scholarly journals Pattern of Childhood Cholelithiasis- Experience in a Tertiary Level Hospital

2021 ◽  
Vol 16 (1) ◽  
pp. 8-11
Author(s):  
Shams ud Din Elias Khan ◽  
Md Mahbubur Rahman ◽  
Zinia Parveen ◽  
Meherun Nessa ◽  
Md Shakhawat Hossain
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Gallstone Formation ◽  
High Rate ◽  
Military Hospital ◽  
Biliary Colic ◽  
Tertiary Level ◽  
Paediatric Surgery ◽  
Age Group ◽  
Level Hospital

Introduction: Cholelithiasis is being frequently diagnosed in children, although not as often as in adult. The real aetiology of gallstone formation is poorly understood, but some inciting factors are assumed to be involved in gallstone formation in children. Traditionally cholelithiasis in children is classified as haemolytic or nonhaemolytic in origin. Nonhaemolytic cholelithiasis seems to be more frequent than haemolytic cholelithiasis at present. Aim: To find out the pattern of childhood cholelithiasis presenting in a tertiary level military hospital. Methods: This retrospective observational study was carried out in the Department of Paediatric Surgery, CMH Dhaka from January 2015 to December 2018. A total of 35 children with cholelithiasis were admitted in this hospital. Results: During the study period 35 children with cholelithiasis were admitted. Among them maximum children 31(88.6%) were in the age group of 6-12 years. Out of them 23(65.7%) were female and 12(34.3%) were male making a female to male ratio of 1.92:1. Twelve children (34.3%) were asymptomatic and 23(65.71%) were symptomatic. Among symptomatic group 10(28.6%) had biliary colic, 10(28.6%) had nonspecific abdominal pain and 3(13.0%) had acute abdominal pain. Out of these 35 children, only 4(11.4%) had link with haemolytic anaemia. Conclusion: Cholelithiasis in children is being recognized with increased frequency in recent years. The ratio of cholecystitis and cholelithiasis varies considerably in different countries and centres. Childhood cholelithiasis has less chance of complication and high rate of resolution. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 8-11

scholarly journals Outcome of Peritoneal Dialysis in Children : Experience in a Tertiary Level Hospital in Chittagong, Bangladesh

2013 ◽  
Vol 12 (3) ◽  
pp. 34-36
Author(s):  
Kamal Hossain ◽  
Md Badruddoza ◽  
AMM Ehteshamul Hoque
Keyword(s):  
Peritoneal Dialysis ◽  
Obstructive Uropathy ◽  
Complete Recovery ◽  
Tertiary Level ◽  
Paediatric Surgery ◽  
Age Group ◽  
Medical College ◽  
Practical Procedure ◽  
Level Hospital ◽  
Child Age

Objective: The objective of the study is to see the outcome of peritoneal dialysis in child age group ranging from 6 months to 15 yearsadmitted in ChattagramMaa- Shishu-O-General Hospital ICU setup. Methods: Patients were selected randomly who admitted with the indication of renal replacement therapy.Intermittent peritoneal dialysis was done in 10 patients from February 2012 to January 2013. Results: Out of ten patients eight survived and two died due to complication.The success rate is 80%.Among the survivors four made complete recovery with no complication and another fourwere sent to paediatric surgery for treatment of obstructive uropathy, the primary cause of the renal failure. Conclusion: The data presented indicate that peritoneal dialysis is an effective type of dialysis, that it is safe, that it can be accomplished with a minimum of equipment and that a trained team is essential for its efficient use. It is the preferable practical procedure currently available by which dialysis of an anuric infant or small child can be accomplished. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 34-36

scholarly journals Pattern of Children Presenting with Inguinal Hernia and Hydrocele- Experience in a Tertiary Level Hospital

2017 ◽  
Vol 13 (1) ◽  
pp. 46-50
Author(s):  
Zinia Parveen ◽  
Shams ud Din Elias Khan ◽  
Sharmeen Sultana ◽  
Sangita Mithun ◽  
Mst Nasrin Nahar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Treatment ◽  
Military Hospital ◽  
Tertiary Level ◽  
Indirect Inguinal Hernia ◽  
Paediatric Surgery ◽  
Processus Vaginalis ◽  
Female Ratio ◽  
Patent Processus Vaginalis ◽  
Level Hospital

Introduction: Inguinal hernias and hydroceles are among the common surgical problems in children. Both the hernia and hydrocele share a similar aetiology. Inguinal hernia in a child is usually an indirect inguinal hernia due to patent processus vaginalis. Likewise a fluid filled sac typically found in the scrotum may result from patent processus vaginalis or due to an imbalance between the secretion and absorption within the tunica vaginalis. Very little study was done in Bangladesh on inguinal hernia and hydrocele though these are very common in children. Objective: To observe the pattern of inguinal hernia and hydrocele amongst the children reported to a tertiary level hospital. Materials and Methods: This observational study was carried out in the Department of Paediatric Surgery, Combined Military Hospital, Dhaka during the period of January 2014 to December 2017. During the study period, a total of 258 children with inguinal hernia and hydrocele admitted in this hospital for operative treatment were included in this study. Results: During the study period 258 children with inguinal hernia and hydrocele were operated. Among them 246 (95.35%) had inguinal hernia and 12(4.65%) had hydrocele. Out of the children with inguinal hernia 206 (83.74%) were male and 40(16.26%) were female with male female ratio of 5.15:1. All had indirect inguinal hernia. Right side was involved in 140(56.91%) children. Out of 246 children with inguinal hernia, 161(65.44%) reported between 6 months to 5 years. Thirteen (5.28%) presented before 6 months and 72 (29.27%) presented after 5 years of age. All children were operated by traditional open method as admitted case. Among 12 children with hydrocele 10(83.33%) had right sided hydrocele and 2(16.67%) had hydrocele on the left side. Conclusion: Inguinal hernia and hydrocele occur most frequently in premature neonates. Inguinal hernia does not resolve spontaneously and there is high risk of incarceration requiring operative treatment as early as possible. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 46-50

scholarly journals Torsion of the Omentum: A Rare Cause of Acute Abdomen in a 14-Year-Old Boy

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Chijioke Chinaka ◽  
Shahbaz Mansoor ◽  
Mohamed Salaheidin
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Acute Abdominal Pain ◽  
Age Group ◽  
First Line ◽  
Omental Torsion ◽  
Younger Age ◽  
Remarkable Recovery ◽  
Rule Out

Acute abdominal pain is a common surgical presentation, and most often, the first line of consideration is to rule out acute appendicitis; this is more so when the patient is an adolescent or within younger age group. In most cases, other differentials are considered before omental torsion. Omental torsion is a cause of acute abdominal pain and sometimes mimics acute appendicitis in its presentation. We present a case of a 14-yr-old boy who presented with acute abdomen with symptoms mimicking acute appendicitis. Laparoscopy revealed torsion of the omentum. Omentectomy and appendicectomy were done, and the child discharged four days after following a remarkable recovery.

scholarly journals Colocolic Intussusception in an Older Child: A Rare Case Report and a Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Anupam Das ◽  
Lalmalsawma Ralte ◽  
A. S. Chawla ◽  
S. V. Arya ◽  
Anil Kumar ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
X Rays ◽  
Age Group ◽  
Rare Entity ◽  
Pediatric Age Group ◽  
Rare Case Report ◽  
Descending Colon ◽  
Polypoidal Growth ◽  
Fluid Levels

Intussusception is a common cause of intestinal obstruction and colicky abdominal pain in the children, particularly infants, the commonest being the ileocolic variety with colocolic variety being a very rare entity. We present a case of colocolic intussusception in a 13-year-old boy which is otherwise seen in adults, precipitated by colonic malignancies. The patient presented with acute abdominal pain and bleeding perrectum with obstipation for 7 days. Preoperative USG abdomen was normal, and abdominal X-rays showed multiple air fluid levels. Intraoperative findings included a polypoidal growth in the descending colon as the leading point with the formation of a colo-colic intussusception. Following reduction and segmental resection, histopathology reported mucinous adenocarcinoma of colon which is also a rarity in pediatric age group. This case has been compared with previous cases reported in the literature.

scholarly journals ACUTE ABDOMINAL PAIN IN CHILDREN

2015 ◽  
Vol 22 (08) ◽  
pp. 1080-1086
Author(s):  
Muhammad Ali Sheikh ◽  
Tariq Latif
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdominal Pain ◽  
Paediatric Surgery ◽  
Discharge Diagnosis ◽  
Lower Quadrant ◽  
Rebound Tenderness ◽  
Presenting Symptoms ◽  
Symptoms And Signs ◽  
Right Lower Quadrant

Objective: To determine the clinical outcomes of acute abdominal pain andevaluation of symptoms and signs in children admitted in pediatric surgery department.Design: Cohort study. Place and Duration of study: This study was conducted in Departmentof Paediatric Surgery Shaikh Zayed Hospital, Lahore between August 2010 to August 2012.Patients and methods: Children aged 2 to 14 years who presented to emergency departmentwith complaint of acute abdominal pain of less than 5 days duration and admitted in pediatricsurgery department were included. Presenting symptoms, signs, hospital course of patientsand discharge diagnosis were recoded. Data was analyzed by SPSS. Results: Out of 73104patients who were seen in Paediatric emergency 1420 (1.94%) were referred for surgicalevaluation. Out of these 157 children were admitted. Six patients left against medical adviceso 151 patients were studied. Patients were divided into acute appendicitis, non-specificpain abdomen and miscellaneous categories on the basis of discharge diagnosis. Acuteappendicitis was diagnosed in 61(40.4%) patients. The patients who were admitted and nocause of pain abdomen could be found in them, were included in non-specific pain abdomengroup. NSPA group had 39 (25.8%) patients. Rests of the 51 (33.8%) patients were includedin miscellaneous group. Anorexia, fever, pain in right lower quadrant, tenderness in right iliacfossa, guarding, rebound tenderness and tachycardia were all significantly higher in patientswith acute appendicitis. Conclusion: Most of the children with acute abdominal pain wouldnot require surgery. Detailed history and thorough physical examination are cornerstone of thediagnosis.

scholarly journals Clinical Profile of Hypertrophic Cardiomyopathy in a Tertiary Level Hospital

2014 ◽  
Vol 7 (1) ◽  
pp. 31-37
Author(s):  
MA Malek ◽  
SA Iqbal ◽  
Z Khan ◽  
AFMS Haque ◽  
SA Sultana
Keyword(s):  
Primary Care ◽  
Hypertrophic Cardiomyopathy ◽  
Primary Care Physicians ◽  
Functional Limitation ◽  
Transmitted Disease ◽  
Phenotypic Expression ◽  
Left Ventricular ◽  
Military Hospital ◽  
Tertiary Level ◽  
Level Hospital

Background- Hypertrophic cardiomyopathy (HCM) is a genetically transmitted disease with diverse natural history for which the potential to produce adverse consequences has been emphasized. However, the possibility of this disease remaining clinically dormant for many years has not been as widely appreciated. Certainly, the clinical recognition of previously undiagnosed patients with HCM may be advantageous by permitting risk stratification for sudden cardiac death or for timely pharmacologic therapy when symptoms intervene. The purpose of this study was to assess the disease pattern and the extent to which hypertrophic cardiomyopathy (HCM) exists undetected in a suspected group of population never diagnosed to have any cardiovascular disease, referred from the primary care facilities to one of the largest tertiary level hospital of Bangladesh. Methods-We prospectively conducted an echocardiographic survey in 3648 cases between 19-03-2009 to 03-08-2010 (18 months) in the cardiac centre of Combined Military Hospital, Dhaka, Bangladesh. Results- A total of 3648 cases referred by primary care physicians underwent echocardiogram either to confirm a new diagnosis or to exclude obvious cardiovascular abnormalities. Hypertrophic cardiomyopathy was identified in 148 patients (4.06%) who was not known have any cardiac disease before. At diagnosis, age ranged from 20 to 83 years (mean 52.19) with male gender preponderance (85.81%). Ninety eight patients (67%) had no functional limitation and the remaining fifty patients reported with symptoms mostly giving multiple responses like chest pain (39.2%), palpitation (18.9%), dyspnoea (22.3%), unusual fatigability (16.9%) and syncope (6.8%). Twelve patients had strong suspicion of familial predisposition depending on the symptomatology of the familial tree but were confirmed only in 03 cases by echocardiography. Basal left ventricular outflow obstruction (gradients 20 to 76 mm Hg) was evident in 14 patients (9.45%). Relatively variable phenotypic expression of the disease was substantiated by diffuse thickening of left ventricular wall occurring more commonly than localized distributed hypertrophy (56.08% vs. 43.94%, respectively). Electrocardiogram was abnormal in almost 95% of cases and typical pattern of left ventricular hypertrophy was observed in 25.68% cases. Conclusion -This prospectively assembled data show that HCM cases may remain asymptomatic, clinically dormant and undetectable for many years (often to advance ages) in our community. The actual prevalence of the disease in our community needs to be ascertained which might exceed the prevalence mentioned in the text books. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20798 Cardiovasc. j. 2014; 7(1): 31-37

scholarly journals Acute Abdomen in a Peripheral Military Hospital

1970 ◽  
Vol 5 (2) ◽  
pp. 36-39
Author(s):  
MA Matin ◽  
AKMZ Siddiq ◽  
MM Hasan
Keyword(s):  
Abdominal Pain ◽  
Acute Abdomen ◽  
Conservative Management ◽  
Acute Abdominal Pain ◽  
Large Fraction ◽  
Rapid Onset ◽  
Military Hospital ◽  
Female Predominance ◽  
Life Threatening ◽  
Patient’S History

The term 'acute abdomen' is widely used but poorly defined. Essentially it represents a rapid onset of severe symptoms that may indicate a life threatening intra-abdominal pathology. This observational study was carried out at Combined Military Hospital (CMH) Ghatail (n=87) and CMH Momenshahi (n=63) from June 2006 to June 2007. A total of 150 patients admitted in the surgery ward clinically diagnosed as acute abdomen were studied. The goal of evaluating the patient with acute abdominal pain was to establish an early, efficient, and accurate diagnosis. When evaluating a patient with acute abdominal pain, the most important elements in making an accurate early diagnosis were the patient's history and physical examination. Acute abdominal pain was more common in the age group 21 to 30 years (50%) with female predominance (72.67%). Some patients presented without any associated symptoms other than abdominal pain, other presented with vomiting and fever in addition to abdominal pain. Sixty two (41.33%) patients had no positive findings in laboratory investigation; radiology and ultrasonography. Most of them did not require any surgical intervention. Large fraction of cases (40%) was diagnosed as non specific abdominal pain. Maximum patients (59.33%) responded with conservative management and 40.67% patient required operative treatment. Key words: Acute abdomen, conservative management, non specific pain abdomen. DOI: 10.3329/jafmc.v5i2.4582 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.36-39

Bayesian Diagnostic Probabilities without Assuming Independence of Symptoms

1991 ◽  
Vol 30 (01) ◽  
pp. 15-22 ◽  
Author(s):  
A. Gammerman ◽  
A. R. Thatcher
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Final Diagnosis ◽  
Bayes Theorem ◽  
Bayes Method ◽  
Hospital Records ◽  
Computer Diagnosis ◽  
Bayes Model ◽  
Chi Squared ◽  
Past Data

The paper describes an application of Bayes’ Theorem to the problem of estimating from past data the probabilities that patients have certain diseases, given their symptoms. The data consist of hospital records of patients who suffered acute abdominal pain. For each patient the records showed a large number of symptoms and the final diagnosis, to one of nine diseases or diagnostic groups. Most current methods of computer diagnosis use the “Simple Bayes” model in which the symptoms are assumed to be independent, but the present paper does not make this assumption. Those symptoms (or lack of symptoms) which are most relevant to the diagnosis of each disease are identified by a sequence of chi-squared tests. The computer diagnoses obtained as a result of the implementation of this approach are compared with those given by the “Simple Bayes” method, by the method of classification trees (CART), and also with the preliminary and final diagnoses made by physicians.

Menstruation Among Adolescent Girls Living in Rural Border Areas

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Ritu Gupta ◽  
Ravinder K Gupta ◽  
Vallabh Dogra ◽  
Himani Badyal
Keyword(s):  
Abdominal Pain ◽  
Menstrual Cycle ◽  
Blood Loss ◽  
Prospective Study ◽  
Adolescent Girls ◽  
Common Side Effect ◽  
Age Group ◽  
Different Types ◽  
Study Population ◽  
Border Areas

Objective: To study the various beliefs and problems regarding menstruation among adolescent girls living in rural border areas. Design- Prospective study. Setting- Pediatric outpatient clinic. Materials and methods- About 200 adolescent girls (11-19 years) living in rural border areas were enrolled for the study. These girls were asked about menarche, duration of the cycle, amount of blood loss and the various menstrual problems. They were also asked about the various beliefs and myths regarding menstruation. The girls having any illness affecting the menstrual cycle or those suffering from neuropsychiatric disorders were excluded from this study. Results- About 51% of the study population was in the age group 17-18 years. About 43.5% of girls attained menarche at the age of 10-12 years. About 51% of girls did not know about menstruation before menarche. Abdominal pain was the most common side effect seen in 41% of girls during menstruation. About 61% of girls considered themselves unclean during menstruation.  Twenty percent avoided schools, 20% avoided kitchen, 12% avoided temples while 10% stayed away from friends/ relatives. Only 33% of girls knew that menstruation stops temporarily after becoming pregnant. Twenty-two percent girls were using sanitary napkins while the rest used different types of clothes during the menstrual cycle. Conclusion- There is a dire need to educate girls regarding menstruation before menarche in the rural border areas. Every mother should discuss in a friendly way regarding various aspects of menstruation.

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

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