scholarly journals Aetiological Pattern of Gastrointestinal Perforations: A Prospective Observational Study

2021 ◽  
Vol 29 (2) ◽  
pp. 106-109
Author(s):  
Prosunto Kumar Das ◽  
Chowdhury Md Mushfiqur Rahman ◽  
AZM Mahfuzur Rahman ◽  
Md Nayeem Dewan ◽  
Md Mahmudul Islam ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Early Recognition ◽  
College Hospital ◽  
Female Ratio ◽  
Ulcer Disease ◽  
Medical College ◽  
Surgical Emergencies ◽  
Perforative Peritonitis ◽  
Perforation Peritonitis ◽  
Duodenal Perforations

Introduction: Peritonitis secondary to gastrointestinal perforation is one of the commonest surgical emergencies encountered all over the world. This study was done to highlight the spectrum of perforation peritonitis encountered in surgery unit of Dhaka Medical College Hospital. Method: It was observational prospective of 100 cases of perforation peritonitis treated in our hospital. All cases of perforative peritonitis whether spontaneous, infective or neoplastic pathology were included in this study. Results: The maximum numbers of patients were in age group between 31 to 40 years (39 %) with mean age 35 years. Male female ratio was 9:1. The most common aetiology of perforation peritonitis was peptic ulcer disease (73%) followed by enteric fever (12%), appendicitis (10%), tuberculosis (3%) and malignancy (2%). The most common sites of perforation were in descending order of frequency - first part of the duodenum (65%), terminal ileum (12%), appendix (10%), gastric antrum (9%), jejunum (3%) and rectum (1%). Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (96%), muscle guard and rigidity (100%) were the common signs. Approximately 15-20% presented late with features of shock. Mortality rate was 2% and was significantly high in patients coming hospital late. Conclusion: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever have highest morbidity. Early recognition and timely appropriate intervention is very important in reducing morbidity and mortality. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 106-109

scholarly journals A CLINICAL STUDY AND OUTCOME OF PERFORATIVE PERITONITIS IN A RURAL BASED TEACHING HOSPITAL

2020 ◽  
pp. 1-2
Author(s):  
Kaushik Mandal ◽  
Mohan Kumar Das ◽  
Santanu Dutta ◽  
Anirban Bhunia
Keyword(s):  
Wound Infection ◽  
Early Recognition ◽  
Wound Dehiscence ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Post Operative Period ◽  
Surgical Emergencies ◽  
Study Results ◽  
Perforative Peritonitis ◽  
Gastro Intestinal Tract

Background Peritonitis due to perforation of gastro intestinal tract one of the commonest surgical emergencies all over the world and the most common surgical emergency in India. Aims and objectives to evaluate role of clinical assessment and usefulness of basic investigations in diagnosis and follow-up, to evaluate incidence of wound infection, wound dehiscence in post-operative period, to assess mortality upto1 month of post-operative period. Methods All consenting patients above 18 years treated with symptoms and signs of perforative peritonitis in Burdwan Medical College and Hospital from March 2018 to August 2019 were included in this institution based, interventional, prospective, non-randomised, analytical study. Results We found that 40(80.0%) patients had gas under diaphragm in Chest X-ray report. It was found that 9(18.0%) patients had acute appendicitis, 1(2.0%) patient had appendicular perforation and 40(80.0%) patients had perforative peritonitis. We found that 30(60.0%) patients had chest infection. 10(20.0%) patients had wound infection.6 (12.0%) patients had wound dehiscence. Conclusion Early recognition of symptoms and referral is very important in reducing mortality and morbidity.

scholarly journals Our experience in gastrointestinal perforations: a retrospective study

2017 ◽  
Vol 4 (2) ◽  
pp. 593
Author(s):  
Thammegowda Kemparaj ◽  
Narasimhamurthy Kadirehalli Narasimhaiah ◽  
Ravikiran Keragodu Mayigaiah
Keyword(s):  
Retrospective Study ◽  
Single Unit ◽  
Enteric Fever ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Surgical Emergencies ◽  
Perforative Peritonitis ◽  
Case Files ◽  
Duodenal Perforations ◽  
Surgical Unit

Background: Peritonitis secondary to gastrointestinal perforation is still one of the commonest surgical emergencies in India and is associated with high morbidity and mortality. The present study examines the incidence of various types of gastrointestinal perforations, their complications and the management of patients with postoperative leaks in our surgical unit and compares our findings with those of previous studies performed between 1984 and 2014.Methods: Retrospective study analyzing the case files of all the operated cases of gastrointestinal perforations in a single unit over the last 10 years from September 2005 to August 2015 by open procedure. A total number of 381 cases were studied. All cases with perforative peritonitis, whether spontaneous, infective, traumatic or of neoplastic pathology, were included in the study.Results: Gastrointestinal perforations were common between the ages of 30-50 years; 82% were males. From July to October (rainy seasons) every year a higher number of perforations were noticed; 40% of patients had duodenal, 34% had ileal, 11% appendicular, 6% gastric, 6% jejunal and 3% had colonic perforations. Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (50%) and tachypnea (42%) were common signs; 15-20% presented late with features of shock.Conclusions: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever (typhoid) have highest morbidity and mortality. Most of the anastomotic leaks can be treated conservatively. Mortality depends on the general condition of the patient and associated pre-operative comorbidities.

scholarly journals Peptic Ulcer Disease and Misuses of Ulcer Healing Drugs in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 16 (1) ◽  
pp. 27-34
Author(s):  
Md. Hafiz Md. Hafiz Sardar ◽  
Mohammad Murad Hossain ◽  
Khan Abul Kalam Azad ◽  
Md Uzzwal Mallik ◽  
Moumita Chakraborty
Keyword(s):  
Peptic Ulcer ◽  
Abdominal Pain ◽  
Peptic Ulcer Disease ◽  
College Hospital ◽  
Female Ratio ◽  
Ulcer Disease ◽  
Medical College ◽  
Non Ulcer Dyspepsia ◽  
Irritable Bowel ◽  
Upper Abdominal

This prospective cross sectional study was conducted in Dhaka Medical College Hospital, Dhaka during July, 2013 to December, 2013. Hundred patients were included in this study. Peptic ulcer disease, presented as upper abdominal pain is one of the common disease with a number of underlying causes. Prospective analyses of 100 patients with upper abdominal pain were studied at medicine units of Dhaka Medical College Hospital, Dhaka. Of these 36 patients belonged to peptic ulcer, 20 patients to irritable bowel syndrome and 22 patients to non-ulcer dyspepsia. Next in order were helminthiasis (5 patients), cholelithiasis (4 patients), gastric carcinoma (4 patients), liver abscess (5 patients) chronic pancreatitis (3 patients) and acute pancreatitis (1 patient). Mean age incidence in this series was 39.47 years. Male and female ratio was 1.54:1. Forty patients were smoker with male and female ratio of 3.44:1.All patients had presenting feature of upper abdominal pain. Commonest site of pain was in the epigastrium in 48.08% of cases.Pain was burning in 43.27% cases, periodic pain in 24.03%, and nocturnal hunger pain in 33.65% of cases.Relief of pain after taking food were observed in 38.46%. Epigastric tenderness was present in 56.73% patients.The diagnosis of peptic ulcer disease, irritable bowel syndrome and non-ulcer dyspepsia, the three leading causes of upper abdominal pain, were suspected by history and physical examination but it was difficult to interpret these on clinical ground alone .Some routine and some selected investigation were done for confirmatory diagnosis.In this series, significant disparity detected between clinically diagnosed peptic ulcer diseases 90.38% and endoscopically confirmed peptic ulcer disease, 34.62% cases. As a consequence of wrong diagnosis of PUD, there are huge misuses of ulcer healing drugs and a great economic burden on patients (300 taka per month) and on the nation.DOI: http://dx.doi.org/10.3329/jom.v16i1.22386 J MEDICINE 2015; 16 : 27-34

scholarly journals Prospective study of 50 cases of perforative peritonitis a single centre experience

2017 ◽  
Vol 4 (8) ◽  
pp. 2782
Author(s):  
Prakash B. Patel ◽  
Suryadeep Baria
Keyword(s):  
Prospective Study ◽  
Exploratory Laparotomy ◽  
Medical College ◽  
Primary Peritonitis ◽  
Surgical Emergencies ◽  
Perforative Peritonitis ◽  
Common Etiology ◽  
Perforation Peritonitis ◽  
A Prospective Study ◽  
Surgical Treatments

Background: Perforative peritonitis are most common surgical emergencies seen worldwide. Despite improvement in diagnosis, antibiotics, surgical treatments and intensive care support, it is still an important cause of mortality in surgical patients. This study was done to know the spectrum of etiology, clinical presentation, management and treatment outcomes of patients admitted with perforation peritonitis in our hospital.Methods: A prospective study was done over a period of 3 years from January 2007 to December 2010 in NHL Medical College and V.S. hospital, Ahmedabad which included 50 patients diagnosed with perforation peritonitis. All patients admitted with perforation of gastrointestinal tract were included in this study. All cases of primary peritonitis and anastomotic leaks were excluded from this study.Results: Total 50 cases were included with 80% being males. Highest incidence of perforation peritonitis was noted in 21-30 years of age group in the present study. Most common etiology of perforative peritonitis was noted in the present study was peptic perforation 40% (20) cases, abdominal pain, tenderness were present in all of the perforative peritonitis patients.Conclusions: Perforative peritonitis is more common in male and most common pathology was peptic perforation due to acid peptic disease, in most of the cases after adequate resuscitation and stabilization of the patient Exploratory laparotomy is mainstay treatment modality

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 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 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.

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