Background: Esophageal varices are the consequence of portal hypertension which occurs mostly due to chronic liver disease and bleeding from rupture of this is one of the modes of death. Endoscopic variceal ligation (EVL) till date is recommended and most accepted method of treatment for prevention of both acute and chronic variceal bleeding of cirrhotic patients. Cirrhotic patients are vulnerable to have infection and it is expected to be augmented by any kind of intervention. Endoscopic variceal ligation being used as a modality of treatment, have the potentiality to cause infection in cirrhotic patients and empirical antibiotic prophylaxis is widely practiced in elective EVL but data regarding this is scanty and hence this study was undertaken in the Dept of Gastroenterology from January,2019 to December, 2019. Aims: To see the incidence of bacterial infection in cirrhotic patients following elective EVL. Methods: Fifty four patients were enrolled fulfilling the inclusion and exclusion criteria. Clinical evaluation and biochemical parameters including CBC, CRP, Blood culture, serum billirubin, serum albumin and PT were done. Fifty four EVL sessions were done and in each session, two to six bands were applied. Patients were followed up for 24 hrs to see any clinical signs of infection and CBC, CRP, Blood culture were done at 24 hrs of EVL. Results: Among fifty four subjects, male were 39(72.2%), and female were 15(27.8%) with mean age 46.62 ± 1.34. Eight patients were in Child Pugh A, 43 in Child B and 3 in Child C class ( Child Pugh classification is used to see prognosis in Cirrhosis comprising Encephalopathy, serum billirubin, serum albumin, PT and ascites) . Hepatitis B virus was found to be the most common etiology. Only one subject of Child B class had neutrophilllic leukocytosis with normal other parameters of infection. All other patients did not show any features of infection both clinically and biochemically. Conclusions: The incidence of bacterial infection was found to be an uncommon event following elective EVL in this study J Shaheed Suhrawardy Med Coll 2021; 13(2): 113-116
Diabetes mellitus (DM) is a global burden of disease. Long standing disease causes macrovascular and microvascular complications. Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and it remains a leading cause of blindness and visual impairment in the working-age population in both developing and developed world. Patients with diabetes often developed other ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and maculopathy. The study was carried out to evaluate the ophthalmoscopic changes in type-2 diabetes mellitus (T2DM) patients. This hospital based cross-sectional study was conducted in the department of Medicine, Shaheed Suhrawardy Medical College Hospital, Dhaka, from September 2018 to March 2019. Patients with T2DM attended at the department of medicine within the mentioned period were enrolled after fulfilling the selection criteria. Patients with dense, lentalopacities and other media opacities which prevented posterior segment examination were excluded from the study. Sample was selected by purposive sampling method. Detail demographic data were collected from the patients and recorded in structured case report form. Clinical examination and relevant investigations were done meticulously. Then pupil was dilated and ophthalmoscopic examination was done. Among the 50 diabetic patient’s male was 54%, middle aged (49-60 years) was 54% and sedentary workers was 84.0% with a positive family history of DM was 56.0%. Most of the patients were known hypertensive (64.0%) at the time of enrolment and almost all (94.0%) were taking antihypertensive drug. Retinal photography was performed in all patients and retinopathy was detected in 29 (58%) patients. Fundoscopic findings revealed that cotton-wool spots detected in 32.0% patients, Flame-shaped hemorrhages was 16.0% patients; Arteriovenous nipping was is 18.0% patients and opticdisc swelling (Papilloedema) in 26.0% patients. In this study 21 (42%) patients had normal fundoscopic findings. Retinopathy was more common in smoker (70.0%). Uncontrolled and long-standing diabetes and high HbA1c was major risk factors for the development of retinopathy (P < 0.001). In conclusion, diabetic retinopathy is more common in male smoker with uncontrolled and long-standing diabetic patients. T2DM is a major cause of blindness as it affects microvasculature of retina. Bangladesh Med J. 2021 Sept; 51(1): 33-40
Cet article aborde l'aliénation dans les deux romans"Le dernier colonel" et" Il était une fois un vieux couple heureux".Ce concept a beaucoup d'interprétations : l'aliénation économique, sociale et psychologique.Dans une perspective comparative, nous nous proposons de situer les textes dans leurs contextes : la stérilité des rapports, la vieillesse, le sentiment d'être étranger et les dérives entre cauchemars et hallucinations tout en prenant en considération le vécu des deux auteurs.Et pour cerner notre problématique, nous procèderons à une analyse des techniques de la structure narrative et des figures stylistiques de l'aliénation.C'est dans le cadre spatio-temporel que nous procédons à disséquer l'âme des personnages : la représentation élevée de la forteresse et de la terrasse est dotée d'un potentiel symbolique qui sert à inspirer la distance psychique et dans lequel les protagonistes désirent se recroqueviller.De plus, la temporalité se prête à l'étude de l'aliénation en embrassant la nuit, le moment propice de l'errance.
