scholarly journals Diaphragmatic Hernia with Atypical Presentation - A Case Series

2014 ◽  
Vol 32 (1) ◽  
pp. 45-50
Author(s):  
SMA Shahid ◽  
MN Ali ◽  
M Ahmed ◽  
SS Islam ◽  
SB Hossain

Congenital Diaphragmatic Hernia is one of the most challenging diagnosis faced by pediatric surgeons. From the time of its first anatomic description more than 300 years ago, CDH has carried a high mortality rate. We aimed to review patients who presented with hernia of diaphragm during the last six months. In this retrospective study, the medical records of three patients treated for diaphragmatic hernias who were admitted to Rajshahi Medical College Hospital between July 2012 and December 2012 were analyzed. Three patients with age of 45 days to 7 years were included in the study. Male to female ratio was 1:2. All patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic. One patient needed thoracotomy incision. No patient required mesh repair. The mean hospitalization time was 14 days. There was no postoperative death. Diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21050 J Bangladesh Coll Phys Surg 2014; 32: 45-50

1991 ◽  
Vol 105 (11) ◽  
pp. 899-900 ◽  
Author(s):  
R. Raman ◽  
John Mathew ◽  
John Idikula

AbstractAn analysis of 420 consecutive cases of obliterative otosclerosis seen in the Christian Medical College Hospital, Vellore is presented. The proportion of truly obliterative otosclerosis is 33.09 per cent (139 ears). Our male to female ratio in truly obliterative otosclerosis is 1.48:1, while in the non-obliterative group it was 1.34:1. The mean age at onset in the obliterative group was 19.14 while in the non-oblierative group it was 25.60. This is statistically (P<0.001). The age at presentation was 25.90 in the obliterative group while in non-obliterative group it was 30.86; this is also statistically significant (P<0.001). However the time interval between the age at onset and the age at presentation is not statistically significant.


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 &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.


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.


2019 ◽  
Vol 17 (1) ◽  
pp. 16-19
Author(s):  
Roman Kidwai ◽  
Anup Sharma

Background: About 30% of patients presenting to surgical outpatient department has lower gastrointestinal (LGI) symptoms. Colonoscopy is a low risk and at the same time investigation of choice in these patients which allows visualization of the entire colon and the terminal portion of ileum. This study was done to find out the diagnostic accuracy of colonoscopy in relation to the clinical symptoms of the disease.  Methods: This was a prospective, hospital based study from February 2014 to March 2019 carried out at Nepalgunj Medical College and Teaching Hospital. The colonoscopy diagnosis was compared with the clinical symptoms and further confirmed with histological examination.  Results: 341 patients underwent colonoscopy. There were 234 (68.62%) males and 107 (31.37%) females with the male to female ratio of 2.18: 1. The age ranged from 16 to 81 with the mean age of 59.63±10.37. The most common presenting symptom was per rectal bleeding (40.34%) the after were alteration in bowel habit (17.30%), constipation (12.90%), hematochezia (11.43%). The least common indication for colonoscopy was unexplained anemia. Haemorrhoids were the most common findings consisting 32.55%. In 19.94% it was normal. Majority had various inflammatory conditions, among them 10.85% had proctocolitis, 2.34% were suspected to have ulcerative colitis. There were 17(4.98%) patients with colonic and 13(3.18%)with rectal carcinoma. 10.55% had colorectal polyps. Out of 111 patients suspected to have hemorrhoids clinically 102 had same findings on colonoscopy. Similarly 34 patients presenting with chronic diarrhea with bleeding and 59 with alteration in bowel habit where inflammatory conditions were suspected had similar findings on colonoscopy in 29 and 34 patients respectively. Similarly the suspicion of malignancy on clinical basis was also correlated on colonoscopy. The inflammatory conditions diagnosed on colonoscopy were confirmed in 85.04 % by histology. Similarly malignancy and the presence of polyps diagnosed on colonoscopy were confirmed by histology in 97.05% and in 97.22% cases respectively. Conclusion: Colonoscopy is a safe and effective investigation to diagnose various colorectal conditions. There was a correlation between the clinical symptoms and the colonoscopicdiagnosis especially in conditions like inflammatory and neoplastic colorectal diseases. When combined with histology the diagnostic accuracy can be near 100% in conditions like inflammatory and benign or malignant diseases.


2019 ◽  
Vol 4 (1) ◽  
pp. 645-648
Author(s):  
Bishwa Nath Adhikari ◽  
Pramod Sharma Gautam ◽  
Shishu Upadhyay ◽  
Uday Chandra Prakash

Introduction: Globally, the most common cause for diminution of vision is refractive errors and the number of patients with refractive errors is increasing day by day. The Auto-refraction (AR) is quick and patient friendly procedure as compared to retinoscopy and subjective refraction in finding out refractive errors. Hence, the accuracy of Auto-refractometer in terms of subjective acceptance (SA) should be taken into account before prescribing optical correction based on findings of that particular model of Auto-refractometer. So, this study is directed towards analysis of the accuracy of GRK-2200T Auto-retieratometer in terms of acceptance by comparing findings of AR with that of SC. Objectives: The aim of this study was to assess the refractive status of patient's eyes using auto refractometer (GRK-2200T auto-retierato meter) and to estimate the agreement of it in terms of accuracy in acceptance of subjective correction by the patient. Methodology: A hospital based prospective comparative study conducted on 226 eyes of 113 patients who visited out-patient department (OPD) of Ophthalmology at Nobel Medical College and Teaching Hospital (NoMCTH), Biratnagar diagnosed with Myopia, Hyperopia and Astigmatism. Duration of study was 4 months from 2nd October, 2018 to 2nd February, 2019. All data thus collected was subjected to statistical analysis by using SPSS version 22. Result The mean age of the study subjects was 26.91±7.79 years with male to female ratio of 0.47. When spherical power, cylindrical power and the axis are taken into consideration together, only 13.3% of the total tested eyes subjectively accepted the AR values unchanged. On subjective correction, 32.7% of the tested eyes accepted spherical power while 46.5% accepted cylindrical power and 50.9% accepted axis of AR unchanged. About 52.2% of the total eyes examined fall within the deviation of spherical equivalent (SE) of ±o.25D and up to 67.3% of them fall within the deviation of ±o.50D. Conclusion The auto refraction by GRK-2200T auto-retieratometer was found to be satisfactory for a preliminary refraction but not satisfactory as substitutes for conventional subjective refraction. However, auto refraction values obtained by GRK-2200T auto-retieratometer could be important in order to accurately prescribe the cylindrical power as well as its axis than the spherical component.


2020 ◽  
Vol 23 (2) ◽  
pp. 171-179
Author(s):  
Md Zahidul Islam ◽  
Md Abdur Rahman ◽  
Md Sirajul Islam Mahfuz

Purpose: To analyse the prevalence, distribution and presentation of different congenital head-neck lesions with their age, sex, site and side predilection. Methods: 50 patients of head-neck congenital swelling was selected from january/2013 upto december/2013 in the OPD of otorhino-laryngology, head and neck deptt. of Dhaka medical college hospital under a specific prospective study protocol. Results: The most frequent swelling was thyroglossal cyst(42%), followed by branchial arch anomalies (18%),dermoid cyst(14%),pre-auricular sinus(14%),lymphangioma(8%) and haemangioma(4%).Amongst the cervical swellings the sequential preponderence was thyroglossal cyst(52%),branchial arch anomalies(23%),dermoid cyst(13%), lymphangioma(10%) and haemangioma (2%).The majority of branchial arch anomalies(100%) were of second arch. The majority of patients were of first(52%) and second(30%) decade and the male to female ratio for thyroglossal cysts was 1:1.1.The majority of lesions were painless swelling and all were surgically excised. Conclusion: The overall frequency and age-sex distribution of congenital head-neck swellings as well as site, nature and type specific predominance of some of them in OPD of Dhaka medical college hospital are almost similar to international findings. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 171-179


2014 ◽  
Vol 2 (2) ◽  
pp. 73-78
Author(s):  
Md. Akbar Hossain Bhuyian ◽  
Md. Abdullah Al Farooq ◽  
Md. Minhajuddin Sajid ◽  
MA Mushfiqur Rahman ◽  
Md. Momtazul Hoque ◽  
...  

Background: Ascariasis is a common gastrointestinal infestation worldwide. It affects more children who live in poor hygenic condition. Pediatric surgeons are supposed to manage related surgical complications of ascariasis.Objective: To evaluate the recent pattern of occurrence of intestinal and biliary ascariasis with morbidity and mortality related to it.Materials and Methods:Study design: Retrospective study.Period of study: Study was conducted between Jan 2006 - Dec 2011 (total 06 years).Place of study: This study was carried out in the department of Pediatric Surgery, Chittagong Medical College Hospital (CMCH), Chittagong; Bangladesh.Study Subjects: Patients admitted and diagnosed as intestinal (1591) and biliary (181) ascariasis in the department of Pediatric surgery, CMCH were evaluated.Results: A total of 1772 patients were admitted with surgical complication of ascariasis. Among them 1591 (89.78%) patients were diagnosed as intestinal ascariasis and 181 (10.22%) patients as biliary ascariasis. Age range was 6 months to 12 years with mean age of 6 years for intestinal ascariasis. Biliary ascariasis presented between 3 years to 12 years with mean age of 7 years. Male (1060) suffered more than female (531). Male to female ratio was 2:1 for intestinal ascariasis while females (120)  suffered more than male(61) in biliary ascariasis ( ratio 2: 1). Total 231 surgery both elective and emergencies were done.Discussion: Most of the patients (52-81% ) were treated by endoscopic removal of worm from common bile duct. Some patients (15 - 31 %) were treated successfully by conserevative approach. Only a few patients needed open surgical procedure. No patient had died from biliary ascariasis and death from complications of intestinal ascariasis reduced from 20% to 4% over the last 6 years.Conclusion: There has been a reduced number of disease burden over the last few years from ascariatic and biliary ascariasis.DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19551


2017 ◽  
Vol 3 (1) ◽  
pp. 3-5 ◽  
Author(s):  
Md Shafiul Alam ◽  
Md Abdus Salam ◽  
Tayseer Farzana ◽  
ASM Raushan Newaz ◽  
Md Saiful Islam

Background: Spinal tuberculosis is more frequently reported in developing countries.Objective: The purpose of the present study was to see the socio-demographic characteristics of spinal tuberculosis patients.Methodology: This study was carried out in the Department of Neurosurgery, Dhaka Medical College Hospital during the period of January 2002 to December 2004 to elucidate the effectiveness of surgical and conservative treatment of the tuberculosis of the spine. For this purpose, a total number of 50 consecutive cases admitted during the study period with tuberculosis of the spine supported by investigations were included in this study.Result: The mean age of the patients was 25.4 years and ranged from 7 years to 68 years. The highest incidence of tuberculosis of the spine was found in age group between 11 to 20 years and 70% of the patients were under 30 years of age. Incidence of tuberculosis of this spine was more in male (62%) in comparison to female (3 8%) with a male female ratio of 1.63:1. In this study most of the patients came from low class society (66%) followed by middle class (28%) and high class (6%) respectively.Conclusion: Spinal TB more frequently occurs among the young age group with a male predominance.Bangladesh Journal of Infectious Diseases 2016;3(1):3-5


2020 ◽  
Vol 32 (2) ◽  
pp. 126-129
Author(s):  
Jahangir Alam Mazumder ◽  
Md Golam Mustafa ◽  
AHM Delwar ◽  
Shazibur Rashid ◽  
Md Mostafizur Rahaman ◽  
...  

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified. Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities. Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%). Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation. Medicine Today 2020 Vol.32(2): 126-129


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