum and T. mentagrophytes were other pathogens associated with these infections. These infections were more prevalent in the rainy seasons and in in-contact human patients or pet owners.

Case report on carotid body tumor.

A 40 years old lady presented to us with the complaints of repeated attack of syncope with left sided neck swelling. Ultrasonography, Color Doppler study and arteriography were done which revealed a solid vascular mass in the carotid bifurcation. Mass was resected and histopathology was done. Histopathologic findings were typical of a carotid body tumour. As carotid body tumour is a rare disease. So, we are going to present this in this article.

A case of acute insulin poisoning with attempt to suicide.

A 18 years old girl with no known comorbidities was admitted in female medicine ward through the emergency department with rapid onset of semi consciousness due to hypoglycaemia (plasma glucose in admission was 2.0mmol/L). She had history of self-injection of insulin (regular insulin 300 units) subcutaneously in abdominal wall. However she didn't developed serious complications of hypoglycaemia and was subsequently discharged after conservative treatment.