scholarly journals Bilateral Lumbar Hernia - a Rare Occurence in Infant

2014 ◽  
Vol 1 (2) ◽  
pp. 162-165
Author(s):  
Shahnoor Islam ◽  
AKM Amirul Morshed ◽  
Md. Ashraf Ul Huq ◽  
Md. Mahbub-Ul Alam ◽  
Susankar Kumar Mondal ◽  
...  
Keyword(s):  
Left Kidney ◽  
Lumbar Hernia ◽  
Prosthetic Material ◽  
Absorbable Suture ◽  
Lumbar Region ◽  
College Hospital ◽  
Medical College ◽  
Chief Complaints ◽  
Surgery Department

Lumbar hernias are rare in children. We report a case of bilateral lumbar hernia in a 39 days old boy who was admitted at pediatric surgery department in Dhaka Medical College Hospital with the chief complaints of bilateral flank swellings since birth. There were no urinary or bowel complaints. Palpation revealed reducible, non-tender, soft to firm swellings involving iliolumbar region in left and lumbar region in right . These were increased on crying. On auscultation bowel sounds were present in left side and absent in right side. There were no other congenital anomalies.Ultrasonography revealed herniated bowel loops in left iliolumbar region and mild pelvicalicial dilatation in left kidney and slightly bigger right kidney in right lumbar region. On the basis of these findings a diagnosis of congenital bilateral lumbar hernias were made. Closer of the defects were done by prosthetic material and non- absorbable suture material. He came back for follow-up after 2 weeks, 4 weeks and 6 weeks. Defects were clinically absent and the patient was pain and recurrence-free.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19537

scholarly journals Retroperitoneal Giant Schwannoma: Difficulties in Diagnosis and Subsequent Surgical Management

2012 ◽  
Vol 30 (2) ◽  
pp. 105-107
Author(s):  
MA Rahman ◽  
NU Mahmud
Keyword(s):  
Surgical Management ◽  
Economic Condition ◽  
Left Kidney ◽  
Lumbar Region ◽  
College Hospital ◽  
Medical College ◽  
Specialized Center ◽  
Giant Schwannoma ◽  
Retroperitoneal Schwannoma ◽  
General Surgeons

Management and excision of left hypochondriac mass of a  55 year old lady have been presented in the paper. The  ultrasound of whole abdomen showed two big lumps in the  left hypochondriac and lumbar region which after excision  turned out to be a retroperitoneal schwannoma. The mass  was removed by sacrificing the left kidney. Though it is a  highly specialized operation and should be performed in a  specialized center, sometimes general surgeons are unable  to avoid the operation due to low economic condition of the  patient. The case was performed at the Central Medical  College Hospital, Comilla utilizing the existing facilities.  Fortunately the patient is doing well and leading a normal  life after one and half years of operation   DOI: http://dx.doi.org/10.3329/jbcps.v30i2.11420   J Bangladesh Coll Phys Surg 2012; 30: 105-107    

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

Treatment of Pilonidal Sinus by Limberg Flap-Only Hope of Cure (Study of 50 Cases)

2020 ◽  
Vol 22 (2) ◽  
pp. 89-94
Author(s):  
Nasir Uddin Mahmud ◽  
ABM Khurshid Alam ◽  
Mohammad Altaf Hossain Chawdhury ◽  
Mohammad Abul Khair
Keyword(s):  
Pilonidal Sinus ◽  
Skin Barrier ◽  
Limberg Flap ◽  
College Hospital ◽  
Medical College ◽  
Flap Technique ◽  
Unpleasant Smell ◽  
Lower Morbidity ◽  
Computer Operator

Background : Pilonidal sinus was first described by Dr. A.W. Anderson in 1847 and is often seen in the intergluteal region. It is a disease of mainly younger male and rarely affects after 40. Main causes for the formation of this sinus are hirsutism, sweating in the area, repeated maceration due to trauma, leading to breakage of the skin barrier, attracting hair inside which initiates a foreign body reaction leading to infection with abscess or sinus formation. Most common embarrassing situation is discharging sinus. The diagnosis is mainly on clinical ground. Though there are a lot of modalities of treatment but recurrence is still a challenge. We have adopted Limberg flap technique since 2012 with a least recurrent chance. Objectives : To prove that this procedure will be end up with lower morbidity & least chance of recurrence Methods : This prospective study was done jointly by the Department of Surgery of Central Medical College and Comilla Medical College Hospital. In this series 50 patients were selected from July 2012 to June 2017. Results : Out of 50 patients operated by Limberg flap technique 42(84%) were males and 8(16%) were females. Mean age was 27.3 years (range 18–37years). Of them,12(24%) were driver, 6(12%) police, 6(12%) teacher, 6(12%) student, 5(10%) worker, 4(8%) millitary army, 4(8%) housewife, 4 (8%)service holder, 2(4%) computer operator, 1(2%) doctor and 1(2%) were barber. In our study most common mode of presentation were chronic discharging sinuses 15(30%), beside this 12(24%) had multiple sinuses, 10(20%) had multiple pits,7(14%) had acute abscess and 6(12%) had unpleasant smell. Associated hirsutism were present in 30(60%) and absent in 20(40%) patients. One (2%) male patient had wound gap & discharge and six(12%) patients had flap edema. We have found no recurrence in follow up period. Conclusion : Pilonidal sinus is a notoriously recurrent disease, so treatment by this flap technique is the only hope of cure with lower morbidity. Journal of Surgical Sciences (2018) Vol. 22 (2) : 89-94

scholarly journals A Prospective Study to Observe the Results and Complications of Lateral Internal Sphincterotomy in Anal Fissure

2015 ◽  
Vol 2 (2) ◽  
pp. 81
Author(s):  
Sandesh Pawar ◽  
Sudhir D. Bhamre ◽  
Vijay Malpathak ◽  
Yamini Sorate
Keyword(s):  
Anal Fissure ◽  
Care Center ◽  
Time Frame ◽  
Lateral Internal Sphincterotomy ◽  
Health Care Center ◽  
Internal Sphincterotomy ◽  
Medical College ◽  
A Prospective Study ◽  
Surgery Department

<strong>Aim</strong>: To observe the results and complications of lateral internal sphincterotomy in anal fissure. <strong>Materials&amp;Methods:</strong> The study was carried out as a prospective observational study of 40 patients at surgery department of a medical college&amp;tertiary health care center, over a period of two years that included cases of anal fissure in the age group of 16 years and above for conservative&amp;surgical management. <strong>Results</strong>: The recovery of the patient after this marvellous operation was fast and the pain relief was dramatic. On follow-up at 2 weeks post-operatively pain and other symptoms were present only in 11 patients (27.5%). On follow-up at 8 weeks post-operatively all 40 patients (100%) were symptom-free in this study. The complications that were observed within time frame of this study were Soiling in 4 patients (10%) and incontinence to flatus in 1 patient (2.5%). There was no recurrence of anal fissure observed in this study group within the time frame of this study. <strong>Conclusion</strong>: It is very evident from the above study that 'Lateral Internal Sphincterotomy' is by far the best operation for an indolent anal fissure.

scholarly journals Rectal Foreign Body in a 30 Year Old Male- A Case Report

2018 ◽  
Vol 9 (1) ◽  
pp. 35-37
Author(s):  
Md Monoarul Islam Talukdar ◽  
Quamrul Akter ◽  
Md Abdullah Al Mamun ◽  
Abdullah Md Abu Ayub Ansary
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Young Male ◽  
College Hospital ◽  
Rectal Pain ◽  
Medical College ◽  
Post Operative Period ◽  
Abdominal Radiographs ◽  
Early Decision ◽  
Surgery Department

Though anorectal foreign body cases are rare, they have become increasingly frequent in recent years. Although entrapped foreign bodies are most often related to sexual behavior, they can also result from ingestion or sexual assault. The diagnosis may be made by rectal examination and metallic objects can be confirmed by plain abdominal radiographs. Transanal removal is only possible for very low-lying objects, while patients with high-lying foreign bodies usually require an operative intervention. An early decision of laparotomy should only be made after subjecting the patient to suitable investigations to determine exact location of the object, in order to avoid any inadvertent damage to the adjoining vasculature as well as anal incontinence. . We report the case of a young male who presented at surgery department of Shaheed Suhrawardy medical college hospital with severe rectal pain due to insertion of an apple into rectum by some eunuchs. It was successfully removed transanally under spinal anesthesia. Post operative period was uneventful and referred for psychiatric consultation.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 35-37

scholarly journals Surgical Outcomes of Haemorrhoidectomy along With Suture Haemorrhoidopexy in Multiple Haemorrhoids

2019 ◽  
Vol 6 (2) ◽  
pp. 73-76
Author(s):  
Mohammad Ibrahim Khalil ◽  
Md Ashiqur Rahman ◽  
Adnan Ahmed ◽  
Samia Shihab Uddin ◽  
Mohammad Alauddin ◽  
...  
Keyword(s):  
Operating Time ◽  
Pain Scale ◽  
Late Complications ◽  
Anal Stenosis ◽  
Safe Procedure ◽  
College Hospital ◽  
Primary Position ◽  
Medical College ◽  
Mucosal Oedema

Background: Haemorroid stapler becomes easier and safe to deal multiple and prolapsed haemorrhoid at a time. Objectives: The purpose of the present study was to evaluate the outcome of suture haemorrhoidopexy for secondary position haemorrhoids in addition to haemorrhoidectomy for primary haemorrhoids (multiple). Methodology: This prospective interventional study was performed in Dhaka Medical College Hospital, Dhaka, Bangladesh and in a private hospital in Gazipur, Bangladesh for over five (05) years from January 2012 to December 2016. Patients who were presented with secondary position haemorrhoids in addition to primary position haemorrhoids (multiple haemorrhoids) were included in this study. Open haemorrhoidectomy (Milligan-Morgan) followed by suture haemorrhoidopexy was done. All patients were followed up after 1, 2, 4, 8 weeks, 6 months and 1 yearly. Result: Total 18 patients were operated. Among those immediate complications were encountered in patients in the form of per rectal bleeding 1(5.55%), pain 3(visual pain scale 4)16.66%, mucosal oedema 6(33.33%), no patient developed early postoperative prolapse. No patient developed bowel incontinence. Late complications experienced as prolapse at 1 year follow up which was treated by conservative measures. No patient developed anal stenosis. Mean operating time was 25 minutes and duration of hospital stay was 1 day. Conclusion: Stapled haemorrhoidopexy is a safe procedure for circumferential excision of mucosa and submucosa dealing all haemorrhoids and prolapse simultaneously. Journal of Current and Advance Medical Research 2019;6(2): 73-76

scholarly journals Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders

2020 ◽  
Vol 7 (3) ◽  
pp. e705 ◽  
Author(s):  
Shengde Li ◽  
Haitao Ren ◽  
Yan Xu ◽  
Tao Xu ◽  
Yao Zhang ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Proportional Hazards ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
College Hospital ◽  
Relapse Risk ◽  
Medical College ◽  
Cox Proportional Hazards Models

ObjectiveTo investigate whether the use of mycophenolate mofetil (MMF) could reduce the relapse risk in patients with myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG)-associated disorders (MOGADs).MethodsThis prospective observational cohort study included patients with MOGAD at Peking Union Medical College Hospital between January 1, 2017, and April 30, 2019. The patients were divided into 2 groups: those with (MMF+) or without (MMF−) MMF therapy. The primary outcome was relapse at follow-up. We used Cox proportional hazards models to calculate hazard ratios (HRs) for relapse.ResultsSeventy-nine patients were included in our MOG cohort. Fifty (63.3%) were adults at index date, and 47 (59.5%) were women. Fifty-four (68.4%) were in the MMF+ group, and 25 (31.6%) were in the MMF− group. Clinical and demographic factors, MOG-IgG titer, and follow-up time (median, 472.5 days for MMF+, 261.0 days for MMF−) were comparable between the groups. Relapse rates were 7.4% (4/54) in the MMF+ group and 44.0% (11/25) in the MMF− group. Of all potential confounders, only the use of MMF was associated with reduced risk of relapse. The HR for relapse among patients in the MMF+ group was 0.14 (95% CI, 0.05–0.45) and was 0.08 (95% CI, 0.02–0.28) in a model adjusted for age, sex, disease course, and MOG-IgG titer. MMF therapy also remained associated with a reduced relapse risk in sensitivity analyses. Only one patient (1.9%) discontinued MMF therapy because of adverse effect.ConclusionsThese findings provide a clinical evidence that MMF immunosuppression therapy may prevent relapse in patients with MOGAD.Classification of evidenceThis study provides class IV evidence that for patients with MOGAD, MMF reduces relapse risk.

scholarly journals Effectiveness of Light Emitting Diodes (LED) versus Conventional Phototherapy for Neonatal Jaundice

2018 ◽  
Vol 42 (2) ◽  
pp. 62-66
Author(s):  
MA Rouf ◽  
Md Khairuzzaman ◽  
Nur E Nazni Ferdous ◽  
Md Golam Mowla
Keyword(s):  
Neonatal Jaundice ◽  
Total Sample ◽  
College Hospital ◽  
Light Emitting ◽  
Medical College ◽  
Led Phototherapy ◽  
Modes Of Presentation ◽  
Significant Difference ◽  
Course Variables

Background: Phototherapy is crucially an important aspect for the management of most neonatal jaundice. Neonates are prone to develop bilirubin encephalopathy (kernicterus). LED phototherapy is a new option of managing neonatal jaundice. The objective of this study is to compare the efficacy and safety of LEDs with fluorescent phototherapy in the treatment of indirect hyperbilirubinemia.Method: The study was Experimental research design, prospective study. The Study was conducted at Neonatal unit of Shaheed Suhrawardy Medical College Hospital, Dhaka. Total sample size of the study was one hundred neonates. Fifty for conventional phototherapy and fifty for LED phototherapy. Purposive sampling method was used for the study. The data collection tool of the study was pretested structured questionnaire. The modes of presentation, the clinical examination and investigation findings at admission and during daily follow up were recorded for individual patient.Result: The rate of fall of S. bilirubin was more in those neonates who have had LED phototherapy. As a result, duration of phototherapy as well as hospital stay was less in LED group. Furthermore, higher number of neonates developed rashes in LED group than in conventional group with statistically significant difference. Of course, variables regarding other adverse events did not show any statistically significant difference between two groups.Conclusion: Management of neonatal jaundice may be more effective in LED phototherapy than conventional phototherapy. LED device require shorter duration of phototherapy, thus, shorter hospital stay.Bangladesh J Child Health 2018; VOL 42 (2) :62-66

scholarly journals Dermatological manifestations in PLHIV visiting link ART centre at rural medical college hospital in Western Tamilnadu, India

2017 ◽  
Vol 5 (3) ◽  
pp. 901
Author(s):  
Mohankumar Vedhanayagam ◽  
Rajesh Rajagopalan ◽  
Srinivasahan Karatupalyam Govindan ◽  
Balamurgan Bhavani Rajendran
Keyword(s):  
Side Effects ◽  
Highly Active Antiretroviral Therapy ◽  
Skin Diseases ◽  
Medical College Hospital ◽  
People Living With Hiv ◽  
College Hospital ◽  
Early Management ◽  
Medical College ◽  
Wide Range

Background: Ever since the early reports of human immuno deficiency infection, it presented as wide range of infectious and non-infectious dermatoses which correlate with the degree of immunodeficiency. Skin assessment remains a vital tool in the diagnosis and management of HIV infection due to relative easiness of examination. Most of skin diseases are amenable to diagnosis by inspection and biopsy. In this descriptive study, we have enumerated in detail the dermatological manifestations of Link ART centre clients.Methods: To analyze the dermatological manifestations in people living with HIV, we undertook a prospective observational study of all PLHIV on ART visiting IRT Perundurai Medical College Hospital link anti- retroviral therapy centre (LAC) during July 2015 to August 2016 with focus to skin manifestations.Results: Among the 140 clients, 22 in 2010, 12 in 2011, 6 in 2012, 51 in 2013, 36 in 2014, and 9 in 2015, 3 up to June 2016 enrolled for follow up. 31 were transferred to nearby ART, Link ART centres during this period as per their request, 4 lost for follow up and 6 deceased after enrolment, finally ninety-nine (39 male; 60 female) were utilizing our centre during the study period. Majority of participants were on ZLN (zidovudine, lamivudine, and nevirapine) regimen, hailing from rural zones, belonged to low or low middle income group, were undertaking farming, cattle rearing. CD4 counts of the asymptomatic clients in the ZLN group noted increase and decrease in the ZLE (zidovudine, lamivudine, and efavirenz), TLN (tenofovir, lamivudine, and nevirapine) group.  In the symptomatic clients, decline in the individual and the mean counts except in female ZLN subset. 70% were clinically asymptomatic and 30 % were having some dermatological manifestations. Multiple manifestations were seen in 5 clients during the study period. Dermatological manifestations observed commonly were fungal and viral infections, xerosis/ichthyoses, adverse drug reactions like lipodystrophy, and discoloration of nails.Conclusions: Skin manifestations observed in this study were due to aging and long term cosmetic side effects of highly active antiretroviral therapy  (HAART). Lipodystrophy posed significant aesthetic distress in HAART clients. Hence, early management would decrease the most offending cosmetolgical side effects of the disease and drugs. Therapy yields the declining trend in the inflammatory, infectious dermatoses.

scholarly journals A retrospective study on management of bell\'s palsy in a tertiary care hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 173-176
Author(s):  
P.K Purushothaman ◽  
Dhanyan Harshidan ◽  
Priyangha Elangovan
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Care Hospital ◽  
Bell's Palsy ◽  
College Hospital ◽  
Medical College ◽  
Therapeutic Measures

Bell's palsy is the most common facial nerve disorder. The clinical symptoms of Bell's palsy include facial muscle paralysis, difficulty in eating, drinking and talking. Bell's palsy management is still controversial. Many patients recover spontaneously; some require medicines like corticosteroids, antiviral drugs and other managements.To study the effectiveness of Bell's palsy management that has been followed in our institution.This analysis had carried out from June 2016 to June 2019at SRM Medical College Hospital and Research Institute, Chennai. Total of 30 patients with Bell's palsy who had admitted in the Department of Otorhinolaryngology had enrolled in this study. All the patients underwent thorough clinical examination and laboratory investigation, and the results were statistically analyzed and discussed.Out of 30 patients, 16(53%) patients were males, and 14(47%) patients were females. 53.3% of patients had onset of symptoms after 48 hours. There was a statistical significant improvement in House-Brackman scale on 6 months follow-up.The therapeutic measures for Bell's palsy if initiated within 72 hours of onset aids in bringing better outcome and improves the quality of life in patients.

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