scholarly journals Leiomyomatosis Peritonealis Disseminata Following Laparoscopic Surgery With Uncontained Morcellation: 13 Cases From One Institution

2021 ◽  
Vol 8 ◽  
Author(s):  
Xin Chen ◽  
Haiyuan Liu ◽  
Honghui Shi ◽  
Qingbo Fan ◽  
Dawei Sun ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Clinical Characteristics ◽  
Rare Condition ◽  
Suppressive Therapy ◽  
College Hospital ◽  
Hormonal Stimulation ◽  
Obvious Effect ◽  
Medical College ◽  
Leiomyomatosis Peritonealis Disseminata ◽  
History Of

Objectives: To investigate the clinical characteristics, treatment and prognosis of leiomyomatosis peritonealis disseminata (LPD) following laparoscopic surgery with uncontained morcellation and to summarize clinical features of iatrogenic LPD based on published literature together with our own experience.Methods: A cohort of 13 cases with iatrogenic LPD diagnosed and treated in Peking Union Medical College Hospital from 2011 to 2020 was reported focusing on clinical characteristics, treatment and prognosis.Results: All the patients had a history of laparoscopic myomectomy with uncontained morcellation. The average age was 35.6 (range 25–47) years. The interval between initial laparoscopic surgery and first diagnosis of LPD was 6.08 years on average (range 1–12). Most of the patients had no obvious symptoms. The accuracy of pre-operative diagnosis was low. Two patients had been treated with gonadotropin-releasing hormone agonist (GnRH-a) before surgery without obvious effect. The nodules of LPD are usually located in the lower half of the peritoneal cavity. The most commonly involved site was the pouch of Douglas. The number of nodules ranged from 3 to over 10, and they ranged in size ranged from 0.3 to 22 cm. All patients underwent surgical treatment: six patients underwent laparoscopy and seven underwent laparotomy. Pathology results confirmed LPD. The immunohistochemical profile indicated LPD tends to be positive strongly for desmin, caldesmon, ER, PR and SMA. Only one patient underwent post-operative treatment with GnRH-a. All patients were followed for an average period of 49 months without recurrence.Conclusion: Iatrogenic LPD is a relatively rare condition. Patients usually exhibit no hormonal stimulation factors. Surgery is the main method of treatment, and hormone suppressive therapy is only rarely used. The nodules are usually large and less numerous, and most involve the pelvis. The prognosis of iatrogenic LPD seems good.

Outbreak Of Nipah Encephalitis In Greater Faridpur District

1970 ◽  
Vol 5 (2) ◽  
pp. 63-65
Author(s):  
MY Ali ◽  
SA Fattah ◽  
MM Islam ◽  
MA Hossain ◽  
SY Ali
Keyword(s):  
Health Personnel ◽  
Viral Encephalitis ◽  
Review Article ◽  
Personal Protection ◽  
Emerging Infections ◽  
College Hospital ◽  
Personal Protection Equipment ◽  
Medical College ◽  
History Of ◽  
Deadly Disease

Nipah viral encephalitis is one of the fatal re-emerging infections especially in southeast Asia. After its outbreak in Malaysia and Singapore; repeated outbreaks occurred at western part of Bangladesh especially in Faridpur region. Besides, sporadic attacks appear to occur in the country throughout the year. Here two Nipah outbreaks in greater Faridpur district in 2003 and 2004 are described along with brief review on transmission of the virus. Where the history of illness among patients are very much in favour of man to man transmission. Moreover the death of an intern doctor from Nipah encephalitis who was involved in managing such patients in Faridpur Medical College Hospital strongly suggests man to man transmission of this virus. So, aim of this review article to make the health personnel and general people be aware about man to man transmission of virus, so that they can adapt personal protection equipment (PPE) for their protection against this deadly disease. DOI: 10.3329/fmcj.v5i2.6825Faridpur Med. Coll. J. 2010;5(2):63-65

scholarly journals Choledochal Cyst Coexisting with Gallbladder Carcinoma - An Uncommon Case Report

2017 ◽  
Vol 16 (4) ◽  
pp. 602-605
Author(s):  
Jahangir Hossain Bhuiyan ◽  
Mohibul Aziz ◽  
Omar Faruk ◽  
Mahbub Hasan
Keyword(s):  
Choledochal Cyst ◽  
Gallbladder Carcinoma ◽  
Medical Science ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Low Grade ◽  
College Hospital ◽  
Medical College ◽  
Operative Recovery

Choledochal Cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of choledochal cyst coexisting with gallbladder carcinoma in a Bangladeshi patient. A 35 year old lady presented at IBN Sina Medical College Hospital, Kallyanpur, Dhaka with the history of recurrent right upper quadrant abdominal pain from childhood, which became severe for last 4 days before admission. The pain was colicky in nature and radiated to the back. Episodes were associated with low-grade fever, anorexia as well as vomiting. The preoperative diagnosis was made by abdominal ultrasound and MRCP. Exploratory laparotomy, enbloc cholecystectomy with excision of the choledochal cyst and roux-en-Y hepaticojejunostomy was also done. Post operative recovery was uneventful. Patient was followed up for six months and no obvious complication was noticed. Early suspicion of this rare pancreato-billiary disease is important because surgical treatment is the only way to avoid the complications of the disease.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.602-605

scholarly journals VAGINAL DISCHARGE

2011 ◽  
Vol 18 (04) ◽  
pp. 598-603
Author(s):  
SHAHIDA SHAIKH ◽  
SALEEM AKHTER SHAIKH ◽  
INAYAT MAGSI
Keyword(s):  
Vaginal Discharge ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital ◽  
Internally Displaced ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Medical College ◽  
Abnormal Growth ◽  
History Of

Objective: To observe the results of syndromic management in women living in IDPs camps complaining of chronic vaginal discharge. Design: Descriptive study. Setting: Medical Camps at Larkana set by Chandka Medical College Hospital for Internally Displaced Persons (IDPs) due to floods. Period: 1st September 2010 to 31st December 2010. Material and Methods: Total 200 symptomatic patients aged from 20 to 50 years suffering from chronic vaginal discharge having history of more than 6 months duration were included in the study. Asymptomatic as well as pregnant women and patients with abnormal cervix and having abnormal growth on cervix were excluded from the study. A detailed history and examination (including speculum and vaginal) was done and a proforma was filled. All these patients were given empirical treatment recommended by WHO as syndromic management consisting of stat doses of antifungal along with antibiotics, where no laboratory tests are required before treatment. Results: Next to vaginal discharge which was main symptom in all patients, the other symptoms like dusparunia, dysuria, itching ,lower abdomen pain and low backache was reported 9%, 16%, 20%, 24% and 31% respectively. Also 8% patients reported post coital bleeding. All patients were married and the mean age of the patients was 28+0.2 years and 15% of them were over 40 years. Mean parity was 4±1.Vaginal infection improved in 65% of the patients excellently with a first line single course of antibiotic and percentage raised up to 88% with second course. 19(9.5%) patients couldn’t be followed as they left that camp and 5(2.5%) patients who did not improve with two courses of antibiotics had big cervical erosions, referred to nearby tertiary care hospital for further management. Conclusions: IDPs live in poor conditions in camps without basic facilities and where it is difficult to perform bedside tests like microscopy, Potassium Hydroxide, wet mount films and tests for Sexually transmitted diseases like Chlamydia and gonorrhea are not available, syndromic management there is a rational way of treating cases of chronic vaginal discharge to get quicker response in such desperate women. 

scholarly journals Familial Trend and Socioeconomic Status of the Hypertensive Patients attending at Hypertension Clinic

2012 ◽  
Vol 13 (1) ◽  
pp. 10-15
Author(s):  
Kazi Jahangir Hossain ◽  
Nazma Parvin ◽  
A Wazed ◽  
Md Shamsul Alam ◽  
Md Mustafa Kamal
Keyword(s):  
Socioeconomic Status ◽  
College Hospital ◽  
Hypertensive Patients ◽  
Positive History ◽  
Medical College ◽  
First Degree Relatives ◽  
Hypertension Clinic ◽  
History Of ◽  
Prevention Of Hypertension ◽  
Second Degree

The aim of the study was to investigate familial trend and socioeconomic status of the hypertensive patients attending at the Hypertension Clinic of Dhaka Medical College Hospital, Dhaka. The study period was from July 2009 to June 2010.  A total of 417 patients were recruited of which 245 were male and 172 female respectively, and selected consecutively on the basis of defined criteria.  The research instrument was an interviewer-administered questionnaire. For assessment of familial trend of hypertension, first and second degree relatives of the respondents were investigated.   Results showed that majority of the respondents were educated of which 22.1%(n=92), 18.2%(n=76), 19.9%(83) and 13.7%(n=57) were secondary, higher secondary, graduate and postgraduate educated respectively. In profession, 64.4%(n=111) female had household works, and 56.8%(n=139) male were in service and 41.2%(n=101) businessmen and had monthly income of  Tk. 10,000 to 80,000. The mean age of them was 47.4±6.9 years and BMI was 25.5±3.0 kg/m2. The nutritional status of them were normal in 40.5%(n=169) and rest had different degree of malnutrition.  In malnutrition, 53.1%(n=130) male were overweight, 2.9%(n=7) obese and 0.8%(n=2) undernourished; and 51.2%(n=88) female were overweight, 11.0(n=19) obese and 1.2%(n=2) undernourished respectively.   About 70.5%(n=294) of the studied hypertensive patients had positive history of hypertension in first and second degree relatives of which 17.3%(n=72) had single member positive history of hypertension, 18.2%(n=76) two, 16.8%(n=70) three, 14.1%(n=69) four and 4.1%(n=17) five members. In single member positive, most of them were in first degree relatives; in two members, 67.1%(n=51) were in first degree relatives and 27.6%(n=21) in both first and 2nd degree relatives; in three members, 64.3%(n=45) were in 1st degree and 31.4%(n=22) in both 1st and 2nd degree; in four members, 31.9%(n=22) were in 1st degree relationship, 17.4%(n=12) in 2nd degree and 50.7%(n=35) in both 1st and 2nd degree; and in five members, 17.6%(n=3) and 82.4%(n=14) in second degree, and both 1st and 2nd degree relatives respectively. Heath education and behavioral change intervention programs among the hypertensive population may be one of the most important applicable ways to control and/or prevention of hypertension and its complications in Bangladesh. DOI: http://dx.doi.org/10.3329/jom.v13i1.5941 JOM 2012; 13(1): 10-15

scholarly journals Early detection of cervical intraepithelial lesions by simple visual inspection after acetic acid among women in Rajshahi medical college hospital

1970 ◽  
Vol 10 (4) ◽  
pp. 240-244 ◽  
Author(s):  
N Yusuf ◽  
F Islam ◽  
H Akhter ◽  
MA Ali ◽  
JA Khanam
Keyword(s):  
Visual Inspection ◽  
Invasive Carcinoma ◽  
Final Diagnosis ◽  
Epidemiological Studies ◽  
College Hospital ◽  
Medical College ◽  
Cervical Intraepithelial Lesions ◽  
Carcinoma Of Cervix ◽  
History Of ◽  
Intraepithelial Lesions

Aim: To evaluate the performance of visual inspection of acetic acid (VIA) in the detection of precancerous and early cancerous lesions of cervix. Materials and methods: Total 5593 eligible women who randomly came to the Gyenae out patient department (OPD) of RMCH (Rajshahi Medical College Hospital) were examined by VIA. Detection of well defined, opaque, acetowhite lesions close to the squamocolumner junction or in transitional zone or dense acetowhitening of ulceroproliferative growth on the cervix constituted a positive VIA. Those who had abnormal results in screening test & those who had clinically suspicious lesions were sent for colposcopic evaluation (n= 442) & directed biopsy were taken from colposcopically suspected areas (n=214). The final diagnosis was based on histology. Results: Out of 5593 patients, 442 (7.20%) were VIA positive. 442 patients were colposcopically evaluated .Among them, 228 (51.58%) were normal and 202(45.70%) had different stages of cervical intraepithelial lesions (CIN) and 12 ( 2.71 % ) had carcinoma of cervix. Out of 214 patients biopsied, 23.36 % patients had a final diagnosis of CIN lesions, 5 (2.33%) had carcinoma in-situ & 17 cases (7.94%) had invasive carcinoma. Besides to find out the predictable factors of cervical lesions data have been collected from VIA positive patients regarding age of first coitus and first delivery, history of extra marital exposure and STI, use of contraceptive methods and family history of cancer. Age of first coitus between 12 to 15 years and 16 to 20 years were observed among 203 (46 %) and 40 % (177) women respectively. More than half of the patients (62%) were experienced with their first delivery within the age 15-20 years which was below 15 years of 12 % (53) patients. Fifty four percent patients used OCP and barrier methods used were only 10 %. Family history of cancer was observed among 09 % women. 58% patients were belonged to lower middle class and upper group were only 9% (table 1) Conclusion: In our study detection of different grades of intraepithelial lesions (CIN-I, CIN-II, CIN-III, invasive carcinoma) of cervix by VIA was comparable to that of colposcopy. So VIA is suitable for detection of precursor lesions of cervical cancer in low resource settings and also for diagnosis, follow up treatment and epidemiological studies of cervical cancer. Key words: Visual inspection; VIA; cervical carcinoma; colposcopy; screening; epidemiological studies. DOI: http://dx.doi.org/10.3329/bjms.v10i4.9494 BJMS 2011; 10 (4): 240-244

scholarly journals A Clinico-epidemiological Study of Malaria Patients Admitted in A Tertiary Care Hospital of Bangladesh

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Diagnostic Test ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Clinical Aspects ◽  
Case Report Form ◽  
Care Hospital ◽  
Mosquito Net ◽  
College Hospital ◽  
Medical College ◽  
History Of

Malaria is a public health problem in 90 countries around the world affecting 300 million people and responsible for about 1 million deaths annually. Bangladesh is considered as one of the malaria endemic countries in Asia. Every year large number of people suffered for malaria. But there is little studies about clinico-epidemiology of malaria. Aim: To study the epidemiological and clinical aspects of malaria. Methods: This is a Prospective observational study that was conducted in all medicine unit of Chittagong Medical College Hospital, Chittagong, Bangladesh during August 2017 to June 2018. Total 55 patients were included in the study having malaria diagnosed by blood slide examination or rapid diagnostic test. Patients were enrolled in this study after getting written informed consent from the patient or attendant. Detail demographic and clinical data were recorded in structured case report form. Patients were regularly followed up and outcome recorded. Results: Results showed males (65.5%) of 25±15.109 years of age were the main sufferer. Majority (45%) came from low socio-economic condition (<5000 taka/month). 65.5% patients denied any history of recent travel to malarias’ area. 69.1% cases give history of using mosquito net, but only 25.5% have insecticide treated mosquito net. Majority (89.1%) were diagnosed as severe malaria and only few (10.9%) as uncomplicated malaria. Most of the diagnosis done at Chittagong Medical College Hospital, mainly presenting with coma or altered consciousness and convulsion. At field level diagnostic test done in 67.27% cases, of which RDT in 14.5%, BSE in 45.5% and both in 7.3% cases. 78.2% cases outcome were good with improvement and death occurred in 21.8% cases, mainly due to acute renal failure. Conclusion: Though we are making significant effort to control malaria, still we have to improve in controlling malaria based on both preventing the infection and on prompt effective treatment of the infection and illness when it does occur.

scholarly journals Management of Pelvic Fracture Urethral Injury- 147 Cases

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 179-183
Author(s):  
Hafiz Al Asad ◽  
Nahid Rahman Zico ◽  
AKM Shahadat Hossain ◽  
Zulfia Zinat Chowhury ◽  
Md Mostafizur Rahman ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Pelvic Fracture ◽  
Urethral Catheter ◽  
Urethral Injury ◽  
College Hospital ◽  
Medical College ◽  
History Of ◽  
Anastomotic Urethroplasty

Background: Dhaka Medical College Hospital is the highest referral center for PFUI. As anstomotic urethroplasty is a challenging surgery and most of the surgeons refer these type of injuries to our center, we performed this study to evaluate the outcome of our cases. Objective: This study aims to find the outcome and complications of perineal end to end anastomotic urethroplasty in the management of posterior urethral injury resulting from pelvic fracture. Materials and Methods: We performed 147 perineal bulbo-prostatic anastomotic urethroplasty for PFUIs from January, 2013 to May, 2019. Mean age was 37 years with majority between 21 to 50 years (>85%). Nine patients had history of failed anastomotic urethroplasty. After surgical intervention patients were discharged with a supra-pubic catheter (SPC) and per urethral catheter in situ. On 22nd POD urethral catheter was removed and SPC on the next day if patient can void normally. 1st and 2nd follow up done on of 3rd and 6th month respectively following surgery. If patient voided well and Qmax>15ml/ sec; repair was defined as successful. Results: Success rate of anastomotic urethroplasty for PFUI was 93.87%. Total 9 procedures were failed including 2 urethro-cutaneous fistula and needed re-do anastomosis. Erectile dysfunction (ED) was present in 18 patients before operation and after surgery 12 more patients developed ED and total number was 30 during first follow up, which reduced to 24 during second follow-up. Two patient developed incontinence which improved in subsequent follow-up. Conclusion: Anastomotic urethroplasty remains the gold standard in the management of PFUI. Erectile dysfunction is the main issue to be concerned and need special attention. KYAMC Journal Vol. 10, No.-4, January 2020, Page 179-183

scholarly journals Role of Maternal Smokeless Tobacco Ingestion During Pregnancy in Delivery of Preterm Babies

2017 ◽  
Vol 40 (3) ◽  
pp. 135-138
Author(s):  
Farzana Rahman Munmun ◽  
Md Ekhlasur Rahman ◽  
Ahmed Ferdous Jahangir ◽  
Md Shamsul Arefin Patwary ◽  
Abu Sayeed Chowdhury ◽  
...  
Keyword(s):  
Smokeless Tobacco ◽  
Adverse Pregnancy Outcome ◽  
Retrospective Case ◽  
College Hospital ◽  
Term Neonates ◽  
Medical College ◽  
History Of ◽  
Preterm Babies ◽  
Adverse Pregnancy

Background:Smokeless tobacco is an established cause of adverse pregnancy outcome. Preterm deliveries are quite high(14%) in our country and approximately 39% women in Bangladesh use smokeless tobacco (ST).Objective: To determine the outcome of maternal smokeless tobacco ingestion during pregnancy in delivery of preterm babies.Methods: A retrospective case control study was carried out in the department of Pediatrics & department of Obstetrics and Gynecology in Dhaka Medical College Hospital between July 2010 to June 2011. Immediately after admission, detailed history of the newborn baby & mother was taken. A total of 100 cases (preterm babies) and 100 suitably matched controls (sick term neonates) were enrolled. Every case satisfying the selection criteria (inclusion & exclusion criteria) was enrolled in the study. The mother was asked whether she used to use smokeless tobacco (jorda, shada or gul) during pregnancy and about frequency and duration of ingestion of ST.Results: Baseline characteristics of cases and controls were comparable. ST user mothers of preterm babies used ST about 5 times a day. Maternal smokeless tobacco (ST) use during pregnancy was significantly associated (46%) with the delivery of preterm babies (p<0.001) and carries a risk of 2.7 times than that of non ST users.Conclusion: Maternal ST use ?5 times a day during pregnancy increases 2.7 folds risk of delivery of preterm babies than that of non-ingested.Bangladesh J Child Health 2016; VOL 40 (3) :135-138

scholarly journals Management of Symptomatic Renal Cysts by Laparoscopy: Our Initial Experience

2020 ◽  
Vol 21 (2) ◽  
pp. 137-139
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
AKM Shahadat Hossain ◽  
Rifat Zaman ◽  
Prodyut Kumar Saha ◽  
Hafiz Al Asad ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Renal Cysts ◽  
Standard Of Care ◽  
Drain Tube ◽  
College Hospital ◽  
Medical College ◽  
Cyst Recurrence ◽  
The Mean

Introduction and objective: Over the last decade laparoscopic surgery has been popularized and developed to such an extent that it can be considered gold standard for many types of procedures in urology. Currently the majority of operations in urologic field can be performed by laparoscopy. This is because it is as effective as open surgery, but associated with less postoperative pain, shorter hospital stay, faster recovery and has better cosmetic result. The aim of the study is to evaluate the results of our experience of treating symptomatic renal cysts by laparoscopy. Materials and methods: This prospective study was conducted from January 2015 to December 2017 in the Department of Urology in a single unit of Dhaka Medical College Hospital. All the patients were admitted through out-patient department. Among them those who fulfilled the criteria were selected for laparoscopic surgery. All patients were diagnosed by ultrasonography and computed tomography to determine the Bosniak classification of the cyst & informed written consent was taken. Total five laparoscopic decortication of renal cysts were performed and the results of our experience were compared with data from published article. Pain and cyst recurrence were assessed during the follow-up. Results: Our study described the results of 05 laparoscopic decortication of renal cysts. All procedures were completed successfully by transperitoneal approach, with no major intraoperative and postoperative complications. There was a placement of drain tube in one patient. The mean (range) operative duration was 68 (40–110) min, affected by the site and number of cysts decorticated. The mean post operative hospital stay was 1.8 (1- 3) days. All patients were symptom-free and no sign of recurrence during the follow-up. Conclusion: Laparoscopic decortication of symptomatic renal cysts should be the standard of care and it is feasible with conventional laparoscopic instruments and gives a better cosmetic outcome. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.137-139

scholarly journals Spontaneous Transmural Migration of a Retained Surgical Mop into the Small Intestinal Lumen Causing Sub-Acute Intestinal Obstruction: A Case Report

2011 ◽  
Vol 19 (1) ◽  
pp. 34-37
Author(s):  
Md Moniruzzaman Sarker ◽  
AKM Golam Kibria ◽  
Md Manzurul Haque ◽  
Kali Prosad Sarker ◽  
Md Khalilur Rahman
Keyword(s):  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
College Hospital ◽  
Medical College ◽  
Transmural Migration ◽  
History Of ◽  
Small Intestinal ◽  
The Right ◽  
Surgery Department

A case of sub-acute intestinal obstruction due to spontaneous complete transmural migration of a retained surgical mop into the small intestinal lumen has been treated surgically in surgery department of Rajshahi Medical College Hospital. The patient presented with colicky abdominal pain, nausea, occasional abdominal distention and vomiting. She had history of abdominal operation twice previously. Abdominal examination revealed a mobile lump in the right side of abdomen. Diagnosis could be made only at laparotomy.   doi: 10.3329/taj.v19i1.3167 TAJ 2006; 19(1): 34-37

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