Insulinoma Presenting with Psychiatric Manifestations: A Case Report

Insulinomas, the most common of pancreatic endocrine tumors, usually present with neuroglycopenic and adrenergic features. Chronic or long standing recurrent hypogycaemia can produce intellectual deterioration and neuropsychiatric manifestations. Diagnosis of insulinoma relies on clinical features along with laboratory tests and imaging investigations to aid in localization. A 32-year-old male who presented with prominent neuropsychiatric manifestations and received anti-epileptics as a case of epilepsy and was ultimately diagnosed as insulinoma is reported here. The patient experienced fasting hypoglycemia with neuropsychiatric manifestations; computerized tomography (CT scan) and magnetic resonance imaging (MRI) revealed a diffusely enhanced mass in the head area of pancreas which was histopathologically found to be an insulinoma after hand assisted laparoscopic enucleation. Surgical excision is the treatment of choice and is curative in most cases. Key words: Insulinoma; Psychiatric Manifestation.DOI: 10.3329/bsmmuj.v2i1.3710 BSMMU J 2009; 2(1): 39-4

Authentication and Authorization: Security Issues for Institutional Digital Repositories

Information sharing, dissemination, digital libraries, and repositories are not new concepts. Open Access Initiatives make digital information more accessible to users. Access management is an important issue which illustrates the process of providing controlled, secure access to online resources which involves both authentication and authorization. Online security is one of the key services for the network infrastructure of digital repositories. Confidentiality and integrity of information cannot be ensured without a proper access management mechanism. This paper reviews available informatin on user authentications and authorization, and the authentication of digital materials is illustrated

Creation of Connected Word Speech Corpus for Bangla Speech Recognition Systems

A new speech corpus of connected Bangla words derived from newspapers text corpus BdNC01 has recorded. This has been designed for various research activities related to speaker-independent Bangla speech recognition. The database consists of speech of 100 speakers, each of them uttered 52 sentences as connected words for training database. Another 50 new speakers were employed to speak all the list of speech to construct a test database. Every utterance was repeated 5 times in various days to avoid time variation of speaker property. A total of 62 hours of recording makes the corpus largest in its type, size and application area. This paper describes the motivation for the corpus and the processes undertaken in its construction. The paper concludes with the usability of the corpus. &nbsp

A Novel Technique for Transmission of M-Ary Signal through Wireless Fading Channel Using Wavelet Denoising

The paper proposes a novel technique for reducing noise in M-ary signal transmission through wireless fading channel using wavelet denoising that play the key role. The paper also explains that the conventional threshold-based technique is not capable of denoising M-ary quadrature amplitude modulated (M-QAM) signals having multilevel wavelet coefficients through wireless fading channels. A detailed step by step wavelet decomposition and reconstruction processes are discussed here to transform a signal function into wavelet coefficients using simulation software like MATLAB. A 16-QAM modulated symbol through a Rician fading channel is weighted by a control variable of complex form to force the mean of each detail coefficient except low frequency component to zero to enhance noiseless property. The bit error rate (BER) performance of the simulation results are furnished to show the effectiveness of the proposed technique. The root mean square of the deviation of the reconstruct signal from the original signal is used to express the effectiveness of the proposed technique. The traditional denoising provides very high value (above 90%) of the percentage root mean square difference (PDR) and the proposed technique provides only 10% PDR value for the symbol through a noisy channel. The result of the simulation study reveals that the BER performance can be increased using an appropriate control variable to force the mean of each detail coefficient to zero

48 Insulinoma Presenting with Psychiatric Manifestations: A Case Report

Insulinomas, the most common of pancreatic endocrine tumors, usually present with neuroglycopenic and adrenergic features. Chronic or long standing recurrent hypogycaemia can produce intellectual deterioration and neuropsychiatric manifestations. Diagnosis of insulinoma relies on clinical features along with laboratory tests and imaging investigations to aid in localization. A 32-year-old male who presented with prominent neuropsychiatric manifestations and received anti-epileptics as a case of epilepsy and was ultimately diagnosed as insulinoma is reported here. The patient experienced fasting hypoglycemia with neuropsychiatric manifestations; computerized tomography (CT scan) and magnetic resonance imaging (MRI) revealed a diffusely enhanced mass in the head area of pancreas which was histopathologically found to be an insulinoma after hand assisted laparoscopic enucleation. Surgical excision is the treatment of choice and is curative in most cases

The incidence of hypoglycemia among insulin-treated patients with Type 1 or Type 2 diabetes: Bangladeshi cohort of international operations-hypoglycemia assessment tool study

Objectives: The objective of this study was to assess the incidence of hypoglycemia in patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in Bangladeshi cohort of the International Operations-Hypoglycemia Assessment Tool study. Materials and Methods: Patients diagnosed with either T1DM or T2DM, aged ≥18 years, treated with insulin (any regimen) for >12 months, and completed self-assessment questionnaires (SAQs) to record demography, treatment information, and hypoglycemia during the 6-month retrospective and 4-week prospective periods (a total of 7 months) were enrolled in the study. Results: A total of 1179 patients were enrolled and completed the SAQ1 (T1DM, n = 25; T2DM, n = 1154). Almost all patients (T1DM: 100.0% [95% confidence interval (CI): 86.3%, 100.0%] and T2DM: 97.0% [95% CI: 95.9%, 97.9%]) experienced at least 1 hypoglycemic event prospectively. The estimated rates of any and severe hypoglycemia were 26.6 (95% CI: 19.8, 35.0) and 14.1 (95% CI: 9.3, 20.4) events per patient-per year (PPY), respectively, for patients with T1DM and 18.3 (95% CI: 17.4, 19.2) and 12.1 (95% CI: 11.4, 12.9) events PPY, respectively, for patients with T2DM during the prospective period. At baseline, mean glycated hemoglobin (HbA1c) (±standard deviation) was 8.1 (±1.8%) for T1DM and 8.8 (±1.8%) for T2DM. Hypoglycemic rate was independent of HbA1c levels and types of insulin. Conclusions: This is the first patient dataset of self-reported hypoglycemia in Bangladesh; results confirm that hypoglycemia is underreported