scholarly journals Outcome of Surgical Management in Spontaneous Supratentorial Intracerebral Hemorrhage Patients: A Randomized Control Trial

2018 ◽  
Vol 3 (1) ◽  
pp. 37-41
Author(s):  
Mohammad Rafiqul Islam ◽  
Mohammad Ashraful Haque ◽  
Amir Mohammad Khan ◽  
Md Mahfuzur Rahman ◽  
Kazi Nur Asfia ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Randomized Control Trial ◽  
Conservative Group ◽  
Medical College ◽  
Group I ◽  
Surgical Evacuation ◽  
Study Population ◽  
Randomized Control ◽  
One Year ◽  
Outcome Of Surgery

Background: Management of spontaneous supratentorial intracerebral hemorrhage is crucial.Objective: The purpose of the present study was to compare the outcome of surgery in relation to conservative management of spontaneous supratentorial intracerebral hemorrhage.Methodology: This was a single centred, parallel randomized control trial which was conducted in the Department of Neurosurgery at Dhaka Medical College and Hospital from January 2010 to October 2011 for a period of one year and ten months. All hypertensive patients with spontaneous supratentorial intracerebral hemorrhage who were admitted within 48 hours of stroke in Neurosurgery Department during the study period were considered as a study population. Patients underwent surgery was considered as group I and patients those who did not give the consent for operation were treated conservatively was considered as group II. Surgery and conservative groups were matched in age.Result: A total of 31 patients were enrolled in this study. Fourteen (14) patients underwent surgical evacuation while seventeen (17) patients those who didn’t give consent for operation were selected for conservative therapy. The distribution of the study patients according to GOS (30 days) that 6(42.9%) and 10 (58.8%) patients in surgery and conservatively managed patients were dead respectively; however, 4(28.6%) patients in surgery and 3(17.6%) patient in conservative group had good recovery. Besides, 2(14.3%) surgery patients and 3(17.6%) conservative patients were severe disabled. Moreover, 2(14.3%) surgery patients and 1(5.9%) conservative patients were moderately disabled.Conclusion: In conclusion surgical evacuation of spontaneous supratentorial intracerebral hemorrhage has a benefit on outcome compared to conservative medical treatment.Journal of National Institute of Neurosciences Bangladesh, 2017;3(1): 37-41

scholarly journals Correlation of Glasgow outcome scale (GOS) and Haematoma Volume during Surgical and Conservative Management of Spontaneous Supratentorial Intracerebral Hemorrhage Patients

2020 ◽  
Vol 17 (1) ◽  
pp. 9-14
Author(s):  
Mohammad Rafiqul Islam ◽  
Mohammad Ashraful Haque ◽  
Khaled Ahmedur Rahman ◽  
Mohammad Mahfuzur Rahman ◽  
Moazzam Hossain Talukder ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Conservative Management ◽  
Glasgow Outcome Scale ◽  
Significant Negative Correlation ◽  
Hematoma Volume ◽  
Conservative Group ◽  
Medical College ◽  
Haematoma Volume ◽  
Group I ◽  
Group Ii

Background: Haematoma volume is an important issue for the management of spontaneous supratentorial intracerebral hemorrhage patients. Objective: The purpose of the present study was to correlate the Glasgow outcome scale (GOS) and haematoma volume during surgical and conservative management of spontaneous supratentorial intracerebral hemorrhage patients. Methodology: This randomized control trial which was conducted in the Department of Neurosurgery at Dhaka Medical College and Hospital from January 2010 to October 2011 for a period of one year and ten months. All hypertensive patients with spontaneous supratentorial intracerebral hemorrhage who were admitted within 48 hours of stroke in Neurosurgery Department during the study period were considered as a study population. Patients underwent surgery was considered as group I and patients those who did not give the consent for operation were treated conservatively was considered as group II. Surgery and conservative groups were matched in age, GCS, GOS, hematoma location and volume of hematoma. Result: A total of 31 patients were enrolled in this study of which 14 patients underwent surgical evacuation and 17 cases were selected for conservative therapy. Significant negative correlation was found between GCS on admission with hematoma volume in surgery group (r=-0.631; P=0.016) and conservative group (r=- 0.854; p=0.001). A negative but not significant correlation (r=-0.426; P=0.129) between GOS with hematoma volume in group I, where negative significant correlation (r=-0.503; P=0.039) in conservative group II. Conclusion: In conclusion Glasgow outcome scale (GOS) is positively correlated with the haematoma volume during surgical and conservative management of spontaneous supratentorial intracerebral hemorrhage patients Journal of Science Foundation 2019;17(1):9-14

scholarly journals Comparison of Glasgow Outcome Scale (GOS) and Glasgow Coma Scale (GCS) between Surgical and Conservative Management of Spontaneous Supratentorial Intracerebral Hemorrhage Patients: A Randomized Control Trial

2018 ◽  
Vol 5 (2) ◽  
pp. 49-54 ◽  
Author(s):  
Mohammad Rafiqul Islam ◽  
Md Shafiqul Kabir Khan ◽  
Md Mahfuzur Rahman ◽  
Moajjam Hossain Talukder ◽  
Md Rezaul Karim ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Intracerebral Hemorrhage ◽  
Conservative Management ◽  
Glasgow Outcome Scale ◽  
Randomized Control Trial ◽  
Coma Scale ◽  
Group I ◽  
Randomized Control ◽  
Gcs Score

Background: Glasgow outcome scale (GOS) and Glasgow Coma Scale (GCS) were the important parameter for the proper management of spontaneous supratentorialintracerebral hemorrhage patients.Objective: The purpose of the present study was to compare the GOS and GCS between surgical and conservative management of spontaneous supratentorialintracerebral hemorrhage patients.Methodology: This randomized control trial was conducted in the Department of Neurosurgery at Dhaka Medical College and Hospital from January 2010 to October 2011 for a period of one year and ten months. All hypertensive patients with spontaneous supratentorial intracerebral hemorrhage who were admitted within 48 hours of stroke in Neurosurgery Department during the study period were considered as a study population. Patients underwent surgery was considered as group I and patients those who did not give the consent for operation were treated conservatively was considered as group II.Result: A total of 31 patients were enrolled in this study of which 14 patients underwent surgical evacuation and 17 patients were selected for conservative therapy. Significant positive correlation was found between the GCS score on admission and GOS at 30 days follow-up in surgery group (r=0.649; p<0.05). But a positive significant correlation (r=0.613; P=0.020) was between GCS follow up with GCS on admission in surgery patients and (r=0.575; P=0.016) in conservative group.Conclusion: In conclusion both GOS and GCS are essential during the management of surgical and conservative spontaneous supratentorialintracerebral hemorrhage patients.Journal of Current and Advance Medical Research 2018;5(2):49-54

B Lynch Suture and Intrauteribne Balloon Tamponade for Management of Severe Postpartum Hemorrhage: A Comparative Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Postpartum Hemorrhage ◽  
Randomized Control Trial ◽  
P Value ◽  
Bleeding Control ◽  
Balloon Tamponade ◽  
Group I ◽  
Randomized Control ◽  
Group Ii

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate

scholarly journals Effect of pentoxifylline on histological activity and fibrosis of nonalcoholic steatohepatitis patients: A one year randomized control trial

2017 ◽  
Vol 5 (3) ◽  
pp. 155-163 ◽  
Author(s):  
Shahinul Alam ◽  
SKM Nazmul Hasan ◽  
Golam Mustafa ◽  
Mahabubul Alam ◽  
Mohammad Kamal ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Nonalcoholic Steatohepatitis ◽  
Randomized Control Trial ◽  
Lifestyle Modification ◽  
Control Group ◽  
Open Label ◽  
Histological Activity ◽  
Randomized Control ◽  
One Year ◽  
Lobular Inflammation

AbstractBackground and ObjectivesTo observe the effect of Pentoxifylline for 1 year on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis (NASH).Materials and MethodsA single center, open label Randomized Control Trial. Patients were included if they had ultrasonographic evidence of fatty liver and nonalcoholic fatty liver disease activity score (NAS) ≥ 5 on liver histology. A total of 35 patients were selected; 25 of PL (Experimental) group and 10 of L (Control) group. PL group received 400 mg pentoxifylline thrice daily along with lifestyle modification and there was only lifestyle modification for the L group. After one year, NAS and fibrosis was compared in both groups.ResultsIn PL group, NAS improved 2.10 ± 1.07; whereas in L group, NAS was 0.90 ± 0.99 (P = 0.006). As per the protocol analysis, NAS ≥ 2 improved in 15/20 (75%) in PL group and in 3/10 (30%) in L group (P = 0.018). In PL group, the individual component of NAS, steatosis improved from 2.30 ± 0.66 to 0.95 ± 0.76 (P = 0.000), lobular inflammation from 1.65 ± 0.59 to 1.05 ± 0.51 (P = 0.002) and hepatocyte ballooning from 1.50 ± 0.51 to 1.30 ± 0.57 (P = 0.258). In L group, steatosis improved from 2.30 ± 0.68 to 1.40 ± 1.08 (P = 0.01), lobular inflammation and hepatocyte ballooning did not improve. The fibrosis score did not improve in any group. In PL group, NAS improved significantly (P = 0.027; OR=22.76, CI=1.43-362.40) independent of weight reduction.ConclusionPentoxifylline for 1 year improves the hepatic histological activity but not fibrosis of NASH patients.

scholarly journals DUAL EFFECT OF ATORVASTATIN ON ENDOTHELIUM

2015 ◽  
Vol 22 (09) ◽  
pp. 1196-1202
Author(s):  
Faizania Shabbir ◽  
Muhammad Alamgir Khan ◽  
Tausif Ahmed Rajput
Keyword(s):  
Colorimetric Method ◽  
The Body ◽  
Sprague Dawley ◽  
Dual Effect ◽  
Immunosorbant Assay ◽  
Group Iii ◽  
Medical College ◽  
Group I ◽  
Randomized Control ◽  
Enzyme Linked Immunosorbant Assay

Objective: The objective of the study was to observe the effect of lipid loweringtherapy on homocysteine and TXA2 concentration in obese hyperlipidemic Sprague Dawleyrats. Design: Randomized Control Trial (RCT). Place and Duration of study: The study wasconducted in Department of Physiology and Centre for Research in Experimental and AppliedMedicine (CREAM), Army Medical College, Rawalpindi; and National Institute of Health (NIH)Islamabad over a period of 12 months. Methodology: Ninety healthy Sprague Dawley ratsdivided into three equal groups. Group I (n=30) were healthy controls, group II (n=30) weremade obese and group III (n=30) were obese treated (atorvastatin 10 mg/kg/day orally bygavage method for three weeks). Body weight was recorded thrice weekly, lipid profile wasmeasured by colorimetric method on microlab and homocysteine and TXA2 were measuredby Enzyme Linked Immunosorbant Assay. Results: Serum low density lipoproteins and TXA2decreased after three weeks of atorvastatin administration, elevated HCY concentration in obesehyperlipidemic rats however was not significantly affected. Conclusion: Atorvastatin apart fromlowering lipid levels in the body also reduces TXA2 concentration which is a vasoprotective.Elevated HCY concentration which is deleterious to the endothelium however is not affected.

scholarly journals A-V Fistula Blood Flow and Complications: A One Year Survey

2014 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Tania Mahbub ◽  
Md. Nizamuddin Chowdhury ◽  
Ferdous Jahan ◽  
Aparna Das ◽  
Md. Motlabur Rahman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cross Sectional Study ◽  
Visualization Technique ◽  
Colour Doppler ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Study Population ◽  
One Year ◽  
Venous Fistula

Background: Worldwide haemodialysis(HD) is the mostly used method of renal replacement therapy. Arteriovenous fistula use is on rise due to Fistula First Initiative due to least complications of fistulae than catheters.But they are also subjected to many complications. Thereby appropriate surveillance of the fistulae is important.Objectives: To measure the blood flow as well as fistula related complications in study population. Materials and Methods: This was a cross sectional study, conducted in the department of Nephrology, Dhaka Medical College Hospital during September 2010 to December 2011.Total 118 subjects were included in the study. Besides visualization technique colour Doppler ultrasonogram of fistula and  echocardiography were performed for each patients. Results: Most of the patients had adequate fistula flow. Aneurysm was most common complication. Many subjects were suffered from primary and secondary fistula failure. Conclusion: Arterio-Venous fistula is subjected to many complications and appropriate surveillance should be launched to detect complications and to prevent fistula failure.DOI: http://dx.doi.org/10.3329/jom.v15i2.20681 J MEDICINE 2014; 15 : 110-113

scholarly journals A community based study of scenario of glaucoma in Aligarh, India

2019 ◽  
Vol 6 (9) ◽  
pp. 4098
Author(s):  
Syed Zulfequar Ahmad ◽  
Anees Ahmad ◽  
Najam Khalique ◽  
Yasir Alvi
Keyword(s):  
Open Angle Glaucoma ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Angle Closure ◽  
Cross Sectional ◽  
Medical College ◽  
Primary Angle Closure Glaucoma ◽  
Study Population ◽  
Eye Examination ◽  
One Year

Background: Glaucoma is the leading cause of irreversible blindness worldwide and is second only to cataracts as the most common cause of blindness overall. In the developing world, the prevalence of glaucoma is expected to rise even more dramatically as the population of adults has doubled within a span of few decades. So this study was done with an objective of finding out the prevalence of glaucoma among adults aged 40 years and above in the field practice area of the Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh.Methods: A cross-sectional study was carried out for the duration of one year. A total of 680 persons were interviewed and examined by a trained ophthalmologist for detailed eye examination including visual acuity, refraction and slit-lamp bio-microscopy, intraocular pressure (IOP) by Keeler Pulsair non-contact tonometer confirm by applanation tonometry, gonioscopy, and dilated fundus examination after ruling out the risk of angle closure. Anderson criteria were used to diagnose glaucomatous visual field defect.Results: In our study population, the IOP of the majority of population lied in 11-15 mm Hg with a mean IOP of 13.42±4.09 mmHg. In regard to optic disc examination, a cup to disc ratio of >0.6 was found in 35 eyes. According to the predefined criteria, a total of 31 subjects were diagnosed as glaucoma in either one or both eyes. The overall prevalence of glaucoma was found to be 4.6% (31/680), with the prevalence of primary open angle glaucoma, primary angle closure glaucoma, normotensive glaucoma and secondary glaucoma as 1.3%, 1.2%, 1.2% and 0.9% respectively.Conclusions: The prevalence of glaucoma is quite high in an elder population of Aligarh. This should warrant more intensive activities, focusing not only on early diagnosis and management of glaucoma but also include strengthening preventive ophthalmic care.

scholarly journals Comparative Efficacy of Phenobarbitone versus levetiracetam in the initial treatment of neonatal seizure

2020 ◽  
Vol 27 (2) ◽  
pp. 182-189
Author(s):  
Md Tafazzal Hossain Khan ◽  
Mohammed Mahfuzur Rahman ◽  
Manisha Banerjee ◽  
Md Zahir Uddin ◽  
Nurun Nahar ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Hospital Stay ◽  
Initial Treatment ◽  
Randomized Control Trial ◽  
Neurodevelopmental Outcome ◽  
Neonatal Seizure ◽  
Neonatal Seizures ◽  
College Hospital ◽  
Medical College ◽  
Randomized Control

Neonatal seizures are common in the first month of life and may impair neurodevelopmental outcome. Phenobarbitone (PB) currently represents the anti epileptic drug (AED) of choice, despite related to cognitive impairment in human subjects and limited efficacy. Intravenous levetiracetam is increasingly being used in the neonatal period to treat seizures. Presently, insufficient data about the efficacy and safety of intravenous levetriacetam in neonates, we have structured a randomized control trial with levetiracetam in the initial treatment of acute neonatal seizure. Objective: To find out the efficacy of levtiraracetam for controlling the convulsions in acute neonatal seizures compared to phenobarbitone. Methodology: The study was a randomized control trial. A total of 100 neonates from 0 day to 28 days of age irrespective of sex with clinical presentation of neonatal seizures admitted in the special care baby unit (SCABU) of Dhaka Medical College Hospital were included in the study and were randomly assigned to either levetiracetam or Phenobarbitone group after matching inclusion and exclusion criteria. The outcome variables were seizure control, times taken to be seizure free, and hospital stay. Outcome was evaluated through routine monitoring up to 48 hours and followed up to discharge or death. Result: The study groups were almost similar with respect to their demographic characteristics like age, sex and gestational age. According to maternal obstetric data i.e- antenatal care (ANC), modes of delivery in the both groups were statistically not significant. Seizures status was nonsignificant in both groups. The study demonstrated that controlling the seizure with levetiracetam & Phenobarbitone were 66.0% and 34.0% respectively. Length of the hospital stay was shorter in levetiracetam group. Eventually the phenobarbitone group required more than one drug to control seizures.. But immediate adverse effect was not significant in both groups. Conclusion: The study concluded that levetiracetum significantly control the convulsion in comparison to phenobarbitone as first line antiepileptic drug in the initial treatment of acute neonatal seizures. Both the modalities of treatment were found to have no adverse effect. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 182-189

scholarly journals Effectiveness of ultrasound-guided hydrostatic reduction of intussusception in children

2020 ◽  
Vol 27 (2) ◽  
pp. 134-140
Author(s):  
Sumi Datta ◽  
Md Jamal ◽  
Yesmina Rahman ◽  
Mahbuba Hussain ◽  
Fahmida Yeshmina ◽  
...  
Keyword(s):  
Success Rate ◽  
Nonoperative Treatment ◽  
Age Group ◽  
Ultrasound Guided ◽  
Interventional Study ◽  
Hydrostatic Reduction ◽  
Medical College ◽  
Study Population ◽  
One Year ◽  
Successful Reduction

Aim: To review the effectiveness of ultrasound- guided hydrostatic reduction of intussusception in children. Methods: This prospective interventional study was done during one year period from January 2014 to December 2014 in the department of Radiology and Imaging of Dhaka Medical College and Hospital, Dhaka and included 30 children clinically and radiologically diagnosed as intussusception with symptoms d” 48 hours. They underwent ultrasound-guided hydrostatic reduction using normal saline and the effectiveness of this technique was reviewed. Results: Majority of the study population were in the age group of 7-24 months with mean age of 9.04± 2.48 months. 100% patients who presented within 24 hours of their symptoms achieved successful reduction whereas success rate of reduction were 95% and 0% respectively in patients presented within 24-36 hours and after 36 hours of their symptoms. 60% cases required 5-10 minutes for successful reduction, 20% cases required 3-5 minutes and 10% patients needed > 10 minutes. Within 3 attempts, reduction happened in 90% cases whereas 10% cases failed to reduce. No case was tried for reduction after 3 attempts in consideration of the bowel pathology and complications. Only 10% patients developed negligible complications. No case showed recurrence. Conclusion: Ultrasound guided hydrostatic reduction of intussusception is an effective nonoperative treatment of intussusception in children because of its high success rate, less complications and recurrence rate. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 134-140

scholarly journals Comparison between Pendant Positions versus Traditional Sitting Positions for Successful Spinal Puncture in Patients Undergoing Caesarean Deliveries

2021 ◽  
Vol 15 (7) ◽  
pp. 1804-1806
Author(s):  
Noman Tariq ◽  
Shahid Rasool Dar ◽  
Khalid Abaidullah ◽  
Sunila Riaz
Keyword(s):  
Pregnant Women ◽  
Randomized Control Trial ◽  
Needle Insertion ◽  
Sitting Position ◽  
Spinal Puncture ◽  
Standard Position ◽  
Group I ◽  
Randomized Control ◽  
Group Ii ◽  
Better Than

Aim: To determine the effectiveness among pendant position and traditional sitting position in term of successful spinal puncture in patients underwent caesarean deliveries. Study Design: Randomized control trial Place and Duration of Study: Department of Anaesthesia, Ghurki Trust Teaching Hospital, Lahore from 1st April 2020 to 31st March 2021. Methodology: One hundred and eighty patients were included. Patient’s detailed demographics were recorded after taking written consent. Patients were aged between 20-50 years. Patients were equally divided into two groups, group I had 90 patients underwent pendant position and group II had 90 patients and underwent for traditional sitting. Randomly one of two positions was performed with the L3-L4 interface in spinal puncture. Time for successful spinal puncture, number of needle to bone contacts and total number of attempts were calculated. Results: Mean age of the patients in group I was 27.6±17.04 years with mean BMI 24.25±2.63 kg/m2 and in group II, mean age was 29.23±14.24 years with mean BMI 26.55±6.36 kg/m2. Mean height of patients in group I was 2.6524±1.0054 meter and in group II was 2.6516±1.0042 meter. Weight of the patients in group I 63.48±22.13 kg and in group II was 65.46±17.19 kg. Success rate after first attempt in group I was 80 (94.44%) and group II was 72 (80%). For spinal needle insertion, fewer mean times was observed in group I 19.55±11.221 sec as compared to group II 28.14±18.226 sec. Number of needle to bone contacts was higher 66.7% in group I and in group II 40%. Number of attempt was less in group I as compared to group II. Conclusion: The pendant position in the pregnant women who had a caesarean sector was much better than the standard position in order to provide the 1st attempt of spinal puncture. Keywords: Caesarean, Spinal anaesthesia, Traditional sitting, Pendant position

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