Objective: To find out the relationship between hematological parameters and disease severity amo... more Objective: To find out the relationship between hematological parameters and disease severity among COVID-19 patients. Methods: This cross-sectional analytical study was conducted in the COVID unit of Dhaka Medical College and Hospital (DMCH). The study was conducted from October 2020 to September 2021. Patients diagnosed with COVID-19 infection detected by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) admitting in the Corona unit of DMCH, Dhaka, Bangladesh. Purposive sampling technique was applied to collect the samples. 96 patients were included for the study. Result: In case of severity of patients, 17 (17.7%) patients had mild illness, 29 (30.2%) had moderate illness and 50 (52.1%) patients had severe illness due to COVID-19 infection. Furthermore, according to gender, the proportion of male patients (70.0%) were significantly more in severe group compared to mild/moderate group (47.8%). Moreover, the mean age of the patients in severe group (56.2± 14.3) wer...
Background: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of hematological malig... more Background: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of hematological malignancy of large B lymphocytes with a diffuse growth pattern. It is the most common type of adult non-Hodgkin lymphoma (NHL), making up to 30-40% of NHL. Although DLBCL is potentially curable, it remains a challenging lymphoma to manage because of the biological and clinical heterogeneity of the disease.Aim of the study was to compare the outcome of different chemotherapeutic regimens in newly diagnosed DLBCL patients. Methods: This quasi-experimental study was conducted at Department ofHematology,Dhaka Medical College Hospital(DMCH) from January 2018 to June 2019 including nineteen newly diagnosed DLBCL with stage I to IV A/B cases. Protocol was approved by ethical review committee (ERC) of DMCH. Patients aged e”18 years and < 65 years were enrolled for this study and were divided into two groups as arm A treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, prednison...
Background Antimicrobials like fourth-generation cephalosporins, carbapenems, or β-lactams are wi... more Background Antimicrobials like fourth-generation cephalosporins, carbapenems, or β-lactams are widely used in treatment of febrile neutropenia (FN). The present study aimed to compare the efficacy of cefepime, meropenem, and piperacillin/tazobactam as initial treatment for chemo-induced FN in patients with hematological malignancy. Methods This was an observational study conducted in the Department of Hematology of Dhaka Medical College Hospital from July 2020 to June 2021 including 99 adult FN patients with hematological malignancy who were randomized equally to three treatment arms to receive cefepime, meropenem, or piperacillin/tazobactam as an empirical antibiotic. Response to therapy was defined as improvement in symptoms (e.g., defervescence) or in laboratory values including neutrophil counts on day 3 and day 7 after the initiation of the therapy. Chi-square test and Fisher’s exact test were used to compare the efficacy of the treatment regimens. Results Response rate to init...
Background Hemophilia is one of the commonest inherited bleeding disorders which may lead to chro... more Background Hemophilia is one of the commonest inherited bleeding disorders which may lead to chronic bleeding tendencies and life-long disabilities if not properly managed. Knowing the pattern of the disease aids in the prevention of disability and improvement of quality of life in hemophilia. However, there is a dearth of literature on the issue in Bangladesh. So, this study was designed to explore the frequency and site of spontaneous bleeding in moderate and severe hemophilia patients visiting in a tertiary level hospital. Methods This descriptive cross-sectional study was conducted at the department of Hematology and Bone Marrow Transplantation (BMT) Center in Dhaka Medical College Hospital, Dhaka between February 2020 and August 2020. A total of 44 diagnosed cases of moderate to severe hemophilia were included in the study according to inclusion criteria. A detailed inquiry of history, thorough physical examination and relevant investigations were done and were recorded in case...
Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell... more Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell transplantation (HSCT) was first described almost 60 years ago, and its use has expanded significantly over the last 20 years. Whereas HSCT has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and health care provider training that are required to provide such a service have prohibited it from being widely adopted, particularly in developing countries. Methods Over the past two decades, however, efforts to bring HSCT to the developing world have increased, and several institutions have described their efforts to establish such a program. We aim to provide an overview of the current challenges and applications of HSCT in developing countries as well as to describe our experience in developing an HSCT program at Dhaka Medical College and Hospital in Bangladesh via a partnership with health care providers at Massachu...
COVID-19 is a cause of life threating severe acute respiratory syndrome (SARS) caused by a novel ... more COVID-19 is a cause of life threating severe acute respiratory syndrome (SARS) caused by a novel corona virus named as SARS-Cov-2. Since it has 1st been identified in the city of Wuhan in China in December, 2019, it has spread rapidly all over the world. As it is a newly emerged viral infection and any vaccine or specific therapy yet to be proven as clearly effective, multiple therapeutic option with supportive intent as well as search for specific therapy to combat the virus are under vigorous trial around the world. Convalescent plasma therapy is one such investigational therapeutic option for COVID-19 with hope that neutralizing antibodies present in plasma of persons recovered from COVID-19 would be able to neutralize the virus in infected person.
Background: Because of great concerns about mortality and morbidity due to infection in febrile n... more Background: Because of great concerns about mortality and morbidity due to infection in febrile neutropenic patients, the appropriate empirical antibiotic should be started immediately. Although there are established guidelines for the use of empirical therapy in febrile neutropenia, local microbiological pattern and antibiotic susceptibility should be considered for better outcome. There is paucity of data regarding the organism isolated and sensitivity in febrile neutropenic patients in Dhaka Medical College Hospital (DMCH). Objectives: The current study aimed to find out causative organisms for febrile neutropenia and to observe their antimicrobial sensitivity pattern. Materials and method: This was a prospective observational study carried out in department of haematology and BMT of Dhaka Medical college hospital during the period of October, 2014 to July, 2015. Total 104 patients experienced febrile neutropenia and both febrile blood and urine samples were collected and sent f...
Background: Acute promyelocytic leukaemia (APL) is curable with carefully selected treatment prot... more Background: Acute promyelocytic leukaemia (APL) is curable with carefully selected treatment protocol. Reduction of early fatal haemorrhage in initial phase of induction with cost effective combination of chemotherapeutic agents is considered to be the main challenge for successful outcome in APL. Objective: The study was conducted to see the effectiveness of the use of all-trans retinoic acid (ATRA) followed by single agent Arsenic tri oxide (ATO) in the induction phase of the management of APL. Methodology: This is an observational study and was conducted from October 2012 to September 2013, in department of Haematology and BMT of Dhaka Medical College Hospital, Dhaka, Bangladesh. Total 17 patients with PML/RARA positive APL were enrolled and all patients were treated with sequential use of ATRA in a dose of 45mg/m2 for initial 2-3 weeks up to differentiation and then ATO in a dose of 0.15mg/kg daily was used in induction up to 60 days after taking informed written consent. Outcom...
INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for ma... more INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and healthcare provider training that are required has prohibited it from being widely adapted. We describe our experience in developing a transplant program at Dhaka Medical College and Hospital (DMCH) in Bangladesh via a partnership with health care providers at the Massachusetts General Hospital (MGH). In 2011, the Minister of Health in Bangladesh became interested in establishing a transplant program at Dhaka Medical College and Hospital (DMCH). DMCH was established in 1946 and has 2300 beds located in two buildings (DMCH-1 with 1800 beds and DMCH-2 with 500 beds). The Bangladesh government and AK Khan Healthcare trust, an interested non-governmental organization (NGO), provided funding for the endeavor. Despite available funding, we faced significant challenges due to limitations in experienced ...
INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for ma... more INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and healthcare provider training that are required have impeded widespread implementation in resource-constrained settings. We describe our experience in developing a transplant program at Dhaka Medical College and Hospital (DMCH) in Bangladesh via a partnership with health care providers at the Massachusetts General Hospital (MGH). In 2011, the Minister of Health determined that there was a need for a transplant program in Bangaladesh. The Bangladesh government and AK Khan Healthcare trust, an interested non-governmental organization, provided funding for the endeavor. We discuss four key aspects of the program, including: (1) formalizing of a collaborative partnership; (2) infrastructure development; (3) human resource capacity building and implementation of the concept of clinical teamwork; and (4...
Chattagram Maa-O-Shishu Hospital Medical College Journal
Background : To explore the relative frequency and different forms of lymphoma in tertiary level ... more Background : To explore the relative frequency and different forms of lymphoma in tertiary level hospital. Methods: This descriptive observational study was carried out in the Department of Hematology at Dhaka Medical College Hospital, Dhaka. Patients attended with solid tissue lymphoma in Outpatient, Inpatient and Lymphoma Clinic services of Department of Hematology and Bone Marrow Transplant, Dhaka Medical College Hospital, Dhaka were taken as study population as per inclusion criteria. A total of 63 patients with lymphoma diagnosed by histopathologically were selected initially, among them 53 were confirmed by immunohistochemistry taken as study population finally. Results: Mean age was 39.2 ± 15.5 years, median age was 36 years within the range of 14 – 75 years. Males were predominant. Male female ratio was 4.3:1. Most of the samples were collected from cervical lymph node (84.1%). Most of the patients came with fatigue and significant weight loss. Maximum 42 (79.24%) cases were...
Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell... more Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell transplantation (HSCT) was first described almost 60 years ago, and its use has expanded significantly over the last 20 years. Whereas HSCT has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and health care provider training that are required to provide such a service have prohibited it from being widely adopted, particularly in developing countries. Methods Over the past two decades, however, efforts to bring HSCT to the developing world have increased, and several institutions have described their efforts to establish such a program. We aim to provide an overview of the current challenges and applications of HSCT in developing countries as well as to describe our experience in developing an HSCT program at Dhaka Medical College and Hospital in Bangladesh via a partnership with health care providers at Massachu...
Objective: To find out the relationship between hematological parameters and disease severity amo... more Objective: To find out the relationship between hematological parameters and disease severity among COVID-19 patients. Methods: This cross-sectional analytical study was conducted in the COVID unit of Dhaka Medical College and Hospital (DMCH). The study was conducted from October 2020 to September 2021. Patients diagnosed with COVID-19 infection detected by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) admitting in the Corona unit of DMCH, Dhaka, Bangladesh. Purposive sampling technique was applied to collect the samples. 96 patients were included for the study. Result: In case of severity of patients, 17 (17.7%) patients had mild illness, 29 (30.2%) had moderate illness and 50 (52.1%) patients had severe illness due to COVID-19 infection. Furthermore, according to gender, the proportion of male patients (70.0%) were significantly more in severe group compared to mild/moderate group (47.8%). Moreover, the mean age of the patients in severe group (56.2± 14.3) wer...
Background: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of hematological malig... more Background: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of hematological malignancy of large B lymphocytes with a diffuse growth pattern. It is the most common type of adult non-Hodgkin lymphoma (NHL), making up to 30-40% of NHL. Although DLBCL is potentially curable, it remains a challenging lymphoma to manage because of the biological and clinical heterogeneity of the disease.Aim of the study was to compare the outcome of different chemotherapeutic regimens in newly diagnosed DLBCL patients. Methods: This quasi-experimental study was conducted at Department ofHematology,Dhaka Medical College Hospital(DMCH) from January 2018 to June 2019 including nineteen newly diagnosed DLBCL with stage I to IV A/B cases. Protocol was approved by ethical review committee (ERC) of DMCH. Patients aged e”18 years and < 65 years were enrolled for this study and were divided into two groups as arm A treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, prednison...
Background Antimicrobials like fourth-generation cephalosporins, carbapenems, or β-lactams are wi... more Background Antimicrobials like fourth-generation cephalosporins, carbapenems, or β-lactams are widely used in treatment of febrile neutropenia (FN). The present study aimed to compare the efficacy of cefepime, meropenem, and piperacillin/tazobactam as initial treatment for chemo-induced FN in patients with hematological malignancy. Methods This was an observational study conducted in the Department of Hematology of Dhaka Medical College Hospital from July 2020 to June 2021 including 99 adult FN patients with hematological malignancy who were randomized equally to three treatment arms to receive cefepime, meropenem, or piperacillin/tazobactam as an empirical antibiotic. Response to therapy was defined as improvement in symptoms (e.g., defervescence) or in laboratory values including neutrophil counts on day 3 and day 7 after the initiation of the therapy. Chi-square test and Fisher’s exact test were used to compare the efficacy of the treatment regimens. Results Response rate to init...
Background Hemophilia is one of the commonest inherited bleeding disorders which may lead to chro... more Background Hemophilia is one of the commonest inherited bleeding disorders which may lead to chronic bleeding tendencies and life-long disabilities if not properly managed. Knowing the pattern of the disease aids in the prevention of disability and improvement of quality of life in hemophilia. However, there is a dearth of literature on the issue in Bangladesh. So, this study was designed to explore the frequency and site of spontaneous bleeding in moderate and severe hemophilia patients visiting in a tertiary level hospital. Methods This descriptive cross-sectional study was conducted at the department of Hematology and Bone Marrow Transplantation (BMT) Center in Dhaka Medical College Hospital, Dhaka between February 2020 and August 2020. A total of 44 diagnosed cases of moderate to severe hemophilia were included in the study according to inclusion criteria. A detailed inquiry of history, thorough physical examination and relevant investigations were done and were recorded in case...
Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell... more Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell transplantation (HSCT) was first described almost 60 years ago, and its use has expanded significantly over the last 20 years. Whereas HSCT has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and health care provider training that are required to provide such a service have prohibited it from being widely adopted, particularly in developing countries. Methods Over the past two decades, however, efforts to bring HSCT to the developing world have increased, and several institutions have described their efforts to establish such a program. We aim to provide an overview of the current challenges and applications of HSCT in developing countries as well as to describe our experience in developing an HSCT program at Dhaka Medical College and Hospital in Bangladesh via a partnership with health care providers at Massachu...
COVID-19 is a cause of life threating severe acute respiratory syndrome (SARS) caused by a novel ... more COVID-19 is a cause of life threating severe acute respiratory syndrome (SARS) caused by a novel corona virus named as SARS-Cov-2. Since it has 1st been identified in the city of Wuhan in China in December, 2019, it has spread rapidly all over the world. As it is a newly emerged viral infection and any vaccine or specific therapy yet to be proven as clearly effective, multiple therapeutic option with supportive intent as well as search for specific therapy to combat the virus are under vigorous trial around the world. Convalescent plasma therapy is one such investigational therapeutic option for COVID-19 with hope that neutralizing antibodies present in plasma of persons recovered from COVID-19 would be able to neutralize the virus in infected person.
Background: Because of great concerns about mortality and morbidity due to infection in febrile n... more Background: Because of great concerns about mortality and morbidity due to infection in febrile neutropenic patients, the appropriate empirical antibiotic should be started immediately. Although there are established guidelines for the use of empirical therapy in febrile neutropenia, local microbiological pattern and antibiotic susceptibility should be considered for better outcome. There is paucity of data regarding the organism isolated and sensitivity in febrile neutropenic patients in Dhaka Medical College Hospital (DMCH). Objectives: The current study aimed to find out causative organisms for febrile neutropenia and to observe their antimicrobial sensitivity pattern. Materials and method: This was a prospective observational study carried out in department of haematology and BMT of Dhaka Medical college hospital during the period of October, 2014 to July, 2015. Total 104 patients experienced febrile neutropenia and both febrile blood and urine samples were collected and sent f...
Background: Acute promyelocytic leukaemia (APL) is curable with carefully selected treatment prot... more Background: Acute promyelocytic leukaemia (APL) is curable with carefully selected treatment protocol. Reduction of early fatal haemorrhage in initial phase of induction with cost effective combination of chemotherapeutic agents is considered to be the main challenge for successful outcome in APL. Objective: The study was conducted to see the effectiveness of the use of all-trans retinoic acid (ATRA) followed by single agent Arsenic tri oxide (ATO) in the induction phase of the management of APL. Methodology: This is an observational study and was conducted from October 2012 to September 2013, in department of Haematology and BMT of Dhaka Medical College Hospital, Dhaka, Bangladesh. Total 17 patients with PML/RARA positive APL were enrolled and all patients were treated with sequential use of ATRA in a dose of 45mg/m2 for initial 2-3 weeks up to differentiation and then ATO in a dose of 0.15mg/kg daily was used in induction up to 60 days after taking informed written consent. Outcom...
INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for ma... more INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and healthcare provider training that are required has prohibited it from being widely adapted. We describe our experience in developing a transplant program at Dhaka Medical College and Hospital (DMCH) in Bangladesh via a partnership with health care providers at the Massachusetts General Hospital (MGH). In 2011, the Minister of Health in Bangladesh became interested in establishing a transplant program at Dhaka Medical College and Hospital (DMCH). DMCH was established in 1946 and has 2300 beds located in two buildings (DMCH-1 with 1800 beds and DMCH-2 with 500 beds). The Bangladesh government and AK Khan Healthcare trust, an interested non-governmental organization (NGO), provided funding for the endeavor. Despite available funding, we faced significant challenges due to limitations in experienced ...
INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for ma... more INTRODUCTION While hematopoietic stem cell transplantation has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and healthcare provider training that are required have impeded widespread implementation in resource-constrained settings. We describe our experience in developing a transplant program at Dhaka Medical College and Hospital (DMCH) in Bangladesh via a partnership with health care providers at the Massachusetts General Hospital (MGH). In 2011, the Minister of Health determined that there was a need for a transplant program in Bangaladesh. The Bangladesh government and AK Khan Healthcare trust, an interested non-governmental organization, provided funding for the endeavor. We discuss four key aspects of the program, including: (1) formalizing of a collaborative partnership; (2) infrastructure development; (3) human resource capacity building and implementation of the concept of clinical teamwork; and (4...
Chattagram Maa-O-Shishu Hospital Medical College Journal
Background : To explore the relative frequency and different forms of lymphoma in tertiary level ... more Background : To explore the relative frequency and different forms of lymphoma in tertiary level hospital. Methods: This descriptive observational study was carried out in the Department of Hematology at Dhaka Medical College Hospital, Dhaka. Patients attended with solid tissue lymphoma in Outpatient, Inpatient and Lymphoma Clinic services of Department of Hematology and Bone Marrow Transplant, Dhaka Medical College Hospital, Dhaka were taken as study population as per inclusion criteria. A total of 63 patients with lymphoma diagnosed by histopathologically were selected initially, among them 53 were confirmed by immunohistochemistry taken as study population finally. Results: Mean age was 39.2 ± 15.5 years, median age was 36 years within the range of 14 – 75 years. Males were predominant. Male female ratio was 4.3:1. Most of the samples were collected from cervical lymph node (84.1%). Most of the patients came with fatigue and significant weight loss. Maximum 42 (79.24%) cases were...
Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell... more Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell transplantation (HSCT) was first described almost 60 years ago, and its use has expanded significantly over the last 20 years. Whereas HSCT has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and health care provider training that are required to provide such a service have prohibited it from being widely adopted, particularly in developing countries. Methods Over the past two decades, however, efforts to bring HSCT to the developing world have increased, and several institutions have described their efforts to establish such a program. We aim to provide an overview of the current challenges and applications of HSCT in developing countries as well as to describe our experience in developing an HSCT program at Dhaka Medical College and Hospital in Bangladesh via a partnership with health care providers at Massachu...
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