A Clinical Study on Etiological Factors and Management of Epistaxis at a Tertiary Level Hospital

2020 ◽  
Vol 26 (1) ◽  
pp. 45-54
Author(s):  
Rashedul Islam ◽  
Mohammad Asraful Islam ◽  
AHM Rashid E Mahbub ◽  
AHM Rashid E Mahbub ◽  
Anup Kumar Chowdhury ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Medical College Hospital ◽  
Nasal Packing ◽  
Urban Habitat ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Rural Habitat ◽  
Nasal Bleeding

Background: Epistaxis is a common otolaryngological emergency worldwide affecting up to 60% of the population in their lifetime. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Dhaka Medical College Hospital, a tertiary care hospital in BANGLADESH. Objective: The study is carried out with an objective to evaluate on etiological profile and management of epistaxis. Methods: This cross sectional study was conducted among the emergency and admitted patient with epistaxis at Dhaka Medical College Hospital from 1st November 2013 to 30th April 2014. Results: During the period under study, a total 104 patients were studied. The etiology of the cause of epistaxis was grouped into traumatic and non- traumatic. Among them 46 (44.23%) patient were in traumatic epistaxis and 58 (55.77%) patient were in non traumatic epistaxis. Male were affected more frequently than female in this study. There were 74 (71.15%) male and 30 (28.85%) females with a male female ratio of 2.47:1 Majority of the patients in this study were in 2nd decade (21.15%) followed by 6th decade (19.23%) and 3rd decade (17.31%). Among the 104 patients with epistaxis 78 (75%) were urban habitat and 26 (25%) were rural habitat. Significantly more patients were from urban resident. Regarding etiology and sex distribution there were no significant differences between urban and rural habitat. The present study shows that the most common cause of epistaxis was trauma (44.23%) followed by idiopathic (25%) and hypertension (17.31%). Local pain (41.31%), nasal obstruction (13.04%), nasal deformity (17.39%) associated other injury (13.04%) was more frequent in traumatic patient. Significant raise of blood pressure (Systoloic BP >160 mm Hg and diastolic BP > 100 mm Hg) were found in 58 (55.77%) non-traumatic patient. Severity of the nasal bleeding was mild to severe degree in both the groups. Significantly anterior epistaxis is common among the traumatic epistaxis group (69.57%) and posterior epistaxis in non-traumatic epistaxis group (46.55%). About 27.59% patient the exact site was not detected as there was diffuse bleeding. In case of nasal bleeding, bleeding from septum 42 (40.38%), from lateral wall 32 (30.76%) and from floor of the nose 23 (22.15%). Control of bleeding by the direct method was possible in 11 (10.57%) patients. Anterior nasal packing was given in 86 (82.69%) patients and post nasal packing was given in 3 (2.89%) patients. Conclusion: A high incidence in young adults was reported with preponderance of males over females. Occurrence of different types of epistaxis was strongly related with the certain demographic factors like age, sex and habitat of the patient. This study supports the credibility of conservative management procedure in the treatment of epistaxis. Simple nasal packing is the commonly practice conservative method with high success. Hence, this approach should be the preferred option in the management of epistaxis especially in developing countries. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 45-54

scholarly journals Multimorbidity Patterns Among Hospitalized Geriatric Patients in Medicine Wards of a Tertiary Care Hospital in Dhaka City

2021 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Sumiya Bent Kalam ◽  
Sadia Islam ◽  
Mohammad Abdullah Az Zubayer Khan ◽  
Tanjina Akhter
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College

Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59

scholarly journals Socio-demographic Characteristics of Vesico-vaginal fistula (VVF) patients attended at a tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Medical College Hospital ◽  
Care Hospital ◽  
Vaginal Fistula ◽  
College Hospital ◽  
Medical College ◽  
The Mean ◽  
Vesico Vaginal Fistula

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117

scholarly journals Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female ◽  
Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

scholarly journals A Clinico-epidemiological Study of Malaria Patients Admitted in A Tertiary Care Hospital of Bangladesh

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Diagnostic Test ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Clinical Aspects ◽  
Case Report Form ◽  
Care Hospital ◽  
Mosquito Net ◽  
College Hospital ◽  
Medical College ◽  
History Of

Malaria is a public health problem in 90 countries around the world affecting 300 million people and responsible for about 1 million deaths annually. Bangladesh is considered as one of the malaria endemic countries in Asia. Every year large number of people suffered for malaria. But there is little studies about clinico-epidemiology of malaria. Aim: To study the epidemiological and clinical aspects of malaria. Methods: This is a Prospective observational study that was conducted in all medicine unit of Chittagong Medical College Hospital, Chittagong, Bangladesh during August 2017 to June 2018. Total 55 patients were included in the study having malaria diagnosed by blood slide examination or rapid diagnostic test. Patients were enrolled in this study after getting written informed consent from the patient or attendant. Detail demographic and clinical data were recorded in structured case report form. Patients were regularly followed up and outcome recorded. Results: Results showed males (65.5%) of 25±15.109 years of age were the main sufferer. Majority (45%) came from low socio-economic condition (<5000 taka/month). 65.5% patients denied any history of recent travel to malarias’ area. 69.1% cases give history of using mosquito net, but only 25.5% have insecticide treated mosquito net. Majority (89.1%) were diagnosed as severe malaria and only few (10.9%) as uncomplicated malaria. Most of the diagnosis done at Chittagong Medical College Hospital, mainly presenting with coma or altered consciousness and convulsion. At field level diagnostic test done in 67.27% cases, of which RDT in 14.5%, BSE in 45.5% and both in 7.3% cases. 78.2% cases outcome were good with improvement and death occurred in 21.8% cases, mainly due to acute renal failure. Conclusion: Though we are making significant effort to control malaria, still we have to improve in controlling malaria based on both preventing the infection and on prompt effective treatment of the infection and illness when it does occur.

scholarly journals Current Spectrum of Intestinal Obstruction in a Teaching Hospital

2019 ◽  
Vol 32 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Tamanna Tasnim ◽  
Md Mizanur Rahman ◽  
Ariful Alam ◽  
Rupsha Nura Laila ◽  
Abdul Matin ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Tertiary Care ◽  
Intestinal Tuberculosis ◽  
Large Bowel Obstruction ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Current Spectrum ◽  
Previous Laparotomy

Intestinal Obstruction is a common surgical emergency and constitutes a major cause of morbidity and financial expenditure in hospitals around the world. This study aimed to provide the current spectrum of intestinal obstruction in a tertiary care hospital with a special view to identify any change in the aetiologic pattern. This prospective observational study was carried out in all four surgical units of Rajshahi Medical College Hospital from September 2010 to August 2011. The study included 250 adult patients with clinical and radiological evidence of complete intestinal obstruction. Out of 250 consecutive patients ranging between (13-90) years with a male to female ratio of 2.1:1, the maximum cases were within (31-40) years and (51-60) years of age group. In this study 175 cases (70%) were presented with small bowel and 75 cases (30%) with large bowel obstruction. The main causes of obstructions were bands and adhesions (44%) followed by volvulus (18%), external hernias (16%), neoplasm (12%), intussusceptions (3.2%), intestinal tuberculosis (2.8%) and miscellaneous (4%). Approximately, 86% patient with adhesive obstructions had previous laparotomy while 42% needed surgical exploration for failed conservative management. The overall mortality was 8%; mainly owing to strangulating obstruction and old age. Varying degrees of wound infections were the common post-operative complications. There was a significant change in the aetiologic pattern of intestinal obstruction. Post operative adhesions were the commonest cause of obstruction and appendicectomy was the most common previous operation causing adhesion. TAJ 2019; 32(1): 62-69

scholarly journals Pattern of Cardiovascular Drugs Use in Outpatient Department in a Tertiary Care Hospital of Bangladesh

2018 ◽  
Vol 32 (2) ◽  
pp. 65-69
Author(s):  
Udoy Shankar Roy ◽  
AKM Monwarul Islam ◽  
Mohsin Ahmed ◽  
Murshidur Rahman Khan ◽  
Nihar Ranjan Sarker
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cardiovascular Drugs ◽  
Medical College Hospital ◽  
Outpatient Department ◽  
Essential Medicines ◽  
Fixed Dose ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College

Objective: The objective of the present study was to provide recent population-based information on use of cardiovascular drugs in outpatients in a tertiary care hospital of Dhaka, Bangladesh.Methods: A prospective study of cardiovascular prescriptions of Outpatient Department of Department of Cardiology of Shaheed Suhrawardy Medical college hospital Dhaka, Bangladesh was carried out. A total of 215 prescriptions were collected for the study in Shaheed Suhrawardy Medical College Hospital Dhaka, Bangladesh from July 2015 to June 2016. The prescriptions were evaluated for rationality based on WHO model list of essential medicines. The prescriptions were critically analyzed using predetermined parameters.Results: Out of 215 prescriptions collected, 120 drugs were found to be repeatedly prescribed. The results revealed that all single dose formulations prescribed were rationally in accordance with WHO essential drug list whereas fixed dose combinations prescribed remain questionable. A pattern of polypharmacy was clearly evident.Conclusion: Medications are a critical modality for prolongation and improved quality of life. Campaign and intervention should be focused on patients with more than three diagnostic cardiovascular conditions in order to minimize polypharmacy in patients particularly elderly.Bangladesh Heart Journal 2017; 32(2) : 65-69

scholarly journals Pattern of Disorders in Neurology Outpatient Department: Experience from a Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 25 (1) ◽  
pp. 53-57
Author(s):  
Ahmed Hossian Chowdhury ◽  
Swapon Kumar Ghose ◽  
Kazi Gias Uddin Ahmed ◽  
ATM Hasibul Hasan ◽  
Kanol Saha ◽  
...  
Keyword(s):  
Back Pain ◽  
Tertiary Care ◽  
Headache Disorder ◽  
Male Dominance ◽  
Care Hospital ◽  
Vestibular Disorder ◽  
College Hospital ◽  
Aged Patients ◽  
Female Ratio ◽  
Medical College

Objective: To determine the pattern of neurologic disorder in the specialized neurology out patient at tertiary care level.Methods: This observational study was carried out in specialized neurology outpatient clinic of Dhaka Medical College Hospital from July 2015 to July 2016, which included 8892 patients. Data were collected through a predesigned questionnaire from the hospital database kept at the clinic.Result: A total of 8892 patients were seen in neurology OPD in one year. About one third of the patients presented at 21-30 years of age. There was a male dominance (53%) with a male to female ratio of 1.12:1. Most of the patients had hypertension (3201, 36%) followed by diabetes and ischemic heart disease (1956, 22%; 1423, 16%) as co-morbid condition. Majority had Headache (4090, 46%) followed by vertigo (1067, 12%); vomiting (711, 8%) and neck and/ back pain (702, 8%) as presenting symptom at onset. Majority of the patients (46%) were diagnosed as headache disorder (Tension type headache in 33.5%, Migraine 7.5% and mixed headache in 5%) followed by ischemic stroke (896, 10%); polyneuropathy (446, 5%); vestibular disorder (441, 5%); movement disorder (267, 3%) and anxiety/depression (254, 3%). About 15% (1346) patient were undiagnosed at initial visit.Conclusion: Neurological diseases are not uncommon even at middle aged patients. Headache, vertigo, neck/back pain are common presenting symptom. Headache disorders and stroke are the commonest neurologic diagnosis at OPD.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 53-57

scholarly journals The Common Causes Leading to Pancytopenia at Tertiary Care Hospital Hossain

2018 ◽  
Vol 26 (2) ◽  
pp. 157-161
Author(s):  
Mohammad Zaid Hossain ◽  
Mohammad Manirul Islam ◽  
Masuma Ahmed Salsabil ◽  
Quadrat E Elahi ◽  
Mazharul Islam ◽  
...  
Keyword(s):  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Clinical Feature ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Erythroid Hyperplasia ◽  
Detailed Medical History ◽  
Common Causes

Pancytopenia is a triad of simultaneous presence of anemia, leucopenia and thrombocytopenia. It is result from a number of disease processes. Both hematopoietic and nonhematopoietic conditions manifest with features of pancytopenia.Methods: This was a cross-sectional study carried out in the Department of Medicine, Dhaka Medical College Hospital between December 2016 to July 2017. We included adult patients of both sexes having age 16 years and above. Criteria for inclusion were persistent pancytopenia on peripheral blood film of more than one week duration. All patients underwent a detailed medical history and full physical examination followed by blood sampling for the investigations. After taking all the aseptic measures and with standard technique the diagnostic bone marrow aspiration and trephine biopsy were done.Results: There were 36 patients with pancytopenia which were included in this study. There were 20 (56%) males and 16 (44%) females with a 1.25:1 male to female ratio and a mean age 47.30 years ± 15.01 SD. The most common complaints were bleeding manifestation (29/36), followed by generalized weakness (27/36) and fever (25/36). Anaemia was the most common (100%) clinical feature followed by jaundice and splenomegaly (6/36). Aplastic anemia was the commonest cause that was observed in 27.78% (10/36) cases followed by Megaloblastic anemia 16.67% (6/36) and erythroid hyperplasia 13.88% (5/36).Conclusion: Aplastic anaemia is leading cause of pancytopenia in this study followed by megaloblastic anaemia and hypersplenism being second and third common causes respectively. Pancytopenia should be suspected on clinical grounds when a patient presents with unexplained anemia, prolonged fever and tendency to bleed.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 157-161

scholarly journals Etiological Profile and Management of Epistaxis in Tertiary Care Hospital

2019 ◽  
Vol 12 (1) ◽  
pp. 13-16
Author(s):  
B Sigdel ◽  
R Nepali ◽  
Neeraj KC ◽  
T Dubey ◽  
B Neupane ◽  
...  
Keyword(s):  
Tertiary Care ◽  
College Teaching ◽  
Nasal Packing ◽  
Care Hospital ◽  
Artery Ligation ◽  
Female Ratio ◽  
Medical College ◽  
Male Preponderance ◽  
Nasal Trauma ◽  
Nasal Drop

Introduction: Epistaxis is a common otolaryngological emergency condition. It occurs due to local and systemic cause. Local cause lies within the nose bleeding either anterior or posterior. Commonest site of bleeding anterior epistaxis is kiesselbach’s plexus. In posterior epistaxis, it is difficult to locate bleeding site. Epistaxis is controlled by simply pinching of nose, decongested nasal drop and abgel packing. Some cases become more challenging required nasal packing and arterial ligation. Objectives: To study the epidemiological pattern and management of epistaxis. Methods: This was a retrospective study on pattern of epistaxis man­aged at Gandaki Medical College Teaching Hospital over a period from April 2015 to April 2016. Information regarding demographic profile, presentation and management of epistaxis was obtained from the Hospital records, ENT Outpatient clinic, Emergency Department, ENT ward and operation theatre. Results: A total of 78 cases were managed during study period. There was a significant male preponderance with male to female ratio 1.78:1. Patients’ age varied from eight to 80 years with mean age 40.7 years. The peak age of incidence was 21 - 30 years group. Idiopathic nasal bleeding 27 (34.6%) was commonest followed by nasal trauma 23 (29.5%) cases and hypertension 16 (20.5%) cases. Seventeen (21.8%) cases managed in day care basis with decongested nasal drop, chemi­cal cautery and abgel packing. Remaining cases required nasal packing and bipolar cautery and other specific form of treatment. Five (6.4%) cases required sphenopalatine artery ligation with no recurrence of bleeding. Conclusions: Epistaxis is common ENT emergency. Most common causes are idiopathic followed by nasal trauma and hypertension. Prompt management is instituted according to cases. Most of the cas­es are managed by non-surgical method.

scholarly journals Bacterial Contamination of Stethoscope in a Tertiary Care Hospital

2018 ◽  
Vol 30 (2) ◽  
pp. 1-6
Author(s):  
Md Azizul Haque ◽  
Khandaker Md Faisal Alam ◽  
Laila Shamima Sharmin ◽  
Atike Mahmud ◽  
MM Washee Parvez ◽  
...  
Keyword(s):  
Bacterial Contamination ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Medical College Hospital ◽  
P Value ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Bacterial contamination of stethoscope and its role in transmission of nosocomial infection is little known among the healthcare workers of Bangladesh. The objectives of our study is to evaluate stethoscope handling and cleaning practices, to find out the bacterial agents contaminating the stethoscopes, to determine the antibiotic sensitivity patterns of bacterial isolates from stethoscopes, and to evaluate the relationship between stethoscope cleaning practices with contamination of stethoscope in Rajshahi Medical College Hospital. This observational cross sectional study was carried out in Rajshahi Medical College Hospital during March, 2017. One hundred doctors working in different departments of RMCH were chosen randomly and were asked to fill up a self-explanatory simple questionnaire. Samples from100 stethoscopes were obtained after swabbing the diaphragm and the bell of the stethoscope with a sterile swab moistened with saline. These swabs were immediately streaked onto blood agar, Mcconkey agar and chocholate agar following the standard protocol. Out of 100 stethoscopes examined for bacterial contamination, 19 stethoscopes (19%) were found to be contaminated. The organisms isolated were MRSA, pseudomonas aeruginosa, and E. coli. Among the 19 participants with bacterial contamination of stethoscope, 6 doctors (31.6%) said they used to clean their stethoscope at least occasionally and 13 doctors (68.4%) had never cleaned their stethoscope. This difference was found to be statistically significant (p value <0.005).TAJ 2017; 30(2): 1-6

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