Abstract:
Background: Tracheostomy is the most commonly performed procedure worldwide. It is
mai...
Abstract:
Background: Tracheostomy is the most commonly performed procedure worldwide. It is
mainly done in the critically ill patients requiring long term ventilation, facial trauma, laryngeal
fractures, laryngeal malignancy, etc. Converting from endotracheal intubation to tracheostomy
has many benefits in terms of maintaining the laryngeal function, feeding, safety and it is
more comfortable than endotracheal intubation. Tracheostomized patients requires less
analgesics and sedatives. It also helps in easier and early weaning from mechanical ventilator,
possibility of speech, initiation of oral intake of medication. This all contributes to shorter ICU
stay and hospital stay which becomes more cost effective.
Methods: This is a prospective observational study that was conducted in the 22 bedded
neuro intensive care and medical intensive care unit of Birat Medical College and Teaching
Hospital. The data were collected from 1
st
Aug 2021 to 28
tracheostomy for prolonged intubation, protection of airway and to maintain tracheobronchial
toileting was taking under study.
Results: Our study was a prospective observational regarding percutaneous dilatational
tracheostomy. A total of 71 patients were included in the study. Out of which 39(54.9%) were
male and 32(45.1%) were female with the ratio of (1.2:1). The age of the patients ranged from
18-82 years with the mean age of 53.25. The most common indication of percutaneous
dilatational tracheostomy was prolonged intubation and that accounted for 29(40.8%) of the
patients which was followed by airway protection 27(38%) patients and to maintain the
pulmonary hygiene was seen in 15 (21.1%) patients.
Conclusion: Tracheostomy is among the most frequently performed procedures in critically
ill patients. Percutaneous dilatational tracheostomy is a safe and feasible procedure performed
at bedside with minimal invasive technique in ICU.
Abstract
Background: The anterior cruciate ligament (ACL) is a major knee stabilizing factor during...
Abstract
Background: The anterior cruciate ligament (ACL) is a major knee stabilizing factor during
both of the knee’s rotational and anteroposterior stability.
ACL damage is a major injury to the
knee joint. For identification of ACL injury routinely we practice Anterior drawer test,
Lachman’s test and Pivot shift test. In this study we evaluate the accuracy of Lelli’s test for
detecting ACL tear and compare it with MRI findings.
Methods: This study included 100 patients attending outdoor patient department at
Department of orthopedics, Combined Military Hospital (CMH) Bogura from February 2022
to February 2023. aged between 20-60 years with knee symptoms of giving way/locking/pain.
Clinical history and detail clinical assessment of knee for instability including Lelli’s test were
performed by standard technique and recorded in the Performa. All patients send for MRI of
knee and result were compared with Lelli’s test to assess the reliability of clinical test as
screening test for ACL injury.
Results: In this study total numbers of cases were 100 with mean age was 35 ± 09 years and
most of the patients were male 98(98.00%). Maximum injuries occurred on the right side 80
(80.00%). The most common cause of ACL injury was sports activities 85(85.00%) and chief
complaints of giving way 82(82.00%). In this study Lelli’s test had sensitivity 94.18 %( CI
70.93-94.57) and Specificity 93.33 %( CI 79.85-97.17)
Conclusion: Lelli’s test is a simple with high sensitivity and specificity which can be used as
a screening test for evaluation of ACL function in both acute and chronic knee injury.
Abstract
Background: Respiratory distress syndrome of neonates (RDS) is one of the most common
cau...
Abstract
Background: Respiratory distress syndrome of neonates (RDS) is one of the most common
causes of neonatal mortality.
Objective: The purpose of this study was to investigate socio-demographic, maternal and
neonatal factors related to RDS in neonates in context of tertiary level hospital.
Methods: This cross sectional study was conducted in Dhaka Medical College Hospital and
Ad-din Women’s Medical College and Hospitalduring 1
st
January to 31
December 2017
among 186 purposively selected neonates. Data were collected by document review and face
to face interview with complete privacy using semi-structured questionnaire and check list.
Results: Regarding socio-demographic factors, Considering the maternal factors, majority of
the mothers(61.3%) had taken 4 or more checkup during their antenatal period and 87.1%
had institutional delivery while approximately half (52.7%) of the mothers had Caesarean
delivery. Among the mothers, 17.2% had history of high blood pressure during pregnancy,
10.8% diabetes mellitus, 14% oligohydramnios and 37.1% mothers had PROM. RDS was
more common in preterm neonates or below 37 weeks (85.5%) and maximum were low birth
weight or below 2500 gram (90.3%), 52 babies (28%) were born of multiple pregnancy, more
than half of the babies (62.4%) had moaning sound (grunting) and most of all (92.5%) had
chest recession.
Conclusion: The factors related to RDS are not preventable but are predictable if ANC for all
the mothers can be ensured.If the possibility of occurrence of RDS can be assumed considering
these factors, necessary precautions for earlier diagnosis and adequate management can be
taken which can contribute in reducing neonatal mortality rate.
Keywords: Respiratory distress syndrome, neonatal mortality, intercostals recession,
intercostals recession.
Abstract:
Objective: In this study 50 patients of neck swelling were studied to compare the findi...
Abstract:
Objective: In this study 50 patients of neck swelling were studied to compare the findings
with clinical diagnosis and histopathological report for its diagnostic reliability.
Methods: This cross sectional study was done in Department of Otolaryngology – Head &
Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2015 to
June 2017. Fine needle aspiration cytology, MRI, CT scan, and histopathological examinations
of postoperative specimen of neck swelling, presentation of analyzed data by various tables,
graphs and figures done.
Results: In the present series, 50 cases of neck swelling were studied. Out of these 50 cases
19 were male and 31 were female. The male, female ratio was 1:1.63. Age range was 4 – 60
years with maximum frequency in the 4
th
decade with the 3
rd
and 2
nd
in the following suit.
Most of the patient were poor. Clinical, cytological and histopathological diagnosis were available
in all the cases. The three sorts of diagnoses were compared with each other. Histopathologically
12 cases were tubercular lymphadenopathy. Metastatic carcinoma and lymphoma, 5 cases for
each. 12 were nodular goiter, 5 were thyroid carcinoma. Rest were benign, congenital and
nonspecific inflammatory conditions. Correct diagnosis was made by FNAC in 45 cases. In
the rest 5 cases, smear were unsatisfactory in 2 cases and gives inconclusive result, remaining
3 were follicular neoplasm and no definitive result were made which were subsequently
diagnosed by histopathological examination as a follicular adenoma in 1, and follicular carcinoma
in 2 cases. Sensitivity of FNAC in the diagnosis of neck masses were found 91% for
tuberculosis, 100% for metastatic carcinoma also for salivary gland tumour. In case of nodular
goiter sensitivity was 92%. But it is only 60% sensitive in case of thyroid malignancy, as
FNAC cannot demarcate clearly between follicular adenoma and follicular cell carcinoma. But
its accuracy in diagnosing papillary cell carcinoma of thyroid was 100%.
Conclusion: Keeping the limitations in mind, FNAC can reduce substantially the need of
open biopsy for histopathological examination. The study with the popular saying of Stewart
“Diagnosis by aspiration is as reliable as the combined intelligence of the clinician and pathologist
makes it”.
Abstract
Background: Refractive error in children aged 5-15 years is an important public health
pr...
Abstract
Background: Refractive error in children aged 5-15 years is an important public health
problem. Myopia and hypermetropia are leading cause of refractive errors in children in this
age group. Both which are visually impairing conditions that can be significantly improved
through adequate refractive correction. Population based refractive error studies in children
have shows that nearly half of the visual impairment associated with correctable refractive
error in this age group in not receiving attention specially those children living in disadvantaged
social and economic condition
Methods: This is an observational study. One hundred children of a village Darisharifpur,
upazilla- Bera, district Pabna were studied
in Random sampling method. Data were collected from children aged between 9-15 years.
Refractive error with other related variables were enclosed with data and and that were
analyzed.
Results:100 children of village with visual problem or symptoms related to visual acuity
were examined and prevalence of refractive error in my study 11%. Myopia (72.72%) is more
common refractive error my study, myopia 46%, hypermetropia 25%, astigmatism 27%.
Majority (63.63%) of refractive error was found in between -0.50D to -1.99D in my study .
In my study majority of refractive errors are within 6/9 to 6/18.
Conclusions: Myopia and hypermetropia are leading cause of refractive errors in children in
this age group. Both which are visually impairing conditions that can be significantly improved
through adequate refractive correction.
Abstract
Background: Tonsillectomy is a relatively safe procedure in expert hand, but it is associa...
Abstract
Background: Tonsillectomy is a relatively safe procedure in expert hand, but it is associated
with certain complications. Taste distortion (dysgeusia) is a rare complication of Tonsillectomy
that was complained by some patients after operation.
Methods: This retrospective study was done searching the medical records of Department of
ENT, Bangladesh Medical College, Dhaka. Total 607 patient was studied, from the year 2012
to 2022. All methods of Tonsillectomy were considered for study.
Result: Taste distortion was found in 1.15% cases of cold steel tonsillectomy, 0.5% in
diathermy coagulation tonsillectomy but no case was found in cases of LASER or coblation
method.
Conclusion: No dissection of tissues beyond lower pole of tonsil is recommended.
Abstract:
Background: Epistaxis is a worldwide common otolaryngological emergency. Many of them
s...
Abstract:
Background: Epistaxis is a worldwide common otolaryngological emergency. Many of them
suffers at least once in their lifetime. This study was conducted to describe demographical
distribution of epistaxis among the patient that came for treatment at Pabna medical college
hospital.
Objective: To evaluate frequency of epistaxis among population of different group of age, sex,
habitat and circadian variation.
Methods: This cross sectional study was done among the admitted patients with epistaxis at
Pabna medical college hospital from 1
st
November 2020 to31st October 2021. Total 100
patients were included in this research.
Result: Male was affected more frequently than female in this study. Among them 75% was
male and 25% females with a ratio of 3:1.majority of the patient in this study were 5
decade(80%). Among the 100 patient with epistaxis 60% were urban habitat and 40% were
rural habitat, Regarding aetiology and sex there was no significant difference between rural
and urban habitat. Frequency of epistaxis shows circadian variation. Most of the patient of
epistaxis were admitted at evening and late night, 20% and 25% accordingly. Frequency of
epistaxis is more in November 15%, March 25%, no remarkable variation seen in rest of the
time of year.
Conclusion : A high incidence in young adults was reported with preponderance of male
over female. Occurrence of epistaxis was strongly related with the certain demographic
factors like age, sex, and habitat of the patient.
Abstract
Introduction: Tuberculosis (TB) is a major global health issue, with millions of people af...
Abstract
Introduction: Tuberculosis (TB) is a major global health issue, with millions of people affected
each year. Timely detection and appropriate management of TB are essential to reduce its
spread and associated morbidity and mortality. In this study, the authors aimed to observe the
prevalence of common clinical symptoms among diagnosed TB patients and their duration.
The study findings can provide valuable insights for healthcare providers in managing TB
patients and improving treatment outcomes.
Methods: This observational cross-sectional study was conducted at the Department of
Mdicine, Pabna Medical College, Pabna. Study was done from January 2021 to December 2021.
Result: Most participants were aged 31-50 years, with 37.93% falling into the 41-50 age
range. 58.62% were male, while 41.38% were female. Housewives (37.93%), laborers/farmers
(34.48%), and students (12.07%) made up the majority of participants. Bronchial asthma
(86.21%) was the most prevalent comorbidity, followed by hypertension (36.21%) and diabetes
mellitus (17.24%). The majority of participants (63.79%) fell within the normal BMI range of
18.5-24.9. Cough (94.83%) and fever (74.14%) were the most common symptoms. Among
the 43 participants with on and off fever, 53.49% had been experiencing fever for more than
2 weeks up to 1 month. Among the 55 participants with continuous cough, 60% had been
experiencing cough for more than 2 weeks up to 1 month.
Conclusion: The study found that most participants were between the ages of 31-50 years,
with a majority being male. Bronchial asthma was the most common comorbidity observed.
The majority of participants had a normal BMI, and cough was the most prevalent symptom.
The duration of fever and cough among TB patients was found to be prolonged, with a majority
experiencing symptoms for more than 2 weeks up to 1 month. Early diagnosis and treatment
are essential to prevent the progression of the disease and reduce the duration of symptoms.
Abstract:
Background: Laparoscopic cholecystectomy results in lesspost operative pain than open...
Abstract:
Background: Laparoscopic cholecystectomy results in lesspost operative pain than open
cholecystectomy. However post operative pain remainsan issue following the procedurewhich
can prolong hospital stay and lead to increased morbidity.
Objectives: Effective management of post operative pain will thus help to mobilize the patients
earlier, reduce the requirement for post operative analgesic; early hospital discharge, return
to normal activities & normal work. This will help to reduce the total cost related to the
operation and total working days lost.
Methods:In this randomized controlled trial A total of 100 patients undergoing routine
laparoscopic cholecystectomy were enrolled in this study during March 2015 to May 2016 in
Pabna Medical College Hospital. The patients were randomly assigned in control group and
bupivacaine group. Patients of the bupivacaine group received local anesthetic agent bupivacaine
at their port sites which was infiltrated in the skin, subcutaneous tissue, fascia, and liver bed
at the end of the surgery. The control group received normal saline in the same manner. All
the patients were followed up to assess the intensity of post operative pain using visual
analogue pain scale at 4 hours, 12 hours and 24 hours of operation as well as at the time of
discharge from the hospital and at one week after the operation. Data regarding the first
analgesic request by the patient after surgery, total doses of analgesic consumed in the post
operative period and return to normal day to day activities and the normal work were also
collected.
Results:Datawere analyzed using SPSS Statistics 17.0 and revealed that patients receiving
bupivacaine infiltration at their port sites and liver bed following the surgery had lower pain
scores at the times of assessment than those who received normal saline at their port sites. The
patients of the bupivacaine group also took longer time for first request for analgesic after
surgery and required less doses of analgesic.
Conclusion: Infiltration of bupivacaine at port site and liver bed following laparoscopic
cholecystectomy is an effective method of managing post operative pain. This also lower the
doses of analgesic required, thus laparoscopic cholecystectomy can be considered as a fast -
track surgery.
Abstract
Background: Vaginal hysterectomy is infrequently carried out when there is no utero–
vagi...
Abstract
Background: Vaginal hysterectomy is infrequently carried out when there is no utero–
vaginal prolapse. The past few years have seen growing indications of vaginal hysterectomy
which is now preferred over abdominal hysterectomy. Despite enough evidences in favour of
vaginal hysterectomy, it is not the preferred route for hysterectomy in our country, probably
due to lack of technical skill and expertise in non-descent vaginal hysterectomy in our country
Methods: This cross-sectional comparative study was done in the Department of Obstetrics
& Gynaecology, in Institute of Child and Mother Health (ICMH), Dhaka.
The Study period was 6 months, from
May 2015 to October 2015.
Results: Baseline characteristics were similar were similar in both groups of patients. There
was no intraoperative complication in either either group. Operative time, intraoperative
blood loss, time of out-of-bed activity, mean maximum postoperative body temperature and
duration of fever were significantly shorter and less severe in the in the Vaginal Hysterectomy
group compared to Abdominal hysterectomy group. In addition, vaginal length in the VH
group was significantly shorter than AH group.
Conclusion: Despite the overwhelming evidence in favour of vaginal hysterectomy, it is not
a preferred route for hysterectomy in case of undescended uterus in Bangladesh. The reason
for this practice may be lack of controlled evidence in favour of vaginal hysterectomy and lack
of expertise & skill of the surgeon in our country.
