Papers by Mahmudur Siddiqui
Bangladesh Journal of Neuroscience, 1970
Tuberous sclerosis (TS) is one of the important neurocutaneous syndrome with a variety of clinica... more Tuberous sclerosis (TS) is one of the important neurocutaneous syndrome with a variety of clinical manifestations. We present a 19 years old boy with classical triad of Tuberous sclerosis who had seizure, mental retardation, facial angiofibromas and also having other features which cover the newer diagnostic criteria's. TS should be considered as a differential diagnosis in patient of seizure with mental retardation. Introduction: Tuberous sclerosis (TS) or Bourneville's disease is an autosomal dominant neurocutaneous syndrome classically characterized by a clinical triad of epileptic seizures, mental retardation, and skin lesions 1. The disease has an incidence of 1:10,000 to 1:70,000 life births. TS affects both sexes equally and also in all races 2. TS was first observed by Von Recklinshausen in 1862, but the first clear description of TS was given by Desire-Magloire Bourneville in 1880, who recognized the pathological features of white tumours or tubers and areas of sclerosis of cerebral gyri at post-mortem in patients with epilepsy and mental retardation. In 1908, Vogt reported the classical clinical triad of TS 3. The name,
Anwer Khan Modern Medical College Journal, Mar 1, 2018
Recent studies have suggested that mycophenolate mofetil (MMF) may offer advantages over intraven... more Recent studies have suggested that mycophenolate mofetil (MMF) may offer advantages over intravenous cyclophosphamide (IVC) for the treatment of lupus nephritis, but these therapies have not been compared in an international randomized, controlled trial. Here, the comparison of MMF and IVC as induction treatment for active lupus nephritis in a multinational, two-phase (induction and maintenance) study was shown in the different study. Lupus nephritis (LN) occurs in up to 60% of adults with systemic lupus erythematosus (SLE) and predicts poor survival. The prevalence of SLE and LN and treatment response vary by age, gender, location, and race/ethnicity; LN is especially common in black and Hispanic patients in the United States. MMF was at least as effective as IVC in induction treatment in previous trials in Hong Kong, Malaysia, China, and the United States. Meta-analyses of these and smaller trials suggested that MMF may offer advantages over IVC, but they have not yet been compared in an international randomized, controlled trial. Many comparative studies were undertaken in patients with LN, a two-part trial to assess the efficacy and safety of MMF as induction therapy and subsequently as maintenance therapy for LN. This article will describe the comparison of MMF with IVC, both with corticosteroids.
PubMed, 2010
Fahr's disease, first described by Karl Theodor Fahr in 1930, refers to sporadic or familial idio... more Fahr's disease, first described by Karl Theodor Fahr in 1930, refers to sporadic or familial idiopathic basal ganglia calcification that is associated with many neurological and psychiatric abnormalities, but may also be secondary to other diseases. Most cases present with extrapyramidal symptoms. But here we describe a case of Fahr's disease, who presented with complex partial seizure and behavioral abnormalities. On screening, the cause of seizure was found to be bilateral calcification of cerebellum, basal ganglia and thalamus, due to abnormal calcium and phosphate metabolism. A clinical diagnosis of complex-partial seizure with secondary generalization due to secondary Fahr's disease was done on the basis of clinical features, investigations, and exclusion of other causes of intracranial calcification.
Journal of Bangladesh College of Physicians and Surgeons, Feb 27, 2020
Anwer Khan Modern Medical College Journal, May 7, 2014
EECP consists of three pneumatic compression cuffs applied to each of the patient's legs. The mec... more EECP consists of three pneumatic compression cuffs applied to each of the patient's legs. The mechanism is synchronized with the patient's electrocardiogram. The cuffs are sequentially inflated during diastole, in the calves followed by lower thighs followed by upper thighs, resulting in an increase in diastolic blood pressure (diastolic augmentation) and retrograde aortic diastolic blood flow. We know 80% coronary flow access during diastole & only 20% in systole. At the end of diastole, pressure is released simultaneously from all cuffs at a time, resulting in systolic unloading and after load reduction. This sequential compression results in increase venous return and augment diastolic
University Heart Journal, Mar 29, 2012
Enhanced External Counterpulsation (EECP) is a noninvasive mode of treatment to improve myocardia... more Enhanced External Counterpulsation (EECP) is a noninvasive mode of treatment to improve myocardial perfusion and cardiac output, thereby reducing symptoms of angina and heart failure. 1 It was given on outpatient basis. EECP is used to stabilize the coronary circulation in patients with severe coronary artery disease when maximal medical therapy and/or invasive procedures have proven inadequate. 1 Improved technology in percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG) has made it possible to successfully treat patients with chronic angina pectoris. However, a large number of patients remain symptomatic in spite of PTCA or CABG, continue to be ineffective or associated with an unacceptable risk of complications. There is an increasingly large population of patients who have persistent residual anginal symptoms and they remain severely restricted physically. 2 Following bypass surgery, 75% of patients are symptom free from ischemic events for 5 years or more, and 50% remain so after 10 years or more. 3 EECP has been shown to be effective in these group of patient. 4,5 Complete resolution of ischemic perfusion defects was achieved in 67%, partial reperfusion with decrease in size of defects was noted in 11%, and no change was seen in 22% of patients. 5
Case Reports, Jan 23, 2012
Springer eBooks, 2017
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Anwer Khan Modern Medical College Journal, Aug 10, 2020
Hepatitis outbreaks in hemodialysis (HD) patients and staff were reported in the late 1960s, and ... more Hepatitis outbreaks in hemodialysis (HD) patients and staff were reported in the late 1960s, and a number of hepatotropic viruses transmitted by blood and other body fluids have been identified. Hepatitis B virus (HBV) was the first significant hepatotropic virus to be identified in HD centers. HBV infection has been effectively controlled by active vaccination, screening of blood donors, the use of erythropoietin and segregation of HBV carriers. Hepatitis delta virus is a defective virus that can only infect HBV-positive individuals. Hepatitis C virus (HCV) is the most significant cause of non-A, non-B hepatitis and is mainly transmitted by blood transfusion. The introduction in 1990 of routine screening of blood donors for HCV contributed significantly to the control of HCV transmission. An effective HCV vaccine remains an unsolved challenge; however, pegylation of interferon-alfa has made it possible to treat HCV-positive dialysis patients. Unexplained sporadic outbreaks of hepatitis by the mid-1990s prompted the discovery of hepatitis G virus, hepatitis GB virus C and the TT virus. The vigilant observation of guidelines on universal precaution and regular virologic testing are the cornerstones of the effective control of chronic hepatitis in the setting of HD. Major recent advances in the viral diagnosis technology and the development of new oral, direct acting antiviral agents (DAAs) allow early diagnosis and better therapeutic response. The current update will review the recent developments, controversies and new treatment of viral hepatitis in HD patients.
Bangladesh Journal of Medicine, Feb 8, 2018
Anwer Khan Modern Medical College Journal, Mar 7, 2023
Background and objectives: AKI is an increasingly common complication of critical illness, with s... more Background and objectives: AKI is an increasingly common complication of critical illness, with some researches showing that as high as 1 in 5 adults and 1 in 3 children experiencing AKI per hospital admission. Whether occurring in the community or in the hospital, the clinical and public health importance of AKI is well established due to the association with high mortality and its separate independent effect on the risk of death and resource use. This study was aimed to find out the etiology and outcome of acute kidney injury patients requiring haemodialysis. Methods: A retrospective study was done on 70 patients of AKI who required haemodialysis support in dialysis unit of medicine department of Jahurul Islam Medical College Hospital, Kishoreganj during the time period from Jan-2018 to Dec-2020. All patients of age 13 and above with AKI and have been dialyzed at least once during the study period were included. Results: In this study, there was an overall male preponderance (70%) with age range of 13-40 years (48.57%). Most common features of presentation were oliguria, cough, respiratory distress, drowsiness, disorientation, reddish urine, pedal edema, fever and high blood pressure. The most common causes of AKI were sepsis (30%), hypovolemia (21.42%), acute glomerulonephritis (AGN) (14.29%) and pregnancy related causes (10%). Common indications for haemodialysis of AKI patients were refractory fluid overload (70%), features of uraemic encephalopathy (22.86%). In this study, 78.57% of AKI patients requiring haemodialysis were improved and discharged, 08.57% patients were progressed to end stage renal disease, 07.15% patients were expired and 05.71% patients were absconded. Conclusion: It is concluded that sepsis, hypovolemia, AGN, obstetric causes, surgical causes and nephrotoxins were the primary causes of AKI patients requiring haemodialysis in this study. Most of these causes can be prevented with simple interventions such as appropriate management of infections, health education on oral rehydration, quality prenatal and emergency obstetric care and taking appropriate precautions when prescribing potentially nephrotoxic medications. Majority of the patients of AKI with complications were improved with haemodialysis. So, expansion of haemodialysis services to all parts of the country is necessary.
Anwer Khan Modern Medical College Journal, Dec 5, 2018
Background: B-type natriuretic peptide (BNP) is a biomarker of cardiovascular disease that is com... more Background: B-type natriuretic peptide (BNP) is a biomarker of cardiovascular disease that is common in patients with chronic kidney disease (CKD). The influence of glomerular filtration rate (GFR) on BNP in CKD may stem from failure to account fully for the effects of coexistent cardiac disease, dysfunction and volume overload. Material & Methods: This is a cross sectional descriptive type of observational study conducted by the Department of Nephrology of Anwer Khan Modern Medical College Hospital during the period of Jan 2016 to Dec 2016. Results: A total number of 71 patients were included in the study. Out of them 42(59.15%) were male and 29(40.85%) were female with a M:F of 1.45:1. The mean age of the patients was 62.54+13.92 years (Range 18-90 years). Mean e GFR was 21.81+15.01 ml/min/1.73 body surface area, mean Serum Creatinine was 5.04+3.29 mg/dl, mean Hb% was 10.90+1.5 gm/dl and that of BNP was 1335.03+1838.43 Pg/ml and that of Ejection Fraction (EF) was 50.05+12.61%. 21.12%(15) were on Stage 3 CKD(Chronic Kidney Disease) and 33.80% (24) and 45.08%(32) were on Stage-4 and Stage-5 respectively.There was a strong and highly significant inverse association between BNP and e GFR (p<0.001), with higher BNP level observed in those with lower eGFR. BNP is directly proportional to Serum Creatinine which is significant (p<0.001). BNP rises as Serum Creatinine rises. Regarding echocardiographic changes, almost all the patients 69(97.18%) had Left ventricular hypertrophy (LVH). 24(33.80%) had Left ventricular (LV) diastolic dysfunction, 19(26.76%) had LV systolic dysfunction and dilated LV and rest of them 28(39.44%)had good biventricular function. 35 (49.29%) patients had mild pericardial effusion(PE) and 39(54.92%) had hypokinesia in different cardiac wall. Most of the patients 65(91.54%) had mild mitral regurgitation (MR), tricuspid regurgitation (TR), aortic regurgitation (AR). Conclusion: Our goal was to provide compelling evidence of the association of renal function and BNP, with the full expectation that additional prospective studies will be required to validate and better define this relationship. Ideally, clinicians need clear guidelines regarding BNP and heart failure that include consideration of eGFR. Currently most institutions, including our own, continue to use BNP cutoff diagnostic levels that have not been adjusted for eGFR. Our data emphasized that a single BNP measurement must be evaluated in conjunction with the entire clinical presentation, particularly the level of renal failure.
Anwer Khan Modern Medical College Journal, Aug 23, 2017
and the Indian subcontinent. However a major outbreak in 2015 affected several countries of the R... more and the Indian subcontinent. However a major outbreak in 2015 affected several countries of the Region of the Americas as well. The name Chikungunya comes from word "swahili" meaning 'that which bends up' referring to the stooped posture the victim adopt to relief the joint pain. Immunity is long lasting. Commonly the mosquitoes involved in the transmission of disease are Aedes aegypti and Aedes albopictus, those two species are also transmit other mosquito-borne viruses, including dengue. Ae. aegypti is more closely associated with human habitation and uses indoor breeding sites, including flower vases, water storage vessels and concrete water tanks in bathrooms, as well as the same artificial outdoor habitats as Ae. albopictus. Both species are found biting outdoors, but Ae. aegypti also feed indoors. The species Ae. albopictus thrives in a wider range of waterfilled breeding sites than Ae. aegypti, including coconut husks, cocoa pods, bamboo stumps, tree holes and rock pools, in addition to artificial containers such as vehicle tyres and saucers beneath plant pots. This diversity of habitats explains the abundance of Ae. albopictus in rural as well as peri-urban areas and shady city parks. After the bite of an infected mosquito, onset of illness occurs usually between 4 and 8 days but it can range from 2 to 12 days. The spread of Chikungunya virus carrying mosquitoes has increased due to the lack of cleanliness and the almost closure of mosquito elimination program in the city. The incidence of Chikungunya increases after heavy rains due to number of increased breeding places the vector prefers.
Anwer Khan Modern Medical College Journal, Feb 6, 2013
Case Report A 55 years old normotensive, nondiabetic, nonsmoker, previously healthy man from Myme... more Case Report A 55 years old normotensive, nondiabetic, nonsmoker, previously healthy man from Mymensingh presented with sudden onset of weakness of the left side of his body. On quarry, he gave history of global dull headache and fullness of upper abdomen for last 1 month. There was no history of chest pain, chest tightness, palpitation, respiratory distress, skin rash, bleeding manifestation, itching, blurring of vision, leg swelling and fever. On clinical examination, he was alert, well oriented with plethora and injected conjunctivae, no cyanosis, blood pressure was 130/80 mm of Hg.
Anwer Khan Modern Medical College Journal, Nov 10, 2013
Medical College Hospital with the complaints of fever, multiple joint pain and skin rashes over w... more Medical College Hospital with the complaints of fever, multiple joint pain and skin rashes over whole body for last 3 months. Fever was high grade continuous in nature. Generalized macular rashes especially in upper limbs, chest and back, with symmetrical polyarthritis involving wrist, proximal interphalangeal joints (PIP), metacarpophalangeal joints (MCP), knees and ankles. On quarry she also gave no history of sore throat for last 1 month. There were no early morning stiffness, ocular symptoms, orogenital ulcers, urinary symptoms, photophobia, and contact to infected person or major systemic symptoms.
Bangladesh Journal of Medicine, Jan 21, 2018
Acute interstitial pneumonia (AIP) is an idiopathic lung disease characterized by rapidly progres... more Acute interstitial pneumonia (AIP) is an idiopathic lung disease characterized by rapidly progressive dyspnoea, respiratory failure developing over days to weeks in patients without pre-existing lung disease. AIP show a very poor prognosis, with high mortality and remains unfamiliar to physicians. In this report, we present a case of a mid-age male with AIP who, was treated with intensive medical facilities, still showed a rapid progressive clinical deterioration, and eventually died of respiratory failure.
Anwer Khan Modern Medical College Journal, 2018
Primary Splenic Lymphoma (PSL) is a rare neoplasm of the spleen. PSL is generally presented as B ... more Primary Splenic Lymphoma (PSL) is a rare neoplasm of the spleen. PSL is generally presented as B cell non-Hodgkin lymphoma. Primary involvement of the spleen by lymphoma is much less common than secondary involvement. It usually presents with nonspecific symptoms like left upper abdominal pain or discomfort due to splenomegaly, pyrexia, weight loss, night sweats and weakness. In this article, we are reporting a case of PSL in a 23 years old boy who presented with splenomegaly and non-specifc symptoms.
Journal of medicine, 1970
Clinical Presentation A 40-year-old previously healthy man presented with sudden dimness of visio... more Clinical Presentation A 40-year-old previously healthy man presented with sudden dimness of vision in his right eye without any pain or redness. Clinical examination revealed visual acuity 6/36 and normal anterior segment of right eye. But fundoscopic examination of right eye revealed (Fig 1,2). Left eye was normal.
Anwer Khan Modern Medical College Journal
Cerebral aspergillosis has the tendency to occur in immune-compromised patients. Less commonly, i... more Cerebral aspergillosis has the tendency to occur in immune-compromised patients. Less commonly, immune-competent individuals can be affected, with neuroimaging findings being difficult to interpret. A surgical excision with aggressive antifungal therapy is required for a proper management. This case report describes an immune-competent patient with cerebral aspergillosis that presented radiologically as a suspicious mass to be diagnosed pathologically and excised surgically. AKMMC J 2021; 12(2): 107-112
Anwer Khan Modern Medical College Journal
Background: Covid-19 is a new disease first originated in Wuhan, China in December 2019. It is no... more Background: Covid-19 is a new disease first originated in Wuhan, China in December 2019. It is now pandemic globally1, 2. The disease affected almost all countries of the world. Aims and objectives: To see different aspects of clinical presentations of COVID-19 in Bangladesh. Methods: Subjects tested, admitted and treated were included in the study. Total 441 cases were included for the study. Data was collected, compiled and analyzed. Results: Male: female ratio, n= 441, Ratio= 2.4:1. Nasopharyngeal swab was positive in 59% and 41% oropharyngeal sample was positive. 74% test was positive among 220 patients and 26% negative. Smoking accounts for 65% among predisposing factors. Among the co-morbid conditions Hypertension accounts for 37%, Bronchial asthma 23%, Diabetes mellitus 30%. Clinical symptoms were fever 90%, body ache 95%, cough 80%, and headache were 75%. Other symptoms were less. Symptoms may one or more in the same patient. In our series 30 (07%) cases were had respiratory...
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Papers by Mahmudur Siddiqui