scholarly journals Surgery at Cranio-vertebral (CV) Junction: Our Experience of 32 Cases

1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Type I ◽  
College Hospital ◽  
Chiari Malformation Type I ◽  
Female Ratio ◽  
Medical College ◽  
Neoplastic Lesion ◽  
Wide Range

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)

scholarly journals Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital

2015 ◽  
Vol 4 (1) ◽  
pp. 11-18
Author(s):  
Tahmina Hossain ◽  
Md Ashraf Ul Huq
Keyword(s):  
Inguinal Hernia ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Oral Feeding ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
Laparoscopic Procedures ◽  
Surgical Conditions ◽  
Care Surgery

Purpose: Laparoscopy is gaining popularity over laparotomy in various surgical conditions. Now a day, an increasing number of diagnostic and therapeutic surgical procedures are being done laparoscopically. The aim of this study was to assess the safety and feasibility of laparoscopy in children.Materials and Methods: This retrospective study was carried out in the Department of Pediatric Surgery of Dhaka Medical College Hospital over a period of 52 (Fifty two) months from June 2009 to August 2013. A total of 123 patients were operated laparoscopically up to 12 years of age for different surgical conditions. Data was collected from the hospital records and analyzed retrospectively.Results: Out of these 123 laparoscopically performed cases, Appendectomy was performed in 39 cases, closure of internal inguinal ring for Inguinal Hernia was done in 36 patients, 20 patients underwent Cholecystctomy, 16 patients had laparoscopic procedures for impalpable Undescended Testis (UDT), 5 patients were operated for Adnexal Mass of which one case was converted into open procedure due to technical difficulties and 1 for Pancreatic Pseudo cyst. Diagnostic Laparoscopy was performed for 2 patients with Biliary Atresia and 4 patients for Ambiguous Genitalia. Median age of the patients was 6.08 years (ranging from 2 months to 12 years of age). The length of post operative hospital stay was 2-3 days. All the laparoscopic procedures for Inguinal Hernia and impalpable UDT were performed as day care surgery. Operative and post operative complications were minimal. Other advantages of the laparoscopic procedures were smaller incisions, incidental diagnosis of other associated pathology, lesser post operative pain, earlier oral feeding, quicker mobilization and a better cosmetic result.Conclusion: With the recent development of laparoscopic surgical techniques and equipments, laparoscopic surgical procedures are becoming popular day by day and can be performed safely for both diagnostic and therapeutic purposes in pediatric surgical patients.J. Paediatr. Surg. Bangladesh 4(1): 11-18, 2013 (January)

scholarly journals Acute Kidney Injury in Patients of Intensive Care Unit

2017 ◽  
Vol 8 (1) ◽  
pp. 38-44
Author(s):  
Nazneen Mahmood ◽  
Md Fazlur Rahman ◽  
Md Mostafizur Rahman ◽  
SM Hossain Shahid ◽  
Md Mahmudur Ahman Siddiqui
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Type I ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Failure Group ◽  
Medical College

Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44

scholarly journals Renal Involvement and HBV Infection Are Common in Chinese Patients With Cryoglobulinemia

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Bai ◽  
Lixia Zhang ◽  
Jiuliang Zhao ◽  
Shangzhu Zhang ◽  
Jiaxin Zhou ◽  
...  
Keyword(s):  
Renal Involvement ◽  
Connective Tissue Diseases ◽  
Clinical Manifestations ◽  
Hbv Infection ◽  
Chinese Patients ◽  
Type I ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Significant Difference

Objectives: This study aimed to describe the main characteristics of Chinese patients with cryoglobulinemia, especially the characteristics of patients with different causes of cryoglobulinemia.Methods: Eighty inpatients diagnosed with cryoglobulinemia from different wards in Peking Union Medical College Hospital were included in this study. Demographic, clinical, biological, and renal pathological data were collected. We analyzed the characteristics of 61 patients with different causes of cryoglobulinemia.Results: Most patients (36/80, 45%) were diagnosed between 40 and 60 years of age. The male: female ratio was 1:1.5. Mixed (II + III) cryoglobulinemia accounted for the majority (43.8%) of cases. Renal involvement (87.5%), cutaneous involvement (57.5%), and fever (27.5%) were the most common clinical manifestations, while other manifestations included serositis and pulmonary and gastrointestinal involvement. The most common renal histopathological pattern was membranoproliferative glomerulonephritis (25/42, 59.5%). The secondary causes of cryoglobulinemia included infectious diseases (26/61, 32.5%), such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and connective tissue diseases (22/61, 27.5%), such as lupus and hematologic tumors (13/61, 16.3%). Patients with hematologic tumors were diagnosed at an older age (P = 0.044) and mostly had type I cryoglobulinemia (P < 0.001). No significant difference in clinical or biological manifestations was found among patients with different causes of cryoglobulinemia.Conclusions: This is the largest cohort of Chinese patients with cryoglobulinemia. We found that renal involvement and HBV infection might be more common in Chinese patients with cryoglobulinemia.

scholarly journals Study on Diagnostic Evaluation of Pancytopenic Patients

2020 ◽  
Vol 32 (1) ◽  
pp. 58-61
Author(s):  
Md Rezaul Karim Chowdhury ◽  
Md Haroon Ur Rashid ◽  
Amina Begum ◽  
Shamimur Rahman ◽  
Md Momenuzzaman Khan
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Clinical Findings ◽  
Medical College Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Presenting Symptoms ◽  
Erythroid Hyperplasia ◽  
Medicine Today

Introduction: Pancytopenia is a common hematological problem with an extensive differential diagnosis and is a challenging problem to the treating physician. Bone marrow aspiration and biopsy is an important diagnostic test for patient management. The objective of this study is to find out the incidence various causes of pancytopenia in patients attending to the Enam medical college hospital in savar. Materials and Methods: This prospective observational study was done in the department of haematology, Enam Medical College Hospital (EMCH) from July 2012 to June 2019. Results: In our study out of 66 patients, 36 (54.55%) were male, 30 (45.45%) were female and male to female ratio were 1.2:1.Generalized weakness 47 (71.21%) and fever 23 (34.85%) were the most common presenting symptoms followed by bleeding 17 (25.76%), weight loss 6 (12.12%), bodyache 6 (9.09%). Most common clinical findings were anemia 57 (86.36%) and bone tenderness 22 (33.33%). Other physical findings were purpura/brusing 13 (19.70%), splenomegaly 10 (15.15%), lymphadenopathy 4 (6.06%) and hepatomegaly 3 (4.55%). Hematological malignancy 29 (43.94%) and hypoplastic marrow 26 (39.39%) were the most common bone marrow finding of pancytopenic patients followed by megaloblastic anaemia 4 (6.06%), leishmaniasias 5 (7.58), and erythroid hyperplasia 2 (3.03%). Acute myeloid leukaemia was the common haematological malignancy 16 (24.24%), others were acute lymphoblastic leukaemia 5 (7.58%). Myelodysplastic syndrome 3 (4.55%), multiple myeloma 4 (6.06%), chronic myelogenous leukaemia in blastic crisis 1 (1.52%). Conclusion: So we concluded that complete workup is essential for all cases of pancytopenia to find out the treatable cases and to reduce the motality and morbidity in serious diseases. Medicine Today 2020 Vol.32(1): 58-61

Utility of Tolonium Chloride Rinse in the Diagnosis of Oral Cancer

2020 ◽  
Vol 26 (1) ◽  
pp. 11-17
Author(s):  
Md Kamruzzaman ◽  
Kazi Nurjahan ◽  
AS Gazi Sharifuddin ◽  
SK Ballav
Keyword(s):  
Developing Countries ◽  
Oral Cancer ◽  
Prospective Study ◽  
Diagnostic Delay ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Biopsy Report ◽  
Patient Side ◽  
Tolonium Chloride

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

scholarly journals Predisposing Factors of Scabies among the Patients Attending Skin and Venereal Disease Outdoor of Dhaka Medical College Hospital

1970 ◽  
Vol 9 (2) ◽  
pp. 82-86
Author(s):  
Afzalur Rahman Mahmood ◽  
Zannatun Nur
Keyword(s):  
Standard Deviation ◽  
Venereal Disease ◽  
Family Members ◽  
Predisposing Factors ◽  
Medical College Hospital ◽  
College Hospital ◽  
Socioeconomic Condition ◽  
Female Ratio ◽  
Level Of Education ◽  
Medical College

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

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 <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.

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.

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.

STUDY OF OUTCOME OF CHRONIC KIDNEY DISEASE IN DIABETIC PATIENTS IN THANJAVUR MEDICAL COLLEGE HOSPITAL

2021 ◽  
pp. 17-20
Author(s):  
S.Hema Akilandeswari ◽  
K. Rajkanth ◽  
S. Janani
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Medical College Hospital ◽  
Diabetic Patients ◽  
Type I ◽  
Strong Positive Correlation ◽  
College Hospital ◽  
Medical College

Background: Diabetes Mellitus is one of the common causes of Chronic Kidney Disease which usually leads to end-stage kidney disease. Thus this study was planned to nd out the outcome of CKD in DM, disease progression, appropriate management and the complications. Methods: A cross sectional study among Diabetes Mellitus patients with Chronic Kidney Disease attending the Department of Nephrology and Department of Medicine in Thanjavur Medical College Hospital during the period of July and August 2018. The duration of study period was 2 months. All patients who attended the outpatient department (OPD) and in-patients departments with Type I and Type II diabetes mellitus associated with chronic kidney disease, on any line of management were included in this study. A total of 101 patients were included. Statistical Package for Social Sciences (SPSS for Windows V20) was used for data analysis. Results: Poor glycemic control, albuminuria, hypertriglyceridemia (greater than 150), increase in LDLlevels (greater than 100), BMI (greater than or equal to 25), poor BP control and a longer duration of diabetes mellitus had a strong positive correlation with decrease in eGFR less than 60 ml/min. Glycemic control, weight reduction and adequate BPcontrol retard the progression of CKD. Conclusion: Albuminuria and decline in eGFR both are independent risk factors for diabetic CKD and are strong predictors of morbidity and mortality from a major vascular event, especially cardiovascular complications and stroke.

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