Introduction: in hemodialysis patients. Osteoporosis associated with kidney disease chronic is a complex entity with significant morbidity and mortality relative to risk of fracture. Its prevalence is high, but the incrimination of clinical and biological factors remains poorly identified. The purpose of our study is to determine the prevalence and factors associated with osteoporosis. Methods: A cross-sectional study included 40 chronic hemodialysis patients for at least 6 months. All subjects underwent a bone mineral density (BMD) assay with dual-energy x-rays absorptiometry (DXA) at the lumbar spine (LS) and femoral neck (FN). Data were statistically analyzed by means of descriptive analysis. Patients were divided into 2 groups based on the T-score to define the osteoporotic (t score≤-2.5) and the no-osteoporotic (t score>-2.5). The search for the risk factors studied [age, duration of hemodialysis, parathyroid hormone (PTH), alkaline phosphatases (ALP), and calcification of the abdominal aorta (AAC)] has been carried out by logistic regression. Results: The average age was 59 ± 16 years, 47% were women, and the median of hemodialysis duration was 54 months. The prevalence of osteoporosis at the lumbar spine was 27.5% and at the femoral neck was 32.5%. Regarding risk factors, at the LS, the factors associated with osteoporosis retained in the univariate analysis were age (p=0.034), PTH (p=0.024), AAC (p=0.024), ALP (p=0.027) and in the multivariate analysis, only PTH was significantly associated (p=0.019). At the FN; The factors associated with osteoporosis retained in analysis univariate were age (p = 0.03), AAC (p = 0.01), ALP (p=0.04) and in analysis multivariate was the APL (p= 0.035). Conclusion: Osteoporosis is associated with turnover abnormalities. We suggest that regular screening for fracture risk using DXA and early correction of the disorders.

Introduction: Sjögren's syndrome (SS) is a systemic autoimmune disease whose target is the epithelium of the exocrine glands and in particular the salivary glands. SS affects women more often with a sex ratio of 9 women to 1 man and the peak frequency is around age 50. It is mainly described in Western literature where it seems to come second after RA. In Africa, it is mainly reported in the Maghreb. We report a case, revealed by pulmonary damage at the Nianankoro Fomba hospital in Ségou. Observation: This was a patient, aged 50, without any particular ATCD, who had consulted for chronic cough with mucco-purulent sputum and dyspnea, which had been present for more than four (4) months. Faced with the failure of a trial anti-tuberculosis treatment despite the negativity of the sputum testing for BARR in the Pneumophthisiology department, she decided to consult internal medicine. Clinical examination revealed NYHA stage III dyspnea. A chest CT concluded with bilateral pulmonary parenchymal interstitial syndrome associated with inflammatory bronchopathy with bronchiectasis. The immunological assessment revealed positive anti–SSA and anti–SSB Abs. Clinical improvement was obtained after initiation of corticosteroids and immunosuppressants. Conclusion: This observation illustrates the interest of looking for latent SS in the etiological assessment of a persistent cough.

Introduction: Diabetes is a major cause of death and disability worldwide. It also represents a significant risk factor for stroke. The excess stroke risk associated with diabetes is significantly higher in women than in men, independent of sex differences observed for other major cardiovascular risk factors. Materials and Method: This retrospective descriptive study was carried out in the Internal Medicine department of Point G University Hospital from January 2008 to December 2012. Included in this work were all type 2 diabetic patients hospitalized in the department during the duration of the study, presenting clinical signs of sentivo-motor deficit with performance of a brain CT scan. Results: At the end of this work, 358 patients were hospitalized, among whom 19 cases of established stroke were recorded, i.e. a frequency of 5.3%. Dilated cardiomyopathy represented 36.8% of cases. LVH and repolarization disorders accounted for 21.1% each. Composite ischemic stroke represented 79% of cases followed by mixed stroke or 16% of cases. The evolution was marked by after-effects such as left hemiparesis 36.8%, right hemiplegia 10.5% and death in 5.3% of cases. Dyslipidemia 82%, hypertension 84.21% were the risk factors most associated with diabetes. Conclusion: Strokes are common in type 2 diabetic patients. Their prevention requires better management of diabetes and its associated risk factors.

Introduction: The presence of distant metastases is one of the important predictive factors of poor outcomes in patients with thyroid carcinoma. It is rarely observed at early presentation of differentiated thyroid carcinoma (DTC). This study aimed to analyze the frequency of distant metastasis in differentiated carcinoma of the thyroid. Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology, Rajshahi Medical College Hospital, Rajshahi, and Department of Otolaryngology Bangabandhu Sheikh Mujib Medical University (BSMMU), from July 2011 to Jun 2012. A total of 40 patients were selected as study subjects by simple random sampling technique. A descriptive analysis of data was carried out by using a statistical package for social science (SPSS) 22.0 for Windows. Result: In this study, a majority (35, 87.5%) of the patients suffered from papillary carcinoma, followed by (5,12.5%) follicular carcinoma. Considering the distant metastasis, 2 (5.71%) patients had metastasis to the lung among the patients with papillary carcinoma (n=35). 1 patient had lung metastasis and another 1 patient had bony metastasis among the follicular carcinoma patients. In terms of distant metastasis, 50% of the patients had distant metastasis from each papillary and follicular carcinoma. Conclusion: This study concludes that metastasis in differentiated thyroid carcinoma is not uncommon. Distant metastasis is more common in follicular thyroid carcinoma than papillary carcinoma. Lung and bone metastasis are common regarding the site of metastasis.

Background: Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent symptoms that last weeks to months following the acute phase of COVID-19. This condition affects a substantial number of COVID-19 survivors, impacting multiple organ systems and significantly reducing quality of life. Method: This literature review synthesized research on the delayed and long-term physical side effects of COVID-19. A comprehensive search was conducted using Google Scholar and PubMed to identify open-access, English-language studies. Keywords included "COVID-19 side effects," "long COVID," and "post-acute sequelae of COVID-19." Relevant studies were screened and analyzed for key findings and limitations. Findings: The review identified significant long-term symptoms affecting COVID-19 survivors, including fatigue, dyspnea, chest pain, cognitive impairments, and musculoskeletal pain. These symptoms persist across diverse populations, regardless of the severity of the initial infection. Key limitations in existing studies include small sample sizes, single-center designs, and potential biases in self-reported data. Conclusion: Long COVID presents a major public health challenge, necessitating a multidisciplinary approach to manage its extensive and multifaceted impacts. Continued research, standardized diagnostic criteria, and comprehensive care models are essential to address the long-term needs of COVID-19 survivors and mitigate the broader economic and social burdens.

Inflammatory bowel disease (IBD) begins usually between 20 and 30. A second peak in incidence between 50 and 70 has been recognized. IBD in the elderly is defined as disease diagnosed after the age of 60. IBD in the elderly are special entity, characterized by their weakness, associated comorbidity, and their sometimes-severe course. The aim of this study was to investigate the epidemiological, clinical, therapeutic and evolutionary particularities of IBD in elderly. This is a retrospective study over a 5-year period from July 2018 to July 2023 on 424 patients followed for IBD. We included patients with documented CD or UC and who are over 60 years of age at the time of diagnosis. Of the 16 patients enrolled, mean age at diagnosis was 69.48 [60-82], sex ratio F/M 1.28, 2 patients were smokers (12.5%), 13 (81.25%) had at least one associated comorbidity. 7 patients had CD (43.75%), 7 had UC (43.75%), and 2 had indeterminate colitis (12.5%). 3 patients underwent surgery (18.75%), 2 for severe acute colitis with subtotal colectomy and ileorectal anastomosis, and 1 for ileal fistulas with ileocecal resection and ileocolic anastomosis. The progression was favorable, with an average number of relapses of 2/year, and an average number of severe relapses of 0.5/year. Maintenance of remission was noted in 15 cases (93.75%). 8 patients were on 5-Aminosalicylates (5ASA) (50%), corticosteroids and immunosuppressives was prescribed in 4 patients (25%), anti-TNFs in 2 patients (12.5%), anti-interleukins 1 patient (6.25%) and 1 patient was in remission on no treatment. In conclusion, the disease localization and phenotype in this study are like those reported in the literature relating to elderly IBD patients, and despite concerns about the risk of acquiring infections and malignancies in this age group, a high rate of corticosteroids and immunosuppressive prescription is noted.

Background: Platelet-rich plasma (PRP) therapy has emerged as a promising treatment for androgenetic alopecia (AA), addressing the need for effective hair restoration with minimal invasiveness. However, questions remain regarding the optimal frequency and duration of PRP treatment. Objective: This study aimed to assess the impact of PRP therapy on hair density and diameter in AGA patients, considering variations in treatment response across different AGA grades and alopecia durations. Method: A 6-month open-labeled pilot study was conducted on 30 male participants with AGA Grades III-VII. PRP was administered every 15 days for six sessions, and hair parameters were evaluated using trichoscan. Results: The study demonstrated a significant increase in both hair diameter and density over six months of platelet-rich plasma (PRP) therapy for androgenetic alopecia (AGA). Initially, the mean hair diameter was 0.055 mm, rising to 0.075 mm by the study's end, with a substantial increase of 0.021 mm at six months, equating to a 39.85% improvement. Similarly, hair density increased notably from 6.13 to 8.43 hairs per 10 mm², with the most significant rise at the six-month mark, showing a mean increase of 2.3 hairs per 10 mm², reflecting a 39.73% enhancement. All AGA grades experienced increased hair diameter and density, with Grade 5 showing the highest diameter increase (0.03 mm), and Grade 4A exhibiting the highest density increase (3.0 hairs per 10 mm²). Statistical analysis confirmed significant improvements across all grades (p = 0.0446 for diameter; p = 0.0196 for density). Additionally, patients with alopecia durations up to five years experienced the highest improvements in both diameter (0.026 mm) and density (2.68 hairs per 10 mm²), while longer durations showed lower enhancements (p = 0.0485 for diameter; p = 0.0096 for density). Conclusion: PRP therapy demonstrated efficacy across all AGA grades and durations, suggesting its potential as a promising treatment option for AGA. Further research is needed to validate these findings and establish PRP therapy as a standard AGA treatment.

Background: Typhoid fever, caused by Salmonella typhi and Salmonella paratyphi, infects various organs after entering the bloodstream. It typically presents with headache, fever, splenomegaly, abdominal pain, and leucopenia, among other symptoms. Globally, it affects 11-21 million people annually, causing 120,000-160,000 deaths, with Southeast Asia being the most impacted region. Improved water, sanitation, and hygiene (WASH) practices are crucial for prevention, alongside targeted public health strategies in endemic regions like Bangladesh. Aim of the study: The study aims to identify demographic risk factors associated with typhoid fever in Bangladesh. Methods: This cross-sectional observational study was conducted at the Department of Medicine, North Bengal Medical College Hospital, Sirajganj, Bangladesh, over 12 months. We included 72 patients presenting with fever, headache, and abdominal pain, with positive blood culture reports for Salmonella typhi and Salmonella paratyphi, aged 18 years and above, who provided informed consent. Excluded were patients on antibiotics and those with multiple blood culture samples. A short questionnaire, validated through a pilot study, captured demographic and clinical data. Result: Mostly 76.39% of participants were aged 18-45. Males comprised 58.33% of participants, and females 41.67%. Occupationally, 48.61% were civil servants, 16.67% housewives, 13.89% students, 12.50% businessmen, and 8.33% farmers. Socio-economically, 16.67% were upper class, 37.50% middle class, and 45.83% lower class. Urban residents made up 40.28% and rural residents 59.72%. All participants had a fever, with other symptoms including headache (69.44%), abdominal pain (48.61%), vomiting (20.83%), coated tongue (27.78%), and constipation (61.11%). Conclusion: This study examines factors influencing enteric fever in Bangladesh, noting higher prevalence among males aged 18-45 due to occupational risks. Lower socio-economic status and rural living also increase risk, highlighting healthcare disparities. Common symptoms included fever, headache, and abdominal pain. Improving sanitation and targeting high-risk groups can reduce incidence.

Background: Blunt abdominal injury is common in trauma patients. Evaluation of patients who have sustained blunt abdominal trauma may pose a formidable problem and significant intra abdominal injury is one of the most difficult problems faced by emergency doctors and surgeons in the management of trauma. Traumatic bowel injury is one of the curable traumatic conditions. An accurate and timely diagnosis and treatment giving an excellent outcome in most cases. A delay in diagnosis is associated with significant morbidity and mortality. Objectives: To determine the pattern of bowel injury from blunt abdominal trauma, and outcome of their management of the patient after surgery in a tertiary care hospital. Methods: It was an observational study carried out in the department of surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogura from April '2020 to September '2020. Thereafter, they were scrutinized according to eligibility criteria and 50 patients were finalized. Patients with a history of bowel injury are managed with blunt abdominal trauma after proper counseling, results were tabulated and analyzed. Results: A total of 50 patients were enrolled comprising 42(84%) males and 8(16%) females and male-female ration 21:4. Out of 50 patients, most of 18(35%) patients had 31-40 years age group. The mean age was 33.9±7.2 years. Maximum patients reported within 1-6 hours 28(56%) and next group within about 1 hours 11(22%). The average time lapsed was 5.79 hours. 18(36%) patients had concomitant injuries, like 1(2%) patient had a head injury, 8(16%) had pelvic fracture, 4(8%) patients had long bone fracture, 3(6%) patients had soft tissue injury and 2(4%) patients had blunt chest injury. Features of peritonitis were present at initial evaluation 42(84%) patients abdominal pain and features of paralytic ileus 21(42%). 28(56%) cases sustained injury from motor vehicle accident as passenger. Sites of bowel injury were: duodenum 3(6%), jejunum 24(48%), ileum 8(16%), large gut 8(16%), both small and large gut 2(4%). Conclusion: Traumatic bowel injury is one of the commonest traumatic conditions that are encountered in hospitals, namely in the department of surgery. The management of traumatic bowel injury has a fairly good prognosis in developed countries. The outcome is not as good as expected in the third world countries, like our country, due to certain prevailing adverse conditions. The injury in the small bowel is associated with more morbidity than that in the large bowel injury.