scholarly journals Surgical Management of Breast Cancer under Local Anaesthesia: A Surgeon's Perspective

2017 ◽  
Vol 5 (2) ◽  
pp. 63-67
Author(s):  
Tapesh Kumar Paul ◽  
AR Chowdhury ◽  
Russel Ahmed Khan Lodi ◽  
Shayda Ali ◽  
Mohammad Arman Zahed Basunia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Elderly Patients ◽  
Surgical Management ◽  
Local Anaesthesia ◽  
Local Anaesthetics ◽  
Breast Cancer Surgery ◽  
Medical Conditions ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Treatment of breast cancer without surgery may not be effective. But in elderly patients with lots of co-morbidities, surgical management often cannot be done due to the significant risks of general anesthesia. The need for a safe, easy and effective alternative anaesthetic technique that can provide adequate peroperative analgesia as well as reduced anxiety in such group of patients was the main indication for this study.Materials and method: This prospective study was done on eleven patients, with coexisting medical conditions and who were not at all fit for general anaesthesia, and underwent breast cancer surgery under local anaesthesia. The patients were studied with regard to intraoperative analgesia, haemodynamic stability and complications related to technique. The study was done in Delta Medical College Hospital, Dhaka, Bangladesh.Results: Mean±SD of study patients were 64.7±7 years old and all were suffering from coexisting medical conditions. Following local anaesthesia, mean intraoperative heart rate was 81.5±11.8 beats/min and the mean blood pressure was 127.3/79±9.6/7.0 mmHg. Patients felt no pain after infiltration of local anaesthetics, but experienced it if any place was missed before dissection. No complication occurred due to this procedure. All the candidates were fully satisfied with the procedure.Conclusion: Local anaesthesia provides satisfactory pain control along with keeping haemodynamics stable for surgical treatment of breast cancer among elderly patients having co-morbid conditions.Delta Med Col J. Jul 2017 5(2): 63-67

scholarly journals Cataract Surgery under Local Anaesthesia - Search for Safer One

2018 ◽  
Vol 6 (2) ◽  
pp. 68-72
Author(s):  
Md Abdus Salam Siddique ◽  
Md Fazlul Hoque ◽  
Md Jamal Abu Naser
Keyword(s):  
Cataract Surgery ◽  
Local Anaesthesia ◽  
Local Anaesthetics ◽  
Clinical Parameter ◽  
Success Rates ◽  
College Hospital ◽  
After Effects ◽  
Medical College ◽  
Peribulbar Block

Background: Cataract surgery is usually done under local anaesthesia. But till now there are no absolutely safe local anaesthetics. Current study is done to find out a safer local anaesthetic for cataract surgery.Objective: To evaluate the onset, duration, quality, side effects and safety of bupivacaine and lignocaine in peribulbar block (PBB) for cataract surgery.Materials and method: This was a randomized observational controlled clinical study done in Monno Medical College Hospital, Manikganj, Bangladesh, in the period of October, 2014 to October, 2015. Two hundred cataract patients attending ophthalmology department were allocated to receive either 4 mL 0.5% bupivacaine+4 ml 2% lignocaine or 8 mL of 2% lignocaine for peribulbar block during cataract surgery. Onset, duration, quality of anaesthesia and after effects were used as a clinical parameter for the study.Results: Mean anaesthetic durations of lignocaine and bupivacaine+lignocaine were 75 minutes and 120 minutes respectively. Least complications were observed in subjects with lignocaine.Conclusion: Peribulbar blocks with 2% lignocaine provide better anaesthesia for cataract surgery and success rates are high without any complications. Anaesthetic time of lignocaine alone is enough for cataract surgeryDelta Med Col J. Jan 2018 6(2): 68-72

scholarly journals Etiological Evaluation of Acute Confusional State in Elderly (≥60 Years) Patients

2021 ◽  
Vol 22 (1) ◽  
pp. 41-45
Author(s):  
Md Motlabur Rahman ◽  
Rakesh Panday ◽  
Kamal Uddin Sohel ◽  
Zuhayer Ahmed ◽  
Shahana Khanam ◽  
...  
Keyword(s):  
The Elderly ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Medical Conditions ◽  
Acute Confusional State ◽  
Confusional State ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
The Mean

Background: Acute confusional state or delirium is a frequent cause of hospital admission in the elderly. It is characterized by an acute fluctuating impairment of cognitive functions and inattention. Recognition and prompt treatment is crucial to decrease the morbidity and mortality of hospitalized elderly patients. Aim of this study was to evaluate the distribution of common medical conditions related to acute confusional state among elderly hospitalized Patients. Methods: This was a cross sectional study. We enrolled 380 patients from different medicine wards in Dhaka Medical College Hospital. We included patients with acute confusional state/delirium of less than 7 days duration. The enrolled patients fulfilled the diagnostic criteria of an acute confusional state. A predesigned checklist was used for data collection. Head injury was excluded by history and CT scan of brain. Patients with preexisting illnesses, such as dementia, psychiatric illnesses and recurrent seizures, and any case of poisoning was excluded. All findings were noted and recorded. A written informed consent was taken from the attendant and relatives. Result: Among 380 patients, most of confusional state developed after the age of 65 years and the mean age was 69 +/-7.6 years. Associated medical conditions were uncontrolled hypertension (63.2%), fever & infection (41.6%), uncontrolled DM (36.6%), CVD (28.4%), CKD & electrolytes abnormalities (10.5%), joint diseases & pain (13.7%). Most of the patients used plyphormacy (76.6%) out of which antihypertensive (60%) were common. The mean duration of presentation was 6.1+/-0.6 days, and among all patients about 63.7% were improved, 29.50% was in persistant symptom of confusion and 6.8% of them died. Conclusion: Acute confusional state was common after 65 years. Uncontrolled hypertension, fever & infection, uncontrolled diabetes, CVD, CKD & electrolytes abnormalities and polypharmacy were found commonly in patients with acute confusional state. J MEDICINE JAN 2021; 22 (1) : 41-45

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

scholarly journals Prevalence of Pre-Existing Corneal Astigmatism in Age Related Cataract Patient

2013 ◽  
Vol 8 (1) ◽  
pp. 02-04
Author(s):  
Md Abdur Rashid ◽  
KH Anowar Hossain ◽  
AKM Rafiqul Islam
Keyword(s):  
Prospective Study ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Corneal Astigmatism ◽  
Normal Vision ◽  
College Hospital ◽  
Medical College ◽  
Cataract Patient ◽  
Age Related ◽  
The Mean

Cataract surgery is no more a blind rehabilitation surgery, it absolutely gives normal vision. In the era of modern cataract surgery patients expectations are also high about visual outcome. This prospective study was carried out to investigate the magnitude and pattern of pre-existing corneal astigmatism in age related cataract patient at Faridpur Medical College Hospital, Faridpur and Agha Yusuf Adhunik Hospital, Kustia, from July 2009 to June 2012. We examined 850 eyes of 730 patients who underwent cataract surgery. The mean age at the time of surgery was 61.9±8.1 (40 to 70) years. Corneal astigmatism was measured by Auto Refracto Keratometer at least two times for each patient. Astigmatism was calculated from diopteric difference of vertical reading from horizontal reading. With the rule (WTR) astigmatism was considered when steep meridian at 90°± 20°. Against the rule (ATR) astigmatism was considered when steep meridian at 180°±20°. Astigmatism is in other direction is defined as oblique. On keratometry, when vertical reading (k1) was found greater than horizontal (k2) was considered WTR astigmatism and the reverse reading for ATR astigmatism. The percentage of corneal astigmatism was 1D or less was 69.6%, more than 1D and less than 1.5D, 27.6% and more than 1.5D and less then 2D 2.8%. Prevalence of ATR astigmatism was more than WTR astigmatism and prevalence of ATR astigmatism increases significantly with age. Approximately two third of pre-operative patient had 1D or less astigmatism and one third had more than 1D corneal astigmatism. DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16887 Faridpur Med. Coll. J. 2013;8(1): 02-04

scholarly journals Outcome analysis of surgical management of comminuted quadrilateral plate acetabulum fractures

2019 ◽  
Vol 5 (5) ◽  
pp. 883
Author(s):  
Chandan Uday Kulkarni ◽  
Abhijit Sen ◽  
Jimi Jose
Keyword(s):  
Surgical Management ◽  
Operating Time ◽  
Clinical Score ◽  
Outcome Analysis ◽  
Medical College ◽  
Quadrilateral Plate ◽  
Spring Plate ◽  
Acetabulum Fractures ◽  
Clinical And Radiological Outcome ◽  
The Mean

<p class="abstract"><strong>Background:</strong> The acetabular quadrilateral fractures are difficult to treat and ORIF using a spring plate buttressing the quadrilateral surface underneath an iliopectenial plate in a 90-90 construct. The aim of the study was to assess the clinical and radiological outcome, success rate and proportion of the post-operative complications of surgical management of comminuted quadrilateral plate acetabulum fractures after ORIF.</p><p class="abstract"><strong>Methods:</strong> It was a hospital based descriptive type of observational study conducted in the Department of Orthopedics, SMS Medical College. The data collection was done from May 2016 up to June 2018. The sample size was 31 for the study purpose, at 95% confidence limits and 20% relative allowable error.<strong></strong></p><p class="abstract"><strong>Results: </strong>We studied 31 patients of communited quadrilateral plate fractures, who were evaluated preoperatively and optimized. ORIF was performed. The mean blood loss was 450 ml and the mean operating time was 130 minutes. The patients were followed up at 1 year postoperatively where 24 patients had an excellent to good Harris Hip clinical score and 24 patients had an excellent to good Matta radiological score, and both were found to be statistically significant.</p><p><strong>Conclusions:</strong> Comminuted quadrilateral plate fractures of the acetabulum are managed surgically by ORIF using a spring buttressing plate beneath the infrapectenial plate. The clinical and radiological follow up for one year duration scores showed good scores which were statistically significant, indicating the success of quadrilateral fixation using this technique. </p>

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 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.

A STUDY OF HYPERURICACIDEMIA AND THE PRESENCE AND SEVERITY OF ACUTE CORONARY SYNDROME IN INDEX MEDICAL COLLEGE, HOSPITAL AND RESEARCH CENTER, INDORE ( M.P.)

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
B. Khanam ◽  
M. Imran Khan ◽  
Ajay Kumar Singh ◽  
Sumit Solanki ◽  
S.M. Holkar
Keyword(s):  
Acute Coronary Syndrome ◽  
Control Group ◽  
Case Group ◽  
College Hospital ◽  
Medical College ◽  
Coronary Syndrome ◽  
Luminal Stenosis ◽  
Angiographic Evidence ◽  
The Mean ◽  
High Uric Acid

Background: Few studies have assessed the relation of hyperuricacidemia with the acute coronary syndrome (ACS). This study investigated the association between high uric acid levels with the presence and severity of ACS.  Methods: Three hundred and seventy patients having angiographic evidence of atherosclerosis (CAD + case group) compared to 170 patients with no luminal stenosis (n=110) or with <50% luminal stenosis (n=60) at coronary angiography (CAD – control group). Results: The mean age of the patients was 60 ± 10 years (317 men, 58.7%). Hyperuricacidemia was more likely associated with a trend toward higher vessel scores, indicating a more severe CAD (adjusted OR=1.51, 95% CI=1.09-2.09; P=0.005) in the whole population. A comparison of sex-specific values showed a significant association existed only in men. Conclusions: Asymptomatic hyperuricacidemia may be associated with the presence and severity of ACS. Keywords: Hyperuricacidemia, Severity & Acute Coronary Syndrome.

Sign in / Sign up

Export Citation Format

Share Document