A 42-year-old female presented with asymptomatic massive splenomegaly

This article has no abstract. The first 100 words appear below: A 42-year-old female hailing from Brahmanbaria, Bangladesh was admitted with the complaints of abdominal pain which was more marked in the left upper abdomen. Fifteen days before admission in this department, she had a history of physical assault, since then she was experiencing pain over different parts of her body including abdomen. She took analgesic for this pain. Other regional pain subsided but the abdominal pain was persisting

A 42-year-old female presented with asymptomatic massive splenomegaly

This article has no abstract. The first 100 words appear below: A 42-year-old female hailing from Brahmanbaria, Bangladesh was admitted with the complaints of abdominal pain which was more marked in the left upper abdomen. Fifteen days before admission in this department, she had a history of physical assault, since then she was experiencing pain over different parts of her body including abdomen. She took analgesic for this pain. Other regional pain subsided but the abdominal pain was persisting

The role of HbA1c as a diagnostic test for type 2 diabetes mellitus in Bangladesh

Background: Type 2 diabetes mellitus is a serious chronic disease with microvascular complications such as retinopathy, nephropathy and neuropathy and macrovascular complications such as cardiac, peripheral arterial and cerebrovascular disease. Objective: The aim of the study was to investigate the value of HbAlc as a diagnostic test for type 2 diabetes mellitus in Bangladeshi inclividuals. Methods: This cross sectional study was conducted in the Department of Biochemis­try, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. A total 657 patients, who were attended in the one point sample collection centre of Bangabandhu Sheikh Mujib Medical University for oral glucose tolerance test (OGIT) from 1st April 2014 to 30th June 2014, were purposively enrolled in this study. According to WHO criteria and based on OGIT findings study subjects were categorized into Normoglycemic (257), IFG (82), IGT (174), and DM (347). Fasting plasma glucose. HbA1c and plasma glucose at 2 hour after glucose load on OGIT was done from all the study subjects. Results: With a cut-off value of 6.J %, HbAlc had a maximal sensitivity and specificity of 97.0% and 49.0% respectively with a positive predictive value 65.5% and a negative predictive value 94.0%. HbA1c had a sensitivity of 93.0% and a specificity of 63.0% was calculated with a cut-off value of 6.5% with positive predictive value 77.5% and negative predictive value 90.0%. Both fasting plasma glucose levels and 2 hour plasma glucose levels were showed significant positive correlation with HbAlc (r = 0.788, P = 0.000 and r = 0.800, P = 0.000 respectively). Conclusion: The study suggests that measurement of HbAlc could be used to make diagnosis of T2DM in the Bangladeshi population

Relationship between severity of hypertension and renal impairment in preeclampsia

The aim of this study was to determine the relationship between the severity of hypertension and renal impairment in preeclampsia. This study was conducted on 92 diagnosed cases of mild (n=42) and severe (n=50) preeclampsia patients from August 2010 to July 2011. All the patients were almost identical in terms of age and socioeconomic status. The results of the study showed that the mean serum creatinine and uric acid levels were significantly high in severe preeclampsia patient compared to mild preeclampsia and both systolic and diastolic blood pressures had the positive and significant effects on the serum creatinine and uric acid levels. In conclusion, impairment of renal function has the positive and significant relationship with the severity of blood pressure in the preeclamptic patient

Estimated GFR (eGFR) by prediction equation in staging of chronic kidney disease compared to gamma camera GFR

Background: Glomerular filtration rate is an effective tool for diagnosis and staging of chronic kidney disease. The effect ofrenal insufficiency by different method of this tool among patients with CKD is controversial. Objective: The objec­tive of this study was to evaluate the performance of eGFR in staging of CKD compared to gamma camera based GFR. Methods: This cross sectional analytical study was conducted in the Department of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU) with the collaboration with National Institute of Nuclear Medicine and Allied Sciences, BSMMU during the period of January 2011 to December 2012. Gama camera based GFR was estimated from DTP A reno gram and eGFR was estimated by three prediction equations. Comparison was done by Bland Altman agree­ment test to see the agreement on the measurement of GFR between three equation based eGFR method and gama camera based GFR method. Staging comparison was done by Kappa analysis to see the agreement between the stages identified by those different methods. Results: Bland-Altman agreement analysis between GFR measured by gamma camera, CG equation ,CG equation corrected by BSA and MDRD equation shows statistically significant. CKD stages determined by CG GFR, CG GFR corrected by BSA , MDRD GFR and gamma camera based GFR was compared by Kappa statistical analysis .The kappa value was 0.66, 0.77 and 0.79 respectively. Conclusions: This study findings suggest that GFR estimation by MDRD equation in CKD patients shows good agreement with gamma camera based GFR and for staging of CKD patients, eGFR by MDRD formula may be used as very effective tool in Bangladeshi population

Estimated GFR (eGFR) by prediction equation in staging of chronic kidney disease compared to gamma camera GFR

Background: Glomerular filtration rate is an effective tool for diagnosis and staging of chronic kidney disease. The effect ofrenal insufficiency by different method of this tool among patients with CKD is controversial.Objective: The objec­tive of this study was to evaluate the performance of eGFR in staging of CKD compared to gamma camera based GFR.Methods: This cross sectional analytical study was conducted in the Department of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU) with the collaboration with National Institute of Nuclear Medicine and Allied Sciences, BSMMU during the period of January 2011 to December 2012. Gama camera based GFR was estimated from DTP A reno gram and eGFR was estimated by three prediction equations. Comparison was done by Bland Altman agree­ment test to see the agreement on the measurement of GFR between three equation based eGFR method and gama camera based GFR method. Staging comparison was done by Kappa analysis to see the agreement between the stages identified by those different methods.Results: Bland-Altman agreement analysis between GFR measured by gamma camera, CG equation ,CG equation corrected by BSA and MDRD equation shows statistically significant. CKD stages determined by CG GFR, CG GFR corrected by BSA , MDRD GFR and gamma camera based GFR was compared by Kappa statistical analysis .The kappa value was 0.66, 0.77 and 0.79 respectively.Conclusions: This study findings suggest that GFR estimation by MDRD equation in CKD patients shows good agreement with gamma camera based GFR and for staging of CKD patients, eGFR by MDRD formula may be used as very effective tool in Bangladeshi population

Estimated GFR (eGFR) by prediction equation in staging of chronic kidney disease compared to gamma camera GFR

Background: Glomerular filtration rate is an effective tool for diagnosis and staging of chronic kidney disease. The effect ofrenal insufficiency by different method of this tool among patients with CKD is controversial.Objective: The objec­tive of this study was to evaluate the performance of eGFR in staging of CKD compared to gamma camera based GFR.Methods: This cross sectional analytical study was conducted in the Department of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU) with the collaboration with National Institute of Nuclear Medicine and Allied Sciences, BSMMU during the period of January 2011 to December 2012. Gama camera based GFR was estimated from DTP A reno gram and eGFR was estimated by three prediction equations. Comparison was done by Bland Altman agree­ment test to see the agreement on the measurement of GFR between three equation based eGFR method and gama camera based GFR method. Staging comparison was done by Kappa analysis to see the agreement between the stages identified by those different methods.Results: Bland-Altman agreement analysis between GFR measured by gamma camera, CG equation ,CG equation corrected by BSA and MDRD equation shows statistically significant. CKD stages determined by CG GFR, CG GFR corrected by BSA , MDRD GFR and gamma camera based GFR was compared by Kappa statistical analysis .The kappa value was 0.66, 0.77 and 0.79 respectively.Conclusions: This study findings suggest that GFR estimation by MDRD equation in CKD patients shows good agreement with gamma camera based GFR and for staging of CKD patients, eGFR by MDRD formula may be used as very effective tool in Bangladeshi population

Plasma B-type natriuretic peptide concentration for diagnosis of acute heart failure with renal insufficiency

Background : Plasma B-type natriuretic peptide (BNP) is the diagnostic tool for acute heart failure (AHF).This natriu­retic peptide level depends on renal function, through renal metabolism and excretion. Therefore we examined the effect ofrenal impairment on plasma BNP level during diagnosis of AHF.Objective: The objective of the study was to assess the effect of renal dysfunction on plasma BNP level and to determine appropriate cutoff value of plasma BNP to diagnose the patients of AHF with renal insufficiency.Methods: This cross sectional analytical study was conducted in the Depart­ment of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU). The study was done among 90 AHF patients selected from cardiology emergency department during the period of July 2012 to June 2013. After enrollment plasma BNP concentration was measured and eGFR was estimated from serum creatinine by the four parameter Modifica­tion of Diet and Renal Disease (MORD) equation and then grouped into two groups on the basis of empirical cut off value of eGFR 60 ml/min/1.73 m2Results: In this study a significant negative correlation was found between plasma BNP evel and eGFR (P<0.001 ), with higher BNP levels observed as eGFR declined. The optimal BNP cutoff value for diagno­sis of AHF patients with renal insufficiency was 824 pg/ml. At this cutoff level AHF with renal insufficiency could be diagnosed with sensitivity and specificity of 84% and 71 %, respectively.Conclusions: By adjusting the cutoff value, plasma BNP can be used to diagnose AHF with renal insufficiency with an acceptable sensitivity and specificity

Plasma B-type natriuretic peptide concentration for diagnosis of acute heart failure with renal insufficiency

Background : Plasma B-type natriuretic peptide (BNP) is the diagnostic tool for acute heart failure (AHF).This natriu­retic peptide level depends on renal function, through renal metabolism and excretion. Therefore we examined the effect ofrenal impairment on plasma BNP level during diagnosis of AHF. Objective: The objective of the study was to assess the effect of renal dysfunction on plasma BNP level and to determine appropriate cutoff value of plasma BNP to diagnose the patients of AHF with renal insufficiency. Methods: This cross sectional analytical study was conducted in the Depart­ment of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU). The study was done among 90 AHF patients selected from cardiology emergency department during the period of July 2012 to June 2013. After enrollment plasma BNP concentration was measured and eGFR was estimated from serum creatinine by the four parameter Modifica­tion of Diet and Renal Disease (MORD) equation and then grouped into two groups on the basis of empirical cut off value of eGFR 60 ml/min/1.73 m2 Results: In this study a significant negative correlation was found between plasma BNP evel and eGFR (P<0.001 ), with higher BNP levels observed as eGFR declined. The optimal BNP cutoff value for diagno­sis of AHF patients with renal insufficiency was 824 pg/ml. At this cutoff level AHF with renal insufficiency could be diagnosed with sensitivity and specificity of 84% and 71 %, respectively. Conclusions: By adjusting the cutoff value, plasma BNP can be used to diagnose AHF with renal insufficiency with an acceptable sensitivity and specificity