scholarly journals Epidemiology, Clinical Profile and Outcome of Patients of Snake Bite in Mymensingh Medical College Hospital

1970 ◽  
Vol 27 (2) ◽  
pp. 70-75 ◽  
Author(s):  
Md Titu Miah ◽  
AKM Aminul Hoque ◽  
Binoy Krishna Tarafder ◽  
Md Kamal Hossain Patwary ◽  
Raihan Rotap Khan ◽  
...  

Snake bite is a serious global health problem. Incidence is high in Bangladesh and mortality is identified to be one of the highest in the world. Most bites are occurred by nonpoisonous snakes and as many as 40% bites inflicted by venomous snakes do not produce features of envenoming. They need supportive treatment only. Poisonous bites are treated with antivenin. But most people apply tight tourniquet and take useless and harmful treatment from traditional healers before getting admitted in hospital. Delay in diagnosis and treatment causes fatality in many cases. 46 patients admitted in department of Medicine, MMCH from April,07 to March,08 with snake bites were studied. Among them 35% were poisonous and 65% were nonpoisonous bites. Male and female ratio was 3.6:1. Mean age (years) was 34.9 ± 16.2 SD. Mean time of interval between bite and hospitalization (hours) was 7.8 ± 9.5 SD. 94% bites occurred in land and 7% in water. 100% patients applied multiple tourniquets in the affected limb. 24% patients received treatment from traditional healers with development of cellulitis in 64% of them. None received proper first aid management. Most incidences were in July - August. Snakes could not be identified in 50% poisonous and 77% non-poisonous cases. Among the identified poisonous snakes, kraits were 84%. Clinical features were also suggestive of krait bite in 88% poisonous cases. Among poisonous cases, 94% presented with neurological manifestation and ptosis was present in all of them. 75% poisonous snake-bite patients received antivenin and none of them developed anaphylaxis. Among 4 poisonous snake bite patients who did not receive antivenin, 2 survived. Mortality in poisonous cases was 44%. All of the non-poisonous cases improved with supportive treatment. DOI: 10.3329/jbcps.v27i2.4249 J Bangladesh Coll Phys Surg 2009; 27: 70-75

2014 ◽  
Vol 13 (1) ◽  
pp. 7-12
Author(s):  
Prabal Chakraborty ◽  
Jishu Deb Nath ◽  
MA Faiz ◽  
Anannya Das ◽  
Abdul Qayum Chowdhury

Background: Snake bite is an important health hazard which may lead to fatality in rural areas of Bangladesh. An epidemiological study estimated the incidence of snake bite in Bangladesh about 8,000 per year with 22% mortality. In majority of cases the victims die before entrance to hospital because of their treatment seeking behavior from Ohzas. Present study is to see the clinical profile of snake bite cases admitted in Dhaka Medical College Hospital and also to find out problems in diagnosis and management and outcomes.Methods: Fifty patients of snake bites treated in Dhaka Medical College Hospital, Dhaka, Bangladesh between July 2005 and December 2006 were studied. A questionnaire, containing information on bite, physical examination and identification of snake brought was used.Results: Among the patients venomous snake was 6 (50%) with cobra and 6 (50%) with suspected krait bite. Males were bitten more frequently than females 42(82%) versus 9(18%). Regarding occupation, 28 (56%) was farmer. Majority 37(74%) came from rural areas. Highest number of bite occurred in evening 20(40%). Most snake bite occurred during rural foot walking (30%) followed by sleeping (14%).Total 54% of bite occurred during outdoor activities. Most common site of bite is lower limb 35(70%). Tight tourniquet used in 45(90%) cases and in 8(16%) cases limb was immobilized. Twenty eight (56%) of the patients received treatment from Ohzas. All venomous bites (12) presented with features of neurotoxicity with local envenoming in 6(50%) cases. In 6(50%) cases there were only neuroparalysis. Four (33.34 % of venomous snake) patients required respiratory support and 10(83% of venomous bite) patients required antivenom. There were no anaphylactic reactions and only 2 patients suffered pyrogenic reaction. The outcome was excellent with only one death and only one case of residual effects.Conclusion: To develop an appropriate prevention and control strategy, reliable and timely information has a crucial role. A functional mechanism should be developed to gather information not only about the cases and deaths but other aspects of the snakebite epidemiology.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19410


Author(s):  
Meenakshi B. ◽  
Shantaraman K. ◽  
Indhumathi M. ◽  
Arumugapandian S. Mohan

Background: Snake-bites are well-known common medical emergencies in many parts of the world. In India 46,000 people are dying every year from snakebites. However, the true scale of mortality and morbidity from snake-bite remains uncertain. This study analyses the clinical profile and outcomes of the snake bite poisoning in patients admitted to this centre.Methods: This cross sectional study analyses the data of 150patients admitted to the Intensive Medical Care Unit of Tirunelveli Medical College Hospital with the history of snake bite between April and September of 2015 as available in their case records.Results: In this study, 42.7% of the patients were in the age group of 18 to 40 years and 64% were males with rural: urban ratio of 2.3: 1. About 82.7% of bites were haematotoxic, 10.7% neurotoxic and the remaining nontoxic bites. About 54% patients recovered completely, 44% had some form of morbidity at discharge and mortality was 2%. Out of 136 patients who were treated with Anti-snake venom (ASV), 9.6% developed ADR. The common ADR was itching and hypotension followed by rigor, breathlessness and edema of lips and eyes.Conclusions: This study highlights the need for early treatment intervention post bite. Imparting health education about early pre-hospital management and transfer to the hospital will help in the prevention of deaths due to snakebite. Identification of the type of snake is essential to decide on the type of toxicity and method of treatment to be instituted.


2020 ◽  
Vol 6 (5) ◽  
pp. 188-192
Author(s):  
K Karthik Iyer ◽  
◽  
AK Biswas ◽  

Background: Poison is one of the most common reason for admission to an emergency department with half a million death each year attributed to it. Hazaribagh owing to its open fields, and agriculture being the primary source of employment, has its local population exposed to a variety of poisonous agents, both chemical and environmental. Aims and Objective: The purpose of our study is to determine the epidemiology and outcome of the poisoning cases being admitted to our hospital. Study Design: This is a retrospective/prospective observational study over a period of 1 year from July, 2019 to June 2020. Setting: Department of General Medicine, Hazaribagh Medical College and Hospital, Jharkhand. Material and Method: A total of 1318 patients meeting the inclusion criteria were studied. Data was collected by direct interview and the reviewing of case records and entered in a proforma which was later analysed. Result: Our cohort comprised of 37.2% males and 62.7% females with female: male ratio of 1.7:1.The majority were females between the ages of 21-30 years. Upon questioning,63.5% had consumed poison intentionally versus only a 36.5% who were accidentally exposed. Among those with intentional poisoning, 69.1% were females. The incidence of accidental poison exposure on the other hand was similar for both genders 51.5% v/s 49.5%. Maximum incidence was seen in rainy season in the months of June, July and August with 32.9% and least number of cases was reported in the summer months between March and May. The incidence of accidental poisoning was maximum during the rainy reason, predominantly owing to higher incidences of snake bite during these months. Ingestion was the predominant mode of poisoning with 64.5% followed by animal bites and stings. Predominant household or agricultural poison was noted to be pesticides and that among environmental agents was found to be snake bite. Among drugs and plants ingestions, sleeping pills and wild mushroom were most commonly seen. The average duration of hospital stay for cases admitted with poisoning was 2.13±1.2 days. 62.8% patients were treated successfully and discharged, 25.5% left against medical advice, 10.2%were referred due to complications and 1.5% died. Among those who died 18 out of 20 had intentionally consumed pesticides and were all females. Conclusion: Intentional poisoning in the form of para suicide comprised the majority of our cohort closely followed by snake bites, both which were favoured by the geographical location of the study centre. A comprehensive approach targeting the problem at grass root level can lead to decreased in the incidence of such poisoning cases and also reduced the incurred burden on the health care system.


2020 ◽  
Vol 26 (1) ◽  
pp. 11-17
Author(s):  
Md Kamruzzaman ◽  
Kazi Nurjahan ◽  
AS Gazi Sharifuddin ◽  
SK Ballav

Background: Oral cancer burden in developing countries is huge. In Bangladesh and India incidence were 10.6% and 10.4% respectively on 2018. At the same time worldwide incident was only 2%. Majority patients present at advanced stage and their survival rate is poor. Diagnostic delay from patient side and health delivery system side is significantly longer and it is more in developing countries. Like other malignancy early diagnosis can save a lot of these patient. Methods: This prospective study was carried out in Khulna Medical College Hospital from July 2017 to July 2019. Patients who will meet the criteria for this prospective study and capable and willing to give informed consent were enrolled. 20 second rinse/gargle with 10ml of 1% Tolonium chloride solution was done. Biopsy were taken from stained lesion, biopsy report were compared with TC stained lesions. Results: Out of 1650 patients in our outdoor department for various problem and only 30 cases were selected for this study according to selection criteria. Of 30 patients, 18 (60%) were male and 12 (40%) were female. The male-to-female ratio was 3:2. It was found that the sensitivity of 1% Tolonium Chloride rinse for oral precancer and cancer detection was 83.33%, whereas the specificity was 84.21%. Conclusion: Tolonium chloride rinse is a good screening test for oral cancer diagnosis with sensitivity 83.33% and specificity 84.21%. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 11-17


1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)


1970 ◽  
Vol 9 (2) ◽  
pp. 82-86
Author(s):  
Afzalur Rahman Mahmood ◽  
Zannatun Nur

This cross sectional type of descriptive study was carried out among the patients attending the Skin and Venereal Disease (VD) Out Patient Department (OPD) of Dhaka Medical College Hospital (DMCH) from August 2006 to November 2006 with a view to explore the current situation of scabies and its predisposing factors. In this regard 213 clinically diagnosed scabies contracted patients were interviewed randomly by using pre-tested questionnaire. Risk factors were assessed considering their dwelling places, types of families, number of family members, persons living in each room, using fomites of infected persons, socioeconomic condition, occupation, level of education, regular bathing and cloth washing habit along with age, sex distribution and clinical presentation of scabies. The mean age of the respondents was 13.16 years with a standard deviation (SD) of ±5.38 years and majority (36.15%) was in the age group of 1-5 years. Male, female ratio was 1.15:1. Major level of education was in the group of class I to V (38%). 50.73% had family members comprised of 4 to 6. Majority (38.50%) belonged to lower middle class (income 3001-6000 taka/month). Among the respondents maximum (54.93%) were infected by family members. 77.94% respondents used fomites of affected persons and 66% respondents shared beds of infected persons. Mean duration of illness was 42 days with standard deviation of ±4.47 days. Among the male, majority (82.63%) had lesion on lower abdomen and buttock. In contrary, 80.28% female had lesion on hand. 58.68% presented with papule. The study recommends that emphasis should be given on personal hygiene and life style of people as well as educating them about scabies. Key words: Scabies, Predisposing factors, Skin and VD outdoor DOI = 10.3329/jom.v9i2.1436    J MEDICINE 2008; 9 : 82-86


2021 ◽  
Vol 8 ◽  
Author(s):  
Jianchun Xiao ◽  
Zixuan Zhao ◽  
Binglu Li ◽  
Taiping Zhang

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 <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.


2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  

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.


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

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.


1970 ◽  
Vol 19 (1) ◽  
pp. 7-10
Author(s):  
CM Ali ◽  
TK Sikdar ◽  
N Sultana ◽  
N Ahmed ◽  
AKMR Haque ◽  
...  

The study was conducted among 568 patients of STDs out of 58560 male and female patients in the OPD of Dermatology Department of Dhaka Medical College Hospital (DMCH) during the period of March 2009 to February 2010 irrespective of sex and age >15 years with a view to assess the prevalence of sexually transmitted diseases. In this study prevalence of STDs such as gonorrhea, syphilis, non gonococcal urethritis, chancroid, genital herpes and genital warts were 29.58%, 12.68%, 41.58%,4.93%,8.45% and 2.82% respectively; male and female ratio were 3.73:1. The highest prevalence rate was found in age group of 25-34 years (42.25%). According to educational status of the respondents, 33.80% were up to secondary level and only 2.82% were master degree holder. Among occupation 36.62% were in service, and 15.49% were students. According to socioeconomic status 40.14% were poor and only 9.86% were from upper middle class. Key words: Sexually transmitted diseases; prevalence. DOI: 10.3329/jdmc.v19i1.6243 J Dhaka Med. Coll. 2010; 19(1) : 7-10.


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