scholarly journals Five Years Experience of Tracheostomy at a Tertiary Level Hospital (Dhaka Medical College Hospital) In Bangladesh: Review of 257 Cases

2020 ◽  
Vol 5 (4) ◽  
pp. 1507-1514
Author(s):  
Mostafa Kamal Arefin ◽  
Md. Abdul Quddus Shohag ◽  
Satinath Chandra Sarker ◽  
AKM Ferdous Rahman ◽  
Mohammad Shaharior Arafat ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Medical College Hospital ◽  
Upper Airway Obstruction ◽  
Ethical Review ◽  
Head Neck Cancer ◽  
College Hospital ◽  
Medical College ◽  
Emergency Tracheostomy ◽  
The World

Tracheostomy is a life saving and important surgical procedure throughout the world from long since. Minimum number of study were conducted on tracheostomy in our setting. Based on number, probably Dhaka Medical College Hospital is one of the top institute in the world, where highest number of tracheostomy is being operated (3-10 per day). So, our purpose of this study is to describe our own experiences, regarding indication, complication , decanulation, morbidity and mortality following tracheostomy and to compare the results with the institutes of other countries of the world. Methods It is a prospective observational study, conducted at Dhaka Medical College Hospital from July 2014 to June 2019. Data were collected from the Registers of emergency and elective operation theatre, indoor, intensive care unit (ICU) and medical record room (where file of all patients are being kept for long time). SPSS software was used for data processing and analysis. Prior to the study ethical approval was obtained from Ethical review committee. Results Total 257 patients were selected for the study. Among them 210 (81.71%) were male and 47 (18.29%) were female. Most of the patients were elderly, above sixty years. Commonest indication for tracheostomy were upper airway obstruction due to laryngeal or other head neck cancer in 70.04% of patients. Next important indication was upper airway obstruction due to trauma in 24.9% cases. Most of the time (82.88%) we had to perform Emergency tracheostomy. Longitudinal or

scholarly journals Upper airway obstruction caused by primary lymphoplasmacytic lymphoma of the retropharyngeal space: a case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Chinyere N. Asoegwu ◽  
Okezie O. Kanu ◽  
Clement C. Nwawolo
Keyword(s):  
Lymph Nodes ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Retropharyngeal Space ◽  
Histopathological Diagnosis ◽  
Lymphoplasmacytic Lymphoma ◽  
Malignant Tumours ◽  
Post Surgery ◽  
Emergency Tracheostomy

Abstract Background Primary malignant tumours of the retropharyngeal space are rare with only a few case reports in the literature. Lymphoplasmacytic lymphoma is a rare subtype of non-Hodgkin lymphoma and is very rarely found as a primary tumour of the retropharyngeal space. Case presentation We report the case of progressive upper airway obstruction in a 49-year-old male caused by a primary malignant tumour of the retropharyngeal space lymph nodes. He had an emergency tracheostomy to relieve the upper airway obstruction followed a week later by an elective surgical excision of the tumour via the trans-cervical route. A mixed population of lymphocytes, with a marked presence of Dutcher bodies, was noted on histopathology and positive CD20 on immunohistochemistry, confirming the lymphoplasmacytic lymphoma of the retropharyngeal space. The watchful waiting treatment method for the lymphoma was employed for him since he had no symptoms relating to lymphoma and no serum Waldenström’s macroglobulinemia. He has remained symptom-free 3 years post-surgery. Conclusion Primary malignant tumours involving the retropharyngeal space lymph nodes are very rare. They can rarely grow to a size huge enough to cause obstructive upper aerodigestive symptoms. Primary lymphoma of the retropharyngeal space should be considered in the diagnosis of the tumours involving the retropharyngeal space lymph nodes. Excisional biopsy is important to obtain tissue for histopathological diagnosis and the relief of upper aerodigestive tract obstruction when present.

scholarly journals Ludwig’s Angina: a study of 50 cases

1970 ◽  
Vol 14 (2) ◽  
pp. 51-56
Author(s):  
Md Abu Yusuf Fakir ◽  
Md Arif Hossain Bhuyan ◽  
Md Mosleh Uddin ◽  
HM Mustafizur Rahman ◽  
Syed Hasan Imam Al-Masum ◽  
...  
Keyword(s):  
Neck Surgery ◽  
Medical College Hospital ◽  
College Hospital ◽  
Incision And Drainage ◽  
Artificial Airway ◽  
Medical College ◽  
Intravenous Antibiotics ◽  
Emergency Tracheostomy ◽  
Ludwig’S Angina ◽  
Ludwig's Angina

Objective: To evaluate the clinical outcome, morbidity and mortality of patients diagnosed as Ludwig's angina. Study design: Retrospective study. Setting: Department of Otolaryngology & Head and Neck Surgery, Dhaka Medical College Hospital and Apollo Hospitals Dhaka. Patients and Methods: 50 patients were included in this study (36 males and 14 female) between the ages of 8 and 78 years (mean, 45.5 years) who were treated between January 2007 and December 2008 in the department of Otolaryngology and Head-Neck surgery, Dhaka Medical College Hospital and Apollo Hospitals Dhaka. Etiology, microbiology, associated systemic diseases, treatment, airway management, duration of hospital stay and outcome were reviewed. Results: Most common age group was 3rd decade (42%) and 72% patients were male. Most patients came from poor socio-economic condition and rural area of Bangladesh. 100% patients presented with neck swelling, pain, tenderness and fever. Dental infection was documented as the most common cause (70%) of Ludwig's angina, followed by infection of the tonsils (10%) and submandibular gland (6%). Systemic illnesses included diabetes mellitus (30%) and chronic renal failure (4%).Streptococcus is commonest organism found in culture of pus. Intravenous antibiotics were started immediately in all patients. 4 patients underwent emergency tracheostomy. 40 patients underwent incision and drainage. Infected tooth/ teeth were also removed at the same time. Postoperatively, the airway was secured by endotracheal intubation in 1 case and by tracheotomy in 5 cases. In 88 %( 44 patients) of the cases, no artificial airway was used. 9 patients were managed in the intensive care unit for 1 to 3 days. All except 1 patient made uneventful recoveries and they were discharged after 3 to 26 days of hospitalization (mean, 14.1 days). Conclusion: Airway protection, aggressive antibiotic therapy and surgical decompression can significantly alter the mortality rate of Ludwig's angina. Key Words: Cellulitis, Ludwig's angina, surgical decompressionDOI: 10.3329/bjo.v14i2.3281 Bangladesh J of Otorhinolaryngology 2008; 14(2) : 51-56

scholarly journals Japanese Encephalitis: Bangladesh Perspective: A Revi

1970 ◽  
Vol 17 (1) ◽  
pp. 57-70
Author(s):  
Sultana M Hussain ◽  
ARM Saifuddin Ekram ◽  
MJ Hossain ◽  
E Gurley ◽  
S Lubey
Keyword(s):  
Disease Control ◽  
Japanese Encephalitis Virus ◽  
Japanese Encephalitis ◽  
Viral Encephalitis ◽  
Medical College Hospital ◽  
College Hospital ◽  
Population Research ◽  
Medical College ◽  
The World ◽  
Control And Prevention

Japanese encephalitis is numerically one of the most important causes of mosquito borne viral encephalitis not only in Asia but all over the world. Japanese encephalitis infection has not been recognized in Bangladesh since an outbreak in 1977 near Mymensingh. A prospective hospital based surveillance study carried out by Centre for Health and Population Research (ICDDR,B) and the Centers for Disease Control and Prevention (CDC), USA began in June 2003 at Dhaka, Mymenhsingh and Rajshahi Medical College Hospital to find out the causes of encephalitis proved that there are 6% patient who were admitted to the hospital with the sign and symptoms of encephalitis were infected with JE. In Rajshahi Medical College Hospital 12.38% encephalitic patients had JE infection. Though the study is ongoing but these data suggest that Japanese encephalitis virus is an emerging cause of encephalitis in Bangladesh.   doi: 10.3329/taj.v17i1.3493 TAJ 2004; 17(1) : 57-70

Nasal polyposis: unusual indication for tracheostomy

2004 ◽  
Vol 118 (4) ◽  
pp. 305-306 ◽  
Author(s):  
Swati Kumar ◽  
Eslam Osman ◽  
Jonathan A. J. Deans ◽  
John Scally
Keyword(s):  
Airway Obstruction ◽  
Nasal Obstruction ◽  
Rare Case ◽  
Nasal Polyposis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Significant Morbidity ◽  
First Case ◽  
Emergency Tracheostomy ◽  
History Of

A rare case of nasal polyposis requiring urgent tracheostomy is reported. A70-year-old male presented to the hospital with stridor. He had a 10-year history of nasal obstruction. A large proliferative mass was found to be occupying both the nasal cavities. An emergency tracheostomy and biopsy of the lesion was performed. A computerized axial scan (CT) demonstrated that the lesion occupied the pharynx reaching up to the laryngeal inlet. To our knowledge this is the first case reported in the literature. Upper airway obstruction from nasal polypsis uncommon but can cause significant morbidity if not appropriately managed.

Acute tonsillectomy in the management of infectious mononucleosis

1992 ◽  
Vol 106 (11) ◽  
pp. 989-991 ◽  
Author(s):  
D. S. Stevenson ◽  
G. Webster ◽  
I. A. Stewart
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Respiratory Obstruction ◽  
Recurrent Tonsillitis ◽  
Emergency Tracheostomy ◽  
Life Threatening

AbstractLife-threatening upper airway obstruction can be caused by tonsillopharyngitis secondary to infectious mononucleosis (IM). The administration of corticosteroids, emergency tracheostomy and acute tonsillectomy have been advocated as ways of managing this problem. In a series of 25 patients admitted over a five-year period with IM, 15 were judged to have symptoms severe enough to warrant the administration of corticosteroids. Six of these 15 patients had little improvement in their condition and thus underwent acute tonsillectomy. There were no significant complications of this surgery. A further three patients who received corticosteroids required tonsillectomy for recurrent tonsillitis later in the study period. By contrast, only one of the ten patients who did not receive corticosteroids subsequently required tonsillectomy. Acute tonsillectomy is of value in selected cases of IM tonsillopharyngitis. It may decrease the morbidity of recurrent tonsillitis after IM, in addition to averting the immediate risk of respiratory obstruction.

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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