scholarly journals Comparative Efficacy of Phenytoin Versus Lidocaine in the Management of Intractable Seizure in Neonate

2017 ◽  
Vol 25 (2) ◽  
pp. 94-99
Author(s):  
Shah Abdullah Al Baqui ◽  
Md Tafazzal Hossain Khan ◽  
Md Abid Hossain Mollah ◽  
Manisha Banerjee ◽  
Md Mahfuzur Rahman ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Length Of Hospital Stay ◽  
Medical Emergency ◽  
Neonatal Seizure ◽  
P Value ◽  
College Hospital ◽  
Lidocaine Group ◽  
Medical College ◽  
Group A ◽  
Group B

Background : Intractable neonatal seizure are common acute medical emergency in neonatal period than at any other period of life. In our daily practice treatment of intractable neonatal seizures still relies primarily on phenytoin, despite an estimated efficacy of less than 50% and concern over neurodegenerative side effects. Several studies indicate value for lidocaine as an anticonvulsant in the treatment of intractable neonatal seizure.Aim : The objective of this study was to compare the efficacy of Phenytoin with Lidocaine in the management of intractable seizure in neonate.Methodology : A Randomized control trial was carried out in the Department of Neonatology, Dhaka Medical College Hospital (DMCH), Dhaka between July 2013 to June 2014. A total of 78 newborn with neonatal seizure. admitted in SCABU & not responding to total doses of Inj. Phenobarbital (40 mg/kg) were included in the study and were randomly assigned to either Inj. Lidocaine (Group A=39) or to Inj. Phenytoin (Group B=39). The main outcome variables were control of seizure, adverse effects, time of cessation of seizure.Results : The study demonstrated that intractable seizure of 24 neonates (75%) were controlled with Inj. Lidocaine and intractable seizure of 20 neonates (57.1%) were controlled with Inj. Phenytoin(P-Value 0.124). Adverse effects of drugs such as apnea, bradycardia, drowsiness and lethargy were observed in 4 patients (12.5%) of Lidocaine group (Group A) and 10 (28.6%) of Phenytoin group (Group=B) (P-Value 0.106). Time required for cessation of intractable seizures were nearly similar in both groups. In group A 75% of patients responded within 24 hours and in group B 71% patients responded in same duration(P-Value 0.931). Length of hospital stay was less in phenytoin group compare to lidocaine group(P-Value 0.352). None of the following results were statistically significant.Conclusion : The study concluded that Inj. Lidocaine is similar to Inj. Phenytoin in controlling intractable neonatal seizure.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 94-99

Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

2021 ◽  
Vol 15 (5) ◽  
pp. 1134-1135
Author(s):  
M. A. Chhutto ◽  
A. H. Mugheri ◽  
A. H. Phulpoto ◽  
I. A. Ansari ◽  
A. Shaikh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
P Value ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

scholarly journals Haematocrit Value in Preeclampsia

2016 ◽  
Vol 30 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Sankar Kumar Basak ◽  
Kohinoor Begum ◽  
Maliha Rashid ◽  
Nahid Yasmin ◽  
Hasina Begum
Keyword(s):  
Pregnant Women ◽  
Strong Association ◽  
Cross Sectional Study ◽  
P Value ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Group A ◽  
The Mean ◽  
Group B

Objective(s): To assess the association between the haematocrit value and severity of preeclampsia.Materials & Methods: This cross sectional study was conducted in the department of Obstetrics & Gynaecology of Dhaka Medical College Hospital, Dhaka during the period of January 2012 to December 2013. Total of 100 patients were studied and they were divided into two groups – group-A and group-B. Fifty preeclamptic patients were included in the group-A and 50 normal pregnant women were included in the group-B.Results: Majority of preeclamptic women (68%) and normal pregnant women (76%) were in the age group of 20-30 years with the mean ages of group-A and group-B subjects were 26.50±5.71 and 26.26±4.91 years respectively. Eighty six percent of group-A and 70% of group-B women were of lower socioeconomic status. Majority of the study subjects (74% of group-A and 80% of group-B) were housewife. More than half (54%) of the preeclamptic women were primigravid and 60% of normal pregnant women were multigravid. Among the preeclamptic subjects 16 (32%) had mild hypertension (DBP<110mmHg) and 34 (68%) had severe hypertension (DBP ? 110 mmHg). Out of 50 preeclamptic subjects 45 (90%) had severe proteinuria (+++) and only 5 (10%) had moderate (++) proteinuria.The mean haematocrit value of preeclamptic patients was 34.881±3.03 and that of normal pregnant women was 31.94±1.2. It was statistically significant (P value 0.001). The mean haematocrit value of normal pregnant, mild and severe preeclamptic women were 31.94±1.2, 33.31±2.57 and 35.62±2.95 respectively. It was also statistically significant (P value 0.001).Conclusion: This study shows that haematocrit value of preeclamptic patients is significantly higher compared to that of the normal pregnant women (P<0.05). There is a strong association of increasead haematocrit and preeclampsia.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 80-85

scholarly journals Comparative Study on Planned repeat Caesarean Section and Unplanned Repeat Caesarean Section

2016 ◽  
Vol 24 (1) ◽  
pp. 57-61
Author(s):  
Jinnatun Nur ◽  
Rashida Khanom ◽  
Sumaya Akter
Keyword(s):  
Caesarean Section ◽  
Subsequent Pregnancy ◽  
T Test ◽  
P Value ◽  
Retrospective Case ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
First Time

Repeat Caesarean section always carries more risk than first time caesarian delivery. In our country, antenatal care is always neglected. When this negligence occurs during subsequent pregnancy who had already goes on Caesarean section for the first pregnancy. In our study, we try to compare between the planned and unplanned repeat Caesarean section. The study was carried out at Mymensingh Medical College Hospital, Mymensingh and Amina Nursing Home at Charpara Mymensingh. This was a retrospective case control study, There were 100 patients in Group: A, (Planned repeat Caesarean section), Group B was also consisted with 100 patients (Unplanned repeat Caesarean section). Odd ratio was measured. Odd ratio between group; A and Group: B was 2.8. The two groups were compared by their age and independent t test was carried out. Group: A. Mean ± SD 25.76 ± 4.461Group: B. Mean ± SD = 26.12 ± 5.513. By pair independent t test: P value: .076ns. So we can conclude that regular antenatal Check up is mandatory for those whose 1st delivery was conducted by Caesarean section irrespective of age and economical status.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 57-61

scholarly journals Comparative study between the outcome of Laparoscopic Palomo and open inguinal Varicocelectomy

2015 ◽  
Vol 22 (2) ◽  
pp. 156-162
Author(s):  
Uttam Karmaker ◽  
SM Mahbub Alam ◽  
Md Shafiqul Alam Chowdhury ◽  
Mohammed Mizanur Rahman ◽  
Md Nazmul Islam ◽  
...  
Keyword(s):  
Semen Quality ◽  
Sperm Count ◽  
Semen Analysis ◽  
Testicular Atrophy ◽  
P Value ◽  
College Hospital ◽  
Medical College ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

Background: The ideal method of varicocele treatment is a controversial issue. The present study was designed to compare the outcome of laparoscopic palomo and open inguinal varicocelectomy. Methods: The present quasi experimental study was conducted in the Department of Urology, Dhaka Medical College Hospital, Dhaka, between July 2010 and June 2012 to compare the outcome of open inguinal and laparoscopic Palomo approach of varicocelectomy. Purposively selected 50 patients were divided into equal two groups, Group A and Group B treated with open inguinal varicocelectomy and laparoscopic Palomo varicocelectomy respectively. Statistical analyses were done by using SPSS and p value <0.05 was considered as significant. Results: In the present study, mean age of the patients of Group A and Group B were 29.1 ± 2.0 and 28.9±1.5 years respectively. Among the patients of Group A developed neither hydroeele nor testicular atrophy, where as in patients of Group B 20% and 12% developed hydrocele and testicular atrophy respectively. The recurrence rate of varicocele was lower in the Group A than that in the Group B. The findings of semen analysis at 1st and 2nd follow up visits show that there was negligible improvement in semen quality in terms of sperm count, motility and morphology. Conclusion: Open inguinal varicocelectomy is better than laparoscopic palomo varicocelectomy. Although sooner return to work is achieved by laparoscopic varicocelectomy, complications are more frequent than the open inguinal method. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21527 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 156-162

scholarly journals Effectiveness of tibolone in the management of postmenopausal symptoms

2021 ◽  
Vol 53 (1-2) ◽  
pp. 31-34
Author(s):  
Shamima Akhter ◽  
Md Nazrul Islam ◽  
Nasreen Akhter ◽  
SM Kamal
Keyword(s):  
Adverse Effects ◽  
Placebo Treatment ◽  
Baseline Assessment ◽  
College Hospital ◽  
Medical College ◽  
Postmenopausal Symptoms ◽  
Night Sweats ◽  
Group A ◽  
Group B

Background: Tibolone is a synthetic hormone relplacemert therpy prepration with estrogenic, progestogenic and androgenic tissue selective mechanism of action. It has advantages over traditional preparations of estrogen and progesterone considering the risks and adverse effects. Objective: To evaluate the extent of effectiveness and adverse effects of Tibolone. Method: This clinical trial was done in Khulna Medical College Hospital between January to December 2019. Postmenopusal women were selected by inclusion and exclusion criteria. Alternate participant was included in two different group. Participants of group A was treated with Tibolone for 6 months and participants of group B was treated with placebo for 6 months. Each participant was followed up after 3 and 6 months. Four categories of postmenopausal symptoms (hot flushes, night sweats, sleep disturbance and mood swinging) were evaluated. Participants were monitored for any adverse effects. Severity of postmenopausal symptoms was measured by using menopausal visual analogue scale. Results: Total 90 partcipants, were enrolled in this study, half of them were included in each group. Baseline assessment in group A participants revealed mild, moderate and severe symptoms in 05 (12%), 29 (64%) and 11 (24%) women respectively. After 6 months of treatment with tibolone, 35 (78%) participants became asymptomatic. This improvement is statistically significant (p<0.001). In group B, participant's baseline assessment revealed mild, moderate and severe symptoms in 07 (16%), 28 (62%) and 10 (22%) cases respectively. After 6 months of treatment with placebo, 02 (05%) women were asymptomatic. This improvement is not statistically significant. No adverse event was observed during treatment with tibolone. Comparison between the tibolone and placebo treatment group showed, tibolone treatment is better. Conclusion: Tibolone effectively relieves the postmenopausal symptoms and improves the quality of women's health at menopause. Bang Med J Khulna 2020: 53 : 31-34

Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin
Keyword(s):  
Comparative Study ◽  
Acute Urinary Retention ◽  
Bladder Capacity ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

scholarly journals Role of Combined Mifepristone and Misoprostol Verses Misoprostol Alone in Induction of Labour in Patients with Intrauterine Foetal Death - a Randomized Comparison Between their Outcome

2017 ◽  
Vol 8 (1) ◽  
pp. 50-54
Author(s):  
Sharmin Abbasi ◽  
Sehereen Farhad Siddiqua ◽  
Mohammad Noor A Alam ◽  
Suha Jesmin ◽  
Md Mahmudur Rahman Siddiqui ◽  
...  
Keyword(s):  
Fetal Death ◽  
Research Work ◽  
Medical College Hospital ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death ◽  
College Hospital ◽  
Medical College ◽  
Misoprostol Group ◽  
Group A ◽  
Group B

Background: Intrauterine fetal death is means- intrapartum death after the fetus has reached the age of viability8. As in IUFD journey, labor pain will be fruitless. So, it is of utmost importance to search for the method which can reduce hours of pain in labor of IUFD cases.Metarials Methods: In this research work patients divided in two groups. Induction of labour in one group was given by combination of mifepristone and misoprostol other group by misoprostol only and we try to find out the best method. To compare the effectiveness, induction to delivery interval, safety and side effects of combination of mifepristone and misoprostol versus conventional use of misoprostol alone in induction of labour in patients with intrauterine fetal death. It is a Prospective randomized comparative study in Anwer Khan Modern Medical College Hospital and Dhaka Medical College Hospital among 70 patients with IUFD after 28 weeks of gestation during January 2014- January 2016.Result: We allowed the patients up to third gravid and after 28 weeks of gestation. Patients were grouped as Group A(35) & Group B (35). In Group A Induction was given by single oral dose of 200 mg mifepristone, and after 48 hours, tab. Misoprostol in post. fornix started if <34 weeks-100 ?gm dose and >34 weeks-50 ?gm dose. Doses were repeated every 6 hourly intervals if required. In Group B Induction was given by 100 ?gm misoprostol at 6 hourly interval in post. Fornix. In both groups we allowed misoprostol maximum 600 ?gm. Oxytocin was given for augmentation if needed. The two study groups did not differ demographically. Induction to delivery time was shorter with combined regimen group (P<0.001). Induction to delivery interval ranges from 10-12 hours in mifepristone plus misoprostole group.In only misoprostol group it was about 24-26 hours. Doses of misoprostol was lower in combined group (P<0.001). 4 patients need Oxytocin for augmentation in only misoprostol group. In combined group oxytocin was not needed. The two groups did not differ as regards complications experienced during labour and delivery significantly. In overall out come 2 failed induction in misoprostol only group but not in combinedgroup.Conclusion: In Induction of IUFD mifepriston plus misoprostol is an effective combined group. It is safe, non invasive, easily tolerable, highly cost effective, had less induction to delivery interval, required less dose of misoprostol and no need of augmentation with oxytocin. So,the combined group is more effective than conventional regimen of misoprostol alone.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 50-54

scholarly journals Outcome of Premature Rupture of Membranes – A Study of 120 Cases in Dhaka Medical College Hospital

2017 ◽  
Vol 25 (2) ◽  
pp. 82-86
Author(s):  
Afrina Begum ◽  
Tabassum Ghani ◽  
Subinoy Krishna Paul ◽  
Taufiqua Hussain ◽  
Noorjahan ◽  
...  
Keyword(s):  
Medical College Hospital ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Hypertensive Disorder ◽  
Premature Rupture ◽  
Maternal Complications ◽  
College Hospital ◽  
Medical College ◽  
Group A

Introduction: Premature rupture of membrane or PROM means when membrane ruptures before the onset of labour at a gestational age less than 37 completed weeks. In Bangladesh, every year, around 28,000 women die due to complications of pregnancy and childbirth. Nonscientific intervention in PROM made at various levels intensify the pregnancy complications several times, thereby leading many more deaths of foetus and newborn. Aetiology of PROM is largely unknown. The possible causes are either reduction of membrane strength or an increase in intrauterine pressure or both. Proper diagnostic facilities, proper monitoring and standard protocol in the management can improve the maternal and fetal outcome.Aim and objective: The aim of the study was to observe the incidence, type and maternal and fetal outcome of PROM.Materials and Method: A prospective case control analytical study was carried out at Dhaka Medical College Hospital, Dhaka from May ‘2000 to December‘2000. Total 120 patients were selected for this study among them 60 patients as case (Group A) and 60 patients were taken as control (Group B). Both primi and multigravida with Pregnancy more than 28 weeks with intact membrane as control and spontaneous rupture of membrane taken as case. High- risk patients such as hypertensive disorder of pregnancy, APH, cardiac disease, previous H/O caesarean section were excluded from the study. After taking proper history, speculum examination, some diagnostic investigations were carried out. Findings were recorded in predesigned questionnaire and statistical analysis were done using computerized software SPSS for Windows. A P value < 0.05 was taken as significant.Results: In our study maternal complications were significantly higher in Group A patients (Chi-square test: X2 = 6.263, df= 1, P< 0.05). Number of premature babies in PROM patients (25%) was significantly higher than control group. Perinatal morbidity was found higher in PROM (36.66%) compared to control group (31.66%). Most common morbidity was neonatal jaundice in PROM patients (13.33%) compared to babies of control group (8.33%).Conclusion: This study focused on certain risk factors in relation to PROM which can be preventable and reduce incidence and improvement of maternal and fetal outcome.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 82-86

scholarly journals A comparison of epidural analgesia provided by Bupivacaine plus Pethidine, Bupivacaine plus Morphine, or Bupivacaine plus Morphine plus Midazolam for lower limb Orthopaedic surgery

2014 ◽  
Vol 4 (1) ◽  
pp. 19-21
Author(s):  
NR Sharma ◽  
U Rai ◽  
S Panthee ◽  
P Shrestha
Keyword(s):  
Epidural Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Epidural Morphine ◽  
P Value ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Good Patient Satisfaction

Epidural anaesthesia and analgesia in orthopaedic surgeries helps to prevent thromboembolic phenomenon by increasing venodynamics. Adequate post operative analgesia with good patient satisfaction has been observed with this technique. The objective of this study was to assess the duration of postoperative analgesia and complications in patients receiving epidural anesthesia with morphine, midazolam and pethidine in combination with bupivacaine. We prospectively studied 75 Patients who were scheduled for elective lower limb orthopaedic surgery with epidural anaesthesia. This study was conducted from March 2010 to March 2012 at Lumbini Medical College Palpa. They were randomly divided by lottery method into three equal groups. Group ‘A’ (BP) received 50 mg epidural pethidine (3 ml) with 0.5 % bupivacaine 13 ml. Group ‘ B’ (BM) received 5 mg (3 ml) epidural morphine with 13 ml of 0.5% bupivacaine and Group’ C’ (BMM) received 5 mg (1 ml) epidural morphine with 13 ml 0.5% bupivacaine and 2 mg (2 ml) epidural midazolam. All the patients were observed for 24 hours for quality of analgesia and other side effects like nausea vomiting, and pruritus. Data were analysed by SPSS-16.0 software. The result of the study shows the duration of analgesia was prolonged in BMM group than BM, and BP group and was statistically significant (P value <0.001). Incidence of nausea and vomiting in BMM group was lower than that of BP and BM group but was statistically insignificantly (P value 0.489). Pruritus was absent in BP group and was more with BM and BMM group (P value 0.007). In conclusion the use of epidural morphine and midazolam in combination with bupivacaine is the satisfactory method of post operative analgesia. By adding midazolam, duration of analgesia can be increased with decrease in incidence of nausea, vomiting and pruritus. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10842 Journal of Chitwan Medical College 2014; 4(1): 19-21

Sign in / Sign up

Export Citation Format

Share Document