Early bi-canalicular silicone stent intubation in failed DCR with endoscopic visualization: a combined approach

Background: Chronic dacryosystitis is a common condition affecting the eye and presenting to ENT surgeons and ophthalmologists, and treated with DCR (dacryocystorhinostomy). In few cases there can be recurrence of symptoms following DCR surgery which can be treated with bi-canalicular silicone intubation. The aim of this study is to assess the effectiveness of an early bi-canalicular silicone intubation in patients with failed DCR using endoscopic visualisation.Methods: This was a prospective observational study. Thirteen cases of DCR operated for chronic dacryocystitis at St John’s Medical College Hospital were reviewed between January 2014 and February 2017. Endoscopic DCR was done for five patients and external DCR for eight patients, number of males were 5 (38%) and females were 8 (62%). Age: 9–73 years (avg: 40.5 years). Results: Nine patients had complete resolution of symptoms following the primary DCR (4 following external DCR and 5 following endonasal endoscopic DCR). Four patients had failed DCR with persistence of watering three months following primary DCR surgery. Re-DCR with bi - canalicular silicon stent intubation was done in failed cases. Postoperative follow up of all the four patients showed complete resolution of symptoms.Conclusions: Failed DCR surgeries can be effectively intubated using bi–canlicular silicon tubes in the early postoperative period following DCR surgery. Silicone tube intubation is the most safe and cost effective method. Endoscopic visualization gives an added advantage of localizing the cause for a failed DCR.

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Use of Betel Leaves in Pediatric Stoma Care

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v1i2.19534 ◽

2014 ◽

Vol 1 (2) ◽

pp. 148-152

Author(s):

Md. Ashraf Ul Huq ◽

A K M Mizanur Rahman ◽

Tahmina Hossain

Keyword(s):

Zinc Oxide ◽

Cost Effective ◽

College Hospital ◽

Mucosal Ulceration ◽

Medical College ◽

Betel Leaf ◽

Number Of Patients ◽

Peristomal Skin ◽

Two Parameters ◽

Stoma Care

Background: To find out a practicable, cost effective and easily available alternative of commercial stoma care devices for pediatric patients in a developing country.Methods: The study was conducted in the department of Pediatric Surgery in Dhaka Medical College Hospital, Bangladesh, during two years period from May 2009 to April 2011. Number of patients was 162 with age range 2 days to 7 years, mean age 2.3 years. As early as a colostomy or ileostomy had started functioning, a central hole was made in a betel leaf. The hole could just snugly accommodate the stoma. After applying a layer of zinc oxide paste over the peristomal skin the leaf was placed as such the stoma rotrudes through the hole. The smooth shiny surface of the leaf would face upwards and rough surface downwards. Another intact betel leaf with the shiny surface also facing upwards would cover the stoma. The leaves did not act as a reservoir rather simply acted as a barrier between the effluent and the peristomal skin. Fifty seven patients with colostomy and 11 with leostomy used stoma appliances (wafer with bag). Eighty six patients with colostomy and 8 patients with ileostomy used betel leaves and zinc oxide paste. Mean length of time between creation and closure of a colostomy was 9 months and that of an ileostomy was three months. It was ensured that each individual patient had used his or her respective stoma care method till closure of the stomas. Two parameters were used to evaluate the outcome of the above mentioned stoma care methods: (a) peristomal skin excoriation and (b) insultto the stomal mucosa in the form of ulceration.Results: Among the patients who used stoma appliances 21.53% developed peristomal skin excoriation, 7.69% developed mucosal ulceration and 6.34% patients developed local hypersensitivity reaction to stoma adhesive. On the contrary, patients who were managed with betel leaves 20.93% developed peristomal skin excoriation and 8.13% developed mucosal ulceration. No incidence of allergic reaction to local application of betel leaf and zinc oxide occurred. Average cost for betel leaves was less than 0.50 US$ per month in comparison to about 30 US$ for ostomy appliances.Conclusion: Betel leaves may be used as a cheap, easily available, non irritant and effective alternative of commercial appliances to protect the stomas and peristomal skin in pediatric patients.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19534

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Role of Silicone Stenting in Endoscopic Dacryocystorhinostomy: A Comparative Study

International Journal of Advanced and Integrated Medical Sciences ◽

10.5005/jp-journals-10050-0002 ◽

2016 ◽

Vol 1 (1) ◽

pp. 4-6 ◽

Cited By ~ 2

Author(s):

Shahzad Ahmad ◽

Bhawana Pant

Keyword(s):

Comparative Study ◽

Nasolacrimal Duct ◽

Endoscopic Dacryocystorhinostomy ◽

Medical College ◽

Randomized Design ◽

Silicone Stent ◽

Foreign Body Reactions ◽

Endoscopic Dcr ◽

The Cost

ABSTRACT Objective To evaluate the role of using silicone stent in endoscopic dacryocystorhinostomy (DCR) and compare the results with endoscopic DCR without silicone stenting. Design Prospective study, interventional type, randomized design and comparative analysis. Materials and methods The study was done in Department of Otorhinolaryngology, Government Medical College and Dr Susheela Tiwari Hospital, Haldwani, Uttarakhand. We included 30 patients in the study presenting with epiphora with or without mucocele and congenital cases of dacryocystitis and nasolacrimal duct (NLD) blockage were included in the study. All patients were divided into two groups. First one undergoing endoscopic DCR and silicone stent was used in all cases and second one underwent endoscopic DCR and no stent was used. Postoperative assessment was carried out at the end of 1st, 3rd, 6th and 10th week and the role of silicone stent was subjected to compare. Result Use of silicone stent was not improving the results and risk of failure of the surgery had increased with stent due to granulation formation in the lacrimal sac region. Apart from that, foreign body reactions in the form of irritation, pain were seen with stent. It also added the cost of surgery without giving much benefit to the patient. How to cite this article Ahmad S, Pant B. Role of Silicone Stenting in Endoscopic Dacryocystorhinostomy: A Comparative Study. Int J Adv Integ Med Sci 2016;1(1):4-6.

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Aetiological Pattern of Haemoptysis in a Tertiary Level Hospital in Bangladesh

TAJ Journal of Teachers Association ◽

10.3329/taj.v22i1.5015 ◽

1970 ◽

Vol 22 (1) ◽

pp. 22-25 ◽

Cited By ~ 1

Author(s):

M Khalilur Rahman ◽

MM Rahman Khan ◽

MH Tarik ◽

MA Alim ◽

MH Rashid ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Bronchial Carcinoma ◽

Cost Effective ◽

Lung Abscess ◽

College Hospital ◽

X Ray ◽

Medical College ◽

Chest X Ray ◽

Valvular Diseases ◽

Aetiological Diagnosis

To identify the causes of haemoptysis and to diagnose the diseases clinically and cost effective laboratory investigations in our situation. Fifty consecutive cases of haemoptysis admitted at Rajshahi Medical College Hospital, Rajshahi during 2000-2001 were prospectively studied .Pulmonary tuberculosis was the commonest found in 19 (38%) cases. Tuberculer bacilli could be isolated in 5 (26.31%) of the cases. Eight (16%) patients were mitral valvular diseases . Bronchial carcinoma was 4(8%) of the series. Three patients (6%) were lung abscess. Six patients (12%) had bronchiectasis. Five patients (10%) had pneumonia. Remaining five (10%) patients were miscellaneous aetiology. In the present series it has been found that pulmonary tuberculosis and mitral valvular disease comprise 54% of the cases. Chest X-ray and sputum examination were found to be the two most useful investigations necessary for aetiological diagnosis of haemoptysis. Within limited resources the aetiological diagnosis of haemoptysis can easily be done in the majority of cases by doing chest X-ray and sputum examination in our country. DOI: 10.3329/taj.v22i1.5015 TAJ 2009; 22(1): 22-25

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Endoscopic dacryocystorhinostomy with silicon stent: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181872 ◽

2018 ◽

Vol 4 (3) ◽

pp. 785

Author(s):

Neeraj Suri ◽

Bhavya B. M.

Keyword(s):

Cost Effective ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Invasive Technique ◽

Safe Alternative ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Endoscopic Dcr ◽

Surgical Modality ◽

External Dcr

Background: Dacryocystorhinostomy is the current surgical modality of treatment preferred for patients with nasolacrimal duct obstruction. Both external and endonasal endoscopic approaches have been in practice with their own merits and demerits. Since the invention of endoscopes, endoscopic DCR is preferred for its scarless, minimally invasive technique and many modifications have been done over years like placement of silicon stents to reduce recurrence.Methods: In our study we evaluated 70 patients with epiphora with obstruction in nasolacrimal duct, Fresh cases and revision cases who had undergone either external and/ endoscopic DCR without stent were included. All patients underwent endoscopic dacryocystorhinostomy (DCR) with silicon stent placement. Patients were followed postoperatively for a period of 6 months to 3 years. Results: The results were compared with that of external DCR and endoscopic DCR without stent. In our study we found that, endoscopic DCR with silicon stent had less chances of recurrence and synechiae formation. Results at 3 years follow up have been good with 95.7% patients relieved of symptoms completely.Conclusions: Endoscopic DCR is a cost effective and a safe alternative for External DCR in patients with nasolacrimal duct obstruction. We found that endoscopic DCR with stenting had several advantages over more conventional external approach.

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Ultrasonographic Findings of Brain in Perinatal Asphyxiated Babies

TAJ Journal of Teachers Association ◽

10.3329/taj.v29i2.39103 ◽

2018 ◽

Vol 29 (2) ◽

pp. 21-25

Author(s):

M Luthfor Rahman ◽

Kabiruzzaman Shah ◽

Parimal K Paul ◽

Sanaul Haq ◽

M Belal Uddin ◽

...

Keyword(s):

Perinatal Asphyxia ◽

Cost Effective ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Paediatric Department ◽

Preterm Babies ◽

Stage 1 ◽

Cns Lesions

Perinatal asphyxia is a major cause of morbidity and mortality among the newborns in developing countries like Bangladesh. The CNS lesions following perinatal asphyxia can be detected by ultrasonography before closure of fontanels which is easier, cost-effective, and convenient than other methods like CT scan and MRI. This cross-sectional type of descriptive study was conducted on 99 perinatal asphyxiated babies in the Paediatric department of Rajshahi Medical College Hospital during the period of July 2008 to June 2010 to assess CNS lesions in different grades of HIE in term and preterm babies. A non-random purposive sampling method was adopted to select the sample unit. Ultrasonography of the brain of each patient was done at the Centre for Nuclear Medicine & Ultrasound, Rajshahi only once within first 28 days of life when the baby became clinically stable. Ultrasonographic findings showed that 13.1% term babies had abnormal findings of which cerebral edema occupied the major portions (54.54 %). About 20.0% preterm babies had abnormal ultrasonographic findings of which ventriculomegaly without IVH (66.6%).The study also showed that the prevalence of intracranial abnormality was higher (78.6%) among the perinatal asphyxiated babies with HIE stage-2 in comparison to that of the HIE stage-3 (14.3%) and HIE stage-1(7.1%).So, this study provided evidences in favour of role of ultrasonography of brain in the evaluation of perinatal asphyxiated babies and designing appropriate management.TAJ 2016; 29(2): 21-25

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MANAGEMENT OF ADHESIVE CAPSULITIS OF SHOULDER JOINT BY SINGLE PLATELET RICH PLASMA INJECTION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i3.1826 ◽

2021 ◽

Vol 5 (3) ◽

Author(s):

Himanshu Suman ◽

Puneet Kumar Acharya ◽

Jyoti Krishna ◽

Yash Sharma ◽

Oaj Dosaj

Keyword(s):

Glenohumeral Joint ◽

Platelet Rich Plasma ◽

Adhesive Capsulitis ◽

Cost Effective ◽

College Hospital ◽

Duration Of Symptoms ◽

Medical College ◽

Vas Score ◽

Plasma Injection ◽

Hospital Patients

Introduction: Adhesive capsulitis is a painful impairment characterized by the restriction of movement of shoulder due to the adhesions across the glenohumeral joint, injection of platelet-rich plasma is effective treatment to reduce the pain and restore the movement of shoulder. Aim: To assess the effectiveness single PRP injection in management of adhesive capsulitis. Material and Methods: This study enrolled 12 patients experiencing the shoulder pain for at least 3 months and attending our medical college hospital. Patients with adhesive capsulitis were given a single injection of PRP (4 ml) and followed up for 12 weeks, VAS scores and Disability Index scores were recorded and compared with the baseline scores. Result: In present study majority of patients were females with mean duration of symptoms was 3 months. Post PRP treatment all the patients have shown significant improvement on pains VAS score, movement VAS score on 2nd, 6th, and 12th weeks follow up. Conclusion: Present studies conclude that the AC is more prevalent among females which can be treated effectively with PRP technique. PRP as is a simple, safe and cost-effective management of AC without any adverse effects. Keywords: Adhesive Capsulitis, Platelet-Rich Plasma, Corticosteroid, Intra-articular

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Hazards of Wearing Diaper among Infants

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v35i4.34736 ◽

2017 ◽

Vol 35 (4) ◽

pp. 170-173

Author(s):

Subrata Roy ◽

Md Abid Hossain Mollah ◽

MA Mannan ◽

Zohora Jameela Khan ◽

Abdullah Al Amin ◽

...

Keyword(s):

Age Distribution ◽

Cost Effective ◽

Male Infant ◽

Diaper Dermatitis ◽

College Hospital ◽

Factors Affecting ◽

Face To Face ◽

Medical College ◽

Disposable Diaper ◽

Medical University

Background: The use of disposable diaper is gradually increasing for the infants in our country. However, the major hazard of diaper is diaper dermatitis. The magnitude of diaper related hazards is unknown in Bangladesh. This study was conducted to assess the frequency of hazards of wearing diaper among infants.Objectives: The study was conducted (i) to observe diaper related hazards among infants and (ii) to assess the factors affecting diaper related hazards.Materials and Methods: This observational study was conducted at department of Pediatrics of Dhaka Medical College Hospital & Bangabandhu Sheikh Mujib Medical University during May to September 2012. Fifty children aged 7 days to 12 months wearing disposable diaper for at least 7 days were enrolled in this study. A face to face interview was taken and finding were recorded on a preset questionnaire. The infants were also examined for presence of diaper rash. Obtained data were analyzed thoroughly by SPSS 21. Results: Among 50 children, 24(48%) male and 26(52%) female infants. Of them 13(26%) infants developed diaper rash in their diaper wearing time. The age distribution of the cases was 3(23.1%) below 01 months; 2(15.3%) 1-6 months and 8(61.6%) 7-12 months. Six (24%) male infant and 7(27%) female infant developed rash in their diaper wearing time. Diapers are mostly used by solvent families as diapers are not cost effective. The frequency 84.6%, increases with increased duration of using a single diaper at a time for more than 4 hours without change whereas those who changed diaper more frequently every 3-4 hours and 1-2 hours have diaper rash 15.4% and 0% respectively.Conclusion: From the result of the present study it can be concluded that the frequency of diaper rash is increased with increasing age of infants and use of diaper for long duration.J Bangladesh Coll Phys Surg 2017; 35(4): 170-173

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A randomised open label comparative study evaluating the effectiveness, adherence and safety between 2% mupirocin ointment and 2% fusidic acid cream in children with impetigo

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20192095 ◽

2019 ◽

Vol 5 (3) ◽

pp. 511

Author(s):

Ravichandran Velappan ◽

Sindhuja Ramasamy ◽

Shridhar Venu ◽

Muthusubramanian Chandrasekar

Keyword(s):

Fusidic Acid ◽

Skin Infection ◽

Clinical Success ◽

Cost Effective ◽

Open Label ◽

College Hospital ◽

Medical College ◽

Disease Characteristics ◽

Mupirocin Ointment ◽

Systemic Antibiotics

Background: Impetigo is a superficial bacterial skin infection that affects mainly children, which is highly contagious. Topical anti-bacterials are most commonly used in both primary and secondary impetigo. Clinical trials have shown high efficacy of these topicals along with systemic antibiotics in both complicated and uncomplicated impetigo. However use of these topical modalities alone in uncomplicated primary impetigo is limited. The aim of the study was to compare the efficacy, safety and adherence to treatment of mupirocin with fusidic acid in primary impetigo.Methods: A total of 60 patients with a clinical diagnosis of primary impetigo, between 2-14 years of age, having <10 lesions, skin infection rating score >4 and pus score equal to or more than one who attended Dermatology OPD, in Chengalpattu Medical College Hospital from February 2018 to March 2019. Study design was a comparative analytical study.Results: Baseline disease characteristics such as number of lesions, the severity of disease (SIRS), and pus scores were statistically similar between the two groups. The clinical improvement observed with mupirocin (25/30) and fusidic acid (24/30) treatment in primary impetigo was not statistically significant (p>0.05). Both drugs were tolerated well.Conclusions: Both mupirocin and fusidic acid showed similar clinical success in patients with primary impetigo. Though fusidic acid has additional anti-inflammatory property and its treatment is cost effective, but irritant effects observed in some patients, which reduces the compliance, lead to consider mupirocin as first line treatment in primary impetigo.

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A Comparative Study between Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy – A Hospital-Based Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/522 ◽

2020 ◽

Vol 7 (44) ◽

pp. 2526-2529

Author(s):

Kanishka Chowdhury ◽

Sagar Karmakar ◽

Subhadip Sarkar ◽

Suman Mukhopadhyay

Keyword(s):

Invasive Procedure ◽

External Approach ◽

Medical College ◽

Chronic Dacryocystitis ◽

Group A ◽

Study Population ◽

Endoscopic Dcr ◽

External Dacryocystorhinostomy ◽

Group B ◽

External Dcr

BACKGROUND Dacryocystorhinostomy (DCR) can be performed via two approaches either external approach or endonasally. Earlier, external approach was preferred but with the recent introduction of endoscopy, the focus has shifted to endoscopic DCR as it is a less invasive procedure. This study was conducted to compare both the approaches. METHODS 50 patients were selected from patients attending eye and ENT OPD of a medical college in Kolkata with complaints of watering and / or discharge or with other features of chronic dacryocystitis e.g., mucocele, pyocele etc. They were then allocated in to two groups, group A (patients who will undergo endo DCR) and group B (patients who will undergo external DCR). Results of both were compared. RESULTS The mean age of study population was 34.34 ± 6.65 yrs. Among the study population, 36 patients (72 %) were female and 14 were male (28 %). Mean age of Group A (i.e. patients subjected to endo DCR) was 34.60 ± 5.72, while that of Group B (patients undergone external DCR) was 34.08 ± 7.58 yrs. Patients had a right sided predilection for DCR operation (66 %). Most common presenting symptom was epiphora (66 %) followed by epiphora with discharge. Mean time taken for the operation was significantly (p < 0.0001) more in group B (117 ± 14.43 mins) compared to that in group A (46.60 ± 8.63 mins). Massive intraoperative bleeding was more common in group B (32 %) compared to that in group A (p = 0.0023). Group B had a significantly higher rate of post-operative complications (56 %) compared to that in group A (p = 0.00085). Group B also had a higher success rate compared to group A; but this difference was not significant. (p = 0.22144). CONCLUSIONS Both the approaches have their own merits and demerits; but both are accepted alternatives, so either approach could be performed depending on the situation. KEYWORDS Endoscopic DCR, External DCR, Epiphora

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EARLY LAPAROSCOPIC CHOLECYSTECTOMY

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.01.2719 ◽

2008 ◽

Vol 15 (01) ◽

pp. 162-167

Author(s):

THAKUR K. HINDUJA ◽

SHER MOHAMMAD SHAIKH ◽

MALICK HUSSAIN JALBAN ◽

Nisar Ahmed Shaikh ◽

Ishaque Soomro

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Cost Effective ◽

Abdominal Ultrasound ◽

Related Complication ◽

College Hospital ◽

Female Ratio ◽

Early Laparoscopic Cholecystectomy ◽

Medical College ◽

Surgical Units

To assess the clinical out come of laparoscopic Cholecystectomyfor management of acute cholecystitis and to evaluate its safety, frequency of complications. Design: Observationalstudy. Setting: Surgical Units II and III Of Chandka Medical College Hospital Larkana.. Period: From 01.09.2003 upto 31.12.2007 Patients & Methods: A total of 100 consecutive cases of, acute cholecystitis confirmed subsequentlyby abdominal ultrasound scanning, who were admitted for early laparoscopic cholecystectomy. Results: There wasfemale preponderance with male to Female ratio of 1:4.5. Mean age was 45.75, SD 11.99, and most of patients werereceived with in 24 hours from the onset of symptoms. In 51 patients ultrasound reveals Edematous GB in 24(24%),Empyma 8(8%), Contracted 10(10%), Perforated 5(5%) and Gangrenous GB in 4(4%) while 49(49%) have acutecholecystitis with cholelithiasis. The conversion rate was 6%; The minimum time taken during the procedure was 50minutes. No mortality was reported in this series. Conclusion: Emergency / early cholecystectomy is reliable and safemodality cost effective, and timely surgery with modern conception in themanagement of acute cholecysttitis, becauseof accelerated recovery, negligible wound infection or related complication, and less postoperative pain. So Lap Choleshould be preferred technique now days for the treatment of acute cholecystitis at our Institute.

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