Background: COVID-19 infection caused by the new coronavirus was reported in December by the World Health Organization 2019 in China. The main clinical manifestations of infected patients are fever, cough, and dyspnea. Musculoskeletal symptoms, including myalgia, arthralgia, and fatigue, are nearly constantly present. Objective: To evaluate the musculoskeletal symptoms and their relationship with disease severity in patients with COVID-19 infection attending a tertiary-level hospital in Bangladesh.Materials and Methods: This cross-sectional study, conducted at Dhaka Medical College Hospital, Bangladesh, aimed to evaluate the prevalence of musculoskeletal symptoms and their relationship with disease severity in 113 patients with RT-PCR-confirmed COVID-19. Results: The findings revealed that musculoskeletal manifestations were highly common, present in 82.3% of the patients. The most frequent symptoms were fatigue (77.4%) and myalgia (67.7%), followed by arthralgia (22.6%). The study further established a significant relationship between fatigue and the severity of the COVID-19 illness. Additionally, a notable gender disparity was observed, with female patients reporting significantly higher psychological fatigue scores compared to males. Conclusion: The research concludes that musculoskeletal symptoms, particularly fatigue and myalgia, are predominant clinical features in COVID-19 patients. The association of fatigue with disease severity and its higher prevalence in females underscores the need for clinicians to recognize these symptoms.
A 50-year-old man's initial symptom of acromegaly was diabetic ketoacidosis (DKA). The patient presented with abdominal pain, polyuria, polydipsia, hyperhidrosis, and enlargement of the extremities. His acromegalic features also were macroglossia, and jaw prominence. Lab testing showed hyperglycemia, high HbA1c, and elevated IGF-1. MRI showed a pituitary macroadenoma. After initial treatment following the diabetic ketoacidosis protocol, he was referred to neurosurgeon. DKA is often the presenting feature of type 1 diabetes. It may also occur in type 1 and type 2 diabetes due to severe illness, infections, myocardial infarction, heart failure, pancreatitis, pregnancy, or steroids. In acromegaly, GH induces insulin resistance and poor glucose metabolism. Acromegaly may induce glucose intolerance, however, DKA is rare. Some cases were treated with surgery or somatostatin. This case highlights the need to treat acromegaly in unexplained DKA patients, particularly those with physical symptoms.
Background: Sodomy, or non-consensual anal intercourse, is a legally and socially sensitive issue in Bangladesh, often underreported due to stigma and criminalization under Section 377 of the Penal Code. Forensic investigation of such cases is limited, especially for male and transgender victims. This study reviews the forensic patterns, practices, and challenges associated with sodomy cases reported in 2024. Materials and Methods: A retrospective analysis was conducted on 71 medico-legal sodomy cases documented across 15 health institutions in Bangladesh between January and December 2024. Data included demographic details, injury patterns, forensic findings, time of reporting, and perpetrator relationship. A comparative literature review was undertaken for contextual discussion. Results: Of the 71 cases, 83.1% involved male victims and 16.9% transgender individuals, with 85.9% being minors. Anal injuries were present in 85.9% of cases, predominantly abrasions and tears. Only 12.7% of cases had positive semen detection, mainly among those reported within 24 hours. Most assaults (71.8%) were committed by known individuals. Delayed reporting (over 72 hours in 63% of cases) significantly reduced the forensic yield. Conclusion: Reform is urgently needed in forensic procedures, legal interpretation of Section 377, and victim support systems to improve justice for sodomy survivors in Bangladesh.
Background: Bangladesh is located within a seismically active region influenced by the interactions of the Indian, Eurasian, and Burmese tectonic plates, making the country vulnerable to potentially damaging earthquakes. Despite this geological risk, earthquake preparedness in Bangladesh has historically received limited attention, largely due to the country’s greater exposure to floods and cyclones and the absence of a catastrophic earthquake in recent decades. This relative seismic quiescence has contributed to low public risk perception and inadequate prioritization of earthquake-specific preparedness. In contrast, neighboring South Asian countries have experienced multiple devastating earthquakes, resulting in substantial mortality and a high burden of long-term disability.Materials and Methods: This article is a narrative review synthesizing existing evidence on earthquake risk and preparedness in Bangladesh, with emphasis on the role of Rehabilitation Medicine in disaster management. Relevant literature was identified through searches of PubMed, Google Scholar, and selected grey literature from national and international disaster management and health agencies. Search terms included earthquake, Bangladesh, South Asia, disaster preparedness, rehabilitation, and physiatry. Sources were selected based on relevance to seismic risk, injury patterns, rehabilitation needs, and disaster rehabilitation models, and findings were synthesized thematically. Formal systematic review procedures were not applied.Results: Evidence from South Asia consistently demonstrates that earthquakes result in significant long-term disability, predominantly due to musculoskeletal trauma, spinal cord injuries, and neurological impairments. However, current preparedness frameworks in Bangladesh insufficiently integrate rehabilitation services, workforce planning, and continuity of care across the disaster management continuum.Conclusion: Rehabilitation must be recognized as a core component of earthquake preparedness in Bangladesh. Systematic integration of physiatrist-led rehabilitation teams within disaster management systems is essential to reduce long-term disability, optimize functional outcomes, and strengthen national health system resilience against future seismic events.
