Para Kala-Azar Dermal Leishmaniasis: A Case Report.

Rarely, post-kala-azar dermal leishmaniasis (PKDL) may coexist with visceral leishmaniasis (VL). The concomitant PKDL and VL are referred to as Para-kala-azar dermal Leishmaniasis. We report a case of Para kala-azar dermal leishmaniasis in a chronic Hepatitis-B virus-infected patient who presented with an abdominal lump and multiple maculopapular skin lesions and is resistant to sodium stibogluconate but successfully treated with liposomal Amphotericin-B.

Impact of COVID-19 on hospital admission of acute stroke patients in Bangladesh.

BACKGROUND: With the proposed pathophysiologic mechanism of neurologic injury by SARS CoV-2, the frequency of stroke and henceforth the related hospital admissions were expected to rise. This paper investigated this presumption by comparing the frequency of admissions of stroke cases in Bangladesh before and during the pandemic. METHODS: This is a retrospective analysis of stroke admissions in a 100-bed stroke unit at the National Institute of Neurosciences and Hospital (NINS&H) which is considerably a large stroke unit. All the admitted cases from 1 January to 30 June 2020 were considered. Poisson regression models were used to determine whether statistically significant changes in admission rates can be found before and after 25 March since when there is a surge in COVID-19 infections. RESULTS: A total of 1394 stroke patients took admission in the stroke unit during the study period. Half of the patients were older than 60 years, whereas only 2.6% were 30 years old or younger. The male to female ratio is 1.06:1. From January to March 2020, the mean rate of admission was 302.3 cases per month, which dropped to 162.3 cases per month from April to June, with an overall reduction of 46.3% in acute stroke admission per month. In those two periods, reductions in average admission per month for ischemic stroke (IST), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and venous stroke (VS) were 45.5%, 37.2%, 71.4% and 39.0%, respectively. Based on weekly data, results of Poisson regressions confirm that the average number of admissions per week dropped significantly during the last three months of the sample period. Further, in the first three months, a total of 22 cases of hyperacute stroke management were done, whereas, in the last three months, there was an 86.4% reduction in the number of hyperacute stroke patients getting reperfusion treatment. Only 38 patients (2.7%) were later found to be RT-PCR SARS Cov-2 positive based on nasal swab testing. CONCLUSION: This study revealed a more than fifty percent reduction in acute stroke admission during the COVID-19 pandemic. Whether the reduction is related to the fear of getting infected by COVID-19 from hospitalization or the overall restriction on public movement or stay-home measures remains unknown.

Chikungunya - an emerging infection in Bangladesh: a case series.

INTRODUCTION: Chikungunya is an arthropod-borne virus endemic to Africa, Southeast Asia and India that causes acute febrile polyarthralgia and arthritis. In this short case series, we discuss six Bangladeshi patients with chikungunya fever. Though Bangladesh is in endemic zone, it is not common here, hence it demands attention for proper diagnosis and management. CASE PRESENTATION: The six cases of chikungunya we report occurred in native Bangladeshi women with ages ranging from 20 to 50 years and all having a middle class family background. Three women had severe incapacitating arthralgia as well as a maculo-papular rash and a high fever. The other three had a high grade fever and arthralgia only, but no rash. They were tested for chikungunya immunoglobulin M antibody and found to be positive in all cases. They were treated symptomatically with non-steroidal anti-inflammatory drugs and found responsive in most cases. CONCLUSION: From this case series, it is evident that chikungunya is not that uncommon in Bangladesh. But the concomitant presence of other arthropod-borne infections with similar courses of illness makes most physicians less aware of this infection. An awareness and clinical knowledge are necessary to diagnose chikungunya infection properly.

Influence of socio-demographic factors on awareness of HIV/AIDS among Bangladeshi garment workers.

The study was conducted to assess the level of awareness on HIV/AIDS (Acquired Immune Deficiency Syndrome) and the Influence of different socio-demographic factors among the garment workers in Bangladesh. This cross sectional study was carried out among 303 workers in three selected garment factories in Dhaka city from July 2010 to June 1011. Data were collected by face to face interview through a predesigned questionnaire containing desired information. The majority of workers (76.6%) were within the 17-19 years age group. The female respondents predominated (55.1%). A considerable number of the sample population (39.3%) completed the primary education. But majority belonged to low income group (68.4%), followed by the very low income group (22.4%). Almost everyone (98.3%) except five of the respondents heard the word HIV/AIDS and most of them (90.6%) knew that the disease is transmissible from person to person and mainly by sexual intercourse (78.9%). Only 28.2% had some idea about the sign symptoms of HIV. About (64.4%) thought that persons having heterosexual partners (including prostitutes) are high-risk groups. Though many (74.2%) of the respondents thought that HIV/AIDS is preventable, only 45% said HIV/AIDS is not curable. But 70.5% answered that death is the ultimate fate. The main source of information was radio/TV, newspaper. Unfortunately, 76.9% of the respondents had poor awareness while only 10.6% had good awareness. The level of awareness increased with age (p = <0.05). Though the male were slightly more aware than the female, the relationship is not statistically significant (p= > 0.05). Awareness among S.S.C. passed and above is quite more than the awareness of illiterate (p = <0.01). But there was no relation (p= > 0.05) of level of family income and living pattern with level of awareness. Even being a risk group the garment workers not much aware of HIV/AIDS. The level of awareness increased with age and literacy, which shows the window of opportunity for the policymakers that educational intervention program, may be effective for them.