Surgical Evaluation of P-Possum and Cr-Possum Scores in Patient Undergoing Colorectal Cancer Operation

2020 ◽  
Vol 6 (2) ◽  
pp. 118-123
Author(s):  
SM Syeed Ul Alam ◽  
Ayesha Rahman ◽  
Akhter Ahmed ◽  
Muhammad Faridul Haque ◽  
Nazia Mehnaz Joty ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Scoring System ◽  
Colorectal Cancer Patient ◽  
Risk Groups ◽  
College Hospital ◽  
Medical College ◽  
Possum Score ◽  
Surgical Evaluation ◽  
Predicted Values ◽  
Possum Model

Background: "Portsmouth" modification of POSSUM (P-POSSUM) scoring system used to assess mortality in general surgical patients and “Colorectal” Cr-POSSUM scoring system used for mortality assessment for colorectal patient. Objective: The purpose of the present study was to estimate the validity of the P-POSSUM (Portsmouth-POSSUM) and Cr-POSSUM (Colorectal-POSSUM) score in predicting the risk of mortality in colorectal cancer patient. Methodology: This was single centre clinical trial was carried out in the Department of Surgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from November 2013 to April 2014 for a period of six (06) months. Patients of both sex who got admitted in the surgery in-patient department for elective colorectal cancer operations were selected as study population. Both the P-POSSUM and Cr-POSSUM, physiological score, operative score, predicted mortality rate were calculated using an online POSSUM calculator. Based on both P-POSSUM and Cr-POSSUM Scoring, patients were categorized into three risk groups. Then a comparative analysis was performed between the observed and the predicted values as well as the Observed/Predicted ratio (O:P) in all the risk groups. Results: A total of 50 patients with the median age of 50 (ranging 20 to 72) years were studied. 30 days overall observed mortality was 3(6%) patients. The mean P-POSSUM and C-POSSUM physiological scores were 32.49±2.08 and 13.92±1.30 respectively. However, the operative score was 11.59±1.46 and 8.12±0.24 in P-POSSUM and C-POSSUM respectively. The overall mortality predicted by the P-POSSUM model was 5 patients (19.33±2.87) and mortality predicted by the Cr-POSSUM model was 4 patients (20.66±4.09). Conclusion: In conclusion both model accurately predicted the risk of postoperative death. Cr-POSSUM provided a better fit to observed results than P-POSSUM. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 118-123

scholarly journals A Study of Maternal Breast Feeding Issues during Early Postnatal Days

2020 ◽  
Vol 2 (4) ◽  
pp. 219-224
Author(s):  
Shreedhara Avabratha K. ◽  
Sweta Shanbhag ◽  
Rilna Clara Joseph ◽  
Varadaraj Shenoy K.
Keyword(s):  
Breast Feeding ◽  
Risk Groups ◽  
General Information ◽  
Feeding Problems ◽  
College Hospital ◽  
Discharge Data ◽  
Medical College ◽  
Discharge From Hospital ◽  
First Interview

Background: The success in breast-feeding is dependent on early initiation and effective management of breast feeding problems during early postnatal days. Objectives: To identify breast feeding problems and their etiologies during early postnatal days until discharge from hospital. Methodology: Descriptive study done in a medical college hospital. One hundred and twenty mothers in early postnatal days were enrolled in the study. Sick mothers, sick neonates admitted in NICU for >24 hours and where breast-feeding was contraindicated were excluded. Data was collected by direct interview with the mother by the investigators and were entered in the proforma. The questionnaire contained general information of the mothers, self-reported and observed problems about breast feeding. The first interview was carried out within 12 hours of delivery after taking informed consent. Follow up interviews were done on 24 hourly basis until discharge. Data was analyzed statistically. Results: Mothers were aged between 22 to 40 years with more than half in 26-30 years range. Majority were homemakers and educated up to high school. 31(25.8%) were primi mothers. 64(53%) had vaginal and 56(47%) had caesarean deliveries. 61.6% of the mothers knew about colostrum and its benefits. Most (98.3%) of the mothers felt that there is a need for education about breast-feeding. Majority had initiated breast feeds within an hour or at least within 4 hours (LSCS mothers). Insufficiency of milk and problems with latching, positioning and sucking were some of the problems noted. Though most of the problems were resolved before discharge, few persisted until discharge. Perceived milk insufficiency, latching problems and breast problems were higher in primi and found to be statistically significant. Objective problems like poor positioning, sucking etc were higher among primi and caesarean mothers. Even problems that remained at discharge were also more among them. Conclusions: Most common problems were positioning, emphasizing the need for teaching/training. Primi and delivery by LSCS were found to have higher feeding problems emphasizing the need to focus on these high risk groups. Doi: 10.28991/SciMedJ-2020-0204-4 Full Text: PDF

scholarly journals ANI scoring system – In differentiating alcoholic and non-alcoholic liver disease

2021 ◽  
Vol 12 (11) ◽  
pp. 104-107
Author(s):  
Anitha G ◽  
Sivakumar J ◽  
Kalavathy Ponniraivan
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Alcoholic Liver Disease ◽  
Scoring System ◽  
Research Centre ◽  
College Hospital ◽  
Alcoholic Fatty Liver ◽  
Medical College ◽  
Non Invasive ◽  
Invasive Method

Background: Alcoholic liver disease/non-alcoholic liver disease Index – ANI scoring system was constructed for clinically diagnosing the etiology of liver diseases, avoiding the risks of liver biopsy. Aims and Objectives: This study aims to test the reliability of ANI scoring system as a non-invasive method to distinguish alcoholic liver disease (ALD) from non-alcoholic fatty liver disease (NAFLD). Materials and Methods: This retrospective study was conducted on 177 (114 men and 58 women) treated as inpatients in Trichy SRM Medical College Hospital and Research Centre, Trichy, in the period of December 1, 2015–August 1, 2016. About 40 patients with etiology of viral, autoimmune, and biliary lithiasis were excluded. A total of 137 patients (98 men and 39 women) were classified into two groups, ALD (70) and NAFLD (67) based on diagnosis. Parameters of ANI – AST, ALT, MCV, BMI, and sex were recorded. ANI was calculated by online calculator. Results: ANI was significantly higher in patients with ALD than NAFLD (P<0.01). The cutoff value of ANI is –0.11. Conclusion: On the basis of the results, ANI scoring system may be used in clinically distinguishing ALD from NAFLD, avoiding the risks of liver biopsy.

The prognostic analysis of 123 postpartum choriocarcinoma cases

2008 ◽  
Vol 18 (5) ◽  
pp. 1097-1101 ◽  
Author(s):  
Y. Ma ◽  
Y. Xiang ◽  
X. R. Wan ◽  
Y. Chen ◽  
F. Z. Feng ◽  
...  
Keyword(s):  
Scoring System ◽  
Risk Group ◽  
Stage Iv ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Time Interval ◽  
College Hospital ◽  
Comprehensive Therapy ◽  
Significant Difference

A retrospective analysis of 123 postpartum choriocarcinoma cases treated at the Peking Union Medical College Hospital between December 1985 and December 2006 was performed. All the patients with postpartum choriocarcinoma received chemotherapy, combined with comprehensive therapy. The total number of chemotherapy cycles was 1041 (8.5 for every patient on average). The complete remission (CR) was achieved in 108 patients (87.8%), whereas five patients had partial remission and ten died. Of the 26 patients who became resistant to 5-fluorouracil combined chemotherapy, 18 achieved CR. Of the four cases who had recurrence, three achieved CR. The patients were divided into high- and low-risk groups, based on the new FIGO 2000 risk factor scoring system. Seventy-five patients were in high-risk group, with a score of 7 or more. Among them, 62 achieved CR (82.7%). The remaining 48 patients were in the low-risk group, with a score of 6 or less, among whom 46 patients achieved CR (95.8%). There is a significant difference in CR rate between the two groups. Based on the FIGO staging and scoring system, 24 patients were diagnosed as FIGO stage I, 9 stage II, 66 stage III, and 24 stage IV. The rate of CR was 100%, 100%, 91%, and 62.5%, respectively. Our experience shows that prognosis of postpartum choriocarcinoma is good when multiagent systemic chemotherapy is applied. Shortened time interval between the antecedent pregnancy and the treatment will lead to better prognosis

scholarly journals Ponseti Technique is the Best Option for the Treatment of Idiopathic Congenital Club Foot by the Age of Two Years

2015 ◽  
Vol 14 (2) ◽  
pp. 27-30
Author(s):  
Md Mostafizur Rahman ◽  
Shafiqul Islam ◽  
Abdur Rouf ◽  
Md Abdul Momen ◽  
Md Zahidul Islam ◽  
...  
Keyword(s):  
Satisfactory Result ◽  
Scoring System ◽  
Club Foot ◽  
Low Cost ◽  
Developing Nations ◽  
Medical College Hospital ◽  
Congenital Deformity ◽  
Interventional Study ◽  
College Hospital ◽  
Medical College

Club foot is the commonest congenital deformity in babies. Around 80% of the cases occur in developing nations. There are many option for treating club foot, Ponseti technique is one of them. This prospective interventional study was carried out at the Department of Orthopaedic & Traumatology, Rangpur Medical College Hospital, over period of 3 year from 22/09/2011 to 22/12/2014. One hundrad and Fifty patients of two hundrads and twenty three foots were treated by ponseti technique and followed up for the purpose of this study. Both rigid and non rigid variety of club foot were treated irrespective of sex and side of foot involvement. Pirani scoring system was used to assess the severity of deformity, needs of tenotomy and evaluation of result. All the patients were treated by Ponseti technique, only 83 (11.1%) foot by plaster, 140 (88.9%) foot required tenotomy. There were complication of 29 (13%) foot of 19 patients in the form of plaster sore. All patients were under bracing protocol. In this study it is found that 94.61% satisfactory result. So Ponseti technique is a safe, effective & low cost and easily acceptable. So it is the best option for the treatment of idiopathic congenital club foot under the age of two years.Chatt Maa Shi Hosp Med Coll J; Vol.14 (2); Jul 2015; Page 27-30

SIGNIFICANCE OF PLACENTAL HISTOPATHOLOGICAL FINDINGS IN PRETERM/TERM BIRTH

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang
Keyword(s):  
Preterm Birth ◽  
Comparative Study ◽  
Pregnancy Outcome ◽  
Neonatal Morbidity ◽  
Research Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Chorionic Villi ◽  
Term Birth ◽  
Medical College

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.

Isolation of post operative hospital acquired infections in a private hospital of Bangladesh and identification of clonal relatedness of E. coli by using Pulse filed gel electrophoresis

2012 ◽  
Vol 6 (2) ◽  
pp. 7-10
Author(s):  
Mohammad Murshed ◽  
Sabeena Shahnaz ◽  
Md. Abdul Malek
Keyword(s):  
Private Hospital ◽  
Isolation And Identification ◽  
College Hospital ◽  
Hospital Acquired Infection ◽  
E Coli ◽  
Hospital Acquired Infections ◽  
Medical College ◽  
Clonal Relatedness ◽  
Hospital Acquired ◽  
Dressing Materials

Isolation and identification of post operative hospital acquired infection was carried out from July 2008 to December 2008 in Holy Family Red Crescent Medical College Hospital (private hospital). The major pathogen of wound infection was E. coli. A total; of 120 samples were collected from the surrounding environment of post operative room like floor, bed sheets, instruments, dressing materials, catheter, nasogastric and endotracheal tube. E. coli (40%) was the predominant organism followed by S. aureus (24%). DNA fingerprinting analysis using pulsed field gel electreopheresis of XbaI restriction digested genomic DNA showed that clonal relatedness between the two clinical nd environmental isolates were 100%.DOI: http://dx.doi.org/10.3329/bjmm.v6i2.19369 Bangladesh J Med Microbiol 2012; 06(02): 7-10

Rapid detection of Rotavirus antigen in stool sample of acute diarrheic children

2012 ◽  
Vol 6 (1) ◽  
pp. 11-13
Author(s):  
Sushmita Roy ◽  
S.M. Shamsuzzaman ◽  
K.Z. Mamun
Keyword(s):  
Stool Sample ◽  
Rapid Detection ◽  
Cross Sectional Study ◽  
Rapid Diagnosis ◽  
Age Group ◽  
College Hospital ◽  
Cross Sectional ◽  
Rotavirus Infection ◽  
Medical College ◽  
Stool Samples

Rotavirus is one of the leading causes of pediatric diarrhea globally. Accurate and rapid diagnosis of Rotavirus diarrhea should reduce unnecessary use of antibiotics and ultimately reduce drug resistance. Study was designed for rapid diagnosis of Rotavirus antigen in stool sample by ICT (Immunochromatographic test) as well as to observe the seasonal variation of rotavirus infection. This cross sectional study was carried out in the department of Microbiology, Dhaka Medical College from January 2011 to December 2011. Eighty stool samples were collected from Dhaka Shishu Hospital and Dhaka Medical College Hospital. All samples were tested for rotavirus antigen by ICT. Among 80 patients, 42 (52.5%) samples were positive for rotavirus antigen. Among these 42 positive samples, 30 (71.43%) were from 0-12 months of age group, 10 (23.81%) from 13 to 24 months of age group and rest 2 (4.76%) from 25 to 36 months of age group. Rotavirus Ag was detected in stool samples from January to April and another peak episode from October to December. Considering the importance of Rotavirus associated diarrhea, rapid detection of Rotavirus infection in human is substantially needed and should be routinely practiced.DOI: http://dx.doi.org/10.3329/bjmm.v6i1.19354 Bangladesh J Med Microbiol 2012; 06(01): 11-13

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

Outcome of Percutaneous Nephrostomy in Children With Ureteropelvic Junction Obstruction

2020 ◽  
Vol 20 (2) ◽  
pp. 61-64
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
Rifat Zaman ◽  
Md Amanur Rasul ◽  
Akm Shahadat Hossain ◽  
Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Renal Function ◽  
Low Dose ◽  
Ureteropelvic Junction Obstruction ◽  
Percutaneous Nephrostomy ◽  
Ureteropelvic Junction ◽  
College Hospital ◽  
Medical College ◽  
Split Renal Function

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

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