scholarly journals An Audit of the Patients Treated in Paediatric Surgery Department of Ad-din Women’s Medical College Hospital, Dhaka

2015 ◽  
Vol 3 (1) ◽  
pp. 26-29
Author(s):  
Musrat Rahman ◽  
Rezaul Islam ◽  
SM A Alim
Keyword(s):  
Quality Of Service ◽  
Pediatric Surgery ◽  
Randomized Study ◽  
Medical College Hospital ◽  
Paediatric Surgery ◽  
College Hospital ◽  
Medical College ◽  
Overall Performance ◽  
Surgical Audit

Background: Surgery without audit is like playing without keeping the score. Medical/Surgical Audit is the evaluation of the quality and efficiency of the surgical services offered to the patients by a group of Medical Personnel in a Hospital. A surgical Audit of the patients of Department of Pediatric Surgery in a non-government Hospital was performed to evaluate overall performance and the quality of service delivered to the patients.Methods: It was a randomized study carried out in the department of Pediatric surgery in Ad-din Women’s’ Medical College Hospital during the period of January 2008 to December 2012 (total 5 years). Total 4613 patients were included in this study. Among them 832 (15.91%) patients were treated after admission and 4396(84.09%) patients were treated as OPD patients.Results: Among the total 4613 patients, 3953 patients were male and 660 patients were female. Total 3127 patients were under 5 years and 1486 patients were over 5 years. Among total 832 admission, 551 (66.22%) were elective cases and 281 (33.78%) were emergency cases.Conclusion: Clinical audit is a process. It is a process used by clinicians who seek to improve patient care. So in this audit we have tried to evaluate our overall performance and the quality of service delivered to our patients in the last 5 years period to find out the limitations and deficiencies prevailing in this field.J. Paediatr. Surg. Bangladesh 3(1): 26-29, 2012 (January)

scholarly journals Evaluation of Congenital Upper Urinary Tract Anomalies in Hypospadias

2014 ◽  
Vol 2 (2) ◽  
pp. 68-72
Author(s):  
Md. Abdullah Al Farooq ◽  
Shafiqul Hoque
Keyword(s):  
Urinary Tract ◽  
Vesicoureteric Reflux ◽  
Upper Urinary Tract ◽  
Medical College Hospital ◽  
Paediatric Surgery ◽  
College Hospital ◽  
Pelviureteric Junction Obstruction ◽  
Medical College ◽  
Genital Ambiguity ◽  
Urinary Tract Anomalies

Background: Hypospadias may be associated with other congenital upper urinary tract anomalies. Literature showed various opinions to evaluate or not to evaluate upper urinary tract in hypospadias patient. Frequency of upper urinary tract anomalies also varies. This study was carried out on this background to avoid confusion.Objectives: Morphological evaluation of upper urinary tract to find out the frequency of upper urinary tract anomalies associated with uncomplicated hypospadias patients and give a guideline for investigation of such patients. Methods: This prospective study was designed and accomplished in the Departments of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka; Dhaka Medical College Hospital (DMCH), Dhaka and Chittagong Medical College Hospital (CMCH), Chittagong; Bangladesh from October 2004 to June 2006. Eighty five (85) patient with hypospadias having neither any congenital anomalies, nor other genital ambiguity, nor any secondary vesicoureteric reflux (VUR) or meatal stenosis were selected for the study. Detailed history and examination were carried out. Upper urinary tract of all patients were evaluated by Ultrasonography (USG), Intravenous Urography (IVU), and Micturating Cystourethrography (MCU).To exclude genital ambiguity in perineal hypospadias, karyotype were done to ascertain male sex. Results were analyzed by SPSS with the help of Chi-square and Z approximation test . Result : Eighty five (85) patients were taken. All patients were evaluated by USG, IVU and MCU to detect congenital upper urinary tract anomalies.Results: Four (4) patients had had upper urinary tract anomalies. One (1) patient found to have left sided pelviureteric junction obstruction (PUJO) while one (1) patient had right sided pelviureteric junction obstruction (PUJO). One (1) patient was found to have left sided pelviureteric duplication and the last patient with left renal agenesis. USG detected three (3) anomalies in 85 patients (3.53%) and IVU detected all four (4) anomalies in 85 patients (4.7%), but no primary reflux was detected by MCU. Overall frequency of upper urinary tract anomalies was 4.7%. Eighty one (81) patients (95.3%) had no anomalies. USG detected 3 (three) anomalies out of 4 (four) patients (75%) & IVU detected all four anomalies (100%). Absence of upper urinary tract anomaly was statistically significant.Conclusion: Frequency of upper urinary tract anomalies are significantly low  (4.7%) in uncomplicated hypospadias. USG can detect 75% congenital upper urinary tract anomalies in hypospadias patients. So USG is good enough and recommended to evaluate upper urinary tract anomalies in uncomplicated hypospadias patients. There is no need to evaluate upper urinary tract by IVU or MCU in such patients, if asymptomatic otherwise.DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19547

scholarly journals Post-Operative Restlessness During Recovery Period Following General Anaesthesia

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 645-648
Author(s):  
Md Rashid Ali ◽  
Shamim Adam ◽  
KR Khan ◽  
Zahir Al Imran
Keyword(s):  
General Anaesthesia ◽  
Orthopaedic Surgery ◽  
Recovery Period ◽  
Medical College Hospital ◽  
Paediatric Surgery ◽  
College Hospital ◽  
Medical College ◽  
Key Word ◽  
Different Types ◽  
North Bengal

Background: Smooth induction and smooth maintenance, smooth reversal and quite recovery is a key word in general anaesthesia. All anaesthetist desires that his patients wake-up smoothly & quietly. However the matter is not easy at all. Anaesthetist often faces a bitter experiences & awk.ward situation during recovery from anaesthesia. Objective: To detect the degree & frequency of restlessness in various types of patients of different age & sex groups and in different types of operations.Methodology & Materials : Our study was carried out in North Bengal Medical College Hospital, Sirajgonj, in between July/2014 & December/2014. 60 (sixty) patients were chosen of different age & sex group and of different types of operation for this perpous.Results: Our study shows that the patients of E.N.T. surgery & the patients of Paediatric surgery, were most vulnerable & responded badly, during reversal and in the post operative ward. Among others a few of them developed restlessness due to some other cause. The children were more prone to develop restlessness than the adults. The Orthopaedic surgery patients also responded badly during recovery period.Conclusion: Special attention should given to this matter as it is really a hazardous situation to all; (i.e. anaesthetist, surgeon, O.T. Sister). An adequate pre-medication,smooth induction, quiet maintenance, smooth reversal & a suitable post operative analgesic is absolutely necessary. Pre anesthetic visit & close rapport with the patient is also essential to overcome this situation.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 645-648

scholarly journals Neonatal Surgery: Demand and Survival Both are Increasing: Eight Years Experience in Dhaka Medical College Hospital, Bangladesh

2014 ◽  
Vol 1 (1) ◽  
pp. 30-35
Author(s):  
Abdul Hanif ◽  
Kaniz Hasina ◽  
Ahmed Zahid Hossain ◽  
S M Shamsul Huda ◽  
M Kamrul Hassan ◽  
...  
Keyword(s):  
Developing Countries ◽  
Pediatric Surgery ◽  
Intestinal Atresia ◽  
Posterior Urethral Valves ◽  
Medical College Hospital ◽  
Infant Mortality Rate ◽  
World Health ◽  
College Hospital ◽  
Medical College ◽  
Mdg 4

Purpose: In order to achieve the Millennium Development Goal (MDG) 4 target of a two-thirds reduction in under-five mortality from 1990 to 2015, major reductions are going to be required in neonatal mortality. Congenital anomalies have become the fourth cause of neonatal deaths and most of these are curable. Dhaka Medical College Hospital is the largest public hospital of the country and serving the poor and lower middle class people where surgery and medical facilities are mostly free of cost. This study was done to see the types of neonatal surgical patients admitted in this hospital and their management out come with limited facilities and find out the ways to improve the scenario to contribute in achieving the MDG.Materials & Methods: This was a retrospective study done over a period of 8 years from July 2001 to June 2009 and carried out in the Department of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka. A total of 650 neonates were admitted during this period and it was the 17.99% of total number of 3612 pediatric surgical admission upto12 years of age. Data was collected from hospital records and analyzed retrospectively.Results: Out of these 650 neonates 533(80%) were admitted for Neonatal Intestinal Obstruction (NIO) and omphalocele were 59 (9.07%), ectopia vesicae are 14 (2.15% ), posterior urethral valves (PUV) were 19 (2.92%), gastroschisis were 7 (1.07%) , congenital diaphragmatic hernia (CDH) were 16 (2.46%),Tracheo-oesophageal fistula 1 (0.15%), and Conjoint twin 1 (0.15%). The most common cause of NIO was anorectal malformation (ARM) and 194 (66.43%) patients have high variety and 98(33.56%) patients have low variety ARM. Next was Hirschsprung disease and 137 (21.07%) neonates presented with this. Thirty-Five (5.38%) patients presented with septicemia and 40 (6.15%) presented with intestinal atresia, 20 (3.07%) neonates had meconium ileus and 9 (1.38%) patients presented with volvulus neonatorum. Five hundred and Fifty-nine patients (86.00%) were managed surgically. Out of 650 patients, 69 died, so mortality was 10.61% and before surgery 2.76% and after surgery was 7.84%.Conclusion: Pediatric surgeons by their skill and teamwork greatly improved the neonatal surgical service and contributing significantly in reducing infant mortality rate and to achieve MDG 4. But to improve further, neonatal intensive care unit (NICU) and other support systems are essential as well as support from UNICEF and World Health Organization (WHO) to include pediatric surgery and surgeons in their activities especially in developing countries. Due to socio-political and economic reasons of the developing countries the roll of pediatric surgeons are multidimensional.DOI: http://dx.doi.org/10.3329/jpsb.v1i1.19463

scholarly journals Clinical presentation of congenital neck mass in children

2012 ◽  
Vol 18 (1) ◽  
pp. 16-22
Author(s):  
Mazharul Alam Siddique ◽  
Mahbuba Hossen ◽  
Ahmmad Taous ◽  
Kazi Shamimus Salam ◽  
Belayat Hossain Siddiquee ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Neck Surgery ◽  
Neck Mass ◽  
Medical College Hospital ◽  
Paediatric Surgery ◽  
College Hospital ◽  
Medical College ◽  
Neck Masses ◽  
Common Location ◽  
Complete Surgical Excision

Background: Congenital neck mass is a very common problem in children in Otolaryngology & Head-Neck Surgery and Paediatric Surgery Department but data of our country is inadequate and there is lack of published study. This study will help to diagnose congenital neck masses, evaluate the success of surgical treatment in our country.Objective: To assess the frequency of congenital neck mass in children and to see the clinical presentation of different congenital neck mass.Study design: Cross sectional prospective study.Place of study: Department of Otolaryngology – Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Dhaka Medical College Hospital (DMCH)l, Dhaka and Mymensingh Medical College Hospital (MMCH), Mymensingh.Methodology: Patients below the age of 18 years with congenital neck mass who presented to three tertiary level hospitals from January 2010 to December 2010 were included in this study. Total thirty six patients were purposively selected. Age, gender, types of swelling and location were examined, investigations were done. Data was analyzed with SPSS software and was presented in the form of tables, diagrams and pie charts.Results: 36 patients with different congenital neck swelling were examined. Out of 36 patients, thyroglossal cysts were commonest- 21(58.33%). Other congenital lesions were as follows: Branchial cyst 7(19.44), Lymphangioma 3(8.33%), Haemangioma 3(8.33%), Dermoid cyst 2(5.55%). Midline was most common location 21 (58.33%).Conclusion: Congenital neck masses constitute important differential diagnosis for neck masses. These masses constitute diagnostic and therapeutic challenges for many clinicians. Correct diagnosis, safe and complete surgical excision requires sound knowledge of the location and extent of these masses.   DOI: http://dx.doi.org/10.3329/bjo.v18i1.10409  Bangladesh J Otorhinolaryngol 2012; 18(1): 16-22

scholarly journals Single Stage Urethroplasty for Proximal Hypospadias with Chordee

1970 ◽  
Vol 6 (2) ◽  
pp. 66-69 ◽  
Author(s):  
MK Hassan ◽  
AC Paul ◽  
MA Khair ◽  
RK Saha ◽  
A Hanif ◽  
...  
Keyword(s):  
Blood Supply ◽  
Single Stage ◽  
Medical College Hospital ◽  
Paediatric Surgery ◽  
College Hospital ◽  
Proximal Hypospadias ◽  
Medical College ◽  
Dual Blood Supply ◽  
Good Cosmesis ◽  
Surgery Department

Proximal hypospadias with chordee usually requires two stage procedures: 1st stage is orthoplasty and ventral parking of prepucial skin and 2nd stage is urethroplasty after 6 months of 1st stage. The aim of this study is to describe and report the outcome of a single stage repair- Koyanagi Nanamura procedure for proximal hypospadias with chordee. Between January 2006 to December 2010, 44 boys with proximal hypospadias underwent repair using the Koyanagi Nanamura technique in Paediatric Surgery Department of Faridpur Medical College Hospital and Dhaka Medical College Hospital. The boys' age ranged from 1 to 7 years. The technique employs the use of lateral penile skin and extends into the inner preputial skin. This flap enjoys double blood supply from the base of the meatus as well as the preputial vessels. Follow-up period was 6 months. Satisfactory results were obtained in 39 (88.6%) patients. Three patients developed fistulae. Two patients developed meatal stenosis. Results were considered satisfactory when the boy achieves a glanular meatus, single forward stream, unimpeded voiding, good cosmesis, and no need for secondary surgery for the urethra. Koyanagi Nanamura procedure is a reliable procedure in which the lateral flaps have dual blood supply, which produces good results (88.6%) and is suitable for proximal forms of hypospadias with chordee. Key words: Hypospadias; Chordee; Fistula; Penis DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9202 FMCJ 2011; 6(2): 66-69

scholarly journals Clinical Presentation of the Epileptic Patients at People Medical College Hospital, Nawabshah, Pakistan

2021 ◽  
pp. 267-273
Author(s):  
Jeando Khan Daidano ◽  
Haresh Kumar Makheja ◽  
Moti Ram Bhatia ◽  
Waseem Raja Memon ◽  
Anwar Ali Jamali ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Medical College Hospital ◽  
Chi Square ◽  
College Hospital ◽  
Medicine Department ◽  
Medical College ◽  
Epileptic Patients ◽  
Minimum Age ◽  
The Mean

Objective: study will determine clinical presentation, risk, and type of seizures in epileptic patients.  Methodology: This observational study was conducted in Medicine department People Medical College Hospital (PMCH) Nawabshah from January 2020 to December 2020. 110 patients were included for study after informed permission of the patient or their relative. Male and female were selected. Known epileptic patients were included in the study, patients with false seizures were excluded from the study. Statically analysis was done by software SSPS 22 version. Results: Age ranged 18 to 60 years. All the patients included in the study epilepsy was noted. The mean age of patients was 37.40 SD 8.71 years. The minimum age was 28 years while maximum 60 years. Pearson Chi-Square Value 105.000a  Asymp. Sig. (2-sided) .000, Likelihood Ratio Value 135.012  Asymp. Sig. (2-sided) .000, Linear-by-Linear Association Value 16.297 Asymp. Sig. (2-sided) .000 which were statistically significant. Conclusion: Epilepsy is treatable common neurological disease in Pakistan. quality of life can be improved by Education of the patients and their relatives, without socioeconomically  burden.

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