scholarly journals The Functional Outcome of Spontaneous Hypertensive Supratentorial Intracerebral Haemorrhage after Surgery

2020 ◽  
Vol 7 ◽  
Author(s):  
Saumitra Sarkar ◽  
Avijit Dey ◽  
Kamal Hossen ◽  
Saumik Sarkar
Keyword(s):  
Functional Outcome ◽  
Intracerebral Haemorrhage ◽  
Glasgow Outcome Scale ◽  
Vascular Malformations ◽  
Intracerebral Hematoma ◽  
College Hospital ◽  
Female Ratio ◽  
Significant Difference ◽  
Surgical Evacuation ◽  
The Mean

This study was to determine the different parameters that affect the outcome and the functional recovery after surgical evacuation of spontaneous hypertensive supratentorial intracerebral haemorrhage. This cross-sectional analytic study was conducted in the Department of Neuro- surgery, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh during a period of 4 years from January 2016 to December 2019 and total 96 patients were included in this study. Patients with post-traumatic hematomas, intracranial space-occupying lesions with bleeds, haemorrhagic transformation of an ischemic stroke, vascular malformations, aneurysms, and infratentorial haemorrhages were excluded from the study. Decompressive craniotomy and evacuation of clot was performed in most of the cases. The outcome of the patients was categorized according to the Glasgow Outcome Scale. Outcome was classified as “favourable” if the Glasgow Outcome Scale (GOS) score was 5 or 4, and classified as “unfavorable” if GOS score was 3 or less. The mean age of the patients was 57.99±12.74 years with male and female ratio was 1.66. The mean blood volume was 28±19.99 cc and all patients were hypertensive. There was significant difference (p <0.001) in outcome in relation of age and volume of blood. Age > 70 years, GCS < 8 on admission, clot volume above 40 cc, and intraventricular extension remain the most consistent predictors of mortality and poor outcome following surgical evacuation of spontaneous supratentorial intracerebral hematoma. The present study could only assess mortality and the functional outcome. Since a proportion of survivors had an unfavorable outcome, quality of life measures is important and need to be addressed in future studies.

scholarly journals Surgery for primary intracerebral haemorrhage: is it safe and effective?

2013 ◽  
Vol 38 (3) ◽  
pp. 74-78
Author(s):  
MMH Talukder ◽  
KMT Islam ◽  
M Hossain ◽  
MU Jahan ◽  
F Mahmood ◽  
...  
Keyword(s):  
Intracerebral Haemorrhage ◽  
Glasgow Outcome Scale ◽  
Control Group ◽  
Intracerebral Haematoma ◽  
College Hospital ◽  
Conservative Group ◽  
Best Medical Treatment ◽  
Significant Difference ◽  
Group A ◽  
Group B

This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College Hospital from January 2006 to October 2007. All patients with primary intracerebral haematoma with Glasgow Coma Scale (GCS) 5-15 (on admission) and heamatoma volume 30 cc or above admitted at Neurosurgery department managed conservatively or surgically were included in this study. Total 60 patients were selected, of them 30 patients managed conservatively and 30 patients managed surgically. Conservatively managed patients regarded as control group (Group-A) and surgically managed patients regarded as experimental group (Group-B). Patients or attendants refused to operate were included in the conservative group. All the selected patients were evaluated on the basis of detailed history, clinical examination (general and neurological examination) and CT scan findings. Outcome was evaluated in term of Glasgow Outcome Scale (GOS). Best medical treatment was given for conservative group and operations were done for surgical group and followed up after surgery till discharge by observing GCS and GOS at discharge. Number of death were 15 (50%) patients in group- A and 13 (43%) patients in group-B. There was no significant difference in mortality rate between two groups but outcome was relatively better in group-B. According to Glasgow Outcome Scale, dependency in group-A and group-B was 26.6% and 23.4% respectively. So dependency were more in group-A. But there was no significant difference statistically. Seven (23.4%) patients were independent in group-A but 10(43.3%) patients were independent in group-B. However in relative terms of outcome of group-B was better than that of group-A. In our study we found no statistically significant difference in outcome between medical and surgical management of primary intracerebral haemorrhage. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14328 Bangladesh Med Res Counc Bull 2012; 38(3): 74-78 (December)

scholarly journals Evaluation of Thyroid Function in Persons having Nodular Goiter without Thyroid Related Symptoms

2018 ◽  
Vol 19 (1) ◽  
pp. 24-27
Author(s):  
Md Kabiruzzaman Shah ◽  
Nasrin Begum ◽  
Mosharruf Hossain ◽  
Parvez Ahmed ◽  
Monoarul Islam ◽  
...  
Keyword(s):  
Normal Individual ◽  
Nodular Goiter ◽  
Control Group ◽  
Control Groups ◽  
College Hospital ◽  
Female Ratio ◽  
Significant Difference ◽  
Serum T4 ◽  
The Mean ◽  
And Control

Objective: Objective of this study was to evaluate thyroid hormone level in nodular goiter patient without thyroid related symptoms and normal individual among the population of north-west part along the belt of river Padma.Patients and methods: It was a cross sectional study during the period of one year between July 2005 to June 2006. Total 200 samples were taken within 15 to 50 years age who attended in Institute of Nuclear Medicine & Allied Sciences (INMAS) Rajshahi and OPD Rajshahi Medical college Hospital (RMCH). Diagnosed cases of hypothyroidism, hyperthyroidism, patients treated with radioiodine, pregnant and lactating lady, chronic illness, chronic kidney disease and known cardiac patients were not included in this study. An informed written consent was taken after counseling. Data were collected in predesigned data collection sheet and statistical analysis was performed.Results: Total 100 patients of nodular goiter and 100 normal individual were enrolled for this study. About 37% of study groups were between the age of 20-30 years and 31% in between 30-40 years of age. Male female ratio was 1:2.6. Cold nodular goiter was 75 %, multinodular goiter in 16% cases and partially cold nodular goiter in 9%. The mean ± SD of serum T 3 was 1.89± 0.61 nmol/L and 1.88+-0.44 nmol/L in study and control groups respectively. The mean ± SD of serum T4 was 99.90 ± 29.03 nmol/L and 122.93 ±25.31nmol/L in study and control group and serum TSH was 1.42 ± 1.07 mIU/L and 1.34 ±- 0.54mIU/L in study and control group respectively.Conclusion: This study gave an impression in hormone status of nodular goiter patients in comparison to normal individual. Statistically no significance difference was seen in mean T3 and TSH value between study and control groups however significant difference was seen in mean serum T4 value (p< 0.01).Bangladesh J. Nuclear Med. 19(1): 24-27, January 2016

EXPRESS: Comparison of Mothership versus Drip-and-Ship Models in treating patients with Acute Ischemic Stroke: A systematic review and meta-analysis

2021 ◽  
pp. 174749302110132
Author(s):  
Ahmed Mohamed ◽  
Nida Fatima ◽  
Ashfaq Shuaib ◽  
Maher Saqqur
Keyword(s):  
Functional Outcome ◽  
Meta Analysis ◽  
Critical Time ◽  
Functional Independence ◽  
Models Of Care ◽  
Randomized Control Trials ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Significant Difference ◽  
The Mean ◽  
Randomized Control

Introduction There is controversy if direct to comprehensive center “mothership” (MS) or stopping at primary center for thrombolysis before transfer to comprehensive center “drip-and- ship” (DS) are best models of treatment of acute stroke. In this study, we compare MS and DS models to evaluate the best option of functional outcome. Methods Studies between 1990 and 2020 were extracted from online electronic databases. We compared the clinical outcomes, critical time measurements, functional independence and mortality were then compared. Results A total of 7,824 patients’ data were retrieved from 13 publications (3 randomized control trials and 10 retrospective ones). 4,639 (59.3%) patients were treated under MS model and 3,185 (40.7%) followed the DS model with mean age of 70.01±3.58 vs. 69.03±3.36; p< 0 .001, respectively. The National Institute Health Stroke Scale was 15.57±3.83 for the MS and 15.72±2.99 for the DS model (p=<0.001). The mean symptoms onset-to-puncture time was significantly shorter in the MS group compared to the DS (159.69 min vs. 223.89 min; p=<0.001, respectively). Moreover, the collected data indicated no significant difference between symptom’s onset to intravenous (IV) thrombolysis time and stroke onset-to-successful recanalization time (p=0.205 and p=<0.001, respectively). Patients had significantly worse functional outcome [modified rankin score (mRS)] (3-6) at 90-days in the DS model [Odds Ratio (OR): 1.47, 95% Confidence Interval (CI): 1.13-1.92, p<0.004] and 1.49-folds higher likelihood of symptomatic intracerebral hemorrhage (OR: 1.49, 95%CI: 1.22-1.81, p<0.0001) compared to MS. However, there were no statistically significant difference in terms of mortality (OR: 1.16, 95%CI: 0.87-1.55, p=0.32) and successful recanalization (OR: 1.12, 95%CI: 0.76-1.65, p=0.56) between the two models of care. Conclusion Patients in the MS model have significantly improved functional independence and recovery. Further studies are needed as the data from prospectively randomized studies is not of sufficient quality to make definite recommendations.

TO COMPARE THE EFFECTIVENESS OF NEBULISATION WITH ADRENALINE, 3% HYPERTONIC SALINE AND NORMAL SALINE IN BRONCHIOLITIS IN CHILDREN OF 2 TO 24 MONTHS OF AGE BASED ON CLINICAL SEVERITY SCORE AND NEBULISATION FREQUENCY.

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Priyanka Jain ◽  
Rakesh Jain
Keyword(s):  
Hypertonic Saline ◽  
Normal Saline ◽  
Mean Difference ◽  
Clinical Severity ◽  
Research Centre ◽  
P Value ◽  
College Hospital ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e.  adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.

scholarly journals The post-lunch effect of regular and decaffeinated coffee on psychomotor performance: a randomized double-blind cross-over study

2021 ◽  
Vol 10 (8) ◽  
pp. 954
Author(s):  
Suganthi S. Ramachandran ◽  
Vijay L. Kumar ◽  
S. N. Dwivedi ◽  
Vishwajeet Singh ◽  
Pooja Gupta
Keyword(s):  
Healthy Volunteers ◽  
Psychomotor Performance ◽  
Subjective Ratings ◽  
Double Blind ◽  
Flicker Fusion Frequency ◽  
Female Ratio ◽  
Cardiovascular Parameters ◽  
Significant Difference ◽  
Decaffeinated Coffee ◽  
The Mean

Background: This study aimed to compare the effect of regular coffee and decaffeinated coffee on psychomotor performance in healthy volunteers during post-lunch period.Methods: In this randomized double-blind cross-over study, adult healthy volunteers were given hot coffee (3 g each of regular or decaffeinated coffee) during post-lunch period. Psychomotor functions (critical flicker-fusion frequency (CFF), choice reaction time (CRT) and error count in hand-steadiness test (HST)), blood pressure and heart rate were measured pre-lunch, pre-coffee (1-hour post-lunch) and 1-hour post-coffee consumption. Subjective ratings of sleepiness and mood were also assessed during post-lunch sessions.Results: The mean age of the participants (n=16) was 27.4±2.7 years with a male: female ratio of 7:9. There was no significant deterioration in psychomotor performance post-lunch when compared to pre-lunch on both the days. The mean CFF, CRT, errors committed in HST and cardiovascular parameters did not differ significantly between regular coffee and decaffeinated groups during post-lunch sessions. There was no significant difference in values of cardiovascular parameters as well as subjective ratings of sleep and mood between two groups.Conclusions: In healthy adult individuals’ consumption of both regular coffee and decaffeinated coffee during the post-lunch period did not affect psychomotor performance.

scholarly journals Primary Retroperitoneal Ganglioneuroma: A Retrospective Cohort Study of 32 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianchun Xiao ◽  
Zixuan Zhao ◽  
Binglu Li ◽  
Taiping Zhang
Keyword(s):  
Growth Pattern ◽  
Clinical Manifestations ◽  
Incomplete Resection ◽  
Radiological Imaging ◽  
College Hospital ◽  
Laboratory Findings ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
The Masses

Purpose: To investigate the clinical characteristics, diagnosis, differential diagnosis, therapy options, and outcomes of retroperitoneal ganglioneuroma.Methods: In this retrospective study, we collected and analyzed the clinical data of 32 patients diagnosed with retroperitoneal ganglioneuroma and admitted to Peking Union Medical College Hospital from October 2012 to August 2019.Results: Among our 32 cases with retroperitoneal ganglioneuroma, the male-to-female ratio was 1:3 and the mean age was 35. Only 25% of the cases presented with abdominal pain while more than 65% had no specific symptoms. The masses could be found through physical examination in only five patients. Most of the tumors are located near the renal area. They were usually single and displayed an embedded growth pattern with diameters &lt;10 cm, clear borders, and soft texture. For radiological imaging, the majority of tumors demonstrated soft tissue density with mild-to-moderate enhancement on CT imaging and showed hypoecho with moderate blood flow signals in ultrasound. No significantly abnormal laboratory examinations were found in most patients. Of all the 32 patients, 2 chose surveillance after biopsy due to difficulties in operation, while others chose surgical resection. The mean follow-up time was 15.8 months among 26 patients. The tumor remained stable in the surveillance cases. Residual tumors were found in four cases receiving operations with no progress and discomfort. No recurrence was seen in all patients.Conclusions: The retroperitoneal ganglioneuroma is a benign tumor without specific clinical manifestations or significant laboratory findings. Typically, it is shown as low density with a clear border and an embedded growth pattern in radiological imaging. The overall prognosis is good. Surgery is an effective approach with possible severe complications. Incomplete resection or surveillance can be considered for some cases where complete resection is difficult to achieve.

Laparoscopic Cholecystectomy for Acute Cholecystitis: Indication, Risk, and Outcome

2021 ◽  
Vol 8 (06) ◽  
pp. 5508-5513
Author(s):  
Dr. Shiladitya Shil ◽  
Dr. Ashutosh Deb Sarma ◽  
Dr. Md. Alomgir Islam ◽  
Dr. Md. Abdullah-Hel-Baki Abdul ◽  
Dr.Monira Begum
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prospective Observational Study ◽  
The Other ◽  
Surgical Indication ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
Good Treatment Option

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.

scholarly journals Changes in the physiological parameters of newborns in the first one hour of life

2019 ◽  
Vol 6 (4) ◽  
pp. 1533
Author(s):  
Shasidhar Reddy Y. ◽  
Abdul Mohid Syed ◽  
Gangadhar B. Belavadi
Keyword(s):  
Heart Rate ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Oxygen Saturation ◽  
Mode Of Delivery ◽  
Physiological Parameters ◽  
Peripheral Oxygen Saturation ◽  
College Hospital ◽  
Significant Difference ◽  
The Mean

Background: The transition from a fetus to a newborn is the most complex adaptation that occurs in human experience. This study assessed three physiological parameters viz. temperature (core and peripheral), oxygen saturation and heart rate so as to avoid the delay in normal transitional adaptation.Methods: This cross-sectional observational study was done at Narayana Medical College Hospital, Nellore, Andhra Pradesh, India. A total of 150 neonates born from June 2017 to February 2018 were monitored for heart rate, oxygen saturation, core and peripheral temperature from birth to 60 minutes.Results: Most of the mother’s (45.33%) were aged between 22 to 25 years and the mean age was 23.75±3.64 years. History of consanguineous marriage was noted in 33.33%. The mode of delivery was vaginal in 70.67% of the babies. The mean gestational age was 38.74±1.36 weeks. The birth weight among 62% of the babies was between 2.5 to 3.49 Kgs and mean birth weight was 2.81±0.49 kgs. The meconium stained liquor and requirement of resuscitation was noted in 9.33% and 10.67% respectively.Conclusions: Significant difference was noted with regard to heart rate in babies with active resuscitation, low birth weight (<2.5 kg), meconium stained liquor and warmer care compared to normal babies. There was variation in oxygen saturation in babies who required resuscitation and warmer care, and those who had low birth weight. The mean peripheral and core temperature were different in babies with abdominal care compared to warmer care.

scholarly journals Socio-demographic Characteristics of Patients with Tuberculosis Spine in Bangladesh

2017 ◽  
Vol 3 (1) ◽  
pp. 3-5 ◽  
Author(s):  
Md Shafiul Alam ◽  
Md Abdus Salam ◽  
Tayseer Farzana ◽  
ASM Raushan Newaz ◽  
Md Saiful Islam
Keyword(s):  
Spinal Tuberculosis ◽  
Demographic Characteristics ◽  
Age Group ◽  
College Hospital ◽  
Female Ratio ◽  
High Class ◽  
Medical College ◽  
Class Society ◽  
Male Female Ratio ◽  
The Mean

Background: Spinal tuberculosis is more frequently reported in developing countries.Objective: The purpose of the present study was to see the socio-demographic characteristics of spinal tuberculosis patients.Methodology: This study was carried out in the Department of Neurosurgery, Dhaka Medical College Hospital during the period of January 2002 to December 2004 to elucidate the effectiveness of surgical and conservative treatment of the tuberculosis of the spine. For this purpose, a total number of 50 consecutive cases admitted during the study period with tuberculosis of the spine supported by investigations were included in this study.Result: The mean age of the patients was 25.4 years and ranged from 7 years to 68 years. The highest incidence of tuberculosis of the spine was found in age group between 11 to 20 years and 70% of the patients were under 30 years of age. Incidence of tuberculosis of this spine was more in male (62%) in comparison to female (3 8%) with a male female ratio of 1.63:1. In this study most of the patients came from low class society (66%) followed by middle class (28%) and high class (6%) respectively.Conclusion: Spinal TB more frequently occurs among the young age group with a male predominance.Bangladesh Journal of Infectious Diseases 2016;3(1):3-5

scholarly journals Early experience and patient-reported outcomes of 503 INFINITY total ankle arthroplasties

2021 ◽  
Vol 103-B (7) ◽  
pp. 1270-1276
Author(s):  
David N. Townshend ◽  
Andrew J. F. Bing ◽  
Timothy M. Clough ◽  
Ian T. Sharpe ◽  
Andy Goldberg ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Early Experience ◽  
Outcome Data ◽  
Patient Specific ◽  
Patient Specific Instrumentation ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean ◽  
One Year

Aims This is a multicentre, non-inventor, prospective observational study of 503 INFINITY fixed bearing total ankle arthroplasties (TAAs). We report our early experience, complications, and radiological and functional outcomes. Methods Patients were recruited from 11 specialist centres between June 2016 and November 2019. Demographic, radiological, and functional outcome data (Ankle Osteoarthritis Scale, Manchester Oxford Questionnaire, and EuroQol five-dimension five-level score) were collected preoperatively, at six months, one year, and two years. The Canadian Orthopaedic Foot and Ankle Society (COFAS) grading system was used to stratify deformity. Early and late complications and reoperations were recorded as adverse events. Radiographs were assessed for lucencies, cysts, and/or subsidence. Results In all, 500 patients reached six-month follow-up, 420 reached one-year follow-up, and 188 reached two-year follow-up. The mean age was 67.8 years (23.9 to 88.5). A total of 38 patients (7.5%) presented with inflammatory arthritis. A total of 101 (20.0%) of implantations used patient-specific instrumentation; 167 patients (33.1%) underwent an additional procedure at the time of surgery. A total of seven patients died of unrelated causes, two withdrew, and one was lost to follow-up. The mean follow-up was 16.2 months (6 to 36). There was a significant improvement from baseline across all functional outcome scores at six months, one, and two years. There was no significant difference in outcomes with the use of patient-specific instrumentation, type of arthritis, or COFAS type. Five (1.0%) implants were revised. The overall complication rate was 8.8%. The non-revision reoperation rate was 1.4%. The 30-day readmission rate was 1.2% and the one-year mortality 0.74%. Conclusion The early experience and complications reported in this study support the current use of the INFINITY TAA as a safe and effective implant in the treatment of end-stage ankle arthritis. Cite this article: Bone Joint J 2021;103-B(7):1270–1276.

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