Renal Tubular acidosis (RTA) is a tubular acidification disorder characterised by severe electrolyte disturbances mainly hypokalemia and normal anion gap acidosis out of proportion to GFR. Sjogrens syndrome though a rare disorder usually causes distal RTA however few studies have reported cases of Proximal RTA as well. Here we report a case of Acute onset quadriparesis in a young female which was attributed to Hypokalemia. Further evaluation revealed that RTA probably was proximal in origin due to Sjogrens Syndrome.

Introduction: COVID-19 infection has spread with the development of the pandemic and is transmitted by respiratory droplets. Severe and critically ill patients may deteriorate rapidly and progress to multiple organ failure and death. It is imperative to determine the prognostic values associated with this disease. We aimed to test the strength of the bun/creatinine ratio in predicting mortality in critically ill patients in the infected group. Material and method: 158 patient data were included in our study after ethics committee approval. The blood results in intensive care units were analyzed, and the patients were grouped as group 1 and group 2. Age, gender, comorbid conditions, bun creatinine, and other blood values were compared statistically. With this comparison, the effects on mortality and clinical features were evaluated. Results: The study included 158 patients between Mar 31 and Dec 31, 2020. Routine blood tests were seen in these patients according to the intensive care evaluation criteria. It was observed that bun, creatinine, IL-6, CRP values were higher, and GFR, total protein values were lower in the patients who lost their lives. The bun/creatinine ratio was similar between the groups. Conclusion: It was found that urea and creatinine could help in demonstrating mortality in critical intensive care patients. The bun/creatinine ratio was not associated with mortality in covid 19 infected critical intensive care patients. Studies with larger numbers of patients are needed.

Background: Coronaviral disorder (COVID-19) is a worldwide pandemic originating in Wuhan, China and spreading rapidly across the world and infecting human beings independently of age, sex, and race. There is still a lot to learn, given the nature of this infection. People with COVID-19 have reported a variety of symptoms, ranging from minor symptoms (e.g., common cold) to serious conditions such as bronchitis, pneumonia, severe acute air distress (ARDS) syndrome, multi-organ failure and even death. Comorbidity is a key component in the pandemic result COVID-19 which frequently results in fast and serious development, including death. Objective: The research examined the socio-demographic characteristics and characteristics of COVID-19 and assessed the effect of comorbidity on their hospital result. Methods: This observatory research was placed from April 2020 to September 2020 at Rajshahi Medical College, Rajshahi and CDM Hospital, Rajshahi (COVID-19) specialized hospital for a period of 06 months. All clinically suspected RT-PCR confirmation patients were included. Data were gathered via thorough patient history and then reviewed, consistency checked, and resulted modified. The coded data were examined using the SPSS software program after editing and coding. Results: The research included 627 patients, 552 of whom were in the covid ward and 75 in the ICU. 354 of Covid's (552) hospitalized patients were male (64.13%) and 198 (35.86%) were female (1:0.56%) patients. Young patients (age 19-50) were more impacted and hospitalized (62.86%), urban patients (52.61%) more susceptible than rural patients (47.28 percent). The primary symptoms were fever, cough and shortness of breath (63.04 percent, 45.47, and 42.39 percent, respectively). 44.20 per cent of patients with 55.79 per cent co-morbidities are not comorbid. Concerning co-morbidities. The major concurrent illnesses were hypertension (17.57%), followed by diabetes (15.94%), ischemic cardiac disease (05.60%), chronic blockage (05.60%), chronic renal disease (2.2%), heart attack (1.44%) and cancer (1.54 percent). (0.36%) of the population. A total of 75 patients, most of them seniors, required ICU treatment (64 out of 75). With regards to hospital outcomes, 96.74% (534 of the 552) and 45.34% (34 of the 75) of ICU admitted patients were released safely, whereas 03.2% and 54.66% of ICU patients hospitalized had expired. The number of fatalities among seniors was greater (n=43; 72.88 percent). Hypertension, diabetes and ischemic heart disease were often associated with dementia (42.37 percent, 37.28 percent, and 16.94 percent, respectively). Conclusion: The huge number of people with fever, poisoning and shortness of breath. The percentage of COVID-19 hospitalizations linked to mortality has remained high the elderly and those suffering from one or more comorbid illnesses. Elderly and comorbid patients should thus take all the required measures to prevent SARS CoV-2 infections.

Background: Compared to percutaneous surgery, open repair of Achilles tendon rupture has been associated with a greater rate of wound complications. On the other hand, percutaneous repair has been related to a greater risk of rerupture and sural nerve injury in several investigations. Purposes: As far as function and cosmesis were concerned, we compared the two types of repairs in the following ways: (1) muscular strength and ankle ROM; (2) calf and ankle perimeter; (3) single heel rise tests and work return. Methods: A multicentered based non-randomized quasi-experimental prospective study was performed in Joypurhat 250 bed District Hospital, Rajshahi, Bangladesh, from June 2019 to December 2020. Percutaneous Achilles tendon repair was performed on 17 patients, while open Achilles’ tendon repair was performed on 15 of the 32 surgically treated patients. As a result of this, all patients followed a standardized rehabilitation protocol. The minimum follow-up was six months (mean, 18 months; range, 6–48 months). Results: There were no significant differences in calf and ankle circumference or in plantar flexor strength across groups. Patients who underwent open versus percutaneous repair had a lengthier return-to-work period (5.6 months versus 2.8 months). The open repair group's mean scar length was higher (9.5 cm versus 2.9 cm). Those in the percutaneous group had a more attractive look than those in the other groups. In the open repair group, two wound complications and one rerupture were discovered. An individual in the percutaneous repair group had an incident of deep vein thrombosis. Within six months of surgery, all problems had happened. Patients with nerve damage were not found during our study. Conclusions: Percutaneous repair is functionally equivalent to open repair, but it is more aesthetically pleasing, has fewer wound problems and does not appear to raise the risk of rerupture.

Introduction: Covid 19 disease is considered a common public health problem and one of the leading causes of death. The clinical feature of this disease is that thyroid hormone levels are considered to be critically important in demonstrating vital functions. The effect of hormone levels on vital functions was investigated. Material and method: The patients who were treated in the intensive care unit between March 2020-2021 were examined and written informed consent was obtained from the patients. The thyroid hormone levels of the patients in the intensive care units were compared statistically and its effect on clinically important values was examined. Results: A total of 204 patients were included in the study. Thyroid hormone levels and infection parameters of the patients admitted to the intensive care unit were compared with their clinical features. Free t3 and free t 4 levels were found to be effective on mortality. Conclusion: It was supported by our study that fT3 and fT4 levels were lower in the group of patients who lost their lives in patients with severely severe COVID-19 infection. It has been seen that these hormone levels can be shown as a mortality indicator in the COVID-19 patient group, and we believe that prospective analyzes with additional studies can be illuminating on the subject.