Saturday, February 4, 2012
Tuesday, September 14, 2010
Anthrax আন্থ্রাক্স

আন্থ্রাক্স, বাকটেরিয়া (Bacillus anthracis) জনিত পশু হইতে ছড়ানো (zoonotic) এক প্রকার মারাত্বক অসুখ। সাথারণত গরু, ছাগল, ভেড়া, মহিষ ইত্যাদি পশুর মধ্যে এ রোগ দেখা যায় এবং আক্রান্ত গৃহ পালিত পশু থেকে মানুষের মধ্যে এ অসুখের জীবাণু ছড়াতে পারে। এ জীবানুর মধ্যে স্পোর(spore) তৈরী হয় যা সহজে নষ্ট হয় না এবং আক্রান্ত প্রানীর শরীর বা এর মৃত দেহ থেকে এই স্পোর মাটিতে পড়লে তা বহু বছর পর্যন্ত অক্ষত অবস্থায় থাকে। সুস্থ পশু ঘাস খাওয়ার সময় এই স্পোর নিশ্বাসের সংগে ফুসফুসে গেলে কিংবা পেটে গেলে সেই পশু কয়েকদিনের মধ্যে আক্রান্ত হয় এবং আক্রান্ত হওয়ার পর অতি দ্রুত মারা যায়। আক্রান্ত পশু নাড়া চাড়া করার সময় অথবা পশুর পশম থেকে এই স্পোর মানুষের শরীরে বিভিন্নভাবে প্রবেশ করে ঐ রোগের সৃষ্টি করতে পারে।
মানূষের মধ্যে তিন ভাবে এই জীবানু ছড়াতে পারে-১)চর্মে - সবচেয়ে বেশী (৯৫%) ২) ফুসফুসের মাধ্যমে - ৫% ৩)ও পেটের অসুখ (gastroenteritis)- যা খুবেই কম দেখা যায়।
চর্মে আগে থেকে কাটা বা ক্ষত থাকলে সেখানে জীবানুর স্পোর সংক্রামিত হয়ে এক প্রকার ব্যথাবিহীন ঘা(malignant
pastule)
সৃস্টি হবে যা অন্যান্য জীবনুর প্রদাহ থেকে আলাদা এবং চিকিৎসা ছাড়া সহজে ভাল হয় না। ঘায়ের মাঝখানে কাল বর্ণ ধারণ করে। সংক্রামিত
মাছি কামড় দিলে ও শরীরের যে কোন স্থানের চর্মে এ রোগ ছড়াতে পারে। সময়মত চিকিৎসা না করলে মৃত্যুর হার ১০-২০%। চিকিৎসার সময় আক্রান্ত স্থানটি ঢেকে রাখতে হবে এবং ব্যবহৃত ব্যান্ডেজটি পুড়ে ফেলতে হবে। ঠিকমত চিকিৎসা বা এন্টিবায়োটিক প্রয়োগ করলেও ক্ষত সাড়তে ৩ থেকে ৪ সপ্তাহ লেগে যায়। সম্ভাবনাময় এলাকার লোকজন অথবা যারা পশু নিয়ে নাড়া চারা করেন তারা আগে থেকে পেনিসিলিন ঔষধ খেলে এ রোগের প্রকোপ কম দেখা যায়। তবে এর টীকা নেওয়ার ব্যবস্থা আছে।
সবচেয়ে মারাত্ত্বক হচ্ছে ফুসফুসের প্রদাহ-এতে মৃত্যুর হার ১০০%। জীবানুর স্পোর নিশ্বাসের সংগে ফুসফুসে গেলে তা সহজে জীবন্ত (vegetative) বাকটেরিয়ায় রুপান্তরিত হয় এবং ৩-৭ দিনের মধ্যে শ্বাসকষট সহ রোগের অন্যান্য লক্ষণ দেখা যায়। চিকিৎসা করলে ও মানুষ বা পশুর রোগের লক্ষণ আসার ১-৪ দিনের মধ্যে মৃত্যু ঘটায় । আন্থ্রাক্সে আক্রান্ত পশুর নাক, মুখ বা পায়ু পথ দিয়ে সাধারনত রক্ত ক্ষরণ হতে দেখা যায়।
আশে পাশের জেলায় বা উপজেলায় আন্থ্রাক্স দেখা দিলে নিজেদের এলাকার বাজার থেকে অজানা মাংস কিনে আনলে তা ভাল ভাবে সিদ্ধ করতে হবে(১০ মিনিট সিদ্ধ করলে স্পোর মারা যায়)।তবে খাওয়ার মাধ্যমে এ রোগ খুবই কম ছড়ায়। পেটের পীড়া ছাড়াও গলায় প্রদাহ হতে পারে। ব্যবহৃত থলে,বাসন, মেঝে বা বাতরুম ইত্যাদি পটাসিয়াম পারমাংগানেট (‘পটাশ’-যা ঔষধের দোকানে পাওয়া যায়) দিয়ে ভিজে রাখতে হবে । মাংস নাড়া চাড়া করলে তা হাতের চর্মে আন্থ্রাক্স হাতে পারে কিংবা মুখে গেলে পেটের পীড়া হতে পারে। নিশ্বাসের সংগে যাতে কোনক্রমে জীবানু না যেতে পারে সে দিকে খেয়াল রাখতে হবে। কোন এলাকায় আন্থ্রাক্স দেখা দিলে সেখানকার হেলথ্ সার্টিফিকেট ছাড়া কোন পশুর মাংস কোনক্রমেই বিক্রয় বা কেনা যাবে না।
আক্রান্ত পশু মারা গেলে কমপক্ষে ৬/৭ ফুট গভীর গর্ত খুড়ে তাতে ক্যালসিয়াম অক্সাইড অথবা পটাসিয়াম পারমাংগানেট ভালভাবে মিশায়ে পুঁতে ফেলতে হবে। মৃত পশু সাবধানে নাড়া চারা করতে হবে। গোয়াল ঘরে পটাসিয়াম পারমাংগানেট পানিতে মিশায়ে মেঝেতে ঢেলে দিতে হবে- এ ব্যাপারে অবশ্যই নিকটবর্তী পশু হাসপাতাল থেকে পরামর্শ নিতে হবে।
Anthrax: English version
Anthrax is a bacterial zoonotic disease caused by Bacillus anthracis which predominantly causes disease in herbivores such as cattle, goats, and sheep. B. anthracis is spore forming organism and anthrax spores can remain viable for decades in soil after spreading from infected animal or carcasses. Healthy animal get the disease by inhaling or ingestion spore during grassing. The animal become ill in few days of inhaling spore and dies rapidly. Naturally occurring human infection is generally the result of contact with anthrax -infected animals, carcasses or animal products such as goat or sheep hair.
Human gets the disease by three routes
1) Skin infection – this is most common type of anthrax -95%
2) Lung infection -5%- this is very dreadful type
3) Gastroenteritis – it is very rare.
Skin infection occurs by contamination of spore or bacteria in the previously abraded region. The lesion of cutaneous anthrax typically begins as a papule following the introduction of spores through an opening in the skin. This papule then evolves to a painless vesicle followed by the development of a coal-black, necrotic eschar (malignant pustule). Contaminated flies can also spread the disease by bite in the skin of neck or face. If untreated the mortality rate is 10-20%. The wound should be covered with bandage and used bandage should be safely disposed off or burned. The wound heals in 3-4 weeks even after treatment with appropriate antibiotic. Prophylactic use of penicillin can decrease incidence of anthrax in endemic area. Vaccine is available.
Pulmonary infection is very dreadful condition. After inhalation spore initial symptoms are like viral infection and it rapidly turns to moribund state. The symptoms appear in 3-7 days after exposure to spore and death typically occurred within 1–4 days following the onset of symptoms. Human to human infection not documented. Infected animal shows bleeding from natural opening like mouth, nose and anus.
Gastroenteritis due to anthrax is very rare. If there is evidence of anthrax in neighboring districts or upazilla use of meat should be care fully handled or it is better to avoid it. It should be properly cooked (spore is killed by boiling in 10 minutes). Other than gastroenteritis there may be infection in the throat also. Used bags, utensil, kitchen or bathrooms floors should be disinfected with potassium permanganate. People with skin abrasion should not handle suspicious meat. Strict precaution should be maintained about the inhalation of spore. Meat must not be sold or bought under no circumstance without proper heath certificate of the animal.
Carcasses should be properly and care fully handled and disposed off. It should be buried in 6-7 feet deep in the soil mixed with potassium permanganate or calcium oxide. The cattle house and its floor should be equally disinfected properly with potassium permanganate or calcium oxide. People should consult with veterinary hospital.
Wednesday, November 11, 2009
Is female with Rh negative blood a problem?
Wednesday, October 7, 2009
Vewing without spectackles by Hypermetropic Persons
Saturday, October 3, 2009
High leucocytosis interferes with colorimetric measurement of Haemoglobin
Hemoglobin estimation of a solution or a blood sample is commonly done in most cases by cyanmethhemoglobin method. But a less familiar method, which is also a photoelectric colorimetric methed,1developed by us, is followed in some areas of Bangladesh. The later method is a acid-hematin method and has found to have similar accuracy and stability. Unlike cyanmethhemoglobin method, it is very cheap and has a advantage that no biohazardous chemical have been used here2. Interestingly, during the development of the new method with a comparison to cyanmethhemoglobin method, it is observed that in both methods prepared fluid mixed with blood of high WBC count showed optical density resulting hemoglobin level that didn’t correspond with clinical condition of the patient. That means higher hemoglobin level was observed in a clinically anemic patient whose WBC count is very high e.g. in case leukemia. Moreover the blood mixed fluid, which is clear in other cases, was found to be hazy in these cases. To get rid from the problem we centrifuge the fluid and the clear supernatant fluid was used to measure the optical density and then the actual level of hemoglobin could be estimated which corresponded well with clinical condition of the patient. The deposit, after centrifugation, was examined under microscope and found plenty intact WBC. In normal cases, the deposits also shown WBC but were in very small number. Roughly it was estimated that hemoglobin level was increased by 1.2 to 1.4 gram% for 105WBC/cumm of blood. So, during estimation of hemoglobin in patient with very high WBC count (e.g leukemia) optical density should be taken from the supernatant fluid after centrifugation for few minutes (more than 3 minutes is satisfactory) of the prepared fluid.
Cyanmethaemoglobin method is followed in many countries for the last few decades, though potassium cyanide, which is used in this method, carries potential health hazard. Besides this, the limitation regarding high WBC count should be always considered. It can be easily proved in any laboratory by estimating hemoglobin of a patient having very high WBC count e.g. leukemia, by measuring absorbance before and after centrifuging the measuring fluid.
References:
- Mujibur Rahman. A New Method for Measuring Hemoglobin. Laboratory Hematology; 2003, Vol 9, No 3: 179.
- Barbara J Brain & Imelda Bates. Basic haematologic techniques. Dacie and Lewis Practical Haematology. Ninth Edition, Churchill Livingstone. 2001.19-46.
Friday, September 25, 2009
Why malarial parasite usually not found in peripheral blood
It is a common problem that malarial parasite is usually not found in peripheral blood in most suspected cases of malaria. The causes of this failure are many. It is important that there are many causes of febrile illnesses coming with shivering and going off with sweating like in malaria.
Among these:
1) Misdiagnosis: It is documented-
a.Tuberculosis, particularly extra pulmonary cases may be confused with malaria because of its single rise of temperature at the evening time. Particularly in younger patients the bout of fever may be so heightened that it starts with shivering and goes with sweating. In tuberculosis history is longer, weight loss and anorexia almost present in all cases but headache is rare which is common in malaria.
b. UTI (urinary tract infection)- fever in UTI case usually appears with shivering and goes with sweating but it occurs in multiple times in a day. There should be no symptoms of burning or frequency micturition when it affects the upper part of urinary tract. In this case (upper UTI) lower abdominal or back pain is common. Simple routine urine examination excludes the diagnosis.
c. Viral infection:- Viral infection is the commonest cause of febrile illnesses. Its onset is usually acute, seasonal and similar history of other members or neighbours. Most people in our country uses few doses of paracetamol before seeking advice from physician. Physician finds history of shivering and sweating in these cases but it is due to effect of paracetamol. When the action of paracetamol goes off fever comes again with shivering and when it acts fever goes with sweating.
d. Meningitis : It is a case of medical emergency. High rise of fever with headache is must so can be confused with malaria.
2. Use of some anibiotics can also prevent appearence MP in peripheral blood- like fluoroquinolones (e.g, ciprofloxacin), cotrimoxazole, tetracycline etc.
3. Collection of blood: After excluding the above causes of fever if diagnosis goes in favour of malaria, still malarial parasite may not be found in peripheral blood due to
a. Blood examined at early stage of malarial infection - Particularly in first week of illness number of infected RBC may be so low that MP can not be seen even after searching for longer period.
b. Time of collection- This is very critical that when blood should be collected for MP. Many physicians advice to collect blood at the height of temperature. But this is a wrong idea. Fever in malaria synchronizes with rupture of infected RBC releasing hemozoin, a febrile toxin. So at the height of temperature there should not be any intact infected RBC containing MP for demonstration in peripheral blood unless double cycles or multiple cycles on malarial infection are running which also not very rare. So, blood should be collected 1 to 2 hours or more before the onset of fever. When a fever goes off blood should to be collected at least 10 hours after an attack of fever because, this time is needed to develop a ring form of malarial parasite inside red cells.
Sunday, September 20, 2009
Computer problems those can be solved at home
Saturday, September 19, 2009
Resurgent of Vector borne Diseases- In context to Bangladesh :Some Suggestions



In context to Bangladesh, India can be major source of those new types of diseases like dengue. In India, dengue has been epidemic for several years. Although dengue fever was documented in Bangladesh from the mid-1960s to the mid-1990s, but an outbreak of dengue haemorrhagic fever has not been previously reported.But in 2000, through mid November 5,575 hospitalized dengue cases were reported to the Ministry of Health in Bangladesh, with a case-fatality rate of 1.61 %.
Ades mosquito, the vector of this disease, can not fly more than 100 meters from its residence. So, there is no way to move this vector from air port to populating area of Dhaka, where dengue outbreak started first in Bangladesh. Moreover, the air way communications from Bangladesh to India have been established many years before liberation but there was no dengue outbreak during this period. So, there is very little chance of transmitting the disease by this route. Moreover, under the WHO International Health Regulation (IHR), all international airports and seaports are kept free from all types of mosquitoes for a distance of 400 meters around the perimeter of the ports.8 But it is possible that, the infected mosquito can travel via bus or train under their seats, in between luggage and transmit the disease to other populating area nearby the stoppage. The time of emergence of dengue outbreak in Bangladesh that occurred first in Dhaka coincides with period after the introduction of bus communication between Dhaka and Kolkata. So it will be logical to claim that the infected vectors can easily migrate to Dhaka via bus from India. Now, the recent introduction of railway communication can exacerbate the condition or import of new diseases agents like Japanese B encephalitis, chikangunya which are known to prevalent in many areas of India. So, it should be an urgent matter to prevent such migration of vectors through vehicles like bus or train.
The measures those can be taken to limit vectors migration could be as follows:
1) Before starting, the train or bus should make free from any vectors by using effective insecticides before the passengers take their seats.
2) The international train or bus should not be used for domestic purposes.
3) The stoppages for train or bus in both countries should be sufficiently away from localities and the area should be carefully monitored for vectors.
4) Traveler's quarantine should be strictly maintained. Our government should be aware of the factor of migration of infected vectors urgently. If it is ignored, it will be not so late when even a lay man will bother for uncommon diseases like Japanese B encephalitis, chikangunya or other uncommon vector borne diseases as like as dengue today.
The recent outbreake of swaine flu in Bangladesh is a great concern which was first introduced in Dhaka by a infected passenger came from USA through air-port. I think it was not so difficult to prevent entry of such pandemic disease in our country through airport if sufficient measures were taken to quarantine the suspected patient coming from outside of the country.
Wednesday, September 9, 2009
Health care: Food & Antioxidant- How does it help us

Tuesday, August 18, 2009
Health care: Allergy-"CONTACT DERMATITIS"

