Agenesis of dorsal pancreas is a rare congenital anomaly that results from defective development of pancreas with less than 100 cases described in the literature. Patients may present with epigastric pain, acute or chronic pancreatitis and various disorders of glucose metabolism, can even be asymptomatic. About half of affected individuals develop diabetes mellitus, resulting from reduced islet cell mass. Being very rare, it is generally not kept in mind while dealing these cases and not suspected until imaging investigations are done. In our case study, 14-years-old twin brothers presented with polyuria and polydipsia for seven days. During evaluation diabetes mellitus with dorsal pancreatic agenesis was detected in both brothers. BIRDEM Med J 2026; 16(2): 109-112
Background: Emphysematous pyelonephritis is an acute and severe form of necrotising infection of kidneys and perinephric tissues. Diabetes mellitus, kidney stones and immune suppression states are recognised risk factors for emphysematous pyelonephritis. This study aimed to identify the risk factors contributing to emphysematous pyelonephritis among type 2 diabetic subjects. Methods: This case-control study was done in the Department of Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh from 2023 to 2025. Adult type 2 diabetic patients with computed tomography (CT) scan confirmed emphysematous pyelonephritis were cases and age and sex matched type 2 diabetic patients having acute pyelonephritis were controls. Duration of diabetes, status of glycaemic control (HbA1c), hypertension, pre-existing chronic kidney disease, presence of renal and/or ureteric stones, vesico-ureteric reflux and history of prior urinary tract infection were evaluated as risk factors for emphysematous pyelonephritis. Results: Total patients were 42 including 21 cases and 21 controls. Univariate analysis revealed that high HbA1c [odds ratio (OR) 15.43, 95% confidence interval (CI) 2.81 – 84.72, p 0.0016], duration of diabetes (OR 2.23, 95% CI 0.36 – 13.78, p 0.38), presence of hypertension (OR 1.78, 95% CI 0.52 – 6.10, p 0.35), chronic kidney disease (OR 3.8, 95% CI 0.66 – 21.59, p 0.13) and renal/ureteric stone (OR 1.87, 95% CI 0.38 – 9.12, p 0.43) were risk factors for emphysematous pyelonephritis. Conclusion: High HbA1c appeared as significant risk factor for emphysematous pyelonephritis among patients with type 2 diabetes mellitus. BIRDEM Med J 2026; 16(2): 65-69
Background: This study aimed to determine the prevalence of hearing impairment (HI) in infants of diabetic mothers (IDM) and to investigate its association with maternal diabetes type and maternal glycemic control. Methods: In this prospective hospital-based observational cohort study, infants born to mothers with either pregestational diabetes (PGDM) or gestational diabetes (GDM) were classified as IDM. We screened 474 IDM over 1 year (January to December, 2021) for HI using Distortion Product Otoacoustic Emissions (DPOAE) in two steps. The first screening was conducted before the infants were 30 days old, and a second test was administered two weeks later for those who did not pass the initial screening. Infants who failed both DPOAE tests underwent further evaluation with Auditory Brainstem Response Audiometry (ABR) at three months to confirm the presence of HI. All the tests were performed in required ideal environment and with expert technician. Results: After all the tests, 42 (8.9%) IDM were discovered as having HI. Among them 34 (81%) had unilateral and 8 (19%) had bilateral HI. The prevalence of HI was significantly higher (p < 0.00) in infants with pre-gestational diabetic mothers (19, 19.5%) than in GDM (23, 6.1%). Infants of mothers with uncontrolled (HbA1c >6.1%) blood glucose had a significantly higher rate (p 0.04) of HI than that of well-controlled diabetic mother (HbA1c <6.1%). Conclusion: The prevalence of HI in IDM was 8.9% in our study. It was significantly higher in infants of mothers with pre-gestational diabetes and with uncontrolled blood sugar. BIRDEM Med J 2026; 16(2): 52-57
Polycythaemia rubra vera (PRV) is a myeloproliferative neoplasm of stem cells that lead to trilineage haemopoietic cell hyperplasia, which carries a risk of thrombotic complications. Untreated cases may lead to myelofibrosis and leukaemia. An individual with erythrocytosis is screened by Janus Kinase-2 gene (JAK-2) V617F mutation analysis. Here, two cases with ruddy cyanosis were discussed with focus on importance of JAK2 mutation study for diagnosing PRV along with other clinical and laboratory work up. This study highlights the role of phlebotomy in preventing thrombotic complications in addition to other antiplatelet and cytoreductive drugs. BIRDEM Med J 2026; 16(2): 95-99
Background:Colposcopy is a highly useful tool for early detection of precancerous cervical lesions. Colposcopy gives quick result and guides the site of biopsy which can be done in a single visit proving itself a better screening modality for premalignant lesion and thus plays an important role in primary screening, guiding cervical biopsy and even treatment in some cases. This study was carried out to compare the colposcopy findings with the histopathological diagnosis in women attending the outpatient department with per vaginal white discharge, post coital bleeding, intermenstrual bleeding or post-menopausal bleeding or where colposcopy was done as a screening test. Methods: This retrospective study was conducted in the Department of Obstetrics and Gynaecology in BIRDEM General Hospital (Mohila O Shishu). Relevant data of 58 women from March 2023 to December 2023 from the colposcopy register were used. Patients were referred for colposcopy based on clinical symptoms or who had unhealthy cervix on per speculum examination. Cervical lesions were assessed colposcopically, biopsy was taken and was sent for histopsthology. Statistical analysis was performed by statistical software SPSS version 27.0. Results: The mean age (±SD) of the participants was 45.64±10.05 years and majority of the subjects (39.7%) were in the 40-49 years age group. Most prevalent premalignant cervical lesion diagnosed colposcopically was cervical intraepithelial neoplasia I (CIN I) (18; 31.03%) followed by CIN II (5; 8.62%). On histopathology, the most common benign lesion was chronic cervicitis in 34(58.62%) cases and the commonest premalignant lesion was CIN I in 16(27.58%) cases and it was most common (8.62%) in the 50-59 year age group. For any type of CIN, colposcopy demonstrated a sensitivity of 66.67% (95% CI: 46.04-83.48) and specificity of 76.32% (95% CI: 59.76-88.56) when compared to histopathology. The overall accuracy of colposcopy was 72.31% (95% CI: 59.81-82.69). Conclusion: This study demonstrated a high sensitivity, specificity, PPV, NPV and accuracy of colposcopy when compared to histopathological findings in diagnosing cervical premalignant conditions. BIRDEM Med J 2026; 16(2): 80-86
